48 results on '"DeYoung BR"'
Search Results
2. Viscosupplementation pseudotumor. A case report.
- Author
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Jones KB, Patel PP, DeYoung BR, Buckwalter JA, Jones, Kevin B, Patel, Pranav P, DeYoung, Barry R, and Buckwalter, Joseph A
- Published
- 2005
3. Unusual presentation of lipoblastoma as a skin dimple of the thigh. A report of three cases.
- Author
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Jones KB, Morcuende JA, DeYoung BR, El-Khoury GY, Buckwalter JA, Dietz FR, Jones, Kevin B, Morcuende, José A, DeYoung, Barry R, El-Khoury, Georges Y, Buckwalter, Joseph A, and Dietz, Frederick R
- Published
- 2004
4. Maxillary malignant mesenchymoma and massive fibrous dysplasia.
- Author
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Beuerlein ME, Schuller DE, and DeYoung BR
- Published
- 1997
5. Frequent mutation of p16 in squamous cell carcinoma of the head and neck.
- Author
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Lang JC, Tobin EJ, Knobloch TJ, Schuller DE, Bartynski KJ, Mountain RE, Nicholson R, DeYoung BR, Weghorst CM, Lang, J C, Tobin, E J, Knobloch, T J, Schuller, D E, Bartynski, K J, Mountain, R E, Nicholson, R, DeYoung, B R, and Weghorst, C M
- Abstract
RNA was isolated from 22 squamous cell carcinomas (SCCs) obtained from diverse sites within the head and neck and from matched normal tissue where available. Tissue samples were then screened for expression of RNA from tumor suppressor gene p16 by utilizing semiquantitative reverse transcriptase polymerase chain reaction (RT-PCR) analysis. p16-Specific PCR amplification products generated from tumor samples were subject to further analysis by direct DNA sequencing to determine if any tumor sample harbored a p16 mutation. The results show the presence of mutations in 10 of 22 (45%) of the tumor samples. Mutations comprise two identical point mutations, two small deletions (1 bp and 2 bp), one single-nucleotide insertion, four larger deletions, and an insertion/deletion. No mutations in p16 have been identified by analysis of PCR products generated from normal matched tissue, suggesting that p16 alterations are generated by somatic mutation and are not germline in origin. All 22 samples were analyzed additionally by immunohistochemistry for nuclear expression of the retinoblastoma (RB) tumor suppressor gene product. Results show lack of RB nuclear expression in only one sample, suggesting that mutation of RB is an infrequent event in the development of SCC of the head and neck (SCCHN). [ABSTRACT FROM AUTHOR]
- Published
- 1998
6. Comparison of fungal culture versus surgical pathology examination in the detection of Histoplasma in surgically excised pulmonary granulomas.
- Author
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Weydert JA, Van Natta TL, and DeYoung BR
- Published
- 2007
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7. Emerging eosinophilic (allergic) esophagitis: increased incidence or increased recognition?
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Vanderheyden AD, Petras RE, DeYoung BR, and Mitros FA
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- 2007
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8. Differentiating Intrarenal Ectopic Adrenal Tissue From Renal Cell Carcinoma in the Kidney.
- Author
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Yousif MQ, Salih ZT, DeYoung BR, and Qasem SA
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- Adolescent, Adult, Aged, Biomarkers, Tumor analysis, Diagnosis, Differential, Female, Humans, Immunohistochemistry, Male, Middle Aged, Young Adult, Adrenal Glands, Carcinoma, Renal Cell diagnosis, Choristoma diagnosis, Kidney Diseases diagnosis, Kidney Neoplasms diagnosis
- Abstract
Background: Adrenal rest (AR) is the presence of ectopic adrenal cortical tissue, often identified incidentally during autopsy (20% of postmortem examination). In the kidney, AR can be found in 6% of the general population. Ectopic adrenal tissue is of no functional significance but may in some cases, pose a diagnostic challenge for the pathologist, especially in the context of renal clear cell renal cell carcinoma (RCC) and small needle biopsies., Aim: To investigate the utility of immunohistochemical stains in distinguishing AR from RCC., Methods: Archival cases of AR, in our institution, were reviewed and compared with a cohort of RCC cases using a panel of immunohistochemical stains, including PAX2, PAX8, calretinin, and inhibin., Results: Nine of 10 (90%) cases of AR showed positive staining for inhibin and negative staining for calretinin, PAX2 and PAX8. One AR case was positive for PAX2 and PAX8 in addition to inhibin. All (100%) RCC cases were positive for PAX2 and PAX8, but negative for inhibin and calretinin., Conclusions: A panel of PAX2, PAX8 and inhibin may be useful markers for distinguishing AR from RCC. Calretinin was noncontributory in our study.
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- 2018
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9. Incorporating blood-based liquid biopsy information into cancer staging: time for a TNMB system?
- Author
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Yang M, Forbes ME, Bitting RL, O'Neill SS, Chou PC, Topaloglu U, Miller LD, Hawkins GA, Grant SC, DeYoung BR, Petty WJ, Chen K, Pasche BC, and Zhang W
- Subjects
- Humans, Neoplasms classification, Neoplasms diagnosis, Biomarkers, Tumor blood, Circulating Tumor DNA blood, Liquid Biopsy methods, Neoplasm Staging methods, Neoplasms blood
- Abstract
Tissue biopsy is the standard diagnostic procedure for cancer. Biopsy may also provide material for genotyping, which can assist in the diagnosis and selection of targeted therapies but may fall short in cases of inadequate sampling, particularly from highly heterogeneous tumors. Traditional tissue biopsy suffers greater limitations in its prognostic capability over the course of disease, most obviously as an invasive procedure with potential complications, but also with respect to probable tumor clonal evolution and metastasis over time from initial biopsy evaluation. Recent work highlights circulating tumor DNA (ctDNA) present in the blood as a supplemental, or perhaps an alternative, source of DNA to identify the clinically relevant cancer mutational landscape. Indeed, this noninvasive approach may facilitate repeated monitoring of disease progression and treatment response, serving as a means to guide targeted therapies based on detected actionable mutations in patients with advanced or metastatic solid tumors. Notably, ctDNA is heralding a revolution in the range of genomic profiling and molecular mechanisms to be utilized in the battle against cancer. This review will discuss the biology of ctDNA, current methods of detection and potential applications of this information in tumor diagnosis, treatment, and disease prognosis. Conventional classification of tumors to describe cancer stage follow the TNM notation system, heavily weighting local tumor extent (T), lymph node invasion (N), and detectable metastasis (M). With recent advancements in genomics and bioinformatics, it is conceivable that routine analysis of ctDNA from liquid biopsy (B) may make cancer diagnosis, treatment, and prognosis more accurate for individual patients. We put forward the futuristic concept of TNMB tumor classification, opening a new horizon for precision medicine with the hope of creating better outcomes for cancer patients.
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- 2018
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10. Diagnosing bone lesions: a practical non-pathology centric formulaic approach.
- Author
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DeYoung BR
- Subjects
- Age Factors, Algorithms, Humans, Tomography, X-Ray Computed methods, Bone Diseases diagnosis
- Abstract
Bone lesions are perceived to be some of the most difficult lesions that pathologists encounter. The reasons for this are multiple and include lack of experience/familiarity, the need to rely heavily on non-pathology information and data, and the fact that many lesions are associated with either procedures or treatments with significant morbidity. However, in fact, the majority of bone lesions can be accurately assessed on the basis of data not directly related to traditional pathologic based assessment. In order to achieve this state, the pathologist must understand the consistent clinical parameters of most bone lesions, including their clinical presentation, the bone involved, particularly the anatomic site of the bone involved, and a fundamental, basic understanding of imaging studies, especially the plain radiograph. Once these principles are understood and mastered, the pathologist can easily diagnose most bone lesions, using traditional pathologic assessment to confirm the diagnosis., (Copyright © 2014 Elsevier Inc. All rights reserved.)
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- 2014
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11. Cartilage-forming tumors.
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Qasem SA and DeYoung BR
- Subjects
- Bone Neoplasms diagnosis, Bone Neoplasms genetics, Chondroblastoma diagnosis, Chondroblastoma pathology, Chondroma diagnosis, Chondroma pathology, Chondrosarcoma diagnosis, Chondrosarcoma pathology, Diagnosis, Differential, Humans, Osteochondroma diagnosis, Osteochondroma pathology, Bone Neoplasms pathology, Cartilage pathology
- Abstract
Cartilage-forming tumors as a group are the most common primary bone tumors; this is largely due to the common occurrence of asymptomatic benign lesions such as osteochondroma and enchondroma. The common feature of these tumors is the presence of chondrocytic cells and the formation of cartilaginous tumor matrix. Some of these tumors are true neoplasms while others are hamartomas or developmental abnormalities. The morphologic heterogeneity of these tumors may be explained by a common multipotent mesenchymal cell differentiating along the lines of fetal-adult cartilage maturation. Recently mutations in IDH1 and IDH2 have been detected in a variety of benign and malignant cartilaginous tumors.(1-4.), (Copyright © 2014 Elsevier Inc. All rights reserved.)
- Published
- 2014
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12. Secondary chondrosarcoma of the pelvis arising from a solitary exostosis in an 11-year-old patient: a case report with 5-year follow-up.
- Author
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Nystrom LM, DeYoung BR, and Morcuende JA
- Subjects
- Adolescent, Bone Neoplasms surgery, Child, Chondrosarcoma surgery, Female, Follow-Up Studies, Humans, Osteochondroma surgery, Pelvic Bones surgery, Treatment Outcome, Bone Neoplasms pathology, Chondrosarcoma pathology, Osteochondroma pathology, Pelvic Bones pathology
- Abstract
Although conversion of an osteochondroma to chondrosarcoma is a well-described rare occurrence, it is usually associated with syndromes such as multiple hereditary exostoses and is much more common after maturity. We present here a rare case of secondary pelvic chondrosarcoma arising from a solitary exostosis in a pediatric patient. An 11-year-old, otherwise healthy, female was referred to our clinic for evaluation of a pelvic mass detected on a radiograph. The radiographs obtained by the referring physician demonstrated a large lesion arising from the right superior pubic ramus, which was visible but not identified on an abdominal radiograph several years prior. Histopathologic analysis showed chondrosarcoma which was supported by an additional opinion to rule out chondroblastic osteosarcoma. The patient was treated with wide resection without adjuvant therapy and is doing well with no evidence of recurrence five years post-operatively. There have been only a few small case series describing chondrosarcoma in the pediatric patient. Even rarer are descriptions of secondary chondrosarcoma with only occasional cases reported as part of larger case series. Chondrosarcoma is a rare and difficult diagnosis in the pediatric patient. There is often considerable debate between chondrosarcoma and chondroblastic osteosarcoma, and the treatment implications of differentiating these diagnoses are of paramount importance.
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- 2013
13. Relationship between HER-2 overexpression and brain metastasis in esophageal cancer patients.
- Author
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Abu Hejleh T, Deyoung BR, Engelman E, Deutsch JM, Zimmerman B, Halfdanarson TR, Berg DJ, Parekh KR, Lynch WR, Iannettoni MD, Bhatia S, and Clamon G
- Abstract
Aim: To study if HER-2 overexpression by locally advanced esophageal cancers increase the chance of brain metastasis following esophagectomy., Methods: We retrospectively reviewed the medical records of esophageal cancer patients who underwent esophagectomy at University of Iowa Hospitals and Clinics between 2000 and 2010. Data analyzed consisted of demographic and clinical variables. The brain metastasis tissue was assayed for HER-2 overexpression utilizing the FDA approved DAKO Hercept Test(®)., Results: One hundred and forty two patients were reviewed. Median age was 64 years (36-86 years). Eighty eight patients (62%) received neoadjuvant chemoradiotherapy. Pathological complete and partial responses were achieved in 17 (19%) and 71 (81%) patients. Cancer relapsed in 43/142 (30%) patients. The brain was the first site of relapse in 9/43 patients (21%, 95% CI: 10%-36%). HER-2 immunohistochemistry testing of the brain metastasis tissue showed that 5/9 (56%) cases overexpressed HER-2 (3+ staining)., Conclusion: HER-2 overexpression might be associated with increased risk of brain metastasis in esophageal cancer patients following esophagectomy. Further studies will be required to validate this observation.
- Published
- 2012
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14. Consensus statement on effective communication of urgent diagnoses and significant, unexpected diagnoses in surgical pathology and cytopathology from the College of American Pathologists and Association of Directors of Anatomic and Surgical Pathology.
- Author
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Nakhleh RE, Myers JL, Allen TC, DeYoung BR, Fitzgibbons PL, Funkhouser WK, Mody DR, Lynn A, Fatheree LA, Smith AT, Lal A, and Silverman JF
- Subjects
- Humans, Diagnosis, Time Factors, Systematic Reviews as Topic, Interdisciplinary Communication, Pathology, Clinical, Pathology, Surgical
- Abstract
Context: Recognizing the difficulty in applying the concept of critical values to anatomic pathology diagnoses, the College of American Pathologists and the Association of Directors of Anatomic and Surgical Pathology have chosen to reevaluate the concept of critical diagnoses., Objective: To promote effective communication of urgent and significant, unexpected diagnoses in surgical pathology and cytology., Design: A comprehensive literature search was conducted and reviewed by an expert panel., Results: A policy of effective communication of important results in surgical pathology and cytology is desirable to enhance patient safety and to address multiple regulatory requirements., Conclusions: Each institution should create its own policy regarding urgent diagnoses and significant, unexpected diagnoses in anatomic pathology. This policy should be separate from critical results or panic-value policies in clinical pathology, with the expectation of a different time frame for communication. Urgent diagnosis is defined as a medical condition that, in most cases, should be addressed as soon as possible. Significant, unexpected diagnosis is defined as a medical condition that is clinically unusual or unforeseen and should be addressed at some point in the patient's course. Further details of this statement are provided.
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- 2012
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15. Matching residents to pathology fellowships: the road less traveled?
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Myers JL, Yousem SA, DeYoung BR, and Cibull ML
- Subjects
- Career Choice, Fellowships and Scholarships organization & administration, Humans, Education, Medical, Graduate, Fellowships and Scholarships trends, Internship and Residency, Pathology, Clinical education, Pathology, Surgical education
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- 2011
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16. Micro-recanalization in a biodegradable graft for reconstruction of the vas deferens is enhanced by sildenafil citrate.
- Author
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Holoch PA, Mallapragada SK, Ariza CA, Griffith TS, Deyoung BR, and Wald M
- Subjects
- Animals, Azoospermia surgery, Cyclic GMP urine, Male, Polyesters, Purines therapeutic use, Rats, Rats, Sprague-Dawley, Sildenafil Citrate, Absorbable Implants, Neovascularization, Physiologic drug effects, Piperazines therapeutic use, Sulfones therapeutic use, Vas Deferens surgery, Vasovasostomy methods
- Abstract
This study investigated the effect of sildenafil citrate on micro-recanalization and neovascularization, which were previously demonstrated in a rat model using biodegradable grafts (BGs) for vas deferens reconstruction. A total of 24 male rats underwent bilateral vasectomy with removal of a 0.5-cm vasal segment and were randomly assigned to four groups. Groups 1 and 2 underwent immediate vasovasostomy. Groups 3 and 4 underwent interposition of a 0.5-cm BG in the vasal gap. Groups 1 and 3 were given 5 mg kg(-1) day(-1) oral sildenafil. Other groups were given placebo. Rats were housed with females 12 weeks postoperatively. Reconstructed vasal segments were harvested 16 weeks postoperatively and analyzed histologically. Fluid from the distal vasal stump was analyzed for motile sperm. Urine samples obtained 16 weeks postoperatively were analyzed for cGMP levels. cGMP levels in rats treated with sildenafil were significantly higher than in control rats. No pregnancies were sired by grafted groups. In all, 5/6 rats in group 1 and 3/6 rats in group 2 sired litters. No motile sperm were noted in the vasal fluid of the grafted groups. Motile sperm were noted in all rats in group 1 and in 5/6 rats in group 2. In addition, 29 and 4 microcanals were detected in the sildenafil and placebo groups, respectively (P = 0.023). No microcanal exceeded 3 mm in length. An average of 12 and 28 blood vessels per graft were noted in the placebo and sildenafil groups, respectively (P < 0.0001). In conclusion, sildenafil enhances micro-recanalization and neovascularization in BG used for vas deferens reconstruction, but does not increase the microcanal length after 16 weeks.
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- 2010
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17. Antibody expiration in the context of resource limitation: what is the evidence basis?
- Author
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Savage EC and DeYoung BR
- Subjects
- Formaldehyde, Humans, Immunoenzyme Techniques economics, Paraffin Embedding, Pathology, Clinical economics, Specimen Handling, Staining and Labeling standards, Time Factors, Tissue Fixation, Antibodies analysis, Biomarkers, Tumor analysis, Drug Stability, Immunoenzyme Techniques standards, Neoplasms chemistry, Pathology, Clinical standards
- Abstract
The implementation and enforcement of the College of American Pathologists Survey Checklist ANP 22432 has renewed attention on the issue of outdating of antibodies used for immunohistochemical analysis. The current study examined the staining patterns of 26 recently acquired primary antibodies and their expired counterparts. Two reviewers examined sequential sections of formalin-fixed, paraffin-embedded tissue samples for staining intensity and percentage of positivity. Appropriate positive and negative control studies were performed. Of the 26 antibodies, 20 exhibited no difference in percentage of positivity or staining intensity. Of the remaining 6, 3 showed better performance with the expired cohort and 3 with nonexpired antibodies. However, no antibody staining characteristics varied by more than 1 step, and in no case was positive staining lost after antibody expiration. Negligible differences exist in immunostaining between outdated and current antibodies. Thus, exemption for primary antibodies from existing regulations would conserve resources without adversely impacting patient care.
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- 2010
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18. Pathology education: quo vadis?
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Taylor CR, DeYoung BR, and Cohen MB
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- Curriculum, Faculty, Humans, Microscopy, Surveys and Questionnaires, Teaching methods, Education, Medical, Undergraduate methods, Pathology, Clinical education
- Abstract
The teaching of pathology and the face of pathology as a career are changing rapidly. A short questionnaire was constructed covering key areas impacted by curricular change to collect data for a workshop to be held at the Annual Meeting of the West and Mid-West Region of the Association of Pathology Chairs. Questions included the ongoing existence of pathology as a separate discipline, the degree of 'control' exercised by pathology faculty, the length of the course (hours), the use of microscopes, and selected outcomes data, specifically National Board of Medical Examiners graphs of comparative performance of disciplines and US Medical Licensing Examination Step 1 data. The written responses and discussion by attendees at the meeting are presented with preliminary analysis and commentary. It was concluded that 'evidence-based education' represents something of a novelty, worthy of further study.
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- 2008
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19. RDP58 inhibits T cell-mediated bladder inflammation in an autoimmune cystitis model.
- Author
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Liu W, Deyoung BR, Chen X, Evanoff DP, and Luo Y
- Subjects
- Animals, Autoimmune Diseases immunology, Autoimmune Diseases pathology, CD8-Positive T-Lymphocytes immunology, Cystitis immunology, Cystitis pathology, Cytokines biosynthesis, Cytokines drug effects, Disease Models, Animal, Enzyme-Linked Immunosorbent Assay, Female, Flow Cytometry, Injections, Intralesional, Mice, Mice, Transgenic, Reverse Transcriptase Polymerase Chain Reaction, Autoimmune Diseases drug therapy, CD8-Positive T-Lymphocytes drug effects, Cystitis drug therapy, Immunosuppressive Agents administration & dosage, Peptides administration & dosage
- Abstract
Interstitial cystitis (IC) is a chronic inflammatory condition of the urinary bladder with a strong autoimmune component. Currently, the major challenge in IC treatment is the development of effective therapies. RDP58 is a novel d-amino acid decapeptide with potent immunosuppressive activity. In this study, we investigated whether RDP58 was effective as an intravesical agent for treating bladder autoimmune inflammation in a transgenic mouse model (URO-OVA mice). URO-OVA mice were adoptively transferred with syngeneic activated splenocytes of OT-I mice transgenic for the OVA-specific CD8(+) TCR for cystitis induction and treated intravesically with RDP58 at days 0 and 3. Compared with controls, the RDP58-treated bladders showed markedly reduced histopathology and expressions of mRNAs and proteins of TNF-alpha, NGF and substance P. To determine whether the inhibition of bladder inflammation by RDP58 was due to the interference with effector T cells, we treated the cells with RDP58 in vitro. Cells treated with RDP58 showed reduced production of TNF-alpha and IFN-gamma as well as apoptotic death. Collectively, these results indicate that RDP58 is effective for treating T cell-mediated experimental autoimmune cystitis and may serve as a useful intravesical agent for the treatment of autoimmune-associated bladder inflammation such as IC.
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- 2008
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20. Her-2/neu expression in salivary duct carcinoma: an immunohistochemical and chromogenic in situ hybridization study.
- Author
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Johnson CJ, Barry MB, Vasef MA, and Deyoung BR
- Subjects
- Humans, Immunohistochemistry, In Situ Hybridization methods, Receptor, ErbB-2 genetics, Carcinoma, Ductal metabolism, Receptor, ErbB-2 metabolism, Salivary Gland Neoplasms metabolism
- Abstract
Salivary duct carcinoma (SDC) shares significant morphologic and immunophenotypic overlap with ductal carcinoma of the breast, including HER-2/neu expression. Previous studies have detected HER-2/neu at the protein level in SDCs; however, no study, to date, has assayed whether this expression is related to gene amplification detected by chromogenic in situ hybridization (CISH). Formalin-fixed, paraffin-embedded tissue sections from 12 previously diagnosed SDCs were evaluated by immunohistochemistry (IHC) and CISH for HER-2/neu status. Result concordance was seen in all 12 cases. A total of 4 SDCs were positive by IHC; all 4 cases showed amplification with CISH. The remaining 8 cases were negative by IHC and showed no gene amplification with CISH. SDCs in this study show HER-2/neu overexpression on both the protein and gene levels in approximately 30% of cases. These findings suggest a role may exist for Herceptin (trastuzumab) based therapy in some SDC patients.
- Published
- 2008
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21. Extranodal extension in metastatic non-small cell lung cancer.
- Author
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Bell AM, DeYoung BR, and Weydert J
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- Adult, Aged, Aged, 80 and over, Carcinoma, Non-Small-Cell Lung mortality, Carcinoma, Non-Small-Cell Lung secondary, Female, Genes, p53 physiology, Humans, Immunohistochemistry, Lung Neoplasms mortality, Lung Neoplasms pathology, Lymphatic Metastasis, Male, Mediastinum, Middle Aged, Neoplasm Staging, Survival Rate, Treatment Outcome, Carcinoma, Non-Small-Cell Lung surgery, Lung Neoplasms surgery, Lymph Node Excision methods
- Published
- 2007
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22. Chondroblastoma of the femoral diaphysis: report of a rare phenomenon and review of literature.
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Clapper AT and DeYoung BR
- Subjects
- Adolescent, Chondroblastoma diagnostic imaging, Chondroblastoma surgery, Curettage, Femoral Neoplasms diagnostic imaging, Femoral Neoplasms surgery, Humans, Male, Radiography, Chondroblastoma pathology, Diaphyses, Femoral Neoplasms pathology
- Abstract
Chondroblastoma (CB) is a relatively rare yet well-studied benign neoplasm of bone. The purported neoplastic cell is the chondroblast, a cell which normally populates areas of secondary ossification. Numerous studies have shown that CB overwhelmingly arises from the epimetaphyseal region of skeletally immature individuals. Only rare cases have been reported in the diaphyseal region, and many of these involve metacarpals or metatarsals, which may lack a true anatomic diaphysis. The remaining cases of diaphyseal CBs synchronously involve the neighboring epimetaphysis, making determination of the initiation point impossible. We report a case of a CB isolated to the radiologic femoral diaphysis. To our knowledge, this is the first case of a diaphyseal-based CB to be reported in the pathology literature and only the second case published overall.
- Published
- 2007
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23. Recommendations for the supervision of pathology assistants.
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Yousem SA, Brooks JS, DeYoung BR, and Wick MR
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- Humans, Pathology, Surgical education, Health Planning Guidelines, Pathology, Surgical organization & administration, Physician Assistants organization & administration, Societies, Medical
- Published
- 2006
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24. Recommendations for the supervision of pathology assistants: association of directors of anatomic and surgical pathology.
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Yousem SA, Brooks JS, DeYoung BR, and Wick MR
- Subjects
- Humans, Association, Health Planning Guidelines, Pathology, Surgical organization & administration, Physician Assistants organization & administration, Societies, Medical
- Published
- 2006
- Full Text
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25. Ethanol as a local adjuvant for giant cell tumor of bone.
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Jones KB, DeYoung BR, Morcuende JA, and Buckwalter JA
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- Adult, Bone Neoplasms surgery, Combined Modality Therapy, Curettage, Decision Trees, Female, Giant Cell Tumor of Bone surgery, Humans, Male, Middle Aged, Retrospective Studies, Bone Neoplasms therapy, Ethanol therapeutic use, Giant Cell Tumor of Bone therapy
- Abstract
Giant cell tumor is an aggressive benign neoplasm of bone. A number of adjuvant agents have been used to supplement intralesional curettage to reduce the otherwise high local recurrence rate. High concentration ethanol is more readily available and less toxic to use than some common alternatives. No report on its use in a group of patients with giant cell tumor is available. Records were retrospectively reviewed for all giant cell tumors treated by intralesional curettage and high concentration ethanol irrigation as the only chemical adjuvant. Twenty-five primary excisional curettages and 12 repeat curettages for giant cell tumors of bone were performed in 31 patients. Patients were followed for a mean of three years and 10 months. There were five recurrences after primary excision procedures, and three after repeat excisions. Only use of a high-speed burr and lower Campanacci staging correlated with reduced recurrence rate, and these were not statistically significant. Most defects were filled with allograft or calcium sulfate. In the 11 patients treated primarily with curettage using a high-speed burr and adjuvant ethanol with minimum two-year follow-up, only one stage 3 lesion in a distal radius recurred. Multiple washes with high concentration ethanol, when used in conjunction with aggressive curettage including high-speed burring, is an effective and safe adjuvant. The necessity of any chemical adjuvant after appropriately aggressive curettage and burring can only be definitively demonstrated with a prospective, randomized, multi-center trial. Until such evidence becomes available, the use of adjuvant ethanol offers a compromise between higher toxicity adjuvants and no chemical adjuvant at all.
- Published
- 2006
26. Elevated fibroblast growth factor-23 in hypophosphatemic linear nevus sebaceous syndrome.
- Author
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Hoffman WH, Jueppner HW, Deyoung BR, O'dorisio MS, and Given KS
- Subjects
- Adolescent, Antineoplastic Agents, Hormonal therapeutic use, Calcitriol therapeutic use, Fibroblast Growth Factor-23, Humans, Male, Nevus, Pigmented drug therapy, Nevus, Pigmented surgery, Octreotide therapeutic use, Phosphates therapeutic use, Sebaceous Gland Neoplasms drug therapy, Sebaceous Gland Neoplasms surgery, Syndrome, Treatment Outcome, Fibroblast Growth Factors blood, Hypophosphatemia blood, Nevus, Pigmented blood, Sebaceous Gland Neoplasms blood
- Abstract
We report on an adolescent who experienced the onset of linear nevus sebaceous syndrome (LNSS) prior to 1 year of age. At 7 years of age he was diagnosed to have hypophosphatemic rickets. He was suboptimally controlled with phosphate and calcitriol treatment and sustained numerous insufficiency fractures ipsilateral to the linear sebaceous nevus. Fibroblast growth factor-23 (FGF-23), the phosphaturic peptide, was elevated in the plasma. Treamtent with the somatostatin agonist, octreotide, and excision of the nevus were followed by normalization of FGF-23 and clinical improvement. The patient also had hyperimmunoglobulinemia E, which responded to octreotide and surgery. We speculate that in some patients with LNSS there may be more than one mediator of hypophosphatemia and that FGF-23 is the mediator of hyperphosphaturia in this and other hypophosphatemic syndromes.
- Published
- 2005
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27. Benign lesions in cancer patients: Case 1. Sarcoidosis after chemoradiation for head and neck cancer.
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Yao M, Funk GF, Goldstein DP, DeYoung BR, and Graham MM
- Subjects
- Cisplatin administration & dosage, Combined Modality Therapy, Diagnosis, Differential, Fluorodeoxyglucose F18, Humans, Male, Middle Aged, Neoplasm Metastasis, Positron-Emission Tomography, Radiopharmaceuticals, Sarcoidosis diagnosis, Antineoplastic Agents adverse effects, Antineoplastic Agents therapeutic use, Head and Neck Neoplasms drug therapy, Head and Neck Neoplasms radiotherapy, Radiation Injuries pathology, Sarcoidosis etiology
- Published
- 2005
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28. Necrotizing fasciitis caused by xanthogranulomatous and emphysematous pyelonephritis: importance of the inferior lumbar triangle pathway.
- Author
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Ishigami K, Bolton-Smith JA, Deyoung BR, and Barloon TJ
- Subjects
- Adult, Emphysema surgery, Fasciitis, Necrotizing surgery, Female, Humans, Kidney pathology, Pyelonephritis, Xanthogranulomatous surgery, Tomography, X-Ray Computed, Emphysema complications, Fasciitis, Necrotizing diagnostic imaging, Fasciitis, Necrotizing etiology, Pyelonephritis, Xanthogranulomatous complications
- Published
- 2004
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29. Biological significance of focal adhesion kinase in ovarian cancer: role in migration and invasion.
- Author
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Sood AK, Coffin JE, Schneider GB, Fletcher MS, DeYoung BR, Gruman LM, Gershenson DM, Schaller MD, and Hendrix MJ
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- Adult, Aged, Aged, 80 and over, Blotting, Western, Cell Line, Tumor, Female, Focal Adhesion Kinase 1, Focal Adhesion Protein-Tyrosine Kinases, Humans, Immunohistochemistry, Middle Aged, Neoplasm Invasiveness, Ovarian Neoplasms mortality, Precipitin Tests, Prognosis, Transfection, Biomarkers, Tumor analysis, Cell Movement physiology, Ovarian Neoplasms enzymology, Ovarian Neoplasms pathology, Protein-Tyrosine Kinases metabolism
- Abstract
Focal adhesion kinase (FAK) is a nonreceptor tyrosine kinase that is activated by integrin clustering. There are limited data regarding the functional role of FAK in ovarian cancer migration and invasion. In the current study, FAK expression was evaluated in ovarian cell lines (nontransformed and cancer), 12 benign ovarian samples, and in 79 invasive epithelial ovarian cancers. All three ovarian cancer cell lines overexpressed FAK compared to the nontransformed cells. The dominant-negative construct called FAK-related nonkinase (FRNK) was introduced into two ovarian cancer cell lines (SKOV3 and 222). FRNK promoted FAK dephosphorylation without changing total FAK levels in these cell lines. Furthermore, FRNK decreased the in vitro invasive ability of ovarian cancer cells by 56 to 85% and decreased migration by 52 to 68%. FRNK-transfected cells also displayed poor cell spreading. Immunohistochemical analysis revealed that the surface epithelium from all benign ovarian samples had weak FAK expression. In contrast, 68% of invasive ovarian cancers overexpressed FAK. FAK overexpression was significantly associated with high tumor stage, high tumor grade, positive lymph nodes and presence of distant metastasis (all P values <0.05). FAK overexpression was also associated with shorter overall survival (P = 0.008). Multivariate analysis revealed that FAK overexpression and residual disease >1 cm were independent predictors of poor survival. These data indicate that FAK is overexpressed in most invasive ovarian cancers and plays a functionally significant role in ovarian cancer migration and invasion. Thus, FAK may be an important therapeutic target in ovarian carcinoma.
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- 2004
- Full Text
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30. Telomerase reverse transcriptase subunit expression is associated with chondrosarcoma malignancy.
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Martin JA, DeYoung BR, Gitelis S, Weydert JA, Klingelhutz AJ, Kurriger G, and Buckwalter JA
- Subjects
- Biomarkers, Tumor analysis, Bone Neoplasms pathology, Cell Line, Tumor, Chondrocytes enzymology, Chondrocytes pathology, Chondroma enzymology, Chondroma pathology, Chondrosarcoma pathology, DNA-Binding Proteins, Humans, Immunohistochemistry, Prognosis, Tumor Cells, Cultured, Bone Neoplasms enzymology, Chondrosarcoma enzymology, Telomerase metabolism
- Abstract
Expression of the telomerase reverse transcriptase subunit telomerase reverse transcriptase gene is associated with most human malignancies. Because telomerase reverse transcriptase is rarely expressed in normal tissue, its presence in pathologic specimens is considered a marker of transformed cells. Moreover, high levels of expression have been correlated with poor prognosis in many cancers. Although telomerase activity has been found in chondrosarcomas, its prognostic significance in these malignant cartilage tumors is unknown. Malignancy in cartilage-derived tumors is assessed routinely by histomorphologic grading, but even well differentiated, low-grade lesions can metastasize. This unpredictable behavior greatly complicates the clinical treatment of cartilage tumors, making better prognostic indicators desirable. To address this issue we used immunohistochemistry to compare telomerase reverse transcriptase expression in a collection of 61 tumors consisting of malignant chondrosarcomas of varying grade and benign enchondromas. Associated case histories were reviewed to test the hypothesis that telomerase reverse transcriptase expression levels correlated with subsequent tumor recurrence. We found that the relative abundance of telomerase reverse transcriptase-expressing cells correlated significantly with grade and recurrence. These findings indicate that telomerase reverse transcriptase immunostaining may be a useful adjunct to the conventional three-level grading system.
- Published
- 2004
- Full Text
- View/download PDF
31. Alpha-inhibin immunoreactivity in soft-tissue neoplasia.
- Author
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Schraith DF, Hahm GK, Niemann TH, and DeYoung BR
- Subjects
- Humans, Immunohistochemistry, Neoplasms, Connective and Soft Tissue metabolism, Inhibins analysis, Neoplasms, Connective and Soft Tissue pathology
- Abstract
Antibodies directed against alpha-inhibin have been previously reported as staining both sex cord-stromal neoplasms as well as adrenal cortical tumors. This relatively restricted immunoreactivity pattern is useful in the assessment of retroperitoneal masses, especially in a setting of limited tissue (e.g., needle biopsy). However, no study to date has evaluated alpha-inhibin immunoreactivity in soft-tissue neoplasms, which frequently enter the differential diagnosis of retroperitoneal masses. We investigate the incidence of alpha-inhibin staining in a variety of soft-tissue neoplasms by using formalin-fixed, paraffin-embedded tissue sections from 282 previously classified soft-tissue neoplasms with anti-alpha-inhibin (Serotec, 1:75). A modified avidin-biotin complex method was used after heat-induced epitope retrieval. Cytoplasmic granular staining was considered positive. Of the 282 tumors studied, a total of 8 (2.8%) demonstrated positive staining with anti-alpha-inhibin antibody. These included 4 of 25 liposarcomas (16%), 2 of 18 angiosarcomas (11%), 1 of 48 lipomas (2.1%), and 1 of 1 rhabdomyoma (100%). Negative staining was noted among hemangiomas (0/28), schwannomas (0/32), leiomyomas (0/16), fibrosarcomas (0/2), fibromas (0/11), dermatofibromas (0/9), neurofibromas (0/6), synovial sarcomas (0/15), rhabdomyosarcomas (0/10), Triton tumors (0/2), and malignant fibrous histiocytomas (0/59). We conclude that rare soft-tissue tumors, especially those exhibiting either lipomatous or vascular differentiation, demonstrate alpha-inhibin immunoreactivity. These findings re-emphasize the need for a well-construed antibody panel when immunohistochemical methods are employed in the evaluation of retroperitoneal neoplasms. However, the rarity of alpha-inhibin expression by soft-tissue neoplasms provides further support for its overall specificity as a marker of adrenal cortical differentiation in the biopsy evaluation of a retroperitoneal mass.
- Published
- 2003
- Full Text
- View/download PDF
32. The impact of p53 protein core domain structural alteration on ovarian cancer survival.
- Author
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Rose SL, Robertson AD, Goodheart MJ, Smith BJ, DeYoung BR, and Buller RE
- Subjects
- Amino Acid Substitution, DNA, Neoplasm metabolism, Exons genetics, Female, Humans, Neoplasm Staging, Ovarian Neoplasms mortality, Ovarian Neoplasms pathology, Protein Folding, Survival Analysis, Tumor Suppressor Protein p53 chemistry, Tumor Suppressor Protein p53 metabolism, Genes, p53 genetics, Mutation genetics, Mutation, Missense genetics, Ovarian Neoplasms genetics, Tumor Suppressor Protein p53 genetics
- Abstract
Purpose: Although survival with a p53 missense mutation is highly variable, p53-null mutation is an independent adverse prognostic factor for advanced stage ovarian cancer. By evaluating ovarian cancer survival based upon a structure function analysis of the p53 protein, we tested the hypothesis that not all missense mutations are equivalent., Experimental Design: The p53 gene was sequenced from 267 consecutive ovarian cancers. The effect of individual missense mutations on p53 structure was analyzed using the International Agency for Research on Cancer p53 Mutational Database, which specifies the effects of p53 mutations on p53 core domain structure. Mutations in the p53 core domain were classified as either explained or not explained in structural or functional terms by their predicted effects on protein folding, protein-DNA contacts, or mutation in highly conserved residues. Null mutations were classified by their mechanism of origin., Results: Mutations were sequenced from 125 tumors. Effects of 62 of the 82 missense mutations (76%) could be explained by alterations in the p53 protein. Twenty-three (28%) of the explained mutations occurred in highly conserved regions of the p53 core protein. Twenty-two nonsense point mutations and 21 frameshift null mutations were sequenced. Survival was independent of missense mutation type and mechanism of null mutation., Conclusions: The hypothesis that not all missense mutations are equivalent is, therefore, rejected. Furthermore, p53 core domain structural alteration secondary to missense point mutation is not functionally equivalent to a p53-null mutation. The poor prognosis associated with p53-null mutation is independent of the mutation mechanism.
- Published
- 2003
33. The influence of microvessel density on ovarian carcinogenesis.
- Author
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Stone PJ, Goodheart MJ, Rose SL, Smith BJ, DeYoung BR, and Buller RE
- Subjects
- CA-125 Antigen blood, Epithelial Cells pathology, Female, Humans, Middle Aged, Neoplasm Staging, Neoplasm, Residual, Neovascularization, Pathologic metabolism, Ovarian Neoplasms blood, Platelet Endothelial Cell Adhesion Molecule-1 metabolism, Neovascularization, Pathologic pathology, Ovarian Neoplasms blood supply, Ovarian Neoplasms pathology
- Abstract
Objective: Tumor microvessel density, measured by CD31 immunohistochemistry, correlates with survival in patients with ovarian cancer. CA 125 is secreted by most ovarian cancers, and we have previously shown that the rate of decline of CA 125 is also predictive of ovarian cancer survival. Because increased tumor vascularity may allow metastases on one hand, while facilitating the delivery of chemotherapy on the other, we investigated the relationship of tumor microvessel density to preoperative CA 125, residual disease, and the initial response to treatment., Methods: FIGO stage, grade, age, residual disease, and CD31 microvessel density count were correlated with consecutive patients (n = 202) diagnosed with epithelial ovarian cancer who met entry criteria. The relationship of CD31 staining to preoperative CA 125, and the rate of decline in CA 125 (slope) as a measure of initial response to therapy, was also evaluated based on complete CA 125 data. Spearman correlation and the Wilcoxon rank sum test were used for bivariate analyses. Linear and logistic regression was used for multivariate analysis., Results: There were 21 stage I, 14 stage II, 125 stage III, and 42 stage IV patients diagnosed with epithelial ovarian cancer included in the study. More than half (N = 126) of the patients were optimally cytoreduced. Elevated microvessel density was associated with advanced stage of disease (P = 0.0453), grade (P = 0.0002), and an increased amount of residual disease (P = 0.0144). CA 125 values were higher in patients with residual disease versus patients without residual disease (P = 0.0357), and the decline in the CA 125 (slope) was less steep in patients without residual disease versus patients with residual disease (P = 0.0003). However, the initial response to chemotherapy was unrelated to the microvessel density count as measured by CD31 antibody staining (P = 0.7911). In multivariate analyses, CD31 counts remained significant in relationship to grade. Nonideal slopes, indicating decreased response, were associated with increasing age (P = 0.0008) and residual disease (P = 0.0035)., Conclusion: Elevated ovarian cancer microvessel density count is related to advanced stage and grade of disease, and compromised potential for cytoreduction. Residual disease is associated with higher CA 125 levels and faster CA 125 decline rates. The rate of decline of CA 125 during the initial response to treatment cannot be predicted based on CD31 counts, confirming a complex relationship between tumor vascularity, metastasis, and response to treatment.
- Published
- 2003
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34. p21 expression predicts outcome in p53-null ovarian carcinoma.
- Author
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Rose SL, Goodheart MJ, DeYoung BR, Smith BJ, and Buller RE
- Subjects
- Antibodies, Monoclonal, Cell Cycle, Cell Division, Female, Humans, Multivariate Analysis, Mutation, Mutation, Missense, Ovarian Neoplasms mortality, Prognosis, Proportional Hazards Models, Time Factors, Treatment Outcome, Genes, p53, Ovarian Neoplasms genetics, Ovarian Neoplasms metabolism, Proto-Oncogene Proteins p21(ras) biosynthesis, Proto-Oncogene Proteins p21(ras) physiology
- Abstract
Purpose: p21 is a direct p53 response gene. Although several studies have correlated p21 and p53 expression, only one has evaluated p21 expression as a function of sequenced p53 gene mutation. We hypothesize that such an analysis may be useful in prognosticating outcome for individuals diagnosed with epithelial ovarian cancer., Experimental Design: DNA from the primary ovarian cancers of 267 patients was studied. p53 mutations were directly sequenced. Two percent or greater nuclear staining with WAF1/CIP1 monoclonal antibody was determined by a hazard ratio analysis to constitute positive p21 expression., Results: Positive p21 nuclear staining occurred more frequently in p53 wild-type ovarian tumors than tumors found to have a p53 mutation (P = 0.001). Positive p21 staining conferred an overall survival advantage (P = 0.02). p21 expression in cancers with p53 missense mutations was not prognostic but did show a strong trend toward significance in the wild-type p53 subset (P = 0.056). Surprisingly, positive p21 staining reflected compromised survival for individuals with p53-null ovarian cancers (P = 0.005). The mean expression level for p21-positive stains in the wild-type group was greater than in null p53 cancers (23 versus 11%; P = 0.001). A Cox multivariable analysis revealed p21 to be a strong independent prognostic factor in p53-null ovarian cancer (P = 0.02)., Conclusion: p21 expression is closely related to sequenced p53 mutations. This is the first study of positive p21 staining as an independent poor prognostic factor in p53-null ovarian cancer. A dual role for p21 activity, dependent on levels of expression, appears to explain these paradoxical results and is consistent with a complex model for regulation of p21.
- Published
- 2003
35. Dermatofibroma-like granular cell tumor.
- Author
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Cheng SD, Usmani AS, DeYoung BR, Ly M, and Pellegrini AE
- Subjects
- Biomarkers, Tumor analysis, Female, Granular Cell Tumor chemistry, Histiocytoma, Benign Fibrous chemistry, Humans, Middle Aged, Neoplasm Proteins analysis, Phosphopyruvate Hydratase analysis, S100 Proteins analysis, Skin Neoplasms chemistry, Transglutaminases analysis, Granular Cell Tumor pathology, Histiocytoma, Benign Fibrous pathology, Skin Neoplasms pathology
- Abstract
Background: There have been several reports in the literature of dermatofibromas with granular cells. Here we report a granular cell tumor with the architecture of a dermatofibroma. This is the first report of this histological variant of granular cell tumor. The lesion was a 2.5-cm oval, hyperpigmented plaque present for "years" on the back of a 60-year-old African-American woman., Methods: The specimen was processed using formalin fixation and paraffin embedding. Tissue sections were stained with hematoxylin and eosin. Immunohistochemical studies were performed with antibodies directed against S-100 protein, neuron-specific enolase, and factor XIIIa., Results: Histopathologic examination revealed granular cells, some of which were spindle shaped, distributed singly and in small groups between collagen bundles resembling a dermatofibroma. Immunohistochemical studies showed the tumor cells to be positive for S-100 and neuron-specific enolase and negative for factor XIIIa., Conclusion: The immunohistochemical findings support the diagnosis of a granular cell tumor with a dermatofibroma-like pattern.
- Published
- 2001
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36. Primary localized extranodal hodgkin disease of the transverse colon.
- Author
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Vadmal MS, LaValle GP, DeYoung BR, Frankel WL, and Marsh WL
- Subjects
- Adult, Colonic Neoplasms metabolism, Female, Hodgkin Disease metabolism, Humans, Immunohistochemistry, Ki-1 Antigen analysis, Lewis X Antigen analysis, Vimentin analysis, Colonic Neoplasms pathology, Hodgkin Disease pathology
- Abstract
Extranodal Hodgkin disease presenting as a primary localized neoplasm is uncommon, with rare case reports describing primary sites other than lymph nodes. The gastrointestinal tract is the most frequent site of involvement by extranodal Hodgkin disease, typically involving the stomach or small bowel. To date, we have been able to find only one fully documented case of Hodgkin disease of the sigmoid colon confirmed by immunohistochemical studies. We report a case of extranodal Hodgkin disease involving the transverse colon, presenting as inflammatory bowel disease and documented by light microscopic, immunohistochemical, cytogenetic, and molecular studies.
- Published
- 2000
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37. Immunohistologic evaluation of metastatic carcinomas of unknown origin: an algorithmic approach.
- Author
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DeYoung BR and Wick MR
- Subjects
- Biomarkers, Tumor analysis, Biomarkers, Tumor immunology, Carcinoma metabolism, Carcinoma, Neuroendocrine diagnosis, Humans, Neoplasms, Unknown Primary metabolism, Algorithms, Carcinoma diagnosis, Carcinoma secondary, Immunohistochemistry, Neoplasms, Unknown Primary diagnosis
- Abstract
Pathologists are now asked frequently to determine the primary site for metastatic carcinomas of unknown origin (MCUO), using adjunctive morphological techniques such as electron microscopy, immunohistology, and other modalities. The authors present an algorithmic immunohistochemical approach to this problem that is based on their experience with over 2,800 routinely-processed epithelial malignancies of various types. These have been studied with antibodies to keratins, vimentin, epithelial membrane antigen, MOC-31, tumor associated-glycoprotein-72 (recognized by monoclonal antibody B72.3), prostate-specific antigen, thyroglobulin, gross cystic disease fluid protein-15, carcinoembryonic antigen, CA-125, CA19-9, placental alkaline phosphatase, S100 protein, and estrogen receptor protein. The algorithm that is structured around these 14 analytes is based on the relative predictive value of each marker, which in turn, determines its place in the sequence of interpretation. The authors' experience with this approach shows 67% accuracy with regard to the ultimately determined site of origin for MCUO, a figure which is similar to that reported by other investigators.
- Published
- 2000
38. MOC31 immunoreactivity in primary and metastatic carcinoma of the liver. Report of findings and review of other utilized markers.
- Author
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Proca DM, Niemann TH, Porcell AI, and DeYoung BR
- Subjects
- Adenocarcinoma diagnosis, Adenocarcinoma metabolism, Adenocarcinoma secondary, Antibodies, Monoclonal, Biomarkers, Tumor immunology, Carcinoma, Hepatocellular diagnosis, Carcinoma, Hepatocellular metabolism, Cholangiocarcinoma diagnosis, Cholangiocarcinoma metabolism, Diagnosis, Differential, Female, Humans, Immunohistochemistry, Liver Neoplasms diagnosis, Male, Membrane Glycoproteins immunology, Neoplasm Proteins immunology, Biomarkers, Tumor metabolism, Liver Neoplasms metabolism, Liver Neoplasms secondary, Membrane Glycoproteins metabolism, Neoplasm Proteins metabolism
- Abstract
Differentiating between primary tumors of the liver and metastatic lesions can, at times, be difficult. Various histochemical and immunohistochemical methods have been used in an effort to better delineate between hepatocellular carcinoma (HCC), especially the microglandular variant, primary cholangiocarcinoma, and metastatic adenocarcinoma; these ancillary studies can yield less than satisfactory results. Recently, anti-MOC31, a monoclonal antibody directed against a cell surface glycoprotein, has been shown to be helpful in distinguishing between adenocarcinoma and mesothelioma. This study addresses whether this antibody might be helpful in distinguishing between HCC, primary cholangiocarcinoma, and metastatic adenocarcinoma in the liver. Formalin-fixed, paraffin-embedded tissue sections from 15 HCC (including 10 microglandular variants), 14 primary cholangiocarcinomas, and 33 metastatic adenocarcinomas (7 colon, 1 lung, 8 breast, 4 GE jct/gastric, 9 pancreas, 2 small intestine, 1 renal, 1 ovary) were immunostained with anti-MOC 31 (1:40, Dako) after protease digestion and biotin block using a modified ABC technique. Positive staining was limited to membrane based reactivity; controls stained appropriately. Immunoreactivity for MOC31 was observed in 14 of 14 cholangiocarcinomas and 33 of 33 metastatic tumors. Staining was diffuse, intense, and readily interpretable, with rare exceptions. All 15 cases of HCC were negative. We conclude that cholangiocarcinoma and metastatic adenocarcinoma from a variety of sites express MOC31; HCC is uniformly negative for this marker. Anti-MOC31 may prove useful in the evaluation of liver neoplasms where primary hepatocellular and adenocarcinoma enter the differential diagnosis; it is not useful in separating primary cholangiocarcinoma from metastatic adenocarcinoma.
- Published
- 2000
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39. Angiosarcoma of the mandible: a case report and review of the literature.
- Author
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Loudon JA, Billy ML, DeYoung BR, and Allen CM
- Subjects
- Aged, Antibodies metabolism, Biopsy, Diagnosis, Differential, Female, Hemangiosarcoma metabolism, Hemangiosarcoma pathology, Humans, Immunohistochemistry, Mandible metabolism, Mandible pathology, Mandibular Neoplasms metabolism, Mandibular Neoplasms pathology, Platelet Endothelial Cell Adhesion Molecule-1 immunology, von Willebrand Factor immunology, Hemangiosarcoma diagnosis, Mandibular Neoplasms diagnosis
- Abstract
Angiosarcoma is a rare malignancy that is characterized by endothelial cell differentiation. In the head and neck area, most of these lesions arise in the scalps of elderly individuals. Less commonly, angiosarcomas can be found within bone. The purpose of this report is to describe an example of angiosarcoma involving the floor of the mouth and right body of the mandible. The histopathologic and immunopathologic features of these lesions are also reviewed.
- Published
- 2000
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40. CD31 immunoreactivity in small round cell tumors.
- Author
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Nicholson SA, McDermott MB, DeYoung BR, and Swanson PE
- Subjects
- Esthesioneuroblastoma, Olfactory immunology, Esthesioneuroblastoma, Olfactory pathology, Humans, Immunohistochemistry, Kidney Neoplasms immunology, Kidney Neoplasms pathology, Leukemia, Lymphocytic, Chronic, B-Cell immunology, Leukemia, Lymphocytic, Chronic, B-Cell pathology, Nasal Cavity, Neoplasms pathology, Neuroblastoma immunology, Neuroblastoma pathology, Neuroectodermal Tumors, Primitive immunology, Neuroectodermal Tumors, Primitive pathology, Nose Neoplasms immunology, Nose Neoplasms pathology, Retinal Neoplasms immunology, Retinal Neoplasms pathology, Retinoblastoma immunology, Retinoblastoma pathology, Rhabdomyosarcoma immunology, Rhabdomyosarcoma pathology, Sarcoma, Ewing immunology, Sarcoma, Ewing pathology, Wilms Tumor immunology, Wilms Tumor pathology, Biomarkers, Tumor metabolism, Neoplasms immunology, Platelet Endothelial Cell Adhesion Molecule-1 metabolism
- Abstract
CD31 has been shown to be a sensitive and specific marker for endothelial differentiation among epithelioid and spindled-pleomorphic human neoplasms. However, the role of this marker in the evaluation of small round cell tumors has not been evaluated. Formalin-fixed, paraffin-embedded tissue sections from 276 small round cell tumors, including 85 Ewing's sarcoma/primitive neuroectodermal tumors (ES/PNET), 52 rhabdomyosarcomas, 10 extraabdominal polyphenotypic small cell tumors, six desmoplastic small cell tumors, 11 neuroblastomas, 23 Wilms' tumors, 20 retinoblastomas, 13 esthesioneuroblastomas, and 56 small cell malignant lymphomas were stained with CD31 (JC/70A, 1:40), using a modified avidinbiotin-peroxidase complex technique, after citrate buffer microwave epitope retrieval. Among nonlymphoid small round cell tumors, four of 85 ES/PNET were at least focally reactive. No other lesion in this group was positive. In contrast, the majority of well-differentiated (11 of 17), intermediately differentiated (two of three), and lymphoblastic lymphomas (three of three) were positive. Small cleaved lymphomas (three of 13 follicular, one of 13 diffuse) were less often reactive, whereas small noncleaved lesions were negative. Although reactivity for CD31 in ES/PNET is uncommon, the presence of platelet/endothelial cell adhesion molecule in a small cell neoplasm should not in isolation be taken as evidence of hematopoietic origin. These results further define the utility of CD31 in the evaluation of human neoplasms.
- Published
- 2000
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- View/download PDF
41. An immunohistochemical study of Na+/I- symporter in human thyroid tissues and salivary gland tissues.
- Author
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Jhiang SM, Cho JY, Ryu KY, DeYoung BR, Smanik PA, McGaughy VR, Fischer AH, and Mazzaferri EL
- Subjects
- Animals, COS Cells, Humans, Immunohistochemistry, Carrier Proteins analysis, Iodides metabolism, Membrane Proteins analysis, Salivary Glands chemistry, Symporters, Thyroid Gland chemistry
- Abstract
The human Na+/I- symporter (hNIS) is the plasma membrane protein that mediates active iodide uptake into several tissues, such as the thyroid and salivary glands. To study the distribution and cellular localization of the hNIS protein, we have generated a polyclonal antibody that could detect the hNIS protein by immunohistochemical staining on tissue sections. In normal thyroids, hNIS expression is heterogeneous, and it is only detected in sporadic thyrocytes of a given follicle. The hNIS protein was not detected in thyroid carcinomas, yet it was detected in the majority of thyrocytes in Graves' thyroids. In salivary glands, hNIS protein was not detected in acinar cells, but it was detected in ductal cells. The hNIS proteins are clustered in the basal and lateral membranes in cells stained positive for hNIS.
- Published
- 1998
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42. Castleman disease mimicking a hepatic neoplasm.
- Author
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Cirillo RL Jr, Vitellas KM, Deyoung BR, and Bennett WF
- Subjects
- Adult, Castleman Disease pathology, Cholangiopancreatography, Endoscopic Retrograde, Diagnosis, Differential, Female, Humans, Liver Neoplasms pathology, Tomography, Emission-Computed, Single-Photon, Tomography, X-Ray Computed, Castleman Disease diagnosis, Liver Neoplasms diagnosis
- Abstract
Castleman disease, or angiofollicullar hyperplasia, is a rare cause of lymph node enlargement. This most commonly occurs within the thorax, although rare extrathoracic presentations have been described. Only two cases with hepatic localization have been reported. We present a case of Castleman disease within the porta hepatis masquerading as a hepatic neoplasm.
- Published
- 1998
- Full Text
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43. Alterations in the expression of alpha6beta4 integrin and p21/WAF1/Cip1 in N-nitrosomethylbenzylamine-induced rat esophageal tumorigenesis.
- Author
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Khare L, Sabourin CL, DeYoung BR, Wagner BA, and Stoner GD
- Subjects
- Animals, Biomarkers, Tumor metabolism, Blotting, Northern, Cyclin-Dependent Kinase Inhibitor p21, Dimethylnitrosamine toxicity, Disease Models, Animal, Disease Progression, Esophagus drug effects, Esophagus metabolism, Fluorescent Antibody Technique, Integrin alpha6beta4, Male, Polymerase Chain Reaction, Precancerous Conditions chemically induced, Precancerous Conditions metabolism, RNA, Messenger metabolism, Rats, Rats, Inbred F344, Transcription, Genetic, Antigens, Surface biosynthesis, Carcinogens toxicity, Cyclins biosynthesis, Dimethylnitrosamine analogs & derivatives, Esophageal Neoplasms chemically induced, Esophageal Neoplasms metabolism, Integrins biosynthesis
- Abstract
Integrin alpha6beta4 is altered in many neoplastic cells, but no data exist to show this happens in esophageal neoplasms. To examine the expression of this integrin in rat esophageal tumorigenesis induced by N-nitrosomethylbenzylamine (NMBA), (alpha6 and beta4 expression was evaluated in normal esophageal epithelium, in NMBA-induced preneoplastic lesions, and in papillomas by quantitative reverse transcription (RT)-polymerase chain reaction (PCR) and immunohistochemical analysis. Because the 34 subunit of this integrin has been found to cause cell-cycle arrest by the induction of p21/WAF1/Cip1, the expression of p21/WAF1/Cip1 was also analyzed by RT-PCR. Compared with the levels in normal epithelium, the alpha6A, alpha6B, and beta4 integrin levels in esophageal papillomas were 1.9-, 2.2-, and 2.1-fold lower, respectively. RT-PCR analysis showed no significant differences in integrin levels between preneoplastic and normal samples, and northern blot analysis of the beta4 integrin produced results in agreement with the RT-PCR results. The p21/WAF1/Cip1 level was decreased 1.6-fold in preneoplastic tissues and 3.1-fold in papilloma samples when compared with the mRNA levels in normal epithelium. Immunostaining showed that alpha6beta4 integrin was localized at the basolateral surface of the basal cells in normal esophageal epithelium. In preneoplastic lesions, however, the expression of this integrin was not polarized and was expressed in basal cells as well as in suprabasal cells. Beta4 expression was significantly reduced and alpha6A expression was decreased and delocalized in papillomas. These findings suggest that alteration in alpha6beta4 integrin and p21/WAF1/Cip1 expression may be an important biomarker for tumor progression in NMBA-induced rat esophageal tumorigenesis.
- Published
- 1998
44. Genetic alterations in gastrinomas and nonfunctioning pancreatic neuroendocrine tumors: an analysis of p16/MTS1 tumor suppressor gene inactivation.
- Author
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Muscarella P, Melvin WS, Fisher WE, Foor J, Ellison EC, Herman JG, Schirmer WJ, Hitchcock CL, DeYoung BR, and Weghorst CM
- Subjects
- CpG Islands, Cyclin-Dependent Kinase Inhibitor p16 metabolism, DNA Methylation, DNA Primers chemistry, DNA, Neoplasm analysis, Gastrinoma metabolism, Gastrinoma pathology, Humans, Neuroendocrine Tumors metabolism, Neuroendocrine Tumors pathology, Pancreatic Neoplasms metabolism, Pancreatic Neoplasms pathology, Polymerase Chain Reaction, Cyclin-Dependent Kinase Inhibitor p16 genetics, Gastrinoma genetics, Gene Deletion, Genes, p16 genetics, Neuroendocrine Tumors genetics, Pancreatic Neoplasms genetics, Point Mutation
- Abstract
Neoplasms of the endocrine pancreas are extremely rare, and molecular mechanisms influencing their development are poorly understood. Nevertheless, gastrinomas have become a paradigm for the study of hormonally active tumors. In the present study, 12 gastrinoma and nonfunctioning pancreatic neuroendocrine tumor specimens were evaluated for genetic alterations of the p16/MTS1 tumor suppressor gene. DNA extracted from microdissected portions of paraffin-embedded tumor sections were examined for mutations and homozygous deletions using "Cold" single-strand conformation polymorphism and semiquantitative PCR-based analyses, respectively. Samples were also analyzed for the presence of 5' CpG island hypermethylation using methylation-specific PCR. The p16/MTS1 gene was found to be homozygously deleted in 41.7% of tumors and methylated in 58.3%, but no mutations were identified by single-strand conformation polymorphism analyses. Overall, 91.7% of the specimens demonstrated inactivating alterations in p16/MTS1. These data suggest that transcriptional silencing of p16/MTS1 is a frequent event in these rare and poorly understood tumors.
- Published
- 1998
45. Endoscopic appearance of cryptosporidial duodenitis.
- Author
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Papp JP Jr, DeYoung BR, and Fromkes JJ
- Subjects
- AIDS-Related Opportunistic Infections parasitology, Duodenitis diagnosis, Endoscopy, Digestive System, Humans, Male, Middle Aged, AIDS-Related Opportunistic Infections diagnosis, Cryptosporidiosis diagnosis, Duodenitis parasitology
- Abstract
Cryptosporidial oocyst infection is a common cause of diarrhea in patients with AIDS. Concomitant symptoms can include crampy abdominal pain, nausea, vomiting, and anorexia. Esophagogastroduodenoscopy is then useful for delineating potentially treatable pathogens. We report a case of cryptosporidial duodenitis with characteristic endoscopic findings, biopsy correlate, and a review of the current literature. The endoscopic appearance illustrated strongly suggests proximal small bowel mucosal involvement with cryptosporidial oocysts.
- Published
- 1996
46. CD31 immunoreactivity in mesenchymal neoplasms of the skin and subcutis: report of 145 cases and review of putative immunohistologic markers of endothelial differentiation.
- Author
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DeYoung BR, Swanson PE, Argenyi ZB, Ritter JH, Fitzgibbon JF, Stahl DJ, Hoover W, and Wick MR
- Subjects
- Antigens, CD34 analysis, Biomarkers, Tumor immunology, Cell Differentiation immunology, Endothelium, Vascular pathology, Humans, Lectins analysis, Platelet Endothelial Cell Adhesion Molecule-1, Skin Neoplasms pathology, Vascular Neoplasms pathology, Antigens, Differentiation, Myelomonocytic analysis, Cell Adhesion Molecules analysis, Endothelium, Vascular immunology, Plant Lectins, Skin Neoplasms immunology, Vascular Neoplasms immunology
- Abstract
CD31 has recently been reported as a specific marker of endothelial differentiation among non-hematopoietic human neoplasms. In order to address this contention in particular regard to tumors of the skin and subcutis, the authors undertook a comparative study that surveyed 145 mesenchymal lesions. The antibodies used were directed against CD31 (clone JC/70A) and CD34 (clone My10), and these were compared with binding of Ulex europaeus I agglutinin (UEA). Proliferations that were included in the category of vascular tumors included cavernous and capillary hemangiomas (17 cases); lymphangiomas (8); epithelioid ("histiocytoid") hemangiomas (3), papillary endovascular hemangioendothelioma (1), angiosarcoma (7), and Kaposi's sarcoma of the mixed angiomatoid and spindle-cell type (17). CD31-immunoreactivity was observed in 35 of 53 vascular lesions; the neoplastic cells in a single angiosarcoma and the spindle cells in each case of Kaposi's sarcoma (KS) were not labeled. In all of the latter tumors, however, staining for CD31 was identified in the endothelia of angiomatoid areas and non-neoplastic blood vessels. These results compared favorably with those seen with anti-CD34, which decorated 36 of 53 vascular tumors--including 8 of 17 KS cases--and UEA, which bound to the neoplastic cells of 36 lesions. In contrast, all of 92 non-endothelial tumors included in this study (34 nerve sheath tumors [30 benign; 4 malignant]; 39 fibrohistiocytic neoplasms [11 benign; 28 malignant]; 9 smooth muscle tumors [6 benign; 3 malignant]; 7 glomus tumors; and 3 giant cell fibroblastomas) were negative for CD31. UEA labeled 3 non-vascular neoplasms, whereas 38 lesions of that type were CD34-positive.(ABSTRACT TRUNCATED AT 250 WORDS)
- Published
- 1995
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- View/download PDF
47. Lymphangiomyomatosis recurrence in the allograft after single-lung transplantation.
- Author
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O'Brien JD, Lium JH, Parosa JF, Deyoung BR, Wick MR, and Trulock EP
- Subjects
- Adult, Aspergillosis pathology, Female, Humans, Lung Diseases, Fungal pathology, Lung Neoplasms surgery, Lymphangioleiomyomatosis surgery, Recurrence, Lung pathology, Lung Neoplasms pathology, Lung Transplantation pathology, Lymphangioleiomyomatosis pathology
- Abstract
The evolution of lung transplantation has offered an additional treatment option for patients with a variety of end-stage lung diseases, including some with systemic disorders. Lymphangiomyomatosis (LAM) is a multisystem disease of premenopausal women. The lung is the most frequently involved vital organ, and respiratory failure is the most common case of death. A small number of patients with LAM have undergone lung transplantation. This report describes a case of recurrent LAM in the allograft after single lung transplantation and discusses the implications of this finding.
- Published
- 1995
- Full Text
- View/download PDF
48. Fibroma and giant cell tumor of tendon sheath: a comparative histological and immunohistological study.
- Author
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Maluf HM, DeYoung BR, Swanson PE, and Wick MR
- Subjects
- Adolescent, Adult, Aged, Antigens, CD analysis, Diagnosis, Differential, Female, Fibroma chemistry, Humans, Immunohistochemistry, Male, Middle Aged, S100 Proteins analysis, Soft Tissue Neoplasms chemistry, Synovitis, Pigmented Villonodular metabolism, Fibroma pathology, Intermediate Filament Proteins analysis, Soft Tissue Neoplasms pathology, Synovitis, Pigmented Villonodular pathology, Tendons
- Abstract
Giant cell tumor of tendon sheath (GCTTS; "nodular tenosynovitis") and fibroma of tendon sheath (FTS) have traditionally been considered to be two points in a single neoplastic continuum. However, no systematic studies have addressed this concept directly to date. To more clearly define their relationship to one another, we studied five FTSs and seven typical GCTTSs by light microscopy and paraffin section immunohistochemistry. Tissue samples were stained for vimentin, desmin, smooth muscle actin (SMA), S100 protein, leukocyte common antigen (CD45), CD68 antigen (KP1), HAM56 antigen, alpha-1-antichymotrypsin (AACT), and MAC387 antigen. These reagents were chosen to address proposed "fibrohistiocytic" and myofibroblastic lineages for the two lesions. All tumors had a lobular appearance. GCTTS was more cellular than FTS; it contained conspicuous numbers of osteoclast-like cells, and the stroma was not extensively hyalinized. In contrast, FTS was matrix-rich, often with extensive stromal sclerosis, and contained only rare giant cells. Immunophenotyping of GCTTS showed that both the spindle cell and giant cell components were positive for vimentin, LCA, CD68, HAM56, AACT, and MAC387, suggesting monocyte-macrophage-like features. Limited reactivity for desmin and SMA also implied conjoint myofibroblastic differentiation. On the other hand, FTS showed focal staining with HAM56 (all cases) and for CD68 (one case); staining for vimentin and SMA was uniformly intense and diffuse. Based on these results, we conclude that GCTTS and FTS both exhibit varying degrees of monocyte-macrophage-like and myofibroblastic differentiation. The predominance of macrophage-related determinants in GCTTS and myofibroblastic markers in FTS supports the premise that these lesions represent phenotypic extremes of a single clinicopathologic entity.
- Published
- 1995
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