Primary retroperitoneal mucinous cystadenomas (PRMCs) are extremely rare tumors and their association with sarcoma-like mural nodules (SLMNs) has not been described thoroughly. The aim of this study is to characterize the gross and microscopic features and the immunohistochemical profile of the first case of PRMC with SLMN and to discuss the differential diagnosis of SLMNs. The literature related to primary retroperitoneal mucinous tumors is reviewed in an attempt to clarify the histogenesis of the epithelial and sarcomatoid components of the associated mural nodules. A 34-yr-old woman presented with a 14-cm retroperitoneal cystic lesion with a 6-cm mural nodule. An immunohistochemical study with a panel of 19 antibodies and a histochemical study for mucin stains were performed. The epithelial component of the PRMC showed positive staining for cytokeratin (CK) 7, CK AE1/3, epithelial membrane antigen, carcinoembryonic antigen, and calretinin. The neoplasm was not immunoreactive for CK 20, CK 5/6, and the other antibodies used in this study. In addition, it stained positively for mucin by mucicarmine, periodic acid-Schiff, and Alcian blue. The stromal cells of the cyst showed estrogen receptor positivity. SLMN cells were negative for all CKs and other epithelial markers used in the study, but they showed diffuse positive staining for vimentin and CD68, and positive staining for Ki-67 was demonstrated in 25% of these cells. The immunohistochemical and histochemical profiles of PRMC were similar to those of ovarian mucinous neoplasms and the mesothelium. The formation of SLMNs seems to be related to subepithelial hemorrhage and some reactive epithelial changes near the mural nodules. The specific immunohistochemical and morphologic features of SLMNs are helpful in differentiating them from malignant mural nodules, including true sarcomas, osteoclast-rich undifferentiated carcinomas, and carcinosarcomas. Such a differentiation is critical in view of its significant impact on the management of these neoplasms, particularly in young patients who desire to preserve their fertility.
The glutathione S-transferases (GST) are enzymes catalyzing reactions including carcinogens. GSTT1 and GSTM1 genes are polymorphic in humans. The relations between polymorphism of some GST genes and cancer have been reported. In this study, we aimed to investigate the distribution of GSTT1 and GSTM1 polymorphisms in a group of gastric cancer patients. The study group consisted of 50 patients (21 females, 29 males) with gastric adenocarcinoma from the archives of the pathology department of a training hospital. Fifty-seven healthy control subjects were included in the study as a control group. DNA was extracted from peripheral venous blood of control subjects and from the paraffin blocks of cases. Genotyping of GSTT1 and GSTM1 genes was performed with duplex polymerase chain reaction. No differences in the frequencies of GSTM1 or GSTT1 null genotypes were observed between patients and healthy subjects (GSTM1: 52% vs. 43.85%, OR = 1.27, 95% CI: 0.55-2.96; GSTT1: 38.46% vs. 28.07%, OR = 0.72, 95% CI: 0.25-1.96). Moreover, simultaneous carriage of both genotypes was almost identical in both groups. GSTM1 or GSTT1 null genotypes were not different in diffuse or intestinal type gastric cancer. Our data suggest that the GSTM1 and GSTT1 polymorphisms are not associated with gastric cancer in a small group of the Turkish population.
Can horizontal diameter of colorectal tumor help predict prognosis? INTRODUCTIONColorectal cancer (CRC) is the third most common cancer among men and women in developed countries (1, 2). The preferred management of non-metastatic colon cancer is removal of the tumor and surrounding lymph nodes. Post-surgical treatment is closely related to the tumor node metastasis (TNM) staging system (3, 4).Depth of tumor penetration (T), regional lymph node involvement (N), and distant metastasis (M) are major parameters predicting the prognosis in CRC patients. The literature data show that tumor staging may be more accurate and the prognosis may be more favorable as the number of harvested lymph nodes increases (5-7).Several studies show that vertical penetration of the tumor on the bowel wall is related to the number of positive lymph nodes and a poorer prognosis. The relationship between horizontal tumor diameter and prognosis is still controversial (8-10). Few studies in gastric and colon cancer indicate that the horizontal extension of the tumor could be an important prognostic factor (2, 11, 12).In this study, we aimed to investigate the relationship between horizontal tumor diameter and prognosis, as well as other well-known prognostic factors of CRC. MATERIAL AND METHODSA total of 486 colorectal cancer patients who were treated in our surgical clinic between 1991 and 2012 were enrolled. Data were obtained from a CRC database and the medical records of the patients. Clinical information and follow-up data were obtained from hospital charts and electronic records. Patients who received neo-adjuvant therapy or underwent palliative resection, had a pathological diagnosis other than adenocarcinoma, and patients with inflammatory bowel disease were excluded (n=47). The remaining 439 patients were included in our retrospective analysis.Adjuvant chemotherapy was given according to the lymph node involvement. Patients with nodenegative tumors did not receive chemotherapy. Patients showing poor prognostic indicators, such as
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