Pilomatrixoma: features of a case diagnosed by fine needle aspiration with literature review

Pilomatrixoma [PMX] is a benign skin appendage tumor with differentiation toward hair cells, particularly hair matrix. It has classic histomorphology. However, fine needle aspiration cytology [FNAC] diagnosis may be extremely dificult and it can be mistaken for a malignant tumor. To our knowledge there are isolated case reports and some handful of series of cases reported in the literature elaborating cytologic features of PMX. We describe clinical and cytological findings in a 29-year-old male patient with skin nodule on the right upper arm. We also review the literature and conclude that identification of unique constellation of cytological features, e.g., basaloid cells, ghost cells, refractile keratin material and foreign body giant cells etc., in appropriate clinical context are most helpful in diagnosis and obviate unnecessary radical surgery

Adenomatous colorectal polyps in patients referred for colonoscopy in regional hospital in Kuwait

Adenomatous colorectal polyps [ACPs] are known to be the precursor lesions for colorectal cancer. The aim of the study was to determine the prevalence, endoscopic and pathological features of ACPs in patients referred for colonoscopy. The endoscopic and histological reports of adult patients who underwent complete colonoscopy in the gastroenterology unit of a regional Kuwaiti hospital between January 2008 and December 2008 were retrospectively studied. The specimens of polyps were reviewed by an experienced pathologist who was blinded to the clinical or endoscopic information. Non-neoplastic polyps were not included in the analysis. Of 530 eligible patients [mean age, 45 years; male-female ratio, 2:1], 54 [10%] had 103 ACPs. Of the patients with ACPs [mean age, 57 years], 43 [80%] were males and 36 [67%] were Kuwaitis. Histopathological examination of the most significant polyp in each patient revealed that 40 [74%] polyps were tubular adenomas [TAs]; 11 [20%], tubulovillous [TV] adenomas; and 3 [6%], villous adenomas. High-grade dysplasia was noticed in 4 [10%] adenomas. Fifteen [2.8%] of the 530 patients had advanced ACPs. Logistic regression analysis of some variables and their association with ACPs found that age [P<0.001; OR, 1.9; CI, 1.5-2.3], history of adenoma [P=0.001; OR, 6.4; CI, .2.1-19.4] and being Kuwaitis [P=0.029; OR, 2.1; CI, 1.1-4.1] to be independently associated with ACPs. The most common histological type of ACPs was tubular adenoma. Advancing age, being Kuwaiti nationals and prior removal of ACPs were significantly associated with the occurrence of ACPs