Endocrine mucin-producing sweat gland carcinoma and associated primary cutaneous mucinous carcinoma: Review of the literature.

BACKGROUND: Endocrine mucin-producing sweat gland carcinoma (EMPSGC) is a rare, low-grade, cutaneous adnexal carcinoma with neuroendocrine differentiation. It is considered to be a precursor of invasive neuroendocrine type primary cutaneous mucinous carcinoma (PCMC). OBJECTIVE: To review clinicopathological literature summary of EMPSGC and associated neuroendocrine PCMC from all reported cases and compare its behavior vs non-neuroendocrine PCMC data reported in the literature. METHODS: A review of English literature of all EMPSGC cases with and without associated PCMC was carried out. RESULTS: EMPSGC was associated with invasive neuroendocrine type PCMC in 35.7% of cases. We found the recurrence rate of PCMC associated with EMPSGC of about 12.3%, which is much less than the 30% recurrence rate reported for the non-neuroendocrine subtype of PCMC. The non-neuroendocrine subtype of PCMC shows a 4% and 11% rate of distant and lymph node metastasis, respectively, vs EMPSGC-associated neuroendocrine type of PCMC, which is very indolent and only one recent case of locoregional metastasis out of 190 EMPSGC cases has been reported so far. LIMITATION: Limitation of our study includes data derivation from case reports and case series in the literature. CONCLUSION: The prognostic benefits for this cohort of patients may be considered in their overall management.

Macroscopic and microscopic characteristics of low grade appendiceal mucinous neoplasms (LAMN) on appendectomy specimens and correlations with pseudomyxoma peritonei development risk.

Low grade appendiceal mucinous neoplasm (LAMN) is the primary source of pseudomyxoma peritonei (PMP). PMP may develop after seemingly complete resection of primary tumor by appendectomy, which is unpredictable due to lack of reliable prognostic indicators. We retrospectively reviewed 154 surgically resected LAMNs to explore if any of the macroscopic and microscopic characteristics may be associated with increasing risk of PMP development. Our major findings include: (1) As compared to those without PMP, the cases that developed PMP were more frequent to have (a) smaller luminal diameter (<1 cm) and thicker wall, separate mucin aggregations, and microscopic perforation/rupture, all suggestive of luminal mucin leakage; (b) microscopic acellular mucin presenting on serosal surface and not being confined to mucosa; and (c) neoplastic epithelium dissecting outward beyond mucosa, however, with similar frequency of neoplastic cells being present in muscularis propria. (2) Involvement of neoplastic cells or/and acellular mucin at surgical margin did not necessarily lead to tumor recurrence or subsequent PMP, and clear margin did not absolutely prevent PMP development. (3) Coexisting diverticulum, resulted from neoplastic or non-neoplastic mucosa being herniated through muscle-lacking vascular hiatus of appendiceal wall, was seen in a quarter of LAMN cases, regardless of PMP. The diverticular portion of tumor involvement was often the weakest point where rupture occurred. In conclusion, proper evaluation of surgical specimens with search for mucin and neoplastic cells on serosa and for microscopic perforation, which are of prognostic significance, should be emphasized.

Carcinoma mucinoso primario de piel / Primary mucinous skin carcinoma

El adenocarcinoma mucinoso primario de piel es una neoplasia anexial, maligna e infrecuente, que afecta principalmente a hombres en una relación 2:1 con respecto a las mujeres. Presenta mayor incidencia entre la sexta y séptima década de la vida, y se manifiesta como un tumor único, asintomático, de tamaño variable. La localización más frecuente es la región periorbitaria y el cuero cabelludo. Se comunica el caso de una paciente de 92 años, con diagnóstico de carcinoma mucinoso primario de piel, sin evidencia de enfermedad sistémica ni recurrencia local al año de la resección por cirugía micrográfica de Mohs. Describimos sus principales características clínicas, dermatoscópicas y hallazgos histopatológicos. (AU)

Primary mucinous adenocarcinoma of the skin is an adnexal, malignant, and infrequent neoplasm that mainly affects men with a 2: 1 ratio, with respect to women. It presents higher incidence between the sixth and seventh decade of life, and manifests as a single tumor, asymptomatic, of variable size. The most frequent location is the periorbital region and scalp. We report the case of a 92-year-old patient with a diagnosis of primary mucinous skin carcinoma, without evidence of systemic disease or local recurrence one year after resection by Mohs micrographic surgery. We describe its main clinical features, dermatoscopic and histopathological findings. (AU)

Mucinous tubular and spindle cell carcinoma of the kidney with prominent papillary component, a non-classic morphologic variant. A histologic, immunohistochemical, electron microscopic and fluorescence in situ hybridization study.

Mucinous tubular and spindle cell carcinoma (MTSCC) is a rare type of kidney tumor with relatively indolent behavior. Non-classic morphological variants have not been well studied and rarely been reported. We report a challenging case MTSCC with a peculiar morphology in a 42-year-old man, arising in a background of end-stage renal disease (ESRD). Predominant areas with extensive papillary architecture, psammoma bodies and stromal macrophageal aggregates, reminiscent of a papillary renal cell carcinoma (papillary RCC), were intermixed with foci that transitioned into a MTSCC-like morphology exhibiting elongated tubules and a low grade spindle cell component in a background of mucinous stroma. Immunohistochemistry demonstrated diffuse positivity for P504s/AMACR and vimentin in tumor cells. Focal positivity for RCC, CD10 and CK7 was also noted. Kidney-specific cadherin, cytokeratin 34betaE12 and TFE3 stains were negative in the tumor. The major differential diagnostic considerations were papillary RCC, clear cell papillary RCC, and Xp11.2 translocation carcinoma. Negative FISH studies for trisomy 7 and 17 in both papillary and spindled components supported the diagnosis of MTSCC. The ultrastructural profile was not entirely indicative of the cellular origin of the tumor. Cytogenetic analysis should be performed in atypical cases of MTSCC for precise diagnosis.

Biochemical and ultrastructural correlations of calreticulin and thioredoxin expression in breast mucinous carcinoma and infiltrating ductal carcinoma non-special type.

Mucinous infiltrating invasive ductal adenocarcinoma consists of 2-4% invasive breast cancer, but is a very interesting type due to its macroscopic similarity to non-special-type (NST) ductal carcinoma. The macroscopic similarity of mucinous and infiltrating ductal carcinoma NST adenocarcinomas consists of a loose and edematous stroma, which is often seen in portions of NST carcinoma and may mimic the mucin pools of mucinous carcinoma. In this study the authors examined the ultrastructural differences between mucinous carcinoma and infiltrating ductal carcinoma NST. They also examined the protein expression of the tissues by 2D electrophoresis due to their belief that from the results of these two levels it is possible to understand the changes that take place both in the ultrastructural and biochemical levels in these two types of breast cancer. The ultrastructural results from mucinous carcinoma have shown many changes in cytoplasmic organelles in comparison to normal samples, depending on the grade and the number of metastatic lymph nodes. At the 2D elecrophoresis level the authors studied two interesting polypeptides, calreticulin and thioredoxin. Both of these proteins were found in patterns of fibroadenoma, mucinous carcinoma, and NST carcinoma, but with different quantitative expression among them. In the future the quantitative differences of these two proteins may provide specific tumor markers for these two types of carcinoma.

Mesenteric venous collateral vessels mimicking cystic pancreatic neoplasm.

We report an unusual case of intrapancreatic mesenteric venous collateral vessels following partial pancreatic surgical resection resembling pancreatic neoplasm upon greyscale sonographic and unenhanced CT examinations.

Carcinoma mucinoso tubular y fusocelular renal. Descripción de los hallazgos citológicos de un caso pobre en mucina / Mucinous tubular and spindle cell renal carcinoma. Cytological findings in a case with poor mucin content

La clasificación de la OMS 2004 describe el carcinoma renal mucinoso tubular y fusocelular (CRMTF), como una neoplasia de bajo grado, que histológicamente se caracteriza por presentar en distintas proporciones, un estroma mucinoso y una población de células cuboides y fusiformes dispuestas en túbulos y fascículos. El diagnóstico citológico de este carcinoma se sustenta en identificar en los extendidos una proliferación celular de bajo grado sobre un fondo mixoide. Recientemente han sido descritas variantes pobres en mucina del CRMTF y que, junto a las formas clásicas, completan el espectro morfológico del tumor. En estos casos, el diagnóstico citológico se ve dificultado ante la ausencia o escasez de sustancia mixoide. En este artículo se presenta un nuevo caso de CRMTF variante pobre en mucina de predominio tubular, con especial mención al cuadro citológico. Las características citológicas de esta variante específica no han sido descritas previamente en la literatura. El cuadro descrito contribuye a completar el espectro citológico que puede adoptar el CRMTF(AU)

The 2004 WHO classification describes mucinous tubular and spindle cell renal carcinoma (MTSC) as a low grade neoplasm with a characteristic histological picture of varying proportions of mucinous stroma and cuboid and spindle cells arranged in tubules and fascicles. The cytological diagnosis of this carcinoma is made by identifying low grade cellular proliferation against a myxoid background. Recently, MTSC variants with poor mucin content have been described which, together with the classical forms, complete the morphological spectrum of this tumour. In these cases, the cytological diagnosis is difficult due to the absence or scarcity of the myxoid component. We present a case of a new, predominantly tubular, MTSC variant which had a poor mucin content. Special emphasis is placed on the cytological findings of this previously unreported variant which completes the cytological range of appearances that can be adopted by MTSC(AU)

Surface topography and ultrastructural changes of mucinous carcinoma breast cells.

Mucinous carcinoma of the breast (MCB) is histologically classified into 2 groups: (1) pure MCB and (2) mixed MCB. Pure MCB carries a better diagnosis than mixed MCB. This research relates to the cell surface topography and ultrastructure of the cells in the above cases and aims to find the differences between them, by means of two methods: scanning electron microscopy (SEM) and transmission electron microscopy (TEM). For the SEM examination, it was necessary to initially culture the MCB tissues and then proceed with the usual SEM method. In contrast, for the TEM technique, MCB tissues were initially fixed followed by the classic TEM method. The authors found the topography of pure MCB cases to be without nodes. The cell membrane was smooth, with numerous pores and small ruffles that covered the entire cell. The ultrastructural appearance of the same cases was with a normal cell membrane containing abundant collagen fibers. They also had many small vesicles containing mucin as well as secretory droplets. In contrast the mixed MCB had a number of lymph nodes and their cell surface topography showed stronger changes such as microvilli, numerous blebs, ruffles and many long projections. Their ultrastructure showed very long microvilli with large cytoplasmic inclusions and extracellular mucin collections, electron-dense material vacuoles, and many important cytoplasmic organelles. An important fact is that mixed MCB also contains areas of infiltrating ductal carcinoma. These cells of the cytoplasmic organelles are clearly responsible for the synthesis, storage, and secretion of the characteristic mucin of this tumor type. Evidently, this abnormal mucin production and the abundance of secretory granules along with the long projections observed in the topographical structure might be responsible for transferring tumor cells to neighboring organs, thus being responsible for metastatic disease.

Subjective sonographic assessment for differentiation between malignant and benign adnexal masses.

OBJECTIVE: To determine the accuracy of subjective sonographic assessment in distinguishing between benign and malignant adnexal masses. STUDY DESIGN: Cross-sectional descriptive study. METHODS: The patients scheduled for elective surgery due to adnexal masses were recruited into the study. All patients were sonographically examined within 72 hours of surgery were subjectively evaluated by the experienced sonographer, who had no any information of the patients, to differentiate between benign and malignant adnexal masses based on sonographic morphology. The final diagnoses, used as gold standard, were based on either pathological or operative findings. RESULTS: One hundred and fifty-eight patients with 174 adnexal masses, (benign; 108 and malignant; 66) were recruited into the study. The accuracy, sensitivity, specificity, positive predictive value, and negative predictive value were of 89.7%, 84.9 % and 92.6 %, 87.5% and 90.9%, respectively. CONCLUSIONS: Subjective evaluation of sonographic morphology has high accuracy in differentiating between benign and malignant adnexal masses.

Sonographic morphology scores (SMS) for differentiation between benign and malignant adnexal masses.

OBJECTIVE: To determine the sensitivity and specificity of a scoring system for distinguishing between benign and malignant adnexal masses and to detect threshold scores for prediction of malignant ovarian tumors. STUDY DESIGN: Cross-sectional diagnostic testing. SETTING: Department of Obstetrics and Gynecology, Faculty of Medicine, Chiang Mai University. SUBJECTS: A total 158 patients scheduled for elective surgery due to ovarian tumors at Maharaj Nakorn Chiang Mai Hospital between June 16, 2002 and August 8, 2004 were recruited into the study. METHODS: All patients were sonographically examed within 72 hours before surgery by the same sonographer to evaluate the morphology including wall structure, shadowing, septum, echogenicity and score the tumors. The final diagnosis was based on either pathological or operative findings. MAIN OUTCOME MEASURE: Sensitivity and specificity of the best cut-off score. RESULTS: A score of 5 from the receiver operating characteristic curve was found to be the best cut-off score, giving a sensitivity and a specificity of 85% and 70%, respectively. CONCLUSION: Sonographic morphology scores are useful in distinguishing adnexal malignancies from benign lesions in some selected cases.

HATH1 expression in mucinous cancers of the colorectum and related lesions.

PURPOSE: Mucinous cancers and signet ring carcinomas are distinct classes of colon cancers characterized by their production of copious quantities of intestinal goblet cell mucin, MUC2. Deletion of transcription factor HATH1 ablates the biogenesis of goblet cells in developing mouse intestine, and forced expression of HATH1 results in elevated expression of MUC2 in colon cancer cells. The aim of this study was to assess the possible role of HATH1 in the development of mucinous cancers and signet ring carcinomas. EXPERIMENTAL DESIGN: Immunohistochemistry and confocal microscopy was used to examine HATH1 expression and subcellular distribution in normal colon and small intestine, mucinous cancers, signet ring carcinomas, and nonmucinous cancers and in precursor lesions, including hyperplastic polyps, serrated adenomas, tubular adenomas, and villous adenomas. We also analyzed the transactivation of MUC2 promoter/reporter constructs by a HATH1 expression vector. RESULTS: HATH1 expression transactivated MUC2 promoter/reporter constructs, an activity that was significantly inhibited by mutation of putative HATH1-binding sites. HATH1 was expressed in the nuclei of goblet cells and in the cytoplasm and nuclei of enteroendocrine cells of the colon. In the small intestine, only cytoplasmic expression of HATH1 in enteroendocrine cells was detected. HATH1 was found to be strongly expressed in the nuclei of hyperplastic polyps, serrated adenomas, villous adenomas, mucinous cancers, and signet ring carcinomas but repressed in nonmucinous cancers and tubular adenomas. CONCLUSIONS: This study confirms the importance of HATH1 for the development of intestinal secretory cells. The results further suggest that HATH1 is an important factor in the up-regulation of MUC2 expression that occurs in mucinous cancers and signet ring carcinomas. In addition, the expression of HATH1 in hyperplastic polyps, serrated adenomas, and villous adenomas lends support to the hypothesis that these neoplasms are frequent precursors in mucinous cancer and signet ring carcinoma development.

Low-grade tubular-mucinous renal neoplasm with neuroendocrine differentiation: a histological, immunohistochemical and ultrastructural study.

Low-grade tubular-mucinous renal neoplasm (LGTMRN) was recently established as a distinct carcinoma classification. A 70-year-old, female traffic accident victim underwent a detailed examination that disclosed a huge mass in the lower pole of the left kidney. The patient underwent a nephrectomy based on a diagnosis of renal tumor. Macroscopically, the tumor was well demarcated and a whitish color with focal hemorrhage. Histological examination showed that tumor cells proliferated through tubular, trabecular, and solid growth patterns in the mucinous background. Focally, foci of clear cells or the proliferation of spindle cells was also observed. Nuclei were generally round and uniform in size. No abnormal mitotic figures were identified. Immunohistochemically, tumor cells were diffusely positive for AE1/AE3, vimentin and chromogranin A, and focally positive for cytokeratin (CK) 18, CK19, Ulex europaeus agglutinin-1, epithelial membrane antigen, neuron-specific enolase (NSE), CD9 and CD57. Ultrastructurally, tumor cells contained a moderate number of mitochondria, rough endoplasmic reticulum and dense-core granules. No renin granules or glycogen were observed. Microvilli were focally seen. Our results render further evidence that LGTMRN is a distinct entity from the hitherto established renal neoplasms. Foci of clear cells and neuroendocrine differentiation should be added to the histological spectrum of LGTMRN.

[Allicin induced cell cycle arrest in human gastric cancer cell lines].

OBJECTIVE: To study the effect of allicin on cell cycle of human gastric cancer cell lines, MGC-803 and SGC-7901, and its possible mechanisms. METHODS: The gastric cancer cell lines MGC-803 and SGC-7901 were treated with allicin. Proliferation inhibitory rate was detected by trypan-blue exclusion. Morphologic changes were observed by electron microscopy. The cell cycle was examined by flow cytometry and Giemsa staining. Expression of p21WAF1, p16INK4 protein and mRNA was detected by immunohistochemistry and RT-PCR. RESULTS: The gastric cancer cells were inhibited after exposure to allicin for 24 hr, The IC50 was 6.4 microg/ml in MGC-803 cells and 7.3 microg/ml in SGC-7901cells. After exposure to allicin of 12 microg/ml for 24 hr, it caused the cytotoxic effect on the cells, including cellular membrane breakagy. After exposure to allicin of 3 microg/ml, 6 microg/ml and 9 microg/ml for 24 hr, compared with the control group, the proportion of cells in the G0/G1 phase was decreased and that in the G2/M phase was increased significantly (P < 0.01). After exposure to allicin of 6 microg/ml for 24 hr, compared with the control group, cell division index was much higher, suggesting that allicin could induce cell arrest in M phase. The expression levels of p21WAF1 and p16INK4 protein and mRNA in MGC-803 cells and p21WAF1 protein and mRNA in SGC-7901 cells were markedly up-regulated. CONCLUSION: Allicin induce cell arrest of gastric cancer in M phase, which may be related to the up-regulated expression of p21WAF1 and p16INK4 genes.

Fine-needle aspiration cytology findings of an uncommon micropapillary variant of pure mucinous carcinoma of the breast: review of patients over an 8-year period.

BACKGROUND: Previous attempts at subclassifying pure mucinous carcinomas of the breast based on architectural patterns and other associated features are on record. A distinctive micropapillary variant with most tumor cells arranged in micropapillae/pseudoacini has not been described previously. METHODS: The author reviewed the histologic slides from all 556 patients who underwent wide excision/mastectomy for mammary ductal carcinoma, either in situ or invasive, at Pamela Youde Nethersole Eastern Hospital, Hong Kong, during an 8-year period from early 1994 to the end of 2001. Five patients with pure mucinous carcinoma with diffuse micropapillary architecture were noted. The cytologic features (if available) were correlated with clinical, radiologic, and pathologic findings. RESULTS: Among the five patients with pure mammary mucinous carcinoma (micropapillary variant), three patients underwent preoperative fine-needle aspiration biopsies and had specimens available for review. The direct smears and cytospin preparations were of moderate cellularity and showed cohesive clusters and micropapillae of mildly pleomorphic tumor cells among a mucoid background. True tumor papillae with fibrovascular cores were not present. Nuclear hobnailing was observed commonly, and occasional psammoma bodies were found. There were also scanty isolated tumor cells scattered around. The pseudoacinar pattern was appreciated more readily in the cell block sections. Histologic examination of the surgical specimens showed features of pure mucinous carcinoma with diffuse micropapillary architecture. The micropapillary arrangement was confirmed further by the demonstration of a reverse polarity immunostaining pattern for epithelial membrane antigen and the identification of microvilli rimming the periphery of tumor cell clusters under the electron microscope. Peritumoral lymphovascular permeation and ipsilateral axillary lymph node metastasis was found in one of the patients. CONCLUSIONS: The micropapillary variant of mammary mucinous carcinoma demonstrates characteristic cytologic and histologic features that warrant special attention. It may represent the mucinous counterpart of invasive micropapillary carcinoma. Further analysis of a larger series of patients, however, will be required to delineate its prognostic significance, especially its propensity for lymph node metastasis.

Colloid (mucinous noncystic) carcinoma of the pancreas.

In the past, colloid (mucinous noncystic) carcinoma (CC) of the pancreas had been included under the category of ordinary ductal adenocarcinoma, a tumor with a dismal prognosis, or was frequently misdiagnosed as mucinous cystadenocarcinoma. The clinicopathologic features of CC have not yet been well characterized, because most cases on record have been parts of studies on either mucinous cystic neoplasms (MCN) or intraductal papillary mucinous neoplasms (IPMN), with which colloid carcinomas are frequently associated. To determine the clinicopathologic characteristics of CC, 17 pancreatic tumors composed predominantly (>80%) of CC (defined as nodular extracellular mucin lakes with scanty malignant epithelial cells) and in which the invasive carcinoma measured larger than 1 cm were studied. Ten of these were originally classified as mucinous ductal adenocarcinoma and four as mucinous cystadenocarcinoma. The mean age of the patients was 61 years; 9 were men and 8 were women. The mean size of the CC was 5.3 cm (range, 1.2-16 cm). In more than half of the patients, CC represented the invasive component of an IPMN (in nine cases) or MCN (in one case). The tumors were composed of well-defined pools of mucin with sparse malignant cells in various patterns of distribution. Signet-ring cells floating in the mucin (but not as individual cells infiltrating stroma, a characteristic finding of signet-ring cell adenocarcinomas) were commonly identified and were prominent in five cases. Perineurial invasion was noted in six cases and regional lymph node metastases in eight. Mutation in codon 12 of the k-ras gene was detected in only 4 of 12 cases studied and p53 mutation in 2 of 9. Immunohistochemical and histochemical mucin stains suggested luminalization of the basal aspects of the cells. Five-year survival was 57%. At an overall mean follow up of 57 months, 10 patients were alive with no evidence of disease (median, 79 mos), including four with lymph node metastasis, three others with perineurial invasion, and another with vascular invasion. Four patients died of disease (18, 18, 25, and 26 mos), and three died of thromboembolism (with persistent disease) at 2, 5, 10 months. All seven patients who died with or of tumor had undergone incisional biopsy of the tumor either before the operation or intraoperatively, whereas none of the patients who were alive had incisional biopsy. When compared with 82 cases of resectable ordinary ductal adenocarcinoma on whom follow-up and staging information was complete, it was found that the patients with CC present with larger tumors (p = 0.03) but lower stage (p = 0.01). The prognosis of CC is significantly better: 2-year and 5-year survival are 70% versus 28% and 57% versus 12%, respectively (p = 0.001). In conclusion, pancreatic CC may occur with or without an identifiable IPMN and MCN component, and should be distinguished from mucinous cystadenocarcinoma, ordinary ductal adenocarcinoma, and signet-ring cell adenocarcinoma. CC of the pancreas is associated with a significantly better prognosis than ordinary ductal adenocarcinoma. In addition to its distinctive morphologic and clinical characteristics, CC of the pancreas also appears to have a low incidence of mutation in codon 12 of the k-ras gene. In cases with a clinical suspicion of colloid carcinoma, the possibility that an incisional biopsy may contribute to thromboembolic complications or even dissemination of the tumor may need to be considered. The luminalization of the basal aspects of the tumor cells may be the cause of stromal mucin accumulation that characterizes colloid carcinoma and may act as a containing factor.

AgNORs in breast tumours.

There is evidence that the quantitative distribution of AgNOR proteins is a proliferation-related parameter that can be used as a prognostic index in tumour pathology. In breast cancer, some authors found a significant prognostic correlation of AgNOR protein quantity, whereas other did not. However, in all the reports dealing with AgNOR area (as opposed to count) this parameter was always turned out to be an independent prognostic indicator. The present study tests the significance of AgNOR proteins in a large series of primary breast carcinomas, exploring the associations between the AgNOR protein amount, as evaluated by image cytometry, and the other well-established prognostic markers commonly considered for breast cancer, along with patients' survival. Our results demonstrated a highly significant association between AgNOR protein quantity and tumour prognosis. Moreover, when the AgNOR area values were entered in multivariate analysis together with the other predictive parameters commonly considered in breast carcinomas, they showed an independent prognostic value together with Ki67-labelling index (LI), N-status and tumour size. Considering node-negative and -positive cases separately, the AgNOR protein area and Ki67-LI both come out as a independent predictors only in the latter group: the short follow-up time of our series (36 months median) could be responsible for this discrepancy.

Bone marrow relapse in primary mucinous carcinoma of skin.

Primary mucinous carcinoma of skin is a rare adnexal tumor arising from the eccrine sweat gland. The tumors grow slowly and have low rates of local recurrence and rare chances of distant metastasis. The authors report a 70-year-old man with primary mucinous skin carcinoma who had a relapse in bone marrow 19 months after initial treatment.

[Mucinous breast carcinomas with neuroendocrine differentiation]. / Mutsinozni kartsinomi na g'rdata s nevroendokrinna diferentsiatsiia.

Mucinous breast carcinomas, denominated also gelatinous, mucoid and colloid (collomas), represent a heterogeneous group of neoplasms. More than half of them exhibit signs of neuroendocrine differentiation. Eighteen mucus producing carcinomas of the breast are subjected to morphological study. On the ground of demonstrating argyrophilia by the methods of Grimelius and Churukian--Shenk, and presence of secreting granules during electron microscopic study, they are assigned under the heading apudomas, i.e. tumors of the diffuse endocrine system, or the so-called APUD-system. The important practical implications of demonstrating neuroendocrine cells with a special reference to the biological patterns of this particular type of tumors are discussed.

Ultrastructural features of adenoma malignum of the uterine cervix: demonstration of gastric phenotypes.

Histochemical staining has shown that so-called adenoma malignum (the mucinous type of minimal deviation adenocarcinoma [mucinous MDA]) of the uterine cervix expresses gastric phenotypes. The present ultrastructural study was undertaken to explore the fine structure and phenotypic expression of this tumor, and to make comparisons with normal cervical glands and gastric pyloric mucosa. Post-embedding, double-immunogold staining for gastric gland mucous cell mucin (HIK1083-reactive mucin) and lysozyme revealed localization exclusively to the matrix and to the core of the mucin granules, respectively, both in mucinous MDA and gastric pyloric mucosa. Mucin granules of normal cervical gland cells lacked core structures and showed no immunoreactivity with HIK1083 or lysozyme. Thus, mucinous MDA was confirmed to be a tumor expressing gastric phenotypes ultrastructurally. Both markers should be useful for the identification of tumor cells.