Differentiation cystic

Fig. 13.6 Triple staining of an adenoid cystic carcinoma for K14 (green a), (b) for K8/18 (red b) and for SMA (pink c). Note that the k 4+ cells differentiate to glandular and myoepithelial cells...

P. Mylona, J.D. Glazier, S.L. Greenwood, M.K. Sides, and C.P. Sibley. Expression of the cystic fibrosis (CF) and multidrug resistance (MDR1) genes during development and differentiation in the human placenta. Mol Hum Reprod. 2 693-698 (1996). 

Fig. 10.4. Potential development of a protoscolex of Echinococcus granulosus or E. multilocularis in different habitats. 1, In the dog gut, the scolex evaginates, the organism attaches to the mucosa, differentiates in a strobilar direction and develops into an adult tapeworm. 2, In vivo, if a hydatid cyst bursts or leaks (as during a surgical operation) each protoscolex can differentiate in a cystic direction and form a (secondary) hydatid cyst. (After Smyth, 1987b.)...

Gottstein, B., Schantz, P. M., Todorov, T., Saimot, A. G. Jaquier, P. (1986). An international study on the serological differential diagnosis of human and cystic alveolar echonococcosis. Bulletin of the World Health Organization, 64 101-5. 

Bassi C, Salvia R, Gumbs AA, Butturini G Falconi M, Pederzoli P, The value of standard serum tumor markers in differentiating mucinous from serous cystic tumors of the pancreas CEA, Ca 19-9, Ca 125, Ca 15-3, Langenbecks Arch. Surg., 387 281-285, 2002. 

Stefaniak, J., Lemke, A. Clinical aspects of the hepatic cystic echinococcosis. Differential diagnosis of echinococcus cysts in the Hver by ultrasonography and fine needle aspiration biopsy. Hepatol. Polska 1995 2 33-38... 

Four types of cysts can be differentiated (i.) dysontogenetic cysts, (2.) parasitic (or infectious) cysts, (i.) neoplastic cysts and (4.) post-traumatic cysts. The cause of cystic neoplasms is unknown. Traumatic cysts (C. Whipple, 1898) occur from an injured intrahepatic bile duct after blunt abdominal trauma. (136)... 

Intrahepatic localizations must be distinguished from extrahepatic CCC. They are subdivided into three areas of the large bile duct (1.) the upper third from the hver hilum to the opening of the cystic duct (frequency about 49%) (2.) the medial third of the common bile duct (frequency about 25%) (i.) the lower third reaching to the opening into the duodenum (frequency about 19%). Diffuse involvement of the whole extrahepatic area was found in 7% of cases. Tumours situated in the upper third are designated proximal, central or hilar CCC and are also known as Klatskin tumours. (204) Distal localizations of the extrahepatic CCC must be clearly differentiated from carcinomas of Vater s ampulla and of the pancreas head. 

Rhabdomyosarcoma is a mesenchymal tumour of grey colour with partially cystic growth. (12) It mainly occurs during childhood. (277) The tumour cells appear small, round or spindle-like, hyperchromatic, occasionally with eosinophilic cytoplasm. (279) They show various stages of differentiation of embryonal skeletal muscle cells. This tumour originates from peribiliary located muscu-... 

Isotretinoin is indicated for the treatment of severe recalcitrant cystic acne. Because of the risks of adverse effects, its use should be reserved for patients who are unresponsive to conventional acne therapies. Treatment should be individu-alixed and modilled depending on the course of the di.sease. The mechanism is believed to involve inhibition of sebaceous gland function and follicular keratinixation. Isotretinoin reduces sebum production, the size of the glantfs. and gland differentiation. 

Cholangiocarcinoma, or primary carcinoma of the bile ducts, can arise at any point in the biliary tree, including the small intrahepatic bile duct radicals. This lesion is typically associated with underlying liver disease, such as (1) PSC, (2) congenital cystic lesions, or (3) chronic infestation with Clonorchis sinensis. The clinical picture presentation is that of cholestasis, including jaundice, dark urine, tan-colored stool, and pruritus. Differentiation from other cholestatic diseases is made by visualizing the biliary tree. 

Claeys S, Van Hoecke H, Holtappels G, et al Nasal polyps in patients with and without cystic fibrosis a differentiation by innate markers and inflammatory mediators. Clin Exp Allergy 2005 35 467-472. 

TABLE 9.2 Differentiating Basaloid Squamous Cell Carcinoma from Adenoid Cystic and Small Cell Neuroendocrine Carcinoma ... 

Histologically, BSCC has a biphasic appearance, where the basaloid component usually dominates. The second component of a conventional SCC is usually only minor and can even be quite focal." BSCC usually grows in smooth contoured lobules, large nests, or trabecular cordlike arrangements of small clusters or even single cells. The lobules often contain central comedo-type necrosis. Cystic spaces and even abortive ductal differentiation can be present in a minority of the tumors. Very rarely the tumor can have deposition... 

The differential diagnosis for BSCC can be broad, especially in small biopsies where it can be difficult to appreciate all of the histologic features. Included in the differential diagnosis are the two most important mim-ickers adenoid cystic carcinoma and small cell neuroendocrine carcinoma.Immunohistochemical stains are particularly useful in resolving this differential diagnosis (Table 9.2). 

The differential diagnosis for basaloid squamous cell carcinoma (BSCC) includes adenoid cystic carcinoma and small cell neuroendocrine carcinoma. 

TABLE 9.12 Differential Diagnosis of Pleomorphic Adenoma (PA), Polymorphous Low-Grade Adenocarcinoma (PLGA), and Adenoid Cystic Carcinoma (ACC) ... 

Vargas V, Sudilovsky D, Kaplan MJ. Mixed tumor, polymorphous low-grade adenocarcinoma and adenoid cystic carcinoma of the salivary gland pathogenic implications and differential diagnosis by Ki-67 (Mib 1), Bel 2 and S-100 immunohistochem-istry. Appl Immunohistochem. 1997 5 8-16. 

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