14^th International Conference on Surgical Pathology & Cancer Diagnosis May 17-18, 2018 Rome, Italy

Biography:

Charles D Sturgis has completed his MD at the University of Kansas in 1992. He then finished Residency in Anatomic and Clinical Pathology at Northwestern Univeristy in 1997. He completed a fellowship in Cytopathology at the University of Texas MD Anderson Cancer Center in 1998. He is currently working as an Associate Professor of Pathology and Associate Residency Program Director for Anatomic Pathology at the Cleveland Clinic Lerner College of Medicine in Cleveland, Ohio, USA.  He is the author of more than 60 peer-reviewed medical and scientific manuscript publications, several book chapters, and more than 70 peer-reviewed published abstracts.

Abstract:

Invasive breast carcinoma is the most common infiltrating visceral malignancy in women in the USA.  More than 200,000 cases were reported in 2015. The role of the androgen receptors (ARs) in mammary carcinogenesis is a current topic of scientific investigation.  AR expression is present in normal mammary epithelium and in many invasive breast cancers and cell lines. ARs belong to a family of intracellular steroid hormone receptors and function as ligand dependent transcription factors that regulate target gene expression.  The AR gene is located on the X chromosome at q11 with no corresponding allele on the Y chromosome, and the gene functions as a single copy.   Recent studies have queried the value of ARs as predictors of therapeutic response and have sought to address roles for ARs as therapeutic targets for antiandrogenic targeted endocrine therapies. The majority of studies regarding AR expression in breast cancers have focused on triple negative breast carcinomas.  Because of the high reported proportion of AR positivity (36%) in triple negative invasive carcinomas, some authors have proposed that routine assessment of ARs should be pursued.  In addition, a number of published data sets from phase II trials have suggested proof of principle for efficacy and minimal toxicity of anti-androgens in treating patients with locally advanced and/or metastatic AR positive breast carcinoma.  In this oral presentation, I reveiw and summarize salient literature regarding assessment of ARs in invasive breast carcinoma and also discuss novel concepts for the study of ARs in mammary ductal carcinoma in situ.

Biography:

Maria J Worsham completed her PhD in 1993 from Wayne State School of Medicine, Detroit, Michigan, followed by a three year Medical Genetics Fellowship at Henry Ford Health System (HFHS). She is a Fellow of American College of Medical Genetics and Genomics with subspeciliaties in Clinical Cytogentics and Clinical Molecular Genetics. As Senior Scientist and Professor of Pathology, she heads the HFHS Cancer Genetic Research Program. The multi-disciplinary program integrates genomics, epigenomics, next generation sequencing, and immune checkpoint research strategies for tumor biomarkers of potential clinical benefit in the diagnosis, prognosis., and treatment of cancer.

Abstract:

There has been relatively little advancement in changing the management of women with estrogen receptor (ER) negative breast cancer (BC), mainly due to a dearth of actionable therapeutic targets. The majority of published studies investigating driver genes have focused primarily on genomic mutations which have led to novel study designs (basket trials) where patients with a rare mutation, regardless of tumor histology, are matched to a drug expected to work through the mutated pathway. This study illustrates network integration of epigenomic data to prioritize ER negative specific methylated genes as potential epigenetic drivers of aggressive disease. A master regulator is a gene or drug positioned as the central or master hub that has the ability to command or influence downstream events.  Causal Network Analysis (CNA) was used to find networks with directionality that connect upstream master regulators with a 16 candidate methylation gene signature differentiating ER negative from ER positive BC. CNA software identified 4 hierarchical networks and their corresponding master regulatory molecules, diethylstilbestrol, transcription regulator SP1, MSH2, and 15-ketoprotaglandin E2. Diethylstilbestrol and SP1 had direct regulatory influence (depth level 1) to the candidate molecules ALPL, CCND1, EGFR, ESR1 and CCND1, CIRBP, EGFR, ESR1, respectively. In this study, direct regulatory influence, noted for 5/16 candidate genes indicates additional rationale for further consideration and validation of ALPL, CCND1, CIRBP, EGFR, ESR1 as potential epigenetic driver targets in ER negative BC. Currently epigenetic therapy exhibits clinical efficacy in patients with acute myeloid leukemia (AML) and myelodysplastic syndromes (MDS) including those patients not responding to cytotoxic therapy.

Biography:

Biography will be updated sooon!!!

Abstract:

Introduction:

As the continuum of Endometrial Neoplasia (EN) is recognized to extend from Atypical Endometrial Hyperplasia (AEH) through Endometrial Carcinoma (EC), ¹ we may need to non-invasively predict its natural biological behavior.  To that end, the authors have investigated the use of three-Dimensional transvaginal sonography (3D TVS) techniques to identify the features of this neoplastic entity pre-operatively, to possibly predict the extent of its required surgical treatment.

Methods:

All patients in this continuous ongoing investigation who were histologically diagnosed with AEH or EC were examined sonographically, using 3D TVS with Power Doppler Angiography (PDA), and Virtual Organ Computer-Aided Analysis (VOCAL) system from April 1, 2015 to the present.  All of these patients underwent a subsequent surgical procedure with the resulting histology surgically obtained to be compared with those pre-operative ultrasound findings.  

Results:

The identified sonographic features of the cases enrolled in this study were compared with the intraoperative and post-operative pathologic findings.  With the results of 20 patients thus far, the ultrasound findings predicted the minimum EC staging 100 % of the time.  Deep myometrial invasion (≥50%) and cervical stromal invasion were specifically identified and which is naturally associated with the surgical staging of EC. 

Conclusions:

This ongoing investigation seeks to validate the findings of Alcazar² and those of Karlsson³, to sonographically identify the features of this oncologic condition, to properly predict its optimal surgical treatment.  The clinical importance of this should be recognized, for the impact it can have on patient care, in that there is often difficulty in properly obtaining the diagnosis of this entity (EC) when it presents as Postmenopausal Bleeding (PMB).  An example of this is when cervical stenosis is encountered, which can prevent pipelle sampling of the endometrium.  It is believed that we are introducing what should become the standard care for patients who are at risk of Endometrial Carcinoma.  Though a variety of procedures have been used to determine the definitive staging of this disease entity at the time of surgery (e.g. Sentinel Node Biopsy and Frozen section) ⁴, the ideal time to determine the staging is preoperatively.  In this way, the optimal surgical treatment can be planned, as to whether pelvic lymphadenectomy should also be performed at the time of hysterectomy, if Stage IB or Stage II EC is present. 

Biography:

Anita S. Bhaduri  has completed her MD at the age of 27 years from Kanpur University.She is Consultant Histopathologist at PD Hinduja Hospital & MRC, a premier tertiary care multispeciality hospital  at Mumbai. She has published more than 46 papers in reputed journals and has been serving as an editorial board member of repute of several journals.She currently holds the position of Honorary Secretary & Treasurer of IAP-Indian Divion and has served as a Councillor on the same committee earlier.She has received the British Council TCTP Award and is a trained  assessor with the College of American Pathologists.

Abstract:

An increase in awareness of breast cancer and screening mammography has led to increase in the detection of non-palpable breast cancers. Very little data is available on the key features of such tumors in our country. According to the latest ICMR statistics, breast cancer is the most common cancer among Indian women with an estimated 1.5 lakh (over 10 per cent of all cancers)new cases during 2016.( ICMR). There in an increase in the incidence of breast cancer in younger women both globally and in India. To our knowledge no study which looks at screen detected breast cancers has been done so far in India

According to the National Cancer Registry almost 48% of breast cancer patients currently are below 50 of age in comparison to 25 years back when 69% of the patients were over fifty years of age.

The aim of this study was to analyse the characteristics of non-palpable breast cancers and to compare these tumors in pre[<50yrs] and post menopausal women(>50) at a tertiary care centre in urban setting in India.

This study included 146 cases of biopsy proven In-situ and invasive malignancies. It was then divided into two groups based on age less than and more than 50years. Data was collected from the available medical records and then statistically processed.

It was seen that non-palpable screen detected malignancies showed smaller T size, higher ER positivity, lower grade and rare propensity for lymph node and systemic metastasis. Pre-menopausal patients however showed more cases of triple negative and Her 2 positive tumors menopausal patients however showed more cases of triple negative and Her 2 positive tumors along with higher lymph node positivity.

Conclusions:

Screening mammogram with biopsy diagnosis in suspicious BIRADS lesions is an important part of management of patients with non-palpable screen detected breast lesions.It provides  better prognosis in patients harbouring malignancy due to early detection, smaller size of the tumors and favourable prognostic factors. Breast cancer screening is not a method of prevention in India partly because of the cost and also because breast cancer awareness has not fully permeated the society. Nevertheless, the introduction of sonomammogram with increased awareness of breast cancer in urban cities of India has led to an increased detection of non-palpable breast lesions that cannot be detected through physical examination. This has led to an increased detection of malignancies as well as various non-malignant and premalignant entities in the breast. Image-guided biopsies are performed for abnormalities detected by sonomammogram, which prevents a considerable number of patients from undergoing surgical interventions requiring longer hospital stay and higher cost.

Biography:

Arnav Kr. Roychoudhury has completed his MD from Mahatma Gandhi University of Health Sciences. He has done Clinical observership in Surgical Pathology from Tata Memorial Hospital . He has published more than 14 papers in reputed journals and has served as an reviewer.

Abstract:

Background: Diseases of Gastro Intestinal Tract (GIT) are more common than any other systems in human body. Adenocarcinomas are more common in intestine. Aims and Objectives: To study the age, sex, and site wise distribution of various types of benign and malignant GI lesions. Materials and methods: The prospective study of 159 patients having gastrointestinal lesion were included in this study over a period of one year from October 2016 to September 2017. The materials were collected in the form of biopsy and resected specimens of gastrointestinal tract with relevant clinical history and sent in 10% Formalin and processed in automatic tissue processor. Routine Hematoxylin and Eosin stain and special stains were done wherever needed. Results: Out of total 5000 specimens 159 cases (3.18%) were GIT lesions, both benign and malignant. Appendicitis was the most common benign lesion comprising of 52.14% of cases. Adenocarcinoma being the most common type of gastrointestinal tract malignancy (48.57%). The second most common malignancy was squamous cell carcinoma (37.14%). Most common lesion of the oesophagus was squamous cell carcinoma whereas adenocarcinomas were the most common lesion of stomach and large intestine followed. Conclusion: Histopathological evaluation is the gold standard for the early detection of GI tract lesions especially malignant one hence it helps in their early management.

Biography:

Maria Carmina Santiago is currently a fourth year resident from the Department of Obstetrics and Gynecology at the University of the Philippines-Philippine General Hospital.

Abstract:

This is a case of a 42 G1P0 (0010), presenting with abnormal uterine bleeding and secondary infertility, who underwent total hysterectomy for myoma uteri. Histopathology, however, revealed a uterine tumor resembling ovarian sex-cord stromal tumor. Uterine tumors resembling ovarian sex-cord stromal tumors (UTROSCTs) are rare neoplasms with less than 100 documented cases, first described by Morehead and Bowman in 1945. They were classified by Clement and Scully into two groups: the first included those whose were less than 50% sex-cord like tissue (endometrial stromal tumor with sex cord-like elements, ESTSCLE or Type I) and the second whose tissue were almost completely sex-cord like tissue (classic UTROSCT or Type II). These tumors are typically benign, though some cases (those classified as Type I) are more aggressive. On immunohistochemistry, the tumor showed positivity for WT1, CD99, vimentin, and CK, classifying it as Type II. This confers a better prognosis for this patient.

Biography:

Shruti Bhargava is Assistant Professor of Pathology at SMS Medical College, Jaipur, India. She is a MBBS (gold medalist) from SMS Medical College and MD (Pathology) from Aligarh Muslim University, India. She is also a Resource faculty, Medical Education Unit, SMS medical College, Jaipur and the Assistant Editor of Rajasthan Medical Journal. She has been a Member of stem cell committee of SMS Medical College and Co-investigator in ICMR funded Limbal stem cell project at SMS Medical College, Jaipur. She has been trained in Dermatopathology at Delhi, human stem cell cultivation at LVPEI, Hyderabad and basic genetics techniques at ACTREC, TMH, Mumbai.  She has been a visiting fellow in diagnostic pathology at LUMC, The Netherlands and in Cytopathology at Istanbul University Medical School, Turkey.

Abstract:

Background: Ovarian tumors are rare in adolescents. This study was conducted at SMS Medical College, Jaipur during the last eight years, to find out the incidence of different ovarian tumors in girls between 10 to 19 years of age, to correlate the clinical and histopathological findings and to help clinicians in solving diagnostic dilemmas in some of these patients.

Material and method: After the detailed clinical notes were analyzed, histopathological examination was done on ovarian tumor specimens received in the department of pathology, along with immunohistochemistry wherever required.

Results: A total of 478 cases of ovarian tumors were studied. The patient’s age ranged from 10 to 19 years with 4% being pre menarcheal. The main complaint was abdominal pain or abdominal distension. Bilaterality was observed in 7% cases.  Out of 478 cases, 23 % were malignant while the rest were benign. The various benign tumors observed were serous cystadenoma, mucinous cystadenoma, teratoma, fibrothecoma and sex cord tumor with annular tubules while malignant ones observed were mucinous cystadenocarcinoma, immature teratoma, dysgerminoma, yolk sac tumor, granulosa cell tumor and sertoli leydig cell tumor.

Conclusion: This study emphasizes the role of early and correct diagnosis of ovarian tumors in adolescents since appropriate treatment bears important implications on the future reproductive lives of females.

Biography:

Nidhi Bansal has completed her MD Pathology from Mahatma Gandhi University of Health Sciences. She is currently working as an Assistant Professor in the Department of Immunohematology and Blood Transfusion in Guru Gobind Singh Medical College & Hospital. She has published more than 14 papers in reputed journals. Her research interest includes Histo-cytopathology.

Abstract:

Introduction: Gallbladder stones are the commonest disorder among gall bladder lesions and are usually asymptomatic. Its frequency in cholecystectomy specimens is not clear. The aim of this study was to report the morphological variants and frequency of different lesions in cholecystectomy specimens.

Objective: To study the various histopathological spectrums of gall bladder lesions.

Materials & Methods: In present study, we have studied a total of 141 cases of gall bladder lesions during the period of six months, from April 2017 to October 2017 in the Department of Pathology at Adesh Institute of Medical Sciences and Research, Bathinda.

Results: Benign lesions of gall bladder outnumbered the malignant ones with non-neoplastic lesions, accounting for 93.6% (132 cases) with chronic calculous cholecystitis contributing the majority of the non-neoplastic lesions (49.64%), followed by cholesterolosis (22.69%), acalculous cholecystitis (4.96%), followed by gangrenous and xanthogranulomatous cholecystitis. Females were predominantly affected in the present study with total 107 cases out of 141 cases (75.8% cases). Most of the non-neoplastic lesions of the gall bladder lesions are common in 3^rd, 4^th and 5^th decades of life. Neoplastic lesions of the gall bladder were common in 5^th, 6^th and 7^th decades of life. Out of 141 cases, five cases were of adenocarcinoma of gall bladder (3.5%). The mean age of patients with adenocarcinoma of gall bladder was 60.8 years.

Conclusion: Gall bladder lesions were common indication for surgical intervention and pathological evaluation. Most of them were inflammatory lesions with cholelithiasis; however, thorough examination is important as these lesions may progress to fatal malignancies.

Biography:

Priti Joshi MBBS, MD, FRCPath is a Consultant Anatomic Pathologist and Cytopathologist at Cleveland Clinic in Abu Dhabi. She is a Fellow of The Royal College of Pathologists, UK. Her areas of interest are Gynecological, Urological and Gastrointestinal Pathology and has over 17 years experience in the field. 

Abstract:

Testicular tumors are diverse and diagnostically challenging and yet a very unique and fascinating group of tumors. Accurate diagnosis has major therapeutic and prognostic implications, emphasizing the need for correct recognition of morphological patterns which guide the use of appropriate immunohistochemical antibodies. They are also of great interest to researchers and oncologists for their biologic diversity with scope for full cure following appropriate treatment.

More than 95% of testicular tumors arise from the germ cells and are broadly subdivided into seminomatous and nonseminomatous germ cell tumors. Although the common testicular tumors are easy to recognize histologically, diagnostic challenges are frequently encountered. The purpose of this presentation is to increase awareness of this and enable a conscientious pathologist to look out for and consider such diagnostic challenges in seemingly straightforward cases. Special consideration must also be given to tumors arising in dysgenetic gonads.

Biography:

Biography will be updated soon!!!

Abstract:

Biography:

Rasha Ahmed Khairy has completed her M.D at the age of 33 years from Faculty of medicine, Cairo University . She is lecturer of pathology in faculty of medicine, Cairo University.She  has published 9 papers in reputed journals and has joined as a reviwer in reputed journal. 

Abstract:

Introduction: In human cancers, podoplanin expression and its correlation with tumour invasive potential raise its possible role as a diagnostic and prognostic marker for cancer.Aim:To investigate the immunohistochemical expression of podoplanin in laryngeal Squamous Cell Carcinoma (SCC) and dysplasia.Materials and Methods:This study included a total of 60 archived, formalin fixed, paraffin embedded tissue blocks of 40 cases of laryngeal SCC and 20 cases of dysplastic lesions. The samples were immunohistochemically analysed for podoplanin expression.Results:Podoplanin expression was significantly higher in laryngeal SCC (90%) than laryngeal dysplastic lesions (55%) (p-value=0.002). The expression of podoplanin was significantly increased with the higher grades of dysplasia (p-value=0.016). A significant positive correlation was detected between podoplanin expression in laryngeal SCC and depth of tumour invasion (p-value=0.035), and stage (p-value=0.026).Conclusion:The high expression of podoplanin in laryngeal SCC and its significant correlation with poor prognostic parameters recommends podoplanin as a prognostic marker in laryngeal SCC. In addition, increased podoplanin expression with higher grades of dysplasia, supports its role in malignant transformation and allows us to recommend its evaluation in premalignant lesions.

Biography:

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Abstract:

Solid Pseudo-papillary Neoplasm of the pancreas (SPN) is a rare entity. It represents 0.2-2.7% of all pancreatic cancers. Predominantly occurs in young females in the second to third decades of life. The etiology of SPN involves mutations in the gene that encodes beta-catenin. SPN’s are typically indolent tumors, which are usually confined to the pancreas. We report a case of SPN in a 9 years old female who presented with intermittent abdominal pain for the last 4 months. Computed tomography CT abdomen and pelvis demonstrated 2.8 cm pancreatic mass in the tail. Distal pancreatectomy was performed. Pathological evaluation was diagnostic for SPN in the tail of pancreas. Our case is distinct because of the young age of the patient along with peripancreatic soft tissue, perineural and lymphovascular invasion. The tumor cells exhibited cytoplasmic and nuclear immunorreactivity for beta-catenin and progesterone receptor; few cells were positive for synaptophysin but the tumor was negative for chromogranin.

Biography:

Biography will be updated soon!!!

Abstract:

Objectives 1)​​ ​To​ ​assess​ ​the​ ​diagnostic​ ​value​ ​of​ ​Breast​ ​Imaging​ ​Reporting​ ​and​ ​Data​ ​system​ ​(BI-RADS)​ ​​ ​in​ ​screening​ ​and​ ​management​ ​of​ ​non​ ​-​ ​palpable​ ​breast​ ​lesions​ ​in​ ​the​ ​setting​ ​of​ ​a tertiary​ ​care​ ​hospital​ ​in​ ​Western​ ​India​ ​(​ ​Mumbai,​ ​Maharashtra)​ ​with​ ​histopathological correlation.

2)​ ​Evaluate​ ​the​ ​rates​ ​of​ ​radiologic​ ​and​ ​pathologic​ ​correlation​ ​in​ ​breast​ ​biopsies.

 3) Subcategorization of BI- RADS Category 4 to 4a,4b and 4c and correlation with histopathology.

Material​ ​and​ ​methods:​​ ​The​ ​authors​ ​retrospectively​ ​reviewed​ ​the​ ​mammography​ ​and sonography​ ​findings​ ​of​ ​425​ ​women​ ​who​ ​had​ ​come​ ​for​ ​screening​ ​between​ ​May​ ​2010​ ​and​ ​May 2016.​ ​BIRADS​ ​categorisation​ ​of​ ​these​ ​lesions​ ​by​ ​combined​ ​mammography​ ​and​ ​ultrasound was​ ​followed​ ​by​ ​histopathological​ ​examination. 

Results:​ ​​​ ​All​ ​425​ ​cases​ ​were​ ​classified​ ​into​ ​​ ​BI-RADS​ ​categories​ ​2,3,4​ ​and​ ​5.​ ​The​ ​distribution of​ ​lesions​ ​on​ ​BI-RADS​ ​category​ ​was​ ​BI-RADS​ ​2​ ​:7(1.6%),​ ​BI-RADS​ ​3:100(23.52%),​ ​BI-RADS 4a:154(36.23%),​ ​BI-RADS​ ​4b:39(9.17%),​ ​BI-RADS​ ​4c:71(16.7%),​ ​BI-RADS​ ​5:54(12.7%). 

​Malignancy​ ​was​ ​detected​ ​in​ ​5​ ​(5%)​ ​​ ​BIRADS​ ​3​ ​lesions,​ ​in​ ​9​ ​(5.7%)​ ​BIRADS​ ​4a​ ​lesions,​ ​in​ ​21 (54%)​ ​BIRADS​ ​4b​ ​lesions,​ ​in​ ​64(92.7%)​ ​BIRADS​ ​4c​ ​lesions​ ​and​ ​in​ ​47​ ​(87%)​ ​BIRADS​ ​5 lesions.

Histology​ ​revealed​ ​279​ ​benign​ ​cases​ ​(65.64%),​ ​33(7.7%)​ ​DCIS​ ​and​ ​113​ ​invasive malignancies​ ​(26.5%).​ ​It​ ​was​ ​seen​ ​that​ ​the​ ​sensitivity,​ ​specificity,​ ​positive​ ​predictive value, negative​ ​predictive​ ​value​ ​and​ ​Diagnostic​ ​accuracy​ ​of​ ​BIRADS​ ​was​ ​89.73%, 90.32%,82.91%,94.38%​ ​and​ ​90.12%​ ​respectively.​ ​The​ ​disease​ ​prevalence,​ ​positive​ ​likelihood ratio,​ ​negative​ ​likelihood​ ​ratio​ ​and​ ​area​ ​under​ ​the​ ​curve​ ​was​ ​34.35%, 9.272, 0.114​ ​and​ ​0.9 respectively. 

Conclusions:​ ​​In​ ​our​ ​study,​ ​BIRADS​ ​proved​ ​to​ ​be​ ​a​ ​very​ ​good​ ​diagnostic​ ​test​ ​in​ ​the​ ​screening and​ ​initial​ ​management​ ​of​ ​non​ ​-palpable​ ​breast​ ​lesions.​ ​​ Majority​ ​of​ ​the​ ​lesions​ ​detected​ ​were benign​ ​and​ ​the​ ​malignant​ ​cases​ ​showed​ ​better​ ​prognostic​ ​features​ ​like​ ​smaller​ ​size,​ ​more​ ​ER positivity,​ ​lower​ ​rates​ ​of​ ​lymphatic​ ​and​ ​metastatic​ ​spread. The subcategorization of BI – RADS 4 lesions into 4a, 4b and 4c further demonstrated ​that​ ​these​ ​subcategories​ ​remain​ ​as​ ​invaluable contribution​ ​for​ ​accurate​ ​assessment​ ​of​ ​lesions​ ​suspicious​ ​for​ ​malignancy.  ​The​ ​present​ ​study​ ​has​ ​demonstrated that​ ​BI-RADS​ ​allows​ ​a​ ​safe​ ​prediction​ ​of​ ​high​ ​suspicion​ ​of​ ​malignancy​ ​in​ ​category​ ​4C​ ​&​ ​5 and​ ​low​ ​suspicion​ ​for​ ​category​ ​3​ ​and​ ​4A.​ ​​ ​ ​ ​​

Biography:

Shruti Bhargava is Assistant Professor of Pathology at SMS Medical College, Jaipur, India. She is a MBBS (gold medalist) from SMS Medical College and MD (Pathology) from Aligarh Muslim University, India. She is also a Resource faculty, Medical Education Unit, SMS medical College, Jaipur and the Assistant Editor of Rajasthan Medical Journal. She has been a Member of stem cell committee of SMS Medical College and Co-investigator in ICMR funded Limbal stem cell project at SMS Medical College, Jaipur. She has been trained in Dermatopathology at Delhi, human stem cell cultivation at LVPEI, Hyderabad and basic genetics techniques at ACTREC, TMH, Mumbai.  She has been a visiting fellow in diagnostic pathology at LUMC, The Netherlands and in Cytopathology at Istanbul University Medical School, Turkey.

Abstract:

The present study was conducted in the Department of Pathology, SMS Medical College, Jaipur, India, over a span of 5 years, to evaluate the role of sediment cytology of specimen fixatives, which is usually discarded. The cytological diagnosis was then compared with histological diagnosis, taking the latter as gold standard. Mostly the smears showed adequate cellularity and preserved cellular morphology. Out of total 570 cases studied, cytology labelled 277 lesions as malignant, 231 as benign and 62 lesions as inconclusive. Final histological examination proved 289 lesions as benign and 281 lesions as malignant. Sediment cytology was able to correctly diagnose 508 of 570 cases. Hence sediment cytology of specimen fixatives can be a good and cost effective complementary method to histopathology in the study of ovarian lesions, especially in places where frozen section facility is not available as it is simple, inexpensive and helps in relatively rapid diagnosis.

Biography:

Priti Joshi MBBS, MD, FRCPath is a Consultant Anatomic Pathologist and Cytopathologist at Cleveland Clinic in Abu Dhabi. She is a Fellow of The Royal College of Pathologists, UK. Her areas of interest are Gynaecological, Urological and Gastrointestinal Pathology and has over 17 years experience in the field. 

Abstract:

Ovarian cysts, tumours and tumour-like conditions are common in routine gynaecology and histology practices. Majority of cases including malignancies are without diagnostic challenges. The mainstay of this presentation is to demonstrate 3 cases (2 cases of teratoma and 1 case of endometriosis) in which the diagnosis had a huge impact on patient treatment and further management because of the unusual associated clinical implications.

Biography:

Biography will be updated soon!!!

Abstract:

Introduction

Early pT1 colorectal carcinoma is defined by invasion of tumour into the submucosa and not beyond. Depth of invasion, histological grade, presence of lymphovascular invasion, budding, poorly differentiated clusters and resection margins are important predictors of lymph node metastasis and tumour behaviour.

Materials and Methods

This is a retrospective analysis of pT1 colorectal cancers diagnosed in the histopathology department over a period of 7 years (2010-2016). The available clinical records and histopathology slides were reviewed for various parameters.

Results

The study included 28 BCSP cases and 51 non-screening cases that had either polypectomies or colorectal resections. Male predominance with an age range of 55-74yrs was noted in BCSP cases; however, in non-screening patients the age range was 49-91 years. In BCSP cases all polyp cancers were on left side with sigmoid colon (18/28) being the commonest site. In non-screening cases, cancers were noted in both right and left sides of colon with rectum being the commonest site (22/51). The cancers were smaller in BCSP cases (width <5mm in 25/28) whereas a proportion were larger (width >5mm in 22/51) in non-screening cases. Poorly differentiated clusters were more commonly seen in non-screening cases (13/51) as compared to BCSP cases (1/28). In patients who underwent major resections, lymph node metastasis was seen in 5 non-screening cases and only 1 BCSP case.

Conclusion

BCSP cases tend to have smaller polyp cancers, all on the left side and with very low incidence of lymph node metastasis as compared to non-screening pT1 cancers. 

Biography:

Rasha Ahmed Khairy has completed her M.D at the age of 33 years from Faculty of medicine, Cairo University . She is lecturer of pathology in faculty of medicine, Cairo University.She  has published 9 papers in reputed journals and has joined as a reviwer in reputed journal.           

Abstract:

Introduction: CD44 is a cell adhesion molecule assumed to be related to tumour invasion and metastatic ability and is expressed in variety of tumours including meningiomas.

Aim:To evaluate the immunohistochemical expression of CD44 in variable grades and variants of eningioma and to correlate the results with Ki-67 proliferation index and available clinicopathologic variables.

Materials and Methods:A total of 40 meningioma cases were studied for immunohistochemical expression of CD44 and Ki-67 and correlated with different clinicopathologic variables. A p-value less than 0.05 was considered statistically significant.

Results:CD44 was markedly expressed in high grade (II and III) meningioma (81.8%) compared to grade I (18.2%) and that was statistically significant (p<0.001). Ki-67 proliferation activity was significantly correlated with meningioma grade (p<0.001) and brain invasiveness (p=0.033). Moreover, statistically positive correlation (p=0.01) was reported between CD44 and Ki-67 proliferative activity. No statistically significant correlation was detected between CD44 or Ki-67 expression and patients’ age, sex, and tumour recurrence rate (p>0.05).

Conclusion:We concluded that CD44 is a marker of aggressiveness in meningioma as it was significantly highly expressed in grade II and III meningioma and was, positively correlated with higher Ki-67 proliferation indices. Therefore, researches should be carried out to identify the role of CD44 targeted therapy in atypical and anaplastic meningiomas as done in other tumours e.g., breast cancer.

Biography:

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Abstract:

HCC  presents with widely varying biological behavior. patterns  This may stem from its diverse etiologies including different types of viruses, nonviral etiologies and environmental factors. This widely diverse natural history  may reflect the underlying molecular mechanisms involved in the process of hepatic carcinogenesis in Egyptian patients complicating HCV type 4.

Aim: Determination  of the gene expression pattern of a cohort of biopsies from cases of Egyptian HCCs complicating chronic HCV  genotype 4 using qRT PCR technology using RT2 profiler PCR array for Human insulin signaling pathway which includes primers for 84 insulin pathway related genes.

Methods: Total RNA was extracted from 32 Formalin fixed paraffin embedded  tissues of human hepatocellular carcinoma cases and six healthy liver donors to be used as normal controls. Followed by reverse transcription of the RNA to cDNA. We then performed qRT PCR using RT2 Profiler PCR Array Human Insulin Signaling Pathway (QIAGEN) to determine the expression levels of 84 Insulin Signaling Pathway related genes. The gene expression levels were correlated to different patient/tumor characteristics.

Results: Gene dysregulation was observed in HCC patients relative to control group. Six genes namely AEBP1, AKT2, FOS, PIK3R1, PRKCI, SHC1 genes were significantly overexpressed in HCC patients relative to control group. SHC1 was the most significantly overexpressed gene (0.001)  On the other hand, Twelve genes,  namely ADRB3, DUSP14, ERCC1, FRS3, IGF2, INS, IRS1, JUN, MTOR,tPIK3R2, PPP1CA, RPS6KA1 and VEGF were significantly under expressed in HCC patients relative to the control group. Where PPP1CA and INS were the 2 most significantly under expressed genes (0.002) .

Statistically significant differences in the levels of expression of GSK3A (0.002) was observed between low and high grade HCCs.

Also, significant differences were seen in the expression of AEBP1 (0.040), AKT1 (0.024) and FBP1 (0.007) between patients below and above 60 years of age.

DOK1 (0.037) was expressed at significantly  higher levels in females as compared to male patients.

RPS6KA1 (0.034) was significantly under expressed in HBcAg positive cases as compared to negative ones.

AKT1 (0.019) and MAPK1 (0.017) were significantly upregulated  in the presence of Aflatoxin positivity whereas RPS6KA1 (0.046) was significantly under expressed.

Inn cases with thrombocytopenia, AKT1 (0.038) was significantly upregulated,  BCL2L1 (0.045) was significantly downregulated as was  VEGFA (0.038).

Cases with high AFP levels showed significant upregulation of  AKT2 .021) and PRKCI (0.016).

Conclusion: Therapy of HCC  has to based on the molecular characteristics of the particular tumor at hand.   The gene expression patterns identified in this study, especially the upregulated  ones may serve  as possible targets for therapy of HCC patients.