Biomedical subjects
Bernard Gosselin
Publications and source records attributed to Bernard Gosselin.
[Organized hematoma of the buttock].
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Diagnostic value of MUC4 immunostaining in distinguishing epithelial mesothelioma and lung adenocarcinoma.
The distinction between pleural malignant mesothelioma and pleural infiltration by adenocarcinomas has complex therapeutic and medicolegal implications. Although the panel of adenocarcinoma-associated antibodies and one or two mesothelioma markers is useful in this purpose, most of these antibodies are not totally specific. We determined the diagnostic value of MUC4 immunostaining in this issue. MUC4 gene expression was also studied by in situ hybridization and RT-PCR. MUC4 is a membrane-bound mucin that has been suggested to be implicated in malignant progression in humans and rats. The MUC4 gene is expressed in various normal epithelial tissues of endodermic origin and carcinomas. In the respiratory tract, MUC4 transcripts have been detected in normal respiratory epithelium and lung carcinomas. MUC4 protein was expressed in 32 of 35 (91.4%) lung adenocarcinomas on paraffin-embedded tissue. None of the 41 malignant mesotheliomas nor the 32 cases of benign mesothelial cells expressed MUC4 at the protein and mRNA levels. We conclude that MUC4 is a very specific (100%) and sensitive (91.4%) marker of lung adenocarcinomas on paraffin-embedded tissue that could be useful in diagnostic practice in the distinction between malignant mesothelioma and adenocarcinoma.
Histologic structure and development of the laryngeal macula flava.
The laryngeal maculae flavae (MF) have been previously described as cellular condensations at the extremities of the vocal cords, but the exact nature and role of the MF are unknown. The purpose of this study is a histomorphological analysis of the nature and development of the MF in human vocal cords, from the beginning of fetal life to adulthood. Eighty-six larynges, from the fetus at 12 weeks of amenorrhea (WA) to adulthood, were collected from autopsies and studied by light microscopy with hematoxylin and eosin, orcein, and Alcian blue staining and pS 100 immunostaining. Our observations allowed us to separate the fetal development of the MF into 4 periods. The first corresponds to the appearance of the posterior MF between 13 and 15 WA. In the second period, the anterior MF appeared between 16 and 18 WA, allowing definition of the intermacular space. Fibrous structures, composed of collagen and elastic fibers, of the MF and intermacular space developed between 20 and 33 WA. The last period, from 33 WA to birth, corresponded to a maturation of these structures. In adults, the histologic structure of the MF presented a concentric peripheral fibrous layer associated with a central cellular component. Structural analysis of the MF concludes in favor of the chondroid nature of the macular cell. These observations bring into question the current knowledge on the MF. From these observations, the role of the MF in the developing vocal cord is discussed.
Value of frozen section examination for the management of nonpalpable incidental testicular tumors.
OBJECTIVES: To determine the value of frozen section examination for the management of small incidental testis tumors. METHODS: We reviewed all cases of incidental nonpalpable testis tumors that have been examined in frozen section during the period 1996-2002. For each case, frozen section and definitive histological slides were available and were reviewed. RESULTS: Fifteen cases were retrieved in the files of the Department of Pathology. Nine cases were discovered by ultrasonography examination in patients presenting with infertility. Six cases were discovered incidentally by sonography for testis trauma or scrotal pain. The patients were aged from 18 to 43 years. The tumors measured from 4 to 16 mm. Frozen section examination concluded in 9 cases to a benign lesion "Leydig cell nodule", in four cases a diagnosis of malignancy was retained and the last two cases were inconclusive. The standard microscopic examination confirmed the 9 cases of Leydig cell tumors; malignancy was confirmed in the 4 cases (3 seminomas and one teratoma) and the uncertain cases were benign Sertoli cells tumors. Benign lesions were treated by a conservative approach. CONCLUSION: Frozen section examination is a useful method for the management of small incidental masses of the testis.
Primary atypical carcinoid of the kidney: a classification is needed.
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MUC6 is a marker of seminal vesicle-ejaculatory duct epithelium and is useful for the differential diagnosis with prostate adenocarcinoma.
The diagnosis of prostate adenocarcinoma is usually made on needle biopsies. Numerous benign lesions may mimic malignancy, especially when the focus of carcinoma is limited. The presence of seminal vesicle-ejaculatory duct epithelium on prostate biopsy is not rare and could cause confusion with adenocarcinoma. Lipochrome pigments are frequently encountered in seminal vesicle-ejaculatory duct but may be also seen in prostate adenocarcinoma. Prostate specific antigen immunostaining in difficult cases is sometimes used, but high-grade adenocarcinomas may be negative. In one previous report, MUC6 was found to be expressed in seminal vesicle but not in normal prostate. MUC6 belongs to the family of human mucin genes. So we investigated herein the immunohistochemical expression of MUC6 in prostate adenocarcinomas and seminal vesicle-ejaculatory duct. We have tested 30 prostate adenocarcinomas of various grade, 10 normal seminal vesicles, and 10 prostate adenocarcinomas invading the seminal vesicles. The tissues were fixed in 10% buffered formalin and embedded in paraffin. Immunohistochemistry was performed using the avidin-biotin-peroxidase complex technique. All adenocarcinomas and normal prostate structures tested were negative. In contrast, all seminal vesicles were diffusely immunostained with MUC6 antibody. We concluded that MUC6 is a valuable marker of seminal vesicle-ejaculatory duct and is useful for the differential diagnosis with prostate adenocarcinoma.
Expression of human mucin genes during normal and abnormal renal development.
Human mucin genes encode large O-glycoproteins, which are expressed in various epithelial tissues. The proteins are the main components of mucus, but also might be involved in morphogenesis of or carcinogenesis in many organs. We studied the expression of human mucin genes during fetal kidney development and in malformed cystic renal diseases in 10 normal fetal kidneys and 12 malformed kidneys by in situ hybridization and immunohistochemical analysis. MUC1, MUC3, and MUC6 were expressed in normal fetal kidney. MUC1 was expressed from 7.5 weeks of gestation in the metanephric blastema and throughout fetal life in the ureteric buds, distal convoluted tubules, and collecting ducts. MUC3 was expressed weakly in immature tubules from 8 weeks of gestation, after which it was expressed weakly and focally in the proximal convoluted tubules. MUC6 was expressed at 9.5 weeks of gestation in the tips of the ureteric buds and later in the collecting ducts. In malformative cystic diseases, only MUC1 expression was retained; no expression of MUC6 and MUC3 was observed. These results implicate human mucin genes (MUC1, MUC3, and MUC6) in renal morphogenesis processes.
Gamna-Gandy nodules in a renal clear cell carcinoma.
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Pathologic quiz case: A subcutis nodule of the right thoracic wall.
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Schwannoma of the sinonasal tract: a clinicopathologic and immunohistochemical study of 5 cases.
CONTEXT: Peripheral nerve sheath tumors are soft tissue neoplasms rarely encountered in the nasal cavity and paranasal sinuses. OBJECTIVE: To describe the clinicopathologic and immunohistochemical features of a series of schwannomas of the sinonasal tract. DESIGN: Surgical pathology files were searched for the diagnosis "sinonasal schwannoma." All histologic documents and clinical data were reviewed. Immunohistochemistry was performed on paraffin-embedded tissue with antibodies to S100 protein, epithelial membrane antigen, CD34, and MIB-1. RESULSTS: Five cases of sinonasal schwannoma were retrieved; patients included 3 women and 2 men, aged 20 to 56 years. Three cases were located in the ethmoid sinus. Clinical symptoms were nonspecific (nasal obstruction, epistaxis, and anosmia). All tumors were treated with conservative surgical resection. Pathologic examination showed a spindle cell proliferation without encapsulation in all cases. No cytologic atypia was seen, and the mitotic activity was low (<3 mitotic figures/10 high-power fields). Immunohistochemistry showed diffuse positivity with S100 protein and negativity with CD34 and epithelial membrane antigen. MIB-1 staining was low (1%-5% of tumor cell nuclei stained). During the follow-up (median, 6 years), no recurrence or metastasis was observed. CONCLUSIONS: Schwannoma is a very unusual tumor of the sinonasal tract and is associated with nonspecific symptoms. Histologically, sinonasal schwannomas differ from schwannomas of other locations by their lack of a peripheral capsule and possible ulceration of the epithelial covering. Sinonasal schwannomas are treated with conservative surgical resection and have an excellent prognosis.
Gastric heterotopia in the nasopharynx.
Heterotopic gastrointestinal mucosa is rare in head and neck area. Most cases are described in oral cavity especially in the floor of the mouth. We present herein the case of an 8-month old infant with a tumor-like mass in the cavum which consisted of an heterotopic gastric mucosa. This case is the first described in this localisation. A brief review of the literature and histopathologic differential diagnoses will be study.
Low-grade myxoid renal epithelial neoplasms with distal nephron differentiation: a distinct clinicopathologic entity?
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Calretinin: a valuable marker of normal and neoplastic Leydig cells of the testis.
Sex cord-stromal tumors represent approximately 4% of all testicular neoplasms. Leydig cell tumor (LCT) is the most common entity, followed by Sertoli cell tumor (SCT). Leydig cell tumor histologic diagnosis is usually easy, but occasional forms of LCT could mimic others neoplasms, especially SCT or variants of yolk sac tumor. The aim of this study was to investigate calretinin expression in LCT and SCT of the testis. We evaluated calretinin reactivity in formalin-fixed, paraffin-embedded sections of 10 LCT, three SCT, five Leydig cell hyperplasia, two Sertoli cell adenomas, eight seminomatous tumors, five nonseminomatous germ cell tumors (mixed tumor), one adenomatoid tumor, and two normal testes using a standard immunohistochemical technique with a microwave-mediated epitope retrieval. All cases of LCT showed a positive staining that was diffuse and intense, constantly cytoplasmic, and sometimes nuclear. A positive strong and diffuse cytoplasmic and sometimes nuclear staining was also observed in Leydig cell hyperplasia and in normal Leydig cells. No staining was seen in two of three cases of SCT, and focal staining was observed in the third case. Only rare scattered cells were weakly immunostained in the Sertoli cell nodules. Seminomatous and nonseminomatous germ cell tumors were negative. Calretinin is an interesting marker of normal and neoplastic Leydig cells of the testis and may be of value in the diagnosis of atypical LCT.
Morphologic subtyping of papillary renal cell carcinoma: correlation with prognosis and differential expression of MUC1 between the two subtypes.
Papillary renal cell carcinoma is now a well-established entity with distinct histological and cytogenetic features. A subdivision has been proposed in correlation with prognosis. Type 1 is the most frequent subtype and appears to have a better prognosis than Type 2. The subdivision is based on microscopic criteria. To investigate these 2 types of papillary renal cell carcinoma, we have compared the clinical features, ancillary factors (TNM stage, Fuhrman grade), survival and MUC1 expression in 25 Type 1 and 12 Type 2 papillary renal cell carcinomas. Type 2 tumors were significantly associated with a higher Fuhrman grade (Grade III frequent; P <.001). Type 2 tumors were also associated with a poorer prognosis than Type 1 (P <.005). Fuhrman grade was significantly associated with prognosis (P <.005). The type and the prognosis were not correlated with the TNM stage. We have shown a differential expression of MUC1 between Type 1 and Type 2 with a polarized expression in Type 1 and a rare expression in Type 2. In conclusion we confirm that the morphologic sub-typing and Fuhrman grade are valuable factors of outcome of papillary renal cell carcinomas and that MUC1 immunostaining is useful in differentiating Type 1 and Type 2 tumors.
CD30 and CD117 (c-kit) used in combination are useful for distinguishing embryonal carcinoma from seminoma.
Germ-cell tumors are the most common malignant neoplasms of the testis. Seminomatous and non-seminomatous tumors must be differentiated because the treatment and the prognosis are different. In light microscopic examination, seminoma may sometimes be difficult to distinguish from the solid pattern of embryonal carcinoma (EC). Although studies have shown that CD30 was a good marker of embryonal carcinoma and that c-kit was regularly expressed in seminoma, none has described the value of CD30 and CD117 (c-kit) in combination for the differential diagnosis between EC and seminoma. We selected 25 pure seminomas, seven pure ECs, and seven mixed germ-cell tumors composed of seminoma and EC from our archives and studied their immunoreactivity for CD30 and CD117. We observed that 27/35 seminomas were CD117+/CD30-; none of the seminoma was CD117-/CD30+. Conversely, 11/14 ECs were CD30+/CD117- and none was CD30-/CD117+. Our findings suggest that CD117 and CD30 immunohistochemistry used in combination represents a valuable tool for distinguishing seminoma from EC.
MUC1 expression is correlated with nuclear grade and tumor progression in pT1 renal clear cell carcinoma.
We studied, by immunohistochemical analysis, the expression of MUC1 and epithelial membrane antigen in 44 stage pT1 renal cell carcinomas (RCCs). Six patients had a metastatic evolution. The percentage of stained cells was determined for each tumor. All tumors and normal adjacent renal parenchyma were stained. In normal kidney, distal convoluted tubules and collecting ducts stained strongly with an apical distribution. In tumors, there was a significant statistical correlation of the MUC1 expression level with the nuclear grade and with tumor progression. High-grade tumors had more stained cells than did low-grade tumors. Metastatic tumors also were more stained than nonmetastatic lesions. By using the Kaplan-Meier method and the log-rank test, we observed that patients with fewer than 10% of stained cells had no metastatic evolution. In contrast, patients with 70% or more stained cells had significantly lower metastasis-free survival rates. We conclude that MUC1 is expressed in RCC and is associated with tumor progression in pT1 RCC.
Microcystic transitional cell carcinoma: a report of 2 cases arising in the renal pelvis.
Microcystic transitional cell carcinoma is a rare variant of urothelial carcinoma; to date, it has been described only in the urinary bladder. We report 2 cases of microcystic transitional cell carcinoma arising in the renal pelvis. The first case occurred in a 73-year-old man with a history of superficially invasive transitional cell carcinoma who presented with macroscopic hematuria and anemia. The second case occurred in a 62-year-old woman who had no relevant medical history and presented with hematuria. Computed tomographic scan revealed a tumor of the renal pelvis. In both cases, microscopic examination showed invasive transitional cell carcinoma with prominent cystic features. The cysts were irregular in size and were deeply infiltrative. The cysts were lined by single or multiple layers of cuboidal or flattened cells with minimal cytological atypia. The first patient died of his disease 18 months after presentation. The second patient remained well at her 6-month follow-up examination. Microcystic transitional cell carcinoma is an unusual, deceptively bland variant of urothelial carcinoma, which can mimic benign lesions.