Case Reports in Pathology最新文献

{"title":"Extraskeletal Myxoid Chondrosarcoma Mimicking Myoepithelial Tumor.","authors":"Bowen Jiang, Masatake Matsuoka, Kanako C Hatanaka, Shinichi Nakazato, Harumi Nakamura, Seiji Nakamura, Hirokazu Shimizu, Tomohiro Onodera, Shinya Tanaka, Yutaka Hatanaka, Norimasa Iwasaki","doi":"10.1155/crip/2779791","DOIUrl":"https://doi.org/10.1155/crip/2779791","url":null,"abstract":"<p><p>Extraskeletal myxoid chondrosarcoma (EMC) is a rare soft tissue sarcoma defined by its characteristic multinodular myxoid architecture and distinctive clinicopathological features. Although EMC typically exhibits a multinodular myxoid architecture, its histologic variability and frequent immunophenotypic overlap with other myxoid tumors can make diagnosis challenging. We report a case of EMC arising around the left knee of a 73-year-old male patient. Histologically, the tumor exhibited abundant myxoid stroma with lace-like and haphazard cellular arrangements and focal epithelioid morphology. Immunohistochemically, the lesion showed diffuse positivity for several myoepithelial markers, including epithelial membrane antigen, <i>α</i>-smooth muscle actin, HHF35, calponin, and p63. However, the absence of cytokeratin and SOX10 expression raised diagnostic uncertainty despite the myoepithelial-like immunoprofile. Because immunohistochemistry remained inconclusive, targeted RNA sequencing was performed on formalin-fixed, paraffin-embedded tissue. A <i>TAF15</i>::<i>NR4A3</i> fusion transcript was identified, leading to revision of the initial diagnosis to EMC. At 3-year follow-up, the patient remains free of recurrence or metastasis. This case demonstrates the potential for EMC to mimic myoepithelial tumors and supports the use of molecular analysis when histologic or immunohistochemical findings are insufficient for diagnosis.</p>","PeriodicalId":45638,"journal":{"name":"Case Reports in Pathology","volume":"2026 ","pages":"2779791"},"PeriodicalIF":0.5,"publicationDate":"2026-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13136674/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147844182","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":"Collision Tumors Involving Metastatic Carcinoma and Plasma Cell Myeloma: Report of Two Cases.","authors":"Ahmed A Ahmed, Muhammad Hassaan Khalid, Asad Ur Rehman, Nghia D Nguyen, Xinhai Robert Zhang","doi":"10.1155/crip/9279261","DOIUrl":"https://doi.org/10.1155/crip/9279261","url":null,"abstract":"<p><p>Synchronous coexistence of plasma cell neoplasms (PCNs) and metastatic carcinoma is not a common phenomenon and poses a significant diagnostic challenge requiring meticulous histopathological and immunophenotypic analysis for accurate lineage assignment. We report two cases of collision tumors comprising PCN and metastatic lung carcinoma. Case 1 involved a 68-year-old male with metastatic non-small cell lung adenocarcinoma who developed intracranial lesions; resection revealed metastatic adenocarcinoma intermingled with clonal plasma cells. Case 2 was a 73-year-old woman with a lytic iliac crest lesion whose bone marrow and lesion biopsies showed diffuse infiltration by both carcinoma and atypical plasma cells. Comprehensive immunohistochemical profiling, in situ hybridization (ISH), and molecular studies were performed. In both cases, histology demonstrated two distinct, intermingled cell populations without transitional features. IHC was critical for confirmation: the carcinoma cells expressed epithelial markers (AE1/AE3), whereas the plasma cell components were positive for CD138. ISH in Case 1 and flow cytometry in Case 2 confirmed clonality (kappa light-chain restriction). The final diagnoses were collision tumors of metastatic non-small cell lung adenocarcinoma with synchronous PCN (Case 1) and metastatic small cell carcinoma with synchronous PCN (Case 2). There are sporadic reports of PCN coexistent in the same lesion with solid tumors. These cases reveal the critical role of the pathologist in diagnosing collision tumors. IHC panel, including cytokeratins, CD138, and MUM1, can help in distinguishing these dual populations and avoiding diagnostic pitfalls.</p>","PeriodicalId":45638,"journal":{"name":"Case Reports in Pathology","volume":"2026 ","pages":"9279261"},"PeriodicalIF":0.5,"publicationDate":"2026-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13109713/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147783633","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":"Morular Metaplasia in Fundic Gland Polyps-A Case Report of a Rare Finding in a Common Lesion.","authors":"Benjamin Kennedy, Deepti Jacob, Kerry Bernal, Geoffrey Talmon","doi":"10.1155/crip/9126498","DOIUrl":"https://doi.org/10.1155/crip/9126498","url":null,"abstract":"<p><strong>Background: </strong>Morular metaplasia is a phenomenon described in neoplasms of various sites, including endometrioid neoplasms of the uterus and colonic tubular adenomas. Although of questionable biological significance, they may be confused with squamous differentiation/neoplasia or neuroendocrine lesions.</p><p><strong>Case presentation: </strong>A 34 year-old female patient on proton-pump inhibitor therapy underwent esophagogastroduodenoscopy for evaluation of bloating and reflux-type symptoms, which revealed three mucosal polyps within the proximal stomach. Microscopic examination showed conventional fundic gland polyps with foci of squamoid nests of whorled cells. These cells were positive for CDX2, demonstrated abnormal beta-catenin staining, and were negative for neuroendocrine markers. The diagnosis is fundic gland polyps with morular metaplasia.</p><p><strong>Conclusion: </strong>This case expands the types of lesions in which morular metaplasia may be identified, particularly in the setting of lesions with abnormalities of the Wnt/beta-catenin pathway protein expression, and raises awareness of the finding that may be confused with neoplastic lesions.</p>","PeriodicalId":45638,"journal":{"name":"Case Reports in Pathology","volume":"2026 ","pages":"9126498"},"PeriodicalIF":0.5,"publicationDate":"2026-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13109716/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147783635","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":"Unveiling a Rare Pathology: Case Report of Carcinosarcoma of the Gallbladder.","authors":"Gul Wymer, Laci-Rae Pitter, Susana Ferra","doi":"10.1155/crip/2521664","DOIUrl":"https://doi.org/10.1155/crip/2521664","url":null,"abstract":"<p><strong>Introduction and importance: </strong>Gallbladder carcinosarcoma (GBCS) is a rare and aggressive biliary tract malignancy, constituting approximately 1.7% of gallbladder cancers, with fewer than 100 cases reported in the English literature as of 2023. These tumors, often affecting gynecological organs, feature both carcinomatous and sarcomatous components. They predominantly occur in females, with a mean presentation age of 66 years. Diagnosis is primarily based on pathological analysis, and the mainstay of treatment is surgical excision.</p><p><strong>Presentation of case: </strong>We present a case of an 81-year-old female with no significant medical history, who was admitted after a fall. A CT scan revealed an 18.2 cm gallbladder mass extending into the liver and colon. The patient underwent tumor resection. Pathological examination confirmed a carcinosarcoma with osteoid and cartilage elements, supported by immunohistochemical staining as gallbladder primary.</p><p><strong>Clinical discussion: </strong>Carcinosarcomas are composed of both epithelial (commonly adenocarcinoma) and mesenchymal (spindle cell) components. Their pathogenesis remains poorly understood. Typically diagnosed at advanced stages, these tumors have a poor prognosis, with survival rates ranging from 2.9 to 6 months. Gallbladder carcinosarcomas behave similarly to sarcomas, exhibiting rapid growth and resistance to both radiation and chemotherapy. Current treatment consensus involves surgical excision of the gallbladder, extrahepatic bile duct, regional lymphadenectomy, and possibly pancreaticoduodenectomy depending on tumor extent.</p><p><strong>Conclusion: </strong>Gallbladder carcinosarcoma is a rare and aggressive malignancy with a poor prognosis even following complete resection. Given the limited number of cases, further research is necessary to improve treatment strategies for these patients.</p>","PeriodicalId":45638,"journal":{"name":"Case Reports in Pathology","volume":"2026 ","pages":"2521664"},"PeriodicalIF":0.5,"publicationDate":"2026-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13107420/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147783582","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":"A Public Health Scourge: The Recent Surge of an Ancient Disease.","authors":"Abigail Pleiss, Mikale Kuntz, Selly Strauch, Susan Roe","doi":"10.1155/crip/5799790","DOIUrl":"10.1155/crip/5799790","url":null,"abstract":"<p><p>The recent resurgence of congenital syphilis is striking, with an increase in cases 10-fold over the past 12 years, including a 30% rise within the past 3 years alone. The consequences of untreated maternal syphilis can be severe, contributing to significant fetal and neonatal illness and death in cases of congenital syphilis. We present a case involving a male fetus delivered stillborn at 33 weeks' gestation to a 30-year-old woman with limited prenatal care. The mother had been diagnosed with late latent syphilis 8 days before delivery and had a history of polysubstance use. Ultrasound at 32 weeks and 5 days revealed intrauterine fetal demise. Fetal measurements corresponded to approximately 27 weeks' gestation and demonstrated significant hydrops. Postmortem examination showed maceration, enlarged placenta, and focal necrotizing funisitis. Additional findings included arteritis of chorionic plate vessels and placental changes consistent with maternal vascular malperfusion. Radiographic evaluation identified lucent metaphyseal bands in the long bones. Immunohistochemical staining detected spirochetal organisms within the lung and placenta tissues. This case highlights the profound clinical implications of congenital syphilis and reinforces the necessity of consistent prenatal screening and prompt treatment of maternal infection.</p>","PeriodicalId":45638,"journal":{"name":"Case Reports in Pathology","volume":"2026 ","pages":"5799790"},"PeriodicalIF":0.5,"publicationDate":"2026-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13084188/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147724089","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":"Collision of Hypopharyngeal Small-Cell Neuroendocrine Carcinoma and Laryngeal Squamous Cell Carcinoma at the Aryepiglottic Fold: Case Report and Review of Literature.","authors":"Neda Mladenovic, Sasa Jakovljevic, Nada Tomanovic, Katarina Jovanovic, Nemanja Radivojevic, Djurdjina Kablar, Ana Marija Tomic","doi":"10.1155/crip/6630405","DOIUrl":"https://doi.org/10.1155/crip/6630405","url":null,"abstract":"<p><strong>Background: </strong>Collision tumors are neoplasms in which two histologically different and topographically independent tumors are joined within the same mass. The aim of this paper is to present a rare case of collision carcinoma of the larynx (squamous cell and small-cell neuroendocrine carcinoma).</p><p><strong>Case report—diagnosis/treatment: </strong>A 72-year-old patient was reported to our clinic because of hoarseness, dyspnea, and dysphagia. Neck CT showed a right-sided laryngeal tumor. The patient underwent total laryngectomy, partial pharyngectomy, and right-sided thyroidectomy with bilateral selective neck dissection. A clear collision of two morphologically and immunohistochemically different components of the tumor was seen on the sections sampled from the aryepiglottic fold.</p><p><strong>Conclusions: </strong>This case highlights the critical importance of obtaining multiple samples during tumor biopsy and emphasizes the role of detailed immunohistochemical staining. Considering the differences in histology, it is difficult to propose guidelines for treatment of these cancers.</p>","PeriodicalId":45638,"journal":{"name":"Case Reports in Pathology","volume":"2026 ","pages":"6630405"},"PeriodicalIF":0.5,"publicationDate":"2026-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13069147/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147677645","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":"Laryngeal Adenoid Cystic Carcinoma-Two Case Reports and Literature Review.","authors":"Katarina Jovanovic, Sasa Jakovljevic, Neda Mladenovic, Nemanja Radivojevic, Djurdjina Kablar, Ana Marija Tomic, Hristina Glogovac, Zoran Dudvarski","doi":"10.1155/crip/4744129","DOIUrl":"https://doi.org/10.1155/crip/4744129","url":null,"abstract":"<p><p>Laryngeal adenoid cystic carcinoma (LACC) is a rare malignant tumor, representing less than 1% of all laryngeal cancers. This tumor arises from the minor salivary or mucous glands of the upper respiratory tract and is characterized by slow growth, local invasiveness, and a high propensity for distant metastases. The submucosal extension and lack of symptoms often delay diagnosis. Such features present notable challenges in clinical practice.We report two cases of LACC in elderly male patients with clinically advanced laryngeal tumors. The first case involved a 73-year-old patient with bilateral laryngeal paralysis and subglottic stenosis caused by a tumor. Despite a prior history of tracheal adenoid cystic carcinoma treated 9 years earlier, recurrence was considered unlikely based on the available clinical, radiological, and pathological findings. Histopathological analysis confirmed the diagnosis of LACC. The patient underwent total laryngectomy, bilateral selective neck dissection, and right hemithyroidectomy. Postoperative histopathology classified the tumor as pT4aN0, and the patient remains recurrence-free 24 months post-surgery.The second case involved a 79-year-old patient presenting with persistent hoarseness and right-sided laryngeal immobility. Computed tomography scan of the neck revealed a hyperdense paraglottic mass causing laryngeal stenosis and thyroid cartilage erosion. After histopathological confirmation of LACC on an open laryngeal biopsy specimen obtained during laryngofissure, the patient underwent total laryngectomy with selective neck dissection and received postoperative radiotherapy at a total dose of 63 Gy in 30 fractions. Seventeen months after treatment, the patient remains in good health without recurrence.These two cases of LACC, both presenting in elderly male patients without traditional risk factors, showed advanced transglottic extension with cartilage invasion and differing histological patterns-cribriform/tubular in one case and predominantly solid in the other. Despite the challenges in achieving early diagnosis due to submucosal tumor growth, both patients responded favorably to surgery with or without adjuvant radiotherapy. The observed variability in macroscopic and microscopic features underscores the need for individualized treatment strategies and supports the potential value of detailed histopathological classification in guiding therapeutic decision-making for this rare tumor type.</p>","PeriodicalId":45638,"journal":{"name":"Case Reports in Pathology","volume":"2026 ","pages":"4744129"},"PeriodicalIF":0.5,"publicationDate":"2026-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13058926/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147646708","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":"Bilateral Lung Transplantation for Lymphangioleiomyomatosis With Secondary Pulmonary Hemosiderosis: A Case Report.","authors":"Fabio Varon-Vega, Eduardo Tuta-Quintero, David Mendoza, Luis Jaime Tellez, Camilo Rodriguez, Jacqueline Mugnier, María Camila Martínez-Ayala","doi":"10.1155/crip/9989977","DOIUrl":"https://doi.org/10.1155/crip/9989977","url":null,"abstract":"<p><strong>Background: </strong>Pulmonary lymphangioleiomyomatosis (LAM) is a rare and progressive disease characterized by abnormal proliferation of smooth muscle-like cells leading to diffuse cystic destruction of the lung parenchyma and respiratory compromise, predominantly affecting young women. Idiopathic pulmonary hemosiderosis (IPH), a rare disorder characterized by recurrent diffuse alveolar hemorrhage and iron deposition in the lungs, may present with nonspecific respiratory symptoms and radiologic findings that can overlap with other diffuse lung diseases, potentially leading to diagnostic confusion. Such overlap may delay accurate diagnosis and appropriate management.</p><p><strong>Case presentation: </strong>We present the case of a 29-year-old woman with a prior diagnosis of IPH who was listed for lung transplantation. She presented with severe acute respiratory decompensation and required urgent bilateral lung transplantation. Due to intraoperative hemodynamic instability, she underwent the procedure under venoarterial extracorporeal membrane oxygenation (VA-ECMO) support. Histopathological analysis of the explanted lungs revealed pulmonary LAM as the actual underlying condition, not IPH.</p><p><strong>Conclusion: </strong>This case highlights the diagnostic complexity of rare pulmonary diseases and the potential for misdiagnosis, particularly in advanced stages. It underscores the importance of considering LAM in the differential diagnosis of diffuse lung diseases in young women and demonstrates the critical role of lung transplantation and early multidisciplinary intervention in managing end-stage respiratory failure due to rare etiologies.</p>","PeriodicalId":45638,"journal":{"name":"Case Reports in Pathology","volume":"2026 ","pages":"9989977"},"PeriodicalIF":0.5,"publicationDate":"2026-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13054665/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147640149","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":"Mucinous Micropapillary Carcinoma of Breast in a Developing World Setting: Case Series With Clinicopathological Insights and Survival Analysis From a Tertiary Care Hospital.","authors":"Saba Anjum, Mehwish Mooghal, Naila Kayani, Abida Sattar, Lubna Vohra, Sana Zeeshan, Romana Idress","doi":"10.1155/crip/5573148","DOIUrl":"https://doi.org/10.1155/crip/5573148","url":null,"abstract":"<p><strong>Introduction and importance: </strong>Mucinous micropapillary carcinoma breast (MMPC) is one of the rarest subtypes of breast cancer (BC) with clinicopathologic features correlated with poor prognosis. We are aimed at identifying MMPC cases and correlate them with histopathological features, overall survival (OS), and recurrence-free survival (RFS).</p><p><strong>Case presentation/materials and methods: </strong>We retrospectively identified cases of MMPC from our institutional repository from 2017 to 2022. Data were collected regarding age, stage of BC at the time of diagnosis, tumor size, lymphovascular invasion (LVI), extranodal extension (ENE), lymph node (LN) metastasis, tumor biology, recurrence, and OS. Quantitative variables are calculated as median with range (IQR), whereas qualitative variables are presented in percentages.</p><p><strong>Clinical discussion/results: </strong>Nine MMPC cases were reported in the last 6 years, with a median age at diagnosis of 49 years. At diagnosis, 66.67% (6/9) were Stage III followed by Stage II; the average tumor size was 4.5 cm and the majority of tumors were Grade II (77.78%) followed by Grade III. LVI was seen in 66.67%, ENE in 33.33%, and LN metastases in 66.67%. Estrogen receptor (ER)/progesterone receptor (PR) was positive in 77.78%. The OS was 7/9 (77.78%) at the median follow-up of 3.5 years; recurrence was reported in two patients with an RFS of 77.78% (7/9).</p><p><strong>Conclusion: </strong>Our results demonstrate that MMPC is a rare entity that presented at a younger age with more advanced disease. Patients presented with larger tumor size, intermediate- to high-grade tumor morphology, LVI, ENE, and LN metastasis. These tumors also overexpressed ER and PR. Despite this, clinical outcomes in our cohort were relatively favorable, which is also reflected in OS (77.78%) and RFS (77.78%) at a median follow-up of 3.5 years.</p>","PeriodicalId":45638,"journal":{"name":"Case Reports in Pathology","volume":"2026 ","pages":"5573148"},"PeriodicalIF":0.5,"publicationDate":"2026-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12968074/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147436452","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":"Advanced Lymphoblastic Lymphoma, NOS in Leukaemic Phase Presenting With Sudden and Fatal CNS Haemorrhage.","authors":"Emmanuel Kissiedu Antiri, Richard Kwasi Gyasi, Kofi Ulzen-Appiah","doi":"10.1155/crip/5845893","DOIUrl":"https://doi.org/10.1155/crip/5845893","url":null,"abstract":"<p><p>B/T-lymphoblastic lymphoma (LBL), not otherwise specified (NOS), is a rare precursor lymphoid neoplasm that exists along a biological spectrum with acute lymphoblastic leukaemia (ALL). Although traditionally distinguished by the extent of bone marrow involvement, this separation becomes increasingly blurred in advanced or leukaemic presentations. Central nervous system (CNS) haemorrhage is a recognised but uncommon complication of acute leukaemia and is exceptionally rare as an initial manifestation within the LBL-ALL spectrum. We report a 58-year-old man with a 6-month history of recurrent constitutional symptoms and anaemia, partially relieved by supportive therapy, a clinical course more suggestive of an LBL than de novo ALL. On admission, he was febrile, anaemic, thrombocytopenic and hypoxic, with hepatomegaly and mild lymphadenopathy, and deteriorated rapidly, dying within 24 h. Post-mortem examination revealed a hypercellular bone marrow extensively replaced by lymphoblasts, widespread multiorgan infiltration and a large intracerebral haemorrhage with ventricular and subarachnoid extension. Histological examination demonstrated leukostasis, perivascular lymphoblast infiltration, leukaemic nodules and areas of both acute and chronic haemorrhage. The chronic clinical course, limited nodal disease and extensive marrow and extranodal involvement support an interpretation of advanced LBL, NOS in the leukaemic phase. This presentation also highlights the substantial biological overlap with ALL. This case highlights the risk of catastrophic CNS haemorrhage across the LBL-ALL spectrum and reinforces the need for vigilance, timely diagnostics and the enduring value of autopsy in clarifying unexpected deaths.</p>","PeriodicalId":45638,"journal":{"name":"Case Reports in Pathology","volume":"2026 ","pages":"5845893"},"PeriodicalIF":0.5,"publicationDate":"2026-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12968068/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147436500","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}