Biomedical subjects
Publications and source records attributed to G Peter Sarantopoulos.
Pathologists play a central role in the management of cutaneous melanoma in determining that a tumor is a melanoma, whether or not it is primary or metastatic, and whether or not the margins of excision are tumor free and in evaluating prognostic indicators from examination of the primary tumor and, where appropriate, lymph nodes, including the sentinel nodes.
A 9-year-old girl presented with a 2-year history of pigmented streaks on her second right toenail as well as on her fourth and fifth left toenails. The patient was otherwise asymptomatic with no other physical findings. Owing to parental concern, a biopsy was performed, which revealed numerous bacteria as well as Medlar bodies overlying the nail bed with no evidence of a nevomelanocytic lesion. To our knowledge, this is the first report of Medlar bodies causing pigmented streaks in the toenails.
We report the case of an 84-year-old man with multiple squamous cell carcinomas located on his bald scalp, arising in association with underlying paraffinoma. Histologically, poorly differentiated, acantholytic squamous cell carcinomas were located above characteristic pseudocystic spaces. Carcinomas have been reported in association with penile and breast paraffinomas, but we are unaware of any reports of squamous cell carcinoma arising over a scalp paraffinoma.
CONTEXT: In 1999, the World Health Organization redefined bronchioloalveolar carcinomas (BACs) as those neoplasms with only a pure lepidic growth pattern and no invasion. OBJECTIVES: The present study examined 45 lung cancers with a BAC component (1) to determine whether these tumors would be classified as BACs by current World Health Organization standards, (2) to quantitate the BAC component within these tumors, and (3) to see if phenotypic differences exist between the so-called invasive and noninvasive regions of these tumors. DESIGN: Retrospective review of hematoxylin-eosin-stained slides and classification of histologic grade, tumor subtype, and percentage of pure BAC pattern, with further characterization by immunohistochemical staining for thyroid transcription factor 1, cytokeratin 7, cytokeratin 20, and Ki-67 antibodies. RESULTS: Only 7 (15.6%) of the 45 tumors examined could be classified as BAC by current strict World Health Organization criteria. Those tumors, classified as nonmucinous and mixed, showed similar immunohistochemical staining for cytokeratin 7, cytokeratin 20, and thyroid transcription factor 1; mucinous tumors showed disparate staining. Significant differences in immunohistochemical staining and tumor cell proliferation were seen for the regions of tumors designated as lepidic, infiltrative, and leading edge and for the regions of tumors with different histologic grades (ie, well, moderately, and poorly differentiated). CONCLUSIONS: Nonmucinous and mixed BACs are phenotypically similar and show identical immunohistochemical staining patterns; mucinous tumors, on the other hand, show disparate immunohistochemical staining. Pulmonary neoplasms designated as adenocarcinomas with a BAC component represent a heterogenous group with a range of cell types, differentiation, growth, and immunophenotypes. Within an individual neoplasm, there are regional differences in these parameters as well.
We describe a case of cutaneous leishmaniasis in a Spanish patient visiting Los Angeles. Leishmania species cause both cutaneous and visceral disease; the majority of infections with Leishmania are of the cutaneous form. Although leishmaniasis is a relatively rare occurrence in the United States, travel by United States' citizens to endemic regions and increased United States military operations in the Middle East raise the chances of encountering cutaneous leishmaniasis. The following case report and overview of the current literature outlines the major morphologic findings and current diagnostic modalities available to diagnose cutaneous leishmaniasis.