Melanoma gástrico sin origen primario conocido / Gastric melanoma without well-known primary origin

El melanoma maligno es una neoplasia derivada de los melanocitos, que equivale al 5 por ciento de las neoplasias cutáneas. El 95 por ciento de los melanomas se desarrolla en la piel y menos de 3 por ciento corresponde a melanoma metastásico sin evidencia de tumor primario. En el tracto gastrointestinal, la afectación por melanoma es debido la mayoría de las veces a metástasis. El melanoma primario gastrointestinal está descrito que afecta a la zona anorrectal, seguido de esófago. El melanoma gástrico primario es un tumor excepcional, existen muy pocos casos documentados en la literatura. Presentamos el caso de un paciente con un melanoma en estómago como primera manifestación de la enfermedad y hacemos una revisión del estado actual(AU)

Malignant melanoma is a melanocyte-derived neoplasm and accounts for 5 percent of skin neoplasms. Ninety five percent of melanomas appear on the skin and less than 3 percent are metastasic melanoma without primary tumor evidence. In the gastrointestinal tract, most of cases of melanoma are metastasic. Primary gastrointestinal melanoma appears mostly in anorectal area followed by the esophageal area. Primary gastric melanoma is a very rare tumor, and there are very few cases reported in scientific literature. This is the report of a male patient with gastric melanoma as first sign of disease and a review of the present condition of the illness(AU)

[Inflammatory malignant fibrous histiocytoma of the spermatic cord infiltrating an inguinal leiomyoma. Case report with conceptual and bibliographic reviews]. / Fibrohistiocitoma maligno "inflamatorio" de cordón espermático con infiltración sobre un leiomioma inguinal. Presentación de 1 caso con revisión conceptual y de la literatura.

OBJECTIVES: To study paratesticular malignant fibrous histiocytomas (FHM) from the clinical, histological, immunohistochemical and histogenetic, point of view. METHODS: Through Medline and not index-linked search of international scientific literature we have found a total of 77 cases of paratesticular FHM that globally create diagnostic, terminological and therapeutic problems. RESULTS: We include the case number 78 of FHM of spermatic cord, that presents a few special characteristics (not described before) of cutaneous fistula and infiltration of an inguinal leiomyoma, with histological and immunohistochemical confirmation. We performed a conceptual review of this type of tumours, including the evaluation of contradictions and reclassifications that has undergone from its first description, which causes that they are underestimated and their real prevalence in international series is very variable: from 7 to 37% of paratesticular sarcomas. Also, the fact of their low incidence has determined the lack of protocols for diagnosis and treatment. CONCLUSIONS: Paratesticular tumours, although infrequent, have a high rate of malignancy. The FHM concept has varied throughout the last 15 years. Today, this term is synonymous of pleomorphic undifferentiated sarcoma and has been an exclusion diagnosis (Vimentin [+]/ CD 68 [+]--occasionally--without ultrastructural differences), reserving the inflammatory subtype for which they have an inflammatory and histiocytic component. The accomplishment of an intraoperatory biopsy is essential in this location, since it is even difficult to know preoperatively, if a lesion is benign or malignant. The differential diagnosis is only solved after microscopic and inmunohistochemical study. Leiomyoma next to this location (inguinal) could be diagnosed and confused with a nodule of the main FHM. Their immunophenotype allowed us to diagnose it not only as leiomyoma (myogenic markers were positive -non skeletal muscle-), but also to observe the infiltration by the FHM.

Fine needle aspiration cytology of clear cell carcinoma of the gallbladder with hepatic infiltration: a case report.

BACKGROUND: Clear cell carcinoma of the gallbladder (CCG) is an unusual histologic variant recognized in the World Health Organ ization classification of tumors of the gallbladder and extrahepatic bile ducts. Although the clinicopathologic features have been documented in a few reports, to our knowledge the cytologic findings have not been described before. We report the fine needle aspiration cytology (FNAC) findings in a case of CCG with hepatic infiltration. CASE: A 72-year-old woman presented with right upper quadrant pain and hepatomegaly. Serum levels of CA19-9 and alpha-fetoprotein were elevated. Computed tomography revealed several hepatic nodules, the larger of which was a mass in contact with the gallbladder, which had a thickened wall. FNAC showed loose sheets and disassociated cells with abundant, clear, finely vacuolated cytoplasm. Atypical bare nuclei, binucleated cells and some multinucleated cells were also found. A simultaneous trucut biopsy from the main hepatic mass confirmed the diagnosis. CONCLUSION: CCG is a clear cell neoplasm that should be considered when clear changes are observed on FNAC. Recognition of the cytologic features, together with adequate clinicoradiologic study, may be sufficient to establish the diagnosis.

Marginal zone B-cell lymphoma of the parotid gland associated with epithelioid granulomas. Report of a case with fine needle aspiration.

BACKGROUND: Although granulomas can occur in association with malignant neoplasms, including some subtypes of lymphoma, they have been described rarely in marginal zone B-cell lymphoma (MZCL). To our knowledge, the cytologic features of this association have not been documented. We present the cytologic findings with fine needle aspiration cytology (FNAC) of an unusual case of MZCL with concomitant granulomas. CASE: An 82-year-old male presented with a mass in the left parotid gland. The lesion was evaluated by FNAC. The smears showed syncytial aggregates of epithelioid histiocytes intermixed with small and medium-sized lymphoid cells containing round to irregular-shaped nuclei and small nucleoli. Some of these cells had a greater amount of cytoplasm and frequently had a plasmacytoid appearance. The lesion was removed, and histopathologic study showed MZCL associated with extensive nonnecrotizing granulomas. CONCLUSION: Granulomatous reactions can be seen in rare cases of MZCL. However, the cytologic features of the lymphoid infiltrate can suggest the possibility of MZCL in the clinical setting of FNAC performed from an extranodal location, such as the parotid gland.

Lymphoepithelioid cell lymphoma (Lennert's lymphoma). Report of a case with fine needle aspiration cytology.

BACKGROUND: Lymphoepithelioid cell lymphoma (LCL) is a rare morphologic variant of peripheral T-cell lymphoma. Although their histopathologic and immunohistochemical findings are well known, the cytopathologic features have not been well documented. This report describes the fine needle aspiration cytology (FNAC) findings of a case of LCL. CASE: A 75-year-old woman presented with cervical, supraclavicular, axillary and mediastinal lymphadenopathy. FNAC of a cervical lymph node was performed. The smears contained a polymorphous infiltrate formed by abundant histiocytes disposed singly or in clusters, small and medium-sized to large atypical lymphoid cells and reactive cells, including eosinophils and plasma cells. Isolated capillary-sized vessels also were observed. Histopathologic and immunohistochemical examination confirmed the diagnosis of Lennert's lymphoma. CONCLUSION: Although histopathologic and immunohistochemical studies were required for a definitive diagnosis, the findings of FNAC in this case appeared distinctive and suggested the possibility of LCL.

Proliferación nodular y difusa fibrosa de la túnica vaginal del testículo Presentación de un nuevo caso y revisión de la literatura / Nodular and diffuse fibrous proliferation of the tunica vaginalis testis. Report of a new case and a review of the literature

Se presenta un caso de proliferación nodular y difusa fibrosa de la túnica vaginal testicular en un varón de 28 años de edad con 3 años de evolución. La exploración física mostró una masa escrotal firme en el testículo izquierdo. En el acto quirúrgico se observó una cubierta endurecida, multinodular, en la túnica vaginal de dicho testículo. La impresión intraoperatoria fue la de un tumor de músculo liso benigno y la lesión fue extirpada. Macroscópicamente correspondía a una masa firme, multinodular y difusa de la túnica vaginal. Microscópicamente se correspondía con un pseudotumor fibroso formado por tejido conectivo denso hialinizado y fibroblastos con un pequeño número de agregados linfoides en la perifería de la lesión (AU)

Fine needle aspiration cytology of neurothekeoma. A case report.

BACKGROUND: Neurothekeoma (NT) is a rare, benign neoplasm of soft parts with a distinctive histologic appearance. To our knowledge, the cytologic findings have not been described before. We present a case of NT with the cytologic features on fine needle aspiration cytology (FNAC). CASE: A 54-year-old female presented with a circumscribed nodule in the left breast. The lesion was evaluated by FNAC. The smears showed an abundant, metachromatic, myxoid matrix with fusiform and epithelioid cells, some binucleated or multinucleated, loose or in groups and sometimes forming concentric whorls. The lesion was removed, and the diagnosis of NT was made after histopathologic study. CONCLUSION: NT is an extremely rare neoplasm in the mammary region. Fusiform and epithelioid cells arranged in concentric whorls in a myxoid tumor of soft tissue are a distinctive characteristic of this neoplasm and can suggest the diagnosis.