Basic and applied pathology最新文献

Ameloblastic carcinoma, a rare aggressive odontogenic tumor occurs predominantly in the mandibular posterior region. Clinical symptoms are varied with possible metastasis to the regional lymph nodes or lung. Radiographically, it usually manifests as an ill-defined osteolytic radiolucency. Histologically, it resembles ameloblastoma that is mostly devoid of its familiar microscopic features in combination with prominent cytological atypia and mitotic activity. A rare and atypical presentation of ameloblastic carcinoma of the mandible with unconventional clinical and radiological features is documented in this case report.

Background and aim: A study was carried out to analyze the presentation, to identify the causes and to find out the bone marrow morphology in cases of pancytopenia. Pancytopenia was an indication for bone marrow examination in 48 out of a total of 100 cases (48%) for which a bone marrow examination was requested. Methods: The data regarding the various signs and symptoms, the causes and the bone marrow findings were obtained and analyzed using simple statistical methods. All age groups were included for the study. Results: Generalized weakness (70.83%) was the commonest symptom and pallor (45.83%) was the predominant sign. Anisocytosis (79.1%) was the most important peripheral blood finding in pancytopenic patients followed by microcytosis (52.08%). The commonest cause of pancytopenia in the present study was hypoplastic marrow (33.33%), followed by normoblastic erythroid hyperplasia (27.08%), megaloblastic marrow (18.75%), and myelodysplastic syndrome (8.33%). Normal bone marrow and dry tap accounted for three cases each (6.25%). Of the various cases of myelodysplastic syndrome, one was refractory anemia; two were refractory cytopenia with multilineage dysplasia and one myelodysplastic syndrome unclassified. Dry tap was seen in three cases of pancytopenia. Bone marrow biopsy was done in one, which showed features of myelofibrosis. Conclusions: A thorough evaluation of the pancytopenic patients is necessary as it has varied causes.

Background and aim: Limited studies on the relationships between epidermal growth factor receptor (EGFR) expression and the grades of phyllodes tumors (PT) of the breast were reported. This study evaluated the significance of EGFR overexpression in the grading of PT. Methods: Immunohistochemical stain for EGFR was done in 46 PT cases. The differences of EGFR expression according to the degrees of cytologic atypia and mitotic count and between benign, borderline and malignant PTs based on Rosen or World Health Organization (WHO) criteria were analyzed. Results: Significant differences of positive (moderate membranous and cytoplasmic, more than 10% of tumor cells) and strong positive (moderate more than 50% of tumor cells) reactions for EGFR were found according to the degree of cytologic atypia (P= 0.0016 and P= 0.0122) and between the PTs showing ≤5 mitoses and >5 mitoses/10 high power field (P= 0.0230 and P= 0.0058). Positive reaction for EGFR was more common in borderline/malignant PTs than benign PTs, and strong positive reaction for EGFR was relatively common in malignant PTs. Conclusions: Epidermal growth factor receptor overexpression, more than 10% of tumor cells, could be used as an ancillary tool for the discrimination of benign from borderline and malignant PTs.

Background and aim: Xanthogranulomatous inflammatory reaction (XGI) is a rare diagnosis in the gastrointestinal tract. It could be misinterpreted as an invasive cancerous lesion. The pathogenesis of XGI in the gastrointestinal tract (GIXGI) is not well understood. We clinicopathologically studied six cases of GIXGI associated with endoscopic biopsy, mucosal resection, and submucosal dissection of gastric and colonic adenocarcinoma. Methods: Immunohistochemical, special histochemical stains, and tuberculosis-polymerase chain reaction (PCR) were performed. All radiological images and medical records of the patients were reviewed. Results: All cases showed XGI with foamy histiocytes, lymphocytes, and foreign body-type giant cells, which were positive for CD68 and negative for CD117, S-100, and cytokeratin. Acid-fast, Gomori's methenamine silver, periodic acid Schiff stains, and nontuberculous Mycobacterium and Mycobacterium tuberculosis-PCR were also negative. Two of four gastric adenocarcinomas were suspected to be advanced gastric cancer by computed tomography staging. However, the microscopic examination revealed only XGI with a mucosal carcinoma or without any residual tumor cells in the gastric wall. Conclusions: GIXGI may simulate advanced carcinoma clinicoradiologically. GIXGI should be included in the differential diagnosis in the case suggestive of a rapid transition to advanced gastrointestinal carcinoma within 12 weeks from the preoperative endoscopic procedure.

Background and aim: The discs large 1 of Drosophila (DLG1) is a cell junction-localized protein that is required for the maintenance of cyto-architectural stability and alteration of DLG1 may be related to development of epithelial neoplasm. Methods: To determine DLG1 expression in human papillomavirus-related carcinogenesis, DLG1 expression in normal larynx (NL), laryngeal nodule (LN), laryngeal papilloma (LP), and invasive squamous cell carcinoma of larynx (SQCC) was investigated using immunohistochemistry. Results: In LN, the expression pattern of DLG1 was similar to NL showing cytoplasmic expression of basal and suprabasal cells except suprabasal membranous staining, which is observed in NL. In regard to basal cell expression, unlikely NL and LN, and the basal cells of most LPs did not express DLG1. In SQCC, the cancer cells of surface area showed strong cytoplasmic and membranous staining patterns of DLG1 in most SQCCs, whereas cells of deep invasive edge (IE) demonstrated weak cytoplasmic patterns without membranous staining. This expression pattern of DLG1 was similar to that of E-cadherin. Conclusions: Weak expression of DLG1 in IE of SQCC with a pattern similar to E-cadherin suggests that the perturbation of DLG1 as cell junction-localized cyto-architectural protein may be associated with progression of invasiveness.

Background and aim: Pasteurella multocida B:2, which causes hemorrhagic septicemia of ruminants, is believed to enter the host via respiratory and oral routes. While the role of respiratory route of infection has been established, the present study describes the clinical and pathological alterations following oral exposure of buffalo calves to live wild-type Pasteurella multocida B:2. Methods: Nine 8-month-old buffalo calves were selected and divided into three groups. Calves of group 1 were exposed orally to 50 mL of the inoculums containing 10⁹ colony-forming unit (CFU)/mL of live Pasteurella multocida B:2. Calves of group 2 were exposed intra-tracheal to 5 mL of the same inoculums while calves of group 3 were exposed orally to 50 mL of phosphate-buffered saline. Results: Only one calf had to be euthanized at 48 h post-intra-tracheal exposure due to persistent clinical signs of hemorrhagic septicemia. The mean respiratory rate and rectal temperature had significantly increased in calves of groups 1 and 2. The pathological alterations included submandibular and brisket edema, generalized lymphadenopathy, acute fibrinous pneumonia, acute colitis and hemorrhagic typhilitis and proctitis. Nevertheless, oral infection with 10⁹ CFU/mL of live wild-type P. multocida B:2 failed to produce a typical clinical disease. However, P. multocida B:2 was present along the gastro-intestinal tract, including the rectum of the calf that succumbed to the infection at 48 h post-intra-tracheal exposure. Conclusions: The presence of P. multocida B:2 along the gastro-intestinal tract is of concern since transmission via the gastro-intestinal tract of diseased animals is strongly possible.

Background and aim: Immunophenotype analysis of lesional histiocytes in subacute necrotizing lymphadenitis (SNL) has revealed several unexpected findings. Histiocytes express myeloperoxidase (MPO), and immature dendritic cells occupy a significant proportion of the lesional cells in SNL. However, whether MPO-expressing lesional histiocytes of SNL also express immunophenotypic markers of immature dendritic cells has not been determined. Methods: The immunophenotypes of lesional histiocytes in paraffin-embedded tissue sections from 26 patients with SNL were analyzed using a panel of dendritic cell and macrophage markers. Double immunohistochemical staining was also performed to confirm coexpression of several markers. Results: CD11c-expressing histiocytes represented a major component of lesional cells (averaging 50.1% of the lesional area), surpassing CD163-positive histiocytes (averaging 32.0% of the lesional area). Double immunohistochemical staining confirmed that a significant proportion of CD11c-expressing histiocytes also coexpressed MPO as well as CD163. CD123-positive plasmacytoid dendritic cells (averaging 3.2% of the lesional area) were minor lesional cells, and fascin-positive mature dendritic cells were not present in the lesions. Conclusions: Our results demonstrate that the main lesional cells in SNL are histiocytes expressing myeloid dendritic cell and macrophage markers as well as MPO, indicating phenotypic plasticity and functional versatility of histiocyte lineage cells.

We report a patient with gastric adenocarcinoma with choriocarcinomatous and hepatoid differentiation. A 67-year-old man visited our hospital for further evaluations due to gastric adenocarcinoma. The gastric cancer was located in the prepyloric area and appeared to be a protruding mass with an infiltrative growth pattern. Initial pancreatic and postoperative hepatic and pulmonary metastases were detected radiologically. Microscopically, choriocarcinomatous and hepatoid differentiation was observed with a moderately differentiated adenocarcinoma. The choriocarcinomatous components were positive for β-hCG and the hepatoid components were positive for α-fetoprotein (AFP). These uncommon pathological patterns are supposed to arise from the retrodifferentiation pathway of primary gastric adenocarcinoma. The preoperative laboratory data revealed elevated serum AFP (773.4 ng/mL) and carcinoembryonic antigen (62.2 ng/mL), whereas other tests were unremarkable. The prognosis of gastric adenocarcinoma with choriocarcinomatous and hepatoid differentiation is very poor; our patient died 4 months after the operation.

Background and aim: The Hedgehog (Hh) signaling pathway plays an essential role in normal development of normal prostate gland. Deregulation of this pathway is responsible for carcinogenesis of prostatic adenocarcinoma. Methods: Total 176 cases of prostatic adenocarcinomas were prepared and the Hh signaling molecules including Sonic hedgehog (Shh), Patched (Ptch), Smoothened (Smo), GLIoma-associated oncogene (Gli-1) and suppressor of fused (Su[fu]) were immunohistochemically analyzed. Results: Hh signaling molecules were significantly associated with prognostic factors; High Gleason score (≥7) was significantly associated with expression of Shh, Ptch, Smo, and Gli-1; tumor, node and metastasis stages with Shh, Ptch, Smo and Gli-1; initial prostate specific antigen with Ptch and Smo; large tumor volume with Gli-1; perineural invasion with Shh, Smo and Gli-1. Su(fu) was significantly associated inversely with multiplicity of tumor. Conclusions: Hh signaling molecules including Shh, Ptch, Smo and Gli-1 were associated with high Gleason score and advanced stage even in the low Gleason score.