[show abstract][hide abstract] ABSTRACT: Abstract Objective.The aim of this study was to correlate the expression of vascular endothelial growth factor (VEGF) and hypoxia-inducible factor-1α (HIF-1α) with pathological renal artery changes in patients with renal cell carcinoma (RCC). A further aim was to correlate intratumoral microvessel density (MVD) with VEGF and HIF-1α expression and prognostic factors for RCC, including tumour necrosis. Material and methods. Formalin-fixed and paraffin-embedded tissue blocks from 150 patients with RCC and 50 patients with non-tumorous kidney diseases were analysed. The control group consisted of specimens from both renal arteries obtained from 25 decedents at routine autopsy (50 cases in total). Immunohistochemistry was performed using primary antibodies to VEGF, HIF-1α and CD31. Results.Pathological renal artery changes were more common in patients with RCC and non-tumorous kidney diseases than in the control group. MVD was higher in the RCCs of patients with pathological renal artery changes. Tumours with higher HIF-1α expression had higher MVD; however, VEGF expression was not associated with MVD. A significant association was also found between MVD and the extent of tumour necrosis, in that less necrotic tumours had higher MVD. No association between renal artery changes and VEGF and HIF-1α expression was established. Conclusion. Considering the results of this study, the evaluation of renal artery changes in forthcoming research on RCC would be helpful for several reasons: to estimate their incidence in a larger number of patients, to clarify their connection with RCC and to reveal their relationship with MVD in RCC.
[show abstract][hide abstract] ABSTRACT: A giant retroperitoneal liposarcoma that incorporated the descending colon was presented clinically as a palpable abdominal mass in a 37-year-old male patient. Complete surgical resection with adjacent partial colectomy was performed. Total tumor mass was 10.7 kg and pathological examination revealed well differentiated ("lipoma-like") liposarcoma. Literature review shows that aggressive surgical resection remains the mainstay of treatment for retroperitoneal liposarcoma, although there are some promising results that support the use of adjuvant combination chemotherapy in advanced metastatic disease.
[show abstract][hide abstract] ABSTRACT: BACKGROUND: The epithelial cell adhesion molecule (EpCAM) is a transmembrane glycoprotein that was originally identified as a marker for carcinoma, attributable to its high expression on rapidly proliferating tumors of epithelial origin. The role of EpCAM is not limited to cell adhesion but includes diverse processes such as signaling, cell migration, proliferation, and differentiation. OBJECTIVE: Several studies investigated EpCAM expression in prostate carcinoma but none of them confirmed its prognostic role. The aim of our study was to investigate EpCAM expression and its relationship with established prognostic features in prostate carcinoma. MATERIALS AND METHODS: The study included a cohort of 102 patients treated with radical prostatectomy for clinically localized prostate carcinoma. Immunohistochemistry was performed to evaluate the EpCAM expression in prostate cancer and non-neoplastic prostate tissue. The percentage of positively stained carcinoma and benign glands was examined in the whole mount of the chosen slide. RESULTS: The extent of EpCAM expression was significantly higher in malignant than in benign prostatic tissue (P < 0.001). EpCAM expression in prostate cancer was associated with established features indicative of worse prognosis, such as preoperative (P = 0.009) and postoperative (P = 0.004) Gleason score and follow-up time (P < 0.001). Patients with higher preoperative and postoperative Gleason score and short follow-up time had tumors with a significantly higher expression of EpCAM. Negative correlation of follow-up time and EpCAM expression indicated that tumors in patients with biochemical recurrence (BCR) harbored higher EpCAM expression. Moreover, expression of EpCAM was significantly higher in patients with BCR compared with patients without BCR (P < 0.001). Tumors in T3 stage of the disease showed significantly higher EpCAM expression compared with T2 tumors (P = 0.002). Univariate (P < 0.001) and multivariate (P < 0.001) analyses showed that EpCAM expression was a significant predictor of shorter biochemical recurrence free-survival. CONCLUSION: Our results confirmed high level of EpCAM expression in prostate cancer and support its potential role in prostatic cancer progression. In addition, EpCAM could serve as an additional prognostic marker for the recognition of patients with an increased risk of disease recurrence that need introduction of secondary therapy.
[show abstract][hide abstract] ABSTRACT: Large cell neuroendocrine carcinoma (LCNEC) is an aggressive neoplasm with a low frequency of occurrence in the digestive tract. We present a series of eight patients diagnosed with LCNEC of the colon and rectum. Grossly, tumors were presented as endophytic/ulcerative, annular and polypoid masses, with a gray-white color and necrosis in most cases. Histologically, they were high-grade tumors composed of large cells of organoid, nesting, trabecular, rosette-like and palisading patterns, with a high mitotic rate. Tumors were immunoreactive for neuroendocrine markers, including chromogranin A (2/8), synaptophysin (7/8), and neuron-specific enolase (8/8). Moreover, we analyzed the expression of growth hormone (hGH) and growth hormone receptor (GHR) in colorectal LCNECs and six tumors were immunoreactive for hGH, while five tumors were immunoreactive for GHR. To our knowledge hGH and GHR expression has not been previously analyzed in colorectal LCNEC. Their overexpression suggests a role of hGH and GHR in the development of colorectal LCNEC.
Anticancer research 08/2012; 32(8):3377-81. · 1.71 Impact Factor
[show abstract][hide abstract] ABSTRACT: Cases of adult renal cell carcinoma with rhabdoid features have been reported in the literature, usually in association with conventional clear cell and papillary tumors. Till date, only one report described chromophobe renal cell carcinoma with rhabdoid differentiation. We report a case of a 47-year-old male patient that underwent a routine medical check-up. Computer tomography scan revealed a large heterogeneous mass in the left kidney, multiple nodular changes in the lungs and multiple enlarged lymph nodes. On microscopic examination of the left nephrectomy specimen, 65 % of the kidney tumor was comprised of rhabdoid foci and the rest of the tumor showed eosinophilic areas consistent with chromophobe renal cell carcinoma. Final diagnosis was chromophobe renal cell carcinoma with rhabdoid differentiation. Behavior of these tumors in adults is more aggressive, demands more aggressive treatment and has poor prognosis. Therefore, rhabdoid differentiation should be recognized in this type of carcinoma and mentioned in the pathohistology report.
Wiener klinische Wochenschrift 06/2012; 124(11-12):419-21. · 0.81 Impact Factor
[show abstract][hide abstract] ABSTRACT: Glioblastoma is the most frequent, the most malignant and the best vascularised primary brain tumor. Substantial evidence
suggests that IGFBP-2 (insulin-like growth factor binding protein) may play a significant role in the development and progression
of various types of cancer, including the anaplastic progression of astroglial tumors. The correlation of IGFBP-2 and VEGF
over-expression in diffuse gliomas and strong IGFBP-2 immunostaining and co-expression with VEGF in the cells of pseudopalisading
necrosis suggests the induction of IGFBP-2 expression by hypoxia and/or possible involvement of its protein product in angiogenesis.
The aim of this study was to analyze the expression of IGFBP-2 and the relationship between the IGFBP-2 expression, extent
of bizarre angiogenesis and the presence of pseudopalisades. The prognostic impact of these variables was estimated, as well.
Our results revealed that most glioblastoma (75%) express IGFBP2 and that IGFBP2 expression was associated with the presence
of pseudopalisading necrosis as well as extensive bizarre angiogenesis. IGFBP-2 immunoreactivity in more than 5% of tumor
cells and the presence of pseudopalisading necrosis were prognostically significant in univariate analysis (p=0.034) while
in multivariate analysis only a patient’s age and the presence of pseudopalisades remained statistically significant (p=0.004).
The results of our study showed the association of IGFBP-2 expression in glioblastoma with pseudopalisades and bizarre angiogenesis
thus confirming on morphological grounds presumed induction of this gene under hypoxic conditions and its possible role in
[show abstract][hide abstract] ABSTRACT: Introducción
El schwannoma es un tumor benigno, encapsulado, de la vaina de mielina, originándose en las células de Schwann. El schwannoma primario de la glándula suprarrenal es muy infrecuente.
Se presenta un caso de una paciente de 55 años, diagnosticada de cáncer de mama y tratada con mastectomía, linfadenectomía y terapia hormonal. Tres meses tras la mastectomía se detectó ecográficamente un tumor, sin actividad hormonal, en la glándula suprarrenal izquierda. Se sospechó una metástasis y se realizó una adrenalectomía. La histología e inmunohistoquímica del tumor fueron consistentes con schwannoma.
Debido a la poca frecuencia del schwannoma suprarrenal pueden ocurrir problemas diagnósticos y deben diferenciarse de otras lesiones de células de la glándula suprarrenal o de tumores metastásicos.
[show abstract][hide abstract] ABSTRACT: Retraction clefting is known to appear in various types of tumors, but it has only recently been recognized as a specific histological phenomenon. Previously, it was considered merely a laboratory procedure artifact, but lately, there have been some assumptions that peritumoral retractions actually represent lymphatic spaces. In our study, we analyzed neoplastic glands in 52 specimens of prostatic adenocarcinoma. Immunohistochemical analysis was performed using D2-40 antibody, to highlight lymphatic endothelium and thereby differentiate actual lymph vessels or lymphovascular invasion from periacinar retractions. Our results showed that the number of lymph vessels was significantly lower in tumorous tissue compared to adjacent normal prostatic tissue. On the other hand, the number of lymph vessels in tumorous tissue was significantly higher than the number of lymph vessels mimicking periacinar retractions. Overall, the number of lymph vessels mimicking periacinar clefts was particularly low. These results are in accordance with our previous studies, which had shown that periacinar clefting appears due to lack of basal cells and stromal changes around tumorous acini. Also, these results support our hypothesis that retractions do not represent lymph vessels but should be considered a distinct entity, which is proven to be helpful both as diagnostic and predictive factor.
Pathology & Oncology Research 09/2011; 18(2):365-70. · 1.56 Impact Factor
[show abstract][hide abstract] ABSTRACT: The aim of this study was to evaluate endothelial lipase (EL) protein expression in advanced human carotid artery plaques (HCAP) with regard to plaque (in)stability and the incidence of symptoms. HCAP were collected from 66 patients undergoing carotid endarterectomy (CEA). The degree of plaque (in)stability was estimated by ultrasound and histology. In HCAP sections, EL expression was determined by immunostaining and the intensity was assessed on a semi-quantitative scale (low: <25%, high: >25% positive cells). Monocytes and macrophages in adjacent HCAP sections were stained with a CD163 specific antibody. High EL staining was more prevalent in histologically unstable plaques (in 33.3% of fibrous plaques, 50% of ulcerated non-complicated plaques and 79.2% of ulcerated complicated plaques; χ(2) test, p = 0.004) and in the symptomatic group (70.8 vs. 42.9% in the asymptomatic group; χ(2) test, p = 0.028). The majority of EL immunostaining was found in those HCAP regions exhibiting a strong CD163 immunostaining. EL in HCAP might be a marker and/or promoter of plaque instability and HCAP-related symptomatology.
Journal of Neurology 08/2011; 259(3):448-56. · 3.58 Impact Factor
[show abstract][hide abstract] ABSTRACT: To determine whether the presence and extent of peritumoral retraction artefact could be used to predict biochemical recurrence-free survival in prostatic carcinoma.
The study included 162 consecutive patients treated by radical retropubic prostatectomy and bilateral lymphadenectomy for clinically localized prostatic carcinoma. A variable degree of retraction artefact was present in all 162 analysed tumours. The extent of retraction artefact in prostatic carcinomas ranged from 5% to 55% with a median value of 15% (interquartile range 10-25%). We found no correlation between the extent of retraction artefact in the tumours and patient's age (P=0.608), preoperative (P=0.362) and postoperative (P=0.279) Gleason score or lymph node metastases (P=0.084). In contrast, the extent of retraction artefact correlated with high preoperative prostate-specific antigen (P<0.001), short follow-up time (P<0.001), seminal vesicle invasion and/or extracapsular extension of the tumour (T3 stage tumours) (P<0.001) and positive surgical margins (P<0.001). Furthermore, extensive retraction artefact was associated with poor biochemical recurrence-free survival in both univariate (P<0.001) and multivariate analyses (P=0.013).
The presence of extensive retraction artefact in prostatic carcinoma correlates with tumour characteristics signifying aggressive behaviour and indicates poor biochemical recurrence-free survival.
[show abstract][hide abstract] ABSTRACT: There is a well-documented relationship between urinary bladder diverticula and intradiverticular neoplasms. The great majorities of these tumors are urothelial carcinomas, but may also be of glandular or squamous type. Sarcomas occurring within bladder diverticula are exceptionally rare and highly malignant lesions, with only 20 well documented cases published in the literature to date (including carcinosarcomas). We report a case of osteosarcoma of the bladder diverticulum in a 68-year old man, which clinically mimicked intradiverticular calculus. To our knowledge, this is the second case described in the literature to date, and the first in English literature.
[show abstract][hide abstract] ABSTRACT: Acantholytic squamous cell carcinoma (ASCC) is an uncommon histopathologic variant of SCC, characterized by marked acantholysis, wherein the tumor cells demonstrate defective cohesion to one another in the cancer nest leading to a pseudoglandular or pseudovascular appearance. The most common site of ASCC is the sun-exposed areas of the skin. Sporadic cases of ASCC have also been reported in various mucosal membranes and organs but to our knowledge this is the first case of primary ASCC of the large bowel.
A 59-year-old woman underwent right hemicolectomy due to large tumor in cecum and initial part of the ascending colon. Microscopically, the tumor consisted of nests of focally keratinizing large, atypical, squamous epithelial cells. Approximately 70% of the tumor showed acantholytic changes and acantholysis was equally distributed through the entire tumor. Immunohistochemically tumor cells were diffusely positive for cytokeratin (CK) AE1/AE3 and focally positive for epithelial membrane antigen and syndecan 1. All other tested antibodies (CK7, CK 20, CK MNF116, E-cadherin, beta-catenin, p63, p16, CD31, CD34, CEA, estrogen, progesterone) showed negative reaction. Periodic acid Schiff and alcian blue staining showed no intracellular or extracellular mucinous material in the tumor. The diagnosis of acantholytic squamous cell carcinoma of the cecum was suspected and additional examination was recommended to exclude possibility of metastatic carcinoma. Extensive clinical examination which also included whole-body PET/CT scan showed no additional tumors. After the exclusion of possible metastatic disease the diagnosis of primary acantholytic squamous cell carcinoma of the cecum was confirmed. Six months after surgery the metastasis in small intestine and recurrence in the abdominal cavity at the site of surgery appeared and had the same morphological characteristic as the primary tumor in the cecum.
We report a unique case of ASCC arising in cecum and on this way expands the range of tumors originating in colon. Reports of more cases of colonic ASCC would possibly help to elucidate origin, clinical behavior and therapy of these tumors.
[show abstract][hide abstract] ABSTRACT: The distinction between renal oncocytoma (RO) and chromophobe renal cell carcinoma (ChRCC), especially the eosinophilic variant, can often be difficult. Our study has documented for the first time the expression of MAGE-A3/4 and NY-ESO-1 cancer testis antigens (CTAs) in these tumors. A total of 35 patients (17 ROs and 18 ChRCCs) were included in the study. Two antibodies were used for immunohistochemical staining: 57B recognizing multiple MAGE-A and D8.38 recognizing NY-ESO-1 CTAs. Fifteen (88.2%) samples of RO stained positively for both MAGE-A3/4 and NY-ESO-1 antigens. Regarding ChRCC, seven (38.9%) stained positively for MAGE-A3/4 and six (33.3%) for NY-ESO-1 antigens. Median MAGE-A3/4 expression was moderately positive in RO and negative in ChRCC. The difference in MAGE-A3/4 expression between two tumor groups was significant (P=0.0013). Median NY-ESO-1 expression was strongly positive in RO and negative in ChRCC. The difference in NY-ESO-1 expression between two tumor groups was also significant (P=0.0008). Our study has shown that RO had a significantly higher expression of both CTAs. However, additional research is needed to clarify their potential diagnostic implications.
Pathology - Research and Practice 10/2010; 206(10):695-9. · 1.21 Impact Factor
[show abstract][hide abstract] ABSTRACT: – Th e morphological spectrum of gallbladder carcinoma is broad and variable. Most of these tumors are tubular adenocarcinomas. Th ere are some tumors with unusual morpho-logy that may be diffi cult to classify due to their rarity. One of such tumors is the signet-ring cell carcinoma, which is a highly aggressive, mucin producing variant of gallbladder adenocarcinoma predominantly or exclusively composed of signet-ring cells. Histologically, these tumors are similar to their counterparts in other organs such as stomach, colon and breast, and should not be misin-terpreted as metastatic carcinoma from one of these primary sites. Th e literature about this variant of carcinoma is sparse and little is known about it. We found only three cases of signet-ring cell carcinoma of the gallbladder previously reported. We present the case of an 86-year-old woman with signet-ring cell carcinoma of the gallbladder and discuss the potential diagnostic dilemmas and pitfalls.
[show abstract][hide abstract] ABSTRACT: Pancreatic neuroendocrine tumors (PETs) are increasingly recognized. In order to assure an optimal treatment of patients and to propose an efficient diagnostic algorithm we were prompted to organize meetings, with participating experts, specialists in different fields of expertise. The idea for the meetings was to try to give a standardized approach, which would in future help in stratification of PET patients. Results of meetings are given in a form of Consensus guidelines for diagnosis, treatment and follow-up of patients with pancreatic neuroendocrine tumors.
[show abstract][hide abstract] ABSTRACT: Prostate cancer is the most common visceral tumor in males. It is the second most common cause of death in males due to malignant tumors. It usually appears in persons older than 50 years. It can be detected in asymptomatic patients by a simple and easily accessible procedure that includes prostate specific antigen measurement and needle core biopsy. Such an approach enables adequate treatment, insures better prognosis and even cures the patients. We describe the needle core biopsy approach and its potential in the early pathohistological diagnosis of prostate cancer. We also describe the most common histological types of prostate carcinoma as well as various nontumorous mimickers which should be considered in the differential diagnosis, in order to avoid false positive diagnosis and unnecessary prostatectomies.