Human Polyomavirus 7 and WU Polyomavirus-Associated Lymphocytic Bronchitis/Bronchiolitis in Native and Allograft Lung Biopsies From Immunocompromised Patients: Report of 3 Cases and Review of Literature
In this report, 3 transbronchial biopsies showed viral inclusions on histologic examination and were evaluated for anti-SV40 large T antigen (SV40 T Ag) by immunohistochemistry (IHC), in situ hybridization, and viral genome sequencing by polymerase chain reaction. Patients 1 and 2 were immunosuppressed lung transplant recipients. Patient 1 presented with diffuse pruritic rash and respiratory failure, and patient 2 with PyV viremia. Patient 3 had chronic lymphocytic leukemia/small lymphocytic lymphoma and presented with cough and shortness of breath. Histologic examination of all 3 lung biopsies were similar and revealed pr...
Source: Pathology Case Reviews - November 1, 2018 Category: Pathology Tags: Call for Papers 2017 Source Type: research
Expanding the Spectrum of Ciliated Muconodular Papillary Tumor of the Lung: A Case Showing Nonpapillary and Purely Glandular Morphology
We report an unusual case of a subpleural bronchiolar/glandular proliferation in a 76-year-old Hispanic woman with microscopic features reminiscent of those of the so-called ciliated muconodular papillary tumor (CMPT). The lesion presented radiologically as a solitary subpleural nodule measuring 2.7 × 1.2 cm with low standard uptake value (SUV) of 1.4. Microscopically, it was circumscribed but unencaspulated and consisted of mucous-filled spaces lined by cytologically bland cuboidal to low columnar cells, including goblet cells and ciliated epithelium, with underlying nodular collections of basaloid cells. The lining cell...
Source: Pathology Case Reviews - November 1, 2018 Category: Pathology Tags: Case Report Source Type: research
Isolated Pulse Granuloma in a Mesenteric Lymph Node: Unusual Nodal Manifestation Associated With Crohn Disease Complicated by Ileal Adenocarcinoma
We describe a solitary pulse granuloma in a mesenteric lymph node of a 74-year-old male patient with Crohn disease, who presented with an ileal adenocarcinoma, but without demonstrable fistula or perforation. To our knowledge, this is only the second reported example of Crohn disease associated with a pulse granuloma in a mesenteric node and also only the second example of a nodal location for any documented pulse granuloma. We postulate that mesenteric lymph node pulse granuloma may represent a unique and unusual type of morphology associated with Crohn disease. (Source: Pathology Case Reviews)
Source: Pathology Case Reviews - November 1, 2018 Category: Pathology Tags: Case Reviews Source Type: research
Pancreatic-Type Mixed Acinar Neuroendocrine Carcinoma Arising in the Common Bile Duct: A Case Report
We present a case of a 70-year-old woman with constipation, abdominal discomfort, and jaundice. Imaging studies revealed a 1.8-cm solid mass in the common bile duct causing dilatation of intrahepatic and extrahepatic bile ducts, which was resected. Microscopically, the tumor was limited to the wall of the bile duct, without involvement of the pancreas, and was composed of solid sheets and nests of relatively monomorphic cells with minimal to moderate amounts of cytoplasm, granular chromatin, focally prominent nucleoli, and up to 160 mitoses per 10 high-power fields. Immunohistochemistry showed equal to or greater than 30% ...
Source: Pathology Case Reviews - November 1, 2018 Category: Pathology Tags: Case Reviews Source Type: research
Brown Bowel Syndrome Presenting as a Small Bowel Obstruction
We report a case of BBS in a patient with previously undiagnosed primary intestinal lymphangiectasia. The patient had a longstanding history of malnutrition as well as bilateral lower extremity lymphedema and chylous ascites. He presented to our hospital with small bowel obstruction (SBO). Initial magnetic resonance enterography revealed a dilated duodenum, which when biopsied revealed only lymphangiectasia and lymphedema. He was managed conservatively and discharged following resolution of the obstruction. The patient presented again 1 month later with SBO that failed to resolve with conservative treatment. Subsequent exp...
Source: Pathology Case Reviews - November 1, 2018 Category: Pathology Tags: Case Reviews Source Type: research
A Composite Lymphoma Consisting of a Mantle Cell Lymphoma and a Peripheral T-Cell Lymphoma: A Rare Case With Literature Review
A composite lymphoma (CL) is defined as 2 or more morphologically and immunophenotypically distinct lymphomas or lymphoid neoplasms that occur in the same organ or tissue. Many types of CL have been described in the literature, including 52 cases of CL with a component of mantle cell lymphoma (MCL) and only 2 cases of CL consisting of MCL and T-cell lymphoma. We hereby present a case of CL consisting of MCL and peripheral T-cell lymphoma, not otherwise specified. Morphologic features and flow cytometry analysis were both instrumental in the diagnosis of CL. In addition, we reviewed 52 reported cases of CL with MCL as a com...
Source: Pathology Case Reviews - November 1, 2018 Category: Pathology Tags: Case Source Type: research
Follicular Dendritic Cell Sarcoma With NF2 Mutation
Follicular dendritic cell sarcoma (FDCS) is recognized as a diagnostically challenging neoplasm requiring rigorous exclusion of more common entities and high index of suspicion for diagnosis. Here, we report an aggressive case of FDCS arising in the mediastinum, which due to sampling limitations and the inherent difficulty of diagnosis required extensive workup with multiple samples prior to definitive classification. The patient was a 35-year-old woman who presented with progressive dyspnea and mediastinal mass on imaging studies. The initial sampling of the lesion had histologic features raising consideration of FDCS, bu...
Source: Pathology Case Reviews - November 1, 2018 Category: Pathology Tags: Case Review Source Type: research
Whole-Slide Imaging: Thinking Twice Before Hitting the Delete Key
No abstract available (Source: Pathology Case Reviews)
Source: Pathology Case Reviews - November 1, 2018 Category: Pathology Tags: Letter to the Editor Source Type: research
Rare but important diagnostic entities: potpourri of case reports with teachable moments
No abstract available (Source: Pathology Case Reviews)
Source: Pathology Case Reviews - November 1, 2018 Category: Pathology Tags: Editorial Source Type: research
Benign Hepatic Lesions Arising in Accessory Hepatic Lobes
We report the histologic and immunohistochemical features of 3 cases of resected accessory hepatic lobes, all of which contained benign hepatic lesions (2 hepatic adenomas [HAs] and 1 focal nodular hyperplasia). All accessory lobes were connected to the liver by a pedicle. Histologically, all lesions demonstrated no cytologic or architectural atypia. Based on immunohistochemical analysis, 1 HA was classified as inflammatory type (positive for C-reactive protein and serum amyloid A), and 1 was unclassified type (negative for C-reactive protein, serum amyloid A, glutamine synthetase, and β-catenin and positive for liver fat...
Source: Pathology Case Reviews - August 29, 2018 Category: Pathology Tags: Review Source Type: research
Incidental Hepatic Granulomas in a Young Woman
Hepatic granulomas are identified in approximately 3% to 4% of liver biopsies in the Western world. Their presence raises a broad differential diagnosis for the pathologist to consider, including infectious, immune-mediated, and drug-induced etiologies. Certain histologic features of granulomas and the adjacent liver parenchyma can help narrow the differential diagnosis, although clinical and laboratory correlation is often necessary to establish a definitive diagnosis. The purpose of this article is to review the morphologic classification of hepatic granulomas and to discuss hepatic sarcoidosis, one of the most common im...
Source: Pathology Case Reviews - August 29, 2018 Category: Pathology Tags: Case Reviews Source Type: research
Budd-Chiari Syndrome: What Pathologists Need to Know About Hepatic Venous Outflow Obstruction
Hepatic venous outflow obstruction, known as Budd-Chiari syndrome, is a rare but significant cause of hepatic dysfunction. Worldwide, the most common cause of hepatic venous outflow obstruction is thrombosis of the hepatic veins and/or inferior vena cava secondary to an inherited or acquired hypercoagulable state (eg, factor V Leiden deficiency). Depending on the extent and acuity of the thrombosis, patients with Budd-Chiari syndrome may present in acute liver failure or as chronic compensated cirrhosis; almost all will have the classic (but nonspecific) pairing of abdominal pain and ascites. Histologic findings in the liv...
Source: Pathology Case Reviews - August 29, 2018 Category: Pathology Tags: Case Reviews Source Type: research
Liver Transplant in a 71-Year-Old Man With a Diagnosis of Nonalcoholic Steatohepatitis
We report a case of a 71-year-old man who underwent liver transplantation for nonalcoholic steatohepatitis. The explanted liver showed evidence of coexisting α1-antitrypsin deficiency disorder. The clinicopathologic features and epidemiology of fatty liver disease and α1-antitrypsin deficiency disorder are discussed, along with other possible coexisting disease. (Source: Pathology Case Reviews)
Source: Pathology Case Reviews - August 29, 2018 Category: Pathology Tags: Case Reviews Source Type: research
A 64-Year-Old Woman With Posttransplant Hepatitis
We report a case of a 64-year-old woman who underwent liver transplantation for chronic hepatitis C infection with cirrhosis. Several months after transplantation, she underwent a liver biopsy as part of a workup for abnormal serologic studies and transaminase elevation. The biopsy showed nonspecific hepatitis. Eventually, additional serologic testing demonstrated hepatitis E viral infection.
Causes of hepatitis and other forms of posttransplant liver disease, including hepatitis E, are discussed. (Source: Pathology Case Reviews)
Source: Pathology Case Reviews - August 29, 2018 Category: Pathology Tags: Case Reviews Source Type: research
Hyperbilirubinemia in a Hepatitis C Virus Patient After Liver Transplantation
Fibrosing cholestatic hepatitis C virus is a rare, cholestatic hepatitis that can occur in the setting of immunosuppression or after transplantation in individuals with active hepatitis C infection. Its onset is heralded by hyperbilirubinemia and rapidly progresses to graft failure without treatment. It is characterized histologically by ballooning hepatocyte degeneration, bile duct proliferation, cholestasis, and perisinusoidal fibrosis. It is important to distinguish fibrosing cholestatic hepatitis from other common causes of hyperbilirubinemia in the posttransplant setting, including biliary obstruction and acute cellul...
Source: Pathology Case Reviews - August 29, 2018 Category: Pathology Tags: Case Reviews Source Type: research
