Recent advances in computer technology have been made and image analysis (IA) has been introduced into pathological fields. The present study aimed to investigate the utility of IA for the evaluation of nuclear features and staining of immunohistochemistry (IHC) for Ki-67, p53 and GATA-binding protein 3 (GATA-3) in urothelial carcinoma tissue samples. A total of 49 cases of urothelial carcinoma tissue samples were obtained by transurethral resection of bladder tumors, which included 11 low-grade papillary urothelial carcinomas (LGPUCs), 1 non-invasive high-grade urothelial carcinoma and 37 infiltrating urothelial carcinomas (IUCs). Whole slide imaging (WSI) and IA were performed in Feulgen reaction and IHC-stained tissue samples. There was a significant difference in the average nuclear density, standard deviation (SD) of nuclear size and SD of nuclear minimum and maximum diameter between LGPUC and IUC, which is equivalent to the diagnostic features of IUC in nuclear variability, and hyperchromatic nuclei. In addition, the present study revealed that the SD of nuclear density was significantly different between the two groups. Regarding IA in IHC-stained tissue samples, Ki-67 was significantly overexpressed in IUC. Furthermore, the GATA-3 expression level in IUC samples with muscle invasion was significantly downregulated compared with that in non-muscle invasive tumors. The results of the present study suggest that IA in combination with WSI may be a beneficial tool for evaluating morphometric characteristics and performing semi-quantitative analysis of IHC.

Primary villoglandular mucinous adenocarcinoma of the vulva is rare tumor. We report a case of 68-year-old woman who developed this very uncommon malignant tumor. Immunohistochemical examination of this tumor revealed positive staining for Cytokeratin 20, Mucin 2, and CDX2, although Cytokeratin 7 and Mucin 6 were negative. This positive staining indicated the tumor enteric type characters. In order to exclude the possibility of the metastasis from another site, we thoroughly evaluated clinical data and extensively investigated the whole body. However, we could not detect any other tumors. The patient was treated by tumor resection. The patient remains free of disease 5 years after surgery.

Metaplastic carcinoma of the breast with widespread telangiectatic form of osteosarcomatous differentiationTo the Editor: Metaplastic carcinoma (MC) of the breast is relatively rare among invasive breast cancers. MC represents a heterogeneous group of neoplasms that show a variety of appearances which can be classified into five groups according to the 2012 World Health Organization classification of breast tumours: low-grade adenosquamous carcinoma; fibromatosis-like MC; squamous cell carcinoma; spindle cell carcinoma; and MC with mesenchymal differentiation. 1 In particular, MC with heterologous mesenchymal components is very uncommon. We describe a case of MC that showed widespread telangiectatic form of osteosarcomatous differentiation, and highlight the clinicopathological findings.A 73-year-old woman presented with a right subareolar enlarging cystic mass that had been identified 3 months earlier, during follow-up for gastric cancer. She had no history of breast tumor. The lesion enlarged from 13 to 40 mm within the 3 months from first identification. Aspiration cytology and core needle biopsy were performed, but a diagnosis could not be reached due to inadequate samples. After intraoperative excision biopsy revealed malignancy, right mastectomy and sentinel lymph node dissection were performed. DISCLOSURE STATEMENTNone declared.

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