Nests Of Large Cells Research Articles

Tumor-Stroma Ratio in Basaloid and Conventional Laryngeal Squamous Cell Carcinoma: Prognostic Significance and Concordance in Paired Biopsies and Surgical Samples

Basaloid squamous cell carcinoma (BSCC) is a subtype of squamous cell carcinoma (SCC) associated with a poor prognosis. Tumor-stroma ratio (TSR) has been introduced as a prognostic feature in many solid tumors. TSR was investigated in a series of laryngeal BSCCs and compared with a group of stage-matched conventional SCCs (cSCCs), in both preoperative and surgical specimens, with the intent of ascertaining the more aggressive behavior of BSCC and verifying the presence of stromal-related causes. A series of 14 consecutive laryngeal BSCCs and a control group of 28 stage-matched conventional cSCCs were analyzed. A higher nodal metastasis presence was found in BSCCs (57.1% vs. 28.6%). The recurrence rate was 33.5% and 63.6% in the cSCC and BSCC groups; disease-free survival (DFS) was higher, though not significantly, in patients with cSCC. TSR, large cell nests, and tumor budding showed a moderate to very good agreement, and stroma type a good to very good agreement between biopsies and surgical specimens in the cSCC group. In the BSCC group, agreement was poor to very good for TSR and stroma type, and good to very good for large cell nests and tumor budding. Age was the only feature significant in predicting recurrence in the BSCC group (p = 0.0235). In cSCC, TSR low/stroma rich cases, when evaluated on biopsies or surgical specimens, were associated with lower DFS (p = 0.0036; p = 0.0041, respectively). Laryngeal BSCCs showed a lower DFS than cSCCs, even if statistical significance was not reached. TSR, evaluated in laryngeal biopsies and excised tumors, was prognostic in terms of DFS in cSCC but not in BSCC cases.

Primary Alveolar Soft Part Sarcoma Arising in the Thyroid Gland: A Rare Case Report

Background Alveolar soft part sarcoma (ASPS) is a rare aggressive soft tissue sarcoma usually involving the soft tissue of thigh and buttock region in adults. In children, head and neck presentation is more common, with orbit and tongue being the preferred sites. Alveolar soft part sarcoma primarily arising in the thyroid gland is an extremely rare clinical entity, with only two other cases being reported in the literature to date. Case A 16-year-old boy presented with respiratory distress and enlarged thyroid gland. Hemithyroidectomy revealed well-circumscribed nests of large cells with abundant eosinophilic cytoplasm arranged in a pseudoalveolar pattern and separated by fibrous septa containing sinusoidal blood vessels. The tumor cells showed nuclear positivity for TFE3 protein and the TFE3 gene rearrangement in 79% of the nuclei. The patient's most recent chest computed tomography revealed multiple subcentimeter nodules occupying the lung bases emphasizing the aggressiveness of the disease process and the need for constant surveillance.

Basal Ganglia Intracranial Mixed Germ Cell Tumor With Predominance of Yolk Sac Component

Abstract Introduction/Objective Primary intracranial germ cell tumors (ICGCTs) represent a rare heterogenous group of neoplasms with an overall incidence of 3% of all pediatric brain tumors. ICGCTs are classified into germinomatous and non-germinomatous tumors and approximately 25% are mixed, and contain more than one histologic component. Most ICGCTs are located in suprasellar and pineal regions with some occurring in rare locations such as basal ganglia, thalamus and fourth ventricle. Methods In our case, A 9-year-old Asian-American male presented with headaches and a few weeks history of unilateral weakness. Imaging showed a left basal ganglia lesion with midline shift. Serum AFP was elevated at 17,974.5ng/ml. Results Histology revealed a biphasic tumor with a predominant yolk-sac component composed of sheets of pleomorphic cells with prominent nucleoli, focally arranged in a reticular pattern with hyaline globules, increased mitoses and foci of necrosis. A lesser component display features of germinoma, in the form of sheets and nests of large cells with clear vacuolated cytoplasm separated by fibrous septa with lymphocytic infiltrates. Tumor cells in yolk sac component were positive for AFP, while PLAP, CD117, D240 stained germinoma component. After receiving 6 courses of chemotherapy and radiation, MRI did not show any evidence of residual disease. Conclusion Pathogenesis of ICGCT is thought to be either from primordial germ cells that have migrated aberrantly during embryonic development or from pluripotent embryonic cells that have been entrapped into lateral mesoderm due to misfolding and misplacement and then undergo malignant transformation. The outcomes of ICGCTs differ among histological subtypes. Highest survival rates are seen in patients with germinomas or mature teratomas (10- year survival rate >90% in both groups. The lowest survival rates are seen in choriocarcinoma, embryonal carcinoma and yolk sac tumor.

Platelet-derived growth factor-A and vascular endothelial growth factor-C contribute to the development of pulmonary tumor thrombotic microangiopathy in gastric cancer

Pulmonary tumor thrombotic microangiopathy is a rare but lethal complication in cancer-bearing patients, particularly those with gastric cancer. It is characterized by cancer cell emboli with marked intimal proliferation. In the present study, we tried to elucidate the pathogenesis of pulmonary tumor thrombotic microangiopathy, notably angiogenic factors specific for cancer cells lodged in pulmonary arteries. An autopsy series of gastric cancer (51 cases) was reviewed for pulmonary tumor thrombotic microangiopathy and pulmonary tumor cell emboli without intimal proliferation. Pathological and immunohistochemical characteristics were compared between two groups. In eight cases in muscular pulmonary arteries, tumor thrombotic microangiopathy was noted, and in three cases pulmonary tumor emboli without intimal proliferation was noted. Histological features of pulmonary tumor thrombotic microangiopathy included small nests or single cancer cells accompanied by intimal proliferation, whereas in pulmonary tumor emboli large cell nests prevailed. By immunohistochemistry, in pulmonary tumor thrombotic microangiopathy, cancer cells expressed platelet-derived growth factor-A (7/8 cases) and vascular endothelial growth factor-C (8/8) more frequently than in pulmonary tumor emboli (0/3 and 1/3; P = 0.02 and P = 0.055, respectively). Expression of tissue factor, vascular endothelial growth factor-A and -D, osteopontin, fibroblast growth factor-2, and platelet-derived growth factor-B was similar in both groups. Platelet-derived growth factor-A and vascular endothelial growth factor-C might induce intimal proliferation in pulmonary arteries and contribute to the development of pulmonary tumor thrombotic microangiopathy.

33 YEAR‐OLD WOMAN WITH A LARGE SELLAR TUMOR

The authors describe a case of paraganglioma of the sellar region in a young female patient with loss of vision and headache. She presented with amaurosis, depression, anxiety and amenorrhea. Clinical and radiological impression was that it was a meningioma or pituitary adenoma. She received bromocriptine with no reduction of the lesion. She developed panhypopituitarism, but with normal levels of prolactin. It was resected and histological examination revealed nests of large cells with moderate nuclear pleomorphism, vesicular nuclei with occasional nucleoli. There were rare mitotic figures, but no necrosis. Immunohistochemistry was positive for synaptophysin, chromogranin A, and neuron-specific enolase with a few sustentacular cells positive for S100. The Ki67 proliferation was 1-2%. All pituitary hormonal antibodies were negative as well as GFAP, AE1/AE3, p53 and EMA. Paragangliomas affecting the sellar region are extremely rare and might be due to the presence of remnants of paraganglionic tissue or abnormal migration. The patient's post-operative diabetes insipidus remains under medical control.

EBV+ diffuse large B-cell lymphoma arising within atrial myxoma. An example of a distinct primary cardiac EBV+ DLBCL of immunocompetent patients

Cardiac myxoma and diffuse large B-cell lymphoma are uncommon tumors, yet four composite tumors have been reported since 2009. We are reporting on the fifth case providing detailed immunohistochemical and FISH analyses. The lymphoma was present as superficially located nests of large cells with patchy necrosis in the background of a typical atrial myxoma. It displayed features of DLBCL with non-germinal center phenotype, expressed EBER, LMP1, EBNA2 and shared the following features with the previously reported cases: B-cell lineage, high-grade cytology, high proliferation rate, EBV infection in latency type 3 with one tested case and an excellent outcome. The lymphomas arising within myxoma may follow a pathogenic pathway driven by EBV, whose transformation potential is unleashed in the cytokine-rich milieu of a myxoma, presumably accentuating age-related decline of adaptive immunity known as immune senescence. DLBCL arising within atrial myxoma grouped together with EBV+ DLBCL associated with valve prosthesis and with an atrial thrombus differs in the immunocompetent patients from primary cardiac DLBCL, not otherwise specified, in clinical presentation, pathological features and a course of the disease. Distinction between these groups may have important therapeutic consequences.

Nesting interactions of the social wasp Dolichovespula saxonica [F.] (Hymenoptera: Vespinae) in wooden nest boxes for birds in the forest reserve „Las Piwnicki” in the Chełmno Land (Northern Poland)

The aim of this research was to investigate the process of colonization in wooden nest boxes for birds by the wasp Dolichovespula saxonica [F.] in the forest reserve “Las Piwnicki” during 1986-1987. About 69% of 150 nest boxes were colonized (36% by D. saxonica) in 1986 and 35% (10% by D. saxonica) in 1987. Parasite Shecophaga vesparum Court was observed inside small cell nests (SC) and large cell nests (LC) in the ratio of 5(SC) : 3(LC). During the two seasons, the decrease in the number of parasited nests followed with the ratio of 10(1986) : 1(1987). Competition of the „wasp - wasp” type (VV) compared to other competition types, such as „wasp - bird” (VA) and different types with wasps (DT), was the most frequent one among the interactions and followed with the ratio 1(VV) : 7(VA) : 5(DT). The number and proportions of construction types of nests during the studied growing seasons seem to prove the regular and irregular development of the Dolichovespula saxonica colony.

Prognostic indicators of malignancy in adrenal pheochromocytomas: clinical, histopathologic, and cell cycle/apoptosis gene expression analysis

Pheochromocytomas are malignant in approximately 10% of patients. The histologic differentiation between benign and malignant tumors is difficult, the latter diagnosed by the presence of metastatic disease or recurrence. To determine if postoperative histologic evaluation using the previously proposed Pheochromocytoma of the Adrenal Gland Scaled Score (PASS) and cell cycle/apoptosis markers can predict patients at risk for recurrence. Using the Memorial Sloan-Kettering Cancer Center adrenal database, we identified 48 patients with 51 resected pheochromocytomas (1987-2006). A senior endocrine pathologist, blinded to clinical outcome, reviewed the histopathologic characteristics of all cases using the PASS system. This pheochromocytoma scoring system is based on the presence of 12 different histologic parameters, including tumor necrosis, mitotic rate, tumor cell spindling, and the presence of large cell nests. In addition, we constructed a tissue microarray of all 5 malignant tumors and 41 of the benign tumors. By immunostaining of the tissue microarray, we assessed the expression of 7 different cell cycle/apoptosis-related genes (p53, Ki-67, Bcl-2, mdm-2, cyclin D1, p21, and p27). Forty-three patients had a benign clinical course while 5 patients harbored a clinically malignant pheochromocytoma. Tumor necrosis (focal or confluent) was a particularly powerful indicator of malignancy present in 4 of 5 patients (80%) with malignant tumors, but only in 3 of 42 cases (7%) with benign neoplasms (P = .0009). The presence of a high mitotic rate (>3/10 high power fields) and tumor cell spindling significantly correlated with malignancy (P = .026 and .041, respectively). High cellularity was more often present in the malignant lesions (P = .050). There was a highly significant difference in PASS scores between benign and malignant cases (P = .0003). All malignant pheochromocytomas had a PASS score >/=6, well above the previously proposed >/=4 cutoff value. Two of the 4 patients testing positive for Ki-67 (>2% nuclear staining) had a clinically malignant course while only 3 (7%) of the 41 cases with lower Ki-67 positivity rate behaved in a malignant fashion (P = .055). Ki-67-positive tumor had a significantly higher chance of harboring tumor necrosis than Ki-67-negative neoplasms (P < .01). There was no difference in staining between benign and malignant pheochromocytomas using p53, Bcl-2, mdm-2, cyclin D1, p21, and p27. (1) A PASS score of <4 predicted benign pheochromocytomas. (2) All malignant pheochromocytomas had a PASS score >/=6, which was significantly higher compared with the benign lesions. Patients with a PASS score >/=4 should be followed closely for recurrence. (3) p53, Bcl-2, mdm-2, cyclin D1, p21, and p27 appear to have no role in predicting the behavior of pheochromocytomas. Ki-67 may help identify those neoplasms at risk for recurrence by prompting the pathologist to look aggressively for adverse histologic features.

Evidence for Sympodial Vascular Architecture in a Filicalean Fern Rhizome: Dickwhitea allenbyensis gen. et sp. nov. (Athyriaceae)

A new genus and species of anatomically preserved fossil filicalean ferns Dickwhitea allenbyensis gen. et sp. nov. is described from the Middle Eocene Princeton Chert of southern British Columbia, Canada. Rhizomes have a parenchymatous pith surrounded by a ring of five amphiphloic cauline bundles and pairs of frond traces that diverge from adjacent cauline bundles in a 2/5 phyllotaxis. The cortex is also parenchymatous except at the periphery, where there is a well‐developed sclerotic hypodermis. The stipe is characterized by a pair of hippocampiform bundles, and ground tissues are similar to those of the rhizome. Prominent nests of large cells with black contents occur adjacent to the vascular bundles in the ground tissue of the rhizome and stipe. Roots are diarch with cortex that grades from parenchymatous at the interior to sclerotic at the periphery. The vascular architecture of this fern appears to be novel among known Filicales. There are no gaps in the stele that result from the divergence of either frond or root traces, and there is no evidence that cauline bundles anastomose. Rather, the cauline bundles extend through the rhizome independently of each other, with each cauline bundle producing successive frond traces on alternating tangents. Root traces diverge from the outer surface of cauline bundles as is characteristic of solenostelic filicalean species and dictyostelic tree ferns. Examination of the literature reveals that there is a wide range of variation in filicalean vascular architectures that traditionally has not been recognized. Although there is anecdotal evidence that this newly recognized stelar variation is correlated with patterns of systematic diversity, the overall phylogenetic significance of fern vascular architecture has yet to be fully explored.

Evidence for an origin of ethyl-nitrosourea-induced rat central nervous system tumors from pluripotent germinal neuroepithelium.

Brain tumors induced by transplacental application of ethyl-nitrosourea (ENU) in F344 rats were immunohistochemically demonstrated to consist of undifferentiated cells, astriocyte-like cells, oligodendroglia-like cells, and two distinct types of vimentin-expressing cell groupings termed as perivascular small cell nests (PSCNs) and large cell nests (LCNs). Co-distribution of vimentin and glial fibrillary acidic protein (GFAP) was sparsely observed in the astrocyte-like cells, which suggested an immature glial phenotype. PCSNs contained cells expressing GFAP, neuron-specific enolase (NSE), beta-tubulin isotype III, and low-affinity nerve growth factor receptors (LNGFRs). LCNs contained cells showing a neuronal phenotype with expression of low- and middle-molecular mass neurofilament proteins (NF-L and -M) as well as NSE, beta-tubulin isotype III and LNGFR. Double-labelling immunohistochemistry revealed the NF-L-expression in LNGFR-positive LCN-forming cells. Oligodendroglia-like cells and their intercellular neuropil-like structures expressed beta-tubulin isotype III, synaptophysin and NSE, in addition to the expressions of vimentin and GFAP. Electron microscopically, synapse-like structures were formed between these oligodendroglia-like cells and their dendritic processes. Topographically, bidirectional cell transitions from PSCNs to astrocytes and LCNs were indicated. The present study strongly suggests that so-called ENU-induced "gliomas" originate from pluripotent germinal neuroepithelium. Furthermore, LNGFR expression may be responsible for acquisition of neuronal phenotype in these tumors.

Alveolar soft-part sarcoma.

Alveolar soft-part sarcoma is a slow-growing but nevertheless malignant soft tissue tumour arising in muscle. It occurs most frequently in young women and often presents as a painless swelling in an upper or lower limb. The swelling, which may have been present for a considerable time, is firm and appears to be well circumscribed but it may recur locally after excision. Blood-borne metastases to the lung are common and this is frequently the mode of presentation. Lymphatic metastases are unusual. The tumour is composed of nests of large cells and the histological appearances may resemble those of a renal adenocarcinoma (hypernephroma). Six new cases of this very rare tumour are presented and the published reports are reviewed.

Arthropathy induced by antibacterial fused N-alkyl-4-pyridone-3-carboxylic acids

The antibacterial agents, nalidixic, oxolinic and pipemidic acids, induced lameness, associated with exudation of synovial fluid and blistering and ulcerative erosion of articular cartilage, in the joints of the limbs of immature, but not mature, dogs when administered daily, for periods of 1–15 days, at dose rates of 200–1000 mg/kg. Clinical recovery usually occurred within 14–21 days, even with continued medication, but the lesions had not resolved in animals autopsied up to 87 days after withdrawal of the drug. The lesions were also present at autopsy m immature dogs which had received pipemidic acid daily for 6 months, in spite of the fact that the animals had been clinically normal for all except the first 4 or 5 weeks of the study. Microscopical examination showed that fissuring occurred in the intermediate, germinal, zone of cartilage. Hypertrophy of chondrocytes was a common finding, with some large cell nests and multinucleate cells. In a few cases, some disorganisation of epiphyseal plates was seen.

Changes in the Anterior Pituitary Gland of Rats With Experimental Goiter. II

In a previous communication1 cellular changes in the anterior lobe of the pituitary gland of rats reared on a goitrogenic diet2 were described. In male rats fed for 3 to 12 months on the Steenbock and Black diet3 supplemented by viosterol, nests of large cells were seen in the anterior lobe of pituitary glands fixed in Bouin solution and stained with hematoxylin-eosin. We report now the results of histologic examinations of pituitaries which had been fixed in Regaud solution and were stained with methods which permit the identification of granules as well as that of other elements contained in the cytoplasm of the abnormal cells. During life the rats had been treated for 4 to 12 months in the same way and fed the same diet as the animals described before.On sections of pituitaries fixed with Regaud solution and stained with hematoxylin and eosin, groups of large cells can be recognized with the low power objective of the microscope; the picture resembles that of pituitaries fixed with Bouin solution. With...

MULTIPLE PIGMENTED NEVI

Masson's1theory that many if not all of the cellular and pigmented nevi have their origin in the peripheral neuroglia or Schwann cells has been receiving increasingly wide acceptance in recent years.2In his original paper on the subject Masson1reaffirmed Soldan's dictum that pigmented nevi were neuromas of the epidermal and dermal portions of the tactile nerves. An illustration accompanying that paper showed a phenomenon common to both Masson's and Unna's theories of the histogenesis of these lesions, that is, the process Unna3had previously designated asAbtropfung, which consisted of the extrusion from the epidermis into the corium of spheroidal nests of large cells with pale-staining cytoplasm. Unna called these altered basal cells; Masson expressed the belief that they were altered cells of the sheath of Schwann. In their earlier stages of differentiation Masson designated themcellules claires, and he and others2have