Cases reported "Histiocytoma"

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1/5. Pulmonary crystal-storing histiocytoma.

    We describe the case of a 50-year-old woman with a lung tumor composed of crystal-storing histiocytes. These cells and associated plasma cells failed to show clonal light chain restriction, and the patient had no associated hematologic disorder. The differential diagnosis included crystal-storing histiocytosis, characterized by accumulation of crystallized immunoglobulins, a rare manifestation of monoclonal gammopathies/plasma cell dyscrasias. Crystal-laden histiocytes have previously been described in many organs. Four reports have described crystal-storing histiocytosis in the lung, always associated with a lymphoproliferative disorder. The present patient, 1 other case from our archive, and 1 case reported in the literature, all without an association with lymphoproliferative disorder, make a full description and definition of this lesion appropriate. The morphology, immunohistochemical profile, and electron microscopic features are described herein, and the term pulmonary crystal-storing histiocytoma is proposed. A practical algorithm is presented for the assessment of solitary lung masses composed of large histiocytic cells. ( info)

2/5. Use of a vascularized fibula bone flap and intercalary allograft for diaphyseal reconstruction after resection of primary extremity bone sarcomas.

    BACKGROUND: The standard treatment for primary bone sarcomas of the extremities has become chemotherapy and limb salvage surgery. However, the difficulties in achieving reliable long-term healing with allograft reconstruction have led us to use vascularized fibula transfer to enhance healing. methods: From 1992 to 2003, 14 vascularized fibula transfers were performed at our institution for bone reconstruction in 12 patients with bone sarcoma. Free vascularized fibula transfers were performed in 13 cases, and a pedicled vascularized fibula transfer in one case. The mean age was 25 years (range, 6 to 71 years). Locations included the femur (n = 10), humerus (n = 1), and tibia (n = 3). The mean length of the vascularized fibula transfer was 17.4 cm (range, 10 to 24 cm). Indications for use of a vascularized fibula transfer included allograft nonunion (n = 8), and primary diaphyseal bone defect reconstruction combined with an intercalary allograft (n = 6). For all allograft nonunions, a vascularized fibula transfer was used with an onlay technique. For segmental bone defects, an intramedullary technique was used in three cases and an onlay technique in two cases. RESULTS: The overall mean time for bone union after a vascularized fibula transfer was 8.6 months (range, 3 to 24 months): 10 months (range, 5 to 24 months) for patients with allograft nonunions, and 6 months (range, 3 to 8 months) for patients who underwent immediate segmental bone reconstruction. All but one patient had successful bone union. One patient with persistent nonunion required a second vascularized fibula transfer. The mean time from initial limb salvage surgery to full use of the reconstructed limb without restrictions was 28 months (range, 13 to 45 months) for patients treated with a delayed vascularized fibula transfer for an allograft nonunion and 6 months (range, 3 to 8 months) for patients who underwent immediate reconstruction with a vascularized fibula transfer combined with an allograft. CONCLUSIONS: The use of a vascularized fibula transfer combined with an intercalary allograft to reconstruct bone defects after tumor resection can prevent allograft nonunion and result in decreased time to bone healing, leading to earlier patient recovery and return of function. ( info)

3/5. Acute haemorrhage in patients with advanced head and neck cancer: value of endovascular therapy as palliative treatment option.

    AIMS: Acute or subacute haemorrhage is one of the most frightening complications in patients suffering from advanced head and neck cancer. Few articles report experience with superselective endovascular therapy for this purpose. Is endovascular therapy underestimated in the field of palliative head and neck cancer therapy? This study set out to investigate this question. patients AND methods: A review was undertaken of the clinical courses of seven patients (six men, one woman) suffering from incurable, advanced head and neck cancer (four pharyngeal, two laryngeal, one neck) and treated with superselective endovascular strategies as an emergency procedure for acute bleeding. RESULTS: All patients were successfully treated without evidence of neurological complication. patients reached a median survival of 20 weeks (range eight-168 weeks). Following endovascular treatment all patients were discharged from the hospital within several days. Three patients survived almost free of symptoms for several weeks and were able to stay at home with their families until their death. CONCLUSION: We conclude that in the field of palliative care, superselective endovascular therapy deserves to be considered alongside standard treatment options for the management of acute haemorrhage from advanced head and neck cancer. ( info)

4/5. Multinucleate cell angiohistiocytoma. Report of five cases.

    BACKGROUND: Multinucleate cell angiohistiocytoma is an infrequent and most likely non-neoplastic disorder usually seen in acral regions in elderly women. It presents clinically as asymptomatic red-to-brown tumors, with a tendency to confluence. It must be distinguished from other diverse cutaneous lesions, notably dermatofibroma, Kaposi sarcoma, and angiofibroma. methods: We report the clinical, histopathological, and immunohistochemical findings of five patients, all women aged between 51 and 78 years. All except the first presented lesions on both of the lower limbs. None of the patients developed spontaneous resolution of the lesions and one was successfully treated by cryosurgery. COMMENTS: Multinucleate cells are characteristic, but neither exclusive nor pathognomonic, of multinucleate cell angiohistiocytoma, since they can also appear in other inflammatory, neoplastic, or reactive processes. The presence of these cells and vascular proliferation in dermis media are the principal histopathological findings in this infrequent entity. In immunohistochemical studies, the multinucleate cells are often positive for vimentin and factor xiiia. ( info)

5/5. Progressive nodular histiocytoma associated with thrombocytopenia with absent radii (TAR syndrome) and angiofibromas.

    A 50-year-old woman was admitted due to a long-standing history of cutaneous lesions, which were gradually increasing in number and size, located on the trunk and extremities. Histological studies confirmed the initial clinical diagnosis of histiocytomas. Moreover, the patient had numerous smooth erythematous papules on her chin and around her nose, which were diagnosed histologically as angiofibromas. The patient had congenital phocomelia. Analytical and imaging studies revealed the presence of bilateral phocomelia due to absent radii and thrombocytopenia (TAR syndrome). Multiple histiocytomas in a normolipaemic patient bring up several differential diagnoses. Slow progressive evolution without spontaneous resolution and a scattered distribution on the trunk and extremities suggest the diagnosis of progressive nodular histiocytoma. To our knowledge progressive nodular histiocytoma has not been reported previously associated either with TAR syndrome or with angiofibromas. These entities are uncommon, thus their association may not be due to chance. ( info)


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