Electrospray ionization (ESI) of tetrameric platinum(II) acetate, [Pt4(CH3COO)8], in methanol generates the formal platinum(III) dimeric cation [Pt2(CH3COO)3(CH2COO)(MeOH)2]+, which, upon harsher ionization conditions, sequentially loses the two methanol ligands, CO2, and CH2COO to form the platinum(II) dimer [Pt2(CH3COO)2(CH3)]+. Next, intramolecular sequential double hydrogen‐atom transfer from the methyl group concomitant with the elimination of two acetic acid molecules produces Pt2CH+ from which, upon even harsher conditions, PtCH+ is eventually generated. This degradation sequence is supported by collision‐induced dissociation (CID) experiments, extensive isotope‐labeling studies, and DFT calculations. Both PtCH+ and Pt2CH+ react under thermal conditions with the hydrocarbons C2Hn (n=2, 4, 6) and C3Hn (n=6, 8). While, in ion–molecule reactions of PtCH+ with C2 hydrocarbons, the relative rates decrease with increasing n, the opposite trend holds true for Pt2CH+. The Pt2CH+ cluster only sluggishly reacts with C2H2, but with C2H4 and C2H6 dihydrogen loss dominates. The reactions with the latter two substrates were preceded by a complete exchange of all of the hydrogen atoms present in the adduct complex. The PtCH+ ion is much less selective. In the reactions with C2H2 and C2H4, elimination of H2 occurs; however, CH4 formation prevails in the decomposition of the adduct complex that is formed with C2H6. In the reaction with C2H2, in addition to H2 loss, C3H3+ is produced, and this process formally corresponds to the transfer of the cationic methylidyne unit CH+ to C2H2, accompanied by the release of neutral Pt. In the ion–molecule reactions with the C3 hydrocarbons C3H6 and C3H8, dihydrogen loss occurs with high selectivity for Pt2CH+, but in the reactions of these substrates with PtCH+ several reaction routes compete. Finally, in the ion–molecule reactions with ammonia, both platinum complexes give rise to proton transfer to produce NH4+; however, only the encounter complex generated with PtCH+ undergoes efficient dehydrogenation of the substrate, and the rather minor formation of CNH4+ indicates that CN bond coupling is inefficient.

Patient: Male, 62Final Diagnosis: Condyloma acuminatumSymptoms: Urinary retentionMedication: —Clinical Procedure: CystoscopySpecialty: UrologyObjective:Unusual clinical courseBackground:A condyloma acuminatum is a sexually transmitted, human papillomavirus (HPV) associated, neoplasm. In men, it is predominantly found on external genitalia and rarely progresses more proximally than the distal penile urethra. Condyloma acuminata of the prostatic urethra are rare and are usually seen as an extension of, or in association with external lesions. Therefore, it is not typically considered in the differential diagnosis of isolated papillary lesions limited to the prostatic urethra.Case Report:A 62-year-old male with rheumatoid arthritis treated with abatacept presented to urology due to a history of intermittent bladder self-catheterization for urinary obstruction. He underwent a transurethral resection of the prostate and had incidental findings of papillary lesions restricted to the prostatic urethra that were presumed to be urothelial carcinoma. Microscopic examination established the diagnosis of condyloma acuminata, and low-risk HPV 6 and 11 were detected by in-situ hybridization. Subsequent cystoscopy showed marked growth and extension of condyloma acuminata to near the external meatus. After multiple treatments with intraurethral 5-fluorouracil, several small lesions remained in the bulbous urethra. With follow up for 2 years since diagnosis, the patient has not developed external condylomata.Conclusions:A condyloma acuminatum might present as an isolated papillary growth in the prostatic urethra without clinical or historical evidence of a visible lesion on external genitalia. Immunosuppression and/or urethral instrumentation might be a risk factor for such a presentation. Urologists and pathologists should be aware of this rare possibility in order to avoid misdiagnosis, and ensure that the patient receives appropriate therapy.

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Diagnosis of two distinct malignant entities existing concurrently and at the same location (synchronous malignancy) by fineneedle aspiration (FNA) is unusual but may occur. Small lymphocytic lymphoma/chronic lymphocytic leukemia (SLL/CLL) in particular is associated with an increased incidence of secondary tumor, likely due to associated immunodeficiency. Co-occurrence of some carcinomas such as squamous cell carcinoma (SCC), may show especially aggressive behavior. A 57-year-old Caucasian male presented with recurrent upper extremity lymphedema and diffuse lymphadenopathy of the axillary and cervical regions. FNA of a large cervical lymph node was diagnostic for both atypical lymphocytic proliferation and SCC. Flow cytometric analysis showed the atypical lymphocytic proliferation to be positive for CD5, CD23, CD19, CD20, HLA-DR, CD38, and the population was kappa light chain restricted. These cells were negative for CD-10 and FMC-7 antigens, suggesting a phenotype of B-cell SLL/CLL. We report a rare occurrence of metastatic SCC to a lymph node infiltrated by SLL/CLL. The diagnosis was achieved by a combination of cytomorphologic examination of FNA smears, immunohistochemical staining of cell block material, and flow cytometry on the sample obtained by FNA. To the best of our knowledge, only three cases of SCC metastasis to SLL/CLL diagnosed by FNA have been reported in the English literature. Though rare, awareness of such a possibility and careful cytological examination under the appropriate clinical conditions is warranted.

Patient: Male, 61Final Diagnosis: Urothelial carcinoma • lipid-rich variant • metastaticSymptoms: HematuriaMedication: —Clinical Procedure: Transurethral resection of bladder tumour (TURBT)Specialty: UrologyObjective:Rare co-existance of disease or pathologyBackground:The lipid-rich variant is a rare and aggressive type of urothelial carcinoma (UCa), with less than 40 cases reported in the literature. This variant usually presents as an advanced-stage primary tumor.Case Report:We report the case of a 61-year-old man with previous history of T1 high-grade conventional urothelial carcinoma treated with local therapy. The patient later presented with a new 6.5-cm exophytic bladder mass. Histopathological examination revealed a T2 urothelial carcinoma of the lipid-rich variant. Retrospective review of the previous biopsies confirmed conventional high-grade urothelial carcinoma, but scattered rare individual or small clusters of cells that resemble the lipid-rich variant urothelial carcinoma were also noted.Conclusions:The findings in this case suggest that the differential sensitivity of conventional urothelial carcinoma to local therapy may have allowed the lipid-rich variant to predominate in the recurrence. Pathologists should be aware of the lipid-rich variant of urothelial carcinoma. The prognostic significance of rare lipoblast-like cells among predominantly conventional urothelial carcinoma may requires further study.