Sialoblastoma

Sialoblastoma should be considered in the diagnosis of a perinatal neck swelling that appears to be contiguous with the submandibular salivary gland. These are exceedingly rare perinatal salivary tumors of epithelial origin with variable biologic behavior including the potential for local and systemic recurrence.We report the case of a 3-month-old boy who presented with a submandibular swelling of insidious onset that was initially thought to be a lymph node enlargement.     

Sialoblastoma.

Tumours of the salivary gland are very uncommon in children. We present a case of sialoblastoma, a very rare congenital salivary-gland tumour, initially recognised on antenatal ultrasound. After histological diagnosis, a superficial parotidectomy was performed at 21 days of age with preservation of the facial nerve. There is no recurrence at2 years.     

Solitary fibrous tumors of the pleura: clinicopathological and immunohistochemical examination

The purpose of this work was to study clinical and biological characteristics of solitary fibrous tumor (SFT) of the pleura. We reviewed the clinicopathological and immunohistochemical features of 12 patients who underwent surgical resection for SFT. Ten cases were histologically defined as benign; two were found to be malignant. CD34 negativity and strong expression of p53 could be observed in a patient with fatal outcome. Ki-67 expression was increased in malignant cases, as compared with benign. We also found that Bcl-2 expression inversely correlated with a tumor diameter. As the development of malignant SFT might be associated with these molecular statuses, immunohistochemical staining should be performed in all cases to identify the biological characteristics of the tumor.     

Small cell carcinoma of the genitourinary tract: an immunohistochemical, electron microscopic and clinicopathological study.

We examined 13 cases of small cell carcinoma of the genitourinary tract to evaluate and compare the immunocytochemical and ultrastructural features as well as the clinicopathological behavior. Immunohistochemical stains revealed that neuron specific enolase and chromogranin showed differences in staining between the bladder and prostate, as well as between the small cell and adenocarcinomatous components of the prostate. Also, synaptophysin was negative over-all in 12 of 13 cases. Epithelial membrane antigen, carcinoembryonic antigen and keratin showed strong focal positivity within the small cell component. Electron microscopy was performed in 4 cases, with 3 demonstrating neurosecretory granules. Clinically, 6 of the 7 patients with adenocarcinoma/small cell carcinoma of the prostate did poorly, all with a survival of 15 months or less. Of 5 patients with transitional cell/small cell carcinoma of the bladder 2 fared better (both had no evidence of disease at 12 months and 11 years, respectively). Based upon the immunostaining and electron microscopic findings, small cell carcinoma of the genitourinary tract is heterogeneous in appearance and, therefore, may arise from a multipotential cell of origin. This cell of origin may be organ-specific, as demonstrated by the variability in staining characteristics among the prostate, bladder and kidney, as well as by the differences in the clinical behavior of these malignancies. Small cell carcinoma of the prostate has a poor prognosis, while small cell carcinoma of the bladder may portend a better prognosis if diagnosed at an early stage.     

Sclerosing adenosis of the prostate gland. A clinicopathological and immunohistochemical study of 11 cases.

Eleven cases of sclerosing adenosis of the prostate gland, a recently reported uncommon pseudoneoplastic lesion with characteristic histological, histochemical, and immunohistochemical features, are described. The well-circumscribed cellular lesions were composed of variably sized and shaped, often compressed, glands and small clusters of epithelial cells embedded in a cellular, often myxoid stroma. Mild cytologic atypia was occasionally present, and one case had moderate cytologic atypia. A distinct basement membrane often surrounded the glands and clusters. Luminal acid mucin was typically present. Keratin-positive basal cells were present in the glands and as spindle cells in the stroma. The basal cells were also immunoreactive for S-100 and muscle-specific actin, suggesting myoepithelial differentiation. Clinical follow-up has shown no evidence of prostatic carcinoma. The available evidence suggests that sclerosing adenosis of the prostate gland is a benign lesion with distinctive features that should enable it to be distinguished from prostatic adenocarcinoma.     

Sialoblastoma: a congenital epithelial tumor of the salivary gland

Sialoblastoma is a rare congenital epithelial tumor of the salivary gland that is diagnosed at birth or shortly thereafter with significant variability in histologic range and clinical course; hence, for an individual case, it may be difficult to predict the most appropriate therapy [Cancer 1972;30:459-69; Pediatr Pathol 1988;8:447-52; Br J Plast Surg 2000;53(8):697-699]. We report the case of a 4-year-old girl who had a widely spreading sialoblastoma of the left cheek. We were obligated to widely resect the tumor including the trunk of the facial nerve, superior part of the left maxilla, and the zygoma. Although the patient was operated 3 times in 4 years, invasion of the tumor could not be stopped. The patient died because of respiratory insufficiency and deterioration of her general health.     

Renal neuroendocrine tumours: a clinicopathological study

OBJECTIVES: To report cases of primary neuroendocrine tumours (NETs) of the kidney, including carcinoid tumour, large cell neuroendocrine carcinoma (LCNEC) and small cell carcinoma (SCC), which show a wide range of NE differentiation and biological behaviour, and are exceedingly rare. PATIENTS AND METHODS: The clinicopathological features of all nine renal NETs diagnosed during a 7-year period were reviewed. RESULTS: Six carcinoids, two SCC and one LCNEC were identified from 2780 kidney tumours. No patient had carcinoid syndrome or other NE symptoms. Three of six carcinoids and no SCC/LCNEC arose in horseshoe kidneys. The mean size of the six carcinoids and three SCC/LCNEC was 4.8 cm and 12.2 cm, respectively. No carcinoid had tumour necrosis or mitosis. By contrast, three SCC/LCNEC had extensive tumour necrosis and brisk mitosis. All renal NETs were positive for synaptophysin but were variably positive for chromogranin and CD56. Three of six carcinoid tumours were confined to the kidney, and four of five patients were disease-free at a mean (range) of 26 (6-74) months. One patient with nodal metastases has had no recurrence and another died with liver metastases. Three patients with SCC/LCNEC each presented with locally advanced disease and extensive lymphadenopathy; two of them died from distant metastasis or local tumour progression, and the third is currently alive with disease. CONCLUSIONS: Various NETs can occur in the kidney, but rarely. Renal carcinoids have a variable clinical course; SCC and LCNEC are associated with poor clinical outcomes. The diagnosis of NETs, especially LCNEC, requires awareness of their rare occurrence and prudent use of immunohistochemical NE markers.     

偶发性前列腺癌的临床病理学研究

目的:探讨偶发性前列腺癌的临床病理特征及预后.方法:回顾性分析580例膀胱癌根治术中96例偶发前列腺癌的临床资料及病理学特征,并进行预后随访.结果:偶发前列腺癌的发生率为16.6％(96/580).年龄42～90岁,中位年龄为73岁;其中≤60岁6例(6.2％),＞60岁90例(93.8％).肿瘤平均最大直径约3.5 ...     

Lymphocytic adenohypophysitis: an immunohistochemical study

Lymphocytic adenohypophysitis is a rare inflammatory disorder of the anterior pituitary gland. In some cases, there is evidence of concurrent autoimmune disease. We present the case of a 39-year-old woman who developed visual disturbance during the early postpartum period. Magnetic resonance imaging revealed an intrasellar mass with suprasellar extension. Study of the tumor tissue showed diffuse infiltration of the entire pituitary gland by lymphocytes and plasma cells. Immunohistochemical examination revealed that the majority of the infiltrating lymphocytes were T cells that might have modulated the immunoreaction to the anterior pituitary gland. We suggest that the disorder is related to cell-mediated immunity as well as humoral immunity.     

True thymic hyperplasia: a clinicopathological study

In this report, we describe the clinicopathological features of 4 patients with true thymic hyperplasia. This controversial thymic lesion has only recently been defined as a variable, often massive enlargement of the thymus characterized by a nearly normal microscopic structure. Our study of 4 patients and review of the literature indicate that true thymic hyperplasia has a well-defined clinicopathological profile: prevalence in children or young male patients, absence of associated autoimmune diseases, and often presence of respiratory distress or peripheral blood lymphocytosis, or both. True thymic hyperplasia should be considered in the differential diagnosis of anterior mediastinal masses in children and young adolescents.     

Brenner tumours--a clinicopathological study

In a clinicopathological study of 70 Brenner tumours in 61 patients seen at Groote Schuur Hospital during the 30-year period 1956-1985, 68 were benign, 1 malignant and 1 proliferating. Fifty-seven were pure tumours and the remainder were mixed with other ovarian neoplasms. The age range of patients was 26-71 years (median 49 years). Most of the Brenner tumours were incidental findings and probably not responsible for the symptoms or signs, which were most commonly a pelvic mass (28 patients) and abnormal vaginal bleeding (15).     

Retrieved human allografts : a clinicopathological study.

BACKGROUND: We studied seventy-three massive preserved human allografts, retrieved from two to 156 months after implantation, to provide insight into the mechanisms of their repair. METHODS: The specimens were studied with radiographic and histological techniques that permitted time-related quantitative analysis of the reparative mechanisms of union, cortical repair, soft-tissue attachment, fracture, and characteristics of the allograft-cement interface and the articular cartilage. RESULTS: Union at cortical-cortical junctions occurred slowly (approximately twelve months) by host-derived external callus that bridged the junction and filled the gap between abutting cortices. The bone in the gap did not undergo stress-oriented remodeling even after many years, and, when the union was intentionally disrupted, failure occurred at the cement line that marked the allograft-host junction. Repair of the necrotic graft matrix was both external and internal. External repair consisted of the apposition of a thin seam of host bone on the outer surface of the graft, coating about 40% of the surface at one year and 80% at two years. Internal repair was confined to the ends and the periphery of the cortices and penetrated so slowly that only 15% to 20% of the graft was repaired by five years, after which deeper repair seldom occurred. Graft fractures in specimens retrieved soon after fracture showed only necrotic bone adjacent to the fracture site, whereas those retrieved after fracture-healing showed a marked increase in internal repair of the bone about the fracture site. When bone cement had been used to fix a prosthesis, there was no evidence of bone resorption or loosening of the device. The osteoarticular specimens showed no survival of chondrocytes in the articular cartilage. However, the architecture of the acellular cartilage was well preserved after two to three years and occasionally after as many as five years. Late degenerative changes in the articular cartilage coincided with subchondral revascularization and fragmentation, and the articulating surfaces became covered by a pannus of fibrovascular reparative tissue. Degenerative changes in articular cartilage occurred earlier and were more advanced in specimens retrieved from patients with an unstable joint than in those retrieved from patients with a stable joint. CONCLUSIONS: Repair of massive human allografts is an indolent process that follows a fairly predictable course during the first few years and is influenced by other biological activities, such as fracture repair, supplementary autografting, and tumor recurrence.     

Fascia lata valves: a clinicopathological study.

Sixteen frame-mounted fascia lata valves removed from the mitral, aortic or--in one patient--pulmonary position have been detailed histologically. These valves had remained in 15 patients (11 men and four women) for periods varying between 10 and 44 months. The reason for the original transplantation was either chronic rheumatic endocarditis or calcific aortic disease. In the mitral position, the leaflet in position nearest the site of the original anterior mitral valve cusp showed the least changes. The remaining two leaflets of the fascia lata valve in the mitral position, as well as those removed from the aortic or pulmonary position, showed more severe changes; these consisted of degeneration of collagen tissue and often a severe decrease of nuclei belonging to the fibroblastic series. These changes, as well as superimposition of fibrin or fibrous tissue, tended to become more pronounced the longer the valve had remained in the patient. Viability studies in valves removed from two patients have also been undertaken showing very greatly reduced activity. The possible causes for valve dysfunction have been reviewed, and the findings in this study suggest that contraction of fibrous tissue, which sandwiches the fascia lata valve cusps, may contribute to failure of satisfactory valve function. It is concluded that fascia lata forms a poor substitute for replacement of diseased cardiac valves.     

Chordoma in early childhood: a clinicopathological study

A case of clival chordoma in a 4-year-old girl is presented. The tumor regrew rapidly after it was partially removed, and the patient died after a clinical course of 11 months. An autopsy revealed a massive clival mass and widespread metastases in the dura mater, skull bone, bilateral lungs, liver, sternum, left humerus, and vertebrae. Pathological findings showed that the tumor cells were poorly differentiated, with a rare, but typical, physaliphorous appearance. The presence of epithelial differentiation proteins, mitochondria surrounded by rough endoplasmic reticulum, and desmosomes was demonstrated in the tumor cells both immunohistochemically and ultrastructurally. Thus, the tumor was diagnosed as a chordoma. The literature pertaining to intracranial chordoma in early childhood is reviewed. Rapid growth and distant metastases may occur in chordomas at a young age.     

Subacute necrotizing sialadenitis: a clinicopathological study.

OBJECTIVE: To report cases of extra-palatal subacute necrotizing sialadenitis (SANS), an uncommon condition that usually affects palatal minor salivary glands, and to characterize the etiopathogenesis, clinical features, and histology of this lesion. STUDY DESIGN: Retrospective reviews of records for patients with SANS diagnosed between 1999 and 2005; only cases with complete clinical history and histology were included in the study. RESULTS: Five cases (3 women, 2 men) were identified. The majority of patients presented with painful 1.0 to 1.5 cm swellings, with sudden and rapid increase in size. Two cases occurred in the buccal mucosa, 2 on the ventral surface of tongue, and 1 on the upper lip. Histology showed acinar necrosis surrounded by a dense polymorphous inflammatory infiltrate with focal exuberant tissue eosinophilia. Ductal atrophy was seen with minimal squamous metaplasia. In all the cases, healing occurred without any further treatment in 3 weeks. No recurrence was observed. CONCLUSION: SANS is an uncommon, inflammatory condition of unknown etiology affecting minor salivary glands. SANS appears to be a self-limiting process that has distinct characteristic clinical and histologic features. Nevertheless, SANS shares some of the histologic features of early necrotizing sialometaplasia (NS), suggesting a possible relationship between the 2 conditions. Additional reporting of SANS would be helpful in better defining the condition and its delineation from NS.