Search

Aspergillus fumigatus endocarditis is one of the rarest and severest complications in cardiological patients. We describe a patient with an intracardial pacemaker who was diagnosed as having Aspergillus fumigatus endocarditis. Postmortem examination showed a large, Aspergillus-infected thrombus encased in the right ventricle, pulmonary trunk and main pulmonary branches.

Carcinoma is a rare but recognized complication of pharyngoesophageal diverticulum. We report the case of a 49-year-old man operated for a Zenker's diverticulum with an epidermoid carcinoma arising in the diverticulum. Since carcinoma is an uncommon complication of this pathology, we review the literature and discuss the therapeutic options.

The coexistence of a pancreatic papillary cystic tumor with hairy cell leukemia is reported. To the best of our knowledge this association has never been published. A 41-year-old man diagnosed with hairy cell leukemia developed a second malignancy that corresponded to a papillary cystic pancreatic tumor. The patient underwent splenectomy and a tumoral surgical resection, and is currently well at 21 months follow-up. A pathogenetic relationship between the two malignancies was not demonstrated. Hairy cell leukemia has been reported to be associated to a great number of different second malignancies. In contrast, only two papillary cystic tumors of the pancreas have been described associated to a second neoplasm, a papillary thyroid carcinoma and a colonic carcinoma. This unusual benign or low-grade malignant pancreatic tumor more commonly occurs in the tail of the pancreas of young women. We want to stress the unusual presentation of this pancreatic tumor affecting the head of the gland in a male patient as well as its coexistence with a hairy cell leukemia.

Perianal basal cell carcinoma is a very rare tumor accounting for only 0.2% of the anorectal tumors. It must be distinguished from basaloid carcinoma of the anus, which resembles it histologically but shows a much more aggressive behavior, metastasizes early, and often proves fatal, thus requiring different therapy. Differential diagnosis of both entities by light microscopy may be difficult. Five cases of perianal basal cell carcinoma and five cases of basaloid carcinoma were studied by means of immunohistochemistry and flow cytometry. Some immunohistochemical markers, such as epithelial membrane antigen, carcinoembrionic antigen, and keratins, as well as the lectin Ulex europaeus agglutinin I stained basaloid carcinoma and were negative for basal cell carcinoma. In contrast, the monoclonal antibody Ber-EP4 seems to be a good marker for perianal basal cell carcinoma and useful in differentiating it from basaloid carcinoma of the anus. Basaloid carcinomas are associated with a significantly higher S-phase fraction than are perianal basal cell carcinomas (p < 0.01).

A case of chondroid lipoma located in the submandibular region of a 21-year-old man is presented. On macroscopic evaluation the tumor was lobulated and quite yellow. Microscopic examination showed that this tumor was composed of mature adipose tissue and eosinophilic cells. The eosinophilic cells displayed single or multiple vacuoles and resembled lipoblast or hibernoma-like cells. These were set in a myxoid or chondromyxoid stroma. Most cells reacted with antibodies directed against vimentin and neuron-specific enolase. Focal weak positivity for S-100 protein was noted. Principal considerations in the histopathologic differential diagnosis included hibernoma, myxoid liposarcoma, and extraskeletal myxoid chondrosarcoma (chordoid sarcoma).

We present a rare case of parotid gland carcinosarcoma that occurred in an 86-year-old woman. Clinical and histologic data revealed it had developed from a preexisting pleomorphic adenoma. Microscopic examination showed a neoplasm comprised of sarcomatous elements, mainly fibrosarcoma, intermingled with salivary duct-type carcinoma. Sarcomatous cells, excluding those that show chondrosarcomatous differentiation, reacted positively with antibodies directed against vimentin. Carcinomatous cells were positive for epithelial membrane antigen and keratin and negative for myoepithelial markers, which suggest an origin from salivary duct cells. This tumor seemed to consist of two histogenetically different populations of cells without evidence of a common origin from the myoepithelial cell. We also review the literature and discuss the histogenetic origin of true carcinosarcoma of salivary gland.