CLINICOPATHOLOGICAL STUDY IN TRIPLE NEGATIVE BREAST CANCER

Background and Objectives: - Carcinoma Breast is most common malignancy in females in USA and second among cases deaths in females (after lung cancer). There is considerable geographic , ethnic and racial variability in Breast cancer in evidence with about 5 fold variation throughout the world. Triple negative breast cancer is a heterogonous disease diagnosed by Immune Histo Chemistry (IHC).Triple Negative Breast cancer is characterized by tumor that do not express ER or PR and HER2neu . Proto typical Triple Negative Brest cancer is aggressive in nature and associate with poor prognosis. The Objectives of this study is to analyse the clinical and Pathological features of Triple Negative Breast Cancer and compare the result with similar studies in literature. Fifty Methods:- cases Triple negative Breast Cancer were included in this study. Clinical and pathological features and treatment were noted. Incidence Result:- of Triple Negative Breast Cancer was 35%. The median age of presentation was 45yrs. There were 4% males Triple negative Breast cancer cases out of female patients, most of patients were Pre (or) Perimenopausal(65%). 4% patients had family history of malignantly. Most common stage of presentation was stage III (46%). In Stage IV, Lung and bone metastasis was common. Ten Patients received Neoadjuvant chemo therapy (NACJ) and disease progressed in 4% while on Neoadjuvant chemotherapy, Even though 45 patients had surgery only 34 were eligible to received Adjuvant Radiotherapy. Total of 18% Patients had either progressive disease while on treatment (8%) (or) recurrence 10%. Eighteen percent patients died due to the disease. 33% patients on follow up. There were more Invasive Duct Cell carcinoma (IDCC) cases with medullary differentiations (or) Purse medullary Carcinomas (12%). No deaths Occur in the medullary variants TNBC. Majority of the tumor were high grade margins were negative in most of the cases. Incidence of Tri Inclusion:- ple negative breast cases was higher than western literature but comparable to Indian Studies. The age of Presentation was about 10 years younger than western data. Triple Negative Breast cancer was more common in young, pre (or) perimenopausal women. Small number of patients had family history, majority were state II (or) III. There was high number of progressive disease, recurrence and death while on the study (or) within less than 1 yr of treatment. Triple Negative Breast cancer is very aggressive disease with relatively better prognosis in the medullary variant Triple Negative Breast Cancer.

Intracranial tumor in children:a clinicopathological analysis of 221 cases / 临床与实验病理学杂志

Purpose To analyze the clinical and pathological features of intracranial tumor in children. Methods 221 cases of in-tracranial tumors in children ( ages≤18 years) were retrospectively analyzed. Results The cases of intracranial tumor in children ac-counted for 7. 21% of total cases in our hospital during the same period. There is no documented gender bias. There were only 14 cases (6. 33%) with age less than 3 years old. The supratentorial tumors were 153 cases (69. 23%) and infratentorial tumors were 68 cases (30. 77%) . The most frequently affected sites were the cerebral hemispherse, sellar region, vermis and the fourth ventricle. There were 89 benign tumor and 132 malignant tumor in this series of cases. The most common five tumors were astrocytic tumors (30. 32%), embryonal tumors (19. 00%), craniopharyngiomas (11. 76%), ependymal tumors (8. 14%) and germ cell tumors (5. 88%). Conclusion The morbidity of intracranial tumors in children has increased in the recent years. The histological classifica-tion of intracranial tumors in children is multiple and it is essential to make a correct diagnosis.

Detection ofN-myc andALK abnormality in and clinicopathological analyses of 83 cases of neuroblastoma / 临床儿科杂志

ObjectivesTo retrospectively analyze the clinicopathological features of neuroblastoma (NB) and investigate the signiifcance of abnormality ofN-myc and anaplastic lymphoma kinase (ALK) gene copy number change as well asALKmu-tations in NB.Methods Eighty-three NB patients were collected and classiifed into different subgroups according to the clinical stage and histology. Fluorescence in situ hybridization (FISH) was performed to detect the abnormalities ofN-mycandALK genes. The extracted DNA was ampliifed by PCR and sequenced to investigate the point mutations of theALK gene. Follow-up data were collected and survival analysis was performed.ResultsFISH detection showed that the aberration ofN-mycgene copy number presented as gain and ampliifcation. The aberration ofALK gene presented as point mutation and gain. It was shown that 17 cases had the abnormality of bothN-myc andALK gene. Survival analysis showed that the prognostic factors included the clinical stage, age and abnormality ofN-myc genes.ConclusionDetection ofN-myc andALK abnormality in NB would be helpful for evaluating the prognosis and providing theoretical basis forALK target therapy.

Serous microcystic adenoma of pancreas: a clinicopathological study / 中华肝胆外科杂志

Objective To study the clinicopathological features in the diagnosis of serous microcystic adenoma of pancreas.Method A clinicopathological and immunohistochemical study was conducted on 7 patients with serous microcystic adenoma of pancreas.Results All the patients were female,with a mean age of 51 years.Clinical symptoms were present in 2(28.6％)patients.On microscopy,the tumor composed of variable-sized cysts.The cyst wall was covered by simple cuboidal epithelium.The cytoplasm was clear and glycogen-rich.The nucleus of the epithelial cells was small and round.In the center,there was no nucleolus and no nuclear division.There were bulky fibrous tissues between the cystic cavities.Immunohistochemical study showed AE1/AE3,CK7,CK8,CK19,CK/LMW,EMA were positive,and CEA,CD31,CD34,D2-40,Syn,CgA,Calretinin,Vim were negative.Conclusions Serous microcystic adenoma of pancreas is a rare tumor,which was common in old women.Serous microcystic adenoma of pancreas is a benign tumor with good prognosis.The diagnosis is made on histopathological and immunohistochemical study.

Clinicopathological analysis of 58 cases of gastrointestinal stromal tumor / 肿瘤研究与临床

Objective To investigate the clinical presentation, morphological features, immunohistochemical staining of the gastrointestinal stromal tumor (GIST), and its histogenesis as well. Methods The morphologic characteristics of GISTs were studied in 58 cases using light microscopy. The expression of c-kit(CD117), CD34 and vimentin were detected in all of the cases with EnVision staining. Results Among 58 cases of GISTs, 41 were spindle cell type, 5 epithelioid cell type and 12 mixture type, equivalent to 86.6 %(58 of 67) of all of the mesenchymal tumors of gastrointestinal tract admitted in the same period. The epithelioid cell type tumors were mainly composed of the epitheloid cells, predominantly short spindle, oval or round in pattern, with an overall eosinophilic cytoplasm by hematoxylin-eosin stain. Focal cytoplasmic vacuolization was often seen. Sometimes signet-ring like cells and cells with a clear cytoplasm were seen in the epithelioid stromal tumor. The tumor cells arranged in interlacing fascicles forming whorls or sometimes cell clusters. All of the 58 stromal tumors were strongly positive for vimentin (100 %), 55 out of 58 tumors positive for CD117 (94.8 %) and 46 out of 58 positive for CD34(79.3 %). Some cases also expressed SMA, actin, S-100 and MBP. Conclusions GISTs were the most common mesenchymal tumor seen in the gastrointestinal tract. Under light microscope, the morphology of stromal tumors sometimes looks like a leiomyoma or Schwannoma. The application of immunohistochemical markers (particularly CD117 and CD34) is considered necessary for the differential diagnosis. GISTs may originate from the pluripotential precursor cells like the interstitial cells of Cajal.

Goblet cell carcinoid of the appendix: a clinicopathological analysis of 3 cases / 肿瘤研究与临床

Objective To investigate the histogenesis,clinicopathological features and biological behavior of goblet cell carcinoid (GCC) of the appendix. Methods 3 cases of GCC of the appendix were studied by light microscopy and immunohistochemistry. Results 3 cases all occured in men. Microscopically: the tumor was composed of goblet cells containing mucin-filled with basal round to crescentic nuclei without atypia.These tumor cells were arranged in single forms,nests or acinus with no central lumen. 1 case was composed of simple goblet cells and typical carcinoid cells were seen in other 2 cases arranged in trabeculae and tubule.There was transition between goblet cells with tubelar and crypt epithelium.Immunohistochemical staining revealed that goblet cells were positively reacted with CgA, Syn, CEA, CK and p53 in 1 case. Conclusions Goblet cell carcinoid of the appendix arise from a pluripotent cell with divergent neuroendocrine and mucinous differentiation .It is a subtype of carcinoids of the appendix.The diagnosis mainly bases on its morphologic changes and immunohistochemical findings. The unpredictable behavior of this tumor is probably related to its component and the degree of infiltration.

A Clinicopathological Analysis of 52 Cases of Renal Biopsy in Children

PURPOSE: To evaluate the clinical manifestations of various glomerular diseases in children, a clinicopathological study was performed in 52 children who had renal biopsy. The type and relative incidence of the glomerular pathologies were analyzed, and the clinical predictability and usefulness of renal biopsy in glomerular diseases were assessed. METHODS: Medical records of fifty two children with renal disease who had undergone percutaneous renal biopsy under ultrasonic guidance at Chungnam University Hospial from October 1995 to August 2003 were reviewed. In addition, we compared the clinical findings before renal biopsy with the pathological diagnosis. RESULTS: The male to female ratio was 1.6:1 and they were 9.8 2.6 years old on average. The chief complaints for biopsy were hematuria in 22 cases which was the most common (42.3%), proteinuria in 16 cases(30.8%), and hematuria & proteinuria(26.9%). Among the 22 cases of hematuria, there were 15 cases of gross hematuria(68.2%) and 7 cases of microscopic hematuria(31.8%). In terms of histopathologic diagnosis, most of them were primary glomerular diseases(84.6%), which included IgA nephropathy(28.8%), thin glomerular basement membrane disease(25.0%), focal segmental glomerulosclerosis(FSGS)(11.5%), membranous proliferative glomerulonephritis(7.7%), minimal change lesion(3.8%), acute poststreptococcal glomerulonephritis(3.8%) and membranous glomerulonephritis(3.8%). The clinical manifestations and pathologic diagnosis were not correlated. CONCLUSION: The clinical manifestations could not predict the pathological diagnosis. Therefore, renal biopsy would be inevitable in diagnosis of glomerular diseases for effective management and assessment of prognosis.

Clinicopathological Analysis of Malignant Germ Cell Tumors of Ovary / 대한부인종양콜포스코피학회잡지

Malignant germ cell tumors occur in children and young women in reproductive age, of all the germ cell malignancies, only pure dysgerminomas had a high cure rate prior to 1970. This was due to the exquisite radiosensitivity of these tumors. Multiple-agent chemotherapy has dramatically improved the pmgnosis of patients with malignant ovarian germ cell tumors. Clinicopathological analysis was performed on 21 cases of malignant germ cell tumors of the ovary, 9 cases at the department of Obstetrics & Gynecology, Kyung-pook National University Hospital, 4 cases, at the department of Obstetrics and Gynecology, Dong-guk University Kyungju Hospital and 8 cases, at the department of Obstetrics and Gynecology, Dae-gu Fatima Hospital during the period 10 years from July. 19S8 to June. 1997 The results were summarized as follows: 1. The mean age of the patients was 21.8 years old, ranging from 10 to 61 years old. 2. Main initial symptoms were abdominal distension(33.3%), abdominal mass palpation(33.3%), abdominal pain(28.6%), amenorrhea(4.8%) in order. 3. Histologically, the tumors were classified as immature teratoma(57.1%), dysgerminoma(19%), mixed germ cell tumor(9.5%), endodermal sinus tumor(9.5%), embryonal cell carcinoma(4.8%). 4, According to FIGO classification Stage I was the most prevalent(57.1%) at the time of diagnosis while Stage III was forward in 48.6%, Stage II in 9.5%, and no Stage IV, 5. The 5-year survival rate was 80.4% and three patients have died of malignancy and the other 18 patients live without disease from 11 to 102 months, with a median follow-up of 34.2 months. 6. Prognostic factors of malignant germ cell tumors in this study were the clinical stage, the presence of ascites and the residual tumor mass.

Clinicopathological Analysis on the 104 Cases of Malignant Melanoma

The cliniopathological analysis was done on the 104 cases of malignant melanoma diagnosed at the Seoul National University Hospital (SNUH) from 1984 to 1993. The basic clinical data and the pathological items were based on the New Mexico Melanoma Registry Worksheet. The results were as follows. The male to female ratio was 1 : 0.79. Primary cutaneous melanoma was more common in the male (M : F=1 : 0.56) but primary extracutaneous melanoma with slight female dominancy (M : F=1 : 1.25). The peak age was the 6th decade in both cutaneous and extracutaneous malignant melanoma. In 66% (35 cases) of primary cutaneous malignant melanoma, the primary site was located in the acral area (including cases of acral lentiginous and nodular type), of which 63% (41% of total cutaneous melanoma) was acral lentiginous type. Major components of tumor cells were epithelioid. Clark's level of tumor was III or more at the time of the first visit in the majority of the cases (85%). The incidence rate of extracutaneous melanoma was 34.6% (36 cases) among the primary melanoma, and the eyeball (17.3%) was the most prevalent organ. All these features suggest that the racial difference between the Korean and the Caucasian is evident and also that etiologic role of sun damage is not quite marked in the Korean. We also suggest that an early detection program is very important to cure this malignant tumor.