Background and objectiveMismatch repair (MMR) proteins are an integral part of the cell cycle, and they play an important role in the genomic stability of the microsatellite complex. Microsatellite instability (MSI) is associated with Lynch and multi-tumor syndromes. Identifying patients with Lynch syndrome is essential for screening, early detection, and surveillance of other Lynch syndrome-associated tumors. The role of MMR deficiency is well known in colorectal and endometrial adenocarcinoma. However, the role of MMR deficiency in prostatic adenocarcinoma is a matter of controversy. A few studies have been published to analyze the association between MMR deficiency and prostatic adenocarcinoma. In this study, we used immunohistochemistry to look into the expression of four MMR proteins in prostatic adenocarcinoma: MSH2, MSH6, MLH1, and PMS2. MethodologyThis was a cross-sectional descriptive study involving 74 cases of acinar prostatic adenocarcinoma, diagnosed with hematoxylin & eosin (H&E), over a period of six months between December 2021 and May 2022 at the Chughtai Institute of Pathology in Lahore, Pakistan. We performed the immunohistochemical (IHC) analysis and interpretation of four antibodies, i.e., MSH2, MSH6, MLH1, and PMS2. ResultsIn our study, the age of the patients ranged from 50 to 98 years, with a mean age of 67.99 ± 9.59 years. The specimens were collected through transurethral resection of the prostate (TURP), transurethral vaporization of the prostate (TVP), core biopsy, and radical prostatectomy. Isolated loss of each MSH2 and PMS2 was noted in nine cases (12.20%) and MSH6 in two cases (2.70%). There was no loss noted for MLH1. Furthermore, simultaneous loss of MSH2/MSH6 was observed in one case (1.35%). ConclusionOur study findings revealed a low frequency of IHC expression of MMR proteins, especially the concurrent loss of paired MMR proteins. However, prostatic adenocarcinoma is associated with the isolated loss of MMR proteins. Thus, the present study does not warrant reflex testing/screening in every case of prostatic adenocarcinoma, because of its low frequency, which is probably suggestive of its sporadic pattern.
BackgroundB-cell non-Hodgkin lymphoma (NHL) is a common malignancy worldwide and in the Pakistani population. In our population, there was limited information regarding the clinicopathological characteristics of B-cell NHL. This study assessed the disease spectrum and most prevalent subtypes of B-cell NHL. MethodologyAn analysis of 548 cases was conducted in this cross-sectional study between January 2021 and September 2022, using a non-probability consecutive sampling approach. Patient age, gender, site of involvement, and diagnosis were documented according to the 5th edition of the World Health Organization (WHO) Classification of Tumors of Hematopoietic and Lymphoid Tissue, published in 2018. Data were entered and analyzed using Statistical Product and Service Solutions (SPSS) (IBM SPSS Statistics for Windows, Version 26.0, Armonk, NY). ResultsThe mean age of the patients was 47.73±20.44 years. There were 369 males (67.34%) and 179 females (32.66%). The most prevalent type of B-cell NHL was diffuse large B-cell lymphoma (DLBCL) (58.94%), followed by chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL) (13.14%), Burkitt lymphoma (9.85%), and precursor B-cell lymphoblastic lymphoma (5.11%). In contrast to low-grade B-cell NHL (22.99%), high-grade B-cell NHL was more common (77.01%). Nodal involvement was observed in 62.04% of cases. The cervical region was the most common nodal site of involvement (62.04%), and the gastrointestinal tract (GIT) was the most common extranodal site (48.29%). ConclusionThe incidence of B-cell NHL is higher in older age groups. The most common nodal site was the cervical region, whereas the extranodal site was the GIT. The most reported subtype was DLBCL, followed by CLL/SLL, and Burkitt lymphoma. The prevalence of high-grade B-cell NHL is higher than that of low-grade B-cell NHL.
BackgroundSkin adnexal tumors (SATs) are categorized per the site of origin, for example, hair follicles, sebaceous glands, and sweat glands. In our population, there is limited information related to the clinicopathological characteristics of these tumors. Management and prognosis depend largely upon the morphological type of the tumor. In this study, we assessed the disease spectrum and most prevalent subtypes of benign SATs. MethodologyAn analysis of 565 cases was conducted in this cross-sectional study between January 2018 and December 2022, using a non-probability consecutive sampling approach. Patient age, gender, site of involvement, and diagnosis were documented according to the fourth edition of the WHO Classification of Skin Tumors published in 2018. Data were entered and analyzed using SPSS Version 26.0 (IBM Corp., Armonk, NY). ResultsOur study had 565 patients, out of which 271 (47.9%) were males and 294 (52.1%) were females. The mean age was 40.97±19.3 years (range, 2-100 years). Anatomical site variations were as follows, head and neck (n=336, 59.4%), extremities (n=124, 22%), trunk (n=84, 14.9%), and genital areas (n=21, 3.7%). The most common histological subtypes of benign SATs were sweat gland origin (n=350, 62.0%), followed by hair follicle origin (n=161, 28.5 %), and sebaceous gland origin (n=54, 9.5%). ConclusionSweat gland tumors were the most prevalent class of benign SATs in our study, in which hidradenoma and poroma were the most frequent subtypes. Hair follicle origin was the second most prevalent class of tumors with pilomatricoma being the most frequent. Sebaceous tumors were overall uncommon; nevus sebaceous of Jadasshon was the most common tumor in this class.
Collision tumors are type of tumors where two histologically distinct type of tumors occur at the same anatomic location. Breast collision tumors comprising carcinoma and lymphoma or invasive ductal carcinoma with invasive lobular carcinoma are relatively common. However, a collision tumor between metaplastic breast carcinoma (MBC) and invasive lobular carcinoma (ILC) is extremely rare. Here, we report a case of collision tumor in breast comprising MBC and ILC. A 60-year-old female patient presented in outdoor department with palpable painless firm mass in left breast. FNAC diagnosis of class V smears was made. Wide local excision was done and specimen sent for frozen section analysis. On frozen section, diagnosis of malignant neoplasm was made and suspicion of malignant phyllodes and MBC was raised. All margins were reported free as free of the tumor. Further sectioning revealed another tumor, 0.1 cm away from main tumor. Sections from this tumor showed a malignant neoplasm arranged in cords with tumor cells having eccentric nuclei and moderate amount of cytoplasm. Immunohistochemical (IHC) analysis showed spindle cell tumor with profile favoring MBC while IHC analysis of second tumor was consistent with the diagnosis of ILC. Final diagnosis of collision tumor was made. © 2019 Tehran University of Medical Sciences. All rights reserved. Acta Med Iran 2019;57(4):271-275.
Her-2 (ErbB-2) is an oncogene frequently overexpressed in breast and gastric adenocarcinomas, and anti-Her-2 targeted therapy can be given to such patients. Her-2 overexpression and role of anti-Her-2 targeted therapy in cases of gallbladder adenocarcinomas (GBC) are still debatable. Scoring protocols for Her-2 expression in breast and gastric carcinomas are standardized, however, not for carcinomas arising in other body organs like the gallbladder. This study is conducted to evaluate the expression of Her-2 in patients with GBC, which may benefit from targeted therapy. It is a cross-sectional study conducted on patients with GBC (n=63; 53 women and ten men). An automated immunohistochemical technique was used with an anti-ErbB2 antibody. Scoring was conducted according to the CAP (College of American Pathologists) criteria for breast cancer. Positive (3+) Her-2 staining was observed in 8/63 (12.7%). Nine cases (14.3%) showed equivocal staining (2+) pattern. All of the tumors showing Her-2 overexpression were moderately differentiated. This study indicates that a significant number of GBC cases show Her-2 overexpression. This subgroup may benefit from inhibitors of the Her-2 pathway. Standardization of scoring protocol for Her-2 expression in GBC is needed to better evaluate the predictive potential of Her-2 for the treatment of these tumors.
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