Common Histological Type Research Articles

Prediction of histologic types in solid lung lesions using preoperative contrast-enhanced CT.

This study aimed to develop and validate a predicting model for the histologic classification of solid lung lesions based on preoperative contrast-enhanced CT. A primary dataset of 1012 patients from Tianjin Medical University Cancer Institute and Hospital (TMUCIH) was randomly divided into a development cohort (708) and an internal validation cohort (304). Patients from the Second Hospital of Shanxi Medical University (SHSMU) were set as an external validation cohort (212). Two clinical factors (age, gender) and twenty-one characteristics on contrast-enhanced CT were used to construct a multinomial multivariable logistic regression model for the classification of seven common histologic types of solid lung lesions. The area under the receiver operating characteristic curve was used to assess the diagnostic performance of the model in the development and validation cohorts, separately. Multivariable analysis showed that two clinical factors and twenty-one characteristics on contrast-enhanced CT were predictive in lung lesion histologic classification. The mean AUC of the proposed model for histologic classification was 0.95, 0.94, and 0.92 in the development, internal validation, and external validation cohort, respectively. When determining the malignancy of lung lesions based on histologic types, the mean AUC of the model was 0.88, 0.86, and 0.90 in three cohorts. We demonstrated that by utilizing both clinical and CT characteristics on contrast-enhanced CT images, the proposed model could not only effectively stratify histologic types of solid lung lesions, but also enabled accurate assessment of lung lesion malignancy. Such a model has the potential to avoid unnecessary surgery for patients and to guide clinical decision-making for preoperative treatment. • Clinical and CT characteristics on contrast-enhanced CT could be used to differentiate histologic types of solid lung lesions. • Predicting models using preoperative contrast-enhanced CT could accurately assessment of tumor malignancy based on predicted histologic types.

Hematologic Paraneoplastic Syndrome in Newly Diagnosed Patients with Lung Cancer

Introduction: Lung cancer could have signs and symptoms generated by paraneoplastic syndromes. This study aimed to describe and analyze hematologic paraneoplastic syndrome in patients with lung cancer in Indonesia. Methods: This was a cross-sectional analytic study conducted in Persahabatan National Respiratory Referral Hospital, Jakarta, between September 2018 and February 2019, on all newly diagnosed patients with lung cancer whose diagnosis was established and who fulfilled the inclusion and exclusion criteria. Results: The mean age of subjects was 56.7 ± 11.4 years old. Most subjects were male, had normal nutritional status (42.6%), had a smoking history (75%), and had a moderate Brinkman Index (BI) value (52%). The most common type of histology was squamous cell carcinoma (SCC) (39.7%), with advanced stage (83.8%) and performance status <2 (94.1%). Paraneoplastic anemia was 40.4%, associated with poor nutritional status and commonly normocytic normochromic anemia. The proportion of paraneoplastic leukocytosis was 39%, associated with males and smoking history. The proportion of paraneoplastic neutrophilia was 51.5%, and it was related to males, smoking history, and SCC histology type. Paraneoplastic hypereosinophilia and thrombocytosis proportions were 2.9% and 18.4%, respectively. The proportion of paraneoplastic hypercoagulability was 91.2%, which was caused by the elevated D-dimer level. Conclusion: The most common hematologic paraneoplastic syndromes in patients with lung cancer were hypercoagulability, neutrophilia, and anemia. The low hemoglobin (Hb) level of paraneoplastic anemia was associated with low body mass index (BMI). Male and smoking history in lung cancer patients were associated with paraneoplastic leukocytosis and/or neutrophilia.

Pixel-Level Classification of Five Histologic Patterns of Lung Adenocarcinoma.

Lung adenocarcinoma is the most common histologic type of lung cancer. The pixel-level labeling of histologic patterns of lung adenocarcinoma can assist pathologists in determining tumor grading with more details than normal classification. We manually annotated a dataset containing a total of 1000 patches (200 patches for each pattern) of 512 × 512 pixels and 420 patches (contains test sets) of 1024 × 1024 pixels according to the morphological features of the five histologic patterns of lung adenocarcinoma (lepidic, acinar, papillary, micropapillary, and solid). To generate an even large amount of data patches, we developed a data stitching strategy as a data augmentation for classification in model training. Stitched patches improve the Dice similarity coefficient (DSC) scores by 24.06% on the whole-slide image (WSI) with the solid pattern. We propose a WSI analysis framework for lung adenocarcinoma pathology, intelligently labeling lung adenocarcinoma histologic patterns at the pixel level. Our framework contains five branches of deep neural networks for segmenting each histologic pattern. We test our framework with 200 unclassified patches. The DSC scores of our results outpace comparing networks (U-Net, LinkNet, and FPN) by up to 10.78%. We also perform results on four WSIs with an overall accuracy of 99.6%, demonstrating that our network framework exhibits better accuracy and robustness in most cases.

Patterns and trends in esophageal cancer incidence and mortality in China: An analysis based on cancer registry data

BackgroundEsophageal cancer poses a significant global burden, while its patterns and trends remain to be clarified. The aim of this study is to provide an update on the incidence and mortality rates of esophageal cancer and their trends in China based on data from the National Cancer Registry. MethodsWe extracted data from the National Central Cancer Registry (NCCR) of China from 2000 to 2016 and performed comprehensive quality control. We calculated age-standardized rates of China (ASR China) and world (ASR world) using the Chinese population in 2000 and the Segi's world standard population, and performed a joinpoint regression analysis to examine the trend in incidence and mortality of esophageal cancer. The annual percent change (APC) and weighted average APC (AAPC) over the entire study period were estimated to measure the changing trend. Subgroup analyses were conducted by sex, region and pathological type. ResultsA total of 487 eligible cancer registries were included in the data analysis and 22 registries with uninterrupted registration data were used for trend analysis. In 2016, there were an estimated of 184,500 incident cases of esophageal cancer and 142,300 deaths in China. The crude incidence, ASR China and ASR world were 25.25/100,000, 11.00/100,000 and 11.13/100,000, respectively. And the crude mortality, ASR China and ASR world were 19.38/100,000, 8.25/100,000 and 8.28/100,000, respectively. Esophageal squamous cell carcinoma (ESCC) was the most common histological type, accounting for 85.79% of all cases, followed by esophageal adenocarcinoma (EAC) (11.00%) and others (3.21%). There was a decreasing trend of ASR world in incidence and mortality during 2000–2016 with the AAPC of -4.6% (95% CI: -5.7%, -3.4%) and -4.6% (95% CI: -5.2%, -3.9%). The pattern and trend of esophageal cancer differ in sex, region and pathological type. ConclusionsThe burden of esophageal cancer in China remains high with sex, regional and subtype differences. The incidence and mortality of esophageal cancer have continued to decline over the past decade, which was due in part to the reductions in risk factor exposure and the implementation of screening.

Imaging Recommendations for Diagnosis, Staging and Management of Larynx and Hypopharynx Cancer

AbstractWe discussed the imaging recommendations for diagnosis, staging, and management of larynx and hypopharynx cancer. Carcinoma of the larynx is a common cancer, with males being affected more. Hypopharyngeal carcinoma is less common than laryngeal malignancies. Squamous cell carcinoma is the most common histological type. Nonsquamous cell malignant lesions are rare and mostly submucosal lesions. Clinical examination and endoscopy play an integral role in its detection and staging. Imaging also plays a major role in its staging, including local disease extent, nodal and distant metastatic status, as well as to assess response to therapy. Follow-up of treated cases and differentiation of recurrence from post treatment changes can be done on imaging. Early stage disease is treated with single modalities such as radiotherapy or surgery. Advanced disease is treated with multimodality of either chemoradiotherapy or surgery followed by adjuvant radiotherapy with or without concurrent chemotherapy.

CCKAR is a biomarker for prognosis and asynchronous brain metastasis of non-small cell lung cancer.

Non-small cell lung cancer (NSCLC) is the most common histological type of lung cancer, and brain metastasis (BM) is the most lethal complication of NSCLC. The predictive biomarkers and risk factors of asynchronous BM are still unknown. A total of 203 patients with NSCLC were enrolled into our cohort and followed up. The clinicopathological factors such as tumor size, T stage, lymphatic invasion, metastasis and asynchronous BM were investigated. CCKAR expression in NSCLC and resected BM was assessed by IHC, and CCKAR mRNAs in NSCLC and para-tumor tissues were estimated by qRT-PCR. The correlations between CCKAR expression, BM and other clinicopathological factors were assessed by chi-square test, and prognostic significance of CCKAR was estimated by univariate and multivariate analyses. CCKAR was highly expressed in NSCLC tissues compared with para-tumor tissues. CCKAR expression in NSCLC was significantly associated with asynchronous BM. The BM percentages for NSCLC patients with low and high CCKAR were surprisingly 5.2% and 66.6%, respectively. CCKAR expression and BM were unfavorable factors predicting unfavorable outcome of NSCLC. Moreover, CCKAR expression in NSCLC was an independent risk factor of asynchronous BM. CCKAR is a prognostic biomarker of NSCLC. CCKAR expression in NSCLC is positively associated with asynchronous BM, and is a risk factor of asynchronous BM from NSCLC.

Ovarian Follicular Lymphoma Diagnosed due to Hydronephrosis.

A 74-year-old woman presented with left lateral abdominal pain. Abdominal echography revealed left hydronephrosis and a pelvic mass. The patient underwent left adnexal resection of a suspected left ovarian tumor and was diagnosed with follicular lymphoma (FL) of clinical stage IIIA, grade 2. The patient was treated with rituximab-combined chemotherapy and achieved complete remission. The most common histological types of ovarian lymphoma are diffuse large B-cell lymphoma and Burkitt lymphoma, with FL being an extremely rare variant. We herein report a case of ovarian FL diagnosed as hydronephrosis.

INCIDENCE OF UTERINE SARCOMA IN IVANO-FRANKIVSK REGION

Uterine sarcoma (US) is a rare disease characterized by an aggressive course and poor prognosis, accounting for 3–7% of malignant neoplasms of the uterus.
 The goal. Study the incidence of uterine sarcoma in Ivano-Frankivsk region and to analyze the clinical and morphological characteristics of the tumor.
 Materials and methods. Our research is based on clinical observations at the Municipal Non-Profit Institution “Precarpathian Clinical Oncology Center of the Ivano-Frankivsk Regional Council” for the period from 2010 to 2021.
 The results. The analyzed data showed that the number of patients with uterine sarcoma was: stage I – 51.61%, stage II – 25.8%, stage III – 6.45%, and stage IV – 16.15%. Special attention should be paid to the observation of 48 patients with stages I, II uterine sarcoma (pT1-2NOMO).
 The peak incidence of uterine sarcoma in women is observed in the age group of 40-59 years (60.4%).
 The most common histological type is leiomyosarcoma, which accounts for 66.67%. Due to the different pathogenesis of the development of mesenchymal tumors, their clinical characteristics also differ. Leiomyosarcoma of the uterus is most often detected in the age group of 40-59 years (43.75%), but for endometrial stromal sarcomas, the peak incidence falls on the age group of 50-81 years, and it is 22.9%.
 In patients with leiomyosarcoma stage I, the distribution of histological grading is almost the same for G1, G2 – 28.1% and 25%. In stage II leiomyosarcoma, G2 prevails – 18.75%. For endometrial stromal sarcoma, in contrast to leiomyosarcoma, G3 prevails for stage I and II, which is 38% and 25%, respectively.
 In most patients with uterine sarcoma, an unencumbered oncology history was observed. Indicators of tumor markers (CA125, REA) for most patients with stage I-II uterine leiomyosarcoma were normal, for 66.67%.
 Conclusions. Most often, uterine sarcoma occurs in women of perimenopausal and menopausal age; the peak incidence of uterine leiomyosarcoma is in the age group of 40-59 years. The peak incidence in women with endometrial stromal sarcoma was observed in the age group of 50-81 years. Most cases are diagnosed at stage I of the disease, and the most common histological type of all uterine sarcomas is leiomyosarcoma. Endometrial stromal sarcoma is the second histological type of spreading, which in world practice demonstrates the advantage of detecting a low degree of malignancy G1-2. In our clinical study, in stages I-II, the frequency of detection, corresponding to the degree of tumor differentiation, G3 prevails. Among patients with stage I leiomyosarcoma, women with normal BMI prevailed (20.83%); with stage II, women with excess body weight and obesity (Class III) prevailed, which amounted to 25%. The majority of patients with stage I endometrial stromal sarcoma had excessive body weight, which amounted to 36.4%. Women with obesity of Class I predominated in stage II endometrial stromal sarcoma – 27.3%. Non-aggravated oncology history was characteristic for majority of patients with uterine sarcoma. 87.5% of women with stages I, II leiomyosarcoma and 73% of patients with stages I, II endometrial stromal sarcoma had non-aggravated oncology history. In most patients with uterine sarcoma and those who had more than three pregnancies, uterine leiomyoma in the anamnesis was found. Indicators CA125, CEA for most patients with leiomyosarcoma were normal.

Therapeutic Reduction Mammoplasty: Experience of a Single Institute.

Breast cancer is the most common malignancy in women worldwide as reported by the World Health Organization. The concept of oncoplastic breast surgery appeared as an extension of breast-conserving surgery, applying breast reduction techniques with more acceptable aesthetic and functional outcomes. The purpose of the present study was to describe the breast cancer population of a single institute submitted to lumpectomy and bilateral immediate breast reduction or mastopexy and its complications. This is a retrospective observational study including patients submitted to lumpectomy and immediate bilateral breast reduction or mastopexy. Patients and tumour characteristics, surgical technique, complications, follow-up period, and recurrence data were obtained and analyzed. A total of 49 patients were submitted to lumpectomy and bilateral breast therapeutic reduction/mastopexy, with a mean age of 56.47 ±8.58 years and a mean body mass index of 28.68kg/m2 ±3.94 kg/m² between January 2019 and December 2021. Invasive tumours of no specific type, associated or not, with carcinoma intraductal in situ were the most common histological type corresponding to almost 80% of the cases with T1 stage corresponding to more than half of the cases. Sixteen percent of the patients had early minor complications with wound dehiscence associated with wound delayed healing, corresponding to 75% of the cases. Body mass index had a statistical difference between groups (p=0,006, t-test). The low rates of minor and major complications show that immediate therapeutic breast reduction can be a suitable approach in selected cases.

The Role of Intraoperative Transesophageal Echocardiography in the Management of Renal Cell Carcinoma with Atrial Thrombus - Case Report.

Renal cell carcinoma is a common disease, and clear cell renal cell carcinoma is the most common histological type. Renal cell carcinoma has a tendency to infiltrate the venous system including the inferior vena cava and the right atrium of the heart. We present the cases of two patients with renal cell carcinoma with stage IV tumor thrombus according to the Mayo classification, who underwent surgery under transesophageal echocardiography guidance. Apart from standard imaging methods used in renal cancer with tumor thrombus reaching the right atrium of the heart, we consider transesophageal echocardiography to be a very useful tool in the diagnostic work-up, patient monitoring, and selection of appropriate surgical technique.

HEMORRHOIDS AGAIN?

Abstract Introduction Anal cancer represents 4% of digestive tract tumors, although its incidence is increasing due to the growing number of patients with HPV infection, who are immunosuppressed or who practice anal sex. The most common histological type is carcinoma and the usual standard treatment is the combination of radiotherapy with chemotherapy. Survival at 5 years exceeds 50% even in patients with nodal disease. Clinical case We present the case of a 54-year-old man, with a history of anal intercourse, referred to General Surgery for hemorrhoids. During the examination in consultation, an ulcerated excrescent anal lesion was observed. A rectal swab was taken for sexually transmitted diseases and a biopsy of the lesion was HPV+, genotype 16. In the pathology study, anal squamous cell carcinoma was diagnosed. An extension study was performed, objectifying bilateral inguinal lymphadenopathies (N1a) and treatment with radiochemotherapy was started after a decision made by the multidisciplinary tumor committee. Discussion Anal squamous cell carcinoma is the most frequent histological variety of malignant tumors of the anus. The first-line treatment is radiotherapy (which must be to the inguinal region) associated with chemotherapy (5-FU and mitomycin C). A clinical follow-up should be carried out in all cases at 8–12 weeks and, in addition, an annual extension radiological study in locally advanced cases. Rescue surgery will be reserved for those patients with confirmed locoregional recurrence, with abdominoperineal amputation being the indicated technique in most cases.

Early-stage glottic cancer of rare squamous cell carcinoma variants: a population-based study

Background Squamous cell carcinoma (SCC) is the most common histological type of laryngeal cancer. Several variants of SCC have been reported. However, how these variants differ from conventional SCC and how they should be treated remain to be elucidated. Objective To compare the prognosis of early-stage glottic cancer among SCC variants Methods We obtained data from 12471 cases using the Surveillance, Epidemiology, and End Results database. Disease-specific survival (DSS) and overall survival (OS) rates were estimated using the Kaplan–Meier method. A Cox proportional hazard model was used to estimate hazard ratios (HRs) according to the variants. Results HRs for DSS and OS compared with well-differentiated SCC were 3.83 and 3.48 for adenosquamous, 1.42 and 1.42 for basaloid, 1.14 and 1.17 for papillary, 0.85 and 0.94 for spindle, and 0.81 and 1.00 for verrucous SCC. The difference in DSS among the treatment modalities was significant in conventional and papillary SCC (p < .001 and p = .032, respectively). Conclusions The prognosis of SCC variants, except for adenosquamous SCC, is comparable to that of conventional SCC.

Analysis of p21 Expression in Cervical Carcinoma at a Tertiary Institution in Ghana: An Immunohistochemical Study

Abstract Background: Cervical cancer is one of the leading causes of female mortality worldwide. About 85% occur in low-income countries with 13.8% incidence and 14% death in Ghana. p21 has been overexpressed in many cancers. Its overexpression in cervical cancer is linked to tumor growth and a bad prognosis. Aim: The expression profile of p21 in our setting is largely unknown, therefore, the necessity to evaluate p21 expression in cervical cancer. Materials and Methods: A retrospective and descriptive study design was employed to investigate p21 expression in association with demographic and clinicopathological features on formalin-fixed paraffin-embedded cervical cancer tissues. The age, histologic type, and tumor grade of patients were abstracted from the hospital records between January 1, 2015, and December 31, 2016. Tissue microarray of suitable blocks was constructed, and immunohistochemistry was performed. Data were analyzed using the Statistical Package for the Social Sciences (SPSS) version 26. Results: One hundred and thirty-five cases were used for the study with an age range of 31–115 years and mean age of 58.93 years (standard deviation ± 17.88). Majority of the cases were postmenopausal (40–59 years). Squamous cell carcinoma (SCC) was the most common histological type (96.3%) with the nonkeratinizing variant having the highest frequency (53.1%). Majority of the cases were high grade; Grade 2 (33.3%) and Grade 3 (49.6%). Majority of the cases (66.7%) stained positive for p21 antibody. The associations between p21 and the clinicopathological characteristics were not statistically significant (P &gt; 0.05). p21 was more overexpressed in SCC (64.8%) than adenocarcinoma. Conclusion: An overexpression of p21 in this study suggests that it may contribute to antiapoptosis in cervical cancer leading to tumor progression, aggressive behavior, and poor prognosis.

CLINICAL AND PATHOLOGICAL CHARACTERIZATION OF HEPATIC LYMPHOMAS: A RETROSPECTIVE SINGLE-CENTER STUDY.

The incidence of hepatic lymphoma has been increasing recently and diagnosis can be challenging as clinical presentation and radiological findings are usually variable and non-specific. The aims of this study were to describe their main clinical, pathological and imaging characteristics and identify poor prognostic factors. A retrospective study that included all patients with histological diagnosis of liver lymphoma over a 10-year period at our center was performed. A total of 36 patients were identified, with mean age of 56.6 years and male predominance (58%). There were three patients with primary liver lymphoma (8.3%) and 33 with secondary liver lymphoma (91.7%). The most common histological type was diffuse large B-cell lymphoma (33.3%). The most common clinical manifestations included fever, lymphadenopathy, weight loss, night sweats and abdominal discomfort; three patients (11.1%) were asymptomatic. Computed tomography scan revealed heterogenous radiological patterns including a single nodule (26.5%), multiple nodules (41.2%) or diffuse infiltration (32.4%). The mortality rate during follow-up was 55.6%. Higher levels of C-reactive protein (P=0.031) and absence of treatment response (P<0.001) were significantly associated with higher mortality. Hepatic lymphoma is a rare disease that may involve liver as part of a systemic disease or, less commonly, be confined to this organ. Clinical presentation and radiological findings are often variable and non-specific. It is associated with high mortality and poor prognostic factors include higher levels of C-reactive protein and absence of response to treatment.

Urinary Bladder Primary Squamous Cell Carcinoma: A Rare Case Description and Literature Review

Cancer of the urinary bladder is a commonly encountered malignancy of the urinary tract. The most common histologic type is Transitional cell carcinoma (TCC). It accounts for 90-95% of all bladder cancers. It is usually seen in the sixth and seventh decades of life. Men are affected three to four times more than women. The remaining 5-10% of the bladder tumors are other types of epithelial and mesenchymal tumors. Squamous cell carcinoma (SCC) of the urinary bladder is a very uncommon malignancy.

Analysis of the Clinical-Epidemiological Profile and Cytopathological Follow-Up of Women with Cervical Cancer Undergoing Radiotherapy

he objectives of this study were to identify the clinical-epidemiological profile of patients undergoing radiotherapy for malignant neoplasia of the cervix; describe the main cytological changes induced by radiation during post-radiotherapy follow-up; verify the incidence of locoregional recurrence, according to the cytopathological diagnosis and identify the disease-free survival and overall survival of patients followed in the study. The methodological design had a descriptive approach with a quantitative nature and longitudinal character, whose population was composed of 407 patients with cervical cancer who underwent radiotherapy and were followed up for a minimum of 5 years and a maximum of 7 years. The project was approved by the Research Ethics Committee of the National Cancer Institute, Rio de Janeiro, Brazil. Sociodemographic variables and associated risk factors were evaluated; categorical variables (cytopathological) and dependent variables for the outcome of locoregional recurrence, death and disease-free survival. The epidemiological profile of the study population revealed a mean age of 51 years, with an age range primarily from 41 to 50 years, with risk factors associated with smoking being present in 32% of patients. The percentage of alcoholics was just 5.5%. Regarding the number of sexual partners, the average was 4 partners throughout life. Squamous cell carcinoma was the most common histological type (84%). Regarding clinical staging, 2B (42.9%) and 3B (33.7%) were predominant. Of the exams with satisfactory quality for analysis, more than half (64.9%) showed actinic effects. The incidence of locoregional recurrence, according to the cytopathological diagnosis, was 11.8%, of which almost half (47.9%) died. The analysis of locoregional recurrence that impacts disease-free survival was 69.5%. The overall survival found in the analyzed population was 75.7%. The difficulties related to actinic (radiotherapy) effects show the importance of the experience of professionals involved in the analysis of irradiated cells and reflection on the subjectivity of the method. Observing these changes is useful for evaluating the impact of actions taken during the period and planning future actions.

Spectrum of Nasopharyngeal Cancers Seen in the Department of Radiation Oncology University College Hospital, Ibadan

Context: Nasopharyngeal cancers were initially thought to be an uncommon disease in Nigeria, but recent studies have shown a steady increase in the incidence of the disease with an associated increase in morbidity and mortality due to late presentation. Aims: The aims are to evaluate the mode of presentation and referral pattern of nasopharyngeal cancer patients seen. Settings and Design: This was a retrospective review of patients with nasopharyngeal cancer seen in the department of Radiation Oncology U.C.H. Ibadan from 2000 to 2009. Methods and Material: Patients' biodata, clinical–pathologic presentation, and site of referral were retrieved using data extraction form and subsequently analyzed using Microsoft Excel (2013). Statistical Analysis Used: It is a descriptive analysis. Results: A total of 205 patients with histologically confirmed nasopharyngeal cancer seen during the study period were analyzed. The mean age of the patients was 41.7 years with 144 (70.2%) males and 61 (29.8%) females. The commonest presenting complaint was cervical lymphadenopathy in 98.5% of patients followed by nasal blockade, nasal discharge, and epistaxis with 82.0%, 78.0%, and 51.2%, respectively. Undifferentiated carcinoma was the commonest histologic type (68.8%). Majority of patients were civil servants (33.2%). The habit of smoking and alcohol ingestion was unspecified in majority of patients (43.4%). Ingestion of smoked fish has been found in majority of patients (122, 59.5%) with the disease in this study. Most of the patients came from southern part of the country which coincides with the geographic distribution of Burkitt's lymphoma; hence, the possibility of Epstein–Barr virus as one of the likely causative agents. None of the patients presented with stage I disease, while most patients presented at stage III 129 (62.9%). Conclusions: Nasopharyngeal cancer is common. Cervical lymphadenopathy, nasal blockade with undifferentiated histology, and late presentation were the norm. Referrals were from all the regions of the country.

Histopathological evaluation of benign soft tissue lesions at Nnamdi Azikiwe University teaching hospital, Nnewi, south-east Nigeria: A 9-year review

Background: Soft tissue lesions are remarkably diverse and range from inflammatory, self-limited lesions to neoplasm. The diversity of these lesions frequently poses a diagnostic challenge to pathologists and remains a subject of interests. Lack of research on soft tissues in our setting has prompted the need to study them. Objectives: The aim of this study was to determine the benign lesions of soft tissues with respect to age, sex, anatomic site, and histologic types. It also aimed to determine the baseline data of benign soft tissue lesions in Nnewi, Nigeria. Materials and Methods: This study reviewed all histologically diagnosed benign soft tissue lesions at the Histopathology Department of Nnamdi Azikiwe University Teaching Hospital (NAUTH), Nnewi, Nigeria from 2011 to 2019 and classified the tumors using the 2020 WHO Classification of Soft Tissue Tumours. Results: A total of 351 cases of soft tissue lesions were diagnosed during the study period, out of which 251 were benign lesions and accounted for 71.5% (251/351) of all soft tissue lesions, whereas 28.5% (100/351) of the cases were malignant. The benign lesions included inflammatory and benign neoplasm, of which neoplasm accounted for the majority of the cases with a frequency of 94.0% (236/251), whereas inflammatory lesions accounted for 5.9% (15/251). The 236 benign soft tissue tumors diagnosed had a male-to-female ratio of 1: 1.4 with a mean age (SD) of 37.5 (19.5) years. The most frequent occurrence of benign tumors was seen in the fourth decade with 52 cases (21.0%), followed by fifth decade with 42 cases (16.7%). Adipocytic tumors were the commonest with a frequency of 54.0% (135/251), followed by peripheral nerve sheath tumors (PNSTs) with 12.4% (31/251) and then vascular and fibroblastic/myofibroblastic tumors with 10.8% (27/251) and 5.6% (14/251), respectively. Lipoma is the most common histologic type of benign soft tissue tumor and the only benign adipocytic tumor. This is followed by hemangioma 9.6% (24/251) and then neurofibroma 7.6% (19/251). Lipoma accounted for 37.09% (135/351) of all soft tissue lesions and the majority of them were seen in the fourth decade, whereas hemagioma and neurofibroma occurred more at the first decade. The most common anatomic distributions of these benign tumors were lower extremities with 23.5% (n = 59/251), followed by trunk 21.1% (n = 53). The major inflammatory lesions were tuberculoid granulomatous inflammation and panniculitis with 2.3% (6/251) of cases each. Others were necrotizing fasciitis (n = 2) and eosinophilic myositis (n = 1). Conclusion: Benign soft tissue tumors had a slight female preponderance. Lipoma is the single most common benign soft tissue neoplasm, whereas tuberculosis and panniculitis were the two most common inflammatory soft tissue lesions. Histopathological evaluation of these lesions still stands as a gold standard in their diagnosis.

Yassir Alaa Muhammed Hassan Shubbar CORRELATION BETWEEN DIFFERENT CLINICOPATHOLOGICAL PARAMETERS AND MOLECULAR SUBTYPES OF FEMALE BREAST CARCINOMA IN SOUTH REGION OF IRAQ.

The aim: To correlate variable clincopathological parameters with molecular subtypes of the breast carcinoma, which affect the prognosis and management of breast malignancy. Materials and methods: In this study a total of 511 female patients with breast carcinoma were included, ranging from 32 to 85 years of age, with 35.8% premenopausal and 64.1% being post-menopausal. The sample slides were stained immunohistochemically for estrogen receptors (ER), progesterone receptors (PR), ki67 and HER2, the tumors were graded histologically using the Nottingham criteria system. Results: Most tumors (72.8%) ranged between 2 and 5 cm in size; the most common histological type of breast carcinoma (49.7%) was invasive ductal carcinoma of no special type, with grade 2 presented in 51.8% cases; most frequent stage at time of presentation was stage 3A, found in 39.9%; the most frequent molecular subtype was ER and/or PR+, Her2- with low proliferation rate ki67<14% subtype in 48.5%, and those group were more likely (statistically significant) to be older, have stage 3 breast cancer, present with tumor size between 2 and 5 cm and tend to be well differentiated histological grade (grade1), mostly with lymph node positive, and most likely have tumor type of invasive ductal carcinoma of no special type. Conclusions: the most common histological type of breast carcinoma in Iraq south was invasive ductal carcinoma of no special type and most cases showed (ER and/or PR+, HER 2-, low ki67) as the most common molecular subtype.

Clinico-pathological Spectrum of Primary Skin Malignancies in an Indian Tertiary Care Hospital.

Skin malignancies are the most common form of malignant disease in the western world, predominantly affecting older age groups. The majority of skin cancers are basal cell carcinoma (BCC), squamous cell carcinoma (SCC), and malignant melanoma, which account for more than 95% of total skin malignancies. However, in India, these constitute only 1-2% of all cancers. There is an increase in incidence in India over 10 years of period. There is scarcity of data on the clinico-pathological profile of these tumours from this geographical region. This was a retrospective study conducted in a tertiary care teaching hospital in which archival records and histopathology sections of all patients of skin carcinomas diagnosed over a period of 5 years (January 2016 to December 2020) were analysed. The clinical parameters and histopathological features of the cases were analysed and correlated for any possible association. Out of the 230 skin malignancies studied, SCC constituted the most common type (n = 148), followed by BCC (n = 70) and malignant melanoma (n = 12). The tumour commonly presented in the 6th decade of life with slightly higher male preponderance (M: F =1.6:1). Sun-exposed areas were the most common sites, and the common presentations included non-healing ulcer, fungating/cauliflower/polypoidal growth, and hyperpigmented or nodular plaque. In SCC, previous history of diabetes and burns was noted in 10% and 3.4% of the patients, respectively. SCC is likely the most common histological type of skin malignancies in India. The clinico-pathological profile of skin malignancies of patients depends on multiple factors, notably the skin colour and the geographical location.