Role of SET oncoprotein in hepatocellular carcinoma: An immunohistochemical study.

Hepatocellular carcinoma (HCC) is the most prevalent primary cancer of the liver and it is the fourth most common cause of cancer related death worldwide. In Egypt, liver cancer constitutes the most common cause of mortality-related cancer. This study aimed to evaluate the immunohistochemical expression of SET oncoprotein in HCC tissues in comparison with its expression in non tumorous liver tissues and to correlate its expression with clinicopathological parameters. This study investigated 100 cases of HCC (including tumorous and non tumorous tissues). One hundred percent of tumorous and non-tumorous tissues were positive for SET expression. The mean and median values of H-score for SET expression were higher in tumorous than non tumorous tissues (P = .03). Higher SET expression was significantly correlated with larger tumor size (P = .012), positive lymphovascular invasion (P = .028), and shorter overall survival (P < .001). SET expression in tumor tissues is the most independent factor to affect the overall survival of HCC patients. SET plays a role in hepatocarcinogenesis proved by the increase of SET expression from non-tumorous to tumorous tissues. Also, SET can be used as a prognostic indicator and a novel target therapy in HCC patients.

Primary Epithelioid Angiosarcoma of Spleen: A Case Report and Review of Literature.

Splenic angiosarcomas are usually secondary tumours, and only few primary cases have been encountered. We report a unique primary case of epithelioid angiosarcoma arising in the spleen in a male patient 55-year-old and presented to our hospital as a medical emergency with acute abdomen and haemorrhagic ascitis. CT revealed splenic focal lesion and suggested that this abdominal haemorrhage was due to ruptured splenic haemangioma, thus abdominal exploration and splenectomy were done. The histopathological examination showed an infiltrating ill-defined growth formed of high grade epithelioid cells arranged in sheet-like growth pattern, with occasional papillary appearance. The presence of rudimentary vascular channels lined by epithelioid endothelial cells with occasional intraluminal erythrocytes suggested vascular tumour origin. The neoplastic cells showed diffuse expression of CD31 together with focal expression of cytokeratin (CK) and CD34. Because of its epithelioid morphology and unmistakable positivity for CK, this case may be easily misdiagnosed as a metastatic carcinoma, which is not uncommon finding in the spleen. Epithelioid angiosarcoma is a rare type of vascular tumour in the spleen, which co-expresses vascular and epithelial markers making its distinction from metastatic carcinoma is sometimes difficult.

Diagnosis and prognosis of B-cell chronic lymphocytic leukemia/small lymphocytic lymphoma (B-CLL/SLL) and mantle cell lymphoma (MCL).

BACKGROUND: B-cell chronic lymphocytic leukemia/ small lymphocytic lymphoma (B-CLL/SLL) and mantle cell lymphoma (MCL) show many overlapping morphologic and immunophenotyping features, however they have great difference in therapeutic regimens and prognosis. THE AIM OF THE STUDY: Is to determine the diagnostic and prognostic role of clinico-pathologic variables, CD23 and Cyclin D1 oncoprotiens in B-SLL/CLL and MCL. PATIENTS AND METHODS: This study included 25 BCLL/ SLL cases and 25 MCL cases. All cases were carefully examined and stained using CD23 and Cyclin D1 immunostaining. RESULTS: There was significant difference between BCLL/ SLL and MCL regarding several items including pattern of growth, where interfollicular pattern was restricted to B-SLL/CLL while nodular and mantle zone pattern were confined to MCL; pseudo-follicles were only present in B-CLL/SLL. Transformed cells, plasmacytoid cells, peripheral blood lymphocytosis, significant longer survival and good prognosis were statistically more prominent in favor of B-CLL/SLL. On the other hand, cell cleavage, epithelioid histiocytes, plasma cells, naked nuclei, hyalinized venules, deposited hyaline material in background and reticular fibers in addition to higher mitotic index per 20 HPF were more significantly identified in favor of MCL. CD23 was expressed as membranous pattern in 16/25 (64%) of B-CLL/SLL cases and 1/25 (4%) of MCL cases. On the other hand, Cyclin D1 was expressed as nuclear staining in 18/25 (72%) of MCL cases and only 1/25 (4%) of B-CLL/SLL cases. Regarding B-CLL/SLL, age >60 years and mitosis >or=10/20 HPF were independent prognostic factors of shorter survival by multivariate analysis. In MCL, Cyclin D1 overexpression and splenomegaly were independent prognostic factors of survival by multivariate analysis. CONCLUSION: Cyclin D1 is not only implicated in tumor genesis of MCL, but also in progression and extension of the disease when expressed in high levels (50% cut off value) and it seems to have prognostic impact in MCL. This can be used as a basis for future therapeutic strategies targeting cell cycle regulators. This study could support the concept that Cyclin D1 and CD23 immunostaining may be reliable diagnostic tools for discrimination between B-CLL/SLL and MCL.

Expression of matrix metalloproteinase-2 in renal cell carcinoma.

BACKGROUND: Renal cell carcinoma (RCC) is a family of carcinomas arising from the renal tubular epithelium through different genetic lesions. The most common characterstics of RCC are hypervascularity, tendency to metastasize widely before giving rise to any symptoms or signs, and poor prognosis. It has been reported that matrix metallopropteinases (MMPs) are a family of endopeptidases implicated in tissue remodeling and cancer invasion. Therefore, the aim of the present study was to investigate the expression of MMP-2 in RCC and correlate its expression with the clinicopathologic prognostic parameters. MATERIAL AND METHODS: Fifty cases of primary RCC comprised the material of this study. Formalin-fixed paraffin-embedded tissues were stained with MMP-2 immunostaining, using improved streptavidin-biotin amplified system. The intensity of staining and percentage of positive cells were assessed. RESULTS: MMP-2 was expressed as diffuse brown cytoplasmic staining in positive cells. The non-tumorous renal tissue showed negative staining whereas the tumor cells, fibroblasts and vascular endothelial cells showed immunoreactivity in positive cases. 43/50 RCC cases studied were positive for MMP-2. A positive correlation was observed between MMP-2 expression and tumor size, histologic type, capsular & vascular invasion and high levels of cellular proliferation. CONCLUSION: It seems that MMP-2 is involved in tumor expansion phenomena associated with tumor progression, invasion of the microvasculature and distant metastasis of RCC.