Indian journal of pathology & microbiology最新文献

Background: Investigation of a potential prognostic marker expressed in non-small cell lung cancer (NSCLC) can help patients benefit from new target therapeuticmodalities.

Aims: To study the expression and correlation of P53 protein and epithelial-mesenchymal transition (EMT) related makers in NSCLC.

Materials and methods: 32 cases were selected for immunohistochemistry analysis to evaluate the expression of P53 and EMT-related makers.

Results: The positive expression rate of P53 and the incidence of EMT in NSCLC were closely linked to TNM stages, differentiation degree, and lymph node metastasis (P < 0.05). A positive association was found between P53 and EMT (r = 0.380, P < 0.05).

Conclusions: There is a positive association between P53, snail, and EMT. P53 may affect EMT in NSCLC by up-regulating the expression of Snail and further promoting cancer invasion and metastasis.

Abstract: Hematological malignancies are known to have cutaneous manifestations, either in the form of direct infiltration of skin by malignant cells or as a result of paraneoplastic syndrome. Many hematological malignancies, including chronic lymphocytic leukemia (CLL), are known to cause malignancy-induced Eosinophilic Dermatoses. We present a case of an elderly woman who presented with multiple pruritic patches. On clinical examination, the patient had multiple enlarged lymph nodes in the cervical and inguinal regions. The total leucocyte count was elevated and peripheral blood examination showed atypical lymphocytes. Flow cytometry was suggestive of CLL. The skin biopsy was suggestive of Eosinophilic Dermatoses in a case of chronic lymphocytic leukemia. We should be aware of this entity as they mimic insect bites, urticaria, and other skin conditions both histologically and clinically and to avoid a diagnostic pitfall.

Abstract: ALK-positive large B-cell lymphoma (ALK+ LBCL) is a rare neoplasm with an aggressive course and poor therapeutic response to the standard R-CHOP regimen. Owing to its negativity for usual B- and T-cell markers and immunopositivity for epithelial markers, it can be easily misdiagnosed if it is not contemplated. To study the clinicopathological parameters of cases of ALK+ LBCL diagnosed at our institution. A retrospective observational study of ALK+ LBCL was conducted at a tertiary cancer center of North India with cases diagnosed over a period of 3 years. Six cases of ALK+ LBCL were identified. The clinical findings at presentation included mean age of 38.8 years, male-to-female ratio of 5:1, extranodal presentation (1/6 cases), concurrent extranodal and nodal involvement (3/6), nodal presentation (2/6), high serum LDH (5/5), and bone marrow involvement (1/5). Histomorphology of diffuse (100%), alveolar/nested (16.6%), and sinusoidal pattern (1 case upon relapse) and immunoblastic and plasmablastic morphology (100%) and immunopositivity in all cases for ALK-1 protein (100%), CD138 (100%), MUM1 (100%), LCA (100%) along with negativity for EBER-ISH/EBV-LMP1 immunohistochemistry clinched the diagnosis. Fluorescence in situ hybridization analysis for ALK gene rearrangement was detected in 4/4 cases. Four patients received chemotherapy demonstrating relapse in 2 cases: residual disease and no response in one case each, along with death in 2 cases. A high degree of diagnostic suspicion is required for accurate recognition of ALK+ LBCL. Awareness of its histology, immunohistochemistry, and cytogenetics is pivotal for precise identification of this rare entity.

Abstract: The dermatopathological features in morphea (localized scleroderma) and their clinicopathologic correlations are not well described in the literature. To describe dermatopathological changes of different types of morphea and to investigate the association between clinical and histopathological features. A total of 18 cases of morphea who attended our tertiary care center in the last four years were evaluated. We noted clinical characteristics of all patients and dermatopathological changes like the pattern of sclerosis, degree of inflammation, cell types and all epidermal-dermal, and appendageal changes. Clinicopathological correlation was performed to interpret the clinical significance of dermatopathological changes in various types of morphea. Morphea was most commonly noted in the third decade and females. A circumscribed plaque was the most common clinical presentation. Full-thickness pattern of sclerosis was significantly associated with various clinical outcomes. Basal pigmentation and a reduced number of appendages were noted in more than 80% of patients. All patients had various grades of inflammation. Severe and moderate-grade inflammation with eosinophils and plasma cells was associated with pruritus and/or pain. The limitations are small sample size and single-centered case series. The dermatopathological examination of morphea may help in better monitoring and treatment of patients, including patterns of sclerosis and grades of inflammation, and cell types in skin pathology reports will aid in proper and better clinical management.

Abstract: The unicuspid unicommisural aortic valve is an uncommon congenital malformation that often manifests as stenosis with or without regurgitation in adults in their third to fifth decades of life. This report characterizes the morphological features of surgically excised unicuspid valves in adults with clinical correlation. Among the surgically excised aortic valves over a period of 10 years, the clinical data and morphological features of unicuspid aortic valves were analyzed. The patients were grouped by the type of valvular function. Pathological features noted were the shape of the orifice, the status of the commissure and raphe, presence of fibrous thickening, calcification, and other complications. Twenty-three UAVs, excised over a 10-year period, represented 4.16% of the excised diseased aortic valves. There was a male preponderance with a mean age of 47.7 years. Majority of the patients (22 cases) had moderate to severe stenosis with varying degrees of regurgitation, and the valvular disease had been clinically attributed to rheumatic heart disease, bicuspid aortic valve, or senile degenerative changes. Most of the valves (18) had been cut at their commissural regions, and 2 rudimentary commissures or raphes were seen in 21 valves. Cuspal fibrosis/calcification was often associated with complications like ulceration, hemorrhage, and bland vegetations. Aneurysm of the ascending aorta had been present in 1 patient. The unicuspid unicommisural aortic valve while rare is usually clinically classified with the more common, congenitally bicuspid aortic valve. Clinical or imaging diagnosis can be challenging since calcification may obscure the morphology creating difficulties in distinguishing such valves from other congenital or acquired valvular pathologies, especially in older patients. Often it is only the gross examination that leads to the differentiation as was our observation.

Objective: To explore more and better liquid biopsy markers of exosomal microRNAs (exo-miRNAs) in renal interstitial fibrosis (RIF) and to preliminary investigate the biological functions and signaling pathways involved in these markers.

Materials and methods: High-throughput miRNA sequencing was performed on blood and urine exo-miRNAs from three RIF patients and three healthy volunteers, and differential expression analysis and bioinformatic processing were performed.

Results: There were 13 differentially expressed exo-miRNA (DEexo-miRNA) between RIF and healthy blood, and 20 DEexo-miRNAs in urine. These were various DEexo-miRNAs in different specimens, and the former included PC-3p-213532_58, hsa-miR-338-5p_R-1, PC-5p-34127_410, pal-miR-9993a-3p_L+2R-1, and hsa-miR-26a-1-3p with intermediate expression levels; the latter involved hsa-miR-126-3p, hsa-miR-217-5p, hsa-miR-199b-3p_R-1, mmu-miR-5106_R-4_1ss1AG, and PC-5p-39041_356, and others, while hsa-miR-378a-3p, hsa-miR-143-3p_R+1, hsa-miR-183-5p, hsa-miR-126-3p, hsa-miR-155-5p_R-1, mmu-miR-5106_R-4_1ss1AG, hsa-miR-126-5p, and hsa-miR-199b-3p_R-1 had high expression levels. Bioinformatics analysis of the up-regulated DEmiRNA with high expression in urine showed that there are 291 target corresponding mRNAs for six of eight DEexo-miRNAs, with mmu-miR-5106_R-4_1ss1AG and hsa-miR-199b-3p_R-1 having no target gene found in TargetScan and miRanda. GO annotation revealed that GO:0005515 (protein binding) had the lowest P value, involving the most genes. KEGG analysis revealed that the signaling included the mTOR signaling pathway, autophagy - animal, etc., and hsa05200 (pathways in cancer) had a lower P value, involving the most genes.

Conclusions: Urine is a better sample for RIF exo-miRNA detection than blood. Urinary exosomal hsa-miR-143-3p_R+1, hsa-miR-183-5p, hsa-miR-126-3p, mmu-miR-5106_R-4_1ss1AG, hsa-miR-126-5p, and hsa-miR-199b-3p_R-1 are novel liquid biopsy markers for RIF. These DEexo-miRNA may be associated with the occurrence and development of RIF and may participate in specific biological processes by regulating the expression of their target mRNA. Further research may require exploring the specific functions and mechanisms of these miRNAs in RIF, as well as whether they can serve as diagnostic or therapeutic targets for RIF.

Context: Breast cancer is the most common malignancy among women. Established prognostic markers in breast carcinomas include tumor size, histologic grade, nodal status, lymphovascular invasion, perineural invasion, hormone receptor status, HER-2 status, and age.

Aim: To correlate peripheral tumor budding (pTB) with stromal tumor-infiltrating lymphocytes (sTILs) and established prognostic factors in invasive breast carcinoma.

Settings and design: It is a retrospective study conducted at multiple centers including a tertiary care center.

Materials and methods: 100 cases were included over a period of 2.5 years. All cases of invasive breast carcinoma (IBC) in which excision specimens with lymph node dissection were available were studied. Slides were reviewed for pTB and sTILs. Tumor budding of ≤20/10 hpf was considered low tumor budding, and >20 buds/10 hpf was considered high tumor budding. Tumor budding was correlated with age, tumor size, lymphovascular invasion, perineural invasion, tumor stage (pT, pN), stromal tumor-infiltrating lymphocytes, tumor grade, ductal carcinoma in situ, hormonal receptors, and HER2neu.

Statistical analysis: Fisher exact test and Chi-square test were used.

Results: We found that high tumor budding was seen in 34 cases and low tumor budding in 66 cases. There was a statistically significant association between high tumor budding and tumor size (P = 0.007), lymphovascular invasion (P < 0.001), perineural invasion (P = 0.004), tumor staging/pT (P = 0.006), nodal staging/pN (P = 0.001), and low sTILs (P < 0.001). However, the association of high tumor budding with parameters like age (P = 0.979), histological type (P = 0.243), tumor grade (P = 0.052), DCIS (P = 0.478), and ER (P = 0.633), and PR (P = 0.544), HER2Neu status (P = 0.171) was not significant.

Conclusion: This study suggests tumor budding score can be used as a prognostic indicator for breast cancer.