Tubulopapillary Adenocarcinoma Research Articles

Immunoexpression of E-cadherin, CD44 and Claudin 7 in gastric adenocarcinomas.

Gastric adenocarcinomas represent frequent malignant tumors in the digestive tract, with a high and constant mortality rate in last decades. The disturbance of the adhesion molecules expression, which normally is essential in maintaining epithelial homeostasis, has a critical role in the initiation and progression of tumors. In this study, we analyzed the immunoexpression of E-cadherin, cluster of differentiation 44 (CD44), and Claudin 7 in 58 cases of gastric adenocarcinomas, in relation to the histopathological parameters of the lesions' aggressiveness. Increased E-cadherin immunoexpression was observed in tubular adenocarcinomas, those of low grade and in stages I-III. CD44 presented high scores in discohesive, hepatoid, tubular, and tubulopapillary adenocarcinomas, those of high grade and in advanced stages. Claudin 7 associated increased scores for tubular, tubulopapillary and micropapillary tumors, those of low grade and mainly in stage I. The markers used in the study can be useful for assessing the aggressiveness of gastric adenocarcinomas, in the context of specific adapted therapy.

ФИЗИОЛОГИЯ И ПАТОЛОГИЯ МИТОЗА ПРИ ИЗУЧЕНИИ КИНЕТИЧЕСКИХ ПОКАЗАТЕЛЕЙ РОСТА НОВООБРАЗОВАНИЙ ЭПИТЕЛИАЛЬНОГО ПРОИСХОЖДЕНИЯ

This article presents results of a study of proliferative activity of moderately differentiated tubulopapillary adenocarcinoma in the mammary gland of cats. The studies were carried out on the basis of Interdepartment Scientific Center of Veterinary Medicine of Ulyanovsk State Agrarian University. Pathological material was obtained by excisional biopsy in accordance with the rules for taking biomaterial for histological studies. The biopsy material was freed from formalin by rinsing in tap water for 12 ... 24 hours. Slices of 20 ... 30 µm thick were obtained using a freezing microtome MZ-2. The preparations were stained with hematoxylin and eosin according to the standard technique. The parameter of mitotic activity of tumor tissue, the mitotic index, was calculated as the number of mitoses per 1000 cells of the tumor parenchyma, measured in the areas with the highest proliferative activity of the neoplasm on the periphery of the tumor node. Cell nuclei in a state of physiological rest, as well as at the stages of mitosis and apoptosis, clearly visible on photographs of the microscope visual fields, were marked in a graphic editor and counted using the ImageJ program. Based on the data of histological diagnostics of biopsy material slices, such kinetic parameters of tumor growth as mitotic activity were studied - the mitotic index, the number of mitoses in the field of view, the proportion and types of pathologies of cell division, and the cell loss factor, numerically measured in the form of the apoptotic index were calculated. Based on the obtained data, a characteristic was given of the growth rate and invasiveness of this neoplasm of epithelial origin, as well as a prognosis of metastatic activity, the risk of recurrence and the likelihood of complete morphological regression of tumor tissue after radiation and chemotherapy.

Sinonazal Tümörlerden Düşük Dereceli Tübülopapiller Adenokarsinomu: Tanı ve Takip

Low grade tubulopapillary adenocarcinoma is one of the rare sinonasal tumors. A 65-year-old male patient was admitted to our clinic with painless intraoral and extraoral swelling and speech disorder. Radiological examination of the patient revealed a lesion suggesting malignancy. The area of the lesion spread from the left maxillary area to the maxillary sinus, nasal cavity, zygomatic bone and the base of the eye, causing resorption of the bones in the regions. As a result of biopsy, the lesion was diagnosed as well-differentiated low-grade tubulopapillary adenocarcinoma. The patient was referred to the oncology department of the medical faculty and the radiotherapy was started by the medical faculty board, indicating that it was not suitable for surgical treatment. After 1.5-year follow-up, the patient was re-biopsied and diagnosed as poorly differentiated tubulopapillary adenocarcinoma. We think that the aggressive lesion may show heterogeneous differentiation as a possible reason for the differentiation between the two biopsies.

A histopathological study on spontaneous gastrointestinal epithelial tumors in dogs.

The present study evaluated the histopathological features, biological nature, anatomical location, sex, age and breeds of dogs affected by spontaneous gastrointestinal epithelial tumor. Biopsy samples of gastrointestinal tumors, from 95 dogs were examined and classified according to the WHO histological classification. A total of 131 samples, including 38 gastric, 13 small intestinal, and 80 large intestinal tumors were examined. The study observed that Jack Russell Terriers and Miniature Dachshunds were the breeds with the highest predisposition for gastrointestinal tumors. Gastric tumors included 5 adenomas, 30 adenocarcinomas (12 tubular, 2 papillary, 4 tubulopapillary and 12 signet-ring cell carcinomas) and 3 undifferentiated carcinomas. Intestinal tumors included 35 adenomas, 57 adenocarcinomas (43 acinar, 4 papillary, 7 mucinous and 3 signet-ring cell carcinomas), and 1 undifferentiated carcinoma. The study did not detect any difference among the incidence rates of invasion/metastasis in the tubular (44%), papillary (33%) and tubulopapillary (25%) adenocarcinomas. Additionally, the tubular (acinar), papillary and tubulopapillary adenocarcinomas were further divided into 48 polypoid and 17 non-polypoid types, based on their growth patterns. Invasion/metastasis was detected in 21% of the polypoid type and 100% of the non-polypoid type of adenocarcinomas. A correlation was detected between the occurrence of invasion/metastasis and the type of histopathological growth pattern in adenocarcinomas. The study demonstrated that Jack Russell terriers and Miniature Dachshunds are the most common breeds affected by gastrointestinal tumors and the entire group of the canine adenocarcinomas with non-polypoid growth pattern has greater malignant potentials, compared to the adenocarcinomas with polypoid growth patterns.

Immunohistochemical and genetic analysis of respiratory epithelial adenomatoid hamartomas and seromucinous hamartomas: are they precursor lesions to sinonasal low-grade tubulopapillary adenocarcinomas?

Respiratory epithelial adenomatoid hamartoma (REAH) and seromucinous hamartoma (SH) are rare tumor-like lesions of the nasal cavity, paranasal sinuses, and nasopharynx. The pathogenesis of REAH/SH is still unclear. Neoplastic proliferation, chronic mechanical irritation, inflammation, or possible embryological tissue misplacement are speculated as possible mechanisms of their development. Low-grade tubulopapillary adenocarcinoma (LGTA) is a rare variant of nonsalivary, nonintestinal type sinonasal adenocarcinoma. The aim of this study was to evaluate the immunohistochemical and genetic profiles of 10 cases of REAH/SH, with serous, mucinous, and respiratory components evaluated separately and to compare these findings with the features of 9 cases of LGTA. All cases of REAH/SH and LGTA were analyzed immunohistochemically with a cocktail of mucin antigens (MUC1, MUC2, MUC4, MUC5AC, MUC6) and with epithelial (CK7, CK20, CDX2, SATB2) and myoepithelial markers (S100 protein, p63, SOX10). The next-generation sequencing assay was performed using FusionPlex Solid Tumor Kit (ArcherDx) in 10 cases of REAH/SH, and the EGFR-ZNF267 gene fusion was detected in 1 of them. Two female REAH/SH cases were assessed for the presence of clonality. Using the human androgen receptor assay, 1 case was proved to be clonal. The serous component of REAH/SH was positive for CK7/MUC1 and SOX10 similarly to LGTA. Although REAH/SH and LGTA are histopathologically and clinically separate entities, the overlap in their morphological and immunohistochemical profiles suggests that REAH/SH might be a precursor lesion of LGTA.

Tubulopapillary rectal adenocarcinoma in dog: clinical, surgical, pathological and immunophenotypical aspects: case report

ABSTRACT Intestinal carcinomas are rare in dogs. The prognosis and survival time are dependent of the histological type, the invasion of the intestinal wall by the malignant cells and the ability of primary neoplasm to produce metastasis. This study reports a case of a Yorkshire dog that developed a rectal tubulopapillary adenocarcinoma progressing to a peritoneal carcinomatosis and multiple metastasis in large intestines, bladder, kidney, iliac lymph node, liver and lungs, six months after transanal surgical resection of the primary rectal neoplasm. Clinical, surgical, pathological and immunophenotypic findings are described. COX-2 imunohistochemical score was higher in hepatic metastasis (score 9) than in the primary tumour (score 6), and the growth fraction (Ki-67) observed was of 49.2% in the rectal neoplasm.

Carcinocythemia: First report in a cat and literature review

A 6-year-old female neutered European Shorthair cat was presented with a 2-day history of lethargy and hyporexia. On physical examination, the cat was slightly depressed and had a 2.5 cm nodule in the left 3rd mammary gland. The hemogram revealed mild leukocytosis with mature neutrophilia and moderate thrombocytopenia. On blood smear evaluation, rare pleomorphic cells, possibly of epithelial origin, were observed mainly at the feathered edge. The animal died about 12 hours after presentation, and a necropsy was performed. On histopathology, the mammary nodule was diagnosed as a tubulopapillary adenocarcinoma with vascular invasion and widespread metastases. Immunocytochemical tests for cytokeratins (AE1/AE3) confirmed the epithelial phenotype of the neoplastic cells observed on the blood smear. The present report describes a feline mammary carcinoma with widespread metastases and the presence of malignant epithelial cells in the peripheral blood referred to as carcinocythemia. This condition has been previously described in people and dogs. To the author's knowledge, this is the first reported case of feline carcinocythemia. As in other species, the phenomenon was associated with a terminal phase of systemic malignancy.

Lung adenocarcinoma with thyroid metastasis: a case report

BackgroundThe metastases of a primary lung cancer over the thyroid gland are extremely rare. We report on an unusual presentation of thyroid metastasis of lung cancer in order to improve the management of similar cases.Case presentationThree years ago, a Moroccan male 59-year-old was admitted for dyspnea, dry cough, and chest pain. He had smoked about 30 cigarette packs a year. Clinical examination revealed a right thyroid nodule. Chest and neck computed tomography (CT) scan showed a proximal left tumor in contact with the pulmonary artery and revealed a suspected nodule in the right lobe of the thyroid with homolateral neck node. Transbronchial biopsy was performed and pathological examination revealed adenocarcinoma of the lung and positive for thyroid transcription factor. Other explorations carried out, such as brain CT, bone scan and abdominal ultrasound were normal. After a repeated negative fine needle aspiration biopsy of the suspected nodule of the right lobe of the thyroid, we performed total thyroidectomy with neck dissection. An anatomopathologic exam revealed a tubulopapillary adenocarcinoma poorly differentiated. An Immunohistochemistry showed positive tumor cells with TTF1 and cytokeratin (CK) 7 but negative cells with thyroglobulin and CK20. Thus, the pulmonary tumor was classified stage IV. Chemotherapy based on the combination of cisplatin and etoposide was conducted along with supportive care. The tumor grew up with brain metastases after three cycles of chemotherapy. Unfortunately, the patient died 2 months after despite brain radiotherapy.ConclusionWe presented a medical case of a patient with thyroid metastasis resulting from a pulmonary adenocarcinoma which has rapidly evolved to brain metastases. The prognosis was pejorative in our clinical case (5 months after admission).

An unusual case of low-grade tubulopapillary adenocarcinoma of the sinonasal tract

BackgroundLow-grade papillary adenocarcinomas of the sinonasal tract are rare neoplasms. Over recent years, little doubt remains that this tumour represents a separate entity based on morphology, ultrastructural features and behaviour. We outline a case of this rare entity displaying a not hitherto described immunophenotype.Case presentationA 32 year old man presented recurrent epistaxis was evaluated with endoscopy which revealed a well circumscribed pedunculated mass lesion in left nares. The mass was arising from the nasal septum which was excised along with the mass. The biopsy revealed low-grade, non-intestinal type sinonasal tubulopapillary adenocarcinoma.ConclusionTTF-1 immunoreactivity in absence of thyroid or pulmonary primary in the present case remains an enigma. However, this raises the possibility of the utility of this antibody to predict a better clinical outcome in the subset of low grade non-intestinal sinonasal adenocarcinoma. More cases of similar morphological appearance may need to be examined for TTF-1 immunoreactivity and clinically followed up to establish this theory.

Mammary adenocarcinoma in a mare

A non-lactating 17-year-old grey barren Mangalarga Marchador mare was referred to the Large Animal Veterinary Hospital of the Federal Rural University of Rio de Janeiro (UFRRJ), presenting enlargement of the mammary gland. The owner reported that the animal had a lesion in the mammary gland for at least two years, diagnosed and treated as chronic mastitis. Initially only the right gland was involved, presenting ulceration and exudation on the cutaneous surface. After 20 months, the left gland also became affected. The diagnosis of tubulo-papillary adenocarcinoma was based on the typical microscopic lesions. This work shows the importance of the histopathological examination in the differential diagnosis between the neoplasms and the chronic inflammation in the mammary gland of mares, as well as, to show that the cytological examination cannot detect the tumor, in case the puncture is made in areas of secondary infection.

Clinocopathologic and Immunohistochemical Findings of Multiple Genital Leiomyomas and Mammary Adenocarcinomas in a Bitch

A 13-year-old female Pointer dog was presented for evaluation of mammary tumours and bloody vaginal discharge at the Veterinary Teaching Hospital of Mehmet Akif Ersoy University, Faculty of Veterinary Medicine. On the history, owner complained of mammary tumours and bloody vaginal discharge. Three mammary tumours and lymphadenopathy at the mammary lymph nodes were observed at the clinical examination. A big, firm, palpable mass was found in the abdominal cavity. Vaginal cytology revealed numerous pleomorphic and anaplastic cells. Abdominal ultrasonography demonstrated a large mid-abdominal mass at the distal part of the left uterine horn. Also multiple masses in the cervix and vagina were found. Because of the poor prognosis and the desire of the owner, the bitch was killed. At the necropsy numerous masses were seen at the vagina and cervix and one big mass seen at the left cornu uteri. Histopathological diagnosis was leiomyoma. Multiple metastases of mammary tumours were seen at the lungs. Histopathologically, mammary tumours were diagnosed as complex type tubulopapillary adenocarcinoma. The objectives of this study were to measure the proliferation indices in canine complex type mammary adenocarcinoma and genital leiomyomas using immunohistochemical detection of Ki-67 and proliferating cell nuclear antigen to determine the relationship of these antigens to clinical and pathologic variables; and to examine the immunoreactivity of these tumours with different markers. Pan-cytokeratin and S100 were negative, desmin and glial fibriler acidic protein were slight positive and the other markers (carsinoembryogenic antigen, proliferating cell nuclear antigen, vimentin, smooth muscle actin, p53, fibronectin, Ki67) were found strong positive at the genital tumours. Only desmin were negative; the other markers were strong positive at the mammary tumours.

Invasive biliary cystic tumor without ovarian‐like stroma

Presented herein is a rare case of invasive biliary cystic tumor without an ovarian-like stroma, and the apparent sequence underlying its malignant transformation, which was identified on detailed histological examination. A 54-year-old woman was incidentally diagnosed as having a cystic tumor in segment VIII of the liver, and central bisegmentectomy was performed. Macroscopically the tumor measured 4.6 x 3.5 cm; and unilocular cystic and solid areas were seen on cut surface. Microscopically the tumor showed three types of neoplasia: adenoma and tubulopapillary adenocarcinoma in the cystic area, and invasive adenocarcinoma in the solid area. The relative area of the tumor occupied by each of these histological types was approximately 3%, 50% and 47%, respectively. Moreover, transitional zones between adenoma and tubulopapillary adenocarcinoma, and between tubulopapillary adenocarcinoma and invasive adenocarcinoma were noted. The immunohistochemical expression of Ki-67 and p53 increased gradually from adenoma through to tubulopapillary adenocarcinoma, and was highest in invasive adenocarcinoma. MUC1 was positive, and MUC2 and MUC5AC were both negative. No ovarian-like stroma or communication with the bile ducts around the tumor was found in any area of the specimen. On the basis of the World Health Organization histological classification and these pathological findings, the present case was diagnosed as invasive-type biliary cystadenocarcinoma.

Adenocarcinoma of Apocrine Sweat Glands in a Mouflon (Ovis Musimon)

A free-living mouflon (Ovis musimon) was presented with a mass on the left shoulder. At necropsy, multifocal, slightly protruding whitish spots were noted on the kidneys, and several lymph nodes were abnormal. Histologically, the mass was composed of epithelial cells arranged in tubular and tubulopapillary structures. The cytoplasm of the epithelial cells had numerous periodic acid-Schiff-positive and diastase-resistant granules. Ultrastructurally, the cytoplasm of the neoplastic cells contained numerous pleomorphic secretory granules and microvilli, which partially covered the luminal surface of the tumor cells. Metastatic foci were present in prescapular and mediastinal lymph nodes and kidneys. On the basis of histological and ultrastructural findings, this tumor was diagnosed as a tubulopapillary adenocarcinoma, arising from apocrine sweat glands of the skin.

Metastatic Adenocarcinoma of the Gingiva after Metachronous Primary Tumours

This report is of an 82-year-old woman with a mass on the mandibular gingiva, elevated serum carcinoembryonic antigen, and a history of metachronous primary tumours of the endometrium and stomach. The histological diagnosis was tubulopapillary adenocarcinoma and the pathological features were similar to those of the gastric tumour Consequently, the gingival mass was diagnosed as a metastatic gastric adenocarcinoma.

Adenocarcinoma of the Epididymis

Primary epididymal carcinoma is extremely rare and has been the subject of only sporadic case reports; the validity of some of the reported tumors is questionable. We report our experience with four examples, which arose in men 27, 66, 77, and 81 years of age. All of them presented with scrotal masses; three of them had small hydroceles. None had a history of von Hippel-Lindau disease. Grossly, all of the tumors were centered in the epididymis and two were confined to it. One tumor invaded the periepididymal soft tissue and spermatic cord and the fourth invaded the adjacent testis. They were 2.0-7.0 cm in greatest diameter; three had foci of hemorrhage and necrosis. Microscopically, all of the tumors were adenocarcinomas. Two of them were composed of approximately equal numbers of simple tubules and more complex tubulopapillary formations lined by cuboidal or columnar predominantly clear cells that infiltrated the epididymal smooth muscle wall, periepididymal soft tissue, or both. The other two had large cysts into which grew complex papillary or confluent, back-to-back glands lined by columnar cells with clear, lightly amphophilic or eosinophilic cytoplasm. Necrosis was present in three cases. An undifferentiated, sheetlike growth of anaplastic tumor cells was present focally in one case. Cilia were absent. Small amounts of cytoplasmic glycogen were present in the two cases in which periodic acid-Schiff staining was performed. Immunohistochemical staining, performed in one case, demonstrated strong positivity for cytokeratins (AE1/3, Cam 5.2) and epithelial membrane antigen (luminal only). Results of staining for carcinoembryonic antigen, Leu M1, B72.3, and Ber-EP4 were negative. Ultrastructural analysis, performed in one case, showed well-developed desmosomal junctions, cytoplasmic multivesicular bodies, glycogen particles, and well-developed cilia. Two of three patients with follow-up data died of disease 8 months and 2.5 years after diagnosis; the third was disease free 30 years after the diagnosis despite having paraaortic lymph node metastases at the time of presentation. After reviewing the literature and analyzing our cases, we conclude that bona fide examples of epididymal adenocarcinoma are usually tubular, tubulocystic, or tubulopapillary adenocarcinomas, often with an appreciable content of clear cells, which can usually be readily separated from other paratesticular malignant tumors, such as malignant mesothelioma and carcinomas of the müllerian type. Distinction from metastasis may be difficult and may depend largely on careful clinical evaluation.

Laparoscopic Diagnosis of Peritoneal Serous Papillary Carcinoma

Peritoneal serous papillary carcinoma is a rare primary tumor of the peritoneum. We report here a case diagnosed by laparoscopy, and summarize the clinicopathological features previously reported in patients with this tumor. Laparoscopy was performed in a 66-year-old woman with high-protein ascites and a three-month history of lower abdominal pain. Macroscopically, the parietal and visceral peritoneum was studded with prominent white nodules up to 5 mm in diameter. Multiple biopsies revealed a tubulopapillary serous adenocarcinoma. After exclusion of metastatic peritoneal carcinomatosis (especially ovarian cancer) and malignant mesothelioma, the diagnosis of peritoneal serous papillary carcinoma was established. The patient was placed on chemotherapy (first-line: 5-fluorouracil, adriamycin, and mitomycin C; second-line: paclitaxel). She died 22 months after diagnosis. The present case is also remarkable for the coexistence of granulomatous peritonitis overshadowing the malignant nature of the process. This case report emphasizes the importance of laparoscopy with multiple biopsies in the workup of undetermined exudative ascites.

Two Cases of Peritoneal Serous Papillary Adenocarcinoma

Two cases of peritoneal papillary carcinoma are reported. The patient in the first case was a 71-year-old woman with symptoms of obstructive ileus. Laparotomy revealed a tumor in the omentum involving the transverse colon, and several small tumors in the peritoneum and pelvic wall. However, no primary site of the tumor was seen in the ovary, pancreas, or gastrointestinal tract. The patient in the second case was a 44-year-old woman with carcinomatous peritonitis. Postmortem examination revealed multiple tumors in the peritoneum, omentum, and pelvic wall. Tumors were also found in the cortex with mild invasion of the underlying parenchyma of the bilateral ovaries, although these lesions were thought to be metastatic. The histologic features of the tumor in both cases were those of tubulopapillary adenocarcinoma containing scattered psammoma bodies. The cells were positive with the PAS-D technique, but negative with alcian blue staining. In both cases, the serum levels of CA-125 were considerably elevated, and the tumor cells showed positivity for CA-125, S-100 protein, cytokeratin and EMA by immunohistochemistry. The present cases were most likely peritoneal serous papillary adenocarcinoma derived from extraovarian peritoneal mesothelium with müllerian potential, being different from the usual type of diffuse malignant mesothelioma.

Dose response to intrarectal administration of N-methyl-N-nitrosourea and histopathologic evaluation of the effect of two retinoids on colon lesions induced in rats.

Male F344 rats, 8 weeks of age, were given 16 intrarectal administrations of N-methyl-N-nitrosourea (NMU) at one of three dose levels over a period of 8 weeks. Five days after the final NMU instillation, rats were placed on one of three diets: chow with gelatin beadlets, chow with beadlets containing 0.024% 13-cis-retinoic acid, or chow and beadlets with 0.006% of the trimethylmethoxy phenyl analog of retinoic acid ethylamide. Groups of 20-40 rats were killed at 22-26 weeks after the first carcinogen treatment. The number of rats with colon carcinoma and the number of tumors per rat were dose related. In addition, "blind" histopathologic evaluation of four predesignate colon locations revealed a dose-related incidence of microscopic preinvasive and invasive colon carcinomas. The feeding of diets containing these two retinoids did not significantly alter the incidence of these parameters of carcinogenesis or the mean histopathologic score at predesignated colon locations for preinvasive or invasive neoplastic lesions. Over 90% of the colon neoplasms induced were invasive tubulopapillary adenocarcinomas. The diameters of the tumors correlated significantly with degrees of invasion of the colons. Only 1 tumor (a signet ring carcinoma) metastasized to the peritoneal cavity. Only 2 of 300 rats treated with NMU had tumors at sites other than the colon.

Transplantable adenocarcinomas from color-rectal tumors induced by infusion of N-methyl-N'-nitro-N-nitrosoguanidine in ACI/N rats.

Two transplantable strains of adenocarcinoma were established from the carcinomas of the colon and rectum induced by infusion of N-methyl-N'-nitro-N-nitrosoguanidine in inbred ACI/N rats, The tumors are solid type, not converted to ascite form yet, either papillary or tubulo-papillary adenocarcinomas, and particularly grow slowly, showing 2 to 4 months of survival in animals transplanted subcutaneously. Besides histological resemblance of the tumors to human adenocarcinoma of the large intestine, marked mucin production in tumor was noted in one of these strains.