GI, Liver & Pancreas Pathology
Bita Geramizadeh; Mahsa Sehat; Azam Mehrmozayan; Alireza Shojazadeh
Abstract
Background & Objective: Differential diagnosis between cholangiocarcinoma (CCA) and metastatic pancreatic ductal adenocarcinoma (PDA) in the liver is difficult and so far, no specific immunohistochemical marker is reported to differentiate these two tumors. Considering the existing literature, the ...
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Background & Objective: Differential diagnosis between cholangiocarcinoma (CCA) and metastatic pancreatic ductal adenocarcinoma (PDA) in the liver is difficult and so far, no specific immunohistochemical marker is reported to differentiate these two tumors. Considering the existing literature, the level of expression of Annexins (Annexin A1, 10 and 13) have been studied for differential diagnosis between these two tumors by molecular methods and promising results have been reported. Therefore, in this study, we tried to investigate the immunohistochemical value of these three Annexins for the differential diagnosis of CCA and PDA in the liver.Methods: The articles that reported the research subject in 10 years (2009-2019), including 45 cases of CCA and 50 cases of metastatic PDA in the liver were evaluated considering the presence or absence of AnnexinA1 (ANXA1), Annexin A10 (ANXA10) and Annexin A13 (ANXA13) expression by immunohistochemistry, were investigated.Results & Conclusion: This study showed, ANXA1 was positive both in PDA and CCA, ANXA10 was positive in ~60% of PDA cases and ~40% of CCA cases, and ANXA13 was mostly negative in both groups. The best sensitivity was found in cytoplasmic and nuclear ANXA1 (80% and 84%, respectively) to distinguish PDA from CCA and vice versa. The best specificity was observed in ANXA10 and ANXA13 to distinguish PDA from CCA. Also, ANXA13 had the best specificity to distinguish CCA from PDA. Our investigations showed that, ANXA1 probably can classify positive cases correctly, but it cannot discriminate PDA from CCA. ANXA10 had fair sensitivity and specificity to discriminate PDA from CCA. ANXA13 apparently had a high specificity that can help to narrow-down the differential diagnoses.
GI, Liver & Pancreas Pathology
Bita Geramizadeh; Farzaneh Bozorg-Ghalati; Firoozeh Jafari; Mitra Mirzai; Zahra Jowkar
Abstract
Background & Objective: Microsatellite instability is common in familial colorectal cancers. It can be tested by the molecular and immunohistochemical methods. There are very few studies which address comparing the clinicopathological characteristics of microsatellite stable (MSS) and microsatellite ...
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Background & Objective: Microsatellite instability is common in familial colorectal cancers. It can be tested by the molecular and immunohistochemical methods. There are very few studies which address comparing the clinicopathological characteristics of microsatellite stable (MSS) and microsatellite unstable (MSI) colorectal cancers from Iran. n this study, we aimed to evaluate the clinicopathological and immunohistochemical findings of MSS and MSI colorectal cancers in our Center as the largest Center of gastrointestinal surgery and oncology in the South of Iran. We also compared the immunohistochemical method vs. molecular study using DNA sequencing.Methods: For 5 years (2015-2019), 34 patients who underwent operation in the affiliated Hospitals of Shiraz University of Medical Sciences were clinically suspected to microsatellite instability (MSI). The molecular diagnostic tests with DNA sequencing were performed. Clinicopathological and immunohistochemical findings of MSI colorectal cancers were compared with those who were stable. Results: In the South of Iran, MSI colorectal cancers were more common in males. These tumors were more common in the right side with more tendencies to produce mucin with lymphocytic infiltration. Conclusion: It was concluded that immunohistochemistry is a specific method for the diagnosis of MSI colorectal cancers, but false negative rate is high, and sensitivity is low. Therefore, we recommend performing molecular studies by DNA sequencing in colon cancer with clinical suspicion to MSI and negative immunohistochemistry
Uropathology
Bita Geramizadeh; Nadereh Shams; Pouya Iranpour; Mohammad javad Rajabi
Abstract
Renal hemangioma is a rare tumor which can be capillary or cavernous. There have been less than 30 renal capillary hemangioma cases reported in the English literature. Herein we will report a case of renal hemangioma which was detected in a 74-year-old man operated with the impression of urothelial ...
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Renal hemangioma is a rare tumor which can be capillary or cavernous. There have been less than 30 renal capillary hemangioma cases reported in the English literature. Herein we will report a case of renal hemangioma which was detected in a 74-year-old man operated with the impression of urothelial carcinoma of hilum.
Molecular Pathology
Sahand Mohammadzadeh; Zahra Jowkar; Mitra Mirzaee; Bita Geramizadeh
Abstract
Background and Objective: Epidermal growth factor receptor (EGFR) gene mutation, especially in exons 18 to 21, is an important predictor of the response rate of lung adenocarcinoma to tyrosine kinase inhibitors. There are variable reports from Asian and European countries, as well as North America, about ...
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Background and Objective: Epidermal growth factor receptor (EGFR) gene mutation, especially in exons 18 to 21, is an important predictor of the response rate of lung adenocarcinoma to tyrosine kinase inhibitors. There are variable reports from Asian and European countries, as well as North America, about the frequency of the EGFR mutation in lung adenocarcinoma, yet molecular study about this incidence has been published from Iran. In this study, we investigated the frequency of this mutation in our center, which is the largest referral center in the south of country. This report will be the first published article about EGFR mutational analysis from Iran.Methods: During the study period (September 2011 till September 2016) i.e. 5 years, there have been 50 cases of pathologically-confirmed lung adenocarcinoma. These cases underwent mutational analysis for exons 18 to 21 of the EGFR gene by PCR and DNA sequencing. All demographic findings were also extracted from the patients’ charts and recorded.Results: There were 30 male and 20 female patients, with an average age of 58 years. The overall frequency of EGFR mutation was 28% (14 out of 50). The most common mutation was Del 19 (10 of 14, 71.4%), 3 mutations were found in exon 20 and one mutation was found in exon 21. EGFR mutations were more frequent in women than in men (30% versus 26.7%) and in nonsmokers than in smokers (37.9% versus 14.3%).Conclusion: Lung adenocarcinoma with EGFR mutation shows strong association with female non-smokers. Our results showed an intermediate frequency of this mutation, which was higher than results from Western countries and lower than most Asian countries.
Bita Geramizadeh; Mahsa Marzban; David Owen
Abstract
Background: Routine screening colonoscopy is on the rise and pathologists have to deal with the ever larger numbers of excised colonic polyps. It is very important to optimize the patients’ individual treatment and further surveillance. Pathologists play a critical role in management, as most of ...
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Background: Routine screening colonoscopy is on the rise and pathologists have to deal with the ever larger numbers of excised colonic polyps. It is very important to optimize the patients’ individual treatment and further surveillance. Pathologists play a critical role in management, as most of the clinical decisions concerning colonic polyp management are based on pathologic findings. One of the most important clinical issues in colonic adenomas is the diagnosis of malignancy and reporting its different aspects by the pathologist. The histologic type and the extent of carcinoma within a malignant polyp have considerable impact on the decisions of gastroenterologists and surgeons for further management. Therefore, the most recent literature regarding the diagnosis and reporting of the different features of malignant polyps was reviewed. Data Acquisition: There is growing literature regarding the different pathologic features and reporting of malignant colonic polyps, and in this review, published articles that are listed on Google Scholar and Pub Med are discussed. Conclusion: Diagnosis of malignant colon polyp requires the presence of tumor cells that are penetrating beyond the muscular mucosa into submucosa (pT1). As well as establishing a diagnosis of malignant polyp, it is very important to report the size of the invasive component, the presence or absence of lymphovascular invasion, the degree of tumor differentiation and the distance of the carcinoma from the line of resection. Other important features that may be reported include: the presence or absence of tumor budding, the depth of tumor cell penetration into the submucosa, and results of immunohistochemistry for mismatch repair proteins and BRAF.
Hematopathology
Bita Geramizadeh; Fatemeh Jalali
Abstract
Background: Aggressive fibromatosis is a rare benign tumor with no potential for metastasis; however, its aggressive nature causes treatment failure and episodes of recurrence. There is no report from Iran about the treatment of this tumor, and all published articles are single-case reports, therefore ...
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Background: Aggressive fibromatosis is a rare benign tumor with no potential for metastasis; however, its aggressive nature causes treatment failure and episodes of recurrence. There is no report from Iran about the treatment of this tumor, and all published articles are single-case reports, therefore in this study, we report our experience from two of the largest referral centers of the South of Iran. Methods: During five years (2007-2011), among more than 20000 surgical pathology specimens, 25 cases of fibromatosis were identified. Clinicopathologic findings were recorded for all of the cases, and follow up history according to the patients’ charts and direct contact by phone call were extracted. Results: There were 25 cases of fibromatosis, with female predominance, especially in the reproductive ages. All of the tumors had been located in the abdominal area, lower extremity, and head and neck area. Twenty-three cases had been operated for surgical excision. Fifteen cases had at least one episode of recurrence, mostly located in the abdominal area. No death or metastasis occurred. Conclusion: Clinicopathologic findings of desmoid tumor in Iran are very similar to other countries, however, there is still much controversy about the method of treatment for fibromatosis, and there are many challenges for patients, regarding multiple episodes of recurrence and the infiltrative aggressive nature of fibromatosis.
Bita Geramizadeh; Mahsa Marzban; Andrew Churg
Volume 11, Issue 3 , July 2016, , Pages 195-203
Abstract
Background: Solitary fibrous tumor (SFT) is a mesenchymal tumor which is most commonly seen in the pleura; however it can be seen in other organs such as the meninge, gastrointestinal tract, soft tissue, bone, and skin. SFT should be differentiated from other mesenchymal tumors in these organs. Immunohistochemistry ...
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Background: Solitary fibrous tumor (SFT) is a mesenchymal tumor which is most commonly seen in the pleura; however it can be seen in other organs such as the meninge, gastrointestinal tract, soft tissue, bone, and skin. SFT should be differentiated from other mesenchymal tumors in these organs. Immunohistochemistry plays a pivotal role for the histopathologic diagnosis of this tumor. Currently, new markers have been introduced which has been very useful for definite diagnosis of SFT along with other markers in each specific location which are negative in SFT. Methods: Here we review the reported positive and negative immunohistochemical markers of SFT in the English literature with the emphasis on the useful markers in each specific organ. We explored the English literature from 1990 through 2015 via PubMed, Google, and Google scholar using the following search keywords: Solitary fibrous tumor, Solitary fibrous tumor and immunohistochemistry, Solitary fibrous tumor and diagnosis, Solitary fibrous tumor and histogenesis, Solitary fibrous tumor and prognosis, Solitary fibrous tumor and hemangiopericytoma, Solitary fibrous tumor and differential diagnosis, Solitary fibrous tumor and markers. Results: The most important and valuable positive markers in SFT are CD34, CD99, Bcl-2 and STAT-6.There are consistently negative markers in this tumor as well, used according to the tumor location, such as EMA and S100 Conclusion: Immunohistochemistry is very useful for the diagnosis of solitary fibrous tumor and for its differentiation with other spindle cell mesenchymal tumor in different locations.
How to cite this article:
Geramizadeh B, Marzban M, Churg A. Role of Immunohistochemistry in the Diagnosis of Solitary Fibrous Tumor, a Review. Iran J Pathol. 2016; 11(3):195-293.