Acroangiodermatitis or pseudo-Kaposi’s sarcoma: a challenging diagnosis

Acroangiodermatitis (AAD), also referred to as pseudo-Kaposi’s sarcoma, is a vascular-proliferative disease characterized by reactive proliferation of small blood vessels in response to congenital or acquired vascular lesions. There are mainly two clinical variants of acroangiodermatitis; STEWART-BLUEFARB syndrome and the Malian type. There is clinical and histological similarity with Kaposi’s sarcoma hence the interest of immunohistochemical analysis. We report the case of a 40-year-old man with cutaneous lesions localized on the lower limbs. Clinical, dermoscopic, histological and immunohistochemical investigation led to a diagnosis of Kaposi-like acroangiodermatitis.

Recovery of Hippocampal-Dependent Learning Despite Blunting Reactive Adult Neurogenesis After Alcohol Dependence

Background: The excessive alcohol drinking that occurs in alcohol use disorder (AUD) causes neurodegeneration in regions such as the hippocampus, though recovery may occur after a period of abstinence. Mechanisms of recovery are not clear, though reactive neurogenesis has been observed in the hippocampal dentate gyrus following alcohol dependence and correlates to recovery of granule cell number. Objective: We investigated the role of neurons born during reactive neurogenesis in the recovery of hippocampal learning behavior after 4-day binge alcohol exposure, a model of an AUD. We hypothesized that reducing reactive neurogenesis would impair functional recovery. Methods: Adult male rats were subjected to 4-day binge alcohol exposure and two approaches were tested to blunt reactive adult neurogenesis, acute doses of alcohol or the chemotherapy drug, temozolomide (TMZ). Results: Acute 5 g/kg doses of EtOH gavaged T6 and T7 days post binge did not inhibit significantly the number of Bromodeoxyuridine-positive (BrdU+) proliferating cells in EtOH animals receiving 5 g/kg EtOH versus controls. A single cycle of TMZ inhibited reactive proliferation (BrdU+ cells) and neurogenesis (NeuroD+ cells) to that of controls. However, despite this blunting of reactive neurogenesis to basal levels, EtOH-TMZ rats were not impaired in their recovery of acquisition of the Morris water maze (MWM), learning similarly to all other groups 35 days after 4-day binge exposure. Conclusions: These studies show that TMZ is effective in decreasing reactive proliferation/neurogenesis following 4-day binge EtOH exposure, and baseline levels of adult neurogenesis are sufficient to allow recovery of hippocampal function.

The Vascular Convolutions-Papillary Endothelial Hyperplasia

Intravascular papillary endothelial hyperplasia is an exceptional, benign, inflammatory, vascular neoplasm delineating papillary configuration engendered from reactive proliferation of damaged endothelial cells, while being confined to a thrombus. Initially scripted by Pierre Mason in 1923, the tumefaction was denominated as an intra-luminal lesion within an ulcerated, haemorrhoidal vein and designated as “hemangio-endotheliome’ vegetant’ intravasculaire”(1). The neoplasm is additionally nomenclated as Masson’s tumour, Masson’s pseudo-angiosarcoma, endovascularite proliferante thrombopoietique, intravenous atypical vascular proliferation, intravascular angiomatosis, vascular angiomatosis, intravascular endothelial proliferation, reactive papillary endothelial hyperplasia or intravascular papillary endothelial hyperplasia. The papillary neoplasm is associated with deposition of fibrin and thrombotic substances within a painful, ulcerated.

IgG4-related lymphadenopathy masquerading as Hodgkin lymphoma: lessons from a pathologist’s desk

IgG4-related disease (IgG4-RD) is a systemic fibroinflammatory disorder affecting multiple organ systems. The awareness of this disease has tremendously increased over the last decade leading to effective treatment and decreased morbidity to the patients. Histopathology plays an important role in the diagnosis of IgG4-RD, and definite histologic criteria are proposed in clinically suspected patients. We report a patient with multiple organ system involvements of the salivary gland, lymph node and kidney. IgG4-related lymphadenopathy (IgG4-RL) in this patient was misdiagnosed as nodular lymphocyte predominant Hodgkin’s lymphoma (NLPHL). Refractoriness to treatment for NLPHL and subsequent manifestations of renal involvement lead us to the correct diagnosis of this potentially treatable condition. IgG4-RL can mimic reactive proliferation as well as lymphomas. We report the clinical presentation and discuss the problems faced by pathologists in diagnosing IgG4-RL. We believe that awareness of this rare presentation will enhance the knowledge in diagnosing IgG4-RD.

ASSESSMENT OF EFFECTIVENESS OF ANTI-RECURRENT AND HORMONAL THERAPY IN WOMEN WITH UTERINE FIBROIDS IN PREGRAVIDAL PREPARATION

Aim. This study was designed to evaluate the effectiveness of sequential prescription of drugs for anti-recurrent therapy of the uterine fibroids (UF) and combined oral contraceptives (COC) in pregravidal preparation.Materials and methods.There was conducted a prospective, nonrandomized and controlled cohort study of 150 women with UF who are planning a pregnancy after the organ-preserving treatment of uterine fibroids by means of myomectomy with laparoscopic access and pregravidal preparation. The immunohistochemical (IHC) study of the intensity expression of Ki 67, p53, Bcl-2 was performed for the differential diagnosis of reactive proliferation from dysplasia in the distant fibroid node and the selection of anti-recurrent therapy.Results. The duration of the UF disease does not depend on the intensity of expression of p53, Ki-67 or Bcl-2, the level of expression of the progesterone receptors in the distant fibroid node. A negative average correlation between the level of hemoglobin before myomectomy, the duration of the disease (r = -0.3867) and the number of nodes (r = -0.5389) was revealed. After the end of the anti-recurrent treatment in women who underwent organ- preserving treatment of uterine fibroids, the prescription of COC is connected with a further decrease in the size of fibroid nodes remaining after myomectomy from 15.81±0.22 mm to 8.94±0.45 mm (p<0.05), the number of fibroid nodes from 2.25±0.08 to 0.91±0.06 (р<0.05).Conclusion.The combination of anti-recurrent therapy with the subsequent prescription of the COC for prevention of the UF growth in women planning a pregnancy after myomectomy with endoscopic access is highly effective.

Pseudolymphomatous Reaction to Red Tattoo Pigment

Decorative tattooing is a procedure in which exogenous pigment and/or dye is introduced into the dermis with the aim of creating a permanent skin decoration. The increasing prevalence of tattooed individuals leads to more reported tattoo-related complications. Pseudolymphomatous reaction is a benign reactive proliferation of lymphocytes that may uncommonly occur secondary to tattooing. We describe the clinical, histological, and molecular aspects of a pseudolymphomatous reaction to red tattoo pigment.

Review on Retinal Gliosis Illustrated with a Series of Massive Glioses and Focal Nodular Gliosis Cases in Regard to Potential Pitfalls of Ocular Reactive Tumor-like Lesions of this Type

This paper presents a review on retinal gliosis illustrated by series of three cases of patients (a 39-year-old man and a 35-year-old woman with massive retinal gliosis (MRG) and a 51-year-old man with truly focal nodular gliosis of retina) with intraocular tumor-like masses and loss of vision, who recently suffered from painful inflammation of eyeball and who classically had a history of remote ocular trauma, onset of blindness early in lifetime or gradual but progressive loss of sight. The diagnosis of this pathological entity is given for the lesions that are composed of GFAP strongly positive, elongated, fusiform cells consistent with fibrillary astrocytes. As illustrated in cases from our pathological practice, PAS gave positive patchy disseminated reaction in form of cellular densely purplish granules in minority of cells representing glycogen storing. This feature could be consistent with PAS-positive Müller cells that also constitute retinal gliosis as one of cellular components of normal retina that is induced to reactive proliferation. Thus, the paper presents histological background and differential diagnosis of the entity.

An intravascular papillary endothelial hyperplasia of the hand radiologically mimicking a hemangiopericytoma: A case report and literature review

Intravascular papillary endothelial hyperplasia is a rare benign vascular lesion of the skin and subcutaneous tissues, characterized by a reactive proliferation of endothelial cells that can present de novo in normal blood vessels (primary intravascular papillary endothelial hyperplasia), but it can also develop from a pre-existing vascular process (type II intravascular papillary endothelial hyperplasia), or it can arise in an extravascular location from a post-traumatic haematoma. The differential diagnosis between intravascular papillary endothelial hyperplasia and malignant vascular tumours can be challenging, due to the lacking of a specific radiologic description. We present a case of intravascular papillary endothelial hyperplasia of the hand radiologically mimicking a hemangiopericytoma.

Atypical Presentation of Traumatic Neuroma: A case report

Congenital Traumatic neuroma is a rare disorder that represents a reactive proliferation of neural tissue followingdamage to an adjacent nerve. Rarely these lesions appear in the oral cavity with certain predilection for the mental foramen and the tongue area. However, its presentation on lip is more unusual with only few cases being reported in the literature. Typically diagnosed in middle-aged women, patient complains of pain as a frequent symptom. Clinically, the lip lesions appear as a normal or grayish white nodule with a smooth surface that typically resembles a mucocele. We report here a case of a 37-year old female who presented with similar signs and symptoms and was diagnosed clinically as a mucocele. However, histopathological examination revealed it as a traumatic neuroma that was surgically excised. The patient is under follow-up with no signs of recurrence for 18 months.