1/16. Aggressive giant fibroepithelial lesion with unusual vascular stroma--a case report.The stroma of fibroadenoma and phyllodes tumor usually consists of fibroblastic proliferation. Rarely the stroma contains bundles of smooth muscle. Pseudoangiomatous hyperplasia of the mammary stroma has been described in fibroadenomas. However, true benign vascular stroma has not been reported. We report a case of a 34-year-old Chinese woman who presented with a large mass occupying the entire left breast. Left mastectomy was performed and showed a large, well-circumscribed, lobulated, rubbery-firm tumor measuring 13 x 10 x 6 cm. Microscopic examination revealed a fibroepithelial tumor formed by an organoid pattern of ductal structures with a very striking stromal appearance composed of extensive vascular proliferation and that demonstrated strong immunoreactivity for CD31, CD34, and factor viii. Ultrastructural examination revealed intercellular junctions, basal lamina, pinocytotic vesicles, and weibel-palade bodies in the cells lining the vascular spaces, confirming their endothelial nature. These findings rule out the diagnosis of pseudoangiomatous hyperplasia. The patient developed local recurrence a year later, and the resection showed malignant phyllodes tumor with ductal carcinoma in situ.The extensive vascular stroma noted in the primary tumor may have played a role in the malignant transformation of the epithelial and stromal components in this tumor.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
2/16. carcinosarcoma of the submandibular salivary gland. Immunohistochemical findings.Carcinosarcomas of the salivary glands are rare lesions that generally have been associated with benign mixed tumors. The authors report a case of a submandibular gland lesion, which occurred in a 64-year-old man, that was composed of intermingled ductal type adenocarcinoma and osteogenic sarcoma with a large component of osteoclast-like giant cells. The local recurrence of the tumor was entirely sarcomatous with no epithelial component observed. There was no histologic evidence of a preexisting or coexisting pleomorphic adenoma. Immunohistochemical studies confirmed two separate populations of tumor cells, corresponding to the histologic growth pattern. The authors review the literature and discuss histogenetic implications of distinction between de novo carcinosarcoma and carcinosarcoma in association with pleomorphic adenoma.- - - - - - - - - - ranking = 0.25keywords = giant (Clic here for more details about this article) |
3/16. Invasive breast carcinoma with granulomatous response and deposition of unusual amyloid.AIMS: To report an unusual case of invasive breast ductal carcinoma associated with non-caseating epithelioid granuloma and unusual deposition of amyloid. methods: Formalin fixed, paraffin wax embedded tissue from breast and lymph nodes were stained with a variety of methods. Representative tissue fragments were sampled and fixed in 2.5% buffered glutaraldehyde, postfixed in 1% osmium tetroxide, dehydrated and embedded in Araldite. Thin sections were viewed under a Phillips 400T transmission electron microscope. RESULTS: Multinucleated giant Langhans' cells were found in the granulomatas tissue in both breast carcinoma and metastatic axillary lymph node carcinoma. Electron microscopic examination showed "tubular" amyloid deposition intermingled with invasive carcinoma and granuloma. "Tubular amyloid" was characterised by a mesh of non-branching curving fibrils with hollow profiles. These tended to be located in the cell membranes. CONCLUSION: The presence of an epithelioid granulomatous reaction and deposition of "tubular" amyloid in an invasive breast carcinoma could be related to an abnormal immunological response.- - - - - - - - - - ranking = 0.25keywords = giant (Clic here for more details about this article) |
4/16. Ductal carcinoma in situ of the breast with osteoclast-like giant cells.Mammary carcinoma with multinucleated osteoclast-like giant cells (OGCs) is a rare, distinctive variant of breast carcinoma. To date, all of these instances have been described as part of an invasive carcinoma. Here, we report a case of ductal carcinoma in situ of the breast with numerous admixed OGCs present within gland lumens without an associated invasive component. Similar to invasive carcinomas with OGCs, both the in situ carcinoma and the OGCs exhibited overexpression for vascular endothelial growth factor. This case expands the spectrum of tumors associated with OGCs and provides further evidence for the possible role of vascular endothelial growth factor in the stromal-epithelial interactions of in situ mammary carcinoma.- - - - - - - - - - ranking = 1.25keywords = giant (Clic here for more details about this article) |
5/16. Cellular whorls in brain tumors other than meningiomas.Cellular whorls with or without secondary calcification are generally regarded as reliable diagnostic criteria in the differential diagnosis of meningiomas. They may however occasionally occur in other primary and metastatic brain tumors. Five cases (metastatic laryngeal carcinoma, metastatic mammary carcinoma, metastatic melanoma, medulloblastoma, and giant cell glioblastoma) are presented to illustrate this phenomenon occurring in non-meningothelial brain tumors.- - - - - - - - - - ranking = 0.25keywords = giant (Clic here for more details about this article) |
6/16. Osteoclast-type giant cell neoplasms of the parotid gland.The parotid gland is added to the list of parenchymal organs, notably the pancreas, in which osteoclast-like cells appear as constituent cells in their neoplasms. The cells' role in the neoplasms is a reactive one or, more rarely, as an integral element in an osteoclast-type giant cell neoplasm or so-called osteoclastoma. Distinctive in histological appearance, the osteoclast-type giant cell neoplasm is a malignant lesion that, to date, has been described only in the pancreas and parotid glands. This report presents examples of each type of giant cell lesion in the parotid gland.- - - - - - - - - - ranking = 1.75keywords = giant (Clic here for more details about this article) |
7/16. giant cell arteritis of the breast: case report and literature review.The clinical and pathologic features of a case of giant cell arteritis presenting in the breast and those of seven previously reported similar cases are described. A unique finding in the present case was a coincidental in situ and infiltrating ductal carcinoma in the same biopsy specimen. All the patients were postmenopausal women who presented with a firm mass in one or both breasts that mimicked a carcinoma on physical examination. There was no definite clinical evidence of temporal artery involvement in any patient, and two patients had normal temporal arteries on histologic examination. Five patients, however, had systemic manifestations, arteritis in another site, or both. giant cell arteritis presenting in the breast may occur as an isolated finding or represent a manifestation of more widespread disease.- - - - - - - - - - ranking = 0.25keywords = giant (Clic here for more details about this article) |
8/16. Invasive carcinoma of the breast with granulomatous response.Three patients are described who had invasive ductal carcinoma associated with noncaseating epithelioid granulomas. Multinucleated giant cells, predominantly of Langhans' type, were present in the granulomas. The granulomas were restricted to the carcinoma, and no granulomatous response was evident in regional lymph nodes. None of the patients had clinical evidence of systemic granulomatous disease, although one patient subsequently was found to have hepatic portal granulomas. This uncommon tissue response to neoplasm is distinct from carcinomas with osteoclast-like multinucleated giant cells. Similarly, the process differs from the granulomas presenting in axillary lymph nodes that drain a carcinoma.- - - - - - - - - - ranking = 0.5keywords = giant (Clic here for more details about this article) |
9/16. Histopathology of tumour associated sarcoid-like stromal reaction in breast cancer. An analysis of 5 cases with immunohistochemical investigations.In 5 cases of invasive ductal and lobular carcinoma of the breast multiple epithelioid and giant cell containing granulomas were detected, localized mainly in circumferential regions, but also in the center of the carcinomas. These granulomas were interpreted as sarcoid-like stromal reactions, occurring as sarcoid-like lesions in uni- and bilateral primaries, in a recurrent tumour, and also in axillary lymph nodes. Histopathologically, these granulomas were not quite uniform, some of them corresponding to typical sarcoidosis, others showing marked proliferations of epithelioid or giant cells or containing fibrinoid exudate or necroses. The granulomas were surrounded by dense infiltrates of mononuclear cells. tuberculosis and mycosis was excluded. There were no hints of generalized sarcoidosis. Pathogenetically, these are reactions in the tumour stroma of varying intensity, and are not caused by necroses of the tumour tissue nor by microbial infections. Such tumour-associated sarcoid-like stroma reactions are interpreted as a T-cell mediated immune response to an antigen expression of the carcinoma acting as the local trigger; in 2 cases they were connected with sarcoid-like lesions of the axillary lymph nodes. Their occurrence in bilateral carcinoma of the breast points to an immunological disposition for this special kind of host-versus-tumour response. The intensity of these changes in a recurrent tumour reflects an immunological hypersensitivity reaction. The pathogenetic and differential diagnostic aspects of epithelioid granulomas of the female breast in chronic granulomatous mastitis, panniculitis, foreign body reaction, rare infections, and in therapeutically induced sarcoidosis are described and discussed.- - - - - - - - - - ranking = 0.5keywords = giant (Clic here for more details about this article) |
10/16. Postradiation pleomorphic malignant fibrous histiocytoma of the breast.A case of primary malignant fibrous histiocytoma (MFH) of the breast occurring two years after surgical excision and radiation therapy for a carcinoma of the left breast is reported. Fine needle aspiration was positive for malignant cells, consistent with a pleomorphic sarcoma. Cytologic examination revealed giant cells with marked pleomorphism. Some cells showed single large nuclei with cytoplasmic vacuoles while others revealed multinucleation with foamy cytoplasm, phagocytosed erythrocytes and cellular debris. These findings are considered useful in the cytologic diagnosis of the pleomorphic variant of MFH.- - - - - - - - - - ranking = 0.25keywords = giant (Clic here for more details about this article) |
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