148 / 366
observed in some MCNs, debates exist whether cystic tumours with
NMLE considered as MCNs or different disease entity.
Method:
NMLE was defined as flat or cuboidal biliary epithelial cells
without containing mucin. 102 MCNs were classified as MCNs with
NMLE and MCNs with MLE. Twelve MCNs with NMLE were selected
for KRAS mutational analyses with droplet digital PCR after LASER
captured microdissection.
Results:
Patients were 110 females and 2 males with mean age of
46.5 ± 12.3 years. NMLE was noted in 76.8 % (86/112) of MCNs with
46 % of epithelia. MCNs with diffuse (>50 %) NMLE were 38.4 % (43/
112), and smaller (4.2 ± 2.1 cm) than tumours with MLE (6.0 ± 3.6 cm,
p
< 0.01), and all were low grade without accompanying high grade/
carcinoma in situ. KRAS mutation was detected in 92 % (11/12 cases)
of NMLE. Among 9 MCNs with matched MLE and NMLE, 7 had KRAS
mutations both in MLE and NMLE (
p
= 0.34).
Conclusion:
Diffuse NMLE are common in MCNs with small size and low
grade dysplasia. Frequent KRAS mutations are observed both in NMLE and
MLE. Therefore NMLE with MCNs are the same disease entity with MCNs.
PS-07-041
Carcinosarcoma of the gallbladder: A case review
M. Cosic Micev
*
, M. Micev, M. Andrejevic, M. Dimic Cumic, A. Djikic
Rom, D. Galun
*
Clinical Centre of Sebia, Histopathology, Belgrade, Serbia
Objective:
Carcinosarcoma of the gallbladder is very rare primary tumour
having distinctive histomorphological and immunohistochemical features.
However, besides similarities with gynecological type of carcinosarcomas,
it represents problematic issue for correct diagnosis and treatment.
Method:
We present a case of large epigastric mass in a 71-yrs old male
patient who suffered right upper quadrant abdominal pain. Preoperative
MDCT-scan was interpreted as (peri)gastric and/or (peri)hepatic mass
involving IVb segment, leading to radical surgery. Follow-up of histo-
pathologically diagnosed carcinosarcoma after 10 months revealed
unresectable hepatic metastases and we were asked to perform Her-2
testing for possible therapeutic treatment.
Results:
Gross examination revealed circumscribed cystic tumour of the
gallbladder with dominant extramural and intrahepatic growth, measuring
140 mm in greatest diameter. Histology exhibited biphasic tumour with
intermingled adenocarcinomatous and atypical mesenchymal components
(mitotic activity 4/10 HPF) with large chondrosarcomatous areas.
Immunostaining of epithelial component showed strong HER-2, COX2,
EGFR and androgen receptor positivity in about 60 , 70 , 20 and 95 %
tumour cells, respectively. To date we have no results of oncologic treatment.
Conclusion:
Carcinosarcoma with chondrosarcomatous component is
rare histological presentation of the gallbladder that broadens differential
diagnosis. Immunoexpression of HER-2 and other predictors might be
helpful in planning further appropriate treatment.
PS-07-042
A correlation between Glypican-3 (GPC3) expression and the grad-
ing system in hepatocellular carcinoma
V. Herlea
*
, A. Procop, C. Pechianu, M. Mihai, E. Stoica Mustafa, M.
Hortopan, A. Iorgescu, O.-M. Andreoiu, S. Varban, I. Popescu
*
Fundeni Clinical Institute, Pathology, Bucharest, Romania
Objective:
Primary hepatocellular carcinoma (HCC) is a malignant prolif-
eration with hepatocellular differentiation, the most frequent primary liver
malignancy and the 5th most common malignancy worldwide. The purpose
of this study was to determine the variability of GPC3 expression in hepa-
tocellular carcinomas based on the Edmondson-Steiner grading system.
Method:
Grading of hepatocellular carcinoma is based on the
Edmondson
—
Steiner system, on a scale from grade 1 (well
differentiated) to grade 4 (undifferentiated). HCC Grade 1 has a trabecular
pattern similar to normal hepatocytes, whereas Grade 4 HCC often has a
solid (compact) architecture, with a high degree of pleomorphism. We
studied the imunophenotypic profile of 27 cases diagnosed in our pathol-
ogy department as hepatocellular carcinomas, in the last 12 months. Five
cases were diagnosed as Grade I/II (18.52 %), 20 cases as Grade II/III
(74.08 %) and 2 cases as Grade III/IV (7.40 %) Edmondson-Steiner.
Results:
Diffuse cytoplasmic and membranous staining for GPC 3 was
registered gradually with the highest intensity documented in Grade II/III
Edmondson-Steiner HCC and the lowest intensity in Grade III/IV
Edmonson-Steiner HCC.
Conclusion:
GPC3 is a useful marker for establishing the grading of
hepatocellular carcinomas in correlation with the Edmondson-Steiner
classification.
PS-08-001
Crossing paths with lymphomas: A difficult case of histopathological
diagnosis
A. Dumitru
*
, B. Pitrop, M. Sajin, M. Costache, T.-A. Georgescu, M. M.
Cirstoiu
*
University Emergency Hospital, Dept. of Pathology, Bucharest, Romania
Objective:
What initially appeared to be a simple case of lymphoma
originating from the colon turned out to be more than meets the eye
Method:
We report the case of a 51 year old woman who underwent
splenectomy after a traumatizing accident which occurred 2 years ago.
Following a routine checkup in late 2016, a tumour-like mass is discovered
at the junction between the sigmoid and the descending colon. Frozen
examination raised the suspicion of angioimmunoblastic lymphoma
Results:
Histopathological examination infirmed the initial diagnosis and
raised the suspicion of Castleman
’
s disease based on abnormal vascularity
and regression of germinal centers. Under closer examination, the
pseudotumoural mass was resembling spleen tissue. Immunostaining for
CD8 and CD34 was necessary for differential diagnosis and both stains were
positive. It is noteworthy that the only positive endothelial cells for CD8 are
the spleen littoral cells. Thus, we established the final diagnosis of splenosis.
Conclusion:
This case sets the stage for a discussion regarding the way
the human body acts to regenerate pieces of pertaining to the self that are
missing. The pathological approach was also one that posed a great deal
of wonder to the case, since growth of tissue with the same function of an
excised organ is quite uncommon.
PS-08-002
Small cell variant ALK positive anaplastic large-cell lymphoma pre-
senting as an endobronchial mass in a patient with synchronous
breast carcinoma
A. Marques
*
, R. Silva, H. Baldaia, E. Fonseca
*
Centro Hospitalar de São João, Dept. of Pathology, Porto, Portugal
Objective:
Small cell variant ALK positive anaplastic large-cell lympho-
ma (SCVALK + ALCL) is uncommon. Endobronchial involvement by
ALCL is exceedingly rare.
Method:
We present a case of SCVALK + ALCL presenting as an
endobronchial mass in a patient with synchronous no special type
(NST) breast carcinoma.
Results:
A 63 year-old woman with irrelevant past history presented with
recurrent respiratory infections treated with antibiotics. Chest CT
di sp laye d a pe ribronch ial c on sol ida tion i n r i gh t lung.
Monday, 4 September 2017, 09:30
–
10:30, Hall 3
PS-08 Haematopathology
Virchows Arch
(
2017
)
471
(
Suppl 1
):
S1
–
S352
S134