scholarly journals Dermoscopy of the Month

2018 ◽  
Vol 10 (3) ◽  
pp. 101-104 ◽  
Author(s):  
Andrija Jović ◽  
Danica Tiodorović ◽  
Danijela Popović ◽  
Hristina Kocić ◽  
Zorana Zlatanović ◽  
...  
Keyword(s):  
Nail Plate ◽  
Diagnostic Challenge ◽  
Longitudinal Band ◽  
Malignant Lesions ◽  
Longitudinal Melanonychia

Abstract Melanonychia refers to a brown or black coloration of the nail plate caused by numerous factors. Regarding the arrangement of pigmentation, we can differentiate between total melanonychia, when pigmentation involves the whole nail plate, or transverse or longitudinal melanonychia, when pigmentation involves the nail in a form of transverse or longitudinal band of pigmentation, respectively. Since longitudinal melanonychia can be a sign of numerous benign and malignant lesions, it often poses a diagnostic challenge for a dermatologist. Herein, we report a case of a 13-year-old girl who developed longitudinal melanonychia on multiple nails after receiving a therapy with azithromycin.

scholarly journals Tangential Biopsy Thickness versus Lesion Depth in Longitudinal Melanonychia: A Pilot Study

2012 ◽  
Vol 2012 ◽  
pp. 1-4 ◽  
Author(s):  
Nilton Di Chiacchio ◽  
Walter Refkalefsky Loureiro ◽  
Nilceo Schwery Michalany ◽  
Felipe Veiga Kezam Gabriel
Keyword(s):  
Nail Plate ◽  
Histopathological Diagnosis ◽  
Total Thickness ◽  
Thickness Measure ◽  
Histopathologic Diagnosis ◽  
The Matrix ◽  
General Average ◽  
The Mean ◽  
Longitudinal Melanonychia ◽  
Hematoxylin Eosin

Longitudinal melanonychia can be caused by melanocyte activation (hypermelanosis) or proliferation (lentigo, nevus or melanoma). Histopathologic examination is mandatory for suspicious cases of melanomas. Tangential biopsy of the matrix is an elegant technique avoiding nail plate dystrophy, but it was unknown whether the depth of the sample obtained by this method is adequate for histopathologic diagnosis. Twenty-two patients with longitudinal melanonychia striata were submitted to tangential matrix biopsies described by Haneke. The tissue was stained with hematoxylin-eosin and the specimens were measured at 3 distinct points according to the total thickness: largest (A), intermediate (B) and narrowest (C) then divided into 4 groups according to the histopathologic diagnosis (G1: hypermelanosis; G2: lentigos; G3: nevus; G4: melanoma). The lesions were measured using the same method. The mean specimen/lesion thickness measure values for each group was: G1: 0,59/0,10 mm, G2: 0,67/0,08 mm, G3: 0,52/0,05 mm, G4: 0,58/0,10 mm. The general average thickness for all the specimens/lesions was 0,59/0,08 mm. We concluded that the tangential excision, for longitudinal melanonychia, provides an adequate material for histopathological diagnosis.

scholarly journals Spectrum of Cribriform Proliferations of the Prostate: From Benign to Malignant

2018 ◽  
Vol 142 (8) ◽  
pp. 938-946 ◽  
Author(s):  
Thomas K. Lee ◽  
Jae Y. Ro
Keyword(s):  
Intraepithelial Neoplasia ◽  
Intraductal Carcinoma ◽  
Definitive Treatment ◽  
Diagnostic Challenge ◽  
Invasive Adenocarcinoma ◽  
Diagnostic Features ◽  
Carcinoma Of The Prostate ◽  
Gland Carcinoma ◽  
Malignant Lesions ◽  
The University

Context.— The presence of cribriform glands/ducts in the prostate can pose a diagnostic challenge. Cribriform glands/ducts include a spectrum of lesions, from benign to malignant, with vastly different clinical, prognostic, and treatment implications. Objective.— To highlight the diagnostic features of several entities with a common theme of cribriform architecture. We emphasize the importance of distinguishing among benign entities such as cribriform changes and premalignant to malignant entities such as high-grade prostatic intraepithelial neoplasia, atypical intraductal cribriform proliferation, intraductal carcinoma of the prostate, and invasive adenocarcinoma (acinar and ductal types). The diagnostic criteria, differential diagnosis, and clinical implications of these cribriform lesions are discussed. Data Sources.— Literature review of pertinent publications in PubMed up to calendar year 2017. Photomicrographs obtained from cases at the University of California at Irvine and authors' collections. Conclusions.— Although relatively uncommon compared with small acinar lesions (microacinar carcinoma and small gland carcinoma mimickers), large cribriform lesions are increasingly recognized and have become clinically and pathologically important. The spectrum of cribriform lesions includes benign, premalignant, and malignant lesions, and differentiating them can often be subtle and difficult. Intraductal carcinoma of the prostate in particular is independently associated with worse prognosis, and its presence in isolation should prompt definitive treatment. Patients with atypical intraductal cribriform proliferation, intraductal carcinoma of the prostate, or even focal cribriform pattern of invasive adenocarcinoma in biopsies would not be ideal candidates for active surveillance because of the high risk of adverse pathologic findings associated with these entities.

scholarly journals The Diagnostic Challenge of an Infrequent Spectrum of Cryptococcus Infection

2019 ◽  
Vol 2019 ◽  
pp. 1-6 ◽  
Author(s):  
Francisco Barbosa De Araujo Neto ◽  
Camila Corona De Godoy Bueno ◽  
Liege Tambelini Gomes ◽  
Daniela Alejandra Ortiz Navas ◽  
Mark Wanderley ◽  
...  
Keyword(s):  
Fungal Spores ◽  
Unknown Etiology ◽  
Diagnostic Challenge ◽  
Fungal Isolation ◽  
Palpable Mass ◽  
Cryptococcal Infection ◽  
Important Differential Diagnosis ◽  
Chest X Ray ◽  
Malignant Lesions

Cryptococcal infection results from inhalation of fungal spores and usually is confined to the lungs, but may disseminate systemically. Radiologically, cryptococcal infection has multiple forms of presentation. The diagnosis is usually based on fungal isolation from cultured clinical specimens. Long term antifungal therapy is recommended, but surgical procedures may eventually be necessary when large thoracic symptomatic masses are present. We report a case of a 41-year-old male, immunocompetent, investigating a palpable mass in the left supraclavicular region associated with unintentional weight loss over the last three months. He also reported chest pain in this period. Chest X-ray, ultrasonography, and computed tomography were performed, which diagnosed a mediastinal and left supraclavicular mass, interpreted as lymph node conglomerates of unknown etiology. He also underwent a biopsy of the left supraclavicular mass for etiological determination by histopathology, which confirmed cryptococcosis infection. Although very infrequent, mediastinal cryptococcal infection (simulating masses) is a challenging but important differential diagnosis of benign and malignant lesions, since its treatment is usually clinical.

scholarly journals Sinonasal Polyps: A Diagnostic Challenge

2019 ◽  
Vol 27 (3) ◽  
pp. 243-250
Author(s):  
Sucharita Sarkar ◽  
Rama Saha ◽  
Mou Das ◽  
Samares Sardar
Keyword(s):  
Treatment Protocol ◽  
Case Series ◽  
Olfactory Neuroblastoma ◽  
Mass Lesion ◽  
Diagnostic Challenge ◽  
Basal Cell Adenocarcinoma ◽  
Adenoid Cystic ◽  
Malignant Lesions ◽  
One Year ◽  
Gross Examination

Introduction Sinonasal polyps, presenting as mass lesion of nose and paranasal sinuses ranges pathologic entity including infective diseases to malignant lesions. 80% are non-neoplastic lesions and less than 1% are malignant. They all present with symptoms of nasal stuffiness or obstruction and mass lesion, producing significant diagnostic challenges as they possess extremely varied clinical behaviour, etiopathogenesis, treatment protocol as well as prognosis.   Case Series During period of one year (March 2017 to February 2018), we had six patients presenting with nasal polyp having special features that need attention. After proper investigation each case was operated and gross examination followed by histopathology was done. They   revealed six different diagnoses e.g., Olfactory neuroblastoma, Adenoid Cystic Carcinoma, Basal Cell Adenocarcinoma, Sinonasal Mucosal Melanoma, Primitive Neuroectodermal Tumour (PNET) and Aspergilloma. Discussion Clinicians’ attention is drawn to the fact that, similar presentation may have varied differential diagnoses, some of which may be very rare and histopathology is essential for coming to definitive diagnosis.

scholarly journals Non-malignant Oral Ulcer: A Diagnostic Challenge to Otorhinolaryngologists

2019 ◽  
Vol 27 (3) ◽  
pp. 223-228
Author(s):  
Neeraj Aggarwal ◽  
Sirshak Dutta ◽  
Avijit Choudhury ◽  
Mainak Dutta ◽  
Saumik Das ◽  
...  
Keyword(s):  
Oral Cavity ◽  
Clinical Diagnosis ◽  
Histopathological Examination ◽  
Oral Candidiasis ◽  
Tertiary Care ◽  
Diagnostic Challenge ◽  
Erosive Lichen Planus ◽  
Male Preponderance ◽  
Malignant Lesions ◽  
Malignant Ulcer

Introduction Apart from the malignant ulcers a wide variety of dermatological and other systemic conditions can affect oral cavity and often be a diagnostic challenge due to their similar presenting features and appearance. Despite being benign, some of them may be fatal if not diagnosed and treated timely. This study aims to assess the incidence of different non malignant ulcers in oral cavity and to estimate the need for histopathological examination for confirmation of the condition for proper management. Materials and Methods  An institution based observational study was conducted over a time period of 16 months at a tertiary care institute. Total 172 cases were included in the present study irrespective of age, sex and duration. Malignant lesions were excluded from the study. Results The present study shows a slight male preponderance (M:F = 1.48:1) with majority of cases were in age group 20-40 years of age (43.02%). Most commonly encountered were recurrent aphthous stomatitis (27.9%) followed by erosive lichen planus (16.28%), oral candidiasis, angular stomatitis, traumatic ulcers and others. 78.5% were treated successfully on the basis of clinical diagnosis while 21.5% cases needed further histopathological or other investigation for confirmation of diagnosis. Conclusion Though the otolaryngologists are more concerned about malignant ulcer, there are many non malignant ulcers which can cause significant morbidity and can even be fatal and should be given similar importance like malignant lesions. Majority of them can be treated successfully on the basis of clinical diagnosis but histopathological examination may be required in some cases for proper diagnosis and appropriate management.

scholarly journals Verrucopapillary Lesions of the Oral Cavity: A Review

2020 ◽  
Vol 4 (7) ◽  
pp. RV1-RV7
Author(s):  
Sana Khaled ◽  
Santosh R. Bharadwaj ◽  
Bushra Anjum ◽  
Satyanarayana D.
Keyword(s):  
Oral Cavity ◽  
Human Papilloma Virus ◽  
Oral Mucosa ◽  
Diagnostic Approach ◽  
Diagnostic Challenge ◽  
Papilloma Virus ◽  
Histopathological Features ◽  
Potentially Malignant ◽  
Malignant Lesions

Verrucopapillary lesions are a spectrum of benign, potentially malignant and malignant lesions of the oral mucosa which usually are misdiagnosed. They pose a great diagnostic challenge mainly due to confusing terminology and also due to similar clinical and histopathological features which often makes these lesions indistinguishable from one another. The human papilloma virus (HPV) plays a important role in the pathogenesis of majority of these lesions. This review aims to summarize and highlight the key clinical and histopathological features of these lesions, and also provides a diagnostic approach to these entities.

scholarly journals Low-Grade Sinonasal Sarcoma With Neural and Myogenic Features: A Recently Discovered Entity With Unique Features and Diagnostic Challenge

2017 ◽  
Vol 141 (5) ◽  
pp. 718-721 ◽  
Author(s):  
Meriam Triki ◽  
Lobna Ayadi
Keyword(s):  
Smooth Muscle Actin ◽  
S100 Protein ◽  
World Health ◽  
Low Grade ◽  
Diagnostic Challenge ◽  
Nerve Sheath Tumors ◽  
Peripheral Nerve Sheath Tumors ◽  
Neck Tumors ◽  
Malignant Lesions ◽  
Health Organization

Low-grade sinonasal sarcoma with neural and myogenic features is an entity recently described in the literature. Little is known about its etiopathogenesis, natural history, or optimal treatment. In fact, it has relatively unique findings: it has a distinctive cytogenetic signature, and it expresses both smooth muscle actin and S100 protein. However, its diagnosis is challenging on biopsies showing negative staining for these 2 markers. The differential diagnoses include fibrosarcoma, malignant peripheral nerve sheath tumors, and other benign and malignant lesions. A complete resection, with or without radiotherapy, is required because this lesion appears to be locally aggressive. However, the clinical outcome seems to be good. Low-grade sinonasal sarcoma with neural and myogenic features merits classification as an independent tumor in the next World Health Organization classification of head and neck tumors. Reports of additional cases are required to support its unique classification.

LONGITUDINAL MELANONYCHIA: DETECTION AND MANAGEMENT OF NAIL MELANOMA

Hand Surgery ◽  
2013 ◽  
Vol 18 (01) ◽  
pp. 133-139 ◽  
Author(s):  
Kathleen A. Mannava ◽  
Sandeep Mannava ◽  
L. Andrew Koman ◽  
Leslie Robinson-Bostom ◽  
Nathaniel Jellinek
Keyword(s):  
Risk Factors ◽  
Malignant Melanoma ◽  
Mortality Rate ◽  
Delayed Diagnosis ◽  
Nail Plate ◽  
Clinical Approach ◽  
Biopsy Technique ◽  
Longitudinal Melanonychia

Malignant melanoma of the nail confers a higher mortality rate compared to other cutaneous melanomas, which is often attributable to delayed diagnosis. Two-thirds of nail melanomas present as longitudinal melanonychia (LM), longitudinally-oriented brown-black bands of pigment in the nail plate. This article delineates the appropriate clinical approach toward evaluation and management of a patient with longitudinal melanonychia, which includes determining risk factors for melanoma, recognizing scenarios in which biopsy is indicated, selecting the appropriate biopsy technique, and managing a patient in whom the diagnosis of nail melanoma has been made.

scholarly journals Renal Leiomyoma – A Rare Case Report

2021 ◽  
Vol 10 (21) ◽  
pp. 1633-1635
Author(s):  
Raju Kamlakarao Shinde ◽  
Harsh Dinesh Bhalsod ◽  
Sangita Jogdand Shinde
Keyword(s):  
Differential Diagnosis ◽  
Case Report ◽  
Rare Case ◽  
Histopathological Examination ◽  
Incidental Finding ◽  
Benign Lesions ◽  
Diagnostic Challenge ◽  
Rare Case Report ◽  
Incidental Discovery ◽  
Malignant Lesions

Cases of renal leiomyomas are fewer than 100 in the literature and therefore possess a diagnostic challenge.1 By definition, leiomyomas are benign soft tissue neoplasms.2 that arise from smooth muscle cells.3 The most common sites of origin are the uterus, intestines and skin.4 One of the more unusual types of leiomyomas are the ones arising from the kidneys. They account for about 1.5 % benign lesions of kidneys.5 The methods of detection are through discovery during autopsy, incidental discovery during imaging or by clinical diagnosis in symptomatic lesions.6 Prevalence based on incidental finding at the time of autopsy is 4.2 - 5.2 %.7 Creating a differential diagnosis between leiomyomas and other malignant lesions is only possible by histopathological examination.8 We hereby report a case of 26-year-old female who presented with pain in abdomen and on histopathological examination was diagnosed as a case of renal leiomyoma.

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