scholarly journals Tissue eosinophilia: a morphological marker for assessing stromal invasion in squamous neoplasms of the larynx

2013 ◽  
Vol 3 (5) ◽  
pp. 374-378
Author(s):  
RR Bhatta ◽  
RC Adhikari ◽  
G Sayami
Keyword(s):  
High Power ◽  
Squamous Carcinoma ◽  
Tumour Invasion ◽  
Stromal Invasion ◽  
Diagnostic Challenge ◽  
High Power Field ◽  
Morphological Marker ◽  
Predictive Values ◽  
Tissue Eosinophilia ◽  
Eosinophil Counts

Background: The assessment of tumour invasion in squamous neoplasms of the larynx poses a diagnostic challenge, especially in small biopsies that are frequently sectioned tangentially. Eosinophilic infi ltration is thought to be an adjunctive criterion in determining tumour invasion. We investigated whether thresholds of eosinophilic infi ltration in laryngeal squamous neoplasms would aid in determining the presence of invasion. Materials and Methods: Fifty cases of invasive squamous carcinoma, preinvasive squamous neoplasms and benign squamous neoplasms were evaluated. The number of eosinophils per high power field and per 10 high power fields in the stroma adjacent to the neoplastic epithelium were counted and tabulated. For statistical purposes, the elevated eosinophils were defi ned and categorized as: focally and moderately elevated (5-9/HPF), focally and markedly elevated (>10/HPF), diffusely and moderately elevated (5- 19/10HPF), and diffusely and markedly increased (>20/10/HPF). Results: Eosinophil counts were elevated focally and/or diffusely more frequently in invasive squamous carcinoma than in noninvasive tumours. The increased eosinophil counts, specifically >10/HPF and >20/10HPF, were statistically significantly associated with stromal invasion. Greater than 10/HPF and >20/10HPF had sensitivity, specifi city and positive predictive values of 23%,100%, 100% and 11%,100% and 100% respectively. Cytology was able to diagnose 33 out of 36 malignant cases. Of 17 cases which were diagnosed as benign on cytology, 3 cases turned out to be malignant on biopsy. The sensitivity and specifi city of touch smear cytology are 91.6% and 100% respectively. Conclusion: The elevated eosinophil count in squamous neoplasms of larynx is a morphologic feature associated with presence of tumour invasion. When the number of infiltrating eosinophils exceeds 10/ HPF and or >20/10HPF in a laryngeal biopsy with squamous neoplasm, it represents an indicator for the possibility of tumour invasion. Similarly, the presence of eosinophils meeting these thresholds in an excisional specimen should prompt a thorough evaluation for invasiveness, when evidence of invasion is absent or is suspected by conventional criteria in the initial sections. Journal of Pathology of Nepal (2013) Vol. 3, No.1, Issue 5, 374-378 DOI: http://dx.doi.org/10.3126/jpn.v3i5.7861

Febrile Infants at Low Risk for Serious Bacterial Infection—An Appraisal of the Rochester Criteria and Implications for Management

PEDIATRICS ◽  
1994 ◽  
Vol 94 (3) ◽  
pp. 390-396 ◽  
Author(s):  
Julie A. Jaskiewicz ◽  
Carol A. McCarthy ◽  
Amy C. Richardson ◽  
Kathleen C. White ◽  
Donna J. Fisher ◽  
...  
Keyword(s):  
Confidence Interval ◽  
High Power ◽  
Microscopic Examination ◽  
Bacterial Infections ◽  
Antimicrobial Agents ◽  
Low Risk ◽  
High Power Field ◽  
Urine Sediment ◽  
Predictive Values ◽  
Risk Criteria

Objective. Prospective studies were conducted to test the hypothesis that infants unlikely to have serious bacterial infections (SBI) can be accurately identified by low risk criteria. Methods. Febrile infants (rectal T ≥ 38°C) ≤60 days of age were considered at low risk for SBI if they met the following criteria: 1) appear well; 2) were previously healthy; 3) have no focal infection; 4) have WBC count 5.0-15.0 x 109 cells/L (5000-15 000/mm3), band form count≤ 1.5 x 109 cells/L (≤1500/mm3), ≤10 WBC per high power field on microscopic examination of spun urine sediment, and ≤5 WBC per high power field on microscopic examination of a stool smear (if diarrhea). The recommended evaluation included the culture of specimens of blood, cerebrospinal fluid, and urine for bacteria. Outcomes were determined. The negative predictive values of the low risk criteria for SBI and bacteremia were calculated. Results. Of 1057 eligible infants, 931 were well appearing, and, of these, 437 met the remaining low risk criteria. Five low risk infants had SBI including two infants with bacteremia. The negative predictive value of the low risk criteria was 98.9% (95% confidence interval, 97.2% to 99.6%) for SBI, and 99.5% (95% confidence interval, 98.2% to 99.9%) for bacteremia. Conclusions. These data confirm the ability of the low risk criteria to identify infants unlikely to have SBI. Infants who meet the low risk criteria can be carefully observed without administering antimicrobial agents.

scholarly journals Disease activity in eosinophilic esophagitis is associated with impaired esophageal barrier integrity

2017 ◽  
Vol 313 (3) ◽  
pp. G230-G238 ◽  
Author(s):  
Marijn J. Warners ◽  
Bram D. van Rhijn ◽  
Joanne Verheij ◽  
Andreas J. P. M. Smout ◽  
Albert J. Bredenoord
Keyword(s):  
Disease Activity ◽  
Eosinophilic Esophagitis ◽  
High Power ◽  
High Power Field ◽  
Predictive Values ◽  
Impedance Measurements ◽  
Barrier Integrity ◽  
Mucosal Integrity ◽  
Esophageal Eosinophilia ◽  
Active Disease

In eosinophilic esophagitis (EoE), the esophageal barrier integrity is impaired. Integrity can be assessed with different techniques. To assess the correlations between esophageal eosinophilia and various measures of mucosal integrity and to evaluate whether endoscopic impedance measurements can predict disease activity, endoscopies and mucosal integrity measurements were performed in adult EoE patients with active disease (≥15 eosinophils/high-power field) at baseline ( n = 32) and after fluticasone ( n = 15) and elemental dietary treatment ( n = 14) and in controls ( n = 19). Mucosal integrity was evaluated during endoscopy using electrical tissue spectroscopy (ETIS) measuring mucosal impedance and transepithelial electrical resistance (TER) and transepithelial molecule-flux through biopsy specimens in Ussing chambers. We included 61 measurements; 32 of patients at baseline and 29 after treatment, 3 patients dropped out. After treatment, 20 patients were in remission (≤15 eosinophils/high-power field) and these measurements were compared with 41 measurements of patients with active disease (at baseline or after failed treatment). All four mucosal integrity measures showed significant impairment in active EoE compared with remission. Eosinophilia was negatively correlated with ETIS and TER and positively with transepithelial molecule flux ( P ≤ 0.001). The optimal ETIS cutoff to predict disease activity was 6,000 Ω·m with a sensitivity of 79% [95% confidence interval (CI) 54–94%], specificity of 84% (95% CI 69–94%), positive predictive values of 89% (95% CI 77–95%) and negative predictive values of 71% (95% CI 54–84%). In EoE patients, markers of mucosal integrity correlate with esophageal eosinophilia. Additionally, endoscopic mucosal impedance measurements can predict disease activity. NEW & NOTEWORTHY In adult patients with eosinophilic esophagitis (EoE), the mucosal integrity, measured by making use of four different parameters, correlates strongly with esophageal eosinophilia. The accuracy of endoscopically measured mucosal impedance to distinguish active disease from remission was acceptable with moderate specificity and sensitivity. Mucosal impedance measurements can predict disease activity in adult EoE patients.

Distinct Patterns of Tissue Remodeling and Their Prognostic Role in Chronic Rhinosinusitis

ORL ◽  
2021 ◽  
pp. 1-7
Author(s):  
Ho Yun Lee ◽  
Jung-Soo Pyo ◽  
Su Jin Kim
Keyword(s):  
Chronic Rhinosinusitis ◽  
Structural Changes ◽  
Squamous Metaplasia ◽  
Tissue Remodeling ◽  
Sinus Surgery ◽  
Prognostic Role ◽  
High Power Field ◽  
Tissue Eosinophilia ◽  
Allergy Test ◽  
Stromal Edema

<b><i>Introduction:</i></b> Tissue remodeling refers to structural changes that occur in damaged tissue and is associated with disease severity in asthma. However, the characteristics of tissue remodeling and its prognostic role in chronic rhinosinusitis (CRS) remain unclear. In this report, we evaluated the clinical implications of tissue remodeling in CRS. <b><i>Methods:</i></b> We performed a retrospective cohort study of adult patients who underwent endoscopic sinus surgery for bilateral CRS. The histopathology of sinus mucosa was determined by evaluating the inflammatory cell count and tissue remodeling markers (squamous metaplasia, subepithelial gland proliferation, basement membrane [BM] thickening, stromal edema, and fibrosis). Eosinophilic CRS (ECRS) was defined as an eosinophil count &#x3e;15/high-power field in the biopsied tissue. Patient characteristics, allergy test grade, preoperative Lund-Mackay score (LMS), and pre- and postoperative Lund-Kennedy scores (LKSs) were analyzed. <b><i>Results:</i></b> Of the identified patients, 59.1% were classified as ECRS and the remaining 40.9% as non-ECRS. Regarding tissue remodeling markers, stromal edema was seen in 90.9%, BM thickening in 63.6%, and stromal fibrosis in 34.1% of patients. In cases with stromal edema and BM thickening, greater tissue eosinophilia was observed, while stromal fibrosis decreased tissue eosinophilia (<i>p</i> &#x3c; 0.05). Prognostically, subepithelial gland proliferation alone was an independent risk factor for poor postoperative endoscopic findings (odds ratio: 8.250, 95% confidence interval: 1.128–60.319, <i>p</i> = 0.038). <b><i>Conclusions:</i></b> Tissue eosinophilia was commonly associated with BM thickening and stromal edema. Subepithelial gland proliferation predicted a poor surgical prognosis in CRS. These findings imply that tissue remodeling provides additional information not only on the CRS endotype but also on the postsurgical prognosis.

scholarly journals Is There Pathological Uniformity between the Periphery and Center of a Gastrointestinal Stromal Tumor?

2021 ◽  
Vol 10 (4) ◽  
pp. 687
Author(s):  
Seong Ji Choi ◽  
Kwan Hong Lee ◽  
Chan Kyoo Yoo ◽  
Jai Hoon Yoon ◽  
Ki Seok Jang ◽  
...  
Keyword(s):  
Risk Stratification ◽  
Mitotic Index ◽  
High Power ◽  
Malignant Potential ◽  
Mitotic Count ◽  
Pathological Diagnosis ◽  
High Power Field ◽  
Gastric Gists ◽  
Significant Difference ◽  
The Mean

Background: Gastrointestinal stromal tumors (GISTs) are mesenchymal tumors and have some malignant potential. Mitotic count is important for predicting the malignant potential of GISTs. Proper treatment of GISTs requires accurate pathological diagnosis. In general, endoscopic ultrasound-guided fine-needle aspiration and deep biopsy are used for pathological diagnosis of GIST before making decisions about surgery. This study sought to evaluate the pathological uniformity of gastric GISTs for mitotic index of the center and periphery of the GIST. Methods: We retrospectively reviewed the data of 37 gastric GIST patients who underwent wedge resection at Hanyang University Hospital. We used Armed Forces Institute of Pathology criteria to classify gastric GISTs. To determine the pathological uniformity of gastric GISTs, we compared GIST risk stratification between the center and periphery of GISTs. Results: The mean size of GISTs was 3.56 ± 2.10 cm. Three lesions were located in the antrum, 11 in the fundus, 9 in the cardia, and 14 in the body. The mean age of patients was 58.65 ± 9.44 years; 18 patients were male and 19 were female. Thirty-five patients (94.6%) showed the same level of risk stratification between the center and periphery of gastric GISTs, while two patients (5.4%) presented different levels of risk between the two sites. No significant difference in mitotic count was observed between the two sites (kappa value = 0.863; p = 0.001). Conclusions: Mitotic index category (either more than five mitoses per high-power field or five or fewer mitoses per high-power field) of GISTs showed good concurrence between the center and periphery.

Automated image analysis of nuclear atypia in high-power field histopathological image

2015 ◽  
Vol 258 (3) ◽  
pp. 233-240 ◽  
Author(s):  
CHENG LU ◽  
MENGYAO JI ◽  
ZHEN MA ◽  
MRINAL MANDAL
Keyword(s):  
Image Analysis ◽  
High Power ◽  
Automated Image Analysis ◽  
High Power Field ◽  
Nuclear Atypia ◽  
Histopathological Image

Mitotic counts in one high power field in breast core biopsies is equivalent to counts in 10 high power fields

Pathology ◽  
2021 ◽  
Author(s):  
Whayoung Lee ◽  
Timothy Law ◽  
Yunxia Lu ◽  
Thomas K. Lee ◽  
Julio A. Ibarra
Keyword(s):  
High Power ◽  
High Power Field

Mast Cells in Hemangiomas and Vascular Malformations

PEDIATRICS ◽  
1982 ◽  
Vol 70 (1) ◽  
pp. 48-51
Author(s):  
Julie Glowacki ◽  
John B. Mulliken
Keyword(s):  
Mast Cells ◽  
High Power ◽  
Vascular Malformations ◽  
Normal Skin ◽  
High Power Field ◽  
Proliferative Phase ◽  
Large Numbers ◽  
Endothelial Proliferation ◽  
Vascular Birthmarks

Common pediatric vascular birthmarks, classified as hemangiomas or malformations, were analyzed for the presence of mast cells. Hemangiomas in the proliferative phase contained large numbers of mast cells (27 ± 15 cells/high-power field [HPF]) in comparison with hemangiomas in the involuting phase (2.6 ± 2.9), vascular malformations (1.7 ± 3.2), and normal skin (5.0 ± 1.0). Inasmuch as hemangiomas are characterized by endothelial proliferation and increased numbers of mast cells, these data raise the possibility that mast cells may have an important role in the formation and/or maintenance of these lesions.

Mastocytic Enterocolitis: Increased Mucosal Mast Cells in Chronic Intractable Diarrhea

2006 ◽  
Vol 130 (3) ◽  
pp. 362-367 ◽  
Author(s):  
Shriram Jakate ◽  
Mark Demeo ◽  
Rohan John ◽  
Mary Tobin ◽  
Ali Keshavarzian
Keyword(s):  
Mast Cell ◽  
Mast Cells ◽  
High Power ◽  
Chronic Diarrhea ◽  
Duodenal Biopsy ◽  
Mast Cell Tryptase ◽  
High Power Field ◽  
Intractable Diarrhea ◽  
Biopsy Specimens ◽  
Hematoxylin Eosin

Abstract Context.—In some adult patients with chronic intractable diarrhea, the diagnosis remains elusive even after detailed evaluations, and colonic or duodenal biopsy specimens may appear unremarkable on routine hematoxylin-eosin staining. Objectives.—To assess the concentration of mast cells in colonic or duodenal biopsy specimens by immunohistochemical analysis for mast cell tryptase from patients with chronic intractable diarrhea and to evaluate their response to drugs affecting mast cell function. Design.—Mast cells per high-power field were assessed in biopsy specimens from 47 patients with chronic intractable diarrhea, from 50 control subjects, and from 63 patients with other specific diseases that cause chronic diarrhea (inflammatory bowel disease, celiac disease, collagenous colitis, and lymphocytic colitis). Patients with chronic intractable diarrhea who had more than 20 mast cells per high-power field were administered drugs affecting mast cell mediator function and release. Results.—The mean ± SD concentration of mast cells in the 50 control subjects was 13.3 ± 3.5 cells per high-power field; hence, patients with more than 20 mast cells per high-power field were considered to have increased mast cells. Thirty-three (70%) of 47 patients with chronic intractable diarrhea had increased mast cells, and symptoms were controlled by drug therapy in 22 (67%) of the 33 patients. No patient had systemic or cutaneous mastocytosis. No increase in mast cells was seen in patients with other common causes of chronic diarrhea. Conclusions.—In chronic intractable diarrhea, colonic or duodenal biopsy specimens may appear unremarkable on routine hematoxylin-eosin staining, but increased mast cells may be demonstrated by immunohistochemistry for mast cell tryptase, with the novel term mastocytic enterocolitis describing this condition. Similar increases in mast cells are not apparent in control populations or in patients with other specific diseases that cause chronic diarrhea. The cause of the increased mast cells remains to be elucidated.

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