RESUMEN
In an attempt to determine if it is possible to distinguish hamartoma of the breast from fibroadenoma using fine-needle aspiration cytology, we reviewed the cytological slides of 13 histopathologically confirmed cases of hamartoma of the breast and compared them with the cytological features of 13 histologically confirmed fibroadenomas. In each case, we studied the epithelial and stromal features. Cytologic characteristics were retrospectively evaluated in a semiquantitative manner. In conclusion, the finding of intact lobular units and a relative paucity of stroma may suggest the diagnosis of hamartoma.
Asunto(s)
Biopsia con Aguja Fina , Enfermedades de la Mama/diagnóstico , Neoplasias de la Mama/diagnóstico , Fibroadenoma/diagnóstico , Hamartoma/diagnóstico , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Diagnóstico Diferencial , Femenino , Humanos , Persona de Mediana Edad , Estudios Retrospectivos , Células del Estroma/patologíaRESUMEN
To determine the effect of cytological diagnosis, fine-needle aspiration and brush cytology on lung tumors and core-needle biopsy, we retrospectively reviewed 11 cases of large-cell neuroendocrine carcinoma (LCNEC) found in our archives between the years 1997 and 2004. The preoperative cytological diagnosis of LCNEC is challenging because of the broad histologic similarity to other neuroendocrine tumors of the lung. The original cytologic diagnosis was LCNEC in nine of the cases while the remaining two were misdiagnosed as small-cell lung carcinoma. Smears were composed of clusters of intermediate-size cells with amphophylic cytoplasm, some with large nuclei and prominent nucleoli. In two of the cases there was discordance between the cytological findings and the immunohistochemical results. The cytological findings were correlated with histopathological observations.
Asunto(s)
Biopsia con Aguja Fina , Carcinoma de Células Grandes/patología , Carcinoma Neuroendocrino/patología , Neoplasias Pulmonares/patología , Tórax , Adulto , Anciano , Anciano de 80 o más Años , Biomarcadores de Tumor/análisis , Carcinoma de Células Grandes/química , Carcinoma Neuroendocrino/química , Carcinoma de Células Pequeñas/patología , Errores Diagnósticos , Femenino , Humanos , Inmunohistoquímica , Neoplasias Pulmonares/química , Masculino , Persona de Mediana Edad , Reproducibilidad de los Resultados , Estudios RetrospectivosRESUMEN
A 59-year-old man with a history of melena and upper abdominal pain was referred to our hospital. An upper endoscopy was performed, and a gastric ulcer was found bordering the antrum and stomach body. Multiple biopsies from the lesion showed monoclonal plasmacytic infiltration of the mucosa, consistent with the diagnosis of plasmacytoma. Helicobacter pylori was also identified. Triple therapy failed and quadruple therapy eradicated the H. pylori, confirmed by repeated biopsies. Healing of the gastric lesion followed the treatment. Multiple biopsies from the scar and the entire stomach showed complete regression of the plasmacytoma. The association between gastric plasmacytoma and H. pylori is discussed.
Asunto(s)
Infecciones por Helicobacter/complicaciones , Helicobacter pylori , Plasmacitoma/microbiología , Neoplasias Gástricas/microbiología , Humanos , Masculino , Persona de Mediana EdadRESUMEN
BACKGROUND: Breast hamartoma is an unusual, well-circumscribed, tumor-like mass entering into the differential diagnosis of benign breast disease. To the authors' knowledge, the cytology of these lesions has not been well described. Although fine-needle aspiration is a well established procedure for the detection of breast carcinoma, its utility in classifying benign breast disease is less clear. METHODS: Fine-needle aspirates from eight patients with histologically proven hamartomas were reviewed. None of the cases had a preoperative fine-needle aspiration diagnosis of hamartoma. Cytologic characteristics were retrospectively evaluated in a semiquantitative manner and compared with the histologic findings. RESULTS: The aspirates were moderately cellular and contained sheets of both bland ductal cells and lobular units. Adipose tissue was present in varying amounts. Bipolar stromal nuclei were readily apparent, whereas intact stromal fragments were less prominent. Cytologic atypia was uniformly absent. CONCLUSIONS: The cytology of breast hamartomas shows considerable overlap with other benign breast disease and is unlikely to be interpreted as malignant. The findings of intact lobular units and a relative paucity of stroma in an aspirate from a well circumscribed breast lesion may suggest the diagnosis of hamartoma.
Asunto(s)
Enfermedades de la Mama/patología , Hamartoma/patología , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Biopsia con Aguja , Enfermedades de la Mama/diagnóstico , Neoplasias de la Mama/diagnóstico , Neoplasias de la Mama/patología , Diagnóstico Diferencial , Femenino , Hamartoma/diagnóstico , Humanos , Persona de Mediana Edad , Estudios RetrospectivosRESUMEN
Wireless-capsule endoscopy is a new painless technique for endoscopic imaging of the small bowel. A 63-year-old male with iron deficiency anemia and thrombocytosis and extensive negative workup was examined twice with the capsule and was found to have multiple bluish polypoid lesions with a villous-appearing texture. Some of these lesions actually were seen to be bleeding. This is the first time that we have obtained histologic evidence for lesions seen only on the video-capsule endoscopy. The lesion was reached by deep ileoscopy via colonoscopy. On histologic analysis, there was acute and chronic ileitis.
Asunto(s)
Cápsulas , Endoscopios , Ileítis/patología , Ileítis/cirugía , Cirugía Asistida por Video/instrumentación , Humanos , Masculino , Persona de Mediana EdadRESUMEN
BACKGROUND: Carcinoma of the gallbladder is diagnosed in 0.3-1.5% of all cholecystectomy specimens. OBJECTIVES: To establish the overall rate of gallbladder carcinoma and unexpected gallbladder carcinoma based on our experience. METHODS: We retrospectively evaluated all consecutive cholecystectomies performed in our ward during a 6 year period in order to determine the incidence of gallbladder carcinoma and to identify common characteristics of this particular group of patients. RESULTS: Of the 1,697 cholecystectomies performed in our ward during the 6 years, gallbladder carcinoma was diagnosed in six patients (0.35%) but was not suspected prior to surgery in any of them. In accordance with the literature, the occurrence in women (5/6) was higher than in men (1/6). The mean age was 70 years (range 55-90). The most common symptom was abdominal pain; the majority (5/6) had cholelithiasis, and the pathologic report confirmed the diagnosis of adenocarcinoma in all six patients. CONCLUSIONS: The overall incidence of unsuspected gallbladder carcinoma in our series was 0.35%. We could not find any common characteristics for this particular group of patients when compared to patients with non-malignant pathology.
Asunto(s)
Carcinoma/epidemiología , Neoplasias de la Vesícula Biliar/epidemiología , Distribución por Edad , Anciano , Anciano de 80 o más Años , Carcinoma/cirugía , Colecistectomía , Femenino , Neoplasias de la Vesícula Biliar/cirugía , Humanos , Incidencia , Israel/epidemiología , Masculino , Persona de Mediana Edad , Pronóstico , Estudios Retrospectivos , Distribución por SexoRESUMEN
We present a case of spermatic cord cavernous hemangioma. A 32-year-old man presented with a circumscribed, painless mass in the left side of the spermatic cord. An orchiectomy of the left testicle was performed. A 3 x 3 x 2.5-cm mass was present in the spermatic cord area. Histologic examination and immunohistochemical study showed a benign vascular tumor composed of vascular spaces of varying size. Although cavernous hemangioma can occur in any location, the spermatic cord is an extremely rare site, and, to our knowledge, only a few cases have been previously reported.
Asunto(s)
Neoplasias de los Genitales Masculinos/patología , Hemangioma Cavernoso/patología , Cordón Espermático/patología , Adulto , Antígenos CD34/análisis , Endotelio Vascular/química , Endotelio Vascular/patología , Neoplasias de los Genitales Masculinos/química , Neoplasias de los Genitales Masculinos/cirugía , Hemangioma Cavernoso/química , Hemangioma Cavernoso/cirugía , Humanos , Técnicas para Inmunoenzimas , Masculino , Cordón Espermático/química , Cordón Espermático/cirugía , Vimentina/análisisRESUMEN
OBJECTIVE: To evaluate the role of angiogenesis in the pathogenesis of pterygium by comparing the expression of von-Willebrand factor (vWF) and vascular endothelial growth factor (VEGF) in pterygium, and in normal superior bulbar conjunctiva. METHODS: 23 human samples from pterygium and the superior bulbar conjunctiva were stained using rabbit anti-vWF and anti-VEGF antibodies. The density of vWF and VEGF positive vessels, VEGF staining intensity and the number of VEGF positive stromal, epithelial and vascular endothelial cells were evaluated. RESULTS: Pterygium specimens had higher average vWF and VEGF positive microvascular counts per high power field (P = 0.0012), higher average VEGF staining intensity scores in epithelial, stromal and endothelial cells (p < 0.0001) and higher VEGF positive cell counts (P < 0.0001) than normal conjuctiva. CONCLUSIONS: Over-expression of VEGF in pterygium tissue, together with the abundance of vWF-stained new vessels, may support previous suggestions that angiogenesis may play a role in the formation of pterygium.