Fine needle aspiration cytology of small cell neuroendocrine carcinoma of the breast. A case report.

BACKGROUND: Neuroendocrine tumors, usually small cell (oat cell) carcinomas, are almost always primary in the lungs and are highly malignant. Similar tumors have recently been described to occur in various extrapulmonary sites, such as the uterine cervix and prostate. We report a primary neuroendocrine carcinoma of the breast in a female first diagnosed by fine needle aspiration biopsy (FNAB). Search of the literature revealed only three other reports of small cell carcinoma of the breast, one in a male and two in a female, thus making this the third documented case of neuroendocrine carcinoma of the breast in a female. CASE: A 45-year-old, black female presented with a firm, nontender mass at the tail of her left breast. FNAB showed atypical epithelial cells with pale nuclei and inconspicuous nucleoli. An excisional biopsy performed one week later showed microscopically a predominantly solid and syncytial pattern of small cells that appeared spindly in places. It had a high mitotic count, and the stroma was rich in lymphocytes and plasma cells. Immunohistochemical and ultrastructural studies confirmed the diagnosis. CONCLUSION: Small cell (neuroendocrine) mammary carcinoma is a rare entity but does occur and can be diagnosed by FNAB. It does not differ essentially from other mammary neoplasms with regard to prognosis.

Periosteum-wrapped alloplasts for reconstructive head and neck surgery.

Methylmethacrylate is widely used by orthopaedic and neurosurgeons for bone reconstruction. However, there is not much information about the interaction between methylmethacrylate and soft tissues. A prospective canine study was designed to examine the morphologic and histologic aspects of the use of methylmethacrylate with soft tissues. A previous study has shown that by wrapping the prosthesis with dense connective tissue, such as periosteum, better results can be achieved in tracheal reconstruction. Ten wrapped and 10 unwrapped pieces of methylmethacrylate were implanted in dogs, and were removed at intervals of 2, 4, 8, 11 and 16 weeks. Gross morphologic and histologic examination showed better incorporation of the wrapped implants into the surrounding soft tissues with less inflammation when compared to the unwrapped pieces. We suggest that connective tissue wrapped methylmethacrylate alloplasts are better tolerated by surrounding soft tissues and may lead to improved reconstructive results.

Inflammatory pseudosarcoma (pseudotumor) of the bladder.

Inflammatory pseudosarcoma of the bladder is a rare benign entity that cannot be differentiated from malignant tumor at radiologic examination alone. Only pathologic examination can enable a definitive diagnosis. The authors report two cases of these benign tumors in patients with no history of bladder disease or trauma; the tumors were large, demonstrated invasion into local tissues, and recurred in one case after incomplete transurethral resection.