Maeve A. Rahilly

Female adnexal tumour of probable Wolffian origin: a clinicopathological and immunohistochemical study of three cases

The clinical and pathological features of three adnexal tumours of probable Wolffian origin are reported. One case was an incidental finding in a patient who died from ovarian carcinoma; in the other two cases the patients presented with lower abdominal pain. The three tumours were well‐circumscribed, solid masses arising in the leaves of the broad ligament and histological examination showed bland epithelial cells forming tubular, solid and microcystic patterns. The immunohistochemical profile of the tumours was similar to that of Wolffian duct remnants. They co‐expressed cytokeratin and vimentin and lacked epithelial membrane antigen (EMA) reactivity, in contrast to tumours of Müllerian origin which usually express EMA. The differential diagnosis of female adnexal tumours is discussed.

Uterus‐like mass of the ovary associated with endometrioid carcinoma

We describe a solid and cystic right ovarian mass removed from a 38‐year‐old woman. The solid component, which had a central cavity lined by endometriotic tissue and surrounded by a thick muscle wall, strongly resembled a miniature uterus. The contiguous cystic mass was an endometrioid carcinoma. We review the literature and discuss the theories of histogenesis of uterus‐like ovarian masses.

Mucinous anal gland carcinoma with perianal Pagetoid spread

Summary We report a case of well differentiated perianal mucinous carcinoma with associated dysplasia of the adjacent anal gland epithelium. Anal gland dysplasia is only rarely demonstrable histologically in cases of adenocarcinoma of suspected anal gland origin. The tumor was not associated with chronic perianal abscess or fistula formation, which had been regarded as important in the pathogenesis of perianal mucinous carcinoma. There was associated, clinically unsuspected Pegetoid intra-epidermal spread of adenocarcinoma in the perianal skin.

Minimal deviation endometrioid adenocarcinoma of cervix: a clinicopathological and immunohistochemical study of two cases.

We describe the clinicopathological features of two cases of minimal deviation endometrioid adenocarcinoma of cervix. This is a rare tumour whose predominant pattern is one of bland endometrial‐type glands infiltrating the cervical wall without a stromal response. Thus, it may be confused with benign conditions such as cervical endometriosis. The two cases demonstrate that this tumour may behave aggressively despite its bland appearances. An immunohistochemical study was performed and showed only focal reactivity of neoplastic glands for carcinoembryonic antigen, which would limit its diagnostic use in small biopsy specimens.

The prevalence of tubo-endometrial metaplasia and adenomatoid proliferation

With the introduction of cervical screening programmes, and the policy of management of early premalignant squamous lesions of the cervix, pathologists are beginning to see more glandular lesions of the cervix. Some of these represent genuine neoplastic change, while others represent benign conditions such as tubo-endometrial metaplasia, microglandular hyperplasia, inflammatory glandular change, adenomatoid proliferation (‘tunnel clusters’) and mesonephric duct remnants’. Although tubo-endometrial metaplasia and adenomatoid hyperplasia, in particular, are most likely to lead to diagnostic confusion, their incidence has received only brief mention in the literature’. Recently Novotny et 01. alluded to the need for studies to evaluate the prevalence and physiological associations of these benign conditions in the cervix. The purpose of this study was therefore to assess the prevalence of these findings in the uterine cervix and how best to differentiate them from glandular dysplasia.

Abnormal integrin receptor expression in two cases of familial nephronophthisis

Familial nephronophthisis is one of the inherited human cystic kidney diseases and is characterized by progressive renal failure. We have investigated abnormalities of cell‐matrix interactions using immunocytochemistry and electron microscopy in three renal biopsies from two patients with familial nephronophthisis and compared our findings to those seen in thirty other renal biopsies. We found expression of the α5 integrin fibronectin receptor in all three samples of nephronophthisis but in no other renal diseases. There was also enhanced expression of the α2 integrin in nephronophthisis but this appeared to be a common response to tubular injury. Electron microscopy showed thickening of the tubular basement membrane and a loss of organization of the basal pole of tubular epithelium. We conclude that altered cell‐substratum adhesion contributes to the pathogenesis of nephronophthisis.

Translational research will fail without surgical leadership: SCOTRRCC a successful surgeon-led Nationwide translational research infrastructure in renal cancer

BACKGROUND High quality human biosamples with associated high quality clinical data are essential for successful translational research. Despite this, the traditional approach is for the surgeon to act as a technician in the tissue collection act. Biomarker research presents multiple challenges and the field is littered with failures. Tissue quality, poor clinical information, small sample numbers and lack of validation cohorts are just a few reasons for failure. It is clear that the surgeon involved in tissue acquisition must be fully engaged in the process of biosampling for a specific condition, as this will negate many of the issues for translational research failure due to an inadequate bioresource. APPROACH In this Matter for Debate paper, the Scottish Collaboration On Translational Research into Renal Cell Cancer (SCOTRRCC) is discussed as an example of a urological surgery lead bioresource which has resulted in a National collection of renal cancer tissue and blood (from over 900 patients to date), negating all of the traditional issues with biobanks because of close enagagement and acknowledgement of urologists and uropathologists from seven centres around Scotland. SCOTRRCC has leveraged renal cancer research in Scotland resulting in several high impact publications and providing a springboard for future research in this disease in Scotland and beyond. CONCLUSIONS The SCOTRRCC model presented here can be transferred to other surgical disciplines for success in translational research.