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Acta Obstetricia Et Gynecologica... Mar 2014To evaluate ultrasonography and magnetic resonance imaging (MRI) performance in differentiating benign leiomyomas from malignant mesenchymal or mixed tumors (MMT) and...
OBJECTIVE
To evaluate ultrasonography and magnetic resonance imaging (MRI) performance in differentiating benign leiomyomas from malignant mesenchymal or mixed tumors (MMT) and smooth muscle tumors of uncertain malignant potential of the uterus (STUMP).
DESIGN
Retrospective cohort study.
SETTING
University hospital, France.
POPULATION
One hundred and eight women who underwent imaging before surgery for uterine mesenchymal tumor (85 with benign leiomyomas and 23 with MMT/STUMP).
METHODS
The ultrasonography reports were reviewed. Conventional, perfusion and diffusion MRI were blindly analyzed. Recursive partitioning analysis (RPA) was performed to construct diagnostic flowcharts.
MAIN OUTCOME MEASURES
Accuracy of a diagnostic flowchart.
RESULTS
At ultrasonography, single tumor, non-myometrial origin, absence of acoustic shadowing, thickened endometrium and ascites were associated with MMT/STUMP (p = 0.001, p < 0.001, p = 0.03, p < 0.0001 and p = 0.03, respectively). For conventional MRI, single tumor, non-myometrial origin, large tumor, poorly defined margins, thickened endometrium, peritoneal implants, intermediate or high signal intensity in T1 or T2 sequences, heterogeneous T1 signal, cystic alteration of the tumor and heterogeneity of the tumor's enhancement were significantly associated with MMT/STUMP. Perfusion weighted imaging and perfusion curve types were not discriminant. For diffusion weighted imaging, a high signal intensity at b = 1000 s/mm² was associated with MMT/STUMP (p < 0.001). RPA resulted in a model that ultimately included age, number of tumors and the aspect of the endometrium (both evaluated by MRI) and that had an area under the curve of 0.95.
CONCLUSIONS
Simple criteria, such as single tumor, non-myometrial tumor, abnormal endometrium and age, should question the diagnosis of benign leiomyoma. MRI enhanced the sensitivity of detecting MMT/STUMP.
Topics: Adult; Area Under Curve; Cohort Studies; Diagnosis, Differential; Female; Humans; Leiomyoma; Magnetic Resonance Imaging; Mesenchymoma; Middle Aged; Multivariate Analysis; Retrospective Studies; Smooth Muscle Tumor; Ultrasonography; Uterine Neoplasms
PubMed: 24372487
DOI: 10.1111/aogs.12325 -
BMJ Case Reports Feb 2022Lipoblastoma is a rare benign mesenchymal tumour derived from embryonic white fat tissue. Lipoblastoma generally occurs in children less than 3 years of age, and fewer...
Lipoblastoma is a rare benign mesenchymal tumour derived from embryonic white fat tissue. Lipoblastoma generally occurs in children less than 3 years of age, and fewer than 200 cases have been reported in the English literature. There are hardly a dozen reports describing intrathoracic and thoracic involvement. We report a case of a 7-year-old boy who presented with a slowly growing right thoracic wall mass for a duration of 1 year. Radiological investigations (ultrasonography and contrast-enhanced CT of the chest showed the presence of a fat-containing, low density extrapulmonary soft tissue mass) could not confirm the diagnosis, and repeat biopsies also were not conclusive. The mass was excised and histopathology confirmed it as lipoblastoma. A review of literature pertaining to the clinical presentation, radiological features and histopathology of this rare condition has been discussed.
Topics: Child; Humans; Infant; Lipoblastoma; Lipoma; Male; Mesenchymoma; Radiology; Thoracic Wall; Ultrasonography
PubMed: 35131775
DOI: 10.1136/bcr-2021-245345 -
World Journal of Gastroenterology Feb 2007To study the endoscopic, pathological and immunohistochemical features of esophageal mesenchymal tumors.
AIM
To study the endoscopic, pathological and immunohistochemical features of esophageal mesenchymal tumors.
METHODS
Twenty-nine patients diagnosed as esophageal mesenchymal tumors by electronic endoscopy and endoscopic ultrasound (EUS) were observed under light microscopes, and all tissues were stained by the immunohistochemical method. The expression of CD117, CD34, SMA and desmin were measured by staining intensity of cells and positive cell ratios.
RESULTS
Endoscopically, esophageal gastrointestinal stromal tumors (GISTs) and leiomyomas (LMs) had similar appearances, showing submucosal protuberant lesions. They all showed low echo images originated from the muscularis propria or muscularis mucosa on EUS. Endoscopy and EUS could not exactly differentiate esophageal GISTs from LMs. Microscopically, there were two kinds of cells: spindle cell type and epitheloid cell type in esophageal GISTs. Leiomyomas and leiomyosarcomas were only of spindle cell type. One malignancy was found in five cases of esophageal GISTs, and one malignancy in 24 cases of leiomyomas and leiomyosarcomas. Using Fisheros exact method, the differences of malignant lesion proportion were not significant between esophageal LMs and GISTs, 1/5 vs 1/24 (P > 0.05). All cases of esophageal GISTs were positive for CD117, and 3 cases were also positive for CD34. The 24 cases of leiomyomas and leiomyosarcomas were all negative for CD117 and CD34. The differences of positive rates of CD117 and CD34 were significant between esophageal GISTs and LMs, 5/5 vs 0/24, 3/5 vs 0/24 (P < 0.005). All leiomyomas and leiomyosarcomas were positive for SMA, and desmin. Among 5 cases of esophageal GISTs, 2 cases were SMA positive, and 1 case was desmin positive. The differences in positive rates and expression intensity of SMA and desmin were significant between esophageal LMs and GISTs, 24/24 vs 2/5, 24/24 vs 1/5 (P < 0.005).
CONCLUSION
The most common esophageal mesenchymal tumors are leiomyomas, and esophageal GISTs are less common. Most of esophageal LMs and GISTs are benign. Endoscopy and EUS are the effective methods to diagnose esophageal mesenchymal tumors and they can provide useful information for the treatment of these tumors. However, they cannot exactly differentiate esophageal GISTs from LMs. Pathological, especially immunohistochemical features are useful to differentiate GISTs from leiomyomas.
Topics: Actins; Adult; Aged; Antigens, CD34; Desmin; Endoscopy, Gastrointestinal; Esophageal Neoplasms; Female; Humans; Immunohistochemistry; Leiomyoma; Male; Mesenchymoma; Middle Aged; Proto-Oncogene Proteins c-kit
PubMed: 17278201
DOI: 10.3748/wjg.v13.i5.768 -
Asian Pacific Journal of Cancer... 2015To investigate the correlation between extracellular matrix protein-1 (ECM1) and the growth, metastasis and angiogenesis of laryngeal carcinoma. (Comparative Study)
Comparative Study
OBJECTIVE
To investigate the correlation between extracellular matrix protein-1 (ECM1) and the growth, metastasis and angiogenesis of laryngeal carcinoma.
MATERIALS AND METHODS
Forty-five samples with laryngeal benign and malignant tumors confirmed by pathology in Laiwu City People's Hospital from March 2006 to March 2011 were collected, in which there were 29 cases with laryngeal carcinoma and 16 with benign tumors. The expression of ECM1 and factor VIII-related antigens in patients with laryngeal carcinoma and those with benign tumors was respectively detected using immunohistochemical method, and the correlation between ECM1 staining grade and microvessel density (MVD) was analyzed.
RESULTS
In laryngeal carcinoma tissue, ECM1 was mainly expressed in cytoplasm, less in cytomembrane or intercellular substance. With abundant expression in the tissue of laryngeal benign tumors (benign mesenchymoma and hemangioma), ECM1 was primarily expressed in the connective tissue, which was different from the expression in laryngeal carcinoma tissue. The proportion of positive ECM1 staining (++) in patients with laryngeal carcinoma was dramatically higher than those with benign tumors (p<0.05), and that of strongly-positive ECM1 staining (+++) slightly higher. The results of Spearman nonparametric correlation analysis revealed that ECM1 staining grade in laryngeal carcinoma tissue had a significantly-positive correlation with MVD (r=0.866, p=0.000).
CONCLUSIONS
ECM1 expression in laryngeal carcinoma is closely associated with tumor cell growth, metastasis and angiogenesis, which can be considered as an effective predictor in the occurrence and postoperative recurrence of laryngeal carcinoma.
Topics: Adolescent; Adult; Aged; Biomarkers, Tumor; Carcinoma, Squamous Cell; Case-Control Studies; Child; Extracellular Matrix Proteins; Female; Follow-Up Studies; Humans; Immunoenzyme Techniques; Laryngeal Neoplasms; Larynx; Lymphatic Metastasis; Male; Microvessels; Middle Aged; Neoplasm Invasiveness; Neoplasm Staging; Neovascularization, Pathologic; Prognosis; Young Adult
PubMed: 25824756
DOI: 10.7314/apjcp.2015.16.6.2313 -
microRNAs in uterine sarcomas and mixed epithelial-mesenchymal uterine tumors: a preliminary report.Tumour Biology : the Journal of the... Aug 2013Uterine sarcomas and mixed epithelial-mesenchymal uterine tumors are a heterogeneous group of rare tumors for which there are very few diagnostic markers available. As...
Uterine sarcomas and mixed epithelial-mesenchymal uterine tumors are a heterogeneous group of rare tumors for which there are very few diagnostic markers available. As aberrant microRNA (miRNA) expression patterns represent putative diagnostic cancer markers, we aimed to identify miRNA expression profiles of the major uterine sarcoma subtypes and mixed epithelial-mesenchymal tumors of the uterus. Eighty-eight miRNAs were assessed by quantitative RT-PCR in cancerous and non-cancerous tissue samples collected from 29 patients with endometrial sarcoma, leiomyosarcoma, and mixed epithelial-mesenchymal tumors. Tumor and control samples significantly (P < 0.05) differed in the expression of miR-23b, miR-1, let-7f, and let-7c in endometrial sarcomas, and miR-1, let-7c, miR-133b, let-7b, miR-143, let-7a, let-7d, let-7e, let-7g, miR-222, let-7i, and miR-214 in mixed epithelial-mesenchymal tumors. All the significantly changed miRNAs were down-regulated in the malignant tissues as compared to their normal counterparts. This may suggest their tumor suppressor role in these malignancies. No statistically significant changes in miRNA expression levels were found between leiomyosarcoma tumors and controls. The identified miRNAs warrant further studies as valuable candidate markers for the differential diagnosis of uterine sarcomas from benign uterine lesions and between uterine sarcoma subtypes.
Topics: Adult; Aged; Biomarkers, Tumor; Cell Line, Tumor; Endometrial Neoplasms; Female; Gene Expression Profiling; Gene Expression Regulation, Neoplastic; Humans; Leiomyosarcoma; Mesenchymoma; MicroRNAs; Middle Aged; Neoplasms, Glandular and Epithelial; Sarcoma; Uterine Neoplasms
PubMed: 23558962
DOI: 10.1007/s13277-013-0748-5 -
Medical Principles and Practice :... 2002To study the clinicopathological and immunohistochemical features of gastrointestinal stromal tumors (GISTs) in Kuwait.
OBJECTIVES
To study the clinicopathological and immunohistochemical features of gastrointestinal stromal tumors (GISTs) in Kuwait.
MATERIALS AND METHODS
Hematoxylin- and eosin-stained sections of primary gastrointestinal mesenchymal tumors were reviewed. Immunohistochemical staining was performed using a panel of antibodies to determine muscle and neural differentiation, the incidence of CD117 and CD34 expression, as well as bcl-2 and cytokeratin expression. Each stain was interpreted as negative or positive. The staining intensity of positive cases was graded as weak, moderate or strong.
RESULTS
The age range was 25-80 with an average age of 54 and a male:female ratio of 3:2. The stomach was the most common site for these tumors, followed by the small intestine. Histologically, 46% were classified as malignant and 54% were benign. Most of the malignant tumors occurred in males, particularly in the stomach or small intestine. There was no significant difference in patient age between malignant and benign tumors. The most sensitive markers were muscle-specific actin for muscle differentiation and glial fibrillary acidic protein for neural differentiation. CD117 expression was seen in 81% and CD34 in 54% of all tumors.
CONCLUSIONS
The results of this study show that the stomach is the most common site for these tumors, that malignant tumors are more likely to occur in the small intestine than in the stomach, and that there is no difference between benign and malignant tumors with regard to age. Our findings are comparable to those of other workers, although our male:female ratio was slightly higher.
Topics: Actins; Adult; Aged; Aged, 80 and over; Antigens, CD; Antigens, CD34; Female; Gastrointestinal Neoplasms; Glial Fibrillary Acidic Protein; Humans; Immunohistochemistry; Kuwait; Male; Mesenchymoma; Middle Aged; Neoplasm Proteins
PubMed: 12123110
DOI: 10.1159/000058014 -
The American Journal of Pathology Nov 1990For a long time, CD13 molecules have been considered to be restricted to myeloid cells and related neoplasms. Meanwhile, however, expression of CD13 has also been...
For a long time, CD13 molecules have been considered to be restricted to myeloid cells and related neoplasms. Meanwhile, however, expression of CD13 has also been detected in some hepatocellular, gallbladder, renal, and lung carcinomas, and even in some fibrosarcomas and malignant melanomas. In this study, expression of CD13 antigen was immunohistochemically examined in non-neoplastic mesenchymal cells, along with 33 benign and 83 malignant mesenchymal tumors (MET) using CD13 monoclonal antibodies (MAb) My7, U71, WM-15, and MoU48. In non-neoplastic mesenchymal cells, expression of CD13 was restricted to perivascular fibrocytes/blasts, tissue histiocytes, osteoclasts, and to the perineurium of peripheral nerve trunks. Under neoplastic conditions, CD13 was detectable in some tumors of smooth muscle, fibrous, fibrohistiocytic, synovial, osteogenic, and peripheral nerve sheath origin, and even in some tumors of adipose tissue. Tumors of striated muscle origin, of autonomic ganglia, and of cartilage-forming tissues were CD13-negative throughout. Thus in most but not all tumors studied the pattern of expression of CD13 mirrors the situation found in their cells of origin. These findings enrich the data on expression of leukocyte differentiation antigens in extra-hematopoietic tissues. Expression of CD13, which meanwhile is known to be identical to aminopeptidase N, an important peptide-cleaving enzyme, in only some MET might reflect a special functional state of these neoplasms.
Topics: Aminopeptidases; Antibodies, Monoclonal; Antigens, CD; Antigens, Differentiation, Myelomonocytic; Biomarkers, Tumor; CD13 Antigens; Humans; Immunohistochemistry; Mesenchymoma; Reference Values
PubMed: 1978569
DOI: No ID Found -
Head and Neck Pathology Sep 2015Ectomesenchymal chondromyxoid tumors (ECT) are rare, benign, intraoral mesenchymal soft tissue tumors that can be diagnostically challenging. In this study the... (Review)
Review
Ectomesenchymal chondromyxoid tumors (ECT) are rare, benign, intraoral mesenchymal soft tissue tumors that can be diagnostically challenging. In this study the demographic, clinical, histopathologic, and immunohistochemical features of seven ECTs are examined. The differential diagnosis of this rare neoplasm is discussed and the literature is reviewed.
Topics: Adolescent; Adult; Biomarkers, Tumor; Child; Diagnosis, Differential; Female; Humans; Immunohistochemistry; Male; Mesenchymoma; Middle Aged; Soft Tissue Neoplasms; Tongue Neoplasms; Young Adult
PubMed: 25404177
DOI: 10.1007/s12105-014-0578-9 -
Head and Neck Pathology Sep 2008Solitary fibrous tumour (SFT) is a rare tumour principally found in adults in the pleural cavity. Extrapleural occurrences are rare. Two cases of SFT of the thyroid... (Review)
Review
Solitary fibrous tumour (SFT) is a rare tumour principally found in adults in the pleural cavity. Extrapleural occurrences are rare. Two cases of SFT of the thyroid gland are described in this paper showing their distinctive microscopical architecture, namely "patternless growth pattern". It is characterized by a bland spindle-cell proliferation alternating hyper- and hypo-cellular areas, keloid-like hyalinization and a focal hemangiopericytoma-like vascular pattern. Tumour cells revealed a diffuse strong positivity for CD34, CD99, bcl-2 and Vimentin, but negativity for Desmin, EMA, AE1/AE3, SMA, S-100 and CD31 antibodies. The differential diagnosis of thyroid SFT includes different types of spindle cell proliferation, benign and malignant mesenchymal tumours, medullary thyroid carcinoma, fasciitis-like papillary carcinoma, and undifferentiated (anaplastic) carcinoma. However, the morphologic and immunohistochemical findings of SFT are so characteristic that this diagnosis seldom represent a difficulty.
Topics: Adult; Biomarkers, Tumor; Carcinoma; Carcinoma, Medullary; Carcinoma, Papillary; Diagnosis, Differential; Female; Humans; Immunohistochemistry; Male; Mesenchymoma; Middle Aged; Solitary Fibrous Tumors; Thyroid Neoplasms
PubMed: 20614321
DOI: 10.1007/s12105-008-0070-5 -
Medicine Apr 2017Phosphaturic mesenchymal tumor (PMT) is a new tumor entity of soft tissue and bone tumor recently accepted by the World Health Organization, which typically causes the...
RATIONALE
Phosphaturic mesenchymal tumor (PMT) is a new tumor entity of soft tissue and bone tumor recently accepted by the World Health Organization, which typically causes the paraneoplastic syndrome of tumor-induced osteomalacia (TIO). The majority of PMTs follow a benign clinical course and local recurrence occurs in < 10% of cases, malignant PMTs with distant organ metastasis are extremely uncommon.
PATIENT CONCERNS
We reported a 41-year-old woman who was diagnosed with PMT 10 years ago with a repeated recurrence and pulmonary metastasis.
DIAGNOSES
Based on clinical manifestations, MRI scan, serum biochemical indicators evaluation, followed by histopathological examination, the patient was diagnosed as malignant PMT with pulmonary metastasis.
INTERVENTIONS
The patient was treated with calcium, phosphorus, and vitamin D after surgical resection and measured the serum ion concentrations every 3 months.
OUTCOMES
The patient had a favorable outcome for 10 months without recurrence.
LESSONS
PMTs lack of characteristic histological morphology, some recurrence cases may appear benign morphologically; the malignant PMTs are easily overlooked. Patients with PMT should be carefully evaluated and monitored, in order to early identify its malignant potential.
Topics: Adult; Bone Neoplasms; Diagnosis, Differential; Female; Humans; Hypophosphatemia; Liver Neoplasms; Lung Neoplasms; Mesenchymoma; Neoplasms, Connective Tissue; Osteomalacia; Paraneoplastic Syndromes
PubMed: 28445300
DOI: 10.1097/MD.0000000000006750