Cellular localization of MUC1 in Benign and Malignant Breast Lesions with the Histological Correlation and the Prognostic Significance / 한국유방암학회지

PURPOSE: MUC1 is a large transmembrane glycoprotein, which is overexpressed in the majority of carcinomas. The high expression of MUC1 is associated with aggressive tumors, with the MUC1 antigen used as a marker to monitor disease progression in breast cancer patients. Although the MUC1 tumor marker is both sensitive and specific for predicting a relapse in breast cancer, it is not commonly used during the follow-up of breast cancer patients. The aim of this study was to evaluate whether the differential patterns of MUC1 expression in different histological types of breast carcinoma could be used to distinguish tumors from benign lesions, and determine its prognostic relevance with other biological parameters. METHODS: 22 normal breast, 7 intraductal hyper-plasia (IDH) and 307 malignant lesions were selected and immunostained with MUC1. The patterns of reaction were classified as intraluminal border (ILB), cytoplasmic, intercellular membrane (ICM), intranuclear or mixed staining. RESULTS: All the normal breast samples showed weak cytoplasmic staining in the ducts and lobules. All the IDH samples showed moderate cytoplasmic and ILB staining. Of the 307 malignant lesions, only 2 (0.8%) showed negative staining; MUC1 positivity was observed in 4 (1.3%), with only ILB staining; 8 (2.6%) with weak cytoplasmic staining, 16 (5.2%) with weak cytoplasmic and intranuclear staining, 168 (54.7%) with moderate cytoplasmic and ILB staining, and 109 (35.5%) with strong cytoplasmic and ICM staining. MUC1 positivity with a moderate to strong staining intensity was observed in 90.6% of the infiltrating ductal carcinomas (221/244), 96.5% of the intraductal carcinomas (28/29), 87.5% of the infiltrating lobular carcinomas (7/8), 66.6% of the mucinous and secretory carcinomas (10/15), 100.0% of the apocrine carcinomas (5/5) and 100.0% of the medullary carcinomas (6/6). The expression of MUC1 was statistically significant between the histological tumor types (p = 0.034), tumor size (p = 0.046), and HER-2/neu (p = 0.004). CONCLUSION: These data suggest the expression of MUC1 was different in normal breast, IDH and malignant breast tumors, and was significantly correlated with the histological tumor types, tumor size and HER-2/neu oncogene.

The Immunoexpressions and Prognostic Significance of Inhibin Alpha and Beta Human Chorionic Gonadotrophins (hCG) in Breast Carcinomas / Journal of the Korean Cancer Association, 대한암학회지

PURPOSE: Pregnancy and hCG treatments are considered essential for inhibiting breast cancer. The effect of hCG is accompanied by the synthesis of inhibin, a transforming growth factor involved in cell differentiation and proliferation. Inhibin is considered a tumor suppressor, but its role in the breast is unclear. The aim of this study was to determine the frequency and tissue distribution of the expressions of inhibin-alpha and beta-hCG in breast cancer, and their prognostic relevance with other biological parameters. MATERIALS AND METHODS: 334 of formalin-fixed, paraffin embedded tissue blocks were selected, and then immunostained for inhibin-alpha and beta-hCG. The inhibin-alpha expression was compared with those of beta-hCG, ER, PR and HER-2/neu, as well as the tumor characteristics and recurrences. RESULTS: Inhibin-alpha and beta-hCG were expressed in 87 (26.0%) and 44 cases (13.2%), respectively. Inhibin-alpha was found in 25.1% of infiltrating ductal carcinomas (67/267), 26.7% of intraductal carcinomas (8/30), 33.3% of lobular tumors (3/9), 80.0% of apocrine carcinomas (4/5) and 21.7% of the other types (5/23). Inhibin-alpha was correlated with beta-hCG (p<0.0001), PR (p=0.010) and HER-2/ neu (p=0.021). HCG was focally expressed in the cytoplasm of the conventional types, but the apocrine type displayed diffusely intense cytoplasmic staining, which correlated with histological tumor types (p<0.001). CONCLUSION: Inhibin was significantly correlated with the expressions of hCG, PR and HER-2/neu. Therefore, it might be a useful marker in the prevention and hormonal treatment of breast cancer, such as hCG and progesterone. HCG was expressed significantly higher in the apocrine type than the conventional types, suggesting it can be a useful adjunct in differentiating other cancer types.

HER-2/neu Oncogene Amplification by Chromogenic in situ Hybridization in 130 Breast Cancers Using Tissue Microarray and Clinical Follow-up Studies

Determining of HER-2/neu oncogene amplification has become clinically important for managing breast cancer. Fluorescent in situ hybridization (FISH) and immunohistochemistry (IHC) are currently regarded as the standard methods. Chromogenic in situ hybridization (CISH) was investigated as a new modification with an accurate, sensitive technique. From 1998 to 2002, using CISH and IHC, the amplification and protein expression of the HER-2/neu oncogene were examined using paraffin sections in 130 breast carcinomas and to determine the prognostic role of HER-2/neu for outcome after a follow-up of 24- 64 months. Amplifications by CISH and overexpression by IHC were observed in 28 (22%) and 27 cases (20.8%), respectively. Of the 104 patients, 20 patients (19.2%) with amplification had a shorter disease-free interval (34.9 months vs. 38.0 months in controls) (p=0.372). 15 patients (14.4%) had a disease recurrence, but there is no significant difference between 3 patients amplifying the oncogene and 12 patients without oncogene (20.6 months vs. 19.6 months) (p=0.862). 6 patients (5.8%) of these died. CISH is a useful alternative, particularly for confirming the IHC results. There is no relationship between the early recurrence and the HER-2/neu positive group, but lymph node status was statistically significant.

Minimal Deviation Adenocarcinoma, Mucinous Type, of the Uterine Cervix: Report of a Case with Extensive Metastasis to the Uterine Corpus and Bilateral Adnexae

Minimal deviation adenocarcinoma is an extremely well differentiated variant of cervical adenocarcinoma, and is frequently misdiagnosed due to its benign-looking histopathological features. A 38-year-old woman was diagnosed as having had a minimal deviation adenocarcinoma in the cervix, metastasizing to the uterine body and bilateral adnexae. She had a history of right salpingo-oophorectomy 3 years ago, and was diagnosed as having a mucinous cystadenoma. Histologically, the tumor cells were so well-differentiated that they appeared to be almost the same as those of the non-neoplastic cervical glands. Similar glands were found in both ovaries and in the left fallopian tube. PAS staining showed a negative or apical positive pattern in the endocervical-like glands. Immunohistochemical studies for CEA, ER/PR, cytokeratin 20, and p53 were negative, but positive for cytokeratin 7. The HPV DNA microarray test was negative. Clinically, this proved to be an advanced, biologically aggressive disease.

Hyalinizing Spindle Cell Tumor with Giant Rosettes with Pulmonary Metastasis After a Long Hiatus: A Case Report

"Hyalinizing spindle cell tumor with giant rosettes" (HSCTGR) is a recently described tumor, which is regarded as an unusual variant of low-grade fibromyxoid sarcoma. Proof of a metastatic potential was lacking. The patient in the report was a 35-yr-old woman who showed multiple bilateral pulmonary nodules with massive pleural effusion in the right side. She had a history of a mass excision in the right thigh 11 yrs ago at another hospital, which was reported as a "leiomyoma". Two years before this presentation, the patient received a routine chest radiograph which demonstrated bilateral multiple pulmonary nodules. A lobectomy of the left upper lung was performed. The histological findings revealed a well-circumscribed nodule that was characterized by a spindle-shaped fibrous to hyalinized stroma with criss-crossing short fascicles and giant collagen rosettes surrounded by a rim of spindle-shaped cells. Electron microscopy confirmed the fibroblastic nature of the tumor. This case, in addition to at least two other cases reported in the literature, demonstrates that the HSCTGR is a malignant neoplasm with the capacity to metastasize after a long hiatus.

Primary Adenocarcinoma of the Seminal Vesicle: A Case Report

Primary adenocarcinoma of the seminal vesicle is an extremely rare tumor, and its prognosis has been known to be poor. Herein, we report an adenocarcinoma of the seminal vesicle. The patient was a 50-year-old man who complained of a two-month history of terminal hematuria and lower abdominal discomfort. A pelvic magnetic resonance imaging study. Indicated a seminal vesicle cyst with focal intraluminal growth. Right seminal vesiculectomy was performed. Grossly, the seminal vesicle revealed a markedly cystic change with focal, friable, intraluminal papillary growth. The intraluminal mass showed a noninvasive adenocarcinoma with a tubular and tubulopapillary pattern, accompanied by necrosis. Immunohistochemically, the tumor was positive for cytokeratin and carcinoembryonic antigen and negative for prostate specific antigen and prostatic acid phosphatase.

Pulmonary Aspergillus niger Fungus Ball Associated with Calcium Oxalate Crystal: A Case Report

Pulmonary aspergillomas are considered to represent saprophytic growth of hyphae within the preexisting lung cavity. Causative Aspergillus species are mostly composed of A. fumigatus and A. flavus and, occasionally, A. niger. It is difficult to identify these species using histopathologic evaluation without a culture of sputum and bronchoalveolar lavage. We recently experienced a case of pulmonary Aspergillus niger infection associated with characteristic calcium oxalate crystal formation. A large cavity contained hyphae with a typical conidial head, conidiophore, and conidia. Characteristic birefrigent calcium oxalate crystals were demonstrated in the cavity wall.

Cutaneous Ciliated Cyst: Report of a case

Farmer and Helwig coined the term cutaneous ciliated cyst in 1978 to describe specific skin cysts lined with ciliated epithelium a resembling the mucosa of the fallopian tube. Twenty case, of cutaneous ciliated cysts have been published to date. All have been found to affect the lower limb and all patients have been women. The etiology of the cyst is as yet unknown. A 37-year-old woman had a cyst excised from the left buttock. Microscopically, the lining epithelium of the cyst wall was composed of columnar cilited cells similar to those seen in the fallopian tubes. Immunoperoxidase stainings for cytokeratin, epithelial membrane antigen and carcinoembryonic antigen were positive.