101
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Fornelli A, Bacci A, Collina G, Eusebi V. [Breast carcinoma metastatic to meningioma: review of the literature and description of 2 new cases]. Pathologica 1995; 87:506-12. [PMID: 8868176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
UNLABELLED Two cases of breast carcinoma metastatic to meningioma are described in patients 69 and 62 years old respectively. MATERIAL AND METHODS Cases were documented by radiological, histological and immunohistochemical techniques. RESULTS Both meningiomas contained an invasive duct carcinoma of the breast, one of which was apocrine in nature. CONCLUSION It is suggested that metastasis to meningioma is not so rare as it appears from the literature.
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102
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Foschini MP, Sarti F, Dina RE, Giuliani-Picari G, Dal Monte PR, Eusebi V. Standardized reporting of histological diagnoses for non-neoplastic liver conditions in needle biopsies. Virchows Arch 1995; 426:593-6. [PMID: 7655740 DOI: 10.1007/bf00192114] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
The importance of standardizing surgical pathology reports is emerging from the literature. The use of checklists has recently been proposed for diagnosing the major tumour types, but no attention has been given to non-neoplastic conditions. In this paper a checklist for standard reports of liver needle biopsies for non-neoplastic conditions is presented.
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103
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Roncaroli F, Eusebi V. Critical Commentary. Pathol Res Pract 1995. [DOI: 10.1016/s0344-0338(11)80739-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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104
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Eusebi V, Foschini MP, Bussolati G, Rosen PP. Myoblastomatoid (histiocytoid) carcinoma of the breast. A type of apocrine carcinoma. Am J Surg Pathol 1995; 19:553-62. [PMID: 7726365 DOI: 10.1097/00000478-199505000-00007] [Citation(s) in RCA: 48] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Thirteen carcinomas of the breast having in common neoplastic cells with granular to foamy cytoplasm are described. These cells exhibit apocrine differentiation as demonstrated by immunocytochemical and in situ hybridization studies. These tumors can be easily misinterpreted as either fibrohistiocytic or myoblastomatoid (granular cell) tumors. Therefore, the designation of myoblastomatoid (histiocytoid) invasive carcinomas seems the most appropriate for this specific group of apocrine carcinomas.
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105
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Zafrani B, Contesso G, Eusebi V, Holland R, Millis R, Peterse J. Guidelines for the pathological management of mammographically detected breast lesions. Breast 1995. [DOI: 10.1016/0960-9776(95)90030-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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106
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Roncaroli F, Montironi R, Feliciotti F, Losi L, Eusebi V. Sarcomatoid carcinoma of the anorectal junction with neuroendocrine and rhabdomyoblastic features. Am J Surg Pathol 1995; 19:217-23. [PMID: 7832280 DOI: 10.1097/00000478-199502000-00010] [Citation(s) in RCA: 38] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
A case of sarcomatoid carcinoma of the anorectal junction in a 71-year-old woman showing neuroendocrine and rhabdomyoblastic features is described. The tumor was diffusely infiltrative and metastases to regional lymph nodes were found at laparotomy. The patient died 6 months after surgery with widespread metastases.
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107
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Pagani A, Sapino A, Eusebi V, Bergnolo P, Bussolati G. PIP/GCDFP-15 gene expression and apocrine differentiation in carcinomas of the breast. Virchows Arch 1994; 425:459-65. [PMID: 7850069 DOI: 10.1007/bf00197548] [Citation(s) in RCA: 45] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
The frequency and the significance of apocrine differentiation in carcinomas of the breast are uncertain, because of the lack of reliable and reproducible criteria for morphological diagnosis. The 15 kDa glycoprotein of cystic breast disease (GCDFP-15) is regarded as a specific functional marker of apocrine cells. Expression of the prolactin-inducible protein (PIP)/GCDFP-15 gene was investigated by Northern blot analysis and in situ hybridization in breast cancer cell lines and in an unselected series (33 cases) of primary carcinomas of the breast. On the same cases, histological assessment of apocrine differentiation and immunocytochemical detection of GCDFP-15 were also performed and correlated with follow-up data. The presence of PIP/GCDFP-15 mRNA was a feature of a relatively high number of cases, but was incompletely correlated with histological and immunocytochemical evidences of apocrine differentiation. Expression of the PIP/GCDFP-15 gene was significantly associated with relapse-free survival, and may represent a novel variable of functional and prognostic relevance.
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108
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Soares J, Tomasic G, Bucciarelli E, Eusebi V. Intralobular growth of myoepithelial cell carcinoma of the breast. Virchows Arch 1994; 425:205-10. [PMID: 7952505 DOI: 10.1007/bf00230358] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Two cases of intralobular carcinoma of the breast showing myoepithelial cell differentiation are reported. One was an in situ lesion localized within a fibroadenoma; the second was predominantly in situ, but areas of invasion were present. The neoplastic cells had round to ovoid nuclei and were polygonal to spindle in shape displaying glycogen rich clear cytoplasm. Alpha-smooth muscle actin was present in the cytoplasm of the neoplastic cells in both cases. In one case the same cells displayed cytoplasmic microfilaments at electron microscopic level. Intralobular growth of neoplastic myoepithelial cells has never been described in the literature, and this line of differentiation has to be added to the endocrine and apocrine features occasionally observed in in situ lobular carcinomas of the breast.
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109
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Eusebi V, Feudale E, Foschini MP, Micheli A, Conti A, Riva C, Di Palma S, Rilke F. Long-term follow-up of in situ carcinoma of the breast. Semin Diagn Pathol 1994; 11:223-35. [PMID: 7831534] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Eighty cases of duct carcinoma in situ (DCIS) of the breast have been investigated by a cohort-retrospective study. These consisted of 8.5 per 1,000 of 9,446 breast biopsies originally diagnosed as benign, between 1964 and 1976, with a mean follow-up of 17.5 years. There were forty-one cases (51%) of DCIS of clinging type (CC); 30 cases (37.%) of CC associated with other types of DCIS; nine cases of DCIS other than CC two of which were DCIS of comedo-type. Invasive duct carcinoma (IDC) subsequently developed in 11 patients (14%), whereas DCIS recurred in 5 (6%). The recurrence was ipsilateral in 12 of these 16 patients. IDC appeared more frequently, with high statistical significance, when the lesion present in the original biopsy showed pleomorphic (P) nuclei (ie, poorly differentiated cyto-nuclear morphology). The Standardized Morbidity Ratio (SMR) was 8.0 (95% CI; 2.9-17.5) with the general population as reference. IDC that developed following a lesion displaying P nuclei also showed a statistically significantly more aggressive behavior. It is suggested that when cases of DCIS are followed-up for a considerable length of time, a two-wave pattern of aggressiveness becomes apparent. IDC that develops after a poorly differentiated DCIS leads to death more precociously than that appearing after other types of DCIS, especially those showing more bland nuclear cytology.
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110
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Holland R, Peterse JL, Millis RR, Eusebi V, Faverly D, van de Vijver MJ, Zafrani B. Ductal carcinoma in situ: a proposal for a new classification. Semin Diagn Pathol 1994; 11:167-80. [PMID: 7831528] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Details of a proposed new classification for ductal carcinoma in situ (DCIS) are presented. This is based, primarily, on cytonuclear differentiation and, secondarily, on architectural differentiation (cellular polarisation). Three categories are defined. First is poorly differentiated DCIS composed of cells with very pleomorphic, irregularly spaced nuclei, with coarse, clumped chromatin, prominent nucleoli, and frequent mitoses. Architectural differentiation is absent or minimal. The growth pattern is solid or pseudo-cribriform and -micropapillary (without cellular polarisation). Necrosis is usually present. Calcification, when present, is amorphous. Second, at the other end of the spectrum is well-differentiated DCIS, composed of cells with monomorphic, regularly spaced nuclei containing fine chromatin, inconspicuous nucleoli, and few mitoses. The cells show pronounced polarisation with orientation of their apical border towards intercellular spaces usually resulting in cribriform, micropapillary and clinging patterns, although a solid pattern of well-differentiated DCIS also occurs. Necrosis is uncommon. Calcifications, when present, are usually psammomatous. The third category, intermediately differentiated DCIS, is composed of cells showing some pleomorphism but not so marked as in the poorly differentiated group. There is, however, always evidence of polarization around intercellular spaces, although this is not so pronounced as in the well-differentiated group. These two criteria, cytonuclear differentiation and architectural differentiation, have been found to be more consistent throughout a DCIS lesion than previously employed criteria of architectural pattern or the presence or absence of necrosis.
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111
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Damiani S, Miettinen M, Peterse JL, Eusebi V. Solitary fibrous tumour (myofibroblastoma) of the breast. Virchows Arch 1994; 425:89-92. [PMID: 7921419 DOI: 10.1007/bf00193955] [Citation(s) in RCA: 55] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Three new cases of the spindle cell tumour of the breast, usually termed myofibroblastoma, are reported. The histology and the immunological profile (expression of vimentin, CD34 antigen and of muscular markers) appear similar to those of solitary fibrous tumours recently described in various sites. It is proposed to include these mammary lesions into the group of solitary fibrous tumours and to regard breast as an additional site of origin.
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112
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Scarani P, Salvioli GP, Eusebi V. Marcello Malpighi (1628-1694). A founding father of modern anatomic pathology. Am J Surg Pathol 1994; 18:741-6. [PMID: 8017568] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
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113
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Damiani S, Dina R, Eusebi V. Cytologic grading of aggressive and nonaggressive variants of papillary thyroid carcinoma. Am J Clin Pathol 1994; 101:651-5. [PMID: 8178773 DOI: 10.1093/ajcp/101.5.651] [Citation(s) in RCA: 23] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Abstract
To distinguish preoperatively between the usual nonaggressive (classic, follicular, and mixed-papillary and follicular variants) and the aggressive (tall-cell, columnar-cell, and sclerosing diffuse) variants of papillary thyroid carcinoma (PTC), the fine-needle aspiration cytologic smears of 30 cases of PTC were retrospectively reviewed. A three-class grading system, based on the evaluation of four cytologic parameters (cell size, number of nuclear pseudoinclusions, nuclear pleomorphism, and type of chromatin), was applied to each case. A statistically significant association between the cytologic classes and the histologic features of the cases was found. All cytologic grade 1 cases corresponded to the nonaggressive histologic variants, whereas all cytologic grade 3 cases showed features of the aggressive variants of PTC at histologic level.
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114
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Alampi G, Baroni R, Berti E, Ceccarelli C, Dina R, Eusebi V, Giangaspero F, Grigioni FW, Lecce S, Losi L. [Quality control at the Istituto di Anatomia e Istologia patologica at the Università di Bologna]. Pathologica 1994; 86:184-90. [PMID: 7936764] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
The growing importance in medical practice of a standardized diagnosis in cyto- and histopathology and the recent recommendations for the adoption of standardized schemes for quality control in anatomic pathology by International Committees stimulated the medical staff of the Institute of Anatomic Pathology of the University of Bologna to adopt a pertinent method. The method used by the Department of Pathology of the Yale University (New Haven, Connecticut, USA) was chosen. A Committee for the quality control was appointed and two kinds of controls were set up: an External Quality Assessment (review of the difficult cases by external experts, slide seminars) and an Internal Quality Assessment performed by the members of the Committee on the diagnostic and laboratory routine of the Institute. Such a survey is periodically monitored during the monthly meetings of the Committee and described in the monthly reports. The present paper illustrates the method adopted and the preliminary results obtained in order to stimulate the discussion of such a critical theme in contemporary Anatomic Pathology at a national level.
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115
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Foschini MP, Eusebi V. Alveolar soft-part sarcoma: a new type of rhabdomyosarcoma? Semin Diagn Pathol 1994; 11:58-68. [PMID: 8202647] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
Alveolar soft part sarcoma (ASPS) was described as a distinct entity in 1952. ASPS mainly affects young adults, with a slight prevalence of female patients. It arises in the extremities, trunk, and head and neck region. Metastases are frequent and are mainly localized to lungs, brain, and bone. Local recurrences are rare if the primary tumor is completely excised. Adjuvant chemotherapy or radiotherapy are not useful. Death eventually supervenes, after several years, in most of the patients. Histogenesis and differentiation of ASPS, since its first description, have remained a matter of controversy. Many hypotheses have been taken into consideration, among which neural and muscular differentiation are the most plausible. The finding that intracytoplasmic crystals, present in most of the cases, are composed of actin, and the immunocytochemical localization in ASPS of several muscular markers, such as actin (skeletal and smooth muscle actin), desmin, and MyoD1 are all features that point towards skeletal muscle differentiation.
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116
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Fletcher CD, Eusebi V. Tumors showing skeletal muscle differentiation. Introduction. Semin Diagn Pathol 1994; 11:1-2. [PMID: 8202642] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
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117
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Roncaroli F, Rossi R, Severi B, Martinelli GN, Eusebi V. Epithelioid leiomyoma of the breast with granular cell change: a case report. Hum Pathol 1993; 24:1260-3. [PMID: 8244328 DOI: 10.1016/0046-8177(93)90225-6] [Citation(s) in RCA: 29] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
A 42-year-old woman with an epithelioid granular cell leiomyoma of the right breast is reported. The cells were spindle to polygonal and displayed finely granular cytoplasm. The smooth muscle differentiation of this tumor was shown by the immunohistochemical positivity of the neoplastic cells with anti-alpha smooth actin and antidesmin antisera. Microfilaments with focal densities were present in the cytoplasm at an ultrastructural level. The granular cytoplasmic changes are related to a relevant number of lysosomes within the neoplastic cells.
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118
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De Potter CR, Foschini MP, Schelfhout AM, Schroeter CA, Eusebi V. Immunohistochemical study of neu protein overexpression in clinging in situ duct carcinoma of the breast. VIRCHOWS ARCHIV. A, PATHOLOGICAL ANATOMY AND HISTOPATHOLOGY 1993; 422:375-80. [PMID: 8100656 DOI: 10.1007/bf01605456] [Citation(s) in RCA: 24] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
The expression of neu protein in 26 cases of clinging carcinoma (CC) of the breast was investigated. A distinction is made between two types of CC: one with pleomorphic nuclei (PN) and the other with monomorphic nuclei (MN). The PN type of CC overexpresses the neu protein in almost all cases (85.7%), its cells generally exhibit abundant cytoplasm and intraluminal necrosis is frequently observed. The MN type of CC does not overexpress the neu protein, exhibits bland cytological features and shows no necrosis. It is suggested that CC with PN is related to comedo-type carcinoma, while CC with MN is the forerunner of cribriform carcinoma in situ.
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119
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Foschini MP, Dina RE, Eusebi V. Sarcomatoid neoplasms of the breast: proposed definitions for biphasic and monophasic sarcomatoid mammary carcinomas. Semin Diagn Pathol 1993; 10:128-36. [PMID: 8367622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
Biphasic sarcomatoid carcinomas (SC) of the breast are defined as tumors that are composed of overtly carcinomatous and sarcoma-like elements and were known in the past as "carcinosarcomas." On the other hand, monophasic SC show features that are similar to those of sarcomas, but epithelial differentiation is detected in the former of these lesions by immunohistochemical methods. Adequate tissue sampling often is required to demonstrate both components of biphasic SC; if properly performed, this procedure greatly reduces the diagnosis of true mammary "sarcoma." The carcinomatous element of biphasic tumors is characterized either by features of a squamous carcinoma or an invasive ductal adenocarcinoma. Squamous differentiation is more often associated with a spindle-cell, fibrosarcoma-like, or malignant fibrous histiocytoma (MFH)-like sarcomatoid component, whereas adenocarcinomas usually are admixed with sarcoma-like tissues having "heterologous" properties. The overtly epithelial elements of biphasic SC are always immunoreactive for keratin, but areas that simulate sarcoma express this protein more heterogeneously. Both components may show positivity for vimentin, although the sarcoma-like elements do so more consistently. Monophasic SC is composed solely of fusiform and pleomorphic cells that are keratin-positive despite their mimicry of sarcomatous differentiation. This tumor variant commonly assumes a myxoid, angiomatoid, or storiform growth pattern, without recognizable carcinomatous foci by light microscopy. Prognosis and involvement of regional lymph nodes in mammary SC cases is controversial, because different tumors have been grouped together in the past for the analysis of these variables. However, SC generally has a less favorable outcome than that of ordinary invasive carcinomas of the breast.(ABSTRACT TRUNCATED AT 250 WORDS)
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120
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Eusebi V, Foschini MP, Betts CM, Gherardi G, Millis RR, Bussolati G, Azzopardi JG. Microglandular adenosis, apocrine adenosis, and tubular carcinoma of the breast. An immunohistochemical comparison. Am J Surg Pathol 1993; 17:99-109. [PMID: 8422116 DOI: 10.1097/00000478-199302000-00001] [Citation(s) in RCA: 66] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
Four cases of microglandular adenosis (MA), together with four cases of apocrine adenosis (AA) and 10 cases of tubular carcinoma (TC) of the breast were studied at the light and immunohistochemical level. One case of MA was studied with electron microscopy. MA is characterized by an absence of myoepithelial cells (ME), epithelial membrane antigen (EMA), and gross cystic disease fluid protein (GCDFP-15). The absence of EMA in MA makes it unique among benign glandular hyperplasias of the breast. AA contains myoepithelial cells and a distinct basal lamina. It is characterized by the presence of GCDFP-15, the specific apocrine marker, which is not present in MA. TC lacks both myoepithelial cells and a basal lamina. It is negative for GCDFP-15. Periductal and vascular elastosis are common and usually prominent, whereas they are not found in either MA and AA. Other stromal changes further distinguish the three lesions. These three distinct entities can be separated objectively and unequivocally and it is essential that this be done so as to prevent confusion.
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121
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Cossu A, Massarelli G, Manetto V, Viale G, Tanda F, Bosincu L, Iuzzolino P, Cossu S, Padovani R, Eusebi V. Rhabdoid tumours of the central nervous system. Report of three cases with immunocytochemical and ultrastructural findings. VIRCHOWS ARCHIV. A, PATHOLOGICAL ANATOMY AND HISTOPATHOLOGY 1993; 422:81-5. [PMID: 7679853 DOI: 10.1007/bf01605137] [Citation(s) in RCA: 45] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Three cases of rhabdoid tumour of the central nervous system arising in a supratentorial location are reported. The patients were 18, 14, and 7 years old. All three tumours showed a common morphology. The neoplastic cells were usually globoid with round nuclei and prominent nucleoli and large acidophilic, cytoplasmic inclusions were present in many of them. These inclusions showed strong immunoreactivity for vimentin, weak immunoreactivity for epithelial membrane antigen and focal immunoreactivity for cytokeratins. Ultrastructurally they were made up of whorls of intermediate filaments, 8-10 nm in thickness. Rhabdoid tumours of the central nervous system, whatever the cell of origin, appear to be an independent entity with identifiable histology and aggressive behaviour.
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122
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Foschini MP, D'Adda T, Bordi C, Eusebi V. Amyloid stroma in meningiomas. VIRCHOWS ARCHIV. A, PATHOLOGICAL ANATOMY AND HISTOPATHOLOGY 1993; 422:53-9. [PMID: 8438557 DOI: 10.1007/bf01605133] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
Twenty-three cases of meningiomas with psammoma bodies (PBs) and 15 without PBs have been studied using histochemical, ultrastructural and immunohistochemical methods for amyloid. Amyloid was found in all cases showing PBs and in only 5 cases in the group devoid of PBs. Meningiomas may contain amyloid in their stroma.
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123
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Eusebi V, Capella C, Cossu A, Rosai J. Neuroendocrine carcinoma within lymph nodes in the absence of a primary tumor, with special reference to Merkel cell carcinoma. Am J Surg Pathol 1992; 16:658-66. [PMID: 1530107 DOI: 10.1097/00000478-199207000-00004] [Citation(s) in RCA: 68] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
We report eight cases of neuroendocrine carcinomas found within inguinal (five cases), axillary (two cases), and submandibular (one case) lymph nodes. The patients underwent extensive investigations, but no primary tumor was found in any case. Although the existence of an occult or regressed primary cannot be ruled out, the possibility of a lymph node origin should be considered on the basis of epithelial inclusions or anomalous carcinomatous differentiation of stem cells of the lymphoreticular system.
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124
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Eusebi V, Magalhaes F, Azzopardi JG. Pleomorphic lobular carcinoma of the breast: an aggressive tumor showing apocrine differentiation. Hum Pathol 1992; 23:655-62. [PMID: 1592388 DOI: 10.1016/0046-8177(92)90321-s] [Citation(s) in RCA: 199] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Pleomorphic lobular carcinoma of the breast is a recently recognized subtype of invasive lobular carcinoma (ILC). Cytologic features are pleomorphic to a degree that contrasts with the cytologic uniformity of classic ILC. It is this feature that simultaneously gives its name to the tumor and highlights the difficulty of identifying it correctly and distinguishing it from ductal carcinoma. In our series of 10 cases, six tumors also contained lobular carcinoma in situ. Nodal metastases were typically sinusoidal. All tumors showed the dissociated, linear, and single file pattern of classic ILC, together with a targetoid distribution. Intracytoplasmic lumina were present in 50% of the tumors. An eosinophilic, slightly granular cytoplasm suggests the possibility of apocrine differentiation, a suggestion derived also from the frequent presence of foamy cells, a cell type previously identified in histiocytoid lobular carcinoma and shown to have apocrine features. The GCDFP-15 apocrine marker was positive in all 10 tumors, while all control ILCs were negative, confirming the presence of apocrine differentiation in pleomorphic lobular carcinoma. Six of 10 patients died within 42 months of diagnosis. Three other patients developed recurrence or distant metastases at short intervals. Pleomorphic lobular carcinoma is a very aggressive tumor. This behavior is perhaps predictable on the basis of tumor size at presentation and the frequency of nodal metastases. Since grading of lobular carcinoma is difficult, recognition of the pleomorphic subtype is useful in identifying a lethal variant.
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Trerè D, Cancellieri A, Perrone A, Rocchetta G, Pelusi G, Eusebi V, Derenzini M. Ag-NOR protein distribution correlates with patient survival in stage I endometrial adenocarcinoma. VIRCHOWS ARCHIV. A, PATHOLOGICAL ANATOMY AND HISTOPATHOLOGY 1992; 421:203-7. [PMID: 1413487 DOI: 10.1007/bf01611176] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
The relationship between argyrophil nucleolar organizer region (Ag-NOR) protein quantity and prognosis was studied in 33 cases of stage I endometrial adenocarcinoma. Ag-NOR protein quantity was measured by image analysis in silver-stained sections from paraffin-embedded samples of curettings. Patients had a minimum 10-year follow-up. Only 2 out of 25 patients exhibiting a mean Ag-NOR protein area of less than 3 microns2 died of cancer, whereas 5 of the 8 patients with a mean Ag-NOR protein area of more than 3 microns2 died of the disease. The present results demonstrate that the Ag-NOR protein value is closely related to patient survival in stage I endometrial carcinoma and that it is a reliable prognostic indicator in this type of carcinoma.
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