Canine smooth muscle tumors: A clinicopathological study

Canine smooth muscle tumors (SMTs) commonly develop in the alimentary and female genital tracts and less frequently in soft tissue. The definition of histological criteria of malignancy is less detailed for SMTs in dogs than in humans. This study evaluated the clinicopathologic features of canine SMTs and compared the veterinary and human medical criteria of malignancy. A total of 105 canine SMTs were evaluated histologically and classified according to both veterinary and human criteria. The Ki67 labeling index was assessed in all SMTs. Estrogen receptor (ER) and progesterone receptor (PR) expression was evaluated for soft tissue SMTs. Follow-up data were available in 25 cases. SMTs were diagnosed in the female genital tract (42%), alimentary tract (22%), and soft tissue (20%). Soft tissue SMTs frequently arose in the perigenital area, pelvic cavity, and retroperitoneum. A subset of soft tissue SMTs expressed ER and/or PR, resembling the gynecologic type of soft tissue SMT in humans. SMTs were less frequently malignant when assessed with human criteria than with veterinary criteria, better reflecting their benign behavior, especially in the genital tract where human criteria tolerate a higher mitotic count for leiomyoma. Decreased differentiation was correlated with increased proliferation, necrosis, and reduced desmin expression. Mitotic count, Ki67 labeling index, and necrosis were correlated with metastases and tumor-related death. Further prognostic studies are warranted to confirm the better performance of the human criteria when assessing SMT malignancy, especially genital cases, to confirm their usefulness in ER/PR-expressing soft tissue SMTs, and to better define the most useful prognostic parameters for canine SMTs.

Potential Biomarkers of Metastasizing Paragangliomas and Pheochromocytomas

Paragangliomas and pheochromocytomas (PPGLs) are rare neuroendocrine tumors originating from paraganglionic tissue in many sites of the body. Most PPGLs are characterized by nonaggressive behavior but all of them have the potential to metastasize. PPGLs represent a great diagnostic dilemma as it is difficult to recognize tumors that are likely to be metastasizing; criteria of malignancy can be found both in benign and metastatic forms. This review aims to analyze the current knowledge of the nature of metastasizing PPGLs paying particular attention to head and neck paragangliomas (HNPGLs). Potential predictors of the malignancy risk for PPGLs were summarized and discussed. These data may also help in the development of diagnostic and prognostic strategies, as well as in the identification of novel potential therapeutic targets for patients with PPGLs.

Age and Gender in Relation to Colorectal Cancer in Najef Province: A Histopathological Study

Colorectal cancer (CRC), which is also referred to colorectal adenocarcinoma, occurs when the growth of cells goes out of control in the colon or rectum. A number of histological colorectal carcinoma are listed, such as mucinous, signet ring cell, and moderately differentiated adenocarcinoma. The present study included fifty tissue blocks (16 females and 34 males) of patient groups with CRC and thirty five tissue blocks of colon tissue (ulcerative colitis) which were used as control group. The mean age of patients group was 51.44±16.67 years. The majority of patients with colonic carcinoma were above the age of 40, accounting for 80%, while 20% of cases were below the age of 40 years. A recto-sigmoid location is the most common site for colonic tumors accounting for 60%. Grade of tumor was well differentiated in 56%, and the following features were observed: The tissue appears with multi-layering, back to back arrangement (little intervening stroma), loss of polarity, loss of goblet cells, and invasion of stroma and presence of nuclear criteria of malignancy: hyperchromatism, high N/C ratio visible nucleoli and abnormal mitosis. The present results also showed that in grade I lesion, most of tumor retains glandular pattern, moderately differentiated in 28%, and tumor is nearly equally composed of glandular and solid patterns. However the poorly differentiated was 16% with same cellular criteria of malignancy but almost all the tumor was composed of solid areas. The present findings divided the stage of tumor patients into: 22% stage I; 66% stage II, and 12% stage III.

Systematic histopathological analysis of different 5-aminolevulinic acid–induced fluorescence levels in newly diagnosed glioblastomas

OBJECTIVEGlioblastoma (GBM) is characterized by distinct intratumoral histopathological heterogeneity with regard to variable tumor morphology, cell proliferation, and microvascularity. Maximum resection of a GBM results in an improved prognosis and thus represents the aim of surgery in the majority of cases. Fluorescence-guided surgery using 5-aminolevulinic acid (5-ALA) is currently widely applied for improved intraoperative tumor visualization in patients with a GBM. Three intratumoral fluorescence levels (i.e., strong, vague, or no fluorescence) can usually be distinguished during surgery. So far, however, their exact histopathological correlates and their surgical relevance have not been clarified sufficiently. Thus, the aim of this study was to systematically analyze tissue samples from newly diagnosed GBMs with different fluorescence levels according to relevant histopathological parameters.METHODSThis prospective study recruited patients who underwent 5-ALA fluorescence-guided resection of a newly diagnosed radiologically suspected GBM. Each patient received 5-ALA approximately 3 hours before surgery, and a modified neurosurgical microscope was applied for intraoperative visualization of 5-ALA–induced fluorescence. During surgery, tissue samples with strong, vague, or no fluorescence were collected. For each sample, the presence of tumor tissue, quality of tissue (compact, infiltrative, or no tumor), histopathological criteria of malignancy (cell density, nuclear pleomorphism, mitotic activity, and presence of microvascular proliferation/necrosis), proliferation rate (MIB-1 labeling index [LI]), and microvessel density (using CD34 staining) were investigated.RESULTSAltogether, 77 patients with a newly diagnosed, histopathologically confirmed GBM were included, and 131 samples with strong fluorescence, 69 samples with vague fluorescence, and 67 samples with no fluorescence were collected. Tumor tissue was detected in all 131 (100%) of the samples with strong fluorescence and in 65 (94%) of the 69 samples with vague fluorescence. However, mostly infiltrative tumor tissue was still found in 33 (49%) of 67 samples despite their lack of fluorescence. Strong fluorescence corresponded to compact tumors in 109 (83%) of 131 samples, whereas vague fluorescence was consistent with infiltrative tumors in 44 (64%) of 69 samples. In terms of the histopathological criteria of malignancy, a significant positive correlation of all analyzed parameters comprising cell density, nuclear pleomorphism, mitotic activity, microvascular proliferation, and necrosis with the 3 fluorescence levels was observed (p < 0.001). Furthermore, the proliferation rate significantly and positively correlated with strong (MIB-1 LI 28.3%), vague (MIB-1 LI 16.7%), and no (MIB-1 LI 8.8%) fluorescence (p < 0.001). Last, a significantly higher microvessel density was detected in samples with strong fluorescence (CD34 125.5 vessels/0.25 mm2) than in those with vague (CD34 82.8 vessels/0.25 mm2) or no (CD34 68.6 vessels/0.25 mm2) fluorescence (p < 0.001).CONCLUSIONSStrong and vague 5-ALA–induced fluorescence enables visualization of intratumoral areas with specific histopathological features and thus supports neurosurgeons in improving the extent of resection in patients with a newly diagnosed GBM. Despite the lack of fluorescence, tumor tissue was still observed in approximately half of the cases. To overcome this current limitation, the promising approach of complementary spectroscopic measurement of fluorescence should be investigated further.

Solitary Fibrous Tumor of the Pancreas: A Case Report and Review of the Literature

Pancreas is an extremely rare abdominal localization of the solitary fibrous tumor (SFT). It usually grows asymptomatically for a long time before a diagnosis can be made on the basis of symptoms and/or mechanical complications. Due to the rarity and nonspecific clinical presentation, this entity is diagnostically challenging. We present a 47-year-old man with a history of progressive epigastric pain for the last two weeks, and jaundice, who was admitted to hospital for further investigation. Cystadenocarcinoma was suspected based on the radiologic findings, and a pancreatoduodenectomy was performed. The removed portion of the pancreas contained a 3.5 × 2 × 1.8 cm well-circumscribed, but not encapsulated white tumor mass with smooth cut surface, cystic component and duct dilatation within the tumor and within the adjacent pancreatic tissue. Based on the histology and immunostaining profile, a diagnosis of the solitary fibrous tumor was made. One week post-operatively, the patient died due to surgical complications. Microscopic and immunohistochemical examinations are necessary for accurate diagnosis of cystic SFT of the pancreas. Because there is limited data regarding the biological behavior of SFT with extra-pleural localization the authors recommend clinical follow-up for SFT treatment if the criteria of malignancy are not met.

Aspirating cutting paracentetic biopsy as a method of verification of the morphological structure of adrenal tumors

In recent years, incidence of adrenal tumors has increased substantially, to a greater extent this is due to the advent of newer, more sensitive imaging studies. However, the criteria of malignancy, the present, the adrenal intsidentalom based only on the measurement of the size of the education and attempts to calculate the percentage of the mathematical potential malignancy. Based on the results of a survey of 104 patients in the NUZ DKB OAO RZD at the station Yaroslavl, with randomly discovered adrenal tumors, shows the diagnostic value and informative aspiration cutting para-centetic biopsy under ultrasound in the differential diagnosis of adrenal intsidentalom different histological structure. Calculated the sensitivity and specificity of this method of research. Given that the implementation of needle biopsy under ultrasound guidance in the domestic and foreign literature of the estimated negative, mainly because of the risk of complications, clearly demonstrated the safety of aspiration cutting paracentetic biopsy. Taking into account the experience of more than 10,000 diagnostic and therapeutic interventions of our doctors under ultrasound abdominal, retroperitoneal space, pelvis, neck, and the vessels are proposed techniques that improve biopsy formations adrenal glands.