Sarcomatoid carcinoma is a rare biphasic tumor characterized by a combination of malignant epithelial and mesenchymal cells. We report a rare case of sarcomatoid carcinoma of the colon. A 41-yr-old woman was hospitalized with a history of melena. Total colectomy was performed under the impression of colonic carcinoma. Histologically, the tumor was composed of differentiated adenocarcinoma in superficial portion and sarcomatoid spindle cells in deeper portion with a transitional area between the two portions. The sarcomatous areas revealed polygonal and spindle-shaped anaplastic malignant cells arranged in sheet, short fascicular or haphazard pattern. Immunohistochemically, tumor cells showed a positive immunoreaction for cytokeratin, epithelial membrane antigen, and vimentin. The histopathological and immunohistochemical transitions between the adenocarcinoma area and the spindle cell area suggested that the sarcomatous elements originated from the adenocarcinoma during tumor progression.
Adult ; Carcinosarcoma/chemistry/diagnosis/*pathology ; Case Report ; Colonic Neoplasms/chemistry/diagnosis/*pathology ; Female ; Human ; Immunohistochemistry

A case of intestinal angiocentric T/NK-cell lymphoma in a 58-year-old man is reported. The patient presented initially with panperitonitis because of perforation of sigmoid colon diverticulum. He underwent segmentectomy of involved bowel. Histologically, the intestinal wall showed diffuse infiltration of medium or large size lymphoma cells with angiocentric growth and necrosis. The lymphoma cells were CD56+, CD45RO+, CD3+, CD4-, CD8-, CD20-, and CD30- in paraffin sections with germline configuration of TCR-gamma gene, consistent with T/NK-cell lymphoma. Further staging revealed splenomegaly. Intestinal angiocentric T/NK cell lymphoma represents a distinct etiology of diverticulum with perforation.
Antigens, CD56/analysis ; Case Report ; Colon/pathology* ; Colonic Neoplasms/radiography ; Colonic Neoplasms/pathology* ; DNA, Neoplasm/analysis ; Diagnosis, Differential ; Diverticulitis, Colonic/radiography ; Diverticulitis, Colonic/pathology* ; Human ; Immunoglobulins, Heavy-Chain/genetics ; Killer Cells, Natural/pathology* ; Killer Cells, Natural/chemistry ; Lymphoma, T-Cell/pathology* ; Lymphoma, T-Cell/chemistry ; Male ; Middle Age ; Necrosis ; Peritonitis/radiography ; Peritonitis/pathology ; Receptors, Antigen, T-Cell/genetics ; Tomography, X-Ray Computed

OBJECTIVETo study the expression of CDX2 in normal and tumor tissues, and to evaluate the value of CDX2 immunostaining in the diagnosis of gastrointestinal adenocarcinoma.

METHODSeventy-six samples of normal tissue and 612 samples of tumor tissue were studied by tissue microarray technology and immunohistochemistry for CDX2.

RESULTSCDX2 was strongly expressed in surface epithelium of 13 samples of normal intestine and in ductal epithelium of 8 samples of normal pancreas, as well as in 47 samples (92.2%) of colonic adenocarcinoma and 58 samples (66.9%) of gastric adenocarcinoma. As for other tumor types, there was only weak or patchy CDX2 positivity. The positivity rates were as follows: ovarian mucinous adenocarcinoma 15.6% (10/64), pancreatic cancer 33.3% (3/9), thyroid cancer 27.3% (3/11) and extrahepatic biliary cancer 25% (4/16). On the other hand, primary tumors of breast, prostate, kidney, adrenal and liver were negative for CDX2.

CONCLUSIONSCDX2 is expressed mainly in normal epithelium of intestinal tract and small pancreatic ducts, as well as in primary adenocarcinoma of gastrointestinal tract. CDX2 may thus play an important role in distinguishing primary non-intestinal adenocarcinoma from metastatic adenocarcinoma of gastric or colorectal primary.

Adenocarcinoma ; diagnosis ; metabolism ; CDX2 Transcription Factor ; Colonic Neoplasms ; diagnosis ; metabolism ; Female ; Gastrointestinal Neoplasms ; diagnosis ; metabolism ; Gastrointestinal Tract ; chemistry ; pathology ; Homeodomain Proteins ; metabolism ; Humans ; Immunohistochemistry ; Male ; Stomach Neoplasms ; diagnosis ; metabolism ; Tissue Array Analysis

OBJECTIVE: To visualize tumor angiogenesis using the MRI contrast agent, Gd-DTPA-anti-VEGF receptor 2 antibody conjugate, with a 4.7-Tesla MRI instrument in a mouse model. MATERIALS AND METHODS: We designed a tumor angiogenesis-targeting T1 contrast agent that was prepared by the bioconjugation of gadolinium diethylenetriaminepentaacetic acid (Gd-DTPA) and an anti-vascular endothelial growth factor receptor-2 (VEGFR2) antibody. The specific binding of the agent complex to cells that express VEGFR2 was examined in cultured murine endothelial cells (MS-1 cells) with a 4.7-Tesla magnetic resonance imaging scanner. Angiogenesis-specific T1 enhancement was imaged with the Gd-DTPA-anti-VEGFR2 antibody conjugate using a CT-26 adenocarcinoma tumor model in eight mice. As a control, the use of the Gd-DTPA-anti-rat immunoglobulin G (Gd-DTPA-anti-rat IgG) was imaged with a tumor model in eight mice. Statistical significance was assessed using the Mann-Whitney test. Tumor tissue was examined by immunohistochemical analysis. RESULTS: The Gd-DTPA-anti-VEGFR2 antibody conjugate showed predominant binding to cultured endothelial cells that expressed a high level of VEGFR2. Signal enhancement was approximately three-fold for in vivo T1-weighted MR imaging with the use of the Gd-DTPA-anti-VEGFR2 antibody conjugate as compared with the Gd-DTPA-rat IgG in the mouse tumor model (p < 0.05). VEGFR2 expression in CT-26 tumor vessels was demonstrated using immunohistochemical staining. CONCLUSION: MR imaging using the Gd-DTPA-anti-VEGFR2 antibody conjugate as a contrast agent is useful in visualizing noninvasively tumor angiogenesis in a murine tumor model.
Adenocarcinoma/*pathology ; Animals ; Colonic Neoplasms/*pathology ; Contrast Media/chemistry/*diagnostic use ; Gadolinium DTPA/chemistry/*diagnostic use ; Immunoenzyme Techniques ; Magnetic Resonance Imaging/*methods ; Mice ; Mice, Nude ; Neovascularization, Pathologic/*diagnosis ; Rats ; Statistics, Nonparametric ; Tumor Cells, Cultured ; Vascular Endothelial Growth Factor Receptor-2/*antagonists & inhibitors/chemistry