Solid and papillary epithelial neoplasm of the pancreas is a rare, low grade malignant tumor of adolescence. The tumor we described was diagnosed by following preoperative percutaneous fine needle aspiration biopsy and confirmed by tissue examination. Characteristic cytologic findings were monotonous cells arranged in papillary fronds, acinus, and cords in necrotic and hemorrhagic backgrounds. Occasional foamy histiocytes and hyaline globules were present. The cytoplasm of the tumor cells were moderate in amount, pale eosinophilic or vacuolated with distinct borders. The nuclei were centrally located and round. There were one or two small nucleoli and finely granular chromatin throughout the nucleus.
Adolescent ; Male ; Female ; Humans ; Diagnosis, Differential ; Biopsy

This is a case of recurrent malignant fibrous histicytoma, histologic features of which are reminiscent of a clear cell carcinoma of soft tissue or myxoid liposarcoma. The tumor recurred 2 years and 10 months after the initial removal of the primary tumors in the lateral aspect of the left tigh. In view of histogenesis of malignant fibrous histiocytoma, possibility of recurrent tumor with a wide range of histologic features including clear cell type is discussed. Pertinent clinical history with review of the initial tumor is mandatory for a definite assessment of histologic feature of recurrent malignant fibrous histiocytoma.

One hundred twelve cases of cervical intraepithelial neoplasia (CIN) were reviewed to detect the condylomatous lesion characterized by koilocytotic cells. Condylomatous lesions were present in 12 cases (30.8%) of 39 cases with mild dysplasia, 3 cases (15.0%) of 20 moderate dysplasia, 2 cases (13.3%) of 15 severe dysplasia and 4 cases (10.5%) of 38 cases with carcinoma in situ. These 21 cases with condylomatous lesions were subjected to the study on demonstration of human papillomavirus (HPV) antigen with peroxidase antiperoxidase reaction and 6 simple condylomatous lesions of the uterine cervix were included for control. Twenty seven cases with simple cervical condyloma and condylomatous lesions associated revealed 22 cases of flat type, 3 cases of exophytic type, 1 spiked type, and 1 inverted type. Cells showing a positive reaction for HPV antigen were identified in 5 cases (55.6%) of 27 cases with condylomatous lesions. HPV antigen positive nuclei were found chiefly in koilocytotic cells. The prevalence of HPV antigen positive cells was well correlated with the extent and intraepithelial level of the koilocytotic changes. The results of this study provide a confirmation of the presence of HPV antigens in CIN, and suggest that the HPV may be an important factor in the etiology of CIN.
Humans

Gross deciduosis in pregnancy is rare. A case of disseminated deciduosis peritonei studied by light and transmission electron microscopy is reported. The pathogenesis of deciduosis peritonei and relationship with leiomyomatosis peritonealis disseminata are discussed in view of the present findings and those previously reported.
Pregnancy ; Female ; Humans

Cytologic findings of malignant cells obtained by fine needle aspiration from a huge retroperitoneal malignant fibrous histiocytoma were described. The smears contained numerous malignant cells, isolated or in clusters, in a bloody background. The malignant cells had abundant pleomorphic foamy or acidophilic cytoplasm with occasional multilobated vesicular nuclei and prominent nucleoli. Dual differentiation, both histiocytic and fibroblastic types, and neutrophilic inflammatory background were diagnostic of this neoplasm. The report indicated that study of aspiration cytology specimen from a soft tissue tumor was a valuable adjunct to histologic examination.
Biopsy

bcl-2 and c-myc protein expression were studied in 44 epidermal (8 seborrheic keratoses, 21 squamous cell carcinomas, and 15 basal cell carcinomas), and 26 melanocytic tumors(8 nevi, and malignant melanomas) by immunohistochemistry using the specific anti-bcl-2 and anti-c-myc monoclonal antibodies. 14 out of 15 basal cell carcinomas(BCC) (93.3%) showed expression of bcl-2 protein, 12 of which (85.7%) showed coexpression of c-myc protein. In the melanocytic tumors, 7 out of 8 nevi showed bcl-2 expression (87.5%). Five of these 7 cases (62.5%) also showed c-myc protein expression. Eight of 18 malignant melanomas(MM) (44.4%) showed expression of bcl-2 protein and 7 of these 8 cases (38.9%) also showed c-myc protein expression. All seborrheic keratoses and squamous cell carcinoma(SCC) were negative for bcl-2 proteins. 12 of 15 SCCs(80%) were positive for c-myc protein. In conclusion, bcl-2 and c-myc proteins were coexpressed in BCCs, nevi, and MMs. Coexpression of bcl-2 and c-myc proteins in these tumors was statistically significant(p<0.01), while no considerable differences of bcl-2 and c-myc expression were found between nevi and MMs. These results suggests that bcl-2 may cooperate with c-myc to promote tumorigenesis of BCCs, nevi, and MMs(p<0.01).
Cell Transformation, Neoplastic

We studied 24 cases of cutaneous T-cell lymphomas and six cases of benign lymphoproliferative diseases of the skin (2 Jessner's lymphocytic infiltration, 2 pseudolymphoma, 2 lymphomatoid papulosis) for the presence of Epstein-Barr Virus(EBV) RNA, using the in situ hybridization(ISH) method. Among the 24 cases of cutaneous T-cell lymphomas (CTCL), 18 cases including 12 cases of mycosis fungoides(MF) were primary CTCL, and the other 6 cases were secondary CTCL. The ISH study demonstrated a positive reaction for EBER probe in 6 out of the 24 cases(25%) of CTCL, and a negative reaction for BHLF nuclear RNA probe in all the cases studied. Double-labelling immunohistochemistry/ISH studies revealed that the EBV positive cells were CD45RO positive and CD20 negative. EBV genome was not demonstrated in any benign lymphoproliferative diseases of the skin. Among the EBER positive cases, none of the 12 cases of MF demonstrated EBER signals, and 6 out of the 12(50%) cases of CTCL were positive for EBER probe. In conclusion, latent infection of EBV may play a role in the development of non-mycosis fungoides T-cell lymphomas involving the skin.

The authors reviewed surgical materials from 20 patients with carcinoma of the extrahepatic biliary system, and a correlation between macroscopic appearance of the tumors with various clinical features and histopathologic findings was made. Microscopically, the tumors were classified into four types; Four (21%) patients had polypoid tumors, six (32%) had nodular growths, five (26%) were scirrhous constricting in type, and four (21%) had diffusely infiltrating type. Histologically all the differentiation in two cases. The degree of differentiation of the tumors was classified into 3 types: 11 (55%) patients were well differentiated, 3(15%) were moderately well and 6(30%) were poorly differentiated. All polypoid tumors were well differentiated and had low stage. No correlation in the degree of differentiation of the tumor with the stage was present. No correlation in clinical symptoms, duration of symptoms, laboratory findings with morphologic findings of the tumors was noted.

Lipodystrophia centrifugalis abdominalis infantilis, an typical form of progressive lipodystrophy, is a disease mainly decribed in japanese infants. We report a case of lipodystrophia centrifugalis abdominals infantilis in Korean infant. The patient is a 2 year-old-girl with a coin sized well defined depressed lesion with surrounding redness and scaly changes in the right inguinal region. The skin from the depressed lesion revealed changes similar to those originally described by Imamura et al.
Infant ; Male ; Female ; Humans

Eosinophilic cellulitis is a rare dermatosis originally described by Wells as "recurrent granulomatous dermatitis with eosinophilia", then called Wells' syndrome. The etiology is unknown, although a hypersensitivity mechanism is suspected. Flame figures are considered as a characteristic histologic feature of Wells' syndrome. To clarify the nature of eosinophilic cellulitis and its flame figures, the authors have reviewed five cases of eosinophilic cellulitis with its clinical and histopathologic findings. Cutaneous lesions were variable in appearance and was confused with angioedema, urticarial vasculitis, erydiema multiforme, morphea or granuloma annulare. Microscopically, early lesions (2-7 days) showed diffuse dermal eosinophilic infiltration with widespread degranulation, sometimes extended into the underlying muscle. Subepidermal bulla was present in one case. Subsequently, granulomatous features with characteristic "flame figures" became apparent (several months). Collagen alteration by eosinophilic granules resulted in flame figure formation and a granulomatous response. In two patients, there were possible relationships between drug and flare-ups of eosinophilic cellulitis, but the others, no contributory precipitating factors were found. We think that eosinophilic cellulitis represents a severe anaphylactic hypersensitivity reaction to various stimuli showing characteristic histopathology with recurrent episodes and frequent hypereosinophilia in the peripheral blood.