Publications by authors named "Makary R"

Malignant phyllodes tumors (MPTs) represent the most pernicious type of intralobular stromal proliferation known as a "fibroepithelial lesion" (FEL). They comprise a small fraction of breast malignancies and can present as either a pure MPT or sometimes include a heterologous component (liposarcoma, chondrosarcoma, osteosarcoma, or rhabdomyosarcoma). Of the fraction of MPTs that include heterologous components, very little about those with chondroblastic osteosarcomatous differentiation has been described in the literature.

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Benign cystic mesothelioma (BCM), also known as peritoneal inclusion cyst, is a benign mesothelial lined cystic lesion, nearly always described in the pelvis of adult females. The hepatic location of BCM is rarely reported in the literature. We report a case of hepatic benign cysts in a 65-year-old woman that was incidentally discovered by imaging studies 12 years ago as a small cyst.

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Article Synopsis
  • - PTLD, a rare but serious complication affecting about 5% of transplant patients, can be particularly difficult to diagnose when it presents as isolated central nervous system (CNS) lesions, as symptoms often mimic other conditions.
  • - This case study discusses a 72-year-old woman who developed severe headaches and confusion 11 years post-kidney transplant, leading to imaging that revealed abnormal brain swelling, which required surgery for further investigation.
  • - The diagnosis was confirmed as polymorphic type PTLD, highlighting the importance of monitoring immunosuppressive treatments and the need for prompt diagnosis to improve survival chances for affected patients.
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Dedifferentiated chondrosarcoma (DDCS) is a rare entity, constituting only 1-2% of all primary bone tumors, and has a dismal prognosis. Nearly two-thirds of the primary tumors of DDCSs are found in the appendicular skeleton, mostly involving the femur, humerus, and pelvis. DDCS of the small bones of the hand and foot are exceedingly rare with only four cases documented in the literature so far.

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Article Synopsis
  • * Complete surgical removal is difficult due to the tumor's invasive nature, often resulting in recurrence; hence, treatments typically include surgery, radiation therapies like Gamma knife, and ongoing hormone management.
  • * Recent advances in surgical techniques and radiation therapies, along with exploration of novel chemotherapy and immunotherapy options, are evolving the management strategies for CPs, improving outcomes while minimizing complications.
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The falx cerebelli is a small crescent fold of dura mater that is attached to the internal occipital crest and projects forward into the posterior cerebellar notch between the cerebellar hemispheres. We report a rare case of a 61-year-old female who presented with a 1-month history of headache and gait instability. Imaging findings were suggestive of a meningioma arising from the falx cerebelli.

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  • Mullerian adenosarcoma is a rare type of malignant uterine tumor characterized by both benign and malignant cells, and it can follow a history of pelvic irradiation.
  • The case discussed involves a 45-year-old woman who experienced post-menopausal bleeding and had a history of cervical cancer treatment, later diagnosed with adenosarcoma showing malignant features.
  • The patient faced a recurrence of the cancer three months later and ultimately passed away, emphasizing the need for further understanding of the relationship between radiation therapy and the development of such tumors.
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Purpose: Pathological examination of placenta is vital to understand the pathophysiology of adverse perinatal outcomes, prevention of recurring conditions in subsequent pregnancies and medico-legal risk assessment. The College of American Pathologists (CAP) has published a set of guidelines to help guide the submission of placentas to pathology. However, awareness and conformity to these guidelines are not well established and vary from one institution to the other.

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  • Recent claims suggested that cystoisospora organisms were found in the gallbladder mucosa of healthy patients, but this was later disproven through advanced molecular and ultrastructural research.
  • The text provides a summary of the events surrounding the initial false epidemic of pseudo-Cystoisospora, outlining how it started and concluded.
  • It emphasizes the significant role of additional diagnostic techniques in confirming the identification of pathogens alongside traditional morphological methods.
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Metastasis to the pituitary gland is extremely rare (∼2% of sellar masses). Clinical, biochemical, and radiologic characteristics of pituitary metastasis are poorly defined and can be difficult to diagnose before surgery. We present an unusual case with pituitary metastasis as the first manifestation of renal cell carcinoma (RCC).

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Article Synopsis
  • Before cART, HIVAN led to rapid kidney failure and high mortality rates among patients, often due to linked complications.
  • While it's known that cART improves outcomes for HIVAN, there haven't been randomized trials to specifically confirm this benefit.
  • A specific case highlighted a 44-year-old Latino male with HIVAN who stopped needing dialysis within 7 months after starting cART.
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Background: Crocodile tears syndrome, also known as Bogorad syndrome, is characterized by lacrimation secondary to olfactory and gustatory stimuli and mastication. Crocodile tear syndrome is typically encountered as an uncommon complication of Bell's palsy and usually occurs during the recovery phase of the disease course.

Case Description: We present a case of a 39-year-old male who presented with facial paralysis with ipsilateral crocodile tear syndrome caused by a slow flow venous malformation of the petrous bone and facial nerve.

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  • A 52-year-old man was hospitalized due to persistent diarrhea and weakness in his legs for 3 months.
  • He was diagnosed with multiple myeloma and amyloidosis after tests revealed malabsorption, anemia, kidney issues, and amyloid deposits.
  • During his stay, doctors discovered he had rare hypoglycemia caused by anti-insulin antibodies from his cancerous plasma cells.
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Background: Venous invasion (VI) is not frequently evaluated on routine histologic examination of head and neck squamous cell carcinoma (HNSCC), and the prognostic significance is largely unknown. Studies have shown that extramural venous invasion is an adverse prognostic factor in colorectal carcinoma. To our knowledge, this is the first study evaluating the prognostic significance of venous invasion in node-negative (without clinical or pathologic evidence of lymph node involvement) HNSCC, utilizing the elastic stain.

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Objectives: There is recently reported increased prevalence of Isospora organisms in cholecystectomy specimens from immunocompetent patients, especially in acalculous cholecystectomies. We performed an ultrastructural and molecular evaluation of these specimens.

Methods: From 28 gallbladders with intraepithelial inclusions, two specimens with diffuse involvement of the gallbladder epithelium were analyzed by electron microscopy.

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An elderly female patient presented to the clinic with a several-week history of a mass in her left upper arm that was tender to the touch. The mass was initially thought to be a schwannoma of the left radial nerve based on imaging and was surgically removed. The pathology report revealed an uncommon diagnosis of desmoplastic fibroblastoma.

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Head and neck sarcomas are rare but are associated with significant morbidity/mortality and management difficulties. These tumors are best managed in a multidisciplinary setting. Open or core biopsy is essential for histologic diagnosis and grading.

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Sarcoidosis is a chronic and systemic disorder characterized by the formation of non-caseating granulomas. Very few cases of isolated gastrointestinal sarcoidosis have been reported, and even fewer, if any, report gastrointestinal sarcoidosis within multiple gastrointestinal sites concomitantly. We present a 42-year-old white man with chronic diarrhea and abdominal pain for more than 3 years.

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We report the case of a 22-year-old African American female who presented to another facility for routine follow-up in the 34th week of pregnancy with lower extremity swelling and nephrotic-range proteinuria. Although she was normotensive, it was initially thought that she had preeclampsia. She was monitored carefully and delivery was induced at 37 weeks of gestation.

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Eosinophilic polymyositis (EPM) is part of a rare disorder, eosinophilic myopathies (EM), which is a form of polymyositis characterized by the presence of eosinophils in muscle biopsy sections and occasionally blood eosinophilia. Herein, we are presenting an interesting case of eosinophilic polymyositis presenting with muscle pain with no other organ systems involved.

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Antineutrophil cytoplasmic antibody (ANCA) associated vasculitis rarely affects females of reproductive age. A 28-year-old African American woman presented at 8 weeks of gestation with intractable vomiting attributed to hyperemesis gravidarum. She was found to have acute kidney injury that was unresponsive to vigorous fluid resuscitation and urine sediment examination was suggestive of an underlying glomerulonephritis.

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Introduction. The most commonly seen glomerular disease in HIV infected patients is HIV-associated nephropathy (HIVAN); however, a multitude of other nephropathies can occur in HIV infection with an almost equal cumulative frequency. We report an unusual case of a patient with clinical and histological evidence of HIVAN in which the diagnosis was initially confounded by the finding of an elevated serum anti-glomerular basement membrane (anti-GBM) antibody.

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