bromochloroacetic-acid and Hemangioma--Capillary

Solitary pulmonary capillary hemangioma (SPCH) is a rare lung tumor typically presenting as pure or part-solid ground-glass nodules (GGNs) on computed tomography (CT), which clinically resembles early lung cancer.. In addition to 10 recently diagnosed patients with SPCH, 71 benign lung nodules that were surgically resected between January 2013 and December 2017 were reviewed by thoracic pathologists to identify any previously unrecognized SPCH cases. Finally, 6 tumors (8.5%; 6/71) were determined to be SPCH. Elastic fiber stain (orcein stain) as well as immunohistochemistry for cytokeratin, CD31, and thyroid transcription factor 1 were performed for confirmation. Clinical and radiological data were analyzed.. All 16 SPCH lesions were unrecognized or misdiagnosed by general pathologists. The SPCH ranged in size from 3 to 15 mm, and a predominance among women (68.8%; 11/16) was noted. Pathologically, all SPCH lesions were nodular with a higher vascular density than the adjacent lung tissue. Decreased cytokeratin staining and disrupted elastic fibers were clearly observed in all SPCH lesions.. SPCH lesions mimic early lung cancer on CT; they are largely unrecognized by general pathologists and are diagnosed as other nonspecific benign lesions. With careful histologic examination, SPCH can be successfully diagnosed using cytokeratin/CD31 immunohistochemistry and elastic fiber staining.

Topics: Adult; Aged; Diagnosis, Differential; Diagnostic Errors; Elastic Tissue; Female; Hemangioma, Capillary; Humans; Keratins; Lung; Lung Neoplasms; Male; Middle Aged; Sex Factors; Solitary Pulmonary Nodule; Tomography, X-Ray Computed; Tumor Burden

The literature describes a number of vascular alterations in the thyroid gland and its tumors, the majority of which are related to fine-needle aspiration (FNA). These alterations include pseudoangiosarcomatous changes (Masson's lesion), pseudoinvasion in capsular veins, and endothelial proliferations in the needle tract. We present three cases of a unique intravascular endothelial proliferation in the capsular vessels of follicular and/or Hürthle cell thyroid neoplasms (two angioinvasive Hürthle cell carcinomas and one angioinvasive follicular carcinoma), which we think is unrelated to FNA. The lesion consists of spindle cells with plump nuclei, with focal nesting imparting an epithelioid pattern to the lesion. Focally red blood cells percolate between and mix with the spindle cells, recapitulating superficially a Kaposi's like appearance, but we identified no mitotic figures. Only one patient had a preoperative FNA; in that case, the lesions were spatially separate from the needle tract and the usual post-FNA reactive changes. The lesional cells were positive for Factor VIII and CD 31 and negative for cytokeratins and thyroglobulin immunostains. This immunopanel was helpful in distinguishing these lesions from true angioinvasion by thyroid tumor. To date, the etiology of these vascular lesions is unknown, but we postulate that certain follicular-derived thyroid tumors might elaborate angiogenic mediators, which in a cell culture system of follicular thyroid carcinoma can trigger endothelial proliferations.

Topics: Adenocarcinoma, Follicular; Adult; Biomarkers, Tumor; Biopsy, Needle; Endothelium, Vascular; Factor VIII; Female; Hemangioma, Capillary; Humans; Immunoenzyme Techniques; Keratins; Male; Platelet Endothelial Cell Adhesion Molecule-1; Thyroglobulin; Thyroid Neoplasms