1/16. Detection of human papilloma virus type 58 in a case of a perianal bowen's disease coexistent with adult T-cell leukemia.A case of bowen's disease (BD) that appeared in the perianal region of a 65-year-old Japanese woman coexistent with chronic adult T cell leukemia (ATL) is described. Histopathological findings revealed that irregularly arranged tumor cells with atypical nuclei throughout the epidermis, which itself disclosed hyperkeratosis, dyskeratotic cells, and clumping cells. Positive staining for HPV antigens was immunohistochemically seen in several nuclei of the tumor cells. Electron microscopic study of the tumor tissue disclosed virus particles of about 50 nm in diameter form the squamous cells. A positive band at 256 bp was obtained by PCR using HPV-L1 primer. The amplified dna by L1 primer completely corresponded to that of HPV-58.- - - - - - - - - - ranking = 1keywords = antigen (Clic here for more details about this article) |
2/16. bowen's disease showing spontaneous complete regression associated with apoptosis.Spontaneous regression is sometimes seen in malignant skin tumours. We report a 68-year-old woman whose bowen's disease showed spontaneous complete regression. Prominent infiltration of T cells and increased vascularity were found in the upper dermis of the regressed lesion. Strong expression of Fas (APO-1/CD95) antigen, an apoptosis-related tumour necrosis factor receptor family protein, in the primary lesion and faint expression following regression suggest the involvement of Fas-mediated apoptosis in the spontaneous complete regression of our patient's bowen's disease.- - - - - - - - - - ranking = 1keywords = antigen (Clic here for more details about this article) |
3/16. Pagetoid bowen disease: a report of 2 cases that express cytokeratin 7.Bowen disease is a variant of squamous cell carcinoma in situ. In some cases a pagetoid growth pattern can be observed with cytologically atypical clear cells arranged singly and in nests. The differential diagnosis of pagetoid Bowen disease includes primarily Paget disease and malignant melanoma in situ, as well as other less common entities. Two cases of pagetoid Bowen disease are described, one in a 65-year-old man with a thigh lesion and the other in a 25-year-old man with a lesion in the penile/scrotal region. Neither patient had clinical evidence of an internal malignant neoplasm. In both cases, the neoplastic cells were positive for cytokeratin (CK) 7 and CK 19 and were negative for CK 18, CK 20, carcinoembryonic antigen, GCDFP-15, c-erbB2, S100, and HMB-45. In aggregate, these findings support the diagnosis of pagetoid Bowen disease. Previously, others have shown that CK 7 is an almost invariable marker of Paget disease. Thus, we report these two cases to illustrate that CK 7 can be expressed by pagetoid Bowen disease and should not be a cause of confusion in the differential diagnosis.- - - - - - - - - - ranking = 1keywords = antigen (Clic here for more details about this article) |
4/16. Triple cancers in the urogenital area of a patient with aplastic anemia.Three epithelial neoplastic lesions, perineal Bowenoid papulosis, uterine cervical carcinoma, and bladder transitional cell carcinoma, which occurred in a mildly immunosuppressed patient who had aplastic anemia were studied for human papillomavirus (HPV) infection. In the Bowenoid papulosis, HPV type 16 dna was identified by polymerase chain reaction (PCR) and by in situ hybridization (ISH). In contrast, in the uterine cervical carcinoma, HPV 16 was not detected, although possibly another unidentified type of HPV in the lesion was suggested by the ISH findings. In the bladder transitional cell carcinoma, neither papillomavirus genus-specific (PGS) antigen nor HPV dna was found.- - - - - - - - - - ranking = 1keywords = antigen (Clic here for more details about this article) |
5/16. Extramammary Paget disease of the scrotum with features of Bowen disease.The scrotum is an uncommon site for the presentation of extramammary Paget disease (EMPD). We describe a case of EMPD that was discovered in a patient who had been previously diagnosed and treated for squamous cell carcinoma in situ of the scrotum 3 years earlier. Pathologic examination of the current scrotectomy specimen revealed an erythematous patch with areas of pale induration. Microscopic examination revealed areas with the characteristic histology of Paget disease adjacent to areas characteristic of Bowen disease. Immunohistochemical findings demonstrated a strong expression of carcinoembryonic antigen, cytokeratin 7, and low-molecular-weight cytokeratins (CAM 5.2) in both of these areas, giving support to the overall diagnosis of EMPD. High-molecular-weight cytokeratins (34betaE12) were uncharacteristically expressed in the cytoplasm of the Paget cells with equal or greater strength than in the surrounding keratinocytes, suggesting some degree of squamous differentiation. Very few publications have reported the coexistence of EMPD with squamous cell carcinoma in situ, occurring mostly in the vulva. To our knowledge, our case is the first report of scrotal EMPD with features of Bowen disease. Our findings support the theory that primary EMPD arises multifocally from multipotential epidermal cells.- - - - - - - - - - ranking = 1keywords = antigen (Clic here for more details about this article) |
6/16. eccrine porocarcinoma with Bowenoid changes: epithelial membrane antigen is not a useful marker for malignant tumours arising from eccrine gland structures.A case of eccrine porocarcinoma with Bowenoid changes is reported. We compared the results of immunohistochemical staining for epithelial membrane antigen in the present case with results in bowen's disease to determine whether the presence of epithelial membrane antigen (EMA) enabled us to differentiate between bowen's disease and eccrine porocarcinoma with Bowenoid changes. Histologically, the present tumour was characterized by atypical clear cells with Bowenoid changes as well as uniform small cells and intradermal nests with ductal structures. The membrane and cytoplasm of uniform small cells and ductal luminal surfaces were positive for EMA. However, the atypical cells with Bowenoid changes were negative for this. In contrast, tumour cells in bowen's disease were positive for EMA. Although EMA is known to be a useful marker for some benign tumours derived from eccrine ducts, we found it difficult to distinguish eccrine porocarcinoma with Bowenoid changes from bowen's disease using immunohistochemical staining for EMA.- - - - - - - - - - ranking = 6keywords = antigen (Clic here for more details about this article) |
7/16. Bowen's carcinoma of the scrotal skin associated with human papillomavirus type 82.We have previously cloned human papillomavirus type 82 (HPV-82) from a vaginal intraepithelial neoplasia, but it is not known whether HPV-82 can induce a cutaneous lesion. A large erosive nodule developed on the scrotum of a 50-year-old Japanese patient. Histopathologically, the lesion was composed of two distinct parts; one part showing changes characteristic of bowen's disease in the epidermis, and the other showing elongated rete ridges and proliferation of atypical basaloid cells in the dermis. These parts were partially connected, giving the diagnosis of Bowen's carcinoma. Immunohistochemically, HPV capsid antigen was detected only in the nuclei of a few cells on the upper part of the epidermis. HPV-82 was identified in the lesion by blot hybridization and viral dna was demonstrated in the lesion by in situ hybridization. HPV-82 has tropism for both the skin and the genital regions.- - - - - - - - - - ranking = 1keywords = antigen (Clic here for more details about this article) |
8/16. Epidermotropic neuroendocrine carcinoma. Immunohistochemical differentiation from simulators, including malignant melanoma.Epidermotropic neuroendocrine carcinoma (NEC) is rare. Based on such a case in an 88-year-old woman with a facial NEC showing epidermotropism with a pagetoid growth pattern, we asked whether several similar tumors involving the epidermis could be easily differentiated by immunohistochemical methods. We constructed a panel of control cases (2 each) for NEC, clear cell bowen's disease (CCBD), Paget's disease (PD), superficial basal cell carcinoma (SBCC), cutaneous T-cell lymphoma (CTTL), and superficial spreading malignant melanoma (SSMM) to compare with our patient. A panel of antibodies including epithelial membrane antigen (EMA), neuron specific enolase (NSE), AE1/3 cytokeratin (CK), carcinoembryonic antigen (CEA), leukocyte common antigen (LCA), S-100, and HMB-45 were applied. Cutaneous NEC controls and our patient's tumor were strongly positive for EMA and NSE and had paranuclear dot-like cytoplasmic positivity for CK. CCBD was moderate to strong for CK. PD was strong for CEA. SBCC was essentially negative for all. CTLL was strong for LCA. SSMM was strong for S-100 and HMB-45. Controls were either negative or weak for the antibodies not mentioned. We conclude that this antibody panel can reliably differentiate these epidermotropic or juxtaepidermal tumors in diagnostic dermatopathology and should be applied to lesions requiring separation beyond H & E capabilities, especially with superficial shave biopsies showing small cell "Pagetoid" growth patterns.- - - - - - - - - - ranking = 3keywords = antigen (Clic here for more details about this article) |
9/16. Pigmented malignant hidroacanthoma simplex mimicking irritated seborrheic keratosis.Pigmented variant of malignant hidroacanthoma simplex (PMHS) is very rare. We are aware of only two reported cases, all arising in pigmented hidroacanthoma simplex (HS). We report the third case of PMHS arising in a pigmented HS. A 71-year-old-woman presented with a well-demarcated pigmented hyperkeratotic tumor on the right knee resembling irritated seborrheic keratosis. Histopathologic examination of the excised tumor revealed intraepidermal proliferation of atypical polygonal poroid cells forming large, sharply demarcated nests with colonization of dendritic melanocytes. In addition, there were focal changes of a benign pigmented HS and syringofibroadenoma. The key diagnostic features of ductal structures and intracytoplasmic lumina were highlighted by carcinoembryonic antigen and epithelial membrane antigen immunostaining. PMHS should be differentiated from irritated seborrheic keratosis, melanoacanthoma, bowen's disease and malignant melanoma both clinically and pathologically.- - - - - - - - - - ranking = 2keywords = antigen (Clic here for more details about this article) |
10/16. bowen's disease with invasive adnexal carcinoma: the pluripotential nature of bowen's disease cells.bowen's disease rarely exhibits multiple combinations of premalignant and/or malignant skin lesions. bowen's disease with invasive adnexal carcinoma was originally described by Kao, but is not well recognized by clinicians due to its rarity and lack of specific clinical features of this condition. Herein, we describe three unusual cases of bowen's disease with invasive adnexal carcinoma. The two distinct neoplastic areas exhibited continuity both clinically and histologically. The plaque lesions possessed clinical features typical of bowen's disease. In cases 1 and 3, we confirmed the adnexal tumor within tumors of bowen's disease, the diagnosis of which is eccrine porocarcinoma. The tumor in case 2 was characteristic to trichilemmal carcinoma. Immunohistochemically, the tumor cells of bowen's disease and the adnexal carcinoma differed in antigenicities. The present cases support a notion that bowen's disease maintains a pluripotential nature.- - - - - - - - - - ranking = 1keywords = antigen (Clic here for more details about this article) |
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