The prognostic value of CD133 in ovarian surface epithelial tumors

Background: Ovarian cancer, the fifth leading cause of cancer-related death in women, is a highly lethal disease among all gynecologic malignancies.Stem cells (SCs) are undifferentiated cells destined to replenish the pool of mature cells whenever needed.In recent years, accumulating data demonstrate that a small subset of cells exists within a tumor, termed cancer stem cells (CSC), responsible for cancer development and recurrence. CD133 is considered a CSC marker in several non-ovarian cancers including cancers of the colon, the lung, and the brain.Objective: To evaluate the expression of the stem cells marker CD133 in surface epithelial tumors of the ovary and its correlation with clinic-pathological parameters.Patients and methods: 60 cases, divided into 39 cases of serous tumors, 12 cases of mucinous tumors, 6 cases of endometrioid carcinoma and 3 Brenner tumors from 2018 to 2020, were stained for CD133 antibodies by immunohistochemistry. All clinical data were obtained from patients reports.Results: CD133 expression was found in 84.62% of ovarian epithelial cancer and in 37.5% of borderline tumors. CD133 expression showed a significant correlation with histopathological subtypes: high-grade serous carcinoma and mucinous tumors (P=0.001). Evaluation of CD133 in relation to other histopathological parameters: CD133 showed significant correlation with presence of psammoma bodies, and presence of necrosis (P= 0.049, and 0.005) respectively. Also, statistical evaluation of CD133 expression according to presence of lymphovascular emboli, peritoneal nodules, and infiltration to other organs showed high significance with (P= 0.001) similarly to all.Conclusion: CD133 expression could be a predictor of poor clinical outcome for patients with ovarian surface epithelial tumors as its expression was associated with high-grade serous carcinoma, necrosis, lympho-vascular emboli and peritoneal nodules

Diagnostic criteria of well differentiated thyroid tumor of uncertain malignant potential; a histomorphological and immunohistochemical appraisal

AbstractBackgroundWell differentiated thyroid tumor of uncertain malignant potential (WDT-UMP) represents a true “gray zone” of “follicular patterned” thyroid lesions, that needs to be characterized in order to outright the diagnosis of carcinoma and avoid unnecessary aggressive treatment.AimTo emphasize on the histomorphological criteria for more accurate diagnosis of WDT-UMP. Also to compare the immunohistochemical expression of CK19 of WDT-UMP versus adenoma and papillary thyroid carcinoma (PTC).Materials and methodsThe study included 60 thyroid specimens; 18 WDT-UMPs, 24 PTC (18 classic variant and 6 follicular variants) and 18 benign thyroid lesions (8 adenoma, 6 Hashimoto’s thyroiditis and 4 hyperplastic nodules). H&E stained sections were assessed according to the published major and minor criteria of malignancy in the thyroid. CK 19 immunostaining was examined and evaluated according to the proportion and intensity scores.ResultsWe could detect the absence of nuclear inclusions, presence of characteristic nuclear groove, nuclear clearing, ovoid nuclei, nuclear crowdness, nuclear enlargement and pleomorphism as important reliable features for diagnosis of WDT-UMP with p value (<0.0001 for each). WDT-UMP showed moderate to strong CK 19 immunostaining with proportion scores 3 and 4; an intermediate expression profile; higher than adenoma and less than papillary carcinoma (p<0.0001).ConclusionThe constellations of both major and minor criteria of malignancy are important clues for WDT-UMP diagnosis which could be ascertained by CK 19 immunostaining

Picrosirius red staining assessment of collagen after dermal roller application: A minimally invasive percutaneous collagen induction therapy

Background: Percutaneous collagen induction (PCI) through dermal roller breaks old collagen strands, promotes removal of damaged collagen and induces more collagen formation. Collagen fibers can be assessed by traditional stains or by polarized light assessment of Picrosirius red stain. Objective: The purpose of the current study is the clinical and histopathological evaluation of percutaneous collagen formation in atrophic acne scars after dermal roller application. Patients and Methods: Total study duration was 26 weeks in which 12 patients received seven sessions of PCI at 3-weeks interval, 3 mm punch biopsy specimens of scars were obtained before and after treatment (at 18 and 26 weeks). Microscopic examination of pre and post operative biopsies were done, using routine stains and Picrosirius red stain. Results: PCI induced notable improvement in the appearance of acne scars with significant reduction in the score from 123.3 ± 24.5 to 74.16 ± 16.49 (P = 0.00) after 26 weeks. Polarized light assessment of Picrosirius red stain clarified the gradual replacement of old thick orange-red birefringent collagen fibers by newly synthesized thin green-yellow birefringent ones postoperatively. Conclusion: Skin needling is a simple and minimally invasive procedure. The polarized light assessment of Picrosirius red stain clarified the change of the optical properties of collagen fibers according to the maturation process

Basal cell hyperplasia (BCH) versus high grade prostatic intraepithelial neoplasia (HGPIN) in tiny prostatic needle biopsies: Unusual diagnostic dilemma

Background: Histopathological differentiation between BCH and HGPIN in prostatic needle biopsies is a diagnostic challenge. The gold standard for detection of HGPIN and BCH is histopathological examination; however subjectivity in interpretation and tiny volume of obtained tissue hamper reliable diagnosis. Aims: The aim of this study was to assess usefulness of using the p63 and p504s to solve this problem. Although the use of p63 and p504s is now well established in differentiation between preneoplastic and neoplastic prostatic lesions, their usefulness in tiny tissue material is, however, not fully studied. Methods: The study included a spectrum of 30 prostatic needle biopsies (5 BCH, 10 HGPIN, 10 indefinite luminal proliferations where BCH and HGPIN could not be distinguished from each other and 5 adenocarcinomas). H&E stained sections were examined for histopathological features. Other sections were stained immunohistochemically with p63 and p504s. Results: The mean age of patients was 69 (SD = 7.6) years. PSA range was 1.3–2.7 ng/ml. Ultrasongraphic findings were unremarkable. All BCH showed p504s−/p63+ pattern, All HGPIN had p504s+/p63+ pattern while carcinomas were p504s+/p63−. After immunostaining combined with histopathological features; the 10 indefinite specimens could be diagnosed as 4 BCH and 6 HGPIN. The article explains how applying this staining pattern on the challenging specimens, combined with histopathological features, can be helpful in proper identification of prostatic proliferations