Ovarian neoplasms in F344 rats and B6C3F1 mice

The National Toxicology Program (NTP) classification system for rat and mouse ovarian tumors is presented. The classification system is based on previous classification systems and on a review of all the primary ovarian tumors from the archives of the National Cancer Institute (NCI) and NTP Carcinogenesis Testing Programs. The relative frequency and principal diagnostic features of 204 ovarian tumors from 39,851 female F344 rats and 587 ovarian tumors from 41,102 female B6C3F1 mice are described. The most frequently observed neoplasms in F344 rats were malignant granulosa cell tumors (29% of primary rat ovarian neoplasms observed), benign undifferentiated sex cord-stromal tumors (26%), benign granulosa cell tumors (16%), and benign Sertoli cell tumors (7%). The most frequent neoplasms in B6C3F1 mice were cystadenomas (24%), tubulostromal adenomas (24%), benign granulosa cell tumors (21%), and benign teratomas (8%).

Biliary cystadenoma of the extrahepatic bile ducts: report of a case and review of the literature

Benign neoplasms of the extrahepatic bile ducts are rare and there have only been thirteen reported cases of cystadenoma. One case of cystadenoma of the common hepatic duct and solitary hepatic cyst is presented here and a total of fourteen cases are reviewed. The patient was a 45 year old woman, who complained of abdominal pain with rigidity, but without jaundice. Ultrasonography of the liver showed a 6 cm cyst of the right lobe. Percutaneous transhepatic cholangiography revealed a multilobular cystic mass. At emergency laparotomy, a polypoid multilobular tumor with a stalk was found hanging from the common hepatic duct and was excised. Almost all the patients reported were middle age woman with jaundice. Preoperative diagnosis was made possible by percutaneous transhepatic cholangiography, endoscopic retrograde cholangiography or ultrasonography. The treatment of choice was complete excision. In three cases, a solitary hepatic cyst accompanied the cystadenoma of the common hepatic duct.

Papillary adenoma in a lateral cervical cyst

A lateral cervical cyst located in the left lower neck and had no connection with the thymus, thyroid or parotid gland has been described. Its origin might be the remnant of thymic duct, since Hassal's corpuscle-like structure was found in the cystic wall, although established thymic tissue could not be detected. The most interesting feature of the cyst was that the lining showed papillary adenoma approximately in one-fifth of the luminar surface, whereas the rest was lined by either cuboidal to columnar, nonciliated epithelial cells or metaplastic squamous epithelial cells. This is the first documented case of papillary adenoma in a lateral cervical cyst of possible thymic duct origin.

Aggressive digital papillary adenoma and adenocarcinoma. A clinicopathological study of 57 patients, with histochemical, immunopathological, and ultrastructural observations

Fifty-seven examples of a rare eccrine sweat gland tumor (aggressive digital papillary adenoma and adenocarcinoma) were studied by means of light microscopy, electron microscopy, and immunoperoxidase techniques. The neoplasm occurred as a single, painless mass, almost exclusively on the fingers, toes, and adjacent skin of the palms and soles. Microscopic features were distinct from those of other eccrine sweat gland tumors and often led to the diagnosis of such metastatic carcinoma as that of the breast. The characteristic histologic features included tubuloalveolar and ductal structures with areas of papillary projections protruding into cystic lumina. The stroma varied from thin, fibrous septae to areas of dense, hyalinized collagen. Forty tumors were classified as adenoma (ADPA) and 17 as adenocarcinoma (ADPAca). Histologically, ADPAca was distinguished from ADPA by its poor glandular differentiation and by necrosis, cellular atypia and pleomorphism, invasion of soft tissue and bone, and invasion of blood vessels. Eighteen (50%) patients with ADPA and 8 (47.0%) who had ADPAca developed recurrent lesions (2 months to 9 years) after surgical removal of the tumor. Seven (41.2%) patients with ADPAca developed metastases, of which 5 involved the lung. Three patients died of metastases, 5 to 20 years after surgical treatment of the primary tumor. The histologic malignant features in ADPAca are indicative of potential for distant metastasis and fatality. The recognition of aggressive digital papillary adenoma and adenocarcinoma as a distinct clinicopathological eccrine sweat gland neoplasm is important because of the potential for aggressive local growth and distant metastasis.

Cystic neoplasms of the pancreas

Cystic neoplasms of the pancreas, including 4 patients with serous cystadenoma and 11 with mucinous cystic neoplasm, were studied. Serous cystadenomas composed of epithelial cells with glycogen in the cytoplasm were benign in all, whereas mucinous cystic neoplasms consisted of four benign, two borderline, and five malignant lesions. The average size was 1.8 cm in the greatest diameter in benign mucinous cystadenomas, about 5 cm in borderline tumors, and more than 8 cm in mucinous cystadenocarcinomas. Histologically, in all borderline and malignant lesions, the cysts contained areas lined with epithelium and had a benign appearance, comparable with that of mucinous cystadenoma. These observations suggest a borderline or malignant disease in the case of a benign mucinous cystadenoma. An immunohistochemical study for carcinoembryonic antigen and carbohydrate antigen 19-9 showed denser and diffuse localizations of such materials in the cytoplasm and the stroma in the case of malignant lesions, as compared to findings in borderline and benign cases.

Papillary eccrine adenoma. Light-microscopic, histochemical, and immunohistochemical studies

In 1977, Rulon and Helwig described 14 cases of a benign sweat gland tumor that they termed papillary eccrine adenoma. These neoplasms have a characteristic morphology, consisting of dilated ducts that contain eosinophilic secretion and are often associated with intraluminal papillations. They also stressed the benign clinical behavior of these neoplasms. Since their original description, occasional single cases have been reported. We describe herein four new cases and their immunohistochemical characteristics, including the presence of cytokeratins, S100 protein, and carcinoembryonic antigen.

Morphology and classification of ovarian neoplasms in F344 rats and (C57BL/6 X C3H)F1 mice

For the updating of the National Toxicology Program (NTP) classification system for rat and mouse ovarian tumors, all the primary ovarian tumors from the archives of the National Cancer Institute and NTP Carcinogenesis Testing Programs were reviewed. The relative frequency and principal diagnostic features of 204 ovarian tumors from 39,851 female F344 rats and of 587 ovarian tumors from 41,102 female (C57BL/6 X C3H)F1 (B6C3F1) mice were described. The most frequently observed neoplasms in F344 rats were malignant granulosa cell tumors (29% of primary rat ovarian neoplasms observed), benign undifferentiated sex cord-stromal tumors (26%), benign granulosa cell tumors (16%), and benign Sertoli cell tumors (7%). The most frequent neoplasms in B6C3F1 mice were cystadenomas (24%), tubulostromal adenomas (24%), benign granulosa cell tumors (21%), and benign teratomas (8%). Ovarian neoplasms were not significantly related to treatment in rats. Tubulostromal adenomas, benign and malignant granulosa cell tumors, and benign teratomas were significantly more frequent in treated mice than in controls.

[Pancreatic cystadenomas. Pitfalls and limitations of radiologic diagnosis]

Pancreatic cystadenoma (CA) are rare tumors. According to the classification described by Compagno and Oertel, microcystic and macrocystic CA are differentiated. The former is a benign tumor with slow growth, but the latter has a malignant potential. According to the literature, these tumors may be differentiated on the basis of US and CT findings in a high percentage of cases. We report a series of 11 cases (5 microcystic CA, 4 mucinous CA, 1 leiomyoblastoma and 1 adrenal cyst) representing all cases of radiologically suspected CA and all cases of histologically proved CA. A correct diagnosis of microcystic CA was possible in 2 out of 5 cases, and in 3 out of 4 cases of mucinous CA. The 2 extra-pancreatic tumors were misinterpreted as mucinous CA. No patient had a false positive diagnosis of microcystic CA. The diagnosis of mucinous CA was made in 7 cases, but only 3 were true positives. There was 1 false negative of mucinous CA. In other cases, laparotomy and resection are mandatory as sonography and CT cannot accurately detect malignancy or differentiate pancreatic CA from adjacent sites tumors.

Unusual features of parovarian cysts. A report of two cases

In two cases, parovarian cysts were well characterized by ultrasonography and presented with unusual clinical features. In one case the cysts were present bilaterally and associated with an arcuate uterus. In the other, histology of the cyst revealed a papillary serous cystadenoma. The lesion was also associated with an arcuate uterus.

So-called "papillary and cystic neoplasm of the pancreas." An immunohistochemical and ultrastructural study

A case of so-called "papillary and cystic neoplasm of the pancreas" (PCNP) was reported and investigated immunohistochemically and ultrastructurally. A tumor of the pancreatic head in a 21-year-old female was curatively resected. The tumor was cystic and histologically consisted of uniform cells in papillary and solid structure. Although there was no immunoreactivity for pancreaticogut hormones or secretory products of the pancreas in the tumor cells, most of the tumor cells were diffusely immunoreactive for neuron-specific enolase (NSE). Some neurosecretory granules were detected in the tumor cells ultrastructurally. Both facts suggested endocrine cell character of the tumor. Certain cases of PCNP might show a differentiation to endocrine cells.

Ovarian cysts in pregnancy: does ultrasound make traditional management inappropriate?

In a retrospective series of 131 ovarian tumors associated with pregnancy, 81 (including one carcinoma and six tumors of borderline malignancy) were removed. Eighty-three cysts were examined by ultrasound. All 15 of less than 5 cm in diameter resolved spontaneously. Of 68 larger than 5 cm in diameter, 39 had a simple internal echo pattern and a smooth wall; 19 of these disappeared, and the histology of seven others suggested they might have resolved if treated conservatively. Three of the tumors of borderline malignancy also showed a simple ultrasound pattern, but higher-resolution machines may have differentiated two of these. We suggest a policy of selective conservative management of ovarian cysts during pregnancy on the basis of the ultrasound appearance.

Visceral intravascular capillary hemangioma

In the course of routine pathologic examination of an ovarian serous cystadenoma excised from a 35-year-old woman, an intravascular mass in the cyst capsule was noted. Histologically, this was found to be an intravenous capillary hemangioma. To our knowledge, no such lesion has been previously reported. The relationship of this lesion to intravenous pyogenic granuloma and features by which the two may be distinguished are discussed. Other primary intravascular endothelial tumors are briefly reviewed.

[A case of retroperitoneal mucinous cystadenoma of borderline malignancy]

Surgical experience of a rare case of malignant retroperitoneal cyst is reported. A 41-year-old female was admitted on Feb. 26, 1986, complaining of left lower abdominal tumor and mild abdominal pain. She underwent complete removal of an abdominal tumor located at the left flank lateral to the sigmoid colon on March 5. The tumor was well encapsulated, cystic and oval, 12 X 10 X 9 cm in size. Histologic feature of the tumor is classified as mucinous cystadenoma of low grade malignancy by WHO classification.

Enzootic nasal tumour of sheep

This is the first report of Enzootic Nasal Tumours (ENT) of sheep in Israel. The report includes a detailed clinical, pathological and histopathological description of the syndrome. All 7 affected sheep suffered clinically from serous to muco-purulent nasal discharge and respiratory distress due to obstruction of the upper airway by a neoplastic process. Three of the tumours were histopathologically identified as tubular adenomas, 3 were mucoid adenomas and one was a papillary adenoma. The tumours caused destruction of the turbinate bones and nasal septum.

Cystic tumors mistaken for pancreatic pseudocysts

A small fraction of pancreatic cysts are neoplastic rather than inflammatory in origin. Failure to recognize the true nature of a neoplastic cyst will lead to an incorrect treatment strategy. This is a report of eight patients whose cystic neoplasms were misdiagnosed and maltreated. Five of the eight tumors proved to be malignant. Five were drained by anastomosis to a viscus and one by aspiration; drainage was recommended for the other two. Treatment by drainage led to complications (persistent painful gastric ulcer, infection in the cysts), growth of new cysts, no cures, but missed opportunities to cure cancer. Three patients with no metastases at first operation had metastatic spread to the liver, omentum, or lungs at reoperation. In three of the five cases initially treated by cystenterostomy (including one cancer), subsequent resection was possible and probably curative. One cystadenocarcinoma was watched for 3 years before apparently curative resection. Guidelines based on serum and cyst amylase levels, morphologic appearance, angiography, pancreatography, and biopsy are given for the purpose of differentiating inflammatory cysts from neoplastic cysts of the pancreas. Confusion of these entities should not occur, but errors can often be corrected.

Cystic epithelial-stromal tumor of the seminal vesicle

A cystic tumor composed of atypical glands in a cellular stroma arose in the pelvis of a 49-year-old man. Two years later an identical tumor was again excised from the pelvis. Morphologic, immunohistochemical and ultrastructural studies indicate that this neoplasm arose in the seminal vesicle, possibly from a seminal vesicle cyst. The tumor did not involve the prostate gland, and immunohistochemical stains for prostate-specific antigen and prostatic acid phosphatase were negative. Ultrastructural study showed that both the glandular and mesenchymal components of the tumor recapitulated features of normal seminal vesicle, further establishing origin from this site. This tumor resembles the rare cystadenoma of the seminal vesicle, yet the cytologic atypia suggests low grade malignant potential. Following the second excision, the patient has had a disease-free interval of 18 months. Long term follow-up and recognition of additional cases is necessary to define the biologic potential of this unusual tumor.

Evolution of the expression of fetal acinar antigens during carcinogenesis of the pancreas in hamsters: individual follow-up by open biopsy

Individual lesions in the pancreas and the presence of fetal acinar antigens along with carcinogenesis induced by N-nitrosobis(2-oxopropyl)amine (CAS: 60599-38-4) were studied by open biopsy in 16 Syrian golden hamsters 13, 22, and 40 weeks after initiation of treatment. At 13 weeks, cystadenoma and regular ductal hyperplasia were noted in 3 animals and 1 animal, respectively. Staining for fetal acinar antigens in the pancreas was found in 69% of the hamsters. At 22 weeks, cystadenoma and hyperplastic ducts were common (60 and 53%), and 3 hamsters developed pancreatic adenocarcinoma. Fetal acinar antigens persisted in the acini and extended to irregular hyperplastic ducts and tumor cells. At 40 weeks, ductal proliferation was the main lesion in all pancreatic tissue, and 9 animals had adenocarcinoma. Acinar antigens were found in the remaining acini, in irregular hyperplastic ducts, and in tumor cells. Thus, once reexpressed, fetal acinar antigens persist in pancreatic lesions and pancreatic carcinomas in the hamster.

Linear nevi, hemihypertrophy, connective tissue hamartomas, and unusual neoplasms in children

The association of cutaneous nevi, hemihypertrophy, and connective tissue overgrowth has been described in many patients. We report long-term follow-up in two boys with such association who in addition developed testicular neoplasms. One patient also had progressive spinal cord compression as a result of stenosis of the spinal canal, and required amputation of a severely deformed limb. The importance of careful, long-term management in such patients is emphasized.