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Smooth Muscle Hamartoma

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61. Nonneoplastic Epithelial Disorders of the Vulva (Overview)

, and Skene ducts. Different epithelia, from keratinized squamous epithelium to squamous mucosa, cover the vulva. The labia minora are rich with sebaceous glands but have few sweat glands and no hair follicles. The epithelium of the vestibule is neither pigmented nor keratinized and contains eccrine glands. Benign vulvar disorders are a significant issue for patients. These disorders include vulvar atrophy, benign tumors, hamartomas and cysts, infectious disorders, and nonneoplastic epithelial disorders (...) : , lentiginosis, and benign vulvar melanosis Postinflammatory hypopigmentation Vulvar melanosis [ ] Benign tumors, hamartomas, and cysts involving the vulvar region include the following [ ] : Bartholin and Skene duct cysts (fibroepithelial polyp) Fibroma, fibromyoma, and dermatofibroma Hidradenoma Syringoma Hemangioma Angiokeratoma Heterotopic sebaceous glands and sebaceous gland hyperplasia Papillomatosis (papillary vulvar hirsutism) Schwannoma [ ] Angiomyxoma: a benign and aggressive mesenchymal tumor

2014 eMedicine.com

62. Solitary Pulmonary Nodule (Overview)

, marblelike consistency. Histologically, hamartomas generally consist of epithelial tissue and other tissues, such as fat and cartilage. Hamartomas can be easily enucleated, but wedge resection is also appropriate. Hamartomas consist of haphazardly organized mature cells and tissues. Hamartomas are composed mostly of masses of hyaline cartilage with a myxoid connective tissue, adipose cells, smooth muscle cells, and clefts lined with respiratory epithelium. See the image below. A right lower lobe solitary (...) pulmonary nodule is the the best chance for cure. Benign lung tumors Benign lung tumors are a heterogenous group of neoplastic lesions originating from pulmonary structures. These tumors include bronchial adenomas, hamartomas, and a group of uncommon neoplasms (eg, chondromas, fibromas, lipomas, leiomyomas, hemangiomas, teratomas, pseudolymphomas, endometrioma, and bronchial glomus tumors). Although benign lung tumors do not pose a significant health problem, complications can result if an obstructive

2014 eMedicine.com

63. Angioma Serpiginosum (Treatment)

-Juanes-Jimenez J. [Six cases of nevus oligemicus]. Actas Dermosifiliogr . 2008 May. 99(4):301-4. . Vivehanantha S, Browne F, Bowen C, Brundler MA, Hughes J, Moss C, et al. A congenital smooth muscle hamartoma masquerading as a reticulate vascular naevus. Clin Exp Dermatol . 2013 Jun 13. . Miura T, Yamamoto T. Pediatric linear scleroderma initially developed with angioma serpiginosum-like appearances. J Dermatol . 2015 May 11. . Polla LL, Tan OT, Garden JM, Parrish JA. Tunable pulsed dye laser

2014 eMedicine.com

64. Benign Vulvar Lesions (Treatment)

. Different epithelia, from keratinized squamous epithelium to squamous mucosa, cover the vulva. The labia minora are rich with sebaceous glands but have few sweat glands and no hair follicles. The epithelium of the vestibule is neither pigmented nor keratinized and contains eccrine glands. Benign vulvar disorders are a significant issue for patients. These disorders include vulvar atrophy, benign tumors, hamartomas and cysts, infectious disorders, and nonneoplastic epithelial disorders. [ ] Infectious (...) vulvar melanosis Postinflammatory hypopigmentation Vulvar melanosis [ ] Benign tumors, hamartomas, and cysts involving the vulvar region include the following [ ] : Bartholin and Skene duct cysts (fibroepithelial polyp) Fibroma, fibromyoma, and dermatofibroma Hidradenoma Syringoma Hemangioma Angiokeratoma Heterotopic sebaceous glands and sebaceous gland hyperplasia Papillomatosis (papillary vulvar hirsutism) Schwannoma [ ] Angiomyxoma: a benign and aggressive mesenchymal tumor. [ ] Congenital

2014 eMedicine.com

65. Oral Manifestations of Systemic Diseases (Treatment)

on lemons or in patients with bulimia who are often in the habit of brushing their teeth after purging, which results in a labial or facial loss of enamel. Enamel erosion due to gastric fluid exposure is most commonly seen on the palatal surfaces of the maxillary teeth. [ ] Erosion of the enamel exposes the underlying dentin, which is softer and more opaque yellow. The extent of erosion depends on the frequency and quantity of exposure, along with the duration of disease. Newly exposed dentin is smooth

2014 eMedicine.com

66. Urologic Imaging Without X-rays: Ultrasound, MRI, and Nuclear Medicine (Treatment)

some or all of the TZ. Such calcifications have been correlated with a history of prostatitis but are often seen in healthy young men with no history of prostatic inflammation. The preprostatic sphincter, composed of the bladder neck and periurethral tissue, is located between the 2 lobes of the TZ. This structure demonstrates the dramatic hypoechogenicity typical of muscle due to the concentration of smooth muscle fibers. These muscles appear as an inverted Y, which has been termed the Eiffel (...) , this variant gives the appearance of bilateral basilar hypoechogenicity. In 12% of patients, abnormal penetration of the seminal vesicles and vas deferens was present at the rectal surface of the prostate, characterized by a lack of CZ tissue posterior to these structures, which sonographically appeared as midline hypoechogenicity at the base of the prostate. In 6% of cases, abnormally large (>2 mm in diameter) smooth muscle bundles were present within the ejaculatory duct sheath, which also produced

2014 eMedicine.com

67. Peutz-Jeghers Syndrome (Treatment)

syndrome are typical hamartomas. Their histology is characterized by extensive smooth muscle arborization throughout the polyp. [ , ] This may give the lesion the appearance of pseudoinvasion, because some of the epithelial cells, usually from benign glands, are surrounded by the smooth muscle (the lack of dysplasia in the polyps help to differentiate pseudoinvasion from malignancy). [ , ] Cancer develops in the gastrointestinal tract of patients with Peutz-Jeghers syndrome with a higher frequency than (...) of a “clean-sweep” strategy for disease surveillance or because they are resulting in symptoms, including bleeding. Previous Next: Histologic Findings Polyps in Peutz-Jeghers syndrome (PJS) can reliably be differentiated from other types of polyps only by histopathology, [ ] and surgical pathologists can have a critical role in recommending genetic counseling and surveillance of the patient and/or family members when the diagnosis is suspected. [ ] Smooth-muscle hyperplasia, with an elongated, arborized

2014 eMedicine.com

68. Nonneoplastic Epithelial Disorders of the Vulva (Treatment)

, and Skene ducts. Different epithelia, from keratinized squamous epithelium to squamous mucosa, cover the vulva. The labia minora are rich with sebaceous glands but have few sweat glands and no hair follicles. The epithelium of the vestibule is neither pigmented nor keratinized and contains eccrine glands. Benign vulvar disorders are a significant issue for patients. These disorders include vulvar atrophy, benign tumors, hamartomas and cysts, infectious disorders, and nonneoplastic epithelial disorders (...) : , lentiginosis, and benign vulvar melanosis Postinflammatory hypopigmentation Vulvar melanosis [ ] Benign tumors, hamartomas, and cysts involving the vulvar region include the following [ ] : Bartholin and Skene duct cysts (fibroepithelial polyp) Fibroma, fibromyoma, and dermatofibroma Hidradenoma Syringoma Hemangioma Angiokeratoma Heterotopic sebaceous glands and sebaceous gland hyperplasia Papillomatosis (papillary vulvar hirsutism) Schwannoma [ ] Angiomyxoma: a benign and aggressive mesenchymal tumor

2014 eMedicine.com

69. Peutz-Jeghers Syndrome (Overview)

syndrome are typical hamartomas. Their histology is characterized by extensive smooth muscle arborization throughout the polyp. [ , ] This may give the lesion the appearance of pseudoinvasion, because some of the epithelial cells, usually from benign glands, are surrounded by the smooth muscle (the lack of dysplasia in the polyps help to differentiate pseudoinvasion from malignancy). [ , ] Cancer develops in the gastrointestinal tract of patients with Peutz-Jeghers syndrome with a higher frequency than (...) of a “clean-sweep” strategy for disease surveillance or because they are resulting in symptoms, including bleeding. Previous Next: Histologic Findings Polyps in Peutz-Jeghers syndrome (PJS) can reliably be differentiated from other types of polyps only by histopathology, [ ] and surgical pathologists can have a critical role in recommending genetic counseling and surveillance of the patient and/or family members when the diagnosis is suspected. [ ] Smooth-muscle hyperplasia, with an elongated, arborized

2014 eMedicine.com

70. Pilar Cyst (Overview)

aggressive. Recurrences and metastases have been observed, with rare malignant transformation. [ , ] Next: Pathophysiology Erroneously but often called sebaceous cysts, trichilemmal cysts are lined by stratified squamous epithelium similar to that in the isthmus of the hair follicle. [ ] This is the segment between the insertion of the erector pili muscle and the sebaceous gland duct, where no inner root sheath exists. The keratinization is similar to that which occurs in the outer root sheath (...) , Swanson NA. Benign Epithelial Tumors, Hamartomas, and Hyperplasias. Goldsmith LA, Katz SI, Gilchrest BA, Paller AS, Leffell DJ, Wolff K, eds. Fitzpatrick's Dermatology in General Medicine . 8th ed. New York, NY: McGraw-Hill; 2012. 1334. James WD, Berger TG, Elston DM. Andrews’ Diseases of the Skin: Clinical Dermatology . 12th ed. Philadelphia, Pa: Saunders Elsevier; 2015. 673. Al-Khateeb TH, Al-Masri NM, Al-Zoubi F. Cutaneous cysts of the head and neck. J Oral Maxillofac Surg . Jan 2009. 67(1):52-7

2014 eMedicine.com

71. Nevi, Melanocytic (Overview)

such as hair follicles, within the subcutis, and sometimes within skeletal muscle, smooth muscle bundles, nerves, or sebaceous glands. Errant embryological migration is also believed to be the source of melanocytic nevus cell "rests," which can be observed in the capsules of lymph nodes. Occasionally, rests of melanocytes can also be found in the subcapsular space or within lymph node trabecula. The importance of melanocytic nevus rests is that they can sometimes be mistaken for metastatic deposits because (...) Author: Timothy McCalmont, MD; Chief Editor: Dirk M Elston, MD Share Email Print Feedback Close Sections Sections Melanocytic Nevi Overview Background Melanocytic nevi are benign neoplasms or hamartomas composed of melanocytes, the pigment-producing cells that constitutively colonize the epidermis. Melanocytes are derived from the neural crest and migrate during embryogenesis to selected ectodermal sites (primarily the skin and the CNS), but also to the eyes and the ears. Ectopic melanocytes have

2014 eMedicine.com

72. Neuro-ophthalmic Examination (Overview)

. Multiple occlusions of the branch retinal artery in a patient with deafness and cerebrovascular accident may suggest Susac syndrome. Retinochoroidal striae may indicate an orbital mass lesion. Some of the phakomatoses have classic fundus findings. Astrocytic hamartomas (ie, mulberry-like tumors) may be seen with tuberous sclerosis. Retinal angiomatosis may be seen in patients with von Hippel disease. Retinal arteriovenous malformation may be seen with Wyburn-Mason syndrome. Diffuse choroidal (...) that lid-inferior gaze synkinesis is not missed, and, second, with the lids lifted so that the lids do not obscure the eyes. Smooth pursuit is tested by having the patient slowly follow a moving target. Saccades can be tested by asking the patient to move his or her eyes in a particular direction. Separating saccades from smooth pursuit may be clinically important. Smooth pursuit may be irregular in brainstem-cerebellar disease, and catch-up saccades may be required. In Parinaud syndrome, upgaze

2014 eMedicine.com

73. Solitary Pulmonary Nodule (Treatment)

, marblelike consistency. Histologically, hamartomas generally consist of epithelial tissue and other tissues, such as fat and cartilage. Hamartomas can be easily enucleated, but wedge resection is also appropriate. Hamartomas consist of haphazardly organized mature cells and tissues. Hamartomas are composed mostly of masses of hyaline cartilage with a myxoid connective tissue, adipose cells, smooth muscle cells, and clefts lined with respiratory epithelium. See the image below. A right lower lobe solitary (...) pulmonary nodule is the the best chance for cure. Benign lung tumors Benign lung tumors are a heterogenous group of neoplastic lesions originating from pulmonary structures. These tumors include bronchial adenomas, hamartomas, and a group of uncommon neoplasms (eg, chondromas, fibromas, lipomas, leiomyomas, hemangiomas, teratomas, pseudolymphomas, endometrioma, and bronchial glomus tumors). Although benign lung tumors do not pose a significant health problem, complications can result if an obstructive

2014 eMedicine.com

74. Sebaceous Adenoma (Overview)

differentiation. The following terms are recognized within this category: sebaceous adenoma, sebaceous epithelioma (sebaceoma), sebaceous carcinoma, basal cell carcinoma with sebaceous differentiation, sebocrine adenoma, and sebomatricoma. Skin lesions containing benign sebaceous gland proliferation (eg, sebaceous hyperplasia), congenital hamartomas (eg, nevus sebaceus), and lesions with ectopic sebaceous structures (eg, Fordyce spot, Montgomery tubercles) are generally not considered to be true sebaceous (...) be identified that synthesize melanin-containing organelles (melanin granules) in the ducts and acini of human sebaceous glands. [ ] As one of the skin's adnexal structures, the sebaceous gland is intimately associated with hair (pilar) and arrector pili muscle. Because of the intimate association of sebaceous glands with hair and apocrine ducts, many sebaceous neoplasms show complex histopathologic features with various elements of pilar and sweat gland differentiation. Pilar and sebaceous neoplasms share

2014 eMedicine.com

75. Oral Manifestations of Systemic Diseases (Overview)

on lemons or in patients with bulimia who are often in the habit of brushing their teeth after purging, which results in a labial or facial loss of enamel. Enamel erosion due to gastric fluid exposure is most commonly seen on the palatal surfaces of the maxillary teeth. [ ] Erosion of the enamel exposes the underlying dentin, which is softer and more opaque yellow. The extent of erosion depends on the frequency and quantity of exposure, along with the duration of disease. Newly exposed dentin is smooth

2014 eMedicine.com

76. Glomus Tumor (Overview)

, with most cases involving subungual sites. These tumors are characteristically painful, often causing paroxysmal pain in response to temperature changes (especially cold) or pressure. Note the images below. Glomus tumor. Multiple glomus tumors. Glomus tumors are thought to arise from the glomus body or Sucquet-Hoyer canal, a thermoregulatory arteriovenous shunt composed of modified smooth muscle cells. [ , ] Glomus tumors most frequently occur in areas with high concentrations of glomus bodies (...) canal), primary collecting vein, intraglomerular reticulum, and a capsular portion. These specialized arteriovenous anastomoses are particularly concentrated in the reticular dermis of the fingers. Glomus tumors are thought to represent hamartomatous proliferations of modified smooth muscle cells originating from preexisting normal glomus cell populations. The three components of most glomus tumors include glomus cells, vasculature, and smooth muscle cells. The most common type of glomus tumor

2014 eMedicine.com

77. Urologic Imaging Without X-rays: Ultrasound, MRI, and Nuclear Medicine (Overview)

correlated with a history of prostatitis but are often seen in healthy young men with no history of prostatic inflammation. The preprostatic sphincter, composed of the bladder neck and periurethral tissue, is located between the 2 lobes of the TZ. This structure demonstrates the dramatic hypoechogenicity typical of muscle due to the concentration of smooth muscle fibers. These muscles appear as an inverted Y, which has been termed the Eiffel Tower sign, in the axial plane and as a curved, triangular (...) basilar hypoechogenicity. In 12% of patients, abnormal penetration of the seminal vesicles and vas deferens was present at the rectal surface of the prostate, characterized by a lack of CZ tissue posterior to these structures, which sonographically appeared as midline hypoechogenicity at the base of the prostate. In 6% of cases, abnormally large (>2 mm in diameter) smooth muscle bundles were present within the ejaculatory duct sheath, which also produced midline hypoechogenicity at the prostate base

2014 eMedicine.com

78. Benign Vulvar Lesions (Overview)

epithelia, from keratinized squamous epithelium to squamous mucosa, cover the vulva. The labia minora are rich with sebaceous glands but have few sweat glands and no hair follicles. The epithelium of the vestibule is neither pigmented nor keratinized and contains eccrine glands. Benign vulvar disorders are a significant issue for patients. These disorders include vulvar atrophy, benign tumors, hamartomas and cysts, infectious disorders, and nonneoplastic epithelial disorders. [ ] Infectious disorders (...) melanosis Postinflammatory hypopigmentation Vulvar melanosis [ ] Benign tumors, hamartomas, and cysts involving the vulvar region include the following [ ] : Bartholin and Skene duct cysts (fibroepithelial polyp) Fibroma, fibromyoma, and dermatofibroma Hidradenoma Syringoma Hemangioma Angiokeratoma Heterotopic sebaceous glands and sebaceous gland hyperplasia Papillomatosis (papillary vulvar hirsutism) Schwannoma [ ] Angiomyxoma: a benign and aggressive mesenchymal tumor. [ ] Congenital malformations

2014 eMedicine.com

79. Oral Manifestations of Systemic Diseases (Follow-up)

on lemons or in patients with bulimia who are often in the habit of brushing their teeth after purging, which results in a labial or facial loss of enamel. Enamel erosion due to gastric fluid exposure is most commonly seen on the palatal surfaces of the maxillary teeth. [ ] Erosion of the enamel exposes the underlying dentin, which is softer and more opaque yellow. The extent of erosion depends on the frequency and quantity of exposure, along with the duration of disease. Newly exposed dentin is smooth

2014 eMedicine.com

80. Angioma Serpiginosum (Overview)

Dermosifiliogr . 2008 May. 99(4):301-4. . Vivehanantha S, Browne F, Bowen C, Brundler MA, Hughes J, Moss C, et al. A congenital smooth muscle hamartoma masquerading as a reticulate vascular naevus. Clin Exp Dermatol . 2013 Jun 13. . Miura T, Yamamoto T. Pediatric linear scleroderma initially developed with angioma serpiginosum-like appearances. J Dermatol . 2015 May 11. . Polla LL, Tan OT, Garden JM, Parrish JA. Tunable pulsed dye laser for the treatment of benign cutaneous vascular ectasia. Dermatologica

2014 eMedicine.com

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