Adenoid cystic carcinoma of bartholin's gland clinically mimics endometriosis, a case report

Adenoid cystic carcinoma of Bartholin's gland is a rare malignant tumor of female genital tract. We report a case of a 42-year-old woman, presenting a palpable painful mass and burning sensation on the left side of vulva during the preceding two months. Based on examination, a solid fixed painful nodule with intact mucosa was palpated on the left side of the vagina. Histological features were compatible with adenoid cystic carcinoma. Often, such lesion is clinically misdiagnosed as a cyst or inflammation. The present case was carried out with an impression of endometriosis. The possibility of cancer should be considered in any female older than 40 years of age with a lesion near the Bartholin's glands

Evaluation of Ki67, p16 and CK17 markers in differentiating cervical intraepithelial neoplasia and benign lesions

Background: Cervical intraepithelial neoplasia [CIN] is a premalignant lesion capable of progressing to cervical cancer. Despite the existing well-defined criteria, the histomorphologic diagnosis is subject to high rates of discordance among pathologists. The aim of this study was to evaluate Ki-67 [MIB- 1], CK17 and p16 [INK4a] [p16] markers by immunohistochemical methods in differentiating CIN from benign cervical lesions

Methods: The present study reviewed and re-classified 77 cervical biopsies, originally diagnosed as 31 non-CIN, and 46 CIN, as 54 non-CIN, and 23 CIN based on at least two similar diagnoses. Immunostaining by Ki67, p16 and CK17 markers was performed on all cases and the results were compared with pervious and consensus diagnosis

Results: The overall agreement between pervious and consensus diagnosis was 67.5% [Kappa=0.39, P<0.001]. The sensitivity and specificity of Ki67 immunostaining were 95.6% and 85.1% respectively, while for p16 the corresponding values were 91.3% and 98.1%. The overall agreement, for both p16 and Ki67, with consensus diagnosis were significant [P<0.001]. The sensitivity and specificity of CK17 negative staining in CIN detection were 39.1% and 40.7% respectively

Conclusion: Ki67 and p16 markers are recommended as complementary tests for differentiating between dysplastic and non-dysplastic lesions. CK17 does not discriminate between immature metaplasia with and without dysplasia

Value of CD10 expression in differentiating cutaneous basal from squamous cell carcinomas and basal cell carcinoma from trichoepithelioma

Background: In addition to the well-defined histological criteria for squamous cell carcinoma [SCC] and basal cell carcinoma [BCC], immunohistochemical techniques can be used in difficult cases for their differentiation. As differential diagnosis between trichoepithelioma [TE] and BCC is sometimes difficult for the clinician and the pathologist, CD10 may be a useful marker for definite diagnosis. We aimed to evaluate the usefulness of this marker in the differentiation between SCC and BCC and also in the differentiation between BCC and TE

Methods: Fifty-five BCC cases, 50 SCC cases, and 20 cases of benign adnexal tumor with follicular differentiation were retrieved from the archives of the pathology departments of hospitals affiliated with Shiraz University of Medical Sciences. Immunohistochemistry for CD10 was performed on the sections obtained from formalin-fixed, paraffin-embedded blocks. CD10 immunoreactivity in the stroma and/or tumor cells was determined as follows: negative [0]; 1+[10-50% positive cells]; and 2+[>50% positive cells]

Results: Comparison of CD10 expression between the BCC and SCC groups showed a significant difference [P<0.001] in each of the tumor and stromal cells. Comparison of CD10 expression between the BCC and TE groups demonstrated a significant difference in both the tumor and stromal cells [P<0.001]. There was no significant difference in CD10 expression between the stromal and tumor cells of the BCC subtypes

Conclusion: CD10 is a useful adjunct marker in distinguishing TE from BCC. CD10 is suggested to be one of the useful immunohistochemical markers to differentiate BCC from SCC

giant polypoid basal cell carcinoma of the lower extremity

Less than 1% of basal cell carcinomas are giant basal cell carcinomas. Giant basal cell carcinomas are rare. They preferentially involve the trunk and are commonly associated with neglect. Giant basal cell carcinomas of 10 cm or greater are associated with a high rate of metastasis. We report a case of giant basal cell carcinoma of the leg which is not associated with neglect and no signs of metastasis, despite being more than 10 cm in diameter. The present paper includes a brief review of the literature