1/4. Tubulovillous adenoma of the urinary bladder.We report a case of vesical tubulovillous adenoma that occurred in a background of protracted chronic cystitis with intestinal-type glandular metaplasia and extensive cellular atypia (dysplasia) in the flat mucosa. flow cytometry analysis showed dna aneuploidy in the adenoma. Increased expression of the tumor suppresser gene, p53, and also of cellular proliferation markers (proliferating cell nuclear antigen and MIB-1) were detected in the villous adenoma and in the dysplastic regions of the flat metaplastic mucosa. These findings provide insight into the biology of intestinal metaplasia and also lend support to the theory of the chronic irritation-metaplasia-dysplasia-carcinoma sequence.- - - - - - - - - - ranking = 1keywords = antigen (Clic here for more details about this article) |
2/4. Villous adenomas of the urinary tract: report of two cases.Villous adenomas are rare tumors of the urinary tract. They are morphologically identical to their counterpart in the colon. The histogenesis and malignant potential are uncertain. We report on 2 cases, 1 each in the urethra and bladder. The first is a 57-year-old male who complained of an acute attack of urinary retention. A papillary tumor, measuring 3.0 x 2.0 cm, was found in the prostatic portion of the urethra by cystoscopy, and the tumor was removed transurethrally. The second case, a 33-year-old male, was a victim of chronic pyelonephritis with severe hydronephrosis resulting from a left renal staghorn stone. A papillary tumor was noted on the dome of the urinary bladder. The tumor, measuring 2.0 x 2.0 cm, was resected by transurethral resection. No recurrence or malignant transformation has been found during the follow-up period. The features of morphology, immunohistochemistry, and histochemistry were well studied. Staining by periodic acid-Schiff (PAS) stain, alcian blue at pH 1.0, and alcian blue at pH 2.5 were all positive. The carcinoembryonic antigen was strongly positive in the neoplastic glands, especially in the luminal border. We also review the previous literature and discuss the histogenesis, diagnosis, and treatment.- - - - - - - - - - ranking = 1keywords = antigen (Clic here for more details about this article) |
3/4. incidence and pathogenesis of villous tumors of the gallbladder, and their relation to cancer.The aim of this study was to investigate the incidence and pathogenesis of villous tumors of the gallbladder, and their relation to cancer. Five hundred and thirty-three cases of cholecystectomy and 1300 randomly selected autopsy cases, mainly elderly individuals, were investigated. Gallbladders were fixed in 10% formalin after operation or at autopsy, followed by macroscopic study. In cases of villous tumors, the entire gallbladder was cut into 5-mm-thick serial sections, embedded in paraffin, cut to 4-microns, stained with hematoxylin and eosin (H&E), and histologically studied. To investigate cancer-associated antigens, i.e., carcinoembryonic antigen (CEA) and carbohydrate antigen (CA) 19-9, deparaffinized sections were examined by the peroxidase-antiperoxidase (PAP) immunohistochemical technique with anti-CEA and anti-CA 19-9 antibodies. Villous tumor was found in two resected cases (0.38%) and in one autopsy case (0.08%). Histologically, one of the villous tumors consisted mainly of a proliferation of lining epithelia; the other two consisted mainly of a proliferation of glands. In all three cases, the patients had had accompanying chronic or acute inflammation and two were accompanied by cholecystolithiasis, which made us aware of the importance of inflammation or trauma from stones in the pathogenesis of such neoplasms. Although no apparent cancerous epithelium was observed in any of these tumors by studying H&E specimens, moderate structural and cellular atypism was found in one of them. The atypical epithelium in this case was positively stained for CEA and CA 19-9. It was concluded that villous tumor should be considered to be a premalignant lesion.- - - - - - - - - - ranking = 3keywords = antigen (Clic here for more details about this article) |
4/4. Tripartite differentiation in a carcinoma of the duodenum.BACKGROUND. Carcinomas containing three distinctly different cell lines have been encountered in the colon and rectum, but a tripartite malignancy in the small intestine has not been reported previously. methods. A duodenal carcinoma was studied by light and electron microscopic examination and immunohistochemistry. RESULTS. The duodenal carcinoma was found to have tripartite glandular, squamous, and neuroendocrine differentiation. Histologically, an adenocarcinoma, which originated in a villous adenoma, was continuous with squamous cell carcinoma and small cell carcinoma components. Tumor cells of the squamous cell carcinoma component had conspicuous intercellular bridges but did not form keratin pearls. Immunohistochemical analysis showed strong expression of carcinoembryonic antigen (CEA) by the adenocarcinomatous component. The squamous cell carcinoma component demonstrated focal weak CEA and neuron specific enolase (NSE) reactivity. Ultrastructurally, tumor cells of this component had frequent desmosomes and free tonofilaments. The small cell carcinoma had clusters of dense core granules in tumor cell cytoplasmic processes, which are indicative of neuroendocrine differentiation. This neuroendocrine component was immunoreactive for somatostatin and NSE. CONCLUSIONS. This case of tripartite duodenal carcinoma supports the theory of an origin from an intestinal pluripotential stem cell capable of differentiating into multiple cell types.- - - - - - - - - - ranking = 1keywords = antigen (Clic here for more details about this article) |