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Tricholemmal carcinoma : a study of seven cases

Seven cases of tricholemmal carcinoma (TLC), a rarely recognized cutaneous adnexal neoplasm of external hair sheath origin, are described. Most occurred on sun‐exposed skin; five involved the head and neck, one the right leg, and one the right thigh. TLC had a generally short history and all were treated by local excision. The lesions had an exophytic (3 cases) or polypoid (4 cases) gross appearance. Histologically, TLG exhibited a sharply circumscribed, tabular epithelial proliferation in continuity with the epidermis. A cytologic hallmark of these tumors was the presence of large cells with PAS‐reactive, diastase‐sensitive, clear iii‐ pale eosinophilic cytoplasm. High mitotic rate was a constant feature. Four tumors were infiltrative, with pushing borders, whereas three were intraepithelial. One case showed acantholysis. Immunocytochemistry revealed positively for prekeratin and negativity for (CEA and EMA, supporting the trichogenic origin of these tumors. Ultrastructural examination gave clear indication of epithelial origin for (he cells but did not verify hair follicular differentiation. Despite locally aggressive growth, (he clinical course of TLC appeared indolent. Moreover, there are no cases with metastases reported in the literature.

Fibronectin, laminin, type IV collagen distribution, and myofibroblastic stromal reaction in aggressive and nonaggressive basal cell carcinoma.

The stromal myofibroblastic reaction and extracellular matrix in a series of 19 morphologically and clinically aggressive basal cell carcinomas (BCC) were examined by an immunohistochemical staining panel for myofibroblastic markers (vimentin, actin, and desmin), for basement membrane components (laminin and type IV collagen), and for fibronectin. Results were compared with a series of 19 nonaggressive BCC. The aggressive BCC showed discontinuous staining for laminin and type IV collagen, a marked myofibroblastic response, and increased stromal fibronectin. Conversely, the nonaggressive BCC showed a continuous basement membrane and a total lack of staining for fibronectin and myofibroblastic markers in all but three cases. This report suggests that a combined analysis of extracellular matrix components and myofibroblastic markers may be useful for evaluating the clinical behavior including the metastatic capability of aggressive BCC.

Juvenile Hyaline Fibromatosis A Case Report of A Localized Form

Juvenile hyaline fibromatosis is a rare soft-tissue, tumor-like condition that usually arises in children. We report a case characterized by localized lesions and very slow progression. We postulate the existence of two distinct forms of juvenile hyaline fibromatosis-a localized form with very slow growth and a diffuse form with large and rapidly growing tumors.

Smooth muscle tumors of the breast: clinicopathologic features of two cases.

Two cases of smooth muscle tumor of the breast with high tendency to local relapses are reported. The common cytohistologic feature of these infrequent neoplasms is interfacing bundles with spindle-shaped cells showing eosinophilic cytoplasm and blunt-ended nuclei. In estimating the prognosis of these lesions, the mitotic index must be evaluated together with evidence of necrosis and hypercellularity. The present cases suggest that, in the absence of the ancillary features, a mitotic rate of 1-3 × 10 HPF might define a “grey zone” in the spectrum of lesions between leiomyomas and leiomyosarcomas: the smooth muscle tumors of indeterminate prognosis (low risk lesions).

Giant adenomatoid tumors of the uterus

Two cases of adenomatoid tumor of the uterus of unusually large size are reported. One was 12 cm, the other 13 cm in diameter and one was located in the lateral wall and the other in the posterior wall of the uterus. Both were an unusually large or giant variant of adenomatoid tumor of the uterus. The cystic macroscopical and microscopical pattern is characteristic of giant adenomatoid tumors. The origin of these neoplasms is discussed.

Epithelioid hemangioendothelioma of the larynx.

Epithelioid hemangioendothelioma is an uncommon vascular tumor of the soft tissues. Several reports have described this tumor in visceral locations such as liver, lung, and brain. To the best of our knowledge this is the first report of an immunohistochemical and ultrastructural study of a primary epithelioid hemangioendothelioma occurring in the larynx. Difficulties concerning the differential diagnosis and clinical problems arising from surgical therapy in the laryngeal area are also discussed.

GRANULAR CELL BASAL CELL CARCINOMA OF THE SKIN. REPORT OF A CASE WITH IMMUNOCYTOCHEMICAL POSITIVITY FOR LYSOZYME

Granular cell tumors have been described in many sites throughout the body. To our knowledge, few cases have been described in the literature. We report here the sixth case, in which positivity for lysozyme was also observed for the first time. The problems of the histogenesis and differential diagnosis of this rare variant of basal cell carcinoma are also discussed.

INTRACYSTIC PAPILLARY CARCINOMA OF THE MALE BREAST. A CASE REPORT (HISTOCHEMICAL, IMMUNOHISTOCHEMICAL AND ULTRASTRUCTURAL STUDY)

We report a case of intracystic papillary carcinoma of the male breast in a 70-year-old male Caucasian. Grossly, the tumor was a cystic lesion measuring 6 cm in diameter. It contained hemorrhagic fluid and a mural nodule with filiform projections. PAS stain with and without digestion revealed small clumps of diastase-resistent material in the cytoplasm of the neoplastic cells. Grimelius stain was positive. Immunoperoxidase stains were negative for neuron-specific enolase, S100 protein, cromogranin and synaptophysin and were positive for carcinoembryonic antigen and epithelial membrane antigen. On ultrastructural examination the neoplastic cells showed membrane-bound, dense-core secretory granules. We believe that this neoplasm, despite negative neuroendocrine markers, is a variant of mammary adenocarcinoma with endocrine differentiation, partly because of the positive Grimelius stain and partly because of the presence of electron-dense granules, which according to some authors represent lactational differentiation.

Neurothekeoma of the Thumb. A Case Report

A benign tumor of nerve sheath origin occurring in the dermis of a thumb is described. Histologically, these lesions contained nests and cords of large cells surrounded by thin bands of collagen fibers scattered in a myxoid background. The immunocytochemical reaction for S-100 protein was positive.

ADENOSQUAMOUS CARCINOMA OF THE COLON : CASE REPORT OF AN UNUSUAL TYPE

Primary adenosquamous carcinoma of the colon is a rare entity. Its prevalent site of origin is at the level of the proximal portion of the large bowel. The tumor presents in young patients and follows a highly aggressive course. We present an extremely unusual case of adenosquamous carcinoma in which the classical mucinous and signet-ring cell adenocarcinoma was associated with the squamous component. The prognosis of this rare neoplasm is very poor.