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Are all adenomatoid tumors adenomatoid mesotheliomas?

The ultrastructure of three histologically typical adenomatoid tumors of the epididymis is presented. Two of the three tumors showed morphologic features of mesothelium similar to those reported in the literature. The third tumor demonstrated a multilayered basal lamina and Weibel-Palade bodies, both of which have been found consistently in sclerosing hemangiomas. Although the ultrastructure of the first two tumors confirms the theory of a mesothelial origin of adenomatoid tumors, the findings of the third tumor indicate that a histologically typical adenomatoid tumor may not necessarily be a mesothelioma and that electron microscopy is indispensable in establishing their nature. These findings also lead us to suggest that the term adenomatoid tumor should remain in use for light microscopic diagnosis, and that the term adenomatoid mesothelioma should be applied only when the mesothelial nature of an adenomatoid tumor is proven by electron microscopy. For those that show ultrastructural evidence of endothelial origin, the term adenomatoid angioma seems to be appropriate and accurate. It is possible that the adenomatoid angioma represents a variant of the histiocytoid hemangioma.

Adenoma↗

Intrascrotal adenomatoid tumors.

Adenomatoid tumors are regarded as uncommon neoplasms of the paratesticular tissues, probably of mesothelial origin. The majority of cases reported have involved the epididymis. We report our experience with 8 cases of testicular tumors and 11 of epididymal adenomatoid tumors during a 13-year period, and review the relevant literature. The incidence of adenomatoid tumors relative to all tumors in the testis was 6.9% (8 of 116), exceeding that of Leydig cell tumors, which were previously believed to be the most common benign testicular neoplasms. The adenomatoid tumors included 38% epididymal tumors (11 of 29). The clinical course of the tumors was benign, without recurrences. Local excision is regarded as the treatment of choice for epididymal and testicular adenomatoid tumors.

Adult↗

Histiocytoid (epithelioid) hemangioma of the testis. The so-called vascular variant of "adenomatoid tumor".

Adenomatoid tumors are well-recognized neoplasms generally considered to be of mesothelial derivation. We describe an unusual vascular neoplasm that arose in the testis of a 29-year-old and resembled an adenomatoid tumor by light microscopy. An orchiectomy was performed, and the patient is alive and disease-free 3 years later. The 2-cm tumor was composed of small tubules lined by mesothelial-like cells with uniform, vesicular nuclei. However, some lumina contained erythrocytes, and immunohistochemically, the luminal cells reacted with antibodies to vimentin, Factor VIII-related antigen, and Ulex europaeus I lectin but not cytokeratin or epithelial membrane antigen. A cuff of muscle-specific actin-positive cells surrounded the luminal cell layer. This adenomatoid-like vascular neoplasm is more properly interpreted as a histiocytoid (epithelioid) hemangioma. Although some authors have considered microscopically similar lesions to represent a vascular variant of adenomatoid tumor, we prefer to reserve the term "adenomatoid tumor" for microscopically appropriate proliferations that have mesothelial features.

Adenoma↗

Sarcoidosis involving a paratesticular adenomatoid tumor.

Adenomatoid tumor is a common paratesticular neoplasm which may occur at any age and can involve the epididymis, testes, spermatic cord, and ejaculatory duct. Sarcoidosis of the genitourinary tract is exceedingly rare with approximately 30 cases of epididymal sarcoidosis reported. We report the first case of an epididymal adenomatoid tumor involved by classic sarcoid granulomata in a patient with systemic sarcoidosis.

Adenomatoid Tumor↗

Suprarenal occurrence of an adenomatoid tumor.

Adenomatoid tumors are rare, benign mesotheliomas that usually are associated with genito-urinary tract. The suprarenal occurrence of this tumor is uncommon. We present such a case and review the origin of the adenomatoid tumor.

Adult↗

Thread-like bridging strands: a morphologic feature present in all adenomatoid tumors.

Adenomatoid tumor (AT) is a benign, relatively rare neoplasm occurring primarily in the genital tract of both genders. Histologically, ATs were composed of fibrous tissue, which are separated by numerous slit-like and pseudotubular spaces. Peculiar "thread-like bridging strands" (TBS) crossing the pseudotubular spaces are typical morphologic feature. In this study, the frequency of occurrence of these TBS within a large series of ATs in various organs was examined. Sixty-nine cases were included in our study. Twenty-eight cases occurred in women, 41 cases in men. Tumors were located in the myometrium, fallopian tube, ovary, epididymis, tunica albuginea, and testicular parenchyma. Tumor size ranged from 0.8 to 8.2 cm (mean, 2.7 cm). TBS were found in 100% of cases. Presence of thin intraluminal TBS within ATs was a constant morphologic feature independently on gender and localization of the lesions. Ultrastructurally, they were always formed by apposition of attenuated cytoplasm of two adjacent mesothelial cells. In our opinion, TBS are morphologically very specific for ATs and we are not aware of any other epithelial structure in any organ demonstrating as appearance similar to these TBS of ATs.

Adenomatoid Tumor↗

[Adenomatoid tumor].

Adenomatoid tumour is a neoplastic process of discussed origin, but the immunohistochemical phenotype leads a mesothelial derivation. The preferential site of origin is the genital apparatus of both sexes, however extragenital cases have been described. The histological pattern varies from tubular formation, to solid growth, to cystic areas. In the present report we described a case of Adenomatoid tumour of the uterus body in a 46 years old patient.

Actins↗

Combined epithelial odontogenic tumor: adenomatoid odontogenic tumor and calcifying epithelial odontogenic tumor.

1. Two cases of a combined epithelial odontogenic tumor which had areas of AOT and CEOT were presented. 2. A review of the studies on histogenesis of the AOT revealed that the tumor probably consists of preameloblasts, stratum intermedium, and stellate reticulum. 3. A review of the studies on histogenesis of the CEOT revealed that the probable origin was in cells of stratum intermedium. 4. It is suggested that the present cases support the aforementioned theories of histogenesis and represent AOT's which contain foci of CEOT. 5. The suggested treatment is simple surgical excision.

Adolescent↗

Origin of adenomatoid tumor: a comparison between the structure of adenomatoid tumor and epididymal duct cells.

In this study the structure of the adenomatoid tumor was compared with that of the epididymal duct cells. Several similar histochemical and ultrastructural features such as PAS-positive cytoplasmic granules, microvilli, intracellular vacuoles, and extracellular canaliculi were found. Based on these findings, it is suggested that the adenomatoid tumor is derived from the coelomic epithelium after it has begun to differentiate in the direction of genital epithelia. Because mesothelial cells are also derived from coelomic epithelial cells, the similarities between adenomatoid tumor and mesothelial cells may also be explained.

Adenoma↗

Immunohistochemical and electron microscopic study of twelve adenomatoid tumors.

Twelve adenomatoid tumors were examined immunohistochemically with antibody probes to keratin and factor VIII-related antigen (FVIII-RA). None of the tumors labeled with FVIII-RA antibodies, whereas all but one labeled for keratin. Electron microscopy was done on tissue from paraffin-embedded blocks from all but one of the adenomatoid tumors. Both the immunohistochemical and electron microscopic results favor a mesothelial origin of adenomatoid tumors.

Adult↗

[Three cases of adenomatoid tumor of the uterus].

Adenomatoid tumors arising in the uterus are not well-recognized and sometimes mistaken for other benign or malignant neoplasms. This study describes three cases of uterine adenomatoid tumors with clinical, light microscopic, histochemical and electron microscopical studies. Four distinctive histologic patterns (solid, adenoid, angiomatoid, cystic) were identified. Acid mucopolysaccharide was present in three cases and was digested by hyaluronidase. Immunohistochemically, tumor cells were positive for cytokeratin and vimentin. Electron microscopy revealed microvilli, intermediate filaments and dilated intercellular spaces. This gives further support to a mesothelial origin of the adenomatoid tumor. Interestingly, one case showed that the adenomatoid tumor was multiple and one nodule was connected with leiomyomatous nodule. In the other case, the tumor was large 5 x 4 x 4.5 cm). These features were unusual.

Adenomatoid Tumor↗

Mixed tumor of paratesticular rhabdomyosarcoma and an adenomatoid tumor in an elderly patient.

We report a case of a mixed tumor of paratesticular rhabdomyosarcoma and an adenomatoid tumor in an elderly patient. Rhabdomyosarcoma is one of the most common childhood tumors; however, it rarely occurs in the elderly. In addition, to our knowledge, paratesticular rhabdomyosarcoma and adenomatoid tumor rarely form mixed tumors. Finally, we consider the pathogenesis of diploblastic tumors.

Aged↗

Adenomatoid tumor of the testes.

Adenomatoid tumors are rare benign neoplasms thought to be of mesothelial origin. Although most reported cases arise from the epididymis, rare cases have been reported in the spermatic cord, testicular tunica, ejaculatory ducts, prostate, and suprarenal recess. In female subjects, adenomatoid tumors are commonly found in the uterus and fallopian tubes. Because of the benign nature of this tumor, the treatment of choice is local excision. We describe a rare case of adenomatoid tumor of the testis treated by local excision.

Adenomatoid Tumor↗

Extragenital adenomatoid tumor of a mediastinal lymph node.

Adenomatoid tumors are benign neoplasms found predominantly in male and female genital tracts. Rare extragenital adenomatoid tumors have been discovered that involve serosal surfaces and nonmesothelial-lined organs such as adrenal glands. Since the discovery of adenomatoid tumors, their histogenetic origin has been debated. Many researchers support a mesothelial cell origin for adenomatoid tumors because these tumors characteristically express a mesothelial phenotype. Tumor derivation from primitive pluripotent mesenchymal cells and coelomic epithelium also has been suggested because of the anatomical distribution of the tumors. Despite their characteristic mesothelial phenotype and histological appearance, adenomatoid tumors have an extensive differential diagnosis that includes vascular neoplasms, malignant mesothelioma, germ cell tumors, and metastatic adenocarcinoma. Recognition of these tumors may be especially difficult when examined at frozen section and when adenomatoid tumors are encountered in rare extragenital sites. We describe an adenomatoid tumor of a mediastinal lymph node that was found incidentally during a redo Collis-Nissen gastroplasty. On frozen section examination, this tumor was misinterpreted as metastatic adenocarcinoma. The hematoxylin-eosin histological, immunohistochemical, and ultrastructural studies confirmed the mesothelial phenotype of this tumor. To our knowledge, this is the first description of a lymph node adenomatoid tumor.

Adenocarcinoma↗

Adenomatoid tumors of the uterus.

Adenomatoid tumors arising in the uterus are not well-recognized and are sometimes mistaken for other benign or malignant neoplasms. This study is a clinicopathologic analysis of 12 uterine adenomatoid tumors. Characteristically, they were small nodular lesions (mean diameter 2.1 cm) in the subserosa or outer wall of the myometrium. Four distinctive histologic types (adenoid, angiomatoid, solid, and cystic) were identified; each tumor consisted of a combination of one major and at least one minor type. The nodular proliferation of smooth muscle which accompanied some tumors was regarded as a non-neoplastic hyperplasia of myometrium. In two cases, small foci of serosal endosalpingiosis were adjacent to the tumor. Theories of histogenesis are discussed, and classification of the adenomatoid tumor as a type of benign mesothelioma is endorsed.

Adult↗