Leucocyte common antigen (CD45) and CD5 positivity in an “undifferentiated” carcinoma: a potential diagnostic pitfall

Ngo, Nye Thane; Patel, Kaushik; Isaacson, Peter G.; Naresh, Kikkeri N.

doi:10.1136/jcp.2006.044750

Cited by 18 publications

(14 citation statements)

References 9 publications

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“…This is supported by data from the post-RP cohort that neither AR-V was detectable in whole-blood-derived RNA (Table 3). Cross contamination could be caused by non-specific binding of the CD45 antibodies, aberrant expression of CD45 by cancer cells 25,26 , or the formation of lymphocytes/cancer cells microemboli 27 . Regardless, this observation suggests the CTCs could be lost during negative selection.…”

Section: Discussionmentioning

confidence: 99%

A Whole Blood Assay for AR-V7 and AR^v567esin Patients with Prostate Cancer

Liu

Ledet

et al. 2016

Journal of Urology

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Purpose The majority of prostate cancer mortality can be attributed to metastatic castration-resistant prostate cancer, an advanced stage which remains incurable despite recent advances. The androgen receptor (AR) signaling axis remains active in CRPC. Recent studies suggest that the expression of an AR splice variant, AR-V7, may underlie resistance to abiraterone and enzalutamide. However, controversy exists over the optimal assay. The objective of this study is to develop a fast and sensitive assay for AR splice variants (AR-Vs) in patients. Materials and Methods Two approaches were assessed in this study. The first was based on depletion of leukocytes and the second used RNA purified directly from whole blood preserved in PAXgene tubes. Transcript expression was analyzed by quantitative RT-PCR. Results Through side-by-side comparison, we concluded that the whole-blood approach was suitable for the detection of AR-Vs. The specificity of the assay was corroborated in a cancer-free cohort. Using the PAXgene assay, samples from a cohort of 46 CRPC patients were analyzed. Overall, AR-V7 and ARv567es were detected in 67.53% and 29.87% of the samples, respectively. Statistical analysis revealed a strong association of AR-V positivity with a history of second-line hormonal therapies. Conclusions To our knowledge, this study is the first to demonstrate PAXgene-preserved whole blood can be used to obtain clinically relevant information regarding the expression of two AR-Vs. The data from a CRPC cohort support a role of AR-Vs in resistance to therapies targeting the AR ligand-binding domain.

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Section: Discussionmentioning

confidence: 99%

A Whole Blood Assay for AR-V7 and AR^v567esin Patients with Prostate Cancer

Liu

Ledet

et al. 2016

Journal of Urology

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“…CD20 is expressed in 14.8% and 8.2% of the encapsulated and infiltrative variants of PTC, respectively, as well as in metastatic PTC . CD45 can even be exceptionally expressed by undifferentiated carcinoma . As for Pax‐5, apart from positivity reported in few Merkel cell carcinoma (along with coexpression of TTF‐1), the monoclonal Pax‐5 antibody we tested seems to be the most discriminant marker in the differential diagnosis between an ATC and a high‐grade B‐cell lymphoma.…”

Section: Discussionmentioning

confidence: 79%

“…Surprisingly, diffuse and strong expression of CD45 and CD20 by tumour cells was observed, thus raising some incertitude as for the expression of Pax‐8 only by malignancies of epithelial lineage. Knowing that a subset of aggressive primary thyroid carcinoma shows an aberrant expression of CD20 and that CD45 positivity has been rarely described in undifferentiated carcinomas, a strong and diffuse expression of Pax‐5 unequivocally confirmed the lymphomatous nature of the aspirated tumour.…”

Section: Materials and Methods Resultsmentioning

confidence: 85%

“…This was further demonstrated by the absence of Pax‐8 mRNA in the B‐cell lines studied. Knowing of the possible pitfalls of CD20 and CD45 expression in poorly differentiated epithelial malignancies reported in the cervical region necessitated additional specific B‐cell markers . The demonstration of a diffuse and strong nuclear expression of Pax‐5 in tumour cells using a monoclonal antibody (1EW, Leica biosystems, Muttenz, Switzerland) in cytological (cytoblock from the FNAC) and histological (lymph node biopsy) materials confirmed the hypothesis of a polyclonal Pax‐8 antibody to Pax‐5 epitope cross‐reaction.…”

Section: Discussionmentioning

confidence: 85%

“…Concerning markers of lymphoid lineage, as already mentioned, there are some known overlapping stainings among lymphoma and carcinoma that can be troublesome in some situations . CD20 is expressed in 14.8% and 8.2% of the encapsulated and infiltrative variants of PTC, respectively, as well as in metastatic PTC .…”

Section: Discussionmentioning

confidence: 97%

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Hazardous cross‐reaction in a thyroid fine needle aspiration

et al. 2018

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Thyroid fine needle aspiration cytology (FNAC) is one of the most frequently performed medical procedures worldwide. 1 It is used as a diagnostic test to separate benign thyroid nodules (colloidal and hyperplastic nodules) from thyroid malignancies, either primary (papillary thyroid carcinoma [PTC], medullary thyroid carcinoma, poorly differentiated thyroid carcinoma [PDTC], anaplastic thyroid carcinoma [ATC]) or, less often, metastatic. 2 The negative and positive predictive values of this procedure in The Bethesda System for Reporting Thyroid Cytopathology are, respectively, 97% and 98% for the benign and malignant categories. 3 Being so frequent a procedure, it is not rare in general cytopathology practice to encounter unusual lesions that pose diagnostic problems. The modern cytopathologist should also be aware of the clinical setting in which a lesion is aspirated and should interpret cytomorphology and ancillary tests results as a whole, to maintain high thyroid FNAC diagnostic accuracy.We report one such difficult case that required integration of clinical, morphological and immunohistochemical findings to reach a correct diagnosis. | CASE HISTORYA 54-year-old man with unremarkable past medical history presented with a rapidly growing right laterocervical nodule that, as he said, had become palpable within a month. However, he also complained of pharyngeal discomfort with right shoulder pain for several months. On examination, the patient was in overall good physical condition. Cervical palpation confirmed a diffusely enlarged right thyroid lobe, as well as a right cervical mass measuring approximatively 5 cm. No sign of thyroid dysfunction was noted. A cervical ultrasound (US) confirmed the clinical appreciation and revealed multiple and bilateral enlarged lymph nodes, all of them with highly suspicious features. This presentation suggested a primary malignant thyroid neoplasm with local metastatic spread. FNAC under US guidance was then performed on the right thyroid lobe and the largest pathological lymph node. Following a cytopathological diagnosis of a high-grade B-cell lymphoma, a lymph node biopsy was performed for precise subtyping and final diagnosis. Meanwhile, 18-fludeoxyglucose positron emission tomography/computed tomography revealed multiple pathological uptake in the liver and spleen, as well as in the previously described cervical lesions. 3 | MATERIALS AND METHODS, RESULTS Cervical echography showed a 3.8 × 3.3 × 2.5 cm hypoechoic and hypovascular thyroid lesion with digitiform outline and heterogeneous content (Figure 1A, upper part), as well as multiple hypoechoic and partly ill-defined lymph nodes showing pathological vascularization and measuring up to 5.0 × 4.1 x 2.4 cm in the right neck levels II, III and IV (Figure 1A, lower part). FNAC material aspirated from the thyroid lesion and the largest pathological lymph node showed similar cytomorphological features, consisting mainly of numerous malignant cells, isolated (Figure 1B) or forming loosely cohesive clusters on a background of ...

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Collagen fibrils and cell nuclei are entrapped within Randall's plaques but not in CaOx matrix overgrowth: A microscopic inquiry into Randall's plaque stone pathogenesis

Canela

Bledsoe

Worcester

et al. 2021

The Anatomical Record

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Calcium oxalate (CaOx) stones can grow attached to the renal papillary calcification known as Randall's plaque. Although stone growth on Randall's plaque is a common phenomenon, this mechanism of stone formation is still poorly understood. The objective of this study was to investigate the microenvironment of mature Randall's plaque, explore its molecular composition and differentiate plaque from CaOx overgrowth using multimodal imaging on demineralized stone sections. Fluorescence imaging showed consistent differences in autofluorescence patterns between Randall's plaque and calcium oxalate overgrowth regions. Second harmonic generation imaging established the presence of collagen only in regions of decalcified Randall's plaque but not in regions of CaOx overgrowth matrix. Surprisingly, in these stone sections we observed cell nuclei with preserved morphology within regions of mature Randall's plaque. These conserved cells had variable expression of vimentin and CD45. The presence of nuclei in mature plaque indicates that mineralization is not necessarily associated with cell death. The markers identified suggest that some of the entrapped cells may be undergoing dedifferentiation or could emanate from a mesenchymal or immune origin. We propose that entrapped cells may play an important role in the growth and maintenance of Randall's plaque. Further characterization of these cells and thorough analyses of the mineralized stone forming renal papilla will be fundamental in understanding the pathogenesis of Randall's plaque and CaOx stone formation.

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Leucocyte common antigen (CD45) and CD5 positivity in an “undifferentiated” carcinoma: a potential diagnostic pitfall

Cited by 18 publications

References 9 publications

A Whole Blood Assay for AR-V7 and AR^v567esin Patients with Prostate Cancer

A Whole Blood Assay for AR-V7 and AR^v567esin Patients with Prostate Cancer

Hazardous cross‐reaction in a thyroid fine needle aspiration

Collagen fibrils and cell nuclei are entrapped within Randall's plaques but not in CaOx matrix overgrowth: A microscopic inquiry into Randall's plaque stone pathogenesis

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Leucocyte common antigen (CD45) and CD5 positivity in an “undifferentiated” carcinoma: a potential diagnostic pitfall

Cited by 18 publications

References 9 publications

A Whole Blood Assay for AR-V7 and ARv567esin Patients with Prostate Cancer

A Whole Blood Assay for AR-V7 and ARv567esin Patients with Prostate Cancer

Hazardous cross‐reaction in a thyroid fine needle aspiration

Collagen fibrils and cell nuclei are entrapped within Randall's plaques but not in CaOx matrix overgrowth: A microscopic inquiry into Randall's plaque stone pathogenesis

Contact Info

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A Whole Blood Assay for AR-V7 and AR^v567esin Patients with Prostate Cancer

A Whole Blood Assay for AR-V7 and AR^v567esin Patients with Prostate Cancer