Pleomorphic hyalinizing angiectatic tumor of the male breast: a heretofore unreported occurrence.

Pleomorphic hyalinizing angiectatic tumor (PHAT) is considered an unusual mesenchymal tumor of intermediate malignant potential that is distinguished by a prominent angiectatic vasculature with clusters of thin-walled, fibrin-lined vessels surrounded by sheets of spindled and pleomorphic cells. This lesion occurs mostly in the subcutaneous soft tissues of the lower extremities. In this paper, the authors report the first case of PHAT involving the breast parenchyma of a 75-year-old man. The patient was referred to the hospital with a history of a painless left breast mass that had been growing for several years. The lesion did not recur after surgery. The tumor exhibited histopathologic and immunohistochemical features identical to those of a PHAT of other sites. The purpose of this report is to add a rare tumor to the differential diagnosis of mammary spindle cell neoplasms.

[Enterocolic phlebitis. Description of a case and review of the literature]. / Flebite enterocolica. Descrizione di un caso e revisione della letteratura.

OBJECTIVE: To report about a case of enterocolic phlebitis, a rare cause of ischemic intestinal necrosis. RESULTS AND CONCLUSIONS: The patient, a 71 year-old male, presented with signs of acute abdomen. A right hemicolectomy was performed, which revealed a tubulovillous adenoma with high grade dysplasia located in the ascending colon, and a diffuse ischemic colitis. A localized lymphocytic and granulomatous phlebitis was present in the resected colon. The arteries were spared by the inflammatory process. The patient is alive and well 7 years after surgery. The literature concerning enterocolic phlebitis, a peculiar form of localized intestinal vasculitis, is briefly summarized.

[Mixed neoplasia of the stomach: description of a case of tubular adenoma combined with carcinoid]. / Neoplasie combinate dello stomaco: descrizione di un caso di adenoma tubulare combinato con carcinoide.

We report about a gastric polyp that was a combination of tubular adenoma and carcinoid. The patient, a 76 year-old male, presented with 1 cm sessile polyp, located in the gastric body, that was a combination of a tubular adenoma with moderate dysplasia and a small carcinoid. Immunohistochemically, the latter component was positive for chromogranin and synaptophysin. The patient is alive and well 10 months after endoscopical polypectomy.

[Solitary fibrous pseudopapillary tumor of the lung: pulmonary fibroadenoma and adenofibroma revisited]. / Tumore fibroso solitario pseudopapillare del polmone: fibroadenoma e adenofibroma polmonari rivisitati.

We describe a peculiar pulmonary lesion, that we interpreted as a pseudopapillary variant of solitary fibrous tumor. The patient was a 62-year-old asymptomatic male, non smoking, presenting with a peripheral nodule, 0.8 cm across, located in the lower lobe of the right lung. The patient is alive and well 18 months after surgical excision of the nodule. Microscopically, the lesion was well-circumscribed and characterized by a diffuse pseudopapillary pattern. Pseudopapillae were large, and were covered by a rim of cubic epithelium devoid of atypia. The stromal axis was fibrous and contained scattered bland spindle cells. Immunohistochemically, the latter were strongly positive for vimentin and CD34, focally positive for BCL2 and CD99, negative for cytokeratin, EMA, TTF1, calretinin, smooth muscle actin, desmin and S100 protein; the epithelial cells were immunoreactive for cytokeratin, EMA and TTF1. We interpret this lesion as a peculiar pseudopapillary variant of solitary fibrous tumor, corresponding to what has been reported in the literature as pulmonary adenofibroma and fibroadenoma. The most important differential diagnostic considerations are briefly discussed.

[Small-cell mesothelioma of the pleura: description of a case]. / Mesotelioma a piccole cellule della pleura: descrizione di un caso.

A case of mesothelioma with a small cell component in a 53-year-old, non-smoker woman. The patient had a history of asbestos exposure, and presented with thoracic pain. A total body computed tomogram showed a left pleural effusion and a 7.5-cm pleural mass. Thoracoscopy revealed a diffuse nodular thickening of the left parietal pleura, and a biopsy was performed. The patient died of the disease 4 months after diagnosis. Microscopically, the pleural neoplasm was composed of three different components: 40% of the tumor showed the classic histology of a malignant epithelial mesothelioma, 40% was composed of small- to medium-sized cells with open nuclear chromatin, evident nucleoli and high mitotic activity, and 20% of the neoplasm was indistinguishable from a small cell carcinoma. Immunohistochemically, the first component was diffusely and strongly positive for cytokeratin AE1/AE3, cytokeratin CAM 5.2 and EMA, focally positive for BER-EP4, and negative for CD15, B 72.3, CEA, LCA, chromogranin, synaptophysin, TTF-1 and CD99. The cells of the second component were positive only for cytokeratin AE1/AE3 and cytokeratin CAM 5.2, and the elements of the third component were negative for all the antibodies tested. Pleural mesothelioma with a small cell component is rare. The most useful parameters to distinguish it from other small cell malignancies that may involve the pleura, particularly small cell carcinoma of pulmonary origin, are discussed.

[Pulmonary metastasis of epidermoid carcinoma of the larynx: a case with an interstitial pattern of growth]. / Metastasi polmonare di carcinoma epidermoide del laringe: descrizione di un caso con pattern di crescita interstiziale.

We describe a pulmonary metastasis from a laryngeal epidermoid carcinoma, characterized by an interstitial pattern of growth. The patient, a 71-year-old man, smoker, presented with a large laryngeal neoplasm and with two pulmonary masses, one located in the apex and the other in the lower lobe of the right lung. The patient underwent a total laryngectomy and a right pneumonectomy and he died from neoplastic progression 2 years after surgery. Microscopically, the laryngeal tumour was an epidermoid carcinoma and the apical pulmonary mass was an adenocarcinoma. The pulmonary neoplasm of the lower lobe, 5.5 cm across, was an epidermoid carcinoma that we interpreted to be a metastasis from the larynx. The case is peculiar because tumour cells proliferated exclusively in the interstitium. When extensive as in our case, this pattern of growth is rare and it may pose some diagnostic problems.

[Pulmonary carcinoma with myoepithelial differentiation, analogous to basal cell adenocarcionma of the salivary glands: description of a case]. / Carcinoma polmonare con differenziazione mioepiteliale, analogo all'adenocarcinoma a cellule basali delle ghiandole salivari: descrizione di un caso.

We describe a case of pulmonary carcinoma with myoepithelial differentiation, analogous to basal cell adenocarcinoma of salivary glands. The patient, a 60 year-old man, smoker, presented with three peripheral nodules of the left lung. Preoperative staging was negative for metastatic disease and the patient underwent a surgical resection of the nodules. After 22 months, the patient is alive with no evidence of disease. Microscopically, the tumours were composed of atypical cells arranged in lobules, separated by basal membrane-like material. Immunohistochemically, tumour cells were positive for cytokeratin AE1/AE3, cytokeratin 14, vimentin, calponin, S-100 protein and gliofibrillary acid protein (GFAP). Electron microscopy showed features of epithelial and myoid differentiation and confirmed the myoepithelial nature of the tumour. Pulmonary tumours with myoepithelial differentiation are rare, but they have a wide and distinctive morphological spectrum.

[Clear-cell tumor of the lung: description of a case 1 mm in diameter ("micro-sugar tumor")]. / Tumore a cellule chiare del polmone: descrizione di un caso di 1 mm di diametro ("micro-sugar tumour").

Clear cell ("sugar") tumour of the lung is a rare neoplasm, generally presenting as a discrete nodule on the chest X-ray. We report a case of clear cell tumour of the lung in a 64-year-old woman. The tumour at presentation was 1 mm in diameter.

[Combined neoplasia of the lung: description of a case of adenocarcinoma mixed with typical carcinoid]. / Neoplasie combinate del polmone: descrizione di un caso di adenocarcinoma combinato con carcinoide tipico.

OBJECTIVE: To report about a lung tumor that was a combination of typical carcinoid and adenocarcinoma. RESULTS AND CONCLUSIONS: The patient, a 71-year-old male, presented with a 2.5-cm pulmonary nodule that, microscopically, was a combination of an adenocarcinoma (tubular with clear cell features and bronchioloalveolar) and a typical carcinoid. Immunohistochemically, both components were positive for cytokeratin, but only the carcinoid component was positive for chromogranin and synaptophysin. In the range of neuroendocrine tumors of the lung, a combination with other histological types of carcinoma (squamous, adeno, large cell and pleomorphic) can be found with both small cell carcinoma and large cell neuroendocrine carcinoma, but is very rare with typical and atypical carcinoids.

[Extrarenal retroperitoneal angiomyolipoma: description of a case and review of the literature]. / Angiomiolipoma retroperitoneale extrarenale: descrizione di un caso e revisione della letteratura.

A case of retroperitoneal extrarenal angiomyolipoma is described. The patient, a 61-year-old woman, presented with a large retroperitoneal lipomatous mass. Histologically, it consisted of lipomatous tissue. Focally, there was interstitial and perivascular proliferation of bland oval and epithelioid cells with a large, eosinophilic or clear cytoplasm. Immunohistochemically, these elements were positive for smooth muscle actin and HMB-45. The literature on retroperitoneal extrarenal angiomyolipoma is briefly reviewed. It is important that the pathologist recognize this lesion, even when it is located in the retroperitoneum outside the kidney, and differentiate it from a liposarcoma.

[Localized lymph node lymphangiomyoma. Description of 2 cases]. / Linfangiomioma linfonodale localizzato. Descrizione di due casi.

Lymphangioleiomyomatosis is a rare disease characterized by an immature-appearing smooth muscle proliferation in the lung and along axial lymphatics. Rarely it is limited to lymph nodes, without extranodal disease. Two cases of localized nodal lymphangiomyoma in a 48 and 54 year-old women are presented: in both cases the lesion was limited to pelvic lymph nodes and it was an incidental finding during staging for tumours of the gynaecological tract.

[Malignant melanoma with pseudoepitheliomatous reaction marker. A case report]. / Melanoma maligno con marcata reazione pseudoepiteliomatosa. Descrizione di un caso.

Pseudoepitheliomatous hyperplasia or pseudocarcinomatous hyperplasia (PEH) is characterized by a downward expansion of the epidermis, which can simulate a squamous cell carcinoma (SC). It is usually associated to chronic inflammatory conditions, but rarely it can hide a tumour. In the present paper a case of melanoma (M) associated with a prominent PEH is described. The patient is a 79-year old woman who presented a polypoid, ulcerated lesion of the left thigh. The lesion was entirely removed. The patient is free of disease 5-years after surgery. On histology, the malignant melanomatous proliferation was closely admixed to sheets of squamous cells. The possibility of SC was excluded as the squamous component did not show architectural disarray, prominent nucleoli and atypical mitoses. Siringomatous metaplasia was observed in the deeper portion of the lesion. On the basis of these findings the diagnosis of melanoma (M) associated to prominent PEH was considered the most likely.