Malignant spiradenoma/cylindroma of the vulva

Malignant spiradenoma/cylindroma of the vulva is an extremely rare adnexal tumor. We report the clinicopathological features of a 58-year-old woman who presented with malignant spiradenoma/ cylindroma originating in the vulva and metastasized to the inguinal lymph nodes. Surgical excision with adequate margins and lymph node dissection was performed. Sections from the case were stained with Periodic Acid Schiff stain before and after diastase. Immunohistochemical study of the case using antibodies to carcinoembryonic antigen [CEA], epithelial membrane antigen [EMA], cytokeratin5/6 [CK 5/6], p63, cytokeratin7 [CK 7], smooth muscle actin [SMA], and S100 were performed. Microscopic examination revealed that spiradenoma nodules were positive to EMA and CEA. However, the cylindroma lobules showed strong immunoreactivity to p63 and CK5/6, whereas both tumor components were negative to S100, SMA, and CK7. Malignant spiradenoma/cylindroma is a rare tumor with controversial histogenesis that should be considered in the differential diagnosis of primary adnexal carcinoma and secondary metastatic tumors in the vulva. Further studies on a wider cohort should be encouraged

value of immunohistochemistry in the diagnosis of epidermolysis bullosa

Epidermolysis bullosa [EB] constitute a group of inherited skin disorders unified by the common link of blisters that develop at sites of pressures, rubbing or trauma at or soon after birth. Based on electron microscopic examination to determine the level of skin cleavage, EB has been broadly divided into three categories. our study intends to examine the value of immunohistochemical staining in subclassifying EB into its major forms. tissue sections of paraffin embedded skin biopsy of EB cases are immunolabelled for collagen IV and cytokeratin to determine the line of cleavage and the location of bullous formation. Our study demonstrated that immunohistochemistry is successful in classifying 86% of EB cases, the failure in one case of dystrophic epidermolysis bullosa was due to fault of cytokeratin staining. immunohistochemical staining on routinely processed specimens could be useful in EB classification however it still cannot fully replace electron microscopic examination

Inflammatory bowel disease in the Western Saudi Arabia

To observe the pattern of inflammatory bowel diseases [IBD] among the people of Western region of Saudi Arabia, and to correlate the findings with published data. This is a retrospective study. All colonic biopsies were reviewed which were received, and processed at the Histopathology Department of King Abdul-Aziz University Hospital, Jeddah, Kingdom of Saudi Arabia, from January 2002 to July 2007. Ethical approval was obtained from the Bioethical and Research Committee. There were 711 colonic biopsies received during this period. One hundred and twenty-two patients were diagnosed with ulcerative colitis [UC]. There were 65 males and 57 females. The age ranged between 4-73 years. Most of the UC patients presented in adolescence, and in the adult age. Crohn's disease [CD] was diagnosed in 15 patients, 7 males and 8 females. The age ranged from 1-40 years. Most of the cases were seen in the adult age group. We conclude that IBD is certainly one of the major serious colonic lesions in our society, which should be thoroughly investigated by the combined efforts of clinicians and pathologists. We also conclude that gastrointestinal tuberculosis and infective colitis should always be investigated before suggesting the specific diagnosis of IBD. We recommend a broad based epidemiological study, simultaneously involving clinicians, and pathologists, to document the characteristics of this disease in our society

Multiple primary malignancies of thyroid, kidneys and prostate: synchronous and metachronous presentation in one patient

Synchronous appearance of 2 different primary malignant neoplasms is a rare phenomenon. We describe a patient with Synchronous presentation of 3 primary carcinomas included prostate carcinoma [PCA] and bilateral renal cell carcinoma [RCC]. papillary and classic clear cell types. Furthermore previous history indicated the presence of thyroid papillary carcinoma [TPCA] that was resected 10 years ago. Immunohistochemistry was applied to confirm the primary nature of these neoplasms. The patient is in a good health 1 year following total prostatectomy and bilateral partial nephrectomies. We report this very rare case, which up to our knowledge is the first case that represents the combination of carcinomas of thyroid, prostate and both kidneys in one patient and we emphasize the importance of immunohistochemistry to document the primary nature of such neoplasms

Investigation of the biological significance of p53 tumor suppressor gene and Ki-67 in colorectal carcinoma resected from Saudi patients: An immunohistochemical analysis

p53 protein accumulation has been shown to be an unfavorable prognostic parameter in many human cancers, but findings in colorectal carcinoma [CRC] are equivocal. The objective of this study is to evaluate the value of p53 and Ki-67 as prognostic markers in patients with colorectal carcinoma. We conducted a retrospective analysis on 56 colorectal cancer specimens resected at King Abdulaziz university hospital, Jeddah, Saudi Arabia [40 cases of left colon and 16 from right colon]. Immunohistochemistry [IHC] was performed on formalin fixed paraffin embedded tissue using the avidin-biotin peroxidase complex method. Antibodies to p53 [DO7] and Ki-67 were used. This was correlated with the following clinicopathologic parameters: patient sex, age and survival; pathological stage, and grade of the tumors. Among the 56 cases of colorectal cancer [male/female=1.3; mean age 54.9 years, range 30-80 years], 85.7% [n=48] of tumors were positive for p13 IHC. Ki-67 was positive in 94% [n=53]. The p53 positivity in different stages was as follows [2/2 stage A, 23/28 stage B, 15/18 stage C and 8/8 stage D]. The positivity of p53 according to tumor differentiation was as follows: [well differentiated 6/6, moderately differentiated 38/45, poorly differentiated 4/5]. P53 was positive in 34/40 of left colon [including rectosigmoid] and in 14/16 of right colon carcinoma. Imunoreactivity for p53 was seen in adenomatous epithelium only in 8/22 cases. Although p53 and Ki-67 expression expresse4 strongly in cancer compared to normal tissue [p<0.05], there was no relation with survival, grade or Dukes' stage of the tumor. P53 cannot be considered as independent prognostic marker in colorectal carcinoma