BACKGROUND: Endocervical glandular lesions include glandular atypia (GA), endocervical glandular dysplasia (EGD), adenocarcinoma in situ (AIS), and invasive adenocarcinoma (IA). The diagnosis of malignant glandular lesions is occasionally difficult to distinguish from benign mimickers, and the morphologic features of EGD remain unsettled. METHODS: Immunohistochemical stains for MIB-1, p53 and CEA were performed on 81 cases of paraffin-embedded endocervical glandular lesions including 22 IA, 15 AIS, 15 EGD, 13 GA, 8 microglandular hyperplasia (MGH) and 8 tubal metaplasia (TM). RESULTS: The MIB-1 labelling index of IA was 59.68%, 69.53% for AIS, 26.60% for EGD, 16.03% for benign. p53 overexpression was noted in 4 (18%) cases of IA, 3 (20%) of AIS, but none of EGD and benign lesions. It was Interesting to note that one case of MGH showed p53 staining in low intensity. Diffuse strong cytoplasmic CEA positivity was present in all of IA and AIS, whereas seven (47%) of 15 EGD and 12 (41%) of 29 benign lesions showed focal cytoplasmic CEA positivity. There were significant differences in MIB-1 and CEA immunostainings among the adenocarcinoma, EGD, and benign glandular lesions. Adenocarcinoma was closely related to p53 overexpression, although occurring in a low percentage of the cases. CONCLUSION: MIB-1 immunostaining can be useful in differentiating among endocervical adenocarcinoma, endocervical glandular dysplasia and benign glandular lesions. p53 overexpression might be helpful in the diagnosis of adenocarcinoma.
Adenocarcinoma ; Coloring Agents ; Cytoplasm ; Diagnosis ; Hyperplasia ; Metaplasia

PURPOSE: We evaluated the correlation between the carcinogenesis of gallbladder and the expression of lysozyme, p53, c-erbB2 and CEA in gallbladder lesions. MATERIALS AND METHODS: Thirty cases of gallbladder lesions (containing 17 cases of GB carcinoma) were examined. We analyzed the clinicopathologic findings of the early (stage I & II) and advanced carcinoma (stage III, IV & V) and those of carcinoma with or without metaplasia in the tumor. We performed p53, c-erbB2 and CEA immunohistochemical staining and compared their findings with those of normal mucosa and preneoplastic lesions. We also performed lysozyme immunohistochemical staining and compared its finding with metaplastic and non-metaplastic lesions. RESULTS: There are two distinct genetic pathways in gallbladder cacinogenesis and metaplastic carcinoma was more frequent than non-metaplastic carcinoma. Metaplasia of gallbladder did not reveal any difference of the clinicopathologic findings and depth of invasion (Nevin stage). Lysozyme expression was found in all metaplastic lesions but non-expression did not indicate non-metaplastic lesions. p53 mutations and c-erbB2 alterations may have a role in the carcinogenesis of gallbladder carcinomas, especially, in a late event, and in an early and late events, respectively. The correlation of p53 and c-erbB2 expressions was found but which did not indicate that the co-expression was needed in the carcinogenesis. CEA immunohistochemical staining may be helpful in the differential diagnosis of benign lesions and precancerous and cancerous lesions of the gallbladder. CONCLUSION: These results suggest that p53 mutations and c-erbB2 alterations may have a role in the carcinogenesis of gallbladder carcinomas, especially, in a late event, and in an early and late events, respectively.
Carcinogenesis ; Diagnosis, Differential ; Gallbladder* ; Metaplasia* ; Mucous Membrane ; Muramidase

Fibrous dysplasia is a developmental disease of bone in which there is replacement of normal spongiosa and filling of the medullary cavity of affected bones by an abnormal fibrous tissue that contains trabeculae of poorly calcified primitive bone formed by osseous metaplasia. Fibrous dysplasia arising in the paranasal sinus is rare and often presents a diagnostic challenge. It is usually secondary to extension of disease from adjacent bones and is rarely limited to the sinuses. We have described two cases of fibrous dysplasia involving the sphenoid sinus and a case of fibrous dysplasia involving the sphenoethmoid sinus with narrowed orbital apex. A brief update of the clinical aspects, radiolographic appearance, diagnosis, and management of craniofacial fibrous dysplasia is proved.
Diagnosis ; Ethmoid Sinus ; Metaplasia ; Orbit ; Paranasal Sinuses* ; Sphenoid Sinus

OBJECTIVETo investigate the clinical presentations and pathologic features of undifferentiated sarcoma of the prostate with cartilage metaplasia, and to clarify its category.

METHODSWe analyzed the clinical data of a case of undifferentiated sarcoma of the prostate with cartilage metaplasia treated by surgical resection. The tumor tissue was subjected to routine HE and immunohistochemical staining, its histological structure and immunohistochemical expression were observed under the light microscope, and relevant literature on its manifestations was reviewed.

RESULTSThe case was pathologically diagnosed as gray prostate tumor, with chondrosarcomatous and undifferentiated malignant mesenchymal components under the light microscope. Immunohistochemical staining revealed vimentin (+), local CD117 (+/-), SMA (-), Des (-), myoglobin (-), CD34 (-), CK7 (-), and CK8 (-). Tumor metastasis was found 2 months after the operation, and the patient died 4 months later.

CONCLUSIONUndifferentiated sarcoma of the prostate with cartilage metaplasia is a very rare and highly malignant aggressive tumor, which can be diagnosed by biopsy and immunohistochemistry.

Adult ; Cartilage ; pathology ; Humans ; Male ; Metaplasia ; Prostate ; pathology ; Prostatic Neoplasms ; diagnosis ; pathology ; Sarcoma ; diagnosis ; pathology

Fibrous dysplasia is a benign bony disorder that contains trabeculae of poorly calcified primitive bone formed by osseous metaplasia. It is also characterized by replacement of normal spongiosa by abnormal fibrous tissues. We retrospectively analyzed the computed tomographic (CT) findings of 29 cases with clinically and radiologically diagnosed craniofacial fibrous dysplasia. In 2 cases, only cranial bones were involved and in 7 cases only facial bones were involved. Involvements of both cranial and facial bones were noted in the remained 20 cases. The commonly involved bones in the decreasing order of frequency were as follows: frontal, sphenoidal, ethmoidal and temporal bones in cranium and maxilla, zygoma, lacrimal bones and mandible in facial bones. Even though plain films are enough to diagnose the fibrous dysplasia, we think that CT is useful in more accurate diagnosis by demonstrating amorphous "ground-glass" appearance in the lesion and defining the exact extent of craniofacial fibrous dysplasia.
Diagnosis ; Facial Bones ; Mandible ; Maxilla ; Metaplasia ; Retrospective Studies ; Skull ; Temporal Bone ; Zygoma

BACKGROUND AND AIMS: To assess the relationship between the intestinal metaplasia, Helico-bacter pylori infection, and H. pylori positivity, the difference in the type of intestinal metaplasia according to H. pylori status were examined. METHODS: Chromoendoscopy by methylene blue stain method was performed to assess the diagnostic viability for the detection of intestinal metaplasia in subjects who having histologically determined intes-tinal metaplasia. RESULTS: Intestinal metaplasia was found in 35 subjects. Of these, 21subjects (60%) were male and 14 subjects (40%) were female. Of 35 subjects, 26 subjects were H. pylori positive cases (74.3%) and 9 subjects were H. pylori negative cases (25.7%). The mean age of intestinal metaplasia subjects was 51.5 8.9 years. Of these, the mean age of H. pylori positive subjects was 49.5 8.0 years, whereas the mean age of H. pylori negative subjects was 57.2 9.2 years (p <0.05). On the type of intestinal metaplasia, 31 subjects showed type I (88.6%) and 4 subjects showed type II (11.4%). There was no statistical difference of intestinal metaplasia type according to H. pylori status. The diagnostic value of methylene blue chromoendoscopy in the diagnosis of intestinal metaplasia had a sensitivity of 82.4%, specificity of 100%, positive predictivevalue of 100% and negative predictive value of 75%. CONCLUSIONS: Although a causal relationship between H. pylori infection and the histogenesis of intestinal metaplasia was not proven, it is suggested that H. pylori positive cases lead to an earlier development of intestinal metaplasia than H. pylori negative cases. Therefore, it is important to assess the probability of the development of gastric carcinoma through a follow up study.
Diagnosis ; Female ; Follow-Up Studies ; Helicobacter pylori* ; Helicobacter* ; Humans ; Male ; Metaplasia* ; Methylene Blue* ; Sensitivity and Specificity

PURPOSE: To report one case of pleomorphic adenoma of the lacrimal gland in a child. CASE SUMMARY: A 7-year-old boy presented with a 2-month history of an exophthalmos and mild ptosis of the left eye; there were no other ophthalmologic problems. Orbit MRI revealed a well-defined mass in the left lacrimal gland and a defect in the orbital roof due to pressure erosion. Tumor resection was performed via a lateral orbitotomy and a biopsy was requested. The biopsy revealed tumor tissue that was composed of epithelial elements with variably sized duct formation. Focal squamous metaplasia and keratin production was also observed. CONCLUSIONS: Pleomorphic adenoma of the lacrimal gland should be considered as a differential diagnosis of a lacrimal gland mass in a child.
Adenoma, Pleomorphic* ; Biopsy ; Child* ; Diagnosis, Differential ; Exophthalmos ; Humans ; Lacrimal Apparatus* ; Magnetic Resonance Imaging ; Male ; Metaplasia ; Orbit

Since localized amyloid deposits of the ureter were first described by Lehmann in 1937, approximately 90 cases have been reported. Isolated primary amyloidosis of the ureter is a rare disease, and its diagnosis cannot be made by radiologic findings. Because of radiographic similarity to transitional cell carcinoma, these lesions are often clinically mistaken for malignancies, and nephroureterectomy is usually performed. Here, we report a case of localized ureteral amyloidosis with osseous metaplasia, which was managed successfully by renal sparing segmental resection with the bladder Boari flap.
Amyloidosis* ; Carcinoma, Transitional Cell ; Diagnosis ; Metaplasia* ; Plaque, Amyloid ; Rare Diseases ; Ureter* ; Urinary Bladder

PURPOSE: The importance of Helicobacter pylori eradication after endoscopic resection (ER) of gastric neoplasms remains controversial. In this study, we clarified the importance of H. pylori eradication for metachronous lesions after ER. MATERIALS AND METHODS: This study included 3,882 patients with gastric neoplasms who underwent ER. We included patients infected with H. pylori who received eradication therapy. Among them, 34 patients with metachronous lesions after ER and 102 age- and sex-matched patients (nonmetachronous group) were enrolled. Background mucosal pathologies such as atrophy and intestinal metaplasia (IM) were evaluated endoscopically. The expression levels of CDX1, CDX2, Sonic hedgehog (SHH), and SOX2 were evaluated based on H. pylori eradication and the development of metachronous lesions. RESULTS: The eradication failure rate was higher in the metachronous group than in the nonmetachronous group (P=0.036). Open-type atrophy (P=0.003) and moderate-to-severe IM (P=0.001) occurred more frequently in the metachronous group. In patients with an initial diagnosis of dysplasia, the eradication failure rate was higher in the metachronous group than in the nonmetachronous group (P=0.002). In addition, open-type atrophy was more frequent in the metachronous group (P=0.047). In patients with an initial diagnosis of carcinoma, moderate-to-severe IM occurred more frequently in the metachronous group (P=0.003); however, the eradication failure rate was not significantly different between the two groups. SHH and SOX2 expression was increased, and CDX2 expression was decreased in the nonmetachronous group after eradication (P<0.05). CONCLUSIONS: Open-type atrophy, moderate-to-severe IM, and H. pylori eradication failure were significantly associated with metachronous lesions. However, eradication failure was significantly associated with dysplasia, but not carcinoma, in the metachronous group. Thus, H. pylori eradication may play an important role in preventing metachronous lesions after ER for precancerous lesions before carcinomatous transformation.
Atrophy ; Diagnosis ; Hedgehogs ; Helicobacter pylori* ; Helicobacter* ; Humans ; Metaplasia ; Pathology ; Recurrence* ; Stomach Neoplasms*

Barrett's esophagus is considered as a premalignant condition in which columnar epithelium replaces the normal esophageal squamous epithelium. The diagnosis of Barrett's esophagus is based on the endoscopic finding of columnar epithelium lining the distal esophagus and histologic confirmation of the presence of specialized intestinal metaplasia. According to the extent of the metaplastic lining from the esophagogastric junction, Barrett's esophagus has been divided into long-segment (> or =3 cm in length) and short-segment (<3 cm in length). Long-segment Barrett's esophagus can be easily identified at endoscopy, but it is difficult to separate short-segment Barrett's esophagus from intestinal metaplasia of cardia. It has been reported that Barrett's CK 7/20 pattern is an objective marker of Barrett's mucosa, and can differentiate Barrett's mucosa from gastric intestinal metaplasia. We report here two cases of adenocarcinoma of esophagus arising from short-segment Barrett's esophagus, diagnosed by endoscopic and histologic findngs, and treated by endoscopic mucosal resection.
Adenocarcinoma* ; Barrett Esophagus* ; Cardia ; Diagnosis ; Endoscopy ; Epithelium ; Esophagogastric Junction ; Esophagus ; Metaplasia ; Mucous Membrane