RESUMO
We describe a 76-year-old white male with subungual amelanotic melanoma. The lack of pigmentation of the lesion may cause misdiagnosis and aggravate its poor prognosis.
Assuntos
Melanoma Amelanótico/patologia , Doenças da Unha/patologia , Idoso , Amputação Cirúrgica , Biomarcadores Tumorais/análise , Dedos/patologia , Dedos/cirurgia , Humanos , Masculino , Melanoma Amelanótico/química , Melanoma Amelanótico/cirurgia , Doenças da Unha/cirurgiaRESUMO
Angiosarcoma that develops in areas of chronic lymphedema is also called Stewart-Treves syndrome. It usually appears in areas of lymphedema several years after mastectomy for breast carcinoma. Only 10% of these angiosarcomas occur in areas of chronic lymphedema as a result of another cause. We present a patient with epithelioid angiosarcoma as a rare complication of elephantiasis.
Assuntos
Elefantíase/complicações , Hemangiossarcoma/complicações , Neoplasias Cutâneas/complicações , Doença Crônica , Feminino , Hemangiossarcoma/patologia , Humanos , Pessoa de Meia-Idade , Neoplasias Cutâneas/patologia , SíndromeRESUMO
A 47-year-old Bedouin man presented with an ulcerated nodule of several months' duration on the nape of the neck. The nodule developed on an asymptomatic, slowly growing plaque which appeared during childhood. Physical examination revealed two erythematous plaques covering the posterior and right lateral aspects of the neck. The border of the plaques was soft, circinate, with a reddish-brown color, while the center was slightly erythematous and atrophic. An ulcerated nodule measuring 2 cm was seen on one of the plaques. Physical examination was unremarkable with no lymphadenopathy. Laboratory tests, including complete blood cell count, erythrocyte sedimentation rate (ESR), and routine chemistry tests, were all within normal limits. Chest X-ray showed a small calcified perihilar lymph node. The Mantoux test was positive with erythema and induration of 15 mm after 48 h. Biopsy from a plaque showed extensive diffuse granulomatous infiltration throughout the dermis with epithelioid and Langhans giant cells surrounded by mononuclear inflammatory cells. No caseation necrosis was present. Ziehl-Neelsen, periodic acid-Schiff (PAS), and Giemsa stains were negative. Polymerase chain reaction (PCR) for the detection of Mycobacterium tuberculosis and atypical mycobacteria from a skin sample was also negative. Fresh tissue cultures yielded M. tuberculosis after 6 weeks. A biopsy specimen from the ulcerated nodule demonstrated islands of atypical malignant squamous cells invading the dermis, which were compatible with moderately differentiated squamous cell carcinoma (SCC). The ulcerated nodule was completely excised, and treatment for tuberculosis was initiated with a combination of isoniazid, rifampicin, and pyrazinamide. Within 3 months of therapy, the patient's lesions resolved, leaving only slightly atrophic hypopigmented scars. A month after the treatment's initiation, an enlarged cervical lymph node was noted showing metastatic SCC on histologic examination. The patient underwent neck dissection and radiation therapy without evidence of any further metastases.
Assuntos
Carcinoma de Células Escamosas/complicações , Lúpus Vulgar/complicações , Neoplasias Cutâneas/complicações , Carcinoma de Células Escamosas/secundário , Humanos , Metástase Linfática , Masculino , Pessoa de Meia-Idade , Neoplasias Cutâneas/patologiaRESUMO
In a bed of anthracite or bituminous coke fluidized by air at 10 to 15 meters per second at 1200 degrees to 1400 degrees C, molten ash forms beads on the surface of a coke particle, some exuding from its interior. The beads merge and detach them-selves to grow further as loose fluidized ash agglomerates of low carbon content.
