scholarly journals Immunohistochemical Markers and the Clinical Course of Adenosarcoma: a Series of Seven Cases

2020 ◽  
Author(s):  
Makiko Omi ◽  
Akiko Tonooka ◽  
Tomohiro Chiba ◽  
Hidetaka Nomura ◽  
Hiroyuki Kanao ◽  
...  

Abstract Background: Uterine adenosarcoma, a rare subtype of uterine tumor, is a biphasic tumor consisting of epithelial and mesenchymal elements. There is no research comparing histopathological features of primary and recurrent tumors, including immunohistochemistry; furthermore, the relationship between pathology and the clinical course is unclear. We reviewed the pathology and immunohistochemical features of 7 adenosarcoma cases and investigated the relevance of the histomorphological features to the clinical course. We also compared immunohistochemical features of primary and recurrent tumors.Methods: Seven patients with adenosarcoma who underwent surgery in our hospital were evaluated. We performed immunohistochemical staining for the estrogen receptor (ER), progesterone receptor (PR), p53, and two SWI/SNF chromatin-remodeling proteins (SMARCA4, BCOR), which were recently developed for the diagnosis of undifferentiated sarcomas in addition to conventional staining methods. Results: All patients were International Federation of Gynecology and Obstetrics stage 1B to 1C. All tumors were polypoid, and every patient presented with abnormal uterine bleeding. Six patients were over 50 years old and were menopausal; 1 patient was under 50 years old and was non-menopausal (average age 59.1 years). Histologically, the sarcomatous components were homologous in 6 patients and heterogenous in 1 patient. Four patients were recurrent patients; 3 were non-recurrent. All 4 recurrent patients showed high-grade morphology with sarcomatous overgrowth and were negative for ER and PR. Three recurrences could be evaluated by imaging, showing recurrence only in a distant area; biopsy specimens from these tissues revealed the identical mesenchymal component found in the primary tumor without a benign epithelial component. Immunohistochemical staining results were also the same as for the original tumor, except for the p53 expression in 1 patient. At the primary site, p53 was overexpressed in 2 recurrent patients and had a wild-type level in 1 recurrent patient; however, all 3 recurrent tissues showed overexpression of p53. None of the 7 cases showed SMARCA4 loss, and BCOR expression was positive in 1 case.Conclusions: Initial pathological analysis of the adenosarcoma with appropriate immunohistochemical staining is vital for prognostic assessment. Expression of p53 might increase at recurrence. SMARCA4 and BCOR could be an index of malignancy, regardless of sarcomatous overgrowth.

2020 ◽  
Vol 15 (1) ◽  
Author(s):  
Makiko Omi ◽  
Akiko Tonooka ◽  
Tomohiro Chiba ◽  
Yuji Tanaka ◽  
Atsushi Fusegi ◽  
...  

Abstract Background Uterine adenosarcoma, a rare uterine tumor subtype, is a biphasic tumor consisting of epithelial and mesenchymal elements. To date, there is no research comparing the histopathological features and immunohistochemistry of primary and recurrent tumors; furthermore, the relationship between pathology and the clinical course remains unclear. We reviewed the pathology and immunohistochemical features of patients with adenosarcoma and investigated the relevance of the histomorphological features to the clinical course. We also compared the immunohistochemical features of the primary and recurrent tumors. Methods The data of seven patients with adenosarcoma who underwent surgery in our hospital were evaluated. We performed immunohistochemical staining for the progesterone receptor, estrogen receptor, p53, and two Switch/Sucrose Non-Fermentable chromatin remodeling proteins (SMARCA4, BCOR), which were recently developed for the undifferentiated sarcoma diagnosis in addition to conventional staining methods. Results All patients had International Federation of Gynecology and Obstetrics stage IB–IC diseases. All tumors were polypoid and every patient presented with abnormal uterine bleeding. Six patients aged over 50 years and were menopausal; one patient aged under 50 years and was non-menopausal (average age: 59.1 years). Histologically, the sarcomatous components were homologous and heterogenous in six and one patient, respectively. Four and three cases were recurrent and non-recurrent, respectively. The recurrent patients showed high-grade morphology with sarcomatous overgrowth and were negative for ER and PR. Three recurrences could be evaluated by imaging, showing recurrence only in a distant area; biopsy specimens from these tissues revealed the identical mesenchymal component found in the primary tumor without a benign epithelial component. Immunohistochemical staining results were also similar to the corresponding of the original tumor, except for the p53 expression in one patient. At the primary site, p53 was overexpressed in two recurrent patients and had a wild-type level in one recurrent patient; however, all three recurrent tissues showed p53 overexpression. None of our patients showed SMARCA4 loss, and BCOR expression was positive in one case. Conclusions Initial pathological adenosarcoma analysis with appropriate immunohistochemical staining is vital for prognostic assessment. p53 expression might increase at recurrence. SMARCA4 and BCOR might not be an index of malignancy.


2012 ◽  
Vol 19 (2) ◽  
Author(s):  
Ahmad Zulfan Hendri ◽  
Danarto HR

Objective: To know the relationship between p53 expression and prostate specific antigen (PSA) serum level in prostate cancer patients. Material & method: Specimens were studied from patients with pathological diagnosis of prostate cancer in Sardjito Hospital Yogyakarta during 2007 to 2008. The p53 expression was measured by immunohistochemical staining. The stains were done in Department of Anatomical Pathology and examined by a pathologist. The relationship between p53 mutated expression and PSA serum level were analyzed with correlation coefficient (rs). Results: There were 29 patients included in this study. The mean age was 66,34 ± 8,15 (50 - 83) years old. The mean PSA serum level was 165,98 ± 269,208 (1,4 – 1051) ng/ml. The mean number of p53 expression was 111,38 ± 94,30 (16 – 396). There was positive correlation between p53 expression and increasing PSA serum level in the prostate cancer patients (rs + 0,497; p = 0,006). Conclusion: P53 expression was positively correlated with increasing PSA serum level.Keywords: Prostate cancer, p53 expression, PSA serum level.


Author(s):  
Lawrence Frenkel ◽  
Fernando Gomez ◽  
Joseph A Bellanti

Background: Since its initial description in December 2019 in Wuhan, China, coronavirus disease 2019 (COVID-19) has rapidly progressed into a worldwide pandemic, which has affected millions of lives. Unlike the disease in adults, the vast majority of children with COVID-19 have mild symptoms and are largely spared from severe respiratory disease. However, thereare children who have significant respiratory disease, and some may develop a hyperinflammatory response similar to thatseen in adults with COVID-19 and in children with Kawasaki disease (KD), which has been termed multisystem inflammatory syndrome in children (MIS-C).Objective: The purpose of this report was to examine the current evidence that supports the etiopathogenesis of COVID-19 in children and the relationship of COVID-19 with KD and MIS-C as a basis for a better understanding of the clinical course, diagnosis, and management of these clinically perplexing conditions.Results: The pathogenesis of COVID-19 is carried out in two distinct but overlapping phases of COVID-19: the first triggered by the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) itself and the second by the host immune response. Children with KD have fewer of the previously described COVID-19–associated KD features with less prominent acute respiratory distress syndrome and shock than children with MIS-C.Conclusion: COVID-19 in adults usually includes severe respiratory symptoms and pathology, with a high mortality. Ithas become apparent that children are infected as easily as adults but are more often asymptomatic and have milder diseasebecause of their immature immune systems. Although children are largely spared from severe respiratory disease, they canpresent with a SARS-CoV-2–associated MIS-C similar to KD.


2021 ◽  
pp. 1-7
Author(s):  
Niv Pencovich ◽  
Nadav Nevo ◽  
Roi Weiser ◽  
Ekaterina Bonder ◽  
Yoel Bogoch ◽  
...  

<b><i>Introduction:</i></b> Accumulation of plasma mitochondrial DNA (mtDNA) following severe trauma has been shown to correlate with the development of systemic inflammatory response syndrome (SIRS) and may predict mortality. Our objective was to investigate the relationship between levels of circulatory mtDNA following pancreaticoduodenectomy (PD) and the postoperative course. <b><i>Methods:</i></b> Levels of plasma mtDNA were assessed by real-time PCR of the mitochondrial genes <i>ND1</i> and <i>COX3</i> in 23 consecutive patients who underwent PD 1 day prior to surgery, within 8 h after surgery, and on postoperative day (POD)1 and POD5. The abundance of mtDNA was assessed relative to preoperative levels and in relation to parameters reflecting the postoperative clinical course. <b><i>Results:</i></b> When pooled for all patients, the circulating mtDNA levels were significantly increased after surgery. However, while a significant (at least &#x3e;2-fold and up to &#x3e;20-fold) rise was noted in 11 patients, no change in mtDNA levels was noted in the other 12 following surgery. Postoperative rise in circulating mtDNA was associated with an increased rate of postoperative fever until day 5, decreased hemoglobin and albumin levels, and increased white blood cell counts. These patients also suffered from increased rates of delayed gastric emptying. No significant differences were demonstrated in other postoperative parameters. <b><i>Conclusion:</i></b> Circulating mtDNA surge is associated with an inflammatory response following PD and may potentially be used as an early marker for postoperative course. Studies of larger patient cohorts are warranted.


2004 ◽  
Vol 10 (3) ◽  
pp. 266-271 ◽  
Author(s):  
B Zakrzewska-Pniewska ◽  
M Styczynska ◽  
A Podlecka ◽  
R Samocka ◽  
B Peplonska ◽  
...  

The importance of apolipoprotein E (ApoE) and myeloperoxidase (MPO) genotypes in the clinical characteristics of multiple sclerosis (MS) has been recently emphasized. In a large group of Polish patients we have tested the hypothesis that polymorphism in ApoE and MPO genes may influence the course of the disease. G enotypes were determined in 117 MS patients (74 females and 43 males; 99 sporadic and 18 familial cases) with mean EDSS of 3.6, mean age of 44.1 years, mean duration of the disease 12.8 years and mean onset of MS at 31.2 years, and in 100 healthy controls. The relationship between ApoE and MPO genes’ polymorphism and the MS activity as well as the defect of remyelination (diffuse demyelination) and brain atrophy on MRI were analysed. The ApoE o4 allele was not related to the disease course or the ApoE o2 to the intensity of demyelination on MRI. The genotype MPO G/G was found in all familial MS and in 57% (56/99) of sporadic cases. This genotype was also related to more pronounced brain atrophy on MRI. The MPO G/G subpopulation was characterized by a significantly higher proportion of patients with secondary progressive MS (PB- 0.05) and by a higher value of EDSS. A ccording to our results the MPO G allele is frequently found (in 96% of cases) among Polish patients with MS. More severe nervous tissue damage in the MPO G/G form can be explained by the mechanism of accelerated oxidative stress. It seems that MPO G/G genotype may be one of the genetic factors influencing the progression rate of disability in MS patients.


2014 ◽  
Vol 13 (2) ◽  
pp. 135-139 ◽  
Author(s):  
Nazlima Nargis ◽  
Iqbal Karim ◽  
Khondaker Bulbul Sarwar

Background: Abnormal uterine bleeding (AUB) is the most common reason for gynecological visits for perimenopausal bleeding and may account for more than 25% of all hysterectomies. Objective: This study was aimed to review the causes of abnormal uterine bleeding in perimenopausal women establishing the correlation with ultrasonographic and histopathological examinations. Study Method: This descriptive study was conducted in the department of gynecology and obstetrics, Ibn Sina Medical College, Dhaka during January to December 2012. Two hundred and eleven women were selected for this study, who admitted into the hospital with abnormal uterine bleeding in perimenopausal age. The clinical, ultrasonographic and histopathological findings of these women were evaluated in this study. Results: Menorrhagia was the major symptom (52.6%) irrespective of age and parity. All these women underwent D&C followed by either medical management or hysterectomy depending upon the diagnosis. The histopathological findings of endometrium were analyzed and confirmed as fibroid uterus (58.28%) and DUB (17.58%) correlated well with transvaginal sonography (TVS) and histopathological examination. Hysterectomy conferred other uterine lesions as adenomyosis (18.71%), endometrial polyp (4.81%) and malignancy (1.06%). Conclusion: Abnormal uterine bleeding in perimenopausal age group is a common but ill-defined entity which needs proper evaluation. Accurate diagnosis of the causative factors of AUB in this age group is of utmost importance so that appropriate management can be established early that leads the minimization of the patients’ sufferings. DOI: http://dx.doi.org/10.3329/bjms.v13i2.18295 Bangladesh Journal of Medical Science Vol.13(2) 2014 p.135-139


2017 ◽  
Vol 24 (6) ◽  
pp. 944-949 ◽  
Author(s):  
Shinya Motohashi ◽  
Takefumi Matsuo ◽  
Hidenori Inoue ◽  
Makoto Kaneko ◽  
Shunya Shindo

Heparin-induced thrombocytopenia (HIT) is one of the serious complications in patients who undergo cardiac surgery. However, there remains a major problem in diagnosing HIT because the current immunological assays for detection of HIT antibody have limitations. Furthermore, the clinical course of thrombocytopenia in this surgery makes it increasingly difficult to diagnose HIT. We investigated the relationship between platelet count and HIT antibody in 59 patients who underwent cardiac surgery using cardiopulmonary bypass (CPB). The number of postoperative HIT antibody-positive patients evaluated using enzyme-linked immunosorbent assay kit (polyanion IgG/IgA/IgM complex antibodies/antiplatelet factor 4 enhanced) was 37 (62.7%). In contrast, platelet activation by HIT antibody was evaluated using the serotonin release assay (SRA). More than 20% and 50% release of serotonin was obtained from 12 patients (20.3%) and 8 patients (13.6%), respectively. The levels of d-dimer were significantly different on postoperative day 14 between SRA-positive and SRA-negative groups; however, postoperative thrombus complication was not detected using sonography in the patients with positive serotonin release at all. After being decreased by the operation, their platelet count recovered within 2 weeks in both groups equally. In our study, although the patients were positive in the platelet activating HIT antibody assay, they remained free from thrombosis and their platelet count recovered after early postoperative platelet decrease. Therefore, in addition to the SRA, monitoring of platelet count might be still considered an indispensable factor to facilitate the prediction of HIT thrombosis prior to manifestation in the patients undergoing cardiac surgery using CPB.


Author(s):  
Asli Yarci Gursoy ◽  
Didem Cakmak ◽  
Gulsah Akgul ◽  
Mine Kiseli ◽  
Haldun Umudum ◽  
...  

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