Primary cutaneous marginal IgG4 lymphoma and Rosai-Dorfman's disease coexisting in several lesions of the same patient.

We report the unique association of primary cutaneous marginal zone B-cell lymphoma and Rosai-Dorfman disease (RDD)-type histiocytic infiltrates involving the same lesions. The patient was an 82-year-old woman with 3 long-standing, well-circumscribed firm erythematous to brownish plaques on her left arm, right scapular area, and lumbosacral area. Histopathologic examination disclosed a dermal and subcutaneous nodular lymphoplasmacytic infiltrate with evidence of germinal center colonization and light-chain restriction and sheets of S-100 CD68-positive histiocytes with ample pale cytoplasm and occasional emperipolesis of lymphocytes. The neoplastic plasma cells expressed immunoglobulin (Ig) G4. A review of 14 examples of cutaneous RDD showed a substantial number of IgG4-positive cells in only 3 of them, and a review of 8 primary cutaneous marginal zone B-cell lymphomas disclosed only 2 with significant IgG4 expression. The coexistence of lymphomas and RDD has been rarely reported in the literature but only seldom involving the same lymph node and-to the best of our knowledge-never in the skin.

Seminoma en testículo criptorquídico abdominal / Seminoma in an abdominal cryptorchid testis: a case report

Presentamos el caso de un varón de 35 años que consultó de urgencias por un dolor abdominal de corta evolución. Los estudios de imagen mostraron una úlcera duodenal como origen de los síntomas, pero revelaron una gran tumoración retroperitoneal que fue diagnosticada como posible sarcoma. Tras la extirpación el estudio histopatológico mostró un seminoma sobre testículo criptorquídico. El interés del caso es recordar la importancia de la exploración testicular en varones jóvenes con tumoraciones retroperitoneales, cuyo origen puede ser metástasis de un tumor testicular o, como en nuestro caso, un tumor primario sobre testículo no descendido previamente indiagnosticado(AU)

This unusual case serves as a reminder of the importance of testicular examination in young men presenting with a retroperitoneal mass, as the differential diagnosis should include a metastasis from a primary testicular tumour or a primary tumour arising in a previously undiagnosed cryptorchidism. A 35 year old male presented with vague abdominal pain. Imaging studies revealed a pyloric ulcer, the cause of the pain, but also showed a huge asymptomatic retroperitoneal mass. The radiological diagnosis was a primary soft tissue sarcoma. The mass was resected and was found to be a seminoma arising in a non-descended testis(AU)

Immunohistochemical profile of urothelial and small cell carcinomas of the bladder.

Small cell carcinoma of the bladder is an uncommon and rather aggressive bladder tumor, representing less than 1% of all vesical tumors. Small cell carcinoma of different organs has been shown to express markers of neuroendocrine differentiation, and also thyroid transcription factor 1 (TTF-1). TTF-1 is a transcription factor and its expression has been shown mainly in pulmonary small cell carcinomas and adenocarcinomas and in thyroid tumors. Although it was initially proposed as a useful marker to delineate the origin of metastatic adenocarcinomas from the lung, its expression is being increasingly reported in tumors from different origins. The goal of this review is to analyse the immunohistochemical profile of small cell carcinoma of the bladder and to compare it to classical urothelial cell carcinomas. With this aim we have reviewed the small cell bladder carcinomas diagnosed in a single tertiary hospital in Madrid (Fundación Jiménez Díaz) in the last 12 years. We have found 6 pure small cell carcinomas and performed a wide panel of immunohistochemistry, including cytokeratins 7 and 20, enolase, chromogranin, synaptophysin, CD56 and TTF-1 to these tumors and also to 30 high grade urothelial cell carcinomas of usual type. Only one of our small cell carcinoma cases showed positivity for TTF-1, while five expressed CD56 and four neuron-specific enolase. None of our cases expressed cytokeratin 20 or 7. To our surprise we found a case of conventional urothelial cell carcinoma expressing focally TTF-1. These results are in accordance with the current literature, although our rate of TTF-1 expression (16.6%) is on the low end of the spectrum.