Clear Cell Chondrosarcoma Arising in Hyoid Bone

Clear cell chondrosarcoma, first described by Unni in 1976, is distinguished from classical chondrosarcoma by a typical histological picture, mostly an epiphyseal site of origin, and relatively a benign clinical course. We present a case of clear cell chondrosarcoma arising from hyoid bone in a 70-year-old male. Histologically, large areas of closely packed cells with characteristic clear cytoplasm were seen in addition to the usual elements of a conventional chondrosarcoma. Our search and review of the literature did not reveal any reported case of clear cell chondrosarcoma arising from hyoid bone.

Clinico-Pathologic Evaluation of 18 Cases of Lymphomatoid Papulosis

Lymphomatoid papulosis is an enigmatic disease entity which is clinically benign and histologically malignant. Although sporadic cases have been reported, we could not find any comprehensive report on the combined clinical and histologic features of lymphomatoid papulosis in the literature. Perhaps the most controversial aspect of lymphomatoid papulosis is its pathogenesis and categorization as a benign versus a malignant entity. To date, there are no reports on p53 and bcl-2 protein expression in lymphomatoid papulosis. We analysed the clinico-pathological findings of 18 cases with lymphomatoid papulosis during the 10 year period from 1984 to 1995 and examined the prevalence of immunoreactivity for CD30(DAKO, Ber-H2), p53(DAKO, DO-7), and bcl-2(DAKO, 124) using an immunohistochemical(ABC) method. The results obtained are summarized as follows. 1) Age distribution ranged from 20 to 65, with a mean age of 45 years and a sex distribution which showed a male predominence(8:1). The lesions were located on the trunk and extremities(8cases), extremities (7cases), and trunk(3 cases). The morphology of the lesions were papules or plaques(12 cases), and nodules(6 cases). 2) Histopathologic types were classified into 3 types: type A(4 cases), type B(8 cases) and mixed type (6 cases). 3) Positive immunoreactivity for CD30 was seen in 17%(3 of 18cases): type A(2 of 3) and mixed type(1 of 3). 4) The positive immunoreactivity for p53 and bcl-2 was observed in 29%(5 of 18) and 11%(2 of 18), respectively. 5) Cases showing positive immunoreactivity for P53 were type A(1 of 5), type B(1 of 5), and mixed type(3 of 5). 6) Cases showing positive immunoreactivity for bcl-2 were mixed type(2 of 2). One case developed into Ki-1 lymphoma. These results support the idea that lymphomatoid papulosis and Ki-1 lymphoma represent a continuum. The role of p53 gene mutation and bcl-2 activation in the development of lymphomatoid papulosis is currently unknown. But, our results suggest that p53 gene mutation and bcl-2 activation are not a critical step in the development of lymphomatoid papulosis. Further studies are needed to elucidate the role of p53 gene mutation and bcl-2 activation in the development and progression of lymphomatoid papulosis.

Leiomyosarcoma of the Esophagus: Report of two cases, one with associated squamous cell carcinoma

Two new cases of leiomyosarcoma of the esophagus, one with an associated squamous cell carcinoma, are presented with review of literature. lmmunohistochemical study of MDM2 gene is performed upon these cases, and one case revealed overexpression of the MDM2 protein, whereas the other case showed negative result. And the pathological significance of MDM2 gene expression in esophageal leimyosarcoma is discussed, as, to our knowlege, no esophageal leiomyosarcoma with confirmed MDM2 gene amplification has been reported in the literature, to date. Gross character of these tumors was polypoid. Microscopically, the tumors consisted of interlacing fascicles of elongated spindle-shaped cells. Mitoses could be found without difficulty, with more than five per 10 high power fields. The tumor cells of the both cases showed imunohistochemical reactivity for vimentin and actin. Electron microscopically parallel arrays of myofilaments with interspersed dense bodies in spindle cell components were confirmed. The itera-literature regarding the association of leiomyosarcoma with epithelial malignancy in the gastrointestinal tract as well as esophagus is reviewed, and we found that this is a highly unusual occurrences(3 cases reported so far).