Carlo Baldi

CD10, BCL6, and MUM1 expression in diffuse large B-cell lymphoma on FNA samples

Gene expression profiling has divided diffuse large B‐cell lymphoma (DLBCL) into 2 main subgroups: germinal center B (GCB) and non‐GCB type. This classification is reproducible by immunohistochemistry using specific antibodies such as CD10, B‐cell lymphoma 6 (BCL6), and multiple myeloma oncogene 1 (MUM1). Fine‐needle aspiration (FNA) plays an important role in the diagnosis of non‐Hodgkin lymphoma, and in some cases FNA may be the only available pathological specimen. The objectives of the current study were to evaluate CD10, BCL6, and MUM1 immunostaining on FNA samples by testing the CD10, BCL6, and MUM1 algorithm on both FNA cell blocks (CB) and conventional smears (CS), evaluating differences in CB and CS immunocytochemical (ICC) performance, and comparing results with histological data.

Ultrasound-guided fine needle aspiration cytology of a primary lymph node leiomyoma: a flexible procedure for a complex case.

Background: A primary lymph node leiomyoma diagnosed by fine needle aspiration cytology (FNAC) is reported. Case: A 22-year-old male complained of right groin swelling; ultrasound examination (US) showed a lymph node containing a 20-mm hypoechoic nodule. The residual lymph node was oval, with a well-characterized cortex and hilum. US-FNAC of the nodule showed oval spindle cells embedded in fibrillar matrix. Nuclei were naked and oval with dispersed chromatin but without nucleoli. Immunocytochemistry showed positivity for vimentin and actin, and negativity for cytokeratin, S100, CD23 and CD31. A smear of the residual lymph node showed a reactive lymphoid cell population. FNAC diagnosis was mesenchymal cell proliferation with smooth muscle phenotype; a lymph node is part of the lesion. A CT scan did not detect any inguinal or abdominal mass. The surgical sample was a lymph node containing a spindle cell tumor, which was actin and desmin positive, and S100, CD21, HMB45, CD23 and CD31 negative; MIB1 was positive in <5% of the cells. The residual lymph node was normal. Conclusion: The final diagnosis was primary benign leiomyoma in a lymph node. US-FNAC may frame complex lymph node lesions and provide treatment options.

BAG3 Protein Is Over-Expressed in Endometrioid Endometrial Adenocarcinomas

Endometrioid endometrial cancer is the most common gynaecological tumor in developed countries, and its incidence is increasing. The definition of subtypes, based on clinical and endocrine features or on histopathological characteristics, correlate to some extent with patients prognosis, but there is substantial heterogeneity within tumor types. The search for molecules and mechanisms implied in determining the progression and the response to therapy for this cancer is still ongoing. BAG3 protein, a member of BAG family of co‐chaperones, has a pro‐survival role in several tumor types. BAG3 anti‐apoptotic properties rely on its characteristic to bind several intracellular partners, thereby, modulating crucial events such as apoptosis, differentiation, cell motility, and autophagy. BAG3 expression in human endometrial cancer tissues was not investigated so far. Here, we show that BAG3 protein levels are elevated in tumoral and hyperplastic cells in respect to normal glands. Furthermore, BAG3 subcellular localization appears to be changed in tumoral compared to normal cells. Our results indicate a possible role for BAG3 protein in the maintenance of cell survival in endometrioid endometrial cancer and suggest that this field of studies is worthy of further investigations. J. Cell. Physiol. 232: 309–311, 2017.

The first case of benign multicystic mesothelioma presenting as a splenic mass

Multicystic mesothelioma (MM) is a relatively rare tumour arising in the pelvic peritoneum of the tuboovarian region of young woman. Exceptionally, MM occurs on the serosal surfaces of various organs including kidney, bladder, lymph nodes, and liver. We report here the first case of MM wherein a 58-year-old woman with a previous history of endometriosis of the right ovary presented with a large multicystic mass of the spleen. The diagnosis of MM was made on a surgical specimen after splenectomy. A histopathologic examination is always necessary for the diagnosis of MM which should be differentiated from other lesions particularly from cystic lymphangioma. At one year follow-up, the patient had no evidence of recurrence. Despite the high frequency of local recurrences, MM is a benign lesion and ‘en bloc’ surgical excision with prolonged follow-ups is the treatment of choice.

Epithelioid variant of pleomorphic liposarcoma as potential mimic of metastatic carcinoma.

We report a case of epithelioid variant of pleomorphic liposarcoma (EPL) found in the the infrapatellar fat pad of Hoffa of a 31-year old male. Histologically, the predominant population was formed by epithelioid cells with eosinophilic or clear cytoplasm admixed with rare pleomorphic lipoblasts. The immunohistochemical panel was not helpful in the diagnosis. FISH analysis using the locus-specific indicator CHOP (12q13) dual color break apart was applied to representative formalin-fixed, paraffin-embedded tissue sections. The result of FISH indicated a rearranged CHOP (DDIT3) gene and confirmed the diagnosis of EPL. The EPL should be differentiated from a metastatic carcinoma or other type of sarcoma. In these cases a clinicopathological correlation and an exhaustive sampling of the specimen for demonstration of lipogenic areas or pleomorphic lipoblasts is always necessary. FISH with demonstration of CHOP gene rearrangement is useful in providing specific ancillary information for the difficult differential diagnosis of this case.

Expression of the anti-apoptotic BAG3 protein in leg venous ulcerative tissues

TO THE EDITOR The healing process after an injury consists of a complex cascade of cellular and molecular events; the failure of one or more of these events causes chronic tissue ulceration that, despite several therapeutic options, represents a significant problem in our society. Notably, clinical examination of wounds is not sufficient in predicting which wounds will have impaired ability to heal and which treatment will succeed. In this respect, the identification of molecules involved in this process is needed for improving our management of repair. BAG3, a stress responseinduced cochaperone, interacts with Hsp70 and other proteins through its BAG, WW, proline-rich and IPV(Ile-Pro-Val) motifs; it regulates several cellular processes including apoptosis, autophagy and cell motility. Although its participation in stress response may suggest a possible role for BAG3 in the healing pathologies, BAG3 expression in ulcerated wounds had never been studied. To this end, BAG3 expression was analyzed by immunohystochemistry in ulcerous tissues from 13 patients with lower leg venous ulcers of different etiology (diabetes, venous insufficiency, trauma or vasculitis). BAG3 staining resulted positive in a portion of the tissue analyzed (Figure 1a) and its highest levels were found in endothelial and stroma cells in the granulation tissues (Figures 1a and b). Notably, endothelial cells in normal skin adjacent to ulcerated tissue resulted negative (Figure 1b, right panel). Because BAG3 was not expressed in all the analyzed tissues, a possible association between BAG3 expression and specific features of tissues, possibly reflecting specific phases of the healing process, were analyzed (Figure 1c). We found a complete association (P= 0.001) between BAG3 and presence of granulation tissue. Indeed, all the nine specimens with granulation tissue features were positive for BAG3 expression; on the other hand, specimens in which granulation tissue was not detectable were BAG3 negative. Therefore, BAG3 appeared expressed in the proliferation/repair phase of wound healing, probably sustaining cell survival and/or cell cycle progression. Consistently, the