1/13. Case report: A case of lymphoepithelioma-like carcinoma of the oesophagus and review of the literature.A 78-year-old Japanese female was admitted to our hospital with dysphagia and weight loss. An oesophageal tumour was demonstrated radiologically and endoscopically, and was diagnosed as oesophageal cancer by biopsy. Histologically, the resected tumour showed poorly differentiated squamous cell carcinoma with prominent lymphoid stroma and was diagnosed as the so-called lymphoepithelioma-like carcinoma (LELC). Epstein-Barr virus in the tumour was negative by polymerase chain reaction and in situ hybridization. Oesophageal LELC is extremely rare. The cases in the literature, as well as the one reported here, presented with gross features of a submucosal tumour-like appearance. Although the differentiation of the tumour cells is often poor, prognosis seems to be better than for other types of oesophageal cancer. Oesophageal LELC has characteristic clinicopathological features and should be classified by criteria independent of other types of tumour.- - - - - - - - - - ranking = 1keywords = hybridization (Clic here for more details about this article) |
2/13. Clonal analysis of a case of multifocal oesophageal (Barrett's) adenocarcinoma by comparative genomic hybridization.Oesophageal adenocarcinomas arising in Barrett's epithelium occasionally present as multiple lesions. This could be due to either a multifocal presentation of the same tumour, or different neoplasms arising simultaneously in a dysplastic Barrett's oesophagus ('field cancerization'). This is a report of the genetic analysis of multiple neoplastic sites in a Barrett's oesophagus with an extensive area of dysplasia. In addition, the dysplastic Barrett's epithelium was evaluated. For the genetic screening, comparative genomic hybridization (CGH) allowed evaluation of the whole genome of each specimen. Five cancerous regions were selected and subsequently dissected from paraffin-embedded tissue blocks. The use of archival materials enabled a targeted collection of representative tumour locations. Multiple genetic aberrations were detected by CGH in all cancer sites. Losses on 3p, 4, 7q, 18q, and Y, as well as gains on 8q, 9q, 12p, 13q, 17q, 20p and X, were found in each specimen. In four out of the five lesions, simultaneous losses on 9p, 15q, and 16q, with concomitant gains on 5p, 7q, and 10p, were disclosed by CGH. Adjacent high-grade dysplastic Barrett's mucosa shared the losses on 3p, 4, 7q, 9p, 18, and Y, as well as the gains on 5p, 7q, 13q, 17q, and X, thereby confirming its precursor status. Within this single and rare case of multifocal Barrett's adenocarcinoma, a monoclonal genotype was present. This must have been caused by an extensive outgrowth of a single tumour.- - - - - - - - - - ranking = 5keywords = hybridization (Clic here for more details about this article) |
3/13. Synovial sarcoma of the upper digestive tract: a report of two cases with demonstration of the X;18 translocation by fluorescence in situ hybridization.Two cases of synovial sarcoma that arose in the upper digestive tract are reported. One case was a polypoid mass that arose at the gastroesophageal junction; the other was a large intramural mass that arose in the wall of the stomach. Both cases had a classic biphasic pattern. In the stomach tumor, the biphasic morphology was focal and there was an abrupt transition to poorly differentiated synovial sarcoma. The tumors had immunohistochemical features that were consistent with synovial sarcoma. Ultrastructural evaluation of the gastroesophageal tumor supported the diagnosis. The diagnostic X;18 translocation was demonstrated by fluorescence in situ hybridization on sections from paraffin-embedded tissue in 86% and 50% of interphase nuclei from the gastroesophageal and gastric tumor, respectively. The translocation was present in equal frequency in the epithelial and spindle cells in the biphasic areas and the poorly differentiated areas of the gastric tumor, indicating that the development of the more aggressive subclone was probably due to genetic mutations not encompassing the SYT-SSX gene fusion product. We are aware of only five reported cases of synovial sarcoma arising in the digestive tract, all in the proximal esophagus. These cases are the first reported arising in the gastroesophageal junction and stomach and the only cases of synovial sarcoma of the digestive tract in which the diagnostic translocation was demonstrated. Sarcomatoid carcinoma (carcinosarcoma) and gastrointestinal stromal tumor are the main differential diagnoses for synovial sarcoma in this site. Synovial sarcoma of the digestive tract may be underdiagnosed, and its recognition may have important clinical implications. fluorescence in situ hybridization is helpful in making this distinction.- - - - - - - - - - ranking = 6keywords = hybridization (Clic here for more details about this article) |
4/13. Primary esophageal lymphoepithelioma.Lymphoepitheliomas are extremely rare outside the nasopharynx. Extranasopharyngeal lymphoepithellomas may be located in the stomach or digestive tract, and only one single case of esophageal location has been found in our review. In many cases the tumor is related to Epstein-Barr virus infection. We report a case of undifferentiated carcinoma of the distal third of the esophagus in a 79 year-old man. Pathological examination of the esophagus revealed an undifferentiated carcinoma with lymphold stroma (lymphoepithelioma). in situ hybridization of the neoplastic cells was negative for Epstein-Barr virus. To our knowledge, the present case is the first documented esophageal lymphoepithelioma in Western countries.- - - - - - - - - - ranking = 1keywords = hybridization (Clic here for more details about this article) |
5/13. Malignant potential and cytogenetic characteristics of occult disseminated tumor cells in esophageal cancer.Although micrometastatic cancer cells in lymph nodes can be detected by monoclonal antibodies against epithelial or tumor-associated antigens, it remains unclear whether these cells are precursors of overt metastases or shedded tumor cells with a limited life span. Here we used esophageal cancer as a model to evaluate the prognostic significance and biological characteristics of such micrometastases. In lymph nodes classified as tumor free by conventional histopathological staging, tumor cells were identified with monoclonal antibody Ber-EP4 in 89 of 126 patients (71%) with completely resected (R0) esophageal carcinomas. Multivariate survival analysis underlined the strong and independent prognostic significance of Ber-EP4-positive cells in "node-negative" (pN0) patients. To assess the biology of Ber-EP4-positive cells, we established tumor cell lines from an immunohistochemically positive lymph node and the autologous primary tumor. p53 mutational analysis and multiplex-fluorescence in situ hybridization revealed common aberrations shared between both cell lines, whereas an insertion of chromosome 13 material in the short arm of chromosome 1 was only observed in micrometastatic cells. The tumorigenicity and metastatic potential of both cell lines were demonstrated in severe combined immunodeficient mice. In conclusion, our data provide first direct evidence for the malignant potential of micrometastatic cancer cells.- - - - - - - - - - ranking = 1keywords = hybridization (Clic here for more details about this article) |
6/13. Barrett's adenocarcinoma of the esophagus with lymphoid stroma.We report a case of Barrett's adenocarcinoma of the esophagus with lymphoid stroma. We believe this is the first reported case of this entity, although six previous cases of esophageal lymphoepithelioma-like carcinoma have been reported. The esophageal tumor from a 58-year-old man was examined histologically. In situ hybridization to detect Epstein-Barr virus (EBV) was also performed. The tumor consisted of a poorly differentiated adenocarcinoma with dense lymphoid cell infiltration in the invasive portions and a well-differentiated adenocarcinoma without lymphoid stroma in the mucosa. Barrett's epithelium was observed adjacent to the carcinoma. No positive signals for EBV were detected in the tumor cells. Six previously reported patients with esophageal lymphoepithelioma-like carcinomas, and the current patient, all survived for longer than 24 months, a better outcome than that of patients with esophageal squamous cell carcinomas of usual type. The data suggest that this tumor arose as a mucosal, well-differentiated adenocarcinoma without lymphoid stroma and that EBV had no relation to either its pathogenesis or progression.- - - - - - - - - - ranking = 1keywords = hybridization (Clic here for more details about this article) |
7/13. Epstein-Barr virus-associated lymphoepithelioma-like carcinoma of the esophagus.Epstein-Barr virus (EBV)-associated lymphoepithelioma-like carcinoma (LELC) rarely occurs in the esophagus. We report a case of such tumor arising in the esophagus of a 64-year-old Taiwanese woman. No tumors were detected outside the esophagus including nasopharynx by thorough clinical studies. She underwent subtotal esophagectomy. light microscopy disclosed a poorly differentiated carcinoma morphologically reminiscent of nasopharyngeal undifferentiated carcinoma (lymphoepithelioma). Immunohistochemical stain for latent membrane protein-1 showed positivity on the tumor cells. The infiltrating lymphocytes were chiefly composed of CD8-positive cytotoxic T cells. EBV dna was demonstrated by both nested polymerase chain reaction (PCR) in the main tumor and metastatic lymph node, and localization in the tumor cells by in situ PCR in situ hybridization (ISH). However, the result of EBV-encoded small rna-1 ISH was negative. Our case suggests that LELC of the esophagus may be associated with EBV in the endemic area. Due to its distinct histological features, the association with EBV, and possible prognostic implication, LELC of the esophagus should be precisely diagnosed and discerned from the usual poorly differentiated carcinoma.- - - - - - - - - - ranking = 1keywords = hybridization (Clic here for more details about this article) |
8/13. Squamous papilloma of the esophagus associated with the human papillomavirus.Squamous cell papilloma of the esophagus is a rare lesion involving less than 60 case reports worldwide. These lesions are generally asymptomatic but may at times grow and spread rapidly. One fatality, a result of massive dissemination, has been reported. Until recently, human papillomavirus had not been identified in association with esophageal papillomas. A second case, to the authors' knowledge, of esophageal papillomas associated with human papillomavirus is reported. The virus has been previously shown to be associated with abnormal squamous epithelium in and adjacent to esophageal carcinoma. The virus was identified from biopsy specimens obtained at endoscopy using dna in situ hybridization techniques. The strain of human papillomavirus identified is similar to those found in the oropharynx and genital tract, raising the possibility of sexual transmission. This case also differs from the previous case report involving the human papillomavirus because of the patient's benign clinical course. Our case serves to highlight differences that are perhaps unique to the human papillomavirus. Multiple papillomas found in a proximal location within the esophagus seem to favor involvement of the human papillomavirus. Isolated lesions located distally appear more characteristic of chronic gastroesophageal reflux as an etiology. The syndrome of squamous cell papillomas involving the esophagus is reviewed in the article.- - - - - - - - - - ranking = 1keywords = hybridization (Clic here for more details about this article) |
9/13. Carcinoma cuniculatum of the esophagus.AIMS: Extremely well-differentiated squamous cell carcinoma with the features of so-called carcinoma cuniculatum (CC) is a rare neoplasm. We describe the clinicopathologic findings of the first 2 cases of CC of the esophagus. methods AND RESULTS: Two elderly men presented with symptoms and clinical signs of esophageal malignancy. Repeated endoscopic biopsies of their esophageal tumors were inconclusive. Resection revealed CC of the esophagogastric junction in both cases. The tumors extended into the adventitia but no lymph node metastases were present. in situ hybridization for human papillomavirus HPV subtypes was negative. CONCLUSION: Carcinoma cuniculatum is reported for the first time in the esophagus. The diagnosis of this tumor variant is difficult by means of cytological examination or by endoscopic biopsies alone. Carcinoma cuniculatum in this location shows biologic features similar to verrucous carcinoma (deep penetration, no lymph nodes metastases, and location at one end of the esophagus). No evidence of human papillomavirus could be demonstrated.- - - - - - - - - - ranking = 1keywords = hybridization (Clic here for more details about this article) |
10/13. Primary squamous cell carcinoma of the stomach: a case report with immunohistochemical and molecular biologic studies.Primary squamous cell carcinoma (SCC) of the stomach is an extremely rare tumor and its pathogenesis is still unknown. We report a case of SCC of the stomach in a 69-year-old man. The patient's stomach contained an area of SCC surrounded by squamous metaplasia. To our knowledge, this is the first reported study to have investigated the pathogenesis of this tumor type by immunohistochemistry, liquid hybridization assay for human papilloma virus (HPV) infection, and polymerase chain reaction for Epstein-Barr virus (EBV) infection. These tests yielded proof of EBV infection in surgical specimens of the tumor. Therefore, we suggest that EBV infection may be involved in the pathogenesis of SCC arising in the stomach.- - - - - - - - - - ranking = 1keywords = hybridization (Clic here for more details about this article) |
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