Biomedical subjects

S Suster

Publications and source records attributed to S Suster.

At least 145 records · Page 8Linked to original sources

PubMed1993

Squamous differentiation in malignant eccrine poroma.

Squamous differentiation in poral adnexal neoplasms is a rare event. Two cases are presented of malignant eccrine poroma in which areas of squamous differentiation showing the features of squamous cell carcinoma were present. The areas of squamous differentiation were found within the invasive components of the lesions and appeared to result from direct transformation of the poral epithelial cells. A review of the literature on this unusual phenomenon is presented.

Acrospiroma↗

PubMed1993

Sarcomas with combined features of liposarcoma and leiomyosarcoma. Study of two cases of an unusual soft-tissue tumor showing dual lineage differentiation.

Two cases are described of a soft-tissue sarcoma characterized histologically by the intimate admixture of areas displaying the features of liposarcoma and leiomyosarcoma. Both cases occurred in men, 70 and 77 years of age. The lesions were located in the left scrotum and abdominal cavity, respectively. Histologically, the lipomatous component in both cases consisted predominantly of well-differentiated liposarcoma with myxoid areas. The smooth-muscle component was characterized by intersecting fascicles of spindle cells displaying nuclear atypicality and scattered mitotic figures; the spindle cells in these areas were strongly immunoreactive with actin and desmin antibodies. The above tumors must be distinguished from angiomyolipoma, spindle-cell lipoma, myolipoma of soft tissue, and more importantly, from "dedifferentiated" liposarcoma. The development of dual lineage differentiation within adipose tissue tumors as exemplified by these two cases may be more prevalent than has been generally recognized, and may require the application of immunohistochemical markers for specific identification of the spindle-cell component.

Aged↗

PubMed1993

Treatment of epidermal cysts with Solcoderm (a copper ion and acid solution).

The treatment of epidermal cysts has often posed a problem for dermatologists. Although surgical excision has been adopted as the method of choice for the removal of these lesions, complications of surgery and recurrences have warranted the search for alternate therapeutic modalities. Use of a recently introduced compound, Solcoderm, is reported in the treatment of 116 epidermal cysts in 85 patients over a 2-year period. The satisfactory cosmetic results observed, low incidence of recurrence, low cost and ease of administration, make this drug a viable alternative in the management of epidermal cysts, particularly in those cases where surgery should be avoided.

Acetates↗

PubMed1993

Solitary myofibroma in adults: clinicopathological analysis of a series.

Solitary myofibroma is a recently described, benign neoplasm of superficial soft tissue, which represents the adult counterpart of infantile myofibromatosis and is poorly recognized. Eleven new cases are presented herein. The patients were mostly adults with ages ranging from 13-64 years. They presented with a solitary, usually painless nodule of variable duration in the skin or oral cavity. Histologically, each lesion had a biphasic pattern with spindle cells forming fascicular or whorled areas and rounded, more primitive cells arranged around small vessels, forming haemangiopericytoma-like areas. The characteristic zonation of infantile myofibromatosis was often less marked in adult lesions and there was a haphazard arrangement of the fascicular and pericytic areas in some cases. Hyalinization, especially of the peripheral spindle-celled areas, was frequent. Immunohistochemically, the spindle cells were desmin negative but muscle actin (HHF-35 and IA4) positive. The rounded cells were both desmin and actin negative. Electronmicroscopy confirmed the myofibroblastic/fibroblastic nature of tumour cells in two cases. Although vascular invasion was seen in two cases, solitary adult-type myofibroma pursues a benign clinical course.

Adolescent↗

PubMed1993

Benign trichogenic tumours: a report of two cases supporting a simplified nomenclature.

We report two cases of a rare benign tumour of hair germ. Clinically, both were solitary, well-circumscribed, subcutaneous nodules located in the extremities. Histologically, the tumours were characterized by nests and thin cords of basaloid epithelial cells intimately associated with a cellular stroma. The basaloid cells exhibited peripheral palisading, keratinization in the form of keratotic cysts and squamoid transformation, and pilar differentiation. An unusual, but distinctive, cribriform pattern of growth was observed. There was no communication with the overlying epidermis. Abundant primitive hair germinal buds and rare more advanced abortive hair follicles were identified. These histological appearances encompass features of both trichoblastic fibroma and trichogenic trichoblastoma, thus distinguishing these neoplasms from other skin tumours and reinforcing the hypothesis that these tumours are closely related from a histogenetic point of view. The presence of overlapping histological features can be problematic for practising histopathologists who rarely encounter these conditions. With this in mind, the term benign trichogenic tumour may be more appropriate to encompass these two tumours and related neoplasms that appear to lie within the spectrum of hair follicle development.

Adult↗

PubMed1993

Pulmonary adenofibroma: report of two cases of an unusual type of hamartomatous lesion of the lung.

We report two cases of a primary lung tumour characterized by complex gland-like spaces lined by simple cuboidal to columnar epithelium surrounded by a hyalinized spindle-cell fibroblastic proliferation reminiscent of adenofibromas of the female genital tract. The lesions occurred in a 54-year-old woman and a 56-year-old man. The tumours presented clinically as 1-2 cm, solitary 'coin' lesions and were discovered incidentally on routine chest X-rays. Both lesions were treated by lobectomy. One patient is alive and well with no evidence of disease after 8 years; the other died of myocardial infarction 5 years following resection of his tumour without evidence of recurrence. We interpret these lesions as benign hamartomatous growths; their main importance lies in distinguishing them histologically from other types of pulmonary hamartomas, pulmonary blastomas, intrapulmonary solitary fibrous tumours, and metastases from soft tissue and visceral sarcomas.

Adenofibroma↗

PubMed1993

Laryngeal chondrosarcomas.

Four cases of laryngeal chondrosarcoma are presented. The patients' ages ranged from 60 to 75 years; one was a man and three were women. Two of the tumors arose in the thyroid cartilage, one in the cricoid cartilage, and one in the left arytenoid cartilage. A rapid fatal course with pulmonary and cerebral metastases was observed for the tumor arising in the arytenoid cartilage that histologically corresponded to a myxoid chondrosarcoma. The other three cases corresponded to low-grade, well-differentiated chondrosarcomas of the hyaline type, and the patients were alive and free of recurrence or metastases 3 to 6 years following total and partial laryngectomy. A review of the literature on the topic and the importance of assessing histologic grade, size, and location in the evaluation of these neoplasms is discussed.

Aged↗

PubMed1992

Large cell lymphoma of the mediastinum with marked tropism for germinal centers.

The cases are presented of three patients with large cell malignant lymphoma of the mediastinum with a distinctive growth pattern characterized by marked tropism of tumor cells for germinal centers. The patients' ages ranged from 35 to 70 years; one was a woman, and two were men. Histologically, the lesions were characterized by a proliferation of large atypical cells arranged in clusters that encroached on mantle zones and invaded germinal centers. Immunohistochemical studies showed positive staining of the tumor cells for leukocyte common antigen, L-26 (pan-B-cell antigen), and lambda light chain restriction and negative staining with Leu-M1, UCHL-1 (pan-T-cell antigen), Ber-H2 (Ki-1 antigen), S-100 protein, HMB-45, low-molecular weight keratins, epithelial membrane antigen, carcinoembryonic antigen, and placental alkaline phosphatase. Electron microscopy done on one specimen showed cells with abundant cytoplasm, some of them containing surface microvilli, scant organelles, and scattered polyribosomes consistent with lymphoid cells. Because of their unusual growth pattern and morphology, these tumors can be mistaken for primary or metastatic carcinomas, germ cell tumors (particularly seminomas), and metastatic malignant melanomas. It is proposed that the "germinotropic" features observed in these lesions are the result of active colonization of germinal centers by the tumor cells. The possible pathogenetic implications of this phenomenon are discussed.

Adult↗

PubMed1992

Cystic thymomas. A clinicopathologic study of ten cases.

Cystic degeneration in thymoma is a relatively frequent but focal event. In rare cases, the process proceeds to the extent that most or all of the lesion becomes cystic. The authors studied ten cases of thymoma undergoing cystic degeneration of such degree that the lesions initially were mistaken grossly and microscopically for nonneoplastic thymic cysts. The patients' ages ranged from 23 to 81 years, and the sex distribution was equal. The lesions were characterized by the formation of multiple large cystic cavities filled with clear, hemorrhagic or grumose material. Histologically, residual solid islands showing the characteristic features of thymoma, i.e., biphasic cell population (epithelial cells/lymphocytes), perivascular spaces, and areas of medullary differentiation, were present within the cyst walls. In contrast with nonneoplastic thymic cysts, the walls of the cavities generally were devoid of an epithelial lining; most of the cysts appeared to predominantly result from extreme dilatation and confluence of perivascular spaces. In some instances, the cystic degeneration of the tumor was accompanied by cystic changes of an inflammatory nature in the surrounding, nonneoplastic thymic tissue leading to firm adhesions and apparent infiltration of adjacent mediastinal structures. None of the lesions in the studied patients recurred during follow-up periods of from 2 to 10 years (average follow-up, 5 years). Cystic thymomas should be distinguished from nonneoplastic congenital and acquired thymic cysts and other primary thymic neoplasms undergoing extensive cystic degeneration. It is important not to misinterpret the apparent infiltration of surrounding mediastinal structures that results from the inflammatory changes that often accompany these tumors as evidence of aggressive or malignant behavior.

Adult↗

PubMed1992

Epithelioid and spindle-cell hemangioendothelioma of the spleen. Report of a distinctive splenic vascular neoplasm of childhood.

A case of a distinctive vascular neoplasm of the spleen in a 3-year-old boy is described. The tumor was characterized histologically by a biphasic growth pattern, with discrete nodular areas composed of atypical round, epithelioid cells with large nuclei and prominent nucleoli, and areas showing an intricate proliferation of vascular channels lined by elongated spindle cells. Immunohistochemical studies showed cytoplasmic staining of the tumor cells with factor VIII-related antigen, Ulex europaeus lectin, and vimentin antibodies. Stains for keratin, actin, desmin, lysozyme, and S-100 protein were negative in the tumor cells. Electron microscopy revealed a fairly cohesive population of cells that contained mature and immature cell junctions, basal lamina material, and surface pinocytotic activity consistent with vascular endothelial cells. Five-year follow-up has shown the patient to be alive and free of disease. This case appears to represent a previously unreported primary vascular neoplasm of the spleen showing combined features of epithelioid and spindle-cell hemangioendothelioma. The lesion should be distinguished from other benign and malignant vascular proliferations of the spleen such as Kaposi's sarcoma, angiosarcoma, and the recently described littoral-cell angioma.

Child, Preschool↗

PubMed1992

Acinic cell carcinoma of the lung ("Fechner tumor"). A clinicopathologic, immunohistochemical, and ultrastructural study of five cases.

The clinical, pathological, immunohistochemical, and ultrastructural features in five cases of primary acinic cell carcinoma of the lung are presented. The patients' ages ranged from 44 to 75 years (mean, 56); four were women and one a man. The lesions were discovered incidentally on routine chest x-ray and ranged from 1.2 to 4 cm in greatest diameter. Three tumors were located in the right middle lobe, one in the right upper lobe, and one in the left upper lobe. In three cases, the lesions presented as asymptomatic subpleural nodules in proximity to secondary bronchi, one case presented as an endobronchial tumor that led to obstructive symptoms, and one case as a well-circumscribed deep parenchymal nodule. Histologically, the tumors were composed of clear cells with abundant granular cytoplasm growing as solid sheets with focal acinar, microcystic, and papillocystic areas. Immunohistochemical stains showed strong positivity of the tumor cells for low-molecular-weight cytokeratins and epithelial membrane antigen (EMA). Focal weak cytoplasmic positivity was observed in three cases with alpha-1-antichymotrypsin and in one case with amylase. Stains for vimentin, S-100 protein, chromogranin, and lysozyme were negative in all cases examined. Electron microscopy performed in four cases showed abundant zymogen-type cytoplasmic granules of variable electron density characteristic of acinar-type secretory cells. All patients were treated by lobectomy alone. Follow-up of 3 to 10 years in four cases revealed that all patients were alive and well, with no evidence of recurrence or metastases. Because of their relatively indolent behavior and favorable prognosis, primary acinic cell carcinoma of the lung must be distinguished from other primary and metastatic clear cell tumors of the lung.

Adult↗

PubMed1992

The spectrum of histologic growth patterns in benign and malignant fibrous tumors of the pleura.

A review of the histologic growth patterns in 50 cases of benign and malignant fibrous tumors of the pleura (localized or solitary fibrous tumor, fibrous mesothelioma) is presented. Two major histologic growth patterns were observed admixed in various proportions: solid spindle and diffuse sclerosing. The solid spindle growth pattern assumed various configurations, including fascicular areas, storiform and herringbone formations, angiofibroma and hemangiopericytoma-like areas, synovial sarcoma-like areas, and neural-type palisading, thus simulating a variety of soft-tissue neoplasms. The diffuse sclerosing pattern, although rarely assuming a dominant role, was present in varying proportions in virtually all cases. In areas with extensive sclerosis, focal degeneration of collagen simulating tumor necrosis was often present. Other less frequently observed features were the formation of "amianthoid" fibers, multinucleated giant cells, and foci of metaplastic ossification. On ultrastructural and immunohistochemical examination, the tumor cells showed nondistinct features. Due to the extreme variability in morphologic appearances and the lack of distinctive ultrastructural or immunohistochemical characteristics, these tumors can pose a significant diagnostic problem. Familiarity with their histologic appearances and correlation with the gross findings and clinical setting are essential for arriving at the correct diagnosis.

Adolescent↗

PubMed1991

Syringomatous squamous tumors of the breast.

Four cases are reported of syringomatous squamous tumors of the breast occurring in women aged 37 to 70 years. The lesions were characterized histologically by relatively well-circumscribed tumor-like nodules composed of a proliferation of teardrop or comma-shaped islands of squamous epithelium. The squamous epithelial islands contained central lumens lined by eosinophilic cuticles and were surrounded by a densely cellular fibrous matrix, thus closely resembling the growth pattern of dermal eccrine syringomas. The lesions appeared to arise de novo from breast parenchyma without evidence of transitions with the surrounding normal or hyperplastic mammary epithelium and were not associated with the overlying skin or nipple epidermis. In all cases, the surrounding breast tissue showed fibrocystic and benign proliferative changes, and in one case, the lesion was found in the vicinity of a large cyst surrounded by microcalcifications. All patients were treated by local surgical excision and have shown no evidence of recurrence over a follow-up period of 1 to 6 years. The histologic differential diagnosis and the possible pathogenesis of these lesions are discussed.

Adenoma↗

PubMed1991

Thymic carcinoma. A clinicopathologic study of 60 cases.

The clinicopathologic features of 60 patients with thymic carcinoma were studied. Patients ranged in age from 10 to 76 years (mean, 46), of whom 24 were females and 36 were males. Overall survival at 1, 3, and 5 years was 56.6%, 40%, and 33.3%, respectively. The following morphologic features were correlated with survival: type of tumor margins; presence or absence of a lobular growth pattern; nuclear atypia; necrosis; mitotic activity; and histologic tumor type and grade. Eighty eight percent of patients with poorly circumscribed/infiltrating neoplasms died of their tumors as compared with 16.6% of patients with well-circumscribed neoplasms (P less than 0.0000). Of patients whose tumors had mitotic counts exceeding 10/10 high-power fields (HPF), 84.3% died, as compared with 21.4% of patients with lower mitotic counts (P less than 0.0000). Of patients whose tumors showed lack of lobular growth pattern, 91.6% died, as compared with 29% of those whose tumors had a lobular growth pattern (P less than 0.0000). Finally, 84.6% of patients whose tumors displayed a high-grade histology (lymphoepithelioma-like carcinoma, small cell/neuroendocrine carcinoma, clear cell carcinoma, sarcomatid carcinoma, and anaplastic/undifferentiated carcinoma) died of tumor, as compared with 0% of patients whose tumors were of low-grade histology (well-differentiated squamous carcinoma, mucoepidermoid carcinoma, and basaloid carcinoma) (P less than 0.0000). Evaluation of the various treatment modalities used to treat these patients did not yield any statistically significant correlations with survival. Two clinically distinct groups of patients were identified: one after a relatively favorable clinical course with long survival, and one after a rapidly fatal outcome. The morphologic features of the tumors in these patients correlated well with their clinical behavior; histologic type (and the grade to which it was assigned) constituted the most reliable and important predictor of prognosis.

Adolescent↗

PubMed1991

Multilocular thymic cysts with pseudoepitheliomatous hyperplasia.

Six cases are described of benign thymic cysts of the anterior mediastinum showing focal pseudoepitheliomatous hyperplasia of the lining epithelium. The patients' ages ranged from 11 to 54 years; five cysts occurred in males and one in a female. Histologically, the lesions were characterized by exuberant proliferation of the cyst lining epithelium that grew as sheets and tongues of atypical squamous cells with large, hyperchromatic nuclei, prominent nucleoli, and scattered mitotic figures. The walls of the cyst adjacent to the areas of epithelial proliferation showed abundant hemorrhage, necrosis, and severe inflammatory changes. All cases were treated by local surgical excision. There was no evidence of recurrence or metastases over a follow-up period of up to 8 years (average follow-up, 4 years). It is proposed that pseudoepitheliomatous hyperplasia may develop in thymic cysts as an expression of regeneration of the lining epithelium in response to the inflammatory, hemorrhagic, and necrotizing changes which often accompany these lesions. This should not be mistaken for malignancy, and should be distinguished from the exceptional cases of true thymic neoplasms seen in association with thymic cysts.

Adult↗

PubMed1991

Myoepithelial differentiation in basal cell carcinoma.

Five cases of basal cell carcinomas (BCC) of the skin are described showing morphologic and immunohistochemical features of myoepithelial differentiation. Histologically, they were characterized by a dermal proliferation of tumor cells connected with the epidermis by areas showing the features of conventional BCC, with the deeper portions of the lesion showing a population of oval to spindle cells with eccentric nuclei and homogeneous, ground-glass, or hyaline eosinophilic cytoplasm characteristic of the so-called hyaline cell of myoepithelial tumors of salivary glands. Additionally, scattered cells showing a signet ring configuration were present, and in two cases, focal areas displaying chondromyxoid elements were also seen that appeared to merge imperceptibly with the surrounding spindle cell population. By immunohistochemistry, the tumor cells in the spindle cell component showed strong, diffuse positivity for CAM 5.2 and muscle specific actin, and variable expression of keratin AE1/AE3, vimentin, glial fibrillary acidic protein, and S-100 protein, these findings being consistent with the immunostaining pattern of myoepithelial cells and their neoplasms. A brief review of the literature on the topic is presented, along with a discussion of the possible pathogenesis of this process.

Adult↗

PubMed1991

Primary thymic epithelial neoplasms in children.

Primary epithelial neoplasms of the anterior mediastinum in children are very rare. We have studied 10 cases of thymic epithelial neoplasms in children aged 16 years or less and correlated their histologic features with the clinical outcome. The patients' ages ranged from one to 16 years (mean: 10.2); with a male:female ratio of 1.5:1. Nine patients had symptoms attributable to their tumors; one was asymptomatic. Four patients presented in clinical stage I, one in stage IIb, and five in stage IVb. Histologically, the tumors comprised a heterogenous group displaying a range of morphologic appearances: one tumor had the classic features of lymphocyte-rich thymoma of the adult; four were of the lymphocyte-rich type with associated unusual stromal features; two were spindle cell thymomas with cytologic and architectural atypia; and three displayed obvious cytologic features of malignancy (i.e., thymic carcinoma); two in the last group showed features of small cell carcinoma, and the other was an undifferentiated/anaplastic carcinoma. The epithelial nature of the tumors was supported in six cases by positive staining of the tumor cells with keratin antibodies and in two cases by electron microscopic demonstration of desmosomes and intracytoplasmic bundles of tonofilaments within the tumor cells. The prognosis for these patients correlated well with the degree of atypicality exhibited by the epithelial components; it was very poor in patients with small cell and undifferentiated/anaplastic carcinoma (8 months average survival), better for those with atypical spindle cell thymomas (multiple recurrences and metastases but no fatalities over a 15- to 72-month period), and best in those with lymphocyte-rich thymomas without cytologic atypia (no recurrences or metastases over an 8-month to 3-year follow-up).

Adolescent↗

PubMed1991

Induction of different morphologic features of malignant melanoma and pigmented lesions after transformation of murine melanocytes with bFGF-cDNA and H-ras, myc, neu, and E1a oncogenes.

Malignant melanomas show a remarkable degree of heterogeneity because of different morphologic features, biologic behavior, and prognosis. In this communication, the authors attempted to correlate morphologic heterogeneity of melanomas with transformation by different activated oncogenes; they studied the histologic features of melanocytic lesions induced by murine melanocytes transformed by basic fibroblast growth factor (b-FGF-cDNA) or H-ras, neu, myc, and E1a oncogenes, and the lesions were compared with those observed in human pathology. Tumors formed after grafting onto syngenic mice or subcutaneous injections in nude mice were studied. In syngenic mice, benign melanocytic lesions reminiscent of intradermal nevus were observed with melanocytes transformed with b-FGF-cDNA, and myc and E1a oncogenes. Benign lesions were also formed by neu-transformed melanocytes when they were grafted concomitantly with keratinocytes, whereas malignant tumors were formed by the same cells when grafted alone or together with fibroblasts. In contrast, H-ras melanocytes always formed malignant tumors. In nude mice, b-FGF-transformed melanocytes induced benign lesions, whereas transformed melanocytes by the other oncogenes formed malignant tumors with distinctive and homogeneous morphologic features that depended on the transforming oncogene. Melanomas with either epithelioid cell, spindle cell, small round cell, and anaplastic cell growth patterns could be distinguished after transformation with H-ras, neu, E1a, and myc oncogenes, respectively. These various histologic types are analogous to those that may be observed in human melanomas, even within the same tumor. These studies suggest a possible molecular mechanism for tumor heterogeneity in which distinct oncogenes or oncogenelike activities can be activated in different tumors or discrete parts of the same tumor.

Animals↗