Biomedical subjects
Publications and source records attributed to S Hsueh.
A vaginal squamous cell carcinoma was found to produce amyloid in the more differentiated portion of the tumor. The amyloid was identified by immunohistochemical technique as related to keratin proteins reactive with monoclonal antibodies AE1 and AE3 but not AE2.
A case of embryonal rhabdomyosarcoma of the femur observed in an 11-year-old boy is reported, which simulated an osteosarcoma clinically and radiographically. To our knowledge, this is a second documented case of rhabdomyosarcoma of the long bone.
A histiocytoid hemangioma of the heart is reported, which was found incidentally in a man with unusually high eosinophilia. The eosinophilia subsided dramatically following removal of the tumor. The "histiocytoid" or the "epithelioid" appearance of the tumor cells and the presence of vacuolated cells were the characteristic microscopic features. The endothelial origin of this tumor was verified by positive immunostaining for factor VIII-related antigen and ultrastructural demonstration of intracytoplasmic lumen formation, abundant cytoplasmic filaments, pinocytotic vesicles, and prominent basal lamina. The presence of mitotic activity, cellular pleomorphism, and tumor necrosis raised the possibility of its malignant potential. The occurrence of this tumor in the heart may be mistaken for a myxoma clinically and a metastatic carcinoma pathologically.
In order to better define the frequency and patterns of metastasis to the female genital tract, all cases of nonhematopoietic metastases to the adnexa, uterus, vagina, and vulva encountered in patients treated at Barnes Hospital between 1950 and 1981 were reviewed. Three hundred twenty-five metastatic cancers from 269 patients were recovered. One hundred forty-nine cases were from extragenital primaries; the remaining tumors were intragenital metastases. Ovary and vagina were the most frequent metastatic sites for both extragenital and genital primaries. The majority of the extragenital metastases were adenocarcinomas from the gastrointestinal tract, but a variety of other primaries did spread, on occasion, to the genital tract. Twenty-seven percent of the metastases presented as possible primary gynecologic lesions, and 75% of these tumors had an extragenital origin. It is shown that despite certain trends in the distribution of metastases, all sites in the female genital tract are at risk for the occurrence of metastases.
In Taiwan, a peculiar type of cell with mucicarmine-positive bubbly or vacuolated cytoplasm was sporadically observed in a variety of surgical specimens removed for neoplastic or non-neoplastic conditions. They closely mimicked signet-ring cell carcinoma. Study of 14 such cases and review of the related literature led to the conclusion that the peculiar cells were storage histiocytes containing polyvinylpyrrolidone (PVP). Because they were shown to be mucicarmine-positive, we designated them " mucicarminophilic histiocytes." Particulate bodies sometimes observed in association with mucicarminophilic histiocytes were believed to be the extracellular counterpart of the cytoplasmic vacuoles. Our survey also revealed that PVP-containing intravenous injection fluids had been used in Taiwan as recently as 5 years ago. For surgical pathologists, PVP-containing mucicarminophilic histiocytes should not be mistaken for signet-ring cell carcinoma or signet-ring cell lymphoma. Mucicarminophilic histiocytes can be identified by the positive mucicarmine, colloidal iron, Gomori methenamine silver, Congo red, Sudan black B, Fontana-Masson argentaffin, and Victoria blue; but negative periodic acid-Schiff, alcian blue, and Giemsa stains.
We describe a renal tumor arising in a 4 1/2-year-old boy and characterized by the formation of epithelial tubules in a primitive mesenchymal stroma. We call attention to certain unique structural features of this tumor, which set it apart from Wilms' tumor. The tissue components regularly observed in Wilms' tumor were absent from the primary neoplasm despite exhaustive search, suggesting that this case should be considered distinct from nephroblastoma. However, a metastasis appeared that was formed entirely by undifferentiated nephrogenic cells. Based on structural appearance, histogenesis from mesonephros is tentatively proposed. No precedent was found in the literature of a tumor of this description.
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Two cases of cartilaginous tumors located in the dermis are reported. One tumor occurred on the bridge of the nose and was a true cutaneous chondroma. The other arose on the finger and represented a cutaneous calcifying chondroma. Study of these lesions prompted a review of cartilaginous tumors and tumor-like conditions presenting as cutaneous lesions. A classification proposed includes, in addition to true cutaneous chondromas, developmental anomalies, soft tissue and skeletal tumors and miscellaneous lesions.
The aim of this study was to evaluate the accuracy of human papillomavirus (HPV) genotyping by a polymerase chain reaction (PCR)-based genechip method and to determine the prognostic value of HPV genotype in bulky stage IB or IIA cervical carcinoma treated with neoadjuvant chemotherapy (NAC) and radical surgery. A total of 149 patients had adequate tissue for the study. The SPF1/GP6+ primers were used to amplify a 184 bp fragment. The amplimers were submitted for direct sequencing and hybridization with a genechip using revert-blot detection of 39 types of HPV DNA in a single reaction. Two runs of PCR with respective hybridization were performed for each tumor. The complete concordance of HPV genotyping was 80.5% (120/149) of the paired genechip results. The kappa coefficient was 0.634 (P < 0.0001). HPV DNA sequences were detected in 100% of the specimens, among which 67.8% harbored single type and 32.2% contained multiple types. HPV-16 was detected in 98.7%, HPV-18 in 22.8%, HPV-31 in 0.7%, HPV-45 in 1.3%, HPV-52 in 2.0%, HPV-58 in 6.7%, HPV-59 in 4.7%, and HPV-67 in 0.7%. In multivariate analyses, the HPV genotype [HPV-18 or HPV-16 and HPV-18 only versus all others: relative risk (RR), 2.33; 95% CI, 1.17-4.64; P = 0.016] and pre-NAC tumor size (>5 versus </=5 cm: RR, 2.25; 95% CI, 1.13-4.48; P = 0.021) were significantly related to overall survival. This PCR-based genechip method is sensitive and reproducible for HPV genotyping. The association of HPV-18 or HPV-16 and HPV-18 with poor outcome in cervical carcinoma treated with NAC plus radical surgery is confirmed.
The presence of keratin granulomas in peritoneal cavity associated with ovarian endometrioid carcinoma, which might be related to leakage from the ovarian tumor, is rarely reported. Its clinical significance has not yet been well investigated. We report a case presenting with intermittent abdominal pain after an acute episode 1 month before a complex adnexal tumor was noted. Comprehensive cytoreductive surgery was performed. The ovarian tumor was an endometrioid adenocarcinoma with squamous differentiation. There were diffuse brownish flecks over the omental surface and pelvic peritoneum, which contained fragments of degenerated squamous cells, keratin, and numerous foreign body giant cells. Extensive multiple sections were examined for these implants. DNA flow cytometry and various immunostaining studies (HER-2/neu, p53, CK-7, and cytokeratin [AE1/AE3]) were performed. Since viable epithelial cells in the implants could be differentially identified against mesothelial or granulomatous components by CK-7 staining and DNA aneuploidy was demonstrated on primary ovarian tumor, four courses of chemotherapy were administered. The patient has been free of disease for 18 months since diagnosis.