Angiomatoid fibrous histiocytoma: an expansion of the clinical and histological spectrum.

Angiomatoid fibrous histiocytoma, a fibrohistiocytic tumour of intermediate malignancy that usually presents on extremities of young patients, has a broader clinical/histological spectrum than is widely appreciated. We summarise our experience with an emphasis on unusual features. Twenty-seven cases were analysed for clinical and histological features, including immunohistochemistry and FISH for rearrangements of EWSR1 or FUS. Five (19%) occurred in patients >40 years old, and ten (37%) occurred outside the extremities. Three that occurred in patients >40 years old arose in atypical locations. Evaluation for classical histological features (lymphocytic cuff, fibrous pseudocapsule, pseudovascular spaces, haemorrhage, haemosiderin, and histiocytoid morphology) showed that all had two or more classical features. Unusual features were noted in many cases. Ten (37%) displayed significant areas of sclerosis; three of these ten had areas with a perineurioma-like pattern. Nine displayed at least moderate pleomorphism, with two exhibiting striking pleomorphism. Eight had eosinophils in the stroma, one with numerous eosinophils. One had a reticulated pattern of cells in a myxoid stroma. Mitotic rates were low [average 0.67/10 high power fields (HPFs)]. Three had atypical mitotic figures. Thirteen of 20 (65%) were CD68 positive, 11 of 17 (65%) were EMA positive, and 10 of 18 (56%) were desmin positive. Thirteen of 16 (81%) had a rearrangement of EWSR1; none had a FUS rearrangement.This series expands the spectrum of angiomatoid fibrous histiocytoma.

Infiltration of tumor-associated macrophages is increased in the epithelial and stromal compartments of endometrial carcinomas.

Tumor-associated macrophages (TAMs) are derived from monocytes and recruited to the tumor microenvironment, where they play an important role in the progression of cancer. There is strong evidence for an inverse relationship between TAM density and clinical prognosis in solid tumors of the breast, prostate, ovary, and cervix. However, the role of TAMs in endometrial cancer is not well described. The objectives of this study were to determine whether macrophage distribution or density differed among normal endometrial tissue, hyperplasia, Type I, and II endometrial adenocarcinomas. In addition, we looked for a correlation among TAM density, known histopathologic prognostic indicators, and endometrial cancer progression. The pathologic specimens of women who underwent hysterectomy for benign disorders, endometrial hyperplasia, Type I, or Type II cancers were sectioned and stained with anti-CD68 antibody. The density of CD68 macrophages was quantified and stratified according to their epithelial or stromal location. Type I and II endometrial carcinomas had significantly higher macrophage density in both epithelial and stromal compartments than benign endometrium. In both benign and neoplastic specimens, the numbers of macrophages were significantly higher in the stroma compared with the epithelium. Although there were important trends in the density of TAMs with regard to several histopathologic prognostic indicators of endometrial cancer, none were statistically significant and the patients' cancer progression did not correlate significantly with the number of TAMs.

Surgical considerations for the familial cancer syndrome, neurofibromatosis 1: a comprehensive review.

Neurofibromatosis 1 is one of the more common inheritable disorders that surgeons may encounter. A plethora of systemic associations, both benign and malignant, can affect these patients, and an acute awareness of these associations is essential for proper surgical care. A complete review of this disorder from the surgical perspective follows, highlighting the importance of this awareness. A brief review on the management and follow-up of surgical malignancies associated with this disorder is included.