Basic and applied pathology最新文献

Background and aim: With the increasing therapeutic use of endoscopic resection for intestinal early gastric cancer (EGC), it is very important to predict biological behaviors of intestinal type EGC prior to endoscopic resection. On this background, we tried to elucidate the presumptive clinicopathologic factors and biologic markers to predict submucosal invasion and lymph node metastasis based on mucin expression in EGCs. Methods: One hundred and thirty cases of intestinal EGCs were divided as EGCs with intestinal mucin phenotypes (EGC-IPs) and EGCs with gastric mucin phenotypes (EGC-GPs) based on mucin expression. The expressions of mucins (Muc2, Muc5Ac, Muc6, CD10), other protein markers (p53, CDX2, beta-catenin, E-cadherin, Smad4) by immunohistochemistry were studied. Results: EGC-IPs showed significantly increased p53 expression, CDX2 expression and beta-catenin delocalization than EGC-GPs. Using binary logistic regression analysis, expression of both gastric mucin and nuclear beta-catenin expression could be independent predictive factors of lymph node metastasis and submucosal invasion in intestinal EGCs. Lymphovascular emboli, and size of lesion could be clinicopathological independent predictive factors of lymph node metastasis and submucosal invasion in intestinal EGCs, respectively. Conclusions: Taken together, we suggest that beta-catenin expression based on mucin phenotype might be used to predict biologic behavior prior to endoscopic mucosal resection in intestinal EGC.

The authors describe a case of cerebellopontine (CP) angle melanotic lesion in a 38-year-old man who presented with features of CP angle syndrome 12 years ago. Computed tomography scan showed a mass lesion in the left CP angle, which was excised. Biopsy was suggestive of melanoma due to abundance of melanin. After 12 years, he had local recurrence and was re-operated. On reviewing the previous and later biopsy, final diagnosis of melanocytoma was made because of additional finding of absence of mitosis and macronucleoli, which were overlooked in the previous biopsy. Awareness of this finding reduces the possibility of diagnostic error in melanotic tumors. Reliance on the presence of abundance of melanin as the sole criterion for diagnosing melanoma resulted in erroneous diagnosis in our case. The case is discussed in the light of available literature.

Background and aim: The mammalian target of rapamycin (mTOR) pathway is important for cell survival, growth and proliferation and may be involved in the histological progression of lung adenocarcinoma (AC). Methods: We compared the expression of the mTOR signal pathway molecules, i.e., phosphorylated m-TOR (p-mTOR), phosphatase and tensin homolog deleted on chromosome ten (PTEN), epidermal growth factor receptor (EGFR), and cyclin D1, among lung AC, adenocarcinoma in situ (AIS) including both pure bronchioloalveolar carcinoma (BAC) and peripheral BAC-like lesions around invasive carcinoma, atypical adenomatous hyperplasia (AAH), and normal parenchyma surrounding tumor by immunohistochemistry. The protein expression was also correlated with patients’ clinicopathological data on smoking history, tumor stage at diagnosis, recurrence and survival. Results: Intermediate or strong immunoreactivity for p-mTOR was seen in 84.1% of AC and 90.2% of AIS. Partial or complete loss of PTEN was demonstrated in 88.8% of AC and 30.4% of AIS. A significant trend of increasing EGFR, loss of PTEN, p53 expression and Ki-67 labeling index were observed by histological progression from AAH to invasive AC through AIS. Expression of p-mTOR was associated with smoking status. Conclusions: Activation of mTOR can occur by various stimuli and may be an early event in the carcinogenesis of lung AC, and may be associated with sex and smoking status of the patient.

Background and aim: Studies have shown that polymethoxylated flavones have potent hypolipidemic properties. There are, however, gaps in the literature on their effects on organ structures. This study evaluated the histopathological effects of Ortanique peel polymethoxylated flavones extract (PMF^ort) on the organ structures of diet-induced hypercholesterolemic rats. Methods: Thirty Sprague–Dawley rats were fed normal rat chow as well as high cholesterol diets supplemented with PMF^ort and niacin, respectively. Light microscopic evaluation of the liver, spleen, kidney and bowel of hypercholesterolemic rats fed PMF^ort and niacin was performed to determine possible morphologic alterations, compared to untreated hypercholesterolemic rats. Results: Untreated hypercholesterolemic rats showed significantly altered intestinal morphology, with an increase in the number of absorptive cells and in villus length when compared to untreated normal rats. They also exhibited hepatic steatosis (100%) and inflammation (20%) and lymphoid hyperplasia of the spleen (33%). Hypercholesterolemic rats treated with 1.5% PMF^ort showed reductions in absorptive cell number, villus length and hepatic steatosis compared to the untreated hypercholesterolemic rats. They also showed significant reduction in splenic lymphoid hyperplasia. Conclusions: The current results would suggest that PMF^ort consumption has no toxic effects on the organs of hypercholesterolemic rats but may ameliorate hypercholesterolemia-associated alterations in organ structures.

Background and aim: Mutations in isocitrate dehydrogenase enzyme isoforms 1 (IDH1) and 2 (IDH2) have been identified in many cancers, including gliomas and acute myeloid leukemia. The aim of this study was to determine whether these genes are mutated in the primary central nervous system lymphoma (PCNSL). Methods: We analyzed IDH1 and IDH2 mutations in 20 PCNSL and 30 non-central nervous system (CNS) diffuse large B-cell lymphomas (DLBCLs) using routine formalin-fixed paraffin-embedded tissues and a polymerase chain reaction assay focusing on the known mutation hot spots, Arg 132 of IDH1 and Arg 172 of IDH2. Results: We did not detect mutations in IDH1 or IDH2 in PCNSL nor non-CNS DLBCL. Conclusions: Although IDH1 and IDH2 mutations are known to be important in gliomas and in some hematologic malignancies, they appear to be very rare events in PCNS and non-CNS DLBCLs. Further studies on other IDH mutations in larger, non-CNS DLBCL populations are needed.

Background and aim: The purpose of this study was to investigate the role of serum response factor (SRF) expression and to evaluate its correlation with various clinicopathological parameters in colorectal adenocarcinomas. Methods: We used tissue microarrays consisting of 24 normal mucosa, 50 tubular adenomas, 496 adenocarcinomas, and 128 metastatic lesions. Results: The expression of SRF was rare in normal colonic mucosa with a mean expression score of 0.67 ± 0.17. Tubular adenomas had a mean expression score of 2.48 ± 0.31, adenocarcinomas 2.82 ± 0.13 and lymph node metastases 2.82 ± 0.36. Interestingly, SRF expression was high in distant metastases with a mean expression score of 4.83 ± 0.43. The mean SRF expression was increased significantly early in the normal-adenoma-carcinoma sequence and again in distant metastases. The positive SRF expression was strongly correlated with non-mucinous tumor type (P < 0.001). Moderately and poorly differentiated adenocarcinomas had higher mean expression scores than well-differentiated adenocarcinomas (2.88 ± 0.13 vs 1.33 ± 0.32) (P= 0.015). There were significant associations between SRF expression and expression of p53 (P= 0.034) and Ki-67 (P= 0.001). Conclusions: Our results suggest that SRF expression may be the early event of normal-adenoma-carcinoma sequence of colorectal cancer, especially in adenomatous change of colonic mucosa and may play an important role in distant metastasis of colorectal cancers.

Isolated renal mucormycosis is rare in the immunocompetent host. We retrospectively analyzed all histopathology reports of nephrectomy specimens and renal biopsies from our department in the last year. Three patients of isolated renal mucormycosis were identified. All three patients presented with acute abdomen and renal failure. None had a preceding known predisposing disease for mucormycosis. Ante mortem diagnosis was made in one patient. Fungal culture was positive in one case. We emphasize that isolated renal mucormycosis may affect immunocompetent host and greater clinical suspicion is required for prompt treatment in view of poor prognosis associated with renal mucormycosis.

Background and aim: We describe two cases of pseudoxanthomatous salpingitis (PXS), an uncommon entity, often unknown for clinicians and pathologists. We review the literature on this topic and perform immunohistochemistry in order to study its pathogenesis. Methods: Both cases are studied by histochemical and immnunohistochemical methods with a wide panel of antibodies. Results: One case showed bilateral PXS, ovarian endometriosis and an adenomatoid tumor in the right tube. The second case showed a unilateral focus of tubal endometriosis. The first case displayed pigmented histiocytes, positive with periodic acid-Schiff (PAS), PAS with diastase digestion and focally with Fontana-Masson stains. Abundant hemosiderin granules were present in stromal subepithelial cells but no in histiocytes. In the second case Fontana-Masson and Ziehl-Neelsen methods stained diffusely the histiocytes. Perls stain was positive in some stromal cells and in numerous granular macrophages. The lymphocytic infiltrates presented mainly T cells with different proportions of CD4 and CD8 lymphocytes in each case. The tubal stroma was positive for CD10 in both cases. Conclusions: PXS is a rare condition usually associated with ovarian endometriosis. The physiopathologic way of pseudoxanthomatous histiocytes to accumulate inside the plicae of the tubes is not clear and can be diverse in different cases.

Background and aim: Identifying potential predictive biomarkers of response to endocrine therapy would benefit most estrogen receptor-positive (ER+) breast cancer patients. Our aim was to compare the expression of the wingless type (Wnt) pathway-related proteins (adenomatous polyposis coli [APC], E-cadherin, beta-catenin, cyclin D1, and c-myc) in postmenopausal women with ER+ invasive ductal carcinomas (IDC), prior to and after tamoxifen (n= 18) or anastrozole (n= 15) treatment, in a double-blind, placebo-controlled (n= 25), prospective study for 26 days prior to surgery. Methods: Tissue microarray blocks were constructed from pre- and post-treatment biopsy samples. Nuclear immunostaining of c-myc, APC, estrogen and progesterone receptor levels were assessed using the Allred scoring system, and cytoplasmic immunostaining of cyclin D1, beta-catenin and E-cadherin was assessed with the Hercep-Test system. An anova statistical analysis estimated general equations and analysis of variance with a significance level of 0.05. Results: Tamoxifen increased c-myc (P= 0.0061) and APC (P= 0.0452) expression. Anastrozole did not significantly affect expression of any Wnt-related proteins. Conclusions: In post-menopausal ER+ IDC, tamoxifen for 26 days prior to IDC surgery influenced statistically the expression of important cell cycle regulators as APC and c-myc, whereas anastrozole therapy did not interfere with this pathway during the same period. These Wnt related proteins may contribute to selective estrogen receptor modulator resistance.