scholarly journals Complete Resolution of Pseudomalignant Erosion in a Reflux Gastroesophageal Polyp with Proton Pump Inhibitor

2015 ◽  
Vol 2015 ◽  
pp. 1-3
Author(s):  
Takahiko Nakajima ◽  
Haruo Yagi ◽  
Hayato Baba ◽  
Takashi Minamisaka ◽  
Shigeharu Miwa ◽  
...  
Keyword(s):  
Proton Pump Inhibitor ◽  
Proton Pump ◽  
Stromal Cells ◽  
Complete Resolution ◽  
Biopsy Specimen ◽  
Esophagogastric Junction ◽  
Correct Diagnosis ◽  
Malignant Neoplasm ◽  
Malignant Neoplasms ◽  
Diagnostic Pitfall

Pseudomalignant erosion is a diagnostic pitfall for pathologists in the differential diagnosis of malignant neoplasms. Here, we present a challenging case of a biopsy specimen from the eroded head of a polyp at the esophagogastric junction. A malignant neoplasm could not be ruled out due to the presence of bizarre stromal cells. A second biopsy performed after the administration of a proton pump inhibitor (PPI) for 4 weeks revealed endoscopic resolution of the polyp along with the complete histological resolution of the bizarre stromal cells and led to the diagnosis of pseudomalignant erosion in a reflux gastroesophageal polyp. In conclusion, histological and endoscopic response to PPI therapy is an important clue for the correct diagnosis of reflux gastroesophageal polyps with pseudomalignant erosion.

scholarly journals Chordoma: A Review and Differential Diagnosis

2021 ◽  
Author(s):  
Veronica Ulici ◽  
Jesse Hart
Keyword(s):  
Differential Diagnosis ◽  
Targeted Therapy ◽  
Correct Diagnosis ◽  
Experimental Studies ◽  
Malignant Neoplasm ◽  
Axial Skeleton ◽  
High Rate ◽  
Malignant Neoplasms ◽  
Therapeutic Modalities ◽  
Novel Therapeutic

Context.— Chordomas are uncommon malignant neoplasms with notochordal differentiation encountered by neuropathologists, bone/soft tissue pathologists, and general surgical pathologists. These lesions most commonly arise in the axial skeleton. Optimal therapy typically involves complete surgical resection, which is often technically difficult owing to the anatomic location, leading to a high rate of recurrence. Lesions have been generally resistant to radiation and chemotherapy; however, experimental studies involving targeted therapy and immunotherapy are currently underway. Objective.— To summarize the clinical and pathologic findings of the various types of chordoma (conventional chordoma, dedifferentiated chordoma, and poorly differentiated chordoma), the differential diagnosis, and recent advances in molecular pathogenesis and therapeutic modalities that are reliant on accurate diagnosis. Data Sources.— Literature review based on PubMed searches containing the term “chordoma” that address novel targeted and immunomodulatory therapeutic modalities; ongoing clinical trials involved in treating chordoma with novel therapeutic modalities identified through the Chordoma Foundation and ClinicalTrials.gov; and the authors' practice experience combined with various authoritative texts concerning the subject. Conclusions.— Chordoma is a clinically and histologically unique malignant neoplasm, and numerous diagnostic considerations must be excluded to establish the correct diagnosis. Treatment options have largely been centered on surgical excision with marginal results; however, novel therapeutic options including targeted therapy and immunotherapy are promising means to improve prognosis.

Cystadenoma of the seminal vesicle – Potential diagnostic pitfall: A case report and literature review

2021 ◽  
pp. 205141582110590
Author(s):  
Raduan Ahmed Franca ◽  
Felice Crocetto ◽  
Savio Domenico Pandolfo ◽  
Andrea Ponsiglione ◽  
Corrado Antonio Franzese ◽  
...  
Keyword(s):  
Literature Review ◽  
Seminal Vesicle ◽  
English Literature ◽  
Malignant Neoplasm ◽  
Cystic Mass ◽  
Seminal Vesicles ◽  
Pathological Examination ◽  
Malignant Neoplasms ◽  
Level Of Evidence ◽  
Diagnostic Pitfall

Background: Cystadenomas of the seminal vesicles are benign cystic tumours, currently classified into the group of mixed epithelial-stromal tumours (MEST). Primary tumours arising in the seminal vesicles are quite rare, benign tumours being rarer than malignant ones, with only a few cases reported in the English literature since 1944. Cystadenomas represent a potential diagnostic pitfall, as they can be clinically confused with malignant neoplasms and histologically with non-neoplastic inflammatory lesions or other cystic tumours, even malignant. Objective and methods: We report a case of a 23-year-old man presenting with a cystic mass of the seminal vesicle, clinically suspected to be a malignant neoplasm. On pathological examination, a diagnosis of cystadenoma was made. Diagnostic criteria to make a diagnosis of this tumour are questionable. Therefore, we carried out a literature review in attempt to compare clinico-pathological findings of 28 cases reported in the English literature as cystadenomas of the seminal vesicle. Results: Only 28 cases of cystadenomas of seminal vesicles were reported in the English literature. The available data show the difficulty to rule out malignancy preoperatively in a patient with a solid-cystic mass in the pelvic region, and that morphological findings observed were often reported incompletely. Conclusions: The current classification appears debatable, as well as histopathological criteria to diagnose a cystadenoma of the seminal vesicle. For the proper management of these lesions, a multidisciplinary approach is mandatory. Level of evidence: Not applicable

Mammary Myofibroblastoma: A Tumor With a Wide Morphologic Spectrum

2008 ◽  
Vol 132 (11) ◽  
pp. 1813-1820 ◽  
Author(s):  
Gaetano Magro
Keyword(s):  
Stromal Cells ◽  
Benign Tumor ◽  
Spindle Cell ◽  
Correct Diagnosis ◽  
Original Description ◽  
Needle Aspiration ◽  
Mammographic Screening ◽  
Diagnostic Pitfall ◽  
Pathologic Features ◽  
The Family

Abstract Context.—Myofibroblastoma (MFB) of the breast is an unusual benign tumor that belongs to the family of the “benign spindle cell tumors of the mammary stroma.” The name MFB reflects its cellular composition, comprising mainly stromal cells with fibromyofibroblastic and, less frequently, myoid differentiation. Since the original description, the morphologic spectrum of MFB has been expanded by the recognition of several unusual morphologic variants, such as the cellular, infiltrative, epithelioid, deciduoid-like, lipomatous, collagenized/fibrous, and myxoid variants. Objective.—To review the literature on mammary MFB, discussing the main clinical, radiologic, and pathologic features helpful for diagnosis. Since MFB may show alarming morphologic features, which can lead to a misdiagnosis of malignancy, histologic figures of this tumor, including its more unusual variants, are provided to offer pathologists a practical approach to a correct diagnosis. Histogenesis and pathogenesis of this tumor are also proposed. Data Sources.—Clinicopathologic data on MFB were extracted from all identified articles through PUB Medline– based research. Histologic figures have been taken from the personal archive of the author. Conclusions.—The incidence of MFB diagnosis has increased in recent years, likely due to the mammographic screening. Accordingly, this unusual benign tumor may represent a potential diagnostic pitfall, especially when interpreting fine-needle aspiration and/or needle core biopsy. Pathologists should be aware of the wide morphologic spectrum exhibited by MFB to avoid a misdiagnosis of malignancy.

scholarly journals Pancreatic Acinar Metaplasia in Distal Esophageal Biopsies Is Associated With Chronic Nonsteroidal Anti-inflammatory Drug Use

2018 ◽  
Vol 143 (4) ◽  
pp. 510-512 ◽  
Author(s):  
Suhair Al Salihi ◽  
Vanya Jaitly ◽  
David M. Saulino ◽  
Andrew W. DuPont ◽  
Atilla Ertan ◽  
...  
Keyword(s):  
Drug Use ◽  
Proton Pump Inhibitor ◽  
Proton Pump ◽  
Animal Studies ◽  
Esophagogastric Junction ◽  
Strong Association ◽  
Distal Esophagus ◽  
Inflammatory Drug ◽  
Anti Inflammatory ◽  
Pancreatic Acinar Metaplasia

Context.— The cause of pancreatic acinar metaplasia (PAM) at the distal esophagus/esophagogastric junction is still controversial. Whereas some authors believe it is congenital, others believe it is acquired because of inflammation of the gastric cardia, and more recently it was proposed to be due to chronic proton pump inhibitor use based on a study in rats. Objective.— To determine whether there is correlation between chronic proton pump inhibitor use and PAM in humans. We also investigated the correlation between several clinical and pathologic factors and PAM. Design.— Four hundred forty-four consecutive biopsies from the distal esophagus/esophagogastric junction were reviewed for the presence of PAM, which was then correlated with several clinical and pathologic findings. Results.— Pancreatic acinar metaplasia was found in 71 patients (16%). Pancreatic acinar metaplasia was significantly associated with patient age younger than 51 years (P < .001), chronic carditis (P = .01), and chronic proton pump inhibitor use (P = .008). Surprisingly, we also found significant association between PAM and chronic nonsteroidal anti-inflammatory drug use (P < .001). These associations, including that with chronic nonsteroidal anti-inflammatory drug use, remained significant in multivariate analysis. Conclusions.— Our findings confirm the previous reports of significant association between PAM and chronic carditis and the findings from animal studies of association with chronic proton pump inhibitor use. The strong association with chronic nonsteroidal anti-inflammatory drug use has not been previously reported and warrants further studies.

scholarly journals Development of urinary incontinence in a 7-year old boy after therapy with proton pump inhibitors and complete resolution of his clinicopathologic features of eosinophilic esophagitis after H2-receptor antagonist treatment: A case report

2017 ◽  
Vol 86 (5-6) ◽  
Author(s):  
Rok Orel ◽  
Janez Eržen ◽  
Zvezdana Dolenc Stražar
Keyword(s):  
Adverse Effect ◽  
Urinary Incontinence ◽  
Proton Pump Inhibitor ◽  
Proton Pump ◽  
Eosinophilic Esophagitis ◽  
Complete Resolution ◽  
H2 Receptor Antagonists ◽  
H2 Receptor ◽  
Esophageal Eosinophilia ◽  
Effect Of Therapy

Background: Several diseases result in profound infltration of esophageal mucosa by eosinophilic granulocites, with gastroesophageal reflux disease (GERD), eosinophilic esophagitis (EoE) and proton-pump-inhibitor-responsive esophageal eosinophilia (PPI-REE) being the most prevalent. Proton-pump-inhibitor-responsive esophageal eosinophilia (PPI-REE) is a newly recognized entity that must be differentiated from eosinophilic esophagitis (EoE).Case presentation: A 7-year old Slovenian male presented with a few-month history of chest pain, regurgitation and heartburn. First endoscopy was performed and revealed pronounced longitudinal furrows, and on hystology examination > 70 eosinophils per high power feld were found through the entire thickness of epithelium and in the submucosis with eosinophilic microabscess formation. Results of 24-hour pH-monitoring (without impedance monitoring) excluded pathologic acid reflux. All allergy tests were negative. Te patient started treatment with proton pump inhibitors (PPIs) for three times, twice with pantoprazole before the endoscopy and once with esomeprazole after it to exclude the diagnosis of GERD and PPI-REE. Urinary incontinence reappeared each time just few days after starting treatment and disappeared few days after stopping it. Therefore, urinary incontinence was considered as a plausible adverse effect of therapy with PPIs. As treatment with PPIs was not tolerated, a therapy with H2-receptor antagonists ranitidine was applied for more than 2 months followed by a second endoscopy. Both symptoms and esophageal eosinophilia completely resolved with ranitidine. The resolution of esophageal eosinophilia in PPI-REE has been attributed to proton pump independent antiinflammatory effects of PPIs. No such effects have been described in H2-receptor antagonists.Conclusions: Two unique phenomena were observed in the pediatric patient with profound esophageal eosinophilia: urinary incontinence as an adverse effect of therapy with PPIs, and complete resolution of esophageal eosinophilic inflammation with typical features of EoE after treatment with H2-receptor antagonists.

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