Uropathology
Sushma Bharti; Gautam Ram Choudhary; Jyotsna Naresh Bharti; Garg Pawan Kumar; Arsha BS; Poonam Abhay Elhence
Abstract
Clear cellrenal cell carcinoma (RCC) is the most common malignant renal tumor in adults, while chromophobe RCC (CRCC) is the third most common. Any subtypes of RCC can undergo sarcomatoid differentiation, but heterologous differentiation in sarcomatoid area is very rare in RCC. Here a61-year male is ...
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Clear cellrenal cell carcinoma (RCC) is the most common malignant renal tumor in adults, while chromophobe RCC (CRCC) is the third most common. Any subtypes of RCC can undergo sarcomatoid differentiation, but heterologous differentiation in sarcomatoid area is very rare in RCC. Here a61-year male is presented with hematuria and palpable mass. Clinicoradiologically, RCC was considered and left radical nephrectomy was performed. A well-circumscribed renal mass located in the upper pole of the left kidney with variegation and extensive areas of bony hard calcification noted, was reported as CRCC with sarcomatoid differentiation containing heterologous component. CRCC subtype has good prognosis but show dismal prognosis when associated with sarcomatous differentiation.We found11 cases of sarcomatoid CRCC containing heterologous elements reported in indexed English literature. CRCC must be differentiated from Conventional RCC and Oncocytoma.The extensive sampling of the tumor is needed. We report a very rare case of CRCC with sarcomatoid differentiation containing heterologous elements.
Adriana Handra-Luca
Abstract
Squamous cell differentiation (SCD) may occur in papillary thyroid carcinoma (PTC) only at metastatic sites. We have studied cytokeratin CK5/6 and P63 along with TTF1 (thyroid transcription factor 1) and B-Raf (V-Raf murine sarcoma viral oncogene homolog B1) immunohistochemical expression in neck ...
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Squamous cell differentiation (SCD) may occur in papillary thyroid carcinoma (PTC) only at metastatic sites. We have studied cytokeratin CK5/6 and P63 along with TTF1 (thyroid transcription factor 1) and B-Raf (V-Raf murine sarcoma viral oncogene homolog B1) immunohistochemical expression in neck lymph node metastases of thyroid PTC showing SCD. The patient (21-years) presented with a neck mass. The check-up revealed bilateral thyroid nodules. Total thyroidectomy and neck lymph node dissection were performed. The diagnosis was that of bilateral PTC with lymph node metastases (pT1N1Mx). The metastases were peculiar by the presence of cystic change and of SCD. The thyroid PTC expressed P63 focally and, TTF1 and B-Raf diffusely. Cytokeratin 5/6 was expressed only in the lymph node metastases, in the metastatic cyst lining and in the SCD foci. The P63+ cells outnumbered those CK5/6+. TTF1 expression was faint in SCD. Metastatic, both classical PTC- and SCD-epithelia expressed B-Raf. The expression patterns of CK5/6, P63, TTF1 suggest a luminal/central-to-abluminal/peripheral direction for SCD development from PTC-epithelia in lymph node metastases. Whether this metaplasia type may reflect a regression to a less aggressive morphotype or a progression-switch to squamous cell carcinoma-type differentiation in a composite tumor remains matter of debate.
Nasrin Shayanfar; Shahriar Zohourian Shahzadi
Volume 4, Issue 4 , September 2009, , Pages 167-171
Abstract
Background and Objective: Neuroendocrine differentiation has not been proved to have effects in behavior of colorectal carcinomas. The aim of this study was Immunohistochemical evaluation of neuroendocrine differentiation in colorectal cancer. Patients and Methods: In this cross-sectional study, 83 ...
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Background and Objective: Neuroendocrine differentiation has not been proved to have effects in behavior of colorectal carcinomas. The aim of this study was Immunohistochemical evaluation of neuroendocrine differentiation in colorectal cancer. Patients and Methods: In this cross-sectional study, 83 paraffin blocks from patients admitted in Rasoul-e-akram Hospital, Tehran, Iran, during 2003 to 2008, were evaluated in Pathology Department. All sections were stained with immunohistochemistry method for neuron specific enolase (NSE) and Chromogranin A(CgA). Data were analyzed using SPSS 12.0. Results: Median age of patients was 56 yr. Forty four cases (53%) were female. According to TNM staging system, 11% of cases were in stage I, 29% in IIa, 7% in IIb, 2% in IIIa, 23% in IIIb, 24% IIIc and 2% were in stage IV. Thirteen cases (16%) were NSE positive, 15 cases (18.1%) were CgA positive. Two, 8 and 5 percent of the patients in grade I, II and III were CgA positive, respectively. Two, 6 and 5 percent of the patients in grade I, II and III were NSE positive. In grades II and III, NSE and CgA were significantly higher than grade I (P<0.001). CgA incidence was higher significantly in mucinous carcinomas (P<0.05). Conclusion: Less than 20% of colorectal cancers showed neuroendocrine differentiation. There was no significant relationship between NSE and CgA incidence with stage or tumor site. There was a relationship between histologic grade and above-mentioned markers; this finding may help us in our knowledge about tumor behavior.
