scholarly journals Giant gastric carcinosarcoma infiltrating the left hepatic lobe: a case report

2021 ◽  
pp. 214
Author(s):  
◽  
◽  
Keyword(s):  
Gastric Resection ◽  
Histopathological Examination ◽  
Correct Diagnosis ◽  
Immunohistochemical Analysis ◽  
Needle Aspiration ◽  
Left Hepatic Lobe ◽  
En Bloc ◽  
Hepatic Lobe ◽  
Biopsy Specimens ◽  
Resected Tissue

Gastric carcinosarcoma is a rare biphasic tumor that consists of both carcinomatous and sarcomatous components. Clinical presentation and neoplastic markers are not specific for the disease. Moreover, CT scan cannot distinguish among gastric carcinoma, sarcoma or carcinosarcoma, so it is essential to perform histopathological and immunohistochemical analysis on biopsy specimens or resected tissue to ensure a correct diagnosis. A 72-year-old woman was transferred to our Department from another hospital with a diagnosis of a bleeding tumor localized on the lesser gastric curve, infiltrating the left hepatic lobe. The mass was treated as a gastric malignant mesenchymal neoplasia (gastro-intestinal stromal tumor versus sarcoma) infiltrating the liver. Owing to the bleeding, no further invasive examinations, such as fine needle aspiration biopsy, were planned. Furthermore, no neoadjuvant chemotherapy could be administered before surgery due to persistent anaemia. The scheduled surgical procedure was an atypical gastric resection with “en bloc” hepatic resection. This operation included upper polar and lesser curve resection, with tubulization of the stomach along the greater curve, as well as left lateral hepatic sectionectomy. Histopathological examination and immunohistochemical staining confirmed the diagnosis of gastric carcinosarcoma. This is first report of gastric carcinosarcoma with local liver infiltration, treated with surgical resection.

scholarly journals Cytohistological Concordance of Papillary Carcinoma of Thyroid and Its Variants

2021 ◽  
Vol 8 (04) ◽  
pp. 213-218
Author(s):  
Nameera Saleem ◽  
Naval Kishore Bajaj ◽  
Ezhil Arasi Nagamuthu
Keyword(s):  
Papillary Thyroid Carcinoma ◽  
Thyroid Carcinoma ◽  
Papillary Carcinoma ◽  
Fine Needle Aspiration ◽  
Histopathological Examination ◽  
Correct Diagnosis ◽  
Needle Aspiration ◽  
Papillary Thyroid ◽  
Fine Needle ◽  
Nuclear Features

BACKGROUND Papillary thyroid carcinoma is the most common malignancy of the thyroid gland. Fine Needle Aspiration Cytology (FNAC) is a rapid, safe and economic procedure, and has a sensitivity approaching of 93.5 % and specificity close to 90 % for diagnosing papillary thyroid carcinomas. This study aims at correlating the cytological and histological diagnosis to arrive at the rate of concordance and discordance, identify variants of papillary thyroid carcinoma (PTC) on cytology and discuss the cytological mimics of PTC. METHODS Data from cases was collected over a period of three years (2015 - 2018). A descriptive study was done. Cases from Osmania General Hospital representing histologically proven cases of papillary carcinoma thyroid along with their corresponding cytological findings were analysed. Cytosmears were obtained from fine needle aspiration of thyroid lesions using a 26-gauge needle, stained with haematoxylin and eosin (H&E). Thyroidectomy specimens were fixed in 10 % buffered formalin, grossed and paraffin embedded. After processing, sections obtained by microtomy were stained with H & E for histopathologic evaluation. RESULTS The institute received a total of 258 thyroid specimens for histopathology and 686 cases for thyroid FNAC over a period of three years. This study includes 70 cases which had both cytology and histopathology correlation at our institution. 65 cases were diagnosed as PTC on histopathology and correct diagnosis was made on cytology with 73.8 % concordance (48 / 65 cases) and discordance was seen in 26.1 % (17 / 65 cases). 5 cases were misdiagnosed on cytology as PTC, and on histopathological examination were diagnosed as non-PTC. CONCLUSIONS Fine needle aspiration shows variable accuracy for PTC, ranging from 65 % to 90 %. The architectural arrangement of cells in papillary fragments and presence of nuclear features in majority of cells is diagnostic of the conventional variant of PTC. The other variants however, pose a diagnostic dilemma on account of their architectural variation, altered cytomorphology and the scant presence of nuclear features. An increase in the awareness of cytomorphology of variants and also of the mimics of PTC helps improve the diagnostic accuracy on FNAC. KEYWORDS Papillary Thyroid Carcinoma, Variants of PTC, Cytohistopathological Correlation

scholarly journals Microcalcifications without a thyroid nodule as the sole sign of papillary thyroid carcinoma

2021 ◽  
Vol 2021 ◽  
Author(s):  
Stamatina Ioakim ◽  
Vasilis Constantinides ◽  
Meropi Toumba ◽  
Theodoros Lyssiotis ◽  
Angelos Kyriacou
Keyword(s):  
High Risk ◽  
Papillary Thyroid Carcinoma ◽  
Thyroid Gland ◽  
Thyroid Carcinoma ◽  
Histopathological Examination ◽  
Needle Aspiration ◽  
List Type ◽  
Papillary Thyroid ◽  
Resected Tissue ◽  
Current Guidelines

Summary Our objective is to demonstrate the importance of considering microcalcifications even without evidence of nodules as a potential sign of malignancy. Current guidelines, such as those of the British Thyroid Association, acknowledge the clinical significance of microcalcifications only when found within nodules. In this case, they are considered a suspicious feature, classifying the nodules as U5 (i.e. high risk) where fine-needle aspiration biopsy (FNAB) is warranted, following the high likelihood of cancer in these nodules. In addition, there is a dearth of evidence of ultrasound scan (USS) detection of microcalcifications in the thyroid gland outside of nodules, along with their associated clinical implications. Yet, this clinical manifestation is not so infrequent considering that we do encounter patients in the clinic showing these findings upon ultrasound examination. Three patients who presented to our clinic with thyroid-related symptoms were shown to have areas of microcalcifications without a nodule upon sonographic evaluation of their thyroid gland. These incidentally detected hyperechoic foci were later confirmed to correspond to areas of papillary thyroid carcinoma (PTC) on histopathological examination of resected tissue following thyroidectomy. Four more cases were identified with sonographic evidence of microcalcifications without nodules and given their clinical and other sonographic characteristics were managed with active surveillance instead. Learning points Echogenic foci known as microcalcifications may be visible without apparent association to nodular structures. Microcalcifications without nodules may not be an infrequent finding. Microcalcifications are frequently indicative of malignancy within the thyroid gland even without a clearly delineated nodule. Empirically, the usual guidelines for the management of thyroid nodules can be applied to the management of microcalcifications not confined to a nodule, but such a finding per se should be classified as a ‘high-risk’ sign.

scholarly journals Successful surgical management of an extrahepatic biliary cystadenocarcinoma

Rare Tumors ◽  
2011 ◽  
Vol 3 (4) ◽  
pp. 114-117 ◽  
Author(s):  
Sergio Renato Pais-Costa ◽  
Sandro J. Martins ◽  
Sergio L. M. Araújo ◽  
Olímpia A. T. Lima ◽  
Marcio A. Paes ◽  
...  
Keyword(s):  
Bile Duct ◽  
Bile Leak ◽  
Wall Thickening ◽  
Primary Therapy ◽  
Left Hepatic Lobe ◽  
En Bloc ◽  
Extrahepatic Bile Duct Cancer ◽  
Palpable Mass ◽  
Hepatic Lobe ◽  
Biliary Cystadenocarcinoma

Extrahepatic bile duct cancer is an uncommon disease, and few cases are curable by surgery. We report a case of extrahepatic biliary cystadenocarcinoma (BCAC) associated with atrophy of the left hepatic lobe. A 54-year old male was admitted with painless obstructive jaundice and a hepatic palpable mass noticed one month before presentation. Liver functions tests were consistent with cholestatic damage and serum carbohydrate antigen 19.9 (CA 19-9) was increased before treatment. Magnetic resonance imaging (MRI) disclosed dilatation of the left hepatic bile duct with irregular wall thickening close to the hepatic confluence, and atrophy of left hepatic lobe. The patient was submitted to en bloc extended left hepatectomy with resection of caudate lobe, hilar lymphadenectomy, and suprapancreatic biliary tree resection. All surgical margins were grossly negative, and postoperative course was uneventful, except for a minor bile leak. The patient was discharged on the 15th postoperative day; he is alive without tumor recurrence one year after primary therapy. Although technically challenging, extended en bloc resection is feasible in adults with extrahepatic BCAC and can improve survival with acceptable and manageable morbidity.

Cervical Expanding Hematomas in Dogs: Five Cases

2002 ◽  
Vol 38 (6) ◽  
pp. 533-540 ◽  
Author(s):  
A. J. Deneuche ◽  
V. T. Viateau ◽  
L. Boulouha
Keyword(s):  
Histopathological Examination ◽  
Needle Aspiration ◽  
Surgical Removal ◽  
Coagulation Disorder ◽  
En Bloc ◽  
Chronic Expanding Hematoma ◽  
Coagulation Tests ◽  
Previous Trauma ◽  
Postoperative Drainage ◽  
Veterinary School

Five puppies were presented to the Alfort National Veterinary School for a rapidly expanding, well-demarcated, subcutaneous cervical mass of a few days’ duration. In all cases, previous trauma was reported. Fine-needle aspiration of the mass in each case revealed a serosanguineous fluid containing mainly erythrocytes, with a total protein concentration ranging from 3.5 to 5.2 g/dL. Coagulation tests failed to reveal any coagulation disorder. En-bloc surgical removal of the fluid-filled mass associated with short-term postoperative drainage was curative in all cases. Histopathological examination of the mass revealed encapsulated hematoma. The disease resembles chronic expanding hematoma in humans.

scholarly journals A Peripheral Ameloblastic Fibro-Odontoma in a 3-Year-Old Girl: Case Report, Immunohistochemical Analysis, and Literature Review

2014 ◽  
Vol 2014 ◽  
pp. 1-6 ◽  
Author(s):  
Yi-Chun Lin ◽  
Hsiu-Ming Hsu ◽  
Chiang-Shin Liu ◽  
Kuo Yuan
Keyword(s):  
Histopathological Examination ◽  
Correct Diagnosis ◽  
Immunohistochemical Analysis ◽  
Clinical Appearance ◽  
Jaw Bones ◽  
Tissue Sections ◽  
Odontogenic Epithelium ◽  
Histological Characteristics ◽  
Children And Young Adults

Ameloblastic fibro-odontoma (AFO) predominantly occurs in the jaw bones of children and young adults. Extraosseous AFO is extremely rare. We describe a peripheral ameloblastic fibro-odontoma in the maxillary gingiva of a 3-year-old girl. The clinical appearance resembled fiery red reactive gingival lesions. The histopathological examination of the excised lesion showed small islands and cords of odontogenic epithelium with cellular myxoid stroma in the subepithelial tissue. The mass contained calcified material and an enamel-like deposit. Many small blood vessels appeared in the connective tissue surrounding the odontogenic epithelium. The immunohistochemical assays showed strong reactivity for amelogenin,β-catenin, CD44, and CD31 in the tissue sections. There was no recurrence after the 1-year follow-up. Because this lesion clinically resembles other nonneoplastic lesions and is very rare in gingiva, establishing a correct diagnosis is achieved only based on specific histological characteristics. Conservative excision of the tumor is the treatment of choice.

scholarly journals The Accuracy of Histopathological and Cytopathological Techniques in the Identification of the Mycetoma Causative Agents

2018 ◽  
Author(s):  
Ahmed Hassan Fahal ◽  
Emmanuel Edwar Siddig ◽  
Najwa Adam Mhmoud ◽  
Sahar Mubarak Bakhiet ◽  
Omnia Babekir Abdallah ◽  
...  
Keyword(s):  
Histopathological Examination ◽  
Correct Diagnosis ◽  
Needle Aspiration ◽  
Surgical Biopsy ◽  
Causative Agents ◽  
Actinomadura Madurae ◽  
Madurella Mycetomatis ◽  
Time Required ◽  
Sensitivity Specificity ◽  
Mean Time

Mycetoma is a devastating neglected tropical disease, caused by various fungal and bacterial pathogens. Correct diagnosis to the species level is mandatory for proper treatment. In endemic areas, various diagnostic tests and techniques are in use to achieve that, and that includes grain culture, surgical biopsy histopathological examination, fine needle aspiration cytological (FNAC) examination and in certain centres molecular diagnosis such as PCR. In this retrospective study, the sensitivity, specificity and diagnostic accuracy of grain culture, surgical biopsy histopathological examination and FNAC to identify the mycetoma causative organisms were determined. The histopathological examination appeared to have better sensitivity and specificity. The histological examination results were correct in 714 (97.5%) out of 750 patients infected with Madurella mycetomatis, in 133 (93.6%) out of 142 patients infected with Streptomyces somaliensis, in 53 (74.6%) out of 71 patients infected with Actinomadura madurae and in 12 (75%) out of 16 patients infected with Actinomadura pelletierii. FNAC results were correct in 604 (80.5%) out of 750 patients with Madurella mycetomatis eumycetoma, in 50 (37.5%) out of 133 Streptomyces somaliensis patients, 43 (60.5%) out of 71 Actinomadura madurae patients and 11 (68.7%) out of 16 Actinomadura pelletierii. The mean time required to obtain the FNAC result was one day, and for the histopathological examinations results it was 3.5 days, and for grain it was a mean of 16 days. In conclusion, histopathological examination and FNAC are more practical techniques for rapid species identification than grain culture in many endemic regions.

scholarly journals Endourological treatment of non-muscular-invasive bladder tumors

2021 ◽  
Vol 64 (5) ◽  
pp. 33-37
Author(s):  
Ivan Vladanov ◽  
Keyword(s):  
Transurethral Resection ◽  
Histopathological Examination ◽  
Correct Diagnosis ◽  
Characteristic Size ◽  
En Bloc Resection ◽  
Bloc Resection ◽  
Bladder Tumors ◽  
En Bloc ◽  
Size Number ◽  
Different Types

Background: Transurethral resection of the bladder is one of the essential methods in the diagnosis, treatment and management of non-muscularinvasive bladder cancer. The purpose of the procedure is to remove completely all visually detected tumors with a following establishment of a very precise histological diagnosis. The aim of the study is to compare the results of conventional transurethral endoscopic treatment and the En-bloc resection method using different types of energy sources in the treatment of bladder tumors. Material and methods: A total number of 88 patients underwent endourological interventions. Regarding the distribution, 23 patients had conventional transurethral resection, 22 – En-bloc monopolar resection, 21 – En-bloc bipolar resection and 22 – En-bloc with Thu:YAG laser. Clinical data, intraoperative and postoperative data and also the histopathological examination results were compared. Results: The compared groups were heterogeneous by age, sex, tumor characteristic (size, number, location). No significant differences were observed during the operations, comparing the intraoperative and postoperative complications of the studied groups. The detrusor musculature was detected in 74% of cases after conventional transurethral resection, in 91% of cases of En-bloc monopolar resection, in 95% of cases of En-bloc bipolar resection and in 96% of cases of En-bloc Thu:YAG laser. Conclusions: The En-bloc resection technique of non-muscular-invasive bladder tumors is a safe and effective method comparing with the conventional transurethral resection; it allows more favorable postoperative results and obtaining better quality tumor samples which allow establishing correct diagnosis of the disease.

scholarly journals Biallelic Expression of Mucin-1 in Autosomal Dominant Tubulointerstitial Kidney Disease: Implications for Nongenetic Disease Recognition

2018 ◽  
Vol 29 (9) ◽  
pp. 2298-2309 ◽  
Author(s):  
Karl X. Knaup ◽  
Thomas Hackenbeck ◽  
Bernt Popp ◽  
Johanna Stoeckert ◽  
Andrea Wenzel ◽  
...  
Keyword(s):  
Kidney Disease ◽  
Autosomal Dominant ◽  
Kidney Biopsy ◽  
Correct Diagnosis ◽  
Human Kidney ◽  
Immunohistochemical Analysis ◽  
Mucin 1 ◽  
Biallelic Expression ◽  
Biopsy Specimens ◽  
Snapshot Minisequencing

BackgroundProviding the correct diagnosis for patients with tubulointerstitial kidney disease and secondary degenerative disorders, such as hypertension, remains a challenge. The autosomal dominant tubulointerstitial kidney disease (ADTKD) subtype caused by MUC1 mutations (ADTKD-MUC1) is particularly difficult to diagnose, because the mutational hotspot is a complex repeat domain, inaccessible with routine sequencing techniques. Here, we further evaluated SNaPshot minisequencing as a technique for diagnosing ADTKD-MUC1 and assessed immunodetection of the disease-associated mucin 1 frameshift protein (MUC1-fs) as a nongenetic technique.MethodsWe re-evaluated detection of MUC1 mutations by targeted repeat enrichment and SNaPshot minisequencing by haplotype reconstruction via microsatellite analysis in three independent ADTKD-MUC1 families. Additionally, we generated rabbit polyclonal antibodies against MUC1-fs and evaluated immunodetection of wild-type and mutated allele products in human kidney biopsy specimens.ResultsThe detection of MUC1 mutations by SNaPshot minisequencing was robust. Immunostaining with our MUC1-fs antibodies and an MUC1 antibody showed that both proteins are readily detectable in human ADTKD-MUC1 kidneys, with mucin 1 localized to the apical membrane and MUC1-fs abundantly distributed throughout the cytoplasm. Notably, immunohistochemical analysis of MUC1-fs expression in clinical kidney samples facilitated reliable prediction of the disease status of individual patients.ConclusionsDiagnosing ADTKD-MUC1 by molecular genetics is possible, but it is technically demanding and labor intensive. However, immunohistochemistry on kidney biopsy specimens is feasible for nongenetic diagnosis of ADTKD-MUC1 and therefore, a valid method to select families for further diagnostics. Our data are compatible with the hypothesis that specific molecular effects of MUC1-fs underlie the pathogenesis of this disease.

F.N.A.C. AS DIAGNOSTIC TOOL OF PAROTID TUMORS AND ASSOCIATED PITFALLS IN CORRELATION WITH HISTOPATHOLOGY

2020 ◽  
Vol 4 (1) ◽  
Author(s):  
Bhawana Pant ◽  
Sanjay Gaur ◽  
Prabhat Pant
Keyword(s):  
Preoperative Diagnosis ◽  
Histopathological Examination ◽  
Clinical Information ◽  
Final Diagnosis ◽  
Needle Aspiration ◽  
Histopathological Diagnosis ◽  
Cytological Diagnosis ◽  
Tertiary Referral Centre ◽  
Clear Cut ◽  
Parotid Tumors

F.NA.C has been used for ages as a safe and economical tool for fast preoperative diagnosis of parotid tumors. It has certain pitfall which sometimes leads to misdiagnosis and consequently it may have affect on treatment of the tumors. Keeping in view of the diverse classification of parotid tumors’ information from cytology should be combined with radiology as well as clinical diagnosis. Aim: To discuss some cases where there was discrepancy between cytological diagnosis and histopathological result and also suggest measures to improve the efficacy of F.N.A.C. Material and methods: The study includes 50 cases of parotid tumours who presented to the  department of ENT at Government medical college Haldwani which is a tertiary referral centre during 2009 to 2016. Only adult patients were included and inflammatory swelling were excluded from the study. All patients evaluated  Contrast enhanced computerized tomography(CECT) and  Magnetic resonance imaging (MRI) followed by Fine needle aspiration cytology .Preoperative diagnosis was made upon the findings of the above investigations and different types of  parotid surgeries  were done. . Final diagnosis was made on  histopathological  examination. Result :The most common tumour  came out to be pleomorphic adenoma (23 cases-46%) followed by mucoepidermoid carcinoma(12cases-24%). In ten  cases there was no clear cut  association between cytological diagnosis and final histopathological diagnosis. Conclusion: FNAC is highly sensitive and specific technique for diagnosis of many salivary gland swellings. FNAC can be used preoperatively to avoid unnecessary surgery and biopsy. Details of clinical information and radiologic features may help the pathologist to arrive at the appropriate diagnosis and reduce false interpretation. Pitfalls may also occur with improper technique of FNAC which can be overcome by proper caution.

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