RESUMEN
A meckel's diverticulum is a congenital abnormality of the GI tract seen in approximately 3% of the population. Tumor arising within this entity is a rare, although know complication. We report a gastrointestinal tumor arising within a Meckel's diverticulum in a 28-year-old male.
Asunto(s)
Tumores del Estroma Gastrointestinal/diagnóstico , Neoplasias del Íleon/diagnóstico , Divertículo Ileal/diagnóstico , Adulto , Diagnóstico Diferencial , Humanos , Obstrucción Intestinal/diagnóstico , Laparoscopía , Laparotomía , Masculino , Proteínas Proto-Oncogénicas c-kit/análisisRESUMEN
BACKGROUND: The cytologic features of C-cell hyperplasia of the thyroid have not been previously addressed in the literature. We describe the first case, to our knowledge, of C-cell hyperplasia that was suggested by fine needle aspiration. CASE: Cellular material was obtained from a nonnodular region of the thyroid gland in a 67-year-old male with chronic diarrhea, unexplained elevated serum calcitonin, no clinically detectable thyroid mass and no known medical or family history of an endocrine disorder. Aspiration yielded a scant bimodal cell population composed of benign follicular cells and a second population of larger cells, later confirmed as C-cells via immunohistochemistry. Although the diagnosis of medullary carcinoma was entertained, the absence of a discrete mass clinically and the presence of two interspersed, distinct cell populations suggested the alternate diagnosis, C-cell hyperplasia, which was confirmed by subsequent thyroidectomy. CONCLUSION: C-cell hyperplasia can mimic medullary carcinoma biochemically, and this case suggests the possible role of fine needle aspiration of the thyroid to distinguish between the two. In patients with elevated serum calcitonin and absence of a discrete thyroid nodule, the finding of clusters of calcitonin-positive cells intermixed with normal follicular cells by fine needle aspiration may provide a means of making a presurgical diagnosis of C-cell hyperplasia.
Asunto(s)
Biopsia con Aguja , Carcinoma Medular/diagnóstico , Enfermedades de la Tiroides/patología , Glándula Tiroides/patología , Anciano , Diagnóstico Diferencial , Humanos , Hiperplasia/diagnóstico , Hiperplasia/patología , Masculino , Enfermedades de la Tiroides/diagnósticoRESUMEN
OBJECTIVE: We report six cases of myoid hamartoma of the breast, a rare benign lesion in which the characteristic smooth muscle cells may have epithelioid histology. We emphasize the importance of radiographic correlation and immunohistochemical studies to diagnosis, particularly on stereotactic core biopsies, to avoid potential confusion with infiltrating lobular carcinoma. DESIGN: Case studies. Prospective and retrospective analysis of six cases, including stereotactic biopsy of two. SETTING: Academic medical center-based pathology practice. PATIENTS: Six postmenopausal women, aged 50 to 59 years, with palpable or nonpalpable mammographically evident breast masses. RESULTS: All the lesions were radiographically well circumscribed, most showing heterogeneous radiodensity. Histologically variable amounts of glandular, fibrous, and adipose tissue were admixed with smooth muscle cells, which occasionally had prominent epithelioid features. All the lesions' myoid cells stained for smooth muscle markers as well as steroid receptor proteins. Stereotactic core biopsy was diagnostic in one case, making excision unnecessary. CONCLUSIONS: With proper radiographic correlation and immunohistochemical confirmation, myoid hamartoma can be confidently diagnosed even on the limited tissue samples yielded by stereotactic core biopsy.
Asunto(s)
Neoplasias de la Mama/diagnóstico , Hamartoma/diagnóstico , Membrana Basal/ultraestructura , Biopsia con Aguja/métodos , Neoplasias de la Mama/química , Carcinoma Lobular/diagnóstico , Citoplasma/ultraestructura , Desmosomas/ultraestructura , Diagnóstico Diferencial , Células Epiteliales , Epitelio/patología , Femenino , Hamartoma/química , Humanos , Inmunohistoquímica/métodos , Mamografía/métodos , Microscopía Electrónica , Persona de Mediana Edad , Proteínas Musculares/análisis , Músculo Liso/patologíaAsunto(s)
Muñón Gástrico , Leiomiosarcoma , Neoplasias Primarias Múltiples , Neoplasias Primarias Secundarias , Neoplasias Gástricas , Adulto , Carcinoma de Células en Anillo de Sello , Niño , Condroma , Femenino , Humanos , Leiomiosarcoma/secundario , Leiomiosarcoma/cirugía , Persona de Mediana Edad , Neoplasias Primarias Múltiples/cirugía , Neoplasias Gástricas/secundario , Neoplasias Gástricas/cirugíaRESUMEN
We describe the fifth case, to our knowledge, of an intra-abdominal pulmonary sequestration that histologically displayed the features of congenital cystic adenomatoid malformation (CCAM) type 2. This mass was found during routine prenatal ultrasound in an infant with no other congenital malformations. A literature search found 13 previously reported cases of CCAM in extralobar pulmonary sequestration (EPS), nine of which were thoracic and only four were intra-abdominal. An analysis of our case and the 13 previously reported cases shows that the clinical features of EPS containing CCAM type 2 do not differ significantly from those of EPS occurring alone. The presence of CCAM type 2 in our patient is consistent with previously reported cases. Extralobar pulmonary sequestrations located in the abdomen are rarely diagnosed prior to excision, and the presence of CCAM type 2 in this situation may further compound diagnostic difficulties. The morphologic features separating CCAM into three distinct types and the exclusive association of CCAM type 2 occurring in EPS are also discussed.