Sarcomatoid Carcinoma Manifesting as Recurrent Rectal Cancer and Mimicking Radiation-Induced Extraskeletal Osteosarcoma: A Case Report

2017 ◽  
Vol 25 (8) ◽  
pp. 732-738 ◽  
Author(s):  
MiJo Lee ◽  
Hyun-Jin Son ◽  
Je-Ho Jang ◽  
Hyun-Young Han ◽  
Moon Hyang Park
Keyword(s):  
Rectal Cancer ◽  
Periodic Acid ◽  
Neoadjuvant Chemoradiotherapy ◽  
Sarcomatoid Carcinoma ◽  
Gluteus Maximus ◽  
Recurrent Rectal Cancer ◽  
Extraskeletal Osteosarcoma ◽  
Periodic Acid Schiff ◽  
Calcified Tissue ◽  
Radiation Induced

Here, we report an unusual case of sarcomatoid carcinoma mimicking extraskeletal osteosarcoma that manifested as recurrent rectal cancer. Five years earlier, a 76-year-old male patient had undergone neoadjuvant chemoradiotherapy followed by a laparoscopic low anterior resection due to adenocarcinoma of the rectum. He was admitted because of pain in the anus and left hip. He underwent abdominal computed tomography that revealed a newly developed left perirectal mass with gluteus maximus invasion measuring up to 8 cm, and therefore, an abdominoperineal resection was performed. Histologically, the tumor revealed sheets of spindled or epithelioid cells, an absence of gland formation, mucicarmine and periodic acid–Schiff stain negativity, and prominent intercellular deposits of osteoid-like calcified tissue. Tumor cells were diffusely immunoreactive for vimentin and cytokeratins. Ultrastructural examination demonstrated microvilli on the surface or within intercellular spaces. In this report, we also discuss the possible pathogenesis as well as the differential diagnosis.

scholarly journals Neoadjuvant Chemoradiation Combined with Regional Hyperthermia in Locally Advanced or Recurrent Rectal Cancer

Cancers ◽  
2021 ◽  
Vol 13 (6) ◽  
pp. 1279
Author(s):  
Oliver J. Ott ◽  
Cihan Gani ◽  
Lars H. Lindner ◽  
Manfred Schmidt ◽  
Ulf Lamprecht ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Tumor Regression ◽  
Locally Advanced ◽  
Neoadjuvant Chemoradiotherapy ◽  
Multimodality Treatment ◽  
Complete Response ◽  
Neoadjuvant Chemoradiation ◽  
Recurrent Rectal Cancer ◽  
Treatment Schedule ◽  
Regional Hyperthermia

Background: To prospectively analyze feasibility and pathological complete response (pCR) rates of neoadjuvant chemoradiotherapy combined with regional hyperthermia (RHT) in patients with locally advanced (LARC) or recurrent (LRRC) rectal cancer. Methods: between 2012 and 2018, 111 patients with UICC stage IIB-IV or any locally recurrent rectal cancer were included (HyRec-Trial, ClinicalTrials.gov Identifier: NCT01716949). Patients received radiotherapy with concurrent 5-Fluororuracil (5-FU)/Capecitabine and Oxaliplatin, and RHT. Stage 1 feasibility analysis evaluated dose-limiting toxicities (DLT) after 19 patients, stage 2 after 59 evaluable patients. Analysis of the pCR rate was based on histopathological reports. Results: the feasibility rates for stages 1 and 2 were 90% (17/19) and 73% (43/59), respectively. In the intention-to-treat population the pCR rate was 19% (20/105; 90% confidence interval (CI) 13.0–26.5). In the per-protocol-analysis, complete tumor regression was seen in 28% (18/64) and 38% (3/8) of the patients with LARC and LRRC, respectively. Complete resection rates (R0) among patients with LARC and LRRC who received surgery were 99% (78/84) and 67% (8/12). Conclusions: the intensified neoadjuvant and multimodality treatment schedule was feasible and led to comparable early toxicity rates as described by other trials that used the similar chemoradiation protocol. The presented treatment regimen resulted in a very high pCR rate and appears as a promising option for patients with LRRC.

Modified Gluteus Maximus V-Y Advancement Flap for Reconstruction of Perineal Defects After Resection of Intrapelvic Recurrent Rectal Cancer: Report of a Case

Surgery Today ◽  
2003 ◽  
Vol 33 (8) ◽  
pp. 626-629 ◽  
Author(s):  
Takanori Goi ◽  
Kenji Koneri ◽  
Kanji Katayama ◽  
Kazuo Hirose ◽  
Osamu Takashima ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Gluteus Maximus ◽  
Advancement Flap ◽  
Recurrent Rectal Cancer

scholarly journals Radiation-Induced Pelvic Colorectal Obstruction After Neoadjuvant Chemoradiotherapy and Sphincter-Saving Surgery for Rectal Cancer: Is IMRT Better?

2020 ◽  
Author(s):  
Shenghui Huang ◽  
Minghong Chen ◽  
Xiaojie Wang ◽  
Yuangui Chen ◽  
Xingrong Lu ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Neoadjuvant Chemoradiotherapy ◽  
Intensity Modulated Radiotherapy ◽  
Severe Complication ◽  
Clinical Parameters ◽  
Colorectal Obstruction ◽  
Receiver Operating Characteristic Curves ◽  
Diverting Stoma ◽  
Sphincter Saving ◽  
Radiation Induced

Abstract PurposeRadiation-induced pelvic colorectal obstruction (RIPCO) is a severe complication after neoadjuvant chemoradiotherapy (NCRT) and sphincter-saving surgery (SPS) with for rectal cancer. The incidence and risk factors remain unclear. This study aimed to evaluate the influences of anatomical and clinical parameters including radiation modalities on this complication.MethodsFrom 2010 to 2018, data from patients who received NCRT and SPS with a diverting stoma for rectal cancer were collected. Patients with clinical parameters and complete pelvimetric parameters associated with RIPCO were included for univariate and multivariate analyses. Receiver operating characteristic curves were used to calculate the best cutoff value.ResultsA total of 726 patients with rectal carcinoma received NCRT and SPS with diverting stoma, and 157 patients had complete pelvimetric data. Eighteen of the 726 (2.5%) patients developed RIPCO. Eleven patients only received recreation of a diverting stoma, and four were cured by intersphincteric resection with reconstruction of anastomosis and diverting stoma. In multivariate analysis, BMI (P =0.001), sacral depth (P=0.046), and Intensity-modulated radiotherapy (IMRT) (P<0.001) were independent predictors. The cutoff values of BMI and sacral depth were 21.1 kg/m2 and 4.1 cm, respectively. IMRT was independently associated with a lower incidence of RIPCO (P<0.001). The four-factor scoring system showed that the sensitivity was 88.9%, and the specificity was 85.6%. The AUC was 0.921.ConclusionRIPCO is a rare but severe complication after SPS following NCRT. A BMI more than 21.1 kg/m2, a sacral depth less than 4.1 cm, and IMRT may decrease the risk of RIPCO.

Ultrastructure of the Parotid Gland of the Nine-Banded Armadillo

1977 ◽  
Vol 35 ◽  
pp. 640-641
Author(s):  
J. R. Ruby
Keyword(s):  
Endoplasmic Reticulum ◽  
Parotid Gland ◽  
Periodic Acid ◽  
Acinar Cells ◽  
Duct System ◽  
Parotid Glands ◽  
Dasypus Novemcinctus ◽  
Anterior Portion ◽  
Periodic Acid Schiff ◽  
Thin Sections

Parotid glands were obtained from five adult (four male and one female) armadillos (Dasypus novemcinctus) which were perfusion-fixed. The glands were located in a position similar to that of most mammals. They extended interiorly to the anterior portion of the submandibular gland.In the light microscope, it was noted that the acini were relatively small and stained strongly positive with the periodic acid-Schiff (PAS) and alcian blue techniques, confirming the earlier results of Shackleford (1). Based on these qualities and other structural criteria, these cells have been classified as seromucous (2). The duct system was well developed. There were numerous intercalated ducts and intralobular striated ducts. The striated duct cells contained large amounts of PAS-positive substance.Thin sections revealed that the acinar cells were pyramidal in shape and contained a basally placed, slightly flattened nucleus (Fig. 1). The rough endoplasmic reticulum was also at the base of the cell.

Detection of Carriers in Glanzmann's Thrombasthenia

1983 ◽  
Vol 49 (03) ◽  
pp. 182-186
Author(s):  
G T E Zonneveld ◽  
E F van Leeuwen ◽  
A Sturk ◽  
J W ten Cate
Keyword(s):  
Bleeding Time ◽  
Periodic Acid ◽  
Type I ◽  
Clot Retraction ◽  
Periodic Acid Schiff ◽  
Glanzmann’S Thrombasthenia ◽  
Aggregation Response ◽  
Glanzmann's Thrombasthenia ◽  
Sds Page ◽  
Reduced State

SummaryQuantitative glycoprotein (GP) analysis of whole platelets or platelet membranes was performed by SDS-polyacrylamide gelelectrophoresis (SDS-PAGE) and periodic acid Schiff staining in the families of two unrelated Glanzmann’s thrombasthenia (GT) patients. Each family consisted of two symptom free parents, a symptom free daughter and a GT daughter. All symptom free members had a normal bleeding time, clot retraction and platelet aggregation response to adenosine 5’-diphosphate (ADP), collagen and adrenalin. Platelet Zw* antigen was normally expressed in these subjects. GT patiens, classified as a type I and II subject, showed reduced amounts of GP lib and of GP nia. Analysis of isolated membranes in the non-reduced state, however, showed that the amount of GP Ilia was also reduced in three of the four parents, whereas one parent (of the GT type I patient) and the two unaffected daughters had normal amounts of GP Ilia. Quantitative SDS-PAGE may therefore provide a method for the detection of asymptomatic carriers in GT type I and II.

Swim bladder mycosis in farmed rainbow trout Oncorhynchus mykiss caused by Phoma herbarum and experimental verification of pathogenicity

2020 ◽  
Vol 138 ◽  
pp. 237-246 ◽  
Author(s):  
J Řehulka ◽  
A Kubátová ◽  
V Hubka
Keyword(s):  
Rainbow Trout ◽  
Histopathological Examination ◽  
Periodic Acid ◽  
Bladder Wall ◽  
Swim Bladder ◽  
Cell Reactivity ◽  
Periodic Acid Schiff ◽  
Posterior Portion ◽  
Hepatic Congestion ◽  
Phoma Herbarum

In this study, spontaneous swim bladder mycosis was documented in a farmed fingerling rainbow trout from a raceway culture system. At necropsy, the gross lesions included a thickened swim bladder wall, and the posterior portion of the swim bladder was enlarged due to massive hyperplasia of muscle. A microscopic wet mount examination of the swim bladder contents revealed abundant septate hyphae, and histopathological examination showed periodic acid-Schiff-positive mycelia in the lumen and wall of the swim bladder. Histopathological examination of the thickened posterior swim bladder revealed muscle hyperplasia with expansion by inflammatory cells. The causative agent was identified as Phoma herbarum through morphological analysis and DNA sequencing. The disease was reproduced in rainbow trout fingerlings using intraperitoneal injection of a spore suspension. Necropsy in dead and moribund fish revealed extensive congestion and haemorrhages in the serosa of visceral organs and in liver and abdominal serosanguinous fluid. Histopathological examination showed severe hepatic congestion, sinusoidal dilatation, Kupffer cell reactivity, leukostasis and degenerative changes. Fungi were disseminated to the liver, pyloric caeca, kidney, spleen and heart. Although infections caused by Phoma spp. have been repeatedly reported in fish, species identification has been hampered by extensive taxonomic changes. The results of this study confirmed the pathogenicity of P. herbarum in salmonids by using a reliably identified strain during experimental fish infection and provides new knowledge regarding the course of infection.

Erdheim-Chester Disease Presenting with Histiocytic Colitis and Cytokine Storm

2017 ◽  
Vol 26 (2) ◽  
pp. 183-187
Author(s):  
George P. Christophi ◽  
Yeshika Sharma ◽  
Quader Farhan ◽  
Umang Jain ◽  
Ted Walker ◽  
...  
Keyword(s):  
Periodic Acid ◽  
Poor Response ◽  
Rare Type ◽  
Periodic Acid Schiff ◽  
Hematopoietic Stem ◽  
Hemodynamic Compromise ◽  
Erdheim Chester Disease ◽  
Erdheim Chester ◽  
Chester Disease ◽  
Segmental Colitis

Background: Non-Langerhans histiocytosis is a group of inflammatory lymphoproliferative disorders originating from non-clonal expansion of hematopoietic stem cells into cytokine-secreting dendritic cells or macrophages. Erdheim-Chester Disease (ECD) is a rare type of non-Langerhans cell histiocytosis characterized by tissue inflammation and injury caused by macrophage infiltration and histologic findings of foamy histiocytes. Often ECD involves the skeleton, retroperitoneum and the orbits. This is the first report documenting ECD manifesting as segmental colitis and causing cytokine-release syndrome.Case presentation: A 68-year old woman presented with persistent fever without infectious etiology and hematochezia. Endoscopy showed segmental colitis and pathology revealed infiltration of large foamy histiocytes CD3-/CD20-/CD68+/CD163+/S100- consistent with ECD. The patient was empirically treated with steroids but continued to have fever and developed progressive distributive shock.Conclusion: This case report describes the differential diagnosis of infectious and immune-mediated inflammatory and rheumatologic segmental colitis. Non-Langerhans histiocytosis and ECD are rare causes of gastrointestinal inflammation. Prompt diagnosis is imperative for the appropriate treatment to prevent hemodynamic compromise due to distributive shock or gastrointestinal bleeding. Importantly, gastrointestinal ECD might exhibit poor response to steroid treatment and other potential treatments including chemotherapy, and biologic treatments targeting IL-1 and TNF-alpha signaling should be considered.Abbreviations: AFB: acid-fast bacilli; ECD: Erdheim-Chester Disease; IBD: inflammatory bowel disease; PASD: periodic acid-Schiff with diastase; TB: tuberculosis

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