Heterogenous expression of endothelial cell markers in infantile hemangioendothelioma. Immunohistochemical study of two solitary cases and one multiple one.

Three cases of infantile hemangioendothelioma were immunohistochemically studied with the use of antibodies against von Willebrand factor (vWF), Ulex europaeus I lectin (UEA I), vimentin, thrombomodulin (TM), and actin, as endothelial cell (EC) markers. Because of a broad variety of histologic features, the growth pattern of the tumor cells was subclassified into the following four subtypes: capillary, sinusoidal, cavernous, and myxomatous parts. The solitary tumor from patients 1 and 2 was composed of these four components, but the multiple tumor in the patient 3 consisted of capillary and sinusoidal parts. Immunohistochemically, vWF and vimentin were dominantly expressed in the ECs of the cavernous and myxomatous parts. UEA I had strongly positive results in all histologic types, except the myxomatous part. Expression of vWF and vimentin in neoplastic EC suggests that functional differentiation of the tumor tissue occurs in the myxomatous and cavernous parts and may be related to the spontaneous regression of the infantile hemangioendothelioma.

Condylomatous carcinoma of the vulva with special reference to human papillomavirus DNA.

Nine cases of condylomatous carcinoma (squamous cell carcinoma arising in condyloma acuminatum) of the vulva were studied for their clinical history, histopathology, and presence of human papillomavirus (HPV) DNA. Condylomatous carcinoma occurred primarily in an elderly population with a mean age of 70 years. There was an antecedent history of vulvar condyloma in 77%, with a median of nine months before the documentation of an invasive lesion. The disease had a good prognosis, with few recurrences and no metastasis or deaths from the disease. Human papillomavirus DNA was demonstrated to be present in 55% of these tumors by either filter or in situ hybridization techniques. Both HPV 6 and HPV 16 DNA were identified in an equal number of cases.

Congenital multiple plaquelike glomus tumors.

We encountered two patients with congenital multiple plaquelike glomus tumors. These lesions were present at birth and enlarged with body growth, attaining a diameter of up to 13 cm. The diagnosis was confirmed by histologic and electron-microscopic examination, which revealed the typical changes of glomus tumors. Immunocytochemistry findings demonstrated the tumor cells to be vimentin- and alpha-smooth muscle-actin-positive and desmin-negative. On ultrastructural examination, typical dense bodies and attachment plaques were easily found within the tumor cells. Glomus cells were coated by a thick basal lamina.

Co-existent anaplastic and well differentiated thyroid carcinomas: a nuclear DNA study.

Clonal transformation of well differentiated follicular or papillary carcinomas has been suggested as a mechanism by which anaplastic carcinomas of the thyroid might arise. Of 126 cases of anaplastic (giant cell) carcinomas, 17 (13.5%) contained histologically well differentiated tumour foci within or adjacent to the high grade malignant anaplastic tumour. Cytophotometric DNA analysis after Feulgen staining was performed on 11 cases in order to evaluate ploidy of the anaplastic and the well differentiated tumour cells. The majority of these co-existent carcinomas (9/11) were papillary. All 11 anaplastic carcinomas demonstrated an aneuploid DNA pattern which correlated with a poor clinical outcome (7 of 11 died of disease in less than 6 months). In contrast six co-existent papillary and one co-existent follicular tumours were diploid. These data show that the co-existence of anaplastic and well differentiated carcinoma occurs only rarely and when it occurs only one third of the well differentiated tumours contain aneuploid tumour cells. This suggests that in the majority of cases of anaplastic thyroid carcinoma the malignant cells arise de novo rather than through clonal transformation of well differentiated carcinomas.

Gangliocytic paraganglioma associated with duodenal adenocarcinoma. Case report with immunohistochemical evaluation.

We present the first reported case (to our knowledge) of duodenal gangliocytic paraganglioma (GPG) to be associated with an underlying invasive adenocarcinoma. The patient, a 71-year-old man, presented with epigastric tenderness and was found to have metastatic adenocarcinoma in two regional lymph nodes. Immunohistochemical evaluation of the GPG demonstrated positive staining for gastrin, glial-fibrillary acidic protein, glucagon, neuron-specific enolase, pancreatic polypeptide, S100 protein, somatostatin, and substance P. The clinical, pathologic, and immunohistochemical features of GPG are discussed, with a review of the literature.

[The association of neuro-endocrine carcinoma of the skin and Bowen's disease. Review of the literature apropos of 4 cases]. / Association d'un carcinome neuro-endocrine cutané et d'une maladie de Bowen. Revue de la littérature à propos de quatre cas.

Four cases of neuroendocrine carcinoma following Bowen's disease are presented. An immunohistochemical study was performed. The four patients, 3 men and a woman, ranging from seventy to eighty-seven years of age, developed a nodular tumor on a preexisting cutaneous lesion. In one of those cases the diagnosis of Bowen's disease was confirmed histologically before the apparition of the nodular tumor. The tumors were localized on the scalp, thorax, dorsum of the hand, and the scrotum. The four tumors were immunohistologically typical of neuro-endocrine carcinoma: there was a positivity for neurofilaments, cytokeratins and neurone-specific enolase. The clinico-pathological characteristics of those 4 neuro-endocrine carcinomas associated with a Bowen's disease, when compared with the 15 similar described in the literature, are identical to the isolated neuroendocrine carcinoma, from a clinical, morphological and evolutional point of view. The majority are seen in patients older than 60 years old and one third of the cases described survived at least 5 years. The coexistence of Bowen's disease and neuroendocrine carcinoma, the association of neuroendocrine and epidermoid cells in other cutaneous tumors, reactivate the controversy concerning the histogenesis of the so-called Merkel cell carcinoma. In fact, the histogenesis of the tumor is still not fully understood.

[Biological essence of the squamous-cell structures in 2-component endometrial cancer]. / O biologicheskoi sushchnosti ploskokletochnykh struktur v dvukhkomponentnykh rakakh endometriia.

Combined comparative study of anatomo-histological features, proliferative activity, content of X-chromatin, and ploidy of the nuclei of epithelial structures of 7 adenoacanthomas, 8 glandular-squamous cell carcinomas, and 7 adenocarcinomas (control group) of the endometrium was carried out. Microspectrophotometry of DNA revealed heterogeneity in DNA content and polyploidy typical of malignant growth in all cell populations, including squamous cell component of adenoacanthomas. The correlation between reduced degree of histological differentiation, depth of invasion, and decreased number of nuclei containing X-chromatin bodies as well as the occurrence of histological transitions suggest that adenoacanthomas and glandular-squamous cell carcinomas should be regarded as one group of two-component endometrial tumors and the terms used for their designations as synonyms. Within this group, highly and poorly differentiated variants may be distinguished which is of prognostic importance.

Multiple apocrine hidrocystomas on the eyelids.

A 31-year-old man with multiple cystic tumors symmetrically distributed on his eyelids is presented. Histopathology and immunohistochemistry suggest the diagnosis of apocrine hidrocystomas. Apocrine hidrocystomas occur frequently on the face, but multiple and symmetrical occurrence on the eyelids has not been reported up to now.

Immunohistochemical and radioimmunological determination of beta-HCG and pregnancy-specific beta 1-protein in seminomas.

38 pure and 11 mixed seminomas were studied with the peroxidase-anti-peroxidase method for the presence of chorionic gonadotropin (beta-HCG) and pregnancy-specific beta 1-glycoprotein (SP1). HCG was found in 8 of 49 cases, SP1 in 5 of 49 cases in syncytial and mononuclear giant cells. The 5 pure seminomas with positive tumor markers appear to have no worse prognosis than pure seminomas without HCG or SP1 production. None of the seminomas was found to contain carcinoembryonic antigen or alpha-fetoprotein.

Multiple clustered dermatofibromas. Evolution over 20 years.

A 37 year-old man developed, over 20 years, multiple clustered dermatofibromas on the left thigh. Three similar cases have been described previously and the benign course of this lesion has been referred to. Analysis of collagen amino acids revealed a sharp increase of hydroxylysine on the fibrous central zone, suggesting an abnormal accumulation of type IV collagen.

[Clinical study of multiple primary cancers including lung cancer].

Out of a total of 506 lung cancers treated between 1977 to 1988, a total of 27 (5.3%) multiple primary cancers were uncovered. The patients consisted of 20 males and 7 females and their average age was 67 (48-81) years. The frequency seen in the histological type of patient with multiple primary cancers was the same as that seen in their background lung cancers. Twenty-one (78%) patients were smokers. Thirteen patients (45%) had a family history of cancer. Two cases had 3 family members who had a cancer history. The tumor DNA contents of 2 cases with multiple primary cancers were analyzed. In both cases, the DNA indices were found to differ between the first and the second cancer. Thus, it may be possible to identify multiple primary cancers by determining the tumoral DNA content.

DNA flow cytometry applied to fine needle sampling of human breast cancer.

Breast cancer cells can be obtained directly from the patient with minimal trauma by fine needle sampling (FNS). A method was developed that enabled us to prepare tumor cell nuclei for ploidy determination by flow cytometry (FCM). Fine needle sampling was performed on 235 patients with clinically suspected malignancy. Two hundred sixteen specimens (92%) produced enough material for assessment; 206 were diagnosed as cytologically malignant. In 41 patients surgical specimens from the same tumors were available. Thirty-eight of these specimens (93%) were classified according to ploidy. No significant correlation was found between aneuploidy and clinical stage (size and lymph node involvement). The comparison of DNA histograms from 21 primary breast tumors and homolateral axillary lymph nodes showed mostly similar patterns. On the contrary, eight of nine synchronous bilateral cancers were shown to have different ploidy. Flow-cytometry-derived DNA histograms of fine needle samples could be a valuable tool in the management of breast cancer.

Quantitative x ray microanalysis of pulmonary mineral particles in a patient with pneumoconiosis and two primary lung tumours.

The right upper lung lobe of a 74 year old man was resected for a central tumour. Two primary cancers were found; a central small cell carcinoma and a peripheral squamous cell carcinoma. In addition, the peripheral lung tissue showed generalised peribronchiolar fibrosis extending from the non-respiratory bronchioles to the level of the alveolar ducts. Abundant asbestos bodies and large amounts of black dust were seen around the bronchioles. Pulmonary mineral particles were studied by quantitative energy dispersive x ray microanalysis (EDS) using scanning transmission electron microscopy (STEM). The x ray spectra for mineral particles were measured in thin sections, and the characteristic peak intensities of the elements were converted to weight fractions (in oxides). The results enabled the minerals present to be identified and their presence confirmed by calculating the mineral formula. These originated from nine natural minerals, anthophyllite and chrysotile asbestos, talc, and quartz, feldspars, and muscovite, which are components of sand, and also from two artificial mullites used in fire clay. The exposure history of the patient explained the most likely origins of the minerals detected. The patient had been a mason for 23 years, repairing and demolishing stoves and fireplaces and using asbestos for insulation work.

[Estrogen receptor status of breast cancer patients]. / Untersuchungen zum Ostrogenrezeptorstatus vom Mammakarzinompatientinnen.

Reported in this paper are studies conducted into oestrogen receptor levels of 103 patients with mammary carcinoma, with the dextran-carbon method being used. The findings thus recorded are discussed for their clinical relevance. Recorded were correlations between quantitative oestrogen receptor levels, on the one hand, and menopausal status, grading, histological typing, and tumour size, on the other.

[Malignant schwannoma arising in Recklinghausen's disease--report of 4 cases].

Four cases of malignant schwannoma arising in Recklinghausen's disease are described. The 4 patients, aged 38, 41, 44 and 38, 2 men and 2 women, had up to child-head-sized tumors in the neck, back, axilla and retroperitoneum. Oncostatic chemotherapy and irradiation were ineffective against the malignant schwannoma. In three, surgically tumor-resected cases, local recurrence and rapid tumor growth occurred. Histologically, malignant schwannoma was characterized by the presence of a few collagen fibers among the tumor cells, but abundant argentaffin fibers. Numerous mast cells are frequently seen in neurofibroma, but almost never in malignant schwannoma. In Case 3, with mild atypism, tumor cells were positive for S100 protein.

[Three cases of vulvar bowenoid papulosis: the localization of HPV DNA by in situ hybridization].

Cytological, histological, and molecular biological studies were conducted in 3 cases of vulvar Bowenoid papulosis, using biotinylated HPV DNA probes by in situ hybridization. 1) Cytological findings showed dyskaryotic cells that revealed hyperchromatism with a coarse granular pattern, and a high N/C ratio was observed among the dyskeratotic cells. 2) In 2 cases of Bowenoid papulosis lesions, HPV 16 DNA was detected in the nucleus of the dysplastic cells. 3) In one case of Bowenoid papulosis, a complicated carcinoma in situ of the uterine cervix was observed, and the HPV 16 DNA was found to be positive in both the vulva and cervix.

N-myc oncogene expression in histopathologically unrelated bilateral pediatric renal tumors.

Renal tumors of childhood occasionally exhibit histopathologic and clinical features that preclude accurate diagnosis. Molecular and cell culture techniques may be helpful in better characterizing these cases. This approach was used to examine unusual bilateral renal tumors from a young boy. The left kidney tumor was an undifferentiated neoplasm with light microscopic features suggestive of both Wilms' tumor and neuroblastoma, and the right kidney tumor was identified as multilocular cystic nephroma (MLCN). In vitro tissue culture of tumor cells and hybridization experiments with an N-myc oncogene DNA probe contributed to a revised diagnosis of intrarenal neuroblastoma of the left kidney. A cell line established from the left tumor exhibited neurite outgrowth and was positive for neuron-specific enolase and synaptophysin. N-myc was greater than ten-fold amplified in chromosomal DNA from the left kidney tumor. Measurement of N-myc RNA expression enabled distinction between benign and malignant tumor tissue. The detection of N-myc gene amplification predicted a poor prognosis which was confirmed by the patient's subsequent clinical course.

[Mixed ovarian germinal neoplasia: adult embryonal carcinoma and dysgerminoma with trophoblasts]. / Neoplasia germinale ovarica complessa: carcinoma embrionale adulto e disgerminoma con trofoblasto.

Malignant mixed germ cell tumor of the ovary: embryonal carcinoma and dysgerminoma with trophoblastic cells. A case of ovarian neoplasia in a 19-years-old woman is described showing mixed germ cell tumor patterns. The main component is a solid embryonal carcinoma with mainly syncytial-like, highly anaplastic cells, displaying diffuse CK-immunoreactivities and scattered PLAP-positive cells. Many CK- and beta-HCG-positive syncytiotrophoblastic and intermediate trophoblastic cells are present. A second component is a dysgerminoma with lymphoid stroma and diffuse PLAP-cytomembrane immunoreactivities: rare cells, to be identified as intermediate trophoblast cells, are CK- and strongly beta-HCG-positive. Many syncytiotrophoblastic cells with a brisk CK- and beta-HCG-positivities are also noted. The embryonal carcinoma component is metastasized to the controlateral ovary, uterus and omentum. A complete immunohistochemical analysis is recommended to properly diagnose germ cell neoplasias of the ovary both for descriptive and prognostic-therapeutic purposes. The very rare presence in the same ovarian tumor of mixed patterns as adult embryonal carcinoma and dysgerminoma with trophoblastic cells, is stressed.