11/38. Sclerosing polycystic adenosis of the salivary gland: a report of 16 cases.Sclerosing polycystic adenosis is a recently described, extremely rare, reactive, sclerosing, inflammatory process somewhat similar to fibrocystic changes and adenosis tumor of the breast. To date, there have been 22 cases described in the literature. Because of the infrequency of this lesion, we describe our combined experience with 16 cases, 1 of which has been previously reported. Thirteen tumors arose in the parotid gland, two involved the submandibular gland, and one arose in the buccal mucosa. There were 9 men and 7 women. patients ranged in age from 9 to 75 years. Fourteen patients presented with a primary mass. Two were incidental findings in patients with a mixed tumor and an oncocytoma. Tumors ranged in size from 0.3 to 6 cm in greatest dimension. They are typically well circumscribed and are composed of densely sclerotic lobules with prominent cystic change. Hyperplasia of ductal and acinar elements and areas of apocrine-like metaplasia are frequent. Foci with mild ductal epithelial atypia were frequent with >50% of cases demonstrating at least focal areas of duct epithelial hyperplasia with atypia. Follow-up ranged from 1.5 to 40 years. One tumor recurred twice; no patient has developed metastases or died of disease.- - - - - - - - - - ranking = 1keywords = sclerosing (Clic here for more details about this article) |
12/38. Sebaceous hyperplasia overlying a dermatofibroma.Epithelial changes overlying dermatofibromas are well recognized. The presence of sebaceous differentiation overlying a dermatofibroma is unusual. We report two patients with sebaceous hyperplasia overlying a dermatofibroma and discuss possible mechanisms for induction of the epithelium and adnexa by the mesenchyme in a dermatofibroma.- - - - - - - - - - ranking = 1271.8576093507keywords = dermatofibroma (Clic here for more details about this article) |
13/38. A case of mucinous spherulosis of the breast diagnosed retrospectively in FNA material.We describe for the first time the cytologic features of mucinous spherulosis (MS), a variant of collagenous spherulosis (CS) of the breast characterized by cribiform structures containing lightly basophilic material, embedded in a loosely mucinous acellular background. Histologically, the lesion was part of a complex hyperplasia containing foci of sclerosing adenosis, and foci of atypical ductal hyperplasia (ADH). Immunohistochemical study showed reactivity with smooth muscle actin and focally for cytokeratin 14. Cytologic features of MS were recognized retrospectively and consisted of intermediate to large round hyaline spherules, naked or surrounded by myoepithelial cells. A fibrillary radial appearance was observed with Diff-Quick stain.We draw attention to the importance of recognizing these features because they can easily pose problems either by being overlooked or overdiagnosed as mucinous carcinoma. Differential diagnosis is briefly discussed.- - - - - - - - - - ranking = 1keywords = sclerosing (Clic here for more details about this article) |
14/38. Hemangiomas with localized nodular proliferation of the liver. A suggestion on the pathogenesis of focal nodular hyperplasia.Multiple cavernous hemangiomas circumscribed by focal regenerative nodules of hepatocytes were incidental findings at the autopsy of two elderly men. Neither patient was on steroids or had venous thrombosis. The lesions were not typical for other nodular proliferations of the liver, such as focal nodular hyperplasia, nodular regenerative hyperplasia, or liver cell adenoma, and they have not been previously reported. We also explore the roles of vascular malformation, oral contraceptives, and thrombosis in the pathogenesis of localized nodular proliferation of the liver.- - - - - - - - - - ranking = 0.37834485105194keywords = hemangioma (Clic here for more details about this article) |
15/38. Primary papillary hyperplasia of the gallbladder and cystic and common bile ducts.A unique case of primary papillary hyperplasia of the gallbladder and cystic and common bile ducts occurring in a young female without calculi, ulcerative colitis, or primary sclerosing cholangitis is reported. The papillary lesion involved the mucosa of the entire gallbladder and of the cystic and common bile ducts. Histologically, the gallbladder mucosal folds were close to one another and taller than normal. They were lined by normal-appearing columnar cells and pencil-like cells. The papillary projections of the common bile duct were lined only by columnar cells with prominent subnuclear vacuoles. No endocrine cells or cytologic atypia were noted. The differential diagnoses, including secondary hyperplasia, multiple adenomas, and papillomatosis of the gallbladder, are discussed.- - - - - - - - - - ranking = 1keywords = sclerosing (Clic here for more details about this article) |
16/38. XXY Klinefelter's syndrome with bilateral cryptochidism, obesity, multiple capillary hemangiomas and telangiectasia.A case of XXY Klinefelter's syndrome associated with bilateral cryptochidism, -ultiple capillary hemangiomas and vesical telangiectasia is reported. Testicular biopsy revealed Leydig cell hyperplasia with hyalinization of the seminiferous tubular membrane. The patient presented with recurrent hematuria. Excretory urography, urethroscopy and renal angiography were normal. cystoscopy revealed multiple telangiectasia, which was responsible for the hematuria. To our knowledge this is the first report of multiple capillary hemangiomas and vesical telangiectasia associated with calssical Klinefelter's syndrome.- - - - - - - - - - ranking = 2.2700691063116keywords = hemangioma (Clic here for more details about this article) |
17/38. Intracranial tumor-forming papillary endothelial hyperplasia--a case report.This is a report of extensive intracranial papillary endothelial hyperplasia in a 12-day-old twin. The infant presented with progressive macrocephaly, anemia and hydrocephalus. An MR image showed a large (6 x 5 cm) mass in the right middle cranial fossa. Histologic examination of the resected mass revealed multifocal hemorrhage, organizing in a floridly papillary pattern, in proximity to numerous fibrous bands containing reactive fibroblasts, scattered chronic inflammatory cells and foci of extramedullary hematopoiesis. Although the pattern was complex, neither the papillary regions nor the other areas in the lesion displayed solid proliferations of endothelial cells to support a diagnosis of angiosarcoma. Subsequent to the resection, the infant continued to have hemostatic abnormalities and increasing hydrocephalus. Repeat scans showed a recurrent mass (4 x 4 cm). The child was placed on a protocol for chemotherapy treatment. We hypothesize that the hemorrhage and subsequent organization could have been superimposed upon a preexistent vascular malformation or hemangioma even though Masson's trichrome stain does not unequivocally demonstrate this feature. Most importantly, we would like to emphasize the dilemmas involved in diagnosis and management of this benign disorder.- - - - - - - - - - ranking = 0.37834485105194keywords = hemangioma (Clic here for more details about this article) |
18/38. Cardiac hemangioma with papillary endothelial hyperplasia: report of a resected case and review of the literature.A case of left atrial hemangioma with papillary endothelial hyperplasia in a 42-year-old man is reported. With the aid of cardiopulmonary bypass, the tumor was resected, and the patient is well 22 months after operation. The clinical symptoms at initial examination, operative procedure, and pathological findings are reported, and the diagnostic and therapeutic approaches to cardiac tumors are described briefly. A review of surgically treated hemangiomas is also given.- - - - - - - - - - ranking = 2.2700691063116keywords = hemangioma (Clic here for more details about this article) |
19/38. Multiple focal nodular hyperplasia of the liver associated with vascular malformations of various organs and neoplasia of the brain: a new syndrome.focal nodular hyperplasia (FNH) is a lesion of the liver in which a large anomalous artery is located within a region of hyperplastic hepatic parenchyma. patients with FNH commonly have other lesions, often vascular in nature, in the liver or other organs. We have noted that these associated lesions almost always occur in patients with multiple FNH. We therefore studied 27 autopsied patients with FNH. All 13 with multiple FNH had other lesions such as hemangioma of liver, meningioma, astrocytoma, telangiectasis of the brain, berry aneurysm, dysplastic systemic arteries, and portal vein atresia. One patient had several of these lesions including multiple FNH, meningioma, astrocytoma, vascular malformation of the brain stem, and hemangioma of the liver. In contrast, among the 14 patients with solitary FNH there were no associated lesions, except for hepatic hemangioma in one patient. The prevalence of this syndrome was estimated by examination of 2500 serial autopsies and autopsies with various components of the syndrome. On review of 73 consecutive autopsies with meningioma, three had multiple FNH, compared with seven of 2500 consecutive adult autopsies (P less than 0.001). Multiple FNH was found in two of 83 autopsies with astrocytoma (P less than 0.05) and in one of 139 autopsies with berry aneurysm (not significant). We describe a telangiectatic subtype of FNH which occurs in this syndrome as well as in a minority of patients with solitary FNH. The existence and character of this syndrome suggest that there may be an underlying systemic abnormality in some patients having components of the syndrome. Investigation of patients with multiple FNH lesions may reveal significant treatable lesions.- - - - - - - - - - ranking = 1.1350345531558keywords = hemangioma (Clic here for more details about this article) |
20/38. Pseudoangiomatous hyperplasia of mammary stroma. Some observations regarding its clinicopathologic spectrum.Pseudoangiomatous hyperplasia of mammary stroma (PHMS) is a benign proliferation of keloid-like fibrosis, containing slit-like pseudovascular spaces. Its main importance is its distinction from angiosarcoma; however, the clinicopathologic spectrum of PHMS remains incompletely described. We report two new cases and describe our findings in 200 consecutive breast specimens evaluated for the presence of PHMS. The first patient presented with peau-de-orange change in the overlying breast skin, thus mimicking inflammatory breast carcinoma. Furthermore, this patient's PHMS lesion had been diagnosed and treated inappropriately as a low-grade angiosarcoma. The second case showed the more typical, fibroadenoma-like presentation of PHMS. In addition, PHMS changes occur commonly in routine breast biopsy specimens. In fact, our review of 200 consecutive breast specimens showed PHMS in at least one microscopic focus in 23% of cases. The PHMS changes occurred in younger patients than the control population and were associated with fibrocystic changes, in fibroadenomas, in gynecomastia, in normal breast tissue, and in sclerosing lobular hyperplasia. Ultrastructural and immunohistochemical studies of one case showed that the capillary-like spaces were either acellular or lined by fibroblasts. Pseudoangiomatous hyperplasia of mammary stroma represents a clinicopathologic spectrum, extending from focal, insignificant microscopic changes to cases where PHMS produces a breast mass. Increased awareness of PHMS and its clinicopathologic spectrum will allow its differentiation from other vascular tumors of the breast, especially low-grade angiosarcoma.- - - - - - - - - - ranking = 1keywords = sclerosing (Clic here for more details about this article) |
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