1/8. Salivary duct carcinoma in the submandibular region.A case of salivary duct carcinoma arising in the submandibular region of an 83-year-old man is presented. Histologically, the tumour consisted of solid cell nests with ductal structures. Tumour cell nests showed central comedonecrosis. Immunohistochemically, the tumour cells were positive for keratin and epithelial membrane antigen but negative for S-100 protein and calponin. Clinical features as well as pathological examinations based on haematoxylin-eosin and immunohistochemical stainings were important in the diagnosis of this case.- - - - - - - - - - ranking = 1keywords = antigen (Clic here for more details about this article) |
2/8. Prostatic ductal adenocarcinoma showing Bcl-2 expression.Prostatic ductal adenocarcinoma represents a rare histological variant of prostatic carcinoma with features of a papillary lesion at cystoscopy. There are conflicts regarding the existence, origin, staging, grading, treatment and clinical behavior of this tumor. The aim of the present study is to examine the expression of Bcl-2 and p53 in prostatic ductal adenocarcinoma and to evaluate its origin by analyzing prostate specific antigen, prostate specific acid phosphatase, cytokeratins, epithelial membrane antigen and carcinoembryonic antigen expressions. The results confirmed the expression of prostate specific antigen and prostate specific acid phosphatase in prostatic ductal adenocarcinoma. The demonstrated expression of Bcl-2 was predominant in the better-differentiated tumor. Bcl-2 expression appears not to be associated with neuroendocrine differentiation as assessed by chromogranin a reactivity. Thus, the first case of a prostatic ductal adenocarcinoma showing Bcl-2 expression is presented. The tumor was negative for p53.- - - - - - - - - - ranking = 4keywords = antigen (Clic here for more details about this article) |
3/8. Sarcomatoid salivary duct carcinoma.The so-called sarcomatoid salivary duct carcinoma (SSDC) is one of the variants of salivary duct carcinoma (SDC). This neoplasm is characterized by the presence of both a carcinomatous and a sarcomatoid tumor component. The histology and nomenclature of such neoplasms has been a matter of debate for many years. The histologic, immunohistochemical, and electron microscopic findings including those of 4 previously described cases of SSDC are defined and the different attitudes concerning their etiology will be discussed. In addition, the fine-needle aspiration biopsy of such a case is presented for the first time. In analogy to typical SDC there seems to be a predilection for elderly men and a location in major salivary glands. The resected SSDC tumors measured between 1.5 and 3.5 cm. Histologically, each case was a composite of SDC and sarcomatoid carcinoma. Immunohistochemical positivity for epithelial membrane antigen (EMA) and cytokeratins (AE1/AE3, CAM 5.2) was shown in the sarcomatoid tumor component. The important cytomorphologic feature of SSDC is the presence of cohesive clusters and flat sheets of cells with a cribriform pattern, in combination with an atypical spindle cell component. The use of the term SSDC seems more appropriate than the term carcinosarcoma , as the immunohistochemical, electron microscopic, and recent molecular findings in this and other biphasic neoplasms imply a monoclonal origin.- - - - - - - - - - ranking = 1keywords = antigen (Clic here for more details about this article) |
4/8. Pure prostatic papillary adenocarcinoma with ductal features.Papillary adenocarcinoma resembling ductal carcinoma and arising in the peripheral zone is extremely rare. We report a case of prostatic papillary adenocarcinoma with ductal features. The patient was a 68-year-old man who initially presented with dysuria and sensation of residual urine after voiding. Prostatic needle biopsy findings supported pathological diagnosis of prostatitis. The symptoms were improved by medication for prostatitis, and prostate-specific antigen (PSA) level of 22.6 ng/ml descreased to 9.9 ng/ml. It remained between 7.2 ng/ml and 9.9 ng/ml for 2 years. However, it gradually increased to 11.9 ng/ml. Transrectal digital examination, T2-weighted magnetic resonance imaging (MRI) of the prostate and transrecral ultrasound showed a mass in the enlarged right side of the prostate. Transrectal needle biopsy of the mass was performed, and papillary adenocarcinoma was suspected by histological examination. Radical prostatectomy was performed. Histological and immunohistochemical examination of the prostatectomy specimen revealed pure prostatic papillary adenocarcinoma with ductal features.- - - - - - - - - - ranking = 1keywords = antigen (Clic here for more details about this article) |
5/8. Phenotyping of lymphocytes expressing regulatory and effector markers in infiltrating ductal carcinoma of the breast.Dysfunction of the host immune system in cancer patients can be due to a number of reasons including suppression of tumour associated antigen reactive lymphocytes by regulatory T (Treg) cells. In this study, we used flow cytometry to determine the phenotype and relative abundance of the tumour infiltrating lymphocytes (TILs) from 47 enzymatically dissociated tumour specimens from patients with infiltrating ductal carcinoma (IDC) of the breast. The expression of both effector and regulatory markers on the TILs were determined by using a panel of monoclonal antibodies. Analysis revealed CD8( ) T cells (23.4 /-2.1%) were predominant in TILs, followed by CD4( ) T cells (12.6 /-1.7%) and CD56( ) natural killer cells (6.4 /-0.7%). The CD4( )/CD8( ) ratio was 0.8 /-0.9%. Of the CD8( ) cells, there was a higher number (68.4 /-3.5%) that expressed the effector phenotype, namely, CD8( )CD28( ) and about 46% of this subset expressed the activation marker, CD25. Thus, a lower number of infiltrating CD8( ) T cells (31.6 /-2.8%) expressed the marker for the suppressor phenotype, CD8( )CD28(-). Of the CD4( ) T cells, 59.6 /-3.9% expressed the marker for the regulatory phenotype, CD4( )CD25( ). About 43.6 /-3.8% CD4( )CD25( ) subset co-expressed both the CD152 and FOXP3, the Treg-associated molecules. A positive correlation was found between the presence of CD4( )CD25( ) subset and age (> or =50 years old) (r=0.51; p=0.045). However, no significant correlation between tumour stage and CD4( )CD25( ) T cells was found. In addition, we also found that the CD4( )CD25(-) subset correlated with the expression of the nuclear oestrogen receptor (ER)-alpha in the tumour cells (r=0.45; p=0.040). In conclusion, we detected the presence of cells expressing the markers for Tregs (CD4( )CD25( )) and suppressor (CD8( )CD28(-)) in the tumour microenvironment. This is the first report of the relative abundance of Treg co-expressing CD152 and FOXP3 in breast carcinoma.- - - - - - - - - - ranking = 1keywords = antigen (Clic here for more details about this article) |
6/8. anaphylaxis to isosulfan blue dye during sentinel lymph node biopsy.We describe a case of intraoperative anaphylaxis resulting from isosulfan blue (IB) dye, an agent being increasingly used for identification of sentinel lymph nodes. A 45-year-old woman undergoing a left mastectomy with sentinel lymph node biopsy under general endotracheal anesthesia developed severe intraoperative hypotension and tachycardia 10 minutes after subcutaneous injection of IB dye for lymphatic mapping. This was associated with a reduction in pulse oximeter reading to 89%. She was successfully resuscitated using 1 mg of epinephrine intravenously (IV). Invasive arterial and central venous pressures were initiated; her lymph node biopsy was concluded, but the rest of her procedure was canceled. Postoperative workup revealed a high tryptase level indicative of an intraoperative anaphylactic reaction most probably related to the IB dye. Isosulfan blue dye can act as an antigen, causing a full-blown intraoperative anaphylactic reaction. Early recognition and aggressive hemodynamic interventions can reduce morbidity and mortality.- - - - - - - - - - ranking = 1keywords = antigen (Clic here for more details about this article) |
7/8. Increased serum carbohydrate antigen 19-9 in relapsed ductal breast carcinoma.Increased serum carbohydrate antigen (CA) 19-9 is a quite uncommon manifestation of breast cancer both on early disease and on relapse. A 53-year-old woman with invasive ductal breast carcinoma underwent left-sided mastectomy. Two years later she palpated a subcutaneous mass at the mastectomy scar, arousing suspicion of local relapse. Surgery and histopathology revealed infiltration by breast adenocarcinoma and she was treated with chemotherapy. At that time serum tumor markers, carcinoembryonic antigen (CEA) and CA 15-3 were within normal range. Over the next six months she displayed an increase of serum CEA while serum CA 15-3 remained within normal range. In an attempt to search for a second neoplasm possibly of gastrointestinal (GI) origin, abdominal computed tomography (CT), magnetic resonance imaging (MRI), magnetic resonance cholangio-pancreatography (MRCP), endoscopy of the upper GI tract and colonoscopy were performed, as well as measurement of serum CA 19-9. While no indication of a GI neoplasm was detected, she displayed an over 10-fold increase of serum CA 19-9. The patient had also an X-ray mammography and technetium-99m hexakis-2-methoxyisobutylisonitrile ((99m)Tc-MIBI) scintimammography (SM). Whilst mammography was negative for contralateral disease recurrence, SM was suggestive of axillary lymph node involvement. Axillary lymph node dissection confirmed an extensive metastatic infiltration of these nodes by breast adenocarcinoma. Three months later serum CA 19-9 and CEA became normal. The interest of this case lies on the unexpected high serum CA 19-9 values found in a breast relapsed adenocarcinoma and in the important contribution of SM in diagnosing the axillary lymph node metastatic infiltration.- - - - - - - - - - ranking = 6keywords = antigen (Clic here for more details about this article) |
8/8. Fine needle aspiration cytology of a metastatic duct carcinoma of the prostate: a case report.BACKGROUND: Prostatic ductal carcinoma (PDC) is a rare variant of prostatic adenocarcinoma. Without proper clinical information, a fine needle aspiration (FNA) diagnosis of metastatic PDC can be challenging as this tumor can morphologically mimic adenocarcinomas from other sites. To our knowledge, FNA findings of metastatic PDC have not been previously reported. CASE: An 85-year-old man presented with a large, destructive pelvic bone lesion with soft tissue extension. He had undergone a prostatectomy 30 years earlier for "benign prostatic hypertrophy" but had no known history of malignancy. The aspirates were hypercellular and composed of numerous monolayered or folded cohesive sheets of tumor cells with minimal cytologic atypia. The tumor cells had abundant, clear cytoplasm, evenly spaced nuclei, finely granular chromatin, inconspicuous nucleoli and occasional mitotic figures. The background was clean and contained a few wisps of thin mucin. Cell block sections revealed tumor cells forming tubulopapillary architecture lined with tall columnar cells with focal nuclear pseudostratification, reminiscent of uterine endometrial carcinoma. Positive immunoreactivity for prostate-specific antigen and prostatic acid phosphatase confirmed the tumor's prostatic origin. CONCLUSION: Because of the rarity and nonspecific cytomorphologic characteristics of this tumor, clinical history, radiologic findings and a high index of suspicion in conjunction with ancillary studies are important in achieving a correct FNA diagnosis of metastatic PDC.- - - - - - - - - - ranking = 1keywords = antigen (Clic here for more details about this article) |