[Epithelial markers: myth or reality?].
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Biomedical subjects
Publications and source records attributed to A J Balaton.
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The clinical and pathological features of three unusual soft tissue tumors are presented. They occurred in the groin of elderly patients in the subcutaneous tissue. In Case 1, the inguino-crural tumor coexisted with a second mass in the pelvis. The tumors had a tendency to recur locally and to invade the regional lymph nodes. Metastatic dissemination of the disease resulted in the death of the patient in Case 3. Histologically, the tumors appeared composed of small round cells with scanty cytoplasms, arranged in diffuse, poorly cohesive or solid sheets. In places, a trabecular pattern was noted. Mitotic figures were numerous. Some cells exhibited argyrophil granules. The ultrastructural study revealed compact whorls of intermediate filaments and neurosecretory granules. All three cases displayed a paranuclear dot-like positive reaction with antibodies to cytokeratins and neurofilaments. A diffuse cytoplasmic immunostaining for neuron-specific enolase was present in Cases 1 and 2. Protein S-100, vimentin and leucocyte common antigen could not be demonstrated. All these characteristics, except for the subcutaneous location, are shared with neuroendocrine (Merkel cell) tumors of the skin.
The authors report a protocol for microwave-accelerated decalcification. In comparison to decalcification at ambient temperature, decalcification using the microwave oven is reduced by a factor of 9 for trephine biopsies and by a factor of 11 for bone samples.
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An antiserum to carcinoembryonic antigen (CEA) and a monoclonal antibody to cytokeratin 19 (CK 19) were studied for their suitability as diagnostic reagents for the differential diagnosis of primary and secondary malignant epithelial tumours of the liver, on paraffin sections. With the antiserum to CEA, positive bile canalicular structures were found in 60 per cent of the hepatocellular carcinomas. All the cholangiocarcinomas and 66.6 per cent of the metastatic carcinomas were positive for CEA, without displaying a canalicular staining pattern. All the hepatocellular carcinomas were negative for CK 19. All the cholangiocellular carcinomas and the metastatic carcinomas were positive for CK 19. This staining profile may prove helpful in difficult diagnostic cases.
A 58-year-old man had a persistent perineal sinus following an abdominoperineal resection. An excision of the sinus was performed. Histology revealed that the sinus tract was bordered by a granulation tissue exhibiting numerous vacuolated cells containing polyvinylpyrrolidone. The origin of polyvinylpyrrolidone was related to lengthy irrigation of the fistula with Betadine.
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A case of paravertebral malignant rhabdoid tumor in a 59-year-old man is described. The location of the tumor and age of the patient appear to be unique. The clinical evolution was aggressive and resulted in the death of the patient. The tumor exhibited the light microscopic features of a typical rhabdoid tumor. It was composed of poorly differentiated round or polygonal cells with acidophilic glassy inclusions and vesicular nuclei exhibiting prominent nucleoli. Immunohistochemistry revealed the coexpression of cytokeratin and vimentin in neoplastic cells.
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A case of vacuolated (signet-ring) cell microfollicular adenoma of the thyroid is presented and confronted to the pertinent literature. It is a rare lesion. Its histologic aspect, featuring vacuolated cells and microfollicules, sometimes clover-shaped, and the results of the mucin stains and thyroglobulin immunostaining confirm the follicular-cell nature of the tumor and exclude primary mucin-producing tumors of the thyroid. Arrest of folliculogenesis appears to be the basic mechanism of histogenesis in our case.
A case of plexiform tumorlet of the uterus is reported and studied histologically and by immunohistochemistry. The presence of desmin in the tumour cells demonstrates their smooth muscle origin. These results are compared with other reports in the literature with special emphasis on histogenesis.
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