Primary hepatic carcinoid tumors are extremely rare although the liver is a frequent site of metastases from intestinal carcinoids. Recently we investigated a case of primary hepatic atypical carcinoid in a 47-year-old man who had infested with Clonorchis sinensis for 20 years. The resected right lobe of the liver was almost completely occupied by a huge tumor, measuring 20 x 19 x 12 cm. The cut surfaces of the mass were solid, soft and pale yellow, accompanied by several small satellite nodules, measuring up to 1.5 cm in diameter. Microscopically, the tumor consisted of polygonal to columnar cells with eosinophilic granular cytoplasm forming Lym-numerous small acini and large trabeculae. Their nuclei were round to polygonal with coarse stone chromatin, had obscure to small nucleoli and frequent mitoses. There were multiple necrotic foci of varing sizes. The surrounding dilated bile ducts contained several degenerating worms on in of Clonorchis sinensis. The tumor cells were argyrophil-positive but argentaffin-negative. Immunohistochemically, the tumor cells were positive for cytokeratin, chromogranin and somatostatin but were negative for CEA, AFP, insulin, glucagon, ACTH, growth hormone and volve-prolactin. Ultrastructually, the tumor cells contained variable-sized numerous electron dense of neurosecretory granules.
Male ; Humans ; Neoplasm Metastasis

We report a rare case of carcinosarcoma arising in the stomach. The tumor is presented in the posterior wall of the gastric lower body and antrum of a 56-year-old man. Grossly the tumor has polypoid appearance with diffuse surface ulceration and measures 5.5 cm in diameter. The tumor is accompanied with three separate well differentiated early gastric adenocarcinomas (two EGC type IIc & IIa). Microscopically, the tumor consists of moderately well differentiated adenocarcinoma in the periphery, and lobulated sarcomatous areas in the center, which shows chondroid differentiation. Transitional areas between adenocarcinoma and chondrosarcoma are evident. Immunohistochemical studies show positivity for cytokeratin and carcinoembryonic antigen in the epithelial component, and for vimentin and S-100 in the sarcomatous component. The transitional areas are positive in carcinoembryonic antigen, vimentin, S-100, and cytokeratin. The tumor extended to the subserosa and showed metastasis of only adenocarcinomatous component in six out of 47 dissected perigastric lymph nodes.
Adenocarcinoma ; Carcinoembryonic Antigen ; Carcinosarcoma* ; Chondrosarcoma ; Humans ; Keratins ; Lymph Nodes ; Middle Aged ; Neoplasm Metastasis ; Stomach* ; Ulcer ; Vimentin

A rare case of hepatic metastasis with a choriocarcinomatous component from a composite adenocarcinoma and choriocarcinoma of the sigmoid colon in a 60-year-old man is reported. The hepatic metastasis displayed choriocarcinoma with extensive hemorrhagic necrosis. The tumor cells were poorly differentiated with scattered foci of bizzare syncytiotrophoblastic cells. Retrospective examination of the previous colonic carcinoma proved that the tumor was composed of two distinctive elements. One was a moderately well differentiated adenocarcinoma located in mucosa and submucosa. The other was a deep seated and undifferentiated carcinoma which was made up of hyperchromatic bizzare cells with syncytiotrophoblastic cells. There were transitional foci from adenocarcinoma to undifferentiated carcinoma with trophoblastic cells. Immunohistochemical staining showed beta-hCG expression in the undifferentiated cells of both the primary and the metastatic tumors. Implications for the possible origin and cause of tumor cell heterogeneity are briefly discussed.
Adenocarcinoma* ; Carcinoma ; Choriocarcinoma* ; Colon ; Colon, Sigmoid* ; Female ; Humans ; Middle Aged ; Mucous Membrane ; Necrosis ; Neoplasm Metastasis* ; Population Characteristics ; Pregnancy ; Retrospective Studies ; Trophoblasts

Papillary carcinoma of the thyroid is a well differentiated neoplasm and usually has a good prognosis. However, a subset of morphologically distinct papillary carcinoma has bad prognoses. The tall cell variant of papillary carcinoma (TCPC), characterized by tall columnar cells with a height at least twice the width, is the one of these. In order to differentiate TCPC from usual papillary carcinoma (UPC) in terms of prognosis, we performed immunohistochemical studies for the expression of p53, bcl-2 and Leu-M1 proteins in 25 cases of TCPC, 26 cases of UPC and 14 cases of poorly differentiated, solid type papillary carcinoma (SPC) with an analysis of clinical parameters. The nuclear expression of p53 was noted in one case each of UPC and TCPC. The cytoplasmic p53 expression of TCPC, UPC, and SPC was observed in 17/25 cases (68%), 14/26 cases (54%), 3/14 cases (21%), respectively. bcl-2 expression was 19/25 cases (76%), 18/26 cases (69%), 5/14 cases (36%), and that of Leu-M1 was 21/25 cases (84%), 18/26 cases (69%), 4/14 cases(29%), respectively. There were no statistical significance in the expression of those immunoproteins among these three groups (p>0.05). The p53 protein was consistently expressed in the cytoplasm rather than nucleus in this study and was very well correlated to bcl-2 positivity (p<0.01). There were no statistical significance in any clinical parameters examined among these three groups (p>0.05). In conclusion, TCPC can not be separated from UPC as a distinct entity in this study and the cytoplasmic expression of p53 protein provides another mechanism of p53 inactivation in tumorigenesis of the thyroid papillary carcinoma, possibly by bcl-2 related mechanism.
Carcinogenesis ; Carcinoma, Papillary ; Cytoplasm ; Immunoproteins ; Prognosis ; Thyroid Gland* ; Thyroid Neoplasms*

Primary hepatic sarcoma is a rare tumor, with fewer than 60 previously reported cases. It is thought to arise from hepatic connective tissue or vascular channels. The tumor is located usually in the intrahepatic area. Pedunculated or bulging lesion is also reported. We report a case of primary leiomyosarcoma of the liver occuring in a 62-year-old Korean woman. A pedunculated, 21 16 cm sized mass is located in the left lateral segment of the liver. Microscopically, the tumor is hypercellular and composed of elongated, partly pleomorphic spindle cells with blunt-ended nuclei, which are focally reactive for muscle specific actin. Mitotic figures are 5/10 high power fields (HPFs). No other primary site is recognized on clinical study.
Actins ; Connective Tissue ; Female ; Humans ; Leiomyosarcoma* ; Liver ; Middle Aged ; Sarcoma

Fibroepithelial polyps of the ureter are usually acquired rather than congenital. Most polyps are hamartomatous growths which tend to arise in the proximal portion of the left ureter. Most patients exibit either hematuria or persistent flank pain secondary to partial ureteral obstruction. Because of false positivity of urine cytology, as well as intravenous pyelogram, the correct diagnosis is confused with malignancy. Herein we report four cases of ureteral fibroepithelial polyp, which are associated with stones resulting in partial obstruction of the ureter. One of the four cases is associated with nephrogenic adenoma in the lamina propria of the adjacent ureter. The following report describes clinicopathologic findings of fibroepithelial polyp with review of literatures.
Adenoma

Intraductal variant of peripheral cholangiocarcinoma is extremely rare. This variant shows intraductal growth and intraluminal extension without any infiltrative growth. The mode of intraductal growth is not known. The prognosis of this variant is better than that of usual cholangiocarcinoma. We report three cases, one of which is associated with Clonorchis sinensis (CS) infection. The tumors were entirely confined within the dilated peripheral tributaries of the intrahepatic bile duct. Microscopically, the tumors were well to moderately well differentiated, with a papillary or a micropapillary growth pattern. Focal clear cytoplasmic change and mucin production were noted. The tumors showed intraductal spreading without any invasion to the liver parenchyme. Mucosal hyperplasia and dysplasia were noted in the adjacent ducts. The authors assume that intraductal cholangiocarcinoma is a distinct subtype, and persistent irritation, such as, CS infection may undergo a malignant transformation through mucosal dysplasia.
Bile Ducts, Intrahepatic ; Cholangiocarcinoma* ; Clonorchis sinensis ; Cytoplasm ; Hyperplasia ; Liver* ; Mucins ; Prognosis

Among the therapeutic strategies in cancer immunotherapy—such as immune-modulating antibodies, cancer vaccines, or adoptive T cell transfer—T cells have been an attractive target due to their cytotoxicity toward tumor cells and the tumor antigen-specific binding of their receptors. Leveraging the unique properties of T cells, chimeric antigen receptor-T cells and T cell receptor (TCR)-T cells were developed through genetic modification of their receptors, enhancing the specificity and effectiveness of T cell therapy. Adoptive cell transfer of chimeric antigen receptor-T cells has been successful for the treatment of hematological malignancies. To expand T cell therapy to solid tumors, T cells are modified to express defined TCR targeting tumor associated antigen, which is called TCR-T therapy. This review discusses anti-tumor T cell therapies, with a focus on engineered TCR-T cell therapy.We outline the characteristics of TCR-T cell therapy and its clinical application to non-hematological malignancies.

A case of adenocarcinoma of cystic duct associated with GB empyema is presented. A 72 year old male was admitted to Kwangju Christian hospital because of abdominal pain in right upper quadrant for 4 days. He underwent explolaparotomy under the impression of GB empyema or GB cancer. For seeking causative factor of GB empyema, serial sections of cystic duct and mapping were performed. We can find adenocarcinoma of cystic duct in the specimen removed at cholecystectomy. The criteria for disgnosis of cystie duct carcinoma which was outlined by Farrar. These criteria are; 1) The growth must be restricted to the cystic duct, 2) There is no neoplastic process in the gall bladder, hepatic and common bile duct. 3) Histopathological examination must be comfirm carcinoma. Here we report a case of adenocarcinoma of cystic duct associated with GB empyema with brief review of Literature.
Abdominal Pain ; Adenocarcinoma* ; Aged ; Cholecystectomy ; Common Bile Duct ; Cystic Duct* ; Empyema* ; Gwangju ; Humans ; Male ; Urinary Bladder