Histological Variants Research Articles

Circadian rhythm related genes signature in glioma for drug resistance prediction: a comprehensive analysis integrating transcriptomics and machine learning

BackgroundGliomas, 24% of all primary brain tumors, have diverse histology and poor survival rates, with about 70% recurring due to acquired or de novo resistance. Insomnia in patients is correlated strongly with circadian rhythm disruptions. The correlation between circadian rhythm disorders and drug resistance of some tumors has been proved. However, the precise mechanism underlying the relationship between glioma and circadian rhythm disorders has not been elucidated.MethodsCircadian rhythm-related genes (CRRGs) were identified using the least absolute shrinkage and selection operator (LASSO) regression, and stochastic gradient descent (SGD) was performed to form a circadian rhythm-related score (CRRS) model. The studies of immune cell infiltration, genetic variations, differential gene expression pattern, and single cell analysis were performed for exploring the mechanisms of chemotherapy resistance in glioma. The relationship between CRRGs and chemosensitivity was also confirmed by IC 50 (half maximal inhibitory concentration) analysis.ResultSignatures of 16 CRRGs were screened out and identified. Based on the CRRS model, an optimal comprehensive nomogram was created, exhibiting a favorable potential for predicting drug resistance in samples. Immune infiltration, cell–cell communication, and single cell analysis all indicated that high CRRS group was closely related to innate immune cells. IC50 analysis showed that CRRG knockdown enhanced the chemosensitivity of glioma.ConclusionA significant correlation between CRRGs, drug resistance of glioma, and innate immune cells was found, which might hold a significant role in the drug resistance of glioma.

A comparison of real-world outcomes by mismatch repair status in patients with stage II/III rectal cancer in the Netherlands.

260 Background: A subset of rectal tumours (~3–5%) have mismatch repair deficiency (dMMR); the remaining are classified as MMR proficient (pMMR). A recent trial for stage II/III dMMR rectal cancer (RC) showed that 6 months of neoadjuvant treatment with dostarlimab, a programmed cell death protein 1 inhibitor, induced a 100% clinical complete response rate and allowed for organ preservation. Using real-world data from the Netherlands, a dMMR patient cohort was compared to a matched pMMR cohort to assess if clinical outcomes differed, even after matching for baseline characteristics. Methods: Utilizing data from the Netherlands Cancer Registry, this retrospective analysis assessed patients with stage II/III RC treated from 2015–2022 with known MMR status. The dMMR cohort was matched 1:2 to a cohort of pMMR patients on age, year of diagnosis, tumour clinical (cT) stage, and node clinical (cN) stage. Event-free survival (EFS; defined as first occurrence of locoregional failure, distant metastasis, a new primary colorectal tumour, or death from any cause) and overall survival (OS) were compared using Kaplan-Meier methodology and a univariable Cox model. Results: Among the 7939 patients included, 184 (2.3%) had dMMR tumours. After matching and a loss of 8 dMMR patients due to ineligibility, 176 dMMR patients were compared to 363 pMMR patients. Matching successfully removed differences in age, cT, and cN stage; however, dMMR patients continued to have more BRAF mutants (p=0.014), more poorly differentiated tumours (p<0.001) and more variation in histology (p=0.01). dMMR patients had a statistically significant lower risk of experiencing an event (hazard ratio [HR] 0.54 [95% confidence interval (CI) 0.38–0.77], p<0.001), with a 3-year EFS of 79.6% (95% CI 73.7–86.1) compared to pMMR patients (64.7% [95% CI 59.8–70.1]). For OS, there was no significant difference between the dMMR and pMMR cohorts (HR 0.73 [95% CI 0.47–1.16], p=0.181); however, within the small group of patients with an event, OS at 1 year for dMMR patients was 68.4% (95% CI 55.1–84.9) compared to 93.5% (95% CI 89.5–97.7) for pMMR patients (p=0.001). Conclusions: dMMR RC is rare, and tumour characteristics differ from those of patients with pMMR tumours (1). After controlling for clinical stage and age, this study suggests dMMR patients have improved EFS compared to pMMR patients. There is no significant difference in OS between groups but dMMR patients with an event have worse OS than pMMR patients, highlighting an additional need to prevent recurrence of disease within dMMR patients.1. Lunenberg, R et al. Poster presented at ESMO Congress (Presentation 569P), 13-17 Sept 2024, Barcelona, Spain.

Management trends and outcomes of appendiceal cancers: A National Cancer Database study.

810 Background: Appendiceal tumors encompass a variety of histological types that exhibit different behaviors. The current study aimed to investigate and compare overall survival, predictive factors for overall survival, and management of histological variations of appendiceal tumors. Methods: The National Cancer Data Bank (NCDB) database (2004–2020) was evaluated to include patients with appendiceal tumors histologies including goblet cell adenocarcinoma (GCA), neuroendocrine neoplasm (NEN), non-mucinous adenocarcinoma (NMA), and mucinous adenocarcinoma (MA). Univariate and multivariable analyses were conducted. Results: The GCA, MA, NEN, and NMA groups consist of 6,111, 16,471, 19,199, and 11,065 patients, respectively. The NMA and NEN groups had significantly lowest and higher overall survival compared to other types (p<0.001 for both) (GCC: 143.27 (140.23-146.30), MA: 111.91 (109.996-113.832), NEN: 170.88 (168.56-173.20), and NMA: 101.399 (99.132-103.666) months). The independent predicting factors of worse overall survival were age (HR: 1.03 (1.03-1.04)), black race (HR: 1.24 (1.08-1.43), ref: white race), fourth median income (HR: 0.84 (0.74-0.96), ref: first median), Charleson index comorbidity score (HR: 1.3 (1.22-1.38)), lymphovascular invasion (HR: 1.28 (1.15-1.42)), pathologic stage 2 (HR: 1.32 (1.12-1.57)), stage 3 (HR: 1.99 (1.66-2.40)), stage 4 (HR: 4.20 (3.47-5.07)), ref: stage 1, intraoperative systemic therapy (HR: 0.52 (0.39-0.70)), positive surgical margin (1.55 (1.39-1.73)), number of positive lymph nodes (HR:1.06 (1.05-1.07)), moderately differentiated tumors (HR:1.43 (1.25-1.63)), poorly differentiated (HR: 1.94 (1.69-2.24)), undifferentiated (HR: 1.48 (1.14-1.91)), ref: well differentiated, and NMA type (HR:1.30 (1.10-1.55)). Furthermore, in terms of type of surgery, significantly higher patients of GCA (54.6%) and NMA (55.2%) groups underwent subtotal colectomy compared to other groups. Regarding systemic therapy, significantly higher patients of MA group received intraoperative, and both neoadjuvant and adjuvant therapy compared to other groups. Also, NEN group had significantly higher patients who underwent surgery with laparoscopic approach compared to others. Conclusions: This study reveals that different types of appendiceal tumors have distinct characteristics in regard to overall survival outcomes and treatment approaches. NENs showed the highest survival rates, while NMAs had the lowest. These results underscore the need for personalized treatment strategies for each tumor type to improve patient outcomes.

Comparative Study on Histochemical Expression of CD34 in Different Variants of Ameloblastoma

Ameloblastoma is a benign, locally aggressive, tumor of the oral cavity having a high propensity for recurrence. The growth potential of the tumor is linked to the proliferation of preexisting vasculature and is reflected in CD34 expression. has been rephrased as “Mean Vascular Density (MVD) which measures CD34 expression, aids in predicting this proliferation. Objectives: To evaluate the biological behavior of different variants of Ameloblastoma according to expression of CD34 and to correlate it with age and gender. Methods: The present study was analytical, cross-sectional study composed of total 40, already diagnosed cases of ameloblastoma. Immuno-histochemical expression of CD34 was analyzed. Results: Follicular variant has more growth potential in females 21 (62%) and males reveal more vascular growth in plexiform 19 (80%) acanthomatous (50%) and unicystic variant (50%). More endothelial proliferation in age group of > 40 years was seen in follicular variant, whereas, in age group of < 40 years, plexiform type was more dominant. However, relationship between the age groups and MVD scores were found to be insignificant (p > 0.05). Relationship between CD34 expression in ameloblastoma and its histological variants were also found to be statistically non-significant (p=0.9). Conclusions: All variants display highest Mean Vascular Density (MVD) score in posterior mandible. Follicular variant has more growth potential in females while in males it is found more in plexiform, acanthomatous and unicystic variants. More epithelial proliferation in the follicular variety is observed in the age group over 40, whereas more plexiform type was shown in the age group below 40.

Management and outcomes of thoracic sarcomas - a collaboration between Orthopaedic Oncology and cardiothoracic surgery: seven-year clinical data from a tertiary referral centre

IntroductionSarcomas are rare cancers originating from mesenchymal tissues, manifesting in diverse anatomical locations, but notably in connective tissue, muscles and the skeleton. Thoracic sarcomas present a unique diagnostic and surgical challenge attributable to their rarity and pathoanatomy. Standard practice currently comprises wide surgical excision, often accompanied by adjuvant chemotherapy and/or radiotherapy. This approach necessitates a multidisciplinary team, ideally in specialised cancer centres. The Oxford Bone and Soft Tissue Tumour Service is one such centre, and routinely treats such cancers through collaboration between orthopaedic oncology and cardiothoracic surgeons, as well as members of the wider MDT. This study reports the current management and outcomes of primary thoracic sarcoma patients at the Oxford Sarcoma Service over a seven-year period.ObjectivesGiven the rarity of thoracic sarcomas, and their associated diagnostic and management complexities, our aim is to report on the treatment strategies and outcomes of primary thoracic sarcoma patients treated at the Oxford Sarcoma Service from 2017 to 2023.MethodsData pertaining to all thoracic sarcoma cases discussed in multidisciplinary meetings at the Oxford tertiary centre from 2017 to 2023 were retrieved from the local electronic database. These were analysed using appropriate statistical tests to determine significance of the various observations made.ResultsOf 113 identified cases, chondrosarcoma emerged as the most prevalent histological subtype among 22 distinct varieties. 58% of cases exhibited high-grade features. 32 sarcoma-related deaths occurred, with a mean time from diagnosis to death of 23.16 months. A notable association was observed between high-grade sarcomas and mortality (p = 0.0280). Surgical resection was performed in 77 cases, with 49% of these undergoing surgical resection alone i.e. the patient received no radio- or chemotherapy. Both surgical intervention (p < 0.0001) and clear margins (p = 0.0051) were significantly linked to improved survival. Local recurrence was noted in 28.6% of the 77 surgical cases, and predominantly in the high-grade sarcomas (81.8%). However, no statistical association was found between recurrence and margin status in our data.ConclusionOur results indicate that primary resection remains the cornerstone of thoracic sarcoma treatment, representing the single strongest independent factor for survival in treatable cases. Variability in outcomes and overall survival likely stems from factors such as histological diversity, predominance of high-grade sarcomas, and wide age range at diagnosis. Ongoing prospective database update and collaborative efforts across centres would further clarify prognoses and recommendations for specific tumours, based on observational data.

Life history and growth dynamics of a peirosaurid crocodylomorph (Mesoeucrocodylia; Notosuchia) from the Late Cretaceous of Argentina inferred from its bone histology.

Notosuchia were a successful lineage of Crocodyliformes that achieved a remarkable diversity during the Cretaceous of Gondwana, particularly in South America. Although paleohistology has expanded our knowledge of the paleobiology of notosuchians, several clades of this lineage remain poorly understood in this aspect. Here we help to address this gap by conducting the first histological analysis of appendicular bones of a peirosaurid. To increase our knowledge about growth dynamics and examine intraeskeletal and interspecific histological variation, we analyze the microstructure of a tibia, fibula, phalanx, fragment of ornamented element (possible osteoderm or skull bone) and a possible long bone of an individual assigned to Peirosauridae indet. (MAU-Pv-437). The peirosaurid studied here appears to have reached sexual but not somatic maturity and the minimum age inferred from appendicular bones results in a lower estimated than the age inferred from osteoderms in a previous study on the same individual. The cortical bone in MAU-Pv 437 is formed by vascularized parallel fibered bone/lamellar bone which indicates that this individual experienced a moderate growth rate. This indicates different growth dynamics from what has been observed for other notosuchians specimens, suggesting a lack of a uniform growth pattern for this clade.

Correlation Between Preoperative Neutrophil-to-Lymphocyte Ratio and Clinicopathological Characteristics of Papillary Thyroid Carcinomas: Toward a Preoperative Biomarker.

Introduction: Papillary thyroid carcinoma (PTC) is the most common type of thyroid cancer, with considerable variability in its clinical presentation and prognosis. Recent studies have focused on the relationship between its clinicopathological characteristics and inflammatory biomarkers, particularly the preoperative neutrophil-to-lymphocyte ratio (NLR). Our aim was to investigate the correlation between NLR and the clinicopathological features of PTC. Methods: This was a retrospective study. We involved patients who underwent surgery for PTC over a 5-year period from January 2016 to December 2021. Based on the mean NLR value, the study population was divided into 2 groups, with Group 1 corresponding to patients with an elevated NLR. Results: Our study included 102 patients aged between 20 and 83 years. All patients were euthyroid. The mean preoperative NLR was 2.01 ± 0.62, with 53% of patients classified into Group 1. On ultrasound, most nodules were classified as EU-TIRADS 5, and 38% had a Bethesda category 6 cytology. Final histopathological analysis revealed microcarcinoma in the majority of cases. PTC was multifocal in 35 cases and bilateral in 38, with an aggressive histological variant observed in 45 cases. Multivariate analysis demonstrated a statistically significant correlation between NLR and extrathyroidal invasion, lymph node metastasis, aggressive histological subtypes, and multifocality. Conclusion: NLR is a readily accessible and cost-effective preoperative biomarker. Its use could improve risk stratification and support personalized therapeutic strategies. However, prospective studies with larger, multicenter cohorts are required to validate NLR as a reliable predictive biomarker.

Histiocytoid Sweet Syndrome in a Patient with CRDM-Type Myelodysplastic Syndrome

Histiocytoid Sweet syndrome was first described in 2005 as a histological variant of acute febrile neutrophilic dermatosis. Unlike classic Sweet syndrome, the dermal inflammatory cell infiltrate in histiocytoid Sweet syndrome consists of histiocytoid cells, which are thought to be immature myeloid cells. A 69-year-old male patient with a medical history of CRDM type myelodysplastic syndrome was consulted for a tender and slightly pruritic erythematous papular rash, some lesions showing central vesiculation, disseminated to the trunk and limbs, with an onset of about 1 month. His general condition was relatively good without fever. In the context of the pre-existing haematological condition, a leukemic transformation with concomitant leukaemia cutis was suspected and a skin biopsy was performed. The histopathological examination revealed an infiltrate in the superficial dermis consisting predominantly of mononuclear cells with cytomorphological characteristics of monocyte/histiocyte, with frequent interstitially dispersed neutrophils, and perivascular immature granulocytes and lymphocytes. Immunohistochemical staining was positive for myeloperoxidase and CD68 in numerous cells in the infiltrate, establishing the diagnosis of histiocytoid Sweet syndrome. The histiocytoid variant of Sweet syndrome should be recognized as a distinct entity by clinicians, so Sweet syndrome should not be excluded in the absence of classic clinical and histopathological manifestations.

The effect of neoadjuvant chemotherapy on survival outcomes in patients with variant histologies who underwent radical cystectomy with precystectomy diagnostic accuracy: A multicenter study of the Turkish Urooncology Association.

To evaluate the role of neoadjuvant chemotherapy in the final treatment plan and its impact on survival in bladder cancer patients who were diagnosed with variant histology in the radical cystectomy specimen and whose diagnostic accuracy was achieved with the previous transurethral resection of the bladder specimen. In this retrospective multicenter study, data from 221 patients across 9 centers were analyzed between January 2012 and January 2022. The primary endpoint was overall, cancer-specific, recurrence-free, and metastasis-free survival rates among patients with and without neoadjuvant chemotherapy, and the secondary endpoint was to identify independent predictors of survival. The Kaplan-Meier method was used to estimate overall survival, cancer-specific survival, recurrence-free survival, and metastasis-free survival, and multivariate analyses were performed using the Cox-regression model. Kaplan-Meier estimates of overall, cancer-specific, recurrence-free, and metastasis-free survival demonstrated no significant difference between two groups. Cox multifactorial analysis revealed that the age (HR 1.030, 95% CI 1.003-1.057, p = 0.027), presence of pT4 tumor stage (HR 3.861, 95% CI 1.303-11.494, p = 0.015), and pN+ (HR 2.288, 95% CI 1.475-3.550, p < 0.001) at radical cystectomy histopathology were independent predictors of overall survival; presence of pT4 tumor stage and pN+ at radical cystectomy histopathology were independent predictors of cancer-specific survival (HR 8.245, 95% CI 1.873-36.292, p = 0.005 and HR 1.792, 95% CI 1.049-3.061, p = 0.033) and metastasis-free survival (HR 9.957, 95% CI 1.286-77.073, p = 0.028 and HR 2.949, 95% CI 1.674-5.197, p < 0.001); and the age (HR 1.047, 95% CI 1.006-1.090, p = 0.025) and pN+ at radical cystectomy histopathology (HR 4.150, 95% CI 1.917-8.981, p < 0.001) were independent predictors of recurrence-free survival. Neoadjuvant chemotherapy does not provide any survival advantage in variant histology; therefore, considering the disadvantages, such as delaying radical cystectomy, which can lead to inadvertent disease progression and chemotherapy-related toxicities, cautious should be exercised when administering neoadjuvant chemotherapy.

Immune-Based and Novel Therapies in Variant Histology Renal Cell Carcinomas.

Renal cell carcinoma (RCC) is a heterogeneous disease that represents the most common type of kidney cancer. The classification of RCC is primarily based on distinct morphological and molecular characteristics, with two broad categories: clear cell RCC (ccRCC) and non-clear cell RCC (nccRCC). Clear cell RCC is the predominant subtype, representing about 70-80% of all RCC cases, while non-clear cell subtypes collectively make up the remaining 20-30%. Non-clear cell RCC encompasses many histopathological variants, each with unique biological and clinical characteristics. Additionally, any RCC subtype can undergo sarcomatoid dedifferentiation, which is associated with poor prognosis and rapid disease progression. Recent advances in molecular profiling have also led to the identification of molecularly defined variants, further highlighting the complexity of this disease. While immunotherapy has shown efficacy in some RCC variants and subpopulations, significant gaps remain in the treatment of rare subtypes. This review explores the outcomes of immunotherapy across RCC subtypes, including rare variants, and highlights opportunities for improving care through novel therapies, biomarker-driven approaches, and inclusive clinical trial designs.

Histological Changes in the Lungs and some Haematological and Biochemical Changes in Wistar Rats Following Exposure to Fly Ash Dust

Background: Fly ash dust is a harmful air pollutant that poses a major environmental and health risk. Previous research has linked fly ash dust to respiratory tract disease but its effects on the lung are not well understood. We aimed at investigating body weight, lung histoarchitecture, and haematological and biochemical changes in Wistar rats exposed to fly ash dust. Methods:Twenty-four Wistar rats (12 males, 12 females), weighing 250g-280g, were randomly assigned into 4 groups of 6 animals each. Group A rats were placed in a fly ash dust-free chamber while Group B - D rats were exposed to various concentrations of fly ash dust dispersed from 5g, 10g and 20g of fly ash, respectively. The weights of the animals were recorded weekly and body weight gain computed. At the end of 28th day of exposure, the rats were weighed and euthanized under chloroform anaesthesia. Blood samples were collected through cardiac puncture into plain specimen bottles for biochemical analysis and into EDTA anticoagulant bottles for haematological analysis. The lungs were harvested and processed for histological examination. The obtained data were analyzed using the one-way Analysis of Variance, with level of significance set at P&lt;0.05. Results: Exposure to fly ash dust caused significantly reduced weight gain and haematological alterations in rats including decreased lymphocytes, haemoglobin, and red blood cells. Biochemical analysis revealed increased manganese, urea, and creatinine levels, indicative of manganese poisoning and renal impairment. Additionally, low serum bicarbonate (HCO3-) levels suggested acidosis. Histopathological examination confirmed normal lung architecture in the control group. There were observable histological variations in the lung architecture of the exposed rats (Groups B-D) which include bronchiolar ulceration, activated lymphoid follicles, and patchy alveolar collapse (evidence of pneumonitis). Given the similar biological responses, these effects of fly ash dust on rats can be reasonably extrapolated to humans, highlighting the importance of protective measures for individual occupationally exposed to fly ash dust. Conclusion: Fly ash dust caused body weight loss, histopathological changes in lung tissue, haematological and biochemical derangements which are capable of compromising lung, haematological, biochemical and renal functions, potentially resulting in fatal outcomes.

Unraveling the Mysteries of Ameloblastoma in African Population: A Comprehensive Analysis of 371 Cases from Clinical, Radiological, and Histopathological Perspectives.

To analyze the frequency, clinical, histopathological, and radiological characteristics of ameloblastoma in Nigeria over the course of two decades. A retrospective analysis was conducted on 371 cases at a Nigerian university hospital between 2000 and 2023. Age, gender, site, histological variants, tumor size and duration were analyzed. Statistical analyses included the Shapiro-Wilk test, Mann-Whitney U test, Chi-square test, and Spearman rank correlation analysis. The median patient age was 30years (mean age 32.2), with a male-to-female ratio of 1.12:1. 54.7% of cases occurred in young adults (age range 20-39years). Among the lesions, 11.3% were in the maxilla and 88.7% in the mandible. Patients with mandibular lesions had a median age of 29years, while those with maxillary lesions had a statistically significantly higher median age of 37.5years p-value = 0.001. Median tumor size was 36 cm2 for the mandible and 24 cm2 for the maxilla (significant p-value of 0.002). There was no correlation between tumor size, age, or gender. However, there was a significant correlation between tumor size and the duration of the condition. The study concludes that ameloblastoma is more frequent among younger individuals in Nigeria and often presents with larger tumor sizes, emphasizing the need for early detection and intervention.

Squamous Cell Bladder Cancer: A Rare Histological Variant with a Demand for Modern Cancer Therapeutics.

Bladder cancer is among the most common form of cancer worldwide and is predicted to increase in incidence and mortality over the next decade. Squamous cell carcinoma of the bladder is a rare histological variant typically associated with schistosomiasis, also known as bilharzia, a parasitic infection caused by flatworms called schistosomes or blood flukes, and is generally seen in underdeveloped nations. However, squamous cell carcinoma of the bladder still represents nearly 5% of bladder cancer diagnoses in the western world. Transitional cell carcinoma is the predominant histological variant of bladder cancer found throughout the western world, and nearly all disease indicators and treatments for bladder cancer are driven by this common variant. Squamous cell carcinoma of the bladder shows characteristic features that differ from transitional cell carcinoma, such as differing levels of protein indicators and different response rates to traditional bladder cancer therapies. Common treatment methods for squamous cell carcinoma of the bladder include radical cystectomy, chemotherapies, and radiation. Reviewing the previous literature on the management of squamous cell carcinoma of the bladder, it becomes apparent that this variant needs to be treated differently than common bladder cancer variants and a proper management course needs to be set in place to maximize positive patient outcomes. Such a study will be very helpful for urologists and oncologists to manage patients with bladder squamous cell carcinoma.

Clonal phylogenies inferred from bulk, single cell, and spatial transcriptomic analysis of epithelial cancers.

Epithelial cancers are typically heterogeneous with primary prostate cancer being a typical example of histological and genomic variation. Prior studies of primary prostate cancer tumour genetics revealed extensive inter and intra-patient genomic tumour heterogeneity. Recent advances in machine learning have enabled the inference of ground-truth genomic single-nucleotide and copy number variant status from transcript data. While these inferred SNV and CNV states can be used to resolve clonal phylogenies, however, it is still unknown how faithfully transcript-based tumour phylogenies reconstruct ground truth DNA-based tumour phylogenies. We sought to study the accuracy of inferred-transcript to recapitulate DNA-based tumour phylogenies. We first performed in-silico comparisons of inferred and directly resolved SNV and CNV status, from single cancer cells, from three different cell lines. We found that inferred SNV phylogenies accurately recapitulate DNA phylogenies (entanglement = 0.097). We observed similar results in iCNV and CNV based phylogenies (entanglement = 0.11). Analysis of published prostate cancer DNA phylogenies and inferred CNV, SNV and transcript based phylogenies demonstrated phylogenetic concordance. Finally, a comparison of pseudo-bulked spatial transcriptomic data to adjacent sections with WGS data also demonstrated recapitulation of ground truth (entanglement = 0.35). These results suggest that transcript-based inferred phylogenies recapitulate conventional genomic phylogenies. Further work will need to be done to increase accuracy, genomic, and spatial resolution.

Evaluation of some physiological and histological variables in women with polycystic ovary syndrome in Kirkuk / Iraq

Evaluation of some physiological and histological variables in women with polycystic ovary syndrome in Kirkuk / Iraq

Molecular Basis of Breast Tumor Heterogeneity.

Breast cancer (BC) is a profoundly heterogenous disease, with diverse molecular, histological, and clinical variations. The intricate molecular landscape of BC is evident even at early stages, illustrated by the complexity of the evolution from precursor lesions to invasive carcinoma. The key for therapeutic decision-making is the dynamic assessment of BC receptor status and clinical subtyping. Hereditary BC adds an additional layer of complexity to the disease, given that different cancer susceptibility genes contribute to distinct phenotypes and genomic features. Furthermore, the various BC subtypes display distinct metabolic demands and immune microenvironments. Finally, genotypic-phenotypic correlations in special histologic subtypes of BC inform diagnostic and therapeutic approaches, highlighting the significance of thoroughly comprehending BC heterogeneity.

Analysis of the Clinical Value of hsa_circ_0001955 in Papillary Thyroid Cancer Treated with 131 Iodine.

The prevalent histological variant within differentiated thyroid carcinoma is papillary thyroid carcinoma, also known as PTC. The study investigated the clinical performance of serum hsa_circ_0001955 in predicting the prognosis of PTC treated with radical thyroidectomy and iodine 131 nail clearance. The relative expression of serum circ_0001955 of PTC patients was detected before and after accepting radical thyroidectomy combined with 131I thyroid remnant ablation by RT-qPCR. Serum thyroglobulin (Tg) and thyroglobulin antibody (TgAb) levels were quantified by an automatic chemiluminescence immunoassay analyzer. Multivariate logistic regression analysis was employed to investigate the risk factors associated with the prognosis of PTC patients with postoperative 131I therapy. The serum circ_0001955 levels in 127 PTC patients were higher than that in 96 multinodular goiter patients and 110 healthy controls before treatment and had diagnostic values for PTC patients. After 131I treatment, serum circ_0001955 levels and Tg value have a correlation with potential recurrence (WBS positive). Serum circ_0001955, Tg, and TgAb value, and their combination may have diagnostic value in predicting recurrence. Serum circ_0001955 levels in patients with PTC after radical thyroidectomy and iodine 131 thyroidectomy may help predict recurrence.

Unveiling Rare Breast Neoplasms: Diagnostic Challenges and Insights

Breast neoplasm encompasses a diversified range of different diseases characterized by unique biological and pathological features, clinical presentation, response to treatments, clinical behavior, and outcome. The histological variability has profound prognostic implications, thus playing a pivotal role in diagnosing breast neoplasm. Special histologies can occur rarely, and most information on outcomes and treatments is mainly derived from small series and case reports. Thus, reporting such unusual occurrences is of utmost importance. This is a retrospective study of four years in which 11 cases of breast neoplasm diagnosed on histopathology were assessed. The clinical details were acquired from an electronic search. The hematoxylin and eosin and immunohistochemistry slides were retrieved from the archives to review the histopathological features. The patient’s age ranged from 32 to 72 years (median: 51 years). Eleven unusual cases of breast neoplasms were diagnosed and categorized according to the latest World Health Organisation (WHO) classification. These cases include rare and salivary gland type tumors (2 cases), neuroendocrine neoplasms (1 case), hamartomas of the breast (2 cases), fibroblastic and myofibroblastic tumors of the breast (1 case), peripheral nerve sheath tumor (1 case) and hematolymphoid tumors of the breast (4 cases). The management of unusual breast cancer histotypes represents a real challenge in daily clinical practice. Our data suggest that these variants are distinct clinicopathological entities with unique hormonal receptor statuses. The occurrence of such entities is rare, and they demonstrate different clinical behaviors and responses to treatment, suggesting that a few genomic-specific events might also drive them. Therefore, it is important to indulge in future research on such rare breast neoplasms.

Ganglioglioma cerebral, un reto diagnóstico en pediatría. Reporte de caso

Central nervous system tumors are the most common neoplasms in pediatrics, characterized by a diverse group of locations, histological variants and different forms of clinical presentation, which depend on age, tumor location and the possibility of producing obstruction of cerebrospinal fluid flow, peritumoral cerebral edema and intracranial hypertension (HE). The most common clinical presentations derive from HE, highlighting persistent headache, repeated vomiting, both predominantly present upon awakening. Another common presentation is epileptic seizures (EC), which have focal characteristics and are accompanied by loss of consciousness; in this presentation entity it is frequent to find a normal physical examination. This publication aims to present a clinical case of a 5-year-old patient who debuted with headache, vomiting and focal neurological data, approached and underwent surgery with the diagnosis of intraparenchymal hemorrhage, with the surgical finding of organized intraparenchymal hematoma, partially encapsulated with liquid collection, whose histopathological result was cerebral ganglioglioma, a primary brain tumor, rare in pediatric age.

Clinicopathological features and treatment outcomes of urothelial carcinoma variant histologies and non-urothelial bladder cancers.

Most bladder cancers are pure urothelial carcinomas, but a small portion, approximately 5-10%, have variant histology or are non-urothelial in nature. This research sought to examine the features of and treatment strategies for different types of urothelial carcinoma with variant histologies and non-urothelial bladder cancer. The study cohort comprised individuals with non-urothelial and variant urothelial bladder cancers treated at two medical centres in Ankara, Turkey, between 2005 and 2024. A total of 104 individuals were reviewed, with 88 having urothelial cancer with variant histology and 16 having non-urothelial cancer. Non-urothelial cancers included neuroendocrine, undifferentiated, adenocarcinoma, squamous, sarcoma, and carcinosarcoma, with a median overall survival (OS) of 8months. The most frequent urothelial carcinoma variants were squamous (43 cases), plasmacytoid (9 cases), and sarcomatoid (6 cases). Individuals with operable variants of urothelial malignancies had a median disease-free survival (DFS) of 16.5months, while individuals with inoperable/metastatic variants experienced a median progression-free survival (PFS) of 8.9months. The median OS in the operable cohort was 18.5months, compared to 10.8months in the inoperable/metastatic group. The present study reveals that variant urothelial and non-urothelial bladder cancers are aggressive in nature and have poor prognosis. Given the significant heterogeneity observed in OS, DFS, and PFS among these rare and diverse tumor subtypes, large-scale multicenter investigations are required to establish a consensus on patient handling and treatment.