SATB2 as a Marker of the Proximal Nephron: Expression in Nephrogenic Adenoma and Correlation With Other Renal Tubular Markers.

Nephrogenic adenoma (NA) is an infrequent reactive urothelial lesion. The expression of immunohistochemical renal tubular markers has been reported in NA, although a proximal or distal nephron phenotype has not been established. Special AT-rich sequence-binding protein 2 (SATB2) is a marker of a colorectal origin of adenocarcinomas, occasionally reported in renal samples. We have analyzed SATB2 expression in NA, with correlation with other tubular markers, as well as in the normal kidney. Fifty cases of NA were immunostained with PAX8, SATB2, proximal nephron markers [CD10, renal cell carcinoma (RCC) marker, alpha-methylacyl-CoA racemase (AMACR), and CD15], and distal markers (Ksp cadherin, cytokeratin 7, E-cadherin (E-cad), and cytokeratin 19). Ten normal kidney sections were stained with a double method combining SATB2 plus CD10, RCC marker, AMACR, Ksp cadherin, cytokeratin 7, or E-cad. All NA were immunoreactive for PAX8 and 57% for SATB2. Every case was positive for proximal and distal nephron markers: 100% for cytokeratins 7 and 19, 84.1% E-cad +, 81.6% AMACR +, 68.9% Ksp cadherin +, 63% CD15 +, 53.3% CD10 +, and 28.6 % RCC +. In the normal kidney, SATB2 was detected in the straight part of the proximal tubules and the thin descending loops of Henle. NA shows a multiphenotypic pattern with coexpression of both proximal and distal nephron markers, and constant expression of PAX8, cytokeratins 7 and 19. SATB2 is often positive in NA, which should be kept in mind to avoid a possible misdiagnosis of intestinal adenocarcinoma. SATB2 is a marker of the normal proximal nephron.

Intraductal Carcinoma of the Prostate without High-Grade Invasive Adenocarcinoma: Report of Two Cases and Review of the Literature.

OBJECTIVES: Intraductal carcinoma of the prostate (IDC-P) is usually associated with high grade, aggresive acinar adenocarcinomas. IDC-P is supposed to result from the spread of the adenocarcinoma along the prostatic ducts. IDC-P rarely occurs without invasive carcinoma or with a coexistent low grade adenocarcinoma. MATERIAL AND METHODS: We report two patients, 66 and 75 year-old, who presented IDC-P and low-grade acinar adenocarcinoma foci in their radical prostatectomy surgical specimens. RESULTS: Acinar adenocarcinomas were grade group 1, PTEN+, pT2. In the first case, the invasive adenocarcinoma was adjacent but nor intermingled with the IDC-P, and a discordance in the immunophenotype between them was outstanding (positivity for ERG in the acinar carcinoma being negative in the IDC-P). In the second case, the foci of adenocarcinoma were distant from the IDC-P. The first patient had not biochemical recurrence after a 34 month follow-up period. CONCLUSIONS: This kind of cases supports the existence of an infrequent subtype of IDC-P that could be considered as an in situ neoplasia.

Intraductal Carcinoma of the Prostate without High-Grade Invasive Adenocarcinoma: Report of Two Cases and Review of the Literature

Objectives: Intraductal carcinoma of the prostate (IDC-P) is usually associated with high grade, aggresive acinar adenocarcinomas. IDC-P is supposed to result from the spread of the adenocarcinoma along the prostatic ducts. IDC-P rarely occurs without invasive carcinoma or with a coexistent low grade adenocarcinoma. Material and Methods: We report two patients, 66 and 75 year-old, who presented IDC-P and low-grade acinar adenocarcinoma foci in their radical prostatectomy surgical specimens. Results: Acinar adenocarcinomas were grade group 1, PTEN+, pT2. In the first case, the invasive adenocarcinoma was adjacent but nor intermingled with the IDC-P, and a discordance in the immunophenotype between them was outstanding (positivity for ERG in the acinar carcinoma being negative in the IDC-P). In the second case, the foci of adenocarcinoma were distant from the IDC-P. The first patient had not biochemical recurrence after a 34 month follow-up period. Conclusions: This kind of cases supports the existence of an infrequent subtype of IDC-P that could be considered as an in situ neoplasia (AU)

Objetivos: El carcinoma intraductal de la próstata(CIDP) aparece generalmente asociado a adenocarcinomasacinares agresivos, de alto grado. En general se cree que elCIDP representa una forma de diseminación deladenocarcinoma a los ductos prostáticos. En ocasiones elCIDP aparece, sin embargo, sin tumor infiltrante o conadenocarcinomas de bajo grado.Material y Métodos: Presentamos dos pacientes de66 y 75 años, que en las piezas de prostatectomía radicalpresentaron CIDP y focos de adenocarcinoma acinar degrupo de grado bajo.Resultados: Los adenocarcinomas acinares eran degrupo de grado 1, PTEN+, pT2. En el primer caso, eladenocarcinoma se localizaba adyacente, pero noentremezclado, con el CIDP, y destacaba la discordanciaen el inmunofenotipo entre el adenocarcinoma, ERG+, y elCIDP, que era ERG-. En el segundo, los focos de adenocarcinoma se localizaban a distancia del CIDP. Elprimer paciente no ha presentado recidiva bioquímica tras34 meses de seguimiento.Conclusiones: Las características de los casos quepresentamos apoyan la existencia de un subtipoinfrecuente de CIDP que se podría considerar como unaneoplasia in situ. (AU)

[Cases of circumscribed palmar or plantar hypokeratosis]. / Hipoqueratosis palmar o plantar circunscrita: aportación de dos nuevos casos.

Circumscribed palmar or plantar hypokeratosis (CPH) is a depressed, well-delimited, erythematous lesion usually found in the thenar and hypothenar regions of the palms or the soles, predominately in women. It was first described by Pérez et al. in 2002 as a benign entity of unknown origin. Histologically, the depressed area corresponds to a thinning of the stratum corneum. It is a well-demarcated lesion with a sharp stair in the stratum corneum between normal and involved skin and the affected corneocytes are more eosinophilic than normal. We present two new cases of CPH, both occurring in females and in the hand, one of which was located in the thenar region and the other in the finger. We discuss the histopathological and dermatoscopical findings.

Hipoqueratosis palmar o plantar circunscrita: aportación de dos nuevos casos / Cases of circumscribed palmar or plantar hypokeratosis

La hipoqueratosis circunscrita palmar o plantar (HCP) es una lesión deprimida bien delimitada, eritematosa, de localización más frecuente en las regiones tenar e hipotenar de palmas y plantas, que afecta predominantemente a mujeres. Fue descrita por Pérez et al. en 2002 como una nueva entidad benigna de etiología desconocida. Histológicamente el área deprimida corresponde a un adelgazamiento del espesor de la capa córnea. El límite entre capa córnea normal y adelgazada tiene forma de escalera raída y los corneocitos son más eosinofílicos que los normales adyacentes. Presentamos dos nuevos casos de HCP en mujeres, localizados uno en la región tenar y el otro en un dedo de la mano, con los hallazgos histológicos y dermatoscópicos.(AU)

Circumscribed palmar or plantar hypokeratosis (CPH) is a depressed, well-delimited, erythematous lesion usually found in the thenar and hypothenar regions of the palms or the soles, predominately in women. It was first described by Pérez et al. in 2002 as a benign entity of unknown origin. Histologically, the depressed area corresponds to a thinning of the stratum corneum. It is a well-demarcated lesion with a sharp stair in the stratum corneum between normal and involved skin and the affected corneocytes are more eosinophilic than normal. We present two new cases of CPH, both occurring in females and in the hand, one of which was located in the thenar region and the other in the finger. We discuss the histopathological and dermatoscopical findings.(AU)