Four cases of chondroid syringoma containing large numbers of hyaline or plasmacytoid cells are described. Three cases occurred in the hand and one in the foot. Hyaline cells are commonly seen in mixed tumours and myoepitheliomas of salivary glands and rarely in chondroid syringomas. The hyaline-cell change in three of the cases initially caused diagnostic difficulties and the possibility of sarcoma was raised in two cases. In addition to the characteristic hyaline cells, the presence of tubulo-glandulo-ductal structures, benign squamous epithelium and myxochondroid stroma aided diagnosis. Immunohistochemically, the hyaline cells exhibited positivity for vimentin, cytokeratin, S-100 protein, carcino-embryonic antigen, focal glial fibrillary acidic protein (3 cases), neuron-specific enolase (3 cases) and focal alpha-smooth muscle actin (2 cases). Occasional cells were Ber EP4 positive (2 cases). In some cells, a striking peripheral ring-like positivity for cytokeratin and S-100 protein was noted. Ultrastructurally, desmosomes, varying numbers of tonofibrils and non-bundling intermediate filaments were seen. Scanty fine filaments with vague focal densities were detected in some cells. Our studies suggest that the hyaline cells represent modified epithelial as well as myoepithelial cells. One of our cases also exhibited collagenous spherulosis.
SYNOPSISThe clinical features and the histological and ultrastructural appearances of a case of calcifying epithelial odontogenic tumour are described. The ultrastructural features of the cells of this tumour are comparable to cells of the stratum intermedium of the enamel organ. It is suggested that the amyloid-staining material found in this tumour is a cellular secretion rather than a cytoplasmic degeneration.
Summary:We report a case of angiosarcoma of the glans penis in a 77 year old male Caucasian. The tumour developed 18 years after a course of radiotherapy for a penile ulcer which was an intra-epidermal squamous carcinoma. The differential diagnosis and the concept of radiotherapy-induced angiosarcomas are discussed.
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