Annals of Pathology and Laboratory Medicine

Is Schistosomiasis a Red Herring in Carcinoma of the Bladder?

Haruna Muhammad Sanusi — 2021-09-30

Objective: The specific role Schistosoma ova play in bladder carcinogenesis as well as its association with a specific morphologic subtype has remained inconclusive. This study aims to re-evaluate this relationship morphologically and review the literature.

Materials: A 19-year (1999-2017) review of all cases of carcinoma of the bladder with or without schistosomiasis was conducted. This was supplemented with a review of the literature.

Results: 278 cases of carcinoma of the bladder were diagnosed. These comprised 251 males and 27 females in ratio 9:1 and mean ages 56±15 years and 54±16 years respectively (p 0.6). While none of the 27 carcinomas among females had Schistosoma ova 28 of the 251 carcinomas in males were co-morbid with schistosomiasis. These comprised 13 of the 174 TCC, 14 of the 94 SCC, and 1 of the 10 adenocarcinomas. There were no statistically significant differences in gender (p 0.6), age (p 0.6), or co-morbidity with the parasite (p 0.2) among the various histologic subtypes. A review of the literature shows an association of Schistosoma ova not only with SCC but also with TCC and, but for isolated case reports, there is a paucity of definitive association with cancers outside the bladder.

Conclusion: There were no statistically significant differences in gender, age, or co-morbidity with the parasite among the various histologic subtypes. In addition to this, the literature review suggests there must be other co-factors present only in the bladder, rather than just the ova by itself, responsible for Schistosoma-associated carcinoma in this organ.

To Study Clinicopathological and Immunohistochemical Expression of Estrogen Receptor, Progesterone Receptor and Her-2/Neu in Prostate Carcinoma

Manpreet Kaur — 2021-09-30

Background: Prostate carcinoma is leading cause of cancer related deaths amongst men. This study evaluated expression of ER, PR, HER-2/neu in Prostatic carcinoma and its correlation with Gleason score and other clinical parameters.

Methods: 50 histopathologically proven PCa cases were subjected to IHC for ER, PR, HER-2/neu.

Result: Most common age group involved was 61-80years. Retention of urine was most frequent complaint. Most prominent Gleason score was (3+4) and group grade was 2. ER expression in tumor epithelial cells was 24% and in stromal cells was 36%. PR expression in stromal cells was 32%. HER-2/neu Cytoplasmic positivity was seen in 6% cases. It was seen that with increase in Gleason grade, ER, PR, HER-2/neu positivity was decreased.

Conclusion: ER, PR, HER-2/neu can be used as biomarkers in PCa management.

Molecular Subtyping of Invasive Breast Carcinoma by Immunohistochemistry and Five-Year Survival Study

Raja Silvan Vipparla — 2021-09-30

Background: Global gene expression profiling for Invasive breast carcinoma (IBC) has identified intrinsic subtypes of IBC with differing clinical outcomes and response to therapy. As genotyping assays are limited by availability and cost, we have used Immunohistochemistry (IHC) surrogates to classify IBC into molecular subtypes.

Methods: Representative tumor blocks of 158 surgical specimens of IBC between 2007 to 2017, were selected and IHC done for ER, PR, Her2, Ki67, CK 5/6 and EGFR. The cases were classified into 7 Molecular subtypes (Luminal A, Luminal B, Luminal HER2PR+, Luminal HER2PR-, HER2Enriched, Basal like (BLBC) and non classifiable (NCBC) and correlated with clinico-pathological findings. Five- year survival rate was calculated for patients diagnosed between 2007 to 2013.

Result: The most common subtype was Luminal A (31.0%), followed by Luminal B (25.3%), NCBC (14.6%) and HER2 enriched (13.3%). Among post-menopausal women, common subtypes were Luminal A (33.8%) and Luminal B (24.4%). Among premenopausal women, most cases were NCBC (27.8%) and BLBC (22.2%). 61.2% of Luminal A were Grade2 and 22.4% were Grade 1. Many cases of Luminal B and HER2 positive cases were of Grade3 (45.0%) and (57.1%) respectively. Of the triple-negative category (BLBC & NCBC), 73% were Grade3 with statistically significant correlation (p value < 0.001). Most of these cases were in Tumor stage T2 (70%), followed by T1 (22.3%). Nodal metastasis was seen in 39.6% and 65% respectively of Luminal A and Luminal B subtypes. Distant metastases on follow-up were present in 15.8%, which included HER2 enriched subtype (28.5%), followed by BLBC (20.0%) and NCBC (17.4%). Luminal A cases, had better survival accounting for 88% of all survivors.

Conclusion: Molecular subtyping of IBC using IHC was useful to understand the clinicopathological distinctiveness of each subtype.

Disseminated Histoplasmosis in a Retropositive Young Male: A Case Report

Aniya Antony — 2021-09-30

Disseminated histoplasmosis is caused by the dimorphic fungus Histoplasma capsulatum. This fungal infection is commonly seen in immunocompromised patients, especially in AIDS patients, children and elderly population. Here we present a case report of a 24-year-old male who was admitted with generalised fatigue and generalised lymphadenopathy. He was found to be retropositive on evaluation and FNAC of the node surprisingly revealed Histoplasmosis. Presence of these organisms were also seen on the peripheral smear which could be picked up only on reviewing the smear again. With this case report we wish to emphasize the need for careful and diligent search of these organisms in the peripheral smear.