Solitary fibrous tumors are rare and difficult to diagnose. The occurrence of this entity in the head and neck region constitutes approximately 6% of the cases and is associated with higher rates of recurrence. We report a case of a 61-year old male diagnosed with this rare tumor by fine needle aspiration.

Intrapericardial Diaphragmatic Hernia (IDH) is the rarest type of adult diaphragmatic hernia and colon obstraction. Only a few cases have been reported. Blunt trauma has been implicated in most cases, but few cases were reported from a stab wound to the anterior chest. Patients presented immediately or up to 15 to 20 years following trauma with symptoms which include of: intermittent bowel obstruction, strangulation, cardiac dysfunction, dyspnea, palpitations, and even cardiac tamponade. The most unusual site for a diaphragmatic hernia to occur is through the central tendon of the diaphragm into the pericardium. Physical findings included bowel sounds in the chest, decreased heart and lung sounds, and an absent point of maximal cardiac impulse. We present the case of a 67-year-old man who suffered a bowel obstruction when the transverse colon and omentum became incarcerated in the intrapericardial cavity from diaphragmatic hernia. Defect presumably resulted from blunt chest and abdominal trauma received six month earlier. Laparatomy is the preferred approach to surgical repair of IDH. Since the symptoms referable to adult IDH can be incapacitating or life threatening, herniorrhaphy should be performed promptly upon diagnosis. In this very rare case with delayed presentation of intrapericardial diaphragmatic hernia, we want to review the symptoms, recommendations of evaluation and the best approach of treatment and outcome of treatment.

Recurrent respiratory papillomatosis is a rare and recurring disease characterized by chronic benign papillomas of the epithelial mucosa in the respiratory tract. It is exclusively caused by human papilloma virus. While the majority of human papilloma virus infections are self-limited, some persist, as is the case in recurrent respiratory papillomatosis. Diagnosis is usually achieved by surgical biopsy and the utility of immunohistochemistry studies. Studies showed that cytology specimens in form of fine needle aspiration could provide definite diagnosis of this entity, especially when cytologic sampling is sufficient to produce a cellblock to be utilized for ancillary studies. We report a case of this rare entity diagnosed solely by cytologic sampling. We also discuss the pathophysiology and management modalities.

Epithelioid hemangioendothelioma and epithelioid angiosarcoma are both rare malignancies of endothelial origin. Differentiation of these two diagnoses remains difficult due to their heterogeneous presentation and overlapping morphological features. Here we report a case of a 58-year-old female clinically presenting with primary hepatic vascular neoplasm. She was finally diagnosed with Epithelioid Hemangioendothelioma (EHE) based on cytology sampling and core biopsy. The immunohistochemical (IHC) studies and morphological features of this case may be suggestive of a continuum with Epithelioid Angiosarcoma (EAS). Given the mixed findings exhibited, a plausible intermediate diagnostic entity may be proposed, and further studies are warranted to investigate this possible intermediate variant with optimal management and follow up.

Benign cystic hypersecretory hyperplasia and cystic hypersecretory duct carcinoma of the breast share similar histologic features including formation of cystically dilated ducts containing a homogeneous eosinophilic secretion that resembles thyroid colloid. However, cystic hypersecretory duct carcinoma of the breast is associated with proliferative malignant epithelium. Cystic hypersecretory lesions of the breast present with a varying morphologic features in the same mass. Strict histomorphologic criteria and confirmatory immunohistochemistry studies are essential for definitive diagnosis and appropriate management. We present a case where secretory proliferation of a breast mass displayed spectrum of changes from benign hyperplasia, to atypical hyperplasia, to frank ductal carcinoma in situ. Due to limited reported cases of these entities, little is known about the biological behavior, prognosis and molecular study of these lesions. By reporting more cases, we may reveal the biologic behavior of these uncommon lesions.