1/5. Multiple metastases to the small bowel from large cell bronchial carcinomas.AIM: Metastases from lung cancer to gastrointestinal tract are not rare at postmortem studies but the development of clinically significant symptoms from the gastrointestinal metastases is very unusual. methods: Formalin-fixed, paraffin-embedded tissues were cut into 5 microm thick sections and routinely stained with hematoxylin and eosin. Some slides were also stained with Alcian-PAS. antibodies used were primary antibodies to pancytokeratin, cytokeratin 7, cytokeratin 20, epithelial membrane antigen, vimentin, smooth muscle actin and CD-117. RESULTS: We observed three patients who presented with multiple metastases from large cell bronchial carcinoma to small intestine. Two of them had abdominal symptoms (sudden onset of abdominal pain, constipation and vomiting) and in one case the tumor was incidentally found during autopsy. Microscopically, all tumors showed a same histological pattern and consisted almost exclusively of strands and sheets of poorly cohesive, polymorphic giant cells with scanty, delicate stromas. Few smaller polygonal anaplastic cells dispersed between polymorphic giant cells, were also observed. immunohistochemistry showed positive staining of the tumor cells with cytokeratin and vimentin. Microscopically and immunohistochemically all metastases had a similar pattern to primary anaplastic carcinoma of the small intestine. CONCLUSION: In patients with small intestine tumors showing anaplastic features, especially with multiple tumors, metastases from large cell bronchial carcinoma should be first excluded, because it seems that they are more common than expected.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
2/5. Pleomorphic (anaplastic) neuroblastoma.Four very unusual cases of neuroblastoma in children are reported. Clinically, they had a similar presentation: advanced disease at onset, diffuse abdominal spread, poor treatment response, and rapid progression. Pathologically, the four cases were characterized by a striking degree of cellular and nuclear pleomorphism and anaplasia with bizarre and monstrous expressions. Although some authors have referred to the immature ganglion cells found in neuroblastoma as "bizarre ganglion cells," they usually mean the enlarged, maturing neuroblasts that are typical of ganglioneuroblastoma but far from the extreme anaplasia seen in our cases. A correlation between the clinical course and the histological picture could be hypothetically suggested, but additional evidence and confirmation is needed. These cellular aberrations might represent an unsuccessful and impaired attempt at maturation. Independent from prognosis, the definition of anaplastic neuroblastoma is a useful conceptual specification in the study of this tumor and of giant cell and pleomorphic malignant neoplasms of childhood.- - - - - - - - - - ranking = 0.5keywords = giant (Clic here for more details about this article) |
3/5. Anaplastic transformation of medullary thyroid cancer.The paper presents a detailed microscopic study of a case of medullary thyroid carcinoma with the loss of amyloid production and of argyrophilic cellular granules combined with the prevalence of giant multinucleated cells in a part of the primary tumor and namely in metastatic deposits. These changes are believed to give evidence of anaplastic dedifferentiation. Similar cases to that reported are reviewed with the conclusion that not only differentiated thyroid cancers but medullary thyroid cancers as well are capable of anaplastic transformation. However rare the medullary thyroid cancers are, they should be diagnosed and radically treated so as to prevent their fatal anaplastic transformation.- - - - - - - - - - ranking = 0.5keywords = giant (Clic here for more details about this article) |
4/5. Anaplastic carcinoma of the thyroid: a review of 84 cases of spindle and giant cell carcinoma of the thyroid.Eighty-four cases of spindle and giant cell carcinoma of the thyroid were reviewed. This is a swiftly growing, and rapidly fatal neoplasm that generally develops in the elderly. Treatment of this disease was generally unsuccessful with a 7.1% five-year survival rate and a mean survival period of 6.2 months from the time of tissue diagnosis. In the majority of cases, areas of well-differentiated thyroid carcinoma could be identified, supporting the concept that spindle and giant cell carcinoma results from the transformation of preexisting well-differentiated thyroid carcinoma. Because of the aggressive biologic activity of this neoplasm, we treat all cases as disseminated disease at the time of presentation. Our best therapeutic results have been obtained with a combination of surgery, irradiation, and chemotherapy; however, these results still leave much to be desired. patients with only small foci of spindle and giant cell carcinoma, at the time of diagnosis, may have a better chance of prolonged survival.- - - - - - - - - - ranking = 3.5keywords = giant (Clic here for more details about this article) |
5/5. Anaplastic variant of spermatocytic seminoma.Four examples of spermatocytic seminoma with a predominant anaplastic component occurred in men 33 to 43 years of age, without histories of cyptorchidism. The seminomas presented with painless testicular masses recognized 3 to 18 months before orchiectomy. Preoperative serum measurements of human chorionic gonadotropin and alpha-fetoprotein were negative. All tumors contained areas (10% to 30% of the tumor) in which the three cell types characteristic of conventional spermatocytic seminoma could be identified under light microscopy. The predominant anaplastic component also contained the three cell types, but the nuclei had prominent nucleoli with granular and filamentous chromatin. In addition, sheets of cells with vesicular nuclei and prominent nucleoli superficially resembling embryonal carcinoma were found. There were numerous large mononuclear and multinucleated giant cells with bizarre nuclei and prominent nucleoli, but no sarcomatous elements. Many normal and abnormal mitotic figures were present. Tunical and vascular invasion and extensive necrosis were constant features. immunohistochemistry documented p53 protein overexpression in two tumors, but neoplastic cells were negative with immunostains for placenta-like alkaline phosphatase, leukocyte common antigen, neuron-specific enolase, alpha-fetoprotein, human chorionic gonadotropin, vimentin, and cytokeratins. Ultrastructural examination of the anaplastic component showed large rope-like nucleoli, but the cytoplasmic features were similar to those of conventional spermatocytic seminoma. Despite the presence of a major anaplastic component, no patient has developed metastasis. Larger series and longer follow-up are needed to understand the natural history of these neoplasms.- - - - - - - - - - ranking = 0.5keywords = giant (Clic here for more details about this article) |