Multifocal Epithelioid Angiosarcoma of the Stomach: A Case Report

Angiosarcoma is a very rare neoplasm, and even more so in the gastrointestinal tract where its distinction from adenocarcinoma may be extremely difficult. We report a case of multifocal epithelioid angiosarcoma of the stomach in a 65-year-old woman. Histologically, the tumor foci were composed of haphazard, anastomosing channels lined by malignant endothelial cells with epithelioid features. Those neoplastic cells stained positive for CD31, CD34, and factor VIII-related antigen.

Expression of p63 in Lung Cancer

BACKGROUND: The DNA-binding protein p63, a member of the p53 family, regulates differentiation and proliferation of epithelial progenitor cells. In this study, we evaluated the expression of p63 in lung cancer to gain insight into the pathogenesis of these processes. METHODS: A total of 89 patients who had undergone potentially curative surgery for lung cancer were selected. Expressions of p53, p63, and deltaNp63 were analyzed immunohistologically using a tissue array method with formalin-fixed, paraffin-embedded specimens. Immunohistological results were then correlated with clinicopathological parameters with prognostic implications. RESULTS: Expressions of p63 and deltaNp63 were found in 47 (52.8%) and 38 (43.2%) of the 89 patients, respectively. No relationships between the p63 or deltaNp63 expressions and any clinicopathological variables were found. p63 was expressed in 92.5% (37/40) of the squamous cell carcinomas, 17.9% (7/39) of the adenocarcinomas, 20% (1/5) of the small cell carcinomas, and 0% (0/5) of the large cell carcinomas. deltaNp63 was expressed in 92.3% (36/39) of the squamous cell carcinomas, 2.5% (1/39) of the adenocarcinomas, 0% (0/5) of the small cell carcinomas, 0% (0/5) of the large cell carcinomas, and 50% (1/2) of the adenosquamous cell carcinomas. In the squamous cell carcinomas, significantly high expressions of p63 and deltaNp63 were found (p<0.05). p53 protein was detected in samples from 49 of the 89 patients (55.1%). No significant associations between the p53 expressions and the p63 or deltaNp63 expressions were noted. CONCLUSION: p63 or deltaNp63 is likely to be involved in the development of squamous cell carcinomas of the lung and no significant association was found between p63 or deltaNp63 and patient survival rates.

Comparing Fluorescence In Situ Hybridization and Immunohistochemistry to Determine the HER-2/neu Status in Breast Carcinoma

BACKGROUND: Identification of HER-2/neu status is important in predicting the response to specific chemotherapy in breast carcinoma patients and HER-2/neu status is associated with poor clinical outcome even with systemic chemotherapy. Introduction of fluorescence in situ hybridization (FISH) allows an accurate assessment of the level of gene amplification with information about distribution of gene copies in histologic sections. METHODS: HER-2/neu status was performed on paraffin sections of 176 primary breast carcinomas by FISH, using PathVysion and by immunohistochemistry (IHC), using HercepTest. The results of HER-2/neu amplification was compared with clinical and pathological prognostic factors. RESULTS: HER-2/neu amplification and overexpression were detected in 51 tumors (29.0%) by FISH and 32 tumors (18.2%) by IHC. The results of each method agreed with each other in 157 tumors (concordance: 89.2%, kappa=0.783). HER-2/neu amplification was associated with poor nuclear grade, marked nuclear pleomorphism, and presence of the combined ductal carcinoma in situ in the invasive ductal carcinomas as well as Van Nuys grade of the ductal carcinoma in situ component (p<0.05). CONCLUSIONS: The comparison of FISH and IHC demonstrated an excellent correlation of HER-2/neu overexpression 2+ and 3+ with gene amplification. However, FISH may be a more accurate and reliable method for negative and 1+ cases. HER-2/neu amplification proves to be of prognostic relevance.