1/45. bone marrow metastases in disseminated alveolar rhabdomyosarcoma: case report with ultrastructural study and review.A case of desseminated alveolar rhabdomyosarcoma in an 18-year-old male with leuco-erythroblastic anaemia is described. Numerous bizarre malignant cells, including frequent multinucleated giant cells, were seen in bone marrow aspirates, and osteolytic lesions appeared late in the clinical course. The primary site of the neoplasm remained undertermined during life and also at necropsy, which revealed minute pulmonary metastases and extensive lymph nodal, pleural and skeletal deposits. The diagnosis was confirmed on necropsy tissue by ultrastructural examination which demonstrated numerous thin (5 nm) and thick (15 nm) intracytoplasmic filaments in tumour cells, sometimes organized in bundles; scattered dense Z-band-like bodies, and rod-shaped structures were also seen. The fine structure of the rhabdomyosarcoma in the present case is compared with previous ultrastructural studies. Elongated, thick intracytoplasmic filaments whose diameter corresponds to that of myosin myofilaments are strong evidence for rhabdomyoblastic differentiation and are considered to be the sine qua non of a positive electron microscopic diagnosis of rhabdomyosarcoma. Orgaized bundles of filaments and Z-band-like dense bodies are usually present, and rod-shaped structures are found infrequently, but none of these are necessary for the ultrastructural diagnosis.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
2/45. Malignant giant cell tumor of synovium (malignant pigmented villonodular synovitis).CONTEXT: Pigmented villonodular synovitis (PVNS) is a well-recognized entity that has the potential for extensive local destruction, even though it rarely metastasizes. Rare reports of malignant forms are recorded in the literature. We observed 2 patients in whom examples of PVNS followed an aggressive course with multiple recurrences, metastasis, or degeneration to an appearance resembling malignant fibrous histiocytoma. OBJECTIVE: We studied the occurrence and persistence of aneuploidy for chromosomes 5 and 7 in 2 patients with clinically aggressive PVNS. DESIGN: fluorescence in situ hybridization was performed for the detection of chromosomes 5 and 7 in the primary lesions, recurrences, and metastases in 2 examples of PVNS. RESULTS: fluorescence in situ hybridization demonstrated small but significant numbers of cells with trisomies for chromosomes 7 and/or 5 in both the primary and recurrent lesions of both patients. CONCLUSIONS: The presence of consistent chromosomal trisomies (5 and 7) in both patients' examples of PVNS suggests a neoplastic nature for this lesion. The persistence of these trisomies in the primary lesions, recurrences, and metastases supports a molecular link between the primaries, recurrences, and metastases despite changes in morphologic features. The presence of persistent trisomies in the recurrent and metastatic lesions supports the concept of malignant PVNS.- - - - - - - - - - ranking = 4keywords = giant (Clic here for more details about this article) |
3/45. Perianal verrucose carcinoma spreading to the rectum: report of a case.The case of a 39-year-old man with a perianal verrucose carcinoma of 12 years' duration is presented. After local resection the tumor recurred several times and spread to the rectum. An abdominoperineal resection revealed neither infiltration of deeper layers nor lymph-node metastasis. Five other cases of perianal verrucose carcinoma, only two of which were described in detail, have been reported. Probably other examples have been reported under the names of "perianal florid papillomatosis,"13,23 "giant condyloma acuminatum"26 and "condyloma acuminatum with malignant transformation."9,12,27- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
4/45. Mixed mesenchymal differentiation in meningiomas.Five intracranial meningiomas showing mixed mesenchymal differentiation are described. Three contained cartilage, three contained bone, four contained hyaline fibrous strands or nodules which in two instances were calcified, three contained angiomatous areas, one contained pericytoma-like areas, four contained pleomorphic and sometimes multinucleate giant cells, and one contained a mucoid matrix including spheroidal cells superficially resembling chordoma. The importance of recognising such tumours is emphasised as they can be misdiagnosed as metastatic deposits, particularly in a frozen section.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
5/45. Giant mesenteric lymphoid tumor (Castleman's lymphoma) - a case report.An autopsy case of a giant mesenteric lymphoid tumor in a 57-year-old female was examined anatomo-biologically. A 17X15X6 cm3-sized pinkish gray-coloured medullary tumor occupying the mesenterium with no evident capsule, invaded the small intestine and pancrease head. Histologically, it was a lymphoid tissue consisting of hyalinized angiofollicular architecture having epithelioid cells and tingible body macrophages in the follicles. Some small-sized follicles showed typical Hassalloid architecture and other follicles consisted of monotonous growth of lymphocytes without a mantle zone, some of them fusing with each other. The histopathological appearance of the tumor was that of Castleman's lymphoma and of hyaline-vascular type of Keller's classification. There was another 0.6X0.5X0.5 cm3-sized tumor having an angiofollicular architecture in the subserosa of the sigmoid colon. The present case was complicated with vertebral caries, hypogammaglobulinemia (1.2%), eosinophilia (50%) and panbronchobronchiolitis, the last one being responsible for her death.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
6/45. Factors regulating the metastatic potential of benign giant cell tumour of bone--study of an unusual case with short review of literature.Benign giant cell tumour of bone with metastases to other bones and lungs is extremely rare. Benign metastasising giant cell tumour is distinctly separate from multicentric giant cell tumour, primary and secondary malignant giant cell tumour. Factors regulating the local recurrence and metastatic potential of this benign tumour depend on its aggressiveness which can be better assessed by clinical and radiological parameters rather than the histopathological appearance. A benign giant cell tumour of ischium with metastasis to vertebra and lung over an eleven year period is discussed. Extreme paucity of literature prompted to publish the article. A short review of factors determining the recurrence and metastatic spread of benign giant cell tumour of bone is highlighted.- - - - - - - - - - ranking = 10keywords = giant (Clic here for more details about this article) |
7/45. Malignant melanoma of the head and neck in children. review of the literature and report of a case.Perusal of the literature revealed that until 1970, 13 children with malignant melanoma of the head and neck had been reported. This group includes two cases of melanoma that developed in a giant cell nevus, as well as one case of congenital melanoma. The biologic features of prepubertal melanoma appear basically analogous to those of the adult variety. Malignant melanoma of the auricle is described in a 2 1/2-year-old child. Surgical therapy was given, and BCG vaccination was used as an adjuvant. The patient is alive and free of signs of the disease 2 1/2 years following the operation. This appears to be the third reported case of malignant melanoma of the external ear in a child.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
8/45. Giant cardiac myxoma with malignant transformed glandular structures.A case of a right-sided giant cardiac myxoma with malignant transformation of glandular structures causing systemic metastases is described. Plain chest radiography and computed tomography localized the tumor within the heart. Exact depiction of the origin of the tumor using subtracted 2D-projection MR angiography is documented. Radiologic findings and differential diagnosis of this unique tumor are discussed.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
9/45. Pitfalls in fine needle aspiration cytology of extraadrenal paraganglioma. A report of 2 cases.BACKGROUND: Fine needle aspiration (FNA) is commonly used as an initial diagnostic tool in the evaluation of mass lesions. However, extraadrenal paragangliomas (EAPs) are not commonly seen on FNA and, when encountered, can pose a diagnostic challenge since they have a wide variety of morphologic patterns. CASES: Two intraabdominal EAPs were misdiagnosed as an anaplastic adenocarcinoma of the pancreas with giant cell features and papillary adenocarcinoma of the pancreas. The sources of the pitfalls were inaccurate radiologic localization, misinterpretation of vascular-rich tissue fragments as papillary structures, presence of acinarmicroglandular structures, marked cellular pleomorphism (including multinucleation), prominent nucleoli and some cells with "squamoid" cytoplasm. CONCLUSION: The cytologic features of EAP, although suggestive, are not specific. A high index of suspicion and knowledge of clinical information, exact anatomic location and cytologic morphology combined with appropriate ancillary studies are the key to an accurate diagnosis.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
10/45. Malignant gastrointestinal leiomyosarcoma and gastrointestinal stromal tumor with prominent osteoclast-like giant cells.CONTEXT: One case of leiomyosarcoma and one case of gastrointestinal stromal tumor with prominent osteoclast-like giant cells have so far been reported in the digestive tract. OBJECTIVE: To ascertain the clinicopathologic features and biologic behavior of these tumors, we report 3 additional cases of leiomyosarcoma of the gastrointestinal tract and one malignant gastrointestinal stromal tumor. DESIGN: Histologic and immunohistochemical examinations were performed. Clinical and follow-up data were recorded, and the literature was reviewed. RESULTS: The age of the patients ranged from 50 to 68 years (mean, 62 years). One of the lesions arose in the stomach, one in the ileum, and 2 in the colon. Three tumors showed a strong positivity for muscle actin and desmin and were diagnosed as leiomyosarcomas, 2 of them showing spindle cells and 1 of them showing epithelioid cells. The fourth tumor reacted strongly positive for c-Kit (CD117) and vimentin, and it was diagnosed as an epithelioid malignant gastrointestinal stromal tumor. All tumors were characterized by numerous osteoclast-like giant cells that were unevenly distributed and that, using immunohistochemistry, reacted strongly with CD68. CONCLUSIONS: Malignant stromal tumors with osteoclast-like giant cells of the gastrointestinal tract are rare entities, are more commonly of a myogenic origin such as leiomyosarcoma, and seem to have an aggressive behavior.- - - - - - - - - - ranking = 7keywords = giant (Clic here for more details about this article) |
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