Differential expression of prognostic markers in histological subtypes of papillary renal cell carcinoma.

OBJECTIVE: To assess the expression of the tumour markers stromelysin 3, MUC1, p53 and cytokeratin-7 in papillary renal cell carcinoma (pRCC, for which two histological subtypes are distinguished, i.e. type 1 and type 2, the latter appearing to be associated with a poorer prognosis) and to determine whether any of these markers might be of prognostic value. PATIENTS AND METHODS: In a retrospective study of 50 patients, the type and nuclear grade of tumours was determined by histological analyses, the presence of microvascular emboli detected, and the markers assessed by immunohistochemical analysis using anti-stromelysin 3, anti-MUC1, anti-p53 and anti-cytokeratin-7 antibodies. RESULTS: Twenty-five patients each had a type 1 or type 2 tumour. MUC1 and cytokeratin-7 were principally expressed in type 1 tumours, being detected in 76% and 84%, respectively. By contrast, p53 accumulated principally in type 2 tumours (36%); the accumulation of p53 was also associated with poorer survival. In patients with type 2 tumours with a more unfavourable development, stromelysin-3 expression was associated with a more advanced stage and a higher risk of metastases. CONCLUSION: Subtyping pRCC according to the recommended morphological criteria appears to be worthwhile, and can be reinforced by immunohistochemical tests capable of detecting cytokeratin-7 and MUC1 expression. Immunohistochemical detection of p53 is of prognostic value, as accumulation of this factor is associated with poorer survival.

Atypical presentations of solitary fibrous tumors of the central nervous system: an analysis of unusual clinicopathological and outcome patterns in three new cases with a review of the literature.

Central nervous system (CNS) solitary fibrous tumors (SFTs) are rare mesenchymal neoplasms recognized less than a decade ago. Approximately 60 cases of SFT have been reported in the central nervous system. We describe three atypical SFTs of the CNS, two intracranial and one within the spine. One intracranial SFT arose from the sella turcica and expanded into the suprasellar areas. It relapsed twice during the 3 years following partial resection, and the MiB 1 labeling index steadily increased without obvious malignant transformation. The second SFT arose from the confluence of the sinuses, widely invaded the lateral sinus and adjacent bones, had a low MiB 1 index and has not recurred after 5 years. The intraspinal tumor occurred at T5-T7 in a patient with multiple café-au-lait spots, was predominantly myxoid and developed a second similar lesion at S3-S5 14 years later. The MiB 1 index was lower in the second tumor. Immunohistochemistry confirmed that all were SFTs. These atypical presentations gave us an opportunity to provide further information about the natural histological course of CNS SFTs.

[Superficial angiomyxoma: report of four cases, including two subungueal tumors]. / Angiomyxome superficiel: a propos de quatre cas, dont deux lésions sous-unguéales.

We report four cases of superficial angiomyxomas, including two cutaneous tumors and two subungueal tumors. Histological analysis revealed a recently described tumor, so called superficial angiomyxoma. This is a myxoid paucicellular tumor lobulated and poorly circumbscribed, containing numerous small blood vessels surrounded by a mixed inflammatory cell infiltrate with notable neutrophils. Those tumors are positive for CD34. The differential diagnosis includes myxoid neurothecoma, myxoid neurofibroma and, for ungueal tumors, superficial acral fibromyxoma.

Stromelysin-3 is expressed by aggressive meningiomas.

BACKGROUND: Stromelysin-3 (ST3) that belongs to the metalloproteinase family is proposed to play a role in tumor invasion. The purpose of this work was to study the variation of ST3 expression in meningiomas. METHODS: Twenty atypical meningiomas were retrieved from the Pathology Department's files at Hopital de Bellevue, Saint-Etienne, France. They were compared with 20 benign meningiomas randomly selected from the same file. The tumors were classified using standard histologic criteria. Frozen sections of the tumors were immunostained for ST3 and MIB-1 to evaluate the proliferative activity of tumor cells. RESULTS: The study included 5 fibrous meningiomas, 10 transitional meningiomas, 20 syncitial meningiomas, 2 secretory meningiomas, 2 microcystic meningiomas, and 1 angiomatous meningioma. Stromelysin-3 was expressed within the stromal and neoplastic cells of only 1 benign meningioma and 13 atypical meningiomas. The MIB-1 proliferation index was significantly higher in the meningiomas expressing ST3 (Student t test: P < 0.001). The invasion of bone, muscle, and brain by meningiomas as well the recurrence were statistically correlated with their ST3 expression (Kruskal-Wallis nonparametric correlation test, P = 0.001 and P = 0.008, respectively). CONCLUSIONS: Stromelysin-3 might play an important role in the invasiveness of meningiomas. Therefore, considering, ST3 in association with evaluation of the MIB-1 proliferating index may be an useful tool to assess the behavior of meningiomas.