Department Of Anatomical Pathology Research Articles

Landscape of HER2-low breast cancer: Insights from a six-year study on prevalence and clinicopathological characteristics

Human epidermal growth factor receptor 2 (HER2)-low breast cancer has emerged as a subtype of breast cancer, defined by HER2 1+/2+ in immunohistochemistry (IHC) and absence of ERBB2 gene amplification on fluorescence in situ hybridization (FISH). Recent trials showed marked response of HER2-low breast cancer to novel anti-HER2 antibody-drug-conjugates. Data on characteristics of HER2-low breast cancer subtype is limited. Real-world data from the Anatomic Pathology Department of Hotel-Dieu de France, spanning 2017–2023, was retrospectively collected. HER2-positive patients were excluded to compare HER2-low to HER2-zero breast cancer subtypes. Clinicopathological characteristics between the groups were compared using a Chi-Squared test. Out of 1195 patients, we observed 341 (28.5 %) HER2-low breast cancers cases. HER2-positive breast cancer cases (n = 178; 14.9 %) were excluded. There was no significant difference in age and sex between HER2-low and HER2-zero group (p = 0.33 and 0.79, respectively). HER2-low breast cancer was associated with positive estrogen receptor status and positive progesterone receptor status (p < 0.001 and p = 0.01, respectively). Ductal adenocarcinomas were more commonly observed in HER2-low group (p < 0.001). When stratified by hormone (HR) status, 87.4 % of patients had HR-positive status and 12.6 % were HR-negative. Among the HR-negative group, HER2-low tumors tended to show lower proliferation index compared to HER2-zero tumors (25%vs.10 %, p = 0.04). This study showed that HER2-low is distinct from HER2-zero and is common among patients with breast cancer. Clinicopathological features such as histological type differ between HER2-zero and HER2-low breast cancer. Within HR-negative breast cancer, those with low HER2 expression exhibit a less aggressive profile compared to HER2-zero tumors.

Morphometric studies of the skin of calfs

Relevance. Previously, we conducted comparative morphometric studies of skin samples from different topographic sites in adult cows obtained in winter. At the same time, morphological features of the skin of different topographic areas were established. In this paper, the purpose of our study was to conduct comparative morphometric studies of the skin of different topographic areas in calves.Methods. Morphometric studies of histological preparations were carried out at the Department of Pathological Anatomy and Forensic Veterinary Medicine and at the Department of Biology, Ecology and Histology. Morphometric studies of histological preparations were used to study the thickness of the dermis proper, as well as bundles of collagen fibers of the mesh layer of the dermis. The research results were statistically processed using the "Biostat" program.Results. Morphological features of the skin of different topographic areas in calves have been established, manifested by different thicknesses of skin layers and bundles of collagen fibers of the dermis. The morphometry performed made it possible to supplement the data on the morphological structure of the skin of cattle and can also be used in the study of morpho- and pathogenesis of skin diseases.

Benign Lipomatous Soft Tissue Tumors in Nigerians: An Analysis of the Clinical and Morphological Features of a Common but Important Entity.

Introduction Benign lipomatous tumors are soft tissue tumors that exhibit a predominant adipocytic phenotype. Lipomas are the archetype and are the most common benign soft tissue tumors in adults but relatively uncommon in children. Their sex incidence is equivocal. They sometimes occur in combination with other mesenchymal elements, giving rise to variants including fibrolipoma, angiolipoma, myolipoma, spindle cell lipoma, chondroid lipoma, osteolipoma, and chondrolipoma. Their clinical significance is mainly due to the cosmetic disfigurement of patients and the differential diagnosis of malignant soft tissue tumors. Occasionally, due to their large size or presence near vital organs, they may cause life-threatening and/or excruciating pressure symptoms. This study was purposed to address the dearth of local studies on the clinical and morphological characteristics of benign lipomatous tumors in Nigerians, to compare these with those of other populations, and to establish baseline data. Materials and methods This was a retrospective study of all benign lipomatous tumors seen in the anatomic pathology and forensic medicine department of Asokoro District Hospital, Abuja, Federal Capital Territory, Nigeria, over an eight-year period. Surgical pathology reports were retrieved for patients' biodata and clinical information. The appropriate slides were retrieved, and reviewed, and new sections were cut where necessary. The tumors were classified according to the 2020 World Health Organization (WHO) guidelines and categorized based on size as small, medium, or giant. The data obtained were analyzed, and the results were presented as tables, bar charts, ratios, and percentages. Results Four hundred and eighteen cases met the inclusion criteria. Of these, 58.4% (244/418), occurred in females, while 41.6% (174/418) occurred in males. The age range was six to 91 years, while the median age was 42 years. The least number of cases, 0.5% (2/418), were seen in patients aged less than 10 years, while the majority, 35.4% (148/418), occurred in the fifth decade, followed by 27.8% (116/418) in the fourth. Size-wise, the majority of tumors, 60% (253/418), were medium, followed by small, 22.8% (95/418). Giant-sized tumors significantly accounted for 16.7% (70/418) of the cases. The diagnostic spectrum comprised conventional lipoma and variants such as fibrolipoma, spindle cell lipoma, pleomorphic lipoma, angiolipoma, chondrolipoma, intramuscular lipoma, and osteolipoma. Lipoma and fibrolipoma dominated with 87.1% (364/418) and 10.0% (42/418), respectively, while the rest accounted for <3%. The majority, 31.8% (133/418), occurred in the back/shoulder region, followed by the lower limb with 18.2% (76/418). Only two cases occurred in the abdominal/pelvic region. More tumors occurred in females in all the regions except the head and neck, which had a male-to-female ratio of 1.5:1. Multiple site tumors were more common in males in a ratio of 2.5:1. Most, 41.1% (39/95), of the small-sized tumors, occurred in the head/neck region, largely involving the face, 48.7% (19/39). Conclusion Our study showed many similarities in the clinical and morphological features of benign lipomatous tumors between Nigerians and other regions of the world. A notable finding, however, was the significantly higher proportion of giant benign lipomatous tumors when compared tostudies from other regions, a finding that warrants further studies.

Clinicopathological Analysis of Skin Adnexal Tumours: Four Year Retrospective Study

Background: Cutaneous adnexal tumours are rare, heterogeneous, benign, or malignant tumours that differentiate into one or more types of skin appendages. Methods: This is a retrospective study of 68 cases of cutaneous adnexal tumours diagnosed in our anatomical pathology department over 4 years period from September 2019 to September 2023. Results: Benign adnexal tumours are the most common, accounting for an estimated 97% of cases. These tumours are more frequent in male patients aged between 51 and 70 years. The head and neck region is the most affected area (51% of cases). Tumours originating from the sweat glands were the most frequent. Follicular and sebaceous tumours came second and third. Conclusion: Adnexal tumours are a very diverse group of rare neoplasms. Accurate diagnosis is a challenge for the dermatologist and usually requires the histological study.

The accuracy of fine needle aspiration biopsy (FNAB) in diagnosing musculoskeletal lesion

Fine needle aspiration biopsy (FNAB) is a relatively non-invasive diagnosis of musculoskeletal lesions that is very challenging in some musculoskeletal cases. This study aimed to evaluate the diagnostic utility of FNAB in musculoskeletal lesions. This was a retrospective cross-sectional study involving 180 musculoskeletal patients who underwent FNAB procedure, with or without ultrasound-guided in the Department of Anatomical Pathology, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada/Dr. Sardjito General Hospital, Yogyakarta between 2018 and 2021. The obtained data were then statistically analyzed for sensitivity, specificity, and accuracy. Of 180 cases, 90 (50%) were confirmed with histopathology examination. Further analysis revealed that 33 cases were confirmed positive, 45 patients were true negative, 2 cases were false positive, and 10 were cases false negative. The overall diagnostic sensitivity, specificity, and accuracy of FNAB in musculoskeletal lesions were 76.8, 95.7, and 83%, respectively. FNAB can lead to misinterpretation in cases that show similar morphologic features. Therefore, clinical information and imaging results are necessary to be correlated. In conclusion, FNAB is an efficient and effective technique for early diagnosis in musculoskeletal cases. FNAB can be used to establish the diagnosis of an inoperable tumor because of its high accuracy.

Non-neoplastic Kidney Diseases in Adult Tumor Nephrectomy and Nephroureterectomy Specimens in a Southeast Asian Tertiary Medical Center

OBJECTIVE: Non-neoplastic kidney diseases are concurrently present in up to 15% of patients with renal and ureteral tumors, which have been most studied in the United States. This study was conducted to determine the prevalence and spectrum of renal parenchymal diseases in similar patients from a Southeast Asian academic institution.METHODS: We searched the database of the Department of Anatomical Pathology, Faculty of Medicine Vajira Hospital, Navamindradhiraj University (2012–2022) and found 194 adult nephrectomy and nephroureterectomy specimens with renal, renal pelvis, and ureteral tumors. Additional stains included periodic acid-Schiff, methenamine silver, and Masson trichrome. Direct immunofluorescence microscopy was performed on the paraffin tissue sections for immunoglobulin (Ig) G, IgA, IgM, and kappa and lambda light chains. Clinical information, including age, gender, and co-morbidities, was obtained from the electronic medical records.RESULTS: Analysis of the 194 cases demonstrated the average age was 61 years (range: 17-89 years), with 126 males (65%) and 68 females (35%). After re-examination of the non-neoplastic renal parenchyma, 14 cases (7%) had diffused and/or nodular mesangial sclerosis. Diabetic nephropathy (12 cases) and idiopathic nodular glomerulosclerosis (2 cases) were diagnosed and associated with either stage 1 or 2 genitourinary cancers. Another case was diagnosed with atheroembolic renal disease. In all cases, the concurrent renal diseases were not identified during the initial evaluation.CONCLUSION: Examination of the non-neoplastic renal parenchyma is important to identify non-neoplastic kidney diseases, such as diabetic nephropathy, so early treatment may result in improved clinical outcomes for kidney and urothelial cancer patients.

Death in detention in Dakar prisons: epidemiological and medicolegal aspects

Introduction: The death of a prisoner is a suspicious death requiring systematic medico-legal involvement to determine the circumstances and causes of death. The objective of this study is to determine the profile of people who died in detention in Dakar prisons, to analyze the epidemiological and medicolegal aspects and to propose some preventive measures. Methodology: This is a retrospective study analyzing the causes of death of prisoners in prisons in the Dakar region who were autopsied, from January 2014 to December 2018 in the pathological anatomy and cytology department of the Aristide Le Hospital. Dantec. The data was collected from autopsy reports upon requisition with the aim of determining the circumstances and causes of death of the detainees. Our data was collected using individual collection sheets and subsequently analyzed with Word and Excel software. Results: The average age of the deceased prisoners was 42.4 years. The most represented age group was between 30 and 39 years old with 02 cases/06 or 33.3% with a male predominance. The three penitentiary establishments among the eight (08) recorded cases of death in our study. The Rebeuss Prison recorded 4 cases of death, the Liberty VI Penal Camp and the Special Pavilion each recorded one (01) case of death. Regarding the circumstances of death of detainees, we have identified five (05) cases of natural deaths: three cases of cardiac arrest (myocardial infarction, and or acute pulmonary edema), one suffocation and one case of death of unknown etiology, and a violent death by firearm. Conclusion: Death in a prison environment must be considered suspicious, because people deprived of their liberty have the same right to respect for their life and their dignity as any other person. Our research shows that most deaths in custody are due to natural causes, untreated medical problems or violent deaths. To limit deaths in prison, authorities must take preventive measures to eradicate the causes.

Clinicopathological characteristics of osteosarcoma cases in a tertiary referral hospital in Indonesia: A 5-year retrospective study

Introduction: Osteosarcoma is the most common primary non-hematopoietic malignant bone tumor, which reportedly has a high incidence in several regions of the world including South-east Asia. However in Indonesia, the data regarding osteosarcoma trends and clinicopathological features are still lacking. Therefore, this paper aims to describe the clinicopathological features of osteosarcoma cases in a tertiary referral hospital in Indonesia. Methods: A retrospective study of osteosarcoma cases at the Department of Anatomic Pathology of a tertiary referral hospital in East Java was conducted. Clinicopathological data regarding osteosarcoma cases diagnosed within a 5-year period (January 2018 - December 2022) were obtained. Statistical analysis were performed to the collected data. Results: A total of 44 cases were found, with a male predominance (65.9%) and in the younger age group (11-20 years old, 36.4%). Most of osteosarcoma cases occurred in femur (50%). High grade cases predominated our cohort, with osteoblastic osteosarcoma being the most prevalent histological type (52.3%). Conclusion: Male patients especially in younger age group predominated the cases in our center. Femur is the most common site for osteosarcoma, and most cases of osteosarcoma were of high-grade type. Osteoblastic osteosarcoma is the most common histological diagnosis in our cohort. Future larger-scale studies and nation-wide registry in order to provide better understanding and formulate the best approach for patient management are warranted.

PD-L1, STAT3, IL6, and EGFR Immunoexpressions in High-Grade Osteosarcoma.

Immunotherapy has been widely used in the treatment of various malignancies with satisfactory results. One of the agents for immunotherapy is an inhibitor of programmed cell death-1 and its ligands (PD-1 and PD-L1). However, attempts at utilizing PD-1/PD-L1 immunotherapy in osteosarcoma have not yielded favorable results. This may be due to differences in PD-L1 regulation and the immune landscape in osteosarcoma, as the mechanism is still poorly understood. Therefore, elucidating PD-L1 regulation in osteosarcoma is paramount in order to improve treatment results using immunotherapy. This is a cross-sectional study conducted in the Department of Anatomical Pathology of Saiful Anwar Hospital using 33 paraffin blocks of confirmed cases of osteosarcoma. Immunohistochemical staining using PD-L1, STAT3, IL6, and EGFR was performed. Statistical analyses were subsequently performed on the immunoexpression data of these antibodies. PD-L1, STAT3, IL6, and EGFR expressions were found in 6 (18.2%), 6 (18.2%), 28 (84.8%), and 30 (90.9%) cases, respectively. There were significant correlations between PD-L1 and STAT3 (r = 0.620, p=<0.001), PD-L1 and EGFR (r = 0.449, p=0.009), as well as STAT3 and EGFR (r = 0.351, p=0.045). The existence of a correlation between PD-L1, STAT3, and EGFR indicates the potential role of STAT3 and EGFR in PD-L1 regulation in osteosarcoma, which may become the basis for targeted therapy.

Organization of cervical cancer screening in African countries as a direction of cooperation within the SDGS

The article analyzes the indicators of early cancer detection in progressive and crisis countries in Africa. An analysis of the possible causes of the low detection rate and five-year survival of patients in crisis countries is made. The ways of possible cooperation with the Russian Federation on the way to achieving the Sustainable Development Goals are outlined. According to the United Nations, the African continent includes 54 indepen dent states. Most of them were colonized and had external control of major European countries — Great Britain, France, Germany, and others. In the middle of the 20th century, the process of gaining the independence by African countries began. Nevertheless, to date, the influence of European countries on many spheres of life on the African continent con tinues to persist. African countries have a large gap in socio-economic indicators and are very heterogeneous. Among them, progressive countries can be distinguished — those with experience in effective strategies for achieving the Sustainable Development Goals (SDGs). Such countries include the Republic of Seychelles, Equatorial Guinea, the Repub lic of South Africa, and others. The Russian Federation has strong partnership relations with the Republic of South Africa within the framework of the interstate united group BRICS. Along with the progressive countries, it is necessary to identify crisis countries that have not yet developed experience in effectively achieving the SDGs. Crisis states have many socio-economic issues, low per capita incomes, and big problems in the orga nization of education and health care. These countries include the Republic of Burundi, the Democratic Republic of the Congo, the Central African Republic, and others. The interaction of countries can be aimed at training personnel for the healthcare system of African countries, developing standards for the early detection of oncolog ical diseases of the most typical localizations for African countries, and working out treatment protocols. The possibilities of interaction of the Department of Pathological Anatomy, Omsk State Medical University, and crisis countries of the African continent on the introduction of innovative developments are analyzed. These programs require political, economic, scientific, technological, and socio-cultural cooperation between Russia and African countries.

Clinicopathological Characteristic of Radioactive Iodine-Refractory Differentiated Thyroid Carcinoma at Dr. Hasan Sadikin Hospital 2016-2021

Background Initial therapy for differentiated thyroid carcinoma (DTC) is thyroidectomy with or without cervical lymph node dissection. Furthermore, radioactive iodine (RAI) is given to patients by considering risk stratification and other patient factors. Although most cases of DTC have a good prognosis after standard therapeutic approaches, the risks of local recurrence and distant metastases can be as high as 20% and 10%. Among these patients, two-thirds showed RAI-refractory. This is concerning because 10-year survival rate is less than 10%. This study aimed to analyze the clinicopathological characteristics of RAI-refractory DTC. Methods This is a case-control study. Data was collected from the Department of Nuclear Medicine and Molecular Theranostics and Department of Anatomical Pathology, Faculty of Medicine, Universitas Padjadjaran/Dr. Hasan Sadikin Hospital, Bandung period 1 January 2016 - 31 December 2021. Results Clinicopathological factors associated with RAI-refractory DTC are age, sex, aggressive histologic subtype, LVI (lymphovascular invasion), m-ETE (microscopic extrathyroid extension), TNM (tumor, nodal, metastasis) stage, and ENE (extranodal extension), with p-value &lt;0.05. Meanwhile, there was no significant difference in the histologic type between RAI-refractory and non-RAI-refractory groups. Conclusion In the pathology report, it is necessary to include prognostically relevant tumor histopathological characteristics. In addition to histologic type, histologic subtype, and tumor size, other features such as presence and extent of capsular invasion, LVI, microscopic and macroscopic ETE, ENE, and number and size of metastatic lymph nodes, have been shown to provide additional prognostic information and are required in standard pathology reports for DTC.

The Clinicopathological Profile and Recurrence of Meningioma at Department of Anatomical Pathology, Faculty of Medicine, Universitas Indonesia/Dr. Cipto Mangunkusumo Hospital

Background Meningioma represents the most frequent primary intracranial tumor, and some subtypes may demonstrate aggressive characteristics with a correspondingly elevated risk of recurrence. To predict the likelihood of recurrence, clinical and pathological parameters are essential. More aggressive treatment strategies and strict follow-up can be implemented using these parameters. Therefore, this study aims to determine clinicopathological characteristics of meningioma and its relationship with recurrence. Method This study adopted a retrospective cross-sectional approach using secondary data of meningioma cases from the archives of the Department of Anatomical Pathology, Faculty of Medicine, Universitas Indonesia/Dr. Cipto Mangunkusumo Hospital in 2019-2021. The clinical data were obtained through electronic medical records, and histopathological data assessment, including grade, mitosis, brain invasion, bone invasion, and dural invasion, was conducted through microscopic examination. Result The data indicate that a total of 219 cases of meningioma were reassessed. The mean age of patients was 45±11 years, and the majority (88.1%) were female. The mean tumor size was 5±1.8 cm, with the most common tumor location being the skull base (71%) and 38.6% of cases showed radiological evidence of bone invasion. Subtotal resection was the treatment of choice for most patients (67.8%). CNS WHO grade 1 was found in 91.8% of cases, while Mitotic index ≥4/10 HPF, microscopic evidence of bone invasion, brain invasion, and dural invasion were found in 5%, 33.6%, 3.2%, and 16.8%, respectively. A minimum follow-up of 6 months was fulfilled by 71 cases, and 28% experienced recurrence/progression. These findings showed a significant association between the extent of resection (p=0.007) and tumor size (p=0.02) with the incidence of recurrence. Conclusion Clinical parameters such as the extent of resection and tumor size play a role in predicting the likelihood of meningioma recurrence. The predictive factors knowledge for meningioma recurrence is important in determining treatment strategies and follow-up

Nuclear anaplasia of positive and negative hormonal receptor (estrogen and progesterone receptor) in breast cancer cytology

Background: Breast epithelial duct cells show response to sex hormone such as estrogen and progesterone since they have receptor for estrogen and progesterone. Consequently, malignant cells from breast epithelial ductuli (Breast Ductal Carcinoma) show positivity for estrogen and progesterone receptor (ER and PR). However, when this neoplasm becomes poorly differentiated, they lost these characteristics and became ER and PR negative. On the other hand, poorly differentiated cancer cells show more nuclear enlargement that was accompanied by increase nuclear pleomorphism. This study wants to compare area of breast cancer cells nuclei and nuclear pleiomorphism in positive and negative ER and PR. Material and method: Positive and negative ER and PR breast cancer cases were collected from archive of Anatomic Pathology Department each consisting of ten to fourteen cases. Image analysis was made from each case to measure the area, diameter, and nuclear pleiomorphism. Result and discussion: There were no differences in nuclear size and pleomorphism of breast cancer cells with positive and negative ER and PR. This result show that poorly differentiated cancer cells did not accompany by increase of nuclear anaplasia. Conclusion: There is no difference of cancer cells morphology in positive and negative ER and PR. Hormonal status and anaplasia of cell nuclei can be used as independent prognostic factor to breast cancer progression.

A Retrospective Study of 341 Cases of Primary Extranodal Non-Hodgkin Lymphoma of the Head and Neck

Aims: Our goal was to obtain comprehensive and accurate information about primary extranodal non-Hodgkin lymphomas of the head and neck region to contribute to the advancement of medical knowledge in this field. Materiels and methods: We conducted a retrospective study of 341 patients with primary extra-nodal, non-Hodgkin lymphomas of the head and neck, over a period of 7 years from January 2016 to December 2022, in the departments of ENT and Head and Neck Surgery and Hematology, with the help of the department of anatomical pathology of the university hospital Mohammed VI of Marrakech. Results: 341 patients, with primary extra-nodal, non-Hodgkin lymphomas of the head and neck, was included, with an average age of 57 years, and a sex ratio male/female of 2.21 . in more than half of the cases; Waldeyer's ring was concerned; especially palatine tonsils. Type B NHL was the most frequent and involved 308 patients. Diffuse large B-cell lymphoma was the commonly observed histological type, found in 214 patients; followed by a Follicular Lymphoma and Extra-Nodal NK/T‑Cell Lymphoma, Nasal Type. Following the extension workup; patients were all staged according to the ANN ARBOR classification; with a 77.8% of them were localized stages I and II, and of the therapeutically evaluable cases, complete remission was achieved in 112 patients. Conclusion: Our study focused on all extra-nodal localizations of NHL in the head and neck region. Due to the very heterogeneous nature of these tumors, most of the current studies are limited to a specific site of involvement. Nevertheless, our study provides an overall picture; which those specific studies can be based. The management of NHL has evolved considerably in recent years, insisting on the multidisciplinary character to a better management of these patients.

Presence of tissue schistosomiasis in KwaZulu-Natal, South Africa: a retrospective histopathologic review

BackgroundSchistosomiasis affects many parts of the human body including those not usually accessible during routine clinical follow-up. We investigated the presence of schistosomiasis in routine tissue specimens sent to the only public histopathology laboratory in KwaZulu-Natal, South Africa.MethodsThe catchment area for the Department of Anatomical Pathology constitutes 11 million people in 10 districts. We retrospectively reviewed all the histopathology reports for occurrence of schistosomiasis between 1 January 2015 and 30 June 2020.ResultsSchistosomiasis was identified in the appendix, uterine cervix, urinary bladder, lung, liver, fallopian tubes and prostate. During the study period, 725 cases had a diagnosis of schistosomiasis confirmed on histopathology, which equals 0.3% of the total number of specimens sent to the laboratory. Female genital schistosomiasis represented 49.1% (356/725) of the schistosomiasis cases of which 25.1% (182) were from the uterine cervix and 24% (174) from the fallopian tubes. The appendix had 39.7% (289) of all the cases of schistosomiasis. Other organs were urinary bladder (4.4%, 32), lung (3.2%, 23) and liver (2.6%, 19). There were two cases of schistosomiasis in the prostate and four cases in the anorectal region. The main three indications for taking biopsies were acute appendicitis, cervical intraepithelial neoplasia, and sterilization. Majority of the schistosomiasis cases (312) were from eThekwini/Durban metropolitan district, however this represented only 1.2% (312/25 111) of the specimens received from eThekwini/Durban. The districts with the highest percentage positive cases were uMkhanyakude (43/965, 4.5%), followed by Ugu (129/5 251, 2.6%), and King Cetshwayo districts (132/5 360, 2.5%).ConclusionClinicians in the KwaZulu-Natal public health sector hospitals did not suspect schistosomiasis when they submitted patient samples for histopathological investigations. The study indicates the prevalence and the diversity of the body organs affected by schistosomiasis.

Association Between Patient Characteristics and Histopathological Features of Lung Cancer At RSUP Dr. Mohammad Hoesin Palembang

Introduction. Lung cancer is the uncontrolled growth of malignant cells by the body in lung tissue and is caused by genetic mutations and changes in protein synthesis in normal cells. Histopathological features of lung cancer include squamous cell carcinoma, adenocarcinoma, small cell carcinoma, and other types. Early detection, as well as prevention, needs to be done in high-risk communities with the aim of reducing the number of events. This study aims to determine the relationship between sociodemographic factors and histopathological features of lung cancer. Methods. This study is an analytic observational study with a cross-sectional design. The research sample is in the form of secondary data from the Department of Anatomical Pathology and Medical Record Installation for 2019-2021. The research was conducted at Dr. Mohammad Hoesin Palembang. The sampling technique was carried out by total sampling. Results. Most of the respondents were in the age group &gt;45 years (84.1%), male (78.3%), had no history of smoking (60.9%), the predominant main complaint was shortness of breath (63, 8%), the most common histopathological picture is adenocarcinoma. There was no significant relationship between age (p=0.998), gender (p=0.736), smoking history (p=0.572) and histopathological features of lung cancer patients. Conclusion. There was no significant relationship between age, sex and smoking status on the histopathological features of lung cancer.

Expression of Ki67 and CD68+ cells of red bone marrow monocyte sprout under triptorelin administration in the hypothalamic-pituitary-testis regulatory system: the experimental study

Background. Red bone marrow (RBM) is the main organ of human haemopoiesis. Monocytopoiesis plays an important role in the formation of transitional states: from normal to pathology and in the transformation of pathological processes from one stage to another. In modern urological practice, the substance triptorelin is widely used for androgen deprivation therapy, according to the recommendations of the European Association of Urology. Ki67, a commercially available monoclonal antibody that reacts with a nuclear antigen detected only in proliferating cells, is used to assess immunohistochemical changes. CD68 is a valuable cytochemical marker for immunostaining of monocytes/macrophages during histochemical analysis of tissues in inflammation, cancer and other immunohistopathological purposes. The purpose of the study is to evaluate the proliferative activity and differentiation of progenitor cells through the expression of Ki67 and CD68+ monocyte sprouting of RBM under chemical castration of central origin in male rats caused by the administration of triptorelin solution with quercetin addition to the diet for one year. Materials and methods. The study was conducted on 60 adult male white rats. They were divided into 3 groups: group I — control (n = 10), group II (n = 25) — subcutaneous injection of triptorelin, group III (n = 25) — subcutaneous injection of triptorelin acetate and quercetin. Immunohistochemical analysis of biopsy specimens was conducted following a standard protocol at the Department of Pathological Anatomy in Sumy State University, under the supervision of the Head of the Department, Prof. Romaniuk A.M. Results. The study evaluated Ki67 expression on microsections of rat red bone marrow through immunohistochemistry, which exclusively reacted with nuclear antigen in the monocyte sprout’s proliferating cells. Irregular changes were revealed depending on the experimental groups and time periods. Immunohistochemical analysis of RBM tissue using anti-CD68 antibodies in the experimental groups revealed a strong positive cytoplasmic response in monocytes and resident macrophages located in the monocyte sprout and surrounding environment. The data of the two experimental groups of RBM had a noticeable proliferating compartment, as evidenced by the high content of mitotically active DNA in them. These data correspond to the results obtained in the experiment with triptorelin, where we found a marked positivity of Ki67, depending on the timing of the experiment and the addition of the flavonoid quercetin. This discrepancy suggests that bone marrow cells that grow and proliferate under normal conditions are guided by natural control mechanisms and may lose their Ki67 expression after leaving the progenitor compartment and entering the differentiation compartment. Conclusions. Triptorelin administration induces hormonal imbalance in the hypothalamus-pituitary-testis-RBM system, resulting in quantitative and qualitative alterations in the cells of the RBM monocytic lineage. The level of cell proliferation, as measured by Ki67, is highest during the third month of observation. Cytoplasmic expression of CD68 is evident in two experimental groups from the third to the sixth month, suggesting activation of immunoreactive cells as they migrate from the progenitor compartment to the differentiation compartment.

Analysis of H3k27me3 Expression in Malignant Peripheral Nerve Sheath Tumor (MPNST) and Other Spindle Cell Sarcoma Mimicking MPNST

Malignant Peripheral Nerve Sheath Tumor (MPNST) is a type of spindle cell sarcoma with approximately 5% of all sarcomas. Its diagnosis is challenging due to the absence of specific immunohistochemical markers. Recently, H3K27me3 was discovered as a potential specific immunohistochemical marker to differentiate MPNST from other sarcomas and distinguish between low and high-grade MPNST. Therefore, this research aims to investigate the use of the H3K27me3 as a potential specific marker for Malignant Peripheral Nerve Sheath Tumor (MPNST). A cross-sectional analysis was conducted on 50 cases of sarcomas, including 13 MPNST, 14 synovial sarcomas, 13 dermatofibrosarcoma protuberans (DFSP), and 10 leiomyosarcomas originating from the Department of Anatomical Pathology, Faculty of Medicine, Universitas Indonesia, Cipto Mangunkusumo Hospital (FMUI-CMH) from January 2013 to December 2021. H3K27me3 images were obtained and categorized as complete loss when more than 95% of the tumor cells showed loss of nuclear staining. The results found in MPNST showed a loss of H3K27me3 expression, which is statistically significant compared to other sarcomas mimicking MPNST (p=0.021), indicating its potential as a diagnostic marker. There is a difference in the expression of H3K27me3 between the high and low-grade MPNST but it is not statistically significant (p=0.105). This showed that H3K27me3 loss of expression can be used to diagnose MPNST, especially high-grade MPNST, and differentiate it from other sarcomas mimicking MPNST.

The Association of Plasma Cell Density of the Microenvironment with Classical Hodgkin Lymphoma Stage

Background&#x0D; Plasma cells are important prognostic factors in various malignancies including Classical Hodgkin lymphoma (CHL). In the CHL microenvironment, plasma cells are the main prognostic factors, but research of relationship between plasma cell density in the microenvironment and CHL stage is still very limited. This study aims to determine the relationship between plasma cell density in the microenvironment and the CHL stage.&#x0D; &#x0D; Methods&#x0D; A case series procedure was conducted. The samples were paraffin blocks of CHL patients at Anatomic Pathology Department of Faculty of Medicine Universitas Sriwijaya/Mohammad Hoesin General Hospital. Among 47 cases of CHL diagnosed from 1st Januari 2018 to 30th November 2022, only 30 cases were included. Immunohistochemistry was performed by using specific antibody of plasma cells (anti-CD138 antibody). The number of plasma cells in each sample was calculated based on the expression of CD138 in the cell membrane and cytoplasm with weak-strong intensity. Then the cut-off point value was determined based on the ROC curve to classify the high and low plasma cell densities. The density of plasma cells was correlated to clinicopathological characteristics including age, sex, tumor location, CHL subtypes and stage. Statistical analysis was performed using Spearman test of SPSS with significant consideration if p&lt;0.05.&#x0D; &#x0D; Results&#x0D; A high proportion (&gt;10,9) of tumour-associated plasma cells of the tumor microenvironment was found in CHL advanced stage. Spearman test resulted in a significant correlation between density of plasma cell with advanced stage classical Hodgkin lymphoma (p=0.000).&#x0D; &#x0D; Conclusions&#x0D; There is significant relationship between high density of plasma cells with CHL stage.

The Relationship between Body Mass Index (BMI) and Clinical Pathological Profile of Invasive Breast Carcinoma Patients in the Department of Anatomic Pathology FKUI/RSCM from 2019 to 2022

Background&#x0D; Breast cancer is the most prevalent malignancy among women and is the second largest contributor to cancer-related deaths globally. Women with a high body mass index (BMI) are at a greater risk of developing breast cancer and an increased risk of lymph node metastasis. This retrospective study aimed to determine the relationship between BMI and the clinical pathological profile of invasive breast carcinoma (IBC) patients.&#x0D; Method&#x0D; This study was conducted from 2019 to 2022. Data were collected through the archives of the Department of Anatomic Pathology FKUI/RSCM (Faculty of Medicine, University of Indonesia/Cipto Mangunkusumo Hospital). Clinical pathological data were collected. The histological type, grade, lymphovascular invasion, and lymph node metastasis of the tumors were re-evaluated. The chi-square hypothesis test was used to determine the relationship between BMI and clinical pathological profile. The results were considered statistically significant with a p &lt;0.05.&#x0D; Result&#x0D; A total of 151 cases of IBC with lymph node dissection from 2019 to 2022 were included in this study, all of which were female, with the majority being &gt;50 years old (55%). The most common tumor size and histological type were T2 (39,7%) and invasive ductal carcinoma NST (74,8%), 49% of cases were grade 3 tumors. Most IBC cases had an obese BMI (49%), 63.1% with lymph node metastasis had an overweight-obese BMI. Statistical analysis was performed between BMI and lymph node metastasis status, and p-value=0.025 was obtained. The relationship between tumor size and lymphovascular invasion with lymph node metastasis was also found to be statistically significant, as indicated by a p-value of 0.000.&#x0D; Conclusion&#x0D; Cases with lymph node metastasis had the highest rate of overweight-obesity, and a significant relationship was found between BMI and lymph node metastasis status. A significant relationship was also found between tumor size and lymphovascular invasion with lymph node metastasis.