[show abstract][hide abstract] ABSTRACT: To retrospectively investigate the clinicopathologic spectrum of primary mucosal CD30-positive T-cell lymphoproliferative disorders (PTCLDs) of the head and neck.
Archives of PTCLDs primarily arising in head and neck mucosa were reviewed. Immunostaining of CD20, CD3, CD4, CD8, CD30, CD56, anaplastic lymphoma kinase (ALK), epithelial membrane antigen (EMA), cytotoxic molecules (TIA-1, granzyme B, or perforin), and Ki67; in situ hybridization for Epstein-Barr virus; and T-cell receptor gene rearrangement analysis were performed.
Fourteen cases of primary mucosal anaplastic large cell lymphoma (M-ALCL) were identified, and no lymphomatoid papulosis (LyP) cases were found. All cases demonstrated atypical mononuclear neoplastic cells with diverse histology and cytomorphology. The typical immunophenotype of neoplastic cells was CD3-positive, CD4-positive, CD8-negative, CD30-positive, ALK-negative, and cytotoxic molecules-positive. Infiltration of inflammatory cells was common. All cases presented an indolent course, regardless of therapy.
PTCLDs of the head and neck provisionally included M-ALCL alone.
[show abstract][hide abstract] ABSTRACT: Secretory breast carcinoma is a rare breast cancer with indolent clinical behavior. Recent research showed that secretory breast carcinoma belongs to the phenotypic spectrum of basal-like breast carcinomas. In this study, a clinicopathological and immunophenotypic analysis of secretory breast carcinomas from 15 Chinese patients was conducted. This patient group consisted of 2 males and 13 females, with ages ranging from 10 to 67 years old (median, 36 years old). All patients presented with a painless and firm mass. Tumor size ranged from 10 to 55 mm. Most tumors were located in the outer upper quadrant of the breast. Two patients (2 of 13, 15%) displayed positive axillary lymph nodes. At the microscopic level, the presence of intracellular and extracellular secretory material was the most remarkable feature. Most cases showed mild dysplasia cytologically. All cases were negative for estrogen receptor, progesterone receptor and HER2. The expression rate of the basal-like marker (CK5/6 or epidermal growth factor receptor) was 87% (13 of 15). The basal-like phenotype was identified in 13 cases (87%). Follow-up time ranged from 10 to 55 months (median, 19 months). None of the cases had evidence of recurrence and metastasis. Our study reveals that secretory breast carcinoma is a distinct subset of invasive breast carcinoma, with expression of basal-like markers. It should be noted that secretory breast carcinoma is different from conventional basal-like breast carcinomas. Future studies are required to further understand the prognostic significance of the basal-like markers expression in secretory breast carcinomas.
Modern Pathology 12/2011; 25(4):567-75. · 5.25 Impact Factor
[show abstract][hide abstract] ABSTRACT: Matrix-producing carcinoma (MPC) of the breast is an extremely rare variant of metaplastic carcinoma. The aim of this study was to evaluate the clinicopathological features and immunohistochemical expression profile of this rare tumor in Chinese population. Thirteen cases of MPC were evaluated using morphology observation and immunohistochemistry. All tumors had invasive carcinoma with an abrupt transition to chondromyxoid matrix without an intervening spindle cell sarcomatoid component. The distribution of tumor cells was diffuse in eight cases and peripheral in five cases. Matrix distribution was diffuse or multifocal. Necrosis was present in 11 cases. An overt invasive ductal carcinoma was observed in 11 cases and the other two tumors were consistent with MPC arising in microglandular adenosis. Ten of 13 cases were triple negative (ER-, PR-, Her2/neu-). Eight of 10 triple negative cases were cytokeratin 5/6, cytokeratin 14 or epidermal growth factor receptor positive, consistent with the basal-like phenotype. S-100 protein was positive in all cases. At the time of initial diagnosis, one of 13 patients had lung metastasis and axillary lymph nodes metastasis. Follow-up time ranged from 6 to 30 months. All patients remained alive. One patient developed a soft tissue metastasis 24 months after surgery.
Pathology International 07/2011; 61(7):415-22. · 1.72 Impact Factor
[show abstract][hide abstract] ABSTRACT: HER2/neu alteration detection in breast cancer is important for decision making of the HER2-targeted therapy. We retrospectively analyzed the HER2/neu status by fluorescence in situ hybridization and HER2 protein expression by immunohistochemistry in a cohort of 481 patients with invasive breast cancer. Fluorescence in situ hybridization showed that 57.4% of cases exhibited HER2 amplification but 41.4% did not, and 1.2% exhibited an equivocal status. Immunohistochemistry showed that 10.4%, 16.8%, 38.3%, and 34.5% of cases had scores of 0, 1+, 2+, and 3+, respectively. The HER2 status showed a moderate agreement with HER2 expression with a score of 0, 1+, and 3+ (κ = 0.576, P < .05), and the concordance rate was 90%, 61.7%, and 83.1%, respectively. The HER2 amplification occurred more likely in cases with higher immunohistochemistry scores (P < .001), and polysomy 17 was observed in 28.3% of cases, but more frequently in the HER2 amplification subgroup (33.3%) than in the HER2 nonamplification subgroup (20.1%) (P < .05). There was no significant correlation between the frequency of polysomy 17 and immunohistochemistry scores (P > .05). In the immunohistochemistry 2+ group, 56.5% cases showed HER2/neu amplification, and polysomy 17 occurred more likely in the HER2 amplification subgroup (34.6%) than in the HER2 nonamplification group (13.0%) (P < .001). We concluded that the HER2 status was correlated with HER2 protein expression levels, and it is necessary to determine the HER2 status for cases with immunohistochemistry 2+. The frequency of polysomy 17 was correlated with the HER2 copy number and partially contributed to HER2/neu amplification but not HER2 protein expression.
Human pathology 06/2011; 42(10):1499-504. · 3.03 Impact Factor
[show abstract][hide abstract] ABSTRACT: Objective: To investigate the different nature between hepatoid adenocarcinoma of the stomach (HAS) and common stomach cancer without the hepatoid differentiation areas (non-HAS).
Methods: From January 1996 to December 2007, 45 patients were diagnosed as HAS on the basis of the characteristic histologic features resembling hepatocellular carcinoma in Fudan University Shanghai Cancer Center. The clinicopathologic features and the relevant prognosis of these patients were evaluated. In addition, 225 stage-matched common stomach cancer patients were selected as controls.
Results: Histologically, the polygonal tumor cells were arranged in trabecular fashion or solid nests separated by narrow fibrous stroma composed of sinusoid-like capillaries. Immunohistochemically, the tumor cells were positive for α-fetoprotein. Under transmission electron microscope, numerous circular granules of dense electron were found in the cytoplasm. HAS showed a higher rate of vascular invasion, lymph node metastasis, and liver metastasis than non-HAS. The 5-years survival rates of HAS and non-HAS were 9% and 44%, respectively. The prognosis of HAS was poorer than that of non-HAS (P<0.05).
Conclusion: HAS had different clinicopathologic features and prognosis from non-HAS.
American Journal of Surgical Pathology 09/2010; 34(10):1465-1471. · 4.87 Impact Factor
[show abstract][hide abstract] ABSTRACT: To evaluate CK19, RET, galectin-3 and HBME-1 expression in papillary thyroid carcinoma (PTC) and to evaluate their diagnostic significance.
155 PTC specimens and 83 other diseased-thyroid specimens were collected. Immunohistochemistry for CK19, RET, galectin-3 and HBME-1 was performed.
The 155 PTC cases were classified into eight variants according to the WHO classification, including 74 cases of classic PTC, 40 cases of papillary microcarcinoma, and rare variants. CK19, RET, galectin-3 and HBME-1 expression was 87.1% (135/155), 71.0% (110/155), 91.6% (142/155), and 95.5% (148/155), respectively, for the PTC group; expression of all these markers was much higher than that in the control group (p<0.05). However, the expression of these markers did not differ among the variants (p>0.05). The expression of these markers, particularly CK19 and RET, was diffuse and strong in the papillary structure of PTC, but weak and focal in the papilla of tissue with benign disease. The expression of CK19 in follicular PTC was significantly higher than in follicular thyroid carcinoma (FTC) (p<0.05).
CK19, RET, galectin-3 and HBME-1 expression in PTC was higher than that in benign disease cases, but these were not specific markers for PTC. In summary, combining markers can increase the reliability and differential diagnosis of PTC. It is also worth noting that CK19 was very useful not only for the differentiation of benign and malignant papillary structure but also for the differential diagnosis of follicular PTC and FTC.
Journal of clinical pathology 09/2010; 63(9):786-9. · 2.43 Impact Factor
[show abstract][hide abstract] ABSTRACT: There were no comprehensive studies on the clinicopathologic features and prognosis of alpha-protein-producing gastric cancer. The aim of this study was to elucidate the clinicopathologic characteristics and prognostic factors of alpha-fetoprotein (AFP)-producing gastric cancer.
Among 4,426 gastric cancer patients receiving surgery in the Cancer Hospital of Fudan University from 1996 to 2007, there were 111 patients with elevated serum level of AFP preoperatively after excluding chronic hepatitis, hepatocirrhosis, and hepatocellular carcinoma. Primary lesions of 104 patients were stained positively for AFP. The clinicopathologic characteristics and prognostic factors of AFP-producing gastric cancer were analyzed. Additionally, 208 stage-matched AFP-negative gastric cancer patients were selected as control.
There was a significantly higher incidence of vascular invasion, lymph node metastasis, and liver metastasis in AFP-positive group than in the negative group. The overall 5-year survival rates of AFP-positive and negative groups were 28% and 38%, respectively. The AFP-positive group had a significantly poorer survival in comparison to the stage-matched negative group. The independent prognostic factors of AFP-positive group included liver metastasis and pathological stage.
AFP-positive gastric cancer had more aggressive behavior than that of AFP-negative gastric cancer. In addition to surgery, multimodal therapy should be considered.
Journal of Surgical Oncology 09/2010; 102(3):249-55. · 2.64 Impact Factor
[show abstract][hide abstract] ABSTRACT: To investigate the clinicopathological features and immunophenotype of centrally necrotizing carcinoma (CNC) of the breast to ascertain its relationship to basal-like phenotype and its prognosis.
The clinical and pathological characteristics of 33 CNCs were reviewed. Immunohistochemical study of oestrogen receptor, progesterone receptor, HER2, cytokeratin (CK) 8/18, high-molecular-weight CK (34betaE12), CK5/6, CK14, CK17, smooth muscle antigen, p63, vimentin and epidermal growth factor receptor was performed. The striking feature of CNC was a central, necrotic or acellular zone surrounded by a ring-like area of viable tumour cells. The central zone showed three morphological types: predominance of coagulative necrosis (21 cases), predominance of fibrosis and scar tissue (nine cases) and infarction (three cases). Tumour cells displayed invasive ductal carcinoma of high grade. The expression rate of basal-like markers was higher than that of myoepithelial markers (87.9% versus 46.2%). Basal-like subtype was shown by 63.6% of cases. The expression rate of CK5/6 (90.5%) was highest among basal-like markers. Follow-up data of 19 patients were available. Median progression-free survival was 15.5 months. In 12 patients (63.2%), local recurrence and/or distant metastasis developed (median time to recurrence and/or metastasis, 14.0 months).
CNC has distinctive morphological features, which mostly exhibit a basal-like immunophenotype and poor prognosis. CNC is a typical representative of basal-like breast cancer.
[show abstract][hide abstract] ABSTRACT: Systemic anaplastic large cell lymphoma (ALCL) can be divided into two subgroups, anaplastic lymphoma kinase (ALK)-positive and ALK-negative, based on the expression of ALK protein. Expression of this protein is due to genetic alterations of ALK at 2p23. Overall, observations on ALK protein, ALK mRNA, ALK-associated genetic alterations and their relationships, to one another are not often reported in the literature. In this study, we investigated the expression of ALK protein, mRNA and fusion transcripts involving ALK and their relationships in ALCL and analyzed formalin-fixed, paraffin-embedded tissues. Forty-five human cases were analyzed with immunohistochemistry for the ALK protein and RT-PCR for ALK mRNA and seven kinds of ALK involved fusion transcripts. Our results showed that the expression of ALK protein, ALK mRNA and ALK fusion transcripts were significantly related to one another (P < 0.01). Consistent with the expression of ALK protein, patients presenting with ALK mRNA or ALK involved fusion transcripts were significantly younger than those lacking ALK gene alteration (P < 0.01). This study demonstrates expression of both ALK protein and ALK mRNA are positively correlated with expression of ALK-associated fusion transcripts. Combined detection of ALK protein, ALK mRNA and ALK fusion transcripts can complement each other to aid in the diagnosis of ALCL.
[show abstract][hide abstract] ABSTRACT: Chromosomal instability (CIN) and microsatellite instability (MSI) are two major causes of colorectal cancers. Recently, a percentage of colorectal cancers were found to be neither CIN nor MSI. This study was performed to explore whether microsatellite- and chromosomal-stable (MACS) colorectal cancers comprise a substantially distinct subtype.
Sixty-nine sporadic colorectal cancers were classified into three subsets according to ploidy and microsatellite instability status: CIN+, MSI+, and MACS. Clinicopathologic, genetic, and epigenetic differences among these three groups were investigated by immunohistochemical analysis of p53, APC, hMLH1, and BAX and methylation study of pl4ARF, hMLH1, p161NK4a MGMT, and MINT1 with methylation-specific polymerase chain reaction.
The 69 cases included 49 CIN+, 7 MSI+, and 13 MACS. MACS were found to differ from CIN+ and MSI+ in three aspects. The clinicopathologic features of MACS were similar to MSI+ but distinguished from CIN+. Comparatively, MACS preferred proximal location and poor differentiation (p < 0.05). An immunohistochemical study demonstrated that MACS had a lower rate of loss of hMLH1 or BAX protein than MSI+ and less loss of APC protein than CIN+. In an epigenetic aspect, both MACS and MSI+ had a high rate of CpG island methylator phenotype (46.2 and 42.9%). However, they differed in the presence of hMLH1 methylation (7.7 vs 57.1%, p < 0.05). Otherwise, compared with CIN+, MACS had a more frequent CpG island methylator phenotype and MINT1 methylation (p < 0.05) and relatively more common p161IK4a methylation with marginal significance (p= 0 .056).
MACS sporadic colorectal cancers may compose a unique phenotype with distinct clinicopathologic and molecular characteristics.
International Journal of Colorectal Disease 04/2008; 23(4):365-73. · 2.24 Impact Factor
[show abstract][hide abstract] ABSTRACT: ObjectiveThe membrane-linking protein Ezrin is highly expressed in several types of human cancers. The correlations between its immunoreactivity
and histopathological data as well as patient outcome have previously been shown. However, the role played by Ezrin in the
carcinogenesis, progression and metastasis of primary sporadic colorectal carcinoma (SCRC) is still under investigation. This
study assessed Ezrin protein expression in a series of clinical specimens.
MethodsImmunohistochemical analysis was used to characterize patterns of Ezrin expression in 132 cases of SCRC, including 74 metastatic
cases and 58 non-metastatic cases and 43 adjacent normal colorectal mucosa.
Results(1) The expression rate of Ezrin in SCRC (79.5%) was significantly higher than in adjacent normal colorectal mucosa (11.6%)
(P < 0.001); (2) The total expression rate of Ezrin was 86.5% and 70.7% in metastatic group and non-metastatic group, respectively
(P = 0.026); the membrane expression rate of Ezrin was 31.1% and 6.9% in the two groups, respectively (P < 0.01); (3) There was no relationship between the expression of Ezrin with age, gender, tumor size, location, degree of
differentiation and invasive depth; (4) In the cases with followed-up data, univariate analysis demonstrated that Ezrin expression
and its membrane translocation was correlated with worse patient’s disease-free survival (DFS) (P
uni < 0.05).
ConclusionEzrin was expressed in the majority of SCRC and associated with adverse prognostic factors. The increase expression and the
switch of Ezrin localization from the cytoplasm to the membrane were closely correlated with metastasis in SCRC. It might
be served as an important parameter for determining tumor biological behavior.
The Chinese-German Journal of Clinical Oncology 05/2007; 6(3):P232-P236.