1/29. A retroperitoneal bronchogenic cyst with malignant change.A unique case of adenocarcinoma arising in a retroperitoneal bronchogenic cyst is presented. A 55-year-old woman presented with lower abdominal discomfort. Computed tomography revealed a retroperitoneal cystic mass attached to the ascending colon. The resected cyst was unilocular and filled with milky white mucus and hemorrhagic debris. Histologically, most of the cyst wall was of well-differentiated papillary adenocarcinoma with no cyst wall invasion. Other small areas of the cyst were lined with variably atypical dysplastic/metaplastic cuboidal to pseudostratified columnar epithelium. The cyst wall was mostly hyalinized, but there was apparent thickened subepithelial basement membrane, elastosis, and a single layer of smooth muscle that suggested bronchial wall structures. A mucin staining study with O-acylated sialic acid, which is used for the demonstration of gastrointestinal, cholecystic and uterine cervical mucins, was negative for the mucin-producing epithelial cells of the cyst. Thus, to our knowledge, this is the first reported case of adenocarcinoma arising in a retroperitoneal bronchogenic cyst.- - - - - - - - - - ranking = 1keywords = membrane (Clic here for more details about this article) |
2/29. Extraperitoneal pelvic leiomyosarcoma. MR findings in a case.The magnetic resonance imaging (MRI) of a patient with nongynecologic pelvic leiomyosarcoma is presented. A retroperitoneal mass appeared under the broad ligaments, in the right paravesical and parametrial, lateral pararectal site. The mass leaned on the uterus and vagina. On MRI, the mass had solid structure, isointense on T1-weighted images, inhomogeneously iperintense on T2-weighted images with central areas of increased intensity. Late after contrast agent administration, the mass appeared inhomogeneously ipointense with areas of fair late contrast enhancement. The morphology of the tumor, the retroperitoneal site, and MRI sequences make the differential diagnosis. These evidences were useful in treatment planning.- - - - - - - - - - ranking = 12.347415123457keywords = ligament (Clic here for more details about this article) |
3/29. Bilateral cryptorchidism with bilateral inguinal hernia and retrovesical mass in an infertile man: single-stage laparoscopic management.A 30-year-old married man presented with the complaint of inability to procreate. Examination revealed bilateral nonpalpable testes and bilateral inguinal hernia. ultrasonography of the abdomen could not locate the testis; instead, a hypoechoic 5 x 5-cm mass was found behind the bladder. A CT scan of the abdomen revealed the right testis near the right inguinal canal. The left testis could not be identified beside the soft tissue mass. The patient was taken for diagnostic as well as therapeutic laparoscopy. The testis on the right was found just proximal to the internal inguinal ring, and right orchidopexy was done. The left testis was small and rudimentary; hence, orchidectomy was done. Bilateral laparoscopic herniorrhaphy was carried out with polypropylene mesh by fixing it intracorporeally to the pubic bone, Cooper's ligament, inguinal ligament, and conjoint tendon. Subsequently, the retrovesical mass was excised and retrieved by dilating the umbilical port site. The operative time was 3.5 hours with minimal blood loss. The postoperative period was uneventful, and the patient was discharged after 24 hours. The histopathology examination of the retrovesical mass showed an extragonadal germ cell tumor compatible with seminoma.- - - - - - - - - - ranking = 24.694830246914keywords = ligament (Clic here for more details about this article) |
4/29. Malignant transformation of renal angiomyolipoma.In the present paper, two cases of malignant transformation of renal angiomyolipoma without tuberous sclerosis are reported. Pathological examination revealed that, in both cases, in addition to the areas affected by typical angiomyolipoma, there were areas that contained elevated numbers of perivascular epithelioid cells with prominent nuclear pleomorphism. Immunohistochemical examination revealed that both cases were negative for keratin and epithelial membrane antigen, but were positive for the melanogenesis-related marker HMB-45. Metastatic diseases appeared 40 months after radical nephrectomy in the first case and 18 months in the second case.- - - - - - - - - - ranking = 1keywords = membrane (Clic here for more details about this article) |
5/29. Heterotopic intestinal membrane in a retroperitoneal tumor.Plain abdominal x-rays of a 13-year-old girl with chief complaints of back pain revealed calcification in the upper left abdomen. A calcified tumor was confirmed at the dorsal side of the pancreatic tail upon admission. A completely formed colic membrane free of all other germ layers was discovered within the tumor, leading to a diagnosis of heterotopic colonic membrane. To our knowledge, there have been no other cases of heterotopic intestinal tissue of this type, so we consider this an extremely rare case worth reporting.- - - - - - - - - - ranking = 6keywords = membrane (Clic here for more details about this article) |
6/29. Paraneoplastic opsoclonus-myoclonus syndrome associated with malignant fibrous histiocytoma: neuropathological findings.paraneoplastic syndromes related to soft tissue tumors are very uncommon and an association of paraneoplastic diseases with a malignant fibrous histiocytoma (MFH) has not been reported so far. Opsoclonus-myoclonus is a rare paraneoplastic nervous system syndrome, that was well documented in adult patients with neoplasms particularly of the lung and breast. A 77-year-old woman developed typical opsoclonus-myoclonus syndrome and rapidly progressed to coma. The opsoclonus and generalized myoclonus continued until the patient's death seven months later. An autopsy examination identified a pleomorphic MFH in the retroperitoneum without a metastatic spread. Microscopic examination of the cerebellum revealed an atrophy of the granular layer along with a marked patchy loss of purkinje cells, and a loss of neurons in the cerebellar nuclei accompanied by distinct peridental demyelination and astrogliosis. A moderate loss of neurons and neuronal chromatolysis were observed also in the inferior olivary nuclei. However, the omnipause neurons of the nucleus raphe interpositus, that are supposed to be responsible for opsoclonus generation under pathological conditions, as well as ocular brain stem nuclei were all intact. We failed to prove the presence of known antineuronal anti-Yo, anti-Hu or anti-Ri autoantibodies in both serum and cerebrospinal fluid (CSF) of the patient. However, the confirmation of the intrathecal IgG synthesis by oligoclonal bands in CSF and the immunohistochemical detection of IgG deposits on membranes of purkinje cells, neurons of cerebellar granular layer and in cerebellar nuclei in our case support the presumed autoimmune nature of the disease.- - - - - - - - - - ranking = 1keywords = membrane (Clic here for more details about this article) |
7/29. Antibody titers to desmogleins 1 and 3 in a patient with paraneoplastic pemphigus associated with follicular dendritic cell sarcoma.BACKGROUND: Most paraneoplastic pemphigus (PNP) cases reported to date have been associated with lymphoproliferative neoplasms. patients with PNP have autoantibodies against the plakin family (eg, envoplakin and periplakin). Antibodies against desmoglein 3 (Dsg3) and Dsg1, antigens for classic types of pemphigus, have also been reported to play an important role in the initial stage of PNP. OBSERVATIONS: We describe a patient with PNP associated with follicular dendritic cell sarcoma. Antibodies to envoplakin and periplakin were detected. When only mucosal lesions were observed at the early stage, the antibody to Dsg3 but not to Dsg1 was detected by enzyme-linked immunosorbent assay. After skin lesions appeared, antibodies to Dsg1 and Dsg3 were detected. These titers were elevated, with exacerbation of skin lesions. Although the patient received corticosteroid therapy, double-filtration plasmapheresis, and intravenous human immunoglobulin therapy after surgical resection of follicular dendritic cell sarcoma, she died of fungal infective lung embolisms. A direct immunofluorescence study of autopsy samples showed IgG deposition in the epidermis of the skin and oral mucosal membrane, but not in the lungs and kidneys and follicular dendritic cell sarcoma of the para-aortic area. CONCLUSION: In this patient with PNP and follicular dendritic cell sarcoma, there was an association between the clinical phenotype and the anti-Dsg antibody profile, as seen in pemphigus vulgaris.- - - - - - - - - - ranking = 1keywords = membrane (Clic here for more details about this article) |
8/29. Autoantibody production from a thymoma and a follicular dendritic cell sarcoma associated with paraneoplastic pemphigus.BACKGROUND: Paraneoplastic pemphigus (PNP) is an autoimmune mucocutaneous disease. We previously reported that B cells in a Castleman tumour associated with PNP produced autoantibodies. However, it is uncertain whether the production of autoantibodies from the associated tumour is a common mechanism in PNP. OBJECTIVES: To investigate autoantibody production in a thymoma and a follicular dendritic cell sarcoma that were excised from two patients with PNP. methods: Tumour cells were cultured, and their surface markers were identified. Indirect immunofluorescence, immunoblotting and enzyme-linked immunosorbent assay (ELISA) using culture media from the tumours were used to detect PNP autoantibodies. RESULTS: B cells with markers (CD22 , surface membrane IgG and surface membrane IgM ) of mature B lymphocytes constituted a proportion of cultured tumour cells in both tumours. Western blot showed that the medium from both the thymoma and the follicular dendritic cell sarcoma cells recognized 190-kDa periplakin and 210-kDa envoplakin bands of human epithelial proteins as well as recombinant linker regions of periplakin, envoplakin, desmoplakin and bullous pemphigoid antigen 1. ELISA was positive for antidesmoglein 3 antibody. CONCLUSIONS: The presence and localization in tumours of B-lymphocyte clones against proteins of the plakin family and desmoglein 3 in skin may not be confined to PNP with Castleman disease, but is possibly a common mechanism in PNP associated with various tumours.- - - - - - - - - - ranking = 2keywords = membrane (Clic here for more details about this article) |
9/29. Benign mesenchymoma of the round ligament. A report of two cases with immunohistochemistry.Benign mesenchymomas are tumors composed of an admixture of two or more mature mesenchymal tissue types. Clinically and histologically they are benign lesions. However, they are seldom encapsulated and therefore may recur locally if incompletely excised. The authors report on two benign mesenchymomas composed of mature fat, thin-walled small and medium size vessels, and spindle cells demonstrated to be smooth muscle by immunohistochemical studies. They were diagnosed in women in their 50s. Both were located in the round ligament of the uterus. One was discovered incidentally during hysterectomy, and the other was unusually large, being diagnosed preoperatively as a retroperitoneal liposarcoma. Most round ligament tumors are leiomyomas or fibromas. To the authors' knowledge, this is the first report of benign mesenchymomas occurring in this location.- - - - - - - - - - ranking = 74.084490740741keywords = ligament (Clic here for more details about this article) |
10/29. Ultrastructure of metastatic rete testis adenocarcinoma.adenocarcinoma of the rete testis is a rare tumor. We describe the ultrastructural appearance of a retroperitoneal adenocarcinoma metastatic from the rete testis, and compare this appearance with that of normal human rete testis. Both normal rete epithelium and the tumor showed deep, narrow nuclear invaginations with apparent nuclear lobulation; small, pleomorphic, electron-dense, membrane-bound granules in the basal cytoplasm; lipid droplets in the apical cytoplasm; and distinctive bulbous cytoplasmic projections along the apical surfaces of the cells. In addition, more general features of glandular tissue were seen. Features notable for their absence were mucin granules, microvilli containing filamentous cores, glycocalyx, and glycocalyceal bodies. The ultrastructural appearance was sufficiently distinctive to suggest that, in the proper clinical context, electron microscopy may serve to support a diagnosis of adenocarcinoma of the rete testis.- - - - - - - - - - ranking = 1keywords = membrane (Clic here for more details about this article) |
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