Clinical Histopathological Features Research Articles

Investigation of Clinical Histopathologic Features and Metabolic Parameters of 18F-FDG PET/CT in Invasive Breast Carcinoma with a Micropapillary Component.

The aim of this study was to evaluate the correlation between clinical histopathologic features and micropapillary (MP) ratio with the maximum standardized uptake value (SUVmax) derived from 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) in treatment naïve breast cancer. Twenty-nine patients diagnosed with breast cancer with a MP component who underwent PET/CT imaging before any local and/or systemic treatment were included in this retrospective study. All clinical histopathological features were recorded. SUVmax values were measured from 18F-FDG PET images for primary tumors and metastatic axillary lymph nodes. MP component percentage did not correlate with any clinical histopathological features except age. At early ages, the MP component ratio was significantly higher. Our results showed that there is no significant correlation between the SUVmax value and MP component percentage. A high SUVmax value is generally expected in aggressive malignancies. However, this assumption may not be valid for the MP subgroup, which has an aggressive course compared to other subgroups in breast cancer.

Dermoscopic features of face and scalp basal and squamous cell carcinomas according to clinical histopathologic characteristics and anatomical location

Dermatoscopy is a non-invasive tool that increases the accuracy of non melanoma skin cancer (NMSC) diagnosis. Dermoscopic features of basal cell carcinoma (BCC) and cutaneous squamous cell carcinoma (cSCC) have been already described, however criteria of these skin cancers, according to different anatomical locations of face and scalp have not been described before.

P0415MONOCLONAL GAMMOPATHY-RELATED RENAL DISEASES: NEW CLINICAL AND HISTOLOGICAL PATTERNS

Abstract Background and Aims In the last few years new clinical-histopathological forms of paraproteinemia associated kidney disease have emerged: light chain proximal tubulopathies, proliferative glomerulonephritis with monoclonal immunoglobulin deposits (PGNMID) and C3-glomerulopathy. It is now widely recognized that the pathogenic role of the monoclonal protein depends on the free light chain chemical-physical features, even in the case of “dangerous small B cell clones”. Thus MGRS (monoclonal gammopathy of renal significance) associated disease is now considered a different entity from monoclonal gammopathy of undetermined significance (MGUS). Method We retrospectively evaluated the clinical-histopathological features of the biopsies performed in our Nephrological Unit on patients with MGUS in 2008-2018, in order to re-classify them in accordance with the recent scientific literature. Results Nine patients (7 M/2 F; age 46-77 y) were analyzed: five of them suffering from CKD stage 2, four of them with AKI or rapidly progressive CKD, 7 with proteinuria > 1 g/day, 2 with physiological proteinuria. Bone marrow biopsy: 7 patients with MGUS, 2 with smoldering multiple myeloma. Renal biopsy: 4 glomerulopathies (monoclonal fibrillary glomerulonephritis, cryoglobulinaemic (type I) glomerulonephritis, C3 glomerulonephritis, PGNMID), 5 proximal tubulopathies (2 LCPT with Fanconi syndrome, 1 LCPT without cytoplasmic inclusions and with interstitial inflammatory reaction, 2 LCPT with acute tubular necrosis) Table 1, Table 2, Light microscopy and IF of PGNMID. Conclusion MGRS is responsible for the pathogenesis of new histopathological renal lesions, based on new pathogenetic pathways. The clinical and histological features of the different disease states are dependent on the structure of FLCs. Our retrospective analysis of MGRS biopsies confirms how difficult and complex the diagnostic challenge of monoclonal renal injury really is. The differentiation between MGUS and MGRS is based on renal biopsy and demonstration of monoclonality on kidney tissue even if serum/urine immunofixation is negative. Early biomarkers of the pathogenetic role of monoclonal FLC should be identified both for diagnosis and therapeutical monitoring.

Clinical histopathological features and CDKN2A/CDK4/MITF mutational status of patients with multiple primary melanomas from Bologna: Italy is a fascinating but complex mosaic

The incidence of cutaneous melanoma (cM) has increased in the last decades. Germline mutations in the high-penetrance melanoma susceptibility gene CDKN2A (Cyclin-dependent kinase inhibitor 2A) are associated with a younger age at diagnosis and an increased risk to develop pancreatic cancer. We retrospectively analyzed the data of patients with prior diagnosis of cM referring to our service from January 2005 to May 2017. The aim was to investigate the rate of multiple cMs (MPM), assessing their clinical/pathological features. Moreover, the genetic tests of patients who had undergone CDKN2A/CDKN2B, CDK4 and MITF screening were evaluated. One hundred fifteen patients (9.26%) were diagnosed with MPMs: 70 males (60.87%) and 45 women (39.13%). 75 patients (43 males and 32 females) underwent genetic screening for germline mutations. The screening revealed that 4/75 patients (5.33%) were carriers of the non-synonymous missense variation c.442G>A (p.Ala148Thr) in CDKN2A exon 2 in heterozygosis, 3 of whom had at least one in-situ melanoma. In 1 patient (1.33%) we detected the variation c.249C>A, p.His83Gln in CDKN2A exon 2 in heterozygosis and in 1 patient (1.33%) the mutation c.952G>A (p.Glu318Lys) in MITF gene was found. This study confirms the need for a full body skin examination and a prolonged surveillance in patients affected by cM, as MPMs were detected in up to 10% of total cases in our series and synchronous lesions in 1/5. Moreover, it reflects the great variability of cM high-susceptibility genes mutational status within the Italian territory. Patients carrying c.952G>A (p.Glu318Lys) MITF mutation have a higher risk to develop a nodular cM.

YIA20-002: Racial Differences in Clinical Histopathological Features and Survival of Early- and Average-Onset Colorectal Cancer

YIA20-002: Racial Differences in Clinical Histopathological Features and Survival of Early- and Average-Onset Colorectal Cancer

Clinical histopathologic characteristics of lacrimal glands in lacrimal gland prolapse with blepharochalasis

Objective: To analyze the clinical histopathologic characteristics of lacrimal glands and possible mechanisms of lacrimal gland prolapse in blepharochalasis (BC). Methods: A case-controlled study of 23 consecutive patients with prolapse of lacrimal glands in BC was performed. All samples were obtained during surgery from the Department of Ophthalmology, Beijing Tongren Hospital, Capital Medical University between January 2009 and December 2016. The lacrimal tissue included prolapsed lacrimal glands (30 samples) and controls from the donors in the eye bank of Beijing Tongren Hospital, Capital Medical University (8 samples). Hematoxylin-eosin staining, special staining, immunohistochemistry and colloidal gold-labeled pre-embedded indirect immunogold electron microscopy (Gold-IIEM) were performed to analyze the histopathologic characteristics of the samples. The nonparametric Wilcoxon signed-ranks test was carried out for statistical analysis. Results: Among the 23 patients with lacrimal gland prolapse in BC, there were 3 males and 20 females. The mean age of morbidity was 11 years old (7-16 years). In the 8 normal control cases, 3 males and 5 females were included. The mean age was 15 years (10-20 years). In the 30 prolapsed lacrimal gland samples, hematoxylin-eosin staining showed enlargement of glandular lumina accompanied by inflammatory infiltrates of interstitial tissue in 2 samples. Marked loosening of collagen fibers of the obtainable lacrimal fascia was observed. The results on immunohistochemical staining demonstrated an increased level of immunocytes in the 30 prolapsed lacrimal gland samples, including IgA (+++, ++, +, -; 12, 11, 4, 3 vs. 0, 0, 1, 7; Z=-3.892), CD3(+)T cells (+++, ++, +, -; 2, 19, 7, 2 vs. 0, 0, 1, 7; Z=-4.168), matrix metalloproteinase (MMP)-3 (+++, ++, +, -; 0, 0, 11, 19 vs. 0, 0, 0, 8; Z=-2.005) and MMP-9 (+++, ++, +, -; 14, 14, 0, 2 vs. 0, 0, 0, 8; Z=-4.552) (all P<0.05). IgG, IgM, CD20 and C1-inhibitor were either absent or expressed at background level in the 30 prolapsed lacrimal gland samples (all P>0.05). Gold-IIEM showed zymogon granules in lacrimal glands were out of shape. MMP-3 and MMP-9 colloidal gold particles existed on the zymogon granules, and MMP-3 colloidal gold particles also existed on the surface of lacrimal gland epithelial cells. Conclusions: The histopathological changes in the lacrimal glands of lacrimal gland prolapse with BC include inflammatory infiltration, elastic fiber degeneration, marked loosening of the supporting fascia tissue, and an increased level of immunocytes, including IgA, CD3(+)T cells, MMP-3 and MMP-9. The results suggest that lacrimal gland prolapse with BC may result in the immuno-pathogenetic mechanisms with the involvement of cell-mediated immune responses. (Chin J Ophthalmol, 2020, 56: 205-210).

Relationship between serum C3/C4 ratio and prognosis of immunoglobulin A nephropathy based on propensity score matching.

BackgroundAberrant activation of the complement system plays an important role in the pathogenesis and development of immunoglobulin A nephropathy (IgAN). The relationship between serum complement and the clinical-histopathological features and outcomes of IgAN is controversial. This retrospective study aimed to examine the relationship between the complement 3/4 (C3/C4) ratio and the clinicopathologic changes and prognosis of patients with IgAN.MethodsA total of 397 patients with primary IgAN from January 2007 to December 2012 at the Chinese People's Liberation Army General Hospital were included in this study. The correlation test and Chi-square test or one-way analysis of variance test were performed to evaluate the relationship between the C3/C4 ratio and other clinical-pathological factors. Propensity score matching and a multivariate Cox regression model were used to calculate the risk factors of renal outcome.ResultsThe median follow-up period was 75 months. During the follow-up period, 62 patients (15.6%) developed into the end-stage renal disease (ESRD). The C3/C4 ratio at baseline was associated with the level of serum creatinine (SCr), 24 h urinary protein excretion (24 h Upre), global glomerular sclerosis, and tubulointerstitial lesion. The level of SCr and 24 h Upre and the degree of chronic kidney injury were statistically different among groups defined by different C3/C4 ratio levels. The survival rates of patients among groups with different C3/C4 ratio levels were different. After propensity score matching, eighty-eight pairs of patients were successfully matched, and the C3/C4 ratio was an influencing factor for the patients’ outcome (hazard ratio 0.587, 95% confidence interval 0.329–0.880). Patients with a C3/C4 ratio <3.6 had a poorer outcome compared with the others (P = 0.002).ConclusionsIgAN patients with decreased C3/C4 ratio displayed significantly more severe clinical symptoms and chronic renal injury than patients with higher ratios. A low C3/C4 ratio could be a risk factor for patients developing to ESRD.

Clinical-histopathological Features of Paratesticular Masses and Factors Affecting Survival: Single Center Experience

Clinical-histopathological Features of Paratesticular Masses and Factors Affecting Survival: Single Center Experience

How do etiological factors can explain the different clinical features of patients with differentiated thyroid cancer and their histopathological findings?

The aim was to retrospectively analyse the clinical-histopathological characteristics of patients with newly diagnosis of differentiated thyroid cancer (DTC) referred to two Italian centres, one in Northern and the other in Southern Italy, between 2000 and 2013. 1081 patients were included and subdivided into two groups: group A (474 patients from Novara) and group B (607 patients from Naples). The group A came from the industrial area of Novara, while the Group B came from the areas around Vesuvius and Campi Flegrei. The two groups were comparable for iodine levels, body mass index, diagnostic timing and clinical procedures. For all patients, demographic and clinical data were collected. No difference was found in gender, whereas the age at diagnosis was later in the group A (group A 53.1±15.16years, group B 41.9±14.25years, p<0.001). In both groups, the most frequent histotype was papillary thyroid cancer (PTC) with prevalence of follicular variant in group A (p<0.0001) and classical variant in group B (p<0.0001). Aggressive histological features were mainly seen in group A (bilaterality p<0.0001, multifocality p<0.0001 and thyroid capsular invasion p<0.0001). Microcarcinomas were more frequent in group A (p<0.0001) but mostly characterized by bilaterality (p<0.001) and multifocality (p<0.04). In both groups, tumour-associated thyroiditis showed a significant increase over the years (group A p<0.05, group B p<0.04). Environmental factors could justify the differences found in our study. These preliminary data should stimulate the need for an Italian Cancer Registry of DTC in order to allow an epidemiological characterization, allowing the identification of specific etiological factors and an improvement in the management of the disease.

Clinicopathologic and survival analyses of synchronous primary endometrial and epithelial ovarian cancers.

The aim of the study was to describe clinicopathologic characteristics, survival outcomes and the factors associated with recurrence in patients diagnosed with synchronous primary endometrial and epithelial ovarian cancers. In this retrospective study, 50 patients who were diagnosed with synchronous primary endometrial and epithelial ovarian cancers and underwent surgery between 1998 and 2010 were reviewed. In our study, the median age at the time of diagnosis was 53 years (range 28-79). The most common presenting symptom was abnormal uterine bleeding with a ratio of 36%. Fifty-four percent of the patients had endometrioid type endometrial cancer and endometrioid type ovarian cancer. All patients were surgically staged and the majority of the patients were in stage I for both endometrial cancer (58%) and ovarian cancer (60%). Nearly one-third (32%) of the patients had a recurrence during the follow-up period and by Cox regression analysis the level of cancer antigen 125 (P = 0.023) at diagnosis, serous or clear-cell histopathologic type ovarian cancer (P = 0.029) and stage of endometrial cancer above I (P = 0.048) were found to be independent risk factors associated with development of recurrence. Patients with endometrioid type endometrium histology and endometrioid type ovarian histology had favorable prognosis with 120.00 months mean disease-free survival and 92% disease-free survival rate at 36 months. In our cohort, we found that endometrioid/endometrioid type synchronous primary endometrial and ovarian cancer had different clinical histopathologic characteristics and favorable prognosis compared to the other histologic types of these cancers. Histopathologic type of the ovarian cancer component, stage of endometrial cancer and level of cancer antigen 125 at diagnosis were observed to have a great influence on the development of recurrence and survival of synchronous primary carcinomas of the endometrium and ovary.

Tumorigenesis and tumor progression related gene expression profiles in colorectal cancer

To investigate the different gene expression profiles in colorectal cancer (CRC) has important implications in understanding the correlation between candidate genes and clinical histopathological features, as well as in developing prognostic prediction markers. The purpose of this study was to identify the expression profiles of tumorigenesis and tumor progression related genes in Taiwanese CRC patients. In this study, we analyze 18 candidate gene expressions of 77 CRC tissues by a GeXP multiplexed assay. The results showed VEGF (71.4%), SOX9 (68.8%), MYC (62.3%), CCND1 (59.7%), TP53 (59.4%), MMP9 (53.3%), and BIRC5 (50.6%) as significantly overexpressed genes in CRC tissues. VEGF was the most highly overexpressed gene. In addition, VEGF was overexpressed in larger tumors (P=0.037, OR=2.981, 95% CI, 1.049-8.477). MMP9 overexpression was correlated to deeper tumor invasion (P=0.001, OR=11.022, 95% CI, 2.281-53.262), and BIRC5 was overexpressed in the presence of perineural invasion (P=0.026, OR=4.250, 95% CI, 1.240-14.562). The results of this study offered valuable information about the relationship between different gene expressions and clinical pathological features, and these biomarkers represent a potential role for CRC prognosis prediction and establishing therapeutic strategies.

Expression of metadherin in retinoblastoma and its relationship with histopathological high-risk factors

Background Metadherin is a newly discovered oncogene.It is highly expressed in some solid tumors and plays a significant role in invasion and metastasis of neoplasm as an important biological marker of aggressive cancers.However,there is little data available for the relationship between metadherin expression and clinicopathologic features of retinoblastoma(RB).Objective This study was to investigate the expression of the metadherin in RB cell lines and specimens as well as its clinical significance.Methods The expression of metadherin mRNA in different metastatic potential of RB cell lines(Y79,WERI-RB1 and SO-RB50)was detected by real-time PCR,and the protein expression of metadherin (MDTH)in paraffin-embedded RB tissue was detected by immunohistochemistry.The relevance of metadherin expression to clinical histopathological features was statistically analyzed.Results The relative expression value of metadherin mRNA was 6.11±0.17,6.21±0.21 and 3.97±0.17 in Y79,SORB50,WERI-RB1,respectively,with a significant difference among the three types of cell lines(F =142.643,P＜0.05).The relative expression value of metadherin mRNA was significantly higher in Y79 or SO-RB50 than that in W ERI-RB1 (P=0.000).The expression of MTDH protein mostly located in the cellular membrane and cytoplasm.Among the 54 RB sections,35 (64.81％)showed a high intensity in expression of metadherin protein.The total score of metadherin protein expression was higher in the E stage of RB than that of D stage(P=0.035),in the patients with high-risk factor than those without high-risk factor(P=0.002)and the cases with optic nerve invasion compared to non-invasion (P＝0.017).However,no significant differences were found in the expression of metadherin protein between different ages (P =0.579),different genders (P =0.513),bilateral eyes (P =0.305),different disease courses (P=0.860),various types of differentiation (P =0.537),different degree of the ehoroid invasion (P =0.238),and with or without invasion of the anterior ocular segment (P =0.579).Conclusions Metadherin appears to be highly expressed in RB cells.The activation of the MTDH gene is associated with invasion and metastasis of RB.These results imply that the dynamic change of metadherin expression probably is a prognostic indicator of RB. Key words: Neoplasm; Retinoblastoma; Metadherin; Histopathology/high-risk factor; Invasion; Metatasis; Immunohistochemistry; Real-time PCR

Contralateral Lymph Neck Node Metastasis of Squamous Cell Carcinoma of the Oral Cavity: A Retrospective Analytic Study in 315 Patients

In relation to primary squamous cell carcinoma (SCC) of the oral cavity, many clinical and histopathologic factors have been reported to be predictive for lymph neck node relapse. However, few large studies concerning the association between clinical-histopathologic features and the development of contralateral lymph neck node relapse (CLNR) after surgical resection of primary SCC of the oral cavity are available. The purpose of this study was to analyze those factors related to the appearance of contralateral lymph neck node relapse in patients with SCC of the oral cavity primarily treated by means of surgery. This study was based on a series of 315 consecutive patients with primary SCC of the oral cavity treated between June 1979 and December 1999. All patients were treated primarily by means of surgery with or without adjuvant radiotherapy. The following data were analyzed for each patient: age, gender, habits, time to diagnosis, performance status, tumor clinical features, histologic grade, TNM staging, type of neck dissection, survival outcome, and functional/esthetic results at the end of the follow-up period. Histologic study included the pTNM classification, tumor size, surgical margins, extracapsular spread of lymph neck node metastasis, perineural infiltration, peritumoral inflammation, and bone involvement. Eighty-three patients eventually died of the disease (26.34%). A total of 177 patients were alive with no evidence of recurrence at the end of the study. The mean disease-specific survival rate was 147 +/- 6 months. Twenty-nine (9.1%) patients developed ipsilateral lymph neck node relapse (ILNR), whereas 18 (5.69%) patients developed CLNR. The mean period of time from surgery to the appearance of CLNR was 12.52 months (range, 3 to 49 months). Eighteen of 29 patients with ILNR finally died of the disease. Seven of 18 patients with CLNR died of the disease. Several clinical-pathologic features were predictive for CLNR in SCC of the oral cavity, such as the time to diagnosis, TNM staging, positive ipsilateral clinical N status, histopathologic differentiation, surgical margins of primary tumor resection, type of neck dissection, and perineural infiltration. Delay in diagnosis 12 or more months is associated with increased CLNR. Clinical and pathologic factors predictive for CLNR are TNM tumor staging IV, histopathologic poor-differentiation of the primary tumor, surgical margins less than 1 cm around the primary tumor, performance of isolated ipsilateral modified type III radical neck dissection, and perineural tumor involvement. Presence of ipsilateral neck metastasis at the time of diagnosis is associated with an augmented incidence of CLNR in SCC of the oral cavity.

Pyoderma granulomateux superficiel

Superficial granulomatous pyoderma is a rare variant of pyoderma gangrenosum, which is often diagnosed at a late stage because of misleading clinical-histopathological features. We report a new case of this rare disease. A 67 year-old man presented with inflammatory lesions that had become ulcerated over the past 4 months despite prolonged antibiotic therapy. The histopathological aspect was initially suggestive of palisading granuloma annulare and subsequently a necrotizing granuloma compatible with a mycobacteriosis. The various supplementary examinations eliminated the possibility of an infectious or systemic disease. The lesions became painful and ulcerated. A second biopsy showed a neutrophilic dermatosis with dermal necrosis and a granuloma leading to the diagnosis of superficial granulomatous pyoderma. The lesions healed after 3 months of systemic corticosteroids at the dose of 1 mg/kg/day. The clinical features of superficial granulomatous pyoderma are similar to those of classical pyoderma gangrenosum. However, its histological profile is more superficial and is associated with dermal granulomas. The latter are unusual in neutrophilic dermatosis and would suggest an infectious disease. This explains the frequent diagnostic errors, with inappropriate anti-infectious treatments and notably unnecessary surgical exeresis.

Rabdomiosarcoma de cabeça e pescoço na infância

Rabdomiosarcoma é uma neoplasia maligna originária de células mesenquimais primitivas, podendo ocorrer em qualquer lugar do corpo. É o sarcoma de partes moles mais comum na infância, e localiza-se mais freqüentemente na cabeça e pescoço. OBJETIVO: Estudar a ocorrência de RMS na cabeça e pescoço na infância, correlacionando aspectos clínicos e histopatológicos. FORMA DE ESTUDO: Clínico retrospectivo. MÉTODO: Oitenta e dois pacientes com diagnóstico de sarcomas de partes moles, atendidos no Instituto de Oncopediatria da UNIFESP-EPM de 1988 a 2002 foram incluídos neste estudo. Foram estudados os seguintes parâmetros: incidência de RMS na infância e na cabeça e pescoço, distribuição segundo sexo, faixa etária, tipo histológico, localização primária, óbito X localização, causa mortis. RESULTADOS: Neste estudo 65% dos casos de sarcomas de partes moles corresponderam à RMS; 33% dos casos de RMS localizavam-se na cabeça e pescoço; 77% dos casos de sarcoma de partes moles de cabeça e pescoço corresponderam ao RMS. A média de idade no diagnóstico foi de 7,62 anos, predominando na faixa etária dos 5 aos 9 anos (41%). Em relação ao sexo, encontramos 47% do sexo feminino e 53% do sexo masculino. Quanto ao tipo histológico, o mais comum foi o RMS embrionário correspondendo a 64,6% do total. O sítio primário mais comum foi o orbital (52,8%). Cem por cento, 50% e 33,3% dos pacientes com RMS parameníngeo, não parameníngeo e orbital, respectivamente, evoluíram para óbito. CONCLUSÃO: O RMS é o sarcoma de partes moles mais comum na infância, localizando-se preferencialmente na cabeça e pescoço. Houve predominância do sexo masculino neste estudo; idade média de 7,62 anos predominando a faixa etária dos 5 aos 9 anos. O tipo histológico predominante foi o embrionário e a localização orbital foi mais freqüente. O maior índice de óbito pertenceu aos RMS parameníngeo e o menor ao orbital.

Clinical histopathological characteristics of basal cell carcinoma in Japanese patients

Clinical histopathological characteristics of basal cell carcinoma in Japanese patients

A clinical and histopathologic analysis of the results of conservation surgery and radiation therapy in stage I and II breast carcinoma.

One hundred eighty women with clinical Stage I or II operable breast carcinoma were treated by radiotherapy following local tumor excision at Yale-New Haven Hospital through 1980. With a median follow-up time of 6.9 years, the actuarial 5-year overall and disease-free survival rates were 82% and 78%, respectively. The 5-year actuarial breast-recurrence-free survival rate was 92%. Several clinical-histopathologic features and treatment parameters were assessed for their significance as predictors of local breast failure or distant relapse. Cox lifetable regression analysis showed that patients with clinical Stage II carcinomas had significantly worse overall and relapse-free survival rates, but clinical stage alone had no effect on the rate of breast recurrence. Furthermore, a decrease in overall and disease-free survival was evident when necrosis was present in the tumor or when patients had an infiltrating lobular carcinoma. Breast recurrence-free survival was also influenced adversely by the presence of these two tumor features, especially when either tumor necrosis or infiltrating lobular carcinoma was found in conjunction with clinical Stage II lesions. Other histologic features such as grade, vascular invasion, perineural invasion, or the presence of an intraductal component of carcinoma did not affect outcome, nor did the treatment techniques employed appear to have a differential effect.