Mucinous breast carcinoma presenting as Paget's disease of the nipple in a man: a case report.

INTRODUCTION: Male breast cancer is rare compared to its female counterpart representing less than 1% of cancer in men. Moreover, mucinous carcinoma of the male breast is an extremely rare histological subtype of malignancy. Paget's disease of the nipple is rarely observed in males. CASE REPORT: Herein, we describe a unique case of an 86 years old man with mucinous breast cancer presenting as Paget's disease of the nipple. According to the immunohistochemical evaluation the neoplastic cells were positive for estrogen (ER) and progesterone receptors (PR). CONCLUSION: To our best knowledge this is the first case of mucinous male breast cancer presenting as Paget's disease of the nipple.

Ruptured hemangioma of the umbilical cord and intrauterine fetal death, with review data.

A case of intrauterine fetal death with rupture of a hemangioma in the umbilical cord is presented. Hemangiomas are uncommon tumors of the umbilical cord, and their clinical significance is not entirely clear, but associations with polyhydramnios, fetal disseminated intravascular coagulation, and fetal hydrops have been described. In a high proportion of the umbilical cord hemangiomas reported in the literature (32 cases), the fetus had died in utero as in the present case and only ten cases were vital and completely normal infants. Associated malformations and complications of the umbilical cord hemangioma are reviewed.

Immunohistochemical analysis of expression of bcl-2 protein in papillary carcinomas and papillary microcarcinomas of the thyroid gland.

AIM: To compare the expression of anti-apoptotic protein bcl-2 and tissue proliferation Ki-67 antigen in tissues of human papillary thyroid carcinoma (PTC) and papillary thyroid microcarcinoma (PTMC). METHODS: Bcl-2 protein expression in PTC and PTMC has been evaluated by immunohistochemical analysis. RESULTS: Bcl-2 protein was observed in normal thyroid gland in all the cases; in 25% of the cases of papillary carcinomas the immunoreaction was strong and in 75% of the cases--moderate. In 25% of the cases of papillary microcarcinomas the bcl-2 expression was totally negative and 35% was moderate. Bcl-2 expression was lower in non-sclerosing non-encapsulated (NSNE) (25%) cases of PMCs than in non-sclerosing encapsulated (NSE) (57.15%) cases of PTMCs (p < 0.05). MIB-1/Ki-67 expression was notably reduced or not expressed in normal and benign thyroid tissue. MIB-1 immunoreactivity was present in papillary carcinoma, and on a lower level--in PTMCs. The MIB-1 labelling index of NSE and sclerosing non-encapsulated (SNE) cases was lower than that in NSNE (p < 0.005). CONCLUSION: The present study indicated that NSNE cases of PTMCs may be an early stage in tumor progression, and the bcl-2 and MIB-1 immunohistochemistry may be a valuable tool in predicting the malignant behavior in PMTCs, and contributes to the understanding the growth characteristics of papillary carcinomas of the thyroid gland.

Histologic comparison of vibrating guidewire with conventional guidewire technique in an experimental coronary in vivo model.

PURPOSE: To compare the damage caused by vibrating guidewire manipulation and conventional guidewire manipulation of soft coronary wires in normal sheep coronary arteries. METHODS: Using an intact sheep model the two methods of passing a coronary guidewire down a normal coronary artery under fluoroscopic screening control were studied. The resulting arterial damage caused by the two techniques was studied histologically. The severity of damage was scored from 1 (no damage) to 4 (severe damage) and expressed as: (a) percentage of damaged sections, (b) mean damage score per section and (c) percentage of sections suffering the most severe degree of damage (scores 3 and 4). RESULTS: One hundred and sixty-eight sections were studied. The percentage of damaged sections was lower in the vibrating guidewire group (p = 0.004). The mean damage score and the percentage of sections with a damage score of 3 or 4 were smaller in the vibrating guidewire group than in the conventional guidewire manipulation group (p = 0.001 and p = 0.009, respectively). CONCLUSIONS: Both methods of guidewire manipulation cause identifiable vascular damage. The extent and severity of damage appear greater when the guidewire is manipulated manually.

Immunohistochemical study of the expression of S-100 protein, epithelial membrane antigen, cytokeratin and carcinoembryonic antigen in thyroid lesions.

The diagnosis of papillary carcinoma of the thyroid is based on the two morphological features that best characterize this tumor, the papillae and the nuclear changes. However, both the architectural and cytological hallmarks may be encountered in other conditions such as multinodular goiter, Grave's disease, thyroiditis and hyperplastic areas of follicular neoplasms and thus produce problems in the histopathological interpretation. The distinction of these lesions from papillary carcinoma has important implications for clinical management. Thus the availability of supportive diagnostic evidence would be helpful. In the present study we compared the immunoreactivity for S-100 protein, epithelial membrane antigen (EMA), cytokeratin (Ck) and carcynoembryonic antigen (CEA) in different thyroid pathologies. We conclude that the strong expression of S-100 protein, in combination with EMA expression, is of value in identifying papillary neoplasia and distinguishing it from papillary hyperplasia.

Occult thyroid carcinoma. A study of 160 autopsy cases. The first report for the region of Epirus-Greece.

Thyroid glands from 160 patients, aged 11 to 95 years, without known thyroid disease, collected from medicolegal autopsies, were sectioned at 3-5 mm slices and microscopically examined for occult disease. The glands were normal in 57.9%, while nodules were observed in 16.8% and adenomas in 10.6% of the cases. Carcinomas were found in 12 cases (7.7%) and occult papillary carcinomas in 5.6%. No carcinomas were found in the thyroids of patients less than 40 years of age. There were no significant differences in frequency of occult carcinomas between female and male patients. The diameter of these tumors was less than or equal to 5 mm, with one exception, which had a diameter more than 6 mm. The aim of this article is to provide data about the frequency of occult thyroid tumors in the population of Epirus, which is a district in the north west part of Greece.