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Objective: The aim of this study was to evaluate the relationship between prognostic factors and cancer-specific survival (CSS) in renal tumors larger than ten centimeters. Materials and Methods: We evaluated the data of 126 patients who underwent open radical nephrectomy due to a renal mass larger than 10 cm between January 2010 and June 2016. Kaplan-Meier analysis or Cox regression was used to analyze the relationship between CSS and variables. Pairwise group comparisons were also evaluated with the Log-Rank test. A p-value <0.05 was considered statistically significant. Results: Mean follow-up was 68.5 months and mean survival was 39.2 months. The relationships between tumor histopathology, stage and CSS were significant. Tumor size negatively affected CSS, but the relationship was not significant. Tumor stage (T2b, T3b), tumor thrombus, lymph node metastasis and adjuvant therapy were the most effective independent factors affecting CSS according to Cox regression analysis results. Conclusion: Although tumor size is an important prognostic factor for T2b and lower stage kidney tumors, this effect is less in larger tumors and other clinicopathological features should be considered further to predict prognosis. [ABSTRACT FROM AUTHOR]

Objective: Mucinous tubular and spindle cell carcinomas (MTSCC’s) are recently described rare type of renal cell carcinoma (RCC). MTSCC’s are characterized by small, elongated tubules lined by cuboidal cells and/or cords of spindled cells separated by pale mucinous stroma. They have morphological similarities to papillary RCC (papRCC). We evaluated the importance of the immunohistochemical features in the differential diagnosis of MTSCC and papRCC. Material and Method: We re-evaluated 9 cases of MTSCC diagnosed between 2004 and 2010 and compared 10 cases of papRCC. All tumorswere stained with alpha methylacyl-CoA racemase (AMACR), cytokeratin 7 (CK7), CK19, renal cell carcinoma marker (RCC Ma), CD10 and kidney specific cadherin (KspCad). Results: A total of 6/9 cases were considered classical. Two of 9 MTSCC’s were classified as “mucin-poor”. Foamy macrophages were identified in 4 cases. The immunoreactivity in MTSCC was AMACR 100%, CK7 100%, CK19 100%, RCC Ma 50%, CD10 11%,and KspCad 38% while the values for papRCC were AMACR 100%, CK7 90%, CK19 100%, RCC Ma 100%, CD10 80%, and KspCad 0%.Conclusion: MTSCCs may include little mucin and show a markedpredominance of either of its principal morphological components. They may mimic other forms of RCC. Pathologists should be aware of the histological spectrum of MTSCCs to ensure an accurate diagnosis. Careful attention to the presence of a spindle cell population may be helpful in the differential diagnosis in tumors with predominant compact tubular growth. Immuno histochemical stains for papRCC are also expressed in MTSCC, but strong CD10 expression may not favor MTSCC. [ABSTRACT FROM AUTHOR]

Renal epithelial cells comprise distinct pathological and physiological differences. Renal epithelial neoplasms derived from these cells may show overlapping morphological features, and differential diagnosis requiring the use of ancillary methods. The purpose of this study was to determine the diagnostic utility of the immunohistochemical expression patterns of a wide range of markers in renal epithelial cells. Normal renal cortical parenchyma and renal pelvis were immunostained for cytokeratin (CK) subtypes (CK7, CK19, CK34âE12), vimentin, RCCMa, CD10, CD117, AMACR, WT-1, EMA and p63. The immunohistochemical expression patterns were examined in 10 cases. Although there is some overlap, subtypes of epithelial cells showed distinctive CK and CD expression profiles. Proximal tubular cells showed CD10, RCCMa, AMACR expression. Distal tubular cells and collecting ducts showed CK7, CK19 and EMA expression. Urothelial cells showed CK7, CK19, CK34âE12, and p63 expression. CD117 and vimentin selectively stained intermittently in some cells lining the tubules. Endothelial cells and visceral epithelial cells stained with WT-1. Glomerular epithelial cells stained with CD10, but focal and intermittent staining with AMACR, CK7, CK 19, and RCCMa was found in parietal cells. In conclusion, a panel of cytokeratins, CDs and other markers are helpful in distinguishing epithelial cells and urothelial cells. The expression patterns of these markers may be helpful in the differential diagnosis of epithelial neoplasms. [ABSTRACT FROM AUTHOR]

Environmental pollutants such as organochlorine pesticides (OCPs), polychlorinated biphenyls (PCBs) and polybrominated diphenyl ethers (PBDEs), so called persistent organic pollutants (POPs) have been known to interfere various ion channels in organism, which is the main mechanism of action especially for OCPs. Furthermore, all PCBs and several congeners of OCPs and PBDEs were recently listed as "carcinogen" by the IARC depending on evaluation of epidemiological studies. On the other hand, there have been very little data on the relation between various cancers and tissue burden of these toxicants. In majority of the human studies on a possible association between POPs and cancers, exposure data have been based on statement-based interviews, which potentially impair the accuracy and reliability of quantitative assessment. In order to accurately assess whether environmental exposure to POPs increase risk of kidney, stomach and breast cancers, tumour tissues as well as blood and urines were collected from surgically operated patients. Cellular DNA and protein oxidative damage markers (8-OHdG and dityrosine, respectively), have also been analysed in the patient and healthy control groups, and assessed whether there are changes in these parameters. The data suggest that majority of POPs in cancerous tissues were associated with cancers in patients, while they are less conclusive in blood of the same patients. DNA and protein damage markers were found to be higher in urines of kidney cancer patients compared to healthy volunteers, although inter-individual variability obscured statistical significances. Current findings confirmed that glutathione S-transferase theta1 (GSTT1) nullpolymorphism is a risk factor Bforro ukgidhnte tyo cyaonuc ebry, |a nEdP cIyptsowchicrohme P450 1A1 (CYP1A1) is a risk factor for stomach cancer. Data suggest that environmental exposure to POPs may induce tumour initiation and/or progression in humans however, blood concentrations of the same pollutants do not adequately reflect tissue concentrations except dichlorodiphenyldichloroethylene (DDE), the major metabolite of the notorious organochlorine pesticide dichlorodiphenyltrichloroethylene (DDT). Possible role of interaction of POPs with ion channels in cancer initiation and/or progression remain to be explored. [ABSTRACT FROM AUTHOR]

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Background/aims: We investigated the utility of using histological changes to diagnose infectious oesophagitis when causative organisms cannot be seen., Materials and Methods: Sixty-seven endoscopic biopsy specimens (51 Candida, 9 herpes simplex virus, 4 tuberculosis, and 3 cytomegalovirus oesophagitis) collected from 2000-2010 that matched the investigative criteria were included in the study. Cases were re-evaluated for histological changes observed in oesophagitis, and the findings were statistically compared using nonparametric tests., Results: Thirty-nine cases occurred in male patients, and 28 occurred in female patients; the mean age of the patients was 51±20.1 years (range, 5-94 years). All cases showed lymphocytic and neutrophilic infiltration; while 27 (40.3%) showed eosinophilic infiltration. The density of lymphocytes and eosinophils were 8.43±6 and 1.07±1.62 per high power field, respectively, and these rates were higher in tuberculosis oesophagitis cases. Lamina propria infiltration was present in herpes simplex virus and Candida oesophagitis. Dense neutrophilic infiltration (>50/high power field) was noted in herpes simplex virus oesophagitis. Candida colonization was observed in 82% of cases with eosinophilic infiltration, and 80% of cases with erosion. Ulceration was present in all tuberculosis oesophagitis cases (p<0.001). Basal cell hyperplasia, papillary elongation, and dilated intercellular spaces were seen in all cases except for 2 Candida oesophagitis cases. Lamina propria fibrosis was especially noted in cytomegalovirus oesophagitis cases., Conclusion: It is not possible to distinguish infectious oesophagitis from other subtypes, especially reflux oesophagitis, if the causative organism is not detected. Clinicopathological correlation and control with repeat targeted biopsies are essential for diagnosis.