http://www.hindawi.com The latest articles from Hindawi Publishing Corporation © 2013 , Hindawi Publishing Corporation . All rights reserved. Mon, 20 May 2013 14:10:13 +0000 http://www.hindawi.com/crim/pathology/2013/201095/ We present the first description of amiodarone toxicity in the liver without phospholipidosis or steatosis. In doing so, we will review the various effects of amiodarone toxicity in various organs. The patient is a young adult who had cardiac reconstruction as a child for transposition of the great vessels. A needle biopsy was taken due to elevated liver enzymes. Her ALT was 188 U/L (5–50) and AST 162 U/L (5–50). Alkaline phosphatase, total bilirubin, protein, and albumin were within normal limits. A serologic panel for viral hepatitis was negative. Antinuclear antibodies were positive at 260; however, anti-smooth muscle antibody and anti-mitochondrial antibody were negative. A protein electrophoresis showed a slightly elevated beta globulin 2 level of 0.5. Quantitative immunoglobulin levels were within normal limits except for a slightly elevated IgA 409 mg/dL (60–350). Liver ultrasound was unremarkable. The clinical differential was broad and included hepatic congestion along with autoimmune hepatitis. Sections showed only ballooned hepatocytes with Mallory-Denk bodies and perisinusoidal fibrosis. Arrival to the diagnosis was possible only after careful review of the patient’s medications. After discontinuation of amiodarone, the patient’s liver enzymes returned to normal levels. Adela Cimic and Joseph Sirintrapun Copyright © 2013 Adela Cimic and Joseph Sirintrapun. All rights reserved. Thu, 16 May 2013 11:50:43 +0000 http://www.hindawi.com/crim/pathology/2013/932086/ Granulosa cell tumor (GST) is a sex-cord/stromal neoplasm of the gonads, more commonly arising in the ovaries, while approximately 80 cases have been reported in the testes. Out of these, 30 cases were of the adult type, while the remainder 50 cases were of the juvenile type. The latter mostly concerned infants and followed a benign course. However, the adult type testicular GCTs may be potentially malignant as it also happens in female patients with such neoplasms. We present a case of an adult type GCT located at the left testis. The patient was subjected to total orchiectomy and received no further treatment. Histology showed typical GCT histomorphology with Call-Exner bodies in some places. The immunoprofile of the tumor was CD99 (+), calretinin (+), inhibin (+), alpha smooth muscle actin (+), vimentin (+), ER (−), PR (−), keratin AE1/AE3 (−), alpha fetoprotein (−), CD117 (−), and placental alkaline phosphatase (−). Two years after surgery, the patient is alive and well with no signs of recurrence. Dimosthenis Miliaras, Eleftherios Anagnostou, and Ioannis Moysides Copyright © 2013 Dimosthenis Miliaras et al. All rights reserved. Tue, 14 May 2013 17:32:43 +0000 http://www.hindawi.com/crim/pathology/2013/798435/ Low-grade central osteosarcoma is a rare variant of osteosarcoma which comprises less than 1-2% of all osteosarcomas. Most low-grade osteosarcomas involve long bones, most commonly distal femur, and proximal tibia. Histologically this tumor is difficult to diagnose, and an unusual location makes this diagnosis even more challenging. Here we report a case of low-grade osteosarcoma presenting as a chest wall mass involving the left 6th–8th ribs. This unusual site of presentation significantly added to the diagnostic difficulties of this rare tumor with challenging histologic features. To the best of our knowledge, only six cases of low-grade central osteosarcoma of the ribs have been reported in the English literature. Mana Moghadamfalahi and Houda Alatassi Copyright © 2013 Mana Moghadamfalahi and Houda Alatassi. All rights reserved. Thu, 02 May 2013 14:34:14 +0000 http://www.hindawi.com/crim/pathology/2013/376018/ Ahmad Alkhasawneh, Hui-Jia Dong, Chen Liu, Carmen Allegra, and Robert W. Allan Copyright © 2013 Ahmad Alkhasawneh et al. All rights reserved. Tue, 30 Apr 2013 11:19:09 +0000 http://www.hindawi.com/crim/pathology/2013/204065/ Primary neuroendocrine carcinoma of the breast is a rare entity, comprising <1% of breast carcinomas. Described here is the case of a 78-year-old woman who developed an invasive tumor in the left breast measuring 2.0 cm x 1.5 cm x 1.2 cm. The tumor was composed of only endocrine elements in the invasive part. It infiltrated in a nested fashion with no tubular formation. Intraductal components were present both inside and outside of the invasive portion. Almost all carcinoma cells consisting of invasive and intraductal parts were positive for synaptophysin and neuron-specific enolase. According to the World Health Organization classification 2012, this tumor was subclassified as neuroendocrine tumor, well-differentiated. Among the subgroup, this tumor was relatively high-grade because it was grade 3 tumor with a few mitotic figures. Vascular and lymphatic permeation and lymph node metastases were noted. In the lymph nodes, the morphology of the tumor was similar to the primary site. No distant metastasis and no relapse was seen for one year after surgery. The prognosis of neuroendocrine carcinomas is thought to be worse than invasive mammary carcinomas, not otherwise specified. Therefore, immunohistochemistry for neuroendocrine markers is important in the routine practice to prevent overlooking neuroendocrine carcinomas. Shogo Tajima and Hajime Horiuchi Copyright © 2013 Shogo Tajima and Hajime Horiuchi. All rights reserved. Thu, 18 Apr 2013 13:33:19 +0000 http://www.hindawi.com/crim/pathology/2013/312786/ Distal epithelioid sarcoma is a rare and slowly growing tumor that usually develops in the upper extremities of young adults. Neoplastic cells have both spindle and epithelioid appearance and are characterized by the loss of the nuclear protein SMARCB1/INI1. We present the case of a distal epithelioid sarcoma arising in the thumb of a 14-year-old girl, which immunohistochemically was characterized by the loss of SMARCB1/INI1 protein as well as the expression of podoplanin (D2-40), TLE1, Glut1, and Ca 125; plus, we highlight the differential diagnosis of epithelioid sarcoma from its histological mimics. George Karagkounis, Theodore Argyrakos, G. Charkiolakis, O. Castana, and D. Rontogianni Copyright © 2013 George Karagkounis et al. All rights reserved. Thu, 11 Apr 2013 14:58:34 +0000 http://www.hindawi.com/crim/pathology/2013/648219/ We present a case and review of the literature of well-differentiated sigmoid adenocarcinoma with numerous metastases into pericolic lymph nodes. All positive lymph nodes were small. The authors concluded that there is no clear correlation between nodal size and the likelihood of metastasis in the lymph node, and the status of small lymph nodes must receive special attention by clinicians and pathologists. L. Uriev, I. Maslovsky, F. Barak, and D. Ben-Dor Copyright © 2013 L. Uriev et al. All rights reserved. Mon, 08 Apr 2013 10:57:20 +0000 http://www.hindawi.com/crim/pathology/2013/305321/ Glomus tumors are rare mesenchymal neoplastic lesions arising from glomus bodies that are involved in skin thermoregulation. They are mostly benign tumors, and malignant variants have been rarely reported. The subungual zones of fingers and toes are the most frequent sites of observation. Glomus tumors arising in visceral organs of the gastrointestinal tract are exceedingly rare. Stomach antrum and intestinal duodenum are the most frequent organs involved. No single case of glomus tumor involving intestinal ileum has been previously reported in the English medical literature. To the best of our knowledge, we report the first case of malignant glomus tumor (glomangiosarcoma) of intestinal ileum in a 29-year-old female patient who presented with a 1-month history of a tender pelvi-abdominal mass, constipation, vomiting, and melena. The intestinal ileum glomus tumor was resected, and histopathological diagnosis was consistent with glomangiosarcoma. A postoperative 6-month followup failed to show any evidence of tumor recurrence. Ahmed Abu-Zaid, Ayman Azzam, Tarek Amin, and Shamayel Mohammed Copyright © 2013 Ahmed Abu-Zaid et al. All rights reserved. Thu, 04 Apr 2013 18:39:38 +0000 http://www.hindawi.com/crim/pathology/2013/204082/ Hyperplasia of the endometrial stroma is a poorly recognized lesion, lacking widespread recognition with most, if not all, such cases sequestrated in the literature as endometrial stromal nodules or low-grade endometrial stromal sarcomas. In this paper, we describe three examples of “endometrial stromal hyperplasia” which have a remarkable morphological similarity with the normally proliferating endometrial stroma and the endometrial stromal neoplasms, but which also possess subtle, but sufficient, differences to justify their taxonomic separation. Efthimios Sivridis, Gerasimos Koutsougeras, and Alexandra Giatromanolaki Copyright © 2013 Efthimios Sivridis et al. All rights reserved. Thu, 04 Apr 2013 14:58:54 +0000 http://www.hindawi.com/crim/pathology/2013/397361/ Papillary thyroid carcinoma is the most common differentiated type of thyroid malignancy. It is largely a loco-regional disease with a high tendency to metastasize to regional cervical lymph nodes. Distant hematogenous metastases are very rare and primarily include lungs and bones. Distant bone metastases are present in approximately 1.7% of patients with differentiated thyroid malignancy. Sternum, ribs, and spine are the most frequent sites of osseous metastases. Up to our knowledge, we report the first occurrence of an extra nodal metastasis of papillary thyroid carcinoma to a femoral bone presenting as a pathological fracture in a 21-year-old 37-week primigravida. We report this case because of its unusual site of metastasis and atypical presentation during pregnancy. Moreover, we briefly elaborate on the management of such uncommon cases. Ahmed Abu-Zaid, Ayman Azzam, Hindi Al-Hindi, and Tarek Amin Copyright © 2013 Ahmed Abu-Zaid et al. All rights reserved. Thu, 04 Apr 2013 12:53:14 +0000 http://www.hindawi.com/crim/pathology/2013/581856/ Orbital and ocular adnexal lymphomas are rare and represent around 1-2% of lymphomas and about 8% of the extranodal lymphomas. However, these entities represent the majority of orbital malignancies. Lymphomas of the ocular adnexal region are primary or secondary lymphomas, and the majority of them are composed of small, mature lymphocytes, which provide a large differential diagnosis. Thus, these entities are not easily distinguished from indolent lymphoid processes such as reactive lymphoid hyperplasia. Extranodal marginal zone lymphoma is the most common lymphoma in the ocular adnexal region. However, this entity cannot be distinguished from benign lymphoid proliferations or other lymphomas composed of small, mature lymphocytes by routine histopathology. We describe a 78-year-old man who presents with bilateral upper eyelid masses, which had been present and grew in size over the past twelve months prior to his presentation. A biopsy of the mass shows a monotonous population of small, mature lymphocytes. The immunohistochemical studies performed on the eyelid mass confirmed a monoclonal proliferation of B cells expressing cyclin-D1; therefore, a final diagnosis of mantle cell lymphoma was rendered. A literature review of mantle cell lymphoma with orbital and ocular adnexal involvement and the diagnostic pitfalls in this area of hematopathology are discussed. Elham Vali Khojeini, Benjamin H. Durham, and Mingyi Chen Copyright © 2013 Elham Vali Khojeini et al. All rights reserved. Sun, 31 Mar 2013 09:11:18 +0000 http://www.hindawi.com/crim/pathology/2013/531479/ Papillary intralymphatic angioendothelioma is a rare, low-grade neoplasm of lymphatic channels that usually presents intradermally or subcutaneously. We report the case of a 24-year-old male presenting with an isolated intratesticular palpable mass and symptoms of testicular pain. Preoperative ultrasound examination showed an irregular, heterogeneous mass. Subsequent surgery and pathologic assessment revealed a papillary intralymphatic angioendothelioma (PILA), formerly known as Dabska tumor within the lymphatic spaces. Anne M. Schultheis, Mareike Sandmann, and Stefan Steurer Copyright © 2013 Anne M. Schultheis et al. All rights reserved. Wed, 27 Mar 2013 16:13:50 +0000 http://www.hindawi.com/crim/pathology/2013/836398/ A 58-year-old woman with a history of childhood acute rheumatic fever and resultant mitral valve stenosis was admitted to our cardiovascular surgery clinic complaining of tachycardia, dyspnea, and chest pain. After clinical and radiological findings were evaluated, mitral valve replacement, tricuspid De Vega annuloplasty and plication, and resection of giant left atrium were performed. Atrial thrombus was removed from the top of the left atrial wall. Operation material considered as thrombus was sent to a pathology laboratory for histopathological examination. It was diagnosed with mesothelial/monocytic incidental cardiac lesion (cardiac MICE). Microscopic sections revealed that morphological features of the lesion were different from thrombus. The lesion was composed of a cluster of histiocytoid cells with abundant cytoplasm and oval shaped nuclei and epithelial-like cells resembling mesothelial cells within a fibrin network. Epithelial-like cells formed a papillary configuration in the focal areas. Mitotic figures were absent. Here we present a case which was incidentally found in a patient who underwent mitral valve replacement surgery, as a thrombotic lesion on the left atrium wall. Hilal Erinanç, Murat Günday, Tonguç Saba, Mehmet Özülkü, and Atilla Sezgin Copyright © 2013 Hilal Erinanç et al. All rights reserved. Wed, 27 Mar 2013 14:22:49 +0000 http://www.hindawi.com/crim/pathology/2013/547372/ Plexiform fibrohistiocytic tumor is an intermediate malignant tumor situated in superficial soft tissues. It affects children and young adults. The tumor is most commonly located on upper extremities, whereas involvement of back region is rare. Mitotic activity is generally low (~3/10 HPF). It is rare, but it can exhibit aggressive behavior, so total excision with clear surgical margins and long-term followup is necessary to detect local recurrence and metastases. We report a child with a solid mass on back region which was found to be a mitotically active plexiform fibrohistiocytic tumor (6/10 HPF) after excision. Plexiform fibrohistiocytic tumor (PFT) is a mesenchymal neoplasm of children, adolescents, and young adults. It is characterized by fibrohistiocytic cytomorphology and multinodular growth pattern. Clinically it is usually a slow-growing mass of upper extremities with frequent local recurrence and rare regional lymphatic and systemic metastasis (Fletcher et al. (2002), Enzinger and Zhang (1988), Remstein et al. (1999)). Ebru Zemheri, Şeyma Özkanlı, Serkan Şenol, Filiz Ozen, Cigdem Ulukaya Durakbaşa, İlkin Zindancı, and Hamit Okur Copyright © 2013 Ebru Zemheri et al. All rights reserved. Wed, 27 Mar 2013 13:51:44 +0000 http://www.hindawi.com/crim/pathology/2013/973865/ The juxtaglomerular cell tumor (JGCT) is a rare renal tumor characterized by excessive renin secretion causing intractable hypertension and hypokalemia. However, asymptomatic nonfunctioning JGCT is extremely rare. Here, we report a case of nonfunctioning JGCT in a 31-year-old woman. The patient presented with a left renal tumor without hypertension or hypokalemia. Under a clinical diagnosis of renal cell carcinoma, radical nephrectomy was performed. The tumor was located in the middle portion adjacent to the renal pelvis, measuring 2 cm in size. Pathologically, the tumor was composed of cuboidal cells forming a solid arrangement, immunohistochemically positive for renin. Based on these findings, the tumor was diagnosed as JGCT. In cases with hyperreninism, preoperative diagnosis of JGCT is straightforward but difficult in nonfunctioning case. Generally, JGCT presents a benign biological behavior. Therefore, we should take nonfunctioning JGCT into the differential diagnoses for renal tumors, especially in younger patients to avoid excessive surgery. Ryoko Sakata, Hiroaki Shimoyamada, Masahiro Yanagisawa, Takayuki Murakami, Kazuhide Makiyama, Noboru Nakaigawa, Yoshiaki Inayama, Kenichi Ohashi, Yoji Nagashima, Masahiro Yao, and Yoshinobu Kubota Copyright © 2013 Ryoko Sakata et al. All rights reserved. Wed, 20 Mar 2013 13:50:48 +0000 http://www.hindawi.com/crim/pathology/2013/508619/ Synovial cysts of the temporomandibular joint (TMJ) are very rare, and to date, only 12 cases of a synovial cyst in the TMJ region have been reported in the literature. In this paper, we present the clinicopathological and immunohistochemical characteristics of one such lesion affecting a 48-year-old woman, presented with a mass in the left preauricular region. We describe the usefulness of immunohistochemical analysis for recognizing the synovial lining, which allowed for clear differentiation between ganglion and synovial cysts. Immunohistochemical analyses can be used to diagnose synovial cysts with certainty; however, using at least two markers is advisable to distinguish the two existing synovial cell subtypes. Our findings indicate that synovial cysts of TMJ possess an internal lining dominated by type B (fibroblast-like) synoviocytes. B. Vera-Sirera, J. A. Tomás-Amerigo, C. Baquero, and F. J. Vera-Sempere Copyright © 2013 B. Vera-Sirera et al. All rights reserved. Wed, 06 Mar 2013 16:20:08 +0000 http://www.hindawi.com/crim/pathology/2013/679892/ Acute lymphoblastic leukemia is predominantly found in children. It is a neoplasm of precursor cells or lymphoblasts committed to either a B- or T-cell lineage. The immature cells in B-acute lymphoblastic leukemia/lymphoma can be small or medium sized with scant or moderate cytoplasm and typically express B-cell markers such as CD19, cytoplasmic CD79a, and TdT without surface light chains. These markers, along with cytogenetic studies, are vital to the diagnosis, classification, and treatment of these neoplasms. We present an unusual case of a precursor B-cell ALL, in an 82-year-old woman, who presented with pancytopenia and widespread lymphadenopathy. The cells show L3 morphology (Burkitt-like lymphoma) with coexpression of TdT and surface light chains in addition to an MYC gene translocation and Philadelphia chromosome. Alicia C. Hirzel, Aaron Cotrell, Robert Gasparini, and Vathany Sriganeshan Copyright © 2013 Alicia C. Hirzel et al. All rights reserved. Mon, 04 Mar 2013 13:50:04 +0000 http://www.hindawi.com/crim/pathology/2013/239173/ Mucus gland adenoma is an extremely rare benign lung tumor, presumed to arise from the bronchial mucus glands; it is a TTF-1 negative tumor, centrally located, causing the clinical manifestations of obstruction. We report a TTF-1 negative mucus gland adenoma, arising into the medial bronchopulmonary segment, lacking any relation to a bronchus. Georgia Karpathiou, Efthimios Sivridis, Dimitrios Mikroulis, Marios Froudarakis, and Alexandra Giatromanolaki Copyright © 2013 Georgia Karpathiou et al. All rights reserved. Mon, 04 Mar 2013 12:06:01 +0000 http://www.hindawi.com/crim/pathology/2013/672816/ Malignant melanoma of the gastrointestinal tract is an uncommon neoplasm that could be primary or metastatic. Small intestine represents the most common site for the metastatic melanoma; however, it could be found anywhere in the gastrointestinal tract. Intussusception is a rare cause of intestinal obstruction in adults compared to children. In 90% of the cases, the underlying cause can be found, and in 65% of the cases, intussusception is caused by the neoplastic process. The majority of the neoplasms are benign, and about 15% are malignant. Metastatic melanoma is one of the most common metastatic malignancies to the gastrointestinal tract; however, the premortem diagnosis is rarely made. Here, we report an uncommon clinical presentation of metastatic melanoma causing intussusception in an 80-year-old man. This diagnosis should be considered in a differential diagnosis in any patient who presents with gastrointestinal symptoms and a history of melanoma. Sarah Alghamdi and Yumna Omarzai Copyright © 2013 Sarah Alghamdi and Yumna Omarzai. All rights reserved. Thu, 28 Feb 2013 09:15:11 +0000 http://www.hindawi.com/crim/pathology/2013/849359/ Vivek Gulati, Seun Bakare, Saket Tibrewal, Nizar Ismail, Junaid Sayani, Adnan Aali, Faris Kubba, William Lynn, Andrew Borman, and Davinder Paul Singh Baghla Copyright © 2013 Vivek Gulati et al. All rights reserved. Tue, 26 Feb 2013 09:15:40 +0000 http://www.hindawi.com/crim/pathology/2013/630859/ Malignant Müllerian mixed tumors (MMMTs) of the uterine cervix are extremely rare, accounting for 0.005% of all cervical malignancies. To date, only approximately 50 well-documented cases have been reported. Although several epithelial components have been described in cervical MMMTs, small cell neuroendocrine carcinoma (SCC) has not appeared in the English literature. We present a 43-year-old woman, para 2 gravida 2, who had MMMT with SCC and rhabdomyosarcoma components in the uterine cervix. She was referred to our hospital because of a cervical mass with an abnormal Pap smear result. Cervical biopsy revealed SCC. After neoadjuvant chemotherapy with balloon-occluded arterial infusion, she underwent type II radical hysterectomy with pelvic lymphadenectomy. Histological analysis revealed that the cervical tumor comprised SCC and rhabdomyosarcoma components. Genotype analysis indicated human papillomavirus type 18. She underwent concurrent chemoradiation therapy. The patient had been free of the disease and showed no evidence of recurrence 38 months after operation. Satoru Munakata, Emi Iwai, Tomohito Tanaka, Michihiko Nakamura, and Takayoshi Kanda Copyright © 2013 Satoru Munakata et al. All rights reserved. Mon, 25 Feb 2013 08:42:09 +0000 http://www.hindawi.com/crim/pathology/2013/269543/ An accessory spleen is defined as ectopic splenic tissue that develops due to failure of fusion of cells during embryonic development as they migrate from the midline to the left upper quadrant. While benign, complications may arise which include trauma, torsion, or infarction of the ectopic tissue. Additionally, patients who have had a splenectomy secondary to treatment for previous pathology such as a haematological malignancy or idiopathic thrombocytopenia purpura may experience persistent symptoms due to the accessory splenic tissue. The presence of an accessory spleen is therefore of significant diagnostic and therapeutic importance. To the best of the authors' knowledge, this case is the second and largest reported case of a giant right suprarenal accessory spleen and highlights the difficulty in differentiation of these masses from malignant adrenal tumours. A. Arra, Michael J. Ramdass, A. Mohammed, O. Okoye, D. Thomas, and S. Barrow Copyright © 2013 A. Arra et al. All rights reserved. Thu, 21 Feb 2013 10:05:42 +0000 http://www.hindawi.com/crim/pathology/2013/687427/ Primary thyroid-like follicular carcinoma of the kidney is a rare but newly emerging histological variant of renal cell carcinoma RCC, with only nine cases reported in the literature to date. We present a further case of this unique condition, discuss the workup and typical histological findings, and review the literature regarding this rare histological variant. S. Malde, I. Sheikh, I. Woodman, D. Fish, P. Bilagi, and M. K. M. Sheriff Copyright © 2013 S. Malde et al. All rights reserved. Wed, 13 Feb 2013 16:31:05 +0000 http://www.hindawi.com/crim/pathology/2013/267194/ Undifferentiated spindle-cell carcinoma is a rare gallbladder cancer with a worse or similar prognosis to the generally dismal outcome seen in most gallbladder cancer patients. We reported a case of SpCC, stage IV disease that was initially diagnosed as undifferentiated pleomorphic sarcoma, but deeper sections revealed few clusters of epithelioid clear cells. Although the tumour showed biphasic appearances on haematoxylin and eosin, it exhibited poor protein expression with most sarcoma markers being negative except for focal vimentin positivity. The CEA and CK7 were positive only in the epithelioid clear cell clusters while CD 68 positive was also focally positive in the spindle-cell component. The poor tumour differentiation coupled with advanced stage at presentation was partly responsible for the disease progression and patients' death one year after surgery. Early diagnosis and surgical intervention with better understanding of this tumour biology may offer improved prognosis and survival in this rare cancer. Kabir Bolarinwa Badmos, Laila Salah Seada, Fawaz Fahad Al Rashid, and Hanan Abdulhafez Oreiby Copyright © 2013 Kabir Bolarinwa Badmos et al. All rights reserved. Tue, 12 Feb 2013 14:46:54 +0000 http://www.hindawi.com/crim/pathology/2013/784176/ This is a case report of a previously undescribed 20q chromosomal deletion (del(20q)) in marginal zone lymphoma (MZL). A 54-year-old Caucasian male presented with an enlarging neck mass and multiple violaceous skin nodules over his chest. Biopsy of the neck mass and cervical lymph nodes revealed MZL. Cytogenetic evaluation of both lymph node and bone marrow tissue revealed del(20q). This was an unexpected finding, as del(20q) is associated with myelodysplastic syndromes and myeloproliferative neoplasms and rarely seen in diffuse large B-cell lymphoma, follicular lymphoma, and T-cell lymphoma, but has not previously been described in MZL. We describe the case presentation and histologic findings and discuss the significance of this novel finding. Jason B. Kern, Deiter J. Duff, Jamie L. Odem, Magda Esebua, Lisa R. Smith, Donald Doll, and Michael Wang Copyright © 2013 Jason B. Kern et al. All rights reserved. Wed, 06 Feb 2013 09:38:56 +0000 http://www.hindawi.com/crim/pathology/2013/604560/ Ameloblastic fibrodentinoma (AFD) is considered a mixed odontogenic tumor that is characterized by conserved epithelial and ectomesenchymal neoplastic components. AFD is composed of long narrow cords and islands of odontogenic epithelium; the epithelial strands lie in a myxoid cell-rich ectomesenchymal tissue with stellate-shaped fibroblasts that exhibit long slender cytoplasmic extensions that resemble dental papilla. The lesions show the presence of dysplastic dentin. Although AFD is a rare entity and its very existence is not completely accepted, based on the extent of histodifferentiation, it is considered to represent a stage between ameloblastic fibroma and ameloblastic fibroodontoma. This study aimed to provide a histopathological and immunohistochemical characterization of this infrequent tumor. A large panel of antibodies including amelogenin, Ck 19, calretinin, syndecan-1, E-cadherin, MSH2, histone H3, and Ki-67 was used to illustrate the nature of the tumor. Ronell Bologna-Molina, Sirced Salazar-Rodríguez, Ana María Bedoya-Borella, Ramón Gil Carreón-Burciaga, Gabriel Tapia-Repetto, and Nelly Molina-Frechero Copyright © 2013 Ronell Bologna-Molina et al. All rights reserved. Sun, 20 Jan 2013 11:39:48 +0000 http://www.hindawi.com/crim/pathology/2013/423584/ With the exception of leiomyomas, soft tissue tumors of the uterine corpus are not common. This is particularly true for vascular neoplasms, with the epithelioid hemangioendothelioma being a curiosity; not more than twenty-two cases of malignant hemangioendotheliomas have been reported in the literature so far, all of which were high-grade hemangioendotheliomas (hemangiosarcomas). We present herewith a unique case of low-grade epithelioid hemangioendothelioma of the uterus in a pregnant woman aged 29 years. The clinical, histological, and immunohistochemical characteristics of this entity, together with its differential diagnosis, are discussed. Anastasios V. Koutsopoulos, Efthimios Sivridis, Panagiotis Tsikouras, Vasileios Liberis, Georgia Karpathiou, and Alexandra Giatromanolaki Copyright © 2013 Anastasios V. Koutsopoulos et al. All rights reserved. Mon, 14 Jan 2013 09:31:47 +0000 http://www.hindawi.com/crim/pathology/2013/302304/ B-cell lymphoma, unclassifiable, with features intermediate between diffuse large B-cell lymphoma and Burkitt’s lymphoma (BLUI) is a recently added entity to the World Health Organization (WHO) classification to address a grey zone between large B-cell lymphoma (DLBCL) and Burkitt’s lymphoma (BL). These are rare aggressive lymphomas, which were previously also known as Burkitt’s-like lymphoma (BLL). BL and BLUI/BLL of the colon mostly involve the ileocecal region. In the rectum, BL and BLUI/BLL almost always affect patients with the acquired immune deficiency syndrome (AIDS). We report the first case of rectal BLUI/BLL in an immunocompetent patient who is also negative for MYC abnormalities and the EBV early RNA (EBER) in situ hybridization. Jignesh G. Parikh, Ted Strom, and Ilya Stone Copyright © 2013 Jignesh G. Parikh et al. All rights reserved. Sun, 30 Dec 2012 15:16:51 +0000 http://www.hindawi.com/crim/pathology/2012/340840/ We report here the case of a 61-year-old woman who presented with hydrocephalus and cystic and solid lesions in sella turcica, suprasellar areas, and third ventricle. After ventriculoperitoneal shunt she developed cognitive changes and the cystic lesions enlarged. Magnetic resonance imaging (MRI) demonstrated multiple cysts and a solid lesion in the sella and around the anterior clinoid process. With diagnosis of neurocysticercosis she underwent craniotomy. Pathologic examination documented two different lesions: viable and dead cysticerci with inflaming infiltration and a left anterior clinoidal meningioma. At the second surgery, six weeks later via transnasal transsphenoidal approach a silent corticotroph pituitary adenoma was removed which was studied by histology, immunohistochemistry, and electron microscopy. To our knowledge, the occurrence of these three different lesions in the sellar area was not described before. Maria del Pilar Ramirez, Juan E. Restrepo, Luis V. Syro, Fabio Rotondo, Francisco J. Londoño, Luis C. Penagos, Humberto Uribe, Eva Horvath, and Kalman Kovacs Copyright © 2012 Maria del Pilar Ramirez et al. All rights reserved. Sun, 30 Dec 2012 15:04:20 +0000 http://www.hindawi.com/crim/pathology/2012/827567/ Several conditions require subcutaneous colon bypass surgery in the esophageal diseases treatment. Esophageal reconstructions are high risk procedures because of their morbidity and mortality rate. Cervical anastomotic strictures, colon transplant redundancy, recurrent dysphagia, intestinal obstruction, regurgitation, and aspiration are the most frequent late complications. The patient assessment should be performed with noninvasive methods in order to prevent long-term complications. We report the use of ultrasound (US) and computed tomography (CT) for evaluating a dysphagic patient, after subcutaneous esophageal bypass. A thorax and upper abdomen contrast media CT study with volume rendering reconstruction was performed in order to evaluate late post operative complications. In addition a US examination, performed after CT scan, was used for the assessment of the colonic wall and its vascularization. The subcutaneous esophageal bypass allowed for an effective ultrasound evaluation with no additional discomfort for the patient. ultrasonography has been shown effective in the esophageal bypass follow up, when subcutaneous colon bypass surgery was performed. The ultrasonography evaluation, also thanks to a Doppler flowmetry, allowed completing the patient assessment without additional invasive procedures or contrast. Thus it may be performed as a first level evaluation or in the follow up of subcutaneous esophageal bypass patients. Simone Vetere, Maria Luisa Mennini, Daniele Pironi, Manuela Brighi, and Stefano Pontone Copyright © 2012 Simone Vetere et al. All rights reserved.