This study attempts to evaluate the clinicopathologic features of mixed subtype adenocarcinomas and the prognostic implications of histopathology classifications. Surgical specimens from 141 patients with clinical stage I or II lung adenocarcinoma during the period 1992-2004 were included. These cases were classified into four groups defined by the extent of the bronchioloalveolar carcinoma component: group I: pure bronchioloalveolar carcinoma; group II: mixed subtype with predominant bronchioloalveolar carcinoma component and r5 mm invasive component; group III: mixed subtype with bronchioloalveolar carcinoma component and 45 mm invasive component; group IV: invasive carcinoma with no bronchioloalveolar carcinoma component. Descriptive statistics were used to examine the groups with respect to age, tumor size, lymph node metastasis, and Ki-67 and p53 expression levels. Death rate for the groups was obtained by patient's charts and from the National Death Index database. The population was similar in age, tumor size and lymph node metastasis. Immunohistochemical results showed that the mean Ki-67 labeling and the amount of p53 overexpression had the same trend of increasing mean values or positive results from groups I to IV. The reported proportion of deaths ranged from 0% for groups I and II, 20% in patients with predominant invasive component with bronchioloalveolar carcinoma (group III), and 18% in patients with invasive carcinomas and no bronchioloalveolar carcinoma component (group IV). The difference between the proportion of patients with reported deaths in the time period of this study in the combined greater than 5 mm þ pure invasive groups (groups III, IV), and the o5 mm þ noninvasive groups (groups I, II) is statistically significant. These results suggest that histological features may be useful in defining categories of lung adenocarcinomas with differing survival and prognostic features. These results are helpful in defining a subcategory of 'minimally invasive adenocarcinoma', which has features similar to bronchioloalveolar carcinoma. Noguchi et al 2 looked at small lung adenocarcinomas measuring o2 cm, and defined six different categories including pure bronchioloalveolar carcinoma, bronchioloalveolar carcinoma with areas of fibroblastic foci due to structural collapse, bronchioloalveolar carcinoma with active fibroblastic proliferation, and different categories of invasive carcinoma. They showed that patients with tumors with a pure bronchioloalveolar carcinoma pattern had a 100% 5-year survival, patients with adenocarcinomas of mixed subtype with bronchioloalveolar carcinoma and invasive components had a 75% 5-year survival, while those patients with a purely invasive carcinoma had a 52% 5-year survival.

Background: Schwannoma is most often grown on the trunk, upper and lower extremities, and head and neck, but rarely on the foot. This study aimed to reveal clinical presentations, histopathology and treatment options for schwannoma of the foot. Materials and Methods: Seven schwannomas out of 174 soft-tissue tumors on the foot and ankle were retrieved from our Institute in a 3-year period, and 42 schwannomas on the foot and ankle in the literature in a 30-year period were reviewed. Results: The incidence of schwannoma of foot was found to be 4.0%. The patient age ranged from 8 to 84 years, with a mean of 47.4 years. More than 80% of tumors were located on the ankle, heel and plantar aspect. Overall, 77.6% of patients complained about a painful mass. Magnetic resonance imaging revealed a well-circumscribed, round or ovoid mass with iso-intensity signal compared with surrounding neuromuscular tissues on T1-weighted images and hyper-intensity signal on T2. Forty-eight out of 49 patients were treated with surgical excision or enucleation without recurrence in follow-up from 2 months to 4 years. Histologically, schwannoma was composed of hypercellular Antoni A zone with palisaded spindle cells with strong immunostaining for S-100 and hypocellular Antoni B zone with vascularization in myxoid stroma. Conclusion: Schwannoma of the foot and ankle is a rare, painful, indurated tumor. Magnetic resonance imaging reveals the location, size, texture and relationships with surrounding neuromuscular structures. Surgical excision is the primary treatment option with excellent outcome.Schwannoma, also called neurilemoma, derived from Schwann cells in the peripheral nerves, is a solid, slowgrowing tumor. It was first reported by Verocay in 1910 (1), and was named 'schwannoma' by Masson in 1932 (2). Schwannoma accounts for about 5% benign tumors as revealed by an analysis of 18,677 benign soft-tissue tumors by Kransdorf (3) and others (4). It frequently occurs in the trunk, flexor side of upper and lower extremities, head and neck (3, 5, 6), especially in the eighth cranial vestibular nerves (7-9), but is uncommon on the foot and ankle (10-12). Toepfer et al. observed 11 (10.5%) neurinomas, including both schwannoma and neurofibroma, out of 104 benign softtissue tumors of the foot and ankle at a university tumor institute between 1997 and 2015 (13). Kehoe et al. recorded 12 out of 104 (11.5%) peripheral nerve tumors on the foot in a 32-year period (7), and Carvajal et al. reported eight out of 87 (9.2%) schwannomas were located on the foot in a 16year period observation (14). In 1969, Das Gupta et al. analyzed 303 schwannomas with none of them being on the foot (5), whereas in 1998 with Chaudhuri, they reported four out of 104 schwannomas to be found on the foot (15). Odom et al. reviewed 557 schwannomas and noted 19 (2.93%) involving the foot (16). Most published results were reports of single case or small case series. Here, we report seven cases of schwannoma on the foot and ankle from our Institute in a 3-year period, and further...

A 28-year-old woman with a 2-yr history of unilateral chronic leg swelling, initially thought to be secondary to deep vein thrombosis, later thought to be due to congenital venous malformation, eventually developed a pelvic mass, which was biopsied by fine-needle aspiration. On the basis of cytologic features on smears, high-grade sarcoma was reported. The patient underwent surgery to resect the pelvic mass, which showed anastomosing vascular channels arising from external iliac vein in histology. However, the tumor cells unexpectedly showed strong and diffuse immunohistochemical expression of cytokeratin and epithelial membrane antigen. The case was sent for expert consultation, and the expert's opinion was epithelioid angiosarcoma. The expert's diagnosis was confirmed 2 yr later by local recurrence. The clinical presentation, cytology, histology, and immunohistochemistry of the current case and 15 other cases of epithelioid angiosarcoma found in the cytology literature are summarized. This case illustrates that morphology with clinicopathologic correlation tends to be a better guide than available special techniques.

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BACKGROUND:Fluorescent in situ hybridization (FISH) analysis of urine samples has proven to be a valuable adjunctive test to urine cytology for both diagnosis and monitoring recurrence of urothelial carcinoma. Automated FISH analysis has the potential to improve laboratory efficiency and to reduce interobserver and intraobserver variability, resulting in more accurate, reproducible, assay performance.METHODS:A total of 3200 slides containing urine specimens, hybridized with the UroVysion Bladder Cancer Kit (Abbott Molecular, Des Plaines, Illinois), a 4‐probe set for chromosomes 3, 7, 17, and 9p21, was evaluated at Acupath Laboratories. The slides were analyzed over a 7‐month period, using the Ikoniscope ‐ oncoFISH bladder Test System (Ikonisys, New Haven, Connecticut).RESULTS:Analysis included the incorporation of a “flagging” system developed by Acupath Laboratories to identify cases, based on specific criteria, likely to benefit from further manual review. By using US Food and Drug Administration (FDA)‐cleared scoring criteria, 96.3% of the slides could be reported directly from the automated scan, requiring no manual review of the slide. For the remaining 3.7% of the samples (all of which were very hypocellular), a manual review of each slide subsequently allowed diagnoses to be successfully reported. The average scan time was 31.7 minutes, and the average slide scan review time was 8.3 minutes.CONCLUSIONS:This study demonstrated the value of an automated approach to the analysis of FISH slides, affording the benefit of high‐throughput while providing the user with the necessary images and tools to quickly and accurately report a case. Cancer (Cancer Cytopathol) 2011;. © 2011 American Cancer Society.