Cases reported "Carcinoma in Situ"

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1/8. Oral precancerous and malignant lesions associated with graft-versus-host disease: report of 2 cases.

    The development of secondary malignancies has been recognized as a potential iatrogenic complication in patients who have graft-versus-host disease secondary to bone marrow transplantation. Lymphohematopoietic cancer is most frequent, although solid malignancies have also been reported. We describe 2 patients with graft-versus-host disease who developed oral precancerous and malignant lesions. The first patient, a 24-year-old white man, had erythroplakia of the buccal mucosa that proved to be carcinoma in situ histopathologically. The second patient, a 14-year-old Hispanic boy, developed synchronous cutaneous and lingual squamous cell carcinomas. The current cases and similar sporadic case reports found in the literature highlight the susceptibility of patients with graft-versus-host disease to the development of oral cancer. Therefore, it is recommended that thorough evaluation of the oral mucosa and close follow-up be offered to all patients treated with bone marrow transplantation and particularly to those who develop graft-versus-host disease.
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keywords = precancerous
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2/8. An in situ carcinoma of the pancreas forming 2 invasive ductal carcinomas.

    A 62-year-old man underwent distal pancreatectomy for invasive pancreatic carcinoma. Histopathologically, the main lesion that obstructed the main pancreatic duct and measured 2.0 cm in diameter was a moderately differentiated adenocarcinoma with marked neural invasion. The main pancreatic duct immediately distal to the tumor was lined with carcinoma in situ, and gradual transition from carcinoma in situ to mild atypia was observed. An accessory tumor measuring 0.8 cm in diameter was located in the pancreatic tail. The adjacent pancreatic contained carcinoma in situ and flat dysplastic cells without papillary growth. We concluded that the structure of the cells lining the ducts and the comparatively flat formation and gradual transition indicated that 2 lesions, each invading the pancreatic parenchyma, arose from the intraductal tumor (carcinoma in situ or precancerous lesion).
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keywords = precancerous
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3/8. High-grade pancreatic intraepithelial neoplasia in a patient with familial adenomatous polyposis.

    Familial adenomatous polyposis (FAP) is caused by mutation of the adenomatous polyposis coli (APC) gene and is characterized by multiple colorectal adenomas and tumors of other organs and sites. A 58-year-old woman with FAP syndrome and previous total colectomy presented for routine follow-up examination. Abdominal ultrasound and subsequent endoscopic evaluation revealed ampullary and duodenal polyps, as well as inhomogeneity of the pancreatic head. A pancreaticoduodenectomy confirmed multiple duodenal adenomas. In addition, high-grade pancreatic intraepithelial neoplasia (PanIN-3) was found in the smaller pancreatic ducts. Pancreatic precancerous lesions have only rarely been described in FAP, including 2 pancreatic duct adenomas and 2 intraductal papillary mucinous neoplasms. A review of the world English literature revealed no reports of PanIN-3 in association with FAP. Further studies are required to determine if patients with FAP are at increased risk for pancreatic premalignant lesions.
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keywords = precancerous
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4/8. Premalignant changes in nasal and sinus polyps: a retrospective 10 year study (1979-1988).

    One hundred and seventy cases of nasal and/or sinus polyps diagnosed in the pathology Service of the Hospital Militar Central GOMEZ/ULLA of Madrid (spain) between 1.9.79 and 1.9.88 are reviewed. In two cases areas of 'carcinoma in situ' in the epithelium covering the polyps were demonstrated. The literature is reviewed for reports of malignant transformation and dysplastic changes in nasal and sinusal polyps. We suggest that precancerous changes may occasionally be noted in inflammatory lesions, a fact that pathologists should keep in mind.
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keywords = precancerous
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5/8. bowen's disease, Paget's disease, and malignant melanoma in situ.

    The histologic differential diagnosis of skin lesions characterized by large, atypical, clear cells in the epidermis includes bowen's disease, Paget's disease (mammary and extramammary), malignant melanoma in situ (pagetoid precancerous melanosis), mycosis fungoides, Spitz nevus, and artifact. Our experience with these lesions indicates that these diseases can be differentiated immunohistologically by the standard peroxidase-antiperoxidase technique, using antibodies directed against keratin (KER), carcinoembryonic antigen (CEA), and S-100 protein (S-100). Based on a study of 11 cases of bowen's disease, eight cases of Paget's disease, and nine cases of malignant melanoma in situ, we conclude that the atypical clear cells of bowen's disease stain only with antibodies to KER; those of Paget's disease, exclusively with antibodies to CEA; and those of malignant melanoma in situ, with antibodies to S-100. Additionally, we report a case in which clinical and histologic findings suggested bowen's disease, but immunohistologic findings supported the diagnosis of Paget's disease.
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ranking = 0.2
keywords = precancerous
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6/8. Intramucosal carcinoma of the small intestine arising in regional enteritis (Crohn's disease). Report of a case studied for carcinoembryonic antigen and review of the literature.

    A case of carcinoma of the small intestine arising in a patient with regional enteritis (Crohn's disease) of the ileum is reported. The patient, a 54-year-old woman, had a 21-year history of regional enteritis which was treated intermittently with sulfasalazine and prednisone. Segmental resections of the ileum had been performed on two previous occasions. Because of recurrent low-grade intestinal obstruction, another segment of ileum was resected. The bowel demonstrated the typical gross and histologic appearance of regional enteritis. Histologic examination also disclosed a carcinoma that was confined to the ileal mucosa. This case is the first reported in which a small bowel carcinoma arising in regional enteritis has been found only in the mucosa. Adjacent to the carcinoma, the mucosa showed varying degrees of dysplasia consistent with the "precancerous" changes that have been described in inflammatory bowel disease. Using a peroxidase-antiperoxidase immunoperoxidase technique, carcinoembryonic antigen was identified in normal, hyperplastic, dysplastic, and carcinomatous mucosa, but the most intense staining was seen in hyperplastic and dysplastic cells. Carcinoembryonic staining, however, did not aid in differentiating between hyperplasia, dysplasia, and carcinoma because of an overlap in staining frequency and intensity.
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keywords = precancerous
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7/8. Carcinoma lobulare in situ B in monozygotic twins.

    Some form of predisposition to breast cancer can be inherited, but it is not known whether the same applies to precancerous lesions of the breast. We are reporting on an identical incidence of carcinoma lobulare in situ type B in monozygotic twins. The case report illustrates that in identical twins the environment is usually more similar than in the general population so it is difficult to determine the hereditary component in the manifestation of a specific histologic trait. The observation may support the hypothesis that there is not only a high incidence of multicentric disease in both breasts of one person, but in the breasts of identical twin sisters too.
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ranking = 0.2
keywords = precancerous
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8/8. Generalized juvenile polyposis with mixed pattern and gastric cancer.

    Generalized gastrointestinal juvenile polyposis is a rare form of diffuse polyposis in which cancer infrequently develops. A clinical case is described in which gastric polyps showed a variety of histological features, including both in situ and invasive adenocarcinoma. Many mixed lesions were observed, confirming a morphological sequence already documented in colorectal tumorigenesis but still undefined in gastric tumors. The patient seems strongly predisposed to gastric cancer, presumably on a genetic basis, because he developed a malignancy in a hyperplastic juvenile polyp, usually not considered a precancerous lesion. There is no doubt that cases like this may be important for accurate genetic evaluation and biological characterization.
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