Unique immunohistochemical profiles of MUC5AC, MUC6, P53, and Ki67 in gastric atypical hyperplasia and dysplasia.

OBJECTIVES: Differentiating gastric atypical hyperplasia (AH) from dysplasia, including low-grade dysplasia (LGD) and high-grade dysplasia (HGD), poses significant challenges in small biopsies and specimens with technical artifacts. This study aims to establish objective diagnostic criteria for these conditions through combined morphologic and immunohistochemical (IHC) analyses. METHODS: Between January 2018 and September 2020, a total of 123 gastric mucosa biopsy specimens were collected at Anyang Tumor Hospital. According to the WHO Classification of Digestive System Tumors (5th edition), specimens were categorized into three groups: AH (n=48), LGD (n=30), and HGD (n=45). Morphologic characteristics were assessed, and IHC staining for MUC5AC, MUC6, MUC2, CD10, P53, and Ki67 was performed, followed by statistical analysis. RESULTS: Histologically, AH was predominantly marked by a pronounced inflammatory background (60.42%), intestinal metaplasia (64.58%), indistinct boundaries (83.33%), and a distinct maturation gradient (97.72%). AH nuclei were typically circular (97.92%), with a high nucleus-to-cytoplasm ratio (64.58%), prominent nucleoli (47.92%), and preserved polarity (89.58%). In contrast, LGD and HGD typically exhibited well-defined boundaries with an absent maturation gradient. LGD nuclei were rod-shaped (96.67%), with a low nucleus-to-cytoplasm ratio (96.67%) and preserved polarity (100%), whereas HGD demonstrated a loss of cellular polarity (77.78%). IHC findings revealed a consistent maturation gradient in AH, with polarized MUC5AC and MUC6 expression, significantly reduced in LGD (86.67%), and absent in HGD. P53 expression in HGD showed a predominant 'mutation-type pattern' (66.67%), contrasting with 'wild-type pattern' expression in AH and LGD (100%, 93.33%). Ki67 expression patterns varied from a 'pit neck pattern' in AH (95.83%) to a 'polarity pattern' in LGD (76.67%) and a 'diffuse pattern' in HGD (57.78%). The expression patterns of MUC5AC, MUC6, CD10, P53, and Ki67 varied significantly across the three groups (P<0.001). CONCLUSIONS: The integration of histomorphological features and expression profiles of MUC5AC, MUC6, P53, and Ki67 is instrumental in diagnosing gastric atypical hyperplasia and dysplasia.

Primary squamous cell carcinoma of the breast: report of two cases with HER2 overexpression.

OBJECTIVE: To investigate the clinicopathologic features and immunophenotype of primary squamous cell carcinoma of the breast (PSCCB) with HER2 overexpression. Methods Two cases of PSCCB with HER2 overexpression were retrospectively reviewed, and the pathological features, immunophenotype and prognosis were discussed. Results The tumor showed malignant squamous cells arranged in sheets, groups and nests, forming keratin-pearl and intercellular bridges. Immunohistochemical (IHC) analysis showed that the tumor cells were positive for 34ßE12, p63, CK5/6, E-cadherin and P120, while negative for ER and PR. Furthermore, HER2 overexpression showed strong continuous expression in cell membrane with a score of 3+ by IHC, or amplification by FISH. Conclusions PSCCB is a rare tumor in breast cancer and HER2 overexpression is rather unusual in PSCCB. The diagnosis mainly depends on the clinicopathologic features together with the immunophenotype. HER2 positive indicates poor prognosis. However, targeted therapy for HER2 may be a new hope for patients.

High incidence of MYC rearrangement in human immunodeficiency virus-positive plasmablastic lymphoma.

AIMS: MYC rearrangements are the main cytogenetic alterations in plasmablastic lymphoma (PBL). We aimed to investigate the relationship between MYC rearrangement and the clinicopathological features of PBL. METHODS AND RESULTS: MYC rearrangements assessed in 13 unpublished single-centre PBL cases, and an additional 85 cases from the literature, with reported MYC rearrangement information individualised by patient, were reviewed. In Asia, PBL was much less commonly diagnosed in human immunodeficiency virus (HIV)-positive patients (27% versus 84%, P = 0.000), with older age (median age at diagnosis: 52 years versus 44 years, P = 0.046) and a lower EBV infection rate (56.8% versus 81.8%, P = 0.049), than in non-Asian regions. Overall, MYC rearrangements were identified in 44 of 98 (44.9%) PBL cases, and IGH was the partner in almost all available cases (30/31, 96.8%), as confirmed with a MYC-IGH fusion probe. The MYC rearrangement rate in HIV-positive cases (33/55, 60.0%) was significantly higher than that in HIV-negative cases (11/38, 28.9%, P = 0.003). Patients with MYC rearrangement showed a trend towards an inferior median survival time (9.6 months versus 15.7 months, P = 0.122) and 2-year overall survival (17% versus 32%, P = 0.238). CONCLUSIONS: MYC rearrangement was frequently identified in PBL patients, and IGH was the partner gene in an overwhelming majority of MYC rearrangements. In addition, the MYC rearrangement rate was significantly higher in HIV-positive PBL patients than that in HIV-negative patients. MYC rearrangement may play an important role in the pathogenesis of HIV-positive PBL, but further studies are required to understand the underlying mechanisms.

Solid pseudopaillary neoplasm of the pancreas: analysis of clinicopathological and immunohistochemical features in 10 cases.

OBJECTIVE: The aim of this study was to investigate the clinicopathological features and immunomarkers of Solid Pseudopapillary Neoplasm of the Pancreas (SPN) and to find the best possible immunomarker combination that can accurately diagnose it. METHODS: We retrospectively analyzed 10 patients who underwent surgery for pathologically confirmed SPN from August 2013 to August 2017. Follow-up of the patients was between 9 and 57 months. RESULTS: Clinical symptoms and imaging were atypical. In general, the mass was encapsulated and clearly defined by the surrounding tissues. Cut surface was dusty-red and associated with hemorrhage. The neoplastic cell cytoplasm was eosinophilic or clear, and the nuclei were round or oval, presenting typical features of pseudopapillary distribution around a fibrovascular core. Immunohistochemical results showed that tumor cells were consistently positive for vimentin, CD56, CD10, PR, CD99, ß-catenin and negative for E-cadherin (100%) and chromogranin. CD99 presented a unique dot-like staining pattern in tumor cells. CONCLUSIONS: In view of the atypical clinical manifestations and imaging features of SPN, accurate diagnosis mainly relies on the histomorphology and immunomarker combination including PR, CD99, ß-catenin, and E-cadherin, which might be useful method in the diagnosis of SPN.

Clinical and pathologic diagnosis and different diagnosis of syphilis cervical lymphadenitis.

PURPOSE: To study the clinical pathologic characteristics and differential diagnosis of syphilitic cervical lymphadenitis, and to improve the rate of its diagnosis and treatment. METHODS: Retrospectively analyzed the clinical history, Trepone pallidum-ELISA (TP-ELISA), rapid plasma regain test (RPR) and routine pathological examination of the patient diagnosed as syphilis lymphadenitis. And review related literatures. RESULTS: The main clinical presentation was multiple palpable cervical lymph nodes. The multiple nodes were hard, fixed, and the major diameter of the larger one was 2 cm. The main pathological changes included: the capsule was significantly thickened; reactive hyperplasia of lymphoid follicular with sky star phenomenon; occlusive endovasculitis; perivascular inflammation; the proliferation of epithelioid histiocytes can form granulomas with few multinucleated giant cells; few necrosis. TP-ELISA and RPR were positive. CONCLUSIONS: The pathological changes of syphilitic lymphadenitis have a variety of performance with relatively specific and suggestive alterations which requires a combination of clinical history and laboratory test before the diagnosis, and the clinicians can reduce misdiagnosis and missed diagnosis of the disease by increasing vigilance of it.

Induction of interleukin 2 expression in the liver for the treatment of H22 hepatoma in mice.

BACKGROUND AND AIMS: We designed this study to evaluate the ability of a plasmid carrying an RU486 regulatory system to induce expression of interleukin-2 (IL-2) gene and to examine the antitumour efficacy of the induced IL-2 gene. METHODS: The plasmid pRS-mIL-2,which contains an RU486 inducible system and IL-2 gene was injected into mice. Sera and tissues from liver, spleen, lungs and kidneys were taken to test the properties of the plasmid. To examine the antitumour efficacy of pRS-mIL-2, tumours were established in the liver by direct inoculation of H22 hepatoma cells. RESULTS: The IL-2 levels in serum correlated with the dose of plasmid and RU486. High and sustained IL-2 levels could be achieved by administration of RU486 every day. The mRNA of transgene IL-2 was found only in the liver. Treatment of mice with pRS-mIL-2 plus RU486 resulted in the significant reduction in tumour volume compared with control groups. CONCLUSIONS: Tight temporal and spatial control of transgene IL-2 expression can be achieved by a plasmid containing an RU486 inducible system driven by liver specific promoter. pRS-mIL-2 exhibited strong antitumour efficacy following consecutive induction with RU486.