Tyler S. Yeager , Brandon C. Stroh , Raphael El Youssef , Paul J. Michaels
{"title":"Ectopic prostatic tissue involving the omentum and presenting with intussusception and small intestinal obstruction: A report of a rare case with a review of the literature","authors":"Tyler S. Yeager , Brandon C. Stroh , Raphael El Youssef , Paul J. Michaels","doi":"10.1016/j.hpr.2022.300679","DOIUrl":"10.1016/j.hpr.2022.300679","url":null,"abstract":"<div><p>Ectopic prostatic tissue has been uncommonly reported within the literature in the past, typically described involving areas within the lower genitourinary tract. Although patients can occasionally present with urinary symptoms related to the ectopic prostatic tissue, many of these cases are identified incidentally. Ectopic prostatic tissue, depending on the location, can represent a diagnostic dilemma for both clinicians and pathologists and generate a broad differential diagnosis that includes non-neoplastic and neoplastic proliferations, including both benign and malignant neoplasms.</p><p>Here we report a case of an 85-year-old male who presented with nausea, vomiting, and abdominal pain and was found to have an omental mass causing a distal small intestinal obstruction on pre-operative radiologic imaging, confirmed on exploratory laparotomy. A metastatic carcinoma was suspected clinically, as the patient had a known cystic lesion diffusely involving the pancreas. However, gross and histological evaluation of the specimen revealed an omental mass adherent to the small intestinal serosa that showed central infarction and features diagnostic of ectopic prostatic tissue, confirmed with immunohistochemical stains.</p></div>","PeriodicalId":100612,"journal":{"name":"Human Pathology Reports","volume":"30 ","pages":"Article 300679"},"PeriodicalIF":0.0,"publicationDate":"2022-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2772736X22000913/pdfft?md5=f0cc00aa2870aaeee94fa65295423746&pid=1-s2.0-S2772736X22000913-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91118481","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
William Frank Mawalla , Antimon Tibursi , Leah Mnango , Ahlam Nasser , Saida Salim Saleh , Lilian Gasper Mmbaga , Clara Chamba , Anna Schuh , Collins Meda
{"title":"A rare HIV-associated hyaline vascular multicentric castleman disease with good early response to single-agent rituximab: A case from Tanzania","authors":"William Frank Mawalla , Antimon Tibursi , Leah Mnango , Ahlam Nasser , Saida Salim Saleh , Lilian Gasper Mmbaga , Clara Chamba , Anna Schuh , Collins Meda","doi":"10.1016/j.hpr.2022.300677","DOIUrl":"10.1016/j.hpr.2022.300677","url":null,"abstract":"<div><h3>Background</h3><p>Castleman’s Disease (CD) is a diverse group of non-neoplastic lymphoproliferative disorders characterized by lymphoid endothelial and follicular hyperplasia. Human Immunodeficiency Virus (HIV)-associated Human Herpes Virus type-8 (HHV-8) CD is a form of CD affecting HIV-positive individuals with concomitant HHV-8 infection as the aetiological driver. While the prevalence of HIV and HHV-8 is high in Sub-Saharan Africa (SSA), there are however very few reported cases of CD from the region. This might reflect a high rate of misdiagnosis and under-reporting of HIV-associated HHV-8 CD in limited-resource settings. If diagnosed early and precisely, the HIV-associated HHV-8 CD can be successfully treated with chemotherapy and/or single-agent targeted therapy (rituximab), regimens that are increasingly becoming available.</p></div><div><h3>Case presentation</h3><p>We highlight a rare case of HHV-8 associated Multicentric Castleman Disease (MCD) in an HIV-positive individual who presented with lymphadenopathy, haemolytic anaemia, monoclonal gammopathy and atypical hyaline vascular variant and showed good early response with single-agent rituximab.</p></div><div><h3>Conclusions</h3><p>A high index of suspicion is needed to diagnose CD, especially in regions where infectious diseases are common and share clinicopathological features with malignant diseases. Early diagnosis is the key to appropriate management, with a potential cure for the disease.</p></div>","PeriodicalId":100612,"journal":{"name":"Human Pathology Reports","volume":"30 ","pages":"Article 300677"},"PeriodicalIF":0.0,"publicationDate":"2022-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2772736X22000895/pdfft?md5=4a4baf6c0ddb090c71ede332194d68a0&pid=1-s2.0-S2772736X22000895-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87039166","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Abigail A. Roth , Ashmi Patel , Haneen Salah , Luan D. Truong , Ziad M. El-Zaatari
{"title":"Papillary renal cell carcinoma with malakoplakia: A unique case","authors":"Abigail A. Roth , Ashmi Patel , Haneen Salah , Luan D. Truong , Ziad M. El-Zaatari","doi":"10.1016/j.hpr.2022.300681","DOIUrl":"10.1016/j.hpr.2022.300681","url":null,"abstract":"<div><p>The reported cases of malakoplakia concurrent with renal cell carcinoma (RCC) are exceedingly rare. Two prior cases of malakoplakia have been previously reported in patients with clear cell renal cell carcinoma. We report the third case of concurrent malakoplakia and RCC in the same kidney and the first case of malakoplakia with the papillary type of renal cell carcinoma. Our case occurred in a 73-year-old woman with urinary tract infection and diabetes who was found to have a large renal mass on imaging and underwent radical nephrectomy. Malakoplakia was present both within the tumor and in portions of kidney away from the tumor itself. The microscopic features of malakoplakia included PAS-positive histiocytes with calcium positive Michaelis-Gutmann bodies which were also seen on electron microscopy. Since malakoplakia can mimic renal cell carcinomas (RCC) clinically and pathologically, our case highlights the importance of an awareness of the possible concurrence of these two diagnoses for accurate histopathologic diagnosis and treatment of patients with both diseases.</p></div>","PeriodicalId":100612,"journal":{"name":"Human Pathology Reports","volume":"30 ","pages":"Article 300681"},"PeriodicalIF":0.0,"publicationDate":"2022-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2772736X22000937/pdfft?md5=31f067b3315943121622682301a7be6b&pid=1-s2.0-S2772736X22000937-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85302766","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ahmed I. Younes, Marwan M. Majeed, Moiz Vora, Maurice D. Richardson
{"title":"Activated B-cell signet ring lymphoma: A case report and a comparative review of the literature","authors":"Ahmed I. Younes, Marwan M. Majeed, Moiz Vora, Maurice D. Richardson","doi":"10.1016/j.hpr.2022.300682","DOIUrl":"10.1016/j.hpr.2022.300682","url":null,"abstract":"<div><p>Signet ring cell lymphoma is an exceedingly rare subtype of non-Hodgkin lymphoma that was originally thought to be a morphologic variant of follicular lymphoma. To date, 56 cases have been reported, with the majority occurring in lymph nodes and bone marrow. Herein, we report a case of a 37-year-old female who presented with a left inguinal mass and high suspicion of lymphoma that was rendered on MRI. A successful ultrasound-guided core biopsy was performed. Pathologic examination revealed a diffuse large B-cell lymphoma (DLBCL) with unique signet ring histology and post-germinal center phenotype. In-situ hybridization showed an isolated BCL-6 gene rearrangement and confirmed the absence of a double-hit phenotype. This case would be situated as the second case of activated B-cell (ABC) signet ring lymphoma and the first case to arise in this anatomic location. The patient recently initiated therapy with a standard six-cycle regimen of R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone).</p></div>","PeriodicalId":100612,"journal":{"name":"Human Pathology Reports","volume":"30 ","pages":"Article 300682"},"PeriodicalIF":0.0,"publicationDate":"2022-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2772736X22000949/pdfft?md5=77d6532e5fcb5a78abdea53a74a0ba43&pid=1-s2.0-S2772736X22000949-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87124866","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"EBV positive lymphoma with ambiguous lineage: A diagnostic challenge","authors":"Ali Ismail, Samer Al-Quran, Mustafa Al-Kawaaz","doi":"10.1016/j.hpr.2022.300675","DOIUrl":"10.1016/j.hpr.2022.300675","url":null,"abstract":"<div><p>We describe a case of EBV-positive lymphoma with characterization of histological, immunophenotypic, and molecular features and a brief literature review of similar entities. Atypical large lymphoid cells with pleomorphic nuclei, moderate eosinophilic cytoplasm, and high mitotic activity were noted along with positivity for CD20, OCT2, CD79a, CD19, CD2, perforin, CD30, MUM1, c-MYC, BCL-2, and CD45. Dim positivity with PAX5 and weak cytoplasmic staining with CD3 was noted. These cells were negative for CD4, CD5, CD7, CD8, CD10, BCL-6, CD15, EMA, HHV-8, TdT, Cyclin-D1 and Granzyme B. EBV encoded RNA in situ hybridization was diffusely positive in atypical cells. Both T and B cell gene rearrangements were detected which demonstrates lineage overlap in EBV-positive large cell lymphomas, supported by B and <em>T</em>-cell receptor gamma gene rearrangement proven on molecular studies. The presence of similar entities may lead to potential misclassification of neoplasms. No prognostic significance of this finding was identified.</p></div>","PeriodicalId":100612,"journal":{"name":"Human Pathology Reports","volume":"29 ","pages":"Article 300675"},"PeriodicalIF":0.0,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2772736X22000871/pdfft?md5=2e48b0d2416aea2781fb7a0de49ba849&pid=1-s2.0-S2772736X22000871-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74420711","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Kevin L. Lu , Ryan Sieberg , Rita I. Freimanis , Heather I. Greenwood , Christopher J. Schwartz
{"title":"Alveolar soft part sarcoma of the pectoralis mimicking a breast mass: A case report","authors":"Kevin L. Lu , Ryan Sieberg , Rita I. Freimanis , Heather I. Greenwood , Christopher J. Schwartz","doi":"10.1016/j.hpr.2022.300674","DOIUrl":"10.1016/j.hpr.2022.300674","url":null,"abstract":"<div><p>Alveolar soft part sarcoma (ASPS) is a potentially lethal soft tissue tumor with a xropensity for distant metastasis. We report an exceedingly rare case of an ASPS arising from the pectoralis major in a young woman, with initial clinical findings mimicking a breast mass. We present the radiographic, immunohistochemical, and molecular workup leading to the correct diagnosis, with review of the differential diagnosis.</p></div>","PeriodicalId":100612,"journal":{"name":"Human Pathology Reports","volume":"29 ","pages":"Article 300674"},"PeriodicalIF":0.0,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2772736X2200086X/pdfft?md5=a88fa4a17fbf9a7028de14794c055ca6&pid=1-s2.0-S2772736X2200086X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73394299","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ullas Batra , Shrinidhi Nathany , Mansi Sharma , Surender Dhanda , Joslia T. Jose , Anurag Mehta
{"title":"Discordant EGFR mutation results: A case report","authors":"Ullas Batra , Shrinidhi Nathany , Mansi Sharma , Surender Dhanda , Joslia T. Jose , Anurag Mehta","doi":"10.1016/j.hpr.2022.300665","DOIUrl":"10.1016/j.hpr.2022.300665","url":null,"abstract":"<div><h3>Background</h3><p>Epidermal growth factor receptor (EGFR) is one of the driver mutations in advanced Non – Small Cell Lung Carcinoma (NSCLC) and is prominently chosen to advocate personalized treatment approaches. The advancing field of molecular pathology along with the introduction of the EGFR TKIs has profoundly changed the therapeutic landscape of the NSCLC. But therapeutic decision might be challenging when different testing methods yield non-identical results.</p></div><div><h3>Method</h3><p>A patient diagnosed with lung carcinoma negative for ALK and ROS1 rearrangements was subjected to EGFR testing by Therascreen, plasma based genotyping by Roche cobas V2 and bioRAD droplet digital PCR. Taking into consideration the variant results, both Therascreen and Roche cobas V2 testing was again performed on fresh biopsies.</p></div><div><h3>Result</h3><p>Single gene testing of EGFR by Therascreen was negative. Plasma based genotyping for EGFR mutations using the Roche cobas V2, yielding a del19 mutant whereas, bioRAD droplet digital PCR revealed del19 wild type along with small clone of T790M. The Therascreen assay was negative, whereas the Roche cobas V2 yielded a positive del19 mutant. The T790M clone was not detected by cobas neither in plasma nor in tissue.</p></div><div><h3>Conclusion</h3><p>In view of the absence of T790M mutant, the patient was planned first line therapy of Osimertinib. The choice of testing modality decides the suitable therapy for the patient to a great extent. Although tissue genotyping is still the gold standard, using liquid biopsy genotyping in addition to tissue genotyping improves the discovery of sensitizing mutations in targetable genes, ultimately leading to better patient outcomes.</p></div>","PeriodicalId":100612,"journal":{"name":"Human Pathology Reports","volume":"29 ","pages":"Article 300665"},"PeriodicalIF":0.0,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2772736X22000779/pdfft?md5=ae0d0c2df3e7c2ca9040e408337ff3e4&pid=1-s2.0-S2772736X22000779-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88035517","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jacob C. Kinskey , Mary R. Schwartz , Charles C. Guo , Jae Y. Ro
{"title":"Perivascular epithelioid cell tumor in the mediastinum: Metastasis or multiple primaries?","authors":"Jacob C. Kinskey , Mary R. Schwartz , Charles C. Guo , Jae Y. Ro","doi":"10.1016/j.hpr.2022.300658","DOIUrl":"https://doi.org/10.1016/j.hpr.2022.300658","url":null,"abstract":"<div><p>We report a 38-year-old female with a history of primary pelvic PEComa and subsequent metastatic PEComa to the mediastinum who presented with recurrent mediastinal metastasis in April 2021. At initial presentation in 2010, the patient reported a three-month history of abdominal pain, hot flashes, night sweats, and a one-day history of bloating. Surgery revealed an 18-cm multilobulated pelvic mass involving the posterior uterus, bladder, and bilateral adnexa. Histology showed spindled and epithelioid tumor cells immunopositive for HMB-45, desmin, TFE3, SMA, caldesmon, Melan-A and calretinin. Cytokeratin, S-100, inhibin, myogenin, and OCT3/4 immunostains were negative. In 2013 the patient re-presented with chest pain. Imaging confirmed a mediastinal mass involving the pericardium with histology resembling the previous pelvic mass. Following initial resection and mTOR therapy, the mediastinal mass recurred once in 2015 with similar histologic findings. This case provides the first description of a malignant pelvic PEComa metastasizing to the mediastinum, and demonstrates the challenges associated with diagnosing metastatic PEComa. Though malignant PEComa with metastasis to the mediastinum is rare, it is important to recognize the natural process of this tumor to ensure adequate follow-up and patient care.</p></div>","PeriodicalId":100612,"journal":{"name":"Human Pathology Reports","volume":"29 ","pages":"Article 300658"},"PeriodicalIF":0.0,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2772736X22000706/pdfft?md5=287a42628e2f2200f55f617423d83fcb&pid=1-s2.0-S2772736X22000706-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"137159173","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Trevor F. Killeen , Sarah L. Elfering , Samy M. Riad , Michael A. Linden , Ethan Y. Leng , Raja Kandaswamy , Sarah J. Kizilbash , Blanche M. Chavers , James V. Harmon
{"title":"Nephropathic cystinosis in a kidney transplant recipient: A mesenteric lymph node demonstrates positive birefringent crystals","authors":"Trevor F. Killeen , Sarah L. Elfering , Samy M. Riad , Michael A. Linden , Ethan Y. Leng , Raja Kandaswamy , Sarah J. Kizilbash , Blanche M. Chavers , James V. Harmon","doi":"10.1016/j.hpr.2022.300661","DOIUrl":"10.1016/j.hpr.2022.300661","url":null,"abstract":"<div><p>We report a kidney transplant recipient in their early twenties with infantile nephropathic cystinosis and EBV viremia who presented with right flank pain, night sweats, and right lower quadrant abdominal tenderness. A CT scan of the abdomen demonstrated mesenteric adenopathy. A laparoscopic mesenteric lymph node biopsy was performed with a concern for post-transplant lymphoproliferative disorder (PTLD). Positive birefringent crystals were identified within the tissue macrophages of benign reactive lymph nodes. Immunohistochemical staining and flow cytometry confirmed polyclonal B-cells without evidence of a clonal B-cell population supportive of PTLD. We report intracellular birefringent crystals within lymph nodes in a patient with infantile cystinosis. We review the clinical history of the patient and the pathologic analysis to evaluate for possible PTLD.</p></div>","PeriodicalId":100612,"journal":{"name":"Human Pathology Reports","volume":"29 ","pages":"Article 300661"},"PeriodicalIF":0.0,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2772736X22000731/pdfft?md5=188a83704904b6cf930f2051dfc45413&pid=1-s2.0-S2772736X22000731-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75111992","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Justin T. Kelley , Daniel A. Arber , Scott R. Owens , Laura W. Lamps
{"title":"Extranodal follicular dendritic cell sarcoma intimately associated with the pancreas","authors":"Justin T. Kelley , Daniel A. Arber , Scott R. Owens , Laura W. Lamps","doi":"10.1016/j.hpr.2022.300663","DOIUrl":"10.1016/j.hpr.2022.300663","url":null,"abstract":"<div><p>Follicular dendritic cell sarcomas (FDCS) are rare tumors derived from non-migrating antigen-presenting cells. They are distinguished from other histiocytic and dendritic cells by their immunophenotype, which supports a mesenchymal, non-myeloid stem cell origin. A 63-year-old woman reported painless epigastric fullness for 20 years, and was eventually found to have a 16.0 cm mass indistinguishable from the pancreas and surrounding tissue. Initial needle biopsy showed a high-grade epithelioid malignant neoplasm. A Whipple resection was ultimately performed, and evaluation revealed a malignant epithelioid neoplasm with histologic and immunophenotypic features of FDCS. FDCS is a rare tumor that can involve virtually any nodal or extranodal site, and to our knowledge this is the first reported case of FDCS of the pancreas. This case report emphasizes that FDCS should be considered in the differential diagnosis of pancreatic neoplasms with focal cytokeratin positivity, so that appropriate IHC testing with FDC-associated markers can be used to confirm the diagnosis.</p></div>","PeriodicalId":100612,"journal":{"name":"Human Pathology Reports","volume":"29 ","pages":"Article 300663"},"PeriodicalIF":0.0,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2772736X22000755/pdfft?md5=a94c24db7633fcf46163e45e9836919b&pid=1-s2.0-S2772736X22000755-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80713797","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}