1/21. Sebaceous carcinoma of the breast.We report on a rare distinctive variant of infiltrating ductal carcinoma characterized by sebaceous differentiation of tumor cells. The neoplasm was identified in a lumpectomy specimen from a 45-year-old woman with extensive metastatic disease. In addition to conventional in situ and invasive ductal components, approximately half of the tumor cells exhibited a phenotype resembling tumors of the sebaceous skin appendage with coarsely vacuolated cytoplasm and peripherally displaced nuclei. The sebaceous moiety was also present in the distant metastatic deposits. There was no evidence of mucin production by tumor cells. Ultrastructurally, empty-appearing non-membrane bound vacuoles attested to the sebaceous cells' lipid content. The immunoprofile of the lesion included positivity for cytokeratin and epithelial membrane antigen. vimentin, S100 protein and carcinoembryonic antigen were not expressed. Most tumor cell nuclei reacted with antibodies to oestrogen and progesterone receptors but failed to show overexpression of the HER2/neu protein. The MIB-1 labeling index averaged 16%. At variance with sebaceous breast carcinomas on record, the present case is notable for its prolonged clinical course.- - - - - - - - - - ranking = 1keywords = antigen (Clic here for more details about this article) |
2/21. Primary chondroid melanoma.BACKGROUND: Malignant melanoma is notorious for the wide range of histologic patterns it can assume, among the least frequent of which is chondroid melamona. methods: Two cases of primary chondroid melanoma of the distal lower extremity were studied. Tissue for light microscopy was fixed in formalin, embedded in paraffin, and processed routinely. In one case, transmission electron microscopy and immunohistochemical evaluation were performed. RESULTS: Both cases exhibited melanoma in-situ, a conventional (non-chondroid) invasive component, and areas of chondroid differentiation, as confirmed by strongly positive staining with alcian blue at pH 2.5 and Safranin O. Immunohistochemically, one case expressed S-100 protein and vimentin, and did not express gp100 (HMB-45), tyrosinase, MART-1, the Mel-5 antigen, the NKI/C3 antigen, CD45Ro, cytokeratin, or desmin. Electron microscopy of the chondroid component revealed occasional tumor cells with rare, membrane-bound, electron-dense organelles; the extracellular compartment showed amorphous ground substance consistent with cartilaginous differentiation. CONCLUSIONS: Chondroid change in the absence of osteogenic differentiation is extremely rare in malignant melanoma. melanoma should be considered in the differential diagnosis of primary cutaneous neoplasms exhibiting cartilaginous differentiation.- - - - - - - - - - ranking = 1keywords = antigen (Clic here for more details about this article) |
3/21. Pancreatic granular cell tumor combined with carcinoma in situ.A 58-year-old man was treated for a granular cell tumor (GCT) of the pancreas; a very rarely occurring tumor. The patient, who had been followed for 6 years due to alcoholic hepatitis, chronic pancreatitis and elevated carcinoembryonic antigen (CEA) levels from smoking, was admitted to our hospital for evaluation of back pain, diarrhea and constipation. The patient was diagnosed as having pancreatic head cancer using clinical imaging studies, and a pylorus-preserving pancreatico-duodenectomy was done. In the resected specimen, a white tumor measuring 13 mm in diameter was observed at the pancreatic head, and there was marked fibrous change surrounding the tumor. The microscopic appearance of the pancreas showed atrophy of acinar cells, fibrosis, and dilatation of the main pancreatic duct (MPD). Within the tumor were oval cells with low-grade atypia and an increased number of diffuse eosinophilic granules. Neither mitosis nor invasive findings were observed. periodic acid-Schiff staining and immunohistochemical staining for the S-100 protein were positive, thus the tumor was diagnosed as a benign GCT. In addition, carcinoma in situ was found at the dilated MPD. Therefore, this patient was diagnosed as having GCT with carcinoma in situ of the pancreas. To the best of our knowledge, this is only the fourth case of GCT of the pancreas to be reported.- - - - - - - - - - ranking = 0.5keywords = antigen (Clic here for more details about this article) |
4/21. Primary in situ squamous cell carcinoma of the endometrium, with extensive squamous metaplasia and dysplasia.BACKGROUND: Primary squamous cell carcinoma of the endometrium is exceedingly rare. It has been described in association with pyometra but its etiology is still unclear. CASE: The authors report the case of a 75-year-old woman who presented with pelvic pain and pyometra. No gross tumor was identified in the uterus; however, extensive epidermalization of the endometrial mucosa was noted. Microscopic findings were consistent with a primary in situ squamous carcinoma of the endometrium associated with extensive squamous metaplasia and areas of dysplasia. HPV antigen and dna detection were negative in both the endometrial lesions and the cervix. CONCLUSIONS: These results support the sequence of change with squamous metaplasia, progressing through dysplasia to carcinoma as a possible pathogenetic process. HPV's role, however, remains uncertain.- - - - - - - - - - ranking = 0.5keywords = antigen (Clic here for more details about this article) |
5/21. Sarcomatoid carcinoma of the bladder: a case report.We reported a case of sarcomatoid carcinoma of the bladder in a 78-year-old woman presenting with pollakisuria. She has remained well without any evidence of recurrence for 25 months after radical cystectomy. Microscopic examination revealed a composition almost exclusively of spindle and dedifferentiated cells, accompanied by only a few cells retaining epithelial features of differentiation. The latter cells were immunohistochemically positive for epithelial membrane antigen (EMA). A concomitant carcinoma in situ was present in the adjacent mucosa. Immunohistochemical exploration with EMA proved useful for reinforcing the conventional histological diagnosis.- - - - - - - - - - ranking = 0.5keywords = antigen (Clic here for more details about this article) |
6/21. Mucinous adenocarcinoma of the renal pelvis associated with transitional cell carcinoma in the renal pelvis and the bladder.We report a case of mucinous adenocarcinoma of the renal pelvis associated with bladder carcinoma in situ (CIS). Transitional cell carcinoma (TCC) of the renal pelvis and CIS were also observed adjacent to the adenocarcinoma. Immunohistochemical assessment of the pelvic adenocarcinoma revealed positive expressions for mucin, epithelial membrane antigen, cytokeratin 7, cytokeratin 19 and carcinoembryonal antigen, but not vimentin or chromogranin. Based on the histopathological examinations, the adenocarcinoma of the renal pelvis in the present case may have a similar biological nature to conventional TCC and probably originated by development of pre-existing TCC of the renal pelvis.- - - - - - - - - - ranking = 1keywords = antigen (Clic here for more details about this article) |
7/21. Lobular carcinoma of the breast with hybrid myoepithelial and secretory ("myosecretory") cell differentiation.Three cases of lobular carcinoma of the breast showing a complex morphology that included myoepithelial cell differentiation are reported. One case was a pure in situ acinar lesion, while the other 2 cases were in situ and invasive carcinomas. Three different cell types were seen in these tumors: one was the phenotype commonly seen in the garden variety of in situ lobular carcinoma (LCIS) constituted by noncohesive round to ovoid cells with round nuclei and positivity for epithelial membrane antigen (EMA), estrogen receptor (ER), and progesteron receptor (PR). E-cadherin was negative in these cells. The second type was represented by cohesive elements with irregular nuclei. These cells were immunoreactive for smooth muscle actin, calponin, keratin 14, p63, and e-cadherin. EMA, ER, and PR were consistently negative. The third type, seen in a minority of cell population of case nos. 2 and 3, consisted of cells showing at the same time EMA and smooth muscle actin in their cytoplasm. This type was defined as "hybrid myosecretory cell" to highlight contractile and secretory properties present at the same time. Cells with hybrid features probably indicate that myoepithelial and secretory cells are strictly related and the existence of a stem cell, at least for these cases, is not necessary.- - - - - - - - - - ranking = 0.5keywords = antigen (Clic here for more details about this article) |
8/21. breast cancer and paraneoplastic cerebellar degeneration.Of the remote effects of cancer on the neurologic system, paraneoplastic cerebellar degeneration (PCD), characterized by global cerebellar dysfunction, is second only to paraneoplastic neuropathies in frequency. Recent evidence, including the finding of anti-Purkinje cell (now termed anti-Yo) antibodies directed against specific protein antigens shared by Purkinje's and tumor cells, supports an autoimmune etiology for this disorder. Increasingly, a link between breast cancer and PCD is being recognized. The authors report a case, as well as a comprehensive overview, of 62 women with breast cancer and PCD, identified through a medline (National Library of medicine, washington, DC) computer search (1966 to 1991) and comprehensive reference follow-up of the medical literature. The current understanding of the pathophysiology of PCD, with particular emphasis upon those features both salient and unique to breast cancer, is discussed. Whereas PCD will affect only a small number of patients with breast cancer, recognition of this syndrome is important. Anti-Purkinje cell (anti-Yo) antibody titers are now commercially available through several reference laboratories, and a serum anti-Purkinje cell antibody titer will assist in establishing the diagnosis. Presence of consistent symptoms and elevated titers of anti-Yo antibodies should prompt a search for an otherwise occult, and potentially treatable, malignancy. Only therapy initiated early in the patient's course appears to be of benefit. Finally, investigations into the pathogenesis of this syndrome may shed further light upon other diseases presumed secondary to autoimmune dysfunction.- - - - - - - - - - ranking = 0.5keywords = antigen (Clic here for more details about this article) |
9/21. A patient with simultaneous absence of "classical" natural killer cells (CD3-, CD16 , and NKH1 ) and expansion of CD3 , CD4-, CD8-, NKH1 subset.The clinical manifestations of putative natural killer (NK) cell deficiency are not well-known but theoretically should include recurrent tumors and systemic viral infections. In this article, we discuss a patient with recurrent condylomata, vulvar and cervical carcinoma in situ, pulmonary infiltrates of unknown significance, and a hypercoagulable state. This patient has a dramatic persistent deficiency in her circulating "classic" NK cells (CD3-, CD16 , NKH1 ) and a simultaneous persistent expansion of a normally minor lymphocyte cell subset (CD3 , CD4-, CD8-, NKH1 ) that does not express the alpha beta heterodimer of the T cell receptor. T-lymphocyte function, as measured by mitogen and alloantigen responsiveness in vitro, was normal. The coexistence of this particular clinical complex with this unusual set of laboratory abnormalities tends to emphasize our meager understanding of the biologic role of NK cells. At the very least, these findings suggest that the clinical manifestations of NK cell deficiency need not be dominated by disseminated systemic viral infections and that perhaps there should be a higher index of suspicion for the scrutinization of NK cell function.- - - - - - - - - - ranking = 0.5keywords = antigen (Clic here for more details about this article) |
10/21. Post-surgical necrobiotic granulomas of urinary bladder.Palisading necrobiotic granulomas of the prostate are an uncommon but well-recognized sequela of transurethral surgery. Similar granulomas occurring in 3 patients after transurethral surgery of the urinary bladder are reported. In each case, the lesions were discovered as a result of biopsies done subsequent to transurethral resections of bladder tumors. An idiosyncratic hypersensitivity reaction to a diathermically induced change in the antigenicity of the subepithelial connective tissue is suggested as the cause of these granulomas.- - - - - - - - - - ranking = 0.5keywords = antigen (Clic here for more details about this article) |
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