ABSTRACT
We report the histological, immunohistochemical, and molecular findings of a dedifferentiated liposarcoma with inflammatory myofibroblastic tumor-like features occurring in the paratesticular region. Histologically, the dedifferentiated component closely resembled an inflammatory myofibroblastic tumor. The neoplastic cells were positive for smooth muscle actin with focal CD56, CD99, Bcl2 and EMA expression. WT1, calretinin, myogenin, CK(AE1/AE3), desmin, H-caldesmon, CD34, ALK, CKIT, DOG1, MUC4 and STAT6 were negative. MDM2 showed diffuse and strong nuclear positivity in neoplastic cells and fluorescence in situ hybridization (FISH) revealed amplified MDM2 (high level) but no SYT rearrangement. Although a lipomatous component was evident macroscopically, well-differentiated liposarcomatous components were not evident in the section examined. Dedifferentiated liposarcoma can have prominent inflammatory myofibroblastic tumor-like features. Pathologists should be aware of this histological variant in order to avoid misdiagnosing dedifferentiated liposarcoma as inflammatory myofibroblastic tumor or other spindle cell tumors which have different behavioral patterns and treatment requirements.
Subject(s)
Lipoma , Liposarcoma , Antigens, CD34 , Chromosome Aberrations , Humans , In Situ Hybridization, FluorescenceABSTRACT
Se presenta un estudio histológico, inmunohistoquímico (IHQ) y molecular de un liposarcoma desdiferenciado paratesticular remitido a nuestro centro, con hallazgos histológicos similares a un tumor miofibroblástico inflamatorio. Las células tumorales fueron positivas para actina músculo liso (AML) y focalmente positivas para CD56, CD99, Bcl2 y EMA. La expresión de WT1, calretinina, miogenina, CK(AE1/AE3), desmina, H-caldesmona, CD34, ALK, CKIT, DOG1, MUC4 y STAT6 fue negativa. MDM2 mostró positividad nuclear intensa y difusa por IHQ y alto nivel de amplificación génica mediante hibridación fluorescente in situ (FISH). La FISH no reveló reordenamiento del gen SYT. En el estudio histológico del corte remitido no encontramos evidencias de componente liposarcomatoso bien diferenciado, aunque el aspecto macroscópico de la pieza lo sugería. El liposarcoma desdiferenciado puede presentar hallazgos histológicos que recuerdan a un tumor miofibroblástico inflamatorio y que expanden el espectro histológico de esta variante de liposarcoma. El conocimiento de la existencia de esta variante de liposarcoma es de crucial importancia para no confundirla con otras neoplasias que, aunque histológicamente similares, difieren en la evolución clínica y/o tratamiento.(AU)
We report the histological, immunohistochemical, and molecular findings of a dedifferentiated liposarcoma with inflammatory myofibroblastic tumor-like features occurring in the paratesticular region. Histologically, the dedifferentiated component closely resembled an inflammatory myofibroblastic tumor. The neoplastic cells were positive for smooth muscle actin with focal CD56, CD99, Bcl2 and EMA expression. WT1, calretinin, myogenin, CK(AE1/AE3), desmin, H-caldesmon, CD34, ALK, CKIT, DOG1, MUC4 and STAT6 were negative. MDM2 showed diffuse and strong nuclear positivity in neoplastic cells and fluorescence in situ hybridization (FISH) revealed amplified MDM2 (high level) but no SYT rearrangement. Although a lipomatous component was evident macroscopically, well-differentiated liposarcomatous components were not evident in the section examined. Dedifferentiated liposarcoma can have prominent inflammatory myofibroblastic tumor-like features. Pathologists should be aware of this histological variant in order to avoid misdiagnosing dedifferentiated liposarcoma as inflammatory myofibroblastic tumor or other spindle cell tumors which have different behavioral patterns and treatment requirements.(AU)
Subject(s)
Humans , Liposarcoma , Histology , Immunohistochemistry , Antigens, CD34 , In Situ Hybridization, FluorescenceABSTRACT
BACKGROUND: The diagnosis of advanced lung cancer is made with minimally invasive procedures. This often results in the availability of cytological material only for subtype determination and companion diagnostic testing, with the latter being technically and clinically validated on histological material only. Thus, the primary objective of the MO29978 clinical study was to assess programmed death ligand 1 (PD-L1) protein expression on cytology samples as surrogates for histology samples in patients with lung cancer. METHODS: Formalin-fixed, paraffin-embedded histological samples and cytological cell blocks from 190 patients were analyzed with immunohistochemical assays using the rabbit monoclonal anti-PD-L1 antibody clones SP142 and SP263. PD-L1 expression was quantified on both tumor cells (TC) and tumor-infiltrating immune cells (IC). Overall concordance, sensitivity, specificity, and accuracy, with a 1% cutoff used for both assays, were assessed for PD-L1 expression on TC and IC. RESULTS: In non-small cell lung cancer histology and cytology samples measured with the PD-L1 (SP142) antibody (n = 173), the intraclass correlation coefficients were 0.40 and 0.06 on TC and IC, respectively. With SP142 and SP263, accuracies of 74.1% for TC and 51.9% for IC and accuracies of 75.2% for TC and 61.2% for IC, respectively, were reported. CONCLUSIONS: Overall, this study has demonstrated that PD-L1 analysis on TC is feasible in cytological material, but quantification is challenging. Tumor tissue should be preferred over cell block cytology for PD-L1 immunohistochemical analysis unless laboratories have validated their cytology preanalytical approaches and demonstrated the comparability of histology and cytology for TC PD-L1 results.
Subject(s)
B7-H1 Antigen/metabolism , Biomarkers, Tumor/metabolism , Carcinoma, Non-Small-Cell Lung/diagnosis , Cytodiagnosis/methods , Immunohistochemistry/methods , Lung Neoplasms/diagnosis , Antibodies, Monoclonal/immunology , B7-H1 Antigen/immunology , Biomarkers, Tumor/immunology , Carcinoma, Non-Small-Cell Lung/metabolism , Humans , International Agencies , Lung Neoplasms/metabolism , Prospective Studies , ROC CurveABSTRACT
BACKGROUND: The use of one-step nucleic acid amplification (OSNA) allows for lymph node (LN) metastasis to be detected rapidly and accurately. We conducted a prospective single-centre clinical trial to evaluate OSNA assay in detecting LN metastasis of lung cancer. PATIENTS AND METHODS: A total of 705 LNs from 160 patients with clinical stage IA to IVA lung cancer were included in this study. The LNs were divided and submitted to routine histological diagnosis and OSNA assay and the results were compared. We also examined keratin 19 expression of different histological types lung primary tumours. RESULTS: When the cut-off value was set to 250 copies/µl, the concordance rate between the two methods was 96.17% and the sensitivity 97.14%. Discordant results were observed in 27 LNs of 21 patients. Most of these discordant results were molecular micrometastasis expressing a very low number of copies with negative histology. Most thoracic tumours were positive for keratin 19. CONCLUSIONS: Our data show that the OSNA assay might be a useful and sensitive method to diagnose LN metastasis in lung cancer and could be applied to intraoperative decision-making in personalised lung cancer surgery based on LN status and a more accurate staging of patients.
Subject(s)
Lung Neoplasms/pathology , Lymphatic Metastasis/diagnosis , Nucleic Acid Amplification Techniques/methods , Adult , Aged , Female , Gene Expression Regulation, Neoplastic , Humans , Keratin-19/genetics , Keratin-19/metabolism , Lung Neoplasms/genetics , Lymph Nodes/pathology , Male , Middle Aged , Prospective Studies , Young AdultABSTRACT
Only five cases of multifocal medulloblastoma in the adult have been reported to date. We present a case in a male patient in his 50th decade of life who presented with three extra-axial lesions associated with a parenchymatous lesion of the right middle cerebellar peduncle. Sputum sample examination revealed larvae compatible with strongyloides stercoralis, which was our main differential diagnosis. Histological and immunohistochemical studies revealed the existence of a desmoplastic medulloblastoma.
Subject(s)
Cerebellar Neoplasms/pathology , Medulloblastoma/pathology , Neoplasms, Multiple Primary/pathology , Animals , Biomarkers, Tumor/analysis , Cerebellar Neoplasms/chemistry , Cerebellar Neoplasms/complications , Cerebellar Neoplasms/diagnostic imaging , Chromogranins/analysis , Diagnosis, Differential , Humans , Magnetic Resonance Imaging , Male , Medulloblastoma/chemistry , Medulloblastoma/complications , Medulloblastoma/diagnostic imaging , Middle Aged , Neoplasm Proteins/analysis , Neoplasms, Multiple Primary/chemistry , Neoplasms, Multiple Primary/complications , Neoplasms, Multiple Primary/diagnostic imaging , Neuroimaging , Sputum/parasitology , Strongyloides stercoralis/isolation & purification , Strongyloidiasis/complications , Strongyloidiasis/diagnosis , Strongyloidiasis/pathology , Synaptophysin/analysisABSTRACT
Only five cases of multifocal medulloblastoma in the adult have been reported to date. We present a case in a male patient in his 50th decade of life who presented with three extra-axial lesions associated with a parenchymatous lesion of the right middle cerebellar peduncle. Sputum sample examination revealed larvae compatible with strongyloides stercoralis, which was our main differential diagnosis. Histological and immunohistochemical studies revealed the existence of a desmoplastic medulloblastoma (AU)
En la literatura se han publicado únicamente cinco 5 casos de meduloblastoma multifocal en el adulto. Presentamos el caso de un paciente de sexo masculino en su quinta década de vida con un meduloblastoma multifocal. El paciente presentaba tres 3 lesiones extra-axiales y una lesión parenquimatosa del pedúnculo cerebeloso medio derecho. El estudio de esputo reveló larvas compatibles con Strongyloides stercoralis, siendo esta la primera sospecha diagnóstica. El estudio histológico e inmuhistoquímico reveló la existencia de un meduloblastoma desmoplásico (AU)
Subject(s)
Humans , Male , Middle Aged , Medulloblastoma/pathology , Neuropathology/methods , Neuropathology/trends , Brain Neoplasms/pathology , Immunohistochemistry/methods , Immunohistochemistry/standards , Immunohistochemistry , Neuroblastoma , Magnetic Resonance Imaging , Magnetic Resonance Spectroscopy/methodsABSTRACT
Se analizan 1.980 legrados endocervicales realizados en la Unidad de Patología del Tracto Genital Inferior del Hospital Universitario Virgen de las Nieves de Granada y practicados durante el examen clínico con legras entre 1 y 00, en un período de 3 años. Los resultados se clasifican como: normal, LSIL, HSIL y cáncer. Se encuentra una distribución significativamente diferente cuando se comparan con las diversas categorías de la clasificación citológica de Bethesda, la categorización colposcópica de cambios mayores y menores, colposcopia satisfactoria o insatisfactoria y la histología de la biopsia dirigida exocervical
We analyzed 1980 endocervical curettage procedures carried out at the Lower Genital Tract Diseases Unit at the Virgen de las Nieves University Hospital in Granada (Spain) and performed during clinical examination with curettes sized between 1 and 00 during a 3-year period. The results were classified as normal, low-grade squamous intraepithelial lesions, high-grade squamous intraepithelial lesions, and cancer. A significantly different distribution was found when the diverse categories of the Bethesda cytologic classification, colposcopy categorization of major and minor changes, satisfactory or unsatisfactory colposcopy, and the histological results of colposcopy-directed exocervical biopsy were compared
Subject(s)
Humans , Female , Uterine Cervical Neoplasms/pathology , 31574/pathology , Vacuum Curettage/methods , Colposcopy/methods , Biopsy/methodsABSTRACT
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