1/19. Chronic sclerosing sialadenitis of the submandibular gland associated with idiopathic retroperitoneal fibrosis.We report a case of a 57-year-old man who developed a fibrosclerosing lesion in the submandibular gland and idiopathic retroperitoneal fibrosis (IRF) involving the unilateral periureteral region within a year. Both lesions were resected surgically because of the suspicion of neoplasm. Pathologic examination revealed similar histologic and immunohistochemical features for both lesions, namely, fibrosclerosis with prominent hyalinizing collagen bundles and proliferation of myofibroblastic cells, and a non-neoplastic reactive nature. There was infiltration by lymphocytes with prominent lymph follicles, plasma cells and macrophages. The histologic and immunohistochemical findings suggest that the two lesions were of a similar pathogenesis, which was possibly mediated by macrophages. We think that the present case may be an unusual form of multifocal fibrosclerosis. Although sialolithiasis is thought to be a major pathogenic factor for chronic sclerosing sialadenitis of the submandibular gland, the present case suggests that certain cases might have an etiology similar to IRF.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
2/19. Metaplastic carcinoma of the breast arising within complex sclerosing lesion: a report of five cases.AIMS: This study presents a series of five cases in which metaplastic carcinoma, predominantly low-grade adenosquamous carcinoma, of the breast is seen arising within a background of a complex sclerosing lesion. This association has been recognized previously but has not been documented in detail. This study describes the characteristics of the components present in each case and discusses the existing literature. This observation adds further evidence to support an association between some types of invasive breast carcinoma and sclerosing lesions of the breast. methods AND RESULTS: Four of these cases were received as referral cases for opinion. The fifth was received as part of the routine surgical workload within our own institution. Two patients presented following mammographic screening and three symptomatically; their mean age was 62 years (range 49-68). The mean lesion size was 16 mm (range 7-24). All five lesions showed features of a complex sclerosing lesion/radial scar in the form of central sclerosis with elastosis and radiating benign entrapped tubules. One had associated benign papillary structures and two had focal benign squamous metaplasia. Four cases showed coexisting but distinct areas of low-grade adenosquamous carcinoma with glandular and squamous epithelial differentiation in a spindle cell background. One case had associated undifferentiated spindle cell carcinoma. Detailed immunophenotypic characteristics of two cases are presented. CONCLUSIONS: This series illustrates a postulated but previously unconfirmed association between an unusual form of metaplastic breast carcinoma (adenosquamous carcinoma) and complex sclerosing lesions. The mechanisms of induction of breast carcinoma are poorly understood but these observations further emphasize the potential for sclerosing lesion of the breast to be associated with, and possibly give rise to, invasive carcinoma of different types. The precise nature of the interaction between the pathological processes remains unclear.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
3/19. Histopathologic diagnosis of superficial soft tissue tumors, related lesions, and simulators: an algorithmic approach based on colors: tumors with predominance of pink.An algorithmic approach based on colors for histopathologic diagnosis of soft tissue tumors and their simulators is proposed. At scanning magnification, in specimens stained with hematoxylin and eosin, mesenchymal tumors can be classified according to their color. The color of a tumor is basically determined by density, morphology, and distribution of neoplastic cells, and by density and quantity of the stroma. The basic colors that can be observed by neoplasms stained with hematoxylin and eosin are white, pink, red, and blue. Colors may be used as a first step in choosing the algorithm for specific diagnosis of a given mesenchymal neoplasm. Furthermore, colors may be helpful in understanding the histogenesis of a tumor, and this is especially important in soft tissue pathology, because criteria for benignancy and malignancy vary according to the nature of the neoplasm. In this article, tumors with a predominance of pink are analyzed. Pink tumors are composed of cells with abundant eosinophilic cytoplasm and sparse chromatin in their nuclei, such as leiomyoma. In other cases, the pink color in a tumor is determined by abundant fibrous stroma rather than by characteristics of neoplastic cells, such as sclerotic fibroma.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
4/19. Lymphoepithelioma-like carcinoma of the breast with associated sclerosing lymphocytic lobulitis.The purpose of this article is to highlight an unusual form of breast carcinoma and discuss its differential diagnosis. A 50-year-old woman underwent wide local excision of a breast lump. Microscopic examination revealed features of a lymphoepithelioma-like carcinoma. Individual tumor cells were present within an abundant lymphoid stroma. immunohistochemistry revealed the epithelial nature of the cells and excluded a diagnosis of lymphoma. In addition, surrounding nontumorous breast tissue displayed the histologic features of sclerosing lymphocytic lobulitis or lymphocytic mastopathy. This is the second report of a lymphoepithelioma-like carcinoma of the breast, but to the best of our knowledge, it is the first description of coexistent sclerosing lymphocytic lobulitis.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
5/19. Cutaneous sclerosing Pacinian-like perineurioma.AIMS: The term perineurioma has been used to designate a variety of clinically and histologically different proliferations of perineurial cells based on immunohistochemical and/or ultrastructural characterization. There are two different groups of neoplasms derived from perineurial cells: extraneural or soft tissue perineuriomas, and intraneural perineuriomas. Recently, a sclerosing variant of cutaneous perineurioma has been described. methods AND RESULTS: We report a case of a cutaneous form of perineurioma, combining features of the intraneural and sclerosing varieties, as well as showing a Pacinian pattern of growth. In order to assess the neoplastic nature of the lesion, we performed fluorescence in-situ hybridization (FISH) analysis using a probe which maps to the chromosome band 22q11 and 22q13, allowing us to show deletion or loss of one chromosome 22 in the tumour cells. CONCLUSIONS: This case may be considered a new variant of perineurioma with Pacinian-like features, for which we propose the designation 'sclerosing Pacinian-like perineurioma'.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
6/19. Sclerosing extramedullary hematopoietic tumor.A 73-year-old woman presented with abdominal pain, weakness, and weight loss. Pertinent medical history included myelofibrosis, severe anemia, and lumpectomy for breast cancer. Computed tomography showed marked splenomegaly and numerous soft tissue masses in the mesentery. Excisional biopsy of the mass showed an encapsulated tumor with yellow-tan nodular growth pattern. Microscopically, the tumor was characterized by the presence of bizarre giant cells in background of prominent dense fibrous stroma. The atypical giant cells were positive for FVIII antibody staining. Many other cells were positive for CD43 antibody staining, indicating that the tumor was hematopoietic in nature, so-called sclerosing extramedullary hematopoietic tumor. Extramedullary hematopoiesis is a common phenomenon associated with severe anemia of any cause. When associated with myelofibrosis, however, it has different morphology from extramedullary hematopoiesis of the other causes. The significance of recognizing sclerosing extramedullary hematopoietic tumor is that it is often mistaken for sarcomas and other malignant neoplasms, especially when the clinical history is unknown.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
7/19. Sclerosing encapsulating peritonitis: differential diagnosis to peritoneal encapsulation and abdominal cocoon--a case report.A 59 year old man presented with symptoms of partial bowel obstruction. Small bowel x-ray studies did not allow to identify the nature of the intestinal process in the upper ileum. At laparotomy small bowel encapsulation with a whitish membrane was encountered. Despite partial removal of this membrane small bowel obstruction persisted and two weeks postoperatively the patient died of peritonitis and cardiac insufficiency. autopsy findings revealed massive fibrous adhesions in the abdomen with granulomatous inflammation. The presence of foreign body giant cells and bifringent crystals were characteristic for talcum powder. The latter suggested a causal role of an appendectomy 45 years earlier. The diagnosis of sclerosing encapsulating peritonitis as established in our patient needs to be separated from peritoneal encapsulation, a congenital malformation, and abdominal cocoon, which contains histological elements of inflammation. This case report should draw attention to these entities in the differential diagnosis and surgical management of small bowel obstruction.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
8/19. Phlebosclerotic colitis coincident with carcinoma in adenoma.Phlebosclerosis of the colon is a rare disease characterized by a thickening of the wall of the colon with fibrosis, hyalinization and calcification to the affected veins. These symptoms result in a type of ischemic colitis known as phlebosclerotic colitis. A case of phlebosclerotic colitis coincident with carcinoma in adenoma is reported. A 74-year-old Japanese woman was admitted to hospital because of a mass in her right lower abdomen. Abdominal computed tomography examination revealed linear calcifications in the wall of the cecum and the ascending colon. colonoscopy revealed dark purple mucosa with multiple ulcers in the cecum and the ascending colon. biopsy specimens showed a marked hyalinous thickening of the wall of small blood vessels in the mucosa. Phlebosclerotic colitis was suspected because of negative results with amyloid stain. Alternative ileocolic angiography showed the serpentine of the peripheral nature blood vessels and pooling at the late venous phase. Microscopic examination of the surgically resected colon revealed mucosal and submucosal fibrosis, and a thickening of the venous wall with fibrosis, hyalinization and calcification from the mucosa to the serosa, which caused a marked luminal narrowing. A small polypoid lesion was also found in the affected region and was diagnosed histologically as carcinoma in adenoma. To our knowledge, this is the first reported case of phlebosclerotic colitis complicated by carcinoma.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
9/19. Diabetic (lymphocytic) mastopathy with exuberant lymphohistiocytic and granulomatous response: a case report with review of the literature.We report a case of a 66-year-old woman who presented with multiple painless masses in both breasts. Prior bilateral biopsies were diagnosed as Rosai-Dorfman disease (Sinus histiocytosis with Massive Lymphadenopathy). A recent lumpectomy specimen revealed a gray-white smooth cut surface with a discrete masslike lesion. The histopathology demonstrated a fibrotic breast parenchyma with foci of dense fibrosis and scattered inconspicuous breast epithelium surrounded by lymphocytes that formed aggregates and follicles with germinal centers. The inflammation was in a periductal, perilobular, and perivascular distribution. In addition, an exuberant inflammatory response with histiocytes and fibroblasts was present. This inflammatory response focally surrounded areas of fat necrosis and formed noncaseating granulomas with rare multinucleated giant cells. This process had infiltrative, ill-defined edges and involved the subcutaneous tissues. The overlying epidermis was normal. The final diagnosis was diabetic mastopathy with an exuberant lymphohistiocytic response. The differential diagnosis included Rosai-Dorfman disease, inflammatory myofibroblastic tumor, granulomatous mastitis, sclerosing lipogranulomatous response/sclerosing lipogranuloma, lupus panniculitis, and rheumatoid nodules. Immunohistochemical studies and flow cytometry confirmed the polyclonal nature of the lymphoid infiltrate. After the histologic evaluation, we inquired if the patient had a history of diabetes mellitus, and learned that she did have type 2 noninsulin-dependent diabetes mellitus. In conclusion, we report a case of diabetic mastopathy that presents with bilateral tumorlike masses and an unusual exuberant lymphohistiocytic response with granuloma formation. The pathologist may not be provided with a history of diabetes mellitus, but the characteristic fibrosis, lymphocytic ductitis/lobulitis, and sclerosing lobulitis with perilobular and perivascular lymphocytic infiltrates should provide clues for an accurate diagnosis, even when an exuberant and an unusual lymphohistiocytic response is present. A timely accurate diagnosis can help limit repeat surgeries in this vulnerable group of patients.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
10/19. A case showing sclerosing adenosis and an unusual form of basal cell hyperplasia of the prostate.We describe an unusual case of benign prostatic hyperplasia that demonstrated florid sclerosing adenosis--an uncommon lesion that may be confused with prostate carcinoma. immunohistochemistry utilizing Keratin 903, a basal cell-specific antikeratin antibody, was useful in identifying basal cells in sclerosing adenosis, thus verifying its benign nature. In addition, this case had an unusual form of basal cell hyperplasia that resembled basaloid carcinomas (adenoid cystic carcinoma) involving the prostate.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
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