1/73. Hepatocellular carcinoma metastatic to the oral mucosa: report of a case with multiple gingival localizations.BACKGROUND: Metastases to the oral mucosa are rare, representing less than 1% of the tumors at this site. Most of these metastatic neoplasms originate in the lungs, kidneys, and liver. methods: The clinicopathologic features of an occult hepatocellular carcinoma, metastatic to the oral mucosa, are reported. The patient, a 70-year-old male, complained of 3 distinct polypoid, reddish lesions of the antero-inferior alveolar crest and both the right and left postero-superior attached gingiva, without bone involvement. The lesions were excised, with the clinical diagnosis of multiple vascular tumors, formalin-fixed, paraffin-embedded, cut and stained with hematoxylin and eosin. Consecutive sections were immunostained for alpha-1-antichymotrypsin, CEA, cytokeratins, EMA, hepatocyte antigen, PSA, S-100 protein, and thyroglobulin, using the alkaline phosphatase/anti-alkaline phosphatase technique. RESULTS: The morphologic features of the lesions were consistent with the diagnosis of carcinoma with trabecular and glandular patterns and bile secretion; furthermore, immunohistochemical reactivity for alpha-1-antichymotrypsin, cytokeratins, CEA, EMA, and hepatocyte antigen was demonstrated and the hepatic origin of the tumor was postulated. ultrasonography demonstrated a liver mass, which was biopsied and treated by chemoembolization. While no further complications occurred in the oral mucosa, the patient died 8 months after the diagnosis for widespread diffusion of the tumor to the lungs and brain. CONCLUSIONS: This case emphasizes the need to include metastatic tumors in the differential diagnosis of atypical neoplasms of the oral mucosa and to evaluate the opportunity of surgical treatment in order to preserve the functions of the mouth, even if the prognosis of the primary tumors remains unfavorable.- - - - - - - - - - ranking = 1keywords = gland (Clic here for more details about this article) |
2/73. Histomorphometric characteristics and cellular kinetics of colorectal polyps with epithelial serrated proliferation adjacent to carcinoma.Four cases of colorectal polyps with epithelial serrated proliferation (CP-ESP) with malignant transformation were studied. In CP-ESP adjacent to carcinoma, if the nuclear size in the surface layer was significantly smaller than those in the bottom and the middle layers of the crypts, the specimen was defined as zone formation positive. If there was no significant difference among the layers, the specimen was defined as zone formation negative. Cell kinetics were evaluated using Ki-67 immunostaining. The CP-ESP regions of cases 1 and 2 showed zone formation with inferior and lateral glandular branching, and were qualitatively hyperplastic on cell kinetics. Cases 3 and 4 showed inferior and lateral glandular branching with no zone formation, and were kinetically neoplastic (adenoma). The histogenesis of hyperplastic polyps with atypia (cases 1 and 2) involves the hyperplastic polyp-carcinoma sequence. In contrast, the development of tubulovillous adenoma or serrated adenoma (cases 3 and 4) may involve the tubulovillous adenoma-carcinoma or serrated adenoma-carcinoma sequence.- - - - - - - - - - ranking = 2keywords = gland (Clic here for more details about this article) |
3/73. Clear cell adenocarcinoma with endobronchial polypoid growth.Clear cell adenocarcinoma of the lung is extremely rare. On radiography, a 45-year-old female with fever was found to have an abnormal shadow in the left lower lung field. bronchoscopy revealed a polypoid tumor in the left bronchus. On biopsy, the tumor was determined to be adenocarcinoma. Preoperative examination found no tumors outside of the lung. The patient underwent left lower lobectomy with bronchial wedge resection. The tumor had completely obstructed and dilated the left lower bronchus, but had not invaded the tissue outside the bronchial wall. Microscopically, the cytoplasm of the tumor cells contained abundant glycogen, and the tumor had solid and glandular structures. The tumor was diagnosed as clear cell adenocarcinoma of the lung.- - - - - - - - - - ranking = 1keywords = gland (Clic here for more details about this article) |
4/73. Hamartomatous polyp of the esophagus.Hamartomatous polyp of the cervical esophagus in a 60-year-old man was treated by local resection, and the patient did well. The histopathologic findings showed a predominance of cartilaginous tissue, but the specimen also contained glandular structures and adipose tissue. The diagnosis was choristoma or hamartoma. review of the literature shows this to be the third case reported.- - - - - - - - - - ranking = 1keywords = gland (Clic here for more details about this article) |
5/73. Hamartomatous endocervical polyp with heterologous mesenchymal tissue.We present an endocervical polyp with heterologous elements. Although a few neoplastic cervical lesions with cartilaginous and adipocytic heterologous tissue have been reported, an endocervical polyp with heterologous cartilage and adipose tissue has not been reported before our case. The patient was a 33-year-old woman who presented with abnormal uterine bleeding. On physical examination, there were no remarkable findings other than a cervical polyp protruding into the cervical canal. The polyp was removed. Pathological examination revealed an endocervical polyp with typical epithelial features. The stroma of the polyp contained mature cartilage islands and adipose tissue. There were also many thick-walled vascular structures. Neither stromal periglandular condensation nor atypia was found. Mitotic figures were not observed. Arteriolar structures did not contain internal elastic lamina. In our opinion, these pathological findings are all consistent with a hamartomatous lesion rather than with a true neoplasm.- - - - - - - - - - ranking = 1keywords = gland (Clic here for more details about this article) |
6/73. Distal migration of duodenal tumors: simple prolapse or intussusception?BACKGROUND: To define radiographically simple prolapse or intussusception in cases of distal migration of duodenal tumors. methods: In one pyloric and four duodenal tumors showing distal migration, the findings of gastrointestinal contrast examinations were retrospectively evaluated in relation to CT and operative findings. RESULTS: All lesions were intraluminal growing and well demarcated, and they included two carcinoids, a papillary adenoma, a Brunner's gland adenoma, and a hyperplastic polyp. All lesions were accompanied by long mucosal stalks, and, in three, folding deformity of the proximal jejunum was observed. CT showed no target signs except for one with gastroduodenal intussusception. intussusception was not verified surgically in any cases. CONCLUSION: Distal migration of duodenal tumors can occur as the result of mucosal elongation and slipping. Duodenojejunal intussusception is not necessarily associated with that phenomenon.- - - - - - - - - - ranking = 1keywords = gland (Clic here for more details about this article) |
7/73. Congenital stalked fibromatous polyp of the superior pole of the tonsil containing hairless sebaceous glands.A polyp of the size of a small bean was discovered incidentally on the superior pole of the right tonsil of a 29-year-old man. Morphologically it bore a considerable resemblance to the immature infantile variant of the sebaceous-gland nevus, the Naevus epitheliomatosus sebaceus Wolters, but its top was mature. The polyp is viewed as a congenital dysontogenic tumor which, owing to its fibromatous basis, lack of hair, and its immature and mature sebaceous glands, may be informally classified as a "missing link" between the haired pharyngeal polyp and the pure pharyngeal fibroma.- - - - - - - - - - ranking = 6keywords = gland (Clic here for more details about this article) |
8/73. Regression of fundic gland polyps following acquisition of helicobacter pylori.The prevalence of helicobacter pylori infection is very low in patients with fundic gland polyps (FGPs) of the stomach. We report here two cases with multiple FGPs that regressed following new H pylori acquisition. Patient Nos I and II had multiple FGPs in normal fundic mucosa without inflammatory changes or atrophy. Both were not infected with H pylori. Following acquisition of H pylori infection however, all FGPs in both patients completely disappeared except for one FGP in patient No I. Although the size of the remaining polyp in patient No I was greatly reduced after H pylori acquisition, it became enlarged again after eradication. Interestingly, in the remaining polyp, we found an activating beta-catenin gene mutation whereas no such mutations were detected in FGPs of patient No II. Thus H pylori infection may have an inhibitory effect on the development of FGPs.- - - - - - - - - - ranking = 5keywords = gland (Clic here for more details about this article) |
9/73. Polypoid endometrial adenomyoma in a postmenopausal woman, mimicking cervical cancer, associated with ovarian thecoma.PURPOSE: Atypical polypoid adenomyoma (APA) usually occurs in premenopausal women and arises from the endometrium. APAs protruding into the external os may lead to diagnostic problems. CASE: We present a case of APA in a 62-year-old postmenopausal woman, prolapsing through the external os, clinically mimicking cervical cancer FIGO IB2 (4.5 cmx3 cmx3 cm). Histologically the tumor was composed of endometrioid-like with slight cellular atypia and endocervical-type mucinous glands admixed with smooth muscle bundles, exhibiting low ki-67 antigen immunostaining. The the left adnexa contained an ovarian thecoma. CONCLUSIONS: To the best of our knowledge, this is the first case of APA in a postmenopausal woman, mimicking cervical cancer and associated with ovarian thecoma. Pathogenetically it is proposed, that hyperestrogenism and, in the present case accompanied by progestin production of questionable source, may play an important role in the development of APAs with the admixture of endometrial and endocervical glands.- - - - - - - - - - ranking = 2keywords = gland (Clic here for more details about this article) |
10/73. Giant botryoid fibroepithelial polyp of bladder with myofibroblastic stroma and cystitis cystica et glandularis.A 3-year-old boy presented with a single episode of gross hematuria and no history of previous urinary tract disorder. Imaging studies revealed a large complex polypoid filling defect in the bladder lumen. Several attempts at transurethral biopsy and cytological examination of the urine revealed clumps of benign epithelial cells, but suspicion of a malignant neoplasm such as rhabdomyosarcoma remained high and the lesion was resected. The specimen measured 15 cm, had a narrow zone of attachment to the bladder mucosa, and was grossly botryoid. Changes typical of cystitis cystica et glandularis were present at and near all surfaces. Myxoid stroma contained scattered benign fibroblasts, myofibroblasts, and smooth muscle cells. Inexplicably, one of two karyotyped stromal cells demonstrated a translocation usually associated with rhabdomyosarcoma. This child is well without evidence of bladder abnormality 1.5 years after surgery.- - - - - - - - - - ranking = 5keywords = gland (Clic here for more details about this article) |
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