cribriform

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  • 文章类型: Case Reports
    背景:涎腺型肺癌是罕见的肺部肿瘤,占所有肺部肿瘤的不到1%。其中最常见的两种是腺样囊性癌和粘液表皮样癌。虽然他们通常有懒惰的行为,腺样囊性癌可能更具侵袭性,5年生存率低至55%。文献中报道的病例很少。我们报告了类似的唾液腺型肺癌罕见病例,该病例首次出现左半胸单侧混浊。
    方法:一名38岁的北印度裔男子,他是一个不吸烟的人,出现呼吸急促和咳嗽1年的投诉,在过去2个月中有所增加,并与显着的体重减轻有关。进行了胸部的额叶X光片和胸部的计算机断层扫描,显示左肺上叶有肿块,其中心位于左主支气管。进行了支气管镜引导活检,病理证实诊断为涎腺型肺癌(腺样囊性癌)。主要船只入侵,因此,患者被提供并开始接受姑息治疗,而不是手术治疗。尽管化疗和放疗两个周期的姑息治疗,患者在诊断后2个月内死于该疾病。
    结论:涎腺型肺癌(尤其是腺样囊性癌)通常在晚期出现。肿瘤的可切除性取决于周围主要血管的受累。有趣的是,这些癌症与吸烟无关。预后取决于诊断时的疾病程度。因此,影像学在决定进一步的管理计划中起着重要作用。
    BACKGROUND: Salivary gland-type lung carcinomas are uncommon neoplasms of the lung, representing less than 1% of all lung tumors. The two most common among them are adenoid cystic carcinoma and mucoepidermoid carcinoma. Although they usually have an indolent behavior, adenoid cystic carcinomas can be more aggressive, with 5-year survival as low as 55%. Very few cases are reported in literature. We report a similar rare case of salivary gland type lung carcinoma that presented for the first time with unilateral opacification of left hemithorax.
    METHODS: A 38-year-old man of North Indian origin, who was a a nonsmoker, presented with complaints of shortness of breath and cough for 1 year, which has increased in the last 2 months and was associated with significant weight loss. A frontal radiograph of the chest and computed tomography of the chest were performed, which showed a mass in the left upper lobe of the lung with its epicenter in the left main bronchus. A bronchoscopic guided biopsy was performed, and histopathology confirmed the diagnosis of lung carcinoma of salivary gland type (adenoid cystic carcinoma). There was invasion of major vessels, hence the patient was offered and started on palliative management instead of surgical treatment. In spite of palliative management of two cycles of chemotherapy and radiotherapy, the patient succumbed to the disease within 2 months from the time of diagnosis.
    CONCLUSIONS: Lung carcinoma of the salivary gland type (especially adenoid cystic carcinoma) usually presents at a later stage. The resectability of the tumor depends on the involvement of the surrounding major vessels. Interestingly, these cancers have no association with smoking. The prognosis depends on the extent of the disease at the time of diagnosis. Hence, imaging plays a major role in deciding the further plan of management.
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  • 文章类型: Journal Article
    我们描述了一种罕见的甲状腺乳头状癌的鳞片状变异型。我们报告了一例26岁的女性,其甲状腺肿瘤没有结肠表现。她接受了全甲状腺切除术和中央室颈清扫术。她的组织病理学报告显示,甲状腺左叶乳头状癌。存在局灶性血管造影入侵。即使在这些变体的零星介绍中,结肠镜检查筛查,遗传咨询和家庭成员筛查应始终被认为是甲状腺恶性肿瘤在结肠表现前多年出现的原因.
    We describe a case of cribriform morular variant of papillary thyroid carcinoma which is a rare subtype. We report a case of a 26 year old female who presented with a thyroid tumour without colonic manifestations. She underwent a total thyroidectomy with central compartment neck dissection. Her histopathology report showed Cribriform-Morular variant, Papillary carcinoma of the left lobe of thyroid. Focal Angio-invasion was present. Even in sporadic presentations of these variants, screening colonoscopy, genetic counselling and screening of family members should be invariably considered as many a time thyroid malignancy presents many years prior to colonic manifestations.
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    文章类型: Case Reports
    背景:男性乳腺癌(MBC)相对罕见,约占美国所有男性癌症的1%,占全球乳腺癌的0.6%。在尼日利亚,尽管发病率因地区而异,范围为3.4%至9%,据指出,它正在增加。妇科乳房发育是一种有据可查的诱发因素,也是内源性和外源性雌激素。男性乳腺癌最常见的组织学亚型是浸润性导管癌。浸润性筛状癌,ICC,是一种极其罕见的变体,全球报告的病例不超过10例,当存在时,已被诊断为40岁以上的患者。
    方法:我们介绍一个17岁的案例,男本科生,他因复发而向我们的诊所就诊,无痛,右乳房肿块。三年前,他在另一个健康场所切除了右乳房肿块,在组织病理学上被诊断为浸润性筛状癌。唯一已知的诱发因素是最初的肿块,在他10岁时被切除,组织学诊断为妇科乳房发育症.他接受了手术切除和腋窝淋巴结清除,组织病理学再次证实高级别浸润性筛状癌伴多发淋巴结转移,而免疫组织化学显示三重阴性特征。此后,他被转诊接受辅助治疗,对放疗反应良好。
    结论:在所有女性乳房发育症病例中都需要高度怀疑,所有这些患者都应该接受随访。迅速干预,诉诸组织学,在注明的地方,免疫组织化学,很重要。
    BACKGROUND: Male breast cancers (MBC) are relatively rare, accounting for about 1% of all male cancers in the US and 0.6% of breast cancers worldwide. In Nigeria, though the incidence varies per region, with a range of 3.4 to 9%, it is noted to be increasing. Gynaecomastia is a well-documented predisposing factor as well as endogenous and exogenous oestrogen. The most common histological subtype of male breast cancer is the invasive ductal carcinoma. Invasive cribriform carcinoma, ICC, is an extremely rare variant, with no more than 10 cases reported worldwide and, when present, has been diagnosed in patients above 40 years old.
    METHODS: We present the case of a 17 year-old, male undergraduate student, who presented to our clinic on account of a recurrent, painless, right breast lump. Three years earlier he had had a right breast lump excised at another health facilityand this was diagnosed histopathologicallyas invasive cribriform carcinoma. The only known predisposing factor was an initial lump, excised when he was 10 years old, and diagnosed histologically as gynaecomastia.He had surgical excision and axillary lymph node clearance,and histopathology re-confirmed high grade invasive cribriform carcinoma with multiple lymph node metastases, while immunohistochemistry showed a triple negative signature. He was thereafter referred for adjuvant treatment and has responded well to radiotherapy.
    CONCLUSIONS: There is need for a high index of suspicion in all cases of gynaecomastia, and all such patients should be followed up. Prompt intervention, recourse to histology, and where indicated, immunohistochemistry, are important.
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  • 文章类型: Journal Article
    背景:恶性肿瘤的自发消退(SR)是在没有治疗的情况下原发性或转移性肿瘤组织的部分或完全消失,可以是暂时的或永久的。这里,我们报道了一例极为罕见的男性乳腺癌病例,该病例在肿瘤消失8个月后出现暂时性SR,随后又出现.
    方法:一名70岁的男子在我们医院就诊,主要主诉为疼痛和左乳房肿块。超声检查显示低回声病变,大小为12mm×10mm×8mm。细针抽吸细胞学检查显示许多坏死和变性细胞,以及很少的非典型导管上皮细胞的片状簇。非典型细胞有轻度增大的核仁,局部重叠并形成管状图案。细胞学诊断提示怀疑恶性肿瘤。芯针活检(CNB)显示坏死和变性的细胞伴有微钙化。病理诊断不确定,因为没有活的非典型细胞区域。一个月后计划对左乳腺病变进行切除活检。然而,在患者首次就诊后1个月进行体格检查和超声检查时,很难发现肿瘤。手术被取消了,患者接受随访观察。经过8个月的随访,超声和计算机断层扫描(CT)显示在同一位置再次出现直径为0.6cm的乳腺肿瘤。再次行CNB,发现浸润性导管癌。第一次肿瘤消失后13个月,进行了全乳房切除术和前哨淋巴结活检。组织病理学检查显示浸润性筛状癌无前哨淋巴结转移。病人没有任何并发症,并开始他莫昔芬辅助治疗.患者术后7个月存活无复发。
    结论:在乳腺癌病例中可以发生暂时SR,然后再出现肿瘤。即使患者的乳腺肿瘤似乎消失了,也要跟随他们。当乳腺肿瘤在没有治疗的情况下消失时,临床医生必须意识到癌症SR的可能性,并应跟踪患者以早期发现肿瘤复发。
    BACKGROUND: Spontaneous regression (SR) of a malignant tumor is the partial or complete disappearance of primary or metastatic tumor tissue in the absence of treatment, which can be temporary or permanent. Here, we report an extremely rare case of male breast cancer that exhibited temporary SR followed by reappearance 8 months after tumor disappearance.
    METHODS: A 70-year-old man presented at our hospital with a primary complaint of pain and a lump in his left breast. Ultrasonography revealed a hypoechoic lesion measuring 12 mm × 10 mm × 8 mm. Fine-needle aspiration cytology revealed numerous necrotic and degenerated cells and few sheet-like clusters of atypical ductal epithelial cells. The atypical cells had mildly enlarged nuclei with nucleoli, were focally overlapped and formed tubular patterns. The cytological diagnosis indicated a suspicion of malignancy. Core needle biopsy (CNB) revealed necrotic and degenerated cells with microcalcification. The pathological diagnosis was indeterminate because there was no area of viable atypical cells. An excisional biopsy of the left breast lesion was scheduled one month later. However, it was difficult to detect the tumor during physical examination and ultrasonography performed 1 month after the patient\'s first visit. The operation was canceled, and the patient received follow-up observation. After 8 months of follow-up, ultrasonography and computed tomography (CT) revealed reappearance of a 0.6-cm-diameter breast tumor in the same place. CNB was performed again and revealed invasive ductal carcinoma. A total mastectomy with sentinel lymph node biopsy was performed 13 months after the first tumor disappeared. Histopathological examination revealed invasive cribriform carcinoma without sentinel lymph node metastasis. The patient did not have any complications, and adjuvant therapy with tamoxifen was started. The patient was alive without recurrence 7 months after surgery.
    CONCLUSIONS: Temporary SR followed by tumor reappearance can occur in breast cancer cases, and it is important to follow patients even if their breast tumor has seemingly disappeared. When breast tumors disappear without treatment, clinicians must be aware of the possibility of SR of cancer and should follow the patient for early detection of tumor reappearance.
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  • 文章类型: Journal Article
    叶状肿瘤是一种罕见的乳腺纤维上皮肿瘤。它的特征是基质扩大,细胞数量增加,上皮衬里的裂隙拉长。叶状肿瘤中的乳腺癌很少报道。迄今为止,然而,尚无报道描述恶性叶状肿瘤中出现的浸润性筛状癌。这里,我们报告了一名62岁女性,她的乳房肿块很大。微观上,肿块是典型的恶性叶状肿瘤,表现出发育良好的叶状结构和基质过度生长,具有高细胞性和核多态性。在肿瘤的一部分中,然而,在不存在肌上皮细胞的情况下,上皮成分表现出网状增殖模式,提示浸润性筛状癌。据我们所知,这是罕见的,很难对其进行鉴别诊断。这里,我们通过文献复习来报告我们的病例。
    Phyllodes tumor is an uncommon fibroepithelial neoplasm of the breast. And it is characterized by expanded stroma with increased cellularity and elongated epithelium-lined clefts. Mammary carcinomas within phyllodes tumors have been rarely reported. To date, however, no reports have described the invasive cribriform carcinoma arising in malignant phyllodes tumor. Here, we report a 62-year-old woman who presented with a large breast mass. Microscopically, the mass was a typical malignant phyllodes tumor showing well developed leaf-like architecture and stromal overgrowth with high cellularity and nuclear pleomorphism. In a portion of the tumor, however, the epithelial component showed a cribriform pattern of proliferation in the absence of myoepithelial cells, suggestive of the invasive cribriform carcinoma. To our knowledge, this is rare and it is difficult to make a differential diagnosis of it. Here, we report our case with a review of literatures.
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