Background Solitary fibrous tumour (SFT) is a rare mesenchymal tumour now described at many locations, including the meninges. Intracranial SFT closely resembles meningioma clinically and radiologically, and, like meningioma, reports of meningeal SFT suggest a relatively benign behaviour after complete resection. Histopathological features distinguishing SFT from meningioma include variable cellularity, spindle cells arranged in fascicles, staghorn blood vessels and immunopositivity for CD34.Clinical presentation The case is reported of a 60-year-old man with an anterior cranial fossa meningeal-based mass, which was resected. Histology showed some features in common with SFT ( variable cellularity, spindled morphology, CD34 expression), but included an epithelioid element with cytokeratin and desmin immunopositivity, and lacked the characteristic vascular pattern of SFT. Histological features of meningioma were lacking. Recurrence of the tumour with extracranial extension 9 years later resulted in death of the patient. Histological examination revealed similar biphasic epithelioid and spindled CD34-immunopositive appearance to the earlier tumour, but in addition showed a high-grade element resembling olfactory neuroblastoma.Conclusion This case report is of a meningeal-based mesenchymal neoplasm with histological similarities to SFT. Its morphology and immunophenotype, however, are distinct from SFT and hence it is proposed that it is a newly described entity. In addition, recurrence of the tumour with a high-grade neuroblastic element has, to our knowledge, not previously been described in SFT.

Background NSCLC exhibits considerable heterogeneity in its sensitivity to chemotherapy and similar heterogeneity is noted in vitro in a variety of model systems. This study has tested the hypothesis that the molecular basis of the observed in vitro chemosensitivity of NSCLC lies within the known resistance mechanisms inherent to these patients' tumors. Methods The chemosensitivity of a series of 49 NSCLC tumors was assessed using the ATP-based tumor chemosensitivity assay (ATP-TCA) and compared with quantitative expression of resistance genes measured by RT-PCR in a Taqman Array™ following extraction of RNA from formalin-fixed paraffin-embedded (FFPE) tissue. Results There was considerable heterogeneity between tumors within the ATP-TCA, and while this showed no direct correlation with individual gene expression, there was strong correlation of multi-gene signatures for many of the single agents and combinations tested. For instance, docetaxel activity showed some dependence on the expression of drug pumps, while cisplatin activity showed some dependence on DNA repair enzyme expression. Activity of both drugs was influenced more strongly still by the expression of anti- and pro-apoptotic genes by the tumor for both docetaxel and cisplatin. The doublet combinations of cisplatin with gemcitabine and cisplatin with docetaxel showed gene expression signatures incorporating resistance mechanisms for both agents. Conclusion Genes predicted to be involved in known mechanisms drug sensitivity and resistance correlate well with in vitro chemosensitivity and may allow the definition of predictive signatures to guide individualized chemotherapy in lung cancer.

HistopathologyVolume 50, Issue 3 p. 396-397 Paratesticular mammary-type myofibroblastoma P Mukonoweshuro, P Mukonoweshuro Department of Histopathology and Department of Urology, Derriford Hospital, Plymouth, UKSearch for more papers by this authorF McCormick, F McCormick Department of Histopathology and Department of Urology, Derriford Hospital, Plymouth, UKSearch for more papers by this authorV Rachapalli, V Rachapalli Department of Histopathology and Department of Urology, Derriford Hospital, Plymouth, UKSearch for more papers by this authorS Natale, S Natale Department of Histopathology and Department of Urology, Derriford Hospital, Plymouth, UKSearch for more papers by this authorM E F Smith, M E F Smith Department of Histopathology and Department of Urology, Derriford Hospital, Plymouth, UKSearch for more papers by this author P Mukonoweshuro, P Mukonoweshuro Department of Histopathology and Department of Urology, Derriford Hospital, Plymouth, UKSearch for more papers by this authorF McCormick, F McCormick Department of Histopathology and Department of Urology, Derriford Hospital, Plymouth, UKSearch for more papers by this authorV Rachapalli, V Rachapalli Department of Histopathology and Department of Urology, Derriford Hospital, Plymouth, UKSearch for more papers by this authorS Natale, S Natale Department of Histopathology and Department of Urology, Derriford Hospital, Plymouth, UKSearch for more papers by this authorM E F Smith, M E F Smith Department of Histopathology and Department of Urology, Derriford Hospital, Plymouth, UKSearch for more papers by this author First published: 22 December 2006 https://doi.org/10.1111/j.1365-2559.2007.02588.xCitations: 19Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onEmailFacebookTwitterLinkedInRedditWechat No abstract is available for this article. References 1 McMenamin ME, Fletcher CDM. Mammary-type myofibroblastoma of soft tissue: a tumor closely related to spindle cell lipoma. Am. J. Surg. Pathol. 2001; 25; 1022–1029. Citing Literature Volume50, Issue3February 2007Pages 396-397 ReferencesRelatedInformation

We present two cases of solitary fibrous tumour (SFT) showing biphasic morphology with a spectrum of malignant epithelioid components. Slides prepared from formalin-fixed and paraffin-embedded tissue from both cases were stained with haematoxylin and eosin and by immunohistochemistry. Interphase fluorescent in situ hybridisation studies were performed in both cases using paraffin-embedded tissue to look for the t(X;18) translocation, thereby to exclude synovial sarcoma. Both cases showed biphasic morphology with some areas having typical benign spindled SFT morphology (including CD34 expression) and other areas having a malignant epithelioid appearance. In one of the cases, the epithelioid area, which was well circumscribed and showed packeting of cell groups, demonstrated expression of cytokeratin and epithelial cadherin but not of CD34. In the second case, the immunophenotype of the epithelioid component was similar to that of the benign SFT component. These findings suggest that epithelioid change in SFT shows a range of differentiation at one end, similar to that of a standard SFT, and at the other end, possibly acquiring epithelial characteristics.

B64 Introduction: NSCLC exhibits considerable heterogeneity in its sensitivity to chemotherapy. This study has tested the hypothesis that the molecular basis of this difference lies within the known resistance mechanisms inherent to these patients9 tumors.Methods: The chemosensitivity of a series of 29 tumors was assessed using the ATP-based tumor chemosensitivity assay (ATP-TCA)against cisplatin, and docetaxel, alone and in combination. The results were correlated with quantitative expression of resistance genes measured by RT-PCR in a Taqman Low Density Array (Applied Biosystems) following extraction of mRNA from formalin-fixed paraffin-processed tissue using the AB 6100 extraction system. The results were standardised against the least variable housekeeping gene (PBGD) of those tested. The relationship between chemosensitivity and gene expression was assessed by multiple linear regression analysis.Results: No individual gene expression showed direct correlation with activity in the ATP-TCA. However, docetaxel activity showed some dependence on the expression of Beta-tubulin III, BCRP, MDR1, MRP2 and GSTpi, while cisplatin activity showed some dependence on DNA repair enzyme expression (e.g. ERCC1, MLH1, MSH6). Activity of both drugs was influenced more strongly still by the expression of anti- and pro-apoptotic genes by the tumor for both docetaxel (p

Aims: To investigate the differentiation pattern of epithelioid sarcoma in terms of perineurial and endothelial differentiation, and its relationship to that of meningioma.Methods and results: Nine cases of epithelioid sarcoma and five cases of meningioma were studied in an immunohistochemical analysis of 'perineurial' antigens [GLUT-1, claudin-1, epithelial membrane antigen (EMA) and VE-cadherin] and of 'endothelial' antigens not present on normal perineurium (CD34, CD31, Fli-1). Both epithelioid sarcoma and meningioma showed frequent expression of the perineurial markers GLUT-1, claudin-1 and EMA. VE-cadherin was identified in one of five meningiomas, and in the only case of epithelioid sarcoma in which suitably fixed material was available. CD34 was expressed by all epithelioid sarcomas studied but by none of the meningiomas. Fli-1 was present in a substantial majority of epithelioid sarcomas and by all the meningiomas. CD31 was not detected in any epithelioid sarcoma or meningioma.Conclusions: The results were evaluated in the context of previous immunohistochemical, ultrastructural and genetic studies and suggest that epithelioid sarcoma may be a form of malignant perineurioma with a range of differentiation (epithelial features) akin to that seen in meningioma, reflecting the close relationship between perineurium and meningothelium.

BACKGROUND:Gastric mucosa associated lymphoid tissue (MALT) lymphoma is a low grade B cell lymphoma histologically characterised by neoplastic B cells surrounding follicles in a marginal zone pattern and selectively infiltrating epithelium to form characteristic lymphoepithelial lesions.AIMS:To identify solitary epithelial cells in gastric MALT lymphoma and investigate their nature.METHODS:Anonymised endoscopic biopsies from eight B cell gastric MALT lymphomas and 10 control biopsies from chronic atrophic gastritis were selected. The numbers of solitary cytokeratin positive epithelial cells were assessed both semiquantitatively and quantitatively in immunostained sections. Chromogranin A expression was studied in sections consecutive to those stained for cytokeratin.RESULTS:Statistical analysis of the quantitative data confirmed that solitary epithelial cells were significantly more common in the lymphomas. The study of consecutive sections showed that the single cells express chromogranin A.CONCLUSIONS:The presence of solitary, cytokeratin positive epithelial cells within the neoplastic infiltrate is a characteristic feature of gastric B cell lymphoma. These solitary epithelial cells are of neuroendocrine origin.

Piles of glass slides (fig 1) from cases pending, strewn untidily across a pathologist’s desk, adjacent to his or her microscope, is a far from uncommon sight. As one pile collapses inevitably into another, slides from different cases become increasingly jumbled, and the quick identification of the slides becomes ever more difficult. And while the pathologist eagerly awaits the arrival of the requested levels, special stains, or sections from further blocks, yet more slides (from new cases pending) invariably accumulate. We decided to investigate how common this scenario is and what could be done to improve it. …

Background: Immunocytochemical accumulation of prion protein (PrP) in lymphoid tissues is a feature of variant Creutzfeldt-Jakob disease (vCJD) that has been used both to aid in the diagnosis of patients and as a basis of large scale screening studies to assess the prevalence of preclinical disease in the UK. However, the specificity of this approach is unknown.Aim: To assess the specificity of lymphoreticular accumulation of PrP for vCJD by examining a range of human diseases.Methods: Paraffin wax embedded lymphoreticular tissues from patients with several reactive conditions (58 cases), tumours (27 cases), vCJD (54 cases), and other human prion diseases ( 56 cases) were assessed. PrP accumulation was assessed by immunocytochemistry using two different monoclonal anti-PrP antibodies and a sensitive detection system.Results: All cases of vCJD showed widespread lymphoreticular accumulation of PrP; however, this was not seen in the other conditions examined.Conclusion: Lymphoreticular accumulation of PrP, as assessed by immunocytochemistry, appears to be a highly specific feature of vCJD.

Aim: To investigate the polarity of breast invasive ductal carcinoma cells by comparing the polarity of the tumour located within lymphovascular spaces with that located in the extravascular compartment.Methods: An immunohistochemical study identifying the apical HMFG-1, basolateral AUA-1, and basal laminin polarity markers of 11 cases of invasive ductal carcinoma (grades 1 or 2) metastatic to lymph nodes, all of which contained areas of tumour within and outside of lymphovascular spaces.Results: Only one of 11 tumours had a focus of apparent reversed glandular polarity in the larger extravascular tumour compartment (with AUA-1 present internally and HMFG-1 expressed externally on tumour clumps), but six of the 11 tumours showed reversed glandular polarity (either with AUA-1, or HMFG-1, or both) within the very much smaller lymphovascular space tumour compartment. Laminin was not identified in association with lymphovascular tumour.Conclusions: Reversed glandular polarity in invasive ductal breast carcinomas was identified and was significantly more frequent within vessels than outside of them. Reversal of tumour glandular polarity within lymphovascular spaces allows direct interaction between apical domain-type molecules-which are then aberrantly expressed on the external surface of tumour clumps-and lymphovascular endothelium. Such interactions may affect the establishment of metastatic disease.

HistopathologyVolume 42, Issue 6 p. 620-621 VE-cadherin in perineuriomas A Ali, A Ali Department of Histopathology, Derriford Hospital, Plymouth, UKSearch for more papers by this authorC A Stoddard, C A Stoddard Department of Histopathology, Derriford Hospital, Plymouth, UKSearch for more papers by this authorM E F Smith, M E F Smith Department of Histopathology, Derriford Hospital, Plymouth, UKSearch for more papers by this author A Ali, A Ali Department of Histopathology, Derriford Hospital, Plymouth, UKSearch for more papers by this authorC A Stoddard, C A Stoddard Department of Histopathology, Derriford Hospital, Plymouth, UKSearch for more papers by this authorM E F Smith, M E F Smith Department of Histopathology, Derriford Hospital, Plymouth, UKSearch for more papers by this author First published: 23 May 2003 https://doi.org/10.1046/j.1365-2559.2003.01633.xCitations: 4Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onEmailFacebookTwitterLinkedInRedditWechat References 1 Scheithauer BW, Woodruff JM, Erlandson RA. Tumors of the peripheral nervous system, Fascicle 24, Third Series. Washington DC: Armed Forces Institute of Pathology, 1997; 219–236. 2 Theaker JM, Gatter KC, Puddle J. Epithelial membrane antigen expression by the perineurium of peripheral nerve and in peripheral nerve tumours. Histopathology 1988; 13; 171–179. 3 Theaker JM, Fletcher CDM. Epithelial membrane antigen expression by the perineurial cell: further studies of peripheral nerve lesions. Histopathology 1989; 14; 581–592. 4 Folpe AL, Billings SD, Walsh SV, Weiss SW. Claudin-1, a recently characterized tight junction-associated protein is a highly sensitive marker of perineurial cells and perineuriomas. Mod. Pathol. 2002; 15; 15A. 5 Smith MEF, Jones TA, Hilton D. Vascular endothelial cadherin is expressed by perineurial cells of peripheral nerve. Histopathology 1998; 32; 411–413. 6 Fetsch JF, Miettinen M. Sclerosing perineurioma, a clinicopathologic study of 19 cases of a distinctive soft tissue lesion with a predilection for the fingers and palms of young adults. Am. J. Surg. Pathol. 1997; 21; 1433–1442. 7 Burgues O, Monteagudo C, Noguera R, Revert A, Molina I, Llombart-Bosch A. Cutaneous sclerosing Pacinian-like perineurioma. Histopathology 2001; 39; 498–502. Citing Literature Volume42, Issue6June 2003Pages 620-621 ReferencesRelatedInformation

Aims: Periodic acid-Schiff (PAS)-diastase-positive material was identified within pseudoglandular structures within the small intravascular component of two pleural malignant mesotheliomas. The aim of this study was to ascertain the nature of this material and to asses the polarity of the cells forming the pseudoglandular structure.Methods and results: Immunohistochemistry was performed using antibodies to laminin and type IV collagen and the antibody HBME-1. These demonstrated the material to be basement membrane rather than mucin. The apical polarity marker HBME-1 was not related to the internal pseudoglandular structure but stained the periphery of intravascular tumour clumps.Conclusions: Pseudoluminal PAS-diastase-positive material in malignant mesothelioma may easily be mistaken for epithelial mucin, leading to an erroneous diagnosis of adenocarcinoma. The presence of basement membrane material in pseudolumina, as defined by the presence of laminin and type IV collagen, surrounded by tumour cells whose external surface expresses the apical polarity marker HBME-1 implies inversion of polarity of tumour cells within vascular spaces.

The Journal of PathologyVolume 197, Issue 1 p. 136-137 Book Review Atlas of Tumor Pathology. Tumors of the Soft Tissues. Richard L. Kempson, Christopher D. M. Fletcher, Harry L. Evans, Michael R. Hendrickson, and Richard K. Sibley. AFIP, Bethesda, MD 2001. ISBN: 18810416 M. E. F. Smith, M. E. F. Smith Derriford Hospital, PlymouthSearch for more papers by this author M. E. F. Smith, M. E. F. Smith Derriford Hospital, PlymouthSearch for more papers by this author First published: 10 April 2002 https://doi.org/10.1002/path.1090Citations: 1Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat No abstract is available for this article.Citing Literature Volume197, Issue1May 2002Pages 136-137 RelatedInformation

#### Case history A 53 year old woman presented in October 1987 with a several week history of dyspnoea and left sided pleuritic chest pain. A chest x ray showed a left sided pleural effusion, cytology of which showed reactive mesothelial cells. The effusion recurred in January 1990, prompting bronchoscopic and thoracoscopic examinations. The broncoscopy revealed no abnormalities but the thoracoscopy showed thickening of the pleura at the left lung base. After a pleural biopsy, a diagnosis of metastatic poorly differentiated non small cell carcinoma was made. The patient received six cycles of cisplatin/carboplatin and responded well. However, in 1994, computed tomography revealed a small tumour in the …