Invasive papillary carcinoma

Other forms of adenocarcinoma that occur in the ampullary region include mucinous adenocarcinoma, signet-ring cell adenocarcinoma, and invasive papillary carcinoma, which may mimic in situ neoplasia because of its exophytic growth, papillae formation,... 

In this chapter we will address diagnostic issues involving stromal invasion, papillary lesions, atypical proliferative lesions, discrimination of ductal and lobular neoplasia, identification of breast tumor types, Paget disease of the breast, fibroepithelial lesions, and metastatic breast carcinoma. The diagnostic section is followed by theranostic applications in breast cancer and a discussion regarding immunogenomics. 

Theodorescu, D., Comil, I., Sheehan, C., Man, M. S. and Kerbel, R. S. (1991a) Haras induction of the invasive phenotype results in upregulation of epidermal growth factor receptors and altered responsiveness to epidermal growth factor in human papillary transitional cell carcinoma cell. Cancer Res. 51, 4475-4491. 

A further bladder follow-up of these kidney recipients (cystoscopy and biopsies per 6 months) resulted in the diagnosis of 8 urothelial carcinoma in situ, 4 non-invasive low-grade papillary urothehal carcinoma and 3 infiltrating urothelial cancer, 68 to 169 months after cessation of AA exposure (cumulative incidence of 39.5%). Despite local and/or systemic chemotherapy, 3 patients died and 2 radical cystectomies had to be performed [41]. 

Verrucous carcinoma (VC) and papillary squamous cell carcinoma (PSCC) have a similar gross appearance, but VC has a pushing leading edge and no atypia, whereas PSCC shows c)rtologic atypia and more typical invasion. 

The distribution of p53 has been examined in cases of thyroid carcinoma. In the series reported by Soares and coworkers, p53 was absent from 14 cases of goiter and adenoma and from 12 cases of papillary carcinoma. p53 was present in 20% of follicular carcinomas (predominantly of the widely invasive type), 16% of poorly differentiated carcinomas, and 67% of undifferentiated carcinomas. In the series reported by Holm and Nesland, 6 of 32 (19%) papillary carcinomas, 5 of 29 (17%) follicular carcinomas, and 18 of 24 (75%) undifferentiated carcinomas were p53-F. In contrast, the RB gene product was present in all thyroid carcinomas, suggesting that it does not play a major role in thyroid carcinogenesis. "... 

The t(2 3)(ql3 p25) translocation, found in a subset of thyroid follicular carcinomas, results in fusion of the DNA binding domains of the thyroid transcription factor PAX-8 to domains A-F of the peroxisome proliferation-activated receptor (PPAR) y 1 (Hg. 10.13). Studies using PCR and immunohistochemistry demonstrated that most follicular carcinomas positive for PPAR Y were widely invasive while tumors lacking the rearrangement were PPAR y negative. Papillary carcinomas and Hurthle cell tumors were negative. Other studies, however, have reported positivity both in follicular carcinomas and adenomas. 

Molecular alterations of gallbladder adenomas are fairly different than those observed in the conventional dysplasia-carcinoma sequence. Mutations of the p53 gene are virtually nonexistent in gallbladder adenomas and only rarely detected in EHBD tumors. In contrast, p53 abnormalities are quite common in flat dysplasia and invasive carcinoma. Similarly, mutation of the KRAS oncogene is detected in only 25% of gallbladder adenomas. In contrast, mutations of the -catenin gene, which are uncommon in invasive biliary carcinomas, have been detected in 60% of adenomas, mostly the pyloric gland type, and less commonly the papillary or intestinal typesA ... 

Patel SA, Adams R, Goldstein M, Moskaluk CA. Genetic analysis of invasive carcinoma arising in intraductal oncocytic papillary neoplasm of the pancreas. Am J Surg Pathol. 2002 26 1071-1077. 

Moritani S, Ichihara S, Hasegawa M, et al. Serous papillary adenocarcinoma of the female genital organs and invasive micropapillary carcinoma of the breast. Are WTl, CA125, and GCDEP-15 useful in differential diagnosis Hum Pathol. 2008 39 666-671. 

Papillary lesions range from benign papilloma to atypical papilloma to papillary carcinoma in situ and invasive). There are several reports on the use of myoepithelial... 

Encapsulated papillary carcinoma Absent within, rare +/- around ducts Similar to DCIS, unless frankly invasive... 

Hill CB, Yeh IT. Myoepithelial cell staining patterns of papillary breast lesions Erom intraductal papillomas to invasive papillaty carcinomas. Am J Clin Pathol. 2005 123 36-44. 

Esposito NN, Dabbs DJ, Bhargava R. Are encapsulated papillary carcinomas of the breast in situ or invasive A basement membrane smdy of 27 cases. Am J Clin Pathol. 2009 131 228-242. 

Pathological criteria for classifying thyroid cancer may show discrepancies in the differentiation between foUicu-lar adenoma and minimally invasive follicular carcinoma, and between follicular neoplasia and the folficular variant of papillary carcinoma (Lloyd et al., 2004 Saxen et ai, 1978). The inclusion of papillary microcarcinomas (1.0 cm or less in diameter), which are usually incidental findings or detected by the use of ultrasound-guided thyroid fine-needle aspiration cytology (Lin et al., 1997), the existence of radioactive fallout, which may lead to an increase of differentiated thyroid carcinoma and a rise in population age with time, should also be taken into account when analyzing the epidemiology of thyroid cancer. 

A rise in papillary carcinoma from most series is accompanied by a decrease in the incidence of follicular carcinoma, which was sometimes not as marked as in Salta (Tables 53.4 and 53.6), probably due to the use of routine systematic capsule sampling from follicular neoplasms from the 1980s leading to more frequent identification of minimally invasive follicular carcinomas (Harach et al, 2002 Harach and Williams, 1995 Lang et al, 1980). If this had occurred, the real change in the papillary to follicular carcinoma ratio would have been greater, but would not have affected the incidence of papillary carcinomas, as microcarcinomas were excluded. Furthermore, an increase... 

Papillary thyroid carcinoma is a tumor of thyroid follicular epithelium with papillary and follicular growth pattern and the characteristic nuclear features. Papillary thyroid carcinoma makes about 70% of all thyroid carcinomas, often associated with radiation exposure or high iodine intake, and mainly metastasizes by invasion of lymph vessels. Papillary thyroid carcinoma frequently associated with different rearrangements mainly involving the RET/PTC gene discussed in a previous section. 

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