Unusual Histopathological Findings Research Articles

Aquagenic syringeal acrokeratoderma: unusual prominence on the dorsal aspect of fingers?

Conflicts of interest: none declared. Sir, Aquagenic syringeal acrokeratoderma (ASA) is a rare acquired palmoplantar keratoderma, which manifests after brief exposure to water. Since its first description by English and McCollough1 as transient reactive papulotranslucent acrokeratoderma, this disorder has been reported under many different names, including aquagenic palmoplantar keratoderma,2 aquagenic wrinkling of the palms3, 4 and acquired aquagenic papulotranslucent acrokeratoderma.5 MacCormack et al.6 coined the term ‘aquagenic syringeal acrokeratoderma’ based upon dramatic accentuation after exposure to water, the keratoderma in acral sites, and the dilated sweat ducts. To our knowledge, all previously described cases in the English language literature involved the palms and sometimes soles. We report the first case involving the dorsum of the fingers and show unusual histopathological findings of proliferation and degeneration of the eccrine gland epithelial cells. A 14‐year‐old boy presented with a 5‐year history of asymptomatic, symmetrical, whitish dorsal finger lesions developing immediately after exposure to water. The lesions arose within a minute of immersion in water and resolved within 30 min after drying his hands. Neither his feet nor any other parts of the body were affected. The patient was otherwise healthy, and was not taking any medications. He denied any personal history of hyperhidrosis, atopic diathesis, or any trauma to his hands. No other family members were similarly affected.

Orbital Conjunctival Dermoid Cyst With Oncocytic Differentiation

A dermoid cyst of conjunctival origin ("conjunctivoid") is a rare variant that has conjunctival nonkeratinizing squamous epithelium and goblet cells, instead of keratinizing squamous epithelium of epidermal origin with epidermal appendages. We report a case of a 65-year-old man with a chronic orbital mass, a conjunctival dermoid that was found to have the unusual histopathologic finding of oncocytic differentiation. This is an infrequent benign chronic change in glandular cells characterized by the accumulation of vast numbers of intracellular mitochondria. Occasionally, oncocytic cellular change occurs in malignant tumors, and so complete excision of such lesions is recommended.

First finding of libyostrongylosis in farm-reared ostriches ( Struthio camelus) in Croatia: Unusual histopathological finding in the brain of two ostriches, naturally infected with Libyostrongylus douglasi

In the present work, the very first finding of Libyostrongylus douglasi in farm-reared ostriches in Croatia, was described, not only as the main cause of the death, but also as the cause of persistent infection. The results of histopathological examination of almost all parenchymatous organs in two routinely necropsied ostriches were presented, including atypical histopathological finding in the brain and the result of the L. douglasi scanning electron microscopical (SEM) examination. In order to determine the parasite species to which the larval form found in the brain belonged, polymerase chain reaction (PCR) was performed. Total DNA was isolated from fresh L. douglasi, and from archival formalin-fixed and paraffin-embedded brain section. Additionally, the smears of the proventricular mucosal lining were cytologically examined. Virological examination for newcastle disease virus (NDV) was also performed. As there was very limited information concerned ostrich's health status in Croatian farms, a preliminary evaluation of the parasite infestation level in the Croatian ostrich population over the period 2001–2002 was also done, and an attempt at characterising individual parasite species, was made.

An unusual pathologic feature associated with dermatomyositis

We present a case of juvenile dermatomyositis with unusual histopathologic findings. The child presented with a course consistent with dermatomyositis, a diagnosis confirmed by finding reticulotubular aggregates in endothelial cells on electron microscopy. However, histopathology of his muscle biopsy revealed a striking pattern of glycogen accumulation, to an extent similar to that seen in glycogen storage diseases; this degree of accumulation could potentially confound histopathologic diagnosis.

Two Cases of Melasma with Unusual Histopathologic Findings

We reported two cases of clinically typical melasma presenting with unusual histopathologic findings. In one case, the epidermal melanocytes were markedly increased in number and protruded into the dermis, and in the other case, increased epidermal pigmentation as well as dermal melanocytosis were found. We suggested that the various treatment modalities of melasma should be applied depend on its histopathologic finding.

Vitiligo-like lesions of mycosis fungoides coexisting with large plaque parapsoriasis: An association or a spectrum?

Mycosis fungoides is the commonest type of primary cutaneous T cell lymphoma. Hypopigmented mycosis fungoides is an uncommon variant usually observed in dark-skinned individuals, especially children. Large plaque parapsoriasis, a disease of the middle-aged, and with no racial and geographical predilection, can be regarded as the clinically benign end of the mycosis fungoides disease spectrum. Case of a 24-year-old male, with asymptomatic hypopigmented lesions with characteristics of large plaque parapsoriasis, and vitiligo-like skin lesions with characteristics of mycosis fungoides developing over pre-existing hypopigmented lesions, with no systemic features, is presented for its unusual clinical features and conspicuous histopathological findings.

Zimmermann-Laband Syndrome in an Infant with an Atypical Histologic Finding

Zimmermann-Laband syndrome is an inherited disorder that is characterized by abnormalities of the head, face, hands, and feet. Most children with this disorder have generalized hypertrichosis, large gingivae, and hypoplasia of the fingernails and toenails. We report a male infant who exhibited typical features of Zimmermann-Laband syndrome with an unusual histopathologic finding. Excised tissue from the infant's gingivae showed papillary projections that were composed of hyperplastic stratified squamous epithelium with different amounts of keratinization.

Keloidal granuloma faciale with extrafacial lesions

Granuloma faciale (GF) is a rare cutaneous disorder characterized by one to several soft, erythematous to livid papules, plaques or nodules, usually occurring on the face. Extrafacial lesions are uncommon. A 52-year-old lady with multiple asymptomatic, variously sized brownish-black colored, firm, sharply circumscribed plaques resembling keloids on both cheeks and extrafacial lesions on the right arm and the right breast is presented for its unusual keloidal appearance and typical histopathological findings. She failed to respond to oral dapsone 100 mg daily administered for 3 months. Local infiltration of triamcinolone combined with cryotherapy led to only partial flattening of the lesions. All the skin lesions were excised surgically followed by flap transfer grafting on both cheeks. The cosmetic outcome was highly satisfactory.

Chronic-resorptive Hypophysitis – Inflammatory pseudotumor of the sella turcica? – A case report

A 30 years old female patient (weight 68kg, height 160cm) noticed intermittent visual symptoms without a measurable decline of her visual accuracy. Retrospectively she had a primary oligomenorrhea, soon followed by primary amenorrhea, but no galactorrhea. She additionally suffered from headaches for about two years. Since her birth she is known to have seizures and a mild ataxia, without a structural intracranial or spinal source so far. The latest MRI was done over ten years ago. The most recent MRI revealed an intra- and suprasellär, slightly hyperintense mass in the sella turcica. Endocrinological tests revealed a mild hyperprolactinemia, an hypogonadism and a low growth hormone during hypoglycaemia. Besides a daily fluid intake of 3500ml, a diabetes insipidus was ruled out by normal response of urine and blood osmolality during thirsting. Intraoperatively the normal pituitary gland seemed to be compressed by a very solid and dura-adherent, whitish mass without any evidence of a pituitary adenoma. In the early postoperative course hypogonadism clinically improved.Histopathologically we found a chronic-inflammatory process consisting mainly of mature B-lymphocytes, CD68-positive macrophages and histiocytes infiltrating the surrounding dura mater. There was no evidence of a pituitary adenoma or other tumor cells, especially no signs of a craniopharyngeoma or a xanthogranuloma. Histiocytosis was ruled out by negative staining for S-100 and CD1a. All in all the mass lesion immunohistopathologically had to be classified as a chronic-resorptive Hypophysitis, with structural similarities to an inflammatory pseudotumor of the sella turcica.This case demonstrates either unusual histopathological findings of an intra- and suprasellar mass as well as to some extent unusual clinical features of a resorptive hypophysitis with a long clinical course of endocrinological deficits not involving the posterior lobe of the pituitary gland and the new onset of severe headaches and intermittent visual symptoms.

Aggressive Osteoblastoma of the Mandible Closely Simulating Calcifying Epithelial Odontogenic TumorReport of Two Cases with Unusual Histopathologic Findings

Aggressive Osteoblastoma of the Mandible Closely Simulating Calcifying Epithelial Odontogenic TumorReport of Two Cases with Unusual Histopathologic Findings

Granulomatous pyoderma gangrenosum: two unusual cases showing necrotizing granulomatous inflammation.

We present two cases of pyoderma gangrenosum (PG) with unusual histopathological findings. The main histopathological feature of PG is usually massive neutrophilic infiltration; the neutrophil is thus the cytologic hallmark of PG. The occurrence of vasculitis is controversial. In our patients, in contrast, biopsy specimens revealed extensive granulomatous inflammation with massive tissue necrosis throughout the entire dermis and subcutaneous tissue and vascular involvement simulating many other granulomatous diseases. However, there was no evidence of systemic disease. Our cases may therefore represent a histopathologically distinct subset of PG.

Unusual Endometrial Stromal Cell Changes Mimicking Metastatic Carcinoma

We report an unusual histopathologic finding in the endometrium from six premenopausal or perimenopausal patients who underwent biopsy for abnormal uterine bleeding. In each case the endometrial stromal cells focally exhibited a pronounced epithelioid appearance; some showed a cord-like trabecular pattern and others a signet-ring-like cell change. All raised the possibility of a metastatic malignancy, particularly from the breast. The epithelioid appearance of the stromal cells appears to be an unusual artifact occurring in a background of secretory change and predecidualization with nonmenstrual breakdown.

Dermatomyositis treated with high-dose intravenous immunoglobulins and associated with panniculitis

Polymyositis and dermatomyositis are idiopathic inflammatory myopathies characterized by subacute symmetrical weakness of proximal limb and trunk muscles. Dermatomyositis is distinguished from polymyositis by the presence of rash. We describe an adult patient with treatment-resistant childhood-type dermatomyositis who made a good response to high dose intravenous immunoglobulins. Additionally, there was evidence of panniculitis which is an unusual histopathological finding in dermatomyositis.

A Case of Malignant Melanoma of Soft Parts with Unusual Histopathologic Findings

A Case of Malignant Melanoma of Soft Parts with Unusual Histopathologic Findings

Exostosis of the external auditory canal: an interesting histopathological finding

Perforation of the tympanic membrane is a frequent complication of surgery for exostoses of the external auditory canal. We report an unusual histopathological finding in a temporal bone containing external canal exostoses which suggests that some of these perforations may be unavoidable.

Acquired immunodeficiency syndrome may present as severe restrictive lung disease

A majority of patients with the acquired immunodeficiency syndrome (AIDS) will develop pulmonary disease at some point during their clinical course. Most patients with AIDS-related pulmonary disease present with the subacute onset of fever, cough, and dyspnea often in the context of other clinical findings that suggest infection with human immunodeficiency virus (HIV) [l]. Clinicians must be alert to uncommon presentations of AIDS that may occur, particularly in patients who do not have apparent risk factors for infection with HIV. In the current report, we describe an atypical pulmonary presentation of AIDS that was associated with unusual histopathologic findings of Pneumocystis carinii pneumonia.

Granuloma Annulare-Like Pattern in Mycosis Fungoides

Examination of a biopsy specimen revealed an unusual histopathologic finding in the course of mycosis fungoides. A 59-year-old patient had a progression of mycosis fungoides from the plaque stage in 1965 to the tumor stage in 1968. Between these dates, he had temporary remissions following courses of whole body electron beam therapy and superficial x-ray. In 1968 examination of the biopsy specimen revealed a polymorphous inflammatory cell infiltrate. In 1970 after the patient had received additional superficial x-ray treatments and a course of methotrexate, examination of biopsy specimens from tumor nodules showed an interesting histopathologic alteration: a pattern resembling granuloma annulare.

Mycelial forms of Coccidioides immitis in sputum and tissues of the human host.

Excerpt For half a century it has been known thatCoccidioides immitisordinarily exists in two distinct phases, the saprophytic and the parasitic, the former occurring in external nature and culture...