Soft tissue tumors of the penis. A clinicopathologic study of 46 cases.
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The diagnosis and classification of soft tissue sarcomas can pose difficult problems for the histopathologist. Many sarcomas are too poorly differentiated to exhibit morphological features specific enough to define their histogenesis. Using the immunoperoxidase technique with commercially available antisera as a routine adjunct to other diagnostic aids, it is possible to arrive at more accurate diagnoses on which treatment protocols can be based. In addition a better understanding of mesenchymal neoplasms and their origins can be obtained by functional immunohistochemical studies.
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The light microscopic and immunohistochemical features of 30 primary mesenchymal neoplasms of the urinary bladder are reported. Half of the cases represented smooth and striated muscle tumors (five leiomyomas, seven leiomyosarcomas including epithelioid and myxoid subtypes, one rhabdomyoma, one embryonal rhabdomyosarcoma and one alveolar rhabdomyosarcoma). One third of the tumors were of fibrohistiocytic origin (one fibrous histiocytoma and eight malignant fibrous histiocytomas including fascicular and storiform, inflammatory and pleomorphic subtypes). In addition, a malignant epithelioid schwannoma, a round cell liposarcoma, two hemangiomas and two mixed mesodermal tumors were observed. The morphology of the vesical mesenchymal tumors was identical to that of their counterparts known to occur in other sites, particularly in the soft tissue. Muscle-specific actin, alpha-1-antichymotrypsin, S-100-protein and neuron-specific enolase proved to be useful and reliable immunomarkers for differential diagnosis of poorly differentiated leio- and rhabdomyosarcomas, malignant fibrous histiocytomas and malignant schwannomas. Since some tumors coexpressed several classes of intermediate filaments, diagnostic immunocytochemistry should only be used considering a larger panel of antibodies and in close correlation with the histological and cytological features of the neoplasms.
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The proper management of orbital tumors in children requires a knowledge of the lesions commonly seen in this area, in addition to the appropriate methods of investigation and treatment. A multidisciplinary approach is most beneficial in obtaining the desired results.
Immunohistological demonstration of cell- and tissue-specific antigens in microscopic slides has remarkably influenced the classification of certain cutaneous neoplasms. The following markers are of particular interest in dermatopathology: cell surface antigens of lymphocyte subpopulations, intracytoplasmic immunoglobulins, intermediate filaments, neural markers, epithelial cell membrane antigens, and endothelial products. During the last years, these methods have contributed to our understanding of histogenesis and classification especially of cutaneous lymphomas, epithelial neoplasms, neurogenic tumors, and angiosarcomas.
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