Background: Digital pathology (DP) adoption in Latin America has expanded slower than in develope... more Background: Digital pathology (DP) adoption in Latin America has expanded slower than in developed regions, probably due to many barriers not seen in the latter areas. This article aims to present the current scenario in the region, highlighting barriers and possible solutions to encourage its adoption in Latin American countries.Methods: An expert panel of 9 Latin American medical pathologists and 1 information technology specialist participated in an online modified Delphi panel, utilizing a third-party platform (iAdvise, Within3, USA). Thirteen pre-prepared questions were answered interactively.Results: Experts' observations confirm the paucity of labs in the region that utilize digital pathology technology. The panel ranked obtaining second opinions and presenting images remotely as the main benefit of a digital pathology system, although many others were cited as well. Cost of implantation was the main barrier mentioned by the experts, and payers' and decision makers...
International journal of surgical pathology, Jan 8, 2016
Conjunctival melanoma is the second most common conjunctival malignancy. Its differential diagnos... more Conjunctival melanoma is the second most common conjunctival malignancy. Its differential diagnosis with other conjunctival melanocytic neoplasms is inherently difficult. The presence of epithelial cysts is a useful feature in conjunctival tumors and favors a benign lesion. Herein 2 cases of conjunctival melanoma with cysts are presented. To the best of our knowledge, this is the first series of conjunctival melanoma with epithelial inclusion cysts. This series emphasizes the importance of considering several malignant features when reviewing conjunctival melanocytic lesions, as malignancy can exist even in the presence of epithelial inclusion cysts.
Background. Ocular involvement in mycosis fungoides (MF) cases occurs in one-third of patients wi... more Background. Ocular involvement in mycosis fungoides (MF) cases occurs in one-third of patients with the eyelid being the most frequent site affected; however, conjunctival involvement is rarely reported. Herein, we report a rare case of conjunctival involvement of MF.Case Presentation. A 66-year-old man who was previously diagnosed with MF in 2010 and was treated presented in 2014 complaining of foreign body sensation and redness in both eyes. Slit lamp examination of both eyes showed erythematous conjunctival growth that extended circumferentially. Physical examination revealed erythematous skin lesions on different body parts. Conjunctival biopsy was performed and revealed a dense, highly polymorphic lymphocytic population. The immunophenotype demonstrated a neoplastic T-cell origin consistent with MF. A diagnosis of conjunctival involvement by MF was made. The conjunctiva was treated with radiotherapy resulting in tumor regression. There were no recurrences at the 6-month follow-...
Extensive necrotizing vasculitis (ENV) is a rare paraneoplastic phenomenon, and the majority of c... more Extensive necrotizing vasculitis (ENV) is a rare paraneoplastic phenomenon, and the majority of cases reported are associated with hematolymphoid neoplasms. Histologically, most cases of ENV represent leukocytoclastic vasculitis (LCV). Here we report the clinicopahological features of a 68-year-old man with ENV associated to a Epstein Barr virus-positive diffuse large B-cell lymphoma (EBV+DLBCL) of the elderly, a newly recognized lymphoproliferative disorder, most likely representing a paraneoplastic manifestation. The patient was treated with standard chemotherapy regimen for malignant lymphoma. Due to the extensive involvement of the extremities by ENV, surgical debridement was not feasible and a novel therapy based on CHITOSAN apposits was initiated with overall good response and subsequent re-epithelization of the skin lesions. The patient died of sepsis secondary to a Pseudomona pneumonia 17 months after diagnosis.
Background: Digital pathology (DP) adoption in Latin America has expanded slower than in develope... more Background: Digital pathology (DP) adoption in Latin America has expanded slower than in developed regions, probably due to many barriers not seen in the latter areas. This article aims to present the current scenario in the region, highlighting barriers and possible solutions to encourage its adoption in Latin American countries.Methods: An expert panel of 9 Latin American medical pathologists and 1 information technology specialist participated in an online modified Delphi panel, utilizing a third-party platform (iAdvise, Within3, USA). Thirteen pre-prepared questions were answered interactively.Results: Experts' observations confirm the paucity of labs in the region that utilize digital pathology technology. The panel ranked obtaining second opinions and presenting images remotely as the main benefit of a digital pathology system, although many others were cited as well. Cost of implantation was the main barrier mentioned by the experts, and payers' and decision makers...
International journal of surgical pathology, Jan 8, 2016
Conjunctival melanoma is the second most common conjunctival malignancy. Its differential diagnos... more Conjunctival melanoma is the second most common conjunctival malignancy. Its differential diagnosis with other conjunctival melanocytic neoplasms is inherently difficult. The presence of epithelial cysts is a useful feature in conjunctival tumors and favors a benign lesion. Herein 2 cases of conjunctival melanoma with cysts are presented. To the best of our knowledge, this is the first series of conjunctival melanoma with epithelial inclusion cysts. This series emphasizes the importance of considering several malignant features when reviewing conjunctival melanocytic lesions, as malignancy can exist even in the presence of epithelial inclusion cysts.
Background. Ocular involvement in mycosis fungoides (MF) cases occurs in one-third of patients wi... more Background. Ocular involvement in mycosis fungoides (MF) cases occurs in one-third of patients with the eyelid being the most frequent site affected; however, conjunctival involvement is rarely reported. Herein, we report a rare case of conjunctival involvement of MF.Case Presentation. A 66-year-old man who was previously diagnosed with MF in 2010 and was treated presented in 2014 complaining of foreign body sensation and redness in both eyes. Slit lamp examination of both eyes showed erythematous conjunctival growth that extended circumferentially. Physical examination revealed erythematous skin lesions on different body parts. Conjunctival biopsy was performed and revealed a dense, highly polymorphic lymphocytic population. The immunophenotype demonstrated a neoplastic T-cell origin consistent with MF. A diagnosis of conjunctival involvement by MF was made. The conjunctiva was treated with radiotherapy resulting in tumor regression. There were no recurrences at the 6-month follow-...
Extensive necrotizing vasculitis (ENV) is a rare paraneoplastic phenomenon, and the majority of c... more Extensive necrotizing vasculitis (ENV) is a rare paraneoplastic phenomenon, and the majority of cases reported are associated with hematolymphoid neoplasms. Histologically, most cases of ENV represent leukocytoclastic vasculitis (LCV). Here we report the clinicopahological features of a 68-year-old man with ENV associated to a Epstein Barr virus-positive diffuse large B-cell lymphoma (EBV+DLBCL) of the elderly, a newly recognized lymphoproliferative disorder, most likely representing a paraneoplastic manifestation. The patient was treated with standard chemotherapy regimen for malignant lymphoma. Due to the extensive involvement of the extremities by ENV, surgical debridement was not feasible and a novel therapy based on CHITOSAN apposits was initiated with overall good response and subsequent re-epithelization of the skin lesions. The patient died of sepsis secondary to a Pseudomona pneumonia 17 months after diagnosis.
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