Medical image of the week: solitary fibrous tumor

A 68 year old female with a history of resected lung cancer and new onset joint pain and swelling presented for evaluation. Imaging revealed a right intrapleural mass and resection confirmed solitary fibrous tumor (SFT) of the pleura (benign). The patient experienced resolution of her joint pain, which was due to pulmonary hypertrophic osteoarthropathy, shortly after resection. Although not present in our patient, tumor induced hypoglycemia (Doege-Potter syndrome) can also be seen in SFTs. Solitary fibrous tumors are uncommon neoplasms of mesenchymal tissue, and can originate from either visceral or parietal pleural surfaces. Though they can grow to large size before clinical detection, the majority are benign, and can be treated with en bloc surgical resection

Medical image of the week: CMV cytopathic effect

No abstract available. Article truncated at 150 words. Bronchoalveolar lavage (BAL) was performed on a 45-year old man with a history of treated mycosis fungoides and Sézary syndrome, who presented with fever and pulmonary infiltrates. BAL Papanicolaou stain (Figure 1, 400x) showed single cells (lymphocytes, arrows and alveolar macrophages, stars) and a small cluster of 3 large cells, most likely infected type II pneumocytes, with a single prominent red stained nuclear inclusion surrounded by a clear halo. Nuclear chromatin was marginated on the nuclear membrane creating this “owl’s eye” appearance. In vitro, infected cells show cytomegalovirus (CMV) virions within the nuclear inclusion (Figure 2, small black dots encircled, 8,800x) The "owl's eye" appearance (Figure 1) is the “cytopathic effect” needed to definitively diagnose active CMV infection. While cells infected with adenovirus or herpesvirus may have nuclear inclusions, the cells typically are much smaller. CMV was cultured from the BAL, and no other pathogen was identified by cytology or ..

Medical image of the week: hepatocellular carcinoma with pulmonary metastasis

A 58-year-old man with a history of hepatitis-C, liver cirrhosis and hepatocellular carcinoma treated with sorafenib and chemoembolization was admitted with septic shock due to spontaneous bacterial peritonitis with concomitant hemorrhage and acute renal failure. The patient did not respond to broad-spectrum antibiotics, aggressive care with multiple vasopressors and ventilatory support and died shortly after admission. An autopsy was performed revealing hepatocellular carcinoma with extensive intra-abdominal and thoracic metastasis