Cytologic and histologic features of pigmented pleomorphic xanthoastrocytoma: A case report and literature review.

In the central nervous system, the presence of pigment in astrocytic tumors is rare. Only nine cases were reported in the English literature: one ganglioglioma, one pilocytic astrocytoma, and seven cases of pleomorphic xanthoastrocytoma (PXA). Though squash cytology is a common and useful tool for intraoperative diagnosis during brain tumor surgeries, the cytologic findings of pigmented PXA have not been recorded previously. We present a 32-year-old woman with a mass in her medial right temporal lobe. Intraoperative squash cytology examination demonstrated pleomorphic tumor cells containing cytoplasmic pigment granules. The subsequent tissue section and additional workup revealed a PXA with melanosomal melanin pigment deposits. While conventional PXA has to be differentiated from high-grade tumors such as glioblastoma, in the pigmented variant the presence of pigment can cause further diagnostic confusion with other pigmented tumors, in particular melanoma. It should be added into the differential diagnoses when a brain tumor smear shows nuclear pleomorphism and intracytoplasmic pigment particles.

Unusual axillary metastasis of recurrent nasopharyngeal cancer: A case report.

RATIONALE: Nasopharyngeal carcinoma (NPC) has a high propensity of metastasis. The most commonly described sites of distant metastasis are the bones, lungs, and liver, whereas axillary metastasis is seldom reported. PATIENT CONCERNS: We hereby present the case of a 66-year-old man with NPC, cT2N2M0, at diagnosis. He had completed chemoradiotherapy and been disease-free for 7 years. DIAGNOSES: After that period, late recurrence in the form of a solitary axillary lymph node metastasis was detected and confirmed by core-needle biopsy. INTERVENTIONS: The lesion was chemoresistant but responded to salvage radiotherapy at a dose of 65 Gy in 21 fractions. OUTCOMES: Post-radiotherapy positron emission tomography scan showed no evidence of disease. LESSONS: We suggested that long-term follow-up of NPC patients is important because a late relapse may occur at an unusual site. Aggressive management of solitary metastasis may achieve good outcome.

Metastasizing Ameloblastoma With Localized Interstitial Spread in the Lung: Report of Two Cases.

Ameloblastoma is a locally aggressive, epithelial odontogenic tumor involving mandibles and maxillas. Distant metastasis is a very rare condition and is designated as metastasizing (malignant) ameloblastoma despite its benign histological appearance. Up to now, only 27 well-documented cases of metastasizing ameloblastomas are reported in the literature, and lung is the most commonly involved organ. In previous reports of pulmonary metastasizing ameloblastomas, there was little description of the histopathologic finding. Here, the authors report 2 cases of pulmonary metastasizing ameloblastomas with special emphasis on their interesting, interstitial spread along alveolar septa, resulting in a unique 2-cell pattern under microscopic examination. Pulmonary metastasizing ameloblastoma may pose difficulty in diagnosis if the pathologist is not aware of patient's clinical history of ameloblastoma.

Lymphangioleiomyomatosis, multifocal micronodular pneumocyte hyperplasia, and clear-cell micronodules in a 39-year-old woman with tuberous sclerosis: a case report.

This study reports the case of a 39-year-old woman with tuberous sclerosis complex (TSC) combined lymphangioleiomyomatosis (LAM), multifocal micronodular pneumocyte hyperplasia (MMPH), and clear-cell micronodules. She had repetitious bilateral pneumothoraces, and chest radiography revealed diffuse thin-walled cysts and multiple nodules. Bilateral renal angiomyolipomas (AMLs) and cerebral periventricular spots were also present. Lung biopsy revealed dilated airspace with HMB-45-positive spindle cell infiltration and aggregation indicative of LAM. Randomly distributed nodules of proliferative type II pneumocytes were consistent with MMPH. Clear-cell micronodules comprised nodular aggregation of HMB-45-positive polygonal cells with clear cytoplasm. Abnormal migration and proliferation of HMB-45 immunoreactive perivascular epithelioid cells (PEComas) is posited to indicate LAM and AML histogenesis. Clear-cell micronodules are also believed to be one of the families of PEComas and are reported in association with TSC. These behaviors of perivascular epithelioid cells may play a role in TSC.