Human Pathology Reports最新文献

{"title":"Romiplostim-associated increase in CD34+ megakaryocytes in a case of immune thrombocytopenia: A case report","authors":"Charles M. Lombard ,&nbsp;Jiali Li ,&nbsp;Bijayee Shrestha","doi":"10.1016/j.hpr.2023.300708","DOIUrl":"https://doi.org/10.1016/j.hpr.2023.300708","url":null,"abstract":"<div><p>We report a patient with chronic immune thrombocytopenia purpura who underwent bone marrow biopsies before and after treatment with romiplostim. The biopsy after treatment with romiplostim showed a marked increase in the numbers of megakaryocytes which were CD34 positive. Because increased numbers of CD34 positive megakaryocytes are a feature of myelodysplastic syndromes, an extensive evaluation for myelodysplasia was undertaken including cytogenetic studies, myelodysplasia FISH studies, and NGS studies for mutations associated with myelodysplasia, as well as morphologic evaluation. There was no evidence for myelodysplasia. We suggest that treatment with romiplostim caused the increased number of CD34 positive megakaryocytes in this patient. We propose that the mechanism is through romiplostim mediated cell signaling for endomitosis. DNA synthesis including endomitosis is associated with CD34 expression on megakaryocytes.</p></div>","PeriodicalId":100612,"journal":{"name":"Human Pathology Reports","volume":"32 ","pages":"Article 300708"},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49853669","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Acute systemic infection-associated Russell body gastroesophagitis: A case report and literature review","authors":"Elizaveta Flerova ,&nbsp;Susan Inniss ,&nbsp;Nneamaka Nwaoduah ,&nbsp;Richard P. Denicola ,&nbsp;Jialing Huang","doi":"10.1016/j.hpr.2023.300696","DOIUrl":"https://doi.org/10.1016/j.hpr.2023.300696","url":null,"abstract":"<div><p>Russell body esophagitis/gastritis (RBG) is a rare gastrointestinal inflammatory condition characterized by accumulation of plasma cells containing dense eosinophilic cytoplasmic inclusions, i.e., Russell bodies. Herein, we report a case of RBG in a patient with a systemic inflammation background. A 61-year-old female presented with oral infection. Upper gastrointestinal endoscopy revealed patchy salmon-colored esophageal mucosa proximally to the gastroesophageal junction, suggestive of “Barrett’s esophagus”. Histologic examination of the biopsy tissue from the lower esophagus showed diffuse lymphoplasmacytic infiltration with abundant admixed enlarged plasma cells (Mott cells) containing bright eosinophilic, round, dense, homogenous inclusions (Russell bodies) in cytoplasm. Immunohistochemical study demonstrated membranous staining of CD138 in the Mott cells, while immunoglobulin light chain in situ hybridization revealed positivity of only kappa light chain, indicating kappa light chain restriction and clonality. A proton-pump inhibitor therapy was initiated, but the patient passed away due to generalized infection. Our case suggests that Russell body esophagitis/gastritis (RBG) can be a gastrointestinal presentation associated with acute systemic infection.</p></div>","PeriodicalId":100612,"journal":{"name":"Human Pathology Reports","volume":"31 ","pages":"Article 300696"},"PeriodicalIF":0.0,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49705759","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Usefulness of Elastica van Gieson staining and the number of samples prepared for venous invasion of colorectal cancer (pT2–pT4)","authors":"Kota Nakashima ,&nbsp;Jun Akiba ,&nbsp;Shinji Mizuochi ,&nbsp;Masamichi Nakayama ,&nbsp;Naohiro Yoshida ,&nbsp;Kenichi Koushi ,&nbsp;Takefumi Yoshida ,&nbsp;Fumihiko Fujita ,&nbsp;Hitoshi Obara ,&nbsp;Tatsuyuki Kakuma ,&nbsp;Yoshito Akagi ,&nbsp;Hirohisa Yano","doi":"10.1016/j.hpr.2022.300690","DOIUrl":"https://doi.org/10.1016/j.hpr.2022.300690","url":null,"abstract":"<div><h3>Aims</h3><p>Although venous invasion is an important prognostic factor for colorectal cancer, it may be significantly underestimated in actual daily diagnosis. In this study, hematoxylin–eosin (HE)- and Elastica van Gieson (EVG)-stained specimens of colorectal cancer (pT2–pT4) were obtained, and the influence of the number of specimens and the number of EVG-stained specimens on the prognosis were examined.</p></div><div><h3>Methods and results</h3><p>The presence or absence of venous invasion in 100 colon cancer (pT2–pT4) specimens obtained after surgical resection was observed. Assessments were made by comparing the sections, of either the specimens of the deepest part of the tumor or the whole tumor, stained with only HE, as well as a combination of HE and EVG stains. There was a relative low agreement rate between the assessments made using whole-tumor EVG-stained sections and those employing other methods. With respect to relapse-free survival, no significant difference was observed in the prognosis of cases evaluated using HE-stained samples alone relative to the presence of venous invasion. However, for evaluations made using EVG staining, a significant difference was seen even for deepest-section assessments, and this trend was even stronger when whole-tumor sections were evaluated (EVG [deepest]: <em>P</em> = 0.0128, EVG [whole sections]: <em>P</em> = 0.0069). When the whole-tumor sections were observed with EVG staining, all 15 cases without venous invasion showed no recurrence within the observation period.</p></div><div><h3>Conclusions</h3><p>The addition of EVG staining allowed the identification of venous invasion in patients with colorectal cancer, which eventually affects prognosis. Increasing the number of EVG-stained samples improves the possibility of accurate prediction.</p></div>","PeriodicalId":100612,"journal":{"name":"Human Pathology Reports","volume":"31 ","pages":"Article 300690"},"PeriodicalIF":0.0,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49705823","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Small duct type intrahepatic cholangiocarcinoma with extensive intraductal extension mimics an intraductal tubulopapillary neoplasm","authors":"Mark Fowler,&nbsp;Jeremy D. Ward,&nbsp;Johann D. Hertel,&nbsp;Eizaburo Sasatomi","doi":"10.1016/j.hpr.2022.300687","DOIUrl":"https://doi.org/10.1016/j.hpr.2022.300687","url":null,"abstract":"<div><p>Intrahepatic cholangiocarcinoma (ICCA) is classified into two main subtypes: small duct and large duct types. Small duct ICCAs are typically mass-forming (MF) type, while large duct ICCAs usually present as the periductal-infiltrating (PI) or the intraductal-growing (IG) type. We report an unusual case of small duct ICCA with both MF and IG growth patterns in a male in his early 70s with a 2.4-cm liver mass. Grossly, there was an extensive intraductal lesion and a small MF-type parenchymal nodule. Immunohistochemistry demonstrated the intraductal and invasive components were positive for CK7, CK19, EMA, and NCAM. The intraductal component showed focal immunoreactivity to alpha-fetoprotein and glypican-3, indicating focal hepatocellular differentiation. These features were consistent with small duct ICCA with secondary intraductal extension rather than a pre-existing intraductal tubulopapillary neoplasm (ITPN), demonstrating small duct ICCA can extend into bile duct lumens forming secondary intraductal lesions.</p></div>","PeriodicalId":100612,"journal":{"name":"Human Pathology Reports","volume":"31 ","pages":"Article 300687"},"PeriodicalIF":0.0,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49705576","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Malignant hyperthermia: A case report","authors":"Fereshteh Amiri,&nbsp;Mahbobeh Rashidi,&nbsp;Mohsen Savaei","doi":"10.1016/j.hpr.2023.300693","DOIUrl":"https://doi.org/10.1016/j.hpr.2023.300693","url":null,"abstract":"<div><p>Malignant hyperthermia is a rare hypermetabolic pharmacogenetic pathologic disorder of calcium release control in skeletal muscle following exposure to depolarizing muscle relaxants and inhalational anesthetics in general anesthesia. This report describes the case of a 32-year-old man undergoing emergency laparotomy after being shot in the stomach. The patient suffered a malignant hyperthermia attack following the administration of Succinylcholine to induce anesthesia and Isoflurane to maintain anesthesia. Eventually, we were able to treat the patient for malignant hyperthermia successfully.</p></div>","PeriodicalId":100612,"journal":{"name":"Human Pathology Reports","volume":"31 ","pages":"Article 300693"},"PeriodicalIF":0.0,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49705695","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Large pelvic plexiform schwannoma presenting with a perineal bulge in a child: A case report","authors":"Najla Ben Ghashir ,&nbsp;Luha Allawi ,&nbsp;Seif El Eslam Abdel Salam ,&nbsp;Vito Carlo Alberto Caponio ,&nbsp;Mohamed Tawil","doi":"10.1016/j.hpr.2023.300691","DOIUrl":"https://doi.org/10.1016/j.hpr.2023.300691","url":null,"abstract":"<div><p>Plexiform schwannoma (PS) is a rare tumor that accounts for only 5 % of all schwannomas. Most cases are small, measuring less than 3 cm in diameter, and involve the skin and superficial tissue of the head, neck, or trunk. The location of the pelvis is extremely rare for PS and even so for ordinary schwannomas. We report on our case of a four-year-old Arabic boy who presented with a palpable mass in the perineum. This was found to represent an extrapelvic extension of a large intrapelvic plexiform schwannoma measuring 8 cm in maximum dimension on magnetic resonance imaging (MRI). A diagnosis of plexiform neurofibroma was suspected. However, the mass was surgically resected and histologically confirmed to be benign PS. The location of the pelvis is extremely rare for PS and this clinical presentation with a perineal mass is unique to our case. Distinguishing PS from plexiform neurofibroma or malignant peripheral nerve sheath tumor is of utmost clinical importance. However, the preoperative diagnosis is often challenging due to nonspecific imaging features. The MRI findings highlighted here may help in the preoperative diagnosis of this rare pelvic tumor.</p></div>","PeriodicalId":100612,"journal":{"name":"Human Pathology Reports","volume":"31 ","pages":"Article 300691"},"PeriodicalIF":0.0,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49705517","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dedifferentiation of B-lymphoblastic leukemia/lymphoma with t(9;22) BCR::ABL1 to an undifferentiated neoplasm with strong keratin expression in a patient receiving blinatumomab","authors":"Krasimira A. Rozenova ,&nbsp;Anja C. Roden ,&nbsp;Christopher Hartley ,&nbsp;Jess F. Peterson ,&nbsp;Gregory E. Otteson ,&nbsp;Aref Al-Kali ,&nbsp;Harry E. Fuentes Bayne ,&nbsp;Mithun V. Shah ,&nbsp;Mrinal S. Patnaik ,&nbsp;Rebecca L. King ,&nbsp;Daniel P. Larson","doi":"10.1016/j.hpr.2022.300688","DOIUrl":"https://doi.org/10.1016/j.hpr.2022.300688","url":null,"abstract":"<div><h3>Objectives</h3><p>Lineage switch in patients with B-ALL treated with blinatumomab has been previously reported. We present a case of blinatumomab-treated B-ALL with t(9;22)(q34.1;q11.2) (Ph + B-ALL) relapsing as a keratin-positive undifferentiated neoplasm with lack of B-cell, <em>T</em>-cell, or definitive myeloid antigens and persistent <em>BCR::ABL1</em>.</p></div><div><h3>Results</h3><p>A 47-year-old male with Ph + B-ALL (p190 fusion transcript) experienced early relapse and received multi-agent therapy including blinatumomab and achieved complete remission. Eleven months after initiation of treatment, he presented with a chest wall mass. Biopsy showed an immature- appearing neoplasm without lineage-specific differentiation, but with expression of keratin and retention of the <em>BCR::ABL1</em>. Subsequently, bone marrow relapse with keratin positivity and <em>BCR::ABL1</em> was identified. The findings were most compatible with dedifferentiation and aberrant keratin expression of Ph + B-ALL.</p></div><div><h3>Conclusions</h3><p>We present, to our knowledge, the first reported case of an acute leukemia which relapsed as a dedifferentiated neoplasm and the second reported case of lymphoblastic leukemia with aberrant keratin expression in a patient with Ph + B-ALL and treatment including blinatumomab.</p></div>","PeriodicalId":100612,"journal":{"name":"Human Pathology Reports","volume":"31 ","pages":"Article 300688"},"PeriodicalIF":0.0,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49705827","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neurolipoma of the digit","authors":"Max L. Willinger ,&nbsp;Ariel Henig ,&nbsp;Jessica M. Intravia ,&nbsp;Daniel C. Ramirez ,&nbsp;Morris C. Edelman ,&nbsp;Shachar Kenan","doi":"10.1016/j.hpr.2022.300685","DOIUrl":"https://doi.org/10.1016/j.hpr.2022.300685","url":null,"abstract":"<div><p>Soft tissue masses of the fingers have a broad differential, including both benign and malignant etiologies. Of these, lipomatous tumours of the finger are exceedingly rare, with the subset of neurolipomas, rarer still. Often referred to as lipofibromatous hamartoma (LFH), or lipomatosis of nerve, among more than ten other descriptive terms, these tumours are generally associated with macrodactyly and frequently involve branches of the median nerve of the upper extremity, leading to a spectrum of neurologic sequelae. These tumours represent a diagnostic challenge due to their rarity and neural involvement, which may complicate standard biopsy techniques. Optimal surgical management is dependent on the final diagnosis, if known, or clinical judgement when a biopsy is not feasible. We present a case of a 17-year-old male with an index finger lipomatous soft tissue mass with lesional enhancement seen on imaging. The decision was made to perform an excisional biopsy, with intralesional dissection and preservation of the involved digital nerve. Based on the pathologic findings, he was diagnosed with neurolipoma of the finger without associated macrodactyly. Given the benign nature of these lesions, marginal excision without sacrifice of the involved nerve is recommended. Still, a high index of suspicion should always be employed if an underlying malignancy is suspected in which case wide excision, or amputation would be the treatment of choice after the diagnosis is confirmed. The diagnostic, intraoperative, and postoperative findings of the case are discussed.</p></div>","PeriodicalId":100612,"journal":{"name":"Human Pathology Reports","volume":"31 ","pages":"Article 300685"},"PeriodicalIF":0.0,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49705578","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cavernous angiolipoma of the Subcutis: A case report","authors":"Mitchell Taylor ,&nbsp;Jack Li ,&nbsp;Andrew Siref","doi":"10.1016/j.hpr.2022.300686","DOIUrl":"https://doi.org/10.1016/j.hpr.2022.300686","url":null,"abstract":"<div><p>Lipomas are a benign, soft-tissue tumor consisting of mature adipocytes and present as a slow-growing, painless mass. Angiolipomas are a benign variant of the lipoma and consist of adipose tissue separated by a network of anastomosing capillaries. Rare reports of angiolipomas with vasculature demonstrating a “cavernous” appearance mimicking that of cavernous hemangiomas have been described in the literature. Herein, we report a case of a subcutaneous angiolipoma with a rarely described cavernous vascular proliferation, previously designated as a cavernous angiolipoma.</p></div>","PeriodicalId":100612,"journal":{"name":"Human Pathology Reports","volume":"31 ","pages":"Article 300686"},"PeriodicalIF":0.0,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49705577","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Primary hepatic perivascular epithelioid cell tumor: A case report and review of literature","authors":"Komson Wannasai ,&nbsp;Puwitch Charoenchue ,&nbsp;Worakitti Lapisatepun ,&nbsp;Tarathep Wongsuriyathai ,&nbsp;Sarawut Kongkarnka","doi":"10.1016/j.hpr.2023.300699","DOIUrl":"https://doi.org/10.1016/j.hpr.2023.300699","url":null,"abstract":"<div><p>Primary hepatic perivascular epithelioid cell tumors (PEComas) are extremely rare soft-tissue tumors with few published reports. Herein, a case of a primary hepatic PEComa is reported, along with a review of relevant literature. A mass in the right lobe of the liver was observed during the treatment of a 24-year-old Thai woman with systemic lupus erythematosus. Imaging studies detected a liver mass in segments seven and eight. The patient underwent a right hepatectomy. A tan-brown expansile mass with well-defined borders measuring 3.5 × 4 × 3.3 cm was identified. The tumor consisted of atypical epithelioid cells arranged in a diffuse growth pattern. Thick-walled blood vessels, smooth muscle cells, myxohyaline stroma, and adipose tissue were not observed. HMB45, CD31, and actin were diffusely immunoreactive in the tumor cells, whereas CD117, S100, and hepatocyte-specific-antigen were not. Follow-up revealed recurrent hepatic tumors. This case has been described owing to the rarity of the tumor and the useful correlation between radiologic and pathological findings.</p></div>","PeriodicalId":100612,"journal":{"name":"Human Pathology Reports","volume":"31 ","pages":"Article 300699"},"PeriodicalIF":0.0,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49705715","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}