Comparative immunohistochemical expression of β-catenin, EGFR, ErbB2, and p63 in adamantinomatous and papillary craniopharyngiomas

AbstractCraniopharyngiomas (CPs) are rare epithelial tumors located mainly in the sellar/parasellar region. CPs have been classified into histopathologically, genetically, clinically and prognostically two distinctive subtypes: adamantinomatous and papillary variants.AimTo determine the immunohistochemical expression of β-catenin, EGFR, ErbB2, and p63 in adamantinomatous and papillary CPs.Materials and methodsβ-Catenin, EGFR, ErbB2, and p63 immunostaining was performed on paraffin embedded tissue sections of 25 CPs including 18 adamantinomatous craniopharyngioma (ACP) and 7 cases of papillary craniopharyngiomas (PCPs).Results17 cases (94%) of ACP exhibited strong nuclear/cytoplasmic expression of β-catenin. On the contrary, all cases of PCP showed exclusively membranous expression (P value<0.0001). Regarding EGFR, 15 (83%) and 5 cases (71%) of APC and PCP respectively were positive. On the other hand, only 3 cases (17%) of APC and none of PCP exhibited positivity for ErbB2. p63 over-expression was observed in 16 cases of ACP (89%) and 6 cases of PCP (86%). However, the distribution of p63 staining was diffuse in ACP, while in PCP; the staining was mainly restricted to the basal cell layer.ConclusionNuclear accumulation of β-catenin is a diagnostic hallmark of the ACP and is very helpful in the differential diagnosis between both ACP and PCP in the setting of small biopsies. Moreover, the restricted nuclear β-catenin accumulation in the cohesive cell clusters within the whorl-like areas supports that aberrant β-catenin expression may play a role in the morphogenesis of ACP

Spontaneous haemorrhage of an adrenal angiomyolipoma: case report

Background Angiomyolipomas are rare mesenchymal tumours arising from the perivascular epithelioid cells consisting of variable amounts of adipose, thick-walled blood vessels and smooth muscle cells. These benign tumours commonly occur in the kidney with only a few case reports of adrenal angiomyolipomas which have the potential to reach a large size and haemorrhage. Case presentation A 45-year-old lady presented with a 3-week history of right loin pain, nausea and vomiting. A CT scan revealed a right adrenal angiomyolipoma measuring 6.3 × 6.8 cm with associated haemorrhage. The lesion was successfully treated with right open adrenalectomy, and histology confirmed the diagnosis of adrenal angiomyolipoma. The patient remained well with no evidence of recurrence at the 36-month follow-up. Conclusion Adrenal angiomyolipomas are rare benign tumours that have the ability to reach a large size and potential to bleed. Here, we report the second case of spontaneous haemorrhage in an adrenal angiomyolipoma, which was successfully treated with open adrenalectomy

Essays on Distance Functions and Inefficiency Measurement

This dissertation includes three essays on distance functions and inefficiency measurement. The main focus of the three essays is the measurement and determinants of technical inefficiency theoretically and empirically. Essay 1 provides an up-to-date review that focuses on research methods, including different approaches to measuring technical inefficiency using distance functions, the development of modeling technical inefficiency, and the most common econometric estimation techniques. It also provides a useful guide on when these methods can be used and how to implement them. Regarding estimation issues, I address the important issues that should be managed in future applications while estimating technical inefficiency, including violation of theoretical and econometric regularity, the inaccurate choice of functional form, ignoring the possibility of heterogeneity and heteroskedasticity, and suffering from the endogeneity problem. I also discuss different approaches to deal with these issues, as well as potentially productive areas for future research. Essay 2 derives the interactive effect between input and output technical inefficiencies theoretically using directional distance functions. This derivation solves the arbitrary decomposition of overall technical inefficiency into input and output components in previous studies. I argue that overall technical inefficiency equals the sum of input and output technical inefficiencies plus an interactive effect component which captures the interactions between them. I prove the results theoretically using exogenous and endogenous directional vectors. Essay 3 investigates the relationships among input, output, and overall technical inefficiencies empirically using US banking data set. Using Bayesian estimation with the monotonicity conditions imposed at each observation, I estimate these inefficiencies separately using directional input, output, and technology distance functions. I model the overall technical inefficiency as a linear function of input and output technical inefficiencies, and a term capturing the interactions between them. These determinants of overall technical inefficiency are estimated simultaneously with the variables that determine the frontier. I find significant evidence of the interactive effect between input and output technical inefficiencies which has a negative effect on the overall technical inefficiency. This result is robust to alternative directional vectors and model specifications, suggesting that the adjustability of both inputs and outputs is required for the improvement of efficiency

Giant cell tumor of soft tissue: A case report for the first time in ear

Giant cell tumor of soft tissue is a rare benign tumor of low malignant potential. It counterparts soft tissue bone tumor. Majority of cases are in extremities and to a lesser extent in other regions but rarely in head and neck. Here we report for the first time giant cell tumor of soft tissue in the ear. A 28 years old female presented with painless right ear mass slowly progressing over 2 months associated with discharge for 2 weeks. The condition was initially diagnosed as chronic otitis media. CT scan and Excisional biopsy was done. Microscopically, examination revealed multiple tumor nodules that diffusely infiltrate the soft tissue and covered partially by unremarkable epithelium. The nodules are composed of bland mononuclear cells, short spindle cells and osteoclast giant cells. The mononuclear and giant cells lack striking atypia. However; the mononuclear cells exhibit brisk mitotic activity. The tumor was completely excised and follow up was scheduled after 1 year

Assessment of leptin and resistin levels in non-obese multiple myeloma patients and their relation with Ig level and disease stage

Introduction: Multiple myeloma (MM) accounts for approximately 0.8% of all cancer diagnoses and 0.9% of cancer deaths. Leptin receptors were expressed on CD34+ cells. Resistin receptors were expressed on inflammatory cells and pro-inflammatory cytokines increase the expression of resistin on monocytes. Aim of work: To assess the level of leptin and resistin in non-obese multiple myeloma patients and to study their relation with Ig level and disease stage. Subjects & methods: 32 subjects were included; 16 patients diagnosed with MM and 16 healthy individuals served as control. All were subjected to history taking, clinical examination, routine laboratory investigations and leptin & resistin blood level. Laboratory investigations were done for diagnosis and staging for MM patients. Results: Leptin was significantly higher in MM patients compared with the control group, unlike resistin which showed no significant difference between the two groups. A significant positive relation was found between IgG level & leptin. Similarly, a significant difference in leptin level has been observed between stage I & stage II (higher in II). Conclusions: Leptin may play a role in the pathogenesis of MM and its level may be changed in different stages