Lymphoepithelial carcinoma of the minor salivary gland.

Undifferentiated carcinoma of the minor salivary glands has been rarely reported in the world literature. Lymphoepithelial carcinoma, which is a variant of undifferentiated carcinoma, is distinguished from small cell and large cell undifferentiated carcinoma by its association with benign lymphoepithelial lesions. We report a case of a lymphoepithelial carcinoma developing in a minor salivary gland of the oral cavity in a 69-year-old woman. To our knowledge, this is the first reported case of a lymphoepithelial carcinoma arising from a minor salivary gland.

A 67-year-old woman with gastrointestinal hemorrhage and chronic hepatitis.

The hepatitis C virus (HCV) is responsible for the majority of cases of non-A, non-B hepatitis. Affected patients are usually asymptomatic when initially infected; however, between 70% and 80% will maintain infection and develop chronic liver disease. Of these patients, 20% to 50% progress to cirrhosis, and up to 15% may develop hepatocellular carcinoma. Thus, many patients have significant liver disease when diagnosed. The following case report describes a patient with cirrhosis secondary to hepatitis C, transferred to our institution to manage complications related to portal hypertension.

Polypoid pulmonary endodermal tumor resembling fetal lung: report of a case.

Pulmonary blastoma is a rare malignant neoplasm that histologically resembles airway structures and mesenchymal supporting tissues seen in the early phases of fetal lung development. The tumor either is biphasic with immature epithelial and stromal components or consists solely of an epithelial component. The preferred terminology for the latter is pulmonary endodermal tumor resembling fetal lung. Pulmonary blastoma is usually peripheral in location, and rarely does this tumor present intrabronchially. We report a case of pulmonary endodermal tumor resembling fetal lung presenting as a polypoid intrabronchial mass.

Multilocular renal cyst (cystic nephroma) with müllerian-like stroma.

Multilocular renal cyst is an uncommon lesion of controversial histogenesis. The authors report a case of renal multilocular cyst with müllerian (ovarian)-like stroma. We suggest that this finding would support a dysontogenetic origin for the lesion.

Superior vena cava syndrome associated with malignant mesothelioma.

A 70-year-old former shipyard worker presented with dyspnea and edema of the upper thorax suggesting the diagnosis of superior vena cava syndrome. Further evaluation revealed mesothelioma with both epithelial and spindled histologic patterns. The extensive mesothelioma had invaded the adventitia of the superior vena cava, the pleura of the lungs bilaterally, the superficial myocardium, and the liver. A terminal hyercoagulable state with great vein thrombosis was also contributory. To our knowledge this is the first documented case of superior vena cava syndrome associated with malignant mesothelioma.

Giant cell interstitial pneumonia.

Giant cell interstitial pneumonia is a distinctive and uncommon form of interstitial pneumonia. It is distinguished by the prominence of large, actively phagocytic alveolar giant cells of histiocytic origin in the presence of chronic interstitial pneumonia. Multinucleated type 2 granular pneumocytes are also identified. The multinucleated cells lack viral intranuclear inclusions of the type seen in measles pneumonia. Giant cell interstitial pneumonia may be idiopathic or it may occur with occupational exposure to hard metals or cobalt. We report this case to give recognition to an uncommon interstitial pneumonia.

Metastatic amelanotic melanoma simulating giant-cell tumor of bone.

A case of metastatic malignant melanoma simulating a giant cell tumor of bone is reported. This case typifies the diversity of expression of malignant melanoma. Osteoclast-like giant cells were present only in the femoral head metastasis and were not present in the primary lesion. The giant cell component may be reflective of an inherent and indiscriminant expression which may be seen in a variety of neoplastic bone lesions.

Oxyphilic (Hürthle cell) adenoma arising in a black thyroid gland.

We report this case to further document in the literature morphologic changes encountered in a black thyroid gland. It is only through an expanding data base that future conclusions may be reached regarding the role, if any, of minocycline in some of these alterations.

Myoid hamartomas of the breast.

Tumors containing smooth muscle are rare in the breast. A myoepithelial origin for the myoid component of such lesions was postulated in previous reports. Myoepithelial hyperplasia has long been recognized as a common component of some breast lesions, including sclerosing adenosis, papillomas, and fibroadenomas. Three breast tumors composed of variable admixtures of adipose tissue, fibrous tissue, and smooth muscle are described. The authors postulate that the myoid component of two of the three lesions may have arisen in a milieu of myoepithelial hyperplasia. The origin of the myoid component in the third case is not clearly defined.

Bronchogenic sarcomatoid squamous cell carcinoma with osteoclast-like giant cells.

A 60-year-old man developed a widely metastatic spindle cell neoplasm with admixed osteoclast-like giant cells indistinguishable from malignant giant cell tumor of soft parts. Autopsy revealed a bronchogenic sarcomatoid squamous cell carcinoma that was the primary source of the sarcomatoid metastases. The osteoclast-like giant cells in the metastatic lesions were negative for lysozyme on immunoperoxidase staining. This finding suggested that the multinucleated giant cells were not formed as a cellular response to hemorrhage or to cellular debris induced by the tumor. Extraosseous neoplasms with osteoclast-like giant cells are rare neoplasms that may occur in a variety of organs. This case is the second reported case of a primary neoplasm in the lung that contained these osteoclast-like giant cells. These tumors may cause considerable diagnostic confusion.

Ossifying fasciitis.

Metaplastic bone is an uncommon finding in cases of fasciitis. It has been reported only in occasional cases in series of patients with nodular fasciitis, parosteal fasciitis, proliferative fasciitis, and proliferative myositis. Ossification is relatively common in cranial fasciitis of childhood, a form of fasciitis that may originate in cranial periosteum. We studied a patient with ossifying fasciitis that occurred along the adventitia of the femoral artery, at the site of an earlier angiographic study.

Basaloid carcinoma of uterine cervix.

Basaloid carcinoma is an uncommon tumor of the uterine cervix which has received little recognition in the medical literature. It is characterized by: 1) an ulcerated infiltrating growth pattern, 2) nests or cords of small basaloid cells, 3) prominent peripheral palisading of cells in the tumor nests, and 4) no significant stromal reaction. This cervical neoplasm is an entity distinguishable from adenoid cystic carcinoma, undifferentiated small-cell carcinoma, carcinoid tumor, and regional basaloid patterns in otherwise typical squamous cell carcinoma.

Pentazocine abuse. Report of a case with pulmonary arterial cellulose granulomas and pulmonary hypertension.

We report a patient who developed pulmonary hypertension following repeated intravenous injection of dissolved pentazocine tablets. Through analysis of lung biopsy material, this was shown to be due to embolization of the cellulose filler in the tablet and the tissue reaction it produced. Administration of prednisone appeared to improve the patient's clinical state.

Mucogenic cells of congenital adenomatoid malformation of lung.

Findings of a histochemical and ultrastructural study of the mucogenic cells of congenital adenomatoid malformation of lung indicate that these cells share features with goblet cells of bronchial or intestinal origin and do not indicate a similarity to normal gastric epithelium or glands, as has been previously suggested.

Functioning lipoadenoma of the parathyroid gland.

Lipoadenoma is a rare tumor of the parathyroid gland composed of adult adipose tissue and irregular trabeculae of parathyroid cells. This variant of adenoma is poorly documented. Similar lesions that have been either functional or apparently nonfunctional have been reported as adenoma with unusual stromal development and as parathyroid hamartoma, respectively. In this report, the second case of a functional lipoadenoma of the parathyroid gland is described.