Background
This study investigates the pulmonary arterial histopathology in patients with idiopathic pulmonary arterial hypertension (IPAH) and acute vasoreactive phenotype, who demonstrated ...long-term survival (>30 years) and incidental death from causes other than PAH progression. The pathological changes observed in these patients were compared with those in patients with bone morphogenetic protein receptor type 2 (BMPR2) mutation.
Case Presentation
We present two cases of patients with pulmonary arterial hypertension (PAH) who died incidentally from causes unrelated to PAH progression. We report compares pulmonary arterial histopathology in long-term survivors of CCB-responsive PAH patient and a hereditary PAH patient with a BMPR2 mutation. Lung specimens were analyzed using the Heath and Edwards (HE) classification and percentage muscular wall thickness (%MWT) of pulmonary arterioles. A significant difference in the severity of grading (
p
= 0.0001) and distribution between grades 1-2, 4 (
p
= 0.001), and 5 (
p
= 0.014) was observed between both patients. These findings suggest differential vascular pathology between the two cases, with CCB responders displaying more mild illness lesions compared to BMPR2 mutant patients.
Conclusion
The study revealed that CCB responders exhibit more mild illness vascular lesions than BMPR2 mutant patients despite their long-term survival, suggesting a difference in vascular pathology between the two phenotypes.
Objective: Prevention and treatment of venous crisis after reconstructive microsurgery is complicated and every clinician has concern about it. We present our clinical experience with blood-sucking ...leech therapy for replantation of severed fingers. Methods: Blood-sucking leech therapy was prescribed for venous crisis due to various causes from July 2019-2020 in 8 patients whose distal fingers were severed. Results: After clinical application, their venous congestion was relieved, all the affected fingers survived, and the curative effect was satisfactory. Conclusion: In venous crisis after the replantation of severed fingers, blood-sucking leech therapy has a significant effect which can successfully prevent finger death caused by congestion, reduce the rate of necrosis, and improve survival rate. It is worthy of applying in clinical practice.
Objectives: Kimura’s disease (KD), or eosinophilic lymphogranuloma, is a rare chronic inflammatory condition with unclear etiology. We aim to present our experience with this condition and review the ...available literature. Methods: This report depicts a pathologically proven case of KD in a 44-year-old man with gradually increased swelling in his left parotid region for the past year, which was painless, and pruritus. Results: This report depicts a pathologically proven case of KD in a 44-year-old man with gradually increased swelling in his left parotid region for the past year, which was painless, and pruritus. Conclusion: This report depicts a pathologically proven case of KD in a 44-year-old man with gradually increased swelling in his left parotid region for the past year, which was painless, and pruritus.
Objectives: Sclerosing Angiomatoid Nodular Transformation (SANT) of the spleen is a rare benign vascular lesion with unknown etiology. Our purpose is to present our experience with this condition and ...review the available literature regarding it. Methods: This report depicts a pathologically proven case of SANT in a 32-year-old man with a history of two previous old injuries who presented with weight loss, vomiting and with left upper quadrant pain and an enlarged spleen. Results: The patient was successfully treated by splenectomy and diagnosed with SANT based on histological and immunohistochemical findings postoperatively. Conclusion: Most patients with SANT are asymptomatic. Imaging studies are essential for detection and the management of SANT. However, the final diagnosis can only be made by histopathology. SANT does not recur after splenectomy.
Objective: The purpose of this study was to investigate the effectiveness of immunohistochemical thyroid malignancy markers Galectin-3, HBME-1, Cytokeratin-19, and CD56 in the diagnosis of thyroid ...neoplasm. Methods: The study included a total of 53 cases of thyroid neoplasm on which immunohistochemical IHC staining was performed using the manual staining method. Results: The histopathological diagnosis of thyroid nodules was papillary thyroid carcinoma in 40 (75.5%), follicular thyroid carcinoma in 3 (5.7%), follicular adenoma in 8 (15.1%), medullary thyroid carcinoma in 1 (1.9%), and Hurthle cell carcinoma in 1 (1.9%). Out of 40 cases of papillary thyroid carcinoma, Galectin-3 and CK19 were positive in 36 (90%) cases while expression of HBME1 was seen in 32 (80%) papillary thyroid carcinoma cases, and 16 (40%) stained positive for CD56. For the three follicular thyroid carcinoma cases, CD56 was positive in one case, but the marker was positive in 7 out of 8 cases (87.5%) of follicular adenoma. Conclusion: Our results suggest Galectin-3 and HBME-1 are the most sensitive diagnostic markers for differentiating papillary carcinoma from follicular neoplasm.
ROS1 is an oncogene, expressed primarily in glioblastomas of the brain that has been hypothesized to mediate the effects of early stage tumor progression. In addition, it was reported that ROS1 ...expression was observed in diverse cancer tissue or cell lines and ROS1 is associated with the development of several tumors. However, ROS1 expression has not been studied in breast cancer to date. Therefore, we investigated ROS1 expression at the protein and gene level to compare expression patterns and to verify the association with prognostic factors in invasive ductal carcinoma (IDC) of the breast.
Tissue samples from 203 patients were used. Forty-six cases were available for fresh tissue. We performed immunohistochemical staining and real-time polymerase chain reaction (PCR).
ROS1 expression was significantly lower in proportion to higher histologic grade, higher mitotic counts, lower estrogen receptor expression, and a higher Ki-67 proliferation index, although ROS1 expression was not significantly associated with the survival rate. The result of real-time PCR revealed similar trends, however not statistically significant.
Higher ROS1 expression may be associated with favorable prognostic factors of IDC and its expression in IDC is related to the proliferation of tumor cells.
Store-operated calcium (Ca(2+)) entry (SOCE) is the principal Ca(2+) entry route in non-excitable cells, including cancer cells. We previously demonstrated that Orai1 and STIM1, the molecular ...components of SOCE, are involved in tumorigenesis of clear cell renal cell carcinoma (CCRCC). However, a clinical relevance of Orai1 and STIM1 expression in CCRCC has been ill-defined. Here, we investigated the expression of Orai1 and STIM1 in CCRCC, and compared their expression with clinico-pathological parameters of CCRCC and the patients' outcome. Immunohistochemical staining for Orai1 and STIM1 was performed on 126 formalin fixed paraffin embedded tissue of CCRCC and western blot analysis for Orai1 was performed on the available fresh tissue. The results were compared with generally well-established clinicopathologic prognostic factors in CCRCC and patient survival. Membrane protein Orai1 is expressed in the nuclei in CCRCC, whereas STIM1 shows the cytosolic expression pattern in immunohistochemical staining. Orai1 expression level is inversely correlated with CCRCC tumor grade, whereas STIM1 expression level is not associated with tumor grade. The higher Orai1 expression is significantly associated with lower Fuhrman nuclear grade, pathologic T stage, and TNM stage and with favorable prognosis. The expression level of STIM1 is not correlated with CCRCC grade and clinical outcomes. Orai1 expression in CCRCC is associated with tumor progression and with favorable prognostic factors. These results suggest that Orai1 is an attractive prognostic marker and therapeutic target for CCRCC.
Both insulin and insulin-like growth factor (IGF)-1 signaling are key regulators of energy metabolism, cellular growth, proliferation, and survival. The IGF-1 receptor (IGF-1R) is overexpressed in ...most types of human cancers including renal cell carcinoma (RCC) with poor prognosis. Insulin receptor (IR) shares downstream effectors with IGF-1R; however, the expression and function of IR in the tumorigenesis of renal cancer remains elusive. Therefore, we examined the expression of IR and its prognostic significance in clear cell RCC (CCRCC).
Immunohistochemical staining for IR was performed on 126 formalin-fixed paraffin-embedded CCRCC tissue samples. Eight of these cases were utilized for western blot analysis. The results were compared with various clinico-pathologic parameters of CCRCC and patient survival.
IR was expressed in the nuclei of CCRCC tumor cells in 109 cases (87.9%). Higher IR expression was significantly correlated with the presence of cystic change, lower Fuhrman nuclear grade, lower pathologic T stage, and lower TNM stage, although it wasn't significantly related to diabetes status and patient survival. Western blot analyses supported the results of the immunohistochemistry studies.
IR expression in CCRCC may be associated with favorable prognostic factors.
Klotho functions as a tumor suppressor predominantly expressed in renal tubular cells, the origin of clear cell renal cell carcinoma (ccRCC). Altered expression and/or activity of growth factor ...receptor have been implicated in ccRCC development. Although Klotho suppresses a tumor progression through growth factor receptor signaling including insulin-like growth factor-1 receptor (IGF-1R), the role of Klotho acting on IGF-1R in ccRCC and its clinical relevance remains obscure. Here, we show that Klotho is favorable prognostic factor for ccRCC and exerts tumor suppressive role for ccRCC through inhibiting IGF-1R signaling. Our data shows the following key findings. First, in tumor tissues, the level of Klotho and IGF-1R expression are low or high, respectively, compared to that of adjacent non-neoplastic parenchyma. Second, the Klotho expression is clearly low in higher grade of ccRCC and is closely associated with clinical outcomes in tumor progression. Third, Klotho suppresses IGF-1-stimulated cell proliferation and migration by inhibiting PI3K/Akt pathway. These results provide compelling evidence supporting that Klotho acting on IGF-1R signaling functions as tumor suppressor in ccRCC and suggest that Klotho is a potential carcinostatis substance for ccRCC.
Histone deacetylase 1 (HDAC1) is associated with the expression and function of estrogen receptors and the proliferation of tumor cells, and has been considered a very important factor in breast ...tumor progression and prognosis. Several studies have reported an association between HDAC1 expression and poorer prognosis in cancers including breast cancer, with a few exceptions. However, because of the dearth of studies on HDAC1 expression in breast cancer, its significance for breast cancer prognosis has not been well defined. Therefore, we examined HDAC1 expression in invasive ductal carcinoma (IDC), the most common breast cancer, and investigated its potential prognostic significance.
We used 203 IDC tissue samples. Immunohistochemical stains for HDAC1 and real-time polymerase chain reaction for HDAC1 mRNA were performed and the results were compared to generally well-established prognostic factors in breast cancer and patient survival rates.
HDAC1 expression was significantly reduced in proportion to higher histologic grade, higher nuclear pleomorphism score, and higher mitotic counts, and with lower estrogen receptor expression. Furthermore, it was significantly associated with the survival rate.
HDAC1 expression is a good prognostic indicator in IDC.
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