Bilateral pulmonary metastases of papillary thyroid carcinoma in a 12-year-old child-A case report and review of the literature.

Metastatic disease of the lung has been extensively documented in the adult patient population. The most common primary sources for pulmonary metastases include breast, colon gastrointestinal including pancreas and urinary bladder. Malignant lung tumors in pediatric population is extremely rare. However, like in adult patient population, metastases are more common than primary tumors in lung in pediatric patients. Metastatic spread of tumors can occur both by way of hematogenous spread and lymphatic pathways. We present a rare case of biopsy proven metastatic thyroid carcinoma in the lung in a 12-year-old male child masquerading as bilateral miliary nodules on imaging studies. The importance of recognition of this entity in terms of prognosis and treatment is discussed.

Subzero water transport characteristics and optimal rates of freezing rhesus monkey (Macaca mulatta) ovarian tissue.

The purpose of the present study was to examine the effect of two different suprazero (room temperature +25 degrees C to +4 degrees C) cooling conditions on the measured water transport response of primate (Macaca mulatta) ovarian tissue in the presence and absence of cryoprotective agents (CPAs). Freshly collected Macaca mulatta (rhesus monkey) ovarian tissue sections were cooled at either 0.5 degrees C/min or 40 degrees C/min from 25 to 4 degrees C. A shape independent differential scanning calorimeter (DSC) technique was then used to measure the volumetric shrinkage during freezing of ovarian tissue sections at a freezing rate of 5 degrees C/min in the presence and absence of three different CPAs (0.85 M glycerol, 0.85 M dimethylsulfoxide, and 0.85 M ethylene glycol). Thus, water transport during freezing of primate ovarian tissue was obtained at eight different conditions (i.e., at four different freezing media with two different suprazero cooling conditions). The water transport response of ovarian tissue cooled rapidly from 25 to 4 degrees C was significantly different (P < 0.01) than that of slow cooled tissue, in the freezing media without CPAs and with dimethylsulfoxide. However, the differences in the measured water transport response due to the imposed suprazero cooling conditions were reduced with the addition of glycerol and ethylene glycol (statistically different with P < 0.05). By fitting a model of water transport to the experimentally obtained volumetric shrinkage data the best-fit membrane permeability parameters (L(pg) and E(Lp)) were determined. The best-fit parameters of water transport in primate ovarian tissue sections ranged from: L(pg) = 0.7 to 0.15 microm/min-atm and E(Lp) = 22.1 to 32.1 kcal/mol (the goodness of fit parameter, R(2) > 0.96). These parameters suggest that the "optimal rates of cryopreservation" for ovarian tissue are significantly dependent upon suprazero cooling conditions and the choice of CPA.

Freezing response and optimal cooling rates for cryopreserving sperm cells of striped bass, Morone saxatilis.

This study explored the optimization of techniques for sperm cryopreservation of an economically important fish species, the striped bass Morone saxatilis. The volumetric shrinkage or the water transport response during freezing of sperm cells was obtained using a differential scanning calorimeter (DSC) technique. Water transport was obtained in the presence of extracellular ice at a cooling rate of 20 degrees C/min in two different media: (1) without cryoprotective agents (CPAs), and (2) with 5% (v/v) dimethyl sulfoxide (DMSO). The sperm cell was modeled as a cylinder of length of 22.8 microm and diameter 0.288 microm and was assumed to have an osmotically inactive cell volume (V(b)) of 0.6 V(0), where V(0) is the isotonic or initial cell volume. By fitting a model of water transport to the experimentally determined water transport data, the best fit membrane permeability parameters (reference membrane permeability to water, L(pg) or L(pg)[cpa] and the activation energy, E(Lp) or E(Lp)[cpa]) were determined and ranged from L(pg)=0.011-0.001 microm/min-atm, and E(Lp)=40.2-9.2 kcal/mol). The parameters obtained in this study suggested that the optimal rate of cooling for striped bass sperm cells in the presence and absence of DMSO range from 14 to 20 degrees C/min. These theoretically predicted rates of optimally freezing M. saxatilis sperm compared quite closely with independent and experimentally determined optimal rates of cooling striped bass sperm.

An unusual variant of composite lymphoma: a short case report and review of the literature.

We recently encountered an unusual case of composite lymphoma arising in a 73-year-old man with a history of follicular small cleaved cell lymphoma. The neoplasm was composed of follicular small cleaved cell lymphoma and nodular sclerosing Hodgkin disease within a single groin lymph node. In addition to morphologic evidence, the immunologic studies performed in this case demonstrated the simultaneous occurrence of 2 separate lymphocytic proliferations. To the best of our knowledge, only one such histologic type has been reported in the literature.1 Hodgkin lymphoma can develop in patients with non-Hodgkin disease and vice versa, especially after treatment. The simultaneous occurrence of Hodgkin disease and non-Hodgkin lymphoma in a single lymph node is extremely rare. In this article, the relationship between Hodgkin disease and non-Hodgkin lymphoma is explored, possible explanations for the occurrence of composite lymphoma are discussed, and the literature is reviewed.

Diagnostic pitfalls in fine needle aspiration cytology of pleomorphic lipoma. A case report.

BACKGROUND: Pleomorphic lipoma is an unusual pseudosarcomatous condition with characteristic morphology. Despite its pleomorphic appearance, it follows a benign course and does not recur or metastasize if completely excised. CASE: A 66-year-old man presented with swelling in the back of the neck of approximately six months' duration. The focally cellular aspirate revealed round to oval, hyperchromatic cells, rare multinucleated cells and fragments of mature adipose tissue. On initial evaluation, the smear pattern suggested a malignant neoplasm. However, upon review of the cytologic material along with histology, the characteristic pattern, including floret cells, was recognized. CONCLUSION: The rarity of pleomorphic lipoma and the atypical cellular features of the aspirate can cause difficulty in diagnosing this entity. Awareness of this rare but not-uncommon entity, along with clinical correlation, is crucial in arriving at the correct diagnosis.

A simple yet effective technique to improve laboratory safety for the grossing of large surgical specimens.

In this article we describe a simple technique to avoid accidential needle stick injuries while grossing large specimens. Rubber bands instead of needles and Plexiglas instead of wax board is used to eliminate needle stick injuries. This method is quite simple and imprints of rubber bands do not interfere with gross anatomy of the specimen.

Prevention of carcinoma of cervix with human papillomavirus vaccine.

BACKGROUND: Carcinoma of cervix is the most common cancer found among the women of India. Though cervical cytology screening was effective in preventing carcinoma of cervix in developed nations, it is considered unsuitable in developing countries. Recent research has established an etiological link between human papillomavirus infection and carcinoma of cervix. In this review, an attempt is made to answer the question, 'whether carcinoma of cervix can be prevented with human papillomavirus vaccine?' METHODS: Literature search using Pubmed and Medline was carried out and relevant articles were reviewed. RESULTS: There is ample experimental evidence to show that DNA of human papillomavirus integrates with cervical cell genome. Viral genes E6 and E7 of HPV type 16 and 18 inactivate p53 function and Rb gene, thus immortalize the cervical epithelial cells. Recombinant vaccines blocked the function of E6 and E7 genes preventing development of papillomas in animals. Vaccination with HPV-VLPs encoding for genes of E6 and E7 neutralizes HPV integrated genome of malignant cells of uterine cervix. CONCLUSIONS: Based on experimental evidence, it is possible to prevent carcinoma of cervix with human papillomavirus vaccine, IMPLICATIONS: Further research is necessary to identify a effective and safe HPV vaccine, routes of administration and characteristics of potential beneficiaries.

Thrombotic thrombocytopenia purpura: a single institution experience.

TTP is a disease with protean manifestations leading to errors in diagnosis. Critical reevaluation of a single observer's experience at LIJMC over a 7-year period is compared to that in published literature. We retrospectively analyzed presentation, clinical course, treatment, and outcome of 15 patients treated for TTP between 1990 and 1997 by one of the authors (V.C.). Minimal diagnostic criteria for TTP were unexplained moderate to severe thrombocytopenia (platelet count <100,000/cmm), microangiopathic hemolytic anemia, with or without low grade fever, and no other attributable etiologies. Neurologic and/or renal dysfunction constituted severe grade. Age range was 5-86 years, with one patient age 5, the youngest yet to date reported with classic TTP. Female to male ratio was 2:1. Overall survival rate was 87%; 40% of patients experienced immediate relapse within the first 4 weeks of presentation; and predisposing causes for immediate relapse appear to be intercurrent infections and severity of presentation. There was a 40% incidence of late relapses of TTP. Two patients with an unusually high number of late recurrences (6 and 16) were HCV-Ab positive and the possible role of persistent HCV infection in recurrent TTP was explored.

Skeletal metastases from a granulosa-cell tumor of the ovary: report of a case diagnosed by fine-needle aspiration cytology.

We report on the fine-needle aspiration cytological findings of a metastatic granulosa-cell tumor of the ovary to bone. The patient had undergone resection of a primary ovarian granulosa-cell tumor 15 yr prior to her last admission. Recently she injured her right hip, sustained after a fall. CT examination revealed hypodense lesions involving the posterior body and the right pedicle of the L1 vertebra. The aspirate from the bone yielded a highly cellular smear, composed of round to oval cells with scanty cytoplasm. Many of the cells revealed the presence of nuclear grooves. In areas, the cells were arranged in clusters resembling Call-Exner bodies. The rarity of skeletal metastases from granulosa-cell tumors can cause diagnostic difficulty in diagnosing this entity. Accurate clinical data, radiological findings, and cytological features are important in arriving at the correct diagnosis.