96. Jahrestagung der Deutschen Gesellschaft für Pathologie e. V ...
96. Jahrestagung der Deutschen Gesellschaft für Pathologie e. V ...
96. Jahrestagung der Deutschen Gesellschaft für Pathologie e. V ...
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Abstracts<br />
by H&E, Pas-Alcian and immunohistochemical staining by CK7, CK 19,<br />
EMA, AMACR, Vimentin, NSE, Chromogranin, Synaptophysen, CD 10,<br />
CD 15, CD 57 and Ki-67. A FISH-analysis was done for chromosom 7 and<br />
17.<br />
Results. Classic cases of MTSCC mainly show a relative homogeneous<br />
tubular architecture with low grade morphology and typical mucinous<br />
stroma. The latter react pale for Pas and contains in Acian-blue-reaction<br />
acid mucopolysaccids. In most cases more or less areas of papillary,<br />
plexiforme or glomeruloid growth pattern exists. In parts with very close<br />
packed tubuli the cells become a spindle shape character because of<br />
compression of the tubulus but with predominant low grade atypia. Immunohistochemistry<br />
react positive for CK 7, Ck 19, EMA, AMACR and<br />
Vimentin. Neuroendocrine markers show different pattern. CD 10 reacts<br />
negative. FISH-analysis brought different results for PRCC and MTSCC.<br />
Conclusions. The main part of the MTSCC represents the described tubular<br />
architecture with low grade atypia and typical mucinous extracellular<br />
stroma component in variable dimension. Despite the classic<br />
pattern different extent of other differentiation pattern like papillary,<br />
spindle shaped, plexiforme or glomeruloid occur in the cases. Only in<br />
exceptions tubular growth pattern was displaced by last named differentiations.<br />
Especially papillary growth pattern make it difficult to distinguish<br />
MTSCC from other renal cell carcinomas especially PRCC. The<br />
demarcation to the other types is important because of prognostic differences.<br />
Immunohistochemistry could help with CD 10 negativity but<br />
this reaction is however non-specific. Against this background molecularpathologic<br />
methods are due to help, but also with limitations.<br />
SA-P-089<br />
Solitary fibrous tumor of the kidney<br />
M . Gajda1 , S . Harz1 , H . Wun<strong>der</strong>lich2 , K . Junker2 , M . Grimm2 , D . Katenkamp 1 ,<br />
I . Petersen1 1 2 Institute of Pathology, Jena University Hospital, Department of Urology,<br />
Jena University Hospital<br />
Aims. Solitary fibrous tumors (SFT) are rare spindle cell neoplasms usually<br />
arising in the pleura. They have, however, also been reported at extrapleural<br />
locations. Urogenital localization is rare and to our knowledge,<br />
only 40 cases of SFT of the kidney have been described.<br />
Methods. Detailed clinical and histopathological review of a clinical case<br />
and review of the literature.<br />
Results. We report the case of a typical SFT of the right kidney in a 71-year-old<br />
woman. As part of a CT investigation, a large mass of the right<br />
kidney with suspicion thrombembolic compression and occlusion of the<br />
inferior vena cava was discovered. She un<strong>der</strong>went radical nephrectomy<br />
and lymphadenoctomy, adrenalectomy and interaortocaval lymph node<br />
dissection. The gross specimen included the kidney (12.8×6.6×7.5 cm),<br />
ureter and adrenal gland. Cut section showed a circumscribed pale<br />
brown mass measuring 9.6×7.4×5.2 cm tumor. The tumors consisted of<br />
bland-looking spindle cells arranged in short, ill-defined fascicles and<br />
storiform pattern with characteristic hemangiopericytoma-like blood<br />
vessels. Immunohistochemistry showed reactivity for vimentin, CD 34,<br />
BCL-2 protein and CD99. Immunohistochemical stains for cytokeratin,<br />
S-100, desmin, a-smooth muscle actin, RCC, EMA and CD 10 were negative.<br />
Ki67 labelling index exceeded 10%.<br />
Conclusions. The possibility of SFT should be consi<strong>der</strong>ed in the differential<br />
diagnosis of a renal mass which consists of benign-looking spindle<br />
cells and hemangiopericytomatous blood vessels. Its diagnosis requires<br />
immunohistochemistry and awareness of its possible existence.<br />
166 | Der Pathologe · Supplement 1 · 2012<br />
Poster: Uropathologie II<br />
SA-P-090<br />
Topotecan sensitizes renal cell carcinomas towards ABT-263<br />
induced apoptosis<br />
S . Heikaus1 , V . Nitsche1 , S . Funke1 , H .E . Gabbert1 , C . Mahotka1 1Heinrich-Heine University Hospital, Institute of Pathology, Düsseldorf<br />
Aims. Renal cell carcinomas (RCCs) exhibit a marked resistance towards<br />
conventional chemotherapeutic regiments, thus making new therapeutic<br />
approaches necessary. So-called “targeted therapies” could be one strategy<br />
to overcome this broad resistance. Whereas “targeted therapies” with<br />
Kinase-Inhibitors like Sunitinib or Sorafenib are established in RCCs,<br />
therapies directly targeting apoptotic pathways are not validated. In this<br />
context, the BCL-2 inhibitor ABT-263 might be a promising new agent,<br />
aiming at the mitochondrial pathway of apoptosis, which is impaired in<br />
RCCs. We therefore examined the apoptotic effects of ABT-263 alone<br />
and in combination with Topotecan on the apoptosis of RCC cell lines.<br />
Methods. Cell culture, cell count, quantitative real-time detection PCR,<br />
Western Blot, Fluorescent Immunohistochemistry, Ribonuclease Protection<br />
Assay.<br />
Results. 1.) Expression of pro- and antiapoptotic BCL-2 family members<br />
was analysed in 7 RCC cell lines. Surprisingly, all cell lines expressed<br />
not only multiple antiapoptotic but also important proapoptotic BCL-<br />
2 family members of all functional groups on the mRNA and protein<br />
level. 2.) ABT-263 and Topotecan induced apoptosis but not autophagy<br />
in RCCs. 3.) Sensitivity towards ABT-263 induced cell death inversely<br />
correlated with the expression of MCL-1. 4.) Topotecan downregulated<br />
MCL-1 protein expression in RCCs; in contrast, ABT-263 upregulated<br />
MCL-1 protein expression, whereas the expression of most of the other<br />
BCL-2 family members remained unchanged. 5.) Topotecan pretreatment<br />
weakly sensitized RCC cell lines towards ABT-263 induced apoptosis<br />
by synergistically activating the mitochondrial pathway of apoptosis.<br />
Conclusions. Inhibition of antiapoptotic BCL-2 family members by BCL-<br />
2 inhibitors like ABT-263 might be a promising new approach in terms<br />
of a “targeted therapy” in RCCs. Furthermore, a combination with other<br />
chemotherapeutic agents can obviously enhance their proapoptotic effects.<br />
SA-P-091<br />
Cadherin expression in different histological types of papillary<br />
renal cell carcinoma: a diagnostic tool<br />
C .L . Behnes1 , B . Hemmerlein1 , A . Strauss2 , H .-J . Radzun1 , F . Bremmer1 1 2 University of Göttingen, Institute of Pathology, University of Göttingen,<br />
Institute of Urology<br />
Aims. Cadherins constitute a family of transmembrane glycoproteins<br />
and include a variety of subtypes, of which E-cadherin has been widely<br />
studied. Functionally, the cadherins belong to the adhesion molecules<br />
and form cell-cell contacts. Furthermore they also play a role in the development<br />
of different organs and in tumorigenesis. The papillary renal<br />
cell carcinoma (RCC) is a rare tumor and is divided, based on histological<br />
criteria, into two subtypes, from which the type II papillary RCC<br />
do have a worse prognosis. There are no immunohistochemical markers<br />
for the distinction of these subtypes. Therefore we have examined<br />
the expression of four different cadherins in both subtypes of papillary<br />
RCC in or<strong>der</strong> to find any diagnostically relevant differences.<br />
Methods. The expression of N-, P-, E- und KSP-Cadherin was deternined<br />
in 22 papillary RCC of histological type I and 18 papillary RCC of<br />
histological type II (n=40). The intensity of membranous and cytoplasmic<br />
immunhistochemical staining was semiquantitativly evaluated by<br />
a score from 0 to 3. To compare the data for significant differences we<br />
used the Wilcoxon-Test.