Compared With Elastin Stains, h-Caldesmon and Desmin Offer Superior Detection of Vessel Invasion in Gastric, Pancreatic, and Colorectal Adenocarcinomas

2018 ◽  
Vol 26 (4) ◽  
pp. 318-326 ◽  
Author(s):  
Özgür Ekinci ◽  
Betül Öğüt ◽  
Bülent Çelik ◽  
Ayşe Dursun
Keyword(s):  
Smooth Muscle ◽  
Colorectal Resection ◽  
Colorectal Adenocarcinoma ◽  
Malignant Tumors ◽  
Type A ◽  
Vessel Invasion ◽  
Vein Type ◽  
Colorectal Adenocarcinomas ◽  
Invasion Patterns

Background. The presence of vessel invasion is considered indicative of a poor prognosis in many malignant tumors. We aimed to compare the sensitivity of elastin stains (van Gieson’s and orcein methods) with 2 smooth muscle markers (h-caldesmon and desmin) in gastric, pancreatic, and colorectal adenocarcinoma specimens. Materials and Methods. We used 27 (29.3%) gastric, 35 (38.0%) pancreatic, and 30 (32.6%) colorectal resection specimens. We applied a provisional classification of vessel invasion patterns: type A, a focus with a nearby artery unaccompanied by a vein; type T, a focus at the invasive front without an unaccompanied artery; and type X, foci that only appeared by any of the 4 stains used. Results. There were 369 foci. The smooth muscle markers were more sensitive than the elastin stains, and h-caldesmon more sensitive than desmin, in all types. Among the 139 type A foci, 33 (23.7%) were positive by desmin and h-caldesmon, whereas the elastin stains were not ( P = .001). h-Caldesmon was the only positive marker in 11 (7.9%; P = .011). Among the 78 type T foci, 21 (26.9%) were positive by desmin and h-caldesmon, when both elastin stains were negative ( P = .000). In 16 (20.5%) foci, h-caldesmon was the only positive marker ( P = .002). Among 152 type X foci, 91 (59.9%) were positive by all markers, 26 (17.1%) by both desmin and h-caldesmon, and 9 (5.9%) by only the 2 elastin stains ( P = .001). Conclusion. We recommend these stains for suspect foci in gastric, pancreatic, and colorectal adenocarcinoma specimens. They might highlight both predictable and unpredictable foci.

scholarly journals The Histological Diagnosis of Colonic Adenocarcinoma by Applying Partial Self Supervised Learning

2020 ◽  
Author(s):  
Syed Usama Khalid Bukhari ◽  
Syed Asmara ◽  
Syed Khuzaima Arsalan Bokhari ◽  
Syed Shahzad Hussain ◽  
Syed Umar Armaghan ◽  
...  
Keyword(s):  
Colorectal Adenocarcinoma ◽  
Malignant Tumors ◽  
Colonic Carcinoma ◽  
Histopathological Diagnosis ◽  
Colonic Adenocarcinoma ◽  
Whole Slide Imaging ◽  
Colonic Tissue ◽  
Test Dataset ◽  
Biopsy Specimens

Background: The cancer of colon is one of the important cause of morbidity and mortality in adults. For the management of colonic carcinoma, the definitive diagnosis depends on the histological examination of biopsy specimens. With the development of whole slide imaging, the convolutional neural networks are being applied to diagnose colonic carcinoma by digital image analysis. Aim: The main aim of the current study is to assess the application of deep learning for the histopathological diagnosis of colonic adenocarcinoma by analysing the digitized pathology images. Materials & Methods: The images of colonic adenocarcinoma and non neoplastic colonic tissue have been acquired from the two datasets. The first dataset contains ten thousand images which were used to train and validate the convolutional neural network (CNN) architecture. From the second dataset (Colorectal Adenocarcinoma Gland (CRAG) Dataset) 40% of the images were used as a train set while 60% of the images were used as test dataset. Two histopathologists also evaluated these images. In this study, three variants of CNN (ResNet-18, ResNet-34 and ResNet-50 ) have been employed to evaluate the images. Results: In the present study, three CNN architectures(ResNet-18, ResNet-30, and ResNet-50) were applied for the classification of digitized images of colonic tissue. The accuracy (93.91%) of ResNet-50 was the highest which is followed by ResNet-30 and ResNet-18 with the accuracy of 93.04% each. Conclusion: Based on the findings of the present study and analysis of previously reported series, the development of computer aided technology to evaluate the surgical specimens for the diagnosis of malignant tumors could provide a significant assistance to pathologists.

MRI analysis and surgical treatment of Wassel Type IV duplicated thumbs

2021 ◽  
pp. 175319342098321
Author(s):  
Anyuan Wang ◽  
Jian Ding ◽  
Long Wang ◽  
Tinggang Chu ◽  
Zhipeng Wu ◽  
...  
Keyword(s):  
Type A ◽  
Surgical Reconstruction ◽  
Mri Findings ◽  
Level Of Evidence ◽  
Type D ◽  
Type Iv ◽  
Secondary Operations ◽  
Type C

We present the MRI findings for 39 Wassel Type IV duplicated thumbs in 38 patients. We found that MRI revealed the morphology of the cartilaginous connection between the thumb anlages and the location of the deviation corresponding to the classification of Horii, which allowed precise preoperative planning of corrective osteotomies. All 39 thumbs were available for follow-up after surgical reconstruction at a mean of 29 months (range 25 to 39). Four out of nine Horii Type A cases and all 12 Type B, as well as the six Type C and the six Type D cases, achieved good results according to the Tada scoring system. Five Type A cases achieved fair results with residual stiffness of the interphalangeal joint. No secondary operations were needed. We conclude that MRI proved useful in subclassifying Wassel Type IV duplicated thumbs and may aid in planning the osteotomies needed for their reconstruction. Level of evidence: IV

scholarly journals Mixed adenoneuroendocrine carcinoma of the hepatic bile duct: a case report and review of the literature

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Sulai Liu ◽  
Zhendong Zhong ◽  
Meng Xiao ◽  
Yinghui Song ◽  
Youye Zhu ◽  
...  
Keyword(s):  
Bile Duct ◽  
Neuroendocrine Tumors ◽  
Radical Surgery ◽  
Malignant Tumors ◽  
World Health ◽  
Ki 67 ◽  
Mixed Adenoneuroendocrine Carcinoma ◽  
Hilar Bile Duct ◽  
Hilar Tumor

Abstract Background The World Health Organization's updated classification of digestive system neuroendocrine tumors in 2010 first proposed the classification of mixed adenoneuroendocrine carcinoma (MANEC). The incidence of biliary malignant tumors with neuroendocrine tumors accounts for less than 1% of all neuroendocrine tumors. Moreover, the incidence of hilar bile duct with MANEC is very rare. Case presentation A 65-year-old female patient came to our hospital for repeated abdominal pain for more than 4 months and skin sclera yellow staining for 1 week. Contrast-enhanced computed tomography imaging and magnetic resonance results suggested a hilar tumor for Bismuth-Corlette Type II. The patient underwent radical surgery for hilar cholangiocarcinoma. Finally, the patient was diagnosed with hilar bile duct MANEC, staged 1 (pT1N0M0) based on the eighth edition of the AJCC. Histopathology showed that the tumor was a biliary tumor with both adenocarcinoma and neuroendocrine carcinoma. No evidence of recurrence and metastasis after 20 months of follow-up. Conclusions We first reported a MANEC that originated in the hilar bile duct. As far as we known, there were few reports of biliary MANEC, and the overall prognosis was poor. We also found that the higher the Ki-67 index, the worse the prognosis of this type of patient. Radical surgery is the most effective treatment.

scholarly journals Minimally Modified LDL Upregulates Endothelin Type A Receptors in Rat Coronary Arterial Smooth Muscle Cells

2013 ◽  
Vol 2013 ◽  
pp. 1-11 ◽  
Author(s):  
Jie Li ◽  
Lei Cao ◽  
Cang-Bao Xu ◽  
Jun-Jie Wang ◽  
Yong-Xiao Cao
Keyword(s):  
Smooth Muscle ◽  
Protein Kinase C ◽  
Protein Kinase ◽  
Smooth Muscle Cells ◽  
Coronary Arteries ◽  
Muscle Cells ◽  
Type A ◽  
Receptor Mrna ◽  
Kinase C ◽  
Arterial Smooth Muscle Cells

Minimally modified low-density lipoprotein (mmLDL) is a risk factor for cardiovascular disease. The present study investigated the effects of mmLDL on the expression of endothelin type A () receptors in coronary arteries. Rat coronary arteries were organ-cultured for 24 h. The contractile responses were recorded using a myographic system. receptor mRNA and protein expressions were determined using real-time PCR and western blotting, respectively. The results showed that organ-culturing in the presence of mmLDL enhanced the arterial contractility mediated by the receptor in a concentration-dependent and time-dependent manner. Culturing with mmLDL (10 μg/mL) for 24 h shifted the concentration-contractile curves toward the left significantly with increased of from control of and significantly increased receptor mRNA and protein levels. Inhibition of the protein kinase C, extracellular signal-related kinases 1 and 2 (ERK1/2), or NF-κB activities significantly attenuated the effects of mmLDL. The c-Jun N-terminal kinase inhibitor or the p38 pathway inhibitor, however, had no such effects. The results indicate that mmLDL upregulates the receptors in rat coronary arterial smooth muscle cells mainlyviaactivating protein kinase C, ERK1/2, and the downstream transcriptional factor, NF-κB.

Dendritic Interstitial and Myofibroblastic Cells at the Border of Salivary Gland Tumors

2001 ◽  
Vol 125 (2) ◽  
pp. 232-236
Author(s):  
Lori Soma ◽  
Virginia A. LiVolsi ◽  
Zubair W. Baloch
Keyword(s):  
Smooth Muscle ◽  
Salivary Gland ◽  
Malignant Tumors ◽  
Smooth Muscle Actin ◽  
Staining Intensity ◽  
Interstitial Cells ◽  
Salivary Gland Tumors ◽  
Benign Tumors ◽  
Low Grade ◽  
Muscle Actin

Abstract Objective.—CD34-positive dendritic interstitial cells may be associated with the regulation of tumor growth. This association has been studied in various human neoplasms, especially skin tumors. In this study, we evaluated the distribution of dendritic interstitial cells and myofibroblastic cells at the tumor periphery of various benign and malignant salivary gland neoplasms. Methods.—Forty-nine cases of salivary gland tumors were selected: 16 pleomorphic adenomas, 12 Warthin tumors, 8 polymorphous low-grade tumors, 5 adenoid cystic carcinomas, 6 acinic cell carcinomas, and 2 mucoepidermoid carcinomas. Immunohistochemical analysis was performed by using antibodies for CD34 (dendritic cells) and α-smooth muscle actin (myofibroblast) on formalin-fixed, paraffin-embedded archival tissue. Staining intensity was graded as marked (3+), moderate (2+), weak (1+), and absent (0). Results.—Staining intensity for CD34 was 3+ in 24 (86%) of 28 benign tumors (pleomorphic adenomas and Warthin tumors) and 6 (29%) of 21 malignant tumors (polymorphous low-grade tumors, acinic cell carcinomas, adenoid cystic carcinomas, and mucoepidermoid carcinomas) and 2+ in 4 (19%) of 21 malignant tumors. None of the benign tumors displayed 2+ staining with CD34. Three (11%) of 28 benign and 11 (52%) of 21 of malignant tumors failed to stain with CD34. α-Smooth muscle actin staining was 3+ in 10 (36%) of 28 benign tumors and 6 (29%) of 21 malignant tumors, and 2+ in 11 (39%) of 28 benign and 2 (9%) of 21 malignant tumors. Five (18%) of 28 benign and 11 (52%) of 21 malignant tumors failed to stain with α-smooth muscle actin. Conclusion.—We conclude that the dendritic interstitial cells and myofibroblastic cells may be associated with the regulation of tumor growth in salivary gland tumors.

Benign and Premalignant Lesions of the Pancreas

2016 ◽  
Author(s):  
Abdurrahman Kadayifci ◽  
William R. Brugge
Keyword(s):  
Malignant Tumors ◽  
Balloon Dilation ◽  
Pancreatic Head ◽  
Premalignant Lesions ◽  
World Health ◽  
Pancreatic Tumors ◽  
Thick Wall ◽  
Cystic Lesions ◽  
Cystic Neoplasms

Pancreatic cancer is among the most aggressive human cancers, with few symptoms and clinical findings until it is detected in an advanced stage. Today, the only favorable treatment is surgical resection before progression to an invasive stage. There are a variety of benign and premalignant conditions of the pancreas that may appear similar to malignant tumors; early detection and management of those premalignant pancreatic lesions may provide a significant improvement in patient outcome. This review covers cystic neoplasms of the pancreas, premalignant solid lesions of the pancreas, and inflammatory lesions of the pancreas. Figures show a 30 mm diameter hypoechoic lesion without septae in the pancreatic head, an oval 20 mm diameter pancreatic mass with mixed solid and cystic components, a 24 mm diameter hypoechoic mass with well-defined borders in the tail of the pancreas, a 22 × 18 mm cystic lesion with a thick wall and internal debris in the head of the pancreas, and an endoscopic cyst gastrostomy after balloon dilation. Tables list World Health Organization (WHO) 2010 classification of pancreatic tumors, classification of pancreatic cystic lesions, main characteristics of common pancreatic cystic lesions, high-risk stigmata and worrisome features of intraductal papillary mucinous neoplasm on cross-sectional imaging, and WHO classification of pancreatic neuroendocrine tumors.   This review contains 5 highly rendered figures, 5 tables and 55 references

scholarly journals Surgical Management, Preoperative Tumor Localization, and Histopathology of 80 Patients Operated on for Insulinoma

2019 ◽  
Vol 104 (12) ◽  
pp. 6129-6138 ◽  
Author(s):  
Mikkel Andreassen ◽  
Emma Ilett ◽  
Dominik Wiese ◽  
Emily P Slater ◽  
Marianne Klose ◽  
...  
Keyword(s):  
Malignant Tumors ◽  
Somatostatin Receptor ◽  
Diagnostic Procedures ◽  
Benign Tumors ◽  
Receptor Subtype ◽  
Receptor Imaging ◽  
Venous Sampling ◽  
Transabdominal Ultrasonography ◽  
Positron Emission

Abstract Introduction Diagnosis and pathological classification of insulinomas are challenging. Aim To characterize localization of tumors, surgery outcomes, and histopathology in patients with insulinoma. Methods Patients with surgically resected sporadic insulinoma were included. Results Eighty patients were included. Seven had a malignant tumor. A total of 312 diagnostic examinations were performed: endoscopic ultrasonography (EUS; n = 59; sensitivity, 70%), MRI (n = 33; sensitivity, 58%), CT (n = 55; sensitivity, 47%), transabdominal ultrasonography (US; n = 45; sensitivity, 40%), somatostatin receptor imaging (n = 17; sensitivity, 29%), 18F-fluorodeoxyglucose positron emission tomography/CT (n = 1; negative), percutaneous transhepatic venous sampling (n = 10; sensitivity, 90%), arterial stimulation venous sampling (n = 20; sensitivity, 65%), and intraoperative US (n = 72; sensitivity, 89%). Fourteen tumors could not be visualized. Invasive methods were used in 7 of these 14 patients and localized the tumor in all cases. Median tumor size was 15 mm (range, 7 to 80 mm). Tumors with malignant vs benign behavior showed less staining for insulin (3 of 7 vs 66 of 73; P = 0.015) and for proinsulin (3 of 6 vs 58 of 59; P < 0.001). Staining for glucagon was seen in 2 of 6 malignant tumors and in no benign tumors (P < 0.001). Forty-three insulinomas stained negative for somatostatin receptor subtype 2a. Conclusion Localization of insulinomas requires many different diagnostic procedures. Most tumors can be localized by conventional imaging, including EUS. For nonvisible tumors, invasive methods may be a useful diagnostic tool. Malignant tumors showed reduced staining for insulin and proinsulin and increased staining for glucagon.

Proposal for a New Histopathological Classification of the Carcinomas of the Nasopharynx

1978 ◽  
Vol 64 (5) ◽  
pp. 513-518 ◽  
Author(s):  
Christian Micheau ◽  
Franco Rilke ◽  
Silvana Pilotti
Keyword(s):  
Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Classification Scheme ◽  
Malignant Tumors ◽  
Undifferentiated Carcinoma ◽  
New Classification ◽  
Histopathological Classification ◽  
Potential Origin

A new classification scheme for malignant tumors of the nasopharynx is proposed in which the undifferentiated carcinoma of nasopharyngeal types as a prominent position. This term replaces the previous obsolete term lymphoepithelioma on the basis of its clinicopathologic identity, its separation from squamous cell carcinoma, and its potential origin from anatomical areas other than the nasopharynx.

Proposal for a Clinical Classification of Liver Metastases

1982 ◽  
Vol 68 (5) ◽  
pp. 443-449 ◽  
Author(s):  
Leandro Gennar ◽  
Roberto Doci ◽  
Federico Bozzetti ◽  
Umberto Veronesi
Keyword(s):  
Liver Metastases ◽  
Tnm Classification ◽  
Hepatic Metastases ◽  
Liver Involvement ◽  
Clinical Classification ◽  
General Rules ◽  
Liver Functions ◽  
Prognostic Importance ◽  
Colorectal Adenocarcinomas

The lack of a worldwide-accepted classification of liver metastases makes it difficult to compare data on natural history and results from different treatments. The increasing interest in aggressive multimodal therapies for hepatic metastases prompted us to review the chief prognostic factors and the main published classifications in order to propose a new clinical classification, whose principal application concerns metastases from colorectal adenocarcinomas. Following the general rules of the TNM classification, liver metastases are classified by expressing with letters and numbers the parameters selected for their prognostic importance, clinical applicability and objectivity. H (hepatic) is the letter that indicates the liver is the site of metastasis. Synchronous metastases are indicated by H, metachronous by rH (r = recurrent). The extent of liver involvement is defined: H1, liver involvement less than 25%; H2, from 25 to 50%; H3, more than 50%. Site of metastases is defined by s (single), m (multiple to one surgical lobe), b (to both lobes), i (infiltration of important structures). The alteration of liver functions is indicated by F. The presence of cirrhosis is noted by C.

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