1/28. Metanephric adenofibroma: report of a case and review of the literature.The recent recognition of a variety of pediatric renal tumors of different biologic behavior places an ever-increasing demand on the surgical pathologist for an accurate diagnosis. Although metanephric adenofibroma is one of the rarest benign renal tumors, the clinical importance of correctly diagnosing it cannot be overemphasized because it can potentially be mistaken as Wilms' tumor. We describe the clinical, radiologic, and pathologic features of a case of metanephric adenofibroma and discuss its differential diagnosis. The neoplasm was composed of two discrete components: a major fibroblastic element and a minor immature epithelial element. The latter formed a small nodule beneath the renal capsule, which could barely be detected by magnetic resonance imaging. This subcapsular nodule, however, was slightly soft and tan and was distinctly different from the white, whorled cut surface of the main tumor. It was formed by closely packed small immature epithelial cells in a slightly edematous background, which was histologically identical to metanephric adenoma and closely resembled epithelial Wilms' tumor. Unlike Wilms' tumor, however, the epithelial cells were very bland with no mitoses. The main bulk of the tumor was formed by spindle fibroblastic cells that were cytologically similar to the spindle cells in congenital mesoblastic nephroma. The tumor, however, was well demarcated without the irregular infiltrating edges of congenital mesoblastic nephroma. In contrast to the randomly distributed epithelial element throughout the stromal component in previous reported cases of metanephric adenofibroma, our finding of the exceedingly small and discrete epithelial component expands the known histologic spectrum of the disease. In addition, the presence of such minute epithelial nodule underscores the importance of diligent pathologic examination and careful sampling of tissue for histologic examination.- - - - - - - - - - ranking = 1keywords = neoplasm (Clic here for more details about this article) |
2/28. Endocrine cell micronests in an ovarian mucinous cystadenofibroma: a mimic of microinvasion.An ovarian mucinous cystadenofibroma with peculiar neuroendocrine cell micronests is described in a 59-year-old Japanese woman. Aggregates of epithelial cells resembling microinvasive carcinoma cells were scattered throughout the adenofibromatous area. These micronests were composed of small uniform cells with argentaffin and argyrophil granules. Numerous small cells with neuroendocrine granules were also seen within mucinous glands. This is the first report of neuroendocrine micronests in an ovarian neoplasm, a finding that should be distinguished from microinvasion.- - - - - - - - - - ranking = 1keywords = neoplasm (Clic here for more details about this article) |
3/28. Eccrine syringofibroadenoma (Mascaro): an immunohistochemical study.Eccrine syringofibroadenoma is an uncommon benign eccrine tumor, which was first described by Mascaro in 1963. It usually develops on the extremities of elderly persons. We report on a 74-year-old man who presented with a 2-year history of a slowly growing lesion on his face. A detailed histologic and immunohistochemical study was performed on the biopsy material. The tumor consisted of epidermal-derived anastomosing thin epithelial cords embedded in a fibrovascular stroma. The epithelial cords contained ductal and cystic structures lined by luminal cells, which were decorated by antibodies against carcinoembryonic antigen, keratin K19, K8, and K18. Antibody to keratin K6 decorated the luminal walls of the acrosyringia. antibodies to filaggrin decorated the superficial luminal structures. These results suggest dual acrosyringial and dermal duct differentiation in syringofibroadenoma.- - - - - - - - - - ranking = 0.51290953379721keywords = ductal (Clic here for more details about this article) |
4/28. Biliary adenofibroma: a rare neoplasm of bile duct origin with an indolent behavior.We report a case of biliary adenofibroma in a 47-year-old woman, who presented with right upper quadrant pain for several months. Abdominal imaging revealed a 16-cm solid and cystic mass in the left hepatic lobe. Histologically, the tumor showed two distinct components: 1) cystic and tubular structures lined by low columnar to cuboidal biliary-type epithelium, and 2) a dense fibrous stroma composed of spindle-shaped cells with only mild nuclear pleomorphism and inconspicuous nucleoli. Mitoses and stromal invasion were absent. The glandular epithelium stained positively for keratin AE.3/Cam 5.2, cytokeratin 7, cytokeratin 19, carcinoembryonic antigen, and epithelial membrane antigen and had a low Ki-67 proliferative index. In addition, the epithelium was positive for D10 but did not stain for 1F6 or acid mucin with alcian blue stain. This staining pattern, similar to bile duct hamartoma (von Meyenburg complex) with which this tumor shares morphologic similarity, suggests that biliary adenofibroma originates from interlobular or larger bile ducts. Three years after a subtotal resection no metastasis or significant tumor growth was noted. However, given the marked nuclear p53 immunoreactivity and tetraploidy status observed in this tumor, we cannot exclude that biliary adenofibroma may represent a premalignant process that warrants complete resection and thorough histopathologic examination.- - - - - - - - - - ranking = 4keywords = neoplasm (Clic here for more details about this article) |
5/28. Eccrine syringofibroadenomatosis: a clinical and histologic study and review of the literature.A 56-year-old man had an 11-year history of a psoriasiform eruption of the palms, soles, and shins. An examination revealed well-demarcated patches and plaques of erythematous, fissured, and hyperkeratotic skin with focal erosions. There was no clinical evidence of ectodermal dysplasia. On histologic examination these lesions proved to be eccrine hamartomas that consisted of anastomosing cords and strands of cuboidal epithelial cells with well-formed ducts and a fibrovascular mucinous stroma. Eccrine ductal origin was indicated by histopathologic, histochemical, immunopathologic, and electron microscopic evaluation. These multiple palmoplantar eccrine hamartomas, unassociated with ectodermal dysplasia, represent a sporadic hamartomatous condition that is best designated as "eccrine syringofibroadenomatosis."- - - - - - - - - - ranking = 0.51290953379721keywords = ductal (Clic here for more details about this article) |
6/28. Correlation of radiological and clinical features of metanephric neoplasms in adults.The main objective was to determine the clinical and radiological features of metanephric neoplasms. The tumors were diagnosed on histopathological examination. The clinical data and imaging features were retrospectively analyzed. Between 1998 and 2003, 3 patients underwent radical nephrectomy for renal masses turning out as metanephric neoplasms on histopathology. Two of these tumors were metanephric adenoma (MA) and one was metanephric adenofibroma (MAF). Clinical and radiological features were reviewed. All patients were adult females who presented with flank pain. Tumor was detected on screening ultrasound as a hyperechoic lesion. In all cases CT showed a hyper-attenuating exophytic lesion with cystic areas that enhanced with IV contrast. Based on combination of clinical and imaging features it may be possible to prospectively identify metanephric neoplasms and thus avoid unnecessary radical nephrectomy in favor of conservative surgery.- - - - - - - - - - ranking = 7keywords = neoplasm (Clic here for more details about this article) |
7/28. Combined high grade sarcoma and serous ovarian neoplasm.A case of an ovarian serous epithelial neoplasm of borderline type admixed with sarcomatous elements is reported. This combination seems to be extremely rare with only four cases previously reported. It may represent a type of collision tumour or the development of a sarcoma in a growth with borderline differentiation.- - - - - - - - - - ranking = 5keywords = neoplasm (Clic here for more details about this article) |
8/28. Papillary adenofibroma of the cervix: a case report.Adenofibroma is an extremely rare benign biphasic neoplasm that is classified into the mixed epithelial and mesenchymal tumor group. It typically affects the endometrium, but may occur in the cervix or in an extrauterine location. Preoperative diagnosis of this tumor is usually difficult. We describe the case of a 55-year-old woman with papillary cervical adenofibroma, which appeared as a cervical mass containing multiple cystic components on transvaginal ultrasound. This lesion appears to be clinically and histologically benign but must be differentiated from malignant lesions of the uterus, particularly from adenosarcoma, which can be suggestive of adenofibroma. Accurate diagnosis of these benign tumors permits appropriate counseling of patients.- - - - - - - - - - ranking = 1keywords = neoplasm (Clic here for more details about this article) |
9/28. Adenofibroma of the endometrium protruding into the vaginal cavity: findings on transvaginal ultrasonography, MRI and CT.Adenofibroma is a rare benign biphasic neoplasm that is classified into the mixed epithelial and mesenchymal tumor group. We report the case of a 42-year-old woman with adenofibroma of the endometrium protruding into the vagina. Transvaginal ultrasonography revealed the tumor as an intravaginal mass containing multiple cystic components. magnetic resonance imaging (MRI) showed a heterogeneous high-intensity mass filling the vaginal cavity on T2-weighted imaging, with a low-contrast enhanced septum identified within the mass on gadolinium-enhanced, T1-weighted imaging. Contrast-enhanced computed tomography (CT) showed a heterogeneous low-attenuating multicystic mass filling the vaginal cavity. Although preoperative diagnosis of this rare tumor is very difficult, the combination of MRI, CT, and ultrasonography offers a useful diagnostic tool.- - - - - - - - - - ranking = 1keywords = neoplasm (Clic here for more details about this article) |
10/28. Pleomorphic adenoma (benign mixed tumor) of the breast. An immunohistochemical, flow cytometric, and ultrastructural study and review of the literature.Pleomorphic adenoma (or benign mixed tumor) of the breast is a rare benign neoplasm that might be misinterpreted both clinically and pathologically as a malignant tumor. The authors present an additional case of this unusual lesion studied by immunohistochemistry, electron microscopy, and flow cytometry. A 77-year-old white woman presented with a 2-cm, nontender, mobile, calcified, right subareolar mass suggestive of a fibroadenoma. Microscopically, the tumor resembled a pleomorphic adenoma occurring in salivary glands. Positive immunostaining for S-100 protein, cytokeratin, and muscle-specific actin, as well as the ultrastructural presence of intermediate filaments with dense bodies and intercellular junctions, supported the predominant myoepithelial cell differentiation within the tumor, whereas the epithelial cell component stained only with cytokeratin and contained formed lumina with surface microvilli. The dna pattern was diploid. The patient is alive and well 14 months after surgery. The authors' findings confirm that pleomorphic adenoma of the breast is a benign neoplasm in which myoepithelial cell proliferation plays a major role in tumorigenesis.- - - - - - - - - - ranking = 2keywords = neoplasm (Clic here for more details about this article) |
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