Microglandular adenosis, apocrine adenosis, and tubular carcinoma of the breast. An immunohistochemical comparison.

Four cases of microglandular adenosis (MA), together with four cases of apocrine adenosis (AA) and 10 cases of tubular carcinoma (TC) of the breast were studied at the light and immunohistochemical level. One case of MA was studied with electron microscopy. MA is characterized by an absence of myoepithelial cells (ME), epithelial membrane antigen (EMA), and gross cystic disease fluid protein (GCDFP-15). The absence of EMA in MA makes it unique among benign glandular hyperplasias of the breast. AA contains myoepithelial cells and a distinct basal lamina. It is characterized by the presence of GCDFP-15, the specific apocrine marker, which is not present in MA. TC lacks both myoepithelial cells and a basal lamina. It is negative for GCDFP-15. Periductal and vascular elastosis are common and usually prominent, whereas they are not found in either MA and AA. Other stromal changes further distinguish the three lesions. These three distinct entities can be separated objectively and unequivocally and it is essential that this be done so as to prevent confusion.

Squamous cell carcinoma with prominent myxoid stroma.

Three cases of a squamous cell carcinoma with a prominent myxoid stroma are reported. One case in a 70-year-old woman had presented as a lump in the breast, the other two presented as polypoid lesions of the larynx and cervix uteri in a 65-year-old man and 61-year-old woman, respectively. The carcinomatous component was immersed in abundant extracellular mucosubstances. In addition to occasional squamous pearls, it displayed immunocytochemical evidence of high-weight keratin present in the neoplastic cells and, in one case, desmosomal attachment under electron microscopy. The extracellular mucosubstances proved to be similar to those seen in connective tissue. The differential diagnosis with histologically similar lesions has been taken into consideration, and it has been suggested that this newly described entity showing abundant myxoid stroma has to be distinguished from numerous benign and malignant myxoid soft tissue tumors.

Oat-cell carcinoma of the oesophagus: a recently recognized entity.

A primary oat-cell carcinoma of the oesophagus is described with an adjacent squamous carcinoma, both parts having characteristic ultrastructure. The origin of this mixed tumour is discussed together with the literature on oesophageal carcinomas having an oat-cell pattern.

Oat cell carcinoma of the esophagus. Report of a case.

A case of primary oat cell carcinoma of the esophagus is described. The oat cell pattern appeared intermingled with small areas of squamous carcinoma. The origin of this mixed tumor is discussed together with the literature on esophageal carcinomas with an oat cell pattern.

Strumal carcinoid of the ovary: an immunohistochemical and electron microscopic study.

A case of strumal carcinoid of the ovary is reported. The follicles contained T4-immunoreactive substance, whereas the carcinoid component of the tumor had a trabecular structure and showed argyrophilic elements. Pancreatic-polypeptide and enteroglucagon were localized in these cells by an immunocytochemical method. The same cells displayed small electron-dense endocrine-like granules. A common precursor for the thyroid and carcinoid components is postulated.

Endocrine differentiation in basal cell carcinoma.

Argyrophilic cells have been found in 2 different basal cell carcinomas (BCC), and membrane-bound endocrine-like granules, in the carcinoid range, have been observed in 4 consecutive cases of such tumors. It is postulated that BCC can occasionally display cells showing an endocrine differentiation.

Hypophosphatemic oncogenic osteomalacia: report of three new cases.

Three cases of connective tissue tumors causing hypophosphatemic osteomalacia are reported and the literature is reviewed. In two of our patients the tumors were completely excised with total disappearance of the symptoms. In one case a total excision was not possible and the symptoms of this patient have not completely disappeared. The substance responsible for the syndrome has not been identified yet, but probably interferes with vitamin D renal hydroxylation, thus causing osteomalacia. As more than 30 per cent of cases of this condition have been reported in the last 5 years, it is suggested that these tumors are more frequent than previously believed.

Epithelial-myoepithelial carcinoma of the parotid gland: a clinico-pathologic and immunohistochemical study of seven cases.

Seven cases of epithelial-myoepithelial carcinoma of the parotid gland are reported. Immunohistochemical evidence for the dual (glandular secretory and myoepithelial) differentiation of the cells composing these lesions is presented. Three of the cases recurred locally and two gave rise to metastases. The biologic behavior does not appear to be correlated with the histologic features that constitute the morphologic spectrum of epithelial-myoepithelial carcinoma.

Establishment of a human medulloblastoma cell line (BO-101) demonstrating skeletal muscle differentiation.

A permanent cell line, BO-101, was derived from a classic vermian medulloblastoma in a 9-year-old child. This line grew in vitro in adherent cultures and grew in athymic mice as serially transplantable intracranial and subcutaneous xenografts. Intracranial neoplasms grew as masses of small cells, which focally showed large cells with intense immunoreactivity for desmin, myoglobin and alpha-striated actin. The rhabdomyoblastic nature of these cells was confirmed ultrastructurally. The primary neoplasm showed immunoreactivity for synaptophysin, neuron-specific enolase and vimentin. A large panel of monoclonal antibodies and antisera against neuronal and glial antigens failed to show glial and neuronal immunoreactivity in the cell culture and xenografts. Despite the marked genotypic and phenotypic differences, the original neoplasm and the cell line share a common chromosomal marker del (12) (p 13.1). The BO-101 line differs phenotypically and genotypically from previously established medulloblastoma cell lines and further supports the heterogeneous biologic properties of the cell populations that constitute these neoplasms.

Cytological features of nipple adenoma in scraping smears.

INTRODUCTION: Nipple adenoma (NA) is a benign epithelial lesion of the breast that can clinically simulate Paget's disease or invasive ductal carcinoma. Therefore, correct pre-operative diagnosis is important for appropriate management. METHODS: Cytological samples may be obtained by different methods such as fine needle aspiration, nipple discharge or nipple scraping. Herein, the cytological features of three cases of NA are described in which samples were derived from nipple scraping. RESULTS: In all three cases, patients were adult females presenting with a sub-areolar nodule, showing skin ulceration in 2 of 3 cases. The nipple scraping cytological smears were characterised by a bloody background with epithelial cells arranged in clusters or singularly, showing an irregular nuclei profile. These features could simulate a malignant process. However, at higher magnification, fine nuclear chromatin with inconspicuous nucleoli and presence of myoepithelial cells were helpful to exclude malignancy. DISCUSSION: NA may present "worrisome" cytological features on smears derived from nipple scraping. Therefore, knowledge of the cytological spectrum of this lesion is important to avoid misdiagnosis.

Tumours of the skin adnexa: a case series with focus on multiple segmental forms.

OBJECTIVE: Skin adnexal tumours (SAT) as a whole are rare tumours, and most of our current knowledge on SAT is from single case reports or small series focused on single histotypes. The purpose of this paper is to review a series of benign and malignant SAT diagnosed in a 20-year period. METHODS: All consecutive cases of SAT diagnosed between January 1992 and Dicember 2011 were retrieved. All slides were reviewed and diagnosed according to currently accepted criteria. RESULTS: 281 consecutive cases of SAT were found. The majority of cases (94.3%) were benign, the most frequent histotypes were eccrine spiradenoma, hidrocystoma, eccrine poroma, syringoma, sebaceous adenoma and trichofolliculoma. Benign SAT affected adult males more frequently (M/F = 153/112) (mean age 59 years). Recurrences were rare (2/265). Three cases of multiple segmental spiroadenoma were observed. Malignant SAT consituted only 5.7% of all cases comprising sebaceous carcinoma, extramammary Paget disease and apocrine carcinoma. There was a slight female predilection (M/F = 7/9) (mean age 72 years), although patients were older than those affected by benign SAT. All neoplasms were small and no recurrences were recorded. CONCLUSION: SAT are rare and most frequently benign. Correct diagnosis and complete surgical removal are important.

Primary oat-cell carcinoma of the larynx.

A primary oat-cell carcinoma of the larynx in a 63-year-old man is reported. The oat-cell pattern appeared intermingled at one edge with a squamous carcinoma. The origin of this mixed tumour is considered together with the literature of extrapulmonary carcinomas having an oat-cell pattern.

Ultrastructural organization of nucleoli in benign naevi and malignant melanomas.

We have studied the ultrastructural organization of nucleoli in benign naevi and malignant melanomas. In benign naevus cells the nucleoli displayed a compact ribonucleoprotein distribution, with one or two large fibrillar centres. In malignant melanoma cells the nucleoli were large with an irregular, nucleolonema-like ribonucleoprotein distribution and they exhibited numerous, small fibrillar centres. Statistical evaluation of the size of fibrillar centres indicated a mean value of 0.482 micron 2 +/- 0.136 SD for naevi and 0.221 micron 2 +/- 0.128 SD for malignant melanomas. These features, together with the more dispersed chromatin pattern of malignant melanoma nuclei compared with those of benign naevus cells, are proposed as diagnostic parameters which differentiate benign naevi from malignant melanomas at the ultrastructural level.

Primary sarcomatoid carcinoma of the adrenal gland. First case report.

The first case of a sarcomatoid carcinoma of the adrenal gland is reported. The patient, a 68-year old woman, developed a recurrence two months after presentation and died of the disease 7 months later with multiple metastases. The differential diagnosis of this entity is discussed and its aggressive behaviour is emphasized.

Ultrastructural changes in beta-cells of pancreatic islets in alpha-amanitin-poisoned mice.

In mice poisoned by alpha-amanitin nuclear changes typical of this toxin were observed in beta-cells of pancreatic islets. The lesions became progressively more severe and at 48 h after toxin injection some cells were necrotic. The damage to these cells could have implications in the changes in glycogen metabolism which occur after alpha-aminitin poisoning.

Tubular carcinoma: a variant of secretory breast carcinoma.

Fifteen cases of tubular carcinoma of the breast have been studied using histochemical methods for mucosubstances, immunocytochemical methods for casein and actin and conventional electron microscopy. Mucosubstances and casein were demonstrated lying freely in the lumina of the tubules. Occasionally, mucosubstances and casein assumed the form of target-like intracytoplasmic 'inclusions' like those characteristically seen in lobular carcinoma. The neoplastic cells did not react with antisera specific against actin. Even at ultrastructural level no myoepithelial cells were observed, whilst villi were revealed along the tubular luminal surface. It appears that, in addition to distinctive biological, histological and ultrastructural features, tubular carcinoma has an almost constant histochemical pattern. This suggests a differentiation towards epithelial secretory cells engaged in intensive milk protein production which has also been shown to be a feature of lobular carcinoma. It is concluded that though lobular carcinoma and tubular carcinoma of the breast have been traditionally regarded as two distinct entities, they have certain similar functional characteristics and it is postulated that these two tumours could represent the extreme variants fo the same entity: the infiltrative lobular carcinoma being the most undifferentiated and tubular carcinoma the most highly differentiated.

Progressive hyperpigmentation: case report with a clinical, histological, and ultrastructural investigation.

A clinical, histological and ultrastructural study of a 38-year-old woman with generalized progressive hyperpigmentation is reported. Hyperpigmentation started in early infancy, progressed during childhood and has increased to a dark bronze-brown color with 'mottling' in the last 8 years. Histology and electron microscopy revealed epidermal hypermelanosis and 'negroid' distribution of melanosomes in keratinocytes. In our family, autosomal dominant phenotype transmission with 'variable expression' is suggested. The literature on the entity has been reviewed. This case is another rare example of familial progressive hyperpigmentation.

Massive neuronal destruction in human immunodeficiency virus (HIV) encephalitis. A clinico-pathological study of a pediatric case.

Human immunodeficiency virus (HIV) encephalitis in children with AIDS includes a diffuse white matter disease associated with an inflammatory cell infiltrate that features multinucleated giant cells. Cerebral cortex is relatively preserved and only focal loss of Purkinje cells in the cerebellum has been observed. We describe a case of encephalitis in a child with AIDS in which there was massive and diffuse destruction of the cerebral cortex with severe neuronal loss, marked inflammatory perivascular infiltrate with abundant multinucleated cells and large pleomorphic reactive astrocytes. Similar findings were present in the basal ganglia. Moreover, the cerebellum disclosed a complete loss of Purkinje and granule cells. These findings could not be related to an ischemic mechanism or to an associated opportunistic infection. Electron microscopy showed numerous HIV particles. This case illustrates a different pattern of CNS involvement by HIV and emphasizes the destructive capacity of this neurotropic virus for neural tissue.

Myoepithelial cells in lobular carcinoma in situ of the breast: a parallel immunocytochemical and ultrastructural study.

The distribution and morphology of myoepithelial cells in one case of normal breast and in 4 cases of lobular carcinoma in situ (LCIS) were studed by immunoperoxidase and immunofluorescence with anti-actin antisera and by electron microscopy. The actin-rich cells appeared to lay flattened on the basement membrane, or perpendicular to it, or appeared dislodged toward the center of the neoplastic ductules in the different cases. It is proposed that the presence of actin-rich cells inside the neoplastic aggregates represents a process of colonization of lobular carcinoma by myoepithelial cells dislodged from the basement membrane; a differentiation of some neoplastic cells toward myoepithelial elements might also be taken into consideration. The features here described could identify a preinvasive stage of LCIS.