RESUMEN
BACKGROUND: The cytologic features of C-cell hyperplasia of the thyroid have not been previously addressed in the literature. We describe the first case, to our knowledge, of C-cell hyperplasia that was suggested by fine needle aspiration. CASE: Cellular material was obtained from a nonnodular region of the thyroid gland in a 67-year-old male with chronic diarrhea, unexplained elevated serum calcitonin, no clinically detectable thyroid mass and no known medical or family history of an endocrine disorder. Aspiration yielded a scant bimodal cell population composed of benign follicular cells and a second population of larger cells, later confirmed as C-cells via immunohistochemistry. Although the diagnosis of medullary carcinoma was entertained, the absence of a discrete mass clinically and the presence of two interspersed, distinct cell populations suggested the alternate diagnosis, C-cell hyperplasia, which was confirmed by subsequent thyroidectomy. CONCLUSION: C-cell hyperplasia can mimic medullary carcinoma biochemically, and this case suggests the possible role of fine needle aspiration of the thyroid to distinguish between the two. In patients with elevated serum calcitonin and absence of a discrete thyroid nodule, the finding of clusters of calcitonin-positive cells intermixed with normal follicular cells by fine needle aspiration may provide a means of making a presurgical diagnosis of C-cell hyperplasia.
Asunto(s)
Biopsia con Aguja , Carcinoma Medular/diagnóstico , Enfermedades de la Tiroides/patología , Glándula Tiroides/patología , Anciano , Diagnóstico Diferencial , Humanos , Hiperplasia/diagnóstico , Hiperplasia/patología , Masculino , Enfermedades de la Tiroides/diagnósticoRESUMEN
A 76-year-old female presented with bright red rectal bleeding. Endoscopic evaluation revealed a polypoid lesion sprouting hair in the sigmoid colon. Histologically the resected polyp was composed of elements of all three germ layers, fulfilling the criteria for a teratoma. The differential diagnosis of this benign polyp and its significance are discussed.
Asunto(s)
Neoplasias del Colon Sigmoide/diagnóstico , Teratoma/diagnóstico , Anciano , Colon Sigmoide/patología , Colonoscopía , Femenino , Humanos , Neoplasias del Colon Sigmoide/patología , Teratoma/patologíaAsunto(s)
Leucemia Linfocítica Crónica de Células B/complicaciones , Mucormicosis/complicaciones , Infecciones Oportunistas/diagnóstico , Síndrome de la Vena Cava Superior/etiología , Humanos , Masculino , Persona de Mediana Edad , Mucormicosis/microbiología , Infecciones Oportunistas/etiología , Síndrome de la Vena Cava Superior/patología , Vena Cava Superior/patologíaAsunto(s)
Neoplasias de las Glándulas Suprarrenales/diagnóstico , Lipoma/diagnóstico , Neoplasias de las Glándulas Suprarrenales/patología , Glándulas Suprarrenales/diagnóstico por imagen , Glándulas Suprarrenales/patología , Biopsia con Aguja , Humanos , Lipoma/patología , Masculino , Persona de Mediana Edad , Tomografía Computarizada por Rayos XRESUMEN
Wegener granulomatosis involves both the respiratory and genitourinary systems. Kidney lesions are invariably focal. Wegener granulomatosis only rarely affects other genitourinary organs and, until now, has not been described as a mass in the kidney. In the case presented, the diagnosis was unknown before surgery, though clinically suspected. The management, which included nephrectomy and chemotherapy with cyclophosphamide (Cytoxan) and prednisone, caused a marked improvement, and the patient was discharged in stable condition.
Asunto(s)
Granulomatosis con Poliangitis/patología , Enfermedades Renales/patología , Granulomatosis con Poliangitis/diagnóstico por imagen , Humanos , Enfermedades Renales/diagnóstico por imagen , Enfermedades Pulmonares/diagnóstico por imagen , Masculino , Persona de Mediana Edad , Enfermedades Nasales/patología , Radiografía , CintigrafíaRESUMEN
Villous adenomas occur only rarely in the small intestine and are often associated with malignant changes. Multiple villous adenomas of the small intestine are usually seen only in patients with familial polyposis coli. This is a report of a patient with multiple villous adenomas of the ileum associated with a carcinoma of the cecum which originated from a villous adenoma near the ileocecal valve. There was no evidence of other colonic polyps and no history of familial polyposis coli. It appears that polyposis of the small intestine is a rare clinical entity which cannot often be diagnosed due to difficulty in visualizing this area.
Asunto(s)
Adenoma/patología , Neoplasias del Íleon/patología , Pólipos Intestinales/patología , Adenoma/complicaciones , Anciano , Carcinoma/complicaciones , Neoplasias del Ciego/complicaciones , Humanos , Neoplasias del Íleon/complicaciones , Pólipos Intestinales/complicaciones , MasculinoRESUMEN
A 47-year-old diabetic ethanol and intravenous drug abuser presented with symptoms and signs indistinguishable from subacute thyroiditis. After cultures of cerebrospinal fluid grew Cryptococcus neoformans, the organism was recognized in a review of a fine needle aspirate of the thyroid. Postmortem examination documented extensive thyroid inflammation and fibrosis secondary to involvement by widely disseminated C. neoformans. Fungal infection is an uncommon cause of thyroiditis, and the need for a clinical awareness of fungal thyroiditis is emphasized, as is the need to utilize special stains to detect opportunistic infections when examining cytologic preparations from immunocompromised patients.
Asunto(s)
Criptococosis/diagnóstico , Tiroiditis/diagnóstico , Biopsia con Aguja , Líquido Cefalorraquídeo/microbiología , Criptococosis/líquido cefalorraquídeo , Criptococosis/complicaciones , Criptococosis/patología , Complicaciones de la Diabetes , Humanos , Masculino , Persona de Mediana Edad , Trastornos Relacionados con Sustancias/complicaciones , Tiroiditis/complicaciones , Tiroiditis/patologíaRESUMEN
The thymus was the site of a true histiocytic lymphoma. Immunohistochemical demonstration of lysozyme and alpha-1-antitrypsin in the tumor cells indicated the histiocytic nature of the tumor. Five fetal and five adult thymus glands were studied for the presence and distribution of true histiocytic cells. Histiocytes were demonstrated predominantly in the connective tissue septa and constituted approximately 2% of cells in these thymuses. Histiocytes are therefore a normal constituent of the thymus, which may become the primary site of true histiocytic lymphoma.