Temporal lobe gangliogliomas associated with chronic epilepsy: long-term surgical outcomes.

OBJECTIVE: To review the clinical features and surgical outcome in patients with temporal lobe gangliogliomas associated with intractable chronic epilepsy. METHODS: The Rush University Surgical Epilepsy Database was queried to identify patients with chronic intractable epilepsy who underwent resection of temporal lobe gangliogliomas at Rush University Medical Center. Medical records were reviewed for age of seizure onset, delay to referral for surgery, seizure frequency and characteristics, pre-operative MRI results, extent of resection, pathological diagnosis, complications, length of follow-up, and seizure improvement. RESULTS: Fifteen patients were identified. Average duration between seizure onset and surgery was 14.3 years. Complex partial seizures were the most common presenting symptom. Detailed operative data was available for 11 patients - of these, 90.9% underwent complete resection of the amygdala and either partial or complete resection of the hippocampus, in addition to lesionectomy. Average follow-up was 10.4 years (range 1.6-27.5 years), with 14 patients improving to Engel's class I and one patient to Engel's class III. There were no recurrences, and permanent complications were noted in one patient. CONCLUSIONS: Long-term follow-up of patients with temporal lobe gangliogliomas associated with chronic intractable epilepsy demonstrates excellent results in seizure improvement with surgery and increasingly low incidence of complications with improvements in microsurgical techniques.

Frontal sinus schwannoma: case report and review of literature.

Although schwannomas are frequently found in the head and neck region, sinonasal tract involvement is extremely rare, especially those of the frontal sinus. We report a patient with an incidentally found right frontal sinus lesion. The patient underwent resection of the tumor via a right craniotomy. The histological diagnosis was consistent with a schwannoma. There has been no radiographic recurrence on 2-year follow-up.

Adrenocortical carcinoma presenting with a peritoneal effusion.

In this report, we describe the fine-needle aspiration findings of a case of adrenocortical carcinoma (ACC) that spread to the peritoneal cavity in an 80-year-old female. Cytologically, the peritoneal fluid exhibited clusters and single, small uniform cells with round nuclei and a fine chromatin pattern, which in conjunction with the immunohistochemical stains was diagnostic of ACC. Although ACC is the most common malignant neoplasm of the adrenal gland, its metastatic spread to the peritoneal cavity is exceptionally unusual.

Update on human polyomavirus BK nephropathy.

Polyomavirus BK (BKV) has ebeen identified as the main cause of polyomavirus-associated nephropathy, a major cause of renal allograft failure. Although BKV-associated nephropathy develops in only 2% to 5% of renal transplant recipients, its prognosis when present is very poor, with irreversible graft failure developing in 45% of affected patients. While the use of urine cytology for the detection of decoy cells has been in use for decades, other diagnostic modalities to detect BKV have emerged, including tissue biopsy, polymerase chain reaction, viral culture, and serology. Currently, there is no consensus regarding the laboratory technique best suited for clinical monitoring. This review article will discuss essential and clinical features of polyomavirus, followed by a discussion pertaining to the various diagnostic modalities that contribute to detecting polyomavirus-associated nephropathy.

Extranodal lymphomas: review of clinicopathologic and cytologic features.

Extranodal lymphomas can be challenging for a practicing cytopathologist, especially in the fine needle aspiration clinic setting. These lymphomas can vary in type from one extranodal site to another. A variety of these lymphomas have very specific clinicopathologic features. They also may be associated with underlying autoimmune diseases, immunodeficiency syndromes, infection, or be noted in unique ethnic communities. This article reviews some of the commonly encountered lymphomas in extranodal sites with an emphasis on clinicopathologic and cytologic features.

Right middle lobectomy for a primary pulmonary leiomyoma: a case report.

INTRODUCTION: Primary leiomyoma of the lung is a rare benign tumor that usually presents as a solitary lesion predominantly in young females. Fewer than 100 cases have been reported. Common symptoms include fever, chronic cough, hemoptysis, chest pain, shortness of breath, and pneumonias. CASE PRESENTATION: A 34-year-old, non-smoker female who presented with recurrent pneumonias. She was found to have a primary leiomyoma of the right middle lobe. This was treated by right middle lobectomy. 6-month follow up showed patient doing well without evidence of residual disease on computerized tomography. CONCLUSION: Primary pulmonary leiomyoma is a rare tumor distinct from benign metastasizing leiomyoma. Histologic features include absence of mitotic count, low cellularity, lack of cytologic atypia and pleomorphism. Treatment is by conservative surgical resection and carries a favorable prognosis.