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Gestational Trophoblastic Neoplasia
Published in Pat Price, Karol Sikora, Treatment of Cancer, 2020
Partial hydatidiform moles are genetically nearly all triploid or rarely, tetraploid, with at least two paternal chromosome sets but also some maternal contribution (Figure 23.2c). Although triploidy occurs in 1–3% of all recognized conceptions and in about 20% of spontaneous abortions with abnormal karyotype, triploids due to two sets of maternal chromosomes do not become PHMs.24,25 Flow cytometry, in situ ploidy, or genotyping done from formalin-fixed, paraffin-embedded tissues15 can all therefore help in differentiating CHM from PHM, and PHM from diploid non-molar hydropic abortions.26 Although a variety of reports indicated that diploid PHM exists, genetic analysis of lesions suspected to be such has not supported this suggestion. In general, a diploid molar gestation is believed to be a complete hydatidiform mole.27 In PHMs, swelling tends to be less intense than in CHM and affects only some villi (partial). Thus, two populations of villi usually exist in a partial mole. Both swollen and non-swollen villi can have trophoblastic hyperplasia, which is mild and focal.28–30 Nuclear atypia is infrequent. The villi have characteristic indented or scalloped outlines and round inclusions.31
Endometrial cancer: epidemiology, pathology and natural history
Published in A. R. Genazzani, Hormone Replacement Therapy and Cancer, 2020
Endometrial hyperplasia forms a morphologic continuum of abnormal proliferation ranging from focal glandular crowding or simple hyperplasia to well-differentiated adenocarcinoma. It comprises a variety of patterns of epithelial and stromal proliferation, some of which are characterized by varying degrees of nuclear atypia. For many years, pathologists have been concerned about the malignant potential of the various types of endometrial hyperplasia. Ultrastructural and DNA studies have indicated that nuclear atypia represents a more serious change than architectural abnormalities from the viewpoint of risk of developing carcinoma.
Benign Lymph Node Lesions
Published in Harold R. Schumacher, William A. Rock, Sanford A. Stass, Handbook of Hematologic Pathology, 2019
Sinus histiocytosis with massive lymphadenopathy is a distinctive lesion involving lymph nodes that is better known by its eponym, Rosai-Dorfman disease. Involved lymph nodes are significantly enlarged, with yellowish-white cut surfaces. Microscopically, these lymph nodes have prominent fibrous capsular thickening, but the outstanding and distinctive change is massive expansion of the sinuses, containing numerous histiocytes with abundant cytoplasm and centrally placed vesicular nuclei with one or several nucleoli. Nuclear atypia is usually not present. The cytoplasm of the histiocytes characteristically contains numerous intact lymphocytes, but sometimes the cytoplasm will also contain neutrophils, plasma cells, and red blood cells. Plasma cells are prominent in both the sinuses and intrasinusoidal areas. Foamy macrophages may also occur, but eosinophils are absent and germinal centers are usually not prominent. Numerous extranodal sites may also be involved with this process.
Papillary thyroid carcinoma with hobnail features showing rapid progression and therapy resistance
Published in Acta Chirurgica Belgica, 2021
Anton De Graef, Klaas Van Den Heede, Vanessa Meert, Sam Van Slycke
Fine-needle aspiration cytology (FNAC) of the right thyroid gland was cell-rich due to numerous three-dimensional groups and papillary structures, sometimes with pseudo-rosette-like structures, composed of large cells with spacious, somewhat oxyphilic cytoplasm, and often eccentrically located, enlarged, irregular nuclei. These nuclei sometimes present with coarse chromatin patterns, nuclear anomalies, or prominent nucleoli. There were some mitotic figures retained. In addition to this nuclear atypia, there was architectural atypia: a disorderly organisation with the distorted polarity of these large, atypical cells. In addition to these large atypical cells, fragments of the relatively normal follicular epithelium were detected. Furthermore, a few multinucleated cells, small flakes of colloid, and many cell shadows and cell debris could be found. The tissue was suspect for malignancy, possibly Hürthle cell carcinoma or an oxyphilic variant of PTC, but insufficiently definable based on the material obtained. Unlike normal follicular cells, tumour cells were P53 positive (Figure 4).
A case of psoriatic arthritis with type I cryoglobulinemia associated with multiple myeloma
Published in Modern Rheumatology Case Reports, 2019
Aiko Yamazaki, Keita Fujikawa, Yushiro Endo, Emi Matsuo, Yoko Yokoyama, Akinari Mizokami, Masahiro Nakashima, Atsushi Kawakami
One month after discharge, he was hospitalized again for recurrence of arthralgia and thrombocytopenia. Abnormal cells with nuclear atypia were detected in the peripheral blood. A repeat bone marrow aspiration showed plasma cell proliferation with nuclear atypia (Figure 4); a diagnosis of IgG-κ-type MM was confirmed by immunohistochemical staining, and he was treated with dexamethasone and bortezomib for MM; his symptoms and thrombocytopenia gradually improved. However, after the appearance of pain and purpura in the left lower extremity, his condition suddenly deteriorated and he died within 3 weeks of the second hospitalization. Pseudomonas aeruginosa was detected in the blood and tissue cultures. Autopsy findings revealed no infiltration of myeloma cells in the internal organ and infected sites and pointed to septic shock as the cause of death.
Solitary fibrous tumor of the orbit with growth during pregnancy: a case report
Published in Orbit, 2019
Robert A. Hyde, Yunxiang Liu, Vinay K. Aakalu, Pete Setabutr
An anterior orbitotomy was performed with removal of the mass. Light microscopy of the excised mass showed a circumscribed tumor comprised of ovoid to plump spindle-shaped cells with moderate eosinophilic cytoplasm and ovoid to elongated vesicular nuclei with inconspicuous nucleoli (Figure 2(a)). Up to three mitoses were seen per high power field. Background stroma was fibrocollagenous and richly vascular with the presence of irregular and dilated vessels, some of which had a staghorn appearance. Nuclear atypia was minimal. The tumor cells exhibited patchy positivity for CD34 (Figure 2(b)) and were negative for CD31, smooth muscle actin (SMA), and S100. The tumor cells exhibited diffuse cystoplasmic reactivity for Bcl2 and diffuse nuclear immunoreactivity for STAT6 (Figure 2(c)). A strong expression of progesterone receptor (PR) was seen in these tumor cells (Figure 2(d)). However, fewer than 5% of cells expressed estrogen receptor (ER). Ki67 labelling index was less than 5%. SS18/SSX1 and SS18/SSX2 fusion transcripts were not detected by RT-PCR.