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ABSTRACT: BACKGROUND
Breast mass as the primary manifestation of ovarian cancer is rare. A 62-year-old patient presented with a right side breast tumor, which
turned out to be a metastasis of a primary ovarian cancer.
CASE REPORT
A 62-year-old lady with a right side breast tumor on both physical examination and imaging underwent fine needle aspiration. With the
diagnosis of poorly differentiated carcinoma, the patient underwent lumpectomy. Pathology and immunohistochemical study was in favor of
ovarian primary cancer. Further investigation and total abdominal hysterectomy and bilateral salpingo-oophorectomy confirmed a stage IIIC
epithelial ovarian cancer. Less than 2 years later, the patient presented with a mass on the other breast. Cytology and immunohistochemical
study for WT-1, gross cystic disease fluid protein-15 (BRST-2), and estrogen receptor confirmed metastasis of primary ovarian
origin. Morphologic and immunohistochemical examination of the specimen helped to clarify the correct diagnosis of primary ovarian
carcinoma.
CONCLUSION
Ovarian carcinoma usually presents with signs and symptoms related to the tumor burden within the abdominal cavity. Isolated, breast
involvement without intraabdominal disease is extremely rare. Determining the origin of the primary tumor is important in directing the
actual therapy.
European journal of clinical & medical oncology 12/2012; Volume 4(Issue 4).
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Shahrzad Negahban,
Nasrollah Ahmadi,
Ahmad Oryan,
Habib N. Khojasteh,
Azita Aledavood,
Hossein Soleimanpour,
Mohammad Mohammadianpanah,
Ilske Oschlies,
Stefan Gesk,
Reiner Siebert, Khosrow Daneshbod,
Yahya Daneshbod
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ABSTRACT: Mucosal leishmaniasis (ML) is a rare destructive disease that mainly affects the mucous membranes of the mouth and nose. The etiologic agent(s) of ML are not well known in the Middle East.
Cytologic smears of ML from the mucosal lesions of 7 patients were prepared by scraping. In 2 patients with nasal lesions, exfoliative cytology was made by washing the nasal cavity. The smears were both air dried and fixed in alcohol and stained. Scrapings from the same smears were then tested for leishmanial DNA by nested PCR.
This study characterized 9 isolates of ML, with 7 cases identified as Leishmania major and 2 as Leishmania tropica. While 6 patients were found to be positive by the cytology technique, the nested PCR was positive for all of these samples.
Presence of granuloma and multinucleated giant cells in the negative smears of the patients who showed clinical manifestation of ML was an important clue for diagnosis of this disease. The PCR-based method not only appears to be a precise diagnostic approach in the identification of suspected cases of ML but is also efficient in determining the species of the parasite. L. major and L. tropica can lead to ML, but they result in different cytologic features.
Acta cytologica 01/2012; 56(3):304-9. · 0.49 Impact Factor
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ABSTRACT: Background: Sarcomatoid renal cell carcinoma (SRCC) is an
aggressive tumour thought to arise predominantly from dedifferentiation
of clear cell carcinoma. Testicular metastasis from renal cell
carcinoma is very rare and, to the best of our knowledge, only one
(one out of eight) of such cases was SRCC.
Case: A 42-year-old male patient presented with painful enlargement
of the paratesticular area of 10 days’ duration. Fine needle aspiration was done, which yielded mainly isolated spindle cells.
Immunocytological staining was done and, with impression of spindle
cell carcinoma, orchidectomy was carried out. Histology was a
spindle cell sarcoma and immunostaining confirmed this tumour as
a metastatic SRCC.
Conclusion: SRCC can be a diagnostic pitfall with other spindle
cell tumours of the testis on both cytological and histological
grounds. Immunostaining helps to arrive at the correct diagnosis
and rule out other spindle cell tumours.
Cytopathology 06/2011; 22(1):141-142. · 1.59 Impact Factor
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ABSTRACT: Mucosal leishmaniasis (ML) is a rare disease in the world, even in endemic areas such as Iran. Clinical, histologic, or cytologic assessment may help in the diagnosis of ML.
To describe clinical, histologic, and cytologic findings in ML.
Review of our files showed 11 patients diagnosed with ML, of whom 7 patients had oral lesions, 1 of whom was a known patient with oral leishmaniasis with recurrence of oral lesions; 2 had laryngeal lesions; and 3 had nasal lesions. One case of laryngeal leishmaniasis was a recurrence of prior oral lesions. Cytologic smears were prepared by scraping the lesions with a scalpel or cytobrush. Histology on the biopsies was done for 7 patients. In 2 patients with nasal lesions, exfoliative cytology was made by washing the nasal cavity. Smears were both air dried and fixed in alcohol and stained.
Cytologic findings showed free Leishman-Donovan bodies, intrahistiocytic Leishman-Donovan bodies, atypical organisms, granuloma, acute and chronic inflammatory cells, histiocytes, multinucleated giant cells, mast cells, binucleated histiocytes (Reed-Sternberg-like cells), and plasma cells. In 6 of the patients, biopsy was inconclusive and in subsequent cytology the organism was detected. In 3 cases, findings from clinical and cytologic examinations were suggestive for leishmaniasis; however, with response to treatment, the diagnosis was confirmed. In 5 patients a malignant tumor was suspected because of clinical or histologic findings, but cytology helped to diagnose leishmaniasis. Conclusions: Clinically or histologically, ML can be mistaken for benign and malignant lesions. Scraping or exfoliative cytology is an easy, reliable, and cost-effective method for diagnosing ML. Thus, clinical, histologic, and cytologic features together may help in ML diagnosis.
Archives of pathology & laboratory medicine 04/2011; 135(4):478-82. · 2.58 Impact Factor
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ABSTRACT: Most foreign bodies pass through the gastrointestinal tract uneventful. We report of a case of inadvertently ingested foreign body, which by endoscopy simulated a polyp and on biopsy reported as cancer, so the patient underwent an unnecessary major operation. This report emphasizes the importance of resemblance of foreign bodies with gastrointestinal neoplasm, and endoscopists, surgeons and pathologists should consider this entity in their daily practice.
TheScientificWorldJOURNAL 01/2011; 11:2147-9. · 1.66 Impact Factor
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Shahrzad Negahban,
Inga Nagel,
Hossein Soleimanpour,
Azita Aledavood,
Neda Bagheri,
Mehdi Paydar, Khosrow Daneshbod,
Martin Hasselblatt,
Stefan Gesk,
Reiner Siebert,
Yahya Daneshbod
Journal of Clinical Oncology 11/2010; 28(33):e688-91. · 18.37 Impact Factor
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Shahrzad Negahban,
Nasrollah Ahmadi,
Ahmad Oryan,
Habib N Khojasteh,
Azita Aledavood,
Hossein Soleimanpour,
Mohammad Mohammadianpanah,
Ilske Oschlies,
Stefan Gesk,
Reiner Siebert, Khosrow Daneshbod,
Yahya Daneshbod
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ABSTRACT: Burkitt lymphoma (BL) is a highly aggressive neoplasm, which frequently affects the ileocecal region in the sporadic form and the jaw in the endemic form; however, the breast is a rare primary site of this tumor. Here we describe a case of primary bilateral breast BL presenting during lactation in a 23-year-old woman. Excisional biopsy of breast masses demonstrated a B-cell lymphoma with a characteristic 'starry sky' pattern highly suggestive of BL. The neoplastic cells strongly expressed CD20 and CD10, and showed proliferative activity as measured by Ki-67. An IGH-MYC gene fusion indicating the presence of a typical Burkitt translocation t(8;14)(q24;q32) in the tumor tissue was detected by fluorescent in situ hybridization. The present case, along with a comprehensive review of the literature, demonstrates that BL of the breast should be considered in the differential diagnosis of lesions of the breast during lactation. Whether hormonal or antigenic factors trigger Burkitt lymphomagenesis in the lactating breast warrants further investigation.
Molecular diagnosis & therapy 08/2010; 14(4):243-50. · 1.71 Impact Factor
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American Journal of Hematology 02/2008; 83(12):935-6. · 4.67 Impact Factor
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Diagnostic Cytopathology 10/2007; 35(9):612-4. · 1.16 Impact Factor
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ABSTRACT: Both thyroid lymphoma and anaplastic carcinoma of thyroid present with rapidly growing mass in eldery patients. Anaplastic carcinoma has high mortality rate and combination of surgery, radiation therapy and multidrug chemotherapy are the best chance for cure. Prognosis of thyroid lymphoma is excellent and chemotherapy for widespred lymphoms and radiotherapy with or without adjuvant chemotherapy for tumors localized to the gland, are the treatment of choice.
This article reports a 70 year old man presenting with diffuse neck swelling and hoarseness of few weeks duration. Fine needle aspiration was done and reported as anaplastic carcinoma of thyroid which thyroidectomy was planned. The slides were sent for second opinion. After review, with initial diagnosis of anaplastic carcinoma versus lymphoma, immunocytochemical study was performed. Smears were positive for B cell markers and negative for cytokeratin, so with the impression of diffuse large B cell lymphoma, the patient received two courses of chemotherapy by which the tumor disappeared during two weaks.
Despite previous reports, stating easy diagnosis of high-grade thyroid lymphoma on the grounds of cytomorphological features we like to emphasize, overlapping cytologic features of the curable high grade thyroid lymphoma form noncurable anaplastic thyroid carcinoma and usefulness of immunocytochemistry to differentiate these two disease.
CytoJournal 02/2006; 3:23.
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ABSTRACT: Synovial sarcoma is a rare soft tissue sarcoma in the head and neck region and parapharyngeal space. There is no previous cytologic report of synovial sarcoma of parapharynx. The cytologic and immunocytochemical findings of a parapharyngeal biphasic synovial sarcoma together with diagnostic pitfalls are described.
A 21-year-old girl presented with a 6-month history of progressive right arm pain, neck mass and upper aerodigestive tract obstruction. On physical examination there was a large painless mass arising from the right-sided parapharyngeal space causing airway obstruction. Initial magnetic resonance imaging (MRI) revealed a large tumor in the right-sided parapharyngeal space. Fine needle aspiration through cervical region was performed and was reported as benign spindle cell tumor. Smears were cellular and composed mostly of tight and loose clusters of spindle cells. Epitheloid cells could also be identified intermingled with them. She underwent near total resection of the tumor. Pathologic report disclosed the diagnosis of synovial sarcoma. She then received postoperative adjuvant external radiotherapy.
Due to rarity of this tumor in this region and nonspecific cytologic features, we could not differentiate this tumor from the other more common spindle cell neoplasms. Considering synovial sarcoma in this region and immunocytochemistry can be helpful in rendering a correct initial diagnosis of this tumor.
CytoJournal 02/2006; 3:20.
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ABSTRACT: Abstract
Background
Synovial sarcoma is a rare soft tissue sarcoma in the head and neck region and parapharyngeal space. There is no previous cytologic report of synovial sarcoma of parapharynx. The cytologic and immunocytochemical findings of a parapharyngeal biphasic synovial sarcoma together with diagnostic pitfalls are described.
Case report
A 21-year-old girl presented with a 6-month history of progressive right arm pain, neck mass and upper aerodigestive tract obstruction. On physical examination there was a large painless mass arising from the right-sided parapharyngeal space causing airway obstruction. Initial magnetic resonance imaging (MRI) revealed a large tumor in the right-sided parapharyngeal space. Fine needle aspiration through cervical region was performed and was reported as benign spindle cell tumor. Smears were cellular and composed mostly of tight and loose clusters of spindle cells. Epitheloid cells could also be identified intermingled with them. She underwent near total resection of the tumor. Pathologic report disclosed the diagnosis of synovial sarcoma. She then received postoperative adjuvant external radiotherapy.
Conclusion
Due to rarity of this tumor in this region and nonspecific cytologic features, we could not differentiate this tumor from the other more common spindle cell neoplasms. Considering synovial sarcoma in this region and immunocytochemistry can be helpful in rendering a correct initial diagnosis of this tumor.
CytoJournal. 01/2006;
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ABSTRACT: To present our experience in diagnostic errors and pitfalls on aspiration cytology of salivary region in a high volume of cases.
In a retrospective review of cytology files of a head and neck referral center from 1990 to 2005, the false positive and false negative interpretations on fine needle aspiration (FNA) of salivary lesions were retrieved. These records and slides were reviewed to identify cytologic characteristics that contributed to false diagnosis.
Of a total of 1,040 salivary FNA samples, 376 cases had a final histologic diagnosis with interpretations of benign or malignant. The sensitivity and specificity for correct interpretation of benign and malignant were 87% and 96%, respectively. The most common false negative cases were acinic cell carcinoma, epithelial myoepithelial carcinoma, adenoid cystic carcinoma and basal cell adenocarcinoma. Benign cases with false positive diagnosis were Warthin tumor and pleomorphic adenoma. Selected positive and negative discordant cases are also discussed.
Knowledge of cytologic overlaps and pitfalls on salivary gland FNA, as well as clinical and radiologic features, may help clinicians arrive at the appropriate diagnosis and reduce false interpretations. Several clinically important pitfalls with nonsalivary tumors of jaw and skin are demonstrated in our series.
Acta cytologica 53(1):53-70. · 0.49 Impact Factor
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Acta cytologica 52(3):387-9. · 0.49 Impact Factor
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Acta cytologica 52(2):268-70. · 0.49 Impact Factor
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ABSTRACT: To describe the cytologic, histologic and immunohistochemical findings of a case of epithelial myoepithelial carcinoma (EMC) arising from a pleomorphic adenoma (PA) of the parotid with both malignant epithelial and myoepithelial components.
A 29-year-old female presented with a 1.5 x 1.5-cm, palpable mass of the left parotid of 7-8 months' duration with recent enlargement and pain. Fine needle aspiration biopsy (FNAB) revealed biphasic epithelial (small cell) and myoepithelial (large/clear cell) clusters arranged in a pseudopapillary and trabecular pattern with abundant hyaline material with many naked nuclei, together with areas typical of pleomorphic adenoma (PA) was noted. The cytology was reported as salivary gland neoplasm, "suggestive of adenoid cystic carcinoma, less likely pleomorphic adenoma." The mass was excised and histologically reported as "pleomorphic adenoma, with focal invasion of one resected margin." Four months later the tumor recurred, and FNAB showed almost the same cytologic features as did the previous aspirate. Due to early recurrence, previous histologic sections were reviewed, and typical areas of a biphasic pattern of EMC with atypicality and mitosis of both components was found. The final diagnosis was EMC ex PA.
Although previous reports mention the difficulties in diagnosing EMC and differentiation from the more common salivary gland neoplasms such as PA, we like to emphasize the cytologic confusion that results when the tumors coexist.
Acta cytologica 51(5):807-13. · 0.49 Impact Factor
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ABSTRACT: To describe the cytologic findings of a case of ganglioneuroblastoma metastatic to the jaw and neck.
A 15-year-old boy with a known case of ganglioneuroblastoma of the kidney for the previous 10 years manifested by right mandibular and neck masses on 2 occasions 1 year apart was diagnosed with metastatic ganglioneuroblastoma by fine needle aspiration (FNA). FNA showed neurofibrillary material, small malignant cells, Homer-Wright rosettes. mononucleated, binucleated and multinucleated ganglion cells and Reed Sternberg-like ganglion cells. Metastatic ganglioneuroblastoma was diagnosed on both occasions, and the patient received appropriate treatment, with resolution of the lesions.
This case illustrates the FNA findings of metastatic ganglioneuroblastoma in the head and neck region.
Acta cytologica 51(3):429-33. · 0.49 Impact Factor
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The Breast Journal 13(3):310-1. · 1.64 Impact Factor
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The Breast Journal 13(2):207-8. · 1.64 Impact Factor
