T-cell prolymphocytic leukemia (T-PLL) is a very unusual form of chronic lymphoproliferative diso... more T-cell prolymphocytic leukemia (T-PLL) is a very unusual form of chronic lymphoproliferative disorder, which has rarely been diagnosed by fine needle aspiration (FNA) cytology. We report one such case with some overlapping cytomorphological features with chronic lymphocytic leukemia and acute lymphoblastic leukemia. A 91-year-old man presented with generalized lymphadenopathy, pleural effusion, ascites, and an ulcerated growth in rectum. FNA smears from the left cervical lymph node showed a monotonous population of small lymphoid cells having small but distinct nucleoli that was initially diagnosed as chronic lymphocytic leukemia (CLL). Smears from the left axillary lymph node contained both small and medium-sized lymphoid cells with frequent hand-mirror cell appearance, which has been described in acute lymphoblatic leukemia (ALL). Immunocyto/histochemical stainings on smears and cell block preparations of the aspirate showed the following immunophenotype: CD3+, CD4+, CD5+, CD7+, CD8-, CD20-, CD23-, and Tdt-. Total peripheral blood leukocyte count was 26.4 3 10 9 /L and total lymphocyte count, 8.3 3 10 9 /L with predominance of small lymphocytes. T-cell nature of the neoplasm was confirmed by biopsies from the cervical lymph node (T-cell lymphoma), bone marrow (T-cell lymphoid neoplasm/chronic lymphocytic leukemia), and the ulcerated rectal lesion (atypical T-cell lymphoproliferative disorder). The patient developed deep vein thrombosis, heparin-induced thrombocytopenia and bleeding from duodenal ulcer. By the time the reports of all the investigations were ready, the patient succumbed to bronchopneumonia. To the best of our knowledge, this T-CLL/ T-PLL which was diagnosed initially by FNA cytology with immunocytochemical support is first of its kind to be reported. Diagn. Cytopathol. 2011;00:000-000.
T‐cell prolymphocytic leukemia (T‐PLL) is a very unusual form of chronic lymphoproliferative diso... more T‐cell prolymphocytic leukemia (T‐PLL) is a very unusual form of chronic lymphoproliferative disorder, which has rarely been diagnosed by fine needle aspiration (FNA) cytology. We report one such case with some overlapping cytomorphological features with chronic lymphocytic leukemia and acute lymphoblastic leukemia. A 91‐year‐old man presented with generalized lymphadenopathy, pleural effusion, ascites, and an ulcerated growth in rectum. FNA smears from the left cervical lymph node showed a monotonous population of small lymphoid cells having small but distinct nucleoli that was initially diagnosed as chronic lymphocytic leukemia (CLL). Smears from the left axillary lymph node contained both small and medium‐sized lymphoid cells with frequent hand‐mirror cell appearance, which has been described in acute lymphoblatic leukemia (ALL). Immunocyto/histochemical stainings on smears and cell block preparations of the aspirate showed the following immunophenotype: CD3+, CD4+, CD5+, CD7+, C...
Primary thymic carcinoma-mucoepidermoid cell (MEC) type is rare and only one report describing th... more Primary thymic carcinoma-mucoepidermoid cell (MEC) type is rare and only one report describing the cytologic features of this neoplasm in the metastatic site is described. We describe the cytological features of poorly differentiated carcinoma possibly MEC in a 54-year-old man who presented with cough, weight loss, and puffiness of face for 3 months. The significance of this infrequently encountered neoplasm lies in its potential confusion of origin of the tumor-thymus or metastases from a primary bronchial MEC. Immunocytochemical profile was suggestive of a thymic carcinoma of the MEC type.
An 11-year-old Egyptian boy presented with mild pain in his eft lower jaw accompanied by swelling... more An 11-year-old Egyptian boy presented with mild pain in his eft lower jaw accompanied by swelling. Clinical examination howed a hard, tender mandibular enlargement extending rom the chin to the left molar area. The orthopantomogram OPG) showed poorly defined multilocular radiolucency inolving the mandibular body from the right lateral incisor to he left first molar (Fig 1A). There were discrete signs of esorption of root apices of the adjacent teeth. Computed omography examination disclosed a large expansive osteoytic lesion with a soap bubble appearance and erosion of both estibular and lingual mandibular cortices (Fig 1B). Incisional biopsy was performed under local anesthesia. ections contained spindle cells within fibrous stroma and rregularly distributed multinucleated giant cells clustering round areas of hemorrhage. Periphery of the lesion howed reactive osteoid tissue formation (Fig 1C). The overall clinical, radiologic, and histopathologic picture as consistent with central giant cell granuloma. Laboratory nvestigations including complete blood count, alkaline phoshatase, calcium, and parathormone levels were within noral limits, while phosphorus level was slightly elevated.
Microscopic colitis (MC) is a recognized cause of chronic watery diarrhea. It is characterized by... more Microscopic colitis (MC) is a recognized cause of chronic watery diarrhea. It is characterized by subepithelial collagen deposition or intraepithelial lymphocytic infiltration of the colonic mucosa which, however, appears grossly normal on endoscopy. The term microscopic enterocolitis is applied when MC is associated with similar microscopic affection of the ileum and/or proximal small intestine. MC is reported to be associated with a variety of autoimmune conditions. Systemic lupus erythematosus (SLE) is rarely reported in association with MC. We report a female patient with microscopic enterocolitis as one of the presenting manifestations of SLE.
International Journal of Surgery Case Reports, 2016
BACKGROUND: Appendicular schistosomiasis is an unusual etiology of acute appendicitis, which has ... more BACKGROUND: Appendicular schistosomiasis is an unusual etiology of acute appendicitis, which has been reported in countries endemic in schistosomiasis, such as sub-saharan Africa and South America. Nowadays, due to globalization, this disease has been diagnosed in non-endemic countries. Kuwait is a country possessing a larger percentage of foreigners than national citizens. Therefore, several cases of schistosomal appendicitis were found. METHOD: The clinicopathological records of all patients that underwent appendectomy during January 2007 and December 2011 were recorded from the archives of Al-Adan Hospital in Kuwait. All cases of schistosomal appendicitis were retrieved and the histopathologic slides reconfirmed by the histopathologist. RESULTS: During the 5-year study period, 3012 appendectomies were performed and 8 schistosomal appendicitis were found. They were all Egyptian males that were admitted for a clinical suspicion of acute appendicitis. The age ranged between 24 and 42 years, with a mean age of 32.75 years. All cases showed histological features of acute or acute suppurative inflammation, with ova seen in the vasculature of all layers of appendicular wall. CONCLUSION: Although schistosomiasis is a rare causative agent of acute appendicitis, this however can't be confirmed until histological evaluation. Therefore, adequate follow up postoperatively is necessary to insure eradication of the disease and to prevent further serious consequences.
T-cell prolymphocytic leukemia (T-PLL) is a very unusual form of chronic lymphoproliferative diso... more T-cell prolymphocytic leukemia (T-PLL) is a very unusual form of chronic lymphoproliferative disorder, which has rarely been diagnosed by fine needle aspiration (FNA) cytology. We report one such case with some overlapping cytomorphological features with chronic lymphocytic leukemia and acute lymphoblastic leukemia. A 91-year-old man presented with generalized lymphadenopathy, pleural effusion, ascites, and an ulcerated growth in rectum. FNA smears from the left cervical lymph node showed a monotonous population of small lymphoid cells having small but distinct nucleoli that was initially diagnosed as chronic lymphocytic leukemia (CLL). Smears from the left axillary lymph node contained both small and medium-sized lymphoid cells with frequent hand-mirror cell appearance, which has been described in acute lymphoblatic leukemia (ALL). Immunocyto/histochemical stainings on smears and cell block preparations of the aspirate showed the following immunophenotype: CD3+, CD4+, CD5+, CD7+, CD8-, CD20-, CD23-, and Tdt-. Total peripheral blood leukocyte count was 26.4 3 10 9 /L and total lymphocyte count, 8.3 3 10 9 /L with predominance of small lymphocytes. T-cell nature of the neoplasm was confirmed by biopsies from the cervical lymph node (T-cell lymphoma), bone marrow (T-cell lymphoid neoplasm/chronic lymphocytic leukemia), and the ulcerated rectal lesion (atypical T-cell lymphoproliferative disorder). The patient developed deep vein thrombosis, heparin-induced thrombocytopenia and bleeding from duodenal ulcer. By the time the reports of all the investigations were ready, the patient succumbed to bronchopneumonia. To the best of our knowledge, this T-CLL/ T-PLL which was diagnosed initially by FNA cytology with immunocytochemical support is first of its kind to be reported. Diagn. Cytopathol. 2011;00:000-000.
T‐cell prolymphocytic leukemia (T‐PLL) is a very unusual form of chronic lymphoproliferative diso... more T‐cell prolymphocytic leukemia (T‐PLL) is a very unusual form of chronic lymphoproliferative disorder, which has rarely been diagnosed by fine needle aspiration (FNA) cytology. We report one such case with some overlapping cytomorphological features with chronic lymphocytic leukemia and acute lymphoblastic leukemia. A 91‐year‐old man presented with generalized lymphadenopathy, pleural effusion, ascites, and an ulcerated growth in rectum. FNA smears from the left cervical lymph node showed a monotonous population of small lymphoid cells having small but distinct nucleoli that was initially diagnosed as chronic lymphocytic leukemia (CLL). Smears from the left axillary lymph node contained both small and medium‐sized lymphoid cells with frequent hand‐mirror cell appearance, which has been described in acute lymphoblatic leukemia (ALL). Immunocyto/histochemical stainings on smears and cell block preparations of the aspirate showed the following immunophenotype: CD3+, CD4+, CD5+, CD7+, C...
Primary thymic carcinoma-mucoepidermoid cell (MEC) type is rare and only one report describing th... more Primary thymic carcinoma-mucoepidermoid cell (MEC) type is rare and only one report describing the cytologic features of this neoplasm in the metastatic site is described. We describe the cytological features of poorly differentiated carcinoma possibly MEC in a 54-year-old man who presented with cough, weight loss, and puffiness of face for 3 months. The significance of this infrequently encountered neoplasm lies in its potential confusion of origin of the tumor-thymus or metastases from a primary bronchial MEC. Immunocytochemical profile was suggestive of a thymic carcinoma of the MEC type.
An 11-year-old Egyptian boy presented with mild pain in his eft lower jaw accompanied by swelling... more An 11-year-old Egyptian boy presented with mild pain in his eft lower jaw accompanied by swelling. Clinical examination howed a hard, tender mandibular enlargement extending rom the chin to the left molar area. The orthopantomogram OPG) showed poorly defined multilocular radiolucency inolving the mandibular body from the right lateral incisor to he left first molar (Fig 1A). There were discrete signs of esorption of root apices of the adjacent teeth. Computed omography examination disclosed a large expansive osteoytic lesion with a soap bubble appearance and erosion of both estibular and lingual mandibular cortices (Fig 1B). Incisional biopsy was performed under local anesthesia. ections contained spindle cells within fibrous stroma and rregularly distributed multinucleated giant cells clustering round areas of hemorrhage. Periphery of the lesion howed reactive osteoid tissue formation (Fig 1C). The overall clinical, radiologic, and histopathologic picture as consistent with central giant cell granuloma. Laboratory nvestigations including complete blood count, alkaline phoshatase, calcium, and parathormone levels were within noral limits, while phosphorus level was slightly elevated.
Microscopic colitis (MC) is a recognized cause of chronic watery diarrhea. It is characterized by... more Microscopic colitis (MC) is a recognized cause of chronic watery diarrhea. It is characterized by subepithelial collagen deposition or intraepithelial lymphocytic infiltration of the colonic mucosa which, however, appears grossly normal on endoscopy. The term microscopic enterocolitis is applied when MC is associated with similar microscopic affection of the ileum and/or proximal small intestine. MC is reported to be associated with a variety of autoimmune conditions. Systemic lupus erythematosus (SLE) is rarely reported in association with MC. We report a female patient with microscopic enterocolitis as one of the presenting manifestations of SLE.
International Journal of Surgery Case Reports, 2016
BACKGROUND: Appendicular schistosomiasis is an unusual etiology of acute appendicitis, which has ... more BACKGROUND: Appendicular schistosomiasis is an unusual etiology of acute appendicitis, which has been reported in countries endemic in schistosomiasis, such as sub-saharan Africa and South America. Nowadays, due to globalization, this disease has been diagnosed in non-endemic countries. Kuwait is a country possessing a larger percentage of foreigners than national citizens. Therefore, several cases of schistosomal appendicitis were found. METHOD: The clinicopathological records of all patients that underwent appendectomy during January 2007 and December 2011 were recorded from the archives of Al-Adan Hospital in Kuwait. All cases of schistosomal appendicitis were retrieved and the histopathologic slides reconfirmed by the histopathologist. RESULTS: During the 5-year study period, 3012 appendectomies were performed and 8 schistosomal appendicitis were found. They were all Egyptian males that were admitted for a clinical suspicion of acute appendicitis. The age ranged between 24 and 42 years, with a mean age of 32.75 years. All cases showed histological features of acute or acute suppurative inflammation, with ova seen in the vasculature of all layers of appendicular wall. CONCLUSION: Although schistosomiasis is a rare causative agent of acute appendicitis, this however can't be confirmed until histological evaluation. Therefore, adequate follow up postoperatively is necessary to insure eradication of the disease and to prevent further serious consequences.
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