1/14. Hepatocellular carcinoma metastatic to the oral mucosa: report of a case with multiple gingival localizations.BACKGROUND: Metastases to the oral mucosa are rare, representing less than 1% of the tumors at this site. Most of these metastatic neoplasms originate in the lungs, kidneys, and liver. methods: The clinicopathologic features of an occult hepatocellular carcinoma, metastatic to the oral mucosa, are reported. The patient, a 70-year-old male, complained of 3 distinct polypoid, reddish lesions of the antero-inferior alveolar crest and both the right and left postero-superior attached gingiva, without bone involvement. The lesions were excised, with the clinical diagnosis of multiple vascular tumors, formalin-fixed, paraffin-embedded, cut and stained with hematoxylin and eosin. Consecutive sections were immunostained for alpha-1-antichymotrypsin, CEA, cytokeratins, EMA, hepatocyte antigen, PSA, S-100 protein, and thyroglobulin, using the alkaline phosphatase/anti-alkaline phosphatase technique. RESULTS: The morphologic features of the lesions were consistent with the diagnosis of carcinoma with trabecular and glandular patterns and bile secretion; furthermore, immunohistochemical reactivity for alpha-1-antichymotrypsin, cytokeratins, CEA, EMA, and hepatocyte antigen was demonstrated and the hepatic origin of the tumor was postulated. ultrasonography demonstrated a liver mass, which was biopsied and treated by chemoembolization. While no further complications occurred in the oral mucosa, the patient died 8 months after the diagnosis for widespread diffusion of the tumor to the lungs and brain. CONCLUSIONS: This case emphasizes the need to include metastatic tumors in the differential diagnosis of atypical neoplasms of the oral mucosa and to evaluate the opportunity of surgical treatment in order to preserve the functions of the mouth, even if the prognosis of the primary tumors remains unfavorable.- - - - - - - - - - ranking = 1keywords = antigen (Clic here for more details about this article) |
2/14. Polypoid endometrial adenomyoma in a postmenopausal woman, mimicking cervical cancer, associated with ovarian thecoma.PURPOSE: Atypical polypoid adenomyoma (APA) usually occurs in premenopausal women and arises from the endometrium. APAs protruding into the external os may lead to diagnostic problems. CASE: We present a case of APA in a 62-year-old postmenopausal woman, prolapsing through the external os, clinically mimicking cervical cancer FIGO IB2 (4.5 cmx3 cmx3 cm). Histologically the tumor was composed of endometrioid-like with slight cellular atypia and endocervical-type mucinous glands admixed with smooth muscle bundles, exhibiting low ki-67 antigen immunostaining. The the left adnexa contained an ovarian thecoma. CONCLUSIONS: To the best of our knowledge, this is the first case of APA in a postmenopausal woman, mimicking cervical cancer and associated with ovarian thecoma. Pathogenetically it is proposed, that hyperestrogenism and, in the present case accompanied by progestin production of questionable source, may play an important role in the development of APAs with the admixture of endometrial and endocervical glands.- - - - - - - - - - ranking = 0.5keywords = antigen (Clic here for more details about this article) |
3/14. Papillary adenoma of the prostatic urethra: report of two cases.Papillary adenoma of the prostatic urethra is a rare cause of hematuria, hemospermia and lower urinary tract obstruction, especially in young adults. We report two cases of papillary adenoma and their endoscopic views. One of the patients had a lesion located on the verumontanum and presented with hematuria, hemospermia and symptoms of lower urinary tract obstruction. The other patient had papillary lesions located in the paramontanal gutter and presented with persistent painless hematuria. The origin of both lesions was proven to be prostatic epithelial differentiation using immunohistochemical identification of prostate-specific antigen. Papillary adenoma is believed to be benign, therefore, both lesions were carefully excised and fulgurated transurethrally.- - - - - - - - - - ranking = 0.5keywords = antigen (Clic here for more details about this article) |
4/14. Autologous soluble tumor-associated antigens prevent the toxic side effects of cancer chemotherapy and inhibit the progress of tumorigenesis: case report.In this communication, we report for the first time, that immunization of cancer patients with autologous soluble tumor-associated antigens (sTAA) isolated from their own serum prevents the toxic side effects of chemotherapy, improves the patients' clinical status, and has therapeutic effects without chemotherapy. In 2001 and 2002, two cancer patients were treated, during chemotherapy, with autologous sTAA. Another benign tumor-bearing patient was treated with a medicinal herb and autologous sTAA. Doses for subcutaneous injections varied between 2.5 and 3 mg of sTAA in 0.5 ml of sterile distilled water. injections were performed twice a week or at weekly intervals. In each case, the clinical status of the patient became more stable and healthier. Toxic side effects caused by chemotherapy decreased or even disappeared. No additional toxic side effects were observed after vaccination with sTAA. In the studied cases, a polyp disappeared and a metastatic brain tumor began to encapsulate. No metastases were seen in the case with colon adenocarcinoma. We concluded that vaccination of patients with autologous sTAA prevents the toxic side effects of chemotherapy in cancer patients and improves their clinical status. In the case with the benign tumor, this vaccination activated the host's immune system, prevented progress of the disease and even promoted tumor disappearance. We suggest that immunotherapy with autologous sTAA provides significant clinical benefits in cancer patients and appears to be an important new adjuvant treatment of cancer.- - - - - - - - - - ranking = 2.5keywords = antigen (Clic here for more details about this article) |
5/14. Pulmonary synovial sarcoma with polypoid endobronchial growth: a case report, immunohistochemical and cytogenetic study.A rare case of primary pulmonary synovial sarcoma with polypoid endobronchial growth in a 42-year-old Japanese woman is described. Left upper sleeve lobectomy was performed for the polypoid tumor measuring 2.5 cm in the left major bronchus and the patient was treated with adjuvant chemotherapy. Three years later, a recurrent tumor was discovered. Microscopically, this tumor was characterized by a proliferation of oval to spindle-shaped cells arranged in sheets and fascicles and covered by the thin normal bronchial epithelium. Immunohistochemically, tumor cells were positive for vimentin, and focally positive for pancytokeratin recognized by AE1/AE3, cytokeratin 7 and epithelial membrane antigen. A chimera gene, SYT-SSX1, was detected. Recently, primary pulmonary synovial sarcoma is an increasingly recognized clinical entity; however, most of these tumors present as a parenchymal mass. The present case is a unique example of primary synovial sarcoma of endobronchial polypoid type. This case suggests that pulmonary synovial sarcoma might originate from bronchial submucosal stromal tissue.- - - - - - - - - - ranking = 0.5keywords = antigen (Clic here for more details about this article) |
6/14. Primary diffuse large B-cell lymphoma of the uterus presenting solely as an endometrial polyp.We report a primary diffuse large B-cell lymphoma of endometrial polyp in a 44-year-old woman who presented with irregular vaginal spotting and was found to have a polyp protruding from the cervical os. histology of the polyp showed an atypical diffuse infiltration by large, mononuclear cells within the stroma and between endometrial glands in one of the polypoid fragments. immunohistochemistry and testing for immunoglobulin heavy chain gene rearrangement showed a B-cell lineage, consistent with diffuse large B-cell lymphoma. Staging procedures including detailed gynecology examination, body computed tomography scan, and bone marrow examination, as well as total hysterectomy, showed no evidence of lymphoma outside of the polyp. To our knowledge, this represents the first well-documented instance of primary lymphoma of the uterus presenting as an endometrial polyp. The differential diagnosis of endometrial biopsies containing an atypical lymphoid infiltrate should include the rather rare possibility of primary uterine lymphoma arising in an endometrial polyp. immunohistochemistry and/or molecular analysis for antigen receptor gene rearrangements are critical in arriving at the correct diagnosis.- - - - - - - - - - ranking = 0.5keywords = antigen (Clic here for more details about this article) |
7/14. Latent perianal Paget's disease associated with mucin-producing rectal adenocarcinoma. Report of two cases.Two cases of latent perianal Paget's disease associated with mucin-producing papillary adenocarcinoma of the rectum are described. In both cases, the rectal tumors appeared as polypoid lesions located just above the dentate line. The adjacent anal squamous mucosa showed lateral invasion of alcianophilic mucin-containing Paget cells. Mucin histochemistry revealed the presence of O-acylated and non-O-acylated sialic acids in both neoplastic goblet cells in the adenocarcinomas and Paget cells in the anal mucosa. The Paget cells were immunoreactive diffusely for low-molecular-weight cytokeratin (CAM 5.2) and carcinoembryonic antigen, and focally for CA19-9, epithelial membrane antigen and CA15-3. All these substances were also expressed in the rectal adenocarcinomas but were negative or showed limited expression in the anal squamous epithelium. These findings indicated secondary epidermotropic infiltration of neoplastic goblet cells from the rectal adenocarcinomas.- - - - - - - - - - ranking = 1keywords = antigen (Clic here for more details about this article) |
8/14. Benign polyp with prostatic-type epithelium of the urinary bladder: a case report.We report a case of benign polyp with prostatic-type epithelium of the urinary bladder. A 58-year-old male presented with gross hematuria. Cystoscopic examination revealed a 2-mm polypoid lesion in the mid trigone. Immunohistochemical demonstration of prostatic acid phosphatase and prostatic specific antigen in the urothelial cells as well as the prostatic-type epithelial cells suggested the histogenesis of this polyp to be metaplasia of the urothelium.- - - - - - - - - - ranking = 0.5keywords = antigen (Clic here for more details about this article) |
9/14. Endometrial polyps in postmenopausal patients receiving tamoxifen.The histologic features of an endometrial polyp include irregular, often dilated glands, thick-walled blood vessels, and a fibrotic stroma. Such polyps may be responsive to some chemotherapeutic drugs that can exert hormonal effects. We report on endometrial polyps detected in three postmenopausal patients who were receiving tamoxifen for treatment of metastatic breast carcinoma. The clinical presentation in all cases was vaginal bleeding and all had documented uterine enlargement suggestive of an intrauterine malignancy. The polyps were large, measuring up to 9 cm in largest diameter. On histologic examination each polyp had extensive cystic glandular hyperplasia. In one case foci of atypical epithelial proliferation and predecidualization were noted. The atypical proliferation suggested a borderline neoplastic process and was strongly positive for carcinoembryonic antigen. These findings underscore the marked proliferative changes that can be induced in endometrial polyps in postmenopausal women receiving hormonally active chemotherapeutic agents.- - - - - - - - - - ranking = 0.5keywords = antigen (Clic here for more details about this article) |
10/14. UCHL1-positive extranodal lymphoma resembling multiple lymphomatous polyposis of the gastrointestinal tract.Histopathologic and immunohistochemical studies were done on paraffin sections from a patient with alimentary tract lymphoma resembling multiple lymphomatous polyposis of the gastrointestinal tract (MLP). Diffuse, but not follicular, proliferation of medium-sized lymphoid cells was noted in the polypoid lesions of the alimentary tract, peripancreatic lymph nodes, spleen, liver, and bone marrow. These cells possessed a T-cell-related antigen (UCHL1), but were negative for the B-cell-related and myeloid cell-related antigens examined. Because neoplastic cells in MLP are usually of B-cell origin, the current case will provide important information on the relation between phenotypes and morphologic patterns of proliferation.- - - - - - - - - - ranking = 1keywords = antigen (Clic here for more details about this article) |
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