Papillary serous carcinoma of the ovary: an ultrastructural and immunohistochemical study.

Twenty-four patients with ovarian serous papillary carcinoma were enrolled in the present ultrastructural and immunohistochemical study. Immunohistochemistry was used to examine the status of proliferation activity with antibodies against Ki67 and BM28, and the status of EGFR family members with antibodies against EGFR, c-erbB-2, and c-erbB-4. Ultrastructurally, poorly differentiated tumors often revealed solid sheets of tumor cells with variable desmosomes, cell connection complexies, and microvilli. No mature cilia, which are often present in benign and borderline ovarian epithelial tumors, were seen in these 24 carcinomas. However, two poorly differentiated tumors demonstrated oligocilia. In addition, numerous secondary lysosomes and bizzare intracytoplasmic pseudocavities were more often present in the poorly differentiated tumors. Immunohistochemically, strong expressions of BM28 and Ki67 in more than 50% of the tumor cells were found in 12/15 (80%) and 11/15 (73%) of the poorly differentiated tumors, respectively, compared with 3/9 (33%) and 1/9 (11%) of the moderately differentiated tumors, respectively. Higher levels of EGFR and c-erbB-2 expressions were more often observed in the poorly differentiated tumors, compared with that in the moderately differentiated tumors. In conclusion, oligocilium, numerous secondary lysosomes, and bizarre intracytoplasmic inclusions are more often seen in poorly differentiated ovarian serous carcinomas. Poorly differentiated ovarian serous carcinomas express higher levels of Ki67, BM28, EGFR, and c-erbB-2 proteins.

Immunohistochemical and ultrastructural study of a papillary cystadenocarcinoma arising from the sublingual gland.

Immunohistochemical and ultrastructural findings in a rare case of papillary cystadenocarcinoma arising from the left sublingual gland of a 55-year-old Japanese man are reported. Histologically, the tumor tissue was found to be composed of various-sized cystic cavities in which papillary epithelial projections with thin fibrovascular cores were observed. The papillary projections consisted of a single layer to several layers of high columnar epithelial cells. Invasion to the surrounding fibrous tissue and into the lymphatics was observed, thus suggesting an aggressive potential in the present case. The possibility of the involvement of myoepithelial cells could be excluded based on the immunohistochemical and ultrastructural findings. The immunohistochemical and ultrastructural findings also suggested that this type of salivary gland tumor, at least the present case, may arise from striated or excretory ducts. There was positive immunostaining for tumor markers CA19-9 and CA125. However, the biological role of these carbohydrate antigens in salivary gland tumors is unclear at present. Further investigations are, therefore, called for to solve this issue.

[Giant acinic cell parotid gland adenocarcinoma of the papillary- cystic type]. / Adenocarcinoma gigante de células acinares de tipo quístico papilar en parótida.

A case of a 38-year-old male having an acinic cell adenocarcinoma of the parotid gland is reported. The tumor measured 22 cm and histologically it was of the papillary-cystic type. The following features were of interest: 1) the tumor size surpassed the size of previous reported acinic cell adenocarcinomas by 9 cm; and 2) the rarity of its histological variety (cystic papillary) demanded immunohistochemical and electron microscopic studies to confirm the diagnosis.

Adenocarcinoma gigante de células acinares de tipo quístico papilar en parótida / Giant acinic cell adenocarcinoma with papillary-cystic pattern of the parotid gland

Se presenta el caso de un hombre de 38 años de edad con un adenocarcinoma de células acinares de 22 cm de tipo quístico papilar, originado en la glándula parótida. El interés del caso radica en: 1) el tamaño del tumor que supera en 9 cm al adenocarcinoma de células acinares más grande hasta ahora informado; y 2) la rara variedad histológica quística y papilar demandó estudios de histoquímica, inmunohistoquímica y microscopía electrónica para su diagnóstico

Cytologic features of papillary serous adenocarcinoma of the uterine cervix.

BACKGROUND: The cytologic features of papillary serous carcinoma of the cervix (PSCC) have not been described in detail previously. In this study the cytologic features of primary, pure PSCC are described and correlated with the histology. Comparison is made with papillary serous ovarian carcinoma metastatic to the cervix. METHODS: Seven cases of primary pure PSCC and five cases of ovarian PSCC metastatic to the cervix were retrieved from the pathology files. The cytology records and slides, and clinical charts were traced and examined retrospectively. RESULTS: Five of the 7 patients with PSCC were younger than 40 years. The smears of PSCC contained many groups of atypical glandular cells. Monolayered sheets of mildly atypical glandular cells with papillary branches were observed only in the cases of primary PSCC. All cases contained multilayered sheets of mildly to moderately pleomorphic glandular cells, pseudopapillary fragments, and tight balls of cells resembling endometrial glandular cells. Squamoid cells with abundant densely staining cytoplasm were also encountered. Free-lying dissociated atypical cells were also present, some of which were markedly atypical. A marked tumor diathesis of inflammatory cells, cell debris, and blood was encountered with primary PSCC but was scanty in cases of papillary serous ovarian carcinoma metastatic to the cervix. CONCLUSIONS: PSCC has a relatively characteristic cytologic appearance which usually differs from other endocervical adenocarcinomas and from metastatic papillary serous carcinoma. However, some features may lead to underdiagnosis or confusion with other entities such as squamous carcinoma or endometrial carcinoma.

Transplantation of a human ovarian cystadenocarcinoma into severe combined immunodeficient (SCID) mice--formation of metastases without significant alteration of the tumour cell phenotype.

Human ovarian papillary cystadenocarcinoma cells were injected intraperitoneally into severe combined immunodeficient (SCID) mice. After intraperitoneal application the cells, designated SoTü, grew well in vivo, lodged on to the peritoneum, formed local metastatic deposits, led to the development of ascites in the mice and formed distant metastases in the lungs. If lodged in the ovary, the morphology of the SoTü tumour remarkably resembled that of the primary tumour in the patient. In contrast, several attempts failed to maintain the SoTü cells in vitro. If SCID mouse ascites derived SoTü were transplanted subcutaneously in SCID mice, they formed cystic tumours which also metastasized into the lungs. Immunophenotypical analysis of cell adhesion molecule expression, cell proliferation markers, various oncoproteins, keratin, vimentin, and lectin binding site expression all showed striking similarity between the primary tumour and the SCID mouse explants. In particular, expression of binding sites for the lectin Helix pomatia agglutinin (HPA), which has been shown to be an index of metastatic potential in several human carcinomas, was found on the primary tumour as well as on tumour cells grown in SCID mice, indicating that HPA might be a prognostic indicator in ovarian carcinoma as well. Our results demonstrate that the human/SCID mouse system can mimic growth and distant metastasis formation of human ovarian carcinoma. Although the formation of distant metastases is a relatively rare event in patients, this model system might help to elucidate mechanisms of metastasis formation in ovarian cancer.

Paratesticular serous papillary carcinoma. A report of six cases.

Six intrascrotal, invasive epithelial neoplasms of serous papillary type arose in the paratesticular region of patients 16 to 42 (mean, 30.8) years of age. Five patients, one with an associated hydrocele, presented with a testicular mass and one with a hydrocele only. The serum CA-125 level was elevated in one of the two patients in whom it was measured. Grossly, the tumors were solid, white, or tan, poorly circumscribed, often gritty masses. Four tumors involved primarily the soft tissue between the testis and epididymis (testiculoepididymal groove) and one, the paratesticular soft tissue. The sixth tumor was confined to the visceral tunica vaginalis at the inferior pole of the testis. The most common microscopic pattern was characterized by invasive, well-formed papillae lined by serous cuboidal or columnar cells with eosinophilic cytoplasm and malignant nuclear features. Psammoma bodies were abundant in all the cases. Areas of borderline serous tumor were present in two tumors and predominated in one. Five of five tumors were positive for keratin (AE1/3), S-100, epithelial membrane antigen, and Ber-EP4; three of five for Leu M1 and B72.3; two of five for carcinoembryonic antigen and placental alkaline phosphatase; and one in five for vimentin. Ultrastructural examination in one case demonstrated gland formation with delicate luminal microvilli and cilia. Follow-up information was available in five cases: Three patients are without evidence of disease after relatively short postoperative intervals of 1, 1, and 3 years, although one of these patients has had a persistently elevated CA-125 level. Two patients had recurrence of their tumors 4 and 7 years after diagnosis, one with diffuse abdominal spread, the other in a cervical lymph node. The latter patient died of his disease 5 years after diagnosis.

Ovarian dysplasia: nuclear texture analysis.

BACKGROUND: Ovarian dysplasia has been defined by histologic and morphometric studies focusing on architectural and nuclear profile changes. A new technique is used to enhance the accuracy of this diagnosis by a quantitative evaluation of the nuclear texture that represents the nuclear chromatin pattern on which conventional diagnoses of malignancy are usually made. METHODS: Histologic sections from 35 ovaries classified as malignant (12), dysplastic (12), and normal (11) were evaluated by tracing boundaries of nuclear profiles and measuring "textons" (texture primitives) with a histogram analysis of three zones of gray level densities (called for simplification white, gray, and dark). The average combined area was tabulated for specimens with the same diagnosis, and linear regression plots compared the texton area with total nuclear area. RESULTS: The dimensions of textons originally hidden inside the chromatin and revealed by histograms were found to be closely clustered in normal epithelium, and increasingly dissociated from the containing nucleus as the lesion progressed from dysplastic to malignant. The statistical multivariate analysis including nine parameters correctly classified the three diagnostic categories as normal, dysplastic, and malignant. CONCLUSIONS: Computerized image analysis of nuclear texture adds accuracy to the recently elaborated morphometric methods to define ovarian dysplasia, a potential precursor of ovarian carcinoma.