Primary squamous cell carcinoma of the endometrium is exceedingly rare. To be accepted as a primary carcinoma of the endometrium, the tumor must satisfy the criteria estalished by Fluhmann: There must be; 1) no coexisting endometrial adenocarcinoma, 2) no connection between the endometrial tumor and the squamous epithelium of the cervix, and 3) no squamous cell carcinoma of the cervix. We recently experienced a case of primary squamous cell carcinoma of the endometrium covering the submucosal leiomyoma in a 68-year-old female patient. On gross examination a submucosal leiomyoma covered by an irregular, dirty endometrium was found. On histologic examination the endometrium covering the leiomyoma revealed invasive, well differentiated squamous cell carcinoma. The uterine cervix showed no evidence of malignancy. In situ PCR using a probe for HPV 16/18 was negative in the carcinoma tissue.
Adenocarcinoma ; Aged ; Carcinoma, Squamous Cell* ; Cervix Uteri ; Endometrium* ; Epithelium ; Female ; Humans ; Leiomyoma* ; Polymerase Chain Reaction

No abstract available.
Constriction* ; Heart Ventricles* ; Pulmonary Artery* ; Rabbits*

Polyvesicular vitelline tumor of the ovary is an extremely rare variant of yolk sac tumor. We present a case of pure polyvesicular vitelline tumor in a 43-year-old woman. Light microscopy revealed a predominantly polyvesicular pattern embedded in mesoblastic stroma with the cysts showing two type of lining; tall columnar and cuboidal, or mesothelioid cells. The lining atypical cells showed occasional mitoses and intracytoplasmic PAS positive hyaline globules. In some areas, the cystic space contained a large amount of intraluminal hyaline material. Immunohistochemically, alpha- fetoprotein and alpha-1-antitrypsin were detected as a fine granular deposit in the cytoplasm of epithelial cells and hyaline globules. Electron microscopically, marked specialization of the vesicular lining cells suggested a differentiation toward gut structures and mature yolk sac.
Adult ; Cytoplasm ; Endodermal Sinus Tumor ; Epithelial Cells ; Female ; Fetal Proteins ; Humans ; Hyalin ; Microscopy ; Mitosis ; Ovary* ; Vitellins* ; Yolk Sac

Polyvesicular vitelline tumor of the ovary is an extremely rare variant of yolk sac tumor. We present a case of pure polyvesicular vitelline tumor in a 43-year-old woman. Light microscopy revealed a predominantly polyvesicular pattern embedded in mesoblastic stroma with the cysts showing two type of lining; tall columnar and cuboidal, or mesothelioid cells. The lining atypical cells showed occasional mitoses and intracytoplasmic PAS positive hyaline globules. In some areas, the cystic space contained a large amount of intraluminal hyaline material. Immunohistochemically, alpha- fetoprotein and alpha-1-antitrypsin were detected as a fine granular deposit in the cytoplasm of epithelial cells and hyaline globules. Electron microscopically, marked specialization of the vesicular lining cells suggested a differentiation toward gut structures and mature yolk sac.
Adult ; Cytoplasm ; Endodermal Sinus Tumor ; Epithelial Cells ; Female ; Fetal Proteins ; Humans ; Hyalin ; Microscopy ; Mitosis ; Ovary* ; Vitellins* ; Yolk Sac

We evaluated 1,000 consecutive endometrial curettage samples obtained over a 30 month period. The clinico-pathologic correlation was analysed according to Hendrickson's five criteria based on the practical view. The causes of uterine bleeding in decreasing order of occurrence were as follows: 1) hormonal imbalance lesions (49.2%) encompassing glandular and stromal breakdown suggesting anovulatory bleeding, proliferative phase endometrium, and disordered proliferative endometrium, 2) pregnancy associated lesions (24.2%), 3) organic lesions (13.5%), 4) endometrial hyperplasia (6.9%), and 5) inadequate specimen (6.2%). According to age, pregnancy related lesions were most frequent in the third decade. In the fourth, fifth, and sixth decades, hormonal imbalance lesions were the most common cause. In approximately 30% of the samples, there were two or three morphologic patterns such as anovulatory bleeding with an endometrial polyp, postabortal bleeding with inflammation, and glandular-stromal dissociation with a polyp, which suggested there was a variable histologic morphology in the same disease spectrum. Using immunohistochemical techniques we studied the hormonal dependency of bcl-2 oncoprotein in anovulatory bleeding, endometrial hyperplasia, and proliferative endometrium. 70% of anovulatory bleeding specimens showed weak positivity in the epithelial cytoplasm, and all cases of endometrial hyperplasia and carcinoma showed a strong positivity. These results suggest that there is a estrogenic hormonal dependency of apoptosis in the endometrium.
Apoptosis ; Biopsy* ; Curettage ; Cytoplasm ; Endometrial Hyperplasia ; Endometrium* ; Estrogens ; Female ; Hemorrhage ; Inflammation ; Polyps ; Pregnancy ; Uterine Hemorrhage*

The peripheral blood eosinophil and serum IgE level in 53 patients with atopic dermatitis (AD) were measured. The patients were divided into 2 groups by severity(mild and severe grous) and into 3 groups by the associated respiratory atopic deseases and/or their family history : respiratory group(patient, with both AD and respiratory atopy), family history group (patient with both AD and family history of respiratory atopy), and atopic group(patient with neither respiratory atopy nor family history of respiratorv atopy). We designed to study which factors are important in the elevation of serum IgE and peripheral blood eosinophil level in AD, and to know possible relationships between the serum eosinophil and IgE level and the several groups of AD. The results are as follows : 1. Peripheral eosinophil counts were higher in severe group(224.8/mm) than in mild group (180.0/mm)(p<0.05). 2. Peripheral eosinophil counts were 220.0/mm in atopic group, l65.0/mm in family history group, and 332.4/mm in respiratory group, but there was no stitistically significant difference among 3 groups. This suggests that concomitant respiatitiry atopy or a family history of respiratory atopy is not an important factor in the elvation of peripheral blood eosinophil counts in AD. 3. Serum IgE was higher in severe group(443.2IU/ml) than in mild group(231.5IU/ml)(p<0.05). 4. Serum IgE level in respiratory group(754.6IU/ml) were signifiiantlly higher than in atopic (286.6IU/ml) or family history group(342.0IU/ml)(p<0,01). But there was no significant. difference between family and atopic group. This result suggests that concomittent respiratory atopy is a potential factor in elevation of serurn Igi in AD. 5. Slightly high correlation between peripheral blood and IgE level appeared in all 53 patients (r=0.434) and severe group(r=0.480). But, respiratory group(r=0.060), family history group(r=0.111) and atopic group(r=0.202) showed poor relationships.
Dermatitis, Atopic* ; Eosinophils* ; Humans ; Immunoglobulin E*

Neoplasms showing both carcinomatous and sarcomatous features are well established, and have been reported in practically every organ where carcinoma can occur. But the difference in terminology and difficulties in histopathologic interpretation have hampered adequate understanding of these neoplasms. We report a case of carcinosarcoma in the recurrent form of serous cystadenocarcinoma of the ovary. The patient was a 64-year-old female who underwent total hysterectomy and bilateral salpingoophorectomy three years ago, due to perforated papillary serous cysta denocarcinoma of the right ovary. Recurrent pelvic masses contained both carcinomatous and sarcomatous components. Morphological transition between carcinomatous and sarcomatous components, and epithelial characteristics in the sarcomatous component by immunohistochemistry were recognized. We postulate the histopathogenetic mechanism based on the phenotypic conversion of carcinoma into sarcoma in the carcinosarcoma.
Carcinosarcoma* ; Cystadenocarcinoma, Serous* ; Female ; Humans ; Hysterectomy ; Immunohistochemistry ; Middle Aged ; Ovary* ; Sarcoma

A case of an ovarian mucinous cystadenocarcinoma with mural nodules of anaplastic carcinoma is reported. The patient was a 46-year-old female with a right ovarian cystic mass and underwent a total abdominal hysterectomy with bilateral salpingo-oophorectomy. The patient died of the disease in five months. Macroscopically, the right ovarian cyst wall contained numerous well-demarcated mural nodules. Histologically, the cysts were mucinous cystadenocarcinoma, and the nodules were composed of sarcoma-like spindle and polygonal cells with atypia and numerous mitoses. Spindle cells in the mural nodule showed epithelial characteristics by electron microscopy and immunohistochemistry. This case supports an epithelial origin of the mural nodule of anaplastic carcinoma in ovarian mucinous tumors.
Carcinoma* ; Cystadenocarcinoma, Mucinous* ; Female ; Humans ; Hysterectomy ; Immunohistochemistry ; Microscopy, Electron ; Middle Aged ; Mitosis ; Mucins* ; Ovarian Cysts ; Ovary

Menetrier's disease is characterized by enlarged gastric folds with foveolar hyperplasia and cystic dilatation of gastric glands. The additional biochemical features of hypoproteinemia, hypochlorhydria, and increased gastric mucus are often encountered. The pathogenesis and etiologic factors have not been clearly defined. In this report, we present two cases of Menetrier's disease in the stomach, one occurring in a 38-year-old male, associated with massive hematemesis, and the other in a 39-year-old male. Grossly, both cases showed marked giant gastric rugal folds resembling cerebral convolutions, sparing the antral portion. Microscopically, the giant gastric rugal folds consisted of the striking foveolar hyperplasia accompanied by an occasional presence of the smooth muscle fibers from the muscularis mucosa. The immunohistochemical stain revealed an intense positive reaction for transforming growth factor-alpha (TGF-alpha) and epidermal growth factor receptor (EGF-R) in the majority of mucous cells throughout the gastric mucosa and parietal cells, but did not reveal for epidermal growth factor (EGF). We suggested that TGF-alpha and EGF-R might be involved in the pathogenesis of Menetrier's disese.
Achlorhydria ; Adult ; Dilatation ; Epidermal Growth Factor ; Gastric Mucosa ; Gastritis, Hypertrophic* ; Hematemesis ; Humans ; Hyperplasia ; Hypoproteinemia ; Immunohistochemistry ; Male ; Mucous Membrane ; Mucus ; Muscle, Smooth ; Rabeprazole ; Receptor, Epidermal Growth Factor ; Stomach ; Strikes, Employee ; Transforming Growth Factor alpha

We report an unusual case of sebaceous hyperplasia in an 18-year-old male manifestated clinically as yellowish, grouped papules with a linear distribution, present on the right side of forehead since birth. Histopathologically, a large sebaceous gland composed of numerous lobules grouped around a centrally dilated duct was seen. The sebaceous lobules distributed in the upper dermis showed direct connection to the skin surface, which suggested a transepidermal elimination of sebaceous lobules.
Adolescent ; Dermis ; Forehead ; Humans ; Hyperplasia* ; Male ; Parturition ; Sebaceous Glands ; Skin