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AIMS Little is known regarding the histopathological and molecular features of lung adenocarcinoma skin metastases. Our study is the largest, to our knowledge, to comprehensively explore these to date. METHODS AND RESULTS We performed a retrospective cohort study analysing 42 lung adenocarcinoma skin metastasis samples obtained from a database of 2659 lung adenocarcinomas collected between 2010 and 2020. EGFR exon 19 deletion was detected in one patient and KRAS mutations were detected in 12 (33.3%) patients. The programmed cell death ligand 1 (PD-L1) tumour proportion score was

Thyroid transcription factor 1 (TTF-1) is considered a highly sensitive and specific marker for primary lung adenocarcinoma. However, in recent years retrospective studies of tumor samples have confirmed that, although rare, TTF-1 can also be expressed in colorectal adenocarcinoma. There are a few case reports of patients with TTF-1-positive colon adenocarcinoma in the medical literature but none of TTF-1-positive rectal adenocarcinoma. Here, we present a case of rectal adenocarcinoma with lung metastasis found to be TTF-1 positive on immunohistochemistry. A review and discussion of the available literature is also included.

Lung cancer is the most common malignancy throughout the world. Non-small cell lung carcinoma is the most common type and squamous cell type is the most common in India. Patients mostly present with chest related symptoms and signs. Isolated skeletal muscle metastasis (ISMM) is rarely seen. We describe a patient who presented with ISMM and hypercalcemia without any pulmonary symptoms.

Introduction: Merkel cell carcinoma (MCC) of the skin is a rare, aggressive, malignant neuroendocrine neoplasm. The tumor classically demonstrates positive immunohistochemistry (IHC) staining for chromogranin A(ChrA), cytokeratin 20 (CK20), neuron specific enolase (NSE) and/or achaete-acute complex-like 1 (MASH1). The newly identified Merkel cell polyomavirus (MCPyV) has been found to be associated with most MCC cases. The primary histologic differential diagnoses of cutaneous MCC is small cell primary bronchogenic carcinoma (SCLC); moreover, both are of neuroendocrine origin. SCLC accounts for approximately 10-15% of all primary lung cancer cases; this histologic subtype is a distinct entity with biological and oncological features distinct from non-small cell lung cancer (NSCLC). In contradistinction to MCC, SCLC is classically IHC positive for cytokeratin 7 (CK7) and transcription factor (TTF-1). Similar to SCLC, MCC cell lines may be classified into two different biochemical subgroups designated as Classic and Variant. In our review and case report, we aim to emphasize the importance of a multidisciplinary approach to the approach to this difficult differential diagnosis. We also aim to comment about features of the cells of origin of MCC and SCLC; to summarize the microscopic features of both tumors; and to review their respective epidemiologic, clinical, prognostic and treatment features. We want to emphasize the initial workup study of the differential diagnosis patient, including evaluating clinical lymph nodes, a clinical history of any respiratory abnormality, and chest radiogram. If a diagnosis of primary cutaneous MCC is confirmed, classic treatment includes excision of the primary tumor with wide margins, excision of a sentinel lymph node, and computed tomography, positron emission tomography and/or Fluorine-18fluorodeoxyglucose positron emission tomography scan studies.

Introduction This study’s principal objective was to evaluate the critical role of the application of immunocytochemistry to a novel panel of diagnostic markers for the accurate detection of the source of malignancies in pleural effusions of lung adenocarcinoma. Materials and methods In 40 effusion smears from lung adenocarcinoma, the expression of the E-cadherin, a-catenin, Thyroid Transcription Factor (TTF-1), Epidermal Growth Factor Receptor (EGFR), p53, caspase 9 and 3, Bax and Bcl-2 was examined by immunocytochemistry. Results All cases showed positive immunoreactivity of tumour cells to caspase 3 (42,5%), caspase 9 (40%), Bcl-2 (30%), Bax (40%), p53 (55%), E-cadherin (82,5%), a-catenin (80%), TTF-1 (87,5%) and EGFR (62,5%). The Pearson’s x2 analysis demonstrated a highly significant correlation to each of the other marker when analysed separately. Caspase 3 expression was correlated significantly with caspase 9 (p Conclusions The use of a panel of biomarkers can be of great value in determining effusion immunoprofile in patients with lung adenocarcinoma for clinical application.

Homozygous null mice for thyroid transcription factor (TTF)-2 gene exhibit cleft palate and thyroid malformation. We performed a genetic analysis of the TTF-2 gene in 2 children with congenital hypothyroidism (CH) and cleft palate, 45 children with thyroid dysgenesis, 19 children with isolated cleft palate or cleft lip, 4 patients with thyroid hemiagenesis. The entire coding-region of the TTF-2 gene was analyzed by direct sequencing. Direct sequencing of the TTF-2 gene revealed polymorphisms in the length of the polyalanine tract. The most frequent stretch length was 14 residues and it was found in 50 of 70 (71%) and in 45 of 53 (85%) normal healthy controls. A polyalanine tract of 16 residues in the heterozygous state was seen in 18 of 70 (26%) cases and in 4 of 53 (7%) normal subjects. In 1 of 4 (25%) case of hemiagenesis a polyalanine tract of 16 residues in the homozygous state was observed. In 1 of 26 agenesis the polyalanine tract consisted of 12 residues in the heterozygous state. Direct sequencing also revealed the presence of two silent polymorphisms. No mutations were identified in the TTF-2 gene. In conclusion, our results show that no genetic alteration was present in the TTF-2 gene of these patients, suggesting that defects in the TTF-2 gene are a rare event.

Numerous new immunohistochemical markers that can be used in the diagnosis of mesothelioma have recently become available. As a result, new panels of antibodies that could be useful for distinguishing between epithelioid mesotheliomas and adenocarcinomas have been proposed. However, great differences of opinion exist regarding the individual value of some of these markers, especially when compared with those whose value has already been established. This article provides a critical review of the currently available information on those markers that could be useful in the diagnosis of epithelioid mesotheliomas or whose utility remains controversial. A practical approach to the diagnosis of these tumors is also provided.

Aims : Lung cancer is the most common malignancy throughout the world. Nonsmall cell lung cancer (NSCLC) is the most common type, and squamous cell type is most common in India. Mostly, patients present with chest-related symptoms and signs. Isolated skeletal muscle metastasis (ISMM) is rarely seen. The aim was to see muscle metastasis and its prognosis. Materials and Methods : We are presenting our data of 8 years about this common malignancy with relation to muscle metastasis, either alone or with other system metastasis. Results : Muscle metastasis is seen 1.5% of patients, with male: female of 8:1. Overall median survival was 15 months and progression-free survival was 12 months. Conclusion: One peculiarity seen was ISMM with no pulmonary system and severe paraneoplastic hypercalcemia. Local therapy may be having an impact on overall survival in metachronous muscle involvement.

El objetivo de esta investigación fue estandarizar y crear un protocolo para una técnica de inmunocitoquímica en líquidos pleural y peritoneal, procedimiento de gran utilidad como ayuda diagnóstica cuando no se sabe con certeza donde se encuentra el tumor primario. Incluye la obtención del líquido para determinar mediante el procedimiento tradicional si es positivo para malignidad, el método de procesamiento y el desarrollo de la técnica inmunocitoquímica. Abreviaturas: Ac, anticuerpos; Ag, antígenos; DAB, diaminobenzidina; CEA, antígeno carcinoembrionario; TTF-1, factor de transcripción tiroidea; CK7, queratina.

7530 Background: TTF-1 is expressed in about 72% of ACs. EGFR Mts are present in 10-15% of unselected pts with AC. High TTF1 expression and EGFR Mts are associated with female sex, never-smoking st...