Epibulbar granular cell tumor. Report of a case and review of the literature.

BACKGROUND: The granular cell tumor (GCT) is a common, usually benign, neoplasm of uncertain histogenesis that may affect any organ in the body. It occurs rarely in ophthalmic sites, where orbital location is most frequent. The purpose of this report is to describe a unique case of an epibulbar, subconjunctival GCT in a child. METHOD: Histopathologic examination of the excised tumor included standard and immunohistochemical staining of formaldehyde-fixed, paraffin-embedded tissue. RESULTS: Histopathologic study showed the characteristic morphology of GCT. Immunohistochemistry was strongly positive for vimentin, weakly and partly positive for neuron-specific enolase, and negative for S-100 and HAM-56. CONCLUSIONS: Granular cell tumor must be added to the differential diagnosis of epibulbar masses. Immunohistochemistry of the tumor in this case suggests an uncommitted mesenchymal cell origin.

Bilateral femoral hypoplasia and maternal diabetes mellitus: case report and review of the literature.

The case of a 21-week fetus with bilateral femoral hypoplasia and bowing related to maternal diabetes mellitus is reported. The femoral middiaphysis (site of hypoplasia and bowing) showed intramembranous ossification instead of the normal endochondral ossification, thus pointing to a transient inhibition of chondrogenesis of the mesenchymal femoral model as the causative mechanism. This finding is correlated with the recent experimental advances in the field of limb development in vertebrates.

Acute leukostasis pulmonary distress syndrome.

A 75-year-old woman in accelerated-phase chronic myeloid leukemia with hyperleukocytosis presented with acute respiratory distress syndrome. Despite early and aggressive pulmonary support and cytoreductive chemotherapy, the patient died. Autopsy confirmed the presence of the leukostasis syndrome. The clinical, radiologic, pathophysiologic, and therapeutic aspects of this entity are reviewed.

Uterine leiomyosarcoma with massive necrosis diagnosed during gonadotropin-releasing hormone analog therapy for presumed uterine fibroid.

Recurrence of heavy vaginal bleeding and massive necrosis of a uterine leiomyosarcoma are reported in a 41-year-old female who was being treated with GnRH-a for a presumed uterine fibroid. The pathogenic mechanisms of such an event are reviewed and discussed in light of the available literature on the subject of GnRH-a and the treatment of uterine smooth muscle neoplasms.

Clear cell carcinoma arising in extraovarian endometriosis: report of three cases and review of the literature.

The literature on malignancy arising in extraovarian endometriosis comprises only three cases of clear cell carcinoma. We wish to report the clinical features and pathologic findings of an additional three cases. The first concerns a 39-year-old oriental pregnant woman who presented with a large intraluminal obstructing lesion of the sigmoid colon, the second case deals with an abdominal wall mass that appeared in a cesarean section scar of a 45-year-old black woman, and the third case describes an ulcerating lesion of the perineum and the buttock in a 43-year-old white woman with a long history of endometriosis in an episiotomy scar. Our observations support the notion that clear cell carcinoma arising in extraovarian endometriosis behaves differently from its counterpart in ovarian endometriosis, but more in line with clear cell carcinoma of the endometrium.

Pulmonary oncocytoma. Report of a case with cytologic, histologic and electron microscopic study.

The cytology of a pulmonary oncocytoma diagnosed by bronchial brushings is described along with the light and electron microscopic findings. Ultrastructurally, the tumor cells showed mitochondrial hyperplasia and an absence of neurosecretory granules. The possible histogenesis of pulmonary oncocytomas is discussed.