1/7. Reactive lymphoid hyperplasia of liver coexisting with chronic thyroiditis: radiographical characteristics of the disorder.BACKGROUND: Reactive lymphoid hyperplasia of the liver is an extremely rare entity, with six cases reported so far. methods: We encountered a 47-year-old Japanese female with reactive lymphoid hyperplasia of the liver, which coexisted with chronic thyroiditis. The lesion was discovered incidentally as a hypo-echoic mass with a hyper-echoic rim at a routine ultrasonography examination. It increased from 12 to 17 mm diameter in 6 months. Radiological studies, such as contrast-enhanced computerized tomography (CT) and angiography demonstrated a hypervascular lesion. RESULTS: It was consequently diagnosed as a neoplasm with malignant potentiality and she underwent partial hepatectomy. The lesion was composed of small mature lymphocytes which formed prominent lymphoid follicles with germinal centres, scattered plasma cells and stromal fibrosis. Immunohistochemical study revealed polyclonal origins of the involved lymphocytes. dna analysis for the immunoglobulin heavy gene and the T cell receptor beta gene using Southern blot hybridization showed no monoclonality. The following features have characterized the images in past cases, as well as ours: hypo-echoic mass, occasionally with a rim, in ultrasonography and hypervascularity, shown by angiography and enhanced CT.- - - - - - - - - - ranking = 1keywords = neoplasm (Clic here for more details about this article) |
2/7. Inflammatory intramammary lymph node mimicking the malignant lesion in dynamic MRI: a case report.Enlarged intramammary lymph node (LN) may be caused by inflammation [Arch. Surg. 109 (1974) 759.], reaction to dermatitis [radiology 137 (1980) 15.], tuberculosis [Histopathology 17 (1990) 91.], foreign body such as gold [Hum. Pathol. 19 (1988) 992.], neoplasm including metastasis [Arch. Surg. 109 (1974) 759; AJR, Am J Roentgenol 146 (1986) 133.], and malignant lymphoma [AJR, Am J Roentgenol 161 (1993) 779.]. It is difficult to distinguish benign enlarged LNs from malignant lesion clinically, mammographically, and sonographically. There have been a few reports on the magnetic resonance imaging (MRI) of enlarged intramammary LNs in the English literature. In this article, we present a case in which dynamic MRI indicated inflammatory LNs as highly suspicious of malignancy.- - - - - - - - - - ranking = 1keywords = neoplasm (Clic here for more details about this article) |
3/7. Linear acral pseudolymphomatous angiokeratoma of children (apache): further evidence that apache is a cutaneous pseudolymphoma.Acral pseudolymphomatous angiokeratoma of children (apache) is a recently recognized, rare clinical entity. We report a case of apache in a 9-year-old Japanese girl with a dark red, linear plaque on the posterior area of the right lower leg. Histopathologic findings revealed further evidence that apache was a cutaneous pseudolymphoma rather than a vascular neoplasm because of the presence of distinct primary and secondary lymphoid follicles, and thick-walled, long blood vessels lined with prominent plump endothelial cells similar to high endothelial venules in the paracortical area of the lymph node. In addition to previous descriptions, the patient presented with a distinct linear lesion. Vacuolar alteration of the basal cell layer and scattered eosinophilic bodies in the epidermis were observed, which suggested a lichenoid tissue reaction. We believe that apache might show a distinct linear pattern accompanied by a lichenoid tissue reaction.- - - - - - - - - - ranking = 1keywords = neoplasm (Clic here for more details about this article) |
4/7. Benign fibrous histiocytoma with indeterminate cells and eosinophils: collision, differentiation, or involution?This report describes the clinicopathologic, immunohistochemical, and ultrastructural features of a benign fibrous histiocytoma of 3 years' duration situated on the posterior right arm of a 17-year-old woman. To our knowledge, this is the first published description of an association between the histologic features of benign fibrous histiocytoma with proliferating dermal dendrocytes and solid clusters of indeterminate cells and inflammatory infiltrate containing numerous eosinophils. Cell type identification was confirmed by immunohistochemical demonstration of positivity of indeterminate cells for CD1a and S-100 protein, by absence of Birbeck granules in electron microscopy study, and by positivity of fibroblast-like cells for factor xiiia and negativity for CD34. mitosis or cytologically atypical cells were absent. The MIB1-measured proliferative index of the tumor cells was less than 5% in spindle cells and approximately 15% in indeterminate cells.Possible pathogenic pathways are discussed that could account for divergent differentiation or a combination of neoplasms of different lineages.- - - - - - - - - - ranking = 1keywords = neoplasm (Clic here for more details about this article) |
5/7. Lesions resembling Langerhans cell histiocytosis in association with other lymphoproliferative disorders: a reactive or neoplastic phenomenon?Langerhans cell histiocytosis (LCH) has been described in association with a variety of neoplasms preceding, after, or synchronous with the other tumor. In some cases, a neoplasm may arise as a complication of therapy for LCH, and in others, the association may be coincidental. Synchronous occurrence has been reported most commonly in association with malignant lymphoma in which discrete proliferations of langerhans cells (LCs) histologically indistinguishable from LCH are seen. In most cases, these LCs are closely related to or intermingling with the primary pathology. The nature of LCs in this context remains elusive with debate as to whether they represent a true clonal neoplasm or an exaggerated reactive phenomenon. The lack of evidence for LCH progression or disease elsewhere strongly supports the latter. We have encountered 5 examples of LCH-like proliferations occurring in the context of other lymphoproliferative disorders. These include 2 cases of mycosis fungoides and 1 of cutaneous B-cell pseudolymphoma, associations that to our knowledge have not been described before. Two patients were female, and the clonality of the LC proliferation was assessed using laser capture microdissection and the human androgen receptor. The results showed that the LCs forming discrete nodules in a case of cutaneous B-cell pseudolymphoma and a case of Hodgkin's lymphoma were polyclonal. This suggests that, at least in a proportion of cases, the aggregates of LCs occasionally identified within other lymphoproliferative lesions represent a reactive proliferation rather than a potentially aggressive second neoplasm.- - - - - - - - - - ranking = 4keywords = neoplasm (Clic here for more details about this article) |
6/7. "In situ-like" mantle cell lymphoma: a report of two cases.Mantle cell lymphoma (MCL) is a B cell neoplasm that most often shows a diffuse growth pattern. Two cases of MCL are reported here, both with a previous diagnosis of lymphoid hyperplasia. Morphologically, germinal centres are hyperplasic with a normal or discretely enlarged mantle zone, where foci of irregularly shaped small lymphocytes are seen. These are positive for CD20, CD5 and cyclin d1, confirming a diagnosis of in situ-like MCL. This type differs from the mantle zone pattern in that the neoplastic mantle zone is very thin and there is very little or no spread of tumour cells into interfollicular areas. To the best of our knowledge, this is the first report on such a pattern of MCL, which is important to recognise, as it can be confused with lymphoid hyperplasia.- - - - - - - - - - ranking = 1keywords = neoplasm (Clic here for more details about this article) |
7/7. Atypical lymphoid infiltrates arising in cutaneous lesions of connective tissue disease.Atypical lymphoid infiltrates occurring in the setting of connective-tissue disease (CTD) comprise malignant neoplasms of B-cell or T-cell phenotypes and various reactive lymphoid hyperplasias, such as myoepithelial sialadenitis, lymphocytic thyroiditis, and lymphocytic interstitial pneumonitis. We describe 17 patients with atypical lymphoid infiltrates arising in cutaneous lesions of CTD, the spectrum of which included lupus erythematosus, dermatomyositis, relapsing polychondritis, and lichen sclerosus et atrophicus. There were two principal categories, pseudolymphoma and malignant lymphoma, the former representing 15 of the 17 cases. The clinical and histologic features and possible pathogenetic mechanisms are discussed.- - - - - - - - - - ranking = 1keywords = neoplasm (Clic here for more details about this article) |