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A dermal interstitial lymphocytic infiltrate may represent a diagnostic challenge, particularly if the clinical history is not provided. We present three cases within the histological spectrum of morphea in which the immunohistochemical marker CD34 was helpful in confirming the diagnosis.

CD34 immunostaining increases the sensitivity of placental diagnosis of foetal vascular malperfusion (FVM). This comparative retrospective study was performed to find out whether recent distal FVM lesions diagnosed with CD34 are diagnostically equivalent to remote FVM lesions diagnosed with haematoxylin-eosin (H&E). Clinical and placental phenotypes of 562 placentas from ≥ 20-week, high-risk pregnancies were analysed: Group 1–158 placentas with remote distal villous FVM (by H&E only), Group 2–142 placentas showing clustered endothelial fragmentation by CD34 immunostaining, 98 of them also with H&E distal FVM lesions (on-going, temporal heterogeneity), and Group 3–262 placentas without distal villous FVM. In Group 1, gestational age was the shortest, postnatal mortality most frequent, placental weight the smallest, and intra villous haemorrhage, erythroblasts in foetal blood, hypertrophic decidual arteriopathy, and foetal vascular thrombi most common. In Group 2, placental infarction, post-uterine pattern of chronic placental injury, and excessive extra villous trophoblasts of chorionic disc were most common (p < 0.05). In this cohort of foetuses/neonates dominated by congenital malformations, distal villous FVM was the most common pattern of placental injury, and those diagnosed by CD34 and by H&E are diagnostically/prognostically equivalent. CD34 immunostaining is therefore a powerful tool in the diagnosis of distal villous FVM.

A dermal interstitial lymphocytic infiltrate may represent a diagnostic challenge, particularly if the clinical history is not provided. We present three cases within the histological spectrum of morphea in which the immunohistochemical marker CD34 was helpful in confirming the diagnosis. [ABSTRACT FROM AUTHOR]

DISCUSSION Morphea is an inflammatory dermatosis characterized by fibrosis, sclerosis, and atrophy of the skin and subcutis, variably involving the underlying deeper structures. Diagnosis: Morphea profunda Histopathology showed deep dermal fibrosis, eccrine glands situated higher-up in the dermis than normal, lobular panniculitis with a lymphohistiocytic infiltrate, and lipoatrophy (Figures 3 and 4). Keywords: CD34 immunohistochemistry; dermal collagenization; lipoatrophy; morphea profunda; panniculitis EN CD34 immunohistochemistry dermal collagenization lipoatrophy morphea profunda panniculitis 715 717 3 07/17/23 20230701 NES 230701 CASE PRESENTATION A 10-year-old boy presented with a 4-month history of a gradually deepening depression localized to the skin over the right hip. [Extracted from the article]

CD34 immunostaining increases the sensitivity of placental diagnosis of foetal vascular malperfusion (FVM). This comparative retrospective study was performed to find out whether recent distal FVM lesions diagnosed with CD34 are diagnostically equivalent to remote FVM lesions diagnosed with haematoxylin-eosin (H&E). Clinical and placental phenotypes of 562 placentas from = 20-week, high-risk pregnancies were analysed: Group 1-158 placentas with remote distal villous FVM (by H&E only), Group 2-142 placentas showing clustered endothelial fragmentation by CD34 immunostaining, 98 of them also with H&E distal FVM lesions (on-going, temporal heterogeneity), and Group 3-262 placentas without distal villous FVM. In Group 1, gestational age was the shortest, postnatal mortality most frequent, placental weight the smallest, and intra villous haemorrhage, erythroblasts in foetal blood, hypertrophic decidual arteriopathy, and foetal vascular thrombi most common. In Group 2, placental infarction, post-uterine pattern of chronic placental injury, and excessive extra villous trophoblasts of chorionic disc were most common (p < 0.05). In this cohort of foetuses/neonates dominated by congenital malformations, distal villous FVM was the most common pattern of placental injury, and those diagnosed by CD34 and by H&E are diagnostically/prognostically equivalent. CD34 immunostaining is therefore a powerful tool in the diagnosis of distal villous FVM. [ABSTRACT FROM AUTHOR]

EXIT (ex-utero intrapartum treatment) procedure is a fetal survival-increasing modification of cesarean section. Previously we found an increase incidence of fetal vascular malperfusion (FVM) in placentas from EXIT procedures which indicates the underlying stasis of fetal blood flow in such cases. This retrospective analysis analyzes the impact of the recently introduced CD34 immunostain for the FVM diagnosis in placentas from EXIT procedures. A total of 105 placentas from EXIT procedures (48 to airway, 43 to ECMO and 14 to resection) were studied. In 73 older cases, the placental histological diagnosis of segmental FVM was made on H&E stained placental sections only (segmental villous avascularity) (Group 1), while in 32 most recent cases, the CD34 component of a double E-cadherin/CD34 immunostain slides was also routinely used to detect the early FVM (endothelial fragmentation, villous hypovascularity) (Group 2). Twenty-three clinical and 47 independent placental phenotypes were compared by χ2 or ANOVA, where appropriate. There was no statistical significance between the groups in rates of segmental villous avascularity (29 vs. 34%), but performing CD34 immunostain resulted in adding and/or upgrading 12 more cases of segmental FVM in Group 2, thus increasing the sensitivity of placental examination for FVM by 37%. There were no other statistically significantly differences in clinical (except for congenital diaphragmatic hernias statistically significantly more common in Group 2, 34 vs. 56%, p=0.03) and placental phenotypes, proving the otherwise comparability of the groups. The use of CD34 immunostain increases the sensitivity of placental examination for FVM by 1/3, which may improve the neonatal management by revealing the increased likelihood of the potentially life-threatening neonatal complications. [ABSTRACT FROM AUTHOR]

The percentage of blasts cells in the bone marrow (BM) of MDS patients is one of the key parameters for MDS classification and for the differential diagnosis with acute myeloid leukemia (AML). Currently, the gold standard to determine the blast percentage is conventional cytomorphology. To assess the possible impact of blast cell enumeration in BM biopsies from MDS patients on the final WHO classification using CD34 immunohistochemistry (IHC) a total of 156 BM samples from MDS and MDS-AML patients were studied and compared to blast counts by cytomorphology (CM). Eighty-nine BM aspirates were also studied by flow cytometry (FCM). Percentages of CD34+ blasts by IHC were determined blindly by two hematopathologists. Automated CD34-cell count was performed in 25 cases. Good overall agreement was found for CM and FCM with respect to critical blast thresholds (5%, 10%, 20%) (p < 0.05). However, in 17% of patients, CD34+ blast counts by IHC were higher as compared to CM with possible impact on MDS subclassification. In 7 of 21 AML patients, diagnosis was established on BM histology, while the blast percentage by CM was below the AML threshold. The assessment of CD34+ cells by IHC showed high interobserver agreement (Spearman R 0.95, p < 0.01), while automated CD34 counts were not optimal due to interference with other cellular and stromal elements. BM histology including CD34 IHC improves the diagnostic accuracy in MDS and AML. The quantification of blast cells should be based on the integration of all three methods for reliable disease classification and risk assessment. [ABSTRACT FROM AUTHOR]

In this paper, we attempt to quantify the prognostic information embedded in multi-parametric histologic biopsy images to predict disease aggressiveness in estrogen receptor-positive (ER+) breast cancers (BCa). The novel methodological contribution is in the use of a multi-field-of-view (multi-FOV) framework for integrating image-based information from differently stained histopathology slides. The multi-FOV approach involves a fixed image resolution while simultaneously integrating image descriptors from many FOVs corresponding to different sizes. For each study, the corresponding risk score (high scores reflecting aggressive disease and vice versa), predicted by a molecular assay (Oncotype DX), is available and serves as the surrogate ground truth for long-term patient outcome. Using the risk scores, a trained classifier is used to identify disease aggressiveness for each FOV size. The predictions for each FOV are then combined to yield the final prediction of disease aggressiveness (good, intermediate, or poor outcome). Independent multi-FOV classifiers are constructed for (1) 50 image features describing the spatial arrangement of cancer nuclei (via Voronoi diagram, Delaunay triangulation, and minimum spanning tree graphs) in H and E stained histopathology and (2) one image feature describing the vascular density in CD34 IHC stained histopathology. In a cohort of 29 patients, the multi-FOV classifiers obtained by combining information from the H and E and CD34 IHC stained channels were able to distinguish low- and high-risk patients with an accuracy of 0.91 ± 0.02 and a positive predictive value of 0.94 ± 0.10, suggesting that a purely image-based assay could potentially replace more expensive molecular assays for making disease prognostic predictions. [ABSTRACT FROM AUTHOR]

CD117 (or c-kit) is expressed by the interstitial cells of Cajal (ICC), which are located within the gastrointestinal (GI) muscle coat and directly involved in its motility. CD34 is expressed by several cell types some of which have features and location resembling the ICC; however, a sure identification of these cells is still lacking. In order to establish whether the CD34-positive cells of the human GI tract are to be considered as ICC subpopulation or a novel independent cell type, and to hypothesize their nature and role, we verified CD34 and CD117 receptor expression under light and fluorescence microscope and performed a routine and a CD34-immuno-electron microscopy. CD34-positive cells were seen in the entire human GI tract. In the muscularis propria, shared morphologies similar to the c-kit-positive cells, in the submucosa, resembled fibroblasts. Their ultrastructure resembled that of the fibrocytes/fibroblasts and of the interstitial Cajal-like cells (ICLC). Double labelling and immunoelectro-microscopy demonstrated that they are unequivocally different to the ICC and, due to the similarities with the ICLC, we identified them as ICLC. The novelty of these results is that two types of interstitial cells are present in the GI muscle coat of humans: the ICC and the ICLC. We hypothesize a mechanical role for the septal ICLC, those at the myenteric plexus level and those bordering the muscle layers; a helping role in neurotransmission is proposed for the ICLC intercalated with the intramuscular ICC, possibly in spreading the slow waves generated by the ICC. Furthermore, the possibility that the ICLC represent the adult mesenchymal stromal cells able to guarantee the ICC renewal deserves to be considered. [ABSTRACT FROM AUTHOR]

ABSTRACT- To clarify the relationship between angiogenesis and hepatocarcinogenesis on progression of hepatocellular carcinoma (HCC), we quantitatively evaluated angiogenesis by CD34 immunohistochemistry in liver cirrhosis (LC), adenomatous hyperplasia (AH), and HCC, and proliferative activity estimated by Ki-67 immunohistochemistry. Angiogenesis was evaluated by CD34 immunohistochemistry using monoclonal antibody HPCA-2, and tumor proliferative activity was evaluated using monoclonal antibody MIB-1. We used an image analysis system to assess the microvessel density as the area percentage of the endothelial area. Angiogenesis was generally observed in HCC and there was no significant difference among all clinical stages and histological grades of HCC. On the other hand, the staining of CD34 was partly observed in sinusoids of AH, although no positive staining was seen in any sinusoids of LC. The proliferative activity was significantly correlated with the clinical stage and histological grade of HCC. Our results indicate that the quantitation of angiogenesis does not provide significant prognostic information in HCC, but that it may have diagnostic value in distinguishing HCC from non-HCC. Meanwhile, AH, which is not morphologically diagnosed as cancer, shows positive staining for CD34, suggesting that some portion of AH contains cancerous characteristics. [ABSTRACT FROM AUTHOR]