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共88条结果
  • 1.

    【2hr】Cervical Lymph Node Schwannoma—An Unexpected Diagnosis

    包量

    机译 颈淋巴结神经鞘瘤—意外诊断
    摘要：Introduction:Schwannomas—Schwann cells–originating tumors—may develop in many locations. However, primary schwannomas arising within lymph nodes are extremely rare, with only a few cases described to this date in the English literature. For the intranodal location, most of the cases are described in the abdominal cavity. In these cases, clinicians may consider and check for familial disorders, such as neurofibromatosis type 2 (NF2) and schwannomatosis also called neurofibromatosis type 3. Schwannomas are benign neoplasms. Histologically, differential diagnosis for spindle-cell lesions in lymph nodes is important and must be done carefully, mainly because they may be attributable to metastatic disease. We report a case of a primary schwannoma arising in a cervical lymph node.
  • 2.

    【2hr】Primary Hepatic Follicular Lymphoma Presenting as Sub-acute Liver Failure: A Case Report and Review of the Literature

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    机译 表现为亚急性肝衰竭的原发性肝滤泡性淋巴瘤：病例报告和文献复习。
    摘要：Sub-acute liver failure is a term that describes the relatively sudden loss of liver function, usually >21 days and <26 weeks, with impaired synthetic function and associated encephalopathy in a person with no pre-existing liver disease or cirrhosis. It is commonly caused by viruses and drugs, less so by malignancy. Our patient is a 71-year-old Japanese man who presented with signs of sub-acute liver failure. A subsequent liver biopsy demonstrated involvement by B-cell non-Hodgkin lymphoma. Evaluation of the bone marrow demonstrated significant marrow involvement by B-cell lymphoma. The fluorescence in situ hybridization (FISH) returned positive for t(14; 18). Noted was the patient’s clinical presentation of cholestasis secondary to hepatic lymphoma with no evidence of lymphadenopathy or peripheralized lymphoma. Given the disease distribution, the overall findings are consistent with primary hepatic follicular lymphoma as described in few case reports and small case series in the literature.
  • 3.

    【2hr】Whitish-Yellow Tumor on its Characteristic Cut Surface: A Case Report of Congenital Granular Cell Epulis

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    机译 特征性切面的淡黄色肿瘤：先天性颗粒细胞脓疱病一例报告
    摘要：Introduction:Congenital granular cell epulis is a rare and benign lesion in newborn. There are some papers of the entity; however, there are very few reports focusing on its macroscopic view.
  • 4.

    【2hr】Surgical Resection and Pazopanib Treatment for Recurrent Cardiac Angiosarcoma

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    机译 手术切除和帕唑帕尼治疗复发性心脏血管肉瘤
    摘要：Cardiac sarcoma treatment is challenging for surgeons because of frequent tumor recurrence and poor prognosis. In addition, optimal management of recurrences is not well established. The multi-targeted tyrosine kinase inhibitor, pazopanib, was recently approved for soft-tissue sarcoma. Herein, we present a case involving recurrent cardiac angiosarcoma where the patient survived for 2 years with complete remission of disease after repeated surgical resection and treatment with oral pazopanib. Based on our experience, aggressive surgical resection combined with pazopanib may be a valid treatment for recurrent cardiac angiosarcoma to improve patient survival.
  • 5.

    【2hr】Monostotic Fibrous Dysplasia of the Lumbar Spine With SecondaryFeatures of Solid Variant Aneurysmal Bone Cyst

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    机译 腰椎继发性单核纤维不典型增生实体变异性动脉瘤性骨囊肿的特征
    摘要：Fibrous dysplasia is a benign, mass-forming disease of bone composed of abnormal fibrous and osseous elements that can be accompanied by endocrine dysfunction, skin pigmentation, and intramuscular myxomas. It is usually encountered as a solitary lesion in the tibia or femur but can develop in any bone and can be unifocal or multifocal. Difficulty arises when a solitary lesion is identified in an uncommon site or when there are prominent secondary changes, such as aneurysmal bone cyst (ABC). Molecular studies are available as an adjunct to histomorphology to aid distinction from other entities. GNAS mutations, present in greater than 70% of fibrous dysplasia cases, help in the distinction from primary ABC and low-grade osteosarcoma, which exhibit different molecular abnormalities. We report a case of monostotic fibrous dysplasia in a lumbar vertebral body with secondary change consisting of the solid variant of ABC.
  • 6.

    【2hr】Unexpected Gallbladder Metastasis of Clear Cell Renal Carcinoma

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    机译 透明细胞肾癌的意外胆囊转移
    摘要：Renal cell carcinoma (RCC) commonly metastasizes to areas such as the lungs, liver, bone, brain, adrenals, and lymph nodes. We present a rare case of a 59-year-old female patient with RCC metastasis to the gallbladder. The patient had undergone right nephrectomy for RCC more than 6 years prior to the metastasis. During routine follow-up, a polypoid lesion of the gallbladder was identified. Laparoscopic cholecystectomy was performed, and pathologic examination of the specimen revealed metastatic RCC. The patient was completely asymptomatic, which reinforces the importance of postoperative follow-up. Renal cell carcinoma is one of the few common malignancies for which there is good evidence of survival benefit from surgical resection of the metastatic tumours.
  • 7.

    【2hr】Estrogen Receptor, Progesterone Receptor, and HER-2 Expression inRecurrent Pleomorphic Adenoma

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    机译 雌激素受体，孕激素受体和HER-2在子宫内膜中的表达。复发性多形性腺瘤
    摘要：Pleomorphic adenoma (PA) is the most common salivary gland neoplasm and, although mostly benign, recurrences, being called recurrent pleomorphic adenoma (RPA) and malignant transformation to carcinoma ex pleomorphic adenoma (CXPA), do occur. Recently, attention has been focused on molecular targeted cancer therapy in various tumors, including salivary gland tumors. The aim of this study was to investigate the role of estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor-2 (HER-2) in PA, RPA, and CXPA. In total, 20 cases of PA, 18 of RPA, and 7 cases of CXPA were immunohistochemically studied for ER, PR, and HER-2. For evaluation of ER and PR, only nuclear expression and greater than 10% positive cells were regarded as cutoff criteria. HER-2 was evaluated semiquantitatively and graded from 0 to 3+. HER-2 amplification was assessed by chromogenic in situ hybridization (CISH). Tumors were negative for ER, PR, and HER-2 in all cases of PA and RPA. A case of CXPA showed moderate and complete membranous staining, and 6 cases were negative. HER-2 amplification was not observed in any case. In conclusion, the lack of ER, PR, and HER-2 expression in PA, RPA, and CXPA suggests that these proteins are not involved in progression, recurrence, or malignant transformation of PA.
  • 8.

    【2hr】Psammomatoid Calcification-Rich Oncocytic Thyroid Adenoma With Clear-Cell Change

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    机译 滑膜钙化丰富的胞浆甲状腺腺瘤伴透明细胞改变
    摘要：Abundant calcifications and clear-cell change may occur in oncocytic thyroid adenoma (OTA). We aimed to report the features of a case of OTA peculiar by the presence of extensive calcifications and of a clear-cell component. The OTA was detected on a right thyroid lobectomy specimen. Clear-cell change was observed in 15%-20% of the cells. Numerous, focally confluent psammomatoid calcifications, resulting in macrocalcifications, were identified. The nodule cells, uni- or multinucleated oncocytes, including those with clear cytoplasm, expressed heterogeneously TTF1, S100 protein, Bcl2, CD10, as well as CD138 and CD56. Lipid-droplet markers adipophilin and TIP47 were also expressed. In conclusion, we report a rare type of OTA, peculiar by the presence of numerous psammomatoid calcifications and of macrocalcification and by the presence of clear-cell change. Heterogeneity in membrane CD56 and/or CD138 expression as well as cytoplasmic heterogeneity of Bcl2 and lipid-droplet marker TIP47 might be relevant for calcification and clear-cell change, requiring further investigation.
  • 9.

    【2hr】Ki-67 Evaluation for Clinical Decision in Metastatic Lung Carcinoids:A Proof of Concept

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    机译 Ki-67评价转移性肺癌的临床决策：概念证明
    摘要：Accrual of metastatic pulmonary carcinoid patients for therapy is usually relied on clinical and histologic characterization, with no role for the proliferation activity as defined by Ki-67 labelling index (LI). A total of 14 carcinoid patients with tumour primaries (TP) and 19 corresponding tumour metastases (TM) were blindly reviewed by 2 different pathologists for necrosis, mitotic count, and Ki-67 LI. Ki-67 LI outperformed histologic subtyping, mitotic count, and necrosis with good to almost excellent (0.40-0.75) inter-observer agreement. About 10% cut-off Ki-67 LI predicted survival better than histology for TP and TM for both observers. The TM patients survived differently according to diverse treatments (somatostatin analogues [SSAs], analogues plus additional treatments except for platinum; platinum-based chemotherapy) in close correlation with <10%, 10% to 20%, and >20% cut-off thresholds of Ki-67 LI, respectively. There was also a trend for an increase in Ki-67 LI in TM as compared with TP. This is the first proof of concept in which a clinical potential is preliminarily suggested for Ki-67 LI to better stratify pulmonary metastatic carcinoid patients for treatment according to a criterion of histology-independent biological aggressiveness.
  • 10.

    【2hr】A Pilot Study on Histopathology of the Jejunoileal Atresia—Can it Be Used as a Guide to Determine the Length of Adequate Resection?

    包量

    机译 空肠闭锁的组织病理学初步研究—可以用作确定适当切除长度的指南吗？
    摘要：Introduction:Some studies reported that there is abnormality in the histopathology of atretic bowel in jejunoileal atresia (JIA). We have made an attempt to assess sequential histopathologic changes in the resected atretic segment.
  • 11.

    【2hr】Procalcitonin, C-Reactive Protein, Albumin, and Blood Cultures as Early Markers of Sepsis Diagnosis or Predictors of Outcome: A Prospective Analysis

    包量

    机译 降钙素原，C反应蛋白，白蛋白和血液培养物是败血症诊断或结果预测的早期指标：前瞻性分析
    摘要：Purpose:Sepsis is a condition with high mortality rates and its diagnosis remains a challenge. We assessed epidemiological, clinical data, multiple biomarker profiles, and blood culture with respect to sepsis diagnosis and predictors of outcome.
  • 12.

    【2hr】Diagnostic Value of TROP-2 and CK19 Expression in Papillary Thyroid Carcinoma in Both Surgical and Cytological Specimens

    包量

    机译 TROP-2和CK19在乳头状甲状腺癌中的诊断价值。
    摘要：Papillary thyroid carcinoma (PTC) represents the most common primary malignant thyroid tumor and its diagnosis is dependent on the presence of classic nuclear features that are sometimes seen in some non-neoplastic and benign lesions. Several immunohistochemical markers are used individually or in combination to help in differentiation of PTC from mimickers. The aim of the current study was to assess the diagnostic value of TROP-2 and cytokeratin 19 (CK19) expression in differentiating PTC from other mimickers both singly and in combination. The current study was carried out on 77 surgical specimens (56 PTC and 21 non-neoplastic cases) and 12 cytological specimens (4 THY2, 6 THY4, and 2 THY5). TROP-2 was negative in 81% of non-neoplastic surgical specimens and in 100% of THY2 cytological specimens while it was positive in 71.4% of PTC surgical specimens and 100% of THY4/THY5 cytological specimens. Sensitivity and specificity of TROP-2 positive expression for diagnosis of PTC in surgical specimens reached 71% and 81%, respectively, while it reached 100% for both in cytological specimens. Cytokeratin 19 showed positive expression in 85.7% of non-neoplastic surgical specimens and in 92.9% of PTC surgical specimens. Cytokeratin 19 showed negative expression in 75% of Thy2 cases while it was positive in all studied Thy4 and Thy5 cases. Sensitivity and specificity of CK19 total estimated score for diagnosis of PTC in surgical specimens were 78.6% and 66.7%, respectively, while it reached 100% and 75% in cytological specimens. Positive TROP-2 and CK19 expression in PTC were associated with lymph node metastasis. TROP-2 is a specific rather than sensitive marker while CK19 is a sensitive rather than specific marker in differentiating PTC from other mimickers in surgical specimens. The diagnostic validity of both markers was superior in diagnosis of classic PTC compared with follicular variant PTC. TROP-2 is superior to CK19 in diagnosis of PTC in cytological specimens. Both TROP-2 and CK19 could be used preoperatively in adjunct to hematoxylin and eosin for more confident diagnosis of thyroid cytology and along with radiology as predictors of lymph node metastasis.
  • 13.

    【2hr】Malignant Solitary Fibrous Tumour of the Breast Mimicking a BenignTumor

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    机译 乳腺良性恶性孤立性纤维性肿瘤瘤
    摘要：Solitary fibrous tumour (SFT) of the breast is exceedingly uncommon. Radiological assessment usually shows benign features. We report on a case of malignant SFT of the breast, while emphasizing the need for additional immunostains to reach a definitive diagnosis. Standard treatment consists of lesion removal with adequate margins.
  • 14.

    【2hr】Biliary Intraepithelial Neoplasia in Non-biliary Cirrhosis—Report From 100 Explanted Livers: A Single Center Experience

    包量

    机译 非胆汁性肝硬化的胆道上皮内瘤变-来自100位被移植肝脏的报告：单中心经验
    摘要：Background:Intrahepatic cholangiocarcinoma is a highly malignant tumor with a very short 5-year survival. Multistep carcinogenesis has been suggested as the main pathway for the development of this tumor. Main suggested precursors have been (1) biliary intraepithelial neoplasia (BilIN) and (2) intraductal papillary neoplasm of bile duct (IPNB). The former is flat and does not produce grossly and radiologically detectable mass lesion, but the latter produces grossly identifiable lesion.
  • 15.

    【2hr】Subgemmal Neurogenous Plaque: A Clinical and Pathologic Review With Comparison to Common Head and Neck Neural Tumors

    包量

    机译 亚原发性神经源性斑块：与常见的头颈部神经肿瘤的比较的临床和病理学评论。
    摘要：Objective:In humans, subgemmal neurogenous plaques (SNPs) are normally found associated with taste buds. On histology, SNP may be mistaken for a neural neoplasm. The objective of this study was to correctly differentiate SNP among head and neck neural lesions and provide clinical and pathologic information that may assist in avoiding misdiagnosis. To our knowledge, this is the first study to provide an estimate of the degree of overdiagnoses of mucosal lesions in the head and neck mucosal area.
  • 16.

    【2hr】A Case of Sarcomatoid Renal Cell Carcinoma With Osseous Metaplasia and Papillary Renal Cell Carcinoma Metastasis

    包量

    机译 骨肉化生伴乳头状肾细胞癌转移的肉瘤样肾细胞癌一例
    摘要：Sarcomatoid renal cell carcinoma is an uncommon and aggressive renal tumor with rapid disease progression. A median survival time is only 4-9 months after diagnosis. Osteogenic differentiation is a rare feature of the tumor. Here, we present a case of renal cell carcinoma with sarcomatoid feature and osteoid differentiation, and papillary renal cell carcinoma metastasis in a 58 year-old African-American male. This is the first reported renal cell carcinoma case with the combination of sarcomatoid feature, osteoid differentiation, and papillary renal cell carcinoma metastasis.
  • 17.

    【2hr】Regional Lymph Node Enlargement in Clinically Severe Cherubism

    包量

    机译 临床上严重红唇病的区域淋巴结肿大
    摘要：Cherubism is a rare benign autosomal dominant disorder characterized by progressive, painless, bilateral enlargement of the mandible and/or maxilla because of bone replacement by fibrotic stromal cells and osteoclast-like cells forming multilocular cysts. The lesions typically stabilize and regress after puberty. We present a 14-year-old male with severe familial cherubism. Bilateral mandibular enlargement began around age 4 and progressed until puberty, affecting his speech and mastication without subsequent involution. Composite mandibulectomy and mandible reconstruction with fibula free flap technique improved functionality and cosmesis. Histology was consistent with the diagnosis of cherubism, showing large areas of bland spindle-cell fibrous tissue and moderately abundant collagen and multiple nodules of giant cell-rich tissue resembling central giant cell granuloma. Regional lymph nodes were sampled due to enlargement, demonstrating hemosiderin-laden macrophages and basophilic laminated concretions localized to the cortical interfollicular space and along the peripheral follicular marginal zone, findings which have not been previously reported.
  • 18.

    【2hr】Pseudodematiaceous Fungi in Rhinosinusal Biopsies: Report of 2 Cases With Light and Electron Microscopy Analysis

    包量

    机译 鼻窦活检中的假皮脂瘤真菌：2例光镜和电子显微镜分析报告
    摘要：The diagnosis of a mycosis is often established through a biopsy, which allows to differentiate invasive and non-invasive lesions, and also to identify hyaline and dematiaceous fungi. However, pigmented fungal elements that do not correspond to dematiaceous fungi, which we have called pseudodematiaceous, can occasionally be present in biopsies. Herein, we present 2 cases of mycosis caused by pseudodematiaceous fungi in rhinosinusal biopsies. A new classification for fungi identified in biopsies is proposed, dividing them into 3 groups: hyaline, dematiaceous, and pseudodematiaceous.
  • 19.

    【2hr】Combined Tumors in Hematolymphoid Neoplasms: Case Series of Histiocytic and Langerhans Cell Sarcomas Arising From Low-Grade B-Cell Lymphoma

    包量

    机译 血淋巴样肿瘤中的合并肿瘤：低级B细胞淋巴瘤引起的组织细胞和Langerhans细胞肉瘤病例系列
    摘要：We report an index case of histiocytic sarcoma arising in a 70-year-old patient with long-standing chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL). The patient presented in 2017 with painful, enlarging swelling of the left neck. He had remote history of cutaneous squamous cell carcinoma with no sign of recurrence, and his CLL/SLL was thought to be in remission. Computed tomography showed mild splenomegaly and multifocal lymphadenopathy including a 3-cm left neck mass. Biopsy of the left neck mass showed CLL/SLL with associated histiocytic sarcoma. Flow cytometry demonstrated a B cell neoplasm with CLL/SLL phenotype. Despite radiation therapy, he expired 3 months after presentation. Two similar cases (CLL/SLL and histiocytic sarcoma, follicular lymphoma and Langerhans cell sarcoma) from another institution are also illustrated. The pathological features of combined tumors in lymphoid neoplasms, a general framework to the work-up to determine interrelatedness of tumor components, and the clinical relevance are discussed.
  • 20.

    【2hr】A Case of Gastric Amphicrine Signet-Ring Cell Carcinoma

    包量

    机译 胃性苯丙氨酸印戒细胞癌一例
    摘要：“Amphicrine” (in Greek, amphi- means “both” or “double”) refers to cells that synchronously exhibit the endocrine and exocrine phenotypes. Gastric amphicrine carcinoma is very rare, and only a few case reports are found in the English literature; thus, its pathobiological features remain unclear. Here, we report a case of amphicrine gastric carcinoma. A woman in her sixth decade of life presented with anemia and underwent upper endoscopy, followed by histopathological examination of biopsy specimens. She appeared to have gastric cancer with a tumor measuring 5.0 cm × 4.0 cm in size. Subsequently, the patient underwent total gastrectomy with lymph node dissection. Histopathological examination revealed a poorly cohesive carcinoma that sparsely coexisted with signet-ring cell carcinoma cells with regional lymph node metastasis. Interestingly, synaptophysin immunoreactivity with the coexistence of Alcian blue was found in individual signet-ring cell carcinoma cells. Furthermore, the present amphicrine carcinoma cells immunohistochemically expressed CD44 variant 9, a functional cancer stem cell marker. We believe that the present case findings may support the idea of multipotent stem cells being an origin of amphicrine gastric cancers.
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