GI, Liver & Pancreas Pathology
Shilpa Tukaram Patil; Clement Wilfred Devadass; Prasanna Shetty Badila
Abstract
Background & Objective: Colorectal cancer is the third most prevalent malignancy with high mortality rate, necessitating markers that predict survival and guide the treatment. Previous studies have examined the immunohistochemical expression of Bcl-2, an apoptotic marker, in colorectal carcinoma, ...
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Background & Objective: Colorectal cancer is the third most prevalent malignancy with high mortality rate, necessitating markers that predict survival and guide the treatment. Previous studies have examined the immunohistochemical expression of Bcl-2, an apoptotic marker, in colorectal carcinoma, but results have been contradictory. To evaluate the histopathological features of colorectal carcinoma, immunohistochemical expression of Bcl-2 must be analyzed to find out statistical association of Bcl-2 expression with certain prognostic factors histopathologic type, grade and TNM staging. Methods: This prospective study was conducted on the colectomy specimens of colorectal carcinoma, over a period of two years. The tumor morphology and Bcl-2 status were evaluated by immunohistochemistry in each case. Result: The study included 58 cases, with mean patient age of 47.07 years and male: female ratio of 1.89:1. Bcl-2 positivity was seen in 32.7% of the cases. Weak, moderate, and strong expression of Bcl-2 was seen in 12.1%, 12.1%, and 8.5% of cases respectively. Even though early stages of colorectal carcinoma showed greater frequency of Bcl-2 expression than advanced stages (36.3% versus 28%), however this association was not statistically significant. Conclusion: Lack of statistically significant correlation between Bcl-2 immuno-histochemical expression and prognostic parameters like tumor grade and stage, suggests that Bcl-2 immunoexpression may not be a significant prognostic marker in colorectal carcinoma.
Artem Piddubnyi; Anatolii M Romaniuk; Inna-Margaryta Radomychelski; Yuliia Moskalenko; Roman Moskalenko
Abstract
Background & Objective: To study the immunophenotype of prostate cancer (PC) with the presence and absence of intraluminal inclusions (IIn), depending on the grade score. Methods: A total of 30 PC samples with IIn (group E) and 30 PC samples without them (group C) were studied. These groups were ...
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Background & Objective: To study the immunophenotype of prostate cancer (PC) with the presence and absence of intraluminal inclusions (IIn), depending on the grade score. Methods: A total of 30 PC samples with IIn (group E) and 30 PC samples without them (group C) were studied. These groups were divided into 2 subgroups, depending on the grade of malignancy, which was determined according to the Gleason score as moderate and high-grade tumors. Macroscopic analysis, hematoxylin-eosin staining, immunohistochemistry (androgen receptors, p53 and Bax proteins, Hsp70 and Hsp90, CD68, VEGF, OSN, MMP-1) were used. Results: The expression level of VEGF was higher in the more differentiated tumors of the control group (P<0.01). Increased expression of prognostic-adverse markers p53 (in the presence of IIn, P<0.01) and MMP-1 (P<0.05) was observed. Also, a higher level of OSN expression was found in PC tissue with IIn (P<0.01) due to its participation in the processes of biomineralization. The expression level of CD68 and Bax protein was higher in the PC group with IIn (both P<0.01). Furthermore, Hsp90 had a significantly lower expression level in the PC of group E (P<0.05). Conclusion: the presence of IIn in the PC samples of group E promotes tissue remodeling with mechanical trauma, chronic inflammation, and fibrosis development. The presence of IIn in PC leads to the increase of OSN, CD68 and Bax expression and decrease of Hsp90 and VEGF expression. High expression of p53 and MMP-1 and low expression of OSN and VEGF was identified as a characteristic of high-grade tumors.
Immunology and Serology
Parvin Mahzouni; Fatemeh Taheri
Abstract
Background & Objective: Glioblastoma-multiforme is the high grade form of astrocytic tumors with a short survival time, which are the most common type of brain tumors. Therefore, finding new therapeutic options is essential. Cyclin D1 is expressed in some human malignancies and can be a potential ...
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Background & Objective: Glioblastoma-multiforme is the high grade form of astrocytic tumors with a short survival time, which are the most common type of brain tumors. Therefore, finding new therapeutic options is essential. Cyclin D1 is expressed in some human malignancies and can be a potential target for therapeutic intervention. The aim of the present study was to determine this relationship. Methods: This is a cross-sectional study conducted in the pathology department of Al-Zahra Hospital in Isfahan, Iran. In this study, 100 samples diagnosed with astrocytic tumors between 2011 and 2015 that met the study’s requirements were studied and immunohistochemical staining for cyclin D1 was performed for each specimen. At the end, the relationship between the expression of cyclin D1 and various variables including tumor grades, tumor subtypes and patient demographic features were examined using appropriate statistical tests. Results: Of the 100 samples, cyclin D1 was positive in 60 samples and negative in 40 samples. Moreover, in 26 samples, the amount of the marker was low, while in 34 samples it was high. Following the results of the study, there was a significant difference (P =0.038) in the expression of the cyclin D1 marker among the four different grades of astrocytic tumors. Conclusion: The results showed that the expression of cyclin D1 was associated with different tumor grades, especially the high level of expression in grade 4, and the amount of cyclin D1 increased as the level of grade glioma increased.
Gynecologic Pathology
Mihir A Gudi; Yiu Yi Chung; Nohadani Mahrokh
Abstract
Background and Objective: Anti-CK5/6 monoclonal antibodies have an established role in breast disease diagnosis. Anti-CK5 monoclonal antibodies have recently become commercially available. There has been growing interest in the staining characteristics of anti-CK5 and its potential diagnostic role in ...
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Background and Objective: Anti-CK5/6 monoclonal antibodies have an established role in breast disease diagnosis. Anti-CK5 monoclonal antibodies have recently become commercially available. There has been growing interest in the staining characteristics of anti-CK5 and its potential diagnostic role in place of anti-CK5/6. We aim to compare and contrast the staining characteristics of anti-CK5/6 vs anti-CK5. Material and Methods: 58 tissue blocks containing 122 different lesions were selected from tissue archives. Two specimens (groups) were taken from each lesion One (group) was stained with anti-CK5 and the other (group) with anti-CK5/6 monoclonal antibodies, using the Streptavidin-biotin immuno-peroxidase method. The two groups of slides were compared and contrasted for lesion staining pattern and for intensity, using light microscopy. Results: Results showed that the diagnostic staining pattern was exactly the same in both anti-CK5 and anti-CK5/6 groups, and also showed that anti-CK5, stained most of the lesions more intensely than anti-CK5/6. Conclusion: Anti-CK5 performed at least as well (for lesion-pattern staining), and better (for lesion staining intensity) than did anti-CK5/6 in the diagnosis of a wide range of breast tissues and lesions. It may be justified to safely replace anti-CK5/6 with anti-CK5 in future routine clinical use, with resultant diagnostic and economic benefits.
Bone & Soft tissue Pathology
Monireh Halimi; Samad BeheshtiRouy; Davood Salehi; Seyed Ziaeddin Rasihashemi
Abstract
Background and Objective: Early diagnosis of malignant pleural mesothelioma (MPM) is the key point of its treatment. The main problem is the precise diagnosis of mesothelioma and its differentiation from metastatic lung adenocarcinoma. Mesothelioma exhibits complex immunohistochemical characteristics. ...
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Background and Objective: Early diagnosis of malignant pleural mesothelioma (MPM) is the key point of its treatment. The main problem is the precise diagnosis of mesothelioma and its differentiation from metastatic lung adenocarcinoma. Mesothelioma exhibits complex immunohistochemical characteristics. The aim of this study was to study hybrid immunohistochemistry in the differential diagnosis of primary malignant pleural effusion from metastatic pulmonary cancers. Material and Methods: Twenty tissue samples in paraffin blocks from the pathology department of Imam Reza Hospital in Tabriz whose pathology reports cited mesothelioma or metastatic lung adenocarcinomas, were included in the studies. These tissues were deemed appropriate for IHC in terms of tissue quality and quantity. They were studied and evaluated for pathological markers. Results: In patients with adenocarcinoma CK7 in 100% of patients (13 patients), TTF1 in 61.5% of patients (8 patients) and CEA in 53.8% of patients (7 patients) were positive, but HBME1 and Calretinin were negative for all patients. In patients with mesothelioma, HBME1 and Calretinin were positive in 100% of patients (7 patients) and TTF1, CEA and CK7 were negative. Conclusion: The results of this study showed that CEA, CK7, TTF1, Calretinin and HBME1 are suitable criteria for differentiating between metastatic lung adenocarcinoma and mesothelioma, and can differentiate the mesothelioma and adenocarcinoma with high accuracy.
Oral Pathology
Savita S Thakkannavar; Veena V Naik
Abstract
Background and Objective: This study was aimed to evaluate the collagen fibers qualitatively and its correlation with microvascular density in various grades of oral submucous fibrosis (OSMF). Material and Methods: The present study comprised of total 40 cases of oral submucous fibrosis. Picrosirius ...
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Background and Objective: This study was aimed to evaluate the collagen fibers qualitatively and its correlation with microvascular density in various grades of oral submucous fibrosis (OSMF). Material and Methods: The present study comprised of total 40 cases of oral submucous fibrosis. Picrosirius red staining was done on all the specimens’ sections. They were analyzed for the colour and orientation of collagen fibers. Morphometric measurements were done using image analysis on immunohistochemical stained sections for Factor VIII-related antigen and analyzed for microvascular density. Results: Picrosirius red polarizing microscopy results revealed that there was a shift in the colour of collagen fibers from greenish yellow to orange red and red colour as the severity of the oral submucous fibrosis increased. The collagen fibers showed mixed orientation in early oral submucous fibrosis and parallel orientation in advanced oral submucous fibrosis. There was a significant decrease in microvascular density from early to advanced oral submucous fibrosis. Conclusion: The change in the colours and orientation of collagen fibers in early and advanced oral submucous fibrosis could be attributed to the fibre thickness, type of collagen, alignment and packing, cross-linking of the fibers and the section thickness. However, in advanced cases the vascularity is reduced which may predispose to epithelial atrophy and subsequent malignant changes.
Diagnostic Pathology
Lalit Singh; Nisha Marwah; Namita Bhutani; Devendra Pawar; Raman Kapil; Rajeev Sen
Abstract
Background and Objective: Adenocarcinoma of the prostate is the second most common cause of cancer. The loss of CD10 is a common early event in human prostate cancer and is seen in lower Gleason Score malignancies while increased and altered expression is seen in high Gleason Score tumors, lymph nodes ...
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Background and Objective: Adenocarcinoma of the prostate is the second most common cause of cancer. The loss of CD10 is a common early event in human prostate cancer and is seen in lower Gleason Score malignancies while increased and altered expression is seen in high Gleason Score tumors, lymph nodes and bone metastasis. Material and Methods: This was a prospective observational study conducted on 75 patients suspected to have prostate cancer. Immunohistochemical profile was assessed for PSA, AMACR and CD10 immunostaining. The intensity of CD10 expression and pattern of CD10 staining of tumor cells was evaluated. Results: The patients were in age group of 50-90 years with a mean age of 70.97 ± 9.51 years. As the Grade Group/Gleason Score increased, the number of cases showing negative expression decreased and the pattern of expression changed from membranous to cytoplasmic to both types of expression. As the serum PSA levels increased the intensity of expression changed from focally positive to diffusely positive. The pattern of expression also changed from membranous to cytoplasmic to both (membranous + cytoplasmic) types of expression with an increase in PSA levels. Conclusion: By immunohistochemical analysis we can identify CD10 positive tumors, which may warrant more aggressive initial therapy. A number of drugs against CD10 are available based on which potential targeted therapies could be formulated.
Maryam Ghasemi; Laleh Vahedi-larijani; Omid Emadian; Jamshid Yazdani; Ahmad Sajadianfar; Saeid Abediankenari
Abstract
Background & Objective: This study was designed for the first time for the detection of mutant BRAF V600E and its correlation with clinicophathologic features in a sample of Iranian patients with pathologically proved pigmented skin neoplasms.Methods: 82 paraffin-embedded blocks, including melanocytic ...
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Background & Objective: This study was designed for the first time for the detection of mutant BRAF V600E and its correlation with clinicophathologic features in a sample of Iranian patients with pathologically proved pigmented skin neoplasms.Methods: 82 paraffin-embedded blocks, including melanocytic nevi, malignant melanoma, Basel cell carcinoma, and squamous cell carcinoma were evaluated for BRAF V600E expression by immunohistochemistry in the patients admitted to Ibn Sina Hospital, in the city of Sari, Mazandaran province, North of Iran. The evaluation of immunohistochemical staining was performed by two of the authoring pathologists, and staining intensity was graded from negative (0), weak (1+), moderate (2+) to strong (3+). If twenty percent (or greater) of the tumor cells showed modest to strong cytoplasmic immunoreactivity (score 3+), the neoplasm was considered positive for this tumor marker.Results: Among 82 studied patients, 12 cases (60%) of the malignant melanoma group revealed a high intensity of immunostaining for BRAF V600E, while a significant expression of this marker did not occur in the other investigated skin neoplasm. A great relation between BRAF (V600E) expression and the histologic type of skin cancer was noted. No significant relationship with other parameters such as gender, age, and the grade differentiation of the non-melanoma skin cancer was found. BRAF V600E was weakly correlated with the Clark level of cutaneous malignant melanoma.Conclusion: This data provided further
Farid Kosari; Fatemeh Ghaffari
Volume 13, Issue 4 , October 2018, , Pages 390-396
Abstract
Background and Objective: Hodgkin's lymphoma is a potentially curable hematologic malignancy with difficulty in its diagnosis especially in atypical cases even in expert hands. Today, immunohistochemistry plays a significant role in the diagnosis of it especially applying the anti-CD15 and anti-CD30 ...
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Background and Objective: Hodgkin's lymphoma is a potentially curable hematologic malignancy with difficulty in its diagnosis especially in atypical cases even in expert hands. Today, immunohistochemistry plays a significant role in the diagnosis of it especially applying the anti-CD15 and anti-CD30 antibodies. The negativity of CD15 can be reduced by antigen retrieval for methods. In this study, the effect of autoclave was compared with microwave as heating sources of antigen retrieval in immunohistochemical staining.Methods: Sections prepared from 50 formalin-fixed paraffin-embedded tissue blocks of Classic Hodgkin's lymphomas stained for CD15 and CD30 using autoclave and microwave, were randomly and blindly reviewed by an expert hematopathologist, mostly focusing on Reed-Sternberg cells; the intensities were scored from 0 to +4 and analyzed by SPSS software.Results: Fifty eight percent of patients were male. The mean age was 32 years (range: 7 to 77). Nodular sclerosis was the most prevalent subtype. CD15 positivity in microwave treatment was 92% compared to 50% in autoclave. Negative CD30 decreased from 20% in autoclave to 2% in microwave. Intensity of staining in both markers was at least +1 greater in microwave treatment. No background staining was seen in microwave method.Conclusion: There was bimodal age distribution in Hodgkin's lymphoma patients with the predominant male and Nodular Sclerosis as the most common type. Comparing autoclave and microwave, higher rate of the positivity was detected using microwave treatment, especially in CD15 staining. Improvement in staining intensity was also noticeable in both markers. There was no background or non-specific staining in microwave method. No disturbance of cells or nuclear morphology was also reported. PMID: 30774676 PMCID: PMC6358563
Hiva Saffar; Marzieh Mirzaii; Elham Mirzaian2050@gmail.com; Farid Kosari
Abstract
Background& Objective: Micro-vascular proliferation is an important histological feature of brain glioma with more vascular proliferation is present in higher grades of glioma. CD 105 is expressed in new actively proliferating and immature endothelial cells in tumor environment and appears ...
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Background& Objective: Micro-vascular proliferation is an important histological feature of brain glioma with more vascular proliferation is present in higher grades of glioma. CD 105 is expressed in new actively proliferating and immature endothelial cells in tumor environment and appears to be capable to distinguish between malignant neo-vasculature and normal vessels. Methods: This study was designed to evaluate the Micro-Vessel Density(MVD) in different grades of brain glioma based on CD 105 expression by Immunohistochemistry method to determine whether it can be a helpful marker for rumor grading or not. Paraffin blocks of formalin fixed samples of brain astrocytic glioma were retrieved and IHC was performed using anti-CD105 monoclonal mouse antibody. Results: Total number of 48cases of low and high grade astrocytic gliomas were evaluated.We noted that there was a positive correlation between MVD evaluated by CD105 and tumor grade, meaning that expression was significantly greater in tumors with higher grade (P=0.019). Conclusion: We concluded that MVD quantified by CD 105 has positive correlation with tumor grade. Also we think that expression of CD 105 specially in low-grade glioma can serve as a basis for selective treatment option in combination with current standard care .
Hossein Javid; Isaac Hashemy; Soudabeh Shahid sales; Nema Mohammadian Roshan; Tayyebeh Kianoosh; Farnaz Zahedi Avval
Abstract
Background & objective: Globally, breast cancer is the most common malignancy among females. Prohibition (PHB)-I, a homologous protein, was initially introduced as a suppressor gene for amplification process. Further, the protein has a key role in the cell cycle and is capable of inhibiting ...
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Background & objective: Globally, breast cancer is the most common malignancy among females. Prohibition (PHB)-I, a homologous protein, was initially introduced as a suppressor gene for amplification process. Further, the protein has a key role in the cell cycle and is capable of inhibiting DNA transcription in many cell types. Therefore, its possible role in different types of human malignancies is of interest. The current study aimed at examining the relationship between the tissue distribution of PHB-I and prognostic factors of breast cancer. Method: Paraffin-embedded tissue specimens of 33 patients diagnosed with breast cancer at Omid teaching Hospital, Mashhad, Iran were studied and a commercial monoclonal antibody was used to perform immunohistochemistry (IHC). The relationship between PHB-I tissue expression with age, disease stage, tumor grade and size, as well as hormone receptor status including estrogen (ER) and progesterone (PR) receptors, and Her-2 receptor were evaluated. Results: The Immunohistochemical analysis showed a relative increase in PHB-I tissue expression along with higher tumor grade (P=0.057). In addition, higher expression of ER and PR were observed (P=0.027 and 0.009, respectively). The age of patients and other prognostic factors including Her-2 receptor status and disease stage did not statistically correlate with PHB-I expression. Conclusion: An increased expression of PHB-I was observed in the breast cancer tumors of the current study patients compared with the anatomically healthy margin. Its coloration with some prognostic factors such as disease grade and expression of ER and PR might indicate the PHB-I potential application for diagnostic and patient management purposes.
Gynecologic Pathology
Savita Agarwal; Megha Ralli; Pinki Pandey; Shruti Singh
Abstract
Ovarian small cell carcinoma is a rare and highly malignant tumor with poor prognosis. It usually presents in younger females with features of hypercalcemia. The exact histogenesis of the tumor is unclear and it may present as an undifferentiated tumor. In such cases, immunohistochemistry (IHC) plays ...
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Ovarian small cell carcinoma is a rare and highly malignant tumor with poor prognosis. It usually presents in younger females with features of hypercalcemia. The exact histogenesis of the tumor is unclear and it may present as an undifferentiated tumor. In such cases, immunohistochemistry (IHC) plays an important role to confirm the diagnosis. Limited treatment options are available and mainly include radical surgery followed by adjuvant therapy in advanced stages. The current report was a rare case of small cell carcinoma of ovary presenting no symptoms of hypercalcemia diagnosed on histopathological examination and IHC findings.
Amir Hossein Jafarian; Masoumeh Gharib; Nema Mohammadian Roshan; Samaneh Sherafatnia; Abbas Ali Omidi; Sahar Bagheri
Abstract
Background & objective: The histologic distinction of small cell from non-small cell lung carcinoma and correct identification of all subtypes of lung carcinoma are very important in treatment management. The main method for histologic classification of lung tumors is based on morphology. However, ...
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Background & objective: The histologic distinction of small cell from non-small cell lung carcinoma and correct identification of all subtypes of lung carcinoma are very important in treatment management. The main method for histologic classification of lung tumors is based on morphology. However, in small bronchoscopic biopsies in particular, distinction is very difficult upon morphology alone. The current study aimed at evaluating the utility of a panel of antibodies, consisting of thyroid transcription factor (TTF-1), P63, high molecular weight keratin [HMWK (34βE12)], cytokeratin (CK7), and cluster of differentiation (CD56) for accurate distinction of bronchogenic carcinomas. Methods: Bronchoscopic biopsies of 60 lung carcinoma cases including 20 small cell carcinomas, 20 adenocarcinomas, and 20 squamous cell carcinomas (SCCs) with typical morphologic features were selected. All these cases were immunohistochemically stained for TTF-1, P63, HMWK (34βE12), CK7, and CD56. All immunostained slides were scored as either positive or negative. Results: The mean age of the patients was 60 years; ranged from 35 to 81. Sixteen patients were female and 44 were male. All adenocarcinomas were positive for CK7 and most of them (18/20; 90%) were positive for TTF-1. Most of small cell lung carcinomas were positive for TTF-1 (17/20; 85%), and CD56 (18/20; 90%). All squamous cell carcinomas (SCCs) were negative for TTF-1, but most of them were positive for HMWK (34βE12) and P63. Conclusion: The obtained data showed that TTF-1, P63, CK7, CD56 and/or 34βE12 represent a useful panel of antibodies to identify lung carcinoma subtypes in small bronchoscopic biopsies.
Zaidoon A. Musa; Ban J. Qasim; A.Wahab A.K. Al Shaikhly
Abstract
Background and Objective:Determination of HER2 gene is crucial in breast carcinoma management and prognosis, as HER2 alterations are linked to a shorter disease-free period, overall survival and resistance to tamoxifen anti-estrogen therapy and other chemotherapy regimens, regardless of the nodal or ...
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Background and Objective:Determination of HER2 gene is crucial in breast carcinoma management and prognosis, as HER2 alterations are linked to a shorter disease-free period, overall survival and resistance to tamoxifen anti-estrogen therapy and other chemotherapy regimens, regardless of the nodal or hormone receptor status. This study aimed to estimate HER2 gene status of infiltrative mammary cancer cases with immunohistochemically equivocal (2+) score using Silver DNA in Situ Hybridization(SISH) technique and to investigate its association with clinicopathological variables. Methods: The study included 52 formalin-fixed paraffin embedded tissue blocks from female patients with invasive breast carcinoma with score of 2+ (equivocal) HER2 immunohistochemistry. All cases were studied by silver DNA in situ hybridization technique (SISH) for the determination of the amplified HER2 DNA. Results: TheSISH technique showed that HER2 gene was not amplified in 33 cases out of 52 (63.5%); while the rest of 19 cases (36.5%) revealed amplified gene status.According to age, HER2 gene status reported non-significant difference in the age groups between cases with amplified and non-amplified gene status (P=0.173). There was a significant negative association between positive Estrogen (ER) and Progesterone (PR) status and HER2 gene amplification (P= 0.002 and 0.017, respectively). Conclusion: More than half of breast carcinoma cases with equivocal HER2 immunoreactivity showed non-amplified gene status; this needs to be considered by oncologists in their management planning of breast cancer. Amplified HER2 gene is significantly associated with negative ER and PR status that affects patients’ management protocols and future outcome of the disease.
Mina Majdi; Hana Saffar; Alireza Ghanadan
Volume 11, Issue 5 , October 2016, , Pages 423-426
Abstract
Cutaneous metaplastic synovial cyst (CMSC), presents as a solitary, tender subcutaneous nodule that usually occurs at the site of previous surgery or trauma. Histologically, the lesion is characterized by a cystic structure with villous-like projections that lined by metaplastic synovial tissue. The ...
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Cutaneous metaplastic synovial cyst (CMSC), presents as a solitary, tender subcutaneous nodule that usually occurs at the site of previous surgery or trauma. Histologically, the lesion is characterized by a cystic structure with villous-like projections that lined by metaplastic synovial tissue. The main cause remains unclear, but trauma is presumed to be a precipitating factor, as most reported cases have a history of antecedent cutaneous injury. Here we present a case of CMSC in a 51 yr old man, presented with a painless deep-seated dermal nodule in the medial aspect of left ankle without history of any trauma or surgery in this site. Immuno-histochemistry study reveals positive reaction for CD68 in the cystic wall and negative reactions for S-100. CMSC is a unique lesion and worthy to attention, and should be included in the differential diagnosis of deep dermal cutaneous cysts.
Nasser Rakhshani; Mohammadreza Araste; Farid Imanzade; Mahshid Panahi; Fahimeh Safarnezhad Tameshkel; Masoud Reza Sohrabi; Mohammad Hadi Karbalaie Niya; Farhad Zamani
Volume 11, Issue 4 , October 2016, , Pages 409-415
Abstract
Background: Hirschsprung disease is a complex genetic disorder of the enteric nervous system (ENS), often called congenital aganglionic megacolon and characterized by the absence of enteric neurons along a variable length of the intestine. The definitive diagnosis of Hirschsprung disease relies on histologic ...
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Background: Hirschsprung disease is a complex genetic disorder of the enteric nervous system (ENS), often called congenital aganglionic megacolon and characterized by the absence of enteric neurons along a variable length of the intestine. The definitive diagnosis of Hirschsprung disease relies on histologic and/or histochemical staining of sections from suction rectal biopsies. Calretinin immunohistochemistry (IHC) may be a useful in its diagnosis. This study aimed to proof the usefulness of immunohistochemical staining for calretinin in rule out of Hirschsprung disease. Methods: Paraffin blocks and slides were retrieved from the pathology archives of Ali Asghar Hospital, Tehran, Iran from 2007 to 2011 with pathology report based on the presence (14 patients) or absence (70 patients) of ganglion cells and transitional zone anatomical region (10 patients). Slides were stained with hematoxylin and eosin method to confirm the initial diagnosis was verification again. After preparing the slides, they were stained by IHC for calretinin. Then, the results were analyzed using SPSS software. Results: In most patients, IHC for calretinin provided highly compatible results with hematoxylin-eosin findings in diagnosis of Hirschsprung disease. The values of specificity and accuracy between calretinin and standard histology (H&E) compared by the Fisher exact test declared calretinin presented significantly higher specificity and accuracy values than H&E staining (P <0.0001). Conclusion: Calretinin IHC overcomes most of the difficulties encountered using the histology hematoxylin-eosin. Then, IHC for calretinin is a good ancillary method used by pathologists in diagnosis of Hirschsprung disease.
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.
Hamid Tabrizchee; Armita Esmaili
Volume 6, Issue 4 , September 2011, , Pages 193-201
Abstract
Background and Objectives: Classic Hodgkin lymphoma (CHL), anaplastic large cell lymphoma (ALCL) and some cases of diffuse large B cell lymphoma (DLBCL) have overlapping morphologic features. Since they all represent distinct clinico-pathologic entities, we explored the differential diagnostic ...
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Background and Objectives: Classic Hodgkin lymphoma (CHL), anaplastic large cell lymphoma (ALCL) and some cases of diffuse large B cell lymphoma (DLBCL) have overlapping morphologic features. Since they all represent distinct clinico-pathologic entities, we explored the differential diagnostic impact of immunophenotyping to discriminate between them. Materials and Methods: We included 61 cases diagnosed as CHL, ALCL, and anaplastic variant of DLBCL. We reviewed morphologic microscopic findings by conventional staining and immunohistochemistry (IHC) with antibodies against PAX-5, CD30, CD15, CD45, EMA, ALK-1, and LMP-1. Results: Fifty cases corresponded to CHL (81.97%), 4 cases to ALCL (6.56%), and 4 cases to DLBCL (6.56%) excluding 3 cases, which remained unclassifiable (4.92%). PAX-5 was expressed in 94% of CHL and 100% of DLBCL cases. LMP-1 was expressed in 52% of CHL and 25% of DLBCL cases. EMA was invariably expressed in all 4 cases of ALK+ALCL. It was expressed in 4/50 cases (8%) of CHL and in 2/4 cases (50%) of DLBCL. CD45 was expressed in all cases of ALCL and DLBCL but also in 3/50 cases (6%) of CHL. Conclusion: The differentiation between ALCL and CHL based on EMA and CD45 is not reliable. Utilization of PAX-5 in combination with other markers such as CD15 and LMP-1 is recommended. CD20 and PAX-5 are not too helpful in the differentiation of CHL and DLBCL, while CD15 and CD79a were found to be quite useful discriminative markers for this purpose.
Amir Hossein Jafarian; Jahanshah Salehinejad; Bahareh Joushan; Abbas Ali Omidi
Volume 6, Issue 2 , April 2011, , Pages 86-92
Abstract
Background and Objectives: Adenoid cystic carcinoma (ACC), the most common malignant tumor of submandibular and minor salivary glands, is characterized by a high rate of local recurrence and distant hematogenous metastasis and tendency to invade peripheral nerves. In spite of radiotherapy and ...
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Background and Objectives: Adenoid cystic carcinoma (ACC), the most common malignant tumor of submandibular and minor salivary glands, is characterized by a high rate of local recurrence and distant hematogenous metastasis and tendency to invade peripheral nerves. In spite of radiotherapy and surgical treatment, the long-term prognosis is dismal. Today, many studies are being conducted using the immunohistochemical markers to help in the evaluation of ACC prognosis. The present investigation was performed to survey immunohistochemically HER2/neu over expression in adenoid cystic carcinoma of salivary glands. Materials and Methods: The 24 existing samples of formalin-fixed paraffin embedded specimen were stained with HER2/neu markers. Tumors with moderate (2+) to strong (3+) complete membrane staining in at least 10% of the tumor cells were scored as positive for over expression. Results: The overall frequency of over expression for HER2/neu was 45.8% and 11 specimen were positive for HER2/neu expression. A significant relationship was found between HER2/neu over expression and grade of ACC. No significant relationship was detected between immunostaining of HER2/neu and histologic pattern. Conclusion: HER2/neu immunostaining might be reliable and useful for evaluation of ACC prognosis.
Farid Kosari; Naghmeh Amin Taheri; Alireza Sadeghipour; Kamran Alimoghaddam; Ardeshir Ghavamzadeh
Volume 6, Issue 1 , January 2011, , Pages 8-12
Abstract
Background and Objectives: Epstein Barr Virus (EBV) is one of the members of herpesviridae family and a sub-category of Gamma herpes virinae. EBV, which normally has CR2 or CD21 receptors on B-lymphocytes, has mutagenic features for them. The virus plays an important role in causing some malignant ...
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Background and Objectives: Epstein Barr Virus (EBV) is one of the members of herpesviridae family and a sub-category of Gamma herpes virinae. EBV, which normally has CR2 or CD21 receptors on B-lymphocytes, has mutagenic features for them. The virus plays an important role in causing some malignant cancers. About 30% of the cases with non-Hodgkin’s lymphoma are diffuse large B-cell lymphoma (DLBCL). In the present study, the incidence rate of EBV in DLBCL was evaluated.
Materials and Methods: Immunohistochemistry (IHC) and PCR methods were used for studying the relationship between EBV and DLBCL. Paraffin blocks of 116 patients from Sina & Shariati hospitals, Tehran, Iran, with DLBCL diagnoses in 2005-2009 were collected. EBV-LMP in IHC and PCR virus genome in PCR were examined.
Results: Findings of the PCR method showed that 28 cases of the total 116 patients with DLBCL were EBV positive (the frequency of EBV positivity was correspondingly 40% and 60% in females and males) and this shows a 25.8% EBV frequency in DLBCL. IHC findings showed that six cases were EBV positive. The compatibility of positive IHC and PCR responses was two cases and there are four conflicting cases.
Conclusion: It seems that PCR is a more appropriate method for diagnosing EBV and IHC cannot solely prove the presence of EBV in DCBCL patients.
Background and Objectives: Epstein Barr Virus (EBV) is one of the members of herpesviridae family and a sub-category of Gamma herpes virinae. EBV, which normally has CR2 or CD21 receptors on B-lymphocytes, has mutagenic features for them. The virus plays an important role in causing some malignant cancers. About 30% of the cases with non-Hodgkin’s lymphoma are diffuse large B-cell lymphoma (DLBCL). In the present study, the incidence rate of EBV in DLBCL was evaluated.
Materials and Methods: Immunohistochemistry (IHC) and PCR methods were used for studying the relationship between EBV and DLBCL. Paraffin blocks of 116 patients from Sina & Shariati hospitals, Tehran, Iran, with DLBCL diagnoses in 2005-2009 were collected. EBV-LMP in IHC and PCR virus genome in PCR were examined.
Results: Findings of the PCR method showed that 28 cases of the total 116 patients with DLBCL were EBV positive (the frequency of EBV positivity was correspondingly 40% and 60% in females and males) and this shows a 25.8% EBV frequency in DLBCL. IHC findings showed that six cases were EBV positive. The compatibility of positive IHC and PCR responses was two cases and there are four conflicting cases.
Conclusion: It seems that PCR is a more appropriate method for diagnosing EBV and IHC cannot solely prove the presence of EBV in DCBCL patients.
Background and Objectives: Epstein Barr Virus (EBV) is one of the members of herpesviridae family and a sub-category of Gamma herpes virinae. EBV, which normally has CR2 or CD21 receptors on B-lymphocytes, has mutagenic features for them. The virus plays an important role in causing some malignant cancers. About 30% of the cases with non-Hodgkin’s lymphoma are diffuse large B-cell lymphoma (DLBCL). In the present study, the incidence rate of EBV in DLBCL was evaluated.
Materials and Methods: Immunohistochemistry (IHC) and PCR methods were used for studying the relationship between EBV and DLBCL. Paraffin blocks of 116 patients from Sina & Shariati hospitals, Tehran, Iran, with DLBCL diagnoses in 2005-2009 were collected. EBV-LMP in IHC and PCR virus genome in PCR were examined.
Results: Findings of the PCR method showed that 28 cases of the total 116 patients with DLBCL were EBV positive (the frequency of EBV positivity was correspondingly 40% and 60% in females and males) and this shows a 25.8% EBV frequency in DLBCL. IHC findings showed that six cases were EBV positive. The compatibility of positive IHC and PCR responses was two cases and there are four conflicting cases.
Conclusion: It seems that PCR is a more appropriate method for diagnosing EBV and IHC cannot solely prove the presence of EBV in DCBCL patients.
Background and Objectives: Epstein Barr Virus (EBV) is one of the members of herpesviridae family and a sub-category of Gamma herpes virinae. EBV, which normally has CR2 or CD21 receptors on B-lymphocytes, has mutagenic features for them. The virus plays an important role in causing some malignant cancers. About 30% of the cases with non-Hodgkin’s lymphoma are diffuse large B-cell lymphoma (DLBCL). In the present study, the incidence rate of EBV in DLBCL was evaluated.
Materials and Methods: Immunohistochemistry (IHC) and PCR methods were used for studying the relationship between EBV and DLBCL. Paraffin blocks of 116 patients from Sina & Shariati hospitals, Tehran, Iran, with DLBCL diagnoses in 2005-2009 were collected. EBV-LMP in IHC and PCR virus genome in PCR were examined.
Results: Findings of the PCR method showed that 28 cases of the total 116 patients with DLBCL were EBV positive (the frequency of EBV positivity was correspondingly 40% and 60% in females and males) and this shows a 25.8% EBV frequency in DLBCL. IHC findings showed that six cases were EBV positive. The compatibility of positive IHC and PCR responses was two cases and there are four conflicting cases.
Conclusion: It seems that PCR is a more appropriate method for diagnosing EBV and IHC cannot solely prove the presence of EBV in DCBCL patients.
Background and Objectives: Epstein Barr Virus (EBV) is one of the members of herpesviridae family and a sub-category of Gamma herpes virinae. EBV, which normally has CR2 or CD21 receptors on B-lymphocytes, has mutagenic features for them. The virus plays an important role in causing some malignant cancers. About 30% of the cases with non-Hodgkin’s lymphoma are diffuse large B-cell lymphoma (DLBCL). In the present study, the incidence rate of EBV in DLBCL was evaluated.
Materials and Methods: Immunohistochemistry (IHC) and PCR methods were used for studying the relationship between EBV and DLBCL. Paraffin blocks of 116 patients from Sina & Shariati hospitals, Tehran, Iran, with DLBCL diagnoses in 2005-2009 were collected. EBV-LMP in IHC and PCR virus genome in PCR were examined.
Results: Findings of the PCR method showed that 28 cases of the total 116 patients with DLBCL were EBV positive (the frequency of EBV positivity was correspondingly 40% and 60% in females and males) and this shows a 25.8% EBV frequency in DLBCL. IHC findings showed that six cases were EBV positive. The compatibility of positive IHC and PCR responses was two cases and there are four conflicting cases.
Conclusion: It seems that PCR is a more appropriate method for diagnosing EBV and IHC cannot solely prove the presence of EBV in DCBCL patients.
Zohreh Yousefi; Nourieh Sharifi; Farnoosh Sadatmand; Soodabeh Shaid Salles
Volume 4, Issue 4 , September 2009, , Pages 172-176
Abstract
Background and Objective: Histopathological evaluation of granulosa cell tumors (GCT) of the ovary may be confused morphologically with a wide variety of the tumors. Immunohistochemical staining for inhibin and calretinin can be used for better diagnosis. Although it has been suggested that inhibin can ...
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Background and Objective: Histopathological evaluation of granulosa cell tumors (GCT) of the ovary may be confused morphologically with a wide variety of the tumors. Immunohistochemical staining for inhibin and calretinin can be used for better diagnosis. Although it has been suggested that inhibin can be a sensitive marker for GCT, it maybe had negative results in some cases. In addition, caltrinin has been proposed as a marker for GCT. The aim of this study was to investigate the immunohistochemical methods (IHC) including a comparison of calretinin and inhibin markers in the diagnosis of these tumors. Patients and Methods: This prospective study carried out from 2000 to 2009 at Ghaem and Omid hospitals, Mashad University of Medical Sciences, Iran. A total of 23 ovarian GCT specimens were immunostained with commercially available antibodies to find out calretinin and inhibin immunoreactivity. Data were analyzed by descriptive statistical method. A P value of =Results: For diagnosing GCT, the sensitivity of calretinin was 100% and that of the inhibin was almost 73.9%. The extent and severity of staining was more extensive for calretinin compared to inhibin PConclusion: Calretinin is a more sensitive biomarker for GCT than inhibin.
Afsaneh Rajabiani; Hossein Vakili
Volume 4, Issue 4 , September 2009, , Pages 190-193
Abstract
Primary fallopian tube carcinoma is a rare tumor that histologically and clinically resembles epithelial ovarian cancer. Here we introduce a case of tubal carcinoma in a postmenopausal woman. The diagnosis of primary fallopian tube carcinoma is rarely considered preoperatively and is usually first appreciated ...
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Primary fallopian tube carcinoma is a rare tumor that histologically and clinically resembles epithelial ovarian cancer. Here we introduce a case of tubal carcinoma in a postmenopausal woman. The diagnosis of primary fallopian tube carcinoma is rarely considered preoperatively and is usually first appreciated by the pathologist. Because of low frequency of tubal carcinoma, there are few systemic pathological reports of its mode and extent of spread. Surgical staging and management as the use of chemotherapy follow the concepts used in epithelial ovarian cancer. In contrast to epithelial ovarian cancer, it is the importance of early lymphatic spread in this disease. The earlier diagnosis of primary fallopian tube carcinoma leads to an apparent better survival compared with its ovarian counterpart. However, as with epithelial ovarian carcinoma, stage and residual tumor are the most important prognostic variables. Only with more extensive clinical researches, ovarian carcinoma management principles should be used in clinical practice of this tumor.
Seyed Hamid Madani; Etrat Javadi Rad; Ahmad Faramarzi
Volume 4, Issue 3 , June 2009, , Pages 137-140
Abstract
Kaposiform hemangioendothelioma (KHE) appears as a single lesion at birth or early infancy in an equal sex ratio. A rare aggressive vascular proliferation has been recognized as a separate entity from other childhood vascular neoplasm. A 3-year-old Iranian boy with a rapidly enlarging mass in ...
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Kaposiform hemangioendothelioma (KHE) appears as a single lesion at birth or early infancy in an equal sex ratio. A rare aggressive vascular proliferation has been recognized as a separate entity from other childhood vascular neoplasm. A 3-year-old Iranian boy with a rapidly enlarging mass in his (posterior aspect of skull at the midline) skull was present here. Physical examination revealed a dark-red, firm mass measuring 5 × 4.5 cm in the posterior aspect of skull. No association with Kasabach- Merritt syndrome (KMS) was observed despite its size. Histologically, KHE was composed of infiltrating nodules with slitlike or crescentic vessels that are poorly canalized and lined by spindled endothelium cells. Immunohistochemically, both spindle and epithelioid cells were immunoreactive for CD34 and CD31, while negative for EMA, cytokeratin or S100 protein. α- SMA were detected in pericytes surrounding spindle cells. Recurrence occurred 2 month after first operation. Wide resection was performed at second operation and the patient was still alive during the 1-year follow- up period.
N. Sharifi; M. Katebi
Volume 3, Issue 3 , June 2008, , Pages 146-150
Abstract
Background and Objective: Histological grading has prognostic and therapeutic implications in meningioma. However, histological criteria are sometimes not fulfilled to predict the biological behavior of meningiomas. P63 gene is a novel P53 family member, known as tumor suppressor factor, with ...
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Background and Objective: Histological grading has prognostic and therapeutic implications in meningioma. However, histological criteria are sometimes not fulfilled to predict the biological behavior of meningiomas. P63 gene is a novel P53 family member, known as tumor suppressor factor, with multiple isoforms and shows high expression in many normal and neoplastic human tissues. In this study, we investigated expression of P63 in different histological grades of meningiomas. Material and Methods: For this purpose, we studied and analyzed the immunohistochemical expression of P63 by a monoclonal antibody (clone 4A4) that recognizes all P63 isoforms in 52 cases of meningioma including WHO grade I (42 cases), grade II (7 cases) and grade III (3 cases). Correlation between histological grade and parameters like cell nuclear immunoreactivity to P63 antibody, age, gender and site of meningioma was analyzed by parametric and non-parametric statistical tests. Results: Among 52 patients analyzed, there were 35 females (67.3 %) and 17 males (32.7%) between 13 and 75 years old. Histological grading revealed 42 cases (80.8%) as WHO grade I, 7 (13.5%) as grade II and 3 (5.8%) cases were grade III. Expression of P63 protein was found in 83.2% of cases with grade I but in grade II and III, all of the cases were immunoreactive, so as in grade III, 100% of cases were with higher percent of nuclear reactivity in our study. Correlation between histological grade and nuclear immunoreactivity was highly significant (p=0.001). Conclusion: We conclude that the immunohistochemical staining of P63 will be valuable in discrimination of different grades of meningiomas.
Sakineh Amouian; Mahdi Farzadnia; Bahram Memar; Armin Attaranzadeh; Naser Tayyebi
Volume 3, Issue 1 , January 2008, , Pages 25-29
Abstract
Background and Objective: Evaluation of tumor proliferative activity may provide a predicting parameter to estimate biologic aggression and a subsequent prognosis that has been evaluated in many malignancies. We have selected renal cell carcinoma (RCC) in this study. To determine tumor proliferative ...
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Background and Objective: Evaluation of tumor proliferative activity may provide a predicting parameter to estimate biologic aggression and a subsequent prognosis that has been evaluated in many malignancies. We have selected renal cell carcinoma (RCC) in this study. To determine tumor proliferative activity, KI67 antibody was applied and results were compared with apoptosis, applying P53 antibody and using immunohistochemical staining. Patients and Methods: Specimens of 30 patients who underwent radical nephrectomy for RCC were selected for histopathology and immunohistochemical study. Two different grading systems (S&H, Fuhrman) were used to calibrate average nucleoli diameter and tumor grading on all specimens. After processing of paraffin-embedded samples, they were immunohistochemically stained applying (MIB-1) KI67 monoclonal and P53 antibodies. Then, statistical analysis was done. Results: Tumor grading correlated with the average nucleus diameter. Positive reaction to KI67 and P53 antibodies in tumors increased as compared to control group. No significant relationship between age, sex and tumor grade was obtained. Conclusion: These two antibodies are as easy and reliable markers that could be applied on formalin-fixed tissues for better assessment of the biologic behavior of RCC and probably prediction of patients’ outcome.
