Kikuchi lymphadenitis cytology, histopathology correlation and immunohistochemical study

Kikuchi's lymphadenitis [KL], a benign and unusual self-limiting histiocytic necrotizing lymphadenitis of unknown origin, should be included in the differential diagnosis of lymphadenopathy and fever of unknown cause. Lymph node fine needle aspiration cytology [FNAC] is valuable in solving the diagnostic problems of clinical adenopathy. The Present research is aiming to study the correlation between fine needle aspiration cytology [FNAC] versus histopathology in diagnosing KL, studying the types of cells and the origin of plasmacytoid cells and we are also aiming to study the pathogenesis of apoptosis in this type of necrotizing lymphadenitis. Four cases of Kikuchi's lymphadenitis were received at Pathology Department, Al-Baraha Hospital, Ministry of Health, and Dubai, United Arab Emirates. Patient's clinical data were collected from their files. Fine-needle aspiration cytology from the four patients as well as histological sections from formalin fixed, paraffin blocks were studied. Immunohistochemistry was applied using monoclonal antibodies for Granzyme-B, CD68, CD20, CD3, CD8 andCD4; in addition we used also monoclonal mouse antihu-man bcl2 and P53 protein for evaluation of apoptotic activity. Four cases of KD were received at pathology department, AL Baraha hospital, Dubai. Three cases were female's average age 24.6 and one 17 Years old boy. All cases were Indian. Fine needle aspiration cytology [FNAC] was performed for every case. PAP smears, H and E sections and immnuohistochemistry [CD3, CD20, CD4, CD68, Granenzyme-B, BCL2 and P53] were done for every case. Out results showed FNAC diagnosis depend mainly on the detection of histocytes with peripheral crescent nuclei and phagocytosis of apoptotic debris. Immunohistochemical study revealed that plasmacytoid cells are histocytic in origin, the most common type of lymphocytes are CD8+T cells. Pathogenesis of apoptosis in this disease is mainly due to Granenzyme B secreted by T-killer cells and the genetic apoptotic pathology alteration [BCL2, P53] has no rule in its parthenogenesis. Fine needle aspiration cytology is a helpful and conclusive technique for the diagnosis of typically presented cases of Kikuchi lymphadenitis. The histiocytes and plasmacytoid cells are of the same origin. The main lymphoid cellular infiltrate is by the cytotoxic T lymphocyte which releases Granzyme-B protein [effector] that induces apoptosis in target cells as a result of an acquired stimulus and apoptotic genes have no role in induction of apoptosis in Kikuchi lymphadenitis

Expression of cancer-testis associated antigen MAGE-1 in relation to CD8+ T lymphocytes in breast infiltrating duct carcinoma [NOS]

Breast cancers are known to frequently [over] express several well-characterized tumor-associated antigens [TAAs] such as members of the MAGE-family. In the present study we are aiming to evaluate MAGE-1 expression in breast infiltrating duct carcinoma [NOS] in relation to some other known prognostic factors. We will compare this with MAGE-1 expression in some of the benign breast tumors and tumor-like lesions. We are also aiming to study the relation between MAGE-1 expression and lymphocytic response specifically CD8+ T lymphocytes as a hope for further breast cancer immunotherapy. After obtaining informed consent, tissues were obtained from patients undergoing breast lumpectomy or mastectomy. 132 patients of breast infiltrating duct carcinoma [IDC] [NOS] and 65 benign breast lesions were enrolled in this study. The cases were evaluated clinically by the surgeon and physician and any other information was added from the accompanying clinical data. All cases were studied by the histopathologist and immunostain was done for MAGE-1 and CDS. The malignant cases were additionally stained by estrogjenj-eceptors, progesterone receptors and Her-2 as a prognostic markers. The results were statistically studied and tabulated. In the present study we classified the patients into two groups. Group I: Include patients with breast carcinomas of IDC [NOS] type and group II: Include patients with benign breast lesions. The total number of cases was 197, 35 were males while 162 were females. Age ranged between 18-88.132 of the cases were with IDC [NOS] and 65 were with benign breast lesions. There was a significant difference in V1AGE-1 expression between the both groups, it was more expressed in group I and there was a highly significant relation between MAGE-1 expression in IDC [NOS] and the score of CD8+lymphocytes. On the other hand the relation between MAGE-1 and CD8+ lymphocytes was not significant in group II. In fibrocytic disease [FCD], MAGE was +2 in most of FCD cases and CD8+ lymphocytes scored +4 in four cases, but still the relation between the both variables non significant. We have demonstrated in the present study that MAGE-1 is expressed in some of benign breast lesions and at a high proportion in high-grade, hormone receptor-negative breast cancer, suggesting that MAGE-1 could be an indicator of aggressive diseases and can be a promising tumor antigen for immunotherapy of breast cancer with poor prognosis. On the other hand we suggest further studies to evaluate the rule of MAGE-1 vaccine in benign breast lesions as a preventive therapy

Study of angiogenesis, P53 and NM23 expression in colorectal carcinoma

Colorectal carcinoma [CRC] is not uncommon in Egypt. Sustained angiogenesis is characteristic of several pathological conditions including tumor growth. Many researches were conducted to investigate the role of P53 in colorectal carcinogenesis; also the role of NM23 in tumor progression and for metastasic potential is not so clear in CRC. In this research we are aiming to study the pattern and density of angiogenesis in colorectal carcinomas, in addition to other histopathological prognostic factors. Besides we are also aiming to study the expression of P53 and NM23 and the relation between these three factors [Angiogenesis, P53 and NM23] in different grades and stages of colorectal carcinomas. The study comprised 44 resection specimens of colorectal carcinomas collected from specimens of department of pathology, Faculty of Medicine, Tanta University Hospital and from same of the private laboratories. Each block was stained by hematoxylin and eosin [H and E], immunohistochemical stain for CD34, VEGF, P53 and NM23. Histopathological assessment of grading was done according to WHO classification and staged according to TNM classification. The present study includes 44 cases of colorectal adenocarcinoma 35 were male patients and 9 cases were females. The age range was 20 to 80 years. The patients were grouped into three groups as follows: Group [1]: CRC without nodal or distant metastasis, group [II]: CRC with nodal but no distant metastasis and group [III]: CRC with distant metastasis. Most of the tumors were conventional invasive adenocarcinomas, on studying angiogenesis we found that the relation of microvascular density [MVD] detected by CD34 was not significant with the tumor size. Besides there were a significant results between the microvascular density and metastatic history of the disease. There were significant results between VEGF expression and the studied variables. The study ol apoptosis using P53 reveals significant relation between it and the studied variables but not with the nodal or blood metastasis, there was an inverse relation between NM23 and both VEGF and P53, but the results was not significant with the tumor grade and size, so in the present study the relation between VEGF, P53 and NM23 was significant but each marker have its own variable result with the grade .size and the stage of the tumor. In the present study it can be concluded that MVD at vascular hot spots is a very important predictive factor in CRC in addition to VEGF .P53 over expression has an impact on the biological behavior of CRC being more expressed in biological aggressive tumors and it has a role in angiogenicStudy of Angiogenesis, P53 and NM23 Expression in Colorectal Carcinoma activity of the tumor. We also concluded that NM23 is an important metastatic suppressor gene in CRC. So NM23, P53, VEGF and MVD by CD34 all are important to predict the outcome of the disease and they can be used as a guide for treatment. MVD, microvascular density; VEGF, vascular endothelial growth factor; CRC, colorectal carcinoma