Human telomerase reverse transcriptase (hTERT) expression in borderline ovarian tumors: an immunohistochemical study.

OBJECTIVE: To investigate the expression of human telomerase reverse transcriptase (hTERT) in epithelial borderline ovarian tumor (BOT) by immunohistochemistry with correlation to clinicopathologic variables. MATERIAL AND METHOD: Paraffin-embedded tissue sections of 62 borderline ovarian tumors (47 mucinous, 14 serous, and 1 clear cell) and 12 epthelial ovarian carcinomas were immunostained with antibodies to hTERT. The intensity and quantity of the immunostaining was determined and analyzed with clinicopathological characteristics. RESULTS: hTERT expression was detected in 48.4% of BOT and all cases of epithelial ovarian carcinoma. In immunoreactive BOT 50% of cases were scored as high expression. Serous BOT had the highest rate of hTERT expression. There was no significant statistical difference of hTERT immunoreactivity between histologic types of BOT. No hTERT immunoreactivity was observed in the benign parts of the same slides of each immunoreactive case. hTERT immunoreactivity was positively correlated with FIGO stage (p = 0.04), but not with other variables. The mean follow-up time of BOT cases was 81.63 months and no recurrence or death was noted. CONCLUSION: hTERT expression was found in half of BOT and all of epithelial ovarian carcinoma. High hTERT expression was associated with FIGO stage.

Comparison between adenocarcinoma in both endocervical and endometrial specimens from fractional curettage and pathologic findings in subsequent hysterectomy specimens.

OBJECTIVE: To evaluate the hysterectomy specimen findings in the patients who underwent fractional curettage (F&C) with presence of adenocarcinoma in both endocervical and endometrial specimens. MATERIAL AND METHOD: Forty-one patients who had adenocarcinoma in both endocervical and endometrial specimens from F&C and underwent subsequent hysterectomy for surgical staging without pre-operative radiotherapy or chemotherapy at King Chulalongkorn Memorial Hospital between 1999 and 2007 were evaluated Histologic slides from both F&C and hysterectomy specimens were reviewed and assessed All cases of endometrial adenocarcinoma with cervical involvement (stage 2) in hysterectomy specimens were also assessed and compared to the results in F&C specimens. RESULTS: Fifteen patients (36.6%) with both positive endocervical and endometrial specimens from F&C were diagnosed as endometrial adenocarcinoma within uterine cavity with lower uterine segment involvement. Only 34.1% of cases were endometrial carcinomas with cervical involvement. In the 35 cases with endometrial carcinoma stage 2, 60% had adenocarcinoma in both endocervical and endometrial specimens from F&C. CONCLUSION: In the patients who had adenocarcinoma in both endocervical and endometrial specimens from fractional curettage, the most common final pathological diagnosis from hysterectomy specimens was endometrial adenocarcinoma within uterine cavity with lower uterine segment involvement. Therefore, only 60% of endometrial carcinoma stage 2 revealed positive adenocarcinoma in both endocervical and endometrial specimens from fractional curettage.

Detection of PTEN immunoreactivity in endometrial hyperplasia and adenocarcinoma.

OBJECTIVE: To investigate PTEN (phosphatase and tensin homolog deleted on chromosome 10) expression in endometrial hyperplasia and adenocarcinoma as analyzed by immunohistochemistry. MATERIAL AND METHOD: PTEN protein expression was evaluated by immunohistrochemical study of 70 paraffin-embedded curettage endometrial tissue samples (10 normal endometrium, 55 endometrial hyperplasia, and 15 endometrial adenocarcinomas) selected from surgical pathology files of the Division of Gynecologic Pathology, Department of Obstetrics and Gynecology, Faculty of Medicine, Chulalongkorn University, from 2001 to 2004. Intensity of epithelial staining of PTEN immunoreactivity in different histologic types was determined. RESULTS: Absence of PTEN protein expression was detected in 60% of endometrial carcinoma, 60% of atypical endometrial hyperplasia, and 24% of typical endometrial hyperplasia. In endometrial hyperplasia without atypia group, the majority of cases revealed moderate to strong PTEN expression, with 70% in simple hyperplasia and 47% in complex hyperplasia. There is a significant statistical difference of PTEN immunoreactivity among proliferative endometrium, endometrial hyperplasia and endometrial carcinoma group (p = 0.004). CONCLUSION: Complete loss of PTEN protein expression was most commonly found in endometrial carcinoma and hyperplasia with cytologic atypia.

Primary hyperoxaluria.

A 5-month-old female infant who had chronic diarrhea and acute renal failure was referred to Chulalongkorn Hospital for further investigation and management. Laboratory investigation revealed elevated blood urea nitrogen and creatinine level, hypocalcemia, hyperphosphatemia, and hyponatremia. Ultrasonography of the kidneys showed normal size with bilateral hyperechoic kidneys. Eyes examination was compatible with oxalosis maculopathy. Urine organic acid analysis revealed peak of oxalate and glycolate. Clinical impression concluded acute renal failure from hyperoxaluria. The patient underwent continuous venovenous hemodiafiltration (CVVH-DF) with regional citrate anticoagulation and expired on day 13 after admission. Pathological examination of kidney necropsy revealed diffuse intraluminal deposition of oxalate crystals within the renal parenchyma. Primary hyperoxaluria is a very rare disease and has rarely been reported in Thailand. In the presented case, the diagnosis was delayed due to uncommon presentation and unavailability of diagnostic laboratory.

Paraurethral leiomyoma: a case report.

A paraurethral leiomyoma is a rare benign hormone-dependent tumor of mesenchymal origin. A 43-year-old woman presented with a palpable mass near the urethral opening with no abnormal urinary symptom. Simple excision was performed Histopathological diagnosis was paraurethral leiomyoma with confirmation by immunohistochemical study. Further hormonal study of the tumor yielded positive estrogen and progesterone receptor expression, suggesting conservative treatment with gonadotropin-releasing hormone (GnRH) agonist or antagonist may have a role as an alternative treatment in an inoperable case.

Desmoplastic infantile ganglioglioma with high proliferation index: report of a case.

Desmoplastic infantile ganglioglioma (DIG) is an uncommon neuroepithelial tumor associated with epilepsy, mostly occurring in the first 2 years of life. Most DIGs carry good prognosis after complete resection, even when a primitive cellular element is present. However a few examples of DIG with histologic anaplasia have recently been reported, and one demonstrated an unusual aggressive behavior. The authors describe herein a DIG with high Ki-67 proliferation index (30%) in a 10-month-old male infant with epilepsy, but with an excellent prognosis after total tumor resection.