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1
Marpeau, O., P. Y. Ancel, M. Antoine, S. Uzan, and E. Barranger. "Cancers du sein bilatéraux synchrones : facteurs de risque, diagnostic, histologie, traitement." Gynécologie Obstétrique & Fertilité 36, no. 1 (January 2008): 35–44. http://dx.doi.org/10.1016/j.gyobfe.2007.09.021.
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Schneider, Udo, Werner Stenzel, and Bruno Stuhlmüller. "Biomarker und Histologie bei idiopathischen inflammatorischen Myopathien." Aktuelle Rheumatologie 46, no. 04 (August 2021): 343–60. http://dx.doi.org/10.1055/a-1548-8934.
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ZusammenfassungDie idiopathischen inflammatorischen Myopathien (IIM) sind eine Gruppe entzündlicher Muskelerkrankungen für deren Diagnosestellung, Verlaufsbeurteilung, Prognoseabschätzung und Risikostratifizierung Biomarker eine jeweils essentielle Rolle spielen. Biomarker in diesem Kontext können sowohl „herkömmliche“ serologische Marker wie Muskelenzyme oder Autoantikörper, histologische Marker wie entitätsspezifische inflammatorische Muster, aber auch genomische und genetische Marker sein. Der vorliegende Artikel gibt einen Überblick über bewährte und innovative Marker.
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Cussigh, Christiane S., Ferdinand Toberer, Alexander Enk, Holger A. Haenssle, and Christine Fink. "Therapieansprechen auf intraläsionale Steroidinjektionen bei granulomatöser Entzündungsreaktion nach Tätowierungen." Der Hautarzt 71, no. 10 (July 21, 2020): 805–8. http://dx.doi.org/10.1007/s00105-020-04654-8.
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Zusammenfassung Tätowierungen inklusive Permanent-Make-up können diverse Komplikationen wie virale oder bakterielle Infektionen sowie allergische und entzündliche Reaktionen nach sich ziehen. Bei Letzteren weist die Histologie neben exogenem Pigment ein Entzündungsinfiltrat auf, das je nach Reaktionsmuster lymphozytär oder histiozytär-granulomatös dominiert sein kann. Nachfolgend wird über die erfolgreiche Therapie mittels intraläsionaler Triamcinolonacetonid-Injektionen bei granulomatöser Entzündungsreaktion nach Tätowierungen in 2 Fällen berichtet.
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Hoepffner, N. "Diagnostik bei chronisch entzündlichen Darmerkrankungen." Arthritis und Rheuma 33, no. 03 (2013): 163–68. http://dx.doi.org/10.1055/s-0037-1618181.
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ZusammenfassungColitis ulcerosa und Morbus Crohn sind chronisch entzündliche Erkrankungen des Gastrointestinaltraktes, die multifaktoriell auf einer inadäquaten Immunantwort auf die intestinale Mikroflora bei genetisch empfänglichen Individuen unter bestimmten Voraussetzungen beruht. Eine zentrale Rolle in der Diagnostik kommt der klinischen Untersuchung und Anamnese zu, ergänzt durch Endoskopie und Histologie und weitere bildgebende Verfahren. Wichtig ist die Berücksichtigung möglicher Differenzialdiagnosen sowie der Möglichkeit der extraintestinalen Manifestation einer chronisch entzündlichen Darmerkrankung, die oftmals richtungsweisend in der Erstdiagnose sein kann.
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Katsios, Andreas, George N. Thalmann, and Tobias Gross. "Die unklare Nierenraumforderung: wie weiter?" Urologie in der Praxis 22, no. 4 (November 9, 2020): 142–46. http://dx.doi.org/10.1007/s41973-020-00116-9.
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ZusammenfassungRaumforderungen der Niere sind eine heterogene Gruppe von benignen und malignen Tumoren. Eine entscheidende Rolle bei der weitergehenden Differenzierung und auch Überwachung spielt die Bildgebung. In gewissen Fällen kann eine Biopsie sinnvoll sein, insbesondere bei der Abklärung von metastasierten Leiden oder vor ablativen Verfahren zur Gewinnung einer Histologie. Bei T1/T2-Tumoren sollte, wenn immer vertretbar, eine Nierenteilresektion angestrebt werden, die minimal-invasiven Operationen sind zunehmend die Modalität der Wahl, jedoch sollte die minimal-invasive Methode nicht auf Kosten eines Nierenerhalts forciert werden. Bei älteren und komorbiden Patienten mit kleinen Nierentumoren ist die aktive Überwachung eine valide Alternative zur unmittelbaren Chirurgie.
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Kretzschmar, Alexander. "Positive Daten auch bei Problemindikationen: Die Hoffnung überwiegt." Onkologische Welt 01, no. 06 (2010): 260–62. http://dx.doi.org/10.1055/s-0038-1631095.
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Mit mehr als 14 000 Teilnehmern konnte der ESMO-Kongress 2010 in Mailand einen neuen Besucherrekord verzeichnen, wie ESMO-Präsident Prof. David Kerr Oxford/ Großbritannien verkündete. Neben hoffnungsvollen neuen Studiendaten, beispielsweise beim NSCLC, dem tripelnegativen Mammakarzinom oder dem metastasierten Prostatakarzinom, zeigten einige negative Studien, dass die modernen zielgerichteten Therapien sehr überlegt eingesetzt werden müssen, um erfolgreich zu sein. Dies wird aus einigen Studien deutlich, deren Protokolle in einer Zeit entwickelt wurden, in der man noch von einem vergleichsweise breiten Einsatz dieser Substanzen ausging. Heute weiß man, dass die Identifikation der Patientenpopulation mit dem „richtigen” Rezeptor- und Mutationsprofil und der passenden Histologie eine wesentliche Voraussetzung für den Therapieerfolg ist.
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Monasterio, Carmen, Annegrit Decker, Franziska Schauer, Nico Büttner, Arthur Schmidt, Annette Schmitt-Gräff, and Wolfgang Kreisel. "Der Lichen planus des Ösophagus – Eine unterschätzte Erkrankung." Zeitschrift für Gastroenterologie 59, no. 05 (April 8, 2021): 460–69. http://dx.doi.org/10.1055/a-1378-9380.
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ZusammenfassungEine Beteiligung des Ösophagus bei der Hauterkrankung Lichen planus wurde erstmals 1982 beschrieben und fast 30 Jahre lang als eine Rarität angesehen. Untersuchungen der letzten 10 Jahre aber zeigen, dass diese Erkrankung weniger selten ist als angenommen. Es ist sogar anzunehmen, dass der ösophageale Lichen planus (Esophageal Lichen planus, ELP) häufiger ist als die Eosinophile Ösophagitis (EoE). Die Ösophagusbeteiligung betrifft meist Frauen im mittleren Alter. Das Hauptsymptom ist eine Dysphagie. Endoskopisch erkennt man in der Speiseröhre eine charakteristische Schleimhautablösung, eine Trachealisierung, und gelegentlich Hyperkeratosen und bei langem Bestehen auch Stenosen. Wegweisend ist die Histologie mit einer subepithelialen Ablösung sowie einem bandförmigen Infiltrat aus T-Lymphozyten, dem Nachweis von apoptotischen Keratinozyten (Civatte Bodies) und Dyskeratosen. Die direkte Immunfluoreszenz zeigt Fibrinogen-Ablagerungen entlang der Basalmembran. Eine etablierte Therapie gibt es bisher nicht. Die Behandlung mit topischen Steroiden ist in 2/3 der Fälle wirksam. Eine Therapie wie beim klassischen Lichen planus scheint unwirksam zu sein. Bei symptomatischen Stenosen kann eine Dilatation indiziert sein. Der ELP reiht sich in die Gruppe der „neuen“ immunologisch vermittelten Erkrankungen des Ösophagus ein.
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Nickeleit and Mihatsch. "Warum lässt sich die Nierenbiopsie nicht durch nicht-invasive Methoden ersetzen?" Praxis 91, no. 15 (April 1, 2002): 650–52. http://dx.doi.org/10.1024/0369-8394.91.15.650.
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Erkrankungen der Niere sind häufig fokaler Natur und befallen primär oft einzelne Kompartimente der Niere – Arterien, Arteriolen, Glomerula oder tubulo-interstitieller Raum. Als Folgeveränderung können dann andere Kompartimente miterkranken. Der Krankheitsprozess kann in einer potentiell reversiblen Frühphase oder aber irreversiblen, vernarbten Spätphase vorliegen. Derartige Veränderungen sind nur histologisch adäquat zu charakterisieren. Morphologische Untersuchungen basierend auf Licht-, Immunfluoreszenz- und Elektronenmikroskopie ermöglichen eine Diagnosestellung und geben therapeutisch und prognostisch relevante Hinweise. Die Histologie liefert die Basis für die pathophysiologische Analyse von Nierenerkrankungen. Nach wie vor ist die Biopsie unübertroffen, um eine Funktionsstörung der Eigen- oder Transplantatniere abzuklären. Von einem Ersatz der Nierenbiopsie durch nicht-invasive Methoden kann in naher Zukunft nicht die Rede sein. Die Biopsie wird eher noch an Bedeutung gewinnen.
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Högger, Lisa, and Stephan Vavricka. "Mikroskopische Kolitis." Praxis 107, no. 22 (October 2018): 1195–99. http://dx.doi.org/10.1024/1661-8157/a003099.
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Zusammenfassung. Die mikroskopische Kolitis (MC) ist immer noch eine unterschätzte Ursache einer chronischen, nicht blutigen Diarrhö. Typischerweise manifestiert sich die Erkrankung bei älteren Patienten, mit einer Dominanz bei Frauen. Die Inzidenz ist zunehmend. Ursache und Pathophysiologie sind unklar, scheinen aber multifaktoriell zu sein. Die Erkrankung ist familiär gehäuft und tritt häufig in Zusammenhang mit anderen Autoimmunerkrankungen auf. Die Diagnose der mikroskopischen Kolitis wird, wie der Name impliziert, anhand der Histologie gestellt. Es lassen sich histologisch zwei Formen unterscheiden: Die lymphozytäre Kolitis (LC) und die kollagene Kolitis (CC). Der Krankheitsverlauf ist benigne, jedoch kommt es häufig zu einem chronisch rezidivierenden Verlauf. Durch die Symptome ist die Lebensqualität der Patienten beeinträchtigt. Aus diesem Grund sind die richtige Diagnose und damit die Zuführung zu einer adäquaten Therapie für den Patienten wichtig. Ziel ist, das Bewusstsein für die Erkrankung zu steigern.
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Schröder, Sören, and Thomas Günther. "Verbesserte mikroskopische Diagnostik des ösophagealen Soorbefalls durch zusätzliche Zytospin-Analyse der Fixationslösung von Ösophagusbiopsien." Zeitschrift für Gastroenterologie 56, no. 07 (May 9, 2018): 752–55. http://dx.doi.org/10.1055/a-0606-5689.
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ZusammenfassungDer Nachweis oder Ausschluss einer Soor-Ösophagitis, der häufigsten infektiösen Erkrankung der Speiseröhre, gehört zu den Standardaufgaben der diagnostischen Histopathologie. Die Pilzhyphen besiedeln überwiegend nur die obersten Schichten des ösophagealen Plattenepithels. Eine ungünstige Positionierung der Biopsiepartikel im Paraffinblock kann eine Ursache sein, weshalb die Biopsiehistologie ein falsch-negatives Ergebnis liefert. Die vorgelegte Untersuchung sollte prüfen, ob die hier bestehende diagnostische Lücke durch die Zytospin-Analyse der Fixationslösung verbessert werden kann.Analysiert wurden von 150 konsekutiven Patienten mit klinischer Diagnose oder Fragestellung „Soor“ oder „Soor-Ösophagitis“ eingesandte Ösophagusbiopsien. Unter jeweiliger Verblindung des Pathologen hinsichtlich des Ergebnisses der anderen Analyse wurden parallel einerseits die Gewebsproben konventionell histologisch mittels Hämatoxylin-Eosin- und PAS-Färbung sowie andererseits Zytospin-Präparationen des üblicherweise nach Entnahme der Biopsien aus dem Einsendungsröhrchen entsorgten Formalins zytologisch auf den Nachweis von Pilzhyphen untersucht. Die zytologischen Präparate wurden ebenfalls PAS-gefärbt. Von den 89 Zytospin-positiven Fällen lag in 64 Fällen (71,9 %) ein positives Ergebnis der routinehistologischen Untersuchung vor. In den verbleibenden 25 Fällen (28,1 %) wurden Pilzhyphen histologisch erst bei Reevaluation der Originalschnitte (n = 6) oder nach kompletter Aufarbeitung des Paraffinblocks (n = 5) gesichert oder ließen sich auch nach vollständiger Aufarbeitung des Paraffinblocks nicht nachweisen (n = 14). Nur bei einem der 61 Zytospin-negativen Untersuchungsfälle erbrachte die Histologie einen positiven Candida-Nachweis und bei allen anderen Proben ein ebenfalls negatives Resultat.Unsere Ergebnisse zeigen, dass die diagnostische Sicherheit beim Nachweis eines ösophagealen Soorbefalls um mehr als ein Viertel erhöht werden kann, wenn über die routinemäßig durchgeführte Histologie der Biopsieproben hinaus auch eine zytologische Analyse der Fixationslösung vorgenommen wird.
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Hüfner, M., P. Georgi, and G. Berding. "Thyreoglobulin, 131J-Ganzkörperszintigraphie und Risikofaktoren in der Nachsorge des differenzierten Schilddrüsenkarzinoms." Nuklearmedizin 31, no. 01 (1992): 32–37. http://dx.doi.org/10.1055/s-0038-1629597.
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ZusammenfassungIn einer retrospektiven Studie wurden Ergebnisse der 131J-Ganzkörperszintigraphie und der Bestimmung des Thyreoglobulins (Tg) in der Nachsorge von 85 Patienten mit differenziertem Schilddrüsenkarzinom untersucht. Alle Patienten waren nach abgeschlossener Therapie zunächst als tumorfrei eingestuft worden. Bei 11 Patienten trat jedoch im weiteren Verlauf ein Rezidiv auf. Von 24 wegen Rezidivverdachts durchgeführten 131J-Szintigraphien ergaben 5 die Lokalisation eines Rezidivs. Im Rahmen von 71 Routineuntersuchungen unter endogener TSH-Stimulation konnte in zwei Fällen jeweils ein Jahr nach abgeschlossener Therapie ein neuer pathologischer Befund erhoben werden. 10 der 11 Rezidive traten in einer high-risk Gruppe von 40 Patienten mit follikulärer Histologie oder Stadium III oder IV (UICC 1987) auf. Nur ein Rezidiv wurde in einer low-risk Gruppe von 41 Patienten mit papillärer Histologie und UICC-Stadium I oder II beobachtet. Später als ein Jahr nach Abschluß der Therapie wurde kein Rezidiv bei einem Patienten der low-risk Gruppe beobachtet. Die vorliegenden Ergebnisse sprechen für die Notwendigkeit von 131J-Szintigraphie und Tg-Bestimmung unter endogener TSH-Stimulation bei Rezidivverdacht und routinemäßig etwa ein Jahr nach der letzten Therapie bei allen Patienten. Bei unauffälligem Verlauf sollte jedoch später diese Diagnostik routinemäßig nur bei erhöhtem Rezidivrisiko durchgeführt werden. Mit einer cut-off Grenze zur Bewertung des Tg-Spiegels von 5 ng/ml im Vergleich zung/ml nahm die Zahl der falsch-negativen Tg-Befunde unter Suppressionstherapie deutlicher ab, als diejenige der »falsch-positiven« Befunde zunahm. Eine cut-off Grenze von 5 ng/ml dürfte notwendig sein, um die Zahl der falschnegativen Tg-Befunde zu minimieren; es ist zu hoffen, daß durch die neuen sensitiven IRMA-Methoden die Zahl der »falsch-positiven« Befunde verringert werden wird.
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Dufour and Oneta. "Alkoholische und nicht-alkoholische Steatohepatitis." Therapeutische Umschau 61, no. 8 (August 1, 2004): 505–12. http://dx.doi.org/10.1024/0040-5930.61.8.505.
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Chronischer Aethylismus stellt seit Menschengedenken ein großes soziales und gesundheitliches Problem dar. Es führt unter anderem bei einigen der Betroffenen zu einer Steatohepatitis (ASH), die beschleunigt in eine Zirrhose übergehen kann. Aufgrund der in der westlichen Welt jährlich zunehmenden Adipositas mit der Assoziation zum metabolischen Syndrom resp. mit Entwicklung einer Insulinresistenz wird uns in Zukunft immer öfter eine weitere Form der Steatohepatitis beschäftigen, die sog. nicht-alkoholische Steatohepatitis (NASH). Die klinische Abgrenzung dieser beiden Formen untereinander kann oftmals schwierig sein. Als Hilfsmittel zur Identifikation eines versteckten Alkoholabusus können die CAGE-Fragen und die Fremdanamnese angewandt werden. Beide Erkrankungen können klinisch nur vermutet werden. Die definitive Diagnose gelingt erst mittels der Leberbiopsie, welche ein typisches histologisches Bild einer Fettleber mit Hepatozytennekrosen und vor allem polymorphkernigen Leukozyteninfiltraten zeigt. Die Histologie vermag aber nicht zwischen ASH und NASH zu differenzieren. Dies lässt ähnliche oder gleiche Pathomechanismen vermuten. Die Therapieansätze wiederum sind unterschiedlich. Die Therapie der Wahl bei ASH ist die Alkoholabstinenz, diejenige von NASH die Reduktion der Insulinresistenz, in erster Linie durch eine Gewichtsabnahme
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Schirmer, Jan H., and Bimba F. Hoyer. "IgG4-assoziierte Erkrankung." DMW - Deutsche Medizinische Wochenschrift 144, no. 24 (December 2019): 1726–30. http://dx.doi.org/10.1055/a-0857-1007.
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Was ist neu? Übersicht und Nomenklatur Die IgG4-assoziierte Erkrankung (IgG4-RD) ist eine erst kürzlich beschriebene heterogene Krankheitsentität, der viele vorher als eigenständige Einzelorganerkrankungen interpretierte Manifestationen zugerechnet werden. Hauptsymptom ist die Schwellung oder Vergrößerung betroffener Organe. Diagnose und Klassifikation Die Diagnose wird in Zusammenschau von Anamnese, klinischem Bild, Bildgebung, Histopathologie und IgG4-spezifischen Tests in Labor und Histologie gestellt. Labor und Bildgebung Häufige Laborbefunde sind: erhöhtes Serum-IgG4, IgE und CRP, Hypergammaglobulinämie, Hypokomplementämie und Eosinophilie. Histopathologie. Das typische Bild umfasst folgende Hauptcharakteristika: dichte lymphoplasmazelluläre Infiltrate, storiforme Fibrose und obliterative Phlebitis. Ferner treten vermehrte IgG4-positive Plasmazellen auf. Differenzialdiagnostische Abgrenzung Diverse andere Krankheitsbilder können die IgG4-RD imitieren. Medikamentöse Therapie Neu sind eine Studie zu Mycophenolat-Mofetil und Daten zu Rituximab bei sonst weitgehend fehlender Evidenz aus Studien zur Behandlung der IgG4-RD. Glukokortikoide Glukokortikoide (GC) sind die Grundlage der medikamentösen Therapie. Konventionelle Immunsuppressiva Es herrscht weiterhin kein Konsens, ob konventionelle Immunsuppressiva als GC-sparende Therapie immer oder nur in besonderen Fällen Teil der medikamentösen Therapie sein sollten. Biologika Rituximab ist eine etablierte Reservetherapie. Interventionelle und chirurgische Verfahren Mechanische Obstruktionen und Kompressionen können chirurgische und interventionelle Verfahren notwendig machen.
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Wolff, B., and C. K. Matiasek. "Untersuchungen zur urämischen und hepatischen Neuropathie bei Hund und Katze." Tierärztliche Praxis Ausgabe K: Kleintiere / Heimtiere 34, no. 05 (2006): 319–28. http://dx.doi.org/10.1055/s-0037-1622545.
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Zusammenfassung Ziel dieser Untersuchung war, das Vorkommen und die Häufigkeit urämischer und hepatischer Neuropathien beim Kleintier zu untersuchen und einen Beitrag zur Verbesserung diagnostischer Möglichkeiten, insbesondere im Hinblick auf die Biopsiediagnostik, zu leisten. Material und Methoden: Von 14 Hunden und 32 Katzen mit Nieren-und Lebererkrankungen wurden Proben des Nervus fibularis communis mittels Histologie und Nervenfaserzupfpräparation ausgewertet. Ergebnisse: Im Einzelnen zeigten sechs von acht urämischen Hunden, acht von 16 urämischen Katzen sowie vier von sechs Hunden und sieben von 16 Katzen mit Lebererkrankungen eine subakute bis chronische Neuropathie. Krankheitsübergreifend präsentierte sich das pathologische Bild bei den Hunden einheitlich axonal, wohingegen die Katzennerven, selbst innerhalb einer Gruppe, eine deutliche Heterogenität aufwiesen. Schlussfolgerungen: Nieren-und wahrscheinlich auch Lebererkrankungen sind bei Hund und Katze als Risikofaktoren für Neuropathien zu betrachten. Diese äußern sich in den meisten Fällen, wie beim Menschen, axonal und besitzen keine histologische Spezifität. Bei der Katze treten im Zusammenhang mit beiden Grunderkrankungen auch entzündliche Demyelinisierungen mit Ähnlichkeit zur chronisch-entzündlichen demyelinisierenden Polyneuropathie (CIDP) auf, was therapeutisch von Bedeutung sein mag. Klinische Relevanz: Mit zunehmenden Verbesserungen in der Therapie metabolischer Erkrankungen, die jedoch nicht zwangsläufig zu einer vollständigen Rekonvaleszenz oder Unterbrechung aller pathophysiologischen Abläufe führen, und einer höheren Lebenserwartung der betroffenen Tiere wird die klinische Bedeutung sekundärer Neuropathien weiter zunehmen.
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Plantade, R. "SEIN5 Les tumeurs papillaires non malignes du sein : quelle prise en charge apres diagnostic histologique percutane." Journal de Radiologie 87, no. 10 (October 2006): 1555. http://dx.doi.org/10.1016/s0221-0363(06)87967-9.
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Tefferi, A., R. A. Zellers, P. M. Banks, T. M. Therneau, and J. P. Colgan. "Clinical correlates of distinct immunophenotypic and histologic subcategories of lymphocyte-predominance Hodgkin's disease." Journal of Clinical Oncology 8, no. 12 (December 1990): 1959–65. http://dx.doi.org/10.1200/jco.1990.8.12.1959.
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Histologic and paraffin immunohistologic studies were carried out on 32 patients with lymphocyte-predominance Hodgkin's disease (LPHD) seen from 1970 through 1982. While nodular histology was accurately predictive of B-cell phenotype (Leu M1 -/L26+), diffuse histology corresponded to either B-cell or Hodgkin's (Leu M1 +/L26-) phenotype, not invariably predictable even when attention was paid to subtle paragranuloma cytology. Clinical characteristics were compared between histologic (diffuse v nodular) and immunophenotypic (Leu M1 +/L26-, Hodgkin's phenotype, v Leu M1 -/L26+, B-cell phenotype) subgroups. Ten patients have since died, and the median follow-up of the living patients was 14 years (range, 6 to 31). Of the several clinical parameters compared, only axillary nodal presentation was strongly associated with both B-cell phenotype and nodular histology, while male predominance related more to B-cell phenotype than nodular histology. No significant difference in overall survival or relapse rate was apparent among either the histologic or the immunophenotypic subgroups. However, very late but salvageable relapses were associated with nodular histology. The incidences of secondary malignancies and death from Hodgkin's disease (HD) were also comparable between the subgroups. Although difference in clinical presentation may exist, neither the histologic nor the immunophenotypic subcategories of LPHD could be demonstrated to correlate with differences in clinical outcome.
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Philip, Errol James, Francis Wright, Daniel Myung Kim, Daniel Kwon, Hansen Ho, Son Ho, Edna Cheung, et al. "Efficacy of immune checkpoint inhibitors (ICIs) in rare histological variants of bladder cancer." Journal of Clinical Oncology 38, no. 6_suppl (February 20, 2020): 502. http://dx.doi.org/10.1200/jco.2020.38.6_suppl.502.
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502 Background: ICIs are effective agents in metastatic urothelial carcinoma in both platinum-refractory and frontline settings. Responses in patients (pts) with non-urothelial histological variants are not well defined. Methods: We undertook a retrospective analysis of pts with metastatic bladder cancer treated with ICI monotherapy. Pts were identified as having a variant histology if any non-urothelial component was present. Fisher’s exact test was used to assess differences in ORR by histology. Results: Between 12/2014 and 10/2019, 102 pts received ICI monotherapy, of whom 93 were evaluable for response and 33 had variant histology. Median age was 70 yrs, 66% were male, 50% received prior platinum-based chemotherapy. Most received pembrolizumab (66%) or atezolizumab (33%). ORR in the overall cohort was 26% (15% PR, 11% CR), with 12% having SD. Histology breakdown and responses are shown in Table. Although twice as many responses were seen in urothelial pts as in pts with variant histologies (ORR 31% vs 15%), this difference was non-significant (p = 0.14). Conclusions: In this large single-institution cohort, ORR in a heterogeneous population of bladder cancer pts was consistent with data previously reported in clinical trials. Pts with variant histologies had numerically lower responses relative to pure urothelial histology, but this difference was not statistically significant. Clinical benefit to ICIs was seen across multiple variant histologies suggesting potential efficacy in this patient population that should be confirmed prospectively.[Table: see text]
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Nassar, Amin, Kent William Mouw, Catherine Curran, Archana Agarwal, Andres Acosta, Mark A. Preston, Matthew Mossanen, et al. "Genomic profiling of variant urinary tract tumor histologies." Journal of Clinical Oncology 37, no. 7_suppl (March 1, 2019): 450. http://dx.doi.org/10.1200/jco.2019.37.7_suppl.450.
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450 Background: Little is known about the genomic features of rare histologic variants of urinary tract (UT) tumors. The purpose of this study is to compare the pattern of genetic alterations in UT tumors with adenocarcinoma (AD), small cell (SC), or squamous cell (SQ) histology to UT tumors with urothelial carcinoma (UC) histology. Methods: We identified patients with pure variant (AD, SC, or SQ) or UC histology evaluated at Dana Farber Cancer Institute (DFCI). Tumors with mixed histology were excluded. We employed Oncopanel, which assesses 275-447 cancer genes for somatic mutations and copy number variations (CNVs). Alterations observed at an allele frequency > 0.1% in the ExAC database were assumed to be germline variants and were excluded. Mutation frequencies, CNVs, and tumor mutation burden (TMB) were determined for AD, SC, SQ, and UC, and were compared using the Fisher’s Exact test and Kruskall Wallis Test. Nominal p values were obtained, and fdr correction was employed (q < 0.1). Results: Genetic data was available for 11 AD, 6 SC, 9 SQ, and 120 UC tumors. All patients had muscle-invasive disease. The mean age was 67.8 years and 74% of patients were male. Overall, UC had significantly higher TMB than AD (median = 9.5 vs median = 6 respectively, p = 0.03). There were no significant differences in the CNV count among the four subtypes. Statistically significant differences in genetic alterations by subtype are shown in the Table. ARID1A and KDM6A mutations were less common in the variant histologies; while DICER1, FBXW7, MAP2K4, and MYB alterations were higher in ≥1 variant histology. RB1 and TP53 mutations were enriched in SC tumors while SMAD4 alterations were enriched in AD tumors. Conclusions: Genetic features of variant histology UT tumors differ from those seen in UC, suggesting biological differences and possibly different therapies. Validation in larger datasets is warranted. [Table: see text]
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Nair, S. G., C. H. Amadio, M. Scarlato, and D. A. Forman. "Frequency of histopathologic types of soft tissue sarcoma (STS) reported from a large community-based hospital over a 20 year period." Journal of Clinical Oncology 24, no. 18_suppl (June 20, 2006): 19507. http://dx.doi.org/10.1200/jco.2006.24.18_suppl.19507.
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19507 Background: Soft Tissue Sarcomas (STS) are rare tumors primarily of mesenchymal origin. The World Health Organization recognizes more than 50 subtypes of STS. Previously reported frequencies of histopathologic types of STS come from a handful of large cancer centers. The incidence of tumor types seen at large cancer treatment centers do not necessarily reflect the histologies seen at community hospitals. We sought to determine the frequency of histopathologic types of adult STS seen at our large community-based hospital. Methods: We performed a search of our tumor registry from the year 1984 through 2004 looking for histologic types of non-GIST STS involving the peripheral nervous system, autonomic nervous system, retroperitoneum, peritoneum, other connective and soft tissue locations. Our tumor registry is certified through the American College of Surgeons. Our pathologist are board certified, highly skilled, and commonly refer pathologic specimens for second opinion if a histologic diagnosis is in doubt. The 10 most common histologies diagnosed are reported. Results: Our hospital diagnosed and treated 250 STS over this 20 year period. The histologic type of sarcoma by number and percent of total cases is as follows: Malignant fibrous histiocytoma 60 (24%), Liposarcoma 51 (20%), Leiomyosarcoma 38(15%), Sarcoma N.O.S. 18(7%), Hemangiosarcoma 15 (6%), Synovial Sarcoma 10 (4%), Rhabdomyosarcoma 9 (4%), Fibrosarcoma 9 (4%), Spindle Cell Sarcoma 7 (3%), and Giant Cell Sarcoma 3 (3%). Conclusions: The frequency of the most common histologic types of soft tissue sarcoma seen at our community hospital is quite consistent with that previously reported in the literature from large referral-based cancer centers. There does not appear to be an influence of selection bias in previous reports of relative frequency of histopathologic types of STS. No significant financial relationships to disclose.
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Schulz-Wendtland, Rüdiger, Caroline Preuss, Peter Fasching, Christian Loehberg, Michael Lux, Julius Emons, Matthias Beckmann, Michael Uder, and Markus Mueller-Schimpfle. "Galaktografie mit Tomosynthese (Galaktomosynthese) – Renaissance einer Methode?" Senologie - Zeitschrift für Mammadiagnostik und -therapie 15, no. 02 (June 2018): 109–14. http://dx.doi.org/10.1055/a-0600-9406.
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Zusammenfassung Einleitung Die konventionelle Galaktografie stellte jahrzehntelang das einzige bildgebende Verfahren zur Darstellung von Milchgängen in der Brust dar. Heute verfügen wir in der Diagnostik über ein multimodales Konzept aus hochauflösendem Ultraschall, der Magnetresonanz-(MR-)Mammografie und der Duktoskopie/Galaktoskopie mit Sensitivitäten und Spezifitäten bis zu 95%. Ziel unserer Untersuchung war es, erstmalig die Tomosynthesetechnik in der Galaktografie einzusetzen und die daraus generierten synthetischen digitalen 2-D-Vollfeld-Mammografien mit der etablierten Methode der duktusorientierten Sonografie zu vergleichen. Es sollen mit beiden Methoden invasive Mammakarzinome und deren Vorstufen wie duktale Carcinoma in situ (DCIS) sowie benigne Befunde erkannt werden. Material und Methoden Wir führten bei 5 Patientinnen mit pathologischer Mamillensekretion sowohl eine duktusorientierte Sonografie, eine kontrastmittelunterstützte Galaktografie mithilfe der Tomosynthese in 3-D sowie auch den daraus generierten synthetischen digitalen 2-D-Vollfeld-Mammografien durch. Die Auswertung der unterschiedlichen Untersuchungsmodalitäten erfolgte durch 3 in der komplementären Mammadiagnostik erfahrene Untersucher (1, 5 und 15 Jahre) und wurde mit der endgültigen Histologie korreliert. Ergebnisse Alle 3 Untersucher beurteilten unabhängig voneinander die Bilder des duktusorientierten Ultraschalls und der kontrastmittelunterstützten Galaktografie in Tomosynthesetechnik in 3-D und den daraus generierten, synthetischen digitalen 2-D-Vollfeld-Mammografien. Die Ergebnisse wurden mit den histopathologischen Befunden der Operationspräparate korreliert, wobei sich bei den 5 Patientinnen 1 invasives Mammakarzinom, 2-mal ein duktales Carcinoma in situ (DCIS) und 2 benigne Befunde ergaben. Alle 3 Untersucher lagen bei der Verdachtsdiagnose in der Standardbildgebung der duktusorientierten Sonografie seltener richtig als bei der erstmalig durchgeführten, kontrastmittelunterstützten Galaktografie in Tomosynthesetechnik und den daraus generierten, synthetischen digitalen 2-D-Vollfeld-Mammografien. Schlussfolgerung Erstmalig wurde die Brusttomosynthese in der Galaktografie (Galaktomosynthese) eingesetzt und ermöglichte eine digitale, 3-dimensionale Darstellung von suspekten Befunden. Zusammen mit den daraus synthetisierten, digitalen 2-D-Vollfeld-Mammografien könnte dies in Zukunft eine sinnvolle Ergänzung der komplementären Mammadiagnostik sein – und eine Renaissance dieser Methode. Im Vergleich mit dem duktusorientierten Ultraschall in Hochauflösung erzielten die Untersucher mit der kontrastmittelunterstützten Galaktografie in Tomosynthesetechnik und den daraus generierten, synthetischen digitalen 2-D-Vollfeld-Mammografien bessere Ergebnisse in Korrelation mit den histopathologischen Befunden.
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Smith, Kathleen J., Marguerite Germain, and Henry Skelton. "Histopathologic Features Seen with Radiation Recall or Enhancement Eruptions." Journal of Cutaneous Medicine and Surgery 6, no. 6 (November 2002): 535–40. http://dx.doi.org/10.1177/120347540200600603.
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Background: Although a radiation recall or enhancement eruption has been associated with a number of chemotherapeutic drugs, the histologic features have rarely been described. Objective: Our goal was to define the histologic features of radiation recall and enhancement eruptions in order to better understand their pathogenesis. Methods: We present ten patients on chemotherapeutic agents who developed erythematous maculopapular to psoriasiform eruptions often with associated follicular pustules. These eruptions occurred at the sites of prior or concurrent radiation therapy. Results: The most common class of drugs inducing these reactions were antibiotic chemotherapeutic agents alone or in combination with other chemotherapeutic drugs. In addition to routine histology, in four patients immunohistochemical staining for p53 was performed at the sites of the eruptions after resolution and at noninvolved sites matched for ultraviolet radiation (UVR) exposure. Histologic features in patients receiving concurrent radiation therapy included epidermal dysplasia, keratinocytes showing features of necrosis, increased mitotic figures, and a mixed inflammatory infiltrate. At sites of prior radiation therapy, the biopsy specimens showed a similar spectrum of epidermal changes and, in some cases, psoriasiform dermatitis with clearing within cells in the upper layers of the epidermis. Additional dermal changes included dermal fibrosis, vasodilatation, and atypical fibroblasts. Moderate to marked solar elastosis was seen in the majority of biopsy specimens. Immunohistochemical studies after resolution showed only a modest increase in p53 staining in epidermal keratinocytes in 3 of 4 sites of recall and enhancement eruptions after resolution of the reactions compared to skin that was matched for similar UVR exposure. Conclusion: Cumulative direct DNA damage and oxidative stress are probably important in radiation recall and enhancement eruptions, and these changes may be modulated by underlying nutritional deficits. Cumulative p53 mutations may play some role but are probably not a major factor in these eruptions. Mitochondrial dysfunction, which is known to occur with prior and concurrent radiation and chemotherapy, may be important in these eruptions. In addition to improvements in general nutrition, topical or oral antioxidant therapy may be a potential therapy to avoid radiation enhancement and recall reactions.
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Strassburg. "Autoimmune Lebererkrankungen und Überlappungssyndrome." Praxis 95, no. 36 (September 1, 2006): 1363–81. http://dx.doi.org/10.1024/1661-8157.95.36.1363.
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Autoimmunerkrankungen der Leber sind ätiologisch ungeklärte chronisch entzündliche Erkrankungen, die zu einem immunologischen Angriff auf die Hepatozyten, die kleinsten mikroskopischen Gallengänge oder das gesamte in der Cholangiographie darstellbare Gallenwegssystem führen. Nosologisch werden dazu die Autoimmunhepatitis (AIH), die primär biliäre Zirrhose (PBC) und die primär sklerosierende Cholangitis (PSC) gezählt. Diese unterscheiden sich nicht nur in ihrem klinischen Profil, sondern auch in der diagnostischen Strategie, der Therapie und ihrer Remissionswahrscheinlichkeit und in ihren Assoziationen mit anderen immunvermittelten Erkrankungen sowie Karzinomerkrankungen. PBC und PSC sind cholestatische Erkrankungen. Die PBC betrifft überwiegend Frauen, ist diagnostisch bereits durch spezifische antimitochondriale Autoantikörper gegen Pyruvatdehydrogenase (PDH-E2) zu sichern, weist oft ein umfangreiches Spektrum rheumatologischer extrahepatischer Syndrome auf und spricht unbefriedigend auf Immunsuppression an. Ursodesoxycholsäure führt zu biochemischen und möglicherweise histologischen Verbesserungen. Die PSC hingegen betrifft jüngere Männer, die in 75% gleichzeitig an einer entzündlichen Darmerkrankung leiden. Sie weist keine krankheitsspezifischen Serumautoantikörper auf, wird durch Histologie der Leber und den typischen Befund bei der Cholangiographie diagnostiziert und führt in 10–20% zu Cholangiokarzinomen und auch Kolonkarzinomen. Auch die PSC spricht unbefriedigend auf Immunsuppression an, ihre Therapie ist durch mechanische Gallenwegsinterventionen, Cholangitisbehandlung und die Gabe von Ursodesoxycholsäure gekennzeichnet. Die AIH schliesslich ist eine «klassische Autoimmunerkrankung» mit weiblicher Prädisposition, zirkulierenden Autoantikörpern, Immunglobulinerhöhung, extrahepatischen Assoziationen anderer Autoimmunerkrankungen und ist durch ein dramatisches Ansprechen auf Immunsuppression mit einer Normalisierung der Prognose bei Remissionsinduktion und Zirrhosevermeidung gekennzeichnet. Ihre Diagnose wird allerdings nur durch den Ausschluss anderer chronischer Lebererkrankungen erreicht, welche ebenfalls mit dem biochemischen, histologischen und klinischen Bild einer Hepatitis einhergehen. Vor diesem Hintergrund ist die präzise Diagnostik prognostisch von entscheidendem Wert. Trotz der scheinbar klaren Trennung der drei Krankheitsbilder ergeben sich überlappende Syndrome. Diese können unter anderem durch die Koexistenz serologischer Parameter von PBC und AIH, von Cholestase und Hepatitis, von Autoantikörpern und Virusmarkern, dem konsekutiven Auftreten von PBC und AIH oder AIH und PSC gekennzeichnet sein. Fälle einer Überlappung von zwei genuinen Krankheitsbildern sind selten. Dies ist aus therapeutischer Sicht relevant und muss zu der strikten klinischen und diagnostischen Unterscheidung von serologischer Autoimmunität (Autoantikörper) und Autoimmunerkrankung (z.B. AIH) führen, um zu einer effizienten therapeutischen Strategie zu führen. AIH, PBC und PSC sind etablierte Indikationen zur Lebertransplantation mit guten Ergebnissen. Sie ist dann indiziert, wenn die Zirrhose progredient ist und zur Leberfunktionseinschränkung führt.
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Hochster, H. S., K. M. Kim, M. D. Green, R. B. Mann, R. S. Neiman, M. M. Oken, P. A. Cassileth, P. Stott, P. Ritch, and M. J. O'Connell. "Activity of fludarabine in previously treated non-Hodgkin's low-grade lymphoma: results of an Eastern Cooperative Oncology Group study." Journal of Clinical Oncology 10, no. 1 (January 1992): 28–32. http://dx.doi.org/10.1200/jco.1992.10.1.28.
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PURPOSE Fludarabine (2-fluoro-arabanoside-monophosphate) is a new antimetabolite chemotherapeutic agent. We performed a multicenter, phase II study of this drug in previously treated patients with refractory or relapsed non-Hodgkin's lymphoma (NHL) to determine its response rate by histologic classification. PATIENTS AND METHODS Sixty-two assessable patients were given 18 mg/m2 by intravenous (IV) bolus injection daily for 5 days, every 28 days. Forty-eight percent had previously had one chemotherapy regimen, and the remainder had had two regimens; 42% had had radiation. RESULTS Patients received 273 cycles of fludarabine chemotherapy, with a median of two cycles and ranging up to 25 cycles. Sixty patients were assessable for response, including nine complete responses (CRs; 15%) and nine partial responses (PRs; 15%). The response rate for patients with lower-grade histology was 52% (13 of 25); the greatest response rate was seen in those with follicular small cleaved-cell lymphoma, including seven of 11 treated. Five responders remain in unmaintained remission; the median survival of responders is greater than 30 months. Toxicity included mild neutropenia and a 10% incidence of grade 3 neurologic toxicity with occasional reversible visual and auditory changes. CONCLUSION Fludarabine is active in patients with previously treated NHL (particularly low-grade histologies). Future studies will examine its activity in combination with other chemotherapeutic agents in previously untreated patients.
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Bolfa, Pompei, Lusan DellaGrotte, Teri Weronko, and Anibal G. Armien. "Cutaneous epithelioid hemangiosarcoma with granular cell differentiation in a dog: a case report and review of the literature." Journal of Veterinary Diagnostic Investigation 30, no. 6 (August 23, 2018): 951–54. http://dx.doi.org/10.1177/1040638718794785.
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We report a case of cutaneous epithelioid hemangiosarcoma in a dog in which the majority of the neoplastic cells displayed histologic and ultrastructural features similar to those seen in granular cell tumors (GCTs). This intersection of hemangiosarcoma and granular cell change adds to the argument that GCTs are heterogeneous in histologic origin and underlines the fact that pathologists should not consider all GCTs as a single entity. The combination of histology in typical areas of the tumor with ultrastructural changes and the correct immunohistochemical markers can facilitate the accurate diagnosis of tumors with granular cell differentiation. Besides characteristic intracytoplasmic PAS-positive granules and ultrastructural proteinaceous accumulation within single membrane vesicles (presumably lysosomes and phagolysosomes), we suggest the following combination of markers for the diagnosis of granular cell angiosarcoma and/or hemangiosarcoma: vimentin positive, NSE and/or S100 negative, CD31 positive. We propose that the histologic granular appearance represents a metabolic defect of the neoplastic cells, which supports variability in cell origin for granular cell differentiation.
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Gu, Xiaoyan, Yihua He, Zhian Li, Jiancheng Han, Jian Chen, and J. V. (Ian) Nixon. "Echocardiographic versus Histologic Findings in Marfan Syndrome." Texas Heart Institute Journal 42, no. 1 (February 1, 2015): 30–34. http://dx.doi.org/10.14503/thij-13-3848.
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This retrospective study attempted to establish the prevalence of multiple-valve involvement in Marfan syndrome and to compare echocardiographic with histopathologic findings in Marfan patients undergoing valvular or aortic surgery. We reviewed echocardiograms of 73 Marfan patients who underwent cardiovascular surgery from January 2004 through October 2009. Tissue histology was available for comparison in 29 patients. Among the 73 patients, 66 underwent aortic valve replacement or the Bentall procedure. Histologic findings were available in 29 patients, all of whom had myxomatous degeneration. Of 63 patients with moderate or severe aortic regurgitation as determined by echocardiography, 4 had thickened aortic valves. The echocardiographic findings in 18 patients with mitral involvement included mitral prolapse in 15. Of 11 patients with moderate or severe mitral regurgitation as determined by echocardiography, 4 underwent mitral valve repair and 7 mitral valve replacement. Histologic findings among mitral valve replacement patients showed thickened valve tissue and myxomatous degeneration. Tricuspid involvement was seen echocardiographically in 8 patients, all of whom had tricuspid prolapse. Two patients had severe tricuspid regurgitation, and both underwent repair. Both mitral and tricuspid involvement were seen echocardiographically in 7 patients. Among the 73 patients undergoing cardiac surgery for Marfan syndrome, 66 had moderate or severe aortic regurgitation, although their valves manifested few histologic changes. Eighteen patients had mitral involvement (moderate or severe mitral regurgitation, prolapse, or both), and 8 had tricuspid involvement. Mitral valves were most frequently found to have histologic changes, but the tricuspid valve was invariably involved.
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Anderson, Bryan E., Christine L. Mackley, and Klaus F. Helm. "Alopecia Mucinosa: Report of a Case and Review." Journal of Cutaneous Medicine and Surgery 7, no. 2 (March 2003): 124–28. http://dx.doi.org/10.1177/120347540300700205.
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Background: Alopecia mucinosa has been shown to be associated with many benign and malignant conditions. It can be seen in childhood but is seen more commonly in adulthood. Alopecia mucinosa is generally felt to occur in three settings: a primary idiopathic form, a form associated with malignancy, and a form secondary to inflammatory conditions. The histologic hallmark is the accumulation of mucin in the follicular epithelium, called follicular mucinosis. Therapy for alopecia mucinosa remains problematic. Objective: We present a representative case of alopecia mucinosa and discuss the etiology, histology, epidemiology, treatment, and prognosis. Conclusion: We report a case of idiopathic alopecia mucinosa that responded to minocycline with a complete remission and we review the literature on alopecia mucinosa.
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Plantade, A., T. Choueiri, B. Escudier, B. Rini, S. Negrier, A. Ravaud, S. Oudard, P. Elson, and R. Bukowski. "Treatment outcome for metastatic papillary and chromophobe renal cell carcinoma (RCC) patients treated with tyrosine-kinase inhibitors (TKIs) sunitinib and sorafenib." Journal of Clinical Oncology 25, no. 18_suppl (June 20, 2007): 5037. http://dx.doi.org/10.1200/jco.2007.25.18_suppl.5037.
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5037 Background: Sunitinib (SUNI) and sorafenib (SORAF) are novel TKIs that have shown significant clinical activity in metastatic clear-cell RCC. Papillary (PAP) and chromophobe (CHRM) histologies represent the majority non-clear-cell RCC. The activity of SUNI and SORAF in non-clear cell histologies has not been evaluated. Methods: Clinical features at study entry and treatment outcomes were evaluated in all patients (pts) with metastatic PAP and CHRM RCC who received either SUNI or SORAF as their initial TKI treatment at one of five different cancer centers in France and USA between 2002 and 2006. Descriptive statistics were used to evaluate the collected data. Overall Response rate (ORR) was investigator-assessed per RECIST criteria. Fisher’s exact test was used for categorical variables and the Kaplan-Meier method was used to estimate survival (Overall Survival (OS) and progression-free survival (PFS)). Results: Median age for the 53 patients was 59 years and 64% were male. The number of patients with PAP and CHRM histologies were 41 (77%) and 12 (23%), respectively. Nephrectomy was performed in 87% of patients and 33/53 (62%) of pts were previously treated (26/33, 79%, with cytokines). ORR, PFS and OS for the entire cohort were 10%, 8.9 months (m) and 12.2 m, respectively. Twenty (38%) and 33 (62%) pts were treated with SUNI and SORAF, respectively. 3/12 (25%) of CHRM pts had an ORR vs. 2/41(4.8%) with PAP histology (P=0.07). PFS for CHRM pts was 9.3 m compared to 6.6 m for PAP pts (p=0.07). OS was not different across histologies and type of TKI received. SUNI treated pts had an ORR of 15% and PFS of 11.9 m compared to 6% (p=0.3) and 5.5 m for SORAF pts (p=0.002), respectively. Other factors found to be associated with shorter PFS include ECOG PS >0 (p=0.03) and hemoglobin< normal (p=0.02). Conclusions: TKI may have activity in metastatic CHRM RCC, similar to what is seen in clear-cell histology. Minimal activity however is noted in PAP RCC, justifying continued investigations of novel agents in this histology. No significant financial relationships to disclose.
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Barroil, M., F. Fasquelle, V. Foulongne, J. Ramos, and B. Guillot. "Double composante histologique au sein de lésions métastatiques d’un carcinome de Merkel." Annales de Dermatologie et de Vénéréologie 144, no. 12 (December 2017): S164. http://dx.doi.org/10.1016/j.annder.2017.09.237.
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Aisner, S. C., D. M. Finkelstein, D. S. Ettinger, M. D. Abeloff, J. C. Ruckdeschel, and J. C. Eggleston. "The clinical significance of variant-morphology small-cell carcinoma of the lung." Journal of Clinical Oncology 8, no. 3 (March 1990): 402–8. http://dx.doi.org/10.1200/jco.1990.8.3.402.
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Past attempts to subclassify small-cell lung cancer (SCCL) histology (oat cell, fusiform, polygonal, intermediate, etc) have not been useful because of interrater variability and a lack of clinical significance. A review of outcome in a previous series suggested that a different histologic subtype, small-cell/large-cell (SC/LC) conferred an inferior response and survival analogous to the relative chemotherapy and radiation resistance seen in the variant-morphology (SC/LC) cultured cell lines. To evaluate the clinical impact of SC/LC we applied the proposed International Association for the study of Lung Cancer (IASLC) histology subclassification that incorporates the SC/LC category for patients with extensive-disease SCCL entering Eastern Cooperative Oncology Group (ECOG) protocol 1582. All cases were reviewed for eligibility by one pathologist, and all possible SC/LC (variant) plus 10% of all cases were reviewed together with a second pathologist; 577 of the 628 patients who entered were eligible, of whom 550 had histologic material submitted for review and are considered for this analysis. Initial review disclosed 24 cases with SC/LC (4.4%) and 526 with "classic" histology. The second review showed 100% agreement for classic form, but only 11 SC/LC cases with concordance between the reviewing pathologists. Eight of 24 (33%) cases from first review and three of 11 (27%) with concordance on second review achieved complete response (CR) compared with 101 of 526 (19%) for "classic" SCCL (P = .11 and .45, respectively, for the first and second review groups).(ABSTRACT TRUNCATED AT 250 WORDS)
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Ramamurthy, Chethan, David Arguello, Fern Anari, Pooja Ghatalia, Matthew R. Zibelman, Elizabeth R. Plimack, Earle Frederick Burgess, et al. "Molecular profiling of aggressive variant urothelial carcinoma." Journal of Clinical Oncology 37, no. 7_suppl (March 1, 2019): 378. http://dx.doi.org/10.1200/jco.2019.37.7_suppl.378.
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378 Background: The WHO recognizes multiple variant histologies of urothelial carcinoma (vUC), many of which have been associated with poor outcomes compared with urothelial carcinoma (UC). We aimed to explore molecular differences between aggressive vUC and UC. Methods: 23 micropapillary (MP), 16 plasmacytoid (P), 23 sarcomatoid (S), 7 nested (N), 6 clear cell (CC), and 2 giant cell (GC) vUC specimens were tested between 2012 to 2018 via a multiplatform profiling service (Caris Life Sciences, Phoenix, AZ) consisting of gene sequencing (next generation sequencing [NGS]), gene amplification (CISH or NGS), and protein expression (immunohistochemistry [IHC]). Findings were compared to 435 control UC specimens using the Chi-square test. Results: 84% of samples were from primary tumor. Alterations identified are summarized in Table 1, and are notable for high rates of TP53 mutations across histologic subtypes, varying rates of RB1, ERBB2 and FGFR mutations, and overall low rates of DNA damage repair (DDR) mutations (29 genes reported) except in S. There were more ARID1A mutations detected in MP than UC (100% [3 specimens] v. 41.3%, p=0.044), and more CDH1 mutations in P than UC (50% [4 specimens] v. 2%, p<0.001). CISH ERBB2 (HER2) amplification was seen in 27.3% MP compared with only 10.4% in UC (p=0.005). Compared to UC, PD-L1 IHC (SP142 assay) was positive (>5%) in a high proportion of S (55.6%, p=0.002) but in a lower proportion of other vUC (e.g. absent in P). Tumor mutational burden (TMB) was high in a lower proportion of vUC: 18.4% UC vs. 14.3% MP, 0% P, 16.7% S. Conclusions: Aggressive variant histology UCs have a differential profile of molecular aberrations compared to UC, with notable differences in potential targets such as HER2 and DDR genes as well as immunotherapy biomarkers. Further studies are needed to confirm these findings, and may support therapy development for these rare, aggressive UC subtypes. Aberrations (%) in Variant Histology UC. [Table: see text]
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Bendon, R. W., O. Faye-Petersen, Z. Pavlova, F. Qureshi, B. Mercer, M. Miodovnik, A. F. Das, et al. "Fetal Membrane Histology in Preterm Premature Rupture of Membranes: Comparison to Controls, and between Antibiotic and Placebo Treatment." Pediatric and Developmental Pathology 2, no. 6 (November 1999): 552–58. http://dx.doi.org/10.1007/s100249900161.
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The objectives of this study were to test the hypotheses that antibiotic therapy will alter the histologic appearance of fetal membranes in preterm premature rupture of membranes (pPROM), and that the membrane histology will demonstrate distinct differences between term and preterm rupture of membranes. We also wished to test interobserver variability of pathologists. Placental membranes were sampled from 268 women participating in a randomized placebo-controlled trial of antibiotic therapy for pPROM at 24–32 weeks of gestation (cases) and from 4 control groups who were not in the randomized trial: (1) preterm labor without pPROM ( n = 21), ( 2) term labor ( n = 65), (3) term PROM ( n = 21), and ( 4) term cesarean section ( n = 27). The cases and controls were scored for 40 histologic features by pathologists blinded to the identity of each sample (case or control). pPROM histology of samples from patients receiving antibiotics and those receiving placebo was compared using a chi-squared test and with control groups using logistic regression. There were no histological differences between pPROM cases treated with antibiotic and those receiving placebo, nor with respect to duration of membrane rupture greater or less than 48 h. Concordance among pathologists was low for features other than acute inflammation. Logistic regression analysis controlled for race and pathologist, and demonstrated that all of the control groups had significantly fewer common markers of acute inflammation when compared with the pPROM cases. This study suggests that histopathologic evidence of infection is seen more frequently with pPROM than in preterm or term controls. The histologic features used in this study cannot be used to determine the effectiveness of antibiotic therapy.
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Bomeisl, Philip E., Cheryl L. Thompson, Lyndsay N. Harris, and Hannah L. Gilmore. "Comparison of Oncotype DX Recurrence Score by Histologic Types of Breast Carcinoma." Archives of Pathology & Laboratory Medicine 139, no. 12 (December 1, 2015): 1546–49. http://dx.doi.org/10.5858/arpa.2014-0557-oa.
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ContextOncotype DX (ODX) is a widely used commercial assay that estimates the risk of distant recurrence and may predict the benefit of chemotherapy in a subset of breast cancers. Some studies have shown the ability to predict Oncotype DX recurrence score (ODXRS), based on routinely reported pathologic features; however, there are limited data correlating specific histologic type of breast cancer to ODXRS.ObjectiveTo compare ODXRS to specific histologic types of breast cancer.DesignOne hundred eighty-four cases were sent for ODXRS testing and the results were compared with histologic type and grade.ResultsThe highest average ODXRS was seen in invasive ductal carcinoma with micropapillary features (29) followed by invasive ductal carcinoma not otherwise specified (mean = 19.4, SD = 11.6), invasive mucinous carcinoma (mean = 17.2, SD = 5.9), invasive lobular carcinoma (mean = 15.7, SD = 7.2), mixed ductal and lobular carcinoma (mean = 14.1, SD = 7.7), tubular carcinoma (10.0), and mixed ductal and mucinous carcinoma (mean = 8.0, SD = 4.2). Most tumors that had a high ODXRS were grade 3 invasive ductal carcinoma, representing 13 of a total of 20 cases (65%). Interestingly, 3 of the 4 cases of pure invasive mucinous carcinoma had an intermediate ODXRS.ConclusionsAlthough the numbers are small, our findings raise further awareness of the significance between histologic type and grade, and RS in breast cancer. In some special histologic types of breast cancer, particularly those considered to follow either an excellent or poor clinical course by histology alone, it is unclear whether the ODXRS results are as meaningful as in carcinomas of no special type. Further investigation with higher numbers and outcome data is needed.
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McNiff, Jennifer M., and Earl J. Glusac. "Histologic features of melanocytic nevi seen in association with mycosis fungoides." Journal of Cutaneous Pathology 30, no. 10 (October 22, 2003): 606–10. http://dx.doi.org/10.1034/j.1600-0560.2003.00127.x.
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Qasrawi, Ayman, Zin Myint, Yanal Mufeed Alnimer, and Edward H. Romond. "Oncotype DX score in hormone receptor-positive/HER2-positive breast cancer: A SEER analysis." Journal of Clinical Oncology 37, no. 15_suppl (May 20, 2019): e12044-e12044. http://dx.doi.org/10.1200/jco.2019.37.15_suppl.e12044.
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e12044 Background: The recurrence score Oncotype DX (RS) predicts the need for adjuvant chemotherapy in hormone receptor positive (HR+) early stage breast cancer (BC). However, it has not been validated for HR+/HER2+ BC cases. We aim to evaluate the results of RS in HR+/HER2+ BC by using the Surveillance, Epidemiology, and End Results Program (SEER) national database. Methods: We identified patients with non-metastatic HR+/HER2+ BC with reported RS scores from the national SEER database between 2010 and 2015. Data obtained included demographics, histologic subtypes, grading, tumor size, nodal status, HR status and overall survival (OS) outcomes. RS scores were divided into low/intermediate (≤30) and high ( > 30). Histologic subtypes were further categorized into favorable (lobular, tubular, mucinous, and cribriform) and unfavorable (infiltrating ductal, mixed ductal, and micropapillary). We used Kaplan-Meier & Cox regression to analyze the survival outcomes. Logistic regression analysis was used to analyze the correlation between variables and different RS scores. Results: A total of 1537 patients were included. Median age was 61 (25-90). Majority of the patients presented with node negative disease (85%), low/intermediate grade (71%), tumor size < 20 mm (73%), unfavorable histology (89%), and only 15% had negative progesterone receptor (PR –). High RS score ( > 30) was seen in 24% of cases. After a median follow-up of 38 m (1-72), the five-year OS was 94.5%. Chemotherapy was given to 71% and 35% of those with RS > 30 and ≤30, respectively. There was a strong correlation between age > 60 ([hazard ratio, HR] = 4.9, p < 0.0001) and RS > 30 (HR = 2.4, p = 0.004) with worse outcomes on multivariate analysis. However, there were no associations between histologic subtype, tumor size, grade, nodal status and chemotherapy with survival. Tumor size > 20 mm (OR = 1.5), unfavorable histology ([odds ratio, OR] = 3.5), PR – (OR = 4.3) and high grade tumors (OR = 4.5) were independent predictors of RS > 30 (p < 0.0001). Conclusions: Our study shows that large tumor size ( > 20 mm), higher grade, PR –, and unfavorable histology were independent risk factors for higher RS in patients with localized early stage HR+/HER2+. High RS was associated with worse outcome.
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Al Saadi, T., N. Dendukuri, M. El Khoury, and B. Mesurolle. "SEIN-WS-3 Aspect des carcinomes mammaires invasifs en fonction de leur grade histologique." Journal de Radiologie 88, no. 10 (October 2007): 1604. http://dx.doi.org/10.1016/s0221-0363(07)82005-1.
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Goesch, Torsten R., Nancy A. Wilson, Weifeng Zeng, Bret M. Verhoven, Weixiong Zhong, Maya M. Coumbe Gitter, and William E. Fahl. "Suppression of Inflammation-Associated Kidney Damage Post-Transplant Using the New PrC-210 Free Radical Scavenger in Rats." Biomolecules 11, no. 7 (July 19, 2021): 1054. http://dx.doi.org/10.3390/biom11071054.
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Allograft kidney transplantation, which triggers host cellular- and antibody-mediated rejection of the kidney, is a major contributor to kidney damage during transplant. Here, we asked whether PrC-210 would suppress damage seen in allograft kidney transplant. Brown Norway (BN) rat kidneys were perfused in situ (UW Solution) with or without added 30 mM PrC-210, and then immediately transplanted into Lewis (LEW) rats. 20 h later, the transplanted BN kidneys and LEW rat plasma were analyzed. Kidney histology, and kidney/serum levels of several inflammation-associated cytokines, were measured to assess mismatch-related kidney pathology, and PrC-210 protective efficacy. Twenty hours after the allograft transplants: (i) significant histologic kidney tubule damage and mononuclear inflammatory cell infiltration were seen in allograft kidneys; (ii) kidney function metrics (creatinine and BUN) were significantly elevated; (iii) significant changes in key cytokines, i.e., TIMP-1, TNF-alpha and MIP-3A/CCL20, and kidney activated caspase levels were seen. In PrC-210-treated kidneys and recipient rats, (i) kidney histologic damage (Banff Scores) and mononuclear infiltration were reduced to untreated background levels; (ii) creatinine and BUN were significantly reduced; and (iii) activated caspase and cytokine changes were significantly reduced, some to background. In conclusion, the results suggest that PrC-210 could provide broadly applicable organ protection for many allograft transplantation conditions; it could protect transplanted kidneys during and after all stages of the transplantation process—from organ donation, through transportation, re-implantation and the post-operative inflammation—to minimize acute and chronic rejection.
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Giakoumis, Matrona, Jay D. Ryan, and Jigna Jani. "Histologic Evaluation of Intermetatarsal Morton’s Neuroma." Journal of the American Podiatric Medical Association 103, no. 3 (May 1, 2013): 218–22. http://dx.doi.org/10.7547/1030218.
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Background: The present study was conducted in an attempt to obtain consistent similarities among histologic findings of surgically excised neuromas. Secondly, we looked for a correlation between the presence of a neuroma with certain comorbidities. Methods: A total of 22 specimens with a preoperative diagnosis of Morton’s neuroma were sent to the pathology laboratory, and evaluation was performed by a single pathologist. Results: Degenerative changes were seen in 59% of the specimens. Patient age showed trends toward affecting nerve fibrosis, nerve diameter, vessel obstruction, and degenerative changes. The most frequent comorbidity was hypertension, seen in 44% of the participants. Conclusions: Significant histologic similarities among results were not seen; however, certain trends were discovered. Degenerative changes were appreciated in most specimens. Definite histologic findings of neuroma recur, but difficulty in consistent reproducibility may be related to factors such as age, sex, and comorbidities. (J Am Podiatr Med Assoc 103(3): 218–222, 2013)
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Smith, D. C., J. A. Tucker, and D. L. Trump. "Hypercalcemia and neuroendocrine carcinoma of the prostate: a report of three cases and a review of the literature." Journal of Clinical Oncology 10, no. 3 (March 1992): 499–505. http://dx.doi.org/10.1200/jco.1992.10.3.499.
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PURPOSE Hypercalcemia is a rare complication of prostate cancer, and no definite association with any histologic subtype of prostatic malignancy has been documented. We have recently seen three patients who developed hypercalcemia in the setting of prostate cancer. All had neuroendocrine carcinoma of the prostate (NCPs), which prompted an exploration of the potential association of hypercalcemia with NCP. DESIGN An extensive review of literature published in the English-language was conducted to identify cases of hypercalcemia associated with prostate cancer and well-documented cases of NCP. RESULTS We found 17 reported cases of hypercalcemia clearly associated with prostate cancer and a total of 61 cases of well-documented NCP. Including our cases, 11 of the 20 reported cases of hypercalcemia associated with prostate carcinoma were in patients with neuroendocrine carcinomas. CONCLUSION Hypercalcemia in the setting of prostate cancer should prompt a search for unusual histologies.
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Pukhalskaya, Tatsiana, J. Ahmad Brown, Adam A. Sills, and Bruce R. Smoller. "A Longstanding, Persistent and Recurrent Case of Cryptogenic Panniculitis." Case Reports in Dermatology 12, no. 3 (November 4, 2020): 199–208. http://dx.doi.org/10.1159/000509605.
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Subcutaneous panniculitis-like T-cell lymphoma (SPTCL) is a rare subtype of cutaneous T-cell lymphoma. There may be a significant histologic overlap with traumatic panniculitis and lupus profundus. We describe a 54-year-old woman who had received a diagnosis of SPTCL based upon a left parietal scalp biopsy 5 years earlier. This diagnosis was supported by immunohistochemistry (IHC) demonstrating a CD8+ predominant lymphocyte population in the subcutis. T-cell gene rearrangement studies were not performed at that time. The patient was treated and showed significant clinical improvement. When several tender erythematous subcutaneous nodules appeared on the upper back, left plantar surface and pretibial region, repeat biopsy was performed. Histology revealed a lobular and septal panniculitis with no vasculitis. The infiltrate contained abundant eosinophils and histiocytes not seen in the original biopsy specimen. IHC demonstrated a mixture of CD4+, CD8+ and CD7+ lymphocytes with abundant CD68+ histiocytes. T-cell gene rearrangement studies performed on one of the lesions failed to demonstrate clonality. It is important to recognize that patients with SPTCL are not exempt from other types of panniculitis, and complete histologic, IHC and molecular workups are essential to properly classify all cutaneous lesions in these patients.
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Pai, Ashok P., Monica Brown, Chong-xian Pan, and Primo Lara. "Evolving trends in non-clear cell renal cell cancer (RCC) epidemiology: A large registry analysis of 4,483 patients." Journal of Clinical Oncology 30, no. 5_suppl (February 10, 2012): 374. http://dx.doi.org/10.1200/jco.2012.30.5_suppl.374.
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374 Background: Non-clear cell (ncc) RCC is uncommon but includes a heterogeneous group of histologic subtypes such as papillary, chromophobe (Chr), medullary (Med), and collecting duct (CD) cancers. We used a large cancer registry to define nccRCC clinical features and outcomes, identify prognostic variables, and to generate hypotheses for further study. Methods: Invasive RCC tumors in the California Cancer Registry from 1998–2009 among adults > 18 years of age (n=38,251) were analyzed. Baseline clinical and tumor variables were collected. Primary outcome measures were 3-year cause-specific (CSS) and overall survival (OS). Uni- and multivariate survival analysis were used to identify predictors of CSS and OS. Results: Of 38,251 RCC cases, 19,149 (50%) were of clear cell type; 14,619 (38.2%) were “unclassified”. Thus, 4,483 (11.7%) nccRCC cases were identified and included in this analysis. Of these, 3304 (73.7%) were diagnosed in 2004–09, suggesting a shift to more precise coding of histologic subtypes starting in the early 2000s. Histology distribution (n, %): papillary − 2,863 (63.9%); Chr − 1,507 (33.6%); and other including Med and CD − 113 (2.5%). Variables associated with significantly better OS and CSS (univariate analysis) were Chr histology, female sex, and higher socioeconomic status (SES). Significantly worse OS and CSS were seen in Med+CD, age > 65 yrs, no nephrectomy (Nx), and higher stage. Non-hispanic blacks had significantly worse OS and CSS, while the “targeted therapy era” (2004–2009) was associated with better OS. Multivariate analysis showed the following to be independently associated with outcomes (all p <0.001; Hazard Ratios [HR] shown for CSS and OS): Chr histology (0.48, 0.56), Med+CD histology (2.99, 2.42), no Nx (2.84, 3.18), regional stage (5.84, 1.98), distant stage (25.7, 7.67); and non-hispanic blacks (1.5,2 p=0.006; 1.25, p=0.03). Age > 65 yrs (HR 1.78, p<0.001) and high SES (HR 0.88, p=0.001) were associated with OS but not CSS. Conclusions: This is among the largest registry analyses of nccRCC ever performed, showing emerging trends in this uncommon RCC subset. Clinical variables associated with CSS and OS were identified that can inform the design of future clinical trials in nccRCC.
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Pai, Ashok P., Monica Brown, Chong-xian Pan, and Primo Lara. "Evolving trends in non-clear cell renal cell cancer (RCC) epidemiology: A large registry analysis of 4,483 patients." Journal of Clinical Oncology 30, no. 15_suppl (May 20, 2012): 4607. http://dx.doi.org/10.1200/jco.2012.30.15_suppl.4607.
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4607 Background: Non-clear cell (ncc) RCC is uncommon but includes a heterogeneous group of histologic subtypes such as papillary, chromophobe (Chr), medullary (Med), and collecting duct (CD) cancers. We used a large cancer registry to define nccRCC clinical features and outcomes, identify prognostic variables, and to generate hypotheses for further study. Methods: Invasive RCC tumors in the California Cancer Registry from 1998-2009 among adults > 18 years of age (n=38,251) were analyzed. Baseline clinical and tumor variables were collected. Primary outcome measures were 3-year cause-specific (CSS) and overall survival (OS). Uni- and multivariate survival analysis were used to identify predictors of CSS and OS. Results: Of 38,251 RCC cases, 19,149 (50%) were of clear cell type; 14,619 (38.2%) were “unclassified.” Thus, 4,483 (11.7%) nccRCC cases were identified and included in this analysis. Of these, 3,304 (73.7%) were diagnosed in 2004-09, suggesting a shift to more precise coding of histologic subtypes starting in the early 2000s. Histology distribution (n, %): papillary - 2,863 (63.9%); Chr - 1,507 (33.6%); and other including Med and CD - 113 (2.5%). Variables associated with significantly better OS and CSS (univariate analysis) were Chr histology, female sex, and higher socioeconomic status (SES). Significantly worse OS and CSS were seen in Med+CD, age > 65 yrs, no nephrectomy (Nx), and higher stage. Non-hispanic blacks had significantly worse OS and CSS, while the “targeted therapy era” (2004-2009) was associated with better OS. Multivariate analysis showed the following to be independently associated with outcomes (all p <0.001; Hazard Ratios [HR] shown for CSS and OS): Chr histology (0.48, 0.56), Med+CD histology (2.99, 2.42), no Nx (2.84, 3.18), regional stage (5.84, 1.98), distant stage (25.7, 7.67); and non-hispanic blacks (1.5,2 p=0.006; 1.25, p=0.03). Age > 65 yrs (HR 1.78, p<0.001) and high SES (HR 0.88, p=0.001) were associated with OS but not CSS. Conclusions: This is among the largest registry analyses of nccRCC ever performed, showing emerging trends in this uncommon RCC subset. Clinical variables associated with CSS and OS were identified that can inform the design of future clinical trials in nccRCC.
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Chokshi, R. J., D. Arrese, M. P. Kuhrt, M. Routt, E. Kocak, and E. W. Martin. "Pelvic malignancies undergoing exenteration." Journal of Clinical Oncology 29, no. 4_suppl (February 1, 2011): 579. http://dx.doi.org/10.1200/jco.2011.29.4_suppl.579.
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579 Background: Pelvic exenteration is reserved for patients with locally invasive and recurrent pelvic malignancies. The literature demonstrates a high morbidity and mortality associated with this operation. At our institution, a high volume of pelvic exenterations are undertaken and their outcomes have been studied. Methods: The medical records of 53 patients with varying pelvic pathologies who underwent pelvic exenteration between 2004 and 2010 were reviewed. Demographics, histologies, periprocedural events, and outcomes were analyzed. Results: Patients were divided into a colorectal (n = 37) and noncolorectal (n = 16) group for analysis based on histology. The two groups were similar in demographics, perioperative events, and length of stay. Resection status, chemotherapy use, and intraoperative radiation therapy showed no statistical difference. Complications showed a difference in perineal abscesses in the colorectal group. The colorectal group showed a survival difference when comparing R0 resection versus R1/R2, however no difference was seen in primary versus recurrent tumors. The median survival was 20.3 months in the colorectal group and 4.8 months in the noncolorectal group. Conclusions: Patients undergoing exenteration for colorectal histology have improved survival when compared to pelvic malignancies of other origins. The greatest effect on long term survival is seen in the colorectal group undergoing a R0 resection. Despite pelvic exenterations carrying a high morbidity and mortality, careful patient selection can optimize outcomes. [Table: see text] No significant financial relationships to disclose.
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Plantade, R. "Les tumeurs papillaires non malignes du sein : quelle prise en charge apres diagnostic histologique percutane." Journal de Radiologie 87, no. 10 (October 2006): 1389. http://dx.doi.org/10.1016/s0221-0363(06)87348-8.
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Defaud-Hénon, Florence, Christine Tunon-de-Lara, Marion Fournier, Marion Marty, Valérie Velasco, Isabelle de Mascarel, and Gaëtan MacGrogan. "Le carcinome adénoïde kystique du sein : étude clinique, histologique, immunohistochimique et revue de la littérature." Annales de Pathologie 30, no. 1 (February 2010): 7–16. http://dx.doi.org/10.1016/j.annpat.2010.01.003.
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Fitriani, Fitriani, Husmimi Husmimi, and Muslim Akmal. "Aplikasi Metode Emersi Fiksatif Berbeda terhadap Morfologi Histologi Testis dan Epididimis Kambing Lokal(Capra sp.)." Jurnal Agripet 18, no. 1 (April 1, 2018): 24–29. http://dx.doi.org/10.17969/agripet.v18i1.8848.
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ABSTRAK. Penelitian ini bertujuan untuk melihat morfologi histologi testis dan epididymis kambing lokal(Capra sp.) dengan umur 1-1,5 tahun. Penelitian ini merupakan penelitian eksperimen laboratorik dengan menggunakan 6 testis dan 6 epididimis yang diambil secara acak dan masing-masing di fiksasi dalam fiksatif formalin dan neutral buffered formaline (NBF) 10% dengan waktu fiksasi 15 hari. Pembuatan dan pengamatan jaringan testis dan epididimis dilakukan di laboratorium histologi FKH Unsyiah. Pengamatan mikroskopis secara kualitatif yang diamati pada 10 tubulus testis dan epididimis. Hasil pengamatan dianalisis secara deskriptif. Secara mikroskopik, gambaran struktur jaringan testis dan epididimis kambing terlihat jelas. Ruang antar membran tubulus pada metode emersi fiksatif formalin masih terlihat longgar, sedangkan pada metode emersi fiksatif NBF terlihat padat. Pengerutan sel sangat terlihat pada fiksatif formalin dibandingkan fiksatif NB, namun autolisis sel terlihat tidak nyata pada kedua fiksatif tersebut. Secara umum, kondisi membran tubulus terlihat utuh pada testis dan epididimis dengan fiksatif formalin dan NBF, namun sedikit terlihat degenerasi hidropis pada ruang antar sel dalam tubulus seminiferus. Dari hasil penelitian disimpulkan bahwa perbedaan hasil pada preparat testis dan epididimis dengan menggunakan fiksatif berbeda, kemungkinan dapat dipengaruhi oleh jenis bahan fiksatif, ukuran dan struktur yang berbeda pada kedua organ. Pemilihan metode emersi fiksatif pada jaringan testis dan epididimis sangat penting untuk mempermudah pengamatan morfologi histologi.(Application of different fixative emersi methods for histological morphology of testicular and epididymal local goats (Capra sp.))ABSTRACT. This research was conducted to observe the histological morphology of testicular and epididymal tissues of local goats at the same age (1-1,5 years old). This research is laboratory experimental research using 6 testes and epididymis 6 taken randomly and each fixed in fixative neutral buffered formalin (nbf) and formaline 10% with a 15 day fixation time. Preparation and observation of the epididymis and testicle tissue is performed in the laboratory of histology FKH Unsyiah. Qualitative microscopic observations were observed in 10 testes and epididymal tubules. The observations analyzed descriptively. Microscopically, the picture of tissue structure of the testes and epididymis of kacang goats is evident.The intermediate space of the tubules in the formalin fixation emersy method still looks loose, whereas in NBF fixative emersy method looks solid. Cell shrinking is highly visible in formalin fixation compared with NBF fixation, but cellular autolysis appears to be invisible in both fixation methods. Generally, tubular membrane conditions are seen intact on the testes and epididymis with formalin and nbf fixation. Differences in results on testicular and epididymal preparations using different fixative materials, may be affected by different types of fixation, size and structure in both organs. The selection of a fixative emersi method on testicular tissue and epididiymis is essential to evaluate the histologic morphology.
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Costello, Brian Addis, Thai Huu Ho, Gabriela Perez Burbano, David W. Hillman, Fernando Quevedo, Henry C. Pitot, Lance C. Pagliaro, et al. "Phase II efficacy trial of pazopanib in nonclear cell metastatic renal cell cancer (mRCC): PINCR." Journal of Clinical Oncology 38, no. 6_suppl (February 20, 2020): 696. http://dx.doi.org/10.1200/jco.2020.38.6_suppl.696.
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696 Background: A number of treatments for metastatic renal cell carcinoma (RCC) have been FDA approved since December, 2005. Trials evaluating these agents excluded non-clear cell histologies and therefore the efficacy of these treatments remains unclear in patients (pts) with metastatic non-clear cell RCC (mncRCC). Methods: This is a single arm Phase II study designed to determine the efficacy of pazopanib in mncRCC. Treatment was pazopanib 800 mg by mouth daily until progression or intolerability of treatment. Dose reductions were allowed for toxicity with dose level -1 being 600 mg daily and dose level -2, 400 mg daily. Cycles were every 28 days. Main eligibility criteria included: (1) age ³ 18 years old; (2) histologic confirmation of ncRCC; (3) ECOG Performance Status (PS) 0, 1, or 2; (4) up to one prior treatment for mncRCC (5) measurable or non-measurable metastatic disease per RECIST criteria. The primary endpoint was overall survival rate at 12 months. Secondary endpoints were best tumor response rates after two cycles, PFS, OS and toxicity. Results: 38 pts were enrolled between May 16, 2013 and February 1, 2018. 35 pts were evaluable for primary endpoint. Median age 63 years old and 22/35 (62.9%) were male. Most common histology was papillary RCC, 14/35 (40%), and most common number of metastatic sites was 1. 29/35 (82.9%) had prior nephrectomy and 30/35 (85.7%) had no prior systemic therapy. Median number of cycles was 5. 12-month OS was 65.7% (90% CI, 50.5-78.9%). Best response in first 2 cycles: PR 11%, SD 60%, PD 9%, not evaluated 20%. Median PFS was 7.5 months (90% CI, 5.0-11.0); median OS 18.9 months (90% CI, 13.0-NE). Grade 3 / 4 AEs seen in 25 pts with hypertension, transaminitis and abdominal pain being most common (seen in >10%). Conclusions: There are limited data about the efficacy of available therapies for mncRCC. This study shows that pazopanib has similar efficacy compared to historical data in clinical trials using other TKIs in mncRCC. The safety profile of pazopanib in pts with mncRCC was found to be similar to that found in prior clinical trials studying pazopanib. Our findings warrant further investigation into the utility of pazopanib in metastatic ncRCC. Clinical trial information: NCT01767636.
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Monai, Elena, Anders Johansen, Erik Clasen-Linde, Ewa Rajpert-De Meyts, Niels Erik Skakkebæk, Katharina M. Main, Anne Jørgensen, and Rikke Beck Jensen. "CENTRAL PRECOCIOUS PUBERTY IN TWO BOYS WITH PRADER-WILLI SYNDROME ON GROWTH HORMONE TREATMENT." AACE Clinical Case Reports 5, no. 6 (November 2019): e352-e356. http://dx.doi.org/10.4158/accr-2019-0245.
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Objective: Prader-Willi syndrome (PWS) is a rare genetic neuroendocrine disorder characterized by hypotonia, obesity, short stature, and mental retardation. Incomplete or delayed pubertal development as well as premature adrenarche are usually found in PWS, whereas central precocious puberty is rarely seen. Methods: This study reports the clinical, biochemical, and histologic findings in 2 boys with PWS who developed central precocious puberty. Results: Both boys were started on growth hormone therapy during the first years of life according to the PWS indication. They had both bilateral cryptorchidism at birth and had orchidopexy in early childhood. Retrospective histologic analysis of testicular biopsies demonstrated largely normal tissue architecture and germ cell maturation, but severely decreased number of prespermatogonia in one of the patients. Both boys had premature adrenarche around the age of 6. Precocious puberty was diagnosed in both boys with enlargement of testicular volume (>3 mL), signs of virilization and a pubertal response to a gonadotropin-releasing hormone (GnRH) test and they were both treated with GnRH analog. Conclusion: The cases described here displayed typical characteristics for PWS, a considerable heterogeneity of the hypothalamic-pituitary function, as well as testicular histology. Central precocious puberty is extremely rare in PWS boys, but growth hormone treatment may play a role in the pubertal timing.
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Martinka, Magda, Andrea K. Bruecks, and Martin J. Trotter. "Histologic Spectrum of Melanocytic Nevi Removed from Patients > 60 Years of Age." Journal of Cutaneous Medicine and Surgery 11, no. 5 (September 2007): 168–73. http://dx.doi.org/10.2310/7750.2007.00028.
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Background: The histology of melanocytic nevi removed from older patients often differs from that of nevi from younger adults. According to the literature, the most common nevus in older individuals is the intradermal nevus, and purely junctional nevi are rare and should alert the pathologist to a possible melanoma precursor. Objective: To evaluate the histologic features of melanocytic nevi removed from patients > 60 year of age. Methods: Biopsies of nevi ( N = 215) from 172 patients > 60 years (mean age 69 ± 7 years) were examined retrospectively by three dermatopathologists, a consensus diagnosis was rendered, and the spectrum of histologic features was documented. Results: Junctional melanocytic nevi were frequently diagnosed in older patients (21% of cases) and a lentiginous, often heavily pigmented growth pattern was common (12% of nevi). Severely atypical (dysplastic) changes were found in 6% of nevi removed from older patients. Conclusions: We conclude that benign junctional nevi are relatively common in older patients and that a lentiginous, heavily pigmented growth pattern, traditionally associated with younger individuals, is often seen in both junctional and compound nevi in this older age group. This pattern must be differentiated from dysplastic nevus and melanoma in situ, which they may clinically resemble.
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Milroy, Christopher M., Charis Kepron, and Jacqueline L. Parai. "Histologic Changes In Recreational Drug Misuse." Academic Forensic Pathology 8, no. 3 (August 31, 2018): 653–91. http://dx.doi.org/10.1177/1925362118797740.
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Use of recreational drugs is associated with a number of histologic changes. These may be related to the method of administration or due to systemic effects of the drugs. This paper reviews the histopathological features seen following recreational drug use. With injection, there may be local effects from abscess formation and systemic effects may result in amyloidosis. Injections have been associated with necrotizing fasciitis, anthrax, and clostridial infections. Systemic effects include infective endocarditis, with the risk of embolization, and abscesses may be seen in organs in the absence of infective endocarditis. Viral complications of injection include hepatitis and human immunodeficiency virus (HIV) infection. Injecting crushed tablets can result in intravascular granulomata in the lungs. Smoking drugs is associated with intraalveolar changes, including blackand brown-pigmented macrophages in crack cocaine and cannabis smoking, respectively. Snorting may result in intraalveolar granulomata forming when crush tablets are used and there may be systemic granulomata. Stimulants are associated with cardiovascular and cerebrovascular pathology, including contraction band necrosis and myocardial fibrosis, as well as coronary artery dissection. Stimulants may cause hyperpyrexia and rhabdomyolysis, which may be associated with changes in multiple organs including myoglobin casts in the kidney. Opioids cause respiratory depression and this can be associated with inhalational pneumonia and hypoxia in other organs if there is resuscitation and a period of survival. Ketamine use has been associated with changes in the urothelium and the liver. This paper reviews histology changes that may be seen in drug-related deaths using illustrative cases.
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Eckhardt, Michael, Kabeer Shah, Melanie Bois, Joseph Maleszewski, Kellyanna Moore, and Peter Lin. "Healed Fracture of Superior Horn of Thyroid Cartilage in Autoerotic Asphyxia: An Indication of Prior Activity? A Case Report Utilizing 3D Scanning and Printing of the Larynx." Academic Forensic Pathology 8, no. 1 (March 2018): 170–79. http://dx.doi.org/10.23907/2018.012.
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Evidence of prior autoerotic asphyxia is often difficult to establish due to the decedent's efforts to hide the activity from others. In this case report, we suggest that a healed fracture of the thyroid cartilage is indicative of prior autoerotic asphyxia activity. The decedent was a 45-year-old man who was found unclothed on the floor of his bedroom with a belt ligature around the neck. A second rope ligature was loosely wrapped around the decedent's wrists, scrotum, and penis. A definitive escape mechanism was not identified, but a nearby towel and barbell weight may have comprised a possible escape mechanism. There was no known history of depression or prior autoerotic activity. Autopsy was notable for the presence of a healed fracture of the right superior horn of the thyroid cartilage. Three-dimensional (3D) surface scanning and 3D printing was utilized to preserve the anatomical findings prior to histologic sampling. To our knowledge, this is the first reported use of 3D surface scanning and 3D printing for the purpose of documenting a forensic finding prior to alteration of the anatomical specimen for histologic sampling. Acute fractures of the superior horns of the thyroid cartilage are not infrequently seen in ligature hanging. Therefore, the presence of a healed fracture in the setting of autoerotic asphyxia likely indicates prior activity. Histologic sampling of the laryngeal cartilages to detect occult healed fractures in autoerotic asphyxia may be useful. Three-dimensional scanning and printing may alleviate concerns for specimen alteration due to histology sampling.