UNASSIGNED: Prurigo nodularis (PN) is a chronic dermatologic condition presenting as multiple papulonodular lesions occurring with intense pruritus. Though numerous agents (topical, systemic, phototherapy and biological drugs) have been tried, the outcomes are variable.
UNASSIGNED: The aim of this study was to assess the role of topical and systemic therapies in primary PN by comparing the Pruritus Grading System (PGS) score at baseline and 1 month post-therapy.
UNASSIGNED: Of 86 diagnosed cases of PN, 49 cases of primary PN were clinically graded by Pruritus Grading System Score (PGSS), and assessed histopathologically by IHC staining (STAT-1, 3, and 6). Apart from topical agents, oral nortriptyline (mild grade), methotrexate (moderate grade) and thalidomide (severe grade) were administered, whereas doxepin was administered for itching. The PGSS was assessed after 1 month of therapy.
UNASSIGNED: Among 49 patients of PN, the majority of patients showed a significant decrease in PGSS (P = <0.001) in 1 mont, which correlated with STAT-6 expression. The combination of different topical and oral agents resulted in a statistically significant change in severity, though individual drugs did not achieve statistically significant results.
UNASSIGNED: A combination of selected oral and topical agents can effectively control the severity of PN within one month, and this was found to correlate with STAT 6 expression.

BACKGROUND: Prurigo nodularis (PN) is a chronic dermatologic condition manifesting as multiple papulonodular lesions occurring on the background of intense pruritus. PN could be primary or secondary. The exact immune pathogenesis of PN is not yet clear, and multiple pathways are proposed with the JAK-STAT pathway rarely being investigated.
OBJECTIVE: In this study, our aim was to assess the role of Th cells in PN by comparing the expression of STAT 1, 3, and 6 in involved and normal skin of primary prurigo nodularis.
METHODS: A total of 49 clinico-histopathologically proven cases of primary prurigo nodularis were included. Two skin biopsies for each patient from lesional and non-lesional skin were stained with STAT 1, 3, and 6, and the nuclear staining pattern in the epidermis was graded as strong, moderate, weak, or none.
RESULTS: Statistically significant expression of STAT 3 and STAT 6 staining was seen in the epidermis of the lesional skin as compared to non-lesional skin.
CONCLUSIONS: Our study showed a marked dominance of STAT 3 and STAT 6 staining in the epidermis which signifies that the keratinocytes play an important role in PN and suggest that Th2, Th17, and Th22 cytokines mediate the tissue response in PN.

OBJECTIVE: Optimization of diagnosis and treatment of patients with solitary fibrous tumor of pleura, analysis of overall survival and disease-free survival, predictors of recurrence.
METHODS: There were 66 patients with solitary fibrous tumor of pleura (26 men and 40 women) aged 57.6 years (range 26-80 years). Asymptomatic course was found in 29 (44%) patients, various symptoms - in 37 (56%) patients. Thoracotomy was applied in 36 patients, thoracoscopy - in 30 patients. Immunohistochemical examination included analysis of definition of Stat6 expression.
RESULTS: Benign variant of SFT was diagnosed in 50 (75.7%) patients, malignant variant - in 16 (24.3%) patients. STAT6 expression was observed in all cases. Postoperative morbidity was 9%, mortality - 1.6%. Recurrence was diagnosed in 2 (4%) patients with benign variant of disease and in 5 (31.2%) patients with malignant variant (2 of them died from progression of disease). Progression-free survival was 89.4%, overall survival - 95.4%. Predictors of recurrence are tumor dimension over 10 cm, necrosis and/or hemorrhagic component of tumor, mitotic count of at least four per 10 high-power fields.
UNASSIGNED: Olitary fibrous tumor of pleura is a rare mesenchymal fibroblastic neoplasm growing from submesothelial layer. Differential and preoperative morphological diagnosis of SFT is difficult and demands a special immunohistochemical examination with analysis of Stat 6 expression. Surgery is preferred for tumor de novo and recurrent neoplasm.
UNASSIGNED: Оптимизация диагностики и лечебной тактики у больных солитарной фиброзной опухолью (СФО) плевры, определение общей и безрецидивной выживаемости, выявление предикторов высокого риска рецидива.
UNASSIGNED: В торакальном отделении МНИОИ им. П.А. Герцена и МГОБ №62 ДЗМ с 2001 по 2018 г. оперированы 66 больных СФО плевры. Возраст больных варьировал от 26 до 80 лет (в среднем 57,6 года). Мужчин было 26 (39,4%), женщин — 40 (60,6%). У 29 (44%) больных отмечено бессимптомное течение, у 37 (56%) — различная симптоматика. Всем больным произведено хирургическое лечение. Торакотомный доступ применен у 36, торакоскопия — у 30 больных. Иммуногистохимическое исследование обязательно включало определение экспрессии Stat 6.
UNASSIGNED: Доброкачественный вариант СФО диагностирован у 50 (75,7%), злокачественный — у 16 (24,3%) больных. У всех больных при иммуногистохимическом исследовании выявлена экспрессия Stat 6. Частота послеоперационных осложнений составила 9%, летальность — 1,6%. Рецидив заболевания при доброкачественном варианте возник у 2 (4%) больных, при злокачественном — у 5 (31,2%). Двое (3%) больных со злокачественным вариантом СФО плевры погибли от прогрессирования заболевания. Безрецидивная выживаемость составила 89,4%, общая выживаемость — 95,4%. Предикторами высокого риска рецидива являются размеры образования более 10 см, некроз и/или геморрагический компонент в опухолевом узле, высокий клеточный состав, большое количество митозов (более 4 в 10 полях зрения).
UNASSIGNED: СФО плевры — редкая мезенхимальная опухоль фибробластической природы, развивающаяся из субмезотелиального слоя. Дифференциальная и дооперационная морфологическая диагностика СФО сложна и требует специального иммуногистохимического исследования с определением экспрессии Stat 6. Основным методом лечения является хирургический, в том числе и при рецидиве заболевания.

Solitary fibrous tumor (SFT) is a mesenchymal tumor initially described in the pleura. When the tumor is located in the pleura and the classic histologic findings are present, the diagnosis of SFT can be straightforward. However, the cytologic diagnosis of perigastric SFT can be challenging due its rarity with only one cytology case report. Another confounding factor is its potential mimicry with other perigastric/gastric mesenchymal tumors. Herein, we report a case of perigastric SFT diagnosed on cytology in conjunction with immunohistochemical stains. The patient is a 79-year-old woman who presented with an enlarging perigastric mass on computerized tomography scan which was highly concerning for a saccular aneurysm. Endoscopic ultrasound (EUS) revealed a 6.6 cm hypoechoic lesion abutting the stomach. An EUS-guided fine needle aspiration was performed. The smears showed singly scattered to clusters of bland spindle cells with scant cytoplasm dispersed in a bloody background. The cell block showed similar spindle cells focally supported by a collagenized stroma. Immunohistochemical stains performed on the cell block showed the tumor cells were positive for CD34, BCL2, and STAT6 and negative for CD117, DOG1, CD31, ERG-ENDO, AE1/AE3, S-100, desmin, and synaptophysin, supporting the diagnosis of solitary fibrous tumor.

The diagnosis of spindle cell lesions of the breast parenchyma is challenging. Some of these lesions share the expression of CD34, posing differential diagnostic problems, especially in core biopsies. Recently, antibodies against the STAT6 C-terminal, are being used in paraffin-embedded tissues as a surrogate for identifying the NAB2-STA6 fusion gene which is considered a specific molecular marker for solitary fibrous tumor. Accordingly, we investigated the expression of STAT6 in a large series of uncommon spindle cell tumor-like and tumor lesions occurring primarily in the breast parenchyma. We collected 10 classic-type myofibroblastomas, 9 desmoid-type fibromatosis, 6 spindle cell metaplastic carcinoma, 5 benign fibroblastic spindle cell tumors, 3 solitary fibrous tumors, 7 pseudoangiomatous stromal hyperplasias, 2 reactive spindle cell nodules, 1 leiomyoma, 1 spindle cell lipoma, 1 case of inflammatory pseudotumor, 1 nodular fasciitis, 1 myxoma and 1 dermatofibrosarcoma protuberans. A diffuse and strong nuclear STAT6 expression was restricted only to solitary fibrous tumors, while the other lesions were negative or showed only weak cytoplasmic expression. The present study confirms that the demonstration of a diffuse and strong STAT6 nuclear staining is very helpful in distinguishing solitary fibrous tumor from other spindle cell mimics arising in the breast.