Expression of clusterin in colorectal carcinoma in relation to clinicopathological criteria

Background/Aim: Colorectal carcinoma (CRC) carries a high incidence of morbidity and mortality.Prognosis is related to nodal metastasis and stage. Clusterin is a widely distributed glycoproteinwith not yet fully understood functions. Clusterin may be overexpressed in some tumours or underexpressed in other tumours. The aim behind this study is to examine the relation of clusterincytoplasmic immunostaining to tumour characteristics, disease relapse, and survival in CRC. Materialsand Methods: Paraffin blocks of 133 CRCs were retrieved from the Department of Pathology,King Abdulaziz University, Jeddah, Saudi Arabia. Immunostaining was done using antibody toclusterin. Staining expression in 10% of malignant cells was used as a cut-off to determine lowimmunostaining and high immunostaining. Statistical tests were used to evaluate the association ofclusterin immunostaining with clinicopathological parameters. Results: Immunohistochemical resultsshowed clusterin low immunostaining in CRC and nodal metastases. No association was foundbetween clusterin immunostaining and tumour grade, age, tumour invasiveness, distant metastases,vascular invasion, nodal metastases, relapse, and survival. Conclusion: Our study showed low clusterinimmunostaining in CRC with lack of association with prognostic indicators in CRC. These resultsraise the controversy of understanding the role of clusterin in CRC. Further molecular studies arerequired to explore more about possible mechanisms of clusterin association with tumorigenicity,apoptosis, tumour growth progression, local and vascular invasion, and metastasis of CRC.

Hepatic-associated immunoglobulin-A nephropathy in a child with liver cirrhosis and portal hypertension

Hepatic-associated immunoglobulin A [IgA] nephropathy is a relatively common condition that occurs in adults with liver cirrhosis and portal hypertension. However, it is rare in children. This condition is characterized by the deposition of IgA in the renal glomeruli. The present report describes a 14-year-old boy with cryptogenic liver cirrhosis and portal hypertension who presented with hematuria and proteinuria associated with histological changes of IgA nephropathy

Primary gallbladder carcer in Saudi Arabia

Gallbladder carcinoma [GBC] is rare neoplasm. Very little information is available in the literature regarding the pattern of this cancer in the kingdom of Saudi Arabia [KSA]. The objective of this is to review all the cases of GBC and to review the epidemiological, clinical, and pathological features of GBC in two major institutions in KSA. We retrospectively reviewed the records of the pathology department at king Abdulaziz university hospital [1997-2005] and king Faisal specialist hospital and research center, Jeddah [200-2005]. All the primary gallbladder carcinomas were included in the study. Only twenty eight cases of primary GBC were identified. The age ranged between 30 and 90 years. Mean age was 64 years. There were 22 female and 6 male female ratio was 1: 3.7. The patients presented clinically with symptoms of cholecystitis. Polypoid lesions have been seen in 12 cases, wall thickening in 14 cases and ulcerative lesions in 2 cases. The tumor size ranged between 1 and 7 cm. Microscopic evaluation revealed well differentiated carcinoma in 9 cases, moderately differentiated in 15 cases and poorly differentiated in 4 cases. The tumor invaded the serosa in 7 cases, muscle in 20 cases and only case limited to the lamina propria. GBC is a rare neoplasm in Saudi population. Careful pathoiogical examination of an the gallbladders resected for either inflammation or because gallstone is very important. Well sampling of any abnormal areas is recommended to detect incidental carcinoma in cases, which are not suspected clinically

Rosai-dorfman disease of the larynx. a case report with molecular genetic analysis for immunoglobulin and t-cell receptor genes rearrangement

Sinus histiocytosis with massive lymphadenopathy [SHML], or Rosai-Dorfman disease [RDD], is rare histiocytic disorder originally described in 1969 as a benign Clinicopathoiogic entity characterized by massive bilateral cervical lymphadenopathy and fever. The indolent clinical course of RDD suggests a reactive disorder rather than a neopiastic process. We present a 21 year- old woman with RDD of the larynx with a recurrence of the disease after 13 months. To determine whether the lymphoplasmacytic components in these lesions clonal or polyclonal we performed a molecular testing using PCR and southern blot analyses to examine Immunoglobulin [JH] and T-cell receptor genes [TCR] genes rearrangement. The analysis showed polyclonal pattern [germline] for JH and TCR. Surface marker analysis by flow cytometry and immunohistochernistry revealed a mixed population of T and B cells with no evidence of light or heavy chain restriction. This indicates that the lymphoplasmacytic proliferation in RDD is reactive and consistent with the indolent behavior

Expression of nm23 antimetastatic gene product in prostate carcinoma in Saudi patients and its relation to chromosomal instability

The nm23 gene was initially cloned as a metastasis suppressor gene, but the clinical relevance of nm23 as a prognostic indicator for human cancers remains controversial. Chromosomal instability [CIN] is a high frequency of chromosomal loss and gain that has been demonstrated in dysplastic and neoplastic lesions. Recently CIN has been shown in prostate carcinoma [Pca] and its precursor. The objectives of this project are: firstly to study the nm23 expression pattern in Pca and to study the relation between nm23 expression and CIN. Immunohistochemistry with a polyclonal antibody was employed to study the expression of the nm23 protein in formalin-fixed, paraffin-embedded tissue specimens obtained from patients with Pca [n: 28], collected from the department of Pathology at King Abdulaziz Hospital [Jeddah, Saudi Arabia]. CIN was studied by using dualcolor interphase fluorescence in situ hybridization [IFISH] performed on archived Pca. Expression of nm23 was noted in 24 out of 28 Pca [85%]. Five of the patients have evidence of metastasis and four of them showed strong nm23 expression. CIN was detected in 8 out of 18 cases with interpretable IFISH signals. Nm23 expression was seen in 7/8 of CIN positive and in 8/10 of the CIN negative cases. Nm23 positivity was seen in 6/8 cases of Gleason score 6,12/14 cases of score 7, 4/4 cases of score 8 and 2/2 cases of score 9. Normal and hyperplastic tissue show either negative or weak cytoplasmic staining. The results suggest that expression of nm23 in Pca is not correlated to tumor metastasis in contrast to carcinoma in other organs. While our data suggest that nm23 may help in the distinction of normal from malignant prostatic tissue, these results do not point to nm23 as a reliable prognostic marker in Pca. Nm23 is not correlated to the CIN in Pca

Histiocytic necrotising lymphadenitis [Kikuchi-Fujimoto disease] inSaudi Arabia: clinicopathology and immunohistochemistry

Kikuchi-Fujimoto disease [KFD] is a rare entity of uncertain cause that commonly presents as a benign self-limiting disease of unknown origin. The objective of this study was to document the clinical features, mode of presentation, histopathological and immunohistochemical [IHC] features of KFD at our institutions since little is known about this disease in our region. We reviewed the histopathological reports of all lymph nodes resected at or referred to King Abdulaziz University Hospital between 1990 and 2003 and King Faisal Specialist Hospital and Research Center, Jeddah, Kingdom of Saudi Arabia between 2000 and 2003. All cases diagnosed as KFD were identified and the histological slides and clinical data were reviewed. IHC was performed for the proliferative marker Ki- 67 and the apoptosis-related markers Bcl-2 and p53. In 2500 lymph node biopsies, 15 cases were diagnosed as KFD. The female to male ratio was 2.7:1. One patient presented with axillary lymphadenopathy and the others presented with cervical lymphadenopathy. Ages averaged 29 years and ranged from 13 to 46 years. There was no recurrence of the lymphadenopathy over 1 to 10 years of follow up. Bcl-2 and p53 were negative and Ki-67 was positive in 11 of 15 cases. The results support earlier findings that KFD is a selflimiting disorder that requires no specific management. We suggest a clinical follow-up for several years. The female predominance was striking. Apoptosis-regulating proteins are not helpful in the diagnosis. KFD usually expressed the proliferation-associated nuclear antigen Ki-67. Increased awareness of KFD will minimize the risk of confusing this entity with malignant lymphoma or other serious conditions

Chromosomal instability detected by interphase fluorescence in situ hybridization and its relation to p53 alteration in prostate carcinoma in Saudi patients

Chromosomal instability [CIN] is a feature of human neoplasm. The p53 mutation has been shown to be associated with CIN in many human dysplastic and neoplastic lesions. The objective of this study was to examine CIN and p53 mutations in prostate carcinoma [Pca] resected from Saudi patients. Testing of p53 alteration using immunohistochemistry was performed on 28 archived prostatic carcinoma specimens containing Pca foci from Saudi patients seen at King Abdul-Aziz University Hospital, Jeddah, Kingdom of Saudi Arabia. Chromosomal instability was evaluated in the same tissues by interphase in situ hybridization [IFISH] using centromere probes for chromosome 7 and 8. Immunohistochemistry and IFISH were performed at Princess Margaret Hospital, University Health Network, Toronto, Ontario, Canada in 2001. The p53 immunoreactivity was found in 29% in Pca and 0% in benign epithelium. Interphase in situ hybridization revealed numerical chromosomal alterations in keeping with CIN in 63% of p53 positive and 20% p53 negative Pca. No evidence of CIN was seen in non-neoplastic epithelium. We concluded that CIN as determined by IFISH is present in Pca from Saudi patients similarly to those reported in western countries. The p53 mutation occurs relatively infrequently in Pca and is associated with the presence of CIN at least in a subset of Pca