Ectopic thyroid tissue in the adrenal gland: a case report with clinical and pathogenetic implications.

Ectopic thyroid tissue (ETT) was usually discovered in head and neck region, adrenal ETT was rare reported in literature. Here is a report of adrenal gland cyst with ETT in a 49-year old woman who was admitted to our hospital for health care. CT scan demonstrated a mass in left adrenal gland, and surgical resection was prepared. The mass was cystic, composed of normal adrenal and ectopic thyroid tissue, and was histologically benign. Immnunohistochemistry showed that the ETT was positive for TG and TTF-1, molecular examination indicated that ETT was without the molecular alterations associated with thyroid carcinoma (BRAF V600E, K-RAS). Further work-up did not show evidence of thyroid malignancy.

Evaluation of specific marker CK13 and CK10/13 combined with APM staining for the diagnosis of amniotic fluid embolism and aspiration.

OBJECTIVE: To explore the value of CK13 (Rab) and CK10/13(Mab) as objective and specific biomarkers combined with Alcian-Phloxine-Martius yellow (APM) staining for the diagnosis of amniotic fluid embolism (AFE) and amniotic fluid aspiration (AFA). METHODS: A retrospective study of forensic autopsy cases of 148 neonatal deaths and 19 maternal deaths in the perinatal stage was conducted at the Institute of Pathology and Forensic Medicine, Zhejiang University. Medical records were reviewed and monoclonal antibody for CK13 (Rab) and CK10/13 (Mab) as immunostaining of amniotic fluid squamous cells, APM staining, and Hematoxylin and Eosin (HE) staining were used to diagnose the AFE and AFA. Descriptive statistics of the patient population were analyzed using SPSS 20.0 software. RESULTS: Immunoreactivity of CK13 and CK10/13 specifically identified squamous cells of all the AFE and AFA cases. The amniotic fluid squamous cells were stained positive in a deep brown color with the monoclonal antibody to CK 13 and CK10/13 whereas the endothelial cells and alveolar epithelial cells were negative. There was no CK13 or CK10/13 expression in the non-AFE and non-AFA cases. With APM staining keratinized squamous cells were pink and mucus was blue-green in marked contrast with the surrounding tissue, which improved the detection rates of both keratinized squamous cells and mucus. CONCLUSIONS: CK13 (Rab) and CK10/13 (Mab) are valuable and reliable biomarkers of amniotic fluid squamous cells. APM reveals enriched mucus and keratinized squamous cells of amniotic fluid. Immunohistochemical detection of CK13 and CK10/13 combined with APM staining can improve the accuracy and reduce the difficulty in the diagnosis of AFE and AFA.

A Case of Multiple Liver Metastasis of True Gastric Leiomyosarcoma after Complete Surgical Resection

Primary leiomyosarcomas of the stomach are very rare tumors originating from mesenchymal tissues and account for only 1% of all malignant gastric neoplasm. We present here a case of primary gastric leiomyosarcoma in a 79-year-old man who presented with a 10 day history of epigastric pain and gastric subepithelial tumor. Endoscopic examination showed a 5 cm in diameter, subepithelial tumor located in the body of the stomach. Radiological investigations showed nonspecific findings except for the primary gastric lesion. Complete histological evaluation including immnuohistochemical staining after complete surgical resection revealed a true leiomyosarcoma of the stomach. One year later, the patient presented with dyspepsia. Endoscopic and radiological evaluation showed a recurrent leiomyosarcoma with multiple liver metastases. Our experience suggests that a careful clinical follow-up after surgical resection should be recommended in patients with gastric leiomyosarcomas because of their aggressive clinical behavior.

Immunohistochemical Analysis for p53 and TGF-beta Expression Pattern in Ovarian Epithelial Tumors / 대한산부인과학회잡지

OBJECTIVE: To verify the pattern of p53 and TGF-beta protein expression in benign and malignant epithelial ovarian tumors. METHODS: An immunohistochemical technique was applied to formalin-fixed paraffin-embedded samples of 22 benign and 9 malignant epithelial ovarian tumors using p53 monoclonal antibody and TGF-beta polyclonal antibody. Expressions of p53 and TGF-beta protein in two histological types were compared, and correlated with clinico-pathologic findings of the respective cases. RESULTS: p53 immunoreactivity of high or intermediate degree was detected in 2 out of 22 benign (9%) and 5 out of 9 malignant (55%) cases. On the other hand, intermediate to high TGF-beta expression was found in 17 out of 22 benign (77%), and 3 out of 9 malignant (33%) cases. The prevalence differences of p53 and TGF-beta expression between benign and malignant groups were statistically significant (p<0.05). In addition, the prevalence of immunoreactivities of p53 and TGF-beta in malignant tumor didn't show any association with age, tumor size, histologic types and stage. CONCLUSION: Our results suggest that p53 expression and loss of TGF-beta expression may play an important role in the malignant transformation of ovarian epithelial cells. However further studies seem to be necessary to know the exact relationship between their roles.

Expression of E-cadherin in Benign, Borderline, and Malignant Ovarian Epithelial Tumors / 대한산부인과학회잡지

OBJECTIVE: To investigate the expression of E-cadherin in benign, borderline, and malignant ovarian tumors. METHODS: An immunohistochemical technique was applied to formalin-fixed paraffin-embedded samples of 20 benign cystic ovarian tumors, 14 borderline ovarian tumors and 13 ovarian carcinomas. Expressions of E-cadherin immunostaining in three histological types were compared, and the survival rate in malignant ovarian cancer according to E-cadherin expression was also assessed. RESULTS: E-cadherin was positively or heterogeneously expressed in both benign and borderline ovarian tumors. But it was negatively, heterogeneously, or positively expressed in malignant ovarian tumors. The difference of expression of E-cadherin between borderline and malignant ovarian tumors was statisticaIly significant (p<0.05). In ovarian carcinoma, there was difference between negative and positive group in survival (p<0.05). CONCLUSION: Our results suggest that alterations in E-cadherin seem to occur at a later stage of the ovarian carcinogenesis, and may have some prognostic value in malignant ovarian tumor.

Comparison of NM23-H1/NDP Kinase and CD44v Expression in Human Skin Cancer : An Immunohistochemical Study / 대한해부학회지

Two isotypes of nm23 gene have been reported as multifunctional genes as well as CD44 gene. In tumor, both of genes, one isotype of human nm23, nm23-H1 and splice variants of surface glycoprotein CD44[CD44 v8-10], are correlated with tumor growth and metatastic potential[Keim et al., 1992 ; Dall et al., 1995]. However, the correlation of expression between these genes in tumor was not reported. In this immunohistochemical study on skin cancers, basal cell carcinoma, squamous cell carcinoma, and malignant melanoma, we intended to clarify the differences of expression on the basis of origins of skin tumors, basal cell, prickle cell, melanin producing cell, and compare the alterations of expressions between two genes in each tumor, respectively. The conclusion of this comparison is that relative parallel alteration in expressions between nm23-H1/NDP kinase and CD44 v8-10 was observed in basal cell carcinoma and malignant melanoma with inverse relation in differentiation. In squamous carcinoma, the expressions of two genes were much associated with differentiation. On the periphery of tumor, very low level of nm23-H1 protein and high level of CD44 v8-10 protein were detected.