Basic and applied pathology最新文献

Background and aim: The human epidermal growth factor receptor 2 (HER2) gene is an important tumor marker in breast cancer. The silver in situ hybridization (SISH) has been recently introduced for measuring the HER2 amplification status. We evaluated the concordance between HER2 gene amplification in invasive breast cancer as determined by the fluorescence in situ hybridization (FISH) and SISH techniques and we compared the results to that of immunohistochemical (IHC) staining with using polyclonal c-erbB-2 antibody and monoclonal HER2 antibody. Methods: A total of 90 cases were analyzed by direct-labeled manual FISH and bright field automated SISH. All the specimens underwent IHC staining using c-erbB-2 and PATHWAY 4B5. The evaluation was performed by following the recommendation of the manufacturer and the American Society of Clinical Oncology/College of American Pathologists (ASCO/CAP) guidelines. Results: The overall concordance rate between FISH and SISH was 98.8% (Kappa index: 0.96). There was no significant difference in estimating the HER2 status using polyclonal and monoclonal antibody. Conclusions: The 98.8% concordance of FISH fulfills the ASCO/CAP requirement of greater than 95% concordance for the amplified cases versus the non-amplified cases. The HER2 gene copy status can be reliably determined by SISH.

The variations in nucleolar organizer regions (AgNOR) and the increase in Ki67 expression and correlation with histological findings in 64 specimen squamous epithelium from normal epithelium to overt carcinoma were evaluated. Mean AgNOR counts (mAgNOR), proliferative index (pAgNOR), variation in size and dispersion of AgNOR dots in cells were graded and compared in normal, dysplastic, primary and metastatic squamous cell carcinoma (SCC). The Ki67 percentage is significantly increased from normal squamous to SCC group, and the reactivity of staining were related to histological differentiation. The mAgNOR counts were high in all 44 cases of primary and metastatic SCC and low in normal squamous tissue and increased in dysplastic lesions. The mAgNOR count in SCC increased from well differentiated to poorly differentiated. PAgNOR counts were gradually increased in different grade of SCC, 1.4% in well differentiated, 6% in moderately differentiated, 19% in poorly differentiated. There was only significant difference between well differentiated versus poorly differentiated cases. Only significant correlation between Ki67 percentage and mAgNOR and between Ki67 percentage and pAgNOR in primary SCC group was noticed. Therefore, Ki67 is gold standard method for evaluation of proliferation activity. AgNOR quantity is proportional to the proliferative activity of the cell but does not necessarily indicate malignancy.

Background and aim: Fish live in direct contact with their immediate external environment and, therefore, are highly vulnerable to aquatic pollutants. We aimed to investigate histopathologic changes in the gills and skin of fish exposed to plant extracts. Methods: Clarias gariepinus adults were exposed to 0 mg/L, 85 mg/L, 100 mg/L, 115 mg/L, 130 mg/L and 145 mg/L concentrations of ethanolic extracts of Parkia biglobosa pods over a 96-h period. Results: Gills from exposed fish showed hyperemia and severe edema with fusion of secondary lamellae. The skin from exposed fish showed hyperplasia of mucus producing cells, epidermal and dermal polymorphonuclear leukocytic infiltrations with areas of dermal necrosis and aggregation of melanin pigments. Fish from the control group showed no histopathologic changes. Conclusions: Ethanolic extract of P. biglobosa pods is toxic to adult C. gariepinus. Therefore, extensive use of this tree to harvest fish for human consumption should be discouraged pending further investigations to determine the safety of such practices to human health.

Background and aim: Low gamma-glutamyltranspeptidase (γ-GTP) familial intrahepatic cholestasis is a broad-spectrum condition that ranges from mild to severe. Severe forms of low γ-GTP familial intrahepatic cholestasis, including progressive familial intrahepatic cholestasis type-1 and -2 (PFIC-1 and PFIC-2), present with symptoms of cholestasis early in life and may progress to cirrhosis. Methods: We included five patients with low γ-GTP, cholestasis and hyperbilirubinemia. We analyzed clinicopathological features of these five cases. Results: The age of the patients at diagnosis ranged from 1 month to 1 year old. All patients presented with jaundice, and one experienced pruritus. In contrast to hyperbilirubinemia, serum γ-GTP levels were relatively low, or within normal range. Microscopically, intracanalicular cholestasis, bile duct loss or atrophy and varying degrees of fibrosis were found in all of the cases, whereas giant cell formation of hepatocytes was detected in three cases. Anti-ABCB11 immunostaining revealed loss of expression in three cases with diffuse giant cell transformation of hepatocytes but retained expression in one case with no giant cell transformation. Conclusions: Low γ-GTP familial intrahepatic cholestasis (PFIC-1 and PFIC-2) should be considered a differential diagnosis when pediatric patients with cholestatic liver diseases associated with normal to low serum γ-GTP levels relative to the extent of cholestasis.

Background and aim: The goal of this study was to investigate whether physical stress is able to modulate apoptotic response in rat myocardial tissue. The effects of foot shock stress on the histopatological changes and immunohistochemistry for p53, bcl-2 and bax were evaluated. Methods: Male Wistar rats (n= 10) were distributed into two groups: group 1, control and group 2, stress. The stress protocol consisted of one daily foot-shock session applied on three consecutive days. Results: The results pointed out no remarkable changes of myocardial tissue between groups. Also, the foot shock stress was not able to modulate p53, bcl-2 or bax expression, as depicted by no significant statistically differences (P > 0.05) between groups for all immunomarkers evaluated. Conclusions: Taken together, our results suggest that foot shock stress did not induce histopathological changes in rat myocardial tissue. It seems that physical stress is not able to modulate apoptotic response in rats. Certainly, this finding offers new insights into the mechanisms underlying the relation between apoptosis and cardiac injury after stress.

Background and aim: A gender difference has been linked to the incidence and mortality of lung carcinomas. However, a comprehensive investigation including immunohistochemical studies of the gender difference involved in lung carcinoma progression has not been conducted. Methods: A total of 66 adenocarcinoma (AD) and 102 squamous cell carcinoma (SQ) samples were analyzed using immunohistochemistry for cell cycle-specific markers cyclin A, cyclin B1, cyclin D1 and Ki-67. Automated silver-enhanced in situ hybridization was used to evaluate epidermal growth factor receptor (EGFR) copy number. Results: For AD, male sex was significantly associated with the expression of cyclinA, cyclinB1 and high pathological tumor-node-metastasis (p-TNM) staging. For SQ, ever-smokers were associated with the expression of cyclin B1 and cyclin D1. For AD, ever-smokers were associated with the expression of cyclin A, cyclin B1 and Ki-67. There is no statistical significant correlation of smoking history with p-TNM stage and EGFR gene copy number in the AD or SQ, although the number of cases is limited. Conclusions: These results indicate that a gender difference contributes to AD growth and that smoking is associated with SQ and AD growth. The differential effects of gender and smoking differences may contribute through different pathways for AD and SQ subtypes.

Sclerosing epithelioid fibrosarcoma is an unusual variant of fibrosarcoma composed of epithelioid cells arranged in strands and nests in the background of a highly sclerotic collagenous stroma. Despite the relatively bland appearance and low mitotic activity, the tumor is capable of local recurrence and distant metastasis. We report a case of sclerosing epithelioid fibrosarcoma arising from the chest wall in a 26-year-old man. Microscopically, the tumor showed proliferation of round, oval, or angulated tumor cells in the sclerotic collagenous stroma. The tumor cells were small to medium in size, had pale eosinophilic cytoplasm and were arranged in cords, strands, and clusters. Immunohistochemically, the tumor cells were diffusely positive for vimentin, but negative for pan-cytokeratin, S100 protein, human melanoma black 45, CD34, smooth muscle actin, and desmin. The tumor cells showed paranuclear dot-like staining for beta-catenin on immunostaining, but no nuclear staining was observed. The patient is alive 13 months after surgery.

Juvenile ossifying fibroma is a variant of ossifying fibroma, commonly involving sinunasal tract of children. It is an aggressive condition that leads to the destruction of adjacent structures. Distinction from other fibro-osseous lesions is important. Juvenile ossifying fibroma has two histologic subtypes that are psammomatous and trabecular type. We present herein two cases of juvenile psammomatoid ossifying fibroma occuring in a 22 month old and a 5 year old child, which arose in the bilateral maxillary sinuses and led to bulging of the cheek and nasal obstruction. The tumor in case 1 could not be completely excised due to its huge size and massive destruction of the bilateral maxilla. The tumor in case 2 was completely excised through staged operations. Tumors in both cases were diagnosed as juvenile pammomatoid cement-ossifying fibroma by the histology. Here, we report two cases from Korea and describe psammomatoid morphology and how to differentiate it from other fibro-osseous lesions.

Umbilical masses are very rare a clinical presentation in neonates. We report here a case of heterotopic liver within the umbilicus of an 18 day-old newborn. The baby was born in 38 weeks and 2 days' gestation, and weighed 3.0 kg at birth, who presented with a congenital protruding umbilical mass, measuring 1.8 cm in greatest dimension. Abdominal ultrasonography found no connection with the visceral organ. The histology of the lesion consisted with epithelial cells organized into plates or cords separated by thin vascular channels. The component cells were polygonal in shape and contained eosinophilic cytoplasm with round and prominent nucleoli, which were morphologically consistent with hepatocytes. They were positive for hepatocyte-antigen and cytokeratin-18. A review of literature revealed six other heterotopic liver in umbilicus. The six previous cases measured from 2 cm to 7.5 cm, and thus the present case is the smallest one. Of the six previous cases, four had clinical symptoms such as intrauterine death, infection, obstruction of the bile ducts. Our case and the other two previous cases had no associated symptoms, which means heterotopic liver in umbilicus can present only as mass itself without accompanying any clinical symptoms. To the best of our knowledge, this is the seventh reported case of ectopic liver in the umbilicus in the literature.

We report two cases of plasmacytoid urothelial carcinoma of the urinary bladder. The tumor in the first case presented as an irregular and erythematous urinary bladder lesion with pararectal or rectal tumor extension. Perineal, scrotal and intrabdominal metastases developed within 4 months despite neoadjuvant chemotherapy. A muscle-invasive urinary bladder tumor was seen in the second case with perivesical and perivesicular extension and regional lymph metastases at cystoprostatectomy. The tumor cells in both cases were nested or dyscohesive, and resembled plasma cells; focal signet ring cells were also seen in the second case. The advanced stage of both cases is consistent with the reported aggressive biologic course of most of these tumors. Awareness of this rare variant when dealing with urogenital tract carcinoma is important since the morphology may suggest another diagnosis. Because of peculiar expression of CD138, a plasma cell-associated marker, these tumors may be mistaken for a plasma cell-derived neoplasm.