Squamous Differentiation in the Thyroid: Metaplasia, Neoplasia, or Bystander?

2021 ◽  
pp. 106689692110651
Author(s):  
Meagan A. Chambers ◽  
Peter M. Sadow ◽  
Darcy A. Kerr
Keyword(s):  
Squamous Epithelium ◽  
Clinical Information ◽  
Follicular Cells ◽  
Squamous Differentiation ◽  
Neoplastic Processes ◽  
Molecular Context ◽  
Institutional Landscape ◽  
Aggressive Tumors ◽  
Pathology Reports ◽  
Thyroid Malignancies

Background. Squamous differentiation within the thyroid is seen in a variety of settings. Squamous epithelium is non-native to the thyroid, and its debated origins span reactive metaplasia and developmental/embryologic remnants. Despite a lack of clarity as to its evolution, squamous epithelium may be associated with both neoplastic and non-neoplastic processes. Methods. Thyroid pathology reports spanning a 30-year period were reviewed for terms indicating squamous features. Associated diagnostic and clinical information was collated. Results. Four hundred and twenty seven of 17,452 (2.4%) thyroid surgical pathology cases during this period utilized terminology indicating squamous differentiation including 243 malignant (58%) and 178 benign (42%) diagnoses. There were 111 (26%) primary thyroid malignancies with squamous differentiation, 116 (28%) malignancies of non-thyroid origin including local extension from nearby cancers, and 16 (4%) malignancies of uncertain primary. Most benign lesions were non-neoplastic (84%). The minor subset representing benign neoplasia was interpreted as secondary reactive changes. Conclusion. While squamous differentiation is seen routinely in the thyroid, it is most commonly reported in malignancy. For primary thyroid malignancies reported to demonstrate a squamous component, biologically aggressive tumors were overrepresented. Available evidence suggests that multiple pathways may contribute to the presence of squamous epithelium in the thyroid including metaplasia of mature follicular cells, development from established embryonic remnants, or inception in putative, incompletely characterized stem-like cells. Our retrospective review presents an institutional landscape from which further investigation into the frequency and unique histologic and molecular context of intrathyroidal squamous differentiation as a driver or terminal event in thyroid pathophysiology.

Magnetic resonance imaging of primary cerebral gliosarcoma: a report of 15 cases

2008 ◽  
Vol 49 (9) ◽  
pp. 1058-1067 ◽  
Author(s):  
L. Han ◽  
X. Zhang ◽  
S. Qiu ◽  
X. Li ◽  
W. Xiong ◽  
...  
Keyword(s):  
Magnetic Resonance ◽  
Clinical Information ◽  
Cerebellar Hemisphere ◽  
Imaging Features ◽  
Resonance Imaging ◽  
Mr Images ◽  
Peripheral Location ◽  
Pathology Reports ◽  
The Right ◽  
Radiologic Features

Background: Gliosarcomas are rare tumors with mixed glial and mesenchymal components. Many of their radiologic features resemble those of other primary brain malignancies. Purpose: To investigate the magnetic resonance (MR) imaging features of gliosarcomas. Material and Methods: We retrospectively reviewed the MR images, pathology reports, and clinical information of 11 male and four female patients aged 15–71 years to evaluate the location, morphology, enhancement, and other features of their pathologically confirmed gliosarcomas. Results: Apart from one tumor in the right cerebellar hemisphere, all were supratentorial. Two tumors were intraventricular, and four involved the corpus callosum. The tumors were well demarcated, with an inhomogeneous or cystic appearance and moderate-to-extensive surrounding edema. Thick walls with strong rim and ring-like enhancement were observed in 13 (87%). Seven (47%) showed intratumoral paliform enhancement. Conclusion: Gliosarcoma demonstrates certain characteristic MR features, such as supratentorial and peripheral location, well-demarcated, abutting a dural surface, uneven and thick-walled rim-like or ring enhancement, as well as intratumoral strip enhancement. These findings, combined with patient age, can aid the differential diagnosis of gliosarcomas from more common primary brain tumors.

Granulomas in Diagnostic Biopsies Associated With High Risk of Crohn’s Complications—But May Be Preventable

2021 ◽  
Author(s):  
Lindsey S Lawrence ◽  
Amer Heider ◽  
Andrew A M Singer ◽  
Haley C Neef ◽  
Jeremy Adler
Keyword(s):  
Intestinal Inflammation ◽  
Perianal Fistula ◽  
Granulomatous Inflammation ◽  
Clinical Information ◽  
Increased Risk ◽  
Tnf Α ◽  
Pathology Reports ◽  
Factor Α ◽  
Necrosis Factor ◽  
Reduced Risk

Abstract Background Granulomatous intestinal inflammation may be associated with aggressive Crohn’s disease (CD) behavior. However, this has not been confirmed, and it is unknown if associated disease complications are preventable. Methods This is a retrospective cohort of patients younger than 21 years at CD diagnosis (November 1, 2005 to November 11, 2015). Clinical information was abstracted, including dates of starting medications and the timing of perianal fistula or stricture development, if any. Diagnostic pathology reports were reviewed, and a subset of biopsy slides were evaluated by a blinded pathologist. Patients were excluded if perianal fistula or stricture developed within 30 days after CD diagnosis. Medications were included in analyses only if started >90 days before development of perianal fistula or stricture. Results In total, 198 patients were included. Half (54%) had granulomas at diagnosis. Granulomas were associated with a greater than 3-fold increased risk of perianal fistula (hazard ration [HR] = 3.24; 95% confidence interval CI], 1.40–7.48). Immunomodulator and anti-tumor necrosis factor-α (anti-TNF) therapy were associated with 90% (HR, = 0.10; 95% CI, 0.03–0.42) and 98% (HR, = 0.02; 95% CI, 0.01–0.10) reduced risk of perianal fistula, respectively. Patients with granulomatous inflammation preferentially responded to anti-TNF therapy with reduced risk of perianal fistula. The presence of granulomas was not associated with risk of stricture. Immunomodulator and anti-TNF therapy were associated with 96% (HR, = 0.04; 95% CI, 0.01–0.22) and 94% (HR, = 0.06; 95% CI, 0.02–0.20) reduced risk of stricture, respectively. Conclusions Granulomas are associated with increased risk of perianal fistula but not stricture. Steroid sparing therapies seem to reduce the risk of both perianal fistula and stricture. For those with granulomas, anti-TNF-α therapy greatly reduced the risk of perianal fistula development, whereas immunomodulators did not.

Histometrical Changes in the Thyroid Gland of Chabro Chicken Reared during Summer and Winter Seasons

2020 ◽  
Author(s):  
Amit Singh Vishen ◽  
Varsha Gupta ◽  
S.P. Singh ◽  
Abhinov Verma ◽  
Rakesh Kumar Gupta ◽  
...  
Keyword(s):  
Thyroid Gland ◽  
Seasonal Changes ◽  
Squamous Epithelium ◽  
Poultry Farm ◽  
Follicular Cells ◽  
Climatic Variations ◽  
Reticular Fibers ◽  
Poultry Birds ◽  
The Tropics ◽  
Apparently Healthy

Background: Chabro is a strain of poultry birds especially designed for backyard farming and is more adoptive to climatic variations in the tropics. The thyroid gland plays an important role in controlling basal metabolic rate. The histoarchitectural changes of the gland in association with seasonal changes has not been studied so far in Chabro. The present study describes the season related variations in the histometry of thyroid gland.Methods: Micrometrical studies were conducted on thyroid gland of eight to ten weeks old 24 apparently healthy Chabro chickens procured from Poultry Farm, DUVASU, Mathura after approval of CPCSEA. For this study the chickens were divided into two groups consist of 12 chickens in each group reared in summer and winter seasons.Result: Histologically, the thyroid gland was composed of stroma and parenchyma. The capsule had outer thick adipose and inner thin fibrous layers. The follicles were filled with colloid produced by the follicular cells. The percentage of small follicles was more followed by medium and large follicles. The follicles were lined by simple squamous epithelium in summer and cuboidal epithelial cells in winter. All micrometrical parameters, amount of reticular fibers, percentage of large and active follicles were higher in winter.

scholarly journals The feasibility of using natural language processing to extract clinical information from breast pathology reports

2012 ◽  
Vol 3 (1) ◽  
pp. 23 ◽  
Author(s):  
KevinS Hughes ◽  
JullietteM Buckley ◽  
SuzanneB Coopey ◽  
John Sharko ◽  
Fernanda Polubriaginof ◽  
...  
Keyword(s):  
Natural Language Processing ◽  
Natural Language ◽  
Language Processing ◽  
Clinical Information ◽  
Breast Pathology ◽  
Pathology Reports

Mixed invasive ductal-lobular carcinoma: Clinicopathological characterization and clinical outcomes.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. e12531-e12531
Author(s):  
Azadeh Nasrazadani ◽  
Yujia Li ◽  
George Tseng ◽  
Jennifer Xavier ◽  
Sarah Hugar ◽  
...  
Keyword(s):  
Cancer Registry ◽  
Ductal Carcinoma ◽  
Lobular Carcinoma ◽  
Disease Free Survival ◽  
Clinical Information ◽  
Cancer Registries ◽  
Limited Information ◽  
Pathology Reports ◽  
Definition Of ◽  
The Individual

e12531 Background: Mixed Invasive Ductal-Lobular Carcinoma (IDC-L) is a histological subtype of invasive breast carcinoma comprised of both ductal and lobular morphologies. There is limited information on the relative proportions of the individual components in IDC-L and on outcomes compared to invasive lobular carcinoma (ILC) and invasive ductal carcinoma (IDC). Methods: Clinical information was abstracted from 16,308 patients with invasive breast cancer seen at UPMC Magee Women’s Hospital from 1990-2017 using the UPMC Network Cancer Registry. A systematic chart review was performed on a subset of patients annotated with IDC-L (n=806); however, a thorough review of pathology reports led to the exclusion of all but 408 patients for further analysis, due to the lack of a standardized definition of IDC-L. Of the 408 cases, 92% were estrogen receptor (ER)+. Survival of patients with ER+ IDC-L (n=376) was compared to ER+ IDC (n=9,716) and ER+ ILC (1,465). For a subset of IDC-L cases (n=54), distributions of individual subtype components were abstracted from pathology reports. Results: IDC-L made up 2.5% of the total cases (408/16,308). IDC-L tumors were on average 31% ductal and 69% lobular (p =0.001). Survival analysis showed worse disease free survival (DFS) (p=0.05) and overall survival (OS) (p=0.002) in patients with ER+ ILC compared to ER+ IDC, with ER+ IDC-L patients showing a median OS superior to ILC yet inferior to IDC counterparts (ns). Conclusions: Identification of patients with IDC-L through cancer registry protocols representative of standard practices by national cancer registries revealed a lack of a standardized definition of mixed IDC-L. Reliance on accuracy of these diagnoses calls in to question the reliability of prior clinico-pathologic analyses reported on this topic. DFS and OS of IDC-L patients falls between that of IDC and ILC patients while ILC patients showed significantly worse outcome. The predominant distribution of lobular morphology in IDC-L tumors suggests this subtype may have additional characteristics similar to lobular rather than ductal carcinomas. Comprehensive clinical and molecular characterization of a carefully identified IDC-L cohort is underway.

scholarly journals Roadmap to a Comprehensive Clinical Data Warehouse for Precision Medicine Applications in Oncology

2017 ◽  
Vol 16 ◽  
pp. 117693511769434 ◽  
Author(s):  
David J Foran ◽  
Wenjin Chen ◽  
Huiqi Chu ◽  
Evita Sadimin ◽  
Doreen Loh ◽  
...  
Keyword(s):  
Precision Medicine ◽  
Clinical Data ◽  
Clinical Information ◽  
Trial Management ◽  
Text Documents ◽  
Innovative Solutions ◽  
Clinical Trial Management ◽  
Pathology Reports ◽  
Tumor Registries ◽  
Radiology And Pathology

Leading institutions throughout the country have established Precision Medicine programs to support personalized treatment of patients. A cornerstone for these programs is the establishment of enterprise-wide Clinical Data Warehouses. Working shoulder-to-shoulder, a team of physicians, systems biologists, engineers, and scientists at Rutgers Cancer Institute of New Jersey have designed, developed, and implemented the Warehouse with information originating from data sources, including Electronic Medical Records, Clinical Trial Management Systems, Tumor Registries, Biospecimen Repositories, Radiology and Pathology archives, and Next Generation Sequencing services. Innovative solutions were implemented to detect and extract unstructured clinical information that was embedded in paper/text documents, including synoptic pathology reports. Supporting important precision medicine use cases, the growing Warehouse enables physicians to systematically mine and review the molecular, genomic, image-based, and correlated clinical information of patient tumors individually or as part of large cohorts to identify changes and patterns that may influence treatment decisions and potential outcomes.

Clinicopathological study of blue nevi of the gastrointestinal (GI) tract: first case series

2020 ◽  
pp. jclinpath-2020-206757
Author(s):  
Naziheh Assarzadegan ◽  
Kevan Salimian ◽  
Danielle Hutchings ◽  
Annika Lisbeth Windon ◽  
Lysandra Voltaggio ◽  
...  
Keyword(s):  
Case Series ◽  
Clinical Information ◽  
Endoscopic Examination ◽  
Gi Tract ◽  
Pigmented Lesions ◽  
First Case ◽  
Clinicopathological Findings ◽  
Pathology Reports ◽  
Middle Aged Adults

AimBlue nevus (BN) is a benign melanocytic proliferation that is typically cutaneous. Extracutaneous BN is infrequent and is reported in the mucosa of various organs. Gastrointestinal (GI) tract BN is rare. Here, we describe the clinicopathological findings of the largest series of GI tract BNs.MethodsA search of our Pathology Data System (1984–2019) identified six GI tract blue nevi. Clinical information, pathology reports and available H&E-stained section slides were reviewed.ResultsLesions predominated in the middle-aged adults (mean 54, range 27–80) with a slight female predominance (66%). Most cases arose in the rectum and colon (83%), with one gastric lesion (17%). Four cases were identified during endoscopic examination performed either for screening or for unrelated symptoms (66%). Two patients presented with rectal bleeding (33%) unassociated with the BN. Endoscopically, most lesions appeared as superficial hyperpigmented areas (83%). One case was described as abnormal mucosa (17%). Microscopically, the mucosa was involved in all of the cases (100%). One case showed submucosal extension in addition to the mucosal component (17%). Lesions showed a proliferation of bland spindle cells with abundant granular pigment. No nuclear atypia or mitoses were identified. Immunostains showed immunoreactivity for melanocytic markers. Follow-up information available for five patients showed no recurrences to date (mean follow-up 1 year).ConclusionsBN is a benign melanocytic proliferation. It is important to be aware of the occurrence of such lesions outside of the skin and consider the possibility of BN when pigmented lesions are encountered in the GI tract.

Epithelial Membrane Antigen Expression in Benign and Malignant Squamous Epithelium of the Head and Neck

1987 ◽  
Vol 97 (3) ◽  
pp. 288-293 ◽  
Author(s):  
Bruce Fernandez ◽  
Judi Lund ◽  
Frederick Meyers
Keyword(s):  
Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Epithelial Membrane Antigen ◽  
Squamous Epithelium ◽  
Clinical Information ◽  
Antigen Expression ◽  
Immunoperoxidase Technique ◽  
Fixed Tissue ◽  
Well Differentiated

A distinction between benign, preneoplastic, and malignant tissue, based upon the expression of surface antigens, would provide useful clinical information. Epithelial membrane antigen (EMA) has been reported in squamous cell carcinomas, but not in normal squamous epithelium. Twenty-nine specimens from 15 patients, representative of the spectra of changes seen in squamous cell epithelium from normal through dysplasia to squamous cell carcinoma, were fixed in B-5 and examined with anti-EMA monoclonal antibody in an immunoperoxidase technique. Normal squamous epithelium does express EMA. Squamous cell carcinoma also expresses EMA. Well-differentiated tumors stain more intensely and in greater numbers of cells than less-differentiated tumors. The presence or absence of EMA expression does not distinguish normal squamous epithelium from carcinoma. Investigations of membrane antigen content in fixed tissue must use methods of fixation that preserve antigenicity. While strict quantitation of immunoperoxidase preparations is not possible, quantitative differences in expression may be important.

Amplification of chromosome 3q21-25 in urothelial carcinoma with squamous differentiation.

2016 ◽  
Vol 34 (2_suppl) ◽  
pp. 457-457
Author(s):  
Thomas Sanford ◽  
Maxwell V. Meng ◽  
Sima P. Porten
Keyword(s):  
Urothelial Carcinoma ◽  
Population Based ◽  
Squamous Differentiation ◽  
Chi Square ◽  
Squamous Cancer ◽  
Variant Histology ◽  
Carcinoma Of The Bladder ◽  
Pathology Reports ◽  
Chromosomal Amplifications ◽  
Chi Square Analysis

457 Background: Squamous differentiation is found in up to 60% of patients with urothelial carcinoma of the bladder. There is conflicting evidence regarding clinical relevance of aberrant urothelial differentiation as both population-based and retrospective studies have supported and refuted its correlation with poor prognosis and advanced stage in multivariate models. The biology of these tumors is poorly understood but some suggest that extensive squamous differentiation may resemble pure squamous tumors with similar responses to chemotherapy, radiation, and higher rate of local recurrence. Our aim was to compare tumors with squamous differentiation with those of pure urothelial histology at the genomic level to better elucidate targetable differences. Methods: We reviewed pathology reports for 412 patients with urothelial carcinoma from TCGA to identify patients with any amount squamous differentiation. Copy number alteration data obtained via the GISTC algorithm was downloaded from cbioportal.com. Chi square analysis was used to compare chromosomal amplifications in samples with squamous differentiation compared with samples that had no amount of variant histology. Results: 50 patients (12%) had some squamous differentiation, of which 15 commented on the percent of involvement – on average, 17% of the sample had squamous differentiation. A total of 257 (62%) of patients had no variant histology. Multiple specific sites in the 3q21-26 chromosomal region were noted to be amplified in squamous histology compared with pure urothelial carcinoma. Specific genes found to be amplified included SOX2 and PIK3. Conclusions: Amplifications of chromosome 3q21-25 were enriched in patients with squamous differentiation compared to those with pure urothelial carcinoma of the bladder. Amplification of this region has been reported in squamous transformation in multiple sites, including lung cancer. This study shows that, similar to other cancers, SOX2 may be necessary for squamous transformation. Furthermore, squamous cancer, which has traditionally though to be chemo-resistant, may respond to agents that target amplifications of genes found on the long arm of chromosome 3 including the PIK3-Akt pathway.

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