Benign spindle cell lesions of the breast: a diagnostic approach to solitary fibrous tumour, nodular pseudoangiomatous stromal hyperplasia and nodular fasciitis

2019 ◽  
Vol 72 (6) ◽  
pp. 438-442 ◽  
Author(s):  
Julia R Naso ◽  
Connie G Chiu ◽  
Michelle E Goecke ◽  
Debra Chang ◽  
Carolyn J Shiau
Keyword(s):  
Differential Diagnosis ◽  
Clinical Management ◽  
Core Biopsy ◽  
Spindle Cell ◽  
Solitary Fibrous Tumour ◽  
Accurate Diagnosis ◽  
Diagnostic Approach ◽  
Nodular Fasciitis ◽  
Pseudoangiomatous Stromal Hyperplasia ◽  
Ancillary Studies

Benign spindle cell lesions of the breast include neoplastic and reactive entities that are diagnostically challenging given their rarity and similar histomorphology. Accurate diagnosis on percutaneous core biopsy within this category is essential as some lesions require excision and surveillance, whereas others may be observed. We present three cases of rare benign spindle cell lesions of the breast that reflect the diversity of this group: solitary fibrous tumour, nodular pseudoangiomatous stromal hyperplasia and nodular fasciitis. Through these cases, we discuss the associated differential diagnosis and demonstrate how emerging ancillary studies can be integrated into a diagnostic approach. We highlight distinctive clinical and histopathological features and summarise recent updates to the clinical management of these lesions. An organised approach to the broad differential of spindle cell lesions is essential for appropriate diagnosis and treatment.

scholarly journals Cellular Spindled Histiocytic Pseudotumor: A Benign Mimic of Spindle Cell Neoplasia of the Breast

2019 ◽  
Vol 143 (12) ◽  
pp. 1497-1503
Author(s):  
Ellen G. East ◽  
Cody S. Carter ◽  
Andrew P. Sciallis
Keyword(s):  
Differential Diagnosis ◽  
Spindle Cell ◽  
Data Sources ◽  
Fat Necrosis ◽  
Ancillary Studies

Context.— Cellular spindled histiocytic pseudotumor (CSHPT) is an exuberant, dense histiocytic proliferation seen in the setting of mammary fat necrosis. CSHPT has a broad histologic differential diagnosis, including benign, malignant, and inflammatory etiologies. Objectives.— To highlight the most important histologic and immunohistochemical findings of CSHPT and provide comparisons to entities within the broad differential diagnosis. Data Sources.— Recently published literature regarding CSHPT and other diagnostic considerations. Conclusions.— CSHPT is a benign histiocytic proliferation with a broad differential diagnosis, for which comprehensive ancillary studies may be required to exclude malignant and infectious entities.

scholarly journals Differential Diagnosis of Hypoglycemia

2021 ◽  
Vol 96 (6) ◽  
pp. 484-492
Author(s):  
Young Sang Lyu ◽  
Jin Hwa Kim ◽  
Sang Yong Kim
Keyword(s):  
Differential Diagnosis ◽  
Treatment Strategy ◽  
Accurate Diagnosis ◽  
Diagnostic Approach ◽  
Hypoglycemic Agents ◽  
Blood Testing ◽  
Appropriate Treatment ◽  
Life Threatening

Hypoglycemia is common but can lead to life-threatening consequences. Accurate diagnosis is important to establish the appropriate treatment strategy. Most cases of hypoglycemia are caused by hypoglycemic agents, although it can occur in individuals without diabetes. A systemic and comprehensive diagnostic approach is required to diagnose hypoglycemia in patients without diabetes. It is important to perform appropriate blood testing during an episode of hypoglycemia. This review will focus on the definition, differential diagnosis, causes, and treatment of hypoglycemia, particularly in people without diabetes.

scholarly journals Mammary Hibernoma: A Rare Entity

2014 ◽  
Vol 139 (12) ◽  
pp. 1565-1567 ◽  
Author(s):  
Meghan P. Riley ◽  
Dipti M. Karamchandani
Keyword(s):  
Differential Diagnosis ◽  
Spindle Cell ◽  
Clinical Importance ◽  
Screening Mammography ◽  
Rare Entity ◽  
Inflammatory Conditions ◽  
Malignant Breast ◽  
Cell Variant ◽  
Histologic Types ◽  
Ancillary Studies

Hibernoma arising in the breast is rare and may present as an asymptomatic mass or may be detected by screening mammography. Four histologic types have been identified: typical, myxoid variant, spindle cell variant, and the lipoma-like variant. The most common “typical variant” is composed of pale to eosinophilic multivacuolated cells with interspersed univacuolar cells. Hibernomas are universally benign and are not known to recur or have an aggressive behavior, even in incompletely excised lesions. Hence, their clinical importance lies in distinguishing them from other benign and malignant breast neoplasms as well as inflammatory conditions that come into the histologic or radiologic differential. This review discusses the clinical features, radiologic and histopathologic characteristics, ancillary studies, suggested pathogenesis, differential diagnosis, and treatment of and prognosis for these uncommon lesions.

scholarly journals Differential Diagnosis of Azoospermia in Men with Infertility

2021 ◽  
Vol 10 (14) ◽  
pp. 3144
Author(s):  
Danilo L. Andrade ◽  
Marina C. Viana ◽  
Sandro C. Esteves
Keyword(s):  
Differential Diagnosis ◽  
Physical Examination ◽  
Detailed Analysis ◽  
Clinical Management ◽  
Semen Analysis ◽  
Testicular Biopsy ◽  
Nonobstructive Azoospermia ◽  
Sperm Cryopreservation ◽  
Imaging Studies ◽  
Detailed Medical History

The differential diagnosis between obstructive and nonobstructive azoospermia is the first step in the clinical management of azoospermic patients with infertility. It includes a detailed medical history and physical examination, semen analysis, hormonal assessment, genetic tests, and imaging studies. A testicular biopsy is reserved for the cases of doubt, mainly in patients whose history, physical examination, and endocrine analysis are inconclusive. The latter should be combined with sperm extraction for possible sperm cryopreservation. We present a detailed analysis on how to make the azoospermia differential diagnosis and discuss three clinical cases where the differential diagnosis was challenging. A coordinated effort involving reproductive urologists/andrologists, geneticists, pathologists, and embryologists will offer the best diagnostic path for men with azoospermia.

The 6C model for accurately capturing the patient’s medical history

Diagnosis ◽  
2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Taro Shimizu
Keyword(s):  
Artificial Intelligence ◽  
Differential Diagnosis ◽  
Patient Safety ◽  
Information Processing ◽  
Safety Concern ◽  
Data Gathering ◽  
Diagnostic Errors ◽  
Accurate Diagnosis ◽  
History Taking ◽  
Novel Approach

Abstract Diagnostic errors are an internationally recognized patient safety concern, and leading causes are faulty data gathering and faulty information processing. Obtaining a full and accurate history from the patient is the foundation for timely and accurate diagnosis. A key concept underlying ideal history acquisition is “history clarification,” meaning that the history is clarified to be depicted as clearly as a video, with the chronology being accurately reproduced. A novel approach is presented to improve history-taking, involving six dimensions: Courtesy, Control, Compassion, Curiosity, Clear mind, and Concentration, the ‘6 C’s’. We report a case that illustrates how the 6C approach can improve diagnosis, especially in relation to artificial intelligence tools that assist with differential diagnosis.

A rare case of rectal bleeding and Fusobacterium mortiferum sepsis due to solitary fibrous tumour originating from the mesentery

2021 ◽  
Vol 14 (10) ◽  
pp. e244603
Author(s):  
Swaminathan Perinkulam Sathyanarayanan ◽  
Khizar Hamid ◽  
Kayla Hoerschgen ◽  
Tony Oliver
Keyword(s):  
Abdominal Pain ◽  
Rectal Bleeding ◽  
Rare Case ◽  
Fusion Gene ◽  
Solitary Fibrous Tumour ◽  
Accurate Diagnosis ◽  
Solitary Fibrous Tumours ◽  
Mesenchymal Tumours

Solitary fibrous tumours (SFTs) are rare mesenchymal tumours that are mostly seen in the pleura. Lately, they have also been described in other locations. Recent discovery of the NAB2-STAT6 fusion gene which is specific for SFTs has led to an accurate diagnosis of SFTs. The occurrence of SFTs in the mesentery is very rarely reported in the literature. We report a case of a 63-year-old female who presented with abdominal pain, rectal bleeding and Fusobacterium bacteraemia, who was ultimately found to have a mesenteric SFT.

scholarly journals Lipoma of the Thumb: Spindle Cell Subtype

2016 ◽  
Vol 2016 ◽  
pp. 1-3 ◽  
Author(s):  
Johnny El Rayes ◽  
Roula Bou Sader ◽  
Elie Saliba
Keyword(s):  
Differential Diagnosis ◽  
Soft Tissue ◽  
Clinical Examination ◽  
Spindle Cell ◽  
Excisional Biopsy ◽  
Spindle Cell Lipoma ◽  
Cell Subtype ◽  
Soft Tissue Swelling ◽  
Palmar Aspect

We report hereby the case of a 61-year-old man who presented with a soft-tissue swelling on the palmar aspect of the thumb. A detailed clinical examination followed by ultrasonography and excisional biopsy confirmed a spindle cell lipoma. Lipomas are rare in the hand and exceptional in the fingers, and we report, to our knowledge, the first spindle cell lipoma in the thumb to help in the differential diagnosis of a similar swelling.

The Diagnostic Accuracy of Percutaneous Renal Needle Core Biopsy and Its Potential Impact on the Clinical Management of Renal Cortical Neoplasms

2014 ◽  
Vol 138 (12) ◽  
pp. 1673-1679 ◽  
Author(s):  
Lan L. Gellert ◽  
Rohit Mehra ◽  
Ying-Bei Chen ◽  
Anuradha Gopalan ◽  
Samson W. Fine ◽  
...  
Keyword(s):  
Clinical Management ◽  
Renal Cell ◽  
Core Biopsy ◽  
Clear Cell ◽  
Renal Tumors ◽  
Low Grade ◽  
Renal Cell Carcinomas ◽  
Biopsy Diagnosis ◽  
Potential Impact ◽  
Renal Cortical Neoplasms

Context While biopsies are now increasingly being performed for the diagnosis of renal cortical neoplasms, the influence of the rendered pathological diagnoses on the clinical management is only rarely documented. Objectives To report our experience with consecutively performed renal biopsies and the potential impact of the diagnosis on subsequent clinical management. Design Material from needle biopsies performed consecutively at our institution between 2006 and 2011 was reviewed. The influence of the reported pathology results on the clinical management was determined from patient follow-up medical record review. Results In total, 218 percutaneous biopsies for renal masses were performed during this period. Among them, 181 (83%) yielded neoplastic tissue, including 81 clear cell renal cell carcinomas, 29 low-grade oncocytic neoplasms, 7 papillary renal cell carcinomas, 5 clear cell papillary renal cell carcinomas, 5 angiomyolipomas, and 14 urothelial carcinomas. Fourteen additional cases (6%) contained lesional material from clinically known nonneoplastic processes, for a total diagnostic yield of 89%. Twenty-three (11%) were nonrepresentative of lesional tissue. In 10 of these, repeat biopsies or resections established the diagnosis of renal tumors. Biopsy diagnosis was confirmed in 29 of 30 cases (97%) on subsequent nephrectomy. Following the biopsy diagnosis, there were significant differences in the clinical management; overall, 79% of clear cell renal cell carcinomas received therapeutic interventions, and 17% were put on active surveillance. In contrast, 77% of the benign or low-grade lesions were put on active surveillance. Conclusions Accurate and specific diagnosis can be rendered on renal core biopsy in most renal tumors, and the biopsy diagnosis can have a definitive role in their clinical management.

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