bromochloroacetic-acid and Calcinosis

To help the clinician understand the different odontogenic tumors found commonly in the maxillary sinus in terms of clinical and radiographic findings, diagnosis and treatment.. The classification of odontogenic tumors has changed recently with the addition of the odontogenic keratocyst and calcifying odontogenic cyst (Gorlin cyst) from the realm of odontogenic cysts to being classified by the WHO as odontogenic tumors based upon their neoplastic biologic behavior. The odontogenic keratocyst is now called a keratocystic odontogenic tumor. The calcifying odontogenic cyst is now called a calcifying cystic odontogenic tumor.. The diagnosis of odontogenic tumors of the maxillary sinus is difficult and challenging. Surgeons need to work in conjunction with an oral and maxillofacial pathologist to ensure accurate diagnosis for proper surgical planning.

Topics: Ameloblastoma; Calcinosis; Diagnosis, Differential; Fibroma; Humans; Keratins; Maxillary Sinus; Odontogenesis; Odontogenic Cysts; Paranasal Sinus Neoplasms; Tomography, X-Ray Computed

Primary intracranial squamous cell carcinoma is extremely rare, with most of the cases arising from malignant transformation of an epidermoid or a dermoid cyst. We report here a case of a 45-year-old male patient who presented with 1-month history of intermittent headache and recent onset of altered sensorium. Imaging revealed a midline posterior fossa mass lesion compressing the fourth ventricle and causing hydrocephalus. A provisional diagnosis of dermoid cyst was considered. Histopathological examination revealed a squamous cell carcinoma possibly arising from an underlying epidermoid cyst. This entity is being reported for its rarity.

Topics: Brain Diseases; Calcinosis; Carcinoma, Squamous Cell; Cell Transformation, Neoplastic; Cholesterol; Cranial Fossa, Posterior; Diagnosis, Differential; Epidermal Cyst; Fourth Ventricle; Humans; Keratins; Male; Middle Aged; Skull Base Neoplasms; Tomography, X-Ray Computed

Topics: Biomarkers, Tumor; Biopsy; Calcinosis; Carcinoma, Squamous Cell; Humans; Immunohistochemistry; Keratins; Mouth Neoplasms

Scrotal calcinosis is a rare and benign condition characterized by multiple calcific deposits occurring in scrotum and formed as nodules and lumps within scrotal skin with any systemic metabolic disorder. The so-called idiopathic scrotal calcinosis does not appear to be idiopathic, but rather a process of dystrophic calcification of epidermal cysts. Histological examination shows calcium deposites with in the dermis that may be surrounded with histiocytes and an inflammatory giant cell reaction. The aim of this paper was to detect dystrophic calcification of epidermal cysts and to take attention to the incorrect terminology of "idiopathic calsification".. This is a two-centered study of scrotal calcinosis with 17 cases, on which clinical and histopathological examinations were conducted.. The patients we examined all had scrotal epidermoid cysts in varying stages of inflammation coexisted with scrotal calcinosis. Some cyts (52.9%) had intact epithelial walls, others (35.2%) showed rupture of their epithelial walls associated with the presence of keratin fibers and calcium granules in the surrounding dermis and all had naked calcium deposits lying in the dermis.. The spectrum of the changes that we experienced in the histology, coupled with the normal values in the biochemical profile, shore up the theory of dystrophic calcification of epithelial cysts. During the time first these cysts become inflamed than rupture in the and calcium depocytes replase with the cysts.

Topics: Adult; Aged; Aged, 80 and over; Calcinosis; Calcium; Epidermal Cyst; Genital Diseases, Male; Humans; Inflammation; Keratins; Male; Middle Aged; Retrospective Studies; Scrotum; Terminology as Topic; Young Adult

We report 3 cases of primary renal cell tumor simulating atrophic kidney with distinct gross, morphologic, immunohistochemical, and molecular genetic features. The tumors were retrieved out of more than 17 000 renal tumors from the Plzen Tumor Registry. Tissues for light microscopy had been fixed, embedded, and stained with hematoxylin and eosin using routine procedures. The tumors were further analyzed using immunohistochemistry, array comparative genomic hybridization, and human androgen receptor. Analyses of VHL gene and loss of heterozygosity (LOH) 3p were also performed. The patients were 2 women and 1 man, with ages ranging from 29 to 35 years (mean, 31.3 years). Grossly, the neoplasms were encapsulated and round with largest diameter of 3.5 cm (mean, 3.2 cm). Follow-up available for all patients ranged from 2 to 14 years (mean, 8 years). No aggressive behavior was noted. Histologically, akin to atrophic (postpyelonephritic) kidney parenchyma, the tumors were composed of follicles of varying sizes that were filled by eosinophilic secretion. Rare areas contained collapsed follicles. Each follicle was endowed with a small capillary. The stroma was loose, inconspicuous, and focally fibrotic. Two types of calcifications were noted: typical psammoma bodies and amorphous dark-blue stained calcified deposits. Immunohistochemically, tumors were strongly positive for cytokeratins (OSCAR), CD10, and vimentin, with weak immunopositivity for CAM5.2 and AE1-AE3. WT1 and cathepsin K were weakly to moderately focally to diffusely positive. Tumors were negative for cytokeratin 20, carbonic anhydrase IX, parvalbumin, HMB45, TTF1, TFE3, chromogranin A, thyroglobulin, PAX8, and ALK. Only 1 case was suitable for molecular genetic analyses. No mutations were found in the VHL gene; no methylation of VHL promoter was noted. No numerical aberrations were found by array comparative genomic hybridization analysis. LOH for chromosome 3p was not detected. Analysis of clonality (human androgen receptor) revealed the monoclonal nature of the tumor. We describe an unknown tumor of the kidney that (1) resembles renal atrophic kidney or nodular goiter of thyroidal gland; (2) contains a leiomyomatous capsule and 2 types of calcifications; (3) lacks mitoses, atypias, necroses, and hemorrhages and nearly lack Ki-67 positivity; and (4) so far showed benign biological behavior.

Topics: Adult; Atrophy; Biomarkers, Tumor; Calcinosis; Comparative Genomic Hybridization; Diagnosis, Differential; DNA Methylation; Female; Goiter, Nodular; Humans; Keratins; Kidney; Kidney Neoplasms; Leiomyomatosis; Loss of Heterozygosity; Male; Mutation; Receptors, Androgen; Thyroid Gland; Vimentin; Von Hippel-Lindau Tumor Suppressor Protein

Topics: Aged; Biomarkers, Tumor; Breast Neoplasms; Calcinosis; Carcinoma, Intraductal, Noninfiltrating; Cell Nucleus; ErbB Receptors; Female; Humans; Keratins; Ki-67 Antigen; Tumor Suppressor Protein p53

Hair cortex comedo was described originally in an article detailing 2 cases of a comedo-like clinical lesion that was histologically a keratinous plug with cornification similar to the cortex of the hair shaft. We have collected retro- and prospectively a series of 34 cases of hair cortex comedo. In our series, there was a slight female predominance (Male:Female of 1:1.4), and the mean patient age was 28.8 years. All lesions were solitary, distributed mainly on the head and neck or trunk, and were described clinically as a blue subcutaneous papule or nodule with "cyst" as the most common clinical differential diagnosis. Histologic examination showed a solitary, vertically oriented, uniformly sized oval nodule of compact laminated corneocytes sitting in a patulous invagination lined by epithelium similar to the infundibulum, isthmus, or combinations of them; rarely matrical epithelium was identified. Entrapped melanin (30/34 cases), shadow cells (16/34 cases), and calcification (12/34 cases) were identified commonly. Remnants of a surrounding follicle were noted in 15 cases, with infundibular epithelium in 9 of the cases, isthmic epithelium in 3, and matrical or supramatrical epithelium (or both) in 3. There was an associated dense granulomatous infiltrate in the majority of the cases (25/34). Although hair cortex comedo was thought originally to be a variant of dilated pore of Winer, we believe that these distinctive lesions, which are characterized histopathologically by a uniformly sized vertically oriented dermal plug of laminated corneocytes with entrapped melanin and surrounding granulomatous inflammation, are likely derived from matrical or supramatrical cells (or both).

Topics: Adolescent; Adult; Aged; Aged, 80 and over; Calcinosis; Child; Child, Preschool; Diagnosis, Differential; Epithelial Cells; Female; Granuloma; Hair Diseases; Hair Follicle; Humans; Keratins; Male; Melanins; Middle Aged; Missouri; Predictive Value of Tests; Prospective Studies; Retrospective Studies; Young Adult

The presence of psammoma bodies (PBs) in cervical smears is a rare finding. These structures have been identified in association with a wide range of benign and malignant conditions within the female genital tract. PBs in cervical smears have usually been associated with malignant serous epithelial ovarian tumors. However, many PBs associated with atypical squamous cells were detected in cervical smears of an 83-year-old woman with complaint of postmenopausal bleeding. Colposcopic examination revealed an ulceroinfiltrative growth in the cervix. Histological examination of the biopsy specimen from the growth revealed keratinizing squamous cell carcinoma with multiple and singly arranged PBs. This report suggests that cytologists should aware of the possibilities, on finding PBs associated with atypical cells in cervical specimens and report the cases accordingly.

Topics: Aged, 80 and over; Calcinosis; Carcinoma, Squamous Cell; Female; Humans; Keratins; Uterine Cervical Neoplasms; Vaginal Smears

Scrotal calcinosis is a rare disorder characterized by multiple papules or nodules of calcification in the scrotal skin. The etiology of this entity is speculative largely as a result of the paucity of larger series.This study of 20 patients with scrotal calcinosis was undertaken to critically analyze the histology with a view to assess the probable etiology of this lesion. Two thirds of the patients were young adults. Of these, 11 patients (55%) were asymptomatic and 9 complained of symptoms related to the breakdown of these lesions (eg, discharge, itching, or heaviness in the scrotum). All cases showed classical histologic features of scrotal calcinosis with a variable amount of calcification in the dermis. In 14 cases the etiology of this calcification could be traced to originate from dilated epidermal cysts. The spectrum of changes probably started with the cystic dilation of the hair follicle, then calcification around and within this cyst. Finally the epithelial elements disappeared, leaving behind residual areas of calcification. The remaining 6 cases did not have epithelial cysts in the vicinity. Based on these observations we conclude that scrotal calcinosis results from calcification of hair follicular or epidermal cysts, but as most of the cases report, this epithelium disappears and may not be seen.

Topics: Adult; Calcinosis; Disease Progression; Epidermal Cyst; Genital Diseases, Male; Hair Diseases; Hair Follicle; Humans; Immunohistochemistry; Keratins; Male; Scrotum; Skin Diseases

Topics: Adenoma, Pleomorphic; Adult; Biomarkers, Tumor; Bone Marrow Cells; Calcinosis; Forehead; Humans; Keratins; Male; Ossification, Heterotopic; Radiography; Sweat Gland Neoplasms

Topics: Adult; Calcinosis; Carcinoma, Papillary; Female; Humans; Immunohistochemistry; Keratins; Ossification, Heterotopic; Pancreatic Neoplasms; Phosphopyruvate Hydratase; Vimentin

A peripheral ameloblastoma with atypical features occurring on the left maxillary alveolar ridge of 40-year-old man is described, along with an immunohistochemical profile of its cytokeratin (CK). The lesion apparently originated from the surface gingival epithelium. The tumor nests or strands were highly cellular with a variable degree of squamous differentiation and microcyst formation. Occasional mitotic figures and dystrophic calcification, both of which are not seen in conventional ameloblastomas, were also observed. The tumor infiltrated deep into the alveolar mucosa, including the periodontal ligament, and showed histological and topographical evidence of atypism, resulting in resorption of the underlying alveolar bone. On the CK immunohistochemistry, CK19 was demonstrated in all the types of neoplastic epithelia, including microcyst-forming cells, densely packed round or spindle cells within the tumor nests, cells with squamous metaplasia, and peripheral tall columnar cells. The CK immunohistochemical findings suggest the lesion's cell of odontogenic origin; they may reflect an immature phenotypic expression of cell differentiation in the odontogenic epithelia during the tumor growth in the gingival mucosa.

Topics: Adult; Alveolar Bone Loss; Ameloblastoma; Calcinosis; Cell Differentiation; Epithelium; Gingival Neoplasms; Humans; Immunohistochemistry; Keratins; Male; Metaplasia; Mitosis; Mouth Mucosa; Periodontal Ligament; Phenotype

We describe a patient with hyperplastic mesothelial cells localized to mediastinal lymph node sinuses. These mesothelial cells were originally misdiagnosed as metastatic carcinoma, and the patient received radiotherapy. Histologic review, immunohistochemistry, and ultrastructural studies confirmed mesothelial cell origin. These nodal mesothelial cells were associated with pericardial and pleural effusions. Extranodal lymphatics also contained hyperplastic mesothelial cells, confirming their mode of lymphatic transport to node sinuses. This finding supports the theory that hyperplastic mesothelial cells derive from reactive serosal mesothelium and are dislodged into draining lymphatics. This is the first report, to our knowledge, that demonstrates the pathogenetic significance of this lymphatic transport mechanism. Awareness of intralymphatic and nodal benign hyperplastic mesothelial cells and their mimicry of invasive malignant neoplasms is important for accurate diagnoses and appropriate therapy.

Topics: Adipose Tissue; Calcinosis; Diagnosis, Differential; Epithelium; Female; Humans; Hyperplasia; Immunohistochemistry; Keratins; Lymph Nodes; Lymphatic Metastasis; Middle Aged; Neoplasms, Unknown Primary

Differentiating chronic aseptic meningitis from leptomeningeal carcinomatosis or gliomatosis can be difficult, particularly when the differentiation is based solely on routine cytologic examination. The diagnosis of cerebrospinal fluid tumor dissemination in at-risk patients requires cytologic examination of cerebrospinal fluid and radiography of the leptomeninges. Routine cytologic examination alone has proven less than desirable, in most instances providing confirmation in as little as 50% of cases in the first lumbar puncture. This percentage increases to 85% to 90% after multiple lumbar punctures. We retrospectively reviewed 2 cases of leptomeningeal dissemination (one gliomatosis, the other carcinomatosis) with initial false-negative test results. However, after further examination of the cerebrospinal fluid by selected battery of immunocytochemical stains, both cases were identified as positive for malignancy (ie, false negatives). Immunocytochemistry can be useful in distinguishing chronic aseptic meningitis from leptomeningeal carcinomatosis or gliomatosis in patients at risk or when abnormal cells are seen on routine cerebrospinal fluid cytologic examination.

Topics: Adult; Aged; Bile Duct Neoplasms; Bile Ducts, Intrahepatic; Brain Edema; Calcinosis; Cerebrospinal Fluid; Cholangiocarcinoma; Chronic Disease; Diagnosis, Differential; Fatal Outcome; Female; Glial Fibrillary Acidic Protein; Humans; Immunohistochemistry; Keratins; Male; Meningeal Neoplasms; Meningitis, Aseptic; Mucin-1; Neoplasms, Neuroepithelial; Retrospective Studies

Calcifying epithelial odontogenic tumor, also known as Pindborg tumor, is a rare benign tumor with locally aggressive behavior. It is characterized by squamous epithelial cells, calcifications, and eosinophilic deposits that have been identified as amyloid. We report a case of calcifying epithelial odontogenic tumor and investigate the nature of the amyloid, using histologic, immunohistochemical, and ultrastructural studies. The amyloid was immunohistochemically negative for basement membrane components and positive for all cytokeratin stains performed (cocktail of cytokeratins 1, 5, 6, 8, 13, and 16, and cytokeratins AE1 and AE3). The amyloid stained focally in a glandular-like pattern, reminiscent of the epithelial glandlike structures of the tumor. We conclude that the amyloid is derived from filamentous degeneration of keratin filaments that originate from the tumor squamous epithelium. The keratin degeneration is part of a developmental or aging process that the tumor undergoes.

Topics: Amyloid; Calcinosis; Epithelial Cells; Female; Humans; Immunohistochemistry; Keratins; Maxillary Neoplasms; Middle Aged; Odontogenic Tumors; Radiography

A rare case of clear cell variant of calcifying epithelial odontogenic tumor is presented with immunohistochemical and ultrastructural investigations. A 14-year-old Japanese girl was admitted with a complaint of swelling in the right posterior maxilla. Radiological examination showed a well-circumscribed radiolucent lesion located close to the impacted third molar. After only a partial tumor excision, the tumor recurred 13 years later. It appeared radiologically as an irregular radiodensity, and a subtotal maxillectomy was performed. Histological examination showed sheets and/or strands composed almost entirely of clear vacuolated epithelial cells in a stroma containing intercellular amyloid-like material and calcification. Histochemical and ultrastructural analysis detected cytoplasmic glycogen granules in the clear cells, and positive immunoreactivities for cytokeratins 8, 13 and 19; filaggrin and anti-ameloblastoma antibodies suggested an odontogenic epithelial origin.

Topics: Adolescent; Amyloid; Antibodies, Neoplasm; Calcinosis; Epithelial Cells; Female; Filaggrin Proteins; Glycogen; Humans; Immunohistochemistry; Intermediate Filament Proteins; Intermediate Filaments; Keratins; Maxillary Neoplasms; Microscopy, Electron; Odontogenic Tumors

To illustrate unusual patterns of isolated supradiaphragmatic presentation and relapse of papillary serous adenocarcinoma of the ovary.. Retrospective study of five women (26-57 years) managed by a specialist gynaecological oncology unit.. Three women relapsed in the neck, mediastinal or axillary nodes 3 to 5 years after complete abdomino-pelvic remission. Two women presented with pleural or cervical lymph node metastases respectively 2 and 13 years before the primary pelvic tumour was discovered. Clinical presentations in these five women mimicked metastatic thyroid and breast cancer and mesothelioma. In four of the five woman supradiaphragmatic nodal disease was heavily calcified.. Women with papillary serous ovarian cancer may develop supradiaphragmatic disease without evidence of peritoneal metastasis or primary pelvic tumours. Isolated supradiaphragmatic relapse may occur many years after complete remission of abdomino-pelvic disease. Calcification in supradiaphragmatic lymph nodes should not be assumed to be due to old granulomatous disease as this may be the only clue to relapsing disease. Review of prior histology and use of immunohistochemical stains were valuable in diagnosis of these cases.

Topics: Adult; Axilla; Biomarkers, Tumor; CA-125 Antigen; Calcinosis; Clavicle; Cystadenocarcinoma, Papillary; Female; Humans; Keratin-7; Keratins; Lymph Nodes; Lymphatic Metastasis; Middle Aged; Neck; Ovarian Neoplasms; Radiography; Retrospective Studies

The retinal pigment epithelium (RPE) can undergo reactive hyperplasia and metaplasia following a variety of ocular insults. However, true neoplasms of the RPE are rare. We report a case of a papillary adenocarcinoma of the RPE arising in the blind staphylomatous right eye of a 79-year-old woman with a long history of bilateral posterior staphylomas who was seen with increasing pain and exophthalmos of the right eye. Findings from ultrasonography and computed tomography demonstrated linear calcification consistent with osseous metaplasia of the RPE. Progression of the exophthalmos and worsening exposure keratitis led to enucleation of the eye. Gross pathology showed a 79-mm-long globe. Histopathologic findings revealed a largely amelanotic papillary adenocarcinoma arising from the RPE. Positive immunoreactivity for cytokeratin supported the epithelial origin of the tumor. Adenocarcinoma of the RPE is rare but may develop in a blind eye.

Topics: Adenocarcinoma, Papillary; Aged; Biomarkers, Tumor; Blindness; Calcinosis; Exophthalmos; Eye Enucleation; Female; Humans; Keratins; Magnetic Resonance Imaging; Metaplasia; Pain; Pigment Epithelium of Eye; Retinal Neoplasms; Scleral Diseases; Tomography, X-Ray Computed

Extensive epidermal necrosis in newborn infants is an unusual event of heterogeneous cause.. The objective of this article is to describe what seems to be a previously unrecognized lethal disease.. The clinical and histopathologic features of three premature infants, two of them nonidentical twins, and the autopsy findings of one of them were analyzed.. Intrauterine lethal epidermal necrosis with hair follicle calcification, except for the face, hands, feet, elbows, and knees, was present in all three patients. Some histopathologic features were suggestive of epidermal apoptosis.. We propose that the clinicopathologic alterations in our patients represent a new condition that may be caused by massive epidermal apoptosis.

Topics: Apoptosis; Calcinosis; Collagen; Diseases in Twins; Elbow; Epidermis; Face; Fatal Outcome; Female; Fetal Diseases; Foot; Hair Diseases; Hair Follicle; Hand; Humans; Infant, Newborn; Infant, Premature; Infant, Premature, Diseases; Keratinocytes; Keratins; Knee; Necrosis; Skin; Skin Abnormalities; Twins, Dizygotic

A case of squamous cell carcinoma of the tongue is reported with emphasis on an atypical finding of cervical lymph node metastasis visible on computed tomography. Multiple cervical lymph nodes revealed a high computed tomographic value of about 330 HU, lower than that of calcification. The lymph nodes revealed well-defined elliptical hyperechoic masses with an echogenic line and posterior shadow on ultrasonography. The appearance of a high density mass on computed tomography with a computed tomographic value lower than that of calcification may be a reliable finding of metastasis because it demonstrates the presence of marked keratinization produced by squamous cell carcinoma.

Topics: Calcinosis; Carcinoma, Squamous Cell; Humans; Keratins; Lymph Nodes; Lymphatic Metastasis; Male; Middle Aged; Neck; Radiography, Panoramic; Reproducibility of Results; Tomography, X-Ray Computed; Tongue Neoplasms; Ultrasonography

The objective of this investigation was to study the relationship of the ghost cell ameloblastoma (GCA), which is a form of type II calcifying odontogenic cyst (COC), to the adamantinomatous craniopharyngioma (ACP). H&E sections of 26 examples of ACP were compared to three cases of GCA and to the reported microscopic features of that tumor. Clinical records of the ACPs were studied to determine their biologic behavior compared to that of the ameloblastomas. Immunohistochemical studies of nine examples of ACP were performed for KL1 (high mol.wt cytokeratins), 5D3 (low mol.wt cytokeratins) and involucrin (characteristic of terminally differentiated keratinocytes) using the peroxidase-antiperoxidase method. The results were compared with those reported for COC and ameloblastoma. ACP and GCA exhibited similar microscopic features, including pre-ameloblasts, tissue resembling stellate reticulum, ghost cells and calcifications; both tumors grew slowly and were invasive. ACP and COC, and by interpolation GCA, exhibited similar features with all three antibodies. The ghost cells did not exhibit any immunoreactivity but the adjacent cells stained positively for involucrin. The immunological features of ACP were similar to those reported in ameloblastomas for squamous differentiation. However, because of their rarity, no ameloblastomas exhibiting keratinization, including ghost cells, have yet been studied with these antibodies. We conclude that ACP and GCA are homologous lesions.

Topics: Ameloblastoma; Ameloblasts; Biology; Calcinosis; Cell Differentiation; Coloring Agents; Craniopharyngioma; Eosine Yellowish-(YS); Epithelial Cells; Fluorescent Dyes; Hematoxylin; Humans; Immunoenzyme Techniques; Immunohistochemistry; Jaw Neoplasms; Keratinocytes; Keratins; Molecular Weight; Odontogenic Cyst, Calcifying; Pituitary Neoplasms; Protein Precursors

Topics: Adolescent; Amyloid; Calcinosis; Calcium; Cell Division; Cell Nucleus; Cytoplasm; Cytoplasmic Granules; Desmosomes; Epithelium; Female; Glycogen; Humans; Intermediate Filaments; Keratins; Maxillary Neoplasms; Microscopy, Electron; Microvilli; Odontogenic Tumors

Histological, immunohistochemical and electron microscopical studies revealed one feline and four canine calcifying epithelial odontogenic tumours in 115 oral tumours over a 10-year period. The tumours consisted of islands and sheets of odontogenic epithelium of varying size within a stroma of fibrous connective tissues. The tumour cells were pleomorphic with variable amounts of eosinophilic cytoplasm and large hyperchromatic, polymorphic nuclei with prominent nucleoli. Clusters of keratinized tumour cells ("shadow cells") were frequently seen within the islands and sheets. The multiple spherules of homogeneous eosinophilic material stained positively with Congo red and Dylon stains and produced an apple green birefringence under polarization microscopy, indicative of amyloid. Mineralized foci were scattered throughout the tumour masses and in the homogeneous spherules. Immunohistochemically, the tumour cells reacted with anti-human keratin antibody, but not with anti-human vimentin or anti-chicken desmin antibodies. The homogeneous spherules did not react with anti-human keratin, anti-human vimentin, anti-chicken desmin, anti-amyloid A, anti-laminin or anti-human collagen (type I, III, IV) antibodies. Ultrastructurally, the cytoplasm of tumour cells was abundant and contained a large number of electron-dense bundles of tonofilaments. The homogeneous spherules consisted of fine filaments measuring about 10-12 nm in diameter.

Topics: Amyloid; Animals; Calcinosis; Cat Diseases; Cats; Dog Diseases; Dogs; Female; Keratins; Male; Mandibular Neoplasms; Maxillary Neoplasms; Neoplasm Proteins; Neoplasm Recurrence, Local; Neoplasms, Multiple Primary; Odontogenic Tumors; Osteolysis; Retrospective Studies

To identify the CT and MR characteristics of craniopharyngiomas, to evaluate the histologic types of craniopharyngioma, and to compare the radiologic/histologic appearance and type of therapy with tumor recurrence.. We reviewed the records of 45 patients with craniopharyngiomas for which surgical specimens (n = 45), preoperative MR or CT studies (n = 27), or other MR or CT studies or reports (n = 18) were available. Radiologic appearance, histologic morphology, treatment, and tumor recurrence were studied.. Adamantinomatous epithelium was found in 40 of 45 surgical specimens, keratin in 34 of 45, and squamous epithelium in 11 of 45. A continuum of mixed morphology rather than distinct subtypes of tumors was found. The radiologic appearance did not correlate with the histologic features. No statistically significant difference was found between children and adults with respect to tumor size, calcification, histology, or tumor recurrence. Patients treated with radiation after subtotal resection had far fewer tumor recurrences (n = 3) than patients treated with surgery alone (n = 18).. Craniopharyngiomas could not be divided into distinct histologic types. No differentiating radiologic or histologic characteristics could be established for craniopharyngiomas in children versus adults. Radiation treatment was strongly associated with tumor regression or lack of recurrence.

Topics: Adolescent; Adult; Age Factors; Calcinosis; Child; Child, Preschool; Craniopharyngioma; Epithelium; Female; Follow-Up Studies; Humans; Keratins; Magnetic Resonance Imaging; Male; Middle Aged; Neoplasm Recurrence, Local; Pituitary Neoplasms; Radiotherapy, Adjuvant; Remission Induction; Retrospective Studies; Tomography, X-Ray Computed

Five cases of large cell calcifying Sertoli cell tumour of the testis not associated with complex dysplastic syndromes are reported. The age of the patients ranged from 13 to 34 years and all the tumours were histologically similar, having large, isomorphic, non-mitotic, eosinophilic Sertoli cells with foci of calcification. Flow cytometry demonstrated the cells to be diploid or hypodiploid. All cases were positive for vimentin and focally positive for low molecular weight keratin. The present cases, together with a review of the 22 previously reported tumours, demonstrate that there are two clear cut types of large cell calcifying Sertoli cell tumour; those which are associated with complex dysplastic syndromes and which are bilateral and multifocal, and those which are not associated and are unilateral and focal. Prognosis in all of our cases was uniformly good despite invasion of the rete testis in two cases. It is considered that conservative resection of the tumour is the treatment of choice in cases not associated with complex dysplastic syndromes, since the malignancy rate is low.

Topics: Adolescent; Adult; Calcinosis; Diagnosis, Differential; Flow Cytometry; Humans; Immunohistochemistry; Keratins; Male; Sertoli Cell Tumor; Testicular Neoplasms; Ultrasonography; Vimentin

Multiple keratocysts of the jaws are habitual in the nevoid basal cell carcinoma syndrome (Gorlin and Goltz. Syndrome). The authors report 3 cases of multiple keratocysts in a 28 year-old woman and in two men respectively ages of 27 and 21 years. In the third case some anomalies in which calcification of the falx cerebri were noted and suggested the Gorlin's syndrome. The limits of this syndrome with multiple keratocysts of the jaws are discussed.

Topics: Adult; Basal Cell Nevus Syndrome; Calcinosis; Dura Mater; Female; Humans; Keratins; Male; Mandibular Diseases; Maxillary Diseases; Maxillary Sinus; Odontogenic Cysts; Paranasal Sinus Diseases

An unusual case of ameloblastoma which depicts cystic follicles containing orthokeratin, parakeratin, desquamated epithelium and necrotic material with dystrophic calcification is presented. The presence of ameloblast-like cells confirms the diagnosis of an ameloblastoma. However, certain features resembled those of the keratoameloblastoma and others, less convincively, the papilliferous keratoameloblastoma. The extensive keratinisation in this tumour and in the aforementioned neoplasms raises the question whether they represent variants of the acanthomatous ameloblastoma.

Topics: Adult; Ameloblastoma; Ameloblasts; Calcinosis; Cysts; Epithelium; Female; Humans; Keratins; Mandibular Neoplasms; Necrosis

The histological and ultrastructural features, as well as the immunoreactivity of one case of uncommon primary papillary and psammomatous adenocarcinoma of the umbilicus are studied in the present work. The observations have been undertaken in a nine-year follow-up, and have included the primitive tumour, two local recidives, and inguinal lymphatic metastasis on two occasions. Papillary structures, numerous psammoma bodies, as well as weak and focal positive reactions to CEA and cytokeratin were present in all the tumours. Since these features and their ultrastructural characteristics were identical to primary papillary serous neoplasias of the peritoneum and ovarium, the hypothesis of an origin in coelomic remnants is considered.

Topics: Adenocarcinoma; Adenocarcinoma, Papillary; Calcinosis; Carcinoembryonic Antigen; Female; Humans; Keratins; Microscopy, Electron; Middle Aged; Organelles; Umbilicus

A 22-year-old man had had a dome-shaped tumor on his penis for one year. Neither his particular past history nor family history was available. The excised specimen contained numerous von Kossa-positive deposits. Four types of histologic pattern were identified: 1) a cystic structure filled with amorphous material lined by a few layers of epithelial cells, 2) a cyst containing calcified deposits in the keratinous material, 3) a large calcified nodule lined by attenuated epithelial cyst walls, 4) numerous calcium collections without an epithelial wall. The cystic structure showed the histologic features of syringoma or sweat duct milia. The luminal cells of the cyst showed positive immunoreactivity for both keratin and carcinoembryonic antigen. These findings suggested that the keratinous contents of syringoma had gradually calcified, the cyst wall had been attenuated, and, finally, numerous calcium collections without an epithelial wall were formed. Our case further supported the hypothesis that penile calcinosis as well as scrotal calcinosis might derive from syringoma.

Topics: Adult; Calcinosis; Carcinoembryonic Antigen; Connective Tissue; Cysts; Epithelium; Fibrosis; Humans; Keratins; Male; Penile Diseases; Sweat Glands

The appearance of calcific masses within the dermis of scrotal skin is generally referred to as idiopathic scrotal calcinosis. There has been some debate about the pathogenesis of these calcium deposits. This debate centers on the question of whether the calcium deposition is truly idiopathic or whether it occurs as a result of preexisting epidermal cysts. We have performed immunohistochemical staining for keratin in nine patients with apparent idiopathic scrotal calcinosis and have found no evidence of keratin in the dermal tissue immediately adjacent to the calcium deposits. We conclude that idiopathic scrotal calcinosis is idiopathic.

Topics: Adolescent; Adult; Aged; Calcinosis; Epidermal Cyst; Genital Diseases, Male; Humans; Immunohistochemistry; Keratins; Male; Middle Aged; Scrotum; Skin Diseases

A case is described of ameloblastoma of maxilla presenting with numerous calcified keratin pearls. The significance of cellular variation in relation to the behavioural potential of the ameloblastoma in general is briefly discussed.

Topics: Adult; Ameloblastoma; Calcinosis; Humans; Keratins; Male; Maxillary Neoplasms

The calcifying odontogenic cyst (COC) is a rare lesion without specific clinical characteristics. Its diagnosis is essentially histopathological showing the presence of ghost cells associated with narrow squamous epithelium, the basal strata of which consist of clearly delineated cells differentiating in areas of the stellate reticulum in a similar way to ameloblastoma. The results of ultrastructural observations of the ghost cells as well as histochemical and immunohistochemical studies suggest that they are the sites of abnormal keratinisation. The aim of this study of one COC mas to locate the stages in epithelial maturation associated with the formation of ghost cells. Six monoclonal antibodies were used; three with a wide spectrum (KL1, AE3, AE1), two with a narrow spectrum against high molecular weight cytokeratins (AE2, AE8) and one against vimentin (M725). Histopathological examination of the COC revealed three different types of cells in the epithelial lining and the epithelial islands; small basal cubic cells surrounding larger ones placed centrally or suprabasally; balloon shaped cells or flattened ghost cells rolled up on themselves to resemble keratinising pearls, or cornifying cells. The ghost cells and cornifying cells had an altered distribution of their cytokeratins demonstrated by the absence of staining of antibodies against cytokeratins. The differentiated cells adjacent to them showed cytokeratins typical of squamous epithelium rather than those associated with the process of keratinization. The coexistence of cornifying and ghost cells testifies to the great potential of odontogenic epithelium to form numerous epithelial islands.

Topics: Adult; Calcinosis; Cell Membrane; Connective Tissue; Epithelium; Fibrosis; Humans; Hyperplasia; Keratins; Male; Odontogenic Tumors; Vimentin

A 29-year-old man had a 2-year history of multiple, asymptomatic, firm, subcutaneous nodules on the scrotal skin, which sometimes discharged a chalky material. Fifty-one nodules were observed in the histopathologic examination, which revealed, in addition to the typical findings of idiopathic calcinosis of the scrotum, various forms of intact cysts: epidermal (some calcified), pilar (calcified), hybrid (calcified), and indeterminate cysts with diffusely calcified keratinous content and attenuated walls. A mixture of calcified keratinous material and inflammatory infiltrates was detected, with or without remnants of the cyst wall. These findings suggest that idiopathic calcinosis of the scrotum derives from the dystrophic calcification of cysts.

Topics: Adult; Calcinosis; Epidermal Cyst; Genital Diseases, Male; Humans; Keratins; Male; Scrotum

A very rare odontogenic epithelial tumor with the combined characteristics of an adenomatoid odontogenic tumor (AOT) and calcifying epithelial odontogenic tumor (CEOT) was found in a 27 year old female. The histopathology, immunohistochemistry of keratin, lectin-binding patterns and distribution of carbonic anhydrase were determined. The nature of the calcified bodies was also examined biophysically. The tumor consisted of cuboidal and columnar odontogenic epithelial cells in the cystic wall, and AOT and CEOT in the central cavity. Odontogenic epithelial cells forming the cyst wall in the CEOT were positive for TK- and KL1-keratins, while that detected with PKK1 antibody was absent in the tumorous epithelium. Lectin binding of tumor epithelial cells was examined with Concanavalin A (Con A), peanut agglutinin (PNA), soybean agglutinin (SBA), dolichos biflorus agglutinin (DBA), wheat germ agglutinin (WGA), ricinus communis agglutinin (RCA-I), and ulex europeus agglutinin I (UEA-I) lectins, and the tumor epithelium indicated existence of glucose, mannose, Gal, GalNAc, and GlcNAc residues. The lectin binding patterns of the calcified material showed an increased intensity by enzymatic pretreatments. With an electron probe X-ray microanalyser (EPMA), the calcified lesions gave a high peak for calcium ion and for phosphorus ion and a low one for magnesium ion, as obtained from line and surface analysis.

Topics: Adult; Calcinosis; Carbonic Anhydrases; Electron Probe Microanalysis; Female; Humans; Keratins; Maxillary Neoplasms; Odontogenic Tumors; Radiography

Ghost cells in complex odontoma were studied by light microscopic and scanning electron microscopic examination of decalcified sections. They were found at different locations in odontomas: next to tubular dentin, at the site where enamel would be expected; adjacent to remnants of enamel matrix or surrounded by enamel matrix; within granular calcified masses in contact with bone or tubular dentin; in contact with ameloblasts or adjacent to small rests of odontogenic epithelium. They were either isolated or arranged in groups. Their cytoplasm presented a fibrillar component and a lack of keratohyaline. In a complex odontoma, ghost cell keratinization occurs as a result of metaplastic transformation. The calcifying process in these cells was found to be a passive one, with the cells becoming gradually entrapped within the calcified material--bone, osteoid, dentin, dystrophic osteodentin, or dystrophic granular or lamellar types of calcification. Complex odontomas contain both normal and metaplastic odontogenic epithelial cells, which may have lost their developmental and inductive properties.

Topics: Ameloblasts; Calcinosis; Cytoplasm; Cytoskeleton; Epithelium; Humans; Keratins; Microscopy, Electron, Scanning; Odontogenic Tumors; Odontoma; Staining and Labeling

An infrared spectrum of the calcified epithelioma excised from the eyelid of a three-year old girl was observed. Main absorption peaks were assigned as proteins and calcium phosphate. The crystallinity of calcium phosphate was 41%. The relative content of proteins and calcium phosphate was monitored as 7.4:1, reproducing the spectrum of the calcified epithelioma with a mixture of keratin and calcium phosphate. An epithelioma taken from the trunk of a 41-year-old man showed no calcification and the infrared spectrum of this epithelioma showed no absorption peaks of calcium phosphate.

Topics: Adult; Calcinosis; Calcium Phosphates; Carcinoma; Child, Preschool; Eyelid Neoplasms; Female; Humans; Keratins; Male; Neoplasm Proteins; Skin Neoplasms; Spectrophotometry, Infrared

Three males with the X-linked disorder dyskeratosis congenita are described. Each suffered femoral fractures after minimal trauma with poor healing. Long bones showed coarse trabecular patterns of the metaphyses and small lucency areas in the diaphyses. Two of the males were retarded brothers who additionally showed intracranial calcifications.

Topics: Adolescent; Bone and Bones; Bone Diseases; Calcinosis; Female; Fractures, Bone; Humans; Intellectual Disability; Keratins; Male; Osteoporosis; Radiography; Sex Chromosome Aberrations; Skin Diseases; Skull; Syndrome; X Chromosome

Topics: Adult; Alveolar Process; Calcinosis; Connective Tissue; Epithelium; Female; Humans; Hyalin; Jaw Neoplasms; Keratins; Mandibular Neoplasms; Maxillary Neoplasms; Odontogenic Tumors

Large cystic lesions of the maxillary sinus may initially manifest with malocclusion, cosmetic deformity, or both. Their origin may be odontogenic or nonodontogenic. Proper diagnosis of these cysts immeasurably aids in adequate (nonmutilating) treatment. A recent case of a calcifying and keratinizing odontogenic cyst that initially manifested as a facial mass exemplifies the need for adequate clinical and histological diagnosis to ensure appropriate treatment. Fewer than 35 cases have been reported since the original description in 1962.

Topics: Adult; Calcinosis; Humans; Keratins; Male; Maxillary Sinus; Odontogenesis; Odontogenic Cysts; Paranasal Sinus Neoplasms

Topics: Adult; Calcinosis; Humans; Keratins; Male; Maxillary Neoplasms; Odontogenic Tumors

Topics: Calcinosis; Female; Humans; Keratins; Mandibular Neoplasms; Middle Aged; Odontogenic Cysts

Topics: Adolescent; Adult; Aged; Basophils; Calcinosis; Child; Child, Preschool; Citrulline; Epithelial Cells; Eyelid Neoplasms; Facial Neoplasms; Female; Granulation Tissue; Hair; Humans; Infant; Keratins; Male; Sex Factors; Skin Neoplasms; Staining and Labeling; Syndrome

Topics: Amyloid; Calcinosis; Histocytochemistry; Humans; Keratins; Male; Mandibular Neoplasms; Microscopy, Electron; Middle Aged; Neoplasm Proteins; Odontogenic Tumors; Staining and Labeling

Topics: Calcinosis; Humans; Jaw Diseases; Keratins; Odontogenic Cysts

Topics: Adolescent; Adult; Basement Membrane; Calcinosis; Cell Differentiation; Cell Nucleus; Cerebral Ventricle Neoplasms; Child; Child, Preschool; Collagen; Connective Tissue Cells; Craniopharyngioma; Desmosomes; Epithelial Cells; Golgi Apparatus; Humans; Hydroxyapatites; Keratins; Microscopy, Electron; Neuroglia; Pituitary Neoplasms

Topics: Animals; Calcification, Physiologic; Calcinosis; Calcium; Dihydrotachysterol; Hair; Hypercalcemia; Keratins; Male; Phosphorus; Rats; Skin; Time Factors; X-Ray Diffraction

Topics: Basophils; Calcinosis; Hair; Humans; Keratins; Ossification, Heterotopic; Skin Neoplasms; Staining and Labeling

Topics: Calcinosis; Cysts; Gingiva; Humans; Keratins; Postoperative Complications; Transplantation, Autologous; Wound Healing

Topics: Animals; Calcinosis; Calciphylaxis; Calcium; Cholecalciferol; Hair Removal; Keratins; Male; Microscopy, Electron; Phosphorus; Rats; Rickets; Skin Diseases

Topics: Adolescent; Adult; Calcinosis; Child; Child, Preschool; Female; Hair; Humans; In Vitro Techniques; Keratins; Male; Microscopy, Electron; Middle Aged; Nails