ABSTRACT
Aim: Since early diagnosis and treatment of melanoma can significantly improve patients’ prognosis, discovering new criteria to help differentiate between benign and malignant melanocytic lesions is of significance. In this study we aim to clarify the relationship between the presence of intracytoplasmic eosinophilic inclusion bodies inside melanocytes and the nature of the melanocytic lesion. Methods: Medical records and pathology slides pertaining to 187 patients with melanocytic lesions who had undergone biopsy in Razi Hospital between March 2014 and March 2015 were gathered. Slides were re-examined by a dermatopathologist using a light microscope. Clinical and pathological data were analyzed using SPSS. Results: A total of 196 specimens from 187 patients were studied. The median age of our patients was 42.26 years and 61.5% of them were female while 38.5% were male. The specific eosinophilic intracytoplasmic inclusion bodies were observed in 14 specimens; 8 of which were intradermal nevi and the remaining 6 were from compound nevi. These bodies tended to be present in lesions with congenital features. We found no correlation between age, sex or location of the lesion with the presence of aforementioned bodies. Conclusion: Eosinophilic inclusion bodies present in the cytoplasm of melanocytes are associated with benign melanocytic lesions and are mostly observed in cells with abundant vacuolated cytoplasm and in lesions with congenital features. Therefore these bodies can be helpful in diagnosing benign and longstanding lesions and differentiating them from malignancies.
ABSTRACT
The clinical significance of cytoplasmic inclusions(CPI) in synovial fluid(SF) examination was evaluated. We examined SF specimens collected from major rheumatology clinics in the Philadelphia area during the period of January to December 1995. Among 759 patients in the initial study group, 419 cases with established diagnoses and full synovial analyses were included. Their diagnoses and SF analysis results including leukocyte counts, differential counts and wet preparations were collected and analysed. Ninety seven of the 419 SF specimens were found to have CPI. CPI were found in SF from almost all rheumatic diseases. They were most likely to be found in inflammatory arthropathy including rheumatoid arthritis(RA, 46%), juvenile rheumatoid arthritis(JRA, 78%) and psoriatic arthritis(55%). On the contrary, CPI were least common in crystal-induced arthropathy among the inflammatory arthropathy. CPI were found 8 out of 98 gout cases(8%) and 2 among 53 calcium pyrophosphate dihydrate(CPPD) deposition disease(4%). In noninflammatory arthropathy, CPI were found in only 6 cases(6%) out of the 103 osteoarthritis(OA). In RA cases with non-inflammatory SF, 4 of the 20 SF(20%) had CPI while only 6% of OA SF had CPI. OA SF with CPI were all noninflammatory SF. In summary, CPI were a common finding on SF examination. CPI were more likely to be found in inflammatory arthropathy than noninflammatory. Among inflammatory arthropathy, CPI can favor non-crystal arthropathy than crystal arthropathy. Awareness of the presence of CPI is suggested as an addendum to routine SF analysis. Renewed investigation of the several types of CPI may add further to the understanding of joint disease.
Subject(s)
Inclusion Bodies/pathology , Rheumatic Diseases/physiopathology , Synovial Fluid/cytologyABSTRACT
Malignant rhabdoid tumor of the kidney(MRTK), an uncommon renal tumor found in children, is one of the most lethal neoplasms of early life. It was first recognized during a review of the first National Wilms' Tumor Study(NWTS) as an extremely aggressive neoplasm whose appearance often mimicks those of skeletal muscle tumors, but without histological, immunohistochemical, and ultrastructural markers of rhabdomyogenesis. Herein we present two cases of malignant rhabdoid tumor of the kidney, one occurring in a 6-month-old male baby, and the other in a 123-month-old girl. They presented a huge tender mass on the left upper quadrant of the abdomen. Microscopically, each case was very cellular and composed of sheets of round or polygonal cells with ample cytoplasm often containing eosinophilic filamentous inclusions and round vesicular nuclei with prominent nucleoli. Case 1 showed lymphomatoid pattern, but case 2 showed foci of several variant patterns associated with classic appearances. The tumor cells showed a strong reactivity for vimentin in both cases. Unusually, case 2 showed focal reactivity for epithelial membrane antigen(EMA), muscle specific actin, and smooth muscle actin. Ultrastructural study confirmed the presence of whorled bundles of intermediate filaments in paranuclear position, and a prominent nucleolus.