t(3;14)(q26;q11) associated with megakaryoblastic transformation of chronic myeloid leukemia.
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Biomedical subjects
Publications and source records attributed to A Matilla.
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The small oat cell type of carcinoma is only rarely seen in extrapulmonary sites. To date, nineteen cases have been described in the oesophagus, almost all by Japanese authors. In this report we review the relevant literature and add one more case of pure type to the total. The histopathological, histochemical and ultrastructural findings and the similarity of this tumour to the oat cell bronchial carcinoma, lead one to propose that it originates in the cells of the APUD series, which have been demonstrated in the normal oesophageal epithelium. Thus is represents on endocrine carcinoma of the oesophagus.
Fibro-histiocytic neoplasms are uncommon in the respiratory tract. This paper presents a clinical and histological description of a case of fibrous histiocytoma at the level of the third tracheal ring. This cases shares some features with the four cases previously described, viz., the growth occurs mainly in young adults; recurrences are common; and all have shown similar benign histological patterns. Ultrastructural investigations confirmed the fibro-histiocytic nature of the neoplasm.
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A benign nonchromaffin paraganglioma of the duodenum is described and compared with other reported cases. Duodenal location is extremely rare but the morphology, based on the optical microscopic pattern (Zellballen) and the ultrastructural appearance is, comparable with paragangliomas of other sites. The lack of nerve fibres and ganglion cells in this tumour, together with the absence of a positive chromaffin reaction permits us to classify it as a pure nonchromaffin paraganglioma. This finding constitutes indirect evidence of the probable existence of a paraganglion in the duodenal wall, a structure not yet demonstrated in the adult.
A previously unreported association of Brenner and adenomatoid tumor found in the tunica vaginalis testis is presented. Many ultrastructural features found in mesothelial cells such as intercellular spaces, deeply indented nuclei, tonofilaments and tight desmosomes, were also shared by cells present in both neoplastic patterns. The previous histogenetic origins ascribed to testicular Brenner tumors are discussed and the evidence for their origin in the mesothelium considered.
A case of necrotizing sialometaplasia of the lower lip, a previously unreported location for this lesion, is presented. In the past, other cases of this benign process occuring in this site may have been confused with squamous-cell or mucoepidermoid carcinoma. In order to arrive at the correct diagnosis, an ample biopsy of the lesion is mandatory.
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3 cases of cutaneous vegetant intravascular hemangioendothelioma are presented, 2 of them corresponded to a pure form, whilst the other arose in a pyogenic granuloma. All lesions behaved in a benign fashion. In some cases these may mimic an angiosarcoma (Masson's pseudoangiosarcoma). The endothelial proliferation, which characterizes the lesion, is considered as a reactive phenomenon secondary to fibrin deposits originating from the destruction of the vascular walls of a hemangioma.
Four cases of polyvesicular vitelline tumor are presented; two were of a previously unreported pure type, and the other two were mixed with endodermal sinus tumor. The morphologic features of the vesicles favor an endodermal origin, as originally proposed by Teilum. Marked specialization of the vesicular lining cells, seen ultrastructurally, suggests a differentiation toward gut structures and mature yolk sac. One case of pure polyvesicular vitelline tumor showed massive erythropoiesis. We propose that the pure tumor reflects an intermediate degree of differentiation within the selectively endodermal yolk sac tumor group, that is, a further stage of organization than the endodermal sinus tumor. In our cases of pure polyvesicular vitelline tumor, the marked degree of differentiaiton was correlated with an improved prognosis, as in the case of the possible homologue of this tumor, the yolk sac tumor of the infant testis. In contrast, the two cases of the tumor admixed with endodermal sinus tumor illustrated the low survival rate expected in the pure endodermal sinus tumor; in these cases the metastases had no polyvesicular component. Because of the significance of such a difference in prognosis we emphasize the importance of an accurate diagnosis, suggesting that a large number of sections be taken in order to demonstrate any endodermal sinus tumor component that may be present, and that the possibility of pure polyvesicular vitelline tumor always be considered in the differential diagnosis of multicystic ovarian tumors.
Electron microscopic features of the eighth documented case of leiomyomatosis peritonealis disseminata identify the main proliferative cell type as a mature leiomyocyte with all its associated ultrastructural features. The histogenesis of this neoplasm is considered to be a multicentric metaplastic change determined by an abnormal tissue response to the elevated hormonal levels occurring in pregnancy or ovarian functioning tumors. It is suggested that the cell of origin is the multipotent subcelomic mesenchymal cell, which retains the capacity to differentiate into several tissues, among them smooth muscle. To illustrate this possibility, myofibroblasts, cells with hybrid characters of fibroblasts and leiomyocytes, were observed; these may represent a transitional stage between the mesenchymal cell and the smooth muscle proliferating cell.
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