DOCSLIB.ORG

Splenic Angiosarcoma: a Clinicopathologic and Immunophenotypic Study of 28 Cases Thomas S

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Splenic Angiosarcoma: a Clinicopathologic and Immunophenotypic Study of 28 Cases Thomas S Splenic Angiosarcoma: A Clinicopathologic and Immunophenotypic Study of 28 Cases Thomas S. Neuhauser, M.D., Gregory A. Derringer, M.D., Lester D. R. Thompson, M.D., Julie C. Fanburg-Smith, M.D., Markku Miettinen, M.D., Anne Saaristo, M.B., Susan L. Abbondanzo, M.D. Departments of Hematopathology (TSN, GAD, SLA), Endocrine and Otorhinolaryngic-Head & Neck Pathology (LDRT), Soft Tissue Pathology (JCF-S, MM), Armed Forces Institute of Pathology, Washington, DC; Molecular/Cancer Biology Laboratory, Haartman Institute, University of Helsinki, Finland (AS); Wilford Hall Medical Center, Lackland AFB, Texas (TSN) entiation (CD34, FVIIIRAg, VEGFR3, and CD31) Primary angiosarcoma of the spleen is a rare neo- and at least one marker of histiocytic differen- plasm that has not been well characterized. We de- tiation (CD68 and/or lysozyme). Metastases de- scribe the clinical, morphologic, and immunophe- veloped in 100% of patients during the course of notypic findings of 28 cases of primary splenic their disease. Twenty-six patients died of dis- angiosarcoma, including one case that shares fea- ease despite aggressive therapy, whereas only tures of lymphangioma/lymphangiosarcoma. The two patients are alive at last follow-up, one with patients included 16 men and 12 women, aged 29 to disease at 8 years and the other without disease 85 years, with a mean of 59 years and median of 63 at 10 years. In conclusion, primary splenic an- years. The majority of patients (75%) complained of giosarcoma is an extremely aggressive neo- abdominal pain, and 25% presented with splenic plasm that is almost universally fatal. The ma- rupture. The most common physical finding was jority of splenic angiosarcomas coexpress splenomegaly (71%). Seventeen of 21 patients were histiocytic and endothelial markers by immu- reported to have anemia. Macroscopic examination nohistochemical analysis, which suggest that showed splenomegaly in 85% cases. Sectioning re- some tumors may originate from splenic lining vealed discrete lesions in 88% of cases, ranging from cells. well-circumscribed firm nodules to poorly delin- eated foci of necrosis and hemorrhage associated KEY WORDS: Angiosarcoma, Hemangioma, Histo- with cystic spaces. Microscopically, the tumors were genesis, Immunohistochemistry, Littoral cell angi- heterogenous; however, all cases demonstrated at oma, Lymphangioma, Lymphangiosarcoma. least a focal vasoformative component lined by Mod Pathol 2000;13(9):978–987 atypical endothelial cells. Solid sarcomatous, papil- lary, and epithelioid growth patterns were observed. Primary malignant vascular neoplasms of the The solid sarcomatous component resembled fibro- spleen are rare and carry a dismal prognosis regard- sarcoma in two cases and malignant fibrous- less of the treatment regimen (1–5). Although all histiocytoma in one case. Hemorrhage, necrosis, cases demonstrate at least a focal vasoformative hemosiderin, extramedullary hematopoiesis, and component, malignant splenic vascular tumors intracytoplasmic hyaline globules were frequently may be mistaken for benign vascular or malignant identified. A panel of immunohistochemical studies non-vascular tumors because of their frequently revealed that the majority of tumors were immuno- highly variable histology. The pathologic features reactive for at least two markers of vascular differ- and a comprehensive immunohistochemical pro- file have not been well addressed in the literature to date. Copyright © 2000 by The United States and Canadian Academy of We describe the clinical, pathologic, and immu- Pathology, Inc. VOL. 13, NO. 9, P. 978, 2000 Printed in the U.S.A. nophenotypic features of 28 splenic angiosarcomas Date of acceptance: March 23, 2000. and analyze this data as it relates to disease course The opinions or assertions contained herein are the private views of the authors and are not to be construed as official or as reflecting the views of and patient outcome. We also compare the immu- the Department of the Air Force, the Department of the Navy, or the Department of Defense. nohistochemical features of these tumors to three Address reprint requests to: Thomas S. Neuhauser, MD, Wilford Hall benign primary splenic tumor subtypes: lym- Medical Center, Department of Pathology, 2200 Bergquist Drive, Suite #1, Lackland AFB, TX 78236; e-mail: [email protected]; phangioma, hemangioma, and littoral cell angi- fax: 210-292-7484. oma. 978 MATERIALS AND METHODS Department of Defense Directive 3216.2 relating to human subjects in research. Fifty-three cases of angiosarcoma involving the Hematoxylin and eosin (H&E) and periodic acid- spleen were selected from a review of 376 splenec- Schiff stained slides for all cases were reviewed to tomy specimens retrieved from the archives of the confirm that established light microscopic his- Hematopathology Tumor Registry at the Armed topathologic criteria for angiosarcoma were ful- Forces Institute of Pathology (AFIP), Washington, filled (3). Criteria include the presence of a vasofor- DC, between 1970 and 1998. Twenty-five of the 53 mative component and cytologic features of cases of angiosarcoma were excluded from further malignancy, including cellular atypia and mitotic study because they did not fulfill our inclusion cri- activity. Five of our cases were previously reported teria: primary origin in the spleen, sufficient mate- (3). A number of histomorphologic characteristics rial for immunohistochemical analysis, and ade- quate clinical information. The remaining 28 cases were tabulated for each case, including histologic represented approximately 7.4% of all benign or growth pattern(s), presence or absence of necrosis, malignant primary splenic tumors (376) seen in hemorrhage, hemosiderin, hyaline globules, he- consultation during this time. Primary origin in the mophagocytosis, calcification, thrombosis, ex- spleen was defined as no metastasis at the time of tramedullary hematopoiesis, and fibrosis. Nuclear presentation as determined by sophisticated radio- atypia was separated into three grades (mild, mod- logic procedures and/or surgical staging (18/28 cas- erate, and severe) with benign endothelial cells as a es), or overwhelming tumor burden in the spleen in reference. Mild atypia referred to nuclei with min- cases with concomitant metastasis (10/28 cases). imal pleomorphism and hyperchromasia, severe The spleen was virtually replaced by the malig- atypia referred to nuclei showing frank anaplasia nancy in the majority of the latter cases. Twenty- with large irregular nuclei with hyperchromasia, three cases were obtained from civilian sources and and moderate atypia referred to those nuclei that five cases from military hospitals and Veterans Ad- fell between the two extremes. Mitotic figures were ϫ ministration Medical Centers. counted on an Olympus BH-2 microscope at 40 . Materials within the files of the AFIP were sup- The areas with the highest number of mitoses were plemented by a review of the patient demographics, chosen for counting. signs and symptoms at presentation, duration of Immunophenotypic studies were performed on a symptoms before presentation, medical history, ra- single block by the standardized avidin-biotin diographic studies performed, laboratory test re- method of Hsu et al. (6) using 4-␮m thick sections sults, surgical pathology and operative reports, can- on all formalin-fixed, paraffin-embedded cases of cer registry records, and by written questionnaires splenic angiosarcoma, 10 cases of littoral cell angi- or oral communication with the treating physi- oma, and nine cases each of splenic hemangioma cian(s). Follow-up data included information re- and splenic lymphangioma. Table 1 indexes the garding environmental exposures, occupational immunohistochemical antibody panel chosen. history, the specific type(s) and length of treatment When required, proteolytic antigen retrieval was methods used, and the current status of the disease performed with predigestion for 3 min with 0.05% and patient. This clinical investigation was con- Protease VIII (Sigma Chemical Co., St. Louis, MO) ducted in accordance and compliance with all stat- in a 0.1-M phosphate buffer at a pH of 7.8 at 37° C utes, directives, and guidelines of the Code of Fed- (7). Antigen enhancement (recovery) was per- eral Regulations, Title 45, Part 46, and the formed, as required, using formalin-fixed, paraffin- TABLE 1. Immunohistochemical Panel Primary Antigen Antibody (Clone) Company Dilution Antibody Recovery CD31 (JC/70) mm DAKO, Carpinteria, CA 1:100 Microwave CD34 (Q BEND) mm AMAC, Westbrook, ME 1:100 N/A Factor VIIIRAg rp DAKO 1:50 N/A VEGFR3 (9D9) mm Dr. Kari Alitalo, Helskinki, Finland {88} 1:1000 Microwave CD68 (KP1) mm DAKO 1:500 Enzyme Lysozyme rp DAKO 1:1000 Enzyme Ki-67 mm Coulter Immunotech, Westbrook, ME 1:40 Microwave EMA (E29) mm DAKO 1:100 N/A Cytokeratin (AE1/AE3, CK1) mm Boehringer, Indianapolis, IN 1:400 N/A S-100 R rp Sigma Diagnostics, St. Louis, MO 1:2000 N/A CD21 (1F8) mm DAKO 1:50 Enzyme CD8 (C8/144B) mm DAKO 1:100 Microwave N/A, not applicable; mm, mouse monoclonal; rp, rabbit polyclonal; VEGFR3, vascular endothelial growth factor receptor 3; EMA, epithelial membrane antigen; Enzyme, enzymatic protein digestion; Microwave, microwave epitope retrieval. Splenic Angiosarcoma (T.S. Neuhauser, et al.) 979 embedded tissue treated with a buffered citric acid (n ϭ 13). Four patients had leukocytosis and four solution and heated for 20 min in a calibrated mi- patients had thrombocytopenia. Additional labo- crowave oven (8). Following this,
Load more

Recommended publications
  • Recurrent Targetoid Hemosiderotic Hemangioma in a 26-Year-Old Man
    CASE REPORT Recurrent Targetoid Hemosiderotic Hemangioma in a 26-Year-Old Man LT Sarah Broski Gendernalik, DO, MC (FS), USN LT James D. Gendernalik, DO, MC (FS), USN A 26-year-old previously healthy man presented with a 6-mm violaceous papule that had a surrounding 1.5-cm annular, nonblanching, erythematous halo on the right-sided flank. The man reported the lesion had been recurring for 4 to 5 years, flaring every 4 to 5 months and then slowly disap - pearing until the cycle recurred. Targetoid hemosiderotic hemangioma was clinically diagnosed. The lesion was removed by means of elliptical excision and the condition resolved. The authors discuss the clinical appearance, his - tology, and etiology of targetoid hemosiderotic heman - giomas. J Am Osteopath Assoc . 2011;111(2);117-118 argetoid hemosiderotic hemangiomas (THHs) are a com - Tmonly misdiagnosed presentation encountered in the primary care setting. In the present case report, we aim to pro - Figure. A 6-mm violaceous papule with a surrounding 1.5-cm annular, nonblanching, erythematous halo in a 26-year-old man. vide general practitioners with an understanding of the clin - ical appearance, pathology, and prognosis of THH. Report of Case A 26-year-old previously healthy man presented to our primary around it and itched and burned each time it developed. The care clinic with a 6-mm violaceous papule with a surrounding lesion faded completely to normal-appearing skin between 1.5-cm annular, nonblanching, erythematous halo on the right- episodes, without evidence of a papule or postinflammatory sided flank ( Figure ). The patient stated that the lesion had hyperpigmentation.
    [Show full text]
  • Hemangiosarcoma Philip J
    Ettinger & Feldman – Textbook of Veterinary Internal Medicine Client Information Sheet Hemangiosarcoma Philip J. Bergman What is hemangiosarcoma? Hemangiosarcoma (HSA; angiosarcoma or malignant hemangioendothelioma) is an extremely aggressive tumor of blood vessel origin. Because blood vessels are present throughout the body, virtually any site in the body can have HSA. HSA occurs most frequently in dogs (approximately 2% of all tumors) and the most common site is the spleen. However, additional common sites include the heart, liver, muscle, lung skin, bones, kidney, brain, abdomen, and oral cavity. In three large canine splenic disease studies encompassing approximately 2000 dogs, a “rule of two thirds” was found suggesting that approximately two thirds of dogs with a splenic mass have a cancer (therefore one third are not malignant) and two thirds of the malignant tumors of the spleen are HSA. HSA is a disease generally of older dogs and cats with an average onset of 9 to 10 years; however, there are reports of extremely young dogs and cats with this disease (5 to 6 months to a few years of age). German shepherd dogs are most commonly diagnosed with HSA; however, other large breed dogs such as golden retrievers and Labrador retrievers may also be overrepresented. In cats, the most common breed is the domestic shorthair. The cause of HSA in dogs and cats is presently unknown. Exposures to toxins such as chemicals, insecticides, and radiation have been reported in humans to be associated with HSA. Ultraviolet light exposure from the sun may be a potential cause of HSA in dogs, as HSAs of the skin are commonly seen in dogs with light hair and poor pigmentation (e.g., Salukis, Whippets, and white Bulldogs).
    [Show full text]
  • Endogenous Dendritic Cells from the Tumor Microenvironment Support T
    Endogenous dendritic cells from the tumor PNAS PLUS microenvironment support T-ALL growth via IGF1R activation Todd A. Tripletta, Kim T. Cardenasa,1, Jessica N. Lancastera, Zicheng Hua, Hilary J. Seldena, Guadalupe J. Jassoa, Sadhana Balasubramanyama, Kathy Chana, LiQi Lib, Xi Chenc,d, Andrea N. Marcogliesee, Utpal P. Davéf, Paul E. Loveb, and Lauren I. R. Ehrlicha,2 aDepartment of Molecular Biosciences, Institute for Cellular and Molecular Biology, The University of Texas at Austin, Austin, TX 78712; bSection on Hematopoiesis and Lymphocyte Biology, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD 20892; cDivision of Biostatistics, Department of Health Sciences, University of Miami Miller School of Medicine, Miami, FL 33136; dSylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL 33136; eDepartment of Pathology and Immunology, Baylor College of Medicine, Houston, TX 77030; and fDivision of Hematology/Oncology, Tennessee Valley Healthcare System and Vanderbilt University Medical Center, Nashville, TN 37232 Edited by Zena Werb, University of California, San Francisco, CA, and approved January 14, 2016 (received for review October 15, 2015) Primary T-cell acute lymphoblastic leukemia (T-ALL) cells require tumor growth and metastasis (3). Tumor-associated macrophages stromal-derived signals to survive. Although many studies have (TAMs), which resemble alternatively activated (M2) macro- identified cell-intrinsic alterations in signaling pathways that promote phages (4), also support tumor growth. TAMs suppress antitumor T-ALL growth, the identity of endogenous stromal cells and their immune responses, promote tumor invasion and angiogenesis, and associated signals in the tumor microenvironment that support T-ALL are negatively associated with clinical outcomes (5).
    [Show full text]
  • Tumors and Tumor-Like Lesions of Blood Vessels 16 F.Ramon
    16_DeSchepper_Tumors_and 15.09.2005 13:27 Uhr Seite 263 Chapter Tumors and Tumor-like Lesions of Blood Vessels 16 F.Ramon Contents 42]. There are two major classification schemes for vas- cular tumors. That of Enzinger et al. [12] relies on 16.1 Introduction . 263 pathological criteria and includes clinical and radiolog- 16.2 Definition and Classification . 264 ical features when appropriate. On the other hand, the 16.2.1 Benign Vascular Tumors . 264 classification of Mulliken and Glowacki [42] is based on 16.2.1.1 Classification of Mulliken . 264 endothelial growth characteristics and distinguishes 16.2.1.2 Classification of Enzinger . 264 16.2.1.3 WHO Classification . 265 hemangiomas from vascular malformations. The latter 16.2.2 Vascular Tumors of Borderline classification shows good correlation with the clinical or Intermediate Malignancy . 265 picture and imaging findings. 16.2.3 Malignant Vascular Tumors . 265 Hemangiomas are characterized by a phase of prolif- 16.2.4 Glomus Tumor . 266 eration and a stationary period, followed by involution. 16.2.5 Hemangiopericytoma . 266 Vascular malformations are no real tumors and can be 16.3 Incidence and Clinical Behavior . 266 divided into low- or high-flow lesions [65]. 16.3.1 Benign Vascular Tumors . 266 Cutaneous and subcutaneous lesions are usually 16.3.2 Angiomatous Syndromes . 267 easily diagnosed and present no significant diagnostic 16.3.3 Hemangioendothelioma . 267 problems. On the other hand, hemangiomas or vascular 16.3.4 Angiosarcomas . 268 16.3.5 Glomus Tumor . 268 malformations that arise in deep soft tissue must be dif- 16.3.6 Hemangiopericytoma .
    [Show full text]
  • Cutaneous Angiosarcoma: Report of Three Different and Typical Cases Admitted in a Unique Dermatology Clinic*
    CASE REPORT 235 s Cutaneous angiosarcoma: report of three different and typical cases admitted in a unique dermatology clinic* Aline Neves Freitas Cabral1 Rafael Henrique Rocha1 Ana Cristina Vervloet do Amaral1 Karina Bittencourt Medeiros2 Paulo Sérgio Emerich Nogueira1 Lucia Martins Diniz3 DOI: http://dx.doi.org/10.1590/abd1806-4841.20175326 Abstract: Angiosarcoma is a rare and aggressive tumor with high rates of metastasis and relapse. It shows a particular predi- lection for the skin and superficial soft tissues. We report three distinct and typical cases of angiosarcoma that were diagnosed in a single dermatology clinic over the course of less than a year: i) Angiosarcoma in lower limb affected by chronic lymph- edema, featuring Stewart-Treves syndrome; ii) a case of the most common type of angiosarcoma loated in the scalp and face of elderly man and; iii) a skin Angiosarcoma in previously irradiated breast. All lesions presented characteristic histopathological findings: irregular vascular proliferation that dissects the collagen bundles with atypical endothelial nuclei projection toward the lumen. Keywords: Hemangiosarcoma; Lymphangiosarcoma; Lymphedema; Non-Filarial Lymphedema; Sarcoma INTRODUCTION Angiosarcoma (AS) is a rare and aggressive neoplasm, that fibers, formed by endothelium with atypical nuclei, prominent to- originates from endothelial cells of lymphatic and blood vessels. It ac- ward the lumen; The tumoral lesion exhibited cohesive epithelioid counts for 5% of malignant skin tumors and less than 1% of all sarco- masses of atypical, large, rounded cells with acidophilic cytoplasm mas. It is notable for having a predilection for the skin and superficial and frequent mitotic figures. (Figure 2). Immunohistochemical anal- soft tissues.
    [Show full text]
  • Lymphangioma Circumscriptum of the Vulva- a Case Series Dermatology Section
    DOI: 10.7860/JCDR/2021/47435.14553 Case Series Lymphangioma Circumscriptum of the Vulva- A Case Series Dermatology Section RASHMI S MAHAJAN1, YOGESH S MARFATIA2, ATMAKALYANI R SHAH3, KISHAN R NINAMA4 ABSTRACT Vulval dermatoses pose a diagnostic and therapeutic challenge for the dermatologists. Lymphangioma Circumscriptum (LC) is a form of lymphangioma affecting the skin and subcutaneous tissues that is characterised by benign dilation of lymphatic channels. This uncommon condition is known to occur over the chest, mouth, axilla, tongue, and rarely in the vulva. In this series, authors present three cases of LC of vulva in women between the age group of 45 to 60 years with late-onset fluid-filled lesions over the vulva. The first case had history of hysterectomy prior to onset of lesions, the second case had a spontaneous onset of lesions while the third was a suspected case of pelvic tuberculosis with secondary lymphangioma. Keywords: Lymphangiectasia, Vulvar, Vulval epithelium INTRODUCTION Disorders of vulval epithelium are a confusing spectrum of disorders. They are broadly classified as-1) Inflammatory, 2) Ulcerative and Bullous, 3) Infections, 4) Benign tumours and 5) Malignancies. It is essential to know the exact aetiology to plan successful therapy. LC is a benign lymphatic malformation characterised by dilation of lymphatic vessels in the skin and subcutaneous tissue with lesions erupting locally as isolated or grouped translucid, thin-walled vesicles filled with a clear liquid [1]. These pathological lymphatic malformations have no communication with the normal lymphatics [2]. The precise cause of LC is not established. It could be congenital or acquired as a result of damage to the lymphatic vessels secondary to various aetiologies.
    [Show full text]
  • Toxicological Profile for Glyphosate Were
    A f Toxicological Profile for Glyphosate August 2020 GLYPHOSATE II DISCLAIMER Use of trade names is for identification only and does not imply endorsement by the Agency for Toxic Substances and Disease Registry, the Public Health Service, or the U.S. Department of Health and Human Services. GLYPHOSATE III FOREWORD This toxicological profile is prepared in accordance with guidelines developed by the Agency for Toxic Substances and Disease Registry (ATSDR) and the Environmental Protection Agency (EPA). The original guidelines were published in the Federal Register on April 17, 1987. Each profile will be revised and republished as necessary. The ATSDR toxicological profile succinctly characterizes the toxicologic and adverse health effects information for these toxic substances described therein. Each peer-reviewed profile identifies and reviews the key literature that describes a substance's toxicologic properties. Other pertinent literature is also presented, but is described in less detail than the key studies. The profile is not intended to be an exhaustive document; however, more comprehensive sources of specialty information are referenced. The focus of the profiles is on health and toxicologic information; therefore, each toxicological profile begins with a relevance to public health discussion which would allow a public health professional to make a real-time determination of whether the presence of a particular substance in the environment poses a potential threat to human health. The adequacy of information to determine a substance's
    [Show full text]
  • Vascular Tumors and Malformations of the Orbit
    14 Vascular Tumors Kaan Gündüz and Zeynel A. Karcioglu ascular tumors and malformations of the orbit VIII related antigen (v,w,f), CV141 (endothelium, comprise an important group of orbital space- mesothelium, and squamous cells), and VEGFR-3 Voccupying lesions. Reviews indicate that vas- (channels, neovascular endothelium). None of the cell cular lesions account for 6.2 to 12.0% of all histopatho- markers is absolutely specific in its application; a com- logically documented orbital space-occupying lesions bination is recommended in difficult cases. CD31 is (Table 14.1).1–5 There is ultrastructural and immuno- the most often used endothelial cell marker, with pos- histochemical evidence that capillary and cavernous itive membrane staining pattern in over 90% of cap- hemangiomas, lymphangioma, and other vascular le- illary hemangiomas, cavernous hemangiomas, and an- sions are of different nosologic origins, yet in many giosarcomas; CD34 is expressed only in about 50% of patients these entities coexist. Hence, some prefer to endothelial cell tumors. Lymphangioma pattern, on use a single umbrella term, “vascular hamartomatous the other hand, is negative with CD31 and CD34, lesions” to identify these masses, with the qualifica- but, it is positive with VEGFR-3. VEGFR-3 expression tion that, in a given case, one tissue element may pre- is also seen in Kaposi sarcoma and in neovascular dominate.6 For example, an “infantile hemangioma” endothelium. In hemangiopericytomas, the tumor may contain a few caverns or intertwined abnormal cells are typically positive for vimentin and CD34 and blood vessels, but its predominating component is negative for markers of endothelia (factor VIII, CD31, usually capillary hemangioma.
    [Show full text]
  • Glomus Tumor in the Floor of the Mouth: a Case Report and Review of the Literature Haixiao Zou1,2, Li Song1, Mengqi Jia2,3, Li Wang4 and Yanfang Sun2,3*
    Zou et al. World Journal of Surgical Oncology (2018) 16:201 https://doi.org/10.1186/s12957-018-1503-6 CASEREPORT Open Access Glomus tumor in the floor of the mouth: a case report and review of the literature Haixiao Zou1,2, Li Song1, Mengqi Jia2,3, Li Wang4 and Yanfang Sun2,3* Abstract Background: Glomus tumors are rare benign neoplasms that usually occur in the upper and lower extremities. Oral cavity involvement is exceptionally rare, with only a few cases reported to date. Case presentation: A 24-year-old woman with complaints of swelling in the left floor of her mouth for 6 months was referred to our institution. Her swallowing function was slightly affected; however, she did not have pain or tongue paralysis. Enhanced computed tomography revealed a 2.8 × 1.8 × 2.1 cm-sized well-defined, solid, heterogeneous nodule above the mylohyoid muscle. The mandible appeared to be uninvolved. The patient underwent surgery via an intraoral approach; histopathological examination revealed a glomus tumor. The patient has had no evidence of recurrence over 4 years of follow-up. Conclusions: Glomus tumors should be considered when patients present with painless nodules in the floor of the mouth. Keywords: Glomus tumor, Floor of mouth, Oral surgery Background Case presentation Theglomusbodyisaspecialarteriovenousanasto- A 24-year-old woman with a 6-month history of swelling mosisandfunctionsinthermalregulation.Glomustu- in the left floor of her mouth was referred to our institu- mors are rare, benign, mesenchymal tumors that tion. Although she experienced slight difficulty in swal- originate from modified smooth muscle cells of the lowing, she did not experience pain or tongue paralysis.
    [Show full text]
  • Benign Hemangiomas
    TUMORS OF BLOOD VESSELS CHARLES F. GESCHICKTER, M.D. (From tke Surgical Palkological Laboratory, Department of Surgery, Johns Hopkins Hospital and University) AND LOUISA E. KEASBEY, M.D. (Lancaster Gcaeral Hospital, Lancuster, Pennsylvania) Tumors of the blood vessels are perhaps as common as any form of neoplasm occurring in the human body. The greatest number of these lesions are benign angiomas of the body surfaces, small elevated red areas which remain without symptoms throughout life and are not subjected to treatment. Larger tumors of this type which undergb active growth after birth or which are situated about the face or oral cavity, where they constitute cosmetic defects, are more often the object of surgical removal. The majority of the vascular tumors clinically or pathologically studied fall into this latter group. Benign angiomas of similar pathologic nature occur in all of the internal viscera but are most common in the liver, where they are disclosed usually at autopsy. Angiomas of the bone, muscle, and the central nervous system are of less common occurrence, but, because of the symptoms produced, a higher percentage are available for study. Malignant lesions of the blood vessels are far more rare than was formerly supposed. An occasional angioma may metastasize following trauma or after repeated recurrences, but less than 1per cent of benign angiomas subjected to treatment fall into this group. I Primarily ma- lignant tumors of the vascular system-angiosarcomas-are equally rare. The pathological criteria for these growths have never been ade- quately established, and there is no general agreement as to this par- ticular form of tumor.
    [Show full text]
  • Angiosarcomas and Other Sarcomas of Endothelial Origin
    Angiosarcomas and Other Sarcomas of Endothelial Origin a,b a Angela Cioffi, MD , Sonia Reichert, MD , c a,b,d, Cristina R. Antonescu, MD , Robert G. Maki, MD, PhD, FACP * KEYWORDS Angiosarcoma Epithelioid hemangioendothelioma Vascular sarcoma Kaposi sarcoma VEGF KDR FLT4 Translocation Organ transplant KEY POINTS Vascular sarcomas are rare and collectively affect fewer than 600 people a year in the United States (incidence approximately 2/million). Because angiosarcomas, hemangioendotheliomas, and other vascular tumors have unique embryonal derivation, it is not surprising that they have a unique sensitivity pattern to chemotherapy agents. Surgery, when possible, remains the primary treatment for angiosarcomas. Adjuvant radiation for primary disease seems prudent for at least some angiosarcoma, given the high local-regional recurrence rate of these tumors. Angiosarcomas also have a high rate of metastasis, but it is not clear that adjuvant chemotherapy improves survival. Epithelioid hemangioendothelioma is a unique form of sarcoma often presenting as multi- focal disease. Most patients can do well with observation alone, although a fraction of pa- tients have more aggressive disease and have difficulties in both local control and metastatic disease. Continued Disclosures: R.G. Maki receives clinical research support from Morphotek/Eisai, Ziopharm, and Imclone/Lilly. He has also consulted for Eisai, Morphotek/Eisai, Imclone/Lilly, Taiho, Glaxo- SmithKline, Merck, Champions Biotechnology, and Pfizer. He has received speaker’s fees from Novartis. He is an unpaid consultant for the Sarcoma Foundation of America, SARC: Sarcoma Alliance for Research through Collaboration, n-of-one, and 23 & me. C.R. Antonescu, A. Cioffi, and S. Reichert report no conflicts.
    [Show full text]
  • WSC 20-21 Conf 6 Illustrated Results
    Joint Pathology CenterJoint Pathology Center Veterinary PathologyVeterinary Services Pathology Services WEDNESDAY SLIDE CONFERENCE 2020-2021 WEDNESDAY SLIDE CONFERENCE 2019-2020 Conference 6 C o n f e r e n c e 16 29 January 2020 30 September 2020 Dr. Ingeborg Langohr, DVM, PhD, DACVP Professor Department of Pathobiological Sciences Louisiana State University School of Veterinary Medicine Joint Pathology Center Baton Rouge, LA Silver Spring, Maryland CASE I: CASE S1809996 1: N16 (JPC-032 4135077(4084301).-00 ) Microscopic2.2x1.5x2 Description: cm firm mass The originatinginterstitium from the dura within themater section (meningioma). is diffusely infiltrated by Signalment:Signalment: A 3-month 13- old,yrs male,of age, mixed spayed- female,moderate to large numbers of predominantly breed pigGolden (Sus scrofa Retriever,) Canis lupus familiaris, caninemononuclear. Laboratory cells along results: with edema. There is abundantCytology: type II pneumocyteIt was reported hyperplasia that ante -mortem History: This pig had no previous signs of History: lining alveolarcytology septae of blood and manysmears of from the this animal were illness, andIt waswas reportedfound dead. that the patient had decreased consistent with lymphoid leukemia. appetite and lethargy for the past 1-2 weeks andalveolar spacesSpecial have staining: central Under areas polarized of light, Congo Gross Pathologyhad diarrhea: Approximately for ~1 day. She70% had of a history ofnecrotic macrophagesRed special admixedstain withrevealed other apple-green the lungs,seizures primarily for thein the past cranial ~3 years; regions her last of seizure wasmononuclear birefringence cells and of fewer material neutrophils. effacing glomeruli and the lobes,1 were month patchy ago. darkThe red,patient and hadfirm a generalizedOccasionally cardiac there vessel is free.
    [Show full text]