1/198. Inflammatory pseudotumor of the urinary bladder with aberrant expression of cytokeratin. Report of a case with cytologic, immunocytochemical and cytogenetic findings.BACKGROUND: Cytologic descriptions of inflammatory pseudotumor of the urinary bladder are exceedingly rare. We describe here an additional case of this disease, including its cytologic features and aberrant expression of cytokeratin. CASE: A 35-year-old male presented with gross hematuria but no history of bladder surgery. urine cytology revealed a few atypical spindle cells suspicious for sarcoma. Histologically, the lesion consisted of spindle cells of various sizes and shapes, proliferating in irregularly running bundles, but no severe nuclear atypia or pathologic mitosis was found. Immunocytochemically, these cells were unexpectedly positive for cytokeratin as well as for vimentin and muscle actin. All metaphase cells examined revealed a normal male karyotype. CONCLUSION: Inflammatory pseudotumor must be distinguished in particular from leiomyosarcoma and spindle cell carcinoma. To avoid an erroneous diagnosis, recognition of this entity is important, together with careful histologic examination and awareness of the possible aberrant expression of cytokeratin.- - - - - - - - - - ranking = 1keywords = spindle cell, spindle (Clic here for more details about this article) |
2/198. A case of synchronous double primary lung cancer with neuroendocrine features.We report a case of unique double primary lung cancers with neuroendocrine features in a 63-year-old male smoker. The mass in the left lower lobe (LLL) was a small cell/large cell carcinoma with spindle cell sarcomatous areas and organoid structure. The mass in the left upper lobe (LUL) was a tubular adenocarcinoma with neuroendocrine features including organoid nests showing occasional rosette formation, nuclear palisading in the periphery of the nests and positive immunoreaction for CD56, chromogranin a and synaptophysin. The difference in histological structures between the two masses led us to diagnose double primary lung cancer. The combination of small cell lung carcinoma and spindle cell carcinoma is very uncommon. The relationship between LLL and LUL tumors remains unclear. Multiple lung cancers with neuroendocrine features have only rarely been reported in the literature. The patient in our case died of widespread cancer 2 years and 4 months after the surgery without adjuvant chemotherapy, a longer postoperative survival time than in cases of ordinary extensive small cell lung cancer. Multiple lung cancers with neuroendocrine features are extremely rare and similar cases have not been reported in the literature. Neuroendocrine differentiation has attracted widespread attention and, therefore, examining neuroendocrine features in lung cancers is important.- - - - - - - - - - ranking = 0.66666666666667keywords = spindle cell, spindle (Clic here for more details about this article) |
3/198. Pseudomesotheliomatous carcinoma involving pleura and peritoneum: A clinicopathologic and immunohistochemical study of three cases.Pseudomesotheliomatous carcinoma is a rare variant of peripheral adenocarcinoma of the lung that can manifest clinical, radiologic, and pathologic features similar to malignant mesothelioma. We present three patients with pseudomesotheliomatous carcinoma of the lung. In one patient the carcinoma extended beyond the thorax and extensively involved the peritoneum, mesentery, omentum, and intestines. All patients experienced weight loss and chest pain. All were white men aged 63, 65, and 67 years. Two were smokers and had shortness of breath, cough, and pleural effusion. One had a history of asbestos exposure. No patient developed dyspnea or hemoptysis. One was successfully treated for prostatic carcinoma 18 months earlier. Radiographically, all tumors were pleura-based. Grossly, the tumors spread extensively over pleural (and in one case peritoneal) surfaces and mimicked malignant mesothelioma. Histologically, all tumors were poorly differentiated and necrotic; two tumors exhibited spindle-cell components and desmoplasia. Mucin production was detectable in none, 10%, and 50% of tumor cells. The percentages of tumor cells immunoreactive for Ber-EP4 were 70%, 100%, and 80%; for Leu MI 0%, 90%, and 50%; for epithelial membrane antigen 80%, 80%, and 100%; for B 72.3%, 0%, 90%, and 20%; for polyclonal carcinoembryonic antigen 0%, 10%, and 10%; and for monoclonal 5%, 0%, and 0%. Of these, Ber-EP4 and B 72.3 rendered the most reliable diagnostic results. The clinical, radiologic, and gross and routine histologic findings were similar to those of a malignant mesothelioma; the final diagnosis could be made based mainly on immunocytochemical results. We have reviewed the English and German literature regarding 65 such tumors and present our experience with three additional cases. We emphasize the application of immunocytochemical studies on pleura-based poorly or undifferentiated malignant tumors of unknown origin.- - - - - - - - - - ranking = 0.086502431102122keywords = spindle (Clic here for more details about this article) |
4/198. Epithelial-myoepithelial carcinoma arising in the nasal cavity: a case report and review of literature.Epithelial-myoepithelial carcinoma is an uncommon, low-grade, malignant epithelial neoplasm composed of variable proportions of ductular cells and large, clear staining, myoepithelial cells arranged around the periphery of the ducts. About 120 cases have been reported in the world literature, most of which were located in salivary glands, except for a few cases occurring in unusual locations such as breast, lacrimal gland, nose, paranasal sinus, trachea, bronchus, and lung. We here reported the second case of epithelial-myoepithelial carcinoma of the nasal cavity with extension to the nasopharynx. The patient was a 61 year old Chinese female with two month's history of progressive nasal obstruction. Histopathologically, the tumor showed typical myoepithelial and ductal cells biphasic differentiation, duct-like structure and infiltrating growth pattern. Some ductal cells showed the characteristics of oxyphilic cell, which had never been reported before. recurrence and metastasis rates of epithelial-myoepithelial carcinoma varied from 35% to 50% and 8.1% to 25% respectively in different reports. The present case had neither recurrence nor metastasis twenty months after operation. When epithelial-myoepithelial carcinoma is mainly composed of spindle myoepithelial cells, the differential diagnosis should include myoepithelioma, neurofibroma, leiomyoma and hemangiopericytoma.- - - - - - - - - - ranking = 0.086502431102122keywords = spindle (Clic here for more details about this article) |
5/198. Spindle cell carcinoma of the pancreas: a case report.We report on a resected case of spindle cell carcinoma of the pancreas in a 73 year-old Japanese male who has a history of diabetes mellitus. The patient visited his neighborhood hospital complaining of abdominal pain and was referred to our hospital for further examination of a pancreatic tumor discovered by abdominal ultrasonography. Upon the diagnosis of ductal carcinoma, a distal pancreatectomy with splenectomy was performed. Microscopically, the tumor was composed of spindle cells arranged in interlacing bundles with frequent mitotic figures. The diagnosis of spindle cell carcinoma of the pancreas was confirmed by immunohistochemical studies. To our knowledge, our case is the first resected case of spindle cell carcinoma arising from the pancreas in the English literature.- - - - - - - - - - ranking = 1.3333333333333keywords = spindle cell, spindle (Clic here for more details about this article) |
6/198. Solitary fibrous tumour of the forearm. A rare tumour in an atypical site.Solitary fibrous tumour (SFT) is a rare spindle cell neoplasm that usually arises from serosal surfaces. Although it is now increasingly recognized in extra-serosal locations, only two previous cases of SFT arising in an extremity have been reported. We describe another such case and review the literature regarding extra-serosal SFT.- - - - - - - - - - ranking = 0.33333333333333keywords = spindle cell, spindle (Clic here for more details about this article) |
7/198. pheochromocytoma associated with neuroendocrine carcinoma. A new type of composite pheochromocytoma.The coexistence of pheochromocytoma and other tumor types in a single adrenal gland has been rarely documented. This type of pheochromocytoma is designated "composite" or "mixed," depending on whether the pheochromocytoma and the nonpheochromocytoma components show the same embryologic origin. The nonpheochromocytoma components reported in the composite pheochromocytoma include ganglioneuroma, ganglioneuroblastoma, neuroblastoma, and malignant schwannoma. The components found in the mixed pheochromocytoma include adrenal cortical neoplasms and spindle cell sarcoma. We report a unique case of composite pheochromocytoma in which the nonpheochromocytoma element is a neuroendocrine carcinoma. The histologic and the immunohistochemical profiles of the 2 distinct components of this tumor were typical for those of pheochromocytoma and neuroendocrine carcinoma. This dual differentiation was also supported by ultrastructural findings. This case not only broadens the morphologic spectrum of composite pheochromocytoma but also provides some additional insight into the histogenesis of this rare but fascinating type of tumor.- - - - - - - - - - ranking = 0.33333333333333keywords = spindle cell, spindle (Clic here for more details about this article) |
8/198. Sarcomatoid carcinoma of the prostate: progression from adenocarcinoma is associated with p53 over-expression.BACKGROUND: The pathogenesis of sarcomatoid metaplasia of prostatic adenocarcinoma is uncertain. The histologic features of sarcomatoid carcinoma arising in two patients with previously irradiated prostatic adenocarcinoma are reported and the relationship between prostatic adenocarcinoma and subsequent sarcomatoid carcinoma is investigated by immunohistochemical detection of epithelial and soft tissue tumor markers, and p53 protein. methods AND RESULTS: Two patients, aged 72 and 67 years, underwent localized radiotherapy for prostatic adenocarcinoma and re-presented with sarcomatoid carcinoma 41 months and 60 months later, respectively. In both cases the tumor consisted of anaplastic spindle cells with occasional osteoclast-like giant cells. The initial tumors showed immunohistochemical staining typical of prostatic adenocarcinoma with absence of expression of p53 protein. The subsequent sarcomatoid carcinomas were positive for vimentin and negative for epithelial cell markers. In both cases serial biopsies showed a temporal increase in tumor expression of p53 protein. CONCLUSIONS: The development of sarcomatoid carcinoma in prostatic adenocarcinoma is associated with progressive accumulation of p53. This is suggestive of increasing clonal dominance of dedifferentiated tumor cells carrying p53 mutations.- - - - - - - - - - ranking = 0.33333333333333keywords = spindle cell, spindle (Clic here for more details about this article) |
9/198. Complete remission of pulmonary spindle cell carcinoma after treatment with oral germanium sesquioxide.Spindle cell carcinoma (SCC) is a rare form of lung cancer representing 0.2 to 0.3% of all primary pulmonary malignancies. Even with combined surgery, chemotherapy, and radiation therapy, these tumors are associated with a poor prognosis and only 10% of patients survive 2 years after diagnosis. We describe a patient with an unresectable SCC who, following no response to conventional treatment with combined modality therapy, chose to medicate herself with daily doses of germanium obtained in a health food store. She noted prompt symptomatic improvement and remains clinically and radiographically free of disease 42 months after starting her alternative therapy.- - - - - - - - - - ranking = 1.3333333333333keywords = spindle cell, spindle (Clic here for more details about this article) |
10/198. A pancreatic anaplastic carcinoma of spindle-cell form.A 56-yr-old man with complaint of abdominal pain and body weight loss was admitted to our hospital. Contrast-enhanced computed tomography on admission revealed a pancreatic tumor. Contrast-enhanced computed tomography 1 m.o. after admission revealed rapid growth of this tumor. We performed exploratory laparotomy with only a needle biopsy of the unresectable tumor because of extensive spread, including liver metastases. Further histological and immunohistochemical examination revealed that both the pancreatic tumor and the hepatic metastases featured malignant spindle-shaped cells. Despite radiotherapy, the patient died 40 d after laparotomy.- - - - - - - - - - ranking = 0.43251215551061keywords = spindle (Clic here for more details about this article) |
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