Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0027627 (metastases)
 103,950 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Four plexosarcomas (gastrointestinal autonomic nerve tumors) characterized by light microscopic, immunocytochemical, and ultrastructural examination, including immunoelectron microscopy in one case, are described. The four neoplasms occurred in the small intestine (duodenum, two; jejunum, one; and ileum, one) and they had an aggressive course with either local or distant metastases. The light-microscopic patterns varied from epithelioid and organoid to spindle cells, mimicking endocrine and sarcomatous neoplasms. Ultrastructurally, these tumors exhibited interdigitating cytoplasmic processes that contained scattered aggregates of membrane-bound granules varying in size from 100 to 300 nm intermixed with empty vesicles and numerous diffusely distributed intermediate filaments. Basal lamina covering cell surfaces, attachment plaques, and myofilaments, as expected in smooth-muscle tumors, were not identified, and diffusely distributed membrane-bound granules, as seen in paragangliomas and carcinoid tumors, were also absent. By immunocytochemistry, the tumors were intensely positive for vimentin and neuron-specific enolase and focally positive for neurofilaments and synaptophysin. In addition, three tumors were S100 protein positive and one stained for vasoactive intestinal peptide. Similar positive immunocytochemical reactions were identified in normal enteric plexus. It is essential to recognize plexosarcomas, which are invariably accompanied by aggressive clinical behavior, in spite of a seemingly benign, mitotically inactive light-microscopic appearance in most instances. Ultrastructural examination can readily separate plexosarcomas from paragangliomas and other sarcomatous and endocrine neoplasms.
 ...
PMID:Gastrointestinal autonomic nerve tumors. 'Plexosarcomas'. 275 84

The clinical and pathologic features of 70 examples of carcinosarcoma (CS) of the breast are reported. Thirty-three neoplasms had infiltrating carcinoma, seven had in situ carcinoma, and 28 had both admixed or contiguous with the sarcomatous component. Squamous carcinoma, present in 15 neoplasms, was the exclusive epithelial component of two. The admixed carcinoma often appeared distinct from the sarcoma component; however, at high magnification transitional differentiation zones and more subtle merging of infiltrating carcinoma with sarcoma were present in most neoplasms. A total of 40 neoplasms were studied by immunohistochemistry for keratins, EMA, vimentin, S-100 protein, and actin. The sarcomatous component in 55% of CS was immunoreactive for keratin, and 98% were immunoreactive for vimentin. A majority were also immunoreactive for actin (77%), and S-100 protein (55%). Ultrastructural examination of the sarcoma in eight neoplasms yielded variable nonspecific findings compatible with sarcoma. These findings indicate biphasic differentiation by cells possessing epithelial and mesenchymal characteristics and suggest myoepithelial origin or differentiation. The cumulative 5-year survival rate for CS was 49%, worse than for other forms of metaplastic carcinoma. The respective 5-year survivals for TNM clinical Stages I, II, and III were 100%, 63%, and 35%. Of patients with axillary dissection, 26% had metastases to axillary lymph nodes with carcinoma as the most frequent component to metastasize. Metastasis was an ominous sign as 33 of 34 patients who developed metastases died from tumor. Local recurrence was not as ominous as 40% who had only local recurrence subsequently died from tumor. Size and microscopic circumscription were also significant prognostic factors.
 ...
PMID:Metaplastic carcinomas of the breast. III. Carcinosarcoma. 277 8

Pleomorphic spindle cells, osteoclastlike giant cells and plaques of osteoidlike material were the cytologic features observed in fine needle aspirates of the breast tumors from two patients. This cytologic pattern suggested a diagnosis of osteogenic sarcoma, a rare neoplasm in the breast. Immunoperoxidase staining performed on the original smears showed reactivity for vimentin in both cases. One tumor was also positive for epithelial membrane antigen (EMA); reactivity for this marker revealed the metaplastic nature of the sarcomatous cells in this tumor, suggesting a diagnosis of metaplastic carcinoma. Histologically, both tumors showed a sarcomatous pattern, with osteoid and chondroid formation, with no evidence of epithelial differentiation. Polyclonal and monoclonal antibodies against epithelial and mesenchymal markers used in tissue sections confirmed the immunophenotypes identified cytologically. Based on the immunochemical findings, the final diagnoses were osteogenic sarcoma of the breast in one case and osteogenic metaplastic carcinoma of the breast in the second case. Both patients died of metastatic disease within one year. These cases (1) show the reliability and accuracy of the immunoperoxidase method in making a differential diagnosis of ambiguous cytologic patterns in fine needle aspirates, (2) support the occurrence of a true osteogenic sarcoma of the breast (comparable to its skeletal counterpart) and (3) demonstrate that metaplastic carcinomas may closely simulate sarcomas of the breast, morphologically as well as biologically. Immunochemical staining techniques play an important role in the differential diagnosis of these neoplasms.
 ...
PMID:Primary osteogenic sarcoma and osteogenic metaplastic carcinoma of the breast. Immunocytochemical identification in fine needle aspirates. 278 63

Four cases of esophageal polypoid tumors composed of squamous cell carcinoma and spindle cell sarcomatous components were investigated. Squamous cell carcinoma was consistently present in the base of the polypoid lesions in all four cases and was also intermingled with spindle-shaped sarcomatous cells in two cases. Metastases in the lymph nodes were observed in two cases: one was squamous cell carcinoma with a sarcomatous component and the other consisted of a pure sarcomatous component. All tumors involved at least the muscularis mucosae. In the sarcomatous region, the tumor was composed of highly anaplastic cells with or without forming interlacing fascicles. Pleomorphism was marked and bizarre giant cell forms were frequent. Mitoses were frequently present. Immunohistochemical study revealed that the anaplastic cells in the sarcomatous component in all cases were immunoreactive to desmin, muscle actin, vimentin, and alpha 1-antichymotrypsin, but were negative for cytokeratin, even in the metastatic tumors of the lymph nodes. The immunohistochemical results favor myogenic differentiation of the anaplastic cells, and these tumors were considered to be true carcinosarcomas composed of squamous cell carcinoma and leiomyosarcoma.
 ...
PMID:Myogenic expression in esophageal polypoid tumors. 280 46

Undecalcified methylmethacrylate(MMA)-embedded biopsies and surgical specimens from 20 bone metastases of differentiated or medullary thyroid carcinomas or prostate carcinomas were investigated immunohistologically for the presence of thyroglobulin, cytokeratin, vimentin, and CEA. The immunoreactions on MMA-sections revealed the same staining patterns as those demonstrated using paraffin sections of the primary lesions. Conversely, immunohistological examination of decalcified paraffin-embedded specimens of the same metastases yielded either false-negative results or results that did not allow an exact evaluation. The findings demonstrate the usefulness and limitations of immunohistology when performed on undecalcified plastic-embedded material.
 ...
PMID:Bone metastases of differentiated and medullary thyroid gland carcinomas. Usefulness and limitations of immunohistology performed on undecalcified plastic-embedded tissue specimens. 309 40

Three patients with epithelioid haemangioendothelioma (EHE) are described. Two patients presented with pulmonary infiltrates and one with a hepatic tumour. All had a metastatic disease ending fatally, and all were autopsied. The diagnosis was confirmed either by immunohistological or ultrastructural analysis. All three tumours were cytokeratin-negative and vimentin-positive, while only two contained cells reacting with the antibody of factor VIII-related antigen. Electron microscopy of the third tumour revealed features indicating endothelial differentiation. A short literature review is also presented demonstrating that the outlook of EHE is worse than previously thought.
 ...
PMID:Fatal epithelioid haemangioendothelioma presenting in the lung and liver. 309 56

A 38-year-old woman was operated on to remove a large tumor that replaced the left adrenal gland. The tumor was encapsulated and showed small areas typical of pheochromocytoma, and spindle cell or undifferentiated round cell sarcoma in most areas. Metastases of primitive round cell appearance were operated from the abdominal cavity and abdominal wall shortly after the initial surgery. Eighteen months after the first operation, the patient was alive with metastases in liver and retroperitoneal space. The pheochromocytomalike component showed a typical ultrastructural and immunohistochemical profile of pheochromocytoma and was positive for neurofilaments, synaptophysin, neuron-specific enolase, and S-100 protein in the sustentacular cells. The sarcomatous areas showed fibroblastoid spindle cells that were often surrounded by a basal lamina. Immunohistochemistry revealed S-100 protein positivity in many spindle cells, but markers of pheochromocytoma or epithelial differentiation were absent. The metastases lacked all markers except for vimentin, and the cells were undifferentiated by electron microscopy. These findings suggest that the neoplasm was a compound tumor with a typical pheochromocytoma component and a sarcoma resembling a malignant schwannoma. Neoplastic proliferation of the S-100 protein-positive Schwann-cell-like sustentacular cells of the pheochromocytoma would be an explanation for the genesis of this sarcoma associated with pheochromocytoma.
 ...
PMID:Pheochromocytoma combined with malignant schwannoma: unusual neoplasm of the adrenal medulla. 319 94

A predominantly benign medulloepithelioma of the ciliary body was diagnosed in an 8-year-old girl and resected by iridocyclectomy. It recurred twice during 30 months. Highly malignant histopathologic features developed, and the eye finally perforated and had to be enucleated. No recurrence or metastases have subsequently developed. Histologically, the tumor was a nonteratoid medulloepithelioma consisting of elements resembling embryonic retina, nonpigmented ciliary epithelium, and neuroblasts, but had also areas of obvious glial and neuronal differentiation as judged by immunohistochemistry. The neuroepithelial tumor cells were positive for neuron-specific enolase, vimentin, and often for S-100 protein. The neuroblastic cells were generally positive for neuron-specific enolase and synaptophysin, but were intermixed with glia-like tumor cells positive for vimentin, glial fibrillary acidic protein, and S-100 protein. The results suggest that even a nonteratoid medulloepithelioma may be, unlike retinoblastoma, a truly multipotential tumor.
 ...
PMID:Recurrent medulloepithelioma of the ciliary body. Immunohistochemical characteristics. 321 66

An intimal sarcoma of the abdominal aorta in a 63-year-old woman is reported. The clinical symptoms consisted of chronic arterial hypertension, vomiting and epigastric pain. Treatment was operative, but the patient died 20 hours after surgery. The studies were performed on a surgical specimen and on autopsy material. The aortic tumour consisted of pleomorphic spindle-shaped and giant cells. In the vertebral metastases a storiform pattern of the tumour cells was found. No specific features characteristic for leiomyogenic, lipogenic or an endothelial nature of the tumour giant cells was disclosed in electron microscopy and the picture rather indicated their histiocytic character. Of the 18 cellular markers studied, the immunostainings for vimentin and alpha-1-antichymotrypsin were evidently positive. The tumour was classified as a pleomorphic intimal aortic sarcoma probably a malignant fibrous histiocytoma (MFH). The literature on 26 previously published aortal tumours is reviewed with emphasis on their topographical distribution and histological classification. In only 4 previous cases was the final diagnosis supported by electron microscopical or immunopathological findings. The role of marker studies in the classification of aortal tumours is discussed.
 ...
PMID:Immunohistochemical and ultrastructural studies of a primary aortic intimal sarcoma. 321 94

Carcinomas histologically resembling nasopharyngeal lymphoepithelioma have been identified in the salivary gland, thymus, tonsil, and uterine cervix. Five patients with similar tumors primary in the skin are described. The patients ranged in age from 50 to 81 yr. Four neoplasms were situated on the head, and one was located on the shoulder. Microscopically, they were concentrated in the mid- and deep dermis and lacked connections with epidermis. The pattern was of multiple nodules, smaller irregular islands, and cords. The uniform tumor cells had moderate amounts of lightly eosinophilic cytoplasm and vesicular nuclei with one or two prominent nucleoli. A lymphoid infiltrate was intimately associated with each neoplasm and obscured the malignant epithelium in one. Neither squamous nor glandular differentiation was present, but all tumors exhibited intracytoplasmic mucin. Immunohistochemistry was positive for cytokeratin (5 of 5; diffuse) and epithelial membrane antigen (4 of 5; 3 diffuse, 1 focal). Focal reactivity was also noted for carcinoembryonic antigen (1 of 5), neuron-specific enolase (1 of 5), and vimentin (1 of 5). S100 protein, leukocyte common antigen, Factor VIII-related antigen, prostate-specific antigen (males), Leu M1, and salivary amylase reactivity were absent. One patient developed local recurrence and metastases after 39 mo and was dead of disease at 57 mo. The remaining four were free of disease after 46, 27, 25, and 6 mo of follow-up. The diagnosis of lymphoepithelioma-like carcinoma of the skin is based on microscopic findings and exclusion of occult malignancy. The tumor can be confused with a lymphoid infiltrate and is differentiated from Merkel cell carcinoma primarily on cytologic grounds. The neoplasm may be of adnexal origin.
 ...
PMID:Lymphoepithelioma-like carcinoma of the skin. 323 11


<< Previous 1 2 3 4 5 6 7 8 9 10 Next >>