ABSTRACT
Emperipolesis is a biological process defined by the presence of an intact cell within the cytoplasm of another cell. In pleural fluid cytology, the phenomenon is very rare but has already been described in B-cell lymphoma. Here, we report the first case of a T-cell lymphoma diagnosed on a pleural fluid exhibiting extensive emperipolesis of tumor cells by mesothelial cells. Additionally, in order to evaluate the prevalence of emperipolesis in lymphocyte rich pleural effusion cytology, we reviewed cases from our archive, including cases with lymphoma and cases with reactive T-lymphocyte rich effusion.
Subject(s)
Emperipolesis , Epithelial Cells/pathology , Mediastinal Neoplasms/pathology , Pleural Effusion, Malignant/pathology , Precursor T-Cell Lymphoblastic Leukemia-Lymphoma/pathology , Cytodiagnosis , Humans , Lymphocytes/pathology , Male , Middle AgedABSTRACT
We report the case of a previously healthy young man who presented to the hospital with hemoptysis and dyspnea. Hemoptysis is a frequently encountered symptom in daily routine and investigations can easily be deferred to a longer time frame. Our case illustrates the importance of a prompt investigation and treatment of underlying causes. Furthermore one should not hesitate to include rare, yet life threatening conditions in differential diagnosis.
Subject(s)
Anti-Glomerular Basement Membrane Disease/diagnosis , Cocaine-Related Disorders/complications , Cocaine/toxicity , Hemoptysis/etiology , Hemorrhage/etiology , Pulmonary Alveoli/drug effects , Pulmonary Alveoli/pathology , Adult , Anti-Glomerular Basement Membrane Disease/pathology , Anti-Glomerular Basement Membrane Disease/therapy , Autoantibodies/blood , Bronchoscopy , Diagnosis, Differential , Hemoptysis/pathology , Hemoptysis/therapy , Hemorrhage/diagnosis , Hemorrhage/pathology , Humans , Male , Tomography, X-Ray ComputedABSTRACT
Most commonly, patients with pulmonary embolism present with dyspnea, chest pain, and/or tachypnea to the emergency department (ED). The presence of multiple suggestive symptoms, especially when severe, significantly reduces delay in diagnosis. We report a case of an 86-year-old patient presenting to the ED with nonspecific complaints: she claimed to feel lethargic and "reluctant to prepare meals." She did not complain of either dyspnea or chest pain. As underlying cause, an intrapulmonary cavitation with pulmonary embolism was found. The combination of absence of specific symptoms regarding pulmonary embolism and radiologic findings of an obstructed pulmonary artery supplying the cavitary lung segment is rare. Common etiologies of cavitary lung processes are discussed, and risk factors of pulmonary infarction are highlighted.
