Endocervical adenocarcinoma associated with lobular endocervical glandular hyperplasia showing rapid reaccumulation of hydrometra

2008 ◽  
Vol 18 (6) ◽  
pp. 1285-1288 ◽  
Author(s):  
K. Takeuchi ◽  
T. Tsujino ◽  
M. Sugimoto ◽  
S. Yoshida ◽  
S. Kitazawa
Keyword(s):  
Biopsy Specimen ◽  
Unknown Origin ◽  
Exploratory Laparotomy ◽  
Pelvic Lymphadenectomy ◽  
Imaging Studies ◽  
Endocervical Adenocarcinoma ◽  
Total Hysterectomy ◽  
Carcinoma Tissue ◽  
Biopsy Specimens ◽  
Adenocarcinoma Cells

Mucinous endocervical adenocarcinoma is characterized by increased watery vaginal discharge, but the early diagnosis is sometimes difficult because biopsy specimen might only serve to sample a superficial part of the tumor. The patient presented with complaints of abdominal distention. No vaginal bleeding or watery discharge was observed. Hydrometra was suspected by imaging studies. Rapid reaccumulation of hydrometra was seen despite drainage. Papanicolaou smear of endocervix and endometrium followed by fractional curettage was performed, but failed to confirm the diagnosis. To investigate the unknown origin of hydrometra, an exploratory laparotomy with total hysterectomy and bilateral salpingo-oophorectomy was performed, followed by pelvic lymphadenectomy because biopsy specimens during operation suggested adenocarcinoma of the cervix. The final pathologic study of surgical specimens revealed mucinous adenocarcinoma, which was located on the proximal area of cervix. Adjacent to carcinoma tissue, lobular endocervical glandular hyperplasia (LEGH) was detected. Pyloric gland mucin (HIK1083), MUC6, and MUC5AC were diffusely immunopositive in the cytoplasm of LEGH cells and the immunoreactivity became weaker in adenocarcinoma cells with tumor progression and loss of differentiation. Based on histopathologic features of the present case, there seems to be a possible link between LEGH and conventional mucinous endocervical adenocarcinomas. The physician should keep in mind the possible existence of endocervical adenocarcinoma in a patient showing rapid reaccumulation of hydrometra, when uterine malignancies are clinically suspected and biopsy finding fails to confirm the diagnosis.

The Microheterogeneity of Human Liver and Serum Ferritins Measured on Minute Amounts of Ferritin in Crude Samples

1984 ◽  
Vol 21 (6) ◽  
pp. 471-476 ◽  
Author(s):  
F M J Zuyderhoudt ◽  
C Linthorst
Keyword(s):  
Liver Biopsy ◽  
Iron Overload ◽  
Liver Tissue ◽  
Biopsy Specimen ◽  
Unknown Origin ◽  
Enzyme Linked Immunosorbent Assay ◽  
Liver Biopsy Specimen ◽  
Tissue Samples ◽  
Ferritin Concentration ◽  
Biopsy Specimens

A method is presented to measure the microheterogeneity of ferritin in μg amounts, without purifying the samples extensively. Ferritin-containing samples such as serum and homogenized liver-biopsy specimens were mixed with Sephadex G-75 and ampholines. Isoelectric focussing was performed and the pH gradient in the Sephadex was measured. The Sephadex was divided into predetermined pH ranges and the ferritin eluted from these fractions. Ferritin concentration was measured by an enzyme-linked immunosorbent assay. The method proved to be reproducible. The isoferritin profiles of different human serum and liver tissue samples were quite variable. In most cases serum ferritins focussed between approximately pH 5·5 and pH 4·9 and liver ferritins between approximately pH 5·8 and pH 5·3. We examined whether there was a similarity in the isoferritin patterns of serum and liver of distinct patients. We also studied liver tissue and serum from a patient with haemochromatosis and from a child with iron overload of unknown origin. In the serum of our patients the isoferritin pattern had shifted to lower pI when compared with that found in liver tissue. Only in the case of a patient with transfusion iron overload were basic isoferritins measured in the serum. In this case no liver biopsy specimen was available for comparison.

scholarly journals Epithelioid trophoblastic tumor coexisting with choriocarcinoma around an abdominal wall cesarean scar: a case report and review of the literature

2020 ◽  
Vol 14 (1) ◽  
Author(s):  
Chunfeng Yang ◽  
Jianqi Li ◽  
Yuanyuan Zhang ◽  
Hanzhen Xiong ◽  
Xiujie Sheng
Keyword(s):  
Abdominal Wall ◽  
Chorionic Gonadotropin ◽  
Human Chorionic Gonadotropin ◽  
Unknown Origin ◽  
Exploratory Laparotomy ◽  
Cesarean Scar ◽  
Trophoblastic Tumor ◽  
Epithelioid Trophoblastic Tumor ◽  
Trophoblastic Tumors ◽  
Wall Lesion

Abstract Background Mixed gestational trophoblastic neoplasms are extremely rare and comprise a group of fetal trophoblastic tumors including choriocarcinomas, epithelioid trophoblastic tumors, and placental site trophoblastic tumors. We present a case of a patient with extrauterine mixed gestational trophoblastic neoplasm adjacent to the abdominal wall cesarean scar. On the basis of a literature review, this type of case has never been reported before due to the unique lesion location and low incidence. Case presentation Our patient was a 39-year-old Chinese woman who had a history of two cesarean sections and one miscarriage. She had a recurrent anterior abdominal wall mass around her cesarean scar, and the mass was initially suspected of being choriocarcinoma of unknown origin. The patient had concomitant negative or mildly increased serum β-human chorionic gonadotropin at follow-up and no abnormal vaginal bleeding or abdominal pain. However, she underwent local excision twice and had two courses of chemotherapy with an etoposide and cisplatin regimen. She finally opted for exploratory laparotomy with abdominal wall lesion removal, subtotal hysterectomy, bilateral salpingectomy, and left ovarian cyst resection, which showed the abdominal wall lesion, whose components were revealed by microscopy and immunohistochemical staining to be approximately 90% epithelioid trophoblastic tumors and 10% choriocarcinomas from a solely extrauterine mixed gestational trophoblastic neoplasm around an abdominal wall cesarean scar. Conclusions It is worth noting whether epithelioid trophoblastic tumor exists in the setting of persistent positive low-level β-human chorionic gonadotropin. More studies are required to provide mechanistic insights into these mixed gestational trophoblastic neoplasms.

scholarly journals The number of osteoclasts in a biopsy specimen can predict the efficacy of neoadjuvant chemotherapy for primary osteosarcoma

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Y. Araki ◽  
N. Yamamoto ◽  
K. Hayashi ◽  
A. Takeuchi ◽  
S. Miwa ◽  
...  
Keyword(s):  
Neoadjuvant Chemotherapy ◽  
Biopsy Specimen ◽  
Osteoclast Differentiation ◽  
Poor Response ◽  
Underlying Mechanism ◽  
Biopsy Specimens ◽  
Response To Chemotherapy ◽  
Simple Factor ◽  
Chemotherapy Agents ◽  
Chemotherapy Efficacy

AbstractOsteosarcoma is the most common primary malignant bone tumor, and its standard treatment is a combination of surgery and chemotherapy. A poor response to chemotherapy causes unfavorable oncological outcomes. We investigated the correlation between osteoclast differentiation in biopsy specimens and the efficacy of neoadjuvant chemotherapy in resected specimens. Forty-nine patients who underwent neoadjuvant chemotherapy and subsequent surgical treatment at our institution between 1999 and 2018 were enrolled. Using medical records, we investigated the age, sex, tumor size, location, subtype, staging, chemotherapy agents (doxorubicin, cisplatin, ifosfamide, and methotrexate), number of neoadjuvant chemotherapy courses, number of osteoclasts in biopsy specimens, and efficacy of neoadjuvant chemotherapy according to the Rosen and Huvos classification (Grade I-IV) in resected specimens. Univariate and multivariate analyses were performed to identify factors predictive of a good response in resected specimens after neoadjuvant chemotherapy. A good response (Grade III/IV) was detected in 25, while a poor response (Grade I/II) was detected in 24. According to the multivariate analysis, ≥ 46 years old (odds ratio [OR], 0.05; 95% confidence interval [CI], 0.01–0.45; p < 0.01) and ≥ 5 mature osteoclasts in a biopsy specimen (OR, 36.9; 95% CI, 6.03–225; p < 0.01) were significantly associated with the neoadjuvant chemotherapy efficacy. The accuracy for predicting a good response to chemotherapy based on ≥ 5 osteoclasts in a biopsy specimen in patients < 46 years old was 85%. The number of mature osteoclasts in biopsy specimens is a simple factor for predicting the efficacy of chemotherapy before treatment, although further studies will be required to determine the underlying mechanism.

scholarly journals A young lady with inflammation of unknown origin

2018 ◽  
Vol 18 (2) ◽  
pp. 67-71
Author(s):  
Chiu Sum Chu ◽  
Chi Hung To ◽  
Chi Chiu Mok
Keyword(s):  
Young Women ◽  
Systemic Vasculitis ◽  
Unknown Origin ◽  
Young Lady ◽  
Imaging Studies ◽  
Biochemical Tests ◽  
Vascular Stenosis ◽  
High Index Of Suspicion ◽  
Anemia Of Chronic Inflammation ◽  
Delay In Treatment

Abstract Takayasu’s arteritis (TAK) is a systemic vasculitis mainly affecting the aorta and its first branches. The initial presentation can be very non-specific while its sequelae can be debilitating and fatal. Apart from clinical and biochemical tests, imaging studies remain pivotal for the diagnosis of this rare disease. Delay in treatment may result in vascular stenosis, leading to morbidity and mortality. We report a case of a young woman who presented with anemia with no obvious causes. Subsequently she developed ischemic symptoms and the diagnosis of TAK was established with magnetic resonance angiography (MRA). Our case illustrates the importance of recognition of the possibility of TAK in young women who presented with non-specific systemic upset and anemia of chronic inflammation. A high index of suspicion is needed and imaging studies should be considered early. The treatment of TAK will also be briefly reviewed.

scholarly journals Pathomorphological features of clinical forms of ulcerative colitis in children

2021 ◽  
Vol 16 (1) ◽  
pp. 1-7
Author(s):  
M.F. Denysova ◽  
T.D. Zadorozhna ◽  
N.Yu. Bukulova ◽  
T.М. Archakova
Keyword(s):  
Ulcerative Colitis ◽  
Inflammatory Process ◽  
Unknown Origin ◽  
Chronic Inflammatory Disease ◽  
Clinical Forms ◽  
Biopsy Specimens ◽  
Histological Method ◽  
Intestine Mucosa ◽  
Mucous Barrier ◽  
Hematoxylin Eosin

Background. Ulcerative colitis is a chronic inflammatory disease of unknown origin, characterized by a clinically recurrent course with periods of bloody diarrhea and pathomorpholo­gical-diffuse inflammatory process in the colon. The problem of ulcerative colitis requires further study of the clinical features of the disease, taking into account the localization, degree of activity of the inflammatory process, changes in the structure of the mucous membrane that will help increase the efficiency of ulcerative colitis diagnosis in childhood. Materials and methods. On the basis of clinical and statistical analysis of 116 case histories of children aged 4–18 years with ulcerative colitis, the features of its clinical forms — total, segmental and distal — were studied during the period of exacerbation of the disease. Four hundred and forty-five biopsy specimens obtained during colonoscopy were histologically examined. After biopsy sampling, specimens were fixed in 10% formalin and were processed according to the generally accepted histological method with section staining using hematoxylin-eosin and according to Van Gieson. Results. Changes in the architecto­nics of the large intestine mucosa, which reduce the resistance of the mucous barrier, as well as impaired blood supply — a factor in the development of hemic hypoxia — are significant for the mechanisms of ulcerative colitis exacerbation.

Megacystis-Microcolon-Intestinal Hypoperistalsis Syndrome

PEDIATRICS ◽  
1979 ◽  
Vol 63 (5) ◽  
pp. 805-808
Author(s):  
Thomas E. Wiswell ◽  
James S. Rawlings ◽  
James L. Wilson ◽  
Gary Pettett
Keyword(s):  
Neonatal Period ◽  
Ganglion Cells ◽  
Plain Film ◽  
Rectal Biopsy ◽  
Exploratory Laparotomy ◽  
Nerve Fibers ◽  
Bladder Obstruction ◽  
Distended Abdomen ◽  
Biopsy Specimens ◽  
Hypoperistalsis Syndrome

The syndrome of megacystis-microcolon-intestinal hypoperistalsis has been reported in a total of seven female infants. Massive abdominal distention secondary to a distended urinary Fig 1. Plain film of markedly distended abdomen with no air beyond stomach. Stomach is displaced upward toward left. der was the major presenting characteristic. Iutestinal hypoperistalsis, apparent in the early neonatal period, persists without improvement. Exploratory laparotomy reveals malrotation and malfixation of a small microcolon. No anatomic cause of intestinal or bladder obstruction can be found. Intestinal and/or rectal biopsy specimens contain abundant ganglion cells and nerve fibers. The outcome has been uniformly fatal, with survival in the reported cases ranging from two days to 34 months.

scholarly journals What Can Be Done to Improve Research Biopsy Quality in Oncology Clinical Trials?

2018 ◽  
Vol 14 (11) ◽  
pp. e722-e728 ◽  
Author(s):  
Katherine V. Ferry-Galow ◽  
Vivekananda Datta ◽  
Hala R. Makhlouf ◽  
John Wright ◽  
Bradford J. Wood ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Anticancer Agents ◽  
Biopsy Specimen ◽  
Tissue Quality ◽  
Tumor Biopsy ◽  
Time Investment ◽  
Biopsy Specimens ◽  
Oncology Clinical Trials ◽  
Specimen Quality ◽  
Academic Recognition

Purpose: Research biopsy specimens collected in clinical trials often present requirements beyond those of tumor biopsy specimens collected for diagnostic purposes. Research biopsies underpin hypothesis-driven drug development, pharmacodynamic assessment of molecularly targeted anticancer agents, and, increasingly, genomic assessment for precision medicine; insufficient biopsy specimen quality or quantity therefore compromises the scientific value of a study and the resources devoted to it, as well as each patient’s contribution to and potential benefit from a clinical trial. Methods: To improve research biopsy specimen quality, we consulted with other translational oncology teams and reviewed current best practices. Results: Among the recommendations were improving communication between oncologists and interventional radiologists, providing feedback on specimen sufficiency, increasing academic recognition and financial support for the time investment required by radiologists to collect and preserve research biopsy specimens, and improving real-time assessment of tissue quality. Conclusion: Implementing these recommendations at the National Cancer Institute’s Developmental Therapeutics Clinic has demonstrably improved the quality of biopsy specimens collected; more widespread dissemination of these recommendations beyond large clinical cancer centers is possible and will be of value to the community in improving clinical research and, ultimately, patient care.

scholarly journals Degenerated fibroid: a diagnostic dilemma

2020 ◽  
Vol 9 (4) ◽  
pp. 1766
Author(s):  
Nayanika Gaur ◽  
Manish Jha
Keyword(s):  
Histopathological Examination ◽  
Exploratory Laparotomy ◽  
Total Abdominal Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Cystic Degeneration ◽  
Ovarian Malignancy ◽  
Imaging Studies ◽  
Diagnostic Dilemma ◽  
Fibroid Uterus ◽  
Wide Range

Leiomyoma is one of the most commonly encountered benign gynaecological neoplasms. With a wide range of symptoms, sometimes even asymptomatic, these tumors are easy to diagnose and treat, unless there are degenerative changes, which makes them difficult to diagnose and differentiating them from other serious conditions including malignancy, thereby, complicating their management also. Here, the case present to you a case of 48-year-old women with symptoms and clinical examination suggesting fibroid uterus but imaging studies inconclusive to differentiate fibroid uterus with ovarian malignancy, thus, creating a diagnostic dilemma. Ultimately, patient underwent exploratory laparotomy, keeping possibility of ovarian malignancy. Histopathological examination of the specimen of total abdominal hysterectomy with bilateral salpingo-oopherectomy concluded extensive cystic degeneration of leiomyoma and no evidence of malignancy.

scholarly journals Peritoneal Tuberculosis Mimicking Peritoneal Carcinomatosis

2014 ◽  
Vol 2014 ◽  
pp. 1-3 ◽  
Author(s):  
Mehmet Akce ◽  
Sarah Bonner ◽  
Eugene Liu ◽  
Rebecca Daniel
Keyword(s):  
Weight Loss ◽  
Peritoneal Carcinomatosis ◽  
Biopsy Specimen ◽  
Exploratory Laparotomy ◽  
Peritoneal Tuberculosis ◽  
Blood Cell Count ◽  
Purified Protein Derivative ◽  
Acid Fast Bacilli ◽  
Omental Caking ◽  
Necrotizing Granulomas

A 67-year-old male presented with fatigue, abdominal pain , and 30-pound weight loss over 3 months. Computerized tomography (CT) abdomen displayed ascites with thickening and enhancement of the peritoneum and mottled nodular appearing as soft tissue consistent with omental caking worrisome for peritoneal carcinomatosis. A paracentesis revealed white blood cell count of 2,500 with 98% lymphocytes and serum ascites albumin gradient of 0.9 g/L. No acid-fast bacilli were seen by microscopic exam and culture was negative. Purified protein derivative skin test (PPD) was negative and CXR did not reveal any infiltrates. Esophagogastroduodenoscopy (EGD) and colonoscopy were unrevealing. The patient underwent exploratory laparotomy with round ligament and peritoneal biopsies that revealed numerous necrotizing granulomas. Acid-fast bacteria Ziehl-Neelsen stain (AFB) of the biopsy specimen revealed single acid-fast bacilli. Treatment for M. tuberculosis was initiated and final culture revealed that mycobacterium tuberculosis was sensitive to Isoniazid, Rifampin, Ethambutol, and Pyrazinamide. After 6 months of treatment, the ascites and peritoneal carcinomatosis resolved.

scholarly journals Extensive eye-oral-bronchial mucosal nodules with eosinopgillia: a rare case report and literature review

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Lujin Wu ◽  
Qianru Leng ◽  
Yan Wang ◽  
Daowen Wang ◽  
Danlei Yang
Keyword(s):  
Biopsy Specimen ◽  
Rare Case ◽  
Unknown Origin ◽  
Neoplastic Disease ◽  
Multisystem Disease ◽  
Case Presentation ◽  
Large Numbers ◽  
Detailed Medical History ◽  
Mucous Membranes ◽  
Rare Case Report

Abstract Background Mucosal nodules can be caused by infection, inflammation and neoplastic disease. Many noninfectious diseases, such as eosinophilia, amyloidosis, sarcoidosis, Wegener’s granuloma, langerhans cell histiocytosis etc., are associated with the formation of multisytem mucosal nodules, especially significant bronchial lesions. Detailed medical history, comprehensive metabolic profile, biopsy specimen and imaging examinations are required for differentiating among these disorders. The process of diagnosis and treatment of our patient’s mucosal nodules was challenging, which could be helpful to similar cases. Case presentation We represent a case of a 29-year-old woman with plentiful nodules of unknown origin on extensive mucous membranes. Biopsy specimen reports inflammatory lesions with large numbers of neutrophils, lymphocytes, and varying degrees of eosinophils. Treatment of anti-infection, anti-tussive and anti-allergic was ineffective, but glucocorticoid showed great improvement to her symptoms. Conclusion We experienced a rare case with plentiful nodules of unknown origin on extensive mucous membranes. She may be a specific phenotype of eosinophilia or may be a novel multisystem disease with respiratory system as the primary symptom. The diagnosis of our patient remains unclear, but tentative glucocorticoid therapy was beneficial.

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