1/16. Aggressive giant fibroepithelial lesion with unusual vascular stroma--a case report.The stroma of fibroadenoma and phyllodes tumor usually consists of fibroblastic proliferation. Rarely the stroma contains bundles of smooth muscle. Pseudoangiomatous hyperplasia of the mammary stroma has been described in fibroadenomas. However, true benign vascular stroma has not been reported. We report a case of a 34-year-old Chinese woman who presented with a large mass occupying the entire left breast. Left mastectomy was performed and showed a large, well-circumscribed, lobulated, rubbery-firm tumor measuring 13 x 10 x 6 cm. Microscopic examination revealed a fibroepithelial tumor formed by an organoid pattern of ductal structures with a very striking stromal appearance composed of extensive vascular proliferation and that demonstrated strong immunoreactivity for CD31, CD34, and factor viii. Ultrastructural examination revealed intercellular junctions, basal lamina, pinocytotic vesicles, and weibel-palade bodies in the cells lining the vascular spaces, confirming their endothelial nature. These findings rule out the diagnosis of pseudoangiomatous hyperplasia. The patient developed local recurrence a year later, and the resection showed malignant phyllodes tumor with ductal carcinoma in situ.The extensive vascular stroma noted in the primary tumor may have played a role in the malignant transformation of the epithelial and stromal components in this tumor.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
2/16. Intraductal carcinoma of the pancreas.Four multicentric intraductal papillary carcinomas arising in the main pancreatic duct are presented. Three of the neoplasms showed stromal invasion and metastasized to regional lymph nodes. Three patients had a long history of epigastric pain, confirming the progressive slow growth and less aggressive nature of this clinicopathologic entity. Histologically, all tumors were papillary, and three also showed a pseudocribriform pattern. Individual cells exhibited a range of atypia from mild to overt malignant change. Focal intestinal differentiation was recognized in two tumors. Despite the well-differentiated appearance of these tumors, two patients died within 1 year of surgery. One patient with an entirely intraductal carcinoma is alive and well 3 years after surgical treatment. The fourth patient who had lymph node metastasis is alive 6 months after a Whipple's procedure.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
3/16. Neural invasion in intraductal carcinoma of the breast.Although perineural invasion in a malignancy favors the diagnosis of invasive over in situ carcinoma, we report a case of cribriform intraduct carcinoma of the breast showing perineural invasion. The in situ nature of the lesion is supported by the finding of an intact actin-positive myoepithelial cell layer around the cribriform growths and the preservation of lobular architecture.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
4/16. Intraductal growth of malignant mammary myoepithelioma.This report describes the histologic and immunohistologic features of an intraductal myoepithelial tumor that developed in the breast of a 61-year-old woman. Histologically, the tumor proliferated intraductally, with both a comedo or doughnut pattern and a solid pattern containing narrow fibrovascular cores, mimicking what appeared to be a conventional intraductal carcinoma. No fine papillary or arborizing growth or cribriform formation was observed. Tumor cells at the ductal peripheral zone were polygonal and clear with abundant glycogen in the cytoplasm; they were transformed into nonclear cells with slightly eosinophilic cytoplasm toward the center of the involved ducts. Occasionally, nonclear cells were elongated, with a centrally located cigar-shaped nucleus. These elongated or spindle cells tended to show a fascicular and streaming pattern similar to that of a smooth muscle tumor. Immunohistochemically, alpha smooth muscle actin (alpha-SM-actin) and S-100 protein were expressed in most of the nonclear cells. While clear cells also had a positive reaction for S-100 protein, they were mostly negative or barely positive for alpha-SM-actin. Epithelial membrane antigen (EMA) was also positive in a certain number of polygonal cells. These results support the myoepithelial nature of the present tumor, and some cells might also be immunologically differentiated into ductal epithelial cells. In addition to cytological atypia, frequent mitoses, and central necrosis within ducts, there was a minimal but evident stromal invasion, suggesting histological malignancy in this peculiar tumor.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
5/16. Development of early malignant bilateral breast disease in relation to antidepressant treatment.The aim of this study is to present two rare cases of young female patients who were under antidepressant medication and developed bilateral breast disease; histology confirmed the noninvasive, malignant nature. The role of that type of agents in the breast pathology is briefly discussed, based on the data of the current literature.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
6/16. cauda equina compression associated with breast cancer. A case study in differential diagnosis.The determination of the etiology of spinal cord compression in cancer patients is essential for appropriate therapy. patients with metastatic disease are not immune to the development of superimposed nonmalignant disease. Although metastatic epidural compression may occur in up to 9% of breast cancer patients, care must be taken to rule out other nonmetastatic lesions causing compression. The association of concurrent breast carcinoma and a spinal neurilemoma simulating a metastatic lesion seems not to have been previously reported. A neurilemoma was observed in a 50-year-old woman. A neurilemoma suspected to be a metastatic lesion may produce the clinical features of pain, neurologic deficit, and weakness. Differentiation will be aided by roentgenograms, radionuclide bone scans, computed tomography, and possible magnetic resonance imaging. Radiologic differentiation hinges on the recognition and the slow-growing nature and noninvasive boundaries of the nonmalignant lesion. Ultimate verification is by biopsy. Treatment should consist of neurectomy, if severely symptomatic, and stabilization as indicated.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
7/16. 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) |
8/16. Erythrophagocytosis by epithelial cells of a breast carcinoma.Erytrophagocytosis by epithelial tumor cells has been observed in metastases of ductal carcinoma of the female breast. Some malignant cells of this tumor seem to be capable of phagocytizing and digesting extravasated red blood cells with for formation of residual hemosiderin probably from their hemoglobin content. Erythrophagocytosis has been observed only in hemorrhagic areas of the tumor. Erythrophagocytosis has been observed only in hemorrhagic areas of the tumor. Although the nature of this phenomenon is unknown, it is postulated that acquired hematological disturbancess during the natural course of the malignant disease affect the surface of the red blood cells making them vulnerable to phagocytosis by the malignant cells. This case seems to represent the second time such a phenomenon has been reported in an epithelial neoplasm in man. However, it has been more frequently observed in reticulo-endothelial malignancies. The possible occurence of this phenomenon should alert pathologists to search for it in primary and metastatic epithelial tumors and in living patients to correlate pertinent hematological studies in an attempt to elucidate its possible significance.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
9/16. Minimal breast cancer: a clinical appraisal.Eighty-five patients with a diagnosis of minimal breast cancer were evaluated. The predominant lesion was intraductal carcinoma, and axillary metastases occurred in association with minimal breast cancer in seven of 96 cases. One death occurred due to minimal breast cancer. Bilateral mammary carcinoma was evident in 24% and bilateral minimal breast cancer in 13% of the patients. The component lesions of minimal breast cancer have varied biologic activity, but prognosis is good with a variety of operations. The multifocal nature of minimal breast cancer and the potential for metastases should be recognized. Therapy should include removal of the entire mammary parenchyma and low axillary nodes. The high incidence of bilateral malignancy supports elective contralateral biopsy at the time of therapy for minimal breast cancer.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
10/16. Percutaneous transthoracic needle aspiration biopsy: a case report of implantation metastasis.Dissemination of tumor cells along the needle tract after needle aspiration biopsy has been reported in the literature, but it is an extremely uncommon event, especially when 'fine needles' (above 21 Gauge) are used. In the work presented, a patient with a mammary nodule of doubtful nature is reported. After histological evaluation the node proved to be an intra-mammary dissemination of poorly differentiated adenocarcinoma of the lung via the needle track after aspiration biopsy. The needle used was a 20 Gauge, which is not included in the fine needle category recommended by most authors. The possibility of tumor cells dissemination after needle biopsies is discussed.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
| | Next -> |