Immunoistochimica della tirosin fosfatasi SHP1 nell'adenocarcinoma endometriale. Dati preliminari.

Introduzione Il carcinoma endometriale è la più comune neoplasia invasiva ginecologica, con una incidenza di circa 33000 nuovi casi/anno e una prevalenza in costante aumento. L’analisi genetica delle neoplasie volta all’identificazione dei geni implicati nello sviluppo, crescita e aggressività dei tumori sta suscitando ormai da anni l’interesse dei ricercatori per le possibilità di trattamenti mirati di alta efficacia e basso profilo di tossicità. In questo senso il presente studio è stato disegnato al fine di valutare l’espressione della proteina fosfatasi SPH1nel carcinoma endometriale di Tipo I e II. Materiali e metodi Lo studio ha preso in considerazione 66 pazienti con diagnosi istologica di adenocarcinoma dell’endometrio dal 1998 al 2007. Le reazioni immunoistochimiche sono state eseguite impiegando la tecnica dell’immunoperossidasi. Le sezioni di tessuto sono state incubate con l’anticorpo monoclonale primario SHP1 previo smascheramento antigenico mediante bagno termostatato a 98° C per 30 minuti con tampone EDTA a Ph9. Il software statistico utilizzato è stato SPSS 11.0. (SPSS Inc., Chicago, IL). Risultati La correlazione tra SHP1 - l’istotipo e stadio FIGO non ha evidenziato valori statisticamente significativi, mentre tra SHP1 e Grading l’analisi è risultata significativa p<0.5. La correlazione tra recidiva/ morte ed espressione di SHP1 pur risultando inversamente proporzionale non raggiunge il valori di significatività. Discussione Dai nostri dati, per ora preliminari in quanto eseguiti solo sul 50% del campione disponibile, è emerso che l’espressione di SHP-1 non è correlata significativamente né con l’istotipo né con lo stadio FIGO. L’analisi sui dati di sopravvivenza e recidiva non hanno mostrato correlazione con SHP-1.E’ invece risultata statisticamente significativa l’associazione SHP-1 e Grading. Riteniamo che il presente studio nonostante i primi dati parziali non incoraggianti possa, una volta conclusa l’analisi di tutti i casi selezionati, portare alla luce un risultati significativi

Primary pure spindle cell carcinoma (sarcomatoid carcinoma) of the ovary: A case report with immunohistochemical study

BACKGROUND: In the ovary, sarcomatoid carcinoma has been reported only as mural nodules in epithelial malignant or borderline serous or mucinous cystic neoplasms, and in teratomas. In this paper we report a rare case of a solid sarcomatoid carcinoma of the ovary, without accompanying component of giant cells, pleomorphic cells, or glandular and other epithelial structures. CASE PRESENTATION: This case report refers to a sarcomatoid carcinoma of the ovary in in a 57&nbsp;year-old woman with abdominal pain. Macroscopically, the neoplasm was a 15x10x5 cm ovarian mass that featured gray white solid fleshy areas, interspersed with areas of necrosis, hemorrhage and cystic spaces filled with thick fluid. The epithelial differentiation of the tumor was demonstrated by strong and diffuse reactivity to CAM5.2 and focal immunoreactivity to EMA. A diagnosis of malignant mesenchymal tumor was excluded due to negativity for desmin, smooth muscle actin, caldesmon, CD34, CD10, and myoglobin. Neural, neuroendocrine neoplasm, melanoma and Perivascular Epithelioid Cell Tumor (PEComa) were excluded because of negativity for S100, chromogranin, synaptophysin and HMB45. CONCLUSION: Primary ovarian spindle cell carcinoma is a rare neoplasm, which must be considered in the differential diagnosis of solid ovarian mass with spindle cell appearance. This case adds to our knowledge of the biological behavior of these rare neoplasms. The distinction from true sarcomas and carcinosarcomas is important because of the more favorable prognosis of the spindle cell carcinomas. However their diagnosis necessitates a careful tissue sampling and immunohistochemical staining

The impact of uterine neoplastic tissue in accurately examined Fallopian tubes in pathological diagnosis and clinical managment

ABSTRACT The presence of intraluminal uterine neoplastic tissue or neoplastic cells in accurately examined Fallopian tubes can pose serious diagnostic problems for pathologists. Indeed, this finding, with the simultaneous presence of neoplastic cells in the intraoperative cytology of peritoneal washing, might suggest the retrograde transtubal spread of a uterine malignancy and, consequently, can be responsible for its upstaging, with an impact on the therapeutic approach. In a comment on our previously paper, in which we demonstrated this unusual mechanism of metastasis in a case of uterine serous carcinoma, and by a mini-review of the retrograde transtubal spread of uterine carcinoma, we discuss the pathological criteria for this findings and its impact on the management of patients affected by all subtypes of minimally invasive uterine carcinomas

A new case of primary signet-ring cell carcinoma of the cervix with prominent endometrial and myometrial involvement: Immunohistochemical and molecular studies and review of the literature

<p>Abstract</p> <p>Background</p> <p>As a rule, endocervical tumours with signet-ring cell are classed as metastatic extra-genital neoplasms. In a patient aged 45 years, we describe primary cervical signet-ring cell carcinoma (PCSRCC) characterized by prominent endometrial and myometrial involvement, simulating primary endometrial adenocarcinoma with cervical extension. In addition, a review was made of the literature to identify the clinical and pathological features of this rare malignancy.</p> <p>Case presentation</p> <p>A 45-year-old woman was referred to our Gynaecology Department due to persistent abnormal vaginal bleeding. Transvaginal ultrasonography showed slight endometrial irregularities in the whole uterine cavity suggestive of endometrial neoplasms. Pelvic magnetic resonance imaging revealed diffuse enlargement of the cervix, which had been replaced by a mass. Induration extended to the parametria and sigmoid colon fat.</p> <p>Histological examination of endometrial curettage and a cervical biopsy revealed a neoplasm characterized by neoplastic signet-ring cells and trabecular structures. Immunohistochemical analysis and molecular studies showed certain findings consistent with a cervical neoplasm, such as positivity to CEA, keratin 7, Ca-125 and p16 and the presence of HPV (Human Papilloma Virus) DNA 18.</p> <p>On examination of the hysterectomy with bilateral salpingo-oophorectomy and pelvic lymphadenectomy, the lesion replacing the cervix, endometrium and myometrium, revealed the same immunohistochemical findings observed on endometrial curettage and cervical biopsy specimens. Metastases were found in an ovarian cystic lesion and the lymph nodes.</p> <p>Conclusion</p> <p>With this report the authors have demonstrated that the spread of cervical adenocarcinoma to the uterine corpus, although rare, may be observed, and that in this instance immunohistochemical and molecular studies can provide sufficient information for accurate diagnosis even on small biopsy specimens.</p

An unusual mechanism of metastasis in serous carcinoma of the endometrium associated with BRCA1 mutation gene: A case report with clinical and immunohistochemical features

The current case report documented a uterine highgrade serous carcinoma in a 48yearold woman with previous clinical history of breast cancer, BRCA1 gene mutation, and melanoma of the back. Uterine Serous Carcinoma (USC) was minimally invasive with fallopian tubes, ovaries, omentum, peritoneal surface and lymph node biopsy demonstrating no evidence of neoplasm at the time of total abdominal hysterectomy with bilateral salpingooophorectomy. In the peritoneal washing cytology and in the lumen of both fallopian tubes there were neoplastic cells which, on immunohistochemical analysis, showed immunoreactivity for p53 and p16 and negativity for WT1, supporting the endometrial origin of these malignant serous neoplastic cells. One year after surgery, the patient presented with recurrent peritoneal neoplastic nodules and metastases into intestinal lymphnodes. To detect neoplastic USC cells in the fallopian tube lumen and to prove a retrograde transtubal spread into the peritoneal cavity, it is mandatory to examine the fallopian tubes in their entirety according to the SEEFIM (Sectioning and Extensively Examining the Fimbria) protocol. In addition, this case report highlights the importance of the peritoneal cytology and omentectomy during a total abdominal hysterectomy with bilateral salpingooophorectomy to establish adequate staging and future patient management, even in cases of minimally invasive serous endometrial carcinoma

Glomerella Leaf Spot Caused by a Nonhomothallic Strain of Glomerella cingulata on Highbush Blueberry Nursery Plants in Buenos Aires, Argentina

In February 2009, irregular-shaped leaf spots affected blueberry (Vaccinium corymbosum L. ‘Blue Crisp’, ‘Misty’, and ‘Sharp Blue’) nursery plants in Buenos Aires. Single-spore cultures on potato dextrose agar and oat agar showed aerial white mycelium that turned light and dark gray, dark brown acervuli with setae, and a salmon-to-orange conidial mass. Septate, dark brown, 62 to 78 μm long setae were abundant in the acervulus. Conidia were unicellular, hyaline, straight, cylindrical, round at the ends, and averaged 15.2 (12.1 to 16.9) × 5.4 (4.9 to 6.2) μm. Dark brown, ovate to clavate, 10.25 × 6.25 μm (9 to 12 × 5 to 8) appressoria with a noticeable pore formed on slides near the edge of the cover glass. Dark subglobose structures were recorded immersed in the culture medium. No asci or ascospores were observed, indicating a nonhomothallic condition. The fungus was identified as Colletotrichum gloeosporioides (Penz.) Penz & Sacc. (teleomorph Glomerella cingulata (Stoneman) Spauld. & H. Schrenk) with traits similar to those already described (1). DNA was obtained from mycelium with a standard DNA extraction kit and the ribosomal, internal transcribed spacer (ITS) 1 and ITS2 regions were PCR amplified and sequenced with primers ITS1 and ITS4 (2). A BLASTN algorithm search revealed 100% identity of the sequence (535 bp long) with G. cingulata/C. gloeosporioides from citrus and mango and one from coffee identified as C. kahawae (GenBank Accession No. JF908919). The nucleotide sequence was deposited in GenBank (Accession No. JQ340087). Pathogenicity was verified on young plants and detached leaves of highbush blueberry ‘Emerald’, ‘Misty’, ‘O'Neal’, and ‘Santa Fe’, olive (Olea europaea ‘Arbequina’), and marketed fruits of apple, mango, orange, and tomato. Disinfected healthy leaves were inoculated with a 9-mm2 mycelial block and incubated at 24°C with 12 h of light. Young plants were infected by placing the disinfected end of the branches within a micropipette tip filled with mycelium and kept under greenhouse conditions. Asymptomatic fruits of apple, mango, orange, and tomato were inoculated by placing a mycelial block on a small wound made on their surface. Detached leaves of highbush blueberry ‘Emerald’, ‘O'Neal’, ‘Misty’, and ‘Santa Fe’ showed 0.1 to 1.5 × 0.8 to 2 cm necrotic lesions after 3 days, covering 43 to 100% of the ‘Emerald’ leaf area after 8 days. Young plants of blueberry ‘Emerald’ and ‘Misty’ showed 1.5 to 3 cm necrotic lesions, acervuli, a salmon-orange conidial mass, and death of leaves at 25 days. On olive ‘Arbequina’, leaf necrotic lesions reached 0.1 to 3.5 cm after 5 days. Symptoms developed slowly on infected tomato fruits while inoculated fruits of apple, mango, and orange showed dark brown lesions that measured 2 to 7 × 1 to 3.5 cm at 5 days. No symptoms were observed on controls. The fungus was reisolated from inoculated plant parts. The disease was previously cited in Argentina (3), but to our knowledge, this is the first report of a nonhomothallic strain of G. cingulata from highbush blueberry colonizing and deteriorating fruits of apple, mango, orange, and tomato.Fil: Perez, Beatriz Alida. Instituto Nacional de Tecnología Agropecuaria. Centro de Investigación en Ciencias Veterinarias y Agronómicas. Instituto de Microbiología y Zoología Agrícola; ArgentinaFil: Wright, Eduardo Roberto. Universidad de Buenos Aires. Facultad de Agronomía. Departamento de Producción Vegetal. Cátedra de Fitopatología; ArgentinaFil: Berretta, Marcelo Facundo. Instituto Nacional de Tecnologia Agropecuaria. Centro de Investigacion En Ciencias Veterinarias y Agronomicas. Instituto de Agrobiotecnologia y Biologia Molecular. Grupo Vinculado Instituto de Microbiologia y Zoologia Agrigola Al Iabimo | Consejo Nacional de Investigaciones Cientificas y Tecnicas. Oficina de Coordinacion Administrativa Pque. Centenario. Instituto de Agrobiotecnologia y Biologia Molecular. Grupo Vinculado Instituto de Microbiologia y Zoologia Agrigola Al Iabimo.; Argentin

Coexistence of homologous-type carcinosarcoma of the cervix with undifferentiated carcinoma of the endometrium: A case report with Immunohistochemical analysis and literature review.

We report a case of undifferentiated carcinoma of the endometrium associated with malignant mixed Müllerian tumour of the uterine cervix. Immunohistochemical analysis with multiple markers was performed to demonstrate the coexistence of highly two aggressive components in the same uterus. Clinical data were collected and followed up, and a careful literature review was performed to establish the occurence of these components in a uterine malignancy

Neuroendocrine Small Cell Carcinoma of the Cervix: A case report

Merkel cell polyomavirus (MCPyV) has been found in patients with Merkel cell carcinoma and respiratory tract infections. Merkel cell carcinoma is a primary aggressive neuroendocrine carcinoma of the skin. It has been demonstrated that MCPyV can be transmitted during sexual activity and may be present in the oral and anogenital mucosa. The aim of the present study was to evaluate whether MCPyV coexisted with HPV in three cases of neuroendocrine small cell carcinoma of the cervix using PCR and immunohistochemical analysis Three cases of NSC of the cervix were identified in the pathology archives of Parma University (Italy). Of these, two cases were associated with an adenocarcinomatous component. A set of general primers from the L1 region (forward, L1C1 and reverse, L1C2 or L1C2M) was PCR amplified to detect the broad‑spectrum DNA of genital HPV. The presence of MCPyV was investigated via immunohistochemistry using a mouse monoclonal antibody against the MCPyV LT antigen and through PCR analysis to separate viral DNA. HPV DNA was present in all three neuroendocrine carcinomas and in the adenocarcinoma component of the two mixed cases. None of the cases were immunoreactive to CM2B4 and did not contain viral DNA in either their neuroendocrine or adenocarcinomatous component. Whilst it is difficult to draw definitive conclusions from such a small sample size, these data suggested that MCPyV does not coexist with HPV in the cervix. However, in the present study, the absence of detectable MCPyV may have been due to the presence of a genotype that was not detected by the primers used in the PCR analysis or by the antibody used for the immunohistochemical study. MCPyV microRNA may also have been present, inhibiting LT expression. Additional studies with larger cohorts and more advanced molecular biology techniques are required to confirm the hypothesis of the current study

The Evolving Role of Local Treatments for HCC in the Third Millennium

Hepatocellular carcinoma (HCC) represents the fifth most common malignancy and the third cancer-related cause of death worldwide. The aim of this review was to clarify the role of local treatments for HCC, analyzing the indications and defining future perspectives