ABSTRACT
Mycosis fungoides (MF), the most common type of cutaneous T-cell lymphoma, is a low-grade lymphoma usually occurring after the age of 50 years. We present a case of a 60-year-old man with cutaneous manifestations of MF, who later developed bilateral eyelid ulceration. MF is a highly recalcitrant disease with a relentless course. Our patient highlights a delayed presentation in MF with bilateral upper lid ulcerative lesions, which responded well to systemic chemotherapy, commenced for a visceral indication.
Subject(s)
Eyelid Diseases/etiology , Mycosis Fungoides/complications , Skin Neoplasms/complications , Ulcer/etiology , Biopsy , Diagnosis, Differential , Eyelid Diseases/diagnosis , Humans , Male , Middle Aged , Mycosis Fungoides/diagnosis , Rare Diseases , Skin Neoplasms/diagnosis , Ulcer/diagnosisABSTRACT
Patients with isolated axillary lymphadenopathy are often referred to rapid-access breast clinics for diagnostic evaluation. In the absence of a discernable breast primary, tissue diagnosis has conventionally been pursued using open biopsy. We aimed to assess the value of freehand needle core biopsy (FNCB) as an alternative to this. A prospective audit was conducted over 6 years from 2002 to 2008. Twenty-eight procedures were performed, all carried out under local anaesthesia in the outpatient setting. The majority of cases (10) revealed metastatic breast cancer. Other diagnoses included metastatic ovarian cancer (2), metastatic melanoma (3), lymphoma (4), silicone granuloma (1) and chronic lymphocytic leukemia (1). Seven patients had inconclusive histology necessitating further open biopsy. This revealed primary lymphoma in 6 cases and benign histology in one. FNCB thus avoided the need for diagnostic excision biopsy in 75% (21/28) patients. However, it was found to be less useful in diagnosing de-novo lymphoma.
Subject(s)
Biopsy, Needle/methods , Lymphatic Diseases/pathology , Lymphatic Metastasis/pathology , Neoplasms/pathology , Aged , Diagnosis, Differential , Female , Humans , Middle Aged , Prospective Studies , Sensitivity and Specificity , United KingdomABSTRACT
Although unilateral male breast swelling is relatively common, a histological diagnosis is infrequently obtained. From 1998 to 2003 we routinely performed needle core biopsy on all men presenting with unilateral breast swelling in whom there was diagnostic uncertainty. Of 113 patients, 93% had gynaecomastia, two patients had primary breast cancer and one had metastatic lymphoma. One patient had chronic mastitis. Gamolenic acid treatment produced a 73% response rate amongst patients presenting with pain. Core biopsy is a safe and effective method of diagnosing unilateral male breast swelling, which allows either confident reassurance or definitive treatment of those with cancer or pain.
