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We herein describe a case of a 55-year-old healthy woman with localized primary thymic amyloidosis presented as a mediastinal mass, found incidentally by chest radiography.
Computed tomography revealed a 4.1 cm soft tissue lesion with nodular calcification in the left anterior mediastinum.
The resected specimen was a well-defined lobulating mass with calcification. Microscopically, the mass was consisted of amorphous eosinophilc hyalinized substances involving the thymus and intrathymic lymph nodes. These eosinophilic substances showed apple-green bi-refringence under polarized light after staining with Congo red. In immunohistochemical study, they were positive for kappa and lambda light chains and negative for amyloid A. There was no evidence of systemic amyloidosis in clinical investigations. A final diagnosis of localized primary thymic amyloidosis was made.
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EBUS-TBNA diagnosis of localised amyloidosis presenting as mediastinal lymphadenopathy Avnee Kumar, Barathi Sivasailam, Ellen Marciniak, Janaki Deepak BMJ Case Reports.2018; 11(1): e226619. CrossRef
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We performed dual color fluorescence in situ hybridization (FISH) for the bcr/abl fusion in CML using the peripheral blood smears without destruction of cell morphology to determine the bcr/abl fusion. Two patients of CML, one patient in accelerated phase and one patient in chronic phase, were selected. The blood smears were fixed in absolute methanol. FISH was performed with the Mbcr/abl translocation DNA probe mixture and the slides were stained with Wright's stain after FISH. The blood smears of both cases revealed distinct signals without destruction of cellular morphology. The normoblasts and lymphocytes revealed beautiful fused bcr/abl signals as well as granulocytes in both cases. The results provide a novel finding that the normoblasts and lymphocytes in CML are also neoplastic clonal cells which has not been demonstrated with a single-cell approach before.
Placental transmogrification (PT) is an unusual condition in which the alveoli develop a peculiar villous configuration that resembles the placental villi. We report a rare case of pulmonary PT in a 46-year-old man who presented with multiple cystic lesions and nodules on radiography. The patient was treated with a surgical excision. The cut surface of the lung lesion had a villous spongiform manifestation with a partly yellow granular appearance.
Microscopically, multiple papillary cores mimicking the villous structures of the placenta were observed within the bullous airspaces. These papillary cores contained many vascular structures, lymphoid aggregates, interstitial clear cells, mature fat and dystrophic calcification. This case was solitary and not associated with other pulmonary or systemic diseases. The etiology is unknown, and further studies will be needed to understand the pathogenesis of the lesion.
Solitary pulmonary lymphangiomas are extremely rare. We report here on an unique case of solitary pulmonary lymphangioma in an adult. A well-circumscribed, 6 cm-sized, pleural based lesion with fluid attenuation was found in a 50-year-old Korean male. He had no previous history of disease or trauma. The wedge-resected lung revealed an ill-demarcated lesion with multiple microscopic cysts and the cystic walls had loose intervening stroma.
BACKGROUND Isolated pulmonary cryptococcosis is uncommon, and it can be seen in both immunocompetent and immunocompromised individuals. In Korea, twenty cases have been described thus far. METHODS We report six additional cases of isolated pulmonary cryptococcosis, which were diagnosed by surgical biopsies or fine needle aspiration cytology. We also reviewed the clinicoradiologic and pathologic findings of all the previously published Korean cases of isolated pulmonary cryptococcosis. RESULTS Only two patients out of six cases exhibited mild cough and/or fever. Radiologically, three cases presented with multiple subpleural nodules, two with a solitary pulmonary nodule, and one with patchy pneumonic infiltration. On systemic steroid therapy, one case was in severe immunocompromised status at the time of the diagnoses; but three cases had histories of gastric or uterine cervix carcinomas, raising the initial clinical impression of hematogeneous pulmonary metastatic nodules, and one case was accompanied by synchronous pulmonary adenocarcinoma. After reviewing all twenty-six cases of isolated pulmonary cryptococcosis (twenty reported in Korea and our six additional cases), the most common radiologic finding was solitary pulmonary nodule (50%), followed by subpleurally located, multiple nodules (26.9%), pneumonic infiltrates (19.2%), and pleural effusion with thickened pleura (3.8%). Two cases were also accompanied by hilar lymphadenopathy (7.7%). Clinically, presenting symptoms varied: 18 of 26 cases (69.2%) were accompanied by cough and mild fever, but 8 of 26 cases (30.8%) were entirely asymptomatic. CONCLUSIONS Since isolated pulmonary cryptococcosis presents itself with nonspecific clinicoradiologic findings, early recognition and differentiation from malignant tumors and pulmonary tuberculosis -the most common causes of solitary pulmonary nodules in Korea- are important to avoiding unnecessary treatment.