Frequent isolation of capnophilic bacteria in aspirate from Bartholin's gland abscesses and cysts

Aspirate samples were obtained from 73 patients undergoing surgery for a Bartholin's gland abscess or cyst. Capnophilic bacteria were isolated from 22 % of cases, in contrast to previous reports of sporadic isolation. The threeStreptococcus pneumoniae isolates were serotype 3 or 4. The eightHaemophilus influenzae isolates could not be serotyped; six of them were biotype II but the electrophoretic band patterns of their outer membrane proteins were heterogeneous, indicating that non-serotypable strains from the same anatomical site may not be related. FourNeisseria gonorrhoeae isolates and one strain ofNeisseria subflava were recovered. The role of capnophilic bacteria in the pathogenesis of infections of the Bartholin's gland remains to be clarified.     

Adenocarcinoma of Bartholin's gland

Bartholin's gland carcinoma is an uncommon disease representing 0.1% of all female genital malignant neoplasms. Five Bartholin's gland adenocarcinomas were selected by the criteria of Chamlian and Taylor. Three patients died from metastatic disease within four years; two are free of apparent disease 14 months and 13 years, respectively, after initial diagnosis. Poor prognosis was associated with large tumor size, poor histopathologic differentiation, and lymph node involvement. Transmission electron microscopy verified the glandular nature of the poorly differentiated lesions. All five tumors demonstrated junctional complexes, abundant rough endoplasmic reticulum, secretory vacuoles, and glandular formation. Low levels of estrogen receptor and moderate levels of progesterone receptor were present in the one case measured. Endogenous peroxidase, and inducible enzyme in estrogen-sensitive tissues, was observed in two of the five tumors.     

Renal adenocarcinoma presenting with bilateral metastases to Bartholin's glands: primary diagnosis by aspiration cytology

The first recorded case of renal adenocarcinoma presenting with bilateral metastases to the Bartholin's glands is presented. Primary diagnosis of the metastatic deposits was made by fine-needle aspiration cytology with subsequent localization of the unsuspected renal primary. The value of fine-needle aspiration in the identification of inapparent primary tumors is discussed and cytological findings are described in detail.     

Carcinomas of Bartholin's gland. Histogenesis and the etiological role of human papillomavirus.

In this study, we examine 10 primary carcinomas of Bartholin's gland, including seven squamous carcinomas, two adenoid cystic carcinomas, and one adenocarcinoma, as well as four non-neoplastic Bartholin's gland. Six of seven squamous cell carcinomas contained human papillomavirus (HPV) type 16 DNA detectable by the polymerase chain reaction; one of these demonstrated HPV type 16 by in situ hybridization. The two adenoid cystic carcinomas, the adenocarcinoma, and the non-neoplastic Bartholin's gland epithelium showed no evidence of HPV DNA by polymerase chain reaction or in situ hybridization. A panel of eight antibodies (Cam 5.2, B72.3, CEA, EMA, MCA, Lewis X, ER, and PR) demonstrate that the squamous, transition zone, duct, acinar, and myoepithelial cells or Bartholin's gland are antigenically distinct, and are similar to those reported in analogous areas of the uterine cervix. Squamous carcinoma and adenocarcinomas of Bartholin's gland are antigenically similar, and seem to arise from the transition zone of the Bartholin's gland duct. The origin of adenoid cystic carcinomas is more difficult to determine; it is distinct from squamous and adenocarcinomas and seems more likely to arise from myoepithelial cells. We conclude that adenocarcinoma and squamous cell carcinoma of Bartholin's gland arise in the transition zone of Bartholin's gland, which is similar to the transition zone of the uterine cervix. We also show that HPV is associated with Bartholin's gland carcinoma and may play a role in the genesis of malignancy.     

Malacoplakia of Bartholin's gland

Two cases of malacoplakia involving Bartholin's glands occurred in postmenopausal women. Grossly the lesions were ovoid cysts with rubbery, soft walls. Microscopically there were sheets of von Hansemann's histiocytes and rare Michaelis-Gutmann bodies. After surgical excision, both patients remained asymptomatic. These cases involving Bartholin's glands are, to our knowledge, the first reported in the female genital tract.     

Histopathology of fibro-osseous and cystic tumors of bone

Fibro-osseous and cystic tumors are some of the more common tumors encountered in bone pathology. Although there is significant histologic overlap, fibro-osseous tumors of bone have distinct clinical, radiologic and pathogenetic features. Similarly, cystic lesions have characteristic radiologic and pathologic features that help distinguish them from tumor of bone that can have secondarily cystic components. More recently, specific genetic abnormalities have been identified in a subset of fibro-osseous and cystic tumors, such as fibrous dysplasia and aneurysmal bone cyst. Herein we discuss the clinical, radiologic, pathologic and genetic features of fibro-osseous and cystic tumors of bone.     

Small cell neuroendocrine carcinoma of Bartholin's gland

A small cell neuroendocrine carcinoma that arose in Bartholin's gland in a 30-year-old woman is reported. The tumor had light, electron microscopic, and immunohistochemical features typical of pulmonary small cell carcinoma and was metastatic to inguinal lymph nodes at presentation. This is the first reported example of this tumor occurring in Bartholin's gland.     

Squamous cell carcinoma and osteosarcoma arising from a dermoid cyst-a case report and review of literature

A rare case of multiple malignant tumors (poorly differentiated squamous cell carcinoma and high grade osteosarcoma) arising in an ovarian dermoid cyst of a 55 year old female is reported. To the best of our knowledge, this is the first well documented example of such an unusual combination of tumors arising in a dermoid cyst. The osteosarcoma and squamous cell carcinoma appear to arise in the background of benign teratomatous environment of a dermoid cyst rather than from “pure” mixed mesodermal tumors of the ovary. The tumors did not appear to have well demarcated boundaries with a junction or close intermingling of both cell types, features less favorable for collision tumor or carcinosarcoma. Despite extensive surgery with negative surgical margins and combination chemotherapy, the patient had recurrence of the tumor within four months and she died secondary to septicemia to chemotherapy and bilateral pulmonary emboli shortly after.     

Cyst fluid cytology and chemical features in a case of lymphoepithelial cyst of the pancreas: A rare and difficult preoperative diagnosis.

Most pancreatic cysts (90%) are inflammatory pseudocysts. Approximately 10% of pancreatic cysts are neoplasms, including serous cystadenomas, and mucinous tumors, some of which are malignant. Analysis of pancreatic cyst fluid obtained by percutaneous or endoscopic fine-needle aspiration is increasingly being used for the preoperative diagnosis of pancreatic or peripancreatic cysts. However, cyst fluid chemical and cytologic features in less common types of pancreatic cysts have not been reported. Lymphoepithelial cyst of the pancreas is exceedingly rare, and only occasional individual reports have described cyst fluid findings. We report on a case of lymphoepithelial cyst of the pancreas developing in a middle-aged man. Cyst fluid aspirated under radiological guidance showed elevated levels of carcinoembryonic antigen (CEA), CA19-9, CA 125, and amylase, and a viscosity greater than that of serum. A cell block preparation of a fine-needle aspiration showed tissue fragments with a keratinized squamous lining and a lymphocytic infiltrate in the wall, and abundant background keratinous debris. The cytologic and biochemical findings in this case exhibit similarities to the findings reported in other reports, and may represent a recognizable pattern on cyst fluid analysis.     

Cytogenetic-morphologic correlations in aneurysmal bone cyst, giant cell tumor of bone and combined lesions. A report from the CHAMP study group.

Aneurysmal bone cyst and giant cell tumor of bone are relatively rare bone tumors that sometimes coexist. We examined the karyotypes of 3 aneurysmal bone cysts, 12 giant cell tumors, and 3 combined lesions. All aneurysmal bone cysts showed involvement of chromosome segments 17p11-13 and/or 16q22. In addition, in 1 of the 3 giant cell tumors with secondary aneurysmal bone cyst, both chromosome bands were rearranged as well, albeit not in a balanced translocation. Seven out of 12 giant cell tumors were characterized by telomeric associations. One giant cell tumor showed a dup(16)(q13q22), suggesting the presence of a (minor) secondary aneurysmal bone cyst component, despite the absence of histological proof. Our results, combined with literature data further substantiate that segments 16q22 and 17p11-13 are nonrandomly involved in at least some aneurysmal bone cysts, irrespective of subtype (primary, secondary, intra/extraosseous, solid or classic). These findings strongly suggest that some aneurysmal bone cysts are true neoplasms. In addition, telomeric associations are the most frequent chromosomal aberrations in giant cell tumor of bone, the significance of which remains elusive. In combined giant cell tumor/aneurysmal bone cyst each component seems to retain its own karyotypic abnormality.     

Retroperitoneale Zysten, die Nebennierenzysten imitieren können

Adrenal cysts are uncommon lesions and most of them are found incidentally during abdominal imaging. We report on two benign extraadrenal lesions mimicking adrenal tumors in abdominal imaging. The histopathological investigation of the lesions revealed a foregut duplication cyst of the lesser gastric curvature and an epithelial inclusion cyst (epidermoid cyst) in an intrapancreatic accessory spleen respectively.     

Odontogenic ghost cell tumor

Odontogenic ghost cell tumor is a rare epithelial odontogenic tumor that is the neoplastic counterpart of the calcifying odontogenic cyst. There is confusion and controversy in the literature regarding the integration or segregation of these 2 lesions. It shows many histologic features with ameloblastoma but in addition has characteristic ghost cells and dentinoid. It occurs within the maxillary and mandibular bones (central) and in the gingival soft tissues (peripheral). Peripheral tumors are treated with simple excision. Although central tumors are often amenable to curettage or simple excision, some tumors have been more aggressive and require partial resection of the jaw. Malignant tumors with similar features have been reported. This is a US government work. There are no restrictions on its use.     

Mucocele-like changes in Bartholin's glands

Two cases are described in which changes identical to those of oral mucocele occurred in Bartholin's glands. The histopathology, histochemistry, and pathogenesis are discussed.     

Angiomatous lesion and delayed cyst formation after gamma knife surgery for intracranial meningioma: case report and review of literatures

Gamma Knife has become a major therapeutic method for intracranial meningiomas, vascular malformations and schwannomas with exact effect. In recent years an increasing number of delayed complications after Gamma Knife surgery have been reported, such as secondary tumors, cystic changes or cyst formation. But angiomatous lesion and delayed cyst formation after Gamma Knife for intracranial lesion has rarely been reported. Here we report the first case of angiomatous lesion and delayed cyst formation following Gamma Knife for intracranial meningioma and discuss its pathogenesis.     

Endocrine cells in the female genital tract

Endocrine cells are normal inhabitants of the para-urethral, Bartholin's and endocervical glands and of mesonephric rests. All these cells were characterized as serotonin-storing cells. In the para-urethral and Bartholin's glands, serotonin-containing cells were most often found in the transitional epithelium of excretory ducts. Endocrine cells participated in some pathological conditions. Abundant argentaffin cells were observed among the terminal ductules in chronic bartholinitis and serotonin-storing cells were identified in a peculiar ectocervical epithelium. Numerous serotonin-storing cells were detected in a well-differentiated adenocarcinoma of cervix occurring in a patient with the Peutz-Jeghers syndrome. Argyrophilic cells were present in cases of endometrial carcinomas; a striking feature was the demonstration of gut peptide hormones in an unusual type of endometrial adenocarcinoma. Finally, serotonin-storing cells were a constituent of Brenner tumours. It is suggested that a similar endocrine pattern may be shared by tissues originating from both Müllerian ducts and the urogenital sinus.     

Cytokeratin7 expression in histologic and cytologic specimens of cystic neck metastasis from HPV positive squamous cell carcinoma of the tonsil: A case report

The majority of cystic squamous cell carcinomas (SCCs) of the neck have been shown to be metastatic tumors from tonsillar SCCs associated with high‐risk human papillomavirus (HR HPV). Recent studies have demonstrated cytokeratin (CK)7 involvement in the development of HPV positive SCC, but no report has been issued on its simultaneous expression in primary tonsillar and metastatic tumor with cystic change. We present a case of HPV positive tonsillar SCC of a 42‐year‐old male that initially manifested as a cystic neck mass expressing CK7, CK19, and p16 in primary and metastatic tumors. Immunohistochemical examination revealed diffuse CK19 and p16 expression, and patchy CK7 expression in the solid components of primary and metastatic tumors. However, in cystic components of metastatic tumors the expression of CK7 and CK19 was preserved but p16 expression was absent, which was consistent with immunocytochemical findings of fine‐needle aspirates from cystic neck mass. In immunocytochemistry performed on aspirates of a branchial cleft cyst for the comparison of cystic SCC and benign cyst, CK19 staining was positive but CK7 and p16 staining was negative. These results suggest that CK7 immunocytochemistry on aspirated material from cystic neck mass may be a useful adjunct for distinguishing cystic metastasis of tonsillar SCC from branchial cleft cyst, although a larger scale study would be required.     

Zystische Pankreastumoren und ihre Klassifikation

Cystic tumors and tumor-like lesions of the pancreas are rare, but have attracted a great deal of attention because they are easily recognized with new imaging methods and, in contrast to ductal adenocarcinoma, they can usually be cured surgically. The increasing resection rate in recent years has also increased our knowledge of cystic pancreatic tumors by conspicuously enlarging their morphological spectrum. Known entities have been better characterized (i.e. solid pseudopapillary neoplasm, intraductal papillary mucinous neoplasm) and new ones described (serous oligocystic adenoma, mucinous non-neoplastic cyst, acinar cell cystadenoma and cystic hamartoma). This review discusses the most important cystic tumors and tumor-like lesions, presents a new classification, and summarizes the immunohistochemical differential diagnosis.     

Giant cell tumor of the scapula associated with secondary aneurysmal bone cyst

Giant cell tumors are distinctive neoplasms characterized by a profusion of multinucleate giant cells scattered throughout a stroma of mononuclear cells. Most giant cell tumors are found at the epiphyses of long bones, especially around the knee joint. Flat bone involvement is rare. However, a case of giant cell tumor with secondary aneurysmal bone cyst was encountered at the scapula of a 25-year-old man. Since the occurrence of a giant cell tumor with secondary aneurysmal bone cyst on flat bones (i.e., the scapula) is extremely rare, the above-mentioned case is worthy of reporting.     

A case of malignancy in a thyroglossal duct cyst--recommendations for management

Thyroglossal duct cyst carcinomas are rare tumors with just more than 200 cases published to date. This is a case report of a thyroglossal duct cyst harboring an occult carcinoma for which a Sistrunk operation was performed. Histopathological examination revealed a papillary carcinoma arising from a thyroglossal duct cyst after which the patient underwent a total thyroidectomy. With current evidence-based guidelines lacking, we discussed some of the issues relevant to the surgical planning and postoperative management of such a patient.     

Pancreatic neoplasms with abundant mucus production: emphasis on intraductal papillary-mucinous tumors and mucinous cystic tumors.

The clinicopathologic features and problems in classification and diagnosis of the pancreatic neoplasms with abundant mucus production are presented. In this article, the various reported concepts and terminology of these mucus-producing pancreatic tumors are summarized, and the differences between intraductal papillary-mucinous tumors and mucinous cystic tumors are specifically discussed. Intraductal papillary-mucinous tumors show diffuse or segmental dilatation of the pancreatic ducts with intraductal papillary growth. Mucinous cystic tumors are mucus-producing tumors showing cyst formation, which is often accompanied by intracystic papillary projections and "ovarian-type" stroma. Intraductal papillary-mucinous tumors occur most often in the pancreatic head of elderly men, whereas mucinous cystic tumors typically occur in the pancreatic tail or body of middle-aged women. Histologically, these tumors show a wide cytologic spectrum from benign to borderline to malignant. These tumors pursue an indolent clinical course compared with conventional ductal carcinoma of the pancreas. Mucinous cystadenocarcinomas have a higher malignant potential than intraductal papillary-mucinous adenocarcinomas, yet these tumors recur infrequently if they are excised completely. Because of the differences in clinicopathologic features, these tumors should be clearly separated from conventional ductal carcinoma of the pancreas.