Histomorphological spectrum of ovarian tumors - A tertiary care center experience

Background: Ovarian tumors are a heterogeneous group of neoplasms with variable clinical, morphological, and histological features. Ovarian cancer is the leading cause of death in females. Aims and Objectives: (1) To study and characterize the ovarian tumors based on gross and histopathological features. (2) To study prevalence and age distribution of various ovarian tumors. (3) To study the clinical features in patients with ovarian tumors. (4)To compare the frequency of benign and malignant neoplasms of the ovary with other studies. Materials and Methods: This is a prospective study conducted in Upgraded Department of Pathology, Modern Government maternity hospital, and Osmania General Hospital, Hyderabad, Telangana from March 2018 to February 2021. A total of 200 ovarian tumors were studied. Results: Out of 200 ovarian tumors, 132 were benign, seven were borderline and 61 were malignant. The surface epithelial tumors were the most common tumors accounting for 159cases (79.5%), germ cell tumors were seen in 27 cases (13.5%), sex-cord stromal tumors formed 10 cases (5%), and metastasis in 4 cases (2%). Conclusion: Ovary is a common site of tumors in the female genital tract and usually presents with a variety of clinocomorphological and histological features. Benign are the most common, of these surface epithelial tumors are the commonest, affects mainly reproductive age group.

Cytokine production by peripheral blood lymphocytes in patients with ovarian epithelial tumors

In presence of autoserum, production of IL1b, IL2, IL4, IL6 and TNFa by peripheral blood lymphocytes of 30 patients with epithelial tumors of ovaries and 50 patients with epithelial ovarian cancer of I-IV stages was investigated. The data received enable to ascertain the increase of mononuclear activity during ovarian tumor progression, increase of T-helpers of the second type activity, along with the reduction of T-helpers of the first type activity in peripheral blood of patients, and abnormalities of IL6-dependent mechanism of control of ILIb and TNFa production by peripheral blood lymphocytes of patients with ovarian cancer.

CT-Based Radiomics Nomogram for Differentiation of Anterior Mediastinal Thymic Cyst From Thymic Epithelial Tumor

ObjectivesThis study aimed to distinguish preoperatively anterior mediastinal thymic cysts from thymic epithelial tumors via a computed tomography (CT)-based radiomics nomogram.MethodsThis study analyzed 74 samples of thymic cysts and 116 samples of thymic epithelial tumors as confirmed by pathology examination that were collected from January 2014 to December 2020. Among the patients, 151 cases (scanned at CT 1) were selected as the training cohort, and 39 cases (scanned at CT 2 and 3) served as the validation cohort. Radiomics features were extracted from pre-contrast CT images. Key features were selected by SelectKBest and least absolute shrinkage and selection operator and then used to build a radiomics signature (Rad-score). The radiomics nomogram developed herein via multivariate logistic regression analysis incorporated clinical factors, conventional CT findings, and Rad-score. Its performance in distinguishing the samples of thymic cysts from those of thymic epithelial tumors was assessed via discrimination, calibration curve, and decision curve analysis (DCA).ResultsThe radiomics nomogram, which incorporated 16 radiomics features and 3 conventional CT findings, including lesion edge, lobulation, and CT value, performed better than Rad-score, conventional CT model, and the clinical judgment by radiologists in distinguishing thymic cysts from thymic epithelial tumors. The area under the receiver operating characteristic (ROC) curve of the nomogram was 0.980 [95% confidence interval (CI), 0.963–0.993] in the training cohort and 0.992 (95% CI, 0.969–1.000) in the validation cohort. The calibration curve and the results of DCA indicated that the nomogram has good consistency and valuable clinical utility.ConclusionThe CT-based radiomics nomogram presented herein may serve as an effective and convenient tool for differentiating thymic cysts from thymic epithelial tumors. Thus, it may aid in clinical decision-making.

Ephrin Receptors (Ephs) Expression in Thymic Epithelial Tumors: Prognostic Implications and Future Therapeutic Approaches

Ephrin receptors (Ephs) are receptor tyrosine kinases (RTKs) implicated in tissue development and homeostasis, and they are aberrantly expressed in tumors. Here, immunohistochemical Eph type-A and -B expression in thymic epithelial tumors (TETs) was assessed and correlated with clinicopathological parameters. Tissue microarrays from 98 TETs were stained for EphA1, -A2, -A4 -A6, -B1, -B2, -B4 and -B6. The relationship between neoplastic and lymphoid cell immunoreactivity score (H-score), histopathological parameters (Pearson’s test) and survival of 35 patients (Mantel-Cox model) was explored. Epithelial-rich subtypes showed higher EphA6 cytoplasmic H-score (B2/B3, carcinoma) (p < 0.001) and stronger EphA4 H-score (B3, carcinoma) (p = 0.011). The immature T-cells, especially in subtypes AB/B1, had higher EphB6 H-score than carcinoma-associated mature lymphocytes (p < 0.001); carcinomas had higher lymphocytic EphB1 H-score (p = 0.026). Higher lymphocytic and lower epithelial EphB6 H-score correlated with Masaoka stage ≤II (p = 0.043, p = 0.010, respectively). All cases showed variable epithelial and lymphocytic EphA2 expression, but clinicopathological associations were not reached. Our study confirmed that Eph type-A and -B expression in TETs is associated with established prognostic parameters, i.e., tumor subtype and Masaoka stage, although correlation with patient survival was not reached. Such findings suggest involvement of these RTKs in thymic neoplasia, as well as their potential utility as treatment targets.