Solitary Fibrous Tumor Arising from the Sphenoid Sinus

Solitary fibrous tumor (SFT) is an uncommon neoplasm that usually arises from the pleura. To our knowledge, only 30 cases of SFTs in the nasal cavity and paranasal sinuses have been reported in the literature. We describe an SFT that arose from the right sphenoid sinus and extended to the nasal cavity and epipharynx. The tumor was completely removed by endoscopic sinus surgery without complication. The patient is taking an uneventful course without any evidence of recurrence of the disease 8 months after surgery now

Subconjunctival orbital fat herniation mimicking lipomatous tumors

Subconjunctival fat herniation is rarely described in the literature, but it is common in clinical practice. It represents prolapse of the intraconal fat to the subconjunctiva, mainly from aging. It usually occurs in the superotemporal quadrant of the globe, and rarely causes symptoms. Microscopically, multinucleated giant cells that frequently have a floret-like appearance (floretlike cells), and also bizarre adipocytes with nuclear vacuoles (Lochkern cells) are seen. We present a case of a 68-year-old Japanese man with subconjunctival fat herniation that showed floret-like cells and Lochkern cells. The differential diagnosis included lipomatous tumors of the orbit such as pleomorphic lipoma, liposarcoma, as these resemble subconjunctival fat herniation macroscopically. It is important to make a histopathological diagnosis for fat herniation to avoid overlooking malignant tumors and over-treating benign lesions

A Case of Intraductal Papillary Neoplasm of the Bile Duct with Stromal Invasion

Intraductal papillary neoplasm of the bile duct (IPNB) represents biliary papillary tumors mainly growing and is considered to be of relatively low-grade malignancy. Here we report a case of IPNB in whom the poorly differentiated component deeply infiltrated the bile duct wall. A 77-year-old male had an invasive carcinoma of the bile duct 3 cm in size. He underwent right hemihepatectomy with combined resection of the extrahepatic bile duct. Papillary growing tumor was observed in the common bile duct and the right posterior Glisson's pedicle was invaded. Histologic finding showed papillary adenocarcinoma in the surface layer superficially extending to the epithelium of the surrounding bile duct. In the subserosal layer, the tumor represented poorly differentiated adenocarcinoma. The tumor was diagnosed as invasive bile duct carcinoma arising from IPNB

Recurrent sebaceous carcinoma with wide intraepithelial spread to the nasal cavity: Report of two cases

Background: Sebaceous carcinoma (SC) is a relatively rare tumor that usually arises from the eyelid. Local extension down the nasolacrimal duct is relatively rare event for SC.Method: We herein report two cases of recurrent SC in the nasal cavity. Both patients had previously received primary treatment for SC of the eyelid. Seven years after the initial treatment, the first patient presented with a mass on the left medial canthus of the eyelid. Sixteen months after the initial treatment, the second patient presented with a large mass in the right nasal cavity.Results: The wide intraepithelial spread of SC over 30 mm from the initial surgical margin was beyond our expectations. The first patient is currently alive with local recurrence following the administration of chemoradiotherapy 46 months after treatment, while the second patient died of distant metastasis.Conclusion: This report focuses on the unique clinical features of intranasal recurrence of SC after treatment

Intracranial Rosai-Dorfman Disease - a Case Report and a Review of the Literature

Rosai-Dorfman disease (RDD) is an uncommon, non-neoplastic benign lymphoproliferative disease characterized by prominent,painless cervical lymphadenopathy with fever and leukocytosis. RDD is histologically characterized by emperipolesis,where large histiocytes become infiltrated with lymphocytes and plasma cells. Intracranial RDD is extremely rare. Only 79cases have been reported, including the present case. Intracranial RDD is associated with headaches, seizures, and numbnesscaused by increased intracranial pressure. A 67-year-old Japanese woman presented with dizziness and was diagnosedwith a tumor in the cerebral falx. The preoperative radiological diagnosis was meningioma. She had no lymphadenopathy. Thepatient underwent a craniotomy and tumor resection. The tumor consisted of lymphoid tissue with scattered lymph follicles.The infiltrating histiocytes showed emperipolesis. The histiocytes were immunoreactive for S-100 protein and CD68 and negativefor CD1a, leading to the diagnosis of intracranial RDD. The postoperative course was uneventful without further therapy.The dizziness had not re-appeared and MRI demonstrated no recurrence of tumors for 7 months. Intracranial RDD shows amale predominance and occurs later in life than nodal RDD. The clinical manifestations and prognosis are variable dependingon the location of the tumor and treatment. Most intracranial RDD have a benign course, but long-term follow-up is important,because recurrence has been observed

Surgical resection of a pulmonary artery pseudoaneurysm after middle lobectomy: Report of a case

A case of surgical resection of a pulmonary artery pseudoaneurysm after middle lobectomy is reported. A 76-year-old man with lung cancer, interstitial pulmonary fibrosis, and pneumoconiosis was referred for surgical resection. Right middle lobectomy with lymph node dissection was successfully performed. Postoperatively, the patient did well until a sudden high fever developed on postoperative day eight. Antibiotic therapy was started for suspected acute pneumonia, but the low-grade fever did not improve. Contrast-enhanced computed tomography showed a bronchopleural fistula that caused a pulmonary artery pseudoaneurysm. Right lower lobectomy via posterolateral thoracotomy was performed to resect the pseudoaneurysm. The pulmonary artery stump was sutured by monofilament unabsorbable stiches. The bronchus stump was sutured interruptedly with a pedicle of intercostal muscles. The patient’s postoperative course following repeat thoracotomy was complicated, including exacerbation of interstitial pneumonia and tracheostomy. He is still in hospital, and weaning off the mechanical ventilator is being attempted

Clinical significance of nuclear non-phosphorylated beta-catenin in acute myeloid leukaemia and myelodysplastic syndrome

Wnt signaling activates the canonical pathway and induces the accumulation of non-phosphorylated beta-catenin (NPBC) in the nucleus. Although this pathway plays an important role in the maintenance of haematopoietic stem cells as well as in oncogenesis, the significance of nuclear NPBC remains unclear in malignant haematopoiesis. This study examined the expression of nuclear NPBC in bone marrow specimens from 54 and 44 patients with de novo acute myeloid leukaemia (AML) and myelodysplastic syndrome (MDS), respectively. On immunohistochemistry with an anti-NPBC antibody, the nuclei were positively stained in 22 and 18 of AML and MDS specimens, respectively. Staining of nuclear NPBC was associated with AML subtypes (M6 and M7), low complete remission (CR) rate, and poor prognosis. Nuclear NPBC was also associated with a high score when using the International Prognostic Scoring System (IPSS) for MDS and with −7/−7q and complex karyotypes. These findings suggest that in situ detection of nuclear NPBC by immunohistochemistry could provide new insights into the pathogenesis and prognosis of AML and MDS

Small Cell Carcinoma of the Ureter with Malignant Lymphoma: Case Report and Literature Review

A 78-year-old man was referred to our hospital for gross hematuria. Ultrasonography and magnetic resonance urography revealed tumor in the right lower ureter. Computed tomography revealed right cervical lymph node swelling and pathological diagnosis was diffuse large B-cell lymphoma. Right nephroureterectomy was performed and pathologic examination revealed small cell carcinoma of the ureter with a small urothelial cell carcinoma component. As the patient had concomitant other malignancies, additional systemic chemotherapy was not performed. As of 3 months after operation, postoperative course has been uneventful. Only 11 cases of primary small cell carcinoma of the ureter have been described

Is it practical to determine the therapeutic strategy for breast cancer by evaluating pathological findings in core needle biopsy specimens?

Background; Core needle biopsy (CNB) specimens have been widely used not only for the diagnosis of breast cancer, but also for assessing biomarkers, including lymphovascular invasion (ly and v), nuclear grading, the estrogen receptor (ER), progesterone receptor (PR), human epidermal growth factor receptor 2 (HER-2) and Ki-67. We herein compared the pathological biomarkers of ER+/HER2- invasive breast cancers in CNB with those in the subsequent surgical specimens.　Methods; Patients with ER+/HER2- invasive breast cancer who presented to our department from August 2011 to July 2013 who had CNB and subsequent surgery were included. Lymphovascular invasion (ly, v) and nuclear grading were determined by hematoxylin and eosin staining, and the ER, PgR, HER-2, and Ki-67 status were evaluated by immunohistochemistry.　Results; The concordance rates between CNB and surgical specimens for the ly, v, nuclear grading, ER and PgR were 2.4%, 2.9%, 63.0%, 96.4% and 82.1%, respectively. Lymphovascular invasion and nuclear grading tended to be underestimated with CNB in discordant cases. The Ki-67 labeling index in CNB specimens was strongly correlated with that in surgical specimens (correlation coefficient 0.75, p<0.0001). Consequently, there was a reasonable level of agreement between CNB and surgical specimens for surrogate subtyping (82.1%).　Conclusions; CNB provided reliable information on the expression of hormone receptors, Ki-67 in ER+/HER2- invasive breast cancers. However, because of the substantial discordance between CNB and surgical specimens, the status of lymphovascular invasion and nuclear grading should not be concluded based on CNB specimens