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PubMed2000

Nonprotruding colorectal neoplasms: epidemiologic viewpoint.

Histologic sections from 781 nonprotruding colorectal neoplasias (adenomas and early carcinomas) recorded in Sweden and in Japan were reviewed by the same observer, using strict histologic criteria. Low grade dysplasia (LGD) was present in 82.8% (299/361) of the nonprotruding neoplasms recorded in Sweden but in only 42.6% (179/420) of those recorded in Japan. On the other hand, high grade dysplasia (HGD) was found in 42.4% (178/420) of the nonprotruding colorectal neoplasias in Japanese patients but in only 14.1% (51/361) of those in Swedish patients. Whereas 15.0% (63/420) of the nonprotruding neoplasms in Japan were intramucosal carcinomas (IMCs) or submucosal carcinomas (SMCs), only 3.0% (11/361) of those reviewed in Sweden were IMCs or SMCs. Thus in Japan the lesions were histologically more "advanced" (significantly more lesions had HGD) and more "aggressive" (significantly more lesions were IMC or SMC) than in Sweden. The cause(s) of that phenomenon remains elusive. The term nonpolypoid adenoma connotes a group of dysplastic lesions with different histologic phenotypes. Interestingly, similar phenotypes were recently found in overt colorectal carcinomas in both Sweden and Japan. Experimental and clinical findings indicate that nonprotruding colorectal adenomas are closely associated with colonic lymphoid nodules, suggesting that the lymphoid-associated colorectal mucosa might be the birthplace of many nonprotruding adenomas (and consequently of nonprotruding early colorectal carcinomas).

Adenoma↗

PubMed2007

Genomic aberrations are rare in urothelial neoplasms of patients 19 years or younger.

Urothelial neoplasms in patients 19 years of age or younger are rare, and the data regarding clinical outcome are conflicting. Molecular data are not available. Urothelial tumours from 14 patients aged 4 to 19 years were analysed, including FGFR3 and TP53 mutation screening, comparative genomic hybridization (CGH), UroVysion FISH analysis, polymerase chain reaction for human papillomavirus (HPV), microsatellite analysis using the NIH consensus panel for detection of microsatellite instability (MSI) and six markers for loss of heterozygosity on chromosome arms 9p, 9q, and 17p and immunohistochemistry for TP53, Ki-67, CK20 and the mismatch repair proteins (MRPs) hMSH2, hMLH1, and hMSH6. Based on the 2004 WHO classification, one urothelial papilloma, seven papillary urothelial neoplasms of low malignant potential (PUNLMPs), five low-grade, and one high-grade papillary urothelial carcinoma were included. No multifocal tumours were found and recurrence was seen in only one patient with a urothelial papilloma. All patients were alive with no evidence of disease at a median follow-up of 3.0 years. We found no mutations in FGFR3, deletions of chromosome arms 9p, 9q or 17p, MSI or MRP loss, or HPV positivity in any of the patients. Three cases showed chromosome alterations in CGH analyses, urothelial dedifferentiation with CK20 overexpression, or aneuploidy, and one TP53 mutation with TP53 overexpression was found. Urothelial neoplasms in people younger than 20 years are predominantly low grade and are associated with a favourable clinical outcome. Genetic alterations frequently seen in older adults are extremely rare in young patients. Urothelial neoplasms in children and young adults appear to be biologically distinct and lack genetic instability in most cases.

Adolescent↗

PubMed1993

Extraskeletal myxoid chondrosarcoma. A clinicopathologic and immunohistochemical study of two cases.

Two extraskeletal myxoid chondrosarcomas arising on the left lower extremity of two women, aged 48 and 72 years, respectively, are reported. One case mimicked clinically an organized hematoma. By light microscopy, they showed a lobular architecture. Anastomosing cords of cells lying in a myxoid background were the histologic hallmark. Based on conventional criteria, they were classified as neoplasms of low (G1) and intermediate (G2) grade malignancy. Both cases were strongly positive for S-100 protein and vimentin. Follow-up confirmed the low aggressiveness of this entity.

Aged↗

PubMed1988

Frantz's tumor: a papillary and cystic tumor of the pancreas in girls.

Four girls with Frantz's tumor, a papillary and cystic tumor of the pancreas, are studied and discussed in comparison with 112 cases in the literature, including 58 Japanese cases. The neoplasms occur predominantly in girls and young women. Up to recently, the tumors have possibly been misclassified as nonfunctioning islet cell tumor or carcinoma, acinar cell carcinoma, papillary cystadenocarcinoma, or pancreatoblastoma according to microscopic findings and frequently have been managed with aggressive surgery such as pancreatoduodenectomy. The tumors are well encapsulated and the cut surfaces show characteristically solid and hemorrhagic-necrotic patterns. Ultrasonography and CT scan are the most useful tools for the diagnosis. The neoplasms usually behave like a very low-grade malignancy, so that complete removal is the treatment of choice for the tumor arising anywhere in the pancreas. Immunochemical and electron microscopic studies can differentiate Frantz's tumor from other neoplasms and also suggest that the tumors originate from primordial cells or multipotential stem cells capable of differentiating into both exocrine and endocrine lines.

Adolescent↗

PubMed1992

[An immunohistochemical and ultrastructural survey on smooth muscle tumors of the alimentary tract].

33 cases of smooth muscle tumors of the alimentary tract were analysed. Among them, 18 cases showed positive reaction to desmin, including one out of two cases of esophageal neoplasms, 6 out of 11 cases of gastric neoplasms, 5 from 12 cases of small intestinal neoplasms, 6 from 8 cases of large intestinal neoplasms, 14 out of 21 cases of benign tumors as well as sarcomas in grade I, and 4 from 12 cases of sarcomas in grade II and III (only mild positive result obtained in grade II and III-sarcomas). S-100 protein staining was performed in 27 cases and positive reaction was obtained only in five. Among them, 2 cases showed prominent positive reaction. 20 cases were studied by electron microscopy, and cytoplasmic myofilaments as well as dense bodies were demonstrated in 7 cases. All of them were the benign neoplasm or sarcoma in grade I. The conclusion is that most stromal tumors of the digestive system are originating from the smooth muscle, except very few cases are neurogenic in origin.

Desmin↗

PubMed1995

The efficacy of tamoxifen as an antiproliferative agent in vitro for benign and malignant pediatric glial tumors.

Recent studies have suggested that the triphenylethylene antiestrogen tamoxifen inhibits the proliferation in vitro of a substantial percentage of cell lines derived from adult high-grade gliomas, potentially acting through inhibition of the second messenger protein kinase C. These findings have formed the impetus for clinical trials of this agent in adults with malignant gliomas. However, it has previously remained uncertain whether tamoxifen has a similar inhibitory effect on the proliferation of pediatric high-grade gliomas, and whether low-grade gliomas, which constitute the majority of glial neoplasms in children, are also inhibited by this agent. To address these issues, the present study examined the effect of tamoxifen on proliferation and viability in a series of low-passage cell lines derived both from low-grade and high-grade pediatric gliomas. This agent was tested in three malignant gliomas, two pilocytic astrocytomas, two non-pilocytic low-grade astrocytomas, 1 mixed glioma, and 1 oligodendroglioma. Tamoxifen produced a dose-dependent inhibition of proliferation in two of the three malignant glioma cell lines and in each of the low-grade glioma cell lines with a 50% effective dose of approximately 3 micrograms/ml (5.4 microM), which is comparable to the IC50 for inhibition of PKC activity by this agent. No significant cytotoxicity was encountered at this concentration. However, complete elimination of proliferation was achieved with a dose of 10 micrograms/ml (17.8 microM), which produced a direct cytotoxic effect. We conclude that tamoxifen inhibits proliferation of cell lines derived from both low-grade and high-grade pediatric glial tumors in vitro at concentrations that may be achievable clinically with high-dose oral therapy.(ABSTRACT TRUNCATED AT 250 WORDS)

Antineoplastic Agents, Hormonal↗

PubMed1989

Paragangliomas: assessment of prognosis by histologic, immunohistochemical, and ultrastructural techniques.

To predict clinical outcome, we studied 42 paragangliomas from 37 patients by routine histology, immunohistochemistry, and electron microscopy. A panel of antisera to neuron-specific enolase (NSE), chromogranin, and met-enkephalin was used to identify chief (type I) cells, and S-100 protein and glial fibrillary acid protein (GFAP) sustentacular (type II) cells. The intensity of staining of type I cells and the density of type II cells were assessed semiquantitatively (0 to 4+) in a total of 38 tumors. A total of 23 of 24 low-grade tumors (solitary, multiple, or associated with other neoplasms; 95.8%) contained type II cells immunoreactive with either S-100 protein or GFAP, and all were positive when S-100 protein and GFAP were used in combination. Five of the nine intermediate-grade (recurrent and/or locally aggressive) tumors were identified as glomus jugulare tumors (GJT). Three intermediate-grade GJTs were devoid of GFAP-reactive type II cells and four GJTs were negative for S-100 protein. Type II cells were identified in only one of five high-grade (malignant) paragangliomas and that tumor contained vanishingly rare cells that were weakly S-100 protein positive but GFAP negative. Sustentacular cell density and chief cell staining intensity were both inversely related to tumor grade. The most sensitive chief cell marker was NSE (92.1%), followed by chromogranin (84.2%). The least sensitive (73.0%) and specific marker was met-enkephalin. Combinations of NSE or chromogranin with met-enkephalin identified chief cells in all cases. Electron microscopy identified neurosecretory granule-containing chief cells, but was of less value in delineating sustentacular cells because of their scarcity and the absence of specific features. By comparison, immunohistochemistry was superior in identifying sustentacular cells. The use of an immunohistochemical panel, in addition to routine histology, can confirm the diagnosis of a paraganglioma and can give an indication of the likely prognosis for a patient.

Adolescent↗

PubMed1990

Disorders of the salivary glands.

A careful history and physical examination is essential in diagnosing and treating salivary gland disorders. This alone may identify congenital lesions, trauma, acute and chronic inflammatory diseases, and a variety of other conditions affecting the salivary glands. The most common presenting complaint is that of a lump in a salivary gland, and the onus is on the physician to prove the presence or absence of malignancy. Laboratory and radiographic studies are of minimum value in making this distinction, and biopsy, under general anesthesia, by a competent head and neck surgeon with microscopic evaluation is often necessary. Office biopsy or large or fine-needle aspiration should not be attempted. Fortunately, most neoplasms are benign, and many malignant forms are low grade and have a good prognosis.

Humans↗

PubMed2003

Tumor cytosol dipeptidyl peptidase III activity is increased with histological aggressiveness of ovarian primary carcinomas.

OBJECTIVE: Proteolytic enzymes have been implicated in the progression of various human malignancies, including ovarian cancer. The enhanced expression of dipeptidyl peptidase III (DPP III) was found in endometrial carcinomas of various histological types and grade. The aim of this study was to assess activity of DPP III in ovarian tissue specimens and to correlate it with clinico-pathological data. METHODS: DPP III hydrolytic activity toward Arg-Arg-2-naphthylamide was determined in 108 ovarian tissue cytosol specimens of 79 patients. The data obtained for 41 ovarian primary carcinoma specimens were stratified according to clinical stage, histological grade and type, and age of the patients. RESULTS: Median DPP III activity expressed as milliunits per milligram protein was 6 in normal ovarian tissues (n = 29), 6.5 in benign ovarian tumors (n = 19), 19.5 in primary ovarian carcinomas (n = 41), 12.5 in nonepithelial primary ovarian tumors (n = 7), and 22.1 in metastatic ovarian malignancies (n = 12). A significant rise in median DPP III specific activity was observed in malignant ovarian tumors (of epithelial, nonepithelial, and metastatic origin), but not in benign ovarian tumors, compared to the activity in normal tissue. A significant difference of DPP III expression was found between the group of normal tissues and tumors of clinical stage I and II, of grade 2 and 3, of serous and mucinous histologic type. CONCLUSIONS: DPP III activity of benign ovarian tumors equaled that in normal ovarian tissue. In malignant neoplasms of the ovary it increased with growing histologic grade.

Adult↗

PubMed2003

Optic pathway tumors in children.

Tumors of the optic pathways are sub-divided in this review into those that arise in one or both optic nerves anterior to the chiasm (optic nerve tumors); those that arise within the chiasm and do not extend significantly into the hypothalamus (optic chiasmatic tumors) and the large exophytic tumors that involve both the optic chiasm and the hypothalamus to a lesser or greater degree (optic chiasmatic/hypothalamic tumors). The management of optic chiasmatic gliomas is controversial, partly related to failure to separate out chiasmatic tumors from the chiasmatic/hypothalamic tumors. The optic nerve tumors are reviewed briefly, since they rarely extend intracranially. Chiasmatic tumors tend to be associated with NF1 and to behave almost like hamartomas. Close observation is usually the most appropriate management. On the other hand, chiasmatic/hypothalamic tumors grow like typical neoplasms. The tumors are almost uniformly low grade astrocytomas, but growth rates may berapid, especially in infants. Modern management has trended away from radical surgical resection, which has significant morbidity, to chemotherapy as the first line of treatment. In this review, the clinical presentation and management of different types of optic pathway tumors are discussed.

Child↗

PubMed1988

Renal cell carcinoma. Prognostic significance of morphologic parameters in 121 cases.

Morphologic parameters were correlated with survival in 121 renal cortical neoplasms including 116 carcinomas and five oncocytomas. An increasing nuclear grade was generally correlated with a significant decrease in disease-free survival although no statistical difference was found between nuclear Grade 1 and 2 tumors. Similarly, a higher stage at diagnosis predicted a shorter disease-free survival. Renal vein invasion adversely affected prognosis only for high nuclear grade carcinomas. Papillary and spindled carcinomas, independent of nuclear grade, were associated with a significant decrease in disease-free survival compared to tumors with a solid pattern. Patients with large neoplasms (greater than 10 cm) had a significantly worse disease-free survival than patients with tumors 10 cm or less. The prognostic significance of tumor cell type is less clear. Patients with oncocytomas had the best disease-free survival compared with patients with tumors of other cell types. However, the difference in survival was not statistically significant for low-grade tumors, suggesting that nuclear grade rather than cell type may be the more important determinant.

Adenoma↗

PubMedDate not supplied

Regression of grade III astrocytoma during the treatment of CML with imatinib mesylate.

Astrocytomas are central nervous system neoplasms, which are derived predominately from astrocytes. On the basis of the histopathologic characteristics astrocytomas are graded from I to IV. The cells that demonstrate the greatest degree of anaplasia are used to determine the histologic grade of the tumor. The mean age of survival are approximately 10 years from the time of diagnosis for pilocystic astrocytomas (World Health Organization grade I), more than 5 years for patients with low-grade diffuse astrocytomas (WHO grade II), 2 to 5 years for those with anaplastic astrocytomas (WHO grade III), and less than 1 year for patients with glioblastoma (WHO grade IV). The treatment is a combination of surgery, radiation, and chemotherapy depending of the grade of astrocytoma. We present a case of 31-year-old man with grade III astrocytoma with subsequent chronic myelogenous leukemia treated with imatinib mesylate as part of his chronic myelogenous leukemia treatment failing to show recurrence of the astrocytoma 10 years after standard treatment for astrocytoma.

Adult↗

PubMedDate not supplied

[Cystic-papillary neoplasm of the pancreas: a case report in childhood].

A solid and cystic tumor of the pancreas in a 11-year-old girl is reported. The child presented with abdominal pain and vomiting. A voluminous tumor, arising from the pancreas tail, was removed with distal pancreatectomy. These neoplasma occur predominantly in girls and young women, the prognosis is usually good in spite of histologic finding of apparent malignancy. The histochemical, immunohistochemical and electron examinations of this tumor show polymorphic differentiation, which means that part of the all can differentiate into duct epithelium, acinar or endocrine line. So up to, recently this tumor has been misclassified within other pancreatic tumors, and frequently has been managed with aggressive surgery. But as the neoplasm usually behaves like a very low grade malignancy, its complete removal is the treatment of choice for the tumors arising anywhere in the pancreas. The authors emphasize the importance of accurate diagnosis and of extirpative surgery in children with pancreatic malignancy.

Child↗

PubMed1999

Papillary cystic neoplasm of the pancreas in a teenage boy.

We present a case of a 13-year-old boy with a left-sided abdominal mass which proved to be a papillary cystic neoplasm of the pancreas. This low-grade malignant lesion of young patients is very rare, and exceedingly rare in males. The prognosis following resection of this tumor is good. We present the ultrasound and computed tomographic picture of this lesion, as well as the gross and microscopic pathology.

Adolescent↗

PubMed1995

Benign lymphoepithelial parotid lesions in HIV-positive patients: spectrum of findings at gray-scale and Doppler sonography.

OBJECTIVE: Benign lymphoepithelial lesions are intraparotid nodules that develop as an early manifestation of HIV infection. The purpose of this study was to describe the spectrum of sonographic and Doppler findings of benign lymphoepithelial lesions in HIV-positive patients and to assess whether these findings are specific for the diagnosis of such lesions. SUBJECTS AND METHODS: Nine HIV-positive patients with swelling of the parotid gland caused by single or multiple parotid nodules were evaluated. Fourteen nodules were identified sonographically and proved to be benign lymphoepithelial lesions at cytologic examination. They were assessed with gray-scale, duplex, color Doppler, and power Doppler sonography. For each nodule, the echogenicity, grade and pattern of vascularity, and spectral tracings were evaluated. RESULTS: Benign lymphoepithelial lesions manifested as parotid nodules with a wide spectrum of sonographic appearances, ranging from simple cysts to mixed masses with predominantly solid components. Cystic lesions (10/14) were not purely anechoic; they had an internal network of thin septa supplied by vessel pedicles and, in four of 10 cases, a solid mural nodule. On the other hand, mixed nodules (4/14) had a higher conspicuity of solid tissue and thicker stromal septa, thus resembling a parotid neoplasm more than a cyst. The overall grade of vascularity of benign lymphoepithelial lesions varied from avascular to intensely hypervascular. Generally, mixed nodules were more hypervascular than were the cystlike ones. Spectral analysis showed slow velocity (peak systolic velocity range, 8-28 cm/sec; mean, 20 20 cm/sec) and low impedance (resistive index range, 0.36-0.70; mean, 0.57) arterial flows. CONCLUSION: The spectrum of sonographic and Doppler features of benign lymphoepithelial lesions in HIV-positive patients is broad. Sonographic findings are non-specific for the diagnosis of such lesions, especially in cases of mixed solid-cystic isolated nodules.

Adult↗

PubMed1990

'Atypical adenomatous hyperplasia' in liver cirrhosis: low-grade hepatocellular carcinoma or borderline lesion?

Adenomatous hyperplasia, defined as a sizable parenchymal nodule in cirrhosis, was examined morphologically. Ninety-seven nodules of adenomatous hyperplasia were obtained from 47 cirrhotic livers and were divided into 'ordinary' (44 nodules) and 'atypical' (53 nodules) types. The former consisted of hepatocytes similar to those of the surrounding liver, and showed regularly distributed portal tracts. The latter type was composed of hepatocytes showing nuclear atypia, relative to the surrounding liver, and showed irregular or sparse portal tracts. Atypical nodules were histologically heterogeneous, possessing areas of normo-trabecular, compact, pseudoglandular and/or scirrhous patterns. Several cytological changes, such as clear cell change, small or large cell change and fatty change, were intermingled variably within a given nodule. Atypical nodules showed expansive and/or replacing growth into the surrounding liver. Atypical hepatocytes also infiltrated into the fibrous septa and portal tracts. Foci of overt hepatocellular carcinoma were found in 11 of the 53 atypical nodules. These findings suggest that ordinary adenomatous hyperplasia may be a large-sized regenerative nodule, while atypical adenomatous hyperplasia may be a hepatocellular neoplasm, a peculiar form of low-grade hepatocellular carcinoma or borderline lesion, in which overt hepatocellular carcinoma is likely to evolve through multiple steps.

Adult↗

PubMedDate not supplied

Ki-67 labeling index as a marker of malignancy in ocular surface neoplasms.

PURPOSE: To evaluate the relationships among histopathological type, clinical malignant grade, and Ki-67 labeling index (LI) in sebaceous gland carcinoma (SGC), conjunctival squamous cell carcinoma (SCC), and conjunctival intraepithelial neoplasia (CIN), with pterygium and normal conjunctiva as controls. METHODS: This retrospective study was conducted at the Department of Ophthalmology, Kyoto Prefectural University of Medicine, Kyoto, Japan. We used tissue specimens obtained from 20 patients (four SGC, four SCC, four CIN, four pterygium, and four normal conjunctiva). Ki-67 immunohistochemical analysis was performed in all 20 cases. RESULTS: The Ki-67 labeling index (LI) was 46.1 +/- 3.0% (average +/- SD) in SGC, 28.4 +/- 4.5% in SCC, 20.0 +/- 7.2% in CIN, 9.0 +/- 2.2% in pterygium, and 6.8 +/- 2.3% in normal conjunctiva. Ki-67 LI was significantly (Mann-Whitney U test, P < 0.05) higher in SGC than in SCC, and higher, but not significantly, in SCC than in CIN. Ki-67 LI was significantly (P < 0.05) higher in SCC and CIN than in pterygium. CONCLUSIONS: These results suggest that Ki-67 LI may be a sensitive marker for ocular malignant tumor grading.

Adenocarcinoma, Sebaceous↗

PubMed2006

Low-grade fibromyxoid sarcoma: a brief review.

Low-grade fibromyxoid sarcomas are uncommon deep soft tissue neoplasms first described by Evans in 1987. They exhibit a deceptively benign appearance, with a whorled or linear arrangement of spindle-shaped cells showing few to absent mitoses. A characteristic, but not specific, feature is the presence of areas of myxoid stroma. Recurrences are common, and late metastases have been recorded. A closely related but morphologically distinct tumor, the so-called hyalinizing spindle cell tumor with giant rosettes, has also been described; both neoplasms share the same cytogenetic abnormality, a balanced translocation resulting in a FUS/CREB3L2 fusion gene. Because of similar clinical behavior and the common cytogenetic abnormality, some authors prefer to consider both lesions as a single entity within the spectrum of low-grade sarcomas.

Cyclic AMP Response Element-Binding Protein↗