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  #1  
Old 10-30-2012
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Microscope Immunohistochemical staining-Guys crack this!

Q. Clinical study is performed on biopsy specimens obtained from patients who had a malignant neoplasm. It is observed that a subset of these biopsies shows a neoplasm composed predominantly of cells with a spindle shape and a high N/C ratio with marked pleomorphism. These cells are vimentin positive, cytokeratin negative, and CD45 negative by immunohistochemical staining. This type of neoplasm is most likely to have been diagnosed in which of the following patients?
A A 35 yr. old woman with a left breast mass and enlarged axillary lymph nodes
B A 55 yr. old woman with massive ascites and multiple peritoneal metastases
C A 25 yr. old man with an enlarged left testis
D A 15 yr. old man with a mass in the left femur and lung metastases
E A 5 yr. old man with a right renal mass

I saw this when i was looking for a mnemonic to remember IHC Staining...i know it's asking which disorder arises from a connective tissue but i need y'all to make input...
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Old 10-30-2012
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Also,is it high yield to cram those IHC stains? someone please help!
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  #3  
Old 10-30-2012
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Default my asnwer D

mmmm it`s a WDF Qs, but vimentin positive indicates a conective tissue affected (BONE?) and CD45 negative wich is "marker" of hematopoietic stem cell (leukocite linage) and " spindle shape cells" can resemble GIANT CELL TUMOR (Osteoclastoma),,, but not completely sure
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  #4  
Old 10-30-2012
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B -Kruckenberg tumour?
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Old 10-31-2012
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spindle shaped cells with vimentin positive indicates SARCOMA
?OSTEOSARCOMA
MY ANS IS A 15 yr. old man with a mass in the left femur and lung metastase
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  #6  
Old 10-31-2012
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Correct Answer D may be the answer

Ok like i said,i didn't know exactly what the answer would be but from research and the inputs from you guys,i think D is it.Osteosarcoma arises from connective tissue,that we all know and has a metastasis to the lung which is the most common cause of death in patients with it.Also,the age range for the patient in option D falls has the highest frequency rate and femur is the most common site according to emedicine.Read more here http://emedicine.medscape.com/articl...overview#a0103 if there's a better explanation,please bring it up!
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Hey buddys I found this page really interesting about vimentin as tumor marker

http://www.aaomp.org/annual-meeting/...%20Handout.pdf

(check page 23 and 24)

so the answer may be letter B

B) A 55 yr. old woman with massive ascites and multiple peritoneal metastases
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Old 10-31-2012
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also thinking B) ---ovarian tumor(FA-2012 pg.547)
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