DOCSLIB.ORG

Morphological Patterns of Primary Nonendocrine Human Pancreas Carcinoma'

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Morphological Patterns of Primary Nonendocrine Human Pancreas Carcinoma' [CANCER RESEARCH 35, 2234-2248, August 1975] Morphological Patterns of Primary Nonendocrine Human Pancreas Carcinoma' Antonio L Cubifla and Patrick J. Fitzgerald2 Department of Pathology, Memorial Hospital, Memorial Sloan-Kettering Cancer Center, New York, New York UX@21 Summary the parenchymal cells. In the subsequent 5 decades terms such as mucous adenocarcinoma, colloid carcinoma, duct The study of histological sectionsof 406 casesof nonen adenocarcinoma, pleomorphic cancer, papillary adenocar docrine pancreas carcinoma at Memorial Hospital mdi cinoma, cystadenocarcinoma, and other variants, such as cated that morphological patterns of pancreas carcinoma epidermoid carcinoma, mucoepidermoid cancer, giant-cell could be delineated as follows: duct cell adenocarcinoma carcinoma, adenoacanthoma, and acinar cell carcinoma, (76%), giant-cell carcinoma (5%), microadenocarcinoma have appeared (7, 18, 23, 47, 62). Subtypes of islet-cell (4%), adenosquamous carcinoma (4%), mucinous adeno tumors have been defined (27). As pointed out by Baylor carcinoma (2%), anaplastic carcinoma (2%), cystadenocar and Berg (5) in discussing the limitations of their study of cinoma ( 1%), acinar cell carcinoma (1 %), carcinoma in 5000 patients with pancreas cancer from 8 cancer registries, childhood (under 1%), unclassified (7%). few pathologists precisely characterize the microscopic In 195 cases of patients with pancreas carcinoma, search features of their cases. was made for changes in the pancreas duct epithelium and We have reviewed cases of cancer of the pancreas at these were compared to duct epithelium in a control group Memorial Hospital to determine whether there are defina of 100 pancreases from autopsies of patients with nonpan ble morphological subgroups and to indicate their relative creatic cancer. The following incidences were found for distribution in our material. The delineation of morphologi pancreas cancer and nonpancreatic cancer, respectively: cal patterns of pancreas cancer may eventually permit a mucous cell hypertrophy, 39 versus 28%; pyloric gland correlation with some genetic, biochemical, endocrinologi metaplasia, 28 and 17%; epidermoid metaplasia, 6 and 12%; cal, clinical, epidemiological, prognostic, or other parame papillary hyperplasia, 42 and 12%; atypical duct hyper ter of significance and thereby further an understanding of plasia, 14% and none; carcinoma in situ in 19% and none in this neoplasm that appears to be increasing and has such a the control group. poor prognosis for the patient at the present time. Mucin in the majority of pancreas cancers suggested that the cell type of origin of the common pancreas cancer is the mucin-producing duct epithelium. The association of Materials and Methods atypias and carcinomas in situ in the patients with pancreas carcinoma implies, by analogy to other organs, that there From a survey of 757 cases listed as cancer of the may be a significant latent period between the appearance of pancreas in the Cancer Registry, Clinical Information carcinoma in situ and the grossly recognizable pancreas Center, Memorial Hospital, during the years 1949 through cancer. 1972, we have been able to examine histological sections of tissue from 503 cases. Sixty-seven were eliminated from the study for the following reasons: in 42 cases biopsy material Introduction did not show any cancer; 3 cases were reclassified as periampullary carcinoma; 7 cases were reclassified as The morphological classification of primary pancreas metastatic cancer (2 casesof oat-cell carcinoma of lung; 1 carcinomas of the nonendocrine variety would seem to pose case each of adenocarcinoma of the lung, breast, and colon; no problem to the pathologist because most of these cancers I malignant lymphoma; and 1 embryonal rhabdomyo@ar are adenocarcinomas and they span the spectrum com coma of the retroperitoneum); in 13 cases aspiration biop monly found with adenocarcinomas of other organs. Origi sies did not furnish enough tissue for classification; 1 de nally, Ewing ( 18), from this laboratory, described only 2 batable case w@sof either gastric or pancreas origin; and 1 types of pancreascancers,cylindrical cell adenocarcinoma tumor was believed to be of common bile duct origin rather arising from the ducts and carcinoma simplex arising from than of pancreatic duct. Thirty cases of malignant islet-cell tumor, recently reported from this laboratory (14), were 1 Presented at the Symposium “Current Progress in Pancreatic Car also excluded. cinogenesis Research,― February 4, 1975, Orlando, Fla., as part of the Cases coded as ampullary or periampullary cancer, Third Annual Carcinogenesis Conference. Aided by Contract NOl CP-43232 from the National Cancer Institute, NIH, Bethesda, Md. duodenal cancer, islet-cell tumors, or retroperitoneal tu 2 Presenter. mors involving the pancreas were not examined, and 2234 CANCER RESEARCH VOL. 35 Downloaded from cancerres.aacrjournals.org on September 25, 2021. © 1975 American Association for Cancer Research. Patterns of Pancreatic Carcinoma possibly a few pancreas cancers were thereby lost to our interpretation made on the small sampling of a tumor, study. which was sometimes restricted to only a few slides. There In 406 cases there was an operative biopsy ofa pancreatic were some cases (7%) where admixtures oftypes occurred so tumor; a confirmation of a pancreas cancer in the surgically that they were listed as unclassified. A much larger resected pancreas, or autopsy specimen; or, in association sampling might change the subtyping of cancers or the with a lesion clearly defined in the operative notes as a incidence of changes in duct epithelium. pancreatic tumor, there was a biopsy taken of a regional lymph node, or of a metastatic lesion, which revealed a neoplasm consistent with pancreas cancer. In 29 1 cases Results tissue diagnostic of pancreas cancer was obtained at opera tion, and in 115 casesthe tissue was obtained at autopsy. In Nonendocrine Pancreas Neoplasms 99 cases surgically resected (partial or total) pancreas tissue was studied. Histological slides of the primary tumor varied Benign Epithelial Nonendocrine Neoplasms. We were able from 4 to 9, but often only 1 or a few, slides of the to examine histological material from only 7 cases of benign metastasis were available. Additional slides, particularly epithelial nonendocrine neoplasms (3 serous and 4 mucinous for the demonstration of mucin, were cut from the paraffin cystadenomas) and from I case containing a microscopic embedded block in 53 cases. focus of adenomatous hyperplasia of acinar cells found Recently, we have obtained for electron microscopy incidentally at autopsy. ultrastructural studies pancreas cancer tissue removed at Malignant Epithelial Neoplasms. We have classified pri operation in 28 cases and from autopsy in 3 cases (not mary malignant lesions of the nonendocrine pancreas under included in the morphological classification study). the general headings of carcinomas (Table 1), sarcomas, In 214 cases (99 cases of partial or total pancreatectomy primary malignant lymphomas, a miscellaneous group, and and 115 autopsies), additional study of the pancreas cancer metastatic cancer. We estimate that over 95% of the material for associated hyperplasia, metaplasia, atypias, or malignant lesions of the nonendocrine pancreas are adeno carcinoma in situ changes in the duct epithelium was carcinomas and the following appear to be distinctive types. attempted. Nineteen cases were rejected because of autol Duct Cell A denocarcinoma [Adenocarcinoma, Cylindri ysis ofduct epithelium or insufficient ductal tissue present in cal-Cell Adenocarcinoma (18), Papillary Adenocarcinoma the histological slides, leaving 195 cases with adequate (23), Pancreas Cancer (5)]. In the normal duct system of the material. Pancreases from 100 consecutive autopsies (per human pancreas there is variation from the flat to cuboidal formed in 1973) of patients with nonpancreatic cancers, epithelium of the smallest ductules to the high columnar similar in age and sex to the pancreascancer cases,were mucouscell ofthe epithelium in the headofthe pancreas(9, used as controls. Patients were subjected to different 24). There is absence of mucin in the smallest ductules, as regimensof chemotherapy or radiotherapy in the 2 groups, indicated by the negative mucin stains, and the presence of and no corrections were made for these factors. Four to 9 mucin, indicated by a positive mucin stain, in the apical histological sections from each pancreas of the 2 groups region of the columnar cell of the duct epithelium, particu were examined. larly in the larger ducts (24, 46). By electron microscopy it Standard fixation in 10% formalin solution and staining can be demonstrated that droplets of mucigen are present in with hematoxylin and eosin were used for all tissues. Meyer's the duct epithelium (9) (Fig. 7) and not in the smallest mucicarmine stain (45) wasusedto demonstratemucin, and epithelial cells of the ductules. the periodic acid-Schiff (43) and Alcian blue stains (44) Our cases of duct adenocarcinomas were similar to the were used to indicate pyloric gland metaplasia (57, 58, 68). adenocarcinomas seen elsewhere in the biliary tract, gas The tissue for electron microscopy was fixed overnight in trointestinal tract, lung, and other organs (Figs. I and 2). Karnovsky fixative, rinsed in buffer (s-collidine), and post There was a mixture of large and small glands, often with I fixed for 1 hr in 1% osmium tetroxide. The specimens were embedded in epoxy
Load more

Recommended publications
  • Malignant Transformation of Liver Cysts Into Cholangiocarcinoma During Follow-Up: Potential Dangers of Liver Cysts
    Malignant Transformation of Liver Cysts Into Cholangiocarcinoma During Follow-up: Potential Dangers of Liver Cysts Fu-sheng Liu Wuhan University Second Clinical Hospital: Wuhan University Zhongnan Hospital https://orcid.org/0000-0003-1175-5209 Ke-lu Li Department of Pathology, Wuhan University Zhongnan Hospital Yue-ming He Department of Hepatobiliary&Pancreatic Surgery, Zhongnan Hospital of Wuhan University Zhong-lin Zhang Department of Hepatobiliary&Pancreatic Surgery, Zhongnan Hospital of Wuhan University Yu-feng Yuan Department of Hepatobiliary&Pancreatic Surgery, Zhongnan Hospital of Wuhan University Hai-tao Wang ( [email protected] ) Wuhan University Second Clinical Hospital: Wuhan University Zhongnan Hospital Case Report Keywords: Liver cysts, intrahepatic cholangiocarcinoma, malignant transformation Posted Date: July 9th, 2021 DOI: https://doi.org/10.21203/rs.3.rs-684869/v1 License: This work is licensed under a Creative Commons Attribution 4.0 International License. Read Full License Page 1/12 Abstract Background: The liver cyst is a common disease in hepatobiliary surgery. Most patients have no apparent symptoms and are usually diagnosed accidentally during imaging examinations. The vast majority of patients with liver cysts follow a benign course, with very few serious complications and rare reports of malignant changes. Case Presentation: We present two cases of liver cysts that evolved into intrahepatic tumors during the follow-up process. The rst patient had undergone a fenestration and drainage operation for the liver cyst, and the cancer was found at the cyst’s position in the third year after the procedure. Microscopically, bile duct cells formed the cyst wall. Tumor cells can be seen on the cyst wall and its surroundings to form adenoid structures of different sizes, shapes, and irregular arrangements, some of which are arranged in clusters.
    [Show full text]
  • Life Expectancy and Incidence of Malignant Disease Iv
    LIFE EXPECTANCY AND INCIDENCE OF MALIGNANT DISEASE IV. CARCINOMAOF THE GENITO-URINARYTRACT CLAUDE E. WELCH,' M.D., AND IRA T. NATHANSON,? MS., M.D. (Front the Collis P. Huntington Memorial Hospital of Harvard University, and the Pondville State Hospitul, Wre~ztham,Mass.) In previous communications the life expectancy of patients with cancer of the breast (I), oral cavity (2), and gastro-intestinal tract (3) has been discussed. In the present paper the life expectancy of patients with carci- noma of the genito-urinary tract will be considered. The discussion will include cancer of the vulva, vagina, cervix and fundus uteri, ovary, penis, testicle, prostate, bladder, and kidney. All cases of cancer of these organs admitted to the Collis P. Huntington Memorial and Pondville Hospitals in the years 1912-1933 have been reviewed personally. It must again be stressed that these hospitals are organized strictly for the care of cancer patients. All those with cancer that apply are admitted for treatment; many of them have only terminal care. Only those cases in which a definite history of the date of onset could not be determined or in which the diagnosis was uncertain have been omitted in the present study. In compiling statistics on age and sex incidence all cases entering the hospitals before Jan. 1, 1936, have been included. The method of calculation of the life expectancy curves was fully described in the first paper (1). No at- tempt to evaluate the number of five-year survivals has been made, since many of the patients did not receive their initial treatment in these hospitals.
    [Show full text]
  • Human Anatomy As Related to Tumor Formation Book Four
    SEER Program Self Instructional Manual for Cancer Registrars Human Anatomy as Related to Tumor Formation Book Four Second Edition U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES Public Health Service National Institutesof Health SEER PROGRAM SELF-INSTRUCTIONAL MANUAL FOR CANCER REGISTRARS Book 4 - Human Anatomy as Related to Tumor Formation Second Edition Prepared by: SEER Program Cancer Statistics Branch National Cancer Institute Editor in Chief: Evelyn M. Shambaugh, M.A., CTR Cancer Statistics Branch National Cancer Institute Assisted by Self-Instructional Manual Committee: Dr. Robert F. Ryan, Emeritus Professor of Surgery Tulane University School of Medicine New Orleans, Louisiana Mildred A. Weiss Los Angeles, California Mary A. Kruse Bethesda, Maryland Jean Cicero, ART, CTR Health Data Systems Professional Services Riverdale, Maryland Pat Kenny Medical Illustrator for Division of Research Services National Institutes of Health CONTENTS BOOK 4: HUMAN ANATOMY AS RELATED TO TUMOR FORMATION Page Section A--Objectives and Content of Book 4 ............................... 1 Section B--Terms Used to Indicate Body Location and Position .................. 5 Section C--The Integumentary System ..................................... 19 Section D--The Lymphatic System ....................................... 51 Section E--The Cardiovascular System ..................................... 97 Section F--The Respiratory System ....................................... 129 Section G--The Digestive System ......................................... 163 Section
    [Show full text]
  • Focal Pancreatic Lesions: Role of Contrast-Enhanced Ultrasonography
    diagnostics Review Focal Pancreatic Lesions: Role of Contrast-Enhanced Ultrasonography Tommaso Vincenzo Bartolotta 1,2 , Angelo Randazzo 1 , Eleonora Bruno 1, Pierpaolo Alongi 2,3,* and Adele Taibbi 1 1 BiND Department: Biomedicine, Neuroscience and Advanced Diagnostic, University of Palermo, Via Del Vespro, 129, 90127 Palermo, Italy; [email protected] (T.V.B.); [email protected] (A.R.); [email protected] (E.B.); [email protected] (A.T.) 2 Department of Radiology, Fondazione Istituto Giuseppe Giglio Ct.da Pietrapollastra, Via Pisciotto, Cefalù, 90015 Palermo, Italy 3 Unit of Nuclear Medicine, Fondazione Istituto Giuseppe Giglio Ct.da Pietrapollastra, Via Pisciotto, Cefalù, 90015 Palermo, Italy * Correspondence: [email protected] Abstract: The introduction of contrast-enhanced ultrasonography (CEUS) has led to a significant improvement in the diagnostic accuracy of ultrasound in the characterization of a pancreatic mass. CEUS, by using a blood pool contrast agent, can provide dynamic information concerning macro- and micro-circulation of focal lesions and of normal parenchyma, without the use of ionizing radiation. On the basis of personal experience and literature data, the purpose of this article is to describe and discuss CEUS imaging findings of the main solid and cystic pancreatic lesions with varying prevalence. Keywords: contrast-enhanced ultrasound; pancreas; diagnostic imaging Citation: Bartolotta, T.V.; Randazzo, A.; Bruno, E.; Alongi, P.; Taibbi, A. Focal Pancreatic Lesions: Role of Contrast-Enhanced Ultrasonography. 1. Introduction Diagnostics 2021, 11, 957. Contrast-enhanced Ultrasound (CEUS) allows non-invasive assessment of normal and https://doi.org/10.3390/ pathologic perfusion of various organs in real time throughout the vascular phase, without diagnostics11060957 the use of ionizing radiation and with a much higher temporal resolution than Computed Tomography (CT) and Magnetic Resonance Imaging (MRI) [??? ].
    [Show full text]
  • Please Bring Your ~Rotocol, but Do Not Bring Slides Or Microscopes to T He Meeting, CALIFORNIA TUMOR TISSUE REGISTRY
    CALIFORNIA TUMOR TISSUE REGISTRY FIFTY- SEVENTH SEMI-ANNUAL SLIDE S~IINAR ON TIJMORS OF THE F~IALE GENITAL TRACT MODERATOR: RlCl!AlUJ C, KEMPSON, M, D, ASSOCIATE PROFESSOR OF PATHOLOGY & CO-DIRECTOR OF SURGICAL PATHOLOGY STANFORD UNIVERSITY MEDICAL CEllTER STANFOliD, CALIFORNIA CHAl~lAN : ALBERT HIRST, M, D, PROFESSOR OF PATHOLOGY LOMA LINDA UNIVERSITY MEDICAL CENTER L~.A LINDA, CALIPORNIA SUNDAY, APRIL 21, 1974 9 : 00 A. M. - 5:30 P,M, REGISTRATION: 7:30 A. M. PASADENA HILTON HOTEL PASADENA, CALIFORNIA Please bring your ~rotocol, but do not bring slides or microscopes to t he meeting, CALIFORNIA TUMOR TISSUE REGISTRY ~lELDON K, BULLOCK, M, D, (EXECUTIVE DIRECTOR) ROGER TERRY, ~1. Ii, (CO-EXECUTIVE DIRECTOR) ~Irs, June Kinsman Mrs. Coral Angus Miss G, Wilma Cline Mrs, Helen Yoshiyama ~fr s. Cheryl Konno Miss Peggy Higgins Mrs. Hataie Nakamura SPONSORS: l~BER PATHOLOGISTS AMERICAN CANCER SOCIETY, CALIFORNIA DIVISION CALIFORNIA MEDICAL ASSOCIATION LAC-USC MEDICAL CENlllR REGIONAL STUDY GRaJPS: LOS ANGELES SAN F~ICISCO CEt;TRAL VALLEY OAKLAND WEST LOS ANGELES SOUTH BAY SANTA EARBARA SAN DIEGO INLAND (SAN BERNARDINO) OHIO SEATTLE ORANGE STOCKTON ARGENTINA SACRJIMENTO ILLINOIS We acknowledge with thanks the voluntary help given by JOHN TRAGERMAN, M. D., PATHOLOGIST, LAC-USC MEDICAL CENlllR VIVIAN GILDENHORN, ASSOCIATE PATHOLOGIST, I~TERCOMMUNITY HOSPITAL ROBERT M. SILTON, M. D,, ASSISTANT PATHOLOGIST, CITY OF HOPE tiEDICAL CENTER JOHN N, O'DON~LL, H. D,, RESIDENT IN PATHOLOGY, LAC-USC MEDICAL CEN!ER JOHN R. CMIG, H. D., RESIDENT IN PATHOLOGY, LAC-USC MEDICAL CENTER CHAPLES GOLDSMITH, M, D. , RESIDENT IN PATHOLOGY, LAC-USC ~IEDICAL CEUTER HAROLD AMSBAUGH, MEDICAL STUDENT, LAC-USC MEDICAL GgNTER N~IE-: E, G.
    [Show full text]
  • 26 and TIMP-4 in Pancreatic Adenocarcinoma
    Modern Pathology (2007) 20, 1128–1140 & 2007 USCAP, Inc All rights reserved 0893-3952/07 $30.00 www.modernpathology.org Increased expression of matrix metalloproteinases-21 and -26 and TIMP-4 in pancreatic adenocarcinoma Ville Bister1, Tiina Skoog2,3, Susanna Virolainen4, Tuula Kiviluoto5, Pauli Puolakkainen5 and Ulpu Saarialho-Kere1,2 1Department of Dermatology, Helsinki University Central Hospital and Biomedicum Helsinki, University of Helsinki, Helsinki, Finland; 2Department of Dermatology, Karolinska Institutet at Stockholm So¨der Hospital, Stockholm, Sweden; 3Department of Biosciences and Nutrition, Karolinska Institutet, Novum, Huddinge, Stockholm, Sweden; 4Department of Pathology, Helsinki University Central Hospital, University of Helsinki, Helsinki, Finland and 5Department of Surgery, Helsinki University Central Hospital, University of Helsinki, Helsinki, Finland Pancreatic adenocarcinoma is known for early aggressive local invasion, high metastatic potential, and a low 5- year survival rate. Matrix metalloproteinases (MMPs) play important roles in tumor growth and invasion. Earlier studies on pancreatic cancer have found increased expression of certain MMPs to correlate with poorer prognosis, short survival time or presence of metastases. We studied the expression of MMP-21, -26, and tissue inhibitor of matrix metalloproteinases (TIMP)-4 in 50 tissue samples, including 25 adenocarcinomas, seven other malignant pancreatic tumors, and 18 control samples of non-neoplastic pancreatic tissue with immunohistochemistry. The regulation of MMP-21, -26, and TIMP-4 mRNAs by cytokines was studied with RT-PCR in pancreatic cancer cell lines PANC-1, BxPC-3, and AsPC-1. MMP-21, -26, and TIMP-4 were detected in cancer cells in 64, 40, and 60% of tumors, respectively. MMP-21 expressed in well-differentiated cancer cells and occasional fibroblasts, like TIMP-4, tended to diminish in intensity from grade I to grade III tumors.
    [Show full text]
  • New Jersey State Cancer Registry List of Reportable Diseases and Conditions Effective Date March 10, 2011; Revised March 2019
    New Jersey State Cancer Registry List of reportable diseases and conditions Effective date March 10, 2011; Revised March 2019 General Rules for Reportability (a) If a diagnosis includes any of the following words, every New Jersey health care facility, physician, dentist, other health care provider or independent clinical laboratory shall report the case to the Department in accordance with the provisions of N.J.A.C. 8:57A. Cancer; Carcinoma; Adenocarcinoma; Carcinoid tumor; Leukemia; Lymphoma; Malignant; and/or Sarcoma (b) Every New Jersey health care facility, physician, dentist, other health care provider or independent clinical laboratory shall report any case having a diagnosis listed at (g) below and which contains any of the following terms in the final diagnosis to the Department in accordance with the provisions of N.J.A.C. 8:57A. Apparent(ly); Appears; Compatible/Compatible with; Consistent with; Favors; Malignant appearing; Most likely; Presumed; Probable; Suspect(ed); Suspicious (for); and/or Typical (of) (c) Basal cell carcinomas and squamous cell carcinomas of the skin are NOT reportable, except when they are diagnosed in the labia, clitoris, vulva, prepuce, penis or scrotum. (d) Carcinoma in situ of the cervix and/or cervical squamous intraepithelial neoplasia III (CIN III) are NOT reportable. (e) Insofar as soft tissue tumors can arise in almost any body site, the primary site of the soft tissue tumor shall also be examined for any questionable neoplasm. NJSCR REPORTABILITY LIST – 2019 1 (f) If any uncertainty regarding the reporting of a particular case exists, the health care facility, physician, dentist, other health care provider or independent clinical laboratory shall contact the Department for guidance at (609) 633‐0500 or view information on the following website http://www.nj.gov/health/ces/njscr.shtml.
    [Show full text]
  • CA54/61 As a Marker for Epithelial Ovarian Cancer
    [CANCER RESEARCH 52, 1205-1209, March 1. 1992] CA54/61 as a Marker for Epithelial Ovarian Cancer Shiro Nozawa,1 Daisuke Aoki, Masazumi Yajima, Katsumi Tsukazaki, Toshibumi Kobayashi, Eizo Kimura, Yoshiteru Terashima, Noriyuki Inaba, Hiroyoshi Takamizawa, Yoshiyuki Negishi, Hisanao Ohkura, Hiroshi Sato, and Hiroshi Mochizuki Department of Obstetrics and Gynecology, School of Medicine, Keio University, 35 Shinanomachi, Shinjuku-ku, Tokyo 160 [S. N., D. A., M. Y., K. T., T. K.]; Department of Obstetrics and Gynecology, The Jikei University School of Medicine, 3-25-8 Nishi-Shinbashi, Minato-kit, Tokyo 105 [E. K., Y. T.J; Department of Obstetrics and Gynecology, School of Medicine, Chiba University, 1-8-1 Inohana, Chiba-shi, Chiba 280 (N. !.. H. T.J; Department of Obstetrics and Gynecology, Tokyo Medical College, 6-7-1 Nishi-Shinjuku, Shinjuku-ku, Tokyo 160 [Y. N.]; Department of Internal Medicine, National Cancer Center, 5-1-1 Tsukiji, Chuo-ku, Tokyo 104 [H. O.J; and Laboratories for Bioscience, Mochida Pharmaceutical Co., Ltd., 1-1-1 Kamiya, Kita-ku, Tokyo 115 [H. S., H. M.J, Japan ABSTRACT MATERIALS AND METHODS Using a new one-step, double-determinant enzyme immunoassay, we Subjects. Sera were obtained from 348 healthy subjects, comprising performed quantitative measurements of a mucin-type glycoprotein anti 270 females and 78 males; from 351 patients with various noncancerous diseases, including 138 with ovarian benign tumors (including endo gen (CA54/61) that we recently detected in sera of ovarian carcinoma metriotic cyst), 27 with ovarian borderline tumors, 122 with uterine patients. When the cutoff value was set at 12 units/ml, at which a high myoma or adenomyosis, and 59 with benign disease of nongynecolog- diagnostic efficiency was demonstrated [or at 20 units/ml (mean + 3 SD ical organs: from 318 pregnant women; and from 43 umbilical cord of healthy females)], the positive rates of ovarian serous, mucinous, clear veins.
    [Show full text]
  • Treatment Strategy for Patients with Cystic Lesions Mimicking a Liver Tumor a Recent 10-Year Surgical Experience in Japan
    ORIGINAL ARTICLE Treatment Strategy for Patients With Cystic Lesions Mimicking a Liver Tumor A Recent 10-Year Surgical Experience in Japan Mitsuo Shimada, MD, PhD; Kenji Takenaka, MD, PhD; Tomonobu Gion, MD; Yuh Fujiwara, MD; Kenichi Taguchi, MD; Kiyoshi Kajiyama, MD; Ken Shirabe, MD; Keizo Sugimachi, MD, PhD Objective: To clarify some of the difficulties in deter- rhage in 7 patients, localized cystic dilation of the bile duct mining the appropriate surgical indications for cystic le- due to hepatolithiasis in 1, cystadenoma in 1, and mucin- sions mimicking a neoplasm in the liver. producing cholangiocarcinoma in 1. In only one case was postoperative diagnosis identical to the preoperative diag- Design: A retrospective review of hepatic resections for nosis. In one case, an intraoperative pathological exami- cystic lesions mimicking a neoplasm in the liver be- nation showed the tumor to be a mucin-producing cho- tween August 1, 1986, and July 31, 1996. langiocarcinoma instead of a cystadenocarcinoma. A tumor- marker analysis of the fluid in the cystic lesions also did Setting: A university hospital with a long history of he- not contribute to a definite diagnosis. Furthermore, cyto- patic resection for cystic lesions mimicking a neoplasm logical examination of the fluid could not completely ex- in the liver. clude malignancy. Neither mortality nor morbidity oc- curred in any of the patients, and their mean length of Patients: Ten patients with such cystic lesions in the hospitalization after hepatectomy was only 13.7 days. liver, who underwent a hepatectomy during a recent 10- year period, were included in this study. Conclusions: The accurate diagnosis of cystic lesions mimicking a tumor remains problematic; however, the Main Outcome Measures: Detailed clinicopatho- results of hepatectomy for such cases are normally sat- logic data were analyzed, and comparisons were made isfactory.
    [Show full text]
  • Letters to the Editor EXTRAHEPATIC BILIARY
    ABCDDV/904 ABCD Arq Bras Cir Dig Carta ao Editor 2013;26(1):66-68 CISTOADENOCARCINOMA BILIAR EXTRA-HEPÁTICO MIMETIZANDO TUMOR DE KLATSKIN Extrahepatic biliary cystadenocarcinoma mimicking Klatskin tumor Sergio Renato PAIS-COSTA, Sandro Jose MARTINS, Sergio Luiz Melo ARAUJO, Olímpia Alves Teixeira LIMA, Marcio Almeida PAES, Marcio Lobo GUIMARAES Trabalho realizado no Hospital Santa Lucia, Brasília, DF, Brasil. estava elevado com 345 U/l. O paciente foi submetido à tomografia computadorizada, que mostrou lesão Correspondência: Sergio Renato Pais Costa, cística com irregularidade e parede espessa com dutos e-mail [email protected] biliares intra-hepáticos dilatados principalmente do lado esquerdo e atrofia do lobo esquerdo. Foi submetido à Fonte de financiamento: não há colangioressonância que mostrou dilatação da árvore Conflito de interesses: não há biliar intra-hepática mais significativa no lado esquerdo, Recebido para publicação: 26/08/2011 ducto biliar com irregularidade e com parede mais Aceito para publicação: 22/08/2012 espessada perto de confluência hepática (Figura 1). O paciente foi submetido a exame radiológico sem sinais INTRODUÇÃO de disseminação sistêmica. O diagnóstico inicial era colangiocarcinoma hilar ou cistoadenoma extra biliar ou istadenocarcinoma biliar (BCAC) é uma rara cistoadenocarcinoma. Foi indicado tratamento cirúrgico, neoplasia maligna cística. Alguns autores com ressecção da árvore biliar suprapancreática incluindo Cpensam ser ela a conversão de cistoadenoma confluência hilar e hepatectomia em bloco estendida à biliar de longa evolução. Na maioria dos casos ocorre esquerda com lobectomia caudada. Linfadenectomia no parênquima (cistadenocarcinoma intra-hepático); hilar foi também realizada durante a ressecção cirúrgica por vezes, pode ser observado com origem biliar extra- (Figura 2).
    [Show full text]
  • Endometrial Carcinoma
    10 Endometrial Carcinoma Important Issues in Interpretation of The tumors are often associated with hyper- Biopsies . 209 plasia and atypical hyperplasia, conditions that Criteria for the Diagnosis of result from unopposed estrogenic stimulation Well-Differentiated Endometrial such as anovulatory cycles that normally occur Adenocarcinoma . 209 at the time of menopause or in younger women Benign Changes that Mimic with the Stein–Leventhal syndrome (polycystic Carcinoma . 214 ovarian disease). Unopposed exogenous estro- Malignant Neoplasms—Classification, gen use as hormone replacement therapy in Grading, and Staging of the Tumor . 216 older women also predisposes to endometrial Classification . 216 carcinoma that tends to be low-grade. In hys- Grading . 216 Clinically Important Histologic terectomy specimens these low-grade tumors Subtypes . 221 generally show minimal myometrial invasion, Staging . 236 although deep invasion can occur in some Endometrial Versus Endocervical cases.5;6 The prognosis is generally good, with a Carcinoma . 237 5-year survival of 80% or better.3 Metastatic Carcinoma . 238 Type II neoplasms represent another, very Clinical Queries and Reporting . 239 different, form of endometrial carcinoma. They are high-grade neoplasms that do not appear to be related to sustained estrogen stimulation.1;2;4 Endometrial adenocarcinoma is the most com- Tumors in this group account for 15% to 20% mon malignant tumor of the female genital of all endometrial carcinomas. The prototypical tract in the United States. This neoplasm rep- type II neoplasm is serous carcinoma, but other resents a biologically and morphologically histologic subtypes include clear cell carcino- diverse group of tumors, with differing patho- mas and other carcinomas that show high-grade genesis.1–4 These tumors have two basic clinico- nuclear features.
    [Show full text]
  • A Rare Case of Intraductal Papilloma Arising from Minor Salivary Gland in the Floor of the Mouth
    Hindawi Case Reports in Pathology Volume 2020, Article ID 8882871, 3 pages https://doi.org/10.1155/2020/8882871 Case Report A Rare Case of Intraductal Papilloma Arising from Minor Salivary Gland in the Floor of the Mouth Agnes Assao,1 Silas Antonio Juvencio de Freitas Filho ,1 Luiz Antônio Simonetti Júnior,2 and Denise Tostes Oliveira 1 1Department of Surgery, Stomatology, Pathology and Radiology (Area of Pathology), Bauru School of Dentistry, University of São Paulo, Bauru, São Paulo, Brazil 2Private Practice, Bauru, SP, Brazil Correspondence should be addressed to Denise Tostes Oliveira; [email protected] Received 12 July 2020; Revised 9 August 2020; Accepted 16 August 2020; Published 25 August 2020 Academic Editor: Tanja Batinac Copyright © 2020 Agnes Assao et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. A 77-year-old woman with a rare oral intraductal papilloma arising from the minor salivary gland located on the floor of the mouth and causing the mucus retention is reported. Microscopically, the lesion was characterized by unicystic cavity exhibiting the lumen partially filled by papillary projections of the ductal epithelium with varying degree of oncocytic metaplasia. Based on the histopathological analysis, the differential diagnosis of oral intraductal papillomas and other ductal neoplasms of salivary origin are discussed. 1. Introduction to the trauma of the complete dentures. The intraoral exam- ination revealed a unique soft nodule, tender to palpation, The incidence of oral tumors arising from the salivary ductal covered with clinically normal mucosa, well-circumscribed, ffi glands, such as intraductal papillomas, is di cult to deter- sessile, located at the floor of the mouth, in the anterior left ff mine because di erent terminology has been used for the region of the mandible, measuring 1:1×0:9×0:7cm.
    [Show full text]