Systemic mastocytosis associated with essential thrombocythemia.

Mastocytosis comprises a spectrum of disorders characterized by abnormal growth of mast cells (MS). Four entities are recognizable according to WHO classification. Association of systemic mastocytosis (SM) with a chronic myeloproliferative neoplasia (SM-AHNMD) is the second frequently category. Published descriptions of the clinicopathologic features of SM-AHNMD are largely limited to individual case reports. We present the case of a 41-year-old woman with thrombocytosis and mild splenomegaly. Clinical suspicion was of chronic myeloproliferative neoplasia (CMN). Bone marrow trephine biopsy examination (histology and immunohistochemistry for CD117 and CD25) revealed a SM associated with CMN, essential thrombocythemia (ET) type. The JAK2 V617F (for CMN) was detected but KIT/Asp816Val (reported in ~80% of SM) was absent. We discussed the particularity of the cases correlated with a review of the literature.

"In situ" mantle cell lymphoma associated with hyaline-vascular Castleman disease.

Mantle cell lymphoma (MCL) is a very rare non-Hodgkin B-cell lymphoma, with an aggressive clinical course and poor response to conventional therapy. Few cases of "in situ" MCL were reported in the last years. We present the case of a 31-year-old woman with a unique cervical lymphadenopathy. The morphologic findings are of hyaline-vascular Castleman disease (HV-CD). Immunohistochemical stain for cyclin D1 detects scattered cyclin D1+ cells within the mantle zones of few reactive-appearing lymphoid follicles, corresponding to the definition of "in situ" MCL. We also performed cyclin D1 in other 27 cases of CD (13 HV-CD and 14 plasma-cell CD) but the reported case was the only who associated "in situ" MCL. An adequate immunohistochemical panel, including a marker for cyclin D1, is required to differentiate this neoplasm from follicular hyperplasia. From our knowledge, this is the first reported case of "in situ" MCL associated with HV-CD.

[The indications of bronchial resection and anastomosis in lung cancer]. / Indicatii ale rezectiei bronhoanastomoza în neoplasmul bronhopulmonar.

Bronchial resection and anastomosis represents an alternative to the pneumonectomy in patients with severe impairment of pulmonary function and/or other diseases which make such radical surgery too risky. The authors present two clinical cases of right upper lobe lung cancer (a squamous-cell carcinoma and an adenocarcinoma) admitted in the Thoracic Surgery Department of the National Institute of Pulmonology "Marius Nasta" from Jan-March 2001, in which they could not perform pneumonectomy because of unacceptable high risks. In both patients a right upper lobectomy with "sleeve" resection was done, with the anastomosis of right main bronchus to the intermediary one. The clinical, bronchoscopic and functional results were excellent. The literature review also shows very good results of this technique in the surgical treatment of lung cancer. For these reasons, the authors recommend this procedure in all the cases in which it can be technically applied; more than that, the survival rate is similar with other more radical techniques, but without any complications.