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

Herein, we present two cases of Brenner tumor, a rarely occurring neoplasm in the ovaries, obtained via intraoperative fine needle aspiration. The borderline Brenner tumor exhibited marked squamous metaplasia, characterized by individually distributed atypical squamous cells. A benign Brenner tumor associated with mucinous cystadenoma evidenced typical mucinous metaplastic features and transitional foci. These distinctive features may prove helpful in differential diagnosis of varied ovarian tumors, and particularly for intraoperative consultation.
Biopsy, Fine-Needle ; Brenner Tumor ; Cystadenoma, Mucinous ; Diagnosis, Differential ; Female ; Metaplasia ; Mucins ; Ovary

To examine the relationship between gastric ulcer and gastric cancer, we investigated petients with gastric ulcer diagnosed from 1986 to l993. We reviewed the endoscopic reports and films of patients with gastric ulcer retrospectively. We excluded the patients who was diagnosed as gastric cancer in two years follow-up. The results were as follaws; 1) During follow-up of the original cohort, there were 5 patients(0.5~%) in whom gastric cancer developed at the same site initially diagnosed as gastric ulcer. The gross type of the lesion was early gastric cancer in two and advanced gastric cancer in three patients 2) The time interval between the initial diagnosis of gastric ulcer and cancer development was from 31 months to 70 months (average 51 months). 3) At the initial examination of 5 gastric cancer patients, the diagnosis was active gastric ulcer in four, multiple gastric ulcer in one, and linear gastrie ulcer in one patient. Characteristic endoscopic findjngs were gastric ulcer with clubbing mucosal folds in three and gastric ulcer with bleeding in one patient. 4) During the follow-up period, endoscopicailly and histologically healing of gastric uleer was observed in one patient and histologic finding showed chronic superficial gastritits with intestinal metaplasia. These results suggest that gastric ulcers rarely progress to gastric cancer. However if the endoscopic findings are suspicious for malignancy, then follow-up endoscopy until complete healing should be done.
Cohort Studies ; Diagnosis ; Endoscopy ; Follow-Up Studies* ; Hemorrhage ; Humans ; Metaplasia ; Stomach Neoplasms* ; Stomach Ulcer* ; Ulcer

We present a case of huge nasal polyp with metaplastic ossification, which obstructed left nasal cavity and nasopharynx, and provoked both nasal obstruction and sleep apnea. The patient had a history of previous sinus surgery at local hospital 30 years ago. Nasal polyp with metaplstic ossification was removed by endoscopic sinus surgery. This case highlights the importance of including metaplastic ossification of nasal polyp in the differential diagnosis of nasal cavity mass.
Diagnosis, Differential ; Humans ; Metaplasia ; Nasal Cavity ; Nasal Obstruction ; Nasal Polyps* ; Nasopharynx* ; Sleep Apnea Syndromes

We present a case of huge nasal polyp with metaplastic ossification, which obstructed left nasal cavity and nasopharynx, and provoked both nasal obstruction and sleep apnea. The patient had a history of previous sinus surgery at local hospital 30 years ago. Nasal polyp with metaplstic ossification was removed by endoscopic sinus surgery. This case highlights the importance of including metaplastic ossification of nasal polyp in the differential diagnosis of nasal cavity mass.
Diagnosis, Differential ; Humans ; Metaplasia ; Nasal Cavity ; Nasal Obstruction ; Nasal Polyps* ; Nasopharynx* ; Sleep Apnea Syndromes

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

PURPOSE: To determine the relationship between fibrocystic change and parenchymal pattern and fibroadenoma on mammogram. MATERIALS AND METHODS: Mammograms of 135 patients with histologically-diagnosed fibrocystic disease after excisional biopsy were retrospectively analyzed and correlated with pathologic specimens. Classification ofthe parenchymal pattern was based on Wolfe's method. RESULTS: On mammogram, we observed abnormality in 88 out ofthe 135 cases ; these latter consisted of 70 cases of DY, 30 of P2, 20 of P1, and 15 of Nl, following Wolfe's parenchymal patterns. Among the 88 abnormal cases we observed 37 cases of mass with clear boundaries, five cases of mass with unclear boundaries, 22 with clustered microcalcifications, six with macrocalcifications and 18 with asymmetric dense breast. Histologic examination revealed a varying composition of stromal fibrosis, epithelialhyperplasia, cyst formation, apocrine metaplasia, etc. Histologically fibroadenomatoid change in 18 cases was appeared as a radiopaque mass on mammogram, especially in those cases where the change was well-defined, which were all except three. CONCLUSION: Fibrocystic disease was prevalent in Wolfe's P2 and DY patterns(about 80 %).About 40 % of fibrocystic change appearing as a well defined mass on mammogram showed fibroadenomatoid change histologically and was difficult to differentiate from fibroadenoma. Fibrocystic disease should therefore be included in the differential diagnosis of a mass which on mammogram is well-defined.
Biopsy ; Breast* ; Classification ; Diagnosis, Differential ; Fibroadenoma* ; Fibrosis ; Humans ; Metaplasia ; Retrospective Studies