Coexistence of Malakoplakia and Papillary Urothelial Carcinoma of the Urinary Bladder.

Malakoplakia is a rare granulomatous disease that commonly involves the genitourinary tract, with the urinary bladder being the most frequently affected site. Grossly, malakoplakia can present as soft yellow plaques, nodules, bladder mass, or even without any visible lesion. In this article, we present a 74-year-old female with a background of hypertension, hyperlipidemia, and poorly controlled diabetes who presented with sepsis of unknown origin.

PlasmaKinetic™ (bipolar) transurethral resection of prostate: a prospective trial to study pathological artefacts, surgical parameters and clinical outcomes.

Introduction: The aims of the study were to compare the degree of cautery artefacts in prostatic chips between monopolar and PlasmaKinetic™ transurethral resection of prostate (TURP), and to determine if there is any difference in the intraoperative and post surgical parameters between them.

Methods: After institutional review board approval, patients were prospectively enrolled to undergo PlasmaKinetic™ TURP. Their parameters were compared with those of the historical monopolar TURP controls.

'Prechronous' metastasis in clear cell renal cell carcinoma: a case report.

Introduction: Although metastatic carcinoma in the presence of an occult primary tumor is well recognized, underlying reasons for the failure of the primary tumor to manifest are uncertain. Explanations for this phenomenon have ranged from spontaneous regression of the primary tumor to early metastasis of the primary tumor before manifestation of a less aggressive primary tumor. We report a case of 'prechronous' metastasis arising from clear cell renal cell carcinoma, where metastatic disease initially manifested in the absence of a primary renal tumor, followed by aggressive growth of the primary renal lesion.

Clinical application of fluorescence endoscopic imaging using hypericin for the diagnosis of human oral cavity lesions.

Background: Diagnosis of oral cancer is conventionally carried out using white light endoscopy and histopathology of biopsy samples. However, oral tumours are mostly superficial and the lesion and its margins can be difficult to visualise under white light. We present clinical data on fluorescence diagnostic imaging of oral lesions using hypericin, a plant-based photosensitiser.

EUS-FNA of the left adrenal gland is safe and useful.

Introduction: There are limited data on the use of endosonography-guided fine-needle aspiration (EUS-FNA) to determine the nature of left adrenal lesions. We described our experience in performing EUS-FNA of left adrenal lesions.

Clinical Picture: During a 20-week period, data on consecutive patients who underwent EUS with or without EUS-FNA were prospectively captured.

Laser confocal endomicroscopy as a novel technique for fluorescence diagnostic imaging of the oral cavity.

Malignancies of the oral cavity are conventionally diagnosed by white light endoscopy, biopsy, and histopathology. However, it is often difficult to distinguish between benign and premalignant or early lesions. A laser confocal endomicroscope (LCE) offers noninvasive, in vivo surface and subsurface fluorescence imaging of tissue.

Metastatic malignant phaeochromocytoma: A rare entity that underlies a therapeutic quandary.

Phaeochromocytoma is a rare condition that provides a diagnostic challenge as a result of its variable presentation. Treatment of metastatic malignant phaeochromocytoma is also not well defined owing to its rarity. We present four such cases and a review of the literature.

Cutaneous melioidosis.

Melioidosis is an infection caused by the gram-negative bacterium Burkholderia pseudomallei. This disease is endemic in Southeast Asia and North Australia with sporadic occurrence in temperate countries, mostly imported from travellers. Any organ can be involved in melioidosis whereby Burkholderia pseudomallei causes an acute inflammatory reaction with rapid development of small abcesses which tend to coalesce to form larger abscesses.

Clinical mimicry of hepatocellular carcinoma: imaging-pathological correlation.

This pictorial essay aims to show the clinical mimicry of hepatocellular carcinoma (HCC) and its diagnostic difficulty, and to create awareness among clinicians and radiologists of potential diagnostic pitfalls. A selected consecutive series of hepatectomies with proven HCC over a three-year period, identifying clinical presentation, blood results and imaging of patients with difficult preoperative diagnosis, was reviewed. The imaging of the focal liver lesions is presented pictorially with pathological correlation.

Primary cardiac paraganglioma.

We report a case of a 29-year-old male, who during workup of hypertension was found to have a malignant primary paraganglioma of the heart. The tumor arose from the site of the aortopulmonary window and right ventricular outflow tract (RVOT) and was removed with the aid of cardiopulmonary bypass. Reconstruction of the RVOT and pulmonary valve was necessary because of involvement by the tumor.

A case of metastatic squamous cell carcinoma of the hypopharynx manifesting as acute abdomen.

Introduction: Squamous cell head and neck cancers are usually confined to local and regional sites but occasionally, patients may present with rare manifestations of distant metastases.

Clinical Picture: A 23-year-old female was treated with concurrent chemo-radiotherapy for stage IVA post-cricoid squamous cell carcinoma. A month later, she presented with acute abdomen and was found to have extensive peritoneal nodules at laparotomy.

Primary acinic cell carcinoma of the lung with lymph node metastasis.

We report the case of a 30-year-old woman who presented with a subpleural mass in the lower lobe of the right lung, which was found incidentally on a routine chest radiograph. A wedge biopsy followed by lobectomy and lymph node staging revealed an acinic cell carcinoma with involvement of a hilar lymph node. The subcarinal and mediastinal lymph nodes were free of tumor.

Multicentricity in papillary thyroid carcinoma: analysis of predictive factors.

Objectives: Multicentricity has been cited as a rationale for total thyroidectomy in patients with papillary thyroid carcinoma (PTC) confined to one lobe. The purpose of this study was to examine the incidence of multicentricity of PTC in a cohort of 165 patients with PTC confined to one lobe and to examine clinical and pathologic features that may help predict for the presence of contralateral disease.

Design: Retrospective review.

Abnormalities of the ARF-p53 pathway in oral squamous cell carcinoma.

Oral squamous cell carcinoma (OSCC) is associated with heavy smoking and drinking, but the molecular pathway of tumorigenesis is not understood. Inactivation of the p53 tumor suppressor gene is likely to play an important role since p53 mutation is frequently found. The p14ARF tumor suppressor gene is functionally linked to p53, because it is activated by oncogenes and causes p53-dependent growth arrest and apoptosis.

Amelioration of disease severity by intraarticular hylan therapy in bilateral canine osteoarthritis.

Because of its high molecular weight, the glycosaminoglycan molecule hyaluronan is responsible for the viscoelastic properties of normal synovial fluid. In osteoarthritis, the concentration and molecular weight of hyaluronan in synovial fluid is diminished: this impairs the ability of synovial fluid to effectively lubricate joints, absorb loads, and exert anti-inflammatory effects. Using a bilateral anterior cruciate-ligament transection and partial neurectomy canine model of osteoarthritis, this study examined the effect of viscosupplementation with hylan G-F 20 as a treatment for osteoarthritis.

A central giant cell granuloma influenced by pregnancy.

A case of a 17-year-old patient with exacerbation of a central giant cell granuloma of the mandible during pregnancy is reported. The possible relationship of the giant cell lesion to a pre-existing fibrous dysplasia is considered although there was lack of histological evidence.

Pediatric malignant ovarian tumors: a 43-year review.

Thirty-eight girls with malignant ovarian tumors were reviewed and studied during a 43-year period, 1945 to 1988 inclusive. The age range was 3 to 16 years. Eighteen girls were prepubertal and 16 were pubertal at diagnosis.

Acinic cell tumour: a metastasis in the lung diagnosed by electron microscopy of aspirated material.

A case of acinic cell carcinoma, metastatic to lung is presented. Fine needle aspiration showed a low-grade adenocarcinoma. Electron microscopy of the aspirated material, however, allowed definite preoperative diagnosis of metastatic acinic cell carcinoma.