Browsing by Author "Peddireddy, Navya"
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Item The Art of Diagnosis: Cyto-Histopathological Correlation in Metastatic Lung Cancers - A Rare Case Report(2024-03-21) Peddireddy, NavyaBackground Metaplastic breast carcinoma (MBC), an exceptionally rare and heterogeneous triple-negative subtype of breast cancer, accounts for less than 1% of all breast carcinomas. This case report exemplifies the pivotal role of cytohistological correlation in diagnosing lung metastasis through fine needle aspiration biopsy. The case of a 90-year-old female with a complex medical history is presented, highlighting the importance of careful clinical assessment in metastatic lung cancers. Case Information A 90-year-old female, with a history of metaplastic breast carcinoma following a left mastectomy 20 months ago, was admitted due to a four-week history of progressive dyspnea and fatigue. Despite being a non-smoker, she had a history of essential tremor, dementia, and chronic obstructive pulmonary disease. Extensive diagnostic evaluations, including laboratory results and imaging, revealed pulmonary nodules and partially calcified pleural masses bilaterally along with pleural effusions, raising concerns of metastasis. Thoracentesis initially showed negative pathology findings, along with subsequent CT-guided lung biopsies, prompting an investigation into the patient’s prior oncology history. The patient's past oncology reports were revisited, uncovering a diagnosis of metaplastic carcinoma with mesenchymal differentiation in the breast. Cytohistological correlation was performed, ultimately confirming the presence of malignant cells in the lung biopsy, leading to the diagnosis of stage IV triple-negative metaplastic breast carcinoma with malignant pleural effusion. Conclusions Metaplastic breast carcinoma is characterized by the differentiation of malignant cells toward mesenchymal and squamous elements, making it a rare and heterogeneous cancer. The patient's case, with lung metastasis originating from a metaplastic breast carcinoma, is a rare occurrence, further emphasizing the importance of accurate diagnosis in such unique situations. The report underscores the significance of meticulous medical history collection, interdisciplinary communication, expert consultation, and cyto-histopathological correlation in achieving accurate pathological and clinical diagnoses in metastatic lung cancers. Metaplastic breast carcinoma's rarity and heterogeneity contribute to its generally poor prognosis, with factors like advanced age, high-grade tumors, and distant metastasis reducing survival rates. In most cases, surgical resection remains the primary treatment approach, followed by platinum-based chemotherapy. Promising treatment avenues, including immunotherapy and molecular targeted therapies, may improve patient outcomes, but these options depend on individual circumstances. In the case presented here, the patient's age and comorbidities influenced the decision to opt for hospice care, highlighting the importance of tailoring treatment strategies to a patient's unique situation. This case report not only sheds light on a rare occurrence but also serves as a reminder of the importance of comprehensive medical assessments in managing complex clinical scenarios.Item Presentations of Cutaneous Disease in Various Skin Pigmentations: Tinea Corporis(2024-03-21) Peddireddy, Navya; Van Alfen, BradenBackground Tinea corporis, a superficial fungal skin infection, typically manifests as pruritic annular erythematous scaly plaques with central clearing. This condition can involve every body region. Here we present tinea corporis across various skin pigmentations. The goal is to highlight distinctions and similarities in light, medium, and dark skin tones, using the Fitzpatrick scale for stratification of skin types. We hope this can aid primary care clinicians in early recognition of this common condition. Case Information We present a series of cases illustrating the diverse manifestations of tinea corporis across different Fitzpatrick skin types. In Figure 2, a 28-year-old with Fitzpatrick I displays well-defined, scaly plaques on the inner thigh. Figure 3 features a 3-year-old of Fitzpatrick II with a large, poorly defined plaque on the right posterior thigh. A 33-year-old Fitzpatrick III male of showcases an erythematous, scaly plaque extending from the groin (Figure 4). Figure 5 presents a 15-year-old with Fitzpatrick IV, exhibiting well-demarcated erythematous plaques on the left arm with inflamed papules on the neck and arm. A 69-year-old female of Fitzpatrick V displays pink to violaceous plaques with hyperpigmentation and white/gray scales (Figure 6). These cases highlight the diverse clinical presentations that can be seen in different Fitzpatrick skin types. Conclusions Tinea corporis is a common superficial fungal infection of the skin that tends to be more prevalent in younger demographics and thrives in humid environments. Trichophyton rubrum is the most common dermatophyte culprit for this fungal infection. It can spread easily between different parts of the body, accentuating the need for comprehensive evaluations encompassing various anatomical areas. Diagnosis of tinea corporis across various skin tones involves recognizing the influence of age, environmental factors, and the Fitzpatrick scale on its clinical presentation. Variations can be observed in the degree of scaling and the amount of erythema. Bright red erythema is harder to distinguish in darker Fitzpatrick skin types (IV-VI). Instead, erythema may appear more hyperpigmented. Likewise, scale may be more easily seen in these skin types. Identifying tinea corporis in light, medium, and dark skin tones is crucial for early intervention. Confirmatory diagnostic procedures, such as KOH scrapings and fungal cultures from lesion swabs are valuable in confirming the presence of dermatophyte involvement.