A Rare Case of Neonatal Intrahepatic Cholestasis Caused by Citrin Deficiency in the United States
We describe the case of a 9-week-old female infant of Ashkenazi Jewish descent who presented with failure to thrive, vomiting, and persistent jaundice. Laboratory tests showed positive urine reducing substances as well as an abnormal amino acid profile, with increased arginine, threonine, methionine, tyrosine, lysine, and grossly elevated citrulline levels. Liver biopsy demonstrated the presence of cholestatic hepatitis with mixed steatosis and siderosis. Based on the aforementioned findings, a preliminary diagnosis of neonatal intrahepatic cholestasis caused by citrin deficiency was made. This diagnosis was later confirme...
Source: Pathology Case Reviews - August 29, 2018 Category: Pathology Tags: Case Reviews Source Type: research
Histopathologic Approach to Cholestatic Diseases of the Liver
Liver biopsy specimens of patients with cholestatic diseases pose a challenge to pathologists since, in most instances, this procedure is performed in a selected group of patients in whom clinical, laboratory, and imaging studies are inconclusive. Proper interpretation of the various histologic features is facilitated by the recognition of the most common patterns, which correlate with a defined group of diseases. Cholestatic disorders are grouped in 2 broad categories: acute and chronic. Four histologic patterns with different clinical implication are recognized within the first category: (1) ductular reaction, (2) pure c...
Source: Pathology Case Reviews - August 29, 2018 Category: Pathology Tags: Review Source Type: research
Topics in Medical and Transplant Liver Pathology—Editors' Remarks
No abstract available (Source: Pathology Case Reviews)
Source: Pathology Case Reviews - August 29, 2018 Category: Pathology Tags: Editorial Source Type: research
Acid-Fast Bacteria in Disguise: Mycobacterium avium Complex in Purulent Exudate; Ultrasound Correlation
In immunocompetent hosts, Mycobacterium avium complex lymphadenitis is almost exclusively a disease of children, involving cervical lymph nodes. In the setting of human immunodeficiency virus infection, it can occur as a manifestation of the immune reconstitution inflammatory syndrome. This case study reports a case of M. avium complex in the setting of immune reconstitution inflammatory syndrome, presenting as purulent lymphadenitis, correlating cytopathology and surgical pathology findings with ultrasound imaging. (Source: Pathology Case Reviews)
Source: Pathology Case Reviews - June 27, 2018 Category: Pathology Tags: Case Reports Source Type: research
Pancreatic Neuroendocrine Tumors: Update on the New World Health Organization Classification Erratum
No abstract available (Source: Pathology Case Reviews)
Source: Pathology Case Reviews - June 27, 2018 Category: Pathology Tags: Erratum Source Type: research
Lymph Node Fine-Needle Aspiration: 2 Cases Demonstrating Benefits of Ultrasound Guidance
Pathologist performed fine-needle aspiration (FNA) biopsies yield high adequacy rates, result in effective triage of material for additional studies, and offer a minimally invasive method for tissue procurement. Ultrasound-guided FNA (US-FNA) expands the scope of pathologists' FNA capabilities allowing for deeper, nonpalpable lesions to be biopsied while avoiding crucial structures and enabling targeted biopsies of sonographically concerning regions. To illustrate the utility of US-FNA in clinical practice, we present 2 cases in which diagnostic material was obtained by pathologist-performed US-FNA from neck lymph nodes de...
Source: Pathology Case Reviews - June 27, 2018 Category: Pathology Tags: Case Reports Source Type: research
The Utility of Ultrasound in the Diagnosis of “Cystic” Lesions of the Salivary Gland
Unlike in the thyroid, ultrasound (US) imaging of salivary gland lesions that show posterior enhancement or through transmission does not necessarily imply the presence of a cystic lesion. The 3 cases presented in this article illustrate the wide range of diagnoses that may have very similar findings by US imaging. Thus, emphasis is placed on the need for sampling of these lesions with careful evaluation of both US images and ideally US-guided fine-needle aspiration cytology to arrive at an accurate interpretation. (Source: Pathology Case Reviews)
Source: Pathology Case Reviews - June 27, 2018 Category: Pathology Tags: Case Reports Source Type: research
Extensive Intravascular Thyroid Vein Extension in Follicular Thyroid Carcinoma: Ultrasound Clues
The identification of intravascular tumor thrombi in thyroid at the time of fine-needle aspiration is important as it is, by definition, a diagnosis of malignancy. While ultrasound findings of tumor thrombi in the great veins of the neck have been well described, thrombi in the thyroid veins can be very difficult to detect and have been seldom reported. This case study, with extensive thyroid vein tumor involvement, provides clues for raising the possibility of a malignant process at the time of ultrasound-guided FNA, by correlating the pathology findings with the ultrasound images. (Source: Pathology Case Reviews)
Source: Pathology Case Reviews - June 27, 2018 Category: Pathology Tags: Case Reports Source Type: research
Sonographic Breast Mimickers: Examples of Cases Outside the Box
Ultrasound in breast imaging has enhanced the field of radiology by using this distinct modality to evaluate breast lesions using unique features that are not available by traditional mammography. These features that are used can help characterize lesions in the breast into benign, suspicious, or malignant entities. However, not all lesions of the breast fall into these set categories, and sampling of the masses may be necessary to avoid pitfalls. In this article, we list the criteria that are classically used to favor benign versus malignant lesions and then have 2 examples that fall outside of the box and needed sampling...
Source: Pathology Case Reviews - June 27, 2018 Category: Pathology Tags: Case Reports Source Type: research
Creating Custom Phantoms for Ultrasound-Guided Fine-Needle Aspiration Biopsy Training
Ultrasound-guided fine-needle aspiration (US-FNA) is superior to conventional fine-needle aspiration biopsies and when performed by cytopathologists yields higher diagnostic rates than when performed by nonpathologists. Ultrasound-guided fine-needle aspiration allows operators to perform targeted biopsies while avoiding critical nearby structures, decreasing the risk of procedural complications. Traditionally, cytopathology training programs have purchased costly commercial phantom models on which to train residents and fellows and provide opportunities for cytopathologists to practice their US-FNA technique. While phantom...
Source: Pathology Case Reviews - June 27, 2018 Category: Pathology Tags: Reviews Source Type: research
Ultrasound-Guided Fine-Needle Aspiration Biopsy of Salivary Glands: A Practical Review
We present a practical guide for using ultrasound evaluation in the biopsy of the salivary glands for the practicing cytopathologist including common pitfalls, common lesional characteristics, and relevant lymph node morphological findings. (Source: Pathology Case Reviews)
Source: Pathology Case Reviews - June 27, 2018 Category: Pathology Tags: Reviews Source Type: research
Ultrasound-Guided Fine-Needle Aspiration of Thyroid Nodules: Pearls and Potential
Thyroid nodules are a commonplace clinical problem. Ultrasound-guided fine-needle aspiration biopsy is often the first step in the diagnosis and management of these nodules. We provide a review of technical considerations, performance, and techniques for thyroid nodule ultrasound-guided biopsy. (Source: Pathology Case Reviews)
Source: Pathology Case Reviews - June 27, 2018 Category: Pathology Tags: Reviews Source Type: research
Ultrasound-Guided Fine-Needle Aspiration Practice Patterns
In conclusion, a variety of methods, all targeted to optimizing patient care and rapid diagnosis, work well and are generally well received by the physicians who refer their patients for care. (Source: Pathology Case Reviews)
Source: Pathology Case Reviews - June 27, 2018 Category: Pathology Tags: Reviews Source Type: research
Cytopathologists and Ultrasound-Guided Fine-Needle Aspiration: Embracing the Black and White
No abstract available (Source: Pathology Case Reviews)
Source: Pathology Case Reviews - June 27, 2018 Category: Pathology Tags: Editorial Source Type: research
Pure Red Cell Aplasia Due to T-Cell Large Granular Lymphocytic Leukemia After Hematopoietic Stem Cell Transplantation
Although reactive polytypic large granular lymphocyte (LGL) expansions after hematopoietic stem cell transplant (HSCT) due to viral infection are common, T-cell large granular lymphocytic leukemia (T-LGLL) is extremely rare and usually clinically indolent and requires no treatment in the post-HSCT setting. In contrast, here we present a case of post-HSCT donor-derived T-LGLL that led to pure red cell aplasia with severe patient morbidity. After diagnosis, the patient received immunosuppressive treatment with a dramatic response and has been transfusion independent for more than a year. To our knowledge, this is the first c...
Source: Pathology Case Reviews - April 28, 2018 Category: Pathology Tags: Case Reports Source Type: research
