No abstract available.
Adenomyoma/*pathology ; Ampulla of Vater/*pathology ; Common Bile Duct Neoplasms/*pathology ; Female ; Humans ; Male

No abstract available.
Adenomyoma/*pathology ; Ampulla of Vater/*pathology ; Common Bile Duct Neoplasms/*pathology ; Female ; Humans ; Male

Atypical polypoid adenomyoma (APA) is an uncommon type of polypoid characterized by fibroid stroma and endometrial glands. It occurs mostly in premenopausal women and rarely in postmenopausal women with irregular vaginal bleeding. In our current case, a 76-year-old woman presented with irregular vaginal bleeding. The final pathological diagnosis of the mass was APA. APA is not easy to diagnose before surgery. On the one hand, there was no obvious particularity in imaging features and clinical features, especially for uncomfortably identifying endometrial cancer. On the other hand, APA has a pedicle, attaching to any part of the uterine cavity, which can cause pseudocoel between the mass with the uterine cavity wall. So, when it comes to getting the pathological tissue in the absence of hysteroscopy, it is easy to access to the pseudocoel and obtain endometrial tissue rather than the pathological tissue of the mass. Therefore, preoperative imaging examination is of great significance diagnosis way of thinking to clinicians for APA. In the meantime, pathological tissue of APA can be obtained by hysteroscopy in visual conditions.
Adenomyoma/pathology* ; Aged ; Female ; Humans ; Hysteroscopy ; Magnetic Resonance Imaging ; Pregnancy ; Uterine Hemorrhage ; Uterine Neoplasms/diagnostic imaging*

A heterotopic pancreas in the gastrointestinal tract is mostly found incidentally and its malignant transformation is extremely rare. We describe the second case of adenocarcinoma arising in a gastric heterotopic pancreas of an asymptomatic 35-yr-old man in Korea. Esophagogastroduodenoscopy revealed a submucosal tumor with an irregular central umbilication in the gastric antrum. A wedge resection specimen demonstrated a submucosal oligolocular cystic mass (1.7x1.4x1.2 cm) with a solid portion. Microscopically, the cystic portion was composed of dilated pancreaticobiliary type ducts with adjacent small foci of periductal glandular structures. The adenocarcinoma components in the solid area infiltrated the proper muscle and the overlying mucosa of the stomach. The transitional area between the benign ductal structures and the adenocarcinoma component was found. The follow-up course was uneventful 5 months postoperatively.
Adenocarcinoma/complications/*diagnosis/pathology ; Adenomyoma/pathology ; Adult ; Autopsy ; Choristoma ; Epithelium/pathology ; Gastric Mucosa/pathology ; Human ; Male ; Pancreas/*abnormalities ; Pancreatic Neoplasms/complications/*diagnosis/pathology ; Time Factors

BACKGROUND/AIMS: The objective of our study was to identify useful computed tomography (CT) findings for differentiating fundal type adenomyomatosis from localized chronic cholecystitis involving the fundus of the gallbladder. METHODS: We retrospectively identified cases of 41 patients with pathologically proven adenomyomatosis (n=21) or chronic cholecystitis (n=20) who had fundal thickening of the gallbladder on preoperative abdominal CT. Analysis of the CT findings included evaluation of the thickness, contour, border, intralesional cystic area, adjacent gallbladder wall thickening, presence of inner layer enhancement, enhancement grade, enhancement pattern, and presence of stones. Statistical analyses were performed using the Mann-Whitney U test and Fisher exact test. RESULTS: Oval contour, inner layer enhancement and intralesional cystic area were more frequently noted in adenomyomatosis than in chronic cholecystitis (p<0.05 for each finding). Flat contour and adjacent gallbladder wall thickening were more frequently observed in chronic cholecystitis than in adenomyomatosis. No differences between adenomyomatosis and chronic cholecystitis in terms of the thickness, enhancement grade, enhancement pattern and presence of stones were apparent. CONCLUSIONS: CT may help to differentiate fundal type adenomyomatosis from localized chronic cholecystitis involving the fundus of the gallbladder.
Adenomyoma/*pathology/radiography ; Adult ; Aged ; Cholecystitis/*pathology/radiography ; Chronic Disease ; Diagnosis, Differential ; Female ; Gallbladder ; Gallbladder Neoplasms/*pathology/radiography ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Tomography, X-Ray Computed

OBJECTIVETo investigate the diagnostic pathological features of endometrial carcinomas present in women under 40 years of age (by curettage samples).

METHODSA retrospective analysis was performed on 20 cases of endometrial carcinomas in women under 40 years of age.

RESULTSThe patients included 18 endometrioid adenocarcinoma cases, one adenosquamous carcinoma case, and one papillary serous carcinoma case. The morphological features of the endometrial adenocarcinoaare loss of polarity (orientation) of the endometrial glands. The tumor cells have large round vesicular nuclei, prominent nucleoli and coarse chromatin. In addition, endometrial stroma was instead of by the fibrous and/or granulation tissue type stroma, usually with inflammatory response. Majority cases of endometrioid adenocarcinomas had superficial invasion of myometrium and no lymph node metastasis. The adenosquamous case metastasized to the ovaries and the papillary serous carcinoma case metastasized to the pelvic lymph nodes.

CONCLUSIONSEndometrial carcinomas which are highly differentiated endometrioid adenocarcinomas occur frequently in women under 40 years of age. An important differential diagnosis of the endometrioid carcinoma in a curettage specimen is to differentiate it from atypical endometrial hyperplasia and atypical polypoid adenomyoma.

Adenomyoma ; pathology ; Adult ; Carcinoma, Adenosquamous ; secondary ; Carcinoma, Endometrioid ; pathology ; Carcinoma, Papillary ; pathology ; Diagnosis, Differential ; Dilatation and Curettage ; Endometrial Hyperplasia ; pathology ; Endometrial Neoplasms ; pathology ; Female ; Humans ; Lymph Nodes ; pathology ; Lymphatic Metastasis ; Myometrium ; pathology ; Ovarian Neoplasms ; secondary ; Pelvis ; Retrospective Studies

OBJECTIVETo study the clinicopathologic features, immunophenotype and differential diagnosis of plexiform angiomyxoid myofibroblastic tumor (PAMT) of the stomach.

METHODSThe clinical and pathologic findings of 3 cases of PAMT in the gastric antrum were retrospectively analyzed. Immunohistochemical study was carried out and the literature was reviewed.

RESULTSThe age of patients ranged from 31 to 47 years. The male-to-female ratio was 1:2. The clinical presentation included epigastric pain and distension. Endoscopically, the tumor mass protruded into the gastric cavity at the antrum and ranged from 4.5 cm to 8.0 cm in greatest dimension. One of the tumors studied was associated with surface ulceration. Histologically, the tumors were located in the gastric wall. They were composed of bland spindle cells and small vessels arranged in a plexiform or nodular pattern within a myxoid stroma. Immunohistochemical study showed that the spindle cells were consistently positive for smooth muscle actin and muscle-specific actin. There was focal staining for h-caldesmon, desmin in case 3 and focal positive for epithelial membrane antigen, CAM5.2 in case 1. Further, CD10 and progesterone receptor were positive in case 3.

CONCLUSIONSPAMT represents a rare novel mesenchymal tumor of the stomach, with a propensity of gastric antral involvement. The distinctive pathologic features help to differentiate this entity from other benign and malignant tumors.

Actins ; metabolism ; Adenomyoma ; metabolism ; pathology ; Adult ; Antigens, CD34 ; metabolism ; Diagnosis, Differential ; Female ; Fibromatosis, Abdominal ; metabolism ; pathology ; Follow-Up Studies ; Gastrectomy ; methods ; Gastrointestinal Stromal Tumors ; metabolism ; pathology ; Humans ; Male ; Middle Aged ; Myofibroma ; metabolism ; pathology ; surgery ; Myxoma ; metabolism ; pathology ; surgery ; Proto-Oncogene Proteins c-kit ; metabolism ; Stomach Neoplasms ; metabolism ; pathology ; surgery

Adenocarcinoma ; pathology ; Adenomatoid Tumor ; metabolism ; pathology ; surgery ; Adenomyoma ; pathology ; Adult ; Antibodies, Monoclonal, Murine-Derived ; metabolism ; Biomarkers, Tumor ; metabolism ; Calbindin 2 ; metabolism ; Diagnosis, Differential ; Female ; Follow-Up Studies ; Humans ; Keratins ; metabolism ; Leiomyoma ; pathology ; Lymphatic Vessel Tumors ; metabolism ; pathology ; Middle Aged ; Uterine Neoplasms ; metabolism ; pathology ; surgery ; Young Adult

BACKGROUND/AIMS: Ampullary adenomyoma is a benign lesion whose malignant potential has yet to be confirmed. Despite its benign nature, adenomyoma is frequently misdiagnosed as a carcinoma or adenoma and is overtreated by extensive surgery. This study was performed to analyze the clinical, pathological, and immunohistochemical features of adenomyomas in the ampulla of Vater. METHODS: Nine cases of adenomyoma in the ampulla of Vater, diagnosed in Chungbuk National University Hospital between 2008 and 2011, were enrolled in this study. We reviewed the clinical data on the symptoms, laboratory data, and radiologic findings of the abdominal computed tomography and endoscopic retrograde cholangiopancreatography. For pathological analysis, all the slides were reviewed by one pathologist, and immunohistochemical stainings with antibodies against cytokeratin 7 (CK7), cytokeratin 20 (CK20), alpha-smooth muscle actin (alpha-SMA), and Ki-67 antigen were performed. RESULTS: All the cases were CK7 positive and CK20 negative. A strong cytoplasmic expression of alpha-SMA was confirmed in all cases. The Ki-67 index was less than 1% in eight cases and 5% in one case. Four cases underwent endoscopic papillectomy, and one case received surgical ampullectomy during colorectal cancer surgery. Five cases that underwent endoscopic or surgical treatment remained symptom-free for three years. Four cases that were closely observed with repeated endoscopic examinations exhibited no interval changes in the papillary lesions. CONCLUSIONS: Endoscopic biopsy and immunohistochemistry can aid in the diagnosis of ampullary adenomyomas. Endoscopic papillectomy or surgical ampullectomy is adequate for the treatment of symptomatic ampullary adenomyomas.
Actins/metabolism ; Adenomyoma/*pathology/surgery ; Aged ; Ampulla of Vater/*pathology ; Cholangiopancreatography, Endoscopic Retrograde ; Common Bile Duct Neoplasms/*pathology/surgery ; Female ; Humans ; Immunohistochemistry ; Keratin-20/metabolism ; Keratin-7/metabolism ; Ki-67 Antigen/metabolism ; Male ; Middle Aged ; Retrospective Studies ; Tomography, X-Ray Computed ; Treatment Outcome