The histologic differentiation of endometrial and endocervical adenocarcinomas is a common diagnostic problum of clinical importance, because the staging, treatment and prognosis of these lesions are quite different. First, we examined the distribution of acid mucin in endometrial and endocervical adenocarcinoma (23 cases and 25 cases repectively), but distinguishing differences between endometrial and endocervical adenocarcinoma, especially of endometrioid type, were not observed. Secondly, the distribution of low-molecular weight cytokeratin, vimentin and carcino-embryonic antigen (CEA) by immunohistochemistry were examined in formalin-fixed tissues. CEA was present in 88% of endocervical adenocarcinomas and 34.8% of endometrial adenocarcinoma. vimentin was found in 91.3% of endometrial adenocarcinomas, in contrast with only in 16% of endocervical adenocarcinomas. This study showed that the presence of vimentin in neoplastic glands, in which CEA is negative, may be helpful in the differential diagnosis of endometrial from endocervical adenocarcinomas.
Diagnosis, Differential ; Adenocarcinoma

The histologic differentiation of endometrial and endocervical adenocarcinomas is a common diagnostic problum of clinical importance, because the staging, treatment and prognosis of these lesions are quite different. First, we examined the distribution of acid mucin in endometrial and endocervical adenocarcinoma (23 cases and 25 cases repectively), but distinguishing differences between endometrial and endocervical adenocarcinoma, especially of endometrioid type, were not observed. Secondly, the distribution of low-molecular weight cytokeratin, vimentin and carcino-embryonic antigen (CEA) by immunohistochemistry were examined in formalin-fixed tissues. CEA was present in 88% of endocervical adenocarcinomas and 34.8% of endometrial adenocarcinoma. vimentin was found in 91.3% of endometrial adenocarcinomas, in contrast with only in 16% of endocervical adenocarcinomas. This study showed that the presence of vimentin in neoplastic glands, in which CEA is negative, may be helpful in the differential diagnosis of endometrial from endocervical adenocarcinomas.
Diagnosis, Differential ; Adenocarcinoma

We report a case of postpartum choriocarcinoma from a 23-year old primiparous woman which was preceded by fetal anemia and intrauterine fetal death at 37 weeks' gestation. It has not been previously described in Korean literatures. The placenta, weighing 550 gm, contained multiple intervillous thrombi with laminated fibrin residue and pale cut curface. Histologic evidence of choriocarcinoma was not found in the placenta or in any fetal organs at autopsy, but large number of nucleated red blood cells and immature hemopoietic cells in the fetal capillaries of the placenta suggested the presence of fetal anemia. It was assumed that feto-maternal transfusion might had played a major role of fetal anemia and death.
Female ; Infant, Newborn ; Humans

We report a rare case of intrathoracic lymphangiomatosis associated with chylothorax in a 3-year-old boy. The patient had been healthy until he had chickenpox followed by continued dyspnea. The biopsy specimen showed proliferating lymphatic channels & spindle cells in the lung tissue. The boy died of respiratory failure despite conservative treatment and surgical treatment with pleurodesis. An autopsy was performed. Pleura and pericardium showed severe adhesion to the right lung parenchyma. The cut surface of lung showed thickened interlobular septum with honeycomb-appearance. Histologically, extensive intercommunicating and anastomosing endothelial-lined lymphatic channels were noted along the visceral and parietal pleura, pericardium, around the great vessels, and in the anterior mediastinum over the thymus. These lymphatic channels infiltrated into the pulmonary parenchyme along the bronchovascular bundles. There were scattered areas of spindle cell proliferation with extravasation of RBCs mimicking Kaposi's sarcoma. Histologic diagnosis and differential diagnosis on biopsy materials can be difficult to establish but awareness of the intrathoracic lymphangiomatosis and its various clinical presentation may be helpful for diagnosis.
Autopsy* ; Biopsy ; Cell Proliferation ; Chickenpox ; Child, Preschool ; Chylothorax ; Diagnosis ; Diagnosis, Differential ; Dyspnea ; Humans ; Lung ; Male ; Mediastinum ; Pericardium ; Pleura ; Pleurodesis ; Respiratory Insufficiency ; Sarcoma, Kaposi ; Thymus Gland

Endometrial ossifications in seven patients who presented with secondary or primary infertility were described. Herein, we described step-by-step bone forming process in the endometrium and we compared the clinicopathological features of metaplastic ossification and fetal remnants. In five of seven patients, metaplasia was unquestionable etiology of ossification, which was ocquired in the healing process of postabortion endometritis. Ossifications were recurred during the follow-up periods after total hysteroscopic removal in 2 cases. Three cases were followed by normal pregnancy, after total hysteroscopic removal of bony spicules in 2 cases and with retaining of bony spicules in 1 case. In one other case, bony spicules of fetal remnants were verified by multiple fetal hair shafts and endochondral bone formation. Therefore, the cause of endometrial ossification can only be determined by histological findings and careful past obstetric history.
Pregnancy ; Female ; Humans

During evaluation of follow-up curettage of endometrial hyperplasia after progesterone treatment, we have noticed that the foci of squamous or morular metaplasia are persistent or even markedly increased after the hyperplastic glands have all disappeared. These observations have led us to study the histological changes of squamous or morular metaplasia in the hyperplastic endometrium after progesterone treatment and to examine the changes of estrogen receptors(ER) and progesterone receptors(PR) to find out, if there is any pathogenetic role of progesterone administration on the squamous or morular metaplasia. Squamous or morular metaplasia was associated in 21 cases (13.5 %) out of 156 endometrial hyperplasia during the study periods and all of them were associated with complex hyperplasia, but not associated with simple hyperplasia. At follow-up curettage after progesterone treatment, squamous metaplasia newly appeared in 3 cases(20 %), markedly increased in 4 cases(26.7%), persisted in 4 cases(26.7%) and decreased in 4 cases(26.7%), even after hyperplastic glands have all disappeared or were markedly decreased. On immunohistochemical staining, metaplastic foci showed ER- and PR- in 13 cases (87 %) in contrast to the surrounding endometrium and the remaining 2 cases showed minimal ER+ and PR+ confined to several nuclei. Intensity or staining pattern of ER and PR in metaplastic foci were not changed with progesterone treatment. In the background endometrium, intensity of glandular ER+ and PR + was higher than that of the stroma at the initial curettage, however, progesterone treatment predominantly down-regulated glandular ER+ more than stromal ER+. Increment or persistence of squamous metaplasia along the progesterone treatment seemingly would implicate hormonal influences as playing a significant role in the formation of squamous or morular metaplasia and the absence of cellular receptors for these hormones in the metaplastic foci may suggest qualitative changes in the receptors.

A vestibular adenoma arising in mucin-secreting glands of the vulva is described. Grossly, the adenoma was a firm, well-demarcated solid mass with mucoid cut surface, measuring 3.5x3x3 cm, which was associated with an adjacent Bartholin's duct cyst. Microscopically, the solid mass was composed of proliferated mucous acini separted by fibromuscular septa and ducts lined by mucin-secreting columnar epithelium, transitional epithelium or metaplastic squamous epithelium. To our knowledge, less than 20 cases of such cases have been reported in the English literatures. However, whether the nature of proliferation is neoplastic or non-tumorous is still unclear.
Adenoma

Unknown primary melanoma shows only metastatic malignant malanoma without obvious primary tumor. These unusual instances of unknown primary melanoma have reported incidences of 1.0~8.7%. This 51 year old patient had many intra-abdominal and mesenteric masses without visible primary tumor. The most commonly accepted explanation for unknown primary melanoma is spontaneous regression of a primary skin lesion.
Incidence ; Neoplasm Metastasis

Small cell carcinoma of the ovary is rare malignancy occurring in women under 40 years of age(average, 23 years), which is associated with hypercalcemia in two thirds of cases. Its histogenesis is uncertain, but the possibilities of common epithelial, neuroendocrine, sex cord stromal and germ cell origin are suggested. All reported cases were proved to have rapid fatal course despite various therapy and 5 years suvival rate was only 10%. We report one case of a 20-year old woman with primary small cell carcinoma of the left ovary. The ovary was markedly enlarged and completely replaced by a mass, measuring 21x16x8 cm. Microscopic examination revealed dimorphic population of small and large malignant cell producing immature follicle-like structure which is characteristic of small cell carcinoma of the ovary. These pathological findings were similar to those of granulosa cell tumor, which is required to make differential diagnosis from small cell carcinoma. Immunohistochemical stains for cytokeratin and vimentin were positive, but those for S-100 protein and NSE were negative. One month after the initial operation, the tumor has recurred and the second and the second palliative operation followed by 3 cycles of chemotherapy was done. The patient showed disseminated metastasis at present time.
Female ; Humans ; Diagnosis, Differential ; Neoplasm Metastasis

The concurrence of typical carcinoid admixed with adenocarcinoma of the gastrointestinal tract is a well known but unusual phenomenom that has been reported in the esophagus, stomach, gall bladder, colon and appendix. The amine precursor uptake and decarboxylation (APUD) concept included the idea that neuroendocrine cells of the gastrointestinal tract were dervied from the neural crest by a process of migration during embryogenesis. However the intimate admixture of cells which have morphologic and immunocytochemical properties of both carcinoid tumors and adenocarcinoma suggests that these tumors are derived from a multipotential stem cell showing bidirectional differentiation rather than from unrelated cell lines. The term composite carcinoma-carcinoid tumor is therefore an appropriate designation for these neoplasms. We report a case of composite carcinoma-carcinoid tumor of the stomach in a 38 year-old female with brief review of literature.
Female ; Humans ; Adenocarcinoma