1/60. Squamous carcinoma in situ of the skin containing premelanosomes, with melanocytic colonization of the tumor.Premelanosomes in nonmelanocytic epithelial neoplasms and "colonization" of nonmelanocytic tumors by melanocytes are two phenomena rarely documented in the literature. We report a squamous carcinoma-in-situ of skin displaying both phenomena. light microscopy showed clusters of tumor cells in the epidermis, some of which contained melanin. Dendritic melanocytes were admixed with the tumor cells. No ulceration was present. Immunoperoxidase stains for keratin showed no staining of tumor cells. Some nondendritic cells stained for HMB-45, consistent with a melanocytic lesion. Electron microscopy showed two cell types, one with desmosomes, tonofilaments, and premelanosomes and a second dendritic type with only premelanosomes. Premelanosomes were also present free in the intercellular space. These findings suggest that premelanosomes may first be discharged by melanocytes into the intercellular space and are then phagocytosed by the neoplastic cells. Thus the presence of premelanosomes in a tumor cell is not pathognomonic for melanoma or other neural crest tumors.- - - - - - - - - - ranking = 1keywords = neoplasm (Clic here for more details about this article) |
2/60. Fifty-three month persistence of ring chromosome in noninvasive bladder carcinoma.In a recurrent noninvasive papillary carcinoma of the bladder cytogenetic analysis by the direct technique was carried out on cystoscopic biopsies obtained at 53 month intervals. Persistent similar karyotypic abnormalities including aneuploidy, and ring and other marker chromosomes, the hallmarks of invasive cancer, were present in both specimens. In the 1973 specimen, dna banding was identified in 35 per cent of the metaphases and in 56 per cent of the karyotypes. The continuing abnormal chromosomal silhouette of this tumor supports the stemline cell concept for malignancies, even when applied to such relatively benign neoplasms as this noninvasive carcinoma of the bladder.- - - - - - - - - - ranking = 1keywords = neoplasm (Clic here for more details about this article) |
3/60. Combined intraepithelial squamous neoplasia and atypical fibroxanthoma of the cornea and limbus.PURPOSE: To investigate a case of an unusual neoplasm of the cornea and limbus. methods: A 59-year-old man presented with a highly vascularized, nodular mass involving the left cornea and limbus. An excisional biopsy and, subsequently, a superficial lamellar keratectomy and multiple conjunctival biopsies were performed. At the 6-month follow-up examination, repeat conjunctival biopsies were performed. RESULTS: Histopathologic examination of the corneal specimen showed a high-grade intraepithelial squamous neoplasia (in situ carcinoma) overlying an atypical fibroxanthoma. CONCLUSION: We report the clinical and histologic appearance of a corneal/limbal neoplasm consisting of an intraepithelial squamous neoplasia and an atypical fibroxanthoma.- - - - - - - - - - ranking = 2keywords = neoplasm (Clic here for more details about this article) |
4/60. Sebaceous carcinoma of the breast.We report on a rare distinctive variant of infiltrating ductal carcinoma characterized by sebaceous differentiation of tumor cells. The neoplasm was identified in a lumpectomy specimen from a 45-year-old woman with extensive metastatic disease. In addition to conventional in situ and invasive ductal components, approximately half of the tumor cells exhibited a phenotype resembling tumors of the sebaceous skin appendage with coarsely vacuolated cytoplasm and peripherally displaced nuclei. The sebaceous moiety was also present in the distant metastatic deposits. There was no evidence of mucin production by tumor cells. Ultrastructurally, empty-appearing non-membrane bound vacuoles attested to the sebaceous cells' lipid content. The immunoprofile of the lesion included positivity for cytokeratin and epithelial membrane antigen. vimentin, S100 protein and carcinoembryonic antigen were not expressed. Most tumor cell nuclei reacted with antibodies to oestrogen and progesterone receptors but failed to show overexpression of the HER2/neu protein. The MIB-1 labeling index averaged 16%. At variance with sebaceous breast carcinomas on record, the present case is notable for its prolonged clinical course.- - - - - - - - - - ranking = 1keywords = neoplasm (Clic here for more details about this article) |
5/60. Potential utility of adjunctive histopathologic evaluation of some tumors treated by Mohs micrographic surgery.BACKGROUND: Mohs micrographic surgery is a highly effective, tissue-conserving method for removing certain cutaneous neoplasms. Horizontal Mohs tissue sectioning permits complete histologic evaluation of the true surgical margin, but does not aim to evaluate the overall morphology of the tumor. mohs surgery is designed primarily to answer the question "Is it all out?" as opposed to "What is it?" A preoperative biopsy is relied on, in most cases, to provide an accurate diagnosis. The histology from this biopsy might be the only view of the tumor if the first Mohs stage is clear. However, histopathologic review of small biopsies may sometimes give incomplete information about the entirety of the tumor. OBJECTIVE: To illustrate the potential utility of adjunctive histopathologic examination of some tumors treated by mohs surgery. methods: We present four cases to illustrate situations where pre-Mohs biopsy provided incomplete information. The limitations of these biopsies was clarified after the tumor was visualized on a positive first Mohs layer and/or when the tissue was subsequently sectioned vertically. RESULTS: Cases of tumors where preoperative biopsies gave incomplete information are presented: sebaceous carcinoma versus basal cell carcinoma (BCC), invasive versus in situ squamous cell carcinoma (SCC), and SCC versus keratoacanthoma. CONCLUSION: The Mohs technique allows histologic examination of the complete surgical margin around cutaneous neoplasms, optimizing tissue sparing and resulting in superior cure rates. However, in rare cases additional evaluation of the tissue by vertical sectioning can provide important adjunctive histopathologic information that can effect ultimate patient management.- - - - - - - - - - ranking = 2keywords = neoplasm (Clic here for more details about this article) |
6/60. mucocele-like tumor of the breast associated with ductal carcinoma in situ and mucinous carcinoma : a case report.mucocele-like tumor (MLT) of the breast is a rare neoplasm. Although this lesion was considered benign when first described, the concept of a pathologic continuum with mucinous carcinoma was evident in subsequent reports. Only a few cases of MLT have been reported in korea. We describe a case of MLT associated with ductal carcinoma in situ and mucinous carcinoma in a 34-yr-old female. Histological examination showed multiple mucus-filled cysts of varying size. Extravasated mucin was present in the surrounding stroma. The lining of the cysts in most areas were of flat or cuboidal epithelium and devoid of cellular atypia. The lining epithelium showed proliferative change ranging from atypical ductal hyperplasia to ductal carcinoma in situ, micropapillary type. A microscopic focus of mucinous carcinoma within MLT was also noted. None of the lesions exhibited epithelial reactivity for p53 protein. The patient is alive and well without evidence of disease 54 months after initial treatment. This case supports the concept that MLT encompasses a spectrum of pathologic lesions including benign tumor, atypical ductal hyperplasia, ductal carcinoma in situ, and mucinous carcinoma.- - - - - - - - - - ranking = 1keywords = neoplasm (Clic here for more details about this article) |
7/60. Primary chondroid melanoma.BACKGROUND: Malignant melanoma is notorious for the wide range of histologic patterns it can assume, among the least frequent of which is chondroid melamona. methods: Two cases of primary chondroid melanoma of the distal lower extremity were studied. Tissue for light microscopy was fixed in formalin, embedded in paraffin, and processed routinely. In one case, transmission electron microscopy and immunohistochemical evaluation were performed. RESULTS: Both cases exhibited melanoma in-situ, a conventional (non-chondroid) invasive component, and areas of chondroid differentiation, as confirmed by strongly positive staining with alcian blue at pH 2.5 and Safranin O. Immunohistochemically, one case expressed S-100 protein and vimentin, and did not express gp100 (HMB-45), tyrosinase, MART-1, the Mel-5 antigen, the NKI/C3 antigen, CD45Ro, cytokeratin, or desmin. Electron microscopy of the chondroid component revealed occasional tumor cells with rare, membrane-bound, electron-dense organelles; the extracellular compartment showed amorphous ground substance consistent with cartilaginous differentiation. CONCLUSIONS: Chondroid change in the absence of osteogenic differentiation is extremely rare in malignant melanoma. melanoma should be considered in the differential diagnosis of primary cutaneous neoplasms exhibiting cartilaginous differentiation.- - - - - - - - - - ranking = 1keywords = neoplasm (Clic here for more details about this article) |
8/60. Clear-cell porocarcinoma in situ: a cytologic variant of porocarcinoma in situ.Poromas are benign neoplasms composed of poroid and cuticular cells. Four histopathologic variants of poromas are accepted, according to the architectural features of the neoplasm: hidroacanthoma simplex or intraepidermal poroma; eccrine poroma, which is a poroma connected to the epidermis that extends to superficial dermis; dermal duct tumor, which develops when the neoplasm is composed of small, solid aggregations of poroid and cuticular cells confined to the dermis with little or no connection with the epidermis; and poroid hidradenoma, which is a solid-cystic, dermal poroma. The malignant counterpart of hidroacanthoma simplex is named malignant hidroacanthoma simplex or porocarcinoma in situ. This report describes an example of clear-cell malignant hidroacanthoma simplex, a cytologic variant of porocarcinoma in situ, which, to our knowledge, has not been previously reported. In contrast with other clear-cell neoplasms, a relation with diabetes mellitus could not be clearly established in this case.- - - - - - - - - - ranking = 4keywords = neoplasm (Clic here for more details about this article) |
9/60. Multiple neoplasms: a case report.patients diagnosed with Chronic Lymphocytic leukemia (CLL) have an increased risk of developing second primary cancers. However, as far as we know, more than one type of subsequent malignancy in one patient has not been described. We report a case of two different skin cancers following CLL. A 68-year-old female patient, in whom CLL was diagnosed 5 years earlier, presented with a pigmentation in the left lower eyelid. biopsy showed a melanoma. The tumor was excised and histopathological examination revealed a superficial spreading melanoma. Half a year later, a new pigmented tumor was seen in the transplant of the left lower eyelid. biopsy was performed and histopathological examination showed an intraepithelial squamous cell carcinoma. This was treated with 5 fluorouracil 1% eyedrops.- - - - - - - - - - ranking = 4keywords = neoplasm (Clic here for more details about this article) |
10/60. Trichofolliculoma of the vulva associated with vulvar intraepithelial neoplasia: report of three cases and review of the literature.Trichofolliculoma is an uncommon, benign cutaneous adnexal neoplasm most commonly occurring on the head and neck. Trichofolliculoma of the vulva has not been previously reported. The juxtaposition of a trichofolliculoma in an excisional biopsy specimen performed for vulvar intraepithelial neoplasia (VIN III) created a diagnostic dilemma and prompted a review of our files from 1989 to 2000 for additional cases. A search for benign hair follicle tumors of the vulva identified two additional trichofolliculomas. All three vulvar trichofolliculomas were associated with VIN III. During this same period, 628 cases of vulvar intraepithelial neoplasia II and III were identified. The appearance of trichofolliculoma at this previously unreported site may present diagnostic difficulty.- - - - - - - - - - ranking = 1keywords = neoplasm (Clic here for more details about this article) |
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