bluuebunny/crossref_metadata_2025 huggingface dataset:
Leadership Behaviors and Multidimensional Role Ambiguity Perceptions in Team Sports
Authors: Beauchamp Mark R. , Bray Steven R. , Eys Mark A. , Carron Albert V.
Published: June 2007

The relationships between leadership behaviors and athletes’ perceptions of role ambiguity were investigated within interdependent team sports. Early to midway through their respective seasons, the degree to which coaches engaged in training and instruction and positive feedback behaviors was investigated in relation to athletes’ subsequent perceptions of multi-dimensional role ambiguity. For nonstarters, coaches’ training and instruction accounted for significant variation in offensive and defensive role consequences ambiguity as well as offensive role evaluation ambiguity. However, for starters, neither of the leadership dimensions assessed in this study could explain significant variance in any of the role ambiguity dimensions. Results are discussed in terms of theory development and further research investigating possible antecedents of multidimensional role ambiguity.
Therapeutic Factors at the Beginning of the Intervention Process in Groups for Men Who Batter
Authors: Roy Valérie , Turcotte Daniel , Montminy Lyse , Lindsay Jocelyn
Published: June 2007

This study aims to identify which therapeutic factors supported members in their commitment to a group for abusive men. Seventy-one members of therapy groups for men who batter were asked to rank therapeutic factors based on how they experienced the relative importance of these factors in their experience at the beginning of the group process. Findings indicate that at this stage, abusive men place greater importance on cognitive aspects that correspond to a process of self-understanding and awareness of their problem, whereas the interactive and emotional aspects of the group experience appear less significant. Results are discussed in terms of members’ characteristics and purposes for these groups.
Social Work Services on an Organ Transplantation Program: A Preliminary Cost-Benefit Analysis
Authors: Paris Wayne , Hutkin-Slade Linda , Calhoun-Wilson Gayla , Slentz Beth , Oehlert William
Published: June 2007

Objective: A prospective clinical trial was conducted to measure the effectiveness and cost-benefit of social work clinical practice on a multi-organ transplant program. Method: Recipient financial, clinical, and quality-of-life data were collected for patients who received organ transplants in 1995 ( N= 105) at Integris Oklahoma Transplantation Institute. Results: The income produced for the organization exceeded the cost of providing social work services but demonstrated only a limited ability to reduce the future cost exposure for the program. Prioritized clinical practice identified those at greatest need of social work services, provided the framework for interventions and reporting of outcomes, while maintaining a patient's quality-of-life. Conclusions: The outcome-based clinical research has resulted in policies and clinical practice patterns that are both beneficial for transplant patients and meet the economic and clinical mandates of the employing organization.
Paraphilia and Fetishism
Authors: Wiederman Michael W.
Published: June 2007

Atypical sexual behavior is intriguing to many people, yet the empirical research on paraphilia and fetishism is relatively lacking. Nonetheless, clinicians are often called on to intervene in such cases, particularly when the paraphilia involves nonconsenting partners. This review article is structured around a brief historical overview of the diagnostic classification of atypical sexual behavior in the United States, descriptions of the types of atypical sexual behavior that receive clinical attention, an overview of the models that have been proposed to explain the development of atypical sexual behavior, and finally a summary of the most common treatments for these problems.
Epithelioid Hemangioendothelioma of the Spermatic Cord
Authors: McCluggage W. G. , Dolan S. , Cameron C. H. S. , Russellt C. F. J.
Published: June 2007

This report describes an epithelioid hemangioendothelioma arising on the spermatic cord of a 50-year-old man who presented with a nodule in the right hemiscrotum. Histologic examination showed a cellular tumor composed of epithelioid cells, many of which had intracytoplasmic lumina containing red blood cells. Immunohistochemistry showed focal positivity of tumor cells with the endothelial markers CD34, factor VIII-related antigen, and Ulex and with the anticytokeratin antibodies CAM5.2 and AE1/AE3. Ultrastructural examination revealed polygonal tumor cells forming vascular spaces and intracytoplasmic lumina containing red blood cells. This is the second documented occurrence of epithelioid hemangioendothelioma at this site. The case illustrates the value of immunohistochemistry and electron microscopy in establishing a diagnosis.
Diagnostic Value of Calretinin in Mast Cell Lesions of the Skin
Authors: Mangini Janine , Silverman Jan F. , Dabbs David J. , Tung Ming Y. , Silverman Alan R.
Published: June 2007

The diagnosis of mast cell lesions of the skin can occasionally be challenging. Calretinin, a 29 kD neuron-specific calcium-binding protein found mostly in the CNS and retina, has been shown to be a positive marker for mesotheliomas, and is also expressed in mast cells. We studied the diagnostic value of calretinin and compared our results to other established ancillary studies used to identify mast cells, such as Toluidine blue and the Leder stain. Sixty-three cases were studied, including 45 mast cell lesions (22 urticaria pigmentosum, 17 mastocytomas, and six telangiectasia macularis eruptiva perstans [TMEP]), seven nevi, three melanomas, four granular cell tumors of the skin, three cutaneous lymphomas, and one granulocytic sarcoma. Patients ranged in age from less than 1 to 85 years with a median age of 29 years. The group consisted of 36 females and 27 males. Calretinin was expressed in all 45 mast cell lesions. Negative staining for calretinin was seen in all skin lesions that potentially could be considered in the differential diagnosis of mast cell lesions such as nevi, melanomas, lymphomas, and the granulocytic sarcoma. However, calretinin expression was noted in four/four granular cell tumors. Leder and Toluidine blue stains were positive in all 45 mast cell lesions, and all nonmast cell lesions were negative with these stains. In conclusion, our study demonstrated that calretinin is a sensitive and specific marker of mast cells and can be an aid in distinguishing mast cell lesions from other skin lesions considered in the differential diagnosis. Calretinin may be more sensitive than the currently used special stains utilized to diagnose mast cell lesions having few diagnostic mast cells such as TMEP. However, this immunoperoxidase stain does not add significant diagnostic information in most cases, when compared with the currently used less expensive special stains and, therefore, is not cost-effective.
p53 Overexpression and Steroid Hormone Receptor Status in Endometrial Carcinoma
Authors: Fernando Sujatha S. E. , Wu Xiaojuan , Perera Lakmalie S.
Published: June 2007

Mutations of the p53 tumor suppressor gene often occur in a variety of human malignant tumors and are frequently associated with overexpression of p53 protein. This study was designed to examine indirectly the frequency of p53 protein in primary endometrial carcinoma and to correlate the overexpression with steroid hormone receptor status including pS2 protein status. The study was performed on 79 formalinfixed, paraffin-embedded tissues of endometrial carcinoma. P53 protein overexpression was detected by means of immunohistochemistry using monoclonal antibody NCL-p53-D07. Estrogen and progesterone receptor status was determined by immunohistochemistry using the monoclonal antibodies NCL-ER-LH2 and NCL-PGR, respectively, and the pS2 protein using polyclonal antibody NCL-pS2. Overexpression of p53 protein was found in 27 (34%) of the 79 endometrial carcinomas. A strong positive relationship was demonstrated between histologic grade and p53 protein overexpression. There was a significant correlation between p53 protein overexpression and negative estrogen receptor status (49%) negative progesterone receptor status (49%) as well as a negative pS2 protein (45%). The results suggest that overexpression of p53 is associated with high malignant potential. However, p53 overexpression itself does not appear to be an independent prognostic factor in endometrial carcinomas.
Epstein-Barr Virus-Associated Cholangiocarcinoma with Lymphoepithelioma-Like Component
Authors: Ortiz Maria R. , Garijo Gloria , Adrados Manuel , Lopez-Bonet Eugenio , Acero Doroteo , Bernado Luis
Published: June 2007

We report the case of a 19-year-old woman who presented with a hepatic mass without cirrhosis. Light microscopy revealed a cholangiocarcinoma having both well-differentiated adenocarcinoma and lymphoepithelioma-like undifferentiated carcinoma components. By immunohistochemistry, the tumor showed strong and diffuse expression for cytokeratin AE1, 5D3, and CK22. The tumor cells were positive for p53 protein (more than 75% of the cells) but negative for bcl-2 and LMP-1. Abundant Epstein-Barr virus EBER 2 oligonucleotides were detected in both tumor components, but not in the lymphoid stroma or the nontumor liver. To the best of our knowledge, this is the third report of an Epstein-Barr virus-associated primary hepatobiliary adenocarcinoma with lymphoepithelioma-like component.
Ewing Tumor: Tumor Biology and Clinical Applications
Authors: de Alava Enrique , Pardo Javier
Published: June 2007

The Ewing tumor family includes classical Ewing's sarcoma of bone and soft tissues, peripheral primitive neuroectodermal tumors (pPNET), Askin tumor, and other less frequent variants. This group of tumors is defined by the consistent presence of chromosomal translocations resulting in gene fusions between EWS gene and a member of the ETS family of transcription factors, mainly FLI1 and ERG. Analogous fusions are seen in other solid developmental tumors, like desmoplastic small round cell tumor. These fusions, which are consistently present and tumor-specific, control transcription of several target genes, largely unknown but critical to cell proliferation and differentiation. Therefore, gene fusions are useful to diagnose and classify small round cell tumors, have prognostic significance, are probably useful to detect micrometastasis and monitor minimal residual disease, and are potential therapeutic targets. Secondary molecular alterations, which include mutations of cell cycle regulatory genes, are not tumor-specific but are related to progression and may have prognostic value. The Ewing tumor family represents a paradigm of the application of the knowledge of biology of neoplasia to the clinical management of patients.
Lobular Carcinoma in Situ and Infiltrating Ductal Carcinoma: Frequent Presence of DCIS as a Precursor Lesion
Authors: Maluf Horacio , Koerner Frederick
Published: June 2007

Infiltrating ductal carcinoma (IDC) occurs frequently in patients with lobular carcinoma in-situ (LCIS). LCIS is not thought to be the direct precursor of the invasive component. The authors analyzed 15 cases of coexisting LCIS and IDC and found ductal carcinoma in situ (DCIS) in 12. The DCIS and IDC were of similar grade and located in the same area. Selected cases stained with E-cadherin demonstrated a different immunophenotype for the lobular and ductal lesions. These results support the notion that DCIS is the direct precursor of IDC occurring in patients with LCIS.
Small Cell Variant of Renal Oncocytoma—A Rare and Misleading Type of Benign Renal Tumor
Authors: Hes Ondrej , Michal Michal , Boudova Ludmila , Mukensnabl Petr , Kinkor Zdenek , Miculka Petr
Published: June 2007

Here we report 3 cases of renal oncocytoma with a dominating small cell component arising in adult women. These 3 cases of small cell variant of renal oncocytoma were found among 134 cases of oncocytomas of the kidney in the routine and consultation files of the authors. TAvo of 3 cases were initially thought to be a malignant tumor by the referring pathologists. In all 3 cases minor areas of the tumors, which were identical to the classical renal oncocytomas were found. The small cell areas were arranged in a characteristic organoid pattern different from all the known types of the renal benign and malignant tumors. We summarize all morphologic, immunohistochemical, and ultrastructural features of this unusual oncocytoma variant with regard to its differential diagnosis.
Real-time Quantitative Analysis of E-cadherin Expression in ret/PTC-1-Activated Thyroid Neoplasms
Authors: Smyth P. , Sheils O. , Finn S. , Martin C. , O'Leary J. , Sweeney E. C.
Published: June 2007

Papillary thyroid carcinoma (PTC), the most common variety of thyroid cancer, is found in a variety of morphologic variants, usually grows slowly, and is clinically indolent, although rare, aggressive forms, with local invasion or distant metastases, occur. Our group has previously demonstrated an association between Hashimoto thyroiditis and ret/PTC-1 activation, and have hypothesised that c-ret activation might be implicated in immune reaction to thyroid epithelium. The objective of this study was to examine expression of the cellular adhesion molecule, E-cadherin, in various thyroid tumor types and Hashimoto thyroiditis in the context of ret/PTC-1 positivity by using laser capture microdissection and TaqManTm reverse transcription-polymerase chain reaction (RT-PCR). Variable down-regulation of E-cadherin among carcinomas was demonstrated, with anaplastic carcinomas showing little or no expression. Follicular thyroid carcinomas consistently had significantly decreased E-cadherin expression compared with papillary thyroid carcinomas. The ret/PTC-1-positive papillary thyroid carcinoma (PTCret+) and Hashimoto thyroiditis cases had consistently lower Ecadherin expression levels than the corresponding ret/PTC-1-negative papillary carcinomas (PTCret-), suggesting not only an association between ret activation and the loss of cellular adhesion but also, more significantly, an association between papillary thyroid carcinoma and Hashimoto thyroiditis.
Monotypic Angiomyolipoma of the Nasal Cavity: A Heretofore Undescribed Occurrence
Authors: Banerjee S. Sankar , Eyden Brian , Trenholm Philip W. , Sheikh Mohammed Yunuf , Wakamatsu Kazumasa , Ancans Janis , Rosai Juan
Published: June 2007

A monotypic angiomyolipoma of the nasal cavity in a 34-year-old woman is described. Tumor cells were spindled or epithelioid and contained glycogen and diastase-resistant PAS-positive granules. There were few mitoses, and necrosis was absent, indicating a benign tumor. The stroma was markedly vascular, and a few adipocytes were seen in one area. Cells were positive for melanocyte and muscle markers. Electron microscopy revealed abundant dense granules. Although melanin was absent histochemically, it was present using a chemical assay, and the granules may, therefore, be atypical melanosomes. Fine actin filaments, attachment plaques and lamina were present. Initial assessment of the lesion indicated malignant melanoma, but the inunostaining and histologic features indicated monotypic angiomyolipoma. To the best of our knowledge, this is the first such case in the nasal cavity.
Recurrent Chondromyxoid Fibroma of the Thoracic Spine 30 Years After Primary Excision
Authors: Kikuchi Fumihito , Dorfman Howard D. , Kane Philip B.
Published: June 2007

We report a case of late recurrence of chondromyxoid fibroma (CMF) arising in a thoracic vertebra in an 11-year-old male. This was treated by curettage, and 30 years later, the patient noticed shoulder pain and leg weakness. A recurrent mass appeared at the same site in the spinous process of T6. The histologic features of the recurrent tumor were similar to those of the primary lesion. A total of 38 cases of CMF of the vertebra have been reported. Only 3 of 38 previously reported vertebral CMF recurred. Tumors recurred 2 years after operation in 2 cases, and 7 years after operation in 1 case.
Adenomatous Polyposis Coli (APC) Protein Expression in Primary and Metastatic Serous Ovarian Carcinoma
Authors: Karbova Eleonora , Davidson Ben , Metodiev Krassimir , Tropé Claes G. , Nesland Jahn M.
Published: June 2007

The aim of this study was to investigate protein expression of adenomatous polypois coli (APC) in primary and metastatic serous ovarian carcinoma. The expression of 3-catenin and E-cadherin was additionally analyzed. One hundred and thirteen priary (n=56) and metastatic (n=57) lesions were immunohistochemically stained for APC, E-cadherin, and f-catenin. Staining extent was scored. Possible differences in immunoreactivity in primary and metastatic sites and the association between the proteins analyzed were evaluated statistically. Cytoplasmic immunoreactivity for APC was found in 67/113 (59%) tumors, most often in the majority (>50%) of cells. E-cadherin was detected in 102/113 (90%) carcinomas, while P-catenin was exressed in 109/113 (97%) specimens. Nuclear expression of f-catenin was seen in 3/113 (3%) specimens, all negative for APC. APC and f-catenin were often coexressed, but this finding failed to reach statistical significance (p=0. 1 1). A significant association was seen between E-cadherin and f-catenin expression (p=0.001). APC expression was comparable in primary and metastatic tumors (p>0.05). In concluion, APC expression is absent in a considerable number of both primary and metastatic ovarian carcinomas, but this finding is only rarely coupled to nuclear acumulation of f-catenin. These findings support the role for f-catenin signaling via the Wingless/Wnt pathway in ovarian carcinoma. The mechanism behind the downegulated expression of APC in serous ovarian carcinoma and its significance has yet to be elucidated.
Lymph Node Lesion in Adult-Onset Still's Disease Resembling Peripheral T-Cell Lymphoma: A Report of Three Cases
Authors: Kojima Masaru , Nakamura Shigeo , Miyawaki Shyuichi , Yashiro Kunihiko , Oyama Tetsunari , Itoh Hideaki , Sakata Noriyuki , Sugihara Shiro , Masawa Nobuhide
Published: June 2007

Adult-onset Still's disease (AOSD) is known to be a cause of fever of unknown origin. We describe the clinicopathologic, immunohistologic, and genotypic features of 3 patients with lymph node lesions from AOSD, which posed a serious diagnostic difficulty from peripheral T-cell lymphomas. The patients were 22-, 26-, and 63-year-old Japanese women. At the onset of disease, all patients had multicentric lymphadenopathy in association with clinical and laboratory findings suggestive of a malignant lymphoma. None of the patients developed malignant lymphomas during the follow-up period. Histologically, the lesions were characterized by paracortical hyperplasia with prominent vascular proliferation. In the paracortical area, there was a mixed infiltrate including small-to-medium-sized lymphocytes, variable numbers of eosinophils, plasma cells, and B immunoblasts. Polymerase chain reaction analysis demonstrated that neither clonal rearrangement of the T-cell receptor y-chain gene nor immunoglobulin heavy-chain rearrangement was detected in any patient. Although AOSD appears to be a rare systemic inflammatory disorder, the lymph node lesion should be added to the differential consideration of benign lymph node lesions simulating node-based peripheral T-cell lymphoma.
Low-Grade Fibrosarcoma (Hyalinizing Spindle Cell Tumor with Giant Rosettes) with Pulmonary Metastases at Presentation: Case Report and Review of the Literature
Authors: O'Sullivan Maureen J. , Sirgi Karim E. , Dehner Louis P.
Published: June 2007

Hyalinizing spindle cell tumor with giant rosettes (HSCT) is presently considered a low-grade fibrosarcoma and is also considered a variant of low-grade fibromyxoid sarcoma by some. None of the HSCTs in the original series had manifested malignant behavior in the form of metastasis, but since that initial report, 2 patients have been reported with pulmonary metastases and another patient with multiple pulmonary nodules in the absence of an identifiable primary tumor. Our patient is the second recorded case of HSCT with pulmonary metastases at the time of diagnosis. A needle biopsy of the axillary mass in the present case consisted mainly of densely hyalinized collagen, whereas the lung nodules had the characteristic giant collagen rosettes surounded by a bland spindle cell stroma. This case, in addition to at least 2 others in the literature, has demonstrated that the HSCT is a malignant neoplasm with the caacity to metastasize; however, the presence and even persistence of metastatic leions in the lung has not altered to date an otherwise indolent clinical course. The fact should not be overlooked that the HSCT is a recently reported entity whose natural history and nosology are subjects of continuing observation, study, and discussion.
Polymorphous Low-Grade Adenocarcinoma of the Vulva and Vagina: A Tumor Resembling Adenoid Cystic Carcinoma
Authors: Young Stephanie , Leon Marino , Talerman Aleksander , Teresi Maria , Emmadi Rajysree
Published: June 2007

We report the first case of a polymorphous low-grade adenocarcinoma (PLGA) occurring in the vulva and vagina of a 32-year-old woman. This tumor consisted of cellular lobules with distinct cribriform, papillary, and cystic patterns. Owing to its location and its distinct cribriform pattern, this lesion was initially diagnosed as an unusual variant of adenoid cystic carcinoma (ACC). However, this diagnosis was revised to PLGA when it was recognized that the cribriform, papillary and cystic patterns and their concomitant occurrence in the same lesion are characteristic of PLGA. PLGA should be added to the differential diagnosis of vulvar and vaginal neoplasia.
Papillary Endothelial Hyperplasia of the Breast: The Great Impostor for Angiosarcoma
Authors: Branton Philip A. , Lininger Ruth , Tavassoli F. A.
Published: June 2007

Seventeen cases of papillary endothelial hyperplasia (PEH, Masson's vegetant intravascular hemangioendothelioma) involving breast or mammary subcutaneous tissues are described. The mean patient agewas 59; 14 (82%) were female and 12 (71%) presented with a mass. Nine women had mammographic evaluation, 3 of whom had microcalcifications. Five neoplasms were discovered by routine mammography. Sixteen cases were 2.7 cm or less in greatest dimension, and 8 (47%) wereassociated with a thrombus and/or cavernous hemangioma. Follow-up in 10 cases (up to nearly 8 years) showed no recurrences. Fifty-nine percent of the cases were received at AFIP for consultation with a working diagnosis of angiosarcoma. Features that help distinguish PEHfrom angiosarcoma include circumscription of the lesion, location in avessel or association with thrombus, and papillary architecture without significant cytologic atypia or areas of solid growth. The recognition of the morphologic features of this lesion and its inclusion in the differential diagnosis of vascular mammary tumors will reduce the likelihood of its misdiagnosis as an angiosarcoma and avoid unnecessary and aggressive therapy.
Poorly Differentiated Extraskeletal Myxoid Chondrosarcoma with t(9;22) (q22;ql) Translocation Presenting Initially as a Solid Variant Devoid of Myxoid Areas
Authors: Reid Robin , de Silva M. Vipula Chandu , Paterson Lindsay
Published: June 2007

Extraskeletal myxoid chondrosarcoma (EMC) is a rare soft tissue tumor associated with the translocation t(9;22) (q22;ql 1-12). Although it has a typical microscopic appearance its morphologic spectrum is wide. We report a case of clinically aggressive, poorly differentiated EMC showing the characteristic translocation, which presented initially as a poorly differentiated sarcoma devoid of myxoid areas in the upper arm of an 85-year-old man. The recurrent tumor contained scattered myxoid areas, which merged imperceptibly with the poorly differentiated areas. Some myxoid areas contained necrotic foci surrounded by viable cells giving rise to a pseudorosettelike arrangement. There were epithelioid foci. This case confirms that solid variants of EMC may exist. Poorly differentiated EMC may have a worse prognosis than classic EMC.
Leiomyosarcoma at the Site of an Ileal Neobladder: A Heretofore Unreported Occurrence
Authors: Tumino Rosario , Serrao Antonio , Ninfo Vito
Published: June 2007

We report a case of leiomyosarcoma arising from the intestinal side of an orthotopic ileal neobladder in a male patient 2 years aftersurgery for papillary urothelial carcinoma of the bladder. IntJSurg Pathol 11(2):149-151, 2003
Myeloid Sarcoma: Clinical and Morphologic Criteria Useful for Diagnosis
Authors: Audouin J. , Comperat E. , Tourneau A. Le , Camilleri-Broët S. , Adida C. , Molina T. , Diebold J.
Published: June 2007

Extramedullary accumulation of myeloblasts or immature myeloid cells form tumors called myeloid sarcoma in the WHO classification. Such tumors develop in lymphoid organs, bone (skull, orbit, etc.), skin, soft tissue, various mucosae and organs, and the CNS. They may precede or occur concurrently with acute myeloid leukemia, or reveal blastic transformation of chronic myeloproliferative disorders or myelodysplastic syndromes. They may also reveal relapses in treated patients. They are constituted by a diffuse infiltrate made up of medium-to-large cells. The cells are difficult to identify. Imprints are very useful. Immunohistochemistry can help diagnose and distinguish four variants: granulocytic myeloperoxidase (MPO+, CD 68+ [KP1, PGM1-] lysozyme+, CD 34), monoblastic (MPO-, CD 68+, [KPI+, PGMI+] lysozyme+, CD 34-), myelomonoblastic (MPO-, CD 68+, [KPI+, PGM1+] lysozyme+, CD 34-), or megakaryoblastic (positivity for factor VIII, CD 61, CD 31). Immunohistochemistry sometimes demonstrates expression of CD 43, CD 7, CD 79a, and CD 56 (particularly the monoblastic variant with t[8;2 1]). Recently the demonstration of CD 99 and CD 1 7, which can now be done on paraffin sections, may be useful to identify blasts of granulocytic origin. The diagnosis is missed in about 50% of cases when immunohistochemistry is not used. Patients with myeloid sarcomas should be treated in the same way as patients with acute myeloblastic leukemia. Disease progression and prognosis are similar for the two conditions.
Microscopic Colitis with Giant Cells: A Rare New Histopathologic Subtype?
Authors: Sandmeier D. , Bouzourene H.
Published: June 2007

Collagenous and lymphocytic colitis might be part of the same disease spectrum. In this report, we present a histopathologic subtype of microscopic colitis characterized by the presence of subepithelial multinucleated giant cells. This reaction is very unusual and not explicable by any underlying disease process or previous treatment. Among 490 cases of microscopic colitis (MC) diagnosed between 1992 and 2002, we found 2 cases with macrophages and giant cells (0.4%). One case of lymphocytic colitis (LC) and 1 case of collagenous colitis (CC) presented aggregates of macrophages and giant cells located in the superficial part of the lamina propria. Infectious or noninfectious colonic granulomatous diseases were excluded on histologic, clinical, and biological grounds. The recognition of this feature in an MC is important to avoid the diagnosis of granulomatous infectious or idiopathic colitis such as Crohn's disease. Even if very unusual, this subtype of MC evolves favorably since the 2 patients responded well to corticosteroid treatment.
Myoid Angioendothelioma of the Spleen
Authors: Karim Rooshdiya Z. , Ma-Wyatt Jenny , Cox Michael , Scolyer Richard A.
Published: June 2007

Although vascular neoplasms of the spleen are rare, they are the most common nonhemopoietic proliferation of the organ, and include hemangiomas, lymphangiomas, hamartomas, littoral cell angiomas, hemangioendotheliomas, and angiosarcomas, as well as the recently described myoid angioendothelioma (MA). MA is an uncommon, benign tumor of the spleen, which is morphologically characterized by a composite of vascular spaces and stromal cells with myoid features. In 1999, in the only report of this unusual neoplasm, Kraus and Dehner described the features of 3 cases. We present another case of MA of the spleen occurring in a 51-year-old man that demonstrated the characteristic morphologic and immunohistochemical features of this neoplasm. In addition to the features described by Kraus and Dehner, our case also displayed the previously unreported findings of focal spindling of the stromal cells and scattered S 100-positive cells in the stroma. The case was further unique in having a central stellate scar. Careful attention to histology, possibly with the aid of immunohistochemistry, should distinguish other splenic neoplasms from MA. Although MA is a morphologically distinct lesion, its histologic spectrum, biological behavior, and relationship to other vascular tumors are yet to be fully discovered. It is hoped that the recognition of further cases, and the use of newer molecular technologies, will help better define the nosological position and implications of the diagnosis of this unusual tumor.
Periprostatic Subendothelial Intravascular Granulomatosis: A Mimic of High-Grade Intravascular Prostatic Adenocarcinoma
Authors: Crawford Byron E. , Daroca Philip J. , Davis Rodney
Published: June 2007

A rare case of intravascular granulomatous inflammation mimicking intravascular prostatic adenocarcinoma is reported. To the author's knowledge, there have been no previous reports of prostatic or periprostatic intravascular granulomatous inflammation. A 67-year-old man presented with elevated serum-prostate specific antigen (PSA) and was found to have a high-grade adenocarcinoma of the prostate. A radical prostatectomy revealed intravascular subendothelial granulomatous inflammation mimicking vascular invasion of a high-grade adenocarcinoma found elsewhere in the prostate. Immunoperoxidase stains confirmed that the subendothelial infiltrate was composed of histiocytes and not tumor cells. Periprostatic subendothelial intravascular granulomatosis is a rare event, which may mimic vascular involvement of high-grade prostatic adenocarcinoma and may result from a previous needle biopsy of the prostate. Possible mechanisms for this finding are discussed. It is important to distinguish this process from high-grade prostatic adenocarcinoma involving blood vessels for obvious clinical reasons.
Divergent Differentiation In Malignant Soft Tissue Neoplasms: The Paradigm of Liposarcoma and Malignant Peripheral Nerve Sheath Tumor
Authors: Pytel Peter , Taxy Jerome B. , Krausz Thomas
Published: June 2007

In tumors clonality does not always translate into morphologic uniformity. While most sarcomas exhibit only one line of histologic differentiation, a minority may display a strikingly diverse phenotype in addition to the main lineage. This phenomenon not only presents a diagnostic problem but also raises questions about the commitment of tumor cells toward a specific phenotype. Among sarcomas, malignant peripheral nerve sheath tumor (MPNST) and dedifferentiated liposarcoma are two entities in which divergent differentiation is a relatively frequent event. Diagnostically it is crucial to recognize the “primary” sarcoma in such tumors correctly and distinguish it from the “secondary” divergent elements. The presence of the latter could be the first morphologic clue to a specific sarcoma type. Even though it may be difficult to explain the pathogenesis of divergent differentiation, divergence still illustrates that the phenotype of a tumor cell is not set in stone but can be modulated or switched by a number of factors.
Dual CD 117 Expression in Gastrointestinal Stromal Tumor (GIST) and Paraganglioma of Carney Triad: A Case Report
Authors: Horenstein Marcelo G. , Hitchcock Thomas A. , Tucker J. Allan
Published: June 2007

Carney triad is a rare syndrome, with only 20 complete cases reported. We report a 36-year-old white woman with complete Carney triad, including metastatic gastric stromal tumor (GIST), pulmonary chondroma, and nonfunctioning extraadrenal paraganglioma. Immunohistochemistry was positive for CD34 and CD 117 (c-kit) in the GIST, and positive for chromogranin and CD 117 in the paraganglioma. Ultrastructural studies demonstrated skeinoid fibers in the GIST. To our knowledge, this is the 21st complete Carney triad case reported and the first report of dual expression CD 117 in both GIST and paraganglioma, a finding with intriguing pathogenetic implications related to the organization of the autonomic nervous system.
Granulomatous Interstitial Nephritis: A Clinicopathologic Study of 46 Cases from a Single Institution
Authors: Bijol Vanesa , Mendez Gonzalo P. , Nose Vania , Rennke Helmut G.
Published: June 2007

Acute interstitial nephritis is commonly seen in kidney biopsies of patients with acute renal failure; however, granulomatous interstitial nephritis (GIN) is rare. We identified 46 cases of GIN in a 17-year period in this institution and we investigated their most probable etiologies. Complete clinical information was available in 38 patients. Seventeen of 38 patients (44.7%) were classified as drug-induced. Renal sarcoidosis was responsible for 28.9% of cases, and the remaining 15.9% of cases included Wegeners granulomatosis, foreign body giant cell reaction, GIN secondary to intravesical bacillus Calmette-Guerin therapy for bladder cancer, and xanthogranulomatous pyelonephritis. Clinical investigation failed to reveal possible etiology in 4 patients (10.5%), classified as idiopathic. We concluded that three quarters of our cases were either drug-induced or due to sarcoidosis; only a small proportion of our cases occurred secondary to any other cause or to unknown factors.
Carcinoma of the Neck Showing Thymic-like Elements (CASTLE): Report of a Case and Review of the Literature
Authors: Piacentini Maria Gaia , Romano Fabrizio , Fina Sergio , Sartori Paola , Leone Eugenio Biagio , Rubino Barbara , Uggeri Franco
Published: June 2007

Carcinoma showing thymic-like elements (CASTLE) is a rare tumor affecting thyroid and neck soft tissues, which has to be distinguished from squamous cell and anaplastic thyroid carcinoma, because it has a better prognosis. We report a new case of CASTLE which occurred in a patient submitted to total thyroidectomy with central neck dissection. The tumor stained positively for CD5, which seems to be the most useful marker in the differential diagnosis. By the analysis of the 18 cases reported in literature, total thyroidectomy with selective modified neck dissection should be the treatment of choice and radiotherapy should be considered for patients with positive nodal status.
Synchronous Sporadic Carcinoma and Primary Hyperplasia of the Parathyroid Glands: A Case Report and Review of the Literature
Authors: Sinha S. , Sinha A. , McPherson G. A. D.
Published: June 2007

Parathyroid carcinoma is the least common endocrine malignancy. Although it has been noted to be associated with certain clinical factors, such as familial hyper-parathyroidism, its etiology remains unknown. In rare instances, particularly in patients with chronic renal failure, it has been proposed that parathyroid carcinoma can arise from malignant transformation of benign lesions. We present a case of synchronous malignant and primary hyperplastic parathyroid disease in a patient with normal renal function. A 46-year-old woman was seen with symptomatic refractory hypercalcemia. Investigations suggested a hyperactive parathyroid gland. Operative findings were of a low-grade parathyroid carcinoma in concurrence with diffuse hyperplasia of the remaining glands. To our knowledge this represents the fifth reported case. The possibility of malignant change in hyperplastic parathyroid tissue has implications for patient management and follow-up, particularly if tissue is left in situ to maintain hormonal function.
Leydig Cell Tumor of the Testis With Histological and Immunohistochemical Features of Malignancy in a 1-Year-Old Boy With Isosexual Pseudoprecocity
Authors: Drut Ricardo , Wludarski Sheila , Segatelli Vanderlei , de Oliveira Ebe , Barbosa Ana , Matheus Andre , Bacchi Carlos
Published: June 2007

The article reports the clinical, histopathological, and immunohistochemical findings of a 1-year-old boy presenting with isosexual pseudoprecocity attributable to a functioning Leydig cell tumor of the testis. The case appears to represent the youngest patient ever recognized with this well-known syndrome. Malignancy features were also for the first time initially assessed using criteria, retrospectively developed from the literature, for metastasizing Leydig cell tumor. All the following were found: infiltrative borders, cellular pleomorphism, high mitotic index (12-14/high-power field), high MIB-1 index (40%), P53 positivity in 50% of the cells, and bcl-2 positivity in 15% of the cells. Immunohistochemistry proved the cells of the tumor to be positive for inhibin, Melan-A, synaptophysin, cytokeratin, and calretinin and negative for S-100 and chromogranin A. Notably, lipochrome and crystals of Reinke were not found in the tumor cells. Although the neoplasm fulfilled the criteria for a potentially metastasizing Leydig cell tumor, there was no evidence of that event having occurred, perhaps as a result of early treatment or as indication that criteria developed for Leydig cell tumor of adults may not apply to children.
Polypoid Dermal Dendrocytic Hamartoma in a Giant Congenital Melanocytic Nevus
Authors: Drut Ricardo
Published: June 2007

Giant congenital melanocytic nevus (CMN) might be complicated by the development of several tumor types, mainly melanoma and rhabdomyosarcoma, but also poorly differentiated neoplasms. Striking polypoid exophytic masses occasionally result from neuroectodermal and neuromesenchymal hamartomatous overgrowths, which lends support to the concept of pluripotential melanoblastomatous and neurocristic origin of these lesions. The present report describes what appears to be a unique example of dermal hamartomatous polypoid CD34+ fibrogenic proliferation devoid of melanin, namely a dendrocytoma, surrounded by the melanocytes from the nevus, located in the skin of the scrotum against a background of giant CMN. The differential diagnosis included dermatofibrosarcoma protuberans, giant-cell fibroblastoma, angiofibroma, Bednar tumor, other types of dermal dendrocytic hamartoma, and neurocristic cutaneous hamartoma. This case lends support to the proposed neurocristic origin of dermal fibrogenic cells.
Poorly Differentiated Adenocarcinomas of Prostate Versus High-Grade Urothelial Carcinoma of the Bladder: A Diagnostic Dilemma With Immunohistochemical Evaluation of 2 Cases
Authors: Martínez-Rodríguez Miguel , Ramos David , Soriano Pilar , Subramaniam Manish , Navarro Samuel , Llombart-Bosch Antonio
Published: June 2007

The differential diagnosis between carcinoma of the urinary bladder and adenocarcinoma of the prostate can be difficult, especially in the poorly differentiated forms infiltrating the neighboring organs. In this article, the authors report 2 cases that pose a diagnostic dilemma to the pathologist. The first is an infiltration of the bladder by a poorly differentiated adenocarcinoma of the prostate, which was clinically suspected as a papillary urothelial neoplasm. The second is a collision tumor composed of prostatic adenocarcinoma and urothelial carcinoma observed on a core needle biopsy of the prostate. In both cases, a large panel of immunohistochemical markers were used and demonstrated positivity for prostate-specific antigen and alpha methyl racemase in the prostatic carcinomas and immunoreactivity for CK7, CK20, Ag 34βE12, and p53 in the urothelial carcinoma. The differentiating histological and immunohistochemical findings are discussed.
Squamous Cell Carcinoma Arising in Hormonally Treated Adenocarcinoma of the Prostate
Authors: Wang Qi , Lin Ching-Shen , Unger Pamela D.
Published: June 2007

Adenocarcinoma of acinar origin comprises almost all of the primary prostatic carcinomas. In contrast, prostatic squamous cell carcinoma is extraordinarily rare. We report a case of primary squamous cell carcinoma of the prostate that developed in a 64-year-old man, 3 months after treatment with diethylstilbestrol (DES) and flutamide for stage D2 adenocarcinoma of the prostate. This case report describes a transformation from adenocarcinoma to pure squamous cell carcinoma following the use of DES. The etiology of the squamous cell carcinoma in the present case and those previously reported in the literature are discussed.
Benign Vaginal Mesenchymoma Showing Mature Skeletal Muscle, Smooth Muscle, and Fatty Differentiation
Authors: Mann Stephen , Russell Peter , Wills Edward J. , Watson Geoffrey , Atkinson Kenneth
Published: June 2007

A 28-year-old woman presented with a firm mass in the rectovaginal septum, noted incidentally during vaginal delivery of a term neonate. The mass was composed of three rounded, semiconfluent, submucosal nodules that “shelled out” surgically. The main histologic features were a hyalinized and myxoid background stroma showing variable vascular patterns of both thick and thin-walled vessels and occasional spindle cells. Embedded in this stroma were varying numbers of single or small groups of mature, mitotically inactive, rhabdomyocytes, smooth muscle cells, and adipocytes. The rhabdomyocytes tended to be arranged radially in focal aggregates and were found in only one of the three tumor nodules, while the smooth muscle and fatty elements were more random and widespread in distribution. We have not encountered such a lesion in the literature and have designated it as a benign mesenchymoma of the vagina.
p53 and Breast Cancer
Authors: Robbins Peter
Published: June 2007

Inactivation of the p53 tumor suppressor gene is one of the commonest genetic changes identified in human breast cancer. In this review, the structure and function of the p53 gene and its protein products will be discussed, with particular reference to p53 alterations that contribute to carcinogenesis. The frequency and pattern of p53 alterations in breast cancer will be outlined, laboratory methods for their detection briefly summarized, and the potential use of p53 as a prognostic and predictive marker discussed.
Hemangiopericytoma of the Ovary
Authors: Kawauchi Shigeto , Fukuda Toshirou , Amada Satoshi , Kaku Tsunehisa , Nakano Hito-o , Tsuneyoshi Masazumi
Published: June 2007

A hemangiopericytoma occurring in the right ovary of a 29-year-old woman is reported. Microscopically, the tumor exhibited a solid proliferation of uniform oval to spindled cells with a homogeneous vascular pattern and necrosis. Immunohistochemically, the tumor cells were negative for both estrogen receptor and progesterone receptor. Ultrastructurally, the tumor cells contained a small amount of actin filaments, and were separated by basal lamina or collagen fibers. When making a diagnosis, it is difficult to distinguish hemangiopericytoma of the ovary from extrauterine endometrial stromal sarcoma. In addition to the findings described above, the absence of either pre-existing endometriosis or glandular differentiation in the tumor, along with the immunohistochemical negativity for sex-steroid hormone receptors, indicated the diagnosis of hemangiopericytoma of the ovary.
A High Frequency of Human Papilloma Virus (HPV) DNA Type 16 in Biopsies of Cervical Squamous Cell Neoplasia of Uygur Women
Authors: Suzuk Lalai , Noffsinger Amy E. , Ali Muhammad , Fenoglio-Preiser Cecilia M.
Published: June 2007

Cervical carcinoma ranks among the most common tumors worldwide and is especially prevalent in the developing world. Strong evidence supports the role of human papillomavirus (HPV) infection in the genesis of these tumors. The authors examined 65 cervical neoplasias from a population of women at particularly high risk for the development of cervical cancer in Western China. HPV DNA analysis consisted of in-situ hybridization (n=65) and polymerase chain reaction (PCR) (n=58) for the detection of HPV types 6, 11, 16, 18, 31, 33, and 35. Both consensus and type-specific primers for HPV types 6, 16, and 18 were used in the PCR studies. Overall, HPV DNA was detected in 76.9% of cases. In-situ hybridization identified HPV DNA in 43.1% of patients. PCR with consensus primers detected HPV DNA in 22.4% of lesions, whereas type-specific primers for the HPV E6 gene demonstrated HPV DNA in 77.6% of cervical tumors. Type-specific PCR was more sensitive than LI consensus PCR and in-situ hybridization for detection of HPV DNA. Thirty-two (55.2%) cases that were negative by LI consensus PCR and 21 (32.3%) that were negative by in-situ hybridization were positive by type-specific PCR. Of the 50 cases positive for HPV DNA by one or more of these assays, 94% (n=47) were identified as HPV type 16; 4% (n=2) as HPV 31, 33, or 35; and 2% (n=I) as another, unidentified, HPV type. These data support the role of HPV in the pathogenesis of cervical carcinoma in high-risk women living in Western China. This study represents the first report of HPV analyses in Uygur women with cervical cancer.
T-Cell-Rich B-Large-Cell Lymphoma Simulating Hodgkin's Disease: Report of Two Cases with Transformation to Pleomorphic B-Large-Cell Lymphoma
Authors: Wang Qi , Unger Pamela D. , Strauchen James A.
Published: June 2007

Malignant lymphomas resembling Hodgkin's disease in which the Hodgkin's-like cells express a B-cell phenotype pose a diagnostic and therapeutic dilemma. Recent studies have suggested these lymphomas are T-cell-rich B-large-cell lymphomas. In the present study we present two cases of malignant lymphomas meeting the histologic criteria for Hodgkin's disease, in which the Hodgkin's-like cells expressed a B-cell phenotype (CD20 positive, CD 15 negative, CD30 negative). In both cases therapy for Hodgkin's disease was unsuccessful, and the histology at relapse was that of a pleomorphic B-cell large-cell lymphoma. The findings support the view that malignant lymphomas resembling Hodgkin's disease, in which the Hodgkin's-like cells express a B-cell phenotype, are T-cell-rich B-large-cell lymphomas, and suggest a role for immunophenotyping of atypical cases of Hodgkin's disease.
Ectopic Pancreas in the Proximal Jejunum Associated with Duodenal Brunner's Gland Hyperplasia and Bile Duct Hamartoma
Authors: Levitt Marc A. , Merola Stephen , Fiel Maria Isabel , Pertsemlidis Demetrius
Published: June 2007

A case of a patient with ectopic pancreas in the proximal jejunum associated with duodenal bile duct hamartoma and Brunner's gland hyperplasia is described. The simultaneous finding of these discrete and uncommon lesions has not been previously reported and allows for speculation about a common embryologic origin.
Extraskeletal Myxoid Chondrosarcoma
Authors: Jambhekar Nirmala A. , Baraniya Jitendra , Baruah Rajendra , Joshi Ujjwala , Badhwar Rajesh
Published: June 2007

Extraskeletal myxoid chondrosarcoma is a rare soft-tissue sarcoma of the extremities that is considered to be indolent, but yet it has a capacity for multiple recurrences and lung metastasis. In a 23-year period, 10 cases of this rare tumor were reported in this institute. The authors studied the clinicopathologic features, including histochemical and immunohistochemical reactions, of these 10 cases, with a view to evaluate whether any constant pattern emerged. The histologic features include a lobular or nodular growth pattern, periodic acid-Schiff's stain positivity, diastase sensitivity, alian blue positivity with and without pretreatment by testicular hyaluronidase, lack of epithelial markers, and positivity for S-100 protein and vimentin. The purpose of this article is to stress that the above-mentioned features are of immense help in deineating this rare tumor from other tumors associated with myxoid and chondroid differentiation. The authors did not find any consistent relationship between site, celularity, and development of lung metastasis.