Cystic nephroma (CN) is a benign cystic neoplasm composed of mixed epithelial and stromal elements. Less than 200 cases have been reported. We had a patient, a 41-year-old woman, who had a huge typical CN. The patient was admitted for a right renal mass that was found incidentally. On laparaoscopic right nephrectomy, there was an encapsulated 7 cm multilocular cystic mass at the upper pole. Microscopically, the cystic wall was lined by a single layer of low cuboidal or hobnail epithelium without a solid area. The thin septa were composed of bland, ovarian type spindle cells. The main differential diagnoses were mixed epithelial and stromal tumor (MEST), low grade multilocular renal cell carcinoma, and tubulocystic carcinoma. The results of immunohistochemical staining were cytokeratin 7/19(+/+) and CD10(-) in lining epithelium, estrogen receptor/progesterone receptor(+/+) in stromal cells. After surgery, she was free of recurrence for 10 months. We report this rare case and compare it with other cystic renal tumors, especially MEST.
Adult ; Carcinoma, Renal Cell ; Diagnosis, Differential ; Epithelium ; Estrogens ; Female ; Humans ; Keratins ; Kidney ; Nephrectomy ; Receptors, Estrogen ; Recurrence ; Stromal Cells

We herein present a rare case of pineocytoma in a 23-year-old female exhibiting distinct histomorphological features. The tumor contained highly pleomorphic, often multinucleated giant cells in the background of otherwise benign pineocytomatous architecture, which at first led to an erroneous diagnosis of a high grade malignancy. However, the worrisome histological findings turned out to be constituents of a distinct subtype of pineocytoma previously described as pleomorphic variant of pineocytoma. Although it is rare, pathologists should be aware of this entity since the tumor takes on a benign clinical course like any other classic pineocytomas.
Diagnosis ; Female ; Giant Cells ; Humans ; Pineal Gland ; Pinealoma* ; Young Adult

Cutaneous metastasis from lung cancer is less common than metastasis from other organs. However, lung cancer is the most common origin of cutaneous metastasis in men and the second most common in women. Recognition of cutaneous metastatic cancer is important because it can be the first sign of visceral cancer. Although skin metastasis can appear on any cutaneous surface, the most common site is the chest wall. The prognosis for patients having lung cancer with cutaneous metastasis is very poor because the disease is advanced, with the involvement of other sites such as the brain, liver, bone, and adrenal gland. Herein, we report a case of an 87-year-old male with an undifferentiated metastatic carcinoma of the scrotum originating from lung cancer which was found later than the cutaneous metastatic cancer.
Adrenal Glands ; Aged, 80 and over ; Brain ; Female ; Humans ; Liver ; Lung Neoplasms* ; Lung* ; Male ; Neoplasm Metastasis ; Prognosis ; Scrotum ; Skin ; Thoracic Wall

A 35-year-old man complained of right truncal pain around T7-8 dermatomal distribution and on examination, T7-8 spinal tenderness was observed. Magnetic resonance imaging showed osteolytic mass in T8 vertebral body without structural lesions involving spinal nerve roots. Dermatomal somatosensory evoked potentials (DSEP) were helpful in diagnosis with thoracic radiculopathy. Finally, Langerhans cell histiocytosis was confirmed in bone biopsy. Thoracic radiculopathy can be caused by various etiologies including bone tumor and DSEP is useful supplementary tool for diagnosing thoracic radiculopathy.

The development and standardization of cytologic screening of the uterine cervix has dramatically decreased the prevalence of squamous cell carcinoma of the uterine cervix. Advances in the understanding of biology of human papillomavirus have contributed to upgrading the histologic diagnosis of the uterine cervix; however, cytologic screening that should triage those that need further management still poses several difficulties in interpretation. Cytologic features of high grade intraepithelial squamous lesion (HSIL) mimics including atrophy, immature metaplasia, and transitional metaplasia, and glandular lesion masquerades including tubal metaplasia and HSIL with glandular involvement are described with accentuation mainly on the differential points. When the cytologic features lie in a gray zone between the differentials, the most important key to the more accurate interpretation is sticking to the very basics of cytology; screening the background and cellular architecture, and then scrutinizing the nuclear and cytoplasmic details.

Acute tubular necrosis is a major cause of acute renal failure. Acute renal failure that is caused by crystal deposition can result from drug toxicity, lymphoplasmacytic neoplasms, ingestion of industrial organic solvents, or intratubular obstruction due to degenerated red blood cells and red blood cell casts. We herein present an uncommon case of acute renal failure in a 57-year-old woman showing an unusually massive accumulation of variable-sized, round, ellipsoid or rhomboid, pale-pink, refractile bodies in the proximal and distal tubular epithelial cells, interstitial macrophages and Bowman's spaces. These bodies were electron dense with a maximum diameter of 3 micrometer. The information we gathered from the patient history, the laboratory data and the various histochemical and immunohistochemical analyses failed to reveal the exact nature of these crystal-like structures.
Acute Kidney Injury* ; Drug-Related Side Effects and Adverse Reactions ; Eating ; Epithelial Cells ; Epithelium* ; Erythrocytes ; Female ; Humans ; Macrophages ; Middle Aged ; Necrosis ; Renal Insufficiency ; Solvents

We report a case of a 38-year-old male with extranodal NK/T-cell lymphoma, nasal type, showing unusual clinical and pathological features. The patient was admitted for soft tissue swelling and tenderness in both legs. The patient had been treated intermittently 8 months prior for repeated muco-cutaneous ulcers. A muscle biopsy showed medium-sized atypical lymphoid cells with bizarre nuclei and plump cytoplasm, infiltrating to the skeletal muscle fibers with angiocentricity. The immunoresults were Ki-1+, CD56+, cytoplasmic CD3+, with EBV-in situ hybridization +. The patient rapidly deteriorated and died of sepsis and respiratory failure shortly after initiation of low-dose chemotherapy. A careful review of previous biopsies revealed scarce atypical lymphoid cells around vessels with similar immunoprofiles without the presence of Ki-1 positive cells. This case emphasizes that an extranodal NK/T-cell lymphoma may have a dermatomyositis-like diffuse presentation. Ki-1 co-expression can be an unexpected event in a process of the disease course; however, this should be validated with future studies.
Adult ; Biopsy ; Cytoplasm ; Dermatomyositis* ; Drug Therapy ; Humans ; Leg ; Lymphocytes ; Lymphoma* ; Male ; Muscle Fibers, Skeletal ; Respiratory Insufficiency ; Sepsis ; Ulcer

PURPOSE: Osteopontin (OPN) binds to CD44 and nuclear factor-kappaB (NFkappaB) and OPN mediates tumorigenesis, invasion and metastasis, but the interrelationships between OPN, CD44 and NFkappaB are not fully understood, and especially in gastric carcinogenesis. We examined the expressions of OPN, CD44, and NFkappaB in untreated gastric adenocarcinomas. MATERIALS AND METHODS: The materials from 211 cases of gastric adenocarcinoma were immunostained for OPN, CD44 and NFkappaB by using a tissue microarray. The OPN mRNA expression was measured in 10 cases by performing real-time RT-PCR. RESULTS: The expression of OPN, CD44 and NFkappaB was noted in 61.7%, 11.4% and 26.6% of the adenocarcinoma tissues, respectively. No significant correlation was detected among the expressions of these proteins. The OPN protein expression was negatively correlated with angioinvasion (p<0.05) and patient survival (p<0.05), whereas the CD44 and NFkappaB protein expressions were not correlated with any of the clinicopathological factors we examined. The depth of invasion, lymph node status and perineural invasions were prognostic factors based on the Cox analysis. The OPN mRNA expression showed no significant difference between the adenocarcinoma and the paired normal mucosa on real-time RT-PCR. CONCLUSION: OPN may have a currently undetermined role in gastric carcinogenesis, and CD44 and NFkappaB may have minor roles in gastric adenocarcinoma.
Adenocarcinoma ; Cell Transformation, Neoplastic ; Humans ; Lymph Nodes ; Mucous Membrane ; Neoplasm Metastasis ; Osteopontin ; Proteins ; RNA, Messenger ; Stomach

BACKGROUND: The Pap smear has brought about a dramatic improvement in the prevention of cervical cancer in women worldwide. In an effort to decrease the occasional false negatives in the Pap smear and further increase the screened population, ThinPrep Pap Test (TP), a fluid-based cytology collection method, has been developed. With preservation of claimed advantages of TP, we have developed a Pap test solution for manual preparatory process and compared our manually processed fluid-based Pap smear with TP to identify cytologic similarities and differences between the two methods. METHODS: Cervical swipes of 204 patients were prospectively collected in the 'Pap solution' and also in PreservCyt solution for TP. Diagnoses and smear characteristics were compared. RESULTS: The diagnoses of the paired smears agreed in 190 of the 204 cases (93.1%). The smear characteristics regarding overall cellularity and background cellularities were similar in the two methods and the stainability of the cells was virtually the same. CONCLUSIONS: The 'Pap solution' has similar performance characteristics as TP in many aspects. With its advantages of cost-effectiveness and easier preparatory process, the 'Pap solution' can match previously implemented thin layer preparation.
Female ; Humans ; Prospective Studies ; Uterine Cervical Neoplasms

To evaluate the roles of 4 putative downstream molecules (ERK, p38 MAPK, JNK and AKT) of the RET signal pathway in the tumorigenesis of papillary carcinomas, the expression patterns of RET and phosphorylated forms of ERK, p38 MAPK, JNK and AKT were evaluated in 115 cases of papillary thyroid carcinomas by 3 mm-core tissue microarray based immunohistochemical staining. The prevalence of RET protein expression was 62.6%. No distinct expression of p-ERK and p-p38 MAPK was demonstrated in tumor cells of papillary carcinomas. All papillary carcinomas except 5 cases expressed nuclear p-JNK and p-JNK expression was increased in tumors compared with paired normal tissues (p < 0.05). There was no difference in the p-JNK expression between RET protein-positive and RET protein-negative papillary carcinomas (p > 0.05). Unequivocal nuclear staining for p-AKT was demonstrated only in 10 cases of papillary carcinomas, and all of them showed focal staining. Our results showing constitutive expression of p-JNK in most cases of surgically excised papillary thyroid carcinomas irrespective of RET protein expression status suggest that JNK activation may play a role in the tumorigenesis or survival of sporadic papillary thyroid carcinoma.
Adult ; Aged ; Carcinoma, Papillary/*metabolism/pathology ; Female ; Human ; Male ; Middle Aged ; Mitogen-Activated Protein Kinases/*metabolism ; Proto-Oncogene Proteins/*metabolism ; Receptor Protein-Tyrosine Kinases/metabolism ; Support, Non-U.S. Gov't ; Thyroid Neoplasms/*metabolism/pathology