Low Molecular Weight Keratin Research Articles

Diffuse Large B-cell Lymphoma (DLBCL) involving the Uterine Corpus presenting with Abnormal Uterine Bleeding: A Rare Case Report

Abstract Introduction/Objective Diffuse Large B-cell Lymphoma (DLBCL) is an aggressive type of non-Hodgkin lymphoma. Lymphomas affecting the female genital system are extremely rare, accounting for about 1% of extra-nodal lymphomas, with DLBCL being the most common type. We present a rare case of uterine lymphoma presenting with abnormal uterine bleeding. Methods/Case Report A 50-year-old female presented with abnormal uterine bleeding and fatigue for the past three weeks. Laboratory work-up showed hemoglobin level of 5.5 g/dL. Pelvic ultrasound revealed thickening of the endometrium and a 1.6 cm hypoechoic uterine lesion along with multiple enlarged bilateral adnexal lymph nodes. Histological examination of the endometrial biopsy demonstrated endometrial fragments with diffuse subepithelial proliferation of large, poorly differentiated cells with round nuclear contours, finely dispersed chromatin, relatively inconspicuous nucleoli and moderate amount of cytoplasm. Many scattered mitoses and apoptotic bodies were present. Primary set of immunohistochemical stains were performed to rule out primary uterine epithelial or mesenchymal tumors. The tumor cells were negative for pan-keratin, high and low molecular weight keratins and positive for CD45. Further work-up demonstrated CD20 positivity. It was diagnosed as DLBCL with a non-germinal center, double expressor phenotype and a high Ki-67 proliferation. Fluorescence in-situ hybridization studies were negative for MYC and BCL6 gene rearrangements and IGH-BCL2 translocation. Further radiological workup revealed diffuse lymphadenopathy with multiple pulmonary and renal nodules consistent with Stage IV DLBCL. She was treated with six cycles of R-CHOP regimen, and complete metabolic response was achieved. Results (if a Case Study enter NA) NA Conclusion Uterine lymphomas are very rare and on small biopsies may histologically mimic poorly differentiated uterine malignancies such as dedifferentiated/undifferentiated carcinomas. Adding lymphoma lineage markers to poorly differentiated tumors is recommended to avoid missing such a rare entity.

Biphasic synovial sarcoma with myoepithelial features: a distinctive variant with a predilection for the foot.

Synovial sarcoma (SS) is a tumor known for its classic monophasic spindle cell or biphasic morphology. However, it exhibits a wide range of histologic variations, leading to diagnostic challenges. Here, we present four cases of molecularly confirmed, biphasic SS originating in the feet and displaying myoepithelial differentiation. The patients were two men and two women with an age range from 19 to 71 years (mean, 45 years). Each tumor showed foci with conventional spindle cell morphology. The epithelial components included areas with nests and cords of epithelioid cells set within a hyalinized and sclerotic stroma. The cytoplasm was clear to pale and eosinophilic. The nuclei were ovoid-round with fine chromatin and small to inconspicuous nucleoli. Mitotic figures were present (2-13 per 10 high-power fields; mean, 6.5). Immunohistochemical studies showed variable staining of the myoepithelial-like regions for low molecular weight keratins, EMA, p63, and S100 protein. Molecular studies confirmed the presence of SS18::SSX1/2 fusion in all four tumors. These cases highlight an unusual variant of synovial sarcoma with an apparent predilection for the distal lower extremity and suggest that differentiation of biphasic synovial sarcoma may be impacted by the anatomic site. Awareness of this variant is important to avoid misclassification and potential treatment and prognostic implications.

Extraction and improvement of protein functionality using steam explosion pretreatment: advances, challenges, and perspectives.

Protein has become an increasingly valuable food component with high global demand. Consequently, unconventional sources, such as industrial and agroindustrial wastes and by-products, emerge as interesting alternatives to meet this demand, considering the UN Sustainable Development Goals and the transition to a circular economy. In this context, this work presents a review of the use of Steam Explosion (SE), a green technique that can be employed as a pretreatment for various waste materials, including bones, hide/leather, feathers, and wool, aimming the extraction of protein compounds, such as low molecular weight biopeptides, gelatin, and keratin, as well as to enhance the protein functionality of grains and meals. The SE technique and the main factors affecting the process's efficiency were detailed. Promising experimental studies are discussed, along with the mechanisms responsible for protein extraction and functionality improvement, as well as the main reported and suggested applications. In general, steam explosion favored yields in subsequent extraction processes, ranging from 27 to 95%, in addition to enhancing solubility and functional protein properties. Nonetheless, it is crucial to maintain the continuity of research on this topic to drive advancements in ensuring the safety of the extracted compounds for use in consumable products and oral ingestion.

Keratin granuloma-associated giant cells in oral squamous cell carcinoma: A blessing in disguise?

Keratin spillage-associated foreign body giant cell granuloma formation is a well-known phenomenon in oral squamous cell carcinoma (OSCC) pathogenesis. It is mainly associated with well-differentiated grade and multi-nucleated giant cells (MGCs) with active engulfment and clearance of keratin debris from the tumor microenvironment. Although not widely investigated, these MGCs are genetically and immunologically programmed for keratin clearance. With this knowledge in mind, we propose that these programmed MGCs might also attack and degrade the tumor cells due to the presence of high and low molecular weight keratin inside the tumor cells. This process can reduce the tumor burden and improves the overall prognosis in OSCC patients. In support of this contention, an improved prognosis has been reported in OSCC patients with keratin granuloma and MGC formation. We also put forth the purposeful induction of keratin granuloma formation in well-differentiated squamous cell carcinoma as an interesting therapeutic opportunity in the future. This could be achieved through intra-lesional injection of natural or synthetic high molecular weight keratin in the stroma of OSCC tissue. Moreover, the possibility of syncytium formation with tumor cells along with granuloma-associated cytokines' impact have also been discussed in the present paper.

Nasopharyngeal carcinoma with non-squamous immunophenotype: a clinicopathological analysis of 23 cases

Objective: To investigate the pathological subtypes and clinicopathological characteristics of the non-squamous immunophenotype nasopharyngeal carcinoma (NSNPC). Methods: The clinicopathological features of the non-squamous immunophenotype nasopharyngeal carcinoma diagnosed between 2011 and 2019 at the First Affiliated Hospital of Zhengzhou University were analyzed using hematoxylin and eosin staining, immunohistochemistry, in situ hybridization, transmission electron microscopy and PCR gene rearrangement. Follow-up data were also collected. Results: There were 14 males and 9 females with a median age of 46 years (ranging from 16 to 76 years) with an average age of 45 years. Microscopically, patterns were similar to the classic nasopharyngeal carcinoma. Immunohistochemistry showed that most NSNPC cases expressed low molecular weight keratin (CK8/18, CK8 and CKL) and expressed pathway proteins in a low level (EGFR, PI3K, p-AKT and p-mTOR), which had significant difference from classic nasopharyngeal carcinoma group (P<0.05). Other proteins including CK5/6, CKpan, CK7, Syn, CD56, CgA, SOX-10, AKT, mTOR, Notch, STAT3 and p-STAT3 showed no statistical difference between the two groups. Pathogen detection showed that EBER was positive (18/23, 78.3%) and HPV positive(2/23, 8.7%)which were HPV35 and HPV38. The cancer suppressor gene BLU was highly expressed in NSNPC; RASSF1 and Rbms3 were less expressed in NSNPC, in line with classic NPC. As a whole, NSNPC was characterized by ultrastructures of low-differentiated squamous cell carcinoma. Compared with classic nasopharyngeal carcinoma, NSNPC had a lower recurrence rate and earlier clinical stage(P<0.05),but there was no significant correlation with age, sex, distant metastasis and death (P>0.05). Conclusions: The histological morphology, etiology and gene changes of NSNPC are similar to those of classical nasopharyngeal carcinoma and ultrastructural findings show that NSNPC still belongs to undifferentiated type in non-keratinized squamous cell carcinoma. The malignant degree of NSNPC is low and the prognosis is good.

Eccrine Squamous Syringometaplasia Associated With Lichen Sclerosus et Atrophicus.

Eccrine squamous syringometaplasia (ESS) has been associated with several conditions including morphea, linear scleroderma, and burns. It is yet to be reported in lichen sclerosus et atrophicus (LSA). We describe a bullous LSA plaque on the forearm of a woman with pre-existing genital LSA and vitiligo. Besides the histopathological findings of bullous LSA, numerous small irregular squamoid structures were present in the mid and upper dermis always above the normal eccrine glands. The histopathology, periodic acid-Schiff stain, and positive immunostains for P63, low molecular weight keratins 8&18, epithelial membrane antigen, and carcinoembryonic antigen supported the diagnosis of ESS. The pathogenesis of ESS in LSA may be related to ischemia, inflammation, and fibrosis.

Bioactive Low Molecular Weight Keratin Hydrolysates for Improving Skin Wound Healing.

Keratin biomaterials with high molecular weights were intensively investigated but few are marketed due to complex methods of extraction and preparation and limited understanding of their influence on cells behavior. In this context the aim of this research was to elucidate decisive molecular factors for skin homeostasis restoration induced by two low molecular weight keratin hydrolysates extracted and conditioned through a simple and green method. Two keratin hydrolysates with molecular weights of 3758 and 12,400 Da were physico-chemically characterized and their structure was assessed by circular dichroism (CD) and FTIR spectroscopy in view of bioactive potential identification. Other investigations were focused on several molecular factors: α1, α2 and β1 integrin mediated signals, cell cycle progression in pro-inflammatory conditions (TNFα/LPS stimulated keratinocytes and fibroblasts) and ICAM-1/VCAM-1 inhibition in human vascular endothelial cells. Flow cytometry techniques demonstrated a distinctive pattern of efficacy: keratin hydrolysates over-expressed α1 and α2 subunits, responsible for tight bounds between fibroblasts and collagen or laminin 1; both actives stimulated the epidermal turn-over and inhibited VCAM over-expression in pro-inflammatory conditions associated with bacterial infections. Our results offer mechanistic insights in wound healing signaling factors modulated by the two low molecular weight keratin hydrolysates which still preserve bioactive secondary structure.

Study on Effect of Skin Elasticity by Polar Low Molecular Weight Keratin Peptide

Study on Effect of Skin Elasticity by Polar Low Molecular Weight Keratin Peptide

Can Thiourea Dioxide Regenerate Keratin from Waste Wool?

ABSTRACT Wool is a natural biopolymer with excellent biocompatibility. This dense structure makes it difficult to recycle the millions of wool textiles discarded annually. This study reports, for the first time, the regeneration of keratin using thiourea dioxide. Disulfide bonds were cleavage from the result of Raman test. FTIR, XRD and 13C-NMR tests determined that regenerated wool keratin retained protein macromolecule backbone, though the crystallinity degree and α-helix structure content decreased slightly. SDS-PAGE results demonstrated that the process contributed to an increase of low molecular weight keratin. All the results in this study indicate that thiourea dioxide is an effective solvent for the regeneration of wool keratin. The study offers a novel approach for the regeneration and recycle of other natural protein-based material.

Application of wool keratin: an anti-ultraviolet wall material in spray drying.

Low-molecular-weight keratin (LMWK) obtained from wool was employed as a wall material for the spray drying encapsulation of fish oil. Microcapsules with different LMWK contents were prepared, and their anti-ultraviolet performance and other features were studied. The results showed that LMWK was able to improve the encapsulation efficiency of fish oil because of its good emulsifying properties. When the LMWK content was increased from 0 to 10, 30 and 50%, the shelf life of the microcapsules under ultraviolet irradiation increased from 48 to 96h, 144h and 168h, respectively. The strongest absorption efficiency of LMWK is shown in the UVc band. The chemical structure of LMWK did not change during an ultraviolet accelerating ageing test.

Primary Clear Cell Sarcoma of the Breast: A Case Report

Abstract Casestudy: Clear cell sarcoma (CCS), also known as malignant melanoma of soft parts, is a primary soft tissue neoplasm exhibiting evidence of melanocytic differentiation. It is an uncommon aggressive tumor that arises in tendons and aponeuroses of the distal extremities. Here, we report the first case of primary CCS of the breast. The patient was a 43-year-old female who presented with a left breast mass and underwent surgical resection at an outside hospital. No history of melanoma or any other malignancies was reported. Grossly, it was described as a 2 x 1.5 x 1.5 cm, well-demarcated, white nodular mass. Microscopic examination showed a malignant neoplasm composed of short spindle cells with ill-defined, eosinophilic cytoplasm and ovoid nuclei with finely stippled chromatin and exhibiting moderate pleomorphism. The lesional cells were arranged in short interlacing fascicles with abundant collagen, with brisk mitotic activity (&amp;gt;15/10 HPF). The differential diagnosis included spindle cell carcinoma, myoepithelial carcinoma and melanocytic neoplasm. The tumor cells were immunoreactive for S-100 protein, SOX10, Mart-1, HMB45 and MiTF, but negative for multiple cytokeratins (including high and low molecular weight keratins), p63, EMA, CEA, Caldesmon, smooth muscle myosin, calponin, desmin, ERG, and CD31, thus confirming melanocytic origin. EWSR1 gene rearrangement was detected by fluorescence in situ hybridization analysis using break-apart probes. Overall, the histomorphology combined with the immunophenotype and cytogenetic characteristics, was most consistent with a CCS. To our knowledge, no primary CCS of the breast has been previously reported in the English language literature.

A Single Liver Metastasis from Pleural Biphasic Mesothelioma.

Virtually any malignancy can metastasize to the liver. Large solitary metastases are rare and can be difficult to distinguish from primary tumors. Malignant mesothelioma is often considered as a locally invasive cancer but tumor dissemination to extra-thoracic sites is possible, and the liver can be involved. Herein, we present a rare case of pleural mesothelioma with a solitary large liver metastasis diagnosed postmortem in a ninety-two-year-old man with 35 years of exposure to asbestos. Results of immunohistochemical staining of the pleural and liver tumor were similar, both positive for low-molecular weight keratins, calretinin, vimentin, and podoplanin, and negative for Claudin-4, TTF1, CEA, BerEP4, CK7, CK19, CK20, BAP1, Hep Par1, p40, and WT1. Fluorescent in-situ hybridization (FISH) for p16/CDKN2A was also performed and a homozygous deletion was detected in both tumors, supporting the diagnosis of mesothelioma. Reporting this case, we would like to point out that extra-thoracic dissemination from pleural mesothelioma, even if exceptional, can occur. In cases where differential diagnoses are challenging, the value of ancillary techniques and a practical approach to diagnostic work-up is of primary importance.

Insight into the Regulatory Function of Human Hair Keratins in Wound Healing Using Proteomics.

Keratins derived from human hair possess excellent wound healing qualities. However, their functional contribution to this process is poorly understood. In this study, the regulatory function of human hair keratins in wound healing is investigated using proteomic analysis by dividing keratins into different groups based on their molecular weight distributions: low molecular weight keratins (LMWK, 10-30 kDa), medium molecular weight keratins (MMWK, 30-50 kDa), and high molecular weight keratins (HMWK, >50 kDa). Keratin hydrogels with different molecular weights exhibit various morphologies, rheological properties, degradation rates, and wound healing activities. Using proteomic analysis, LMWK and HMWK hydrogels exhibit a stronger regulatory ability for wound healing at days 1 and 7, respectively. The major functions of LMWK during wound healing are regulation of cells communication and function. In contrast, proteins associated with energy metabolism are significantly expressed after HMWK hydrogel treatment at day 1, and these play an important role in cellular growth and reactive oxygen species scavenging at day 7. These results demonstrate that the wound healing qualities of human hair keratins are influenced by their molecular weight distribution, and the proteomic analysis sheds new light on the regulatory function of human hair keratins during wound healing.

Study to Evaluate HER2-neu Expression in Different Histopathological Grades of Prostatic Carcinoma in a Tertiary Care Centre, Bareilly

Introduction: Prostate cancer is the second most common neoplasm among men around the world. Two routinely used immunocytochemical markers for prostatic epithelium are Prostatic Acid Phosphatase (PAP) and Prostatic Specific Antigen (PSA). Various other markers like Prostate-Specific Membrane Antigen (PSMA), androgen and progesterone receptors, HER2-neu, low molecular weight keratin, etc., are also used. HER2-neu overexpression has been implicated in tumorigenesis and has been correlated with a poor prognosis for patients with breast cancer, ovarian cancer, and gastric cancer. Use of Trastuzumab for the treatment of breast carcinoma has improved prognosis in HER2-neu positive cases. Recent studies have suggested the correlation of HER2-neu overexpression with higher grades of prostate cancer. Aim: To study HER2-neu expression in different histopathological grades of prostatic carcinoma. Materials and Methods: A prospective study was carried out on 41 histopathologically proven cases of prostatic carcinoma in Pathology Department of SRMSIMS, Bareilly over a period of one year and six months (November 2017 to April 2019). Gleason grading and HER2-neu Immunohistochemistry was applied on every case and then correlated. Statistical tests were applied, statistical software Statistical Package for the Social Sciences (SPSS) version 21. Results: A 92.7% (38/41) cases were reported as Prostatic Adenocarcinoma of Non-Mucinous type. Total of 42.5% (17/40) were grouped under Grade group 5, 27.5% (11/40) cases under Grade group 3 and 10% (4/40) under Grade groups 1,2 and 4 each. Out of total, 14.6% (6/41) cases were considered as positive and 80.5% (33/41) cases were considered as negative for HER2-neu expression and 4.9% (2/41) cases were considered as equivocal (Fluorescence In Situ Hybridization (FISH) conformation required). In cases with positive HER2-neu expression, mean group grade was calculated to be 4.83±0.40 and in patients with negative HER2-neu expression, it was 3.38±1.40 (it was calculated to find correlation between group grade and HER2-neu expression). There was a significant statistical difference (p=0.00003668) found between the Gleason Group Grade in HER2-neu positive and negative patients as HER2-neu positivity is seen in higher group grades. One case was reported as neuroendocrine carcinoma in which Gleason grading was not done. Conclusion: Compared to low Gleason Group Grade carcinoma, higher percentage of HER2-neu expression was seen in high Gleason Group grade carcinoma.

Fluorescence-based Quantification of Bioactive Keratin Peptides from Feathers for Optimizing Large-scale Anaerobic Fermentation and Purification

The extremely thermophilic eubacterium Fervidobacterium islandicum AW-1 produces low molecular weight (LMW; < 1 kDa) keratin peptides (KPs) from poultry feathers at 70°C. However, detection and quantification of feather hydrolysate-derived peptides is needed for optimizing fermentation and down-stream processes. Herein, we developed a large-scale fermentation and purification of skin anti-aging LMW KPs from recalcitrant feathers using fluorescence-based quantification of N-terminal prolinecontaining KPs derivatized with 3,4-dihydroxybenzoic acid to yield fluorescent adducts. Fluorescent products were correlated with bioactive KP concentrations in keratin fractions and cosmetic formulations. Subsequent anaerobic fermentative keratinolysis and large-scale purification achieved 4.4 g/L LMW KPs from 8 g/L native feathers in a 5 L batch bioreactor, generating 0.8 g/L purified MMP-1 suppressive KPs (yield = 1.2%). This demonstrated the feasibility of industrial-scale anaerobic feather digestion and purification of LMW KPs to produce skin anti-aging peptides from keratin hydrolysates in a more environmentally sustainable manner.

Low-molecular weight keratins with anti-skin aging activity produced by anaerobic digestion of poultry feathers with Fervidobacterium islandicum AW-1

Bioactive peptides contribute to various cellular processes including improved skin physiology. Hence, bioactive keratins have attracted considerable attention as active cosmetic ingredients for skin health. Here, we obtained low molecular weight (LMW) keratins from native chicken feathers by anaerobic digestion with an extremely thermophilic bacterium Fervidobacterium islandicum AW-1, followed by stepwise fractionation through ultrafiltration. To assess the effects of the feather keratins on skin health, we performed in vitro and ex vivo assays to investigate their inhibitory effects on matrix metalloproteinases (MMPs). As results, LMW feather keratins marginally inhibited collagenase, elastase, and radical scavenging activities. On the other hand, LMW feather keratins significantly suppressed the expression of ultraviolet B (UVB)-induced MMP-1 and MMP-13 in human dermal fibroblasts. Furthermore, phospho-kinase antibody array revealed that LMW feather keratins suppressed UVB-induced phosphorylation of Akts, c-Jun N-terminal kinases 1, p38 beta, and RSK2, but not ERKs in human dermal fibroblast. Overall, these results suggest that LMW feather keratins are potential candidates as cosmeceutical peptides for anti-skin aging.

NordiQC Assessments of Low Molecular Weight Keratin 8/18 Immunoassays.

This paper is number 2 in a series developed through a partnership between ISIMM and NordiQC for the purpose of reporting research assessing the performance characteristics of immunoassays in an external proficiency testing program.

Sclerosing Microcystic Adenocarcinoma of the Head and Neck Mucosa: A Neoplasm Closely Resembling Microcystic Adnexal Carcinoma.

Microcystic adnexal carcinoma (MAC) occurs predominantly in the centrofacial skin and has been only rarely reported in mucosal surfaces. We here present a 5 case series of tumors closely resembling MAC occurring in the mucosal surfaces of the head and neck, which we have termed sclerosing microcystic adenocarcinomas. These tumors showed a predilection for women (4:1) with an average patient age of 52.6years (range 41-73years). Location included the tongue (n=2), the floor of the mouth (n=2), and the nasopharynx/clivus (n=1). One occurred after radiation therapy and another occurred in the setting of immune compromise. Immunohistochemistry highlighted a dual cell population with luminal cells showing positivity for high and low-molecular weight keratins and surrounding myoepithelial cells showing S100 and smooth muscle actin staining. No cases had nodal involvement, and the single patient with clinical follow-up was alive and free of disease 34months after diagnosis and definitive radiochemotherapy. Differential diagnoses for all cases diverged from those provoked by MAC in the skin and included a variety of salivary gland neoplasms such as adenoid cystic carcinoma, polymorphous low gradeadenocarcinoma, and mucoepidermoid carcinoma. Recognition of sclerosing microcystic adenocarcinoma in the head and neck mucosa is critical given its bland appearance and subtle infiltration pattern, infrequency of nodal involvement, and behavioral differences from the other entities on the differential.

Cutaneous spindle cell squamous cell carcinoma.

Dear Editor: Spindle cell squamous cell carcinoma (SpSCC) is a rare variant of squamous cell carcinoma (SCC). Despite having clinical attributes that overlap conventional SCC, these lesions are pathologically distinct and are comprised of spindled cells that infiltrate the dermis as single cells or cohesive nests; that lack features of keratinization. SpSCC most commonly occurs in the larynx, and less often in the hypopharynx, oropharynx, and nasal cavity1. It is extremely rare to find SpSCC confined to the cutaneous lesion, and only three cases have previously been reported in Korea. A 73-year-old woman presented with a 1-year history of a pruritic, solitary mass on the face. Physical examination revealed an irregular-shaped, erythematous, firm, fixed mass with a yellowish crust on her left upper perioral area. The mass was 1.3 cm in diameter and was slowly expanding (Fig. 1). The patient had a history of a wide excision of basal cell carcinoma on her nose 2 years previously, and no relapse has been observed. Fig. 1 (A, B) Solitary, 1.3 cm-sized, irregular-shaped, erythematous, firm mass with a yellowish crust on the left upper perioral area. Histologic examination of the lesion showed spindle-shaped cells with hyperchromatic nuclei infiltrating the dermis in a whorl-like pattern (Fig. 2). Furthermore, immunohistochemical investigation revealed the specimen was positive for cytokeratins (34βE12, CK5/6, AE1/3) and vimentin, but was negative for smooth muscle actin (SMA), S-100, and CD68. Through histologic features and immunohistochemical evaluation, she was diagnosed with SpSCC. The lesion was surgically removed 13 months previously and no relapse has been observed. Fig. 2 (A) Diffuse dermal infiltrates of spindle cells (HE B: ×200, C: ×400). (D) Positive immunostaining for 34βE12, ... Cutaneous SpSCC presents as a raised or exophytic nodule accompanied by spontaneous bleeding and central ulceration similar to conventional SCC2. It is usually confined to sun-damaged sites such as the head, neck, chest, and upper extremities or areas that have received prior ionizing radiation2,3. Although the rarity of these tumors makes difficult to study patient survival rates, the literature suggests an overall prognosis similar to that of conventional SCC. SpSCC must be distinguished from other spindle cell lesions such as atypical fibroxanthoma (AFX), spindle cell/desmoplastic melanoma, cutaneous leiomyosarcoma, and scars. Immunohistochemistry has become the essential method in the pathologic workup of these tumors. The spindle cells in SpSCC stained positively for one or more of the cytokeratins (34βE12, AE1/3, cam 5.2, low molecular weight keratin) and the mesenchymal marker, vimentin. Each of these neoplasms stained negatively for S-100, CD68, and SMA; whereas AFX showed positivity for CD68, but lacked keratin and S-100. The spindle cell melanomas showed a connection with the epithelium that was contiguous with similar junctional cells possessing cytoplasmic melanin and S-100 immunostaining, but lacking keratins. The leiomyosarcomas showed positivity with SMA and vimentin, and were negative for keratins and S-100. The scars were negative for all immunohistochemical stains4. Cutaneous SpSCC is so rare subtype of SCC that pathophysiology, prognostic factors, and metastatic risk are not well-established. It is known that SpSCCs that are associated with radiation, burn scars, and immunosuppression may correlate with aggressive clinical courses5. Further studies of this rare entity are needed to establish its biological behavior, and the accumulation of more case reports will aid in determining a precise prognosis.

A collecting duct carcinoma producing carcinoembryonic antigen and Ca-125 in a 29-year-old woman

Collecting duct carcinoma is a rare renal malignant neoplasm, arising from the medullary collecting duct and accounting for less than 1% of renal cell carcinomas. It is more common in middle-aged men and is usually presented with hematuria, abdominal mass and back or flank pain. Its immunohistochemical analysis detects the expression of various markers, such as low and high molecular weight keratins, Ulex europaeus agglutinin-1, epithelial membrane antigen and peanut lectin. Here, we present a case of a 29-year-old woman with CDC presented with back pain and supraclavicular lymphadenopathy that produced carcinoembryonic antigen and CA-125.