Breast Pathology
Primariadewi Rustamadji; Elvan Wiyarta; Kristina Anna Bethania
Abstract
Background & Objective: Invasive breast carcinoma of no special type (IBC-NST) is the most common type of breast cancer, which mainly causes axillary lymph-node metastasis (ALNM). Building on our previous research, we wanted to explore the optimal combination of AKT2, CD44v6, and MT1-MMP for the ...
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Background & Objective: Invasive breast carcinoma of no special type (IBC-NST) is the most common type of breast cancer, which mainly causes axillary lymph-node metastasis (ALNM). Building on our previous research, we wanted to explore the optimal combination of AKT2, CD44v6, and MT1-MMP for the ALNM prediction.Methods: The presence or absence of ALNM was used to separate 46 paraffin blocks containing IBC-NST primary tumors into two groups. Age, tumor grade, tumor size, receptor status (ER, PR, HER2, Ki-67, TOP2A), and test biomarker expression were evaluated. Biomarker expressions were assessed by IHC staining and categorized according to their respective cut-offs from our previous study, while other data were collected from archives. Data was gathered and analyzed using univariate, multivariate, and AUROC models.Results: The expression of CD44v6 (OR: 12.77, 95% CI: 2.18-87.12, P=0.005) was identified as the independent variable for ALNM. Meanwhile, AKT2 expression (OR: 3.22, 95% CI: 0.36-22.41, P=0.237) and MT1-MMP expression (OR: 5.35, 95% CI: 0.83-34.54, P=0.078) did not demonstrate a statistically significant independent association in respect to ALNM. Combining AKT2 and MT1-MMP on CD44v6 increased overall accuracy by 4% compared to CD44v6 alone (AUROC 0.89 vs. 0.85).Conclusion: The combined usage of AKT2, CD44v6, and MT1-MMP revealed no significant change compared to CD44v6 alone. Due to cost and practicality, we propose using CD44v6 as a biomarker predictor of ALNM in IBC-NST.
Endocrine Pathology
Elham Mirzaian; Shafighe Asgarikarchekani; Ashkan Abdoli
Abstract
Acinic cell carcinoma (ACC) is a low or intermediate-grade malignant epithelial neoplasm of the salivary glands that generally shows an indolent behavior. Most cases arise in the major salivary glands, especially the parotid gland. ACC is usually known as a low-grade malignant tumor; however, poorly ...
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Acinic cell carcinoma (ACC) is a low or intermediate-grade malignant epithelial neoplasm of the salivary glands that generally shows an indolent behavior. Most cases arise in the major salivary glands, especially the parotid gland. ACC is usually known as a low-grade malignant tumor; however, poorly differentiated and high-grade transformed variants have been reported and may have a tendency for late recurrence and metastasis.Our case was a 49-year-old woman with a history of a right parotid rapidly growing mass lesion, which was cytologically diagnosed as monomorphic adenoma on fine-needle aspiration (FNA). Finally, the diagnosis of ACC with dedifferentiated components was reported followed by parotidectomy. After 30 sessions of radiotherapy, she presented with hemifacial paresis. An imaging examination of the brain showed intracranial hemorrhage, and she underwent a craniotomy. We performed histopathological and immunohistochemistry (IHC) examinations and diagnosed metastatic ACC with the dedifferentiated components.Few studies have reported ACC cases with dedifferentiated components and aggressive behavior, and to the best of our knowledge, this is the first published English report from the Persian population.
Breast Pathology
Armin Borhan; Zohreh Nozarian; Alireza Abdollahi; Reza Shahsiah; Hadiseh Mohammadpour; Arash Borhan
Abstract
Background & Objective: Nowadays, actin-binding proteins such as Villin and Gelsolin have been considered to be associated with aggressive tumors. This study mainly aims to determine the relationship between Gelsolin and Villin genes expression and metastasis of axillary lymph nodes in patients with ...
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Background & Objective: Nowadays, actin-binding proteins such as Villin and Gelsolin have been considered to be associated with aggressive tumors. This study mainly aims to determine the relationship between Gelsolin and Villin genes expression and metastasis of axillary lymph nodes in patients with breast cancer.Methods: The included population consisted of 40 confirmed cases of female breast cancer (including 20 patients with breast cancer along with axillary lymph node metastasis and 20 patients without axillary lymph node metastasis). Expression of Villin and Gelsolin genes was evaluated using Real-time PCR and pre-designed primers.Results: The mean expression level of Villin in groups with and without axillary lymph node metastasis was 3.33±1.35 and 0.87±0.88, respectively (p <0.001). The mean Gelsolin expression levels in both groups (with and without axillary lymph node metastasis) were 4.13±2.40 and 1.00±0.35, respectively (p <0.001). The significant relationships were independent of individuals’ age.Conclusion: Patients with axillary lymph node metastasis may express significant higher level of Villin and Gelsolin gens.
Molecular Pathology
Zohreh Rahimi; Maryam Bozorgi Zarini Bozorgi Zarini; Ziba Rahimi; Ebrahim Shakiba; Asad Vaisi-Raygani; Mohammad Taher Moradi; Kheirolah Yari
Abstract
Background & Objective: Breast cancer (BC) is known to be the most prevalent cancer among women. One-carbon metabolism (OCM) disturbance might play an important role in the etiology of BC. The present study aimed to investigate the thymidylate synthase (TYMS), 5-methyltetrahydrofolate-homocysteine ...
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Background & Objective: Breast cancer (BC) is known to be the most prevalent cancer among women. One-carbon metabolism (OCM) disturbance might play an important role in the etiology of BC. The present study aimed to investigate the thymidylate synthase (TYMS), 5-methyltetrahydrofolate-homocysteine methyltransferase (MTR), and methionine synthase reductase (MTRR) variants as good candidates for studying the role of genetic variants of folate metabolizing enzymes in the risk of BC.Methods: The present case-control study consisted of 100 BC patients and 141 healthy females. The TYMS 2R/3R (rs34743033), MTR c.2756A>G (rs1805087), and MTRR c.66A>G (rs1801394) variants were detected by polymerase chain reaction (PCR), PCR-restriction fragment length polymorphism (RFLP), and a designed amplification-refractory mutation system (ARMS) method, respectively.Results: The 3R allele of TYMS enhanced the risk of BC by 2.84-fold (p <0.001). In the presence of TYMS 3R/3R, compared to TYMS 2R/3R, there was a trend toward enhancing the risk of metastasis by 4.15-fold (95% CI: 0.96-17.85, p =0.055). The frequencies of MTR c.2756A>G and MTRR c.66A>G variants were not significantly different among patients and controls.Conclusion: We observed that the TYMS 3R is a risk allele for susceptibility to BC and this allele tends to increase the BC metastasis.
Neuropathology
atieh zandnejadi; Arezoo Eftekhar-Javadi; HEDIEH MORADI TABRIZ
Abstract
Glioblastoma (WHO grade IV) is the most common malignant tumor of neural tissues in adults as a primary tumor. Because of blood brain barrier and short median survival of patients with glioblastoma, metastasis of this tumor is very rare. A 46-year-old man was admitted to Sina hospital with chief complaint ...
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Glioblastoma (WHO grade IV) is the most common malignant tumor of neural tissues in adults as a primary tumor. Because of blood brain barrier and short median survival of patients with glioblastoma, metastasis of this tumor is very rare. A 46-year-old man was admitted to Sina hospital with chief complaint of headache and visual impairment. After neuro-radiologic evaluation the patient underwent surgery. Pathologic examination of the tumor confirmed the diagnosis of glioblastoma multiforme. Cytogenetic study of the tumor cells confirmed GBM IDH1 wild type with TERT mutation and EGFR amplification. Two months after surgical resection, the tumor recurred with involvement of the dura matter. After the second operation, metastasis to the pelvic cavity and cervical lymph node was found. Almost all cases of glioblastoma metastasis had undergone surgery or any manipulation; this fact suggests that iatrogenic intra-vascular seeding of tumor cells at the time of resection and disruption of blood brain barrier could cause extra-neural metastasis.
Nephropathology
Hedieh Moradi Tabriz; Arezoo Eftekhar-Javadi; Atiieh Zandnejadi
Abstract
Thyroid gland metastatic tumors are rare in clinical practice. Clear cell RCC is one of common metastatic tumors to thyroid. We here reported a case of incidentally found clear cell renal carcinoma metastasis to the thyroid gland 3 years after nephrectomy, in the thyroidectomy procedure performed for ...
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Thyroid gland metastatic tumors are rare in clinical practice. Clear cell RCC is one of common metastatic tumors to thyroid. We here reported a case of incidentally found clear cell renal carcinoma metastasis to the thyroid gland 3 years after nephrectomy, in the thyroidectomy procedure performed for the patient due to the thyroid enlargement caused by multinodular goiter. A 65-year-old Iranian man with a history of multinodular goiter referred to our surgery clinic for thyroidectomy because of compressive effects on the trachea. Patient had a history of nephrectomy due to clear cell RCC 3 years ago. After thyroidectomy, gross and histological examination of thyroid revealed clear cell renal carcinoma metastasis to the thyroid gland in the setting of a multinodular goiter. The diagnosis was confirmed by immunohistochemistry staining. Patients with multinodular goiter are more prone to present with metastasis to thyroid gland if they have a history of malignancy, especially renal cell carcinoma.
Head and Neck Pathology
Hassan Mir Mohammad Sadeghi; Abbas Karimi; Amirsina Rahpeima; Samira Derakhshan
Abstract
Salivary duct carcinoma (SDC) is a rare and highly aggressive salivary gland tumor with poor prognosis, rapid growth, distant metastasis, early regional metastasis, and a high rate of recurrence. The parotid gland is the most common site of involvement, and the lungs and the bones are the most common ...
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Salivary duct carcinoma (SDC) is a rare and highly aggressive salivary gland tumor with poor prognosis, rapid growth, distant metastasis, early regional metastasis, and a high rate of recurrence. The parotid gland is the most common site of involvement, and the lungs and the bones are the most common sites of distant metastasis of SDC. Herein, we present a case of SDC of the parotid gland in a 62-year-old male patient with an unusual metastasis to the skin of the primary site and brain 6 years after primary treatment, which comprised of total parotidectomy and radical neck dissection followed by radiotherapy. It is noteworthy that in few cases of SDC with infiltration, (and not in low-grade intraductal carcinoma of the salivary glands), routine treatment may not suffice, and long-term follow-up is highly recommended.
Farahnaz Bidari-Zerehpoosh; Guive Sharifi; Sara Zahedifard; Hussein Soleimantabar; Kaveh Ebrahimzadeh; Arezoo Aghakhani
Volume 9, Issue 3 , July 2014, , Pages 229-233
Abstract
Follicular thyroid carcinoma (FTC) is the second most common type of thyroid cancer after papillary carcinoma. It usually grows slowly and is clinically indolent; but rarely, its aggressive forms with distant metastases can occur. We report here an uncommon case of bilateral orbital metastasis of FTC. ...
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Follicular thyroid carcinoma (FTC) is the second most common type of thyroid cancer after papillary carcinoma. It usually grows slowly and is clinically indolent; but rarely, its aggressive forms with distant metastases can occur. We report here an uncommon case of bilateral orbital metastasis of FTC. A 70-year-old woman presented with bilateral exophtalmus and past medical history of thyroid nodule surgery 15 years ago. Radiologic evaluation showed massive bilateral orbital mass with extension to calvarium. Tumor decompressed and removed with the suction and curettage and the patient was treated with chemoradiotherapy after operation. Pathologic examination showed metastatic follicular thyroid carcinoma. Although orbital metastasis of follicular thyroid carcinoma is uncommon, FTC should be considered as a potential primary neoplasm in a patient with orbital mass
Maryam Kadivar; Pegah Babaheidarian; Ali Zare Mirzae; Mohammadreza Fakhraie
Volume 8, Issue 2 , April 2013, , Pages 115-118
Abstract
There are few reported cases of endobronchial metastasis of pheochromocytoma literature. We present here a 56-year old woman who underwent left lower lobectomy of lung, following pneumonia with unresolved chest radiographs. Computed tomography showed a lobulated soft tissue mass, measuring, 38×27 ...
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There are few reported cases of endobronchial metastasis of pheochromocytoma literature. We present here a 56-year old woman who underwent left lower lobectomy of lung, following pneumonia with unresolved chest radiographs. Computed tomography showed a lobulated soft tissue mass, measuring, 38×27 mm, at the perivascular space of anterior mediastinum. The resected specimen, showed lobulated tumor arranged in nesting pattern within arcuate vascular network. Immunohistochemistry showed intense positive staining of epitheloid cell (chief cells) for chromogranin and synaptophysin which were negative for cytokeratin. Sustentacular cells were strongly positive for S-100. Although very rare, physicians should keep in mind the possibility of endobronchial metastasis in patients with a history of pheochromocytoma.
Shokouh aghipour zahir; Kiyanoosh Sedaghat; Saeed Kargar
Volume 7, Issue 4 , September 2012, , Pages 246-250
Abstract
Endometrial adenocarcinoma is uncommon in fewer than 40-year-old people. The first common sign and symptoms are abnormal vaginal bleeding and discharge. Metastasis is occurred in the late stage. Here we present a 31-year-old nullipar woman who was admitted to surgical ward with enlarged right inguinal ...
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Endometrial adenocarcinoma is uncommon in fewer than 40-year-old people. The first common sign and symptoms are abnormal vaginal bleeding and discharge. Metastasis is occurred in the late stage. Here we present a 31-year-old nullipar woman who was admitted to surgical ward with enlarged right inguinal lymphnode from one month ago. She had no history of previous malignancy, infectious condition, vaginal bleeding, and discharge. Abdominal sonography revealed no abnormality. She underwent surgical biopsy and metastatic adenocarcinoma most suspected from genital tract was reported. Based on pathological recommendation diagnostic curettage was performed and endometrial adenocarcinoma of conventional type as a first origin was confirmed. To our knowledge metastasis to inguinal lymph node as a first manifestation of endometrial carcinoma is rare.
Priyanka Joseph Koshy; Mijil Anand Justin; Meenakshi Vedavyasan; Thomas Alexander; Renu G’Boy Varghese
Volume 7, Issue 1 , January 2012, , Pages 58-62
Abstract
The presence of a low level of M protein in the peripheral blood <3gm/dl which is below the required cut off for the diagnosis of plasma cell myeloma is known as monoclonal gammopathy of undetermined significance (MGUS). Elevated levels of serum M protein and detection of M band on serum protein electrophoresis ...
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The presence of a low level of M protein in the peripheral blood <3gm/dl which is below the required cut off for the diagnosis of plasma cell myeloma is known as monoclonal gammopathy of undetermined significance (MGUS). Elevated levels of serum M protein and detection of M band on serum protein electrophoresis (SPE) can occur in chronic diseases not related to B cell disorders and not always diagnostic for B cell dyscrasias. It can also be seen in non hematological malignancies as seen in our case. We present a case of MGUS in a 59yr male patient, previously diagnosed and surgically treated for carcinoma prostate and colon. Serum electrophoresis revealed an M Band – monoclonal protein of 1.9 gm/dl. Urine for Bence Jones proteins was negative and his skeletal X-rays did not reveal lytic lesions. Bone marrow aspiration revealed metastatic carcinoma. Plasma cells formed 1% of the bone marrow differential count.
Krishnamurthy Jayashree; Divya Kota Nagappa
Volume 6, Issue 4 , September 2011, , Pages 212-215
Abstract
Bronchiolo-alveolar carcinoma with subcutaneous chest wall metastasis is a very rare presentation. A case of 36- year-old male with metastatic subcutaneous chest nodule of bronchiolo-alveolar carcinoma, diagnosed by fine needle aspiration cytology, is reported here. Cutaneous metastases are of ...
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Bronchiolo-alveolar carcinoma with subcutaneous chest wall metastasis is a very rare presentation. A case of 36- year-old male with metastatic subcutaneous chest nodule of bronchiolo-alveolar carcinoma, diagnosed by fine needle aspiration cytology, is reported here. Cutaneous metastases are of diagnostic importance because they may be the first manifestation of an undiscovered internal malignancy and indicates a poor prognostic sign. Fine needle aspiration cytology plays an important role in the early diagnosis of subcutaneous metastasis and helps to differentiate from other subcutaneous nodules like skin adnexal lesions, soft tissue tumors and inflammatory lesions.
Dhaneshor Sharma; Tomcha Singh; Rajesh Singh Laishram; Ranjit Singh
Volume 6, Issue 3 , June 2011, , Pages 143-146
Abstract
Breast metastasis of ovarian carcinoma is rare. To date, only 39 cases have been reported in the English-language literature so far. We are herewith reporting a primary ovarian papillary serous cyst adenocarcinoma metastasing ...
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Breast metastasis of ovarian carcinoma is rare. To date, only 39 cases have been reported in the English-language literature so far. We are herewith reporting a primary ovarian papillary serous cyst adenocarcinoma metastasing to breast and epsilateral supraclavicular node in a 58 year old female as the first case in our centre, located at North-East India. The purpose of reporting this case is to emphasize the need of examining breasts in patients of ovarian cancer and the need to exercise meticulous care to exclude second primary at breast from possible secondaries at breast from ovarian can cer.
Indranil Chakrabarti; Anuradha De; Kaushik Majumdar; Amita Amita
Volume 5, Issue 3 , June 2010, , Pages 150-153
Abstract
Adenosquamous carcinomas of stomach are rare entities comprising 0.5% of stomach carcinomas. Here, we report a case of a 50-year-old female, who presented with weakness, pallor, and symptoms of gastric outlet obstruction. A partial gastrectomy was done and histology showed evidence of adenosquamous ...
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Adenosquamous carcinomas of stomach are rare entities comprising 0.5% of stomach carcinomas. Here, we report a case of a 50-year-old female, who presented with weakness, pallor, and symptoms of gastric outlet obstruction. A partial gastrectomy was done and histology showed evidence of adenosquamous carcinoma of the antrum with metastasis to the perigastric lymph nodes. The patient condition improved at 6-month follow-up.
