Mesenchymal hamartoma of the chest wall in infants and children: a clinicopathological study of five patients.

Mesenchymal hamartoma of chest-wall is a rare benign lesion that has varied histological characteristics and usually occurs during early infancy. We report the histological characteristics of mesenchymal hamartoma found in five patients aged respectively 25 days, 5 months, 8 months, and 4 and 8 years at presentation. Two patients presented with respiratory distress, two with an asymptomatic chest-wall mass, and one with a deformity of the left chest wall. Surgical resection was performed on four patients and a biopsy only in one patient. Overall, the tumors were well delineated, lobulated, tan to reddish in color, and on section showed blood-filled cystic spaces with interspersed small islands of cartilage and fibrous tissue. Histological analyses demonstrated mixtures of bone trabeculae with spindle-cell stroma, chondroblast-like proliferation, mature and immature hyaline cartilage, and aneurysmal bone cyst formation. All patients are alive and well without evidence of disease. Despite the alarming clinical and histologic presentation, mesenchymal hamartoma of the chest wall is a non-neoplastic benign lesion.

Functional parathyroid carcinoma. Cytology, histology, and ultrastructure of a case.

A case of a functional parathyroid carcinoma that recurred 1 year after being resected is presented. The clinical and laboratory data and the histologic structure are presented with confirmatory electron microscopy. The preoperative aspiration biopsy showed findings suggestive of parathyroid carcinoma although simultaneous core biopsy results were reported as parathyroid adenoma. The differential cytologic diagnosis with thyroid neoplasms is discussed.

El uso de varios métodos diagnósticos en la evaluación pre-operatoria del nódulo tiroideo / The use of different diagnostic methods in the preoperative evaluation of thyroid nodule

En los últimos años hemos reunido un grupo de 90 pacientes con patología tiroidea diversa, principalmente nódulos solitarios que han sido evaluados con diferentes procedimientos diagnósticos y hemos analizado la utilidad de cada uno de ellos para establecer el diagnóstico pre-operatorio. Los procedimientos utilizados fueron; gammagrafía con 131 I, gammagrafía con 99 m Tc, ultrasonografía, citología por aspiración con aguja fina y biopsia por punción percutánea. En 94.4% de los pacientes al sexo femenino y en 66% de ellos la edad oscilló entre los 21 y 50 años. La presencia de lesiones no captante (frías) con 131 I o con 99 m Tc no esta blece el diagnóstico de cáncer de tiroides pero indudablemente constituye un signo de alto riesgo. El estudio ultra-sonográfico es también de utilidad y de acuerdo con nuestros resultados pudimos establecer que la presencia de lesiones quísticas reduce las posibilidades de un carcinoma. La citología por aspiración con aguja fina nos permite establecer el diagnóstico corecto en el 81.4% de los casos estudiados y la biopsia por punción percutánea establece el diagnóstico correcto en el 87.1% de los casos. Cuando en el mismo paciente se usaron ambos métodos el diagnóstico correcto se estableció en todos ellos. Concluimos que en la evaluación pre-operatoria de las enfermedades tiroideas los métodos más útiles por ser sencillos, libres de complicaciones importantes y económicos son la citología por aspiración con aguja fina y la biopsia percutánea de tiroides

Giant cell reparative granuloma of the cranial vault: exceptional bone lesion.

Giant cell reparative granuloma (GCRG) is an uncommon nonneoplastic lesion of bone. It is even rarer in the bones of the skull, particularly in the calvarial bones. Originally considered to be peculiar to the jawbones, GCRG has been described in some other locations, such as the short tubular bones of the hand and the facial (paranasal) bones. Only one GCRG has been found in the skull, this one in the temporal bone. The authors were unable to find a report of such a lesion in the bones of the calvarium. The etiology of GCRG is unknown, but it is believed to result from a traumatic intraosseous hemorrhage or periosteal reaction. A GCRG was diagnosed in a 31-month-old male infant who presented with a nonpainful, slow-growing, right frontal swelling, apparently related to a head contusion that had occurred 21 months earlier. The lesion was removed surgically. The main differential diagnosis is giant cell tumor.

Hemosiderosis pulmonar idiopatica. / Idiopatic pulmonary hemosiderosis

Se presenta el caso clinico de un nino de 13 anos de edad, con manifestaciones clinicas, radiologicas y de laboratorio compatibles con hemosiderosis pulmonar idiopatica (HPI), la cual se corroboro mediante estudio de biopsia pulmonar. El tratamiento fue a base de prednisona, con evolucion satisfactoria y desaparicion de la sintomatologia clinica

Transient embolic aorto-arteritis. Presentation of a patient.

The clinical and postmortem data from a 14-year-old girl who had transient embolic aorto-arteritis are presented. This disease was first described in 1974 by Peiris and Wickremasinghe in Hindu patients and is characterized by repetitive embolic occlusion of intra- and extracranial vessels of the brain, originating from focal thrombotic lesions in the aorta and its primary branches. The main histopathological lesion is located in the elastic tissue of the media in these arteries with alterations that vary from mild arteritis of the vasa vasorum to degeneration and destruction of the media which predisposes to aneurysm formation. This new entity apparently affects only adolescents and young adults and has no relation to atherosclerosis or other non-specific arteritides previously described. To our knowledge, this is the first such patient reported in America.