ABSTRACT
There is a lot of difficulty in the diagnosis of follicular lesions of the thyroid by fine needle aspiration cytology(FNAC). The main purpose of this report is offering more guidance regarding the cytologic appearance to distinguish follicular neoplasm from nodular goiter and laying stress on the presence of mixed group. The histologic and cytologic findings of 23 follicular neoplasms and 13 nodular (adenomatous) goiters were reviewed. Histologic specimens were classified into the microfollicular(MIF), mixed(MIX), and nodular goiter(NG) groups. The comparison of histologic patterns with histologic diagnosis revealed that all the lesions with predominantly microfollicular, trabecular, or solid pattern were follicular carcinoma and all the lesions with predominantly macrofollicular pattern were nodular goiter. The distinguishing cytologic features for the MIF group were irregular cell arrangement in cell groups(100%, p=0.00001), absence of atrophic follicular cells(100%, p=0.0007), abundant microfollicles(100%, p=0.002), pleomorphic nuclei(100%, p=0.002), not predominant syncytial smear pattern(100%, p=0.002), heterochromatin(100%, p=0.032), absence of macrofollicles(100%, p=0.038), scant colloid(100%, p=0.04), clear background(83%, p=0.00006), and uniform sized follicles(83%, p=0.014). And regular cell arrangement(honeycomb appearance) in cell groups(85%, p=0.0000), atrophic change of follicular cells(69%, p=0.0002), syncytial smear pattern(54%, p=0.006), monomorphic nuclei(85%, p=0.008), and hemorrhagic background(100%, p=0.027) were characteristic features of the NG group. Seventeen out of 36 cases(47%) were the MIX group composed of combined cytologic features of the MIF and NG groups. Therefore the frequent presence of the MIX group is considered to be main cause of the difficultyin the diagnosis of follicular lesions by FNAC. The mixed morphologic feature may support the hypothesis of a biologic "continuum" between nodular goiter and follicular neoplasm of thyroid gland.
Subject(s)
Biopsy, Fine-Needle , Diagnosis , Goiter , Goiter, Nodular , Thyroid GlandABSTRACT
PURPOSE: Primary pulmonary lymphoma(PPL) arising in the lung as the initial site is very rare. Authors experienced two cases of PPL and report the radiologic findings and clinical characteristics with a brief reviewof the literature. METHODS AND MATERIALS: Plain chest radiograph and enhanced axial CT scan of the chest were taken. We analyzed radiologic findings of the two cases and correlated with broncoscopic and pathologic findings. RESULTS: Plain chest radiograph showed a mass like consolidative lesion on RML without peripheral atelectasis. Chest CT scan revealed a mass like consolidation with airbronchogram and the absence of a hilar mass or thoracic adenopathy. Percutaneous needle aspiration and biopsy(PCNA and PCNB) of the RML mass confirmed B-cell lymphoma, in both cases. CONCLUSION: PPL must be included in the differential diagnosis of chronic alveolar consolidation such as bronchioloalveolar cell carcinoma.
Subject(s)
Diagnosis, Differential , Lung , Lymphoma , Lymphoma, B-Cell , Needles , Pulmonary Atelectasis , Radiography, Thoracic , Thorax , Tomography, X-Ray ComputedABSTRACT
Adenomatoid tumors are well-recognized neoplasms generally to be of mesothelial derivation. We experienced a case of an adenomatoid tumor of the tail of the epididymis in a 56-year-old male. Grossly the tumor was firm and whitish gray, and microscopically it consisted of glandular, cord-like, microcystic structures which were lined by flattened endothelial like to plump cuboidal cells. Immunohistochemical stains whowed positivity for keratin and negativity for facter VIII related antigen and carcinoembryonic antigen. Ultrastructually, there was many long microvilli projecting into the glandular lumina and intracytoplasmic luminal spaces, desmosomes, and prominent cytoplasmic tonofilaments. Those findings strongly support the mesothelial origin of the adenomatoid tumor especially in the glandular type. It also lead us to suggest that the term adenomatoid tumor should be remain in use for light microscopic diagnosis, and that the term adenomatoid mesothelioma should be applied when the mesothelial nature of an adenomatoid tumor is proven by electron microscopy and immunohistochemical stains.
ABSTRACT
Embryonal carcinoma of testis may be composed of primitive cells with epithelial appearance showing prominent variation in size and shape, clear cytoplasm, overlapping nuclei. and many mitoses. Multiple lymph node enlargement was noticed in a 45-year-old man with known huge testicular tumor, 20 x 15 cm, and clinically malignant lymphoma was suspected. Microscopic and cytologic finding of both biopsy and needle aspiration from neck lymph node disclosed highly undifferentiated large cells, mostly in solid sheets and often forming glandular spaces. Massive necrosis was observed. Cytologic diagnosis of embryonal carcinoma was made possible, relied on the result of immunohistochemistry that revealed negative LCA, and positive cytokeratin and CEA as well as the cytologic features. Serum levels of HCG and AFP of the patient, in addition, were markedly elevated.
Subject(s)
Male , Humans , Biopsy , Neoplasm MetastasisABSTRACT
Leiomyoma of the urethra is a rare condition, which is more common in female than in male subjects. A case of leiomyoma of female urethra in a twenty-two years old female arising from anterior lip of the external urethral meatus is presented. The presenting symptoms were painless mass on the anterior lip of the external urethral meatus and voiding difficulty. The mass was easily removed by surgical resection and confirmed as leiomyoma histologically.
Subject(s)
Female , Humans , Male , Leiomyoma , Lip , UrethraABSTRACT
Merkel cell carcinoma, also known as neuroendocrine carcinoma of skin is now well recognized entity of malignant skin tumor to clinicians and pathologists. A few cases have been reported up to now in the literature, but the information regarding the appropriate treatment modalities have not been obtained in detail. The clinical, histologic and ultrastructural features and the treatment of a case of primary Merkel cell carcinoma of eyelid in a 75 year-old male is presented.
Subject(s)
Aged , Humans , Male , Carcinoma, Merkel Cell , Carcinoma, Neuroendocrine , Eyelids , SkinABSTRACT
The term malignant mesenchymoma has been applied to those tumors of the soft tissue of mesenchymal origin which are composed of tumor cells differentiating into two or more unrelated malignant forms in addition to the fibrosarcomatous element. Recently authors experienced a case of malignant mesenchymoma in the right axillary area. Microscopically the sarcoma revealed multiple pattern of differentiation, including liposarcoma, malignant schwannoma, fibrosarcoma, malignant fibrous histiocytoma and rhabdomyoblastoma. The presence of rhabdomyblastic cells were proved by immunochemical study utilizing desmin. This patient was treated with surgical excision and radiation.
ABSTRACT
No abstract available.
ABSTRACT
Twelve hyperlipidemic patients taking ginseng extract 1.0 gm daily were studied for sequential changes in blood lipid levels for 16 weeks. Following results were observed. 1. HDL-C was markedly elevated from the beginning through test period while TG is conversely decreased. 2. TC and LDL-C revealed the tendency to decrease but not significant in degree. 3. No remarkable untoward reaction was observed with long term ginseng extract administration. In summary, the beneficial effect of ginseng extract on abnormal blood lipids level is unequivocal and the author recommend the use of ginseng extract to patient being on the verge of atherosclerosis.