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Elevated serum CA-125 and pelvic masses — not always on ovarian carcinoma
Posters: Gynecological Pathology / Pathology - Research and Practice 200 (2004) 327-330
329
J. MAKOVITZKY ~, M. LOEBERMANN 2, F. PRALL 3, A. STACHS 4
been shown that placental hypoxia as well as apoptosis are pathogenetic factors for pregnancy-induced hypertensive diseases and IUGR. The aim of the study was to analyse placental expression of BNIP3 in pregnancies complicated by preeclampsia or HELLPsyndrome. Methods: Placental tissues was sampled from ten pregnancies with preeclampsia, HELLP-syndrome and gestational age-matched controls. The placental expression of BNIP3 has been investigated with immunohistochemistry by the use of a specific human BNIP3 antibody. Results: BNIP3 was immunohistochemically detectable in the syncytiotrophoblast, villus stroma and vascular endothelium of each placental sample. The expression is significantly decreased in pregnancies complicated by either preeclampsia (factor 0.62; p < 0.05) or HELLP-syndrome (factor 0.54; p < 0.05) compared to gestational age-matched control pregnancies. Conclusions: Pregnancies with placental dysfunction and hypertensive pregnancy disorders with different clinical manifestations are characterized by a significant decreased expression of BNIP3. These results suggest that the in generally accepted hypothesis of increasing placental apoptosis in pregnancy-induced hypertensive disorders caused by disturbed trophoblast invasion has to be partly revised.
1Abteilung for Gynakopathologie, 2Abteilung ftir Tropenmedizin und Infektionskrankheiten, 3Institut for Pathologie, 4 Universit~its-Franenklinik,Universit~it Rostock
An Analysis of Clinicopathologic Factors in Uterine Smooth Muscle Tumors
lines (Ovcar-3, Skov-3, tAW-42, ES-2). Although the four cell lines expressed comparable levels of both ROCK-isoforms, ES-2 was about 2-fold more invasive in the Boyden Chamber Assay. The invasive capacity of the other three cell lines could be stimulated by lysophosphatidyl acid (LPA), a known Rho-inducer. Surprisingly, treatment with Y-27632 did not inhibit Matrigel invasion, but had the same stimulatory effect on invasion of Ovcar-3, Skov-3 and OAW-42 as LPA. The stimulation was dependent on the concentration of Y-27632 and HA-1077, respectively. The combination ofY27632 with LPA showed a slight increase compared to each substance alone. Conclusions: In our study, we showed that inhibiton of ROCK resuits in increased invasion of human ovarian carcinoma cells. Further studies should clarify which mechanisms contribute to different effects in different tumor models.
275
Elevated serum CA-125 and pelvic masses not always an ovarian carcinoma
Background: Serum cancer antigen 125 (CA-125) may be mildly elevated in benign diseases but is generally associated with ovarian carcinoma. In some patients presenting with high levels of CA-125 and ovarian tumour this marker may still be misleading. Case report: We report the case of a 22-year old patient who presented with bleeding disorders, night-sweats and lower abdominal pain. Sonographic examination revealed a cystic ovarian mass. The serum level of CA-125 was found to be elevated 24-fold above the upper limit of normal. Computed tomography showed tumour-like polycystic masses in the ovarian region bilaterally. A pelviscopy revealed disseminated peritoneal effusions compatible with peritoneal carcinosis. Histology of cervix and endometrium abrasion revealed epitheloid-cell granuloma and giant-cells of the Langhans-type. Biopsies done during pelviscopy also showed histological changes compatible with ovarian and peritoneal tuberculosis. Subsequent further evaluation revealed a positive tuberculin-test. However, Ziehl-Neelsen stains and PCR-methods were not able to detect tuberculosis in the biopsy material, sputum, or urine. Urine samples cultured Mycobacterium tuberculosis after 3 weeks and treatment of the genitourinary tuberculosis resulted in clinical improvement and reduction of CA- 125 serum levels. Conclusions: Genitourinary tuberculosis is a rare cause of pelvic masses in central Europe and may therefore cause diagnostic difficulties. Symptoms and morphologic changes may mimic malignancies, high levels of CA-125 may be detected not only in ovarian carcinoma, but also in tuberculosis affecting the ovaria.
276
Localization and expression of the pro-apoptotic "cell death" factor BNIP3 in placentas from hypertensive pregnancies Titel H. STEPAN, S. P URZ, C. LEO, M. HOCKEL, L.-C. HORN 1 Universit~itsfranenklinikLeipzig Institut fiir Pathologie, Universitgt Leipzig Aims: BNIP3 is a pro-apoptotic factor of the Bcl-2-family and is hypoxia-mediated expressed in malignant tumours. Recently it has
277
J. WALDMANN, J. MAKOVITZKY, A. STACHS, G. STROPAHL 1 Franenklinik, Universit~it Rostock /Institut ffir Pathologie, Universit~it Rostock Aims: The study is designed to classify and analyse leiomyomas, leiomyoblastomas and leiomyosarcomas in the uterine corpus. It is based on the evaluation of records of more than 1400 patients (hysterectomy) treated at the university's hospital between 1/1997 and 6/2003. Moreover, particular attention is given to those of patients suffering from leiomyosarcomas. Methods: The data is obtained by use of both the conventional histology (HE and Giemsa) and the immunohistochemistry with markers for leiomyosarcomas (desmin, actin, sm-actin, vimentin and Ki 67). Different statistical methods are used to describe and to analyse the data. Results: A number of diagrams based on different microscopic findings, localizations and age-groups illustrate the (relative) frequency of each single class of smooth muscle tumor of the uterine corpus and its correlations. Of the 1422 patients, 7 suffer from leiomyosarcoma, 26 from leiomyoblastoma and the remaining are diagnosed as leiomyoma. The leiomyosarcomas show an elevated mitosis index and atypical muscle fibres in different stages of maturation and necroses. Conclusions: Based on our study a leiomyosarcoma can be expected to occur in less than 0.5% of uterine smooth muscle tumors. In 2 (out of 7) cases a leiomyosarcoma is assumed to have its origin in a leiomyoma.
278
Apaf-1 is regulated by hypoxia in cervical cancer
C. RICHTER 1, C. LEO 1, A. SCHUTZ 2, IM. HOCKEL 1, L.-C. HORN 2 Universit~its-Frauenldinik(Triersches Institut), Universit~t Leipzig 2Institut fiir Pathologie, Universit~it Leipzig
329
J. MAKOVITZKY ~, M. LOEBERMANN 2, F. PRALL 3, A. STACHS 4
been shown that placental hypoxia as well as apoptosis are pathogenetic factors for pregnancy-induced hypertensive diseases and IUGR. The aim of the study was to analyse placental expression of BNIP3 in pregnancies complicated by preeclampsia or HELLPsyndrome. Methods: Placental tissues was sampled from ten pregnancies with preeclampsia, HELLP-syndrome and gestational age-matched controls. The placental expression of BNIP3 has been investigated with immunohistochemistry by the use of a specific human BNIP3 antibody. Results: BNIP3 was immunohistochemically detectable in the syncytiotrophoblast, villus stroma and vascular endothelium of each placental sample. The expression is significantly decreased in pregnancies complicated by either preeclampsia (factor 0.62; p < 0.05) or HELLP-syndrome (factor 0.54; p < 0.05) compared to gestational age-matched control pregnancies. Conclusions: Pregnancies with placental dysfunction and hypertensive pregnancy disorders with different clinical manifestations are characterized by a significant decreased expression of BNIP3. These results suggest that the in generally accepted hypothesis of increasing placental apoptosis in pregnancy-induced hypertensive disorders caused by disturbed trophoblast invasion has to be partly revised.
1Abteilung for Gynakopathologie, 2Abteilung ftir Tropenmedizin und Infektionskrankheiten, 3Institut for Pathologie, 4 Universit~its-Franenklinik,Universit~it Rostock
An Analysis of Clinicopathologic Factors in Uterine Smooth Muscle Tumors
lines (Ovcar-3, Skov-3, tAW-42, ES-2). Although the four cell lines expressed comparable levels of both ROCK-isoforms, ES-2 was about 2-fold more invasive in the Boyden Chamber Assay. The invasive capacity of the other three cell lines could be stimulated by lysophosphatidyl acid (LPA), a known Rho-inducer. Surprisingly, treatment with Y-27632 did not inhibit Matrigel invasion, but had the same stimulatory effect on invasion of Ovcar-3, Skov-3 and OAW-42 as LPA. The stimulation was dependent on the concentration of Y-27632 and HA-1077, respectively. The combination ofY27632 with LPA showed a slight increase compared to each substance alone. Conclusions: In our study, we showed that inhibiton of ROCK resuits in increased invasion of human ovarian carcinoma cells. Further studies should clarify which mechanisms contribute to different effects in different tumor models.
275
Elevated serum CA-125 and pelvic masses not always an ovarian carcinoma
Background: Serum cancer antigen 125 (CA-125) may be mildly elevated in benign diseases but is generally associated with ovarian carcinoma. In some patients presenting with high levels of CA-125 and ovarian tumour this marker may still be misleading. Case report: We report the case of a 22-year old patient who presented with bleeding disorders, night-sweats and lower abdominal pain. Sonographic examination revealed a cystic ovarian mass. The serum level of CA-125 was found to be elevated 24-fold above the upper limit of normal. Computed tomography showed tumour-like polycystic masses in the ovarian region bilaterally. A pelviscopy revealed disseminated peritoneal effusions compatible with peritoneal carcinosis. Histology of cervix and endometrium abrasion revealed epitheloid-cell granuloma and giant-cells of the Langhans-type. Biopsies done during pelviscopy also showed histological changes compatible with ovarian and peritoneal tuberculosis. Subsequent further evaluation revealed a positive tuberculin-test. However, Ziehl-Neelsen stains and PCR-methods were not able to detect tuberculosis in the biopsy material, sputum, or urine. Urine samples cultured Mycobacterium tuberculosis after 3 weeks and treatment of the genitourinary tuberculosis resulted in clinical improvement and reduction of CA- 125 serum levels. Conclusions: Genitourinary tuberculosis is a rare cause of pelvic masses in central Europe and may therefore cause diagnostic difficulties. Symptoms and morphologic changes may mimic malignancies, high levels of CA-125 may be detected not only in ovarian carcinoma, but also in tuberculosis affecting the ovaria.
276
Localization and expression of the pro-apoptotic "cell death" factor BNIP3 in placentas from hypertensive pregnancies Titel H. STEPAN, S. P URZ, C. LEO, M. HOCKEL, L.-C. HORN 1 Universit~itsfranenklinikLeipzig Institut fiir Pathologie, Universitgt Leipzig Aims: BNIP3 is a pro-apoptotic factor of the Bcl-2-family and is hypoxia-mediated expressed in malignant tumours. Recently it has
277
J. WALDMANN, J. MAKOVITZKY, A. STACHS, G. STROPAHL 1 Franenklinik, Universit~it Rostock /Institut ffir Pathologie, Universit~it Rostock Aims: The study is designed to classify and analyse leiomyomas, leiomyoblastomas and leiomyosarcomas in the uterine corpus. It is based on the evaluation of records of more than 1400 patients (hysterectomy) treated at the university's hospital between 1/1997 and 6/2003. Moreover, particular attention is given to those of patients suffering from leiomyosarcomas. Methods: The data is obtained by use of both the conventional histology (HE and Giemsa) and the immunohistochemistry with markers for leiomyosarcomas (desmin, actin, sm-actin, vimentin and Ki 67). Different statistical methods are used to describe and to analyse the data. Results: A number of diagrams based on different microscopic findings, localizations and age-groups illustrate the (relative) frequency of each single class of smooth muscle tumor of the uterine corpus and its correlations. Of the 1422 patients, 7 suffer from leiomyosarcoma, 26 from leiomyoblastoma and the remaining are diagnosed as leiomyoma. The leiomyosarcomas show an elevated mitosis index and atypical muscle fibres in different stages of maturation and necroses. Conclusions: Based on our study a leiomyosarcoma can be expected to occur in less than 0.5% of uterine smooth muscle tumors. In 2 (out of 7) cases a leiomyosarcoma is assumed to have its origin in a leiomyoma.
278
Apaf-1 is regulated by hypoxia in cervical cancer
C. RICHTER 1, C. LEO 1, A. SCHUTZ 2, IM. HOCKEL 1, L.-C. HORN 2 Universit~its-Frauenldinik(Triersches Institut), Universit~t Leipzig 2Institut fiir Pathologie, Universit~it Leipzig