Simultaneous occurrence of T-cell and B-cell neoplasms is rare, and etiologic relationships between these 2 malignancies are poorly understood. We describe the case of a 66-year-old woman who was ...admitted to the hospital because of fever, hemoptysis, lymphadenopathy, and skin rash. Enlarged lymph nodes in axillary, pectoral, paratracheal, and periportal regions as well as slight hepatomegaly and splenomegaly were confirmed. A peripheral blood smear revealed rouleaux formation and numerous circulating plasma cells, with plasmacytoid lymphocytes. Immunofixation-electrophoresis detected a monoclonal band defined as immunoglobulin (IgG)-lambda light chains with broad-band polyclonal IgA. The patient died from abrupt splenic rupture before diagnostic work-up was finished. Postmortem examination revealed infiltration of atypical lymphoid cells exhibiting high proliferative activity admixed with typical and atypical plasma cells in several organs. Thus, plasma cell leukemia (IgG-lambda) as a rare and aggressive variant of plasma cell myeloma in the present case was associated with aggressive peripheral T-cell lymphoma and polyclonal (IgA) plasmacytosis.
Cilj istraživanja je bio utvrditi utjecaj pandemije COVID-19 na sveukupni rad patohistološkog i citološkog laboratorija u KBC-u Rijeka kao i na dijagnostiku nekih od najčešćih malignih bolesti.
...Retrospektivno su iz računalne baze podataka izvučeni i međusobno uspoređeni brojevi patohistoloških i citoloških nalaza, novodijagnosticiranih malignoma dojke, pluća, debelog crijeva, endometrija i prostate te molekularnih testova za analizu mutacije EGFR i HPV-infekcije za razdoblje od 1. ožujka do 30. rujna 2019. (prije pandemije) te od 1. ožujka do 30. rujna 2020. (za vrijeme pandemije COVID-19).
Ukupni broj izvršenih pretraga bio je statistički značajno manji za vrijeme pandemije COVID-19 u 2020. u odnosu na isto razdoblje 2019. (p<0,000), patohistološke dijagnostike za 24%, neginekoloških citoloških nalaza za 20%, ginekoloških za 13% te papa testova za 11% manje. Za vrijeme COVID-19 u odnosu na isto razdoblje prije pandemije broj novodijagnosticiranih malignih tumora značajno je smanjen za maligne novotvorine debelog crijeva (–25%, p<0,0001). Smanjenje novih slučajeva karcinoma dojke (–3%) i karcinoma prostate (–4%) bilo je manje izraženo, dok je povećanje evidentirano za karcinome pluća (+2%) i endometrija (+53%). Broj HPV-testova značajno je pao za vrijeme pandemije COVID-19, za 40% (p<0,0001).
Ovim radom smo potvrdili očekivano značajno smanjenje opsega rada tijekom prvog vala pandemije COVID-19 u 2020., i to od 11% do 40%, iako broj bolesnica/ka s novodijagnosticiranim karcinomima, osim s karcinomom debelog crijeva, nije značajno pao. Važno bi bilo formirati zajednički nacionalni registar koji bi prikupio ne samo dijagnostičke, već i terapijske postupke, posebno onkoloških bolesnica/ka, čime bi se dobio objektivniji uvid u probleme zdravstvenog sustava za vrijeme pandemije. Ovi podatci mogu poslužiti promišljanju mjera i strategije za što adekvatnije zbrinjavanje ne samo oboljelih od COVID-19, već i ostalih.
Bone Marrow Burkitt Lymphoma in a Child Knežić, Matija; Bekafigo, Irena Seili; Roganović, Jelena ...
Case reports in pathology,
09/2020, Letnik:
2020
Journal Article
Recenzirano
Odprti dostop
Burkitt lymphoma (BL) is a highly aggressive but potentially curable disease as long as adequately treated within due time. BL may occur primarily and exclusively in the bone marrow as a form of ...peripheral and extranodal disease. BL cases with isolated bone marrow involvement are challenging in regard to a prompt diagnostic process. We report a case of a sporadic extranodal subtype of isolated bone marrow BL in an 11-year-old boy. Bone marrow aspiration and biopsy, flow cytometry, and immunohistochemistry along with cytogenetics are compulsory in order to achieve the adequate diagnosis.
Estimation of plasma cell infiltrates in bone marrow aspirates (BMA) and bone marrow biopsy (BMB) is a standard method in the diagnosis and monitoring of multiple myeloma (MM). Plasma cell fraction ...in the bone marrow is therefore critical for the classification and optimal clinical management of patients with plasma cell dyscrasias. The aim of the study was to compare the percentage of plasma cells obtained by both methods with the patient clinical parameters and survival.
This retrospective study included BMA and BMB of 59 MM patients. The conventional differential count was determined in BMA to estimate the percentage and cytologic grade of plasma cells. The pattern of neoplastic infiltration and percentage of plasma cells were estimated on CD138 immunostained BMB slides microscopically and by computer-assisted image analysis (CIA).
Significantly higher values of plasma cell infiltrates were observed in pathologist (47.7 +/- 24.8) and CIA (44.1 +/- 30.6) reports in comparison with cytologist analysis (30.6 +/- 17.1; P < 0.001 and P < 0.0048, respectively). BMB assessment by pathologist counting and using CIA showed strongest correlation (r = 0.8; P < 0.0001). Correlation was also observed between the pathologist and cytologist counts (r = 0.321; P = 0.015) as well as comparing the percentage of plasma cells in BMA and CIA (r = 0.27; P = 0.05). Patients with clinical stage I/II had a significantly lower CIA plasma cell count than those with clinical stage III (P = 0.008). Overall survival was shorter in patients with more than 25% of atypical plasma cell morphology estimated in BMA (P = 0.05) and a higher percentage of tumor cell infiltrates estimated by the pathologist and CIA (P = 0.0341 and P = 0.013, respectively).
Study results suggested the combined analyses to be useful as a routine procedure to achieve more accurate and informative diagnostic data.
Objective – Spindle epithelial tumor with thymus-like element (SETTLE) is an extremely rare neoplasm of the thyroid gland. We present the first case of SETTLE in Croatia.Case Report – A 17-year-old ...girl with Hashimoto’s thyroiditis was presented with an asymptomatic solitary thyroid nodule. Fine-needle aspiration cytology was suggestive of SETTLE. The patient underwent hemithyroidectomy and immunohistopathology confirmed the diagnosis. There is no evidence of local or distant disease recur- rence at 8 years after surgery. Conclusion – SETTLE should be included in the differential diagnosis of thyroid gland tumors in children and adolescents. Surgical resection is the mainstay of treatment. Due to possible late metastases, a close and long-term follow-up is recommended.
Introduction: Perivascular epitheloid cell tumors (PEComa) represent a group of usually benign mesenchymal neoplasms. Malignant variants are usually found only in adults.
Case: We present a ...10-year-old girl with infraclavicular malignant PEComa, negative for HMB-45 and Melan A but focally positive for MITF.
Conclusion: To the best of our knowledge, no malignant variant of PEComa has been described in soft tissue in a child. Generally, PEComas are immunoreactive for HMB-45 and/or Melan A while our case was negative for both. Further studies are necessary to elucidate the significance of this immunohistochemical finding.
Celotno besedilo
Dostopno za:
DOBA, IJS, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Abstract
Introduction
Merkel cell carcinoma is a rare and aggressive primary cutaneous neuroendocrine malignant tumor. The tumor has a high rate of local recurrence after surgical removal. ...Spontaneous regression appears to be relatively common in this rare type of tumor.
Case presentation
We describe the clinical course, cytological and histological findings of a Merkel cell carcinoma in a 70-year-old Caucasian woman, simultaneously diagnosed with chronic lymphatic leukemia. The tumor showed clinical regression after fine needle aspiration. At primary presentation, the tumor had no apparent leukocyte infiltration, but was completely cleared by T-cell mediated immunity within 3 weeks after fine needle aspiration.
Conclusion
Fine needle aspiration may have acted as a mechanical trigger involved in the activation of cell-mediated immunity, leading to the clinical and histological regression of the tumor. To the best of our knowledge, this is the first case report of spontaneous regression of Merkel cell carcinoma in a patient with a co-malignancy, that is to say, chronic lymphocytic leukemia.
Citološka punkcija štitnjače nezamjenjiva je dijagnostička metoda u procjeni rizika za malignitet u čvorovima štitnjače. Bethesda klasifikacija citoloških nalaza štitnjače nastala je 2007. godine kao ...rezultat analize velikog broja podataka prikupljenih iz različitih ustanova i sadrži šest kategorija. Za svaku kategoriju procijenjen je rizik za malignitet i usvojene preporuke za daljnji postupak s pacijentom, a ujednačena je i terminologija u citološkim nalazima. Primjenjuje se u Sjedinjenim Američkim Državama i većini europskih zemalja uz neke nacionalne modifikacije. Prikazani su također i prvi rezultati njene primjene na Odjelu za opću citologiju Kliničkog bolničkog centra Rijeka u 2015. godini.
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