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PS-21-001
Patella- unusual localisation of bone tumours
J. Jevtic
*
, R. Kovacevic, Z. Vucinic, G. Djuricic, D. Ristic, J. Sopta
*
Institute of Pathology, Belgrade, Serbia
Objective:
Tumours of the patella are very rare. Primary tumours are
much more common than metastases. According to literature, the most
frequent primary patellar neoplasms are chondroblastoma and giant cell
tumour.
Method:
A total of 25094 medical records from Register of bone
and soft tissue lesions biopsies were included in the study.
Results:
Only nine (0.04 %) patients had patellar tumours. Six of these
were benign, one was a pseudotumoural lesion and two was reported as
malignant. Benign primary bone tumours diagnosed in patella were: two
osteochondromas, chondroblastoma, enchondroma, osteoblastoma, cav-
ernous hemangioma. Malignant tumour were: metastasis of urothelial
carcinoma and multiple myeloma. Brown tumour in hyperparathy-
roidism was diagnosed in one case. Eight patients were male, and
just patient with hyperparathyroidism was female. The youngest
patient was a 9 years old boy with osteochondroma and the oldest
was 68 years old male with plasmacytoma. Clinical presentation
was unspecific pain and swelling. A patient with solitary metasta-
tic urothelial carcinoma was presented with pathological fracture.
P a t i e n t s we r e t r e a t e d s u r g i c a l l y, a n d i n t wo c a s e s
(chondroblastoma and metastatic urothelial carcinoma) total
patellectomy was performed.
Conclusion:
Although very rare, patellar neoplasms should be consid-
ered whenever patients complain about symptoms related to knee area.
Early diagnosis and adequate treatment insure excellent prognosis.
PS-21-002
Aquaporin 1 and Fibulin-3 as potential biomarkers of malignant
mesothelioma in workers occupationally exposed to Fluoro-edenite
fibres: A preliminary report
G. Angelico
*
, A. Ieni, R. Caltabiano, C. Loreto, C. Ledda, V. Rapisarda,
G. Tuccari
*
AOU Policlinico G. Martino, Dept. of Human Pathology, Messina, Italy
Objective:
Aquaporin 1 (AQP1) and Fibulin-3 (Fb-3) have been pro-
posed as biomarkers for the diagnosis and prognosis of malignant pleural
mesothelioma (MPM). An increased standardised incidence and mortal-
ity rate due to MPM in Biancavilla, a little town of eastern Sicily (Italy)
was observed in general population exposed to a natural fiber Fluoro-
edenite (FE). The aim of the present study was to investigate the immu-
nohistochemical expression of AQP1 and Fb-3 in a cohort of patients
affected by MPM related to FE exposure.
Method:
Pathological reports, clinical and follow-up data from eight
patients who underwent surgery for MPM, all resident in the town of
Biancavilla and exposed to FE. AQP1 and Fb-3 were processed by
DAKO Autostainer. AQP1 overexpression was defined when
≥
50 % of
tumour membranous cell staining; Fb-3 immunoexpression was achieved
by densitometric and morphometric analyses.
Results:
Immunohistochemical overexpression of AQP1 was document-
ed in 5 cases, which showed a significantly higher disease free survival
(29.1 months) in comparison to that observed in patients with no
AQP1overexpression (7.5 months). In six cases, nuclear and cytoplasmic
expressions, of Fb-3 in neoplastic cells were revealed.
Conclusion:
Our findings stress the role of AQP1 and Fb-3 in MPM
tumourigenesis, with a potential diagnostic and prognostic role.
PS-21-003
Two rare dedifferentiated bone tumours
C. Quadros
*
, J. Tavares, R. Luís, D. López-Presa
*
Hospital de Santa Maria, Lisbon, Portugal
Objective:
In dedifferentiated osseous neoplasias two distinct con-
stituents can be observed: a low-grade well differentiated sarcoma
and a high-grade dedifferentiated sarcoma, the latest dictating the
overall prognosis. We present two cases of dedifferentiated bone
tumours.
Method:
Case 1: a 55 year-old woman with a history of
sacrococcygeal chordoma treated with surgery, chemotherapy and
radiotherapy, complained of bilateral lumbar pain, paresthesias and
hypoesthesias during a follow-up appointment; imaging studies
revealed a volumous lesion within the sacrococcygeal region; the
patient was re-interventioned. Case 2: a 66 year-old man with a
negligible medical background, presented with a femoral patho-
logic fracture; an intra-medullary lesion was identified
intraoperatively.
Results:
Case 1: the diagnosis of a dedifferentiated chordoma was
established, unfortunately without follow-up information for con-
trol since the patient belonged to other institution. Case 2: the
surgical specimen heralded a biphasic tumour displaying a well-
differentiated chondrosarcoma component and a high-grade sarco-
matous component with epithelioid morphology; the clinical man-
agement remains to be decided through multidisciplinary
consensus.
Conclusion:
Chordoma is a rare tumour and its dedifferentiated variant
represents an exceedingly rare entity. Dedifferentiated chondrosarcoma is
also an uncommon neoplasm which develops only in 10
–
15 % of the
central chondrosarcomas. We report two cases of such entities and a
review of the literature.
PS-21-004
Robust and reproducible pathologist training for PD-L1 assessing
tumour cells (TC) and immune cells (IC) utilising novel digital train-
ing platform
E. Dennis
*
, B. Vennapusa, E. ElGabry, E. Walker, D. Smith, J. Cardona,
M. Kockx
*
Ventana Medical Systems, Inc, Medical Affairs, Tucson, USA
Objective:
PD-L1 expressed on TC and IC plays an important role in
down-regulating anti-cancer immune responses and may predict benefit
of PD-L1/PD-1 inhibitors. Thus, assessment of TC and IC is incorpo-
rated in the VENTANA PD-L1 (SP142) Assay (SP142 Assay) scoring
algorithm. IC scoring is a new parameter for companion diagnostics
and pathologist training is recommended. Traditional glass slide training
covering one specific cut-off is expensive, time-consuming and chal-
lenging for broad global reach. An innovative approach was developed
to provide a standardized, robust and practical training model.
Method:
A universal scoring approach with TC and IC bins for
non-small cell lung cancer (NSCLC) and IC bins for urothelial
cancer (UC) was developed. A novel digital platform was custom-
ized with a rapid, user-friendly interface, facilitating monitoring of
scores and reporting. 74 cases, each with three slides (H&E, neg-
ative control, SP142 IHC) were uploaded. A global train-the-
trainer program enabled local training sessions to be conducted
using the digital platform.
Results:
410 pathologists were trained in 29 countries. Average
Proficiency Test score was 94 % and pathologist satisfaction score 4.7/5.
Conclusion:
SP142 Assay training for TCs and ICs across the dynamic
range of staining on a novel digital training platform is robust and suc-
cessful with excellent pathologist concordance scores.
Wednesday, 6 September 2017, 09:30
–
10:30, Hall 3
PS-21 Other Topics
Virchows Arch
(
2017
)
471
(
Suppl 1
):
S1
–
S352
S247