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1.
Lung ; 198(1): 31-33, 2020 02.
Artículo en Inglés | MEDLINE | ID: mdl-31583455

RESUMEN

Electronic cigarettes, pens, cartridges and other devices were developed as nicotine delivery systems not requiring combustion of tobacco leaves. This technology was subsequently employed to deliver the cannabis component tetrahydrocannabinol (THC) via products often manufactured without adequate quality oversight and sold illegally. Recently, five patients presenting within a 2-month period with acute respiratory failure due to acute lipoid pneumonia after inhaling THC-containing concentrates or oils have been described. We report a 28-year-old previously healthy man who presented in acute respiratory failure 2 weeks after initiating use of a street-purchased THC-containing vape cartridge. Bronchoalveolar lavage cytology with oil red O staining confirmed the diagnosis of acute lipoid pneumonia. Diffuse alveolar hemorrhage and eosinophilic pneumonia were excluded. Evolving evidence supports a clinical entity of acute respiratory failure due to acute, exogenous lipoid pneumonia induced by THC-containing concentrates or oils inhaled through a variety of vaping products. All six patients reported to date received intravenous corticosteroids and survived to hospital discharge.


Asunto(s)
Cannabis , Aceites de Plantas/efectos adversos , Neumonía Lipoidea/etiología , Insuficiencia Respiratoria/etiología , Vapeo/efectos adversos , Administración por Inhalación , Adulto , Broncoscopía , Cannabidiol , Dronabinol , Sistemas Electrónicos de Liberación de Nicotina , Glucocorticoides/uso terapéutico , Humanos , Hipoxia , Intubación Intratraqueal , Macrófagos Alveolares/patología , Masculino , Metilprednisolona/uso terapéutico , Neumonía Lipoidea/diagnóstico por imagen , Neumonía Lipoidea/patología , Neumonía Lipoidea/terapia , Respiración Artificial , Insuficiencia Respiratoria/diagnóstico , Insuficiencia Respiratoria/terapia , Tomografía Computarizada por Rayos X
2.
Acta Cytol ; 54(5): 707-11, 2010.
Artículo en Inglés | MEDLINE | ID: mdl-20968160

RESUMEN

BACKGROUND: Follicular dendritic cell (FDC) sarcoma is an uncommon neoplasm occurring not only in lymph nodes but also in extranodal sites. Because of an increasing number of case reports, awareness of this tumor has grown. The nature of the disease and its relation to other diseases, treatment, prognosis and immunochemistry findings are being actively studied. So far, only a limited number of cytology cases describing the fine needle aspiration (FNA) biopsy findings of FDC sarcoma have been reported. CASE: A 47-year-old man had a history of hypertension and human immunodeficiency virus (HIV) infection treated with antiretroviral therapy. He developed a slowly growing, nontender right neck mass over the course of 3 years. FNA revealed sheets and thick syncytial clusters of bland cells with pale cytoplasm and indistinct cell borders, round to oval nuclei with fine or vesicular chromatin, and small nucleoli. The mass was subsequently excised. A diagnosis of FDC sarcoma was made based on the histologic appearance and the marker studies. Conclusion The diagnosis ofFDC sarcoma in FNA can be suspected if a pathologist is aware of its characteristic features. Research studies have demonstrated the presence of HIV-related FDC hyperplasia. It is likely that HIV infection may have played a role in tumor formation in this patient. (Acta


Asunto(s)
Sarcoma de Células Dendríticas Foliculares/patología , Seropositividad para VIH/patología , Neoplasias de Cabeza y Cuello/patología , Biopsia con Aguja Fina , Sarcoma de Células Dendríticas Foliculares/cirugía , Neoplasias de Cabeza y Cuello/cirugía , Humanos , Hipertensión/complicaciones , Masculino , Persona de Mediana Edad
3.
Acta Cytol ; 53(2): 211-4, 2009.
Artículo en Inglés | MEDLINE | ID: mdl-19365978

RESUMEN

BACKGROUND: Clinical, radiologic and pathologic evaluation of a breast mass during pregnancy and lactation often presents a challenge. We report a case of a longstanding benign breast mass that was negative on fine needle aspiration biopsy (FNAB) but sonographically appeared suspicious for carcinoma. CASE: A 41-year-old patient presented with a long-standing benign breast nodule that increased in size postpartum and became painful. The patient was breastfeeding when she developed mastitis in the surrounding area and was treated with antibiotics. The inflammation resolved, but the original mass persisted. FNA of the mass yielded thick, whitish material that on microscopic examination showed clusters of ductal cells with striking reactive, reparative and lactation changes admixed with amorphous material and crystals. The smear pattern was interpreted as negative. However, the sonogram revealed a solid lesion with mixed echogenicity suspicious for malignancy. The patient underwent lumpectomy, which showed concomitant fibroadenoma and galactocele. CONCLUSION: We suspect that in lactating patients preexisting breast masses may interfere with the milk flow, thus rendering the breast tissue around the mass prone to galactocele formation. This may result in erroneous clinical and radiologic impression of growth and transformation of a preexisting lesion.


Asunto(s)
Quiste Mamario/diagnóstico , Neoplasias de la Mama/diagnóstico , Fibroadenoma/diagnóstico , Adulto , Antibacterianos/uso terapéutico , Biopsia con Aguja Fina , Quiste Mamario/complicaciones , Lactancia Materna , Neoplasias de la Mama/complicaciones , Femenino , Fibroadenoma/complicaciones , Humanos , Trastornos de la Lactancia/etiología , Mastitis/tratamiento farmacológico , Embarazo , Complicaciones Neoplásicas del Embarazo/patología
4.
J Pediatr Hematol Oncol ; 30(8): 625-7, 2008 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-18799943

RESUMEN

Fine-needle aspiration biopsy (FNAB) is a well-recognized minimally invasive tool in the diagnosis of neoplasia of various organ systems. Several reports in the literature suggest that FNAB can be an accurate method for the preoperative diagnosis and treatment planning. We describe a case to caution the interpretation from a FNAB that contains suboptimal contents (basaloid cells only) and highlight a clinical-pathologic-based algorithm that can provide the appropriate management for the patient when the cytopathologic diagnosis does not fit the clinical impression.


Asunto(s)
Biopsia con Aguja Fina , Errores Diagnósticos , Enfermedades del Cabello/diagnóstico , Pilomatrixoma/diagnóstico , Neoplasias Cutáneas/diagnóstico , Carcinoma de Células Pequeñas/patología , Enfermedades del Cabello/cirugía , Humanos , Lactante , Masculino , Pilomatrixoma/cirugía , Neoplasias Cutáneas/cirugía
5.
Acta Cytol ; 50(3): 257-62, 2006.
Artículo en Inglés | MEDLINE | ID: mdl-16780018

RESUMEN

OBJECTIVE: To investigate immunohistochemical staining of hepatocyte paraffin-1 (HepPar1), alpha-fetoprotein (AFP), polyclonal carcinoembryonic antigen (pCEA), monoclonal CEA (mCEA), MOC-31 and CD10 for differential diagnosis of hepatocellular carcinoma (HCC) from metastatic adenocarcinoma (MA) on fine needle aspiration biopsy (FNAB). STUDY DESIGN: Fifty-one archival, paraffin-embedded FNAB cell blocks, representing 18 HCCs and 33 MAs, were immunostained with antibodies for AFP, CD10, pCEA, mCEA, HepPar1 and MOC-31. RESULTS: HepPar1, AFP, canalicular pCEA and CD10 were positive in 78% (14 of 18), 28% (5 of 18), 72% (13 of 18) and 35% (6 of 17) of cases of HCC, respectively. The 33 MAs were negative for immunostaining of the above antibodies except for one AFP-positive MA. Ninety-seven percent (31 of 32) of the MAs and 6% (1 of 17) of the HCCs were positive for MOC-31. Monoclonal CEA was immunoreactive on 82% (27 of 33) of the MAs and negative on all the HCCs. CONCLUSION: HepPar1 was the most sensitive marker for HCC, followed by canalicular staining for pCEA. For MA, MOC-31 was the most sensitive marker; mCEA was slightly less sensitive but more specific. We suggest using HepPar1, pCEA, CD10, MOC-31 and mCEA as a panel for distinguishing HCC from MA in liver FNAB.


Asunto(s)
Adenocarcinoma/secundario , Antígenos de Neoplasias/análisis , Biomarcadores de Tumor/análisis , Carcinoma Hepatocelular/patología , Neoplasias Hepáticas/patología , Neoplasias Hepáticas/secundario , Hígado/patología , Adenocarcinoma/inmunología , Biopsia con Aguja Fina , Antígeno Carcinoembrionario/análisis , Carcinoma Hepatocelular/inmunología , Diagnóstico Diferencial , Humanos , Inmunohistoquímica , Hígado/inmunología , Neoplasias Hepáticas/inmunología , Neprilisina/análisis , Estudios Retrospectivos
6.
Ocul Oncol Pathol ; 2(2): 62-5, 2015 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-27171824

RESUMEN

PURPOSE: To report a case of recurrent immunodeficiency-associated Burkitt lymphoma (BL) that initially presented as severe anterior uveitis. METHODS: Case report. RESULTS: To our knowledge, this is the first reported case of isolated anterior uveitis related to immunodeficiency-associated BL. A 34-year-old African American woman with a history of HIV and BL in remission presented with unilateral anterior uveitis. Histopathologic study of an aqueous humor specimen was consistent for BL. CONCLUSION: The patient's initial presentation masqueraded as anterior uveitis, but her condition rapidly progressed with significant central nervous system involvement. Ocular involvement of immunodeficiency-associated BL is rare, with isolated anterior uveitis being even rarer. This must be kept in mind in the differential diagnosis for any patient with immunodeficiency, especially with a history of previous BL.

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