MedWorm: Pathology Top 20

A simple immunohistochemical algorithm predicts the risk of distant metastases in right‐sided colon cancer

Histopathology — Fri, 27 Jan 2012 05:24:10 +0100

Conclusions: By the use of three markers, this algorithm allowed identification of subgroups of right‐sided CC patients with extremely high and extremely low risk of distant metastases. (Source: Histopathology)

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Glucocorticoid regulation of a novel HPV E6‐p53‐miR‐145 pathway modulates invasion and therapy resistance of cervical cancer cells

The Journal of Pathology — Mon, 30 Jan 2012 06:38:06 +0100

AbstractGlucocorticoids are stress‐responsive neuroendocrine mediators and play an important role in malignant progression, especially in solid tumors. We demonstrate a novel mechanism by which glucocorticoids modulate p53‐dependent miR‐145 expression in HPV positive cervical cancer cells through induction of E6 proteins. We found that expression of miR‐145 was reduced in cervical cancer tissues. Cortisol induced HPV E6 expression and suppressed p53 and miR‐145 in cervical cancer cells. MiR‐145 expression in cervical cancer cells was wild‐type p53‐dependent, and cortisol‐induced downregulation of miR‐145 expression prevented chemotherapy‐induced apoptosis whereas overexpression of miR‐145 enhanced sensitivity to mitomycin and reversed the chemoresistance induced by ...

PRAME (Preferentially Expressed Antigen of Melanoma) Is a Novel Marker for Differentiating Serous Carcinoma From Malignant Mesothelioma.

American Journal of Clinical Pathology — Thu, 26 Jan 2012 22:56:09 +0100

The objective of this study was to validate this finding at the messenger RNA (mRNA) and protein levels. Quantitative real-time polymerase chain reaction analysis of 126 müllerian carcinomas and 23 malignant mesotheliomas showed significantly higher PRAME mRNA expression in the former tumor (P < .001; test sensitivity and specificity, 89% and 91%, respectively). PRAME protein was expressed in 41 of 50 müllerian carcinomas and 0 of 30 mesotheliomas using Western blotting (P < .001; test sensitivity and specificity, 82% and 100%, respectively). PRAME levels in müllerian carcinoma were unrelated to survival; however, PRAME protein expression was up-regulated in solid metastases compared with primary carcinoma and effusions (P < .001). Our data confirm that PRAME effectively differ...

The value of CDX2 and cytokeratins 7 and 20 expression in differentiating colorectal adenocarcinomas from extraintestinal gastrointestinal adenocarcinomas: cytokeratin 7/20+ phenotype is more spesific than CDX2 antibody

Diagnostic Pathology — Mon, 23 Jan 2012 05:00:00 +0100

Conclusions: Both the CK7/CK20+ phenotype and expression of the antibody CDX2 are highly specific and sensitive markers of colorectal origin. CDX2 expression should be a useful adjunct for the diagnosis of intestinal adenocarcinomas, particularly when better established markers such as CK7 and CK20 yield equivocal results. The CK7/CK20+ phenotype is superior in its specificity and positive predictive value and might be preferred.Virtual slides:The virtual slide(s) for this article can be found here:http://www.diagnosticpathology.diagnomx.eu/vs/4851011866354821 (Source: Diagnostic Pathology)

Pathologic observations of the duodenum in 615 consecutive duodenal specimens in a single Japanese hospital: II. malignant lesions.

International Journal of Clinical and Experimental Pathology — Tue, 07 Feb 2012 13:36:02 +0100

Authors: Terada T Abstract The author investigated histopathology of 615 consecutive duodenal specimens in our pathology laboratory in Japan. A computer review of the duodenal specimens was done. In cases of malignancy, histological slides were reviewed. The duodenal specimens were composed of 567 benign lesions (92%) and 48 malignant lesions (8%). The 48 malignant lesions were composed of 20 cases (42%) of primary adenocarcinoma, 10 cases (21%) of primary adenocarcinoma of ampulla Vater, 4 cases (8%) of primary squamous cell carcinoma, 1 (2%) cases of primary spindle cell carcinoma, 4 (8%) cases of carcinoid tumors, 1 (2%) case of malignant lymphoma, and 8 cases (17%) of secondary carcinoma from the pancreatic carcinoma or bile duct carcinoma. The primary adenocarcinoma (n=20) was...

Patients with thymomas have an increased risk of developing additional malignancies: lack of immunological surveillance?

Histopathology — Fri, 27 Jan 2012 05:24:13 +0100

Conclusions: Patients affected by thymomas showed a significantly higher risk of developing additional malignancies than those in the control groups, and cases that exhibited a predominantly cortical component were more likely to develop other neoplasms. This may be related to the functions of cortical thymic epithelial cells in providing for T lymphocyte maturation through interaction with major histocompatibility complexes. (Source: Histopathology)

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Rare case of a primary non-dural central nervous system low grade B-cell lymphoma and literature review.

International Journal of Clinical and Experimental Pathology — Tue, 07 Feb 2012 13:36:02 +0100

We present a case of a 70-year-old HIV negative man with a five-year history of progressive dysnomia and new onset right extremity numbness, dysarthria, and blurry vision. On magnetic resonance imaging (MRI), an infiltrative enhancing tumor was noted. Follow up brain biopsy results revealed a small lymphocytic infiltrate with scattered plasma cells in a predominantly perivascular growth pattern. Flow-cytometric findings revealed a lambda monotypic B-cell population. The morphology and the flow cytometric findings were consistent with involvement by a low grade B-cell lymphoma. Subsequent positron emission tomography (PET) studies along with bone marrow biopsy and serum protein electrophoresis showed no evidence of systemic disease. The above findings are consistent with involvement by a no...

HMGA1 and HMGA2 protein expression correlates with advanced tumour grade and lymph node metastasis in pancreatic adenocarcinoma

Histopathology — Fri, 27 Jan 2012 05:24:06 +0100

Conclusions: Our results suggest that HMGA1 and HMGA2 are implicated in pancreatic carcinogenesis and may play a role in tumour progression towards a more malignant phenotype. (Source: Histopathology)

p53 Nuclear Expression Correlates With Hemizygous TP53 Deletion and Predicts an Adverse Outcome for Patients With Relapsed/Refractory Multiple Myeloma Treated With Lenalidomide.

American Journal of Clinical Pathology — Thu, 26 Jan 2012 22:56:52 +0100

Authors: Chen MH, Qi CX, Saha MN, Chang H Abstract del(17p13)(TP53) seems to be an independent poor prognostic factor in patients with relapsed/refractory multiple myeloma (MM) receiving lenalidomide. However, whether aberrant p53 nuclear expression detected by immunohistochemical analysis can be used as a surrogate marker for del(17p13)(TP53) in prognostic evaluation of lenalidomide-treated relapsed/refractory MM remains unclear. The p53 expression in myeloma cells from 88 patients was evaluated by immunohistochemical analysis, and 17p13(TP53) gene status was examined by fluorescence in situ hybridization (FISH). FISH detected hemizygous del(17p13)(TP53) in 13 (15%), and immunohistochemical analysis detected p53 nuclear expression in 11 cases (13%). del(17p13) (TP53) and p53 expre...

Acquired hemophilia associated with bullous pemphigoid: a case report.

International Journal of Clinical and Experimental Pathology — Tue, 07 Feb 2012 13:36:02 +0100

We described the case of a 60-year-old female patient who developed bullous pemphigoid for 3 month and presented with bleeding tendency and hematoma in the tongue. Therapy with methylprednisolone, cyclophosphamide, intravenous immunoglobulin and factor VIII reposition was instituted, resulting in a remission of the bleeding and negativity for antibodies against factor VIII titers. We concluded that, despite its rarity, the presence of acquired factor VIII inhibitors should be investigated when patients with autoimmune diseases develop bleeding manifestations. PMID: 22295154 [PubMed - in process] (Source: International Journal of Clinical and Experimental Pathology)

Spindle cell carcinoma progressed from transitional cell carcinoma of the urinary bladder.

International Journal of Clinical and Experimental Pathology — Tue, 07 Feb 2012 13:36:02 +0100

Authors: Terada T Abstract The author reports a very rare case of spindle cell carcinoma (SpCC) of the urinary bladder progressed from ordinary papillary transitional cell carcinoma (TCC). A 63-year-old man complained of hematuria. A transurethral endoscopic examination revealed a papillary tumor, and transuthetral resection of bladder tumor (TUR-BT) was performed and was diagnosed as ordinary papillary urothelial TCC. Since then, he was treated with TUR-BT eight times. Chemotherapy, radiation, radical cystectomy and lymph nodes dissection were performed 16 years after the first TUR-BT. However, he developed rectal mucosal metastasis. He is now alive 17 years after the first presentation. All the TUR-BT specimens were ordinary papillary TCCs without invasion (pTa). Immunohistochemi...

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Value of PAX8 and WT1 Immunostaining in Confirming the Ovarian Origin of Metastatic Carcinoma in Serous Effusion Specimens.

American Journal of Clinical Pathology — Thu, 26 Jan 2012 22:54:33 +0100

Authors: Zhao L, Guo M, Sneige N, Gong Y Abstract We evaluated the detection rates of PAX8 and WT1 immunostaining in 68 (45 as cell blocks, 23 as smears) serous effusion specimens that had a cytologic diagnosis of metastatic carcinoma of ovarian origin. Of the cases, 58 (85%) were positive for PAX8, 56 (82%) were positive for WT1, and 64 (94%) were immunoreactive with either or both markers. Detection rates of PAX8 and WT1 were 85% (44/52) and 92% (48/52), respectively, for metastatic serous carcinoma and 100% (5/5) and 20% (1/5), respectively, for metastatic clear cell carcinoma. Detection rates using cell blocks and smears were 91% and 78%, respectively, with PAX8 and 82% and 83%, respectively, with WT1. We concluded that PAX8 and WT1 had comparable overall detection rates in con...

H1N1: overview and perspectives

Jornal Brasileiro de Patologia e Medicina Laboratorial — Sat, 14 Jan 2012 16:50:49 +0100

O vírus influenza de origem suína, A/California/04/2009 (H1N1), foi inicialmente detectado no México e determinou a pandemia de influenza de 2009. Em agosto de 2010, a Organização Mundial da Saúde (OMS) declarou o início da fase pós-pandêmica. As características dessa última pandemia foram marcadamente diferentes das anteriores. O vírus emergiu de rearranjos genéticos originários em hospedeiro mamífero não humano, demonstrou transmissibilidade interespécies e afetou a população humana de forma diferente dos vírus pandêmicos anteriores (1918, 1957 e 1968) com maior morbidade e mortalidade em crianças e adultos jovens. Atualmente, o vírus apresenta padrão sazonal da mesma forma que o influenza A H3N2 e o influenza B, mantendo, até o momento, o mesmo perfil de patogen...

Image Analysis of HER2 Immunohistochemical Staining: Reproducibility and Concordance With Fluorescence In Situ Hybridization of a Laboratory-Validated Scoring Technique.

American Journal of Clinical Pathology — Thu, 26 Jan 2012 22:55:27 +0100

Authors: Minot DM, Voss J, Rademacher S, Lwin T, Orsulak J, Caron B, Ketterling R, Nassar A, Chen B, Clayton A Abstract Image analysis of the HER2 immunohistochemical (IHC) stain can help determine which breast cancer patients may benefit from HER2-targeted therapy. We studied the concordance of HER2 IHC and fluorescence in situ hybridization (FISH) as well as reproducibility of surgical pathologist (SP) and cytotechnologist (CT) interpretations using manual and image analysis methodologies on 154 IHC cases. Concordances with FISH were good for IHC negative (0, 1+) cases (range, 97%-100%) and positive (3+) cases (range, 87%-100%). Image analysis had fewer equivocal (2+) results (10.4%) than CT (14.9%) and SP (16.2%) manual methods, with higher concordances to FISH (31%, 26%, and 20...

Prognostic value of bcl-2 and bax tumor cell expression in patients with non muscle-invasive bladder cancer receiving bacillus calmette-guerin immunotherapy.

Ultrastructural Pathology — Wed, 08 Feb 2012 03:06:09 +0100

In conclusion, the expression of Bcl-2 and Bax in NMIBC could have a prognostic value in assessing the risk of recurrence after BCG immunotherapy. These findings require further investigations on larger cohort in order to ascertain new molecular markers of the response to BCG immunotherapy. PMID: 22292735 [PubMed - in process] (Source: Ultrastructural Pathology)

Characterization of polybrominated diphenyl ether toxicity in wistar han rats and use of liver microarray data for predicting disease susceptibilities.

Toxicologic Pathology — Fri, 27 Jan 2012 01:54:02 +0100

Authors: Dunnick JK, Brix A, Cunny H, Vallant M, Shockley KR Abstract The toxicity of polybrominated diphenyl ethers (PBDEs), flame-retardant components, was characterized in offspring from Wistar Han dams exposed by gavage to a PBDE mixture (DE71) starting at gestation day 6 and continuing to weaning on postnatal day (PND) 21. Offspring from the dams underwent PBDE direct dosing by gavage at the same dose as their dams from PND 12 to PND 21, and then after weaning for another thirteen weeks. Liver samples were collected at PND 22 and week 13 for liver gene expression analysis (Affymetrix Rat Genome 230 2.0 Array). Treatment with PBDE induced 1,066 liver gene transcript changes in females and 1,200 transcriptional changes in males at PND 22 (false discovery rate < 0.01), but onl...

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Histologic tumor necrosis is an independent prognostic indicator for clear cell and papillary renal cell carcinoma.

American Journal of Clinical Pathology — Thu, 26 Jan 2012 22:55:05 +0100

Authors: Pichler M, Hutterer GC, Chromecki TF, Jesche J, Kampel-Kettner K, Rehak P, Pummer K, Zigeuner R Abstract Histologic tumor necrosis (TN) has been reported to indicate a poor prognosis for different human cancers. In papillary renal cell carcinoma (RCC), data regarding the prognostic impact of TN are conflicting. We retrospectively studied the pathology records of 2,333 consecutive patients who underwent nephrectomy from 1984 to 2006 at a single tertiary academic center. In multivariate analyses regarding clear cell RCC, the presence of histologic TN was an independent negative prognostic factor for metastasis-free (hazard ratio [HR], 2.32; confidence interval [CI], 1.86-2.9; P < .001) and overall (HR, 1.52; CI, 1.31-1.76; P < .001) survival. Regarding papillary RCC, t...

Desmoplastic trichoepithelioma with perineural involvement: a series of seven cases.

Journal of Cutaneous Pathology — Mon, 30 Jan 2012 06:28:50 +0100

We present a series of seven desmoplastic trichoepitheliomas with otherwise typical presentation and morphology, nevertheless demonstrating epithelium present in the perineural spaces of adjacent small dermal nerves. Patients ranged in age from 14 to 66 years (mean 44 years). All seven tumors were restricted to dermis, showed strands of basaloid epithelium in desmoplastic stroma, and contained CK20‐positive cells. Additionally, five of five examined tumors displayed diffuse expression of p75 neurotrophin receptor. Five patients were followed‐up clinically (follow‐up time range: 2 months ‐ 4 years). No tumor recurrence was observed in any of these patients. We postulate that perineural involvement is an unusual feature of desmoplastic trichoepithelioma that should not be equated wit...

Lymphoepithelioma-like carcinoma of the colon.

International Journal of Clinical and Experimental Pathology — Tue, 07 Feb 2012 13:36:02 +0100

Authors: Delaney D, Chetty R Abstract An 85-year old female had a polypoid tumour in the sigmoid colon that histologically conformed to a lymphoepithelioma-like (LEL) carcinoma. The tumour was arranged in cords, chains, clusters and microalveoli of pleomorphic, irregular cells set within a dense intratumoral lymphocytic stroma. The tumour was EBV-negative and showed loss of MLH-1 and PMS-2 mismatch repair proteins. The patient did not fulfil the criteria for HNPCC. Only 5 other cases of primary colonic LEL carcinoma have been described previously and only one case appears to have an unequivocal association with EBV. In addition, one of the cases was encountered in a HNPCC patient. This is an unusual morphologic variant of a microsatellite unstable tumour with a LEL pattern, not ass...

Ascitic fluid due to type II herpes simplex virus infection: Report of a case with immunocytochemical confirmation

Diagnostic Cytopathology — Mon, 30 Jan 2012 06:31:20 +0100

This report highlights that the presence of abundant cell debris, degenerative cells and apoptotic bodies, and the absence of vivid mesothelial cells are the key cytological findings to suspect HSV peritonitis, and the diagnosis can be confirmed by careful surveillance for characteristic nuclear findings of single or multinucleated cells. The frequency of opportunistic infection is increased because of the increased numbers of iatrogenic immunocompromised patients as seen in this case, therefore, cytological examination is a useful method for early detection of the causative agent of peritonitis including HSV. Diagn. Cytopathol. 2011; © 2011 Wiley Periodicals, Inc. (Source: Diagnostic Cytopathology)