BACKGROUND: Dermatofibroma (DF) comprises a heterogeneous group of mesenchymal tumors, with fibroblastic and histiocytic elements present in varying proportions. The cell of origin of DF has been investigated, but remains unclear. OBJECTIVE: The present study attempted to investigate the expression of leukocyte-specific protein 1 (LSP1), a marker of fibrocytes, in DF. Additionally, we evaluated the effectiveness of LSP1 in the differential diagnosis of DF from dermatofibrosarcoma protuberans (DFSP). METHODS: Immunohistochemical staining was performed on 20 cases of DF using antibodies against LSP1, CD68, and factor XIIIa (FXIIIa). In addition, the expression of LSP1 and FXIIIa was evaluated in 20 cases of DFSP. RESULTS: Eighteen of 20 cases (90%) of DF stained positive for LSP1, with variation in the intensity of expression. CD68 was positive in 10 cases (50%), and FXIIIa was expressed in all cases of DF. There were differences between the regional expression patterns of the three markers in individual tumors. In contrast, only 2 of 20 cases of DFSP expressed LSP1, and none of DFSP cases stained positive for FXIIIa. CONCLUSION: The LSP1-positive cells in DF could potentially be fibrocyte-like cells. FXIIIa and CD68 expression suggests that dermal dendritic cells and histiocytes are constituent cells of DF. It is known that fibrocytes, dermal dendritic cells and histiocytes are all derived from CD14+ monocytes. Therefore, we suggest that DF may originate from CD14+ monocytes. Additionally, the LSP1 immunohistochemical stain could be useful in distinguishing between DF and DFSP.
Antibodies ; Dermatofibrosarcoma ; Diagnosis* ; Diagnosis, Differential ; Factor XIIIa ; Fibroblasts ; Histiocytes ; Histiocytoma, Benign Fibrous* ; Langerhans Cells ; Monocytes

BACKGROUND: Since 2007 when anaplastic lymphoma kinase (ALK) rearrangements were discovered in non-small cell lung cancer, the ALK gene has received attention due to ALK-targeted therapy, and a notable treatment advantage has been observed in patients harboring the EML4/ALK translocation. However, using ALK-fluorescence in situ hybridization (FISH) as the standard method has demerits such as high cost, a time-consuming process, dependency on interpretation skill, and tissue preparation. We analyzed the histologic findings which could complement the limitation of ALK-FISH test for pulmonary adenocarcinoma. METHODS: Two hundred five cases of ALK-positive and 101 of ALK-negative pulmonary adenocarcinoma from January 2007 to May 2013 were enrolled in this study. The histologic findings and ALK immunohistochemistry results were reviewed and compared with the results of ALK-FISH and EGFR/KRAS mutation status. RESULTS: Acinar, cribriform, and solid growth patterns, extracellular and intracellular mucin production, and presence of signet-ring-cell element, and psammoma body were significantly more often present in ALK-positive cancer. In addition, the presence of goblet cell-like cells and presence of nuclear inclusion and groove resembling papillary thyroid carcinoma were common in the ALK-positive group. CONCLUSIONS: The above histologic parameters can be helpful in predicting ALK rearranged pulmonary adenocarcinoma, leading to rapid FISH analysis and timely treatment.
Adenocarcinoma* ; Carcinoma, Non-Small-Cell Lung ; Complement System Proteins ; Humans ; Immunohistochemistry ; In Situ Hybridization ; In Situ Hybridization, Fluorescence ; Intranuclear Inclusion Bodies ; Lung ; Lymphoma* ; Mucins ; Phosphotransferases* ; Thyroid Neoplasms

Endoscopic resection is currently accepted as a standard therapy for colon polyp because of its safety and efficiency. The indications for endoscopic resection have been expanded to treat mucosal colon cancer and submucosal tumor. The major complications of endoscopic resection are hemorrhage, perforation and post- polypectomy coagulation syndrome. Hemorrhage is the most common complication, and this can occur immediately following colonoscopic polypectomy or it can be delayed after completion of the procedure. Delayed hemorrhage usually occurs within 7 days and this can stop by itself or the hemorrhage can be controlled endoscopically in the majority of patients, with only the unusual and serious cases requiring transfusion, angiography and surgery. We experienced a case of delayed massive hemorrhage with hypotension that required transfusion 12 days after performing endoscopic resection for rectal carcinoid tumor. We report here on this case to provide a good example and to place emphasis on delayed massive hemorrhage after endoscopic resection.
Angiography ; Carcinoid Tumor ; Colon ; Colonic Neoplasms ; Hemorrhage ; Humans ; Hypogonadism ; Hypotension ; Mitochondrial Diseases ; Ophthalmoplegia ; Polyps

We report an extraordinary case of diffuse large B-cell lymphoma arising in a cystic necrotic mass in a 35-year-old man who presented with a soft tissue mass at the site of previous surgery. A benign mass was surgically removed 17 years ago, after which a cystic lesion gradually developed at the same site. The resected mass appeared as a thick-walled cyst filled with brown necrotic and hemorrhagic material. On microscopic examination, the cyst wall was primarily necrotic tissue with some aggregates of large atypical lymphoid cells. These atypical cells were diffusely positive for CD20 and showed a high proliferation index, Epstein-Barr virus positivity, and clonal rearrangement of the immunoglobulin gene. His present condition was diagnosed as Epstein-Barr virus-associated diffuse large B-cell lymphoma arising from chronic inflammation. It is important to be aware of the clinical manifestations and histological features of this rare disease in light of diagnosis and treatment.
Adult ; B-Lymphocytes ; Epstein-Barr Virus Infections ; Genes, Immunoglobulin ; Herpesvirus 4, Human ; Humans ; Incidental Findings ; Inflammation ; Light ; Lymphocytes ; Lymphoma, B-Cell ; Lymphoma, Large B-Cell, Diffuse ; Rare Diseases

PURPOSE: The recently developed method of rapid immunohistochemistry (IHC) was applied to the intraoperative examination of sentinel lymph node (SLN) because as their routine frozen-section examination is liable to yield a false-negative results. This study is devoted to establish a reliable protocol for rapid IHC of SLN. METHODS: Between August 2004 and April 2005 a retrospective study was performed. SLNs from 50 breast cancer patients with clinically negative SLN were examined intraoperatively using hematoxylin-eosin (H&E) stain and immunostain for cytokeratin by rapid IHC assay. After examination of the frozen section, the SLNs were paraffin embedded and serially sectioned at 5 micrometer intervals. RESULTS: The median age and tumor size of the patients was 61.0 years and 1.4 cm (6% Tis, 70% T1, and 24% T2), respectively. The total number of dissected SLN was 112, with a mean of 2.2 (range, 1~4) SLNs per patient. Seven SLNs were found to be positive from metastasis in permanent pathological sections. Of these, 5 were stained by both intraoperative rapid IHC and H&E stain while one was not stained at all. The remaining SLN was initially stained with only the rapid IHC assay. The mean turn around time of the rapid IHC was less than 20 minutes, with sensitivity, true negative value, true positive values and accuracy of 85.7, 99.1, 100, and 99.1% respectively. CONCLUSIONS: The rapid IHC was a very sensitive and rapid technique for the intraoperative detection of metastatic involvement of SLNs, whitch may be helpful at increasing the accuracy of detecting the micro-metastasis of sentinel lymph nodes during an operation.
Breast Neoplasms* ; Breast* ; Frozen Sections ; Humans ; Immunohistochemistry* ; Keratins ; Lymph Nodes* ; Neoplasm Metastasis ; Neoplasm Micrometastasis ; Paraffin ; Retrospective Studies

PURPOSE: The aim of this study was to compare the micrometastasis group with the macrometastasis group, and to analyze clinical and pathological variables to determine what factors might predict non-sentinel lymph node (NSLN) involvement in the women with sentinel nodes that contained only micrometastasis. METHODS: Between June 2003 and September 2005, 650 patients with primary breast cancer and who underwent a SLN procedure were retrospectively reviewed. Of those 650 patients, 138 patients with metastasis in the SLNs were analyzed. RESULTS: The median number of harvested sentinel lymph nodes (SLNs) was 2.5 (range: 1~7) and the median number of tumor positive LNs was 2.1 (range: 1~22). Of the 138 patients with a positive SLN, macrometastasis was identified in 105 patients and micrometastasis was noted in 33 patients. The SLN micrometastases were smaller than 0.2 mm in 18 patients and it was between 0.2 to 2.0 mm in 15 patients. Completion axillary dissection was performed in 17 (51.5%) patients with SLN micrometastasis and in 105 (100%) patients with SLN macrometastasis. NSLN involvement was found in 43/105 (41.0%) patients with SLN macrometastasis, while it was not found in the patients with SLN micrometastasis. Univariate analysis showed that T stage, multiplicity, lymphovascular invasion and histologic type were significantly associated with the difference between micrometastasis and macrometastasis in the SLNs. Multivariate analysis identified T stage as a significant factor. CONCLUSION: This study suggests that NSLN metastasis is associated with size of metastasis found in the SLN and completion axillary dissection may not be necessary in patients who have micrometastatic disease in the SLN.
Breast Neoplasms* ; Breast* ; Female ; Humans ; Lymph Nodes* ; Multivariate Analysis ; Neoplasm Metastasis ; Neoplasm Micrometastasis* ; Retrospective Studies

No abstract available.
Aged ; Antibodies, Antinuclear/analysis/*immunology ; Antiviral Agents/therapeutic use ; Fluorescent Antibody Technique ; Hepatitis C/*diagnosis/drug therapy ; Humans ; Liver Failure/diagnosis/immunology ; Male

BACKGROUND: All aspects of mucoepidermoid carcinoma (MEC) of the lung including histologic grading, clinical behavior and its differentiation from adenosquamous cell carcinoma are still not fully understood. METHODS: We reviewed the hematoxylin-eosin stained slides and medical records of 31 cases of MEC of the lungs. The cases were classified as low and high grade according to the quantitative grading system formulated for MEC. High grade tumors were tested for an epidermal growth factor receptor (EGFR) mutation. RESULTS: Twenty eight cases were classified as low grade and 3 cases as high grade. Histologically, lower glandular component, cellular atypia, necrosis, mitoses >4/10 high power fields, and endolymphatic tumor emboli were typical characteristics of a high grade tumor. Although some tumors showed histologic features mimicking high grade tumors, they were classified as low grade tumors according to this quantitative grading system. Low grade tumors showed no recurrence or metastasis. However, among three patients with a high grade tumor, two had distant metastases and one died of disease. Additionally, an EGFR mutation was not detected. CONCLUSIONS: A high grade MEC was consistently different from a low grade tumor with regard to malignant histologic features and poor prognosis. Therefore, correct histologic grading is important in predicting the prognosis to avoid unnecessary treatment.
Bronchi ; Carcinoma, Mucoepidermoid ; Humans ; Lung ; Lung Neoplasms ; Medical Records ; Mitosis ; Necrosis ; Neoplasm Metastasis ; Prognosis ; Receptor, Epidermal Growth Factor ; Recurrence

Synchronous primary lung cancers are relatively rare. The accurate diagnosis remains challenging, despite of the routine use of bronchoscopy and computed tomography (CT) of the chest. Herein we report a case of synchronous triple primary cancers of the right lung in a 72-year-old male patient in whom each tumor presented distinct CT imaging findings.
Adenocarcinoma/*diagnosis/pathology/radiography ; Adenocarcinoma, Mucinous/*diagnosis/pathology/radiography ; Aged ; Bronchoscopy ; Carcinoma, Squamous Cell/*diagnosis/pathology/radiography ; Diagnosis, Differential ; Humans ; Lung Neoplasms/*diagnosis/pathology/radiography ; Male ; Neoplasm Staging ; Neoplasms, Multiple Primary ; Positron-Emission Tomography ; Tomography, X-Ray Computed

OBJECTIVE: We wanted to assess the safety and efficacy of performing radiofrequency ablation (RFA) in patients with non-colorectal liver metastases. MATERIALS AND METHODS: In this retrospective study, 25 patients with 40 hepatic metastases (M:F = 17:8; mean age, 57 years; tumor size, 0.5-5.0 cm) from a non-colorectal origin (stomach, biliary, breast, pancreas, kidney and skin) were treated with RFA. The RFA procedures were performed using either an internally cooled electrode or a clustered electrode under ultrasound or CT guidance. Contrast-enhanced CT scans were obtained immediately after RFA and follow-up CT scans were performed within three months after ablation and subsequently at least every six months. The intrahepatic disease-free interval was estimated and the overall survival from the time of the initial RFA was analyzed using the Kaplan-Meier method. RESULTS: No intraprocedural deaths occurred, but four major complications developed, including abscesses (n = 3) and pneumothorax (n = 1). Technical effectiveness was determined on the initial follow-up images. During the follow-up period (range, 5.9-68.6 months; median time, 18.8 months) for 37 tumors in 22 patients where technical effectiveness was achieved, 12 lesions (32%, 12 of 37) showed local tumor progression and new intrahepatic metastases occurred in 13 patients (59%, 13 of 22). The median intrahepatic disease-free interval was 10.1 months. The 1-year, 3-year and 5-year overall survival rates after RFA were 86%, 39% and 19%, respectively. CONCLUSION: RFA showed intermediate therapeutic effectiveness for the treatment of non-colorectal origin liver metastases.
Adult ; Aged ; Aged, 80 and over ; *Catheter Ablation/adverse effects ; Disease Progression ; Disease-Free Survival ; Female ; Humans ; Liver Neoplasms/mortality/radiography/*secondary/*surgery ; Male ; Middle Aged ; Neoplasm Recurrence, Local ; Radiography, Interventional ; Tomography, X-Ray Computed ; Ultrasonography, Interventional