Résumé
Seborrheic keratosis is a common benign epidermal tumor histologically composed of basaloid and squamous cells. It mainly occurs on the face, scalp, and trunk, and presents clinically as a well-circumscribed, brownish to black papule, nodule, or plaque. Trichoblastoma is a relatively rare benign, slow-growing tumor showing differentiation toward the primitive hair follicle. It clinically manifests as a solitary, skin to erythematous colored, well-circumscribed dermal nodule located predominantly on the head and neck with a predilection for the scalp. Histologically, a well-demarcated mass of follicular germinative cells that show various degrees of differentiation, arranged in lobules, sheets, and nests, is located in the dermis or subcutaneous fat layer. We report the case of a 28-year-old female patient with a solitary, 2.0x4.0-cm black plaque with a 0.7-cm skin-colored nodule on the scalp. Histologically, the entire black plaque had prominent hyperkeratosis, acanthosis, and papillomatosis with horn cysts. The central nodule showed well-circumscribed, various-sized dermal tumor lobules without a connection to the overlying epidermis. The lobular aggregation was composed of numerous basaloid epithelial nests and multiple primitive papillary structures with distinct peripheral palisading of nuclei. According to these findings, the scalp lesion was diagnosed as a composite tumor associating trichoblastoma and seborrheic keratosis.
Sujets)
Adulte , Animaux , Femelle , Humains , Derme , Épiderme , Follicule pileux , Tête , Cornes , Kératose séborrhéique , Cou , Papillome , Cuir chevelu , Peau , Graisse sous-cutanéeRésumé
Seborrheic keratosis is a common benign epidermal tumor histologically composed of basaloid and squamous cells. It mainly occurs on the face, scalp, and trunk, and presents clinically as a well-circumscribed, brownish to black papule, nodule, or plaque. Trichoblastoma is a relatively rare benign, slow-growing tumor showing differentiation toward the primitive hair follicle. It clinically manifests as a solitary, skin to erythematous colored, well-circumscribed dermal nodule located predominantly on the head and neck with a predilection for the scalp. Histologically, a well-demarcated mass of follicular germinative cells that show various degrees of differentiation, arranged in lobules, sheets, and nests, is located in the dermis or subcutaneous fat layer. We report the case of a 28-year-old female patient with a solitary, 2.0x4.0-cm black plaque with a 0.7-cm skin-colored nodule on the scalp. Histologically, the entire black plaque had prominent hyperkeratosis, acanthosis, and papillomatosis with horn cysts. The central nodule showed well-circumscribed, various-sized dermal tumor lobules without a connection to the overlying epidermis. The lobular aggregation was composed of numerous basaloid epithelial nests and multiple primitive papillary structures with distinct peripheral palisading of nuclei. According to these findings, the scalp lesion was diagnosed as a composite tumor associating trichoblastoma and seborrheic keratosis.
Sujets)
Adulte , Animaux , Femelle , Humains , Derme , Épiderme , Follicule pileux , Tête , Cornes , Kératose séborrhéique , Cou , Papillome , Cuir chevelu , Peau , Graisse sous-cutanéeRésumé
A 70-year-old woman was admitted to our department with epigastric discomfort and nausea over the duration of 1 month. An esophagogastroduodenoscopy showed the presence of a 1.0x1.0 cm-sized flat lesion with central ulceration at the greater curvature side of the antrum. A biopsy demonstrated the presence of an adenocarcinoma of well differentiated, intestinal type in the stomach. Endoscopic submucosal dissection was done and the diagnosis of a composite neuroendocrine carcinoma with an adenocarcinoma of the stomach was confirmed. We report a case of a gastric composite tumor with an adenocarcinoma and neuroendocrine carcinoma confirmed by endoscopic submucosal dissection with a review of the literature.
Sujets)
Femelle , Humains , Adénocarcinome , Biopsie , Carcinome neuroendocrine , Endoscopie digestive , Nausée , Estomac , UlcèreRésumé
A composite glandular/exocrine-endocrine carcinoma of the gastrointestinal tract is characterized by the co-existence of two adjacent, but histologically-distinct tumors in an organ. Composite glandular/exocrine-endocrine carcinomas are a special type of tumor comprised of common adenocarcinomas and neuroendocrine components that account for at least one-third of the entire tumor area. Composite tumors have been reported in a range of organs, but are relatively rare in the stomach. We report a case of a composite neuroendocrine carcinoma with an adenocarcinoma of the stomach (mixed exocrine-endocrine carcinoma), which was misdiagnosed as a giant submucosal tumor preoperatively based on esophagogastroduodenoscopy and a contrast-enhanced axial computed tomographic scan.
Sujets)
Adénocarcinome , Carcinome neuroendocrine , Endoscopie digestive , Tube digestif , EstomacRésumé
A 55 year-old man was admitted with epigastric pain of one-month duration. We performed an esophagogastroduodenoscopy that showed the presence of a 3 cm sized polypoid mass at the lesser curvature side of the antrum. A biopsy demonstrated the presence of a neuroendocrine carcinoma of the stomach. A subtotal gastrectomy with D2 lymph node dissection was performed and the microscopic features of the resected specimen confirmed the diagnosis of a composite large cell neuroendocrine carcinoma with an adenocarcinoma of the stomach. A gastric neuroendocrine carcinoma is extremely rare and a composite neuroendocrine carcinoma with an adenocarcinoma of the stomach has been rarely reported. We report a case of a gastric composite tumor with an adenocarcinoma and a large cell neuroendocrine carcinoma.
Sujets)
Adénocarcinome , Biopsie , Carcinome neuroendocrine , Endoscopie digestive , Gastrectomie , Lymphadénectomie , EstomacRésumé
A gastric carcinoid is a rare disease that accounts for only 0.3% of all primary gastric tumors. It can be multiple or occur with other types of tumor. However, there has been a recent increase in incidence. While carcinoids of the appendix and rectum are accompanied by adenoma or adenocarcinoma, a gastric carcinoid rarely occurs with an adenocarcinoma, particularly with a gastric adenoma. We encountered a case of a gastric adenoma and carcinoid mixed as a composite tumor, which became a lesion. The lesion resembled a type IIc early gastric cancer at the endoscopic examination and was removed by an endoscopic mucosal resection. We report a composite tumor of the gastric antrum composed of areas of adenoma and carcinoid, with an analysis of the histological components by immunohistochemical staining. Microscopically, the lesion was composed of a gastric adenoma and carcinoid as a composite tumor.
Sujets)
Adénocarcinome , Adénomes , Appendice vermiforme , Tumeur carcinoïde , Incidence , Antre pylorique , Maladies rares , Rectum , Tumeurs de l'estomacRésumé
Most tumors affecting Vater's ampulla are adenocarcinomas. Other histological variants or mixed forms are less frequent, even rare. We treated a rare case of composite signet-ring cell carcinoma and well differentiated neuroendocrine carcinoma of the ampulla of Vater in a 72-year-old Korean man with abdominal discomfort and jaundice for two weeks. Computed tomography (CT) and endoscopic retrograde cholangiopancreatography (ERCP) revealed a 2 cm protruding mass with an abrupt narrowing of the distal common bile duct. Pancreaticoduodenectomy was performed. An ill-defined nodular 2 cm mass in the ampulla of Vater invaded the entire duodenal wall and pancreatic parenchyma with duct dilatation of the remaining common bile duct and pancreatic duct. Two out of twenty regional lymph nodes were positive for metastases. Histopathologically, the tumor was composed of mucinous adenocarcinoma with predominant signet-ring cell components (80%) and well-differentiated neuroendocrine carcinoma (20%). There were intermingled and transitional areas between both elements as well as amphicrine tumor cells with dual differentiation. By Immunohistochemistry, the adenocarcinoma with signet-ring cells was positive for CK7 and CEA and the neuroendocrine carcinoma was diffusely positive for CK7, synaptophysin and chromogranin but negative for insulin and CEA. Of the two metastatic peripancreatic lymph nodes, one was a neuroendocrine carcinoma and the other was an adenocarcinoma. The postoperative course was uneventful. The patient refused adjuvant chemotherapy and was discharged to home 13 days later. The patient died of multiple liver metastases and carcinomatosis 11 months after surgery.
Sujets)
Sujet âgé , Humains , Adénocarcinome , Adénocarcinome mucineux , Ampoule hépatopancréatique , Carcinomes , Carcinome neuroendocrine , Structures cellulaires , Traitement médicamenteux adjuvant , Cholangiopancréatographie rétrograde endoscopique , Conduit cholédoque , Dilatation , Immunohistochimie , Insuline , Ictère , Foie , Noeuds lymphatiques , Métastase tumorale , Conduits pancréatiques , Duodénopancréatectomie , SynaptophysineRésumé
An adenocarcinoid is a mixed tumor comprised of both carcinoid and adenocarcinomatous components that is commonly found in the esophagus, stomach, duodenum, small bowel and appendix, and is also rarely found in the large bowel. A 61 year old male visited our institution because of a change in bowel habitus 3 months prior to the time of his visit. Colonoscopic findings revealed a 2 x 2 cm round smooth surface mass 7 cm from the anal verge, and an endoscopic ultrasonograph revealed a round hypoechoic mass in the submucosal layer. The mass was resected by endoscopic mucosal resection using a cap- fitted endoscope. Pathologic analysis of the mass confirmed that it was a composite tumor comprised of carcinoid and adenocarcinomatous components. To the best of our knowledge, this paper is the first case of rectal adenocarcinoid reported in Korea.
Sujets)
Humains , Mâle , Adulte d'âge moyen , Appendice vermiforme , Tumeur carcinoïde , Duodénum , Endoscopes , Oesophage , Corée , EstomacRésumé
Carcinoid tumors show variety of pathological features and some of them are admixed with adenocarcinoma. The carcinoma-carcinoid spectrum is a concept of classifying tumors based on the tumor mass differentiation which is composed of tissues of both endocrine and nonendocrine functions. When two types of tissues exist within one tumor intermingled with each other in a similar proportion, it is called composite tumor. On the other hand, collision tumor is characterized by the presence of two localized tissue types adjacently together. Gastric composite tumors are relatively rare. According to the reports on the Korean literature, there are several collision tumors, but only one case of gastric composite tumor has been cited. Reports of multiple synchronous or metachronous cancers have increased steadily during the last decades. Multiple gastric carcinoids or carcinoid tumors developed in association with gastric adenocarcinoma contribute to this trend. We report one case of gastric composite tumor simultaneously occurring with a early gastric adenocarcinoma with review of the literature.
Sujets)
Humains , Mâle , Adulte d'âge moyen , Adénocarcinome/anatomopathologie , Tumeur carcinoïde/anatomopathologie , Tumeurs primitives multiples/anatomopathologie , Tumeurs de l'estomac/anatomopathologieRésumé
The occurrence of a carcinoid admixed with an adenocarcinoma of the gastrointestinal tract is an unusual phenomenon which has been reported in the esophagus, stomach, gallbladder, colon, and appendix. Herein, we describe an extremely rare case of a composite tumor of the common bile duct. A 50-year-old woman who suffered from right upper abdominal pain and jaundice was found on radiographical investigations and operation to have a tumor in the common bile duct. Histopathologically, the resected tumor was composed mainly of solid nests of atypical round cells and partially of a well-differentiated adenocarcinoma showing a mutual transition in the mucosal layer. Both immunohistochemical and ultrastructural analyses confirmed a composite tumor: a neuroendocrine cell carcinoma and a tubular adenocarcinoma.
Sujets)
Femelle , Humains , Adulte d'âge moyen , Douleur abdominale , Adénocarcinome , Appendice vermiforme , Conduits biliaires , Tumeur carcinoïde , Côlon , Conduit cholédoque , Oesophage , Vésicule biliaire , Tube digestif , Ictère , Cellules neuroendocrines , EstomacRésumé
Small cell neuroendocrine carcinoma of the uterine cervix is a distinct subtype of cervical cancer that appears analogous to oat cell carcinoma and carcinoid tumors of the lung. It has been assumed to be derived from the neural crest via argyrophilic cells in the normal endocervix. We have recently encountered a case of small cell neuroendocrine carcinoma of the uterine cervix coexisting with adenocarcinoma which was argyrophil negative. A 66-year-old multiparous woman was admitted because of vaginal bleeding for 2 months. Cervicovaginal smear revealed several scattered clusters and sheets of monotonous small cells with some peripheral palisading in the background of hemorrhage and necrosis. Radical hysterectomy specimen revealed an ulcerofungating tumor on endocervical canal which was composed of two components. Major component of the tumor was made up of monomorphic population of small oval-shaped tumor cells arranged in sheets and partly in acinar structures or trabecular fashion. Other component was adenocarcinoma, endocervical well-differentiated type. Argyrophilia was present on the Grimelius stain and immunohistochemical studies revealed diffuse positivity to neuron-specific enolase and carcinoembryonic antigen. Electron microscopic examination showed clusters of small round to oval cells, which had a few well-formed desmosomes and several membrane-bound, dense-core neuro- sectetory granules.
Sujets)
Sujet âgé , Femelle , Humains , Mâle , Adénocarcinome , Antigène carcinoembryonnaire , Tumeur carcinoïde , Carcinome neuroendocrine , Carcinome à petites cellules , Col de l'utérus , Desmosomes , Épididymite , Hémorragie , Hystérectomie , Poumon , Nécrose , Crête neurale , Enolase , , Tumeurs du col de l'utérus , Hémorragie utérineRésumé
Small cell neuroendocrine carcinoma of the uterine cervix is a distinct subtype of cervical cancer that appears analogous to oat cell carcinoma and carcinoid tumors of the lung. It has been assumed to be derived from the neural crest via argyrophilic cells in the normal endocervix. We have recently encountered a case of small cell neuroendocrine carcinoma of the uterine cervix coexisting with adenocarcinoma which was argyrophil negative. A 66-year-old multiparous woman was admitted because of vaginal bleeding for 2 months. Cervicovaginal smear revealed several scattered clusters and sheets of monotonous small cells with some peripheral palisading in the background of hemorrhage and necrosis. Radical hysterectomy specimen revealed and ulcerofungating tumor on endocervical canal which was composed of two components. Major component of the tumor was made up of monomorphic population of small oval-shaped tumor cells arranged in sheets and partly in acinar structeres or trabecular fashion. Other component was adenocarcinoma, endocervical well-differentiated type. Argyropilia was present on the Grimelius stain and immunohistochemical studies revealed diffuse positivity to neuron-specific enolase and carcinoembryonic antigen. Electron microscopic examination showed clusters of small round to oval cells, which had a few well-formed desmosomes and several membrane-bound, dense-core neurosectetory granules.