Significance of Expression of PSP94 Isoforms in Etiology of Benign Prostatic Hyperplasia and Prostate Cancer.

Background: Prostate Secretory Protein of 94 Amino Acids (PSP94) level is known to increase in benign prostatic hyperplasia (BPH) and decrease in prostate cancer (PCa). However, there has not been a consensus on the abundance and significance of the different isoforms of PSP94 during the development of BPH and PCa. Methods: Benign and malignant prostate tissue was ascertained histologically. Biplex polymerase chain reaction (PCR) and real-time PCR were employed to quantitate the two isoforms, PSP94 (MSMB1) and PSP57 (MSMB2). Results: Higher abundance of both MSMB1 and MSMB2 transcripts was observed in BPH as compared to PCa. Further, there was a strong positive correlation between the transcript levels of these isoforms, MSMB1 and MSMB2, in samples from both BPH and PCa patients. Conclusions: PSP57 (MSMB2) transcript may not be involved in the development of BPH or PCa and could have a physiological role in prostate cells.

Clinico-pathological spectrum of primary ovarian malignant mixed mullerian tumors (OMMMT) from a tertiary cancer institute: A series of 27 cases.

Aims and Objectives: To study the clinico-pathological characteristics of primary ovarian malignant mixed mullerian tumor (OMMMT) and assess the prognostic factors associated with treatment outcome and survival. Materials and methods: The pathology database was searched for primary ovarian carcinosarcoma diagnosed and/or managed at our institute from period of January 2004 to July 2010. The histological sections were reviewed, with emphasis on type and grade of epithelial and sarcomatous components. The medical records were retrospectively analyzed for clinical details and follow up. Results: A total of 27 cases of primary ovarian carcinosarcoma were identifi ed. The median age at diagnosis was 51 years. Fourteen patients had advanced stage (stage III and IV) at presentation. Cytoreductive surgery was done in 18 cases, and 7 had received upfront chemotherapy. Histologically, 10 cases had epithelial predominance (> 50% epithelial component) and 11 had sarcoma predominance. The most frequent epithelial component was endometroid type, and most common sarcoma component was rhabdomyosarcomatous. Hyaline droplets within sarcomatous stroma were seen prominently in 15 cases. Three cases showed germ cell / yolk sac-like areas. Eighteen cases had follow up with a median of 15 months (4-40 months). The recurrence-free survival in advanced stage and sarcoma predominant was 10.5 months in comparison to 13 months in early stage and epithelial predominant OMMMT. Conclusion: Primary ovarian carcinosarcoma is a rare biphasic malignancy with variable proportions of epithelial and spindle elements. Presence of hyaline droplets within spindle sarcoma in a biopsy from ovarian mass should alert the pathologists regarding MMMT. Advanced stage, suboptimal cytoreduction, and sarcoma predominant tumors are likely to have a worse outcome in ovarian MMMT.

Localized amyloidosis of the urinary bladder, clinically masquerading as bladder cancer.

Amyloidosis is characterized by extracellular deposition of a proteinaceous, hyaline material. Localized deposition of amyloid in individual organs is uncommon. It can occur in the absence of systemic involvement. Herein, we describe two cases of localized amyloidosis of the urinary bladder, which clinically, radiologically, and on cystoscopy masqueraded as bladder cancer. A diagnosis of amyloidosis in both these cases was ascertained on biopsy, supplemented with special stains.

Isolated gall bladder metastasis from renal cell carcinoma.

Gall bladder metastasis from renal cell carcinoma is rare. We report a 46-year-old man with isolated gall bladder metastasis from renal cell carcinoma 11 months after radical nephrectomy. He underwent cholecystectomy and frozen section revealed the metastatic tumor. Sixteen months later, the patient is free of disease.

Cervical lymphoma presenting as irregular vaginal bleeding.

Non-Hodgkin lymphoma (NHL) causes many deaths worldwide and its incidence is increasing. They commonly occur in middle-aged and elderly people and are disseminated at diagnosis. The patients usually present with lymphadenopathy, fever, night sweats and weight loss. We report an interesting case of NHL in a 35 year old female, who primarily presented with irregular bleeding per vaginum.

Renal angiomyolipomas--a study of 18 cases.

Angiomyolipoma is a distinctive neoplasm composed of an intimate admixture of three components, viz. mature adipocytes, smooth muscle cells and blood vessels. This study was undertaken to better define the various morphological patterns of angiomyolipoma and their immunohistochemical profile. The paraffin blocks and slides of 18 cases of renal angiomyolipoma, accessioned over a period of 8 years from Tata Memorial Hospital, were reviewed. There were 2 men and 16 women in the age range of 17 to 68 years. Pre-operative fine needle aspiration cytology (FNAC) was performed in 6 cases, of which 5 were erroneously diagnosed as renal cell carcinomal sarcoma. Histologically, 14 cases revealed conventional histology. The remaining 4 cases were particularly misleading posing diagnostic problems due to variant patterns (leiomyomatous variant-3 cases and epithelioid variant- 1 case). Apart from the usual histology, necrosis, giant cells, and varying degrees of nuclear pleomorphism were present in three of the cases. Immunohistochemistry performed in 16 cases revealed immunoreactivity for HMB45 in all the 16 tumors (100%), estrogen receptor (ER) and progesterone receptor ((PR) in 2 cases (12.5%) and 6 cases (37.5%) respectively.