North American Journal of Medicine and Science
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Histopathological Features of Aneurysmal Bone Cyst of the Temporal Bone – A Case Report and Review of Literature
Get PDFAneurysmal bone cyst (ABC) is a rare lesion. We described an ABC of the temporal bone. The patient was a 46-year-old woman presenting with a progressively enlarging mass in the left temporal region with unknown duration. A CT revealed a 3 x 3.5 cm osteolytic lesion involving the left temporal bone. MRI revealed a 3.6 x 2.6 x 2.7 cm well-defined expansile lesion centered in the left temporal bone. The patient subsequently underwent MRI-guided stereotactic left frontotemporoparietal craniectomy and the lesion was completely removed. Following surgery, the patient has been followed for the past 9 months without evidence of residual/recurrent disease. Morphologically, the lesion consisted of cystic and solid areas. The cystic areas demonstrate multi-cystic architecture between bony trabeculae separated by thick septa. These septa contained abundant fibroblasts, spindle-shaped stromal cells, and giant cells with scattered hemosiderin laden macrophages. The solid areas consisted of spindle-shaped stromal cells with oval nuclei, proliferating blood vessels, mononuclear cells and some interspersed multinucleated giant cells
Dietary Fiber Intake and Mortality from All Causes, Cardiovascular Disease, Cancer, Infectious Diseases and Others: A Meta-Analysis of 42 Prospective Cohort Studies with 1,752,848 Participants
Get PDFResults from observational studies on dietary fiber intake on total mortality and cause-specific mortality are inconsistent. The objective of the present meta-analysis was to investigate dietary fiber intake and mortality, and cause-specific mortality. Medline, EMBASE and web of science database was searched for cohort studies published from inception to February 2013. Studies were included if they provided a hazard ratio (HR) and corresponding 95% CI for mortality in relation to fiber consumption. A database was developed on the basis of 25 eligible studies and 42 cohorts, including 1,752,848 individuals with an average 12.4 years of follow-up. Compared with those who consumed lowest fiber, for individuals who ate highest fiber, mortality rate was lower by 23% (HR, 0.77; 95% CI, 0.72-0.81) for cardiovascular diseases (CVD), by 23% (HR, 0.77; 95% CI, 0.73-0.81) for all-cause mortality, by 17% (HR, 0.83; 95% CI, 0.74- 0.91) for cancer, by 68% for digestive diseases, by 58 % for infectious diseases, 43 % for inflammatory diseases. For each 10 g/d increase in fiber intake, the pooled HR was estimated to be 0.89 (95% CI, 0.86-0.93) for all-cause mortality, 0.91 (95% CI, 0.88-0.94) for cancer, 0.80 (95% CI, 0.72-0.88) for coronary heart disease (CHD) mortality, and 0.66 (95% CI, 0.40-0.92) for ischemic heart disease (IHD) mortality. Dietary fiber and CVD mortality showed a strong dose-response relation. For each 10 g/d increase in fiber intake, the pooled HR of CVD mortality was estimated to be 0.83 (95% CI, 0.80-0.87; P for trend=0.001). In conclusion, our meta-analysis results clearly show that high dietary fiber intake is associated with low all-cause mortality and mortality due to CVD, CHD, cancer, digestive disease, infectious diseases, and other inflammatory diseases
Intralymphatic Histiocytosis and Hypertrichosis Occurring Over the Site of a Titanium Hip Implant in a Patch Test Negative Patient
Get PDFIntralymphatic histiocytosis typically presents as erythematous indurated plaques on the limbs of older individuals. Some affected individuals have underlying rheumatoid arthritis. When intralymphatic histiocytosis is associated with joint replacement surgery, plaques commonly occur near the skin incision. Biopsy reveals dilated lymphatics filled with large numbers of histiocytes. Although the etiology of this peculiar phenomenon is unknown, numerous cases have been associated with metal implants. We report an additional patient with intravascular histiocytosis associated with a metal hip implant. Patch testing to a special metal series which included the component of the implant was negative. Our patient also developed hypertrichosis with silvery hairs overlying her plaque. We review the literature on intralymphatic histiocytosis associated with metal implants, present the diagnostic histologic findings, and explore possible etiologies for this uncommon reactive phenomenon
Recent Advances in Cervical Cancer Screening
Get PDFCenters for Disease Control and Prevention (CDC) estimates that about 11,967 new cases of HPV-associated cervical cancer are diagnosed in the United States each year. More black and Hispanic women get cervical cancer than women of other races or ethnicities, possibly because of decreased access to Pap testing or follow-up treatment. Based on solid evidence, cervical cancer screening and protection against HPV infection by vaccination against HPV types 16/18, use of barrier contraceptives, and sexual abstinence decreases cervical cancer incidence. Also avoidance of active and passive cigarette smoking, high parity, and long term use of contraceptives decreases the risk of cervical cancer. In this article, we aim to review the preventative and screening methods for cervical cancer. Discussion of the latest Cervical Cancer Screening Guidelines chart given by CDC that compares recommendations from the American Cancer Society, Preventive Services Task Force, and the American College of Obstetricians and Gynecologists is done.With the FDA approval of the first HPV test for primary cervical cancer screening on April 25th, 2014, clinicians now have 3 different first line screening options, the Pap test, co-testing with Pap and HPV tests, and HPV testing as a stand-alone test. Specifically, the Roche Cobas® HPV Test was approved for primary screening for cervical cancer as a stand-alone test.Clinical trials that evaluate cancer-screening methods are taking place in many parts of the country. Ongoing trials on the development of Human Papillomavirus Type 16 E7- specific Human Immunologic Assays in Non-HLA2 Type Human Being, Molecular markers in Cervical Cancer Screening, and multispectral digital colposcopy are going on. These improvements in screening strategies along with therapeutic and preventive methods contribute significantly to the control and prevention of cervical cancer
Takotsubo Cardiomyopathy in a Patient with Chronic Inflammatory Demyelinating Polyneuropathy
Get PDFTakotsubo cardiomyopathy is an acute non-ischemic cardiomyopathy and may be triggered by physical, emotional stress or following excessive catecholamines in the body. It has been associated with many neurologic conditions. We report a patient with chronic inflammatory demyelinating polyneuropathy (CIDP) who developed acute transient cardiomyopathy after an episode of hypoxia. To our knowledge, this is the first reported case of takotsubo cardiomyopathy associated with CIDP
Developing an Optimal Biofunctional Scaffold for Hematopoietic Stem Cell Quiescent Maintenance and Expansion
Get PDFHematopoietic stem cells (HSCs), characterized by their CD34 glycoprotein expression, can be extensively exploited in a variety of clinical applications to treat bone-marrow related disorders and cancers, which affect hundreds of thousands worldwide. HSCs are known to efficiently self-renew and maintain their quiescent state in their in vivo microenvironment, but rapidly lose their multipotency in vitro due to quick onsets of differentiation. Shortages of available donor cells have led to scientific interest in developing biofunctional scaffolds – such as cross-linked polymer hydrogels – that mimic the natural stem cell niche. Here we show that a firm, gelatin-based hydrogel cross-linked by microbial transglutaminase (mTG) (in a ratio of 1:25 mTG to gelatin) is ideal for quiescent self-renewal, and that the purine derivative, Stemregenin 1 (SR1), aids in directing cell migration, proliferation, and stemness. The 1:25 ratio with exposure to SR1 yielded a promisingly high stemness level of 94.53%. Our results demonstrate the previously undocumented effectiveness of gelatin hydrogels as biomimetic scaffolds suitable for HSC expansion. Furthermore, our findings and the culture system we have developed are expected to facilitate bone marrow disease treatment by providing large quantities of quiescent HSCs for medical applications and potentially diminishing the high demand for marrow donors.
Immunophenotypic Pattern of Eosinophilia by Flow Cytometry
No full textEosinophilia is commonly seen in variety of conditions, including infections, hypersensitivities, autoimmune disorders, idiopathic hypereosinophilic syndrome and certain neoplasms. In the latter, eosinophilia may present as a secondary (benign) component (Hodgkin lymphoma, T-cell lymphoma, acute leukemia or systemic mastocytosis) or as myeloproliferative neoplasm (MPN) characterized by clonal eosinophilic expansion. MPN with eosinophilia includes chronic eosinophilic leukemia (CEL) and MPN with rearrangement of PDGFRA, PDGFRB or FGFR1. Identification of eosinophilia by flow cytometry (FC) may be difficult due to (1) lack of eosinophil-specific immunophenotypic markers, (2) overlap of phenotypic features of eosinophils with other populations and (3) low forward scatter leading to confusion with cellular debris. Based on immunophenotypic analysis of 15 cases, here we present the FC pattern of eosinophilia easily recognizable by routine flow cytometric analysis in a clinical laboratory. Identification of eosinophilia by FC with follow-up reflex cytogenetic/FISH and/or PCR testing may be helpful to differentiate between reactive conditions and malignant eosinophilic disorders when clinically indicated.
A Review of Cytology of Salivary Gland Lesions: Old, Updated and New
Get PDFFine needle aspiration (FNA) biopsy plays a critical role in the diagnosis of salivary gland lesion. Compared to excisional biopsy, FNA is safer, faster and less tumor seeding spread. The sensitivity and specificity of FNA for diagnosing neoplasm is very high. In this review, we will discuss the cytological findings of a wide spectrum of non-neoplastic and neoplastic diseases in salivary glands. We will further discuss the differentiation diagnosis for each entity. The new molecular findings in salivary gland tumors will be addressed.
Clear Cell (Tubulo) Papillary Renal Cell Carcinoma: A Case Report and Literature Review of a Recently Recognized New Entity
Get PDFClear cell (tubulo) papillary renal cell carcinoma (CCPRCC) is a newly established entity in renal tumor classification. Here we report a case of CCPRCC in a 61 year old male with long history of hypertension, chronic renal failure, and one year history of dialysis. Grossly the tumor is multicystic. Microscopically, bland appearing tubules and occasional small papillae with low grade nuclei are noted. The characteristic linear arrangement of nuclei deviating from basal aspect of the lumens is prominent. Immunohistochemically, the tumor cells are positive for CK7, high-molecular weight cytokeratin (HMWK), CA-IX (cup-shape pattern), and negative for AMACR and CD10. The histology and immunophenotype all qualify this tumor as CCPRCC. The diagnostic criteria and the related differential diagnoses are also discussed.
Cavernous Hemangioma of the Uvula: Report a Rare Case with Literature Review
Get PDFHemangiomas of the oral cavity are relatively rare with a prevalence rate of less than 1%, mostly involving lips, tongue, buccal mucosa, and palate. Cavernous hemangioma is a subtype of hemangioma. The involvement of uvula by a cavernous hemangioma is extremely rare. To date, only 4 cases have been reported in the English literature. Here we report one such case with analysis of its histologic and immunohistochemical features. The patient is a 58-year-old white male with a mass on the left side of his uvula. Because a simple excision of this lesion would have rendered the inferior portion of the uvula pedunculated, possibly causing a globus sensation, a partial uvulectomy was done to maintain the integrity of the remaining uvular structure. Grossly, the lesion was a tan-pink polypoid mass partially covered by squamous mucosa, measuring 0.8 x 0.5 x 0.3 cm. Microscopic examination revealed poorly circumscribed large cavernous spaces lined by flattened endothelium, separated by scant connective tissue, morphologically consistent with cavernous hemangioma. Immunohistochemical study showed that CD34 stain highlighted the endothelial cells, supporting this diagnosis. By reporting this case with rare erratic location of cavernous hemangioma, we like to raise the awareness that cavernous hemangioma is also in the differential diagnosis when a patient presents with an elongated uvula or uvular mass