Variant Of Tumor Research Articles

Diffuse glioneuronal tumour with oligodendroglioma-like features and nuclear clusters (DGONC) - a molecularly defined glioneuronal CNS tumour class displaying recurrent monosomy 14.

DNA methylation-based central nervous system (CNS) tumour classification has identified numerous molecularly distinct tumour types, and clinically relevant subgroups among known CNS tumour entities that were previously thought to represent homogeneous diseases. Our study aimed at characterizing a novel, molecularly defined variant of glioneuronal CNS tumour. DNA methylation profiling was performed using the Infinium MethylationEPIC or 450k BeadChip arrays (Illumina) and analysed using the 'conumee' package in R computing environment. Additional gene panel sequencing was also performed. Tumour samples were collected at the German Cancer Research Centre (DKFZ) and provided by multinational collaborators. Histological sections were also collected and independently reviewed. Genome-wide DNA methylation data from >25000 CNS tumours were screened for clusters separated from established DNA methylation classes, revealing a novel group comprising 31 tumours, mainly found in paediatric patients. This DNA methylation-defined variant of low-grade CNS tumours with glioneuronal differentiation displays recurrent monosomy 14, nuclear clusters within a morphology that is otherwise reminiscent of oligodendroglioma and other established entities with clear cell histology, and a lack of genetic alterations commonly observed in other (paediatric) glioneuronal entities. DNA methylation-based tumour classification is an objective method of assessing tumour origins, which may aid in diagnosis, especially for atypical cases. With increasing sample size, methylation analysis allows for the identification of rare, putative new tumour entities, which are currently not recognized by the WHO classification. Our study revealed the existence of a DNA methylation-defined class of low-grade glioneuronal tumours with recurrent monosomy 14, oligodendroglioma-like features and nuclear clusters.

Rare Case of Lipomatous Mixed Tumor With Follicular Differentiation

Cutaneous mixed tumors are adnexal neoplasms characterized by a mixture of epithelial, myoepithelial, and stromal components of varying proportions. The diagnosis may be of little challenge when chondroid or myxoid components are dominant. However, there are variants of the cutaneous mixed tumor where more uncommon features predominate, making the diagnosis more challenging. Here, we present a case of a rare variant of the cutaneous mixed tumor with extensive adipocytic and follicular differentiation. This is the second case of such a tumor reported to literature to our knowledge.

Ovarian Seromucinous Tumors: Pathogenesis, Morphologic Spectrum, and Clinical Issues.

Ovarian seromucinous tumors were introduced in the 2014 World Health Organization (WHO) classification as one of the seven types of ovarian epithelial tumors. They are characterized by frequent association with endometriosis and bilaterality, microscopic appearance of papillary architecture, and admixture of a variety of müllerian-type epithelium. They are considered to be endometriosis-related ovarian neoplasms, along with endometrioid and clear cell tumors; recent molecular studies suggest this particular tumor is a variant of endometrioid tumor. Discrepancies in nomenclature, definition, and morphology of seromucinous tumors appear to be a source of confusion, for both clinicians and general surgicalpathologists. This review summarizes the clinicopathological features of benign, borderline, and malignant seromucinous tumors, as well as controversies regarding these tumors.

Histopathological Variants of Ovarian Tumors and Their Presentation in Rural Tertiary Care Center of Northern India: An Observational Study

Ovarian cancer is one of the common gynecological cancers with high mortality rates. The study was conducted to know prevalence, histopathological variants, presentation and outcome in women with ovarian tumors. Present study was conducted in Obstetrics and Gynecology department of rural tertiary center over one year (December 2017–November 2018) on women with unilateral/bilateral ovarian masses fulfilling inclusion criteria. Demographic features including age, parity, nature, laterality and histopathological variants were analyzed and compared. Statistical analysis was done using SPSS 20.0 version software. Of 122 cases, 49 (40.2%) had benign tumors, 05 (4.1%) borderline, 64 (52.5%) primary malignant tumors and 04 (3.3%) secondary metastatic deposits. Majority of the women (60.3%) with malignant tumors presented at stage II/III. Most of the women (89.8%) with benign tumors had unilateral lesions, and 64.1% women with malignant tumors had bilateral masses (p < 0.05). Both benign (59.1%) and malignant (87.0%) unilateral ovarian masses were more common on right. CA125 was significantly higher in women with malignant tumors as compared to benign (p = 0.024) and borderline tumors (p = 0.386). On histopathological examination, most common malignant ovarian tumor was serous cystadenocarcinoma (39.1%) and in benign mature teratomas (42.9%). Diabetes mellitus was significantly associated with malignant ovarian tumors (p = 0.016). Epithelial ovarian tumors were most common malignant tumors and mature teratomas most common benign tumors. Ovarian malignancies present at advanced stage and have high mortality.

SMARCA4-deficient Sinonasal Carcinoma: A Series of 10 Cases Expanding the Genetic Spectrum of SWI/SNF-driven Sinonasal Malignancies.

The molecular pathogenesis of poorly differentiated sinonasal carcinoma received significant attention in recent years. As a consequence, several unclassified carcinomas in the morphologic spectrum of sinonasal undifferentiated carcinoma have been reclassified as distinctive genetically defined variants or entities. Among the latter are NUT-rearranged carcinoma and SMARCB1-deficient carcinomas. In this study, we further characterize a rare variant of sinonasal undifferentiated carcinoma-like tumors characterized by inactivation of the SWItch/Sucrose Nonfermentable chromatin remodeler SMARCA4 (BRG1) detectable by immunohistochemistry. Patients were 7 males and 3 females aged 20 to 67 years (median, 44). Tumors originated in the nasal cavity (6), nose and sinuses (2), or at unspecified site (2). Six tumors were initially misdiagnosed as small cell neuroendocrine carcinoma (SCNEC) or large cell neuroendocrine carcinoma (LCNEC). Histologically, the tumors were composed of small basaloid (3 cases) or large epithelioid (7) cells disposed into nests and solid sheets with extensive areas of necrosis. No glands or other differentiating features were noted. Abortive rosettes were seen in 1 case. Immunohistochemistry showed consistent expression of pankeratin and absence of CK5, p63, p16, and NUT in all tumors tested. Other tested markers were variably positive: CK7 (2/6), synaptophysin (9/10; mostly focal and weak), chromogranin-A (4/10; focal), and CD56 (3/5; focal). All tumors showed total loss of SMARCA4 and retained expression of SMARCB1/INI1. Co-loss of SMARCA2 was seen in 1 of 8 cases. Limited data were available on treatment and follow-up. Two patients received surgery (1 also radiotherapy) and 3 received chemotherapy. Metastases (cervical nodes, liver, bone, and lung/mediastinal) were detected in 3 patients; 2 were alive under palliative chemotherapy at 8 and 9 months while 1 died of progressive lung disease at 7 months. Three patients (1 with brain invasion) died soon after diagnosis (1 to 3 mo). In total, 4 of 6 patients (66%) with follow-up died of disease (median, 3 mo). This series characterizes SMARCA4-deficient sinonasal carcinoma as a genetically distinct aggressive entity in the spectrum of undifferentiated sinonasal carcinomas. These variants add to the spectrum of SWItch/Sucrose Nonfermentable-deficient sinonasal carcinomas, at the same time expanding the topographic distribution of SMARCA4-related malignancies.

Treatment of primary craniofacial (sinonasal) malignant tumors affecting the anterior and middle skull base

Sinonasal malignant tumors are characterized by high histological variability and complexity of the differential diagnosis. Currently, there are classifications of these tumors, which are based on their localization and involvement of various anatomical structures. However, generally accepted algorithms for treatment of this pathology have not yet been developed. This review describes the most important algorithms for treatment of the most common histological variants of sinonasal malignant tumors: squamous cell carcinoma, adenocarcinoma, sinonasal undifferentiated carcinoma, esthesioneuroblastoma, adenoid cystic cancer, and sinonasal adenocarcinoma. The main problems in choosing the approach for treating these tumors are the lack of generally accepted resectability criteria and contradictions between oncological and neurosurgical indications for surgical treatment. Further research is needed to study the role of radiosensitizers and radioprotectors in comprehensive treatment of sinonasal malignant tumors.

The utility of angioembolisation prior to surgery in a highly vascular renal tumour

Epithelioid angiomyolipoma is a rare variant of renal tumour with potential for aggressive biological profile. We present a12 year old girl with a large angiomyolipoma that created diagnostic and treatment difficulty and review this condition. A 12 year old girl presented with right flank pain. Imaging discovered a large mass arising from the upper pole of the right kidney but inseparable from the adrenal gland and under-surface of the liver. The lesion was highly vascular with a very large draining vein into the renal vein, initially precluding safe needle biopsy. MRI showed small component of fat. A provisional diagnosis of angiomylipoma was made. There was no systemic evidence of tuberous sclerosis. The patient required multiple episodes of embolization to enable safe biopsy as there was diffuse dysplastic and aneurysmal arterial supply from renal, adrenal, phrenic, lumbar and hepatic arteries. Biopsy was performed percutaneously with a balloon in the renal artery. Histology confirmed epithelioid angiomyolipoma. Further sequential embolization was performed to devascularise the tumour prior the surgery. The patient was able to undergo a partial nephrectomy with virtually no blood loss. Epithelioid angiomyolipoma is a rare variant of angiomyolipoma which has been described to have a more aggressive course in some patients. They tend to be larger lesions. The paucity of fat in our patient made imaging diagnosis doubtful. Embolization not only made biopsy safer but also facilitated a safe partial resection of the affected kidney. Histology confirmed the initial diagnosis with complete resection of the lesion. Epithelioid angiomyolipoma defines a group of tumours that are not potentially malignant. This case shows that biopsy of vascular lesions and renal sparing surgery is possible and safe when combined with pre-operative embolization. We highlight the role of pre-operative embolization to avoid haemorrhage and facilitate safe dissection of operative planes.

Epithelioid malignant peripheral nerve sheath tumor arising in schwannoma

Epithelioid malignant peripheral nerve sheath tumor (EMPNST, malignant epithelioid schwannoma) is a rare variant of malignant peripheral nerve sheath tumor that has morphologic and immunophenotypic overlap with a variety of epithelioid neoplasms. Because of its rarity it may be potentially underrecognized. We describe a case arising in the subcutis of the thigh in a 25 year-old female, and discuss the pathologic features and differential diagnosis.

Survival analysis of oropharyngeal squamous cell carcinoma patients linked to histopathology, disease stage, tumor stage, risk factors, and received therapy.

Survival of oropharyngeal squamous cell carcinoma (OSCC) patients depends on the risk and environmental factors, tumor biology, achievements in diagnostics and treatment approaches. To perform a survival analysis of the patients with OSCC treated over a 10-year period in a single hospital in Latvia linking these data to histopathological findings, risk factors and received therapy. The main outcome measures were overall and disease-specific survival (OS and DS) along with histopathology analysis. Kaplan - Meier survival analysis showed better survival for females, younger patients lacking bad habits, operated and received radiotherapy, with lower T grade and disease stage. Cox regression showed diminished early death risk in patients with lower T grade, no regional metastases (N0) and bad habits, operated and received radiotherapy. A vast majority of tumors were localized in palatine tonsils and the base of the tongue. The localization did not correlate with mean survival time/survival. Lower OS (p = 0.03) and DS (p = 0.026) were estimated for patients with pharyngeal wall and tonsillar involvement compared to tumors localized in the soft palate. A histological variant of tumor seemed irrelevant estimating OS and DS, whereas therapeutic modalities significantly affected survival. OSCC patients with lower T grade, N0status, lacking bad habits, and surgically treated had better survival.

Treatment of Aggressive Non-Hodgkin’s Lymphomas in Pregnancy

Background. The management of aggressive lymphomas in pregnancy depends on the time of diagnosis and immu-nomorphological variant of tumor. The rarity of aggressive lymphomas in pregnant women, the absence of consistent approaches to the treatment of such patients, the lack of data on physical growth of children as well as the incidence of newborns’ congenital and acquired pathology make this subject of vital importance. Aim. To analyze the treatment results in patients with newly diagnosed aggressive lymphoma at different stages of pregnancy. Materials &amp; Methods. From 1993 to 2020 at the National Research Center for Hematology 74 pregnant women with lymphomas were treated. Aggressive tumors were detected in 17 (23 %) of them: primary mediastinal (thymic) large B-cell lymphoma (п = 14), anaplastic large-cell lymphoma ALK+ (п = 1), high-grade B-cell lymphoma, unspecified (п = 1), and diffuse large B-cell lymphoma (п = 1). The median age of patients was 30 years (range 21-37 years). The median pregnancy stage on the diagnosis of aggressive lymphoma was 21 weeks (range 11-32 weeks). Results. In 1 case on the diagnosis of aggressive lymphoma at 11 weeks gestation dexamethasone 8 mg daily was administered up to the second trimester of pregnancy, afterwards the patient received polychemotherapy. On the diagnosis of aggressive lymphoma in the second (п = 13) and third (п = 2) trimesters of pregnancy the patients received polychemotherapy followed by delivery. In the third trimester of pregnancy delivery was performed with subsequent polychemotherapy in 1 patient. There were born 18 babies (1 pregnancy was multifetal): 8 girls and 10 boys. Conclusion. As a result of the chosen tactics and the work of interdisciplinary team of doctors all patients, who completed the treatment, are followed-up in complete remission. All born babies, despite chemotherapy and perinatal complications, are alive and develop without abnormalities.

MicroRNA dysregulation interplay with childhood abdominal tumors.

Abdominal tumors (AT) in children account for approximately 17% of all pediatric solid tumor cases, and frequently exhibit embryonal histological features that differentiate them from adult cancers. Current molecular approaches have greatly improved the understanding of the distinctive pathology of each tumor type and enabled the characterization of novel tumor biomarkers. As seen in abdominal adult tumors, microRNAs (miRNAs) have been increasingly implicated in either the initiation or progression of childhood cancer. Moreover, besides predicting patient prognosis, they represent valuable diagnostic tools that may also assist the surveillance of tumor behavior and treatment response, as well as the identification of the primary metastatic sites. Thus, the present study was undertaken to compile up-to-date information regarding the role of dysregulated miRNAs in the most common histological variants of AT, including neuroblastoma, nephroblastoma, hepatoblastoma, hepatocarcinoma, and adrenal tumors. Additionally, the clinical implications of dysregulated miRNAs as potential diagnostic tools or indicators of prognosis were evaluated.

Approaches to Tumor Classification in Pulmonary Sarcomatoid Carcinoma.

Pulmonary sarcomatoid carcinoma (PSC) is a heterogeneous category of primary lung cancer accounting from 0.3% to 3% of all primary lung malignancies. According to the most recent 2015 World Health Organization (WHO) classification, PSC includes several different variants of malignant epithelial tumors (carcinomas) histologically mimicking sarcomas showing or entirely lacking a conventional component of non-small cell lung cancer (NSCLC). Thus, this rare subheading of lung neoplasms includes pleomorphic carcinoma, spindle cell carcinoma, giant cell carcinoma, pulmonary blastoma, and carcinosarcoma. A diagnosis of PSC may be suspected on small biopsy or cytology, but commonly requires a surgical resection to reach a conclusive definition. The majority of patients with PSC consists of elderly, smoking men with a large, peripheral mass characterized by well-defined margins. However, presentation with a central, polypoid endobronchial lesion is well-documented, particularly in pleomorphic carcinoma and carcinosarcoma showing a squamous cell carcinoma component. As expected, PSC may pose diagnostic problems and immunohistochemistry is largely used when pathologists deal these tumors in routine practice. Indeed, PSC tends to overexpress molecules associated with the epithelial-to-mesenchymal transition, such as vimentin, but the panel of immunostains also includes epithelial markers (cytokeratins, EMA), TTF-1, p40 and negative markers (e.g., melanocytic, mesothelial and sarcoma-related primary antibodies). Although rare, PSC has increased their interest among oncologist community for different reasons: a. identification of the epithelial-to-mesenchymal phenomenon as a major mechanism of secondary resistance to tyrosine kinase inhibitors; b. over-expression of PD-L1 and effective treatment with immunotherapy; c. identification of c-MET exon 14 skipping mutation representing an effective target to crizotinib and other specific inhibitors. In this review, the feasibility of the diagnosis of PSC, its differential diagnosis and novel molecular findings characterizing this group of lung tumor are discussed.

Cancer Stem Cells and Neuroblastoma: Characteristics and Therapeutic Targeting Options.

The majority of embryonal tumors or childhood blastomas derive from pluripotent progenitors or fetal stem cells that acquire cancer stem cell (CSC) properties: multipotency, self-renewal ability, metastatic potential, chemoresistance, more pronounced levels of drug transporters, enhanced DNA-damage repair mechanisms, and a quiescent state. Neuroblastoma (NB) is considered a neuroendocrine tumor and is the most common extracranial neoplasm in children. NB pathogenesis has frequently been associated with epigenetic dysregulation and a failure to implement a differentiation program. The origin, characteristics, and isolation of the CSC subpopulation in NB are still incompletely understood, despite the evidence that this cell subset contributes to disease recurrence and acquired resistance to standard therapies. Here, we summarize the literature regarding the isolation and characterization of CSCs in NB over the past decades, from the early recognition of the expression of stem cell factor (SCF) or its receptor c-KIT to more recent studies identifying the ability of G-CSF and STAT3 to support stem cell-like properties in NB cells. Additionally, we review the morphological variants of NB tumors whose recent epigenetic analyses have shed light on the tumor heterogeneity so common in NB. NB-derived mesenchymal stem cells have recently been isolated from primary tumors of NB patients and associated with a pro-tumorigenic role in the tumor microenvironment, enabling immune escape by tumors, and contributing to their invasive and metastatic capabilities. In particular, we will focus on epigenetic reprogramming in the CSC subpopulation in NB and strategies to target CSCs in NB.

Epithelioid trophoblastic tumor of the uterus: currently available diagnostic methods, determining an effective treatment strategy (case report)

Gestational trophoblastic disease is a group of pathological conditions of the trophoblast, which includes both benign and malignant forms. Epithelioid trophoblastic tumor is one of the rare malignant trophoblastic tumors. The tumor develops from intermediate trophoblastic cells and is characterized by the absence of villi and presence of clusters of atypical mononuclear trophoblastic cells and elements of syncytiotrophoblast, similar to epithelial cells in their appearance. Patients with epithelioid trophoblastic tumors usually have extragenital tumor foci with no pathology detected in the uterus. Pelvic ultrasound is an essential stage of such patients' examination. Conventional ultrasound and Doppler ultrasonography are informative, reliable, easy to use, and non-invasive diagnostic procedures that provide wide opportunities of dynamic evaluation of the disease during the course of anticancer therapy and subsequent follow up. Comprehensive diagnostics enables timely detection of a rare morphological variant of a malignant trophoblastic tumor and ensures right decision on the treatment strategy, which is the key to a favorable outcome with preserved reproductive function.

Laparoscopic Resection of a Hydropic Leiomyoma

Video Objective We describe a resection of an asymptomatic hydropic leiomyoma presenting as either a post-surgical change or a uterine malformation, and briefly review the literature for similar case presentations. Setting A 34-year-old otherwise healthy woman was referred for resection of a uterine mass after it was incidentally discovered at the time of laparoscopic cholecystectomy. Imaging revealed a 17-cm fluid-containing mass arising from the cervix that was thought to either be a residual cyst from her prior cesarean scar or an obstructed horn of a didelphys or bicornuate uterus. Interventions The patient was taken for diagnostic hysteroscopy that revealed a normal intrauterine cavity, and diagnostic laparoscopy with laparoscopic resection of the mass using blunt bipolar dissection. The defect was repaired with 0-PDS and the mass was removed via a mini-laparotomy after enclosed morcellation in a specimen bag. Chromopertubation was performed at the end of the procedure ensuring tubal patency. Conclusion Hydropic leiomyomas are rare variants of uterine mesenchymal tumors that present in reproductive-aged women as large, indolent pelvic masses with imaging features of cystic or degenerating changes often concerning for malignancy. We describe the first case to be managed laparoscopically, and to present as a possible uterine malformation or post-surgical change, further showing the degree of the diagnostic challenge posed by hydropic leiomyomas and the importance of preoperative imaging.

Mass lesions of the myometrium: interpretation and management of unexpected pathology.

Uterine leiomyomas are the most common benign uterine smooth muscle tumors. On the basis of imaging, these masses are often presumed to be benign conventional leiomyomas and surgical excision is a common treatment choice. After myomectomy or hysterectomy for presumed leiomyomas, the surgical pathology report may reveal an unexpected diagnosis of another type of mesenchymal tumor. These can range from a variant of benign smooth muscle tumors to smooth muscle tumors of uncertain malignant potential to malignant sarcomas. This review describes these variant pathologies and reviews data on recurrence risk and postoperative management. The majority of benign smooth muscle tumors will be classified as leiomyomas. Cellular, bizarre nuclei, mitotically active, epitheliod, myxoid, and dissecting are all terms that describe pathologic variants of benign leiomyomas. Smooth muscle tumors of uncertain malignant potential contain both benign and malignant features and should be referred to Gynecologic Oncology for follow-up. Leiomyosarcomas and low-grade endometrial stromal sarcomas may present preoperatively as benign tumors but are malignant with a high risk of recurrence and should be referred to Gynecologic Oncology. We advocate for the continued benefits of minimally invasive procedures in appropriately selected patients. Despite these measures, unexpected pathologic diagnoses can occur and should be managed appropriately.

Pulmonary Myoepithelial Tumors With Exuberant Reactive Pneumocytes: Proposed Reclassification of So-called Pneumocytic Adenomyoepithelioma.

Pneumocytic adenomyoepithelioma (PAM) was first described in 2007 and was included in the 2015 World Health Organization Classification of lung tumors as a variant of epithelial-myoepithelial tumor. This rare pulmonary neoplasm was reported to show both myoepithelial and duct-like components, with the latter exhibiting pneumocytic differentiation with TTF-1 expression. We present an index case and 6 additional retrospectively identified cases of pulmonary tumors with prototypical features of PAM. However, with additional clinicoradiologic, histologic, immunohistochemical and cytogenetic data, we were able to reclassify them as myoepithelial neoplasms-both primary and metastatic-with entrapped exuberantly hyperplastic alveolar structures lined by TTF-1 pneumocytes. We reviewed the available literature related to PAM and myoepithelial tumors. Our cases suggest that the entity referred to as PAM represents interstitial growth of myoepithelial neoplasms enticing marked proliferation of entrapped pneumocytes rather than a distinct biphasic neoplasm with pneumocytic differentiation.

A Rare Case of Sclerosing Variant of Pancreatic Neuroendocrine Tumor-Expressing Glucagon

Abstract Introduction Sclerosing variant of pancreatic neuroendocrine tumor (PanNET) is a rare variant of PanNET characterized by decreased tumor cellularity and prominent stromal fibrosis, and it is considered associated with serotonin expression. We herein present an unusual case of a sclerosing PanNET expressing glucagon. Methods The patient, a 75-year-old woman with refractory diabetes, scaly erythematous skin plaques in the eyelid, bilateral elbows and scalp, and episodes of nausea and poor appetite, presented to emergency department for acute abdominal pain. Abdominal computed tomography showed a 17-mm pancreatic head mass. Endoscopic ultrasound with fine-needle biopsy was performed for histopathological examination, followed by pancreaticoduodenectomy. Results Biopsy showed a background of predominantly blood and benign strips of pancreatic parenchyma and scanty fragments of fibrotic hyalinized stroma containing medium-sized atypical monotonous cells with round-to-ovoid nuclei, smooth borders, and inconspicuous nucleoli. These cells were difficult to characterize morphologically due to the scanty sampling. Immunohistochemical stains revealed the atypical cells were positive for AE1/AE2, synaptophysin, chromogranin, and glucagon and negative for insulin, serotonin, and pancreatic polypeptide. The lack of heterogeneous peptide cell composition supported a neoplastic proliferation of neuroendocrine cells. The pancreaticoduodenectomy specimen showed a 1.2-cm white firm mass in the pancreatic head. Histopathological study showed that, in a sclerotic background, the tumor cells grew mostly in trabecular patterns and occasionally in single cells, infiltrating into adjacent pancreatic parenchyma, and showed the same immunoprofile features as in the biopsy specimen. The proliferative index was &lt;3%, supporting the diagnosis of low-grade sclerosing PanNET. The patient recovered well postsurgery. Moreover, the episodes of nausea and loss of appetite improved postsurgery. Patient did not show up for follow-up appointments in the dermatology clinic. Conclusion Sclerosing PanNET is challenging for diagnosis, especially on small biopsy specimens. Immunohistochemistry helps establish the diagnosis. Our case demonstrates a rare presentation of sclerosing PanNET expressing glucagon.

Identification of a Specific Gene Module for Predicting Prognosis in Glioblastoma Patients.

Introduction: Glioblastoma (GBM) is the most common and malignant variant of intrinsic glial brain tumors. The poor prognosis of GBM has not significantly improved despite the development of innovative diagnostic methods and new therapies. Therefore, further understanding the molecular mechanism that underlies the aggressive behavior of GBM and the identification of appropriate prognostic markers and therapeutic targets is necessary to allow early diagnosis, to develop appropriate therapies and to improve prognoses.Methods: We used a weighted gene co-expression network analysis (WGCNA) to construct a gene co-expression network with 524 glioblastoma samples from The Cancer Genome Atlas (TCGA). A risk score was then constructed based on four module genes and the patients' overall survival (OS) rate. The prognostic and predictive accuracy of the risk score were verified in the GSE16011 cohort and the REMBRANDT cohort.Results: We identified a gene module (the green module) related to prognosis. Then, multivariate Cox analysis was performed on 4 hub genes to construct a Cox proportional hazards regression model from 524 glioblastoma patients. A risk score for predicting survival time was calculated with the following formula based on the top four genes in the green module: risk score = (0.00889 × EXPCLEC5A) + (0.0681 × EXPFMOD) + (0.1724 × EXPFKBP9) + (0.1557 × EXPLGALS8). The 5-year survival rate of the high-risk group (survival rate: 2.7%, 95% CI: 1.2–6.3%) was significantly lower than that of the low-risk group (survival rate: 8.8%, 95% CI: 5.5–14.1%).Conclusions: This study demonstrated the potential application of a WGCNA-based gene prognostic model for predicting the survival outcome of glioblastoma patients.

A histopathological study of colorectal neoplasms in a tertiary care hospital

A wide variety of lesions affect the colon, including neoplastic and non-neoplastic. The clinical diagnosis is usually delayed due to vague symptoms. Colorectal cancer is the 3rd most common tumor type worldwide, and one of the leading causes of cancer related deaths. Pathological examination of biopsy and resected specimens are of crucial for determining the extent of disease, patient management and prognosis assessment. Our aim is to study the histomorphology of various neoplastic lesions of colorectum, to evaluate the incidence, age and sex ratio and classify them in to benign and malignant tumors. A cross-sectional study for 2 years from 1st June 2016 to 31st May 2018 and total of 44 cases were evaluated. The material for study comprised of both resected specimens and biopsies of neoplastic lesions of colorectum received in department of Pathology in J. J. M Medical College were subjected for detailed examination including gross and histopathological findings. Out of 44 specimen received, 17(38.7%) were resected specimens and 27(61.3%) were biopsy specimens and the lesions were further classified in to benign and malignant with 34% and 66% respectively. Most common histological variant of malignant tumor was moderately differentiated adenocarcinoma, and most common benign tumor was juvenile polyp. The majority of patients are between 61-70 years. Females were most commonly affected. Malignant lesions are more common than benign lesions in the colon. Adenocarcinoma is the most common malignant lesions of colon in our study. Keywords: Adenocarcinoma, Colorectal, Neoplasm, Polyp.