4 research outputs found
Frequency, histological, and immunohistochemical properties of massive inflammatory lymphocytic infiltration of leiomyomas of the uterus: An entity causing diagnostic difficulties
Massive lymphocytic infiltration of the leiomyomas of the uterus is rare
and causes diagnostic difficulties. The objective of this study is to
estimate the frequency, to analyze the clinicopathologic features, to
explore the possible pathogenetic factors, and to discuss the
differential diagnosis of this entity. We reviewed the pathology reports
of 379 patients who underwent surgery for leiomyomas at Our institution,
from 1999 until 2003, and we identified five cases of leiomyomas with
massive lymphocytic infiltration. Thereafter, we reviewed the records of
these five patients to identify the clinical, ultrasonographic, and
surgical findings they had presented. Leiomyomas with lymphocytic
infiltration were characterized by the presence of small lymphocytes,
few plasma cells, and occasional germinal lymphocytes such as
lymphoblasts confined into the leiomyoma. Immunohistochemistry was
positive for desmin and leukocyte common antigen and showed a positive
reaction to kappa and lambda light chains that is consistent with the
polyclonal nature of an inflammatory infiltration. Gross appearance and
ultrasonographic and color Doppler findings were the same as of a
typical leiomyoma. Lymphocytic infiltration of leiomyomas is a rare
histological entity. Although an inflammatory process seems to be the
pathogenetic factor, other mechanisms such as an immunoloaical or
autoimmune response, a specific human leukocyte antigen alteration, or a
viral infection could also be the cause of this entity. Differential
diagnosis must be made from malignant lymphoma, pyomyoma, and
inflammatory pseudotumor of the uterus, based on their special
histological characteristics
Special problems encountering surgical management of large retroperitoneal schwannomas
Abstract Background Retroperitoneal schwannomas are rare, usually benign tumors that originate in the neural sheath and account for only a small percentage of retroperitoneal tumors. The aim of this clinical study is to present our experience in managing retroperitoneal schwannomas with a review of the current literature and to point out the surgical technical difficulties we faced, due to the tumor's strange behavior that eroded the vertebra in two cases without causing malignant invasion. Methods We reviewed the medical files of 69 patients treated in our department for retroperitoneal tumors from January 1991 until December 2006. Five patients had retroperitoneal schwannomas according to pathology report. Results There were two male and three female patients, with a mean age of 56 years (range 44–67 years). All patients were asymptomatic and none suffered from von Recklinghausen disease. Imaging workup included ultrasonography, computed tomography and magnetic resonance imaging. One patient, after having a non-diagnostic computed tomography fine needle aspiration (CT-FNA), underwent exploratory laparotomy and incisional biopsy that established the diagnosis of schwannoma. After complete excision of the tumors, postoperative course was uneventful in all patients. Tumors' maximum diameter was 12.7 cm (range 7–20 cm). No recurrences were detected during the follow up period (6–75 months). Conclusion Preoperative establishment of diagnosis is difficult in case of retroperitoneal schwannomas, however close relationship of retroperitoneal tumors with adjacent neural structures in imaging studies should raise a suspicion. Complete surgical resection is the treatment of choice. Histology and Immunohistochemistry confirms the diagnosis.</p