147 results on '"Neoplasms, Complex and Mixed diagnosis"'
Search Results
2. Mixed epithelial and stromal tumor of the kidney: A case report.
- Author
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Tang Z, Chen H, Kui X, and Yan R
- Subjects
- Humans, Kidney pathology, Kidney Neoplasms diagnostic imaging, Kidney Neoplasms surgery, Kidney Neoplasms pathology, Soft Tissue Neoplasms, Neoplasms, Complex and Mixed diagnosis, Neoplasms, Complex and Mixed surgery
- Abstract
Competing Interests: Declaration of competing interest The authors declare that they have no competing interests.
- Published
- 2024
- Full Text
- View/download PDF
3. Mixed Epithelial-stromal Tumor: Another Example of Confusing Subclassifications.
- Author
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Machuca-Aguado J, Umbría-Jiménez S, García-Escudero A, Giráldez-Puig J, and González-Cámpora R
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- Humans, Stromal Cells, Kidney Neoplasms, Neoplasms, Complex and Mixed diagnosis
- Abstract
Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
- Published
- 2023
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4. Sarcomatoid Dedifferentiated Melanoma: The Diagnostic Role of Next-Generation Sequencing.
- Author
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Valiga AA, Fuller CG, Doyle JA, and Lee JB
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- Aged, Combined Modality Therapy, Diagnosis, Differential, High-Throughput Nucleotide Sequencing, Humans, Knee, Male, Melanoma pathology, Melanoma therapy, Neoplasms, Complex and Mixed pathology, Neoplasms, Complex and Mixed therapy, Sarcoma pathology, Sarcoma therapy, Skin Neoplasms pathology, Skin Neoplasms therapy, Melanoma diagnosis, Neoplasms, Complex and Mixed diagnosis, Sarcoma diagnosis, Skin Neoplasms diagnosis
- Abstract
Abstract: Sarcomatoid dedifferentiated melanoma (SDDM) represents a diagnostic challenge as this cutaneous spindle cell melanoma lacks expression of classic melanocytic markers including S100, SOX10, Melan-A, HMB45, and MITF. The expression of the emerging melanoma marker preferentially expressed antigen in melanoma (PRAME) in SDDM is largely unknown. In this article, a case of SDDM arising in association with a nodular melanoma is highlighted. A 65-year-old man presented with a several week history of an ulcerated lesion on the right medial knee. A shave biopsy of the lesion revealed a biphasic neoplasm, which consisted of a centrally located poorly differentiated spindle cell component and an adjacent nodular component consisting of atypical melanocytes arranged in nests and fascicles. While the nodular component stained for S100, SOX10, and Melan-A, the spindle cell component failed to stain for these conventional melanocytic markers, only staining diffusely for CD10 and faintly for CD68. Both components stained for PRAME diffusely albeit less intensely within the spindle cell component. Next-generation DNA sequencing assay of the microdissected biphasic components revealed a shared mutation of NRAS. The results of the PRAME immunohistochemical stain and next-generation DNA sequencing assay facilitated in establishing the diagnosis of SDDM in association with nodular melanoma., Competing Interests: The authors declare no conflicts of interest., (Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.)
- Published
- 2022
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5. Hybrid Carcinoma of the Parotid Gland: An Extremely Rare Three Cases with an Immunohistochemical Analysis and a Review of the Literature.
- Author
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Kusafuka K, Yamashita M, Yamanaka S, Hirata K, Kubota A, Muramatsu A, Arai K, and Suzuki M
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- Aged, Carcinoma diagnosis, Carcinoma metabolism, Female, Humans, Immunohistochemistry, Male, Neoplasms, Complex and Mixed diagnosis, Neoplasms, Complex and Mixed metabolism, Parotid Neoplasms diagnosis, Parotid Neoplasms metabolism, Biomarkers, Tumor metabolism, Carcinoma pathology, Neoplasms, Complex and Mixed pathology, Parotid Neoplasms pathology
- Abstract
Salivary hybrid carcinoma (HC) is defined as when two or more kinds of carcinoma exist at the same location in a single mass. We reestimated and examined three cases of salivary gland HC. Case 1 involved a 76-year-old male. Case 2 involved a 74-year-old female. Case 3 involved a 66-year-old male. Histologically, case 1 involved a combination of salivary duct carcinoma (SDC) and squamous cell carcinoma (SqCC). Immunohistochemically, the former was positive for gross cystic disease fluid protein (GCDFP)-15 and androgen receptor (AR). Case 2 involved a combination of SqCC and neuroendocrine carcinoma. Immunohistochemically the latter was positive for synaptophysin and neural cell adhesion molecule (NCAM). Case 3 involved a combination of SDC and epithelial-myoepithelial carcinoma (EMC). Immunohistochemically, the former was positive for GCDFP-15 and AR, whereas the inner cells of the latter were positive for cytokeratin 7, and the outer cells of the latter were positive for actin. Because of the transitional zone between SDC and EMC, it was speculated that high-grade SDC arose from low-grade EMC.
- Published
- 2022
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6. Microcystic stromal tumour arising in association with serous cystadenoma.
- Author
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Wilson Y, Salfinger S, and Stewart C
- Subjects
- Cystadenoma, Serous diagnosis, Female, Humans, Middle Aged, Neoplasms, Complex and Mixed diagnosis, Ovarian Neoplasms diagnosis, Sex Cord-Gonadal Stromal Tumors diagnosis, Cystadenoma, Serous pathology, Neoplasms, Complex and Mixed pathology, Ovarian Neoplasms pathology, Sex Cord-Gonadal Stromal Tumors pathology
- Published
- 2021
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7. Oropharyngeal Mixed Neuroendocrine-Nonneuroendocrine Neoplasm (MiNEN): A Case Report and Literature Review.
- Author
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Robinson L, Schouwstra CM, and van Heerden WFP
- Subjects
- Biomarkers, Tumor analysis, Diagnosis, Differential, Humans, Male, Middle Aged, Neoplasms, Complex and Mixed pathology, Neuroendocrine Tumors pathology, Oropharyngeal Neoplasms pathology, Smokers, Tomography, X-Ray Computed, Neoplasms, Complex and Mixed diagnosis, Neuroendocrine Tumors diagnosis, Oropharyngeal Neoplasms diagnosis
- Abstract
Primary mixed neuroendocrine-nonneuroendocrine neoplasm (MiNEN) of the head and neck region is a rare biphasic tumor with an aggressive biological behavior. This report highlights an additional case of oropharyngeal MiNEN in a 46-year-old male patient with a previous long-term smoking history. Histologic evaluation revealed a biphasic tumor infiltrating the lamina propria. The first component consisted of a classic keratinizing squamous cell carcinoma. The second component consisted of small-to-intermediate sized cells with neuroendocrine features. Synaptophysin and CD56 immunohistochemical stains confirmed neuroendocrine lineage in this component. The presence of two morphological components with neuroendocrine and nonneuroendocrine features on histologic assessment should alert the pathologist to consider a MiNEN in their case work-up., (© 2021. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)
- Published
- 2021
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8. High-grade Urothelial Carcinoma with Malignant Melanocytic Differentiation.
- Author
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Xu H, Genega EM, Zhuang L, and Zhou M
- Subjects
- Aged, 80 and over, Biomarkers, Tumor analysis, Biopsy, Carcinoma, Transitional Cell pathology, Carcinoma, Transitional Cell surgery, Cell Differentiation, Cytoreduction Surgical Procedures, Female, Humans, Melanoma pathology, Melanoma surgery, Neoplasm Grading, Neoplasms, Complex and Mixed pathology, Neoplasms, Complex and Mixed surgery, Urinary Bladder diagnostic imaging, Urinary Bladder surgery, Urinary Bladder Neoplasms pathology, Urinary Bladder Neoplasms surgery, Urothelium diagnostic imaging, Urothelium pathology, Urothelium surgery, Carcinoma, Transitional Cell diagnosis, Melanoma diagnosis, Neoplasms, Complex and Mixed diagnosis, Urinary Bladder pathology, Urinary Bladder Neoplasms diagnosis
- Abstract
Urothelial carcinoma usually shows divergent differentiation and variant histology with squamous and glandular morphology being most common. In this report, we present a case of divergent malignant melanocytic differentiation in a high-grade urothelial carcinoma. A 98-year-old East Asian woman with an anterior bladder wall mass underwent resection, which revealed a high-grade poorly differentiated tumor. A minor component of high-grade papillary urothelial carcinoma and carcinoma in situ is also present. The majority of the tumor cells are morphologically and immunohistochemically consistent with melanoma, a minority of cells are positive for urothelial markers, and rare cells coexpress both melanocytic and urothelial markers. Cells that express melanocytic markers or urothelial markers are intimately admixed together. Taken together, a diagnosis of high-grade urothelial carcinoma with malignant melanocytic differentiation was rendered. This is the first report in the literature of malignant melanocytic differentiation in a high-grade urothelial carcinoma, a finding that may have important diagnostic and therapeutic implications.
- Published
- 2021
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9. A collision tumor of solitary fibrous tumor/hemangiopericytoma and meningioma: A case report with literature review.
- Author
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Ashizawa K, Ogura K, Nagase S, Sakaguchi A, Tokugawa J, Hishii M, Fukunaga M, Hirose T, and Matsumoto T
- Subjects
- Cerebellar Neoplasms diagnosis, Female, Hemangiopericytoma diagnosis, Humans, Meningeal Neoplasms diagnosis, Meningioma diagnosis, Middle Aged, Neoplasms, Complex and Mixed diagnosis, Solitary Fibrous Tumors diagnosis, Cerebellar Neoplasms pathology, Hemangiopericytoma pathology, Meningeal Neoplasms pathology, Meningioma pathology, Neoplasms, Complex and Mixed pathology, Solitary Fibrous Tumors pathology
- Abstract
An intracranial collision tumor is a rare lesion composed of two histologically different neoplasms in the same anatomic location. Even more rare is the collision tumor of a solitary fibrous tumor/hemangiopericytoma (SFT/HPC) and meningioma. The patient was a 46-year-old woman who had a 40 × 35 × 30-mm mass in the vermis of the cerebellum. Histologically, the mass consisted of two different components. One component showed the morphology of meningioma (World Health Organization (WHO) grade I), and the other component exhibited small round cell proliferation with hypercellular density, which was revealed to be SFT/HPC (WHO grade III) based on STAT6 immunohistochemistry. STAT6 showed completely different immunohistochemistry results in these two components (nuclear-negative in meningioma and nuclear-positive in SFT/HPC). Since these two neoplasms are associated with different prognoses, they should be distinguished from each other. When meningioma and an SFT/HPC-like lesion are identified morphologically, it is important to recognize the presence of such a collision tumor composed of meningioma and SFT/HPC, and identify the SFT/HPC component by employing STAT6 immunohistochemistry., (© 2021 Japanese Society of Pathology and John Wiley & Sons Australia, Ltd.)
- Published
- 2021
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10. Tiny but Mighty: Collision Tumor of a Superficial Adenocarcinoma Arising From a Tubulovillous Adenoma with Associated Low-Grade Follicular Lymphoma.
- Author
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Lin YS, Hamilton AER, Henderson C, and Farzin M
- Subjects
- Adenocarcinoma pathology, Adenocarcinoma surgery, Aged, Biopsy, Colon pathology, Colon surgery, Colonic Neoplasms pathology, Colonic Neoplasms surgery, Female, Humans, Intestinal Mucosa pathology, Intestinal Mucosa surgery, Lymphoma, Follicular pathology, Lymphoma, Follicular surgery, Neoplasms, Complex and Mixed pathology, Neoplasms, Complex and Mixed surgery, Adenocarcinoma diagnosis, Colonic Neoplasms diagnosis, Lymphoma, Follicular diagnosis, Neoplasms, Complex and Mixed diagnosis
- Abstract
Collision tumors are rare and there have only been a few previously described cases between an intestinal adenoma and a lymphoma. We report the first case of a 74-year-old woman who on investigation for iron deficiency had a tubulovillous adenoma with underlying follicular lymphoma. The atypical lymphoid proliferation showed immunohistochemical positivity for cluster of differentiation 20 (CD20), B-cell lymphoma 2 (BCL2), and B-cell lymphoma 6 (BCL6). Subsequent right hemicolectomy showed a superficially invasive adenocarcinoma.
- Published
- 2021
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11. Parotid Salivary Duct Carcinoma With a Prominent Squamous Component: Immunohistochemical Profile, Diagnostic Pitfalls, and Therapeutic Implications.
- Author
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Hardy N, Thompson J, Mehra R, Drachenberg CB, Hatten K, and Papadimitriou JC
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- Aged, Biomarkers, Tumor analysis, Biomarkers, Tumor antagonists & inhibitors, Biomarkers, Tumor genetics, Biopsy, Carcinoma, Ductal genetics, Carcinoma, Ductal pathology, Carcinoma, Ductal therapy, Carcinoma, Squamous Cell genetics, Carcinoma, Squamous Cell pathology, Carcinoma, Squamous Cell therapy, Chemoradiotherapy methods, DNA Mutational Analysis, Diagnosis, Differential, Fatal Outcome, Female, Humans, Immunohistochemistry, Mutation, Neoplasms, Complex and Mixed genetics, Neoplasms, Complex and Mixed pathology, Neoplasms, Complex and Mixed therapy, Palliative Care methods, Parotid Neoplasms genetics, Parotid Neoplasms pathology, Parotid Neoplasms therapy, Carcinoma, Ductal diagnosis, Carcinoma, Squamous Cell diagnosis, Neoplasms, Complex and Mixed diagnosis, Parotid Gland pathology, Parotid Neoplasms diagnosis
- Abstract
Salivary duct carcinoma of the parotid gland is a highly aggressive epithelial malignancy morphologically resembling high-grade, invasive, and in situ breast carcinoma. It can occasionally present with variable morphology making it diagnostically challenging in cases with unusual morphological components. Ancillary testing, particularly androgen receptor (AR) positivity on immunohistochemistry, can be very helpful in cases that demonstrate extensive squamous morphology, since AR positivity is uncommon in both the primary salivary gland and metastatic squamous cell carcinomas to the parotid. In this report, we describe a case of salivary duct carcinoma that showed only a squamous cell carcinoma component on the initial primary tumor site biopsy, as well as in subsequent contralateral neck lymph node and skin metastases. Apart from the variable morphology, the typical salivary duct and squamous cell carcinoma tumor components also showed significant immunohistochemical differences, including differential staining of human epidermal growth factor receptor 2/neu. The associated diagnostic pitfalls, distinct immunoprofiles of the tumor components, helpful adjuncts for making the correct diagnosis, and associated therapeutic implications are discussed.
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- 2021
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12. Borderline Brenner Tumor of the Ovary Coexisting With an Ovarian Mucinous Cystadenoma With Focal Atypical Epithelial Proliferation: A Rare Case With Review of the Literature.
- Author
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Salibay CJ, Zanfagnin V, Miller H, Walia S, Brunette LL, and Wang T
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- Appendectomy, Brenner Tumor pathology, Brenner Tumor surgery, Cell Proliferation, Cystadenoma, Mucinous pathology, Cystadenoma, Mucinous surgery, Female, Humans, Hysterectomy, Middle Aged, Neoplasms, Complex and Mixed pathology, Ovarian Neoplasms pathology, Ovarian Neoplasms surgery, Ovary diagnostic imaging, Ovary surgery, Salpingo-oophorectomy, Brenner Tumor diagnosis, Cystadenoma, Mucinous diagnosis, Neoplasms, Complex and Mixed diagnosis, Ovarian Neoplasms diagnosis, Ovary pathology
- Abstract
Ovarian Brenner tumors, accounting for ∼5% of overall ovarian epithelial neoplasm, are often reported in association with mucinous neoplasm. Histogenetically, the two tumors are thought to arise from similar precursors. To date, fewer than 60 borderline Brenner tumors alone have been reported, and the concomitant presence of atypical proliferative components in Brenner and mucinous tumors is even rarer. Therefore, the clinicopathological characteristics and prognosis of patients with the borderline Brenner tumors alone or coexisting with mucinous neoplasm are extremely limited. Herein, we report a unique case of a 53-year-old woman with a unilateral ovarian borderline Brenner tumor associated with focal atypical mucinous epithelial proliferation and her clinical presentations. The clinicopathological features of the tumor are documented and the literature review along with the clinical molecular advances are summarized in this study.
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- 2021
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13. Mixed Intraepithelial Neoplasia-Well-Differentiated Neuroendocrine Tumor of the Gallbladder: A Hitherto Unreported Combination.
- Author
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Kővári B, Turkevi-Nagy S, Lauwers GY, and Jiang K
- Subjects
- Carcinoma in Situ pathology, Carcinoma in Situ surgery, Cholecystectomy, Laparoscopic, Diagnosis, Differential, Gallbladder pathology, Gallbladder surgery, Gallbladder Neoplasms pathology, Gallbladder Neoplasms surgery, Humans, Male, Middle Aged, Neoplasms, Complex and Mixed pathology, Neoplasms, Complex and Mixed surgery, Neuroendocrine Tumors pathology, Neuroendocrine Tumors surgery, Carcinoma in Situ diagnosis, Gallbladder Neoplasms diagnosis, Neoplasms, Complex and Mixed diagnosis, Neuroendocrine Tumors diagnosis
- Abstract
Adenocarcinomas and noninvasive intraepithelial neoplasms (either polypoid or flat) are the most common gallbladder tumors; however, neuroendocrine neoplasms (NENs) can also occur. The majority of NENs are represented by neuroendocrine carcinomas (NECs), while neuroendocrine tumors (NETs) are extremely rare in this location. Occasionally, NEN may present as a part of a mixed neoplasm, with a coexisting non-neuroendocrine component. The latest World Health Organization classification denotes these lesions as mixed neuroendocrine-non-NENs (MiNENs). A novel type of MiNEN, the mixed adenoma well-differentiated NET (MANET), has been increasingly recognized and reported. In such lesions, a dysplastic noninvasive neoplasm and a NET represent the exocrine and endocrine component, respectively. MANETs have mostly been identified in the colon, small intestines, and stomach. In this article, we report, we believe, the first case of mixed gallbladder neoplasm with both biliary intraepithelial neoplasia (BilIN) and NET components, which may be regarded as a variant of MANET. Given the expectably favorable prognoses of MANETs, it is imperative not to misdiagnose the infiltrative yet indolent neuroendocrine component as an invasive adenocarcinoma or a NEC.
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- 2021
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14. Sebaceous Epithelial-Myoepithelial Carcinoma With Aggressive Behavior and Evidence of Preexisting Pleomorphic Adenoma.
- Author
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Ngo MH, Krishnan V, Piché J, and Berdugo J
- Subjects
- Adenocarcinoma, Sebaceous pathology, Adenocarcinoma, Sebaceous surgery, Adenoma, Pleomorphic pathology, Adenoma, Pleomorphic surgery, Aged, Humans, Male, Neoplasms, Complex and Mixed pathology, Neoplasms, Complex and Mixed surgery, Parotid Gland diagnostic imaging, Parotid Gland surgery, Parotid Neoplasms pathology, Parotid Neoplasms surgery, Tomography, X-Ray Computed, Adenocarcinoma, Sebaceous diagnosis, Adenoma, Pleomorphic diagnosis, Neoplasms, Complex and Mixed diagnosis, Parotid Gland pathology, Parotid Neoplasms diagnosis
- Abstract
Epithelial-myoepithelial carcinoma (EMCA) is a rare low-grade carcinoma of the salivary glands with multiple morphological variants. One such variant, sebaceous EMCA (SEMCA), has been reported in the literature. Distinguishing it from other tumors such as sebaceous carcinoma is crucial, as SEMCA typically behaves more indolently. We present a case of a SEMCA in the right parotid of a 71-year-old man that shows features of aggressive behavior such as facial nerve invasion and extraparenchymal extension. Also, we report evidence of preexisting pleomorphic adenoma within this tumor.
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- 2021
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15. Role of SMARCA4 (BRG1) and SMARCB1 (INI1) in Dedifferentiated Endometrial Carcinoma With Paradoxical Aberrant Expression of MMR in the Well-Differentiated Component: A Case Report and Review of the Literature.
- Author
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Kaur R, Mehta J, and Borges AM
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- Antineoplastic Combined Chemotherapy Protocols pharmacology, Antineoplastic Combined Chemotherapy Protocols therapeutic use, Carcinoma diagnosis, Carcinoma drug therapy, Carcinoma pathology, Cell Dedifferentiation genetics, DNA Mismatch Repair, Drug Resistance, Neoplasm genetics, Endometrial Neoplasms diagnosis, Endometrial Neoplasms drug therapy, Endometrial Neoplasms pathology, Endometrium pathology, Female, Gene Expression Profiling, Gene Expression Regulation, Neoplastic, Humans, Middle Aged, Neoplasm Grading, Neoplasms, Complex and Mixed diagnosis, Neoplasms, Complex and Mixed drug therapy, Neoplasms, Complex and Mixed pathology, Carcinoma genetics, DNA Helicases metabolism, Endometrial Neoplasms genetics, Neoplasms, Complex and Mixed genetics, Nuclear Proteins metabolism, SMARCB1 Protein metabolism, Transcription Factors metabolism
- Abstract
Introduction: Dedifferentiated endometrial carcinoma is an uncommon highly aggressive uterine tumor. It comprises 2 components: a well-differentiated, low-grade epithelial carcinoma and an undifferentiated carcinoma. The undifferentiated carcinoma frequently exhibits rhabdoid cytologic features. Many of these tumors are characterized by an aberrant switch/sucrose non-fermenting (SWI/SNF) complex. They may also exhibit aberrant expression of mismatch repair (MMR) proteins. Together, these play an important role in the pathogenesis and aggressive nature of the tumor., Material and Methods: We present a case of dedifferentiated endometrial carcinoma in a 63-year-old female showing loss of expression of SWI/SNF-related, matrix-associated, actin-dependent regulator of chromatin, subfamily A, member 4 (SMARCA4/BRG1), and aberrant expression of MMR proteins. We also review the literature starting from the earliest recognition of this entity and the various studies done to explain its molecular pathogenesis and prognostic importance., Results and Conclusions: Recognition of SWI/SNF complex-deficient dedifferentiated endometrial carcinoma is important as these tumors do not respond to platinum-based chemotherapy, and consideration of alternative therapies is often necessary. We also want to emphasize that though most of the studies have found MMR deficiency in the undifferentiated carcinoma component, it may be seen only in the low-grade, well-differentiated component, as observed in this case.
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- 2021
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16. Mixed phenotype acute leukemia in a child associated with a NUP98-NSD1 fusion and NRAS p.Gly61Arg mutation.
- Author
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Ganapathi SS, Raikar SS, Yatsenko SA, Djokic M, and Bukowinski A
- Subjects
- Adolescent, Antineoplastic Combined Chemotherapy Protocols therapeutic use, Biopsy, Bone Marrow pathology, Fatal Outcome, Female, Hematopoietic Stem Cell Transplantation, Humans, Leukemia, Myeloid, Acute genetics, Leukemia, Myeloid, Acute pathology, Leukemia, Myeloid, Acute therapy, Mutation, Neoadjuvant Therapy, Neoplasms, Complex and Mixed genetics, Neoplasms, Complex and Mixed pathology, Neoplasms, Complex and Mixed therapy, Precursor Cell Lymphoblastic Leukemia-Lymphoma genetics, Precursor Cell Lymphoblastic Leukemia-Lymphoma pathology, Precursor Cell Lymphoblastic Leukemia-Lymphoma therapy, GTP Phosphohydrolases genetics, Leukemia, Myeloid, Acute diagnosis, Membrane Proteins genetics, Neoplasms, Complex and Mixed diagnosis, Oncogene Proteins, Fusion genetics, Precursor Cell Lymphoblastic Leukemia-Lymphoma diagnosis
- Abstract
Background: Mixed phenotype acute leukemia (MPAL) is a rare subset of acute leukemia in the pediatric population associated with genetic alterations seen in both acute lymphoblastic leukemia (ALL) and acute myeloid leukemia (AML)., Case: We describe a patient with MPAL with a NUP98 (nucleoporin 98)-NSD1 gene fusion (nuclear receptor binding SET domain protein1) and NRAS (neuroblastoma RAS viral oncogene homolog mutation) p.Gly61Arg mutation who was treated with upfront AML-based chemotherapy, received hematopoietic stem cell transplant (HSCT), but unfortunately died from relapsed disease., Conclusion: This case highlights the challenges faced in choosing treatment options in MPAL patients with complex genomics, with predominant myeloid features., (© 2021 The Authors. Cancer Reports published by Wiley Periodicals LLC.)
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- 2021
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17. Mixed Invasive Apocrine Papillary/Micropapillary Carcinoma of the Breast: Another Brick in the Triple-Negative Wall.
- Author
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Cima L, Mirabassi N, Sartori C, Carbone FG, Morelli L, Cserni G, and Barbareschi M
- Subjects
- Aged, Apocrine Glands surgery, Biopsy, Large-Core Needle, Carcinoma, Papillary pathology, Carcinoma, Papillary surgery, Female, Humans, Mammary Glands, Human surgery, Mastectomy, Segmental, Neoplasms, Complex and Mixed pathology, Neoplasms, Complex and Mixed surgery, Treatment Outcome, Triple Negative Breast Neoplasms pathology, Triple Negative Breast Neoplasms surgery, Apocrine Glands pathology, Carcinoma, Papillary diagnosis, Mammary Glands, Human pathology, Neoplasms, Complex and Mixed diagnosis, Triple Negative Breast Neoplasms diagnosis
- Abstract
Pure invasive papillary carcinoma (IPC) is a rare subtype of breast carcinoma with good prognosis compared with classical invasive breast carcinoma (IBC) of no special type. The majority of IPC are estrogen receptor and progesterone receptor (ER/PR) positive and HER2 negative (luminal A-like). We report the case of a 72-year-old women who was referred to the Senology Clinic for a routine workup following surgery for an intraductal papilloma. The core needle biopsy (CNB) showed a lesion mainly composed of irregular papillae and micropapillae with apocrine epithelial cells of low-to-intermediate nuclear grade, without a myoepithelial cell layer within the papillae and at the periphery, as demonstrated with multiple immunostains. The diagnosis of apocrine papillary lesion of uncertain malignant potential was made. The subsequent lumpectomy showed an IBC with the same cyto-architectural features as the CNB. In addition, lymphovascular invasion and papillary/micropapillary apocrine in situ lesion were noted. Notably, the tumor was ER/PR and HER2 negative and strongly positive for androgen receptor. A final diagnosis of mixed apocrine papillary/micropapillary carcinoma with triple-negative status was made. To the best of our knowledge, this is the first report of an IBC with these features. Breast pathologists should be aware of this entity when dealing with CNB samples characterized by a complex papillary lesion with apocrine atypia that lacks a myoepithelial cell layer on multiple immunostains. These lesions should be classified at least as of uncertain malignant potential based on the cyto-architectural features prompting a surgery for removal.
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- 2021
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18. Sex Cord Tumor With Annular Tubules-Like Histologic Pattern in Adult Granulosa Cell Tumor: Case Report of a Hitherto Unreported Morphologic Variant.
- Author
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Chang RJ, Reuther J, Gandhi I, Roy A, Jain S, and Masand RP
- Subjects
- DNA Mutational Analysis, Female, Forkhead Box Protein L2 genetics, Granulosa Cell Tumor genetics, Granulosa Cell Tumor pathology, Humans, Hysterectomy, Middle Aged, Mutation, Neoplasms, Complex and Mixed genetics, Neoplasms, Complex and Mixed pathology, Ovarian Neoplasms genetics, Ovarian Neoplasms pathology, Salpingo-oophorectomy, Sex Cord-Gonadal Stromal Tumors genetics, Sex Cord-Gonadal Stromal Tumors pathology, Granulosa Cell Tumor diagnosis, Neoplasms, Complex and Mixed diagnosis, Ovarian Neoplasms diagnosis, Ovary pathology, Sex Cord-Gonadal Stromal Tumors diagnosis
- Abstract
Adult granulosa cell tumor (AGCT) and sex cord tumor with annular tubules (SCTAT) are distinct sex cord stromal tumors with different molecular signatures. We present a unique case of an incidental ovarian tumor with mixed AGCT and SCTAT morphologic patterns. Due to the unusual co-occurrence, molecular testing was separately performed on both components. Despite minimal overlap in morphology, both the SCTAT and AGCT components were found to have an identical mutation profile, including the prototypical FOXL2 p.C134W mutation characteristic of AGCT. We thus present the first report of AGCT with SCTAT-like pattern.
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- 2021
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19. Composite hemangioendothelioma of the spleen with multiple metastases: CT findings and review of the literature.
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Li WW, Liang P, Zhao HP, Zhang YX, Liu YY, and Gao JB
- Subjects
- Aged, Hemangioendothelioma secondary, Hemangioendothelioma surgery, Humans, Male, Neoplasms, Complex and Mixed secondary, Neoplasms, Complex and Mixed surgery, Spleen diagnostic imaging, Splenectomy, Splenic Neoplasms pathology, Splenic Neoplasms surgery, Tomography, X-Ray Computed, Treatment Outcome, Hemangioendothelioma diagnosis, Neoplasms, Complex and Mixed diagnosis, Spleen pathology, Splenic Neoplasms diagnosis
- Abstract
Abstract: Composite hemangioendothelioma (CHE) is a rare vascular neoplasm of intermediate malignant potential. Only 52 cases have been reported in the English literature, and one case previously reported occurred in the spleen. The purpose of our study was to report a 65-year-old man diagnosed as CHE primary arising from the spleen with multiple metastases.Clinical and imaging features, laboratory tests, and pathological results about CHE were described in detail in this study.The patient presented with multiple lesions in bilateral lungs and spleen that had been incidentally detected by computed tomography (CT). Except for thrombocytopenia, other laboratory tests were not significant. The CT scan of the abdomen revealed multiple round-like and irregularly mixed density masses with unclear borders in enlarged spleen. And contrast enhancement showed mild heterogeneous enhancement. CT scan also showed widespread liver, ribs, lungs, and vertebral bodies metastases. This diagnosis was confirmed by histopathological examination. The patient underwent splenectomy and still survives with tumors after six months followed-up.Due to the lack of specificity of clinical features and laboratory tests, it is necessary to combine imaging features and pathological findings to make a correct diagnosis., Competing Interests: The authors have no conflicts of interest to disclose., (Copyright © 2021 the Author(s). Published by Wolters Kluwer Health, Inc.)
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- 2021
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20. Gastric adenocarcinoma of fundic gland (chief cell predominant type) coexisting with well differentiated intestinal adenocarcinoma: A case report.
- Author
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Liu L, Han L, Ma Q, and Zhang J
- Subjects
- Adenocarcinoma pathology, Adenocarcinoma surgery, Adenocarcinoma in Situ pathology, Adenocarcinoma in Situ surgery, Aged, 80 and over, Biomarkers, Tumor analysis, Biopsy, Chief Cells, Gastric pathology, Endoscopy, Digestive System, Endosonography, Gastrectomy, Gastric Fundus cytology, Gastric Fundus diagnostic imaging, Gastric Fundus surgery, Humans, Intestinal Mucosa pathology, Male, Mucin-6 analysis, Neoplasms, Complex and Mixed pathology, Neoplasms, Complex and Mixed surgery, Pepsinogen A analysis, Stomach Neoplasms pathology, Stomach Neoplasms surgery, Treatment Outcome, Adenocarcinoma diagnosis, Adenocarcinoma in Situ diagnosis, Gastric Fundus pathology, Neoplasms, Complex and Mixed diagnosis, Stomach Neoplasms diagnosis
- Abstract
Rationale: Gastric adenocarcinoma of fundic gland (chief cell predominant type) (GA-FG-CCP) is a new, rare variant of gastric adenocarcinoma, which is characterized by mild nuclear atypia and specific immunohistochemical markers., Patient Concerns: An 84-year-old Chinese man was referred to our hospital for endoscopic resection of a gastric lesion., Interventions: We performed endoscopic submucosal dissection, and successfully removed the lesion., Diagnosis: Esophago gastroduodenoscopy showed a slightly elevated lesion with a diameter of 22 mm in the posterior wall of cardia. Magnifying endoscopy with narrow band imaging revealed an abnormal microsurface and microvessels on the tumor surface. Endoscopic ultrasonography revealed a hypoechoic mass located in the first layer. The pathological diagnosis of the biopsy specimens indicated that the tumor was high grade intraepithelial neoplasia. The pathological diagnosis differed between the superficial and deeper part of the lesion. The superficial part was composed of a tubular structure with prominent atypia and was diagnosed as well differentiated intestinal adenocarcinoma. The deeper part was composed of a well-differentiated tubular adenocarcinoma mimicking the fundic gland cells, mainly the chief cells. The tumor cells showed mild nuclear atypia and was positive for pepsinogen-I (PG-I) and mucin-6 (MUC6). This deeper part was diagnosed as GA-FG-CCP., Outcomes: The tumor was successfully removed. This patient had no discomfort during the follow-up period (10 months)., Lessons: We present a rare case of GA-FG-CCP coexisted with well-differentiated tubular adenocarcinoma. GA-FG-CCP exists in the deep mucosal layer and the muscularis mucosa, which could not be found under endoscopy, but could be discerned in pathology with mild nuclear atypia and special biomarkers., Competing Interests: The authors have no conflicts of interests to disclose., (Copyright © 2021 the Author(s). Published by Wolters Kluwer Health, Inc.)
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- 2021
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21. Combined Nevus-Mastocytosis; Random Coincidence or Complex Biological Relationship?
- Author
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Van Rooyen DM, Grohs RL, and Mesbah Ardakani N
- Subjects
- Female, Humans, Immunohistochemistry, Mastocytosis, Cutaneous diagnosis, Middle Aged, Neoplasms, Complex and Mixed diagnosis, Nevus, Pigmented diagnosis, Skin Neoplasms diagnosis, Mastocytosis, Cutaneous pathology, Neoplasms, Complex and Mixed pathology, Nevus, Pigmented pathology, Skin Neoplasms pathology
- Abstract
Competing Interests: The authors declare no conflicts of interest.
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- 2021
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22. A Novel Case of Mammary-Type Myofibroblastoma With Sarcomatous Features.
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Strait AM, Linos K, Tafe LJ, and Muller KE
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- Aged, Biomarkers, Tumor genetics, Breast surgery, Breast Neoplasms, Male genetics, Breast Neoplasms, Male pathology, Breast Neoplasms, Male surgery, Chromosomes, Human, Pair 13 genetics, DNA Copy Number Variations, Diagnosis, Differential, Humans, Male, Neoplasms, Complex and Mixed pathology, Neoplasms, Complex and Mixed surgery, Neoplasms, Muscle Tissue genetics, Neoplasms, Muscle Tissue pathology, Neoplasms, Muscle Tissue surgery, Breast pathology, Breast Neoplasms, Male diagnosis, Neoplasms, Complex and Mixed diagnosis, Neoplasms, Muscle Tissue diagnosis
- Abstract
Mammary-type myofibroblastoma (MFB) is a benign spindle cell tumor of the breast and soft tissue characterized by 13q14 alterations leading to loss of Rb-1 protein expression, a feature shared among spindle cell lipoma and cellular angiofibroma. In this article, we present a novel case of MFB arising in the left breast of a 70-year old man that microscopically showed an abrupt transition from classic MFB morphology to an area with cytologic atypia and mitotic activity, akin to sarcomatous transformation described in cellular angiofibromas. A thorough workup of the molecular underpinnings of both components using chromosomal microarray and next-generation sequencing platforms supported a clonal relationship. Nearly identical copy number changes, including a single copy loss of 13q14, were found in both components; in addition, the sarcomatous component harbored biallelic TP53 alterations. It is important for pathologists to recognize that sarcomatous features can occur in mammary-type MFB to arrive at the correct diagnosis.
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- 2021
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23. Management of complex head-and-neck basal cell carcinomas using a combined reflectance confocal microscopy/optical coherence tomography: a descriptive study.
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Navarrete-Dechent C, Aleissa S, Cordova M, Liopyris K, Sahu A, Rossi AM, Lee EH, and Nehal KS
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- Aged, Aged, 80 and over, Biopsy, Carcinoma, Basal Cell pathology, Carcinoma, Basal Cell surgery, Clinical Decision-Making, Female, Head and Neck Neoplasms pathology, Head and Neck Neoplasms surgery, Humans, Male, Microscopy, Confocal methods, Middle Aged, Neoplasms, Complex and Mixed pathology, Neoplasms, Complex and Mixed surgery, Prospective Studies, Skin diagnostic imaging, Skin pathology, Skin Neoplasms pathology, Skin Neoplasms surgery, Carcinoma, Basal Cell diagnosis, Head and Neck Neoplasms diagnosis, Multimodal Imaging methods, Neoplasms, Complex and Mixed diagnosis, Skin Neoplasms diagnosis, Tomography, Optical Coherence methods
- Abstract
Introduction: Recently, a combined reflectance confocal microscopy (RCM)-optical coherence tomography (OCT) has been tested for the diagnosis of basal cell carcinoma (BCC). Evaluating the role of RCM-OCT in management of complex BCCs has not been studied. The objective of the study was to investigate the utility of a new combined RCM-OCT device in the evaluation and management of complex BCCs in a descriptive study., Methods: Prospective study of consecutive cases (July 2018-June 2019) of biopsy-proven 'complex' BCC defined as BCC in the head-and-neck area with multiple high-risk criteria such as large size in the mask area, multiple recurrences, and high-risk subtype. All cases were evaluated with a combined RCM-OCT device that provided simultaneous image viewing on a screen. Lesions were evaluated bedside with RCM-OCT according to previously described criteria., Results: Ten patients with complex head-and-neck BCCs had mean age of 73.1 ± 13.0 years. Six (60%) patients were males. Mean BCC clinical size was 1.9 ± 1.2 cm (range 0.6-4.0 cm). RCM detected residual BCC in 8 out of 10 cases (80%) and OCT detected residual BCC in all 10 cases (100%). Six BCCs (60%) had a depth estimate of > 1000 µm under OCT. In five cases, (50%) RCM-OCT imaging results led to a change/modification in BCC management., Conclusion: The use of a combined RCM-OCT device may help in the evaluation of complex head-and-neck BCCs by guiding treatment selection and defining the extent of surgery.
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- 2021
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24. The prognosis of invasive ductal carcinoma, lobular carcinoma and mixed ductal and lobular carcinoma according to molecular subtypes of the breast.
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Zhao H
- Subjects
- Aged, Biomarkers, Tumor analysis, Biomarkers, Tumor metabolism, Breast surgery, Breast Neoplasms diagnosis, Breast Neoplasms pathology, Breast Neoplasms therapy, Carcinoma, Ductal, Breast diagnosis, Carcinoma, Ductal, Breast pathology, Carcinoma, Ductal, Breast therapy, Carcinoma, Lobular diagnosis, Carcinoma, Lobular pathology, Carcinoma, Lobular therapy, Chemotherapy, Adjuvant statistics & numerical data, Clinical Decision-Making, Female, Follow-Up Studies, Humans, Kaplan-Meier Estimate, Mastectomy methods, Mastectomy statistics & numerical data, Middle Aged, Neoplasm Grading, Neoplasm Staging, Neoplasms, Complex and Mixed diagnosis, Neoplasms, Complex and Mixed pathology, Neoplasms, Complex and Mixed therapy, Prognosis, Receptor, ErbB-2 analysis, Receptor, ErbB-2 metabolism, Receptors, Estrogen analysis, Receptors, Estrogen metabolism, Retrospective Studies, SEER Program statistics & numerical data, Breast pathology, Breast Neoplasms mortality, Carcinoma, Ductal, Breast mortality, Carcinoma, Lobular mortality, Neoplasms, Complex and Mixed mortality
- Abstract
Background: To investigate the prognosis of females with invasive ductal carcinoma (IDC), invasive lobular carcinoma (ILC), and mixed invasive ductal and lobular carcinoma (IDLC) according to hormone receptor (HR) and HER2 status., Methods: Data of 171,881 patients from the SEER database were analyzed. Propensity score matching was used to balance the covariates. Breast cancer-specific survival (BCSS) and overall survival (OS) of IDC, ILC, and IDLC were investigated., Results: Patients with ILC were older, had lower tumor grade, higher tumor stage, larger tumor size, more nodal metastasis, higher estrogen receptor(+), lower HER2(-), and less likely to receive partial mastectomy and chemotherapy compared with IDC and IDLC. ILC and IDLC showed better prognosis than IDC after matching by Kaplan-Meier curves. Multivariate Cox regression showed better OS of ILC and IDLC compared with IDC with hazard ratio and a 95% confidence interval of 0.84 (0.77-0.90) and 0.91 (0.83-1.00), respectively. For HR(+)HER2(-) subgroup, ILC showed better OS than IDC; IDC showed worse BCSS and OS than IDLC. For HR(+)HER2(+); ILC showed better OS compared with IDLC; there were no survival differences of IDC, ILC, and IDLC for HER2(+). For HR(-)HER2(-), ILC and IDC showed better BCSS and OS compared with IDLC by multivariate analysis., Conclusions: The prognoses of female patients with IDC, ILC or IDLC were associated with the molecular subtypes of breast carcinoma. Management decisions should be based on pathological types and molecular subtypes.
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- 2021
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25. Presentation and outcome of mixed neuroendocrine non-neuroendocrine neoplasms of the pancreas.
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Nießen A, Schimmack S, Weber TF, Mayer P, Bergmann F, Hinz U, Büchler MW, and Strobel O
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- Adenocarcinoma diagnosis, Adenocarcinoma surgery, Adenocarcinoma therapy, Adult, Aged, Aged, 80 and over, Carcinoma, Acinar Cell diagnosis, Carcinoma, Acinar Cell surgery, Carcinoma, Acinar Cell therapy, Carcinoma, Pancreatic Ductal diagnosis, Carcinoma, Pancreatic Ductal surgery, Carcinoma, Pancreatic Ductal therapy, Case-Control Studies, Female, Humans, Kaplan-Meier Estimate, Male, Middle Aged, Neoplasm Metastasis, Neoplasms, Complex and Mixed surgery, Neuroendocrine Tumors surgery, Pancreatectomy, Pancreatic Neoplasms surgery, Retrospective Studies, Survival Analysis, Treatment Outcome, Neoplasms, Complex and Mixed diagnosis, Neoplasms, Complex and Mixed therapy, Neuroendocrine Tumors diagnosis, Neuroendocrine Tumors therapy, Pancreatic Neoplasms diagnosis, Pancreatic Neoplasms therapy
- Abstract
Background/objectives: Mixed neuroendocrine non-neuroendocrine neoplasms (MiNEN) of the pancreas and periampullary region are extremely rare and heterogeneous malignancies. Literature is sparse, clinical management is not standardized and little is known about survival outcomes. The aim of this study was to identify pathological and radiological features of MiNEN and assess the outcome of surgical management., Methods: Patients undergoing surgery for pancreatic and periampullary MiNEN between 2001 and 2019 were retrospectively analysed based on a prospective database. Histological, radiological and clinical features were assessed. Survival was analysed in a nested case-control study and matched-pair analyses with pure neuroendocrine neoplasms (pNEN) and ductal adeno- or acinar cell carcinomas of the pancreas. A literature review with focus on survival after surgical resection was additionally performed., Results: Of 13 patients with MiNEN, 5 had acinar-MiNEN and 8 adeno-MiNEN. Two of 5 (40%) acinar-MiNEN and one adeno-MiNEN patients had liver metastases. All but one adeno-MiNEN (88%) showed preoperative radiological features of pancreatic adenocarcinoma, 3 of 5 (60%) acinar-MiNEN exhibited mainly neuroendocrine features. No surgical mortality was observed. The 5-year overall survival rate in all MiNEN was 40%. Five-year survival rate was 58% in adeno-MiNEN and comparable to that of matched ductal adenocarcinomas (36%) and pNEN (48%). Five-year overall survival rate was 20% in acinar-MiNEN, compared to 39% in acinar carcinoma patients and 59% in matched pNEN patients., Conclusions: MiNEN are rare and difficult to distinguish from pure adenocarcinoma or neuroendocrine neoplasm preoperatively. Surgical resection would therefore be the treatment of choice in localized tumors., (Copyright © 2020 IAP and EPC. Published by Elsevier B.V. All rights reserved.)
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- 2021
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26. The clinical characteristics and prognostic factors of combined Hepatocellular Carcinoma and Cholangiocarcinoma, Hepatocellular Carcinoma and Intrahepatic Cholangiocarcinoma after Surgical Resection: A propensity score matching analysis.
- Author
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Tang Y, Wang L, Teng F, Zhang T, Zhao Y, and Chen Z
- Subjects
- Bile Duct Neoplasms mortality, Bile Duct Neoplasms pathology, Bile Duct Neoplasms therapy, Bile Ducts, Intrahepatic pathology, Bile Ducts, Intrahepatic surgery, Carcinoma, Hepatocellular mortality, Carcinoma, Hepatocellular pathology, Carcinoma, Hepatocellular therapy, Chemoembolization, Therapeutic statistics & numerical data, Cholangiocarcinoma mortality, Cholangiocarcinoma pathology, Cholangiocarcinoma therapy, Combined Modality Therapy methods, Combined Modality Therapy statistics & numerical data, Disease-Free Survival, Female, Follow-Up Studies, Hepatectomy, Humans, Liver pathology, Liver surgery, Liver Neoplasms mortality, Liver Neoplasms therapy, Male, Margins of Excision, Middle Aged, Neoplasms, Complex and Mixed mortality, Neoplasms, Complex and Mixed pathology, Neoplasms, Complex and Mixed therapy, Prognosis, Propensity Score, Retrospective Studies, Bile Duct Neoplasms diagnosis, Carcinoma, Hepatocellular diagnosis, Cholangiocarcinoma diagnosis, Liver Neoplasms diagnosis, Neoplasms, Complex and Mixed diagnosis
- Abstract
Background: Clinical characteristics and prognosis among combined hepatocellular carcinoma (HCC) and cholangiocarcinoma (cHCC-CC) with HCC and intrahepatic cholangiocarcinoma (ICC) were inconsistent in previous studies. The aim of this study was to compare postoperative prognosis among cHCC-CC, HCC and ICC, and investigated the prognostic risk factor of cHCC-CC after surgical resection. Methods: A total of 1041 eligible patients with pathological diagnosis of cHCC-CC (n=135), HCC (n=698) and ICC (n=208) were enrolled in this study. Univariate and multivariate Cox analysis were applied for assessing important risk factors. cHCC-CC were further 1:1 matched with HCC and ICC on important clinical risk factors. Survival curves of matched and unmatched cohorts were depicted by Kaplan-Meier method with log-rank test. Results: Patients with cHCC-CC had similar rate of sex, age and cirrhosis with HCC ( p< 0.05) and comparable incidence of hepatitis B or C with ICC ( p= 0.197). Patients of cHCC-CC had intermediate prognosis between HCC and ICC, with median overall survival (OS) time of cHCC-CC, HCC and ICC of 20.5 months, 35.7 months and 11.6 months ( p< 0.001). In matched cohorts, the OS of cHCC-CC were worse than HCC ( p< 0.001) but comparable with ICC ( p= 0.06), while the disease-free survival (DFS) of cHCC-CC was worse than HCC but better than ICC ( p< 0.05). And lymph node infiltration and postoperative transarterial chemoembolization (TACE) were independent risk factors of cHCC-CC associated with prognosis. Conclusion: The long term survival of cHCC-CC was worse than HCC but comparable with ICC when matched on albumin level, tumor size, lymph node infiltration, tumor stage and margin. Presence of lymph node infiltration and no postoperative TACE were associated with poor prognosis of cHCC-CC., Competing Interests: Competing Interests: The authors have declared that no competing interest exists., (© The author(s).)
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- 2021
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27. Hybrid Low-Grade Fibromyxoid Sarcoma and Sclerosing Epithelioid Fibrosarcoma of the Pancreas.
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Kramer SP, Bowman CJ, Wang ZJ, Sheahon KM, Nakakura EK, Cho SJ, Umetsu SE, and Behr SC
- Subjects
- Biopsy, Fibrosarcoma pathology, Fibrosarcoma surgery, Humans, Magnetic Resonance Imaging, Male, Middle Aged, Neoplasm Grading, Neoplasms, Complex and Mixed pathology, Neoplasms, Complex and Mixed surgery, Pancreas diagnostic imaging, Pancreas surgery, Pancreatic Neoplasms pathology, Pancreatic Neoplasms surgery, Pancreaticoduodenectomy, Positron Emission Tomography Computed Tomography, Treatment Outcome, Fibrosarcoma diagnosis, Neoplasms, Complex and Mixed diagnosis, Pancreas pathology, Pancreatic Neoplasms diagnosis
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- 2020
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28. Predictors of Lymph Node Metastasis and Differences Between Pure and Mixed Histologic Types of Early Gastric Signet-ring Cell Carcinomas.
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Chu Y, Mao T, Li X, Jing X, Ren M, Huang Z, Zhou XB, Chen Y, and Tian Z
- Subjects
- Adult, Aged, Aged, 80 and over, Carcinoma, Signet Ring Cell diagnosis, Carcinoma, Signet Ring Cell mortality, Carcinoma, Signet Ring Cell surgery, Female, Follow-Up Studies, Gastrectomy, Humans, Lymph Node Excision, Lymph Nodes surgery, Lymphatic Metastasis, Male, Middle Aged, Neoplasm Invasiveness, Neoplasm Staging, Neoplasms, Complex and Mixed diagnosis, Neoplasms, Complex and Mixed mortality, Neoplasms, Complex and Mixed surgery, Prognosis, Retrospective Studies, Risk Factors, Stomach Neoplasms diagnosis, Stomach Neoplasms mortality, Stomach Neoplasms surgery, Survival Analysis, Carcinoma, Signet Ring Cell pathology, Lymph Nodes pathology, Neoplasms, Complex and Mixed pathology, Stomach Neoplasms pathology
- Abstract
The aim of this study was to investigate predictors of lymph node metastasis (LNM) in early gastric signet-ring cell carcinoma (SRCC) and determine clinicopathologic and prognostic differences of different histologic subtypes. We retrospectively analyzed 13,661 gastric cancer patients; 231 were eligible for inclusion. Data for clinical, endoscopic, and histopathologic characteristics and prognoses were collected. Patients were followed up regarding postresection survival; overall and disease-specific survival rates were estimated by the Kaplan-Meier method with a log-rank test, and prognostic factors were evaluated by Cox regression. LNM incidence in early SRCC was 16.0% (37/231) overall: 6.9% (8/116) and 25.2% (29/115) in patients with pure and mixed SRCC, respectively. Univariate and multivariate analyses revealed SM2 invasion (odds ratio [OR]=5.070, P=0.003), lymphovascular invasion (LVI) (OR=14.876, P<0.001), pathologic pattern of mixed SRCC (OR=3.226, P=0.026), ulcer presence (OR=3.340, P=0.019) and lesion size over 20 mm (OR=2.823, P=0.015) as independent risk factors for LNM. Compared with pure SRCC, the mixed subtype was associated with older age, larger lesion size, higher LVI frequency, more frequent perineural invasion, and most importantly, higher LNM incidence. Patients with pure SRCC showed significantly longer overall survival (P=0.004) and disease-specific survival (P=0.002) than mixed SRCC patients. Pathologic subtype (hazard ratio [HR]=3.682; P=0.047), age (HR=5.246; P=0.001), SM1 invasion (HR=6.192; P=0.023), SM2 invasion (HR=7.529; P=0.021) and LNM (HR=5.352; P<0.001) were independent prognostic factors. Independent risk factors for LNM in early gastric SRCC were SM2 invasion, LVI, pathologic pattern, ulcer presence and lesion size over 20 mm. Early SRCC should be further classified by the purity of the SRC component.
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- 2020
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29. Tumour-to-tumour metastasis: breast carcinoma to an olfactory neuroblastoma.
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Bashyam A, Grammatopoulou V, Crook T, Di Palma S, and Sunkaraneni VS
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- Aged, Breast Neoplasms therapy, Carcinoma, Lobular diagnosis, Carcinoma, Lobular surgery, Chemotherapy, Adjuvant methods, Esthesioneuroblastoma, Olfactory pathology, Esthesioneuroblastoma, Olfactory surgery, Female, Humans, Magnetic Resonance Imaging, Mastectomy, Nasal Bone diagnostic imaging, Nasal Bone pathology, Nasal Bone surgery, Nasal Cavity diagnostic imaging, Neoadjuvant Therapy methods, Neoplasms, Complex and Mixed pathology, Neoplasms, Complex and Mixed surgery, Neoplasms, Second Primary pathology, Neoplasms, Second Primary surgery, Nose Neoplasms pathology, Nose Neoplasms surgery, Tomography, X-Ray Computed, Breast Neoplasms pathology, Carcinoma, Lobular secondary, Esthesioneuroblastoma, Olfactory diagnosis, Neoplasms, Complex and Mixed diagnosis, Neoplasms, Second Primary diagnosis, Nose Neoplasms diagnosis
- Abstract
Tumour-to-tumour metastasis is a rare phenomenon. It occurs when a primary tumour is a recipient of a separate tumour within the same individual. We present a case of a 66-year-old woman with known breast cancer who presented with one-sided nasal symptoms. Examination and imaging revealed a unilateral polyp arising from the skull base. She underwent endoscopic polypectomy with the histology demonstrating tumour-to-tumour metastasis from a breast carcinoma to an olfactory neuroblastoma, a rare sinonasal tumour. Clinicians should be cautious of distant metastases in any patient presenting with head and neck symptoms and a known primary tumour. This is the first documented case of this type.
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- 2020
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30. Case of spiradenocylindroma expressed hair follicle stem cell markers.
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Sato T, Noto M, Ansai SI, Ishikawa N, Manabe M, and Osada SI
- Subjects
- Acrospiroma pathology, Acrospiroma surgery, Aged, Antigens, CD analysis, Antigens, CD metabolism, Biomarkers, Tumor analysis, Biopsy, Carcinoma, Adenoid Cystic pathology, Carcinoma, Adenoid Cystic surgery, Hair Follicle cytology, Hair Follicle metabolism, Humans, Keratin-15 analysis, Keratin-15 metabolism, Leg, Male, Neoplasms, Complex and Mixed pathology, Neoplasms, Complex and Mixed surgery, Stem Cells metabolism, Sweat Gland Neoplasms pathology, Sweat Gland Neoplasms surgery, Sweat Glands pathology, Sweat Glands surgery, Acrospiroma diagnosis, Biomarkers, Tumor metabolism, Carcinoma, Adenoid Cystic diagnosis, Neoplasms, Complex and Mixed diagnosis, Sweat Gland Neoplasms diagnosis
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- 2020
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31. Cushing's disease due to a pituitary adenoma as a component of collision tumor: A case report and review of the literature.
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Gezer E, Cantürk Z, Selek A, Çetinarslan B, Tarkun İ, Sözen M, Kiraz U, Gürbüz YS, Ceylan S, and Çabuk B
- Subjects
- ACTH-Secreting Pituitary Adenoma complications, ACTH-Secreting Pituitary Adenoma diagnosis, Adult, Female, Humans, Meningeal Neoplasms diagnosis, Meningeal Neoplasms pathology, Meningeal Neoplasms surgery, Meningioma diagnosis, Meningioma pathology, Meningioma surgery, Neoplasms, Complex and Mixed diagnosis, Pituitary Neoplasms complications, Pituitary Neoplasms diagnosis, ACTH-Secreting Pituitary Adenoma pathology, Cushing Syndrome etiology, Neoplasms, Complex and Mixed pathology, Pituitary Neoplasms pathology
- Abstract
Background: The coexistence of two morphologically different tumors attached to each other creates a very rare type of tumor called a collision tumor. Collision tumors containing pituitary adenoma-sellar meningioma have only been described in four cases to date; we discuss a fifth case harboring a collision tumor comprising a pituitary corticotroph adenoma and a sellar meningioma in the same anatomic position., Case Presentation: A 34-year-old Caucasian woman presented with menstrual irregularity, severe weakness of the proximal muscles, and 10-15 kg weight gain within a year. Basal plasma cortisol and adrenocorticotrophic hormone levels were 17.7 mg/dL and 58 pg/mL, respectively. Her diurnal cortisol rhythm was impaired (plasma cortisol at 23:00, 18.2 mg/dL) and after a 48-hour, 2-mg dexamethasone suppression test, plasma cortisol level was 13.6 mg/dL. The results were consistent with a diagnosis of Cushing's syndrome. We then performed a nocturnal 8-mg dexamethasone suppression test and the suppression of cortisol was not greater than 50% (21.4 to 19.3). A pituitary magnetic resonance imaging revealed a tuberculum sellae meningioma arising from within the sellar region. An operation was chosen in order to examine whether the tumor was an adrenocorticotrophic hormone/corticotropin-releasing hormone-secreting lesion or if there were any microadenomas that could be observed during the operation. Via an extended endoscopic endonasal approach the meningioma was resected successfully. Unexpectedly, our patient complained of nausea and vomiting postoperatively. Plasma cortisol was 2.6 mg/dL and orally administered hydrocortisone treatment was initiated immediately. Histopathological examination revealed that the tumor generally consisted of a pituitary corticotroph adenoma infiltrated by meningioma. Our patient maintained hydrocortisone treatment for 11 months. At the latest visit, she had lost 12 kg, and her hypertension, menstrual irregularity, and weakness of the proximal muscles had disappeared. Her mental and physical wellbeing were restored., Conclusions: To the best of our knowledge, this is the first report of Cushing's disease due to a pituitary corticotroph adenoma adjacent to a meningioma. Even if a high-dose dexamethasone suppression test fails to suppress basal cortisol level, the importance of considering a suprasellar/sellar meningioma a possible component of a collision tumor presenting as adrenocorticotrophic hormone-dependent Cushing's syndrome is highlighted here.
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- 2020
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32. Multiple carcinosarcomas of the esophagus with adeno-carcinomatous components: A case report.
- Author
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Okamoto H, Kikuchi H, Naganuma H, and Kamei T
- Subjects
- Adenocarcinoma pathology, Adenocarcinoma surgery, Biomarkers, Tumor analysis, Biomarkers, Tumor metabolism, Carcinosarcoma pathology, Carcinosarcoma surgery, Esophageal Neoplasms pathology, Esophageal Neoplasms surgery, Esophagectomy methods, Esophagus diagnostic imaging, Esophagus pathology, Esophagus surgery, Humans, Male, Middle Aged, Neoplasms, Complex and Mixed pathology, Neoplasms, Complex and Mixed surgery, Neoplasms, Multiple Primary pathology, Neoplasms, Multiple Primary surgery, Thoracoscopy, Treatment Outcome, Adenocarcinoma diagnosis, Carcinosarcoma diagnosis, Esophageal Neoplasms diagnosis, Neoplasms, Complex and Mixed diagnosis, Neoplasms, Multiple Primary diagnosis
- Abstract
Background: Carcinosarcoma (spindle cell carcinoma) of the esophagus is an extremely rare event; the etiology and origins of this neoplasm have not yet been determined. Epithelial-mesenchymal transition (EMT) has been associated with invasion and metastasis, and may be related to the generation of a stem cell population within this tumor., Case Summary: We present the case of a 61-year-old male with nausea and fever. Upper gastrointestinal endoscopy revealed the presence of type 1 and 0-IIc lesions located 35 cm from the incisors toward the esophago-gastric junction. Thoracoscopic esophagectomy was performed. Macroscopic analysis revealed three polypoid lesions in the abdominal esophagus that accompanied the main lesion in the lower thoracic esophagus and 0-IIc lesions that spread continuously with them. Histologically, the lesions included proliferating spindle cells. Adeno-carcinomatous components were detected in a section near the foot, and squamous cell carcinoma was identified in the mucosa at the base of the tumor. The patient was diagnosed with multiple carcinosarcomas, staged at pT1b (SM3), pN1 (#110, #7), cM0, Stage II (sarcomatous metastasis to the lymph nodes). Spindle cells did not express E-cadherin but were positive for EMT markers, including zinc finger E-box-binding homeobox 1, TWIST, and snail family transcriptional repressor 2. The patient has experienced no recurrence at 5 years and 2 mo after surgery., Conclusion: This report suggests that multiple sarcomatous tumors may be generated from primary squamous cell carcinoma via mechanisms related to EMT., Competing Interests: Conflict-of-interest statement: The authors have no conflicts to declare., (©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.)
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- 2020
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33. Combination of Pembrolizumab With Platinum-containing Chemotherapy for Pleomorphic Carcinoma of the Lung.
- Author
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Okauchi S, Sasatani Y, Shiozawa T, Yamada H, Miyazaki K, Takayashiki N, and Satoh H
- Subjects
- Antibodies, Monoclonal, Humanized administration & dosage, Antineoplastic Agents, Immunological administration & dosage, Antineoplastic Combined Chemotherapy Protocols adverse effects, Humans, Lung Neoplasms diagnosis, Lung Neoplasms mortality, Male, Middle Aged, Neoplasms, Complex and Mixed diagnosis, Neoplasms, Complex and Mixed mortality, Organoplatinum Compounds administration & dosage, Radiography, Thoracic, Tomography, X-Ray Computed, Antineoplastic Combined Chemotherapy Protocols therapeutic use, Lung Neoplasms drug therapy, Neoplasms, Complex and Mixed drug therapy
- Abstract
Background/aim: Pleomorphic carcinoma of the lung is a rare, highly malignant subtype of lung cancer, with a more aggressive clinical course compared with other types of non-small-cell lung cancer (NSCLC). Platinum-containing chemotherapy has been the standard therapy for patients with NSCLC and pembrolizumab is one of the novel and reliable agents for these patients., Case Report: We herein report the case of a 60-year-old man with advanced chemo-naïve pleomorphic carcinoma of the lung who was successfully treated with a combination of pembrolizumab with platinum-containing chemotherapy., Conclusion: In the absence of definitive clinical trials, which are unlikely to be performed due to the rarity of this tumor, our case demonstrates the potential utility of the combination of pembrolizumab with platinum-containing chemotherapy. Our result also suggest that this combination of therapy may be key to the treatment of pleomorphic carcinoma of the lung., (Copyright© 2020, International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.)
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- 2020
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34. Merkel cell carcinoma with divergent differentiation.
- Author
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Gaitskell K, Nassar S, and Ibrahim H
- Subjects
- Aged, 80 and over, Carcinoma, Merkel Cell diagnosis, Female, Humans, Male, Neoplasm Recurrence, Local pathology, Neoplasms, Complex and Mixed diagnosis, Skin Neoplasms diagnosis, Carcinoma, Merkel Cell pathology, Cell Differentiation, Neoplasms, Complex and Mixed pathology, Skin Neoplasms pathology
- Abstract
Merkel cell carcinoma (MCC) is a rare primary neuroendocrine carcinoma of the skin, usually occurring at sun-exposed sites in elderly people. Divergent differentiation in MCC, although rare, has been reported in previous case series. We describe two new cases of MCC with divergent differentiation. Patient 1 was a 96-year-old man with a scalp lesion; on biopsy, the morphology and immunoprofile suggested MCC with divergent squamous differentiation. Patient 2 was an 87-year-old woman with a lesion on her leg, originally reported as squamous cell carcinoma, later showing extensive local recurrence. On review, primary histology showed an MCC with divergent differentiation, most likely trichilemmal carcinoma; the recurrence showed only MCC. These cases illustrate that MCC is capable of divergent differentiation, including squamous and adnexal morphologies. Correct diagnosis is essential for appropriate prognosis and management, as later recurrence or metastases may only show the Merkel cell component., (© 2019 British Association of Dermatologists.)
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- 2020
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35. Thyroid-Like Follicular Renal Cell Carcinoma Arising Within Benign Mixed Epithelial and Stromal Tumor.
- Author
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Tretiakova MS, Kehr EL, Gore JL, and Tykodi SS
- Subjects
- Adenocarcinoma, Follicular pathology, Adult, Carcinoma, Renal Cell diagnosis, Female, Humans, Kidney Neoplasms diagnosis, Neoplasms, Complex and Mixed diagnosis, Neoplasms, Glandular and Epithelial diagnosis, Thyroid Neoplasms pathology, Carcinoma, Renal Cell pathology, Kidney Neoplasms pathology, Neoplasms, Complex and Mixed pathology, Neoplasms, Glandular and Epithelial pathology
- Abstract
Thyroid-like follicular renal cell carcinoma (TLF-RCC) is an extremely rare tumor with less than 40 published reports. These tumors are morphologically distinct with striking resemblance to thyroid follicular tumors, but immunohistochemically different due to lack of thyroglobulin and thyroid transcription factor 1 expression. TLF-RCCs arise in younger patients (mean age = 41 years) with female predominance and in all reported cases were solitary tumors without coexisting epithelial or mesenchymal kidney neoplasms. In this article, we report a case of a 42-year-old woman who presented with an incidental 4-cm solid and cystic left renal mass of the upper pole, which was resected. A detailed imaging assessment, pathologic findings, and immunohistochemical studies revealed a partially encapsulated TLF-RCC arising in a background of mixed epithelial and stromal tumor.
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- 2020
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36. A Low-Grade Myxoid Liposarcoma Arising in a Deep-Seated Conventional Lipoma.
- Author
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Tsagkozis P and Haglund F
- Subjects
- Cyclin-Dependent Kinase 4 genetics, Cytogenetic Analysis, Gene Amplification, Humans, Lipoma genetics, Lipoma pathology, Lipoma surgery, Liposarcoma, Myxoid genetics, Liposarcoma, Myxoid pathology, Liposarcoma, Myxoid surgery, Magnetic Resonance Imaging, Male, Neoplasms, Complex and Mixed genetics, Neoplasms, Complex and Mixed pathology, Neoplasms, Complex and Mixed surgery, Oncogene Proteins, Fusion genetics, Proto-Oncogene Proteins c-mdm2 genetics, RNA-Binding Protein FUS genetics, Subcutaneous Fat diagnostic imaging, Subcutaneous Fat surgery, Thigh, Transcription Factor CHOP genetics, Treatment Outcome, Young Adult, Lipoma diagnosis, Liposarcoma, Myxoid diagnosis, Neoplasms, Complex and Mixed diagnosis, Subcutaneous Fat pathology
- Abstract
Myxoid liposarcomas (MLS) are known to arise de novo and have not been shown to derive from previous benign lesions (lipomas), whereas lipomas occasionally harbor areas of other benign mesenchymal tissue. Rarely, tumors presenting with MLS or round cell liposarcomas together with conventional liposarcoma have been classified as mixed liposarcomas. However, no case of MLS arising in a conventional lipoma has been described. In this article, we report a case of a young male presenting with a deep-seated soft tissue tumor of the posterior part of the thigh. The tumor was removed en bloc. Grossing revealed a small encapsulated myxoid lesion (2.5 cm) within the larger lipomatous tumor (14 cm). Histological examination and cytogenetic analysis revealed a FUS-CHOP positive low-grade MLS arising in a conventional lipoma without histological atypia, FUS-CHOP fusion, or CDK4/MDM2 amplification. While we cannot conclude whether these were collision tumors or an MLS progression from a lipoma, this case highlights the value of careful grossing in the soft tissue setting.
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- 2019
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37. Meningioma-like Tumor of the Skin Revisited: A Distinct CD34+ Dermal Tumor With an Expanded Histologic Spectrum.
- Author
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Monteagudo C, Jiménez AI, Arnandis A, and Barr RJ
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- Adult, Aged, Diagnosis, Differential, Female, Follow-Up Studies, Humans, Immunohistochemistry, Male, Middle Aged, Neoplasms, Complex and Mixed diagnosis, Neoplasms, Complex and Mixed metabolism, Skin Neoplasms diagnosis, Skin Neoplasms metabolism, Antigens, CD34 metabolism, Biomarkers, Tumor metabolism, Neoplasms, Complex and Mixed pathology, Skin Neoplasms pathology
- Abstract
The term meningioma-like tumor of the skin (MLTS) was coined in 1993 to designate a particular whorled spindle cell superficial cutaneous tumor. No additional confirmed cases of this entity have been reported to date. Some authors have speculated that these cases might be cellular neurothekeomas. In order to delineate the histologic spectrum and the immunophenotype of this unusual tumor, we studied 5 cases, 2 previously unreported and the 3 original cases. The immunohistochemical findings of case 5, however, were limited to those from the original study. Clinically, the tumor presented as a reddish papule, plaque, or nodule, located in the extremities or trunk. The patient often referred to a recent growth of a longstanding lesion. Histologically, the characteristic whorled spindle and stellate dendritic cell population, commonly in a perivascular arrangement, and variable myxoid component, were consistently found in all cases. A prominent microvasculature was also a constant finding. The presence of large deciduoid cells was conspicuous in one case. A reticular pattern of multivacuolated cells giving a chordoma-like appearance was evident in another case. Tumor cells were diffusely positive for CD34 in all 4 cases studied, and negative for S-100, EMA, NKI-C3, CD68, and smooth muscle markers. No complete loss of retinoblastoma protein was found. No brachyury immunostaining was found in the case with chordoid features. No EWSR1 or NAB2-STAT6 gene fusions were found. From these findings, we demonstrate that MLTS is a distinct CD34 spindle cell benign dermal tumor, unrelated to cellular neurothekeoma, and exhibiting myxoid, deciduoid, or chordoma-like features.
- Published
- 2019
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38. Retroperitoneal Well-Differentiated Liposarcoma With Uterine-Type Leiomyomatous Differentiation: A First Case Report With Literature Analysis of Soft Tissue Sarcomas With Dual Lipomatous and Low-Grade Smooth Muscle Differentiation.
- Author
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Tran TAN and de La Fuente S
- Subjects
- Adult, Biomarkers, Tumor analysis, Cell Differentiation, Female, Humans, Leiomyoma pathology, Leiomyoma surgery, Liposarcoma pathology, Liposarcoma surgery, Neoplasm Grading, Neoplasms, Complex and Mixed pathology, Neoplasms, Complex and Mixed surgery, Retroperitoneal Neoplasms pathology, Retroperitoneal Neoplasms surgery, Retroperitoneal Space diagnostic imaging, Retroperitoneal Space pathology, Tomography, X-Ray Computed, Treatment Outcome, Leiomyoma diagnosis, Liposarcoma diagnosis, Neoplasms, Complex and Mixed diagnosis, Retroperitoneal Neoplasms diagnosis
- Abstract
The occurrence of smooth muscle differentiation in a liposarcoma is a very uncommon phenomenon, even in dedifferentiated liposarcomas. In dedifferentiated liposarcomas, the leiomyosarcomatous component frequently displays high-grade cytologic features, increased mitotic activity, and tumor necrosis. Even more unusual are rare reported cases of low-grade smooth muscle differentiation in atypical lipomatous tumors/well-differentiated liposarcomas (WDLS). The current case describes a 39-year-old female with a large retroperitoneal WDLS harboring a well-demarcated mass composed of benign-appearing smooth muscle fascicles completely lacking cytologic atypia and mitotic activity. In conjunction with the immunopositivity for estrogen and progesterone receptors, the morphology of this nodule was highly reminiscent of a uterine-type leiomyoma. Of note, the lipomatous component largely displayed a lipoma-like appearance with only rare foci of mildly atypical spindle cell proliferation among the adipocytes and few fibrous septae harboring atypical stromal cells. Immunohistochemical and fluorescence in situ hybridization studies revealed MDM2 gene amplification in both the lipomatous and leiomyoma-like areas, thus confirming the diagnosis of a WDLS with smooth muscle differentiation. A literature review on the subject of sarcomas with dual adipocytic and low-grade smooth muscle differentiation provided sufficient supporting evidence to categorize the tumor as a WDLS with "leiomyomatous" differentiation. Pathologists should be aware of the occurrence of uterine-type leiomyomatous differentiation in retroperitoneal WDLS to avoid potential diagnostic errors.
- Published
- 2019
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39. Thyroid-Like Follicular Carcinoma of the Kidney With Extensive Sarcomatoid Differentiation: A Case Report and Review of the Literature.
- Author
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Jenkins TM, Rosenbaum J, Zhang PJ, Schwartz LE, Nayak A, Cooper K, Tickoo SK, and Lal P
- Subjects
- Adenocarcinoma, Follicular pathology, Adenocarcinoma, Follicular secondary, Biomarkers, Tumor analysis, Biomarkers, Tumor genetics, Carcinoma, Renal Cell pathology, Carcinoma, Renal Cell secondary, Diagnosis, Differential, Fatal Outcome, Female, Humans, Kidney pathology, Kidney surgery, Kidney Neoplasms pathology, Kidney Neoplasms secondary, Middle Aged, Neoplasms, Complex and Mixed pathology, Nephrectomy, Sarcoma pathology, Thyroid Neoplasms diagnosis, Thyroid Neoplasms pathology, Adenocarcinoma, Follicular diagnosis, Carcinoma, Renal Cell diagnosis, Kidney Neoplasms diagnosis, Neoplasms, Complex and Mixed diagnosis, Sarcoma diagnosis
- Abstract
Thyroid-like follicular carcinoma of the kidney (TLFCK) is an extremely rare primary renal malignancy that typically has an indolent course and good prognosis. Histologically, this tumor mimics follicular carcinoma of the thyroid; however, typical thyroid markers are negative. There are fewer than 40 cases reported in the literature, and thus, the prognosis and course of disease is not well understood. Sarcomatoid differentiation has never been reported in a case of TLFCK. We present a case of a 48-year-old woman with an aggressive TLFCK with extensive sarcomatoid differentiation and metastatic disease at presentation. We performed targeted next-generation sequencing of both the thyroid-like component and the poorly differentiated sarcomatoid component using our solid tumor panel to evaluate for any disease-associated mutations and to better understand the molecular profile of these tumors.
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- 2019
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40. Mixed Adenocarcinomatous and Neuroendocrine Tumor of the Urinary Bladder With Concomitant Carcinoma In Situ: A Case Report With a Comprehensive Immunohistochemical Analysis and Review of the Literature.
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Tränkenschuh W, Biesdorf AS, Papadimas N, Samara S, Hefty R, and Stahl PR
- Subjects
- Adenocarcinoma pathology, Adenocarcinoma surgery, Aged, Biomarkers, Tumor analysis, Carcinoma in Situ pathology, Carcinoma in Situ surgery, Carcinoma, Neuroendocrine pathology, Carcinoma, Neuroendocrine surgery, Cystectomy, Humans, Immunohistochemistry, Male, Neoplasm Invasiveness pathology, Neoplasms, Complex and Mixed pathology, Neoplasms, Complex and Mixed surgery, Urinary Bladder pathology, Urinary Bladder surgery, Urinary Bladder Neoplasms pathology, Urinary Bladder Neoplasms surgery, Urothelium pathology, Urothelium surgery, Adenocarcinoma diagnosis, Carcinoma in Situ diagnosis, Carcinoma, Neuroendocrine diagnosis, Neoplasms, Complex and Mixed diagnosis, Urinary Bladder Neoplasms diagnosis
- Abstract
Mixed adenoneuroendocrine carcinomas are rare and usually occur in the gastrointestinal tract. Although there have been several investigations regarding their developmental mechanism, the molecular origin of these tumors remains unclear. In this article, we present an exceedingly rare case of a mixed tumor of the urinary bladder with an adenocarcinomatous and a neuroendocrine component and a concomitant urothelial carcinoma in situ (CIS). Due to this extraordinary combination of tumor components, our goal was to extensively examine the 3 tumor components with regard to a representable common origin. Therefore, a comprehensive immunohistochemical analysis and review of the literature was performed. Besides expected outcome, our examination also revealed surprising staining results. Urothelial CIS, like the adenocarcinomatous component, showed strong staining for CDX2. In addition, parts of the adenocarcinoma were positive for synaptophysin like the neuroendocrine tumor component. All 3 components showed a significant overexpression of p53 and a moderate to strong membranous and cytoplasmatic staining for β-catenin. To our knowledge, we are the first to describe a case of a mixed tumor of the urinary bladder with an adenocarcinomatous and a neuroendocrine component and a concomitant CIS. The components share striking molecular features that argue for a common clonal origin and a development of the invasive tumor via the urothelial precursor lesion.
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- 2019
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41. Epithelioid Hemangioendothelioma Arising Within Mediastinal Myelolipoma: A WWTR1-Driven Composite Neoplasm.
- Author
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Diaz-Perez JA, Velez-Torres J, Iakymenko O, Villamizar N, and Rosenberg AE
- Subjects
- Calcium-Binding Proteins genetics, Calcium-Binding Proteins metabolism, Female, Hemangioendothelioma, Epithelioid genetics, Hemangioendothelioma, Epithelioid pathology, Humans, Mediastinal Neoplasms genetics, Mediastinal Neoplasms pathology, Mediastinum pathology, Middle Aged, Myelolipoma genetics, Myelolipoma pathology, Neoplasms, Complex and Mixed genetics, Neoplasms, Complex and Mixed pathology, Oncogene Proteins, Fusion metabolism, Trans-Activators genetics, Trans-Activators metabolism, Transcriptional Coactivator with PDZ-Binding Motif Proteins, Hemangioendothelioma, Epithelioid diagnosis, Mediastinal Neoplasms diagnosis, Myelolipoma diagnosis, Neoplasms, Complex and Mixed diagnosis, Oncogene Proteins, Fusion genetics
- Abstract
In this article, we describe a case of conventional epithelioid hemangioendothelioma (EHE) arising within an extra-adrenal myelolipoma. This composite neoplasm arose in the mediastinum of a 51-year-old female. The tumor was composed of a large myelolipoma that contained nodules of EHE consisting of CD31-positive epithelioid endothelial cells that grew in solid cords and were enmeshed in a basophilic hyalinized stroma. Both EHE and myelolipoma are characterized genetically by alterations of WWTR1. We demonstrated the expression of CAMTA-1 chimeric protein by immunohistochemistry both in the neoplastic endothelial cells of EHE and some of the endothelial cells lining the blood vessels in the myelolipoma. To the best of our knowledge, this is the first report of a malignant vascular neoplasm arising in association with myelolipoma.
- Published
- 2019
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42. Acute liver injury leading to death in the setting of brentuximab vedotin monotherapy.
- Author
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Neeman J, Friedman A, and McKendrick J
- Subjects
- Aged, Biopsy, Chemical and Drug Induced Liver Injury diagnosis, Fatal Outcome, Hodgkin Disease diagnosis, Humans, Liver diagnostic imaging, Liver drug effects, Liver pathology, Lymphoma, Follicular diagnosis, Male, Neoplasm Recurrence, Local diagnosis, Neoplasms, Complex and Mixed diagnosis, Neutropenia etiology, Severity of Illness Index, Ultrasonography, Brentuximab Vedotin adverse effects, Chemical and Drug Induced Liver Injury etiology, Hodgkin Disease drug therapy, Lymphoma, Follicular drug therapy, Neoplasm Recurrence, Local drug therapy, Neoplasms, Complex and Mixed drug therapy
- Abstract
A 67-year-old man with an 11-year history of composite lymphoma was admitted with fevers in the context of neutropenia and acute liver injury, 4 months after the commencement of single-agent brentuximab vedotin. Fevers resolved with intravenous antibiotics, however, his liver function tests remained abnormal and he continued to be deeply jaundiced over the course of his 3-week illness. A liver screen failed to indicate a cause for his liver function test abnormalities and two separate liver biopsies were suggestive of drug-induced liver injury. There was no evidence on biopsy of lymphoma. After consultation with two hepatologists, trials of steroids and ursodeoxycholic acid were unsuccessful. Twenty-five days into admission, he became septic with a normal peripheral blood count and deteriorated rapidly. After discussion with the family, he was deemed not to be for further escalation of care, and he died within several hours. This report summarizes the evidence in relation to hepatotoxicity of brentuximab vedotin.
- Published
- 2019
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43. Luteinized Fibrothecoma.
- Author
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Haghayeghi K, Hansen K, and Quddus MR
- Subjects
- Female, Humans, Hysterectomy, Lutein metabolism, Middle Aged, Neoplasms, Complex and Mixed pathology, Neoplasms, Complex and Mixed surgery, Ovarian Neoplasms pathology, Ovarian Neoplasms surgery, Salpingo-oophorectomy, Thecoma pathology, Thecoma surgery, Fibroma diagnosis, Neoplasms, Complex and Mixed diagnosis, Ovarian Neoplasms diagnosis, Ovary pathology, Thecoma diagnosis
- Published
- 2019
- Full Text
- View/download PDF
44. A case of large cell neuroendocrine carcinoma exhibiting rhabdoid features in the esophagogastric junction.
- Author
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Ichimata S, Aoyagi D, Takehana T, Uehara T, and Shiozawa S
- Subjects
- Aged, 80 and over, Carcinoma, Neuroendocrine diagnosis, Esophageal Neoplasms diagnosis, Humans, Male, Neoplasms, Complex and Mixed diagnosis, Rhabdoid Tumor diagnosis, Carcinoma, Neuroendocrine pathology, Esophageal Neoplasms pathology, Esophagogastric Junction pathology, Neoplasms, Complex and Mixed pathology, Rhabdoid Tumor pathology
- Abstract
We report a case of large cell neuroendocrine carcinoma with rhabdoid features in the esophagogastric junction. An 81-year-old man presented to Saku Central Hospital Advanced Care Center with a tumor in the esophagogastric junction. During upper gastrointestinal endoscopy, an ulcerative tumor, measuring 4 × 3 cm in diameter, was observed. Computed tomography revealed lymph node metastasis, but no metastasis to other organs was observed. A thoracoscopic subtotal esophagectomy was performed. Histopathologically, anaplastic large cells exhibited a solid growth pattern with focal and geographic necrosis. Approximately half of the tumor cells exhibited large nuclei with conspicuous nucleoli; an eosinophilic "rhabdoid" cytoplasmic inclusion; and a nucleus displaced eccentrically by the cytoplasmic inclusion body. Immunohistochemically, tumor cells, including rhabdoid cells, were focally positive for pan-cytokeratin and diffusely positive for vimentin and synaptophysin. Additionally, electron microscopy identified dense-core granules in the tumor cells. Therefore, a diagnosis of large cell neuroendocrine carcinoma with rhabdoid features was made. A few cases of esophageal neuroendocrine tumors with rhabdoid features have been reported in the lung and pancreas; however, this is the first report of large cell neuroendocrine carcinoma with rhabdoid features in the esophagogastric junction., (© 2019 Japanese Society of Pathology and John Wiley & Sons Australia, Ltd.)
- Published
- 2019
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45. Blaschkoid distribution of composite syringocystadenoma papilliferum and tubular apocrine adenoma without naevus sebaceous.
- Author
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Khullar G, Sharma S, Ramesh V, and Mann KK
- Subjects
- Apocrine Glands pathology, Facial Neoplasms pathology, Humans, Male, Neoplasms, Complex and Mixed pathology, Sweat Gland Neoplasms pathology, Young Adult, Facial Neoplasms diagnosis, Neoplasms, Complex and Mixed diagnosis, Sweat Gland Neoplasms diagnosis, Tubular Sweat Gland Adenomas diagnosis
- Published
- 2019
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- View/download PDF
46. Primary Renal Hybrid Low-grade Fibromyxoid Sarcoma-Sclerosing Epithelioid Fibrosarcoma: An Unusual Pediatric Case With EWSR1-CREB3L1 Fusion.
- Author
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Mok Y, Pang YH, Sanjeev JS, Kuick CH, and Chang KT
- Subjects
- Child, Fatal Outcome, Female, Fibrosarcoma genetics, Fibrosarcoma pathology, Humans, Neoplasms, Complex and Mixed genetics, Neoplasms, Complex and Mixed pathology, Biomarkers, Tumor genetics, Cyclic AMP Response Element-Binding Protein genetics, Fibrosarcoma diagnosis, Gene Fusion, Neoplasms, Complex and Mixed diagnosis, Nerve Tissue Proteins genetics, Oncogene Proteins, Fusion genetics, RNA-Binding Protein EWS genetics
- Abstract
Low-grade fibromyxoid sarcoma (LGFMS) and sclerosing epithelioid fibrosarcoma (SEF) are rare tumors with distinct sets of morphological features, both characterized by MUC4 immunoreactivity. Tumors exhibiting features of both entities are considered hybrid LGFMS-SEF lesions. While the majority of LGFMS cases are characterized by FUS-CREB3L2 gene fusions, most cases of pure SEF show EWSR1 gene rearrangements. In the largest study of hybrid LGFMS-SEF tumors to date, all cases exhibited FUS rearrangements, a similar genetic profile to LGFMS. We herein describe the clinicopathological features and genetic findings of a case of primary renal hybrid LGFMS-SEF occurring in a 10-year-old child, with disseminated metastases. Fusion gene detection using a next-generation sequencing-based anchored multiplex PCR technique (Archer FusionPlex Sarcoma Panel) was performed on both the primary renal tumor that showed the morphology of a LGFMS, and a cervical metastasis that showed the morphology of SEF. An EWSR1-CREB3L1 gene fusion occurring between exon 11 of EWSR1 and exon 6 of CREB3L1 was present in both the LGFMS and SEF components. This unusual case provides evidence that a subset of hybrid LGFMS-SEF harbor EWSR1-CREB3L1 gene fusions. In this case, these features were associated with an aggressive clinical course, with disease-associated mortality occurring within 12 months of diagnosis.
- Published
- 2018
- Full Text
- View/download PDF
47. TLE1 Expression in Malignant Rhabdoid Tumor and Atypical Teratoid/Rhabdoid Tumor.
- Author
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Duncan VE, Wicker JA, Kelly DR, and Li R
- Subjects
- Adolescent, Child, Child, Preschool, Co-Repressor Proteins, Diagnosis, Differential, Female, Humans, Infant, Male, Neoplasms, Complex and Mixed metabolism, Rhabdoid Tumor metabolism, Soft Tissue Neoplasms metabolism, Teratoma metabolism, Biomarkers, Tumor metabolism, Neoplasms, Complex and Mixed diagnosis, Repressor Proteins metabolism, Rhabdoid Tumor diagnosis, Soft Tissue Neoplasms diagnosis, Teratoma diagnosis
- Abstract
Malignant rhabdoid tumors (MRT; atypical teratoid/rhabdoid tumor [ATRT] in the central nervous system) are aggressive tumors in infants and children which can overlap with other sarcomas, such as synovial sarcoma (SS). The gold standard for SS diagnosis is characterization of the t(X;18) chromosomal translocation. However, stratification of cases for molecular analysis is not always straightforward or feasible. Recent literature suggests transducer-like enhancer of split 1 (TLE1) protein expression may distinguish SS from certain histologic mimics; however, this has not been investigated in MRT and ATRT. We stained whole-tissue sections of 18 archived cases of MRT and ATRT with TLE1. Nuclear expression was scored using a 4-tiered (0, 1+, 2+, and 3+) scale describing staining intensity, extent, or combination of both. The majority of MRT and ATRT cases showed some TLE1 immunoreactivity (n = 16; 89% for ≥1 + staining); 14 (78%) of total cases showed ≥2 + positivity using any of the 3 scoring systems. Over half (n = 10; 56%) of cases showed ≥2 + staining; 4 (22%) cases showed 3 + strong and diffuse TLE1 staining measured by all scoring systems in agreement. Although still of potential use, we urge caution in the interpretation of TLE1 when the differential diagnosis includes both SS and MRT or ATRT.
- Published
- 2018
- Full Text
- View/download PDF
48. What is this patient's unusual skin lesion?
- Author
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Saikaly LE, Saikaly SK, and Khachemoune A
- Subjects
- Aged, Carcinoma, Basosquamous pathology, Female, Humans, Neoplasms, Complex and Mixed pathology, Skin Neoplasms pathology, Carcinoma, Basosquamous diagnosis, Neoplasms, Complex and Mixed diagnosis, Skin Neoplasms diagnosis
- Published
- 2018
- Full Text
- View/download PDF
49. Mixed Tumor, Eccrine Type: So What If it's Vulval!
- Author
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Makhija M, Gorji M, and Kube M
- Subjects
- Aged, Female, Humans, Middle Aged, Diagnosis, Differential, Eccrine Glands pathology, Scalp pathology, Vulva pathology, Breast Neoplasms pathology, Head and Neck Neoplasms diagnosis, Head and Neck Neoplasms pathology, Neoplasms, Complex and Mixed diagnosis, Neoplasms, Complex and Mixed pathology, Skin Neoplasms diagnosis, Skin Neoplasms pathology, Vulvar Neoplasms diagnosis, Vulvar Neoplasms pathology
- Published
- 2018
- Full Text
- View/download PDF
50. Testicular Cancer in Monozygotic Twin Brothers with Urticaria Pigmentosa.
- Author
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Péčová T, Vorčáková K, Žaliová M, Burjanivová T, Malicherová B, Plank L, Trka J, Péčová K, Adamicová K, Péč M, and Pec J
- Subjects
- Adult, Chemotherapy, Adjuvant, DNA Mutational Analysis, Genetic Predisposition to Disease, Humans, Male, Neoplasms, Complex and Mixed diagnosis, Neoplasms, Complex and Mixed therapy, Neoplasms, Germ Cell and Embryonal diagnosis, Neoplasms, Germ Cell and Embryonal therapy, Orchiectomy, Phenotype, Testicular Neoplasms diagnosis, Testicular Neoplasms therapy, Urticaria Pigmentosa diagnosis, Mutation, Neoplasms, Complex and Mixed genetics, Neoplasms, Germ Cell and Embryonal genetics, Proto-Oncogene Proteins c-kit genetics, Testicular Neoplasms genetics, Twins, Monozygotic genetics, Urticaria Pigmentosa genetics
- Published
- 2018
- Full Text
- View/download PDF
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