11/121. Squamous cell carcinoma detected by high-molecular-weight cytokeratin immunostaining mimicking atypical fibroxanthoma.Atypical fibroxanthoma can mimic other tumors, particularly spindle cell squamous cell carcinoma and spindle cell or desmoplastic melanoma. We describe a patient with chronic lymphocytic leukemia who developed acantholytic squamous cell carcinoma on the face, which recurred and metastasized to a cervical lymph node. This tumor was at first diagnosed as atypical fibroxanthoma because of its histologic and immunostaining similarity. It showed weak or negative keratin cocktail staining and strong vimentin staining. However, a recurrent tumor was immunostained for high-molecular-weight keratin and showed strong positivity. Aggressive behavior of this squamous cell carcinoma may be due to altered immune response secondary to chronic lymphocytic leukemia.- - - - - - - - - - ranking = 1keywords = spindle cell, spindle (Clic here for more details about this article) |
12/121. Giant dermatofibroma with monster cells.We report a case of a 64-year-old woman with a giant dermatofibroma on her back with the unusual histologic feature of monster cells. The firm, exophytic, 3-cm nodule had purple and yellow components with surface telangiectasia. Histologic examination demonstrated characteristic findings of a dermatofibroma, including rete ridge flattening and bridging; a stroma containing scattered, large, round, eosinophilic collagen bundles; and a polymorphous dermal infiltrate of spindle and xanthomatous cells with scattered siderophages. Some xanthomatous cells demonstrated features consistent with monster cells, including huge bizarre nuclei and one or more nucleoli. Immunohistochemical staining for factor xiiia was positive. A diagnosis of giant dermatofibroma with monster cells (DFMC) was made. Giant dermatofibromas are rare, with monster cells being an uncommon finding in dermatofibroma. To our knowledge, this is the first report of DFMC.- - - - - - - - - - ranking = 0.12887028432485keywords = spindle (Clic here for more details about this article) |
13/121. Polypoid sarcomas of the esophagus. A rare but potentially curable neoplasm.Five patients with polypoid esophageal sarcoma are reported. All had dysphagia similar to that occurring in epithelial carcinoma of the esophagus. The clinical diagnosis of sarcoma was suspected when barium swallow showed a large polypoid lesion. biopsy was often inconclusive concerning the nature of the lesion except to identify it as a neoplastic process. In spite of their large size, the tumors remained superficial within the esophageal wall. Nodal or distant organ metastasis was absent in 4 of the 5 patients. The histology of these tumors suggests that so-called carcinosarcoma is an epithelial carcinoma of the esophagus with varying amounts of spindle cell features and should be considered separately from sarcoma arising from mesenchymal tissue. Unlike carcinoma, esophageal sarcoma has a favorable prognosis following radical resection, and recent advances in esophageal surgery have decreased the mortality and morbidity of esophagectomy.- - - - - - - - - - ranking = 0.5keywords = spindle cell, spindle (Clic here for more details about this article) |
14/121. Spindle-cell squamous carcinoma exhibiting myofibroblastic differentiation. A study of two cases showing fibronexus junctions.The features of two spindle-cell carcinomas of the dermis are described with special reference to the presence of fibronexus junctions in tumour cells. The cases were of a 78-year-old man with a left eye-lid tumour and a 78-year-old woman with a naso-labial fold tumour, who had been given radiotherapy 13 years earlier for a clinically diagnosed basal cell carcinoma. Both specimens were slightly ulcerated and polypoid. Histologically, invasive tumour consisted of interlacing fascicles of plump spindled and oval cells, which were positive for several anti-cytokeratin antibodies, epithelial membrane antigen, vimentin and smooth-muscle and muscle-specific actins. Ultrastructurally, tumour cells in both cases contained rough endoplasmic reticulum (prominent in case 1), tonofibrils, desmosomes and smooth-muscle type myofilaments with focal densities. Fibronexus junctions were also present, which correlated with positive staining for fibronectin. This is the first documentation of the fibronexus in epithelial tissue in vivo, and the first unambiguous demonstration in a spindle-cell carcinoma. It extends the known distribution of the fibronexus and expands the ultrastructural spectrum of squamous carcinoma.- - - - - - - - - - ranking = 0.38661085297454keywords = spindle (Clic here for more details about this article) |
15/121. Transitional cell carcinoma of the uterine cervix. A report of six cases with clinical, histologic and cytologic findings.BACKGROUND: Transitional cell carcinoma of the cervix (TCCC) is a rare neoplasm of recent description. The cytologic characteristics of the tumor have not been published to date. Six cases of TCCC are described, including their clinical, histologic, cytologic and immunohistochemical features. CASES: All cases presented at an advanced clinical stage; two recurred, and one metastasized. Five cases showed a papillary exophytic pattern, and one case showed an "inverted" endophytic pattern similar to that of transitional cell carcinoma of the urothelium (TCCU). The cytokeratin profile was similar to that of squamous cell carcinoma of the cervix (SCCC), positive for CK 7 and negative for CK 20. The cervical smears showed a background that was necrotic or hemorrhagic. The cells with transitional features formed cohesive groups in a multilayered fashion and had an oval or spindle shape with tapered ends. The nuclei were hyperchromatic, with coarse and medium-sized granules that frequently displayed a wrinkled membrane, nuclear grooves and rare pseudoinclusions. The nucleoli were small or absent. Others cells with cytologic characteristics of SCCC were seen in all cases. CONCLUSION: TCCC is a rare neoplasm that probably represents a subgroup of SCCC. The most frequent histologic pattern is papillary-exophytic, but it can be inverted-endophytic. In cervical smears there are cells with characteristics of regular SCCC and others resembling those of TCCU. A larger number of cases is needed to define the evolution and clinical outcome.- - - - - - - - - - ranking = 0.12887028432485keywords = spindle (Clic here for more details about this article) |
16/121. Intramucosal naevus with pseudoepitheliomatous hyperplasia in the gingiva: a case report.This article describes the unusual case of an intraoral pigmented naevus with pseudoepitheliomatous hyperplasia of the gingiva. A 62-year-old man presented with an almost coal-black pigmented and partly white, spotted, dome-shaped swelling on the lingual gingiva of the mandible. Histologically, the lesion consisted of clusters of round-shaped naevus cells containing melanin granules, reactive with both S-100 immunohistochemical stain and Masson-Fontana silver stain, and pseudoinvasive squamous nests, reactive with cytokeratin. The pathogenesis of the present lesion and problems encountered in its differential diagnosis are discussed.- - - - - - - - - - ranking = 0.12419976075364keywords = naevus (Clic here for more details about this article) |
17/121. Primary squamous-cell carcinoma of the thyroid gland: new evidence in support of follicular epithelial cell origin.Primary squamous-cell carcinoma (SCC) of the thyroid gland is extremely rare. We had an opportunity to treat two such cases recently. Two elderly females presented with left lobe thyroid swelling that had a history of long-standing goiter. Fine-needle aspiration (FNA) of the thyroid nodule was done in both cases. FNA cytology showed an thyroid abscess in the first, and a Hurthle-cell neoplasm in the second case. Histopathologic diagnosis was a well-differentiated squamous-cell carcinoma with an adjacent area of lymphocytic thyroiditis in the first case, and a moderately differentiated squamous-cell carcinoma in association with a Hurthle-cell adenoma in the second case. Serial sections of the excised gland ruled out any other associated thyroid malignancy. Immunostaining for pan-cytokeratin, thyroglobulin, and calcitonin were performed. The tumor, comprising polygonal and spindle cells, showed positive staining for cytokeratin and thyroglobulin; however, calcitonin did not stain any structures. Exhaustive clinical, endoscopic, and radiological examinations, i.e., X-ray of the chest, contrast-enhanced computer tomography (CECT) of the neck and chest, and ENT checkup in both cases did not reveal any primary site of squamous-cell carcinoma as the likely source of the metastases, or any contiguous spread from neighboring structures. Both patients had ipsilateral nodal metastases, and both succumbed to the disease within 6 mo of histological diagnosis. The interesting observation in both cases was thyroglobulin positivity, indicating a follicular epithelial cell origin of the SCC.- - - - - - - - - - ranking = 0.5keywords = spindle cell, spindle (Clic here for more details about this article) |
18/121. Spindle-cell tumours of the larynx: diagnostic pitfalls. A case report and review of the literature.Malignant laryngeal tumours with spindle-cell morphology are relatively rare. Differential diagnosis of spindle-cell carcinoma, leiomyosarcoma, fibrosarcoma, rhabdomyosarcoma, malignant melanoma and inflammatory myofibroblastic tumour may be particularly difficult. Ambiguous and indeterminate diagnoses are also possible after immunohistochemical investigations of the expression of specific tumour markers but electron microscopic observations help to clarify most of these diagnoses.- - - - - - - - - - ranking = 0.25774056864969keywords = spindle (Clic here for more details about this article) |
19/121. Squamous cell carcinoma complicating naevus sebaceous of Jadassohn in a child.We present a case of squamous cell carcinoma arising in a naevus sebaceous of Jadassohn (NSJ) in a 15-year-old girl. Both these events are rare, and this is the first reported case of a squamous cell carcinoma developing in NSJ in a child. The previous literature on sebaceous naevi and malignancies arising thereof is reviewed and discussed. Early excision is recommended in any cases of nodular change in sebaceous naevi in all age groups.- - - - - - - - - - ranking = 0.10349980062803keywords = naevus (Clic here for more details about this article) |
20/121. Squamocellular carcinoma and chondrosarcoma: a true pulmonary carcinosarcoma. Report of a case.BACKGROUND: carcinosarcoma is one of the less common tumors of the lung and is composed of a mixture of malignant epithelial and mesenchymal elements of the type ordinarily seen in malignancies of adults. The carcinomatous component is mostly epidermoid and sometimes adenomatoid or undifferentiated. The mesenchymal part is mostly a spindle cell sarcoma and sometimes a polymorphocellular sarcoma. Differentiation as osteosarcoma and chondrosarcoma is rare. CASE REPORT: This report describes the case of a patient with carcinosarcoma of the lung composed of epidermoid carcinoma and chondrosarcoma. A left hilar mass was incidentally diagnosed. The patient was submitted to surgical exploration and a left lower lobectomy with dissection of local lymph nodes was performed. At microscopy the tumor was composed of both epithelial and stromal malignant component. The epithelial component consisted of poorly-differentiated squamous cell carcinoma and the stromal component consisted of chondrosarcoma. He remains well 30 months later. CONCLUSION: The prognosis of patients with carcinosarcoma is not always unfavourable. Potentially curative surgical resections should always be attempted. Pathologists should be aware of a wrong diagnosis of undifferentiated small cell lung carcinoma which eliminates the patient from surgery.- - - - - - - - - - ranking = 0.5keywords = spindle cell, spindle (Clic here for more details about this article) |
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