Five cases of an unusual pseudoangiomatous variant of spindle cell lipoma are presented. In keeping with more typical cases, these lesions occurred principally in the shoulder and neck regions of adult males. The lesions all had the features of typical spindle cell lipoma but, in addition, exhibited irregular and branching spaces with villiform connective tissue projections, giving a striking angiomatoid appearance. Although the pathogenesis is uncertain, this unusual histological pattern seems to be the result of myxoid degeneration and may lead to a mistaken diagnosis of a true vascular tumour or other non-lipomatous spindle cell lesion.

OBJECTIVE.The purpose of this study was to characterize the normal zonal anatomy and vascularity of the cervix on in vivo and in vitro MR images obtained with a receiver coil surrounding the cervix. These appearances provide a normal data base from which to interpret subtle changes in early neoplasia. SUBJECTS AND METHODS. Thirteen women of reproductive age with clinically and cytologically normal cerviceswere imaged with a ring-design solenoid receiver coil that was placed intravaginally and enveloped the cervix. Ti-and T2-weighted axial images were obtained. Seven uterine specimens resected for benign disease were similarly studied, and imaging appearances were correlated with histologic findings.RESULTS. In the in vivo studies, the endocervical mucosa and two stromal zones surrounding the high-signal central canal were identified. Unlike the uterine body, they could be differentiated on both Ti-and T2-weighted images, on which the inner ring had a low signal and the outer ring had an intermediate signal intensity. The outer zone was highly vascularized, with inflow effects from large vessels visible on single-slice scans. On administration of gadopentetate dimegiumine, the endocervical mucosa enhanced rapidly, whereas the outer stroma showed more gradual enhancement. The inner zone enhanced slowly relative to the outer zone. The parametrium was visualized up to 6 cm from the center of the coil, and adjacent colon, fat, and blood vessels were identified.Up to four lymph nodes less than i cm in diameter were seen in the parametrium of three subjects.In the in vitro studies, the endocervical mucosa was of high signal intensity. in the fibromuscular cervix, an inner low-signal ring correlated with a region of tightly packed stroma (fibroblasts and smooth muscle cells; cell count, 5900 ± 2376 nuclei/mm2) and the intermediate-signal-intensity outer zone corresponded to a region of more loosely packed stroma (cell count, 2199 ± 558 nuclei/mm2). Retention cysts were present in two multiparous cervices. CONCLUSION.These detailed appearances and enhancement patterns of the normal cervix need to be recognized so that subtle changes in locally invasive cervical neoplasia can be identified. AJR i994;163:607-612

Pseudoangiomatous stromal hyperplasia (PASH) is a rare benign proliferating breast condition. It was first reported in 1986 when Vuitch, Rosen, and Erlandson described nine cases of benign well-circumscribed, breast masses that simulated vascular lesions consisting of mammary stromal proliferations (Vuitch et al. (1986)). Since then there have been few reported cases of PASH in the literature (Taira et al. (2005)). We describe a large PASH, mimicking inflammatory carcinoma in a young lady that was excised with excellent cosmetic results.

Vulval biopsies from a 66-year-old lady complaining of pruritus showed intraepithelial Paget's disease. On simple vulvectomy, extramammary Paget's disease was found to be associated with vulval intra-epithelial neoplasia (VIN III) and superficial dermal invasive adenocarcinoma. Bilateral inguinal lymphadenectomy later revealed metastatic spread of the tumour. We believe this is a unique combination and discuss the possible origins in relation to this lady's past medical history of breast carcinoma 20 years and spinal metastases 17 years before.

No abstract