scholarly journals IMPORTANCE OF CLASSICAL MORPHOLOGY IN THE DIAGNOSIS OF MYELODYSPLASTIC SYNDROME

2015 ◽  
Vol 7 ◽  
pp. e2015035 ◽  
Author(s):  
Rosangela Invernizzi ◽  
Federica Quaglia ◽  
Matteo Giovanni Della Porta

Myelodysplastic syndromes (MDS) are hematopoietic stem cell disorders characterized by dysplastic, ineffective, clonal and neoplastic hematopoiesis. MDS represent a complex hematological problem: differences in disease presentation, progression and outcome  have necessitated the use of classification systems to improve diagnosis, prognostication and treatment selection. However, since a single biological or genetic reliable diagnostic marker has not yet been discovered for MDS, quantitative and qualitative dysplastic morphological alterations of bone marrow precursors and of peripheral blood cells are still fundamental for diagnostic classification. In this paper World Health Organization (WHO) classification refinements and current minimal diagnostic criteria proposed by expert panels are highlighted and related problematic issues are discussed. The recommendations should facilitate diagnostic and prognostic evaluations in MDS and selection of patients for new effective targeted therapies. Although in the future morphology should be supplemented with new molecular techniques, the morphological approach, at least for the moment, is still the cornerstone for the diagnosis and classification of these disorders.

2020 ◽  
Vol 23 (4) ◽  
pp. 329-339
Author(s):  
Irina V. Kononenko ◽  
Olga M. Smirnova ◽  
Aleksandr Y. Mayorov ◽  
Marina V. Shestakova

The review focuses on the new WHO classification published in 2019. Unlike the previous classification, this classification does not recognize subtypes of T1DM and T2DM and offers new types of diabetes: “hybrid types of diabetes” and “unclassified diabetes”. This classification provides practical guidance to clinicians for assigning a type of diabetes to individuals and choose appropriate treatment (whether or not to start treatment with insulin), particularly at the time of diagnosis. This review presents the variety of forms of diabetes, the features of their clinical picture, and also emphasizes the importance of molecular genetic and immunological studies to identify types of diabetes and determine personalized therapy. The selection of “hybrid forms” of diabetes is due to the fact that the treatment of these types of diabetes has its own characteristics associated with the specific pathogenesis of diseases. However, it is obvious that further studies should relate to the study of the mechanisms of damage and decrease in the function of в-cells. Perhaps future classification systems and, as a consequence, personalized treatment will focus on various mechanisms of damage to β-cells.


2008 ◽  
Vol 132 (7) ◽  
pp. 1055-1061 ◽  
Author(s):  
Teri J. Franks ◽  
Jeffrey R. Galvin

Abstract Context.—Tumors with neuroendocrine morphology are a distinct subset of lung neoplasms sharing characteristic histologic, immunohistochemical, ultrastructural, and molecular features. Objective.—To review the current histologic classification and the diagnostic criteria for the major categories of neuroendocrine tumors of the lung. Data Sources.—Published classification systems from the World Health Organization and pertinent peer-reviewed articles indexed in PubMed (National Library of Medicine) form the basis of this review. Conclusions.—Accurate classification of the neuroendocrine tumors of the lung requires knowledge of specific criteria separating the major categories, which is essential for determining prognosis and treatment.


CNS Spectrums ◽  
2016 ◽  
Vol 21 (4) ◽  
pp. 349-354 ◽  
Author(s):  
Falko Biedermann ◽  
W. Wolfgang Fleischhacker

The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) was published by the American Psychiatric Association (APA) in 2013, and the Work Group on the Classification of Psychotic disorders (WGPD), installed by the World Health Organization (WHO), is expected to publish the new chapter about schizophrenia and other primary psychotic disorders in 2017. We reviewed the available literature to summarize the major changes, innovations, and developments of both manuals. If available and possible, we outline the theoretical background behind these changes. Due to the fact that the development of ICD-11 has not yet been completed, the details about ICD-11 are still proposals under ongoing revision. In this ongoing process, they may be revised and therefore have to be seen as proposals. DSM-5 has eliminated schizophrenia subtypes and replaced them with a dimensional approach based on symptom assessments. ICD-11 will most likely go in a similar direction, as both manuals are planned to be more harmonized, although some differences will remain in details and the conceptual orientation. Next to these modifications, ICD-11 will provide a transsectional diagnostic criterion for schizoaffective disorders and a reorganization of acute and transient psychotic and delusional disorders. In this manuscript, we will compare the 2 classification systems.


2016 ◽  
Vol 60 (4) ◽  
pp. 284-301 ◽  
Author(s):  
Helena Barroca ◽  
Cristina Marques

According to the World Health Organization (WHO), the new classification of lymphomas is mainly based on morphological, immunophenotypical, and molecular criteria. Consequently, this new approach has led from the substantial role that architecture played in the past to a secondary panel highlighting the role of fine-needle biopsy (FNB). Applied together with other ancillary techniques, such as flow cytometry (FC), FNB is a potential tool for the diagnosis of lymphomas, and enlarged lymph nodes represent an excellent target for the implementation of this technique. Despite the difficulties inherent in this technology, which might pose problems in differential diagnosis, in the majority of cases this joint work allows an accurate diagnosis of malignancy and even correct subcharacterization in routine lymphomas. Additionally, in selected cases, other molecular techniques like FISH and PCR can also be performed on FNB specimens, helping in the characterization and diagnosis of lymphomas. In this review, we discuss the basic aspects of the combination of FNB cytology and FC in the diagnosis and subclassification of lymphomas. The preanalytical phase is extensively discussed. The advantages, disadvantages, and technical limitations of this joint work are addressed in general and in terms of the accurate subclassification of lymphomas.


CNS Spectrums ◽  
2016 ◽  
Vol 21 (4) ◽  
pp. 324-333 ◽  
Author(s):  
Anna Marras ◽  
Naomi Fineberg ◽  
Stefano Pallanti

Obsessive-compulsive disorder (OCD) has been recognized as mainly characterized by compulsivity rather than anxiety and, therefore, was removed from the anxiety disorders chapter and given its own in both the American Psychiatric Association (APA)Diagnostic and Statistical Manual of Mental Disorders(DSM-5) and the Beta Draft Version of the 11th revision of the World Health Organization (WHO)International Classification of Diseases(ICD-11). This revised clustering is based on increasing evidence of common affected neurocircuits between disorders, differently from previous classification systems based on interrater agreement. In this article, we focus on the classification of obsessive-compulsive and related disorders (OCRDs), examining the differences in approach adopted by these 2 nosological systems, with particular attention to the proposed changes in the forthcoming ICD-11. At this stage, notable differences in the ICD classification are emerging from the previous revision, apparently converging toward a reformulation of OCRDs that is closer to the DSM-5.


2019 ◽  
Vol 153 (1) ◽  
pp. 40-48 ◽  
Author(s):  
Antonio Travaglino ◽  
Antonio Raffone ◽  
Gabriele Saccone ◽  
Massimo Mascolo ◽  
Maurizio Guida ◽  
...  

Abstract Objectives To assess congruence between World Health Organization (WHO) 1994 and endometrial intraepithelial neoplasia (EIN) classification systems of endometrial hyperplasia. Methods Systematic review and meta-analysis were performed by searching electronic databases for studies that classified endometrial hyperplasia according to both WHO 1994 and EIN systems. Congruence was based on the rate of specimens classified as EIN in WHO categories, which should be virtually 0.000 in nonatypical hyperplasia (NAH) and 1.000 in atypical hyperplasia (AH). Subgroup analyses were performed based on architecture complexity. Results Eight studies with 1,352 hyperplasias were included. Congruence with EIN criteria was fair in NAH (0.241) and moderate in AH (0.815). Subgroup analyses of NAH showed high congruence in simple NAH (0.065), null in complex NAH (0.517), null in simple AH (0.148), and high in complex AH (0.901). Conclusions WHO 1994 system is not congruent with the EIN system and cannot be directly translated into a dual classification.


1994 ◽  
Vol 165 (3) ◽  
pp. 287-292 ◽  
Author(s):  
William Li. Parry-Jones ◽  
Brenda Parry-Jones

Successive editions of the ICD and DSM classification systems have exercised a major influence over contemporary diagnostic practice and perceptions of the form and structure of disorders. Periodic revision has been based on clinical and epidemiological research, and minimal attention has been given to any possible contribution from historical evidence. To test the potential value of such evidence, the historical manifestations of four eating disorders (anorexia, bulimia, rumination and pica) were considered in relation to the clinical descriptions and diagnostic criteria of DSM–III–R (American Psychiatric Association, 1987) and ICD–10 (World Health Organization, 1992). For each disorder, evidence is presented of continuities and discontinuities with the phenomena recognised currently. Instances of symptom overlap between disorders and the implications of the historical findings for some current classificatory issues are discussed. When spread over several centuries, case numbers remain relatively small, the amount of clinical detail is highly variable, and temporal distribution is uneven. The conclusions that can be drawn, therefore, are necessarily somewhat tentative and subjective.


1983 ◽  
Vol 13 (4) ◽  
pp. 907-921 ◽  
Author(s):  

The development and promotion of a ‘common language’ in the mental health field is a lasting objective of the World Health Organization. In the 1960s, experts from 35 countries participated in the WHO programme on the standardization of psychiatric diagnosis, classification and statistics which reviewed the state of the field and resulted in the glossary of mental disorders, first produced as a companion to ICD-8 and later incorporated, with modifications, in Chapter V of ICD-9.


Pathogens ◽  
2021 ◽  
Vol 10 (3) ◽  
pp. 353
Author(s):  
Lizhong Wu ◽  
Pema ◽  
Longlong Mu ◽  
Mingjue Si ◽  
Jie Xu ◽  
...  

Pulmonary cystic echinococcosis remains a serious threat to public health. A standardized, imaging-based classification method for pulmonary echinococcosis has not yet been developed despite the existence of a standardized ultrasound classification method and treatment plan for hepatic cystic echinococcosis. Chest computed tomography (CT) images from 34 cases of pulmonary cystic echinococcosis with 46 lesions were used for classification based on the World Health Organization (WHO) standardized ultrasound classification of hepatic cystic echinococcosis. CT findings were compared with intraoperative observations and postoperative pathological results to assess accuracy. Pulmonary cystic echinococcosis was common in women (14/34, 41.2%) and children (14/34, 41.2%) with a single cyst (28/46, 60.9%). Most lesions were classified as cystic echinococcosis 1(CE1, 19/46) or cystic echinococcosis 3(CE3, 21/46). Blood leukocytosis was mostly observed in CE3 lesions (100%, 9/9) (p < 0.05). The preoperative CT diagnosis of pulmonary cystic echinococcosis had an accuracy rate of 100%. The preoperative CT typing, and postoperative pathological typing had a coincidence rate of 97.8% (45/46). Our study provided a classification method based on CT imaging for pulmonary cystic echinococcosis that can be used during pre-surgical planning to reduce patient’s postoperative complications and mortality.


Cancers ◽  
2021 ◽  
Vol 13 (22) ◽  
pp. 5666
Author(s):  
Marco Pizzi ◽  
Giorgio Alberto Croci ◽  
Marco Ruggeri ◽  
Silvia Tabano ◽  
Angelo Paolo Dei Tos ◽  
...  

Myeloproliferative neoplasms (MPNs) are a heterogeneous group of clonal hematopoietic stem cell disorders, characterized by increased proliferation of one or more myeloid lineages in the bone marrow. The classification and diagnostic criteria of MPNs have undergone relevant changes over the years, reflecting the increased awareness on these conditions and a better understanding of their biological and clinical-pathological features. The current World Health Organization (WHO) Classification acknowledges four main sub-groups of MPNs: (i) Chronic Myeloid Leukemia; (ii) classical Philadelphia-negative MPNs (Polycythemia Vera; Essential Thrombocythemia; Primary Myelofibrosis); (iii) non-classical Philadelphia-negative MPNs (Chronic Neutrophilic Leukemia; Chronic Eosinophilic Leukemia); and (iv) MPNs, unclassifiable (MPN-U). The latter are currently defined as MPNs with clinical-pathological findings not fulfilling the diagnostic criteria for any other entity. The MPN-U spectrum traditionally encompasses early phase MPNs, terminal (i.e., advanced fibrotic) MPNs, and cases associated with inflammatory or neoplastic disorders that obscure the clinical-histological picture. Several lines of evidence and clinical practice suggest the existence of additional myeloid neoplasms that may expand the spectrum of MPN-U. To gain insight into such disorders, this review addresses the history of MPN classification, the evolution of their diagnostic criteria and the complex clinical-pathological and biological features of MPN-U.


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