RESUMO
BACKGROUND: Annular lichenoid dermatitis of youth (ALDY) is a rare form of dermatitis mainly affecting children and young people. All cases reported show a consistent clinical and histological picture. This is the first case described in the French literature. PATIENTS AND METHODS: A 5-year-old girl presented an annular isolated patch of the lower abdomen with an erythematosquamous border and central hypopigmentation for one year. Topical corticosteroids and pimecrolimus proved effective but relapse occurred after treatment withdrawal. DISCUSSION: Over sixty cases of ALDY are described in the English-language medical literature. The main differential diagnosis is childhood mycosis fungoides, particularly the hypopigmented variant. Biopsy is necessary for diagnosis since it can reveal typical histological features. Histopathology in all cases shows lichenoid reaction with CD4+ and CD8+ polyclonal lymphocytes. It is limited to the tips of rete ridges and associated with apoptosis of keratinocytes resulting in quadrangular-shaped rete ridges. Our case does not demonstrate either epidermotropism or atypical lymphocytes. CONCLUSION: Annular lichenoid dermatitis of youth (ALDY) is a poorly known distinctive entity within the lichenoid dermatitis family. Clinical-histological correlation is essential to diagnosis. The etiology is still unknown and the course is mostly chronic.
Assuntos
Dermatite/diagnóstico , Erupções Liquenoides/diagnóstico , Pré-Escolar , Dermatite/patologia , Diagnóstico Diferencial , Feminino , Humanos , Erupções Liquenoides/patologia , Micose Fungoide/diagnósticoRESUMO
Pulmonary nodules are a common reason for consultation and their investigation must always exclude a possible neoplastic cause. This means that, in addition to a thorough history, investigations may be necessary which are sometimes invasive and therefore potentially a cause of iatrogenic harm. The toxic aetiologies for pulmonary nodules are rare. We report a case of a patient with pulmonary nodules occurring predominantly in the right lung, about 1cm in diameter, non-cavitating without calcification, and sometimes surrounded by a peripheral halo. The nodules were a chance finding during preoperative evaluation. After a comprehensive review, a reaction to an inhaled irritant was the preferred hypothesis, specifically overuse of a compound insecticide containing, in addition to the propellant gas and solvent type hydrocarbon - a mixture of piperonyl butoxide, of esbiothrine and permethrin. Removal of this led to the complete disappearance of nodules. Pathological examination identified bronchiolitis obliterans with organising pneumonia accompanied by non-necrotizing granulomas and lipid vacuoles.
Assuntos
Inseticidas/toxicidade , Nódulos Pulmonares Múltiplos/induzido quimicamente , Nódulos Pulmonares Múltiplos/diagnóstico , Transtornos Fóbicos/complicações , Idoso , Animais , Feminino , Humanos , Nódulos Pulmonares Múltiplos/complicações , Nódulos Pulmonares Múltiplos/patologia , AranhasRESUMO
We report the case of a 55-year-old woman who presented at the emergency department with hypogastric pain, fever, clinical signs of sepsis and a critical inflammation syndrome in her blood test values. CT-scan of the abdomen demonstrated an infected aneurysm of the right iliac artery. The patient underwent surgery with a favorable outcome. Histological examination of resected artery was performed and compared to the CT features. The authors review the literature and stress the importance of early diagnosis and treatement.
Assuntos
Aneurisma Infectado/diagnóstico por imagem , Aneurisma Ilíaco/diagnóstico por imagem , Aneurisma Infectado/patologia , Aneurisma Infectado/cirurgia , Feminino , Humanos , Aneurisma Ilíaco/patologia , Aneurisma Ilíaco/cirurgia , Pessoa de Meia-Idade , Tomografia Computadorizada por Raios XAssuntos
Leucemia Linfocítica Crônica de Células B/patologia , Linfoma de Células B/patologia , Linfoma Difuso de Grandes Células B/patologia , Segunda Neoplasia Primária/patologia , Derrame Pleural Maligno/etiologia , Idoso , Humanos , Imuno-Histoquímica , Leucemia Linfocítica Crônica de Células B/metabolismo , Linfoma de Células B/complicações , Linfoma de Células B/metabolismo , Linfoma Difuso de Grandes Células B/complicações , Linfoma Difuso de Grandes Células B/metabolismo , Masculino , Segunda Neoplasia Primária/complicações , Segunda Neoplasia Primária/metabolismo , Derrame Pleural Maligno/citologia , Sarcoma de Kaposi/patologiaAssuntos
Leucemia Mieloide/cirurgia , Transplante de Células-Tronco de Sangue Periférico , Mielofibrose Primária/cirurgia , Doença Aguda , Anemia Refratária/tratamento farmacológico , Anemia Refratária/etiologia , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Terapia Combinada , Citarabina/administração & dosagem , Eritropoetina/uso terapêutico , Etoposídeo/administração & dosagem , Seguimentos , Fator Estimulador de Colônias de Granulócitos/uso terapêutico , Humanos , Leucemia Mieloide/tratamento farmacológico , Leucemia Mieloide/patologia , Masculino , Metotrexato/administração & dosagem , Pessoa de Meia-Idade , Mitoxantrona/administração & dosagem , Complicações Pós-Operatórias/tratamento farmacológico , Complicações Pós-Operatórias/etiologia , Mielofibrose Primária/tratamento farmacológico , Mielofibrose Primária/patologia , Proteínas Recombinantes , Condicionamento Pré-Transplante/efeitos adversos , Transplante Autólogo , Irradiação Corporal Total/efeitos adversosRESUMO
Ameloblastic fibro-odontoma is a rare and benign tumor. It usually affects young patients. This report describes the case of a ten year old child presenting an asymptomatic and slow-growing tumor located in the posterior region of the mandible. The course was normal and no recurrence was found after simple enucleation of the tumor.
Assuntos
Neoplasias Mandibulares/patologia , Odontoma/patologia , Criança , Tecido Conjuntivo/patologia , Esmalte Dentário/patologia , Polpa Dentária/patologia , Dentina/patologia , Epitélio/patologia , Feminino , Seguimentos , HumanosAssuntos
Neoplasias das Tubas Uterinas/diagnóstico , Lipoma/diagnóstico , Adulto , Idoso , Ligamento Largo , Diagnóstico Diferencial , Neoplasias das Tubas Uterinas/complicações , Neoplasias das Tubas Uterinas/patologia , Neoplasias das Tubas Uterinas/cirurgia , Feminino , Humanos , Lipoma/complicações , Lipoma/patologia , Lipoma/cirurgia , SalpingostomiaRESUMO
Verrucous carcinoma is a rare subtype of well-differentiated squamous cell carcinoma that may occur anywhere on the skin. It is slow growing, enlarging relentlessly and invading locally. Some cases were reported to occur on chronic scar tissue but demonstrated the same clinical course than in other locations. Herein, we report on a very unusual case of cutaneous verrucous carcinoma arisen from a long-standing (40 years old) burn scar and which involved the pleura five years after the initial surgical resection. To our best knowledge, this is the first case of pleural involvement by a verrucous carcinoma originating from the skin.
Assuntos
Carcinoma Verrucoso/patologia , Neoplasias Cutâneas/patologia , Idoso , Carcinoma Verrucoso/cirurgia , Evolução Fatal , Feminino , Humanos , Neoplasias Cutâneas/cirurgiaRESUMO
Primary T-cell lymphoma of the stomach is a rare disease, most gastric lymphomas being of B-cell type. Here we describe a unique case of primary neutrophil-rich CD30-positive anaplastic large cell lymphoma (ALCL) of the stomach that was treated and cured by combined chemotherapy. According to our literature review, only 7 cases of primary gastric ALCL have been previously reported, none of them being of the neutrophil-rich subtype. Although very peculiar in its histological presentation, which may simulate an inflammatory or carcinomatous process, the natural history as well as the clinical features of this unusual gastric lymphoma does not differ from the other reported cases of gastric ALCL.
Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica , Antígeno Ki-1/análise , Linfoma Anaplásico de Células Grandes/patologia , Neutrófilos/imunologia , Neoplasias Gástricas/patologia , Antineoplásicos/administração & dosagem , Ciclofosfamida/administração & dosagem , Doxorrubicina/administração & dosagem , Humanos , Linfoma Anaplásico de Células Grandes/tratamento farmacológico , Masculino , Pessoa de Meia-Idade , Neutrófilos/patologia , Neoplasias Gástricas/tratamento farmacológico , Vincristina/administração & dosagemAssuntos
Crise Blástica/genética , Genes abl , Haploidia , Antineoplásicos/uso terapêutico , Humanos , Hidroxiureia/uso terapêutico , Hibridização in Situ Fluorescente , Leucemia Mielogênica Crônica BCR-ABL Positiva/tratamento farmacológico , Leucemia Mielogênica Crônica BCR-ABL Positiva/genética , Leucemia Mielogênica Crônica BCR-ABL Positiva/patologia , Masculino , Pessoa de Meia-IdadeRESUMO
The case of a 40-year-old black man, who developed a very unusual tumour-like lymphoid hyperplasia involving primarily the subcutaneous tissue, is reported. The lesion, which arose at a site of tribal scarifications, displayed a deceptive morphology that closely resembled subcutaneous panniculitis-like T-cell lymphoma (SPTCL). An accurate diagnosis could only be made following detailed immunohistochemical and molecular studies. Although SPTCL has been thought to represent a very specific clinicopathologic entity, the present case illustrates that its histological appearance can, however, be closely mimicked by reactive and benign conditions.
Assuntos
Linfoma Cutâneo de Células T/patologia , Pele/patologia , Adulto , Cicatriz , Humanos , Hiperplasia , Imunofenotipagem , Linfoma Cutâneo de Células T/imunologia , MasculinoRESUMO
Langerhans' cell histiocytosis (LCH) may be associated with a wide range of neoplastic disorders. However, the combination of a LCH and a basal cell carcinoma (BCC) of the skin still represents a highly unusual condition. In this publication, we report the case of a 48-year-old woman who developed a localized LCH involving the area of a previously excised BCC. Although the exact pathogenesis of this peculiar association remains yet to be elucidated, the hypothesis of an exaggerated Langerhans' cell reaction in response to the underlying BCC appears to be attractive.
Assuntos
Carcinoma Basocelular/patologia , Histiocitose de Células de Langerhans/patologia , Neoplasias Cutâneas/patologia , Carcinoma Basocelular/cirurgia , Feminino , Humanos , Pessoa de Meia-Idade , Neoplasias Cutâneas/cirurgiaRESUMO
Hyperplastic lymphoid tissues of the Waldeyer's ring in human immunodeficiency virus (HIV)-infected patients may occasionally contain multinucleated giant cells (MGCs). These cells, which are unrelated to any opportunistic infection, previously have been demonstrated to harbor significant amounts of HIV. Studies undertaken to characterize these MGCs have generated conflicting results: some reports suggested a macrophage origin, whereas others supported a dendritic cell lineage. This study was performed to determine the occurrence of MGCs in a series of adenoid/tonsil specimens from HIV-seropositive patients showing no histological evidence of opportunistic infection in order to further characterize the phenotype of these cells and to investigate the role of a viral infection in their pathogenesis. Adenoid/tonsil tissue specimens from 21 HIV-seropositive patients with no documented opportunistic infection were scrutinized for the presence of MGCs and evaluated immunohistochemically on paraffin sections by antibodies directed against various macrophage and DC antigens. These antigens included CD68, the macrophage marker 3A5, major histocompatibility complex Class II, S-100 protein, CD1a, and CD83. Additional immunostainings directed at CD21 and CD35 as well as at the HIV-associated p24 antigen were also performed. Finally, the presence of Epstein-Barr virus and human herpesvirus 8 viral sequences was investigated by in situ hybridization and by polymerase chain reaction analysis, respectively. MGCs were found in 14 patients (66.7%), regardless of gender, age, method of viral transmission, CD4 cell count, viral load, or ethnic group. These cells were mostly localized at the lymphoepithelium layer of the tonsillar crypts and, to a lesser extent, in the interfollicular areas of the underlying lymphoid tissue, which consistently exhibited features of follicular hyperplasia. Phenotypically, MGCs were found to be CD68+, 3A5+, major histocompatibility complex Class II+, S-100 protein+/-, CD1a-, CD21-, CD35-, and CD83-. Although the HIV-associated p24 protein was consistently present in the cytoplasm of these cells, no sign of Epstein-Barr virus or human herpesvirus 8 infection could be demonstrated. Consequently, our study didn't show any conclusive evidence to support that MGCs in hyperplastic lymphoid tissues of the Waldeyer's ring from HIV-seropositive patients originated from dendritic cells. The definite nature of these cells has yet to be elucidated, but it is plausible that they simply represent activated macrophages that are infected with HIV present in the oropharyngeal secretions during the circulation of their precursor through the lymphoepithelium area of adenoids and tonsils.
Assuntos
Tonsila Faríngea/patologia , Células Gigantes/patologia , Infecções por HIV/patologia , Tonsila Palatina/patologia , Tonsila Faríngea/metabolismo , Adulto , Núcleo Celular/ultraestrutura , Criança , Pré-Escolar , Feminino , Células Gigantes/metabolismo , Infecções por HIV/metabolismo , Humanos , Imuno-Histoquímica , Masculino , Pessoa de Meia-Idade , Tonsila Palatina/metabolismoRESUMO
A nine year old boy with localised Castleman disease of the hyaline-vascular subtype developed a calcifying fibrous pseudotumour. This pathological association does not appear to have been described before. In this case, the development of this very unusual soft tissue tumour-like process was thought to be related to a previous fine needle aspiration biopsy, which was performed because of lymphadenopathy localised to the right inguinal area. This case provides further evidence of the reactive nature of calcifying fibrous pseudotumour and also broadens the pathological spectrum of the stromal cell proliferation that occasionally supervenes within lesions of Castleman disease, hyaline-vascular type.
Assuntos
Biópsia por Agulha/efeitos adversos , Calcinose/etiologia , Hiperplasia do Linfonodo Gigante/patologia , Linfonodos/patologia , Calcinose/patologia , Criança , Fibrose , Humanos , Canal Inguinal , MasculinoRESUMO
Several viral agents have been detected in the lesional tissue of Kaposi's sarcoma (KS). Their precise oncogenic role remains to be determined. A 32-year-old heterosexual man with acquired immunodeficiency syndrome (AIDS) who had penile lesions of KS with overlying epithelial changes characteristic of intraepithelial neoplasia associated with concurrent infection by human papillomavirus (HPV) and human herpesvirus 8 (HHV-8) is reported. The absence of viral DNA from uninvolved skin suggests that this coinfection is more than coincidental and may involve synergy between these viruses, as has already been suggested for HPV and herpes simplex 2 virus.
Assuntos
Neoplasias Penianas/patologia , Sarcoma de Kaposi/patologia , Neoplasias Cutâneas/patologia , Síndrome da Imunodeficiência Adquirida/complicações , Adulto , Antígenos CD34/análise , Fator VIII/análise , Herpesvirus Humano 8/genética , Humanos , Imuno-Histoquímica , Masculino , Papillomaviridae/genética , Neoplasias Penianas/complicações , Pênis/química , Pênis/patologia , Pênis/virologia , Molécula-1 de Adesão Celular Endotelial a Plaquetas/análise , Reação em Cadeia da Polimerase , Sarcoma de Kaposi/complicações , Sarcoma de Kaposi/virologia , Neoplasias Cutâneas/complicações , Infecções Tumorais por Vírus/complicações , Infecções Tumorais por Vírus/virologiaRESUMO
Numerous chromosome abnormalities have been described in myelodysplastic syndromes, but single karyotypic aberrations are much less frequent. We report the case of a 65-year-old woman who presented a trisomy 21 as the sole karyotypic anomaly for a refractory anemia with ring sideroblasts. The nature of such an anomaly is discussed in regard to pathogenesis and prognosis.
Assuntos
Anemia Sideroblástica/genética , Síndrome de Down , Idoso , Medula Óssea/patologia , Medula Óssea/fisiologia , Feminino , Humanos , Hibridização in Situ FluorescenteRESUMO
We report the case of a 69-year-old white woman who developed a natural killer (NK)-like T-cell lymphoma involving primarily the stomach. The tumour consisted of large and pleomorphic lymphocytes infiltrating the gastric mucosa. Immunohistochemistry performed on paraffin sections showed the neoplastic cells to be CD3+, CD5-, CD8-, CD43+, CD45RO+, and CD57+. In addition, these cells also expressed HLA-DR, granzyme B, and, to a lesser extent, the CD30 activation marker. No pathologic features suggesting Helicobacter pylori, Epstein-Barr virus infection, or lymphocytic gastritis were found within adjacent normal mucosa. The patient had no previous history of coeliac disease, and her serology for H. pylori was negative. Since lymphomas are usually considered the neoplastic counterpart of normal lymphocytic subsets, it is possible that in this case the tumour cells originate from a distinct cytotoxic T-cell population normally present within the gastric mucosa. The pathogenesis of this highly unusual neoplasm, however, remains a mystery.