Eosinophilic Secretions Research Articles

Salivary gland-like low-grade clear cell carcinomas of the thoracic cavity: A clinical, immunohistochemical, and molecular analysis of three cases.

Three cases of an unusual neoplasm with striking clear cell features resembling salivary gland origin of the thoracic cavity are presented. The patients were three men between the ages of 52 and 69years (average: 60.5years), who presented with non-specific symptoms, such as chest pain, cough, and dyspnea. Diagnostic imaging showed that two tumors were intrapulmonary neoplasms, one in right lower lobe and one in the left upper lobe, while the third tumor was located in the anterior mediastinum. Surgical resection was accomplished in all cases. Grossly, the tumors were described as light tan, soft and well-delineated. Necrosis and hemorrhage were not present. Histologically, the three tumors showed similar morphological features consisting of a neoplastic cellular proliferation arranged in small lobules and round glandular structures, some of which contained amorphous eosinophilic secretions. Individual tumor cells had abundant clear cytoplasm, round nuclei, and inconspicuous nucleoli. Cellular atypia was minimal and only scattered mitotic figures were present. Immunohistochemical studies showed that the tumor cells were positive for pancytokeratin and GATA-3, focally and weakly positive for DOG1 and TRPS1 while negative for numerous other epithelial and neuroendocrine markers. Molecular analysis showed negative results for EGFR, ROS1, or ALK mutation, MAML2 and EWSR1 rearrangement and ETV6::NTRK3 fusion, respectively. Clinical follow up showed that all patients were alive without tumor recurrence or metastasis. We believe that the histological features, immunohistochemical profile, and the results of the molecular analysis are supportive of a yet undescribed tumor entity, provisionally designated as salivary gland-like low-grade clear cell carcinomas.

Features of mammary gland morphology in domestic carnivores

The mammary gland is a target organ for hormones in the hypothalamus, pituitary gland, thyroid gland, and ovaries. In the postnatal period of animal ontogenesis, breast growth, and development are determined by the estrous cycle and pregnancy. One of the most pressing problems in morphology, mammology, and reproductology of animals is the study of the structure of the breast at the macro and microscopic levels. However, modern studies on the morphology of animals' breasts are mainly devoted to the features of pathomorphological changes in the breast during carcinogenesis. The work aims to conduct a scientific review of the study of normal breast morphology in domestic carnivores. Electronic publication searches have been conducted in the Web of Science, Scopus, PubMed, and Google Scholar databases over the past 20 years. The principles of objectivity and a comprehensive attitude to studying the chosen problem are used. The authors of the review article review the current scientific literature and summarize current knowledge on the features of dog and cat breast morphology. The anatomical structure of the breast of animals is presented with an emphasis on its topography. According to the description of the microscopic structure of the breast, its main structural components are characterized by secretory parts (alveoli and tubes) and intraparticle excretory ducts. Anatomical characteristics of the nerves, blood, and lymphatic vessels of the mammary glands of dogs and cats are presented. Morphological changes in the mammary gland of dogs and cats at different stages of the estrus cycle and during pregnancy are described; in particular, the mammary gland is at rest (inactive) during proestrus and estrus. According to diestrus, due to an increase in progesterone levels, successive morphological changes occur, in particular, stromal and ductal proliferation; early development of lobules with branching ducts and proliferation of alveoli; the dominance of glandular tissue with large lobules containing secretory material; early regression, an increase in interparticle connective tissue, eosinophilic protein secretion in dilated ducts and alveoli. Complete involution of the alveoli and tubes of the breast is recorded at the end of the anestrus. The described anatomical and microscopic features of the structure of the mammary glands of dogs and cats are relevant for the comparative morphology of carnivores at different stages of the sexual cycle and during pregnancy. Data on blood supply, lymphatic drainage, and innervation of the breast are essential for its functional characteristics in normal and pathological conditions, particularly for developing a reasonable model of breast extirpation in malignant tumors.

Vulvar Hidradenoma Papilliferum.

This study examines the clinical and pathological characteristics, immune profile, histological occurrence, diagnosis, and differential diagnosis of vulvar hidradenoma papilliferum. An analysis was conducted on clinical data, histological patterns, and immunohistochemical findings from 45 cases of vulvar hidradenoma papilliferum, and relevant published articles were reviewed. Simultaneously, high-risk HPV typing was performed on these 45 cases. The 45 cases of vulvar hidradenoma papilliferum displayed tumor sizes ranging from 0.3 to 2.0 cm and were observed to be pink or red in appearance. Vacuolated cytoplasm, large abnormal nuclei, distinct nucleoli, and scattered eosinophilic luminal secretions were observed in the glands. Positive staining for CK7 and progesterone receptor (PR) with focal mammaglobin and GCDFP-15 expression was found through immunohistochemistry. CK20 staining was noted as negative. Hidradenoma papilliferum is a rare benign tumor that originates in secretory glands. The diagnosis of this condition is aided by gross and immunohistochemical results, and differentiation from other conditions is necessary.

Morphology, immunohistochemistry characteristics, and clinical presentation of microcystic urothelial carcinoma: a series of 10 cases

BackgroundMicrocystic urothelial carcinoma (MUC) is a rare variant of urothelial carcinoma with histological appearances similar to begin lesions. Thus far, approximately 50 cases have been reported. Here, we investigated the clinicopathological features of MUC.MethodsClinical data and paraffin-embedded tissue blocks were collected. Immunohistochemical staining and polymerase chain reaction–Sanger sequencing were performed to detect the phenotype and TERT mutation status of MUC, respectively.ResultsThe mean patient age was 58.8 ± 14.5 years, with a male predominance (8:2). The pathological stage was T1 in one case, T2 in three cases, T3 in four cases, and T4 in two cases. Tumor metastases or death occurred in all five patients who were followed up within 1–3 years. Histological analyses revealed microcystic, tubular, cribriform, and occasionally cord-like structures, which generally lacked interstitial reactions. The lumens were empty, contained eosinophilic secretion, or were filled with mucin. The microcysts/tubules/cribriform patterns were lined by flat, cuboid, signet ring, or columnar types of epithelia. The cuboid, signet ring, and columnar types represented “glandular metaplasia” or glandular differentiation of urothelial carcinoma. Immunohistochemistry analyses revealed distinct co-expression patterns involving the luminal markers FOXA1 and GATA3, as well as the basal markers CK5/6 and CD44. All 10 cases exhibited a luminal phenotype according to the GATA3+/CK14- criterion, whereas nine cases exhibited a luminal phenotype according to the FOXA1+/CK14- criterion. The telomerase reverse transcriptase-C228T mutation was detected in seven cases.ConclusionsMUC is a rare variant with a deceptively benign form of urothelial carcinoma, which is generally identified as a late-stage tumor with a poor prognosis. It exhibits distinct co-expression of luminal and basal markers, along with the TERT-C228T mutation.

Cystic Hypersecretory Carcinoma of the Breast: A Rare Case Report with Review of Literature and Emphasis on Differential Diagnosis.

Karthik DhandapanCystic hypersecretory carcinoma (CHC) is a rare subset of in-situ breast carcinoma with or without associated invasive carcinoma. It is part of a spectrum of cystic hypersecretory lesions that includes cystic hypersecretory hyperplasia (CHH), CHH with atypia, CHC in situ, and CHC with invasion. Only 20 cases of CHC with invasion have been reported so far. A 60-year-old female presented with a palpable right breast mass. A core needle biopsy was carried out, which was reported as invasive breast carcinoma with areas of ductal carcinoma in situ (DCIS). Modified radical mastectomy was done post-neo-adjuvant chemotherapy; On microscopy, dilated cystic spaces filled with eosinophilic secretions (thyroid colloid-like), lining neoplastic cells with variable degrees of proliferation and atypia were seen. There were multiple foci of invasion; both skin invasion and axillary lymph node metastasis were present. Immunohistochemistry (IHC) was done with relevant markers; correlating all these findings, a diagnosis of CHC with invasion was made. CHC is a distinct form of DCIS with or without associated invasion. Awareness of this entity is required to rule out other differential diagnoses and to avoid misinterpretation. Little is known about the IHC profile, biological behavior, prognosis, and molecular profile of CHC due to its rarity.

Biochemical and Histopathological evaluation of prostatic tissue under effect of Pterostilbene in benign prostatic hyperplasia rat model

Background: Benign prostatic hyperplasia [BPH] is the urologic condition that affects elderly men the most frequently Benign prostatic hyperplasia. Benign prostatic hyperplasia must be distinguished from
 lower urinary tract symptoms and benign prostatic enlargement. which refers to an enlarged prostate, benign prostatic hyperplasia is a purely histological term the development, maintenance, and secretory activity of the prostate and other sex-accessory tissues are stimulated by the presence of certain hormones and growth factors. the pathophysiology of Benign prostatic hyperplasia is significantly influenced by the activity of the enzyme 5α-reductase. It's important to remember that 5-αreductase is responsible for creating Dihydrotestosterone a stronger androgen. Pterostilbene Mostly found in blueberries and grapes and pterostilbene substance with a number of biological properties including anticancer properties. pterostilbene is a lipid-soluble molecule that exists in both cis and trans forms with the latter being more prevalent. The conventional medication for Benign prostatic hyperplasia utilized in this trial was finasteride which inhibits the 5α-reductase enzyme and lowers the amount of Dihydrotestosterone.
 Methods: Forty-eight male rats were divided into six groups; the control group consisted of eight rats who received subcutaneous injections of oil vehicle for a period of 42 days. The induction group consisted of eight rats who received subcutaneous injections of testosterone propionate for a period of fourteen days. The finasteride group consisted of eight rats who received finasteride 0.44 mg/kg by oral gavage for a period of twenty-eight days following the induction of Benign prostatic hyperplasia and Pterostilbene 200 group included 8 rats were given pterostilbene 200mg/kg by oral gavage for 28 days after 14 days of Benign prostatic hyperplasia induction. pterostilbene 100 group included 8 rats were given a pterostilbene 100mg/kg per day kg by oral gavage for 28 days after 14 days of induction Benign prostatic hyperplasia dose and the resveratrol group included 8 rats were given a resveratrol 100mg/kg per day kg by oral gavage for 28 days after 14 days of induction Benign prostatic hyperplasia After twenty-eight days.
 Results: Histological section of prostate Pterostilbene 200 were similar those in control negative revealed numerous variable sizes alveoli that filled with homogenous eosinophilic secretion, had normal epithelial and stromal tissue.
 Conclusion: Pterostilbene have a potent anti-proliferative effect by decrease the hyperplastic nodules for prostate and return epithelial cell to normal and have a very good scavenging activity for free radical [very good as antioxidant] in compare with Vitamin c and resveratrol.
 Aim of study: evaluate the effect of Pterostilbene as Anti proliferative on Benign prostatic hyperplasia and assess the antioxidant activity for Pterostilbene by DPPH Assay.

Theama japonica sp. nov., an Interstitial Polyclad Flatworm Showing a Wide Distribution along Japanese Coasts.

We establish a new interstitial polyclad species, Theama japonica sp. nov., based on specimens collected from coarse-sandy habitats in three Japanese main islands (Hokkaido, Honshu, and Shikoku) along the coasts of the Pacific Ocean and the Sea of Japan. Theama japonica is characterized by i) two pairs of cerebral eyespots and four to six precerebral eyespots; ii) eosinophilic secretion glands distributed in the distal half of the inner ventral part of the prostatic vesicle; iii) a conical penis papilla, bent up dorsally, with a sclerotized inner wall; iv) the prostatic sheath with an inner angular fold on the dorso-distal side; and v) the external cilia longer dorsally than ventrally. Partial sequences of the cytochrome c oxidase subunit I (COI) gene from 20 specimens collected at eight localities along Japanese coasts represented 19 haplotypes. The uncorrected p-distances among these COI haplotypes fell within intraspecific variations observed in other polyclads. A network analysis based on these COI haplotypes suggested a geographically non-cohesive genetic structure of the species, possibly indicating the species' high dispersibility. Molecular phylogenetic analyses based on a concatenated dataset of 18S and 28S rDNA sequences showed T. japonica formed a clade with other Theama species. The resulting tree also indicates that our new species is more closely related to Theama sp. from Colombia than species from Panama and Croatia.

A case series on allergic fungal rhino sinusitis – variable presentations

Allergic fungal rhino sinusitis (AFRS) is a non-invasive fungal sinusitis resulting from an allergic and immunologic response to the presence of extramucosal fungal hyphae in the sinuses. Defined largely by the presence of allergic fungal mucin, which is a thick, tenacious, and eosinophilic secretion with characteristic histologic findings. To present a case series on the variable presentations in patients diagnosed with AFRS. A retrospective study of 10 cases that presented to Rajiv Gandhi Government General Hospital ENT outpatient department with allergic fungal rhinosinusitis confirmed by diagnostic nasal endoscopy and CT scan who were managed successfully by endoscopic sinus surgery. In our study, out of 10 cases, nine patients had unilateral symptoms, only one patient has bilateral symptoms. Most common presentation was headache, facial pain, nasal obstruction, and nasal discharge. Some patients had variable presentations such as proptosis, oroantral fistula, blurring of vision, watering of eye, and unilateral frontal headache. On diagnostic nasal endoscopy, two patients had nasal polyposis. Complete disease clearance was achieved in nine cases by functional endoscopic sinus surgery. Patients were started on topical and oral corticosteroids, pre/postoperatively. On follow-up, only one patient had recurrence. Preventing and treating the condition, as well as its spread and complications, are greatly aided by early detection and management of AFRS. The key to enhancing the result is surgical intervention (endoscopic sinus surgery) and medical therapy (corticosteroids). Antifungals have limited role in treatment of AFRS. Longstanding unilateral Sinusitis should always raise suspicious of AFRS.

Daily Egg-Cycle in Japanese Quail: Serum Biochemistry, Bones, and Oviduct Changes

This study described changes in the serum biochemistry, morphology of genital organs, long bone, and eggshell during the daily egg formation cycle in Japanese quails. Sixty quails (18-wk) were distributed in 6 groups according to hours post-oviposition (POV): 0 hr POV (16h00), 2 hrs POV (egg in magnum), and 4, 8, 14, and 20 hrs POV (egg in uterus). The magnum had higher relative weight before the next ovulation (20 and 0 hr POV), and its tubular glands showed functional variation through periods: abundant eosinophilic, PAS+, and negative Alcian blue secretion at 0 and 2 hrs, empty glands aspect at 4 hrs, and filled again at 20 hrs POV. Serum albumin and total Ca had the highest value in the 2 hrs group, and the lowest in 8 and 14 hrs groups. Egg-cycle period affected the Ca% of the medullar bone of the femur and tibiotarsus, with the lowest mean at 14 hrs POV (06h00), and the highest mean after oviposition (0 hr POV), showing the recovery of Ca stores in long bones for the next egg cycle. Analysis of the eggshell using scanning electron microscopy evidenced that palisade layer formation starts during the night (8-14 hrs POV), and most parts are secreted during the day period. In conclusion, eggshell secretion in light periods, high magnum activity and medullary bone Ca deposition during midday and afternoon, as well as the ovulation/oviposition in the afternoon, are the main characteristics of the distinct physiological aspects of the egg cycle in quails.

Sekretuar Meningiom: Radyolojik ve Patolojik Olarak Malign Tümörlerle Karıştırılabilen Nadir Bir Antite

AbstractMeningiomas are slow growing, extra axial brain tumors that originating from the meningothelial cells of the arachnoid. Meningiomas are the most common brain tumors, however secretory meningiomas are extremely rare variant and can be confused radiologically and pathologically with malignant tumors. A 48 years old male was presented with a complaint of headache and visual impairment in the left eye. Magnetic resonance imaging revealed an extra axial mass lesion in the left pontocerebellar region, 57x48x30 mm in size, and marked edema around the mass. Microscopically, a tumoral lesion consisting ofuniform meningothelial cells with oval-round nuclei, thin vesiculated chromatin, and moderately eosinophilic cytoplasm was observed. The presence of epithelial differentiation characterized by pseudopsammom structures formed by lumens containing eosinophilic secretion was appointed among the tumor cells. Eosinophilic secretion within the lumens were highlighted with histochemical periodic acid schiff (PAS) stain. Immunoreaction was observed in the pseudopsammom structures and the surrounding tumor cells with carcinoembryonic antigen (CEA), epithelial membrane antigen (EMA) and pan cytokeratin (Pan-CK). Tumor cells were immunopositive with Vimentin and progesterone receptor (PR). Ki67 proliferation index was determined as <1%. No necrosis or mitosis were detected. The tumor was reported as ‘‘secretory meningioma’’. No additional treatment was applied to the case and no recurrence was detected in 32 month follow-up after surgical resection. Although secretory meningiomas are not clinically important due to their benign course, differantial diagnosis is critical, since they can be confused with malign tumors because of marked brain edema radiologically, elevated serum CEA levels and epithelial differentiation.

Renal replacement lipomatosis with granulomatous inflammation – A case report and review of literature

Renal replacement lipomatosis can be defined as the proliferation of fibrofatty tissue which subsequently replace the renal parenchyma. It is usually benign unilateral and occurs as a result of severe atrophy or destruction of the renal parenchyma, due to a calculus with secondary proliferation of renal sinus, renal hilus, and perirenal fatty tissue to a variable extent.A 55yr old female presented to surgeon with history ofpain and swelling in right flank. On CECT abdomen there was seen non functional right kidney with staghorn calculi along with perirenal abscess. Patient was treated with nephrectomy and drainage of collection. Intraoperatively Perirenal Abscess extending to psoas and iliopsoas region along with dense adhesion between kidney and liver was found. The multiple sections studied from the lesion showed extensive fibrofatty tissue with few tubule like structures lined by cuboidal epithelium and containing dense eosinophilic secretions. There is seen mixed inflammatory infiltrates with granulomas. Histological features confirmed that Renal replacement lipomatosis with granulomatous inflammation.The clinical importance of RRL is that it stimulates fat-containing tumors in the kidney or its vicinity such as lipomas, angiomyolipomas and liposarcomas can be misdiagnosed preoperatively. Hence this case report has been presented to create awareness of this condition among the pathologist and practicing urosurgeons.

A Parotid Gland Mammary Analogue Secretory Carcinoma in a 4-Year-Old Boy: Case Report and Literature Review

Background: Mammary analogue secretory carcinoma (MASC) is characterized by similar histologic, immunohistochemical, and molecular features with breast secretory carcinoma. MASC usually occurs in adults. Case report: A 4-year-old boy presented with a right infra-auricular mass. Features of the tumor include solid, tubular, and papillary growth patterns, with homogenous eosinophilic secretions inside microcystic structures. Immunohistochemical stains showed strong, diffuse staining for CK7, S100, pan-TRK protein. P63 was positive in a peripheral pattern. Fluorescence in situ hybridization (FISH) analysis showed the characteristic ETV6-NTRK3 gene fusion. Conclusion: Typical histological, immunohistochemical, and molecular features are present in MASC occurring early in childhood.

Secretory Carcinoma of the Breast Mimicking Invasive Ductal Carcinoma: A Case Report

Patient: Female, 40-year-old Final Diagnosis: Secretory breast carcinoma Symptoms: Breast mass Medication:— Clinical Procedure: — Specialty: Oncology Objective: Rare disease Background:Secretory breast carcinoma (SBC), an extremely rare malignancy, is related to a chromosomal translocation which leads to an ETV6-NTRK3 fusion mutation. SBC is characterized by eosinophilic secretions and is usually triple-negative, with a small number of patients demonstrating ER-positivity of the tumors. Diagnosis can be challenging and requires genomic testing for confirmation.Case Report:A 40-year-old woman presented with a breast mass found on mammography. She underwent an ultrasound-guided biopsy of the tumor. Initial pathology evaluation revealed features consistent with invasive ductal carcinoma. The immunochemistry report described an ER-positive, PR-negative, and HER2-negative tumor. The specimen was sent for oncotype scoring, which was not performed due to the specimen not meeting the criteria for invasive ductal carcinoma and displaying pathological features of SBC. A fluorescent in situ hybridization (FISH) study revealed ETV6 translocation, consistent with the diagnosis of SBC. The patient underwent lumpectomy followed by adjuvant radiotherapy and endocrine therapy. She remains in complete remission 3 years after treatment.Conclusions:Accurately diagnosing SBC is of extreme importance as it has an indolent clinical course, but has a favorable prognosis if detected early. Due to nonspecific imaging findings, pathology evaluation with immunohistochemical staining followed by genomic testing is required. Our case highlights the challenges associated with SBC diagnosis requiring genomic testing due to equivocal pathological findings, along with increasing incidence of SBT in adults. There are no established guidelines for SBC management. The mainstay of treatment is partial or total mastectomy. Data on the benefits of adjuvant endocrine therapy, chemotherapy, and radiotherapy are inconclusive.

Mesonephric-Like Adenocarcinoma of Uterine Corpus: A Clinicopathological and Targeted Genomic Profiling Study in a Single Institution

BackgroundMesonephric-like adenocarcinoma (MLA) is a recently characterized, rare, and aggressive neoplasm that mostly arises in the uterine corpus and ovary. MLA shows characteristic pathological features similar to mesonephric adenocarcinoma of the cervix. The origin of MLA is still controversial and recognition of it remains challenging for pathologists. The aim of this study was to enrich the clinicopathological features of MLA in the uterine corpus and explore its molecular alterations by targeted next-generation sequencing (NGS).MethodsFour cases of MLA were identified among a total of 398 endometrial carcinomas diagnosed in our institution between January 2014 and December 2021. Immunohistochemistry and targeted NGS spanning 437 cancer-relevant genes were performed.ResultsThe most common symptom was abnormal vaginal bleeding, and the average age was 68 years. Histologically, the tumors showed a mixture of varied growth patterns including papillary, glandular, tubular, cribriform, solid, and slit-like architectures, which were lined by columnar to cuboidal cells with overlapping vesicular nuclei and sometimes nuclear grooves. Intraluminal eosinophilic colloid-like secretions were focally evident in three of the four cases. Immunohistochemically, the MLAs were positive for GATA3 (4/4), TTF-1 (3/3), luminal CD10 (3/3), calretinin (2/3), and patchy P16 (3/3) and were negative for ER (0/4) and PR (0/4). The expression of P53 was “wild type” (4/4). By targeted NGS, 3/4 (75%), 2/4 (50%), and 1/4 (25%) cases harbored PIK3CA, KRAS, and PTEN mutations, respectively. None of the tumors had mutations in DNA mismatch repair genes, ARID1A/B, POLE, CTNNB1, SMARCA4, or TP53. At the time of diagnosis, three were presented with FIGO IB stage and one with IIIC stage. Two patients received postoperative chemotherapy and radiotherapy and they were alive without evidence of disease at 8 and 56 months follow-up, respectively. One patient developed pulmonary metastasis 13 months after surgery and chemotherapy, and one was dead of the disease 24 months after the operation without adjuvant therapy.ConclusionsMLA is a rare and aggressive malignancy, representing approximately 1% of all endometrial carcinomas. It exhibits mixed architectures associated with distinctive immunophenotype and recurrent KRAS and PIK3CA mutations, supporting classified as of Müllerian origin with mesonephric differentiation.

Utility of p63 and PTEN staining in distinguishing cervical microglandular hyperplasia from endometrial endometrioid carcinoma with microglandular/mucinous features.

AimsDistinction between well‐differentiated endometrial carcinoma (EMCA) with microglandular/mucinous features and benign endocervical microglandular hyperplasia (MGH) can be a diagnostic challenge, especially when tissue is limited. The immunostains used to distinguish endocervical and endometrial carcinoma are less useful when the differential diagnosis is MGH. Here, we investigate the utility of p63 and phosphatase and tensin homologue (PTEN) to aid accurate classification.Methods and resultsCases obtained from our pathology archives included 25 EMCA with mucinous/microglandular features, 26 MGH and nine atypical microglandular proliferations. Cases were assessed for glandular architecture, presence of mucinous and/or eosinophilic luminal secretions, subnuclear vacuoles, foamy histiocytes, inflammation, squamous metaplasia, cytological atypia and mitotic activity. The presence and pattern of immunohistochemical staining for p63 and PTEN was recorded. Microglandular proliferations with cytological atypia, mitotic activity, foamy histiocytes and complex glandular architecture were more commonly seen in EMCA, while small glands, bland nuclei and subnuclear vacuoles were enriched in MGH. All MGH cases displayed p63‐positive subcolumnar reserve cells and retained PTEN expression. Four EMCA cases showed non‐specific focal p63 staining either at the surface of the tumour or in areas of squamous differentiation. p63 and PTEN immunostains accurately predicted the final diagnosis for 3 atypical microglandular proliferation cases with follow‐up.ConclusionsWhile there are morphological characteristics that differentiate EMCA and MGH, there is frequent overlap between these entities. Nonetheless, the pattern and extent of p63 and PTEN can aid accurate classification. Consistent p63‐positive subcolumnar reserve cells were seen only in MGH.

THYROID-LIKE FOLLICULAR CARCINOMA OF THE KIDNEY IN A CHRONIC DIALYSIS PATIENT: ONE CASE REPORT AND REVIEW OF THE LITERATURE

Thyroid-like follicular carcinoma of the kidney (TLFCK) is an extremely rare subtype of renal cell carcinoma (RCC) that histologically mimics primary follicular carcinoma of the thyroid gland. This new entity has not yet been integrated into the current WHO classification of renal tumors due to the limited data available. We report a further case of this rare histological entity, discuss the clinical, histological and immunohistochemical findings and provide an update on the review of the literature. A 73-year-old woman was found to have a left renal mass during her annual medical checkup. Her past medical history included high blood pressure and renal failure at hemodialysis stage. The patient underwent a nephrectomy with simple postoperative course. The tumor was described as being round, well circumscribed and dark brown in color. Histologically, the tumor showed follicular architecture with macro and micro follicles containing eosinophilic secretions or colloid-like material. Immunohistochemical studies demonstrated that the tumor cells exhibited no immunoreactivity for thyroid transcription factor-1 and thyroglobulin. The tumor cells showed intensive staining for cytokeratin 7 (CK7). The tumor cells were completely negative for CK20, WT1 and PAX8. Molecular biology was not carried out for lack of means. These findings are dissimilar to previously classified renal neoplasm. Thyroid-like follicular renal cell carcinoma represents a unique histologic subtype of renal cell carcinoma of low malignant potential and its primary importance is to distinguish it from metastatic carcinoma from the thyroid. A correct histopathologic diagnosis has important clinical and therapeutic implications. The current consensus from ISUP is not to recommend TLFCK as a new WHO histologic classification due to the small number of cases therefore, documentation of all cases available seems to be important to gain additional knowledge.

Mesonephric-like Adenocarcinoma of the Ovary: Clinicopathological and Molecular Characteristics.

Mesonephric-like adenocarcinoma (MLA) arising in the ovary is a rare malignant tumor of the female genital tract. Although the clinicopathological and molecular characteristics of uterine MLA have been accumulated, those of ovarian MLA have not been firmly clarified. In this study, we investigated the clinicopathological, immunohistochemical, and genetic features of five ovarian MLAs. A review of electronic medical records and pathology slides, immunostaining, and targeted sequencing was performed. On imaging, ovarian MLA presented as either a mixed solid and cystic mass or a purely solid mass. One, three, and one patient were diagnosed as having FIGO stage IA, IC, and II MLA, respectively. Four patients with stage IC–II tumor underwent post-operative adjuvant chemotherapy. Three of the four patients whose follow-up information was available did not experience recurrence. In contrast, the remaining patient with stage IA tumor who did not receive any adjuvant treatment developed multiple metastatic recurrences at post-operative 13 months. Histologically, ovarian MLAs characteristically displayed architectural diversity, compactly aggregated small tubules, and eosinophilic intraluminal secretions. Four tumors were found to be associated with endometriotic cysts. Two cases showed some areas of high-grade nuclear atypia, brisk mitotic activity, and necrosis. Immunohistochemically, all cases showed positive immunoreactivities for at least three of the four examined mesonephric markers (GATA3, PAX2, TTF1, and CD10), lack of WT1 expression, non-diffuse p16 immunoreactivity, and wild-type p53 immunostaining pattern. Targeted sequencing analysis revealed that all four examined cases harbored pathogenic KRAS mutations: p.G12V (2/4); p.G12D (1/4); and p.G12C (1/4). In addition, we reviewed the previous literature reporting 60 cases of ovarian MLA. Our findings corroborate those of the previous data regarding the clinical presentation, histological features, immunophenotypes, and molecular alterations. Our observations should encourage pathologists to recognize and accurately diagnose this rare but distinct entity.

Mesonephric-like Adenocarcinoma of the Uterine Corpus: Comprehensive Analyses of Clinicopathological, Molecular, and Prognostic Characteristics With Retrospective Review of 237 Endometrial Carcinoma Cases.

Uterine mesonephric-like adenocarcinoma (MLA) is a rare malignant tumor of the female genital tract. We reviewed 237 endometrial carcinoma cases and investigated the clinicopathological and molecular characteristics of uterine MLA. We found that 3.0% (7/237) of the endometrial carcinoma cases were MLAs. Compared to endometrial endometrioid carcinoma, MLA showed larger tumor size, deeper myometrial invasion, increasingly advanced-stage disease, and more frequent lymphovascular space invasion. All MLAs exhibited architectural diversity, compactly aggregated small tubules, eosinophilic intraluminal secretions, overlapped and angulated nuclei, scant cytoplasm, and presence of spindle cells. All the MLAs expressed at least two mesonephric markers. All except one MLA harbored activating Kirsten rat sarcoma viral oncogene homolog mutations. All patients with MLA developed postoperative metastases. MLA had the lowest progression-free survival rate among different histological types of endometrial carcinoma. Uterine MLA is a highly aggressive gynecological malignancy, showing unique morphological and molecular features, frequent recurrences and metastases, as well as poor prognosis.

Histological Investigation of Cyclic Variation in Secretory Activity of Seminal Vesicles in Emballonurid Bat, Taphozous kacchensis (Dobson)

The present study describes the cyclical changes in the secretory activity of the seminal vesicle in the emballonurid bat, Taphozous kacchensis. The secretory activity in the seminal vesicles during the quiescence cycle was not well marked in T. kacchensis. During the sexually quiescent period (May to August), seminal vesicles were regressed, the tubules were lined by cuboidal to low columnar epithelial cells with round to elongated darkly stained basally to centrally placed nuclei. Cytoplasm was basophilic containing fine or coarse secretory granules in the cytoplasm. The lumina of the tubules were devoid of secretion. During the pre-breeding (September to January) period, the tubules were enlarged and were lined by tall columnar epithelial cells with large spherical basally situated nucleus. The secretory blebs were seen arising from the apical surface of the cells and were seen releasing into the lumen. Lumina of the tubules were filled with homogenous eosinophilic secretion. During the breeding period (February to March), the seminal vesicle showed hypertrophy resulting in the increase in the tubular diameter as compared to that of quiescent period. The epithelial lining of the tubules was cuboidal with centrally placed nuclei. The tubular lumina were full of homogenous secretion during active pre-breeding and breeding period as the secretory material released into the lumen by both apocrine and merocrine modes. Regressive changes in the seminal vesicle were evident from April. The tubules showed gradual hypotrophy as the quiescent period approaches in May.

Surgical excision of a lactating adenoma with rapid enlargement: A case report.

Introduction and importanceA lactating adenoma is a benign breast tumor occurring in young women during pregnancy or lactation. Its growth is usually slow but, occasionally, can become rapid, resulting in a giant mass. This case report outlines an example of the rapid growth of a lactating adenoma, which was surgically excised. In this case, malignancy could not be ruled out, and biopsy and surgical excision were considered.Case presentationWe present the case of a 28-year-old woman referred to us owing to the presence of a left breast mass with progressive enlargement. She initially presented with a left breast mass of approximately 20-mm in size, which increased to an approximate size of 70 mm during pregnancy. The patient's mammogram showed an equal-density lobular mass in the left breast. Ultrasonography and magnetic resonance imaging revealed a circumscribed lobular mass with cystic regions in the upper lateral quadrant. The patient was diagnosed with adenosis using core needle biopsy. However, it did not shrink during follow-up, and resection was performed. Histologically, the proliferation of the cystic ducts containing eosinophilic secretions and dilated tubules consisting of cuboidal or hobnail-shaped cells were observed.Clinical discussionLactating adenoma, phyllodes tumor, and breast cancer are essential differential diagnoses when the size of breast masses increases rapidly. Ultrasonography is the first choice to examine lactating adenomas. Echogenic bands and pseudocapsules are characteristics of lactating adenomas.ConclusionSurgical excision is a notable treatment option when a lactating adenoma exhibits rapid growth or increase in mass, as it could be malignant.