The expression and localization of estrogen receptor beta in hyperplastic and neoplastic prostate lesions.

BACKGROUND/AIM: Benign acini in benign prostatic hyperplasia (BPH) are lined with pseudostratified cylindrical epithelium with a continuous basal cell layer. Adenocarcinoma of the prostate is the most common cancer in men. High gradus-prostatic intraepithelial neoplasia (HGPIN) lesions precede invasive cancer. Prostate adenocarcinoma (PCa) implies a complete absence of basal cells and stromal invasion by malignant acini. Estrogen receptor (ER) is located in nuclei of acinar basal and secretory cells and partially in stromal cells. The aim of this research was to demonstrate and localize ER in BPH and in PCa of different Gleason scores. Considering literature data for ER-beta. expression in different morphologic prostate lesions, it is assumed that there is expression of ER-beta in most moderately differentiated PCa, and that the observed receptor expression is lost with increasing of the Gleason score. METHODS: Four groups of patients were formed: the control with BPH and three experimental groups with PCa of different grades and scores, according to the Gleason grading system. The patients were male of various ages suspected of PCa, based on clinical and laboratory parameters. The study was conducted in a period 2010-2012. None of the patients received prior hormonal therapy. Sextant byopsies with BPH and PCa were treated for ER-beta (Novacastra). Localization and intensity of ER-beta expression is reported through the score: 0 = zero; 1 = < 1%; 2 = 1-10%; 3=11-33%; 4= 34-66%; 5- > 66%. Positive fibroblasts and endothelial cells are used for comparison. RESULTS: ER-beta expression in acinar epithelial cells was the weakest in well-differentiated adenocarcinoma. A decline of ER-beta expression was noticed in malignant lesions of the prostate vs. benign ones. Less differentiated adenocarcinomas showed a decrease of ER-beta expression in basal and in the secretory cells. ER-beta expression in basal cells was stronger than in secretory ones in BPH and well-differentiated adenocarcinoma. CONCLUSION: ER-beta expression was most pronounced in BHP samples and declined in malignant prostate lesions. This finding supports statement on anticiproliferative role of ER-beta in prostatic tissue.

Squamous cell carcinoma in mature cystic teratoma of the ovary.

INTRODUCTION: Malignant transformation is a rare complication of mature cystic teratoma, with squamous cell carcinoma as the most common malignancy (in 75% of cases). In this article we present a case of a well-differentiated squamous cell carcinoma arising in a mature cystic teratoma and discuss the morphological and clinico-pathological features of malignant transformation in teratoma. CASE REPORT: An 80-year-old woman with symptoms of acute abdomen underwent left salpingo-oophorectomy. Gross examination showed a cystic mass measuring 20 cm in diameter, with papillary formation on its internal surface. Histology revealed a well-differentiated squamous cell carcinoma arising in mature cystic teratoma. Squamous epithelium surrounding the tumor was dysplastic. CONCLUSION: Squamous cell carcinoma in mature cystic teratoma is a rare pathologic event and in most cases it is an accidental pathohistological finding.

[Morphology and immunohistochemical studies of ovarian strumal carcinoid].

INTRODUCTION: Teratomas are tumors derived from pluripotent germ cells, and they appear most frequently in ovaries. Strumal carcinoid belongs to the group of monodermal teratomas. Strumal carcinoid is characterized by the presence of carcinoid tumor, intermingled with thyroid tissue. CASE REPORT: A 52-year-old postmenopausal woman was referred to the Department of Gynecology and Obstetrics, Clinical Center of Vojvodina, Novi Sad with complex right adnexal mass for surgery. Laparotomy revealed tumor arising from the right ovary, of firm consistency and intact capsule. On gross examination, yellowish brown tumor was 26 x 17 x 10 cm, with vague nodularity. The cut sections revealed predominantly solid mass with two cystic areas, and one of the cysts showed a tuft of hair. On histopathological examination, the cystic spaces were lined with skin and mucinous epithelium. The solid areas showed a population of monomorphic cells with eosinophilic cytoplasm and nuclei with "salt and pepper" chromatin, arranged in acinar and trabecular patterns, respectively. In addition, focally follicular structures with central eosinophilic colloid-like material were seen. Based on the presence of these two components, a diagnosis of Strumal Carcinoid was made and confirmed on immunohistochemistry. The tumor cells were diffusely immunopositive for synaptophysin, chromogranin, and the follicles including the central coIloid were immunopositive for thyroglobulin and Thyroid transcription factor-1. Neither proliferative or mitotic activity nor capsular or angiolymphatic invasion were noticed. At 3 year follow up the patient was disease free. CONCLUSION: In order to diagnose this rare tumor a team, consisting of a pathologist, surgeon and radiologist, is needed. Diagnosis of strumal carcinoid has to be confirmed on immunohistochemistry.

Age-related skin changes.

Age-related skin changes can be induced by chronological ageing, manifested in subcutaneous fat reduction, and photo-ageing eliciting increased elastotic substance in the upper dermis, destruction of its fibrilar structure, augmented intercellular substance and moderate inflammatory infiltrate. Forty-five biopsy skin samples of the sun-exposed and sun-protected skin were analyzed. The patients were both males and females, aged from 17 to 81 years. The thickness of the epidermal layers and the number of cellular living layers is greater in younger skin. The amount of keratohyaline granules is enlarged in older skin. Dermoepidermal junction is flattened and the presence of elastotic material in the dermis is pronounced with age. The amount of inflammatory infiltrate is increased, the fibrous trabeculae are thickened in older skin and the atrophy of the hypodermis is observed. Chronological ageing alters the fibroblasts metabolism by reducing their life span, capacity to divide and produce collagen. During ageing, the enlargement of collagen fibrils diminishes the skin elasticity.

[Mucinous cystadenofiobroma of the ovary].

INTRODUCTION: Cystadenofibromas are tumors of the ovary which originate from the surface coelomic epithelium. Benign mucinous cystadenofibroma is a very rare form of these tumors, which consists of dominant stromal component of the connective tissue and one or more cysts. CASE REPORT: The case of a 62-year-old female with tumor of right ovary is reported in this paper. Histologically, tumor of the ovary had multilocular cystic formation, lined by a single-layer of mucoproductive cylindrical epithelium - endocervical type. In one area of tumor, the stromal component was abundant and made from partially hyalinised dense connective tissue. Mucinous cystadenofibroma was diagnosed on the basis of histological examination. Since the mucinous type of cystadenofibroma or adenofibroma is rare, this case has been chosen to be presented. CONCLUSION: Mucinous cystadenofibromas are differentially-diagnostically very similar to different malignant tumors and it is extremely important to make correct diagnosis of these neoplasms.