Useful Immunohistochemical Markers of Tumor Differentiation

Calcifying pseudoneoplasm of the neuraxis (CAPNON) is a rare tumefactive lesion with unclear pathogenesis. It is diagnosed by pathological findings of the typical histological features that include granular amorphous cores with palisading spindle to epithelioid cells, variable fibrous stroma, foreign-body reaction with giant cells, and calcification/ossification occasionally with psammoma bodies. However, its histopathology may be variable and currently immunohistochemistry plays a limited role in its diagnosis and understanding the pathogenesis. In this study, we examined 6 cases of CAPNONs including 3 intracranial and 3 spinal epidural lesions (age range: 59–69 years; 3 males and 3 females). Immunohistochemistry revealed that all CAPNON cores contain abundant positive deposits of neurofilament protein (NFP), which was supported by electron microscopy finding of filaments (8–13 nm in diameter). In comparison, no NFP positivity was found in 5 psammomatous/metaplastic meningiomas or 7 intervertebral tissue lesions with calcification/ossification. In addition, CAPNON cellular areas showed variable numbers of CD8+ cytotoxic T-cells with less CD4+ T-cells and a decreased ratio of CD4/CD8+ cells, versus the intervertebral tissue lesions without CD8+ or CD4+ cells. Our findings suggest that NFP may be a principal constituent of CAPNONs, and thus involved in the pathogenesis of CAPNON. Given the decreased CD4/CD8 ratio, the pathogenic process of CAPNON is possibly immune- mediated.LEARNING OBJECTIVESThe presentation will enable the learner to: 1.Discuss histopathological features of calcifying pseudoneoplasm of the neuraxis (CAPNON) with variation of non-core components.2.Explore diagnostic and pathogenic roles of immunohistochemical markers including neurofilament protein and CD4/CD8 in CAPNON.

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Epithelioid Sarcoma Arising in a Long-Term Survivor of an Atypical Teratoid/Rhabdoid Tumor in a Patient With Rhabdoid Tumor Predisposition Syndrome

Pediatric and Developmental Pathology ◽

10.1177/1093526620986492 ◽

2021 ◽

pp. 109352662098649

Author(s):

Tiffany G Baker ◽

Michael J Lyons ◽

Lee Leddy ◽

David M Parham ◽

Cynthia T Welsh

Keyword(s):

Epithelioid Sarcoma ◽

Rhabdoid Tumor ◽

Malignant Rhabdoid Tumor ◽

Atypical Teratoid Rhabdoid Tumor ◽

Diagnostic Challenge ◽

Patient Demographics ◽

Immunohistochemical Markers ◽

Genetic Aberration ◽

Atypical Teratoid ◽

Rhabdoid Tumors

Rhabdoid tumor predisposition syndrome (RTPS) is defined as the presence of a SMARCB1 or SMARCA4 genetic aberration in a patient with malignant rhabdoid tumor. Patients with RTPS are more likely to present with synchronous or metachronous rhabdoid tumors. Based on the current state of rhabdoid tumor taxonomy, these diagnoses are based largely on patient demographics, anatomic location of disease, and immunohistochemistry, despite their nearly identical histologic and immunohistochemical profiles. Thus, the true distinction between such tumors remains a diagnostic challenge. Central nervous system atypical teratoid/rhabdoid tumor (AT/RT) is a rare, aggressive, primarily pediatric malignancy with variable histologic features and a well documented association with loss of SMARCB1 expression. Epithelioid sarcoma (ES) is a rare soft tissue tumor arising in patients of all ages and characteristically staining for both mesenchymal and epithelial immunohistochemical markers while usually demonstrating loss of SMARCB1 expression. To our knowledge we herein present the first documented case of a patient with RTPS who presented with metachronous AT/RT and ES.

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Sinonasal SMARCB1 (INI1) Deficient Carcinoma with Yolk Sac Tumor Differentiation: A Case Report and Treatment Options

Head and Neck Pathology ◽

10.1007/s12105-021-01375-9 ◽

2021 ◽

Author(s):

Burak Hazir ◽

Berkay Şímșek ◽

Arzu Erdemír ◽

Fatih Gürler ◽

Ozan Yazici ◽

...

Keyword(s):

Case Report ◽

Treatment Options ◽

Yolk Sac ◽

Yolk Sac Tumor ◽

Tumor Differentiation

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Peritoneal well-differentiated papillary mesothelioma associated with infertility in a 37-year-old woman

Journal of International Medical Research ◽

10.1177/0300060520986680 ◽

2021 ◽

Vol 49 (1) ◽

pp. 030006052098668

Author(s):

Bo Pang ◽

Cong Hu ◽

Qian Liu ◽

Jinyu Yu ◽

Zhentong Wei ◽

...

Keyword(s):

Benign Tumors ◽

Free Fluid ◽

Adenomatoid Tumor ◽

Cancer Antigen 125 ◽

Immunohistochemical Markers ◽

Serum Ca125 ◽

Life Threatening ◽

Well Differentiated ◽

The Right

Well-differentiated papillary mesothelioma (WDPM) is an uncommon mesothelial tumor. The lesions may be single or multiple and usually behave in a benign or indolent fashion, sometimes persisting for many years. In the present case, a 37-year-old woman had experienced primary infertility for 12 years, and a diagnostic laparoscopy was performed. Approximately 200 mL of dark red, free fluid in the pelvis and more than 10 yellow-white nodules on the surface of the right round ligament, sacrum ligament, right fallopian tube, and both sides of the uterus were found. A lesionectomy was performed and immunohistochemical markers indicated WDPM with adenomatoid tumor. The patient was monitored by computed tomography and serum CA125 (cancer antigen 125) levels for 49 months with no recurrence. WDPM and adenomatoid tumor are both benign tumors of mesothelial origin. Because of the lack of effective radical treatment, regular follow-up is sufficient. However, the effects of estrogen and progesterone on WDPM and adenomatoid tumors during ovulation or pregnancy remains unclear. Although WDPM is not life threatening, a strategy to fulfill the fertility requirements of women with this condition is a new challenge for infertility doctors.

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The Role of Immunohistochemical Markers for the Diagnosis and Prognosis of Adrenocortical Neoplasms

Journal of Personalized Medicine ◽

10.3390/jpm11030208 ◽

2021 ◽

Vol 11 (3) ◽

pp. 208

Author(s):

Anna Angelousi ◽

Georgios Kyriakopoulos ◽

Fani Athanasouli ◽

Anastasia Dimitriadi ◽

Eva Kassi ◽

...

Keyword(s):

Transcriptome Analysis ◽

Cox Regression ◽

P53 Protein ◽

Immunohistochemical Analysis ◽

Ki 67 ◽

Diagnosis And Prognosis ◽

Immunohistochemical Markers ◽

Small Series ◽

Morphological Criteria ◽

Survival And Development

Adrenal cortical carcinoma (ACC) is a rare cancer with poor prognosis that needs to be distinguished from adrenocortical adenomas (ACAs). Although, the recently developed transcriptome analysis seems to be a reliable tool for the differential diagnosis of adrenocortical neoplasms, it is not widely available in clinical practice. We aim to evaluate histological and immunohistochemical markers for the distinction of ACCs from ACAs along with assessing their prognostic role. Clinical data were retrospectively analyzed from 37 patients; 24 archived, formalin-fixed, and paraffin-embedded ACC samples underwent histochemical analysis of reticulin and immunohistochemical analysis of p27, p53, Ki-67 markers and were compared with 13 ACA samples. Weiss and Helsinki scores were also considered. Kaplan−Meier and univariate Cox regression methods were implemented to identify prognostic effects. Altered reticulin pattern, Ki-67% labelling index and overexpression of p53 protein were found to be useful histopathological markers for distinguishing ACAs from ACCs. Among the studied markers, only pathological p53 nuclear protein expression was found to reach statistically significant association with poor survival and development of metastases, although in a small series of patients. In conclusion, altered reticulin pattern and p53/Ki-67 expression are useful markers for distinguishing ACCs from ACAs. Immunohistopathology alone cannot discriminate ACCs with different prognosis and it should be combined with morphological criteria and transcriptome analysis.

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