Balloon cell malignant melanoma (BCMM) is a rare histologic variant of malignant melanoma, which is composed either predominantly or entirely of large clear or foamy cells. The incidence of balloon cell malignant melanoma is about 0.15% of all cutaneous malignant melanomas. Recently, we experienced a case of cutaneous balloon cell malignant melanoma in the right lower abdomen with right inguinal and both axillary lymph node metastasis in a 56-year-old man. The cutaneous lesion was 4.5 3.5 cm in size, a well-demarcated black nodular mass, involving abdominal skin and subcutaneous tissue. The tumor was histologically composed of two types of tumor cells: predominant clear cell and focal, pigmented spindle cell. The nodal lesion was composed entirely of clear cells. Both clear and spindle cells showed positive reaction for S-100 protein and HMB-45 on immunohistochemistry.
Abdomen ; Humans ; Immunohistochemistry ; Incidence ; Lymph Nodes ; Melanoma* ; Middle Aged ; Neoplasm Metastasis ; S100 Proteins ; Skin ; Subcutaneous Tissue

No abstract available.
Lymphangioma* ; Orbit*

Epithelioid smooth muscle tumor is relatively rare and potentially malignant, especially in retroperitoneum. Distinct criteria for malignancy still have not been clarified in this epithelioid variant arising in retroperitoneum. We report a deceptively benign-appearing epithelioid leiomyosarcoma in a 50-year-old female. She was admitted with abdominal discomfort and dysuria. Abdominal CT showed a well-demarcated, 10 10 cm sized, solid mass in retroperitoneum. Concomitant metastatic lesions were noted in right lung field. Surgical excision of retroperitoneal mass and right lung lobectomy were performed. The retroperitoneal mass showed yellowish-tan, well-delineated and lobulated appearance. Histologically, this tumor was composed of predominantly epithelioid, round to oval cells with distinct clear cytoplasm and slightly atypical nuclei. Mitosis was rare (0~1/50 HPF). Lung lesions were morphologically similar to that of retroperitoneum.
Cytoplasm ; Dysuria ; Female ; Humans ; Leiomyosarcoma* ; Lung ; Middle Aged ; Mitosis ; Smooth Muscle Tumor ; Tomography, X-Ray Computed

No abstract available.
Bandages* ; Gentian Violet* ; Gentiana* ; Methicillin-Resistant Staphylococcus aureus* ; Wounds and Injuries*

The outcome of endoscopic management of pancreatic fluid collections is dependent on the type of collection being treated. While pseudocysts have an excellent treatment response, the outcomes are modest for walled-off pancreatic necrosis. Recent advances in cross-sectional body imaging have enabled a more accurate distinction of pancreatic fluid collections, which, in turn, facilitates the correct triage of patients to receive the appropriate treatment. Newly described endoscopic techniques and the development of dedicated accessories have improved the clinical outcomes in walled-off pancreatic necrosis, with treatment success rates comparable to that of minimally invasive surgery. This review summarizes the key concepts and provides a concise update on the endoscopic management of pancreatic fluid collections.
Drainage ; Endosonography ; Humans ; Necrosis* ; Pancreatic Pseudocyst* ; Surgical Procedures, Minimally Invasive ; Triage

When performing endoscopic ultrasound-guided fine needle aspiration (EUS-FNA), identifying neoplasia in the setting of chronic pancreatitis can be technically challenging. The morphology of an ill-defined mass on sonography, presence of calcifications or intervening collaterals, reverberation from a biliary stent, low yield of tissue procurement, and interpretative errors in cytopathology can result in both false-negative and false-positive results. Although these challenges cannot be completely eliminated, elastography or contrast-enhanced imaging can aid in differentiating an inflammatory mass from a neoplasm. Also, performing more passes of FNA, procuring core biopsy material, performing rapid onsite evaluation, conducting ancillary pathology studies, and even repeating the procedure on a different day can aid in improving the diagnostic performance of EUS-FNA. This review provides a concise update and offers practical tips to improving the diagnostic yield of EUS-FNA when sampling solid pancreatic mass lesions in the setting of chronic pancreatitis.
Biopsy ; Biopsy, Fine-Needle ; Elasticity Imaging Techniques ; Endoscopic Ultrasound-Guided Fine Needle Aspiration* ; Endosonography ; Pancreatic Neoplasms ; Pancreatitis, Chronic* ; Pathology ; Stents ; Tissue and Organ Procurement

Anticardiolipin antibodies(ACA) were assayed by an enzyme-linked immunosorbent assay (ELISA) in 68 patients with Behçet's disease. Twenty seven (39.7 %) patients showed levels of ACA five standard deviations above the value of the control group. The frequency of ACA isotype IgM was found to be significantly increased in these patients. However, ACA was not found to have a significant association with clinical activity, thrombosis, positive Venereal Disease Research Laboratory(VDRL) test or antinuclear antibodies (ANA).
Antibodies, Anticardiolipin* ; Antibodies, Antinuclear ; Enzyme-Linked Immunosorbent Assay ; Humans ; Immunoglobulin M ; Sexually Transmitted Diseases ; Thrombosis

Endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) is routinely performed for establishing tissue diagnosis in patients with gastrointestinal tumors. The concept of delivering chemotherapy based on molecular markers and the ability to establish a reliable diagnosis in lieu of an onsite cytopathologist has fuelled the recent trend in procuring core tissue by means of EUS-guided fine needle biopsy. To overcome the technical limitations induced by the rigidity of the Trucut biopsy needle, a new ProCore needle with reverse bevel technology has been developed. Recent data suggests that the newly developed flexible 19 gauge needle can also procure core tissue and has easy maneuverability when navigating the transduodenal route. Irrespective of the needles being used, the best clinical outcomes can be attained only by practicing evidence-based techniques, procuring adequate quantity of sample for ancillary studies, and processing the specimens appropriately.
Biopsy ; Biopsy, Fine-Needle ; Endoscopic Ultrasound-Guided Fine Needle Aspiration ; Humans ; Needles

The conventional management of pancreatic fluid collections (PFCs) involves surgery or percutaneous drainage. While surgery is associated with significant complications and mortality, percutaneous drainage is associated with prolonged hospitalization and oftentimes the need for other adjunctive treatment measures. Therefore, the use of endoscopy to drain PFCs is becoming increasingly popular. Randomized trials have demonstrated that endoscopic ultrasound-guided drainage is superior to conventional endoscopy in terms of technical success and potentially decreases the rates of procedural complications. While transmural drainage is usually undertaken by deployment of plastic endoprosthesis, of late, fully covered self-expandable metal stents are being placed with increasing frequency. However, the benefits of this approach are unclear and require further validation in prospective trials.
Drainage ; Endoscopy ; Hospitalization ; Pancreatic Pseudocyst ; Plastics ; Stents