Objective: To investigate the expression differences of LLGL2 between prostatic ductal adenocarcinoma (PDA) and prostatic acinar adenocarcinoma, and its potential clinical significance. Methods: Eighteen patients diagnosed of PDA or prostatic acinar adenocarcinoma with PDA component by histopathology during January 2015 and December 2019 in the Beijing Hospital, China were retrospectively studied. The transcriptome analysis was conducted using the tissue of PDA and prostatic acinar adenocarcinoma. Differentially expressed genes and the differences in expression profiles were identified. Further, differentially expressed proteins were verified by immunohistochemistry. Results: The tissue from 8 of the 18 patients were used for transcriptome analysis, the results of which were compared with data from public databases. 129 differentially expressed genes were identified. 45 of them were upregulated while 84 were downregulated. The results of gene enrichment analysis and gene oncology (GO) analysis revealed that the differentially expressed genes were mostly enriched in the hypertrophic cardiomyopathy and interleukin-17 related pathways. GPAT2, LLGL2, MAMDC4, PCSK9 and SMIM6 were differentially expressed between PDA and prostatic acinar adenocarcinoma. Moreover, LLGL2 was more likely expressed in the cytoplasm (P=0.04) than the nucleus (P<0.01) in PDA, compared with prostatic acinar adenocarcinoma. Conclusions: The gene expression profiling indicates that PDA are very similar to prostatic acinar adenocarcinoma. Among the differentially expressed proteins screened and verified in this study, the expression of GPAT2, LLGL2, MAMDC4 and PCSK9 is increased in PDA, while that of SMIM6 is reduced in PDA. The expression of LLGL2 shows significantly different patterns between PDA and prostatic acinar carcinoma, and thus may help differentiate PDA from prostatic acinar adenocarcinoma in clinical practice.
Male ; Humans ; Carcinoma, Acinar Cell/pathology* ; Proprotein Convertase 9 ; Prostate/pathology* ; Retrospective Studies ; Prostatic Neoplasms/metabolism*

A case of pancreatic carcinoma with both acinar and endocrine features is presented. The patient was a 52-year-old female presenting with jaundice of 3 weeks' duration. The tumor was a 6 x 6 cm-sized round solid mass in the head of pancreas, invading the superior mesenteric vein. Histologically, it was composed of monotonous ovoid cells with eosinophilic granular cytoplasm in solid nests and sheets with occasional acinar and glandular differentiation. Immunohistochemical study revealed coexpression of acinar and endocrine markers; amylase, chromogranin, neuron-specific enolase, glucagon, somatostatin, and gastrin in tumor cells. This is the first documented case of mixed acinar-endocrine carcinoma of the pancreas in Korea, and its amphicrine nature reflects a close histogenetic relationship between pancreatic exocrine and endocrine cells.
Carcinoma, Acinar Cell/metabolism/*pathology ; Carcinoma, Islet Cell/metabolism/*pathology ; Case Report ; Cell Transformation, Neoplastic ; Female ; Human ; Middle Age ; Pancreatic Neoplasms/metabolism/*pathology ; Tumor Markers, Biological

Objective: To investigate the clinicopathological characteristics of pancreatic lesions in children. Methods: The clinicopathological data of pancreatic lesions in children were analyzed including 42 cases of pancreatic tumors diagnosed from January 2000 to May 2021 in Guangzhou Women's and Children's Medical Center, Guangzhou, China. Histological and immunohistochemical assessments were performed . Related literature was reviewed. Results: The 42 pediatric patients with pancreatic lesions aged 1 day to 12 years (mean, 4.25 years). There were 23 males and 19 females. Clinical presentations included abdominal masses, abdominal pain, vomiting and persistent hypoglycemia after birth. Ultrasound and computerized tomography examination showed space-occupying pancreatic lesions in 31 cases, but no detectable pancreatic lesions in 11 cases. Histologically, among the 42 cases, 22 cases (52.4%) were neoplastic, including 18 cases of epithelial origin. Nine cases of pancreatoblastoma showed that the epithelial tumor cells were arranged in a trabecular pattern, with squamous nests. Six cases of solid-pseudopapillary tumors revealed hemorrhagic and necrotic cysts and monomorphic epithelioid cells arranged in solid sheets, nests or pseudopapillae. Two cases of neuroendocrine tumors showed tumor cells arranged in cords or nests; one case had a mitotic count of about 3/10 high power field, and a Ki-67 index of about 5%, which was consistent with G2 neuroendocrine tumor; the other case showed tumor cells with cytological atypia, brisk mitoses, about 25/10 HPF and a Ki-67 index of about 80%, consistent with small-cell type neuroendocrine carcinoma. The case of acinar cell carcinoma showed high cellularity, tumor cells in solid, cord-like or acinar-like arrangement with little stroma, and monotonous tumor cells with single distinct nucleolus. There were 4 cases of mesenchymal tumors, including 3 cases of Kaposi's hemangioendothelioma and 1 case of inflammatory myofibroblastic tumor. Among the 20 cases (47.6%) of non-neoplastic lesions, there were 11 cases of hyperinsulinism with ATP-sensitive potassium channel abnormality (HAPCA). Severn cases of diffuse type HAPCA in which the islets scattered between the pancreatic acinar tissue, enlarged, and prominent nuclei. Three cases of focal type HAPCA showed pancreatic islet hyperplasia in the form of nested nodules (0.6-1.5 cm). One case of atypical type HAPCA had extensive islet hyperplasia in pancreatic tissue, and scattered proliferation of nest-like nodules was noted. There were also 7 cases of pseudocyst and 2 cases of congenital cyst. Immunohistochemically, pancreatoblastomas were diffusely positive for CKpan, CK8/18, and β-catenin (nuclear staining of squamous nests only). Solid-pseudopapillary tumors expressed CD10, cyclin D1, CD99, vimentin, CD56, and β-catenin (nuclear staining). Neuroendocrine tumors were positive for CK, Syn, NSE, CgA, CD56, and β-catenin (membranous staining). The acinar cell carcinoma was positive for CK8/18, trypsin, and β-catenin (membranous staining). Conclusions: Pancreatic lesions in children have a wide range of histopathological types. HAPCA is the most common lesion of newborns. Pediatric pancreatic tumors are rare and mostly malignant. It is important to recognize them and make correct pathological diagnoses.
Carcinoma, Acinar Cell/pathology* ; Carcinoma, Squamous Cell ; Child ; Female ; Humans ; Hyperplasia ; Infant, Newborn ; Ki-67 Antigen ; Male ; Neuroendocrine Tumors ; Pancreatic Neoplasms/metabolism* ; beta Catenin/analysis*

OBJECTIVETo study the clinicopathologic features of 30 cases of pseudohyperplastic prostatic adenocarcinoma (PHPA).

METHODSEight hundred and sixty cases of ultrasound-guided prostatic needle biopsy and 46 cases of radical prostatectomy specimens collected during the period from January 1, 2005 to December 31, 2006 were retrieved from the archival files. The incidence, morphology, pathologic differential diagnosis, tumor volume, preferred location and Gleason's score were studied. The tissue sections suspicious for PHPA were immunohistochemically stained with high-molecular weight cytokeratin (34betaE12) or CK5/6, p63, AMACR, and cocktail antibody of 34betaE12/p63/AMACR. Cases with PHPA component more than 60% in at least one single slide were selected and pathologically analyzed.

RESULTSPHPA was present in 7% of needle biopsy and 15.2% of prostatectomy specimens. Histologically, 66.7% of PHPA demonstrated direct transition with conventional acinar adenocarcinoma; and 76.7% of cases had coexisting conventional acinar adenocarcinoma in the remaining tissue blocks. The tumor volume accounted for 5% to 100% of total carcinoma among core needle biopsy and 1% to 30% of total carcinoma among radical prostatectomy. PHPA resembled benign prostate glands, in which the hyperplastic malignant acini were predominantly of medium to large size. The neoplastic cells were well-differentiated, with basally located nuclei and luminal corpora amylacea. However, amongst the 20 pathologic indices of prostatic malignancy studied, occurrence of 10 or more indices exceeded 66.7%. Although PHPA looked benign morphologically, 66.7% cases had stromal invasion, 6.7% had perineural invasion and 3.3% had bone metastasis. The tumor was primarily located in the peripheral zone.

CONCLUSIONSPHPA is not a rare phenomenon in prostatic adenocarcinoma. Majority of cases have concurrent conventional acinar adenocarcinoma. It is different from well-differentiated (with Gleason's score 1 or 2) adenocarcinoma with a relatively indolent clinical course. In contrast, PHPA corresponds to moderately differentiated adenocarcinoma with Gleason's score of 3.

Adenocarcinoma ; metabolism ; pathology ; surgery ; Biopsy, Needle ; Carcinoma, Acinar Cell ; metabolism ; pathology ; Diagnosis, Differential ; Follow-Up Studies ; Humans ; Immunohistochemistry ; Male ; Prostatectomy ; Prostatic Hyperplasia ; metabolism ; pathology ; surgery ; Prostatic Neoplasms ; metabolism ; pathology ; surgery ; Racemases and Epimerases ; metabolism

Adenocarcinoma ; pathology ; Adenocarcinoma, Clear Cell ; genetics ; metabolism ; Carcinoma ; pathology ; Carcinoma, Acinar Cell ; pathology ; Carcinoma, Adenoid Cystic ; genetics ; metabolism ; Carcinoma, Mucoepidermoid ; genetics ; pathology ; Humans ; Myoepithelioma ; pathology ; Neoplasm Grading ; Oncogene Fusion ; Oncogene Proteins, Fusion ; metabolism ; Salivary Gland Neoplasms ; genetics ; pathology ; Salivary Glands ; pathology ; Translocation, Genetic

Pancreas acinar cell carcinoma (ACC) accounts for only 1-2% of pancreatic exocrine malignant tumor. The symptoms of patients with ACC are usually non-specific, for example the anorexia and weight loss. Patients may develop Schmid's triad including subcutaneous fat necrosis, polyarthritis, and eosinophilia. We reported a case of ACC which was manifested by subcutaneous nodule as initial clinical symptom. To our knowledge, this is the first reported case of ACC presenting as subcutaneous fat necrosis in Korea.
Carcinoma, Acinar Cell/*diagnosis/surgery/ultrasonography ; Fat Necrosis/pathology ; Humans ; Keratins/metabolism ; Male ; Middle Aged ; Pancreatic Neoplasms/*diagnosis/surgery/ultrasonography ; Subcutaneous Fat/*pathology ; Synaptophysin/metabolism ; Tomography, X-Ray Computed

OBJECTIVETo study the expression, clinicopathologic correlation and prognostic significance of caveolin-1 in lung adenocarcinomas(LAC).

METHODSImmunohistochemical study (EnVision method) for caveolin-1 and TTF-1 was carried out in 185 cases of LAC encountered during the period from 2005 to 2010. The correlation between caveolin-1 expression and various clinicopathologic parameters was analyzed statistically.

RESULTSThe rate of caveolin-1 expression in the 185 cases of LAC was 26.5% (49/185) and significantly lower than that in normal lung tissue (P<0.01). There was also higher rate of caveolin-1 expression in male patients (P=0.004), smokers (P=0.006), tumors larger than 3.5 cm (P=0.048), predominantly solid tumor subtype (P=0.025), high tumor grade (P=0.044), tumors with vascular invasion (P=0.019), lymph node metastasis (P=0.030), recurrence (P=0.021) and high clinical stage (P=0.027). The expression level of caveolin-1 in TTF1-negative cases was significantly higher than that in TTF1-positive cases and caveolin-1 expression also negatively correlated with TTF-1 expression in LAC (r=-0.154, P=0.037). The five-year overall survival rate of patients with caveolin-1 positive tumors was lower than that in caveolin-1 negative group (P<0.01).Univariate analysis indicated the expression level of caveolin-1 and TTF-1 (P<0.01), histologic subtype (P=0.002), tumor grade (P=0.002), tumor size (P=0.009), vascular invasion (P=0.019), lymph node metastasis (P=0.018), recurrence (P=0.032) and clinical stage (P=0.024) correlated with the survival of patients with LAC. COX multivariate analysis revealed that LAC with caveolin-1 positive expression, TTF-1 negative expression and high tumor grade carried a significantly unfavorable prognosis.

CONCLUSIONCaveolin-1 expression correlates with histologic subtype, tumor grade, invasiveness and metastatic potential of LAC. The detection of caveolin-1 in LAC is helpful in predicting prognosis.LAC with caveolin-1 expression carries a poor prognosis.

Adenocarcinoma ; metabolism ; pathology ; surgery ; Adenocarcinoma, Papillary ; metabolism ; pathology ; surgery ; Adult ; Aged ; Aged, 80 and over ; Carcinoma, Acinar Cell ; metabolism ; pathology ; surgery ; Caveolin 1 ; metabolism ; DNA-Binding Proteins ; metabolism ; Female ; Follow-Up Studies ; Humans ; Lung Neoplasms ; metabolism ; pathology ; surgery ; Lymphatic Metastasis ; Male ; Middle Aged ; Neoplasm Recurrence, Local ; Neoplasm Staging ; Prognosis ; Survival Rate ; Transcription Factors ; Tumor Burden