Roberto Bondi

Histologic spectrum of carcinomas with eccrine ductal differentiation (sweat-gland ductal carcinomas)

Seven cases of sweat-gland carcinomas showing eccrine ductal differentiation (ductal carcinomas) are presented. The tumors had a variable histological appearance, but were basically characterized by the following histological elements: (a) tubular structures, sometimes cystic or having a “tadpole” appearance; (b) solid islands of squamous, basaloid, or clear cells; (c) periodic acid-Schiff-positive endoluminal and/or intracellular material; and (d) infiltrating growth. Immunocytochemically, tumor cells were positive for keratin and negative for actin. Endoluminal material contained carcinoembryonic antigen in five of seven cases. Although it is not yet clear whether carcinomas exhibiting eccrine ductal differentiation may represent a specific histotype or a group encompassing several distinct clincopathological entities, the histological analysis of the cases suggested that the wide spectrum of their histological appearances may be due to variable grades of differentiation.

Intestinal-type adenocarcinoma of the sinonasal tract: a clinicopathologic study of 18 cases.

Background Intestinal-type adenocarcinoma (ITAC) of the nose and paranasal sinuses is a relatively rare tumor. It commonly affects subjects exposed to wood or leather dust. Methods The authors present the clinicopathologic findings of 18 cases of sinonasal ITACs and review the proposed histologic classifications. Results All patients, except one, were males; mean age was 60 years (range, 41-79); in 9 cases an occupational exposure to wood or leather dust was found. Common presenting symptoms were epistaxis, nasal obstruction and rhinorrhea. Histologically, tumors were divided into four groups: well-differentiated (G1) ITACs = 3 cases; moderately differentiated (G2) ITACs = 8 cases; poorly differentiated (G3) ITACs = 2 cases; mucinous (M) ITACs = 5 cases. Immunocytochemically, 16/17 cases were positive for carcinoembryonal antigen, 1/17 for somatostatin, and 0/16 cases for gastrin. Conclusions Sinonasal ITACs are aggressive tumors, often diagnosed in a relatively advanced stage. Owing the close similarity of the microscopic aspects, a histologic classification of ITACs analogous to that of colonic adenocarcinomas is proposed.

Histologic-prognostic correlations in adenoid cystic carcinoma of major and minor salivary glands of the oral cavity.

Thirty-four cases of adenoid cystic carcinoma (ACC) of the major and minor salivary glands of the oral cavity, treated by wide surgical excision, were studied. The relationship between prognosis of the neoplasm and various morphologic factors were evaluated. Among the morphologic parameters previously studied, which according to various authors may be linked to the evolution of this tumor, we confirmed correlations for both histologic patterns and perineural invasion. In addition, the authors propose neoplastic growth type as a new parameter prognostically significant in ACC. In fact, none of the patients with the pushing type growth pattern died during the study period (p = 0.007). These same patients presented disease-free periods (mean 56 months, median 58 months) significantly longer than those with the infiltrating type growth pattern (mean 28 months, median 24 months).

Histological analysis of intraepidermal proliferations of atypical melanocytes

Fifty cutaneous pigmented lesions characterized by an intraepidermal proliferation of atypical melanocytes were reviewed. Several histological parameters (position of melanocytes in the epidermis, nuclear melanocytic atypia, presence or absence of pagetoid melanocytes, nucleoli, and others) were evaluated. On the basis of the results, the investigated cases were classified into three groups. In group 1, pagetoid melanocytes were present, melanocytic atypia was severe and continuous, all epidermal layers were involved by melanocytic proliferation, and a pattern of epidermal infiltration was recognized. In group 2, pagetoid meianocytes were absent, melanocytic atypia was mild-moderate and discontinuous, the lower epidermis only was involved by melanocytic proliferation, and a pattern of epidermal pseudoinfiltration was recognized. Group 3 cases were in an intermediate area between the two major groups. The results showed that intraepidermal proliferations of atypical melanocytes lie on one line, in which groups 1 and 2 account for the extremes.

MUCINOUS CARCINOMA OF SWEAT GLANDS

Three cases of primary cutaneous mucinous carcinoma of sweat gland origin are presented. Patients were a 47-year-old man and 2 females aged 70 and 71 years. The clinical and pathologic features of the described tumors were similar to those reported in the literature, except for 2 of the involved sites (abdominal skin and vulva), not previously described.

Adenoid cystic carcinoma of sweat glands: report of two cases.

Two cases of primary cutaneous adenoid cystic carcinoma (ACC) of sweat gland origin are reported. The patients were a 83-year-old man and a 40-year-old woman. Histologically, the neoplasms showed the classic appearence of ACC. CEA, actin and S-100 protein were immunocytochemically demonstrated to be contained in some neoplastic cells. The literature on sweat gland ACC is reviewed and the clinlcopathologic profile of this rare tumor considered.

Cell kinetics of melanocytes in common and dysplastic nevi and in primary and metastatic cutaneous melanoma.

The 3H-thymidine labelling (LI) and mitotic (MI) indexes were calculated in 29 cutaneous melanocytic lesions: 6 common nevi (CN), 11 dysplastic nevi, subclassified as nevi with architectural atypia (NAA = 4) and nevi with cyto-architectural atypia (NCAA = 7), 2 melanomas in situ (MIS), 4 invasive superficial spreading melanomas (IM) and 6 metastatic melanomas (MM). The LI mean values resulted to be: CN = 0.23%, NAA = 0.98%, NCAA = 1.79%, MIS = 5.75%, IM = 5.16%, MM = 3.80%. In CN, NAA, NCAA and MIS, these values were calculated at epidermal level; in IM and MM at dermal level. At dermal level, the LI mean values of CN, NAA and NCAA were: 0.20%, 0.20%, 0.23% respectively. The MI mean value was close to 0 in CN, NAA, NCAA, MIS; 0.18% in IM, 0.16% in MM. Confirming a low proliferative activity in CN and a high activity in melanomas (MIS, IM, MM), the results showed that dysplastic nevi (NAA, NCAA) had a proliferative activity intermediate between common nevi and melanomas. The lesions with melanocytic atypia (NCAA) resulted to have a higher proliferative activity than those without this histological feature (NAA).

Multicentric reticulohistiocytosis. Report of three cases with the evaluation of tissue proteinase activity.

Three cases of multicentric reticulohistiocytosis showing typical clinical, histologic, and ultrastructural findings are reported. In one, gastric cancer occurred; in the other two cases, severe polyarthritis was the only detectable internal involvement. The serine proteinases, urokinase and tissue-type plasminogen activator, were evaluated both with the autohistographic technique and spectrophotometric assay in lesional skin and synovia. Urokinase levels appeared grossly increased in the lesional synovia and moderately increased in the lesional skin. We suggest that urokinase, presumably released by the activated proliferating histiocytes, may play a major role in the extracellular matrix degradation leading to erosion of cartilage and adjacent bone in multicentric reticulohistiocytosis.

Benign Melanocytic Lesions: A Morphometric Analysis

Nuclei of melanocytes in 10 lentigines simplices, 10 junctional, 10 compound and 10 intradermal acquired melanocytic nevi were morphometrically evaluated, at three different skin levels: epidermis, papillary and reticular dermis. The considered parameters were: area, perimeter, form Ar, and form Ell. Mean values of nuclear area and form Ell demonstrated a progressive increase from lentigines to junctional to compound to dermal nevi. This trend was also observed for each considered level. In compound nevi mean values of nuclear area showed an increase from the epidermis to the papillary dermis. In compound and intradermal nevi they showed a decrease from the papillary to the reticular dermis. Mean values of nuclear form Ell presented a continuous increase from the epidermis to the papillary and reticular dermis. Our study shows that, in the evolution of the considered melanocytic lesions (from lentigo to dermal nevi), the nuclei of melanocytes become larger and rounder. In compound nevi, epidermal nuclei were smaller and more elongated than those of the papillary dermis. In compound and intradermal nevi, superficial dermal nuclei appeared larger but less round than the deep ones. These peculiar findings have been generally referred to as a melanocytic maturation process. They are also probably due to other factors, perhaps local factors, because a similar trend is observed in some malignant melanomas.

Immunolocalization of extracellular matrix components in mixed tumors of the skin.

Mixed tumors of the skin are characterized by a proliferation of epithelial cells embedded in a mesenchymal matrix with a wide spectrum of histologic appearances. The characterization of the extracellular matrix components of mixed tumors of the skin has so far received little attention. We performed an immunohistochemical study of type IV collagen, laminin. fibronectin. and tenascin distribution in a series of 10 mixed tumors of the skin. Laminin localized at the basement membrane around solid epithelial nests and tubulo-alveolar structures, whereas type IV collagen, fibronectin, and tenascin were also expressed in the myxoid stroma. Tenascin and fibronectin localized in the chondroid matrix. The extracellular matrix components were prominently expressed in mixed tumors of the skin. suggesting that they could play an important role in the formation and organization of myxoid and chondroid matrices and in the epithelialmesenchymal interactions of these tumors.