Search

A 75-year-old man presented with subcutaneous indurations in his left upper arm and scrotum after receiving injections of leuprorelin acetate (LA) for prostate cancer. The indurations were diagnosed as sclerosing lipogranuloma in the scrotum and foreign body granuloma in the left upper arm. The patient's condition improved with treatment, and further studies are needed to understand the phenomenon of granuloma formation at LA injection sites. The article highlights the importance of patient consent and declares no conflicts of interest. [Extracted from the article]

The article titled "Understanding the Term 'Necrobiosis'" explains the term "necrobiosis" in dermatopathology and its various interpretations. It discusses the confusion caused by different authors describing the term differently. The article suggests using simpler terminology like "altered collagen" or "altered dermal connective tissue" when describing histological sections or generating skin biopsy reports. Necrobiosis refers to histopathological changes in the dermal connective tissue, including the presence of flame figures and structural alterations in collagen fibers. It can be seen in conditions like granuloma annulare, lupus miliaris disseminatus faciei, and sarcoidosis, but using more specific descriptions may be more helpful. [Extracted from the article]

A xanthoma is an extremely rare condition that affects the soft tissues and bones and is characterized by a predominance of lipid-rich foamy histiocytes. The onset of xanthomas is frequently accompanied by primary or secondary hyperlipidemia. Primary bone xanthomas are very uncommon benign bone lesions that are not linked to hyperlipidemia. Histopathologically, they are distinguished by histiocytes, an abundance of foam cells or xanthoma cells that contain lipids, and a paucity of multinucleated giant cells. There have only been four reports of primary maxillary xanthoma in the medical literature. We present a rare primary intrabony xanthoma of the anterior maxilla in a 23-year-old normolipidemic female patient with solitary radiolucency. Using CD68, S-100, and CD1a immunohistochemical staining, it is possible to distinguish between macrophage/non-Langerhans histiocytes and Langerhans histiocytes. Therefore, a diagnosis of a central xanthoma of the jaws must be made. [ABSTRACT FROM AUTHOR]

This article discusses a case of extrafacial rosacea, a skin disorder that typically affects the face but in this case presented on the arms. The patient, a 40-year-old male, had erythematous skin lesions on both arms that were occasionally itchy and worsened during the summer. Despite previous treatments, the lesions did not improve until the patient was prescribed doxycycline, metronidazole gel, and ivermectin. Extrafacial rosacea is a rare variant of rosacea that predominantly affects men and can be challenging to diagnose without facial lesions. The exact cause of extrafacial rosacea is unknown, but it is believed to involve Demodex infestation and may be triggered by UV light. Treatment options include topical and systemic therapies, as well as avoiding exacerbating factors. [Extracted from the article]

Introduction: Peripheral giant cell granuloma (PGCG) is a type of reactive hyperplastic lesion in the oral cavity that develops due to local irritation or chronic trauma, originating from the periosteum or periodontal membrane. It primarily affects the alveolar mucosa of the posterior mandibular region and has a peak incidence in the age range of the fourth to sixth decades of life, with a 2:1 female predilection. The aim of the study was to analyse the histopathological pattern of peripheral giant cell granuloma. Materials and Methods: This retrospective study was conducted at a tertiary care teaching hospital from 2018 to 2023 after obtaining the required institutional ethical board approval (SMC/UECM/2023/627/296). All the cases of maxillofacial lesions referred/reported to and which conformed to the set inclusion and exclusion criteria were included. Data were analysed by calculating the percentage of the variables. IBM SPSS version 20 software was used to analyse the descriptive data. Results: Out of 12 patients, four were males and eight were females. The age ranged from 20 to 60 years with an average age of 40 years. All the patients included in the study showed multinucleated giant cells and inflammatory cells, 83.3% showed fibrous stroma and 50% showed para-keratinisation and haemosiderin pigments. Discussion: PGCG, a reparative lesion, seems to occur mostly in the 40–60 years of life with female predilection and commonly seen histopathological features included multinuclear giant cells, inflammatory cells in all cases, 83.3% fibrous stroma and 50% both para-keratinisation and haemosiderin pigments. [ABSTRACT FROM AUTHOR]

This article discusses a case of a 24-year-old female patient with HIV infection who initially presented with symptoms resembling tuberculosis. However, further examination revealed that she had Cryptococcus neoformans, a fungus that commonly affects immunocompromised individuals. Cryptococcosis, caused by inhaling spores, can be life-threatening and prompt diagnosis is crucial. The article highlights the importance of considering cryptococcosis as a diagnostic possibility, especially in immunocompromised individuals. It also discusses the diagnosis and treatment of cryptococcal lymphadenitis in HIV patients, emphasizing the importance of early detection and treatment for better patient outcomes. [Extracted from the article]

Oral hyaline ring granuloma is an unusual granulomatous lesion affecting the jaws characterized by the presence of numerous eosinophilic rings with multinucleated giant cells. The lesion can be of central or peripheral variety, caused by the impaction of foreign particles in the oral cavity. While literature describes this lesion in association with dentures, carious teeth and extraction socket, this paper reports the first case of an oral hyaline ring granuloma associated with an impacted premolar tooth and its surgical management. [ABSTRACT FROM AUTHOR]

The document discusses a case of Congenital Self-Healing Reticulohistiocytosis (CSHRH), a rare benign variant of Langerhans cell histiocytosis (LCH), in a newborn with diffuse skin erosions. The child's condition improved over time, leaving behind atrophic hypopigmented scars. CSHRH typically presents as painless skin lesions that may develop into vesicles and crusting, with a good prognosis overall. The article emphasizes the importance of early recognition and evaluation to differentiate benign transient causes from serious systemic diseases in neonates with skin erosions. [Extracted from the article]

This article discusses a rare case of histoid leprosy, a variant of multibacillary leprosy, in a 30-year-old male patient. The patient presented with skin-colored lesions on the forehead and bridge of the nose. The lesions were soft in consistency and had follicular openings. A skin biopsy confirmed the diagnosis of histoid leprosy, and the patient was started on multidrug therapy, which resulted in the resolution of the lesions. Histoid leprosy is a rare form of leprosy that typically occurs in relapsed or resistant cases, but this case was unique as it presented without a history of previous treatment. The article emphasizes the importance of complete treatment to eliminate leprosy. [Extracted from the article]

Multinucleated giant cells are commonly encountered in histopathology and are mostly a clue to diagnosis but sometimes pose a diagnostic confusion. The present study elucidates a case series of giant cell lesions (GCL) with emphasis on differential diagnosis and other investigations that contribute towards arriving at a final diagnosis. We also intended to devise an algorithmic approach for the accurate pathological characterization of these lesions. All the cases reported in the department from January 2018 to June 2019 were reviewed by pathologists and the total number of lesions where giant cells were diagnostic or an additional finding were included in this study. Twenty-five cases out of 1000 biopsies were diagnosed based on giant cell morphology. The most frequent lesions were central giant cell granuloma, followed by cherubism, hyperparathyroidism, peripheral giant cell granuloma, tuberculosis, and hybrid lesion. A systematic approach towards differential diagnosis for such cases and a diagnostic algorithm was devised which is being followed as per the reported spectrum of GCL. Radiological, serology, and sometimes ancillary staining techniques are essential for the accurate histopathological diagnosis of giant cell lesions. Our diagnostic algorithm helps narrow down the spectrum of investigations necessary to characterize these lesions, enabling for a swifter and more confident identification of the pathologies. [ABSTRACT FROM AUTHOR]

Controversies exist in literature regarding nature, pathogenesis, and behaviour of giant cell lesions (GCLs) of jaws. Studies were attempted to solve these mysteries with immunohistochemical analysis, using various biological markers. Thus, the aim of this review is to appraise the role of immunohistochemistry (IHC) in evaluating the pathogenesis, cellular phenotype, nature, and behaviour of GCLs of jaws. PubMed, PubMed Central, and Clinical Key (Medline) databases were searched electronically irrespective of date of publication with assortment of several independent terms. Fifty-five articles that fulfilled the eligibility criteria were included in the review. Out of 55 included articles, 49 were associated with nature, pathogenesis, and behaviour and six articles were associated with treatment and outcome prediction. Although IHC solved some of the controversies associated with GCLs of jaws such as the osteoclastic phenotype of multinucleated giant cells, immunoexpression of proliferative markers does not distinct non-aggressive from aggressive central GCL but the nature, histogenesis, pathogenesis, and exact behaviour still remain debatable. With regard to formulation of treatment plan, immunohistochemical analysis revealed that expression of glucocorticoid and calcitonin receptors could act as a tool to decide the therapeutic strategy and aid in therapeutic adjustments according to evolution of the lesion. [ABSTRACT FROM AUTHOR]

Xanthogranulomatous inflammation is a rare form of chronic inflammation characterized by the presence of lipid-laden macrophages, multinucleate giant cells, and chronic inflammatory cells. It is an uncommon finding in the breast. Obstruction, infection with low-virulence organisms, defective lipid transport, autoimmune disorders, and allergic reactions have been implicated. Very few reports of xanthogranulomatous mastitis (XGM) have been reported in which coexistent benign and malignant lesions have been found. Clinical presentation of XGM is variable. Many patients present with pain and breast lumps. The lesions can mimic benign or malignant breast neoplasms clinically and radiologically which warrant a pathological diagnosis either by core or excisional biopsy. Histopathology examination is the key for diagnosis. Surgical excision is the choice of treatment. Larger lesions can be treated conservatively with antibiotics before surgical excision. [ABSTRACT FROM AUTHOR]

Malignant gastrointestinal (GI) neuroectodermal tumor is an extremely rare entity that was first described by Zambrano et al. in 2003 as "clear cell sarcoma (CCS)-like tumor of the GI tract." It shares some of the histopathological features of CCS but lacks the immunohistochemical (IHC) reactivity for melanocytic markers. Most mesenchymal neoplasms of the GI tract belong to the category of GI stromal tumors and are characterized by the IHC expression of c-KIT. In cases, without detectable KIT receptor expression, several differential diagnoses have to be taken into consideration. In this article, we describe such a case and present a review of all the reported cases till date. We also present the current available knowledge on its pathology and molecular genetics along with the limitations in its diagnosis. Here, we report a case of a 32-year-old man with a tumor of the small bowel composed of polygonal tumor cells arranged in solid nests, alveolar pattern, and pseudopapillary and admixed with numerous osteoclast-like multinucleated giant cells. Immunohistochemically, the tumor cells strongly expressed S-100 protein only. HMB-45, melan-A, CD117, cytokeratin, desmin, smooth muscle actin, and CD-34 were absent. Ki-67 index was 15%. The diagnosis was further confirmed by fluorescence in situ hybridization (FISH) demonstrating the presence of EWSR1 (22q12) translocation. A final diagnosis of malignant gastroneuroectodermal tumor was rendered. The patient is disease-free for 20 months of postsurgery. The diagnosis of this entity should be considered in the presence of S-100-positivity and multinucleated osteoclastic giant cells and the absence of melanocytic differentiation in a tumor arising from GI tract. Further confirmation can be done by performing FISH analysis. [ABSTRACT FROM AUTHOR]

Peripheral giant cell granuloma (PGCG) is a benign, hyperplastic reactive lesion arising from the mucoperiosteum of the alveolar ridge following chronic irritation or trauma. It is characterized by the presence of multinucleated giant cells. We report a 12-year-old male with massive maxillary PGCG where ultrasonography was used as the first line of investigation to determine the severity and vascularity of the lesion based on differential diagnosis. The ultrasonographic findings showed well-defined hyperechoic multifocal echogenic areas and low-resistant spectral waveforms obtained on Doppler were consistent with benign soft tissue lesions. The histopathological examination showed that of a typical multinucleated giant cell with the diagnosis of PGCG. [ABSTRACT FROM AUTHOR]

Xanthogranulomatous inflammation, a specific form of chronic inflammation, is marked by parenchymal destruction, proliferative fibrosis, and infiltration of typical foamy histiocytes admixed with hemosiderin-laden macrophages and foreign-body giant cells. Myometrial xanthomatosis, a term designated for nodular or diffuse histiocytic hyperplasia of the myometrium, has been reported in association with pregnancy-related procedures. Moreover, a 2--3-fold increase in histiocytic counts has been observed in leiomyomatous areas than in adjacent normal myometrium. The first evidence of collections of lipid-laden macrophages was documented in the form of yellowish degeneration of uterine leiomyomas. We report a case of xanthogranulomatous change in a leiomyoma in a 47-year-old female who presented with abnormal uterine bleeding. To the best of our knowledge, this is the first report of xanthogranulomatous variant/degenerative change in a leiomyoma. This case highlights a new variant of leiomyoma which both gynecologists and pathologists should be aware of as it may pose a diagnostic challenge both clinically as well as pathologically. [ABSTRACT FROM AUTHOR]

Introduction: A chalazion is a common localized lipogranulomatous inflammation of the eyelid. Histopathological diagnosis of chalazia is essential to rule out malignancy in particular sebaceous carcinoma. Our aim is to understand and classify the histopathological findings of chalazia and to determine any association with a patient's demographics. Materials and Methods: H and E sections were reviewed and classified into four categories: (1) lipogranulomas only, (2) lipogranulomas with multinucleated giant cells, (3) lipogranulomas with abscess, and (4) fibrosis without lipogranulomas or granulomatous inflammation. Patients' sex, age, and location of the lesion were analyzed. Results: Five hundred and forty cases included men (54.6%) and women (45.4%) with the mean age of 45.3 (13--89; standard deviation, 16.8). Five hundred and eight had information regarding location: left lower eyelid, 21.1%; right lower eyelid, 19.5%; left upper eyelid, 30.5%; and right upper eyelid, 28.9%. Category 1 accounted for 44.6%; category 2, 41.5%; category 3, 7.0%; and category 4, 6.9%. There was no significant correlation between classification and sex (P = 0.210) or age group (0-50 and > 50) (P = 0.369) nor between presence of giant cells and/or abscess and location (P = 0.826). Mean ages of category 1 (47.0) and 2 (43.1) were significantly different (P = 0.011). Conclusion: Four histopathological subtypes were equally distributed across sexes and eyelid locations. Individuals in category 1 are older than category 2. Favoring a systematic way to analyze the histopathology of chalazia may result in fewer missed diagnoses of malignancy and other inflammatory or infectious diseases. [ABSTRACT FROM AUTHOR]

Numerous ghost-like cells along with a few multi-nucleated giant cells, inflammatory cells, and nuclear debris were also seen. Dear Editor, Pilomatrixoma is a benign tumor of skin appendages with presumed differentiation toward hair follicle matrix cells.[[1]] It was first described in 1880 by Malherbe and Chenantais as "calcifying epithelioma of sebaceous origin". Cell block of the patient showed a few fragments of ghost cells along with mature adipocytes [[Figure 3]d inset]. [Extracted from the article]

Objective: To investigate the bone-resorbing effect of demethylbelamcandaquinone B (Dmcq B) extracted from Marantodes pumilum var. alata on osteoclast differentiation in RAW264.7 cells. Methods: RAW264.7 macrophages were differentiated using RANKL into osteoclast-like cells. Then, they were treated with 10 μg/mL Marantodes pumilum var. alata crude aqueous extract, 5 μg/ mL dichloromethane fraction, and 0.6 μg/mL Dmcq B and 0.06 μg/ mL estradiol. Tartrate-resistant acid phosphatase 5b (TRACP 5b) as an osteoclast phenotypic marker was determined by TRACP staining and TRACP 5b colometric assay, and bone-resorbing pits were examined. The gene expression of pro-inflammatory cytokines (TNF-α and IL-6) was measured. Moreover, the protein expressions of pro-inflammatory cytokines (TNF-α and IL-6) and estrogen receptors were evaluated. Results: Marantodes pumilum var. alata crude aqueous extract and Dmcq B inhibited RANKL-stimulated osteoclast differentiation as evidenced by size reduction of giant multinucleated osteoclast cells, decreased TRACP 5b activity as well as the subsiding of resorbed pit area compared with normal control. In addition, they reduced the gene and protein expressions of TNF-α and IL-6. Marantodes pumilum var. alata, Dmcq B, and estradiol treatments increased the protein expressions of estrogen receptors alpha and beta in osteoclasts. Conclusions: Marantodes pumilum var. alata and its active compound, Dmcq B can inhibit osteoclast differentiation. [ABSTRACT FROM AUTHOR]

Background: Fine-needle aspiration cytology remains the preliminary test for diagnosing papillary thyroid carcinoma (PTC). Numerous features are established to arrive at the diagnosis. However, few cases pose a challenge to correctly diagnose PTC. Our study aims to elicit the combination of features to aid in the diagnosis of such cases. Materials and Methods: Cytology smears of histologically proven cases of PTC and benign diagnoses were included as case (n = 36) and control group (n = 38), respectively. Features including papillae with cores, 3-D caps, nuclear grooves (NG), intranuclear cytoplasmic inclusions (INCI), giant cells, macrophages, cellular swirls, psammoma bodies, pale chromatin, nuclear overlapping, nuclear enlargement, and metaplastic cells were assessed. Statistic tests including Independent t test/Mann–Whitney Test and Chi-Square test/Fisher's Exact test were used. Receiver operating characteristic curve was used to assess the cut-off point of many cytological features to predict PTC. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of cytological features was calculated to predict PTC. Results: Presence of five or more cytological features (papillae with cores, cellular swirls, NG, INCI, and psammoma bodies) together could diagnose PTC (PPV) in 78.95% of the cases, with a NPV of 83.33%. Diagnostic accuracy of these five features combined was 81.08%. Papillae with cores and nuclear grooving were the most sensitive cytological features, whereas INCI followed by cellular swirls and NG were the most specific features. Conclusion: Relying on a combination of the most sensitive and specific features rather than any one cytological feature can help reduce the misdiagnoses in PTC. [ABSTRACT FROM AUTHOR]

The Rationale: Undifferentiated pleomorphic sarcoma originally known as malignant fibrous histiocytoma was declassified by the World Health Organization in 2002 as a formal diagnostic entity and renamed as an undifferentiated pleomorphic sarcoma. It accounts for <1% of malignant tumours of the long bone. Patient Concerns: A 33-year-old male patient reported with swelling and pain in the lower left posterior jaw region for 3 months with a history of fall on the floor 3 months back. Diagnosis: On examination, diffuse solitary swelling was present on the left lower third of the face and was diagnosed radiographically and histopathologically as undifferentiated pleomorphic sarcoma of the mandible. Treatment and Outcomes: Selective neck dissection, followed by reconstruction with fibula osteomyocutaneous flap and then referred for adjuvant radiotherapy. Take-away Lessons: Vimentin staining plays a substantial role in the diagnosis of undifferentiated pleomorphic sarcoma. A long-term follow-up after treatment is required to increase the chances of disease-free survival for the patients. [ABSTRACT FROM AUTHOR]

The current COVID-19 pandemic is associated with various cutaneous manifestations like urticaria, morbilliform rash, papulovesicular exanthem, chilblain lesions, and livedo reticularis[[1]] Prevalence of herpes-zoster (HZ) as well as vesicular eruptions mimicking herpes infection has been increasingly reported during the pandemic. Fernandez-Nieto et al.[[7]] studied 53 cases of COVID-19 patients with vesicular eruptions and categorized 24 cases as COVID-19 associated vesicular rashes after ruling out other common conditions. Decreased cell-mediated immunity caused by COVID-19 infection as evidenced by a reduction in lymphocyte count, and of CD3+, CD4+ and CD8+ T cells has been proposed as a reason for reactivation of HZ during COVID-19 infection which is also likely in our case. [Extracted from the article]

JXG presents usually in early childhood as well-demarcated solitary or multiple, firm, rubbery papules or nodules, pink to red in color with a yellow tinge in early lesions, later acquiring yellow-brown hue with occasional telangiectasia. Common morphological presentations of BCH include multiple skin-colored to yellowish papules in a cephalic distribution.[[3]] However, rarely, as in the index case, a solitary nodule may be a presenting feature. Clinical and Dermoscopic Findings An 8-month-old male child born out of nonconsanguineous marriage with normal growth and developmental milestones presented with a 2-month history of an asymptomatic protuberant nodule over the right cheek. [Extracted from the article]

Introduction: Conventional oral squamous cell carcinoma (OSCC) is relatively easy to diagnose on histopathology, as it comprises dysplastic epithelial cells with variable degrees of squamous differentiation. Different grading systems have been employed in grading OSCC based on its dysplastic features and host response. Some unusual features such as clear cell change, epithelial-mesenchymal transition (EMT), stromal hyalinization, stromal desmoplasia, perineural invasion, vascular invasion, tissue eosinophilia, giant cells, and tertiary lymphoid follicle formation are evident in OSCC histologically but have not yet been accounted in any grading systems of OSCC except perineural and vascular invasion.Aim: The aim of the present study was to identify these uncommon features and to correlate them with different grades of OSCC.Materials and Methods:This study was conducted on 100 histopathologically confirmed OSCC cases retrieved from the archives of our department. They were graded on the basis of Broder's grading system and were reviewed for the features mentioned above. Data collected were subjected to statistical analysis.Results: Clear cell change, EMT, foreign body giant cells, and tumor giant cells were observed in 13%, 20%, 1%, and 3% of cases, respectively. We found stromal desmoplasia in 15% and stromal hyalinization in 9% of cases. Tissue eosinophilia, tertiary lymphoid follicle formation, and perineural invasion were observed in 12%, 3%, and 2% of cases, respectively. Vascular invasion was not evident in any of the cases examined.Conclusion: The incidence of the unusual features was 7.8% in our study. [ABSTRACT FROM AUTHOR]

The fibrous histiocytoma is a soft-tissue neoplasm of the biphasic cell population of fibroblasts and histiocytes that affects the dermis and the subcutaneous tissue. The objective of this article is to report a case of benign fibrous histiocytoma (BFH) of the lower lip in a 32-year-old female patient with a chief complaint of swelling in the lower lip for the past 1 month. With diagnostic clinical hypothesis of fibrous hyperplasia, fibrous histiocytoma and mucocele, an excisional biopsy was performed. The histopathological examination revealed a nonencapsulated proliferation of spindle cells with some giant multinucleated cells in the periphery of the lesion. Multinucleated giant cells and lymphocytes were noted throughout the lesion. Immunohistochemical reactions were performed, staining only CD68 in the multinucleated giant cells. According to these characteristics, the final diagnosis was BFH. [ABSTRACT FROM AUTHOR]

Fibrous histiocytoma is a soft-tissue tumor that may present as a fibrous mass anywhere in the human body. The involvement of the oral cavity is rare. We here report a case of benign fibrous histiocytoma localized in the maxilla. A 25-year-old male presented with a slowly increasing large painless mass over the left side of the upper jaw for 5 months. The swelling was of gradual onset, slowly progressive and was not associated with pain, tenderness, or discharge. The radiographic appearance showed a multilocular mixed radiodense, radiolucent lesion in the left posterior maxilla. The histopathological report showed connective tissue component having streaming fascicles of spindle-shaped cells showing a storiform pattern. Many areas showed foamy histiocytes along with few multinucleated giant cells. The cells were appearing benign without any appearance of atypia. The tumor cells were positive for CD-68 and vimentin and negative for CD-34 and S100. The lesion was excised under general anesthesia. [ABSTRACT FROM AUTHOR]

Giant cell-rich osteosarcoma (GCRO) is an exceedingly rare histological variant of conventional primary osteosarcoma. It constitutes about 1%–3% of all osteosarcomas, and is extremely uncommon in the maxillofacial region. The unusual histopathological appearance and the rarity of the lesion poses a great diagnostic challenge. This article aims to present a rare case of GCRO involving the mandible in a 52-year-old male patient. [ABSTRACT FROM AUTHOR]

The giant cell granuloma is an identical reactive lesion which is mostly progressive in nature. The clinical behavior of these lesions varies from indolent to aggressive variant. The central form of giant cell granuloma involves the craniofacial bone, followed by long bones of hands and feet. These lesions are usually asymptomatic lesions and are discovered incidentally during routine radiographic examination. Radiograph features reveal multilocular jaw lesions, generally anterior to the first molar regions. Histologically, the lesion shows proliferating spindle-shaped stromal cells in a fibrovascular connective tissue stroma, which characteristically contains multiple multinucleated giant cells. Hemorrhage and hemosiderin pigmentations are often seen in tumor. Central giant cell granuloma is often confused with giant cell tumor of bone histologically. Here, we report a young male who was found to have large central giant cell granuloma in the anterior part of the mandible. The surgical treatment approach of central giant cell granuloma is discussed in this article. [ABSTRACT FROM AUTHOR]

Spindle cell/pleomorphic lipoma (SC/PL) is a subcutaneous mass usually localised on nape, shoulder or upper back. It is a benign lipogenic tumour composed of primitive CD34-positive spindle cells, floret-like multinucleated giant cells and mature adipocytes. Complete surgical excision is the optimal treatment. This unusual tumour in the larynx has only been reported in the medical literature once and was treated surgically by open approach. Actually, transoral robotic surgery (TORS) is most suitable because provides tridimensional magnified view plus a greater mobility with instruments, allowing complete and safe removal of the supraglottic mass, allowing rapid healing and recovery. We present the first case of a SC/PL of larynx managed with TORS. Four hours after surgery, the patient was able to take a soft diet and was discharged 2 h later. The follow-up showed an excellent clinical and functional outcome. [ABSTRACT FROM AUTHOR]

Anaplastic thyroid carcinoma (ATC) is a rare, highly malignant thyroid tumor with dismal prognosis. Osteoclastic giant cell variant of ATC is extremely rare and is characterized by the presence of a large number of multinucleated giant cells resembling osteoclasts. We report here this unusual variant in a 67-year-old female with a history of long-standing goiter of 13 years duration. Histologically, many multinucleated osteoclast-like giant cells were seen accompanying the malignant spindle cell component. Despite extensive sampling, no evidence of differentiated thyroid malignancy could be elucidated. [ABSTRACT FROM AUTHOR]

Central giant cell granuloma (CGCG) is an uncommon, benign but aggressive osteolytic neoplasm of the craniomaxillofacial region, histologically characterized by an abundance of evenly distributed multinucleated giant cells within a sea of spindle-shaped mesenchymal stromal cells, scattered throughout the fibrovascular connective tissue stroma containing areas of hemorrhage. A rapid diagnostic assessment, together with an adequate histopathologic verification, is essential to improve the management and the prognosis of this locally destructive lesion. A rare case of a large destructive CGCG involving the entire right angle of mandible, causing extensive bony resorption, and buccal, medial as well as inferior border cortical expansion with multiple perforations, in a young child is presented. It was treated successfully by enucleation and aggressive curettage followed by peripheral ostectomy preserving the continuity of the mandible. Two adjunctive measures were employed; first, chemical cauterization of the residual bony walls to prevent possible recurrence, for which this tumor is notorious, and second, placement of fresh autologous platelet-rich fibrin within the bony defect to hasten bone fill and reossification, thus obviating the need for a bone graft. [ABSTRACT FROM AUTHOR]

There are multiple lesions in the jawbones with a common histological character of the presence of osteoclast-like giant cells under one category – giant cell lesions. The central giant cell granuloma (CGCG) is the most common of all and is found to be more prevalent in the Indian population. The pathogenicity still remains an enigma and needs to be differentiated from other look-alike lesions in order to have proper treatment planning. Furthermore, CGCG specifically needs to be differentiated from central giant cell tumor to avoid mutilating surgeries. This article is an attempt to give an outline of the CGCG with updating of the latest information on the perception of this lesion. [ABSTRACT FROM AUTHOR]

Giant cell angiofibroma (GCA) is a rare, soft-tissue neoplasm that has a tendency to arise from the mesenchymal tissues of the head and neck, especially involving the orbital region. It is a benign neoplasm characterized by the presence of multinucleated stromal giant cells and angiectoid spaces. GCA belongs to the group of solitary fibrous tumor with histomorphological features intermediate between those of solitary fibrous tumor and giant cell fibroblastoma. CD34 immunoreactivity of tumor cells carries potential diagnostic value. Recurrence after the complete surgical excision is rare. We report the case of a 62-year-old male who presented with complaints of pain and heaviness in the lower abdomen. On computed tomography, a well-defined solid cystic mass was observed in the pelvis. Surgical resection was done, and the histopathological and immunohistochemical examination findings rendered the diagnosis of GCA. The patient had an uneventful postoperative period. [ABSTRACT FROM AUTHOR]

The peripheral giant cell granuloma (PGCG) is a benign oral lesion occurring on the gingiva and alveolar ridge. It is the most common oral lesion and occurs at an average age of 30 years. The upsurge in the levels of estrogen and progesterone in pregnancy leads to a plethora of changes in various parts of human body, including the oral cavity. In the oral cavity, changes are commonly seen on the gingiva. These include pyogenic granuloma, PGCG and also peripheral ossifying fibroma, etc., The etiology of PGCG in our case might be related to hormonal alterations during the gestation period. [ABSTRACT FROM AUTHOR]

Xanthogranulomatous endometritis is an uncommon benign lesion characterized by the destruction of endometrium and replacement by the sheets of foamy histiocytes, lymphocytes, plasma cells, multinucleated giant cells, fibrosis, calcification, and accompanying polymorphonuclear leukocytes. It is commonly mistaken for malignancy clinicoradiologically, and therefore, histopathological examination is of utmost importance. We report the case of a 61-year-old postmenopausal female who presented with pyometra, bulky uterus, and cervical stenosis, and histopathology revealed XGE. [ABSTRACT FROM AUTHOR]

The young age of the patient and absence of fever made the diagnosis of Lipschultz ulcer unlikely. They confirmed the application of the cream precisely over the affected areas and denied the possibility of direct contact of the cream with the vulvovaginal area. To the Editor, A 6-year-old girl was brought with complaints of multiple painful raw areas over the genitalia for 3 days with associated urinary retention for the past 16 h. [Extracted from the article]

Giant cells in soft tissue (ST) tumors are rare, pose great challenges to treating clinicians, and diagnosing pathologists. Common lesion with giant cells includes benign conditions such as nodular fasciitis to highly malignant lesions such as giant cell variant of malignant fibrous histiocytoma and extraskeletal osteosarcoma. Giant cell tumors of ST, extension of bony lesion to the ST are also rare possibilities. Recently, giant cell fibroblastoma and dermatofibrosarcoma protuberans have also been added to this list. These tumors show unpredictable behavior; some patients are cured by simple surgical excision whereas others develop metastasis. Diagnosing these in cytology is still more challenging. We report here a rare case of a giant cell-rich dermatofibrosarcoma protuberans in a 23-year-old male who presented with ST lesion in left forearm since 6 months. The lesion was predicted in fine-needle aspiration cytology and confirmed later with histopathology. When evaluated along with clinical features, the cytological features are very useful to distinguish between these tumors with giant cell morphology. [ABSTRACT FROM AUTHOR]

The 1,450-nm diode laser has also been shown to be fairly effective.[[4]] Other conditions to rule out in such a case are papular sarcoidosis, GR, CGPD, and POD. In the pediatric age group, important differentials to keep in mind are childhood granulomatous perioral dermatitis (CGPD), granulomatous-rosacea (GR), papular sarcoidosis, peri-oral dermatitis (POD), and lupus miliaris disseminatus faciei (LMDF). Sir, Granulomatous facial dermatoses share the common histological features of epithelioid cell granulomas. [Extracted from the article]

Varicella eruption may be atypical with extensive lesions, continued appearance, and hemorrhagic lesions. They are febrile purpura, malignant chickenpox with purpura, postinfectious purpura, purpura fulminans, and anaphylactoid purpura. Anaphylactoid purpura is the same as Henoch-Schoenlein purpura.[[3]] Our patient had hemorrhagic vesicles from the onset without petechiae, constitutional, or systemic features, as reported in febrile purpura. [Extracted from the article]

Annular elastolytic giant cell granuloma initially described by O'Brien in 1975 is a disorder of uncertain etiopathogenesis presenting with annular erythematous plaques predominantly on the sun-exposed areas. Hisptopathologically, it is characterized by elastin degenration, multinucleate giant cells, and elastophagocytosis. The authors came across 10 such cases, which were managed with hydroxychloroquine resulting in complete resolution in 4-6 months. [ABSTRACT FROM AUTHOR]

Dear Editor, Langerhans cell histiocytosis (LCH) is a rare neoplastic disorder, characterized by proliferation of Langerhans cells. Langerhans cell histiocytosis (LCH): Guidelines for diagnosis, clinical work-up, and treatment for patients till the age of 18 years. [Extracted from the article]

Int J Dermatol 1993;32:508-11. 2 Ayhan E,Alabalik U,Avci Y. Dermoscopic evaluation of two patients with lupus miliaris disseminatus faciei. The dermoscopic findings of differentials have been discussed in [Table 1].{Table 1} Surprisingly, on detailed literature search we could come across a single case report focussing on dermoscopy in lupus miliaris disseminatus faciei. A 38- year-old male with fitzpatrick skin type IV presented with multiple, asymptomatic, reddish brown eruptions all over the face and ears that had evolved over a period of 3 months. [Extracted from the article]

Peripheral giant cell granuloma (PGCG) is a non-neoplastic, tumor-like reactive lesion occurring exclusively on gingiva/alveolar crest. It is thought to arise from the periodontal ligament or the periosteum. Clinically, it bears resemblance to pyogenic granuloma, peripheral ossifying fibroma and many other peripheral lesions seen in the oral cavity, thereby histopathology is mandatory for the diagnosis of this lesion. The lesion although being relatively common, but still carries a lot of ambiguity. The ambiguity is in terms of its etiology, growth potential, biological behavior (recurrence), histogenesis of its cells and its treatment. The entity further holds significance because of its notorious behavior and its high tendency to recur. The present paper describes recurrent PGCG with a comprehensive insight of the literature on its etiology, clinical, radiological, histological, ultrastructural and molecular aspects. Special attention is given on the histogenesis of cells and their types as also on the differential diagnosis and treatment of this lesion. [ABSTRACT FROM AUTHOR]

Purpose: The host tissue reaction to the xenogeneic bone substitute Bio-Oss™ (Geistlich Biomaterials, Wolhousen, Switzerland) was investigated focusing on the participating inflammatory cells and implantation bed vascularization. Materials and Methods: Bio-Oss™ was implanted subcutaneously into CD1 mice for up to 60 days and analyzed by means of specialized histological and histomorphometrical techniques after explantation. Results: Bio-Oss™ induced within the first 15 days an early high vascularization combined with a marked presence of multinucleated giant cells. The latter cells were associated mainly with the smaller sized granules within the implantation bed. Toward the end of the study the number of multinucleated giant cells decreased while the tissue reaction to the larger granules was mainly mononuclear. Conclusion: The results of the present study showed that smaller xenogeneic bone substitute granules induce multinucleated giant cells, whereas the larger-sized ones became integrated within the implantation bed by means of a mononuclear cell-triggered granulation tissue. Obviously, the presence of multinucleated giant cells within biomaterial implantation beds is not only related to the type of synthetic bone substitute material, but also to the granule size of the “natural-based” xenogeneic bone substitute material. [ABSTRACT FROM AUTHOR]

Cherubism is a self-limiting non-neoplastic autosomal dominant fibro-osseous disorder of the jaw usually found in children between 2-5 years of age. It occurs predominantly in boys and is characterized clinically by bilateral swelling of cheeks due to bony enlargement of the jaw that gives the patient a typical cherubic look. Cherubism may occur as solitary cases or in many members of family, often in multiple lesions. Radiographically the lesions appear as multilocular bilateral radiolucent areas. The present case report describes a 13-year-old female cherubic child with progressive swelling of cheeks. [ABSTRACT FROM AUTHOR]