Sclerosing hemangioma (pneumocytoma) is a rare benign lung tumor with uncertain histogenesis but characteristic histology. Reports of the cytopathology of this tumor are even rarer with only a handful of cases in the literature--many of these incorrectly diagnosed by cytology initially. Herein, we describe a case of sclerosing hemangioma diagnosed prima facie by fine-needle aspiration cytology. A cell block preparation with accompanying immunohistochemistry was instrumental in making the diagnosis. A review of the literature is also presented.
Four patients with synchronous breast cancer and lymphoma are described. In all cases, the lymphoma was an unexpected finding in the histopathology of the axillary lymph-node dissection. The diagnosis of synchronous malignancies poses challenges for both the diagnosing pathologist and the treating clinician.
We report two cases of atypical fibroxanthoma (AFX) that both had the previously unreported feature of neural invasion (one perineural and the other intraneural). AFXs recur in approximately 10% of cases but only rarely metastasize. Features associated with recurrence are inadequate excision and invasion into fat. Features associated with metastasis include recurrence, vascular invasion, deep tissue invasion, and tumor necrosis. Both of these tumors invaded deeply into subcutaneous fat and reached the deep fascia. Some authors would regard such cases as malignant fibrous histiocytoma (MFH) because of such deep extension; however, the concept of AFX as a superficial variant of MFH is outmoded--AFX is a distinct clinicopathologic entity with established clinical, histological, and immunohistochemical features.
In this study of resected stage 1 primary lung adenocarcinoma, we found mitotic index to be the only independent prognostic marker. It was more closely associated with outcome than either pathologic T stage or IASLC/ATS/ERS architecture-based classification. Further validation of concordance and reproducibility in reporting mitotic index, as well as validation of prognostic significance, needs to be undertaken in independent data sets.
Sir: Lipomatous hypertrophy of the interatrial septum (LHIS) is an uncommon lesion rarely encountered as a surgical specimen. I present an atypical case which is
Granulocytic sarcoma is a rare manifestation of myeloid leukemia and is even rarer as a primary presentation. Granulocytic sarcoma may affect any organ and has many modes of presentation. Diagnosis by cytology is possible as long as the diagnosis is considered. Diagnosis by cytology of body cavity effusion fluid has rarely been described. We present an unusual case of granulocytic sarcoma in which pleural effusion was a part of the initial presentation. Cytologic examination of the pleural effusion was able to make the definitive diagnosis of granulocytic sarcoma.
The global landscape of molecular testing is rapidly changing, with the recent publication of the International Association for the Study of Lung Cancer (IASLC)/College of American Pathologists (CAP) guidelines and the ALK Atlas. The IASLC/CAP guidelines recommend that tumors from patients with non-small cell lung cancer (NSCLC) be tested for ALK rearrangements in addition to epidermal growth factor receptor (EGFR) mutations. The spur for this recommendation is the availability of novel therapies that target these rearrangements. This article is based on coverage of a
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