Deep penetrating nevus: a case report and brief literature review

BACKGROUND -: Deep penetrating nevus (DPN) is a distinct variant of melanocytic nevus and remains a histopathologic challenge to pathologists because of its resemblance to blue nevus, malignant melanoma, pigmented Spitz nevus, and congenital melanocytic nevus. It often goes unrecognized due to its relative rarity. CASE PRESENTATION -: Here we report a case of DPN of the left anterior leg in a 51-year old female. A brief review of the literature shows that these lesions have a distinct growth pattern and cellular morphology that can differentiate these lesions from other entities including malignant melanoma. CONCLUSION -: It is important to recognize these features because DPN carries a better prognosis than malignant melanoma

Giant atypical carcinoid of the liver with vascular metastases and local sinusoidal invasion: a case report

We present the case of a 46 year old woman with a giant, 23-centimeter, atypical carcinoid of the liver. A primary site for this neoplasm could not be identified despite multiple radiographic imaging studies, including a somatostatin scan, and a thorough inspection of the bowel during surgical resection of the lesion. Histologically, the tumor displayed mild cytologic atypia, abundant necrosis, and intravascular metastases, the last feature of which was identified by immunohistochemical markers for chromogranin and synaptophysin. Also described is the unusual sinusoidal infiltration, or "spillage," of tumor cells into the surrounding liver parenchyma, a feature that has not been described as far as we are aware but may suggest an aggressive clinical course. Even though an exact definition of atypia for these lesions apparently does not exist at this point, the multiple atypical features in this case strongly suggest the diagnosis of atypical carcinoid of the liver, thus far an altogether rare and vaguely reported entity. As more cases arise in the medical literature, it may be worthwhile to establish a set of guidelines to define atypical hepatic carcinoids and other gastrointestinal carcinoids, although survivorship data thus far indicates no significant difference in the prognosis between typical versus atypical variants

Infiltrating myoepithelial carcinoma of the breast, a case report and cytologic-histologic correlation

Abstract Introduction Infiltrating myoepithelial carcinoma remains a rarely encountered lesion of the breast. The few cases that have surfaced firmly document the histopathology of this tumor, but its cytologic characteristics seemingly have been described in only one other report. Case presentation Here we present the cytologic findings from a case of infiltrating myoepithelial carcinoma of the breast in a 52-year-old female and provide a histologic correlation with the subsequent biopsy and mastectomy specimens. While the cytology specimens displayed more myoepithelial cellular heterogeneity than was present on histology, a number of cytologic features including hypercellularity, pleomorphic spindle cells, and mitotic activity correlated well with the histopathology. Conclusion The role of fine needle aspiration in the diagnosis of mammary myoepithelial carcinoma, in this case, was to establish malignancy rather than to arrive at a specific diagnosis, as a number of different entities potentially can mimic this neoplasm on cytologic specimens.</p

Infiltrating myoepithelial carcinoma of the breast, a case report and cytologic-histologic correlation

INTRODUCTION: Infiltrating myoepithelial carcinoma remains a rarely encountered lesion of the breast. The few cases that have surfaced firmly document the histopathology of this tumor, but its cytologic characteristics seemingly have been described in only one other report. CASE PRESENTATION: Here we present the cytologic findings from a case of infiltrating myoepithelial carcinoma of the breast in a 52-year-old female and provide a histologic correlation with the subsequent biopsy and mastectomy specimens. While the cytology specimens displayed more myoepithelial cellular heterogeneity than was present on histology, a number of cytologic features including hypercellularity, pleomorphic spindle cells, and mitotic activity correlated well with the histopathology. CONCLUSION: The role of fine needle aspiration in the diagnosis of mammary myoepithelial carcinoma, in this case, was to establish malignancy rather than to arrive at a specific diagnosis, as a number of different entities potentially can mimic this neoplasm on cytologic specimens

Histology from the edge of the tumor as the neoplastic cells invade the surrounding breast tissue (hematoxylin and eosin, ×100)

<p><b>Copyright information:</b></p><p>Taken from "Infiltrating myoepithelial carcinoma of the breast, a case report and cytologic-histologic correlation"</p><p>http://www.diagnosticpathology.org/content/3/1/7</p><p>Diagnostic Pathology 2008;3():7-7.</p><p>Published online 8 Feb 2008</p><p>PMCID:PMC2257926.</p><p></p

FNA smear from the breast mass showing a crowded, haphazardly arranged cluster of cells lying amidst a metachromatic stroma

<p><b>Copyright information:</b></p><p>Taken from "Infiltrating myoepithelial carcinoma of the breast, a case report and cytologic-histologic correlation"</p><p>http://www.diagnosticpathology.org/content/3/1/7</p><p>Diagnostic Pathology 2008;3():7-7.</p><p>Published online 8 Feb 2008</p><p>PMCID:PMC2257926.</p><p></p

Biomechanical evaluation of fetal calf skull as a model for testing halo-pin designs for use in children

Rigid immobilization of the cervical spine in children is normally accomplished with a halo ring attached to the skull with pins. Concern exists about the risk of halo pin complications in small children due to their diminished skull thickness. More data are needed on biomechanical properties of the immature skull and on safe levels for halo pin penetration forces. The study included halo pin penetration tests on 43 skull samples obtained from eight fetal calves, radial compression tests of 11 skull samples, and histology. Compressive composite elastic modulus (15-139 MPa), yield stress (1-5 MPa) and composite consolidation modulus (188-479 MPa) were measured in the skull\u27s radial direction. Pin penetration force (F) in Newtons at a pin-penetration depth equal to the original skull thickness (T) in mm, was related to T as: F=100+4.3eT (R2=0.76, p\u3c0.0001). However, the 95% confidence limits on individual predictions were wide, e.g., 0-475 MPa for T=1.5 mm and 0-700 MPa for T=4 mm. These results suggest that skull thickness cannot be reliably used to predict halo pin penetration loads in a skull with similar structural and mechanical properties to that of the fetal calf. Due to the lack of available human data for comparison, the relevance of using the fetal calf skull as a model for human infants and young children remains inconclusive. Clinical recommendations regarding pediatric halo pin penetration loads cannot be made without further study of children\u27s skull structure and biomechanical properties. © 2006 Elsevier Ltd. All rights reserved

(A) The enormous tumor has all but replaced and distorted the right hepatic lobectomy specimen

<p><b>Copyright information:</b></p><p>Taken from "Giant atypical carcinoid of the liver with vascular metastases and local sinusoidal invasion: a case report"</p><p>http://www.jmedicalcasereports.com/content/1/1/47</p><p>Journal of Medical Case Reports 2007;1():47-47.</p><p>Published online 12 Jul 2007</p><p>PMCID:PMC1950516.</p><p></p> (B) Cut sections reveal diffuse areas of necrosis and a large, irregular central scar. (C) The tumor is composed mostly of a trabecular architecture but with some scattered acinar structures (H&E, 400×). The cells show mild atypia while displaying eccentric, "salt and pepper" nuclei and gritty pink cytoplasm (inset, H&E, 1000×)

(A) Multiple areas of intravascular invasion are found throughout the liver (H&E, 400×)

<p><b>Copyright information:</b></p><p>Taken from "Giant atypical carcinoid of the liver with vascular metastases and local sinusoidal invasion: a case report"</p><p>http://www.jmedicalcasereports.com/content/1/1/47</p><p>Journal of Medical Case Reports 2007;1():47-47.</p><p>Published online 12 Jul 2007</p><p>PMCID:PMC1950516.</p><p></p> (B) A stain for the neuroendocrine marker chromogranin reveals the tumor border at the left edge of the photomicrograph (H&E, 100×) with multiple scattered neoplastic cells spilling into the surrounding liver parenchyma (inset, H&E, 400×)