Journal of Pathology and Translational Medicine

Case Reports

The Cytology of Metastatic Angiosarcoma in Pleural Fluid : A Case Report.: Na Rae Kim, Dong Hae Chung, Hyun Yee Cho; Korean J Pathol. 2009;43(3):285-259.; DOI: https://doi.org/10.4132/KoreanJPathol.2009.43.3.285

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A 74-year-old woman presented with an abrupt onset of dyspnea that she had experienced for a week. She had been suffering from cutaneous nodules in the scalp for a year. Thoracentesis of the pleural fluid was performed. The Papanicolaou-stained smears, Thin prep and cell block preparations revealed clusters of oval-shaped cells concentrically layered about amorphous acellular cores, i.e., there was microacinar lumen formation as well as singly scattered atypical cells. The cells occasionally demonstrated intracytoplasmic vacuoles and hemosiderin deposits. Those cells stained for CD31 and they were negative for pancytokeratin. Punch biopsy from the scalp nodules revealed angiosarcoma. There are currently few reported cases of angiosarcoma in an exfoliative pleural effusion. Angiosarcoma has diverse, heterogeneous cytologic features. Making the cytologic diagnosis of metastatic angiosarcoma in pleural fluid is a challenge for pathologists. Knowledge of the clinical history is of great help for diagnosing this tumor when it appears in rare sites. Immunopanels with CD31, pancytokeratin and TTF-1 are helpful for making the differential diagnosis. The pathologists should look for clues suggesting the presence of vascular differentiation in the exfoliative cytologic materials when a diagnosis of angiosarcoma is suspected.

Citations

Citations to this article as recorded by

Metastatic pleural angiosarcoma: A diagnostic pitfall might be overcome by morphologic clues and clinical correlation
Ok Ran Shin, Uiju Cho, Eundeok Chang, Kyung Jin Seo
Diagnostic Cytopathology.2015; 43(8): 669. CrossRef
Pleural fluid cytology in metastatic uterine angiosarcoma—A case report—
Shiho KURODA, Shioto SUZUKI, Akira KURITA, Mari MURAKI, Fumihiko TANIOKA
The Journal of the Japanese Society of Clinical Cytology.2014; 53(6): 498. CrossRef
Intranasal delivery of biologics to the central nervous system
Jeffrey J. Lochhead, Robert G. Thorne
Advanced Drug Delivery Reviews.2012; 64(7): 614. CrossRef
Fine Needle Aspiration Cytologic Findings of Angiosarcoma - Report of Two Cases -
Jin Xian Ji, Young Chae Chu, Lucia Kim, Suk Jin Choi, In Suh Park, Jee Young Han, Joon Mee Kim, Kyu Ho Kim, Ju Young Song
The Korean Journal of Pathology.2011; 45(2): 217. CrossRef

Tubular Apocrine Adenoma: A case report.: Seong Beom Lee, Jeana Kim, Seok Jin Kang, Sun Moo Kim; Korean J Pathol. 1995;29(6):797-799.

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Abstract PDF: Tubular apocrine adenoma is a rare benign tumor occuring most often on the scalp. We examined a case of a 69-year-old female who had a well demarcated solid nodule on the scalp. Pathol Microscopically, the tumor was composed of lobules of tubular structures. The tumor lobules were surrounded by a stroma of dense fibrous connective tissue. The tubular structures were usually formed of two rows of epithelial cells. In some areas, the widely dilated tubular structures showed papillary projections into the cavities. Some epithelial cells showed liculoma on decapitation secretion into the cystic structure. Problems of differential diagnosis with other adnexal tumors are briefly discussed.

Original Article

Juvenile Hyaline Fibromatosis in an Adult.: Young A Kim, Seoung Wan Chae, Chong Jai Kim, Je G Chi; Korean J Pathol. 2000;34(3):239-242.

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Abstract PDF: Juvenile hyaline fibromatosis is a rare disorder probably inherited as an autosomal recessive trait. It is characterized by multiple slowly growing subcutaneous nodules, hypertrophy of gingiva, flexion contracture, and radiolucent bone destruction. The histological features of the tumor-like lesions are characterized by the deposition of amorphous hyaline material in which spindle shaped cells are embedded. We report a case of juvenile hyaline fibromatosis in a 26 year-old-woman. She had multiple subcutaneous nodules in scalp, ear, forearms, right knee, and back. Surgical excision of the tumors in the scalp and ear was done. The largest one measured 13 9 6 cm, and had homogeneous, grayish yellow cut surface with calcification. Light microscopic examination showed abundant eosinophilic hyaline material with extensive calcification and metaplastic bone formation. Spindle cells were rarely observed at the periphery of the tumor. Hyaline matrix was PAS positive, diastase resistant, and alcian blue negative. Scattered spindle cells were positive for vimentin but negative for S-100 protein and smooth muscle actin. There were many reports regarding early lesions of juvenile hyaline fibromatosis; however in this patient, tumor existed for more than 20 years and the histology was somewhat different from the early lesions reported in the literature.

Case Reports

Fine Needle Aspiration Cytology of Metastatic Epithelial-Myoepithelial Carcinoma of the Scalp: A Case Report .: Mi Seon Kwon, Seung Sook Lee, Jae Soo Koh, Jin Haeng Chung; Korean J Cytopathol. 2000;11(2):93-97.

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Abstract PDF: Epithelial-myoepithelial carcinoma is an uncommon, low grade malignant epithelial neoplasm and metastasis is exceedingly rare. This article highlights the fine needle aspiration cytology(FNAC) of a case of metastatic epithelial-myoepithelial carcinoma of the scalp. A 51-year-old female presented with the left parietotemporal scalp mass two months after the left parotidectomy for epithelial-myoepithelial carcinoma. FNAC from the scalp mass showed a biphasic population of ductal epithelial and myoepithelial origin. These epithelial aggregates were numerous and formed a distinct three dimensional architecture in the background of numerous naked nuclei. The three dimensional architectures were predominantly composed of tightly cohesive eosinophilic ductular epithelial cells which tended to aggregate, overlap, and form tubules. Clear myoepithelial cells in three dimensional tissue fragment were inapparent and a few were attached to the periphery of the fragments. A few myoepithelial cells with clear abundant vaculoated cytoplasm were found in the foamy background. The cytological diagnosis was metastatic epithelial-myoepithelial carcinoma. The histologic findings of the scalp mass were those of typical epithelial-myoepithelial carcinoma. Cytologic distinction of epithelial-myoepithleial carcinoma, pleomorphic adenoma, and adenoid cystic carcinoma may be very difficult but careful attention to clinical features and cellualr details can classify these neoplasms correctly.

Malignant Melanoma Arising in Giant Congenital Melanocytic Nevus: A case report.: Jung Sun Kim, Sang Yong Song, Kye Yong Song, Je G Chi; Korean J Pathol. 1993;27(6):650-655.

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Abstract PDF: Giant congenital melanocytic nevus is found in 0.1% of live born infants. If present, this lesion has a 6.3% chance to develop malignant melanoma. We report such a case in a 22-year-old woman who had multiple pigmented skin lesions since birth. Rapidly growing masses were recently detected in the 19 cm-sized occipital pigmented lesion. Removed scalp lesion revealed yellowish white lobulated soft nodules in the background of pigmented nevus. Microscopically, the nodules consisted of epithelioid cells with prominent nucleoli, and pleomorphic cells including signetring cells. These cells seldom contained melanin pigment. There were metastatic aggregates of tumor cells in the cervical lymph node, which were reminiscent of germinal centers of lymph nodes. S-100 protein immunostaining was helpful to distinguish them. Incidentally, focally scattered pigmented spindle cells were seen in the capsule of a lymph node

Primary Cutaneous Meningioma arising from the Scalp: A case report.: Sug Hyung Lee, Seok Jin Gang, Sun Moo Kim; Korean J Pathol. 1993;27(2):181-183.

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Abstract PDF: Primary cutaneous meningiomas are extremely rare tumors found in the cutis or subcutis, and generally have a benign course. The tend to be located on the scalp, face, neck. or paravertebral area. The primary cutaneous meningioma bears similarities to developmental defects and probably originates from arachnoid cell rests in the skin, although diverse groups of cutaneous meningiomas seem to arise from several different sources. A case of primary cutaneous meningioma occuring in the scalp of left parietal area of a 27-year-old female is presented. Clinically the lesion appeared as indolent, slow growing cutaneous mass and has no connection with underlying brain tissue, as determined by examination of the roentgenographs. The definite diagnosis was made after pathological examination. Microscopically the tumor is composed of sheets and nests of meningothelial cells. Immunohistochemical and electron microscopic studies reveal the typical findings of meningioma.

Subcutaneous Granuloma Annulare of the Scalp: A case report.: Geon Kook Lee, Joong Seok Seo, Kye Yong Song, Seong Hye Park, Je G Chi, Kyoung Chan Park; Korean J Pathol. 1991;25(2):178-182.

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Abstract PDF: Subcutaneous granuloma annulare (SGA) is a rare, benign noninfectious histiocytic disease of unknown cause, characterized by necrobiosis of the connective tissue surrounded by infiltrates of histiocytes and lymphocytes. We report a case of SGA in a 49/12-year-old boy. The lesions were five nontender subcutaneous nodules in the parieto-occipital scalp, measuring 1.0 cm to 2.0 cm in diameter. Microscopical examination revealed variable stages of multiple necrobiotic areas, which showed central necrobiosis with palisading histiocytes, involving both the lower dermis and subcutaneous fatty tissue. Electron microscopic findings revealed many histiocytes in the necrobiotic areas with degenerating and necrotic collagen fibers as well as regenerating fibroblasts.

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