Oncocytic Biliary Cystadenocarcinoma: A Case Report and Review of the Literature

2004 ◽  
Vol 128 (2) ◽  
pp. e25-e28 ◽  
Author(s):  
Richard L. Bardin ◽  
Jacqueline K. Trupiano ◽  
Russell M. Howerton ◽  
Kim R. Geisinger
Keyword(s):  
Prognostic Significance ◽  
Cytokeratin 20 ◽  
Cytoplasmic Staining ◽  
Female Patients ◽  
Biliary Cystadenocarcinoma ◽  
Granular Cytoplasm ◽  
Mesenchymal Stroma ◽  
The Right ◽  
Papillary Neoplasm ◽  
Granular Cytoplasmic Staining

Abstract We report an unusual case of biliary cystadenocarcinoma with oncocytic differentiation. The patient was a 43-year-old woman who presented with right upper quadrant pain. Imaging revealed a 16 × 10 × 10-cm, heterogenous, right hepatic mass with extension into the right atrium. Surgical resection revealed a papillary neoplasm of malignant cells with atypical hyperchromatic nuclei and prominent nucleoli lining fibrovascular cores. Mesenchymal stroma was not present. The majority of the epithelial cells had abundant eosinophilic granular cytoplasm, consistent with oncocytic differentiation. There was extensive stromal and hepatic parenchymal invasion. Immunohistochemical staining revealed a “biliary pattern” of cytokeratin subset immunoreactivity, with positivity for cytokeratin 7 and an absence of staining with cytokeratin 20. The tumor was negative for mucin, carcinoembryonic antigen, α-fetoprotein, calretinin, CD31, and chromogranin. There was granular cytoplasmic staining with phosphotungstic acid hematoxylin, consistent with the presence of abundant mitochondria. Electron microscopy revealed abundant mitochondria within the neoplastic cells. This case is quite unusual because female patients only rarely lack the characteristic ovarian-like mesenchymal stroma of biliary cystadenomas/cystadenocarcinomas. Furthermore, to our knowledge, oncocytic differentiation in this neoplasm has been reported previously on only 2 occasions. The biologic behavior and prognostic significance, if any, of the lack of mesenchymal stroma in female patients or the presence of oncocytic differentiation remains to be further elucidated as more of these cases are described.

Immunohistochemical analysis of kallikrein-related peptidases in the normal kidney and renal tumors: potential clinical implications

2010 ◽  
Vol 391 (4) ◽  
Author(s):  
Manal Gabril ◽  
Nicole M. White ◽  
Madeleine Moussa ◽  
Tsz-fung F. Chow ◽  
Shereen M. Metias ◽  
...  
Keyword(s):  
Clear Cell ◽  
Prognostic Significance ◽  
Immunohistochemical Analysis ◽  
Renal Tumors ◽  
Low Grade ◽  
High Grade ◽  
Cytoplasmic Staining ◽  
Chromophobe Rcc ◽  
Clear Cell Rcc ◽  
Granular Cytoplasmic Staining

Abstract Kallikrein-related peptidases (KLKs) have been shown to be differentially expressed in various malignancies and shown to be useful tumor markers. Previous immunohistochemistry (IHC) analysis demonstrated that KLKs 5, 6, 10, and 11 have a potential prognostic significance in renal cell carcinoma (RCC). To further explore the significance of KLKs, we examined KLKs 1, 6, 7, and 15 in different subtypes of renal tumors. KLK1 has stronger expression in high grade compared to low grade clear cell RCC. However, KLK6 and KLK7 show strong expression in low grade in contrast to high grade clear cell RCC. Furthermore, the expression of KLK7 can distinguish between oncocytoma and chromophobe RCC. Oncocytoma showed diffuse, strong granular cytoplasmic staining, but chromophobe RCC showed focal weak homogeneous cytoplasmic stain. The pattern of staining of different KLKs can also be helpful in differentiating some of the subtypes of renal tumors. Our results show the potential ability of KLKs to serve as diagnostic markers and expand previous data about the prognostic significance of KLKs in kidney cancer. In addition, our study is the first to show the ability of KLK staining to distinguish various types of kidney cancers when morphology is similar.

Beta-1 adrenoceptor gene polimorphism in heart failure: clinical and prognostic significance in female patients

2008 ◽  
Vol 7 ◽  
pp. 90-91
Author(s):  
S NODARI ◽  
M METRA ◽  
A MANERBA ◽  
G MILESI ◽  
N BERLINGHIERI ◽  
...  
Keyword(s):  
Heart Failure ◽  
Prognostic Significance ◽  
Female Patients

scholarly journals Primary telencephalic lymphoma in a horse

2015 ◽  
Vol 36 (6) ◽  
pp. 3801
Author(s):  
Clairton Marcolongo-Pereira ◽  
Bruna Da Rosa Curcio ◽  
Douglas Pacheco Oliveira ◽  
Ana Carolina Barreto Coelho ◽  
Bianca Lemos Santos ◽  
...  
Keyword(s):  
Central Nervous System Lymphoma ◽  
Internal Capsule ◽  
Partial Loss ◽  
Moderate Amount ◽  
Cytoplasmic Staining ◽  
Neurological Signs ◽  
Eosinophilic Cytoplasm ◽  
Diffuse Cytoplasmic Staining ◽  
The Right ◽  
The Brain

A case of T small cell type lymphoma in the brain of a horse is described. A 20-year-old female Crioulo equine showed neurological signs characterized by ataxia, circling and partial loss of smell and sight. During necropsy, a whitish, firm, unencapsulated mass compressing the structures of the nervous tissue was observed, extending from the olfactory bulb to the internal capsule of the right telencephalon. Microscopic examination showed the proliferation of round cells with a small to moderate amount of eosinophilic cytoplasm. Nuclei were centrally located, irregularly round and occasionally cleaved and hyperchromatic. Immunohistochemistry for CD3 showed a moderate diffuse cytoplasmic staining. This is a rare primary central nervous system lymphoma in horses, with few reports in the veterinary literature. Nevertheless, it should be considered as a differential diagnosis in equines with neurological signs.

scholarly journals CLINICAL AND MORPHOLOGICAL JUSTIFICATION OF THE SURGICAL TREATMENT OF CHRONIC ABDOMINAL SYNDROME IN CHILDREN

2019 ◽  
Vol 20 (5) ◽  
pp. 270-276
Author(s):  
Igor N. Khvorostov ◽  
A. G. Sinitsyn ◽  
G. L. Snigyr
Keyword(s):  
Surgical Treatment ◽  
Acute Inflammation ◽  
Prognostic Significance ◽  
Morphological Examination ◽  
Moderate Amount ◽  
Muscular Layer ◽  
Collagen Iii ◽  
The Right ◽  
Immunohistochemical Studies

The chronic recurrent abdominal syndrome (CRAS) in the right lower fossa in children is believed not to be independent nosological unit and is diagnosed as an exception. We carried out comparative studies of the clinical picture, results of morphological and immunohistochemical studies of remote appendicitis in 55 CRAS children and 35 children with acute destructive appendicitis. The low prognostic significance of appendicular scales for the determination of indications to the surgical treatment of CRAS was established. Morphological examination in most cases revealed signs of chronic inflammation with fibrosis of the mucosa and submucosa of the appendix in CRAS children. Immunohistochemical studies revealed the pronounced expression of protein VEGF, MMP-9 and VCAM-1 predominantly in the submucosal and the muscular layer, moderate expression for Collagen-III-alpha-1. The low number of positively stained cells for the VIP protein located both in the mucosa and in the submucosa. The number of MMP-9-positive cells was the largest, there was seen a moderate amount of VEGF, VIP and Collagen-III-alpha-1-positive cells. The disappearance of the abdominal syndrome after appendectomy was noted in 6% of CRAS patients. Recurrence of pain was observed in girls of pubertal age with the irregular menstrual cycle. The established changes in remote appendicitis, other than acute inflammation, make it possible to consider reasonable appendectomy as a way of treating CRAS in children.

Abstract 14468: Right Heart: Renal Venous Stasis Determinant in Acute Heart Failure

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Alessandro Vella ◽  
Gianmarco Carenini ◽  
Francesco Bandera ◽  
Marco Guazzi
Keyword(s):  
Heart Failure ◽  
Acute Heart Failure ◽  
Prognostic Significance ◽  
Right Atrial ◽  
Venous Stasis ◽  
Main Role ◽  
Prognostic Impact ◽  
Primary Role ◽  
Right Heart ◽  
The Right

Introduction: The heart-kidney interaction in heart failure (HF) is a matter of special interest, especially due to its strong prognostic significance. The search for a reliable, non-invasive parameter with high pathophysiological and prognostic impact to evaluate HF-related renal congestion remains attractive. Doppler evaluation of intra-renal venous flow (IRVF) has been recently employed in HF patients, with a spectrum of findings ranging from a normal continuous flow to a monophasic discontinuous one, indicative of low and high degrees of renal congestion, respectively. Hypothesis: We postulated a role for right atrial dynamics in the renal congestion pathophysiology. The impairment in atrial deformation and pump function may play a primary role increasing the pulsatile backward load in the venous system, especially in acute heart failure (AHF) patients. Methods: 119 consecutive AHF patients were prospectively investigated within 48 hours from admission. Doppler-derived descriptors of renal hemodynamics included the renal arterial resistive index, IRVF pattern, venous impedance index and renal venous stasis index (RVSI). Results: Right atrial peak longitudinal strain (RAPLS) showed a strong correlation with IRVF pattern (Fig A) and various indices of RV function (TAPSE, S’, FAC) and RV coupling as represented by the TAPSE/PASP ratio (Fig B). At multivariate regression analysis, TAPSE/PASP ratio emerged as the main determinant of RVSI. On the other hand, considering only patients with a clearly impaired RV coupling (TAPSE/PASP <0.30), RAPLS emerged as the best determinant of RVSI (Fig C-D). Conclusions: Our data confirms the main role of the right heart in determining renal stasis in HF patients. When RV to pulmonary circulation uncoupling is severe, the right atrium becomes the key balancing factor in the venous renal flow response. Studies on the mechanistic contribution of the RA dysfunction and the recovery potential of interventions are warranted.

Diagnostic role of ASL-perfusion of liver in magnetic resonance imaging in assessing risk of developing portal hypertension in patients with viral hepatitis

2021 ◽  
pp. 38-43
Author(s):  
E. N. Simakina ◽  
T. G. Morozova
Keyword(s):  
Magnetic Resonance Imaging ◽  
Portal Hypertension ◽  
Magnetic Resonance ◽  
Viral Hepatitis ◽  
Prognostic Significance ◽  
Resonance Imaging ◽  
Diagnostic Role ◽  
Right Lobe ◽  
The Right

Objective. To establish the diagnostic role of ASL-perfusion of the liver in magnetic resonance imaging (MRI) in assessing the risk of portal hypertension in patients with viral hepatitis. Materials and methods. 109 patients with viral hepatitis were examined, including 69 (63.3 %) men and 40 (36.7 %) women, the average age of patients was 49.0 ± 2.3 years. All subjects (n = 109) underwent abdominal ultrasound with doppler vascular examination and clinical elastography, ASL-perfusion of the liver with MRI with an assessment of the volume of hepatic blood flow (HBF, ml/100 g/min).Results. The highest diagnostic and prognostic significance of ASL-perfusion for the liver is a targeted study of changes in the right lobe: for the right lobe, AUROC = 0.886 (95 % CI: 0.799–0.889); for the left, AUROC = 0.635 (95 % CI 0.627–0.641). The diagnostic and prognostic significance of ASLperfusion was evaluated in comparison with ultrasound with doppler vascular examination: AUROC = 0.991 (95 % CI: 0.880–0.993); AUROC = 0.801 (95 % CI: 0.776–0.804), respectively. The quantitative and qualitative characteristics of ASL – liver perfusion were evaluated.Conclusion. When performing ASL-perfusion of the liver, MRI should evaluate quantitative and qualitative criteria. Criteria for the prognosis of portal hypertension according to ASL- perfusion in MRI in patients with viral hepatitis: HBF 131–160 ml/100 g /min, red card – very high risk, HBF = 161–185 ml/100 g/min, red card – high, HBF = 40–130 ml/100 g/min, mixed card – medium; HBF = 131–160 ml/100 g/min, blue card-low risk (r = 0.883).

scholarly journals Olfactory Bulb Volume and Olfactory Sulcus Depth in Patients With OSA: An MRI Evaluation

2019 ◽  
Vol 99 (7) ◽  
pp. 442-447
Author(s):  
Adil Doğan ◽  
Nuray Bayar Muluk ◽  
Hamza Şahin
Keyword(s):  
Olfactory Bulb ◽  
Upper Airway ◽  
Magnetic Resonance Images ◽  
Control Group ◽  
Apnea Hypopnea Index ◽  
Female Patients ◽  
Proinflammatory Mediators ◽  
Obstructive Sleep ◽  
Picture Archiving And Communication ◽  
The Right

Objectives: We evaluated olfactory functions in patients with obstructive sleep apnea (OSA). Methods: The cranial magnetic resonance images of 58 adult patients (36 males and 22 females) aged 27 to 79 years were retrieved from the hospital picture archiving and communication system (PACS) system. There were 29 patients with OSA (17 males and 12 females), diagnosed according to the polysomnography results. A control group consisted of 29 healthy patients without OSA. Olfactory bulb (OB) volume and olfactory sulcus (OS) depth measurements were performed. Nasal septal deviation (SD) was also evaluated and recorded as no SD, deviation to the right, and deviation to the left in all groups. Results: Olfactory bulb volumes of the OSA group were significantly lower than those of the control group ( P < .05), whereas OS depth values were not different ( P > .05). There was a positive correlation between the right and left OB volumes and right and left OS depth values ( P < .05). In older patients with OSA and in female patients with OSA, OB volumes decreased bilaterally ( P < .05). Olfactory sulcus depth of the right side was lower in the female patients with OSA compared to the male patients with OSA ( P < .05). There were no significant correlations between apnea–hypopnea index and OB volumes and OS depth values in the OSA group ( P > .05) Conclusion: In patients with OSA, OB volumes decreased bilaterally. It may be related to intermittent nocturnal hypoxia/reoxygenation episodes, which may be a trigger for upper airway inflammation; and proinflammatory mediators maybe harmful on olfactory neuroepithelium and olfactory impairment may occur.

Immunohistochemical Detection of Uroplakin III, Cytokeratin 7, and Cytokeratin 20 in Canine Urothelial Tumors

2003 ◽  
Vol 40 (1) ◽  
pp. 55-62 ◽  
Author(s):  
J. A. Ramos-Vara ◽  
M. A. Miller ◽  
M. Boucher ◽  
A. Roudabush ◽  
G. C. Johnson
Keyword(s):  
Urinary Bladder ◽  
Transitional Cell ◽  
Cytokeratin 20 ◽  
Cytokeratin 7 ◽  
Bladder Tumors ◽  
Cytoplasmic Staining ◽  
Negative Results ◽  
Urothelial Tumors ◽  
Carcinoma Of The Bladder ◽  
Intermediate Cells

Immunohistochemistry for uroplakin III (UP III), cytokeratin 7 (CK 7), and cytokeratin 20 (CK 20) using commercially available antibodies was done in normal canine urinary bladder and 72 canine urinary bladder tumors that had been fixed in formalin and embedded in paraffin. Prolonged fixation (3–28 days) did not significantly alter the immunostaining for UP III. There was moderate reduction in the intensity for CK 7 and CK 20 after 1 week of fixation. UP III was detected in superficial (umbrella) cells and some intermediate cells of the normal urinary bladder, 7 of 7 transitional cell papillomas (TCPs), 50 of 55 transitional cell carcinomas (TCCs), and 4 of 5 metastatic TCCs. Staining was typically outlined in the plasma membrane, but diffuse or focal cytoplasmic staining was also observed. Intracytoplasmic lumina were usually positive for UP III. One squamous cell carcinoma of the bladder, 4 nonepithelial bladder tumors, and 285 nonurothelial tumors from different nonurinary locations were negative for UP III. CK 7 was detected in 7 of 7 TCPs, 53 of 54 TCCs, and 5 of 5 metastatic TCCs. The staining for CK 7 was diffuse cytoplasmic. CK 20 was detected in 1 of 7 TCPs, 37 of 54 TCCs, and 1 of 5 metastatic TCCs. The staining with CK 20 was cytoplasmic and weaker than with antibodies to UP III or CK 7. There was concurrent expression of UP III, CK 7, and CK 20 in 36 of 54 TCCs. UP III is a specific and sensitive marker for canine transitional epithelial (urothelial) neoplasms, detecting 91% of TCCs. Negative results may be observed with anaplastic tumors.

Prognostic significance of HPV and p16 status in patients with oropharyngeal cancer treated on a large international phase III trial

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. 6004-6004 ◽  
Author(s):  
D. Rischin ◽  
R. Young ◽  
R. Fisher ◽  
S. Fox ◽  
Q. Le ◽  
...  
Keyword(s):  
Oropharyngeal Cancer ◽  
Cox Regression ◽  
Cell Cancer ◽  
Prognostic Significance ◽  
Phase Iii ◽  
Tumor Control ◽  
Eligibility Criteria ◽  
Cytoplasmic Staining ◽  
Phase Iii Trial ◽  
Hpv Status

6004 Background: Previous studies have reported that in patients with oropharyngeal cancer (OPC) the presence of human papilloma virus (HPV) is associated with an improved prognosis. We sought to determine the prognostic importance of HPV and p16 in patients with OPC treated with concurrent chemoradiation on a large international phase III trial. Methods: Patients with previously untreated Stage III or IV head and neck squamous cell cancer were randomized to receive definitive radiotherapy concurrently with either cisplatin or cisplatin plus tirapazamine. In this substudy, analyses were restricted to patients with OPC who received > 60 Gy and did not have major radiation deviations predicted to impact on tumor control. HPV 16/18 were detected by in situ hybridization and scored as detected or undetected. p16 was detected by immunohistochemistry. Nuclear and cytoplasmic staining intensity of tumor cells was scored as grade 0–3, with grade 2 and 3 called positive. Log rank and Cox regression used for survival analyses. p values were 2-sided . Results: 384 out of 861 patients had OPC and met the eligibility criteria. Slides were available for HPV assay in 195 and for p16 in 186, and for both in 173. 54/195 (28%) were HPV positive, 107/186 (58%) were p16 positive. HPV pos tumors were associated with better 2-year overall survival (OS) (94 v 77%, p = 0.007) and better failure-free survival (FFS) (86 v 75%, p = 0.035) compared to HPV neg tumors. Similarly p16 pos tumors were associated with better 2-year OS (92 v 75%, p = 0.004) and FFS (87 v 72%, p = 0.003) compared to p16 neg . After adjustment for stage, Hb and ECOG PS, HPV pos had better OS than HPV neg (HR 0.29, p = 0.018), and p16 pos had better OS than p16 neg (HR 0.39, p = 0.013). When the HPV and p16 results were combined the relative HRs for OS were: HPVpos/p16pos 0.35 (45 patients, 26% of cases), HPVpos/p16neg 0 (3pts, 2%), HPVneg/p16pos 0.73 (58pts, 33%), HPVneg/p16neg 1.79 (67 pts, 39%). Conclusions: Our results confirm the prognostic significance of tumor HPV status in oropharyngeal cancer treated with chemoradiation, but also show that p16 identifies a larger group with an improved prognosis. The HPV neg/p16 pos population has a better prognosis compared to patients with HPV neg/p16 neg tumors. No significant financial relationships to disclose.

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