Evidence Of Neoplastic Cells Research Articles

Synchronous nodal metastatic risk in screening detected and endoscopically removed pT1 colorectal cancers

BackgroundThe population screening campaigns have resulted in increasing the prevalence of endoscopically resected colorectal cancers (CRCs) invading the submucosa (pT1). Synchronous nodal involvement occurs in less than 15 % of these tumors. Histologic criteria currently used for selecting patients needing resection are imprecise and most patients could have been simply followed-up. Tumor infiltrating lymphocytes (TILs) and mismatch repair (MMR) status impact on CRC prognosis. To identify patients requiring completion surgery, the value of histologic variables, TILs and MMR status as risk factors of nodal metastasis was investigated in screening detected and endoscopically removed pT1 CRCs. MethodsIn 102 endoscopically resected pT1 CRCs, the cancer phenotype, CD3+ and CD8+ TILs, and MMR status were assessed. Univariate and multivariate analyses were used to evaluate the correlation with nodal metastasis. ResultsPositive resection margin, evidence of vascular invasion and tumor budding, wide area of submucosal invasion, and high number of CD3+ TILs were associated with nodal metastasis in univariate analyses. Vascular invasion was statistically independent in multivariate analysis. Evidence of neoplastic cells in the vessels and/or at the excision border featured 5 out of 5 metastatic tumors and 13 out of 97 non-metastatic ones. ConclusionsCompletion surgery should be recommended only in pT1 CRC with vascular invasion or with tumor cells reaching the margin. In all other cases, the treatment choice should result from a multidisciplinary discussion on the patient-centered evaluation of the risk-benefit ratio.

Augmented Reality Visualization Using Image Overlay Technology for MR-Guided Interventions

The purpose of this study was to prospectively test the hypothesis that image overlay technology facilitates accurate navigation for magnetic resonance (MR)-guided osseous biopsy. A prototype augmented reality image overlay system was used in conjunction with a clinical 1.5-T MR imaging system. Osseous biopsy of a total of 16 lesions was planned in 4 human cadavers with osseous metastases. A loadable module of 3D Slicer open-source medical image analysis and visualization software was developed and used for display of MR images, lesion identification, planning of virtual biopsy paths, and navigation of drill placement. The osseous drill biopsy was performed by maneuvering the drill along the displayed MR image containing the virtual biopsy path into the target. The drill placement and the final drill position were monitored by intermittent MR imaging. Outcome variables included successful drill placement, number of intermittent MR imaging control steps, target error, number of performed passes and tissue sampling, time requirements, and pathological analysis of the obtained osseous core specimens including adequacy of specimens, presence of tumor cells, and degree of necrosis. A total of 16 osseous lesions were sampled with percutaneous osseous drill biopsy. Eight lesions were located in the osseous pelvis (8/16, 50%) and 8 (8/16, 50%) lesions were located in the thoracic and lumbar spine. Lesion size was 2.2 cm (1.1-3.5 cm). Four (2-8) MR imaging control steps were required. MR imaging demonstrated successful drill placement inside 16 of the 16 target lesions (100%). One needle pass was sufficient for accurate targeting of all lesions. One tissue sample was obtained in 8 of the 16 lesions (50%); 2, in 6 of the 16 lesions (38%); and 3, in 2 of the 16 lesions (12%). The target error was 4.3 mm (0.8-6.8 mm). Length of time required for biopsy of a single lesion was 38 minutes (20-55 minutes). Specimens of 15 of the 16 lesions (94%) were sufficient for pathological evaluation. Of those 15 diagnostic specimens, 14 (93%) contained neoplastic cells, whereas 1 (7%) specimen demonstrated bone marrow without evidence of neoplastic cells. Of those 14 diagnostic specimens, 11 (79%) were diagnostic for carcinoma or adenocarcinoma, which was concordant with the primary neoplasm, whereas, in 3 of the 14 diagnostic specimens (21%), the neoplastic cells were indeterminate. Image overlay technology provided accurate navigation for the MR-guided biopsy of osseous lesions of the spine and the pelvis in human cadavers at 1.5 T. The high technical and diagnostic yield supports further evaluation with clinical trials.

Hemangiossarcoma Renal Bilateral Primário Em Cão - Relato De Caso

Reporting of renal neoplasm with aid sonographic image. Canine female, SRD, 12 years, 19 Kg, vomiting and pale anorexia. Mucosas, abdominal swelling, pain on palpation of the hypogastrium right and left side, tachypnea, dehydration and temperature of 38.1°C. Normocytic normochromic anemia, leukocytosis neutrophilic. Elevated serum creatinine and urea. Left kidney with partial loss of architecture, increased echogenicity of the cortical region. Ureter hydronephrosis. Cranial mass with mixed echogenicity in the sagittal plane. Right kidney-increased echogenicity in the cortical region. Perirenal mass with mixed echogenicity with hipoecogênea anecogêneas areas. The histopathologic diagnosis was bilateral renal hemangiosarcoma, without evidence of neoplastic cells in other organs such as spleen, liver and right atrium. Renal neoplasms are rare and may produce local or systemic manifestations signs of renal failure with azotemia, as evidenced in the dog study. The more common in dogs, hemangiosarcoma is in the right atrium and the kidney as metastasis, which was not observed in this study, confirming a case of bilateral renal primary hemangiosarcoma.

Diagnosis and treatment of a primary splenic lymphoma in a mule

Summary The case reported here describes a transthoracic approach for removal of a splenic lymphoma from a 5-year-old mule. Nine months prior to presentation at Iowa State University College of Veterinary Medicine (ISUCVM), abdominal ultrasound was performed as part of a work-up to investigate the cause of lethargy, anorexia and anaemia. Ultrasound examination identified a haemoabdomen and multiple splenic masses. Transabdominal biopsies were collected for histopathological evaluation and lymphoma diagnosed. Based on a number of clinical and laboratory examinations there was a lack of support for multicentric involvement and all results suggested solitary splenic involvement. Surgical removal of the spleen was accomplished via a transthoracic approach without complications. Histopathology of the splenic masses revealed a B cell lymphoma. Bone marrow was collected during surgery and submitted for cytology and was found to contain a normal lymphoid population with no evidence of neoplastic cells. The mule was discharged from the hospital 11 days after surgery.

Macular Hole With Retinal Pigment Epithelium Hyperplasia Simulating Neoplasm

A case in which a retinal pigment epithelium migration through a stage IV macular hole onto the retinal surface simulated a retinal pigment epithelium neoplasm is described. A 69-year-old woman presented with a hyperpigmented membranous retinal surface growth temporal to a stage IV macular hole in the left eye. Clinical examination and optical coherence tomography were performed prior to pars plana vitrectomy with membrane peeling. Histopathologic processing revealed melanosomes and retinal pigment epithelium with no evidence of neoplastic cells. Retinal pigment epithelium migration can occur through a full-thickness macular hole onto the retinal surface, simulating a retinal pigment epithelium neoplasm. It may be a poor prognostic indicator for visual success.

Fibrosing inflammatory pseudotumor

Fibrosing inflammatory pseudotumor is a non-specific inflammatory process of uncertain etiology. Histology of this lesion shows a polymorphous infiltrate with plasma cells, lymphocytes and eosinophils with a significant reactive fibrovascular component [Sung MV, Kim K, Lee C, Moh JH, Kim WH, Han MH. Fibrosing inflammatory pseudotumors of the central skull base. Laryngoscope 1997;107(12):1651–5; Helemberger RC, Mancuso AA. Wegener granulomatosis if the Eustachian tube and skull base mimicking a malignant tumor. AJNR 1996;17:1785–90]. This reactive fibroinflammatory process can be locally aggressive and mimic a malignant lesion. It has been described involving the skull base, orbit, ear, the parotid glad, paranasal sinuses and the pterygomaxilary space. The Tolosa Hunt syndrome and the orbitary pseudotumor, probably, represent a clinical variant of this process. Central skull base involvement is an unusual form of inflammatory pseudotumor, fewer than 30 cases have been described in the literature until now. Common clinical manifestations are pain and a variety of neurological dysfunctions of the cranial nerves specially nerves VII, IX, X and XII. Imaging studies, computed tomography (CT), magnetic resonance imaging (MR) and positron emission tomography (PET) demonstrate the extent of the lesion but cannot rule out a malignant process [Sung MV, Kim K, Lee C, Moh JH, Kim WH, Han MH. Fibrosing inflammatory pseudotumors of the central skull base. Laryngoscope 1997;107(12):1651–5; Helemberger RC, Mancuso AA. Wegener granulomatosis if the Eustachian tube and skull base mimicking a malignant tumor. AJNR 1996;17:1785–90; Han MH, Je GC, Myung SK, Kee HC, Kwang HK, Kyung MY. Fibrosing inflammatory pseudotumors involving the skull base: MR and CT manifestations with histopathologic comparison. AJNR 1996;17:515–21]. However, biopsy results are negative with chronic inflammation without any evidence of neoplastic cells. We present a case of fibroinflammatory pseudotumor of the central skull base with paralyses of lower cranial nerves, including nerves IX, X and XII.