Cases reported "Lip Neoplasms"

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1/7. Microcystic adnexal carcinoma. Electron microscopic and immunohistochemical study.

    We present a patient with microcystic adnexal carcinoma. The lesion was an indurated plaque on the skin of the right upper lip of a 58-year-old woman which was slowly growing during 27 years. carcinoembryonic antigen was immunoreactive in the luminal contents of the tumor ducts and in the cytoplasm of cells surrounding ducts. S-100 protein was positive in the cytoplasm of a few cells at the lower dermis. These observations suggested that this tumor was related to sweat glands. Furthermore, electron microscopy revealed that tumor cells had features of eccrine ductal cells. These observations confirm that this tumor appeared at least capable of eccrine duct differentiation.
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2/7. Sclerosing-sweat-duct (microcystic adnexal) carcinoma--a tumor from a single eccrine origin.

    A patient with a sclerosing-sweat-duct carcinoma of the upper lip is reported. Histologically the tumour showed solid islands and strands of squamous cells and sparse small ductal structures, some of them containing central cores of dense eosinophilic keratin. All this was embedded in a sclerotic stroma. These features, in addition to positive immunoreactivity for carcinoembryonic antigen (CEA) in the lumina of small ducts, and the presence of S-100 protein-positive cells in some cords and ducts, are consistent with the notion that this tumour exhibits differentiation toward eccrine sweat structures.
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3/7. Microcystic adnexal carcinoma: a light microscopic, immunohistochemical and ultrastructural study.

    We report a case of microcystic adnexal carcinoma (MAC) occurring on the upper lip of an 82-year-old woman. Microscopically the tumor showed both pilar and sweat gland differentiation, involved the entire dermis and subcutaneous tissue, and invaded perineural spaces. Immunoperoxidase studies revealed carcinoembryonic antigen to be present in the ductal lining cells and in the amorphous content in the lumen, confirming sweat gland differentiation. The S-100 protein was positive in dendritic cells within the solid cell nests, but negative in cells lining cystic spaces. Ultrastructural study confirmed that the neoplasm was composed of two components, with pilar and eccrine differentiation. The former showed concentric layers of squamous epithelial cells with well-developed desmosomes and cytofilaments. The latter had ductal and alveolar structures; the ultrastructural features included: i) numerous villous folds of plasma membrane to interdigitate each other by focal desmosomes, ii) aggregates of cytofilaments, and iii) basally located myoepithelial cells which were separated from the surrounding stroma by rather thick basement membrane. In addition, distinct amyloid deposition was also observed on ultrastructural examination. To our knowledge, amyloid deposition has not been previously reported in MAC.
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4/7. glomus tumor of the lip. A case report and immunohistochemical study.

    A rare glomus tumor of the lip is reported and--with nineteen glomus tumors from other sites--examined immunohistochemically with both monoclonal and polyclonal antibodies. In every case, the glomus cells showed strong reactivity with antivimentin, and factor viii-related antigen was consistently identified in the endothelial cells but not in the glomus cells. Antiblood group A antigen was located in endothelial cells in nine cases; of these nine, five also showed focal staining in glomus cells. In no case was there reactivity with antibodies to common leukocyte antigen or cytokeratin proteins. These results support the hypothesis of Tajima et al. that the glomus cell is transitional--between smooth muscle and vascular endothelium--being essentially a modified, smooth muscle cell with some endothelial cell properties.
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5/7. Microcystic adnexal carcinoma. Immunohistologic observations suggesting dual (pilar and eccrine) differentiation.

    Microcystic adnexal carcinoma (MAC) is a locally aggressive neoplasm that has recently been recognized as a clinicopathologic entity. Its histologic appearance includes both pilar and eccrine differentiation. We initially treated two patients with MAC of the cheek and of the nasolabial fold, respectively; by microscopically controlled excision because of the contiguous growth of the tumors. Despite the benign histologic appearance, there was deep and extensive infiltration of the subcutaneous tissue. Both patients responded favorably to initial treatment with microscopically controlled excision. In addition, immunoperoxidase staining for carcinoembryonic antigen supported the dual differentiation of this unusual neoplasm. We speculate that previous radiotherapy may be an important predisposing factor in the pathogenesis of MAC.
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6/7. Histologic spectrum of carcinomas with eccrine ductal differentiation (sweat-gland ductal carcinomas).

    Seven cases of sweat-gland carcinomas showing eccrine ductal differentiation (ductal carcinomas) are presented. The tumors had a variable histological appearance, but were basically characterized by the following histological elements: (a) tubular structures, sometimes cystic or having a "tadpole" appearance; (b) solid islands of squamous, basaloid, or clear cells; (c) periodic acid-Schiff-positive endoluminal and/or intracellular material; and (d) infiltrating growth. Immunocytochemically, tumor cells were positive for keratin and negative for actin. Endoluminal material contained carcinoembryonic antigen in five of seven cases. Although it is not yet clear whether carcinomas exhibiting eccrine ductal differentiation may represent a specific histotype or a group encompassing several distinct clinicopathological entities, the histological analysis of the cases suggested that the wide spectrum of their histological appearances may be due to variable grades of differentiation.
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7/7. The hybrid epidermoid and apocrine cyst. A combination of apocrine hidrocystoma and epidermal inclusion cyst.

    We describe four cases of unusual superficial cutaneous cysts that have a lining epithelium composed of apocrine cells immediately adjacent to keratinizing squamous epithelium with an intact granular layer. Two of the cysts were on the nipple of the breast and two of the cysts were on the face. The lumina of all four cysts contained keratin. Immunoperoxidase staining for carcinoembryonic antigen in the facial cysts showed positive staining within the apocrine cells of the lining epithelium in one case. The pathogenesis of these lesions is uncertain. We suggest that these unusual cysts be called hybrid epidermoid and apocrine cysts.
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