1/75. Cutaneous ciliated cyst of the right lower leg.A 23-year-old Japanese woman with a cutaneous ciliated cyst on her right lower leg is reported. A subcutaneous cyst, measuring 2.5 cm in diameter with papillary projections into the lumen, was lined with ciliated cuboidal to columnar epithelia with partial stratification, histologically. These lining cells did not produce mucin. Immunohistochemically, the ciliated lining cells of the cyst were diffusely positive to epithelial membrane antigen and cytokeratin. In addition, positive immunoreaction with anti-desmin monoclonal antibody was observed in the body of the cilia. Less than 10% of the epithelial cells revealed positive immunoreaction to S-100 protein and estrogen receptor.- - - - - - - - - - ranking = 1keywords = antigen (Clic here for more details about this article) |
2/75. Benign epithelial cyst of the spleen with a high production of carbohydrate antigen 19-9.A rare case of an epithelial splenic cyst showing a high production of the carbohydrate antigen 19-9 (CA19-9) is presented. A 19-year-old female with high fever and loss of appetite was diagnosed as having a splenic cyst. Laboratory data revealed unusually elevated serum levels of both CA19-9 and CA125. The histological diagnosis was an epithelial splenic cyst, and immunohistochemically the wall of the splenic cyst was strongly positive for CA19-9 and slightly positive for both CA125 and CEA. Fluid in the splenic cyst contained quite high levels of CA19-9, CA125 and CEA. After splenectomy, the serum levels of CA19-9 and CA125 gradually decreased. These findings suggested that the splenic cyst produced CA19-9, CA125 and CEA. And with very high levels of CA19-9 and CA1 25 in the cyst, some had entered into systemic circulation.- - - - - - - - - - ranking = 5keywords = antigen (Clic here for more details about this article) |
3/75. Spontaneous rupture of a nonparasitic liver cyst complicated by intracystic hemorrhage.a case of spontaneous rupture of simple liver cyst complicated by intracystic hemorrhage is described. This rare condition was detected in a 61-year-old man who underwent left trisegmentectomy of liver under a suspected diagnosis of cystadenocarcinoma because of elevated serum levels of carbohydrate antigen (CA) 19-9 and DUPAN 2, and the presence of an intracystic structure. The resected specimen showed a benign liver cyst with intracystic hematoma and high levels of CA19-9 and DUPAN 2 in the cystic fluid. It is suggested that cyst rupture may increase serum levels of tumor markers whose levels are high in the cystic fluid, and that repeated observations of an intracystic structure may be the most reliable method to distinguish intracystic hemorrhage from cystic neoplasm.- - - - - - - - - - ranking = 1keywords = antigen (Clic here for more details about this article) |
4/75. Epithelial splenic cysts in an intrapancreatic accessory spleen and spleen.A rare case of cysts simultaneously occurring in the intrapancreatic accessory spleen and spleen in a 49-year-old female is reported. The patient underwent distal pancreatomy for a cystic tumor of the pancreas, and a splenectomy. A multilocular cyst (4.3 x 2.6 cm) in an accessory spleen at the pancreas tail, and a solitary cyst (1.2 x 0.9 cm) of the spleen were found. The cyst in the intrapancreatic accessory spleen was lined by non-keratinizing stratified squamous epithelium, and the spleen cyst by a single layer of flat epithelium; these lining cells were positive for alcian blue stain and periodic acid-schiff reaction, and were immunohistochemically positive for cytokeratin, HBME-1 and Sialyl-Tn. Epithelial membrane antigen, carcinoembryonic antigen and CA19-9 were positive in the accessory spleen cyst but were negative in the spleen cyst. An electron microscopic examination of the flat epithelium of the spleen cyst revealed numerous microvilli on the surface, cytoplasmic microfilaments, and a number of tight junctions between adjacent cells. These features suggested that the two cysts differ in nature, and origin; the accessory spleen cyst may be an embryonic inclusion of the pancreas duct while the spleen cyst may be an inclusion cyst of the mesothelium.- - - - - - - - - - ranking = 2keywords = antigen (Clic here for more details about this article) |
5/75. Primary seminal vesicle carcinoma: an immunohistochemical analysis of four cases.Primary adenocarcinoma of the seminal vesicles is an extremely rare neoplasm. Because prompt diagnosis and treatment are associated with improved long-term survival, accurate recognition of this neoplasm is important, particularly when evaluating limited biopsy material. immunohistochemistry can be used to rule out neoplasms that commonly invade the seminal vesicles, such as prostatic adenocarcinoma. Previous reports have shown that seminal vesicle adenocarcinoma (SVCA) is negative for prostate-specific antigen (PSA) and prostate-specific acid phosphatase (PAP); however, little else is known of its immunophenotype. Consequently, we evaluated the utility of cancer antigen 125 (CA-125) and cytokeratin (CK) subsets 7 and 20 for distinguishing SVCA from other neoplasms that enter the differential diagnosis. Four cases of SVCA-three cases of bladder adenocarcinoma and a rare case of adenocarcinoma arising in a mullerian duct cyst-were immunostained for CA-125, CK7, and CK20. Three of four cases of SVCA were CA-125 positive and CK7 positive. All four cases were CK20 negative. All bladder adenocarcinomas and the mullerian duct cyst adenocarcinoma were CK7 positive and negative for CA-125 and CK20. In addition, CA-125 immunostaining was performed in neoplasms that commonly invade the seminal vesicles, including prostatic adenocarcinoma (n = 40), bladder transitional cell carcinoma (n = 32), and rectal adenocarcinoma (n = 10), and all were negative for this antigen. In conclusion, the present study has shown that the CK7-positive, CK20-negative, CA-125-positive, PSA/PAP-negative immunophenotype of papillary SVCA is unique and can be used in conjunction with histomorphology to distinguish it from other tumors that enter the differential diagnosis, including prostatic adenocarcinoma (CA-125 negative, PSA/PAP positive), bladder transitional cell carcinoma (CK20 positive, CA-125 negative), rectal adenocarcinoma (CA-125 negative, CK7 negative, CK20 positive), bladder adenocarcinoma (CA-125 negative), and adenocarcinoma arising in a mullerian duct cyst (CA-125 negative).- - - - - - - - - - ranking = 3keywords = antigen (Clic here for more details about this article) |
6/75. A carcinoembryonic antigen-secreting adenocarcinoma arising within a retrorectal tailgut cyst: clinicopathological considerations.Retrorectal tailgut cysts (TGC) develop from postanal fetal gut remnants. They have specific radiological and histopathological features that distinguish them from dermoid cysts, enteric duplication cysts, and teratomas. We report a patient with a carcinoembryonic antigen-producing adenocarcinoma arising within a TGC who underwent resection through a combined anterior laparotomy/posterior pelvic approach. Despite complete resection and delayed but complete functional recovery, diffusely metastatic disease was encountered 6 months after resection. Diagnostic, therapeutic, histopathological, and oncological implications of this illustrative case are discussed. It seems possible to use carcinoembryonic antigen measurements for treatment planning and for assessing treatment response for this rare disease. The described outcome also suggests that TGC can develop malignant degeneration and should be resected at the time of diagnosis.- - - - - - - - - - ranking = 6keywords = antigen (Clic here for more details about this article) |
7/75. Cystic synovial sarcoma.A case of synovial sarcoma of the paraspinal region showing massive cystic changes is described. The tumor presented in a 53-year-old white woman who noticed a lump on the upper aspect of her back. magnetic resonance imaging of the cervical spine showed a heterogeneous paraspinal mass with well-defined margins and a multilocular quality with foci of hemorrhage. Fine needle aspiration of the mass showed clusters of polygonal cells admixed with a scattered spindle cell component. Surgical excision of the mass showed a well-circumscribed but nonencapsulated tumor that showed multiple small cystic structures on cross-section. Histologic examination showed a biphasic neoplasm characterized by bland-appearing glandular elements embedded in a moderately cellular spindle cell stroma. The tumor contained multiple cysts of varying size. Immunohistochemical studies showed the glandular component to be positive for cytokeratin and epithelial membrane antigen. The spindle cell component was immunoreactive for cytokeratin, vimentin, bcl-2, and CD99. Stains for muscle-specific actin, smooth muscle actin, S-100 protein, and CD34 were negative. cytogenetic analysis showed a balanced reciprocal translocation involving chromosomes X and 18, in addition to other clonal abnormalities. Synovial sarcoma should be considered in the differential diagnosis of cystic lesions involving the soft tissues. magnetic resonance imaging is considered the procedure of choice for the evaluation of soft tissue tumors because of its superior soft tissue contrast and multiplanar imaging capability. While the imaging features of soft tissue tumors are often nonspecific, magnetic resonance imaging may provide helpful clues, thus narrowing the differential diagnosis. Immunohistochemical studies and cytogenetic analysis may be very helpful for establishing the correct diagnosis in cases with this unusual presentation. Ann Diagn Pathol 5:48-56, 2001.- - - - - - - - - - ranking = 1keywords = antigen (Clic here for more details about this article) |
8/75. Elevated carbohydrate antigen 19-9 in patients with true (epithelial) splenic cysts--Rare or undiscovered?Carbohydrate antigen 19-9 is a well known marker for pancreatic adenocarcinoma. However, its limitation is its nonspecificity, because elevated levels may be encountered in other gastrointestinal disorders, both benign and malignant. The following case is a patient with a true (epithelial) splenic cyst with elevated serum levels of carbohydrate antigen 19-9.- - - - - - - - - - ranking = 6keywords = antigen (Clic here for more details about this article) |
9/75. Intravenous leiomyomatosis of the uterus with multiple pulmonary metastases associated with large bullae-like cyst formation.We present a case of uterine intravenous leiomyomatosis associated with multiple pulmonary metastases with bullae-like cystic change. A 53-year-old woman who had undergone hysterectomy 5 years previously underwent an operation for multiple pulmonary nodules with bullae formation. After resection of several large bullae, a subsequent extirpation of the pulmonary nodules was performed, and a pathological examination showed multiple leiomyomatous nodules with occasional cystic change. A review of the previous slides of the uterus and immunohistochemical analysis of the proliferating ability using anti-Ki-67 and anti-proliferating cell nuclear antigen (PCNA) antibodies were performed. Proliferating cells of the uterus had very few mitotic figures for their high cellularity, and the labeling indices of Ki-67 and PCNA indicated very low levels in both uterine neoplasm and pulmonary nodules. From these findings, an intravenous leiomyomatosis associated with multiple pulmonary metastases was diagnosed.- - - - - - - - - - ranking = 1keywords = antigen (Clic here for more details about this article) |
10/75. Median raphe cyst of the penis: a report of two cases with immunohistochemical investigation.Penile median raphe cysts are uncommon benign lesions occurring predominantly in the ventral aspect of the glans penis of young men. We observed two cases: those of a 67-year-old patient and a 22-year-old patient. The epithelial lining of the cysts was composed of pluristratified small cells that focally showed rows of columnar cells above the inner surface as well as a monolayered mucinous columnar epithelium. A columnar cell lining predominated in the younger patient. The cytokeratin (CK) immunostaining pattern of the two cysts (CK7( ), CK13( ), CK20(-), CAM 5.2( )) supports the interpretation of a columnar mucinous epithelium undergoing immature urothelial metaplasia. carcinoembryonic antigen immunostaining positivity of the columnar cells is probably related to the dysembryogenetic cloacal nature of the cysts. Neuroendocrine differentiation of sparse cells interspersed in the pluristratified epithelium was documented by immunohistochemical staining for chromogranin and synaptophysin. cilia were not identified in the columnar cells by light microscopy or by antidynein immunohistochemistry.- - - - - - - - - - ranking = 1keywords = antigen (Clic here for more details about this article) |
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