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Resumen:El porocarcinoma ecrino es un tipo muy poco frecuente de cáncer de piel, originado en la porción epidérmica de las glándulas sudoríparas ecrinas. Representa no más del 0.01% de los tumores cutáneos. El 20% de los porocarcinomas ecrinos son recurrentes y el 20% producen metástasis a ganglios linfáticos. Se ha reportado escasos casos de metástasis a distancia. Tiene un índice de mortalidad del 67% de los pacientes con metástasis.El diagnóstico es basado en los hallazgos histopatológicos y los estudios complementarios de inmunohistoquímica, a veces necesarios para el diagnóstico diferencial con otros tipos más frecuentes de cáncer de piel.No existen pruebas de que este tipo de carcinoma responda a la quimioterapia ni la radioterapia. Se considera que el manejo principal debe ser la resección quirúrgica y la electroquimioterapia.
Abstract:Eccrine porocarcinoma is a rare type of skin cáncer arising from the intraepidermal portion of eccrine sweat glands, representing no more tan 0.01% of all cutaneous tumors. 20% of the Eccrine porocarcinoma will recur and 20% will metastasize to regional lymph nodes. Few cases of distant metastases has been reported . There is a mortality rate of 67% in patients with metastases. The diagnosis is primarily based on histopathologic findings and complementary immunohistochemistry for differential diagnosis mainly with more frequent skin cáncer.Neither chemotherapy nor radiation therapy has been proven to be of clinical benefit in treating this type of carcinoma. It is considered that the management should be based on surgical resection and electrochemotherapy.
Subject(s)
Humans , Sweat Gland Neoplasms , Sweat Glands , Poroma , Eccrine PorocarcinomaABSTRACT
Objective To analyze clinicopathologic features of sebaceoma. Methods Clinical, pathologic and immunohistochemical findings from 31 cases of sebaceoma were retrospectively analyzed. The clinicopathologic features of sebaceoma were investigated. Results There were 9 males and 22 females. The patients′ age was 53.90 ± 15.40 years, and the clinical course was 9.41 ± 13.75 years. Sebaceoma predominantly affected the face. The common lesion of sebaceoma was red, yellowish?red, skin?colored or slight brown papules, with no subjective symptoms in most cases. Histopathologically, neoplasms had symmetric structures, and were located in the dermis. Epidermal involvements were found in 9 cases. The neoplasm cells were mainly composed of basaloid cells, a few mature sebocytes and some transition cells. The proportion of mature sebocyts was less than 1%in 26 cases, less than 20%in 2 cases, and 20%-40%in 3 cases. Mitoses were occasionally found in 5 cases. One patient was complicated by eccrine poroma. Varying amounts of ducts were found in all the patients. Immunohistochemical staining showed that epithelial membrane antigen was expressed on ducts and mature sebocytes in all the patients, while epithelial antigen was undetected in any of the patients. Carcinoembryonic antigen, androgen receptor and D2?40 were found in 20, 24 and 28 patients with sebaceoma, respectively. Conclusions The diagnosis of sebaceoma mainly depends on histopathological examination. Combined immunohistochemical detection of epithelial membrane antigen, androgen receptor and D2?40 is beneficial to its differential diagnosis.
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Ependymomas commonly arise in the central nervous system. Extraneural presentation is quite rare. Herein, we describe a primary extraneural ependymoma in a young female. The mass was located in the right inguinal area. The cut surface of the 7.5 mm × 6.5 mm × 4.5 mm sized tumor was brownish‑yellow in color. Histologically, it was hypercellular exhibiting pseudorosette or rosette formations and some papillary structures. Mitosis was counted as high as 10 per 10 high power fields. Neither necrosis nor vascular endothelial proliferation within the tumor was observed. Tumor cells showed strong glial fibrillary acidic protein immunoreactivity. On epithelial membrane antigen, intracytoplasmic dot‑like immunostaining was observed. This is the first report presenting a primary extraneural anaplastic ependymoma arising in the inguinal subcutaneous region.
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El perineuroma es un tumor benigno raro que deriva de las células perineurales de la vaina del nervio. Fue descrito por primera vez en 1978 por Lazarus y Trombetta, quienes basaron su diagnóstico en las características ultraestructurales de las células de esta neoplasia. Posteriormente el perfil inmunohistoquímico de las células perineurales permitió la identificación de esta entidad con mayor facilidad. Se describe una mujer de 47 años de edad con tumor en pared abdominal, referida al Hospital de Oncología por diagnóstico de histiocitoma fibroso maligno plexiforme. Se revisó el caso y solicitó inmunohistoquímica. La conclusión fue diagnóstico de perineuroma de tejidos blandos.
The perineuroma is a rare benign tumor, derived from nerve sheath perineurial cells. It was first described in 1978 by Lazarus and Trombetta, who based their diagnosis on the ultrastructural features of perineurioma cells. Subsequently, the immunohistochemical profile of perineurial cells allowed an easier diagnosis of this condition. A case of perineurioma in a 47-year-old woman is reported. The patient presented with an abdominal wall mass, with aprevious diagnosis of malignant fibrous histiocytoma (MFH). The case was reviewed at an oncology hospital, inmunohistochemistry was performed and the concluding diagnosis was soft tissue perineurioma.
Subject(s)
Humans , Female , Middle Aged , Abdominal Wall , Nerve Sheath Neoplasms/pathology , Soft Tissue Neoplasms/pathologyABSTRACT
Objective: To observe the differential expression of epithelial membrane antigen (EMA) and renal cell carcinoma marker (RCC-Ma) in early renal carcinoma and corresponding adjacent (0.5, 1.0, and 2.0 cm) tissues, so as to estimate the safe margin of laparoscopic partial nephrectomy for renal tumors. Methods: Tissue microarrys, including 44 tissues of clear cell renal cell carcinoma[A] and normal renal cortex tissues of different distances to the tumor: 0.5 cm[B], 1.0 cm[C] and 2.0 cm [D], were constructed. The expression of EMA and RCC-Ma was examined by immunohistochemical staining in the four groups. Results: Intensive membranous and (or) cytoplasmic staining of EMA and RCC-Ma was observed in the cancer and adjacent tissues. The positive rate in group A was significantly higher than those of the other three groups (A [15.91%/ 18.18%], B[84.09%/79.55%], C[86.36%/77.27%] and D[79.55%/75.00%], P0.05). Conclusion: Our data denote that, when laparoscopic partial nephrectomy is done for early renal carcinoma, at least 5 mm of normal parenchyma tissue beyond the pesudocapsule should be excised with the tumor.
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Objective To evaluate the prognostic impact of a wide spectrum of pathologic parameters in a consecutive series of homogenously treated and well-characterized patients with stage Ⅰ and Ⅱ colorectal cancer, and to investigate the prognostic value of lymph node occult disease (micrometastasis) in disease-free survival rate detected by immunohistochemistry with epithelial membrane antigen and carcinoembryonic antigen. Methods The study included 126 patients operated on by a single surgeon for stage Ⅰ and Ⅱ colorectal tumors. The postoperative follow-up was performed for 64 to 106 months. At least 10 lymph nodes were harvested and examined in all the specimens. The prognostic value of 10 pathologic parameters, including lymph node occult disease (micrometastasis) detected by immunohistochemistry was investigated. Results Multivariate analysis identified lymphatic vessel invasion (absent or present;P=0.009) in lymph node positive and negative by immunohistochemistry. The five-year disease-free survival rates were 78.7%, 65.5% and 43.8% for the lymph node negative, isolated tumor cells and micrometastasis groups, respectively. There was significant difference between the lymph node negative and micrometastasis groups (P=0.005). However, the difference between the lymph node negative and isolated tumor cells groups was not statistically significant (P=0.144). Conclusions We propose that for patients found micrometastasis in lymph node with high-risk stage Ⅰ and Ⅱ colorectal cancer, adjuvant therapies are justified and effective.
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The clinical, radiological and pathologic features of a biphasic synovial sarcoma in the left elbow joint of a two-year-old male Rottweiler are presented. The tumor showed positive immunoreactivity for vimentin, Epithelial Membrane Antigen (EMA), p53 and PCNA, while it was negative for the cytokeratin used, S-100, Rb and p21. Immunohistochemistry for EMA allowed the identification of epithelioid components of synovial sarcoma, and may, therefore, contribute in establishing a diagnosis of biphasic synovial sarcoma. Intratumoral variation in PCNA immunoreactivity was minimal, indicating that the various tumor components proliferate at more or less similar rates. Overall, the characterized immunohistochemical profile for canine synovial sarcoma, not defined previously, may provide clues to the histogenesis of the phenotypically mesenchymal and epithelial elements of the tumor, and may be of value in the differential diagnosis of challenging cases, decreasing the risk of under- and mis-diagnosis. Although more cases need to be studied to determine whether there is a consistent pattern of immunostaining in canine synovial sarcoma, its potential significance is discussed in relation to the histogenesis, molecular pathology and differential diagnosis of canine synovial sarcoma.
Subject(s)
Animals , Dogs , Male , Mucin-1/analysis , Dog Diseases/pathology , Elbow Joint/abnormalities , Forelimb , Histocytochemistry/veterinary , Immunohistochemistry/veterinary , Keratins/analysis , Oncogene Protein p21(ras)/analysis , Proliferating Cell Nuclear Antigen/analysis , Retinoblastoma Protein/analysis , Sarcoma, Synovial/chemistry , Soft Tissue Neoplasms/chemistry , Tumor Suppressor Protein p53/analysis , Vimentin/analysisABSTRACT
One case of hepatocellular carcinoma with sarcomatous changes is presented. Histologically, the tumor was composed of hepatocellular-carcinomatous and sarcomatous components, including trabecular, pseudoglandular, and spindle-shaped varieties. There was a transitional cell form between the carcinoma and sarcomatous cells. Immunohistochemical examination for alpha-feto protein reveals positive staining in hepatocellular carcinoma component, and vimentin had positive result in most spindle-shaped sarcomatous cells and some epithelial tumor cells, whereas cytokeratin and EMA(epithelial membrane antigen) revealed negative staining in tumor cells, On the basis of this findings, the possibility of sarcomatous transformation of hepatocellular carcinoma was discussed.
Subject(s)
Carcinoma, Hepatocellular , Immunohistochemistry , Keratins , Liver , Membranes , Negative Staining , VimentinABSTRACT
Purpose: To evaluate the diagnostic utility of detection of Cytokeratin 19 (CK19), b-100 protein and epithelial membrane antigen ( EMA) in thyroid papillary carcinoma, follicular carcinoma and papillary hyperplasia. Methods: 65 thyroid lesions were stained immunohistochemically for CK19, S-100 protein and EMA. Results: CK19, S-100 and EMA are negative in all papillary hyperplasia. CK19 expression was strong and diffuse in 100% of papillary carcinoma including the follicular variant of papillary carcinoma, and was positive in 22% of follicular carcinoma. S-100 and EMA were respectively present in 61% and 100% of classic papillary carcinoma, in 38% and 54% of follicular variant of papillary carcinoma and in 44% and 11 % of follicular carcinoma. Conclusions: Our observations suggest that the expression of CK19, in combination with S-100 and EMA expression, is helpful in the diagnosis of thyroid lesions. CK19 is a valuable marker in the distinction of papillary carcinomas from papillary hyperplasia.
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Objective To assess the diagnosis value of epithelial membrane antigen (EMA) immunocytochemistry examination in meningeal carcinomatosis.Methods The routine cerebrospinal fluid cytologic examination and EMA immunocytochemistry examination of 23 cerebrospinal fluid specimens from 14 patients with definitive meningeal carcinomatosis were analyzed,retrospectively.Results The positive rate of routine cerebrospinal fluid cytologic examination and EMA immunocytochemistry examination were 39.13%(9/23)and 86.96%(20/23),respectively. There was a significant difference between two results ( P
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A total of 42 cases undifferentiated large cell tumors were stained by immunoperoxidase techniques using antibodies against leukocyte common antigen (LCA) and epithelial membrane antigen (EMA). In 18 of the 21 cases studied, initially diagnosed as malignant lymphoma or Hodgkin's disease, reactivity with monoclonal anti-LCA (and noreactivity with monoclonal anti-EMA)indicated that the tumor was a lymphomas. The remaining 3 cases gave the reverse reaction pattern and therefore were classified as carcinoma. One out of 16 cases diagnosed as undifferentiated carcinoma proved to be a case of mialignant lymphoma in 5 patients in whom the original diagnosis was uncertain, a definite diagnosis was possible in all cases and 3 of these proved to be large cell lymphoma; the remainders, undifferentiated carcinoma. It is suggested that the staining of undifferentiated human neoplasms using combinations of antibodies reactive with epithelial and lymphoid cells may result in much greater diagnostic accuracy.
Subject(s)
HumansABSTRACT
A total of 42 cases undifferentiated large cell tumors were stained by immunoperoxidase techniques using antibodies against leukocyte common antigen (LCA) and epithelial membrane antigen (EMA). In 18 of the 21 cases studied, initially diagnosed as malignant lymphoma or Hodgkin's disease, reactivity with monoclonal anti-LCA (and noreactivity with monoclonal anti-EMA)indicated that the tumor was a lymphomas. The remaining 3 cases gave the reverse reaction pattern and therefore were classified as carcinoma. One out of 16 cases diagnosed as undifferentiated carcinoma proved to be a case of mialignant lymphoma in 5 patients in whom the original diagnosis was uncertain, a definite diagnosis was possible in all cases and 3 of these proved to be large cell lymphoma; the remainders, undifferentiated carcinoma. It is suggested that the staining of undifferentiated human neoplasms using combinations of antibodies reactive with epithelial and lymphoid cells may result in much greater diagnostic accuracy.
Subject(s)
HumansABSTRACT
A case of plasma cell granuloma in the right lateral ventricle simulating a meningioma of a 24-year-old man which was totally removed is presented. Plasma cell granuloma is a rare nonneoplastic lesion of unknown etiology which exclusively occurs in the lung. However on review of the English literature, only four prior cases of extrapulmonary plasma cell granulomas in the central nervous system have been reported.