1/21. adenomyoepithelioma of the breast. A review of three cases with reappraisal of the fine needle aspiration biopsy findings.OBJECTIVE: To describe the fine needle aspiration cytology findings of adenomyoepithelioma of the breast, with histologic correlation. STUDY DESIGN: The author reviewed the cytologic findings of three cases of adenomyoepithelioma of the breast in the files of Pamela Youde Nethersole Eastern Hospital in a three-year period, 1998-2000. The diagnosis was confirmed by histologic examination, immunohistochemical study and electron microscopy. RESULTS: All cases showed similar cytologic findings. The direct smears and cytospin preparations contained an obvious biphasic cell population. There were clusters and sheets of benign apocrine cells admixed with clumps of bland-looking oval to spindle cells. The apocrine cells contained larger, round nuclei; prominent solitary nucleoli; and ample eosinophilic, granular cytoplasm. In contrast, the spindle cells had oval nuclei, fine chromatin, inconspicuous nucleoli and scanty amphophilic cytoplasm. A small number of named nuclei and foamy macrophages was noted in the background. The characteristic stromal elements seen in fibroepithelial tumor of the breast were not found. The myoepithelial nature of the spindle cells was confirmed by immunohistochemical and ultrastructural studies. Subsequent simple mastectomy and wide local excision were performed on cases 1 and 2, respectively, revealing focal carcinomatous transformation in the adenomyoepitheliomas. The carcinoma cells, however, were not sampled in the initial cytologic specimens. CONCLUSION: The cytologic features of adenomyoepithelioma, though variable and subtle, are characteristic enough for diagnosis. Recognition of the peculiar combination of benign apocrine cells and clumps of nondescript spindle cells should alert the cytologist to this rare but distinct entity, which carries a propensity for malignant transformation.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
2/21. Cutaneous metastasis from adenoid cystic carcinoma of the parotid gland.BACKGROUND: Cutaneous metastasis from adenoid cystic carcinoma of the salivary gland is very rare. OBJECTIVE: To present an unusual case of cutaneous metastasis from adenoid cystic carcinoma of the right parotid gland. methods: A 63-year-old woman with multiple subcutaneous nodules on the abdomen and a gradually enlarged mass over the right parotid area was examined. A skin biopsy was taken from one of the abdominal nodules. RESULT: skin biopsy demonstrated the characteristic histopathologic features of metastatic adenoid cystic carcinoma. A subsequent computerized tomography of the head and neck revealed a huge soft tissue mass involving the right parotid gland. Computerized tomography of the chest revealed extensive nodular pleural thickening, and pleural biopsy also showed typical histopathologic features of metastatic adenoid cystic carcinoma. All of these results are consistent with the diagnosis of an adenoid cystic carcinoma of the right parotid gland with disseminated metastases. CONCLUSION: We report a rare case of cutaneous metastasis from adenoid cystic carcinoma of the right parotid gland. The presentation of cutaneous metastasis is often nonspecific and may mimic benign lesions. Subcutaneous nodules that are rapidly developing or eruptive, are rapidly growing and have stony hardness in nature, have pain or tenderness, and have nonhealing ulceration remind us of the possibility of cutaneous metastases. Dermatologists and dermatologic surgeons should keep the diagnosis of cutaneous metastasis in mind and always perform skin biopsy when encountering these lesions.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
3/21. Difficulties in diagnosing lesions in the floor of the mouth--report of two rare cases.This article highlights 2 contrasting lesions of the floor of the mouth, the first being a benign lipoma growth and the latter, an adenoid cystic carcinoma. Both of these lesions appear clinically similar, presenting as a swelling with normal overlying mucosa and otherwise asymptomatic at the time of clinical examination. As the swelling for Case 1 is small and fluctuant, no special investigation was ordered, whereas a computed tomographic scan was ordered for the larger expansile lesion in Case 2. The lesions were excised under local and general anaesthesia respectively and a histology henceforth. Recovery for both cases were uneventful and no recurrence or complication was noted to date when this article was written. The two extreme natures of the lesions manifested in the region serve as a cautionary note to clinicians.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
4/21. MR features of masticatory muscles in adenoid cystic carcinoma involving the masticator space.Adenoid cystic carcinoma (ACC) is known for its slow-growing but severely infiltrative nature with little tissue reaction. Although the masticatory muscles are often involved, their imaging features have not been well elucidated. We hereby report three patients with widespread ACC, which initially appeared with trismus and/or temporomandibular symptoms and involved the masticator space. Possible features of masticator space involvement are presented on magnetic resonance (MR) images. Masticatory muscle changes on MR images consisted of two aspects, namely, denervation changes and direct tumour invasion.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
5/21. Adenoid cystic carcinoma of the breast: truly uncommon or easily overlooked?BACKGROUND: Adenoid cystic carcinoma of the breast is an uncommon histologic form of breast cancer, comprising in most series less than 1% of all mammary cancers. Due to the rarity, little information about its presentation on image studies has been noted in the literature. Here we report two additional cases with emphasis on the intriguing image presentations. CASE ONE: A 67-year-old woman came to our clinic with the chief complaint of mastodynia. No obvious palpable mass of breast was found on physical examination. mammography showed a small well-defined nodule in the medial part of the left breast without mammographic evidence of malignancy. ultrasonography showed a 1.5 cm nodule with well-defined margin and heterogenous echogenicity in the medial part of the left breast. Unusually, a painful sensation was experienced on compression by the probe. The final pathological report was adenoid cystic carcinoma. CASE TWO: A 48-year-old woman also came to our clinic with the chief complaint of mastodynia. No obvious palpable mass of breast was found on physical examination. mammography showed dense mammary tissue with no mammographic evidence of malignancy. ultrasonography showed two contiguous well-defined nodules with heterogenous echogenicity in the upper, middle part of the left breast. Unusually, a painful sensation was also noted on compression by the probe. Histopathological examination showed typical features of an adenoid cystic carcinoma. CONCLUSION: Adenoid cystic carcinoma of the breast fails to show the typical appearance of invasive ductal carcinoma on both mammogram and ultrasonography, probably due to its relatively well-defined nature with less surrounding architectural disruption and fibrosis. Hence a "negative" finding or a benign-looking breast lesion on mammography cannot completely exclude the existence of this disease. The presence of a painful breast lesion without obvious inflammatory evidence while compressed is a meaningful clue, which should lead to the suspicion of adenoid cystic carcinoma of the breast.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
6/21. Adenoid cystic carcinoma of Bartholin's gland: a clinical, immunohistochemical and ultrastructural study of a case with regard to its histogenesis.Adenoid cystic carcinoma of Bartholin's gland is a rare tumor, of which 45 cases including the present one have been reported in the literature. Although the histogenesis of this tumor is still controversial, the tumor is suspected to be of myoepithelial origin, and most studies have been performed on the salivary glands with few reports concerning Bartholin's gland. We report a case of adenoid cystic carcinoma of Bartholin's gland with regard to its histogenesis. A typical tumor nest had three main components: true luminary structures containing sialomucins, solid monotonous cells of a myoepithelial nature, and numerous pseudocysts containing abundant proteoglycans and basal membrane-like materials. From these results we speculate that reserve cells located in the intercalated small ducts of Bartholin's gland may have the potential to differentiate into two cell types, myoepithelial and luminary cells, the former forming the pseudocysts.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
7/21. Tracheobronchial resection and reconstruction. A report of five cases.During the past six years, five patients have undergone tracheal or tracheobronchial reconstruction in our Department. In three patients, a segmental tracheal resection was performed because of post-tracheostomy stricture or cylindroma of the trachea. Two patients were treated for a carcinoid type of bronchial adenoma--one by sleeve resection of an intermediate bronchus and one by pneumonectomy with partial resection and reconstruction of part of the trachea. The exact location, length and nature of the lesions were demonstrated by endoscopy, tomography and tracheobronchography. The surgical and anesthetic problems associated with tracheobronchial reconstruction are discussed.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
8/21. Adenoid cystic carcinoma of ceruminous gland: a case report.Adenoid cystic carcinoma of the external auditory canal (EAC) is a very rare malignant tumor and its diagnosis is frequently missed because of the superficial nature of biopsies. A 30 year old male presented with 6 months history of recurrent painful right ear discharge. On examination there was a nodule of 2 cms in diameter. The microscopic examination of the punch biopsy specimen of tumor revealed typical features of an adenoid cystic carcinoma. While reporting the biopsies of external auditory canal one should keep the adenoid cystic carcinoma as one of the possible differentials, especially if the biopsy is superficial, problem is recurrent and histopathological features suggest the granulation tissue.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
9/21. Pseudoadenoid cystic carcinoma of the breast.An example of a cribriform intraductal carcinoma that closely resembled adenoid cystic carcinoma is described. The true nature of the tumor was revealed by electron microscopy and the case is used to demonstrate that the diagnosis of this tumor cannot be safely made by routine histologic techniques alone. review of conflicting views othe value of mucin histochemistry expressed in the literature suggest that ultrastructural examination is a useful alternative tool in the differentiation of adenoid cystic carcinoma of the breast from cribriform intraductal carcinoma.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
10/21. Benign dermal cylindroma of the external auditory canal: a clinicopathological report.Considerable confusion exists regarding the nature of benign dermal cylindroma of the external auditory canal. In the past, authors have used the term cylindroma to refer to malignant lesions such as adenoid cystic carcinoma. Benign dermal cylindroma is a specific clinical entity consisting of benign tumors arising from the epidermal appendages; however, whether they are apocrine- or eccrine-derived is not conclusively known. Six per cent are reported to be related to the ear. Histologically they are characterized by cords of basophilic cells, hyaline material, and cystic duct-like structures. Rarely, cases of malignant degeneration are reported. However, for the most part, these lesions are benign and should be treated with complete local excision. radiotherapy may be useful in treating massive lesions not amenable to surgery.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
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