Acral Papulovesicular Eruption in a Soldier Following Smallpox Vaccination.

Smallpox vaccination is associated with several potential cutaneous adverse reactions, ranging from benign self-limited hypersensitivity reactions to life-threatening eczema vaccinatum and progressive vaccinia. Acral papulovesicular eruption is a distinct presentation that has been described in US Military service members following vaccination with the second-generation smallpox vaccine (ACAM2000, Sanofi Pasteur Biologics Co). We describe a case of this unique cutaneous eruption and review previously described cutaneous adverse events associated with smallpox vaccination.

Cutaneous Leishmaniasis in a Saudi Arabian Soldier Stationed in the United States.

Background: Leishmaniasis is a common parasitic disease seen in many parts of the world, especially in areas where current U.S. and international forces are deployed.

Aleukemic Myeloid Leukemia Cutis with a Kikuchi Disease-Like Inflammatory Pattern in Myelodysplastic Syndrome.

Myeloid leukemia cutis (MLC) is a rare disease characterized by the infiltration of neoplastic myeloid, myelomonocytic, or monocytic precursors into the skin, producing clinically nonspecific-appearing papules, nodules, plaques, or purpura that necessitate biopsy for definitive diagnosis. In general, it is considered an extramedullary manifestation of acute myeloid leukemia (AML) similar to myeloid sarcoma, also known as a chloroma. MLC often develops in patients with an established diagnosis of AML and is only rarely seen before the onset of systemic disease.

Primary intra-renal desmoplastic small round cell tumor: expanding the histologic spectrum, with special emphasis on the differential diagnostic considerations.

Intra-abdominal desmoplastic small round cell tumor (DSRCT) is a rare, aggressive tumor affecting adolescent and young males. DSRCT presenting as a primary renal mass in the absence of visceral or serosal involvement is extremely rare. Herein, we present the pathologic and molecular findings in the case of a young man who presented with a large renal mass without any visceral or serosal involvement.

Re-examination of features to distinguish polyarteritis nodosa from superficial thrombophlebitis.

The correct identification of vessel type is crucial in distinguishing cutaneous polyarteritis nodosa from superficial thrombophlebitis. As the treatment and prognosis of these conditions are very different, correct diagnosis is critical, but they have overlapping clinical and histopathologic features, which can sometimes make the distinction difficult. Features commonly used to distinguish an artery from vein include vessel shape and diameter, the presence or absence of an internal elastic lamina, smooth muscle pattern, and the presence or absence of valves.

Gastroduodenal Cryptococcus in an AIDS Patient Presenting With Melena.

Gastrointestinal cryptococcosis is extremely rare with only a few case reports found in the literature and involvement primarily identified post-mortem. This is a case of 54-year-old man with a 20-year history of poorly controlled human immunodeficiency virus presented with constitutional symptoms along with melena. Diagnostic work up with esophagogastroduodenoscopy showed 4 irregular ulcers in the stomach notable for red-pigmented lesions within the ulcers, erythematous mucosa in the antrum and patchy friable mucosa in the duodenum.

Smooth muscle pattern is more reliable than the presence or absence of an internal elastic lamina in distinguishing an artery from a vein.

Background: Major pathology textbooks suggest that the shape of the vessel and the presence or absence of an internal elastic lamina are the best means to distinguish an artery from a vein. Because the shape of the vessel is highly dependent upon the plane of section, the internal elastic lamina is often cited as a more reliable criterion. After evaluating a patient with superficial thrombophlebitis, in whom these conventional criteria had led to a misdiagnosis of polyarteritis nodosa, we sought to determine whether the pattern of smooth muscle in the media is a more sensitive discriminator between an artery and a vein.

Safety of band ligator use in the small bowel and the colon.

Background: Endoscopic band ligation for bleeding small-bowel vascular lesions has been reported as safe and efficacious based on small case series. There have been several other published case reports of band ligators used for bleeding lesions, usually Dieulafoy's lesions, in the stomach, the proximal small bowel, and the colon. In addition, this method has been used for postpolypectomy bleeding stalks.

A comparison of vertical versus transverse sections in the evaluation of alopecia biopsy specimens.

Background: Both vertical and transverse sections are used in the histologic interpretation of alopecia biopsy specimens. Although a combination of the two may be optimal, the pathologist is frequently only provided with a single specimen. Even though the trend in recent years has been toward transverse sections in this setting, we are not aware of any published data directly comparing the two methods.

The accuracy of the report of hepatic steatosis on ultrasonography in patients infected with hepatitis C in a clinical setting: a retrospective observational study.

Background: Steatosis is occasionally reported during screening ultrasonography in patients with hepatitis C virus (HCV). We conducted a retrospective observational study to assess the factors associated with steatosis on ultrasonography and the relationship between steatosis on ultrasound versus biopsy in patients infected with HCV in a clinical setting. Our hypothesis was ultrasonography would perform poorly for the detection of steatosis outside of the context of a controlled study, primarily due to false-positive results caused by hepatic fibrosis and inflammation.

Atypical junctional melanocytic proliferations in benign lichenoid keratosis.

Melanocytic lesions with lichenoid regression may mimic a benign lichenoid keratosis (BLK) histologically. A total of 336 BLKs were reviewed and deeper sections obtained to determine the frequency of this phenomenon. Two cases (0.