This case report describes a rare case of plasmacytoid myoepithelioma (PM) located in the hard palate of a 15-year-old male. Histological analysis revealed sheets and islands of round plasmacytoid cells with hyaline cytoplasm. Immunohistochemistry showed the cells were positive for S-100 protein and vimentin, but negative for smooth muscle actin and cytokeratin 14. Though usually considered a benign tumor, myoepitheliomas can be more aggressive than pleomorphic adenomas. Complete surgical excision was performed and no recurrence was detected.
This document summarizes the key differences between primary and secondary angiosarcoma (AS) of the breast. Primary AS typically affects younger women (median age 40) and presents as masses within the breast parenchyma, while secondary AS affects older women (median age 67-71) and develops in irradiated breast skin and subcutaneous tissue 7-10 years after radiation therapy. Both forms have a poor prognosis. Surgical management often involves mastectomy but optimal margins are unclear. Adjuvant chemotherapy and radiation have shown mixed results, and larger randomized trials are needed to determine their effectiveness for AS of the breast.
This document summarizes a study examining the presence of cancer-associated fibroblasts (CAFs) in different subtypes of neuroblastoma tumors. The study found that CAFs, identified by alpha-smooth muscle actin expression, were abundant in schwannian stroma-poor neuroblastoma regions and associated with microvascular proliferation, but were less prevalent in schwannian stroma-rich regions. This suggests CAFs may promote angiogenesis in aggressive, schwannian stroma-poor neuroblastomas.
This document provides an overview of the origin and types of cancer cells. It discusses the history of cancer studies from ancient Egypt and Greece. There are hundreds of types of cancers that are broadly classified as carcinomas, sarcomas, or leukemias/lymphomas depending on the type of cell they arise from. Carcinomas make up 90% of cancers and arise from epithelial cells that line surfaces. Sarcomas are rare cancers of connective tissues. Leukemias and lymphomas develop from blood or immune system cells. The document provides examples of common cancer types within each broad classification.
MORPHOLOGICAL CHARACTERISTICS OF METASTATIC BRAIN TUMORS AND THEIR PRIMARY SO...pbij
Evaluation of morphological differences between primary tumors and their intracerebral metastases was performed in operational specimens from 41 patients with intracerebral metastases (carcinoma in 80,5±6,19 %, melanoma in 19,5±6,19 %) and primary tumors: skin melanoma (8 cases), lungs carcinoma (17 cases), breast carcinoma (16 cases). Standard basic micromorphological processing was performed.
The structure of intracerebral metastatic melanoma foci had similarities with primary foci, but with higher atypicity, vascularity, surrounding by "muffs" of tumor cells, hemorrhagic, inflammatory and necrotic foci. Tumor tissue of lungs-derived metastatic focus repeated the structure of primary tumor, in patches glandular formations go with solid layers of acinar structures in the center, stroma in these places is not prominent giving an evidence of de-differentiation. In primary breast tumors and their brain metastases morphology was almost identical. It was proved that brain metastatic tumor tissue is characterized by lower differentiation comparing with primary tumor.
Primary mediastinal liposarcoma of the superior, middle, and anterior mediast...Mary Ondinee Manalo Igot
Primary mediastinal liposarcoma of the superior, middle, and anterior mediastinum
https://www.actamedicaphilippina.org/issue/1102
This document compares risk factors and molecular analysis of right-sided colon cancer and left-sided colon cancer. It discusses that:
- Right-sided colon cancer predominantly follows a MSI pathway while left-sided colon cancer follows a CIN pathway.
- There are differences in the embryonic development, function, and gene expression between the right and left colon that influence cancer risk.
- Certain risk factors like family history, inflammatory bowel disease, diet, and geographic location are associated with increased rates of either right-sided or left-sided colon cancers.
Molecular Genetics and Recent updates of Soft tissue tumours Dr.Argha BaruahArgha Baruah
(i) Soft tissue tumors are diagnostically challenging due to clinical, radiological, and histological overlap. Molecular classification divides tumors into those with specific genetic alterations like translocations or mutations, and those with complex karyotypes.
(ii) Recent updates include classification of additional tumor types like EWSR1-SMAD3 positive fibroblastic tumor and NTRK-rearranged spindle cell neoplasm. Dedifferentiated liposarcoma may have a worse prognosis with high-grade or rhabdomyoblastic differentiation.
(iii) Emerging entities include CIC-rearranged round cell sarcoma and sarcoma with BCOR rearrangements, expanding the molecular
New Mechanism in the Regulation of Human Genes and Disappearance of Genetic M...Mariluz Laverde
The U2AF protein plays an important role in splicing pre-RNA into mRNA by alternating between an open and closed confirmation when bound to a matching RNA sequence. This discovery provides insight into the regulation of protein synthesis and many signaling pathways in cells. Sézary syndrome is a type of skin cancer characterized by cancerous T-cell lymphocytes in the skin and blood that can spread to lymph nodes. The loss of the E2A gene was found to enable tumor growth in mice and some human lymphomas. These findings may help develop new, more effective cancer therapies.
This document summarizes the key differences between primary and secondary angiosarcoma (AS) of the breast. Primary AS typically affects younger women (median age 40) and presents as masses within the breast parenchyma, while secondary AS affects older women (median age 67-71) and develops in irradiated breast skin and subcutaneous tissue 7-10 years after radiation therapy. Both forms have a poor prognosis. Surgical management often involves mastectomy but optimal margins are unclear. Adjuvant chemotherapy and radiation have shown mixed results, and larger randomized trials are needed to determine their effectiveness for AS of the breast.
This document summarizes a study examining the presence of cancer-associated fibroblasts (CAFs) in different subtypes of neuroblastoma tumors. The study found that CAFs, identified by alpha-smooth muscle actin expression, were abundant in schwannian stroma-poor neuroblastoma regions and associated with microvascular proliferation, but were less prevalent in schwannian stroma-rich regions. This suggests CAFs may promote angiogenesis in aggressive, schwannian stroma-poor neuroblastomas.
This document provides an overview of the origin and types of cancer cells. It discusses the history of cancer studies from ancient Egypt and Greece. There are hundreds of types of cancers that are broadly classified as carcinomas, sarcomas, or leukemias/lymphomas depending on the type of cell they arise from. Carcinomas make up 90% of cancers and arise from epithelial cells that line surfaces. Sarcomas are rare cancers of connective tissues. Leukemias and lymphomas develop from blood or immune system cells. The document provides examples of common cancer types within each broad classification.
MORPHOLOGICAL CHARACTERISTICS OF METASTATIC BRAIN TUMORS AND THEIR PRIMARY SO...pbij
Evaluation of morphological differences between primary tumors and their intracerebral metastases was performed in operational specimens from 41 patients with intracerebral metastases (carcinoma in 80,5±6,19 %, melanoma in 19,5±6,19 %) and primary tumors: skin melanoma (8 cases), lungs carcinoma (17 cases), breast carcinoma (16 cases). Standard basic micromorphological processing was performed.
The structure of intracerebral metastatic melanoma foci had similarities with primary foci, but with higher atypicity, vascularity, surrounding by "muffs" of tumor cells, hemorrhagic, inflammatory and necrotic foci. Tumor tissue of lungs-derived metastatic focus repeated the structure of primary tumor, in patches glandular formations go with solid layers of acinar structures in the center, stroma in these places is not prominent giving an evidence of de-differentiation. In primary breast tumors and their brain metastases morphology was almost identical. It was proved that brain metastatic tumor tissue is characterized by lower differentiation comparing with primary tumor.
Primary mediastinal liposarcoma of the superior, middle, and anterior mediast...Mary Ondinee Manalo Igot
Primary mediastinal liposarcoma of the superior, middle, and anterior mediastinum
https://www.actamedicaphilippina.org/issue/1102
This document compares risk factors and molecular analysis of right-sided colon cancer and left-sided colon cancer. It discusses that:
- Right-sided colon cancer predominantly follows a MSI pathway while left-sided colon cancer follows a CIN pathway.
- There are differences in the embryonic development, function, and gene expression between the right and left colon that influence cancer risk.
- Certain risk factors like family history, inflammatory bowel disease, diet, and geographic location are associated with increased rates of either right-sided or left-sided colon cancers.
Molecular Genetics and Recent updates of Soft tissue tumours Dr.Argha BaruahArgha Baruah
(i) Soft tissue tumors are diagnostically challenging due to clinical, radiological, and histological overlap. Molecular classification divides tumors into those with specific genetic alterations like translocations or mutations, and those with complex karyotypes.
(ii) Recent updates include classification of additional tumor types like EWSR1-SMAD3 positive fibroblastic tumor and NTRK-rearranged spindle cell neoplasm. Dedifferentiated liposarcoma may have a worse prognosis with high-grade or rhabdomyoblastic differentiation.
(iii) Emerging entities include CIC-rearranged round cell sarcoma and sarcoma with BCOR rearrangements, expanding the molecular
New Mechanism in the Regulation of Human Genes and Disappearance of Genetic M...Mariluz Laverde
The U2AF protein plays an important role in splicing pre-RNA into mRNA by alternating between an open and closed confirmation when bound to a matching RNA sequence. This discovery provides insight into the regulation of protein synthesis and many signaling pathways in cells. Sézary syndrome is a type of skin cancer characterized by cancerous T-cell lymphocytes in the skin and blood that can spread to lymph nodes. The loss of the E2A gene was found to enable tumor growth in mice and some human lymphomas. These findings may help develop new, more effective cancer therapies.
WHO 2016 update on classification of Lymphoid neoplasms Arijit Roy
This document summarizes the major proposed changes in the 2016 revision of the World Health Organization classification of lymphoid neoplasms compared to the 2008 classification. Some key changes include distinguishing low-count from high-count monoclonal B-cell lymphocytosis, recognizing provisional entities like large B-cell lymphoma with IRF4 rearrangement, and emphasizing prognostic markers for diffuse large B-cell lymphoma like double expression of MYC and BCL2 proteins. The revision aims to better classify hematologic malignancies based on new clinical, pathological and genetic data.
This document discusses a study to create tissue engineering models of breast cancer metastasis. The researchers will develop 3D scaffolds mimicking adipose and bone tissue with varying stiffness. They will seed metastatic breast cancer cells onto the scaffolds to study changes in gene expression, histology, and markers as the cells metastasize from softer adipose-like scaffolds to stiffer bone-like scaffolds. The goal is to better understand the mechanisms driving breast cancer metastasis in order to develop new prevention and treatment strategies.
The document describes an interactive microscopy session on deep soft tissue spindle cell tumors. It presents two cases of monophasic synovial sarcoma in the first case, discussing the histology, immunoprofile and genetics of this tumor. The second case presents two examples of malignant peripheral nerve sheath tumor (MPNST), noting their characteristic histological features and association with neurofibromatosis type 1 or prior radiation therapy. Key differential diagnoses and diagnostic markers are also mentioned.
Defect in recruiting effector memory CD8+ T-cells in malignant pleural effusi...Enrique Moreno Gonzalez
Malignant pleural effusions (MPE) are a common and fatal complication in cancers including lung or breast cancers, or malignant pleural mesothelioma (MPM). MPE animal models and immunotherapy trials in MPM patients previously suggested defects of the cellular immunity in MPE. However only few observational studies of the immune response were done in MPM patients, using questionable control groups (transudate…).
Role of Flow Cytometric Immunophenotyping in Plasma Cell DyscrasiasApollo Hospitals
Immunophenotyping is being routinely used for the diagnosis of leukemias. With the advent of specific markers for plasma cells, it has become possible to differentiate between benign and malignant plasma cells based on their immunophenotypic profile. The enhanced use of immunophenotyping in plasma cells dyscrasias may help to categorize the borderline cases which can not be done with morphology alone. Also the immunophenotypic profiling of plasma cells would help in Minimal Residual Disease (MRD) evaluation of patients on treatment of multiple myeloma (MM).
This document discusses various papillary tumors of the central nervous system. It begins by outlining the typical age ranges and locations for different tumor types, then describes key histological features. Several specific tumor types are discussed in more detail, including choroid plexus tumors, ependymomas, astroblastoma, meningioma, glioblastoma, craniopharyngioma, germ cell tumors, and metastatic tumors. Immunohistochemistry staining patterns are also provided to aid in diagnosis. The summary emphasizes that the diagnostic approach is to first consider the patient's age and radiology findings, examine histological features, and only use IHC when necessary to determine a tumor's primary origin.
1) Cancer metastasis is a multi-step process involving invasion of surrounding tissue, transportation through the bloodstream, and formation of tumors in distant organs.
2) Key steps include degradation of the extracellular matrix, entry and survival in the circulation, arrest and extravasation at distant sites, and induction of angiogenesis to establish blood supply for growing tumors.
3) Factors such as matrix metalloproteinases, integrins, and angiogenic growth factors regulate these steps by promoting degradation of barriers, cell adhesion, and new blood vessel formation to enable metastatic tumors to grow.
The document summarizes the process of cancer metastasis through the invasion-metastasis cascade. It involves 6 key steps: 1) Localized invasion of primary tumor cells aided by loss of cell adhesion molecules and matrix metalloproteinases. 2) Intravasation of tumor cells into blood vessels assisted by tumor-associated macrophages. 3) Transport of circulating tumor cells protected by platelet emboli. 4) Extravasation of tumor cells from vessels into distant tissues. 5) Formation of dormant micrometastases. 6) Rare colonization of micrometastases into macroscopic tumors limited by the foreign tissue environment. Metastasis suppressor genes and strategies targeting multiple steps simultaneously show promise for preventing cancer spread.
This document discusses several indolent lymphoproliferative disorders of the gastrointestinal tract, including lymphomatoid gastropathy, NK cell enteropathy, and indolent T-cell lymphoproliferative disorders. It provides details on clinical presentations, endoscopic findings, histopathology, immunophenotypes, clinical outcomes, and differential diagnoses. Key points are that these disorders can present with nonspecific GI symptoms and are characterized by non-destructive, superficial infiltrates that rarely progress. Correct diagnosis requires integrating multiple findings to distinguish them from other entities like celiac disease or aggressive lymphomas. Optimal treatment approaches remain unclear.
Cancer Stem Cells (CSCs) have become a vital target for biologists and researchers.
The following presentation focuses on the treatment of cancer through targeting CSCs and its advantages.
1) Cancer begins as abnormal cells that grow uncontrollably and can become invasive, spreading to other parts of the body.
2) There are several types of cancer including carcinomas, sarcomas, leukemias, lymphomas, and central nervous system cancers.
3) Metastasis is when cancer cells spread from the original tumor site through the bloodstream or lymphatic system and form new tumors in other parts of the body. The major steps in metastasis include invasion, circulation, arrest in distant organs, and growth of new tumors.
A comprehensive review of Cutaneous Lymphomas - both B-Cell and T-Cell with latest treatment strategies. Target audience are oncologists, dermatologists, oncology physicians, dermatology and oncology fellows
The document discusses soft tissue tumours in children, with a focus on rhabdomyosarcoma and molecular diagnostic techniques. It notes that soft tissue tumours in children are challenging to diagnose due to their rarity and morphological features. Molecular techniques such as fluorescence in situ hybridization and PCR have become important diagnostic and prognostic tools because many paediatric tumours have specific translocations and fusion genes. Rhabdomyosarcoma is the most common soft tissue sarcoma in children, and molecular analysis can distinguish between embryonal and alveolar subtypes, which have different prognoses. Immunohistochemistry is also useful but molecular analysis has provided more definitive diagnoses.
Adenoidcystic carcinoma in head and neck cancersAjeet Gandhi
This document summarizes the management of adenoid cystic carcinoma (ACC), a rare type of head and neck cancer. It finds that surgery is the primary treatment but adjuvant radiation improves disease-free survival. For patients with positive margins or extracapsular extension, concurrent chemotherapy with radiation may provide better local control. Recurrence is common, occurring locally or distantly even many years later. Future prospects include tailoring treatment based on molecular profiling, as certain gene mutations are associated with worse outcomes. The current study found multi-modality treatment with surgery and adjuvant radiation provides superior outcomes for ACC of the head and neck.
Recent changes in 2016 who classification of myeloid neoplasmDr.Pooja Dwivedi
The document summarizes the major changes made in the 2016 WHO Classification of Myeloid Neoplasms compared to previous classifications. Key changes include:
1. Mastocytosis is now classified as a separate disease category rather than a subgroup of myeloproliferative neoplasms.
2. Chronic myelomonocytic leukemia is further divided into CMML-0, CMML-1, and CMML-2 based on blast percentage thresholds.
3. Myeloid/lymphoid neoplasms with gene rearrangements such as PCM1-JAK2 are included as provisional entities.
This case study describes two cases of men with primary extragonadal germ cell tumors who were also found to have testicular microlithiasis (TM). Both men presented with seminoma originating in unusual extragonadal locations (retroperitoneum and mediastinum). In both cases, ultrasound found TM but no testicular lesions. While the association between primary extragonadal germ cell tumor and TM is not well understood, a literature review found several other reported cases of TM occurring with primary extragonadal germ cell tumors, especially in younger patients. The findings suggest TM may be correlated with primary extragonadal germ cell tumors, though more research is needed.
Invadopodia play an important role in cancer cell invasion and metastasis. Key proteins involved in invadopodia include actin regulators like cortactin and N-WASP, and adaptor proteins like TKS4 and TKS5. Invadopodia allow cancer cells to degrade the extracellular matrix through metalloproteinases. Cancer cells employ various mechanisms to evade the host immune response after extravasation, including secreting TGFβ and expressing toll-like receptors and tumor counterattack proteins that can kill lymphocytes. Successful metastasis requires cancer cells to survive in the bloodstream, home to appropriate tissues, and overcome host defenses at the secondary site.
This document discusses the cytopathology of metastatic neoplasms. It covers metastatic neoplasms in lymph nodes and lungs, including patterns of spread and cytological features that can indicate the primary site. Diagnosis of primary and secondary lymphomatous effusions is also addressed. Key points include that lymph nodes and lungs are common sites of metastasis, cytology can provide clues to the primary site through cell morphology and patterns, and immunohistochemistry is often needed to confirm diagnosis and primary site.
Potential of Targeting Bone Metastases with Immunotherapies_Crimson PublishersCrimsonpublishersCancer
Potential of Targeting Bone Metastases with Immunotherapies
Bone metastases are common in many cancers and result in low survival rates. Immunotherapies have shown promise in treating some patients with bone metastases. Case reports have shown individual patients experiencing decreased bone lesion growth or complete remission of bone metastases using immunotherapies targeting PD-1, PD-L1, or CTLA-4. However, immunotherapies may also cause harmful skeletal effects like fractures or spinal cord compression. Further research is still needed to determine if immunotherapies are effective against bone metastases in large patient groups and to understand their potential skeletal side effects.
1. The patient presented with a palatal swelling and MRI revealed another parotid lesion. Biopsies found polymorphous adenocarcinoma in the palate and pleomorphic adenoma in the parotid gland.
2. Both lesions were surgically removed. Post-operative radiation was recommended for the palatal tumor due to perineural invasion.
3. Having multiple salivary gland tumors is unusual but not unheard of. MRI proved useful for detecting the additional concealed parotid lesion in this case. Each tumor requires separate diagnosis and treatment.
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
More than 90% of malignant tumors in the oral region are squamous cell carcinomas arising from the mucosal epithelium.
However, it is now apparent that these mucosal carcinomas comprise a number of different diseases that must be considered separately, due to differences in site, etiology, prognosis and management.
WHO 2016 update on classification of Lymphoid neoplasms Arijit Roy
This document summarizes the major proposed changes in the 2016 revision of the World Health Organization classification of lymphoid neoplasms compared to the 2008 classification. Some key changes include distinguishing low-count from high-count monoclonal B-cell lymphocytosis, recognizing provisional entities like large B-cell lymphoma with IRF4 rearrangement, and emphasizing prognostic markers for diffuse large B-cell lymphoma like double expression of MYC and BCL2 proteins. The revision aims to better classify hematologic malignancies based on new clinical, pathological and genetic data.
This document discusses a study to create tissue engineering models of breast cancer metastasis. The researchers will develop 3D scaffolds mimicking adipose and bone tissue with varying stiffness. They will seed metastatic breast cancer cells onto the scaffolds to study changes in gene expression, histology, and markers as the cells metastasize from softer adipose-like scaffolds to stiffer bone-like scaffolds. The goal is to better understand the mechanisms driving breast cancer metastasis in order to develop new prevention and treatment strategies.
The document describes an interactive microscopy session on deep soft tissue spindle cell tumors. It presents two cases of monophasic synovial sarcoma in the first case, discussing the histology, immunoprofile and genetics of this tumor. The second case presents two examples of malignant peripheral nerve sheath tumor (MPNST), noting their characteristic histological features and association with neurofibromatosis type 1 or prior radiation therapy. Key differential diagnoses and diagnostic markers are also mentioned.
Defect in recruiting effector memory CD8+ T-cells in malignant pleural effusi...Enrique Moreno Gonzalez
Malignant pleural effusions (MPE) are a common and fatal complication in cancers including lung or breast cancers, or malignant pleural mesothelioma (MPM). MPE animal models and immunotherapy trials in MPM patients previously suggested defects of the cellular immunity in MPE. However only few observational studies of the immune response were done in MPM patients, using questionable control groups (transudate…).
Role of Flow Cytometric Immunophenotyping in Plasma Cell DyscrasiasApollo Hospitals
Immunophenotyping is being routinely used for the diagnosis of leukemias. With the advent of specific markers for plasma cells, it has become possible to differentiate between benign and malignant plasma cells based on their immunophenotypic profile. The enhanced use of immunophenotyping in plasma cells dyscrasias may help to categorize the borderline cases which can not be done with morphology alone. Also the immunophenotypic profiling of plasma cells would help in Minimal Residual Disease (MRD) evaluation of patients on treatment of multiple myeloma (MM).
This document discusses various papillary tumors of the central nervous system. It begins by outlining the typical age ranges and locations for different tumor types, then describes key histological features. Several specific tumor types are discussed in more detail, including choroid plexus tumors, ependymomas, astroblastoma, meningioma, glioblastoma, craniopharyngioma, germ cell tumors, and metastatic tumors. Immunohistochemistry staining patterns are also provided to aid in diagnosis. The summary emphasizes that the diagnostic approach is to first consider the patient's age and radiology findings, examine histological features, and only use IHC when necessary to determine a tumor's primary origin.
1) Cancer metastasis is a multi-step process involving invasion of surrounding tissue, transportation through the bloodstream, and formation of tumors in distant organs.
2) Key steps include degradation of the extracellular matrix, entry and survival in the circulation, arrest and extravasation at distant sites, and induction of angiogenesis to establish blood supply for growing tumors.
3) Factors such as matrix metalloproteinases, integrins, and angiogenic growth factors regulate these steps by promoting degradation of barriers, cell adhesion, and new blood vessel formation to enable metastatic tumors to grow.
The document summarizes the process of cancer metastasis through the invasion-metastasis cascade. It involves 6 key steps: 1) Localized invasion of primary tumor cells aided by loss of cell adhesion molecules and matrix metalloproteinases. 2) Intravasation of tumor cells into blood vessels assisted by tumor-associated macrophages. 3) Transport of circulating tumor cells protected by platelet emboli. 4) Extravasation of tumor cells from vessels into distant tissues. 5) Formation of dormant micrometastases. 6) Rare colonization of micrometastases into macroscopic tumors limited by the foreign tissue environment. Metastasis suppressor genes and strategies targeting multiple steps simultaneously show promise for preventing cancer spread.
This document discusses several indolent lymphoproliferative disorders of the gastrointestinal tract, including lymphomatoid gastropathy, NK cell enteropathy, and indolent T-cell lymphoproliferative disorders. It provides details on clinical presentations, endoscopic findings, histopathology, immunophenotypes, clinical outcomes, and differential diagnoses. Key points are that these disorders can present with nonspecific GI symptoms and are characterized by non-destructive, superficial infiltrates that rarely progress. Correct diagnosis requires integrating multiple findings to distinguish them from other entities like celiac disease or aggressive lymphomas. Optimal treatment approaches remain unclear.
Cancer Stem Cells (CSCs) have become a vital target for biologists and researchers.
The following presentation focuses on the treatment of cancer through targeting CSCs and its advantages.
1) Cancer begins as abnormal cells that grow uncontrollably and can become invasive, spreading to other parts of the body.
2) There are several types of cancer including carcinomas, sarcomas, leukemias, lymphomas, and central nervous system cancers.
3) Metastasis is when cancer cells spread from the original tumor site through the bloodstream or lymphatic system and form new tumors in other parts of the body. The major steps in metastasis include invasion, circulation, arrest in distant organs, and growth of new tumors.
A comprehensive review of Cutaneous Lymphomas - both B-Cell and T-Cell with latest treatment strategies. Target audience are oncologists, dermatologists, oncology physicians, dermatology and oncology fellows
The document discusses soft tissue tumours in children, with a focus on rhabdomyosarcoma and molecular diagnostic techniques. It notes that soft tissue tumours in children are challenging to diagnose due to their rarity and morphological features. Molecular techniques such as fluorescence in situ hybridization and PCR have become important diagnostic and prognostic tools because many paediatric tumours have specific translocations and fusion genes. Rhabdomyosarcoma is the most common soft tissue sarcoma in children, and molecular analysis can distinguish between embryonal and alveolar subtypes, which have different prognoses. Immunohistochemistry is also useful but molecular analysis has provided more definitive diagnoses.
Adenoidcystic carcinoma in head and neck cancersAjeet Gandhi
This document summarizes the management of adenoid cystic carcinoma (ACC), a rare type of head and neck cancer. It finds that surgery is the primary treatment but adjuvant radiation improves disease-free survival. For patients with positive margins or extracapsular extension, concurrent chemotherapy with radiation may provide better local control. Recurrence is common, occurring locally or distantly even many years later. Future prospects include tailoring treatment based on molecular profiling, as certain gene mutations are associated with worse outcomes. The current study found multi-modality treatment with surgery and adjuvant radiation provides superior outcomes for ACC of the head and neck.
Recent changes in 2016 who classification of myeloid neoplasmDr.Pooja Dwivedi
The document summarizes the major changes made in the 2016 WHO Classification of Myeloid Neoplasms compared to previous classifications. Key changes include:
1. Mastocytosis is now classified as a separate disease category rather than a subgroup of myeloproliferative neoplasms.
2. Chronic myelomonocytic leukemia is further divided into CMML-0, CMML-1, and CMML-2 based on blast percentage thresholds.
3. Myeloid/lymphoid neoplasms with gene rearrangements such as PCM1-JAK2 are included as provisional entities.
This case study describes two cases of men with primary extragonadal germ cell tumors who were also found to have testicular microlithiasis (TM). Both men presented with seminoma originating in unusual extragonadal locations (retroperitoneum and mediastinum). In both cases, ultrasound found TM but no testicular lesions. While the association between primary extragonadal germ cell tumor and TM is not well understood, a literature review found several other reported cases of TM occurring with primary extragonadal germ cell tumors, especially in younger patients. The findings suggest TM may be correlated with primary extragonadal germ cell tumors, though more research is needed.
Invadopodia play an important role in cancer cell invasion and metastasis. Key proteins involved in invadopodia include actin regulators like cortactin and N-WASP, and adaptor proteins like TKS4 and TKS5. Invadopodia allow cancer cells to degrade the extracellular matrix through metalloproteinases. Cancer cells employ various mechanisms to evade the host immune response after extravasation, including secreting TGFβ and expressing toll-like receptors and tumor counterattack proteins that can kill lymphocytes. Successful metastasis requires cancer cells to survive in the bloodstream, home to appropriate tissues, and overcome host defenses at the secondary site.
This document discusses the cytopathology of metastatic neoplasms. It covers metastatic neoplasms in lymph nodes and lungs, including patterns of spread and cytological features that can indicate the primary site. Diagnosis of primary and secondary lymphomatous effusions is also addressed. Key points include that lymph nodes and lungs are common sites of metastasis, cytology can provide clues to the primary site through cell morphology and patterns, and immunohistochemistry is often needed to confirm diagnosis and primary site.
Potential of Targeting Bone Metastases with Immunotherapies_Crimson PublishersCrimsonpublishersCancer
Potential of Targeting Bone Metastases with Immunotherapies
Bone metastases are common in many cancers and result in low survival rates. Immunotherapies have shown promise in treating some patients with bone metastases. Case reports have shown individual patients experiencing decreased bone lesion growth or complete remission of bone metastases using immunotherapies targeting PD-1, PD-L1, or CTLA-4. However, immunotherapies may also cause harmful skeletal effects like fractures or spinal cord compression. Further research is still needed to determine if immunotherapies are effective against bone metastases in large patient groups and to understand their potential skeletal side effects.
1. The patient presented with a palatal swelling and MRI revealed another parotid lesion. Biopsies found polymorphous adenocarcinoma in the palate and pleomorphic adenoma in the parotid gland.
2. Both lesions were surgically removed. Post-operative radiation was recommended for the palatal tumor due to perineural invasion.
3. Having multiple salivary gland tumors is unusual but not unheard of. MRI proved useful for detecting the additional concealed parotid lesion in this case. Each tumor requires separate diagnosis and treatment.
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
More than 90% of malignant tumors in the oral region are squamous cell carcinomas arising from the mucosal epithelium.
However, it is now apparent that these mucosal carcinomas comprise a number of different diseases that must be considered separately, due to differences in site, etiology, prognosis and management.
More than 90% of malignant tumors in the oral region are squamous cell carcinomas arising from the mucosal epithelium.
However, it is now apparent that these mucosal carcinomas comprise a number of different diseases that must be considered separately, due to differences in site, etiology, prognosis and management.
Secondary Extramedullary Plasmacytoma Diagnosed by Fine Needle Aspiration Cyt...Apollo Hospitals
This case report describes a 33-year old female patient who presented with multiple subcutaneous lumps. Fine needle aspiration cytology of the lumps revealed sheets of plasmacytoid cells, indicating a diagnosis of secondary extramedullary plasmacytoma. Further investigations including immunoglobulin profile, serum protein electrophoresis and bone marrow biopsy confirmed the presence of multiple myeloma. While extramedullary plasmacytomas usually represent systemic multiple myeloma, cytological diagnosis allows for timely treatment.
Fine needle aspiration biopsy of ameloblastic carcinoma of the mandible a cas...Quách Bảo Toàn
1) A 74-year-old female presented with a painless swelling in her right mandible and imaging showed a radiolucent lesion.
2) A fine-needle aspiration biopsy was performed and cytology revealed basaloid cells arranged in a palisade pattern and stellate-shaped cells, consistent with a diagnosis of ameloblastoma. However, atypical cells and mitoses also seen, leading to a diagnosis of ameloblastic carcinoma.
3) The patient underwent chemotherapy, showing remission of the lesion. Fine-needle aspiration biopsy is an effective minimally invasive technique for diagnosing odontogenic tumors like ameloblastoma and can determine if atypical features
Cytological diagnosis of mesothelioma:Recent AdvancesnehaSingh1543
This document discusses recent advances in the cytological diagnosis of mesothelioma. It begins with an introduction to mesothelioma, including its etiology and risk factors associated with asbestos exposure. The document then covers the cytological diagnostic approach, including distinguishing features of malignant mesothelioma cells compared to reactive mesothelial cells or metastatic adenocarcinoma. Immunohistochemistry and biomarkers like GLUT-1, IMP-3, and BAP1 loss are important diagnostic tools. Recent advances include the discovery of genetic alterations like chromothripsis and an immunogenic potential of mesothelioma.
Atypical ameloblastoma – an enigma in diagnosis review of literature and rep...Quách Bảo Toàn
This case report describes an atypical ameloblastoma presenting diagnostic challenges. Histologically, the lesion showed features of both benign and malignant ameloblastoma. While areas displayed typical ameloblastoma characteristics, other areas showed epithelial dedifferentiation like cellular pleomorphism and atypical mitoses. However, these atypical features were not sufficient to classify it as ameloblastic carcinoma. The case was therefore diagnosed as an atypical ameloblastoma and close follow up was recommended due to its ambiguous nature between benign and malignant pathology. The report also briefly reviews the classification and literature on odontogenic malignancies.
Pleomorphic adenoma of the buccal salivary glandPrashant Munde
Salivary gland swellings can result from tumors, an inflammatory process
or cysts. It can sometimes be difficult to establish; whether pathology arises
from the salivary gland itself or adjacent structures. Neoplasms of the salivary
glands account for less than 1% of all tumors, 3–5% of all head and neck
tumors and benign pleomorphic adenoma (PA) of minor salivary glands arising
de novo is very rare. PA is the most common tumor of the salivary gland. While
the majority arises from the parotid gland, only a small percentage arises from
the buccal minor salivary gland. A case of PA of minor salivary glands in the
buccal mucosa in a 70‑year‑old female is discussed. It includes review of
literature, clinical features, histopathology, radiological findings and treatment
of the tumor; with emphasis on diagnosis.
Dr. Ahmed M. Adawy, Professor Emeritus, Dep. Oral & Maxillofacial Surgery. Former Dean, Faculty of Dental Medicine, Al-Azhar University. Ameloblastoma is benign slow-growing but locally invasive neoplasm of odontogenic origin. In 2005, the WHO has classified ameloblastomas into multi cystic, unicystic and peripheral subtypes. The clinical picture, radiographic findings and differential diagnosis are presented. Treatment of ameloblastomas is primarily surgical. There has been some debate regarding the most appropriate method for removing. These range from conservative to radical modes. Some authors advocate conservative approach and thought that ameloblastoma are essentially benign in nature and should be treated as such. However, this conservative approach result in recurrence rates of 55% to 90%of the cases. Currently, the standard of care for ameloblastoma includes en bloc resection with 1-2 combine margin and immediate bone reconstruction. Despite the medical nature of a surgical resection, it may actually involve less morbidity than extensive hard and soft tissue resection with associated extensive morbidity that may be warranted in case of recurrence following inadequate primary treatment.
We know that mesothelioma patients would rather stay local when receiving treatment,rnso we will review options for private medical centers, surgical consultants, clinical trials,rnand match you up with friendly, local physicians wherever we can.
We know that mesothelioma patients would rather stay local when receiving treatment,rnso we will review options for private medical centers, surgical consultants, clinical trials,rnand match you up with friendly, local physicians wherever we can.
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2. Santos et al. Head & Face Medicine 2011, 7:24
http://www.head-face-med.com/content/7/1/24
the School of Dentistry of the University Tiradentes
(Aracaju/SE, Brazil) in March of 2005. Intraoral examination revealed an asymptomatic swelling on the right
side of the hard palate. It was approximately 3.5 cm in
size and according to the patient had been present for
the past 1 year. The overlying mucosa was intact and
normal in color and appearance. The teeth involved
were all vital and no phlogistic signs were observed
(Figure 1a). His past medical history and the family history were analyzed in detail but were noncontributory.
Computed tomography of the lesion was done and
showed a large hypodense tumoral image in the right
side of the palate, where it had provoked a slight erosion
of the maxillary cortical bone (Figure 1b).
Incisional biopsy was performed and the surgical specimen was sent for histopathological analysis. Histological sections of the specimen revealed a salivary gland
neoplasm whose parenchyma consisted of plasmacytoid
cells with eccentric round nuclei and eosinophilic (hyaline) cytoplasm, predominantly arranged in islands and
sheets of tumoral cells. Less commonly, the tumoral
cells were organized in anastomosing strings mimicking
a pseudo-cribriform arrangement. Foci of hemorrhage
and hemosiderin pigmentation were also found. The
stroma showed strong hyalinization of the connective
tissue with focal areas of myxoid changes (Figure 2).
Immunohistochemically, the cytoplasm of the plasmacytoid cells was positive for S-100 protein and vimentin
(Figures 3a and 3b) and negative for smooth muscle
actin (a-SMA) (Figure 3d) and cytokeratin 14 (CK14).
Focal reactivity for glial fibrillary acidic protein (GFAP)
was observed in some areas (Figure 3c). The overall picture suggested the diagnosis of PM. The definitive treatment in this situation was surgical excision, extending
down to the periosteum and including the overlying
Page 2 of 6
mucosa. The patient continues to be under rigorous follow-up and no recurrence has been detected so far.
Discussion
Myoepitheliomas are benign neoplasms of salivary
glands derived from myoepithelial cells. These tumors
can occur at any age but are most common in young
adults between the ages of 30 and 50, with the average
of age in 36.3 years [3]. Most myoepitheliomas affect
the parotid gland and minor salivary glands of the palate
[2,7]. At date, and in our knowledge, it has been
reported seven cases of plasmacytoid myoepithelioma
from palate in children or adolescents [9-14], including
the present one (table 1), attesting the rarity of this
tumor in young patients.
In the current case, the tumor presented as a welldefined homogeneous enhancement with smooth contour. This CT pattern has been previously reported in
benign myoepitheliomas of the palate [15]. However,
slight erosion of the maxillary bone was observed in this
case. Although the bone involvement might be interpreted as imaginologic signs of malignancy [16], erosion
of the palatal cortical bone has also been seen in other
benign salivary gland tumors of the palate, such as pleomorphic adenomas [17].
Although the architectural variations of myoepitheliomas are well defined, it must be emphasized that they
can at times be difficult to differentiate from other
tumors, particularly PAs. It has been suggested that
these lesions are two different forms of the same entity
[7]. However, other authors have stressed that myoepitheliomas are tumors exclusively composed of myoepithelial cells, with an absent or inconspicuous ductal
component, and must be definitely differentiated from
mixed tumors as they may present a more aggressive
Figure 1 Clinical and imaging features. (a) Intraoral swelling in the right side of the hard palate. (b) Computed tomography showing large
hypodense tumor provoking slight erosion of maxillary cortical bone.
3. Santos et al. Head & Face Medicine 2011, 7:24
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Page 3 of 6
Figure 2 Histopathology findings. Histological sections stained in HE. (a) Well-circumscribed proliferation of sheets, islands, and strings of
myoepithelial cells (40×); (b) Strong hyalinization of the connective tissue and foci of hemorrhage seen amidst the tumoral cells (Hematoxyin/
Eosin, 40×) (c) Detail of the round-shaped myoepithelial cells showing eccentric nucleus (100×); (d) Tumoral plasmacytoid cells arranged in a
pseudo-cribriform pattern within myxomatous background (100×).
behavior [18]. In the present case, the neoplastic cells
were all round-shaped with eccentric nuclei and eosinophilic hyalinized cytoplasm and thus resembled plasma
cells. No ductal/luminal cellular differentiation was seen
in either the incisional or excisional surgical specimens.
These findings are in agreement with the reports in literature and are absolutely consistent with the diagnosis
of PM [2,14,19,20]. In addition, despite the fact that this
tumor showed intense hyalinization of the connective
tissue as well as foci of myxoid changes, no evidence of
chondroid or osteoid tissue was found. Similar findings
were described by other authors [21], who emphasize
that this sort of stromal differentiation is to be expected
in PAs but not in myoepitheliomas. The pseudo-cribriform pattern seen in some focal areas of the tumor
could perhaps lead to a misdiagnosis of adenoid cystic
carcinoma. However, in contrast to myoepitheliomas,
these last malignant tumors are clearly infiltrative and,
characteristically, show basal membrane-like globules
surrounded by rather bland myoepithelial cells with
hyperchromatic nuclei, arranged in tubular, cribriform,
and solid patterns [3].
It is also important to separate benign from malignant
variants of myoepitheliomas. Malignant tumors are differentiated from their benign counterparts by their characteristic multi-lobulated architecture, presence of
infiltrating growth, necrotic areas, cellular polymorphism, and mitotic figures [19]. Since none of these histological features were observed in this case, in addition to
the lack of cell atypia, it was considered as a typical
benign neoplasm. It has also been suggested that assessment of cell proliferative activity may be helpful in the
differential diagnosis between benign and malignant
myoepitheliomas. In this vein, a Ki-67 labelling index of
more than 10% in myoepitheliomas is highly suggestive
of malignant biological behavior [8].
4. Santos et al. Head & Face Medicine 2011, 7:24
http://www.head-face-med.com/content/7/1/24
Page 4 of 6
Figure 3 Immunohistochemical findings. Immunohistochemical study of tumor plasmacytoid cells revealed (a) strong positivity for S-100
protein, (b) moderate immunoreactivity for vimentin, and (c) focal immunoreactivity for GFAP, (d) Tumor cells failed in immunostaining for aSMA, although the muscular walls of the blood vessels (positive control) were positive (Streptavidin-Biotin Complex, 100×).
The immunohistochemical study of the current case
demonstrated positivity for S-100 protein and vimentin
but not for a-SMA and CK14. Focal positivity was also
seen for GFAP. Normal myoepithelial cells show myogenic differentiation, which is revealed by the presence
of actin filaments as well as filaments of cytokeratin.
However, tumoral myoepithelial cells rarely show the
Table 1 Demographic data of PM of palate occurring in
younger reported in literature (Including present case).
Authors
Age
Gender
Kahn & Schoub (1973)
17
Female
Nesland et al (1981)
18
Female
Lins & Gnepp (1986)
8
Female
Arkuszewski P et al (2005)
12
Male
Nwoku et al (2005)
11
Male
Perez et al (2007)
13
Male
Santos et al (2011)
15
Male
same cytoskeleton as normal cells, although some traces
of the normal components of the cytoskeleton may be
retained. Therefore, it is suggested that tumor myoepithelial cells might exhibit different stages of differentiation [21,22].
CK14 is responsible for the anchorage of myoepithelial
cells to the basement membrane and is considered a
useful marker of normal myoepithelial cells; it is usually
unexpressed in tumor cells, unless those cells present
terminal differentiation [23]. Once the myoepithelial
cells in myoepitheliomas are no longer confined to the
basement membrane – which is fragmented in these
tumors – lack of CK14 expression is supposed to be
expected [19]. In the current case, these findings were
confirmed, as the tumor cells showed no reactivity for
this particular cytokeratin.
The negativity for myogenic markers is expected in
the plasmacytoid variant, a quite rare and controversial
subtype of myoepithelioma that frequently lacks
5. Santos et al. Head & Face Medicine 2011, 7:24
http://www.head-face-med.com/content/7/1/24
myogenic differentiation, even though it is positive for
pan-cytokeratin [24,25]. It has been demonstrated that
cultured cell lines derived from PMs express a-SMA,
but this is not so for the tumoral cells of paraffinembedded tissue. These findings suggest that plasmacytoid cells show full myoepithelial differentiation in vitro.
Thus, they should be considered myoepithelial-like cells,
and the lack of myogenic differentiation in vivo could be
due to an inhibitory process mediated by the extracellular matrix [24]. Supporting this theory, the neoplastic
cells were negative for a-SMA In the present case. On
the other hand, immunopositivity for myogenic markers
in PM has been demonstrated by Scarpellini et al., [25]
suggesting that these plasmacytoid cells might exhibit
distinct myoepithelial phenotypes in different tumors.
Immunoreactivity for S-100 protein is currently considered an important characteristic of this morphologic
variant of myoepithelioma [3]. Similar to the findings in
the present case, many studies have reported strong S100 positivity in this kind of salivary gland tumor
[3,8,14,20]. On the other hand, some authors have
asserted that these plasmacytoid cells are also positive
for GFAP [19], which was confirmed in the current
case. Moreover, vimentin was also expressed by tumoral
plasmacytoid cells in this case. Although this antigen is
frequently detected in mesenchymal cells, in this case, it
was extensively expressed in the neoplastic myoepithelial
cells [19,26,27]. It is suggested that the immunohistochemical expression of vimentin may indicate that
myoepithelial cells in tumors such as myoepitheliomas
do not reach complete differentiation [24].
Despite the fact that some studies have pointed to a
myoepithelial nature for plasmacytoid cells, studies have
provided some evidence that plasmacytoid cells might present a luminal phenotype in PAs, as long as they failed in
expressing myogenic markers, such as a-SMA, but widely
expressed CKs 18 and 19 [6]. This particular profile is
expressed by the luminal cells and some of the basal cells
of normal salivary glands [24]. Nevertheless, further studies are necessary to find out whether plasmacytoid cells
in myoepithelioma are true myoepithelial cells or not.
As performed in the current case, surgery with a margin of normal uninvolved tissue being included within
the surgical excision is the first choice of treatment for
benign myoepitheliomas, and the recurrence rates are
similar to those of the pleomorphic adenomas [15]. The
prognosis for benign myoepitheliomas is quite favorable,
but patients should undergo regular follow-up examinations to rule out local recurrence [18].
Consent
Written consent for publication was obtained from the
patient’s parent.
Page 5 of 6
Acknowledgements
The authors are grateful to Rose Nelly Pereira-Filho (Institute for Technology
and Research, laboratory of structural biology and morphology - Aracaju)
and thank her for the valuable technical support with images. The authors
also wish to thank the patient and their family for their contribution to this
article.
Author details
1
Department of Dentistry, School of Dentistry, University Tiradentes, Aracaju,
SE, Brazil. 2Department of Morphology, Faculty of Biology, University
Tiradentes, Aracaju, SE, Brazil. 3Department of Stomatology, School of
Dentistry, University Tiradentes, Aracaju, SE, Brazil. 4Department of Oral
Surgery, School of Dentistry, University Tiradentes, Aracaju, SE, Brazil.
5
Department of Oral Pathology, School of Dentistry, University Tiradentes,
Aracaju, SE, Brazil.
Authors’ contributions
SEP and AJRLC drafted the manuscript. AJRLC, GMZ, SEP and CDRR carried
out the histological analysis, wrote the histological part of the paper and
contributed to the writing of the final version. PJC, MAUC and SEP analysed
the patient’s history, reviewed the patient data and surgically removed the
tumors. Each author reviewed the paper for content and contributed to the
writing of the manuscript. All authors approved the final report.
Competing interests
The authors declare that they have no competing interests.
Received: 24 March 2011 Accepted: 12 December 2011
Published: 12 December 2011
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Cite this article as: Santos et al.: Plasmacytoid myoepithelioma of minor
salivary glands: report of case with emphasis in the
immunohistochemical findings. Head & Face Medicine 2011 7:24.
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