Basic and applied pathology最新文献

Primary adrenal lymphoma is rare, but clinically important. We report a unique case of adrenal lymphoma which showed extensive cystic change mimicking a pseudocyst. Seventy-three-year-old man visited our hospital for healthcare check-up, and was found to have a large adrenal cystic mass. He was received adrenalectomy on the impression of an adrenal pseudocyst. On gross examination, the mass was a unilocular cyst with no solid mass formation. Microscopically, the cyst wall had no epithelial lining, but was infiltrated by some atypical large lymphoid tumor cells. The cystic space was filled with coagulative necrotic material with the tumor cell shadow. The most of the tumor cells expressed leukocyte common antigen, CD20, PAX5, Ki-67, and Epstein-Barr virus (EBV)-encoded RNA, which was consistent with EBV-positive diffuse large B-cell lymphoma of the elderly. No extra-adrenal involvement was observed in imaging studies. We concluded that primary adrenal lymphoma should be considered as a rare but important cause of adrenal cysts.

Anti-glomerular basement membrane antibody-mediated glomerulonephritis (anti-GBM Ab-mediated GN) is a rare autoimmune disease, characterized by crescentic glomeruli and linear GBM staining with immunoglobulin G (IgG). Exposure to viruses can trigger the formation of autoantibodies to the GBM. We report the first case of anti-GBM Ab-mediated GN associated with hepatitis A virus (HAV) infection. Although the pathogenesis of HAV-related anti-GBM Ab-mediated GN has not been documented, we suggest that the immune complexes produced by HAV infection might be deposited in the glomerular capillary walls and lead to immune complex-mediated glomerular damage, resulting in exposure of the sequestered GBM antigens and the formation of anti-GBM antibodies. Under immunosuppressive and intravenous cyclophosphamide therapy, his renal function has been improving without development of pulmonary symptoms.

Background and aim: Nasal polyposis is a relatively common condition found in 1–4% of the general population and in high percentages of some groups of patients. Nasal polyps diagnosed clinically are not always of inflammatory origin. A variety of non-neoplastic and neoplastic conditions can present as nasal polyps. The aim of this study was to determine the various histopathological types, the predominant cells involved in the pathogenesis of inflammatory polyps with special reference to mast cells and to correlate them clinicopathologically. Methods: A total of 100 cases clinically diagnosed as nasal polyp, were studied over a period of 18 months. Results: Out of 100 cases studied, 91% of them were non-neoplastic and 9% were neoplastic. Among the non-neoplastic conditions, non-allergic polyps accounted for 70% and allergic polyps accounted for 21% of cases. Among the neoplastic lesions, 6% were benign and 3% malignant. Squamous metaplasia was seen in 16.38% of cases. In stroma, mononuclear cells were predominant in 63.7% of inflammatory polyps, eosinophils in 19.11%, prominent edematous stroma in 26.39%, and vasculature > 2/high power field (hpf) in 20.39% of inflammatory polyps. 0–5 mast cells per 10 hpf were seen in 97.8% of inflammatory polyps in epithelium, whereas 11–20 mast cells in 26.4% of inflammatory polyps were seen in stroma. Conclusions: Nasal polyps diagnosed clinically are not always of inflammatory origin and therefore have to be subjected for histopathology.

A 50-year-old woman, who underwent left mastectomy 2 years ago for infiltrating ductal carcinoma, came for follow up. A routine ultrasound of the abdomen detected a lesion in the spleen, which was suspected to be an abscess/metastasis. There was no apparent involvement of other organs such as liver, bone, lungs etc. The patient underwent splenectomy and recovered without any complications. On histopathological examination, it was diagnosed to be splenic metastasis from breast carcinoma. We present this case because of the rarity of the lesion and also as a reminder to be cognizant of one of the less likely differential diagnosis of an intraparenchymal solid splenic mass.

Primary localized amyloidosis of the urinary tract is a rare disease, usually mimicking a malignancy or inflammation in its clinical presentation and in diagnostic imaging studies. We present a case of localized amyloidosis arising in the left upper ureter in a 77-year-old man. The patient visited the hospital complaining of painless gross hematuria and dysuria for 1 month. Laboratory examination revealed hematuria only. Urine cytology was unremarkable. Abdominal computed tomography revealed an obstructing mass with calcification in the ureter. The clinical impression was of a ureteral stone or malignancy. A nephroureterectomy was performed. The ureter showed segmental fibrotic thickening with luminal obstruction. Microscopic examination revealed deposition of pale-eosinophilic amorphous material with calcification and ossification. Congo-red staining showed amyloid deposits with positive polarizing microscopic findings. Although its incidence is rare, localized amyloidosis should be considered in the differential diagnosis of ureteral tumorous lesions to avoid unnecessary surgery.