Lobular neoplasia. Long term risk of breast cancer and relation to other factors.

Background: Lobular neoplasia (LN), also known as lobular carcinoma in situ, is an incidental histologic finding in tissue removed at breast surgery. Patients with LN are known to be predisposed to develop invasive or intraductal carcinoma (CA). This study investigates factors that influence the cancer risk in LN patients.

Complex colon duplication mimicking an obstructed, non-functioning kidney in a newborn with imperforate anus and spinal dysraphism.

Gastrointestinal (GI) duplications contain tissue resembling several portions of the GI tract and are associated with vertebral and genitourinary (GU) abnormalities [1-4]. We report a newborn with low, imperforate anus and lumbosacral dysraphism, who presented with a large cystic mass in the left renal fossa and pelvis. The flank mass (felt initially to be a dysplastic kidney and ureter) proved to be a complex GI duplication with histologic evidence of gastric, small bowel, and colonic mucosa, as well as respiratory epithelium and pancreatic tissue.

Reproducibility and validity of pathologic classifications of benign breast disease and implications for clinical applications.

Background: Research studies on the relationship between benign breast diseases and cancer risk typically identify certain conditions as risk factors, and others as carrying no prognostic significance. This study addresses several issues concerning the relevance of such research results for advising individual patients in a clinical setting.

Methods: Data were obtained as part of a "blinded" retrospective pathology review of benign breast biopsies.

Prognostic significance of benign proliferative breast disease.

Background: Recent studies concerning an association between benign breast diseases and risk of subsequent breast cancer have focused on benign proliferative lesions recognized in biopsy specimens. Some have implicated atypical hyperplasia as being associated with the greatest risk.

Methods: The histologic sections of specified benign breast lesions from 1799 women were reviewed and reclassified, using published criteria for proliferative disease.

The epidemiology of gross cystic disease of the breast confirmed by biopsy or by aspiration of cyst fluid.

This study concerns 3443 patients treated by 1 physician for benign breast conditions, with follow-up on 94% of the patients averaging 19 years. Over three quarters of these patients had gross cystic disease (GCD) of the breast confirmed by aspiration of cyst fluid or by biopsy. Diagnosis of GCD by microscopic pathology review alone is shown to have high error rates when compared with information in the operative report and the gross pathology report.

Hepatobiliary complications of polyarteritis nodosa.

Although polyarteritis nodosa (PAN) may result in thrombosis or aneurysm formation in any organ in the body, hepatobiliary complications are unusual. We reviewed seven cases that demonstrated the diagnostic difficulties and therapeutic options available in the management of hepatobiliary PAN. No consistent sign that indicated the severity of hepatobiliary PAN could be identified.

Elastofibroma dorsi: benign chest wall tumor.

Elastofibroma dorsi was diagnosed in seven patients at the Columbia-Presbyterian Medical Center between 1976 and 1986. The ages of the patients ranged from 6 to 79 years (mean 49.3 years).

Nonepithelial tumors of the nasal cavity, paranasal sinuses, and nasopharynx. A clinicopathologic study. XIV: Chordomas.

Twenty cases of a rare tumor, chordoma involving the nasal cavity, paranasal sinuses, or nasopharynx, are reported. Patients most often had localized headache, nasal obstruction, decreased hearing, or symptoms related to cranial nerve involvement, especially diplopia. A mass bulging into the nasopharynx, posterior nasal cavity, or pharynx was found on physical examination in 13 of these 20 patients, and in another 6 patients on radiologic examination.

Carcinoid tumorlets of the lung with metastasis to a peribronchial lymph node. Report of a case and review of the literature.

A case of a rare entity, pulmonary tumorlets that metastasized to a peribronchial lymph node, is reported. The patient, a 38-year-old man, underwent a right pneumonectomy for end-stage lung disease caused by bronchiectasis, chronic bronchitis, and pulmonary fibrosis. No tumors were detected on radiologic or on gross examination of the lung.

Mucoepidermoid carcinoma arising in an intraparotid lymph node.

A well-differentiated mucoepidermoid carcinoma that was confined to, and apparently arose within, an intraparotid lymph node is reported. Salivary gland ducts and acini often are found within intraparotid lymph nodes, and occasionally within extraparotid nodes. Salivary gland tumors, both benign and malignant, can develop within this ectopic salivary tissue.

Nonepithelial tumors of the nasal cavity, paranasal sinuses, and nasopharynx. A clinicopathologic study. XIII: Meningiomas.

Twelve cases of meningiomas involving the nasal cavity and paranasal sinuses are reported. Meningiomas only rarely involve the upper respiratory tract; these 12 cases were found among the 566,000 surgical pathology cases that have been studied in this laboratory. In this series, five meningiomas probably arose in the cranial cavity and secondarily extended into the nasal cavity and paranasal sinuses.

Intramucosal carcinoma of the small intestine arising in regional enteritis (Crohn's disease). Report of a case studied for carcinoembryonic antigen and review of the literature.

A case of carcinoma of the small intestine arising in a patient with regional enteritis (Crohn's disease) of the ileum is reported. The patient, a 54-year-old woman, had a 21-year history of regional enteritis which was treated intermittently with sulfasalazine and prednisone. Segmental resections of the ileum had been performed on two previous occasions.

Rare synchronous parotid tumors of different histologic types.

A review of the approximately 2000 parotid salivary gland tumors studied at the Columbia-Presbyterian Medical Center in New York from 1918 to 1978 showed that separate, synchronous neoplasms of different histologic types were found in the parotid gland in only 7 patients. In 6 of these patients, there was a clinically solitary mass; in the other patient, two separate nodules were palpated. In each case, subtotal or total parotidectomy was performed.

Adenoid cystic carcinoma involving the external auditory canal. A clinicopathologic study of 16 cases.

Sixteen patients with a rare tumor, adenoid cystic carcinoma (ACC) involving the external auditory canal, have been studied. Clinically, most patients complained of ear pain, often of several years duration. On physical examination, a mass or a nodule usually was identified in the ear canal.

Nonepithelial tumors of the nasal cavity, paranasal sinuses and nasopharynx. A clinicopathologic study. XII: Schwann cell tumors (neurilemoma, neurofibroma, malignant schwannoma).

Twelve Schwann cell tumors (two neurilemomas, six neurofibromas, and four malignant schwannomas), arising in the nasal cavity, paranasal sinuses or nasopharynx, are described. Schwann cell neoplasms only rarely develop in this area. Clinically, these tumors lead to nonspecific symptoms including nasal obstruction epistaxis, facial pain and swellling, and proptosis, similar to those produced by other neoplasms that involve this area.

Adenomatous and carcinomatous changes in hamartomatous polyps of the small intestine (Peutz-Jeghers syndrome): report of a case and review of the literature.

The authors report the unique case of a patient with the Peutz-Jeghers (P-J) syndrome who had multiple small bowel hamartomatous polyps, some of which also showed adenomatous and carcinomatous changes. Over the course of 30 years, over 100 small bowel and colonic polyps were resected; all histologically demonstrated the typical features seen in hamartomatous polyps. Several jejunoileal polyps excised during the last few months of the patient's life showed not only hamartomatous features but also adenomatous epithelium.

Extramammary Paget's disease.

Extramammary Paget's disease is an in situ skin and mucosal carcinoma frequently associated with and probably arising in a subjacent or regionally proximate carcinoma. Microscopic spread of tumor cells almost always extends beyond clinically apparent disease. Surgical treatment requires carefully planned, systematic excision under precise histologic control.

Bilateral nasal squamous carcinoma arising in papillomatosis: report of a case developing after chemotherapy for leukemia.

A patient with a 25-year history of recurrent left nasal polyps is described. Recurrent papillomatosis (schneiderian or inverted papilloma) involving the left nasal cavity had been histologically documented for five years. Following the onset of and chemotherapy for acute myelomonocytic leukemia, the patient developed papillomatosis in the right nasal cavity and invasive squamous cell carcinomas in both nasal cavities.

Pancreatoduodenal resection and total pnacreatectomy--an institutional review.

Between 1940 and 1978, 150 major pancreatic resections--92 pancreatoduodenal resections (PDRs) and 58 total pancreatectomies (TPs)--were performed for benign and malignant disease. The majority of resections were for pancreatic cancer (70 patients) and ampullary cancer (40 patients). The overall operative mortality rate for PDR was 14%; it was 26% for TP.

Adenomas of the small intestine: a clinicopathologic review of 51 cases and a study of their relationship to carcinoma.

The authors studied 51 patients who had small bowel tumors that contained adenomatous epithelium. These rare lesions were identified among 392,000 surgical pathology cases seen during a 62-year period. Grossly and histologically, adenomas arising in the mucosa of the small intestine are similar to the adenomas found in the colon.

Acinic cell carcinoma arising in nasal cavity: report of a case with ultrastructural observations.

An acinic cell carcinoma (ACC) arising in the nasal cavity, a rare entity, is presented. The tumor involved the left lower turbinate and showed the classic features of ACC on light microscopic examination. On ultrastructural examination, tumor cells contained numerous secretory granules, diagnostic of ACC.

Lacrimal gland malignant mixed tumors (carcinomas arising in benign mixed tumors): a clinico-pathologic study.

Six cases of a rare entity, lacrimal gland malignant mixed tumor (MMT), or carcinoma arising in benign mixed tumor (BMT), are presented. Clinically, 2 patients had a long history of orbital protrusion, which recently had progressed more rapidly, In 2 other cases, the carcinomas evolved after recurrences of BMT. Two other patients experienced the recent onset of symptoms, without a known tumor previously having been present.

Non-epithelial tumors of the nasal cavity, paranasal sinuses and nasopharynx: a clinico-pathologic study XI. fibrous histiocytomas.

As part of our review of non-epithelial tumors involving the nasal cavity, paranasal sinuses, and nasopharynx, nine fibrous histiocytomas (FH) are reported. FH probably are derived from undifferentiated mesenchymal stem cells that have the ability to differentiate into two different pathways, one fibroblastic and the other histiocytic. The proportion of these two different elements varies greatly in different lesions.