Incidentally Detected ALK-Positive Histiocytosis with EML4::ALK Fusion in a Solitary Pulmonary Nodule Following COVID-19 Infection: A Rare Case Report.

We hereby report a patient with ALK-positive histiocytosis with localized lung involvement. A 47-year-old woman presented with a solitary pulmonary nodule in the left upper lobe, 7 months after COVID infection. A well-defined 15 mm yellow mass was found in trisegmentectomy specimen. Histopathological examination revealed that the mass was composed of epithelioid and spindle cells with foamy cytoplasms. No necrosis, pleomorphism, or nuclear atypia was detected. The cells were positive for CD68, CD163, PU.1, ALK and negative for KRT, smooth muscle actin (SMA), S100, Melan-A, CD34, STAT6, and BRAF VE1. Flourescence in situ hybridization demonstrated ALK gene rearrangement, and next generation sequencing confirmed EML4::ALK fusion. Lung involvement in ALK-positive histiocytosis is characterized by the presence of pulmonary nodules, which can be seen in all forms of the disease. However, lung involvement is rarely seen in single-system ALK-positive histiocytosis. Our report represents the fourth documented instance of localized lung involvement in ALK-positive histiocytosis, an exceedingly rare occurrence, and it is the third instance with available molecular data.

Boraginaceae plant fragment as a foreign body in the lacrimal duct: Multidisciplinary diagnosis.

Foreign bodies in the lacrimal drainage system pose a substantial challenge in clinical practice due to their potential morbidity and diverse origins. Many foreign bodies are inorganic; however, organic foreign bodies, although uncommon, present diagnostic challenges. We present the case of a 57-year-old woman who had epiphora in her right eye. Patient's physical examination suggested an obstruction in the nasolacrimal duct. An external dacryocystorhinostomy (DCR) was scheduled. The surgery uncovered a polyp-like intrasaccal structure, which was subsequently identified as an organic foreign body through a comprehensive histopathological examination. This case underscores the significance of precise histopathological evaluation, multidisciplinary collaboration, and meticulous assessment in the identification of uncommon intraorbital organic foreign bodies.