Primary and secondary localization in major salivary glands are a relatively rare occurrence. Lymphomas localized in major salivary glands can involve either the gland parenchyma or the ...intraglandular nodes. There are clinical, histological and therefore prognostic differences between these two categories; nevertheless, a possible method to discern between these two forms has been given little regard in scientific literature.
In order to investigate such a possibility, examinations of 15 patients (9 female patients and 6 male patients, average age of 65 years) have been reanalyzed. Out of 15 cases, 13 were found to be indolent Non-Hodgkin's Lymphomas (NHL) (B-cell follicular centre origin), 1 was assessed as NHL originating from the MALT and the last case was identified as a high malignancy grade NHL associated with a Sjogren's syndrome.
According to the ultrasonographic and vascular distinctive features (hypoechoic structure, sharp margins, roundish shape, presence of vascular hilus), five cases, later reconfirmed by bioptic examinations, were assessed as nodal lesions.
Therefore, we believe it is possible to avoid the surgical removal of the lesions (to assess the stage of the disease) in a relevant number of cases, as ultrasonography associated with color and power Doppler along with cytological examination by Fine-Needle-Aspiration biopsy appears to be of adequate diagnostic value.
Summary It is difficult to evaluate the prognostic value of histologic criteria in gastric cancer because of the high variability of morphologic patterns. Recently, histologic subtypes of low, ...intermediate, or high malignant potential have been identified, providing the basis for a prognostically informative grading system. Because array comparative genomic hybridization systems allow systematic analysis of chromosome alterations, which may be prognostically and pathogenetically informative, we applied high-resolution genome-wide array comparative genomic hybridization to archival material from 81 gastric cancer cases followed for a median of 150 months after surgery. The DNA extracted from paraffin sections gave useful results in 49 tumors, 18 of which were of low-grade, 24 of intermediate, and 7 of high-grade histotypes. Based on the number of chromosome aberrations and the presence/absence of amplifications, 3 tumor clusters of increasing genomic lesion severity were constructed, which proved to correlate significantly with histologic grade and stage as well as with patient survival. Further investigation documented the lower number and severity of genomic alterations in tumors with microsatellite DNA instability and high CD8-rich lymphoid response; the close association of 8p23.1 amplification with cardial cancer; the frequent amplification of genes involved in cell renewal (CDC6, HER2, GRB7, IGFBP4) at 17q12-q21.1, with close histochemical correlation with HER2 membranous expression; and more sporadic amplification of chromosome regions harboring important oncogenes like MYC, KRAS, NRAS, CRKL, CCNE1, or ZNF217. We conclude that genome-wide array comparative genomic hybridization of gastric cancer contributes prognostically relevant information providing a genetic background for histologic grading.
Pulmonary sequestration has always been diagnosed by direct demonstration of the vessels tributary to the lesion, usually by angiography. Conventional CT can identify the arterial supply in only two ...thirds of cases. We report a case of pulmonary sequestration diagnosed using Spiral CT, based on the demonstration of both arterial supply and venous drainage. The capabilities of Spiral CT to detect subtle vessel abnormalities and to yield reliable multiplanar imaging enabled us to show the whole course of both the artery and the vein tributary to the lesion. Axial images were the most useful ones to diagnose pulmonary sequestration; 2D and 3D reconstructions were useful for a detailed and immediate spatial depiction of the parenchymal abnormality and of its vascular pedicle.
Pathology of gastrointestinal disorders Rindi, Guido; Inzani, Frediano; Solcia, Enrico
Endocrinology and metabolism clinics of North America,
12/2010, Volume:
39, Issue:
4
Journal Article
Peer reviewed
Nonneoplastic and neoplastic proliferative lesions of endocrine cells of the gastrointestinal tract are detailed. A multistep continuum from hyperplasia, dysplasia to neoplasia is identified for ...histamine-producing enterochromaffin-like (ECL) cells of the gastric corpus. Most gastric neuroendocrine tumors (NETs) are silent and composed by ECL cells, the second most frequent neuroendocrine neoplasms being the high-grade neuroendocrine carcinoma (NEC). In the duodenum, preneoplastic lesions are similarly described for gastrin (G) and somatostatin (D) cells. G-cell NETs are the most frequent neuroendocrine tumors of the duodenum, either functioning or nonfunctioning, followed by D-cell NETs and gangliocytic paraganglioma (GCP). No systematic definition of nonneoplastic lesions exists for endocrine cells of the ileum, appendix, and colon-rectum. The most frequent ileal NETs are serotonin-producing enterochromaffin (EC)-cell NETs (classic carcinoid), associating with functional syndrome only in presence of liver metastases. Neoplasms are usually larger in the colon as compared with the small lesions observed in the rectum. High-grade NECs are observed in the colon and rectum-sigmoid, often associate with nonendocrine neoplastic components, and fare an aggressive course with poor outcome and short survival.
Non-neoplastic proliferative lesions of endocrine cells have been described throughout the gastrointestinal tract and pancreas. A multistep continuum from hyperplasia and dysplasia to neoplasia ...originally was identified and systematically defined for histamine-producing enterochromaffin-like (ECL) cells of the gastric corpus. More recently, a similar classification system was devised for gastrin (G)- and somatostatin (D)-producing cells in the duodenum. Preneoplastic lesions of the endocrine pancreas still lack a solid and widely accepted definition of a multistep growth process. Similarly, in spite of reports of carcinoid-associated endocrine cell hyperplasia, there is no systematic definition of nonneoplastic lesions of the endocrine cells of the ileum, appendix and colorectum.
Summary Diffuse gastric cancer, characterized by poorly cohesive, diffusely infiltrating cells with no or little gland formation, is known to show several morphologic variants, but their prognostic ...value, if any, is poorly documented. In this article, 119 cases of invasive (T1b to T4) diffuse gastric cancer, which had undergone potentially curative surgery and were followed postoperatively for a median time of more than 10 years, were investigated for histologic or histochemical patterns possibly predictive of survival. Among 5 histologic groups identified, a low-grade subtype (17 cases) with prominent desmoplasia closely surrounding individual tumor cells (tumor embedding desmoplasia) and no or scarce angio-lympho-neuroinvasion showed stage-independent improved survival compared with 36 non–low-grade desmoplastic, 24 signet ring, and 28 diffuse cancers not otherwise specified. Fourteen cases with anaplastic cells showed clinicopathologic patterns and outcome of highly malignant neoplasms. None of the tumor cell differentiation markers (including 6 mucins and 3 proteases) nor proliferative index or p53 protein expression had independent predictive power, although MUC1 was significantly less expressed in low-grade desmoplastic cases. Cox survival analysis showed the significantly better prognosis of 17 low-grade desmoplastic and worse prognosis of 14 anaplastic cancers compared with the remaining 88 cases. In conclusion, a low-grade desmoplastic and a high-grade anaplastic subtype should be separated histologically from the bulk of diffuse gastric cancers owing to their distinctive histologic, clinicopathologic, and prognostic aspects.
To test the vascular wall response to an expanded polytetrafluoroethylene-covered stent, compared with conventional stenting, up to 6 months after deployment in the vascular district of a swine ...model.
Fourteen minipigs underwent implantation of expanded polytetrafluoroethylene-covered stents (CS) and bare stents (BS) in five peripheral arteries. Animals were killed at different time points (from 1 to 180 days). Histopathologic assessment by morphologic and morphometric analysis and by scanning electron microscopy (SEM) were used to assess the incorporation characteristics and re-endothelialization extent of the two types of stents.
A total of 70 stents (14 CS and 14 BS in the renal arteries; 28 CS in the iliac arteries, and 14 CS in the aorta) were implanted. Microscopic examination confirmed the absence of occlusive thrombi in both the CS and BS groups. Microthrombi were observed in 10 of 13 CS (77% of cases) and in four of four BS (100% of cases, p < 0.05). Inflammation was mild in 69% of segments in which a CS was implanted and in 74% of segments in which a BS was implanted (p = NS), while a severe inflammatory reaction was observed in 6% of CS segments and in 8% of BS segments (p = NS). No differences were detected at the long-term analysis between neointimal thickness in CS compared with BS segments (0.46 +/- 0.18 mm vs 0.42 +/- 0.26 mm at 90 days and 0.36 +/- 0.08 mm vs 0.35 +/- 0.04 mm at 180 days; p = NS, respectively). At SEM analysis, re-endothelization was evident 15 days after the implant in both CS and BS starting from the stent edges.
CS implantation did not elicit a more severe thrombotic deposition compared with that of BS. A similar inflammatory reaction of the arterial wall was present in the two stent groups 3 and 6 months following the implant. In addition, CS implantation did not stimulate excessive neointimal formation when compared with BS.
