The prolapse of a fallopian tube into the vagina is a rare complication of hysterectomy. We recently experienced a case of tubal prolapse after a laparoscopic hysterectomy in a 44-year-old woman. The vaginal examination showed a polypoid mass in the vaginal apex. Microscopically, the mass had the typical appearance of a fallopian tube with chronic inflammation. The cytologic finding of a vaginal vault smear was also described.
Adult ; Fallopian Tubes* ; Female ; Gynecological Examination ; Humans ; Hysterectomy* ; Inflammation ; Prolapse* ; Vagina

Well-differentiated papillary mesothelioma (WDPM) of the peritoneum is considered to be a distinct subtype of peritoneal mesothelioma and has mostly behaved in a benign fashion. We report a case of WDPM in a 48-year-old-woman. It was incidentally found during a hysterectomy for a uterine cervical carcinoma. Grossly, the tumor was composed of multiple peritoneal nodules, measuring up to 2 cm. Microscopically, the nodules showed well-developed papillae lined by a single layer of cuboidal mesothelial cells. Immunohistochemical staining revealed a positive reaction for cytokeratin and a negative reacion for carcinoembryonic antigen and Leu-M1. Ultrastructurally, the tumor cells showed numerous long, slender microvilli and desmosomes.
Carcinoembryonic Antigen ; Desmosomes ; Hysterectomy ; Keratins ; Mesothelioma* ; Microvilli ; Peritoneum*

Recently developed new classifications (Holland, Van Nuys, modified Lagios) of ductal carcinoma in situ (DCIS) linked to outcome have emphasized the importance of nuclear morphology rather than architecture. We have evaluated these three classifications in ductal carcinomas composed of in situ and invasive carcinomas. The reproducibility of three classifications was assessed (n=49), and the histological grade of the DCIS was compared with the histologic differentiation (modified Bloom & Richardson method) and nuclear grade (modified Black method) of the coexisting invasive ductal carcinoma (n=45). According to Holland classification, the DCIS component was poorly differentiated in 51.0%, intermediately differentiated in 40.8%, and well differentiated in 8.2%. Using the Van Nuys classification, the DCIS component was group 3 (high grade with or without necrosis) in 44.9%, group 2 (non-high grade with necrosis) in 28.6%, and group 1 (non-high grade without necrosis) in 26.5%. According to the modified Lagios classification, the DCIS component was high-grade in 42.8%, intermediate-grade in 32.7%, and low-grade in 24.5%. The histologic grades of the three classifications revealed significant correlations between Holland and Van Nuys classification (p<0.0001) and between Holland and modified Lagios classification (p<0.0001), especially in poorly differentiated/group 3/high-grade DCIS. The reproducibility of classification of the DCIS was 71.4% in the Holland, 61.2% in the Van Nuys, and 55.1% in the modified Lagios classifications. The grade of the DCIS showed significant correlation with the grade of coexisting invasive ductal carcinoma (p<0.0001), especially in poorly differentiated/group 3/high-grade DCIS. In conclusion, DCIS grade, determined by the Holland, Van Nuys or modified Lagios classifications, is closely correlated with the histologic grade of the invasive ductal component in tumors composed of in situ and invasive ductal carcinoma, and may be a useful factor to estimate clinical behavior of DCIS. In our experience the Holland classification is recommended for DCIS classification due to its high reproducibility.
Breast* ; Carcinoma, Ductal* ; Carcinoma, Intraductal, Noninfiltrating* ; Classification* ; Netherlands

Pseudoangiomatous stromal hyperplasia (PASH) of the breast occurs in premenopausal women and is characterized by anastomosing channels lined by spindle cells. It has been suggested to be of hormonal origin. This unusual condition may also be mistaken for a vascular tumor. We analyzed eight cases of PASH of the breast in Samsung Cheil Hospital from 1992 through 1998. All patients were premenopausal and had painless breast lump. Clinical diagnoses were fibroadenomas. Grossly, the masses were well circumscribed, nonhemorrhagic and measure 2.2 to 5 cm. Histologically, they consisted of complex interanastomosing channels lined by slender spindle cells, which resembled low grade angiosarcoma. Cells that line the interanastomosing channels showed no immunoreactivity for Factor VIII and electron microscopic findings consistent with fibroblast. All patients were treated with surgical excision and none of them had recurrence for 1 to 69 months (mean: 19 months) postoperatively. Pathologic diagnosis of PASH may be difficult unless the pathologists are aware of the presence of a mass lesion and appreciate the characteristic stromal changes. PASH should be included in the differential diagnosis of a circumscribed mass, especially in the premenopausal women.
Breast* ; Diagnosis ; Diagnosis, Differential ; Factor VIII ; Female ; Fibroadenoma ; Fibroblasts ; Hemangiosarcoma ; Humans ; Hyperplasia* ; Recurrence

Osteochondrodysplasia is a heterogeneous group of disorders appearing short limbed dwarfism. Because many of these entities are lethal and hereditary, an accurate diagnosis is mandatory. The purpose of this study is to define the clinicopathologic features and radiologic findings of osteochondrodysplasia. We reviewed 29 autopsy cases of congenital short limbed dwarfism, consisting of thanatophoric dysplasia (TD) (12 cases), osteogenesis imperfecta (OI) (12 cases), asphyxiating thoracic dysplasia (ATD) (3 cases), short-rib-polydactyly syndrome (SRPS) (1 case) and hypochondrogenesis (1 case). The gestational age ranged from 16 to 41 weeks. Of 6 fetuses that were born alive, 3 were ATD, 2 were TD and 1 was hypochondrogenesis. TD was frequently complicated by hydramnios. Of 8 cases studied chromosomally, only 1 showed chromosomal abnormality -46XY, inv 9. Intrauterine growth retardation was frequently associated with OI. Pulmonary hypoplasia was present in 23 cases (79%), including all cases of ATD, SRPS and hypochondrogenesis, 11 in TD and 7 in OI. Other associated anomalies were present in 17 cases (59%).
Autopsy* ; Chromosome Aberrations ; Diagnosis ; Dwarfism ; Extremities ; Fetal Growth Retardation ; Fetus ; Gestational Age ; Osteochondrodysplasias* ; Osteogenesis Imperfecta ; Polyhydramnios ; Thanatophoric Dysplasia

Gastric metastasis (GM) from cervical cancer is extremely rare, and only a few cases have been reported in the English literature. Gastric-type mucinous adenocarcinomas (GAS) of the uterine cervix are rare. GAS is an aggressive cancer commonly found in advanced stages; however, GM has not been reported. This study presents a rare case of GM from GAS of the uterine cervix in a 61-year-old female and describes the radiological findings of both the GM and cervical mucinous adenocarcinoma. GM appeared as a poor enhancing submucosal mass. The cervical mucinous adenocarcinoma appeared as an infiltrating mass with poor contrast enhancement. It exhibited mildly high and low signal intensities on the diffusion-weighted image and apparent diffusion coefficient map, respectively. This case is extremely rare and challenging to diagnose; however, if cervical cancer is an human papillomavirus-independent GAS type and a submucosal lesion is found in the stomach, the possibility of metastasis with a pattern similar to our case could be considered.

Gastric metastasis (GM) from cervical cancer is extremely rare, and only a few cases have been reported in the English literature. Gastric-type mucinous adenocarcinomas (GAS) of the uterine cervix are rare. GAS is an aggressive cancer commonly found in advanced stages; however, GM has not been reported. This study presents a rare case of GM from GAS of the uterine cervix in a 61-year-old female and describes the radiological findings of both the GM and cervical mucinous adenocarcinoma. GM appeared as a poor enhancing submucosal mass. The cervical mucinous adenocarcinoma appeared as an infiltrating mass with poor contrast enhancement. It exhibited mildly high and low signal intensities on the diffusion-weighted image and apparent diffusion coefficient map, respectively. This case is extremely rare and challenging to diagnose; however, if cervical cancer is an human papillomavirus-independent GAS type and a submucosal lesion is found in the stomach, the possibility of metastasis with a pattern similar to our case could be considered.

Gastric metastasis (GM) from cervical cancer is extremely rare, and only a few cases have been reported in the English literature. Gastric-type mucinous adenocarcinomas (GAS) of the uterine cervix are rare. GAS is an aggressive cancer commonly found in advanced stages; however, GM has not been reported. This study presents a rare case of GM from GAS of the uterine cervix in a 61-year-old female and describes the radiological findings of both the GM and cervical mucinous adenocarcinoma. GM appeared as a poor enhancing submucosal mass. The cervical mucinous adenocarcinoma appeared as an infiltrating mass with poor contrast enhancement. It exhibited mildly high and low signal intensities on the diffusion-weighted image and apparent diffusion coefficient map, respectively. This case is extremely rare and challenging to diagnose; however, if cervical cancer is an human papillomavirus-independent GAS type and a submucosal lesion is found in the stomach, the possibility of metastasis with a pattern similar to our case could be considered.

Adenomatoid tumors are well-recognized neoplasms generally to be of mesothelial derivation. We experienced a case of an adenomatoid tumor of the tail of the epididymis in a 56-year-old male. Grossly the tumor was firm and whitish gray, and microscopically it consisted of glandular, cord-like, microcystic structures which were lined by flattened endothelial like to plump cuboidal cells. Immunohistochemical stains whowed positivity for keratin and negativity for facter VIII related antigen and carcinoembryonic antigen. Ultrastructually, there was many long microvilli projecting into the glandular lumina and intracytoplasmic luminal spaces, desmosomes, and prominent cytoplasmic tonofilaments. Those findings strongly support the mesothelial origin of the adenomatoid tumor especially in the glandular type. It also lead us to suggest that the term adenomatoid tumor should be remain in use for light microscopic diagnosis, and that the term adenomatoid mesothelioma should be applied when the mesothelial nature of an adenomatoid tumor is proven by electron microscopy and immunohistochemical stains.

Pilomattiaoma, aften called calcifying epithelioma of Malherbe, is a benign tumor originating from the outer root sheath cell of the hair follicle and extending into the hair matrix, Pilomatricoma usually occurs as a single, asymptomatic dermal or subcutaneous nodule. Multiple lesions are quite unueuel, comprising only 2-3.5% of cases. We report two patients with multiple pilomatricoma.
Hair ; Hair Follicle ; Humans ; Pilomatrixoma*