Expanding your gay and lesbian patient base: what savvy medical practices know.

Many medical practices are looking at options to reach out to the gay, lesbian, bisexual, and transgender community as a means of expanding business and improving quality of care. This article sets out steps that any practice can take to market to this community and improve its cultural competence.

Morphological characterization of the breast in Proteus syndrome complicated by ductal carcinoma in situ.

Proteus syndrome (PS) is a severe, variable, and rare disorder with asymmetric and disproportionate overgrowth of body parts, cerebriform connective tissue nevi, epidermal nevi, dysregulated adipose tissue, and vascular malformations. It is associated with benign and occasionally malignant tumors. We report the first case of ductal carcinoma in situ (DCIS) in a 28-yr-old woman with PS who underwent a mastectomy for asymmetric overgrowth.

Umbilical cord stricture and overcoiling are common causes of fetal demise.

Although umbilical cord stricture and umbilical cord overcoiling have been established as causes of intrauterine fetal demise, relatively few studies addressed this issue, most of them being case reports. We reviewed a total of 268 fetal autopsies during a 3-year period from 1998 to 2001. One hundred thirty nine cases of fetal demise including spontaneous abortion were identified.

Risk factors for carcinoma of the pelvic ileal pouch/anal canal in ulcerative colitis.

Patients with ulcerative colitis who undergo proctocolectomy and an ileal anal anastomosis (IPAA) require surveillance; dysplasia and carcinoma occur in both the small intestinal mucosa of the ileal pouch and the retained rectal mucosa as early as 2 yr after ileostomy closure. This study evaluated risk factors for carcinoma (eg, dysplasia, p53 overexpression, labeling index, and aneuploidy) in the small intestinal and rectal mucosa. Thirty patients (age 14-64 yr) with ulcerative colitis and IPAA were studied.

Inlet patch: prevalence, histologic type, and association with esophagitis, Barrett esophagus, and antritis.

Context: Inlet patch is a congenital anomaly of the cervical esophagus consisting of gastric mucosa. Case reports have documented the histologic type and its associated complications.

Objective: To report the prevalence and histologic types of inlet patch as well as its association with Barrett esophagus and Helicobacter pylori-associated gastritis.

Biliary atresia revisited.

Extrahepatic biliary atresia (EHBA) is an inflammatory fibrosing process affecting the extrahepatic and intrahepatic biliary tree resulting in fibrous obliteration of the extrahepatic biliary tract, ductopenia of intrahepatic bile ducts, and biliary cirrhosis. EHBA is divided into a correctable and a noncorrectable type with focal patency of the otherwise atretic biliary tree in the former and no patency of the biliary tree in the noncorrectable type. EHBA is divided in a fetal, prenatal or embryonic, and a more common, perinatal, acquired form.

Mature cystic teratoma of the ovary associated with complete colonic wall and mucinous cystadenoma.

Mature cystic teratomas of the ovary frequently contain intestinal type epithelium, but they are rarely associated with complete intestinal wall. The association of mature cystic teratoma with mucinous cystadenoma is not unusual. However, the pathogenetic relationship between these two lesions remains unanswered.

Malignant rhabdoid tumor of the kidney in an adult: a case report and review of the literature.

Malignant rhabdoid tumor of the kidney is an uncommon renal tumor in children. The tumor has aggressive behavior and a poor prognosis and is extremely rare in adults; only 3 cases of renal rhabdoid tumors have been reported in adults. We describe here the microscopic, immunohistochemical, and electron microscopic characteristics of another case in a 38-year-old woman.

Unusual hepatic tumor with features of mesenchymal hamartoma and congenital solitary nonparasitic cyst.

We report a hepatic tumor in an adolescent that does not fit into any of the described categories of liver tumors. The patient presented with hepatomegaly, abdominal pain, and normal liver function test; the tumor was cystic in imaging studies. The resected specimen, result of a partial hepatectomy, measured 21 cm and was multicystic with solid areas.

Combined adenocarcinoma and carcinoid tumor in atrophic gastritis.

The development of adenocarcinoma or carcinoid tumors in atrophic gastritis is widely documented. We report the simultaneous occurrence of gastric adenocarcinoma and carcinoid (composite tumor) in atrophic gastritis, a finding reported only twice before in the literature. This 52-yr-old man with rectal bleeding, epigastric pain, and iron deficiency anemia was noted to have multiple polypoid masses on upper endoscopy.

Atypical morphologic presentation of biliary atresia and value of serial liver biopsies.

Background: Liver biopsy findings are important in diagnosing extrahepatic biliary atresia. Diffuse ductular proliferation is a characteristic finding. We describe four patients with conjugated hyperbilirubinemia in whom the initial liver biopsy findings showed a lack of ductular proliferation, despite subsequent development of biliary atresia.