Frequent Histological Diagnosis Research Articles

Supervivencia en relación a los factores pronóstico en una serie de pacientes con carcinoma de células renales

To analyze the survival rate in a series of patients with the diagnosis of renal cell carcinoma over a 19 year period based on prognostic factors usually employed in clinical practice. Retrospective study of 259 consecutive patients with the diagnosis of renal cell carcinoma undergoing surgery in our department between 1988 and 2006. From clinical, pathological, and follow-up data we performed a survival study comparing the impact of usual prognostic factors: stage, tumor size, nuclear grade, etc. 264 surgical procedures were performed in 259 patients, with a mean age of 6 1.91 yr. The most frequent way of diagnosis was incidental finding (52.12% of the cases); radical nephrectomy was performed in 72.97% of the cases in comparison with 26.25% partial nephrectomies. Clear cell carcinoma was the most frequent histological diagnosis (69.88%). Patients with clear cell carcinoma, symptomatic tumors, bigger size, and greater Fuhrman nuclear grade presented worse survivals, mainly in tumors with stage >pT3a. The presence of involved lymph nodes or distant metastases is associated with a much lower cancer-specific survival. Global five-year cancer-specific survival was over 80%. The classical prognostic factors used to predict survival in renal cancer are still useful, mainly pathological stage pT. We observed a better survival in comparison with older series, but this kind of tumors continue generating important morbidity-mortality.

Prevalence of hysteroscopic findings and histologic diagnoses in patients with abnormal uterine bleeding

To describe the prevalence of hysteroscopic findings and histologic diagnoses in patients with abnormal uterine bleeding (AUB). Retrospective series of consecutive patients. Tertiary care university hospital and private office. Four thousand fifty-four hysteroscopies with biopsy in patients with AUB evaluated between June 1993 and December 2004. Hysteroscopies were performed using 2.9-mm or 4-mm telescopes with CO(2) or saline as the distension media. Biopsies were done with a 5-mm grasper or with a Novak's curette. Prevalence of hysteroscopic findings and histologic analysis of biopsies. Endometrial polyp was the most frequent hysteroscopic finding, accounting for 1,374 (33.9%) cases. Normal uterine cavity and cervical canal were found in 814 (20.1%) patients. Submucous fibroids were diagnosed in 302 (7.5%) women. Normal endometrium was the most frequent histologic diagnosis, accounting for 1,888 (46.6%) cases. Endometrial polyp was found in 1,115 (27.5%) patients. Endometrial hyperplasia was diagnosed in 613 (15.1%) and endometrial cancer in 105 (2.6%) women. Endometrial polyps are the most frequent hysteroscopic findings in patients with AUB, whereas normal endometrium is the most frequent histologic diagnosis.

Prevalence and genotyping of human papillomavirus infection in women with vulvodynia

Evidence of vulvar human papillomavirus infection varies and the frequency of the different genotypes has not been adequately assessed. Fifty consecutive sexually active healthy patients with vulvodynia and suspected of human papillomavirus infection underwent a vulvoscopy and biopsy. Ten normal vulvar samples were also enrolled as control. Histological and vulvoscopic findings were compared in relation to human papillomavirus-DNA presence and genotyping by a broad-spectrum polymerase chain reaction and reverse hybridization line probe assay. Although the clinical and histological diagnoses did not always coincide, a good association was found (p<0.0001). Human papillomavirus-DNA was detected in 42% of all biopsies and in none of the controls, and less frequently in acetowhite-positive patients (33.3%, p<0.03). Squamous papillomatosis (74%) was the most frequent histological diagnosis, followed by condyloma (20%). Condyloma (90%) but not squamous papillomatosis (29.7%) was significantly associated with human papillomavirus-DNA presence. Out of the vulvoscopically normal patients, one (33%) was human papillomavirus-DNA positive. Out of the recorded microscopic features, only koilocytosis was associated with human papillomavirus-DNA presence. Eight different human papillomavirus genotypes were detected: high-risk 16 (43%), 31 (19%), 52 (14.3%), 68, and 59 (4.8% each), and low-risk types 6 (71.4%), 11, and 40 (4.8% each); 33.3% of infections were multiple, ranging from 2 to 4 genotypes. Out of the human papillomavirus-DNA positive squamous papillomatosis, 72.7% showed a high-risk type but the infection remained episomal. Our data confirm human papillomavirus as a frequent cause of vulvodynia and its frequent association with squamous papillomatosis or condyloma. The high-risk human papillomavirus in squamous papillomatosis suggests screening for possible undiagnosed cervical infection.

Toxic myopathies: muscle biopsy features

Several drugs and toxic substances can cause muscular abnormalities and are frequent causes of acquired myopathies. We present a series of 32 patients, predominance of young adult patients, diagnosed with toxic myopathy. The most common substances inducing myopathy were corticosteroids (56.2%) followed by the propoxyphene, neuroleptics, zidovudine and drug-induced hypokalemia. The investigation showed normal serum creatine kinase levels in 65.4%, myopathic pattern of the needle electromyography in 40% and the more frequent histological diagnosis of the muscle biopsy was type 2 fiber atrophy (59.3%). Clinical features, etiology, course of the disease, serum levels of muscular enzymes, electromyographic features and, especially, muscle biopsy features are discussed.

Factors impacting survival of patients with post-surgical disease recurrence in non-small cell lung cancer (NSCLC)

7223 Background: There are no standard recommendations for follow-up of NSCLC patients post surgery. To be of value, follow-up should detect disease recurrence early enough to allow timely initiation of effective treatment leading to clinical benefit. Methods: Patients diagnosed with NSCLC in Manitoba, Canada, who underwent a surgical procedure at the two teaching hospitals between January 1996 and December 2001, were identified using the Cancer Registry. We included 435 patients who underwent complete surgical resection of pathologic Stage IA to IIB disease. To date, a detailed retrospective chart review has been completed on 249 of these patients. Median follow-up of this population was 3.45 years. Results: The median age was 66.4 years and 51% were male. 68% had Stage I disease. Lobectomy (73%) was more commonly performed over wedge resection (14%) and pneumonectomy (13%). The most frequent histological diagnosis was adenocarcinoma (52%) followed by squamous cell (29%) and bronchoalveolar carcinoma (13%). Disease recurred in 68% of patients. Recurrence was detected in 52 patients by routine imaging during follow-up. 117 had symptoms suggestive of disease recurrence prompting additional investigation. Median time to recurrence was 1.2 and 1.5 years (NS) respectively for the symptomatic and asymptomatic group. The median overall survival of the asymptomatic patients (4.19 years) was significantly (p = 0.007) greater than the symptomatic patients (2.66 years). Similarly, the median survival from the time of recurrence was greater for the asymptomatic patients (1.6 vs. 0.7 years, p = 0.004). A multivariate analysis identified symptoms (p = 0.02) at the time of recurrence and stage (p = 0.01) of the disease at the initial presentation as significant independent factors impacting overall survival. Only the absence of symptoms had a significant association (p = 0.006) with improved survival after diagnosis of recurrent disease. Conclusions: The diagnosis of recurrence while patients are asymptomatic resulted in better survival. This may suggest that routine post-surgical follow-up of patients with early NSCLC is justified. No significant financial relationships to disclose.

Natural history of sonographically detected simple unilocular adnexal cysts in asymptomatic postmenopausal women

Objective. To determine the natural history of simple unilocular adnexal cysts in asymptomatic postmenopausal women. Methods. Eight thousand seven hundred ninety-four asymptomatic postmenopausal women underwent transvaginal ultrasound as part of routine gynecological check-up at our institution between January 1995 and June 2002. All patients in whom a simple unilocular adnexal cyst was found out were offered surgical treatment or conservative follow-up with serial transvaginal ultrasound at 6-month intervals. In all these cases, serum CA-125 levels was determined. Results. Two hundred twenty-three simple adnexal cysts in 215 women were found out (prevalence: 2.5%). Annual incidence did not change significantly. Sixty-six (30.6%) women were lost after initial diagnosis. One hundred and forty-nine patients with 153 cysts were entered ultimately in the study. Forty-five (30%) underwent surgery (34 after initial diagnosis and 11 during follow-up). A total of 49 cysts were removed. The most frequent histological diagnosis was serous cystadenoma (84%). There was a case of a stage IA ovarian carcinoma (2% of the cysts removed, 0.6% of all the cysts included in the study). One hundred and four patients with 104 cysts underwent conservative follow-up throughout the study period. Forty-six (44%) of these cysts resolved spontaneously (74% of them within 2 years). In 14 (30%) of these women, a new cyst was diagnosed when follow-up went on. In 58 patients, cysts persisted during all study period (median follow-up: 48 months, range: 6–90 months), 69.6% of them remained unchanged, 17.2% increased, and 17.2% decreased. Patients in whom cysts resolved spontaneously had a shorter menopausal time ( P = 0.001) and tend to be younger ( P = 0.06). No differences were found regarding cysts' features. Conclusion. The risk of malignancy of simple adnexal cysts in asymptomatic postmenopausal women is low. Almost half of them will resolve spontaneously during follow-up. Most of those that persist remain unchanged. Asymptomatic postmenopausal women having simple adnexal cysts can be managed conservatively with a very reasonable degree of reassurance.

Treatment of bone and soft tissue sarcomas of the hand and wrist.

We studied 13 consecutive patients with bone and soft tissue sarcomas of the hand and wrist. Chondrosarcoma, Ewing's sarcoma, synovial sarcoma and epithelioid sarcoma were the most frequent histological diagnoses. Limb-sparing surgery was performed in ten patients but eventually three patients required an amputation. Surgical margins were wide in nine patients and marginal in four. Adjuvant therapy for nine patients consisted of chemotherapy in five and chemotherapy with radiation in four. Local recurrence occurred in two patients with epithelioid sarcoma. There was no significant relationship between surgical margin and local recurrence. Distant metastasis occurred in four patients. The 5-year survival rate was 66%. The mean functional score was 87%. Our study indicates that treatment consisting of resection of these tumours with either a wide margin or a marginal margin followed by adjuvant radiation appeared to be safe and resulted in an acceptable degree of limb function except in the patients with epithelioid sarcoma.

Brain tumors during the first year of life.

Of 1728 childhood brain tumors treated at the National Institute of Neurosurgery, Budapest during the years from 1954 until 1995, 83 of the affected children were younger than one year of age. Because of the advent of the CT and MRI scans in the last 11 years, 51 out of the 83 are presented, these being patients treated since these technological advances have been available. There was a male predominance, with 30 boys and 21 girls. Five of the 51 infants were diagnosed before two months of age. The ratio of supratentorial to infratentorial tumors was almost 1:1. Vomiting, alteration of psychomotor development, and macrocrania were the most common presenting features. Craniotomy and tumor debulking was performed in 85% of the children and 94% of the infants. The most frequent histological diagnosis was benign glioma, PNET, malignant glioma, and craniopharyngioma. The surgical mortality rate was 5% for the children and 13% for the infant group. All five neonates survived the surgical procedure. Radiation therapy was given in 29% of the children and in 7% of infants.

Soft tissue sarcomas of the ENT area. A report of experiences of the Vienna University ENT Clinic

Soft-tissue sarcomas of the head and neck are rare. Local recurrence is common, and wide excision is thought to be the mainstay of treatment. Surgical radicality is limited by the vicinity of vital organs. Improvement of cure rates therefore is expected mainly from combined treatment modalities. Retrospective analysis of 32 cases of soft-tissue sarcoma on file at the Department of Otorhinolaryngology of the University of Vienna between 1954 and 1994. The most frequent descriptive histological diagnosis was polymorphic cell sarcoma in 11 cases. An immunohistological verification was possible in seven cases. The larynx and the pharynx (16 percent each) were the most common sites of affection. Incidence peaks were noted in the third and seventh decade of age. Treatment during the 1950s consisted of surgery and/or irradiation and was supplemented from the 1960s on by polychemotherapy. The median survival was 29 months. Three patients are alive, two patients died free of disease and six patients were lost to follow-up. Permanent cure was rare but each therapeutic regimen seemed to provide prolongation of life. The most important prognostic factors were tumor size, histologic grade, and surgical margins.

Primary non-Hodgkin's lymphoma of the salivary glands. An analysis of 22 cases.

Twenty-two patients with primary non-Hodgkin's lymphoma (P-NHL) of the salivary glands have been studied with reference to age, sex, clinical symptoms, location of primary tumor, histological subtype, grade of malignancy according to the Working Formulation, stage of disease, treatment and follow up. The clinical features corresponded with previously reported data on salivary gland lymphomas. The most frequent histological diagnosis was MALT lymphoma. Most patients had a localised low-grade lymphoma. Overall survival was influenced by grade of malignancy according to the Working Formulation.

Clinicopathological Features of Childhood Nephrotic Syndrome in Northern Nigeria&lt;xref ref-type="fn" rid="fn1"&gt;&lt;sup&gt;*&lt;/sup&gt;&lt;/xref&gt;

The clinicopathological features of childhood nephrotic syndrome in northern Nigeria were studied in 100 consecutive patients. The patients presented with gross anasarca and very low serum albumin, which was less than 15 g/l in 30 patients. The three most frequent histological diagnoses in 98 renal biopsies were membranoproliferative glomerulonephritis (25), quartan malarial nephropathy (20), and proliferative glomerulonephritis (19): together they accounted for 65 per cent of all biopsies. Only nine patients had minimal change nephropathy. Antigens were detected by immunofluorescence in the glomeruli of 70 of 76 biopsies (92 per cent): Plasmodium malariae was detected in 25 per cent and hepatitis B surface antigen in 24 per cent. The disease was characterized by progressive deterioration in renal function and a high mortality rate of 13 per cent. Nine of the 13 deaths occurred within one year of diagnosis.

頭頚部悪性腫ようの肺転移例についての検討

In our ORL clinic during the past 11 years (1976-1986) we saw 417 patients with head and neck cancers, 32 of whom developed lung metastases.1) Metastasis was most common in patients with carcinoma of the nasopharynx, tongue, oral cavity, hypopharynx and major salivary glands. Adenoid cystic carcinoma was the most frequent histological diagnosis.2) The progression of the lesions of adenoid cystic carcinoma was found to be gradual, even in patients with metastasis. Therefore their survival periods were relatively long.3) Longer survival periods were noted in patients who received some treatment for their metastases than in those without any treatment.4) Radiotherapy and chemotherapy for metastatic lesions resulted in longer survival periods than did surgical excision alone.5) The choice and performance of therapy for these metastatic cases should be individualized by a joint conference of radiologist, chest surgeon and otolaryngologist.