Langerhans cell histiocytosis of the skull on cytologic squash preparations

Sacral chondroblastoma — a rare location, a rare pathology: A case report and review of literature

BACKGROUND

Chondroblastoma (CB) is an intermediate tumor of cartilage origin. CB involving the sacrum is a very rare pathology.

CASE SUMMARY

A 17-year-old male with sacral CB was diagnosed as CB during the first surgery, and 18 mo later, the tumor recurred and a second surgery was performed with the same pathology result of CB.

CONCLUSION

We recommend complete removal of the tumor in a timely manner, provided that surgical conditions are met. At the same time, other diseases should be carefully differentiated in terms of imaging or pathological features so as to avoid erroneous diagnostic conclusions.

Intraoperative crush smear cytology of vertebral chondroblastoma: A diagnostic challenge

Chondroblastoma is a rare, cartilage producing primary neoplasm of the bone. Although generally benign, chondroblastoma is placed in the "intermediate, rarely metastasizing" category in the 2013 World Health Organization classification of bone tumors. It typically involves the epiphysis of long tubular bones and is exceptionally located in the vertebral column. To the best of our knowledge, less than 35 cases of vertebral chondroblastoma have been reported in the literature. We report a case of chondroblastoma involving D₆ -D₇ vertebrae in a 17-year-old male patient, diagnosed on intraoperative crush cytology and later confirmed on histopathology. Intraoperative crush cytology is rarely been used for the diagnosis of bone lesions. Till date, this is the third case of vertebral chondroblastoma being diagnosed on cytology and first case being diagnosed on intraoperative crush smear cytology. Previous two cases were diagnosed on fine-needle aspiration cytology. Chondroblastoma possesses distinct and diagnostic cytological features, which allows correct diagnosis even in the rarer locations like vertebral column. Crush cytology can be helpful in the rapid intraoperative diagnosis of vertebral chondroblastoma leading to early proper management of the patient.

Skull fracture mimicking eosinophilic granuloma

BACKGROUND

Delayed swelling after skull fractures is an uncommon complication following head trauma in children. Classically, growing skull fractures typically present in patients under 3 years of age with progressive subcutaneous fluid collections, or occasionally with neurologic symptoms. We present the case of a healthy 2-year-old boy with a lytic "punched-out" frontal skull lesion. The child presented 2 months after a minor forehead injury for which no medical attention was sought.

METHODS

The skull defect had no associated leptomeningeal cyst or brain herniation. Imaging and presentation were thought to be consistent with eosinophilic granuloma. Histologic findings demonstrated a healing skull fracture.

RESULTS

Cranioplasty was performed, and the patient had an uncomplicated postoperative course.

CONCLUSIONS

In this report, we describe our experience with this atypical presentation of a healing skull fracture mimicking a typical eosinophilic granuloma.

A rare case of langerhans cell histiocytosis of the skull in an adult: a systematic review

We report a 41-year old male who presented to the Emergency Department after falling while water-skiing. He had a previous medical history included chronic headaches, which had persisted for the last 2-3 months prior to presentation. Computed tomography of the head showed a small hypersensitivity with a small extra axial collection with a maximum thickness of 1mm. Differential diagnoses included an arachnoid cyst, haemangioma, meningioma or a secondary lesion. A diagnosis of Langerhans Cell Histiocytosis was made based on the histopathology examination and the immunoperoxidase staining.

Diagnosis of Langerhans cell histiocytosis on fine needle aspiration cytology: a case report and review of the cytology literature

A case of multifocal Langerhans cell histiocytosis in a two-year-old child is presented where fine needle aspiration was helpful in achieving a rapid and accurate diagnosis in an appropriate clinical and radiological setting. This can avoid unnecessary biopsy and guide the management especially where access to histopathology is limited. The highly characteristic common and rare cytological features are highlighted with focus on differential diagnoses and causes of pitfalls.

Endocrine manifestations of Langerhans cell histiocytosis diagnosed in adults

Langerhans cell histiocytosis (LCH) is a rare granulomatous disease of unknown etiology. We retrospectively reviewed data from four patients (3 males and 1 female), mean age 33.5 years old (range: 21-40), with histopathological diagnosis of LCH. All of them presented with symptoms suggestive of endocrine involvement. The main complaint was goiter in two patients and polyuria and polydipsia in three. Before the LCH diagnosis, two patients had unevaluated symptoms of diabetes insipidus (DI) and hypogonadism. The mean time from symptoms onset to diagnosis was 6.25 years (range: 2-13). Histopathological diagnosis was established by total thyroidectomy (TT) biopsy in two patients, skin lesion biopsy in one, and pituitary stalk biopsy in the other. In the two-first patients, surgery was indicated after the fine-needle aspiration biopsy (FNAB) showed a false positive result of differentiated thyroid carcinoma and immunohistochemistry was used for diagnosis confirmation. Three cases were treated with chemotherapy; one of them had already received radiation therapy on the hypothalamic-pituitary region, developing post-radiation hypopituitarism.