Intraosseous glomus tumor of the fibula

Glomus tumor is a rare, benign vascular tumor and intraosseous glomus tumor, which arises primarily within bone, is even rarer. Fewer than 20 cases have been reported in the literature. We present the case of a 34-year-old woman with glomus tumor primarily in the midshaft of the fibula that radiologically mimicked chondromyxoid fibroma, aneurysmal bone cyst or adamantinoma, together with a review of other reported cases. Received: 5 July 2000 Revision requested: 10 August 2000 Revision received: 28 August 2000 Accepted: 28 August 2000     

几种特殊类型的脂肪肿瘤

对21例特殊类型的脂肪瘤进行了病理和免疫组织化学分析，这些肿瘤包括核形细胞脂肪瘤、脂肪母细胞性脂肪瘤、浸润性脂肪瘤和多形性脂肪瘤。在日常工作中很难将这些肿瘤与脂肪肉瘤鉴别。本文报到的肿瘤常发生在身体的浅表部位．肿瘤生长缓慢，常有包膜，镜下可见脂肪母细胞和成熟的脂肪细胞，无病理性核分裂和毛细血管网，免疫组织化学检查提示；Vimentin（＋），Desmin（－），Lysozyme（-），S－100（-）。     

Proliferative Activity of Adipocytes in Adipose Tissue Tumors

Electron-autoradiographic study of normal and tumor-transformed adipose tissue (common lipoma and destructive lipoma, i.e. infiltrating and degrading lipoma) showed the capacity of adipose tissue cells in lipomas, especially in destructive lipomas, to proliferation and differentiation. In vivo synthesis of DNA in mature adipocytes not observed previously is described. The role of microvascular wall cells as mesenchymal multipotent precursors in the formation of the adipose tissue is discussed. The involvement of the bone marrow mesenchymal stem cell in this process cannot be ruled out. __________ Translated from Kletochnye Tekhnologii v Biologii i Meditsine, No. 3, pp. 140–145, September, 2005     

舌及会厌非典型性脂肪瘤2例并文献复习

目的 探讨非典型性脂肪瘤的临床病理特征。方法 对舌及会厌2例非典型性脂肪瘤进行临床、病理组织学和免疫组织化学观察，并结合文献探讨其临床表现、病理形态及鉴别诊断。结果 在口腔喉咽部位脂肪肉瘤中，舌为好发部位，最多见的亚型为分化型脂肪肉瘤(即非典型性脂肪瘤)，肿瘤呈无症状性缓慢增大，肉眼有者边界清楚，或呈息肉样外观，有者呈浸润性生长；镜下可见不典型的脂肪细胞和脂肪母细胞，散在于成熟的脂肪细胞间，或集中在脂肪组织小叶的纤维间隔内。瘤细胞可呈星芒状、小梭形、印戒样及具有空泡状核有切迹的脂肪母细胞。免疫表型：肿瘤细胞呈vimentin( )、S-100蛋白( )、MSA(-)、NF(-)。结论 口腔喉咽部位的非典型性脂肪瘤是一种罕见的分化良好型脂肪肉瘤，一般不转移，仅见局部复发，预后好，但其易与脂肪瘤、神经纤维瘤等混淆，应注意鉴别。     

Bilateral lipoma arborescens of the subdeltoid bursa

Lipoma arborescens is a rare cause of chronic monoarticular arthritis. It is most commonly seen in the knees, but only a few cases involving other joints, especially the subdeltoid bursa, have been described. To our knowledge, this is the first reported case of lipoma arborescens involving bilateral subdeltoid bursae. Although it is associated with joint effusion, synovial cysts and erosions, the presence of reactive bone formation has not been reported. Magnetic resonance imaging is a very effective method for the diagnosis of this rare condition because of its ability to do tissue characterization.     

Incremental Value of Live/Real Time Three-Dimensional Transthoracic Echocardiography in the Assessment of Right Ventricular Masses

This case series demonstrates the incremental value of three-dimensional transthoracic echocardiography (3D TTE) over two-dimensional transthoracic echocardiography (2D TTE) in the assessment of 11 patients with right ventricular (RV) masses or mass-like lesions (three cases of RV thrombus, one myxoma, one fibroma, one lipoma, one chordoma, and one sarcoma and three cases of RV noncompaction, which are considered to be mass-like in nature). 3D TTE was of incremental value in the assessment of these masses in that 3D TTE has the capacity to section the mass and view it from multiple angles, giving the examiner a more comprehensive assessment of the mass. This was particularly helpful in the cases of thrombi, as the presence of echolucencies indicated clot lysis. In addition, certainty in the number of thrombi present was an advantage of 3D TTE. Also, sectioning of cardiac tumors allowed more confidence in narrowing the differential diagnosis of the etiology of the mass. In addition, 3D TTE allowed us to identify precise location of the attachments of the masses as well as to determine whether there were mobile components to the mass. Another noteworthy advantage of 3D TTE was that the volumes of the masses could be calculated. Additionally, the findings by 3D TTE correlated well with pathologic examination of RV tumors, and some of the masses measured larger by 3D TTE than by 2D TTE, which was also validated in one case by surgery. As in the case of RV fibroma, another advantage was that 3D TTE actually identified more masses than 2D TTE. RV noncompaction was also well studied, and the assessment with 3D TTE helped to give a more definitive diagnosis in these patients.     

Cutaneous lesions associated to multiple endocrine neoplasia syndrome type 1

Background  Multiple endocrine neoplasia type 1 (MEN1) is a genetic disease that predisposes to endocrine tumour development. Some cutaneous lesions (angiofibromas, collagenomas, melanosis guttaca, lipomas, melanomas, 'cafe au lait macules') have been associated to this syndrome. We compare the prevalence of cutaneous lesion in affected patients with their non-carrier relatives.
Patients and method  We studied 9 patients with MEN1 and 20 non-carrier, first-degree relatives. Genetic screening was realized in all of them. Patients were examined by dermatologist, and biopsy was performed when necessary.
Results  Patients with MEN1 presented hyperparathyroidism (100%), neuroendocrine tumours of pancreas (66%) and pituitary adenomas (44%); their relatives were free of endocrine features of MEN1. The studied cutaneous lesions were more prevalent in affected patients than in non-carriers (55.5% vs. 25%; P  = 0.029). Odds ratio of developing cutaneous lesions in MEN1 patients was 6.6 (95% confidence interval, 1.09–40.43). The frequency of angiofibromas was lower (22.2%) than the reported in other studies (43–88%), and we did not find any collagenoma.
Conclusions  MEN1 is associated to some cutaneous lesions and could be useful for detecting MEN1 carriers in an affected family. Cutaneous lesions should be assessed in MEN1 patients.     

Appendicitis masquerading as tumor: a case of two diagnoses

Acute appendicitis remains one of the most difficult diagnoses to make in the Emergency Department. We present a puzzling and unusual case. A 47-year-old man had several hours of acute abdominal pain in the right upper quadrant, point tenderness in the right midquadrant on examination, and normal chemistries. Early appendicitis was suspected and a computed tomography (CT) scan of the abdomen was obtained. Appendicitis was not seen. What was evident was a retroperitoneal lipoma estimated to weigh 10 pounds. The general surgeon was consulted who believed that operation was necessary in light of the patient’s continuing abdominal pain and the presence of the mass. Masses this large could cause pain from local compression of structures, or ischemia of the mass from outgrowing its blood supply. In surgery, a lipoma was observed that filled most of the retroperitoneum and displaced all the contents of the abdomen, including the cecum and its appendix. Also present was an acute appendicitis. On retrospective analysis of the CT scan, the appendicitis was evident but atypically located in the epigastrium. This case illustrates once again that the CT scan is a useful diagnostic adjunct for the diagnosis of new onset abdominal pain and specifically for appendicitis.