Inflammatory myofibroblastic tumor of epididymis: a case report and review of literature

Background Epididymal inflammatory myofibroblastic tumor, also known by various other synonyms is a rare benign disease. Only eight cases have been reported to date. The most common presentation is a scrotal mass of variable duration. For a scrotal mass it is difficult to distinguish a benign or malignant etiology, in addition to the origin whether from testis or epididymis. As a result the definitive diagnosis can only be established by surgical exploration. Case presentation We report the ninth case of epididymal IMT who based on clinical and radiological findings underwent radical orchidectomy, with the histology suggestive of inflammatory myofibroblastic tumor. At 4 years follow up the patient is free of disease recurrence. Conclusion IMT though rare should be considered in the differential diagnosis of epididymal mass. Clinically it is often difficult to distinguish the origin of mass and even though the disease has benign nature and course it is crucial to counsel patients for orchidectomy as definitive diagnosis is established on surgical exploration

Surgical management of pulmonary inflammatory pseudotumors: A single center experience

<p>Abstract</p> <p>Background</p> <p>The pulmonary inflammatory pseudotumor (PIP) is a rare disease. It is still debated whether it represents an inflammatory lesion characterized by uncontrolled cell growth or a true neoplasm. PIP is characterized by a cellular polymorphism.</p> <p>Methods</p> <p>We retrospectively analyzed 8 patients with PIP treated by surgery between 2001 and 2009. Preoperative thoracic computed tomography (CT) scan was performed in all cases. All patients underwent preoperative bronchoscopy with washing and brushing and/or transbronchial biopsy and preoperative cytology examination</p> <p>Results</p> <p>There were 5 men and 3 women, aged between 38 and 69 years (mean of 58 years). 3 patients (37%) were asymptomatic. The others had symptoms characterized by chest pain, shortness of breath and persistent cough or hemoptysis. 5 patients had neutrophilic leucocytosis. CT scan demonstrated solitary nodules (maximum diameter <3 cm) in 5 patients (62%) and lung masses (maximum diameter >3 cm) in 3 patients (37%). In 2 patients there were signs of pleural infiltration. Distant lesions were excluded in all cases. A preoperative histology examination failed to reach a definitive diagnosis in all patients. At surgery, we performed two lobectomies, one segmentectomy and five wedge resections, these being performed with videothoracoscopy (VATS), except for one patient where open surgery was used. Complete tumor resection was obtained in all patients. According to the Matsubara classification, there were 2 cases of organizing pneumonia, 5 cases of fibrous histiocytoma and one case of lymphoplasmacytoma. All patients were discharged alive from hospital between 4 and 7 days after surgery. At follow-up CT scan performed annually (range 11 to 112 months) (mean 58 months), there were no residual lesions, neither local nor distant recurrences.</p> <p>Conclusions</p> <p>PIP is a rare disease. Many synonyms have been used for this disease, usually in relation to the most represented cell type. The true incidence is unclear. Preoperative diagnosis is difficult to reach, despite performing a bronchoscopy or a transparietal needle aspiration. Different classifications have been proposed for PIP. Either medical, radiation or surgical therapy has been used for PIP. Whenever possible, surgery should be considered the standard treatment. Complete surgical resection is advocated to prevent recurrence.</p

Characterizing microplastic hazards: which concentration metrics and particle characteristics are most informative for understanding toxicity in aquatic organisms?

There is definitive evidence that microplastics, defined as plastic particles less than 5 mm in size, are ubiquitous in the environment and can cause harm to aquatic organisms. These findings have prompted legislators and environmental regulators to seek out strategies for managing risk. However, microplastics are also an incredibly diverse contaminant suite, comprising a complex mixture of physical and chemical characteristics (e.g., sizes, morphologies, polymer types, chemical additives, sorbed chemicals, and impurities), making it challenging to identify which particle characteristics might influence the associated hazards to aquatic life. In addition, there is a lack of consensus on how microplastic concentrations should be reported. This not only makes it difficult to compare concentrations across studies, but it also begs the question as to which concentration metric may be most informative for hazard characterization. Thus, an international panel of experts was convened to identify 1) which concentration metrics (e.g., mass or count per unit of volume or mass) are most informative for the development of health-based thresholds and risk assessment and 2) which microplastic characteristics best inform toxicological concerns. Based on existing knowledge, it is recommended that microplastic concentrations in toxicity tests are calculated from both mass and count at minimum, though ideally researchers should report additional metrics, such as volume and surface area, which may be more informative for specific toxicity mechanisms. Regarding particle characteristics, there is sufficient evidence to conclude that particle size is a critical determinant of toxicological outcomes, particularly for the mechanisms of food dilution and tissue translocation

Fibromatosis-like carcinoma-an unusual phenotype of a metaplastic breast tumor associated with a micropapilloma

BACKGROUND: Fibromatosis-like metaplastic carcinoma is a newly described metaplastic breast tumor, literature on which is still evolving. CASE PRESENTATION: A 77-year-old lady presented with a 2 × 2 cm mass with irregular margins in the upper and outer quadrant of left breast. Fine needle aspiration cytology (FNAC) from the lump was inconclusive. A lumpectomy was performed and sent for frozen section, which revealed presence of spindle cells showing mild atypia in a sclerotic stroma. The tumor cells revealed prominent infiltration into the adjacent fat. A differential diagnosis of a low-grade sarcoma vs. a metaplastic carcinoma, favoring the former, was offered. Final histology sections revealed an infiltrating tumor with predominant spindle cells in a collagenous background, simulating a fibromatosis. Adjacent to the tumor were foci of benign ductal hyperplasia and a micropapilloma. Immunohistochemistry (IHC) showed diffuse co-expression of epithelial markers i.e. cytokeratins (CK, HMWCK, CK7) and EMA along with a mesenchymal marker i.e. vimentin in the tumor cells. Myoepithelial markers (SMA and p63) showed focal positivity. A diagnosis of a low-grade fibromatosis-like carcinoma breast associated with a micropapilloma was formed. CONCLUSION: Fibromatosis-like carcinoma is a rare form of a metaplastic breast tumor. This diagnosis requires an index of suspicion while dealing with spindle cell breast tumors. The importance of making this diagnosis to facilitate an intra operative surgical planning is marred by diagnostic difficulties. In such cases, IHC is imperative in forming an objective diagnosis

Research recommendations to better understand the potential health impacts of microplastics to humans and aquatic ecosystems

To assess the potential risk of microplastic exposure to humans and aquatic ecosystems, reliable toxicity data is needed. This includes a more complete foundational understanding of microplastic toxicity and better characterization of the hazards they may present. To expand this understanding, an international group of experts was convened in 2020–2021 to identify critical thresholds at which microplastics found in drinking and ambient waters present a health risk to humans and aquatic organisms. However, their findings were limited by notable data gaps in the literature. Here, we identify those shortcomings and describe four categories of research recommendations needed to address them: 1) adequate particle characterization and selection for toxicity testing; 2) appropriate experimental study designs that allow for the derivation of dose-response curves; 3) establishment of adverse outcome pathways for microplastics; and 4) a clearer understanding of microplastic exposure, particularly for human health. By addressing these four data gaps, researchers will gain a better understanding of the key drivers of microplastic toxicity and the concentrations at which adverse effects may occur, allowing a better understanding of the potential risk that microplastics exposure might pose to human and aquatic ecosystems

Inflammatory myofibroblastic tumor of the lung- a case report

A 45-year-old man presented with a six-month history of progressive dyspnea with productive cough and wheezing. The patient was a heavy smoker and had a history of tongue cancer, hypertension, and asthma. Chest X-ray and computed tomography showed a mass lesion in the left hilar region and total collapse of the upper left lobe of the lung. Bronchoscopy revealed a whitish solid tumor obstructing the left upper lobe bronchus. Positron emission tomography showed increased tracer uptake in the lesion. A thoracoscopic lobectomy of the left upper lobe of the lung was performed. The final pathologic diagnosis was inflammatory myofibroblastic tumor