11/193. Florid cutaneous and mucosal papillomatosis with acanthosis nigricans revealing a primary lung cancer.This is the report of an 80-year-old patient with diffuse brownish hyperpigmentation and velvety thickening of the skin with onset 1 year before. Warty lesions on his limbs were present as well as papillomatous and verrucous lesions on his lips, mouth and eyelid conjunctivae with hyperkeratosis of the nipples. Biopsies, performed at different sites, showed histological pictures consistent with a diagnosis of acanthosis nigricans (AN) with florid cutaneous and mucosal papillomatosis. This type of AN is frequently associated with internal malignancy. In our patient serum levels of tissue polypeptide antigen, carcinoembryonic antigen, cytokeratin fragment and squamous cell carcinoma antigen were high and chest computed tomography scan indicated a large tumour infiltrating the right lung and extending to the mediastinum. Cytological examination of bronchial drainage revealed the presence of neoplastic cells, non-small cell type carcinoma. The most frequent cancer associated with malignant AN is gastric adenocarcinoma. lung tumour has rarely been reported with AN. Malignant AN is sometimes associated with other cutaneous and mucosal warty lesions, as in our patient. These various skin and mucosal lesions are the expression of a systemic epithelial disorder and may help clinicians to suspect a malignant form of AN.- - - - - - - - - - ranking = 1keywords = carcinoma (Clic here for more details about this article) |
12/193. A case of breast cancer associated with juvenile papillomatosis of the male breast.Juvenile papillomatosis of the breast (JPB) was first described in 1980 and is occasionally associated with breast cancer. The literature reports only four cases of JPB in males; none of them associated simultaneously with breast cancer. We present a case of a male with JPB associated with a ductal carcinoma in the same gland.- - - - - - - - - - ranking = 0.33333333333333keywords = carcinoma (Clic here for more details about this article) |
13/193. A solitary bronchial papilloma with malignant changes.We describe a case of solitary papilloma of the bronchus and provide a review of 38 similar cases reported in japan. A 70-year-old man complained of cough and sputum. Chest x-rays and CT scans revealed atelectasis of the right middle lobe. On bronchoscopy, a polypoid tumor was found at the orifice of the bronchus of the right middle lobe. The tumor was histologically diagnosed as a squamous papilloma with moderate atypia. Because of elevated tumor markers and the reported high incidence of malignant changes in papillomas, the tumor was endoscopically resected by electrosurgical snare. While this procedure resulted in improvement of atelectasis, the chest CT taken subsequently revealed a mass adjacent to the resected polypoid tumor in the middle lobe bronchus. Percutaneous needle biopsy followed by histopathological examination confirmed the tumor to be a squamous cell carcinoma. Only three cases of malignant changes in papillomas have been previously reported in japan. Electrosurgical snare, which allows the identification of tissue at the tumor base, should be the treatment of choice rather than YAG laser surgery.- - - - - - - - - - ranking = 0.33333333333333keywords = carcinoma (Clic here for more details about this article) |
14/193. Topoisomerase alpha II, retinoblastoma gene product, and p53: potential relationships with aggressive behavior and malignant transformation in recurrent respiratory papillomatosis.Recurrent respiratory papillomatosis (RRP) has a juvenile aggressive form and an adult more indolent form. Most cases of RRP are cytologically benign; however, some undergo malignant transformation. At present, there are no known markers that help identify patients at risk for aggressive disease. We investigated by immunohistochemistry expressions of topoisomerase alpha II, MIB-1, p53, p21, E-cadherin, retinoblastoma (RB) gene protein product, HER-2/neu, and steroid hormone receptors in a case of juvenile respiratory papillomatosis with malignant transformation to determine whether these markers are associated with malignant transformation. Histologic examination of the pulmonary lobectomy specimen revealed well-differentiated squamous carcinoma and invasive papillomatosis. Increased staining was found in areas of invasive papillomatosis for topoisomerase alpha II, p53, and MIB-1, with highest labeling indices in areas of squamous carcinoma. Staining intensity for RB gene protein product showed gradual decline from benign papilloma (3 ) and invasive papillomatosis (2 ) to squamous carcinoma (0-1 ). Expression of p21 was similar in benign papilloma and invasive papillomatosis but showed reduction in squamous carcinoma. Expressions of E-cadherin, HER-2/neu, and steroid hormone receptors did not appear to correlate with biologic behavior. Increased topoisomerase alpha II and p53 expression along with reduced RB gene protein product and p21 expression may serve as markers of transformation to invasive papillomatosis and squamous carcinoma.- - - - - - - - - - ranking = 1.6666666666667keywords = carcinoma (Clic here for more details about this article) |
15/193. Inverted papilloma of bladder.The fifth reported case of a rare variant of transitional papillary tumor of the bladder termed inverted papilloma is reported with a brief review of the literature. This tumor is likely to be confused with invasive malignant papillary carcinoma although it has adistinct histologic pattern, and it is for this reason that attention is drawn to the entity.- - - - - - - - - - ranking = 0.33333333333333keywords = carcinoma (Clic here for more details about this article) |
16/193. Cytologic diagnosis of vaginal papillary squamotransitional cell carcinoma. A case report.BACKGROUND: Papillary squamous and squamotransitional cell carcinomas of the cervix and vagina are infrequent morphologic variants of squamous cell carcinoma that may be underdiagnosed due to a bland histologic appearance. To our knowledge, this entity has not been previously detected by Pap smear evaluation. CASE: Vaginal wall pap smears were collected from a patient with a previous hysterectomy for microinvasive cervicovaginal squamous cell carcinoma and extensive carcinoma in situ. The smears were characterized by: (1) large, darkly staining, three-dimensional, branching, papillary epithelial fragments with prominent fibrovascular cores and lined with loosely cohesive epithelial cells; (2) a highly cellular background population of dissociated single epithelial cells with features of severe dysplasia, including hyperchromatic, coarse chromatin; scant, delicate, frayed cytoplasm and karyorrhectic debris; (3) syncytial aggregates of severely dysplastic epithelial cells morphologically similar to the single cells; and (4) lack of a recognizable, morphologically distinct "transitional cell" population. CONCLUSION: Papillary squamotransitional cell carcinoma of the vagina is a rare morphologic variant of squamous cell carcinoma that should be distinguished from benign vaginal squamous papillomas, condylomatous lesions and verrucous carcinoma. However, this lesion is also related to human papillomavirus infection, particularly the high-risk types. Papillary squamotransitional cell carcinoma can be suspected on Pap smear when high grade squamous intraepithelial lesion features are found in combination with three-dimensional papillary tissue fragments with prominent fibrovascular cores.- - - - - - - - - - ranking = 4keywords = carcinoma (Clic here for more details about this article) |
17/193. Malignancies arising in oncocytic schneiderian papillomas: a report of 2 cases and review of the literature.Oncocytic schneiderian papillomas (OSPs) are uncommon benign neoplasms that arise from the sinonasal schneiderian epithelium. Malignancies arising in OSPs are rare, and, to our knowledge, only 14 such instances have been reported in the medical literature. We report 2 additional cases--a small cell carcinoma and a sinonasal undifferentiated carcinoma arising in OSPs and presenting synchronously with the benign neoplasm. The potential for malignant transformation in OSPs is small, but warrants that these papillomas be completely excised to exclude a coexisting carcinoma.- - - - - - - - - - ranking = 1keywords = carcinoma (Clic here for more details about this article) |
18/193. Intestinal-type carcinoma of gallbladder. A histochemical and immunologic study.Two intestinal carcinomas of the gallbladder are presented. In both carcinomas the structure was papillary in superficial parts; the deeper ones also tended to an adenomatous structure. One of the tumors was bordered by a mucosa, with both intestinal- and antral-type metaplastic islands. The tumor was mainly a typical papilloma with malignant degeneration and infiltrative growth. The intestinal structure was morphologically clear in the papillary area of both carcinomas, but not distinct in the invasive part of the tumor. In both tumors, goblet cells and columnar cells with a distinct brush border were noted. Histochemical and immunologic methods were used in the identification of the glycoproteins of the tumor cells. With both methods the intestinal character of the tumor could be shown. A positive fluorescence was achieved with an intestinal antiserum in well-differentiated tumorous areas containing goblet cells, as well as in the intestinal metaplastic areas. In the same areas the gallbladder-specific antigen was negative. The antiserum isolated from the normal gastric mucosa and corresponding to neutral glycoprotein gave a positive fluorescence only in the nontumorous metaplastic gastric superficial-type epithelium and in the metaplastic antral-type glands.- - - - - - - - - - ranking = 2.3333333333333keywords = carcinoma (Clic here for more details about this article) |
19/193. Diagnostic pitfalls in fine needle aspiration cytology of atypical apocrine metaplasia in a breast lesion. A case report.BACKGROUND: Apocrine metaplastic cells are frequently encountered in fine needle aspirates of breast lesions. Atypical apocrine metaplastic cells with signet ring features can also occur, and their presence may present a diagnostic dilemma in the differentiation of benign versus malignant lesions. CASE: A fine needle aspirate of a 2.5 x 1.0-cm, subareolar mass in a 47-year-old female showed atypical cells with signet ring morphology. Also present were clusters of cells that were enlarged and showed nuclear atypia, prominent nucleoli and cytoplasmic granules. Papillary cohesive clusters of ductal cells were also identified. The fine needle aspiration diagnosis was mucinous carcinoma. The nodule was excised, and the histologic diagnosis was sclerosing ductal papilloma with atypical apocrine metaplasia. CONCLUSION: Atypical apocrine cells can be misinterpreted as mucinous carcinoma or usual duct adenocarcinoma on fine needle aspiration cytology. We present clues that may help in rendering the correct interpretation.- - - - - - - - - - ranking = 1keywords = carcinoma (Clic here for more details about this article) |
20/193. Epithelial-nerve intermingling in benign breast lesions.Intimate intermingling of benign ductal epithelium and nerves was observed in two specimens of breast tissue with extensive adenosis and papillomatosis. The ducts were not situated within lymphatic channels. Rencent investigations have cast doubt on the very existence of "perineural-lymphatics." And while perineural and intraneural spread of malignant cells is unquestionably frequent, growth and extension seemingly occur along loose connective tissue spaces and not within preformed channels. We suggest that the designation "epithelial-nerve intermingling" appropriately describes this phenomenon, and, whereas this is most frequently found with carcinomatous cells, benign epithellum may and, occasionally does, participate. Thus, epithelial-nerve intermingling is neither necessarily indicative of malignant neoplasia nor should it be a decisive criterion in determining the extension of known malignant neoplasm, unless the epithelial cells are clearly atypical.- - - - - - - - - - ranking = 0.33333333333333keywords = carcinoma (Clic here for more details about this article) |
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