Virchows Archiv

Hansen, Torsten; Katenkamp, Kathrin; Bittinger, Fernando; Kirkpatrick, C.; Katenkamp, Detlef

doi: 10.1007/s00428-007-0376-9pmid: 17377811

We examined ten cases of extrapulmonary lymphangioleiomyoma/lymphangioleiomyomatosis (LAM; all patients female; median age 46.5 years) for immunohistochemical labeling with a monoclonal antibody against podoplanin (D2-40), which is specific for lymphatic endothelial lining. We found positive staining in thin-wall branching vessels reflecting the lymphatic nature of tumor vessels in all cases tested. In contrast, perivascular (HMB-45 positive) myoid cells were not detected by D2-40. The D2-40 labeling confirms the current concept of lymphangiogenic origin of the tumor vessels in LAM. In addition, this study makes a further contribution to the immunohistochemical mapping of this antibody in vascular tumors. Finally, the use of this commercially available antibody provides an additional help in the differential diagnosis of LAM from other soft tissue tumors.

Welker, L.; Müller, M.; Holz, O.; Vollmer, E.; Magnussen, H.; Jörres, R.

doi: 10.1007/s00428-007-0375-xpmid: 17377812

Cytology allows the diagnosis of malignant mesothelioma (MM) from effusions with high specificity but low sensitivity. Conversely, elevated levels of hyaluronic acid (HA) in effusions are sensitive indicators of MM, although specificity is insufficient. We studied whether the cytological diagnosis of MM could be improved by HA analysis. HA was analysed in patients with histologically confirmed MM (n = 162), adenocarcinoma or other malignant tumours (n = 100) and in 90 patients with benign pleural diseases. In 77 out of 162 effusions, all, and in 33 some, cytological criteria of MM were satisfied. The cut-off value of HA showing maximum diagnostic reliability (86%) regarding MM was 30 mg/l (sensitivity 87%, specificity 86%). A HA value of 100 mg/l yielded 39 and 98%, respectively. Seventy three out of 77 patients with cytological findings indicative of MM showed HA levels greater than 30 mg/l as well as 27 of 33 patients with suspicious lesions. These 100 patients were correctly recognised as having MM. The addition of HA analysis to cytology, requiring all or some criteria of MM as positive, increased sensitivity for MM from 48 to 71–91%, whereas specificity only slightly decreased to 94–96%. We conclude that the combined cytological and HA analysis of pleural effusions had the potential to improve the diagnosis of MM.

Weinreb, Ilan; Howarth, David; Latta, Eleanor; Ghazarian, Danny; Chetty, Runjan

doi: 10.1007/s00428-007-0378-7pmid: 17377813

Four cases of malignant PEComas were stained with smooth muscle actin, muscle specific actin, desmin, human melanoma black-45, melan-A, microphthalmia transcription factor, S100 and cyclin D1. One case was studied by electron microscopy (EM). Tumour locations were the thigh, elbow, retroperitoneum and bladder in association with a urachal cyst. There were two men and two women; the average age was 51.3 years, and the size ranged from 5.0–23.0 cm. In three cases, 50–95% of the tumour was composed of pleomorphic sarcomatous areas. All cases had at least focal clear-cell areas. One case showed a continuous single layer of perivascular clear cells remote from the tumour, transitioning to invasive nests and to PEComa. EM demonstrated these cells in apposition to and in direct contact with the abluminal surface of the basal lamina of the capillaries. We suggest the term “pecosis” for these areas. All cases were positive for two or more melanocytic markers and for at least one actin. S100 and desmin were focally positive in one case. Cyclin D1 was positive in 3:4 cases. Four cases of malignant PEComa are described with the existence of a unique lesion (pecosis) in one case. These tumours may manifest largely as sarcomas appearing to be undifferentiated and should be considered in their differential diagnosis.

Giger, Olivier; Lacoste, Elena; Honegger, Christoph; Padberg, Barbara; Moch, Holger; Varga, Zsuzsanna

doi: 10.1007/s00428-007-0377-8pmid: 17318573

We describe a phyllodes tumor of borderline malignancy in the labium majus of a 49-year-old woman. The histogenetic origin of phyllodes tumors in the vulva is controversial. Strong immunoreactivity for NY-BR-1, a novel breast differentiation antigen, was demonstrated within the epithelial components of the phyllodes tumor. A similar expression pattern was observed in mammary-like glands of the vulva. These findings provide further evidence that phyllodes tumors of the vulva might derive from mammary-like glands in the labium majus or from ectopic breast tissue.

Ide, Fumio; Obara, Kumi; Yamada, Hiroyuki; Mishima, Kenji; Saito, Ichiro

doi: 10.1007/s00428-007-0368-9pmid: 17265081

Agaimy, Abbas; Raab, Beate; Bonkowsky, Viktor; Wünsch, Peter

doi: 10.1007/s00428-007-0369-8pmid: 17285324

Magro, Gaetano; Amico, Paolo; Gurrera, Alessandra

doi: 10.1007/s00428-007-0373-zpmid: 17377814

Naitoh, Yoshihisa; Ban, Shinichi; Tsuchiya, Chouji; Sugiura, Yoshiaki; Shimizu, Michio

doi: 10.1007/s00428-007-0389-4pmid: 17333261

doi: 10.1007/s00428-007-0404-9pmid: N/A