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Objective: To assess the utility of four immunohistochemical stains in the categorization of hepatoblastoma. Study Design: Retrospective longitudinal study. Place and Duration of Study: Histopathology Department, Shaukat Khanum Memorial Cancer Hospital, Peshawar Pakistan, from 2016 to 2018. Methodology: We retrospectively reviewed 50 cases of hepatoblastoma from 2016-2018, from our hospital database and studied the pattern of four immunohistochemical stains (Beta-catenin, Glutamine synthetase, Heppar 1 and Cyclin D1) in various subtypes. Results: Ten out of fifty cases were mixed epithelial and mesenchymal hepatoblastomas, and forty were pure epithelial. In the pure epithelial category, the fetal subtype showed Heppar 1 and Cyclin D1 positivity in twenty-eight cases, while Glutamine synthetase and Beta-catenin were positive in all the thirty cases. One case of embryonal subtype displayed negativity for Heppar 1; the rest of the immunohistochemical stains were positive. Ten tumours exhibiting mixed epithelial and mesenchymal morphology showed positivity for all the four immunohistochemical stains in the epithelial component. However, Heppar 1 and cyclin D1 were negative in the mesenchymal component in all the ten cases. Five cases (50%) showed Glutamine synthetase and Beta-catenin positivity in the mesenchymal component. Conclusion: All the four immunohistochemical stains, especially Beta-catenin and Glutamine synthetase, were efficient diagnostic tool, especially for tumours with complex or vague morphological features. [ABSTRACT FROM AUTHOR]

Objective: To investigate the incidence ERG fusion positive adenocarcinoma and its correlation with gleason grade and gleason group. Study Design: Cross-sectional study. Place and Duration of Study: Shaukat Khanum Memorial Cancer Hospital & Research Centre (SKMCH & RC), Lahore Pakistan, from Jan 2018 to Jan 2019. Methodology: A total of 100 cases of prostatic adenocarcinoma were retrieved and ERG immunohistochemical stain was applied on all these cases. ERG expression, extent of staining, percentage of tumor cells positive for ERG, pattern of staining was recorded. We found out relationship of ERG expression and gleason grade/gleason group. Results: ERG expression was seen in 62/100 (62%) cases. Mean patient age of ERG positive prostatic adenocarcinoma patients was 69.68 years. In GG1 (14.5%) 9 cases exhibited ERG positivity. In GG2-3, 41.93% cases and in GG4-5, 43.54% cases showed ERG expression. Conclusion: To conclude, age of presentation of ERG positive adenocarcinoma was high. ERG expression was seen in 62% of our cases which was much higher than reported in other Asian countries. In our study we found a significant correlation between ERG expression and high gleason grade group. [ABSTRACT FROM AUTHOR]

Objective: To assess the expression of GATA-3 among epithelial tumors of four organs including invasive mammary carcinoma, prostatic adenocarcinoma, colorectal carcinoma and high grade serous carcinoma of ovary. Study Design: Case series study. Place and Duration of Study: The study was performed at Shaukat Khanum Memorial Cancer Hospital and Research Center, from Jul 2017 to Dec 2017. Methodology: Twenty cases of each of these tumors were collected and stained with ready to use GATA-3 immunohistochemical stain (Cell marque (L50-823) mouse monoclonal antibody) using BOND III Leica automated immunostainer. The expression of the antibody was assessed by two histopathologists. Diffuse nuclear staining in more than 30% of tumor cells was considered as positive. Results: All the breast carcinomas showed diffuse strong positivity in tumor cells, while all the cases of prostatic adenocarcinoma showed negative staining. Aberrant and focal staining was observed in a few cases of high grade serous and colorectal carcinomas. Three cases of high grade serous carcinoma showed weak nuclear staining in 10% of cells. Only one case of colorectal carcinoma showed weak nuclear blush in 10 to 20% of tumor cells. Conclusion: GATA-3 was found a sensitive and specific marker for mammary carcinomas. It is a useful diagnostic tool and should be included in a panel of immunohistochemical markers when working on a metastatic tumor of unknown origin. [ABSTRACT FROM AUTHOR]

Objective: To differentiate ovarian clear cell carcinoma and serous carcinoma by expression of Napsin A positivity. Study Design: Cross-sectional & descriptive study. Place and Duration of Study: The study was conducted in Shaukat Khannam Memorial cancer hospital from 2016 to 2017. Material and Methods: A total of n=59 cases of previously diagnosed cases of clear cell carcinoma and high grade serous carcinoma were selected for this study. The slides were reviewed by an expert panel. Napsin A (MRQ-60) Ventana monoclonal antibody was applied to all the cases. Weak to strong membranous staining in more 5% tumor cells was considered positive. Results: Mean age of patients in the study was 46.25 ± 11.1 years. There were n=33 (55.9%) cases of serous carcinoma, n=23 (38.9%) cases of clear cell carcinoma and n=3 (5.08%) cases had biphasic morphology. CK7 was applied and showed positive expression in all the cases. Napsin A was found positive in all the cases of clear cell carcinoma as compared to only n=1 (3%) high grade serous carcinomas and none of the mixed tumors. The relationship was considered significant with a p-value of <0.05. Conclusion: Expression of Napsin A showed a significant difference in high grade serous carcinoma and clear cell carcinoma. Therefore, Napsin A was found a sensitive and specific marker for the diagnosis of ovarian clear cell carcinoma and can reliably differentiated it from high grade serous carcinoma. Current research recommends a study with large sample size to insight the expression of Napsin A and other immunohistochemical stains. [ABSTRACT FROM AUTHOR]

Objective: To study the morphological and immunohistochemical features of solid pseudopapillary tumor of pancreas. Study Design: Retrospective study. Place and Duration of Study: Shaukat Khanum Memorial Cancer Hospital and Research Centre from Jun 2016 to Mar 2017. Material and Methods: Sixty-four patients (n=64) including 61 females and 3 males with pathological diagnosis of solid pseudopapillary tumor were selected from archives of Shaukat Khanum Memorial Cancer Hospital and Research Center for the period of 2000-2017. For the sample selected, their morphological features and immunohistochemical profile were reviewed and analyzed. The morphological features are considered as gold standard for the diagnosis. Results: The mean age was 33 years (range 8-50 years). Immunohistochemical stains were performed on formalin fixed paraffin embedded section of 55 cases. Pancytokeratin was performed on 8 cases, out of which only 2 cases showed positivity. CD10 was performed on 14 cases, out of which only 12 cases showed positivity. Neuron specific enolase (NSE), CD56, vimentin, progesterone receptor (PR) and ß catenin were performed on 8,5,3,13 and 16 cases respectively and showed positivity in majority of cases. Neuroendocrine markers (chromogranin and synaptophysin) were performed on 25 and 6 cases, from which it showed weak positivity in 3 cases. CD99 was performed on 19 cases and showed characteristic dot like staining. Conclusion: Among the immunohistochemical stains, CD99 had a specific dot like staining pattern and was used as a first line marker in diagnosis. [ABSTRACT FROM AUTHOR]