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Lytic Lesion (lytic + lesion)

Distribution by Scientific Domains

Medical Sciences	100%

Selected Abstracts

Chronic lymphocytic leukemia presenting as cutaneous and bone involvement

INTERNATIONAL JOURNAL OF DERMATOLOGY, Issue 1 2001
Maria P. Stefanidou MD
An 84-year-old man had a 3-year history of a progressive, painless, papulonodular eruption, that was particularly prominent on the face and extremities. Physical examination revealed firm, bluish-red nodules and plaques, located on the tip of the nose, the cheeks, ears, and distal digits. Skin lesions produced a leonine facies (Fig. 1), deformities of the fingers and toes, finger clubbing, and onyxis. An identical lesion was seen on a postoperational scar on the left cheek. The mucous membranes were spared. The patient had anterior and posterior cervical and bilateral axillary lymphadenopathy and splenomegaly. Figure 1. Leonine facies On admission, the peripheral blood count revealed 260,000/mm3 leukocytes (lymphocytes 97%, neutrophils 2%, and monocytes 1%), a hemoglobin level of 9.5 g/dL, and platelet count of 100,000/mm3. Hypogammaglobulinemia with reduction of immunoglobulin G (IgG) and IgM was found. Radiography of the fingers showed multiple osteolytic lesions of the phalanges and phalangette destruction of the left median finger (Fig. 2a,b). Computed tomography of the chest and abdomen revealed bilateral axillary, mediastinal, and para-aortic lymphadenopathy and spleen enlargement. Figure 2. X-Ray of the hands: (a) ,multiple osteolytic lesions of the phalanges and (b) ,partial destruction of the left median phalangette Skin biopsy specimens from the ear and finger lesions showed a massive nonepidermal leukemic infiltration in the papillary and reticular dermis, with a grenz zone consisting of small lymphocytes (Fig. 3). Figure 3. Skin biopsy (hematoxylin and eosin, ×,250). Massive leukemic infiltration consisting of small lymphocytes. Subepidermally, a grenz zone of connective tissue is noted Biopsy of the enlarged cervical lymph node showed a diffuse infiltration with lymphocytes. Tissue biopsy from a finger lytic lesion revealed infiltration of bone trabecular and fibrous tissue with a dense population of small- and medium-sized lymphocytes. Immunohistochemical study of cutaneous and bone lesions showed that the infiltrate in both biopsies consisted mainly of B lymphocytes (CD20+, CD45R+, CD45Ro,, OPD4,). Peripheral blood smear had a B-cell phenotype (CD19 98%, CD20 97%, CD23 99%, CD25 40%, CD5 90%, HLA-DR 100%). Bone marrow smear and immunophenotyping surface marker analysis found a diffuse pattern of B-lymphocytic infiltration. A diagnosis of B-cell chronic lymphocytic leukemia stage C (Binet staging system), with specific cutaneous and bone lesions, was established. The patient received chemotherapy with chlorambucil and methylprednisolone, which resulted in improvement of the hematologic profile. Two years later, the cutaneous lesions showed partial remission. [source]

Odontogenic keratocyst in maxillary sinus with invasive behaviour

JOURNAL OF ORAL PATHOLOGY & MEDICINE, Issue 4 2006
Eneida Franco Vencio
Odontogenic keratocyst is a cystic lesion characterized by a high rate of recurrence. This report describes a rare case of ciliated epithelium-lined odontogenic keratocyst in the maxilla of a 27-year-old female. Panoramic radiography showed a lytic lesion on the right maxilla associated with an impacted molar tooth. Computerized tomography image revealed the involvement of the lesion with the right maxillary sinus, destroying the sinus floor. Histopathologically, the typical keratinized epithelial-lined cyst of odontogenic keratocyst abruptly changed into a ciliated epithelium, suggesting the fusion of both these epithelia rather a metaplastic transformation. The biological behaviour of odontogenic keratocysts is discussed. [source]

Chordoid meningioma: Rare variant of meningioma

NEUROPATHOLOGY, Issue 3 2004
Özlem Özen
Chordoid meningioma is a rare variant of meningioma that bears a striking histological resemblance to chordoma and has greater likelihood of recurrence. Although most meningiomas occur in the intracranial, orbital and intravertebral cavities, rare meningiomas have been reported in extracranial organs; thus, it is important to be able to distinguish them from other neoplasms that have similar histology but different biological behavior and therapies. A case of chordoid meningioma in a 48-year-old woman who did not have Castleman's syndrome is described in the present report. The patient presented with a mass in her left frontoparietal region, and had been suffering from headaches for many years. Magnetic resonance imaging of the brain demonstrated an expansive lytic lesion in the squamous portion of the left temporal bone. The lesion extended in both directions. Histological examination of the surgical specimen revealed a tumor composed of cords and nests of eosinophilic vacuolated cells embedded in a myxoid matrix. A typical meningiomatous pattern was observed focally, and positive staining of the tumor cells for vimentin and epithelial membrane antigen confirmed the diagnosis of chordoid meningioma. [source]

Acute megakaryocytic leukemia presenting as hypercalcemia with skeletal lytic lesions

EUROPEAN JOURNAL OF HAEMATOLOGY, Issue 6 2002
Jeffrey H. Muler
Abstract:, Acute megakaryocytic leukemia (AML M7) is a rare type of acute myelogenous leukemia in adults, commonly presenting with myelofibrosis. This report describes a case of a 32-yr-old male who presented with hypercalcemia and bony lytic lesions, in the absence of myelofibrosis. The diagnosis of AML M7 should be considered in a patient with pancytopenia, lytic lesions and hypercalcemia. [source]