Lymphoepithelioma-like carcinoma of the prostate
Department of Pathology and Surgery, Faculty of Medicine, University of Cordoba, E-14004 Cordoba, Spain.Human pathology (Impact Factor: 2.77). 04/2009; 40(7):982-7. DOI: 10.1016/j.humpath.2008.12.008
In this report, we summarized the clinicopathologic features of 5 cases of lymphoepithelioma-like carcinoma of the prostate, a rare variant of prostate cancer characterized by a malignant epithelial component densely infiltrated by lymphoid cells. In all 5 patients, there were obstructive symptoms and elevated prostate-specific antigen; one patient had also hematuria. Their ages ranged from 69 to 82 years (mean age, 76 years). The initial diagnosis of lymphoepithelioma-like carcinoma of the prostate was made on transurethral resection in 3 cases and radical prostatectomy in 2 others. In one case the diagnosis of lymphoepithelioma-like carcinoma admixed with conventional acinar adenocarcinoma was an unexpected finding at time of transurethral resection for benign prostatic hyperplasia. Three patients had clinical stage T3 tumors and another had stage T4 disease; stage T1b was present in the remaining case. Microscopically, all tumors contained lymphoepithelioma-like carcinoma, which comprised 10% to 90% of the entire tumor. All cases were associated with adenocarcinoma, either as the sole pattern in 5 cases or with an additional ductal component in 3 cases. One case had additional features of adenosquamous carcinoma. The lymphoepithelioma-like carcinoma component was characterized by indistinct cytoplasmic borders and a syncytial growth pattern. The stroma was densely infiltrated by lymphoid cells admixed with some plasma cells and neutrophils; one case had a prominent infiltration of eosinophils. Immunohistochemical staining demonstrated that lymphoepithelioma-like carcinoma was positive for prostate-specific antigen, prostate acid phosphatase, alpha-methylacyl coenzyme A racemase, and epithelial membrane antigen; several cytokeratins (AE1/AE3, 7, 8, and 20 [rare cells]) were also immunoreactive. The mean Ki-67 labeling index was 53% (range, 40%-70%), and the p53 expression in all cases was low (10%-20%). The lymphoid component was mainly composed of T with a minor subset of B cells, admixed with some dendritic cells and histiocytes as seen by S100 and CD68 immunoreactivity. Latent membrane protein 1 immunostaining and in situ hybridization for Epstein-Barr virus were negative in all 5 lymphoepithelioma-like carcinoma cases. DNA ploidy of lymphoepithelioma-like carcinoma tumors gave DNA histograms with aneuploid peaks. DNA ploidy of the concurrent adenocarcinoma gave DNA aneuploid peaks except in one DNA diploid case. Four patients died of disease from 8 to 26 months; one patient was lost to follow-up. In summary, lymphoepithelioma-like carcinoma of the prostate arise in aggressive prostate cancers at advanced clinical stage. Morphologic recognition and distinction from other prostatic lesions and tumors with prominent lymphoid stroma is critical for its clinical management.
Conference Paper: Introduction to type-2 fuzzy logic systems[Show abstract] [Hide abstract]
ABSTRACT: This paper introduces a robust fuzzy logic system, one that can handle rule uncertainties. We make use of type-2 fuzzy sets for this purpose. The development of a type-2 fuzzy logic system has led to a new operation that we call type-reduction. In the course of this development, we also study set operations on type-2 sets, properties of membership grades of type-2 sets, type-2 relations and their compositions, and defuzzification
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ABSTRACT: Lymphoepithelioma-like carcinoma of the bladder is an uncommon neoplasm, of which 49 cases have been described in the English literature, none of which has been studied for p53 protein expression. We studied three muscle-infiltrating cases of this tumor using immunohistochemical, in situ hybridization and polymerase chain reaction (PCR) methods. The three cases were positive for epithelial markers and negative for lymphoid antigens in the tumoral syncytial areas. The intensive infiltrate of small cells was negative for epithelial and positive for lymphoid markers. This population was mainly made up of cytotoxic T-lymphocytes, positive for TIA-1. p53 protein was intensely positive in more than 90% of the epithelial component nuclei, being negative in the lymphoid cells. PCR study did not show mutations on p53. Both lymphocytes and epithelium were negative for Epstein-Barr virus markers, such as the latent membrane protein and EBER (Epstein-Barr-encoded RNA). The prognosis was very good after radiotherapy and chemotherapy treatment, preserving the bladder despite the muscle infiltration. The presence of an intense cytotoxic T-lymphocyte population may be related to this good prognosis. Both aspects, p53 protein status and T-lymphoid population, had never been studied before in bladder lymphoepithelioma-like carcinoma.
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