Sep 12, 2018 - Expression of Stathmin and tumour cell proliferation in association with ... Diagnosis of atypical glandular epithelium in cervix cytology .... bolic risk, surgical excision is the mainstay of treatment in these patients and median ...
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30th European Congress of Pathology Pathology: Path to Precision medicine 8 – 12 September 2018 Euskalduna Conference Centre, Bilbao, Spain
www.esp-congress.org
Final Programme
069 Hypoxia up-regulates ID proteins in Luminal and HER2-positive breast cancer cell lines Gloria Peiro Cabrera, Spain M. Garcia-Escolano, Y. G. Montoyo-Pujol, S. Pascual-Garcia, P. Martinez-Peinado, J. M. Sempere-Ortells, F. I. Aranda, F. Ortiz-Martinez E-PS-03
E-Posters
Cardiovascular Pathology 001 Obesity paradox: if there genetics involved? Microarray study in morbidly obese decedent patients with severe and minimal atherosclerosis of the aorta Sergey Brodsky, USA S. Mishra, I. Ivanov, A. Toland, P. Fadda, H. Wang, L. Brodsky, R. Barth, R. Ganju 003 Infracentimetric capillary hemangioma of the artery. Report of 3 cases Adriana Handra-Luca, France 004 Papillary fibroelastoma. Clinical and pathological study of 4 cases Gonzalo Garcia De Casasola Rodriguez, Spain A. Marcos Muñoz, D. Parrón Collar, I. Diaz de Lezcano, J. Larrazabal Lopez, M. Atienza Robles, E. M. Fernandez Lomana, A. Nogueira Gregorio, A. Moreno, M. Saiz Camín 005 Morphological features of peripheral thrombi in pulmonary embolism Tatiana Fedorina, Russia Y. Yunusova, P. Suhachyov, T. Shuvalova
007 Wünderlich syndrome by iliac vein rupture, secondary to deep vein thrombosis Julia Garcia Reyero, Spain G. G. Yange Zambrano, A. Gonzalez Castro, M. Ortiz Lasa, S. Marcos González, J. Martínez-Echevarría Gil-Delgad, P. García Arranz, F. J. Gonzalez Sanchez, R. Pellón Daben, A. Azueta Etxebarria 008 Papillary fibroelastoma of the aortic valve. A rare case report Ioannis Dimitriadis, Greece D. Anestakis, M. Kilbasani, A. Baliaka, S. Papaemmanuel 009 Combined forms of amyloidosis (clinical and morphological observation) Margarita Rybakova, Russia I. Kuznetsova, I. Krylova, V. Rodichkina E-PS-04
E-Posters
Cytopathology 001 Diagnosis of atypical glandular epithelium in cervix cytology Maja Nenadovic, Norway K. Al-Shibli, T. Skjeldal, M. Fostervold 002 Cytological diagnosis of a solid-pseudopapillary tumour of the pancreas: a case report Charlotte Dufour, France S. Humez, V. Maunoury, F. El Hajbi, E. Leteurtre 003 Cytological diagnosis of rare pancreatic involvement by multiple myeloma João Fraga, Portugal R. Almeida, H. Moreira, A. C. Lai, M. B. Pimentão, V. Almeida, C. Faria, G. Fernandes
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006 Primary cardiac lymphoma in immunocompetent patient: a case report Luiz Miguel Nova Camacho, Spain M. V. Zelaya Huerta, Á. Panizo, M. Atienza Robles, Y. Rodriguez
E-PS-02
068 Expression of Stathmin and tumour cell proliferation in association with the BRCA1 genotype and a basal-like phenotype in breast cancer Cecilie Askeland, Norway E. Wik, I. M. Stefansson, K. Collett, J. B. Arnes, G. Knutsvik, T. Aas, L. A. Akslen
E-PS-04
E-Posters
ECP 2018 · Bilbao
E-Posters E-PS-07
013 E-cadherin in adenocarcinoma of pancreas Doxakis Anestakis, Greece C. Tsompanidou, M. Lambropoulou, M. Alatsakis, A. Katsourakis, I. Venizelos 014 Pancreatic tail solid pseudopapillary tumour in a young male Galiya Setdikova, Russia O. Paklina, A. Karpov 015 Unusual isotopic fractionation patterns of growing in vivo hepatocellular carcinomas of developmental age Katarzyna Taran, Poland P. Paneth 017 Immunohistochemical evaluation of the expression of MAGE-C1 protein in hepatocellular carcinoma Maria Lambropoulou, Greece S. Tologkos, C. Trypsianis, V. Papadatou, K. Kantartzi, C. Tsigalou, C. Nikolaidou, I. Venizelos, A.-P. Panagiotopoulos, A. Zisimopoulos, N. Papadopoulos
ECP 2018 · Bilbao
022 Pancreatic metastasis on endoscopic ultrasound-guided fine needle aspiration: a study of 12 cases Geanella Geraldine Yange Zambrano, Spain J. Martín López, J. B. Garcia Reyero, J. Martínez-Echevarría Gil-Delgad, M. L. Cagigal Cobo, G. A. Yange Zambrano, H. G. Sarmiento Moncayo, J. C. Yange Zambrano 023 The hidden cause of an acute severe liver injury in an adult female patient George Terinte-Balcan, Romania A. Iorgescu, I. Simionov, M. E. Dumbrava, A.-M. Militaru, I. A. Ostahi, G. Becheanu 025 Factors influencing prognosis in pancreatobiliary neoplasms Estela Aguilar Navarro, Spain C. Diaz Del Arco, J. Martinez Useros, L. Diez Valladares, M. J. Fernández Aceñero, M. A. Ceron Nieto, L. Ortega Medina
018 Transitional liver cell tumour: a case report Vanderlei Segatelli, Brazil E. C. Oliveira, L. Cardili
026 Primary hepatic carcinosarcoma: a rare histopathological diagnosis in a female patient Adelina-Elena Baltan, Romania M. Mihai, M. Manuc, V. Brasoveanu, V. Herlea
019 Intraductal pancreatic acinar cell carcinoma: a case report Macarena Boiza, Spain J. Muñoz, H. D. Quiceno
027 Intraductal tubulo-papillary neoplasm of the pancreas: report of two cases José Ignacio Franco, Spain L. Nova, C. Hörndler, M. L. Gómez
020 Pancreatic carcinoma: prognostic impact of galectin-3 Fatma Khanchel-Lakhoua, Tunisia B. Medini, N. Redissi, W. Koubaa, R. Jouini, A. Chadli, E. Ben Brahim
028 Solid pseudopapillary tumour of the pancreas: clinical, histopathological and immunohistochemical features – a series of 13 cases George Terinte-Balcan, Romania A.-M. Militaru, I. A. Ostahi, V. Enache, M. E. Dumbrava, C. Pechianu, V. Herlea, A. Enculescu, A. Vasile, A. Evsei, F. Staniceanu, C. Popp, G. M. Predescu, G. Becheanu
021 A case report of solid pseudopapillary neoplasia Nagore Arbide, Spain C. Romero, M. Vázquez, J. Velasco
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E-Posters
021 Cavernous haemangioma of adrenal gland. Case report and literature review Olympia Tzaida, Greece L. Karelis, N. Novkovic, G. Stanc, P. Manikis, K. Daniilidou, G. Vecchini 022 The case of the four-time attempt of obliteration of the thyroid gland node with ethanol in the unspecified cystous form of the papillary carcinoma Ekaterina Bondarenko, Russia I. Kazanceva 023 Synchronous multifocal medullary and papillary thyroid carcinoma in same thyroid gland Serdar Altinay, Turkey D. Canoglu, S. C. Dogansen, C. Akarsu, M. E. Günes 024 Mismatch repair gene MSH6 as a prognostic factor in pituitary neuroendocrine tumours Santiago Ortiz, Portugal F. Tortosa 026 Hemangioma-like vascular proliferation of the thyroid: a potential diagnostic pitfall as a consequence of fine needle aspiration biopsy Adela Nechifor-Boila, Romania R. Georgescu, A. Borda 027 Large size oncocytic adenoma of the thyroid: a potential diagnostic pitfall Adela Nechifor-Boila, Romania M. Coros, E. Dee, A. Borda 028 Prognostic factors and classification systems in colorectal neuroendocrine neoplasms Cristina Díaz Del Arco, Spain L. Ortega Medina, E. Aguilar Navarro, M. J. Fernández Aceñero
029 CYP17A1 expression in prostate cancer Alexandra Giatromanolaki, Greece V. Fasoulaki, D. Kalamida, E. Sivridis, M. Koukourakis
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020 Thyroid tuberculosis mimicking a carcinoma Issam Msakni, Tunisia N. Redissi, M. Mhiri, F. Gargouri, N. Mansouri, A. Bouziani, B. Laabidi
030 A rare case of cystic hemangioma of the adrenal gland Doxakis Anestakis, Greece G. Hahalis, C. Nikolaidou, M.-E. Givannakis, N. Raikos, C. Tsompanidou 032 Gastrointestinal metastasis of primary thyroideal eptihelioid angiosarcoma with CYP2D6 c.506-1G>A polymorphism: molecular and immunophenotypical characterisation Esther Sanfeliu, Spain A. Martinez, A. Diez-Caballero, A. Flor, S. Bagué, J. Capdevila, C. Llebaria E-PS-09
E-Posters
Gynaecological Pathology 001 Peculiar features of CEACAM1 and E-cadherin expression in the uterus Mykola Lyndin, Ukraine A. Romaniuk, V. Sikora, N. Gyryavenko, O. Kravtsova, V. Panchenko, Y. Lyndina, B. B. Singer 002 The aggressive EpCAM+CD45+ phenotype in serous epithelial ovarian cancer Valeria Maffeis, Italy L. Nicolè, A. Grego, C. M. Radu, P. Simioni, A. Fassina 003 Glandular carcinomas of the endocervix: a clinicopathological review – experience of a tertiary referral centre Rita Amorim, Portugal C. Estima Fleming, M. Marques Oliveira, L. Ferreira, N. J. Lamas, J. R. Brandão, B. Fernandes, F. Moreno, A. Duarte, J. R. Vizcaíno 004 Uterine florid cystic endosalpingiosis Raquel Machado-Neves, Portugal J. dos Santos, T. Amaro, M. Honavar
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ECP 2018 · Bilbao
004 Brain and pulmonary metastasis from type A thymoma: case report of an extremely unusual malignancy José Ignacio Franco, Spain I. Marquina, S. Vicente, J. Alfaro, S. Hakim, M. Trigo, M. J. Viso, S. Bakali, H. P. Almánzar, A. Sobrino, R. I. Bermúdez 005 Pathogenetic mechanism of limb girdle muscle diseases: an integrated approach Giovanna Cenacchi, Italy V. Papa, R. Costa, M. Fanin, V. Pegoraro, C. Angelini 007 Desmoplastic infantile astrocytoma: a rare case Nurver Ozbay, Turkey A. Aydin 009 Angiolipoma of the spine: a case report and review of the literature Dominique Yuan Bin Seow, Singapore S. H. Lai 010 Intrasellar meningioma: a case report Bethany Mariana Michaelides, Greece E. Lakiotaki, S. Pappa, C. Karampogias, K. Papachristou, S. Gavriilidou, C. Savvidis, T. Choreftaki 011 A case report of papillary tumour of pineal region Grigorios Panselinas, Greece D. Bouklas, M. Chantziara, G. Theodoropoulou, A. Kostopoulou, C. Zorzos, G. Kakiopoulos, N. Georgakoulias, T. Choreftaki 012 Pleomorphic xanthoastrocytoma with anaplastic features: a case report Olympia Tzaida, Greece M. Nifora, E. Arkoumani, L. Karelis, A. Zizi-Serbetzoglou 013 Role of pathologist in driver of treatment of CNS tumours Serdar Altinay, Turkey
E-Posters 014 Primary central nervous system lymphoma associated to Dandy-Walker malformation, a very difficult diagnosis Claudia Carolina Ramos-Rodríguez, Spain J. L. Sanz Trenado, V. Herrera Montoro, J. González García, F. Martín Dávila, M. Delgado Portela, N. Villasanti Rivas, L. González López, H. Caballero-Arzapalo, O. Balcázar-Rojas, M. Calvo-García 015 Central nervous system hemangioblastomas: three case reports Moez Hamdani, Tunisia R. Hadhri, M. Njima, S. Chouchane, D. Chiba, M. Darmoul, A. Zakhama, L. Njim 016 Primer pleomorphic xanthoastrocytoma with anaplastic features: a case report and review of the literature Elife Kimiloglu, Turkey H. C. Agcakoyunlu, O. Gundogar, M. Cin, N. Komut, S. Kabatas 017 Metastatic meningioma to the thoracic pleura Doxakis Anestakis, Greece M.-I. Givannakis, I. Dimitriadis, E. Zagelidou, K. Zekos, T. Givannakis 018 Histopathological lesions in a skeletal muscle regeneration model of adipose tissue implantation Ignacio Ruz-Caracuel, Spain F. Leiva-Cepas, M. J. Gil-Belmonte, I. Gómez-Cabello, J. Cámara-Pérez, I. Jimena, J. Peña 019 Prognostic value of immunohistochemical expression of bcl-2 and p53 in glioblastomas Issam Msakni, Tunisia H. Kammoun, R. Yaiche, F. Gargouri, N. Mansouri, N. Redissi, A. Bouziani, B. Laabidi 020 Craniopharyngioma – a case report Vasileios Charalampidis, Greece I. Kontou Founta, P. Mylonakis, F. Louka, D. Anestakis
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vein and retroperitoneal haematoma. The literature shows better results with a conservative treatment versus a surgical alternative
E-PS-03-008 Papillary fibroelastoma of the aortic valve. A rare case report I. Dimitriadis*, D. Anestakis, M. Kilbasani, A. Baliaka, S. Papaemmanuel * Papanikolaou General Hospital, Pathology LAB, Thessaloniki, Greece Background & Objective: Papillary fibroelastoma is a rare primary tumour of cardiac origin accounting for approximately 10% of all primary cardiac neoplasms. Method: Here, we report our treatment of an aortic valve papillary fibroelastoma that was discovered incidentally, during routine intraoperative TEE, in a patient 36-year old woman. Due to a high thromboembolic risk, surgical excision is the mainstay of treatment in these patients and median sternotomy the most widely used approach. Results: Macroscopically, the tumour (gr.dim.:1,2 cm) characterised by multiple frond-like fibrous projections creating a ‘sea anemone’ appearance when immersed in saline. Histologically, the tumour is comprised of an avascular fibroelastic core, made up of a hyalinised collagen matrix with a rim of smooth muscle cells and elastic fibres, lined by endocardial endothelium. Immunohistochemical characteristics include positive staining for factor VIII-related antigen, CD34 and Vimentin confirming a vascular endothelial cell lining, and multilayered type IV collagen elastic proliferation deep to the surface membrane. Conclusion: The aetiology of PFE remains largely unknown. Recent hypotheses include fibroblast infiltration with organisation of mural thrombi, viral induced tumour growth, and an endothelial response to cardiac surgery, mechanical trauma or thoracic radiation. Historically, PFE has also been described as both a true neoplasm and a hamartomatous lesion, whereas some authors have suggested they are merely an overgrowth of Lambl’s excrescences.
E-PS-03-009 Combined forms of amyloidosis (clinical and morphological observation) M. Rybakova*, I. Kuznetsova, I. Krylova, V. Rodichkina * FSBEI HE I. P. Pavlov SPbSMU, Pathomorphology, Saint Petersburg, Russia Background & Objective: In recent years, many views have significantly changed about amyloidosis. The aim of our study was to determine the clinical and morphological characteristics of combined forms of amyloidosis in patients with chronic heart failure (CHF). Method: The material for the study was the myocardium obtained at autopsy of 89 years man, suffering from arterial hypertension and generalized atherosclerosis with the development of biventricular heart failure. A histological study was carried out with staining: haematoxylin and eosin, Congo-red with an estimate in a polarizing microscope, as well as immunohistochemical study was conducted with confocal laser microscopy using antibodies to Amyloid A (AA); Amyloid-P; IgG Lambda Light Chain (ATTR); AntiPrealbumin. Results: With a macroscopic assessment of heart its weight was 480.0 g, the thickness of the left ventricle wall was 1.6 cm, the right ventricle - 0.4 cm, and the heart index 0.008. The cavities of the heart are enlarged. Myocardium has a dense consistence of dark red color with diffuse interlayers of whitish dense tissue. Microscopically, amyloid is detected in the wall of coronary and intramyocardial vessels and also around vessels of different calibers and between thinned and overgrown cardiomyocytes. Immunohistochemical study revealed colocalization of AA and ATTR both in focal amyloid deposits located between cardiomyocytes and around intramyocardial vessels of different calibers. AA or ATTR was also determined in the wall of arterial vessels and cardiomyocytes.
Conclusion: In this observation, changes in the heart and vessels proceeded under the guise of HIHD. Amyloidosis has been revealed morphologically and the protein precursors were AA and ATTR without clinical and morphological features of the heart.
E-PS-04 | Cytopathology
E-PS-04-001 Diagnosis of atypical glandular epithelium in cervix cytology M. Nenadovic*, K. Al-Shibli, T. Skjeldal, M. Fostervold * Nordland Central Hospital, Dept. of Pathology, Bodø, Norway Background & Objective: Cervical cancer is the third most common type of cancer amongst women worldwide. Human Papilloma Virus (HPV) causes about 99% of the cases of cervical cancer. It is very important to discover and treat premalignant cell changes for prevent the development of cervical cancer and this is the main goal of the Norwegian national screening program. Method: This report assessing cytology diagnosis Atypical Glandular cells of Undetermined Significance (AGUS) and Adenocarcinoma in Situ (ACIS) from 2011 to 2016 diagnosed at the Department of Pathology, Nordland Hospital (NLSH) and correlating it with subsequent histology. It was investigated 235 cases (214 AGUS and 21 ACIS). All the cases were studied and correlation of the results from cytology and histology was done. Positive predictive value (PPV) for both AGUS and ACIS were calculated based on histology-results. Results: Benign histological findings that could explain the AGUS diagnosis include reactive and metaplastic glandular cells. Mild dysplasia (CIN1) were included in the category of benign diagnosis. Premalignant diagnosis includes high grade squamous dysplasia (CIN2/3) and ACIS. Malignant diagnosis includes adenocarcinoma and squamous cell carcinoma. 52% of all the cases had normal/benign histology, 43% had premalignant and 5% had malignant histology. 31% of AGUS cases with a premalignant diagnosis had high grade dysplasia in squamous epithelium (CIN2/3) histologically. PPV were calculated to be 42% for AGUS diagnosis and 100% for ACIS diagnosis. Conclusion: AGUS diagnosis has a relative low PPV compared to ACIS. PPV of both entities is relatively high in NLSH.
E-PS-04-002 Cytological diagnosis of a solid-pseudopapillary tumour of the pancreas: a case report C. Dufour*, S. Humez, V. Maunoury, F. El Hajbi, E. Leteurtre * Lille University Hospital, Institut de Pathologie, Lille, France Background & Objective: Endoscopic ultrasound-guided fine-needle aspiration has become an essential pre-operative method to make accurate diagnosis of cystic and solid pancreatic lesions. Method: We report here a case of a solid-pseudopapillary tumour of the pancreas,diagnosed by afine-needle aspiration in a 70 years old female patient.She was a former smoker and had a history of invasive lobular carcinoma of the breast. A Positron Emission Tomography, performed to assess her breast cancer stage showed a hypermetabolic lesion of the pancreatic tail. Endoscopic ultrasound found a complex and multilocular cystic lesion with no evidence of connection to pancreatic ducts. Clinical context and radiological aspect were in favor of a cystic neuroendocrine lesion or a metastatic lesion of her breast carcinoma. Results: Microscopically, fine-needle aspiration was very cellular and showed numerous papillary structures. They were characterized by a delicate fibrovascular core surrounded by a layer of monomorphic cells with round to oval nuclei, finely granular chromatin and small nucleoli. Many single cells with a similar aspect were also scattered in the background. Immunohistochemical study was performed on the cell block and showed positive staining for CD56, vimentin, CD10 and focally
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Background & Objective: Report a case of primary hepatic clear cell myelomelanocytic tumour (PEComa) to define its histological features. Method: A 42-year-old female presented with pain in right hypochondrium. Her liver function tests showed elevated SGOT, SGPT and GGT levels. On examination there was right hypocondriac lump. Contrast enhanced computed tomography (CT) of the abdomen showed 4x3 cm heterogeneously enhancing lobulated lesion in segment VII and a few lesions approximately 1 cm in length in segment 8, segment 5-6 junction and segment 4 of the liver. A segmental hepatectomy was done. Results: On macroscopic examination, grayish yellow and crisp quality mass relatively demarcated from the surrounding liver parenchyma with a size of 4x3x3 cm was observed. Histopathologic examination revealed a tumour characterized by a population of large epithelioid cells with clear or eosinophilic granular cytoplasm, rich in glycogen. Immunohistochemically, the tumour cells were positive for HMB-45, Melan-A and SMA, but negative for epithelial markers, S-100 protein, and CD10. Conclusion: Perivascular epithelioid cell tumours (PEComas) that show marked female predominance are mesenchymal neoplasms defined by the presence of histologically and immunohistochemically distinctive perivascular epithelioid cells. This tumour family includes angiomyolipoma, clear cell sugar tumour, lymphangioleiomyomatosis, and a group of rare, morphologically and immunophenotypically similar tumours arising at a variety of visceral and soft tissue sites. Hepatic PEComa is very rare neoplasm. The main differential diagnosis of hepatic PEComa includes clear cell variant of liver cell adenoma and hepatocellular carcinoma, metastases of various clear cell carcinomas and metastasis of malignant melanoma.
E-PS-07-013 E-cadherin in adenocarcinoma of pancreas D. Anestakis*, C. Tsompanidou, M. Lambropoulou, M. Alatsakis, A. Katsourakis, I. Venizelos * Aristotle University Thessaloniki, Necrotomic Histopathology, Greece Background & Objective: E-cadherin is important for cell-cell adhesion. Reduction and/or loss ofE-cadherin expression in adenocarcinoma of pancreas correlates positively with malignant transformation, invasion and metastasis of tumour. The aim of study was to examine immunohistochemically the expression of E-cadherin in adenocarcinomas of pancreas and their relationship with clinicopathologic parameters such as histological stage, grade, tumour size, sex and age of the patients. Method: 15 women and 29 men with adenocarcinoma of pancreas treated surgically were examined retrospectively. The age of the patients ranged from 45 to 78 (mean age 65 years). The tumour specimens have been immunostained for E-cadherin. Results: Absent or reduced expression of E-cadherin was observed in 10 of 12 (83%) stageII, 13 of 18 (72%) stageIII and 13 of 14 (92.8%) stageIVadenocarcinomas. The impaired expression of the E-cadherin was observed with a higher frequency in high-grade than in low-grade tumours 82% and 48% respectively, (pA polymorphism: molecular and immunophenotypical characterisation E. Sanfeliu*, A. Martinez, A. Diez-Caballero, A. Flor, I. Ramos, J. Capdevila, C. Llebaria * Centro Medico Teknon, Pathology, Barcelona, Spain
E-PS-09-001 Peculiar features of CEACAM1 and E-cadherin expression in the uterus M. Lyndin*, A. Romaniuk, V. Sikora, N. Gyryavenko, O. Kravtsova, V. Panchenko, Y. Lyndina, B. B. Singer * Sumy State University, Pathology, Ukraine Background & Objective: The aim of our study was to characterize the expression pattern of сarcinoembryonic antigen related cell adhesion molecule 1 (CEACAM1) and E-cadherin in normal, hyperplastic and tumour tissues of the uterine, and to determine the potential correlation between these two adhesion molecules. Method: 45 samples of the uterine tissue (normal, hyperplastic and tumour tissues) were selected for the study. The presence of CEACAM1 (С5-1Х8–0.1μg/ml) and E-cadherin (EP700Y–0.5μg/ml) receptors was detected by the immunofluorescence analyses. Results: E-cadherin is expressed on the basal surface and in the intercellular contacts by all cells of the normal endometrium and under the hyperplasia. The endometrial adenocarcinoma tissues showed a variable Ecadherin expression: basal-intercellular – under formation the glands by the neoplastic cells, entire membranous – under the solid growth of cancer cells and the decreasing expression – when the malignant progression is developing. Conversely, the CEACAM1 receptors are present on the apical surface of the normal and pre-tumour tissues of the uterus. They appear in the cytoplasm when the anaplasia level of the neoplastic cells is increased. It was determined that E-cadherin-positive cells are present when there is no CEACAM1 receptor expression. Conclusion: The endometrial tissue shows a variable expression of СЕАCAM1 and E-cadherin receptors depending on the pathological changes in the uterus. Different patterns of these proteins indicate the absence of any functional correlation between them. However, the alterations of both protein location from cell membrane to their
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Conclusion: In conclusion, pathologists are aware of their responsibility in neurosciences which is increasing in importance, know the value of a multidisciplinary approach in the management of brain tumours together with oncologists, surgeons and radiologists and play an important role in the administration of individualized molecular treatment in metastatic cancers such as lung, breast and melanoma cancer by using skillfully immunohistochemical arguments not only in the accurate diagnosis of primary tumours but even in tumours where the primary source cannot be identified radiologically.
E-PS-17-014 Primary central nervous system lymphoma associated to DandyWalker malformation, a very difficult diagnosis C. C. Ramos-Rodríguez*, J. L. Sanz-Trenado, V. Herrera-Montoro, J. González-García, F. Martín-Dávila, M. Delgado-Portela, N. VillasantiRivas, L. González-López, H. Caballero-Arzapalo, O. Balcázar-Rojas, M. Calvo-García * HGU. Ciudad Real, Pathology, Spain Background & Objective: Primary central nervious system lymphoma is a rare disease in immunocompetent patients, with an incidence of 5/ 1,000,000 person-years. Method: We describe a case and review the literature. Results: 47 years-old woman, with Dandy walker malformation and hydrocephaly, developes headache, somnolence and vomits. MRI shows addicionaly an ependymal/subependymal linear and nodular lesion highlighted by the contrast with perilesional edema was observed aroud temporal, occipital and frontal horns of lateral ventricles. Multiple cytologies were taken, reporting cells with moderate atypia of medium size and scarce cytoplasm suspected of malignancy. CSF biochemistry detected hypoglycorrha-chia, high protein levels, and high ADA. After presenting progressive cognitive deterioration, derivation and cultures were performed without finding germs, empirical treatment was given for mycobacteria and parasites without improvement. When corticosteroids were added, an undulating course was observed, however, it showed multiple convulsive episodes and hyperthermia, finally dying 1,5 months after without a definitive diagnosis. An autopsy was made and the study of CNS shows a cellular proliferation formed by round, medium-large cells, with scarce basophilic cytoplasm and atypical nuclei infiltrating sheets and intense necrosis, the brain tissue adjacent to the lateral ventricles, nuclei from the base, geniculate body and internal capsule. It also compromised meninges, bulge and spinal bulb. The tumour cells were positive for CD20, BCL2, BCL6, MUM1 and EBVand were negative for CD3 and CD10. The rest of the organs were studied, including lymph nodes and bone marrow, without being compromised by lymphoma. Conclusion: We present because it is an infrequent pathology and its association to malformations make more complicated to reach a timely diagnosis.
E-PS-17-015 Central nervous system hemangioblastomas: three case reports M. Hamdani*, R. Hadhri, M. Njima, S. Chouchane, D. Chiba, M. Darmoul, A. Zakhama, L. Njim * Fattouma Bourguiba Hospital, Dept. of Pathology, Djerba, Tunisia Background & Objective: Central nervous system hemangioblastomas (HGB) are rare benign vascular tumours. Cerebellum is the most common location (83%). They can occur either sporadically (67 %) or associated with Von Hippel–Lindau disease (VHL; 33 %). Method: A retrospective study of cases of HGB diagnosed in our department between 2006 and 2017. The histopathological as well as clinical characteristics of this rare disease are discussed. Results: Three cases were reported. All the patients were men, aged 13, 52 and 58-year-old. One patient presented with intracranial
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hypertension’s symptoms, the second with a static and kinetic cerebellar syndrome and the third with a headache. One patient had a familial history of VHL disease. In all cases, imaging revealed a vascularized cerebellar tumour. In two cases, the lesion was resected. In the other case patient underwent a biopsy. In all cases, microscopic study showed a tumour formed by large numbers of thin-walled, fairly closely packed blood vessels and intervening polygonal stromal cells with clear cytoplasm and hyperchromatic nuclei. Immunohistochemical studies revealed no staining for keratin and Pax 8 in stromal cells. Conclusion: The main histopathologic differential diagnosis of HGB is metastatic renal cell carcinoma. Although hemangioblastomas are benign tumours and generally are not invasive in nature, its pathogenic action derives from its mass effect and from peritumoural edema. Advences in microsurgery techniques allow total resection with a low mortality rate.
E-PS-17-016 Primer pleomorphic xanthoastrocytoma with anaplastic features: a case report and review of the literature E. Kimiloglu*, H. C. Agcakoyunlu, O. Gundogar, M. Cin, N. Komut, S. Kabatas * University of Health Sciences, GOP Taksim Research & Education Hospital, Pathology Dept., Istanbul, Turkey Background & Objective: Pleomorphic xanthoastrocytoma(PXA) is a rare astrocytic tumour that is seen less than %1 of all astrocytic glial tumours. It is classified as a low-gradetumour (Grade II)according to WHO classification of tumours of the central nervous system. It usually occurs in young adultsand children. PXAs are typically located on the supratentorial region, especially on the temporal lobe, which is considered as superficial involvement, as a well-circumscribedmass. It is known to have favorable prognosis. Only %9-20 of PXAhas anaplastic features. Method: 25-year-old woman who visitedthe ER of our hospital due to having seizures. It was not accompanied by any neurological symptoms and physical defects. Brain MRI with contrast, showeda well-defined lesion in the right parietal region, which has aheterogeneoussolid-cystic component, and a 2x2 cm mass. In histopathological examination of the lesion, it was composed of plump, spindle-shaped cells, which haveelongated nuclei with pale-pink cytoplasms and also monomultinuclear astrocytes with bizarre nuclei with large, pink granular cytoplasms. There were lipid droplets present in some these cells, which are referred to as ‘xanthomatous cell’. There was necrosis and mitoses were less than 5 /HPF. In the immunochemical panel of the said lesion;GFAP and CD34 staining showed expression in tumour cells, and Ki-67 proliferation index indicated was %2. Silver staining showed reticulin fibers surrounded by individual cells. Results: PXA is rare astrocytic neoplasm. After being surgically removed they have the tendency to recur. %9-20 of recurrent tumours progress to anaplastic transformation. Conclusion: Primer PXA with anaplastic featuresis extremely rare. We presented this case that review of the literature.
E-PS-17-017 Metastatic meningioma to the thoracic pleura D. Anestakis*, M.-I. Givannakis, I. Dimitriadis, E. Zagelidou, K. Zekos,T. Givannakis *
Aristotle University Thessaloniki, Necrotomic Histopathology, Greece
Background & Objective: Meningioma is a neoplastic growth orig-inating from the leptomeninges. Meningiomas comprise approxi-mately 15% of the primary brain tumours. The majority are be-nign; less than 1% metastasize. They are most likely to be found in adults older than 60; the incidence appears to increase with age. Rarely are meningiomas found in children. They occur about twice as often in women as in men.
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Method: This report describes a case of metastatic anaplastic meningioma involving the thoracic pleura in a 47-year-old woman. Results: The patient was treated surgically 1,5 years earlier for an anaplastic meningioma of the right parietal vault. One year later, the patient presented thoracic neuralgia and the CT reveal an intrathoracic mass. Percutaneous CT-guided core biopsy is performed for the evaluation of the indeterminate thoracic mass. Histological findings were compatible with anaplastic meningioma (grade III WHO). Conclusion: Meningiomas arise from arachnoidal cells, most of which are near the vicinity of the venous sinuses, and this is the site of greatest prevalence for meningioma formation. Usually grow slowly, and may reach a large size before interfering with the normal functions of the brain. The resulting symptoms depend on the location of the tumour within the brain. Headache and weakness in an arm or leg are the most common symptoms. However, seizures, personality changes, and/or visual problems may also occur. Extracranial metastases from brain meningiomas is a rare, but well-documented entity. Metastases occur mostly in the lungs, pleura and liver, but may also affect lymph nodes and bones.
E-PS-17-018 Histopathological lesions in a skeletal muscle regeneration model of adipose tissue implantation I. Ruz-Caracuel*, F. Leiva-Cepas, M. J. Gil-Belmonte, I. Gómez-Cabello, J. Cámara-Pérez, I. Jimena, J. Peña * Hospital Universitario La Paz, Servicio Anatomía Patológica, Madrid, Spain Background & Objective: Skeletal muscle has the ability to regenerate and restore its histology after injury if several reintegrative factors are present (revascularization, reinnervation and longitudinal tension). We have a model of adipose tissue to reconstruct volumetric loss in skeletal muscle where some of these factors are lacking. Our objective is to study histological changes at medium and long term in this model. Method: Wistar rats previously anaesthetised were removed a piece of muscle in the tibialis anterior muscle using a cylindrical punch. The defect was filled with a same size piece of adipose tissue taken from the same animal inguinal space. Rats were sacrificed at 21, 28 and 90 days postimplantation, muscles were removed and fast frozen. Cryosections were stained using histological, histochemical and immunohistochemical techniques. Results: Regenerating muscle fibers showed several cytoarchitectural changes that included: fibers with myonuclei clumps, ring fibers, snakecoiled, central spot, split and fragmented muscle fibers. Conclusion: These lesions can be explained on the basis of the lack of reintegrative factors. The use of animal models were etiopathogenesis can be controlled can be very useful to understand changes appearing in human biopsies.
E-PS-17-019 Prognostic value of immunohistochemical expression of bcl-2 and p53 in glioblastomas I. Msakni*, H. Kammoun, R. Yaiche, F. Gargouri, N. Mansouri, N. Redissi, A. Bouziani, B. Laabidi * Military Hospital of Tunis, Dept. of Pathology, Tunisia Background & Objective: Glioblastomas are the most prevalent primary brain malignancy and the prognosis is poor. Age, cognitive status, extent of surgical resection and adjuvant treatment are among the main prognostic factors. Some immunohistochemical markers seem to have a prognostic interest but the results are not unanimous and are sometimes contradictory. The aim of our study was to evaluate the prognostic value of p53 and bcl-2 antibodies in glioblastomas and to find a statistically significant relationship between the expression of these antibodies and the recurrence.
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Method: Fifty-two cases of glioblastoma were identified in the Department of pathology of the Military Hospital of Tunis between 2005 and 2016. An immunohistochemical study was performed followed by a statistical analysis analysing the correlation with the recurrence and the overall survival. Results: The average age of patients was 56 years old. The 1-year survival and 2-year survival were 33% and 4% respectively. The median progression-free survival was 26 weeks. The median survival was 35 weeks. There was Tumour recurrence in 37% of cases. Bcl-2 was expressed in 35% of cases. P53 was present in 13% of cases. Bcl-2 and p53 had no statistically significant relationship with survival and with progression-free survival. Conclusion: Our study concluded that there’s no Prognostic value of bcl2 and p53’s immunohistochemical expression in glioblastomas.
E-PS-17-020 Craniopharyngioma - a case report V. Charalampidis*, I. Kontou Founta, P. Mylonakis, F. Louka, D. Anestakis * Aristotle Univ. Thessaloniki, Forensic Histopathology, Greece Background & Objective: Craniopharyngioma is one rare slowly developing, usually benign tumour. In majority of cases, such tumours grow above the anterior upper lip of pituitary glandand are located mainly on Sella Turcica. Strike 0,12-2/100.000 people a year and they constitute the 2-5% of all brain tumours. Consequently, the rareness of its development constitutes a significant motivation for its notification and its analysis to scientific community. Method: A Male patient was diagnosed with craniopharyngioma after MRI with maximum size 2 cm due to often and intense headaches. Subsequently, he was treated with laser for 3 years because of his not surgically removable area. The irradiation of the area caused metacentric angiopathy and in combination that the incident is one hypertensive patient, came up the automatical rupture of the vessels and the formation of subarachnoid bleeding and haematoma. Regarding the symptomatology, he had visual disorders and breathlessness, for around 3-4 days before his death. Finally, the cause of death was cardiopulmonary failure due to pressure on the basic brain structures. Results: Such tumours are connected with a lot of symptoms from the central nervous system, endocrine systemand eyes. Its sizeis 2-4cm. The diagnosis it depends on clinical and radiological finds and it is confirmed by histological examination. Conclusion: The most usual and efficient technique for treatment is total surgical removal accompanied by radiotherapy. Nonetheless, after every therapy, there is the danger of many complications like pituitary insufficiency and the development diabetes insipidus.
E-PS-17-021 Analysis of survival and prognostic factors of patients with brain glioma E. Ochirjav*, B. Dorj, T. Baldandorj, B. Enkhbat * National Center for Pathology, Minister of Health, Ulaanbaatar, Mongolia Background & Objective: To estimate survival and prognostic factors of brain glioma patients diagnosed in the National Center for Pathology, Mongolia. Method: We retrospectively analyzed data of 107 glioma patients, who were diagnosed from January 2006 to May 2017. There were 52 (48.5%) male-patients and 55 (51.5%) female-patients, as totally. The mean age was 38.04 years old (ranged from 3 to 77). Clinico-pathologic analysis was performed by using archival slides and formalin-fixed, paraffin-embedded tissue. The Kaplan-Meier method was used for survival analysis, and we used univariate and multivariate analysis for prognostic factors.
