Extraocular retinoblastoma in Indian children:clinical,imaging and histopathological features

AIMTo study eyes with extraocular dissemination (EORB), with the following aims: first to establish the mean lag period and to understand various reasons for delayed presentation, second to study their imaging profiles and third to analyze histopathological features of eyes enucleated after neoadjuvant chemotherapy.

A NEWLY RECOGNIZED PRECANCEROUS LESION OF THE STOMACH (HISTOPATHOLOGIC FEATURES OF GLOBOID DYSPLASIA OF HUMAN GASTRIC EPITHELIUM)

The histopathological features of the globoid dysplasia of the human gastric epithelium were described in detail and in series by means of observation of serial sections of 61 cases with globoid dys-plasias. Three grades were divided according to the architectural and cellular atypia of the globoid dys-plasias. The penetration of outer layer globoid dys-plastic cells through the basement membrane of 'the structure of double layers' appeared in typical globoid dysplasia grade II and the infiltration of the globoid dysplastic cells into stroma as well as the formation of incipient focus of signet ring cell carcinoma were described. The twinkling scene of the infiltration of the globoid dysplastic cells into lamina propria through the basement membrane, and the destroying of the basement membrane by the globoid dysplastic cells were shown by means of Gordon Sweet's staining. Through the analysis as for the distribution characteristics of ages and sexes in 61 globoid dysplasia cases and 51 signet ring cell carcinomas, a fact was discovered that the mobility of female cases was ten years prior to that of male ones in average. A conclusion could be made that the globoid dysplasia might be an important precan-cerous lesion of the signet ring cell carcinoma of the stomach.

Carcinoid of the ampulla of Vater: Morphologic features and clinical implications

Carcinoids involving the ampulla of Vater are rare le- sions that may produce painless jaundice. The published data indicate that these tumors, in contrast to their midgut counterparts, metastasize in approximately half of cases irrespective of primary tumor size. Therefore, radical excision in the form of pancreaticoduodenectomy is recommended regardless of tumor size. As with other gastrointestinal carcinoid tumors, biological treatment with octreotide analogues can be applied to symptomatic patients. Tumor-targeted radioactive therapy is a newly emerging treatment option. We here report case of a carcinoid tumor of the ampulla of Vater presenting as painless jaundice in a 65-year old man and review the relevant literature, giving special attention to the mor- phologic features, clinical characteristics, and treatment modalities associated with this disease process.

Contrast-enhanced ultrasound imaging for intestinal lymphoma

BACKGROUND Intestinal lymphoma is a rare tumor.Contrast-enhanced ultrasound(CEUS)findings of intestinal lymphoma have not been reported previously,and the relationship between CEUS and clinicopathological features and prognostic factors is still unknown.AIM To describe the B-mode US and CEUS features of intestinal lymphoma and investigate the correlation of CEUS and histopathological features.METHODS This was a single-center retrospective study.Eighteen patients with histologically confirmed intestinal lymphoma underwent B-mode US and CEUS examinations between October 2016 and November 2019.We summarized the features of Bmode US and CUES imaging of intestinal lymphoma and compared the frequency of tumor necrosis in intestinal lymphomas with reference to different pathological subtypes(aggressive or indolent)and clinical stage(early or advanced).The time–intensity curve parameters of CEUS were also compared between patients with normal and elevated serum lactate dehydrogenase.RESULTS In B-mode imaging,four patterns were observed in intestinal lymphoma:Mass type(12/18,66.7%),infiltration type(1/18,5.6%),mesentery type(4/18,22.2%)and mixed type(1/18,5.6%).All cases were hypoechoic and no cystic areas were detected.On CEUS,most cases(17/18,94.4%)showed arterial hyperechoic enhancement.All cases showed arterial enhancement followed by venous wash out.A relatively high rate of tumor necrosis(11/18,61.1%)was observed in this study.Tumor necrosis on CEUS was more frequent in aggressive subtypes(10/13,76.9%)than in indolent subtypes(1/5,20.0%)(P=0.047).There were no correlations between tumor necrosis and lesion size and Ann Arbor stage.There was no significant difference in time–intensity curve parameters between normal and elevated lactate dehydrogenase groups.CONCLUSION B-mode US and CEUS findings of intestinal lymphoma are characteristic.We observed a high rate of tumor necrosis,which appeared more frequently in aggressive pathological subtypes of intestinal lymphoma.

Ectopic liver tissue (choristoma) on the gallbladder: Acomprehensive literature review

BACKGROUND Liver tissue situated outside the liver with a hepatic connection is usually calledan accessory liver, and that without a connection to the mother liver, is calledectopic liver tissue.AIM To identify studies in the literature on ectopic liver tissue located on thegallbladder surface or mesentery.METHODS We present two patients and review published articles on ectopic liver tissuelocated on the gallbladder surface accessed via PubMed, MEDLINE, GoogleScholar, and Google databases. Keywords used included accessory liver lobe,aberrant liver tissue, ectopic liver tissue, ectopic liver nodule, heterotopic livertissue, hepatic choristoma, heterotopic liver tissue on the gallbladder, and ectopicliver tissue on the gallbladder. The search included articles published before June2020 with no language restriction. Letters to the editor, case reports, reviewarticles, original articles, and meeting presentations were included in the search.Articles or abstracts containing adequate information on age, sex, history of liverdisease, preliminary diagnosis, radiologic tools, lesion size, surgical indication,surgical procedure, and histopathological features of ectopic liver tissue wereincluded in the study.RESULTS A total of 72 articles involving 91 cases of ectopic liver tissue located on the gallbladder surface or mesentery were analyzed. Of these 91 patients, 62 werefemale and 25 were male (no gender available for 4 patients), and the age rangewas 5 d to 91 years. Forty-nine patients underwent surgery for chroniccholecystitis or cholelithiasis, and 14 patients underwent surgery for acutecholecystitis. The remaining 28 patients underwent laparotomy for other reasons.Cholecystectomy was laparoscopic in 69 patients and open in 11 patients. Theremaining 19 patients underwent various other surgical procedures such asautopsy, liver transplantation, living donor hepatectomy, Whipple procedure, andliver segment V resection. Histopathologically, hepatocellular carcinoma wasdetected in the ectopic liver tissue of one patient.CONCLUSION Ectopic liver tissue is a rare developmental anomaly which is usually detectedincidentally. Although most studies suggest that ectopic liver located outside thegallbladder has a high risk of hepatocellular carcinoma, this is not reflected instatistical analysis.

Diagnosis of choroid plexus papilloma: Current perspectives and future directions

Choroid plexus papilloma(CPP)is a rare,slow-growing,and typically benign brain tumor that predominantly affects children.CPP is characterized by well-defined circular or lobulated masses in the ventricles,leading to symptoms related to increased intracranial pressure and hydrocephalus.CPP diagnosis relies on a combination of clinical presentation,imaging findings,and histological examination.The World Health Organization(WHO)classification categorizes choroid plexus tumors into CPP(Grade Ⅰ),atypical CPP(aCPP,Grade Ⅱ),and choroid plexus carcinoma(CPC,Grade Ⅲ).This article reviewed current diagnostics modalities and explored the emergence of new diagnostic methods for CPP.Research on molecular markers and genetic alterations associated with CPP is ongoing,and some potential markers have been identified.These results offered insights into potential therapeutic targets and personalized treatment approaches for CPP.Advancements in radiomics and liquid biopsy hold promise for improving diagnostic accuracy and monitoring treatment outcomes for choroid plexus tumors.Radiomics can provide quantitative data from imaging studies,whereas liquid biopsy can analyze tumor-derived genetic material and molecular markers from body fluids,such as cerebrospinal fluid(CSF)and blood.The rapidly evolving fields of molecular and genetic research and novel diagnostic methods require continuous updates and advancements before their application in clinical practice.We hope that these advancements will lead to earlier and more precise diagnoses,better treatment options,and improved outcomes in patients with CPP and other brain tumors.

Pilomatricoma With Bullous Appearance:A Case Report

Introduction:Pilomatricoma is usually a solitary,deep dermal firm nodule with an overlying normal epidermis.Bullous pilomatricoma is rarely reported;thus,its pathogenesis has not been elucidated.We report a case presenting the pilomatricoma with bullous change.Case presentation:A 19-year-old female presented a firm nodule covered by a bulla on her right upper arm.Histopathological examination showed the tumor was composed of basophilic basal-like cells and shadow cells.No cellular atypia or abnormal mitotic figures were observed.All these clinical characteristics and pathological results point to the diagnosis of bullous pilomatricoma.The tumor was surgically removed by enlargement.Discussion:We hypothesize that a history of trauma and rapid growth may contribute to the diagnosis of the bullous pilomatricoma.The appearance of the bullous can be explained by the dilated lymphatic vessels seen in histopathologic examination.We give a case report help clinicians to better diagnose this entity and decrease the rate of misdiagnosis.Conclusion:We observed a rare bullous variant of pilomatricoma.Hence,when identifying a patient of bullous pilomatricoma,a detailed medical history and physical examination are essential.