Basic and applied pathology最新文献

Background and aim: DNA expression profiling studies of breast cancer have identified subtypes including luminal A, luminal B, human epidermal growth factor receptor 2 (HER2) overexpression, and basal-like type. Among them, the basal-like type was associated with poor outcome. The purpose of this study was to classify breast carcinoma by immunohistochemistry and evaluate its characteristic histopathologic features. Methods: One hundred and four cases of resected infiltrating ductal carcinoma were immunostained for estrogen receptor, HER2, cytokeratin 5/6 and p63 to classification, and basal-like subtype were evaluated for its histopathologic characteristics. Results: The prevalence of subtypes was luminal A 48.1%, luminal B 24.0%, HER2 overexpression 11.5%, normal breast-like 4.8%, and basal-like 11.5%. There was significant correlation between the basal-like type and histologic grade. And it was significantly associated with several morphological features including expanding growth pattern, presence of tumor necrosis and peritumoral lymphocytic infiltration. Conclusions: The results of this study showed that the basal-like type occupied 11.5% of infiltrating ductal carcinoma and was associated with expanding growth pattern, presence of tumor necrosis and peritumoral lymphocytic infiltration.

Background and aim: HepPar-1 is a sensitive and specific antibody. However, when used for the diagnosis of hepatocellular carcinoma (HCC), especially in needle biopsy specimens, this diagnostic approach is limited by potential multifocal expression and/or poorly differentiated HCCs, where it may not be expressed. The goal of this study was to determine the antibodies most sensitive to hepatocyte differentiation in HepPar-1 negative areas including: CD13, CD10, polyclonal carcinoembryonic antigen (pCEA), alpha-fetoprotein (AFP) and glypican-3, for needle biopsy. Methods: Fifty cases of HCCs were obtained from surgically resected livers. Immunohistochemical staining for hepatocyte and biliary markers- HepPar-1, CD13, glypican-3, pCEA, CD10, AFP, cytokeratin (CK)7, CK19, and epithelial cell adhesion molecule (EpCAM) was performed from paraffin block samples. Results: HepPar-1 was diffusely negative in 12 cases. Twenty two cases showed partial expression of the HepPar-1 antibody. Among 34 HepPar-1 negative areas, CD13 was the most consistent antibody (85.3%, 29/34) showing the characteristic bile canaliculi pattern. Immunoexpression of biliary differentiation with CK7, CK19, and EpCAM showed no significant differences in HepPar-1 negative areas. Conclusions: CD13 could be used for the detection of hepatocyte differentiation in HCCs with HepPar-1 negative expression, especially in needle biopsy specimens. In addition, negative immunoexpression for HepPar-1 was not overtly related to biliary differentiation, from an immunohistochemical viewpoint.

Background and aim: The three-panel marker, glypican-3, HSP70 and glutamine synthetase, is helpful for making a diagnosis of early hepatocellular carcinoma. To further characterize the diagnostic values of these three markers, we performed immunostaining studies in non-neoplastic hepatocytes (chronic hepatitis B) and hepatocellular carcinoma. Methods: Immunostaining was performed for all three markers. The cases were 60 needle biopsies of chronic hepatitis B (30 with low-grade activity and 30 with high-grade activity) and 40 hepatocellular carcinomas (HCCs). Results: Glypican-3 staining was detected in only one of the 60 chronic hepatitis B cases, and this case expressed moderate immunoreactivity for glypican-3 and showed high-grade inflammatory activity. HSP70 expression was not observed in any cases. Glutamine synthetase was strongly immunoreactive at peri-venular hepatocytes with cytoplasmic staining in all cases. These findings reflected a normal expression pattern. On the other hand, all three markers were positive in 15 (37.5%) HCCs. At least two of three markers were positive in 26 (65.0%). Moreover, all three markers were negative in 2 (5.0%) HCCs. Conclusions: The combination of these three markers is highly specific for detecting hepatocellular carcinoma. However, caution should be exercised because non-neoplastic hepatocytes in chronic hepatitis B with high necro-inflammatory activity tend to show focal positivity for glypican-3. Also we emphasize that all three markers can show negative immunoreactivity in HCC.

We report herein an unusual case of pulmonary extralobar sequestration (ELS) showing fibroadenomatous change. It was incidentally found in a 41-year-old woman presenting with a paravertebral mass on chest radiography during a routine health check-up. Computed tomography reveled a 3.6 cm, well-defined solid mass in the paravertebral region. The resected mass was predominantly solid and well-covered by pleura with irregular cystic spaces. Microscopically, it showed a unique fibroadenomatous change, dilated bronchiolar structures and prominent fibrous stroma. In the periphery of the mass, a small portion of the lung with normal alveolar structure was noted. The lining epithelium showed reactivity for thyroid transcription factor-1 by immunohistochemical staining.

Background and aims: Atherosclerosis is a systemic disorder that develops in any blood vessel of the body. Atherosclerosis can result in fatal complications such as myocardial infarction or stroke. The aim of this study was to compare the severity of atherosclerosis between the coronary arteries and other peripheral arteries. To our knowledge, no such morphometric tissue studies through autopsy samples so far are available in Korea. Methods: The left anterior descending artery, right coronary artery and bilateral carotid, renal and femoral arteries were obtained from 50 autopsies during the period from June to October 2008. Detailed gross examination of the each arteries was performed to look for the most severe site of luminal narrowing. Results: There was a significant correlation between the maximal carotid artery intima-media thickness and the largest plaque area of the coronary artery (P < 0.05). However, some discordant cases were also noted. Seven cases had more severe coronary atherosclerosis compared to the carotid artery. Conclusions: The careful examination of peripheral arteries including the carotid artery can be helpful in clinical prediction of coronary artery disease. However, such prediction should include other risk factors such as age, hypertension, diabetes and dyslipidemia and other relevant clinical conditions.

Pulmonary epithelial-myoepithelial carcinoma is a rare low-grade malignant neoplasm that has the characteristic histologic features, epithelial and myoepithelial differentiation, similar to the salivary gland counterpart. This tumor is thought to arise from bronchial submucosal glands distributed throughout the lower respiratory tract. We recently experienced a case of epithelial-myoepithelial carcinoma of the bronchus in a 61-year-old man. Computed tomography of his chest revealed an endobronchial mass in the bronchus of the left lower lobe. The lobectomy specimen showed a solitary endobronchial mass, measuring 2.3 cm in greatest diameter. Histologically, the tumor was composed of variable proportions of epithelial and myoepithelial cells. The epithelial cells represented an inner layer of duct-like structures and the outer clear cell layer was myoepithelial-type cells. The epithelial cells were positive for pancytokeratin and the clear myoepithelial cells were positive for vimentin, alpha-smooth muscle actin and S-100 protein. Finally our diagnosis was epithelial-myoepithelial carcinoma of the bronchus.

Background and aim: Many dietary constituents are chemopreventive in animal models and experiments with cultured cells are revealing various potential mechanisms of action. Many of these compounds can prevent, or greatly reduce, initiation of carcinogenesis, or can act on cell proliferation. In this study we examined the effects of topical application of propolis extract, rosemary extract and a mixture of both extracts together on 12-O-tetradecanoylphorbol 13-acetate-induced tumor promotion in mice previously initiated with 7,12-dimethylbenz[a]anthracene. Methods: The propolis extract, rosemary extract and a mixture of both extracts together were applied topically 15 min prior to the application of 5 nmol TPA for 20 weeks. Results: A decrease in the number of skin tumors per mouse by 27, 39, 71% was seen, as well as a decrease in the number of mice with tumors by 22, 31, 75% and inhibited the tumor size per mouse by 46, 62, 72% for propolis, rosemary and both together respectively. Also TUNEL data showed more increased incidence of TUNEL positivity among cancer cells in both topical applications together than their separate application on the back skin of mice. Conclusions: It is likely that the combination of their activities such as antioxidant and cytotoxic ones as well as the combination of several components in both are responsible for their inhibitory effect on carcinogenesis. Further investigations are recommended in order to establish the conditions under which topical application of propolis as well as rosemary produces either protective or deleterious effects.

Primary extracranial meningiomas are rare disease entities, occurring primarily in the head and neck. We herein present a very rare case of primary extracranial meningioma of the retroperitoneum, observed in a 56-year-old man who presented with a retroperitoneal mass measuring 11 cm in its greatest dimension. Histological examination revealed sheets of spindle cells with frequent whorling patterns. The neoplastic cells had abundant light eosinophilic cytoplasm with minimal mitosis or cellular atypism. Immunohistochemical analysis demonstrated diffuse and strong positivity for vimentin and epithelial membrane antigen. Ultrastructural findings revealed abundant intermediate filaments, complex interdigitating cellular processes, and desmosome-like intercellular junctions, all of which are characteristic ultrastructural features of meningiomas. The patient was free of recurrence or metastasis 11 months after surgery. To the best of our knowledge, this is only the second reported case of primary retroperitoneal meningioma.