Juvenile papillomatosis of the breast in young male: a case report.

Juvenile papillomatosis of the breast ("Swiss cheese disease'') is a benign localized proliferative condition of the breast which occurs almost exclusively in young adult women. Patients with this lesion often have a family history of breast carcinoma, but rarely carcinoma may coexist with the lesion at the time of diagnosis. We present a case of a young male with juvenile papillomatosis of the breast. The pathology and clinical management of this rare lesion is discussed.

Long-term safety and tolerance of silicone and self-expandable airway stents: an experimental study.

BACKGROUND: A variety of respiratory stents are currently available, but the ideal airway prosthesis seems far from being recognized. The objective of this study was to verify safety and long-term effect on the bronchial wall of three different types of airway stents. METHODS: Twelve healthy adult sheep were divided in three groups, scheduled to receive: (1) bare self-expandable metallic stents (Gianturco); (2) silicone stents (Dumon); and (3) covered self-expandable synthetic stents (Polyflex). Insertions were performed through a rigid bronchoscope under general anesthesia. Chest roentgenogram was performed 1 and 6 months after surgery, and flexible bronchoscopy after 6 months. Twelve months postoperatively, the animals were killed and a postmortem examination was carried out. RESULTS: All Polyflex stents migrated during the observation period; one late migration was observed in the Dumon group. Microscopic study showed: (1) Gianturco stents: full-thickness perforation of the bronchial wall covered by a thick layer of a chronic inflammatory infiltrate. Infection by Candida at the bottom of some ulcerations; (2) Dumon stents: mild bronchial inflammation (squamous metaplasia, submucosal inflammatory infiltrates; granuloma-like infiltrates). In case of displacement, no significant changes of the previously stented bronchus occurred; and (3) Polyflex stents: no changes of the previously stented bronchi. CONCLUSIONS: Gianturco stents proved unsafe in the long term, owing to the risk of severe airway wall damage. The Polyflex stent is well tolerated but presents a high migration rate. Silicone stents show several limitations but appear to be well tolerated by the host mucosa.

Lymphoepithelial cyst of the pancreas. Report of a case diagnosed by fine needle aspiration biopsy.

BACKGROUND: Lymphoepithelial cysts of the pancreas are very rare lesions. To the best of our knowledge, 24 cases are reported in the literature. CASE: A 64-year-old male presented with gastrointestinal complaints. A computed tomography scan of the abdomen disclosed a 55 x 30-mm, homogeneous mass anterior to and contiguous with the pancreas. Fine needle aspiration biopsy (FNAB) showed threads of tissue composed of stratified squamous epithelium with subepithelial lymphocytic infiltrate and keratinous material. CONCLUSION: This case illustrates that FNAB is a rapid and reliable technique that can be used as the first diagnostic step in cases of cystic lesions of the pancreas. To our knowledge, this is the third case reported of this entity diagnosed with FNAB.

Fine needle aspiration biopsy of salivary gland, 1985-1995.

OBJECTIVE: To evaluate the utility of fine needle aspiration biopsy (FNAB) in the study of salivary gland pathologies and to assess its capacity to provide an accurate diagnosis and discriminate between cases requiring surgery or not. STUDY DESIGN: From January 1985 through December 1995, FNABs were carried out on 153 patients with salivary gland tumors. In 4 of the 153 cases the aspiration was inadequate. Of the remaining 149 FNAB diagnoses, 63 were checked histologically and 86 clinically. RESULTS: Regarding the capacity to discriminate between neoplastic (malignant and benign) and nonneoplastic lesions FNAB correctly diagnosed 144 lesions (135 true negative [TN] and 9 true positive [TP]) and failed in 5 cases (false negative [FN]). Regarding the capacity to discriminate between tumors requiring surgery or not, the FNAB diagnoses were true in 146 cases (83 TP, 63 TN) and false in 3 (2 FN, 1 false positive). The values for sensitivity, specificity, negative predictive value and total diagnostic accuracy were 97.64%, 98.43%, 96.92% and 97.98%, respectively. CONCLUSION: FNAB has an impact on the treatment of salivary gland masses. The data on its ability to distinguish between lesions requiring surgery or not are encouraging.

Fine needle aspiration biopsy diagnosis of a bone metastasis from an occult carcinoma of the liver. A case report.

In a 66-year-old male, fine needle aspiration biopsy (FNAB) of an osteolytic vertebral lesion determined the diagnosis of a liver cell carcinoma, until then clinically silent. FNAB confirmed the diagnosis of the tumor and the identification of the primary site without resorting to surgery.

Fine needle aspiration biopsy in the diagnosis of intrathoracic masses.

During a 3.5-year period (January 1, 1987, to June 30, 1990) 420 percutaneous fine needle aspiration (FNA) biopsies were performed on 390 patients (309 males, 81 females) suffering from one or more intrathoracic, radiologically visible lesions. Aspirations were carried out using 21- or 23-gauge Chiba needles under fluoroscopic or computed tomographic control. The aspirates were used to make minibiopsies and cytologic smears. Diagnosis was possible in 373 cases (95.64%): on the first pass in 344 cases, on the second in 28 cases and on the third in 1. In 17 cases (4.36%) the aspirate was inadequate for diagnosis. There were complications in 10 cases (2.56%) (9 pneumothorax and 1 hemophtysis) requiring intensive care. The 373 percutaneous FNA biopsy diagnoses included 256 malignant tumors (68.63%), of which 234 were primary and 22 were secondary, and 117 benign lesions (31.37%), 5 of them neoplastic and 112 nonneoplastic. Three hundred two of 373 percutaneous FNA biopsy diagnoses were followed (80.96%). One hundred twenty-three follow-ups were histologic (40.73%), including secondary tumors, which could be compared with the primary histotype. Twenty-eight follow-ups were cytologic (9.27%), and 151 were clinical (50.00%), using progression of the disease or the beginning of chemoradiotherapy as a criterion for malignancy and a stable condition or regression of the lesion with nononcologic medical treatment as a criterion for benignity. Percutaneous FNA biopsy diagnoses were confirmed in 288 cases (221 true positives and 67 true negatives) and unconfirmed in 14 (1 false positive and 13 false negatives). Specificity, sensitivity, negative predictive value, positive predictive value and total diagnostic accuracy were, respectively, 98.52, 94.44, 83.75, 99.54 and 95.36%. The histologic typing accuracy of percutaneous FNA biopsy on 70 specimens of surgically removed malignant epithelial neoplasias was 70.00%. These results confirm that percutaneous FNA biopsy is a reliable method of diagnosing intrathoracic masses and reduces the need for diagnostic thoracotomy.