Bilateral axillary node calcifications: a case report and revisiting causes.

A 48-year woman was found to have bilateral axillary nodal microcalcifications on screening mammogram; a new finding compared to the prior mammogram done about 8 years ago. Combining the new finding with the amorphous and fine morphology of the microcalcifications, deemed it suspicious. In the absence of a definite benign cause, that could be attributed to this finding, biopsy was performed. Histology from the bilateral axillary node was reported to be benign with calcifications identified within granulomas. There are only a few cases with bilateral axillary nodal microcalcifications reported in the literature till date. Most of these are from ovarian cancer or related to chrysotherapy for rheumatoid arthritis. Our case is distinct from them as this rare finding was not due to any of the known etiologies and the morphology is quite different from the known granulomatous causes. As we report this rare case, we also revisit the causes of axillary nodal microcalcifications. Familiarity with this subject can help the reporting radiologists to avert an invasive procedure like biopsy in some cases, if the cause of benignity can be confidently identified.

Diagnosis of adenoid cystic carcinoma of the lung by bronchial brushing: a case report.

BACKGROUND: A diagnosis of pulmonary adenoid cystic carcinoma on exfoliative cytology specimen is very uncommon. The diagnostic cytologic material typically is obtained following a tissue biopsy. No previous report of the diagnosis has been made on bronchial brushing cytologic material when the procedure preceded a tissue biopsy. CASE: A 44-year-old man who used to smoke cigarettes and was otherwise well complained of persistent cough for the past 6 months. A chest radiograph revealed a mass lesion in the left hilum. Computed tomography of the chest disclosed an irregular and spiculated soft tissue mass in the left apical anterior segment. Bronchial brushing via bronchoscope was performed, revealing carcinoma cells consistent with an adenoid cystic carcinoma on cytology. A bronchial biopsy and subsequent left upper lobectomy were performed, confirming the diagnosis of adenoid cystic carcinoma of the lung associated with tumor extension to the epithelial surface. CONCLUSION: A diagnosis of bronchial adenoid cystic carcinoma is possible on bronchial brushing. However, as a method in exfoliative cytology, the usefulness of bronchial brushing in diagnosing this tumor is limited by the neoplasm's proximity to the mucosal surface and whether the mucosa has been breached.

Is high-grade prostatic intraepithelial neoplasia on needle biopsy different in an Asian population: a clinicopathologic study performed in Singapore.

OBJECTIVES: To evaluate the incidence, pathologic findings, and follow-up of high-grade prostatic intraepithelial neoplasia (HGPIN) in a series of prostate core biopsies from Singaporean men. METHODS: We studied isolated HGPIN diagnosed on prostate core biopsies and the incidence of cancer discovered in men who had undergone repeat biopsies from 1999 to 2003 at the Department of Pathology, Singapore General Hospital. RESULTS: Of 1219 men undergoing prostate needle biopsy, 56 (4.6%) had isolated HGPIN. Most cases affected a single prostate core (44 cases, 78.6%). Twenty-nine men (51.8%) underwent repeat biopsies. Cancer was discovered in 7 (24.1%) of the 29 men within two repeat biopsies. CONCLUSIONS: The incidence of isolated HGPIN on prostate needle core biopsies in Asian men, as well as the likelihood of subsequent cancer detection, are comparable to the rates reported for Western populations. The relatively low yield of cancer detection on repeat biopsy supports the need to re-evaluate recommendations for rebiopsy strategies.