Pulmonary aspergilloma with prominent oxalate deposition.

Some Aspergillus species produce oxalic acid, which reacts with tissue calcium or blood to precipitate calcium oxalate. Oxalate crystals can induce lung and kidney damage. The presence of oxalate crystals can suggest the diagnosis of aspergillosis, even when Aspergillus hyphae are absent on microscopic slides.

An unusual cause of shoulder pain: osteochondroma of ventral scapula (a case report).

Osteochondromas mainly affect the metaphysis of long bones such as femur, humerus, and tibia. It is unusual in flat bones such as scapula. Osteochondroma of ventral surface of scapula is one of the rare cause of shoulder pain and difficult to diagnose in first place. We report the case of an 18-year old girl, presenting progressive right shoulder pain for two years. Physical examination showed an imbalance of the shoulders, a winging of the right scapula, and a snapping of the shoulder on mobilization. Radiographic evaluation showed a pedunculated bony structure extruding from the scapula. Computed tomography (CT) scanner and magnetic resonance imaging (MRI) revealed a bony exostosis along the medial border on the ventral surface of the right scapula. The patient had an excision of the exostosis. Histologic examination confirmed that the specimen was an osteochondroma with no signs of malignant transformation. The shoulder was immobilized for two weeks. The patient has regained full function of her shoulder, six weeks postoperatively.

Primary signet-ring cell carcinoma of the urinary bladder: A report of two cases.

INTRODUCTION: Primitive bladder adenocarcinomas account for about 2% of urinary bladder tumors. Primary signet-ring cell carcinoma is a rare variant of bladder adenocarcinoma. It is characterized by a late diagnosis and a poor prognosis. The aim of the study was to discuss the clinical, pathological and evolutive features of this rare entity. Clinical Observations: We report two patients a 53-year-old man and a 70-year-old woman. The main reason for consultation was right back pain, mictional burn and total hematuria. Abdominal ultrasound showed a thickened bladder wall measuring 8 mm in thickness. Ultrasonography revealed a budding intravesical lesion with a calculation of the lower left ureter measuring 5mm of great diameter. Cystoscopy showed an atypical tissular lesion frayed whitish and solid in the cut. Pelvic MRI performed in women showed a cervix ill-limited tissue mass invading the anterior vaginal wall. A transurethral resection of the bladder tumor was performed in one case and a biopsy of the bladder lesion for the other case. The immunohistochemical study showed positive tumoral cells to CK7. The diagnosis of signet ring cell adenocarcinoma of the bladder was established. CONCLUSION: Signet ring cell adenocarcinoma of the bladder is an aggressive tumor of rapid development and poor prognosis. Its management is multidisciplinary and involves surgery. Adjuvant chemotherapy should be discussed even if consensual attitude has not been set.

Intranodal Palisaded Myofibroblastoma in a Submandibular Lymph Node.

Intranodal palisaded myofibroblastoma (IPM), also known as "intranodal hemorrhagic spindle cell tumor with amianthoid fibers," is a rare benign mesenchymal tumor originating from smooth muscle cells and myofibroblasts, often with the presence of amianthoid fibers. Usually IPM affects inguinal lymph nodes, but three cases have been described in the submandibular and cervical lymph nodes. We report a new case of a 44-year-old women with submandibular mass. Cervical ultrasound showed a suspect right submandibular adenomegaly. The patient underwent an excision of the submandibular mass. Histological features of the tumor include an encapsulated fusocellular proliferation, with nuclear palisading, amianthoid fibers, hemosiderin pigment, and extravasated erythrocytes. In the light of these results, we made the diagnosis of IPM. No recurrence was found 5 years after surgery.