ABSTRACT
Meningiomas são os principais tumores primários do sistema nervoso central (SNC) que afetam cães e gatos. Na maioria dos casos, são neoplasias benignas, geralmente expansivas, causando compressão do SNC, e raramente fazem metástase para outros órgãos. O presente trabalho tem como objetivo relatar a ocorrência de um meningioma microcístico com metástase pulmonar em um canino de 11 anos de idade, com sinais clínicos de andar cambaleante, compressão da cabeça contra objetos, agitação, salivação e agressividade. Na necropsia, foram observadas, no encéfalo, massas bem delimitadas pardo-avermelhadas, firmes, de aspecto granular, localizadas no córtex parietal e nos núcleos da base. Inúmeras micronodulações de aspecto semelhante foram observadas no pulmão. Histologicamente observaram-se nódulos formados por células neoplásicas fusiformes, com núcleos grandes e alongados e nucléolos evidentes, dispostas de forma frouxa, formando vacúolos e microcistos. À imuno-histoquímica, o meningioma apresentou marcação fortemente positiva para citoqueratina e negativa para vimentina. Por meio da histopatologia e da imuno-histoquímica, foi possível estabelecer a classificação histológica de meningioma microcístico, bem como diferenciá-lo de outras doenças que cursam com sinais nervosos.(AU)
Meningiomas are the main tumors of the central nervous system (CNS) affecting dogs and cats. In most of the cases they are benign neoplasms, usually expansive, causing compression of the CNS and rarely metastasize to other organs. We describe the occurrence of a microcystic meningioma with pulmonary metastasis in an 11 - year - old canine with clinical signs of staggering gait, head compression against objects, agitation, salivation and aggressiveness. At necropsy, well-defined, firm, granular-looking masses located in the parietal cortex and nuclei of the base were observed in the encephalon. Numerous micronodulations of similar appearance were observed in the lung. Histologically, nodules formed by spindle neoplastic cells with large, elongated nuclei and evident nuclei were loosely arranged, forming vacuoles and microcysts. Immunohistochemistry were strongly positive for cytokeratin and negative for vimentin. Through the histopathology and immunohistochemistry, it was possible to establish the histological classification of microcystic meningioma, as well as to differentiate from other diseases that present with nervous signals.(AU)
Subject(s)
Animals , Dogs , Lung/pathology , Meningioma/complications , Meningioma/veterinary , Neoplasm Metastasis , Immunohistochemistry/veterinary , Central Nervous System Neoplasms/veterinary , Lung Neoplasms/veterinaryABSTRACT
Aims and Objectives: The aim is to study the different corneal complications after manual small-incision cataract surgery(MSICS) and their implication on the final visual outcome in the patients.Design: It is a prospective, hospital-based observational study.Materials and Methods: The present study was done among 100 patients who underwent MSICS with implantation of posteriorchamber intraocular lens implantation. Study was conducted over a period of 3 months between March 2018 and May 2018 inGovernment Medical College, Jammu. All patients with clinically significant visual cataract admitted in Ophthalmology Departmentof Government Medical College, Jammu, during the study period were included. The post-operative corneal complications andbest corrected visual acuity (BCVA) of the enrolled patients were reviewed on the 1st, 7th, 15th, 30th, and 45th post-operative day.Results: 100 eyes of 100 patients consisting of 69 males and 31 females who underwent MSICS with intraocular lens implantationin the Department of Ophthalmology were studied. Majority of the patients belonged to the 60–69 years age group whichconstitutes 35 of the total patients. Out of 100 patients, 26 had corneal complications. 24 patients had striate keratopathy – outof whom 16 patients had mild grade striate keratopathy (<10 Descemet’s membrane folds [DMF]) and 8 patients had severegrade striate keratopathy (>10 DMF). 1 patient had microcystic corneal edema, and 1 patient had Descemet’s membranedetachment. After 6 weeks of post-cataract surgery, it was found that 89 patients achieved a BCVA of 6/9 or better.Conclusions: Corneal complications such as striate keratopathy are transient and resolve usually by the end of 2 weeks.Therefore, it was concluded that detailed pre-operative planning and careful surgery can prevent most of these complications.
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Objective To discuss the diagnosis and differential diagnosis of microcystic adnexal carcinoma (MAC).Methods Totally,10 patients with MAC were enrolled from Hospital for Skin Diseases,Chinese Academy of Medical Sciences from 2003 to 2017.Their clinical manifestations,histopathological and immunohistochemical features,treatment and prognosis were retrospectively analyzed.Results Of the 10 patients,3 were males and 7 were females.Their average age at the onset of MAC was 51.65 years.Skin lesions all occurred on the face,and on the upper lip in 6 cases.The lesions usually presented as solitary plaque or nodule,and ulceration occurred in 4 cases.Histopathologically,skin lesions consisted of epithelial cords with different numbers of keratinous cysts and tubular structures,and neural involvement occurred in 6 cases.However,mitotic figures were rare.Immunohistochemical staining showed epithelial cells and keratinous cysts stained positive for cytokeratin,as well as tubular structures and glandular cavities stained positive for carcinoembryonic antigen and epithelial membrane antigen.All the patients received surgical excision,and one patient experienced in situ recurrence 13 years later.No distant metastasis occurred in these patients.Conclusions MAC mainly presents as red plaques with occasional ulceration on the upper lip.Its definite diagnosis depends on characteristic histopathological changes in bidirectional differentiation into hair follicles and sweat glands,and immunohistochemical features are helpful to distinguish MAC from other adnexal tumors.
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Microcystic stromal tumor (MCST) is a rare subtype of sex cord-stromal neoplasm. Tumors from all 31 previously reported cases were located in the ovary. Herein, we present a unique case of a right-side testicular tumor in a 33-year-old Chinese male. The tumor is composed of predominantly lobulated cellular nodules separated by hyalinized fibrous stroma and they expressed CD10, β-catenin (nuclear), and cyclin D1. Molecular analysis identified a point mutation (c.110C>G) in exon 3 of CTNNB1. The histopathological features, immunohistochemistry profiles, and molecular analysis of this tumor were consistent with MCST of the ovary. Therefore, a diagnosis of MCST of the right testicle was determined. To the best of our knowledge, this is the first case of MCST occurring in the testicles. The study may provide new insights to the tumor biology of MCST and a better understanding of this rare entity.
Subject(s)
Adult , Female , Humans , Male , Asian People , Biology , Cyclin D1 , Diagnosis , Exons , Hyalin , Immunohistochemistry , Ovary , Point Mutation , TestisABSTRACT
Microcystic adnexal carcinoma (MAC) was first described in 1982 by Goldstein. Considered a rare malignant skin appendageal tumor, it is often underdiagnosed due to its clinical and histopathological resemblance to other cutaneous neoplasms. MAC is locally aggressive with infiltration of perineural spaces, subcutaneous tissue, skeletal muscles, and so on. Aggressive treatment including wide local excision, Mohs micrographic surgery, or radiation therapy is necessary owing to the high recurrence rate. Herein, we report a case of a 47-year-old Korean woman with a skin-colored hardened plaque on the scalp with a clinical diagnosis of cicatricial alopecia and histopathological diagnosis of MAC. After treatment by Mohs micrographic surgery, the patient is being followed up regularly without any sign of recurrence. This case demonstrates an uncommon topography of MAC on the scalp with secondary cicatricial alopecia and highlights the need for awareness of the potential for MAC in the diagnosis of alopecia with a slow-growing tumor.
Subject(s)
Female , Humans , Middle Aged , Alopecia , Diagnosis , Mohs Surgery , Muscle, Skeletal , Pathology , Recurrence , Scalp , Skin , Skin Neoplasms , Subcutaneous TissueABSTRACT
Objective@#To study the clinicopathologic features, diagnosis and differential diagnosis of pulmonary microcystic fibromyxoma.@*Methods@#In March 2014, at the First Affiliated Hospital to Nanjing Medical University a 58-year-old female patient of pulmonary microcystic fibromyxoma was collected. The clinicopathologic, immunohistochemical and genetic profile of a case of pulmonary microcystic fibromyxoma were studied, and the relevant literature reviewed.@*Results@#The patient was a 58-year-old female who presented with cough and sputum for 1 month. CT scan disclosed a 15 mm nodule in her right middle lobe of lung. The patient underwent a wedge resection with negative margin. Grossly, a well-demarcated peripheral lung nodule was detected, measuring 1.5 cm×1.5 cm×1.0 cm, with myxoid tan-white cut surface containing microcysts. Microscopically, the tumor was composed of bland spindled to stellate-shaped cells widely spaced within prominent fibromyxoid stroma with prominent cystic change. No mitosis or necrosis was present. There were inconspicuous slim curvilinear capillaries and occasional collection of stromal lymphocytes and plasma cells. Immunohistochemically, the tumor cells were positive for vimentin, but negative for CD34, SMA, desmin, S-100 protein, ALK, CKpan, EMA, calretinin and TTF1. Fluorescence in situ hybridization did not show chromosomal translocation involving EWSR1, DDIT3 or FUS genes. The patient was recurrence or metastasis free after follow-up for 38 months.@*Conclusion@#Pulmonary microcystic fibromyxoma is a rare benign lesion that should be differentiated from other lung tumors with myxoid characteristics.
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Objective To analyze the CT and MRI features of pancreatic serous micro-cystic cystadenoma (SMCA).Methods CT and MRI data of 17 patients with SMCA confirmed by pathology were analyzed retrospectively.Tumor's location,diameter,septation,contrast-enhancement features,calcification,central scar, and the extent of pancreaticobiliary duct dilatation were recorded.Results Seventeen patients were enrolled.10 underwent CT,6 underwent MR(2 patients also underwent MRCP), and 1 underwent both CT and MR.Tumors were located at pancreatic head in 2 cases,neck in 2 cases,and body/tail in 13 cases.Lesion size ranged from 1.7 cm to 14 cm with an average of 5.2 cm.Septation was seen in 16 cases.Central scar was seen in 9 cases Septation and scar were enhanced and cystic component was not enhanced on contrast enhancement.6 patients presented the main pancreaticduct dilation.Conclusion Pancreas SMCA has certain imaging features.It is always manifested as lobulated mass with multiple small capsules(<2 cm) and fiber separations.The fiber separation enhance significantly,but lower than normal pancreatic tissue.Central scar is the characteristic manifestation of SMCA, and it manifests iso or slightly lower signal on T1WI and T2WI.Typical SMCA can be diagnosed according to the CT and MR imaging manifestations.
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PURPOSE: To report a case of tamoxifen-induced retinopathy diagnosed using spectral domain optical coherence tomography (SD-OCT). CASE SUMMARY: A 44-year-old female presented with metamorphopsia in the left eye and binocular vision loss which started 5 months prior. She had no record of external trauma, diabetes or high blood pressure; however, she had been taking 21.9 g tamoxifen (20 mg/day) since October 2012 after a surgery of her left breast due to cancer. On the initial visit, fundus photography showed crystalline dot-like deposits in both parafoveae. Additionally, fluorescence angiography revealed a small leakage around the macular area. Optical coherence tomography (OCT) was obtained to differentiate from other diseases because fundus photography showed crystalline retinopathy. The OCT revealed a normal right eye but the left macula had a microcystic lesion. Based on the diagnosis of tamoxifen-induced retinopathy, the patient stopped taking tamoxifen. Three months after discontinuation of tamoxifen, fundus photography showed slightly decreased crystalline deposits in the parafoveal area and visual acuity of the right eye was slightly improved. However, SD-OCT showed a slightly aggravated disruption of the outer retina in both eyes. CONCLUSIONS: Although retinopathy caused by treatment with tamoxifen occurs infrequently, to prevent complications and irreversible damage, patients who take tamoxifen for medical purposes need to undergo a regular ophthalmologic examination.
Subject(s)
Adult , Female , Humans , Breast , Crystallins , Diagnosis , Fluorescein Angiography , Hypertension , Photography , Retina , Tamoxifen , Tomography, Optical Coherence , Vision Disorders , Vision, Binocular , Visual AcuityABSTRACT
Microcystic stromal tumor (MCST) of the ovary is a rare subtype of ovarian tumor first described in 2009. Although high nuclear expression of β-catenin and β-catenin gene (CTNNB1) mutation are related with ovarian MCST, the origin and genetic background of ovarian MCST remain unclear. In this study, two cases of ovarian MCST are presented. Microscopically, the tumors showed a microcystic pattern and regions with lobulated cellular masses with intervening hyalinized, fibrous stroma. Tumor cells of both cases were stained with CD10, vimentin, and Wilms tumor 1. Genetic analysis was performed and β-catenin gene (CTNNB1) mutation in exon 3 was detected in both cases. This is the first report in regards of detecting CTNNB1 mutation in ovarian MCST through the use of pyrosequencing (a novel sequencing technique).
Subject(s)
Female , Exons , Hyalin , Ovary , Vimentin , Wilms TumorABSTRACT
Purpose To study the clinicopathologic features and differential diagnosis of serous microcystic adenoma of pancreas ( SMAP) . Methods Immunohistochemical study was carried out, and the clinical and pathologic features were evaluated in 11 cases of SMAP, and review the literatures. Results The age of onset of 11 cases of SMAP ranged from 41~68 years ( average=55 years) . All of them were females. The clinical presentations were right upper abdominal pain, nausea, vomiting and weight loss. Five tumors located in the pancreas head (45. 5%). Grossly, ten cases were solitary, one case was multiple. The boundary of tumor was clear, the cut surface of tumor was honeycomb. Histologic examination showed that the tumors were made up of small sized capsule wall lining of single-layer flat or cube epithelial cell. The cytoplasm was clear, nucleus was small and no atypical features. Immunohistochemical study showed that all of the 11 cases were positive for CK, CK7, CK18, CK19, EMA, 3 cases were positive for NSE,α-ACT, all of the 11 cases were negative for CgA, Syn, vimentin, TG, Calretinin. Ki-67<1%. Vascular vessels were positive for D2-40 and CD34. Conclusions SMAP is a very rare benign tumor of pancreas. It should be distinguished from oligo-cystic cystadenoma, pseudocyst, mucinous cystadenoma, lymphangioma and capillary hemangioma, mesothelioma.
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La distrofia de Cogan es la distrofia corneal anterior más común, frecuente en adultos del sexo femenino, entre 40-70 años de edad. Presentamos un caso de una paciente de 50 años de edad, del sexo femenino, quien refiere visión borrosa, lagrimeo y fotofobia. Al examen de la córnea en lámpara de hendidura se observan imágenes de color grisáceo en forma de huellas dactilares y de mapa. Esta afección es causada por alteraciones de la membrana basal epitelial que provoca la separación parcial o total del epitelio corneal. Generalmente asintomática, es la causa más frecuente de erosión corneal recurrente. Las opciones terapéuticas varían desde lubricantes, soluciones hipertónicas tópicas, lentes de contacto de vendaje, desbridamiento del epitelio central, micropunciones mecánicas o diatermia y fotoqueratectomía con láser excímer.
Cogan's dystrophy is the most common anterior corneal dystrophy in adult females aged 40-70 years of age. Here is a 50 years-old female patient suffering from blurred vision, weeping eyes and photophobia. On examination, grayish images were observed in the form of fingerprints and map. This disease is caused by alterations of the epithelial basal membrane bringing about partial or total removal of the corneal epithelium. Often asymptomatic, it is the most common cause of recurrent corneal erosion. Treatment options range from lubricants, topical hypertonic solutions, bandage contact lenses, central epithelial debridement, mechanical or diathermy micropuncture and excimer laser photokeratectomy.
Subject(s)
Humans , Female , Middle Aged , Basement Membrane/injuries , Photophobia/diagnosis , Corneal Surgery, Laser/statistics & numerical data , Retinal Dystrophies/diagnosis , Lubricant Eye Drops , Hypertonic SolutionsABSTRACT
Objective To study the clinicopathological features in the diagnosis of serous microcystic adenoma of pancreas.Method A clinicopathological and immunohistochemical study was conducted on 7 patients with serous microcystic adenoma of pancreas.Results All the patients were female,with a mean age of 51 years.Clinical symptoms were present in 2(28.6％)patients.On microscopy,the tumor composed of variable-sized cysts.The cyst wall was covered by simple cuboidal epithelium.The cytoplasm was clear and glycogen-rich.The nucleus of the epithelial cells was small and round.In the center,there was no nucleolus and no nuclear division.There were bulky fibrous tissues between the cystic cavities.Immunohistochemical study showed AE1/AE3,CK7,CK8,CK19,CK/LMW,EMA were positive,and CEA,CD31,CD34,D2-40,Syn,CgA,Calretinin,Vim were negative.Conclusions Serous microcystic adenoma of pancreas is a rare tumor,which was common in old women.Serous microcystic adenoma of pancreas is a benign tumor with good prognosis.The diagnosis is made on histopathological and immunohistochemical study.
ABSTRACT
Serous microcystic adenoma (SMCA) is a rare pancreatic tumor with a striking predilection for elderly females and a rather unique morphology. Classically, the tumor is riddled with innumerable small cysts around a stellate scar. The quintessential histological features are closely placed small cysts lined by glycogen rich cuboidal epithelium. In view of its excellent prognostic outcome, this tumor needs to be accurately diagnosed. This report documents a case of SMCA occurring in a 60-year-old female.
ABSTRACT
Serous microcystic adenoma (SMA) is a rare benign neoplasm. It accounts for 1-2% of all exocrine pancreatic tumors. It is thought to arise from the ductal epithelial cells. It is usually located in the body and the tail of the pancreas. It is important to identify SMAs and distinguish them from mucinous cystic neoplasm, which can be premalignant or malignant, and pseudocyst, which is a non neoplastic condition. We present one such rare case of SMA occurring in the head of the pancreas, an infrequent location requiring a Whippel's resection.
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Objective To investigate the clinicopathologieal features of serous microcystic adenoma of the pancreas. Methods Clinicopathological analysis, histochemieal and immunohistochemical studies were performed in 12 cases of serous microcystic adenoma of the pancreas with follow-up. Results The patients included 9 females and 3 males who ranged in age from 35 to 70 (mean=51.5). Seven patients were discov-ered by check-up incidentally and 5 for the symptoms as upper abdominal uncomfortable or pain. Tumors varied in size from 2.0 cm to 13 cm in maximal diameter(mean=6.0 cm), and all had a multicystic appear-ance. Histologically, all tumors were composed of numerous microcysts lined by a single layer of cuboidal or flattened cells. The tumor cells contained clear cytoplasm with glycogen and centrally located round nuclei mostly uniform without any atypia. Mitoses were very rare or absent. Histochemically, the tumor cells were positive for PAS and negative for AB-PAS. Immunohistochemieally, the tumor cells revealed diffuse positivi-ty of cytokeratins and epithelial membrane antigen, whereas CEA, CgA, Syn, CD34, Vimentin, P53 and S-100 protein were negative. Follow-up in 10 patients (range from 12 to 71 months) showed no recurrence of serous cystadenomas. Conclusion Serous microcystic adenoma of the pancreas is an extremely rare tumor. It is often non-symptomatic. Its diagnosis is mainly dependent on its unique morphological immunohistochemical features. It's biology behavior is necessary to study.
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PURPOSE: Microcystic adnexal carcinoma is a rare malignant appendage tumor, first described by Goldstein et al in 1982. Here, we present our experience in treatment of a case on the lower lip. METHODS: A 52-year-old female with an asymptomatic nodule on the chin, previously misdiagnosed as trichoadenoma by needle aspiration biopsy, was treated by wide excision combined with multiple circumferential frozen biopsies. RESULTS: Pathological examination revealed typical features of microcystic adnexal carcinoma, such as basaloid and squamous cells forming nests and cord-like patterns, horn cysts, and minimal cytologic atypia. The patient has been followed up for 6 months. No sign of recurrence is noted to date. CONCLUSION: Differentiation from other benign adnexal neoplasms is important for its appropriate treatment. Differentiation can be difficult histologically because it is difficult to acquire an adequate biopsy due to its invasiveness, and clinically due to its asymptomatic and slow growing features. Complete excision is the key treatment, but it may not always be the best solution considering the huge defect that may result and the low incidence of metastasis & deaths owing to the tumor. We add this case to the approximately 300 cases reported worldwide with a review of literature.
Subject(s)
Animals , Female , Humans , Middle Aged , Biopsy , Biopsy, Needle , Chin , Horns , Incidence , Needles , Neoplasm Metastasis , RecurrenceABSTRACT
Microcystic adnexal carcinoma is a rare, locally aggressive tumor with a high potential for local recurrence. It usually presents in elderly patients as a solitary, slowly growing, firm, indurated plaque on the face, and particularly on the upper lip or central face. It has occasionally been found in extra-facial locations, including the nipple, axilla and lower extremities, yet scalp involvement has been rarely reported. Histopathologically, it is a poorly circumscribed dermal tumor that shows both follicular and ductal differentiation, and it may extend into the subcutis and skeletal muscle. We report here on a case of microcystic adnexal carcinoma at an unusual site: the scalp. A 42-year-old woman presented with a 6-month history of a painful, solitary, 1 cm-sized, firm, fixed, dome-shaped nodule on the scalp, and this was accompanied by ulceration and oozing. A biopsy specimen demonstrated features of microcystic adnexal carcinoma, with both follicular and ductal differentiation. Immunohistochemical staining for CEA (carcinoembryonic antigen) was positive in the ductal structures, but this was negative in the follicular structures.
Subject(s)
Adult , Aged , Female , Humans , Axilla , Biopsy , Lip , Lower Extremity , Muscle, Skeletal , Nipples , Recurrence , Scalp , UlcerABSTRACT
Microcystic adnexal carcinoma is a rare, locally aggressive tumor with a high potential for local recurrence. It usually presents in elderly patients as a solitary, slowly growing, firm, indurated plaque on the face, and particularly on the upper lip or central face. It has occasionally been found in extra-facial locations, including the nipple, axilla and lower extremities, yet scalp involvement has been rarely reported. Histopathologically, it is a poorly circumscribed dermal tumor that shows both follicular and ductal differentiation, and it may extend into the subcutis and skeletal muscle. We report here on a case of microcystic adnexal carcinoma at an unusual site: the scalp. A 42-year-old woman presented with a 6-month history of a painful, solitary, 1 cm-sized, firm, fixed, dome-shaped nodule on the scalp, and this was accompanied by ulceration and oozing. A biopsy specimen demonstrated features of microcystic adnexal carcinoma, with both follicular and ductal differentiation. Immunohistochemical staining for CEA (carcinoembryonic antigen) was positive in the ductal structures, but this was negative in the follicular structures.
Subject(s)
Adult , Aged , Female , Humans , Axilla , Biopsy , Lip , Lower Extremity , Muscle, Skeletal , Nipples , Recurrence , Scalp , UlcerABSTRACT
The authors report three microcystic meningiomas with its characteristic immunohistochemical findings and chromosomal pattern. Three patients with surgically treated microcystic meningioma were studied for its radiological, histopathological findings, and chromosomal analysis was done in the one patient. Tumors were convexity meningioma in the frontal area. The tumors were enhanced homogenously in the two, and enhanced inhomogenously with multiple small cysts in the other one on preoperative magnetic resonance image. Pathological examination showed marked nuclear pleomorphism, many small cysts, hyaline thickening in blood vessel wall, and mucinous background, compatable to microcystic type. EMA and vimentin were positive on the immunohistochemical stain. Chromosomal analysis showed tetrasomies of chromosome 5, 13, 17, and 20, and trisomies of chromosome 6, 7, 9, 11, 12, 16, 19, and 21, which are quite different from those of benign meningioma.