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In clinical practice, exhaled air analysis is a promising approach for diagnosing lung cancer due to a possibility of rapid and noninvasive sampling. We analyzed the exhaled air of 80 patients with lung cancer to identify differences in the profiles of volatile organic compounds in patients with different histological types and localization of cancer using gas chromatography–mass spectrometry. Some volatile organic compounds and their ratios have been identified, statistically signficant differences in concentrations of which have been found in samples with different localization and histological type.

Sarcomas are rare tumours that represent less than 1% of all malignant tumours in adults. Liposarcomas are among the most common malignant mesenchymal tumours. They are preferentially located in the limbs and the retroperitoneum. Liposarcomas primarily arising in the digestive tract are exceptional with a few cases reported in the literature. Their clinical presentation is variable and the symptoms are not specific. Anatomopathological examination remains the gold standard for the diagnosis and the classification of these tumours, which are divided into 5 histological types according to the 5th edition of the WHO classification of soft tissue tumours. We report two observations of unusual digestive liposarcomas, located in the oesophagus and the colon, emphasizing the variability of the diagnostic challenges, depending on the clinical presentation, the histological type and the analysed material.

BACKGROUND Ovarian tumours are the common cause of morbidity and mortality in women worldwide. Primary epithelial ovarian tumours comprise the majority. Cluster differentiation 44 (CD-44) is a trans-membrane glycoprotein which plays a role in cell- cell interaction, adhesion and migration, leading to the progression and metastasis of tumour. E-cadherin is another cell adhesion molecule which plays an important role in neoplastic progression. So, it is necessary to find out the relationship of CD-44 and E-cadherin expression with histological types and tumour differentiation, which might predict the prognosis. The present study was undertaken to assess the pattern of expression of CD-44 and E-cadherin in primary epithelial tumours of ovary and to determine the relationship between their expression with age, histological type and tumour differentiation. METHODS This is a cross-sectional study conducted in the Department of Pathology, Government Medical College, Thrissur; a tertiary care institution. Histological types and tumour differentiation for each case was determined from haematoxylin and eosin sections. Immunohistochemical stain for CD-44 and E-cadherin was done. Pattern of expression was studied and a semi quantitative score was calculated. Expression of both markers was then compared with the age, histological type and tumour differentiation. RESULTS Out of 57 cases studied, majority of the patients had serous (21 cases) or mucinous tumours (20 cases). The mean age group was 54.5 years. CD-44 expression was significantly correlated with tumour differentiation but there was no correlation found with age and histological type. In E-cadherin expression, there was no correlation with age, histological type and tumour differentiation. CONCLUSIONS For primary epithelial tumours, expression of CD-44 could be an indicator for tumour progression, invasiveness or distant metastasis. Poorly differentiated tumours with increased expression may be helpful in predicting disease progression. Target therapy can be employed in such cases. In case of E-cadherin which is said to be a prognostic marker, more studies help in bridging the gap between prognosis and outcome. KEYWORDS CD-44, E-cadherin, Immunohistochemistry, Epithelial Ovarian Tumours f

Background & objective: The role Ki-67 as a prognostic marker has been studied in many cancers in many studies. However, only few studies reported the prognostic role of Ki-67 in colorectal carcinoma (CRC) with contradictory opinions. The present study was undertaken to assess the Ki-67 proliferation index (PI) in tissue sections of CRC and to investigate the relationship between the proliferative activity and histological type, grade and stage of the tumour. Methods: The present cross-sectional descriptive study was conducted in the Department of Pathology, Rajshahi Medical College, Rajshahi over a period of two years from September 2017 to August 2019. All clinically suspected cases of CRC and later confirmed by histopathology were the study population. A total 44 such cases were included in the study. Tissue sections from 44 formalin-fixed and paraffin-embedded tumor specimens were examined at the Department of Pathology of Rajshahi Medical College, Rajshahi. The cases were histologically classified, graded (WHO) and staged according to TNM and modified Dukes’ staging system. Ki-67 proliferation index was calculated immunohistochemically using the monoclonal antibody MIB-1, and were studied under light microscope. Expression of Ki-67 was calculated as a percentage of labeled nuclei per 500 cells counted in consecutive five high-power fields in the most reactive areas of the slides. The staining results were categorized into groups using a cut-off value of Ki-67 determined by ROC curve analysis. Results: In the present study the cases with high Ki-67 PI were significantly associated with high grade colorectal carcinoma (p = 0.005). TNM Stage-II and Stage-III tumours were more likely to be associated with high Ki-67 PI than those with low Ki-67 PI (p < 0.001). A significant association was observed between Ki-67 immuno-expression and modified Dukes’ staging of the tumours with Stage C being highly associated with high Ki-67 PI (p < 0.001). But histologic tumor type (mucinous and non-mucinous) was not found to be associated with Ki-67 proliferation index. Based on Receiver Operating Characteristic (ROC) curve analysis tumors with nuclear immunoreactivity ≥ 25% were considered as high proliferation index (PI) and < 25% as low PI. The Ki-67 at a cut-off value of >25% had high sensitivity (85.7%) in differentiating high grade CRC from the low-grade tumors but its specificity was moderate (67.6%) with overall diagnostic accuracy being 70.5%. Conclusion: The study concluded that cases with high Ki-67 PI are significantly associated with high grade CRC (poorly differentiated) than the cases with low grade CRC (well and moderately differentiated). TNM Stage-II & Stage-III and modified Dukes’ stage C also more often tend to be associated with high Ki-67 PI than with low Ki-67 PI. Ibrahim Card Med J 2020; 10 (1&2): 33-39

Introduction Ultrasound (US) plays a key role in the detection of testicular tumours. However, reliable characterisation of testicular tumours with US is difficult. The purpose of this study was to investigate the morphological patterns of testicular tumours as seen on modern US imaging and correlate these with histology. Methods The imaging features of 50 testicular tumours were analysed and compared with histology. The US appearance was categorized into 15 distinct morphological patterns. Results Patient’s age ranged from 0.5 to 85 years. Of the 50 tumours in our series, 49 were malignant. Nearly half of the malignancies were seminomatous germ cell tumours (SGCTs). Tumours ranged in size from 10 to 130 mm with considerable overlap of size between tumours of different histological type. Even small (10 mm) tumours in our cohort were malignant. SGCTs demonstrated a narrower range of morphological appearances than non‐seminomatous germ cell tumours (NSGCTs). Calcification was common in both SGCT and NSGCTs. Multicomponent cystic‐solid appearance was only seen in NSGCTs. Conclusion The differentiation of testicular tumours with US continues to be challenging. In this paper, we have demonstrated the diverse morphological patterns of testicular neoplasms and have proposed the study of tumour morphological features as a promising research direction., Ultrasound (US) plays a key role in the detection of testicular tumours. However, reliable characterisation of testicular tumours with US is difficult. In this paper, we have demonstrated the diverse morphological patterns of testicular neoplasms and have proposed the study of tumour morphological features as a promising novel research direction.

Double-positive vasculitis with anti-polynuclear cytoplasm (ANCA) and anti-glomerular basement membrane (GBM) antibodies is a rare entity of systemic vasculitis defined by the presence of ANCA and anti-GBM antibodies. The gradual accumulation of clinical and therapeutic data shows the usefulness of identifying and differentiating this entity from the two vasculitis respectively associated with the isolated presence of each of these two antibodies. Indeed, the double-positive ANCA and anti-GBM vasculitis appears to associate the characteristics of the demography and the extra-renal and pulmonary involvement of the ANCA-associated vasculitis on the one hand, and of the histological type and severe renal prognosis of the anti-MBG vasculitis on the other hand, with the renal involvement which is the only involvement consistently observed in double-positive vasculitis. The aim of this focus is to describe the epidemiological, clinico-biological, histological and prognostic characteristics of this entity, in light of recent literature and ongoing therapeutic changes in the two eponymous vasculitis.

Simple Summary Invasive lobular breast cancer (ILC) is a special type of breast cancer (BC) that was first described in 1941. The diagnosis of ILC is made by microscopy of tumor specimens, which reveals a distinct morphology. This review recapitulates the developments in the microscopic assessment of ILC from 1941 until today. We discuss different concepts of ILC, provide an overview on ILC variants, and highlight advances which have contributed to a better understanding of ILC as a special histologic spectrum of tumors. Abstract Invasive lobular breast cancer (ILC) is the most common special histological type of breast cancer (BC). This review recapitulates developments in the histomorphologic assessment of ILC from its beginnings with the seminal work of Foote and Stewart, which was published in 1941, until today. We discuss different concepts of ILC and their implications. These concepts include (i) BC arising from mammary lobules, (ii) BC growing in dissociated cells and single files, and (iii) BC defined as a morpho-molecular spectrum of tumors with distinct histological and molecular characteristics related to impaired cell adhesion. This review also provides a comprehensive overview of ILC variants, their histomorphology, and differential diagnosis. Furthermore, this review highlights recent advances which have contributed to a better understanding of the histomorphology of ILC, such as the role of the basal lamina component laminin, the molecular specificities of triple-negative ILC, and E-cadherin to P-cadherin expression switching as the molecular determinant of tubular elements in CDH1-deficient ILC. Last but not least, we provide a detailed account of the tumor microenvironment in ILC, including tumor infiltrating lymphocyte (TIL) levels, which are comparatively low in ILC compared to other BCs, but correlate with clinical outcome. The distinct histomorphology of ILC clearly reflects a special tumor biology. In the clinic, special treatment strategies have been established for triple-negative, HER2-positive, and ER-positive BC. Treatment specialization for patients diagnosed with ILC is just in its beginnings. Accordingly, ILC deserves greater attention as a special tumor entity in BC diagnostics, patient care, and cancer research.

Primary adrenal lymphoma (PAL) is a rare subtype of all non-Hodgkin lymphomas in several literature reviews [1,2]. In those reports, the most common histological type of PAL was diffuse large B-cel...

We assessed the utility of the tumor doubling time (TDT) for predicting the histological type of thymic epithelial tumors. We retrospectively reviewed 130 patients with thymic epithelial tumors who underwent computed tomography two or more times before surgery. The patients were divided into low-risk thymoma (types A, AB and B1), high-risk thymoma (types B2 and B3) and thymic carcinoma (thymic carcinoma and thymic neuroendocrine tumor) groups. In the 96 patients who showed tumor enlargement, the relationship between the histological type and the TDT of the tumor was investigated. The study population included 55 men and 41 women from 26 to 82 years of age. The TDT of the thymic carcinoma group (median 205 days) was significantly shorter in comparison to the low-risk thymoma (median 607 days) and high-risk thymoma (median 459 days) groups. No significant differences were observed between the low-risk thymoma and high-risk thymoma groups. When we set the cutoff time for differentiating thymic carcinoma group from thymoma at 313 days, the sensitivity and specificity were 83.8% and 82.1%, respectively. The TDT is a useful parameter for differentiating between thymoma and thymic carcinoma group.

We report the rare case of an adenoma of the nonpigmented ciliary epithelium (NPCE). A 67-year-old healthy man presented with a regularly shaped and nonpigmented mass at the iris root of his right eye. His best-corrected visual acuity was 1.5 with normal intraocular pressure. During observation, the size of the tumor remained stable for 1.5 years but then rapidly grew, extending through the iris, and gradually enlarged to the point of compressing the iris. Ultimately, an iridocyclectomy with scleral resection under a lamellar scleral flap was performed. The histopathologic features of the resected tissue were consistent with adenoma of the NPCE. Histopathological analysis showed that the tumor consisted of both tubular and solid components. There were solid lesions inside of the ciliary epithelium and tubular lesions outside. We observed positive immunoreactivity to vimentin and cytokeratin CK (AE1/AE3) and negative reactivity to S-100 and CD68, both rarely associated with adenoma of NPCE. During 1 year of follow-up after the iridocyclectomy, no signs of tumor recurrence were observed.

Background: Spindle cell carcinoma (SpCC) of the breast is a rare histological type, a subtype of metaplastic carcinoma characterized by atypical spindle cell and epithelial carcinoma. The proportions of the spindle cell and epithelial components vary among tumours. Due to its rarity, biological characteristics of this disease have been poorly studied. Methods: In total, 10 patients with SpCC were surgically treated at our institution from January 2007 to December 2018. We retrospectively investigated these SpCC cases, focusing on the differences between spindle cell and epithelial components. Microsatellite status was also examined. Results: Nine cases were triple-negative breast cancer (TNBC). The rates of high tumour grade were 70% in spindle cell components and 56% in epithelial components ( P = .65), while the mean Ki67 labelling index were 63% and 58%, respectively ( P = .71). Mean programmed death ligand 1 (PD-L1) expression in these components was 11% and 1%, respectively ( P = .20). All 10 tumours were microsatellite stable. Patient outcomes of triple-negative SpCC did not differ from those of propensity-matched patients with conventional TNBC. Conclusions: Spindle cell components showed higher values in factors examined, although there was no statistically significant difference. Our data reveal that these 2 components of SpCC may be of different biological nature.

Pure mucinous breast carcinoma (PMBC) is characterized by clusters of tumor cells floating in abundant extracellular mucin and can be classified into paucicellular (Type A) and hypercellular (Type B) subtypes. However, the clinicopathological and genomic differences between these two subtypes have not been well characterized. We retrospectively investigated the clinicopathologic features of 45 cases of surgically removed PMBC (31 Type A and 14 Type B). We also performed whole-exome sequencing (WES) in eight cases of PMBC. We found that Type B PMBC occurs at an older age and shows more aggressive clinical behavior than Type A. WES analysis revealed that HYDIN was the most frequently mutated gene in both types of PMBC. Although Type B PMBC showed a tendency toward more frequent genetic alterations, there were no statistically significant differences between the two subtypes in single nucleotide variants or insertions or deletions of bases associated with moderate or high effects. Our results provide additional evidence that PMBCs are clinicopathologically and genetically heterogeneous and lack pathognomonic genetic alterations. Further, Type B PMBC is more frequently associated with lymph node metastasis than Type A.

Introduction: Thyroid cancer is one of the most common cancers amongst all endocrine cancers. Incidence of thyroid malignancy is about 3-4% of all malignancy in India and 80% of thyroid malignancy belongs to Papillary Thyroid Carcinoma (PTC). Factors affecting the prognosis of PTC include patient’s gender, age, histological findings, tumour size, lymph node metastasis, extrathyroidal extension, and remote metastasis. Presence of B-type RAF V600E (BRAF V600E) mutation in thyroid carcinoma patients tends to present with more aggressive clinicopathological behaviours of PTC, prompting more aggressive radioiodine treatment. Aim: To find out the frequency of occurrence and expression of BRAF V600E mutation by Immunohistochemistry (IHC) in thyroid cancer and its association with histological type and Tumour Nodes Metastases (TNM) Staging. Materials and Methods: The present observational retrospective study included patients treated for thyroid carcinoma between January 2014 to February 2019 at RL Jalappa hospital and Research centre, Kolar, Karnataka, India. The IHC was done with rabbit monoclonal anti-BRAF V600E antibody IgG Clone RM8 (VE1). Clinical records, Fine Needle Aspiration Cytology (FNAC) diagnosis were analysed for 45 thyroid carcinoma cases. Immunopositivity was scored positive when unambiguous clear cytoplasmic staining for the antibody was observed in tumour cells. Categorical data was presented in the form of frequencies and proportions and continuous data was presented as mean and standard deviation. The t-test were applied to find out the difference in means among the groups. The p-value

Gastric cancers (GCs) are still one of the leading causes of cancer-related mortality. The histological and molecular features of GC may differ widely from area to area within the same tumor. Intratumoral heterogeneity has been considered a major obstacle to an efficient diagnosis and successful molecular treatment. We selected and reevaluated 842 GC cases and analyzed the relationship between numbers or composites of histological patterns within tumors, and clinicopathological parameters in mucosal and invasive areas. In addition, we searched for the GC-associated molecules or molecular subtypes marking histological diversities. GC cases with more histological numbers or mixed types in invasive areas showed significantly higher T grade and staging, whereas those in mucosal areas did not show any significant associations. GCs with histological diversities showed poorer prognosis and characteristically expressed cancer stem cell-related molecules (CD44, CD133 or ALDH1) and receptor tyrosine kinase molecules (HER2, EGFR or c-MET) as well as Helicobacter pylori infection. Expressions of CD44, HER2, c-MET, laminin 5·2 or retained E-cadherin in mucosal areas were predictive of more histological numbers and mixed types in invasive areas. In addition, the chromosomal instability subtype of GC showed significant associations with more histological numbers and mixed histological type, whereas the genomic stability subtype of GC showed a significant relationship with pure type. We displayed the relationship between histological diversity and molecular features in GC, and we hope that the present data can contribute to the early diagnosis and prevention, and effective treatment of GC.

Diffuse large B cell lymphoma (DLBCL) that arises de novo within the spleen is referred to as a primary splenic DLBCL (PS-DLBCL). The PS-DLBCL is a common histological type of splenic lymphomas tho...

Summary The World Health Organization’s new classification of breast tumors has just been published. This review aims to examine the morphological categorization of breast carcinomas which is still principally based on histological features and follows the traditions of histological typing. It gives a subjective and critical view on the WHO classifications and their changes over time, and describes the changes related to some of the most common or challenging breast carcinomas: in situ carcinomas, invasive breast carcinomas of no special type, lobular, cribriform, tubular, mucinous, papillary, metaplastic carcinomas and carcinomas with medullary pattern and those with apocrine differentiation are discussed in more details. Although the 5th edition of the classification is not perfect, it has advantages which are mentioned along with problematic issues of classifications.

Esophageal squamous cell carcinoma, poorly differentiated, 0-Is, T1b-SM2(4,000μm), INFa, ly(+), v(+), HM0, VM0, pR0, 14 × 11 mm, Mt, Lt.

International audience; BackgroundThe objective of the study was to compare the prevalence of occupational exposure to asbestos and crystalline silica according to histological types of lung cancer and age at diagnosis.MethodsCaProMat study is a pooled case‐only study conducted between 1996 and 2011. The current study consisted of 6521 lung cancer cases. Occupational exposure to asbestos and crystalline silica was assessed by two Job‐Exposure Matrices. A weighted prevalence of exposure was derived and compared according to histological types and age at diagnosis.ResultsThere was no difference of weighted prevalence of exposure to asbestos and crystalline silica according to histological types of lung cancer. There was a statistically significant difference of weighted prevalence of exposure to asbestos and crystalline silica according to age at diagnosis.ConclusionsDue to the limited clinical importance of the difference, neither the histological type, nor the age at diagnosis can be used as an indicator for the occupational exposure to asbestos or crystalline silica.

Background/aims The identification of prognostic factors of metastatic development is one of the most important issues in colorectal cancer (CRC) research. The aim of this study was to determine the usefulness of colon tumor characteristics, including location, circumferential location, histological type, and histological grade, as predictors of metastases. Materials and methods To identify potential predictors of CRC spread, we analyzed data of 191 patients who had undergone surgery for colon tumors. We searched for potential associations between the location in the right or left colon, circumferential location, histological type, and histological grade (G-parameter) of colon tumors and the incidence of lymph node and distal metastases. The analysis was based on Pearson's chi-square (χ2) test with a statistical significance of p Results Lymph node metastases were found in 100 patients, including 44 patients with synchronous liver metastases. Lymph node involvement was detected in 43 (52.4%) patients with right-sided and in 57 (52.3%) patients with left-sided tumors (p=0.984). Liver metastases were detected in 19 (23.17%) patients with right-sided colon tumors and in 25 (22.9%) patients with left-sided tumors (p=0.969). Lymph node and liver metastases were found in 60 (47.6%) and 24 (19.0%) patients with annular tumors, respectively (p=NS), and these were found on the mesenteric side in 75.0% (n=30) and 20.0% (n=8) patients (p=0.004) and on the antimesenteric side in 47.6% (n=10) and 48.0% (n=12) patients (p=0.044), respectively. Conclusion The circumferential location of primary colon tumors is a significant predictor of their metastatic potential. The mesenteric location of the tumor is predisposed to lymphatic spread, whereas the antimesenteric location predicts hematogenous spread.

Basal cell carcinoma is the most common skin cancer in the world. The aim of this study was to evaluate the surgical margin of basal cell carcinoma and correlate this with its histologic subtype. A retrospective analysis of pathology laboratory records from 1990 to 2000 was performed and the following data was collected: age, sex, race, anatomical location, histological type, and state of the excision margins in 1,428 histopathological reports of basal cell carcinoma. Ages ranged from 6 to 99 years, with an average of 57. There was a slight predominance of lesions in white women patients, and the most common histological subtype was the nodular, followed by the superficial. The most common locations were in the head and neck, with highest prevalence appeared in the nose. Surgical margins revealed a lateral involvement of 20.14% and a deep involvement of 12.47%. The fibrosing basal cell carcinoma is the histological type that most often presented positive surgical margins.

The purpose of this study was to delineate the various factors that affect the growth characteristics of human cancer xenografts in nude mice and to reveal the relationship between the growth characteristics and radiosensitivity. We retrospectively analyzed 390 xenografts comprising nine different human cancer lines grown in nude mice used in our institute between 2009 and 2015. Tumor growth rate (TCR) was calculated using exponential growth equations. The relationship between the TCR of xenografts and the proliferation of the cells in vitro was examined. Additionally, we examined the correlations between the surviving fractions of cells after 2 Cy irradiation in vitro and the response of the xenograft to radiation. The TCR of xenografts was positively related to the proliferation of the cells in vitro (rp=0.9714, p < 0.0001), whereas it was independent of the histological type of the xenografts. Radiation-induced suppression of the growth rate (T/C%) of xenografts was positively related to the radiosensitivity of the cells in vitro (SF2; rp=0.8684, p=0.0284) and TCR (rp=0.7623, p=0.0780). The proliferation of human cancer cells in vitro and the growth rate of xenografts were positively related. The radiosensitivity of cancer cells, as judged from the SF2 values in vitro, and the radiation-induced suppression of xenograft growth were positively related. In conclusion, the growth rate of human xenografts was independent of histological type and origin of the cancer cells, and was positively related to the proliferation of the cancer cells in vitro.

In classic Hodgkin lymphoma (cHL), Epstein Barr virus (EBV) association varies worldwide. Aims: Our aim was to analyze EBV association with pediatric cHL for the last 28 years. Methods: EBV presence was evaluated by EBERs in situ hybridization and LMP1 immunohistochemistry. Results: Until 2008, we found in pediatric cHL a similar percentage of EBV presence to those observed in adult cHL from developed populations. Nevertheless, in the last 8 years, an unexpected difference in cHL EBV association was proven, along with a slight bias of EBV association with the nodular sclerosis (NS) subtype. Concerning histological subtype distribution, even though MC still prevailed in the whole series, those cases diagnosed as NS showed a sustained rise from 1989 until today. Conclusion: Variations of EBV association of cHL related to geography, age, ethnicity, and histological type have been largely described when compared with different world regions, but interestingly, this single-center revised series brought to light the dynamic process behind the evolution of this relationship over time. Fil: de Matteo, Elena Noemí. Gobierno de la Ciudad de Buenos Aires. Instituto Multidisciplinario de Investigaciones en Patologías Pediátricas. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto Multidisciplinario de Investigaciones en Patologías Pediátricas; Argentina Fil: García Lombardi, Mercedes. Gobierno de la Ciudad de Buenos Aires. Hospital General de Niños "Ricardo Gutiérrez"; Argentina Fil: Preciado, María Victoria. Gobierno de la Ciudad de Buenos Aires. Instituto Multidisciplinario de Investigaciones en Patologías Pediátricas. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto Multidisciplinario de Investigaciones en Patologías Pediátricas; Argentina Fil: Chabay, Paola Andrea. Gobierno de la Ciudad de Buenos Aires. Instituto Multidisciplinario de Investigaciones en Patologías Pediátricas. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto Multidisciplinario de Investigaciones en Patologías Pediátricas; Argentina

Summary Histological examination of canine mammary tumours is mandatory for determining the histological type and grade of the lesions, features that provide relevant information regarding the biological behaviour of the disease. Different histological classification systems and grading methods have been used to characterize canine mammary tumours. In this study, the relationship between the genetic profile of 87 female dogs (i.e. single nucleotide polymorphisms [SNPs] in genes known to be involved in mammary carcinogenesis) and the histological type and grade of malignant mammary tumours was assessed. The results demonstrated a significant relationship between genetic variation in genes RAD51, BRCA2, CHEK2, HER2, CDH1, COMT and PGR and these morphological features of the mammary lesions. Specifically, SNPs in RAD51 (rs23623251 and rs23642734), CHEK2 (rs397511718), HER2 (rs24537329) and PGR (rs8875007) were related to aggressive histotypes, with moderate to high histological grade. In contrast, SNPs in BRCA2 (rs23255542), HER2 (rs24537331), CDH1 (rs852280880 and rs850805755) and COMT (rs851328636, rs853133060 and rs85346495) were associated with tumour histotypes of good prognosis and of low histological grade. These data provide preliminary evidence for a genotypic–phenotypic correlation in canine mammary tumours, highlighting the mechanisms of their genesis, development and progression.

Non-Hodgkin lymphomas (NHL) are typical tumors for the pediatric pathologist to be familiar with as they represent around 7–10% of pediatric malignancies, the fourth most common one in children, being more frequent between 15 and 19 years of age (Minard-Colin et al. J Clin Oncol 33(27):2963–2974, 2015; Bollard et al. Pediatr Blood Cancer 60(6):979–984, 2013; Sandlund and Martin Hematology Am Soc Hematol Educ Program. 2016:589–597, 2016). These lymphomas could arise in any tissue, nodal or extranodal, and the pathologist should be prepared to diagnose its histological type according to the updated revised 2016 WHO Classification of Tumors of Hematopoietic and Lymphoid Tissues (Swerdlow et al. WHO classification of tumours of haematopoietic and lymphoid tissues, revised 4th edition. IARC, Lyon, 2017).

Among lung cancers, a substantial shift over time has occurred in the recorded frequency of adenocarcinoma (AdC) relative to that of squamous cell carcinoma (SqCC). This is evident in many countries, and also in those who have never smoked. We attempted to address the extent to which this increase is real, or an artefact of changing diagnostic practices. We reviewed studies re-evaluating diagnoses using more up-to-date criteria, and studies applying standard criteria to cases collected over a long period. We also describe changes to classifications, and factors affecting diagnostic accuracy and consistency. While the four main types have long remained essentially unchanged, successive WHO classifications differ in how tumours are ascribed to these types. Despite refinement of classifications and technological advances, the decision is ultimately the pathologist's. In 11 studies, 189/1212(15.6%) originally diagnosed AdCs were reclassified as non-AdC on review, whereas 541/1564(34.6%) of non-AdCs were reclassified as AdC, increasing AdCs by 30%. Studies examining trends in the proportion of AdC were conflicting; three showing a declining trend, seven no trend, and six some increase. Some studies find lepidic (bronchioloalveolar) carcinoma, but not other AdC sub-types, increased. The rising AdC/SqCC ratio results at least partly from diagnostic changes.

Background: Inverted follicular keratosis (IFK) is a rare benign skin neoplasm that could be diffcult to diagnose. Pathomorphological verifcation is recognized as the main diagnostic method. Aim: To analyze retrospectively clinical data from 50 IFK cases and to identify morphological tumor characteristics depending on its histological type. Materials and methods: Based on data extracted from medical documentation and reports on skin biopsies from 50 IFK patients, we analyzed retrospectively some clinical data and pathohistological characteristics of IFK. We investigated pathohistological particulars of the tumor, identifed its histological types and the main morphological signs of the neoplasm. We assessed the following histological criteria of IFK: presence and degree of inverted structures, hyperkeratosis, parakeratosis, lymphoid infltrates in the derma. Results: The majority of IFK patients were women (68%) of older age (61.5± 1.6 years). In 40% of cases the tumor was located on the head, mostly on the face (32%); less frequently on the skin of the back (12%) and shanks (12%). At histological assessment, most cases (88%) of IFK were of one type. The most frequent were papillomatous (32%), keratoacanthomatous (26%) and solid (20%) histological types. Inverted structures were found in all histological preparations (100% of cases). Epidermal abnormalities were mostly seen as hyperkeratosis (94% of cases), parakeratosis (84%), acanthosis (78%) and dermal lymphoid infltration (74%). Advanced dermal vascularization was seen only in keratoacanthomous and cystic-keratoacantomous histological types (76.9 and 100% of cases) and was characterized by reactive proliferation of dermal capillaries. Conclusion: Pathomorphological verifcation of IFK is based on identifcation of inverted structures in bioptates. The variety of histological manifestations of the tumor is to be explained by various types of cell diferentiation.

A proposal is put forward to use Bayesian networks to identify risk factors for pulmonary consolidation. An experiment was conducted with 410 fattening lambs from five feedlots in Extremadura (southwestern Spain). Environmental conditions (temperature, relative humidity, and ammonia concentration) were recorded during the study period. In a microbiological study, Mycoplasma spp. and Pasteurellaceae were obtained by conventional culture and identified by nested polymerase chain reaction. After slaughter, lungs were collected and examined macro- and microscopically (histological type and pulmonary consolidation). To the best of the authors’ knowledge, Bayesian networks have not before been used to relate the presence/absence of pulmonary consolidation to environmental conditions, Mycoplasma spp., Pasteurella spp., and histological changes. The results showed that the main factors causing ovine inflammatory respiratory processes and pulmonary consolidation were temperature, relative humidity, and Mycoplasma spp. Control of these factors may help reduce the incidence of pulmonary consolidation.

Two recent studies show the importance of tumour budding and nest size in grading of lung squamous cell carcinoma http://ow.ly/WTaQ2

The increasing proportion of lung cancers classified as adenocarcinoma has been a topic of interest and research. The main objective of the analyses reported here is to summarize how the proportion of adenocarcinoma varies in never smokers by time, sex and region based on published evidence on the distribution of lung cancer types available from epidemiological studies. Based on 219 sex- and period-specific blocks of data drawn from 157 publications, there appears to be a clear time-related increase in the proportion of lung cancers in never smokers that are adenocarcinoma, which is evident in both sexes, and not specific to any region. It is seen whether the denominator of the proportion is made up of adenocarcinoma plus squamous cell carcinoma cases, cases of the four major types combined, or all lung cancer cases. The ratio of adenocarcinoma to squamous cell carcinoma rose continuously from 1950 to 69 to be almost 4 times higher for the data from 2000 onwards. We discuss factors that may have contributed to the observed findings, including changes in lung cancer classification. Our findings argue against the hypothesis that increases in the ratio arise from changes in cigarette design and composition.

MC tended toward worse tumor biological behavior and long-term survival outcome compared to WMDC. Moreover, MC also showed worse clinicopathological features and survival outcome in some selected patients. For these reasons, MC should be deemed as a special histological type of gastric cancer with worse clinicopathological features and survival outcome.

The simultaneous occurrence of primary brain tumors of different histological type in same patient is very rare. Most of these tumors arise after cranial radiotherapy or in association with familial tumor syndromes and very few simultaneously occurring cases have been reported previously. We describe an additional case with simultaneous meningioma and glioblastoma multiforme at different intracranial location, without past cranial radiotherapy or phacomatosis in a 59-year-old female patient. Clinical manifestations, characteristic imaging findings, and possible mechanisms, as well as the treatment results are discussed and compared with previously reported cases.

En el estudio realizado a las 95 mujeres operadas de cáncer de mama en nuestro Departamento vemos como, crece el tamaño del tumor, hay un mayor número de adenopatías afectadas: 37.7% en estadios T3 y T4; 16.1% en estadio T y 2.97% en estadio T1,aún cuando la extracción quirúrgica del número global que adenopatías fue similar en los diversos estadios. El número de adenopatías extraídas era mayor cuando más indiferenciado era el tumor. La media de adenopatías extirpadas ha sido superior a 15. El tipo histológico más frecuente corresponde al carcinoma ductal infiltrante tipo NOS. Respecto a la localización de tumor, son los tumores de origen central los que proporcionan mayor número de adenopatías. El mayor número de cánceres fue encontrado en cuadrantes externos, los que además tuvieron mayor número de adenopatías axilares.

The aim of our study was to establish the relative frequency of biopsy proven tumors of central nervous system (CNS). Two hundred and forty two (242) CNS Biopsy specimens were studied in a one year period. Out of 72 CNS tumors, 66 were primary 4 were metastatic. Among 4 metastatic tumors, the most common histological type is adenocarcinoma. The most frequent type of CNS

Lung cancer is a malignant lung tumor with various histological variants that arise from different cell types, such as bronchial epithelium, bronchioles, alveoli, or bronchial mucous glands. The clinical course and treatment efficacy of lung cancer depends on the histological variant of the tumor. Therefore, accurate identification of the histological type of cancer and respective protein biomarkers is crucial for adequate therapy. Due to the great diversity in the molecular-biological features of lung cancer histological types, detection is impossible without knowledge of the nature and origin of malignant cells, which release certain protein biomarkers into the bloodstream. To date, different panels of biomarkers are used for screening. Unfortunately, a uniform serum biomarker composition capable of distinguishing lung cancer types is yet to be discovered. As such, histological analyses of tumor biopsies and immunohistochemistry are the most frequently used methods for establishing correct diagnoses. Here, we discuss the recent advances in conventional and prospective aptamer based strategies for biomarker discovery. Aptamers like artificial antibodies can serve as molecular recognition elements for isolation detection and search of novel tumor-associated markers. Here we will describe how these small synthetic single stranded oligonucleotides can be used for lung cancer biomarker discovery and utilized for accurate diagnosis and targeted therapy. Furthermore, we describe the most frequently used in-clinic and novel lung cancer biomarkers, which suggest to have the ability of differentiating between histological types of lung cancer and defining metastasis rate.

To evaluate the relationship between our proposed sonographic classification of testicular tumors by tissue harmonic imaging and histological type. We retrospectively analyzed 58 testicular tumors and tumor-like lesions [seminomatous germ cell tumor (SGCT): 28; non-seminomatous germ cell tumor (NSGCT): 16; lymphoid and hematopoietic tumor (LHT): 7; Leydig cell tumor: 1; epidermal cyst: 2; and tumor of paratesticular structure (TPS): 4]. We divided a sonographic image into six types for morphological criteria and three types for color Doppler criteria. We examined the relationship between the sonographic classification and histological type. For morphological criteria, there were 21 cases of Type I (36%), 15 Type II (26%), 9 Type III (15%), five Type IV (9%), five Type V (9%), and three Type VI (5%). For color Doppler criteria, there were 47 cases classified as hypervascular (81%), eight as hypovascular (14%), and three as avascular (5%). Most of the SGCTs were divided into types I and II; the NSGCTs into types III, IV, and V; the LHTs into only type II; and the TPSs into type VI. We established a sonographic classification of testicular tumors with various histological types. This sonographic classification is potentially useful for estimating the histological type of testicular tumors.

The malignant transformation of endometriosis is a very uncommon event but can occur in 0.7% to 1% of all cases. Any histological type of tumor found in the endometrium might also occur in endometriosis. Most malignant tumors that originate from endometriosis are endometrioid adenocarcinomas and also clear-cell type carcinomas. On the other hand, sarcomas, especially endometrial stromal sarcoma (ESS), are extremely unusual representing 12% of all cases. ESS is an uncommon neoplasm and accounts for 0.2% of the uterine malignances. Malignant tumors arising from endometriosis can derive from the uterine wall as well as from extra-uterine sites. The most frequent extrauterine location is the ovary (78.7%), followed by the pelvic peritoneum (5.7%), the rectovaginal septum (4.3%), the colon (4.3%) and the vagina (2%), representing the majority of extragonadal sites. ESSs arising from the extrauterine and extraovarian endometriosis sites in the absence of a primary uterine lesion are extremely rare and the treatment options are not clear. Surgical debulking seems to be the best treatment. Adjuvant therapy, such as radiation, hormonal therapy and chemotherapy are not yet proven to be effective. Molecular target therapy could be a future possibility of treatment. A systematic review of English Medical Literature about incidence, treatment and prognosis of extrauterine ESS arising from endometriosis foci was performed. The selected articles on which this review is based are the following: 9 literature reviews, 8 retrospective studies, 7 case series, 1 prospective trial and 11 case reports.

Most cardiac tumors are clinically silent and are diagnosed only postmortem. If present, symptoms that are nonspecific can be distinguished with difficulty from other causes of cardiovascular disease and are known to be “great mimickers” [1]. One of the most important problems concerning to the diagnosis of cardiac tumors is the lack of specific signs and symptoms. The clinical manifestations of cardiac metastases mainly depend on the size and anatomical location of the tumor, rather than on its histological type. The symptoms of cardiac metastases can be grouped into the following major categories [2–7]

Background S-1 is a novel antimetabolic agent that inhibits thymidylate synthase. The expression of thymidylate synthase is higher in squamous (Sq) non-small cell lung cancer (NSCLC) than in non-Sq NSCLC. The aim of this retrospective study was to assess the efficacy of S-1 monotherapy for advanced NSCLC according to the histological subtype. Methods We reviewed the clinical records of patients with advanced NSCLC treated with S-1 monotherapy as second- or third-line therapy between May 2005 and July 2012 at the Shizuoka Cancer Center. Results A total of 71 patients were included in this retrospective study. Patient characteristics were similar in the Sq NSCLC (n = 15) and non-Sq NSCLC (n = 56) groups, except with regard to gender and smoking status. The overall response rates were 0% (95% confidence interval [CI] 0–17%) for Sq NSCLC and 11% (95% CI 3–19%) for non-Sq NSCLC (P = 0.33). For Sq NSCLC and non-Sq NSCLC, the median progression-free survival times were 2.1 and 2.8 months (P = 0.02), respectively, and the median overall survival times were 6.1 and 10.1 months (P = 0.01), respectively. Conclusion S-1 monotherapy may be more effective in patients with non-Sq NSCLC than in those with Sq NSCLC.

Testicular cancer accounts for 1% of all male cancers yet is the most common cancer affecting men aged 15–44 years. Most testicular cancers are seminomas or non-seminomatous germ cell tumors. Rarely, multiple testicular cancers may occur simultaneously, most often of the same histological type. However, synchronous tumors of different histological types may occur, although rarely. In this case study, we present the sonographic features with histopathologic correlation in a case of unilateral synchronous testicular tumors of discordant histology.

In the United States, renal cell carcinoma (RCC) has rapidly increased in incidence for over two decades. The most common histologic subtypes of RCC, clear cell, papillary, and chromophobe have distinct genetic and clinical characteristics; however, epidemiologic features of these subtypes have not been well characterized, particularly regarding any associations between race, disease subtypes, and recent incidence trends. Using data from the Surveillance, Epidemiology, and End Results (SEER) Program, we examined differences in the age-adjusted incidence rates and trends of RCC subtypes, including analysis focusing on racial differences. Incidence rates increased over time (2001–2009) for all three subtypes. However, the proportion of white cases with clear cell histology was higher than among blacks (50% vs. 31%, respectively), whereas black cases were more likely than white cases to have papillary RCC (23% vs. 9%, respectively). Moreover, papillary RCC incidence increased more rapidly for blacks than whites (P

Signet ring cell carcinoma (SRC) of the stomach is a histological type based on microscopic characteristics. Although the distinctive clinicopathological features of SRC have been reported, results are inconsistent and survival outcomes are uncertain.We retrospectively studied 769 patients with gastric carcinoma who underwent gastrectomy in our institute from 1999 to 2009. Among them, 326 patients (42.4 %) had early gastric cancer (EGC) and 443 patients (57.6 %) had advanced gastric cancer (AGC). Sex, age, tumor location, macroscopic type, tumor size, microscopic invasion, and survival rate were compared between patients with SRC, differentiated-, and undifferentiated-type gastric carcinomas.Fifty-one patients (15.6 %) had SRC in EGC; there were significant differences in sex, age, location, macroscopic type, and size between SRC and the differentiated histological type. However, there was no difference between SRC and undifferentiated-type gastric carcinoma, except for the macroscopic type. Fifty-seven patients (12.9 %) had SRC in AGC. Sex, age, location, size, macroscopic type, perineural invasion, N stage, and hepatic metastasis were significantly different between SRC and the differentiated histological type. Undifferentiated-type gastric carcinoma differed in sex, macroscopic type, and hepatic metastasis. The overall survival rate differed between SRC and other cell types (P0.001). Among all the study patients, age [hazard ratio (HR) 1.013, P = 0.041] and tumor, node, and metastasis (TNM) stage (HR 2.350, P0.001) were important factors for predicting survival. Omitting patients with palliative resection or metastases, TNM stage was still an important factor for survival (HR 2.077, P0.001).Patients with SRC showed similar clinicopathological features with undifferentiated histology. The survival of patients with SRC reflected a better prognosis in patients with undifferentiated gastric carcinoma. However, when narrowing the patients to those with EGC only, survival in EGC patients exhibited no difference between histological types. Among AGC patients, SRC patients had a worse prognosis than other cell types.

Objective To investigate the immunohistochemical expression of p63 in bladder cancer and the variation of expression in relation to histological type, grade and stage of the tumour, and whether bilharziasis (endemic in Egypt) has an effect on its expression, in an attempt to better understand the tumour behaviour and the possibility of using p63 as a prognostic marker. Patients and methods In a prospective study, biopsies were taken from the bladders of 70 patients, who were divided into three groups; group A comprised 10 with a normal urothelium, group B comprised 20 with chronic cystitis (bilharzial and non-bilharzial) and group C contained 40 with bladder cancer. The biopsies were examined for the expression of p63, using immunohistochemical techniques. Results The mean (SD) ages of groups A, B and C were 45.2 (9.5), 50.5 (11.7) and 60.5 (9.9) years, respectively. There was a statistically significant decrease in the expression and immunoreactivity in group C (P

Background/Aim: The aim of this study was to examine the relationship between narrow-band imaging (NBI) magnifying observation using the surface pattern as the main evaluation criterion and pit pattern diagnosis on the basis of magnifying observation using a dye in relation to the characteristics of colorectal tumors according to their morphologies. Methods: In this study, NBI observation and pit pattern diagnosis using a dye with magnifying observation were simultaneously performed in our hospital, and the consecutive 786 cases of colorectal lesions (hyperplasia, adenomata and early carcinomas) that had been endoscopically or surgically resected were retrospectively analyzed. NBI magnifying observation was in conformance with the Hiroshima classification and pit pattern diagnosis was in conformance with the Kudo and Tsuruta classification. The relationship between NBI magnifying observation and pit pattern diagnosis and that between NBI magnifying observation and the histological type/invasion depth were examined in relation to colorectal tumor morphology. Results: Type A corresponded to the type II pit pattern, type B corresponded to the type IIIS, type IIIL and type IV regular pit patterns, type C1 corresponded to the type VI slightly irregular pit pattern, type C2 corresponded to the type VI highly irregular pit pattern and type C3 corresponded to the type VN pit pattern. In the protruded type, the irregularity of type C1 or C2 lesions agreed with the type VI slightly or highly irregular pit pattern, respectively, in 114 cases (64.0%). Moreover, the irregularity was higher with NBI magnifying observation than with pit pattern diagnosis in 58 cases (32.6%). In the superficial type, the irregularity of type C1 or C2 lesions agreed with the type VI slightly or highly irregular pit pattern, respectively, in 63 cases (71.6%). Moreover, the irregularity was higher with NBI magnifying observation than with pit pattern diagnosis in 19 cases (21.6%). In the case of type C1 or C2 lesions, the irregularity tended to be higher with NBI magnifying observation than with pit pattern diagnosis in the protruded type compared to the superficial type (p = 0.087). Conclusion: The surface pattern, which was visible in NBI magnifying observation, differed from the pit pattern findings obtained by magnifying endoscopic observation using a dye. Findings were more detailed in pit pattern diagnosis using a dye than in NBI magnifying observation.