The role of immunohistochemical staining with CK7 in the differential diagnosis of autoimmune hepatitis.

INTRODUCTION: Although the immunohistochemical staining with cytokeratin 7 (CK7) is an adjuvant method for identifying various components of the intrahepatic biliary system, the expression of CK7 does not occur in hepatocytes. In the literature, some studies suggest that a group of cells having dual morphologic and immunophenotypic characteristics of bile duct epithelium and hepatocytes, referred to as progenitor stem cells, was stained positive with CK7. MATERIALS AND METHODS: In this study, we examined a total of 219 cases diagnosed with autoimmune hepatitis, chronic hepatitis B, chronic hepatitis C, and primary biliary cholangitis between 2005 and 2017 in Uludag University, Faculty of Medicine, Department of Medical Pathology. RESULTS: The comparisons of AIH cases with HepB, HepC and PBC cases demonstrated that the immunoreactivity to CK7 was significantly higher in the AIH group (p < 0.005) compared to the groups of HepB and HepC, whereas no significant differences were found between the AIH and PBC groups. CONCLUSIONS: In our study, it was concluded that the immunoreactivity to CK7 could be used as an adjuvant treatment to the clinicopathologic assessment in distinguishing between the AIH cases and chronic viral hepatitis. However, since CK7 immunoreactive hepatocytes were widely detected also in patients with chronic viral hepatitis, and there was no statistically significant difference between the PBC and AIH cases, it has been established that the inclusion of CK7 immunoreactivity into the diagnostic histopathological criteria for AIH would not be convenient (Tab. 1, Fig. 1, Ref. 22).

The effect of a chitosan coating on the adhesive potential and tensile strength of polypropylene meshes.

PURPOSE: The polypropylene mesh used for the repair of abdominal wall hernia can cause intraabdominal adhesions. In this study, the effect of chitosan coating of the polypropylene meshes on the adhesion and tensile strength of the meshes was investigated. METHOD: After coating polypropylene meshes with 2 % chitosan, 5 × 3 cm patches were prepared. Under general anesthesia, sterile laparotomy was performed in 96 Wistar albino female rats that were equally allocated to 6 groups. In the first group, only laparotomy was performed. In the second group, chitosan was applied to the peritoneal cavity, and the laparotomy was closed. In the third group, polypropylene (prolene) patches were used to close the abdomen; in the fourth group, polypropylene polyglecaprone 25 (ultrapro) mesh patches were used to close the abdomen. In the fifth and sixth groups, chitosan-coated versions of the meshes used in the third and fourth groups, respectively, were applied. All skin incisions were closed in all groups. On the 7th and 21st days, eight randomly selected rats from each group were killed. The abdomen was opened, and the adhesions were evaluated using the diamond score. The tensile strength of the meshes was measured by an Instron 4301 device. The histopathological evaluation of the inflammatory response was performed according to the Ehrlich and Hunt classification. RESULTS: The adhesion score was comparable among mesh groups but higher when mesh groups were compared with the control and chitosan groups (p<0.001). The tensile strength of meshes did not differ among mesh groups. Histopathologically, meshes with or without chitosan were similar in terms of inflammatory findings. CONCLUSIONS: The chitosan coating did not affect the adhesion potential, the tensile strength, or the inflammatory response of the polypropylene meshes.

The relationship between histomorphological characteristics and Ki-67 proliferation index in meningiomas.

OBJECTIVES: This study had two aims. The first was to use the Ki 67 proliferation index (Ki-67 PI) to study the relationship between the proliferation potential and histopathological features such as mitosis, necrosis, loss of architecture, small cell change, hypercellularity, pleomorphism, brain invasion, dura invasion, bone invasion, and histological grade. The second aim was to compare primary and recurrent meningioma with respect to morphological characteristics and Ki-67 PI values. BACKGROUND: Meningiomas are tumors whose histological features do not predict their biological behavior. Despite their slow growth and even after total resection, recurrence may occur METHODS: A total of 245 meningioma cases in whom Ki-67 PI was studied were included in the study. The cases were assessed with respect to 10 morphological characteristics, and a possible significant relationship between these and Ki 67 PI was statistically tested. RESULTS: We found a statistically significant relationship between Ki-67 PI and mitotic activity, necrosis, loss of architecture, small cell change, brain invasion. In contrast to brain invasion, no significant relationship was present between dura or bone invasion and Ki-67 PI. We identified asignificant increase in the histological grade, mitotic activity and Ki-67 PI value of recurrent tumors, as compared to primary ones CONCLUSION: Ki-67 PI values overlap in different grades. This overlapping might be due to the heterogeneity of biological activity within the tumor tissue (Tab. 2, Fig. 7, Ref. 21).

The diagnostic utility of maspin in the distinction between malignant mesothelioma and pulmonary adenocarcinoma.

Immunohistochemistry is frequently employed to differentiate between malignant mesothelioma (MM) and pulmonary adenocarcinoma (AC) infiltrating the pleura, but there is uncertainty as to which antibodies are most useful. The present study investigated the presence of the serine protease, maspin, in epithelioid MMs and evaluated the diagnostic utility of maspin for the differential diagnosis between epithelioid MM and pulmonary AC with pleural involvement. The results showed more frequent maspin immunostaining among AC cases compared with MM cases. Maspin positivity was significantly higher among AC cases with respect to both the extent and intensity of staining. A significant difference also existed between the two tumour types with respect to the overall maspin score. Despite these findings, the sensitivity and specificity of maspin positivity to detect AC were only 59% and 73%, respectively, indicating that detection of maspin is of no value for the differential diagnosis of AC and MM.

Metastasis from breast carcinoma to endometrial polyp.

Metastasis of a breast carcinoma to an endometrial polyp is extremely rare, with only ten cases having been reported in the literature up to now. We present the case of a 60-year-old woman with invasive ductal carcinoma who complained of vaginal bleeding. She underwent hysteroscopy with biopsy. Microscopic examination revealed an endometrial polyp which contained foci of adenocarcinoma. The morphologic features of the tumor were identical to the original breast carcinoma.

Lymphangioma of the ovary: a case report and review of the literature.

Lymphangioma of the ovary is a very rare tumor which is usually silent and identified incidentally at operation or autopsy. We report on a 61-year-old woman with lymphangioma of the ovary and review the relevant literature. The microscopic examination of the left ovary revealed numerous vascular spaces of different dimensions of which the inner surfaces were lined with flattened endothelial cells with neither cellular atypia nor extraluminal or intraluminal proliferation. There was no evidence of haemorrhage or necrosis. The stroma was formed by fibrocollagenous tissue infiltrated by rare lymphocytes. The cells lining vascular spaces were immunoreactive for CD31 by immunohistochemical staining.

Sclerosing stromal tumor of the ovary: report of three cases.

We present 3 cases displaying sclerosing stromal tumor (SST) of the ovary and describe their immunohistochemical and electron microscopic findings. The patients were 23, 24 and 28-year-old and had an ovarian mass. Histologically, the tumors had the typical appearance of SST of the ovary. A pseudolobular pattern which was composed of cellular areas and less cellular areas was seen on low-power microscopy.