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Expression of Phox2b in pheochromocytoma of adults and children
IAP 2014 ABSTRACTS
incidentally during imaging studies for an unrelated cause. Adrenal cysts show a spectrum of histological changes. Traditionally, adrenal gland cysts have been classified as pseudocysts, endothelial cysts, epithelial cysts, and parasitic cysts. We report a case of a 29-year-old man who presented to our hospital with history of back pain radiating to both lower limbs. During the workup of the back pain, an incidental finding of a mass displacing the left kidney was seen on MRI. Ultrasound abdomen was done and revealed a large well defined cyst in the left upper quadrant. Contrast enhanced CT was recommended and revealed a 14 13 13 cm, thin walled cystic lesion in the left quadrant. Surgical resection of the cyst was undertaken and the specimen sent for histological examination. Histopathologic examination and immunohistochemical findings were consistent with vascular (endothelial) cyst of the adrenal.
Endocrine Pathology: Poster#103 EXPRESSION OF PHOX2B IN PHEOCHROMOCYTOMA OF ADULTS AND CHILDREN Decaussin Myriam1 and Sartelet Herve´2 1Department of Pathology, Lyon Sud Hospital Centre, Pierre Be´nite, Hospices Civils de Lyon, University Lyon I, France, and 2Department of pathology, Centre hospitalier universitaire Robert Debre, Paris, France Background: Phox2b gene encodes a transcription factor with an expression pattern restricted to the autonomic nervous system during growth, development and adulthood. Phox2b has recently been reported as a useful diagnostic marker for neuroblastic tumors but its expression is controversial in pheochromocytoma. The aim of the study is to determine pattern of expression of Phox2b in a large number of pheochromocytomas of adults or children. Methods: An immunohistochemical study was performed on sixteen adult and pediatric pheochromocytomas with antibodies against Phox2b and neurofilament protein. Two classical neuroblastomas were used as positive control. Results: Every tumor had a non-specific and heterogeneous cytoplasmic expression of Phox2b but only 3 pediatric (18.7%) and 1 adult (6%) pheochromocytomas have demonstrated a specific focal nuclear expression of Phox2b. The tumors with nuclear positivity showed background of neuropil which expressed neurofilament. Conclusion: In the present study, the nuclear expression of Phox2b was focal and associated with neuropil which is only found with neuroblasts but not with chromaffin cells. Also, we can conclude that pheochromocytoma have infrequently foci of neuroblastic tumor areas, particularly in children, while true composite associating large areas of the two types of these tumors are rare.
Endocrine Pathology: Poster#104 HISTOPATHOLOGICAL EVALUATION OF ADRENOCORTICAL CARCINOMAS – A 15 YEAR CASE SERIES Kerollos N. Wanis1 and Rani Kanthan2 1College of Medicine, and 2Department of Pathology & Lab Medicine, University of Saskatchewan, Canada
S73
Adrenocortical carcinoma is a rare cancer, with a reported incidence of 0.5–2.0 cases per million/population/year. Adult adrenocortical carcinoma has a poor prognosis, underscoring the importance of identifying diagnostic and prognostic markers. A 15-year search of our laboratory database for all cases with a diagnosis of adrenocortical carcinoma was undertaken. A total of 8 cases were identified, including one adrenal sarcomatoid carcinoma. We examined the histopathological features of the tumors, specifically assessing for the presence of cellular necrosis, mitotic activity, pleomorphism and vascular invasion. The integrity of the reticulin framework was also examined. Immunohistochemical evaluation of the expression of p53, b-catenin, and Ki67 as a marker of proliferative activity was undertaken. p53 was positive if greater than 10% of cells showed nuclear staining. Necrosis was noted in six of the eight tumors, while vascular invasion was observed in five. Seven tumors had an altered reticulin fiber network. The number of tumors with a high proliferative activity, defined as a Ki67 level of greater than 40%, was six. Five of the tumors were p53 positive, while four stained positive for b-catenin. In summary, we present eight cases of adrenocortical carcinoma with an examination of histological and immunohistochemical features of diagnostic and prognostic value.
Endocrine Pathology: Poster#105 HISTOPATHOLOGICAL PATTERN OF THYROID LESIONS IN KANO: A TEN YEAR RETROSPECTIVE STUDY (2002–2011) Solomon Raphael1, Aminu Zakari Mohammed1 and Iliyasu Yawale1 1Department of Pathology, Aminu Kano Teaching Hospital, Kano, Nigeria, 2Department of Pathology, Ahmadu Bello University, Shika-Zaria, Kaduna, Nigeria Objective: To describe the histopathological pattern of 522 thyroidectomy specimens received at the Pathology department of Aminu Kano Teaching Hospital, Kano, Nigeria, analyse the sex and age variations and compare with findings from previous studies done in Nigeria and elsewhere. Materials and methods: We reviewed slides from paraffin embedded blocks of all thyroidectomy specimens to confirm type of lesion and extracted data such as age and sex from the request forms. Results: The female (86.4%) to male (13.6%) ratio is 6.4:1. The ages ranged from 5 months to 86 years with a mean age of 36.3 years and the relative peak age incidence was seen in the 30–39 years age group. The most common entity was multinodular goitre (57.2%) with a mean age at presentation of 37.5 years. It was followed by thyroid adenomas (15.7%) and thyroid carcinomas (12.6%). Histologically, papillary carcinoma predominated (53%), followed by follicular carcinoma (33.3%) and medullary carcinoma (9.1%). Thyroglossal duct cysts and toxic hyperplasia accounted for 6.9% and 5.4% respectively while thyroiditis was uncommon with only 2 cases (0.4%). Conclusion: Goitre is the most common thyroid lesion in Kano while papillary carcinoma is the most common thyroid cancer, a finding at variance with most reports from Nigeria.
Copyright © Royal College of pathologists of Australasia. Unauthorized reproduction of this article is prohibited.
incidentally during imaging studies for an unrelated cause. Adrenal cysts show a spectrum of histological changes. Traditionally, adrenal gland cysts have been classified as pseudocysts, endothelial cysts, epithelial cysts, and parasitic cysts. We report a case of a 29-year-old man who presented to our hospital with history of back pain radiating to both lower limbs. During the workup of the back pain, an incidental finding of a mass displacing the left kidney was seen on MRI. Ultrasound abdomen was done and revealed a large well defined cyst in the left upper quadrant. Contrast enhanced CT was recommended and revealed a 14 13 13 cm, thin walled cystic lesion in the left quadrant. Surgical resection of the cyst was undertaken and the specimen sent for histological examination. Histopathologic examination and immunohistochemical findings were consistent with vascular (endothelial) cyst of the adrenal.
Endocrine Pathology: Poster#103 EXPRESSION OF PHOX2B IN PHEOCHROMOCYTOMA OF ADULTS AND CHILDREN Decaussin Myriam1 and Sartelet Herve´2 1Department of Pathology, Lyon Sud Hospital Centre, Pierre Be´nite, Hospices Civils de Lyon, University Lyon I, France, and 2Department of pathology, Centre hospitalier universitaire Robert Debre, Paris, France Background: Phox2b gene encodes a transcription factor with an expression pattern restricted to the autonomic nervous system during growth, development and adulthood. Phox2b has recently been reported as a useful diagnostic marker for neuroblastic tumors but its expression is controversial in pheochromocytoma. The aim of the study is to determine pattern of expression of Phox2b in a large number of pheochromocytomas of adults or children. Methods: An immunohistochemical study was performed on sixteen adult and pediatric pheochromocytomas with antibodies against Phox2b and neurofilament protein. Two classical neuroblastomas were used as positive control. Results: Every tumor had a non-specific and heterogeneous cytoplasmic expression of Phox2b but only 3 pediatric (18.7%) and 1 adult (6%) pheochromocytomas have demonstrated a specific focal nuclear expression of Phox2b. The tumors with nuclear positivity showed background of neuropil which expressed neurofilament. Conclusion: In the present study, the nuclear expression of Phox2b was focal and associated with neuropil which is only found with neuroblasts but not with chromaffin cells. Also, we can conclude that pheochromocytoma have infrequently foci of neuroblastic tumor areas, particularly in children, while true composite associating large areas of the two types of these tumors are rare.
Endocrine Pathology: Poster#104 HISTOPATHOLOGICAL EVALUATION OF ADRENOCORTICAL CARCINOMAS – A 15 YEAR CASE SERIES Kerollos N. Wanis1 and Rani Kanthan2 1College of Medicine, and 2Department of Pathology & Lab Medicine, University of Saskatchewan, Canada
S73
Adrenocortical carcinoma is a rare cancer, with a reported incidence of 0.5–2.0 cases per million/population/year. Adult adrenocortical carcinoma has a poor prognosis, underscoring the importance of identifying diagnostic and prognostic markers. A 15-year search of our laboratory database for all cases with a diagnosis of adrenocortical carcinoma was undertaken. A total of 8 cases were identified, including one adrenal sarcomatoid carcinoma. We examined the histopathological features of the tumors, specifically assessing for the presence of cellular necrosis, mitotic activity, pleomorphism and vascular invasion. The integrity of the reticulin framework was also examined. Immunohistochemical evaluation of the expression of p53, b-catenin, and Ki67 as a marker of proliferative activity was undertaken. p53 was positive if greater than 10% of cells showed nuclear staining. Necrosis was noted in six of the eight tumors, while vascular invasion was observed in five. Seven tumors had an altered reticulin fiber network. The number of tumors with a high proliferative activity, defined as a Ki67 level of greater than 40%, was six. Five of the tumors were p53 positive, while four stained positive for b-catenin. In summary, we present eight cases of adrenocortical carcinoma with an examination of histological and immunohistochemical features of diagnostic and prognostic value.
Endocrine Pathology: Poster#105 HISTOPATHOLOGICAL PATTERN OF THYROID LESIONS IN KANO: A TEN YEAR RETROSPECTIVE STUDY (2002–2011) Solomon Raphael1, Aminu Zakari Mohammed1 and Iliyasu Yawale1 1Department of Pathology, Aminu Kano Teaching Hospital, Kano, Nigeria, 2Department of Pathology, Ahmadu Bello University, Shika-Zaria, Kaduna, Nigeria Objective: To describe the histopathological pattern of 522 thyroidectomy specimens received at the Pathology department of Aminu Kano Teaching Hospital, Kano, Nigeria, analyse the sex and age variations and compare with findings from previous studies done in Nigeria and elsewhere. Materials and methods: We reviewed slides from paraffin embedded blocks of all thyroidectomy specimens to confirm type of lesion and extracted data such as age and sex from the request forms. Results: The female (86.4%) to male (13.6%) ratio is 6.4:1. The ages ranged from 5 months to 86 years with a mean age of 36.3 years and the relative peak age incidence was seen in the 30–39 years age group. The most common entity was multinodular goitre (57.2%) with a mean age at presentation of 37.5 years. It was followed by thyroid adenomas (15.7%) and thyroid carcinomas (12.6%). Histologically, papillary carcinoma predominated (53%), followed by follicular carcinoma (33.3%) and medullary carcinoma (9.1%). Thyroglossal duct cysts and toxic hyperplasia accounted for 6.9% and 5.4% respectively while thyroiditis was uncommon with only 2 cases (0.4%). Conclusion: Goitre is the most common thyroid lesion in Kano while papillary carcinoma is the most common thyroid cancer, a finding at variance with most reports from Nigeria.
Copyright © Royal College of pathologists of Australasia. Unauthorized reproduction of this article is prohibited.