International Journal of Surgical Pathology current issue

Reduced p16 and Increased Cyclin D1 and pRb Expression Are Correlated With Progression in Cutaneous Melanocytic Tumors

Wed, 23 Sep 2009 01:56:06 PDT

The immunohistochemical expression of cell cycle proteins p16, cyclin D1, and pRb was assessed in 112 benign and malignant melanocytic tumors and correlated with tumor progression, prognosis, and outcome. Comparing benign and malignant tumors, there were significant differences in the median score for all 3 proteins, with decreased p16 (P = .000001), increased cyclin D1 (P = .01), and increased pRb in melanomas (P = .01). There was a progressive loss of expression of p16 with progression from benign naevi to primary melanomas and to metastases. p16 was significantly decreased in primary tumors from melanoma patients who developed recurrent disease (P = .0000013). Cyclin D1 and pRb showed a progressive increase in expression from benign to malignant tumors but with relative decreases in the more advanced tumors (thick primaries and metastatic melanomas). Alterations in cell cycle proteins involved in G1/S transition are implicated in melanocytic tumor progression and have a potential role in diagnosis and prognostication.

Thyroid Transcription Factor-1 and "Basal Marker"--Expressing Small Cell Carcinoma of the Breast

Ersahin, C., Bandyopadhyay, S., Bhargava, R. — Wed, 23 Sep 2009 01:56:06 PDT

Small cell carcinoma of the breast is a very rare entity that is histologically indistinguishable from small cell carcinomas of other organs. The presence of an in situ component is the most important feature that indicates the primary nature of the breast tumor. Thyroid transcription factor-1 (TTF-1) is a marker specific to lung and thyroid but is also expressed in small cell carcinoma of pulmonary and extrapulmonary origin. TTF-1 expression in breast small cell carcinoma has been reported only rarely. This reported case is unique because of the characteristic morphological features and immunohistochemical profile. The invasive tumor demonstrated neuroendocrine differentiation morphologically and immunohistochemically, expressed by TTF-1, EGFR, and basal-type cytokeratins. An unequivocal in situ component was identified intimately admixed with the invasive carcinoma. To the authors’ knowledge, this is the first report of breast small cell carcinoma showing the expression of "basal markers."

CDX2 Expression in Yolk Sac Component of Testicular Germ Cell Tumors

Bing, Z., Pasha, T., Tomaszewski, J. E., Zhang, P. — Wed, 23 Sep 2009 01:56:06 PDT

CDX2 has been detected in the majority of colorectal adenocarcinoma cases and may be useful in determining the sites of origin of tumors. In this study, the authors evaluated CDX2 expression in germ cell tumors (GCTs) by immunohistochemistry. Forty cases of testicular GCTs and 8 cases of metastatic GCTs were retrieved for study. In the 40 cases of testicular GCTs, 13 were pure seminomas and 27 mixed GCTs. Yolk sac tumor (YST) was identified by morphology and glypican 3 staining in 20 testicular mixed GCTs. Of these 20 cases, 8 cases showed 1+ positivity for CDX2. Other primitive components of GCTs were negative. For the 6 cases of metastatic mixed GCT with YST, 4 cases were positive, 2+ in 2 cases and 1+ in 2 cases. The positivity of CDX2 in GCTs warrants including YST in the differential diagnosis of adenocarcinoma of unknown origin.

Merits of the PMiT (Papillary Microtumor) Terminology in the Definition of a Subset of Incidental Papillary Microcarcinomas of the Thyroid

Asioli, S., Odasso, C., Macri, L., Palestini, N., Bussolati, G. — Wed, 23 Sep 2009 01:56:06 PDT

An exponential increase in the detection of papillary thyroid microcarcinomas (PTMCs) has been observed in recent times, possibly because of recent improvements in the management of thyroid lesions and extensive histological examination. However, no definitive treatment guideline has been developed for PTMC, resulting in patients undergoing overtreatment. In 2003, the term papillary microtumor of the thyroid (PMiT) was proposed for small (≤1 cm) intrathyroidal tumors with excellent prognostic prospects along with strict definition criteria. Since then, the term PMiT has been adopted by clinicians and surgeons. In this article, the authors report a series of 50 consecutive cases of PMiT collected and treated at the University Hospital of Turin, Italy. From the authors’ experience, this terminology, which demarks a subset of PTMC, should be widely adopted as it is biologically sound, well accepted by both clinicians and patients, decreases the danger of overtreatment, minimizes the psychological anxiety engendered by a diagnosis of carcinoma, and maintains the patient’s eligibility for health insurance.

Sclerosing Angiomatoid Nodular Transformation (SANT) of the Spleen: A Report of 3 Cases

Koreishi, A. F., Saenz, A. J., Fleming, S. E., Teruya-Feldstein, J. — Wed, 23 Sep 2009 01:56:06 PDT

The authors describe 3 cases of sclerosing angiomatoid nodular transformation (SANT) of the spleen diagnosed at Memorial Sloan-Kettering Cancer Center within a 1-year period (July 2008 to June 2009). All patients were female, older than 50, with lesions ranging in size from 2 to 4 cm. All were alive and well after splenectomy. All the cases showed characteristic histological and immunophenotypical findings as previously described in the literature, including scattered IgG4positive plasma cells in the fibrosclerotic stroma. Of the 3 patients, 2 had a history of carcinoma, and metastasis was of concern, but a PET scan in one of these patients showed minimal to absent FDG activity suggesting that this process was of a benign indolent nature. However, in 1 patient, a PET scan revealed positive FDG activity, heightening clinical concern for malignancy.

Vascular Endothelial Growth Factor Expression and Neovascularization in Non--Small Cell Lung Carcinoma

Ozbudak, I. H., Ozbilim, G., Kucukosmanoglu, I., Dertsiz, L., Demircan, A. — Wed, 23 Sep 2009 01:56:06 PDT

The prognostic significance of microvascular density (MVD) and vascular endothelial growth factor (VEGF) expression were investigated in 15 patients with adenocarcinoma (AC) and 15 patients with squamous cell carcinoma (SCC). Immunohistochemically, VEGF and factor VIII were applied. The average microvessel counts were given as MVD, and VEGF expression was given as VEGF percentage area and VEGF staining degree. Higher values of MVD were obtained in patients with AC (11.47 ± 3.48) when compared with patients with SCC (7.47 ± 2.50; P = .001) and also in patients at early stages of disease (10.77 ± 3.24) when compared with patients at advanced stages (8.47 ± 3.64; P = .050). A significant correlation was shown between MVD and VEGF percentage area (P = .006) and between VEGF percentage area and VEGF staining degree (P = .000). No significant difference was found in VEGF percentage area between patients with SCC and AC and between patients at early and advanced stages. In conclusion, VEGF or MVD should not be regarded as a solitary prognostic factor but should be supported by other prognostic factors.

Ovarian Malignancies With Cytologically Negative Pleural and Peritoneal Effusions: Demons' or Meigs' Pseudo-syndromes?

Peparini, N., Chirletti, P. — Wed, 23 Sep 2009 01:56:06 PDT

The authors reviewed the original reports of the association of malignant ovarian tumors with cytologically negative pleural and peritoneal effusions, commonly known as Meigs’ pseudo-syndrome and challenged the recent attribution of this disease to Demons. They underlined the historical and clinical interest of the reports of Demons and Meigs and concluded that the term pseudo-Meigs’ syndrome, and not pseudo-Demons’ syndrome, must be used for malignant ovarian lesions with effusions with negative cytology because Demons did not describe a similar syndrome caused by malignant tumors.

Small-Cell Plasmacytoma With Prominent Myxoid Stroma Mimicking a Soft-Tissue Neoplasm

Lara-Torres, C. O, Gomez-Plata, E., Ortiz-Hidalgo, C. — Wed, 23 Sep 2009 01:56:06 PDT

A Large Esophageal Leiomyoma

Angus, A., Slesser, P., Shaw, I. — Wed, 23 Sep 2009 01:56:06 PDT

Histiocytic Corona Around a Glomeruloid Intrafollicular Polyp of the Thyroid

Singh, C., Manivel, J. C., Pambuccian, S. E. — Wed, 23 Sep 2009 01:56:06 PDT

Starry Thyroid

Alsharif, M., Pambuccian, S. — Wed, 23 Sep 2009 01:56:06 PDT