Acantholytic dyskeratotic epidermal nevus: a rare histopathologic feature.

BACKGROUND: Epidermal nevus is a congenital malformation of the epidermis consisting of verrucoid scaly plaques on the skin, often in a linear fashion. Different histologic features have been seen and, at times, acantholytic dyskeratosis has been observed. We report a new case of acantholytic dyskeratotic epidermal nevus. CASE REPORT: A 3-year-old girl presented, since birth, asymptomatic keratotic scaly lesions on the left hemithorax and left arm that followed Blaschko's lines. HISTOLOGY: Biopsies revealed acanthosis, papillomatosis, hyperkeratosis and focal areas of suprabasal clefting with acantholysis, as well as individual dyskeratotic cells (corps ronds et grains) in the upper layers of the epidermis. In the literature, this histologic feature has been reported twice. Generalized or localized Darier's disease are well-established clinical entities with characteristic histologic features of acantholytic dyskeratosis. Because of the linear clinical appearance and the onset at birth or early childhood, the lesions should be regarded as epidermal nevi and not linear Darier's disease. CONCLUSION: We report here an additional case of dyskeratotic epidermal nevus, which is a rare histopathologic feature.

[Venous thrombosis and cancer]. / Thrombose veineuse et cancer.

The incidence of newly diagnosed cancer is increased, among patients with idiopathic venous thromboembolic event (VTE), six to twelve months after the diagnosis. Among these cancers, the most common sites are colorectal, prostate, pancreas, lung and ovary cancers. However, no study has provided convincing evidence that a patient with idiopathic VTE should undergo an extensive search for underlying cancer. An hypercoagulable state is observed in cancer patients, as shown by abnormal "routine" blood tests found in up to 90% of these patients, as well as increased levels of specific markers of coagulation activation. Clinically, these abnormalities are expressed as thrombosis, hemorrhage or low grade or fulminant disseminated intravascular coagulation. The pathophysiology of this thrombophilic state is complex and due to interactions of tumor cells and their products with host cells. Cancer patients are thus at high risk of thrombosis and so far no biological test can predict the VTE. In special conditions, as surgery or during chemotherapy, prophylaxis with various forms of heparins or oral anticoagulant are recommended.

Introital adenosis associated with the Stevens-Johnson syndrome.

A young woman presented with erosive lesions of the labia minora, which appeared 3 years ago after Stevens-Johnson syndrome. Pathological examination showed 'vulval adenosis'. A similar case has been previously reported. Vaporization by carbon-dioxide laser gave satisfactory results, and after 2 years the patient remains totally cured. We discuss several embryological theories which may explain the mechanism of the vulval adenosis in this patient.

Thyroid plasmacytoma with dermatomyositis and palmar fasciitis.

A 74-year-old woman with a primary thyroid plasmacytoma was studied. Clinical signs included a mass in the neck, as well as muscle and skin involvement due to dermatomyositis. In her serum a monoclonal IgG lambda was present. Immunohistochemistry showed an intracellular monoclonal IgG lambda component. After thyroid surgery and radiation, clinical improvement and fall of M protein were noted. On longterm followup, only palmar fasciitis persisted.

[Scintigraphic detection of pheochromocytoma metastases. Morphologic control apropos of a case]. / Détection scintigraphique des métastases de phéochromocytomes. Contrôle morphologique à propos d'un cas.

The authors report a case of malignant pheochromocytoma. They explain the difficulties of the diagnostic of malignancy which can only be confirmed by metastases. Radioisotope scanning with I131 metaiodobenzyl guanidine is the best available method to locate the primary tumor and the metastases. The results of radio isotope scanning are compared to the ultrastructural study.

[Adeno-myoepithelial proliferation in the breast]. / Les proliférations adéno-myoépithéliales du sein.

The authors report 13 cases of myoepithelial cell proliferation in the breast. One of them is a neoplasm with a predominant myoepithelial component. These proliferations in mastopathies or neoplasms raise important questions concerning differential diagnosis with invasive adenocarcinoma and prognosis.