KRAS Mutations and Primary Resistance of Lung Adenocarcinomas to Gefitinib or Erlotinib

Mantle cell lymphoma

Pulmonary alveolar proteinosis

Mucosal melanomas are a rare subtype of melanoma and are associated with a particularly poor prognosis. Due to the rarity of the diagnosis, and the pace with which the management of cutaneous melanoma has evolved over recent years, there is little good evidence to guide management and evidence-based clinical guidelines are still in development in the UK. In this review we provide an overview of the management of mucosal melanoma, highlighting the critical differences between cutaneous and mucosal melanomas, before examining recent advances in the systemic treatment of this disease and likely future directions.

Combatting mucosal melanoma: recent advances and future perspectives.

The bacterium Francisella philomiragia has been isolated from environmental samples originating from around the globe. F. philomiragia-related strains cause fran- cisellosis of both farmed and wild fish. In addition, occa- sional human infections caused by F. philomiragia are found in victims of near-drowning and patients with chronic granulomatous disease. We have shown that F. philomira- gia forms in vitro biofilms with increased formation at 25 °C over 37 °C conditions. We found that F. philomiragia can form a biofilm in a co-culture with live Acanthamoeba castellanii, an aquatic amoeba. Interestingly, amoeba-con- ditioned supernatant has an inhibitory effect on production of biofilm by F. philomiragia, whereas Francisella-condi- tioned supernatant has no effect on growth of amoebae. We have shown that F. philomiragia can infect A. castellanii after only 5 days of co-incubation and that it infects A. castellanii more quickly than the related species F. novicida does. Our studies point to a potentially overlooked interac- tion between F. philomiragia and Acanthamoeba. This re- lationship in the marine lifecycle of F. philomiragia may support the persistence of the bacterium in waterways and its ability to infect fish. An understanding of the persistence of this organism in aquatic systems through biofilm forma- tion and its interaction with Acanthamoeba will be impor- tant in developing prevention strategies for this pathogen.

Francisella philomiragia Biofilm Formation and Interaction With the Aquatic Protist Acanthamoeba castellanii

Phyllodes tumor of the breast is a biphasic fibroepithelial neoplasm 10 to 20% of phyllodes tumor show malignant transformation, often in the form of stroma, which usually shows fibrosarcomatous differentiation and rarely heterologous sarcomatous elements Liposarcomatous differentiation is not common among phyllodes tumors The correct diagnosis of heterologous liposarcomatous differentiation in a malignant PT requires identification of the biphasic component of the tumor We reported a case of malignant phyllodes tumor which initially transformed into liposarcoma, in addition to a very rare intraductal hyperplasia and flat epithelial atypia The patient was a 75-year-old woman, with a lump in the left breast without axillary lymphadenopathy She also have a positive family history of breast carcinoma She underwent surgery and still alive and disease free after one year

Malignant phyllodes tumor of the breast with liposarcomatous differentiation and intraductal hyperplasia.

Introduction: Eosinophilic lung diseases are a rare group of heterogeneous diseases characterized by the increase of the eosinophil ratio in airways and lung parenchyma. Objective: To describe clinical, radiological and laboratory finding in Eosinophilic lung diseases. Methods: The clinical-radiological findings, treatments performed, treatment responses, and prognoses of patients diagnosed with eosinophilic lung disease via bronchoalveolar lavage (BAL) between 2005 and 2015 were retrospectively evaluated. Results: Ten cases were diagnosed (8 women, 2 men). The mean age was 47 years (23-56). The main clinical manifestations were dyspnea and cough. Fever was found in 4 cases. Peripheral eosinophilia and total IgE elevation were present during the admission of all cases. The mean eosinophil ratio in BAL was 42% (35-62%). Asthma was present at diagnosis in all cases. Extra-pulmonary manifestations were rhinosinusitis (n=2), skin lesion (n=1) and cardiac involvement (n=1). In CT scans, all patients had bilateral involvement. The most common radiological pictures were ground-glass opacity, nodular lesions, and consolidation. Proximal bronchectasis was found in two cases. Etiologic diagnosis were chronic eosinophilic pneumonia (n=7), allergic broncho-pulmonary aspergilosis (n=2) and eosinophilic granulomatosis with polyangiitis (EGPA) (n=1). Prednisolone treatment was started for all cases associated with Cyclophosphamide in patient with EGPA. The outcome was favorable in eight patients. One patient developed corticodependant asthma. The patient with EGPA was dead for severe cardiomyopathy. Conclusion: Clinical pictures in pulmonary eosinophilia syndromes are on a wide spectrum, a specific diagnosis is important to predict treatment response and prognosis.

Eosinophilic lung disease

Ectopic breast tissue is defined as glands located outside of the breast. It can be found anywhere along the milk line extending from the axilla to the groin, and can occur in the vulva. Ectopic breast tissue should be excised because it may develop benign or malignant pathologic processes. Less than 40 cases of fibroadenoma in the vulva have been reported in the literature. We report a case of a 37-year-old woman presenting a solitary vulvar mass. The mass was excised completely, and histology demonstrated an ectopic breast fibroadenoma. This is one of the few reports on the benign pathologies of vulvar mammary glands.

Fibroadenoma in an ectopic vulvar breast gland: a common neoplasm in an uncommon site.

Dyshormonogenetic goiter is a rare cause of congenital hypothyroidism occurring due to a lack of enzymes necessary for the synthesis of thyroid hormones. It is morphologically characterized by architectural and cellular pleomorphism that may mimic thyroid malignancy and cause difficulties in differential diagnosis. 
We report a new case occurring in a 37-year-old male with history of hypothyroidism since the age of 6 years treated by L-thyroxin. He developed a progressively slow growing multinodular goiter and consulted for recent dyspnea. Computed tomography scan showed a multinodular plunging goiter with compression of the trachea and vessels in the left side. A total thyroidectomy was performed. 
Gross examination revealed an enlarged and multinodular thyroid gland, presenting hemorrhagic changes in the larger nodules. Histologically, the features were consistent with dyshormonogenetic goiter.
The literature on the histopathology of dyshormonogenetic goiter is reviewed and clues to avoid inappropriate overdiagnosis of malignancy are given.

A rare and particular form of goiter to recognize.

Introduction Le liposarcome, tumeur la plus frequente des tissus mous, touche rarement l’orbite. Moins de 30 cas de liposarcomes primitifs de l’orbite ont ete rapportes. Les liposarcomes metastatiques a l’orbite sont egalement extremement rares avec seulement quelques cas publies. Nous rapportons un nouveau cas de liposarcome orbitaire metastatique. Observation Un homme, âge de 57 ans, consulta pour une exophtalmie d’apparition recente de l’œil gauche. Il avait subi 5 ans auparavant une exerese complete d’un liposarcome myxoide de la cuisse droite. La tomodensitometrie revelait une formation tumorale ovalaire, bien limitee intra-orbitaire gauche, developpee aux depens du muscle droit interne. Elle etait hypodense, se rehaussant de facon heterogene apres injection du produit de contraste. Elle mesurait 30 × 23 × 20 mm et arrivait lateralement au contact du nerf optique, sans l’envahir. Une biopsie montrait des aspects histologiques d’un liposarcome myxoide. Le diagnostic de liposarcome metastasique orbitaire fut retenu. Une exenteration orbitaire gauche fut effectuee 5 mois apres un refus prealable du patient de tout traitement. Conclusion Le liposarcome metastatique a l’orbite est exceptionnel : il doit etre suspecte chez un patient aux antecedents de liposarcome presentant une exophtalmie liee a une tumeur orbitaire.

Emna Braham

Papers

Malignant phyllodes tumor of the breast with liposarcomatous differentiation and intraductal hyperplasia.

Eosinophilic lung disease

Fibroadenoma in an ectopic vulvar breast gland: a common neoplasm in an uncommon site.

A rare and particular form of goiter to recognize.

Métastase orbitaire d’un liposarcome