Soumaya Rammeh

DETECTION OF EPSTEIN-BARR VIRUS IN BREAST CANCERS WITH LYMPHOID STROMA

OBJECTIVE the purpose of our work is to detect Epstein-Barr virus (EBV) in 2 types of breast cancer: medullary carcinoma and high grade invasive ductal carcinoma with lymphoid stroma. PATIENTS AND METHODS we proceeded to a retrospective study of 18 medullary carcinoma and 18 high grade invasive ductal carcinoma with lymphoid stroma. The detection of the virus was carried out by immunohistochemistry with anti-LMP2 antibody and by hybridization in situ by oligonucleotides EBER1 and EBER1. LMP1 as well as hybridization in situ were positive in 5 tumors (3 medullary carcinoma and 2 high grade invasive ductal carcinoma with lymphoid stroma). RESULTS positivity was observed in tumor cells and neither in epithelial non tumoral ones nor in lymphoid cells. DISCUSSION AND CONCLUSIONS during numerous years, correlations between the replication of EBV and the appearance of a malignant phenotype were limited to nasopharyngeal carcinoma and to lymphoid cells. A controversy regarding the association of EBV with breast cancers has recently been reported in the literature. This cancer being very frequent, the involvement of EBV even in a small proportion of breast cancers could have important implications. Our results suggest a possible implication of EBV in these tumours but other studies are necessary.

Salivary duct carcinoma of the parotid gland

Salivary duct carcinoma of the parotid gland is an uncommon tumor, highly aggressive. About 200 cases have been reported in the English literature. Pathomorphologically, these tumors showed great similarities to ductal carcinoma of the female breast, which is why they described this tumor as “salivary duct carcinoma.” The authors describe a new case of salivary duct carcinoma of the parotid gland. We present the case of a 50-year-old patient with progressive facial paralysis. The MRI examination of the head showed two ill-defined formations. A malignant tumor was strongly suspected, so that a total left parotidectomy with excision of the adjacent facial nerve and left lymph node dissection was performed. Microscopic examination concluded to a salivary duct carcinoma of the left parotid gland negative with Her2/neu antibody with lymph node metastasis. There were no recurrences or metastases within 3 years of follow-up. Salivary duct carcinoma of the parotid gland is a rare tumor with an aggressive behavior. This is due to its propensity to infiltrate distant organs. The diagnosis is based on microscopic examination. Treatment modalities are non-consensual, but some authors advocate the necessity of aggressive approach, especially in tumors negative with Heur2/neu antibody. This is due to the fact that the overexpression of this antigen was reported to be associated with a poor prognosis.

Primary lymphoepithelial carcinoma of the parotid gland in a North African woman.

Lymphoepithelial carcinoma of the salivary glands is a rare neoplasm that is characterized by a non-neoplastic lymphocytic infiltration associated with an epithelial proliferation. It involves mainly the parotid gland. Racial and geographical factors contribute to the pathogenesis of this tumor. We report a case of a 70-year old woman from a non-endemic area who presented with several months history of swelling in the parotid region. Magnetic resonance imaging showed a parotid mass suggestive of a pleomorphic adenoma. The diagnosis of lymphoepithelial carcinoma of the parotid gland was performed on the surgical specimen. A primitive nasopharyngeal carcinoma was ruled out by random biopsies of the nasopharynx mucosa. The Epstein-Barr virus (EBV) was absent in neoplastic cells. We insist that, even in non-endemic areas and when clinical and radiological characteristics are not suggestive of malignancy, intra-operative frozen section analysis should be used in order to ensure the appropriate treatment.

Over-expression of EGFR is closely correlated to poor prognosis in Tunisian patients with non-small cell lung adenocarcinoma.

We studied epidermal growth factor receptor (EGFR) expression profile with the aim of an individualized therapy for patients with non-small cell lung cancer (NSCLC) from whom tumor materials are not sufficient for molecular investigations. Using immunohistochemistry, we found a markedly increased EGFR expression with significant difference in term of intensity and distribution from normal mucosa to primary tumors (p < 0.05). Furthermore, patients with EGFR positive tumors had significantly shorter survival than those with EGFR negative tumors (p = 0.0001). Thus, EGFR over-expression is a valuable prognostic marker to predict poor outcome in Tunisian patients with NSCLC.

Expression of Topoisomerase II Alpha, ki67, and p53 in Primary Non-Muscle-Invasive Urothelial Bladder Carcinoma

To assess the prognostic value and clinicopathological correlate of the expression of topoisomerase II alpha, ki67, and p53 in non muscle-invasive urothelial bladder carcinoma. Seventy one cases of formalin-fixed, paraffin-embedded bladder biopsy specimens diagnosed as non muscle invasive urothelial carcinoma were processed by searching our surgical pathology files from 2001–2003. The patients were followed-up for 3–77 months (median = 28). In each case, one tissue block was chosen for immunohistochemical expression of ki67, topoisomerase II alpha and p53. This expression was associated with the pathological stage, grade, recurrence, progression and survival. Positive staining of topoisomerase II alpha, ki67, and p53 was found respectively in 39.5, 38, and 38% cases. We have found a statistically significant correlation between the expression of each of the 3 markers and WHO grade and recurrence. The surexpression of topoisomerase II alpha was associated within increased tumor stage. p53 was associated with tumor progression. On multivariate analysis, p53 was an independent factor of progression into muscle-invasive tumors and none of these markers had predictive value on recurrence. The present findings support the clinical relevance of these markers in bladder cancer.

Prognostic value of immunohistochemical expression profile of epidermal growth factor receptor in urothelial bladder cancer

ABSTRACT We studied epidermal growth factor receptor (EGFR) expression profile in urothelial bladder carcinoma (UBC) which is a complex and heterogeneous disease with a large spectrum of histological aspects and deadly potential. Using immunohistochemistry (IHC), all GI tumors and pTa cases showed a low expression profile of EGFR. However, we note that when the stage of disease is advanced, tumors over-express EGFR. Indeed, 5% and 25% of GII and GIII tumors over-expressed EGFR, respectively. Further, 0% of pTa, 9,5% of pT1, 15% of pT2, 50% of pT3, and 90% of pT4 tumors were shown to be high EGFR expression (HEE). Moreover, we found a statistically significant correlation between the EGFR over-expression and grade and stage (P < 0.05). Thus, EGFR over-expression could be a potential prognostic marker to predict poor outcome in Tunisian patients with UBC.

Liposarcoma of the spermatic cord: A case report and review of literature

a Department of Oncology, Salah Azaiez Institute, Faculty of Medicine of Tunis, Boulevard 9 Avril, Tunis El Manar University, Tunis, France Department of Pathology, Charles Nicolle Hospital, Faculty of Medicine of Tunis, Boulevard 9 Avril, Tunis El Manar University, Tunis, France c Department of Urology, Charles Nicolle Hospital, Faculty of Medicine of Tunis, Boulevard 9 Avril, Tunis El Manar University, Tunis, France

Prognostic Value of Soluble Death Receptor Ligands in Patients with Transitional Cell Carcinoma of Bladder

Background: The activation of Fas/Fas ligand (FasL) and DR4-DR5/tumor necrosis factor-related-apoptosis-inducing ligand (TRAIL) pathways in cancer cells triggers apoptosis. The objective of this study was to investigate the prognostic value of soluble FasL (sFasL) and soluble (sTRAIL) in the serum of patients with bladder cancer. Methods: The sFasL and sTRAIL levels in the sera of patients with bladder cancer or healthy donors were determined using the enzyme-linked immunosorbent assay. Micro-culture tetrazolium viability assay and Western blot were used to analyze cell cytotoxicity and death receptors protein expression respectively. Results: Whether no difference in sTRAIL levels was seen between patients and controls, the level of sFasL was higher in patients than that in healthy donors. According to, sFasL level was the highest in the serum of patients with superficial stage or low- and medium-grade cancer. Moreover, sFasL in patients with superficial noninvasive bladder tumors or low- and medium-grade cancers was higher than that in patients with invasive carcinomas and high-grade cancers. Patients with high levels of sFasL survive longer than those with low levels, probably related to the cytotoxic potential of FasL preserved in its soluble form. Conclusion: The data suggest that monitoring the level of sFasL and its cytotoxic activity could be a prognostic marker in the follow-up of patients with bladder cancer.

Clear Cell Adenocarcinoma of the Female Urethra, Mimicking Cystocele

Clear cell adenocarcinoma of the urethra is an extremely rare neoplasm mainly described in women. Anterior pelvic exenteration was the treatment performed in most reported cases. It seems to have poorer prognosis than urothelial carcinomas.

Le synovialosarcome primitif de la verge

Le synovialosarcome represente un sous-type rare des sarcomes des tissus mous. Son apparition au niveau de la verge est exceptionnelle et seulement deux cas ont ete rapportes dans la litterature auparavant. Nous rapportons un nouveau cas de synovialosarcome de la verge chez un jeune patient de 27 ans, en essayant par l’entremise d’une revue de la litterature de discuter des aspects radiologiques, histologiques, immuno-histochimiques, therapeutiques et pronostiques de cette tumeur exceptionnelle.