1/8. Diagnostic difficulty arising from displaced epithelium after core biopsy in intracystic papillary lesions of the breast.This study reports two cases of intracystic papillary carcinoma of the breast, which had been biopsied preoperatively using a 14 gauge (14G) core biopsy needle. In each case, a needle tract containing groups of epithelial cells within granulation tissue could be identified on histology of the excised specimen. Both cases showed extracapsular tumour, which was interpreted as displacement of epithelium related to preoperative core biopsy. Subsequent axillary lymph node sampling showed no evidence of metastasis. In one case, extracapsular tumour appeared to be in blood vessels, but flattened cells lining the spaces containing tumour failed to react with factor 8 related antigen or CD34 on immunohistochemistry. It is likely that intracystic papillary carcinomas are particularly prone to this artefact because friable tumour fragments escape, accompanied by cyst fluid, when the capsule is punctured by a 14G core biopsy needle.- - - - - - - - - - ranking = 1keywords = antigen (Clic here for more details about this article) |
2/8. Malignant anterior urethral strictures: a rare complication of transurethral resection of malignant prostate.A 65-year old male presented with obstructive voiding symptoms and recurrent hematuria following transurethral resection of malignant prostates. Following an unsuccessful attempt at catheterization, urethroscopy revealed narrowing of anterior urethra secondary to multiple nodular lesions. biopsy of lesion showed adenocarcinoma positive for prostate specific antigen. This rare presentation has been reported only twice in past. Clinical presentation, pathophysiology and brief review of literature are discussed.- - - - - - - - - - ranking = 1keywords = antigen (Clic here for more details about this article) |
3/8. Passive seeding in metanephric adenoma: a review of pseudometastatic lesions in perinephric lymph nodes.Lymph node involvement derived from a discrete neoplastic process fundamentally implies tumor malignancy. However, rarely, inconsequential passive transport of benign neoplastic cells to the lymph node can occur and may cause confusion as to the nature of the neoplasm (ie, malignant vs benign). We describe a 10-cm right renal metanephric adenoma incidentally discovered in a 30-year-old woman during cesarean section for a triplet pregnancy. Subsequent nephrectomy following an equivocal needle biopsy diagnosis showed histologic features classic for metanephric adenoma, including the lack of cytologic atypia and mitoses. necrosis present in this lesion appeared to be secondary to tumor physical disruption. The tumor cells were positive for wilms tumor 1 (WT1) antigen, pankeratin, and CD57, focally positive for epithelial membrane antigen, and negative for cytokeratin 7, cytokeratin 34betaE12, and CD56. Electron microscopy confirmed the tumor's epithelial nature, and cytogenetics revealed a diploid 46XX karyotype. The tumor proliferation index with Ki-67 was only 3% to 5% and the proliferating cell nuclear antigen index was 0%. A single, concurrently resected hilar lymph node contained scattered subcapsular, sinusoidal, and focally intralymphovascular psammoma bodies along with occasional adherent epithelial cells. These cells were highlighted by pankeratin but were nonreactive to WT1 antigen, similar to the nonviable cells in the primary tumor. Clinical surveillance and follow-up showed no disease recurrence 4 years after nephrectomy. We postulate that the lymph node inclusions found in this case represent passive transport of neoplastic cells to the lymph node following manipulation of the renal mass. We conclude that this phenomenon is understudied and underrecognized and can easily be mistaken for metastasis.- - - - - - - - - - ranking = 4keywords = antigen (Clic here for more details about this article) |
4/8. Port site recurrence diagnosed by positron emission tomography after laparoscopic surgery for colon cancer.Port site recurrence after laparoscopic surgery for colorectal cancer patients is a rare complication. We report a case of port site recurrence in a 46-year-old woman that was detected by positron emission tomography (PET) using 18[F]-fluoro-deoxyglucose (FDG). Surgical treatment consisted of laparoscopic ileo-cecal resection and lymph node dissection. At her nine months postoperative follow-up examination, her serum carcinoembryonic antigen (CEA) levels had raised to 15.8ng/mL. Although computed tomography and colonoscopic examination were performed, lung, liver and local recurrence in the colon were not detected. FDG-PET was then performed and detected a higher concentration of FDG at the port site in the abdominal wall. Port site recurrence was diagnosed clinically and surgical resection of tumor at the port site was performed. pathology revealed a moderately differentiated adenocarcinoma diagnosed as port site recurrence. This case suggests that FDG-PET is an important examination for the detection of port site recurrence when serum CEA levels are rising and routinely radiographic examinations are unable to detect the site of recurrence.- - - - - - - - - - ranking = 1keywords = antigen (Clic here for more details about this article) |
5/8. Local recurrence of prostate cancer in rectal submucosa after transrectal needle biopsy and radical prostatectomy.A 69-year-old man with clinical Stage T1cN0M0 prostate cancer underwent radical prostatectomy, revealing negative surgical margins, focal capsular penetration, and negative lymph nodes and seminal vesicles. Five years later, his prostate-specific antigen level had increased to 0.2 ng/mL, and digital rectal examination revealed a palpable submucosal mass in the rectum that was confirmed by colonoscopy and transrectal ultrasonography. Excisional biopsy revealed prostatic adenocarcinoma similar in appearance and grade to the initial needle biopsy. This case report illustrates an extremely rare needle tract adenocarcinoma implantation after needle biopsy of the prostate.- - - - - - - - - - ranking = 1keywords = antigen (Clic here for more details about this article) |
6/8. Malignant transformation of spontaneously regressed retinoblastoma, retinoma/retinocytoma variant.The authors report on a case of a 7-year-old girl who was found on routine preschool screening at age 4 years to have unilateral decreased vision and a retinal lesion consistent clinically with the retinoma or retinocytoma variant of "spontaneously regressed retinoblastoma." The patient was followed closely with photographic documentation. After remaining stable for 3 years, her tumor grew rapidly and seeded the vitreous, prompting enucleation. Histopathologic examination disclosed that the newer elevated part of the tumor was an undifferentiated retinoblastoma, whereas the base of the tumor had the characteristic benign histopathologic features of retinoma/retinocytoma including bland nuclei, a fibrillar eosinophilic stroma, scattered fleurettes, calcific foci within viable tumor, and no mitoses. Immunohistochemical stains disclosed that immunoreactivity for retinal S antigen, S-100 protein, and glial fibrillary acidic protein was confined to cells in the differentiated basal part of the tumor. These histopathologic observations support the concept that tumors with the clinical characteristics of the patient's original lesion are benign variants of retinoblastoma that have arisen de novo rather than retinoblastomas that have undergone spontaneous regression. The clinical developments in this case suggest that retinomas or retinocytomas rarely undergo malignant transformation after a period of clinical dormancy and underscore the necessity for close follow-up of patients with presumed regressed retinoblastoma.- - - - - - - - - - ranking = 1keywords = antigen (Clic here for more details about this article) |
7/8. Early pulmonary recurrence of non-Hodgkin's lymphoma after autologous marrow transplantation: evidence for reinfusion of lymphoma cells?disease recurrence is a major cause of failure after autologous bone marrow transplantation for Hodgkin's disease or non-Hodgkin's lymphoma. Relapse usually occurs at sites of previous involvement. The patient described here died of massive pulmonary involvement with Ki-1 antigen (CD30)-positive immunoblastic lymphoma 2 months after transplantation with unpurged autologous marrow. This relapse in a previously uninvolved organ prompted resectioning of the pre-storage marrow biopsy and resulted in identification of one small aggregation of malignant cells. A review of open lung biopsies and necropsies of autologous marrow recipients treated in Seattle identified no other patients with pulmonary malignancy who lacking previous lung tumor or evidence of contiguous pulmonary and mediastinal involvement. These observations raise questions about the assessment of pre-harvest marrow involvement and the need for marrow purging. This case also suggests that organ and tissue localization of malignant cells may be determined by abnormally expressed 'homing' ligands.- - - - - - - - - - ranking = 1keywords = antigen (Clic here for more details about this article) |
8/8. Perineal seeding of prostate cancer as the only evidence of clinical recurrence 14 years after needle biopsy and radical prostatectomy: molecular correlation.Perineal needle tract seeding of prostate cancer is an unusual complication of perineal prostate biopsy. We report a case with the longest known interval from biopsy to perineal recurrence--14 years. The prostate-specific antigen did not become detectable until 12 years after biopsy and no other metastases were apparent, suggesting that the patient's perineal disease was an isolated recurrence. Immunohistochemical staining of the perineal recurrence and the original biopsy and prostate for the p53 tumor suppressor gene and bcl-2 oncogene proteins revealed rare/absent p53 expression but marked increased bcl-2 expression. This unusual molecular pedigree may help to explain this rare clinical scenario.- - - - - - - - - - ranking = 1keywords = antigen (Clic here for more details about this article) |