96. Jahrestagung der Deutschen Gesellschaft für Pathologie e. V ...

Abstracts
DO-097
Cytokeratin-positive epithelioid angiosarcoma presenting in the
tonsil: a diagnostic challenge
A . Agaimy 1 , H . Kirsche 2 , S . Semrau 3 , H . Iro 2 , A . Hartmann 1
1 Friedrich-Alexander University of Erlangen, Institute of Pathology, Erlangen,
2 Friedrich-Alexander University of Erlangen, Department of Otorhinolaryngology,
Head and Neck Surgery, Erlangen, 3 Friedrich-Alexander University of
Erlangen, Department of Radiation oncology, Erlangen
Aims. The majority of malignant neoplasms of the head and neck represent
squamous cell carcinomas while sarcomas are rare in this anatomic
region. Primary oral cavity sarcomas are exceedingly rare and may pose
a great diagnostic challenge.
Methods. A 71-year-old woman without previous history of malignancy
or radiation to the head and neck presented with an antibiotic-refractory
diffuse painful swelling of the right tonsil necessitating tonsillectomy.
Within months the patient underwent surgical resection of multiple
bleeding intraoral and gastrointestinal metastases. She is currently alive
with disease 9 months from diagnosis.
Results. Histological evaluation revealed subtotal replacement of the
right tonsil by a high-grade epithelioid neoplasm displaying extensive
ulceration, necrosis and primitive vasoformation. Immunohistochemistry
showed strong/diffuse expression of pancytokeratin (CK) antibodies
KL-1 and Lu5, CK8, CK18, CK19, vimentin, CD31, ERG and FLI-1. High
molecular weight cytokeratins (CK5, 34ß12), CK7, CK13 and CK20 were
not expressed.
Conclusions. To our knowledge, this case represents the first well documented
primary epithelioid angiosarcoma of the tonsil. The strong cytokeratin
expression in epithelioid angiosarcomas represents a diagnostic
pitfall. Thus, awareness of this rare and highly aggressive neoplasm is necessary
for distinguishing it from poorly differentiated and acantholytic
squamous cell carcinoma and diffuse large cell lymphoma.
DO-098
Lipomatous neoplasms of the salivary glands. A series of 23 cases
with emphasis on oncocytic lipoadenoma and sebaceous differentiation
A . Agaimy1 , B . Märkl2 , H . Arnholdt2 , J . Zenk3 , V . Bonkowsky4 , M . Michal5 ,
A . Skalova5 , A . Hartmann1 , S . Ihrler6 1Friedrich-Alexander University of Erlangen, Institute of Pathology, Erlangen,
2Augsburg Clinic Center, Augsburg, 3Friedrich-Alexander University of
Erlangen, Department of Otorhinolaryngology, Head and Neck Surgery, Erlangen,
4Nürnberg Clinic Center, Department of Otorhinolaryngology, Head
and Neck Surgery, Nürnberg, 5Charles University, Medical Faculty Hospital,
Department of Pathology, Pilsen, Czech Republic, 6Ludwig Maximilian University,
Munich, Department of Pathology, München
Aims. Lipomatous tumors of salivary glands are rare and have been the
subject of rare case reports in the literature. Accordingly, their morphologic
spectrum and clinicopathological features from a consecutive case
series have not been studied.
Methods. We collected 23 fatty tumors from consecutive surgical pathology
files at four large hospitals (n=17) and from consultation files of two
centers (n=6). Fat-containing pleomorphic adenoma and lipomatous
myoepitheliomas were excluded.
Results. There were 15 males and 8 females aged 18–89 yrs (mean, 55 yrs).
Most tumors (n=21) originated in the parotid gland. Two affected the
submandibular gland. Histologically, the tumors could be categorized
into three groups: ordinary lipoma (n=16; 70%), oncocytic lipoadenoma
(n=4) and non-oncocytic adenolipoma/sialolipoma (n=2). Ordinary lipomas
were either completely intraglandular or they have been submitted
as a lipomatous nodule containing minor foci of residual atrophic
serous acini at the periphery of the lipoma beneath the capsule. None
of the lipomas contained sebaceous elements or oncocytic cells. The less
38 | Der Pathologe · Supplement 1 · 2012
common oncocytic lipoadenoma (synonym: oncocytic sialolipoma) had
a fatty component ranging from 10% to 95% of the lesion that was usually
interspersed between the oncocytic acini. Sebaceous islands were found
in three of the four cases. The oncocytes showed either diffuse solid
sheets with a lobular architecture interrupted by scattered adipocytes
or were scattered between plentiful fatty tissues. The two non-oncocytic
adenolipoma (synonym: non-oncocytic sialolipoma) were predominantly
fatty (70–80%) and prominently lobulated. They displayed a biphasic
pattern with serous tissue diffusely distributed between the fatty components.
One lesion showed foci of sebaceous metaplasia.
Conclusions. Lipomatous tumors of the salivary glands are rare and most
represent intraglandular ordinary lipomas that are otherwise similar
to their soft tissue and cutaneous counterparts. While fairly absent in
ordinary salivary lipomas, sebaceous differentiation seems to be a common
feature of oncocytic lipoadenoma and non-oncocytic sialolipoma.
Lipomatous lesions of the salivary glands do not seem to be association
with other significant salivary gland pathology or to carry a risk of malignant
degeneration. Although lipomatous components in these lesions
might derive from intraglandular adipose tissue, the pathogenesis of the
oncocytic and sebaceous elements (metaplastic vs. neoplastic) remains
unclear.
AG Herz- und Gefäßpathologie
DO-100
microRNA-143 is essential in arteriogenesis
K . Troidl1 , G . Jung1 , C . Troidl2 , W . Schaper 1 , T . Schmitz-Rixen3 1Max-Planck-Institute for Heart and Lung Research, Bad Nauheim,
2 3 Kerckhoff Heart Centre, Bad Nauheim, Goethe University, Frankfurt
Aims. Arteriogenesis – the growth of pre-existing collateral arterioles to
functional arteries – is triggered by increased fluid shear stress (FSS).
MicroRNAs (miRNA) are implicated in post-transcriptional regulation
of gene expression. A FSS-induced signature pattern of miRNAs during
collateral growth might influence signal transduction of the physical
stimulus into a cellular response. We investigated the involvement of
miRNAs in arteriogenesis in a rat model of chronically elevated FSS in
collateral arteries.
Methods. 6 sprague dawley rats were subjected to femoral artery ligature
(FAL). A side-to-side anastomosis distal to the ligature was created
between the femoral artery and the accompanying vein, which leads to
chronically elevated FSS inside the collaterals. Following dissection of
collateral tissue 7 d after surgery, miRNA was isolated and an expression
profile was generated by microarray analysis. Differential expression was
confirmed by qRT-PCR. Cellular localization of selected miRNAs was
assessed by in situ hybridisation combined with immunostaining. By local
blockage of specific miRNAs in mouse collaterals we analyzed their
functional involvement in arteriogenesis.
Results. Growing collaterals showed a significant up-regulation of 6
miRNAs when compared to sham operated controls. miR-143, miR-195,
and miR-24 were localized in the media of growing collaterals. miR-24 is
also expressed in the FSS-stimulated endothelium. Blockage of miR-143
led to severe impairment of arteriogenesis.
Conclusions. These data indicate that miRNas are involved in arteriogenesis.
miR-143 belongs to a cluster which has been assigned to the phenotypic
switch of smooth muscle cells. We identified a functional implication
during vascular remodeling. Targeted modulation of this miRNA
in vivo suggests new treatment options in improvement of collateral
growth.