Minimal deviation adenocarcinoma is an extremely well differentiated variant of cervical adenocarcinoma, and is frequently misdiagnosed due to its benign-looking histopathological features. A 38-year-old woman was diagnosed as having had a minimal deviation adenocarcinoma in the cervix, metastasizing to the uterine body and bilateral adnexae. She had a history of right salpingo-oophorectomy 3 years ago, and was diagnosed as having a mucinous cystadenoma. Histologically, the tumor cells were so well-differentiated that they appeared to be almost the same as those of the non-neoplastic cervical glands. Similar glands were found in both ovaries and in the left fallopian tube. PAS staining showed a negative or apical positive pattern in the endocervical-like glands. Immunohistochemical studies for CEA, ER/PR, cytokeratin 20, and p53 were negative, but positive for cytokeratin 7. The HPV DNA microarray test was negative. Clinically, this proved to be an advanced, biologically aggressive disease.
Adenocarcinoma* ; Adenocarcinoma, Mucinous* ; Adult ; Cervix Uteri* ; Cystadenoma, Mucinous ; Fallopian Tubes ; Female ; Humans ; Keratin-20 ; Keratin-7 ; Neoplasm Metastasis* ; Oligonucleotide Array Sequence Analysis ; Ovary

Primary hepatic carcinosarcoma is a rare tumor comprised of a mixture of carcinomatous and sarcomatous elements. Less than 20 adequately documented cases have been reported, however the imaging features of two cases were briefly described. We present here a case of carcinosarcoma of the liver in a 46-year-old woman, which was confirmed based on pathology. Imaging showed a large mass with large necrotic portions, small cystic portions, calcifications and bone formations.
Carcinosarcoma/*pathology ; Diagnostic Imaging ; Fatal Outcome ; Female ; Humans ; Keratin-19/analysis ; Keratin-7/analysis ; Liver Neoplasms/*pathology ; Middle Aged ; Neoplasm Recurrence, Local ; Staining and Labeling ; Tumor Markers, Biological/analysis ; Vimentin/analysis

Adult ; Antigens, Differentiation ; analysis ; Bile Ducts, Intrahepatic ; pathology ; Cell Division ; Hepatitis, Chronic ; metabolism ; pathology ; Hepatocytes ; pathology ; Humans ; Immunohistochemistry ; Keratin-7 ; Keratins ; analysis ; Liver Regeneration ; Male ; Middle Aged

OBJECTIVETo study human hepatocarcinoma stem cell markers.

METHODSTumor tissue samples were obtained from 8 patients with hepatic cellular cancer undergoing surgical tumor resection and the tumor cells were cultured with primary tissue culture in vitro. The cell subpopulations with each marker were isolated from the tumor cells by immunopanning using oval cell markers (CD34, c-kit, Thy-1, CK7, CK19, CK14). The cells of each phenotype were injected into nude mice to measure their ability of tumor formation and the tumor mass was weighed one month after implantation. The tumorigenic subpopulations of the cells were injected into the nude mice again in 1/4 or 1/10 of their original densities to further analyze their ability of tumor formation.

RESULTSAmong all the cell subpopulations, those positive for CD34, c-kit and CK7, respectively, showed marked difference from the negative cells in their ability of proliferation and tumor formation. The CD34(-), c-kit(+) and CK7(+) subpopulations of the cells exhibited strong capacity of tumor formation even in only 1/4 or 1/10 of their original density.

CONCLUSIONSThere are heterogeneous subpopulations within human hepatocarcinoma with observable difference in tumor formation ability. The strong tumor formation ability of CD34(-), c-kit(+) and CK7(+) subpopulation of the cells suggests that CD34(-), c-kit(+) and CK7(+) represent part of the surface markers of hepatocarcinoma stem cells.

Antigens, CD34 ; analysis ; Biomarkers, Tumor ; analysis ; Carcinoma, Hepatocellular ; metabolism ; pathology ; Humans ; Keratin-7 ; analysis ; Liver Neoplasms ; metabolism ; pathology ; Neoplastic Stem Cells ; metabolism ; Proto-Oncogene Proteins c-kit ; analysis ; Tumor Cells, Cultured

OBJECTIVETo study the diagnosis and differential diagnosis of renal epithelial neoplasms.

METHODSNinety-one cases of renal epithelial neoplasms with detailed pathologic records were enrolled. In addition to microscopic examination, Mowy's colloidal iron staining and immunohistochemical studies (CD10, vimentin and CK7) were also performed.

RESULTSAmong the 91 cases, there were 78 (86%) clear cell renal carcinoma cases, 8 (9%) papillary renal carcinoma cases, 4 (4%) chromophobe renal carcinoma cases and 1 (1%) renal oncocytoma case. Sixty-three of the 78 clear cell renal carcinoma cases were positive for CD10 and 69 were positive for vimentin (81% and 88% respectively), with prominent cell membrane staining. The majority (74/78) of clear cell renal carcinoma were negative for CK7. All 17 clear cell renal carcinoma cases showed negative or focal coarse droplet-like staining pattern for Mowy's colloidal iron stain. All 4 chromophobe renal cell carcinoma cases showed prominent cell membrane staining for CK7 and blue reticular staining pattern for Mowy's colloidal iron stain. All of which were negative for CD10 and vimentin. The case of renal oncocytoma failed to react with antibodies to CD10, vimentin and CK7, or Mowy's colloidal iron stain.

CONCLUSIONSCD10, vimentin, CK7 and Mowy's colloidal iron stains have proved to be useful in differential diagnosis of common renal tumors which may not be easily distinguished on the basis of histologic examination alone.

Adenocarcinoma ; diagnosis ; immunology ; Adenocarcinoma, Clear Cell ; diagnosis ; immunology ; Carcinoma, Papillary ; diagnosis ; immunology ; Colloids ; Diagnosis, Differential ; Humans ; Immunohistochemistry ; Iron ; Keratin-7 ; Keratins ; analysis ; Kidney Neoplasms ; diagnosis ; immunology ; Neprilysin ; analysis ; Staining and Labeling ; methods ; Vimentin ; analysis

7 were overexpressed in gingival hyperplasia. Here we analyzed the effect of FGF-5 on primary cultures of human fibroblast, grown in chemically defined medium, and we compared the proliferative and differentiative cell responses to FGF-5 with FGF-7. Cell counting and RT-PCR showed that FGF-5 was a potent mitogen for human fibroblasts. FGF-5 could up-regulated FGF-7 expression. However, FGF-7 down-regulated the expression of FGF-5 in human fibroblasts. In the cDNA microarray study, Nedd4 binding protein 3, epidermal growth factor receptor pathway substrate 15, transcription factor CP2, CDC20 cell division cycle 20 homolog, BRCA1 associated protein, and glutaminase were increased their expression after the administration of FGF-5. The pinin, ribosomal protein S29, proliferation-associated 2G4, protein phosphatase 1G, PICTAIRE protein kinase 1, cell division cycle 25A, keratin 7, 15, and 17, bone morphogenetic protein 1 and 7, and placental growth factor were In conclusion, FGF-5 was a potent mitogen for human fibroblasts, but FGF-7 was not. FGF-5 could induce FGF-7 expression, but FGF-7 inhibited FGF-5 expression. Thus, the gingival hyperplasia in the immunosuppressed patients seemed to be occurred via the action of FGF-5. The role of FGF-7 that was expressed in these patients might be late events after the expression of FGF-5.]]>
Bone Morphogenetic Protein 1 ; Carrier Proteins ; Cell Count ; Cell Cycle ; DNA, Complementary ; Fibroblasts ; Gingival Hyperplasia ; Glutaminase ; Humans ; Keratin-7 ; Oligonucleotide Array Sequence Analysis ; Organ Transplantation ; Protein Kinases ; Protein Phosphatase 1 ; Receptor, Epidermal Growth Factor ; Ribosomal Proteins ; Transcription Factors ; Transplants

Gastric hepatoid adenocarcinoma is a special type of gastric carcinoma, which produces AFP. We report a case of an metastatic gastric hepatoid adenocarcinoma mistaken for primary hepatocellular carcinoma (HCC). A 72 year-old woman was transferred to our hospital for treatment of the hepatic mass. She underwent subtotal gastrectomy for gastric cancer 2 years ago. A year ago, she was diagnosed with hepatic mass and treated with transhepatic chemoembolization under the suspicion of primary HCC in other hospital. The hepatic mass looked like primary HCC on CT, and serum AFP was elevated to 18,735 IU/mL. We did the transhepatic mass biopsy and compared it to the histology of the previous gastric cancer. The results of immunohistochemical staining between them was coincident, and so it was diagnosed as a hepatic metastasis of gastric hepatoid adenocarcinoma.
Adenocarcinoma/*diagnosis/pathology/surgery ; Aged ; Carcinoma, Hepatocellular/*diagnosis/therapy ; Embolization, Therapeutic ; Endoscopy, Gastrointestinal ; Homeodomain Proteins/metabolism ; Humans ; Keratin-20/metabolism ; Keratin-7/metabolism ; Liver Neoplasms/diagnosis/*secondary/therapy ; Male ; Stomach Neoplasms/*diagnosis/pathology/surgery ; Tomography, X-Ray Computed ; alpha-Fetoproteins/analysis

Gastric hepatoid adenocarcinoma is a special type of gastric carcinoma, which produces AFP. We report a case of an metastatic gastric hepatoid adenocarcinoma mistaken for primary hepatocellular carcinoma (HCC). A 72 year-old woman was transferred to our hospital for treatment of the hepatic mass. She underwent subtotal gastrectomy for gastric cancer 2 years ago. A year ago, she was diagnosed with hepatic mass and treated with transhepatic chemoembolization under the suspicion of primary HCC in other hospital. The hepatic mass looked like primary HCC on CT, and serum AFP was elevated to 18,735 IU/mL. We did the transhepatic mass biopsy and compared it to the histology of the previous gastric cancer. The results of immunohistochemical staining between them was coincident, and so it was diagnosed as a hepatic metastasis of gastric hepatoid adenocarcinoma.
Adenocarcinoma/*diagnosis/pathology/surgery ; Aged ; Carcinoma, Hepatocellular/*diagnosis/therapy ; Embolization, Therapeutic ; Endoscopy, Gastrointestinal ; Homeodomain Proteins/metabolism ; Humans ; Keratin-20/metabolism ; Keratin-7/metabolism ; Liver Neoplasms/diagnosis/*secondary/therapy ; Male ; Stomach Neoplasms/*diagnosis/pathology/surgery ; Tomography, X-Ray Computed ; alpha-Fetoproteins/analysis

Combined hepatocellular carcinoma and cholangiocarcinoma (combined HCC-CC) is a rare subtype of primary liver cancer. We investigated the histopathologic features of transitional or intermediate areas in 21 combined HCC-CCs and immunophenotypes using different hepatic progenitor cell markers (CK7, CK19, c-kit, NCAM, and EpCAM). Major histologic findings of transitional or intermediate areas of 21 combined HCC-CCs included strands/trabeculae of small, uniform, oval-shaped cells with scant cytoplasm and hyperchromatic nuclei embedded within an abundant stroma, small cells with an antler-like anastomosing pattern, and solid nests of intermediate hepatocyte-like cells surrounded by small cells in periphery, in order of frequency. The intermediate area of one tumor was composed predominantly of spindle cells arranged in short fascicles. Immunophenotype of tumor cells with intermediate morphology suggested a progenitor cell origin for this tumor. Clinical findings of combined HCC-CC showed a closer resemblance with those of HCC than those of CC. In univariate analysis, tumor size, TNM stage, and serum alpha-fetoprotein levels showed a significant association with poor patient survival. Serum alpha-fetoprotein level was an independent prognostic indicator in multivariate analysis. In conclusion, an awareness of the clinicopathologic features, specifically the various morphologic features of intermediate areas in this tumor, is essential for prevention of potential misdiagnosis as another tumor.
Adult ; Aged ; Antigens, Neoplasm/metabolism ; Carcinoma, Hepatocellular/*pathology ; Cell Adhesion Molecules/metabolism ; Cholangiocarcinoma/*pathology ; Female ; Humans ; Immunophenotyping ; Keratin-19/metabolism ; Keratin-7/metabolism ; Liver Neoplasms/*pathology ; Male ; Middle Aged ; Neural Cell Adhesion Molecules/metabolism ; Prognosis ; Proto-Oncogene Proteins c-kit/metabolism ; alpha-Fetoproteins/analysis