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PubMed2001

Pulmonary pleomorphic (spindle) cell carcinoma: peculiar clinicopathologic manifestations different from ordinary non-small cell carcinoma.

Pleomorphic (spindle) cell carcinoma, also known as monophasic sarcomatoid carcinoma, is a rare primary pulmonary malignancy. This type of tumor shows concurrent presence of malignant epithelial and homologous sarcomatoid spindle cell components by co-expressing cytokeratin and vimentin in various degrees. Sixteen cases (four central endobronchial lesions and 12 peripheral parenchymal masses) were studied clinicopathologically. Men were affected far more frequently than women (13:3). The patients were between 56 and 80 years of age. The disease is strongly associated with smoking. Among seven of the patients who underwent surgical resection, four of them had mediastinum, pleura and chest wall invasions, and three of them had regional lymph node metastases. All of the patients succumbed to early distant metastases (range 2 weeks-5 months) in organs including brain, bone, adrenal gland, and unusual sites such as esophagus, jejunum, rectum and kidney. The remaining nine inoperable cases were late stage disease and treated with chemoradiotherapy with little effect. The median duration of survival was 3 months. All parenchymal masses appeared as cavities with marked central necrosis, and only peripheral rim of tumor cells was left. More definite diagnostic results will depend on further tissue sections and can be confirmed by immunohistochemical studies. Significantly fewer Ki-67, p53 and c-erb B-2 oncoprotein expressions were also noted.

Aged↗

PubMed1999

Basal cell carcinoma with tumor epithelial and stromal giant cells: a variant of pleomorphic basal cell carcinoma.

A case of basal cell carcinoma with giant cells of the central epithelial and surrounding stromal components is presented. The lesion was an 8-mm dome-shaped papule on the ear of a 66-year-old man. The giant cells of the epithelial component shared the immunophenotype of the more typical cells of the basal cell carcinoma (keratin, smooth muscle actin, and bcl-2 positive), whereas the stromal giant cells were positive only for bcl-2. This case represents a peculiar variant of pleomorphic basal cell carcinoma, the significance of which is unknown.

Actins↗

PubMedDate not supplied

Fine needle aspiration cytology of primary soft tissue tumors. Morphologic analysis of the most frequent types.

We reviewed 98 cases of fine needle aspiration of soft tissue tumors with histologic confirmation performed during an eight-year period and propose a working morphologic classification based on the most prominent cytologic features. Six main tumor groups are recognized: myxoid, round cells, spindle cells, pleomorphic cells, polygonal cells and well differentiated. We believe that this classification allows recognition of the most common soft tissue tumors while helping with the differential diagnosis of other neoplasia, primary or secondary, with similar morphology and a similar presentation.

Adolescent↗

PubMed1989

[Radiosensitivity of soft tissue sarcomas].

The correlation between the effectiveness of radiation therapy and the histology of soft tissue sarcomas was investigated. Of 31 cases with a soft tissue sarcoma of an extremity treated by conservative surgery and postoperative radiation of 3,000-6,000 cGy, local recurrence occurred in 12; 5 out of 7 synovial sarcomas, 4 of 9 MFH, one of 8 liposarcomas, none of 4 rhabdomyosarcomas and 2 of 3 others. As for the histological subtyping, the 31 soft tissue sarcomas were divided into spindle cell, pleomorphic cell, myxoid and round cell type, and recurrence rates were 75%, 33.3%, 16.7% and 0%, respectively. From the remarkable difference in recurrence rate, it was suggested that round cell and myxoid type of soft tissue sarcomas showed a high radiosensitivity compared to the spindle cell type with low sensitivity. Clarifying the degree of radiosensitivity is helpful in deciding on the management of limb salvage in soft tissue sarcomas of an extremity.

Adolescent↗

PubMedDate not supplied

A rapid technique for the fluorescent location of pleomorphic adenoma cells in frozen sections of human salivary glands.

Both acinar cells and pleomorphic adenoma cells possess a cell surface protease, guanidinobenzoatase (GB) which can be located with a fluorescent probe for the active centre of this enzyme. We have developed a rapid, cheap, fluorescent technique for the differential location of pleomorphic adenoma cells and acinar cells in frozen sections of salivary glands. The fluorescence of other cells (which also possess GB) is selectively quenched, such that only the acinar and pleomorphic adenoma cells are visualised by fluorescent microscopy.

Adenoma, Pleomorphic↗

PubMed1993

[Pleomorphic T-cell lymphoma. The diagnostic problems, therapeutic possibilities and infection-induced complications].

A 30-year-old man complained of high fever, resistant to antibiotics, and progressive loss of strength for five weeks. The peripheral blood showed pancytopenia (leucocytes 2200/microliters, platelets 45,000/microliters, haemoglobin 10.7 g/dl). There was also hepatosplenomegaly, abdominal lymph node enlargement, pleural and pericardial effusions and slight excess of lymphocytes in the cerebrospinal fluid. Histological examination of the bone marrow suggested a small-cell pleomorphic T-cell lymphoma, but Hodgkin's disease was also considered. Splenectomy was performed to confirm the diagnosis and treat the pancytopenia. The blood count rapidly returned to normal and the suggestion of Hodgkin's disease was excluded. Intensive chemotherapy (BMFT-ALL protocol) was followed by regression of nearly all the abnormalities, but marrow infiltration persisted. This treatment was discontinued after phase II of induction. After an intercurrent cytomegalovirus infection maintenance treatment with alpha-interferon (up to 5 million units daily) was started. The partial remission remained stable for 22 months. The lymphoma then relapsed but was held in check by further chemotherapy (Dexa-PAMB protocol). For the past 11 months the patient has remained in stable partial remission on treatment with alpha-interferon (3 million units every other day). Frequent infections (sinusitis, diarrhoea, abscess) require close supervision.

Adult↗

PubMed1999

Differential expression of CD34 and Ki-M1p in pleomorphic fibroma and dermatofibroma with monster cells.

Pleomorphic fibroma (PF) and dermatofibroma with monster cells (DFMC) are characterized by the presence of numerous cells with large atypical nuclei. Despite cytologic similarities, the two entities are likely to be unrelated, but their histogenesis is poorly understood. In this study, we examined six cases of PF and eleven cases of DFMC by immunohistochemistry using antibodies against vimentin, alpha-smooth muscle actin, S-100 protein, CD34, factor XIIIa, and the pan-monocytic marker Ki-M1p. Strong vimentin expression was seen in all tumors, whereas none of them expressed S-100 protein. PF consistently exhibited CD34 staining but appeared to be depleted of Ki-M1p positive cells compared with the surrounding normal skin. Conversely, all cases of DFMC contained numerous Ki-M1p positive cells including atypical multinucleate cells, but virtually no CD34 reactivity was observed. A weak staining for alpha-smooth muscle actin was occasionally seen in a subset of the cells of both entities. Our results indicate that PF and DFMC are histogenetically distinct entities that may arise from two different types of dermal dendritic cells defined by their reactivity for CD34 and Ki-M1p, respectively. Immunohistochemistry using these two antibodies permits an easy and reliable discrimination between PF and DFMC.

Actins↗

PubMed1991

Amelanotic melanocytic tumors of the pinna in six F344 rats.

Spontaneous amelanotic melanocytic tumors of the pinna were found in six females of 960 male and 960 female albino (F344/DuCrj) rats which had been used in three different 24-month chronic toxicity studies. The age when the pinnal tumors were detected ranged from 37 to 59 weeks. The tumors were located unilaterally in the pinna and observed as subcutaneous spherical to irregular, solid white masses measuring 7 to 25 mm in diameter. The pinnal tumors were histologically classified into spindle cell and pleomorphic cell types. The spindle cell type was observed in four rats and composed of fusiform cells arranged in interlacing bundles. The pleomorphic cell type was observed in the remaining two rats and composed of pleomorphic large cells arranged in sheets. One tumor of the latter type metastasized to the submaxillary lymph node and lung. Melanin pigments were not demonstrated in any of the tumors. In immunohistochemistry, nuclei and cytoplasm of tumor cells in all the tumors were slightly positive for S-100 protein. Ultrastructurally, tumor cells contained a considerable number of premelanosomes in the cytoplasm. Desmosomes were occasionally observed between the cell membranes of the adjacent tumor cells. No distinct basal lamina was seen around tumor cells.

Animals↗

PubMed2001

Histologic localization of PLAG1 (pleomorphic adenoma gene 1) in pleomorphic adenoma of the salivary gland: cytogenetic evidence of common origin of phenotypically diverse cells.

Pleomorphic adenoma gene 1 (PLAG1), a zinc finger transcription factor gene, is consistently rearranged and overexpressed in human pleomorphic adenomas of the salivary glands with 8q12 translocations. In this report, we describe the immunohistochemical localization of PLAG1 protein in pleomorphic adenomas of the salivary gland and corresponding normal tissue, in relation to cytokeratin, vimentin, and BCL-2 expression. Normal salivary gland tissue was not immunoreactive for PLAG1. In primary pleomorphic adenomas, cells strongly immunoreactive for PLAG1 were detected in the outer layer of tubulo-ductal structures, which are thought to be the origin of cells with bi-directional, epithelial, and mesenchymal phenotypes. In contrast, epithelial cells with abundant cytokeratin in the inner tubulo-ductal structures only sporadically expressed PLAG1. BCL-2 immunoreactivity was found mainly in the cells surrounding the tubulo-ductal structures and in the solid undifferentiated cellular masses, within the areas that had moderate PLAG1 immunoreactivity. The variability of PLAG1 expression in neoplastic cells seemed to reflect the morphologic heterogeneity that correlated with the stage of differentiation of the tumor cells. Immunohistochemical/cytogenetic evaluation of two pleomorphic adenomas with t(3;8)(p21;q12) or t(5;8)(p13;q12) translocations demonstrated the clonal nature of immunophenotypically diverse cells. This finding confirms the theory that pleomorphic adenoma cells share a common single-cell origin, most likely from the epithelial progenitor basal duct cells.

Adenoma, Pleomorphic↗

PubMed1997

HIV-associated oral pleomorphic B-cell malignant lymphoma.

A 48-year-old HIV-seropositive homosexual patient presented with an ulcerative lesion in the left side of the soft palate, extensively involving local soft tissue structures. On histologic evaluation the lesions appeared to be a large-cell high-grade B-cell pleomorphic lymphoma with anaplastic and plasmacytoid features harboring Epstein-Barr virus genome in the tumor cells. Although known to be associated with HIV infection, this is a rare subtype of a malignant lymphoma arising in a patient positive for HIV. Its meaning is yet unknown in biologic and prognostic terms.

Fatal Outcome↗

PubMed1999

Immunohistochemical characterization of pleomorphic giant cells in basal cell carcinoma.

Over 20 cases of basal cell carcinomas with pleomorphic giant cells of the mononuclear or multinucleate type have been described. The nature of these cellular and nuclear changes has not been elucidated. Some authors found that these cells have phagocytic properties and others reported an aneuploid DNA content. We have seen mitotic figures in some of these giant cells, and postulate that these cells are capable of proliferation. Twelve cases of basal cell carcinoma with pleomorphic giant cells were examined using monoclonal antibodies recognizing the proliferating cell nuclear antigen (PCNA), Ki-67, and bcl-2 antigens. Expression of proliferation associated antigens in the giant cell population was higher than in the small cell population. Over expression of bcl-2 was detected in both the small and giant cells in all cases. The results demonstrate that the giant tumor cells are cycling and express bcl-2 protein in a manner consistent with basal cell carcinoma. The changes are unlikely to represent a senescent change as seen occasionally in mesenchymal neoplasms.

Adult↗

PubMedDate not supplied

Spindle cell and pleomorphic lipoma: an ultrastructural study.

Spindle cell and pleomorphic lipoma are rare benign tumors of adipose tissue. Their histogenesis is poorly understood and pleomorphic lipoma has not previously been studied ultrastructurally. This study describes the morphology and ultrastructure of 6 cases of spindle cell and pleomorphic lipoma. Both spindle cell and pleomorphic lipomas showed similar ultrastructural features with an interrupted basal lamina, occasional non-membrane-bound lipid vacuoles and abundant rER. In all the cases mast cells were conspicuous and were intimately related to both spindle and pleomorphic cells. It is proposed that both the spindle and pleomorphic multinucleated cells that characterize these tumors are prelipoblastic mesenchymal cells. The possible significance of an interaction between these cells and mast cells is discussed.

Cell Nucleus↗

PubMed2006

Pleomorphic basal cell carcinoma: case reports and review.

Pleomorphic basal cell carcinoma is a pathologic variant of basal cell carcinoma characterized by the presence of atypical-appearing, mononuclear or multinucleated giant cells. Including our 3 patients, a total of 52 pleomorphic basal cell carcinomas have been described in 48 individuals. The tumors usually present as a nodule on the head or neck. The nuclei of the giant tumor cells are irregularly shaped, hyperchromatic, and 2 to 10 times larger than the nuclei of the surrounding cancer cells. Atypical mitoses may be present. The pathogenesis of pleomorphic basal cell carcinoma remains to be determined; however, investigations utilizing electron microscopy, immunohistochemistry, image analysis, and flow cytometry have provided additional insight regarding the features of the giant tumor cells and the etiology of this cancer. All of these tumors are aneuploid. Although these aneuploid tumors have alarming microscopic features, their clinical course is similar to that of basal cell carcinomas without pleomorphic giant tumor cells. Therefore, appropriate therapy to ensure adequate treatment of the tumor is recommended. Our patients' pleomorphic basal cell carcinomas were successfully treated by excision using the Mohs micrographic surgical technique.

Aged↗

PubMed2001

Establishment and characterization of cell line TNMY1 derived from human malignant fibrous histiocytoma.

Although malignant fibrous histiocytoma (MFH) is one of the most common soft tissue sarcomas, its pathogenesis remains unclear. In this study, a cell line derived from human MFH, TNMY1, was established from a metastatic chest-wall lesion of a 60-year-old woman with MFH. The TNMY1 cell line was passaged 95 times, and it still retained the biological characteristics of the original tumor. TNMY1 consists of spindle-shaped cells and pleomorphic cells associated with multinucleated giant cells. Immunohistochemical studies showed that the spindle-shaped and pleomorphic cells were positive for vimentin, CD68 and alpha-smooth muscle actin, but negative for epithelial membrane antigen, desmin, muscle actin, alpha-sarcomeric actin, myoglobin, lysozyme and S-100 protein. The cells expressed collagen types I, III and V. These results indicate that MFH may originate from mesenchymal stem cells with the potential to differentiate into either fibroblasts or histiocytes. An elevated level of collagen type V mRNA expression is considered to support a diagnosis of MFH.

Animals↗

PubMed1994

A new cytogenetic subgroup in lipomas: loss of chromosome 16 material in spindle cell and pleomorphic lipomas.

Six spindle cell lipomas and two pleomorphic lipomas were analyzed cytogenetically. One spindle cell lipoma had a supernumerary ring chromosome as the sole anomaly. The other five spindle cell lipomas and both pleomorphic lipomas had hypodiploid stemlines with monosomy 16 or unbalanced aberrations leading to loss of 16q13-qter, a feature distinguishing these lipoma subtypes from other benign and borderline adipose tissue tumor histotypes. unbalanced aberrations of chromosomes 13 and 10 were found in five and three cases respectively; 13q12 was lost in all of these cases, whereas there was no common deleted segment in chromosome 10. No aberrations involving 12q13-15, which are frequent in typical lipomas, were found. Both pleomorphic lipomas, but none of the spindle cell lipomas, had hypotetraploid sidelines, multiple nonclonal aberrations, and telomeric associations. The present findings reveal a new cytogenetic/histopathological association in adipose tissue tumors.

Aged↗

PubMed1992

Pleomorphic granular cell astrocytoma of the pineal gland.

BACKGROUND: Primary neoplasms of the pineal gland are uncommon. Two patients with unusual primary pineal tumors that had similar distinctive histologic features are reported. METHODS: The surgically resected neoplastic pineal tissue from these patients were examined by light microscopy, immunohistochemistry, and electron microscopy and correlated with the patients' clinical course. RESULTS: These pineal tumors consisted of a mixture of spindle-shaped cells with fibrillated cell processes and many large lipidized and/or granular pleomorphic cells, some of which were multinucleated. These two tumors superficially resembled pleomorphic xanthoastrocytoma and granular cell tumors of the central nervous system. The pleomorphic tumor cells expressed glial fibrillary acidic protein and some also produced retinal S-antigen, a marker for retinal photoreceptor cells. Long-term follow-up (8 years) on one of these patients suggested a relatively "benign" clinical course. CONCLUSIONS: It is possible that this newly described tumor may be a distinct subset of pineal gland neoplasias with a favorable biologic behavior despite the histologic features that would suggest otherwise.

Adult↗

PubMed1998

Tumors of the pancreas with osteoclast-like and pleomorphic giant cells: an immunohistochemical and ploidy study.

BACKGROUND: Tumors of the pancreas with osteoclast-like giant cells are of uncertain histogenesis and aggressiveness. Their relationship, if any, to undifferentiated (anaplastic) carcinomas of the pancreas with pleomorphic giant cells is also not clear. METHODS: Eleven tumors with osteoclast-like giant cells were studied by immunohistochemistry for epithelial and mesenchymal markers, as well as for a proliferation marker (Ki67) and p53 protein expression. Cytometric image analysis for nuclear DNA content was also performed. K-ras mutations were investigated by DNA sequence analysis. RESULTS: Neoplastic, predominantly spindle-shaped cells and osteoclast-like giant cells were positive for mesenchymal markers CD68, LCA, and A1ACT. These spindle-shaped cells were also positive for human muscle actin. Spindle-shaped cells of seven tumors were also positive for epithelial markers carcinoembryonic antigen, epithelial membrane antigen, or keratin. Nine tumors contained a variable number of pleomorphic giant cells in addition to osteoclast-like giant cells. Pleomorphic giant cells were much less positive for mesenchymal markers than were osteoclast-like giant cells, but they were positive for some epithelial markers. A high percentage of spindle-shaped and pleomorphic giant cells were positive for Ki67. Diploid and aneuploid populations were present in varying proportions in both spindle cells and pleomorphic giant cells. The nuclei of osteoclast-like giant cells, however, were diploid and not proliferating. Spindle-shaped and pleomorphic giant cells were positive for p53 protein in 5 of 10 cases. Five of six tumors studied were positive for K-ras mutations. CONCLUSION: The distinction between tumors with osteoclast-like giant cells and undifferentiated carcinomas with pleomorphic giant cells is often not clear-cut. Both types of tumors have mesenchymal and epithelial characteristics in varying proportions and may arise from an undifferentiated pancreatic stem cell. Long-term survival of two patients suggests that some tumors with osteoclast-like giant cells may have a better prognosis than the usual pancreatic ductal adenocarcinoma.

Cell Division↗

PubMed1995

Pleomorphic basal cell carcinoma.

BACKGROUND: A variant of basal cell carcinoma (BCC) with scattered large, pleomorphic cells has previously been reported as "basal cell epithelioma with giant tumor cells" and "basal cell carcinoma with monster cells." OBJECTIVE: Our purpose was to describe the clinical, histologic, and DNA ploidy findings in BCCs with these cytologic features. METHODS: Nineteen pleomorphic BCCs from 15 patients were prospectively collected, and other BCCs in these patients were retrospectively reviewed by light microscopy. One lesion was recurrent. Seven of the pleomorphic BCCs and one nonpleomorphic BCC were studied by image analysis. RESULTS: These pleomorphic BCCs ranged from 2.8 to 12.5 mm in greatest diameter and were most commonly located on the head and neck. Five BCCs were present on the face and scalp of a patient with basal cell nevus syndrome. There have been no subsequent recurrences of the pleomorphic BCCs (follow-up from 3 to 32 months; median, 20 months). All 19 pleomorphic BCCs displayed characteristic features of BCC: peripheral palisading, stromal retraction, mucin production, and apoptosis. All 19 also showed huge pleomorphic mononucleated and multinucleated giant tumor cells. The nuclei of these large cells were often hyperchromatic with prominent nucleoli and abundant cytoplasm, and occasionally with intranuclear cytoplasmic protrusions. In addition, there were frequent and atypical mitoses in 47% of the cases. All pleomorphic BCCs studied by cell image analysis of formalin-fixed, paraffin-embedded tissue were aneuploid. The DNA content of the giant tumor cells was not a multiple of a single DNA value. CONCLUSION: Pleomorphic BCCs clinically present as typical BCCs. Despite their striking focal cellular atypia, these lesions seem to behave as ordinary BCCs.

Adult↗