140 / 366
PS-06-065
Kaposi sarcoma: Morphological and immunohistochemical diagnos-
tic methods
S. Golubev
*
, S. Anistratov, M. Mnikhovich, V. Luchinin, J. Omarova, A.
Shilov, I. Vasin
*
Laboratoires De Genie, Pathology, Moscow, Russia
Objective:
The differential diagnosis of Kaposi sarcoma (KS) includes
many tumours such as dermatofibroma, histiocytoid hemangioma,
kaposiform hemangioendothelioma, angiosarcoma.
Method:
Biopsy material from seven HIV negative patients (age 45
–
75 years), 3 women (51, 32 %) and 4 men (48, 68 %), was studied. In 6
cases (72,37 %) patients complained of skin tumours. In 1 case (27,63 %)
diagnosis was established post mortem.
Results:
Immunohistochemical studies have shown monomorphic
expression of CD34 by endothelial cells while expression of
Von Willebrand factor was heterogeneous, cells were generally
negative for CD31. Endothelial cells and myofibroblast-like cells
have shown focal intensive nucleocytoplasmatic expression of
HHV8. Myofibroblast-like cells demonstrated intensive Ki-67 pos-
itivity. Additional markers IgL(lambda), IgL(kappa), CD38, CD3,
CD79a, CD30) were used. Cells demonstrate intensive
IgL(lambda), IgL(kappa), CD38 cytoplasmatic expression, CD3,
CD30 membrane and cytoplasmatic expression and membrane ex-
pression of CD79a.
Conclusion:
Pathomorphological diagnostics of KS should include
histological study with consideration of chaotic character of
angiogenesis, proliferation of spindle cells with endothelial
markers, mononuclear cell infiltration, and immunohistochemical
study with CD34, CD36, CD31, Von Willebrand factor, and Ki-
67. Additional markers (IgL(lambda), IgL(kappa), CD38, CD3,
CD79a, CD30) in pathomorphological practice for differential di-
agnosis.
PS-06-066
Merkel cell carcinoma: A histological and immunohistochemical re-
view of 15 cases
G. Kazamias
*
, A. Taliadoros, K. Pavlou, C. Stamou, E. Kavvadas, C.
Kouvidou
*
Evangelismos, General Hospital, Pathology, Athens, Greece
Objective:
Merkel cell carcinoma (MCC) is a rare malignant skin
neoplasm with the potential for local recurrence, spreading to
regional lymph nodes and distant metastases. MCC rarely appears
to arise initially in lymph node propably due to regression of
primary skin tumour.
We present a series of 15 cases
and correlate the immunomorphological features with the progno-
sis and the presence of polyoma virus.
Method:
Patients were 5 male and 10 female, aged between 49 and
90 years. Eight of the skin lesions were located in lower extremities, 1
in the shoulder and 1 in the forearm. Three of them were presented to
inguinal lymph node and two of them in cervical lymph node. PET/CT
scan was performed and excluded a possible primary site or evidence of
metastatic disease.
Results:
Histology revealed round to oval nuclei, scant cytoplasm
with frequent mitoses. The immunohistochemisty revealed positive
staining for CK20, CD56, synaptophysin, NF, focal positivity to
chromogranin and was negative for TTF-1 and CK7. In nine cases
positive nuclear staining to MCPyV was indentified. No better
prognosis in patients with MCPyV positive MCC was found.
Conclusion:
The characteristic histological appearances and a pan-
el of immunohistochemical markers is essential to make the dif-
ferential diagnosis from other small blue cell neoplasms.
PS-07-001
Pancreatic neuroendocrine tumours: Accurate grading with Ki-67
index on Endoscopic Ultrasound-Guided Fine Needle Core Biopsy
(EUS-FNB) specimens using the WHO 2010/ENETS criteria
A. De Leo
*
, C. Ricci, G. Taffurelli, R. Casadei, D. Campana, N. Pagano,
C. Ceccarelli, D. Santini
*
University of Bologna, Pathology Unit, S. Orsola-Malpighi Hospital,
Italy
Objective:
The aim of the study was to determine the diagnostic feasi-
bility and accuracy of Endoscopic Ultrasound-Guided Fine Needle Core
Biopsy (EUS-FNB) in the diagnosis and grading of p-NETs (based on
WHO/ENETS criteria), comparing preoperative pathological biopsies
with final surgical specimens.
Method:
We retrospectively reviewed patients with p-NETs who
underwent EUS-FNB and subsequent pancreatic resection between
2008 and 2017. Ki67 proliferative index was obtained using automated
digital image analysis.
Results:
The study included 35 patients, 54.3 % women and
45.7 % men, mean age 56.6 years. The mean pancreatic mass
size was 29 mm and the most common location was within the
body and/or tail of the pancreas (62.9 %). Tumour grading by Ki-
67 assessment could be performed in all cases (100 %). The
concordance rate of WHO classification between EUS-FNB and
surgical specimens was 85.7 % (30/35), the strength of agreement
was considered to be
“
good
”
(k = 0.727).
Conclusion:
EUS-FNB is a highly accurate technique for the di-
agnosis and grading of p-NETs. There was a good correlation
between the Ki67 of EUS-FNB and surgical specimens.
Preoperative determination of the Ki-67 proliferation index on
EUS-FNB of p-NETs should be systematically reported for an
optimal patient management.
PS-07-002
Prognostic significance of histopathological features in solid
pseudopapillary neoplasm
S. Erbil
*
, A. Argon, Z. Yildirim Ekin, M. Zeytunlu, F. Yilmaz, D. Nart
*
Ege University, Pathology, Izmir, Turkey
Objective:
Solid pseudopapillary neoplasm (SPN) is 0.3
–
2.7 % of all
pancreatic tumours. The aim of this study was to investigate histopatho-
logical and clinical features and associations between clinical outcome of
this rare entity.
Method:
Tumour slides of surgical specimens of 24 cases with SPN
diagnosed in our department from January 2000 to December 2016 were
retrospectively analyzed.
Results:
The mean age was 34.5 years (min. 14, max.66). Of 24
cases, 21(87,5 %) were females. Tumours were located prevalent-
ly in pancreatic tail (11 of 24). Median tumour size was 6 cm
(range, 2
–
15 cm). Of 18 tumours surrounded by capsule, 14 were
invaded the capsule and peripancreatic extension was present in 9
of the cases. Perineural invasion (PNI) was observed 20,8 %(5 of
24) of the patients. There was no peripancreatic spread in 73.7 %
of PNI negative patients (
p
< 0.05). Mitotic activity was absent in
all cases with one exceptional. One patient died of metastatic
disease, 4 months after operation. We observed 10 mitosis/20
HPF, capsule invasion, peripancreatic extension and necrosis in
that case. Diffuse and expansive growth, lymphovascular invasion,
calcification and cholesterol clefts were also evaluated.
Monday, 4 September 2017, 09:30
–
10:30, Hall 3
PS-07 Digestive Diseases Pathology - Liver and Pancreas
Virchows Arch
(
2017
)
471
(
Suppl 1
):
S1
–
S352
S126