bromochloroacetic-acid and Rhabdomyoma

Topics: Actins; Choristoma; Cysts; Desmin; Diagnosis, Differential; Humans; Immunohistochemistry; Keratins; Male; Middle Aged; Mucus; Myoglobin; Pericardium; Rhabdomyoma; Thymoma; Thymus Gland

A 50-year-old man presented with a rapidly growing mass in the area of the right lacrimal gland. An initial erroneous histopathologic diagnosis of a pleomorphic adenoma made on a small-incisional biopsy was later corrected to a malignant rhabdoid tumor when a wide local excision of the tumor was performed. The tumor was composed predominantly of dyscohesive, globoid, and eosinophilic cells, which frequently contained cytoplasmic inclusions. These were demonstrated to be composed of whorls of intermediate vimentin filaments. The tumor cells expressed epithelial membrane antigen as well as cytokeratin. Ultrastructurally, they displayed intercellular junctions and interrupted segments of linear basement membrane material. These findings, together with the development of the lesion within the parenchyma of the lacrimal gland, are suggestive of an epithelial origin. The patient was treated with radical surgery and adjunctive radiotherapy and chemotherapy, which are the recommended treatment modalities for this highly malignant tumor.

Topics: Antigens, Neoplasm; Antineoplastic Combined Chemotherapy Protocols; Combined Modality Therapy; Eye Neoplasms; Humans; Keratins; Kidney Neoplasms; Lacrimal Apparatus Diseases; Male; Middle Aged; Rhabdomyoma

Rhabdomyomas, which are rare striated muscle neoplasms, may occur on oral or genital mucosal surfaces as well as on the skin. Little discussion of rhabdomyomas occurs in any dermatology or dermatopathology literature. We report an 84-year-old patient who had a rhabdomyoma of her lateral tongue and discuss the clinical and histologic characteristics of this unusual type of benign neoplasm.

Topics: Aged; Aged, 80 and over; Diagnosis, Differential; Female; Humans; Immunohistochemistry; Keratins; Rhabdomyoma; S100 Proteins; Tongue Neoplasms

A case of malignant mixed müllerian tumor of the ovary in a 57-year-old woman is reported along with the results of an immunohistochemical study. The tumor, measuring 16 x 10 x 9 cm, was composed predominantly of adenocarcinoma with a smaller amount of anaplastic carcinoma as an epithelial component and chondrosarcoma, liposarcoma, fibrosarcoma and rhabdomyoblasts as mesenchymal elements. Immunohistochemistry using paraffin sections demonstrated cytokeratin (CK) and epithelial membrane antigen (EMA), generally regarded as epithelial markers, not only in the epithelial component but also in chondrosarcoma cells. Vimentin and desmin, generally regarded as mesenchymal markers, were exhibited partly in carcinoma cells as well as in mesenchymal elements. Positive staining for S-100 protein was obtained not only in chondrosarcoma and liposarcoma cells, but also partly in adenocarcinoma cells. This intricate immunohistochemical picture reflected the histologic findings. It is noteworthy that both carcinoma cells and chondrosarcoma cells demonstrated simultaneous expression of CK, EMA, vimentin, desmin and S-100 protein. This somewhat unusual antigen expression by tumor cells may indicate a change in the nature of tumor cells due to microenvironmental factors.

Topics: Adenocarcinoma; alpha-Fetoproteins; Chondrosarcoma; Chorionic Gonadotropin; Desmin; Female; Fibrosarcoma; Humans; Immunohistochemistry; Keratins; Liposarcoma; Membrane Glycoproteins; Middle Aged; Mucin-1; Myoglobin; Neoplasms, Germ Cell and Embryonal; Ovarian Neoplasms; Rhabdomyoma; S100 Proteins; Vimentin

Epithelioid sarcoma (ES) and malignant rhabdoid tumor (MRT) have heretofore been regarded as two separate clinicopathologic entities. However, they have some histologic similarities, and both represent histogenetic and phenotypic enigmas. This study reports the pathologic and immunohistochemical findings of four vulvar neoplasms occurring in young women that represented diagnostic dilemmas because of their similarity to both ES and MRT. Only one case had the classic histologic features of ES, whereas, in our opinion, the other three cases fulfilled the histologic criteria of MRT, despite the fact that two of the three cases were reported earlier as examples of ES. Neither electron microscopy nor immunohistochemistry has been found to be helpful in separating ES from MRT, mainly because they share several ultrastructural and immunophenotypic features. The behavior of these vulvar tumors--ours and the few published examples of ES--is generally aggressive, more in keeping with MRT than classic ES. We believe that some, if not most, putative ES of the vulva are in fact MRT, a neoplasm with an unfavorable prognosis.

Topics: Adult; Cell Nucleus; Female; Humans; Immunohistochemistry; Keratins; Membrane Glycoproteins; Microscopy, Electron; Mucin-1; Organelles; Rhabdomyoma; Sarcoma; Vimentin; Vulvar Neoplasms