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Turkish Journal of Medical Sciences Feb 2020To define the cytomorphologic findings leading to difficulties in diagnosis of Warthin tumors (WTs).
BACKGROUND/AIM
To define the cytomorphologic findings leading to difficulties in diagnosis of Warthin tumors (WTs).
MATERIALS AND METHODS
Forty-eight histopathologically diagnosed WT patients who had fine needle aspiration cytology preoperatively were reevaluated for defining the presence or absence of lymphocytes, oncocytic cell layer, oncocytic cell papillae, granular debris background, mucoid background, macrophages, polymorphonuclear cells, mast cells, squamous-like cells, atypical vacuolated cytoplasmic cells, and giant cells.
RESULTS
Forty-seven tumors were in the parotid gland and one in the submandibular gland. There were 37 (77%) male and 11 (23%) female patients. Cytopathologically in 36 patients the diagnosis was benign neoplasm (WT); in 6, other benign entities; and in 6, suspicious for malignancy. The main characteristic cytomorphologic features of WTs were as follows: 92% lymphoid cells, 83% oncocytic cell layers, and 67% granular debris background. These percentages were 67%, 17%, and 17% in the benign cytology group and 67%, 50%, and 17% in the suspicious for malignancy group, respectively.
CONCLUSION
Absence or lack of main features of WTs with or without presence of squamous-like cells, vacuolated cytoplasmic cells, and inflammatory reaction may cause diagnostic dilemma. The presence of the mast cells accompanied by epithelial tissue was striking for WT diagnosis.
Topics: Adenolymphoma; Biopsy, Fine-Needle; Diagnosis, Differential; Female; Humans; Male; Mast Cells; Parotid Gland; Parotid Neoplasms; Submandibular Gland; Submandibular Gland Neoplasms
PubMed: 31769640
DOI: 10.3906/sag-1901-215 -
Reproduction & Fertility Jul 2022The phenomenal extracellular matrix (ECM) remodelling of the cervix that precedes the myometrial contraction of labour at term or preterm appears to share some common... (Review)
Review
ABSTRACT
The phenomenal extracellular matrix (ECM) remodelling of the cervix that precedes the myometrial contraction of labour at term or preterm appears to share some common mechanisms with the occurrence, growth, invasion and metastasis of cervical carcinoma. Matrix metalloproteinases (MMPs) are zinc-dependent endopeptidases that are pivotal to the complex extracellular tissue modulation that includes degradation, remodelling and exchange of ECM components, which contribute to homeostasis under normal physiological conditions such as cervical remodelling during pregnancy and puerperium. However, in cancer such as that of the uterine cervix, this extensive network of extracellular tissue modulation is altered leading to disrupted cell-cell and cell-basement membrane adhesion, abnormal tissue growth, neovascularization and metastasis that disrupt homeostasis. Cervical ECM remodelling during pregnancy and puerperium could be a physiological albeit benign neoplasm. In this review, we examined the pathophysiologic differences and similarities in the role of MMPs in cervical remodelling and cervical carcinoma.
LAY SUMMARY
During pregnancy and childbirth, the cervix, which is the barrel-shaped lower portion of the womb that connects to the vagina, gradually softens, shortens and opens to allow birth of the baby. This process requires structural and biochemical changes in the cervix that are stimulated by enzymes known as matrix metalloproteinases. Interestingly, these enzymes also affect the structural and biochemical framework of the cervix during cervical cancer, although cervical cancers usually occur after infection by human papillomavirus. This review is intended to identify and explain the similarities and differences between the structural and chemical changes in the cervix during pregnancy and childbirth and the changes seen in cervical cancer.
Topics: Pregnancy; Female; Humans; Animals; Uterine Cervical Neoplasms; Cervix Uteri; Matrix Metalloproteinases; Extracellular Matrix; Carcinoma
PubMed: 37931406
DOI: 10.1530/RAF-22-0015 -
Journal of Radiology Case Reports Apr 2016A 43-year-old man arrived at the emergency department following a syncopal episode. Computed tomography and magnetic resonance images demonstrated a small...
A 43-year-old man arrived at the emergency department following a syncopal episode. Computed tomography and magnetic resonance images demonstrated a small interhemispheric, anterior parafalcine mass that mimicked a meningioma. Surgical excision and subsequent pathologic evaluation revealed an angioleiomyoma and the patient recovered without incident. Angioleiomyomas are classified as benign smooth muscle tumors and are classically seen in adult females arising in the soft tissues of the lower extremities. Although rare, these masses have been described in various intracranial locations, usually extra-axially. A comprehensive review of the literature and discussion are provided, emphasizing histopathologic and imaging features of this uncommon intracranial neoplasm.
Topics: Adult; Angiomyoma; Brain Neoplasms; Diagnosis, Differential; Humans; Magnetic Resonance Imaging; Male; Tomography, X-Ray Computed
PubMed: 27200167
DOI: 10.3941/jrcr.v10i4.2713 -
Head and Neck Pathology Sep 2022Pleomorphic adenoma (PA) is the most common biphasic type of salivary gland tumour to arise in adults. It is a biphasic tumour composed of both luminal (ductal) cells...
Pleomorphic adenoma (PA) is the most common biphasic type of salivary gland tumour to arise in adults. It is a biphasic tumour composed of both luminal (ductal) cells and abluminal (basal and myoepithelial) cells. Other biphasic salivary gland type tumours, both benign and malignant, can mimic PA, especially on small biopsies. Previous studies have shown that glial fibrillary acidic protein (GFAP) is preferentially expressed in PA and can be useful in the distinction from other salivary gland tumours. However, most of these studies were performed on a small subset of tumour types at a time when the classification of salivary gland type tumours was less refined. The purpose of this study was to assess the expression of glial fibrillary acidic protein (GFAP) in a broad group of both benign and malignant salivary gland tumours. The expression of GFAP was assessed in 99 tumours including 54 PAs, 5 basal cell adenomas, 1 myoepitheliomas, 5 adenoid cystic carcinomas, 6 epithelial-myoepithelial carcinomas (EMCA), 6 mucoepidermoid carcinomas, 7 salivary duct carcinomas, 1 adenocarcinomas NOS, 2 myoepithelial carcinomas, 4 basal cell adenocarcinomas, 5 acinic cell carcinomas and 3 polymorphous adenocarcinomas. Of the malignant cases, 8 were classified as carcinomas ex PA. GFAP was also assessed in 19 concurrent biopsy specimens. GFAP was expressed in the resections of 51 PAs examined (94%). Expression was predominantly strong and diffusely seen in myoepithelial cells. Strong and diffuse GFAP expression was also seen in two EMCAs (33%) and one myoepithelial carcinoma (50%). On biopsy specimens, 100% of PAs and basal cell adenomas expressed GFAP. GFAP was also seen in 1 out of 3 carcinomas ex PAs on biopsies. Almost all PAs show strong and diffuse expression of GFAP. In contrast, most malignant neoplasms that can mimic PA on biopsies show only rare, focal expression. Other benign tumours composed of abluminal/myoepithelial cells also show focal expression of GFAP, highlighting the spectrum these tumours share with PA. Overall, the presence of strong and diffuse GFAP expression can favour a benign neoplasm, specifically a PA, on limited biopsy specimens.
Topics: Adenoma; Adenoma, Pleomorphic; Adult; Biomarkers, Tumor; Carcinoma; Carcinoma, Acinar Cell; Glial Fibrillary Acidic Protein; Humans; Immunohistochemistry; Myoepithelioma; Salivary Gland Neoplasms
PubMed: 35064902
DOI: 10.1007/s12105-021-01409-2 -
Journal of the Chinese Medical... Oct 2012Myoma is the most common benign neoplasm that can occur in the female reproductive system, most frequently seen in women in their 50s. Although the majority of myomas... (Review)
Review
Myoma is the most common benign neoplasm that can occur in the female reproductive system, most frequently seen in women in their 50s. Although the majority of myomas are asymptomatic, some patients have symptoms and/or signs of varying degrees. Typical myoma-related symptoms or signs include: (1) menstrual disturbances like menorrhagia, dysmenorrhea and intermenstrual bleeding, (2) pelvic pain unrelated to menstruation, (3) compression symptoms, similar to a sensation of bloatedness, urinary frequency and constipation, (4) subfertility status such as recurrent abortion, preterm labor, dystocia with an increased incidence of Cesarean section, and postpartum hemorrhage, and (5) cosmetic problems due to increased abdominal girth However, there are undoubtedly some clinical presentations secondary to uterine myomas are not so specific, such as: (1) uncommon compression-related symptoms, (2) cardiac symptom and atypical symptoms secondary to vascular involvement or dissemination, (3) abdominal symptoms mimicking pelvic carcinomatosis, (4) dyspnea, (5) pruritus, (6) hiccup or internal bleeding, and (7) vaginal protruding mass or uterine inversion. Familiarization with these symptoms and awareness of other unusual or atypical presentations of uterine myomas will remind clinical practitioners of their significance, and of the necessity of follow-up examinations and individualized management to fit the needs and childbirth desires of the patients.
Topics: Female; Humans; Middle Aged; Myoma; Uterine Neoplasms
PubMed: 23089399
DOI: 10.1016/j.jcma.2012.07.004 -
Cancer Cytopathology Apr 2022Fine-needle aspiration (FNA) is the preferred diagnostic test for salivary gland lesions. The purpose of the Milan System for Reporting Salivary Gland Cytopathology...
Utility of the Milan System for Reporting Salivary Gland Cytology, with focus on the incidence and histologic correlates of atypia of undetermined significance (AUS) and salivary gland neoplasm of uncertain malignant potential (SUMP): A 3-year institutional experience.
BACKGROUND
Fine-needle aspiration (FNA) is the preferred diagnostic test for salivary gland lesions. The purpose of the Milan System for Reporting Salivary Gland Cytopathology (MSRSGC) is to standardize salivary gland cytology reporting and guide treatment decisions. The objective of the current study was to evaluate the utility and performance of the MSRSGC, with a focus on the cytomorphology of lesions diagnosed as atypia of undetermined significance (AUS) and salivary gland neoplasm of uncertain malignant potential (SUMP).
METHODS
In total, 123 salivary gland FNAs were included in the study. FNA diagnoses for all cases were reviewed and recategorized, as applicable, according to the MSRSGC. Cytohistologic correlation was performed in 51 cases that had available surgical follow-up, and the risk of malignancy (ROM) was calculated.
RESULTS
Most FNA samples were from the parotid gland. The mean patient age was 61.4 years, and the male-to-female ratio was 1.3:1. The ROM was 0% (categories I and II; nondiagnostic and benign nonneoplastic, respectively), 50% (category III; AUS), 0% (category IVA; benign neoplasm), 40% (category IVB; SUMP), 100% (category V; suspicious for malignancy), and 100% (category VI; malignant). Sensitivity, specificity, positive predictive value, and negative predictive value were 100% each. In addition, the primary factors for an AUS diagnosis were identified as low cellularity and/or the presence of lymphocytes. The presence of oncocytes followed by cellular atypia in an otherwise classic pleomorphic adenoma were principal factors for a SUMP diagnosis.
CONCLUSIONS
The authors report an ROM comparable to that reported in the literature, with a sensitivity and specificity of 100%, supporting adaptation of the MSRSGC into the system for reporting salivary gland cytology. In addition, the findings emphasize the need to refine criteria for AUS and SUMP, thereby improving the predictive capability and subsequent management of salivary gland lesions.
Topics: Cytodiagnosis; Female; Humans; Incidence; Male; Middle Aged; Retrospective Studies; Salivary Gland Neoplasms; Salivary Glands
PubMed: 34875145
DOI: 10.1002/cncy.22538 -
Revista Brasileira de Ginecologia E... Jun 2018Hemangioma is a benign neoplasm that may affect the vulva, and it can cause functional or emotional disability. This article reports the case of a 52-year-old female...
Hemangioma is a benign neoplasm that may affect the vulva, and it can cause functional or emotional disability. This article reports the case of a 52-year-old female patient with a history of a genital ulcer for the past 3 years and who had undergone various treatments with creams and ointments. The patient was biopsied and diagnosed with vulvar hemangioma and was subsequently submitted to surgical excision of the lesion. We emphasize the importance of following the steps of the differential diagnosis and proceeding with a surgical approach only if necessary.
Topics: Female; Hemangioma; Humans; Middle Aged; Vulvar Neoplasms
PubMed: 29980161
DOI: 10.1055/s-0038-1657786 -
Revista Portuguesa de Pneumologia 2012Pulmonary myxoma is an extremely rare benign neoplasm. It is mostly parenchymal but may occasionally occur within the tracheobronchial tree. There are very few reports...
INTRODUCTION
Pulmonary myxoma is an extremely rare benign neoplasm. It is mostly parenchymal but may occasionally occur within the tracheobronchial tree. There are very few reports of endobronchial myxoma.
CASE REPORT
We describe a case of endobronchial myxoma in a 40-year-old female patient with a history of asthma and repeated right-sided pneumonia. Thoracic computed tomography (CT) showed medium lobe atelectasis. Fiber optic bronchoscopy revealed a polypoid, well-circumscribed tumor, causing total obstruction of the medium lobe bronchus. Biopsy of the mass was non-diagnostic. Further study included a positron emission tomography (PET) which demonstrated low metabolic activity of the tumor and no evidence of neoplasia in other location. The patient was submitted to a medium lobectomy and microscopic examination of the tumor revealed myxoid stroma with lobulated pattern, elongated and stellate cells, compatible with myxoma.
CONCLUSION
Pulmonary myxoma is extraordinary rare and endobronchial location is very few reported in medical literature.
Topics: Adult; Bronchial Neoplasms; Female; Humans; Myxoma
PubMed: 22261261
DOI: 10.1016/j.rppneu.2011.12.004 -
Archives of Pathology & Laboratory... May 2009The morphologic spectrum of mammary fibroepithelial lesions ranges from fibroadenoma, a common benign neoplasm, to phyllodes tumor, an uncommon lesion that can sometimes... (Review)
Review
CONTEXT
The morphologic spectrum of mammary fibroepithelial lesions ranges from fibroadenoma, a common benign neoplasm, to phyllodes tumor, an uncommon lesion that can sometimes recur and metastasize.
OBJECTIVE
To focus on problems encountered in the diagnostic evaluation of fibroepithelial tumors, highlighting the diagnostically relevant morphologic features and providing an update on the immunohistochemical profile and genetic alterations of these rare neoplasms.
DATA SOURCES
A PubMed search of the English-language literature identified published reports on fibroepithelial lesions, with a special focus on phyllodes tumor. The results and conclusions of these studies form the basis of this review.
CONCLUSIONS
The distinction between fibroadenoma and phyllodes tumor is usually not problematic, especially in excision specimens. In some cases, however, the diagnostic evaluation of fibroepithelial lesions can be challenging, especially if only limited material is available. Morphologic predictors of local recurrence of phyllodes tumor include cellularity and cytologic atypia, mitotic activity, positive margins, infiltrative borders, fibroproliferative satellite nodules, and past history of fibroadenoma. Predictors of distant metastasis include size, tumor necrosis, and stromal overgrowth. None of these parameters, however, constitutes a definite marker of malignancy. Presently, molecular and immunohistochemical techniques play a limited role in the diagnosis of fibroepithelial lesions.
Topics: Biomarkers, Tumor; Breast Neoplasms; DNA, Neoplasm; Diagnosis, Differential; Female; Fibroadenoma; Gene Expression; Humans; Immunoenzyme Techniques; Neoplasm Recurrence, Local; Phyllodes Tumor
PubMed: 19415945
DOI: 10.5858/133.5.713 -
Oncology (Williston Park, N.Y.) May 1996Usually considered benign tumors, meningiomas can display aggressive behavior characterized by multiple recurrences and invasion of the brain, dura, and adjacent bone.... (Review)
Review
Usually considered benign tumors, meningiomas can display aggressive behavior characterized by multiple recurrences and invasion of the brain, dura, and adjacent bone. The aggressive or malignant phenotype is difficult to characterize due to the broad spectrum of behaviors exhibited by meningiomas. Recent classification schemes based on features of anaplasia rather than histopathology have been used successfully to identify meningiomas that exhibit features of the aggressive phenotype. Some such tumors can be identified preoperatively by radiographic characteristics. Surgery is the cornerstone of treatment for all types of meningiomas. Conventional radiation therapy is beneficial for patients with recurrent (or incompletely resected) benign meningiomas and is recommended for those with aggressive and malignant meningiomas. Stereotactic radiation and interstitial brachytherapy are useful in some refractory or recurrent meningiomas. Traditional chemotherapeutic agents are not very effective against meningiomas, but hormonal manipulation is under study for patients with inoperable tumors or those who are medically unsuitable for surgery.
Topics: DNA, Neoplasm; Female; Gonadal Steroid Hormones; Humans; Male; Meningeal Neoplasms; Meningioma; Neoplasm Invasiveness; Neoplasm Recurrence, Local; Pregnancy
PubMed: 8738830
DOI: No ID Found