ABSTRACT
INTRODUCTION: Preoperative diagnostic imaging of pancreatic solid pseudopapillary neoplasms (SPNs) is challenging. A few studies have investigated the role of endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) for the diagnosis of SPN. We investigated the diagnostic yield of cell-blocks and immunohistochemistry (IHC) for SPN using EUS-FNA specimens without cytological evaluation. PATIENTS AND METHODS: We retrospectively analysed the histopathology records of patients with suspected SPN, who underwent EUS-FNA biopsy between January 1997 and January 2020. Diagnosis based on cell-blocks (haematoxylin-eosin staining with complementary IHC) was compared with the definitive surgical diagnosis. RESULTS: This study included 25 patients (24 were women). Patients' mean age was 33.7 years (range 12-78 years). The most common symptom was abdominal pain. SPN was an incidental finding in 52% of the patients. The mean lesion size was 4.3 cm (range 1.2-11.4 cm), and the most common endosonographic features included solid-cystic (56%) or solid (40%) tumours. Final diagnoses included SPNs (n = 23) and non-functioning neuroendocrine tumours (n = 2). The overall accuracy of EUS-FNA was 80%. Tumour cells showed immunopositivity for ß-catenin, CD10, CD99 and progesterone receptor (PR) in 93.7%, 87.5%, 83.3% and 66.6% of patients, respectively. No SPN showed immunopositivity for chromogranin A. CONCLUSIONS: Intention-to-diagnose analysis showed that the diagnostic accuracy of EUS-FNA for SPNs using cell blocks and complementary IHC without cytological evaluation was fairly good. Evaluation of ß-catenin, CD 10, CD99 and PR expression must be included in the IHC panel for diagnostic confirmation of SPNs using EUS-FNA biopsy specimens.
Subject(s)
Pancreas/pathology , Pancreatic Neoplasms/diagnosis , Pancreatic Neoplasms/pathology , 12E7 Antigen/metabolism , Adolescent , Adult , Aged , Child , Endoscopic Ultrasound-Guided Fine Needle Aspiration/methods , Endosonography/methods , Female , Humans , Immunohistochemistry/methods , Male , Middle Aged , Neprilysin/metabolism , Pancreas/metabolism , Pancreatic Neoplasms/metabolism , Receptors, Progesterone/metabolism , Retrospective Studies , Young Adult , beta Catenin/metabolismABSTRACT
Glioblastoma (GBM) is the most aggressive type of brain tumor, with an overall survival of 17 months under the current standard of care therapy. CD99, an over-expressed transmembrane protein in several malignancies, has been considered a potential target for immunotherapy. To further understand this potentiality, we analyzed the differential expression of its two isoforms in human astrocytoma specimens, and the CD99 involved signaling pathways in glioma model U87MG cell line. CD99 was also analyzed in GBM molecular subtypes. Whole transcriptomes by RNA-Seq of CD99-siRNA, and functional in vitro assays in CD99-shRNA, that are found in U87MG cells, were performed. Astrocytoma of different malignant grades and U87MG cells only expressed CD99 isoform 1, which was higher in mesenchymal and classical than in proneural GBM subtypes. Genes related to actin dynamics, predominantly to focal adhesion, and lamellipodia/filopodia formation were down-regulated in the transcriptome analysis, when CD99 was silenced. A decrease in tumor cell migration/invasion, and dysfunction of focal adhesion, were observed in functional assays. In addition, a striking morphological change was detected in CD99-silenced U87MG cells, further corroborating CD99 involvement in actin cytoskeleton rearrangement. Inhibiting the overexpressed CD99 may improve resectability and decrease the recurrence rate of GBM by decreasing tumor cells migration and invasion.
Subject(s)
12E7 Antigen/genetics , 12E7 Antigen/metabolism , Brain Neoplasms/genetics , Gene Expression Profiling/methods , Glioblastoma/genetics , Up-Regulation , Brain Neoplasms/metabolism , Cell Line, Tumor , Cell Movement , Focal Adhesion Kinase 1/genetics , Gene Expression Regulation, Neoplastic , Gene Knockdown Techniques , Genes, src/genetics , Glioblastoma/metabolism , Humans , Neoplasm Invasiveness , Protein Isoforms/genetics , Protein Isoforms/metabolism , RNA, Small Interfering/pharmacology , Sequence Analysis, RNAABSTRACT
BACKGROUND: Nodular fasciitis is a benign pseudosarcomatous, self-limited, and reactive process. Based on its clinical and histological features - a fast-growing, solitary tumor with high cellularity and mitotic count - nodular fasciitis is considered to be a benign mimic of sarcoma. METHODS: We present four cases of nodular fasciitis and a review of the literature. RESULTS: The cases we present were initially misdiagnosed as sarcoma; two as dermatofibrosarcoma protuberans, one as atypical fibroxanthoma, and one as leiomyosarcoma. CONCLUSION: Awareness of this entity among dermatologists is important as misdiagnosis may lead to unnecessary treatments associated with increased morbidity.