World Health Organization Histological Typing Research Articles

Inflammatory myofibroblastic tumor of the ascending colon in adults manifested by positive fecal occult blood test

An inflammatory myofibroblastic tumor (IMT) is a neoplasm of myofibroblastic spindle cells with inflammatory infiltrates.1,2 It recurs locally, manifests systemic symptoms, but rarely presents malignant transformation, and is classified as intermediate neoplasm in the World Health Organization histological typing.3 An IMT was originally described in the lung4 and has been documented in many organs of children and adolescents.5 However, only 2 cases have been reported in the colons of adults.6,7 This report describes endoscopic features of this uncommon colonic IMT.

Predictors of recurrence in thymic tumors: Importance of invasion, World Health Organization histology, and size

This study sought to define predictors of recurrence after resection of thymic tumors. A single-institution retrospective study was performed of 179 patients who underwent resection of a thymic tumor from 1972 through 2003. Resection was complete in 90% (161/179) of patients. After a median follow-up of 115 months, the recurrence rate was 11% (20/179), the tumor-related death rate was 7.8% (14/179), and the overall death rate was 36.3% (65/179). Tumor recurrence correlated with advanced stage and histology (P < .0001). The difference in recurrence between Masaoka stage I (0) and II (1.7% [1/59]) was insignificant. Recurrence rates correlated with World Health Organization tumor type: A and AB, 0%; B1 and B2, 8% (4/51); B3, 27% (14/51); and C, 50% (2/4; P < .0001). Tumor size separation into quintiles demonstrated a step-up of recurrence at 8 cm (<8 cm, 1.8% [2/113]; > or =8 cm, 28% [18/64]; P < .003). Multivariate Cox modeling demonstrated that Masaoka stage (odds ratio, 5.70; P < .001), World Health Organization histology (odds ratio, 5.77; P = .003), and size (odds ratio, 1.16; P = .001) were independent predictors of recurrence. The Masaoka staging system could be collapsed to 3 degrees of invasion by combining stages I and II. The World Health Organization histologic type can be simplified for clinical use into A (A, AB), early B (B1, B2), advanced B (B3), and C tumors. Size of 8 cm or larger is an independent risk factor, even when patients with Masaoka stage III tumors are considered alone, and might identify candidates for preoperative therapy.

Prognostic Factors in Thymic Epithelial Tumors Undergoing Complete Resection

The prognostic factors in thymic epithelial tumors (TET) are investigated within a 27-year period in 104 patients submitted to surgical and pathologic complete resection of TET with a mean age of 53 +/- 14.6 years and a male to female ratio of 0.73. The medical records of all patients were reviewed and six variables that could affect the short-term and long-term survival were entered into a Cox regression model. Follow-up was obtained from medical records and telephone contacts up to September 2004 or until the patient's death. Overall 5-year and 10-year survival was 83% and 78%, respectively. Univariate Cox regression analysis showed that long survival was affected by the age of the patient at the time of operation, the response of myasthenia gravis to the operation, the tumor recurrence, the histologic type according to the World Health Organization (WHO) classification, and the Masaoka stage. Multivariate analysis revealed that recurrence of the tumor (p = 0.001), Masaoka stages II or III (p < 0.001), elder age of the patient at the time of operation (p = 0.045), and presence of the WHO histologic types B2 or B3 (p = 0.05) were bad prognostic factors. Recurrence of the tumor, the Masaoka staging, the WHO histologic type, and the age of the patient at the time of operation were the most important prognosticators for patients with TET submitted to complete resection of their tumor.

An Approach to Studying Lung Cancer-related Proteins in Human Blood

Early stage lung cancer detection is the first step toward successful clinical therapy and increased patient survival. Clinicians monitor cancer progression by profiling tumor cell proteins in the blood plasma of afflicted patients. Blood plasma, however, is a difficult cancer protein assessment medium because it is rich in albumins and heterogeneous protein species. We report herein a method to detect the proteins released into the circulatory system by tumor cells. Initially we analyzed the protein components in the conditioned medium (CM) of lung cancer primary cell or organ cultures and in the adjacent normal bronchus using one-dimensional PAGE and nano-ESI-MS/MS. We identified 299 proteins involved in key cellular process such as cell growth, organogenesis, and signal transduction. We selected 13 interesting proteins from this list and analyzed them in 628 blood plasma samples using ELISA. We detected 11 of these 13 proteins in the plasma of lung cancer patients and non-patient controls. Our results showed that plasma matrix metalloproteinase 1 levels were elevated significantly in late stage lung cancer patients and that the plasma levels of 14-3-3 sigma, beta, and eta in the lung cancer patients were significantly lower than those in the control subjects. To our knowledge, this is the first time that fascin, ezrin, CD98, annexin A4, 14-3-3 sigma, 14-3-3 beta, and 14-3-3 eta proteins have been detected in human plasma by ELISA. The preliminary results showed that a combination of CD98, fascin, polymeric immunoglobulin receptor/secretory component and 14-3-3 eta had a higher sensitivity and specificity than any single marker. In conclusion, we report a method to detect proteins released into blood by lung cancer. This pilot approach may lead to the identification of novel protein markers in blood and provide a new method of identifying tumor biomarker profiles for guiding both early detection and therapy of human cancer.

Improved local control with stereotactic radiosurgical boost in patients with nasopharyngeal carcinoma

Purpose: Treatment of nasopharyngeal carcinoma using conventional external beam radiotherapy (EBRT) alone is associated with a significant risk of local recurrence. Stereotactic radiosurgery (STR) was used to boost the tumor site after EBRT to improve local control. Methods and materials Forty-five nasopharyngeal carcinoma patients received a STR boost after EBRT at Stanford University. Seven had T1, 16 had T2, 4 had T3, and 18 had T4 tumors (1997 American Joint Commission on Cancer staging). Ten had Stage II, 8 had Stage III, and 27 had Stage IV neoplasms. Most patients received 66 Gy of EBRT delivered at 2 Gy/fraction. Thirty-six received concurrent cisplatin-based chemotherapy. STR was delivered to the primary site 4–6 weeks after EBRT in one fraction of 7–15 Gy. Results At a medium follow-up of 31 months, no local failures had occurred. The 3-year local control rate was 100%, the freedom from distant metastasis rate was 69%, the progression-free survival rate was 71%, and the overall survival rate was 75%. Univariate and multivariate analyses revealed N stage (favoring N0-N1, p = 0.02, hazard ratio HR 4.2) and World Health Organization histologic type (favoring type III, p = 0.002, HR 13) as significant factors for freedom from distant metastasis. World Health Organization histologic type ( p = 0.004, HR 10.5) and age ( p = 0.01, HR 1.07/y) were significant factors for survival. Late toxicity included transient cranial nerve weakness in 4, radiation-related retinopathy in 1, and asymptomatic temporal lobe necrosis in 3 patients who originally had intracranial tumor extension. Conclusion STR boost after EBRT provided excellent local control in nasopharyngeal carcinoma patients. The incidence of late toxicity was acceptable. More effective systemic treatment is needed to achieve improved survival.

Cherubism: Case Report and Review of the Japanese Literature

Cherubism is a disease of bone characterised by clinical, bilateral, painless enlargement of the jaws. This disease is classified as a non-neoplastic bone lesion in the World Health Organization histological typing of odontogenic tumours. Cherubism is an uncommon disease in Japan and may appear either as a solitary case or among multiple generations in a family. Since cherubism was first described in 1933, many cases have been reported in other countries, but only 13 cases have been reported in Japan. This report is of a 14-year-old girl with non-familial cherubism.

Revision of the 1992-edition of the WHO histological typing of odontogenic tumours. A suggestion.

Classification of odontogenic tumours is an academic exercise that has developed over the last 150 years. It was not until 1971 when a 5-year collaborated effort, organized by the World Health Organization (WHO), resulted in the first consensus on taxonomy of odontogenic tumours. The appearance of this first authoritative guide to the classification of odontogenic tumours marked the start of an era of quite intensive interest for studying this particular field of oral pathology. An updated 2nd edition of the WHO classification was published in 1992.

上唇に発生した乳頭状嚢腺癌の１例

Papillary cystadenocarcinoma is recognized by the World Health Organization (1991) Histological Typing of Salivary Glands Tumors. This lesion rarely occurs in the maxillofacial region. It accounts for less than 0.2% of all salivary gland tumors. We report a rare case of papillary cystadenocarcinoma arising in the upper lip. The patient was a 80-year-old woman with a painless mass in the left upper lip. The lesion was present for about 1 year. The tumor was excised with the surrounding minor salivary glands under local anesthesia. The excised specimen was histologically diagnosed as papillary cystadenocarcinoma, showing invasion to the adjacent minor salivary glands and rupture of the tumor capsule. Because of remaining tumor, additional excision was performed. No sign of recurrence or metastasis has been observed as of about 1 year after operation.

ケルビズムの１例

Cherubism is an uncommon disease in Japan that was first described by Jones as a familialmultilocular cystic disease of the jaws. The disease is classified as a non-neoplastic bone lesion in the World Health Organization histological typing of odontogenic tumors, but diagnostic criteria have notbeen established.We report a non-familial case of cherubism in a 10-year-old boy. The patient clinically showed fullness of the cheeks, slightly upturned eyes, and multiple swellings of the submandibular and cervical lymphnodes. Intraorally, there was bilateral bone expansion from the mandibular first molar region to the ascendingramus. The right first molar was dislocated laterally and the left first molar was unerupted.Radiographically, multilocular radiolucent lesions were found bilaterally from the mandibular firstmolar region to the coronoid process. In addition, there were unilocular radiolucent lesions from the maxillary molar region to the tuberosity on both sides. Biopsy specimens obtained from the mandibular lesionswere diagnosed as giant cell granuloma. The patient is being examined periodically with no treatment. The lesions have shown no evidence of growth for 16 months.

Limitation of annual screening chest radiography for the diagnosis of lung cancer. A retrospective study

The incidence and mortality rates of lung cancer have been increasing in many countries. However, the true effectiveness of screening for lung cancer is still controversial. This study aimed to examine the growth pattern of lung cancer and to evaluate the efficacy of screening. The authors linked the records of annual radiologic screening to cancer registry data and conducted a retrospective follow-up study of radiographs in all patients with lung cancer arising in a population undergoing screening. Among a total of 305,934 participants, screening detected 206 lung cancers, 103 of which were Stage I disease. Seventy-one of the 131 adenocarcinomas were Stage I, and 58% of them showed evidence of cancer for 2 years on a retrospective review of radiographs. Presentation as small faint lesions overlapping the normal chest structures delayed the early detection of adenocarcinoma. The overall sensitivity of screening was 70%, 52% for squamous cell carcinoma and 50% for small cell carcinoma. Rapidly growing Stage II-IV tumors without retrospective evidence of cancer on previous radiographs accounted for most of the cancers detected during the intervals between screening. Both the low detectability of Stage I adenocarcinoma and the late recognition of rapidly growing small cell and squamous cell carcinomas reduced the effectiveness of screening. More effective imaging methods and an antismoking campaign are required to reduce lung cancer mortality.

The World Health Organization histological typing of odontogenic tumours. Introducing the second edition.

The World Health Organization histological typing of odontogenic tumours. Introducing the second edition.

The WHO Histological Typing of Odontogenic Tumours. A commentary on the Second Edition.

This article introduces the revised World Health Organization (WHO) classification of odontogenic tumors and jaw cysts and certain bone lesions that either are peculiar to the jaws or have distinctive features in that location. The new and revised classification is compared with the previous version, the reasons for the changes are outlined, and reference is made to a number of newly characterized lesions that have been included.

The World Health Organization Histological Typing of Breast Tumors—Second Edition

The WHO Histological Classification of Breast Tumors, published in 1968, has been completely revised. This second edition provides a recommended nomenclature, definitions, and code numbers for both tumors and tumor-like lesions. It aims at promoting uniformity in recording and reporting diagnoses in order to facilitate international and other comparisons.

The World Health Organization histological typing of lung tumours. Second edition.

The WHO Histological Classification of Lung Tumours, published in 1967, has been revised. The main features are as follows: Squamous cell carcinoma (epidermoid carcinoma) has the same definition as in the original version, i.e., the identification of keratin and/or intercellular bridges by light microscopy. Three degrees of histological differentiation are described. Dysplasia and carcinoma in situ are discussed. Small cell carcinoma is divided into oat-cell carcinoma, an intermediate cell type and a category for oat-carcinomas combined with other major types. Adenocarcinoma includes the acinar, papillary and bronchiolo-alveolar forms and the solid carcinomas with mucus formation (previously, part of the large cell carcinoma group). Mesothelial tumours are divided into fibrous, epithelial and biphasic subtypes. A number of less common tumours and tumour-like lesions are defined.