Cytologic, immunocytologic, histopathologic and immunohistologic diagnosis of the poorly differentiated sertoli-leydig cell tumor.

BACKGROUND: Sertoli-Leydig cell tumors (SLCTs), also known as arrhenoblastomas, are tumors of the sex cord-stromal group of ovary and testis cancers. They comprise <1% of all ovarian tumors. They are divided into 6 categories based on the degree of differentiation and the presence of heterologous elements. However, <15% of these tumors are poorly differentiated. CASE: A 23-year-old unmarried female presented with an 8-month history of irregular menstrual cycle and abdominal pain. There were no clinical features suggesting virilization. The left salpingo-oophorectomy specimen revealed an oval ovarian mass of 11 × 7 × 4 cm in dimension. Grossly, the cut surface of the mass was yellowish white in color and solid in consistency and touch preparation was made. By applying cytology and immunocytochemistry techniques, a preliminary diagnosis suggestive of poorly differentiated SLCT was made. The tumor was confirmed as a poorly differentiated SLCT. CONCLUSION: Cytology and immunocytochemistry by WT-1, melan A, vimentin and calretinin are helpful in the diagnosis of poorly differentiated SLCTs.

Localized lymphadenitis due to leishmania simulating toxoplasmosis. Value of electron microscopy for differentiation.

Two cases of cervical adenopathy are described. One manifested as lymphoma clinically. Both patients were found to have primary lymph node leishmaniasis without cutaneous, mucosal or visceral involvement. The histologic appearance simulated toxoplasma lymphadenitis. Electron microscopic study differentiated the organism from Toxoplasma, and the condition responded well to antimony therapy.

The prognosis of polyostotic eosinophilic granuloma.

Nine examples of polyostotic histiocytosis without visceral involvement with long-term follow-up are presented. Only one patient had the complete Hand-Schüller-Christian disease triad of multiple osteolytic lesions, diabetes insipidus, and exophthalmos. Three of the nine patients had solitary osseous lesions when first seen but other lesions developed within ten years. The other six had multiple lesions when first seen. In no case was progression to systemic histiocytosis observed. Eight patients were well and in good health seven to 18 years after initial diagnosis. One died indirectly of his disease. Low-dose radiation therapy seems to accelerate healing of lesions.

Idiopathic differentiated histiocytosis.

Eighty-nine cases variously diagnosed as histiocytosis X, eosinophilic granuloma, Hand-Schuller-Christian disease, Letterer-Siwe disease, or malignant histiocytosis from one institution were reviewed. Follow-up data were obtained for all patients. On the basis of clinicopathologic correlation, the following distinct groups were identified. 1. Disseminated histiocytosis (12 patients) with involvement of more than two organ systems at the time of recognition of the disease, affecting children less than 3 years of age (the patient's general condition is poor and hepatosplenomegaly is common. The patients do poorly, and all the patients in this group of the present study died. 2. Histiocytosis confined to bone, whether monostotic (36 patients) or polyostotic (eight patients). This type is self-healing, does not disseminate, and does not require intensive therapy. Clinically the patients are older and in good general condition during the course of the disease. Histologically histiocytes in these two groups are cytologically benign, and the whole process is inflammatory rather than neoplastic. Presence of giant cells, eosinophils, and necrosis are usually associated with better prognosis. Many neoplastic diseases and infectious processes manifest as histiocytosis. More than a third of the cases of this study diagnosed as histiocytosis proved to be other processes. This confusion contributes to differences of various reports and difficulty of interpretation of findings.

Arterial fibrodysplasia: a regional cause of peripheral occlusive vascular disease.

The authors studied 17 cases of symptomatic arterial fibrodysplasia involving peripheral arteries without concomitant renovascular hypertension in Iranian males (age range: twenty-two to forty-five years). Affected arteries were most commonly the femoral, iliac, and popliteal, but in 2 cases the axillary and brachial arteries were also affected. Three cases were progressive. Differential diagnosis of arterial fibrodysplasia is discussed. It is concluded that this entity is the most common cause of peripheral occlusive vascular disease in younger Iranian males.

Pseudoxanthomatous mastocytosis.

A case of xanthelasmoidea (pseudoxanthomatous mastocytosis) occurring in a 50-year-old Iranian man is described. The patient had a large upper gastrointestinal haemorrhage.

Intraosseous schwannoma of T12 with burst fracture of L1.

Intraosseous schwannoma of T12 with burst L1 fracture is extremely rare. Here we present a report of the successful treatment and 18-month follow-up of a 46-year-old man with this complication.