Spindle cell lipoma, an entity first described in 1975, accounts for about 1.5% of adipocytic neoplasms and is outnumbered by conventional benign lipomas by approximately 60 to 1. We report an unusual pseudoangiomatous variant of spindle cell lipoma on the right thigh of a 78-year-old man. The lesion had the features of typical spindle cell lipoma which was composed of mature fat cells and uniform spindle cells in a mucoid matrix with collagen bundles. In addition, the lesion exhibited irregular, branching spaces with villiform connective tissue projections, giving a striking angiomatoid appearance. Immunohistochemically, the spindle cells were positive for CD34, and lining cells of pseudoangiomatous spaces were negative for CD31, factor VIII-Ag.
Adipocytes ; Aged ; Collagen ; Connective Tissue ; Humans ; Lipoma ; Strikes, Employee ; Thigh

BACKGROUND: Desmogleins are calcium-dependent transmembrane glycoproteins of the desmosome that form an import component of the junction complexes of epithelial cells. Desmogleins are involved in maintaining the structural integrity of tissues. So far, four different desmogleins (Dsg1, Dsg2, Dsg3 and Dsg4) have been identified. OBJECTIVE: The purpose of this study was to observe the distribution pattern of desmoglein-3 in the fetal skin during development. METHODS: Skin was obtained from the sole, scalp and lip of 34 fetuses that ranged in age from 10 to 39 weeks of gestational age. Immunohistochemical staining was performed on the paraffin embedded tissue using anti-human monoclonal antibody against the desmoglein-3. RESULTS: The expression of desmoglein-3 in the epidermis appeared in the basal layer of the sole at the 10th week of gestation age. Thereafter, a stronger expression was noted in the middle layer of the sole and scalp epidermis. The basal layer had a stronger expression than did the other layers of the epidermis, followed by the middle and superficial layers. A stronger expression of desmoglein-3 in hair was noted in the outer root sheath, the bulge cells and the eccrine duct cells. The expression of desmoglein-3 in the lip mucosa was strong in both the basal and middle layers, while the skin side of the mucosa showed a stronger expression in basal layer. CONCLUSION: These results suggested that desmoglein-3 plays an important role in the development and differentiation of the epidermis and skin adnexa in the fetal stage, and especially in basal and suprabasal layers.
Desmogleins ; Desmosomes ; Epidermis ; Epithelial Cells ; Fetus ; Gestational Age ; Glycoproteins ; Hair ; Lip ; Mucous Membrane ; Paraffin ; Pregnancy ; Scalp ; Skin

BACKGROUND AND OBJECTIVES: Pneumatization of air cells in the mastoid bone is decreased in chronic otitis media (COM). A decrease in the size of the external auditory canal (EAC) is also found frequently in patients with COM, but this has been little studied. We compared the size of affected bony EACs and the contralateral side in patients with single-side COM using high-resolution computed tomography. SUBJECTS AND METHODS: In total, 99 patients with single-side COM were included. Four indicators related to the size of the bony EAC and IAC were measured using high-resolution computed tomography: the axial and coronal lengths of the tympanic membrane, the length of the isthmus, and the area of the bony ear canal. We also compared both internal auditory canals as negative controls. These assessments were made by radiologists who were blinded to the objective of this study. RESULTS: In patients with single-side COM, the axial length of the tympanic membrane was significantly shorter than normal, and the volume of the EAC was also significantly smaller. The length of the isthmus of the EAC was shorter on the affected side, but the difference was not significant. The IAC volume showed no difference between the two sides. CONCLUSIONS: COM affects general temporal bony development, including the bony EAC and mastoid bone. Therefore, whether to correct this should be considered when preparing for COM surgery.
Ear Canal* ; Humans ; Mastoid ; Otitis Media* ; Otitis* ; Tympanic Membrane

Malignant fibrous histiocytoma (MFH) is the most common soft tissue sarcoma. It is regarded as an undifferentiated pleomorphic sarcoma with an unproven histogenesis. It most commonly occurs in the skeletal muscles of the extremities or the retroperitoneum of adults. It often metastasizes to the lungs, lymph nodes, bones and liver, but rarely to the skin. We report here a case of malignant fibrous histiocytoma that metastasized to the skin.
Adult ; Extremities ; Histiocytoma, Malignant Fibrous ; Humans ; Liver ; Lung ; Lymph Nodes ; Muscle, Skeletal ; Neoplasm Metastasis ; Sarcoma ; Skin

Pseudomembranous colitis (PMC) is a nosocomial and opportunistic infection caused by Clostridium difficile. PMC is related to the use of antibiotics leading to intestinal dysbiosis and an overgrowth of C. difficile. Metronidazole or vancomycin is considered to be the standard therapy for the management of PMC. However, PMC has a 15%-30% recurrence rate and can be refractory to standard treatments, resulting in morbidity and mortality. Here we describe a patient who experienced refractory PMC who was treated with fecal microbiota transplantation. A 69-year-old woman was admitted to the hospital with consistent abdominal pain and diarrhea, which had been present for 5 months. She was diagnosed with PMC by colonoscopy and tested positive for C. difficile toxin. Even though she took metronidazole for 10 days, followed by vancomycin for 4 weeks, her symptoms did not improve. Because of her recurrent and refractory symptoms, we decided to perform fecal microbiota transplantation. Fifty grams of fresh feces from a donor were obtained on the day of the procedure, mixed with 500 mL of normal saline, and then filtered. The filtered solution was administered to the patient's colon using a colonoscope. After the procedure, her symptoms rapidly improved and a follow-up colonoscopy showed that the PMC had resolved without recurrence.
Abdominal Pain ; Aged ; Anti-Bacterial Agents ; Clostridium difficile ; Colon ; Colonoscopes ; Colonoscopy ; Diarrhea ; Dysbiosis ; Enterocolitis, Pseudomembranous* ; Feces ; Female ; Follow-Up Studies ; Humans ; Metronidazole ; Microbiota ; Mortality ; Opportunistic Infections ; Recurrence ; Tissue Donors ; Vancomycin

Primary cutaneous mucinous carcinoma is a rare malignant tumor that originates from the deepest portion of the eccrine sweat duct. Common sites of involvement are the face and scalp. Biopsy shows dermal epithelial cell islands embedded in mucin pools separated by fibrous septae. It is difficult to differentiate this tumor histologically from metastatic adenocarcinoma. Recurrence after excision is common but metastases are rare. We report a primary cutaneous mucinous carcinoma with neuroendocrine differentiation on the right cheek of a 63-year-old man.
Adenocarcinoma ; Adenocarcinoma, Mucinous ; Biopsy ; Cheek ; Epithelial Cells ; Humans ; Islands ; Middle Aged ; Mucins ; Neoplasm Metastasis ; Recurrence ; Scalp ; Sweat

Langerhans cell histiocytosis (LCH) is a reactive disease in which abnormal Langerhans cells accumulate in various body sites. We report here on a 51-year-old male patient with LCH that was classified as single-system disease (restricted LCH). The skin lesions were a small, deep ulcer in the right inguinal area and multiple erythematous papules scattered on the lower abdomen, and the patient had these lesions for 1 year. The histopathologic examination revealed a dense histiocytic infiltration in the dermis, and most of the cells showed the characteristics of "LCH" cells. The immunohistochemistry for S-100 protein and CD1a complex all showed positive results. The patient was much improved after surgical excision of the inguinal ulcer and administering oral isotretinoin (20 mg daily) for 8 months, and there was no recurrence. We think retinoid is an effective treatment option for LCH, especially for single system disease.
Abdomen ; Dermis ; Histiocytosis, Langerhans-Cell ; Humans ; Immunohistochemistry ; Isotretinoin ; Langerhans Cells ; Male ; Middle Aged ; Recurrence ; S100 Proteins ; Skin ; Ulcer

Sorafenib (Nexavar(R)) is an oral multikinase inhibitor that was recently approved for use in metastatic renal cancer. It is currently undergoing investigation for the treatment of locally advanced renal cancer and in other tumor types. It has a broad spectrum of activity in treating multiple tyrosine kinases, including angiogenic factors VEGFR and PDGFR. Common cutaneous toxicities experienced with sorafenib include facial and scalp erythema, hand-foot syndrome, splinter hemorrhages, and alopecia. We report a case of a 57 year-old man diagnosed as renal cell carcinoma with distant metastaisis, who developed a leukocytoclastic vasculitis on the extremities after use of sorafenib.
Alopecia ; Angiogenesis Inducing Agents ; Carcinoma, Renal Cell ; Erythema ; Extremities ; Hand-Foot Syndrome ; Hemorrhage ; Kidney Neoplasms ; Niacinamide ; Phenylurea Compounds ; Phosphotransferases ; Scalp ; Tyrosine ; Vasculitis ; Vasculitis, Leukocytoclastic, Cutaneous

Syringomas confined to the distal extremities are very rare. A 62-year-old man presented with an 8-month history of multiple, light brown, flat-topped papules on both forearms and the dorsa of the hands. Histopathologic examination showed multiple dilated eccrine ducts lined by two rows of epithelial cells. There has currently been less than 10 reported cases of syringoma confined to both forearms and the dorsa of the hands in the world medical literature.
Epithelial Cells ; Extremities ; Forearm ; Hand ; Humans ; Light ; Middle Aged ; Syringoma

Metastatic carcinoma of the penis is rare and in most cases is associated with primary malignancy of the pelvic organs with widespread metastasis. A 64-year-old man presented with a 2 month history of skin-colored papules on his penis. He also had a history of total gastrectomy and chemotherapy due to advanced gastric carcinoma. Skin biopsy from the lesion revealed atypical polygonal cells with hyperchromatic & pleomorphic nuclei in the dermis. Results of immunohistochemical staining showed a positive reaction of CK7, and a negative reaction of CK20, PSA, and CD68. We report herein a case of metastatic cancer of the penis from gastric carcinoma.
Male ; Humans ; Biopsy ; Neoplasm Metastasis