Collagenous spherulosis in an adenomyoepithelioma of the breast.

Collagenous spherulosis (CS) is an incidental finding that usually occurs in association with benign proliferative and preinvasive lesions. Adenomyoepithelioma is a biphasic neoplasm of the breast, composed of both luminal epithelial and myoepithelial cells. Despite the common epimyoepithelial histogenesis, CS has never been described in association with adenomyoepithelioma. This report describes the case of a 48 year old woman who presented with CS of the breast in an adenomyoepithelioma. The combination of these two benign lesions led to diagnostic difficulties; namely, differentiation from adenoid cystic carcinoma, but also cribriform carcinoma and cylindroma of the breast. Antibodies to the oestrogen receptor, progesterone receptor, p63, and c-kit (CD117) proved to be useful adjuncts to differentiate between these lesions.

Clinicopathologic growth factors in vestibular schwannomas: a morphological and immunohistochemical study of 69 tumours.

Tumour growth of vestibular schwannomas is still difficult to predict. The aim of our study was to determine whether any defined histopathological feature was correlated with the clinical course. We did a retrospective study with 69 paraffin-embedded tumours to establish whether the number of vessels, blood cells extravasation or degree of inflammation, all semi-quantitatively assessed, could be indicative of potential of growth. An immunohistochemical study was also performed with an endothelial marker CD34, the leukocyte common antigen CD45 and the estrogen and progesterone hormone receptors. All these parameters were correlated with patient's age, duration of symptoms (d), with a clinical growth index (CLI = tumour size/d). No clinical parameters proved to be predictive of tumour growth. Tumour size was significantly (p = 0.01) related to the number of vessels and we found a significant relationship between the clinical growth index (CLI) and total number of vessels, especially when duration of symptoms lasted less than 1 year (p < 0.001). However, we found no relationship between duration of symptoms or CLI and CD34 index. The degree of inflammation was significantly correlated (p = 0.007) with duration of symptoms when it lasted more than 1 year. The CD45 index and the semi-quantitative evaluation of the inflammation were well correlated (p = 0.001). No estrogen receptors antigenic site was detected and only seven tumours expressed progesterone receptor in a few cells without any significant clinical value. These results suggest that vessel density is determinant for sporadic acoustic neuroma growth especially for a short clinical course.

E-cadherin and beta-catenin expression in breast medullary carcinomas.

The initial step of cancer invasion and metastasis is the escape of tumour cells from the primary site, involving disruption of normal cell-cell adhesion and E-cadherin (E-cad) and beta-catenin (beta-cat) down-regulation, as shown in various types of human malignancies including breast carcinomas. Medullary carcinomas are high grade and poorly differentiated tumours with syncytial typical pattern, and prognosis unexpectedly better than that in high grade breast carcinomas. In a series of 55 breast typical medullary carcinomas diagnosed according to the strict use of Ridolfi et al (Cancer 40: 1365-1385, 1977) criteria, E-cad and beta-cat were investigated using quantitative (SAMBA 2005 system) immunocytochemical assays on frozen sections. Results were compared to that obtained on paraffin sections and in a series (n=55) of grade 3 ductal carcinomas. It was shown that medullary carcinomas significantly (p<0.001) expressed more E-cad and beta-cat than grade 3 ductal carcinomas. E-cad and beta-cat correlated with high expression of P53, of c-erbB, and of Ki-67 antigens, and with lack of hormone receptors antigenic sites (p<0.001). It was concluded that favourable prognosis and syncytial pattern of typical breast medullary carcinomas likely results, at least partly, from a particular expression of cell-cell adhesion molecules, significantly limiting tumour growth and efficiently mastering the tumour cell dissemination, opposing to high proliferative activity (grade 3).

[Pelvic tumoral actinomycosis: a difficult diagnosis. Two case reports]. / L'actinomycose pelvienne tumorale: un diagnostic difficile. A propos de deux cas.

Two cases of intra-uterine device-associated occlusive pelvic pseudo-tumoural actinomycosis are presented. A pre-operative diagnosis of ovarian carcinoma was considered in both cases and lead to a wide and difficult surgery. Actinomycosis was confirmed by the postoperative histopathologic examination, and the patients were successfully treated with penicillin. The difficulties and limits of the clinical and histopathological diagnosis are exposed. The interest of the pre and intra-operative diagnosis which can avoid an extensive surgery with high morbidity is highlighted.