Multiple Cardiac Metastases from a Nonfunctioning Pancreatic Neuroendocrine Tumor / Journal of the Korean Cancer Association, 대한암학회지

Pancreatic neuroendocrine tumors (pNETs) are rare neoplasms, which most commonly metastasize to the liver. However, intrathoracic metastases from pNETs are encountered infrequently. This report describes a case of nonfunctioning pNET with multiple cardiac metastases. A 56-year-old male presented with a palpable abdominal mass that showed progressive enlargement. Findings on computed tomography (CT) of the abdomen revealed two relatively well-marginated inhomogeneous low-attenuation masses, one in the head of the pancreas and the other in the tail. Multiple enhancing masses in the left pericardium with myocardial involvement were observed on chest CT and transthoracic echocardiography. Needle biopsies were performed on the mass in the tail of the pancreas and the left ventricular apical pericardium; histologic examination by hematoxylin and eosin morphology and immunohistochemical staining showed pNET in both. This is the first report of pNET with multiple cardiac metastases to previously undescribed metastatic sites.

Evaluation of Urine Cytology in Urothelial Carcinoma Patients: A Comparison of CellprepPlus(R) Liquid-Based Cytology and Conventional Smear

BACKGROUND: Urine cytology is an important test in the screening of urothlelial neoplasms. The conventional smear (CS) method of testing urine samples has a low sensitivity, approximately 50% result accuracy for detecting urothelial carcinomas, while liquid-based cytology (LBC) has much improved diagnostic accuracy, sensitivity, and specificity. The aim of this study was to compare the morphologic features and diagnostic efficacy of CellprepPlus(R) LBC with those of CS for urine cytology. METHODS: A total of 713 cases of urine specimens collected from November 2009 to September 2010 were included. All specimens were divided equally for the preparation of CellprepPlus(R) LBC and CS for each case. RESULTS: CellprepPlus(R) revealed more cellularity, a cleaner background and better cytomorphologic features, but it showed a less intact architectural pattern compared to that of CS. Of the 88 histologically confirmed cases, the diagnostic sensitivity for CellprepPlus(R) was 50% and higher than the 37.5% for CS. The specificity of both preparations was 100%. CONCLUSIONS: The CellprepPlus(R) showed an improved quality of slides and provided better diagnostic accuracy, thus CellprepPlus(R) could be a first-line screening tool in urinary tract cytology.

Characterization of Monoclonal Antibodies against Human Leukocyte Common Antigen (CD45)

BACKGROUND: The leukocyte common antigen (CD45) is a transmembrane-type protein tyrosine phosphatase that has five isoforms. METHODS: We generated seven murine mAbs against human CD45 by injecting cells from different origins, such as human thymocytes, PBMCs, and leukemic cell lines. By using various immunological methods including flow cytometry, immunohistochemistry, and immunoprecipitation, we evaluated the reactivity of those mAbs to CD45 of thymus as well as tonsil lysates. Furthermore, we transiently transfected COS-7 cells with each of gene constructs that express five human CD45 isoforms respectively, and examined the specificities of the mAbs against the transfected isoforms. RESULTS: In case of thymocytes, lymphocytes, and monocytes, all the seven mAbs demonstrated positive reactivities whereas none was reactive to erythrocytes and platelets. The majority of immune cells in formalin-fixed paraffin-embedded thymus and tonsil tissues displayed strong membranous immunoreactivity, and the main antigen was detected near 220 kDa in all cases. Among the mAbs, four mAbs (AP4, DN11, SHL-1, and P6) recognized a region commonly present in all the five isoforms. One mAb, YG27, recognized four isoforms (ABC, AB, BC, and O). Two mAbs, P1 and P14, recognized the isoforms that contain exon A encoded regions (ABC and AB). CONCLUSION: In this study, we confirmed that AP4, DN11, SHL-1, YG27 and P6, are mAbs reactive with the CD45 antigen whereas P1 and P14 are reactive with the CD45RA antigen.

CellprepPlus(R) Liquid-based Smear in Sono-guided Thyroid Fine Needle Aspiration: A Comparison of Conventional Method and CellprepPlus(R) Liquid-based Cytology

BACKGROUND: Fine needle aspiration (FNA) of the thyroid is a useful tool for the evaluation of benign or malignant thyroid nodules. The improvements in the quality of cytological preparations using the liquid-based cytology (LBC) method have been well-documented. The principal objective of this study was designed to evaluate the diagnostic adequacy, sensitivity, and specificity of the thyroid FNA comparing a conventional smear with the LBC adapted with the filtration method described herein. METHODS: One hundred ninety eight cases of FNA samples obtained from May 2009 to September 2009 were included in this study. All patients were subjected to ultrasound-guided aspiration twice at a target lesion by a radiologist and two types of slides were prepared using conventional smear and LBC. RESULTS: When compared with conventional method, the cellularity was reduced in LBC. However, the malignant tumor cells evidenced the larger and more vesicular nuclei, prominent nucleoli, and distinct nuclear membranes in LBC. Thirty two cases (16.16%) of conventional smear were inadequate, but 96 cases (48.49%) of LBC were inadequate. CONCLUSIONS: Most of the slides using CellprepPlus(R) LBC evidenced lower cellularity and clearer background. However, the conventional smears were found to generate much more applicable samples than CellprepPlus(R) LBC.

Gastroduodenal Intussusception Caused by a Peutz-Jeghers Polyp in a Young Child: A Case Report

Gastroduodenal intussusception is a rare condition caused by the prolapse of a gastric tumor with subsequent invagination of a portion of the gastric wall into the duodenum. Various gastric lesions including adenoma, lipoma, leiomyoma, hamartoma, adenocarcinoma, gastrointestinal stromal tumor (GIST), and as in our case a Peutz-Jeghers polyp, can serve as a lead point of intussusception. Only three cases of gastroduodenal intussusception secondary to a Peutz-Jeghers polyp have been reported. We experienced a case of gastroduodenal intussusception in a 36-month-old boy who presented with intermittent nonbilious vomiting, abdominal pain, and anemia. An abdominal ultrasound and contrast enhanced CT scan showed gastrointestinal intussusception and a mass-like lesion in the second portion of duodenum. A laparotomy revealed a 7x8 cm sized mass at the gastric body, which was pathologically confirmed as a Peutz-Jeghers polyp.

Comparison of Cytologic Evaluation between Conventional Method and CellprepPlus(R) Liquid-Based Cytology in Body Fluid

BACKGROUND: Assessment of body fluid cytology is a useful means of evaluating a metastatic tumor. Liquid-based cytology (LBC) has been developed as a replacement for the conventional Papanicolaou (CP) test. This study was performed to compare CellprepPlus(R) LBC with CP in cytologic diagnosis. METHODS: Body fluid samples (n=188, including 72 peritoneal fluid and 116 pleural fluid samples) were divided equally and analyzed by both CellprepPlus(R) and CP. RESULTS: CellprepPlus(R) revealed distributed thin layers of non-overlapping cells. All CellprepPlus(R) preparations were adequate, while 18 (9.57%) CP preparations were inadequate. The respective diagnostic rates of CellprepPlus(R) and CP were 75.0% and 76.1% negative, 10.6% and 6.38% atypical, 5.85% and 2.66% suspicious, and 8.51% and 5.32% malignant. Of the 58 confirmed cases, the sensitivity of CellprepPlus(R) and CP was 94.4% and 73.3%, respectively, and the negative predictive value was 97.2% and 87.9%, respectively. CONCLUSIONS: CellprepPlus(R) LBC has better sensitivity and negative predictive value, and produces higher quality slide preparations than than CP, making it suitable as in screening of body fluid as a cytologic diagnostic tool.