Papillary Adenoma Research Articles

Middle segment-preserving pancreatectomy for metachronous intraductal papillary mucinous neoplasm after pancreatoduodenectomy: a case report

Total pancreatectomy has occasionally been performed to treat patients with multiple lesions (such as intraductal papillary mucinous neoplasm (IPMN)) or patients who have undergone repeated pancreatic resection. However, deficiencies of the exocrine and endocrine functions worsen patients’ quality of life. Recently, there have been several case reports citing middle segment-preserving pancreatectomy (MSPP) as a safe procedure and beneficial with respect to preservation of the exocrine and endocrine functions. We herein report the case of a patient who underwent MSPP for repeat pancreatectomy for IPMN and in whom a favorable outcome was achieved. The patient, a 70-year-old man, was diagnosed with branch duct-type IPMN (BD-IPMN) with worrisome features in the pancreatic head and a single cyst in the pancreatic tail, during a preoperative examination of early gastric cancer. Pancreatoduodenectomy was performed for BD-IPMN in the pancreatic head and gastric cancer. A histopathological examination showed an intraductal papillary mucinous adenoma (IPMA) with mild-moderate atypia. During the follow-up, the size of the cystic lesion in the pancreatic tail and the diameter of the main pancreatic duct were gradually increasing. Therefore, at 2 years and 6 months after surgery, distal pancreatectomy with preservation of the spleen (namely MSPP) was performed. The pancreatic resection margin was histologically negative. The length and volume of the remnant pancreas were approximately 6 cm and 10 ml, respectively. A histopathological examination showed an IPMA. The patient had no diarrhea or weight loss without digestive enzymes and maintained favorable glucose tolerance without oral hypoglycemic agents or insulin. He has showed no evidence of new lesions in the remnant pancreas at 3 years of follow-up after the last surgery.

Ulva lactuca polysaccharides prevent Wistar rat breast carcinogenesis through the augmentation of apoptosis, enhancement of antioxidant defense system, and suppression of inflammation.

BackgroundRecently, several research studies have been focused on the isolation and function of the polysaccharides derived from different algal species, which revealed multiple biological activities such as antioxidant and antitumor activities. This study assesses the possible breast cancer chemopreventive properties of common seaweeds, sea lettuce, Ulva lactuca (ulvan) polysaccharides using in vitro bioassays on human breast cancer cell line (MCF-7) and an in vivo animal model of breast carcinogenesis.MethodsCytotoxic effect of ulvan polysaccharides on MCF-7 was tested in vitro. For an in vivo investigation, a single dose of 25 mg/kg body weight 7,12-dimethylbenz[a]anthracene (DMBA) and ulvan polysaccharides (50 mg/kg body weight every other day) for 10 weeks were administered orally to the Wistar rats.ResultsDeleterious histopathological alterations in breast tissues including papillary cyst adenoma and hyperplasia of ductal epithelial lining with intraluminal necrotic materials and calcifications were observed in the DMBA-administered group. These lesions were prevented in the DMBA-administered group treated with ulvan polysaccharides. The immunohistochemical sections depicted that the treatment of DMBA-administered rats with ulvan polysaccharides markedly increased the lowered pro-apoptotic protein, p53, and decreased the elevated anti-apoptotic marker, bcl2, expression in the breast tissue. The elevated lipid peroxidation and the suppressed antioxidant enzyme activities in DMBA-administered control were significantly prevented by the treatment with ulvan polysaccharides. The elevated levels of inflammatory cytokines tumor necrosis factor-α and nitric oxide were significantly ameliorated in DMBA-administered rats treated with ulvan polysaccharides as compared to DMBA-administered control.ConclusionIn conclusion, ulvan polysaccharides at the level of initiation and promotion might have potential chemopreventive effects against breast carcinogenesis. These preventive effects may be mediated through the augmentation of apoptosis, suppression of oxidative stress and inflammation, and enhancement of antioxidant defense system.

Stathmin 1 promotes the proliferation and malignant transformation of pancreatic intraductal papillary mucinous neoplasms.

Pancreatic intraductal papillary mucinous neoplasms (IPMNs) are a type of pancreatic tumor, which have been identified following improvements in diagnostic imaging. However, the malignant transformation of IPMN has been difficult to diagnose clinically. To date, the mechanisms driving the progression of IPMN to cancer remain to be fully elucidated. The present study focused on Stathmin 1 (STMN1), a protein that is associated with the development of various types of cancer. The expression of STMN1 was examined immunohistochemically in tissues from cases of IPMN. The correlation between the STMN1 staining and clinical pathological factors was evaluated, and the expression of STMN1, p27 and S-phase kinase-associated protein 2 (SKP2) were compared. High expression levels of STMN1 were significantly correlated with regions of malignancy, and was associated with high expression of SKP2, low expression of nuclear p27 and a high Ki-67 index. High expression levels of STMN1 and SKP2 were significantly correlated with the transformation of IPMN to carcinoma. In addition, within the regions of carcinoma, the expression of STMN1 was weak in regions of adenoma and high in the cancerous regions. It was concluded that the high expression of STMN1 contributed to tumor proliferation and malignant transformation in the patients with IPMN. These results suggested that characterization of the expression of STMN1 may be a promising approach for predicting malignant transformation of pancreatic intraductal papillary mucinous adenoma.

Endoscopic ultrasound-guided fine needle aspiration cytology in pancreatic mass lesions: Our experience

Background and Objectives:Endoscopic ultrasound (EUS) is considered as the most reliable, accurate test in the detection of pancreatic masses, in whom a need for early, accurate detection, and confirmation of neoplasm is important, at the same time avoidance of surgery.Materials and Methods:This was a prospective study of EUS and fine needle aspiration (FNA)/fine needle aspiration biopsy in patients with pancreatic mass between January 2014 and 2017 at Gandhi Hospital, a tertiary government hospital in the state of Telangana. At the time of EUS size, echo characteristics of lesions, vascularity, lymph nodes (LNs) were noted. In 22 patients, 22-gauge, and in 3 patients, 25-gauge were used.Results:Male to female ratio was18:7, with mean age of 54 years. All had pain abdomen - 100%, mass per abdomen - 5, jaundice, vomiting - 3, and hypoglycemic attacks - 2 (8%). 14 (56%) had lesion in head, 3 - head and body, 2 - isthmus, and 5 - body and tail. Metastasis to LN and liver in 2 (8%). FNA results: Adenocarcinoma - 5 (25%), papillary adenoma - 1 (4%), serous cystadenoma - 1 (4%), mucinous cyst adenoma - 1 (4%), insulinoma - 1 (4%) each, gastrointestinal stromal tumor - 2 (8%), atypical cells - 4 (16%), neuroendocrine tumor - 2 (8%), negative for malignancy - 6 (24%). Minor hemorrhage and abdominal pain were noted in three. All positive and atypical cells patients treated accordingly. All negative cases were followed.Conclusion:EUS is a safe, reliable method in the diagnosis of pancreatic mass in providing accurate cytological diagnosis and exact location of small lesions.

Comparative diagnosis of canine mammary tumours by cytology and histopathology

The aim of the present study was to correlate cytological diagnosis after pre-operative fine needle aspiration biopsies from canine mammary tumours with that of histopathological findings. In prospective study, 40 fine-needle aspirate samples were obtained from 40 different cases, out of that, 15 cases were diagnosed mammary gland tumours. Histopathology results included four cystic papillary adenoma, three benign mixed mammary tumours, two each of papillary adenocarcinoma, solid adenocarcinoma, and mammary gland adenoma, and one each of benign mammary myoepithelioma and malignant myoepithelioma. The neoplastic cells in smears were round to caudate, exhibiting anisocytosis, spherical to oval nuclei, anisokaryosis, abnormal nuclear/nucleolar shapes, anisonucleoli, abnormal chromatin pattern, multinucleation and mitotic figures. In case of benign category cells were uniform and in large clusters, having clear cytoplasmic boundaries. On comparing results of cytological diagnosis with the histopathology revealed that 86.66% (13/15) cases of benign and malignant tumours had positive correlation.

What is new in Genitourinary Pathology? Recent developments and highlights of the new 2016 World Health Organization classification of tumors of the urinary system and male genital organs

The recently published 2016 World Health Organization (WHO) Classification of Tumors of the Urinary System and Male Genital Organs stems from the accumulated knowledge and data collected during the last 12 years, since the previous edition of the WHO “blue book” 2004. The major changes in prostate pathology include the introduction of a novel grading system for prostate cancer (Grade Groups/International Society of Urological Pathology (ISUP) grades 1–5), the recognition of intraductal carcinoma as a new entity, and the terminological changes regarding the neuroendocrine prostatic neoplasms. In bladder and urothelial tract, within the spectrum of flat and non-invasive lesions, a newly introduced term “urothelial proliferation of uncertain malignant potential” replaced the term “urothelial hyperplasia”, and the term “urothelial dysplasia” was better defined. A category of “invasive urothelial carcinoma with divergent differentiation” was introduced for tumors showing a component of “usual type” urothelial carcinoma combined with other morphologies. A new WHO/ISUP renal tumor grading system was recommended (Grade 1–4). The definition of renal papillary adenoma was modified and expanded to include papillary neoplasms measuring up to 1.5 cm. Several new epithelial renal tumors were recognized as new entities including: hereditary leiomyomatosis and renal cell carcinoma (RCC) syndrome–associated RCC, succinate dehydrogenase–deficient RCC, tubulocystic RCC, acquired cystic disease–associated RCC, and clear cell papillary RCC. In testis pathology, intratubular proliferations of testicular germ cell tumors were renamed as “germ cell neoplasia in-situ” (GCNIS), and the testicular neoplasms were divided into two main groups: derived from or unrelated to GCNIS. A major change in penile pathology was the introduction of a new classification of penile squamous cell carcinoma, based on the presence of human papillomavirus (HPV), which characterizes penile tumor subtypes as HPV-related or non-HPV-related. A similar distinction was introduced for the preneoplastic penile intraepithelial precursor lesion (PeIN) into non-HPV related (differentiated PeIN) and HPV-related types (undifferentiated PeIN). In this review, we provide a summary and highlight the changes in the genitourinary pathology introduced by the 2016 WHO blue book, and we also discuss some recent developments that may impact the practice of genitourinary pathology in the near future.

Papillary Eccrine Adenoma: A Recent Review of Literature

Background: Papillary eccrine adenoma (PEA) is a very rare benign cutaneous sweat gland tumor, it usually presents as an isolated well-circumscribed dermal nodule existent for a prolonged duration of time. Objectives: We report a case of PEA in a 74-year-old woman from Mexico who presented with a rare case of papillary eccrine adenoma. Materials and methods: We gathered our information by using PubMed and Scopus portal, in total there have been only 48 cases reported so far in English Literature. We present detailed review of findings of all cases reported so far including our case report. Results: Our results indicated that the median age of presentation was 45 years amongst males and females. The mean size of the tumor is approximately 16 mm amongst males and females with more than double the incidence was noted in females, along with a predominant occurrence noted in the Black population. The most common location for presentation was the lower extremities, followed by the upper extremities, abdomen and face respectively. Conclusion: In summary, PEA is a rare benign cutaneous sweat gland tumor representing intradermal proliferation of sweat gland ducts. It is slow growing in nature, with a greater incidence in women, and predominantly presents on the extremities. Despite its typical histological features, at times it can resemble other cutaneous neoplasms, thus it may present with diagnostic challenges. Moh’s technique has lately been reported to have increased success rates in the management of this tumor.

A prospective multicenter study of submucosal injection to improve endoscopic snare papillectomy for ampullary adenoma

Whether or not submucosal injection of a diluted epinephrine solution should be used to lift ampullary tumors during endoscopic snare papillectomy is unclear. This study aimed to investigate the clinical efficacy of a simple snaring method versus submucosal injection for papillectomy. A prospective multicenter study was performed at 4 tertiary referral centers. Patients with papillary lesions were randomized to undergo either simple snare papillectomy (SSP) or submucosal injection papillectomy (SIP) using 1:10,000 diluted epinephrine. The main outcome measures were complete resection rate and post-papillectomy adverse events. A total of 50 patients with biopsy-proven papillary adenomas were enrolled. Complete resection rates in the SSP and SIP groups were 80.8% (21/26) and 50.0% (12/24), respectively (P= .02). However, tumor persistence at 1 month (15.4% vs 8.3%, P= .62) and recurrence at 12 months (12.0% vs 9.5%, P= .58) did not differ despite initial differences in the prevalence of a positive resection margin. The mean tumor size was 12mm in the SSP group and 9.29mm in the SIP group. Post-papillectomy bleeding developed in 42.3% (11/26) and 45.8% (11/24) of patients, respectively (P= .80). Delayed bleeding (>12 h) occurred in 27.3% (3/11) and 36.4% (4/11) of patients, respectively (P= .50). Post-procedure pancreatitis occurred in 15.4% (4/26) and 25% (6/24) of patients, respectively (P= .49). Pancreatitis severity did not differ between the groups, and there were no procedure-related mortalities. Although the recurrence rate was similar between the SSP and SIP groups, SIP showed no advantage over SSP in terms of achieving complete resection or decreasing the frequency of post-papillectomy adverse events, such as bleeding. SSP may thus be a simpler and primarily recommendable technique. (Clinical trial registration number: NCT02165852.).

Endoscopic ampullectomy: a Medical Research Institute experience

Background Ampullary tumors account for 10% of periampullary neoplasms and can occur sporadically or in the setting of familial polyposis syndromes. Although classified as benign, ampullary adenomas are premalignant neoplasms arising from the mucosa. It is thought that the adenoma-to-carcinoma sequence does occur for these lesions. Grossly and histologically, these lesions are similar to the adenomas arising in the mucosa of the large intestine. As regards the lesion assessment of ampullary tumors, multimodality tumor staging is essential before endoscopic resection, which includes endoscopic appearance, histology, endoscopic ultrasound, magnetic resonance cholangiopancreatography, and endoscopic retrograde cholangiopancreatography. Patients and methods From 2013 to 2015, 20 patients admitted to the Endoscopy Unit of the Medical Research Institute Hospital, Alexandria University, underwent endoscopic ampullectomy for presumed benign tumors of the ampulla of Vater with complete follow-up for 1 year until February 2016. Endoscopic resection technique Complete en-bloc excision of the entire neoplasm to the plane of the duodenal wall was carried out. Results Successful ampullectomy was performed in all cases. As regards the pathology of lesions, 10 (50%) patients had tubulovillous adenoma, seven (35%) patients had villous adenoma, one (5%) patient had tubulovillous adenoma with dysplasia, one (5%) patient had adenocarcinoma, and one (5%) patient had carcinoid tumor. Only three (30%) patients with proven malignancy underwent pancreaticoduodenectomy. There were no recurrences in all benign cases, with the only reported complication being bleeding in three malignant cases. Conclusion Endoscopic ampullectomy is a safe and effective therapy for papillary adenomas, when performed by experienced endoscopists. However, there is a substantial incidence of moderate-to-severe complications that the endoscopist must be prepared to identify and manage.

GATA3 Expression in Normal Skin and in Benign and Malignant Epidermal and Cutaneous Adnexal Neoplasms.

:Initial investigations reported GATA3 to be a sensitive and relatively specific marker for mammary and urothelial carcinomas. Recently, GATA3 expression has been described in several other epithelial tumors. However, there has been only limited investigation of GATA3 expression in cutaneous epithelial tumors. The objective of this study was to examine the immunohistochemical expression of GATA3 in a wide variety of cutaneous epithelial neoplasms. GATA3 expression was evaluated in 99 benign and 63 malignant cutaneous epithelial tumors. GATA3 was consistently and usually strongly expressed in clear cell acanthoma, trichofolliculoma, trichoepithelioma, trichilemmoma, sebaceous adenoma, sebaceoma, apocrine hidrocystoma, apocrine tubular papillary adenoma, hidradenoma papilliferum, and syringocystadenoma papilliferum. Hidradenomas exhibited variable positive staining. Most poromas, syringomas, chondroid syringomas, cylindromas, and spiradenomas were negative or only focally and weakly positive. Focal staining was present in all pilomatrixomas. Thirteen of 14 basal cell carcinomas, 21 of 24 squamous carcinomas, and all 6 sebaceous carcinomas exhibited positive staining. The 1 apocrine carcinoma, both mucinous carcinomas, and 2 of 3 microcystic adnexal carcinomas also exhibited positive staining, whereas the 1 eccrine porocarcinoma and the 1 adenoid cystic carcinoma were negative. One of 11 Merkel cell carcinomas exhibited focal weak staining. Our findings demonstrate that GATA3 is expressed in a wide variety of benign and malignant cutaneous epithelial neoplasms. In addition to carcinomas of breast and urothelial origin and other more recently described GATA3-positive tumors, the differential diagnosis of a metastatic tumor of unknown primary origin that expresses GATA3 should also include a carcinoma of cutaneous epithelial origin.

Complex APC germline mutation associated metaplasia and intraepithelial neoplasia (CAM-IEN) of the gallbladder

Preneoplasic and neoplastic changes of the gallbladder of patients with a familial adenomatous polyposis (FAP) are rare, and very little is known about their incidence in patients with an attenuated FAP. We herein report on a unique case of a woman with an attenuated FAP who shows eight distinct, partially preneoplastic differentiation patterns within the gallbladder mucosa, which are: (1) regular gallbladder epithelium, (2) low grade biliary intraepithelial neoplasia, (3) papillary adenoma, (4) Paneth cell metaplasia, (5) goblet cell metaplasia, (6) pancreatic metaplasia, (7) pseudopyloric metaplasia, and (8) neuroendocrine differentiation. Moreover, this is the first case of a KRAS mutation in a gallbladder adenoma of a patient with an APC germline mutation, which is highly suggestive of an early event of malignant transformation. As a consequence of our findings, clinicians should draw special attention to the gallbladder of FAP patients, and a simultaneous protective cholecystectomy of FAP patients, which undergo colectomy and show conspicuous changes of the gallbladder mucosa, should be performed in these patients in order to eliminate the risk of a synchronous or metachronous gallbladder neoplasia.

Histopathological Spectrum of Tumor and Tumor-like Lesions of the Paratestis in a Tertiary Care Hospital.

Tumors and tumor-like lesions (TLL) of the paratesticular region are rare. Very few studies depicting the spectrum of lesions of this location are available in the literature. Malignant neoplasms arising in the paratesticular region represent only 7.0% of malignant tumors presenting as a scrotal mass. TLL and benign tumors are of great interest, because of their topography they can simulate a neoplasm in the paratesticular structures. We sought to study the incidence, nature, pattern, clinical, immune, and histopathological characteristics of tumors and TLL of the paratestis. In this six-year study, records of the cases were reviewed and the histopathology slides were reassessed. Blocks were retrieved and stained immunohistochemically for relevant markers. A total of 47 cases of tumor and TLL of the paratestis were diagnosed over a six-year period. The patients ranged from one to 76 years old and most presented with a scrotal mass. Of these, seven (14.9%) were benign. Lipoma was the most common benign tumor. One case each of adenomatoid tumor, scrotal hemangioma, solitary fibrous tumor, and papillary cyst adenoma were reported. The TLL (70.2%) comprised of 17 cases of epididymal cyst, seven cases of tuberculous epididymitis, four cases of filarial epididymitis, two cases each of non-specific granulomatous epididymitis and fibromatous periorchitis, and one case of mesothelial cyst. Seven malignant tumors (14.9%) were diagnosed all of which were sarcomas. All seven were primary to the paratesticular region. The most common malignant tumor was embryonal rhabdomyosarcoma. One case each of malignant mesothelioma, malignant fibrous histiocytoma, atypical lipomatous tumor/well-differentiated liposarcoma, and myxoid liposarcoma were identified. Neoplasms of the paratesticular region affect patients of all ages, with potentially life-threatening sequelae. Awareness of the entire spectrum and meticulous histopathological examination and immunohistochemical studies are of prime importance in the diagnosis of the various lesions as these influence the mode of therapy and subsequent prognosis of the patient.

Cardiac Rhabdomyomas and Congenital Hypothyroidism: A Coincidence or Hamartia

Cardiac rhabdomyomas are the most common primary cardiac tumors in children. These tumors are generally asymptomatic, although they may be associated with neonatal tuberous sclerosis complex. Despite the fact that thyroid dysfunction rarely occurs in tuberous sclerosis, papillary adenomas (hamartomas) of the thyroid gland have been reported in a number of autopsies. Herein, we present the case of an infant with tuberous sclerosis, congenital hypothyroidism and multiple cardiac rhabdomyomas, leading to atrioventricular node dysfunction. Considering the rarity of this co-occurrence, we decided to report the present case. The co-occurrence of these two disorders in one patient may be a mere coincidence or related to hamartoma of the thyroid gland as a consequence of tuberous sclerosis gene products.

Papillary adenoma arising from an extensive biliary low-grade intraepithelial neoplasia

Papillary adenoma arising from an extensive biliary low-grade intraepithelial neoplasia

The Neutrophil-to-Lymphocyte Ratio Predicts Malignant Potential in Intraductal Papillary Mucinous Neoplasms

BackgroundAccurately identifying malignant components in patients with pancreatic intraductal papillary mucinous neoplasms (IPMN) remains challenging. Preoperative neutrophil-to-lymphocyte ratio (NLR) is a marker of poor prognosis in patients with several types of malignancy. This study assessed whether NLR was predictive of intraductal papillary mucinous carcinoma (IPMC) in patients with IPMN. MethodThis study retrospectively assessed 76 patients who underwent curative resection for IPMN from 1995 to 2015. The correlation between the presence of malignant components and preoperative NLR was analyzed. ResultsPreoperative NLR in IPMC was significantly higher in patients with in IPMC (2.51 ± 0.84) than in patients with intraductal papillary mucinous adenoma (2.01 ± 0.71, P = 0.0079) and healthy volunteers (1.37 ± 0.33, P < 0.0001). NLR was significantly reduced after curative tumor resection. The main duct type (P = 0.0231) and NLR >2.074 (P = 0.0329) were independent predictors of IPMC in all patients. Combined criteria including international consensus guidelines, CA19-9 >37 IU/ml, and NLR >2.074 shows a high positive predictive value of 78 % and high specificity of 96 %. ConclusionsPreoperative NLR is a useful supportive marker to predict IPMC in patients with IPMN.

Bile Duct Papillary Adenoma Degenerating Into Cholangiocarcinoma

A 79 year old Caucasian female was incidentally discovered to have transaminitis on routine labs and underwent right upper quadrant ultrasound revealing a dilated bile duct. MR Abdomen revealed a solid mass in the proximal common hepatic duct. She was asymptomatic without jaundice, weight loss, pruritus or abdominal pain. Additional and repeat labs showed a mildly elevated carbohydrate antigen 19-9 (CA-19-9) at 41.49 and normal carcinoembryonic antigen (CEA). Endoscopic Ultrasound (EUS) revealed a 1.5 x 2 cm mass in the common hepatic duct and fine needle aspiration showed atypical glandular papillary cells with no evidence of neoplasm. Endoscopic Retrograde Cholangiopancreatography (ERCP) with cholangioscopy demonstrated a frond-like mass in the common hepatic duct with pathology indicative of dysplastic epithelium consistent with low-grade dysplasia without frank malignancy. Repeat CA-19-9 level normalized at 30.11. She underwent pre-operative evaluation and was found to have severe aortic stenosis necessitating valve replacement and thus biliary surgery was delayed. Repeat labs four months later showed highly elevated CA-19-9 at 1382.10 concerning for degeneration of adenoma to malignancy. She underwent diagnostic laparoscopy with resection of the extrahepatic biliary tree including bifurcation, Roux-en-Y hepaticojejunostomy, hilar lymphadenectomy and cholecystectomy. Hepatic duct mass pathology showed a 3 x 1.4 cm exophytic papillary adenoma with high grade dysplasia, within which was a 0.3 cm moderately differentiated adenocarcinoma involving the left proximal hepatic duct invading into but not through the hepatic duct wall with negative margins. Final diagnosis was Stage I cholangiocarcinoma (T1N0M0) within a papillary bile duct adenoma. Bile duct adenomas (BDA) are rare bile duct tumors accounting for roughly 6% of extrahepatic tumors. Adenomas of the extrahepatic bile ducts may present with obstructive symptoms or may be asymptomatic, found incidentally on physical exam or imaging. Though defined as a benign tumor, BDAs have carcinogenic potential. The incidence and timing of malignant transformation is not well defined and thus prompt surgical resection is indicated for treatment. In our case, after a necessary delay in therapy, CA-19-9 levels dramatically increased and her tumor that was initially felt to be BDA degenerated to cholangiocarcinoma.Figure 1Figure 2Figure 3

Follicular adenoma associated with spindle cell proliferation, papillary adenoma and colloid goitre in a dromedary camel

In humans, spindle cell lesions associated with thyroid adenoma or carcinoma are rare. A cross section of the thyroid of a dromedary camel showed follicular cysts, and microscopically, both thyroid lobes showed colloid goitre. The left lobe showed spindle cell proliferation associated with follicular adenoma without evidence of capsular or vascular invasion. The spindle cell lesion had cells featuring ground glass or pseudoinclusion nuclei and showed extensive haemorrhage, hyalinization and thrombosis. The right thyroid lobe showed papillary adenoma. Immunohistochemistry showed negative expression for malignancy. Serum Se, free tri-iodothyronine (fT3) and free thyroxine (fT4) values were low and CK activity was high. The histological features were unusual and merit reporting.

The cholesterol-binding protein NPC2 restrains recruitment of stromal macrophage-lineage cells to early-stage lung tumours.

The tumour microenvironment is known to play an integral role in facilitating cancer progression at advanced stages, but its function in some pre-cancerous lesions remains elusive. We have used the V600EBRAF-driven mouse lung model that develop premalignant lesions to understand stroma–tumour interactions during pre-cancerous development. In this model, we have found that immature macrophage-lineage cells (IMCs) producing PDGFA, TGFβ and CC chemokines are recruited to the stroma of premalignant lung adenomas through CC chemokine receptor 1 (CCR1)-dependent mechanisms. Stromal IMCs promote proliferation and transcriptional alterations suggestive of epithelial–mesenchymal transition in isolated premalignant lung tumour cells ex vivo, and are required for the maintenance of early-stage lung tumours in vivo. Furthermore, we have found that IMC recruitment to the microenvironment is restrained by the cholesterol-binding protein, Niemann-Pick type C2 (NPC2). Studies on isolated cells ex vivo confirm that NPC2 is secreted from tumour cells and is taken up by IMCs wherein it suppresses secretion of the CCR1 ligand CC chemokine 6 (CCL6), at least in part by facilitating its lysosomal degradation. Together, these findings show that NPC2 secreted by premalignant lung tumours suppresses IMC recruitment to the microenvironment in a paracrine manner, thus identifying a novel target for the development of chemopreventive strategies in lung cancer.

Epidemiological Study of Mammary Tumors in Female Dogs Diagnosed during the Period 2002-2012: A Growing Animal Health Problem.

Epidemiological studies enable us to analyze disease behavior, define risk factors and establish fundamental prognostic criteria, with the purpose of studying different types of diseases. The aim of this study was to determine the epidemiological characteristics of canine mammary tumors diagnosed during the period 2002-2012. The study was based on a retrospective study consisting of 1,917 biopsies of intact dogs that presented mammary gland lesions. Biopsies were sent to the Department of Pathology FMVZ-UNAM diagnostic service. The annual incidence of mammary tumors was 16.8%: 47.7% (benign) and 47.5% (malignant). The highest number of cases was epithelial, followed by mixed tumors. The most commonly diagnosed tumors were tubular adenoma, papillary adenoma, tubular carcinoma, papillary carcinoma, solid carcinoma, complex carcinoma and carcinosarcoma. Pure breeds accounted for 80% of submissions, and the Poodle, Cocker Spaniel and German Shepherd were consistently affected. Adult female dogs (9 to 12 years old) were most frequently involved, followed by 5- to 8-year-old females. Some association between breeds with histological types of malignant tumors was observed, but no association was found between breeds and BN. Mammary tumors in intact dogs had a high incidence. Benign and malignant tumors had similar frequencies, with an increase in malignant tumors in the past four years of the study. Epithelial tumors were more common, and the most affected were old adult females, purebreds and small-sized dogs. Mammary tumors in dogs are an important animal health problem that needs to be solved by improving veterinary oncology services in Mexico.

Classification and Epidemiology of Mammary Tumours in Pet Rabbits (Oryctolagus cuniculus)

Mammary tumours are common in pet rabbits; however, published studies are predominantly derived from laboratory and meat rabbits. This study reports basic data on type and location of 119 separate tumours from 109 pet rabbits. The animals were aged 2-14 years (mean 5.5 years) and all 90 rabbits of known gender were female. Cranial and caudal mammary glands were affected equally. The majority of lesions (n=105) were classified as carcinomas with 32 tubular, 16 papillary, 12 tubulopapillary, 11 solid, nine adenosquamous, nine comedo type, five complex, four ductal, three cribriform, three anaplastic and one spindle -cell carcinoma. Twelve percent of the lesions were benign, with eight intraductal papillary adenomas, three simple tubular adenomas and one complex adenoma. One non-neoplastic lesion was found in the form of cystic duct ectasia.