Cutaneous Perivascular Epithelioid Cell Tumor of Gynecologic Origin Metastatic to Skin, Lung, Stomach, and Brain

Regarding the first case report recently published by Navale et al1 about a skin perivascular epithelioid cell tumor (PEComa) with focal melanin pigmentation, we wish to present another exceptional case of a malignant uterine PEComa metastatic to skin and lung, gastric lymph-vascular invasion, and brain dissemination, which was also initially misdiagnosed as skin melanoma because of the presence of epithelioid features and the expression of some melanocytic markers. Our patient was a 62-year-old woman, who presented with abnormal uterine bleeding that prompted hysterectomy 3 years ago. An extrainstitutional pathology report on the surgical specimen revealed a lesion compatible with a uterine leiomyosarcoma that was managed with adjuvant radiotherapy. At the 2-year clinical follow-up, the patient presented with a mass on the posterior region of the neck, which required undergoing surgical excision. The pathology study features were compatible with a malignant melanoma. Other reassessment and follow-up studies evidenced a compromise of the lung, with histopathological diagnosis of metastatic melanoma. A year ago, the patient presented with a new pigmented lesion on the right cheek. Once again, the biopsy study revealed a melanoma

Localized Castleman’s Disease in the Breast in a Young Woman

Castleman’s disease (CD) is a rare lymphoproliferative disorder of unknown etiology. It typically occurs in adulthood but it may also develop in childhood. Clinically, this disease may be classified as localized (unicentric) or systemic (multicentric). Six cases of breast CD have been described in the literature, and all have been reported in adults. Herein we describe the case of a 15-year-old female who presented with a slow-growing tumor in the right breast. The tumor was excised and histopathological examination demonstrated hyaline vascular variant CD. After two years of follow-up, the patient was asymptomatic without evidence of cervical or axillary lymphadenopathy

Dermatofibrosarcoma Protuberans Of the Vulva Treated with Mohs Micrographic Surgery

Dermatofibrosarcoma protuberans (DFSP) of the vulva is extremely rare conditions. It has been published approximately 43 case reports in medical literature; most tumors arise on the labia majora. We present a 57-year-old woman with DFSP in vulva that was removed by Mohs Micrographic Surgery technique. The wound exhibited a satisfying functional and cosmetic appearance, with no evidence of deformity of the vulva

Cutaneous perivascular epithelioid cell tumor of gynecologic origin metastatic to skin, lung, stomach, and brain

Q4Q3157-15

microRNA Expression Profiling in Young Prostate Cancer Patients

MicroRNAs (miRNAs) are small, non-coding RNA molecules with multiple roles in many biological processes. Few studies have shown the molecular characteristics in younger prostate cancer (PCa) patients. In this study, we performed miRNA profiling in young PCa (EO-PCa) cases compared with PCa arising in older men (LO-PCa).Experimental Design: Formalin-fixed, paraffin embedded tissue was used. miRNA was extracted for PCR array and NanoString methods. Relative miRNAs expression levels were obtained by comparing young vs older men, and young PCa tumor samples vs normal epithelium.Results: miRNA profiling showed a different expression pattern in PCa arising in younger men, and young PCa tumoral and its normal counterpart. Nine miRNAs (hsa-miR-140-5p, hsa-miR-146a, hsa-miR-29b, hsa-miR-9, hsa-miR-124-3p, hsa-let-7f-5p, hsa-miR-184, hsa-miR-373, hsa-miR-146b-5p) showed differences in the expression compared to LO-PCa. Fourteen miRNAs were significantly up-regulated (miR-1973, miR-663a, miR-575, miR-93-5p, miR-630, miR-600, miR-494, miR-150-5p, miR-137, miR-25-3p, miR-375, miR-489, miR-888-5p, miR-142-3p), while 9 were found down-regulated (miR-21-5p, miR-363-3p, miR-205-5p, miR-548ai, miR-3195, 145-5p, miR-143-3p, miR-222-3p, miR-221-3p) comparing young PCa tumoral tissue compared to normal counterpart. The higher expression of miR-600 and miR-137 were associated with high Gleason score, extraprostatic extension and lymphatic invasion.Conclusion: These results suggest that PCa in younger patients has a different expression profile compared to normal tissue and PCa arising in older man. Differentially expressed miRNAs provide insights of molecular mechanisms involve in this PCa subtype

Interpretation of minor salivary gland biopsy in Sjögren’s syndrome. Clinical-pathological correlation

La biopsia de glándula salival menor (BGSM) es uno de los principales criterios (no el único) para el diagnóstico del síndrome de Sjögren, y esto tiene que ir en conjunto con la clínica y los niveles de anticuerpos. Diferentes clasificaciones se han desarrollado para evaluar la interpretación de los hallazgos observados en la BGSM y poder categorizar / diagnosticar el síndrome de Sjögren. Esto ha causado que los patólogos y los clínicos tengan una inadecuada interpretación de la BGSM debido a que existe confusión por las diferentes escalas de puntuación que se han implementado a lo largo del tiempo. El presente artículo de revisión tiene como objetivo ilustrar a la comunidad científica, especialmente reumatólogos, cirujanos orales, internistas y patólogos, entre otros, sobre los hallazgos a considerar en la BGSM al momento del reporte por parte del patólogo.The minor salivary gland biopsy (MSBG) is one of the main criteria (not the only one) for the diagnosis of Sjögren’s syndrome, and has to be taken in conjunction with the clinic parameters and the antibodies levels. Different classifications have been developed to evaluate the interpretation of the findings observed in the MSBG and to be able to categorise / diagnose Sjögren’s syndrome. This has meant pathologists and clinicians have had anunsuitable interpretation of the MSBG due to the existence of confusion due to the different scoring scales that have been implemented over time. This review article aims to illustrate to the scientific community, especially rheumatologists, oral surgeons, internists, and pathologists, among others, on the findings to be considered in the MSBG when reported by the pathologist

Carcinosarcoma with choriocarcinomatous and osteosarcomatous differentiation in a patient with juvenile polyposis syndrome

Juvenile polyposis syndrome (JPS) is an infrequent autosomal dominant hereditary predisposition to the occurrence of hamartomatous polyps in the colon and rectum. We describe the case of a 12-year-old boy with JPS associated with an abdominal tumor. Histological sections of the abdominal tumor showed components of adenocarcinoma, osteosarcoma, and choriocarcinoma. Immunohistochemistry was AE1/AE3, CK7, HCG and SALL4 positive. Juvenile polyposis syndrome patients are at increased risk of colorectal adenocarcinoma. However, we present a case of an adenocarcinoma associated with other unusual components. This association has not been reported before

Pulmonary Sequestration Associated with Actinomycosis: A Case Report

Background: Bronchopulmonary sequestration is a rare congenital malformation of the lower respiratory tract; it consists of a nonfunctioning mass of lung tissue that is irrigated by an anomalous systemic artery. The association with Actinomyces superinfection has not been well established. Methods: We present the case of a 35-year-old woman with a history of recurrent episodes of pneumonia. Based on radiological and histopathological examination, she was diagnosed with intralobar bronchopulmonary sequestration associated with Actinomyces infection. Promoting clinical suspicion is essential to diagnose pulmonary actinomycosis in patients with recurrent pneumonia, to improve early recognition and timely management

Tumors of the thyroid gland with clear cell change. A potential diagnostic error in pathology

Las lesiones tiroideas con cambio de célula clara son tumores infrecuentes que en general causan dificultad diagnóstica que obliga al patólogo a un riguroso estudio macroscópico e histológico de la pieza en estricta correlación con la historia clínica. El objetivo de esta revisión es conocer una variedad de neoplasias localizadas en la glándula tiroides con cambio de célula clara que hacen necesario complementar el diagnóstico con inmunohistoquímica para determinar la histogénesis y así definir el comportamiento biológico.Thyroid lesions with clear cell change are infrequent tumors that usually cause diagnostic difficulty that oblige the pathologist to a rigorous macroscopic study and histological examination of the work piece in strict correlation with the clinical history. The objective of this review is to know a variety of tumors located in the thyroid gland with clear cell change that in general makes it necessary to complement with immunohistochemistry in order to determine its etiology and define its biological behavior

Thyroid diseases: Differences and controversies between the pathology report and clinical interpretation. PART II: Pathological aspects and diagnostic methods with therapeutic impact

Como revisamos en la primera parte1 hay algunos conceptos que deben ser considerados para el adecuado manejo médico por parte del equipo clínico que recibe el reporte de patología, de esta misma manera existen aspectos por parte del patólogo que este debe conocer, los cuales tienen impacto terapéutico. En esta segunda parte queremos revisar algunos conceptos que son de importancia por parte del patólogo que aplican directamente sobre la interpretación del clínico, como: procesamiento macroscópico; estudio de la citología por aspiración con aguja fina (FNA) vs. biopsia trucut, utilidad de la biopsia por congelación y de la inmunohistoquímica, así como los métodos e imágenes diagnósticas.As was reviewed in the first part, there are some concepts that should be considered for the appropriate medical management by the medical team that receives the pathology report. Similarly, there are some aspects that the pathologist should know, such as those that can have therapeutic impact. In this second part, a short review is presented on some of the concepts that are of importance to the pathologist that apply directly to the interpretation by the clinician, such as the macroscopic processing, the cytology study of the fine-needle aspirate (FNA) vs. “tru-cut” biopsy, the usefulness of the frozen biopsy, and immunohistochemistry, as well as diagnostic methods and diagnostic images