Primary adenosquamous cell carcinoma of the liver, a variant of cholangiocarcinoma is very rare disease and its prognosis is known to be very poor. We describe here a case of primary adenosquamous carcinoma of the liver. The patient was a 60-year-old woman who complained of an eight-month history of intermittent upper abdominal pain. Abdominal computed tomography scan revealed a low density mass and intrahepatic duct stones within the dilated left intrahepatic duct in the left lateral segment. Needle biopsy of the mass was done and the histologic diagnosis was cholangiocarcinoma. Left lobectomy was then performed. Upon gross examination, there was a well defined solid mass and intrahepatic duct stone in the dilated bile duct. Microscopically, the tumor was composed of both adenocarcinoma and squamous cell carcinoma.
Carcinoma, Adenosquamous/*diagnosis/pathology ; English Abstract ; Female ; Humans ; Liver Neoplasms/*diagnosis/pathology ; Middle Aged

Adenosquamous carcinoma of the papilla of Vater is a rare tumor and only a few cases have been reported so far. Here, we report a case of adenosquamous carcinoma in a 76-year-old male who presented with jaundice and right upper quadrant abdominal pain. Ultrasonography and enhanced abdominal CT scans showed dilated common bile duct (CBD) and intrahepatic bile duct (IHD) with a suspicious obstructing mass in distal CBD. On endoscopy, obstructing and ulcerated mass was noted on the papilla of Vater. Histopathological inspection of the biopsied specimens from mass showed adenosquamous cell carcinoma of the papilla of Vater. Since the patient refused operation, we inserted a self-expandable metallic stent in distal CBD. This is the first case report on adenosquamous carcinoma of the papilla of Vater in Korea.
Aged ; Ampulla of Vater/*pathology ; Carcinoma, Adenosquamous/*diagnosis/pathology/surgery ; Cell Differentiation ; Humans ; Immunohistochemistry ; Male ; Tomography, X-Ray Computed

Carcinoma, Adenosquamous ; pathology ; Carcinoma, Squamous Cell ; metabolism ; pathology ; surgery ; Diagnosis, Differential ; Humans ; Jejunal Neoplasms ; metabolism ; pathology ; surgery ; Jejunum ; surgery ; Keratins ; metabolism ; Male ; Middle Aged

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

BACKGROUND: The incidence and the mortality of lung cancer rank first among all malignant tumors and it seriously affects human health. The common types of non-small cell lung cancer (NSCLC) are adenocarcinoma and squamous carcinoma with clinical research and more attention, while adenosquamous carcinoma is a rare pathological subtype of lung cancer, which clinical features and prognostic factors are not yet fully understood. The purpose of this study is to analyze the clinical features and prognosis of lung adenosquamous carcinoma, and construct a nomogram to predict the patients' prognosis. METHODS: We obtained the data of adenosquamous carcinoma patients diagnosed between 2010 and 2015 in the Surveillance, Epidemiology, and End Results (SEER) database of the United States, and compared their clinical features and prognosis with those of lung adenocarcinoma and lung squamous cell carcinoma patients in the same period. Then we used univariate and multivariate analyses to explore the independent prognostic factors of adenosquamous carcinoma. Finally, we constructed and validated a nomogram to visually predict the outcomes of lung adenosquamous carcinoma. RESULTS: 1,453 patients with lung adenosquamous carcinoma were finally included. Compared with patients with lung adenocarcinoma and lung squamous cell carcinoma, the distributions of lung adenocarcinoma patients in most of the variables were medium between lung adenocarcinoma and squamous cell carcinoma. The prognosis of adenosquamous carcinoma was better than that of lung squamous cell carcinoma, but worse than that of lung adenocarcinoma. Multivariate analysis showed that age, differentiation, tumor-node-metastasis (TNM), surgery, and chemotherapy were independent prognostic factors (all P were less than 0.001). We constructed a nomogram with a C-index of 0.783 (0.767-0.799). The distinction test and consistency test showed that the nomogram could predict the patient's prognosis effectively. CONCLUSIONS Lung adenosquamous carcinoma has unique clinical, pathological, and prognostic characteristics. Age, differentiation, T, N, M, surgery, and chemotherapy status are independent predictors of prognosis in patients with adenosquamous carcinoma. Our nomogram can efficiently predict the prognosis of patients.
Aged ; Aged, 80 and over ; Carcinoma, Adenosquamous ; diagnosis ; epidemiology ; pathology ; therapy ; Databases, Factual ; Female ; Humans ; Lung Neoplasms ; diagnosis ; epidemiology ; pathology ; Male ; Middle Aged ; Neoplasm Staging ; Prognosis ; Survival Analysis

OBJECTIVETo investigate the clinicopathological and immunohistochemical features, diagnosis and differential diagnosis of nipple adenoma of the breast.

METHODSMorphological observation and immunohistochemistry were applied to 18 cases of nipple adenoma with a review of the related literatures.

RESULTSThe neoplasms were localized at nipples or under the areola of breast, adherent to the epidermis, mainly composed of dilated ducts in a tubular appearance associated with fibrotic matrix. The glandular epithelium showed various type of proliferation, forming thick layers or complex structures such as papillae, micropapillae, tufts, fronds, arcades or bridges accompanying with solid or cribriform cell nests. The tumor cells were crowding, lack of an uniform morphology and polarity with intact myoepithelial cells around the ducts. By immunostaining, the glandular epithelium was diffusely positive for 34betaE12, patchily positive for CK5/6, and negative for p53 and c-erbB-2. The myoepithelium, positive for p63, smooth muscle actin and Calponin, was well preserved and outlining the ducts.

CONCLUSIONSNipple adenoma is an infrequent type of benign breast neoplasm, presenting as sclerosing papilloma, papillomatosis or florid sclerosing adenosis. It is easily confused with atypical ductal hyperplasia/low grade ductal carcinoma in situ, invasive ductal carcinoma or low grade adenosquamous carcinoma. A correct diagnosis is based on the peculiar location and morphology of the tumor, and immunohistochemistry is helpful in some cases.

Adenoma ; metabolism ; pathology ; surgery ; Adult ; Breast Neoplasms ; metabolism ; pathology ; surgery ; Carcinoma in Situ ; metabolism ; pathology ; Carcinoma, Adenosquamous ; metabolism ; pathology ; Carcinoma, Ductal, Breast ; metabolism ; pathology ; Diagnosis, Differential ; Female ; Humans ; Keratin-5 ; metabolism ; Keratins ; metabolism ; Middle Aged ; Nipples ; metabolism ; pathology ; surgery

The most common pancreatic cancer is adenocarcinoma. Primary adenosquamous cell carcinoma of the pancreas is very rare and aggressive. A 46-year-old man presented with a 3-month history of dyspepsia and a 7-kg weight loss. The physical examination showed tenderness of the right upper quadrant of the abdomen. There was no jaundice. Amylase and lipase were elevated. CA 19-9 was elevated to 566.7 U/mL. Gastroduodenoscopy showed a hard ulceroinfiltrative mass with a yellowish exudate that bled readily on touch in the second portion of the duodenum. Abdominal computed tomography showed a 7.1 x 6.3-cm heterogeneously enhancing mass in the pancreatic head. The pancreatic mass had invaded the duodenum wall, gastric antrum, and gastroduodenal artery sheath. Fine-needle aspiration biopsy of the pancreatic mass revealed adenosquamous cell carcinoma, anaplastic type. We concluded that an adenosquamous cell carcinoma of pancreas had invaded the duodenal mucosa causing ulceration.
Amylases/blood ; Biopsy, Fine-Needle ; CA-19-9 Antigen/blood ; Carcinoma, Adenosquamous/blood/complications/*diagnosis/pathology ; Duodenoscopy ; Duodenum/pathology ; Humans ; Intestinal Mucosa/pathology ; Lipase/blood ; Male ; Middle Aged ; Neoplasm Invasiveness ; Pancreatic Neoplasms/blood/complications/*diagnosis/pathology ; Tomography, X-Ray Computed

OBJECTIVETo investigate the pathologic and immunohistochemical features, diagnosis and differential diagnosis of low-grade adenosquamous carcinoma of the breast and syringomatous adenoma of the nipple.

METHODSSix cases of low-grade adenosquamous carcinoma of the breast and four cases of syringomatous adenoma of the nipple were examined histologically and immunohistochemically (MaxVision method), and the literature was reviewed.

RESULTSThe two types of tumors were similar in morphology, but located in different regions with low-grade adenosquamous carcinoma being present in the deep parenchyma and syringomatous adenoma in nipple. Both types of tumors were composed mainly of well-differentiated glands with angulated, comma shaped or polliwog appearance in a disordered infiltrative pattern. The tumor cells also formed solid tubules, strips or nests, with frequent areas of squamoid differentiation. Mitosis was rare. The interstitial tissue showed abundant spindle cells or sclerotic fibrosis with mixed inflammatory cells infiltration. One case of low-grade adenosquamous carcinoma showed a concomitant malignant adenomyoepithelioma, and another case showed concomitant spindle cell metaplastic carcinoma. One case of syringomatous adenoma involved the deep parenchyma. Immunohistochemistry of low-grade adenosquamous carcinoma showed that CK5/6 and p63 were positive in the outer layer of the glands and the squamoid epithelium, and CD10 was also positive in the outer layer of the glands. ER and HER2 were negative, and PR was also negative except for one case in which the spindle cells were positive for CK5/6, AE1/AE3 and PR focally. Immunostaining of syringomatous adenoma demonstrated that p63 and CK5/6 were positive in the outer layer of the glands and the squamoid epithelium. Calponin, SMA, ER, PR and HER2 were all negative.

CONCLUSIONSLow-grade adenosquamous carcinoma of the breast and syringomatous adenoma of the nipple are similar in morphology and immunohistochemical phenotype, while the biological features are opposite due to different locations. The differential diagnoses include tubular carcinoma, adenosquamous carcinoma, radial sclerosing lesions and others.

Adenocarcinoma ; pathology ; Adult ; Aged ; Breast ; pathology ; Breast Neoplasms ; diagnosis ; metabolism ; pathology ; Carcinoma, Adenosquamous ; diagnosis ; metabolism ; pathology ; Carcinoma, Squamous Cell ; pathology ; Diagnosis, Differential ; Female ; Humans ; Immunohistochemistry ; Keratin-5 ; metabolism ; Keratin-6 ; metabolism ; Middle Aged ; Neprilysin ; metabolism ; Nipples ; pathology ; Sclerosis ; Sweat Gland Neoplasms ; diagnosis ; metabolism ; pathology ; Syringoma ; diagnosis ; metabolism ; pathology ; Transcription Factors ; metabolism ; Tumor Suppressor Proteins ; metabolism

This study was aimed to characterize clinicopathological features and prognosis of patients with adenosquamous lung carcinoma (ASC). Among the 2531 patients with lung cancer who underwent surgery between January 2000 and June 2012 in our hospital, 59 were histologically diagnosed as having ASC. The clinicopathological features and follow-up data of ASC patients were collected and analyzed statistically. Superior lobectomy was accomplished in 40 patients, middle and inferior lobectomy in 3, lobectomy plus partial resection of contralateral lung in 5, partial lung resection in 4, and pneumonectomy in 7. Moreover, 22 cases were found to be adenocarcinoma-predominant, and 18 to be squamous cell carcinoma-predominant. The median survival time was 13.6 months, and the 1-, 3-, and 5-year survival rates were 59.9%, 36.4% and 31.2%, respectively. Of the 52 cases with tissue specimens available, 11 had an EGFR mutation (21.2%) and 2 had a KRAS mutation (3.8%). Multivariate analysis showed that histology subtype, pleural invasion, TNM stage, and postoperative treatment were all independent prognostic factors. The data from the current study demonstrated that SCC-predominant histology represents a better prognosis of ASC. Histology subtype, pleural invasion, TNM stage, and postoperative treatment are independent prognostic factors for ASC and adjuvant therapy may help control the disease.
Adult ; Aged ; Carcinoma, Adenosquamous ; genetics ; pathology ; surgery ; Diagnosis, Differential ; Female ; Humans ; Lung Neoplasms ; genetics ; pathology ; surgery ; Male ; Middle Aged ; Mutation ; Prognosis ; Proto-Oncogene Proteins p21(ras) ; genetics ; Receptor, Epidermal Growth Factor ; genetics ; Retrospective Studies ; Survival Analysis

OBJECTIVEThis study was to review the clinical features, diagnosis, treatment, and prognosis of esophageal adenosquamous carcinoma (ASC).

METHODSClinical data of 22 patients with pathologically confirmed esophageal ASC, treated in the Cancer Center of Sun Yat-sen University from May 1988 to April 2006, were retrospectively analyzed. The survival analysis was performed using Kaplan-Meier method.

RESULTSOf 4208 patients diagnosed as esophageal cancer during the same time in our center, only 22 had esophageal ASC, accounted for 0.52%. The median age of the 22 cases was 60 years (range, 42 to 69 years). Esophageal ASC showed similar clinical symptoms, radiological and endoscopic features to esophageal squamous cell carcinoma (ESCC). Nineteen cases were preoperatively misdiagnosed as ESCC by endoscopic biopsy. Among the 22 patients, 16 were treated by surgery alone, 3 by surgery plus postoperative radiotherapy, and the remaining 3 by radiotherapy, sequential chemoradiotherapy and concurrent chemoradiotherapy, each in one case, respectively. The overall 1-, 3- and 5-year survival rates were 67.6%, 33.8% and 18.1%, respectively, with a median survival time of 24.5 months.

CONCLUSIONEsophageal adenosquamous carcinoma is a rare esophageal disease and prone to be misdiagnosed as esophageal squamous cell carcinoma. Initial surgical treatment combined with other therapies is suggested. The prognosis of esophageal adenosquamous carcinoma has not yet been well established.

Adult ; Aged ; Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Bone Neoplasms ; secondary ; Carcinoma, Adenosquamous ; diagnosis ; therapy ; Carcinoma, Squamous Cell ; diagnosis ; Cisplatin ; administration & dosage ; Diagnostic Errors ; Esophageal Neoplasms ; diagnosis ; pathology ; therapy ; Esophagectomy ; methods ; Female ; Fluorouracil ; administration & dosage ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Neoplasm Recurrence, Local ; Neoplasm Staging ; Retrospective Studies ; Survival Rate