Characterization and spatial distribution of the immune cell infiltrate in triple-negative breast cancer: a novel classification based on plasma cells and CD8+ T cells.

Stromal tumor-infiltrating lymphocytes (sTILs) are a robust prognostic and predictive biomarker in triple-negative breast carcinoma. However, the sTIL compartment comprises different cell populations. The aim of the study is to characterize the distribution of T cells (CD3+ and CD8+), B cells, and plasma cells and explore their association with outcome in the surgical specimen of 62 patients. Furthermore, programmed death ligand 1 expression and the presence of tertiary lymphoid structures (TLSs) are explored. Patients with higher sTILs achieve better progression-free survival (PFS) (P = .0013), and tumors have more plasma cells in the infiltrate. Specifically, higher counts of T cells (both CD3+ and CD8+) have better PFS (P = .002 and P = .0086, respectively) as it is observed in tumors with higher infiltration of CD8+ T cells in the tumor core (P = .035). Higher infiltration by B cells and plasma cells shows a positive tendency toward increased PFS (P = .06 and P = .058). Programmed death ligand 1 (SP142) is positive in 56% of tumors. Tumors with at least 1 TLS (42%) show higher CD8+ T cell infiltration in the tumor core and the sTIL value doubles compared to tumors devoid of TLSs [sTIL mean: 36 ± 11% and 18 ± 5% (CI [Confidence Interval]: 95%), respectively]. Our study demonstrates that the characterization of the immune cell infiltration is as relevant as its distribution. Moreover, the importance of considering different immune cell types for classification is emphasized. Therefore, a new classification of triple-negative breast carcinoma immune infiltration with CD8+ T cell and plasma cell densities in the tumor core and infiltrative margin is proposed.

Study of regulatory T-cells in patients with gastric malt lymphoma: influence on treatment response and outcome.

PURPOSE: FOXP3+ regulatory T cells (Treg) play an essential role in modulating host responses to tumors and infections. The role of these cells in the pathogenesis of MALT lymphomas remains unknown. The aims of the study were to quantify the number of infiltrating FOXP3+ and CD3+ cells in patients with gastric MALT lymphoma at diagnosis and to study kinetics of these cells and CD20+ tumor cells after treatment and during long-term follow-up. METHODS: FOXP3+, CD3+ and CD20+ cells were analyzed by immunohistochemistry and the number of cells was quantified using a micrometric ocular. Samples of 35 patients with gastric MALT lymphoma at diagnosis and after treatment were included. Diagnostic samples were compared to 19 cases of chronic gastritis and diffuse large B-cell lymphoma (DLBCL) of the stomach. RESULTS: The median number of FOXP3+ infiltrating cells was higher (27 cells/cm(2)) in gastric MALT patients than in DLBCL (10 cells; p = 0.162) but similar to chronic gastritis (20 cells; p = 0.605). No characteristic or specific distribution pattern of infiltrating FOXP3+ cells was found. Gastric MALT lymphoma patients responding to bacterial eradication therapy had higher number of FOXP3+ cells at study entry. Kinetics of both infiltrating FOXP3+ cells and tumor CD20+ cells were strongly dependent on the treatment administered. DISCUSSION: Gastric MALT lymphomas have a number of Treg cells more similar to chronic gastritis than to DLBCL. Patients with higher number of tumor infiltrating FOXP3+ cells at study entry seem to have better response to antibiotics. Kinetics of Treg and tumor cells are influenced by type of treatment.

Expression of estrogen and progesterone receptors in the anal canal of women according to age and menopause.

PURPOSE: Fecal incontinence is highly prevalent, especially in menopausal women. The aim of this study was to analyze the expression of estrogen and progesterone receptors in the anal canal of women in relation to menopausal status and age. METHODS: Samples of hemorrhoidal tissue were obtained from 34 women undergoing hemorrhoidectomy. The patients were divided into 2 groups: group 1 consisted of women with a menstrual cycle (n = 17) and group 2 consisted of postmenopausal women (n = 17). Immunostaining of hormone receptors was performed using specific antibodies (DAKO, Copenhagen, Denmark) in cells from the internal anal sphincter, the vascular epithelium, and the squamous epithelium. The percentage of positivity of receptors and the association between age and receptor positivity were compared between the 2 groups. RESULTS: Estrogen receptors were found in the internal anal sphincter in 23.5% in group 1 vs 11.8% in group 2 (P = .656). Progesterone receptors were found in 41.2% in group 1 vs 11.8% of group 2 (P = .118). Squamous epithelium showed estrogen receptors in 52.9% in group 1 vs 64.7% of group 2 (P = .388) and progesterone receptors in 17.6% and 0% in groups 1 and 2, respectively (P = .227). Vascular endothelium showed no receptors. Receptor positivity was not associated with age. CONCLUSION: No significant differences were found in the detection of estrogen and progesterone receptors in structures of the anal canal in women in relation to menopausal status and age.

Síndrome de Meigs y peritonitis esclerosante: una asociación poco frecuente / Meigs’ syndrome and sclerosing peritonitis: an uncommon association

Los tecomas ováricos son tumores estromales relativamente frecuentes que ocasionalmente pueden asociarse con derrame pleural. Los tecomas pueden presentar focos de luteinización y en estos casos se pueden asociar a peritonitis esclerosante. Esta entidad es muy poco frecuente, presenta características histopatológicas propias y clínica heterogénea. Se presenta el caso de una mujer posmenopáusica con dificultad respiratoria y un tumor anexial con sospecha clínica de cáncer ovárico metastásico cuyo estudio anatomopatológico evidenció un tecoma luteinizante con peritonitis esclerosante. Debido a la asociación de una masa ovárica junto a las manifestaciones clínicas que causaba la peritonitis esclerosante es relativamente usual que el diagnóstico de presunción sea de tumor maligno. Todo ello hace importante conocer la entidad, cuya fisiopatología y tratamiento no están consensuados (AU)

Ovarian thecomas are relatively frequent stromal tumors that can occasionally be associated with pleural effusion. Thecomas may contain luteinized foci, and in these cases, can be associated with sclerosing peritonitis. This is a rare, clinically diverse, entity, with its own histopathologic features. We report the case of a postmenopausal woman with respiratory symptoms, bilateral adnexal tumors and suspected metastasizing ovarian cancer, which histopathological study revealed to be a luteinized thecoma associated with sclerosing peritonitis. Due to the clinical manifestations derived from the sclerosing peritonitis and the abdominal mass, a presumptive diagnosis of malignant tumor is quite common. Familiarity with this entity is therefore important. There is no consensus on its physiopathology and treatment (AU)