Malignant hemangiopericytoma arising in neurofibromatosis: a case report with histological, immunohistochemical and ultrastructural studies

Subject. A 27-year-old Hispanic male with clinical manifestation of neurofibromatosis type 1 developed chronic constipation and urination difficulty along with recently increased abdominal bloating and anorexia. He also noted 40 lbs weight loss over period of 1 year. Physical and radiographic examinations revealed a large mass in the right pelvic fossa.Results. The surgically removed tumor was demonstrated, histologically, immunohistochemically, and ultrastructurally, to be a malignant hemangiopericytoma.Discussion.Although non-neurogenic tumors associated with neurofibromatosis have been reported in these patients, only one hemangiopericytoma case has been found in the English literature. We report here another case of this rare malignant hemangiopericytoma in a patient with neurofibromatosis.     

Carcinosarcoma of the gallbladder. A case report with immunohistochemical and ultrastructural studies

The authors present the histologic features, immunohistochemical findings, and ultrastructure of a carcinosarcoma of the gallbladder containing rhabdomyosarcoma as a mesenchymal element. A pedunculated polypoid tumor protruded into the lumen from the fundus of the gallbladder. The neoplasm contained two divergent components. One was malignant mesenchymal tissue with rhabdomyoblastic differentiation; the other was ordinary adenocarcinoma which was observed predominantly at the base of the polyp. Immunohistochemically, the cytoplasm of the rhabdomyoblasts stained with anti-myoglobin, myosin, and muscle actin antibodies. Ultrastructurally, there were a large number of malignant mesenchymal tissues in which various stages of differentiated rhabdomyoblasts were noted. Ultrastructural study was particularly valuable for the identification of sarcomatous elements.     

Histiocytoid carcinoma: a variant of breast cancer

The history of a patient presenting with metachronous bilateral breast cancer displaying histiocytoid features is reviewed. Although regional metastases were noted, this patient has not demonstrated an aggressive systemic disease pattern. In the past, histiocytoid breast cancer has been classified as either a lipid-rich carcinoma or as a variant of lobular carcinoma. However, histiocytoid carcinoma should be considered a distinct entity. Unlike the lipid-rich carcinomas, this tumor stained strongly for mucin. Immunoperoxidase staining indicated strong positively for CEA and negative staining for alpha-lactalbumin. There is suggestive evidence of a relationship between histiocytoid breast carcinoma and breast cancers of apocrine origin. Controversy remains and further evaluation is needed to elucidate the histiogenesis and biological potential of this neoplasm.     

Pulmonary rhabdomyosarcoma with isolated small bowel metastasis. A report of a case with immunohistochemical and ultrastructural studies

A unique case of pulmonary rhabdomyosarcoma with an isolated, symptomatic small bowel metastasis is presented. The tumor affected the middle lobe, and was treated with a right pneumonectomy. Eleven months after the operation, an isolated small bowel metastasis, which produced intestinal obstruction, was resected. The patient is currently alive, 11 months after operation. The myogenous nature of the tumor was confirmed by the immunohistochemical demonstration of myoglobin in the pulmonary and enteric lesion by the ultrastructural findings of poorly developed sarcomeres.     

Spindle-cell ameloblastic carcinoma: A case report with immunohistochemical,ultrastructural, and comparative genomic hybridization analyses

Spindle-cell ameloblastic carcinoma is a classification proposed for a group of rare odontogenic carcinomas with sarcomatoid components and is distinguished from odontogenic carcinosarcoma. We report a case of spindle-cell ameloblastic carcinoma of the right mandible that occurred in a 67-year-old Japanese man. Growth of the tumor was destructive, there was extensive lung metastasis, and the outcome was unfavorable. Ultrastructural and immunohistochemical examination showed the spindle-cell component of the tumor to be epithelial in character. A gain of 5q with amplification of 5q13 was detected in the tumor by comparative genomic hybridization.     

Intracystic papillary carcinoma of the male breast. A case report (histochemical, immunohistochemical and ultrastructural study).

We report a case of intracystic papillary carcinoma of the male breast in a 70-year-old male Caucasian. Grossly, the tumor was a cystic lesion measuring 6 cm in diameter. It contained hemorrhagic fluid and a mural nodule with filiform projections. PAS stain with and without digestion revealed small clumps of diastase-resistant material in the cytoplasm of the neoplastic cells. Grimelius stain was positive. Immunoperoxidase stains were negative for neuron-specific enolase, S100 protein, cromogranin and synaptophysin and were positive for carcinoembryonic antigen and epithelial membrane antigen. On ultrastructural examination the neoplastic cells showed membrane-bound, dense-core secretory granules. We believe that this neoplasm, despite negative neuroendocrine markers, is a variant of mammary adenocarcinoma with endocrine differentiation, partly because of the positive Grimelius stain and partly because of the presence of electron-dense granules, which according to some authors represent lactational differentiation.     

Lymphoplasmacyte-rich meningioma: A case report with histological and immunohistochemical studies

This report concerns a 64-year-old woman with a lymphoplasmacyte-rich meningioma. Radiographically and macroscopically, the tumor had the appearance of an ordinary meningioma. Components of the meningothelial cells were positively immunostained for epithelial membrane antigen. The results of immunohistochemical assays with the antibodies to surface markers of lymphocytes L26 and UCHL-1 indicated that the lymphoplasmacellular proliferation was not neoplastic but probably represented an immune reaction of the host.     

Cytologic and ultrastructural studies of a rare breast carcinoma with osteoclast-like giant cells

An unusual case of breast carcinoma with osteoclast-like giant cells (OGCs) was reported, for which the diagnosis was made by aspiration biopsy. The OGCs appeared to derive from large mononuclear cells, probably via their cellular fusion. The mononuclear cells had abundant lysosome-like granules, endoplasmic reticulum, and mitochondria. They were thought to be histiocytic cells, though active phagocytosis could not be demonstrated. Histologically, the tumor showed a pattern of well differentiated ductal adenocarcinoma, of which the stroma was crowded with histiocytic cells, OGCs, and lymphocytes. Marked hemorrhage and fibrosis were also seen. The tumor cells tended to be distorted and greatly diminished in accord with the accumulation of OGCs.     

Argyrophilic carcinoma "carcinoid tumor" of the breast: case report with electron microscopic and immunohistochemical investigations

A rare primary argyrophilic carcinoma "carcinoid tumor" of the breast in a 48-year-old woman was investigated by light and electron microscopy, and immunohistochemistry. Light microscopy showed the greater part of the tumor to have characteristic histological features of carcinoid tumor and Grimerius' stain revealed the presence of numerous argyrophilic granules in the tumor cells. Numerous neurosecretory granules and bundles of intermediate filaments were observed ultrastructurally in the cytoplasm. In addition, carcinoembryonic antigen (CEA) and neuronespecific enolase (NSE) were detected in the tumor cells using the immunoperoxidase method. From the results, it is speculated that the tumor cells have the ability to produce CEA as well as NSE in the cytoplasm. The observation of ductal spreading in parts of the tumor, and the detection of CEA, suggest the tumor cells to be derived from mammary epithelial cells.     

Mammary carcinoma with argyrophilic cells: an immunohistochemical and ultrastructural study

The immunohistochemical and ultrastructural findings of 7 primary argyrophilic tumors of the breast are described. Five cases were selected because of a growth pattern reminiscent of a "carcinoid" tumor and 2 were obtained from 70 consecutive common carcinomas. All patients were females (mean age 68.8) and none had clinical evidence of hormonal secretion. On ultrastructural examination dense-core granules were seen in addition to findings more suggestive of a common carcinoma. Immunoperoxidase stainings for ACTH, calcitonin etc. were negative in all tumors. The authors believe that organoid growth pattern, argyrophilia and dense-core neurosecretory-like granules are not sufficient elements to demonstrate the endocrine nature of a breast neoplasm.     

Bilateral Breast Cancer with a Unilateral Lipid-rich Carcinoma： A Case Report

Case Report A 38-year old female patient was hospitalized on the 10th of December,2006 as she had noted a lump in her right breast for 3 months.Her past medical history indicated that,because of a left-breast carcinoma complex,she had undergone a radical operation     

Sarcomatoid carcinoma of the urinary bladder: a case report with immunohistochemical and molecular genetic analysis

The author reports a rare case of sarcomatoid carcinoma with an emphasis on immunohistochemical features. A 79-year-old man was admitted to our hospital because of hematuria. An endoscopy revealed a large polypoid tumor in the bladder, and urine cytology demonstrated malignant cells. A cystectomy was performed. The patient is now alive without metastasis 4 months after the operation. Grossly, a large polypoid tumor (5 × 6 × 5 cm) was present in the bladder. Microscopically, the tumor consisted of high-grade transitional cell carcinoma element (10% in area) and sarcomatoid element (90% in area). There was a gradual transition between the two. The tumor cells were invaded into peribladder tissue (pT3b). Immunohistochemically, the sarcomatoid element was positive for four types of pancytokeratins, high-molecular weight cytokeratin (CK), CK5/6, CK7, CK18, CK19, epithelial membrane antigen (EMA), vimentin, p53 protein, p63, Ki-67 (labeling = 92%), neuron-specific enolase (NSE), and platelet-derived growth factor receptor-α (PDGFRA). It was negative for CK14, CK20, melanosome, carcinoembryonic antigen (CEA), desmin, S100 protein, myoglobin, α-smooth muscle antigen (ASMA), CD34, chromogranin, synaptophysin, CD56, CD68, and KIT. The transitional cell carcinoma element showed similar immunoreactivity except for negative CK5/6, positive CK20, and negative vimentin. A molecular genetic analysis of KIT gene (exons 9, 11, 13, and 17) and PDGFRA (exons 12 and 18) gene with the use of PCR-direct sequencing showed no mutations. The present case is the first report of sarcomatoid carcinoma of the urinary bladder demonstrating extensive immunohistochemistry and mutational status of KIT and PDGFRA genes. The sarcomatoid carcinoma in the present case may be derived from sarcomatous differentiation of high-grade transitional cell carcinoma.     

Cavernous lymphangioma of the breast: case report with electron microscopic and immunohistochemical investigations

A rare case of cavernous lymphangioma of the breast in a 16-year-old Japanese girl was investigated by light and electron microscopies, and immunohistochemistry. The patient, who had a soft breast tumor measuring 16 x 14 cm, had undergone a tumorectomy two years after she noticed the tumor. Histologically, the tumor was composed of numerous narrow spaces containing amorphous fluid lined with a monolayer of endothelial cells. Abundant collagen fibers and numerous fibroblasts were found beneath the endothelium. Histological findings confirmed a diagnosis of lymphangioma of the breast. Immunohistochemically, the endothelium showed negative immunoreaction for factor VIII-related antigen, but the discontinuous basal lamina was positive for laminin. Ultrastructurally, numerous microfilaments and pinocytotic vesicles were found in the cytoplasm of the endothelial cells, and intermediate junctions were recognized between adjacent cells. In addition, a discontinuous basal lamina was seen beneath the endothelium. Electron microscopic and immunohistochemical investigations are thus useful in confirming a diagnosis of cavernous lymphangioma of the breast.     

Primary neuroendocrine carcinoma of the breast: a case report

Primary neuroendocrine carcinoma of the breast is an extremely rare tumor. We present our experience of primary neuroendocrine carcinoma of the breast in a 76-year-old woman. Surgical biopsies from breast and axillary lymphadenopathy showed a neuroendocrine carcinoma. Immunohistochemical staining of tumor cells with GCDFP15, NSE and chromogranin were positive. Computed tomography scans of the chest and abdomen showed no lesion for metastasis or another primary origin. Adjuvant hormone therapy was given, since the tumor was immunohistochemically receptor positive.     

Necrotizing lymphadenitis: a review of clinicopathological, immunohistochemical and ultrastructural studies

Necrotizing lymphadenitis (NEL) has been reported to be a reactive process described under differing terminology by Fujimoto et al. (1972), Kikuchi (1972), Wakasa et al. (1973) and other Japanese pathologists. Recently, this type of lymphadenitis has also been reported in America and Europe. In Japan, NEL is observed more frequently in the northern area, however, no characteristic seasonal occurrence has been noted. The disease affects young females more than males, particularly from the third and fourth decades onwards. Common cold-like symptoms, lymphadenopathy of the cervical region and leukopenia are characteristic clinical findings in the early stages. Morphological features of the involved lymph nodes include the presence of numerous immunoblasts, histiocytes and macrophages, the latter with phagocytized nuclear debris derived from degenerated lymphocytes. However, granulocytes are generally absent. Tubular inclusions are observed ultrastructurally. Immunohistochemical studies of peripheral blood using monoclonal antibodies have revealed that the helper/suppressor (Leu 3a/2a) ratio increases gradually with the clinical course because of a decrease in Leu 2a + cells. The pathogenesis of NEL is uncertain, but it has been speculated that there is cytolytic infection of lymphocytes by a virus or other organism, accompanied by secondary blastic transformation of suppressor T-lymphocytes.     

Cytogenetic studies on a patient with prepubertal breast cancer: A case report

Summary Cytogenetic studies were carried in a 10 year old girl with prepubertal breast cancer for assessing inherited genetic susceptibility to chromosome breakage. The girl presented with a tumour in the left breast. Histologically it was diagnosed as secretory carcinoma (SC). Chromosome anomalies observed in phytohemagglutinin (PHA-P) stimulated lymphocytes were del(2)(q33), del(3)(p24), del(7)(q22) and dup(12)(p11p12). The regions involved have been reported in breast tumors. These loci, detected in peripheral blood lymphocytes (PBL), could be the sites susceptible to breakage, its subsequent effect being manifested in the target (breast) tissue.     

Sarcomatoid carcinoma of the stomach. A report of three cases with immunohistochemical and ultrastructural observations

The authors report three cases of sarcomatoid carcinoma arising in the stomach. This uncommon tumor is characterized by a mixture of malignant epithelial and spindle cell elements. All three tumors were large (average diameter, 5 cm) and infiltrated deep into the stomach wall. Two of the tumors had a polypoid configuration; the third was ulcerated and endophytic. Intestinal metaplasia was present adjacent to the tumor in all cases, with dysplasia in two. Immunohistochemical studies showed positivity for cytokeratin, carcinoembryonic antigen, and epithelial membrane antigen in the epithelial component of all tumors, and Leu-M1 was positive in the epithelial component of one. The spindle cell components contained vimentin, and in tumor 2, the spindle cell component was also positive for desmin. Two tumors showed focal positivity for cytokeratin in the spindle cells immediately adjacent to the epithelial component. Ultrastructurally, the spindle cell component of two tumors was composed of undifferentiated cells without specific epithelial or mesenchymal features. The third tumor contained occasional cells with features of myofibroblasts.     

Primary mucinous carcinoma of the thyroid gland: report of a case and ultrastructural study

A follicular carcinoma of the thyroid with extensive mucin production was found in a 54-year-old woman. The primary nature of this rare neoplasm of the thyroid gland is supposrted by the presence of both colloid and mucin-producing follicles. Ultrastructural features confirm the secretion of colloid and mucin in the same neoplastic thyroid cells.     

乳腺浸润性微乳头状癌伴甲状腺转移1例并文献复习

目的 探讨乳腺浸润性微乳头状癌转移至甲状腺的诊断及治疗方法.方法 回顾性分析乳腺浸润性微乳头状癌伴甲状腺转移1例患者的病例资料并复习相关文献.结果 患者2013年经病理诊断为右乳浸润性微乳头状癌伴黏液癌,给予6个周期新辅助化疗后行右乳癌改良根治术,术后采用辅助放疗和他莫昔芬内分泌治疗;2019年因颈部肿块行双侧甲状腺次...