1/13. Endometrioid adenocarcinoma arising from adenomyosis: report and immunohistochemical analysis of an unusual case.A case of endometrioid adenocarcinoma arising from adenomyosis is reported. The patient was a 53-year-old woman who complained of vulvar itching. Smear cytology of the endometrium revealed adenocarcinoma. magnetic resonance imaging of the pelvis revealed a lesion with a slightly high intensity in the uterine fundus on a T2-weighted image. Semiradical total hysterectomy and bilateral adnexectomy were performed, followed by chemotherapy. Histologically, the lesion in the uterine fundus was composed mostly of adenocarcinoma with stromal invasion. There were many adenomyotic foci in and around the carcinoma, including some showing transition to adenocarcinoma. There was no malignant finding in the normally situated endometrium. The carcinoma invaded in the myometrium, involving the uterine serosa, but no dissemination to the peritoneal cavity was found. The carcinoma was, therefore, considered to be endometrioid adenocarcinoma arising from adenomyosis. immunohistochemistry showed expression of p53 oncoprotein and ki-67 antigen in the carcinoma cells. The value of immunohistochemistry in predicting prognosis is discussed.- - - - - - - - - - ranking = 1keywords = antigen (Clic here for more details about this article) |
2/13. Two cases of supernumerary ovary: one with large fibroma with Meig's syndrome and the other with endometriosis and cystic change.Reports of supernumerary ovaries are rare. We describe two such cases, one with fibroma and the other with endometriosis and cystic change. A large fibroma measuring 17.4 x 12.0 x 7.5 cm in size was found in the supernumerary ovary of the omentum in the first case of a 47-year-old married woman with Meig's syndrome. The second case was associated with endometriosis and cystic change, measuring 11 x 5 x 3 cm in size and located in the upper abdominal cavity. It was attached to the uterus of a 28-year-old pregnant woman who had neither fibroma nor Meig's syndrome. Histologically, corpus albicans and a few primordial germ cells were demonstrated, respectively. A fibroma showing a storiform pattern was found in the first case. The second case had endometriosis and a thin-walled cyst with bleeding and necrosis caused by torsion. Immunohistochemically, desmin, alpha-smooth muscle actin, c-kit, CA125, Na /K ATPase, overexpression of p53, myc and ras were all negative in the fibroma cells of the first case, and in the endometriosis and cyst wall of the second case. The fibroma cells were positive for vimentin and estrogen receptor, and the proliferating cell nuclear antigen was sporadically demonstrated in their nuclei. The mutation of the p53 gene at exons 5-8 was not detected by sequence analysis. Using RT-PCR, bax, bcl-2 and p16 were not detected either. Clinically, the two cases presented here did not show abnormal hormonal symptoms. They were diagnosed as abdominal tumors or masses. Based on these considerations, one might assume that supernumerary ovaries are probably more frequent than reported at present.- - - - - - - - - - ranking = 1keywords = antigen (Clic here for more details about this article) |
3/13. Elevated serum CA125 and CA19-9 due to the spontaneous rupture of ovarian endometrioma.A 23-year-old woman was suffered from ruptured ovarian endometrioma with an elevated CA125 and CA19-9 concentration; 9537 and 15,653IU/ml, respectively. Rapid decrease in serum CA125 and CA19-9 was recognized before surgery. Such high levels of both antigens have not been reported in a patient with endometriosis.- - - - - - - - - - ranking = 1keywords = antigen (Clic here for more details about this article) |
4/13. Ovarian mucinous and mixed epithelial carcinomas of mullerian (endocervical-like) type: a clinicopathologic analysis of four cases of an uncommon variant associated with endometriosis.The epithelial cells of ovarian mucinous carcinomas may sometimes appear similar to those of gastrointestinal or endocervical mucinous carcinomas, but most are composed of cells that do not suggest any particular derivation. We report four cases of mucinous ovarian carcinoma in which the cells were entirely or almost entirely endocervical-like. The patients' ages were 34, 43, 44, and 50 years. Two patients had bilateral tumors confined to the ovaries at initial staging; both also had synchronous endometrial carcinomas of the mucinous type. The two other patients had unilateral tumors, both with invasive metastases in the pelvis and abdomen at initial staging. In one of the latter cases a mullerian (endocervical-like) mucinous borderline tumor (MMBT) of the opposite ovary had been removed 5 years earlier, and in this case and two other cases the ovarian carcinomas had foci resembling MMBT, suggesting that they may be an invasive counterpart to these tumors. The six tumors ranged from 4 to 19 cm; five were grossly cystic with papillary or solid areas, and one was entirely solid. They were composed of closely packed glands, cysts, and cysts containing complex papillae. There was abundant intraglandular and intracystic mucin. The epithelial cells were well differentiated with infrequent mitoses and most were tall with mucinous cytoplasm resembling normal endocervical glandular cells. In three tumors there also were round to polygonal cells with eosinophilic cytoplasm; endometrioid foci were present in three tumors and a squamous focus was present in one. One tumor had a focally infiltrative growth pattern with a desmoplastic stromal reaction; the remaining five tumors had an exclusively confluent (expansile) pattern of invasion. endometriosis was present in residual ovarian tissue adjacent to four tumors in three patients and had marked epithelial proliferation in three. All patients were treated postoperatively with chemotherapy and were without clinical recurrence with follow-up intervals of 8 months, 1.2 years, 2.9 years, and 3.8 years. By immunohistochemical analysis the neoplastic epithelium was positive for estrogen and progesterone receptor proteins, vimentin, and cytokeratin 7, and negative or only focally positive for carcinoembryonic antigen and cytokeratin 20, a profile that differs from that of the usual mucinous ovarian carcinoma and is supportive of a mullerian derivation. As with MMBTs, there was a strong association with endometriosis, and these tumors likely arise from endometriosis, possibly through an MMBT precursor in some cases. To better understand their clinicopathologic features and pathogenesis, this uncommon variant should be separated from the usual type in future studies of mucinous carcinomas of the ovary.- - - - - - - - - - ranking = 1keywords = antigen (Clic here for more details about this article) |
5/13. Mutation analysis of BrCA1, BrCA2, and p53 versus soluble HLA class I and class II in a case of familial endometriosis.OBJECTIVE: To investigate possible correlation(s) between mutations of BrCA1, BrCA2, and p53 genes versus soluble HLA expression in familial endometriosis. DESIGN: Mutation analysis. SETTING: University teaching departments and hospital. PATIENT(S): A family with seven women in two generations with familial endometriosis. INTERVENTION(S): Mutation analysis of BrCA1, BrCA2, and p53 genes. MAIN OUTCOME MEASURE(S): A point mutation of the BrCA1 gene appears to inhibit soluble HLA secretion. RESULT(S): Among the three genes examined, only the BrCA1 gene showed a T to A mutation at position 3232 that correlates with total abolishment of both class I and class II antigen release. CONCLUSION(S): A possible correlation between a BrCA1 mutation and soluble HLA expression appears to exist. The mutation is not stage dependent and seemingly influences the secretion of both class I and class II antigens that are totally absent from the serum of only one family member.- - - - - - - - - - ranking = 2keywords = antigen (Clic here for more details about this article) |
6/13. High level of CA 125 due to large endometrioma.BACKGROUND: CA 125 is a tumor-associated antigen. Its high levels are usually associated with ovarian malignancies, whereas smaller increases in the levels were associated with benign gynecologic conditions. The authors report a high level of CA 125 in a case of large ovarian endometrioma. CASE REPORT: A 45-year-old nulliparous Thai woman, presented with an increase of her abdominal girth for 7 months. Transabdominal ultrasonogram demonstrated a large ovarian cyst and multiple small leiomyoma uteri, and serum CA 125 level was 1,006 U/ml. The preoperative diagnosis was ovarian cancer with leiomyoma uteri. Exploratory laparotomy was performed. There were a large right ovarian endometrioma, small left ovarian endometrioma and multiple small leiomyoma. Total abdominal hysterectomy and bilateral salpingo-oophorectomy was performed and histopathology confirmed the diagnosis of endometrioma and leiomyoma. The serum CA 125 level declined to non-detectable at the 4th week. She was well at discharge and throughout her 4th week follow-up period CONCLUSION: Although a very high level of CA 125 is associated with a malignant process, it can also be found in benign conditions such as a large endometrioma. The case emphasizes the association of high levels of CA 125 with benign gynecologic conditions.- - - - - - - - - - ranking = 1keywords = antigen (Clic here for more details about this article) |
7/13. Minimal deviation endometrioid adenocarcinoma of cervix: a clinicopathological and immunohistochemical study of two cases.We describe the clinicopathological features of two cases of minimal deviation endometrioid adenocarcinoma of cervix. This is a rare tumour whose predominant pattern is one of bland endometrial-type glands infiltrating the cervical wall without a stromal response. Thus, it may be confused with benign conditions such as cervical endometriosis. The two cases demonstrate that this tumour may behave aggressively despite its bland appearances. An immunohistochemical study was performed and showed only focal reactivity of neoplastic glands for carcinoembryonic antigen, which would limit its diagnostic use in small biopsy specimens.- - - - - - - - - - ranking = 1keywords = antigen (Clic here for more details about this article) |
8/13. Fine needle aspiration cytology of papillary endometrioid carcinoma of the prostate. The grooved nucleus as a cytologic marker.The fine needle aspiration (FNA) cytologic findings of an endometrioid carcinoma of the prostate are presented, along with the histologic, immunohistochemical and endoscopic features. cystoscopy of an elderly male patient with hematuria and symptoms of bladder outlet obstruction showed the delicate papillary growths at the verumontanum that are characteristic of this lesion. Transrectal FNA of the prostate produced samples that included clusters of malignant cells with crowding and overlapping of hyperchromatic nuclei containing prominent nucleoli and a loss of polarization and cohesion. Many of the groups of tumor cells suggested papillary structures. A novel finding in the aspirate was a grooved nucleus in 10% of the tumor cells. Immunohistochemical staining of biopsy sections of the papillary growths for prostate-specific antigen was strongly positive. It is important to recognize this variant of prostatic carcinoma since its behavior and response to therapy are not yet established.- - - - - - - - - - ranking = 1keywords = antigen (Clic here for more details about this article) |
9/13. Papillary adenocarcinoma of the prostatic urethra.Three cases of papillary carcinoma of the prostate (also called endometrial adenocarcinoma of the prostate; endometrioid carcinoma) were studied for prostate-specific antigen in order to determine their origin and histogenesis. All 3 cases were prostate-specific antigen positive. Two patients were treated with hormonal therapy, 1 with radiotherapy.- - - - - - - - - - ranking = 2keywords = antigen (Clic here for more details about this article) |
10/13. Endometrioid carcinoma of prostate.A prostatic tumor that was excised from a sixty-two-year-old man was found histologically to resemble papillary endometrial carcinoma. A specimen of this prostatic endometrioid carcinoma tested positive for prostate-specific antigen and focally positive for mucin, confirming the prostatic epithelial origin of the tumor. A review of the literature indicates that tumors of this type are best approached as a standard acinar adenocarcinoma of the prostate.- - - - - - - - - - ranking = 1keywords = antigen (Clic here for more details about this article) |
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