Showing papers in "Československá patologie in 1999"

Cytokeratins and lung carcinomas.

Abstract: Background Recently, cytokeratins (CK) were studied as tumor markers for many carcinomas. In lung cancer they appeared to be useful in distinguishing primary from secondary tumors, in histological typing as well as in evaluating patient's prognosis. However, the results have yet to be conclusive. In this study, expression of CK7, CK10/13, CK18, CK19, CK20 was investigated in a group of 72 surgically resected specimens of lung including 31 adenocarcinomas, 30 squamous cell carcinomas and 11 neuroendocrine carcinomas. Cytokeratin immunophenotypes were analyzed in comparison to histological characteristics of tumors, TNM stages and patients survival. Results CK7, CK10/13 and CK18 can be used in distinguishing the lung adenocarcinomas from the lung squamous cell carcinomas: CK7(+), CK10/13(-), CK18(+) for adenocarcinomas; CK7(-), CK10/13(+), CK18(-) for squamous cell carcinomas. Relatively higher CK7 and CK18 immunostaining rates of the squamous cell carcinomas with high keratinization, with high percentage of dead cells and with late stages of disease suggested their prognostic significance but it was not confirmed when comparing different survival groups. Both adenocarcinomas and squamous cell carcinomas were stained strongly with antibody against CK19 (90.3% and 86.7% respectively) but much less with anti-CK20 antibody (9.7% and 3.3% respectively). In general, neuroendocrine tumors of the lung were non-reactive for these cytokeratins except CK18, among them all carcinoid tumors expressed CK18 abundantly.

Sarcomatous chromophobe cell renal carcinoma. 2 case reports

Abstract: Chromophobe cell renal carcinoma is a relatively rare primary tumour of the kidney. We present two cases of sarcomatoid transformation in this type of renal cell carcinoma. Described transformation in chromophobe renal cell carcinoma has been reported previously only in four publications. We present a very unusual aggressive recurrence of one of our cases and introduce the first case of sarcomatoid carcinoma arising from chromophobe cell renal carcinoma of the kidney with rhabdomyoblastic differentiation.

Extraskeletal myxoid chondrosarcoma with neuroendocrine differentiation

Abstract: We describe a case of extraskeletal myxoid chondrosarcoma with neuroendocrine differentiation. The tumor occurred in subcutaneous tissue of the right popliteal region in a 50-year-old man. It measured 5 cm in diameter, was well circumscribed, lobular and gelatinous, and lacked any necrosis or hemorrhage. Histologically, the tumor structure was a typical of extraskeletal myxoid chondrosarcoma. The lesion was lobulated and contained small to medium-sized chondroblast-like cells with ovoid hyperchromatic nuclei and without prominent nucleoli. The cells created cords and nests and showed focally a perivascular rosette-like arrangement. A few of the tumor cells were spindle shaped. The myxoid matrix was stained with alcian blue and this reaction was resistant to prior treatment with hyaluronidase. PAS-positive glycogen was found in the cytoplasm of some tumor cells. Immunohistochemically, the tumor cells were diffusely positive for neuron specific enolase, monoclonal synaptophysin and vimentin. Following antibodies gave negative results: desmin, actins, S-100 protein, pancytokeratin, epithelial membrane antigen, chromogranin A, neurofilament protein, myelinic basic protein, glial fibrillary acidic protein. The patient is well four years after the wide excision of tumor and radiotherapy. Neuroendocrine differentiation in extraskeletal myxoid chondrosarcoma was described at first by Chhieng et al. in 1998 (1). Our observation confirms this interesting finding.

Well differentiated inflammatory subcutaneous liposarcoma (inflammatory atypical lipomatous tumor)

Abstract: Well differential inflammatory liposarcoma is a rare type of low grade liposarcoma. Its microscopical features may simulate benign inflammatory pseudotumor. A case of this lesion was described occurring in the subcutis of the right supraclavicular region in 61-year-old woman. The tumor was round well circumscribed and measured 3 cm in diameter. Histologically, it contained a 1.5 cm inflammatory nodule, which was surrounded by otherwise typical lipoma-like liposarcoma. The inflammatory nodule was composed of lymphocytic aggregates and spindle to stellate cells with mild atypism. No lipoblasts were seen in this area which mimicked an inflammatory pseudotumor. Correct diagnosis was based on the recognition of the lipoma-like liposarcoma area in this lesion. Our patient had no recurrence six years after the tumor excision.

[Malignant branchiogenic cyst--fact or fiction?].

Abstract: A case of a cystic metastasis of squamous cell carcinoma of palatine tonsil in a 54-year-old male is reported, clinically presenting as a branchiogenic cyst. The grade of differentiation of the squamous cell epithelium lining the cyst was very variable: in some areas it was extremely well differentiated, thus resembling common benign branchial cleft cyst; transition to dysplastic areas with features of carcinoma in situ was visible and finally, in one small focus, invasion of the epithelial structures into the lymphoid tissue was observed. Despite its metastatic nature, the tumor fulfilled histological criteria of a so called malignant branchiogenic cyst (branchiogenic carcinoma). The authors discuss the existence of primary malignant branchiogenic cyst and the criteria necessary for its diagnosis.

[Expression of p53, p21 and bcl-2 in prognosis of lung carcinomas].

Abstract: Expression of suppressor genes 53 and bcl-2 as well as of protein p21 (partly induced by p53 gene) was analyzed in a group of 77 resection specimens and bronchial excision of lung carcinomas (of all basic histological types--squamous cell, neuroendocrine, adenocarcinoma, undifferentiated). Simultaneously the relation of tumor immunophenotype and level of differentiation, cell death and 2-year-survival of patients was evaluated. Gene p53 showed non-only an expected strong expression in squamous cell carcinomas but especially in adenocarcinomas, which were newly characterized by exceptional hyper-expression of p53 in lowly differentiated variants. Expression level of protein p21 and gene p53 was parallel only in adenocarcinomas and undifferentiated carcinomas but discordant in squamous cell and neuroendocrine carcinomas. Positivity of p21 slightly prevailed in well-differentiated variants of the histological types but an exceptional positivity was found even in all the undifferentiated carcinomas. Gene bcl-2 revealed a paradox of strong expression in lowly differentiated neuroendocrine and undifferentiated carcinomas. The level of bcl-2 expression in squamous cell carcinomas was found higher than in references. Among tumors with cell death there was an inverted relation of bcl-2 and p53 expression (high/low) in neuroendocrine carcinomas but both of them were mostly negative in squamous cell carcinomas. A more frequent 2-year-survival of squamous cell carcinomas was verified for bcl-2 positive tumors and newly for p53 positive squamous cell carcinomas. Evaluation of the expression of p53, p21 and bcl-2 in lung carcinomas is so equivocal that its prognostic usage was found to be only complementary to the direct immunohistochemical investigation of the growth activities.

[Heterotopic chondro-osteoplastic metaplasia of the subclavian vein wall after long-term catheterization. Case report].

Abstract: A 59-year-old man admitted for i.m. had a 3-way cannula inserted into the right subclavian vein for 31 days. Autopsy revealed a circular firm thickening of the venous wall. Histology identified it as chondroid and osteoid tissue replacing adventitial connective tissue. Unusual chondroosteoplastic metaplasia not described up to now is discussed as about its causes.

Papillary fibroelastoma of the endocardium

Abstract: Six cases of papillary fibroelastoma of the endocardium were presented. All cases appeared as incidental findings at autopsy. Grossly, they were verrucous or tuft-like growths less than 1 cm in size on cardiac valves. Histologically, they consisted of a fibrocollagenous stalk and multiple papillary fronds with typical zonal architecture: central dense hyaline core containing elastic fibers surrounded by a layer of myxoid matrix and covered by hyperplastic endothelial cells. At the surface of papillary fronds there were foci of fibrin deposition. Histogenesis of papillary fibroelastomas is unclear, they are considered variously as primary benign tumours, hamartomas or organized thrombi.

[Malignant myoepithelioma of the parotid gland: cytologic and histologic features].

Abstract: A case of malignant myoepithelioma of the parotid gland in a 34-year-old female is presented. In the fine-needle aspiration material, there was predominance of poorly cohesive polygonal cells with marked nuclear pleomorphism; no mitotic figures were observed. Focally, fragments of myxoid metachromatic intercellular material were also present. Histologically, the tumor was encepsulated, showing focal invasion of the capsule and tumor thrombi in the capsular vessels. The tumor was predominantly solid and myxoid, composed of cells with epithelioid features, marked anisonucleosis and a low mitotic activity. Immunohistochemically, the cells revealed positive staining for S-100 protein, vimentin, cytokeratins, glial acidic fibrillary protein and carcinoembryonic antigen; only several cell groups expressed smooth muscle actin and desmin; muscle specific actin was uniformly negative. In differential diagnosis, it was important to distinguish malignant myoepitelioma mainly from pleomorphic adenoma (mixed tumor), benign myoepithelioma, carcinoma ex pleomorphic adenoma and malignant melanoma. The criteria of malignancy in myoepithelial tumors are discussed.

[Helicobacter heilmanii, a spiral bacterium, in gastric mucosa biopsies].

Abstract: Interest in possible microbiological causes of gastritis has increased significantly since the discovery of Helicobacter pylori (Hp). Recently a spiral bacterium named Helicobacter heilmannii (Hh) was described in association with chronic gastritis in adult and pediatric patients. Comparisons between these two organisms, as well as the literature on Hh, have also been reviewed. The incidence of Hh gastritis is far lower than that of Hp gastritis. Concomitant infections by Hh and Hp are very rare. It is very probable that Hh gastritis is transmitted from domestic animals or pets to humans. The frequency of Hh gastritis (11/6059 cases, 0.18%) in authors' material was similar to that reported in Western Europe. The role of touch cytology has been becoming more and more significant recently in the diagnosis of mucosal infections of the GIT.

[A testicular tumor with features of a sex cord tumor with annular tubules and calcified large-cell Sertoli tumor].

Abstract: An unusual testicular tumour with features of both sex cord tumour with annular tubules and large-cell calcifying Sertoli cell tumour is described. The tumour occurred in a 20-year-old man in the left testis as a 1 cm-measuring well circumscribed solitary lesion. Histologically, it showed sertoliform annular tubules with included eosinophilic nodules as well as isolated large cells and cords to sheets of the cells lying in a sclerosing stroma. A few psammomatous microcalcifications were seen. In contrast to similar cases reported before, the patient did not have any signs of Peutz-Jeghers syndrome, feminization or other complex dysplastic syndromes. The case indicates that tumours of this type may occur in phenotypically normal patients like pure large cell calcifying Sertoli cell tumours or ovarian sex-cord tumours with annular tubules. It further supports a close histogenetic relationship between these two entities.