Cases Of Adenosquamous Cell Carcinoma Research Articles

Evaluation of the Diagnostic Usefulness of ΔNp63 (p40) in Three Cases of Adenosquamous Cell Carcinoma of the Pancreas

近年，扁平上皮癌の診断にΔNp63（p40）の免疫染色検査が行われている．これまでに肺扁平上皮癌に対する有用性が多数報告されており，徐々にその他の癌腫における有用性も報告されている．今回，我々は膵腺扁平上皮癌の3切除例に対してΔNp63の免疫染色検査を行い，その有用性を検討した．症例1は71歳の男性で，膵体部癌の診断で膵体尾部切除を施行した．症例2は81歳の女性で，膵頭部癌の診断で幽門輪温存膵頭十二指腸切除を施行した．症例3は55歳の男性で，膵尾部癌の診断で膵体尾部切除を施行した．いずれの症例も病理組織学的診断は膵腺扁平上皮癌であった．全3例にΔNp63の免疫染色検査を追加し，3例とも扁平上皮癌成分が陽性となった．分化傾向が不明瞭で，HE染色では成分の判別が困難な部位でも扁平上皮癌成分の混在が認識できた．膵腺扁平上皮癌の診断においても，ΔNp63の免疫染色検査は有用と考えられた．

Study of cytomorphology and immunohistochemistry on cell block for categorisation of primary lung tumours

Introduction: Lung cancer is the most common cancer and is the leading cause of mortality worldwide. It accounts for 1-5 million deaths in the world and 2.5 million deaths in developing countries.1 Objectives 1. To study the morphology of primary lung tumours on fine needle aspiration samples. 2. Categorisation of lung tumours by cytomorphology and with immunohistochemistry on cell block wherever available. 2. To assess the diagnostic accuracy of FNAC of lung tumours Methodology: This study was a prospective study conducted on fine needle aspiration samples of 245 cases presenting as lung masses over a period of one year from march 2015 to February 2016. Results: The following observations were made on the sample size of 245 cases of lung tumours. The age of occurrence was between 32-88 years. Most common clinical presentation is cough with expectoration and haemoptysis. Most commonly the lesions were located in the right lung (61.2%). Adenocarcinoma was the most common tumour in our study, followed by squamous cell carcinoma, and neuroendocrine carcinoma. 2 cases of adenosquamous carcinoma, 2 cases of primary plasmacytoma and 1 case of Non-Hodgkin’s lymphoma were also noted. Out 245 cases,30 cases were unsatisfactory aspirate. Out of 215 satisfactory aspirate, IHC was available for 54 cases. IHC confirmed the diagnosis of adenocarcinoma in 30 cases, squamous cell carcinoma in 10 cases, neuroendocrine carcinoma in 11 cases and adenosquamous carcinoma in 2 cases, and 1 case of plasmacytoma lung. We had 2 cases with discordance between cytomorphology and IHC (2 cases which were diagnosed as neuroendocrine carcinoma on cytolomorphology, the IHC findings showed positivity for adenocarcinoma). Immunohistochemistry is helpful in subtyping non- small cell carcinoma, NOS and poorly differentiated carcinoma into adeno, squamous and neuroendocrine carcinomas. 2 cases of adenosquamous cell carcinoma were also confirmed by IHC. Conclusion: The diagnostic accuracy of Fine needle aspiration cytology for primary lung tumours in our study is 87.75%. The sensitivity is 96.4% and specificity 100% in the study. The high accuracy rate was obtained due to correlation with clinical, radiological and cytopathological findings.

Cervical screening and risk of adenosquamous and rare histological types of invasive cervical carcinoma: population based nested case-control study

ObjectivesTo examine the association of cervical cytology screening with the risk of adenosquamous cell carcinoma (ASC) and rare histological types of invasive cervical carcinoma (RICC), using comprehensive registry data, and...

Intestinal obstruction caused by primary adenosquamous cell carcinoma of the small intestine: A case report and review of the literature.

Primary adenosquamous cell carcinoma (ASCC) arising from the ileum is an exceptionally rare malignant neoplasm exhibiting mixed glandular and squamous differentiation. The clinicopathological characteristics of ASCC have not been clearly determined due to its rarity. We herein report a case of a 74-year-old man with a successfully treated ASCC of the ileum. The patient visited a medical clinic due to abdominal pain. Abdominal computed tomography imaging revealed an intestinal tumor in the ileum. Prior to undergoing capsule endoscopy, the patient complained of severe abdominal pain due to intestinal obstruction from the patency capsule and the tumor. Thus, the patient was referred to our hospital for emergency surgery. Upon relieving the obstruction by partial resection of the ileum, an impacted patency capsule with a tumor with ulceration was identified. On histological examination, the tumor consisted of malignant glandular and squamous cell elements. The postoperative course was uneventful, without complications. The patient subsequently received adjuvant chemotherapy with oxaliplatin and capecitabine for 6 months. The patient has no evidence of recurrence 20 months after surgery. To the best of our knowledge, only 8 cases of ASCC have been reported in the English literature to date. This case serves as an important reminder to consider small intestinal carcinoma, including ASCC, in the differential diagnosis of intestinal obstruction.

Video-assisted thoracic surgery double sleeve lobectomy for non-small cell lung cancer: a report of seven cases

Background: Video-assisted thoracic surgery (VATS) double sleeve lobectomy has been rarely reported. We aimed to summarize the techniques and outcomes of this challenging procedure for non-small cell lung cancer (NSCLC) involving both the bronchus and pulmonary artery. Methods: From May 2012 to December 2016, seven patients were selected for VATS double sleeve lobectomy at our center, including four cases of left upper lobectomy and three cases of right upper lobectomy. Surgical procedures were performed with four ports for the first patient and three ports for the other patients. The “hollow out” process was designed for hilum dissection. The main pulmonary artery and interlobar artery were then blocked using two releasable atraumatic endoscopic Bulldog Clamps. Bronchovascular reconstruction was accomplished by the “two-needle-holder suturing technique” through directly watching a video monitor. Low-molecular heparin was subcutaneously administered during the first week after surgery. Results: The operations were uneventful. Surgical duration ranged from 250 to 480 min (median, 318 min) with blood loss between 30 to 200 mL (median, 200 mL). The average number of the dissected lymph nodes was 13 (range, 11–19). Two patients developed postoperative pneumonia with no mortalities. Prolonged air leak (>5 days) was observed in three patients. The median postoperative hospital stay was 15.5 days (range, 5–33 days). There were two cases of adenosquamous cell carcinoma and five cases of squamous cell carcinoma. One patient died of hemoptysis 50 days after surgery, and one died of metastatic lung cancer 2 years after surgery. The other five patients were alive without local recurrence at 4–58 months of follow-up. Conclusions: VATS bronchovascular double sleeve lobectomy is technically difficult but feasible for skilled thoracoscopic surgeons in experienced centers. More data are encouraged to assess the long-term outcomes of this new procedure.

Conventional vs. Liquid Based Cytology in Fine Needle Aspirates of Lung and Mediastinal Masses

Background: Lung cancer most common worldwide cancer, early diagnosis makes effective treatment in lung cancer. Liquid Based Cytology (LBC) for non-gynae specimens has gained popularity over conventional Cytology (CS) during last one decade because of increased sensitivity and specificity. Aim and objectives: To assess the diagnostic utility of LBC versus CS in fine needle aspirates of lung and mediastinal mass lesions. Compare cyto-morphological parameters in terms of adequacy, interpretation, concordance and diagnostic efficiency. Materials and Methods: Eighty -two cases suspected of lung or mediastinal mass lesions underwent imagine guided Transbronchial Needle aspiration (TBNA) or Trans Thoracic Needle aspiration (TTFNA). Fine needle passes were made for both conventional and LBC smears. All smears were examined and diagnosis was correlated in each case with histopathology as gold standard for final diagnosis. Results: Histopathology of 82 cases, 21 were non -neoplastic and 61 were malignant respectively.34 cases of adenocarcinoma, 15 cases of squamous cell carcinoma, 5 cases of adenosquamous cell carcinoma, 4 cases of small cell carcinoma, 1 cases of poorly differentiated 1 case of carcinoid and 1 cases of germ cell tumor. LBC were diagnosed 17 non -neoplastic and 54 were malignant respectively. 25 cases of adenocarcinoma, 11 cases of squamous cell carcinoma, 5 cases of adenosquamous cell carcinoma and 3 cases of small cell carcinoma, CS was diagnosed 4 non -neoplastic and 37 were malignant respectively. 24 cases of adenocarcinoma, 7 cases of squamous cell carcinoma, 4 cases of adenosquamous cell carcinoma and 2 cases of small cell carcinoma. Conclusion: Concordance of LBC with histopathology was found in higher proportion (72%) as compared to conventional smear (48.8%) (p=0.004), because percentage of adequacy for LBC (85.37%) was higher as compared to CS (56.1%) (P<0.001). The assessment of all the morphological parameters were predominantly equal in both methods except in few cases.

Case of adenosquamous cell carcinoma of the gallbladder with so-called carcinosarcoma

Case of adenosquamous cell carcinoma of the gallbladder with so-called carcinosarcoma

A case of adenosquamous cell carcinoma with a pancreaticobiliary maljunction

A case of adenosquamous cell carcinoma with a pancreaticobiliary maljunction

Adenosquamous cell carcinoma derived from intraductal papillary mucinous neoplasm of the pancreas confirmed by genetic analysis.

275 Background: Adenosquamous cell carcinoma (ASC) is an uncommon histologic variant of pancreatic cancer, representing only 1-4 % of all pancreatic neoplasms. Here we reported the extremely rare case of ASC derived from intraductal papillary mucinous neoplasm (IPMN) of the pancreas with intensive pathological and molecular analysis. Methods: A 72-year-old diabetic male with five-year history of non-alcoholic chronic pancreatitis was admitted to our hospital with complaint of epigastric pain. The patient was diagnosed as pancreatic cancer associated with IPMN and pylorus preserving pancreaticoduodenectomy was performed in April 2012. The resected pancreas was fixed in 10% formaldehyde, and the whole specimen was sliced at a thickness of 5-mm for i) pathological analyses using hematoxylin-eosin (H-E) staining and immunostaining with specific antibodies against MUC-1, -2, -5AC, -6, p63 and CD5/6, and ii) deep sequencing of multiplex PCR amplicons of 50 cancer-associated genes utilizing Ion Torrent PGM platform. DNA was obtained from intraepithelial lesions of IPMN, invasive squamous cell carcinoma (SCC) and adenocarcinoma (AC) after enrichment for neoplastic cellularity, using manual microdissection. Results: Pathological findings showed IPMN extended from main pancreatic duct to branch ducts. The invasive tumor was predominantly consisted of poorly-differentiated SCC and small poorly-differentiated AC was also found in the edge of the SCC. All IPMN area analyzed shared combination of the mutations, KRASG12D and GNASR201C. The identical mutations in KRAS and GNAS as IPMNs were also found in SCC and AC. Conclusions: It generally difficult to fully discriminate IPMN-derived cancer (invasive IPMN) from concomitantly and independently developed de novo pancreatic ductal adenocarcinoma (PDA) originating from the “field defect”. In the current case, although SCC is a rare histotype of IPMNs, we considered that the invasive carcinoma was derived from IPMN based on their mutational profile.

肉腫様成分を伴った胆嚢腺扁平上皮癌の1例

症例は60歳，男性．右季肋部痛を主訴に近医受診され，腹部超音波検査にて胆嚢腫瘍の疑いにて当院紹介となった．腹部超音波検査・腹部造影CT検査・腹部MRI検査にて，胆嚢に不整型腫瘤と肝S4への浸潤を認め，胆嚢癌の診断で，肝中央2区域（S4+5+8）切除・胆嚢摘出・肝外胆管切除・2群リンパ節郭清を施行した．病理組織検査にて胆嚢粘膜に腺癌成分を認めたが，大部分は扁平上皮癌成分であった．また，一部の腺癌成分から移行する形で紡錘形細胞を主体とする肉腫様成分が混在しており，免疫組織学的に上皮性マーカーであるAE1/AE3が陽性であり，いわゆる癌肉腫と診断した．肉腫様変化を伴った胆嚢腺扁平上皮癌は，予後は極めて不良とされるが，術後補助化学療法としてS-1療法を選択し，現在術後7カ月無再発生存中である．

左腎合併膵切除を施行した膵腺扁平上皮癌の2例

左腎合併膵切除を施行した膵腺扁平上皮癌の2例

A case of adenosquamous cell carcinoma of the lower bile duct

A case of adenosquamous cell carcinoma of the lower bile duct

WITHDRAWN: Expression analysis of Sca-1 and its significance in lung cancers.

Ahead of Print article withdrawn by publisher. The purpose of the present study was to determine the expression of Sca-1, the stem cell marker, among various lung cancers and evaluate their utility. Immunohistochemistry was done in 151 surgically resected lung cancer specimens or biopsies, including 76 cases of adenocarcinoma, 50 cases of squamous cell carcinoma, 15 cases of small cell carcinoma, 6 cases of adenosquamous cell carcinoma and 4 cases of large cell carcinoma. The results showed that 88 (58.3%) cases were Sca-1 positive. Further analysis showed that in cases of adenocarcinoma, the rate of lymph node invasion and poor differentiation level of Sca-1(+) specimens were respectively higher than those of Sca-1(-) specimens. In cases with small cell carcinoma and squamous cell carcinoma, the rates of lymph node invasion of Sca-1(+) specimens were respectively higher than those of Sca-1(-) specimens. Survival analysis showed that for patients with adenocarcinoma and small cell carcinoma, the average survival time of Sca-1(+) patients was significantly shorter than that of Sca-1(-) patients. Further mutation analysis showed that EGFR mutation rates in Sca-1 (-) adenocarcinoma patients were significantly higher than those of Sca-1 (+) patients, while p53 and KRAS mutation rates in Sca-1 (-) adenocarcinoma and squamous cell carcinoma patients were respectively lower than those of Sca-1 (+) patients. Western blots analysis showed that expression of a Src family tyrosine kinase, Fyn, was positively related with Sca-1 expression levels. These results suggested that Sca-1 expression in some human lung cancers was related with malignancy phenotype and survival time. Keywords: Sca-1 expression, stem cancer cell, lung cancer, malignancy phenotype.

口腔に発生した腺扁平上皮癌の2例

口腔に発生した腺扁平上皮癌の2例

特徴的なFDG-PET所見を呈したG-CSF産生胆嚢腺扁平上皮癌の1剖検例

特徴的なFDG-PET所見を呈したG-CSF産生胆嚢腺扁平上皮癌の1剖検例

A case of adenosquamous cell carcinoma of the gallbladder producing granulocyte-colony stimulating factor

A case of adenosquamous cell carcinoma of the gallbladder producing granulocyte-colony stimulating factor

A Resected Case of Adenosquamous Cell Carcinoma of the Pancreas Derived From Mucin-Producing Cystic Tumor, Revealed by Colonic Ileus

A Resected Case of Adenosquamous Cell Carcinoma of the Pancreas Derived From Mucin-Producing Cystic Tumor, Revealed by Colonic Ileus

十二指腸乳頭部腺扁平上皮癌の1例

十二指腸乳頭部腺扁平上皮癌の1例

Glandular Lesions of the Cervix on Thin-Layer Pap Tests

To determine the cytologic features that are most helpful in characterizing significant glandular lesions of the cervix observed on the ThinPrep (TP) Pap test (Cytyc Corp., Boxborough, Massachusetts, U.S.A.) and to compare these features with those published for conventional smears. Thirty-nine TP preparations with cytologic evidence of glandular lesions of the cervix and histologic and/or clinical correlation were studied. These lesions included (1) 11 cases of benign/reactive conditions; (2) 10 cases of adenocarcinoma in situ (AIS), of which 1 had both AIS and carcinoma in situ; (3) 1 case of invasive adenocarcinoma; (4) 15 cases of squamous intraepithelial lesions and squamous cell carcinoma, including 4 with glandular involvement, and (5) 2 cases of adenosquamous cell carcinoma. These cases were reviewed by the first author without knowledge of the histologic diagnosis. Twenty-five previously published cytologic criteria were used to evaluate glandular cells on TP slides. Statistical analysis was performed using Fisher's exact test to determine the significance of the features studied. All glandular lesions had cytologic features on TP similar to those previously described on conventional smears. However, TP slides demonstrated enhanced nuclear features but less-preserved architectural patterns. Reactive lesions showed minimal overlapping without hyperchromasia or mitotic figures and with normal nuclear/cytoplasmic ratios. AIS and invasive adenocarcinoma cases had similar features. Increased cellularity and overcrowding were prominent, whereas feathering, rosettes and cell strips were present but subtle. Glandular lesions of the cervix on TP slides shared many of the characteristic features reported for conventional smears. However, nuclear details were more pronounced in TP slides, while architectural patterns, although present, were relatively subtle.

下部胆管に発生した腺へん平上皮癌の２例

下部胆管に発生した腺へん平上皮癌の２例