Melan-A Expression in Poorly Differentiated Carcinoma of Lung: A Potential Diagnostic Pitfall

Abstract BackgroundMelan-A/MART-1 is a melanocytic differentiation marker, which is recognized as an antigen on melanoma cells. It is relevant for pathologists as a useful diagnostic marker in the diagnosis of melanocytic tumors. However, the expressional pattern of Melan-A in poorly differentiated carcinoma of lung has never been reported so far.Case presentationHere, we report a 77-year-old female patient who presented with a large mass in the right lung and was subsequently diagnosed with a poorly differentiated carcinoma of lung. We unexpectedly found that the carcinoma in this patient exhibited diffuse Melan-A expression. ConclusionThis is the first case reported of a poorly differentiated carcinoma of lung with Melan-A expression. This report shows that Melan-A can express in poorly differentiated carcinoma, and highlights a potential diagnostic pitfall in the diagnosis of carcinoma, which urges pathologists to exercise caution in cases where Melan-A positivity and illustrates the need for further immunohistochemical or molecular examination to avoid misdiagnosis.

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A diagnostic pitfall in hepatic mesenchymal hamartoma mimicking hepatoblastoma: A case report

10.21203/rs.3.rs-48878/v1 ◽

2020 ◽

Author(s):

Zhihong Chen ◽

Lutong Fang ◽

Ying Zhang ◽

Yuanzi Ye ◽

Wenshu Ji ◽

...

Keyword(s):

Blood Vessels ◽

Female Child ◽

Point Of View ◽

Mesenchymal Hamartoma ◽

Diagnostic Pitfall ◽

First Case ◽

Contrast Enhanced ◽

Enhanced Ct ◽

Vascular Channels ◽

The Right

Abstract Background: Hepatic mesenchymal hamartoma (HMH) is an uncommon benign tumor in children. While mesenchymal hamartomas may be angiomatous and blood vessels may be identified, HMH with a malignant tumor symptom on the contrast-enhanced hepatic computed tomography angiography (CTA) has not been described. Here, we present the first case of HMH mimicking hepatoblastoma on the hepatic CTA from pathological point of view and review the imaging and histological features of this unique lesion. Case presentation: A 2-year-old female child was found a distention in the right abdomen and was admitted to our hospital. The Hepatic CTA showed that the blood vessels were thickened, the tumor blood vessels were clustered in the tumor. According to the hepatic CT findings, the tumor was considered to be malignant, possibly a hepatoblastoma. Microscopic examination showed a tumor arranged in lobules, composed of loose myxoid mesenchyme surrounding ductal structures, with intervening vascular channels. The Immunohistochemical staining revealed positive CK7 and CD34 for the bile duct elements and the lining endothelial cells of the vascular channels. There were abundant blood vessels around the nodules and the margins of remaining hepatocytes, but few in the central region. The blood vessels are small, thin-walled vessels and presented like capillaries and venules. Conclusions: A histological diagnosis of Hepatic Mesenchymal Hamartoma was confirmed by the microscopic examinations. This case adds learning points to radiologists when heterogeneous reinforcement on enhanced CT scan was presented in such a large childhood liver tumor.

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Unique case of inverted papilloma of septum with nasopharyngeal carcinoma: Is it a metachronous tumour?

SAGE Open Medical Case Reports ◽

10.1177/2050313x20922032 ◽

2020 ◽

Vol 8 ◽

pp. 2050313X2092203

Author(s):

Susanne Flach ◽

Aaron SJ Ferguson ◽

Sharon White ◽

Paul S White ◽

Jaiganesh Manickavasagam

Keyword(s):

Malignant Transformation ◽

Inverted Papilloma ◽

High Rate ◽

Unique Case ◽

Solitary Lesion ◽

Poorly Differentiated Carcinoma ◽

Nasopharyngeal Biopsy ◽

Poorly Differentiated ◽

The Right

Inverted papilloma is a rare and benign tumour. It affects the nasal cavity and paranasal sinuses, has a high rate of recurrence and is associated with malignant transformation. Only few cases of a poorly differentiated carcinoma arising from inverted papilloma have been reported, none of which in the nasopharynx. We report a case of a 37-year-old female, who presented originally in 2012 with inverted papilloma of the nasal septum which was surgically resected. Nasopharyngeal biopsy from 2014 was reported as carcinoma in situ and treated with local endoscopic resection. Three years later she presented with a solitary lesion of the right Eustachian tube opening, confirmed as invasive poorly differentiated carcinoma. Imaging revealed T4 N2b M0 malignancy with skull base and prevertebral space invasion, likely extension into right temporal lobe and malignant adenopathy. Although rare, malignant transformation of inverted papilloma in unusual places should be considered during workup and monitoring of patients.

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Adrenocortical sarcomatoid carcinoma: a case report and review of the literature

Journal of Surgical Case Reports ◽

10.1093/jscr/rjaa211 ◽

2020 ◽

Vol 2020 (7) ◽

Author(s):

Derqaoui Sabrine ◽

Bernoussi Zakia ◽

Znati Kaoutar

Keyword(s):

Poor Prognosis ◽

Sarcomatoid Carcinoma ◽

Rare Entity ◽

Rare Cancer ◽

Review Of The Literature ◽

Epithelioid Cells ◽

Poorly Differentiated Carcinoma ◽

S 100 ◽

Poorly Differentiated ◽

The Right

Abstract Adrenal sarcomatoid carcinoma (ASC) is a very rare aggressive variant of adrenocortical carcinoma showing carcinomatous and sarcomatous differentiation. It is a poorly differentiated carcinoma with poor prognosis. The diagnosis requires careful histological and immunohistochemical investigation. We describe a new case of ASC to raise awareness on this extremely rare entity. A 27-year-old woman presented with a right flank pain. Imaging revealed a tissular mass of the right adrenal gland without metastases. After adrenalectomy, histology revealed sheets of epithelioid cells that stained for synaptophysin and Melan-A; and spindled cells staining for S-100. We have reported the clinical and histopathological features of ACS’s case; as it is an extremely rare cancer with a challenging diagnosis. There is a need for a further understanding of ASC’s biology to improve it poor prognosis.

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NUT (Nuclear Protein in Testis) Carcinoma: A Report of Two Cases With Different Histopathologic Features

International Journal of Surgical Pathology ◽

10.1177/1066896918796606 ◽

2018 ◽

Vol 27 (2) ◽

pp. 225-229 ◽

Cited By ~ 3

Author(s):

Rekha Reddy ◽

Tina R. Woods ◽

Robert W. Allan ◽

Paras Malhotra ◽

Hiren J. Mehta ◽

...

Keyword(s):

Nuclear Protein ◽

Undifferentiated Carcinoma ◽

Epithelioid Cells ◽

Squamous Differentiation ◽

Poorly Differentiated Carcinoma ◽

First Case ◽

Eosinophilic Cytoplasm ◽

Poorly Differentiated ◽

Characteristic Features ◽

Actual Incidence

NUT (nuclear protein in testis) carcinoma (NC) is an aggressive carcinoma characterized by rearrangements of the NUT gene on chromosome 15q14. Histologically, it is a poorly differentiated carcinoma composed of monotonous, medium-sized, round cells with scant amphophilic or eosinophilic cytoplasm. Foci of abrupt keratinization are often seen. In this report, we compare the morphology of 2 cases of NC. The first case shows characteristic features of uniform, round epithelioid cells admixed with foci of abrupt keratinization. The second case demonstrates nests of epithelioid-polygonal cells that appear to be loosely cribriform within a mucoid stroma. Although considered rare, the actual incidence of NC may be underestimated, as it is likely that many go undiagnosed because the morphology deviates from what is typical. Our report demonstrates that NC should always be considered in any case of an undifferentiated carcinoma and should not be excluded if typical histologic and immunohistochemical features of squamous differentiation are lacking.

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Frozen Section Diagnostic Pitfalls of Sertoli-Leydig Cell Tumor with Heterologous Elements

Case Reports in Pathology ◽

10.1155/2018/5151082 ◽

2018 ◽

Vol 2018 ◽

pp. 1-4

Author(s):

Ashley Burris ◽

Caleb Hixson ◽

Nathaniel Smith

Keyword(s):

Leydig Cell ◽

Frozen Section ◽

Mucinous Cystadenoma ◽

Leydig Cell Tumor ◽

Cell Tumor ◽

Cystic Neoplasm ◽

Diagnostic Pitfall ◽

Radiologic Imaging ◽

Poorly Differentiated ◽

The Right

A woman in her sixth decade presented with several months of abdominal cramping, decreased appetite, bloating, and increased constipation. Radiologic imaging revealed a 28 cm, multilocular, heterogeneous cystic neoplasm involving the right adnexa. An intraoperative frozen section showed mucinous glandular epithelium, with and without foci of goblet cells, embedded in apparent ovarian stroma. The findings were concerning at least borderline mucinous cystadenoma with possible invasion. Subsequent surgical management and staging were performed. Permanent sections showed a moderately to poorly differentiated Sertoli-Leydig cell tumor (SLCT) with retiform foci and heterologous elements. The discrepancy between frozen and permanent sections was attributable to solely sampling a focus of heterologous elements during intraoperative consultation. The rarity of SLCT and even rarer presence of both heterologous and retiform elements make this concerning frozen section diagnostic pitfall.

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Ectopic adrenocortical carcinoma located in the ovary

Acta Endocrinologica ◽

10.1530/eje-16-0224 ◽

2016 ◽

Vol 175 (4) ◽

pp. K17-K23 ◽

Cited By ~ 7

Author(s):

Farida Chentli ◽

Nadia Terki ◽

Said Azzoug

Keyword(s):

Lymph Node ◽

Lymph Node Metastases ◽

Ovarian Tumor ◽

Histological Study ◽

Large Mass ◽

Lower Abdomen ◽

First Case ◽

Abdomen Ct ◽

Node Metastases ◽

The Right

Aim Ovarian corticosteroid-producing tumors are exquisitely rare. Our aim was to describe the first case observed in our practice. Case history A 34-year-old female was referred for Cushing’s syndrome (CS) occurring in the postpartum period. Clinical examination showed severe CS with diabetes mellitus, hypertension, and a large mass in the right lower abdomen. Biochemistry demonstrated corticotropin (ACTH)-independent CS (cortisol=1900ng/mL (n=50–250), ACTH<10pg/mL (n=20–46)) with estradiol and testosterone overproduction. Investigations Abdomen CT scan revealed a 14cm right ovarian mass and small adrenal glands. Surgical exploration found the ovarian tumor with hemoperitoneum and enlarged lymph nodes. Histological study confirmed adrenocortical tumor located in the ovary with a Weiss score >5, associated with peritoneal and lymph node metastases. Immunohistochemical staining was positive for inhibin-α, melan-A, and SF1, demonstrating tissue of adrenal origin. After surgery, plasma glucose level spontaneously returned to normal. However, the patient died on the second post-surgical day due to catastrophic pulmonary embolism. Conclusion In this reported case, clinical, hormonal, histological, and immunohistochemical findings confirmed a cortisol and sex hormone-producing ovarian tumor with peritoneal and lymph node metastases, a very rare but important condition to recognize.

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Adult-to-Adult Living-Donor Liver Transplantation

Swiss Surgery ◽

10.1024/1023-9332.9.5.227 ◽

2003 ◽

Vol 9 (5) ◽

pp. 227-236 ◽

Cited By ~ 3

Author(s):

Majno ◽

Mentha ◽

Berney ◽

Bühler ◽

Giostra ◽

...

Keyword(s):

Liver Transplantation ◽

Living Donor ◽

Living Donor Liver Transplantation ◽

Therapeutic Option ◽

Donor Liver ◽

Donor Liver Transplantation ◽

Multidisciplinary Program ◽

First Case ◽

Living Donor Transplantation ◽

The Right

Living donor liver transplantation is a relatively new procedure in which the right side of the liver is harvested in a healthy donor and transplanted into a recipient. After the first case in 1994, over 3000 cases have been done worldwide. This review summarizes the reasons why the procedure is needed, describes its main technical aspects, highlights the boundaries in which it can be done safely, summarizes the current experience worldwide and describes the main points of the program in our unit. We argue that living-donor transplantation is a viable alternative to a long time on the waiting list for several patients, and it can be performed safely and successfully provided that all precautions are undertaken to minimize the risks in the donor and to increase the chances of a good outcome in the recipients. If these prerequisites are met, and within the framework of a structured multidisciplinary program, we believe that living-donor liver transplantation should be funded by health insurances as a recognized therapeutic option.

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Primary Gastrointestinal Stromal Tumor of the Liver with Cystic Changes

Case Reports in Gastroenterology ◽

10.1159/000495604 ◽

2019 ◽

Vol 13 (1) ◽

pp. 58-65

Author(s):

Takashi Tashiro ◽

Fumihiro Uwamori ◽

Yukiomi Nakade ◽

Tadahisa Inoue ◽

Yuji Kobayashi ◽

...

Keyword(s):

Liver Tumors ◽

Past History ◽

Brain Infarction ◽

Arterial Phase ◽

First Case ◽

Positron Emission ◽

Cystic Changes ◽

Multiple Bone Metastases ◽

The Right ◽

Cells Of Cajal

Gastrointestinal stromal tumors (GISTs) are known to originate specifically from the intestinal cells of Cajal located in the gastrointestinal mesenchyme. GISTs developing outside of the digestive tract have barely been reported. We encountered a first case of large primary GISTs in the liver with cystic changes. A 63-year-old man with a past history of brain infarction visited our hospital. The computed tomography (CT) revealed a 6-cm and a 10-cm mass in the right and the caudal lobe of the liver, respectively. These tumors have marginal enhancement in the arterial phase; however, they presented as hypodense in the internal tumor sites. Both liver tumors had cystic changes. Gastrointestinal examinations using endoscopy revealed no other gastrointestinal tumors, and [18F]-fluoro-2-deoxy-D-glucose positron emission tomography/CT revealed multiple bone metastases in addition to the liver tumors. The liver tumor specimens were composed of spindle cells, and the immunohistochemical staining for c-Kit and for DOG1, as discovered on GIST, was positive. The patient was diagnosed with primary hepatic GIST with cystic changes.

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Intrascrotal lipoblastoma in adulthood

BMJ Case Reports ◽

10.1136/bcr-2019-231320 ◽

2019 ◽

Vol 12 (12) ◽

pp. e231320

Author(s):

Mário José Pereira-Lourenço ◽

Duarte Vieira-Brito ◽

João Pedro Peralta ◽

Noémia Castelo-Branco

Keyword(s):

Case Report ◽

Magnetic Resonance ◽

S100 Protein ◽

Surgical Excision ◽

Large Mass ◽

Histological Diagnosis ◽

Physical Exam ◽

Nodular Lesion ◽

Inferior Portion ◽

The Right

This case report describes the case of a 37-year-old man that noticed an intrascrotal right mass with 1 month of evolution. During physical exam presented with a large mass at the inferior portion of the right testicle, clearly separated from the testicle, with a tender consistency and mobile. An ultrasound was performed that showed a solid and subcutaneous nodular lesion, extra testicular, heterogeneous, measuring 7.2 cm. Pelvic magnetic resonance imageMRI showed a lesion compatible with a lipoma. The patient was subjected to surgical excision of the lesion by scrotal access, having histology revealed a lipoblastoma (LB) of the scrotum. Histological diagnosis was obtained by microscopic characteristics (well-circumscribed fatty neoplasm) and immunohistochemistry (stains for CD34, S100 protein and PLAG1 were positive; stains for MDM2 and CDK4 were negative). LB is extremely rare after adolescence in any location, being this first described case of intrascrotal LB described in adulthood.

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Thyroid Carcinoma on the Side of the Absent Lobe in a Patient with Thyroid Hemiagenesis

Case Reports in Otolaryngology ◽

10.1155/2017/4592783 ◽

2017 ◽

Vol 2017 ◽

pp. 1-5

Author(s):

Hiroki Sato ◽

Kiyoaki Tsukahara ◽

Ray Motohashi ◽

Midori Wakiya ◽

Hiromi Serizawa ◽

...

Keyword(s):

Thyroid Carcinoma ◽

Papillary Carcinoma ◽

Thyroid Tissue ◽

Needle Aspiration ◽

Left Lobe ◽

Thyroid Hemiagenesis ◽

Poorly Differentiated ◽

Node Metastases ◽

Right Lobe ◽

The Right

Background. Thyroid carcinoma complicated by hemiagenesis is very rare, and previous reports have not described this cancer on the side of the absent lobe. Methods and Results. We report the case of a 64-year-old woman in whom left thyroid hemiagenesis was discovered incidentally during investigations of abnormal sensation during swallowing. A tumorous 1.4 cm lesion was also found on the side of the absent lobe, left of the isthmus. Fine-needle aspiration biopsy revealed class V papillary carcinoma, but no lymph node metastases. Total thyroidectomy was performed for stage cT1bN0M0 carcinoma. Histopathology revealed normal thyroid tissues in the right lobe and isthmus, while the left lobe was absent. The mostly papillary carcinoma was adjacent to the truncated thyroid tissue, with a portion histologically consistent with poorly differentiated carcinoma. Conclusions. All previously reported cases of thyroid cancer complicated by hemiagenesis have represented carcinoma occurring within the present lobe. This case is extremely rare.

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