Clinicopathological Correlation Research Articles

Study of Immunoexpression of Autophagy Markers- LC3A And LC3B in Cervical Squamous Cell Carcinoma and its Clinicopathological Correlation

Study of Immunoexpression of Autophagy Markers- LC3A And LC3B in Cervical Squamous Cell Carcinoma and its Clinicopathological Correlation

Pathology of the spleen : Differential diagnosis of splenomegaly

After describing the anatomy of the spleen and the most important immunohistochemical stains for identifying cellular constituents of the normal splenic compartments, etiologies of splenomegaly and the diagnostic approach for spleen biopsies are discussed using the example of aNorth African patient with arecent migration background and sudden fever. The focus is on infectious diseases and the morphology and molecular features of hematolymphoid neoplasms, particularly the primary "splenic B‑cell lymphomas" according to the World Health Organization (WHO) classification. The importance of clinicopathological correlations and interdisciplinary cooperation in splenic pathology is emphasized.

Prognostic and diagnostic value of circRNA expression in cervical cancer: a meta analysis.

Cervical cancer (CC) is a highly prevalent malignancy of the reproductive system. This study aimed to methodically assess the function of circular RNAs (circRNAs) as possible indicators of CC, with a specific emphasis on their usefulness in the identification, prediction, and correlation with clinicopathological elements. A comprehensive literature search was conducted using databases such as PubMed, Cochrane Library, Web of Science, Embase, and the China National Knowledge Infrastructure (CNKI). The latest data were extracted on May 3rd, 2024. The diagnostic potential of circRNA expression was evaluated using a range of metrics including sensitivity, specificity, and area under the receiver operating characteristic curve (AUC). The importance of circRNAs was further evaluated in terms of clinical relevance, pathological features, and prognostic value using pooled odds ratios (ORs) and hazard ratios (HRs). The meta-analysis included 27 studies, which were categorised based on diagnostic applications (n=3), clinicopathological correlations (n=15), and prognostic evaluations (n=23). Elevated expression levels of oncogenic circRNAs were significantly associated with poor clinical indicators, including tumour size (odds ratio [OR] = 0.425, 95% confidence interval [CI]: 0.267-0.676), International Federation of Gynaecology and Obstetrics (FIGO) stage (OR = 0.315, 95% CI: 0.224-0.443), and lymph node metastasis (OR = 2.975, 95% CI: 1.816-4.872). This upregulation of oncogenic circRNA was also identified as a predictor of worse survival outcomes, with a hazard ratio (HR) of 2.13 (95% CI: 1.73-2.62, P < 0.001). The downregulation of circRNAs with tumour-suppressor properties was similarly associated with poor clinical parameters, such as tumour size (OR = 0.310, 95% CI: 0.102-0.941), FIGO stage (OR = 0.231, 95% CI: 0.101-0.527), and lymph node metastasis (OR = 2.430, 95% CI: 1.156-5.110), and was indicative of a worsened prognosis (HR = 2.20, 95% CI: 1.03-4.70, P = 0.042). In terms of diagnostic value, the pooled sensitivity, specificity, and area under the curve (AUC) were calculated to be 0.85, 0.83, and 0.91, respectively. The results of our meta-analysis indicate that circRNAs have the potential to serve as promising biomarkers for CC diagnosis, prognosis, and clinicopathology. https://www.crd.york.ac.uk/PROSPERO/, identifier CRD42024544997.

Clinical, Pathologic, and Molecular spectrum of Angioinmmunoblastic T-cell Lymphoma Cutaneous Lesions: Clinical, Pathologic, and Molecular Analysis.

Angioimmunoblastic T-cell lymphoma (AITL) is an aggressive malignancy that frequently presents with extranodal involvement. Cutaneous tropism is clinically and histopathologically variable, which may pose a diagnostic challenge. We conducted a retrospective analysis of 40 samples of 20 cases of cutaneous AITL, focusing on the clinicopathologic and molecular correlations between skin and lymph node (LN) samples. In all cases, cutaneous involvement was concurrent with or followed the diagnosis of nodal AITL, with no cases preceding systemic involvement. Clinically, cutaneous AITL presented in 2 main forms: an evanescent rash and persistent lesions, with histopathology revealing diverse infiltration patterns, including perivascular, nodular, granulomatous, panniculitic, vasculitis, and epidermotropic. Clinical presentation and histologic patterns tend to correlate. Histopathologically, plasma cells were present in 15/22 skin samples, 5 of them being kappa-light restricted but polytypic in corresponding LNs. Epstein-Barr virus+ B cells were present in 10 cutaneous lesions and were already present in corresponding LNs. Molecular studies found correlations in all but one case between LN and skin, particularly in the presence of RHOA and TET2 mutations, which were identified in 8 of 12 cases. Molecular analysis was also informative in 4 cases with low levels of infiltration. The study also highlighted unique cases with distinct clinical and histopathologic patterns coexisting in the same patient over time. One case exhibited simultaneous granulomatous and epidermotropic patterns in different skin lesions. Four cases of cutaneous B-cell lymphomas associated with AITL were identified. Our study underscores the importance of integrating clinical, histopathologic, and molecular data to accurately diagnose cutaneous AITL.

Incidental Finding of a Persistent Right Vitelline Artery in a 13-Year-Old Boy with Acute Appendicitis: A Case Report with Clinico-Pathological Correlation and a Comprehensive Literature Review.

The persistence of fetal vitelline structures may occur. The primary intestinal arterial supply development happens normally in this scenario, but a vitelline vascular remnant (VVR) persists. A 13-year-old boy with a history of severe and intermittent abdominal pain since early infancy presented to the Emergency Department with clinical, analytical, and ultrasonographic findings suggestive of acute appendicitis. There was no evidence of intestinal obstruction. Surgical treatment was indicated. A thick fibrovascular band from the umbilicus to the terminal ileum's mesentery was identified during laparoscopy. A gangrenous cecal appendix was also identified. A regular appendectomy and surgical excision of the band was performed. The histopathological study confirmed that it was a persistent right vitelline artery (VVR) and that the patient had acute gangrenous appendicitis. The patient evolved favorably and is currently asymptomatic and under follow-up. The literature on VVR is scarce. The present manuscript reviews the main characteristics of this embryological insult based on the preceding literature. Standardization of terminology regarding VVR will help better understand this pathology in the future.

Interplay and clinicopathological correlates of tumor size, multifocality and aggressive variants in patients with operated differentiated thyroid carcinoma: A retrospective cohort study

Objectives: To investigate the interplay and clinicopathological correlates of tumor size, cancer foci (multifocality/bilaterality), and aggressive variants in patients with operated differentiated thyroid cancer (DTC). Methods: A total of 596 patients with operated DTC (median age: 47.0 (range: 18.0-87.0 years, 77.5% were females) were included in this retrospective cohort study. Data on patient demographics, cancer foci, concomitant Hashimoto's thyroiditis, surgery type, DTC subtype (papillary thyroid cancer [PTC], follicular thyroid cancer [FTC]) and variants, tumor size, lymph node metastasis, tumor invasion were recorded. Results: PTC aggressive variant (21.9%, P=0.045), extrathyroidal invasion (24.6%, P=0.012), tall cell PTC variant (60.3%, P=0.043), and widely invasive FTC variants (60.0% P=0.002) rates were significantly higher in the bilateral multifocal tumors than in the unifocal and unilateral multifocal tumors. The rates of Hashimoto's thyroiditis (59.8%, P&amp;lt;0.001) and PTC subtype (99.6%, P&amp;lt;0.001) were significantly higher, while the rates of lymph node metastasis (5.8%, P&amp;lt;0.001), capsule invasion (11.6%, P&amp;lt;0.001), vascular invasion (0.4%, P&amp;lt;0.001) and extrathyroidal invasion (4.5%, P&amp;lt;0.001) were significantly lower in &amp;lt;10 mm than in &amp;gt;10 mm tumors. Presence vs. absence of PTC aggressive variant was associated with significantly higher greatest tumor size (12 mm, P=0.013) and higher rates of multifocal tumor (50.5%, P=0.013) and extrathyroidal invasion (33.0%, P&amp;lt;0.001). Conclusions: Our findings revealed the presence of bilaterality/multifocality and aggressive variants in a considerable proportion of patients with operated DTC, and a multifaceted interplay between bilaterality/multifocality, tumor size, and PTC aggressive variants, in addition to their individual effects on increased risk of tumor invasion, particularly the extrathyroidal invasion.

Comprehensive analysis pinpoints CCNA2 as a prognostic and immunological biomarker in non-small cell lung cancer

BackgroundLung cancer is a leading cause of morbidity and mortality globally. Despite advances in targeted and immunotherapies, overall survival (OS) rates remain suboptimal. Cyclin-A2 (CCNA2), known for its upregulation in various tumors and role in tumorigenesis, has an undefined function in non-small cell lung cancer (NSCLC).MethodsWe analyzed three microarray datasets from the Gene Expression Omnibus (GEO) repository to identify differentially expressed genes. Using STRING, we constructed a protein-protein interaction (PPI) network to pinpoint hub genes. The expression and prognostic relevance of CCNA2 were validated using GEPIA and the Kaplan-Meier plotter. Clinicopathological correlations were assessed via the Human Protein Atlas (HPA) and UALCAN databases. qRT-PCR and immunohistochemistry (IHC) were performed to validate CCNA2 mRNA and protein levels. Loss-of-function assays in lung cancer cell lines evaluated the biological role of CCNA2. Immune infiltration and single-cell sequencing were also explored.ResultsAnalysis of GSE18842, GSE101929, and GSE116959 datasets identified 321 upregulated and 623 downregulated genes in NSCLC. CCNA2 was confirmed to be highly expressed in NSCLC through qRT-PCR and IHC, with overexpression correlating with advanced pathological stages and lymph node metastasis. The area under the curve (AUC) of CCNA2 indicating high diagnostic accuracy. Immune infiltration and single-cell sequencing revealed that CCNA2 expression was significantly associated with immune cell infiltration, particularly in Tprolif cells.ConclusionCCNA2 is upregulated in NSCLC and shows significant correlation with clinicopathological characteristics. Our findings suggest that CCNA2 may serve as a promising biomarker for both the prognosis and diagnosis of NSCLC.

A case series of dermatopathological features in different types of morphea and their clinical correlates.

The dermatopathological features in morphea (localized scleroderma) and their clinicopathologic correlations are not well described in the literature. To describe dermatopathological changes of different types of morphea and to investigate the association between clinical and histopathological features. A total of 18 cases of morphea who attended our tertiary care center in the last four years were evaluated. We noted clinical characteristics of all patients and dermatopathological changes like the pattern of sclerosis, degree of inflammation, cell types and all epidermal-dermal, and appendageal changes. Clinicopathological correlation was performed to interpret the clinical significance of dermatopathological changes in various types of morphea. Morphea was most commonly noted in the third decade and females. A circumscribed plaque was the most common clinical presentation. Full-thickness pattern of sclerosis was significantly associated with various clinical outcomes. Basal pigmentation and a reduced number of appendages were noted in more than 80% of patients. All patients had various grades of inflammation. Severe and moderate-grade inflammation with eosinophils and plasma cells was associated with pruritus and/or pain. The limitations are small sample size and single-centered case series. The dermatopathological examination of morphea may help in better monitoring and treatment of patients, including patterns of sclerosis and grades of inflammation, and cell types in skin pathology reports will aid in proper and better clinical management.

High CXCL8 expression predicting poor prognosis in triple-negative breast cancer.

Triple-negative breast cancer (TNBC) is highly prone to early relapse and metastasis following standard treatment. CXCL8 is a key factor in tumor invasion and metastasis, but its role in TNBC prognosis and clinicopathological correlations remains poorly understood. This study investigated CXCL8 expression and its clinical significance in TNBC to develop a prognostic nomogram for guiding intensive treatment and follow-up strategies. Public datasets from the gene expression omnibus public datasets platform were analyzed to assess CXCL8 expression. Additionally, paraffin-embedded TNBC specimens collected from our hospital were examined using immunohistochemistry to explore the relationship between CXCL8 expression and clinicopathological features. Survival analysis was performed to evaluate whether CXCL8 serves as an unfavorable prognostic biomarker for TNBC patients. Univariate Cox regression analysis was conducted to identify prognostic factors. Based on these findings, a nomogram was developed to predict TNBC progression risk. CXCL8 expression was significantly higher in TNBC tissues than in adjacent normal tissues ( P < 0.05). Among 122 TNBC patients, 46 were CXCL8-positive and 76 were CXCL8-negative. CXCL8 expression was significantly associated with N stage ( P < 0.05). Progression-free survival (PFS) was markedly shorter in the CXCL8-positive group compared with the CXCL8-negative group ( P < 0.001). Univariate Cox regression identified N1-3, M1, and CXCL8 positivity as significant risk factors for disease progression. A nomogram incorporating these variables (N, M, and CXCL8) was constructed to predict PFS. Time-dependent receiver operating characteristic curve analysis at 12-, 36-, and 48-month demonstrated strong predictive performance, with area under the curve values of 0.857, 0.839, and 0.795, respectively. CXCL8 is highly expressed in TNBC and promotes lymphatic metastasis, serving as an unfavorable prognostic factor. The developed nomogram offers a valuable tool for guiding personalized treatment and follow-up strategies in TNBC patients.

Fundus Autofluorescence Variation in Geographic Atrophy of Age-Related Macular Degeneration: A Clinicopathologic Correlation.

The purpose of this study was to develop ground-truth histology about contributors to variable fundus autofluorescence (FAF) signal and thus inform patient selection for treating geographic atrophy (GA) in age-related macular degeneration (AMD). One woman with bilateral multifocal GA, foveal sparing, and thick choroids underwent 535 to 580 nm excitation FAF in 6 clinic visits (11 to 6 years before death). The left eye was preserved 5 hours after death. Eye-tracked ex vivo imaging aligned sub-micrometer epoxy resin sections (n=140, 60 µm apart) with clinic data. Light microscopic morphology corresponding to FAF features assessed included drusen-driven atrophy, persistent hyperautofluorescence (hyperFAF) islands and peninsulas within atrophy, and hyperFAF and hypoautofluorescence (hypoFAF) inner junctional zone (IJZ) and outer junctional zone (OJZ) relative to descent of external limiting membrane (ELM). Atrophy growth rate was calculated. HypoFAF atrophic spots appeared in association with drusen, and then expanded and coalesced. Over drusen (n=45, all calcified), RPE was continuous and thin, photoreceptors were short or absent, and initially intact ELM descended where RPE was absent. In persistent hyperFAF within atrophy and in the OJZ, the RPE was continuous and dysmorphic, photoreceptors were present and short, and BLamD was thick. In the IJZ, mottled FAF corresponded to dissociated RPE atop persistent BLamD. Overall linear growth rate (0.198 mm/ year) typified multifocal GA. FAF in GA is locally multifactorial, with photoreceptor shortening potentially promoting hyperFAF by increasing incoming excitation light available to RPE fluorophores. RPE dysmorphia may lead to either longer or shorter pathlength for excitation light. At both atrophy initiation and expansion Müller glia are major participants.

Sex differences for regional pathology in people with a high likelihood of Lewy body dementia phenotype based on underlying pathology.

Clinicopathological correlations differ by sex in Lewy body dementia (LBD). However, previous studies have focused on pathological staging systems that place less emphasis on regional pathologies. We included 357 people (131 female, 226 male) with a high likelihood of LBD based on pathology from the Brain Bank for Neurodegenerative (Jacksonville, FL). Sex differences for regional Lewy body, senile plaque, and neurofibrillary tangle counts and their associations with clinical LBD diagnosis were assessed. Females were less likely to have a clinical LBD diagnosis; they had more Lewy bodies, neurofibrillary tangles, and senile plaques in various regions than males (all p's<0.05). A higher likelihood of clinical LBD diagnosis was associated with more middle frontal, cingulate, and entorhinal Lewy body pathology, and more so for males than for females (all p's<0.045). Sex differences for clinicopathological correlations in LBD also occur at the regional pathology level. Femaleshave a higher frequency of clinical misdiagnosis than males. Femaleshave a higher risk of clinical underdiagnosis for Lewy body dementia (LBD) than males.Regional pathology counts differ by sex for people with a high likelihood of LBD.Regional pathology association with clinical LBD diagnosis differs by sex.Regional Lewy body counts have a stronger association with LBD phenotype for males.

Gene copy deletion of STK11, KEAP1, and SMARCA4: clinicopathologic features and association with outcomes to immunotherapy +/- chemotherapy in nonsquamous non-small cell lung cancer.

Mutations in STK11, KEAP1, and SMARCA4 predispose to inferior immune checkpoint inhibitor (ICI) efficacy in non-small cell lung cancer (NSCLC), particularly among KRAS-mutant cases. However, the frequency, clinicopathologic features, and clinical impact of deletions in these genes are poorly characterized. Clinicopathologic correlates of STK11, KEAP1, and SMARCA4 deletion were analyzed in nonsquamous NSCLCs at Dana-Farber Cancer Institute (DFCI). mRNA and LKB1 protein levels were assessed via The Cancer Genome Atlas. Clinical outcomes were analyzed in patients who received ICI+/-chemotherapy at DFCI and Memorial Sloan Kettering Cancer Center (MSKCC). Analyses of each deletion excluded cases with mutations in that gene. Among 3,194 nonsquamous NSCLCs, 14.7% had STK11 deletion (STK11DEL), 13.5% KEAP1 deletion (KEAP1DEL), and 13.7% SMARCA4 deletion (SMARCA4DEL). These deletions correlated with lower PD-L1 expression and higher disease stage, tumor mutational burden, and aneuploidy. STK11DEL, KEAP1DEL, and SMARCA4DEL each correlated with lower corresponding mRNA expression, and STK11DEL with lower LKB1 protein expression. Among 767 patients treated with chemoimmunotherapy, these deletions associated with worse objective response rates (STK11 31% vs. 45%, P=0.005; KEAP1 33% vs. 45%, P=0.03; SMARCA4 29% vs. 45%, P=0.0007), progression free survival (STK11 HR 1.5, P=0.0001; KEAP1 HR 1.4, P=0.002; SMARCA4 HR 1.6, P<0.0001), and overall survival (STK11 HR 1.7, P<0.0001; KEAP1 HR 1.5, P=0.003; SMARCA4 HR 1.7, P<0.0001). The effect of these deletions on chemoimmunotherapy outcomes was comparable to the effect of mutations in these genes. Among 1,267 patients treated with ICI alone, these deletions did not impact outcomes in the MSKCC cohort, but generally associated with worse outcomes in the DFCI cohort among KRAS-mutant cases. STK11, KEAP1, and SMARCA4 deletions correlate with distinct clinicopathologic features, reduced PD-L1, and poor chemoimmunotherapy efficacy in NSCLC.

Direct Immunofluorescence in Dermatomyositis and Lupus Erythematosus: Cross-Sectional Diagnostic Accuracy and Correlation With Serologies and Other Features of Systemic Disease.

This is a retrospective cross-sectional diagnostic test accuracy study of direct immunofluorescence (DIF) performed on a group of potential lupus erythematosus (LE)/dermatomyositis (DM) skin biopsies from 2015 to 2020 at a large, academic medical center. For purposes of this study, which was focused primarily on detection of LE/DM-related interface dermatitis, DIF was considered positive for a LE/DM pattern if it showed granular deposition of immunoglobulin G, with or without C3, at the basement membrane zone on the final pathology report. Blinded clinicopathologic correlation was the reference standard. One thousand fifty-eight sequential pairs of skin biopsies obtained from adults and submitted for both DIF and routine histology were screened. Cases were excluded if histopathology did not demonstrate features that could be consistent with LE/DM (broadly predefined as interface dermatitis and/or neutrophilic dermatosis), resulting in 254 cases of possible LE/DM eruptions for further analysis. Sensitivity of DIF with an immunoglobulin G granular pattern at the basement membrane zone was 71.4% (confidence interval 55.4%-84.3%) in LE-related and 59.3% (confidence interval 38.8%-77.6%) in DM-related eruptions. No statistically significant difference was found in sensitivities of DIF between LE and DM (P = 0.3). DIF positivity did not correlate with available key demographic, clinical, and serologic features.

Clinicopathological Correlation of Invasive Histological Features in Incidentally Detected Appendiceal Neuroendocrine Tumors (aNETs)

Aim: Appendiceal Neuroendocrine Tumors (aNETs) are rare and mostly detected incidentally patients operated on acute appendicitis. These are indolent tumors and mostly benign, however they carry risk of metastasis. This study aims to identify invasive histological features of aNET cases, that are correlated with aggressive behavior other than stage and grading parameters. Material and Methods: This retrospective study includes patient demographics, surgical margin status and pathological features of tumors. ANETs showing adenocarcinoma features, goblet cell features, and mixed features were not included in our study. Results: The mean age of cases with tumors is 41years (11-61 years). The mean tumor diameter was found to be 6.8 mm. Most of tumors were located in the distal appendix (55.5%). All of the tumors show invasive features. Four cases showed invasion to submucosa (pT₁), four cases to muscularis propria (pT₁), eight cases to subserosa (pT₃), and four cases to mesoappendix (pT₃). Follow-up information was available for only one case with Grade-2 features and MAI, no additional surgical treatment was required, and he has survived at 3-year follow-up with no metastasis. Conclusion: Even if it is grade 1stage 1 tumors, may exhibit invasive features with a risk of metastasis. Although LVI and PNI are not included in ANET staging, they are important factors affecting the course of the disease. The literature lacks consensus on the advisability of performing completion right hemicolectomy in patients exhibiting invasive histological features. We believe it prudent to maintain regular follow-up intervals for these individuals

Diffuse Axonal and Vascular Pathology in the Gyrencephalic Brain after High-Energy Blunt Injury: Clinicopathological Correlations Involving the Brainstem.

Traumatic brain injury (TBI) after high-energy, behind helmet blunt trauma (BHBT) is an important but poorly understood clinical entity often associated with apnea and death in humans. In this study, we use a swine model of high-energy BHBT to characterize key neuropathologies and their association with acute respiratory decompensation. Animals with either stable or critical vital signs were euthanized within 4 h after injury for neuropathological assessment, with emphasis on axonal and vascular pathologies in the brainstem. The majority of cases were characterized by fractures of the cranium at or about the impact site, extensive subarachnoid hemorrhages, coup and contrecoup contusions, and primarily diffuse axonal and vascular lesions throughout the cerebrum, particularly in the brainstem. Absence of spontaneous respiration that was encountered frequently was associated with both severity of impact and the severity of brainstem axonal and vascular lesions. A focused regional examination of brainstem pathology indicated a link between adverse outcomes and diffuse axonal lesions within the medial medulla or vascular lesions within the anteroventral brainstem, a pattern suggesting that injury to brainstem respiratory centers may play a role in apnea following BHBT. In addition, while the overall burden of diffuse axonal and vascular pathologies correlated with each other, we found minimal overlap in their regional distribution. Our findings indicate that high-energy, blunt-force impact TBI causes diffuse lesions in axons and blood vessels associated with poor outcomes. They also suggest that axons and vessels may have distinct responses to tissue deformation and that commonly used markers of vascular pathology, for example, in diagnostic radiology, cannot be used as direct surrogates of diffuse axonal injury. In concert, our study underscores the role of regional axonal and vascular injuries in the brainstem in acute respiratory decompensation after high-rate blunt TBI, even in the presence of head protection; it also emphasizes the importance of detailed clinicopathological work in complex brains in the field of TBI.

Unilateral and Bilateral Recurrent Laryngeal Nerve Palsy in Total Thyroidectomy and Its Clinicopathological Correlation: A Multicentric Cohort study

Unilateral and Bilateral Recurrent Laryngeal Nerve Palsy in Total Thyroidectomy and Its Clinicopathological Correlation: A Multicentric Cohort study

Primary Cutaneous Anaplastic Large Cell Lymphoma With Rare Extracutaneous Disseminated Disease: A Case Report.

Primary cutaneous anaplastic large cell lymphoma (pcALCL) is a CD30+ lymphoproliferative disorder with generally favorable outcomes and infrequent extracutaneous spread, usually limited to local lymph nodes. However, there may be extensive histologic overlap with more aggressive CD30+ lymphomas, such as large cell transformation of mycosis fungoides or secondary skin involvement by anaplastic lymphoma kinase (ALK)-negative anaplastic large cell lymphoma. Definitive diagnosis relies on clinicopathologic correlation. We report on a 26-year-old woman who presented to our institution with progressive lower extremity wounds for several months, previously treated with antibiotics and vacuum-assisted closure dressings. Consultation with dermatology and 2 separate biopsies eventually led to the diagnosis of pcALCL. Subsequent imaging revealed stage IV disease with innumerable intensely fluorodeoxyglucose (FDG)-avid subcutaneous, intramuscular, and visceral foci, but paucity of lymph node involvement. The patient's condition deteriorated, and she died during her hospitalization. This case reviews the clinicopathologic findings of pcALCL, emphasizes the importance of clinicopathologic correlation in differentiating between CD30+ lymphoproliferative disorders, highlights the extremely rare phenomenon of systemic intramuscular and visceral disseminated disease occurring in pcALCL, and discusses implications for prognosis.

Clinicopathological Characterization and Correlation of Breast Tumor with Receptor Status at Tertiary Care Centre, Dahod, Gujarat

Clinicopathological Characterization and Correlation of Breast Tumor with Receptor Status at Tertiary Care Centre, Dahod, Gujarat

DEMOGRAPHIC PROFILE OF ORAL LICHEN PLANUS PATIENTS IN THE BULGARIAN POPULATION. CLINICOPATHOLOGICAL CORRELATION IN THE DIAGNOSIS OF THE DISEASE

Oral lichen planus (OLP) is a relatively common mucosal disease that mainly affects middle-aged women, yet the epidemiological characteristics of this condition in the Bulgarian population are poorly studied. OLP is considered a clinic-pathological diagnosis that is sometimes challenging to make. Aim. The aim of the present study was to determine the prevalence of OLP among the Bulgarian population and to evaluate the clinico-pathological correlation in the diagnosis of the disease. Materials and Methods. The files of the patients with diseases of the oral mucosa consulted in the Department of Periodontology and Oral Mucosa Diseases, Medical University of Plovdiv, between 2012-2016, were retrospectively reviewed. A comparison was also made of the clinical and histopathological diagnoses retrieved from the archived pathohistological records for the same cohort of patients. Results. Out of a total of 714 patients with mucosal diseases, 141 have been diagnosed with OLP, with the disease accounting for the largest proportion (20%) among the analyzed group. Male to female ratio was 1:4, and most patients were over 51 years of age. Histological confirmation of the clinical diagnosis OLP has been obtained in 84.1%, and there were additional 10.84% ​​cases with a histological diagnosis of OLP that were clinically misdiagnosed. Conclusion. OLP seems to be of great clinical importance in our country. There is a clinic-pathological discrepancy in the diagnostic evaluation of the disease in a relatively high percentage of cases. Therefore, stricter diagnostic criteria need to be introduced and followed to obtain a more reproducible diagnosis of OLP.

P12 Paradoxal adalimumab induced palmoplantar pustulosis in a patient with Crohn’s disease

Abstract In November 2023, a 25-year-old man presented with pustular lesions on his palms and soles bilaterally. The pustules were sterile and the biopsy was compatible with psoriasiform dermatitis. In the following days, the patient developed erythematous, scaly, indurated, plaques on his trunk. From the clinicopathological correlation, the diagnosis was palmoplantar pustular psoriasis. The patient was under the treatment of adalimumab from the summer of 2021 for Crohn’s disease (40 mg/2 weeks, subcutaneously), until he proceeded to our clinic with palmoplantar pustulosis. Adalimumab was discontinued. The patient was treated with topical cortisone and keratolytics, in combination with ustekinumab for Crohn’s disease, with a gradual improvement of his symptoms. Tumour necrosis factor (TNF) is a pro-inflammatory cytokine. Adalimumab is a fully human immunoglobulin G1 antibody, blocking TNF activity. In our case, we have another paradoxical adverse reaction of adalimumab. Despite the effectiveness of adalimumab in the treatment of psoriasis and Crohn’s d, our patient developed palmoplantar pustular psoriasis, though he was under adalimumab for his Crohn’s d. Ustekinumab is a biological agent targeting interleukine-12 and 23 and is widely used in the management of both psoriasis and Crohn’s d. Our patient switched from adalimumab to ustekinumab, which kept his Crohn’s d stable and improved his palmoplantar pustular psoriasis, after 1 month