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Case Reports in Pathology

Ameerah Alsaqobi, Nabeel Al-Brahim
Background: The transformation of nonosseous soft tissue into bone is known as osseous metaplasia (OM). This condition most commonly affects the musculoskeletal and central nervous systems and it is a well-known phenomenon in different soft tissue organs. Rarely, OM can affect the uterus, which can extend into the cervix. OM affecting the cervix alone is a more rare condition that has multiple different clinical presentations. The presentation can be similar to that of a tumor in extremely rare cases...
2018: Case Reports in Pathology
Satoru Munakata, Eisuke Tomiyama, Hitoshi Takayama
Juxtaglomerular cell tumor (JGCT) is a rare renal tumor, producing renin and behaving almost in a benign fashion. So far, only three cases have been reported as malignant. We report a rare case with atypical JGCT. A 74-year-old male was referred to our hospital due to hypertension, proteinuria, and hematuria. Abdominal CT revealed a mass measured in 9.7×7.0 cm in the lower portion of the right kidney. Right kidney was removed laparoscopically. Grossly, white to tan tumor with massive hemorrhage and necrosis occupied the lower portion of the right kidney...
2018: Case Reports in Pathology
Samir M Amer, Aijan Ukudeyeva, Harold S Pine, Gerald A Campbell, Cecilia G Clement
Introduction: Plexiform schwannoma is a rare variant of schwannoma that accounts for only 5% of all schwannomas. Herein, we present a rare case of plexiform schwannoma of the tongue in a pediatric patient with neurofibromatosis type 2 (NF2). Case Presentation: A 13-year-old female presented with a growing left-sided tongue mass. The patient has a past medical history of NF2. The tongue mass was excised and histopathological examination revealed a spindle cell tumor with multinodular growth pattern, with Verocay bodies' formation...
2018: Case Reports in Pathology
Rana Naous
Clear cell sarcoma of the kidney (CCSK) is an uncommon malignant tumor of uncertain histogenesis that occurs most commonly in childhood. Histologically, CCSK can mimic myxoid variant of synovial sarcoma (SS); however, the double positivity for CD99 and TLE1 in SS helps in excluding CCSK. Herein, we report a rare case of CCSK arising in the left kidney of a 3-year-old girl. The mass grossly measured 9.5 cm in maximum dimension and histologically showed the classic arborizing fibrovascular septae and background myxoid matrix that is usually seen in CCSK...
2018: Case Reports in Pathology
Kanish Mirchia, Rana Naous
Hamartomas are considered a mixture of nonneoplastic tissue, which may be indigenous to a different location in the body. As such, they may be epithelial, mesenchymal, or mixed. In the sinonasal region, the following hamartomatous lesions are considered to lie on a spectrum and include respiratory epithelial adenomatoid hamartoma (REAH), chondro-osseous respiratory epithelial adenomatoid hamartoma (COREAH), and nasal chondromesenchymal hamartoma (NCMH). To our knowledge, less than 50 cases of sinonasal hamartomas have been reported in the English literature so far with NCMH being very rare and primarily a tumor in infancy, with only 2 cases reported in individuals older than 16 years of age...
2018: Case Reports in Pathology
Maria M Picken, Davide Bova, Michael R Pins, Marcus L Quek
Mixed epithelial and stromal tumor (MEST) is a biphasic adult renal lesion composed of solid and cystic areas containing spindle cell stroma and epithelium that lines the tubules and cystic spaces. While most MEST lesions are benign, rare cases with malignant morphology and biology have been reported. We present a case of mixed epithelial and stromal tumor of the kidney (MEST) with extension into the inferior vena cava in a young adult male. We discuss the differential diagnosis of MEST in the context of other biphasic cystic renal lesions and the significance of vascular involvement in the setting of an otherwise benign tumor morphology...
2018: Case Reports in Pathology
Amedeo Ferlosio, Monia Di Prete, Piero Rossi, Elena Campione, Augusto Orlandi
We report the case of a seventy-four-year-old man with a slow-growing 2 cm mass on the back that arose near the surgical scar of previously excised melanoma, invasive to a Breslow depth of 3 mm. Preoperative clinical diagnosis was "in-transit" melanoma metastasis. After surgical excision, histopathologic examination revealed a dermal nodular proliferation of spindle cells arranged in storiform pattern, with mild pleomorphism, infiltrating around appendages and into the subcutaneous tissue. Immunohistochemical investigation documented diffuse positivity for CD34 and vimentin of spindle cells...
2018: Case Reports in Pathology
Roula Katerji, Chad A Hudson
The combination of polycythemia and plasma cell myeloma occurring concurrently is very rare and few cases have been reported in the literature. Further, the vast majority of these cases are cases of polycythemia vera and myeloma. Here, we present a case of polycythemia of undetermined etiology and myeloma. The patient is a 48-year-old Caucasian male who was originally diagnosed with polycythemia of undetermined etiology. Twelve years later, when a bone marrow biopsy was performed in an attempt to determine the etiology of the polycythemia, findings diagnostic of plasma cell myeloma were discovered...
2018: Case Reports in Pathology
Malene Theilmann Thinesen, Ove B Schaffalitzky de Muckadell, Sönke Detlefsen
IgG4-related disease is characterized by lymphoplasmacytic inflammation and fibrosis, often leading to mass-forming lesions in different organs. When IgG4-related disease affects the bile ducts, it is called IgG4-related sclerosing cholangitis. A 74-year-old male complained of dysphagia and abdominal pain. Endoscopic retrograde cholangiography and magnetic resonance cholangiography revealed bile duct changes suspicious of a bile duct carcinoma or cholangitis. Liver biopsy showed storiform fibrosis, lymphoplasmacytic infiltration, obliterative phlebitis, and a portal-based inflammatory nodule with expansion of a portal tract...
2018: Case Reports in Pathology
Tatiana M Villatoro, Stacey K Mardekian
Sinonasal non-intestinal-type adenocarcinoma (non-ITAC) is a rare, morphologically diverse neoplasm of the head and neck. Squamoid morular metaplasia has recently been reported as an occasional finding in non-ITAC. Interestingly, these squamoid morules often show aberrant expression of CDX2 as well as nuclear expression of β -catenin, similar to other tumors that show this type of metaplasia, but the underlying mechanism responsible for this finding is not completely understood. We present two cases of low-grade non-ITAC with squamoid morules coexpressing CDX2 and nuclear β -catenin by immunohistochemistry, both of which were found to harbor a mutation in CTNNB1 , the gene encoding β -catenin...
2018: Case Reports in Pathology
Emily Hero, Martyn Carey, Isabelle Hero, Abeer M Shaaban
Neurofibromatosis type 1 is an autosomal dominant condition which can manifest as multiple neurofibromas within subcutaneous tissue. Neurofibromas of the breast are rare and most often encountered on the nipple-areolar complexes. A 33-year-old woman presented with large, bilateral, fleshy, skin tags of the nipple-areolar complexes. She underwent bilateral diagnostic excision of the lesions and macroscopically, both nipple specimens displaying polypoid lesions. Histological examination showed bilateral neurofibromas comprising skin with underlying dermal proliferation of bland spindle shaped cells with wavy nuclei...
2018: Case Reports in Pathology
Christopher A Febres-Aldana, Jin Min, Marc Rafols, Irvin Willis, John Alexis
Liposarcoma is the most common histologic subtype of soft tissue sarcoma in the retroperitoneum. The distinction of primary cord liposarcomas, which arise in and are confined to the inguinal canal, from inguinoscrotal extension of a retroperitoneal tumor is mandatory. Both can be found incidentally in inguinal hernia sac specimens. Preoperative diagnosis is essential for adequate surgery with clear margins. We present a clinicopathological correlation of two men with slowly growing right para-testicular masses diagnosed as inguinal hernias...
2018: Case Reports in Pathology
Xavier Catteau, Vincent Anaf, Jean-Christophe Noël
Adenolipoleiomyoma is a very rare lesion of the uterus. Only four cases were reported. We describe one case of adenolipoleiomyoma presenting as a polyp in a postmenopausal woman with menorrhagia. Adenolipoleiomyoma is a very rare lesion and the histogenesis remains unclear. We discuss the origin and the differential diagnosis of this lesion.
2018: Case Reports in Pathology
Marcello Filotico, Valentina Moretti, Federica Floccari, Alessandro D'Amuri
A case of lymphoepithelioma-like (LEL) hepatobiliary carcinoma is reported. To date, only 89 cases of this rare neoplasm have been reported, with both hepatocellular and cholangiocellular histotype. The case reported here could be classified as LEL mixed hepatobiliary carcinoma ( Hepato-Cholangio ), a histotype not reported so far in the LEL variant.
2018: Case Reports in Pathology
Rin Yamada, Shin-Ichiro Horiguchi, Tomoko Onishi, Toru Motoi, Tsunekazu Hishima
Gastric carcinoma with enteroblastic differentiation (GCED) is a rare variant of gastric carcinoma, and a part of GCED produces alpha-fetoprotein. GCED is characterized by cells with clear cytoplasm and a tubulopapillary and solid growth pattern resembling those in the primitive gut. GCED is typically overlaid by a conventional adenocarcinoma (CA) component, implying that CA in the mucosa differentiates into GCED during tumor invasion and proliferation. We present the case of a 73-year-old woman with a 10-mm superficial elevated lesion and a slight central depression at the anterior wall of the lower gastric body...
2018: Case Reports in Pathology
Lauren Pearson, Douglas J Taatjes, Michele von Turkovich, Benjamin J King, Maryam Zenali
Chromophobe carcinoma constitutes a small subset of all renal carcinomas. Within this category, rare tumors with divergent differentiation have been recognized. Herein, we report a rare case of composite chromophobe and collecting duct carcinoma and describe its pathologic and clinical features.
2018: Case Reports in Pathology
Carla Bento Nelem-Colturato, Patrícia Maluf Cury, Thiago Machado Pereira, Isabelle Silva Cosso, Kellin Pivato, Luiz Evaristo Ricci Volpato, Alvaro Henrique Borges
Background: Field cancerization is a phenomenon in which prolonged exposure to carcinogens induces changes throughout the epithelium leaving the field ready for the appearance of premalignant or malignant lesions. These alterations can promote the development of multiple carcinomas and explain the appearance of recurrences and second primary tumors. The objective of this study was to report the case of a patient who developed six oral cavity tumors in five years of treatment and, also, demonstrate the immunohistochemical changes for p53 and Ki-67, routinely used to assess dysplasic regions...
2018: Case Reports in Pathology
Joy Roman, Michael I Palmer, Cheryl A Palmer, Nicholas E Johnson, Russell J Butterfield
York Platelet Syndrome (YPS) is a calcium channelopathy caused by gain of function in STIM1, a gene which acts as a calcium sensor. It is characterized by platelet abnormalities and muscle weakness. Medical literature emphasizes the hematologic aspects of the cases with few data of the neuromuscular and neuropathologic evaluation. We present a patient with YPS whose myopathy was the most prominent aspect. She presented around 2 years of age with proximal weakness and easy bruisability. YPS was diagnosed in the infant at 16 months of age at the National Institutes of Health...
2018: Case Reports in Pathology
Trent Irwin, Alexandria R Snow, Taylor S Orton, Christie Elliott
Objective: To present a case of fecal incontinence treated with dextranomer/hyaluronic acid (Solesta®) injections, which later caused clinical confusion and avoidable interventions. The endoscopic, ultrasonographic, and histologic appearances of dextranomer/hyaluronic acid will also be reported. Case Presentation: A middle-aged Hispanic male who failed conservative management of his fecal incontinence was injected with dextranomer/hyaluronic acid in an attempt to alleviate symptoms...
2018: Case Reports in Pathology
Ashley Burris, Caleb Hixson, Nathaniel Smith
A woman in her sixth decade presented with several months of abdominal cramping, decreased appetite, bloating, and increased constipation. Radiologic imaging revealed a 28 cm, multilocular, heterogeneous cystic neoplasm involving the right adnexa. An intraoperative frozen section showed mucinous glandular epithelium, with and without foci of goblet cells, embedded in apparent ovarian stroma. The findings were concerning at least borderline mucinous cystadenoma with possible invasion. Subsequent surgical management and staging were performed...
2018: Case Reports in Pathology
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