bromochloroacetic-acid and Hemangioma

Clear cell renal cell carcinoma (CCRCC) has a rich, sinusoid-like vascularity frequently used as a diagnostic criterion. CCRCC with predominantly vascular architecture has not been described.. To describe 4 unusual CCRCC cases, primarily presenting with hemangioma-like morphologic pattern.. Clinicopathologic and selected immunohistochemical analysis of 4 cases of CCRCC mimicking hemangioma.. Cases were seen in 1 woman and 3 men (average age, 48.8 years; range, 40-66 years). Grossly, tumors were red-brown (3 of 4) with scant bright-yellow foci in 1. The average tumor size was 4 cm (range, 2.5-5.5 cm). Microscopically, all were composed of varying proportions of a rich, arborizing, sinusoid-like vasculature with focal hobnail appearance of endothelial cells. Entrapment of renal tubules between blood vessels was seen at the periphery of the tumors. This morphology was reminiscent of anastomosing hemangioma. Isolated tumor cells resembling lymphocytes with clear halos were sparsely interspersed between vessels. Cytokeratin immunostain confirmed the diagnosis of CCRCC.. Extensive sampling and immunohistochemical workup of what is deemed to be a benign vascular neoplasm of the kidney is needed to rule out the presence of individual carcinoma cells or small viable carcinoma cell clusters.

Topics: Adult; Aged; Carcinoma, Renal Cell; Diagnosis, Differential; Female; Hemangioma; Humans; Immunohistochemistry; Keratins; Kidney Neoplasms; Male; Middle Aged; Mucin-1

A 45-year-old male with alleged asymptomatic hepatic hemangioma of 4 years duration had right upper-quadrant pain and was referred to a tertiary hospital. Computed tomography and magnetic resonance imaging scans revealed a hypervascular mass of about 7 cm containing intratumoral multilobulated cysts. A preoperative liver biopsy was performed, but this failed to provide a definitive diagnosis. The patient underwent a partial hepatectomy of segments IV and VIII. The histologic findings revealed multifocal proliferation of flattened or cuboidal epithelioid cells and a highly vascular edematous stroma. Immunohistochemistry findings demonstrated that the epithelioid tumor cells were positive for cytokeratin (AE1/AE3), vimentin, calretinin, and cytokeratin 5/6, and were focally positive for CD10, and negative for WT1 and CD34, all of which support their mesothelial origin. Immunohistochemistry for a mesothelial marker should be performed for determining the presence of an adenomatoid tumor when benign epithelioid cells are seen.

Topics: Adenomatoid Tumor; Calbindin 2; Hemangioma; Hepatectomy; Humans; Keratins; Liver Neoplasms; Magnetic Resonance Imaging; Male; Middle Aged; Neprilysin; S100 Calcium Binding Protein G; Tomography, X-Ray Computed; Vimentin

Gap junctions (GJs) have been shown to play a role in tumor progression including a variety of keratinocyte-derived and non-keratinocyte-derived skin tumors. Here we show that the synthesis of the GJ proteins connexin 26 and connexin 30 (Cx26 and Cx30) is induced in keratinocyte-derived epithelial skin tumors whereas there is either no change or a downregulation of Cx43. Cx26, Cx30, and Cx43 are absent in non-epithelial skin tumors. Further, Cx26 and Cx30 are induced in the epidermis adjacent to malignant melanoma but absent in the epidermis adjacent to benign non-epithelial skin lesions (melanocytic nevi and angioma). The keratinocyte-derived skin tumors are very heterogeneous regarding the Cx26/Cx30 pattern in the epidermis at the periphery of the tumors. We did not observe any difference in the localization of the very similar proteins Cx26 and Cx30 but a variation in intensity of immunoreactivity. As the staining patterns of Cx26 and Cx30 antibodies are not identical to those of CK6, a marker for hyperproliferation, and CK17, a marker for trauma, we discuss that the induction of these gap junctional proteins exceeds a reflection of reactive hyperproliferative or traumatized epidermis. We further discuss the putative roles of these gap junctional proteins in tumor progression.

Topics: Animals; Bowen's Disease; Carcinoma, Basal Cell; Carcinoma, Squamous Cell; Connexin 26; Connexin 30; Connexins; Epidermis; Hemangioma; Humans; Keratinocytes; Keratins; Keratosis; Liver; Melanoma; Mice; Mice, Inbred C57BL; Microscopy, Fluorescence; Nevus, Pigmented; Skin Neoplasms; Warts

Topics: Adult; Biomarkers; Biomarkers, Tumor; Carcinoid Tumor; Carcinoma, Hepatocellular; Chromogranin A; Cytoplasmic Granules; Diagnosis, Differential; Female; Hemangioma; Humans; Immunohistochemistry; Keratins; Liver Neoplasms; Male; Synaptophysin; Treatment Outcome

Bone vascular tumors are very rare. Epithelioid types are described according to their architecture, their degree of vascular differentiation, and their cytonuclear atypia. The include epithelioid hemangioma, epithelioid hemangioendothelioma, and angiosarcoma. We report a case of L4 corpus vertebral bone epithelioid hemangioma. The patient was a 25-year-old man with a tumor that recurred twice. The lesion was characterized by a vascular lumen lined by cells with regular nuclei and inflammatory infiltrates. Capillaries were lined by prominent epithelioid endothelial cells, associated with CD31+ and cytokeratin-.

Topics: Adult; Bone Neoplasms; Epithelium; Hemangioma; Humans; Immunohistochemistry; Keratins; Lumbar Vertebrae; Male; Neoplasm Recurrence, Local; Platelet Endothelial Cell Adhesion Molecule-1

The unique immunobiology of the placental trophoblast and the increased incidence of hemangiomas in infants born after chorionic villus sampling suggest that an immunologically regulated ectopic focus of trophoblasts could be the cell of origin for proliferative infantile hemangiomas.. To compare tissue from infantile hemangiomas with that of other vascular lesions for the presence of selected placental trophoblast-specific cellular markers.. Twelve tissue specimens taken from infantile hemangiomas on patients aged 5 days to 2 years were retrospectively confirmed clinically and histologically. Negative controls were similarly confirmed, including 6 pyogenic granulomas and 4 vascular-lymphatic malformations. These tissues were used for immunohistochemical analysis of selected trophoblastic markers including human placental lactogen, placental alkaline phosphatase, and cytokeratins 7, 8, and 17.. Tissue submitted from patients seen at Saint Louis University Department of Dermatology and Cardinal Glennon Children's Hospital in St Louis, Mo, between January 1, 1997, and October 31, 1999.. Differential staining for trophoblastic markers in infantile hemangiomas compared with control tissues.. The 12 infantile hemangiomas were uniformly negative for all markers tested. Control tissues were also negative for these markers. Four of the 5 histochemical markers did recognize specific nonvascular, cutaneous elements: placental alkaline phosphatase stained smooth and striated muscle, cytokeratins 7 and 8 stained eccrine glands, and cytokeratin 17 stained pilosebaceous units.. Our results do not support the placental trophoblast as the cell of origin for infantile hemangiomas, but we hope our observations and speculation will stimulate further study of this hypothesis.

Topics: Alkaline Phosphatase; Hemangioma; Humans; Infant; Infant, Newborn; Keratins; Placenta; Placental Lactogen; Retrospective Studies; Trophoblasts

Sclerosing hemangioma of the lung is well characterized histologically, but the line of differentiation expressed by the tumor cells has been unclear. Despite the implication by its name of a vascular neoplasm, sclerosing hemangioma is considered by most authorities to be an epithelial tumor, possibly related to the pulmonary epithelium.. To determine the line of differentiation of the tumor cells with immunohistochemistry and to review the related literature.. Nine cases of histologically typical pulmonary sclerosing hemangioma were studied with pan-epithelial (epithelial membrane antigen [EMA] and CAM 5.2), endothelial (CD31), neuroendocrine (chromogranin A), and pulmonary epithelial markers (thyroid transcription factor-1 and PE10). Staining intensity was separately evaluated in the pale cells of the solid areas and the cells lining the papillary structures.. Both cell types were positive for thyroid transcription factor-1 and EMA in all cases (100%). Thyroid transcription factor-1 showed diffuse strong staining, and EMA staining varied from focal weak to diffuse strong. The pale cells showed focal staining for keratin (CAM 5.2) in 2 (28%) of 7 cases, and for PE10 in 5 (62%) of 8 cases. The papillary lining cells were at least focally positive with CAM 5.2 and PE10 in all cases (100%). Reactions for chromogranin and CD31 were negative in both cell types in every case. The number of PE10- or CAM 5.2-positive papillary lining cells was less than the number of EMA-positive papillary lining cells.. The uniform positivity for EMA is consistent with the notion that the tumor cells of sclerosing hemangioma are epithelial, and the strong thyroid transcription factor-1 positivity suggests differentiation toward pulmonary epithelium. The papillary lining cells expressing EMA as well as PE10 or CAM 5.2 likely represent entrapped metaplastic alveolar epithelium, whereas the papillary lining cells expressing only EMA more likely constitute true neoplastic cells similar to those in the solid areas.

Topics: Adult; Aged; Biomarkers; Biomarkers, Tumor; Chromogranin A; Chromogranins; Female; Hemangioma; Humans; Immunohistochemistry; Keratins; Lung Neoplasms; Male; Middle Aged; Mucin-1; Nuclear Proteins; Platelet Endothelial Cell Adhesion Molecule-1; Protein Precursors; Proteolipids; Thyroid Nuclear Factor 1; Transcription Factors

Nail pathology shares some common features with skin pathology, but it also has its own peculiar aspects. The anatomical and physiological characteristics of the nail unit probably play a major role in determining these pathological differences. Although the presence of keratohyaline granules is a normal feature of the skin, there is no granular layer in the normal nail matrix. As a consequence, nail matrix hypergranulosis should be considered a separate entity from skin hypergranulosis. In our review of 150 longitudinal nail biopsy specimens, keratohyaline granules were seen in the nail matrix of 24 cases of lichen planus, 29 cases of spongiotic trachyonychia, 10 cases of psoriasis, and three cases of Hallopeau acrodermatitis. In all cases, the presence of keratohyaline granules was associated with the absence of the normal keratogenous zone. Similar nail matrix features were detectable in three cases of malignant melanoma, two cases of primary systemic amyloidosis, and one case of histiocytoid hemangioma compressing the nail matrix. Our data suggest that inflammatory and compressive insults to the nail matrix cause both disappearance of the keratogenous zone and matrix keratinization with the formation of keratohyaline granules. Skin hypergranulosis reflects a hyperplasia of a normal skin component. In the nail matrix, however, hypergranulosis represents the appearance of structures not normally present. Nail matrix hypergranulosis should be considered a pattern of nail matrix reaction to different inflammatory insults. It is therefore more analogous to epidermal parakeratosis than to epidermal hypergranulosis.

Topics: Acrodermatitis; Amyloidosis; Biopsy; Epidermis; Epithelium; Hemangioma; Humans; Hyalin; Hyperplasia; Keratins; Keratosis; Lichen Planus; Melanoma; Nail Diseases; Nails; Onychomycosis; Psoriasis

To determine if hyperplastic and neoplastic lesions from medaka showed similar immunoreactivity to intermediate filament antibodies as the tissues of origin, two week old medaka were exposed to 10 or 20 mg/L of methylazoxymethanol acetate for two hours and transferred to clean water for up to six months. Using a streptavidin peroxidase method, paraffin embedded Bouins fixed neoplasms were incubated with cytokeratin, vimentin, or neurofilament antibodies. Like their nonneoplastic cellular counterparts, hepatocellular carcinoma, pancreatic acinar carcinoma and mesenchymal neoplasms including hemangioma and hemangiopericytoma reacted negatively to cytokeratin antibodies. Cholangiocarcinoma, mesothelioma, and proliferative lesions containing biliary epithelial cells reacted positively to cytokeratin antibodies. All neoplasms and proliferative lesions were negative with vimentin and neurofilament antibodies. These data indicate that while some epithelial neoplasms showed cytokeratin reactivity similar to the parent tissues, additional markers are needed to identify mesenchymal tissues and neoplasms.

Topics: Adenoma, Liver Cell; Animals; Antibodies; Carcinogens; Carcinoma, Acinar Cell; Carcinoma, Hepatocellular; Cell Division; Cholangiocarcinoma; Hemangioma; Hemangiopericytoma; Hyperplasia; Immunohistochemistry; Intermediate Filaments; Keratins; Liver; Liver Neoplasms; Methylazoxymethanol Acetate; Neurofilament Proteins; Oryzias; Pancreas; Pancreatic Neoplasms; Vimentin

We describe histological, immunohistochemical and ultrastructural findings in a case of littoral cell angioma of the spleen in a 44 year old man. Beside phagocytosis and heavy haemosiderin deposits in the cytoplasm, a very characteristic and hitherto undescribed feature of the littoral cells was focal accumulations of eosinophilic globules 0.5-2 microns in size, which often entirely filled the cytoplasm of the tumour cells. Ultrastructurally the globules were composed of abundant cytoplasmic deposits of lysosomes and residual bodies. The globules most probably originate from the phagocytized red blood cells, lymphocytes and plasma cells. Immunohistochemically the tumour cells reacted positively with antibodies against factor VIII-related antigen, KiM1P, KP1 and lysozyme and negatively with antibodies against cytokeratins AE1-AE3, EMA and S-100 protein. Ultrastructurally the tumour cells often formed long cytoplasmic processes without external lamina and pinocytic vesicles. Scarce and poorly formed junctions between the tumour cells were seen. Very rarely cytoplasmic rod-shaped microtubulated bodies, often difficult to distinguish from heavy accumulations of lysosomes were observed.

Topics: Adult; Antigens, Neoplasm; Hemangioma; Hemosiderin; Humans; Immunohistochemistry; Keratins; Male; Membrane Glycoproteins; Microscopy, Electron; Mucin-1; Muramidase; Phagocytosis; S100 Proteins; Splenic Neoplasms; von Willebrand Factor

Seven epithelioid and eight non-epithelioid vascular tumors were studied by the avidin-biotin-peroxidase method for the presence of endothelial- and epithelial-associated markers, using Ulex europaeus agglutinin-1 (UEA-1) lectin, and antibodies directed against factor VIII-related antigen, (FVIII-RA), vimentin, keratin, carcinoembryonic antigen, and epithelial membrane antigen. The cases included four epithelioid hemangiomas, two epithelioid hemangioendotheliomas (EHE), one epithelioid angiosarcoma (EAS), four common non-epithelioid capillary hemangiomas, and four non-epithelioid angiosarcomas. Staining for FVIII-RA, UEA-1, and vimentin were observed in all cases. The EAS showed staining for keratin in formalin-fixed, paraffin-embedded sections and in frozen sections. Staining for keratin was also observed in frozen sections of one EHE. Both keratin-positive vascular tumors were confirmed with electron microscopy. Carcinoembryonic antigen and epithelial membrane antigen stains were negative in all cases. Our results show that the epithelioid vascular tumors EHE and EAS, in addition to staining for the endothelial markers and vimentin, may also express the epithelial marker keratin. This is important since these tumors may closely resemble carcinomas by routine light microscopy. This study further underscores the importance of using a broad panel of immunohistochemical markers in the diagnostic workup of soft-tissue neoplasms.

Topics: Biomarkers, Tumor; Carcinoembryonic Antigen; Epithelium; Hemangioendothelioma; Hemangioma; Hemangiosarcoma; Humans; Keratins; Lectins; Leg; Membrane Glycoproteins; Mucin-1; Plant Lectins; Skin; Vimentin; von Willebrand Factor

Cytoskeletal typing of five chorangiomas revealed diffuse staining of the blood vessels with antibodies to vimentin and to alpha smooth muscle (alpha-SM) actin, while cytokeratin 18 decorated the blood vessels focally. Focal staining for desmin was observed in two chorangiomas. Blood vessels of the placentas in which these chorangiomas arose stained for vimentin and alpha-SM actin. In addition, there was positive staining for cytokeratin polypeptide 18 in blood vessels within the chorionic plate and anchoring villi, and occasional staining for desmin. The vasculature of the terminal villi lacked cytokeratins. The stromal elements of the chorangiomas stained for vimentin and focally for alpha-SM actin and cytokeratin 18. A similar staining pattern was also found in the placental stroma, with most of the cytokeratin positivity encountered in the chorionic plate and anchoring villi. Blood vessels in extraplacental hemangiomas were devoid of cytokeratins. These results indicate that chorangiomas originate most likely from blood vessels of the chorionic plate and anchoring villi, which, as chorangiomas, are the site of vascular cytokeratin expression.

Topics: Actins; Blood Vessels; Cytoskeleton; Desmin; Female; Hemangioma; Humans; Immunohistochemistry; Intermediate Filaments; Keratins; Microscopy, Electron; Placenta; Pregnancy; Uterine Neoplasms; Vimentin

Tuberous sclerosis (Bourneville-Pringle phacomatosis) has been known to be associated with cardiac rhabdomyoma, but apparently never previously with primary pericardial mesothelioma. We present an autopsy case of this condition in a 59-year-old man, who had been diagnosed as having tuberous sclerosis in view of the presence of facial sebaceous adenoma, mental retardation, intracranial calcification, cerebral ventricular dilatation and renal tumor. During the clinical course, characterized by heart failure due to cardiac tamponade, cardiac sarcoma was diagnosed by imaging techniques. Autopsy revealed biphasic-type primary pericardial mesothelioma. As to the tuberous sclerosis, atypical giant cells in the tubers of the cerebral cortex and the lateral ventricular wall were found, which were considered to be derived from neurons rather than glial cells on the basis of staining with Bodian, Holzer, and antibodies against NSE, GFA and S-100 protein. In old tubers protruding into the lateral ventricles, fibrous glias were present with dense calcospherite deposits, coinciding with the CT findings. The renal tumors were angiomyolipomas, which were present bilaterally and showed partially infiltrative growth, but seemed to have a benign nature because of the lack of metastasis and atypism of the leiomyocytes.

Topics: Autopsy; Cerebellum; Glial Fibrillary Acidic Protein; Heart Neoplasms; Hemangioma; Histocytochemistry; Humans; Immunohistochemistry; Keratins; Kidney; Kidney Neoplasms; Lipoma; Male; Membrane Glycoproteins; Mesothelioma; Middle Aged; Mucin-1; Pericardium; Phosphopyruvate Hydratase; S100 Proteins; Tuberous Sclerosis

One hundred cutaneous tumors were investigated immunohistopathologically for the expression of intermediate filament (IF) proteins. Epithelial tumors, such as basocellular and squamous cell carcinomas, cutaneous adnexal tumors, and metastatic carcinomas showed keratin positivity in a varying number of tumor cells with two keratin antibodies with different specificities. Neoplastic cells of fibrohistiocytic tumors, pigmented nevi, melanomas, hemangiomas, glomus tumors, and lymphomas were positive for vimentin, but not for keratin or desmin. Cutaneous leiomyomas and leiomyosarcomas, on the other hand, were positive for desmin. The results show that the typing of IFs enables the differential diagnosis between carcinomas and sarcomas or melanomas, epidermal appendage tumors, and mesenchymal tumors, and between fibrohistiocytic and leiomyocytic tumors, and therefore are of diagnostic value in histopathologic problems of the skin.

Topics: Adenocarcinoma; Adenoma, Sweat Gland; Antibodies, Monoclonal; Carcinoma, Adenoid Cystic; Carcinoma, Basal Cell; Carcinoma, Renal Cell; Carcinoma, Squamous Cell; Desmin; Diagnosis, Differential; Fluorescent Antibody Technique; Hemangioma; Histiocytoma, Benign Fibrous; Histocytochemistry; Humans; Intermediate Filament Proteins; Keratins; Leiomyoma; Melanoma; Neoplasm Metastasis; Nevus, Pigmented; Skin Neoplasms; Vimentin

To elucidate the histogenesis of sclerosis haemangioma of the lung, we examined 7 cases with the immunoperoxidase method using antibodies against several useful marker antigens; secretory component (SC), cytokeratins, epithelial membrane antigen (EMA) for epithelial cells, factor VIII related antigens (factor VIII) for endothelial cells, vimentin and desmin for mesenchymal cells. The results were compared with those of histologically normal lung tissues. Both the characteristic round cells arranged in sheets, which are present predominantly in the solid area and are reported to be neoplastic, and the flattened cells lining blood lakes show positive staining for EMA only, with negative staining for the other marker antigens. These observations suggest that these cells are derived from epithelium rather than mesothelium or from endothelium, and are analogous to type I pneumocytes. This conclusion is supported by their immunohistochemical characteristics, in comparison with the localization patterns of the marker antigens in normal lung tissues. However, the lining epithelial cells of papillary projections in the papillary area and of ducts in the solid area stained for SC and cytokeratins as well as EMA, and their immunohistochemical characteristics are analogous to those of bronchiolar epithelial cells or type II pneumocytes in normal lung tissues.

Topics: Adult; Antibodies, Monoclonal; Antigens, Surface; Female; Hemangioma; Histocytochemistry; Humans; Immunochemistry; Immunoenzyme Techniques; Keratins; Lung Neoplasms; Middle Aged; Secretory Component

A histiocytoid hemangioma of the heart is reported, which was found incidentally in a man with unusually high eosinophilia. The eosinophilia subsided dramatically following removal of the tumor. The "histiocytoid" or the "epithelioid" appearance of the tumor cells and the presence of vacuolated cells were the characteristic microscopic features. The endothelial origin of this tumor was verified by positive immunostaining for factor VIII-related antigen and ultrastructural demonstration of intracytoplasmic lumen formation, abundant cytoplasmic filaments, pinocytotic vesicles, and prominent basal lamina. The presence of mitotic activity, cellular pleomorphism, and tumor necrosis raised the possibility of its malignant potential. The occurrence of this tumor in the heart may be mistaken for a myxoma clinically and a metastatic carcinoma pathologically.

Topics: Aged; Cytoplasm; Eosinophilia; Factor VIII; Heart Neoplasms; Hemangioma; Histocytochemistry; Humans; Immunoenzyme Techniques; Keratins; Male