Dedifferentiated primary mediastinal liposarcoma mimicking a thymic tumor.

Mediastinal tumors are heterogeneous and the diagnosis depends on their location in the mediastinum. The most frequent tumors are germinal tumor, lymphoma and thymoma. The clinical and radiological aspects are often not sufficient to orient the diagnosis and biopsy is necessary to confirmed it. Here, we present a rare case of an anterior mediastinal mass incidentally detected in a 63 years old man during assessment for asthma. The lesion was presumptively diagnosed as a thymic epithelial tumor based on location and radiological characteristics. Surgical biopsy revealed a primary dedifferentiated mediastinal liposarcoma with multiple lung metastases.

Health Technology Assessment: introducing a vacuum-based preservation system for biological materials in the anatomic pathology workflow.

INTRODUCTION: The objective of this work is to assess the implementation of a newly introduced medical equipment technology for the vacuum-based preservation of biological materials within an Anatomic Pathology service. METHODS: The approach selected for the analysis is the Health Technology Assessment (HTA ), a comprehensive evaluation method based on relevant scientific evidence and designed to support healthcare decision makers in purchasing, replacing or disposing of technologies. The analysis focused on specific domains such as Technology, Organization, Safety and Economy. RESULTS: The study proves that the use of such technology ensures the biological specimen to be suitably preserved (up to 72 hours), both reducing the amount of fixative being employed in the diagnostic process (30% to 55%) and resulting, in the particular context under examination, in savings of 93%. DISCUSSION: The HTA reported no significant drawbacks related to the use of the technology being examined. Nonetheless, the workflow for managing the transfer of biological materials from the Operating Room to the Anatomic Pathology department needs to be redefined - in terms of handling, processing, storage and disposal. Other elements concerned the monitoring of storage temperature, fresh tissue handling and especially fixative amount reduction, which positively impacts on the operators' safety with regard to chemical hazards.