HighlightsRetroperitoneal Castleman’s disease in the peripancreatic region is a rare entity.Preoperative diagnosis is most often difficult and mimics malignant disease.Surgical en bloc excision is the most commonly performed treatment due to diagnostic dilemma.Preoperative biopsy in cases with strong clinical suspicion can avoid radical surgery.
Background: Forkhead box A1 (FOXA1) plays an important role in several tumors. This study investigated the potential role of FOXA1 expression in thyroid tumors. We conducted a retrospective study of 110 thyroid lesions and tumors diagnosed during 1995-2018. The expression of FOXA1 was analyzed by immunohistochemistry on archival material. Results: No FOXA1 immunostaining was observed in all cases of Graves' disease, Hashimoto's disease, multinodular goiter, and adenoma. FOXA1 expression was absent as well in all papillary and follicular carcinomas, Hurthle cell carcinoma, and undifferentiated sarcoma. Only three anaplastic carcinomas exhibited focally FOXA1 staining. However, FOXA1 was expressed in all medullary carcinomas. No significant correlation was found with all clinicopathological features (p > 0.05 for all). The pattern of FOXA1 staining was similar to that of calcitonin and chromogranin A (p = 0.04 and p = 0.003, respectively).Conclusions: FOXA1 is expressed mostly in all medullary thyroid carcinomas. Hence, FOXA1 could serve as an additional marker for refining the diagnosis of medullary thyroid carcinoma.
Background: Blastomycosis is a non-opportunistic fungal infection caused by Blastomyces dermatitides. Infection of the central nervous system is an uncommon localization of this disease occurring only in 5-10% of cases. Case report: We report a new case of a 57-year-old woman, who was admitted in the neurosurgical department for severe headache, vomiting, and a visual disturbance. Physical and biological investigations were normal. Magnetic resonance imaging led to find an intracranial and extracranial expansive processes, measuring 42 mm in length. The microscopic examination revealed a chronic granulomatous inflammation, associating epithelioid and multinucleated giant cells containing thick-walled budding yeast-like forms. Grocott-Gomori methenamine-silver staining led to confirm its fungal nature, and it was precisely Blastomyces dermatitidis. The postoperative course was complicated by cerebral edema associated with an important cerebral hemorrhage. The patient died 11 days after the surgery. Conclusion: Cerebral involvement remains a serious but uncommon manifestation of blastomycosis. It should be suspected in front of a granulomatous inflammation with the presence of spore on the pathological examination. The delay in diagnosis has been reported to play a significant role in the high mortality rate.
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