Intra-abdominal Solitary Myofibroma in a Child: A Rare Case Report

Intra-abdominal masses in children are usually malignant. Benign tumours at this location are not seen frequently. It is even rarer to find solitary myofibromas intra-abdominally as these tumours are known to have predilection for the head and neck region. We present an unusual case of solitary myofibroma with abdominal localisation in a six-year-old male child who presented with abdominal distension since six months. Computed Tomography (CT) abdomen revealed a complex solid-cystic mass extending from umbilicus to right iliac fossa and measuring 9×6×4 cm. Histopathological examination revealed a tumour displaying biphasic nodular pattern with the presence of lighter staining fascicles of mature myoid cells along with darker staining and more cellular areas of smaller primitive cells. On Immunohistochemistry (IHC), tumour cells were positive for vimentin and Smooth Muscle Actin (SMA) with variable reactivity for desmin while these were negative for CD34 and Anaplastic Lymphoma Kinase 1 (ALK). Based on the histopathological and immunohistochemical findings, final diagnosis of myofibroma was made. Recognition of these lesions is extremely challenging owing to their rare presentation intra-abdominally and also because of their close morphological overlap with other spindle cell tumours commonly found at this site. This case highlights the combined role played by histopathology and IHC in making a clear distinction between different entities. It is imperative for both clinicians and histopathologists to establish the correct diagnosis as excision of the solitary myofibroma is curative in most cases and offers better clinical course than the more commonly found malignant tumours at this site.

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An Unusual Presentation of Leiomyosarcoma Posing a Diagnostic Dilemma: A Case Report

JOURNAL FOR CLINICAL AND DIAGNOSTIC RESEARCH ◽

10.7860/jcdr/2020/46383.14306 ◽

2020 ◽

Author(s):

Smita Singh ◽

Kusha Sharma ◽

Vipan Kumar ◽

Partap Yadav

Keyword(s):

Smooth Muscle ◽

Head And Neck ◽

Histopathological Examination ◽

Smooth Muscle Actin ◽

Correct Diagnosis ◽

Neck Region ◽

Temporal Region ◽

Diagnostic Dilemma ◽

First Case ◽

Painless Mass

Leiomyosarcoma (LMS) is a malignant tumour of smooth muscle origin commonly seen in genital and gastrointestinal location. However, its presence in the head and neck region in a young child is extremely rare. Authors present a unique case of LMS in a one year and five-month-old child who presented with a painless mass in the right temporal region of the head. Histopathological examination revealed a highly cellular tumour arranged in intersecting fascicles of spindle cells with brisk mitotic activity and interspersed areas of necrosis. On Immunohistochemistry (IHC), the tumour cells were positive for Smooth Muscle Actin (SMA), Desmin and Vimentin and negative for S100 and Myogenin. A diagnosis of LMS was thus, made. Head and neck sarcoma is a broad entity encompassing plethora of differentials with closely overlapping morphological features which renders them diagnostically challenging, this can be resolved by employing various immunohistochemical stains readily available in all laboratories. This case highlights the combined role played by histopathology and immunohistochemistry in arriving at the correct diagnosis. To the best of our knowledge, this is the first case of LMS reported in the temporal region of head and is distinct with respect to its rare incidence, location and age at presentation. LMS at this site may masquerade as deceptively benign painless mass and may not be suspected initially, however one should bear in mind that these are moderate-to-high grade tumours and any delay in management may portend poor prognosis. Timely and aggressive surgical management is thus, the mainstay of treatment and critical to patient survival.

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HISTOPATHOLOGICALANALYSIS OF TUMOURS AND TUMOUR-LIKE LESIONS OF COLON AND RECTUM

10.36106/ijsr/2538967 ◽

2021 ◽

pp. 9-11

Author(s):

Durga Nand Jha ◽

Hari Shankar Mishra ◽

Ajit Kumar Chaudhary ◽

Debarshi Jana

Keyword(s):

Histopathological Examination ◽

Correct Diagnosis ◽

Malignant Tumour ◽

Juvenile Polyp ◽

Tubular Adenoma ◽

Malignant Tumours ◽

Cross Sectional ◽

Colorectal Biopsies ◽

Colon And Rectum ◽

Benign Tumours

Background:Tumours and tumour like lesions of the colon and rectum have overlapping clinical presentation and may be difcult to diagnose on clinical grounds alone. Histopathological examination although helpful to arrive at correct diagnosis, at times may be difcult and may require ancillary tests such as immunohistochemistry. Materials and Methods: A prospective cross sectional study enrolled 125 cases of colorectal biopsies after histopathological conrmation of tumours and tumour like lesions. The specimens were received at the Department of Pathology, DMCH, Laheriasarai, Bihar from December 2019 to November 2020. Results: Out of 125 cases, 32 cases were benign tumours, 36 cases were malignant tumours and 57 cases were tumour like lesions. Most common age range was 51-60 years with mean age of 38 years. Males comprised 76.74% and females 23.26% with ratio of 3:1. Juvenile polyp was the commonest lesion. Among benign tumours, tubular adenoma was the most common (19.2%), adenocarcinoma was most common malignant tumour (25.6%) and juvenile polyp was the most common tumour like lesion (27.2%). Left side was most common side (66.67%) and rectum was the most common site (48.8%). Conclusions: The commonest indications for colorectal biopsies were tumours and tumour like lesions. Juvenile polyp was the most common tumour like lesion, tubular adenoma was the most common benign tumour and adenocarcinoma was the most common malignant tumour. Histopathological examination is a gold standard for conrmation of all tumour and tumours like lesions of colon and rectum.

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A Rare Presentation of Inflammatory Myofibroblastic Tumor in the Nasolabial Fold

Case Reports in Otolaryngology ◽

10.1155/2019/3257697 ◽

2019 ◽

Vol 2019 ◽

pp. 1-5

Author(s):

Hind K. Alshammari ◽

Haya F. Alzamami ◽

Mona Ashoor ◽

Wasan F. Almarzouq ◽

Haitham Kussaibi

Keyword(s):

Inflammatory Myofibroblastic Tumor ◽

Soft Tissues ◽

Histopathological Examination ◽

Benign Lesion ◽

Neck Region ◽

Surgical Excision ◽

Nasolabial Fold ◽

Rare Presentation ◽

The Central Nervous System ◽

Sublabial Approach

Inflammatory myofibroblastic tumor (IMT) is a benign lesion that occurs most frequently in the soft tissues and viscera. In the head and neck region, the tumor has been reported to occur in the orbit, tongue, nasopharynx, larynx, and paranasal sinuses and the central nervous system. Despite being a benign lesion, it exhibits infiltrative and destructive behaviours, making histopathological examination necessary to confirm the diagnosis. We report the case of a 38-year-old female presented with a right nasolabial fold mass, which was confirmed histologically to be an IMT. Surgical excision of the mass was achieved through a sublabial approach with an uneventful postoperative period. To the best of our knowledge, this is the first reported case of an IMT in the nasolabial fold.

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Epidermoid cyst of earlobe: a common cyst at an uncommon site

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20193650 ◽

2019 ◽

Vol 5 (5) ◽

pp. 1400

Author(s):

Jayendiran S. ◽

Jinu Vadakkanethu Iype ◽

Srinivasa V.

Keyword(s):

Head And Neck ◽

Malignant Transformation ◽

Clinical Diagnosis ◽

Epidermoid Cyst ◽

Histopathological Examination ◽

Correct Diagnosis ◽

Neck Region ◽

Head And Neck Region ◽

Important Concern ◽

Nylon 4

<p class="abstract">Epidermoid cysts are frequently encountered cutaneous cysts. They are mostly tiny and benign swellings. But rarely they can grow huge in size and malignant transformation can also occur occasionally. Cosmetic disfigurement is also another important concern especially in head and neck region. We report a case of earlobe epidermoid cyst, a location where very few cases have been described in the literature. The cyst was completely excised and the wound was closed with nylon 4/0. Histopathological examination confirmed the diagnosis of an epidermoid cyst. The patient did not have any signs of recurrence even after six months postoperatively. Due to the possibility of malignant transformation and to ensure correct diagnosis, we consider that histopathological examination is necessary for all cysts although the clinical diagnosis could be enough.</p>

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Amoebic Colitis Presenting as Subacute Intestinal Obstruction with Perforation

International Journal of TROPICAL DISEASE & Health ◽

10.9734/ijtdh/2020/v41i1630367 ◽

2020 ◽

pp. 58-62

Author(s):

Renuka Verma ◽

Archana Budhwar ◽

Priyanka Rawat ◽

Niti Dalal ◽

Anjali Bishlay ◽

...

Keyword(s):

Histopathological Examination ◽

Iliac Fossa ◽

Abdominal Distension ◽

Final Diagnosis ◽

Free Fluid ◽

Abdominal Radiography ◽

Plain Abdominal Radiography ◽

Amoebic Colitis ◽

Subacute Intestinal Obstruction

Infestation with Entamoeba histolytica is worldwide, especially in developing areas. Presented case study included amoebic colitis in a 45 years old man complaining of abdominal distension and non-passage of stools since three days. Abdominal region was diffusely distended and tender in right iliac fossa. Plain abdominal radiography revealed prominent gut loops and minimal intergut free fluid. At laparotomy, malrotation of gut was present. Histopathological examination of intestinal samples confirmed final diagnosis of amoebic colitis post-operatively.

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Histopathological analysis of tumours and tumour-like lesions of colon and rectum

Journal of Pathology of Nepal ◽

10.3126/jpn.v10i1.28747 ◽

2020 ◽

Vol 10 (1) ◽

pp. 1654-1658

Author(s):

Pramila Vaidhya ◽

Ram Chandra Adhikari ◽

Anil Dev Pant

Keyword(s):

Histopathological Examination ◽

Correct Diagnosis ◽

Malignant Tumour ◽

Juvenile Polyp ◽

Histopathological Analysis ◽

Tubular Adenoma ◽

Malignant Tumours ◽

Colorectal Biopsies ◽

Colon And Rectum ◽

Benign Tumours

Background: Tumours and tumour like lesions of the colon and rectum have overlapping clinical presentation and may be difficult to diagnose on clinical grounds alone. Histopathological examination although helpful to arrive at correct diagnosis, at times may be difficult and may require ancillary tests such as immunohistochemistry. Materials and Methods: A prospective cross sectional study enrolled 125 cases of colorectal biopsies after histopathological confirmation of tumours and tumour like lesions. The specimens were received at the Department of Pathology, of TUTH, from December 1, 2015 to November 30, 2016. Results: Out of 125 cases, 32 cases were benign tumours, 36 cases were malignant tumours and 57 cases were tumour like lesions. Most common age range was 51-60 years with mean age of 38 years. Males comprised 76.74% and females 23.26% with ratio of 3:1. Juvenile polyp was the commonest lesion. Among benign tumours, tubular adenoma was the most common (19.2%), adenocarcinoma was most common malignant tumour (25.6%) and juvenile polyp was the most common tumour like lesion (27.2%). Left side was most common side (66.67%) and rectum was the most common site (48.8%). Conclusions: The commonest indications for colorectal biopsies were tumours and tumour like lesions. Juvenile polyp was the most common tumour like lesion, tubular adenoma was the most common benign tumour and adenocarcinoma was the most common malignant tumour. Histopathological examination is a gold standard for confirmation of all tumour and tumours like lesions of colon and rectum.

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Fine needle aspiration cytology in the management ENT of patients

The Journal of Laryngology & Otology ◽

10.1017/s0022215100106796 ◽

1988 ◽

Vol 102 (10) ◽

pp. 909-913 ◽

Cited By ~ 26

Author(s):

Lesley A. Smallman ◽

Jennifer A. Young ◽

J. Oates ◽

D. W. Proops ◽

A. P. Johnson

Keyword(s):

Correct Diagnosis ◽

Neck Region ◽

Final Diagnosis ◽

Needle Aspiration ◽

Malignant Tumours ◽

Aspiration Cytology ◽

Head And Neck Region ◽

Needle Aspiration Cytology ◽

Made In

AbstractAspirates were obtained from 142 masses in 120 patients who presented with palpable swellings in the head and neck region. 120 specimens (84.51 per cent) were adequate for diagnostic purposes and the remaining 22 (15.49 per cent) were unsatisfactory. Final diagnosis was based on resection histology in 87 cases and close clinical follow-up in 55 patients. The overall sensitivity and specificity including unsatisfactory aspirates was 81.37 per cent and 93 per cent respectively (if the technically inadequate specimens were deleted 98.81 per cent and 94.44 per cent). In comparison with the final diagnosis typing of malignant tumours was possible in 58.33 per cent. The correct diagnosis was made in 63.89 per cent of benign lesions.

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Bilateral breasts metastases from gall bladder adenocarcinoma: a rare presentation

International Surgery Journal ◽

10.18203/2349-2902.isj20193365 ◽

2019 ◽

Vol 6 (8) ◽

pp. 3019

Author(s):

Vaibhav Raj Gopal ◽

Shailendra Kumar Yadav ◽

Faraz Ahmad ◽

Surender Kumar ◽

Saumya Shukla ◽

...

Keyword(s):

Breast Biopsy ◽

Histopathological Examination ◽

Palliative Therapy ◽

Metastatic Breast ◽

Abdominal Distension ◽

Primary Malignancy ◽

Rare Presentation ◽

Immuno Histochemistry ◽

The Difference ◽

Lost To Follow Up

Bilateral breasts metastasis from gallbladder adenocarcinoma is very rare and has never been reported. Overall incidence of breast metastasis from other primaries as reported in literature is 0.5-3%. A 38 year female presented with progressive abdominal distension followed by lumps in the left and right breasts consecutively. Abdominal examination revealed a huge right upper quadrant lump, hard in consistency and moving with respiration. CT abdomen suggested gallbladder lump infiltrating liver, colon, duodenum and pylorus. HRUSG of breasts revealed malignant lumps. Histopathology and immuno-histochemistry of breast biopsy confirmed it to be metastatic and not the primary (mammaglobin-, GATA 3 -, CK 19+, GCDFP-). Gallbladder biopsy showed adenocarcinoma with similar marker pattern. A diagnosis of gallbladder carcinoma with secondaries in bilateral breasts was made. Patient received one cycle of platinum based palliative chemotherapy and thereafter was lost to follow up. A proper clinical, radiological and histopathological examination is essential to distinguish primary and metastatic breast lesion due to the difference in the management of both. Overall prognosis is very poor and treatment should be directed towards palliative therapy of primary malignancy.

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Exercise-induced ruptured renal tumour in a young patient with hereditary leiomyomata-associated renal cell carcinoma (HLRCC): a case report

African Journal of Urology ◽

10.1186/s12301-021-00263-6 ◽

2021 ◽

Vol 27 (1) ◽

Author(s):

Mohamad Fairuz Mohamad Sharin ◽

Mugialan Pushpanathan ◽

Arvind Vashdev Jagwani ◽

Khairul Asri Mohd Ghani ◽

Saiful Azli Mohd Zainuddin ◽

...

Keyword(s):

Renal Cell Carcinoma ◽

Cell Carcinoma ◽

Renal Cell ◽

Histopathological Examination ◽

Iliac Fossa ◽

Lower Abdominal Pain ◽

Renal Tumour ◽

Strenuous Exercise ◽

Rare Presentation ◽

Exercise Induced

Abstract Background Hereditary leiomyomatosis-associated renal cell carcinoma (HLRCC) is rare with only 300 families reported to date worldwide. Despite highlighting renal malignancy, it is infamous for its cutaneous and leiomyomatosis component as the more common cause of presentation. This report is to highlight the rare presentation of HLRCC which occurs in a teenager which is unfortunately complicated with exercise-induced renal tumour rupture. Case presentation A 22-year-old gentleman presented with severe right lower abdominal pain for 4 days, associated with fever and nausea following a session of strenuous exercise. He has first-degree relatives and second-degree relatives from his maternal side who were genetically tested positive for HLRCC. Clinical examination revealed a tender right lumbar and right iliac fossa region. A computed tomography of the kidneys demonstrated a ruptured right renal tumour with a large right renal subcapsular and contained right retroperitoneal hematoma. An emergency right radical nephrectomy was performed, and he recovered well. The histopathological examination was consistent with HLRCC associated ruptured right renal cell carcinoma. Conclusion Identification of this underreported familial malignancy is paramount as the onset of neoplasia occurs much earlier in life. This necessitates screening of family members at a younger age, and the management is followed by life-long surveillance.

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Splenic Stromal Sarcoma in a Labrador Dog

Acta Scientiae Veterinariae ◽

10.22456/1679-9216.116608 ◽

2021 ◽

Vol 49 ◽

Author(s):

Mateus De Melo Lima Waterloo ◽

Mirza Pessoa de Miranda ◽

Liana Mesquita Vilela ◽

Allynneide Emannuelly da Silva Rodrigues ◽

Gabriela De Souza Borba ◽

...

Keyword(s):

Blood Count ◽

Histopathological Examination ◽

Smooth Muscle Actin ◽

Correct Diagnosis ◽

Serum Biochemistry ◽

Histopathological Diagnosis ◽

Alpha Smooth Muscle Actin ◽

Stromal Sarcoma ◽

Mesenchymal Neoplasm ◽

Veterinary Hospital

Background: Splenic stromal neoplasms are a heterogeneous group of tumors that shares the morphology of spindle cells, and are considered a primary mesenchymal neoplasm of the spleen. Among these neoplasms, some are as yet unclassified. Although stromal neoplasms represent 25 a 50% of dog splenic neoplasms in dogs, subtypes rarely occur alone. As these neoplasms are difficult to diagnose in the routine veterinary medical examination, the objective of this article was to report a case of splenic stromal sarcoma in a dog treated at a private veterinary hospital in Recife, Pernambuco, Brazil. Case: An 8-year-old male labrador dog was treated at a veterinary hospital for an initial clinical suspicion of gastroenteritis. Clinical examinations showed anemic ocular mucosa and a distended abdomen. Considering the animal’s condition, blood count, serum biochemistry, and abdominal ultrasonography (US) were requested. The laboratory tests revealed anemia, thrombocytopenia, leukocytosis with neutrophilia, and changes in the indices of alanine aminotransferase (ALT) and alkaline phosphatase (ALP), among other findings. Abdominal ultrasound showed hepatomegaly, diffuse splenomegaly, a neoformation in the spleen suggestive of splenic neoplasia, and mild cystic prostatic hyperplasia. The dog underwent exploratory laparotomy with splenectomy. During the procedure, a nodule was found attached to the spleen. It was removed, fixed in a 10% neutral buffered formalin solution, and sent for histopathological and immunohistochemical examinations (vimentin, S100, desmin, MyoD1, HHF35, CD31, and alpha smooth muscle actin). The histopathological diagnosis was poorly differentiated spindle cell splenic sarcoma, compatible with splenic stromal sarcoma. Immunohistochemistry showed neoplastic cells immunoreactive for vimentin and S100, and it was not reactive for other markers. Based on the immunohistochemical and morphological profile, the diagnosis of splenic stromal sarcoma was confirmed. Discussion: Dogs affected by splenic neoplasms are generally aged between three and 17 years, and clinically present withanorexia, emesis, lethargy, weight loss, and abdomen distension, which were observed in the present case. However, a purelyclinical diagnosis is disputable, since other diseases can present the same signs. Thus, complementary exams are essential for a correct diagnosis. Laboratory changes in blood count and serum biochemistry are considered nonspecific for splenic neoplasms, with neutrophilic leukocytosis and anemia being consistent with paraneoplastic syndromes frequently diagnosed in small animals. Microscopically, splenic stromal sarcomas are characterized by focal splenic nodules composed of cohesive polygonal to spindle-shaped cell layers. The cells usually exhibit anisokaryosis and often have large oval to round vesicular nuclei and, occasionally, multinucleated cells. They have large areas of necrosis, diffuse or nodular lymphoid aggregates, and foci of extramedullary hematopoiesis, consistent with the histopathological examination reported in the present case. The immunohistochemical analysis included evaluation of seven markers to elucidate the histogenesis of the neoplasm, with the anti-vimentin and anti-S100 markers demonstrating positive cytoplasmic immunoreactivity, revealing the mesenchymal origin of the neoplasm. Thus, the definitive diagnosis was splenic stromal sarcoma, a rare and aggressive neoplasm. Keywords: spleen, histopathology, immunohistochemistry, neoplasm. Descritores: baço, histopatologia, imunohistoquímica, neoplasia

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