Journal of Pathology and Translational Medicine

Case Studies

Inconspicuous longitudinal tears of the intracranial vertebral artery in traumatic basal subarachnoid hemorrhage: Seongho Kim; J Pathol Transl Med. 2020;54(2):179-183. Published online November 8, 2019; DOI: https://doi.org/10.4132/jptm.2019.10.15

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Blunt force trauma to the head or neck region can cause traumatic basal subarachnoid hemorrhage (TBSAH), which can result in rapid loss of consciousness and death; however, detecting such a vascular injury is difficult. Posterior neck dissection was performed to investigate the bleeding focus in TBSAH cases 2018 and 2019. In all four cases, autopsies revealed a longitudinal tear in the midsection of the vertebral artery’s intracranial portion. The midportion of the intracranial vertebral artery appears to be most vulnerable to TBSAH. Interestingly, three of the cases showed only a vaguely visible longitudinal fissure in the artery without a grossly apparent tear; rupture was confirmed by microscopic examination. Longitudinal fissures of the intracranial vertebral artery, which are difficult to identify without detailed examination, may be overlooked in some cases of TBSAH. Thus, careful gross and microscopic examination of the vertebral artery is recommended in cases of TBSAH.

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Effect of Ginseng Extract Ginsenoside Rg1 on Mice with Intracerebral Injury
Zixin Zhuang, Jinman Chen, Hao Xu, Yongjun Wang, Qianqian Liang
Chinese Medicine and Culture.2023;[Epub] CrossRef

Erdheim-Chester Disease Involving Lymph Nodes and Liver Clinically Mimicking Lymphoma: A Case Report: Yeoun Eun Sung, Yoon Seo Lee, Jieun Lee, Kyo Young Lee; J Pathol Transl Med. 2018;52(3):183-190. Published online December 27, 2017; DOI: https://doi.org/10.4132/jptm.2017.10.16

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Abstract PDF

Erdheim-Chester disease (ECD) is a rare non-Langerhans cell histiocytosis and multisystem disease. First described in 1930, there are no more than 750 cases reported. The etiology remains unknown, but a majority of cases of ECD and Langerhans cell histiocytosis were found to have clonal mutations involving genes of the mitogen-activated protein kinase pathway. We recently encountered a 53-year-old male patient with extensive ECD involving the systemic lymph nodes, pleura, liver, and long bones clinically mimicking malignant lymphoma. Biopsies were performed at multiple sites, including a pleural mass, an external iliac lymph node, bone marrow, and the liver. Based on histopathological and immunohistochemical findings of positivity for CD68 and negativity for CD1a and S-100, the patient was diagnosed with ECD. Interferon-α was administered as the first-line treatment, but the patient rapidly progressed to hepatic failure after 2 months of treatment. We report this rare case of ECD clinically mimicking malignant lymphoma and diagnosed by careful pathological review.

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Erdheim–Chester Disease with Isolated CNS Involvement: A Systematic Review of the Literature
Anam Haque, Carlos A. Pérez, Thejasvi A. Reddy, Rajesh K. Gupta
Neurology International.2022; 14(3): 716. CrossRef
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Faezeh Sadat Naji, Minoo Sadat Hajmiri, Zahra Mazari, Faeze Salahshour, Vahid Soleimani, Manouchehr Nakhjavani, Mahboobeh Hemmatabadi
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Morbus Erdheim-Chester
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Primary Necrobiotic Xanthogranulomatous Sialadenitis with Submandibular Gland Localization without Skin Involvement
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Interferon-α

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Case Reports

Chondroblastoma of the Lumbar Spine: A Case Report and Review of the Literature.: Sun A Kim, Kyung Ja Cho, Yong Koo Park, Jong Seok Lee, Heon Ju Kwon, Hyewon Chung, Mi Jung Kim; Korean J Pathol. 2011;45(5):532-536.; DOI: https://doi.org/10.4132/KoreanJPathol.2011.45.5.532

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We report a case of chondroblastoma arising in the lumbar spine in a 25-year-old man who presented with low back pain of 5 years duration. Plain radiography and computed tomography revealed a well-defined osteolytic mass surrounded by marginal sclerosis in the third lumbar vertebra. The mass encroached on the left neural foramen on magnetic resonance imaging. Histologically, the tumor consisted of round to oval cells with eosinophilic cytoplasm and randomly scattered osteoclastic type giant cells. There were characteristic chicken-wire calcification and aneurysmal bone cyst-like changes. Chondroblastomas of the lumbar spine are extremely rare, and only nine cases have been reported. Spinal chondroblastoma should be distinguished from other benign bone tumors, because it tends to show aggressive biological behavior with high recurrence and mortality rates.

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Clinical features, treatments and long-term follow-up outcomes of spinal chondroblastoma: report of 13 clinical cases in a single center
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Journal of Neuro-Oncology.2018; 140(1): 99. CrossRef
Chondroblastoma of the thoracic spine: a rare location. Case report with radiologic-pathologic correlation
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Malignant Eccrine Poroma of Abdomen Brief case report.: Jin Ja Park, Young Hee Choi, Kyung Chan Choi, Young Euy Park; Korean J Pathol. 1998;32(4):312-314.

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Abstract PDF: Eccrine porocarcinoma is a rare tumor of the skin. A case report of an eccrine porocarcinoma metastasizing to epidural space of spinal cord and inguinal area with a nine year follow up is described. The patient had a nodular growth of the abdomen with both inguinal lymphadenopathy three years before its first excision. After a follow up of nine years, he complained a weakness of lower extremities and back pain. Extradural mass of 10th thoracic vertebra and left inguinal mass were found. Subsequently, the masses histologically identical to the skin tumor were found.

Cytohistologic Features of Chordoma Arising in Thoracic Spine: A Case Report.: Seung Yeon Ha, Insun Kim, Sung Hye Park, Heum Rye Park; Korean J Cytopathol. 1995;6(2):199-203.

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Abstract PDF: Chordoma is relatively uncommon tumor comprising 1~4% of primary malignant bone tumors, and believed to arise from the remnants of notochordal tissue. Because of its occurrence in the thoracic spine, we report a case of chordoma in volving the thoracic spine. A 45-year-old male was suffered from chest pain radiating to the back. Chest CT showed a well marginated, round huge mass with multiseptated enhancement at the thoracic spine from T5 to T8 level, After percutaneous needle aspiration, piecemeal resection of the tumor was done. On cytologic smears. two types of neoplastic cells were arranged in sheets and cords in mucinous background. One type of cells consisted of medium sized cells with pink cytoplasm and round nuclei. The other type had voluminous bubbly or clear cytoplasm divided by intracytoplasmic septae imparting a feathery or basket-like appearance. Histologically, the tumor showed lobulated feature divided by fibrous septae and the tumor cells were pink eosinophilic or physaliphorous in morphology. Immunohistochemically, the tumor cells revealed strong positivity for low(AE1) and high (AE3) molecular weight cytokeratins.

Original Article

Cytologic Features of Plasmacytoma of the Ovary and Breast Occurred in a Patient with Solitary Plasmacytoma of Vertebra .: Mi OK Park, Hoon Kyu Oh, Yong Jin Kim, Jae Bok Park; Korean J Cytopathol. 1997;8(2):164-169.

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Abstract PDF: A case of plasmacytoma of the ovary and breast, which developed in a patient with a solitary plasmacytoma in the lumbar vertebra for nine months, was diagnosed cytologically and histologically. Enlargement of the right ovary and multiple palpable masses in the right and left breast were already present at six months after the diagnosis of vertebral solitary plasmacytoma. At eight months, plasma cell leukemia developed, and nine months the enlarged both ovaries, replaced by yellowish-gray solid tumors showed infiltration of immature plasma cells. The cytologic features of the ovarian tumors were same with those of the breast tumor. The tumor cells were of predominantly immature plasma cells with one or more nuclei. Some mature plasma cell had an eccentric nucleus with single nucleolus and peripherally clumped chromatin. Binucleated or multinucleated giant cells were often present. Histologically, sheets of poorly differentiated plasmacytoid tumor cells were separated by strands of hyaline fibrous tissue. On immunohistochemical stains, the tumor cells showed strong reactivity for lambda-light chain but no reaction for kappa-light chain, cytokeratin, or leukocyte common antigen.

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