scholarly journals The Role of Imagistics in the Diagnosis of Chondrosarcomas

2018 ◽  
Vol 1 (Supplement) ◽  
pp. 22
Author(s):  
A.N. Marinescu ◽  
A.I. Nicula ◽  
M.A. Bratu ◽  
G. Iana
Keyword(s):  
Biopsy Specimen ◽  
Bone Tumors ◽  
Malignant Tumors ◽  
Low Grade ◽  
High Grade ◽  
Histological Subtypes ◽  
Size Type ◽  
Cartilaginous Tumors

Abstract Chondrosarcomas are malignant cartilaginous tumors, with many histological subtypes and three grades based on cellularity. They are the second most common primary malignant tumors of the bone. From the histopathologically proved clinical cases, we are reviewing the imaging semiology - size, type of calcifications, cortical breach, endosteal scalloping, permeative or moth eaten bone appearance, and revealing other differentiation elements like location, age, and pain. A special point is the frequent difficulty in distinguishing between enchondromas and low grade conventional chondrosarcomas - as the lesions are very similar both histologically and radiographically. The radiologist should point the area to aim on the biopsy - at areas that may harbor foci of high-grade tumor, such as the ones of endosteal scalloping, soft-tissue components, or diffusely enhancing areas with minimal mineralization. It is known that with cartilaginous tumors, histopathologic examination of the biopsy specimen alone does not permit an accurate classification of the tumor. We emphasized the role of imaging in positive and differential diagnosis, management, and therapy of these bone tumors.

Cartilaginous Tumors of the Larynx

1995 ◽  
Vol 104 (3) ◽  
pp. 251-255 ◽  
Author(s):  
Kenneth O. Devaney ◽  
Alfio Ferlito ◽  
Carl E. Silver
Keyword(s):  
Biopsy Specimen ◽  
Daily Practice ◽  
Low Grade ◽  
High Grade ◽  
Maximum Dimension ◽  
Cytologic Atypia ◽  
Clear Cut ◽  
Cartilaginous Tumor ◽  
Cartilaginous Tumors ◽  
Cartilaginous Lesion

Cartilaginous tumors of the larynx, while rare, will on occasion be encountered by the otolaryngologist in routine daily practice. True laryngeal chondromas are exceedingly rare, and as a consequence, a putative diagnosis of chondroma should be viewed with suspicion. On pathologic examination, laryngeal chondromas usually prove to be small lesions (less than 2 cm in maximum dimension) and may arise in children or adults. Laryngeal chondrosarcomas, by contrast, usually prove to be larger lesions (exceeding 3 cm in greatest dimension) and are typically found in adults. While high-grade chondrosarcomas are readily identifiable on light microscopic study, the distinction between a chondroma and a low-grade chondrosarcoma is often not so clear-cut. Some low-grade chondrosarcomas may show a slight increase in both cellularity and cytologic atypia when compared with chondromas, but the two patterns often overlap. When faced with a limited biopsy specimen of a laryngeal cartilaginous lesion in which neither increased cellularity nor recognizable cytologic atypia is found, a diagnosis of “cartilaginous tumor without obvious evidence of malignancy — further classification dependent on examination of the lesion in its entirety,” or words to this effect, is recommended.

Individual and Community: The Changing Role of Megaliths in the Orcadian Neolithic

1985 ◽  
Vol 51 (1) ◽  
pp. 59-74 ◽  
Author(s):  
Niall Sharples
Keyword(s):  
The Other ◽  
Significant Problem ◽  
Neolithic Period ◽  
Size Type ◽  
The Individual ◽  
Changing Role

This paper is an exploration of the chronological development of a series of elaborate and architecturally distinctive chambered tombs on the Islands of Orkney. It begins with a short critique of the present views of the Orcadian Neolithic and highlights a failure to understand chronological developments as the most significant problem. Thus after a brief classification of the monuments there is a detailed discussion of the chronological evidence which consciously avoids typological assumptions. This is followed by an examination of the various uses the tombs were put to and involves an assessment of the location and architectural visibility of the monuments and the remains found in the chamber. When combined with the chronological evidence a series of changes in monument size, type, location and use can be hypothesized for the neolithic period. This culminates in a shift away from burial monuments to physically defined spaces, presumably used for ceremonial purposes. These changes can be interpreted as deliberate manipulation by groups within that society to change the ideological concepts which defined the role of the individual in relation to the other members of the society.

scholarly journals Immunohistochemical analysis of beta-catenin expression: a probable prognostic marker and potential therapeutic target in renal cell carcinoma

2021 ◽  
Author(s):  
Ayan Kundu ◽  
Anway Sen ◽  
Shouvik Choudhury ◽  
Tapan Kumar Mandal ◽  
Debasish Guha ◽  
...  
Keyword(s):  
Renal Cell Carcinoma ◽  
Cell Carcinoma ◽  
Renal Cell ◽  
Tumor Stage ◽  
Low Grade ◽  
Beta Catenin ◽  
High Grade ◽  
Positive Correlation ◽  
Score Difference

Background and aims. Renal cell carcinoma (RCC) seems to be the most aggressive type of genitourinary neoplasm. Down regulation of normal beta-catenin expression contributes to development of RCC, reflecting the role of beta-catenin/Wnt signaling pathway in pathogenesis. This study aims to evaluate the significance of beta-catenin expression and its correlation with the prognostic parameters. Methods. A cross-sectional observational study was carried out in a tertiary care center on 58 RCC cases using variables like histological grade and type, tumor stage, necrosis. Formalin fixed, paraffin-embedded blocks were evaluated for beta-catenin expression by immunohistochemistry using scoring system. Data were analyzed by mean ± SD, χ2 test, Pearson’s correlation test. Results. Membranous score (MS) had a strong negative correlation with tumor stage (r = -0.407, p = 0.044) and grade (r = -0.787, p = <0.001). Mean membranous score difference between low (Stage 1 and 2) vs. high stage (Stage 3 and 4) and low (Grade 1 and 2) vs. high grade (Grade 3 and 4) was statistically significant (p < 0.001). Cytoplasmic score (CS) had positive correlation with tumor stage (r = 0.586; p = 0.002). No significant correlation was evident between cytoplasmic scores and tumor grade, however the mean cytoplasmic score difference between low grade vs. high grade was statistically significant (p < 0.001). Conclusion. Beta-catenin may play a crucial role in the pathogenesis of RCC and has a positive correlation with the biological behavior of this tumor. The important role of beta-catenin as a prognostic parameter and probably a critical evaluator of targeted chemotherapy cannot be overemphasized.

scholarly journals Interobserver reproducibility of The Paris System for Reporting Urinary Cytology

CytoJournal ◽  
2017 ◽  
Vol 14 ◽  
pp. 17 ◽  
Author(s):  
Theresa Long ◽  
Lester J. Layfield ◽  
Magda Esebua ◽  
Shellaine R. Frazier ◽  
D. Tamar Giorgadze ◽  
...  
Keyword(s):  
Urothelial Carcinoma ◽  
Urinary Cytology ◽  
Low Grade ◽  
High Grade ◽  
Urothelial Cells ◽  
Urothelial Carcinomas ◽  
Absolute Agreement ◽  
Potential Impact ◽  
Urine Specimens

Background: The Paris System for Reporting Urinary Cytology represents a significant improvement in classification of urinary specimens. The system acknowledges the difficulty in cytologically diagnosing low-grade urothelial carcinomas and has developed categories to deal with this issue. The system uses six categories: unsatisfactory, negative for high-grade urothelial carcinoma (NHGUC), atypical urothelial cells, suspicious for high-grade urothelial carcinoma, high-grade urothelial carcinoma, other malignancies and a seventh subcategory (low-grade urothelial neoplasm). Methods: Three hundred and fifty-seven urine specimens were independently reviewed by four cytopathologists unaware of the previous diagnoses. Each cytopathologist rendered a diagnosis according to the Paris System categories. Agreement was assessed using absolute agreement and weighted chance-corrected agreement (kappa). Disagreements were classified as low impact and high impact based on the potential impact of a misclassification on clinical management. Results: The average absolute agreement was 65% with an average expected agreement of 44%. The average chance-corrected agreement (kappa) was 0.32. Nine hundred and ninety-nine of 1902 comparisons between rater pairs were in agreement, but 12% of comparisons differed by two or more categories for the category NHGUC. Approximately 15% of the disagreements were classified as high clinical impact. Conclusions: Our findings indicated that the scheme recommended by the Paris System shows adequate precision for the category NHGUC, but the other categories demonstrated unacceptable interobserver variability. This low level of diagnostic precision may negatively impact the applicability of the Paris System for widespread clinical application.

scholarly journals Diagnostic Value of CT- and MRI-Based Texture Analysis and Imaging Findings for Grading Cartilaginous Tumors in Long Bones

2021 ◽  
Vol 11 ◽  
Author(s):  
Xue-Ying Deng ◽  
Hai-Yan Chen ◽  
Jie-Ni Yu ◽  
Xiu-Liang Zhu ◽  
Jie-Yu Chen ◽  
...  
Keyword(s):  
Texture Analysis ◽  
Feature Model ◽  
Imaging Feature ◽  
Low Grade ◽  
Long Bones ◽  
Imaging Features ◽  
High Grade ◽  
Accuracy Rate ◽  
Predictive Values ◽  
Cartilaginous Tumors

ObjectiveTo confirm the diagnostic performance of computed tomography (CT)-based texture analysis (CTTA) and magnetic resonance imaging (MRI)-based texture analysis for grading cartilaginous tumors in long bones and to compare these findings to radiological features.Materials and MethodsTwenty-nine patients with enchondromas, 20 with low-grade chondrosarcomas and 16 with high-grade chondrosarcomas were included retrospectively. Clinical and radiological information and 9 histogram features extracted from CT, T1WI, and T2WI were evaluated. Binary logistic regression analysis was performed to determine predictive factors for grading cartilaginous tumors and to establish diagnostic models. Another 26 patients were included to validate each model. Receiver operating characteristic (ROC) curves were generated, and accuracy rate, sensitivity, specificity and positive/negative predictive values (PPV/NPV) were calculated.ResultsOn imaging, endosteal scalloping, cortical destruction and calcification shape were predictive for grading cartilaginous tumors. For texture analysis, variance, mean, perc.01%, perc.10%, perc.99% and kurtosis were extracted after multivariate analysis. To differentiate benign cartilaginous tumors from low-grade chondrosarcomas, the imaging features model reached the highest accuracy rate (83.7%) and AUC (0.841), with a sensitivity of 75% and specificity of 93.1%. The CTTA feature model best distinguished low-grade and high-grade chondrosarcomas, with accuracies of 71.9%, and 80% in the training and validation groups, respectively; T1-TA and T2-TA could not distinguish them well. We found that the imaging feature model best differentiated benign and malignant cartilaginous tumors, with an accuracy rate of 89.2%, followed by the T1-TA feature model (80.4%).ConclusionsThe imaging feature model and CTTA- or MRI-based texture analysis have the potential to differentiate cartilaginous tumors in long bones by grade. MRI-based texture analysis failed to grade chondrosarcomas.

Role of magnetic resonance imaging in prediction of chondrosarcoma of bone grade

2021 ◽  
pp. 21-24
Author(s):  
A. V. Fedorova ◽  
N. V. Kochergina ◽  
A. B. Bludov ◽  
I. V. Boulycheva ◽  
E. A. Sushentsov ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Diagnostic Value ◽  
Low Grade ◽  
High Grade ◽  
Resonance Imaging ◽  
Accurate Definition ◽  
Definition Of ◽  
Decisive Rule

Purpose. Determining the diagnostic value of magnetic resonance imaging in the accurate definition of chondrosarcoma of bone grade at the pre-surgery examination. Material and methods. We analyzed examination data (magnetic resonance imaging with no contrast enhancement) of 70 patients with chondrosarcoma (35 patients with low-grade chondrosarcoma and 35 patients with high grade chondrosarcoma). Informative weighted coefficients were determined separately for ‘learning’ and ‘examination’ samples. On the basis of weighted coefficients, the decisive rule was created for differentiation between low-grade and high-grade chondrosarcoma. Results. The sensitivity of the method was 87.0%, specificity was 95.6%, total correct classification was 91.03%. Conclusion. Magnetic resonance imaging is a highly informative method for prediction of chondrosarcoma grade at the pre-surgery examination.

scholarly journals Classification of mucinous appendiceal neoplasm and pseudomyoxma peritonei

2018 ◽  
Vol 8 (1) ◽  
pp. 1301-1307
Author(s):  
Arnab Ghosh
Keyword(s):  
Goblet Cell ◽  
Wide Spectrum ◽  
Low Grade ◽  
Controversial Issues ◽  
High Grade ◽  
Goblet Cell Carcinoid ◽  
Signet Ring Cells ◽  
Mucinous Neoplasm ◽  
Signet Ring

Mucinous appendiceal tumors are uncommon and include a wide spectrum of tumors whose classification remained controversial. Some of these mucin producing appendiceal tumors can disseminate to the peritoneal cavity leading to pseudomyxoma peritonei (PMP). Despite several attempts to classify mucinous tumors of appendix and PMP by different authors in the past, no universally accepted classification system was present. The controversial issues were discussed at the 2012 World Congress of the Peritoneal Surface Oncology Group International (PSOGI) in Berlin. A panel of 71 experts from 13 different countries was formed under the lead co-ordinator Norman J. Carr. A total of 4 rounds of questionnaires and one meeting were held. The opinion of the majority was taken into account. Importance of intactness of muscularis mucosae, pushing invasion and infiltrative invasion were emphasized. The entities Low grade appendiceal mucinous neoplasm (LAMN) and High grade appendiceal mucinous neoplasm (HAMN) were defined.. The terminologies suggested for Goblet cell carcinoid and adenoneuroendocrine carcinoma were goblet cell tumor and adenocarcinoma ex goblet cell carcinoid. Acellular mucin in peritoneum was not classified under PMP which was classified into 3 categories depending upon low grade , high grade cytologic features and presence of signet ring cells. It was suggested to report the extent of mucin and cells separately. A reporting format solely for mucinous appendiceal tumors was formulated by the panel. However, there are some grey areas which may have to be addressed in future.

Imaging in low-grade glioma: a guide for neurologists

2017 ◽  
Vol 18 (1) ◽  
pp. 27-34 ◽  
Author(s):  
Jennifer Larsen ◽  
Nigel Hoggard ◽  
Fiona M McKevitt
Keyword(s):  
Surgical Planning ◽  
World Health Organisation ◽  
Low Grade Glioma ◽  
World Health ◽  
Low Grade ◽  
The Central Nervous System ◽  
Contemporary Management

The management of low-grade glioma (LGG) is shifting as evidence has emergedthat refutes the previously commonplace imaging-based ‘watch and wait’ approach, in favour of early aggressive surgical resection. This coupled with the recent 2016 update to the World Health Organisation Classification of Tumours of the Central Nervous System is changing LGG imaging and management. Recently in Practical Neurology the contemporary management of low-grade glioma and the changes to this grading system were discussed in detail. 1 In this complementary article, we discuss the role of imaging in the diagnosis, surgical planning and post-treatment follow-up of LGG. We describe the principles of imaging these tumours and use several cases to highlight some difficult scenarios.

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