1/155. Epithelial inclusion in axillary lymph node associated with a breast carcinoma: report of a case with a review of the literature.Since epithelial inclusions in axillary lymph nodes are rare, some diagnostic problems concerning their nature have arisen. We report a case of a cystic squamous epithelial inclusion in an axillary lymph node of a patient affected by a high grade breast carcinoma with focal squamous differentiation. Although the lesion was histologically benign, the possibility that it represents a well-differentiated squamous metastasis cannot be completely ruled out. To our knowledge, this is the first case of an epithelial lymph node inclusion associated with a breast carcinoma showing morphological evidence of squamous differentiation. Here, we discuss the diagnostic problems and give a review of the literature.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
2/155. Detection of bilateral multifocal breast cancer using Tc-99m sestamibi imaging. The role of delayed imaging.PURPOSE: Early determination that breast cancer is bilateral and multifocal can change therapy strategy and, subsequently, mortality and morbidity rates. The authors present a case with bilateral, multifocal breast cancer detected only by Tc-99m sestamibi imaging. methods: Early and delayed Tc-99m sestamibi imaging and dynamic MRI were performed in a patient with a right-sided lesion shown on mammography. RESULTS: Although early Tc-99m sestamibi imaging detected bilateral breast cancer foci, both dynamic MRI and mammography missed the lesion in the left breast. Additional lesions seen on delayed Tc-99m sestamibi images of the left breast, which were initially thought to be benign, completely disappeared after concomitant chemotherapy and radiotherapy, suggesting multifocal malignant lesions in the left breast. CONCLUSION: This case suggests that Tc-99m sestamibi may be useful for detecting bilateral cancer, and delayed imaging may give additional information regarding the possible multifocal nature of the disease.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
3/155. Benign lymphangiomatous papules of the skin following radiotherapy: a report of five new cases and review of the literature.AIMS: The aim of this report is to summarize the clinicopathological findings of five cases of a pseudosarcomatous vascular proliferation of the skin at the site of radiotherapy following surgery for carcinoma of the breast and carcinoma of the endometrium. To our knowledge, only five cases of this presumably rare pseudomalignant proliferation have been reported previously. methods AND RESULTS: All patients were females ranging in age from 44 to 70 years. The lesions appeared as solitary or multiple papules or vesicles localized to the field of radiation. Microscopically, they were composed of vascular spaces that exhibited atypical features without qualifying for a diagnosis of angiosarcoma. CONCLUSIONS: Our cases provide additional evidence supporting the benign nature of this atypical vascular proliferation, not recurring, never developing metastases and being cured readily by local excision. Clinical, histopathological and ultrastructural findings suggest a lymphatic origin. Whether these lesions represent a neoplastic or a reactive condition secondary to radiotherapy is unclear. The name 'benign lymphangiomatous papules of the skin following radiotherapy' is proposed.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
4/155. Gamma probe localization of cranial bone lesions.PURPOSE: Staging of cancer is essential to formulate appropriate treatment plans and to help predict prognosis. A solitary region of increased radionuclide uptake ("hot spot") on a bone scan may represent a metastasis or a masquerading lesion. biopsy may be required to determine its histologic nature, but localization of the site may be difficult because bone scans provide poor spatial resolution. methods: In two patients with breast carcinoma, radioactive technetium was administered intravenously and a gamma probe was used preoperatively and intraoperatively to identify the site of cranial bone involvement. RESULTS: The lesions were resected; one was a benign fibro-osseous lesion and one was a metastatic breast adenocarcinoma. CONCLUSIONS: A gamma probe may be helpful in localizing the site of radioactive uptake identified by bone scan.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
5/155. Fine-needle aspiration biopsy of postradiation epithelioid angiosarcoma of breast.Angiosarcoma of breast skin and parenchyma is a rarely reported complication of irradiation for breast carcinoma. We report a case of a subareolar epithelioid angiosarcoma arising 8 years subsequent to lumpectomy and irradiation of the ipsilateral breast for infiltrating carcinoma. The epithelioid appearance of the neoplastic cells on fine-needle aspiration biopsy (FNA) biopsy suggested a recurrence of the primary carcinoma. Careful attention to certain cytomorphologic features and cell block immunohistochemistry were useful in the distinction from recurrent carcinoma. Cytologic features that identified this neoplasm as an angiosarcoma included marked cell discohesiveness, elongate cytoplasmic processes or "pseudopodia," heterogeneous cell size, large nucleoli or macronucleoli, and cytoplasmic lumina. Immunohistochemical markers, including factor viii antigen, CD31, and CD34, were positive, confirming the vascular nature of the neoplasm. Other markers ruled out morphologically similar neoplasms such as recurrent carcinoma and melanoma. Epithelioid angiosarcoma should be included in the differential diagnosis of a suspected recurrence of breast carcinoma several years postirradiation therapy. Diagn. Cytopathol. 2000;22:172-175.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
6/155. Metaplastic carcinoma of the breast arising within complex sclerosing lesion: a report of five cases.AIMS: This study presents a series of five cases in which metaplastic carcinoma, predominantly low-grade adenosquamous carcinoma, of the breast is seen arising within a background of a complex sclerosing lesion. This association has been recognized previously but has not been documented in detail. This study describes the characteristics of the components present in each case and discusses the existing literature. This observation adds further evidence to support an association between some types of invasive breast carcinoma and sclerosing lesions of the breast. methods AND RESULTS: Four of these cases were received as referral cases for opinion. The fifth was received as part of the routine surgical workload within our own institution. Two patients presented following mammographic screening and three symptomatically; their mean age was 62 years (range 49-68). The mean lesion size was 16 mm (range 7-24). All five lesions showed features of a complex sclerosing lesion/radial scar in the form of central sclerosis with elastosis and radiating benign entrapped tubules. One had associated benign papillary structures and two had focal benign squamous metaplasia. Four cases showed coexisting but distinct areas of low-grade adenosquamous carcinoma with glandular and squamous epithelial differentiation in a spindle cell background. One case had associated undifferentiated spindle cell carcinoma. Detailed immunophenotypic characteristics of two cases are presented. CONCLUSIONS: This series illustrates a postulated but previously unconfirmed association between an unusual form of metaplastic breast carcinoma (adenosquamous carcinoma) and complex sclerosing lesions. The mechanisms of induction of breast carcinoma are poorly understood but these observations further emphasize the potential for sclerosing lesion of the breast to be associated with, and possibly give rise to, invasive carcinoma of different types. The precise nature of the interaction between the pathological processes remains unclear.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
7/155. laser scanning cytometry can complement the flow cytometric dna analysis in paraffin-embedded cancer samples: a paradigmatic case.Archival studies on paraffin-embedded tumor samples are often complicated by difficulty obtaining a reliable diploid dna standard. Nontumor cells, e.g., inflammatory and stromal cells, most often found interspersed among tumor cells, would represent a solution to this problem. Unfortunately, there is an inherent difficulty to positively identifying tumor cells in paraffin-embedded specimens. Using an aneuploid paraffin-embedded breast cancer sample, we show here that laser scanning cytometer (LSC) in conjunction with flow cytometry can help to address this issue. Following standard protocols, the tissue was deparaffinized and rehydrated, and the nuclei mechanically isolated before being exposed to propidium iodide. An aliquot served for single-parameter flow cytometric analysis, and the remaining cells were cytocentrifuged onto a microscope slide and LSC analysis was performed. The dna histogram profiles generated by the two approaches were comparable and both showed the presence of cell populations with different dna content. To assess the nature of these subsets, we performed a correlated measurement of dna content and chromatin organization at the single-cell level by LSC. This allowed the identification of several subsets of nuclei. Slides were then stained with Giemsa and the nature of these subsets was assessed morphologically by exploiting the relocating capability of LSC. Inflammatory and stromal cells, residual diploid epithelial cells, and hyperdiploid tumor cells-each characterized by a peculiar coordinate pattern of dna content and chromatin organization-could be positively identified. Diploid, nontumor cells can then be used as an internal standard for dna ploidy.- - - - - - - - - - ranking = 2keywords = nature (Clic here for more details about this article) |
8/155. Intraoperative cytodiagnosis of metastatic brain tumors confused clinically with brain abscess. A report of three cases.BACKGROUND: Cystic lesions of the brain may have diverse etiologies, ranging from true cysts to malignant tumors with cystic degeneration. Preoperative determination of the exact nature of them as well as intraoperative diagnosis may be sometimes difficult or even impossible. sensitivity and specificity of diagnosis will be improved by introducing new methods or combining traditional procedures. CASES: Three metastatic brain carcinomas with primary sites of breast, pancreas and prostate presented as cystic lesions and were confused clinically with abscess. Intraoperative frozen section was not revealing. Cytologic study of sediments of aspirated fluid uncovered malignant cells. CONCLUSION: When combined with frozen section, intraoperative cytologic studies in the form of crush preparation, fine needle aspiration or evaluation of aspirated fluid in cystic lesions (as in our cases) can improve diagnostic accuracy by detecting important diagnostic features that otherwise may be missed.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
9/155. Simultaneous occurrence of fat necrosis and carcinoma after breast injury in a traffic accident.An old female patient presented after a car accident with clinical and sonographic evidence of two lesions, located along the seat-belt line. Despite the recent history of trauma and the localization in the traumatized area, the discrepancy between the sonographic size of the smaller lesion and the findings on palpation, together with the lack of typical mammographic findings for fat necrosis rose the suspicion of malignancy. A fine needle aspiration biopsy was performed to confirm the nature of the smaller lesion.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
10/155. Recent onset of abdominal pain in a patient with advanced breast cancer.abdominal pain is a frequent complaint heard in medical practice. For palliative care patients, there are numerous causes of abdominal pain. Because of the non-invasive nature of palliative care practice, emphasis is made on minimal investigations. We present a case of a 49-year old patient who developed progressive abdominal pain and was found to have gangrenous appendicitis. The patient underwent surgery and was able to be discharged home. Our findings suggest that any new pain in a cancer patient must be carefully evaluated. Because of the presence of opioid analgesics and corticosteroids, symptoms can be less severe and related to diagnosis in palliative care patients.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
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