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ABSTRACT: Squamous carcinoma is the most common malignancy of the vagina. Other malignancies include adenocarcinoma, melanoma, lymphoma, and very rarely, neuroendocrine carcinoma/small-cell carcinoma. Large cell neuroendocrine carcinoma (LCNEC) has not been reported in this location. In this report, we describe a case of LCNEC of the vagina, which is believed to be the first case to date in the English literature. The patient is a 53-year old gravida 3, para 2, African-American woman who had a 4 month history of severe pelvic pain and difficulty voiding and was found to have a firm plate-like mass on the anterior vaginal wall. Thin prep of vaginal swap was interpreted as atypical glandular cells; however, the biopsies showed a large cell neuroendocrine carcinoma which was confirmed by diffuse strong immunoreactivity to AE1/3, CAM5.2, CK7, and CD56 in the tumor cells. Subsequent clinical workup showed that the patient also had numerous metastatic nodules in the bilateral lungs and a vaginal-urethral fistula caused by the tumor. The patient underwent palliative radiation of pelvis for local pain control and then chemotherapy. Although the vaginal tumor increased in size even after radiation, her symptoms were under control and she was doing well for a short period of time. The patient is still alive but developed brain metastasis a year later after initial diagnosis. Despite its rarity, large cell neuroendocrine cell carcinoma should be included in the differential diagnosis when cytomorphology shows features suggestive of neuroendocrine differentiation.
Diagnostic Cytopathology 03/2010; 38(12):925-8. · 1.16 Impact Factor
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ABSTRACT: Fine needle aspiration (FNA) is a valuable, noninvasive, commonly used technique in the diagnoses of head and neck tumors. Adult rhabdomyoma is a rare benign tumor of striate muscle tissue usually located in the head and neck region. Cytomorphologically, the tumor cells have eosinophilic finely granular cytoplasm, which sometimes can mimic other tumors. We report a case of adult rhabdomyoma, which was initially misinterpreted as granular cell tumor on FNA biopsy due to lacking of typical cytological features of adult rhabdomyoma. We recommend that adult rhabdomyoma should be included in differential diagnoses when the cytological features are suggestive of granular cell tumor. A panel of immunohistochemical stains including S100, desmin, and myoglobulin may also be helpful in making correct diagnosis.
Diagnostic Cytopathology 03/2009; 37(7):483-6. · 1.16 Impact Factor
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ABSTRACT: Melanosis refers to abnormal or excessive deposition of melanin pigment in the cells and/or tissue, which can be seen in any organ but commonly in skin and oral mucosa. Melanosis of the urinary bladder is an extremely rare benign condition and only a handful of cases been reported in the English literature before. In this article, we report a new case of urinary melanosis, describe the differential diagnostic features from pseudomelanosis and offer clues for correct diagnosis. We also provide comprehensive review of the literature on the subject.
Diagnostic Pathology 02/2009; 4:24. · 1.64 Impact Factor
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ABSTRACT: Primary malignant melanomas of the uterine cervix are uncommon. We describe an unusual case occurring in a woman with a previous supracervical hysterectomy.
A 63-year-old woman with a history ofsupracervical hysterectomy forfibroids was found to have a high grade squamous intraepithelial lesion on routine Papanicolaou smear and underwent cervical cone excision. Microscopic examination of the cervical cone biopsy showed highly dysplastic cells within the ectocervical mucosa as well as in the underlying stroma. The dysplastic cells were amelanotic and demonstrated immunoreactivity to S-100 protein and HMB-45. There was no evidence of immunoreactivity to leukocyte common antigen or AE1/AE3. Diagnosis of malignant melanoma was made. Subsequently the patient underwent trachelectomy and pelvic lymphadenectomy. Residual malignant melanoma involving the ectocervical squamous mucosa was noted, but bilateral pelvic lymph nodes were negative for metastatic melanoma. The patient had no prior history of cutaneous melanoma or other malignancies. She experienced a local recurrence 1 year after surgery.
To our knowledge, this is the first published case report of primary melanoma of the cervix occurring after supracervical hysterectomy. Although uncommon, melanoma should be considered in the differential diagnosis of high grade dysplasia. This case also demonstrates the importance of the routine annual Papanicolaou smear, not just for high-risk women and cervical cancer but also for older women and those with supracervical hysterectomy.
Acta cytologica 51(1):86-8. · 0.49 Impact Factor
