1/37. Malignant mixed mesodermal tumor presenting as metastatic lymph node adenosquamous cell carcinoma: a case report.A solitary inguinal lymph node metastasis from a poorly differentiated adenosquamous cell carcinoma of unknown origin in a 52-year-old female is described. The patient was reported to have had a 2-cm palpable mass in the left inguinal area for three years. She had made regular annual clinic visits for Pap smears since the age of 45 years. Her last visit was eight months prior to a complaint of progressive abdominal distention and dull pain of three months' duration. physical examination showed a huge pelvic mass, and ultrasound and magnetic resonance imaging of the abdomen showed a 12-cm complex solid mass on the left ovary. The patient underwent a complete excisional biopsy of the left inguinal lymph node. Frozen section pathology revealed a poorly differentiated adenosquamous cell carcinoma. Exploratory laparotomy immediately followed pathologic confirmation of malignancy of the left inguinal lymph node. Complete surgical staging including abdominal cytology, total abdominal hysterectomy, bilateral salpingo-oophorectomy, infracolic omentectomy, retroperitoneal lymph node sampling and excisional biopsy was performed for all suspicious lesions. Stage IIIC malignant mixed mesodermal tumor (MMMT) was diagnosed due to positive left inguinal lymph node metastasis. However, the retroperitoneal lymph node and intra-abdominal cavity did not show spread of the tumors, except those confined to the left ovary with adhesion to the cul-de-sac, and sole lymph node metastasis in a left inguinal lymph node. Although we could not prove that the left inguinal lymph node metastasis had been present for the three years that it was palpable without histologic confirmation, we believe that any enlarged inguinal lymph node might be the first hint of underlying malignancy in the pelvic area, lower extremities or perineal area. In cases of a poorly differentiated carcinoma of inguinal lymph nodes of unknown origin, the abdomen should be carefully evaluated.- - - - - - - - - - ranking = 1keywords = cell (Clic here for more details about this article) |
2/37. Suprasellar malignant mixed germ cell tumour presenting as craniopharyngioma.A 15 year old boy presented with diminution in vision of both eyes, diabetes insipidus and hypopituitarism. MRI was suggestive of a large suprasellar and retrosellar craniopharyngioma with stretching of the optic chiasma. Histopathological findings on the first surgical specimen were interpreted as a craniopharyngioma. He was reoperated on account of clinical deterioration and increase in tumour size. Histological examination this time revealed derivatives of all three germ cell lineages along with areas of embryonal carcinoma, and yolk sac tumour besides squamous cysts, establishing the diagnosis of malignant mixed germ cell tumour. serum and CSF were strongly positive for alpha foetoproteins.- - - - - - - - - - ranking = 1keywords = cell (Clic here for more details about this article) |
3/37. Malignant mixed Mullerian tumor of the uterine cervix with neuroendocrine differentiation.Malignant mixed Mullerian tumors (MMMTs) are rare neoplasms. We report the clinical, pathologic, and immunohistochemical features of an MMMT primary of uterine cervix. This lesion was composed of a poorly differentiated epithelial component (cytokeratin positive) and a spindle cell component (vimentin positive) with heterologous (myoblastic) differentiation (focal 1A4 positive). There were also cells with neuroendocrine features that expressed S-100 and chromogranin a. Along with a brief review of this amazing neoplasm, some histogenetic concepts relevant to this case are discussed. To our knowledge this is the first report of a malignant mixed Mullerian tumor of the uterine cervix with neuroendocrine differentiation.- - - - - - - - - - ranking = 5.4637315037046keywords = spindle cell, spindle, cell (Clic here for more details about this article) |
4/37. Mixed ductal-pancreatic polypeptide-cell carcinoma of the pancreas.AIMS: Mixed ductal-endocrine carcinomas of the pancreas are rare tumours with 10 cases reported in the English literature. We report the first case with a polypeptide-cell component. methods AND RESULTS: : The tumour was fortuitously discovered in a 72-year-old woman during the exploration of an endometrial adenocarcinoma. It measured 100 mm and was located in the tail of the pancreas. On microscopic examination two intermingled endocrine and exocrine components were present. The endocrine component consisted of trabeculae and solid nests composed of cells immunoreactive for chromogranin a, synaptophysin and pancreatic polypeptide, but negative for p53 and Bcl-2 proteins. The exocrine component was composed of tubules lined by atypical cylindrical cells immunoreactive for CK19, CEA, p53 and Bcl-2. The stroma of the endocrine component contained amyloid deposits. CONCLUSION: Mixed ductal-endocrine carcinomas of the pancreas are often described in middle-aged patients. The tumours are usually large and located in the head of the pancreas. An endocrine syndrome is rare and the prognosis is often unfavourable. We report the first case of mixed endocrine-exocrine carcinoma of the pancreas with a pancreatic polypeptide-cell component. The histogenesis of mixed carcinoma of the pancreas is still uncertain but the over-expression of p53 and Bcl-2 could play a major role in the neoplastic progression of the ductal component.- - - - - - - - - - ranking = 1.3333333333333keywords = cell (Clic here for more details about this article) |
5/37. Mixed tumor of the vagina: a case report.We report a case of mixed tumor arising in the lower vaginal wall. The patient was a 20-yr-old nullipararous woman. The tumor was relatively well-defined with expansile margin, and showed solid sheets or fascicles of stromal-type spindle cells and ovoid epithelial cells with sparsely scattered nests of mature squamous epithelium and glands lined by mucinous epithelium. Cellular atypia was not conspicuous, however, mitosis was counted upto 6 per 10 high power fields. We examined this tumor immunohistochemically and ultrastructurally and reviewed the articles to identify the histogenesis. Positive reaction for vimenin and cytokeratin of stromaltype spindle cells and presence of desmosome-like structures and tonofilaments on electron microscopic examination suggested the epithelial origin of the stromaltype spindle cells.- - - - - - - - - - ranking = 16.05786117778keywords = spindle cell, spindle, cell (Clic here for more details about this article) |
6/37. role of FNAC in metastasizing malignant mixed tumor of the external auditory canal. A case report.BACKGROUND: No previous report of metastasizing mixed tumor (pleomorphic adenoma) of the external auditory canal (EAC) has been described. CASE: A 12-year-old, Chinese girl with a history of mixed tumor of the EAC presented with a locally recurrent, aggressive tumor and metastases to the lung and bone five years later. The primary, locally recurrent and metastatic lung tumor showed epithelial and myoepithelial elements with duct formation, chondromyxoid stroma and mitotic activity in the cellular areas on histology. Fine needle aspiration cytology (FNAC) disclosed the presence of spindle cells blending into chondromyxoid fibrillar ground substance in the recurrent and metastatic lung tumors. CONCLUSION: In primary mixed tumor of the EAC, FNAC plays a useful role in the diagnosis of recurrent and metastatic disease. Its ability to identify ominous features, such as increased mitoses in this case, may be limited by sampling. Since cytology and histology cannot reliably prognosticate, long-term follow up of mixed tumor of the EAC after complete excision is advocated.- - - - - - - - - - ranking = 5.4637315037046keywords = spindle cell, spindle, cell (Clic here for more details about this article) |
7/37. Combined small cell carcinoma and clear cell carcinoma of the gallbladder: report of a case and review of the literature.We report a case of an incidental combined carcinoma of the gallbladder in a 66-year-old woman who underwent cholecistectomy for gallstones. The neoplasm was mainly constituted by a clear cell component and a small cell, chromogranin-positive one; it also showed some areas of conventional adenocarcinoma and foci of vascular invasion. The patient died after 3 years following treatment with combination chemotherapy. The histologic and immunohistochemical profile of the lesion is described, together with a brief review of the pertinent bibliography.- - - - - - - - - - ranking = 1.6666666666667keywords = cell (Clic here for more details about this article) |
8/37. Low-grade endometrial stromal sarcoma with an extensive epithelial-like element.A case of low-grade endometrial stromal sarcoma with extensive epithelial-like element (ELE) is reported. This tumor was composed of classical endometrial stromal sarcoma (CESS) showing diffuse proliferation, and ELE occupying approximately 72% of the tumor mass. On immunohistochemistry, ELE was negative for sex-cord differentiation markers, and was positive for myogenic markers used in our investigation, and had a particularly prominent positivity for alpha-smooth muscle actin within the ELE. Therefore, it was considered that ELE showed no true sex cord feature, but smooth muscle differentiation. Moreover, ELE was also positive for CD10, suggesting that it was derived from CESS. It has been reported that there is a distinct clinical behavior between endometrial stromal tumors with abundant ELE and those with limited ELE. In the present case, the Ki-67 labeling index was markedly higher in CESS than in ELE. Therefore, a difference in cell proliferative activity between ELE and CESS might underlie a different clinical prognosis.- - - - - - - - - - ranking = 0.16666666666667keywords = cell (Clic here for more details about this article) |
9/37. Cutaneous myoepithelial neoplasms: clinicopathologic and immunohistochemical study of 20 cases suggesting a continuous spectrum ranging from benign mixed tumor of the skin to cutaneous myoepithelioma and myoepithelial carcinoma.BACKGROUND: Myoepithelial neoplasms, both benign and malignant, are rare but well-established clinicopathologic entities in the salivary glands, the breast, and the lung. Despite similarities between cutaneous sweat glands and glandular structures in the above-mentioned organs as well as the presence of regular myoepithelial cells around cutaneous eccrine/apocrine glands, the concept of cutaneous myoepithelial neoplasms is still debatable and not commonly accepted. methods: Twenty cutaneous myoepithelial neoplasms have been studied histologically and immunohistochemically. RESULTS: Nine neoplasms showed features of benign mixed tumor of the skin (chondroid syringoma) (five females and four males, age range 19-65 years, all cases arose in the head and neck region). Two cases represented the eccrine and seven the apocrine subtype. Interestingly, in three cases of the apocrine subtype, solid areas composed predominantly of myoepithelial cells were detected; these neoplasms were designated as benign mixed tumors with prominent myoepithelial cells. Nine cutaneous neoplasms were composed of spindled, epithelioid, and plasmocytoid cells without ductal differentiation and immunohistochemically stained variably positive for vimentin, epithelial and myogenic markers, S-100 protein, calponin, and glial fibrillary acidic protein (four females and five males, age range 3-71 years, four cases arose in the head and neck region and one case each on the finger, the thigh, the lower leg, the foot, and the breast, respectively); these neoplasms were designated as cutaneous myoepitheliomas. Two morphologically malignant neoplasms with cytologic and immunohistochemical features of myoepithelial cells arose on the face of a 70-year-old female and a 79-year-old male patient; these neoplasms were designated as malignant cutaneous myoepitheliomas (cutaneous myoepithelial carcinomas). CONCLUSIONS: The study suggests a continuous spectrum of cutaneous myoepithelial neoplasms ranging from benign mixed tumor of the skin to cutaneous myoepithelioma and cutaneous myoepithelial carcinoma. Further studies with extended follow-up information are necessary to establish prognostic factors.- - - - - - - - - - ranking = 1.9136648714726keywords = spindle, cell (Clic here for more details about this article) |
10/37. Renal cell carcinoma metastatic to follicular adenoma of the thyroid gland. A case report.BACKGROUND: Renal cell carcinoma is an unpredictable tumor that can recur many years after the original diagnosis and metastasize to uncommon sites, including the thyroid gland. Differential diagnosis from primary thyroid tumor is often difficult both clinically and pathologically. We report a case of metastatic renal cell carcinoma in follicular adenoma of the thyroid gland. CASE: A 48-year-old woman presented with a 3-cm-diameter, palpable mass in the left lobe of the thyroid gland. The patient's history included removal of a left renal mass, which was conventional renal cell carcinoma. Fine needle aspiration cytology smears contained a few small clusters of polygonal cells with abundant, clear cytoplasm and irregular, hyperchromatic nuclei as well as bland-looking thyroid follicle cells and stromal cells. A papillary or follicular growth pattern was not detected. A cell block made from the aspirated sample was composed mainly of clear cells. By immunohistochemical stains, the clear cells were completely negative for TTF-1, thyroglobulin, calcitonin and inhibin while equivocally staining for cytokeratin, CD10 and galectin-3. The histologic diagnosis was renal cell carcinoma metastatic to follicular adenoma of the thyroid gland. CONCLUSION: Renal cell carcinoma metastatic to the thyroid may masquerade as a primary thyroid neoplasm. A history of prior nephrectomy, the presence of unremarkable thyroid follicle cells, the absence of a papillary or follicular growth pattern and immunohistochemical study can help differentiating metastatic renal cell carcinoma from a primary thyroid lesion with clear cell change.- - - - - - - - - - ranking = 3keywords = cell (Clic here for more details about this article) |
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