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Slide Seminar
CYTOPATHOLOGY [SS-14]
Cytology and small biopsies: is there a border?

September 4th, 14.00-16.00 Room 5C
Chairpersons: Martin Toetsch (Austria) and Ambrogio Fassina (Italy)
Case 2
Presented by: Martin Toetsch, Graz, Austria

The progression from Cervical Intraepithelial Neoplasia (CIN) to carcinoma in situ (CIS) to invasive squamous cell carcinoma (SCC) is associated with Epithelial to Mesenchymal Transition (EMT).

EMT is triggered by secreted growth factors of tumor and host cells. Epidermal Growth Factor (EGF) and Epidermal Growth Factor Receptor (EGFR) are up-regulated in stromal invasion and metastasis, and up-regulate the zinc-finger transcription factor Snail-1, which mediates EMT by inducing E-cadherin down-regulation of and vimentin up-regulation.

Adhesion molecules and E-cadherin loss are associated with the acquisition of invasive capacity, high tumor grade and poor prognosis.

In a large series of cervical lesions (CIN1, 2, 3, CIS, SCC), we investigated EMT immuno-expression with a panel of pertinent Antibodies, namely EGFR, Snail-1, E-cadherin, Vimentin, p16, p53

In this series we were able to conclude that

reduced E-Cad expression and acquisition of VIM expression were significantly higher in the invasive group;

CIS group revealed a positive correlation between EGFR and Snail-1 expression;

In the invasive group, upregulated Snail-1 protein was correlated with loss of E-Cad expression and gain of Vim expression;

Overall, a significant inverse correlation between E-Cad and Vim immunoexpressions.

Loss of E-cadherin and acquisition of vimentin expression in the human uterine cervix lesions might be indicators of the progression to microinvasive and invasive SCC via EMT. 



Diagnosis & Comments [0]
Case 3
Presented by: Ambrogio Fassina, Padova, Italy

In this presentation we will review few cases of infrequent secondary cancer localization to the lungs, the differential diagnosis, and the corresponding small tru-cut biopsy.

 Case 1 UN, M 67, single nodule lower right lobe

Case 2 CG, M 69, single nodule left basal lobe

Case 3 TAM, F 65, basal right side nodule

Case 4 DM, M 69, inferior right lobe

Case 5 RO, M 73,  inferior right lobe

Case 6 CM, M 53, large single mass with hilar involvement.

 

SCLC

Cromogranin, Synaptophisin

NSCLC adenocarcinoma

TTF, Napsin-A

NSCLC squamous

p40 (o p63) e CK5/6, Desmocollin

Melanoma

S100, HMB45, Melan-A

Renal Cell Carcinoma

CD10

Soft

CD56, Cromogranin, Synaptophisin, CD99, FLI-1, EMA, Caveolin, BCL2, Myogenina, MYO-D1, WT1

HCC

α-fetoprotein, CK7, CK19

 

Slide1Slide2Slide3Slide4Slide5
Diagnosis & Comments [0]
Case 4
Presented by: Helena Barroca, Porto, Portugal

A twenty year-old female, with recurrent episodes of pneumonia in the left lung, performed a bronchoalveolar lavage, in a regional hospital. The diagnosis of small cell neuroendocrine carcinoma was made.

She was admitted in our hospital and, a PET – TC scan was performed. A primary left pulmonary hilar mass (72.6mm-largest dimension) was identified. Surgical bronchial biopsy showed a poorly differentiated small round cell tumour. The neoplastic cells contained glycogen in the cytoplasm and immunoexpressed CD99, synaptophysin, Cam 5.2 and P63, in the absence of immunoexpression for CD56 (N-CAM), Bcl2 and desmin. A tentative diagnosis of Ewing Family Tumours (EFTs) was advanced. The patient started chemotherapy with VIDE protocol for EFTs. Five months later a PET – TC scan disclosed a partial reduction of the tumour showing a remaining lung hilar lesion with 36.2 mm. A sleeve resection of the left lower lobe was performed.

On macroscopy a tumour (35x20x18mm) involving in the lobar bronchus was identified.

Three months after surgery the patient had no evidence of disease and started three-dimensional (3D) conformal radiotherapy.
Fig 1-bronchial wash-HE- 600XFig 2-tac jpegFig 3-Bronchial bxFig 4-
Diagnosis & Comments [0]
Handout: Download
Case 5
Presented by: Beatrix Cochand-Priollet, Paris, France

In June 2007, a 77 year old man was admitted in the department of rheumatology for a T12 spinal cord compression. This patient was known to have a L4 vertebral angioma as well as diabetes. CT scan and MRI were in favor of T12 compressive metastases; numerous enlarged mediastinal and retroperitoneal lymph nodes were found as well as a multinodular thyroid with a predominant upper left lobe nodule 22 X 15 X20 mm wide. A fine needle aspiration of this nodule was performed under ultrasonography with a 25 Gauge needle. An abundant cytological material was obtained (5 conventionnal slides-MGG staining).Considering the unusual cytological result a microbiopsy was realized two days later with a 21 gauge needle

slide 1 MGG x25Slide2 MGG x25Slide3 MGG x40Slide4 MGG x25 Slide4 MGG x25 Slide 5 MGG x40Slide6 MGG x40
Slide 7 HESlide 8 CD 20
Diagnosis & Comments [0]
Handout: Download
Case 6
Presented by: Pinar Firat, Istanbul, Turkey

38 year old male presenting with cough and backpain. Mediastinal mass and pleural nodules were detected on chest tomography. Fine needle aspiration was performed from a pleural nodule
slide 1(MGG)slide 2 (PAP)slide 3 (PAP)slide 4(MGG)slide 5(MGG)slide 6(MGG)slide 7(MGG)
slide 8(PAP)slide 9(PAP)slide 10(H&E)
Diagnosis & Comments [0]
Handout: Download