Indian journal of pathology & microbiology最新文献

Objective: Several studies have demonstrated that nucleolar spindle-associated protein 1(NUSAP1) can influence the biological behavior of malignant cells. However, the roles of NUSAP1 in laryngeal squamous cell carcinoma (LSCC) remain unknown. The purpose of this study is to analyze the NUSAP1 expression and prognostic significance in LSCC patients.

Materials and methods: NUSAP1 mRNA levels in laryngeal tissues were determined by qRT-PCR. Meanwhile, we examined the expression levels of NUSAP1 protein in 137 primary tumor tissues and 20 cases of normal tissues by immunohistochemistry (IHC) analysis on tissue microarrays (TMA).

Results: Our results revealed that the frequency of high NUSAP1 was significantly higher in cancer tissue compared to normal surgical margins; NUSAP1 expression correlated with clinical features and overall survival (OS). NUSAP1 overexpression was significantly associated with lymph node metastasis (P = 0.023) and TNM stage (P = 0.008); Kaplan-Meier survival curves revealed that patients with high NUSAP1 expression had worse prognoses than patients with low NUSAP1 expression.

Conclusion: The data suggested that NUSAP1 may be identified as a novel prognostic biomarker and targeting NUSAP1 seems to be a novel strategy for LSCC treatment.

Objectives: For oral squamous cell carcinoma (OSCC), we are likely at a juncture in clinical management, where the benefits of therapies are beginning to plateau. Therefore, this study investigated the usefulness of adenosine triphosphate (ATP)-binding cassette subfamily G member 2 (ABCG2), podoplanin (PDPN), and cluster of differentiation (CD) 44 (CD44) that may help to identify patients with an aggressive phenotype and predict prognosis precisely.

Materials and methods: The protein expression of ABCG2, PDPN, and CD44 was investigated in 125 OSCC patients using immunohistochemistry and correlated with clinicopathological parameters and disease outcomes. The data were evaluated using the Statistical Package for the Social Sciences (SPSS) software, and P value ≤0.05 was considered significant.

Results: The protein expression of ABCG2, PDPN, and CD44 was noted in 56%, 43%, and 51%, respectively. ABCG2, PDPN, and CD44 show linear correlation with T3/T4 tumors, presence of metastatic lymph nodes (LNs), and advanced-stage disease. Cox multivariate regression analysis for progression-free survival (PFS) demonstrated that in early-stage patients, CD44 at step 1 (P = 0.007) followed by ABCG2 (P = 0.037) at step 2 was associated with reduced PFS. For overall survival (OS), only ABCG2 (P = 0.019) emerged as a potential parameter. Kaplan-Meier curves showed that the combined signature of ABCG2 with PDPN for total patients, and ABCG2 with CD44 for early-stage patients, emerged as more powerful risk predictors for identifying high-risk patients.

Conclusion: Thus, the combined signature of ABCG2 with PDPN and CD44 could be useful in identifying high-risk patients for more aggressive therapy and effective personalized treatment in the future.

Abstract: Massive ovarian oedema, though rare, frequently mimics an ovarian neoplasm, both clinically and radiologically. Here, we discuss the case of a 12-year-old girl who presented with intermittent pain in the lower abdomen for last one month associated with vomiting. A suspicion of germ cell neoplasm was raised on ultrasound despite mildly raised serum markers. Microscopy from left salpingo-ophrectomy specimen revealed marked oedema of ovarian stroma with preserved primordial follicles at the periphery only. This case highlights the importance of a high index of suspicion, clinically, radiologically and pathologically, especially in cases with only mildly raised serum markers to avoid unwarranted surgery and preserve hormonal function as well as fertility in some cases.

Background: Oral carcinoma is one of the most frequently occurring cancers among Indian men. We conducted this study to find out any association between epidermal growth factor receptor (EGFR) overexpression by immunohistochemical methods with histopathological prognostic parameters like pathological tumor (pT) staging, tumor grade, lymph nodal involvement, extranodal extension (ENE), perineural invasion (PNI), lymphovascular invasion (LVI), and worst pattern of invasion (WPOI).

Materials and methods: This prospective cross-sectional study was conducted in Pathology Department of our institute between December 2021 and November 2022, and a total of 113 confirmed cases of oral squamous cell carcinoma (OSCC) were included in our study. Clinicopathological parameters were recorded, and EGFR expression by immunohistochemistry was evaluated in these patients. The association of EGFR overexpression and the different histopathological parameters according to the College of American Pathologists (CAP) protocol was determined.

Results: Out of 113 cases, 52 cases (46%) were positive for EGFR overexpression on immunohistochemistry. Significant association of EGFR overexpression was noted with pT stage, nodal status N0 versus N1-N2, ENE, PNI, LVI, and WPOI, with P value <0.05. No significant association was noted with tumor grade and nodal status N0-N1 versus N2-N3.

Conclusion: EGFR overexpression can be used as a prognostic marker in addition to histopathological parameters. One can opt for wedge resection in place of extensive surgery if small punch biopsies show EGFR negativity and radiology shows uninvolved lymph nodes. In addition, in EGFR-positive OSCC cases, targeted therapy could be opted to avoid chemotherapy-related toxicity and increase patient survival.

Introduction: Bullous spectrum of cutaneous lichen planus has two distinct forms lichen planus pemphigoids (LPPs) and bullous lichen planus (BLP). There is paucity of literature on the clinical, histopathological, and immunological profile of this rare presentation. We aim to describe the clinical, histological, and immunological features of this distinct form further proposing an algorithmic approach for diagnosis.

Methodology: We conducted a retrospective observational study and reviewed cases of LPP and BLP which were diagnosed in the last 10 years (2011-21). Relevant information (clinical presentation, histology, immunofluorescence finding) was noted on pre-structured proforma and was analyzed.

Results: Out of 1960 biopsies of cutaneous lichen planus, only 21 cases had clinical suspected bullous presentation while immunofluorescence was received for only 16 cases. BLP was seen in the younger age group in comparison with LPPs (25.7 years vs 36.8 years). Bulla was seen in all cases. Dermo-epidermal junctional split was seen in all cases of BLP and LPP. On direct immunofluorescence (DIF) all the cases of LPP either had 1-2+ IgG and/or C3 while cases of BLP were not immunoreactive or had only colloid bodies.

Conclusion: This study describes in detail the clinicopathological profile of BLP and LPP and reiterates the importance of DIF during workup to arrive at a definitive diagnosis.

Abstract: Plasmablastic lymphoma (PBL) is an aggressive lymphoma with the proliferation of plasmablastic cells with a plasma cell immunophenotype and immunonegativity for B-cell markers. Here we present a case of jejunal PBL in an 82-year-old human immunodeficiency virus (HIV) negative and Epstein-Barr (EBV) negative male who presented with subacute intestinal obstruction and histopathological examination showed a large cell lymphoma with plasmablastic differentiation diffusely infiltrating full thickness of the jejunal wall. Neoplastic cells were immunopositive for CD138, MUM-1, EMA, and CD56, along with aberrant expression of pan T-cell marker CD3. No restrictions for kappa and lambda light chains were noted. Ki67 index was >90%. Tumor cells were immunonegative for CD20, CD5, CD7, CD30, and PAX 5. Suspicion of this rare and high-grade lymphoma in immunocompetent patients and at extra-nodal locations along with awareness of diagnostic pitfalls in its immunoprofile will aid in accurate diagnosis and prognostication.

Background: Clear-cell meningioma is a rare subtype, representing 0.2-0.8% of all meningiomas. It is classified as grade 2 according to World Health Organization (WHO) classification due to its aggressive clinical course. Morphologically, it can mimic other clear-cell tumors arising in the central nervous system, each having different clinical behavior, therapeutic protocol, and prognostic outcome.

Aim: This study aims to describe clinicopathological characteristics of clear-cell meningioma and to discuss the histomorphological features and differential diagnosis.

Materials and methods: The demographic, clinical, radiological, histopathological features, and follow-up of the patients were recorded and analyzed.

Results: Clear-cell meningioma constituted 1.3% of all meningiomas. The age of the patients ranged from 16-46 years (mean age - 27 years), with a slight female predominance. Follow-up varied from six months to six years. Recurrence was noted in four patients while three patients died. Histopathology revealed sheets of clear cells with prominent blocky interstitial and perivascular collagen deposition. Focal vague whorl formation and occasional intranuclear inclusions could be identified on careful search. Conventional meningothelial areas or typical psammoma bodies were not seen.

Conclusion: Clear-cell meningioma is a rare subtype of meningioma with aggressive behavior. The presence of blocky collagen, a careful search for whorl formation, and intranuclear inclusions are helpful in approaching the correct diagnosis. An interdisciplinary approach by correlating the clinical, radiological, and histological features can enhance the accuracy of diagnosis.

Abstract: Small cell carcinoma (SCC) is most commonly found in the lung. Extrapulmonary SCC has been reported in various organs. Despite its rarity, primary pleural SCC should be considered along with mesothelioma in the case of a pleura-based mass because of the difference in prognosis and treatment. To highlight the role of morphology and IHC in arriving at a diagnosis of primary pleural SCC. Pleural biopsy with its hematoxylin and eosin-stained and immunohistochemistry slides. Tumor cells were immunoreactive for synaptophysin, chromogranin, CK7, TTF1, and BerEP4, along with focal reactivity for calretinin. The cells were negative for CK5/6, WT1, and mesothelin. A detailed morphological examination plays an important role in ruling out all the tumors displaying small cell features at this site, and a limited IHC panel can aid in arriving at a diagnosis of primary pleural SCC.

Abstract: Solitary small painless lower lip lesions are common and can be of variable etiologies, giving rise to a wide number of clinical and histopathological differentials. From a clinico-pathological perspective, the diagnostic differentials may vary from vascular malformation, basal cell carcinoma, epidermal cyst, traumatic neuroma, neurofibroma, schwannoma, neurilemmoma, skin adnexal tumor, to other mucosal neuromas. Here we are reporting one such rare case masquerading as mucocele in a patient aged 37 years who reported first time at the ENT outpatient department. On biopsy and histopathological examination, a diagnosis of palisaded encapsulated neuroma (PEN), an uncommon benign nerve sheath tumor, was made.