DOCSLIB.ORG

Head and Neck Pathology

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Head and Neck Pathology 316A ANNUAL MEETING ABSTRACTS Results: IPMC involved >5% of villi in 11 of 17 placentas (65%) from FD cases, but Immunohistochemical study showed consistent loss of PAX2 nuclear staining in 100% only 1 of 118 from live births (0.8%, p<0.0001). IPMC involved >10% of villi in 5 of cases regardless of endocervical-type or gastrointestinal-type. All cases showed positive 17 placentas (30%) from FD cases and none from live births (0%, p<0.0001). Clinical PAX8 staining and wild-type p53 staining pattern including those of gastrointestinal data for 11 of the 17 FD cases was available. IPMC in >5% of villi were seen in 3 of type. ER was diffuse (>70%) and strong in eleven cases (85%), focal and moderate the 7 cases where fetus was delivered within 1 day, versus 4 of 4 cases where fetus in two cases. PR was negative in six cases, focal and moderate in four cases, diffuse was retained for >1 days after demise (p<.05). Frequency of IPMC in categories other and strong (>70%) in three cases. P16 was either negative (5) or focally positive (8). than fetal demise are shown in table 1. Conclusions: Pure EMC is diagnostically challenging due to its bland histologic features. Our study demonstrates that loss of PAX2 staining was observed in all cases Percentage of Post Term IUGR Chronic Chorioamnionitis GDM (n=20), regardless of endocervical or gastrointestinal cell type. Retaining strong ER expression Villi involved Births (n=15), Villitis (n=19), n(%) n(%) by IPMC (%) (n=12), n(%) n(%) (n=15), n(%) and variable loss of PR expression occurred in most pure EMC (77%). A panel of immunostains including PAX2, ER and PR can help identify EMC in problematic <1 10(50) 12(60) 5(42) 9(60) 8(53) biopsy/curetting specimens. 1-5 6(30) 6(30) 2(17) 3(20) 2(13) 5-10 1(6) 1257 Pattern C Invasive Endocervical Adenocarcinomas: Can We Identify >10 the More Aggressive Subset? None 3 2 3 3 4 Ranran Zhang, Erin E Medlin, Paul S Weisman, Ahmed Al-Niaimi, Aparna Mahajan. University of Wisconsin Hospital and Clinics, Madison, WI. Figures 1 and 2: IPMC in the basement membranes of villi with perivillous fibrin and Background: A recently proposed classification for endocervical adenocarcinoma (EA) within the perivillous fibrin (1A and 1B). However, IPMC were also present in otherwise has shown that the vast majority of EAs with lymph node metastases (LNM) and/or seemingly normal villi, without any perivillous fibrin (2A). recurrences display a frankly invasive pattern (pattern C). However, even in pattern C tumors, LNM are seen in less than a quarter of cases (24%) and the factors that predict aggressive behavior in this group remain unclear. Design: All available resections of usual type EA with negative margins at our institution from 2002-2014 were retrieved. Other histologic subtypes were excluded. Pattern C assignment required agreement by 2 pathologists (AM, PSW). Tumors were stratified as follows: Greatest horizontal extent (GHE) <1 cm vs ≥ 1cm; depth of invasion (DOI) <1 cm vs ≥ 1cm; % cervical wall invasion (CWI) <50% vs ≥50%; presence of lymphovascular invasion (LVI); and presence of microcystic, elongated, and fragmented pattern invasion (MELF). LNM and recurrence data were recorded. Statistical analysis utilized the 2-tailed Fisher’s exact test. Results: 44 cases of EA were available. 14 cases of other histologic subtypes were excluded, leaving 30 cases of usual type EA (15 pattern A or B, 15 pattern C). LN dissection had been performed in all pattern C cases and in 13/15 pattern A or B cases. All LNM (2 cases) and recurrences (2 cases) occurred in pattern C cases. Among pattern C cases, 11/15 (73%) had GHE ≥ 1cm, 6/15 (40%) had DOI ≥ 1cm, 10/15 (67%) had %CWI ≥50%, 3/15 (20%) had LVI, and 10/15 (67%) had MELF. While all 4 cases with LNM and/or recurrences had GHE ≥ 1cm, CWI ≥50%, and MELF, none of these trends reached statistical significance [GHE ≥ 1cm (4/11 vs 0/4, p = 0.52); CWI ≥50% (4/10 vs 0/5, p = 0.23); MELF (4/10 vs 0/5, p = 0.23)]. Conclusions: While limited by its small size, our study demonstrates that large tumor volume (≥ 1cm GHE), invasion into the outer aspect of the cervix (≥50% CWI), and MELF are frequent findings in pattern C tumors with LNM and/or recurrence. Larger studies are required to determine if these features can reliably predict which pattern C tumors are more likely to run an aggressive clinical course. Head and Neck Pathology 1258 Sinonasal leiomyosarcoma: Analysis of 9 Cases Exploring Their Clinicopathological and Morphological Spectrum with Emphasis on Previous Irradiation and Association with Other Malignancies Abbas Agaimy, Sarina Muller, Lester DR Thompson. University Hospital of Erlangen, Erlangen, Germany; Woodland Hills Medical Center, Woodland Hills, CA. Background: Sinonasal tract leiomyosarcoma is exceedingly rare with less than 100 Conclusions: Association of IPMC with fetal demise, duration of fetal demise and cases reported. Their exact pathogenesis remains unknown and their relationship to perivillous fibrin suggests that IPMC may be a response to a local hypoxic environment. retinoblastoma and previous irradiation has not been specifically explored. Presence of IPMC in more than 10% of villi may be used to support a diagnosis of Design: Routine and consultation cases were reviewed for histologically and intrauterine fetal demise in forensic and medico-legal cases. immunohistochemically proven sinonasal leiomyosarcomas. The tumors were tested with antibodies directed against alpha smooth muscle actin, desmin, h-caldesmon, HMB45, Rb1 and MDM2. 1256 Immunohistochemical Profile of Pure Endometrial Mucinous Results: The 9 cases included 5 males and 4 females aged 26 to 77 years (median: Adenocarcinoma 48 years). Tumor sites were maxillary sinus (n=4), nasal cavity (n=3) and combined Gloria Zhang, Charles V Biscotti, Tao Wu, Xiangdong Ding, Bin Yang. Cleveland Clinic, nasal and sinuses (n=2). Three patients had previous irradiation (2 for retinoblastoma, Cleveland, OH; Kingmed Diagnostics, Guangzhou, OH. 1 for fibrous dysplasia) and another patient had chemotherapy and stem cell Background: Most endometrial mucinous carcinomas (EMC) have a major mucinous transplantation for Hodgkin lymphoma. All patients with follow-up developed either component (>50%) and minor endometrioid component. Pure EMC occurs rarely. local recurrences or/and metastases, mainly to lung (time to metastasis: 16-55 months). EMC’s deceptively bland histopathologic features with low grade nuclear atypia Histologically, all tumors but one were conventional high-grade leiomyosarcomas complicate recognition particularly in endometrial biopsy /curetting specimens. We indistinguishable from their somatic soft tissue counterparts; one of these had a analyzed the clinicopathologic and immunohistochemical features of a series of pure glycogen-rich clear cell (PEComa-like) morphology. The low-grade primary tumor, EMC. showed grade 2 features in the recurrence and grade 3 features in the lung metastases. Design: Seventeen cases of pure EMC (>95% neoplastic mucinous component), Two cases showed dedifferentiation to anaplastic pleomorphic (MFH-like) phenotype. including 8 in-house and 9 consultation cases, were identified from pathology database. Immunohistochemistry (IHC) showed strong diffuse expression for at least two smooth These included 17 biopsies/currettings and 10 hysterectomy specimens. 13 cases had muscle markers and no reactivity for HMB45. None of the cases expressed MDM2. tissue blocks available for immunostaining with PAX2, PAX8, ER, PR, p16, p53. Ten RB1 IHC showed inconsistent pattern. cases of benign endometrium and benign endocervix served as controls. Conclusions: Sinonasal tract leiomyosarcomas are rare aggressive sarcomas that Results: Patients’ age ranged from 50 to 81 years (mean 59). Thireen patients including frequently develop in a background of previous cancer therapy, often radiation for 4 with voluminous mucinous discharge had abnormal uterine bleeding. Histologically, retinoblastoma. The frequency of leiomyosarcoma in this particular clinical setting fifteen cases (88%) were FIGO 1 and two cases were FIGO 2. Fourteen cases (82%) merits further genetic analysis to identify tumors that are Rb1-derived. A history of had endocervical-type mucinous glands including three cases with a predominant irradiation might have been a confounding factor preventing recognition of hereditary microglandular pattern. Three cases (18%) consisted of either gastric or intestinal-type leiomyosarcoma in the setting of retinoblastoma syndrome. mucinous glands. All 17 cases had mild to moderate cytologic atypia with minimal or no mitotic activity. Subsequent hysterectomy specimens were available in 10 cases. Six tumors lacked myometrial invasion, 2 tumors invaded 1/3 of the myometrial thickness and 2 tumors had deeper myometrial invasion (85% and 90% respectively). ANNUAL MEETING ABSTRACTS 317A 1259 Cutaneous Leishmaniasis Presenting as Facial Midline Lesions: mutations were seen in 10% of AciCC. Other GA identified at 4% frequency included A Series of 15 Cases NCOR1, ARID2, ATM, BCOR, ETV6, FBXW7 and HRAS. Among the CRGA, alterations Elie Alam, Ossama Abbas, Roger Moukarbel, Ibrahim Khalifeh. American University in NF1, PIK3CA and BRAF were found in 1 (2%) AciCC each. The NF1 and PIK3CA of Beirut Medical Center, Beirut, Lebanon. GA open consideration for MTOR pathway inhibitors. The single case of AciCC with Background: Midline destructive lesions of the face (MDL) have a wide range of a BRAF GA featured a BRAF kinase domain duplication in an advanced parotid AciCC, etiologies. Cutaneous Leishmaniasis (CL) is rarely reported as a possible cause. which developed in a 38 year old woman that did not respond to conventional treatment, Design: The clinical data, biopsies/scrapings and PCR were collected/performed on but achieved a sustained major clinical response to the anti-BRAF drug regorafenib. patients with solitary CL nose lesions (n=15). Ridley’s Pattern (RP) and Parasitic Index Conclusions: The generally low frequency of GA at 2.28 per tumor reflects the slow (PI) were documented.
Load more

Recommended publications
  • Expression of P16ink4a Protein in Pleomorphic Adenoma And
    Original research Ink4a Expression of p16 protein in pleomorphic J Clin Pathol: first published as 10.1136/jclinpath-2021-207440 on 3 May 2021. Downloaded from adenoma and carcinoma ex pleomorphic adenoma proves diversity of tumour biology and predicts clinical course Ewelina Bartkowiak ,1 Krzysztof Piwowarczyk,1 Magdalena Bodnar,1,2 Paweł Kosikowski,3 Jadzia Chou,1 Aldona Woźniak,3 Małgorzata Wierzbicka1 1Department of Otolaryngology ABSTRACT are an integral feature of PA; however, extensive and Laryngological Oncology, Aims The aim of the study is to correlate p16Ink4a squamous metaplasia is uncommon and can be Poznan University of Medical 7 Sciences, Poznan, Poland expression with the clinical courses of pleomorphic easily misinterpreted as squamous cell carcinoma. 2Department of Clinical adenoma (PA), its malignant transformation (CaexPA) In this paper, we present a new insight into a Pathomorphology, Nicolaus and treatment outcomes. single histological unit: PA. Our 20-year experi- Copernicus University in Toruń Methods Retrospective analysis (1998–2019) of 47 ence of 1500 PAs and extensive observation of their Ludwik Rydygier Collegium CaexPA, 148 PA and 22 normal salivary gland samples individually variable disease courses has prompted Medicum in Bydgoszcz, Bydgoszcz, Poland was performed. PAs were divided into two subsets: us to distinguish two clinically divergent subsets: 8 3Department of Clinical clinically ’slow’ tumours characterised by stable size or ‘fast’ and ‘slow’ tumours. While ‘fast’ PAs are Pathology, Poznan University slow growth; and ’fast’ tumours with rapid growth rate. characterised by a short medical history and rapid of Medical Sciences, Poznan, Results Positive p16Ink4a expression was found in growth, ‘slow’ PAs demonstrate very stable biology Poland 68 PA and 23 CaexPA, and borderline expression in and long- term growth.
    [Show full text]
  • Primary Oncocytic Carcinoma of the Salivary Glands: a Clinicopathologic and Immunohistochemical Study of 12 Cases
    Oral Oncology 46 (2010) 773–778 Contents lists available at ScienceDirect Oral Oncology journal homepage: www.elsevier.com/locate/oraloncology Primary oncocytic carcinoma of the salivary glands: A clinicopathologic and immunohistochemical study of 12 cases Chuan-Xiang Zhou a,1, Dian-Yin Shi b,1, Da-quan Ma b, Jian-guo Zhang b, Guang-Yan Yu b, Yan Gao a,* a Department of Oral Pathology, Peking University School and Hospital of Stomatology, Beijing 100081, PR China b Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing 100081, PR China article info summary Article history: Oncocytic carcinoma (OC) of salivary gland origin is an extremely rare proliferation of malignant onco- Received 31 May 2010 cytes with adenocarcinomatous architectural phenotypes, including infiltrative qualities. To help clarify Received in revised form 26 July 2010 the clinicopathologic and prognostic features of this tumor group, herein, we report 12 OC cases arising Accepted 27 July 2010 from the salivary glands, together with follow-up data and immunohistochemical observations. There Available online 16 September 2010 were 10 males and 2 females with an age range of 41 to 86 years (median age: 61.3 years). Most occurred in the parotid gland (10/12) with one in the palate and one in the retromolar gland. The tumors were Keywords: unencapsulated and often invaded into the nearby gland, lymphatic tissues and nerves. The neoplastic Oncocytic carcinoma cells had eosinophilic granular cytoplasm and round vesicular nuclei with prominent red nucleoli. Ultra- Salivary gland Clinicopathologic structural study, PTAH, and immunohistochemistry staining confirmed the presence of numerous mito- Immunohistochemistry chondria in the cytoplasm of oncocytes.
    [Show full text]
  • Perineural Invasion As a Risk Factor for Locoregional Recurrence of Invasive Breast Cancer Priyanka Narayan1, Jessica Flynn2, Zhigang Zhang2, Erin F
    www.nature.com/scientificreports OPEN Perineural invasion as a risk factor for locoregional recurrence of invasive breast cancer Priyanka Narayan1, Jessica Flynn2, Zhigang Zhang2, Erin F. Gillespie3, Boris Mueller3, Amy J. Xu3, John Cuaron3, Beryl McCormick3, Atif J. Khan3, Oren Cahlon3, Simon N. Powell3, Hannah Wen4 & Lior Z. Braunstein3* Perineural invasion (PNI) is a pathologic fnding observed across a spectrum of solid tumors, typically with adverse prognostic implications. Little is known about how the presence of PNI infuences locoregional recurrence (LRR) among breast cancers. We evaluated the association between PNI and LRR among an unselected, broadly representative cohort of breast cancer patients, and among a propensity-score matched cohort. We ascertained breast cancer patients seen at our institution from 2008 to 2019 for whom PNI status and salient clinicopathologic features were available. Fine-Gray regression models were constructed to evaluate the association between PNI and LRR, accounting for age, tumor size, nodal involvement, estrogen receptor (ER), progesterone receptor (PR), HER2 status, histologic tumor grade, presence of lymphovascular invasion (LVI), and receipt of chemotherapy and/or radiation. Analyses were then refned by comparing PNI-positive patients to a PNI-negative cohort defned by propensity score matching. Among 8864 invasive breast cancers, 1384 (15.6%) were noted to harbor PNI. At a median follow-up of 6.3 years, 428 locoregional recurrence events were observed yielding a 7-year LRR of 7.1% (95% CI 5.5–9.1) for those with PNI and 4.7% (95% CI 4.2–5.3; p = 0.01) for those without. On univariate analysis throughout the entire cohort, presence of PNI was signifcantly associated with an increased risk of LRR (HR 1.39, 95% CI 1.08– 1.78, p < 0.01).
    [Show full text]
  • First Description of a Hybrid Tumor of the Sublingual Gland
    ANTICANCER RESEARCH 33: 4567-4572 (2013) First Description of a Hybrid Tumor of the Sublingual Gland WOLFGANG EICHHORN1, CLARISSA PRECHT1, MANFRED WEHRMANN2, ELISABETH HICKMANN2, MARC EICHHORN3, JÜRGEN ZEUCH3, THOMAS LÖNING4, REINHARD E. FRIEDRICH1, MAX HEILAND1 and JÜRGEN HOFFMANN5 1Department of Oral and Maxillofacial Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; 2Department of Pathology, General Hospital Nuertingen, Hamburg, Germany; 3Department of Oral and Maxillofacial Surgery, General Hospital, Balingen, Germany; 4Department of Pathology, Albertinen Hospital Hamburg, Hamburg, Germany; 5Department of Oral and Maxillofacial Surgery, Heidelberg University Hospital, Heidelberg, Germany Abstract. Background: Hybrid tumours of the salivary account for up to 0.1% of all salivary gland tumours, and glands are rare neoplasms. They are composed of at least both benign and malignant hybrid tumours have been two different tumour entities located in the same topographic reported. The prevalence is 0.4% among parotid gland area and account for only 0.1% of all salivary gland tumours (2). The most frequent tumour entities (Table I) are tumours. The most common component is an adenoid cystic adenoid cystic carcinoma, epithelial-myoepithelial carcinoma carcinoma. There are several possible forms of hybrid and salivary duct carcinoma, the combination of adenoid tumours, which are most commonly located in the parotid cystic carcinoma and epithelial-myoepithelial carcinoma gland. Case Report: We report on a 59-year-old female, who being the most common (1-10). presented with a lesion of the caruncula of the left sublingual To our knowledge, the hybrid tumour presented below is gland. The biopsy showed an adenoid cystic carcinoma in the first described for the sublingual gland.
    [Show full text]
  • Lung Equivalent Terms, Definitions, Charts, Tables and Illustrations C340-C349 (Excludes Lymphoma and Leukemia M9590-9989 and Kaposi Sarcoma M9140)
    Lung Equivalent Terms, Definitions, Charts, Tables and Illustrations C340-C349 (Excludes lymphoma and leukemia M9590-9989 and Kaposi sarcoma M9140) Introduction Use these rules only for cases with primary lung cancer. Lung carcinomas may be broadly grouped into two categories, small cell and non-small cell carcinoma. Frequently a patient may have two or more tumors in one lung and may have one or more tumors in the contralateral lung. The physician may biopsy only one of the tumors. Code the case as a single primary (See Rule M1, Note 2) unless one of the tumors is proven to be a different histology. It is irrelevant whether the other tumors are identified as cancer, primary tumors, or metastases. Equivalent or Equal Terms • Low grade neuroendocrine carcinoma, carcinoid • Tumor, mass, lesion, neoplasm (for multiple primary and histology coding rules only) • Type, subtype, predominantly, with features of, major, or with ___differentiation Obsolete Terms for Small Cell Carcinoma (Terms that are no longer recognized) • Intermediate cell carcinoma (8044) • Mixed small cell/large cell carcinoma (8045) (Code is still used; however current accepted terminology is combined small cell carcinoma) • Oat cell carcinoma (8042) • Small cell anaplastic carcinoma (No ICD-O-3 code) • Undifferentiated small cell carcinoma (No ICD-O-3 code) Definitions Adenocarcinoma with mixed subtypes (8255): A mixture of two or more of the subtypes of adenocarcinoma such as acinar, papillary, bronchoalveolar, or solid with mucin formation. Adenosquamous carcinoma (8560): A single histology in a single tumor composed of both squamous cell carcinoma and adenocarcinoma. Bilateral lung cancer: This phrase simply means that there is at least one malignancy in the right lung and at least one malignancy in the left lung.
    [Show full text]
  • Mixed Squamous Cell and Glandular Papilloma Presented with Peripheral Lung Mass: a Case Report
    J Lung Cancer 2012;11(2):94-96 http://dx.doi.org/10.6058/jlc.2012.11.2.94 Mixed Squamous Cell and Glandular Papilloma Presented with Peripheral Lung Mass: A Case Report Mixed squamous cell and glandular papilloma is a rare pulmonary neoplasm Si-Hyong Jang, M.D.1 2 typically occurring in the central lung area. Herein, we report a case of Tae Sung Kim, M.D., Ph.D. 3 peripherally located mixed papilloma in a 54-year-old man with a complaint Jae Ill Zo, M.D., Ph.D. and Joungho Han, M.D., Ph.D.1 of dyspnea. Chest computed tomography demonstrated an infiltrative peri- pheral lung mass in the right middle lobe, measuring 1.5 cm in diameter. Departments of 1Pathology, 2Radiology, The resected lung tumor had papillary configuration lined by both squamous and 3Thoracic Surgery, Sungkyun- cell epithelium and mucin-containing glandular epithelium. The papillary kwan University School of Medicine, Seoul, Korea stroma showed a fibrovascular core with inflammatory infiltrates. p63 immunostaining was positive in basal and parabasal tumor cells in papillary Received: June 11, 2012 fronds. (J Lung Cancer 2012;11(2):94 96) Revised: August 29, 2012 Accepted: August 30, 2012 Address for correspondence Joungho Han, M.D., Ph.D. Department of Pathology, Samsung Medical Center, Sungkyunkwan Uni- versity School of Medicine, 50, Irwon- dong, Gangnam-gu, Seoul 135-710, Korea Tel: 82-2-3410-2800 Fax: 82-2-3410-0025 Key Words: Lung, Neoplasms, Papilloma E-mail: [email protected] Solitary respiratory papilloma is an unusual benign neoplasm history and laboratory studies were unremarkable.
    [Show full text]
  • Needle Biopsy and Radical Prostatectomy Specimens David J Grignon
    Modern Pathology (2018) 31, S96–S109 S96 © 2018 USCAP, Inc All rights reserved 0893-3952/18 $32.00 Prostate cancer reporting and staging: needle biopsy and radical prostatectomy specimens David J Grignon Department of Pathology and Laboratory Medicine, Indiana University School of Medicine, IUH Pathology Laboratory, Indianapolis, IN, USA Prostatic adenocarcinoma remains the most common cancer affecting men. A substantial majority of patients have the diagnosis made on thin needle biopsies, most often in the absence of a palpable abnormality. Treatment choices ranging from surveillance to radical prostatectomy or radiation therapy are largely driven by the pathologic findings in the biopsy specimen. The first part of this review focuses on important morphologic parameters in needle biopsy specimens that are not covered in the accompanying articles. This includes tumor quantification as well as other parameters such a extraprostatic extension, seminal vesicle invasion, perineural invasion, and lymphovascular invasion. For those men who undergo radical prostatectomy, pathologic stage and other parameters are critical in prognostication and in determining the appropriateness of adjuvant therapy. Staging parameters, including extraprostatic extension, seminal vesicle invasion, and lymph node status are discussed here. Surgical margin status is also an important parameter and definitions and reporting of this feature are detailed. Throughout the article the current reporting guidelines published by the College of American Pathologists and the International Collaboration on Cancer Reporting are highlighted. Modern Pathology (2018) 31, S96–S109; doi:10.1038/modpathol.2017.167 The morphologic aspects of prostatic adenocarcinoma hormonal therapy.4,5 For needle biopsy specimens the have a critical role in the management and prognos- data described below are largely based on standard tication of patients with prostatic adenocarcinoma.
    [Show full text]
  • Perineural Invasion in Oral Squamous Cell Carcinoma: a Discussion of Significance and Review of the Literature ⇑ Nada O
    Oral Oncology 47 (2011) 1005–1010 Contents lists available at SciVerse ScienceDirect Oral Oncology journal homepage: www.elsevier.com/locate/oraloncology Review Perineural invasion in oral squamous cell carcinoma: A discussion of significance and review of the literature ⇑ Nada O. Binmadi a,b, John R. Basile a,c, a Department of Oncology and Diagnostic Sciences, University of Maryland Dental School, 650 West Baltimore Street, 7-North, Baltimore, MD 21201, USA b Department of Oral Basic & Clinical Sciences, King Abdulaziz University, Jeddah 21589, Saudi Arabia c Marlene and Stuart Greenebaum Cancer Center, 22 South Greene Street, Baltimore, MD 21201, USA article info summary Article history: Perineural invasion (PNI) is a tropism of tumor cells for nerve bundles in the surrounding stroma. It is a Received 20 May 2011 form of tumor spread exhibited by neurotropic malignancies that correlates with aggressive behavior, Received in revised form 27 July 2011 disease recurrence and increased morbidity and mortality. Oral squamous cell carcinoma (OSCC) is a neu- Accepted 1 August 2011 rotropic malignancy that traditionally has been difficult to treat and manage. Evidence suggests that Available online 23 August 2011 demonstration of PNI in OSCC should impact adjuvant treatment decisions and surgical management of this disease. Despite its importance as a prognostic indicator, experimental studies to explore the Keywords: molecular mechanisms responsible for PNI are limited. The aim of this review is to discuss the difficulties Oral squamous cell carcinoma in evaluating for PNI, review the literature regarding the relationship of PNI with patient outcomes in Perineural invasion Metastasis OSCC, and summarize the recent studies describing the molecular agents associated with this patholog- Neurotropic carcinoma ical phenomenon.
    [Show full text]
  • Peritoneal Serous Papillary Adenocarcinoma: Report of Four Cases
    □ CASE REPORT □ Peritoneal Serous Papillary Adenocarcinoma: Report of Four Cases Takeshi MINAMI, Koji NAKATANI, Shinya KONDO, Shuji KANAYAMA and Takahiro TSUJIMURA* Abstract Case Reports We report four cases of peritoneal serous papillary Case 1 adenocarcinoma (PSPC), a rare disease; all patients had A 71-year-old woman visited Sumitomo hospital com- ascites and high levels of serum CA125. Clinical and plaining of abdominal distention and was admitted in radiological examinations could not differentiate the February 1989 because of massive ascites. From laboratory disease from peritoneal metastatic tumors and mesothe- data, anemia (Hb 9.2 mg/dl) and a high level of serum lioma, and histopathological analysis including immuno- CA125 (10,330 U/ml) were seen. Abdominal CT revealed a chemistry on the specimen obtained at laparotomy or poorly defined hazy mass in the anterior portion of the peri- laparoscopy was necessary for the diagnosis. One patient toneal cavity with retroperitoneal lymphadenopathy, omental lived for 58 months with cytoreductive surgery and caking appearance, and ascites. Gynecological survey, and chemotherapy, and another is still living after 20 months endoscopic examinations of the upper gastrointestinal tract by chemotherapy alone. In patients with peritoneal tumors and colon did not reveal neoplastic lesions. Because of unknown origin and a high level of serum CA125, tak- adenocarcinoma cells were found in the ascites specimen on ing PSPC into consideration in the differential diagnosis, cytologic examination, intraperitoneal injection of cisplatin histopathological examination should be performed. was started. Then, the ascites and the serum CA125 levels (Internal Medicine 44: 944–948, 2005) decreased. On the 66th hospital day, she complained of sud- den abdominal pain, and free air was intraperitonally ob- Key words: peritoneum, chemotherapy, immunohistochemi- served on abdominal X-P.
    [Show full text]
  • Sinonasal Tumors
    Prepared by Kurt Schaberg Sinonasal/Nasopharyngeal Tumors Benign Sinonasal Papillomas aka Schneiderian papilloma Morphology Location Risk of Molecular transformation Exophytic Exophytic growth; Nasal Very low risk Low-risk HPV immature squamous epithelium septum subtypes Inverted Inverted ‘‘ribbonlike’’ growth; Lateral Low to EGFR immature squamous epithelium; wall and Intermediate risk mutations or transmigrating intraepithelial sinuses low-risk HPV neutrophilic inflammation subtypes Oncocytic Exophytic and endophytic growth; Lateral Low to KRAS multilayered oncocytic epithelium; wall and intermediate microcysts and intraepithelial sinuses neutrophilic microabscesses Modified from: Weindorf et al. Arch Pathol Lab Med—Vol 143, November 2019 Oncocytic Sinonasal Papilloma Note the abundant oncocytic epithelium with numerous neutrophils Inverted Sinonasal Papilloma Note the inverted, “ribbon-like” growth Respiratory Epithelial Adenomatoid Hamartoma aka “REAH” Sinonasal glandular proliferation arising from the surface epithelium (i.e., in continuity with the surface). Invaginations of small to medium-sized glands surrounded by hyalinized stroma with characteristic thickened, eosinophilic basement membrane Exists on a spectrum with seromucinous hamartoma, which has smaller glands. Should be able to draw a circle around all of the glands though, if too confluent → consider a low-grade adenocarcinoma Inflammatory Polyp Surface ciliated, sinonasal mucosa, possibly with squamous metaplasia. Edematous stroma (without a proliferation of seromucinous glands). Mixed inflammation (usu. Lymphocytes, plasma cells, and eosinophils) Pituitary adenoma Benign anterior pituitary tumor Although usually primary to sphenoid bone, can erode into nasopharynx or be ectopic Can result in endocrine disorders, such as Cushing’s disease or acromegaly. Solid, nested, or trabecular growth of epithelioid cells with round nuclei and speckled chromatin and eosinophilic, granular chromatin. Express CK, and neuroendocrine markers.
    [Show full text]
  • Well Differentiated Papillary Mesothelioma of Abdomen‑ a Rare Case with Diagnostic Dilemma
    Published online: 2020-02-19 Case Report Access this article online Quick Response Code: Well differentiated papillary mesothelioma of abdomen‑ a rare case with diagnostic dilemma Aniruddha Saha, Palash Kumar Mandal1, Anupam Manna, Kalyan Khan2, Subrata Pal1 Website: www.jlponline.org Abstract: DOI: 10.4103/JLP.JLP_167_16 Well-differentiated papillary mesothelioma is a rare tumor occurring predominantly in the peritoneum of young women, a few with history of asbestos exposure. A 28-year-old woman presented with ascites and pain abdomen. Ultrasonography and computed tomography scan of the abdomen revealed a mass in the retroperitoneum measuring 15 cm × 12 cm. Histopathological examination along with immunohistochemistry (IHC) confirmed it to be a papillary mesothelioma in the peritoneum. It is difficult to differentiate from more common malignant mesothelioma and papillary adenocarcinoma, which also have poorer prognosis. The difficulty can be resolved by clinico-radiological correlation along with histopathological examination and IHC. Key words: Immunohistochemistry, peritoneum, well-differentiated papillary mesothelioma Introduction The ultrasonography of whole abdomen showed an abdomino‑pelvic mass along ell‑differentiated papillary with ascites. Ascitic fluid examination was Wmesotheliomas (WDPMs) of the done and showed few cellular fragments of peritoneum are uncommon; approximately mesothelial cells admixed with lymphocytes. 50 cases have been reported till date.[1‑5] Abdominal computed tomography (CT) Approximately 75% of the tumors occurred scan showed mass measuring 14 cm × 11 cm, in females who are usually of reproductive but the site of origin could not be identified age but occasionally postmenopausal.[2] and possibility of the left adnexal mass was WDPM is usually an incidental finding at suggested [Figure 1a].
    [Show full text]
  • A Brief History of Head and Neck Pathology Developments☆,☆☆, Lester D.R
    Human Pathology (2020) 95,1–23 www.elsevier.com/locate/humpath Progress in pathology Don't stop the champions of research now: a brief history of head and neck pathology developments☆,☆☆, Lester D.R. Thompson MD a,⁎, James S. Lewis Jr. MD b, Alena Skálová MD, PhD c, Justin A. Bishop MD d aSouthern California Permanente Medical Group, Department of Pathology, Woodland Hills, CA 91365, USA bDepartment of Pathology, Microbiology, and Immunology, Vanderbilt University Medical Center, Nashville, TN 37232, USA cSikl's Department of Pathology, Medical Faculty of Charles University, Faculty Hospital, 305 99 Plzen, Czech Republic dDepartment of Pathology, University of Texas Southwestern Medical Center, Clements University Hospital, Dallas, TX 75390, USA Received 13 August 2019; accepted 14 August 2019 Keywords: Summary The field of head and neck pathology was just developing 50 years ago but has certainly come a Head and neck; long way in a relatively short time. Thousands of developments in diagnostic criteria, tumor classification, Salivary gland neoplasms; malignancy staging, immunohistochemistry application, and molecular testing have been made during this Oropharyngeal; time, with an exponential increase in literature on the topics over the past few decades: There were 3506 ar- Pathology; ticles published on head and neck topics in the decade between 1969 and 1978 (PubMed source), with a Immunohistochemistry; staggering 89266 manuscripts published in the most recent decade. It is daunting and impossible to narrow Paranasal sinus neoplasms; the more than 162000 publications in this field and suggest only a few topics of significance. However, the Molecular breakthrough in this anatomic discipline has been achieved in 3 major sites: oropharyngeal carcinoma, sal- ivary gland neoplasms, and sinonasal tract tumors.
    [Show full text]