levels with malignantepithelial ovarian tumors (p < 0.001). So it can be concluded that serum NGAL can be considered as one of the screening compo- nents that are good enough for ovarian tumors. However, there was no significant difference in serum NGAL levels in various stages of cancer (p = 0.555). This study is in accordance with some previous studies. A study by Jian Wu et al. (2016) which concluded that the increase of NGAL and MMP-9 expression in epithelial ovarian cancer associated with the initiation and progression of epithelial ovarian cancer. These data suggest that NGAL may be a good marker for monitoring the changes in benign lesions, premalignant and malig- nant ovarian tumors and this molecule may be involved in the development of epithelial ovarian cancer. Similarly, a study by Cho (2009) reported an increase in NGAL expression and its association with tumor differentiation in ovarian cancer. 15,16,17
Ovarian cancer has the seventh highest cancer incidence in women worldwide. In 2012, 238,719 new cases were diagnosed and 151,917 women died from the disease . Malignantepithelial tumors comprise 90 % of all ovarian cancers and are usually diagnosed at advanced stages, leading to high mortality and low survival rates [2, 3]. Abnormalities in cell cycle control have been reported in a wide range of human cancers [4, 5]. The eukaryotic cell cycle is divided in five phases: mitosis, gap 0 (G0) gap 1 (G1), synthesis (S) and gap 2 (G2). Most human adult cells are in G0, with no increase in cell size or DNA content. This state is maintained by tumor sup- pressor protein pRb. When external growth factors are present, the cell enters the G1 phase, during which there is duplication of all cellular components, except DNA. This is possible due to the release of the suppressing ef- fects of pRb through the action of complexes formed by cyclins and cyclin-dependent kinases. The inactivation of pRb allows progression through G1 and into the synthe- sis phase, when DNA is replicated. When DNA damage, insufficient cell size or oncogenic stimuli are present, other tumor suppressor proteins are activated and pre- vent passage from G1 to S. If abnormalities are present in these proteins, mutated cells can proliferate unre- strictedly and generate a neoplasm [6–8]. Tumor sup- pressors’ genetic and immunohistochemical alterations are a common finding in human cancers, including ovar- ian epithelial tumors, specially carcinomas [9–16]. In this study, we focus on three of these proteins: p14, p16 and p53.
Immunohistochemical (IHC) analysis of 40 cases of SpCC of the head and neck region were carried out to establish the usefulness of selected IHC markers in dis- tinguishing SpCC from other mucosal spindle-cell neo- plasms. IHC analysis using polymer HRP detection sys- tem and DAB chromogen show concurrent presence of malignantepithelial and sarcomatoid spindle cell com- ponents by co-expression of cytokeratin (CK) and vim- entin to various degrees (Figures 3 and 4). All the SpCC where S-100 protein was carried out shown negative immunoreactivity.
Ductal carcinoma in situ (DCIS) of the breast is defined as a proliferation of malignantepithelial cells confined to the ducto-lobular system of the breast without evidence of stromal invasion [1, 2]. Invasion is defined morphologically, as in other organ sites, by the absence, or breaching, of the basement membrane (BM) barrier between the malignantepithelial cells and surrounding stroma. In the breast there is an additional myoepithelial cell (MEC) layer between the epithelium and the basement membrane. At the molecular level, DCIS progresses to invasive carcinoma when malignant cells acquire the invasive phenotype [1, 3] that is the capability to infiltrate through both the myoepithelial and basement membrane layers. Because of challenges and limitations in identifying BM components using immunocytochemistry (IHC), the MEC layer has gained importance because of the greater simplicity of its identification immunohistochemically and is thus used as a surrogate marker for invasion through the BM. The loss of the MEC layer in breast pathology has become a key criteria for differentiating non-invasive from invasive disease implying, possibly incorrectly in some contexts, direct exposure of the malignantepithelial cells to the stroma and a subsequent ability to infiltrate and metastasize.
According to the ROC curve, and comprehensive ana- lysis of AUC, sensitivity, and speci ﬁ city, it could be con- cluded that energy and energy-mean were the ideal texture parameter or joint diagnostic model to identify parotid PA and malignantepithelial tumors because of their good diagnosis ef ﬁ ciency, with the AUC of 0.887 and 0.888, respectively. The sensitivity of energy was the highest (0.970), and the speci ﬁ city of energy-correlation was the highest (0.970).The energy represents the stability of the lesion texture gray scale change and re ﬂ ects the gray scale distribution uniformity and texture thickness. The higher the energy is, the more regular and stable the current texture change becomes. In this study, the energy of par- otid epithelial malignancy was statistically higher than that of PA. This may be closely related to the histopathological characteristics of PA, such as complicated histological structure and diverse cell types, including glandular epithelium, myoepithelium, mucus, mucoid tissue, and chondroid tissue.
The TLRs are type-I transmembrane proteins which play a key role in the detection of pathogens and in triggering inflammation and immune response to microbial infec- tions . The stimulation of TLRs by their respective ligands initiates well-characterized signaling cascades that enhance cellular resistance against pathogens. TLRs are expressed not only by immune cells, but also by vari- ous cell types including normal and malignantepithelial cells [2,3]. TLR3 is one category of TLR which interact specifically with double-stranded RNA (dsRNA) of viral origin. This binding leads in turn to MAPKs, NF-kB and IRF-3 activation and to IFN-I induction via the adaptor proteins TRIF and RIPK1 [1,4-6]. Activation of these pathways results in the establishment of an anti-viral phenotype. Many additional changes are induced by TLR3 stimulation. Their overall consequences are dependent on the intensity of the stimulation, on the cell context and on concomitant extra-cellular signals. De- pending on these conditions, they can result in apoptotic cell death as well as enhancement of proliferation [7-10].
signi ﬁ cantly increased in carcinomas compared to those in BOTs. 74 However, Ozreti ć et al 75 detected the expression of molecules related to Hh pathway in 41 samples (16 cases of malignantepithelial ovarian cancer, 7 cases of BOT, 9 cases of normal ovarian tissue and 9 cases of fallopian tube tissue) by real-time quantitative PCR. This study showed that GLI1 was highly expressed in BOTs than to ovarian cancer. 75 Song et al 76 using immuno ﬂ uorescent staining to evaluate the expression of genes in Hh pathway in 193 cases of ovarian epithelial tumors (including 147 cases of malignantepithelial ovarian cancer, 30 cases of BOT, 16 cases of benign ovarian epithelial tumors) and 11 cases of normal ovarian epithelial tissues. Compared with benign ovarian epithelial tumor, GLI1 was highly expressed in BOT but there was no sig- ni ﬁ cant difference in expression of GLI1 in BOTs versus ovarian cancer. 76 Survivin has recently been described as a new target of this pathway. 77 In a study by Kanter et al, 77 the expression of Survivin in mucinous ovarian tumors was found in 88.1% of malignant tumors and 18.2% of borderline tumors, respectively, suggesting that Survivin was positively correlated with malignant mucinous tumors.
Due to lack of effective screening methods, 70% of the epithelial carcinomas are diagnosed only at an advanced stage 74 . Various new biological markers have been studied as prognostic and predictive factors for the evaluation of the biological behavior of ovarian cancer and to improve treatment planning. Among these, immunohistochemical staining of P53 and Her2neu have been proposed to be of prognostic value. In the present study potential impact of the expression of P53 and Her2neu protein on the outcome of patients with malignantepithelial ovarian tumors and for their targeted therapy was analysed.
characterization was made regarding location (for example, upper or lower eyelid). Malignantepithelial tumours were the most common diagnosis, accounting for 36.17% cases while only 17.0% in Spraul’s study. Basal cell carcinoma was the most common subtype, with 88.24% of cases; in the remaining literature, we found this to range from 14.3% to 86%. 2-9 The mean age for malignantepithelial tumours
Case presentation: A 77-year-old Caucasian man had been reporting difficulty in swallowing and hoarseness for a month before admission to our department. After several preliminary tests, including a biopsy which was positive for a malignantepithelial neoplasm which required further immunohistochemical study, we decided to operate, removing the base of our patient ’ s tongue and performing a total laryngectomy. Histological examination of the specimen revealed a high-grade leiomyosarcoma of the base of the tongue and of the free edge of the epiglottis. Conclusions: We wish to stress the rarity of this clinical case, related to the site of implantation of the tumor, as confirmed by the difficulties in finding reference to this topic in the international literature. In fact, several cases of leiomyosarcoma have been described, but in different locations from that seen in our patient ’ s case.
Ovarian cancer is one of the most common and lethal cancers in women. Epithelial ovarian can- cers comprise the vast majority of ovarian malignancies, which are most commonly serous carcinomas . In 2013, about 22,240 new cases diagnosed and 14,030 deaths from ovarian cancer occurred in the United States . As ovarian cancer is often asymptomatic in its early stages or presents with vague symp- toms mimicking extra-ovarian disease, more than two thirds of the patients with ovarian can- cer were diagnosed at advanced stage and the overall survival is very poor. Despite advances in surgery and chemotherapy, overall cure rate has remained approximately 30%. The poor clinical outcome mainly comes from the high
There were 5 cases of Carcinoma ex pleomorphic adenoma (CPA) [Figure 4(B)] and these accounted for 2.8% of all tumors and 14.3 % of the malignant tumors. Out of 5 cases, 3 cases were noted in parotid gland and 2 cases in submandibular gland. The malignant component noted was adenocarcinoma in 3 cases, adenoid cystic carcinoma in 1 case and epithelial myoepithelial carcinoma in 1 case. The male to female ratio was 3:2. The age range was 42-76 years. The peak incidence was in the 6th decade.
an otherwise typical adenomyoepithelioma  and those with the overall appearance of an adenomyoepithelioma but seen on close examination to contain foci of cellular atypia and increased mitotic activity. Recurrent tumors and distant metastases have been reported in association of both groups. Among the 11 cases of either epithelial and myoepithelial changes included in these studies [7,8], two cases showed malignant transformation of the myoepithelial component only [1,9] and one cases showed malignant transformation of the epithelial com- ponent only  (Table 2). Because of the capacity of adenomyoepithelioma with both epithelial and myoe- pithelial malignant transformation to metastasize, this entity should preferably be treated by wide local excision with appropriate margins . The presence of metasta- ses was described in patients with a tumor of ≥ about 1.6 cm. The metastases spread mainly via the blood sys- tem, with brain and lungs as main target organs. How- ever, there are no data about sentinel lymph node removal and/or lymphadenectomy and the adjuvant radiotherapy and/or chemotherapy. The genesis of infil- trating breast cancer today is considered to be a complex process with several phases that originates from stem cells of the terminal duct lobular unit (TDLU) . The identification of adult stem cells in the mammary tissue in the TDLU, that are able to differentiate themselves initially into epithelial glandular precursor cells (CK5 and CK8/18 positive), or into precursor cells of the myoepithelial layer (CK5 and SMA positive) and, subse- quently, into mature luminal cells (CK8/18 positive) and mature myoepithelial cells [12,13] (SMA positive), confirmed the distinction of the breast cancer in lu- minal, basal, HER-2 positive and ‘similar to normal’ breast highlighted by gene expression studies [14,15]. Nielsen et al . proposed a panel composed of immuno- histochemical markers anti-ER, anti-EGFR, anti-HER2, and anti-CK 5/6 to identify basal breast cancer . In our case, the epithelioid malignant component revealed a widespread expression of the epithelial luminal CK7 marker together with expression of the ‘staminal’ CK5 marker and the myoepithelial p63 and S-100 markers which could suggest that the origin of this component is from the stem cells of the mammary gland with an inter- mediate epithelial-mesenchymal differentiation. Reis-Filho et al . showed a basal-like immunophenotype (ER-, HER2-, EGFR + and/or CK5/6 +) in 59 out of 65 cases of meta- plastic breast cancer that produces stromal matrix that is an epithelial carcinoma with areas of mesenchymal differentiation . Futhermore, a case of malignant adenomyoepithelioma of the breast that produces stromal matrix was described with immunohistochemical profile of myoepithelial differentiation (S100 e maspin positive) but not basal-like (CK14-negative) in the metaplastic com- ponent . The presence of neoplastic components with
of extracapsular extension and distant metastases . As the few reported imaging features of ovarian struma overlap with those of other lesions, such as ovarian carcinoma, it becomes all the more relevant to be aware of contemporary imaging findings, including state-of-the-art MRI and diffusion- weighted imaging, in order to attempt preoperative diagnosis in these challenging and complex lesions. Failure to charac- terise this rare and usually benign mass as benign may lead to surgical overtreatment when ovarian cancer type surgery (in- cluding bilateral salpingo-oophorectomy, hysterectomy, omentectomy and occasionally appendectomy) is performed. An adjuvant treatment technique that has been suggested for residual, metastatic or recurrent disease of malignant stru- ma is radioiodine therapy, which has been reported to result in favourable outcomes . In patients presenting with multiple metastatic lesions, or for those who absorb radioiodine poorly, external beam radiation has been proposed .
very few reports of TMEC in the medical litera- ture. It was previously reported that TMEC ori- ginates from thymic epithelial cells, and these benign thymic epithelial cells can transform into malignant cells when exposed to certain stimuli . TMEC is a type of thymic carcino- ma. The oncogene MUC1A was shown to be expressed by 94% of thymic carcinomas, and MUC1 can cause transformation of normal cells and inhibit cell apoptosis . A previ- ous study showed that a strong association
Adenoid cystic carcinoma is another neoplasm in the spectrum of hyperplastic and neoplastic lesions character- ized by dual differentiation into ductal and myoepithelial cells . There was only one report that adenoid cystic carcinoma arising in an adenomyoepithelioma in breast , which Hayes commented that “since these neoplasms are so closely related this is an arguable entity” . How- ever, the difference does exist between the two entities. Adenoid cystic carcinoma has a characteristic cribriform architecture, the formation of true glandular spaces and pseudolumens, and the histologically distinct invagination of stroma. It lacks the papillary architecture which is fre- quently seen in adenomyoepithelioma. The myoepithelial cells tend to be smaller and more basaloid, and the arrangement of epithelial and myoepithelial cells is less irregular than that of adenomyoepithelioma [5,18]. Immu- nohistologically, CD117 highlights the epithelial cells of adenoid cystic carcinoma [4,19,20] but is totally negative in malignant adenomyoepithelioma.
Abstract: Malignant mesothelioma is a highly fatal cancer of the visceral and parietal pleura most often caused by asbestos exposure. However, studies over the past thirty-five to forty years have shown that a fibrous zeolite mineral found in the soil, erionite, is a strong causative agent of malignant mesothelioma as well. Cases of erionite- associated pleural mesothelioma have been widely reported in Turkey, but only one case has been documented in North America. Here we report a new North American case of epithelialmalignant pleural mesothelioma in a vehicle repairman who was raised on a farm in the Mexican Volcanic Belt region. The complexities of the case highlight the importance of objective lung digestion studies to uncover the causative agents of mesotheliomas. It also highlights a need for increased environmental precautions and medical vigilance for mesotheliomas in erionite-rich regions of the United States and Mexico.
Background: To study the expression pattern, localisation and potential clinical significance of aquaporin water channels (AQP) both in prostate cancer (PC) cell lines and in benign and malignant human prostate tissue. Methods: The AQP transcript and protein expression of HPrEC, LNCaP, DU-145 and PC3 cell lines was investigated using reverse transcriptase polymerase chain reaction (RT-PCR) and immunofluorescence (IF) microscopy labelling. Immunohistochemistry (IHC) was performed to assess AQP protein expression in surgical specimens of benign prostatic hyperplasia as well as in PC. Tissue mRNA expression of AQPs was quantified by single-step reverse transcriptase quantitative polymerase chain reaction (qPCR). Relative gene expression was determined using the 40- Δ C T method and correlated to clinicopathological parameters.
Abstract: Primary primitive neuroectodermal tumor (PNET) of the cervix is extremely rare. Only few previous re- searches have reported on morphologic descriptions in frozen sections or changes in this tumor after radiotherapy or chemotherapy treatments. In the following study we investigated two cases of PNET in cervix. One of which had taken frozen exam and the other experienced neoadjuvant chemotherapy. Briefly, the morphological analysis in intraoperative frozen indicated small round cell malignant tumor with Homer-Wright rosettes, which similar to that in paraffin sections. The morphological changes after chemotherapy showed glial and epithelial differentiation as well as other common reaction. Immunochemistry test of neural and neuroendocrine markers and the detection of EWSR1 gene rearrangement may show positive in this disease in cervix. In conclusion, the obtained data may be useful for further examination, detection and diagnosis of PNET in clinical practice. Also, to the best of our knowl- edge, this was the first time that morphological and pathological changes were examined in PNET post-chemother- apy. However, the exact mechanisms of these changes require further exploration.
lymphadenopathy or pleural eﬀusion. Complete surgical removal of the tumor along with safety margins was done and sent for histopathology examination. The biopsy report revealed ill-defined neoplastic growth showing biphasic pattern comprising epithelial and mesenchymal components consistent with pulmonary blastoma (Figures 3 and 4). The surgical margins were free of tumor. CT abdomen and bone scintigraphy showed no evidence of distant metastasis. The patient was referred to Radiation Oncology Department for possible intervention, but due to lack of established evidence of the role of radiotherapy in controlling local recurrence, the patient did not receive adjuvant radiotherapy. Due to the presence of certain poor prognostic factors like biphasic type and tumor size more than 5 cm, it was decided to proceed with adjuvant platinum-based chemotherapy comprising of ifosfamide, carboplatin, and VP-16 (ICE protocol). The patient received 6 cycles of the ICE protocol every 3 weeks with prophylactic granulocyte colony stimulating factor (G- CSF) from day 5 to day 12 after each cycle. There was one episode of febrile neutropenia after cycle 4 and the patient recovered completely after treatment with intra- venous antibiotics. Reevaluation was done after 3rd and 6th cycle with CT chest which showed no evidence of recurrence. The patient is in complete remission and currently on a 3- month ongoing followup.