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Boehm, A., A. Dietz et I. S. Horn. « Solide kindliche Speicheldrüsentumoren ». Kinder- und Jugendmedizin 13, no 02 (2013) : 97–105. http://dx.doi.org/10.1055/s-0038-1629326.
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ZusammenfassungSchwellungen der Speicheldrüsen treten bei Kindern häufig auf, wahre solide Speicheldrüsentumoren sind dagegen sehr selten. Die meisten dieser Tumoren treten erst im Alter zwischen 7 und 16 Jahren auf. Die Diagnostik erfolgt neben der klinischen Untersuchung mittels Sonografie, Magnetresonanz- oder Computertomografie.Bei Kindern ist das relative Risiko, dass es sich bei einem Speicheldrüsentumor um ein Malignom handelt, deutlich höher als beim Erwachsenen. Die häufigste gutartige Neoplasie ist das pleomorphe Adenom. Das häufigste Malignom ist das Mukoepidermoidkarzinom. Beide Tumoren treten v. a. in der Glandula parotis auf. Therapie der Wahl ist die operative Resektion des Tumors mit ausreichendem Sicherheitsabstand. Bei Malignomen ist eine Neck dissection bei radiologisch nachgewiesener Lymphknotenmetastasierung oder zusätzlichen Risikofaktoren notwendig. Die Indikation zu einer adjuvanten Radiatio sollte vorsichtig als individuelle Entscheidung getroffen werden.
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Klausenitz, Catharina, Anika Pusch et Birger Mensel. « Solide pseudopapilläre Neoplasie des Pankreas beim Mann mit Ikterus – eine seltene Differentialdiagnose zystischer Pankreasläsionen ». TumorDiagnostik & ; Therapie 40, no 03 (avril 2019) : 196–97. http://dx.doi.org/10.1055/a-0870-9037.
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Klausenitz, Catharina, Anika Pusch et Birger Mensel. « Solide pseudopapilläre Neoplasie des Pankreas beim Mann mit Ikterus – eine seltene Differentialdiagnose zystischer Pankreasläsionen ». RöFo - Fortschritte auf dem Gebiet der Röntgenstrahlen und der bildgebenden Verfahren 190, no 07 (7 février 2018) : 637–38. http://dx.doi.org/10.1055/s-0044-101262.
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Honauer, Prim et Goetschel. « Der kindliche Thymus im Thoraxröntgenbild : Wenn Schiffssegel und Engelsflügel nicht weiterhelfen ». Praxis 96, no 23 (1 juin 2007) : 937–39. http://dx.doi.org/10.1024/1661-8157.96.23.937.
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Das Thoraxröntgenbild eines sechs Monate alten Jungen mit Fieber und Husten zeigt ein retrokardial linksseitiges pneumonisches Infiltrat und bilaterale solide Transparenzminderungen unklarer Ätiologie. Nach klinisch erfolgreicher antibiotischer Therapie zeigt sich im Kontroll-Röntgenbild eine vollständige Auflösung der Konsolidation retrokardial bei persistierenden bilateralen Verschattungen. In der in der Folge durchgeführten Computertomographie fand sich ein ungewöhnlich konfigurierter Thymus von homogener, normaler Struktur. Die Organgrenzen des kindlichen Thymus sind konventionell-radiologisch oft sehr schwer oder gar nicht von den benachbarten anatomischen Strukturen abzugrenzen. Das Organ weist eine grosse interindividuelle Variabiliät bezüglich Form und Grösse auf und kann eine intrathorakale Neoplasie imitieren. Oft wird zur konklusiven Beurteilung der Einsatz von Schnittbildverfahren notwendig.
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Buse, Lurati et Schmid. « Hodentumoren – eine aktuelle Übersicht ». Praxis 92, no 47 (1 novembre 2003) : 1989–97. http://dx.doi.org/10.1024/0369-8394.92.47.1989.
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Hodentumoren machen 1% der Tumoren beim Mann aus, stellen aber die häufigste solide Neoplasie des jungen Mannes dar. Als Risikofaktoren sind hauptsächlich der Kryptorchismus und eine positive persönliche Hodentumor-Anamnese zu erwähnen. Histologisch wird zwischen Keimzell- und Nichtkeimzelltumoren unterschieden, wobei letztere ungefähr 5% aller Hodentumoren darstellen. Die Keimzelltumoren werden ihrerseits in der Klinik in zwei Untergruppen unterteilt: Seminome und Nichtseminome. Die häufigste klinische Erstmanifestation ist eine schmerzlose Induration. Zur Basisdiagnostik gehören die Sonographie und die Bestimmung von Tumormarkern. Der erste therapeutische Schritt ist die inguinale Semikastratio. Die weiteren therapeutischen Optionen erfolgen stadiengerecht: sie beinhalten Radiotherapie, Chemotherapie aber auch abwartende Beobachtung. Prognostisch zeichnen sich Hodentumoren durch ihre gute Heilungsrate (98–100% in frühen Stadien) oder langes rezidivfreies Überleben (80–90% in späteren Stadien) aus.
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Oliva, Fernando Cascelli, Gabriel José Dos Santos, Gustavo Hideki Hideki Orikasa, Milena Martello Cristófalo, Rafael Reis dos Santos, Beatriz Souza dos Santos, Felipe Giacobo Nunes et al. « Tumor de Frantz : desafios diagnósticos e terapêuticos : relato de caso / Frantz’s tumor : diagnostic and therapeutic challenges : case report ». Arquivos Médicos dos Hospitais e da Faculdade de Ciências Médicas da Santa Casa de São Paulo 64, no 1 (6 mai 2019) : 65. http://dx.doi.org/10.26432/1809-3019.2019.64.1.065.
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Introdução: O tumor sólido pseudopapilar do pâncreas ou Tumor de Frantz, é uma neoplasia rara, que acomete preferencialmente mulheres jovens e apresenta bom prognóstico, com baixas taxas de mortalidade. Relato de Caso: O presente trabalho apresenta um caso de uma paciente da Santa Casa de São Paulo, com Tumor de Frantz, seu diagnóstico, tratamento e complicações pós pancreatectomia.Descritores: Pâncreas, Neoplasias pancreáticas, Carcinoma papilar, Pseudocisto pancreático, Fístula pancreáticaAbstractIntroduction: The solid pseudopapillary tumor, or Frantz’s tumor, is a rare neoplasm that occurs mainly in young women and have a good prognosis, with a low mortality rate. Case report: This study aims to describe the diagnosis, treatment and post pancreatectomy complications of a Frantz’s tumor case in Santa Casa of São Paulo.Keywords: Pancreas, Pancreatic neoplasms; Carcinoma, pappilary; Pancreatic pseudocyst; Pancreatic fistula
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Bonaldi, G. « La Neuroradiologia interventistica nella patologia del basicranio ». Rivista di Neuroradiologia 13, no 3 (juin 2000) : 495–507. http://dx.doi.org/10.1177/197140090001300317.
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Il basicranio è sede di una grande varietà di eventi patologici; la sua complessità anatomica condiziona una difficile accessibilità terapeutica, in particolare chirurgica. La neuroradiologia interventistica diviene quindi strumento di grandi utilità e versatilità, potendo da un lato intervenire a supporto del chirurgo, con tecniche di embolizzazione preoperatoria, dall'altro potendo realizzare trattamenti definitivi di lesioni non altrimenti aggredibili. Le lesioni neoplastiche di interesse neurointervenzionistico che più frequentemente coinvolgono tale distretto sono: - i meningiomi, tendenzialmente meno ipervascolari rispetto a quelli della volta, possono beneficiare di un'embolizzazione preoperatoria, in tal caso solitamente realizzata con particelle solide di piccole dimensioni. L'obiettivo è quello di ottenere una devascolarizzazione il più radicale e il più distale possibile; per tale motivo vengono utilizzate particelle anche di diametro medio inferiore ai cento micron, le particelle più usate sono di P.V.A. (gelatina di alcol di polivinile), la tecnica è quella della microcateterizzazione iperselettiva dei rami durali afferenti. Spesso l'asportazione radicale di neoplasie della base cranica (tipicamente i meningiomi della regione cavernosa) non può prescindere da una dissecazione del tumore dalle pareti dall'arteria carotide interna, con conseguente rischio intraoperatorio di lesione od occlusione della stessa. In questi casi diventa importante l'esecuzione preoperatoria di un test d'occlusione per valutare i circoli di compenso. - I chemodectomi sono tumori ipervascolari, pressoché ubiquitari ma la cui sede più frequente è rappresentata dalla regione timpano-giugulare. Una loro asportazione chirurgica totale, che può condurre alla completa guarigione, non può assolutamente prescindere da una devascolarizzazione preoperatoria mediante embolizzazione. Quest'ultima può essere realizzata sia con particelle solide, sia con colle acriliche. - L'angiofibroma giovanile naso-faringeo è una lesione neoplastica benigna, modicamente vascolarizzata, originante a livello del forame sfeno palatino, spesso con coinvolgimento verso l'alto delle regioni etmoidali e del basicranio anteriore, con apporti al circolo patologico neoformato originanti dai sifoni carotidei o dalle arterie oftalmiche, di difficile embolizzazione per via endovascolare con tecnica di microcateterismo; la neoplasia può quindi essere embolizzata mediante puntura diretta (attraverso orifici naturali o per via percutanea) e successiva iniezione di colla acrilica. Alcune malformazioni vascolari che coinvolgono il basicranio sono di particolari interesse terapeutico mediante gli approcci endovascolari della neuroradiologia interventistica. Gli aneurismi del sifone carotideo intracavernoso, che solitamente si rendono evidenti clinicamente quando raggiungono le dimensioni dell'aneurisma gigante, possono essere trattati mediante embolizzazione selettiva con spirali di Guglielmi e risparmio dell'arteria portante; più frequentemente per il loro trattamento è necessario il sacrificio dell'asse carotideo interno, mediante occlusione con palloncini staccabili previo test d'occlusione. Le fistole carotido cavernose dirette sono più spesso di natura post-traumatica, meno frequentemente da rottura di aneurisma intracavernoso, da collagenopatia, da displasia fibro-muscolare. Il trattamento endovascolare è particolarmente elegante, e uno dei primi trattamenti eseguiti a livello intracranico per via endovascolare. La tecnica consiste nel ripristinare la normale pervietà dell'arteria carotide interna, occludendo il tramite patologico, mediante gonfiaggio di un palloncino staccabile nel versante venoso. Solo nelle lesioni traumatiche più gravi, con lacerazioni irregolari o multiple della parete arteriosa, può essere necessario il sacrificio della stessa. È possibile in casi selezionati anche un trattamento per via venosa, mediante stipamento del seno cavernoso con spirali staccabili di Guglielmi. Le fistole durali più frequenti sono a livello della loggia cavernosa e delle regioni dei seni trasverso e sigmoideo. Esse possono essere trattate mediante embolizzazione degli apporti arteriosi durali, con particelle solide oppure con con colle acriliche; è possibile anche un approccio per via venosa a livello di un seno durale di scarico, solitamente occluso per pregresso evento trombotico, e successivo stipamento con spirali metalliche. Nei casi ritenuti chirurgici, con clippaggio dell'origine delle vene di scarico intracraniche, l'embolizzazione preoperatoria può ridurre il rischio dell'intervento diminuendo la pressione nelle strutture venose.
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Andreula, F. C., A. M. N. Recchia-Luciani et L. Garofalo. « Linfomi del sistema nervoso centrale e Aids ». Rivista di Neuroradiologia 10, no 2_suppl (octobre 1997) : 206. http://dx.doi.org/10.1177/19714009970100s292.
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I linfomi del sistema nervoso centrale, a lungo eteroplasie intracraniche rare (1–2%) sono in continuo aumento percentuale in relazione con l'immunodepressione virale dell' AIDS (6% dei pazienti, 3% in età pediatrica), così come con quella iatrogena. Tipiche dei linfomi AIDS l'associazione con l'EB virus, l'elevata malignità, la scarsa risposta alla terapia, la localizzazione (SNC, midollo, intestino, cute, anoretto). Oggi tali tumori sono riscontrati in tutte le età (60 anni è la decade di presentazione tipica negli immunocompetenti). Le forme intracraniche, soprattutto B (80%), sono l'1% dei Non-Hodgkin, e dovrebbero essere considerate in realtà secondarie, dal punto di vista fisiopatologico, anche nei casi in cui l'esordio riguardi il SNC. Dal 20 al 40% dei casi sono forme multiple. Il ruolo giocato dall'Imaging deve essere considerato importante, poiché, nonostante le frequenti recidive a breve termine (la sopravvivenza media dalla diagnosi supera di poco l'anno, ed è minore nell'AIDS), queste forme rispondono, quando correttamente inquadrate, assai bene alle alte dosi di cortisonici (nel 40% dei soggetti trattati, già in 24 ore, per linfolisi e ripristino della b.e.e.) così come alla radioterapia. Nella patogenesi sono invocati differenti meccanismi di interconnessione tra neoplasie e agenti virali. La sede preferenziale è sopratentoriale in regione dei nuclei della base o comunque in strutture in cui la componente prevalente è la sostanza bianca. L'estensione dell'edema è incongrua rispetto all'entità della lesione, in ragione della esigua neoangiogenesi indotta. Queste masse hanno margini relativamente ben definiti solo macroscopicamente, con ben maggiore infiltrazione all'istologia; foci di rammollimento necrotico o emorragico sono rari nei pazienti AIDS. All'istologia la zona centrale di cellularità elevata, più rarefatta in periferia, mostra un caratteristico aspetto a “bulbo di cipolla” della trama reticolare. Queste neoplasie si localizzano a livello degli “involucri” cerebrali: sedi caratteristiche sono infatti le leptomeningi e le aree lungo lo spazio subependimal (40–50%), aree di coinvolgimento rese manifeste dalla impregnazione del m.d.c. L'impregnazione lungo le pareti ventricolari suggerisce la diagnosi specie se le immagini RM rivelano l'ulteriore diffusione delle localizzazione leptomeningee lungo gli spazi perivascolari di Virchow Robin. Questi tumori metastatizzano per via ematica, determinando la comparsa di lesioni parenchimali, leptomeningee e meningo-durali. In sede meningo-durale un notevole infiltrato linfomatoso può assumere aspetto a lente biconvessa. Non esistono significative differenze di imaging tra forme linfomatose primitive e secondarie del S.N.C. La TC dimostra lesioni solide singole o multiple, rotondeggianti, isodense al parenchima, (nel 20% dei casi iperdense) con quasi costante accentuazione dopo m.d.c., raramente solo periferica. La RM dimostra isoiperintensità in T1, modesto incremento in DP e ipointensità rispetto alla grigia in T2, da scarso citoplasma delle cellule componenti. L'impregnazione è unicamente da alterazione della barriera emato-encefalica (scarsa la componente neovascolare).
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BRUNI, L., J. M. BAYAS, A. VILELLA et A. CONESA. « Vaccination coverage in adults undergoing splenectomy : evaluation of hospital vaccination policies ». Epidemiology and Infection 134, no 4 (22 décembre 2005) : 837–44. http://dx.doi.org/10.1017/s0950268805005704.
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Vaccination coverage in 595 adult patients undergoing total splenectomy in the Hospital Clinic of Barcelona during 1992–2002 was studied. The rates of cover for pneumococcal, Haemophilus influenzae type b and meningococcal vaccines were 63, 63 and 61% respectively, during 2000–2002; 32, 17 and 22% in 1997–1999; and 24, 9 and 8% in 1992–1996. Multivariate analysis showed a greater risk of no vaccination in splenectomies due to trauma, malignant neoplasms of solid organs and incidental splenectomy compared with both neoplastic and non-neoplastic haematological disease, and those patients undergoing splenectomy before 2001. Coverage ([ges ]1 vaccine) since 1997 in patients with haematological diseases was 83·5% (71/85), haematological neoplasias 69·2% (18/26), solid organ neoplasms 38·3% (36/94), incidental splenectomy 35·6% (16/45), and traumas 28·4% (21/74). Mandatory hospital admission of patients undergoing splenectomy offers a good opportunity for vaccination of these patients. Specific vaccination policies should be developed to take advantage of this circumstance.
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Basturk, Olca, Ipek Coban et N. Volkan Adsay. « Pancreatic Cysts : Pathologic Classification, Differential Diagnosis, and Clinical Implications ». Archives of Pathology & ; Laboratory Medicine 133, no 3 (1 mars 2009) : 423–38. http://dx.doi.org/10.5858/133.3.423.
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Abstract Context.—Cystic lesions of the pancreas are being recognized with increasing frequency and have become a more common finding in clinical practice because of the widespread use of advanced imaging modalities and the sharp drop in the mortality rate of pancreatic surgery. Consequently, in the past 2 decades, the nature of many cystic tumors in this organ has been better characterized, and significant developments have taken place in the classification and in our understanding of pancreatic cystic lesions. Objective.—To provide an overview of the current concepts in classification, differential diagnosis, and clinical/biologic behavior of pancreatic cystic tumors. Data Sources.—The authors' personal experience, based on institutional and consultation materials, combined with an analysis of the literature. Conclusions.—In contrast to solid tumors, most of which are invasive ductal adenocarcinomas with dismal prognosis, cystic lesions of the pancreas are often either benign or low-grade indolent neoplasia. However, those that are mucinous, namely, intraductal papillary mucinous neoplasms and mucinous cystic neoplasms, constitute an important category because they have well-established malignant potential, representing an adenoma-carcinoma sequence. Those that are nonmucinous such as serous tumors, congenital cysts, lymphoepithelial cysts, and squamoid cyst of pancreatic ducts have no malignant potential. Only rare nonmucinous cystic tumors that occur as a result of degenerative/necrotic changes in otherwise solid neoplasia, such as cystic ductal adenocarcinomas, cystic pancreatic endocrine neoplasia, and solid-pseudopapillary neoplasm, are also malignant and have variable degrees of aggressiveness.
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Comolli, Jessica R., Haley M. H. Olsen, Mauricio Seguel, Rodney W. Schnellbacher, Andrew J. Fox, Stephen J. Divers et Kaori Sakamoto. « Ameloblastoma in a wild black rat snake (Pantherophis alleghaniensis) ». Journal of Veterinary Diagnostic Investigation 27, no 4 (15 juin 2015) : 536–39. http://dx.doi.org/10.1177/1040638715590652.
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Reports of neoplasia in captive reptiles are becoming more frequent; however, there is still scarce knowledge of the occurrence of neoplasia in wild reptiles. A wild black rat snake ( Pantherophis alleghaniensis) was presented to the Zoological Medicine service of the University of Georgia’s Veterinary Teaching Hospital with a 3 cm in diameter solid mandibular mass that was partially ulcerated. Radiographically, the mass was radiopaque with small bone spicules and partial osteolysis of the adjacent mandible. Histologic examination of the mass revealed a neoplasm composed of cuboidal to polygonal cells arranged in islands, anastomosing cords, and trabeculae of pseudostratified epithelium with a palisading peripheral layer of densely packed columnar cells with cytoplasmic clearing. The neoplastic tissue was separated from the mesenchyme by a prominent band of fine collagen. Neoplastic cells were positive for cytokeratin and negative for smooth muscle actin. Electron microscopy highlighted the presence of tonofilaments and microvilli. These findings led to the diagnosis of ameloblastoma, an odontogenic epithelial tumor known to occur in humans and most veterinary species.
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Boursiquot, Brian C., Nancy J. Fischbein, Davud Sirjani et Uchechukwu C. Megwalu. « Risks of Neoplasia and Malignancy in Surgically Resected Cystic Parotid Lesions ». Otolaryngology–Head and Neck Surgery 162, no 1 (3 décembre 2019) : 79–86. http://dx.doi.org/10.1177/0194599819889699.
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Objectives To evaluate the risks of neoplasm and malignancy in surgically treated cystic parotid masses compared with solid or mixed lesions and to evaluate the performance of fine-needle aspiration (FNA) in parotid cysts. Study Design Retrospective cross-sectional study. Setting Single-institution academic tertiary care center. Subjects and Methods Patients without a history of human immunodeficiency virus or head and neck cancer who underwent parotidectomy for parotid masses and had preoperative imaging to characterize lesions as cystic, solid, or mixed (ie, partially cystic and partially solid). We assessed the risks of neoplasia and malignancy, adjusting for age, sex, race/ethnicity, facial nerve weakness, and history of malignancy. We also evaluated the sensitivity and specificity of FNA. Results We included 308 patients, 27 of whom had cystic parotid masses (5 simple and 22 complex). Cystic masses were less likely to be neoplastic compared to solid or mixed masses (44% vs 97%; odds ratio [OR], 0.03; 95% confidence interval [CI], 0.01-0.07); however, there was no difference in the risk of malignancy (22% vs 26%; OR, 0.81; 95% CI, 0.32-2.10). Cystic masses were more likely to yield nondiagnostic FNA cytology results, but for diagnostic samples, FNA was 86% sensitive and 33% specific for diagnosing neoplasia and 75% sensitive and 83% specific for diagnosing malignancy. Conclusion In our population, cystic masses undergoing surgery were less likely to be neoplastic but had a similar risk of malignancy as solid masses. The risk of malignancy should be considered in the management of cystic parotid masses.
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González, Iván A., Douglas R. Stewart, Kris Ann P. Schultz, Amanda P. Field, D. Ashley Hill et Louis P. Dehner. « DICER1 tumor predisposition syndrome : an evolving story initiated with the pleuropulmonary blastoma ». Modern Pathology 35, no 1 (1 octobre 2021) : 4–22. http://dx.doi.org/10.1038/s41379-021-00905-8.
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AbstractDICER1 syndrome (OMIM 606241, 601200) is a rare autosomal dominant familial tumor predisposition disorder with a heterozygous DICER1 germline mutation. The most common tumor seen clinically is the pleuropulmonary blastoma (PPB), a lung neoplasm of early childhood which is classified on its morphologic features into four types (IR, I, II and III) with tumor progression over time within the first 4–5 years of life from the prognostically favorable cystic type I to the unfavorable solid type III. Following the initial report of PPB, its association with other cystic neoplasms was demonstrated in family studies. The detection of the germline mutation in DICER1 provided the opportunity to identify and continue to recognize a number seemingly unrelated extrapulmonary neoplasms: Sertoli-Leydig cell tumor, gynandroblastoma, embryonal rhabdomyosarcomas of the cervix and other sites, multinodular goiter, differentiated and poorly differentiated thyroid carcinoma, cervical-thyroid teratoma, cystic nephroma-anaplastic sarcoma of kidney, nasal chondromesenchymal hamartoma, intestinal juvenile-like hamartomatous polyp, ciliary body medulloepithelioma, pituitary blastoma, pineoblastoma, primary central nervous system sarcoma, embryonal tumor with multilayered rosettes-like cerebellar tumor, PPB-like peritoneal sarcoma, DICER1-associated presacral malignant teratoid neoplasm and other non-neoplastic associations. Each of these neoplasms is characterized by a second somatic mutation in DICER1. In this review, we have summarized the salient clinicopathologic aspects of these tumors whose histopathologic features have several overlapping morphologic attributes particularly the primitive mesenchyme often with rhabdomyoblastic and chondroid differentiation and an uncommitted spindle cell pattern. Several of these tumors have an initial cystic stage from which there is progression to a high grade, complex patterned neoplasm. These pathologic findings in the appropriate clinical setting should serve to alert the pathologist to the possibility of a DICER1-associated neoplasm and initiate appropriate testing on the neoplasm and to alert the clinician about the concern for a DICER1 mutation.
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Hirayama, K., Y. Honda, T. Sako, M. Okamoto, N. Tsunoda, M. Tagami et H. Taniyama. « Invasive Ductal Carcinoma of the Mammary Gland in a Mare ». Veterinary Pathology 40, no 1 (janvier 2003) : 86–91. http://dx.doi.org/10.1354/vp.40-1-86.
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A 21-year-old thoroughbred mare had a 35 X 14 X 10 cm mass involving the mammary gland. Metastases were found in the kidneys, lungs, skeletal muscles, and regional lymph nodes. Histopathologic examination of the tumor revealed a ductal solid carcinoma with extensive intraductal and intralobular involvement and focal infiltration of the adjacent stroma. The intralobular neoplasms were divided into irregularly shaped islands and sheets of polygonal and spindle-shaped epithelial cells by thick or thin fibrous connective tissue bundles. The neoplastic cells had a small or moderate amount of cytoplasm that stained faintly with eosin and round or oval hyperchromatic nuclei. Immunohistochemically, the neoplastic cells were strongly positive for Lu-5, weakly positive for AE1/AE3, vimentin, and glial fibrillary acidic protein, and negative for cytokeratin 8, cytokeratin 14, a-smooth muscle actin, calponin, and S100. The neoplasm was diagnosed as an invasive ductal carcinoma of the mammary gland with multiple metastases.
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Lund, Lidiya, et Ramila Amre. « Epithelioid Angiosarcoma Involving the Lungs ». Archives of Pathology & ; Laboratory Medicine 129, no 1 (1 janvier 2005) : e7-e10. http://dx.doi.org/10.5858/2005-129-e7-eaitl.
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Abstract Diffuse lung involvement by metastatic tumor from an unknown primary site often constitutes a diagnostic dilemma. Although cytologic features and pattern of metastatic spread can guide in narrowing the list of possible primary neoplasms, immunohistochemistry remains pivotal in determining the phenotype of metastatic disease. We report a case with extensive involvement of lung parenchyma by a metastatic epithelioid neoplasm exhibiting a variety of distinctive patterns with a predominance of intra-arterial and lymphangitic spread. Immunohistochemical studies showed no evidence of epithelial, melanocytic, or lymphoid differentiation. The neoplastic cells were strongly positive for vimentin and CD31 but negative for CD34 and factor VIIIR:Ag. Electron microscopy of formalin-fixed tissue revealed multiple Weibel-Palade bodies and pinocytosis, supporting the diagnosis of epithelioid angiosarcoma. Doppler studies performed after pathologic diagnosis was rendered demonstrated 2 discrete hypoechoic masses within the medial aspect of the left proximal calf musculature, suggestive of solid soft tissue neoplasm—a possible source of pulmonary metastatic disease.
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Reindl, Bailey A., Douglas W. Lynch et Ali D. Jassim. « Aggressive Variant of a Solid Pseudopapillary Neoplasm : A Case Report and Literature Review ». Archives of Pathology & ; Laboratory Medicine 138, no 7 (1 juillet 2014) : 974–78. http://dx.doi.org/10.5858/arpa.2013-0184-cr.
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Solid pseudopapillary neoplasm, a lesion of uncertain cellular differentiation, is an unusual tumor of the pancreas with an indolent clinical course that typically arises in young females. We report a case of solid pseudopapillary neoplasm arising in a 17-year-old adolescent girl who presented with progressive abdominal pain. The patient underwent surgical resection of an 18 × 14 × 8-cm pancreatic mass that displayed the usual histologic features of a solid pseudopapillary neoplasm in addition to prominent nuclear atypia, increased proliferative index, and extensive necrosis. These unusual histologic findings are rare and are of particular interest owing to the dramatically decreased survival time displayed in this case. Although precise pathologic criteria suggesting a high risk for aggressive behavior of solid pseudopapillary neoplasms are uncertain, recognition of the unusual pathologic features displayed in this case may be useful in the prediction of potentially more aggressive neoplasms that portend a poorer prognosis.
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La Rosa, Stefano, et Massimo Bongiovanni. « Pancreatic Solid Pseudopapillary Neoplasm : Key Pathologic and Genetic Features ». Archives of Pathology & ; Laboratory Medicine 144, no 7 (20 janvier 2020) : 829–37. http://dx.doi.org/10.5858/arpa.2019-0473-ra.
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Context.— Solid pseudopapillary neoplasm of the pancreas is a low-grade malignant tumor generally associated with a good prognosis. Solid pseudopapillary neoplasms show peculiar morphologic features, but sometimes the differential diagnosis with other pancreatic neoplasms (ie, pancreatic neuroendocrine tumors) can be a challenging task, especially in cytologic or biopsy specimens. In these cases immunohistochemistry is a useful tool, but the diagnostic utility of several proposed immunohistochemical markers is questionable. In recent years, despite several attempts to characterize the pathogenetic, molecular, and prognostic features of solid pseudopapillary neoplasms, they still remain unclear. Objective.— To give the reader a comprehensive update on this entity. Data Sources.— The PubMed database (US National Library of Medicine) was searched using the following string: pseudopapillary tumor [AND/OR] neoplasm [AND/OR] pancreas. All articles written in English were included. In addition, because a heterogeneous terminology has been used in the past to define solid pseudopapillary neoplasms, the reference lists of each paper selected in the PubMed database were also reviewed. Conclusions.— This review gives a comprehensive update on the pathologic, clinical, and molecular features of solid pseudopapillary neoplasms, particularly addressing issues and challenges related to diagnosis. In addition, we have tried to correlate the molecular alterations with the morphologic and clinical features.
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Strik, H. M., P. Proemmel, S. Pilgram-Pastor et J. H. Buhk. « Neoplastic meningitis—Is MRI as sensitive as CSF cytology ? » Journal of Clinical Oncology 27, no 15_suppl (20 mai 2009) : 9566. http://dx.doi.org/10.1200/jco.2009.27.15_suppl.9566.
Texte intégralRésumé :
9566 Background: Although CSF cytology and MRI are standard methods for the diagnosis of neoplastic meningitis (NM), this complication of neoplastic disease still remains to be difficult to detect in some cases. We therefore re-evaluated the sensitivity of gadolinium(GD)-enhanced MRI and cerebrospinal-fluid (CSF)-cytology for the diagnosis of LM differentially for solid and haematological malignancies and for normal or elevated cell counts. Methods: We identified retrospectively 101 cases of NM diagnosed in our CSF laboratory since 1990 with complete data of both MRI and CSF-cytology. 34 had haematological, 67 solid neoplasms. CSF-cell counts were increased in 63 and normal in 35 patients. Results: For haematological neoplasms, MRI was positive in 53%. CSF cytology was positive in 97%. In solid tumours, we found MRI-sensitivity of 0.81 and cytological sensitivity of 0.76. With normal CSF-cell-counts, MRI was positive in 63%, (0.57 haematological, 0.75 solid malignancies), CSF-cytology in 78%, (0.9 in haematological, 0,64 in solid neoplasms). In cases of increased cell-counts, MRI-sensitivity was 0.75 (0.52 for haematological, 0.87 for solid malignancies), and sensitivity of CSF-cytology was 0.89 (1.0 for haematological and 0.82 for solid neoplasms). 23 patients were treated with intrathecal MTX or Ara-C, 16 patients with liposomal Ara-C. 62 patients were not treated intrathecally. Conclusions: We confirmed here the high overall sensitivity of MRI for the diagnosis of neoplastic meningitis. The best sensitivity, however, was seen in solid tumours and elevated cell counts. In haematological malignancies, a markedly lower sensitivity of MRI was seen. Of note, we consider the very high sensitivity of cytology in haematological malignancies to be artificial due to methodological reasons of this retrospective study. We conclude that MRI is a very sensitive method to detect NM especially in solid tumours and elevated cell counts. With normal cell counts and haematological neoplasms, CSF-cytology remains to be superior to radiological methods. [Table: see text]
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Ng, Dennis ZW, Brian KP Goh, Elizabeth HW Tham, Stephanie M. Young et London Lucien PJ Ooi. « Cystic Neoplasms of the Pancreas : Current Diagnostic Modalities and Management ». Annals of the Academy of Medicine, Singapore 38, no 3 (5 mars 2009) : 251–59. http://dx.doi.org/10.47102/annals-acadmedsg.v38n3p251.
Texte intégralRésumé :
Cystic neoplasm of the pancreas is a relatively uncommon condition covering a wide spectrum of pathology. The increasing incidence as a result of routine imaging tests in asymptomatic patients presents a diagnostic and therapeutic problem to the clinician. This paper discusses the role of the various investigative modalities in the management of cystic neoplasia of the pancreas. Key words: Frantz tumour, Intraductal papillary mucinous neoplasm, Mucinous cystadenoma, Mucinous cystadenocarcinoma, Mucinous neoplasm of the pancreas, Solid pseudopapillary neoplasm
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Ozcan, Kerem, et David S. Klimstra. « A Review of Mucinous Cystic and Intraductal Neoplasms of the Pancreatobiliary Tract ». Archives of Pathology & ; Laboratory Medicine 146, no 3 (22 février 2022) : 298–311. http://dx.doi.org/10.5858/arpa.2021-0399-ra.
Texte intégralRésumé :
Context.— Although most pancreatic and bile duct neoplasms are solid, mucinous cystic neoplasms and intraductal neoplasms have been increasingly recognized even when clinically silent, thanks to the increased use of sensitive imaging techniques. Cystic and intraductal neoplasms of the pancreas are often resectable and curable and constitute about 5% of all pancreatic neoplasms. Owing to their preinvasive nature and different biology, recognition of these entities remains a major priority. Mucinous cystic neoplasms are histologically and clinically distinct from other cystic pancreatic neoplasms. Pancreatic intraductal neoplasms encompass 3 major entities: intraductal papillary mucinous neoplasm, intraductal oncocytic papillary neoplasm, and intraductal tubulopapillary neoplasm. Intraductal papillary neoplasms of bile ducts are also preinvasive mass-forming neoplasms with both similarities and differences with their pancreatic counterparts. All of these pancreatobiliary neoplasms have diverse and distinctive clinicopathologic, genetic, and prognostic variations. Objective.— To review the clinical, pathologic, and molecular features of mucinous cystic and intraductal neoplasms of the pancreatobiliary tract. Data Sources.— Literature review, diagnostic manuals, and guidelines. Conclusions.— This review will briefly describe well-known clinical and pathologic features and will focus on selected recently described aspects of morphology, grading, classification, and genomic alterations of cystic and intraductal neoplasms of the pancreatobiliary tract.
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Prömmel, P., S. Pilgram-Pastor, H. Sitter, J. H. Buhk et H. Strik. « Neoplastic Meningitis : How MRI and CSF Cytology Are Influenced by CSF Cell Count and Tumor Type ». Scientific World Journal 2013 (2013) : 1–5. http://dx.doi.org/10.1155/2013/248072.
Texte intégralRésumé :
Background. Although CSF cytology and MRI are standard methods to diagnose neoplastic meningitis (NM), this complication of neoplastic disease remains difficult to detect. We therefore reevaluated the sensitivity of gadolinium (GD)-enhanced MRI and cerebrospinal-fluid (CSF)-cytology and the relevance of tumor type and CSF cell count.Methods. We retrospectively identified 111 cases of NM diagnosed in our CSF laboratory since 1990 with complete documentation of both MRI and CSF cytology. 37 had haematological and 74 solid neoplasms. CSF cell counts were increased in 74 and normal in 37 patients.Results. In hematological neoplasms, MRI was positive in 49% and CSF cytology in 97%. In solid tumors, the sensitivity of MRI was 80% and of cytology 78%. With normal CSF cell counts, MRI was positive in 59% (50% hematological, 72% solid malignancies) and CSF cytology in 76% (92% in hematological, 68% in solid neoplasms). In cases of elevated cell counts, the sensitivity of MRI was 72% (50% for hematological, 83% for solid malignancies) and of CSF cytology 91% (100% for haematological and 85% for solid neoplasms). 91% of cytologically positive cases were diagnosed at first and another 7% at second lumbar puncture. Routine protein analyses had a low sensitivity in detecting NM.Conclusions. The high overall sensitivity of MRI was only confirmed for NM from solid tumors and for elevated CSF cell counts. With normal cell counts and haematological neoplasms, CSF-cytology was superior to MRI. None of the analysed routine CSF proteins had an acceptable sensitivity and specificity in detecting leptomeningeal disease.
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Nascimento, Harlan H. L., Alex dos Santos, Amanda L. Prante, Eryca C. Lamego, Luís A. S. Tondo, Mariana M. Flores, Rafael A. Fighera et Glaucia D. Kommers. « Testicular tumors in 190 dogs : clinical, macroscopic and histopathological aspects ». Pesquisa Veterinária Brasileira 40, no 7 (juillet 2020) : 525–35. http://dx.doi.org/10.1590/1678-5150-pvb-6615.
Texte intégralRésumé :
ABSTRACT: This study aimed to characterize the prevalence and clinical, macroscopic and histopathological aspects of dogs affected by testicular tumors based on biopsy specimens from the Laboratório de Patologia Veterinária of the Universidade Federal de Santa Maria (LPV-UFSM) over 19 years. Parameters regarding the age, size, and breed of the affected dogs were also established. Of all dogs with some type of neoplasm submitted to histopathological analysis at the LPV over these 19 years (n=1,900), 213 (11.2%) had at least one testicular neoplasm. The tissues of 190 dogs (with 220 neoplasms) were available for histological reassessment. The dogs in this study had different types of testicular tumors with relatively similar frequencies. In descending order, the most frequent testicular neoplasms were seminomas (88/220), Leydig (interstitial) cell tumor (LCT; 64/220), Sertoli cell tumor (SCT; 61/220), and mixed germ cell-sex cord stromal tumor (MGSCT) (07/220). Among the dogs of defined breed (119 cases), large breeds had the largest number of cases (50/119), followed by small (47/119) and medium-sized (22/119) breeds. The ages of dogs affected by testicular tumors ranged from 10 months to 18 years. Increased testicular volume was the most common clinical manifestation. Eleven dogs presented information about clinical signs suggestive of hyperestrogenism syndrome (feminization). In seminomas, the diffuse pattern predominated over the intratubular pattern. Two sites (luminal and basal compartments) suggestive of the onset of neoplastic transformations in germ cells were observed in intratubular seminomas. They corroborate the hypothesis that canine seminomas possibly have pathogenesis similar to that observed in human spermatocytic seminomas. The SCTs and LCTs presented high cell morphology variation. SCTs had neoplastic cells organized in five different histological arrangements. As for LCT, solid-diffuse and cystic-vascular histological patterns were the most commonly observed. Through this study, it was possible to establish some of the leading clinical, macroscopic, and histopathological aspects of testicular neoplasms diagnosed over 19 years in the area covered by the LPV-UFSM.
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Young, Robert H. « Testicular Tumors—Some New and a Few Perennial Problems ». Archives of Pathology & ; Laboratory Medicine 132, no 4 (1 avril 2008) : 548–64. http://dx.doi.org/10.5858/2008-132-548-ttnaaf.
Texte intégralRésumé :
Abstract The histopathology of testicular tumors is presented, emphasizing new, unusual, or underemphasized aspects. Within the category of seminoma of the usual type, the recent literature has drawn attention to the presence in occasional tumors of solid or hollow tubules or spaces of varying sizes and shape that may result in cribriform or microcystic patterns, causing potential confusion with other neoplasms, most notably Sertoli cell tumor or yolk sac tumor. Although regions of typical neoplasia and awareness of this phenomenon usually will be diagnostic, immunohistochemistry may play a role in excluding Sertoli cell tumor or yolk sac tumor. Although immunohistochemistry can play an undoubted helpful role in this and selected other areas of testicular tumor evaluation, careful evaluation of the gross and routine microscopic features will solve the vast majority of diagnostic problems. An excellent review of immunohistochemistry in this area by R. E. Emerson, MD, and T. M. Ulbright, MD, is cited herein. Spermatocytic seminoma remains a crucial pitfall in diagnosis, and the pathologist must always be alert to the possible diagnosis when looking at a seminomatous neoplasm, particularly in an older patient, although about one third of these tumors occur in the usual seminoma age range. The embryonal carcinoma has a great diversity of patterns, which are briefly noted. The enigmatic and picturesque tumor, polyembryoma, which virtually never occurs in pure form but may be a confusing component of a variety of mixed germ cell tumors, is discussed and illustrated. The phenomenon of burnt-out germ cell neoplasia is also briefly noted and an excellent recent contribution is referred to. Within the sex cord–stromal family of neoplasms, recent contributions and elaborations of unusual morphologic features of Leydig cell tumors and Sertoli cell tumors are presented. Within the Leydig cell family, cyst formation, adipose metaplasia, calcification or ossification, and spindle cell patterns may be particularly confusing, and in the Sertoli cell family, a great array of patterns caused by differing admixtures of tubular, solid, and stromal components occur. The peculiar lesion, intratubular large cell hyalinizing Sertoli cell tumor, of young boys with Peutz-Jeghers syndrome, is briefly discussed. Some of the problems in the family of hematopoietic neoplasms are reviewed, these processes posing diverse problems in differential diagnosis and their correct recognition having crucial therapeutic implications. Although secondary tumors to the testis have not received the same attention in the literature as the similar phenomenon in the female gonad, remarkable examples of testicular spread of diverse neoplasms, usually carcinoma but rarely melanoma, are seen, and the pathologist should be alert to this possibility, particularly when examining an unusual morphology in an older patient. Finally, a few comments are made on the common paratesticular neoplasm, the adenomatoid tumor, highlighting its varied patterns and recent description of some of the issues that may arise when they undergo total or subtotal infarction.
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Bokemeyer, C., et H. J. Schmoll. « Secondary neoplasms following treatment of malignant germ cell tumors. » Journal of Clinical Oncology 11, no 9 (septembre 1993) : 1703–9. http://dx.doi.org/10.1200/jco.1993.11.9.1703.
Texte intégralRésumé :
PURPOSE The current study investigates the frequency and outcome of secondary malignancies in patients treated for testicular cancer at Hannover University Medical School between 1970 and 1990. PATIENTS AND METHODS One thousand twenty-five patients with a median follow-up duration of 61 months (range, 12 to 240) were included in the analysis. Follow-up was complete in 1,018 patients (99%). Histology was seminoma in 324 patients (38.7%) and nonseminomatous germ cell tumor in 624 patients (61.3%). At the time of median follow-up, 814 patients (79.9%) were alive. RESULTS Fourteen patients developed a secondary neoplasm (cumulative incidence, 1.38%; 95% confidence interval [CI], 0.75 to 2.30); 13 patients had solid tumors and one had secondary lymphoblastic leukemia with a t(4; 11) translocation including band 11q23. None of 224 patients on surveillance strategy (with or without retroperitoneal lymph node dissection [RPLND]) developed a second neoplasm, compared with four of 413 patients (0.97%; 95% CI, 0 to 1.9) after cisplatin-based chemotherapy (not significant) and nine of 332 patients (2.7%; 95% CI, 0.9 to 4.5) after radiotherapy (P = .02). The cumulative incidence of a secondary neoplasia of 1.76% (95% CI, 0.97 to 2.94) in patients treated by radiotherapy and/or chemotherapy was significantly higher compared with patients on surveillance protocols (P = .03). Chemotherapy containing standard-dose etoposide did not increase the risk of occurrence of secondary neoplasms. A significantly elevated relative risk of 7.53 (range, 3.4 to 14.3) compared with the male German population was only found for patients treated by radiotherapy. CONCLUSION Compared with patients who have other curable malignant tumors, an incidence of 1.38 of secondary neoplasms after a median follow-up duration of 61 months is low. The highest risk for secondary neoplasia after treatment of testicular cancer is associated with the use of radiotherapy. Following chemotherapy, no significantly elevated risk was observed. In conclusion, the benefits of curative treatment far outweigh the risk of secondary cancer in patients with malignant germ cell tumors.
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Powers, Charles K., Molly Posa, Dhanashree Rajderkar et Jaclyn Otero. « 10-Year-Old Female with Acute Abdominal Pain with Pancreatic Mass ». Case Reports in Pediatrics 2017 (2017) : 1–4. http://dx.doi.org/10.1155/2017/3253787.
Texte intégralRésumé :
A previously healthy 10-year-old female presented to a local emergency department following three days of nausea and vomiting diagnosed with a solid pseudopapillary tumor. Solid pseudopapillary neoplasms are a rare form of pancreatic cystic neoplasm that typically presents in young females in their 20–30s and are very rare in children. These neoplasms often present as an asymptomatic tumor found on incidental imaging. When symptomatic they most commonly present with abdominal pain and can also cause a palpable abdominal mass, weight loss, gastrointestinal obstruction, and nausea and vomiting. Timely diagnosis of this rare neoplasm is very important because complete resection of the tumor is the definitive treatment and leads to an excellent long-term survival.
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Dronov, O. I., V. L. Dronova, L. O. Roschyna et O. M. Mokryk. « Single clinical observations pseudopapillary solid neoplasms of the pancreas in pregnant women ». HEALTH OF WOMAN, no 4(120) (30 mai 2017) : 11–15. http://dx.doi.org/10.15574/hw.2017.120.11.
Texte intégralRésumé :
The article presents the world data on the incidence, clinical picture and diagnosis of solid pseudopapillary neoplasm both in general and in pregnant women. Two clinical cases of solid pseudopapillary neoplasm in pregnant women were described in detail, with highly specialized surgical and perinatal care in the hospitals of the Center for Surgery of Liver, Biliary and Pancreatic Diseases n.V.S.Zemskov (surgical department) and in the department of surgical gynecology of the SI «Institute of pediatrics, obstetrics and gynecology National Academy of Medical Sciences of Ukraine». Demonstrate the features of diagnosis, surgical treatment of patients with solid pseudopapillary neoplasms during pregnancy. Key words: solid pseudopapillary neoplasm, surgical treatment, pregnancy, management of pregnancy and childbirth.
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Albitar, Maher, Hong Zhang, Ahmad Charifa, Andrew Ip, Ivan De Dios, Wanlong Ma, James McCloskey et al. « Cell-free RNA in liquid biopsy and biomarkers profiling of hematologic and solid tumors. » Journal of Clinical Oncology 40, no 16_suppl (1 juin 2022) : 3047. http://dx.doi.org/10.1200/jco.2022.40.16_suppl.3047.
Texte intégralRésumé :
3047 Background: Expressed RNA can capture mutations, changes in expression levels due to methylation, and provide information on cell of origin, growth, and proliferation status. We developed an approach to isolate fragmented RNA from peripheral blood plasma and explored its potential to be used in liquid biopsy. Methods: Peripheral blood cfRNA was extracted from patients with neoplasms in B-cell (#105), T-cell (#16), Myeloid (#73), and from solid tumors (#44), Normal individuals (#51), and reactive post-transplant (#137). RNA was sequenced using a 1459-gene panel. Expression profile was generated using Cufflinks. Results: cfRNA levels of various solid tumor biomarkers (CA-125, CA-15-3, CEA 8, Keratin19, Keratin6A...) were significantly higher (P < 0.0001) in samples from solid tumors as compared with normal control. Similarly, cfRNA lymphoid markers (CD19, CD22, CD79A, and CD79B...) and cfRNA myeloid markers (CD33, CD14, CD117, CD56...) were all higher in B-cell lymphoid neoplasms and myeloid neoplasms, respectively (P < 0.0001), as compared with control. In evaluating the host immune system, cfRNA CD4:CD8B and CD3D:CD19 ratios in normal controls were as expected (median: 5.92 and 6.87, respectively) and were significantly lower in solid tumors (median 3.40 and 2.23, respectively, P < 0.0002). Solid tumor cfRNA showed CTLA4:CD8B ratio significantly higher in tumors than in normal (median 0.74 vs 0.19, P = 0.0001), while there was no difference in cfRNA PD-L1:CD8B ratio (median 1.45 vs 1.77, P = 0.96). Similar distinct patterns are noted for various cytokine and chemokines. cfRNA was highly predictive of diagnosis (AUC > 0.98) of solid tumors, B-cell lymphoid neoplasms, T-cell lymphoid neoplasms, and myeloid neoplasms as compared with normal control. When a specific neoplastic disease was considered against all cases including control and other neoplasms, the AUC varied between 0.77 and 0.949. Conclusions: This data shows that liquid biopsy using targeted sequencing of cfRNA in patients with various types of cancer provides comprehensive and reliable information on the neoplastic disease as well as the host. [Table: see text]
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Loghin, M. E., et M. D. Groves. « Neoplastic meningitis in unknown primary neoplasms ». Journal of Clinical Oncology 24, no 18_suppl (20 juin 2006) : 11517. http://dx.doi.org/10.1200/jco.2006.24.18_suppl.11517.
Texte intégralRésumé :
11517 Background: Neoplastic meningitis (NM) is diagnosed in 5–8% of patients with solid tumors. Unknown primary cancers (UPC) constitute 1% to 7% of NM cases. There is scattered data addressing NM in the context of UPC. Here we characterize the clinical manifestations, prognostic factors and survival outcomes in patients with NM from UPC. Methods: Through an IRB-approved, retrospective chart-review, spanning 1944–2002, we identified 38 patients with UPC, with NM either the presenting feature or a later manifestation of their systemic cancer. Imaging studies were also reviewed. Results: Median age at UPC diagnosis was 44 (13–72 years); for those patients not presenting with NM, time from UPC diagnosis to NM diagnosis was 10 weeks (range 3–60 weeks). Five patients presented with NM as the first and only manifestation of cancer, 1 presented with NM simultaneously with UPC, and 32 patients presented with UPC, followed by NM. Sixteen of those 32 patients presented with central nervous system (CNS) metastases concomitantly with their UPC diagnosis. The final cancer diagnoses were: melanoma (n=21), adenocarcinoma (n=12), small cell undifferentiated carcinoma (n=2), undifferentiated malignant tumor (n=1), Ewing sarcoma (n=1) and sarcomatoid carcinoma (n=1). The median overall survival after the initial diagnosis of UPC was 54 weeks (range: 6–344 weeks), and the median survival after the diagnosis of NM was 10.7 weeks (range: 2–132 weeks). Thirteen patients had a prolonged survival after the diagnosis of NM (24–132 weeks), 8 with melanoma, 3 with adenocarcinoma, 2 with small cell cancer. Six of the 8 melanoma patients with prolonged survival presented with only CNS disease, and none developed other metastatic sites during the course of their disease. Conclusions: Patients with NM and UPC have a poor prognosis. The most commonly identified primary tumors in patients with NM and UPC are melanoma and adenocarcinoma. UPC presenting as NM, and found to be melanoma limited to the CNS and or meninges, carries a better prognosis than other UPCs with NM where systemic tumor burden is identified. This may aid in the systemic diagnostic evaluation and treatment of such patients. No significant financial relationships to disclose.
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Khan, Dr Sabina, Dr Monal Trisal, Dr Musharraf Husain, Dr Shaan Khetrapal, Dr Mohd Jaseem Hassan et Dr Sujata Jetley. « Solid Pseudopapillary Neoplasm of the Pancreas - A rare entity with emphasis on the differential diagnosis. » Tropical Journal of Pathology and Microbiology 7, no 1 (20 février 2021) : 60–64. http://dx.doi.org/10.17511/jopm.2021.i01.10.
Texte intégralRésumé :
Solid Pseudopapillary Neoplasm of Pancreas (SPNP) is a rare, low-grade malignant solid-cysticneoplasm with papillary architecture. It accounts for 2% to 3% of pancreatic neoplasms and 0.9% to2.7% of exocrine pancreatic neoplasms. It occurs almost exclusively in young women and has anexcellent postsurgical curative rate. Metastasis is rare although it may be locally aggressive. Thesolid pseudopapillary neoplasm of the pancreas pose a diagnostic challenge both clinically andradiologically as it has a nonspecific clinical presentation with vague radiologic features.Histopathological evaluation and immunohistochemistry remains the gold standard in reaching adefinitive diagnosis. Due to its low incidence, the clinical and pathologic features of SPNP have notbeen extensively studied. We report a case of a 32-year-old lady with solid pseudopapillaryneoplasm of the pancreas that was suspected on abdominal CECT as a well-defined mass in theampullary-periampullary region abutting head of the pancreas and confirmed on histopathologicalevaluation with immunohistochemistry.
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Mayerhofer, Thomas, et Rajesh Kumar Jha. « Sphingosine Analogs and Protein Phosphatase 2A as a Molecular Targeted Cancer Therapy : A Mini Systematic Review ». Clinical Cancer Drugs 7, no 2 (6 novembre 2020) : 78–88. http://dx.doi.org/10.2174/2212697x07999200504110631.
Texte intégralRésumé :
Background: Regulation of protein phosphatase 2A (PP2A) plays an important role in hematologic and solid neoplasms. Therefore, the use of sphingosine analogs as anti-neoplastic drugs has shown potential due to their role as PP2A activators. Objective: Investigation of whether sphingosine analogs bind to endogenous inhibitor proteins of PP2A, such as I2 PP2A/SET and/or CIP2A, and whether this binding reactivates PP2A, allowing it to resume its role as a tumor suppressor. Methods: Literature from the PubMed database was searched and those articles related to PP2A and sphingosine analogs were reviewed. Results: Utilization of sphingosine analogs in hematologic and solid neoplasms revealed numerous mechanisms of inducing cell death. Regulation of PP2A through modulation of I2 PP2A/SET and/or CIP2A was demonstrated in a variety of neoplastic processes; however, unique mechanisms such as cell necrosis via the production of reactive oxygen species was also appreciated. Conclusion: Only certain malignancies expressed endogenous inhibitor proteins, yet sphingosine analogs were able to induce cell death in neoplasms that did not express these proteins. This suggests that sphingosine analogs may be utilized for anti-neoplastic therapy via reactivation of PP2A however, it is not the exclusive mechanism for inducing cell death. Further investigation of sphingosine analogs as a novel or adjunctive chemotherapeutic treatment is warranted.
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García Hevia, Alejandro, Agustín Monteferrario, Ángel L. Pierini, Leandro Pierini, Daniel Gatti et Matías Wenger. « Neoplasia sólida pseudopapilar del páncreas ». Revista Argentina de Cirugía 110, no 1 (1 mars 2018) : 37–42. http://dx.doi.org/10.25132/raac.v110.n1.1319.es.
Texte intégral
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P.M, Athira, Rachegowda N, Gaurav Yadav, M. Madhukar et Amrutha Ranganath. « Interesting Case of Solid Pseudopapillary Epithelial Neoplasm of Pancreas (SPEN) In A Pregnant Woman ». JOURNAL OF CLINICAL AND BIOMEDICAL SCIENCES 16, no 1 (19 mars 2019) : 27–28. http://dx.doi.org/10.58739/jcbs/v09i1.5.
Texte intégralRésumé :
Solid pseudopapillary tumours (SPT) are rare, cystic neoplasm of the pancreas with low malignant potential. It usu-ally occurs in females in second to third decade of life and have favourable diagnosis. We present a case of SPT which was diagnosed incidentally in a 19 year old pregnant female at 12 weeks who later had an abortion at 20 weeks of gestation. Pan-creatic pseudopapillary tumors are rare neoplasms with low malignant potential and sound be kept as differential diagnosis while evaluating pancreatic tumors. Keywords: Papillary Tumors, Pancreas.
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Mirza, Rusella, Nestor Dela Cruz et Guillermo A. Herrera. « Thyroid-Like Low-Grade Nasopharyngeal Papillary Adenocarcinoma with Biphasic Histology ». Case Reports in Pathology 2020 (17 janvier 2020) : 1–3. http://dx.doi.org/10.1155/2020/3275916.
Texte intégralRésumé :
Thyroid-like low-grade nasopharyngeal papillary adenocarcinoma (TL-LGNPPA) is a rare primary adenocarcinoma of nasopharynx. The immunohistochemical pattern of this tumor is similar to that of papillary thyroid carcinoma making this neoplasm a challenging diagnosis. A case of TL-LGNPPA with biphasic morphology is presented. The removed tumor from the nasopharynx exhibited a polypoid appearance. Microscopically, it was composed of papillary structures admixed with a few solid areas of spindle cells. The papillae were lined by columnar epithelium. Both the epithelium and the spindle cells were strongly positive for TTF-1 and CK19 and negative for CK5/6, S-100, and thyroglobulin. Cellular atypia, necrosis, and high mitotic rate were absent. Ki67 was less than 2% in the neoplastic cells. No local recurrence or distant metastasis was reported after 12 months of follow-up. Caution should be taken to differentiate TL-LGPPA from other TTF-1-positive neoplasms, especially papillary thyroid carcinoma, as the prognosis for these two tumors is entirely different.
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Chakhachiro, Zaher I., et Ghazi Zaatari. « Solid-Pseudopapillary Neoplasm : A Pancreatic Enigma ». Archives of Pathology & ; Laboratory Medicine 133, no 12 (1 décembre 2009) : 1989–93. http://dx.doi.org/10.5858/133.12.1989.
Texte intégralRésumé :
Abstract Solid-pseudopapillary neoplasm of the pancreas is a relatively uncommon tumor. It typically affects young women, has nonspecific clinical and radiologic manifestations, and can be readily diagnosed by ultrasound-guided fine-needle aspiration and histopathologic evaluation. Histologic features characteristically show loosely cohesive, relatively uniform polygonal cells surrounding delicate capillary-sized blood vessels. Other features include cytoplasmic vacuolization, finely stippled chromatin, nuclear grooving, eosinophilic hyaline globules, and degenerative changes. Almost all solid-pseudopapillary neoplasms harbor mutations in the β-catenin gene. They stain with β-catenin, CD10, and focally with neuroendocrine markers. Although previously considered benign, this tumor is currently considered a low-grade malignant epithelial neoplasm with low metastatic rate and high overall survival. Most patients are cured by complete surgical excision. Despite the characterization of the morphologic and molecular features of this enigmatic neoplasm, more work is needed to uncover its cell of origin and true histogenesis.
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Ekinci, Nese, Eylül Gün, Arzu Avcı et Ahmet Er. « Coexistence of low-grade mucinous neoplasm and carcinoid (collision tumor) within multiple appendiceal diverticula : A case report ». Turkish Journal of Surgery 37, no 3 (1 septembre 2021) : 303–6. http://dx.doi.org/10.47717/turkjsurg.2021.3877.
Texte intégralRésumé :
Neoplasms of the appendix are very rare. They usually show glandular or neuroendocrine differentiation, and when they both occur in the same area, it is called a “collision tumor.” Low-grade mucinous neoplasms associated with appendiceal diverticula are also uncommon. The appendectomy specimen of a 60-year-old man contained dense and mucoid luminal content on the distal tip, and similarly a solid, yellow, lumen-obscuring tumor with a diameter of 1.5 cm at the base of the appendix was detected. Microscopically, there were three diverticula that comprised herniation of the mucosal layer through the appendiceal wall. Interestingly, all of the diverticula and the normal-appearing appendiceal wall were lined by adenomatous epithelium. The luminal portion had pools of mucin-containing, rare clusters of low-grade epithelium that gave rise to the diagnosis of a “low-grade mucinous neoplasm.” The solid-appearing tumor was diagnosed as a “neuroendocrine neoplasm,” and there was no transition zone between these two types of tumors. There are some cases that have been reported as low-grade mucinous neoplasms associated with appendicular diverticula and collision tumors consisting both mucinous neoplasms and carcinoid tumors in the literature; our case has a unique appearance with two different types of tumors both in the appendix wall and within multiple diverticula.
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Heymann, Jonas J., et Momin T. Siddiqui. « Ancillary Techniques in Cytologic Specimens Obtained from Solid Lesions of the Pancreas : A Review ». Acta Cytologica 64, no 1-2 (10 avril 2019) : 103–23. http://dx.doi.org/10.1159/000497153.
Texte intégralRésumé :
Advanced methods of molecular characterization have elucidated the genetic, epigenetic, and proteomic alterations associated with the broad spectrum of pancreatic disease, particularly neoplasia. Next-generation sequencing, in particular, has revealed the genomic diversity among pancreatic ductal adenocarcinoma, neuroendocrine and acinar tumors, solid pseudopapillary neoplasm, and other pancreatico-biliary neoplasms. Differentiating these entities from one another by morphologic analysis alone may be challenging, especially when examining the small quantities of diagnostic material inherent to cytologic specimens. In order to enhance the sensitivity and specificity of pancreatic cytomorphology, multiple diagnostic, prognostic, and predictive ancillary tests have been and continue to be developed. Although a great number of such tests have been developed for evaluation of specimens collected from cystic lesions and strictures, ancillary techniques also play a significant role in the evaluation of cytologic specimens obtained from solid lesions of the pancreas. Furthermore, while some tests have been developed to differentiate diagnostic entities from one another, others have been developed to simply identify dysplasia and malignancy. Ancillary studies are particularly important in the subset of cases for which cytomorphologic analysis provides a result that is equivocal or insufficient to guide clinical management. Selection of appropriate ancillary testing modalities requires familiarity with both their methodology and the molecular basis of the pancreatic diseases for which testing is being performed.
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Cesarman-Maus, Gabriela N., Esteban Braggio, Carmen Lome, Ana Lilia Morales-Leyte et Rafael Fonseca. « Tissue Factor and Hematological Neoplasias ». Blood 120, no 21 (16 novembre 2012) : 5132. http://dx.doi.org/10.1182/blood.v120.21.5132.5132.
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Abstract Abstract 5132 There is a well- recognized correlation between cancer and aberrant hemostasis. Venous thromboembolism (VTE) in individuals with solid epithelial tumors has been associated with a poor prognosis, with more than three-fold higher risk of early death as compared to cancer patients without thrombosis. The expression of tissue factor (TF), a cell-surface membrane glycoprotein that triggers the activation of coagulation by cancer cells, is one of the main underlying mechanisms linking thrombosis and aggressive tumor behavior. TF is expressed in a variety of solid tumors in association with genetic events affecting oncogenes and tumor suppressor genes. However, the mechanisms of thrombosis in individuals with hematological malignancies may differ from those with solid tumors. We have previously shown that despite the high rate of thrombosis in multiple myeloma, malignant plasma cells only rarely express TF. We sought to determine TF gene (F3) and protein expression in hematological neoplasias. F3 expression profiling was studied on a variety of cell lines established from lymphoid and myeloid neoplasias available at Glaxo Smith Kline (GSK) Cancer Cell Line Genomic Profiling Dataset (https://array.nci.nih.gov/caarray/project/woost-00041). Interestingly, F3 expression was absent in all lymphoid neoplasias studied, in sharp contrast to acute myeloid leukemias (AML) and solid tumors, of which 30 and 90% expressed F3, respectively. Immunohistochemistry (IHC) confirmed the absence of TF protein expression in all indolent and high-grade B-cell lymphomas (99 patients, including germinal center and activated B-cell phenotype diffuse large B-cell lymphomas) and in all T-cell lymphomas/leukemias (20 patients) studied. IHC for TF was also negative in AML (11 patients) but positive in representative solid tumors (breast, pancreas, prostate), except for renal cell carcinoma which has been previously shown to lack TF. We propose that the pathogenesis of VTE associated with hematological neoplasias differs from that of solid tumors. Though TF from non-neoplastic cell sources may still be important for the prothrombotic state often seen in these patients, we show there is no evidence for a role of tumor-derived TF in the development of DVT, nor in neoplastic behavior. Thus, treatments directed against TF may not impact on prognosis in lymphoid, and non TF-expressing myeloid neoplasias. Disclosures: No relevant conflicts of interest to declare.
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Tavernier, Emmanuelle, Stephane de Botton, Nathalie Dhedin, Claude-Eric Bulabois, Oumedaly Reman, Norbert Vey, Frederic Garban et al. « Secondary or Concomitant Neoplasms among Adults Diagnosed with Acute Lymphoblastic Leukemia (ALL) and Treated According to the LALA-87 and LALA-94 Trials. » Blood 106, no 11 (16 novembre 2005) : 1826. http://dx.doi.org/10.1182/blood.v106.11.1826.1826.
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Abstract Second malignant neoplasms are a serious complication after successful treatment of childhood ALL. Although treatment intensity and outcome were not comparable, with improvements in survival, it is important to evaluate the rate and the type of second neoplasms in adults with ALL. We analyzed the data from the GET-LALA group. A cohort of 1493 patients, aged 15 to 60 years and enrolled on two successive multicenter protocols between 1987 and 2002, was observed to determine the incidence of second neoplasms and associated risk factors. The median follow-up time from diagnosis was 6 years. By February 2005, secondary or concomitant neoplasms were documented in 23 patients (median age: 36 years, range:18–57) including 9 acute myeloid leukemias, 4 non Hodgkin lymphomas, 5 skin tumors, and 5 other solid tumors (1 lung cancer, 1 tongue carcinoma, 1 thymoma, 1 condrosarcoma, 1 histiocytosis). Neoplasms developed 0.5 to 13.8 years (median, 4.5 years) after the diagnosis of ALL. 22 patients were in first remission, one was in second remission. The overall cumulative risk of secondary neoplasms was 2.1% at 5 years, 4.9% at 10 years, 9.4% at 15 years. The cumulative risk of developing a second hematologic malignancy was 1.8% at 5 years, 2.2% at 10 years, 3.3% at 18 years; that of developing a solid tumor was 0.2% at 5 years, 2.8% at 10 years, 6.2% at 15 years. The development of secondary neoplasm was not associated with the use of any specific cytotoxic agent. However, risk of skin tumor increased with radiation dose and transplantation (p = 0.01). Overall survival after the diagnosis of a second malignant neoplasm was 55% at 10 years. However, the median overall survival in patients developing acute myeloid leukemia was of 5.7 months. Considering the low-survival rate of this large unselected adult ALL cohort (32% at 10 years), considering the poorer results comparing to childhood ALL treatment, the risk of secondary or concomitant neoplasm remains probably under estimated. Larger series with long-term follow-up are, however, mandatory. Figure Figure
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Ahmed, Mousumi, Nazma Afroze et Mahjabin Sabiha. « Morphological Pattern of Ovarian Tumour : Experience in a Tertiary Level Hospital ». Journal of Bangladesh College of Physicians and Surgeons 36, no 1 (29 janvier 2018) : 5–10. http://dx.doi.org/10.3329/jbcps.v36i1.35504.
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Background: Ovarian tumor is a common type of gynecological neoplasm and accounts for 15-25% of all gynecological malignancies. It is associated with high mortality and an accurate histological diagnosis is essential for management of patient.Objective: The study was performed to find out the morphological pattern, nature and age distribution of ovarian tumour in our hospital.Material and methods: It was a prospective study,conducted in the Department of Histopathology and Cytopathology, BIRDEM General Hospital, Dhaka for a period of two years from Jan 2014 to Dec 2015. This study included 186 cases of ovarian tumors sent in the Department of Pathology for histopathological evaluation. Non-neoplastic lesions and tumour-like conditions were excluded from the study. Histological diagnosis, age and laterality of ovary were recorded. Morphological pattern, nature and age distribution of ovarian neoplasms were calculated.Result: 84.95% cases of ovarian tumour were benign, 1.61% cases were borderline and 13.44% cases were malignant. ORIGINAL ARTICLES Surface epithelial tumour was the commonest type of tumour (61.83%), according to the histogenesis , followed by germ cell tumour. Benign serous tumour was the most common type of benign tumor (37.98% cases), followed by mature cystic teratoma (33.55% cases). Serous cystadenocarcinoma was the most common type of malignant tumour (36.0%), followed by endometrioid carcinoma (28.0%). Benign tumours were more frequent in all age group. The incidence of malignant ovarian tumour increased with age and was most frequent in >50 years age group. Benign tumours were commonly cystic, whereas malignant tumours were commonly solid and cystic. 11.23% cases of ovarian tumours were bilateral.Conclusion: Benign ovarian neoplasms were more common than malignant ones and benign serous tumour was the commonest type of benign neoplasm whereas serous cystdenocarcinoma was the commonest type of malignant neoplasm. The pattern and age distribution of ovarian tumour of our study were quite similar with other studies with some variation.J Bangladesh Coll Phys Surg 2018; 36(1): 5-10
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Klimstra, David S., Martha B. Pitman et Ralph H. Hruban. « An Algorithmic Approach to the Diagnosis of Pancreatic Neoplasms ». Archives of Pathology & ; Laboratory Medicine 133, no 3 (1 mars 2009) : 454–64. http://dx.doi.org/10.5858/133.3.454.
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Abstract Context.—The pancreas gives rise to an array of distinct neoplasms that can be solid, cystic, or intraductal and can recapitulate the various lines of differentiation present in the normal gland. Objective.—To develop an algorithmic approach to the diagnosis of pancreatic neoplasms that simplifies their pathologic evaluation. Data Sources.—We reviewed literature related to the classification of pancreatic neoplasms on the basis of their gross, histologic, and immunohistochemical features. Conclusions.—By using a series of dichotomous decisions, the differential diagnosis of a pancreatic neoplasm can be narrowed, and in cases of the more common neoplasms, accurate classification can be achieved. Uncommon neoplasms not accounted for by this approach are also discussed, and the additional diagnostic information needed for complete pathologic reporting is presented.
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Indelicato, Daniel, Kathryn Tringale, Julie Bradley, Raymond Mailhot Vega, Christopher Morris, Dana Casey et Suzanne Wolden. « RONC-03. Secondary Neoplasms in Children with Central Nervous System (CNS) Tumors Following Radiotherapy in the Modern Era ». Neuro-Oncology 24, Supplement_1 (1 juin 2022) : i176—i177. http://dx.doi.org/10.1093/neuonc/noac079.657.
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Abstract PURPOSE: To assess reduction of secondary radiation-induced neoplasms over the past two decades, focusing on children with CNS tumors who received intensity modulated radiotherapy (IMRT) or proton therapy (PT). METHODS: A total of 1044 children received radiotherapy for a primary CNS tumor at 2 institutions between 1999 and 2020, including 99 treated with IMRT and 945 treated with PT. Median age was 8.7 years old. Median follow-up was 6.0 years and included 83 and 510 patients with >5 years follow-up in the IMRT and proton cohorts, respectively. Cumulative incidence method provided estimates of secondary neoplasms encompassing benign and malignant solid tumors as well as leukemia. Multiple variables were assessed using proportional hazard regression for competing risks. RESULTS: Ten-year overall survival was 87.4%. Patients treated with IMRT were significantly older, with a median age of 10.4 vs 8.4 years old (p <0.001), but were more likely to receive craniospinal irradiation (31.3% vs 14.2%, p <0.001) or alkylating chemotherapy (50.5% vs 29.7%, p <0.001). The 5- and 10-year cumulative incidence of second neoplasm was 0.7% and 2.3%, respectively. On multivariate analysis, age <5 (4.9% vs 0.7% at 10 years) and tumor predisposition syndrome (34.3% vs 1.5% at 10 years) were significantly associated with a second neoplasm (p < 0.01 for each). On both univariate and multivariate analyses, PT was not associated with a lower incidence of second neoplasm. Following IMRT, 1/2 second solid tumors occurred outside the target volume, compared to 2/11 after PT. CONCLUSION: Following modern radiotherapy, approximately 2% of children with a CNS tumor will develop a second neoplasm within 10 years of treatment. Compared to IMRT, PT was not associated with an overall reduction in second neoplasms. More events and follow-up beyond 10 years are needed to determine if proton therapy reduces the incidence of second solid tumors occurring specifically in the low dose region.
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Jain, Avi Vinod, Suresh V. Phatak, Laxmi Bishnoi, Rohan Kumar Singh et Prerna Patwa. « Mucinous Cystadenocarcinoma of Pancreas - USG and CT Evaluation - A Case Report ». Journal of Evolution of Medical and Dental Sciences 10, no 32 (9 août 2021) : 2680–83. http://dx.doi.org/10.14260/jemds/2021/546.
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Cystic neoplasms of the pancreas comprise a pathologically heterogeneous group of tumours with many shared clinical features. Although relatively uncommon, they have a very important place within the surgical pathology of the pancreas because of their high cure rate and their potential (and not infrequent) confusion with the far more common pancreatic pseudocysts. Their exact incidence is unknown, but it is frequently quoted that they constitute about 10 % of all cystic lesions of the pancreas.1 The cystic pancreatic lesions are pathologically classified as - cystic teratoma, common cystic pancreatic neoplasms (serous cystadenoma, mucinous cystic neoplasm, intraductal papillary mucinous neoplasm (IPMN), pseudocyst, rare cystic pancreatic neoplasms (solid pseudopapillary tumour, acinar cell cystadenocarcinoma, lymphangioma, haemangioma, paraganglioma), sarcoma, true epithelial cysts (associated with Von Hippel–Lindau disease, autosomal - dominant polycystic kidney disease, and cystic fibrosis), metastasis, solid pancreatic lesions with cystic degeneration (pancreatic adenocarcinoma, cystic islet cell tumour (insulinoma, glucagonoma, gastrinoma).2 Mucinous cystadenoma of pancreas are more commonly seen in middle‑aged females as compared with males.[5,6] Cystadenomas of the pancreas are low‑grade tumours and they constitute about 10 % of pancreatic cysts.3 Their most common location is the body and tail, with the head being a less common site.4 These tumours are more commonly seen in the middle of the pancreas.
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Ho, Caleb, Yanming Zhang, Umut Aypar, Mariko Yabe, Filiz Sen, Maria E. Arcila, Ahmet Dogan et Kseniya Petrova-Drus. « Myeloid/Histiocytic Neoplasms Associated with Germ Cell Tumors Harbor Shared Genetic Abnormalities Indicating a Clonal Relationship, Unique Molecular Pathogenesis and Cellular Origin ». Blood 132, Supplement 1 (29 novembre 2018) : 3077. http://dx.doi.org/10.1182/blood-2018-99-115698.
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Abstract Introduction Neoplasms of different lineages that arise in the same patient and show a clonal relationship are exceedingly rare, but have been described in instances of histiocytic and myeloid/lymphoid neoplasms (Durham BH, et al. Blood 2017;130(2):176-80; Ansari J, et al. Eur J Haematol 2016;97(1):9-16). The clonal relationships can be demonstrated by shared genetic abnormalities such as translocations, somatic mutations, and other chromosomal level alterations. Nevertheless, a clonal link between germ cell tumors (GCT), a group of solid tumors derived from primitive stem cells, and hematologic malignancies has been less well-characterized. Relevant literature has mostly reported associations of GCT with acute leukemias, without a comprehensive assessment of genetic alterations (Mukherjee S et al. Ann Hematol 2017;96: 1435-39). To further characterize this phenomenon, we identified a small cohort of patients diagnosed with both GCT and any myeloid/histiocytic neoplasm. We evaluated their molecular and cytogenetic alterations, identifying shared and unique abnormalities, providing evidence of a clonal relationship between these two groups of neoplasms, which traditionally represent different cellular origins. Methods A search of the pathology database at a major referral center (Memorial Sloan-Kettering Cancer Center) was performed to identify patients diagnosed with GCT between 2012-2018, and had at least 1 prior or subsequent bone marrow biopsy. The medical records were reviewed for details of clinical presentations and evidence of myeloid neoplasm, with corresponding morphologic, cytogenetic, and molecular findings. The findings were correlated with the genetic alterations detected in the GCT during diagnostic work-up. Cytogenetic analyses include karyotyping, fluorescence in situ hybridization (FISH) studies for common abnormalities among myeloid neoplasms, and single nucleotide polymorphism (SNP) array for copy number gain/loss and copy neutral-loss of heterozygosity (CN-LOH). Molecular analyses include an amplicon capture-based next generation sequencing (NGS) assay for 49 genes relevant for hematologic malignancies, and MSK-IMPACTTM, a hybrid capture-based NGS assay for mutation and copy number alteration in 400+ genes. Somatic nature of the identified variants was confirmed on MSK-IMPACTTM by germline variant filtering with the aid of appropriate normal control samples (blood or nail). Results 8 patients with GCT diagnoses showed marrow findings consistent with or suspicious for involvement by myeloid/histiocytic neoplasms, with clinical presentations not typical for therapy-related myeloid neoplasms. The patients were predominantly male (n=6) and young (age range: 13-55, median=26.5). The GCT included mixed GCT (n=6), mature teratoma (n=1) and immature teratoma (n=1). The primary sites of involvement were mediastinum (n=4), testes (n=2), and ovaries (n=2). In all cases, the myeloid/histiocytic neoplasms and GCT were diagnosed in close proximity in time (range: <1 to 24 months). So far, cytogenetic and molecular data in 4 patients with mediastinal-based tumors showed shared alterations between the GCT and myeloid/histiocytic neoplasms, including isochromosome 12p in 3 patients, an alteration characteristic of GCT. Other shared alterations observed included identical mutations in TP53, PIK3CD, KRAS, BCOR; trisomy 1, 8, 21; gain of 21q; loss of 13q; and CN-LOH of 2q, 5q, 17p. Interestingly, in all 4 patients, the GCT and myeloid/histiocytic neoplasm each showed additional unique genetic alterations. Conclusion These findings suggest that a subset of patients with GCT can develop clonally-related myeloid/histiocytic neoplasms, with a relatively short latency period. The genetic changes seen in our cases are relatively less common in conventional myeloid neoplasms, suggesting unique molecular pathogenesis. Yolk sac component in the GCT, which has been described to harbor hematopoietic precursor cells, may contribute to pathogenesis (Orazi A, et al Cancer 1993;71(12):3873-81). Although the detailed pathogenic mechanism remains uncertain, we observed that in the cohort, the GCT and myeloid/histiocytic neoplasm each harbored additional unique genetic changes. This suggests the presence of a common neoplastic progenitor giving rise to neoplasms of different lineages, which subsequently accumulated additional alterations. Disclosures Ho: Invivoscribe, Inc.: Honoraria. Yabe:Y-mAbs Therapeutics: Consultancy. Arcila:Invivoscribe, Inc.: Consultancy, Honoraria.
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Nakaya, Aya, Shinya Fujita, Atsushi Satake, Takahisa Nakanishi, Yoshiko Azuma, Yukie Tsubokura, Akiko Konishi et al. « Human T-cell leukemia virus type І associated with an increased risk of primary malignant neoplasm ». Mediterranean Journal of Hematology and Infectious Diseases 10, no 1 (20 avril 2018) : 2018024. http://dx.doi.org/10.4084/mjhid.2018.024.
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The correlation between human T-cell leukemia virus type І (HTLV-І) infection and malignant neoplasms other than adult T-cell lymphoma (ATL) remains unknown. We analyzed the frequency of primary malignant neoplasm in HTLV-І-seropositive patients. From January 2006 to December 2016, 203 patients were diagnosed as HTLV-І-seropositive at Kansai Medical University Hospital. Among them, 32 developed a primary malignant neoplasm. Their median age was 64 years old, 63% of them were male, and 69% of them were HTLV-I carriers. This group had the following distribution of ATL subtypes: 31% smoldering type, 0% chronic type, 3% acute type, and 3% lymphoma type. Among them, 53% was hematology malignancy, and solid tumor was 47%. The most frequent type of hematological malignancy was T-cell lymphoma (23%), followed B-cell lymphoma (16%), and myelodysplastic syndromes (6%). The most frequent primary solid tumor locations were the lung (15%), followed by the colon (9%), prostate (6%), kidney (6%), cervix (2%), breast (2%), liver (2%), pancreas (2%), and oral cavity (2%). Our results suggest that HTLV-Іinfection is often associated with the development of other malignant neoplasms. Therefore, HTLV-І-positive patients should be made aware of their increased risk for the onset of a malignant neoplasm and undergo increased surveillance.
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Himchak, Evan, Etan Marks, Yang Shi et Yanhua Wang. « Did I Miss It ? Discovering Hidden Coexisting Hematological Neoplasms : A Single Institutional Review of 100 Collision Tumors ». International Journal of Surgical Pathology 26, no 4 (10 janvier 2018) : 296–305. http://dx.doi.org/10.1177/1066896917752862.
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A collision tumor is defined as two histologically distinct tumor types identified at the same anatomic site. Hematolymphoid proliferative disorders (HLPDs), which coincide with non-hematological neoplasms, can mimic an immune response and can easily be overlooked as an immune reaction to a solid organ neoplasm, especially when low grade. In order to avoid a delay in the diagnosis of a HLPD during the workup for a non-hematological neoplasm, we identified a cohort of 100 cases with a HLPD diagnosis during the initial workup and treatment of a non-hematological neoplasm, or vice versa. Among the 100 collision tumors, the most common non-hematological neoplasms associated with a HLPD were from the colon (17%), breast (15%), and prostate (12%). The most commonly identified HLPDs were chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL; 18%), diffuse large B-cell lymphoma (17%), follicular lymphoma (14%), marginal zone lymphoma (10%), acute myeloid leukemia (8%), and classical Hodgkin lymphoma (5%). Interestingly, in this cohort 5% of the low-grade HLPDs, all of them CLL/SLL, were missed at initial sign-out and subsequently required an addendum report. The other 95% of cases were reviewed or signed out by a hematopathologist before the report was finalized for the non-hematological neoplasm. In summary, high-grade hematological malignancies are less likely to be missed; however, low-grade coexisting HLPDs can be overlooked as a reactive immune response to a solid organ neoplasm. Therefore, it is important to keep in mind the existence of collision low-grade HLPDs before assuming the lymphoid infiltrates as an immunological response.
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Ivashkiv, B. B., A. R. Mysak et V. V. Pritsak. « Clinical characteristics of mastocytoma in dogs ». Scientific Messenger of LNU of Veterinary Medicine and Biotechnologies 22, no 98 (22 août 2020) : 144–53. http://dx.doi.org/10.32718/nvlvet9825.
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According to foreign researchers, mastocytoma is one of the most common (7-12 %) skin tumors in dogs. This neoplasia is caused by excessive proliferation of mast cells and characterized by a specific clinical course, unpredictable biological behavior and prognosis. Researches of clinical and morphological features of mastocytoma in geographical populations of Ukraine has not only scientific and general biological interest, but also important practical significance. The purpose of the research was to establish the frequency of spreading, the features of the clinical ostent and pathogenesis of cutaneous mastocytoma in dogs in conditions in Lviv and in the suburban zone of the regional center. The research was performed on dogs with skin tumors (n = 128), including 24 of them with mastocytoma, who came to the Department of Surgery and Clinic of Small Pets of Stepan Gzhytskyj LNUVMB during 2016–2020. The diagnosis on mastocytoma was verified by the results of physical examination and cytological examination of biopsy material of neoplasms. It was found that in the structure of oncological diseases of dogs the share of skin neoplasms was 32.16 %. Among animals with skin neoplasms, mastocytoma was diagnosed in 18.75 % of dogs aged 4 to 16 years. The highest incidence rates were found among animals aged 8 to 11 years; the median incidence was 9.5 years and fashion – 9 years. In terms of breeds, cutaneous mastocytoma was found in dogs of the breed: Rottweiler – 16.7 %, Sharpei – 12.5 %, Staffordshire Terrier – 12.5 %, Labrador – 8.3 %, Boxer – 8.3 %, Doberman – 8.3 %, chow-chow – 8.3 %. At the same time, the German Shepherd, Alabai, Spaniel, French Bulldog and Pug cases of the disease were isolated (4.2 %). Among sick animals, dogs accounted for 54.2 % and females for 45.8 %. It was found that in 41.7 % of the studied animals the rate of neoplasia was extremely rapid, because in 56.5 ± 1.91 days the tumors were doubled in size, which is evidence of significant aggressiveness of tumor growth. In 29.2 % of dogs the time of doubling the size of the primary tumor reached 122.1 ± 10.6 days, in 20.8 % of dogs the period of tumor development lasted for two years. In 8.3 % of dogs, the dynamics of neoplasia development is not clear. Sonography has shown that skin mastocytomas are usually visualized as heterogeneous, with uneven edges and fuzzy contours hypoechoic structures. Visualization of solid hypervascular foci with central type of vascularization, on the background of diffuse infiltration of neoplasia in the deeper layers of the skin and subcutaneous tissue, with a pronounced perinodular inflammatory reaction of the surrounding tissues is a sign of malignancy of the mastocytoma. The generalization of the neoplastic process in the internal organs was found, in particular the spleen, may indicate a predominance of the hematogenous route of metastasis of the mastocytoma. The obtained data complement and expand knowledge about the pathogenesis of mastocytoma in dogs, and also highlight the frequency of spreading and course features of this oncological pathology in a separate geographical population of Ukraine.
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Rodigheri, Sabrina Marin, Felipe Noleto de Paiva, Bruna Fernanda Firmo, Taise Fuchs, Cynthia Bueno Mani et Andrigo Barboza de Nardi. « Parameters of Metabolic Response to Surgical Trauma Induced via Unilateral Total Mastectomy Associated or Not to Ovariohysterectomy in Dogs ». Animals 13, no 5 (3 mars 2023) : 926. http://dx.doi.org/10.3390/ani13050926.
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Surgical excision of solid tumors is required for local control of neoplasms. However, surgical trauma can stimulate the release of proangiogenic growth factors, suppressing cell-mediated immunity and favoring the development of micrometastases and progression of residual disease. The present study aimed to evaluate the intensity of the metabolic response to trauma induced via unilateral mastectomy in bitches with mammary neoplasia, the consequences of its joint performance with ovariohysterectomy, and their respective effects on the organic response. Two groups of animals were evaluated in seven perioperative moments, namely, unilateral mastectomy (G1) and unilateral mastectomy associated with ovariohysterectomy (G2). Thirty-two female dogs were selected, ten clinically healthy, and twenty-two diagnosed with mammary neoplasia. Surgical trauma reduced serum concentrations of albumin and interleukin-2 but increased blood levels of glucose and interleukin-6 in the postoperative of G1 and G2 patients. Moreover, serum cortisol levels increased after unilateral mastectomy associated with ovariohysterectomy. Our findings allowed us to conclude that unilateral mastectomy induces significant metabolic alterations in female dogs with mammary neoplasms and its joint performance with ovariohysterectomy increases the organic response to trauma.
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Pollen, Maressa, Siraj El Jamal, Jack Lewin et Varsha Manucha. « Histiocytic Sarcoma in a Kidney Transplant Patient : A Case Report and Review of the Literature ». Case Reports in Pathology 2016 (2016) : 1–5. http://dx.doi.org/10.1155/2016/3591050.
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Objective. Histiocytic sarcoma (HS) is an aggressive neoplasm with only limited number of reported series of cases and rare case reports of occurrence as a posttransplant neoplastic disorder. The etiology and pathogenesis of the disease is unknown and the optimal treatment is still under investigation. We describe an unusual case of HS in a patient with a remote history of kidney transplant.Method and Results. A 54-year-old male with a remote history of renal transplantation under maintenance immunosuppression presented with features of sepsis. CT abdomen revealed multiple heterogeneous masses in bilateral native kidneys and liver and enlarged abdominal and retroperitoneal lymph nodes. Viral serology work-up was negative. Needle core biopsy revealed a highly undifferentiated neoplasm comprised of highly atypical large cells with eosinophilic to vacuolated cytoplasm and hemophagocytosis. Extended panel of immunohistochemistry proved histiocytic lineage for the tumor cells. The patient expired 2 weeks following the diagnosis.Conclusion. Our case along with three previously published case reports raised the possibility of HS as a treatment-related neoplasm or a posttransplantation neoplastic disorder in solid organ transplant recipients.
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Altissimi, Giancarlo, Massimo Ralli, Giulio Sementilli, Francesco Fiorentino, Andrea Ciofalo, Antonio Greco, Marco de Vincentiis, Alessandro Corsi et Giancarlo Cianfrone. « Adult-Type Rhabdomyoma of the Larynx : Clinicopathologic Study of an Uncommon Tumor in a Rare Location ». Case Reports in Otolaryngology 2017 (2017) : 1–6. http://dx.doi.org/10.1155/2017/7186768.
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Rhabdomyoma is an uncommon benign mesenchymal tumor with skeletal muscle differentiation that may occur either in the heart or in extracardiac sites. Even though the head and neck region is the most common area of extracardiac rhabdomyoma, the larynx is rarely involved. We present the case of an 85-year-old woman who reported a 10-day history of breathing difficulties, dysphagia, and dysphonia. A computed tomography scan of the head and neck showed a contrast-enhanced, solid hypopharyngeal-laryngeal neoplasm with well-defined margins causing subtotal obliteration of the right pyriform sinus and a reduction in air lumen of the laryngeal vestibule. The patient underwent complete endoscopic removal of the lesion; histologic examination revealed an adult-type rhabdomyoma based on the histologic features and the immunoreactivity of the neoplastic cells for desmin, myoglobin, and muscle-specific actin but not for cytokeratin, S-100, CD68R, chromogranin-A, and synaptophysin. Since clinical and imaging features are not specific for rhabdomyoma, histologic examination and immunohistochemical analyses play a central role in the differential diagnosis of the adult-type rhabdomyoma from other laryngeal neoplasms. A correct diagnosis is mandatory to avoid inappropriate treatment.
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Kumar, S., et K. Jabbar. « Serous Cystadenocarcinoma of Pancreas : A Rare Find ». American Journal of Clinical Pathology 158, Supplement_1 (1 novembre 2022) : S60. http://dx.doi.org/10.1093/ajcp/aqac126.120.
Texte intégralRésumé :
Abstract Introduction/Objective Pancreatic cystic neoplasms comprise 1-2% of pancreatic lesions and most of these lesions are cystadenomas. Serous cystadenocarcinoma is an extremely rare but known malignant condition described in the literature and the diagnosis is restricted to cases with distant metastasis of tumor beyond the pancreas. Per WHO, cytologic atypia, vascular, perineural, and adjacent organ and lymph node involvement by direct spread are insufficient for the diagnosis of serous cystadenocarcinoma. Methods/Case Report We report an interesting case of serous cystadenocarcinoma of pancreas in a 55-year-old male with medical history of prostate cancer was found to have a 15 cm mass pancreatic tail suspicious for neuroendocrine tumor and 5 small hepatic lesions suspicious for metastasis. The patient underwent subtotal pancreatectomy and splenectomy, and wedge resection of liver lesions. On gross examination, a yellow cystic mass was present in the pancreatic tail measuring 13.2 cm in the maximum dimension. H&E slides from the pancreas and liver demonstrated a neoplasm composed of cystic and solid areas, within a background of fibrosis and focal hemorrhage. Cystic areas showed microcysts composed of cells with clear cytoplasm and round to oval bland nuclei. Solid areas demonstrated almost no microcysts but sheets and clusters of cells with clear to scant cytoplasm, oval to round nuclei, few areas of atypical hyperchromatic cells, and occasional mitosis. Very focal clusters and cords of neuroendocrine cells, constituting less than 5% of the tumor volume were also identified. Immunohistochemical stains demonstrated the neoplastic cells both in cystic and solid areas were positive for CK7, CK19, MUC6, and inhibin. Ki67 demonstrated an overall proliferation index of 3%. Chromogranin and synaptophysin were negative within the solid and cystic components of the tumor, however, showed positive staining within neuroendocrine foci. Neoplastic cells were negative for all other tested markers including beta-catenin, ER, Hep-par 1, HMB45, IMP3, MART-1, PAX-8, and trypsin. RB1 expression was retained within neoplastic cells. Results (if a Case Study enter NA) N/A. Conclusion The differentiation between benign and malignant serous cystadenoma both histologically and clinically may be very difficult as some cases of serous cystadenocarcinoma may not show overt cytologic atypia. The presence of metastasis, which most often occurs in the liver is required for the diagnosis of serous cystadenocarcinoma.