ABSTRACT
This article discusses the paraganglion system and extra-adrenal paragangliomas. In particular, the clinicopathologic, immunohistochemical, and ultrastructural features of paragangliomas and neuroendocrine neoplasms of the larynx are presented with a discussion of the differential diagnosis.
Subject(s)
Head and Neck Neoplasms/classification , Head and Neck Neoplasms/pathology , Paraganglioma/classification , Paraganglioma/pathology , Biopsy, Needle , Diagnosis, Differential , Female , Head and Neck Neoplasms/diagnosis , Humans , Immunohistochemistry , Male , Paraganglioma/diagnosis , Sensitivity and SpecificityABSTRACT
We report on the fine-needle aspiration cytological findings of a metastatic granulosa-cell tumor of the ovary to bone. The patient had undergone resection of a primary ovarian granulosa-cell tumor 15 yr prior to her last admission. Recently she injured her right hip, sustained after a fall. CT examination revealed hypodense lesions involving the posterior body and the right pedicle of the L1 vertebra. The aspirate from the bone yielded a highly cellular smear, composed of round to oval cells with scanty cytoplasm. Many of the cells revealed the presence of nuclear grooves. In areas, the cells were arranged in clusters resembling Call-Exner bodies. The rarity of skeletal metastases from granulosa-cell tumors can cause diagnostic difficulty in diagnosing this entity. Accurate clinical data, radiological findings, and cytological features are important in arriving at the correct diagnosis.
Subject(s)
Bone Neoplasms/secondary , Granulosa Cell Tumor/secondary , Ovarian Neoplasms/pathology , Aged , Aged, 80 and over , Biopsy, Needle , Bone Neoplasms/pathology , Female , Humans , Liver Neoplasms/secondary , Lumbar Vertebrae/diagnostic imaging , Lumbar Vertebrae/pathology , Tomography, X-Ray ComputedABSTRACT
BACKGROUND: We report the first case of a composite tumor (tall cell and columnar cell variants) of papillary thyroid carcinoma (PTC) diagnosed by fine needle aspiration. It is important to differentiate these uncommon aggressive variants from the usual indolent papillary carcinomas. CASE: Fine needle aspiration cytology was obtained from a rare composite tumor of tall cell and columnar cell variants of papillary thyroid carcinoma. The smears showed a cellular aspirate with scattered single tumor cells and several tissue fragments arranged in a papillary pattern. The tumor cells had abundant nuclear grooves and intranuclear pseudoinclusions. Several of the fragments showed columnar cells with nuclear pseudostratification, and a few clusters displayed tall columnar cells with basal nuclei and abundant cytoplasm. A rare cluster exhibited composite features of tall cell and columnar cell variants. CONCLUSION: Columnar cell and tall cell variants of PTC manifest aggressive clinical behavior. The differential diagnosis of columnar cell variant includes medullary carcinoma of thyroid and metastatic adenocarcinoma. Immunohistochemical stains for calcitonin and thyroglobulin play an important role in difficult cases. The tall cell variant needs to be differentiated from Hürthle cell papillary neoplasm of thyroid, which displays prominent nucleoli and lacks the characteristic nuclear features of PTC. The preoperative diagnosis of these aggressive variants' is important in planning the most appropriate type of treatment.
Subject(s)
Carcinoma, Papillary/pathology , Mixed Tumor, Malignant/pathology , Thyroid Neoplasms/pathology , Aged , Biopsy, Needle , Carcinoma, Papillary/diagnosis , Diagnosis, Differential , Female , Humans , Mixed Tumor, Malignant/diagnosis , Thyroid Neoplasms/diagnosisABSTRACT
Six patients were treated for gradual onset of enophthalmos, a deep superior sulcus and globe ptosis. There was no history of orbital trauma or sinusitis. CT scan showed an opacified shrunken maxillary sinus with dehiscence and depression of the orbital floor and downward displacement of the orbital contents. Pathological review of the surgical specimens showed a respiratory mucosal lining with thick mucoid secretions, new bone formation, but no purulence. The etiology is thought to be maxillary sinus mucocele. Surgical treatment with an otolaryngologist consisted of a Caldwell-Luc procedure to evacuate the maxillary sinus with nasal antrostomy and an orbital floor exploration with insertion of a methylmethacrylate implant molded at the time of surgery to reform the orbital floor and reposition the globe. Follow-up of 2 1/2-4 years shows excellent functional and cosmetic results.
Subject(s)
Blepharoptosis/etiology , Enophthalmos/etiology , Maxillary Sinus , Mucocele/complications , Paranasal Sinus Diseases/complications , Adult , Blepharoptosis/diagnosis , Blepharoptosis/surgery , Enophthalmos/diagnosis , Enophthalmos/surgery , Humans , Male , Methylmethacrylate , Methylmethacrylates , Mucocele/diagnosis , Mucocele/surgery , Orbit/pathology , Orbit/surgery , Paranasal Sinus Diseases/diagnosis , Paranasal Sinus Diseases/surgery , Prostheses and Implants , Tomography, X-Ray Computed , Vasodilator AgentsABSTRACT
A 33-yr-old white woman treated for alcoholic hepatitis developed acute pancreatitis during her hospital stay. At autopsy, two major pathological processes were found: alcoholic cirrhosis and chronic pancreatitis. In both, there was evidence of an acute episode, i.e., acute alcoholic hepatitis and acute hemorrhagic pancreatitis superimposed on the chronic alcoholic lesions. The sequence of events would indicate that the acute pancreatic pathology was precipitated by supranormal ecbolic stimulation of the acinar segment of the "pancreon" units, triggered as a result of a high protein and fat diet.