Polymorphous low-grade adenocarcinoma of the soft palate: fine needle aspiration (FNA) cytology.
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Biomedical subjects
Publications and source records attributed to G P Mincione.
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A case of pseudosarcoma of the urinary bladder is described in a woman aged 23. The tumor presenting with symptoms of cystitis arised in the left wall and invaded vesical cavity and pelvis. Histological, histochemical, immunohistochemical and electron microscope studies revealed a fibroblastic and myofibroblastic proliferation with atypias, accompanied by inflammatory infiltrates and rich vascularity. The tumor was furthermore characterized by extensive necrosis, involving the muscularis propria, and infiltrated the perivesical fat. The favourable outcome four years after partial cystectomy suggests the diagnosis of pseudosarcoma. The differential diagnosis and the pathogenesis of this rare lesion is discussed.
Urinary cytology performed in a woman aged 64 revealed an uncommon cell population with malignant features highly suggestive of a lymphoma. Histologic and immunohistochemical investigations of a polypoid endovesical mass surgically resected showed a lymphoma of histiocytes in the lamina propria of the bladder wall. Clinical, operative and pathologic staging demonstrated that the tumor was confined to bladder. The case repeats the typical features of primary vesical lymphoma reported in the literature. The favourable follow up six years after surgery confirms the good prognosis of bladder Iymphoma treated by aggressive therapy.
p53 was examined by immunohistochemistry in five cases of retinoblastoma, a neoplasm that is caused by a loss of function of the Retinoblastoma susceptibility gene (Rb), mapped to chromosome 13q14. Object of the study was the identification of eventual further gene mutation in retinoblastoma tumor cells determining the onset of an independent tumoral monoclonal cell subset. We did not observe any positive reaction for p53 protein expression in the five cases we analyzed.
We report a study on human papilloma virus (HPV) and p53 protein in 18 cases of urothelial carcinoma grade 1, 2 and 3. The presence of HPV has been correlated to the p53 protein expression, as this virus, once integrated in the cell nuclei, seems to cause the alteration of some genes expression, involved in the cell-cycle regulation, like p53. One case of urothelial papillary carcinoma grade 2, infiltrating the lamina propria, resulted to be positive for HPV type 31/33/51 and for p53 protein. Our data suggest that HPV type 31/33/51 may have played a role in the pathogenesis of this neoplasia causing an alteration of p53 gene.
Two rare cases of paraurethral leiomyoma in women are presented. Physical examination and cystourethrography with previous cytourethroscopy revealed the seat of the masses. Surgical approach by means of incision of the anterior vaginal wall allowed for the complete enucleation of the tumors.
A rare case of papillary urothelial grade 2 carcinoma of the prostate and urethra in a patient with a previous papillary neoplasm of the bladder is reported. The tumor caused hematuria and prostatic enlargement suspicious for cancer. Urinary cytology was diagnostic.
Urine cytology performed in a 64 year old man with pain in the left flank and hematuria revealed tumor cells suggesting a malignant lymphoma. Subsequent radiologic and operative findings showed a neoplasm in the left renal region involving intraabdominal and left inguinal lymph nodes. Biopsies from lymph nodes confirmed the presence of a malignant lymphoma probably of histiocytic type. The histologic classification of the tumor is discussed and the rarity of the finding of lymphoma cells in the urine is noted.
The initial tumors of 21 patients who earlier had presented with superficial noninvasive transitional cell carcinoma of the bladder and who subsequently underwent cystectomy for invasive disease were examined by the specific red cell adherence test. Eighteen of 21 initial tumors (85.7%) were antigen negative. The time from initial tumor resection ranged from twelve to 168 months (mean thirty-eight months). Loss of blood group antigens indicated enhanced biologic aggressiveness of tumors. However the interval to invasion is sufficiently variable as to preclude the use of this assay for timing of radical cystectomy.
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Twelve melanoblastomas of the choroid of different histological types have been studied in the semi-thin sections and at transmission electron microscope. There have been also observed at scanning electron microscope. The ultrastructural findings show some differences in the main cellular types as observed at light microscope by Callender (spindle-shaped cells A and B and epithelioid). In the epithelioid and spindle-shaped B cells a higher number of ribosomes and of mitochondria and large, polymorphous, often multiple nucleoli with reticular structure are observed. There findings may be related to a greater metabolic activity and anaplastic tendency of these cells. Moreover in spindle B - and epithelioid - cell types atypical melanogenesis and nuclear bodies are particularly evident. Scanning electron microscope show well developed cytoplasmic extensions in spindle cells.
Twelve cases of uveal malignant melanoma, including the principal histologic types of this neoplasm according to Callender, were studied with the electron microscope. Nuclear inclusions were observed in each case, more frequently in epithelioid cells: they were probably correlated with nuclear hyperactivity. Melanogenesis in neoplastic cells was sometimes abnormal because of the granular structure of the premelanosomes, of the difference in size and in shape melanosomes, of the difference in size and in shape of the pigment granules and of the different stage of evolution of the premelanosomes in the cell. The size and the degree of reticulation of nucleoli and the number of free ribosomes and mitochondria increased from spindle A, to spindle B and epithelioid cells. This behaviour probably depends on an increasing metabolic activity which is related to the increasing degree of malignancy.
Four malignant uveal melanomas, of which two were of fascicular (subtype B) type one of epithelioid type and one of mixed-type, were examined under a scanning electron microscope. Within the tumors, we can distinguish cells having long cytoplasmatic processes and cells without processes, which correspond to the fusiform and epithelioid cells respectively. The cells also show a more or less marked development of the microvillosities of the cell surface.
We analysed by immunohistochemistry the expression of p53 protein in a case of micro-invasive carcinoma of the conjunctiva. About 50% of tumor cells showed a strong nuclear positivity for p53. This suggests that p53 gene alterations play a role in the development of this type of tumor.
Four cases of conjunctival papilloma in two different patients were examined by in situ hybridization for HPV DNA type 6/11, 16/18 and 31/33/51. Formalin-fixed and paraffin-embedded tissues were hybridized by biotinylated probes. One tumor and one of its recurrences showed nuclear positivity for HPV 6/11 in the superficial cells of the epithelium. The results suggest that HPV type 6/11 may be etiologic agent of conjunctival papillomas. The benign behavior of these neoplasms may be related to the etiologic role of this type of HPV.
The fine needle aspiration cytology of a cystic suprasellar lesion, which caused bilateral hemianopia in a woman aged 63, resulted to be consistent with a craniopharyngioma and was confirmed by tissue diagnosis. The cytological pattern showed macrophages and debris with calcifications indicating the presence of a cyst. Furthermore squamous cells of basal type and ghost cells were identified. These findings together with the seat of the lesion allowed for the diagnosis of craniopharyngioma and for the differentiation from other cystic lesions of the same region. The case confirms the value of the fine needle aspiration cytology in the detection of craniopharyngioma and points out cytological peculiarities of this not rare neoplasm.