Myopathy of the Pipping Muscles, Hepatosis Dietetica, and Cataracts in Emu Chicks (Dromaius Novaehollandiae)

Seven emu chicks (Dromaius novaehollandiae) from a farm with poor hatchability (16-18%) and increased neonatal mortality were presented for necropsy with a history of death at or within a few days after hatching. Macroscopic examination revealed subcutaneous edema and hemorrhages and swelling of the pipping muscles in the proximal neck (71%), pale liver with hemorrhages (71%), noninternalized residual yolk sac (86%) and anasarca (14%). Histologically, the most remarkable findings were necrosis of the musculus complexus (100%) of the pipping muscles, as well as myocardial necrosis and mineralization (29%). Liver contained severe multifocal hepatocellular necrosis and hemorrhages (57%), and both eyes exhibited swollen and vacuolated lenticular fibers in 5 chicks (100%) in which the eyes were examined. The lesions observed here are suggestive of a nutritional deficiency. The deficiency was confirmed by finding low levels of vitamin E in the liver, and vitamin E and vitamin A levels in the feed.

Overexpression of Ephrin A3 Receptor in Canine Prostatic Carcinoma

Ephrin A3 (EphA3), a member of the ephrin receptor tyrosine kinase family, is involved in a variety of functions in normal cells, especially during embryonic development, and alterations in its expression profile have been observed in several human cancers. However, there are no reports of the expression of EphA3 in normal, hyperplastic or neoplastic canine prostate tissue or in other types of canine tumours. Six normal, 15 hyperplastic and 21 neoplastic canine prostates were examined immunohistochemically with a polyclonal antibody specific for human EphA3. The percentage of positive cells in all prostatic carcinomas was increased, with a mean of 89.28 ± 5.18% compared with normal (9.17 ± 6.72%) and hyperplastic prostates (20.00 ± 8.28%). EphA3 expression was not correlated with the histological subtypes of prostate cancer or with the Gleason score. The increase in EphA3 expression in canine prostatic carcinomas suggests the involvement of this receptor in prostatic carcinogenesis and its potential use as a target for new therapeutic strategies.

Abstract P5-08-17: A study of c-Jun N-terminal kinase (JNK) and c-Jun as biomarkers in early breast cancer

Background

The AP-1 transcription factor c-Jun is a key downstream target of c-Jun N-terminal kinase (JNK) which mediates intracellular signalling associated with a variety of cellular functions. The JNK pathway in breast cancer (BC) can be attenuated via loss of function mutations in MAPK kinases as well as via PIK3CA mutations; however, there is contradictory information about the role of JNK pathway and its clinical implications in BC.

Methods

In the current study, the clinicopathological implications of JNK and JUN mRNA expressions were evaluated in multiple independent BC datasets: a) Training-set (Uppsala cohort; n=249), b) Test-set (human genome atlas database; n=540), c) External validation-set (METABRIC cohort; n=1952) and d) Multicentre pooled databases (n=5530). The clinicopathological associations of their phosphorylated proteins (p-Jnk and p-c-Jun) were assessed in the Nottingham Tenovus Primary BC Series (n= 1650) and in an ER negative cohort (n=450).

Results

Both JNK and c-JUN mRNA high expressions were significantly associated with PAM50-Luminal A and ER+/HER2-/low proliferation molecular BC subtypes, tubular/lobular types, and integrative molecular clusters 4 (IntClust.4), ps<0.001. Whereas BC that had both low JNK and c-JUN mRNA, were significantly associated with large tumour size, high grade, absence of hormonal receptors (HR), HER2 overexpression, PAM50 HER2 and PAM50 Basal molecular subtypes, and IntClust.1, 9 and 10 BCs; ps<0.001.

There was a significant positive correlations between p-Jnk and p-c-Jun protein levels (p<0.0001), however; our data suggested that differential p-Jnk/p-c-Jun expression may influence BC phenotypes. BC with p-Jnk-ve/p-c-Jun-ve were associated with the most aggressive phenotypes including largest tumour size, highest grade, lympho-vascular invasion, absence of HR, basal-like-phenotype, HER2 overexpression, and loss of double strand , single stand and base excision DNA repair proteins (ps<0.0001). In addition p-Jnk-ve/ pc-Jun-ve phenotype was associated with the lowest levels of p-38, ATF2, and p-ATF2; ps<0.001. Interestingly, low levels of either c-JUN-mRNA or pc-Jun protein, was associated with, PAM50-luminal B, epithelial mesenchymal transition and TP53 mutation and loss of its downstream proteins such as MDM2, MDM4, Bcle2 and p21; ps<0.05.

JNK+ (mRNA and p-Jnk) and c-JUN+ (mRNA and p-c-Jun) individually were associated with prolonged BC specific survival (ps<0.001). Multivariate cox regression models that included other validated prognostic factors and therapies revealed that c-JUN-mRNA (Uppsala: p=0.005 and METABIRIC: p=0.036) and p-c-Jun (HR: 0.69; 95% CI = 0.55-0.88; p=0.002) were independently associated with clinical outcome. Furthermore, in ER+ high risk BC, exposure to tamoxifen was associated with decreased risk of death from BC in those patients with p-c-Jun-ve BC (HR: 0.65; 95% CI: 0.45-0.95; p=0.025).

Conclusion

JNK and c-JUN mRNA as well as p-Jnk and p-c-Jun protein levels are associated with luminal BC, with p-c-Jun being found to be an independent prognostic factor. The interaction between p-Jnk, p-c-Jun and TP53 mutation could predict response to endocrine therapy in ER+ BC. The role of the transcriptionally active form of c-JUN warrants further investigation with regard to its role in BC.

Citation Format: Palmieri C, Rudraraju B, Giannoudis A, Moore D, Shaw J, Chan S, Ellis IO, Caldas C, Coombes RC, Carroll JS, Ali S, Abdel-Fatah TMA. A study of c-Jun N-terminal kinase (JNK) and c-Jun as biomarkers in early breast cancer. [abstract]. In: Proceedings of the Thirty-Eighth Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2015 Dec 8-12; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2016;76(4 Suppl):Abstract nr P5-08-17.

Abstract OT2-01-06: Phase 2 open label, multinational, randomized, parallel design study investigating the efficacy and safety of GTx-024 on metastatic (MET) or locally advanced (LA) ER+/AR+ breast cancer (BC) in postmenopausal (PM) women

Background: Historically, androgens have been utilized for the treatment of BC as the androgen receptor (AR) is the most highly expressed steroid receptor (∼95% in estrogen receptor positive (ER+), ∼50% in ER negative). However, steroidal androgens often exhibit virilizing side effects, thus limiting clinical use. A non-steroidal, tissue-selective, AR modulator (SARM), GTx-024, offers a targeted approach of AR activation in ER+/AR+ BC without virilization or estrogenic effects. A previous Phase 2 study of 9 mg GTx-024 in MET ER+ BC demonstrated proof-of-concept, with 6/17 ER+/AR+ patients (pts) exhibiting clinical benefit (CB) following 6 months (m) of treatment. Increasing the dose to 18 mg has the potential for greater efficacy without compromising safety.

Trial Design: Open label, multinational, randomized, parallel design Phase 2 study to assess the efficacy and safety of GTx-024 in PM ER+/AR+ BC. Pts will be randomized to receive GTx-024, 9 mg or 18 mg orally (PO) daily. Therapy continues until disease progression. Pts achieving a CB can be treated for 12 m following the initiation of study treatment; those demonstrating continued CB are offered continuation in a safety extension study under a separate protocol.

Eligibility Criteria:

Inclusion: Informed consent, female, ≥18 years (yr), PM, MET or LA ER+ (≥1% staining) BC, HER2 negative, ≥1 prior hormonal treatment for BC (≥6 m response for MET; ≥3 yr response for adjuvant), provide archived tumor tissue for AR determination, measurable or bone-only disease, evidence of PD within 30 days (d), ECOG 0 or 1.

Exclusion: >1 prior chemotherapy regimen for MET, uncontrolled CNS metastases, radiotherapy ≤14d prior to enrollment, major surgery ≤28d prior to enrollment, currently receiving hormone replacement, hepatitis B/C positive, HIV positive, another active cancer.

Specific Aims: Primary endpoint: proportion of AR+ pts in each arm achieving a CB response (CBR) at 24 weeks (wks). CBR defined as pts with a complete response (CR), partial response (PR), or stable disease (SD); per modified RECIST 1.1. Secondary endpoints: objective response rate, progression free survival, time to progression, and duration of response.

Statistical Methods: Simon's two-stage (optimal) design will be used to assess primary efficacy, requiring up to 88 evaluable pts; i.e., pts with centrally confirmed AR+ who receive at least one dose of study drug. The trial will test for an unacceptably low CBR of ≤10% versus a CBR ≥30%. There is no intent to statistically compare the two dose arms, but to determine whether either or both doses result in an acceptable CBR.

Target Accrual: Up to 118 pts will be enrolled. The first stage will be assessed in each arm among the first 18 evaluable pts. If at least 3/18 exhibit CB at 24 wks, then the arm will proceed to the second stage of recruitment up to a total of 44 pts. Otherwise, the arm will be discontinued for lack of efficacy.

Trial Information: www.gtxinc.com

Citation Format: Overmoyer B, Rugo H, Schwartzberg L, Palmieri C, Taylor R, Hancock M, Small S, Johnston MA. Phase 2 open label, multinational, randomized, parallel design study investigating the efficacy and safety of GTx-024 on metastatic (MET) or locally advanced (LA) ER+/AR+ breast cancer (BC) in postmenopausal (PM) women. [abstract]. In: Proceedings of the Thirty-Eighth Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2015 Dec 8-12; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2016;76(4 Suppl):Abstract nr OT2-01-06.

Abstract OT2-01-07: A phase 2 open label, multi-center, multinational study investigating the efficacy and safety of GTx-024 on advanced, androgen receptor-positive triple negative breast cancer (AR+ TNBC)

Background: The androgen receptor (AR) is the most highly expressed steroid receptor in breast cancer (BC) with expression seen in up to 95% of estrogen receptor positive (ER+) and up to 50% of ER negative disease. Historically, steroidal androgens exhibited virilizing side effects, thus limiting clinical use. In TNBC, the expression of AR and androgen synthesizing enzymes is associated with lower proliferation, lower tumor grade, better overall survival, and more favorable clinical outcomes as compared to those patients with TNBC not expressing AR. Data from two trials targeting AR in TNBC indicates low level but encouraging clinical activity. A non-steroidal, tissue-selective, AR modulator (SARM), such as GTx-024, offers a targeted approach of AR activation in AR+ TNBC without virilization or estrogenic effects.

Trial Design: Open label, multicenter, multinational, Phase 2 study for the treatment of advanced or metastatic TNBC. Subjects will receive GTx-024, 18 mg orally (PO) daily, continued until evidence of disease progression or toxicity. Subjects whose tumors demonstrate Clinical Benefit (CB) will be treated on study drug until progression.

Eligibility Criteria:

Inclusion: Female, ≥18 years old, confirmed AR+ (≥10% staining) TNBC (confirmed by medical history), up to 1-2 prior chemotherapy regimens, available archived tumor tissue, measurable or bone-only disease, ECOG 0 or 1, with prior toxicities from chemotherapy resolved.

Exclusion: Life expectancy <4 months, uncontrolled CNS metastases, radiotherapy ≤14 days prior to enrollment, active hepatitis, HIV positive, prior treatment with anti-androgens, testosterone or testosterone-like agents, or estrogens or megesterol acetate, or prior treatment for a different cancer (other than BC or non-melanoma carcinoma of the skin) within the past 2 year

Specific Aims: The primary aim is to measure the proportion of AR+ subjects with CB at 16 weeks; defined as subjects with a complete response (CR), partial response (PR), or stable disease (SD); per modified RECIST 1.1. Secondary endpoints include: objective response rate, progression free survival, and time to progression.

Statistical Methods: Simon's two-stage (optimal) design will be used to assess primary efficacy, requiring up to 41 evaluable subjects; i.e., subjects with centrally confirmed AR+ who receive at least one dose of study drug. The first stage will be assessed among the first 21 evaluable subjects. If at least 2/21 achieve CB per modified RECIST 1.1 at 16 weeks, then the trial will proceed to the second stage of recruitment of up to a total of 41 subjects in the evaluable subset of the Full Analysis Set. Otherwise, the trial will be discontinued for lack of efficacy. The trial will test for an unacceptably low CBR of ≤5% versus a CBR more consistent with ≥20%.

Target Accrual: Up to 55 subjects will be enrolled.

Trial Information: www.gtxinc.com

Citation Format: Rugo H, Overmoyer B, Schwartzberg L, Palmieri C, Taylor R, Hancock M, Small S, Johnston MA. A phase 2 open label, multi-center, multinational study investigating the efficacy and safety of GTx-024 on advanced, androgen receptor-positive triple negative breast cancer (AR+ TNBC). [abstract]. In: Proceedings of the Thirty-Eighth Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2015 Dec 8-12; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2016;76(4 Suppl):Abstract nr OT2-01-07.

Abstract P5-15-07: Knowledge of oncotype Dx recurrence score increases confidence and concordance in adjuvant decisions of U.K. oncologists

Introduction

The addition of Oncotype Dx Recurrence Score (RS) to the assessment of patients with ER positive, HER2 negative, node negative breast cancer has led to a reduction in the use of adjuvant chemotherapy. However, crude measurement of this reduction masks a more complex scenario. Prior to the introduction of routine Oncotype DX testing by NHS England, we wished to explore in more detail the potential impact of the knowledge of the RS on the therapeutic discussion. This study analyses the impact of RS on the adjuvant therapy recommendations within a UK Cancer Centre. In particular, it examines how the degree of certainty the oncologist has about the best option changes with knowledge of RS and how this influences concordance of decision making between oncologists.

Methods

A panel of five breast oncologists reviewed 50 consecutive cases, collected from November 2012 until November 2014, across two hospitals. Oncologists allocated each case to one of four treatment categories: chemotherapy recommended (CRec), chemotherapy discussed with a bias towards recommended (CDis), chemotherapy discussed with a bias toward endocrine therapy alone (EDis) or endocrine therapy only advised (ERec). The cases were analysed blindly and in random order without and with RS . The degree to which knowledge of RS altered treatment recommendation was analyzed. Other outcomes included the proportion of patients who were scored ERec compared with any other outcome, the trend towards definitive recommendations, the impact of RS on concordant decision making and the degree to which outcome was stratified by RS result. Chi squared and Spearman's coefficient statistical tests were used in analysis.

Results

Knowledge of the RS altered the recommended treatment category in 66.7% of cases (p<0.001).

Alterations in treatment recommendations in response to Oncotype Recurrence Score in addition to pathological parameters CRec (n)CDis (n)EDis (n)ERec (n)Without RS2% (1)40% (20)52% (26)6% (3)With RS12% (6)16% (8)26% (13)46% (23)

Overall, RS correlated significantly with treatment recommendation. Oncologists were confident to recommend endocrine therapy alone in 46% of patients when RS was known compared with only 6% of patients without RS. Complete concordance between oncologists increased with the knowledge of RS from 14% to 64%.

Conclusion

Discussion of adjuvant chemotherapy with patients who have ER positive, HER2 negative, node negative breast cancer can be complex and, at times, confusing for the patient, leading to increased distress. This study shows that, in addition to the previously recognised reduction in overall use of chemotherapy, the knowledge of the RS increased the proportion of patients for whom the oncologist felt confident in making a firm treatment recommendation. An added benefit was to increase concordance between different oncologists compared to that achieved when relying on standard pathological features.

Citation Format: Kiernan T, Olsson-Brown AC, Innes H, Holcombe C, Thorp N, O'Hagan J, Wong H, Palmieri C, O'Reilly S. Knowledge of oncotype Dx recurrence score increases confidence and concordance in adjuvant decisions of U.K. oncologists. [abstract]. In: Proceedings of the Thirty-Eighth Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2015 Dec 8-12; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2016;76(4 Suppl):Abstract nr P5-15-07.

A phase II trial of low-dose estradiol in postmenopausal women with advanced breast cancer and acquired resistance to aromatase inhibition

BACKGROUND

High-dose oestrogen (HDE) is effective but toxic in postmenopausal women with advanced breast cancer (ABC). Prolonged oestrogen deprivation sensitises BC cell lines to estrogen and we hypothesised that third-generation aromatase inhibitors (AIs) would sensitise BCs to low-dose estradiol (LDE).

METHODS

A single-arm phase II study of LDE (2 mg estradiol valerate daily) in postmenopausal women with estrogen receptor-positive (ER+) ABC. The primary end-point was clinical benefit (CB) rate. If LDE was ineffective, HDE was offered. If LDE was effective, retreatment with the pre-LDE AI was offered on progression.

RESULTS

Twenty-one patients were recruited before the trial was closed early due to slow accrual; 19 were assessable for efficacy and toxicity. CB was seen in 5 in 19 patients (26%; 95% confidence interval 9.1-51.2%), all with prolonged SD (median duration 16.8 months; range 11.0-29.6). Treatment was discontinued for toxicity in 4 in 19 patients (21%) and 8 in 11 women without hysterectomy experienced vaginal bleeding (VB). After primary LDE failure, three patients received HDE and one achieved a partial response (PR). Following CB on LDE, four patients restarted pre-LDE AI and three achieved CB including one PR. Those with CB to LDE had a significantly longer duration of first-line endocrine therapy for ABC than those without (54.9 versus 16.8 months; p < 0.01) CONCLUSION: LDE is an effective endocrine option in women with evidence of prolonged sensitivity to AI therapy. LDE is reasonably well tolerated although VB is an issue. Re-challenge with the pre-LDE AI following progression confirms re-sensitisation as a true phenomenon.

Proposal of Gleason-like grading system of canine prostate carcinoma in veterinary pathology practice

Gleason grading - the most useful predictor of prognosis for prostate cancer in men - was updated at a 2005 consensus conference by the International Society of Urological Pathology. Since Gleason-like growth patterns have been recognised in dogs, this study aimed to apply the modified Gleason grading to 45 canine prostate carcinomas. A single primary growth pattern was observed in 28 cases, a secondary pattern in 11 cases and a tertiary pattern in 6 cases. Cribriform, solid and small acinar/ductal were the most common primary, secondary and tertiary morphological patterns, respectively. The highest Gleason score (GS10) was obtained in 46.7% of cases. Nine of 14 metastasizing cases were classified as GS10. Gleason pattern 5 was present in 33 of cases. This study suggests that the modified Gleason grading, based on specific histological growth patterns existing in canine prostate carcinomas, may be accepted as a grading system for histopathology in the practice settings in order to complete the clinical assessment for the best management of the patient.

Prognostic and predictive value of ERβ1 and ERβ2 in the Intergroup Exemestane Study (IES)-first results from PathIES†

BACKGROUND

Intergroup Exemestane Study (IES) was a randomised study that showed a survival benefit of switching adjuvant endocrine therapy after 2-3 years from tamoxifen to exemestane. PathIES aimed to assess the potential prognostic and predictive value of ERβ1 and ERβ2 expression in primary tumours in order to determine benefit in the two treatment arms.

PATIENTS AND METHODS

Primary tumour samples were available for 1256 patients (27% IES population). ERβ1 and ERβ2 expression was dichotomised at the median IHC score (high if ERβ1 ≥ 191, ERβ2 ≥ 164). Hazard ratios (HRs) were estimated by multivariable Cox proportional hazards models adjusting for clinicopathological factors. Treatment effects with biomarker expressions were determined by interaction tests. Analysis explored effects of markers both as a continuous variable and with dichotomised cut-offs.

RESULTS

Neither ERβ1 nor ERβ2 were associated with disease-free survival (DFS) or overall survival (OS) in the whole cohort. In patients treated with continued tamoxifen, high ERβ1 expression compared with low was associated with better DFS [HR = 0.38:95% confidence interval (CI) 0.21-0.68, P = 0.001]. DFS benefit of exemestane over tamoxifen (HR = 0.40:95% CI 0.22-0.70) was found in the low ERβ1 subgroup (interaction P = 0.01). No significant difference with treatment was observed for ERβ2 expression in either DFS or OS.

CONCLUSION

In the PathIES population, exemestane appeared to be superior to tamoxifen among patients with low ERβ1 expression but not in those with high ERβ1 expression. This is the first trial of its kind to report a parameter potentially predicting benefit of an aromatase inhibitor when compared with tamoxifen and an independent validation is warranted.

First description of adiaspiromycosis in an Eurasian otter (Lutra lutra) in Italy

Adiaspiromycosis is a pulmonary disease caused by the inhalation of the ubiquitous fungus Emmonsia spp., a common soil inhabitant. Information about the replication and dissemination of the fungus from the primary site is lacking. Members of the Family Mustelidae seem to be highly susceptible to this infection, which has been previously reported in otters (Lutra lutra) in Czech Republic/Slovakia, Finland and in the UK. In many cases, Emmonsia‑associated lesions have also been reported as incidental findings during necropsies of otherwise healthy animals. A road‑killed male Eurasian otter was submitted for the post‑mortem examination on 21st December 2009 at the Veterinary Pathology Unit of the Faculty of Veterinary Medicine of Teramo, as part of the RECAL [RECovery and post‑mortem Analysis of Eurasian otters (Lutra lutra) in the National Park of Cilento, Vallo di Diano and Alburni (Salerno, Italy), and surrounding areas] project. Histologically, multifocal round structures with a PAS‑positive thick tri‑laminar wall and a central basophilic granular mass were observed within the alveoli. The adiaspores were surrounded by a severe granulomatous reaction with high number of macrophages, multinucleated giant cells, eosinophils, neutrophils and fibroblasts. Numerous multifocal cholesterol granulomas were observed close to those fungal‑induced. To the best of our knowledge, this is the first description of adiaspiromycosis in an Eurasian otter in Italy.

Bilateral Malignant Seminomas in Two Unrelated, Aged Trumpeter Hornbills (Bycanistes buccinator)

Seminomas occur infrequently in birds. Two cases of bilateral malignant seminomas in unrelated trumpeter hornbills (Bycanistes buccinator) are described. Case 1 was a 22-year-old trumpeter hornbill submitted for necropsy because of sudden death at a zoo in California. Postmortem examination revealed multiple masses within the body cavity, 2 of which replaced both testes. Case 2 was a 19-year-old trumpeter hornbill at a zoo in North Carolina that underwent exploratory surgery for a suspected gastrointestinal obstruction. Both testes were diffusely enlarged, compressing and replacing the adjacent kidneys. In both birds, the masses were composed of discrete, round to polyhedral cells, typical of seminomas. Examination of the ancestry of the hornbills showed they were unrelated to each other, suggesting a potential predisposition for these birds to develop seminomas.

Pathological characterization of primary splenic myxoid liposarcomas in three dogs

Non-angiomatous-non-lymphomatous sarcomas (NANLs) represent 23%-34% of canine primary splenic sarcomas. Splenic liposarcomas account for 2%-6% of NANLs but myxoid variants are rarely reported and information on their behaviour is fragmentary. An 8-year-old male crossbreed (case 1), a 12-year-old female French bulldog (case 2), and an 11-year-old crossbreed (case 3) underwent splenectomy after the detection of a splenic nodule. Histology, histochemistry, immunohistochemistry, and transmission electron microscopy (TEM) were performed. Bundles of spindle-to-polygonal cells containing occasional cytoplasmic oil-red-O positive vacuoles embedded in an Alcian blue-positive extracellular matrix were observed. Aggregates of round cells were detected in cases 1 and 3. All tumours were vimentin positive and actin, desmin, Factor VIII, and S100 negative. The TEM evidenced different maturational stages of adipose cells (lipoblasts, intermediate, and undifferentiated). All the cases developed hepatic metastases and were euthanized. Disease free interval was 2 months in cases 1 and 3, and 21 months in case 2. The presence of a neoplastic embolus in case 1 and areas of round cell differentiation in cases 1 and 3 represented the sole prognostic indices.

Different Growth Patterns of Canine Prostatic Carcinoma Suggests Different Models of Tumor-Initiating Cells

Controversies remain regarding the cell type from which human prostate cancer originates, and many attempts have been made to identify the cellular origin of canine prostate cancer but without definitive proof. This study aims to evaluate the expression of luminal (androgen receptor [AR], cytokeratin [CK]8/18) and basal (CK14, CK5) cell markers in different histologic subtypes of canine prostatic carcinoma (PC) and to suggest the most likely tumor-initiating cells. Normal prostates (n = 8) were characterized by AR+CK8/18+ luminal cells and few CK5+ basal cells, while CK14 was absent. Similar pattern was observed in all 35 prostates with benign prostatic hyperplasia, except few scattered CK14+ basal cells in 13 samples (37.14%). AR was localized in the nucleus of both normal and hyperplastic cells. In 34 samples of PC, the following growth patterns were identified: cribriform (44.12%), solid (32.35%), small acinar/ductal (20.59%), and micropapillary (2.94%). Most PCs expressed AR and CK8/18, while CK5 and CK14 expression was observed in 25% and 20% of cases, respectively. AR revealed a variable intracellular distribution, both nuclear and cytoplasmic. Solid PC was characterized by an undifferentiated or aberrant phenotype with a reduced expression of AR and CK8/18, increased number of CK14+ cells, and 7 antigen expression patterns. This study demonstrated a predominance of differentiated luminal cell types in canine prostatic tumors, although the role of basal cells in prostate carcinogenesis should also be considered. Moreover, few scattered CK5+ cells in AR+CK8/18+ tumors identified the existence of intermediate cells, from which neoplastic transformation may alternatively commence.

NEOCENT: a randomised feasibility and translational study comparing neoadjuvant endocrine therapy with chemotherapy in ER-rich postmenopausal primary breast cancer

Neoadjuvant endocrine therapy is an alternative to chemotherapy for women with oestrogen receptor (ER)-positive early breast cancer (BC). We aimed to assess feasibility of recruiting patients to a study comparing chemotherapy versus endocrine therapy in postmenopausal women with ER-rich primary BC, and response as well as translational endpoints were assessed. Patients requiring neoadjuvant therapy were randomised to chemotherapy: 6 × 3-weekly cycles FE₁₀₀C or endocrine therapy: letrozole 2.5 mg, daily for 18-23 weeks. Primary endpoints were recruitment feasibility and tissue collection. Secondary endpoints included clinical, radiological and pathological response rates, quality of life and translational endpoints. 63/80 patients approached were eligible, of those 44 (70, 95% CI 57-81) were randomised. 12 (54.5, 95% CI 32.2-75.6) chemotherapy patients showed radiological objective response compared with 13 (59.1, 95% CI 36.4-79.3) letrozole patients. Compared with baseline, mean Ki-67 levels fell in both groups at days 2-4 and at surgery [fold change: 0.24 (95% CI 0.12-0.51) and 0.24; (95% CI 0.15-0.37), respectively]. Plasma total cfDNA levels rose from baseline to week 8 [fold change: chemotherapy 2.10 (95% CI 1.47-3.00), letrozole 1.47(95% CI 0.98-2.20)], and were maintained at surgery in the chemotherapy group [chemotherapy 2.63; 95% CI 1.56-4.41), letrozole 0.95 (95% CI 0.71-1.26)]. An increase in plasma let-7a miRNA was seen at surgery for patients with objective radiological response to chemotherapy. Recruitment and tissue collection endpoints were met; however, a larger trial was deemed unfeasible due to slow accrual. Both regimens were equally efficacious. Dynamic changes were seen in Ki-67 and circulating biomarkers in both groups with increases in cfDNA and let-7a miRNA persisting until surgery for chemotherapy patients.

A retrospective analysis of 111 canine prostatic samples: histopathological findings and classification

The purpose of this retrospective study is to evaluate the frequency and further characterize the pathological features of common and uncommon histological lesions in 111 canine prostatic samples. Benign prostatic hyperplasia, suppurative and non-suppurative prostatitis, and prostate cancer were observed individually or in combination in 45, 11, 68 and 50 samples, respectively. Six growth patterns of prostatic carcinoma were differentiated: papillary, cribriform, solid, small acinar/ductal, signet ring, mucinous. In a few cases, perineurial invasion and collagenous micronodules were observed. Lesions considered preneoplastic in men, such as high-grade prostatic intraepithelial neoplasia (HGPIN) and prostatic inflammatory atrophy (PIA), were observed in 27 and 21 histological samples, respectively. This study represents a detailed characterization of the different histological subtypes of canine prostate cancer. The awareness of the unusual patterns might be critical in avoiding diagnostic misinterpretation. The high prevalence of PIA and HGPIN underlines the reasonable chance of their detection in routine biopsy specimens.

Immunohistochemical Expression of Angiogenic Factors by Neoplastic Epithelial Cells Is Associated With Canine Prostatic Carcinogenesis

The dog is the only species, other than humans, in which spontaneous prostatic cancer occurs; therefore, dogs are a valuable model for the study of factors that regulate tumor progression. Angiogenesis is important in the development and spread of a variety of cancers, including prostate cancer. To better define the role of cancer epithelial cells in prostate cancer neovascularization, immunohistochemical staining for angiogenic factors (vascular endothelial growth factor [VEGF], platelet endothelial cell adhesion molecule–1 [PECAM-1], Tie-2, and fibroblast growth factor–2 [FGF-2]) was performed on formalin-fixed, paraffin-embedded tissues from 10 normal prostates, 15 hyperplastic prostates, and 11 prostatic carcinomas from dogs. Normal and hyperplastic epithelial cells were negative for PECAM-1, VEGF, and Tie-2, while the same markers were expressed with a variable intensity of cytoplasmic staining by neoplastic cells. Mild to moderate FGF-2 staining was detected in all normal prostates with less than 10% of positive cells, mainly distributed in the basal layer. The percentage of FGF-2–positive hyperplastic cells was variable, with both basal and secretory cells exhibiting a perinuclear to diffuse cytoplasmic staining. The mean number of positive cells and the intensity of staining were higher in prostatic carcinomas than normal and hyperplastic prostates. Moreover, microvessel density analyzed on PECAM-1–stained slides was increased in prostate cancer compared with normal and hyperplastic prostates. Therefore, prostatic neoplastic cells are capable of simultaneous expression of various angiogenic factors and may increase tumor proliferation and angiogenesis in a paracrine and autocrine fashion.

Cutaneous mucinosis in a strain of brown-egg laying chickens

Cutaneous mucinosis is a cutaneous disorder described in humans, dogs, and rarely cats but never reported in birds. Twenty-six brown egg-laying chickens between ages 43 and 46 weeks had a history of feather loss, scaly, dry skin, weight loss, and decreased egg production. Microscopic findings in the skin included fragmentation of collagen bundles and interstitial, periadnexal, and perivascular dermal accumulation of wispy, mildly basophilic material that was also occasionally observed within the follicular epithelium. A moderate lymphoplasmacytic and heterophilic perivascular dermatitis was also observed. The wispy to granular material was diffusely Alcian blue positive and periodic acid-Schiff negative (consistent with mucin), suggesting a diagnosis of primary or secondary cutaneous mucinosis. The cause of this condition could not be determined.

Expression of β-catenin and mesenchymal markers in canine prostatic hyperplasia and carcinoma

β-catenin is a nuclear signalling molecule that is associated with human prostatic neoplasia and the epithelial-mesenchymal transition (EMT) process. The present study evaluates immunohistochemically the expression of β-catenin and the mesenchymal markers vimentin, desmin, calponin and smooth muscle actin (SMA) in four normal canine prostates and prostate samples from 15 dogs with benign prostatic hyperplasia (BPH) and six with prostatic carcinoma (PC). β-catenin was located on the membrane of normal epithelial cells, while the same marker had both cytoplasmic and membrane expression in hyperplastic cells and a nuclear redistribution in PC. Vimentin-positive luminal cells were observed in two of the 15 cases of BPH and in all PC samples, suggesting the conversion of neoplastic epithelial cells to a mesenchymal type. SMA was consistently negative in PC, but there was mild desmin and calponin immunoreactivity in these lesions. As in men, β-catenin is involved in canine prostatic carcinogenesis, thus further validating the use of this animal model to study human prostatic disease.

Pathological and biochemical studies of mucopolysaccharidosis type IIIB (Sanfilippo syndrome type B) in juvenile emus (Dromaius novaehollandiae)

Mucopolysaccharidosis (MPS) type IIIB was diagnosed in 14 juvenile emus (Dromaius novaehollandiae), ages 3 weeks to 6 months, based on pathological and biochemical analyses. The animals had a history of neurological signs or sudden death; one of the birds with neurological signs and 3 others experienced acute hemoabdomen. Histopathologically, neuronal swelling and vacuolation in the cerebrum, cerebellum, brainstem, and spinal cord (80%-92%); retina (100%); autonomic ganglia of the intestine (71%); gizzard (50%); adrenal gland (27%); and ear (50%) were noted in affected but not healthy emus. Cytoplasmic vacuoles were also observed in the pancreas, liver, intestine, adrenal glands, and kidneys. The intracytoplasmic inclusions were periodic acid-Schiff and Luxol Fast Blue positive, consistent with a storage disease. Foamy macrophages infiltrated the liver, intestine, tunica media of the aorta, and spleen. By transmission electron microscopy, typical lamellated cytoplasmic bodies were detected in neurons of the brain and retina, while electron-dense bodies consistent with glycosaminoglycan inclusions were observed in hepatocytes and/or hepatic macrophages. The livers of the 2 affected emus studied contained large amounts of heparan sulfate, which is suggestive of MPS type III. Compared with normal controls, hepatic and serum α-N-acetylglucosaminidase activity was very low (<8% of control), while other enzyme activities were normal to increased in the 2 affected emus studied. Moreover, affected emus were homozygous for a 2-bp deletion in the NAGLU gene. This study characterizes the pathology of MPS type IIIB in emus, which is one of the rare inborn errors in birds, showing the homology of this condition to Sanfilippo syndrome in humans.

Effects of aromatase inhibitors and body mass index on steroid hormone levels in women with early and advanced breast cancer

BACKGROUND

Aromatase inhibitors (AIs) are central to the management of oestrogen receptor-positive breast cancer in the adjuvant and metastatic setting. Levels of circulating steroid hormones (SHs) were measured in patients established on AIs to investigate: the influence of body mass index (BMI) in both the adjuvant and metastatic setting; the class of AI utilized in the adjuvant setting (steroidal versus non-steroidal); and differences in SH levels between women treated adjuvantly and those receiving a second-line AI for locally advanced/metastatic disease.

METHODS

Plasma levels of androstenedione, 5-androstene-3β,17β-diol, dehydroepiandrosterone, oestradiol and testosterone were measured by radioimmunoassay in women with breast cancer who were receiving AIs in either an adjuvant or a metastatic setting. Differences between mean SH levels by class of AI, BMI, and second-line versus adjuvant therapy were assessed.

RESULTS

Sixty-four women were receiving AI therapy, 45 (70 per cent) in an adjuvant setting and 19 (30 per cent) were taking a second-line AI. There was no significant correlation between BMI and SH levels. However, BMI was significantly higher in the second-line AI cohort compared with the adjuvant cohort (29.8 versus 26.2 kg/m2 respectively; P = 0.026). In the adjuvant setting, patients receiving a steroidal AI had significantly higher levels of all five hormones (P < 0.050). In the second-line AI cohort, oestradiol levels were significantly higher than in the adjuvant cohort (4.5 versus 3.3 pg/ml respectively; P = 0.022). Multivariable analysis adjusted for BMI confirmed the higher residual oestradiol level in the second-line AI group (P = 0.063) and a significantly higher androstenedione level (P = 0.022).

CONCLUSION

Residual levels of SH were not significantly influenced by BMI. However, the significant differences in residual SH levels between the second-line and adjuvant AI cohort is of relevance in the context of resistance to AI therapy, and warrants further investigation.

Heat shock protein 90 is associated with hyperplasia and neoplastic transformation of canine prostatic epithelial cells

Heat shock protein 90 (HSP90) is a molecular chaperone that regulates critical signalling proteins of cancer development and progression. Abnormal levels of HSP90 have been observed in human prostatic carcinoma (PC), with prognostic and therapeutic implications. Since spontaneously arising canine PC is a valuable model for the human disease, the aim of this study was to evaluate the immunohistochemical expression of HSP90 in two normal canine prostates, 17 canine prostates with benign prostatic hyperplasia (BPH) and five canine prostates with PC. HSP90 was expressed in the cytoplasm of epithelial cells in all samples, with a significant increase in labelled cells in PCs. Nuclear labelling was observed occasionally in normal tissue, but was increased in BPH and PC. HSP90 immunoreactivity in preneoplastic lesions (proliferative inflammatory atrophy and prostatic intraepithelial neoplasia) was similar to that in PCs. Increased HSP90 expression in canine PCs suggests the involvement of this molecule in carcinogenesis and tumour progression, supporting HSP90 as a potential target for therapeutic intervention.

Characterization of cytoplasmic hyaline bodies in a hepatocellular carcinoma of a dog

This report describes the morphological and immunohistochemical features of intracytoplasmic inclusion bodies found in a 13-year-old Yorkshire dog with a hepatocellular carcinoma and referred for anorexia, lethargy and mild polydipsia. Fine-needle aspirates of the large abdominal mass revealed high number of pleomorphic neoplastic hepatocytes, containing round to polygonal, well-demarcated, hyaline bodies. Same findings were histologically confirmed on multiple biopsies. Immunohistochemically, the inclusion bodies were negative for alpha-1-antitrypsin, carcinoembryonary antigen, fibrinogen, IgG, IgM, cytokeratins 7, 8, 18, 19, 20. By transmission electron microscopy, the cytoplasmic inclusions were composed of granular homogeneous or reticulated electrondense matrix, enclosed within dilated rough endoplasmic reticulum or remnants of its membranes, consistent with proteinaceous material accumulated within neoplastic hepatocytes due to aberrant protein secretion or transport. This is the first detailed characterization of hyaline cytoplasmic inclusion bodies in canine hepatocellular carcinoma.

Lethal herpesvirosis in 16 captive horned vipers (Vipera ammodytes ammodytes): pathological and ultrastructural findings

Sixteen captive adult horned vipers (Vipera ammodytes ammodytes) were submitted for necropsy examination following a 2-week history of lethargy, anorexia and dyspnoea. Gross lesions included widespread haemorrhage, serosanguineous effusions in the body cavities and multiple pinpoint white to yellow foci in the liver. Microscopically, there was multifocal hepatic coagulative necrosis associated with intranuclear acidophilic inclusion bodies in sinusoidal endothelial cells. Similar endothelial lesions were observed in the myocardium, fat bodies, kidneys and spleen. Transmission electron microscopy revealed numerous virions (100-110 nm) in the nuclei of endothelial cells and intracytoplasmic enveloped virions (140-150 nm) were also found. The gross and histological findings and the ultrastructural features of the intranuclear inclusions and viral particles were consistent with herpesviral infection. To the best of our knowledge, these are the first reported cases of a lethal herpesvirosis in horned vipers and the second report in snakes.

Another patient with 12q13 microduplication

Interstitial duplication of the long arm of chromosome 12 is a rare cytogenetic condition. While several reports describe distal 12q duplication, only one case report of homogeneous, non-mosaic interstitial 12q13 duplication has been documented to date. The authors of that observation proposed that the associated phenotype represented a phenocopy of Wolf-Hirschhorn syndrome [Dallapiccola et al., 2009]. Only a few other recorded patients with deletion 12q13 → 12q21 involved mosaicism. We describe a new patient with homogeneous 12q13 duplication in a 6-year-old girl who, in early infancy, presented with dysmorphic features suggesting Wolf-Hirschhorn syndrome. What is potentially significant about this patient is that her facial phenotype evolved with age, suggesting a different gestalt in older patients.

Immunohistochemical expression of HOXA-13 in normal, hyperplastic and neoplastic canine prostatic tissue

Homeobox genes are known to be examples of the intimate relationship between embryogenesis and tumourigenesis. Specifically, the HOXA13 gene plays a fundamental role in the development of the urogenital tract and external genitalia and in prostate organogenesis. There are no reports on the expression of HOXA13 in normal, hyperplastic or neoplastic canine prostate tissue or in other types of tumours. Six normal, 16 hyperplastic and 12 neoplastic canine prostates were examined microscopically and immunohistochemically with a polyclonal antibody specific for human HOXA13. An immunohistochemical score was generated. HOXA13 was expressed in the cytoplasm of epithelial cells in normal, hyperplastic and neoplastic prostates. The percentage of immunolabelled cells in all prostatic carcinomas (PCs) was greatly increased, with a score of 85.3 (±5.25) compared with normal (2 ± 0.71) and hyperplastic prostates (6.08 ± 2.21). The increase in HOXA13 expression in canine PCs suggests the involvement of this transcription factor in carcinogenesis and promotion of tumour growth.

An open-label study of lapatinib in women with HER-2-negative early breast cancer: the lapatinib pre-surgical study (LPS study)

BACKGROUND

This phase II, open-label, multicentre study aimed to evaluate changes in cell proliferation and biomarkers, as well as efficacy of lapatinib in treatment-naïve patients with HER-2-negative primary breast cancer.

PATIENTS AND METHODS

Patients received 1500 mg lapatinib for 28-42 days before surgery with repeat biopsies and measurements. The primary end point was inhibition of cell proliferation measured by Ki67; the secondary end points included clinical response, adverse events and changes in FOXO3a, FOXM1, p-AKT and HER-3.

RESULTS

Overall, there was no significant reduction in Ki67 with treatment (assessment carried out in 28 of 31 subjects enrolled). However, four patients (14%) showed a reduction in Ki67 ≥50%. Four of 25 patients (16%) had a partial response to treatment judged by sequential ultrasound measurements. Response, in terms of either Ki67 or ultrasound, did not relate to changes in any biomarker assessed at baseline, including the estrogen receptor (ER) and epidermal growth factor receptor (EGFR). However, all four clinical responders were HER-3 positive, as were three of four Ki67 responders.

CONCLUSIONS

Overall, a pre-surgical course of lapatinib monotherapy had little effect on this group of patients; however, in subsets of patients, especially those with HER-3-positive tumors, we observed either reduction in proliferation (Ki67) or tumor size; EGFR/ER status had no impact.

Evidence of sirenian cold stress syndrome in dugongs Dugong dugon from southeast Queensland, Australia

Cold stress syndrome (CSS) is the term used to describe the range of clinical signs and chronic disease processes that can occur in Florida, USA, manatees Trichechus manatus latirostris exposed to water temperatures below 20°C for extended periods. Although no cold-related adverse events have been described in the closely related dugong Dugong dugon thus far, it has been established that they make movements in response to water temperatures lower than about 17 to 18°C. In this study, archive reports for dugong carcasses submitted to The University of Queensland School of Veterinary Science for post mortem examination during 2010 to 2012 were examined. These animals had been recovered from Moreton Bay, southeast Queensland, Australia, and 10 out of 14 fulfilled the criteria for 'potential cold stress cases.' Epidermal hyperplasia and secondary bacterial infection, serous atrophy of pericardial adipose tissue, and multisystem abscessation were features commonly noted in these cases. Water temperature data were correlated with the time of year that carcasses were submitted for examination. Higher numbers of carcasses diagnosed with potential CSS were noted during sustained periods in which water temperature was below 20°C. Given the pattern of increased submission of non-specifically, chronically unwell animals in the colder months and evidence that environmental conditions known to precipitate CSS occur in southeast Queensland, it is probable that, like manatees, dugongs in this area are affected by CSS. Further investigation to confirm and to better characterize the syndrome is recommended to refine management practices and improve treatment of affected animals.

Leishmania Amastigotes in Neoplastic Cells of 3 Nonhistiocytic Canine Tumors

Concurrent leishmaniasis and neoplasia has been reported in dogs. This study describes the presence of the protozoa within the cytoplasm of neoplastic cells in 3 different types of tumors. Leishmania amastigotes were detected by light and transmission electron microscopy and immunohistochemistry in a fibrosarcoma, a T-cell lymphoma, and an adrenocortical adenoma.

Abstract P2-02-03: The Collagen Receptor Endo180: A Metastatic Plasma Marker In Breast Cancer Modulated By Bisphosphonate Treatment

Purpose: To establish whether the collagen remodelling receptor, Endo180, should be given consideration as a useful plasma marker in metastatic breast cancer.

Patients and Methods: Analysis of MCF-7 and MDA-MB-231 cell conditioned medium validated the anti-human (39.10) monoclonal antibody as suitable for the detection of soluble Endo180 in plasma. Eighty-seven breast cancer patients with early primary, locally advanced and metastatic disease were included in the study. Correlations between Endo180, CA 15–3 antigen (MUC1; mucin 1) and bisphosphonate treatment were investigated.

Results: Endo180 was elevated in metastatic compared to early breast cancer (P &lt;.0001) and was able to differentiate locoregional disease and visceral and/or osseous metastasis (P = .0005). In combination CA 15–3 antigen (cut-off: 28 U/mL) and Endo180 (relative plasma level cut-off range: 0.95–1.65) had sensitivity of 94–97% and specificity of 52–68%. Endo180 levels were significantly higher in patients who were treatment naive (2.17 ± 0.82, N = 13) compared to those previously (1.82 ± 0.33, N = 5) or currently (1.37 ± 0.74, N = 24) receiving bisphosphonates (P = .011). In the bisphosphonate naive setting (N = 57) the combination of Endo180 (relative plasma level cut-off range: 0.95–1.65) and CA 15–3 antigen (cut-off: 28 U/mL) had a sensitivity of 87–92% and specificity of 72–79%.

Conclusion: Endo180 is a plasma marker with high sensitivity in metastatic breast cancer that can be modulated by bisphosphonate treatment.

Citation Information: Cancer Res 2012;72(24 Suppl):Abstract nr P2-02-03.

Abstract P2-10-22: Phosphorylation of Steroid Receptor Coactivator 3 (SRC3) at Ser543 is a novel independent prognostic marker in breast cancer

Introduction: Steroid receptor coactivator 3 (SRC3) acts as a coactivator of nuclear receptors including estrogen receptor-alpha (ER). SRC3 has been implicated in the pathogenesis of breast cancer (BC) as well as in resistance to endocrine therapy. SRC3 is phosphorylated at a number of residues following the stimulation of growth factors or hormones. Tyr24 and Ser543 are both phosphorylated upon estrogen stimulation, while Tyr24 is modulated by JNK and Ser543 by both p38 and JNK. To date, the importance and potential role of phosphorylation at these residues has not been explored in BC. In this study we assessed the protein expression of SRC3, pTyr24 and pSer543 and association with clinico-pathological features and outcome in a well defined breast cancer series.

Methods: The expressions of SRC3, pTyr24 and pSer543 were assessed in the Nottingham Tenovus Primary Breast Cancer Series which consists of 1650 cases of primary invasive. SRC3, pTyr24 and pSer543 were correlated with clinico-pathological data as well as outcome.

Results: SRC3 expression was significantly associated with unfavourable clinicopathological features including ER -ve (p = 0.02), PR –ve (p = .038), HER2 overexpression (p &lt; 0.0001), Triple negative phenotype (p = 0.001), high proliferation (p &lt; 0.0001), high histological grade (p &lt; 0.001), and lympho-vascular invasion. On contrast, the expression of pSer543 was significantly associated with a luminal phenotype, well differentiation, low proliferation (low mitotic index, low Ki67 and low SPAG5; p &lt; 0.0001), hormonal receptors (ERα+ve/PR+ve/AR+ve), absence of both ER-B1 and ER-B5 (p &lt; 0.01), high expression of ER-α associated proteins (cyclin D1 and Bcl2; p &lt; 0.0001), high expression of c-jun (p &lt; 0.0001), JNK (p &lt; 0.0001), SRC3 (p &lt; 0.0001), T24 (p &lt; 0.001) and active p53 transcriptional pathways that regulate cell cycle progression and apoptosis (MDM2+ve, MDM4+ve and Bax+ve; p &lt; 0.01) and absence of basal like phenotypes (p &lt; 0.01). The absence of pSer543 was significantly associated with loss of expression of the key DNA repair proteins including XRCC1 (p &lt; 0.0001), BRCA1 (p &lt; 0.0001), ATM (p = 0.008) and TOP2A (p &lt; 0.0001) reflecting a higher risk of genomic instability. Moreover, absence of pSer543 was more common in BC with a triple negative phenotype (p &lt; 0.001). With regard to outcome, no association with outcome based on the expression of SRC3 either with or without tamoxifen was observed. However, expression of pSer543 was associated with significantly longer disease free survival (DFS) (p &lt; 0.00001) and breast cancer specific survival (BCSS) (p = 0.0001). Furthermore, absence of pSer543 was associated with both a shorter DFS (p = 0.007) and BCSS (p = 0.01) in ER+ ve high risk BC. pSer534 was confirmed as an independent prognostic factor after adjustment for endocrine therapy and other validated prognostic factors and absent of pSer534 was associated with a two-fold increased risk of recurrence (HR = 1.9, CI 95%= 1.2–3.1). Data on Tyr24 will also be presented.

Conclusion: Phosphorylation at Ser543 is associated with a luminal phenotype, positive prognostic factors and sensitivity to tamoxifen. Furthermore, it is an independent prognostic factor. pS543 is a novel prognostic marker in BC and warrants further investigation.

Citation Information: Cancer Res 2012;72(24 Suppl):Abstract nr P2-10-22.

Otitis media associated with Cryptosporidium baileyi in a Saker falcon (Falco cherrug)

A 7-week-old male Saker falcon died with a history of severe refractory dyspnoea and respiratory signs. Microscopical lesions included moderate to severe lymphoplasmacytic inflammation of the middle ears, conjunctivae, third eyelids, choanae, salivary glands of the tongue, turbinates, larynx, trachea, syrinx and bronchi. The lesions were associated with variable numbers of Cryptosporidium spp., further confirmed by transmission electron microscopy and in-situ hybridization. Cryptosporidium baileyi was identified by DNA sequence analysis. C. baileyi may therefore be a cause of otitis media in raptors as it is in man. It is most likely that the middle ears of the Saker falcon acquired the infection through the eustachian tubes that originate near the pharynx in the oral cavity. This is the first description of otitis media associated with C. baileyi in a bird or a mammal except man.

Expression of heat shock proteins in premalignant and malignant urothelial lesions of bovine urinary bladder

Abnormal heat shock protein (HSP) levels have been observed in a number of human tumours, where they are involved in all hallmarks of cancer. Since bovine urothelial tumours share striking morphological and biochemical features with their human counterparts, the aim of this study was to evaluate the immunohistochemical levels of Hsp27, Hsp60, Hsp72, Hsp73 and Hsp90 in 28 normal bovine urinary bladders and 30 bovine papillomavirus-positive urothelial tumours (9 in situ carcinomas, 9 low-grade and 12 high-grade carcinomas) and adjacent premalignant lesions obtained from cows suffering from chronic enzootic haematuria, in order to investigate the role of these proteins in the process of urothelial carcinogenesis. A semi-quantitative method was used for the analysis of the results. Western blot analysis was also used to confirm HSP expression in normal controls. All investigated HSPs were expressed in normal bovine urothelium, showing characteristic patterns of immunolabelling throughout urothelial cell layers, which usually appeared to be conserved in urothelial hyperplasia and dysplasia. On the other hand, gradual loss of Hsp27 immunostaining resulted to be significantly associated with increasing histological grade of malignancy (P < 0.01). As well, a significantly reduced immunosignal of Hsp73 and Hsp90 was observed in high-grade and low-/high-grade carcinomas, respectively (P < 0.01). In contrast, Hsp60 (P < 0.01) and Hsp72 (P < 0.05) immunoreactivity appeared to be significantly increased both in premalignant and malignant lesions when compared to that observed in normal urothelium, thus suggesting an early involvement of these proteins in neoplastic transformation of urinary bladder mucosa.

Allergic dermatitis by Dirofilaria repens in a dog: clinical picture and treatment

Adult stages of Dirofilaria repens (Nematoda, Filarioidea) reside in the subcutaneous tissues of the definitive or occasional host as dogs, other animals, and humans, and it is transmitted by mosquitoes. Canine infections with adults and circulating larvae of D. repens are often considered asymptomatic, although in some cases, the parasite causes subcutaneous nodules, diffused dermatitis, skin lesions, and itching. This report provides a complete clinical description of an unusual case of allergic diffused dermatitis caused by D. repens in a naturally infected dog and its successful treatment with the use of a spot-on solution containing imidacloprid 10%/moxidectin 2.5%. The dog presented multiple pustules and alopecic areas with lichenification, hyperpigmentation, and erythematous scaling margins without pruritus. Histological examination was compatible with allergic dermatitis. After being unsuccessfully managed for suspected food hypersensitivity, with a significantly worsening of the lesions, a Knott’s analysis detected nematode larvae in the blood. Morphological and molecular identification showed them to be D. repens. The dog was then treated with a single administration of a spot-on formulation containing imidacloprid 10%/moxidectin 2.5%, and the dermatological signs completely resolved within 2 months after treatment. The dog showed no recurrence of the lesions, and no circulating microfilariae were found upon microscopic and molecular examination for six consecutive months after treatment. This report indicates the apparent primary role of D. repens in causing hypersensitivity-like skin disease without pruritus in a dog. It also confirms, as recently shown elsewhere, the efficacy of imidacloprid 10%/moxidectin 2.5% in the treatment of dermatitis caused by D. repens.

Use of electron microscopy to classify canine perivascular wall tumors

The histologic classification of canine perivascular wall tumors (PWTs) is controversial. Many PWTs are still classified as hemangiopericytomas (HEPs), and the distinction from peripheral nerve sheath tumors (PNSTs) is still under debate. A recent histologic classification of canine soft tissue sarcomas included most histologic types of PWT but omitted those that were termed undifferentiated. Twelve cases of undifferentiated canine PWTs were evaluated by transmission electron microscopy. The ultrastructural findings supported a perivascular wall origin for all cases with 4 categories of differentiation: myopericytic (n = 4), myofibroblastic (n = 1), fibroblastic (n = 2), and undifferentiated (n = 5). A PNST was considered unlikely in each case based on immunohistochemical expression of desmin and/or the lack of typical ultrastructural features, such as basal lamina. Electron microscopy was pivotal for the subclassification of canine PWTs, and the results support the hypothesis that canine PWTs represent a continuum paralleling the phenotypic plasticity of vascular mural cells. The hypothesis that a subgroup of PWTs could arise from a pluripotent mesenchymal perivascular wall cell was also considered and may explain the diverse differentiation of canine PWTs.

NT5E CpG island methylation is a favourable breast cancer biomarker

BACKGROUND

Relapse risk assessment and individual treatment recommendations remain suboptimal for breast cancer patients. In the light of existing preclinical and clinical data, we studied NT5E (5'-nucleotidase, ecto) expression and NT5E CpG island methylation in breast cancer.

METHODS

We used RT-PCR, qPCR, methylation-specific PCR and pyrosequencing to analyse NT5E in breast carcinoma cell lines and primary and breast carcinomas.

RESULTS

NT5E CpG island methylation was inversely associated with NT5E expression in breast carcinoma cell lines. In clinical series, patients whose primary tumours had NT5E CpG island methylation were less likely to develop metastasis (P=0.003, OR=0.34, 95% CI: 0.17-0.69). In 3/4 paired samples, NT5E was methylated in primary tumours and demethylated in CNS metastases. Patients progressing to non-visceral as compared with visceral metastases were more likely to have NT5E CpG island methylation in primary tumours (P=0.01, OR=11.8). Patients with tumours lacking detectable methylation had shorter disease-free survival (DFS) (P=0.001, HR=2.7) and overall survival (OS) (P=0.001, HR=3). The favourable prognostic value of NT5E methylation was confirmed in oestrogen receptor negative (P=0.011, HR=3.27, 95% CI: 1.31-8.12) and in triple negative cases (P=0.004; HR=6.2, 95% CI: 1.9-20). Moreover, we observed a more favourable outcome to adjuvant chemotherapy in patients whose tumours were positive for NT5E CpG island methylation: DFS (P=0.0016, HR=5.1, 95% CI: 1.8-14.37) and OS (P=0.0005, HR=7.4, 95% CI: 2.416-23.08).

CONCLUSION

NT5E CpG island methylation is a promising breast cancer biomarker.

Primary cutaneous undifferentiated round cell tumor with concurrent polymyositis in a dog

A cutaneous poorly differentiated round cell tumor with concurrent, non-suppurative, polymyositis was diagnosed in a hovawart dog. Histochemical staining, immunohistochemistry, and transmission electron microscopy findings suggested that the tumors cells were of myeloid, or possibly natural killer cell origin. The possibility that the concurrent polymyositis may represent a pre-neoplastic or paraneoplastic process is discussed.

Cloacal fibrosarcoma in a canary (Serinus canaria)

A 1-year-old, male canary (Serinus canaria) with a history of an enlarged abdomen of several days duration died acutely and was submitted for necropsy. Results revealed a yellow to tan hard mass, 2 cm in diameter, adherent to the cloacal wall. Histologically, the mass was composed of interlacing bundles of pleomorphic spindle cells with numerous and bizarre mitotic figures. Neoplastic cells were positive for vimentin and negative for desmin and actin and showed ultrastructural features (dilated stacks of rough endoplasmic reticulum, intermediate filaments, rare collagen secretion granules, lack of external lamina) typical of fibroblasts. Based on these results, the diagnosis was cloacal fibrosarcoma, previously not reported in canaries.