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Cao J, Hacking S, Chavarria-Bernal HD, Bhuiya TA, Khutti S. Androgen Receptor Immunohistochemical Expression in Undifferentiated/Dedifferentiated Endometrial Carcinoma. Int J Gynecol Pathol 2022; 41:28-34. [PMID: 33399351 DOI: 10.1097/pgp.0000000000000756] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Uterine undifferentiated (UC)/dedifferentiated (DEAC) carcinomas are rare malignant neoplasms. They tend to pursue an aggressive clinical course with an advanced stage at presentation. It has been found that androgen receptor (AR) might play a role as a prognostic and therapeutic marker in endometrial carcinoma. However, its expression in UC/DEAC has not been investigated. Herein, the aim of this study was to evaluate the expression of AR along with estrogen receptor (ER), progestin receptor (PR), and HER2 in UC/DEAC and also in other subtypes of high-grade endometrial carcinomas. Review of our pathology database over the period of 2011 to 2019 identified 16 UC/DEAC cases (N=16). We also randomly selected other high-grade endometrial carcinomas including FIGO 3 endometrioid carcinoma (N=9), serous carcinoma (N=8), clear cell carcinoma (N=12) and carcinosarcoma (N=10) for comparison. Immunohistochemical stains for AR, ER, PR, and HER2 were performed on all 55 cases. The protein expression was evaluated both quantitatively and qualitatively. In DEAC cases both the undifferentiated component and the well-differentiated component were recorded separately. Overall, variable degrees of AR reactivity (by Allred scoring method) was present in 63% of UC/DEACs(10/16), 67% of FIGO 3 endometrioid carcinomas (6/9), 88% of serous carcinomas (7/8), 80% of carcinosarcomas (8/10), and 9% of clear cell carcinoma (1/12). AR expression was most often seen with PR (70%) or ER (60%) staining in UC/DEACs. Thirteen cases of UC/DEACs were positive for at least 1 hormone receptor. HER2 was negative in all UC/DEACs. Almost all other high-grade carcinoma cases were negative for HER2 except 20% of carcinosarcoma (2/10) and 13% of serous carcinoma (1/8) which showed 3+ HER2. Loss of AR appears to be associated with worse clinicopathologic parameters in UC/DEAC. AR is highly expressed in UC/DEAC, and in the majority of FIGO 3 endometrioid carcinomas, serous carcinomas, and carcinosarcoma. These findings suggest a potential role for androgen inhibitors in the management of patients with these tumors.
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Affiliation(s)
- Jin Cao
- Department of Pathology and Laboratory Medicine, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell School of Medicine, Hempstead, New York
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Lima B, Gibson GT, Vullaganti S, Malhame K, Maybaum S, Hussain ST, Shah S, Majure DT, Wallach F, Jang K, Bijol V, Esposito MJ, Williamson AK, Thomas RM, Bhuiya TA, Fernandez HA, Stevens GR. COVID-19 in recent heart transplant recipients: Clinicopathologic features and early outcomes. Transpl Infect Dis 2020; 22:e13382. [PMID: 32583620 PMCID: PMC7361062 DOI: 10.1111/tid.13382] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2020] [Accepted: 06/14/2020] [Indexed: 02/06/2023]
Abstract
BACKGROUND The impact of COVID-19 on heart transplant (HTx) recipients remains unclear, particularly in the early post-transplant period. METHODS We share novel insights from our experience in five HTx patients with COVID-19 (three within 2 months post-transplant) from our institution at the epicenter of the pandemic. RESULTS All five exhibited moderate (requiring hospitalization, n = 3) or severe (requiring ICU and/or mechanical ventilation, n = 2) illness. Both cases with severe illness were transplanted approximately 6 weeks before presentation and acquired COVID-19 through community spread. All five patients were on immunosuppressive therapy with mycophenolate mofetil (MMF) and tacrolimus, and three that were transplanted within the prior 2 months were additionally on prednisone. The two cases with severe illness had profound lymphopenia with markedly elevated C-reactive protein, procalcitonin, and ferritin. All had bilateral ground-glass opacities on chest imaging. MMF was discontinued in all five, and both severe cases received convalescent plasma. All three recent transplants underwent routine endomyocardial biopsies, revealing mild (n = 1) or no acute cellular rejection (n = 2), and no visible viral particles on electron microscopy. Within 30 days of admission, the two cases with severe illness remain hospitalized but have clinically improved, while the other three have been discharged. CONCLUSIONS COVID-19 appears to negatively impact outcomes early after heart transplantation.
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Affiliation(s)
- Brian Lima
- Department of Cardiovascular and Thoracic Surgery, North Shore University Hospital / Northwell Health, Manhasset, NY, USA
| | - Gregory T Gibson
- Department of Cardiology, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Manhasset, NY, USA
| | - Sirish Vullaganti
- Department of Cardiology, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Manhasset, NY, USA
| | - Kathryn Malhame
- Department of Cardiovascular and Thoracic Surgery, North Shore University Hospital / Northwell Health, Manhasset, NY, USA
| | - Simon Maybaum
- Department of Cardiology, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Manhasset, NY, USA
| | - Syed T Hussain
- Department of Cardiovascular and Thoracic Surgery, North Shore University Hospital / Northwell Health, Manhasset, NY, USA
| | - Samit Shah
- Department of Cardiology, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Manhasset, NY, USA
| | - David T Majure
- Department of Cardiology, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Manhasset, NY, USA
| | - Fran Wallach
- Division of Infectious Diseases, Northwell Health and Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA
| | - Kristine Jang
- Department of Cardiology, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Manhasset, NY, USA
| | - Vanesa Bijol
- Department of Pathology and Laboratory Medicine, Northwell Health and Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA
| | - Michael J Esposito
- Department of Pathology and Laboratory Medicine, Northwell Health and Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA
| | - Alex K Williamson
- Department of Pathology and Laboratory Medicine, Northwell Health and Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA
| | - Rebecca M Thomas
- Department of Pathology and Laboratory Medicine, Northwell Health and Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA
| | - Tawfiqul A Bhuiya
- Department of Pathology and Laboratory Medicine, Northwell Health and Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA
| | - Harold A Fernandez
- Department of Cardiovascular and Thoracic Surgery, North Shore University Hospital / Northwell Health, Manhasset, NY, USA
| | - Gerin R Stevens
- Department of Cardiology, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Manhasset, NY, USA
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Nayak A, Bleiweiss IJ, Dumoff K, Bhuiya TA. Mucinous Cystadenocarcinoma of the Breast: Report of 2 Cases Including One With Long-Term Local Recurrence. Int J Surg Pathol 2018; 26:749-757. [DOI: 10.1177/1066896918775810] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Primary mucinous cystadenocarcinoma (MCA) of breast is an exceedingly rare tumor with histologic resemblance to MCA arising in ovary, pancreas, and gastrointestinal tract. In this article, we present 2 additional cases of MCA of breast, one highlighting the diagnostic challenges of a rare entity that may potentially lead to unnecessary chemotherapy and the second case presenting with recurrence after 8 years of primary surgical excision defying the indolent behavior reported in the literature. To our knowledge, this is the first reported instance of such behavior.
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Affiliation(s)
- Anupma Nayak
- University of Pennsylvania, Philadelphia, PA, USA
- Hospital of the University of Pennsylvania, Philadelphia, PA, USA
| | - Ira J. Bleiweiss
- University of Pennsylvania, Philadelphia, PA, USA
- Hospital of the University of Pennsylvania, Philadelphia, PA, USA
| | - Kimberly Dumoff
- University of Pennsylvania, Philadelphia, PA, USA
- Hospital of the University of Pennsylvania, Philadelphia, PA, USA
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4
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Brandler TC, Jelloul FZ, Soto D, Das K, Rosen L, Bhuiya TA. Young investigator challenge: Cadherin-17 and SATB2 in cytology specimens: Do these new immunostains help in differentiating metastatic colorectal adenocarcinoma from adenocarcinomas of other origins? Cancer Cytopathol 2015; 123:706-13. [DOI: 10.1002/cncy.21644] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2015] [Revised: 09/22/2015] [Accepted: 10/14/2015] [Indexed: 12/28/2022]
Affiliation(s)
- Tamar C. Brandler
- Department of Pathology; Hofstra North Shore-Long Island Jewish School of Medicine; Lake Success New York
| | - Fatima-Zahra Jelloul
- Department of Pathology; Hofstra North Shore-Long Island Jewish School of Medicine; Lake Success New York
| | - Daniel Soto
- Department of Pathology; Hofstra North Shore-Long Island Jewish School of Medicine; Lake Success New York
| | - Kasturi Das
- Department of Pathology; Hofstra North Shore-Long Island Jewish School of Medicine; Lake Success New York
| | - Lisa Rosen
- Department of Biostatistics; Hofstra North Shore-Long Island Jewish School of Medicine; Lake Success New York
| | - Tawfiqul A. Bhuiya
- Department of Pathology; Hofstra North Shore-Long Island Jewish School of Medicine; Lake Success New York
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Asirvatham JR, Shah A, Carreon CK, Bhuiya TA, Kahn LB, Kostroff K, Morgenstern NJ. Ossifying fibromyxoid tumor of the breast mimicking fibroadenoma: a case report and differential diagnoses. Arch Pathol Lab Med 2014; 138:1098-100. [PMID: 25076299 DOI: 10.5858/arpa.2012-0766-cr] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
An 80-year-old woman presented with a palpable mass in the right breast. Mammographic findings were consistent with calcified fibroadenoma. An ultrasound was performed that showed a solid nodule with peripheral calcification. A core biopsy was obtained that revealed a spindle cell proliferation with a shell of mature bone. The histologic features, in combination with immunohistochemical studies, were those of an ossifying fibromyxoid tumor. Complete excision of the specimen further confirmed the diagnosis. To the best of our knowledge, this is the first reported case of ossifying fibromyxoid tumor occurring in the breast. We review the current literature on ossifying fibromyxoid tumor and discuss the differential diagnoses when confronted with bland spindle cells on a core biopsy of the breast.
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Affiliation(s)
- Jaya Ruth Asirvatham
- From the Departments of Pathology (Drs Asirvatham, Shah, Carreon, Bhuiya, and Kahn) and Surgery (Dr Kostroff), Hofstra-North Shore Long Island Jewish School of Medicine, New York, New York; and New York Hospital of Queens, New York-Presbyterian Health Care System, New York (Dr Morgenstern)
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6
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Brandler TC, Aziz MS, Rosen LM, Bhuiya TA, Yaskiv O. Usefulness of GATA3 and p40 immunostains in the diagnosis of metastatic urothelial carcinoma in cytology specimens. Cancer Cytopathol 2014; 122:468-73. [DOI: 10.1002/cncy.21424] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2014] [Revised: 03/11/2014] [Accepted: 03/12/2013] [Indexed: 11/08/2022]
Affiliation(s)
- Tamar C. Brandler
- Department of Pathology; Hofstra North Shore-LIJ School of Medicine; Lake Success New York
| | - Mohamed S. Aziz
- Department of Pathology; Hofstra North Shore-LIJ School of Medicine; Lake Success New York
| | - Lisa M. Rosen
- Department of Biostatistics; Hofstra North Shore-LIJ School of Medicine; Lake Success New York
| | - Tawfiqul A. Bhuiya
- Department of Pathology; Hofstra North Shore-LIJ School of Medicine; Lake Success New York
| | - Oksana Yaskiv
- Department of Pathology; Hofstra North Shore-LIJ School of Medicine; Lake Success New York
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7
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Groppi DE, Alexis CE, Sugrue CF, Bevis CC, Bhuiya TA, Crawford JM. Consolidation of the North Shore-LIJ Health System anatomic pathology services: the challenge of subspecialization, operations, quality management, staffing, and education. Am J Clin Pathol 2013; 140:20-30. [PMID: 23765530 DOI: 10.1309/ajcpzheyk8xf4fck] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
Abstract
OBJECTIVES To describe our experience, both in meeting challenges and in reporting outcomes, of the consolidation of anatomic pathology services in the North Shore-LIJ Health System in February 2011. METHODS We addressed issues of governance, personnel, physical plant, quality programming, connectivity, and education. CONCLUSIONS The highly regulated nature of the laboratory industry and the fact that patient care necessarily never pauses require that such a consolidation take place without a break in service or degradation in turnaround time and quality while engaging personnel at all levels in the extra duties related to consolidation. Subspecialization has allowed us to better meet the needs of our in-system health care community while increasing our access to the competitive outreach marketplace.
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Affiliation(s)
- Diane E. Groppi
- Department of Pathology and Laboratory Medicine, Hofstra North Shore–LIJ School of Medicine and North Shore–LIJ Health System, Manhasset, NY
| | - Claudine E. Alexis
- Department of Pathology and Laboratory Medicine, Hofstra North Shore–LIJ School of Medicine and North Shore–LIJ Health System, Manhasset, NY
| | - Chiara F. Sugrue
- Department of Pathology and Laboratory Medicine, Hofstra North Shore–LIJ School of Medicine and North Shore–LIJ Health System, Manhasset, NY
| | - Cynthia C. Bevis
- Department of Pathology and Laboratory Medicine, Hofstra North Shore–LIJ School of Medicine and North Shore–LIJ Health System, Manhasset, NY
| | - Tawfiqul A. Bhuiya
- Department of Pathology and Laboratory Medicine, Hofstra North Shore–LIJ School of Medicine and North Shore–LIJ Health System, Manhasset, NY
| | - James M. Crawford
- Department of Pathology and Laboratory Medicine, Hofstra North Shore–LIJ School of Medicine and North Shore–LIJ Health System, Manhasset, NY
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8
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Jain P, Javdan M, Feger FK, Chiu PY, Sison C, Damle RN, Bhuiya TA, Sen F, Abruzzo LV, Burger JA, Rosenwald A, Allen SL, Kolitz JE, Rai KR, Chiorazzi N, Sherry B. Th17 and non-Th17 interleukin-17-expressing cells in chronic lymphocytic leukemia: delineation, distribution, and clinical relevance. Haematologica 2011; 97:599-607. [PMID: 22058222 DOI: 10.3324/haematol.2011.047316] [Citation(s) in RCA: 56] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND The levels and clinical relevance of Th17 cells and other interleukin-17-producing cells have not been analyzed in chronic lymphocytic leukemia. The objective of this study was to quantify blood and tissue levels of Th17 and other interleukin-17-producing cells in patients with this disease and correlate blood levels with clinical outcome. DESIGN AND METHODS Intracellular interleukin-17A was assessed in blood and splenic mononuclear cells from patients with chronic lymphocytic leukemia and healthy subjects using flow cytometry. Interleukin-17A-producing cells were analyzed in formalin-fixed, paraffin-embedded spleen and lymph node sections using immunohistochemistry and immunofluorescence. RESULTS The absolute numbers of Th17 cells in peripheral blood mononuclear cells and the percentages of Th17 cells in spleen cell suspensions were higher in patients with chronic lymphocytic leukemia than in healthy subjects; in six out of eight paired chronic lymphocytic leukemia blood and spleen sample comparisons, Th17 cells were enriched in spleen suspensions. Circulating Th17 levels correlated with better prognostic markers and longer overall survival of the patients. Two "non-Th17" interleukin-17-expressing cells were identified in chronic lymphocytic leukemia spleens: proliferating cells of the granulocytic lineage and mature mast cells. Granulocytes and mast cells in normal spleens did not express interleukin-17. Conversely, both chronic lymphocytic leukemia and healthy lymph nodes contained similar numbers of interleukin-17+ mast cells as well as Th17 cells. CONCLUSIONS Th17 cells are elevated in chronic lymphocytic leukemia patients with better prognostic markers and correlate with longer survival. Furthermore, non-Th17 interleukin-17A-expressing cells exist in chronic lymphocytic leukemia spleens as maturing granulocytes and mature mast cells, suggesting that the microenvironmental milieu in leukemic spleens promotes the recruitment and/or expansion of Th17 and other IL-17-expressing cells. The pathophysiology of Th17 and non-Th17-interleukin-producing cells in chronic lymphocytic leukemia and their distributions and roles in this disease merit further study.
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Affiliation(s)
- Preetesh Jain
- The Feinstein Institute for Medical Research, 350 Community Drive, Manhasset, NY 11030, USA
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9
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Nayak A, Bhuiya TA. Utility of cytokeratin 5/6 and high-molecular-weight keratin in evaluation of cauterized surgical margins in excised specimens of breast ductal carcinoma in situ. Ann Diagn Pathol 2011; 15:243-9. [PMID: 21420886 DOI: 10.1016/j.anndiagpath.2010.12.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2010] [Accepted: 12/10/2010] [Indexed: 10/18/2022]
Abstract
Evaluation of the surgical margins of excision specimens for ductal carcinoma in situ (DCIS) of breast is challenging due to cautery artifact introduced in the specimen at the time of surgery. Cautery destroys the cytoarchitectural features at the tissue margins and makes the distinction between usual ductal hyperplasia (UDH) and DCIS difficult. Previous studies have shown the value of immunohistochemical staining for cytokeratin 5/6 (CK5/6) and high-molecular-weight keratin (HMWK) in distinguishing UDH from DCIS. We hypothesized that staining for CK5/6 and HMWK (34bE12) may be helpful in evaluating the cauterized surgical margins, given the 2 antibodies follow the same pattern as described in the preserved foci of the 2 entities. Forty-three excised breast specimens were stained for CK5/6 and HMWK (34bE12). Study material was divided into 5 groups: DCIS without cautery artifact, UDH without cautery artifact, UDH with cautery artifact, DCIS with mild-to-moderate cautery artifact morphologically recognizable as involving the surgical margin on hematoxylin and eosin stain, and DCIS with severe cautery artifacts precluding the evaluation of surgical margins on hematoxylin and eosin stain. A comparative evaluation of pattern, extent, and intensity of the 2 immunostains was done. Our results strongly suggest that antibodies for CK5/6 and HMWK (34bE12) may be useful in determining the presence of DCIS at surgical margins even in the event of severe cautery artifact.
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Affiliation(s)
- Anupma Nayak
- Department of Pathology and Laboratory Medicine, Albert Einstein College of Medicine at Long Island Jewish Medical Center, New Hyde Park, NY, USA.
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10
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Qiao X, Bhuiya TA, Spitzer M. Differentiating high-grade cervical intraepithelial lesion from atrophy in postmenopausal women using Ki-67, cyclin E, and p16 immunohistochemical analysis. J Low Genit Tract Dis 2005; 9:100-7. [PMID: 15870531 DOI: 10.1097/00128360-200504000-00006] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
OBJECTIVE In postmenopausal women, differentiating high-grade cervical intraepithelial neoplasia (CIN 2,3) from atrophic uterine cervical squamous epithelium histologically may pose a diagnostic challenge. Recent studies have indicated the value of using a combination of Ki-67, cyclin E, and p16 immunohistochemical analysis in recognizing CIN 2,3. In this study, we compared the staining features of Ki-67, cyclin E, and p16 in cervix specimens from postmenopausal women to distinguish CIN 2,3 from atrophy. METHODS Twenty-six formalin-fixed paraffin-embedded archival cervical specimens (4 biopsy, 8 laser cone, and 14 total hysterectomy samples) were selected from 25 women 50 to 80 years of age (mean = 64 years). Cases included CIN 2,3 (n = 10), atrophy (n = 9), and coexistent CIN 2,3 and atrophy (n = 6). Slides were stained with monoclonal antibodies to Ki-67, cyclin E, and p16 using the avidin-biotin-peroxidase method. Strength of staining was graded as 1+ to 3+. Pattern of staining was described as diffuse, patchy, or scattered. Ki-67 staining restricted to the basal/parabasal zone was scored as negative. RESULTS All CIN 2,3 cases demonstrated variable positivity for Ki-67, cyclin E, and p16. Most CIN 2,3 cases showed strong p16 (81.3%) and Ki-67 (75.0%) reactivity, while only 31.3% of them showed strong cyclin E activity. Some CIN 2,3 cases demonstrated strong p16 but weak Ki-61 and cyclin E reactivity. All atrophic epithelia were negative for p16, cyclin E, and Ki-67. In coexistent CIN 2,3 and atrophy cases, the three-antibody panel clearly demarcated the transition from benign to neoplastic epithelia. CONCLUSION P16 is the most valuable marker followed by Ki-67 for differentiating CIN 2,3. While cyclin E appears to add limited value on these two markers. Therefore, although the three-antibody immunohistochemical panel (p16, Ki-67, and cyclin E) can be a valuable adjunct to routine hematoxylin-eosin staining, it is also possible to use the two-antibody panel (p16 and Ki-67) to effectively distinguish CIN 2,3 from atrophy in postmenopausal women.
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Affiliation(s)
- Xiaoying Qiao
- Department of Pathology, Long Island Jewish Medical Center, New Hyde Park, New York, USA.
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11
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Ahmed S, Kussick SJ, Siddiqui AK, Bhuiya TA, Khan A, Sarewitz S, Steinberg H, Sison CP, Rai KR. Bronchial-associated lymphoid tissue lymphoma: a clinical study of a rare disease. Eur J Cancer 2004; 40:1320-6. [PMID: 15177490 DOI: 10.1016/j.ejca.2004.02.006] [Citation(s) in RCA: 114] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2003] [Revised: 02/09/2004] [Accepted: 02/12/2004] [Indexed: 11/22/2022]
Abstract
Bronchial-associated lymphoid tissue (BALT) lymphoma is a distinct subgroup of low-grade B-cell extranodal non-Hodgkin's lymphoma, classified as marginal-zone lymphoma. This study was performed in order to assess the natural history of this rare entity. We evaluated retrospectively the clinical data of 22 patients with biopsy-proven BALT lymphoma at two tertiary-care institutions from 1996 to 2002. Immunophenotyping was done to confirm the abnormal populations of B-lymphoid cells in all cases, and clonality was determined by flow cytometry or molecular studies. There were 11 men and 11 women in the sample, median age 61 years (range 21-80 years); nine were asymptomatic at diagnosis. All 13 symptomatic patients had non-specific pulmonary complaints. On computed tomographic examination of the chest, 11 patients had bilateral disease, 12 had lung nodules, and 10 had a mass or air-space consolidation. In all but one case the disease was localised to the lung at diagnosis and none had peripheral blood or bone marrow involvement. Out of 22 patients, 20 received treatment in various combinations, 12 had chemotherapy and/or rituximab, six had surgery, and two received radiation therapy as primary treatment. A complete response (CR) was achieved in nine patients and a partial response was obtained in 10 patients. Seven of 10 patients who had unilateral disease achieved a CR. The estimated progression-free survival was 53 months. All patients were alive during the median follow-up period of 36 months (range 12-76 months). It appears that BALT lymphoma tends to be localised to lung at the time of diagnosis, responds well to local or systemic therapy, and has a favourable prognosis.
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MESH Headings
- Adult
- Aged
- Aged, 80 and over
- Bronchial Neoplasms/diagnosis
- Bronchial Neoplasms/mortality
- Bronchial Neoplasms/therapy
- Disease-Free Survival
- Female
- Humans
- Immunophenotyping
- Lung Neoplasms/pathology
- Lymphoma, B-Cell/diagnosis
- Lymphoma, B-Cell/mortality
- Lymphoma, B-Cell/therapy
- Lymphoma, B-Cell, Marginal Zone/pathology
- Lymphoma, Non-Hodgkin/diagnosis
- Lymphoma, Non-Hodgkin/mortality
- Lymphoma, Non-Hodgkin/therapy
- Male
- Middle Aged
- Neoplasm Staging
- Neoplasms, Multiple Primary/pathology
- Retrospective Studies
- Tomography, X-Ray Computed
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Affiliation(s)
- Shahid Ahmed
- Saskatoon Cancer Center, University of Saskatchewan Campus, 20 Campus Drive, Saskatoon, SK, Canada S7N4 H4.
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12
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Wu M, Putti TC, Bhuiya TA. Comparative study in the expression of p53, EGFR, TGF-alpha, and cyclin D1 in verrucous carcinoma, verrucous hyperplasia, and squamous cell carcinoma of head and neck region. Appl Immunohistochem Mol Morphol 2002; 10:351-6. [PMID: 12607604 DOI: 10.1097/00129039-200212000-00011] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Verrucous carcinoma (VC) is a locally invasive, nonmetastasizing variant of squamous cell carcinoma (SCC) with distinct clinical and histologic features. Molecular alterations detectable by immunohistochemical analyses in VC have not been extensively studied. This study investigates the expression of p53, epidermal growth factor receptor (EGFR), transforming growth factor-alpha (TGF-alpha), and cyclin D1 in VC, verrucous hyperplasia (VH), and classic SCC of the head and neck. Twenty-six cases of VC, 12 cases of SCC of various differentiations, and 4 cases of VH were studied. Formalin-fixed, paraffin-embedded archival material was used for immunohistochemistry (avidin-biotin immunoperoxidase technique) to study the expression of oncogenes and their tumor markers. Identification of p53 protein was found in 100% of VH, 88% of VC, and 100% of SCC. EGFR expression was noted in 25% of VH, 54% of VC, 40% of well-differentiated SCC (WDSCC), and 100% of moderately and poorly differentiated SCC (MDSCC/PDSCC). TGF-alpha was detected in 25% of VH, 88% of VC, 80% WDSCC, and 100% of MDSCC/PDSCC. Cyclin-D1 expression was seen in 75% of VH, 35% of VC, 100% of WDSCC, 67% of MDSCC, and 50% of PDSCC. Correlation between the level of expression of all markers and the grade of this group of squamous lesions revealed statistically significant correlation coefficients for p53 and EGFR but not for TGF-alpha and cyclin D1.
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Affiliation(s)
- Maoxin Wu
- Department of Pathology, Mount Sinai Hospital, Mount Sinai School of Medicine, New York, New York, USA.
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13
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Ahmed S, Karim A, Hoffman MM, Bhuiya TA, Mattana J. Focal renal mass: an unusual manifestation of chronic lymphocytic leukemia. Clin Nephrol 2002; 58:324-7. [PMID: 12400852 DOI: 10.5414/cnp58324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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Abstract
Lung volume reduction surgery (LVRS) has recently been introduced as a palliative treatment for patients with severe emphysema. The most common postoperative complication is persistent air leak requiring prolonged tube thoracostomy. We describe a unique case of a patient with severe emphysema who underwent LVRS and presented, about a year later, with the repeated expectoration of surgical staples.
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Affiliation(s)
- S Ahmed
- Long Island Jewish Medical Center, New Hyde Park, NY 11042, USA
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Putti TC, Bhuiya TA. Mixed columnar cell and tall cell variant of papillary carcinoma of thyroid: a case report and review of the literature. Pathology 2000; 32:286-9. [PMID: 11186427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/19/2023]
Abstract
Columnar cell and tall cell carcinomas are newly described variants of papillary thyroid carcinoma associated with aggressive clinical behaviour. Although several cases of tall cell and columnar cell variants have been reported, only a single detailed case report of a mixed tall cell and columnar cell variant has been described in the English-language literature. We report another such composite tumour with predominant columna cell features in an elderly female. The tumour showed extrathyroidal extension with intraluminal superior thyroid vein invasion and lymph node metastasis. DNA ploidy analysis showed a diploid DNA content with no increase of S-phase fraction. Immunohistochemistry showed focal positivity for p53 and Ki-67 at the infiltrating margins of the tumour and diffuse positivity for proliferating cell nuclear antigen. The adverse clinical course warrants aggressive treatment and careful follow-up.
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Affiliation(s)
- T C Putti
- Department of Pathology, Long Island Jewish Medical Center, The Long Island Campus of The Albert Einstein College of Medicine, New Hyde Park, NY, USA
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Affiliation(s)
- M Iqbal
- Division of Pulmonary and Critical Care Medicine, Department of Pathology, and Division of Cardiothoracic Surgery, Long Island Jewish Medical Center, New Hyde Park, NY 11042, USA
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Putti TC, Bhuiya TA. Mixed columnar cell and tall cell variant of papillary carcinoma of thyroid: a case report and review of the literature. Pathology 2000. [DOI: 10.1080/pat.32.4.286.289] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Putti TC, Bhuiya TA, Wasserman PG. Fine needle aspiration cytology of mixed tall and columnar cell papillary carcinoma of the thyroid. A case report. Acta Cytol 1998; 42:387-90. [PMID: 9568142 DOI: 10.1159/000331622] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
BACKGROUND We report the first case of a composite tumor (tall cell and columnar cell variants) of papillary thyroid carcinoma (PTC) diagnosed by fine needle aspiration. It is important to differentiate these uncommon aggressive variants from the usual indolent papillary carcinomas. CASE Fine needle aspiration cytology was obtained from a rare composite tumor of tall cell and columnar cell variants of papillary thyroid carcinoma. The smears showed a cellular aspirate with scattered single tumor cells and several tissue fragments arranged in a papillary pattern. The tumor cells had abundant nuclear grooves and intranuclear pseudoinclusions. Several of the fragments showed columnar cells with nuclear pseudostratification, and a few clusters displayed tall columnar cells with basal nuclei and abundant cytoplasm. A rare cluster exhibited composite features of tall cell and columnar cell variants. CONCLUSION Columnar cell and tall cell variants of PTC manifest aggressive clinical behavior. The differential diagnosis of columnar cell variant includes medullary carcinoma of thyroid and metastatic adenocarcinoma. Immunohistochemical stains for calcitonin and thyroglobulin play an important role in difficult cases. The tall cell variant needs to be differentiated from Hürthle cell papillary neoplasm of thyroid, which displays prominent nucleoli and lacks the characteristic nuclear features of PTC. The preoperative diagnosis of these aggressive variants' is important in planning the most appropriate type of treatment.
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Affiliation(s)
- T C Putti
- Department of Pathology, Long Island Jewish Medical Center, Albert Einstein College of Medicine, New Hyde Park, New York 11040, USA
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Bhuiya TA, Shodell M, Fitzgerald-Bocarsly PA, Murasko D, Shah K, Drake D, Siegal FP. Interferon-alpha generation in mice responding to challenge with UV-inactivated herpes simplex virus. J Interferon Res 1994; 14:17-24. [PMID: 8027590 DOI: 10.1089/jir.1994.14.17] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
In humans with advanced human immunodeficiency virus (HIV) infection, an interferon-alpha (IFN-alpha) response by a specialized blood mononuclear cell to herpes simplex virus (HSV) in vitro is associated with resistance to opportunistic infections. A cell type of unknown lineage, designated the natural IFN-producing cell (NIPC), has been identified preliminarily as the source of these IFNs and may have a role in other host defense functions. Earlier studies suggested the existence of analogous HSV-responsive cell populations in mice. The role specifically of IFN-alpha in the murine system, however, has not been characterized. Using IFN bioassay and neutralization with antisera against Type I IFNs and IFN-beta, we have defined the types and sources of IFNs produced by mice in response to in vivo and in vitro challenge with UV-inactivated HSV. After intraperitoneal inoculation with HSV, BALB/c and C57Bl/6 strains produced characteristically different levels of serum IFNs that appeared principally to be IFN-alpha. The response of mononuclear cells from these mice differed from that of the intact mouse. Isolated cells from bone marrow and spleen released detectable IFNs much later than did whole animals, and the IFNs produced by marrow, spleen, and peritoneal cells were usually neutralized by the anti-IFN-beta. Only bone marrow cells produced detectable amounts of IFN-alpha. Both intact mice and their cells became refractory to restimulation with similar kinetics.
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Affiliation(s)
- T A Bhuiya
- Long Island Jewish Medical Center, Albert Einstein College of Medicine, New Hyde Park, NY 11042
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Abstract
This is the first reported case of a Merkel cell carcinoma arising in the oral mucosa. The tumor occurred in a 53-year-old white man, and it originated in the right mucobuccal fold. The Merkel cell origin was confirmed by electron microscopic and immunohistochemical studies.
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Affiliation(s)
- R Mir
- Department of Laboratory Medicine, Long Island Jewish Medical Center, New Hyde Park, N.Y
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