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Primary Neoplasms (primary + neoplasm)

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Medical Sciences	100%

Selected Abstracts

Metastatic cutaneous leiomyosarcoma from primary neoplasm of the mesentery

INTERNATIONAL JOURNAL OF DERMATOLOGY, Issue 8 2001
Kyoung Jin Kim MD
A 31-year-old South Korean woman was referred to the dermatology department from the oncology department for the evaluation of a subcutaneous nodular lesion on the back. Three years before, she noted a palpable, fingertip-sized, nontender mass on her right lower abdomen. The mass had increased in size slowly. One year ago, she visited a local clinic and physical examination revealed a 7 × 8 × 7 cm, slightly tender, deep-seated mass on the right lower quadrant of the abdomen. The mass on the ilial mesentery was resected by surgical exploration and tissue examination revealed leiomyosarcoma. She refused adjuvant chemotherapy. Approximately 3 months later, she re-visited the clinic with a tender, subcutaneous nodule on the back. Cutaneous examination revealed a solitary, 2 × 2 cm, well-defined, hard, movable, subcutaneous nodule on the upper back without skin color change (Fig. 1). She complained of tenderness on touching the lesion. Histologic examination of a biopsy specimen showed irregularly arranged spindle cells scattered throughout the dermis. They were arranged in haphazardly oriented or interweaving fascicles. Most of the spindle cells possessed elongated nuclei with blunt ends and some cells had a polygonal outline with irregularly shaped nuclei (Fig. 2). There were many mitoses: 3,4 per high-power (× 400) field. Immunohistochemically, smooth muscle actin and desmin were positive in most of the tumor cells (Fig. 3). S-100 reactivity was not observed. A diagnosis of metastatic leiomyosarcoma was made. About 1 month later, computed tomography showed two, ill-defined, heterogeneous, low attenuation masses in the right lobe of the liver, suggesting liver metastasis. The patient was treated with chemotherapy for 2 months and remains in good condition. Figure 1. 2 × 2 cm, solitary, well-defined, hard, movable, subcutaneous nodule without any overlying skin change Figure 2. (a) Characteristic findings of cutaneous leiomyosarcoma with markedly high cellularity and densely packed transverse and longitudinal fascicles of cells (hematoxylin and eosin, × 40). (b) High magnification of the neoplasm revealing spindle cells with blunt-ended nuclei, pleomorphism, and mitotic figures (hematoxylin and eosin, × 200) Figure 3. Dense cytoplasmic reactivity for smooth muscle actin is apparent (smooth muscle actin, × 200) [source]

Cytologic diagnosis of osseous lesions: A review with emphasis on the diagnosis of primary neoplasms of bone

DIAGNOSTIC CYTOPATHOLOGY, Issue 4 2009
Lester J. Layfield M.D.
Abstract Fine-needle aspiration has been utilized as the initial diagnostic technique at a large number of body sites for over three quarters of a century. As early as the 1930s, fine-needle aspiration (FNA) was used to investigate lesions of the musculoskeletal system. In many early reports, FNA was most frequently and successfully used for the diagnosis of metastatic disease to bone. Less emphasis was placed on its utility for the investigation of primary neoplasms of bone and soft tissue. Current utilization of FNA continues to de-emphasize its application to the diagnosis of primary lesions of the musculoskeletal system. Recent advances in imaging techniques, immunohistochemistry, and molecular diagnostics along with an increasing familiarity among pathologists with the cytologic appearance of primary osseous tumors has led to reevaluation of the technique for investigation of these tumors. The diagnostic accuracy of FNA along with its relatively low cost and high degree of safety makes it a desirable technique for the investigation of primary lesions of the musculoskeletal system. This article reviews issues of diagnostic accuracy, optimal practice procedures, and benefits of the technique including cost reduction. The article will review criteria for selection of appropriate tissue targets for FNA to reduce the number of unsatisfactory specimens. Cytomorphologic features of the more common primary neoplasms of bone will be summarized along with recommendations for the utilization of immunohistochemistry and molecular diagnostics in the work-up of primary neoplasms of bone. Diagn. Cytopathol. 2009. © 2009 Wiley-Liss, Inc. [source]

Cytology of primary central nervous system neoplasms in cerebrospinal fluid specimens

DIAGNOSTIC CYTOPATHOLOGY, Issue 4 2002
David C. Chhieng M.D.
Abstract Although two-thirds of tumors occurring in the central nervous system (CNS) are primary neoplasms, only 10% of positive cerebrospinal fluid (CSF) specimens are from primary CNS tumors. In this study, we reviewed the cytologic findings of 21 positive CSF specimens from primary CNS tumors. A computer search identified 21 cases of positive CSF specimens from patients with primary CNS tumors from the archives. Follow-up included review of medical charts and histologic correlation. The specimens were from 20 patients (9 females and 11 males). Their ages ranged from 6,83 yr, old with a mean of 30 yr. The cases included 9 medulloblastomas, 7 gliomas (3 glioblastoma multiformes, 2 anaplastic astrocytomas, and 2 ependymomas), 2 germinomas, 2 non-Hodgkin's large B-cell lymphomas, and 1 ganglioneurocytoma. Two cases were classified as suspicious and the remaining as positive for malignancy. Immunocytochemistry was employed in 3 cases to support the cytologic diagnosis. These cases included one large-cell lymphoma (leukocyte-common antigen-positive), one germinoma (placental alkaline phosphatase-positive), and the ganglioneurocytoma (neuron-specific enolase- and synaptophysin-positive). There were no false-positive cases. Our results suggest that positive CSF cytology in patients with a primary CNS tumor is a reliable indicator of malignancy and reflects leptomeningeal involvement. The use of immunocytochemistry is helpful in confirming the cytologic impression in some cases. Diagn. Cytopathol. 2002;26:209,212. © 2002 Wiley-Liss, Inc. [source]