1
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Wang F, Liu Y. Cytomorphological traits of fine-needle aspirates of hyalinizing trabecular tumor of the thyroid gland: A brief report. INDIAN J PATHOL MICR 2024; 67:128-132. [PMID: 38358201 DOI: 10.4103/ijpm.ijpm_405_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/16/2024] Open
Abstract
Background The incidence of thyroid tumor is increasing, and preoperative diagnosis of hyalinizing trabecular tumor (HTT) is difficult. Aim To investigate the cytological features of HTT of the thyroid gland. Settings and Design A retrospective observational study. Materials and Methods Ultrasonography, preoperative needle aspiration cytology, postoperative histopathology, immunohistochemistry, and BRAF V600E gene test were performed in five patients with HTT to analyze the pathological characteristics of the patients and review the relevant literature. Results Four female and one male patients with HTT were recruited. Fine-needle aspiration cytology (FNAC) showed bloodstained background tumor cells with multiple morphologies. The tumor cells exhibited ovoid nuclei, abundant cytoplasm, fine chromatin, nuclear crowding and overlapping, and small nucleoli. Focal nuclear pseudoinclusions and grooves were present. No papillary structures or psammoma bodies were observed. In all cases, tumor cells were radially distributed around the eosinophilic extracellular matrix. In 40% (2 in 5) of cases, trabecular patterns of elongated tumor cells were present, with their nuclei staggered along the longitudinal axis of tumor cells in the trabeculae. FNAC suggested two cases of HTT and three cases of papillary thyroid cancer. Post-operational biopsy indicated they were HTT cases. Conclusion HTT is a rare thyroid tumor with non-specific clinical manifestations. It can be misinterpreted as papillary thyroid carcinoma by FNAC. However, its cytomorphological traits are helpful in the diagnosis. In combination with FNAC, immunohistochemistry, and molecular testing, HTT can be accurately diagnosed.
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Affiliation(s)
- Fei Wang
- Department of Pathology, Yichang Central People's Hospital, Institute of Pathology of China Three Gorges University, Yichang, Hubei Province, China
| | - Yufei Liu
- Department of Pathology, Yichang Central People's Hospital, Institute of Pathology of China Three Gorges University, Yichang, Hubei Province, China
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2
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Nielsen L, Gallardo AMC, Alonso PP, Medina LO, García EL, del Arco CD, Jiménez RB, García LA, Blanco MC, González JV, Serrano MDLT, Fernández-Aceñero MJ. Diagnostic clues for hyalinizing trabecular tumor on fine needle aspiration cytology. Cytojournal 2023; 20:19. [PMID: 37810443 PMCID: PMC10559490 DOI: 10.25259/cytojournal_34_2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Accepted: 06/22/2023] [Indexed: 10/10/2023] Open
Abstract
Objectives The hyalinizing trabecular tumor (HTT) is a rare benign neoplasm of the thyroid gland. This neoplasm has overlapping cytological features with Papillary Thyroid Carcinoma, Medullary Carcinoma and Follicular Neoplasm with Nuclear Features of Papillary Carcinoma. This can lead to misdiagnosis of malignancy in fine needle aspiration (FNA) cytology specimens with unnecessary total thyroidectomy. The aim of this study is to determine if there are some cytological features that could help us to suspect HTT on FNA specimens and avoid radical surgery. Material and Methods With this purpose we have collected 6 cases diagnosed of HTT in Hospital Clínico San Carlos of Madrid (Spain) in the last 10 years and reviewed the cytological specimens. Result We conclude that the presence of hyaline material in FNA specimens of HTT is a constant feature being a diagnostic clue. We must be cautious not to confuse it with dense colloid or amyloid material, the latter seen in Medullary Carcinoma. Papillary architecture and fibrovascular cores are not present in a HTT. Special stains as ki-67, calcitonin and Congo Red staining could help us in achieving the correct diagnosis. Conclusion We feel the cytopathologists must be aware of the distinguishing features of this lesion, mainly the typical hyaline material to achieve a proper diagnosis and be able to reduce unnecessary aggressive management of these patients.
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Affiliation(s)
- Lone Nielsen
- Department of Pathology, Hospital Clínico San Carlos, Madrid, Spain
| | | | | | | | - Esthefanía Latorre García
- Department of Pathology, Hospital General Universitario Nuestra Señora del Prado, Talavera de la Reina, Spain
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3
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Lott Limbach A, Chute DJ. Top 10 Nested Pattern Head and Neck Lesions to Notice. Head Neck Pathol 2023; 17:119-131. [PMID: 36928740 PMCID: PMC10063737 DOI: 10.1007/s12105-023-01534-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Accepted: 01/13/2023] [Indexed: 03/18/2023]
Abstract
BACKGROUND Nested is defined as "cellular clusters arranged in small groupings with intervening vascular or stromal networks, lacking lumens or glandular formation." Using this definition, multiple neoplastic and non-neoplastic lesions of the head and neck come into the differential. We have broadly organized the differential diagnosis of "nested" tumors into entities with neuroendocrine differentiation, squamous differentiation, thyroid follicular cell differentiation, and other lesions. METHODS Review. RESULTS Many different entities have a nested appearance and the morphologic, immunohistochemical, clinical, and radiographic features contribute to the differential diagnosis. The different tumors covered in this review include neuroendocrine neoplasms, paraganglioma, middle ear neuroendocrine tumor (formerly known as middle ear adenoma), medullary thyroid carcinoma, poorly differentiated thyroid carcinoma, olfactory neuroblastoma, ectopic pituitary neuroendocrine tumor, hyalinizing trabecular tumor, solid subtype of papillary thyroid carcinoma, solid cell nests/C-cell hyperplasia, necrotizing sialometaplasia, and meningioma. CONCLUSION In this review, we discuss the morphologic and immunohistochemical features of the covered entities as a guide to differential diagnosis when nested-patterned head and neck lesions are encountered.
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Affiliation(s)
- Abberly Lott Limbach
- Department of Pathology, The Ohio State University Wexner Medical Center, E422 Doan Hall, 410 W 10th Ave, Columbus, OH 43210 USA
| | - Deborah J. Chute
- Department of Pathology, Cleveland Clinic, 9500 Euclid Ave L25, Cleveland, OH 44195 USA
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4
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Christofer Juhlin C, Mete O, Baloch ZW. The 2022 WHO classification of thyroid tumors: novel concepts in nomenclature and grading. Endocr Relat Cancer 2023; 30:ERC-22-0293. [PMID: 36445235 DOI: 10.1530/erc-22-0293] [Citation(s) in RCA: 25] [Impact Index Per Article: 25.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Accepted: 11/23/2022] [Indexed: 11/25/2022]
Abstract
The fifth edition of the Classification of Endocrine and Neuroendocrine Tumors has been released by the World Health Organization. This timely publication integrates several changes to the nomenclature of non-neoplastic and neoplastic thyroid diseases, as well as novel concepts that are essential for patient management. The heterogeneous group of non-neoplastic and benign neoplastic lesions are now collectively termed as 'thyroid follicular nodular disease' to better reflect the clonal and non-clonal proliferations that clinically present as multinodular goiter. Thyroid neoplasms originating from follicular cells are distinctly divided into benign, low-risk and malignant neoplasms. The new classification scheme stresses that papillary thyroid carcinoma (PTC) should be subtyped based on histomorphologic features irrespective of tumor size to avoid treating all sub-centimeter/small lesions as low-risk disease. Formerly known as the cribriform-morular variant of PTC is redefined as cribriform-morular thyroid carcinoma since this tumor is now considered a distinct malignant thyroid neoplasm of uncertain histogenesis. The 'differentiated high-grade thyroid carcinoma' is a new diagnostic category including PTCs, follicular thyroid carcinomas and oncocytic carcinomas with high-grade features associated with poorer prognosis similar to the traditionally defined poorly differentiated thyroid carcinoma as per Turin criteria. In addition, squamous cell carcinoma of the thyroid is now considered a morphologic pattern/subtype of anaplastic thyroid carcinoma. In this review, we will highlight the key changes in the newly devised fifth edition of the WHO classification scheme of thyroid tumors with reflections on its applicability in patient management and future directions in this field.
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Affiliation(s)
- C Christofer Juhlin
- Department of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden
- Department of Pathology and Cancer Diagnostics, Karolinska University Hospital, Stockholm, Sweden
| | - Ozgur Mete
- Department of Pathology, University Health Network, Toronto, ON, Canada
- Endocrine Oncology Site, Princess Margaret Cancer Centre, Toronto, ON, Canada
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON, Canada
| | - Zubair W Baloch
- Department of Pathology & Laboratory Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
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5
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Zhao H, Lu Y, Zheng J, Xie Y, Li Q. Case report: Intraoperative frozen section analysis of Thyroid paraganglioma. Front Oncol 2022; 12:1038076. [PMID: 36387140 PMCID: PMC9664199 DOI: 10.3389/fonc.2022.1038076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Accepted: 10/19/2022] [Indexed: 01/25/2023] Open
Abstract
Paraganglioma (PGL) is a neuroendocrine tumor that arises from the sympathetic or parasympathetic paraganglia. Primary thyroid PGL is extremely rare. PGL may be difficult to diagnose on frozen sections because its histopathological features, such as polygonal tumor cells with eosinophilic cytoplasm arranged irregularly, overlap with those of thyroid follicular adenoma. We present a case of thyroid PGL in a female patient and provide a detailed description of the patient's clinicopathologic characteristics. Cervical computed tomography showed a left thyroid mass with uneven density. Intraoperative frozen section analysis showed an uneven fibrous septa and rich networks of delicate vessels surrounding tumor cell nests. The tumor cells were polygonal or epithelioid with eosinophilic cytoplasm, arranged in a nest, trabecular, or organoid pattern were and diagnosed as thyroid follicular adenoma. However, in postoperative immunohistochemistry, these were diagnosed as thyroid PGL. The postoperative recovery was uneventful. The patient showed no signs of tumor recurrence or metastasis until 16 months of follow-up. Herein, we summarize the characteristic features of thyroid PGL based on frozen section analysis. In the appropriate clinical context, its proper use as diagnostic and differential diagnostic management strategies is recommended.
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Affiliation(s)
- Huanyu Zhao
- Department of Pathology, The First Hospital and College of Basic Medical Sciences, China Medical University, Shenyang, Liaoning, China,*Correspondence: Huanyu Zhao,
| | - Yudie Lu
- Department of Pathology, The First Hospital and College of Basic Medical Sciences, China Medical University, Shenyang, Liaoning, China
| | - Jingrong Zheng
- Department of Pathology, The First Hospital and College of Basic Medical Sciences, China Medical University, Shenyang, Liaoning, China
| | - Yuyao Xie
- Department of Clinical Medicine, The First Clinical College of Jinzhou Medical University, Jinzhou, Liaoning, China
| | - Qingchang Li
- Department of Pathology, The First Hospital and College of Basic Medical Sciences, China Medical University, Shenyang, Liaoning, China
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6
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Vorobeva OM, Sitovskaya DA, Kukanov KK, Ellinidi VN, Samusenko IA, Kalinina NM, Zabrodskaya YM. [The phenomenon of pseudotumorous cross immunohistochemical reactivity of glia in progressive multifocal leukoencephalopathy]. Arkh Patol 2022; 84:36-43. [PMID: 35417947 DOI: 10.17116/patol20228402136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Progressive multifocal leukoencephalopathy (PML) is a subacute demyelinating brain damage caused by infection of oligodendrocytes and astrocytes with the lytic JC virus on the background of immunosuppression. A case report of PML with a tumor-like course is presented. Morphological diagnostics revealed non-specific staining of antibodies to Ki-67, p53, IDH1, NF and Vim in the nuclei of gliocytes affected by the JC virus. Histological examination and microscopic evaluation of the changes in the brain for the diagnosis of PML is a priority. The recommended intravital biopsy does not always help in clear verification of PML due to the limited volume of tissue fragments presented for research. For the correct interpretation of changes during an intravital pathological examination and verification of PML, it is important to take material during a stereotaxic biopsy, not only from the center, but from the edges and perifocal zone of the altered tissues for the possibility of a spatial histological assessment of the pathological process.
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Affiliation(s)
- O M Vorobeva
- Polenov Neurosurgical Institute - the branch of Almazov National Medical Research Centre, St. Petersburg, Russia
| | - D A Sitovskaya
- Polenov Neurosurgical Institute - the branch of Almazov National Medical Research Centre, St. Petersburg, Russia
| | - K K Kukanov
- Polenov Neurosurgical Institute - the branch of Almazov National Medical Research Centre, St. Petersburg, Russia
| | - V N Ellinidi
- The Federal State budgetary institute «the Nikiforov Russian Center of Emergency and Radiation Medicine», St. Petersburg, Russia
| | - I A Samusenko
- The Federal State budgetary institute «the Nikiforov Russian Center of Emergency and Radiation Medicine», St. Petersburg, Russia
| | - N M Kalinina
- The Federal State budgetary institute «the Nikiforov Russian Center of Emergency and Radiation Medicine», St. Petersburg, Russia
| | - Yu M Zabrodskaya
- Polenov Neurosurgical Institute - the branch of Almazov National Medical Research Centre, St. Petersburg, Russia.,The Federal State budgetary institute «the Nikiforov Russian Center of Emergency and Radiation Medicine», St. Petersburg, Russia.,S.M. Kirov Military Medical Academy, St. Petersburg, Russia
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7
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Podany P, Gilani SM. Hyalinizing trabecular tumor: Cytologic, histologic and molecular features and diagnostic considerations. Ann Diagn Pathol 2021; 54:151803. [PMID: 34385072 DOI: 10.1016/j.anndiagpath.2021.151803] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Revised: 07/03/2021] [Accepted: 07/25/2021] [Indexed: 12/24/2022]
Abstract
Hyalinizing trabecular tumors are a follicular origin neoplasm of the thyroid that usually present as an asymptomatic, well circumscribed, solitary mass. However, diagnosis of a hyalinizing trabecular tumor may be challenging especially on fine needle aspiration cytology and requires careful examination of the specimen to rule out potential mimickers such as papillary thyroid carcinoma, medullary thyroid carcinoma, paraganglioma, other follicular patterned neoplasms, intrathyroidal parathyroid tissue, and metastatic disease. We will review the cytologic, histologic and molecular features of hyalinizing trabecular tumors that aid in distinction from these mimickers with overlapping morphologic features and help ensure proper diagnosis for appropriate management.
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Affiliation(s)
- Peter Podany
- Department of Pathology, Yale School of Medicine, New Haven, CT, USA
| | - Syed M Gilani
- Department of Pathology, Yale School of Medicine, New Haven, CT, USA.
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8
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Tsutsumi Y. Pitfalls and Caveats in Applying Chromogenic Immunostaining to Histopathological Diagnosis. Cells 2021; 10:1501. [PMID: 34203756 PMCID: PMC8232789 DOI: 10.3390/cells10061501] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Revised: 06/10/2021] [Accepted: 06/10/2021] [Indexed: 12/17/2022] Open
Abstract
Chromogenic immunohistochemistry (immunostaining using an enzyme-labeled probe) is an essential histochemical technique for analyzing pathogenesis and making a histopathological diagnosis in routine pathology services. In neoplastic lesions, immunohistochemistry allows the study of specific clinical and biological features such as histogenesis, behavioral characteristics, therapeutic targets, and prognostic biomarkers. The needs for appropriate and reproducible methods of immunostaining are prompted by technical development and refinement, commercial availability of a variety of antibodies, advanced applicability of immunohistochemical markers, accelerated analysis of clinicopathological correlations, progress in molecular targeted therapy, and the expectation of advanced histopathological diagnosis. However, immunostaining does have various pitfalls and caveats. Pathologists should learn from previous mistakes and failures and from results indicating false positivity and false negativity. The present review article describes various devices, technical hints, and trouble-shooting guides to keep in mind when performing immunostaining.
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Affiliation(s)
- Yutaka Tsutsumi
- Diagnostic Pathology Clinic, Pathos Tsutsumi, 1551-1 Sankichi-ato, Yawase-cho, Inazawa 492-8342, Aichi, Japan; ; Tel.: +81-587-96-7088; Fax: +81-587-96-7098
- Specially Appointed Professor, School of Medical Technology, Yokkaichi Nursing and Medical Care University, 1200 Kayou-cho, Yokkaichi 512-8045, Mie, Japan
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9
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Anti-Tumor Efficiency of Perillylalcohol/β-Cyclodextrin Inclusion Complexes in a Sarcoma S180-Induced Mice Model. Pharmaceutics 2021; 13:pharmaceutics13020245. [PMID: 33578857 PMCID: PMC7916601 DOI: 10.3390/pharmaceutics13020245] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Revised: 01/17/2021] [Accepted: 02/04/2021] [Indexed: 12/13/2022] Open
Abstract
The low solubility and high volatility of perillyl alcohol (POH) compromise its bioavailability and potential use as chemotherapeutic drug. In this work, we have evaluated the anticancer activity of POH complexed with β-cyclodextrin (β-CD) using three complexation approaches. Molecular docking suggests the hydrogen-bond between POH and β-cyclodextrin in molar proportion was 1:1. Thermal analysis and Fourier-transform infrared spectroscopy (FTIR) confirmed that the POH was enclosed in the β-CD cavity. Also, there was a significant reduction of particle size thereof, indicating a modification of the β-cyclodextrin crystals. The complexes were tested against human L929 fibroblasts after 24 h of incubation showing no signs of cytotoxicity. Concerning the histopathological results, the treatment with POH/β-CD at a dose of 50 mg/kg promoted approximately 60% inhibition of tumor growth in a sarcoma S180-induced mice model and the reduction of nuclear immunoexpression of the Ki67 antigen compared to the control group. Obtained data suggest a significant reduction of cycling cells and tumor proliferation. Our results confirm that complexation of POH/β-CD not only solves the problem related to the volatility of the monoterpene but also increases its efficiency as an antitumor agent.
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10
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Aberrant Cytoplasmic Terminal Deoxynucleotidyl Transferase (TdT) Immunostaining on Previously Frozen, Formalin-fixed Paraffin-embedded Tissue: Cryotomy-induced Antigen Diffusion (CIAD). Appl Immunohistochem Mol Morphol 2021; 29:e17-e19. [PMID: 32590454 DOI: 10.1097/pai.0000000000000863] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Accepted: 06/03/2020] [Indexed: 11/26/2022]
Abstract
Terminal deoxynucleotidyl transferase (TdT) has been localized in both the nuclear and cytoplasmic compartments of lymphoblastic lymphomas when such tumors have been frozen for cryotomy and subsequently, formalin fixed and processed to paraffin. This cryotomy-induced antigen diffusion (CIAD) occurs with several different sources of anti-TdT antisera and was not observed in nonlymphoblastic tumors. CIAD was also not observed with other nuclear antigens including BRG1, Pax5, Ki67, BCL6, INI-1, myogenin, MyoD1, and Phox2B. TdT CIAD seems to be specific for lymphoblastic lymphomas. CIAD is another preanalytical artifact that needs to be considered in immunohistochemistry.
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11
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Guadagno E, D'Avella E, Cappabianca P, Colao A, Del Basso De Caro M. Ki67 in endocrine neoplasms: to count or not to count, this is the question! A systematic review from the English language literature. J Endocrinol Invest 2020; 43:1429-1445. [PMID: 32415572 DOI: 10.1007/s40618-020-01275-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Accepted: 04/23/2020] [Indexed: 12/11/2022]
Abstract
BACKGROUND Endocrine neoplasms are generally slow-growing tumors that can show hormonal activity and give metastases. In most cases they are benign and clearly malignant forms are easy to diagnose. However, borderline forms may occur and be, for the pathologists, very difficult to classify. In these cases, there is a strong need to identify factors that may aid. Official classification systems for endocrine neoplasms are based on the evaluation of proliferation and, in most cases, they rely on mitotic count. In support, the study of Ki67 is carried out which, however, has not yet been included in any official classification system, except for neuroendocrine neoplasms of the gastro-entero-pancreatic tract. PURPOSE The aim of the present study was to investigate the proven or unproven role of Ki67 in endocrine neoplasms, in different districts, in order to bring to light the substantial differences, in terms of proliferation, existing between neoplasms so similar, but at the same time, so different. METHODS A thorough search of English language literature was performed, looking for articles concerning Ki67 in five endocrine neoplasms (pituitary adenomas, thyroid neoplasms, adrenocortical neoplasms, pheochromocytomas and paragangliomas). RESULTS From 2170, 236 articles were selected and it was seen that the endocrine neoplasm in which Ki67 was most studied was the pituitary, where it still shows a controversial role. In other neoplasms different roles were identified. CONCLUSION The pathologist should be aware of the contribution that this proliferative marker can give to the diagnosis and, sometimes, to the therapy selection, for the clinician.
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Affiliation(s)
- E Guadagno
- Pathology Section, Department of Advanced Biomedical Sciences, "Federico II" University of Naples, Via Pansini 5, 80131, Naples, Italy.
| | - E D'Avella
- Division of Neurosurgery, Department of Neurosciences, Reproductive and Odontostomatological Sciences, "Federico II" University of Naples, Via Pansini 5, 80131, Naples, Italy
| | - P Cappabianca
- Division of Neurosurgery, Department of Neurosciences, Reproductive and Odontostomatological Sciences, "Federico II" University of Naples, Via Pansini 5, 80131, Naples, Italy
| | - A Colao
- Endocrinology Section, Department of Clinic Medicine and Surgery, "Federico II" University of Naples, Via Pansini 5, 80131, Naples, Italy
| | - M Del Basso De Caro
- Pathology Section, Department of Advanced Biomedical Sciences, "Federico II" University of Naples, Via Pansini 5, 80131, Naples, Italy
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12
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Rossi ED, Papotti M, Faquin W, Larocca LM, Pantanowitz L. The Diagnosis of Hyalinizing Trabecular Tumor: A Difficult and Controversial Thyroid Entity. Head Neck Pathol 2020; 14:778-784. [PMID: 31571046 PMCID: PMC7413943 DOI: 10.1007/s12105-019-01083-5] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2019] [Accepted: 09/17/2019] [Indexed: 12/27/2022]
Abstract
Hyalinizing trabecular tumor (HTT) is a benign, follicular-derived neoplasm composed of thick trabeculae with round or elongated cells having irregular and clear nuclei, and containing intra-trabecular hyaline material. The cytological features of HTT resemble those of papillary carcinoma, which helps explain why these lesions are usually classified as indeterminate/suspicious according to the Bethesda system for reporting thyroid cytology. A review of the literature indicates that reaching the correct preoperative cytologic diagnosis of HTT remains elusive, as the correct interpretation was achieved in only 8% of cases. In contrast, the correct diagnosis posed a less significant diagnostic challenge in the majority of histological series, despite the reported controversy on the relationship of this tumor with papillary and medullary thyroid carcinomas. The aim of this review is to highlight the cytological and histological clues in the diagnosis of HTT, as well as its molecular profile.
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Affiliation(s)
- Esther Diana Rossi
- Division of Anatomic Pathology and Histology - Fondazione Policlinico Universitario "Agostino Gemelli"-IRCCS, Università Cattolica del Sacro Cuore, Largo Francesco Vito, 1, 00168, Rome, Italy.
| | - Mauro Papotti
- Department of Oncology, University of Turin, Turin, Italy
| | - William Faquin
- Department of Pathology, Massachusetts General Hospital, Pittsburgh, PA, USA
| | - Luigi Maria Larocca
- Division of Anatomic Pathology and Histology - Fondazione Policlinico Universitario "Agostino Gemelli"-IRCCS, Università Cattolica del Sacro Cuore, Largo Francesco Vito, 1, 00168, Rome, Italy
| | - Liron Pantanowitz
- Department of Pathology, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
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13
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Pal P, Chetty R. Multiple sclerosing pneumocytomas: a review. J Clin Pathol 2020; 73:531-534. [PMID: 32317291 DOI: 10.1136/jclinpath-2020-206501] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2020] [Accepted: 02/26/2020] [Indexed: 11/03/2022]
Abstract
Sclerosing pneumocytoma (SP) is a rare benign low-grade tumour of the lung, and typically presents as single discrete coin lesions on imaging. Multiple SP is an exceedingly rare entity and thus reported sparingly. We review the literature on multiple SP, their clinical presentations, histopathology, relevant differential diagnoses and molecular histogenesis of this entity. SP has a predilection for East Asian origin females who have never smoked. Patients are either asymptomatic or have symptoms such as cough, haemoptysis that may be persistent, chest pain if involving the pleura and presents as discrete coin lesion on chest X-ray. Histologically, they are papillary, solid, angiomatoid or sclerotic, or combinations of these four basic patterns. Multiple lesions have the same or slightly different histological patterns. They can be distributed in either lung, in any lobe and can even be bilateral. AKT-1 molecular pathways are pivotal in their molecular pathogenesis. In this review, we further propose a classification based on five types of distribution of multiple SP.
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Affiliation(s)
- Prodipto Pal
- Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada .,Department of Pathology, University Health Network Laboratory Medicine Program, University of Toronto, Toronto, Ontario, Canada
| | - Runjan Chetty
- Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada.,Department of Pathology, University Health Network Laboratory Medicine Program, University of Toronto, Toronto, Ontario, Canada
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14
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Marchiò C, Da Cruz Paula A, Gularte-Merida R, Basili T, Brandes A, da Silva EM, Silveira C, Ferrando L, Metovic J, Maletta F, Annaratone L, Pareja F, Rubin BP, Hoschar AP, De Rosa G, La Rosa S, Bongiovanni M, Purgina B, Piana S, Volante M, Weigelt B, Reis-Filho JS, Papotti M. PAX8-GLIS3 gene fusion is a pathognomonic genetic alteration of hyalinizing trabecular tumors of the thyroid. Mod Pathol 2019; 32:1734-1743. [PMID: 31273314 PMCID: PMC7442035 DOI: 10.1038/s41379-019-0313-x] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2019] [Revised: 05/28/2019] [Accepted: 05/29/2019] [Indexed: 12/28/2022]
Abstract
The hyalinizing trabecular adenoma/tumor is a rare and poorly characterized follicular-derived thyroid neoplasm recently shown to harbor recurrent PAX8-GLIS1 or PAX8-GLIS3 gene fusions. Here we sought to define the repertoire of genetic alterations of hyalinizing trabecular tumors, and whether PAX8-GLIS3 fusions are pathognomonic for hyalinizing trabecular tumors. A discovery series of eight hyalinizing trabecular tumors was subjected to RNA-sequencing (n = 8), whole-exome sequencing (n = 3) or targeted massively parallel sequencing (n = 5). No recurrent somatic mutations or copy number alterations were identified in hyalinizing trabecular tumor, whereas RNA-sequencing revealed the presence of a recurrent genetic rearrangement involving PAX8 (2q14.1) and GLIS3 (9p24.2) genes in all cases. In this in-frame fusion gene, which comprised exons 1-2 of PAX8 and exons 3-11 of GLIS3, GLIS3 is likely placed under the regulation of PAX8. Reverse transcription RT-PCR and/or fluorescence in situ hybridization analyses of a validation series of 26 hyalinizing trabecular tumors revealed that the PAX8-GLIS3 gene fusion was present in all hyalinizing trabecular tumors (100%). No GLIS1 rearrangements were identified. Conversely, no PAX8-GLIS3 gene fusions were detected in a cohort of 237 control thyroid neoplasms, including 15 trabecular thyroid lesions highly resembling hyalinizing trabecular tumor from a morphological standpoint, as well as trabecular/solid follicular adenomas, solid/trabecular variants of papillary carcinoma, and Hurthle cell adenomas or carcinomas. Our data provide evidence to suggest that the PAX8-GLIS3 fusion is pathognomonic for hyalinizing trabecular tumors, and that the presence of the PAX8-GLIS3 fusion in thyroid neoplasms may be used as an ancillary marker for the diagnosis of hyalinizing trabecular tumor, thereby avoiding overtreatment in case of misdiagnoses with apparently similar malignant tumors.
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Affiliation(s)
- Caterina Marchiò
- Pathology Division, Candiolo Cancer Institute, FPO – IRCCS, Candiolo, Italy,Department of Medical Sciences, University of Turin, Torino, Italy
| | - Arnaud Da Cruz Paula
- Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Rodrigo Gularte-Merida
- Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA,Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Thais Basili
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Alissa Brandes
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Edaise M. da Silva
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Catarina Silveira
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Lorenzo Ferrando
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY, USA,Department of Internal Medicine, University of Genoa, Genoa, Italy
| | - Jasna Metovic
- Department of Oncology, University of Turin, at Città della Salute Hospital, Torino, Italy
| | - Francesca Maletta
- Department of Oncology, University of Turin, at Città della Salute Hospital, Torino, Italy
| | - Laura Annaratone
- Pathology Division, Candiolo Cancer Institute, FPO – IRCCS, Candiolo, Italy,Department of Medical Sciences, University of Turin, Torino, Italy
| | - Fresia Pareja
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Brian P. Rubin
- Department of Pathology, Cleveland Clinic, Cleveland, OH, USA
| | | | | | - Stefano La Rosa
- Service of Clinical Pathology, Lausanne University Hospital, Institute of Pathology, Lausanne, Switzerland
| | - Massimo Bongiovanni
- Service of Clinical Pathology, Lausanne University Hospital, Institute of Pathology, Lausanne, Switzerland
| | - Bibianna Purgina
- Department of Pathology and Laboratory Medicine, Ottawa Hospital, Ontario, Canada
| | - Simonetta Piana
- Pathology Unit, Arcispedale Santa Maria Nuova, Azienda USL-IRCCS Reggio Emilia, Italy
| | - Marco Volante
- San Luigi Gonzaga Hospital and Department of Oncology, University of Turin, Orbassano, Italy
| | - Britta Weigelt
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Jorge S. Reis-Filho
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY, USA,Human Oncology and Pathogenesis Program, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Mauro Papotti
- Department of Oncology, University of Turin, at Città della Salute Hospital, Torino, Italy.
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15
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Kop E, de Bock GH, Noordhuis MG, Slagter-Menkema L, van der Laan BFAM, Langendijk JA, Schuuring E, van der Vegt B. Standardised Ki-67 proliferation index assessment in early-stage laryngeal squamous cell carcinoma in relation to local control and survival after primary radiotherapy. Clin Otolaryngol 2019; 45:12-20. [PMID: 31561282 PMCID: PMC6973088 DOI: 10.1111/coa.13449] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2019] [Accepted: 09/08/2019] [Indexed: 12/24/2022]
Abstract
Objectives Ambiguous results have been reported on the predictive value of the Ki‐67 proliferation index (Ki‐67 PI) regarding local control (LC) and survival after primary radiotherapy (RT) in early‐stage laryngeal squamous cell cancer (LSCC). Small study size, heterogenic inclusion, variations in immunostaining and cut‐off values are attributing factors. Our aim was to elucidate the predictive value of the Ki‐67 PI for LC and disease‐specific survival (DSS) using a well‐defined series of T1‐T2 LSCC, standardised automatic immunostaining and digital image analysis (DIA). Methods A consecutive and well‐defined cohort of 208 patients with T1‐T2 LSCC treated with primary RT was selected. The Ki‐67 PI was determined using DIA. Mann‐Whitney U‐tests, logistic and Cox regression analyses were performed to assess associations between Ki‐67 PI, clinicopathological variables, LC and DSS. Results In multivariate Cox regression analysis, poor tumour differentiation (HR 2.20; 95% CI 1.06‐4.59, P = .04) and alcohol use (HR 2.84, 95% CI 1.20‐6.71; P = .02) were independent predictors for LC. Lymph node positivity was an independent predictor for DSS (HR 3.16, 95% CI 1.16‐8.64; P = .03). Ki‐67 PI was not associated with LC (HR 1.59; 95% CI 0.89‐2.81; P = .11) or DSS (HR 0.98; 95% CI 0.57‐1.66; P = .97). In addition, continuous Ki‐67 PI was not associated with LC (HR 2.03; 95% CI 0.37‐11.14, P = .42) or DSS (HR 0.62; 95% CI 0.05‐8.28; P = .72). Conclusion The Ki‐67 PI was not found to be a predictor for LC or DSS and therefore should not be incorporated in treatment‐related decision‐making for LSCC.
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Affiliation(s)
- Emiel Kop
- Department of Otorhinolaryngology, University Medical Center Groningen, Groningen, The Netherlands
| | - Geertruida H de Bock
- Department of Epidemiology, University of Groningen, University Medical Hospital Groningen, Groningen, The Netherlands
| | - Maartje G Noordhuis
- Department of Otorhinolaryngology, University Medical Center Groningen, Groningen, The Netherlands
| | - Lorian Slagter-Menkema
- Department of Otorhinolaryngology, University Medical Center Groningen, Groningen, The Netherlands
| | | | - Johannes A Langendijk
- Department of Radiotherapy, University of Groningen, University Medical Hospital Groningen, Groningen, The Netherlands
| | - Ed Schuuring
- Department of Pathology & Medical Biology, University of Groningen, University Medical Hospital Groningen, Groningen, The Netherlands
| | - Bert van der Vegt
- Department of Pathology & Medical Biology, University of Groningen, University Medical Hospital Groningen, Groningen, The Netherlands
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16
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Dell’Aquila M, Gravina C, Cocomazzi A, Capodimonti S, Musarra T, Sfregola S, Fiorentino V, Revelli L, Martini M, Fadda G, Pantanowitz L, Larocca LM, Rossi ED. A large series of hyalinizing trabecular tumors: Cytomorphology and ancillary techniques on fine needle aspiration. Cancer Cytopathol 2019; 127:390-398. [DOI: 10.1002/cncy.22139] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2019] [Revised: 04/09/2019] [Accepted: 04/10/2019] [Indexed: 01/08/2023]
Affiliation(s)
- Marco Dell’Aquila
- Division of Anatomic Pathology and Histology Fondazione Policlinico “Agostino Gemelli”, IRCCS Rome Italy
| | - Carmen Gravina
- Division of Endocrine‐Surgery Fondazione Policlinico “Agostino Gemelli”, IRCCS Rome Italy
| | - Alessandra Cocomazzi
- Division of Anatomic Pathology and Histology Fondazione Policlinico “Agostino Gemelli”, IRCCS Rome Italy
| | - Sara Capodimonti
- Division of Anatomic Pathology and Histology Fondazione Policlinico “Agostino Gemelli”, IRCCS Rome Italy
| | - Teresa Musarra
- Division of Anatomic Pathology and Histology Fondazione Policlinico “Agostino Gemelli”, IRCCS Rome Italy
| | - Stefania Sfregola
- Division of Anatomic Pathology and Histology Fondazione Policlinico “Agostino Gemelli”, IRCCS Rome Italy
| | - Vincenzo Fiorentino
- Division of Anatomic Pathology and Histology Fondazione Policlinico “Agostino Gemelli”, IRCCS Rome Italy
| | - Luca Revelli
- Division of Endocrine‐Surgery Fondazione Policlinico “Agostino Gemelli”, IRCCS Rome Italy
| | - Maurizio Martini
- Division of Anatomic Pathology and Histology Fondazione Policlinico “Agostino Gemelli”, IRCCS Rome Italy
| | - Guido Fadda
- Division of Anatomic Pathology and Histology Fondazione Policlinico “Agostino Gemelli”, IRCCS Rome Italy
| | - Liron Pantanowitz
- Department of Pathology University of Pittsburgh Medical Center Pittsburgh Pennsylvania
| | - Luigi Maria Larocca
- Division of Anatomic Pathology and Histology Fondazione Policlinico “Agostino Gemelli”, IRCCS Rome Italy
| | - Esther Diana Rossi
- Division of Anatomic Pathology and Histology Fondazione Policlinico “Agostino Gemelli”, IRCCS Rome Italy
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17
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Cameselle-Teijeiro JM, Bella Cueto MR, Eloy C, Abdulkader I, Amendoeira I, Matías-Guiu X, Sobrinho-Simões M. [Tumors of the thyroid gland. Proposal for the management and study of samples from patients with thyroid neoplasms]. REVISTA ESPAÑOLA DE PATOLOGÍA : PUBLICACIÓN OFICIAL DE LA SOCIEDAD ESPAÑOLA DE ANATOMÍA PATOLÓGICA Y DE LA SOCIEDAD ESPAÑOLA DE CITOLOGÍA 2019; 53:27-36. [PMID: 31932006 DOI: 10.1016/j.patol.2019.03.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/04/2019] [Revised: 03/25/2019] [Accepted: 03/30/2019] [Indexed: 11/18/2022]
Abstract
The recent changes in the classification and staging of thyroid tumors have arisen from the need to provide an adequate response to the exponential increase of thyroid cancer, which, however, has not been accompanied by an increase in mortality. These changes pretend to reduce overdiagnoses of malignancy, unnecessary treatment, side effects as well as cost for the health system. To this end, this article reviews recommendations for the management of thyroid surgical pathology samples with emphasis on the new terminology of the WHO classification. The basic criteria for the diagnosis of malignancy in well-differentiated thyroid carcinomas are reviewed and the criteria for NIFTP (non-invasive follicular tumor with papillary-like nuclear features) diagnosis are updated. Recommendations for the elaboration of the pathological report are also included.
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Affiliation(s)
- José Manuel Cameselle-Teijeiro
- Servicio de Anatomía Patológica, Hospital Clínico Universitario, SERGAS, Departamento de Anatomía Patológica, Universidad de Santiago de Compostela, Santiago de Compostela, España.
| | - María Rosa Bella Cueto
- Servicio de Anatomía Patológica, Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí (I3PT), Universitat Autònoma de Barcelona, Sabadell, Barcelona, España
| | - Catarina Eloy
- IPATIMUP-Institute of Molecular Pathology and Immunology, University of Porto, Porto, Portugal
| | - Ihab Abdulkader
- Servicio de Anatomía Patológica, Hospital Clínico Universitario, SERGAS, Departamento de Anatomía Patológica, Universidad de Santiago de Compostela, Santiago de Compostela, España
| | - Isabel Amendoeira
- IPATIMUP-Institute of Molecular Pathology and Immunology, University of Porto, Porto, Portugal; Department of Pathology, Hospital de S. João, Porto, Portugal
| | - Xavier Matías-Guiu
- Servicio de Anatomía Patológica, Hospital Universitari Arnau de Vilanova, Lleida, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Barcelona, España
| | - Manuel Sobrinho-Simões
- IPATIMUP-Institute of Molecular Pathology and Immunology, University of Porto, Porto, Portugal; Department of Pathology, Hospital de S. João, Porto, Portugal
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18
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Abstract
The role of immunohistochemistry (IHC) in endocrine pathology is similar to that in other organ systems in that it can aid in the subclassification of tumors within an organ, confirm site of primary in metastatic disease, provide prognostic information, identify underlying genetic alterations, and predict response to treatment. Although most endocrine tumors do not require IHC to render a diagnosis, there are certain scenarios in which IHC can be extremely helpful. For example, in thyroid, IHC can be used to support tumor dedifferentiation, in the adrenal it can aid in the diagnosis of low-grade adrenocortical carcinomas, and in paragangliomas it can help identify tumors arising as part of an inherited tumor syndrome. This review will focus on the applications of IHC in tumors of the thyroid, parathyroids, adrenals, and paraganglia in adults.
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19
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Recent Advances in the Classification of Low-grade Papillary-like Thyroid Neoplasms and Aggressive Papillary Thyroid Carcinomas: Evolution of Diagnostic Criteria. Adv Anat Pathol 2018; 25:263-272. [PMID: 29762157 DOI: 10.1097/pap.0000000000000198] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
Papillary thyroid carcinomas account for ∼80% of well-differentiated thyroid tumors. During the past decade, several new variants of papillary-like thyroid neoplasms and papillary thyroid carcinomas have been recognized. Some of these neoplasms that were previously classified as malignant have been reclassified as low-grade neoplasms, as the diagnostic criteria have evolved. Similarly, some of the papillary thyroid carcinomas that were previously classified as conventional or classic papillary thyroid carcinomas have now been recognized as more aggressive variants of papillary thyroid carcinomas. Recognizing these differences becomes more important for the proper medical, surgical, and radiotherapeutic management of patients with these neoplasms.
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20
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Analysis of membranous Ki-67 staining in breast cancer and surrounding breast epithelium. Virchows Arch 2018; 473:145-153. [DOI: 10.1007/s00428-018-2343-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2018] [Revised: 03/03/2018] [Accepted: 03/20/2018] [Indexed: 12/29/2022]
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21
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Takada N, Hirokawa M, Ohbayashi C, Nishikawa T, Itoh T, Imagawa N, Oyama T, Handa T, Hasegawa T, Sugita S, Murata A, Miyauchi A. Re-evaluation of MIB-1 immunostaining for diagnosing hyalinizing trabecular tumour of the thyroid: semi-automated techniques with manual antigen retrieval are more accurate than fully automated techniques. Endocr J 2018; 65:239-244. [PMID: 29199205 DOI: 10.1507/endocrj.ej17-0413] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Hyalinizing trabecular tumour (HTT) immunohistochemically shows cell membranous immunoreactivity for MIB-1. This aberrant immunoreactivity is an important factor for the diagnosis of HTT. However, fully automated stainers frequently fail to confirm the immunoreactivity. The aim of this study is to investigate the cause of false negative cell membranous immunoreactivity for MIB-1 in HTT using fully automated stainers, to determine potential reasons for the problem, and to establish methods confirming cell membranous immunoreactivity for MIB-1 in HTT. Six participating institutions examined immunoreactivity for MIB-1 in 10 HTT cases using two approaches: fully automated and semi-automated methods. In the latter, antigen retrieval was carried out using manual methods adopted for routine assays at each institute. The autostainers used included the BOND-MAX, BOND-III, Benchmark XT, and Omnis systems. Using fully automated methods, institute E showed cell membranous MIB-1 positivity in all HTT cases. In contrast, at institute D, all HTT cases were negative. The positive rates of the remaining four institutes ranged from 10% to 20%. The incidence of positive cases using semi-automated methods was 100%, 90%, 90%, 30%, 80%, and 100% at institutes A, B, C, D, E, and F, respectively. We assert that antigen retrieval should be conducted manually for diagnosis of HTT; furthermore, definitively diagnosed HTT should be prepared as the external positive control.
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Affiliation(s)
- Nami Takada
- Department of Clinical Laboratory, Kuma Hospital, Kobe, Hyogo, 650-0011, Japan
| | - Mitsuyoshi Hirokawa
- Department of Diagnostic Pathology and Cytology, Kuma Hospital, Kobe, Hyogo, 650-0011, Japan
| | - Chiho Ohbayashi
- Department of Diagnostic Pathology, Nara Medical University, Kashihara, Nara, 634-8521, Japan
| | - Takeshi Nishikawa
- Department of Diagnostic Pathology, Nara Medical University, Kashihara, Nara, 634-8521, Japan
| | - Tomoo Itoh
- Department of Diagnostic Pathology, Kobe University Graduate School of Medicine, Kobe, Hyogo, 650-0017, Japan
| | - Naoko Imagawa
- Department of Diagnostic Pathology, Kobe University Graduate School of Medicine, Kobe, Hyogo, 650-0017, Japan
| | - Tetsunari Oyama
- Department of Diagnostic Pathology, Gunma University Graduate School of Medicine, Maebashi, Gunma, 370-8511, Japan
| | - Tadashi Handa
- Department of Diagnostic Pathology, Gunma University Graduate School of Medicine, Maebashi, Gunma, 370-8511, Japan
| | - Tadashi Hasegawa
- Department of Surgical Pathology, Sapporo Medical University School of Medicine, Sapporo, Hokkaido 060-8543, Japan
| | - Shintaro Sugita
- Department of Surgical Pathology, Sapporo Medical University School of Medicine, Sapporo, Hokkaido 060-8543, Japan
| | - Akiko Murata
- Department of Technical Development, Genostaff Co. Ltd., Bunkyo-ku, Tokyo 113-0032, Japan
| | - Akira Miyauchi
- Department of Surgery, Kuma Hospital, Kobe, Hyogo, 650-0011, Japan
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22
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Hino R, Motoi N, Toda K, Ebina A, Yamada K, Higuchi M, Hirokawa M, Ishikawa Y. Stromal tiny black dots, like "sugar-coated", of von Kossa stain is a diagnostic clue to hyalinizing trabecular tumor of the thyroid gland. Pathol Int 2018; 68:176-182. [PMID: 29368414 DOI: 10.1111/pin.12638] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2017] [Accepted: 12/13/2017] [Indexed: 12/21/2022]
Abstract
Hyalinizing trabecular tumor (HTT) is a rare low-grade tumor, and a prominent feature is the basement membranous stroma. We assume that such characteristic stromal findings of HTT are related to calcium deposition, and examined HTT samples by von Kossa special staining. There has been no report describing von Kossa special staining for such stroma. We collected 12 cases of HTT and 30 cases of papillary thyroid carcinoma (PTC) that had matched age, gender, tumor size, and surgical procedure characteristics as a control group. We compared the staining pattern and degree of von Kossa positivity between HTT and PTC, and a grading system of von Kossa stain was adopted to highlight differences between them. On von Kossa staining, all HTT revealed many tiny black dots around vessels in the hyalinized stroma, like "sugar-coated", and a high degree of calcium deposition in most cases, whereas PTC showed sparse stromal calcification in some cases. The degree of von Kossa staining was significantly different between the two groups. This is the first report describing abundant tiny black dots, like a "sugar-coated" appearance, of von Kossa stain in HTT. Here, we propose this finding can be a useful diagnostic clue to HTT.
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Affiliation(s)
- Rumi Hino
- Department of Pathology, The Cancer Institute, Japanese Foundation for Cancer Research (JFCR), 3-8-31 Ariake, Koto-ku, Tokyo, Japan.,Department of Sports and Health Science, Daito Bunka University, 560 Iwadono, Higashimathuyama-shi, Saitama, Japan
| | - Noriko Motoi
- Department of Pathology, The Cancer Institute, Japanese Foundation for Cancer Research (JFCR), 3-8-31 Ariake, Koto-ku, Tokyo, Japan.,Department of Pathology and Clinical Laboratories, National Cancer Center Hospital, Chuo-ku, Tokyo, Japan
| | - Kazutoshi Toda
- Division of Head and Neck, The Cancer Institute Hospital, JFCR, Tokyo, Japan
| | - Aya Ebina
- Division of Head and Neck, The Cancer Institute Hospital, JFCR, Tokyo, Japan
| | - Keiko Yamada
- Division of Ultrasonography Examination, The Cancer Institute Hospital, JFCR, Tokyo, Japan
| | - Miyoko Higuchi
- Department of Diagnostic Pathology and Cytology, Kuma Hospital, 8-2-35, Shimoyamate-dori, Chuo-ku, Kobe, Hyogo, Japan
| | - Mitsuyoshi Hirokawa
- Department of Diagnostic Pathology and Cytology, Kuma Hospital, 8-2-35, Shimoyamate-dori, Chuo-ku, Kobe, Hyogo, Japan
| | - Yuichi Ishikawa
- Department of Pathology, The Cancer Institute, Japanese Foundation for Cancer Research (JFCR), 3-8-31 Ariake, Koto-ku, Tokyo, Japan
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23
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Evaluation of the proliferation marker Ki-67 in a large prostatectomy cohort. PLoS One 2017; 12:e0186852. [PMID: 29141018 PMCID: PMC5687762 DOI: 10.1371/journal.pone.0186852] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2017] [Accepted: 10/09/2017] [Indexed: 12/01/2022] Open
Abstract
The tumor proliferation index marker Ki-67 is strongly associated with tumor cell proliferation, growth and progression, and is widely used in routine clinicopathological investigation. Prostate cancer is a complex multifaceted and biologically heterogeneous disease, and overtreatment of localized, low volume indolent tumors, is evident. Here, we aimed to assess Ki-67 expression and related outcomes of 535 patients treated with radical prostatectomy. The percentage of tumor epithelial cells expressing Ki-67 was determined by immunohistochemical assay, both digital image analysis and visual scoring by light microscope were used for quantification. The association of Ki-67 and prostate cancer was evaluated, as well as its prognostic value. There was a positive correlation between high expression of Ki-67 and Gleason score > 7 (p < 0.001) as well as tumor size (≥ 20 mm, p = 0.03). In univariate analyses, a high expression of Ki-67 in tumor epithelium was significantly associated with biochemical failure (BF) (digital scoring, p = 0.014) and (visual scoring, p = 0.004). In the multivariate analyses, a high level of Ki-67 was an independent poor prognostic factor for biochemical failure-free survival (BFFS) (Visual scoring, Ki67, p = 0.012, HR:1.50, CI95% 1.10–2.06). In conclusion, high Ki-67 expression is an independent negative prognostic marker for biochemical failure. Our findings support the role of Ki-67 as a significant, poor prognostic factor for in prostate cancer outcome.
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24
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Saglietti C, Piana S, La Rosa S, Bongiovanni M. Hyalinizing trabecular tumour of the thyroid: fine-needle aspiration cytological diagnosis and correlation with histology. J Clin Pathol 2017; 70:641-647. [PMID: 28424236 DOI: 10.1136/jclinpath-2017-204360] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2017] [Revised: 03/27/2017] [Accepted: 03/28/2017] [Indexed: 11/04/2022]
Abstract
Hyalinizing trabecular tumour (HTT) is a rare thyroid neoplasm of follicular cell origin characterised by a trabecular growth pattern and prominent intratrabecular and intertrabecular hyalinisation. These peculiar histological features allow the prompt recognition of this neoplasm in surgical specimens. However, cytological diagnosis of HTT remains elusive and misleading because of overlapping characteristics with other thyroid tumours, particularly papillary thyroid carcinoma (PTC), medullary thyroid carcinoma (MTC) and the newly described non-invasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP). Nevertheless, the proper recognition of this neoplasm on preoperative cytological preparations is important to avoid unnecessary overtreatment of this indolent lesion. A thorough review of the literature has revealed that the correct diagnosis of HTT in cytological smears is achieved in only 8% of cases. In a further 6% of cases, diagnostic doubt has been indicated. Sixty percent of published cases of HTT have been misdiagnosed as suggestive, suspicious or positive for PTC. These findings underline the difficulties of a cytological-based diagnosis of such entity. In this article we review the cytomorphological features of HTT and their correlation to histological features to provide the reader with the tools to improve diagnostic performance in the identification of HTT on preoperative cytology.
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Affiliation(s)
- Chiara Saglietti
- Service of Clinical Pathology, Lausanne University Hospital, Institute of Pathology, Lausanne, Switzerland
| | - Simonetta Piana
- Pathology Unit, Arcispedale Santa Maria Nuova IRCCS, Reggio Emilia, Italy
| | - Stefano La Rosa
- Service of Clinical Pathology, Lausanne University Hospital, Institute of Pathology, Lausanne, Switzerland
| | - Massimo Bongiovanni
- Service of Clinical Pathology, Lausanne University Hospital, Institute of Pathology, Lausanne, Switzerland
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25
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Ibrahim MAA, Elbakry RH, Bayomy NA. Effect of bisphenol A on morphology, apoptosis and proliferation in the resting mammary gland of the adult albino rat. Int J Exp Pathol 2016; 97:27-36. [PMID: 26877094 DOI: 10.1111/iep.12164] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2015] [Accepted: 11/29/2015] [Indexed: 12/22/2022] Open
Abstract
Bisphenol A (BPA) is a synthetic oestrogen that is extensively used in a wide range of daily used plastic products. This makes it one of the environmental chemicals that may have impact on human health. Due to its oestrogenic effect, BPA might affect the mammary gland. This study aimed to investigate the influence of BPA on the histological structure of the mammary gland of the adult female albino rat and its effect on epithelial cell proliferation and apoptosis status, in addition to its possible modulating effect on estrogen receptor expression. Thirty female adult albino rats were divided into control and experimental groups. The rats in the experimental group were gavaged with 5 mg/kg BPA daily for 8 weeks. The mammary glands were dissected and processed for histological and immunohistochemical stains for Ki-67, activated caspase-3 and estrogen receptor alpha (ER-α). BPA induced an increase in the number and size of the acini and ducts in the mammary gland of treated rats with hyperplasia of their lining epithelial cells. The collagen fibre content was significantly increased in the connective tissue stroma separating the ducts. Immunohistochemical results showed a significant increase in Ki-67 and caspase-3, but a non-significant increase in ER-α expression. Bisphenol A induced structural changes and affected the proliferation rate of mammary glands, so it might be one of the predisposing factors for breast cancer.
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Affiliation(s)
- Marwa A A Ibrahim
- Histology Department, Faculty of Medicine, Tanta University, Tanta, Egypt
| | - Reda H Elbakry
- Histology Department, Faculty of Medicine, Tanta University, Tanta, Egypt
| | - Naglaa A Bayomy
- Histology Department, Faculty of Medicine, Tanta University, Tanta, Egypt.,Anatomy and Tissues department, Faculty of Medicine, Northern Border University, Arar, Saudi Arabia
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26
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Jordan B, Kellner J, Jordan K, Bähre M, Behrmann C, Zierz S. Thymic pathologies in myasthenia gravis: a preoperative assessment of CAT scan and nuclear based imaging. J Neurol 2016; 263:641-8. [PMID: 26810725 DOI: 10.1007/s00415-016-8023-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2015] [Revised: 01/03/2016] [Accepted: 01/04/2016] [Indexed: 12/21/2022]
Abstract
Precise diagnostic work up of a suspected thymic pathology in patients with myasthenia gravis (MG) is very important for potential surgical implications and further disease course. In this study the diagnostic value of combined preoperative radiological (CAT scan) and nuclear based imaging (octreotide and thallium scintigraphy) in patients with MG was evaluated. Twenty four patients were included. Histopathology revealed thymoma in nine patients, thymic carcinoma (TC) in one patient, lymphofollicular hyperplasia in seven patients, and involuted thymus in another seven patients. Diagnostic sensitivity for detecting thymoma/TC was 80 % in CAT scan as well as in somatostatin scintigraphy; the combination of both procedures reached 90 %. However, the diagnostic specifity to exclude thymoma in CAT scan was 100 % and in octreotide scintigraphy 85.7 %. Semiquantitative octreotide uptake significantly correlated with histological grading of thymoma/TC (r = 0.764) and histological proliferation rate Ki67 (r = 0.894). Thallium scintigraphy was positive only in one out of four thymoma cases. In this study, somatostatin scintigraphy has been shown to be a useful additional diagnostic technique in detecting thymic malignancies in patients with MG. These results might be especially helpful in patients with late onset MG as these patients are in general no candidates for thymectomy.
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Affiliation(s)
- Berit Jordan
- Department of Neurology, Martin-Luther-University Halle-Wittenberg, Ernst-Grube-Strasse 40, 06097, Halle/Saale, Germany.
| | - Juliane Kellner
- Department of Neurology, Martin-Luther-University Halle-Wittenberg, Ernst-Grube-Strasse 40, 06097, Halle/Saale, Germany
| | - Karin Jordan
- Department of Hematology and Oncology, Martin-Luther-University Halle-Wittenberg, Ernst-Grube-Strasse 40, 06097, Halle/Saale, Germany
| | - Manfred Bähre
- Department of Nuclear Medicine, Martin-Luther-University Halle-Wittenberg, Ernst-Grube-Strasse 40, 06097, Halle/Saale, Germany
| | - Curd Behrmann
- Department of Radiology, Martin-Luther-University Halle-Wittenberg, Ernst-Grube-Strasse 40, 06097, Halle/Saale, Germany
| | - Stephan Zierz
- Department of Neurology, Martin-Luther-University Halle-Wittenberg, Ernst-Grube-Strasse 40, 06097, Halle/Saale, Germany
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Niemiec J, Adamczyk A, Ambicka A, Mucha-Małecka A, Wysocki WM, Majchrzyk K, Ryś J. BGX-Ki-67 index as a supplementary marker to MIB-1 index, enabling more precise distinction between luminal A and B subtypes of breast carcinoma and eliminating the problem of membranous/cytoplasmic MIB-1 staining. Am J Clin Pathol 2015; 143:419-29. [PMID: 25696801 DOI: 10.1309/ajcphaek82qwqorj] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
OBJECTIVES We compared clinical utility of MIB-1 and BGX-Ki-67 clones of anti-Ki-67 antibody in a group of 156 patients with invasive ductal breast cancer. METHODS MIB-1 labeling index (MIB-1LI) and BGX labeling index (BGXLI) were evaluated immunohistochemically both in primary tumors (T) and synchronous lymph node metastasis (LNM). RESULTS In addition to nuclear MIB-1 staining, in 23 of 145 and 19 of 144 T and LNM, respectively, membranous/cytoplasmic labeling was found. In these cases, BGX-Ki-67 showed exclusively nuclear labeling and presented significantly higher labeling index. High BGXLI(T) was a significant independent negative prognostic factor for disease-free survival. Moreover, based on BGXLI(T)/BGXLI(LNM), patients with high MIB-1LI(T) were stratified into low- and high-risk carriers. CONCLUSIONS In carcinomas with membranous/cytoplasmic MIB-1 staining, additional assessment of BGXLI is recommended. It may help in defining breast cancer subtype and in selection of individuals at risk who, despite appropriate therapy, would benefit from more frequent controls aimed at earlier implementation of second-line treatment.
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Affiliation(s)
- Joanna Niemiec
- Department of Applied Radiobiology, Maria Sklodowska-Curie Memorial Centre and Institute of Oncology, Krakow Branch, Krakow, Poland
| | - Agnieszka Adamczyk
- Department of Applied Radiobiology, Maria Sklodowska-Curie Memorial Centre and Institute of Oncology, Krakow Branch, Krakow, Poland
| | - Aleksandra Ambicka
- Department of Tumor Pathology, Maria Sklodowska-Curie Memorial Centre and Institute of Oncology, Krakow Branch, Krakow, Poland
| | - Anna Mucha-Małecka
- Department of Head and Neck Cancers, Maria Sklodowska-Curie Memorial Centre and Institute of Oncology, Krakow Branch, Krakow, Poland
| | - Wojciech M. Wysocki
- Department of Surgical Oncology, Maria Sklodowska-Curie Memorial Centre and Institute of Oncology, Krakow Branch, Krakow, Poland
| | - Kaja Majchrzyk
- Department of Applied Radiobiology, Maria Sklodowska-Curie Memorial Centre and Institute of Oncology, Krakow Branch, Krakow, Poland
| | - Janusz Ryś
- Department of Tumor Pathology, Maria Sklodowska-Curie Memorial Centre and Institute of Oncology, Krakow Branch, Krakow, Poland
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Park HS, Kim KM, Bae JS, Chung MJ, Lee H, Moon WS, Jang KY. Diagnostic caveats of immunoreactivity for Ki67 and chromogranin A in hyalinizing trabecular tumour of the thyroid. J Clin Pathol 2014; 67:835-9. [PMID: 25012947 DOI: 10.1136/jclinpath-2014-202339] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Abstract
Recent insight into the molecular mechanisms of thyroid carcinogenesis has led to studies involving newly directed antibodies. With the introduction of new molecular targeted therapies, these antibodies may represent useful predictors of therapeutic response in tumors unresponsive to radioiodine or insensitive to conventional antitumor therapies. These markers complement the development of markers that are able to discern benign from malignant entities, including hyalinizing trabecular tumors, oncocytic neoplasms, and follicular variant of papillary thyroid carcinoma. The use of antibodies directed to proteins generated by mutated genes may represent a cost-effective method for diagnosing and managing patients affected by thyroid tumors.
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Affiliation(s)
- Guido Fadda
- Division of Anatomic Pathology and Histology, Agostino Gemelli School of Medicine and Hospital, Catholic University, Largo Francesco Vito, Rome 1 00168, Italy.
| | - Esther Diana Rossi
- Division of Anatomic Pathology and Histology, Agostino Gemelli School of Medicine and Hospital, Catholic University, Largo Francesco Vito, Rome 1 00168, Italy
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Ekholm M, Beglerbegovic S, Grabau D, Lövgren K, Malmström P, Hartman L, Fernö M. Immunohistochemical assessment of Ki67 with antibodies SP6 and MIB1 in primary breast cancer: a comparison of prognostic value and reproducibility. Histopathology 2014; 65:252-60. [PMID: 24527721 DOI: 10.1111/his.12392] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2013] [Accepted: 02/10/2014] [Indexed: 12/23/2022]
Abstract
AIMS To compare SP6 and MIB1 antibodies for assessment of Ki67 in primary breast cancer with regard to prognostic value and reproducibility. METHODS AND RESULTS A cohort of 237 premenopausal women with node-negative breast cancer, mainly (87%) not treated with adjuvant systemic therapy, was used. Assessment of Ki67 (SP6 and MIB1) was performed on tissue microarray by three different investigators. The seventh decile was applied for cut-off. Distant disease-free survival (DDFS) was chosen as endpoint and the follow-up was restricted to 5 years. Eighty-nine per cent of the samples were classified into the same proliferation group, irrespective of antibody used. For both antibodies, high Ki67 was associated with inferior DDFS in univariable analyses (SP6: HR 2.5, P = 0.01; and MIB1: HR 2.8, P = 0.004), but failed to reach statistical significance for DDFS in multivariable analyses adjusted for HER2, age, and tumour size (SP6: HR 2.0, P = 0.074; and MIB1: HR 2.2, P = 0.058). The agreement between different assessors was somewhat higher for MIB1 than for SP6 (κ 0.83-0.88 versus 0.72-0.77). CONCLUSIONS SP6 was not superior to MIB1, but the two antibodies were comparable in the assessment of Ki67. Both MIB1 and SP6 could therefore be considered for prognostic use in primary breast cancer.
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Affiliation(s)
- Maria Ekholm
- Department of Oncology, Ryhov County Hospital, Jönköping, Sweden; Division of Oncology and Pathology, Department of Clinical Sciences Lund, Lund University, Lund, Sweden
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Ji Y, Zheng M, Ye S, Chen J, Chen Y. PTEN and Ki67 expression is associated with clinicopathologic features of non-small cell lung cancer. J Biomed Res 2013; 28:462-7. [PMID: 25469115 PMCID: PMC4250962 DOI: 10.7555/jbr.27.20130084] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2013] [Revised: 07/16/2013] [Accepted: 09/25/2013] [Indexed: 12/20/2022] Open
Abstract
Phosphatase and tensin homolog deleted on chromosome 10 (PTEN) and the proliferating antigen Ki67 have been widely studied in several tumors. However, their role as indicator in non-small cell lung cancer (NSCLC) remains unknown. Here, we investigated the expression of PTEN and Ki67 in NSCLC tissues and paired normal lung tissues to identify whether these proteins are associated with lung cancer development and survival. Immunohistochemistry for PTEN and Ki67 was performed on 67 lung cancer tissues and 41 paired adjacent normal lung tissues to detect the expression of these two proteins. The expression of PTEN in NSCLC tissues (32.8%) was significantly lower than that in normal tissues (82.9%, P < 0.05). In contrast, the expression of Ki67 in NSCLC tissues (76.1%) was significantly higher than that in normal tissues (27.3%, P < 0.05). Expression of both PTEN and Ki67 were strongly associated with tumor histology, clinical stage, lymph node metastasis, differentiation and 4-year postoperative survival rate (P < 0.05). However, PTEN expression was negatively correlated with Ki67 expression (r = -0.279, P < 0.05). In conclusion, low PTEN expression and Ki67 overexpression are associated with malignant invasion and lymph node metastasis of NSCLC. These proteins may serve as diagnostic and prognostic biomarkers of NSCLC.
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Affiliation(s)
- Yong Ji
- Department of Cardiothoracic Surgery, the First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu 210009, China
| | - Mingfeng Zheng
- Department of Cardiothoracic Surgery, the First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu 210009, China
| | - Shugao Ye
- Department of Cardiothoracic Surgery, the First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu 210009, China
| | - Jingyu Chen
- Department of Cardiothoracic Surgery, the First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu 210009, China
| | - Yijiang Chen
- Department of Cardiothoracic Surgery, the First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu 210009, China
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Lenggenhager D, Maggio EM, Moch H, Rössle M. HBME-1 expression in hyalinizing trabecular tumours of the thyroid gland. Histopathology 2013; 62:1092-7. [PMID: 23617709 DOI: 10.1111/his.12123] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2012] [Accepted: 03/04/2013] [Indexed: 11/26/2022]
Abstract
AIMS Hyalinizing trabecular tumour (HTT) is a rare thyroid neoplasm with a trabecular growth pattern, marked intratrabecular hyalinization and nuclear features of papillary thyroid carcinoma (PTC). Immunohistochemical HBME-1 expression was reported recently in PTC, but not in HTT. To clarify further the value of HBME-1 expression as a tool in differential diagnosis, we investigated the immunophenotype of HTT. METHODS AND RESULTS Eight HTT diagnosed from 1997 to 2012 were reviewed on H&E-stained tissue sections and analysed for HBME-1, galectin-3, CK19 and Ki67 expression by immunohistochemistry. Three of eight HTTs (37.5%) were HBME-1 positive, with staining of tumour cells as well as of intratrabecular hyaline matrix material. All cases were CK19 negative. Galectin-3 was expressed weakly in four of eight cases (50%). Five of eight cases (62.5%) showed weak-to-moderate cytoplasmic Ki67 positivity. CONCLUSIONS Immunohistochemical HBME-1 expression is present in HTT and may not serve as a reliable marker in differentiating HTT from PTC. The HBME-1 positivity of the hyaline matrix suggests that this material is partly of cytoplasmic origin.
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Affiliation(s)
- Daniela Lenggenhager
- Institute of Surgical Pathology, University Hospital Zurich, Zurich, Switzerland
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33
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Non-nuclear localization of Ki-67 in human colorectal cancer cells grown as multicellular layers. Arch Pharm Res 2013; 36:634-40. [DOI: 10.1007/s12272-013-0061-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2012] [Accepted: 11/26/2012] [Indexed: 10/27/2022]
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Ting S, Puttinger C, Schmid KW, Sheu-Grabellus SY. [Hyalinizing trabecular tumor of the thyroid. An overcautious designation of a benign thyroid tumour?]. DER PATHOLOGE 2012; 33:135-41. [PMID: 21842215 DOI: 10.1007/s00292-011-1498-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Hyalinizing trabecular tumours of the thyroid represent a rare entity of follicular cell derived tumours and are characterized by a marked intratrabecular hyalinisation. These tumours share architectural similarities with medullary thyroid carcinomas and exhibit nuclear features such as nuclear pseudoinclusions resembling papillary thyroid carcinoma. However, the clinical behaviour remains unclear. On the basis of their inconspicuous appearance and absence of invasion or recurrence during follow-up, the tumour was initially classified as an adenoma. Subsequently, molecular findings such as the detection of RET / PTC rearrangements in some hyalinizing trabecular tumours favoured the designation as a variant of papillary thyroid carcinoma. However, miRNA profiling of hyalinizing trabecular tumours compared with benign thyroid lesions and papillary thyroid carcinoma failed to demonstrate the characteristic up-regulation found in papillary thyroid carcinoma. This article summarizes conventional diagnostic criteria with supplementary information regarding molecular pathogenesis of hyalinizing trabecular tumours of the thyroid.
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Affiliation(s)
- S Ting
- Institut für Pathologie und Neuropathologie, Universitätsklinikum Essen, Hufelandstr. 55, 45122, Essen, Deutschland
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35
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Kim BH, Bae YS, Kim SH, Jeong HJ, Hong SW, Yoon SO. Usefulness of Ki-67 (MIB-1) immunostaining in the diagnosis of pulmonary sclerosing hemangiomas. APMIS 2012; 121:105-10. [PMID: 23030396 DOI: 10.1111/j.1600-0463.2012.02945.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2012] [Accepted: 06/03/2012] [Indexed: 12/01/2022]
Abstract
Pulmonary sclerosing hemangioma (PSH) is an uncommon lung neoplasm with a clinical outcome that is generally benign. However, differentiating PSH from pulmonary carcinoma is sometimes difficult as both lesions share similar histopathologic and immunohistochemical features. In this study, we investigated the usefulness of Ki-67 (MIB-1) immunostaining in the diagnosis of PSH. We compared the staining pattern for Ki-67 (MIB-1) in 29 cases of typical PSH and 79 cases of pulmonary non-small cell carcinoma (NSCLC) using an immunohistochemical method on formalin-fixed paraffin-embedded tissues. In all studied PSH cases, we noted cell membrane and cytoplasmic staining for Ki-67 (MIB-1), but this was not observed in any of the NSCLC cases. The Ki-67 proliferation index was lower in PSH than in the NSCLC cases (mean, 1.1% vs mean, 5.5%; p < 0.001). These findings suggest that cell membrane and cytoplasmic staining for Ki-67 (MIB-1), as well as the Ki-67 proliferation index, may be useful for distinguishing PSH from pulmonary carcinoma.
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Affiliation(s)
- Baek-hui Kim
- Department of Pathology, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea
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36
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Li J, Yang GZ, Gao LX, Yan WX, Jin H, Li L. Hyalinizing trabecular tumor of the thyroid: Case report and review of the literature. Exp Ther Med 2012; 3:1015-1017. [PMID: 22970009 DOI: 10.3892/etm.2012.529] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2012] [Accepted: 03/20/2012] [Indexed: 11/05/2022] Open
Abstract
In 1987, Carney et al described a rare thyroid tumor termed hyalinizing trabecular adenoma presenting characteristics consisting of a trabecular growth pattern and hyalinizing stroma. In subsequent reports, the observed nuclear features and RET alterations led this tumor to be linked to papillary carcinoma. Subsequent reports concerning hyalinizing trabecular carcinoma further complicated its classification. To avoid uncertainties, the definition of hyalinizing trabecular tumor (HTT) is more widely used. Herein, a case of HTT is reported in detail, and the circumstances are also discussed. HTT is thought to be particularly differentiated from papillary carcinoma despite the identical high frequency of nuclear grooves and cytoplasmic inclusions, and MIB-1-positive staining is one of the most accurate diagnostic methods due to the distinct membrane-positive pattern noted in HTT. It is believed that most HTTs are benign and lobectomy is the standard treatment. Pathologists should offer surgeons information concerning diagnosis overlapping with effective treatment.
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Affiliation(s)
- Jing Li
- Department of Pathology, The General Hospital of Beijing Military Command, Beijing 100700
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Ramljak V, Sučić M, Vrdoljak DV, Borojević N. Expression of Ki-67 and p27(Kip1) in fine-needle aspirates from breast carcinoma and benign breast diseases. Diagn Cytopathol 2011; 39:333-40. [PMID: 21488176 DOI: 10.1002/dc.21391] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Cell atypia in breast fine needle aspiration (FNA) can introduce some diagnostic difficulties. Molecules reflecting proliferative cell potential, such as Ki-67 and p27(Kip1) , can help in recognizing the true biological nature of a cell. Thus, the objective of the study was to analyze the difference in Ki-67 and p27(Kip1) cell immunoexpression in breast FNA specimens between fibroadenomas, fibrocystic changes (FCC) with atypia, and breast carcinoma. Microscopic analyses of cell cytomorphology and Ki-67 and p27(Kip1) breast cell immunoexpression were done after standard Pappenheim and immunocytochemical staining (labeled streptavidin-biotin, LSAB) method in autostainer DakoCytomation TechMate™. The study included 50 patients with breast carcinoma, 20 patients with fibroadenoma, and 20 patients with FCC with atypia. High Ki-67 and low or absent p27(Kip1) were found in most patients with breast carcinoma, while majority of FCC with atypia were characterized by low Ki-67 and moderate to high p27(Kip1) cell immunoexpression. Majority of fibroadenomas were associated with low Ki-67 and low to moderate p27(Kip1) cell immunoexpression indicating progressive decrease in cell cycle inhibition, but still not so high proliferative activity as in carcinoma. However, although statistically significant difference for Ki-67 and p27(Kip1) was found between breast lesions in our study, the large ranges observed for each marker make them essentially useless for better cytological diagnosis in a single case. Regarding their opposite role in cell cycle, inverse correlation of Ki-67 and p27(Kip1) was noticed. Poorly differentiated carcinoma cells had mostly high Ki-67 and low p27(Kip1) cell immunoexpression.
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Affiliation(s)
- Vesna Ramljak
- Department of Cytology, University Hospital for Tumors, Zagreb, Croatia
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Lee S, Hong S, Koo JS. Immunohistochemical subclassification of thyroid tumors with a prominent hyalinizing trabecular pattern. APMIS 2011; 119:529-36. [PMID: 21749453 DOI: 10.1111/j.1600-0463.2011.02762.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
The purpose of this study was to evaluate the immunohistochemical characteristics of thyroid tumors with a prominent hyalinizing trabecular pattern (TTHTP). Immunohistochemical stains for thyroid transcription factor 1 (TTF-1), thyroglobulin, CD56, cytokeratin (CK) 19, galectin-3, and Ki-67 were performed on 16 cases of TTHTP. All TTHTPs were positive for TTF-1 and thyroglobulin, and nine cases expressed CD56 and Ki-67. Of these nine cases, seven satisfied the strict criteria of Carney, and four cases were positive for CK19 or/and galectin-3 and negative for Ki-67 and CD56. The remaining three cases had no Ki-67, CD56, CK19 or galectin-3 expression. All TTHTPs meeting the criteria of Carney were hyalinizing trabecular tumors (HTT), and TTHTPs which did not satisfy the criteria of Carney were subclassified according to the immunohistochemical results as the HTT type [Ki-67 (+) and CD56 (+)], papillary thyroid carcinoma (PTC) type [CK19 or galectin-3 (+)/Ki-67 (-) and CD56 (-)], or null type [Ki-67 (-), CD56 (-), CK19 (-) and galectin-3 (-)]. TTHTPs with typical histologic features and/or with typical immunohistochemical manifestations can be categorized as HTT, and the remaining TTHTPs should be categorized as the PTC or null type.
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Affiliation(s)
- Sarah Lee
- Department of Pathology, Yonsei University College of Medicine, Seoul, South Korea
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Kim T, Oh YL, Kim KM, Shin JH. Diagnostic dilemmas of hyalinizing trabecular tumours on fine needle aspiration cytology: a study of seven cases with BRAF mutation analysis. Cytopathology 2011; 22:407-13. [PMID: 21733000 DOI: 10.1111/j.1365-2303.2011.00886.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Hyalinizing trabecular tumours (HTTs) are rare follicular-derived neoplasms that behave in an almost benign manner. HTT is frequently misdiagnosed as papillary carcinoma by fine needle aspiration (FNA) cytology or as papillary or medullary carcinoma on surgical resection. METHODS The authors examined FNA material from seven cases of histologically verified HTT. Cytological findings were reviewed and correlated with ultrasonographic and histological features. In addition, MIB-1 and calcitonin immunostaining was performed on surgical specimens, and BRAF mutation analysis on three pre-operative FNA specimens and seven histology specimens. RESULTS The original cytological diagnosis was either suspicious or positive for papillary carcinoma in all patients. The FNA-based differential diagnoses included HTT, papillary carcinoma or, less likely, medullary carcinoma in two patients. Aspirates showed oval to spindle-shaped cells with frequent intranuclear inclusions, isolated in loosely cohesive groups with a trabecular or syncytial pattern in a bloody background. Radiating arrangements of tumour cells surrounding hyaline stroma with serrated calcifications and a lack of papillary or sheet-like fragments may suggest HTT on FNA. Spherical calcified bodies and possible psammoma bodies were frequently found in three cases. Retrospectively, six of the seven cases showed membranous immunoreactivity for MIB-1, but none of the seven possessed the BRAF (V600E) mutation or showed calcitonin reactivity. CONCLUSIONS Although the recognition of HTT on FNA cytology is difficult, because of its morphological similarities to papillary and medullary carcinoma, its characteristic cytological features along with ultrasonographic findings may suggest the diagnosis preoperatively and avoid surgical over-treatment.
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Affiliation(s)
- T Kim
- Department of Pathology Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
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40
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Cell Membrane and Cytoplasmic Immunoreactivity of MIB-1 in Invasive Breast Carcinoma. Appl Immunohistochem Mol Morphol 2009; 17:563-4. [DOI: 10.1097/pai.0b013e3181a75e83] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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41
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Oncocytoma of the salivary glands: A clinicopathologic and immunohistochemical study. Oral Oncol 2009; 45:e232-8. [DOI: 10.1016/j.oraloncology.2009.08.004] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2009] [Revised: 08/19/2009] [Accepted: 08/19/2009] [Indexed: 11/19/2022]
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Ryska A, Cap J, Vaclavikova E, Dvorakova S, Bendlova B, Hovorkova E, Kohout A. Paraganglioma-like medullary thyroid carcinoma: fine needle aspiration cytology features with histological correlation. Cytopathology 2009; 20:188-94. [DOI: 10.1111/j.1365-2303.2008.00580.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Faratian D, Munro A, Twelves C, Bartlett JMS. Membranous and cytoplasmic staining of Ki67 is associated with HER2 and ER status in invasive breast carcinoma. Histopathology 2009; 54:254-7. [PMID: 19207951 DOI: 10.1111/j.1365-2559.2008.03191.x] [Citation(s) in RCA: 53] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
AIMS Membranous and cytoplasmic Ki67 immunoreactivity has recently been observed in a number of histopathological entities, but frequency of occurrence and relationship to prognosis in more common cancers have not been described. The aim was to describe the pattern and frequency of membranous/cytoplasmic Ki67 in a cohort of invasive breast carcinomas, and their associations with grade, HER2 amplification and oestrogen receptor (ER) expression. METHODS AND RESULTS Three hundred and twenty-two cases of invasive ductal carcinoma were assessed for histological grade, Ki67 (MIB-1 clone) proliferation index and pattern of immunoreactivity, ER expression by immunohistochemistry, and HER2 amplification status by fluorescence in situ hybridization. Overall, 26/322 (8%) breast carcinomas showed membranous/cytoplasmic Ki67, and expression was significantly associated with grade 3, HER2-amplified and ER- tumours. Membranous/cytoplasmic Ki67 was not, however, an independent prognostic factor on multivariate analysis. CONCLUSIONS Membranous/cytoplasmic Ki67 identifies a group of breast carcinomas that may be important to consider separately in prognostic and predictive studies. The mechanism of subcellular Ki67 relocalization remains elusive and further studies are required to establish both the cause and effect of this unusual pattern of Ki67 immunoreactivity.
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Affiliation(s)
- Dana Faratian
- Division of Pathology and Endocrine Cancer Group, University of Edinburgh Cancer Research Centre, Edinburgh, UK
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MIB-1 Cell Membrane Reactivity: A Finding That Should be Interpreted Carefully. Appl Immunohistochem Mol Morphol 2008; 16:568. [DOI: 10.1097/pai.0b013e31817af2cf] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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45
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Carney JA. Hyalinizing trabecular tumors of the thyroid gland: quadruply described but not by the discoverer. Am J Surg Pathol 2008; 32:622-34. [PMID: 18367942 DOI: 10.1097/pas.0b013e3181608545] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Hyalinizing trabecular tumors of the thyroid have been described on 4 occasions, by Carney and colleagues in 1987, by Ward and coworkers in 1982, by Pierre Masson in 1922, and by Rahel Zipkin in 1905. Zipkin credited her chief, Theodor Langhans (of Langhans giant cell fame), with identification of the cases she reported. Unaware of the 3 earlier descriptions, Carney and colleagues described 11 circumscribed or encapsulated thyroid tumors with elongated and polygonal cells arranged in trabeculae that contained a hyaline material resembling amyloid. The nuclei of the tumor cells had cytoplasmic invaginations and grooves similar to those of papillary carcinoma. Carney and colleagues labeled the neoplasms hyalinizing trabecular adenomas because of their microscopic appearance, absence of invasion, and benign natural history. Subsequently, the nuclear features of the tumor and the molecular genetic findings led to the introduction of equivocal designations for it, hyalinizing trabecular tumor and hyalinizing trabecular neoplasm, and later to its designation as a variant of papillary carcinoma. Experience has shown that most circumscribed or encapsulated follicular thyroid tumors with intratrabecular hyalin and nuclear features of papillary carcinoma behave as benign neoplasms. Hyalinizing trabecular carcinoma is a very rare tumor.
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Affiliation(s)
- J Aidan Carney
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN 55905, USA.
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Bussolati G, Leonardo E. Technical pitfalls potentially affecting diagnoses in immunohistochemistry. J Clin Pathol 2008; 61:1184-92. [DOI: 10.1136/jcp.2007.047720] [Citation(s) in RCA: 99] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Result of the immunohistochemical reactions routinely used in diagnostic surgical pathology should be properly interpreted, since false results, related to technical and interpretative pitfalls may lead to incorrect diagnosis. The main sources of such pitfalls are reviewed, analytically described and related to different steps (fixation, tissue processing and embedding, decalcification, antigen retrieval) which may affect the accuracy of immunohistochemistry. In addition, the presence of endogenous enzyme activity, improper binding of avidin to endogenous biotin, incorrect use of antibodies, chromogen and detection systems, as well as incorrect interpretation may produce unreliable data. The high frequency and extension of such pitfalls make mandatory the use of internal and external controls and adoption of cross-validation programmes. The present study, supported by an extensive review of the related literature, is intended as a guideline leading to proper interpretation of immunohistochemical data, an essential component of the diagnostic process. Experience on the antigen retrieval procedures for different antigens is also presented.
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Abstract
Nodules having a non-follicular-non-papillary structure may be frequently encountered in the thyroid, the solid/trabecular arrangement being the most common feature. When solid/trabecular pattern is predominant within a thyroid nodule, the wide range of differential diagnoses represents one of the major diagnostic problems in the routine thyroid practice, including--among others--relatively frequent entities such as trabecular adenoma or solid variant of papillary carcinoma and rare tumors such as hyalinizing trabecular tumor or paraganglioma. Morphology alone may not be sufficient to proper-type solid/trabecular tumors in the thyroid and, therefore, a panel of immunohistochemical markers is recommended, including thyroglobulin/calcitonin as the first step, followed by specific markers according to the morphological and clinical setting. A schematic algorithm is presented, which takes into consideration the diagnostic hallmarks of the most relevant entities that enter in the differential diagnosis in solid/trabecular nodules within the thyroid.
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Affiliation(s)
- Marco Volante
- Department of Clinical and Biological Sciences at San Luigi Hospital, University of Turin, Regione Gonzole 10, Turin, Orbassano, Italy.
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Abstract
Hyalinizing trabecular tumor (HTT) is a rare thyroid tumor of follicular cell origin with a trabecular pattern of growth and marked intratrabecular hyalinization. This tumor is known to share morphological and architectural similarities with paraganglioma and medullary thyroid carcinoma, as well as the nuclear features and RET/PTC1 translocations of papillary thyroid carcinoma. These tumors are not associated with RAS or BRAF mutations. Whether the presence of RET alterations in HTT are sufficient molecular proof of its relationship with papillary thyroid carcinoma (PTC) is still to be defined. Of great interest is the characteristic strong peripheral cytoplasmic and membranous staining of the tumor cells with MIB1 immunostain, not seen in any other thyroid neoplasm. Although cases of malignant HTT have been recorded, HTT should be considered a benign neoplasm or, at most, a neoplasm of extremely low malignant potential.
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Affiliation(s)
- Vânia Nosé
- Department of Pathology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA.
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