[Vaccination granuloma in the breast region--differential diagnosis]. / Vaccinationsgranulom i mammaregionen--en differentialdiagnose.

Vaccination granulomas (VG) caused by injection of aluminum adsorbed vaccines have not been described previously in the breast region. We therefore present eight cases, all in women. None of the small tumors were diagnosed as VG before the operation.

Intramuscular (subfascial) vascular spindle cell lipoma. A case report.

Spindle cell lipoma is a distinct type of lipoma characterized by replacement of mature fat by collagen forming spindle cells. It is a benign lesion occurring chiefly in males older than 45 years and affects the subcutaneous tissues in the regions of the shoulder and posterior neck. Deep-seated (intramuscular) spindle cell lipomas are probably uncommon tumors and to date only two cases have been reported in the literature. A new case of a vascular variant of spindle cell lipoma in an intramuscular (subfascial) location is presented and the differential diagnosis is discussed.

Liposarcoma of the thyroid gland.

The presumed first case of primary liposarcoma of the thyroid gland is presented, and the possible origin of this rare tumor from either mature fat cells or primitive mesenchymal cells is discussed.

Intraepithelial neoplasia in the anal canal. The appearance and relation to genital neoplasia.

Anal canal intraepithelial neoplasia (ACIN) in the form of squamous dysplasia and carcinoma in situ is a rare condition. In this paper we present all 19 cases diagnosed in Denmark in a two-year period. The incidence was 0.2/10(5)/year compared to 0.7/10(5)/year for variants of squamous carcinoma in the anal canal. Most cases of ACIN were incidental findings at minor anal surgery. Histologically, one half of the lesions were located in the anal transitional zone above the dentate line. Two of the 19 patients died from colo-rectal carcinoma and 17 were alive 5 years later. Nine of the patients were controlled by biopting, and 4 recurrences of the intraepithelial changes were found among these, all with an initial lesion of ACIN III. None of the patients developed invasive carcinoma of the anal canal during the 5 years, but one half of the females had previous or accompanying neoplasia of the vulva and perineum.

Precancerous changes in the anal canal epithelium in resection specimens.

Systematic histological examination for precancerous changes was carried out on 139 anal canals resected for anal or colo-rectal tumours or for inflammatory bowel disease. Severe squamous dysplasia or carcinoma in situ were found in 13 of 16 anal canals harbouring variants of squamous carcinoma but not in others. The lesions were mainly or totally located to the anal transitional zone (ATZ) in 11 cases and only in 2 cases exclusively to the squamous zone below the dentate line. Dysplastic areas separate from the tumour were found in 6 of the 13 cases. Junctional melanocytic activity and atypical melanocytic hyperplasia located in the ATZ as well as the squamous zone were present in 1 of 3 cases of malignant melanoma. The findings underline the close relationship between dysplasia and invasive carcinoma in the anal canal. Further they support the concept that basaloid, mucoepidermoid and some ordinary squamous carcinomas arise in the ATZ, and that this may also be the point of origin for malignant melanoma. A search for precancerous changes for anal canal tumours should therefore include the whole ATZ, i.e. in some cases up to 2 cm above the dentate line and it should be borne in mind that the lesions may be spotty.

Adenolipoma of the thyroid gland.

A case of rare fat-cell-containing adenoma, an adenolipoma, in the thyroid gland is reported. Previously documented cases are reviewed. Diffuse lipomatosis of the thyroid, amyloid goitre with adipose tissue, and the relationship between lipomatosis and adenolipoma are discussed.

Endolymphatic stromal myosis with focal tubular-glandular differentiation (biphasic endometrial stromal sarcoma).

A case of low grade endometrial stromal sarcoma with tubular-glandular differentiation is reported. The tumor showed a characteristic pattern of clusters and trabeculae of spindle-shaped cells infiltrating the myometrium. Lymphatic invasion was evident. Foci of solid, alveolar pattern and cleft tubular spaces were seen. The tubular spaces were lined by a cuboidal epithelium, which at the ultrastructural level showed blunt microvilli, and between adjacent cells junctional complexes and desmosomes. Both the spindle-shaped cells and the epithelial cells were rich in cytoplasmic filaments. The latter did not react with serum containing antibody against actin using a two-layer immunoperoxidase method. The ultrastructural resemblance between the epithelial and spindle-shaped cells favors a common cellular origin, the endometrial stromal fibroblast.

Dysplastic changes in the anal canal epithelium in minor surgical specimens.

A ten-year consecutive material of 306 minor surgical specimens from the anal canal showed squamous dysplasia in 2.3 per cent. None of the patients developed carcinoma during an average observation time of 27 months. The average age was 64 years for dysplasia and 67 years for a corresponding series of 12 cases of anal canal carcinoma. It is concluded that all material from the anal canal should be investigated histologically.

Glassy-cell carcinoma of the cervix: case report with a light and electron microscopy study.

A case of glassy-cell carcinoma of the cervix is reported. In the literature this tumor is regarded as an undifferentiated form of mixed carcinomas of the cervix. At the light microscopic level the tumor cells are characterized by a moderate amount of cytoplasm of ground-glass appearance that stains faintly blue with hematoxylin, a distinct cell wall that stains with eosin or with periodic acid-Schiff (PAS), and large vesiculated nuclei with prominent nucleoli. In the cytoplasm of very few tumor cells, a minute amount of Alcian blue-positive material is demonstrated. At the electron microscopic level the tumor cells show distinct cell borders with interdigitating cytoplasmic projections that contain many desmosomes. Cytoplasmic tonofilaments were demonstrated in few tumor cells. The nuclei show a euchromatic appearance with prominent mesh-basket nucleoli. The cytoplasm contains abundant ribosomes, polyribosomes, and round to oval mitochondria with transverse cristae. Some cells contain a prominent Golgi apparatus with many lysosomelike structures. A very few cells have small intracytoplasmic lumina with microvilli and annulate lamellae. The assumption that the glassy-cell carcinoma of the cervix represents a poorly differentiated adenosquamous carcinoma finds support from our ultrastructural study.

Collagenous colitis.

Repeated colonic and rectal biopsies from a 47-year-old woman with chronic watery diarrhoea showed an approximately 50 micrometer thick subepithelial band-like collagenous deposit. The histopathological and clinical picture was consistent with the recently described condition of 'collagenous colitis'.