Role of oestrogen receptor-α and -ß in bladder tissue of patients with a clinical diagnosis of benign prostatic hyperplasia.

OBJECTIVES: To study the differential expression of oestrogen receptor (ER) subtypes in human urinary bladder tissue using immunohistochemistry (IHC) methods and to explore their correlation with various measures of lower urinary tract symptoms (LUTS). METHODS: In this prospective case-control study, the case group comprised 34 patients with bothersome LUTS who underwent transurethral resection of prostate (TURP), while the control group comprised 19 age-matched, otherwise healthy patients who underwent cystoscopy to investigate microscopic haematuria. Cystoscopy and bladder biopsy were performed in both groups. IHC evaluation of biopsy specimens was carried out for ER subtypes (ER-α and ER-ß) and for Ki 67 in semi-quantitative fashion. Correlations of receptors with various measures of benign prostatic hyperplasia (BPH)/LUTS were also assessed. RESULTS: Expression of ER-α (in both epithelial and stromas cells) was statistically significantly greater in the case group than in the control group, but ER-ß expression was not significantly different between the groups. Ki 67 expression was also significantly greater in the case group. Comparison of clinical variables according to receptor status showed that International Prostate Symptom Score (IPSS), post-void residual urine volume (PVR) and prostate volume were significantly associated with epithelial and stromal ER-α; however, ER-ß was associated only with PVR. CONCLUSION: We found significant correlation between bladder ER levels (specifically ER-α) and various clinical measures of BPH. We conclude that ER-α is the key mediator that could be responsible for various clinical measures of BPH/LUTS.

Immunohistochemical analysis of estrogen receptors in prostate and clinical correlation in men with benign prostatic hyperplasia.

PURPOSE: Estrogens act through interaction with 2 receptor subtypes, ER alpha (ERα) and ER beta (ERß), in human prostate. The aim of the present study was to semiquantitatively assess the differential expression of ER subtypes in human benign prostatic hyperplasia (BPH) by use of immunocytochemistry (IHC) methods and to explore their relationship with various measures of BPH. MATERIALS AND METHODS: A total of 45 patients with BPH undergoing transurethral resection of the prostate and 22 patients with bladder cancer with normal prostate undergoing surveillance cystoscopy were studied as cases and controls, respectively. Quantitative immunolabeling of ER subtypes was scored by use of a semiquantitative scale. Also, correlations were assessed between ER levels in prostate and various measures of BPH. RESULTS: Overall, we found strong immunostaining for ERα in stroma and for ERß in epithelium, respectively. The IHC score for ERα differed significantly between BPH patients and controls in both stroma (p≤0.001) and epithelium (p=0.008), respectively. The ERß IHC score was also significantly higher in the epithelium of BPH patients (p=0.01). Also, we found a significant correlation between prostatic ER levels and various clinical measures of BPH. CONCLUSIONS: ERs may play an important role in the pathogenesis of BPH.

Dysembryoplastic neuroepithelial tumor: A rare brain tumor not to be misdiagnosed.

Dysembryoplastic neuroepithelial tumor (DNET) is a recently described, morphologically unique, and surgically curable low-grade brain tumor which is included in the latest WHO classification as neuronal and mixed neuronal-glial tumor. It is usually seen in children and young adults. The importance of this particular entity is that it is a surgically curable neuroepithelial neoplasm. When recognized, the need for adjuvant radiotherapy and chemotherapy is obviated. We hereby present a case report of an 8-year-old male child who presented with intractable seizures and parieto-occipital space occupying lesion. Histologically, the tumor exhibited features of WHO grade I dysembryoplastic neuroepithelial tumor which was further confirmed by immunohistochemistry.

Giant lumbosacral schwannoma in a child.

Small spinal intradural extramedullary schwannoma are a common occurrence in the middle aged. However, giant schwannoma in pediatric age group is rare. We report one such case of giant extradural lumbosacral schwannoma in an 8-year-old child. Clinical features, histopathology and management of giant schwannoma is discussed and the present literature reviewed.