bluuebunny/crossref_metadata_2025_split huggingface dataset:
Metaplastic carcinoma of the breast arising within complex sclerosing lesion: a report of five cases
Authors: Denley  , Pinder  , Tan  , Sim  , Brown  , Barker  , Gearty  , Elston  , Ellis  
Published: March 2003

AimsThis study presents a series of five cases in which metaplastic carcinoma, predominantly low‐grade adenosquamous carcinoma, of the breast is seen arising within a background of a complex sclerosing lesion. This association has been recognized previously but has not been documented in detail. This study describes the characteristics of the components present in each case and discusses the existing literature. This observation adds further evidence to support an association between some types of invasive breast carcinoma and sclerosing lesions of the breast.Methods and resultsFour of these cases were received as referral cases for opinion. The fifth was received as part of the routine surgical workload within our own institution. Two patients presented following mammographic screening and three symptomatically; their mean age was 62 years (range 49–68). The mean lesion size was 16 mm (range 7–24). All five lesions showed features of a complex sclerosing lesion/radial scar in the form of central sclerosis with elastosis and radiating benign entrapped tubules. One had associated benign papillary structures and two had focal benign squamous mletaplasia. Four cases showed coexisting but distinct areas of low‐grade adenosquamous carcinoma with glandular and squamous epithelial differentiation in a spindle cell background. One case had associated undifferentiated spindle cell carcinoma. Detailed immunophenotypic characteristics of two cases are presented.ConclusionsThis series illustrates a postulated but previously unconfirmed association between an unusual form of metaplastic breast carcinoma (adenosquamous carcinoma) and complex sclerosing lesions. The mechanisms of induction of breast carcinoma are poorly understood but these observations further emphasize the potential for sclerosing lesion of the breast to be associated with, and possibly give rise to, invasive carcinoma of different types. The precise nature of the interaction between the pathological processes remains unclear.
Pleomorphic carcinoma of the breast: clinicopathological analysis of 26 cases of an unusual high‐grade phenotype of ductal carcinoma
Authors: Silver S A , Tavassoli F A 
Published: March 2003

AimsPleomorphic carcinoma is a poorly described entity whose phenotype is not well recognized as within the morphological spectrum of breast carcinoma. The purpose of this report is to describe the clinicopathological features of this tumour, and to promote its recognition as an unusual high‐grade morphological variant of mammary ductal carcinoma.Methods and resultsHistological slides of breast carcinomas (N = 64) coded between 1978 and 1995 as having pleomorphic or anaplastic features were reviewed. Pleomorphic carcinoma (N = 26) was diagnosed when ≥ 50% of the tumour manifested a pleomorphic cell population (> sixfold variation in nuclear size). Tumours of lobular origin were excluded. All neoplasms occurred in women with a mean age of 53 years. Patients underwent biopsy and/or mastectomy (n = 24) or lumpectomy (n = 2). The tumours' mean size was 54 mm. All were high‐grade neoplasms. The pleomorphic cell population comprised 50–100% of the tumour; 31% had a prominent spindled morphology. Fifty‐eight per cent of the tumours were initially misclassified by referring pathologists as sarcomas or carcinomas, possibly metastatic. Adjacent DCIS or a transition to classic ductal carcinoma was present in 73%. Five (19%) patients were stage I and three (12%) had stage IV disease. Axillary dissections yielded ≥ 3 (mean 7.2) positive lymph nodes in 52%. Most (68%) tumours were aneuploid; a high S‐phase (> 10%) was present in 63%. All neoplasms were ER negative and all but one were PR negative. p53 expression was present in 71%; none expressed bcl‐2. c‐erbB‐2 was detected in four (19%) node‐positive and in 0 (0%) node‐negative cases (P = 0.01). Of 16 patients with follow‐up, 6 (38%) were disease‐free (mean, 74 months), four (25%) alive with disease (mean, 33 months) and six (38%) dead of disease at a mean of 22 months.ConclusionsPleomorphic carcinoma is a prognostically unfavourable lesion and represents the extreme end of the morphological spectrum of grade III infiltrating ductal carcinoma.
Extremely high Langerhans cell infiltration contributes to the favourable prognosis of HPV‐infected squamous cell carcinoma and adenocarcinoma of the lung
Authors: Miyagi J , Kinjo T , Tsuhako K , Higa M , Iwamasa T , Kamada Y , Hirayasu T 
Published: March 2003

Aims: The infiltration of Langerhans cells in adenocarcinomas and squamous cell carcinomas of the lung was examined in relation to prognostic implications and human papillomavirus (HPV) infection.Methods and results: Samples from 62 adenocarcinoma and 59 squamous cell carcinoma patients in 1995–97, the prognosis of which had been followed up, were used. The Langerhans cells were demonstrated immunohistochemically using anti S100a and CD1 antibodies. Human papillomavirus (HPV) infection was examined by polymerase chain reaction (PCR) and nonisotopic in‐situ hybridization (NISH) methods. Statistical analysis was carried out using the Kaplan–Meier method (Wilcoxon analysis) and multiple regression analysis. HPV infection was demonstrated in 12 cases (19.4%) of adenocarcinoma. The HPV‐infected adenocarcinomas had abundant faintly eosinophilic cytoplasm, and were immunohistochemically positive for the surfactant apoprotein A. In the 59 cases of squamous cell carcinomas 19 were of the well differentiated form, and 29 and 11 were moderately and poorly differentiated cases, respectively. HPV was detected in 29 cases (49.2%) (13 well and 16 moderately differentiated cases). In all HPV‐infected adenocarcinoma and squamous cell carcinoma cases, extremely large numbers of Langerhans cells (more than 100 per high‐power field) were demonstrated in the tumour nests. In contrast, in the non‐HPV‐infected adenocarcinomas and squamous cell carcinomas, only a few (less than about 10 per high‐power field) Langerhans cells were observed. The squamous cell carcinoma cases with high Langerhans cell infiltration, which were also infected with HPV, showed a significantly good prognosis (P = 0.007). The adenocarcinoma cases with high Langerhans cell infiltration tended to have a better prognosis than the cases with low Langerhans cell infiltration, but the difference was not statistically significant. The low number of highly infiltrated cases was insufficient for an adequate statistical analysis. Furthermore, there was no significant correlation between either Langerhans cell infiltration and smoking, or HPV infection and smoking, in either squamous cell carcinoma or adenocarcinoma cases.Conclusions: It was considered that the extremely high Langerhans cell infiltration in the tumours was caused by HPV infection. The extremely large number of Langerhans cells in the tumours contributes to the favourable prognosis for HPV‐infected lung cancer.
Use of calretinin in the differential diagnosis of unicystic ameloblastomas
Authors: Coleman H , Altini M , Ali H , Doglioni C , Favia G , Maiorano E 
Published: March 2003

Aims: Calretinin, a 29‐kDa calcium‐binding protein is expressed widely in normal human tissues and tumours including both unicystic and solid and multicystic ameloblastomas. The histological distinction between unicystic ameloblastomas and certain non‐neoplastic odontogenic cysts can be problematic. The objective of this study was to determine whether calretinin was expressed in the lining epithelium of odontogenic keratocysts, residual and dentigerous cysts and to determine whether this calcium‐binding protein could be used to distinguish these cysts from the unicystic ameloblastoma.Methods and results: The lining epithelium in 22 cases of odontogenic keratocyst, 26 cases of residual cyst and 20 cases of dentigerous cyst were examined for the expression of calretinin. No positive epithelial staining was observed in any of these cystic lesions. In comparison, however, 81.5% of cases of unicystic ameloblastoma showed a coarse dark brown staining of the more superficial epithelial cell layers. Scattered positive stromal and epithelial cells were present; these were interpreted as mast cells.Conclusions: Calretinin appears to be a specific immunohistochemical marker for neoplastic ameloblastic epithelium and we suggest that it may be an important diagnostic aid in the differential diagnosis of cystic odontogenic lesions and ameloblastic tumours.
Cytokeratin 14 expression in epithelial neoplasms: a survey of 435 cases with emphasis on its value in differentiating squamous cell carcinomas from other epithelial tumours
Authors: Chu P G , Lyda M H , Weiss L M 
Published: March 2003

Cytokeratin 14 expression in epithelial neoplasms: a survey of 435 cases with emphasis on its value in differentiating squamous cell carcinomas from other epithelial tumours Aims: The tissue distribution of cytokeratin 14 (CK14) in epithelial neoplasms is not well defined. We have evaluated 435 cases of epithelial neoplasm of various origins with cytokeratin 14 monoclonal antibody with special attention to possible use in differential diagnosis. Methods and results: Immunohistochemistry (ABC–HRP method) was performed for detection of CK14. We found that the expression of cytokeratin 14 was generally restricted to: (i) the majority of cases of squamous cell carcinoma regardless of origin (67/74) and degree of differentiation; (ii) neoplasms with focal squamous differentiation, including endometrial, and ovarian adenocarcinoma, malignant mesothelioma and transitional cell carcinoma; (iii) thymoma (8/8); (iv) myoepithelial components of salivary gland pleomorphic adenoma (3/4); and (v) oncocytic neoplasms, including thyroid Hurthle cell adenoma (1/1) and salivary gland Warthin’s tumour (2/2). Conclusion: CK14 protein is a useful marker in differential diagnosis of squamous cell carcinomas.
A new method of margin evaluation in breast conservation surgery using an adjustable mould during fixation
Authors: Ichihara S , Suzuki H , Kasami M , Aoyama H , Sato Y , Oiwa M , Kurokawa K , Endo T 
Published: March 2003

A new method of margin evaluation in breast conservation surgery using an adjustable mould during fixation Aims: We have developed a new method of breast resection margin assessment in quadrantectomy using an adjustable mould to prevent the three‐dimensional specimen from distorting during fixation. Methods and results: The new method has been applied to 10 consecutive quadrantectomies (six invasive duct carcinomas, four duct carcinoma in situ with or without microinvasion). The precise configuration of the fixed specimen enabled pathologists to examine the side slices, the 5 mm thick slices cut parallel to the flat lateral margins of the specimen, permitting the separation of margin evaluation from tumour characterization. Eight cases with negative margins by our method would also be negative by assessment of inked margins since the margin widths were estimated to be from 5 to 30 mm (average 16.3 mm); two cases with positive margins would also be positive by inked margins. Conclusions: Our new method was as reliable as the inked margins employing sequential slicing of the entire tissue, although it reduced the number of blocks by more than half in invasive carcinomas. A further advantage of this method is that the accuracy in margin evaluation is not influenced by the extent of tumour sampling. In addition, our system can pinpoint the positive margins facilitating re‐excision to obtain tumour‐free margins.
Vascular smooth muscle cells and pericytes express MMP‐1, MMP‐9, TIMP‐1 and type I procollagen in inflammatory bowel disease
Authors: Arihiro S , Ohtani H , Hiwatashi N , Torii A , Sorsa T , Nagura H 
Published: March 2003

Vascular smooth muscle cells and pericytes express MMP‐1, MMP‐9, TIMP‐1 and type I procollagen in inflammatory bowel disease Aims: Matrix metalloproteinases (MMPs) are involved in tissue remodelling, which is one of the important aspects of inflammatory disease. To assess the balance between the matrix degradation and production, we analysed the in situ expression of MMP‐1, ‐3, ‐8 and ‐9, tissue inhibitor of metalloproteinases (TIMP)‐1 and ‐2, and type I procollagen (PC‐I) in inflammatory bowel disease. Methods and results: Immunohistochemistry using frozen sections was performed in 17 patients with ulcerative colitis (UC) and 16 with Crohn’s disease (CD). In both UC and CD, MMPs and TIMPs were expressed by inflammatory cells as well as by fibroblastic cells most prominently in actively inflamed areas in ulcer bases, but sparsely in intact inflamed mucosa in both UC and CD. In UC, inflamed mucosa with erosions expressed these substances focally. Fibroblasts also expressed PC‐I. We identified that vascular smooth muscle cells of venules in ulcer bases expressed MMP‐1 and ‐9, TIMP‐1 and PC‐I. These venules also expressed E‐selectin, a cell adhesion molecule to facilitate the leucocyte extravasation, and vascular endothelial growth factor (VEGF) receptor 2, consistent with their property of newly formed vessels. Conclusions: Our results suggest that MMPs are involved in the tissue remodelling, angiogenesis and promotion of leucocyte extravasation in the actively inflamed area in the ulcer base in both UC and CD. MMP‐1 expression in the mucosa may be related to the initial step of ulceration in UC. Therapeutic manipulation of extracellular matrix turnover would be an effective therapy to alleviate active inflammation and accelerate ulcer healing.
Over‐diagnosis of hydatidiform mole in early tubal ectopic pregnancy
Authors: Burton J L , Lidbury E A , Gillespie A M , Tidy J A , Smith O , Lawry J , Hancock B W , Wells M 
Published: March 2003

Over‐diagnosis of hydatidiform mole in early tubal ectopic pregnancy Aims: Tubal ectopic hydatidiform moles are rare lesions, and only 40 cases have been reported in the world literature. We investigated the apparently high incidence of tubal ectopic hydatidiform moles in women referred for treatment to a Supraregional Trophoblastic Tumour Screening and Treatment Centre between 1986 and 1996. Methods and results: Of 4261 women referred during the study period, 25 (0.6%) had a suspected tubal ectopic hydatidiform mole and paraffin‐embedded tissue was available in 20 (80%) of these. Each case was reviewed by two pathologists and DNA flow cytometric analysis was undertaken when the histological diagnosis was initially deemed equivocal or suggestive of hydatidiform mole. On review, 17 cases (85%) showed no evidence of hydatidiform mole (circumferential trophoblastic proliferation, hydrops, scalloped villi, and stromal karyorrhexis). Of these, 11 cases (65%) showed features of early placentation and six (35%) showed hydropic abortion. DNA flow cytometry was performed in 14 (82%) of these cases and revealed a diploid population in each case. Three cases of molar pregnancy (15%) were identified. Each of these cases had the histological features of an early complete hydatidiform mole. Sufficient tissue was available for DNA flow cytometric analysis in two of these cases and confirmed the presence of diploidy in each. Conclusions: Our results show that tubal ectopic hydatidiform mole is a rare entity and demonstrate that it is over‐diagnosed. Polar trophoblastic proliferation and hydropic villi are features of early placentation and of hydropic abortion. Sheets of extravillous trophoblast may be particularly prominent in tubal ectopic gestation. In the absence of circumferential trophoblastic proliferation combined with hydropic change a diagnosis of gestational trophoblastic disease should be avoided.
Distribution of alpha glutathione S‐transferase in ovarian neoplasms: an immunohistochemical study
Authors: Tiltman A J , Ali H 
Published: March 2003

Distribution of alpha glutathione S‐transferase in ovarian neoplasms: an immunohistochemical study Aims: Alpha glutathione S‐transferase (α‐GST) has been shown to be an immunohistochemical marker for δ4–5 isomerase, an enzyme active in steroidogenesis. The purpose of this study was to document the distribution of α‐GST in ovarian neoplasms in order to evaluate its usefulness as a diagnostic tool. Methods and results: A total of 92 tumours (25 sex cord/stromal, 53 epithelial and 14 germ cell) were subjected to immunohistochemistry using a commercially available polyclonal antibody to α‐GST. The avidin–biotin complex was used as a detection system. Positive staining was found in luteinized stromal cells of all tumour types (58/92). This included the Leydig cells of Sertoli–Leydig cell tumours (7/7) and was particularly prominent in the stromal cells of both benign and malignant mucinous tumours (24/25). Granulosa and Sertoli cells showed weak or no intracytoplasmic staining, which is expected because they do not normally produce androstenedione. They did show some intranuclear staining. Malignant mucinous (12/25) and occasional other epithelial tumours showed focal intracytoplasmic positive staining. Yolk sac tumours showed focal positivity (7/8). Conclusions: Intracytoplasmic staining of stromal cells is considered to indicate steroidogenesis and intranuclear staining the intracytoplasmic transport function of α‐GST. The intracytoplasmic staining of mucinous carcinomas might represent an up‐regulation of some detoxification function. The findings suggest that antibody to α‐GST has some value in the investigation of ovarian pathology and could readily be included in any panel of antibodies used to investigate ovarian neoplasms of uncertain histogenesis.
c‐erbB‐2 and c‐Met expression relates to cholangiocarcinogenesis and progression of intrahepatic cholangiocarcinoma
Authors: Aishima S‐I , Taguchi K‐I , Sugimachi K , Shimada M , Sugimachi K , Tsuneyoshi M 
Published: March 2003

c‐erbB‐2 and c‐Met expression relates to cholangiocarcinogenesis and progression of intrahepatic cholangiocarcinoma Aims: The c‐erbB‐2 and c‐Met proto‐oncogenes are important for tumour invasiveness and metastasis in many types of malignant tumours. Previous studies have indicated that these proteins are associated with carcinogenesis in intrahepatic cholangiocarcinoma. In this study, we examined c‐erbB‐2 and c‐Met expression by immunohistochemistry in hepatolithiasis, intrahepatic cholangiocarcinoma and metastatic lymph node, in order to clarify whether these proteins play a role in carcinogenesis and tumour metastasis in intrahepatic cholangiocarcinoma. Methods and results: In hepatolithiasis, the staining for c‐erbB‐2 was positive in 14 of the 23 (61%) cases, while staining for c‐Met was positive in eight of the 23 (35%) cases. In intrahepatic cholangiocarcinoma, staining for c‐erbB‐2 was positive in 45 of the 81 (55%) cases, while staining for c‐Met was positive in 28 (35%) cases. The positivity of c‐Met staining in intrahepatic cholangiocarcinoma was significantly higher in the differentiated type of cholangiocarcinoma than in the undifferentiated type. In addition, c‐Met‐positive staining had an inverted correlation with tumour size, the presence of perineural invasion and the presence of lymph node metastasis. c‐Met staining had a significantly higher positivity in cases at an early stage of intrahepatic cholangiocarcinoma. In contrast, the positivity of c‐erbB‐2 staining in intrahepatic cholangiocarcinoma was significantly higher in cases with lymph node metastasis than in cases without. In metastatic lymph nodes, the staining for c‐erbB‐2 was positive in 20 of the 25 (80%) cases, while staining for c‐Met was positive in six of the 25 (24%) cases. There was no difference in survival between c‐erbB‐2‐positive and negative patients. However, the patients with c‐Met‐positive tumours had a significantly longer survival than those with c‐Met‐negative tumours in the medium survival term. The multivariate analysis showed the presence of lymph node metastasis, lymphatic permeation and histological differentiation to be independent prognostic factors. Conclusion: These results indicate that increased c‐Met expression participates in cholangiocarcinogenesis and in the early developmental stages of intrahepatic cholangiocarcinoma, while increased c‐erbB‐2 expression contributes to the development of cholangiocarcinogenesis into an advanced stage associated with tumour metastasis.
Respiratory failure due to micronodular type II pneumocyte hyperplasia
Authors: Cancellieri A , Poletti V , Corrin B 
Published: March 2003

Aims:  To report the first case of respiratory failure due to micronodular type II pneumocyte hyperplasia.Methods and results:  Biopsy, explant and autopsy material from a 16‐year‐old girl, a smoker, with no personal or family history of tuberous sclerosis, who died following lung transplantation necessitated by progressive respiratory failure, was evaluated histologically. Micronodular pneumocyte hyperplasia was identified histologically as the cause of the respiratory failure. Foci of hyperplastic type II pneumocytes measuring up to 4 mm were widely scattered through the lungs. The hyperplastic cells had abundant eosinophilic cytoplasm, vesicular nuclei and prominent nucleoli. Immunohistochemistry showed that they stained for cytokeratins AE1, AE3 and CAM 5.2 and for epithelial membrane antigen (EMA), but not for carcinoembryonic antigen (CEA), S100, smooth muscle actin, CD68 and HMB‐45.Conclusions:  Although micronodular type II pneumocyte hyperplasia is usually of no clinical significance, in our patient the process was so florid as to cause respiratory failure, which was severe enough to necessitate lung transplantation.
ALK protein expression in rhabdomyosarcomas
Authors: Pillay K , Govender D , Chetty R 
Published: March 2003

Aims:  The ALK p80 chimeric protein is thought to be up‐regulated as a result of the t(2;5) as classically seen in anaplastic large cell lymphoma. However, rhabdomyosarcomas (in particular, the alveolar subtype) have also been noted to show expression of this protein. This study set out to examine ALK expression in a large number of rhabdomyosarcomas.Methods and results:  Eighty‐three cases of rhabdomyosarcomas and 16 cases of malignant mixed müllerian tumours with a rhabdomyosarcomatous component were retrieved from the archives of the Department of Anatomical Pathology for the period 1983–2001. The sections were stained with polyclonal ALK antibody. There were 52 male and 30 female patients. In one case, the gender of the patient was not indicated. The ages ranged from 1 week to 77 years. The most common site was the head and neck region, followed by the pelvis and extremities. Thirty‐one cases were of the alveolar subtype while 40 cases were embryonal. There were four mixed embryonal/alveolar, six pleomorphic and two unclassifiable rhabdomyosarcomas. Fourteen of the 31 (45%) alveolar rhabdomyosarcomas stained positively for the ALK protein, while only six of the 40 embryonal (15%) cases showed positivity. One case each of the mixed embryonal/alveolar, pleomorphic and unclassified cases was also immunopositive. The rhabdomyosarcomatous component in the malignant mixed müllerian tumours was positive in four of the 16 cases.Conclusion:  We conclude that a proportion of alveolar rhabdomyosarcomas (in particular) exhibit ALK protein expression. However, ALK expression is not restricted to this subtype. An extension of this study is to determine if this over‐expression is as a result of the t(2;5) translocation.