Histologic and immunohistochemical analyses of endometrial carcinomas: experiences from endometrial biopsies in 358 consultation cases.

Context: Uterine serous carcinoma is biologically more aggressive than the endometrioid carcinoma. Because uterine serous carcinoma has a high propensity for lymphovascular invasion and intraperitoneal and extra-abdominal spread, accurate diagnosis of this tumor type in endometrial biopsies/curettings is critical for appropriate clinical management.

Objective: To share our experience in the evaluation of endometrial biopsy specimens in type I and type II endometrial adenocarcinoma.

HMGA2: a potential biomarker complement to P53 for detection of early-stage high-grade papillary serous carcinoma in fallopian tubes.

Before high-grade papillary serous carcinoma (HG-PSC) becomes invasive, it is believed to be a poorly defined short-lived precursor lesion. A recent characterization of serous tubal intraepithelial carcinoma (STIC) and of the p53 signature suggested that HG-PSC may follow a stepwise progression on cellular and molecular levels. High-mobility group AT-hook 2 (HMGA2), an oncofetal protein, is overexpressed in ovarian cancer.

Absence of progesterone receptors in a failed case of fertility-sparing treatment in early endometrial cancer: a case report.

Background: Fertility-sparing treatment may be offered as an alternative to standard surgical management of early-stage, well-differentiated endometrial cancer in young women. Immunostaining for progesterone receptor (PR) status is not currently part of the standard workup before treatment recommendations are made.

Case: We describe a 29-year-old woman who used oral contraceptive pills on a long-term basis in whom early-stage, well-differentiated endometrial cancer was diagnosed.

Postradiation angiosarcoma of the small intestine: a case report and review of literature.

Postradiation angiosarcoma is typically a high-grade sarcoma that presents mainly in the skin and superficial tissues. Postradiation angiosarcoma arising in the small intestine is rare with only 11 cases documented in the English-language literature. Herein, we report a postradiation angiosarcoma of the small intestine 9 years after radiotherapy for uterine cervical adenocarcinoma.

Placental site trophoblastic tumor: a review of 7 cases and their implications for prognosis and treatment.

Objective: To review cases of placental site trophoblastic tumor (PSTT) for prognostic factors and treatment implications.

Study Design: Between 1982 and 2003, 7 cases of PSTT were treated at the Brewer Trophoblastic Disease Center. Pathology and operative reports, patient records and laboratory results were reviewed.

Signet-ring cell change versus signet-ring cell carcinoma: a comparative analysis.

Signet-ring cell change (SCC) is a nonneoplastic condition that morphologically simulates signet-ring cell carcinoma (SRCA). The few case reports on SCC have focused on morphologic characteristics in distinguishing benign from malignant. In biopsy specimens, however, SCC can be easily confused with SRCA, which often demonstrates innocuous cytologic features.

Loss of estrogen receptor (ER) expression in endometrial tumors is not associated with de novo methylation of the 5' end of the ER gene.

Normal endometrium, an estrogen-responsive tissue, expresses the estrogen receptor (ER) alpha gene. Loss of ER expression, the basis for which is currently unknown, is often seen in advanced stage, poor prognosis endometrial tumors. The ER gene undergoes de novo methylation with high frequency in a wide variety of human tumors, including ER-negative breast cancers.

Diagnostic discrepancies in breast specimens subjected to gross reexamination.

To determine the accuracy of gross examination of breast specimens from a large university pathology service, 1120 breast specimens submitted from 1995 to 1997 that had residual tissue after submission of tissue sections were reexamined for diagnostic discrepancies. A total of 520 mastectomies, 143 wire localization excisions, 156 lumpectomies, and 301 mammoplasties were reexamined. Fifty-three (5%) major and 65 (6%) minor diagnostic discrepancies were detected.

Management of twin pregnancies consisting of a complete hydatidiform mole and normal fetus.

Objective: To report the clinical features, management, and outcome of twin pregnancies consisting of a complete hydatidiform mole and a coexisting normal fetus.

Methods: Between 1966 and 1997, seven women with complete hydatidiform mole and coexisting normal fetus were treated at the John I. Brewer Trophoblastic Disease Center of Northwestern University Medical School.

Leiomyoma causing massive ascites, right pleural effusion and respiratory distress. A case report.

Background: Pseudo-Meigs' syndrome, or atypical Meigs' syndrome, occurs when a pelvic mass other than an ovarian fibroma is present with hydrothorax and ascites. Leiomyomas rarely cause this condition.

Case: An otherwise healthy 31-year-old woman presented to the emergency department in acute respiratory distress with massive ascites, pleural effusion and a pedunculated leiomyoma.

Ovarian carcinoma initially presenting as metastatic axillary lymphadenopathy.

Background: Ovarian carcinoma usually presents at advanced stage due to diffuse intraabdominal disease. Presenting signs and symptoms often relate to the degree of intraabdominal spread. It is rare to have distant lymph node metastases, in conjunction with minimal intraabdominal disease, at initial presentation.

Late recurrences of vaginal clear cell adenocarcinoma.

Recurrent vaginal clear cell adenocarcinoma was diagnosed in two DES-exposed patients 17 and 19 years after initial therapy. These cases demonstrate the need for continued clinical evaluation, since patients with clear cell carcinoma of the vagina seem to be at greater risk for developing late recurrences than patients with squamous cell carcinomas.

Pilomatricoma-like endometrioid adenosquamous carcinoma of the ovary with neuroendocrine differentiation.

A case of high-grade endometrioid adenosquamous carcinoma of the ovary showing pilomatricoma-like areas and neuroendocrine differentiation is presented. The pilomatricoma-like areas were strongly positive for cytokeratin and vimentin, whereas the poorly differentiated areas of the tumor were positive for cytokeratin, synaptophysin, and neuron-specific enolase. Review of the literature did not show any published report of adenosquamous carcinoma with pilomatricoma-like areas either in the ovary or in the uterus.

Malignant mesonephric neoplasms of the uterine cervix. A report of eight cases, including four with a malignant spindle cell component.

Eight mesonephric adenocarcinomas of the uterine cervix, four of which had a malignant spindle-cell component, occurred in women aged 34 to 71 (median 43, mean 54.5) years, bringing to 14 the number of cervical mesonephric carcinomas in the literature. The tumors with a malignant spindle-cell component ("malignant mesonephric mixed tumors") are, with one possible exception, the first reported examples at this site.

Anterior mediastinal endodermal sinus (yolk sac) tumor in a female infant.

The first known case of primary anterior mediastinal endodermal sinus (yolk sac) tumor in a female patient, occurring in a 20-month-old infant, is reported. The child presented with cough, fever, and listlessness. Chest x-ray revealed a right anterior mediastinal mass.

Large-cell calcifying Sertoli cell tumor of the testis: a case report with ultrastructural study.

Large-cell calcifying Sertoli cell tumor (LCCSCT) is a rare histologic variant of Sertoli cell tumor. Recently we observed a case of LCCSCT of the testis with no associated endocrine abnormality. Our ultrastructural findings of rows of tight junctions, numerous intracytoplasmic filaments, and abundant rough endoplasmic reticulum in whorled formations support the Sertoli cell origin of this neoplasm.

Mediastinal yolk sac tumor: ultrastructural and immunofluorescent studies.

Primary mediastinal yolk sac tumor is rare. In this report, a case of a 32-year-old male with a mediastinal yolk sac tumor was studied by light, electron, and immunofluorescent microscopy. A positive immunofluorescent reaction to alpha-fetoprotein (AFP) correlated with the PAS-positive hyaline globules and electron-dense deposits seen in intracellular and extracellular locations.

Myoepithelial differentiation and basal lamina deposition in fibroadenoma and adenosis of the breast.

Sixteen cases of breast fibroadenomas and 11 of adenosis were studied ultrastructurally; emphasis was placed on the patterns of myoepithelial differentiation and the number and appearance of the basal laminae. Ducts of both fibroadenomas and adenosis showed well differentiated, peripherally arranged myoepithelial elements with conspicuous cytoplasmic filaments and numerous hemidesmosomes; focal myoepithelial multilayering occurred. Myoepithelial cells exhibited complex, convoluted cytoplasmic processes extending into the stroma and resulting in the formation of pseudocysts containing stromal material.

Squamous cell dysplasia and carcinoma in situ of the cervix and vagina after prenatal exposure to diethylstilbestrol.

Squamous cell abnormalities of the vagina and cervix were evaluated in 1424 women exposed to diethylstilbestrol (DES) in utero. The prevalence of dysplasia was 2.1% and the incidence 0.

Urogenital sinus origin of mucinous and ciliated cysts of the vulva.

The origin of mucinous and ciliated cells in the vulva and the pathogenesis of cysts lined by these epithelia were investigated. Small mucinous glands numbering from one to more than a hundred were encountered in 9 of 19 vulvas (53%) that were consecutively examined at autopsy. Eleven other cysts were encountered clinically.

Fetus papyraceus in twin pregnancy.

Three cases of fetus papyraceus in twin pregnancy were seen over a 4-month period. They were associated with an antepartum stillbirth and intrauterine growth retardation of the larger twin. Two of the 3 mothers exhibited hypertension.