Report of an imported cutaneous disseminated case of paracoccidioidomycosis

La paracoccidioidomicosis es una infección crónica progresiva.Afecta preferentemente a hombres mayores de 35 años, trabajadores ruralesy está limitada geográficamente a ciertas zonas de Latinoamérica.En Europa la enfermedad es muy rara. Presentamos el caso de unaparacoccidioidomicosis que afecta a un varón joven de 27 años, nacido enEcuador, pero residente en España desde hace varios años.Su enfermedad fue diagnosticada inicialmente como blastomicosis.Las típicas células fúngicas de Paracoccidioides brasiliensis fueronposteriormente observadas mediante la tinción de Grocott. El presente casoquiere alertar a micólogos, clínicos y patólogos sobre la posibilidad de quetambién pacientes jóvenes nacidos o que hayan viajado a zonas endémicas,puedan padecer paracoccidioidomicosis u otras micosis importadas(AU)

Paracoccidioidomycosis is a chronic progressive infection. It affects mainlythe elderly and it is geographically limited to certain areas of Latin America.In Europe it is considered a rare imported infection. Here we report a caseof paracoccidioidomycosis that occurred in a 27-year-old Ecuadorian patientliving in Spain initially misdiagnosed as blastomycosis.The typical multi-budding yeast cells of Paracoccidioides brasiliensis wereobserved in Grocott stained samples. This case should alert Spanishmycologists, clinicians and pathologists about the possibility of patients whohave travelled or lived outside Spain may suffer paracoccidioidomycosis orother imported mycoses(AU)

Fine needle aspiration cytology of high grade mucoepidermoid carcinoma of the breast: a case report.

BACKGROUND: Primary mucoepidermoid carcinoma of the breast is a very unusual tumor. It is often misdiagnosed, masquerading under different diagnoses. The cytologic assessment is especially difficult when the lesion is high grade. One reported case was initially diagnosed by fine needle aspiration cytology. CASE: A 69-year-old woman presented with a 6 x 4-cm tumor located in the upper outer quadrant of the right breast. The first cytologic diagnosis suggested ductal carcinoma with atypical squamous metaplasia; further review disclosed that the clusters of epithelial ductal cells displayed a mixed pattern of glandular, squamous and intermediate cells. There also was a scant intracellular and extracellular mucous substance, confirming the diagnosis of mucoepidermoid carcinoma. Histochemistry and immunohistochemistry, performed on the tumor and lymph node metastases, showed cellular staining for periodic acid-Schiff, and keratin, epithelial membrane antigen and carcinoembryonic antigen demonstrated the epithelial origin. The high expression of Ki-67, as well as the finding of 24 metastasized nodes in the axilla, demonstrated the tumor's aggressiveness. CONCLUSION: Fine needle aspiration cytology is a very reliable tool in achieving a fast and accurate diagnosis of primary mucoepidermoid carcinoma of the breast.

Spindle cell malignant melanoma metastatic to the breast from a pigmented lesion on the back. A case report.

BACKGROUND: Tumors metastatic to the breast are quite unusual (1.2% of all tumors). Malignant melanoma is an exception and is one of the principal metastasizing tumors, described mainly as a primary tumor. There are 5 different cytologic patterns; the spindled pattern is very uncommon, more difficult to diagnose and can be confused with a wide range of sarcomatous lesions. Nevertheless, there are some cytologic features that allow differentiation from similar tumors. CASE: A 30-year-old woman presented with a firm, deep, nontender mass in the upper outer quadrant of the right breast. Fine needle aspiration cytology was performed, and the aspiration smears showed spindle-shaped neoplastic cells arranged singly or in clusters with marked nuclear atypia. Melanin pigment was sometimes seen in the cytoplasm of some cells. Pathologic study of the breast tumor corroborated the diagnosis, and later study revealed lymph node metastases and relapse in the breast area and on a scar on the back. Two years earlier, biopsy of a pigmented lesion on the back was diagnosed as a cellular blue nevus. CONCLUSION: The cytologic features of spindle cell melanoma are distinctive. The presence of atypical fusiform cells with elongated cytoplasm; enlarged nuclei, some of them binucleated or multinucleated; prominent nucleoli; intranuclear cytoplasmic inclusions; and melanin pigment can help to diagnose these unusual metastases to the breast. This case was the first of malignant metastatic melanoma with the spindled pattern in which the diagnosis was made by fine needle aspiration cytology.

Spleen metastasis from thyroid carcinoma. Report of a case with diagnosis by fine needle aspiration cytology.

BACKGROUND: Lymphoreticular malignancies are the most common neoplasms involving the spleen. Metastasis can be caused by direct invasion from surrounding tumors or from hematogenous spread. Spleen metastases from thyroid carcinoma are unusual, and only 1 case has been reported; none have been diagnosed by fine needle aspiration cytology (FNAC). CASE: A 75-year-old female was diagnosed 6 months earlier with a poorly differentiated thyroid carcinoma with wide lymphatic and vascular invasion. Abdominal computed tomography (CT) and magnetic resonance imaging showed several spleen nodules. FNAC was performed under CT guidance. Cytologic examination showed atypical epithelial cells with thyroidal characteristics. CONCLUSION: This case had the cytologic findings of a poorly differentiated carcinoma of the thyroid metastatic to spleen. We confirmed the rarity of this pathology and the efficacy of splenic FNAC in the diagnosis.

Angiosarcoma epitelioide de suprarrenal. A propósito de un caso / Adrenal epithelioid angiosarcoma: Case report

OBJETIVO: Presentar un caso de angiosarcoma epitelioide de glándula suprarrenal. MÉTODO: Se revisan los hallazgos clínicos e histopatológicos de este raro sarcoma de localización suprarrenal, revisando la literatura. RESULTADOS: Varón de 60 años, sin antecedentes, con dolor en flanco izquierdo de ocho semanas de duración. En TAC Y RNM se pode de manifiesto la presencia de una gran masa tumoral localizada en zona suprarrenal, sin afectación de riñón. El diagnóstico definitivo se realizo en base al estudio histopatológico y de técnicas de inmunohistoquímica. CONCLUSIONES: A pesar de la rareza de los sarcomas en las glándulas suprarrenales, debe de considerarse el diagnóstico de angiosarcoma en toda tumoración adrenal. El tratamiento de elección es el quirúrgico y ampliado a quimio y/o radioterapia, según el estadio y los factores pronósticos que se deriven del estudio histopatológico (AU)

No disponible

Fine needle aspiration cytology of primary pulmonary meningioma associated with minute meningotheliallike nodules. Report of a case with histologic, immunohistochemical and ultrastructural studies.

BACKGROUND: Pulmonary meningioma is an unusual tumor located in the lung. Minute pulmonary meningotheliallike nodules are also uncommon tumor-like lesions found at the pleuropulmonary level as solitary or multiple nodules. The association of both entities is described in a recent report. CASE: A 58-year-old, male smoker without pathology underwent radiologic study before a surgical procedure. A peripheral nodule was found in the left lower lobe of the lung with benign characteristics. Fine needle aspiration cytology was performed under computed tomography guidance. Cytologic examination showed features of transitional meningioma and other lesions near the tumor. Minute pulmonary meningotheliallike nodules were also present. CONCLUSION: A diagnosis of meningioma should be considered when there is a combination of scanty material, whorls composed of concentrically arranged cells and isolated cells with intranuclear inclusions. The simultaneous presence of meningioma and meningotheliallike nodules corroborates the unifying hypothesis of their common origin and the nature of these rare pulmonary lesions.

[Epithelioid angiosarcoma of the adrenal gland. Report of a case]. / Angiosarcoma epitelioide de suprarrenal. A propósito de un caso.

OBJECTIVES: We report one case of adrenal epithelioid angiosarcoma. METHODS: We review the clinical and histopathological features of this rare adrenal sarcoma and perform a bibliographic review. RESULTS: A 60 year old male without past medical history presented with a six week flank pain. CT scan and MRI showed a big adrenal tumor without renal involvement. Definitive diagnosis was obtained by histopathological study and immunohistochemical techniques. CONCLUSIONS: Although adrenal sarcomas are rare, angiosarcoma must be considered in the differential diagnosis of every adrenal tumor. Surgery is the treatment of choice with or without adjuvant chemotherapy/radiotherapy, depending on pathological stage and prognostic factors derived from the histopathological study.