bromochloroacetic-acid and Fibroma

Cellular fibromas represent ~10% of ovarian fibromas. Mitotically active cellular fibromas show mild nuclear atypia but ≥4 mitoses/10 high-power fields: the clinical course is usually uneventful but literature review is lacking. A 34-yr-old woman underwent left oophorectomy for a 9-cm ovarian mitotically active cellular fibroma at another hospital. The tumor was cellular (spindle cells in fascicular and storiform patterns) revealing mild atypia and 4 nonatypical mitoses/10 high-power fields without necrotic areas. After 16 yr, the tumor recurred as a 5-cm peritoneal nodule on the anterior sigmoid wall near the sigmoid-rectal junction. Frozen section revealed a spindle cell tumor invading the intestinal tunica muscularis propria: a gastrointestinal stromal tumor was favored as previous history was unavailable at that time. Intestinal resection was performed: no residual tumor was found. The patient was followed-up for 8 yr without further recurrences. The peritoneal nodule showed 2 mitoses/10 high-power fields and pericellular reticulin staining. The tumor was variably positive for vimentin/bcl-2/melan-A/CD56/ER/PR/α-inhibin/CD10/calretinin, focally positive for desmin, negative for pan-cytokeratin/actin/EMA/CD34/HMB45/CD117/CD99/S100/synaptophysin. The Ki67-index was ~9%. To our systematic literature review, 7 additional recurrent cases were reported. We describe a mitotically active cellular fibroma recurring after the longest interval of time. Extensive sampling of difficult cases should exclude malignant areas. Moderate nuclear atypia, tumor rupture, adhesions to pelvic/abdominal organs, infarction with extraovarian involvement, and incomplete excision may lead to relapse but there are conflicting data: prolonged follow-up can be suggested in these cases.

Topics: Adult; Biomarkers, Tumor; Diagnosis, Differential; Female; Fibroma; Humans; Inhibins; Keratins; Neoplasm Recurrence, Local; Ovarian Neoplasms; Ovary; Synaptophysin; Vimentin

Plexiform angiomyxoid myofibroblastic tumor (PAMT), also known as plexiform fibromyxoma, is a rare distinctive benign intramural tumor, typical of gastric antrum, commonly causing mucosal ulceration with upper gastrointestinal bleeding and anemia, effectively treated by complete surgical resection usually accomplished by distal gastrectomy.. We herein report a 47-year-old man presenting with a syncopal episode, regurgitation and epigastric discomfort, bearing a gastric antral myxoid plexiform tumor positive for α-smooth muscle actin, vimentin and, partially, for caldesmon, desmin, and CD10; CD117, DOG1, CD34, S100, CAM5.2, CK20, CK7, EMA, p53, CDX2, chromogranin A, synaptophysin, anaplastic lymphoma kinase, Melan-A, and HMB-45 were all negative. All these features are typical of PAMT. Of note, focal positivity for AE1/AE3 and pan-CK KL1 was also present.. The finding of a focal keratin expression in PAMT contributes to enlarge the immunophenotypic spectrum of this tumor type and is relevant for avoiding presurgical misdiagnoses which could ultimately lead to inappropriate overtreatment of patients with PAMT.

Topics: Biomarkers, Tumor; Fibroma; Gastrectomy; Humans; Keratins; Male; Middle Aged; Stomach Neoplasms

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

Peripheral odontogenic fibroma is a rare lesion that arises on the gingiva and can clinically mimic a variety of reactive lesions, benign neoplasms, and metastases. We describe a symptomatic lesion arising on the mandibular gingiva of a 58-year-old female with no history of trauma or dental disease in the area. An excisional biopsy showed the lesional stroma to contain numerous polyhedral granular cells with occasional interspersed islands of inactive odontogenic epithelium. We believe this to represent the fourth case of peripheral granular cell odontogenic fibroma to be reported in detail in the literature.

Topics: Female; Fibroma; Gingival Neoplasms; Granular Cell Tumor; Humans; Keratins; Mandibular Neoplasms; Middle Aged; Odontogenic Tumors

Toto bodies are eosinophilic structures that resemble the cells of the superficial cell layer of the oral epithelium. Toto bodies commonly are associated with inflammatory gingival and other mucosal lesions including pyogenic granuloma, irritational fibroma, epulis fissuratum, peripheral giant cell granuloma and inflammatory hyperplastic gingivitis. We evaluated staining characteristics of Toto bodies to establish their origin and to identify their significance in lesions. We investigated pyogenic granuloma, fibroma and leukoplakia with epithelium that exhibited Toto bodies after hematoxylin and eosin (staining. Sections were stained with Alcian blue, periodic acid-Schiff and Ayoub-Shklar stains to evaluate staining intensity and distribution. More Toto bodies were found in pyogenic granuloma than in fibroma and leukoplakia. PAS and Alcian blue staining exhibited mild intensity and did not establish the origin of Toto bodies. High staining intensity and diffuse distribution of stain was observed using Ayoub-Shklar staining, which indicated that Toto bodies originate from keratin.

Topics: Alcian Blue; Eosine Yellowish-(YS); Epithelial Cells; Epithelium; Fibroma; Hematoxylin; Humans; Keratins; Mouth Mucosa; Staining and Labeling

Fibromatosis of the breast is an uncommon neoplasm with potential for local recurrence. Treatment has traditionally been surgical excision with current trends toward conservative management. Given the option of observation after diagnosis by core needle biopsy (CNB), we sought to evaluate the accuracy of CNB for diagnosing fibromatosis.. We identified a total of 31 cases in which fibromatosis had been diagnosed or included in the differential diagnosis on a CNB, an excision, or both. Morphology and immunohistochemical results were reviewed.. Aberrant nuclear immunoreactivity for β-catenin and absent staining for CD34 were the most useful studies to diagnose fibromatosis, and one or both were performed in 21 (68%) cases. High molecular weight cytokeratins and p63 were helpful to exclude spindle cell carcinoma. Of 26 cases confirmed as fibromatosis on excision, 22 (85%) were diagnosed as fibromatosis or fibromatosis was favored in the differential diagnosis on CNB. More frequent use of immunohistochemistry would likely have resulted in a greater number of definitive diagnoses. Fibromatosis was rarely mistaken for other nonmalignant stromal lesions, with no cases misdiagnosed as carcinoma.. CNB can be an accurate method of diagnosing fibromatosis, allowing observation for a select group of patients.

Topics: Adolescent; Adult; Aged; Aged, 80 and over; Biopsy, Large-Core Needle; Breast Neoplasms; Diagnosis, Differential; Female; Fibroma; Humans; Immunohistochemistry; Keratins; Middle Aged; Sensitivity and Specificity; Young Adult

Low-grade fibromatosis-like spindle cell carcinoma is a rare tumor in the breast, and represents a variant of the very heterogeneous group of metaplastic carcinomas of the breast. These tumors warrant distinction because of their resemblance to pure fibromatosis, their propensity for local recurrence, and their favorable prognosis among the metaplastic carcinomas of the breast. The diagnosis is potentially challenging, particularly on core needle biopsies, because of the morphologic overlap with other low-grade spindle cell lesions. Recognition of a proliferation of cytologically bland spindle cells with areas of epithelial differentiation in combination with immunohistochemistry using antibodies against cytokeratins and myoepithelial markers should aid in producing a definitive diagnosis. These tumors can be locally aggressive with an increased incidence of local recurrence, but the potential for lymph node or distant metastasis is low. Complete excision with adequate margins is considered curative in the majority of cases.

Topics: Biopsy; Breast; Breast Neoplasms; Carcinoma; Diagnosis, Differential; Fibroma; Humans; Immunohistochemistry; Keratins; Neoplasm Grading; Prognosis; Vimentin

Topics: Actins; Adult; Anaplastic Lymphoma Kinase; Diagnosis, Differential; Female; Fibroma; Fibrosarcoma; Follow-Up Studies; Humans; Hysterectomy; Inflammation; Keratins; Leiomyoma; Neoplasm Recurrence, Local; Neoplasms, Muscle Tissue; Receptor Protein-Tyrosine Kinases; Uterine Neoplasms; Young Adult

Odontogenic tumours are considered to be relatively rare; however, several histologically distinct types have been identified in dogs. The more common canine odontogenic tumours are peripheral odontogenic fibroma and canine acanthomatous ameloblastoma. The expression of cytokeratins (CKs) has been established for the human dental germ and odontogenic tumours. The aim of the present study was to describe the immunohistochemical expression of a panel of CKs in the epithelium of the canine dental germ, normal gingiva and odontogenic tumours arising in this species. Samples from 20 odontogenic tumours, 12 tooth germs and three normal gingival tissues were obtained. Each sample was stained with haematoxylin and eosin and subjected to immunohistochemistry for CK expression. The typical expression pattern of CKs in the odontogenic epithelium and gingiva of dogs was CK14 and CK5/6. CKs 7, 8, 18 and 20 were generally absent from the canine dental germ, gingiva and odontogenic tumours. Dogs and man therefore exhibit similar CK expression in the odontogenic epithelium.

Topics: Ameloblastoma; Animals; Cell Differentiation; Dog Diseases; Dogs; Epithelium; Fibroma; Gene Expression Regulation, Neoplastic; Gingiva; Gingival Neoplasms; Intermediate Filaments; Keratins; Neoplasm Proteins; Odontogenic Tumors; Odontoma; Tooth Germ

The aim of this study was to describe the clinicopathologic and immunohistochemical characteristics of 14 cases of central odontogenic fibroma (COF), and the ultrastructural features of 2 of them.. Collaborative retrospective study based on the records of 4 oral pathology diagnostic services in Latin America based on the current World Health Organization classification.. There were 7 male and 7 female patients (mean age 31.8 years). Eight tumors occurred in the maxilla and 6 in the mandible. Thirteen cases were epithelium-rich and 1 epithelium-poor COF. Three were classified as hybrid COF with giant cell lesion. Mean size of the hybrid lesions were larger than pure COF (3.8 vs. 2.4 cm). Odontogenic epithelial islands were immunoreactive for cytokeratin (CK) AE1/AE3, CK5, CK14, CK19, and 34BE12 and negative for CK1 and CK18. Langerhans cells positive for S-100 and CD1a were found within the epithelial islands in 6/6 tested cases. CD68 was expressed in the giant cells of the hybrid lesions and in a few mononuclear cells of 2 cases of COF. Ki-67 index was <1% in all cases. In 6 tumors (42.8%), there were small globular eosinophilic droplets within the epithelial islands, which were positive for collagen type IV, and 9/13 cases (69.2%) were focally positive for smooth muscle actin. In addition to fibroblasts, myofibroblastic differentiation was found in the 2 cases studied ultrastructurally.. Immunohistochemistry was useful to confirm the presence of epithelium and to exclude other central fibrous tumors. COF also contains a variable number of mast cells, Langerhans cells, and myofibroblasts, and further studies are needed to better understand the participation of these cells in COF histogenesis.

Topics: Adolescent; Adult; Epithelium; Female; Fibroma; Humans; Immunohistochemistry; Keratins; Male; Mandibular Neoplasms; Maxillary Neoplasms; Middle Aged; Odontogenic Tumors; Retrospective Studies; Ultrasonography; Young Adult

Topics: Breast Neoplasms; Carcinoma; Female; Fibroma; Humans; Keloid; Keratin-5; Keratins; Lymphatic Metastasis; Metaplasia; Middle Aged

Central odontogenic fibroma (COF) is characterized by poor to cellular fibroblastic proliferation and a variable odontogenic epithelial (OE) component. Central giant cell lesions (CGCL) are osteolytic fibroblastic proliferations characterized by osteoclast-like multinucleated giant cells (MGC). Rare examples of hybrid COF/CGCL have been described. Two pathogenetic theories prevail based on clinicopathologic characteristics. One regards the CGCL component as reactive to the COF, while the other regards the CGCL as inductive of a COF-like proliferation. The possibility of colliding tumors seems unlikely.. Seven patients with hCOF/CGCL, among them one with cherubism, were studied. Immunohistochemistry for cytokeratin 19 was applied to better appreciate the epithelial component.. Six patients were males and one female and their age ranged from 15 to 73 years old. All lesions occurred in the premolars and molars of the mandible and presented as radiolucencies with primarily well-delineated borders. All patients underwent surgical excision and recurrences have not been reported to this date in 6 out of 7 patients (mean follow-up 60.6+/-36.25 months). The COF component predominated in 3 cases and the CGCL component in 3. Zones of collagen fibers featuring a whorling pattern and containing multiple nests of OE were present. In four cases there were hyalinized deposits in OE, while some foci of MGC contained few OE.. Gender predilection in our series is in contrast with previously published reports. However, when all previously reported cases are reviewed there is still female predilection. The predominant site, as previously reported, is the tooth-bearing areas of the posterior mandible. This is the first report of hCOF/CGCL in cherubism. The pathogenesis of hCOF/CGCG remains obscure and molecular interactions would be of interest to be investigated.

Topics: Adolescent; Adult; Aged; Cherubism; Female; Fibroma; Granuloma, Giant Cell; Humans; Jaw Neoplasms; Keratins; Male; Middle Aged; Odontogenic Tumors; Young Adult

Topics: Bone Neoplasms; Chondroblastoma; Fibroma; Humans; Immunohistochemistry; Keratins; Tibia

Breast cancer, a whole body disease, can metastasize at early stage. This study was to explore the correlation of peripheral blood cancer cell (PBCC) content to distant metastasis of breast cancer.. The PBCC content of 65 breast cancer patients and 8 healthy donors was detected by multi-parameter flow cytometry (FCM) with CD45 and cytokeratin staining.. Cancer cells were detected in peripheral blood samples from 57 of the 65 patients; the positive rate was 87.7%. No cancer cell was found in peripheral blood samples from healthy donors. The positive rate of PBCCs was correlated to T stage (r=0.271,P=0.017) and N stage (r=0.393, P=0.002). The patients were followed for 5 years; 2 were lost. Distant metastasis was found in 25 patients with PBCCs. In contrast, no metastasis was found in 8 patients without PBCCs (P<0.05).. Preoperative PBCC content is closely related to distant metastasis of breast cancer. The detection of PBCCs might be useful for individual treatment decision for breast cancer.

Topics: Adult; Aged; Breast Neoplasms; Carcinoma; Female; Fibroma; Flow Cytometry; Follow-Up Studies; Humans; Keratins; Leukocyte Common Antigens; Liver Neoplasms; Lung Neoplasms; Middle Aged; Neoplasm Staging; Neoplastic Cells, Circulating; Young Adult

Topics: Adult; Axilla; Calbindin 2; Desmin; Diagnosis, Differential; Epithelium; Female; Fibroma; Humans; Immunohistochemistry; Keratins; Lymph Nodes; Mesothelioma; Mucin-1; S100 Calcium Binding Protein G; Thoracic Neoplasms; Tumor Suppressor Protein p53

The case describes a 38-year-old woman presenting a multilocular radiolucency affecting the entire right half of the lower jaw, with an unerupted third molar displaced to the region of the coronoid process. The histological study showed the presence of fibroblasts, focally with pleomorphic nuclei, dense collagen and an odontogenic epithelium with dystrophic calcifications. A cyst with an important inflammatory infiltrate was, moreover, observed.

Topics: Adult; Female; Fibroma; Humans; Keratins; Mandibular Neoplasms; Membrane Proteins; Odontogenic Tumors; Radiography; Recurrence; Sex Distribution

Topics: Breast Neoplasms; Carcinoma; Diagnosis, Differential; Female; Fibroma; Humans; Keratins; Middle Aged; Vimentin

Recurrent solitary fibrous tumor of the pleura with malignant progression occurs rarely. We report a case of solitary fibrous tumor of the pleura in an 85-year-old white woman that recurred 4 times during a span of 10 years and subsequently underwent malignant transformation. The accurate diagnosis of solitary fibrous tumor is aided by ancillary techniques, such as immunohistochemical staining; however, with malignant transformation, such tools may be of limited value. Long-term clinical follow-up is recommended for all patients with solitary fibrous tumor because of the potential adverse biological behavior of this tumor, which may lead to repeated recurrences and/or malignant transformation.

Topics: Actins; Aged; Aged, 80 and over; Antigens, CD34; Biomarkers, Tumor; Diagnosis, Differential; Disease Progression; Female; Fibroma; Humans; Keratins; Mesothelioma; Mitotic Index; Neoplasm Recurrence, Local; Pleural Neoplasms; S100 Proteins; Sarcoma; Thoracic Wall

Onychomatricoma (OM) is a tumor of the nail matrix typified histologically by multiple distal fibroepithelial projections and a thick keratogenous zone forming multiple V-shaped invaginations at the level of epithelial ridges, with the formation of a thick nail plate. In its proximal portion, the thickness of the nail looks like a spur originating from the ventral part of the nail plate. In its distal part, beyond the lunula, the nail plate is globally thickened and filled with cavities containing serous fluid. Often, however, the pathologist is not provided with the nail plate. The diagnosis then rests on the presence of a fibroepithelial tumor. In this article the histologic criteria of OM without nail plate are refined and OM is characterized immunohistochemically using three tumors fixed in liquid nitrogen and examined separately from the nail plate. On longitudinal section OM without nail plate appears as a unique pedunculated fibroepithelial tumor i.e., the multiple distal epithelial digitations arranged along a transversal plane are not seen. The feature is reminiscent of fibrokeratoma. When OM is visualized in longitudinal section, 3 main criteria differentiate OM from fibrokeratoma: the presence of epithelial-lined invaginations around optical cavities, a stroma organized in 2 layers, and the absence of horny corn. Patterns of expression of cytokeratins and integrins in OM are identical to that observed in the normal nail matrix. Involucrin finds expression from the basal layer through to the top of the epithelium, where it is more marked and where transglutaminase 1 is restricted. Merkel cells detected by CK 20 are increased in number and sometimes disposed in clusters. The fibrous component of OM is composed of 2 layers: a superficial stroma made of numerous fines fibrils of collagen IV intermingled with collagen I, and deep stroma made principally of collagen I. Antibody AE13, specific to trichocytic keratins Ha 1-4, represent a good potential marker of OM. Its V-shaped expression in epithelium ridges offers early identification of the keratogenous zone of OM, on tumors separated from their nail plates and limited to their fibroepithelial components.

Topics: Biomarkers, Tumor; Diagnosis, Differential; Fibroma; Fluorescent Antibody Technique, Indirect; Humans; Integrins; Keratins; Keratosis; Microscopy, Fluorescence; Nail Diseases; Skin Neoplasms

Spindle cell carcinoma of the breast, a variant of metaplastic carcinoma, includes a wide spectrum of lesions with histomorphologic and nuclear features ranging from overtly malignant to mildly atypical. Spindle cell carcinomas with mildly atypical features may resemble fasciitis, fibromatosis, or myofibroblastic tumors and therefore are often misinterpreted as such. A recent study has suggested that spindle cell carcinomas with a dominant fibromatosis-like phenotype, unlike spindle cell carcinomas in general, have no propensity for distant metastasis and should be termed "tumors" rather than "carcinomas." To investigate the question of fibromatosis-like spindle cell breast carcinoma (FLSpCCs) metastatic potential, we studied cases of FLSpCC seen at the University of Texas M.D. Anderson Cancer Center between 1987 and 2000. Clinical, pathologic, and immunophenotypic features were reviewed, with emphasis on biologic behavior and predictors of clinical outcome. Our series included 24 women who ranged in age from 55 to 85 years (mean 66 years). Tumor size ranged from 1.0 to 5 cm (mean 2.8 cm). Most tumors were grossly well defined but had microscopic infiltrative borders. Tumors showed a dominant fibromatosis-like or myofibroblastic-like growth pattern with prominent collagenization. Inflammatory infiltrate was noted in the majority of tumors. Cytokeratin-positive cells were seen in all cases and usually appeared as cords or sheets of polygonal cells; isolated cytokeratin-positive cells were rare. In most tumors immunoreactivity for smooth muscle actin (SMA) was confined to the cytokeratin-negative cells. In five cases intense co-expression of cytokeratin and SMA was noted. None of the tumors showed immunoreactivity for smooth muscle heavy chain myosin, estrogen receptors, progesterone receptors, or HER-2/neu. Ki-67 expression was noted in fewer than 5% of tumor cells. Treatment consisted of local excision (seven cases) or modified radical mastectomy (13 cases). Treatment was unknown in four cases. In patients who underwent axillary nodal dissection, no lymph node metastases were found. Two of the six patients who underwent local excision developed local recurrence. Two patients who underwent modified radical mastectomy developed lung metastases within 2 years after the initial diagnosis. The metastatic tumors were histologically similar to the primary tumors. Our findings indicate that FLSpCCs have the potential for local recurrence and distant metastasis an

Topics: Actins; Adult; Aged; Aged, 80 and over; Biomarkers, Tumor; Breast Neoplasms; Carcinoma, Squamous Cell; Female; Fibroma; Humans; Immunoenzyme Techniques; Keratins; Lung Neoplasms; Middle Aged; Neoplasm Recurrence, Local

The expression of heat shock proteins HSP60 and HSP70 and cytokeratins CK1/10 and CK7/18 were compared in epithelium of oral lichen planus (OLP) lesions and oral fibromas using an avidin-biotin-peroxidase complex (ABC) immunohistochemical method. An immunostaining intensity distribution (IID) index was developed to assess staining intensity and the proportion of positively stained cells in different layers of the epithelium. The expression of HSP60 in the basal layer was significantly higher in OLP than in fibromas. No difference in HSP70 expression was evident between OLP and fibromas. The expression of CK1/10 in the epithelial basal and suprabasal layers was significantly higher in OLP than in fibromas. There was no demonstrable staining for CK7/18 in either OLP or fibromas. A significant correlation was evident between the expression of HSP60 and CK1/10 in the basal epithelial cells in OLP. The findings support a role for HSP60 in the pathogenesis of OLP. A unifying hypothesis of the pathogenesis of OLP, involving two sequential immune reactions, is proposed.

Topics: Adult; Basement Membrane; Chaperonin 60; Epithelial Cells; Fibroma; Genetic Predisposition to Disease; HSP70 Heat-Shock Proteins; Humans; Immunoenzyme Techniques; Keratins; Lichen Planus, Oral; Middle Aged; Mouth Neoplasms; Odds Ratio; Statistics, Nonparametric

Immunohistochemistry with monospecific antibodies was used to study the expression patterns of cytokeratins (Cks) and vimentin in non-dysplastic lesions of the oral cavity, including lichen planus and fibromas. In hyperplastic lesions, Ck expression did not deviate significantly from the normal non-keratinizing squamous epithelium of the oral cavity. Hyperkeratotic lesions showed pronounced aberrations in their Ck profile. These lesions were characterized by extended expression of the keratinization marker Ck 10, the basal cell Ck 14 and the hyperproliferation-associated Ck 16 in the suprabasal compartment. The stratification markers Cks 4 and 13 showed a decreased expression. Coexpression of Cks and vimentin was found in lesions having accumulations of inflammatory cells in the subepithelial cell layer. These changes are felt to characterize benign mucosal lesions without dysplasia and might be helpful for distinguishing these lesions from potentially malignant ones.

Topics: Antibodies, Monoclonal; Cell Division; Epithelial Cells; Epithelium; Fibroma; Gene Expression Regulation; Humans; Hyperplasia; Immunohistochemistry; Intermediate Filament Proteins; Keratins; Leukoplakia, Oral; Lichen Planus, Oral; Mouth Diseases; Mouth Mucosa; Mouth Neoplasms; Vimentin

Despite controversy regarding its histogenesis, meningeal hemangiopericytoma (HPC) is a well-defined clinicopathologic entity exhibiting high rates of recurrence and late extracranial metastasis. It must be distinguished from several benign neoplasms, particularly fibrous meningioma (FM) and solitary fibrous tumor (SFT). To determine the immunoprofile of HPC, we studied 27 meningeal examples, including 13 low-grade and 14 high-grade tumors. For comparison, 20 FMs and eight SFTs of the meninges were also evaluated. The immunotype of HPC included vimentin (85%), factor XIIIa (78%) in individual scattered cells, Leu-7 (70%), and CD34 (33%) in a weak, patchy pattern. Focal desmin and cytokeratin positivity was only occasionally encountered (20% each). The SFT shared a similar immunophenotype, except that CD34 expression (100%) was characteristically strong and diffuse. The FM characteristically expressed epithelial membrane antibody (EMA) (80%) and S-100 protein (80%); CD34 reactivity (60%) was patchy and weak. Both within and among all three tumor types, MIB-1 labeling indices varied widely. Specifically, they were unrelated to tumor grade in HPC. Significant reactivity for p53 protein was detected in 52% of HPCs, 17% of SFTs, and 5% of FMs. Meningeal HPC exhibits a distinct antigenic profile, one enabling the exclusion of other entities in nearly all cases. The rare expression of desmin or cytokeratin in HPC suggests either the occurrence of divergent differentiation or, less likely, the possibility that its distinctive morphology is but a phenotype shared by several types of meningeal sarcoma.

Topics: Adult; Aged; Antigens, CD34; Biomarkers, Tumor; Female; Fibroma; Hemangiopericytoma; Humans; Immunohistochemistry; Immunophenotyping; Keratins; Male; Meningeal Neoplasms; Meningioma; Middle Aged; Transglutaminases

We report the findings of 19 cases of a previously undescribed spindle cell tumor of soft tissues that resembles a low-grade fibromyxoid sarcoma but contains distinctive rosettelike structures. The tumors occurred principally as a painless, slowly growing, deeply situated mass of the proximal extremities in young to middle-aged adults (age range 14-65 years; mean 38). Although grossly circumscribed, the tumors had infiltrative borders microscopically and were composed of bland spindled cells situated in a hyalinized to myxoid stroma. The most characteristic feature of the tumor was scattered large rosettelike structures that often merged with serpinginous areas of dense hyalinization. The rosettes consisted of a central collagen core surrounded by a rim of rounded cells morphologically and immunophenotypically different from the cells of the spindled stroma. These cells expressed a number of antigens, including S-100 protein, neuron-specific enolase, and leu 22, in contrast to the stroma, which usually lacked these antigens. Of the 12 patients with available follow-up information, one patient treated with simple excision clinically developed local recurrence of the tumor 20 months after initial biopsy. No other recurrences were reported during the limited follow-up period, and no patient developed metastatic disease. However, the favorable prognosis of the patients in our series to date may relate to the limited follow-up period (approximately 3 years), as well as initial treatment by wide excision in nearly half of the patients. We regard the hyalinizing spindle cell tumor with giant rosettes as a distinctive type of low-grade fibroblastic tumor that with time may prove to behave similar to a low-grade fibromyxoid sarcoma and, hence, to represent an unusual variant thereof.

Topics: Actins; Adolescent; Adult; Aged; Antigens, CD; Desmin; Diagnosis, Differential; Female; Fibroma; Fibrosarcoma; Humans; Keratins; Male; Middle Aged; Neurilemmoma; Peripheral Nervous System Neoplasms; Retrospective Studies; S100 Proteins; Soft Tissue Neoplasms; Vimentin

A 47-year-old woman noticed a nodule on her right shoulder that had been gradually increasing in size without symptoms. Histologic features of the biopsied nodule included round to irregularly shaped epithelial lobules demarcated by abundant sclerotic stroma located within the lower dermis and extending to the subcutis. The epithelial lobules consisted of cuboidal to columnar basaloid cells and were frequently arranged in narrow strands with many bifurcations and branching. Cystic structures containing lamellar keratinous material were occasionally found in connection with the lobules. The histologic findings were interpreted as trichoblastic fibroma. Immunohistochemical studies with antibodies directed against cytokeratins (CK) and involucrin revealed positive staining in most of the tumor cells with RCK102 and 34 beta E12 antikeratin antibodies, whereas the epithelial cords and the peripheral cells of the cystic structures stained with 170.2.14, 4.1.18, and CAM 5.2 antikeratin antibodies. However, CK1 or simple epithelial cytokeratins were not detected in any neoplastic elements. Based on comparative immunohistochemical findings in normal hair follicles, we propose that trichoblastic fibroma may first differentiate toward the outermost cell layer of the outer root sheath between the lower permanent portion and the upper transient portion and then into various other parts of the hair follicle.

Topics: Epithelium; Female; Fibroma; Gene Expression Regulation, Neoplastic; Hair Follicle; Humans; Immunohistochemistry; Keratins; Middle Aged; Protein Precursors; Sclerosis; Shoulder; Skin; Skin Neoplasms

Solitary fibrous tumors are rare spindle cell neoplasms that most commonly arise in the pleura. Recently, solitary fibrous tumors of the orbital soft tissues have been described. The authors report the first case of solitary fibrous tumor arising in the lacrimal gland fossa and discuss features that may distinguish solitary fibrous tumor from other lacrimal fossa lesions.. A left lacrimal gland fossa tumor was excised via lateral orbitotomy from a 76-year-old man and analyzed by light microscopy. Immunohistochemical studies were performed using antibodies to CD34, vimentin, epithelial membrane antigen, cytokeratins AE1-3 and Cam5.2, S-100 protein, and actin.. The histopathologic features of the tumor were typical of solitary fibrous tumor. A well-circumscribed, variably cellular proliferation of bland spindle cells displayed both "patternless" and storiform growth patterns. Immunohistochemical studies showed that the tumor cells expressed vimentin and CD34 but did not express epithelial membrane antigen, cytokeratins, S-100 protein, or actin. The patient is free of tumor recurrence after 1 year of follow-up.. The authors report the first case of solitary fibrous tumor arising in the lacrimal gland fossa. The clinical presentation of this tumor was similar to that of pleomorphic adenoma (benign mixed tumor) of the lacrimal gland; fortunately, the treatment for both of these lacrimal gland fossa neoplasms is en bloc excision. The histopathologic appearance of solitary fibrous tumor is varied, and immunohistochemical analysis may help in distinguishing solitary fibrous tumor from other lacrimal fossa lesions. Careful follow-up of patients with solitary fibrous tumor is important because recurrence may present years after excision of the primary tumor.

Topics: Aged; Antigens, CD34; Biomarkers, Tumor; Fibroma; Humans; Immunohistochemistry; Keratins; Lacrimal Apparatus Diseases; Male; Mucin-1; S100 Proteins; Tomography, X-Ray Computed; Vimentin

Peritoneal mesotheliomas are rare in women, compared to serous epithelial neoplasms with which they are often confused. We evaluated the clinicopathologic features of 19 true mesothelial neoplasms affecting the genital tract or peritoneum of women (other than adenomatoid tumors, benign multicystic mesotheliomas, and localized fibrous tumors) to characterize their clinicopathologic features and to determine their clinical behavior. Six tumors were localized to one anatomic site at presentation, and 13 involved more than one anatomic site. The six localized tumors were solitary, small (0.8-2.0 cm), polypoid or nodular lesions, five of which were incidental findings. All had a predominantly tubulopapillary pattern, either pure or mixed with adenomatoid-like or small solid foci. Nuclear grade ranged from 0 to 2. Mitotic figures (MF) were absent in two tumors. The mitosis count in the other four tumors was < 1 MF/10 high-power microscopic fields (HPF) (average method) and ranged from 1 to 3 MF/10 HPF (highest count method). Five patients were alive without recurrence after postoperative intervals ranging from 19 months to 9 years (median, 5 years); one patient died of metastatic gastric carcinoma at 14 months. Thirteen tumors involved more than one anatomic site and were classified as diffuse mesothelioma. Typically, these tumors were symptomatic and accompanied by ascites. The tumors had either a plaque-like or endophytic configuration. Eleven were purely epithelial mesotheliomas, and two had a minor sarcomatoid component. Tubulopapillary patterns were present in 10 tumors, usually admixed with focal adenomatoid-like or solid patterns, and three had a purely solid pattern. All 13 tumors had grade 3 nuclei. The mitosis count ranged from < 1 to 2 MF/10 HPF (average count method) with a range of 1-4 MF/10 HPF by the highest count method. Immunohistochemically, 13/13 tumors stained for cytokeratin (AE1/AE3). None were immunoreactive for polyclonal carcinoembryonic antigen (CEA), Leu-M1, or B72.3. One diffuse mesothelioma stained focally for Ber-EP4, and electron microscopy confirmed the mesothelial nature of this tumor. Nine patients died of tumor after postoperative intervals ranging from 1 month to 6 years. Eleven patients had received postoperative adjuvant intraperitoneal or systemic chemotherapy. One patient died with increased abdominal girth 8 years after operation and one course of intraperitoneal chemotherapy, though the role of mesothelioma in her death

Topics: Adenomatoid Tumor; Adult; Aged; Aged, 80 and over; Female; Fibroma; Follow-Up Studies; Genital Neoplasms, Female; Humans; Immunohistochemistry; Keratins; Mesothelioma; Mesothelioma, Cystic; Microscopy, Electron; Middle Aged; Mitosis; Peritoneal Neoplasms; Prognosis

This article reports a series of 103 cases of giant cell fibromas occurring in the oral mucosa. The commonest location was the gingiva, followed by the tongue and the buccal mucosa. The mean age of the patients was 27.7 years, and the median age 21 years. Microscopically, the tumors were characterized by the presence of large stellate or angular cells, which occasionally contained several nuclei. Immunohistochemical stains showed that the cells were vimentin-positive but negative for S-100 protein, cytokeratin, leukocyte common antigen, and neurofilament.

Topics: Adolescent; Adult; Aged; Cell Nucleus; Child; Child, Preschool; Female; Fibroma; Giant Cells; Gingival Neoplasms; Humans; Immunohistochemistry; Keratins; Leukocyte Common Antigens; Male; Middle Aged; Mouth Mucosa; Mouth Neoplasms; Neurofilament Proteins; S100 Proteins; Tongue Neoplasms; Vimentin

The origin of the stromal, stellate and multinucleate cells in oral giant cell fibroma is unclear. Sixteen giant cell fibromas were stained immunocytochemically for keratin (MNF 116), vimentin, S-100 protein, neurofilaments, glial fibrillary acidic protein, alpha-smooth muscle actin, desmin, CD31 (PECAM-1), CD68, Factor XIIIa and prolyl 4-hydroxylase (5B5). In all cases positive staining was found with vimentin and prolyl 4-hydroxylase, indicating a functional fibroblast phenotype. Reactivity for Factor XIIIa was seen in two cases and in only one was a small number of giant cells stained, suggesting that the majority of oral giant cell fibromas are unrelated to the histologically similar fibrous papule of the nose or facial angiofibroma.

Topics: Actins; Adolescent; Adult; Aged; Animals; Antigens, CD; Antigens, Differentiation, Myelomonocytic; Cell Adhesion Molecules; Desmin; Female; Fibroblasts; Fibroma; Giant Cell Tumors; Glial Fibrillary Acidic Protein; Humans; Immunohistochemistry; Keratins; Male; Middle Aged; Mouth Neoplasms; Neurofilament Proteins; Phenotype; Platelet Endothelial Cell Adhesion Molecule-1; Procollagen-Proline Dioxygenase; S100 Proteins; Stromal Cells; Transglutaminases; Vimentin

A total of 30 sex cord-stromal tumors including 9 adult type and 5 juvenile type granulosa cell tumors (GCTs), 4 Sertoli-Leydig cell tumors (SLTs), 1 gynandroblastoma, 5 thecomas, 2 fibromas and 3 sclerosing stromal tumors were immunohistochemically evaluated by means of cytokeratins of different molecular weight, vimentin and laminin with regard to the histogenesis of these tumors and to the embryogenesis of the sex cord and stroma of developing gonads. For comparison, 7 embryonic gonads, 9 fetal and 9 adult ovaries, 14 fetal and 5 postnatal testes, and 1 gonadoblastoma were also examined. The coelomic epithelium of all gonads were positive for both cytokeratins (CAM 5.2 and AE1) and vimentin. In fetal ovaries, the granulosa cells of primordial follicles express low molecular weight cytokeratins only and those cells of more maturing follicles did not express any cytokeratin or vimentin. In adult ovaries, the granulosa cells of primordial follicles coexpressed low molecular weight cytokeratins and vimentin, but those cells of more maturing follicles expressed vimentin only. In fetal testes before 20 weeks gestational age, the Sertoli and Leydig cells did not express any cytokeratins and vimentin. After that time, both cells expressed vimentin only throughout life. The rete ovarii and rete testis from fetal to adult life coexpressed both low molecular weight cytokeratins and vimentin. The rete ovarii in all ages and rete testis in prenatal and childhood ages were surrounded by the laminin-positive basement membrane, however, the rete testis in adult were not. In neoplasia, the GCTs, thecomas, fibromas, and sclerosing stromal tumors expressed vimentin only.(ABSTRACT TRUNCATED AT 250 WORDS)

Topics: Adult; Basement Membrane; Child, Preschool; Female; Fetus; Fibroma; Gonadoblastoma; Humans; Immunohistochemistry; Infant; Keratins; Laminin; Male; Molecular Weight; Neoplasms, Gonadal Tissue; Ovarian Neoplasms; Ovary; Sertoli-Leydig Cell Tumor; Sex Cord-Gonadal Stromal Tumors; Testis; Thecoma; Vimentin

The localized fibrous tumors of the pleura are rare neoplasms, also known as "benign pleural fibromas" or "localized mesotheliomas", but those names are inaccurate. The tumors are composed of undifferentiated mesenchymal cells, intermediate and differentiated fibroblasts and collagenous interstitial tissue. Their origin is normally the submesothelial layer of the visceral pleura. Mesothelial differentiation is not present. The grading of malignancy doesn't correlate with final outcome, adequacy of surgical excision being the most important factor. This neoplasm may recur but retain its basical histologic features. The positive results for vimentin and negative results for cytokeratin antibodies help to distinguish the localized fibrous tumors from the mesothelioma. We present too cases and their diagnostic possibilities.

Topics: Adult; Biomarkers, Tumor; Diagnosis, Differential; Female; Fibroma; Humans; Keratins; Mesothelioma; Middle Aged; Pleura; Pleural Neoplasms; Vimentin

Pseudosarcomatous fibromyxoid tumor of the genitourinary tract is a rare pathologic entity of hitherto unknown etiology that, because of the cellular pleomorphism and the infiltrative nature of the lesion, may be mistakenly diagnosed as sarcomatoid carcinoma or sarcoma. We retrospectively studied nine pseudosarcomatous fibromyxoid tumors involving the bladder and prostate to define characteristic parameters that may allow for accurate diagnosis. The study patients included four men and five women with a mean age of 48.7 years. Histologic analysis revealed myxoid lesions with a proliferation of spindle fibroblastic cells in a background of granulation tissue-type vascularity and inflammatory cells. Mitoses were infrequent and no atypical forms were found. Immunostaining was positive for vimentin and smooth muscle actin, and negative for S-100 protein, desmin, myoglobin, and keratin. Ultrastructurally, the lesion displayed fibroblastic and myofibroblastic cell features. Flow cytometric DNA content analysis revealed uniform DNA diploidy and a low S-phase fraction. All patients were alive and well with no evidence of disease after a mean follow-up of 4.8 years. In contrast, the sarcomatoid carcinomas and sarcomas of the urinary bladder and prostate that were used as controls occurred in older patients and had more frequent mitoses with atypical forms, tumor-type necrosis, and different immunostaining profiles; they were preponderantly aneuploid or diploid with high S-phase fraction. Awareness of the clinicopathologic and biologic characteristics of these lesions is necessary to ensure their accurate diagnosis and to prevent unnecessary radical therapy.

Topics: Actins; Adult; Carcinoma; Desmin; Diagnosis, Differential; DNA, Neoplasm; Female; Fibroma; Flow Cytometry; Humans; Immunohistochemistry; Keratins; Male; Microscopy, Electron; Middle Aged; Myoglobin; Ploidies; Prostatic Neoplasms; Retrospective Studies; S Phase; S100 Proteins; Sarcoma; Urinary Bladder Neoplasms; Vimentin

Ovarian myxomas recently have been reported as new, distinct pathologic entities that show a myxoid, moderately cellular proliferation of spindle and stellate cells interspersed with areas of fibrosis, hemorrhage, and delicate vascular spaces. These histologic features are frequently seen in the thecoma-fibroma group of ovarian stromal tumors. For this reason, we propose that ovarian myxomas are part of the spectrum of differentiation in thecomas-fibromas of the ovary. To provide histologic and immunohistochemical evidence for this proposal, four ovarian myxomas were compared with 48 primary ovarian stromal tumors in the thecoma-fibroma group from 46 patients. The thecoma-fibroma group of stromal tumors included 23 thecomas, 23 fibromas, and two sclerosing stromal tumors. We found significant (> 25% of histologic appearance) myxoid change in six thecomas and one sclerosing stromal tumor. This myxoid change resembled the histologic appearance of an ovarian myxoma. Immunohistochemical studies on paraffin-embedded material showed vimentin immunostaining in all tumors. Smooth-muscle actin was present in all of the myxomas, in two of the two sclerosing stromal tumors, and in 20 (90%) of the 23 thecomas, but it was present in only 11 (48%) of the 23 fibromas. Desmin staining was not present in any of the four ovarian myxomas or in the two sclerosing stromal tumors, and only three (13%) of the 23 thecomas showed focal staining for desmin. Nine (39%) of the 23 fibromas expressed desmin. S100 protein was expressed in one fibroma and one thecoma, weakly. None of the ovarian myxomas or the thecoma-fibroma group of stromal tumors expressed cytokeratins as detected by three different monoclonal antibody cocktails, ie, cytokeratin AE1/AE3, cytokeratin CAM 5.2, or cytokeratin MAK-6. The ovarian thecoma-fibroma group of stromal tumors form a histologic spectrum of lesions in which clear-cut distinguishing points between various entities are difficult to define. The myxoid change, present in the thecoma-fibroma group of tumors, was indistinguishable histologically and immunohistochemically from ovarian myxoma. For this reason, we propose that ovarian myxomas may be at one end of the spectrum of differentiation in the thecoma-fibroma group of tumors, in which no remaining stromal tumor is detectable.

Topics: Actins; Adult; Aged; Antibodies, Monoclonal; Desmin; Female; Fibroma; Humans; Immunohistochemistry; Keratins; Middle Aged; Myxoma; Ovarian Neoplasms; Thecoma; Vimentin

The most controversial aspect of osteofibrous dysplasia (OFD) is its possible histogenetic relationship to adamantinoma of long bone. Evidence is recently beginning to accumulate that OFD may be a reactive process to regressive adamantinoma. To verify the concept, 13 lesions of OFD were studied again by immunohistochemistry for cytokeratins of different molecular masses, as well as by conventional stainings. In addition, 2 adamantinomas and 6 fibrous dysplasias of the tibia were studied for reference. A small number of spindle- or ovoid-shaped cells scattered individually in the fibro-osseous stroma showed positive reactions for cytokeratins of 55-57 kDa in 2 lesions, and for those of 45-56.5 kDa in 8 lesions of 13 OFDs, although no definite epithelial island could be detected even by immunohistochemistry. Adamantinomas also showed single cytokeratin-positive cells dispersed in fibroblastic stroma, in addition to epithelial islands positive for cytokeratins of both 55-57 kDa and 45-56.5 kDa. All cases of fibrous dysplasia were negative for cytokeratins. During the observation, no case of OFDs progressed to classic adamantinoma. The present study, demonstrating the existence of an intermediate stage between "differentiated adamantinoma" and total elimination of adamantinomatous components, gives further support for the concept that OFD is a secondary reactive process to adamantinomatous tissue. In practice, the existence of single scattered cytokeratin-immunoreactive cells in otherwise typical OFDs may not indicate the truly malignant behaviour of classic adamantinoma, unless discrete epithelioid cell nests are also found.

Topics: Adolescent; Adult; Bone Neoplasms; Child; Child, Preschool; Female; Fibroma; Humans; Immunohistochemistry; Infant; Keratins; Male; Osteoma; Tibia

Five cases of a previously undescribed variant of epithelioid sarcoma are presented. This variant differs from the usual lesion in its absence of the typical necrobiotic nodular epithelioid pattern. It is instead composed of deceptively bland fibrohistiocytic and myoid cells arranged in a fibroma-like or dermatofibroma-like pattern with an affinity for osseous involvement. The clinical presentation, ultrastructural features, and presence of vimentin and low molecular weight keratin within the tumor cells justifies their designation as an epithelioid sarcoma variant.

Topics: Adolescent; Adult; Bone Neoplasms; Calcaneus; Diagnosis, Differential; Female; Femoral Neoplasms; Fibroma; Fingers; Histiocytoma, Benign Fibrous; Humans; Humerus; Keratins; Male; Neoplasm Recurrence, Local; Neoplasms, Multiple Primary; Sarcoma; Skin Neoplasms; Soft Tissue Neoplasms; Thigh; Tibia; Toes; Ulna; Vimentin

A case report of epithelioid adrenal angiosarcoma is presented. Tumor cells showed expression of cytokeratin, Factor VIII-related antigen, Ulex europaeus agglutinin-I, and vimentin. The patient also was found to have mesenteric fibromatosis (abdominal desmoid tumor) and an elevated serum level of estradiol. The authors discuss the unique appearance of these rare tumors, their relationship to hyperestrinism, and review the recent data in the literature showing cytokeratin expression by malignant epithelioid vascular tumors.

Topics: Adrenal Gland Neoplasms; Adult; Estradiol; Fibroma; Hemangiosarcoma; Humans; Immunohistochemistry; Keratins; Male; Mesentery; Peritoneal Neoplasms

A survey of 4342 oral pathology reports accumulated over a five-year period was performed. Diagnoses were 1090 irritation fibromas and 116 giant cell fibromas. A statistical comparison was then made between the giant cell fibromas and the irritation fibromas to determine if there were any differences between these two lesions with respect to sex or race predilection, age distribution, or location in the oral cavity. Finally, various staining techniques were performed on the giant cell fibromas in an attempt to ascertain the origin of the giant cells present in these lesions. The results will be discussed in this paper.

Topics: Adolescent; Adult; Aged; Child; Child, Preschool; Collagen; Epithelium; Female; Fibroma; Giant Cells; Gingival Neoplasms; Humans; Hyperplasia; Immunoenzyme Techniques; Keratins; Male; Middle Aged; Mouth Neoplasms; Palatal Neoplasms; Tongue Neoplasms

Desmoplastic small cell tumors arising diffusely within the abdomen and lacking an apparent organ of origin are rare. Most previously reported cases occurred in children, but young adult patients also have been described. Light microscopic examination shows the tumors to be composed of nests of small cells surrounded by an abundant desmoplastic stroma. Immunohistochemical findings reveal multidirectional differentiation with coexpression of cytokeratin, milk fat globule, neuron-specific enolase, Leu-7, desmin, and vimentin. Electron microscopic examination demonstrates paranuclear condensations of intermediate filaments. The authors describe two patients who died of their disease, despite aggressive chemotherapy and surgical intervention.

Topics: Adolescent; Adult; Biomarkers, Tumor; Desmin; Fibroma; Histocytochemistry; Humans; Immunoenzyme Techniques; Keratins; Male; Peritoneal Neoplasms; Vimentin

We present an anatomical-clinical analysis of ten cases of benign pleural fibroma. This tumour was discovered in a systematic fashion in 8 of the 10 cases and fortuitously in one. Recent radiological examinations enabled the diagnosis to be suspected. Computerised tomography most often precisely identified the pleural topography and imagery by nuclear magnetic resonance in one case visualised fibrous tissue (with a zone of low signals on the scale in T2). The final diagnosis was achieved at the same time as the treatment when an exploratory thoracotomy was performed. In all the cases there was a tumour composed of fusiform cells covered by normal epithelium coming from the viscera pleura 8 times out of 10. The ultrastructure examination and immunohistochemistry of the fusiform cells (Vimentin plus, EMA-, KL1-) allowed for a differentiation of these tumours of connective tissue origin from tumours of mesothelial origin. These analyses constitute an argument in favour of the fibroblastic origin of pleural fibromas.

Topics: Adult; Aged; Female; Fibroblasts; Fibroma; Humans; Immunohistochemistry; Keratins; Male; Middle Aged; Pleural Neoplasms; Vimentin

A case of atypical fibromyxoid tumor of the urinary bladder in a 32-year-old woman is reported. The patient had never complained of urinary symptoms, and bladder tumefaction was revealed fortuitously at pelvic ultrasound. Cystoscopy revealed a peanut-sized mass. Microscopically, the lesion was composed of strap- and tadpole-shaped cells resembling rhabdomyoblasts. For this reason, the tumor was initially diagnosed as embryonal rhabdomyosarcoma. However, immuno-histochemical study was negative for muscle origin, and the tumor has subsequently proved benign. The reported case illustrates the value of immuno-histochemical study in the evaluation of the true type of bizarre stroma cells in this pseudo-sarcomatous lesion. Their recognition is important, because the therapeutic consequences of misinterpreting this tumor as a sarcoma are great.

Topics: Adult; Female; Fibroma; Humans; Immunohistochemistry; Keratins; Urinary Bladder Neoplasms; Vimentin

Topics: Abdominal Neoplasms; Adolescent; Adult; Antibodies, Monoclonal; Cell Transformation, Neoplastic; Child; Desmin; Diagnosis, Differential; Female; Fibroma; Humans; Keratins; Male; Neoplasms, Germ Cell and Embryonal

Two unusual fibroxanthomas were studied by light microscopy. The first case contained numerous osteoclast-like cells and resembled malignant giant cell tumour of soft tissues, a variant of malignant fibrous histiocytoma. Osteoclast-like giant cells were negative for lysozyme and alpha-1-antitrypsin. The second case contained areas of chondroid differentiation which resembled chondrosarcoma. Tumour cells within the cartilaginous areas were positive for S100 protein.

Topics: Aged; Aged, 80 and over; alpha 1-Antitrypsin; Chondrosarcoma; Female; Fibroma; Genetic Variation; Histiocytoma, Benign Fibrous; Humans; Immunohistochemistry; Keratins; Muramidase; S100 Proteins; Skin Neoplasms

We describe 59 cases of a microscopically unique neoplasm that has not been previously reported. The tumor almost exclusively affected adults (range 14-79 years) and had a male predominance (38 men and 21 women). It presented in most cases as a small, painless, well-circumscribed mass (median, 4 cm) in subcutis or muscle. It occurred chiefly in the upper and lower extremities (40 cases) and less frequently in the trunk (11 cases) and the head and neck region (eight cases). Microscopically, the tumor was partly lobulated and composed of small, round cells that had vesicular nuclei and indistinct cytoplasm. Typically, the cells were arranged in a cord- or nestlike pattern within a myxoid matrix that frequently showed transitions toward hyaline fibrosis and focal osteoid formation. In about two-thirds of the cases, the cells contained immunoreactive S-100 protein. An additional typical feature, seen in 48 (81%) of the 59 cases, was the presence of an incomplete shell of mature bone in the capsular region of the tumor. Follow-up information, available in 41 cases, revealed that 11 patients (27%) experienced one or more recurrences. One patient with three recurrences developed a second tumor in the opposite thigh, presumably a metastasis. None of the patients died of the tumor, but three died of causes unrelated to the disease. Although the histogenesis is uncertain, cartilaginous or neural origin seem to be most likely. Until this issue is resolved, we prefer the descriptive and less committal designation of "ossifying fibromyxoid tumor of soft parts."

Topics: Adolescent; Adult; Aged; Chondroma; Chondrosarcoma; Female; Fibroma; Glial Fibrillary Acidic Protein; Humans; Immunohistochemistry; Keratins; Male; Microscopy, Electron; Middle Aged; Neoplasm Recurrence, Local; Ossification, Heterotopic; S100 Proteins; Soft Tissue Neoplasms

Dermatofibromas are frequently associated with acanthosis of the overlying epidermis. Using monospecific antisera and cRNA probes, we have examined the pattern of expression of keratin and keratin mRNA in the affected epidermis of patients with these dermal tumors. Our studies reveal several abnormalities in keratin expression within the thickened areas of overlying epidermis. In two of 15 patients, we detected K6 and K16, keratins which are frequently associated with epidermal diseases of hyperproliferation but are not present in normal epidermis. In both cases, K6 and K16 were found in suprabasal layers, similar to that seen for psoriasis and squamous cell carcinomas. Expression of K6 and K16 in skin samples from patients with dermatofibromas seemed to be dependent upon how near was the tumor to the overlying epidermis, and possibly upon the degree of cellularity within the tumor mass. A second aberration in keratin expression, and one which did not appear to be linked to K6/K16 expression, was the altered expression of the basal epidermal keratin K14. Expression of this keratin and its mRNA was variable, often extending into multiple suprabasal layers and including both basal-like and squamous-like cells. In contrast to the expression of K6/K16, aberrant expression of K14 was a relatively frequent event, occurring in greater than 70% of the dermatofibroma skin samples examined. These observations provide the first biochemical evidence in support of previous morphologic studies, indicating that alterations in epidermal differentiation can occur as a consequence of dermal skin tumors.

Topics: Fibroma; Humans; Immunoblotting; Keratins; Skin; Skin Neoplasms

A fibrous pseudotumor of the testis from a 46-year-old man was examined histologically and immunohistochemically. The tumor, situated in the tunica vaginalis, appeared as multiple round nodules up to 2 cm in diameter, and was composed largely of fibrous tissue with scanty inflammatory cell infiltration. Besides mesothelial cells covering part of the tumor, foci of piled-up cells were found among the fibrous tumor tissue. The cells in the foci were spindle and polygonal in shape, and contained oval nuclei. Immunohistochemically, these cells were positive for vimentin and keratin, but negative for CEA. Similar features have been found in pleural mesothelioma, supporting the concept that testicular fibrous pseudotumor could represent neoplastic growth of the mesothelium of the tunica vaginalis.

Topics: Fibroma; Humans; Immunohistochemistry; Keratins; Male; Mesothelioma; Middle Aged; Testicular Neoplasms; Vimentin

Four cases of ameloblastic fibroma are described immunohistochemically in terms of intermediate-sized proteins in both epithelial and mesodermal components. Keratin proteins were demonstrated by polyclonal anti-keratin antiserum (TK: detecting 41-65 kDa keratins) and 2 monoclonal antibodies to keratin (KL1: 55-57 kDa, PKK1: 44, 46, 52 and 54 kDa), and monoclonal antibodies to vimentin and desmin. Two types of odontogenic epithelial tumour cells were discriminated: undifferentiated odontogenic cells and common ameloblastoma cells. Keratin expression was found to be stronger in undifferentiated cells than in the ameloblastoma cells. Undifferentiated cells were PAS-positive, while ameloblastoma cells were negative. Fibroma cells were strongly positive for vimentin, and negative for desmin. Keratin proteins were also expressed slightly. Thus, coexpression of keratin and vimentin was seen in fibroma cells. Histogenesis is discussed from the standpoint of the distribution patterns of keratin and vimentin, as well as with respect to the histopathology.

Topics: Child; Child, Preschool; Epithelium; Female; Fibroma; Humans; Intermediate Filaments; Jaw Neoplasms; Keratins; Male; Neoplasm Proteins; Odontogenic Tumors; Staining and Labeling

A laryngeal squamous cell carcinoma in situ with an underlying spindle cell nodule (pseudosarcoma) was immunohistochemically labeled with antibodies to tissue-specific intermediate filament proteins, including desmin, vimentin, and cytokeratin. Two distinct populations of cells were found within the lesion: cytokeratin-positive cells, corresponding to the carcinomatous component of the tumor, and vimentin-positive spindle cells in the subepithelial nodule. In view of the strict specificity of antivimentin and anticytokeratin for cells of mesenchymal and epithelial origin, respectively, it is proposed that the two components of the pseudosarcoma in our case are not morphologic variants of the same tumor, and that the subepithelial nodule represents a mesenchymal lesion. These results can, however, not be extrapolated to other cases since in some the spindle cell component may represent metaplastic epithelial cells. In view of the difficulties encountered in reaching a correct diagnosis in these lesions, it is recommended to use intermediate filament typing to elucidate the nature of the spindle cells in this controversial tumor.

Topics: Carcinoma in Situ; Carcinoma, Squamous Cell; Epithelium; Fibroma; Histocytochemistry; Humans; Immunoenzyme Techniques; Intermediate Filament Proteins; Keratins; Laryngeal Neoplasms; Male; Middle Aged

The expression of the intermediate filaments cytokeratin and vimentin were studied immunohistochemically in a series of ovarian sex cord-stromal tumours (26 adult and juvenile granulosa cell tumours, 11 thecomas, six fibromas, three Sertoli-Leydig cell tumours and 1 sex cord tumour with annular tubules). Contrary to previous reports, granulosa cell tumours expressed cytokeratins as well as vimentin. Thecomas and fibromas expressed vimentin only. In Sertoli-Leydig cell tumours and the sex cord tumour with annular tubules, both cytokeratins and vimentin were detected. Correlative studies in adult ovaries showed that patterns of expression in non-neoplastic granulosa, thecal and stromal cells correspond to their neoplastic counterparts. Investigation of fetal ovaries demonstrated that these patterns of intermediate filament expression exist from relatively early stages of development. Ovarian surface epithelium and rete ovarii, like granulosa cells, co-expressed cytokeratin and vimentin. The demonstration of cytokeratins in granulosa cells and the reported presence of desmosomes and tonofilaments, suggests the epithelial nature of these cells although not clarifying their histogenesis. The presence of both these intermediate filaments in granulosa and Sertoli-Leydig cell tumours as well as in some ovarian carcinomas which may mimic them, limits their value in differential diagnosis between these tumour groups.

Topics: Adult; Cytoskeleton; Female; Fibroma; Granulosa Cell Tumor; Humans; Intermediate Filaments; Keratins; Leydig Cell Tumor; Ovarian Neoplasms; Ovary; Thecoma; Vimentin

Eight cases of esophageal carcinoma with prominent spindle cells (carcinosarcoma or pseudosarcoma) were studied using the avidin-biotin immunoperoxidase method and monoclonal antibodies to various keratins and vimentin. In all eight cases positive immunoreactivity for keratin was found in carcinomatous areas and for vimentin, in the spindle cells. It is interesting that five cases demonstrated focal immunoreactivity to keratin in the spindle cell component. Trace positivity to vimentin was seen in the carcinomatous areas in one case. These findings are consistent with the hypothesis that esophageal carcinoma with prominent spindle cells is of epithelial origin and may represent a morphologic variant of squamous cell carcinoma.

Topics: Aged; Aged, 80 and over; Antibodies, Monoclonal; Carcinoma; Carcinoma, Squamous Cell; Carcinosarcoma; Esophageal Neoplasms; Female; Fibroma; Humans; Immunoenzyme Techniques; Keratins; Male; Middle Aged; Molecular Weight; Vimentin

Two monoclonal antibodies, KA 1 and KA 4, raised against human epidermis, were biochemically and immunologically characterized and were shown to react with specific cytokeratin polypeptides. On frozen sections of human mammary gland, these antibodies distinguish between myoepithelial and luminal epithelial cells. We present evidence that in these cells KA 1 antibody recognized cytokeratin 5 and KA 4 antibody cytokeratin 19. In normal mammary tissue, KA 4 antibody invariably reacted with the epithelial cells lining the lumina of acini, ductules, ducts, and sinus. In contrast, KA 1 antibody decorated only the myoepithelial and basal epithelial cells of acini, ducts, and sinus. In ductules, however, KA 1 also stained the luminal cells. All 73 invasive lobular and ductal carcinomas studied reacted with KA 4 antibody; five of these were also positive, apparently in the same tumor cells, with KA 1. The tumor cells of in situ carcinomas were also stained in a homogeneous pattern with KA 4 antibody; KA 1 antibody reacted only with the surrounding myoepithelium. In epithelial hyperplasias, the proliferating cells were decorated by KA 1 and KA 4 antibodies in a heterogeneous pattern. Other antibodies were used for comparison. The results are discussed with respect to epithelial differentiation and pathogenesis and to the application of such antibodies for immunohistodiagnosis of mammary lesions.

Topics: Adenoma; Antibodies, Monoclonal; Antibodies, Neoplasm; Breast Neoplasms; Carcinoma; Carcinoma in Situ; Carcinoma, Intraductal, Noninfiltrating; Epithelium; Female; Fibroma; Fluorescent Antibody Technique; Humans; Keratins; Lactation; Neoplasm Proteins; Papilloma; Pregnancy

It is uncertain whether localized lesions of serosal membranes have a kinship to mesotheliomas or are truly fibromatous in nature. Ultrastructural and immunohistochemical investigations were carried out on 12 localized benign and malignant pleural and peritoneal tumours from 10 patients. Electron microscopic findings, including the consistent and non-fibroblastic cellular organization of localized neoplasms, the presence of some form of intercellular junctions in 7 of 10 cases, basal lamina deposition in 3 cases, and polarized microvilli in one case indicated a form of mesothelial differentiation. Using monoclonal and polyclonal antibodies, positive immunostaining of tumour cells for cytokeratin peptides was detected in one case, while antibody to vimentin stained four cases. Light microscopic, ultrastructural and immunohistochemical features of one benign localized serosal tumour, with a unique blend of epithelial and spindle cells, provided further evidence for a histogenic link between localized serosal tumours and diffuse epithelial mesotheliomas. On the basis of the current findings and reports in the literature, it would appear that the majority of localized tumours of serosal membranes are a subset of mesothelioma, while a minority are fibromas.

Topics: Adult; Aged; Antibodies, Monoclonal; Female; Fibroma; Histocytochemistry; Humans; Keratins; Male; Mesothelioma; Microscopy, Electron; Middle Aged; Peritoneal Neoplasms; Pleural Neoplasms; Serous Membrane

Formalin-fixed, paraffin-embedded biopsies of metaplastic keratinized oral mucosa (fibromas and leukoplakias), oral mucosa with epithelial dysplasia and oral squamous cell carcinomas were stained with two monoclonal anti-keratin antibodies (AE1 and AE2). Intense suprabasal staining was seen with AE1 in metaplastic keratinized epithelium, whereas staining of adjacent normal unkeratinized epithelium generally was restricted to basal cells. In dysplastic epithelium and squamous cell carcinomas, staining with AE1 revealed a highly disturbed anti-keratin staining pattern. AE2 stained metaplastic keratinized epithelium in a suprabasal pattern but adjacent unkeratinized epithelium did not stain. In dysplastic epithelium and squamous cell carcinomas, AE2 staining was variable and sometimes absent. Further studies are indicated to clarify whether changes in anti-keratin staining patterns can be used for diagnostic and prognostic purposes.

Topics: Antibodies, Monoclonal; Carcinoma, Squamous Cell; Epithelium; Erythroplasia; Fibroma; Humans; Keratins; Leukoplakia; Mouth Mucosa; Mouth Neoplasms; Precancerous Conditions; Staining and Labeling

A clinicopathologic study was done of 21 cutaneous, sarcoma-like lesions previously diagnosed as atypical fibroxanthoma, spindle cell carcinoma, or dermal sarcoma. These lesions were most commonly presented as a solitary, often ulcerated nodule, occurring on exposed skin of the face in the elderly or, occasionally, on roentgen-damaged or burnt skin of the head, leg, or hand. Microscopic features of the 21 lesions were, however, not alike, thereby implying that such sarcoma-like lesions had derived from heterogeneous origins. The immunohistochemical staining in a comparative study with two other cases of unequivocal spindle cell squamous carcinoma suggested that these lesions could be histogenetically divided into two different groups: (1) the major group of true atypical fibroxanthoma, consisting of 19 cases, and (2) the minor group of probable spindle cell squamous carcinoma, consisting of 2 cases. Despite a wide histologic spectrum and of heterogeneity of these lesions, there was a benign clinical course in the majority, due in part to the small size and superficial location of the lesions.

Topics: Adult; Aged; Carcinoma; Diagnosis, Differential; Female; Fibroma; Histocytochemistry; Humans; Immunoenzyme Techniques; Keratins; Male; Middle Aged; Skin Neoplasms

For the purpose of clarifying cellular differentiation of epithelioid sarcoma, studies based on various methods were performed. Enzyme histochemical studies showed that epithelioid sarcoma tumor cells have characteristics intermediate between epithelial cells and the large plump cells of synovial sarcoma-incomplete epithelial differentiation. For alkaline phosphatase and adenosine triphosphatase particularly, positive cells and negative cells coexisted, as in the large plump cells of synovial sarcoma. Immunohistochemical studies for alpha 1-antitrypsin, alpha 1-antichymotrypsin, vimentin, and keratin also showed that epithelioid sarcoma tumor cells are very similar to the large plump cells of synovial sarcoma and have incomplete epithelial differentiation. For example, the examinations of serial sections and double staining methods revealed that keratin-positive cells are always vimentin-positive in epithelioid sarcoma and in the monophasic area of synovial sarcoma. Electron-microscopically, bundles of intermediate filaments and filopodia toward the intercellular lumen were observed, as in the monophasic area of synovial sarcoma. The results of enzyme-histochemical and immunohistochemical studies of non-neoplastic synovial lining cells, performed here for the first time, are also discussed.

Topics: Adenosine Triphosphatases; Adult; Alkaline Phosphatase; Cell Transformation, Neoplastic; Female; Fibroma; Humans; Keratins; Male; Microscopy, Electron; Middle Aged; Sarcoma; Sarcoma, Synovial; Staining and Labeling; Vimentin

Histological, histochemical and immunohistochemical findings were studied in 40 cutaneous biopsies from 7 patients with Cowden's disease. Most facial biopsies showed a spectrum of trichilemmomas and related follicular malformations, including cylindrical trichilemmomas, lobulate trichilemmomas (14 lesions), and a keratinizing type sharing features with inverted follicular keratosis. One facial growth showed trichilemmomal changes without apparent follicular origin. Studies for common papilloma virus structural antigens were negative, apart from a typical common wart in one patient. Immunohistochemical studies in 6 facial trichilemmomas and acral keratoses, using a panel of anti-keratin antibodies, disclosed only abnormal differentiation with lack of large keratins in the lobulate trichilemmomas. Nine biopsies revealed a distinctive type of fibroma characterized by an organized pattern of interwoven fascicles of collagen bundles with a laminated or tortuous appearance, embedded in abundant mucin. A number of fibromas showed striking hyalinization; these may represent a second microscopic hallmark of Cowden's disease in addition to facial trichilemmomas.

Topics: Antigens, Viral; Biopsy; Facial Neoplasms; Fibroma; Hamartoma; Humans; Keratins; Skin; Skin Neoplasms; Staining and Labeling; Syndrome

Twelve cases of malignant spindle-cell and sarcomatoid tumours of the skin of debatable nature were studied by immunocytochemical methods, using four antisera which might help contribute to resolution of the problems. The initial diagnosis made on structural grounds was confirmed by immunocytochemistry in six of eight cases in which a specific diagnosis had been made (one melanoma, three squamous carcinomas and two atypical fibroxanthomas). One case, initially regarded as AFX was reclassified as a squamous carcinoma, while a further case of possible AFX could not be confirmed by immunocytochemical study. Of the four cases in which structural examination was inconclusive, two were identified as squamous carcinomas and one as a melanoma by virtue of tumour markers. The fourth case was an intriguing actin-rich tumour of uncertain nature. Immunocytochemistry, despite certain limitations, has a valuable role to play in the analysis of the problematic spindle-cell malignant and pseudomalignant tumours of the skin.

Topics: Actins; Aged; Carcinoma, Squamous Cell; Female; Fibroma; Humans; Immunoenzyme Techniques; Keratins; Male; Melanoma; Middle Aged; Muramidase; S100 Proteins; Skin; Skin Neoplasms

Four cases of squamous cell carcinoma with sarcoma-like stroma located in the vulva (1), vagina (2) and cervix (1) of postmenopausal women are presented. The gross and microscopic features are very similar to those of similarly named tumors occurring in the upper respiratory and digestive tract and in the skin. Light microscopic, electron microscopic, and immunohistochemical examination provided convincing evidence that these tumors are composed solely of squamous cell carcinoma, which has undergone a spindle cell sarcoma-like transformation in the deeper portions. Follow-up revealed an aggressive clinical course in three of the four patients, who died of their tumor between 2 and 45 months after presentation. At the time of death, two of the patients had widespread metastases and the other had massive local recurrence.

Topics: Aged; Carcinoma, Squamous Cell; Carcinosarcoma; Diagnosis, Differential; Female; Fibroma; Follow-Up Studies; Genital Neoplasms, Female; Histocytochemistry; Humans; Keratins; Middle Aged; Sarcoma; Uterine Cervical Neoplasms; Vaginal Neoplasms; Vulvar Neoplasms

A case of fibromatosis occurring in the maxillary sinus 3 months after enucleation of an odontogenic keratocyst from that sinus is reported. This is believed to be the third reported case of fibromatosis in the maxilla and the first case occurring following the enucleation of an odontogenic keratocyst.

Topics: Adolescent; Fibroma; Humans; Keratins; Male; Maxillary Diseases; Maxillary Sinus; Odontogenic Cysts; Paranasal Sinus Neoplasms

The three-dimensional morphology of six dermatofibromas was studied by scanning electron microscopy. Hypertrophic epidermal ridges covered with large keratinized cells overlay each dermal lesion. Small collagenous fibers in the tumors contrasted with the bundles of much larger collagenous fibers in the normal dermis peripheral to the lesions.

Topics: Adult; Female; Fibroma; Humans; Keratins; Male; Microscopy, Electron, Scanning; Middle Aged; Skin; Skin Neoplasms

Topics: Adult; Biopsy; Diagnosis, Differential; Female; Fibroma; Follow-Up Studies; Hair; Hamartoma; Humans; Keratins; Male; Melanins; Middle Aged; Mucins; Neurofibroma; Sensory Receptor Cells; Skin; Skin Neoplasms

Topics: Carcinoma, Squamous Cell; Cell Nucleolus; Cell Nucleus; Collagen; Dermoid Cyst; Epithelial Cells; Epithelium; Female; Fibroma; Humans; Keratins; Middle Aged; Neoplasms, Multiple Primary; Ovarian Neoplasms