Pitfalls and Key Features of a Case of Sclerosing Pneumocytoma: A Cytological Challenge?

2016 ◽  
Vol 60 (1) ◽  
pp. 85-88 ◽  
Author(s):  
Monica Onorati ◽  
Marta Nicola ◽  
Chiara Luisa Bianchi ◽  
Francesco Bini ◽  
Nadia Bellaviti ◽  
...  
Keyword(s):  
Lung Nodule ◽  
Surgical Excision ◽  
Needle Aspiration ◽  
Lung Tumour ◽  
Current Case ◽  
Sclerosing Hemangioma ◽  
Positron Emission ◽  
Key Features ◽  
Needle Aspiration Cytology ◽  
Tomography Scan

Background: The aim of the current case report is to re-evaluate the key features and pitfalls of fine-needle aspiration cytology (FNAC) in the diagnosis of sclerosing pneumocytoma (previously named sclerosing hemangioma) and to establish the importance of FNAC in addressing a proper surgical strategy. Case: Herein we documented a case of a 70- year-old man with a lung nodule which showed a hypermetabolic uptake on positron emission tomography. He therefore underwent FNAC under computed tomography scan guidance with a 22-gauge needle. The cytopathological examination allowed a diagnosis of sclerosing pneumocytoma. A wedge surgical excision was performed and the histological examination confirmed the cytological diagnosis. Conclusion: FNAC is a fundamental tool for distinguishing sclerosing pneumocytoma from a malignant lung tumour and together with clinical, radiological and pathological multidisciplinary assessment is indispensable in planning appropriate surgical management. Cytopathologists should be aware of the pitfalls and key features of the cytopathological diagnosis of sclerosing pneumocytoma, which can significantly change the surgical approach to the patient and protect him from aggressive overtreatment.

Cancer Metastatic to the Parotid Gland

2021 ◽  
pp. 243-264
Keyword(s):  
Parotid Gland ◽  
Skin Flap ◽  
Treatment Options ◽  
Needle Aspiration ◽  
Great Auricular Nerve ◽  
Neck Disease ◽  
Positron Emission ◽  
Needle Aspiration Cytology ◽  
Skin Flap Necrosis ◽  
Tomography Scan

Carcinoma metastatic to the parotid gland is a region-specific disorder. History usually reveals a previous cutaneous squamous cell carcinoma (SCC) or melanoma. Physical examination may show scars of previous operations, current head and neck lesions, associated lymphadenopathy, and altered sensation. Investigations include fiberoptic naso-endoscopy, fine needle aspiration cytology, computed tomography scan, magnetic resonance imaging, and positron emission tomography. Treatment options include surgery (ablative/reconstructive), radiotherapy (indicated for SCC and melanoma), chemotherapy (indicated for SCC), chemo-immunotherapy (may have a role for melanoma). Complications to avoid include (1) wound-related complications (skin flap necrosis and skin flap “button-hole” formation), (2) tumor-related complications (inappropriate surgery due to inadequate preoperative investigation or omitting neck dissection in patients with concomitant neck disease, tumor rupture, and local tumor recurrence), (3) gland-related complications (salivary fistula and sialocele), and (4) nerve-related complications (facial nerve injury, Frey's syndrome or gustatory sweating, and great auricular nerve neuroma).

Liver rheumatoid nodules imitating liver malignancy: a rare occurrence

2020 ◽  
Vol 13 (12) ◽  
pp. e234366
Author(s):  
Jason Wee ◽  
Salar Sobhi ◽  
Bastiaan De Boer ◽  
Dan Xu
Keyword(s):  
Histological Analysis ◽  
Granulomatous Inflammation ◽  
Needle Aspiration ◽  
Upper Respiratory Tract ◽  
Positron Emission Tomography Scan ◽  
Liver Malignancy ◽  
Positron Emission ◽  
Right Lobe ◽  
Upper Respiratory ◽  
Tomography Scan

We describe a case of a 61-year-old man with a background of rheumatoid arthritis who presented to the emergency department with a single-reported episode of haemoptysis on the background of an upper respiratory tract infection. A CT scan revealed an incidental 40 mm mass in upper right lobe of the liver abutting the diaphragmatic surface. A subsequent positron emission tomography scan confirmed the mass and raised the possibility of another lesion in the liver raising the suspicion of malignancy. The case was complicated by the inability to perform a fine needle aspiration biopsy due to the mass’ proximity to the diaphragm. After discussion with the patient, it was decided to resect the affected liver segment. Histological analysis of the mass revealed localised necrotising granulomatous inflammation suggestive of a rheumatoid nodule, which is seldom reported in the literature.

Case of cholestatic jaundice associated with papillary carcinoma of thyroid: a multidisciplinary challenge

2021 ◽  
Vol 14 (2) ◽  
pp. e236372 ◽  
Author(s):  
Sanchit Sharma ◽  
Anoop Saraya ◽  
Prasenjit Das ◽  
Deepak Gunjan
Keyword(s):  
Papillary Carcinoma ◽  
Primary Tumour ◽  
Symptomatic Treatment ◽  
Liver Function Tests ◽  
Needle Aspiration ◽  
Cholestatic Jaundice ◽  
Drug Induced ◽  
Post Surgery ◽  
Positron Emission ◽  
Needle Aspiration Cytology

The report describes a patient with cholestatic jaundice who had incidentally detected parathyroid hormone-independent hypercalcaemia. The differential diagnosis for this presentation includes systemic granulomatous and infiltrative disorders, drug-induced liver injury and malignancy. As the initial investigations were non-contributory towards the aetiology, she was given steroids and later plasma exchange for symptomatic treatment. The differentials were revised again in view of no clinical and biochemical response. A repeat fine-needle aspiration cytology of the thyroid nodule (seen on positron emission tomography/CT) revealed papillary carcinoma of the thyroid. The patient underwent total thyroidectomy. There was a complete normalisation of liver function tests and serum calcium, and resolution of pruritus 3 months post surgery. She was retrospectively diagnosed as a case of papillary carcinoma of the thyroid with paraneoplastic manifestations—hypercalcaemia and cholestatic jaundice—which got resolved with treatment of the primary tumour.

scholarly journals Retroperitoneal pelvic schwannoma in pregnancy: a case report

2017 ◽  
Vol 6 (8) ◽  
pp. 3689 ◽  
Author(s):  
Nithya J. ◽  
Banumathy M. ◽  
Radha A.
Keyword(s):  
Spindle Cell ◽  
Surgical Excision ◽  
Needle Aspiration ◽  
Nerve Sheath Tumor ◽  
Ct Guided ◽  
Spindle Cell Neoplasm ◽  
Complete Surgical Excision ◽  
S 100 ◽  
Needle Aspiration Cytology ◽  
In Pregnancy

Solitary nerve sheath tumor such as Benign schwannomas arising in the pelvic retro peritoneum is infrequently reported. Retroperitoneal location accounts for 0.3-3.2% of primary schwannomas. We report a case of benign retroperitoneal pelvic schwannoma in pregnancy that was incidentally diagnosed when it presented with Preterm premature rupture of membranes and mechanical obstruction for labour. She underwent caesarean section and delivered a healthy baby. She was evaluated in the postoperative period by computerized tomography (CT) imaging studies and CT guided fine needle aspiration cytology (FNAC) was not diagnostic. Complete surgical excision of the tumor was achieved in the postpartum period. The adjacent vascular and urinary channels sustained no injuries and she had no neurologic deficit. Histology revealed spindle cell neoplasm composed of interlacing fascicles and sheets of spindle cell with focal areas of nuclear palisading and thick walled blood vessels. Immunohistochemistry was positive for S 100 suggesting schwannoma. Retroperitoneal location of schwannomas is rare and surgery is curative. Prognosis is good, since recurrence is rare. 

scholarly journals Primary retroperitoneal mullerian adenocarcinoma

Rare Tumors ◽  
2010 ◽  
Vol 2 (1) ◽  
pp. 16-19 ◽  
Author(s):  
Ayman Elnemr ◽  
Yutaka Yonemura ◽  
Masaya Shinbo ◽  
Eisei Nishino
Keyword(s):  
Abdominal Mass ◽  
Needle Aspiration ◽  
Cystic Mass ◽  
High Serum ◽  
Aspiration Cytology ◽  
Positron Emission ◽  
Pet Scanning ◽  
History Of ◽  
Needle Aspiration Cytology ◽  
Primary Retroperitoneal

Mullerian tumors are extremely rare malignancies in the retroperitoneum. We report a case of a 46-year old woman who presented with an eight year history of lower abdominal mass. Ultrasonography (US) and computed tomography (CT) demonstrated a 15×10 cm cystic mass in the left lower retroperitoneum. As serial percutaneous needle aspiration cytology was negative for malignancy, she was observed for seven years. Eleven months ago, the mass was excised. The histopathology was reported as mucinous adenocarcinoma of the retroperitoneum. Six cycles of intraperitoneal (IP) chemotherapy was administered during the last six months after diagnosis of recurrence by aspiration cytology and high serum tumor markers (CEA, CA19-9). A few days ago, positron emission tomographic (PET) scanning showed evidence of local recurrence and single vertebral metastasis, so she was admitted again for systemic chemotherapy. Meticulous revision of additional sections of the tumor revealed papillary, serous, mucinous, and endometrioid subtypes of the mullerian adenocarcinoma. To our knowledge, there has been no similar case described in the literature.

scholarly journals Schwannomas of ear, nose, throat and neck

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Nilam U. Sathe ◽  
Sheetal Shelke ◽  
Ankur Pareek ◽  
Kamini Chavan
Keyword(s):  
Head And Neck ◽  
Management Strategy ◽  
Cranial Nerves ◽  
Needle Aspiration ◽  
Aspiration Cytology ◽  
Neck Masses ◽  
Needle Aspiration Cytology ◽  
Nerve Of Origin ◽  
Tomography Scan ◽  
Nose And Throat

Schwannoma is a benign tumour of nerve sheath origin with latent malignant potential. All cranial nerves can give rise to schwannoma except for olfactory and optic nerves, which are devoid of Schwann cell. Schwanommas are usually asymptomatic and present late owing to compression of nerve of origin. We present our study of 19 cases of schwannoma arising from unusual sites in head and neck, having varied presentation and the challenges faced in management of these cases. These cases presented in detail to the department of Ear, Nose and Throat, KEM Hospital, and were thoroughly evaluated clinically and radiologically to formulate a management strategy. Schwannoma of the head and neck is a rare entity but should be considered as differential diagnosis in unilateral nasal mass cases, palatal masses, anterior and lateral neck masses. Nerve of origin may not always be clear preoperatively but the possibility of postoperative loss of nerve function should be kept in mind. Radiological investigations like computed tomography scan and magnetic resonance imaging play a pivotal role in management. In case of nonvascular neck tumours, fine needle aspiration cytology is crucial but has low accuracy in the diagnosis of neural tumors. Histopathology of excised tumour remains the gold standard in diagnosis.

scholarly journals A Bilobed Schwannoma in Roof of Orbit: A Rare Case Report

2012 ◽  
Vol 2012 ◽  
pp. 1-4
Author(s):  
Somya Dulani ◽  
Sachin Diagavane ◽  
Seema Lele ◽  
Harshal Gaurkhede
Keyword(s):  
Peripheral Nerve ◽  
Surgical Excision ◽  
Needle Aspiration ◽  
Aspiration Cytology ◽  
Supraorbital Nerve ◽  
Nerve Tumor ◽  
Peripheral Nerve Tumor ◽  
Rare Case Report ◽  
Needle Aspiration Cytology ◽  
Painless Mass

In this paper, we report a case of bilobed schwannoma, presented in the roof of orbit arising from supraorbital nerve. A 62-year male presented with a nontender mass in superior part of orbit and eccentric proptosis. Visual acuity and rest of ocular examination were normal. CT scan and MRI orbit revealed an extraconal homogenous bilobed mass, of size 3.5 to 2.5 cms in roof of orbit. Fine needle aspiration cytology was done, which was suggestive of schwannoma a peripheral nerve tumor. Successful surgical excision of intact bilobed schwannoma was done with careful separation and preservation of supraorbital nerve from which it was originated. Postoperative period was uneventful though rare, less than 1%, schwannoma can present as painless mass in the orbit and proptosis. Treatment of choice is surgical excision of intact tumor to prevent recurrence and preservation of peripheral nerve from which it arises.

Lung Nodule with Increasing Fluorodeoxyglucose Uptake in a Patient with a History of Lung Carcinoma and Talc Pleurodesis Evaluated by EBUS-TBNA On-Site Assessment

2017 ◽  
Vol 61 (1) ◽  
pp. 84-86 ◽  
Author(s):  
Elizabeth M. Kurian
Keyword(s):  
New Left ◽  
Lung Nodule ◽  
Needle Aspiration ◽  
Endobronchial Ultrasound ◽  
Talc Pleurodesis ◽  
Site Assessment ◽  
Fdg Uptake ◽  
Positron Emission ◽  
History Of ◽  
Site Evaluation

Background: Fluorodeoxyglucose (FDG) uptake on positron emission tomography (PET) scan is an indicator of potential malignancy or infection. Patients with a history of talc pleurodesis can develop pleural or lung parenchymal nodules/talcomas. In these patients, talc-associated (non-malignancy-related) FDG uptake may occur over years. Case Report: A 66-year-old female presented with a past medical history significant for resected non-small-cell lung cancer and was treated with chemotherapy/radiation. The referring physician indicated that she subsequently developed benign pleural effusions and had talc pleurodesis to limit recurrence. The patient was referred to our institution for endobronchial ultrasound-guided transbronchial fine-needle aspiration (EBUS-TBNA) due to a new left upper lobe nodule with increasing FDG uptake on follow-up interval PET performed at the referring institution. On-site cytologic evaluation showed no evidence of malignancy, but found refractile foreign material, consistent with the presence of talc particles. Conclusion: This case presents the importance of cytologic recognition of talc particles during on-site evaluation and discusses the phenomenon of increasing PET-FDG uptake associated with talc pleurodesis.

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