Comparative topoisomerase IIa and ki 67 protein expression in papillary thyroid carcinoma based on tissue microarrays and image analysis.

PURPOSE: Topoisomerase II alpha (Topo IIa gene location 17q21) is a nucleic enzyme involved in the DNA replication, transcription and chromosome topological formation. Topo IIa inhibition strategies include specific chemotherapeutic agents such as anthracyclines. Our aim was to investigate potential protein alterations of the enzyme comparing them to ki 67 proliferation marker expression in papillary thyroid carcinoma (PTC). MATERIALS AND METHODS: Using tissue microarray (TMA) technology, 50 specimens consisting of histologically confirmed PTCs (n=20), multi-nodular goiters (n=20) and also normal thyroid epithelia (n=10) were cored and re-embedded in the final paraffin block. Immunohistochemical analysis was performed using monoclonal anti-Topo IIa and anti-ki 67 (MIB-1) antibodies. Digital image analysis assay was also applied for the evaluation of the protein expression results (Nuclear Labeling Index-NLI). RESULTS: Topo IIa and ki 67 proteins were overexpressed in 4/20 (20%) and 14/20 (70%) cases, respectively. Concerning multi-nodular goiters, overexpression was observed in 2/20 and 4/20 specimens, respectively. Statistical association was assessed correlating ki 67 expression to pathology type, capsular invasion and also to vascular infiltration (p=0.001, p=0.008, and p=0.012, respectively). Topo IIa protein expression was strongly correlated only to capsular invasion (p=0.004). Overall expression of the examined markers demonstrated a medium concordance (kappa=0.27), but a strong association (p=0.001). CONCLUSION: Topo IIa and also ki 67 overexpression are correlated to an aggressive phenotype in PTC. Topo IIa overexpression maybe is a reliable marker for a rational application of targeted chemotherapeutic strategies in some subgroups of patients.

Metastatic disease in the breast from nonmammary neoplasms.

Breast cancer is the leading cause of death from cancer in women. The metastatic involvement of the breast from nonmammary neoplasms is a relatively rare condition. Female patients are affected five to six times more frequently than male patients. We present seven patients with metastasis in the breast from extramammary tumors. Females seemed to be more frequently affected (6 women and 1 man) and included a wide range of ages (17-70 years old). All female patients had suspicious-looking abnormalities (B1-RADS 4) or lesions highly suspicious of malignancy (BI-RADS 5) in the mammography, without a confirmative fine needle aspiration cytology. The primary malignancies were equally distributed between non-hematological (1 renal adenocarcinoma, 1 melanoma, 1 leiomyosarcoma) and hematological (1 non-Hodgkin's, 2 Hodgkin's lymphomas and 1 leukemia). Treatment is therefore modified, taking into consideration the treatment and prognosis of the primary disease.

Vascular tumors of the female genital tract: a clinicopathological study of nine cases.

UNLABELLED: The aim of this study was to investigate the clinicopathological features of nine unusual vascular tumors of the female genital tract and to investigate the problems in the differential diagnosis from other genital lesions. MATERIAL-METHODS: In a review of 15,000 specimens of the female genital system examined in our Laboratory during the last decade, nine cases of vascular tumors were found. RESULTS: A capillary hemangioma of the endometrium, one capillary and one cavernous hemangioma of the cervix, six vulva lesions (one capillary, and one cavernous hemangioma and four angiokeratomas) and one hemangiosarcoma of the mons pubis in a 76-year-old patient were diagnosed. CONCLUSIONS: The differential diagnosis of the vascular tumors must be made mainly from endometriotic lesions and melanomas. Immunohistochemistry (S-100, CD31, CD34, CKS, EMA) aid in the diagnosis. Local excision is adequate for the benign vascular lesions.