Online ISSN: 2515-8260

Keywords : Immunohistochemistry


Cell Block Technique In The Diagnosis Of Oral Lesions – A Methodical Assessment

Dr. Usha Hegde, Dr. Sreeshyla HS, Dr. Sowmya SV, Dr. Dominic Augustine, Dr. Mangesh Shenoy Panakaje, Dr. Aishwarya Ramesh, Dr. Vanishri C Haragannavar, Dr. Harshitha N

European Journal of Molecular & Clinical Medicine, 2023, Volume 10, Issue 1, Pages 2297-2306

This review aims to explore the use of cell block cytology in the diagnosis of oral lesions
Background: Utilizing the science of cytopathology is cost effective, fast, simple and accurate. Over the years, with the improvements in technical aspects and the appearance of cell block technique in cytopathology, the gold standard of “must have tissue to make an accurate diagnosis” is rapidly changing.
Review results: The review identified articles on use of cell block technique in oral lesions. The current research studies on this technique for oral lesions are very sparse. Most of the identified studies were limited to odontogenic lesions.
Conclusion: Though the cell block technique is being practiced for more than a century now for non-oral lesions, its practice among head and neck lesions is not up to par. Being cost effective, fast, simple, accurate and requires only a small tissue sample, its utilizing in oral diseases needs to be explored further

A study of the role of electron microscopy in fine needle aspirates of neoplastic lesions

Lt Col Shivani Sangwan, Col Prabal Deb, Lt Col Preeti Patni, Brig N S Mani

European Journal of Molecular & Clinical Medicine, 2023, Volume 10, Issue 1, Pages 65-78

Introduction: Evolution of cytopathology in the past few decades as a distinct adjunct in screening and diagnosis of a neoplastic process, has paralleled the development of newer ancillary techniques like immunocytochemistry, flow cytometry, karyotyping and genetic studies. But a combination of LM and IHC will not identify every tumor and some diagnostic problems go unanswered. If the differential diagnosis on routine LM includes a tumor that is known to possess distinctive ultra structure, Electron Microscopy (EM) is clearly the method to select for confirmation as a subsidiary technique.
Aim: Owing to the restricted availability of TEM in most centres,  data pertaining to its utility in tumor cytopathology is limited. Hence, the current study is designed to study the role of Electron Microscopy (EM) in fine needle aspiration cytological examination of neoplastic lesions, to correlate the findings of EM with Light microscopic findings and to correlate the EM findings with immunohistochemical findings, wherever possible.
Materials and Methods: Electron microscopy was carried out in a
total of 50 cases where were subjected to FNAC for suspected neoplastic primary malignant or metastatic lesions. The cellular features of material aspirated were studied and ultrastructural details of cytoplasm including the plasma membranes, organelles and nuclear features were noted. The cases were grouped histogenetically and analysed. The final cytological diagnosis were tabulated and compared with the histopathological diagnosis.

Histopathological Study of Gastrointestinal Stromal Tumors

Maulik kumar P. Vora, Abhishek Raval, Manan Jadav, Ritesh Gohil, Karansinh F. Vala

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 7, Pages 3761-3767

Background: Gatrointestinal stromal tumor (GIST), now the most common mesenchymal tumor of the gastrointestinal tract(GIT), has been frequently studied.
Objectives: Our aim was to study histopathology, demographic profile, histopathological grading, IHC property and behavior of  Gastro intestinal stromal tumor(GIST)
Material & Methods: Retrospectively 50 cases were selected& studied from the department of histopathology of tertiary care hospital,  Ahmedabad, India during  june 2010 to june 2013
Results: 50 cases were studied in our study. Most common site was stomach(40%)followed by jejunum(18%), rectum(16%)& ileum(12%). Most common age group was 51-60 years. Most common presenting symptoms  was abdominal pain (70%)  Seventy  percent of  Gastrointestinal stromal tumor were positive for CD 117(KIT). Histologically majority of them had a pure spindle cell morphology. Eight patients (21%)  had  recurrent /residual  mass of presentation.
Conclusion: In our study large number of  Gastro intestinal stromal tumor were present in the stomach. Most common age group was 51-60 years. Majority of  them  were of pure spindle cell morphology. Molecular studies and larger numbers of cases are required for meaningful conclusion to be drawn.

Role of P63 Immunostain in the Histomorphological Analysis of Salivary Gland Tumors- In Tertiary Care Hospital

C. Shalini, Jostna Devi Akarapu, M. Mamatha, Swathi Cheruku

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 7, Pages 2480-2495

Background: Salivary gland tumors are rare head-and-neck neoplasms. They demonstrate dual cell differentiation and morphologic overlap. Dual cell differentiation requires histomorphological study and immunohistochemistry to diagnose. p63 is a selective  immunohistochemical marker expressed in nuclei of myoepithelial cells and basal duct cells in normal salivary glands and aid in the diagnosis of of salivary gland tumors by highlightining the biphasic nature of the tumors. Extent of p63 positivity can be a useful predictor of clinical outcome and could help in the aggressive mode of treatment in certain types of salivary glands tumors.To study the role of p63 in the diagnosis of salivary gland tumors.
Material and Methods: The present study was conducted at Malla Reddy Institute of Medical Sciences in the Department of Pathology on the surgically resected salivary gland specimens received for routine histopathological evaluation. A total of 60 cases of salivary gland tumors were included in the study. It is a retrospective study carried out from January 2018 to December 2021, on surgically resected salivary gland tumor specimens and Immunohistochemical analysis with p63.
Results: A Total of 60 Salivary gland tumors were studied with different cytomorphology and mixed architectural patterns. In the present study, most frequent age groups were between 40 and 60 years.. All tumors except Warthin's were female-predominant. The parotid gland was the most common site, with adenoid cystic carcinoma mostly seen in smaller salivary glands. Pleomorphic adenoma and Mucoepidermoid carcinoma were frequent tumors seen. Standard techniques of IHC with p63 antibody were carried out on all the 60 Salivary gland tumors. All the benign tumors were positive for p63. Malignant tumors with basal cell involvement, such as Adenoid cystic carcinoma 6/7 cases showed p63 positivity with varying intensities. Clear, intermediate and squamous cells of all Mucoepidermoid carcinoma were p63 positive. p63 was negative in  Acinic cell carcinoma. Differential localization of p63 in various neoplasms was observed which has given information on myoepithelial cells.
Conclusion: P63 is an important Immunohistochemical marker which aids in diagnosis of salivary gland tumors and also helps in localization of myoepithelial cells by differential expression in various salivary gland tumors.

Expression of Aldehyde Dehydrogenases 1 (ALDH1) - A Stem Cell Marker in Non-Neoplastic and Neoplastic Lesions of Gall Bladder – A Correlative Study

Gauri Niranjan, Garima Shukla, Parul Gupta, Nirupma Lal, Shivangi Shukla, Sharique Ahmad

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 7, Pages 812-821

Background: The study aims to analyse expression of stem cell marker aldehyde dehydrogenases 1 (ALDH1) by Immunohistochemistry (IHC) in non-neoplastic and neoplastic lesions of the gall bladder.
Materials and Methods: The study was accomplished at the Department of Pathology Era’s Lucknow Medical College and Hospital, Lucknow. A total of 105 cases were enrolled for the study. The paraffin embedded tissue was subjected to haematoxylin and eosin staining. Immunohistochemistry was done further for the expression of ALDH1 stem cell marker, IHC was further done.
Results: Out of 70 non-neoplastic cases, ALDH1 came out to be positive for 12 cases and 15 cases came out to be positive for ALDH1 out of 35 neoplastic cases. The ALDH1 expression was found to be significantly higher in neoplastic than non-neoplastic lesions. Among the non-neoplastic lesions no significant difference seen with age, sex and cholelithiasis, whereas statistical significance was seen in cases with chronic cholecystitis, metaplasia, hyperplasia and low grade dysplasia as well as in ALDH1 expression in neoplastic lesions associated with cholelithiasis and histological grade of tumour.
Conclusion: ALDH1 expression in non - neoplastic & neoplastic gallbladder lesions may support the concept that the stem cells may be primary target of transformation in gallbladder carcinogenesis associated with prolong inflammation

EXPRESSION OF P53 IN UROTHELIAL CARCINOMA AND ITS CORRELATION WITH THE GRADE OF THE TUMOR – A TWO YEARS STUDY IN A TERTIARY HOSPITAL

Dr Mothkoori Swetha, Dr P.V.Ramana, Dr. Bhanupriya Kakarala, Dr. T. Sundari Devi

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 4, Pages 439-451

BACKGROUND
In India Urothelial carcinoma of bladder  constitutes about 7% of all male cancers. It is associated with high morbidity and mortality.Current grading system in application by WHO/ISUP divides Urothelial malignancies as  low and high grade tumors by morphological criteria. Grading Urothelial carcinomas depending on morphological criteria alone is some times difficult in limited tissue. In such cases tumor grading by alternative  methods like IHC expression is useful. In the present study we have evaluated the diagnostic utility of p53  in grading Urothelial carcinomas.
MATERIALS AND METHODS :
The present study is an observational study conducted at department of Pathology, Gandhi Medical College/Hospital, Secunderabad for over a period of two years from June 2016 to May 2018. A total of 30 TURBT  and  Cystectomy specimens diagnosed as Urothelial carcinoma on routine H&E were included in the study. These tissues were later subjected to IHC markers for  p53. The slides are reviewed and expression of these markers was evaluated and  correlated with grade. The results were statistically analyzed.

Primary Central Nervous System Lymphoma: A Clinicopathological and Cytomorpholgical Study from a Tertiary Care Centre

Swapna Devi, Suneeta Meena, Pramod Kumar Meena, Vedita Singh, Anushka Singh

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 3, Pages 10733-10738

Aim: To analyze the clinicopathological and immunohistochemical features of primary central
nervous system lymphoma (PCNSL) cases occurring in Indian patients and also study the utility
of the crush smear preparation in intraoperative diagnosis.
Material & Methods: 40 cases of PCNSL diagnosed in the Department of Histopathology, were
included in this study. Haematoxylin and Eosin (H and E) stained slides and
immunohistochemistry slides (which included a minimum of Leucocyte common antigen (LCA),
CD20 and CD79aof all these cases were retrieved.
Results: The mean age of the patients was 51.4 years and the median was 50 years (range 30-72
years). The male: female ratio in our study is 1:1. Of the 40 cases, one was a known case of
sarcoidosis (in remission). The only T-cell lymphoma case in our series had a prior history of
treatment for ulcerative colitis (in remission).
Conclusion: Our study shows that PCNSL is seen predominantly in immunocompetent patients
in India. The age of presentation is relatively young. Our study also stresses the utility of crush
smear preparation in establishing an intraoperative diagnosis.

Histopathological Spectrum of Periampullary Tumours with Special Emphasis on Immunohistochemistry

B V V D Kiranmayi, T. Sreedhar, Kusaraju Pyla, C.V. Lakshmi

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 3, Pages 1801-1806

Background:Periampullary tumours are one of the most common cause of cancer
related deaths. They have least survival rates. As most of the periampullary tumours
are malignat tumours, early diagnosis and management improves the survival.
Ampullary adenocarcinomas shows distinct morphologies with specific
immunohistochemistry profile.
Materials and Methods: This study was done over a period of three years in the
department of pathology. Rsectedspecimens (Whipple’s procedure and excision
biopsies) received in the department were adequately grossed, sectioned and stained
with H&E. CK20 and MUC 1 immunohistochemistry markers were applied for
ampullary adenocarcinomas.
Results: Out of 26 cases, 15 were of ampullary adenocarcinomas. Out of ampullary
adenocarcinomas, eight were intestinal type, five were pancreaticobiliary type and two
were mixed type. On IHC with CK20 and MUC1,four cases came out to be intestinal
type adenocarcinomas. Follow up was done in some of these cases to assess the survival
rates.
Conclusion: Prognosis varies among tumour subtypes. Histological subclassification still
holds good for assessing the prognosis in periampullary tumours

Study of skin expression of thrombomodulin in the Psoriatic Plaques

May mostafa Abo Al-kher MSc; Sawsan Khalifa Elsayed M.D; Safinaz Salah Eldin Sayed M.D; Sara Ahmed Galal M.D

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 3, Pages 1625-1637

Background: Psoriasis is a chronic relapsing, immune-mediated inflammatoryskin disease of unknown etiology. The role of thrombomodulin (TM) in different autoimmune inflammatory diseases was explored previously in some studies. Thus; the aim of this study was to assess TM expression in the affected skin of patients with psoriasis.
Methods: This prospective case-control study was carried out on 30 patients with chronic plaque psoriasis and 30 age and gender matched apparently normal subjects as a control group. Skin biopsies were taken for immunohistochemical evaluation of TM expression.
Results: There was a highly significant difference between the two studied groups regarding the expression of TM in the skin. Patients group had a higher expression of TM in both epidermis and dermis compared to controls with a highly statistically significant difference, P-value< 0.01.

Fibro-epithelial Hyperplasia Mimicking Oral Squamous Papilloma in an 8-year-old child - A Rare Case Report

Dr Ellana Jermiah Joseph, BDS; Dr Razia Haidrus, BDS; Dr Anupama Nayak P, MDS; Dr. Sangeeta U Nayak, MDS; Dr. Srikant Natarajan, MDS; Dr. Arathi Rao, MDS; Dr. Deepa G Kamath, MDS

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 3, Pages 1586-1590

Oral mucosa is affected by various papillary lesions. Any oral lesion raises concern because of its clinical appearance. This case report describes the management of an 8-year-old girl with an exophytic papillary growth on the palatal aspect of 64. The lesion clinically resembled an oral squamous papilloma but did not show any signs of a virally infected lesion histopathologic ally or on immunohistochemistry analysis which was unique with this case.

POOR NOCICEPTIVE INNERVATION of NECK SKIN in THREE DOMESTIC RUMINANTS

Ayoub A. Bazzaz

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 9, Pages 111-117

Background: Skin innervation in ruminants has received less attention than other animal skins. The objective was to compare the tissue layers of the skin and detect the expression of nociceptive nerve endings and axons within the neck region of these animals. Methods: Sections of neck (cervical) region of three domestic ruminants involved sheep, goat and bull slaughtered at Kerkuk Slaughter House were studied for both histological, using routine stain, hematoxylene and eosin (H&E) and immune- histochemically using substance-P primary antibody. Results: No conspicuous fundamental differences in the skin layers between these three animals do exist except the bull skin was much thicker than that of sheep and goat, respectively; while more adipose tissue was deposited in sheep in comparison with goat and bull with abundant loose hypodermis in all. Immunohistochemical examinations showed scanty expression of substance-P nerve endings in the epidermis and nerve fibers in the submucosa and hypodermis of all three animals except a few at hair follicles were detectable. Conclusion: The neck skin is charcterised either scanty nerve endings and fibers supplied or run perpendicular to skin surface which could be advantageous for such commercially used meat productive animals to minimize pain during the Islamic manner of slaughtering used to eliminate pain during slaughtering in comparison with other painful methods used in Western society

Expression of proinflammatory cytokine INTERLEUKIN 6 in oral submucous fibrosis and oral squamous cell carcinoma: Immunohistochemical study

Dr. Shruthi Rangaswamy; Dr. Rajkumar G C; Dr. Sharada P

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 11, Pages 5823-5832

Introduction: Interleukin 6 is a proinflammatory cytokine indicated in many types of cancer.
Increased cytokine levels are found in oral submucous fibrosis which is a premalignant
condition. Immunohistochemical evaluation of interleukin 6 will help in better understanding
of progression of OSF and OSCC
Materials and methods: Formalin fixed, paraffin embedded oral submucous fibrosis tissue
blocks were obtained from departmental archives. 40 samples each of early, moderately
advanced and severe OSF were randomly selected. 20 samples of normal mucosa and 20
samples of OSCC were selected. Immunohistochemistry was performed, quantitatively and
qualitatively assessed for expression of IL 6.
Results: The test results demonstrated a significant difference in the percentage of expression
in the IL-6 expression between 3 groups ( P<0.001).. Higher intensity and percentage of
expression was found in OSCC and the expression was cytoplasmic. Despite having an
increasing trend in the expression of IL-6 based on tumour grade, there was no statistically
significant difference noted. OSF group showed higher mean Q scores as compared to control
group but the difference was not statistically significant. Despite having an increasing trend in
the expression of IL-6 based on tumour grade, there was no statistically significant difference
noted.
Conclusion: Interleukin 6 is consistently expressed in oral squamous cell carcinoma but not in
OSF tissues. Immunohistochemical marking of interleukin-6 in surgically excised oral
squamous cell carcinoma specimen may help in understanding prognosis.

Comparative Analysis Of Rt-Pcr And Immunohistochemistry Methods For Determining Her2 Status In Breast Cancer Samples

Shokhista Rustamova; Yodgormirza Nurmatov; Muazzam Bakiyeva; Tokhirjon Rakhmanov

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 3, Pages 3924-3929

This study aimed to compare two methods of quantitative polymerase chain reaction (qPCR) using the intercalating SYBR Green dye and TaqMan hybridization probes to determine the amount of the HER2 gene (human epidermal receptor) in breast tumours.
Methods--- The experiments were carried out with 32 validated samples of breast cancer and two gastric cancer cell lines. An immunohistochemical (IHC) assay was used to evaluate the accuracy of the RT-PCR methods.
Results--- The obtained results show that real-time PCR with the TaqMan probes allows the use of a small amount of DNA (≥0.4 ng/μl) to determine the overexpression of the HER2 gene. Real-time PCR with SYBR Green allowed us to determine the minimum number of false negatives resulting from the absence of marker expression in tumour tissue.
Conclusions--- The full correspondence of the results of the RTPCR and immunohistochemistry methods obtained for the cell line samples makes it possible to introduce the qPCR method into clinical practice for use in detecting the HER2/neu gene content.

Loss Of Immunohistochemical Expression Of Pten As A Predictive Biomarker In Breast Carcinoma

Iftikhar Altemimi; Binan Adil Alaaragy; Yassir Alaa Shubbar; Rihab Hameed; Salah Jumaah

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 1, Pages 3653-3668

Background: Breast cancer is the most common malignancy with a high mortality in females worldwide. Tumor suppressor genes had significant role to maintain genome integrity and the cell cycle. In particular PTEN is a candidate tumor suppressor gene, It has a negative regulator of PI3K/AKT signaling pathway which has a major role in carcinogenesis and dysregulation of it occurs repeatedly in breast cancer. Aim: this article aimed to appraise the associations between PTEN expression in patient had breast cancer with clinic pathological parameters including: age, histological types, and status of estrogen receptor, progesterone receptor, and HER-2/nue receptor, to check the impact of its expression on clinical outcome. Materials and methods: in this case-control study, formalin fixed paraffin embedded tissue from sixty patients with breast carcinoma and twenty patients without cancer (as control groups). Labeled Streptavidin -Biotin (LSAB+) method used to detect PTEN protein expression, HER2/neu, ER and PR receptors by immunohistochemical assay, and then we correlate PTEN expression with each biomarkers and clinic pathological characteristics. Results: 29/60 (45.3%) of cases decreased PTEN expression while its expression retained in 31/60 (51%) of cases. Loss of expression significantly associated: with lymph node metastasis ( p-value=0.0008 ), high grade (p< 0.05 ) , high stage (p-value=0.0001 ) and with triple negative breast cancer (p-value=0.03) . However, loss of PTEN protein expression did not correlate with age, histological types, estrogen, progesterone and HER-2 receptors status. Conclusion: PTEN loss can predict aggressive behavior and worse outcome in patients had breast cancer.