Histological variants of urothelial carcinoma: diagnostic, therapeutic and prognostic implications.

Dirofilaria repens is a nematode affecting domestic and wild canids, transmitted by several species of mosquitoes. It usually causes a non-pathogenic subcutaneous infection in dogs and is the principal agent of human dirofilariosis in the Old World. In the last decades, D. repens has increased in prevalence in areas where it has already been reported and its distribution range has expanded into new areas of Europe, representing a paradigmatic example of an emergent pathogen. Despite its emergence and zoonotic impact, D. repens has received less attention by scientists compared to Dirofilaria immitis. In this review we report the recent advances of D. repens infection in dogs and humans, and transmission by vectors, and discuss possible factors that influence the spread and increase of this zoonotic parasite in Europe. There is evidence that D. repens has spread faster than D. immitis from the endemic areas of southern Europe to northern Europe. Climate change affecting mosquito vectors and the facilitation of pet travel seem to have contributed to this expansion; however, in the authors’ opinion, the major factor is likely the rate of undiagnosed dogs continuing to perpetuate the life-cycle of D. repens. Many infected dogs remain undetected due to the subclinical nature of the disease, the lack of rapid and reliable diagnostic tools and the poor knowledge and still low awareness of D. repens in non-endemic areas. Improved diagnostic tools are warranted to bring D. repens diagnosis to the state of D. immitis diagnosis, as well as improved screening of imported dogs and promotion of preventative measures among veterinarians and dog owners. For vector-borne diseases involving pets, veterinarians play a significant role in prevention and should be more aware of their responsibility in reducing the impact of the zoonotic agents. In addition, they should enhance multisectorial collaboration with medical entomologists and the public health experts, under the concept and the actions of One Health-One Medicine.

/pdf/recent-advances-on-dirofilaria-repens-in-dogs-and-humans-in-48hq0md2g5.pdf

Recent advances on Dirofilaria repens in dogs and humans in Europe

Context—The year 2010 commemorates the 25th year since the seminal publication by Karl Lennert and Harald Stein and others in Kiel, West Germany, describing an unusual large cell lymphoma now known as anaplastic large cell lymphoma (ALCL). Investigators at many universities and hospitals worldwide have contributed to our current in-depth understanding of this unique peripheral T-cell lymphoma, which in its systemic form, principally occurs in children and young adults. Objective—To summarize our current knowledge of the clinical and pathologic features of systemic and primary cutaneous ALCL. Particular emphasis is given to the biology and pathogenesis of ALCL. Data Sources—Search of the medical literature (Ovid MEDLINE In-Process & Other Non-Indexed Citations and Ovid MEDLINE: 1950 to Present [National Library of Medicine]) and more than 20 years of diagnostic experience were used as the source of data for review. Conclusions—Based on immunostaining for activation antigen CD30 and the presence of...

Anaplastic Large Cell Lymphoma: Twenty-Five Years of Discovery

Lymphoepithelial-like carcinomas of the head and neck

Spitz nevi are melanocytic proliferations that are characterized by spindled and/or epithelioid nevomelanocytes. First interpreted as juvenile melanoma, these lesions were later characterized as benign and were observed to affect all age groups. Today, contrasting opinions persist regarding the fundamental benignancy versus malignancy within the spectrum of Spitz tumors. Beyond clinical outcome, this controversy has also been fueled by complex and sometimes convoluted classification schemes based on pathologic characteristics. More recently, immunophenotypic and molecular analyses have begun to clarify the etiologic nature of these tumors. Recent evidence suggests that histopathologic features that suggest more aggressiveness in Spitz tumors relate to mitoses and inflammation.

https://www.jaad.org/article/S0190-9622(11)00860-7/pdf

Spitz nevi and other Spitzoid lesions: Part I. Background and Diagnoses

We report the first case of submandibular gland lymphoepithelioma-like carcinoma (LELC) associated with Epstein–Barr virus (EBV) infection in a North African woman. The patient is a 34-year-old woman with an 8-month history of a submandibular left mass. Physical examination revealed a firm, mobile and indolent submandibular gland mass, measuring 2 2 cm. The magnetic resonance imaging demonstrated a well-delineated tumor mass measuring 30 mm in antero-posterior diameter, with heterogeneous high-intensity signal on T2-weighted images and homogeneous enhancement after contrast product injection (Fig. 1). The contra lateral gland was normal. A submandibulectomy with excision of two lymph nodes was performed. Permanent sections established the diagnosis of LELC of the submandibular salivary gland with reactive lymph nodes. Further investigation consisted of negative random biopsies of the nasopharynx. No more therapy was added. The patient is well with a 40-month follow-up. Histological analysis demonstrated a malignant proliferation growing in a nested and trabecular pattern, arranged in large lobules. Neoplastic cells exhibited syncytial appearance, with a large vesicular nucleus displaying one prominent nucleolus (Fig. 2). Tumor cells were closely intermingled with small aggregates of large pale histiocytes and abundant lymphoid cells, focally arranged in follicles. Some residual salivary gland ducts were present on the periphery of the tumor. Immunohistochemistry (Dako, Denmark; dilution: 1/50) demonstrated that neoplastic cells expressed cytokeratin (clone: MNF116) and epithelial membrane antigen (clone: E29) (Fig. 3) and were negative with EBV-latent membrane antigen LMP-1 antibody (clone: CS1–4). The background lymphoid infiltrate was mixed expressing both CD2O (clone: L26) and CD3 (clone: PC3/188A). CD68 (clone: KP1) staining enhanced the presence of numerous histiocytes. In situ hybridization (ISH) showed that neoplastic cells were strongly and diffusely labeled by the EBV-encoded RNA probe (Dako, Denmark, alkaline phosphatase/antialkaline phosphatase technique) (Fig. 4). Residual normal glands as well as lymphoid and histiocytes were negative. LELC of salivary glands is strongly related to racial factors, since it predominates in Eskimos and Asian pa-

Lymphoepithelioma-like carcinoma of the submandibular salivary gland associated with Epstein–Barr virus in a North African woman

Background Metastases to the breast are rare and can be missed without knowledge of the clinical history. We report an unusual breast metastasis originating in an olfactory neuroblastoma. Case A breast metastasis front esthesioneuroblastonta occurred in a 20-year-old woman 2 years after the onset of the disease. The aspirates were bypercellular and composed of cellular aggregates and single cells with ii monomorphic appearance. The cytoplasm was scanty and inconspicuous. The nucleus was large, with granular, hyperchromatic chromatin. Mitoses and apoptotic bodies were numerous. Because we were unaware of the past history at the time of the cytologic analysis, a definitive diagnosis was made only after pathologic study. Conclusion Esthesioneuroblastoma metastatic to the breast must lie considered in the differential diagnosis of breast metastases. Fine needle aspiration, in conjunction with clinical information, can be effective in the diagnosis of esthesioneuroblastoma metastatic to the breast.

Esthesioneuroblastoma metastatic to the breast in a young woman.

Anaplastic large cell lymphoma (ALCL) represents approximately 10 to 30% of all childhood non-Hodgkin lymphomas. It frequently involves both lymph nodes and extranodal sites whereas primary or secondary muscular involvements are quite uncommon. We describe a case of an 8-year-old boy presented with one month progressively swelling right buttock mass without association of lymphadenopathy or skin extension. Biopsy of the lesion showed large anaplastic cells with voluminous and abundant cytoplasm as well as folded nuclei. The tumour cells were positive for CD30, CD3, EMA and ALK-1. Chemotherapy resulted in durable remission status. This case emphasizes the occurrence of anaplastic large cell lymphoma in the soft tissue and the favourable outcome of ALK-positive anaplastic large cell lymphoma.

Primary CD30/ALK-1 positive anaplastic large cell lymphoma of the skeletal muscle in a child.

Desmoplastic spitz nevus (DSN) is an uncommon melanocytic lesion. The histologic features of this benign tumour may mimic those of certain benign (dermatofibroma and desmoplastic cellular blue nevus) or malignant (metastatic carcinoma and malignant melanoma) neoplasms. We report the case of a male with a DSN, and also review the clinical characteristics, histologic features and differential diagnosis of this extremely rare lesion. The lesion is identified as an asymptomatic reddish-brown dome-shaped papule on the forearm. Microscopic examination showed a symmetric lesion in the dermis. The neoplastic cells were large and epithelioid-shaped, and were either isolated as individual cells or arranged in small nests in a paucicellular hyalinized stroma. Nuclei were large and vesicular with small nucleoli and no mitoses. Diffuse expression of S100 and the absence of staining with antibodies to melan-A and HMB45 was observed. A diagnosis of DSN with free margins was made. The histologic presentation of this benign lesion mimics both benign and malignant neoplasms. The immunohistochemical profile (S100 positive, HMB-45 negative and cytokeratin negative) may be helpful to differentiate it from other lesions.

Desmoplastic spitz nevus: report of a case and review of the literature.

We report an uncommon case of Hodgkin's disease confined to the nasopharynx. An isolated polypoid mass of the nasopharynx was observed in a 41-year-old man presenting with increasing bilateral nasal obstruction. Histological study revealed a mixed cellularity type of Hodgkin's disease. Immunohistochemical analysis revealed CD30 and LMP1 expression and a lack of reactivity to CD15, CD3 and CD20. Serological tests excluded recent infection with Epstein-Barr virus. HD of nasopharynx is rare, but has to be recognized as such in view of appropriate treatment.

Primary Hodgkin's disease of the nasopharynx: a rare but bona fide disease.

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