scholarly journals Superficially Spreading Endocervical Adenocarcinoma in situ with Multifocal Microscopic Involvement of the Endometrial Surface: A Case Report with Emphasis on the Potential for Misdiagnosis Based on Endometrial Curettage Specimens

2020 ◽  
Vol 13 (3) ◽  
pp. 1530-1536
Author(s):  
Inwoo Hwang ◽  
Jiyeon Lee ◽  
Kyue-Hee Choi ◽  
Jiheun Han ◽  
Hyun-Soo Kim
Keyword(s):  
Final Diagnosis ◽  
Accurate Diagnosis ◽  
Surface Epithelium ◽  
Apoptotic Bodies ◽  
Small Tumor ◽  
Histological Features ◽  
Endocervical Adenocarcinoma ◽  
Tumor Tissues ◽  
Mitotic Figures

Misdiagnosis of endocervical adenocarcinoma (EAC) as endometrial endometrioid carcinoma (EEC) is one of the major concerns when evaluating endometrial curettage specimens. It is difficult to differentiate EAC involving the endometrium from EEC, particularly when the specimens have only a few small tumor fragments. We report a case of endocervical adenocarcinoma <i>in situ</i> (AIS) with multifocal microscopic involvement of the endometrium. The endometrial curettage specimen obtained from an 82-year-old woman consisted of a large volume of blood and fibrin, with small endometrial tissue fragments showing microscopic foci of atypical glandular proliferation. Based on the presence of complex glands with stratified mucin-poor columnar epithelium and intermediate-grade nuclear atypia, a preoperative diagnosis of grade 1 EEC was made. However, the hysterectomy specimen revealed an endocervical AIS involving the endocervix and low uterine segment. Frequent mitotic figures and apoptotic bodies, characteristic of AIS, were present. The endometrium showed a few microscopic foci of atypical glandular proliferation involving the surface only. Their histological features were similar to those of the endocervical AIS. Immunohistochemically, the atypical glands exhibited block p16 positivity. The final diagnosis was a superficially spreading endocervical AIS with multifocal microscopic involvement of the endometrial surface epithelium. In summary, small tumor tissues in an endometrial curettage may lead to misdiagnosis of AIS or EAC as EEC, especially when the pathologists are unaware of the possibility of microscopic endometrial involvement of AIS or EAC. The origin of the tumor can be correctly determined based on a combination of histological features and immunostaining. Endocervical AIS involving the endometrium should be included in the differential diagnosis of neoplastic glandular lesions in endometrial curettage specimens. An accurate diagnosis in these cases is important because of its significant implications for clinical management.

scholarly journals Cytological variations and typical diagnostic features of endocervical adenocarcinoma in situ: A retrospective study of 74 cases

CytoJournal ◽  
2015 ◽  
Vol 12 ◽  
pp. 8 ◽  
Author(s):  
Takashi Umezawa ◽  
Miyaka Umemori ◽  
Ayana Horiguchi ◽  
Kouichi Nomura ◽  
Hiroyuki Takahashi ◽  
...  
Keyword(s):  
Diagnostic Accuracy ◽  
Single Cells ◽  
Adenocarcinoma In Situ ◽  
Endocervical Adenocarcinoma ◽  
Necrotic Tumor ◽  
Papanicolaou Smears ◽  
Typical Type ◽  
Polymorphic Type ◽  
Mitotic Figures

Background: The sensitivity of Papanicolaou smears for detecting endocervical adenocarcinoma in situ (AIS) is very low. A comprehensive cytological analysis of endocervical AIS is necessary to increase diagnostic accuracy. Methods: The subjects were 74 patients with pathologically-diagnosed AIS. A total of 140 Papanicolaou smears were reviewed to calculate the sensitivity of the Papanicolaou smears for detecting AIS and the incidence of sampling/screening/diagnostic errors. The cytological review was performed by 6 cytotechnologists, and the final cytological diagnosis was obtained at the consensus meeting. We classified the cases into three differentiation types; typical type (well-differentiated AIS), polymorphic type (poorly differentiated AIS), and mixed typical and polymorphic type. Three cytological subtypes (endocervical, endometrioid and intestinal subtypes) of AIS were also analyzed. Results: The sensitivity of the original Papanicolaou smears for the detection of AIS was 44.6%, while that for the detection of AIS and adenocarcinoma was 63.5%. The diagnostic accuracy of AIS increased to 78.5% in the final diagnosis. The common characteristic features were microbiopsies/hyperchromatic crowded groups (HCG) (82.0%) and mitotic figures (72.2%). The appearance of single cells (2.8%) was rare, and all the cervical cytology smears showed no evidence of necrotic tumor diathesis. The most common AIS was the typical type (41 cases, 67.2%) among all cytologically-diagnosed AIS or adenocarcinoma cases (61 cases). Although mixed typical and polymorphic AIS existed in 17 cases (27.9%), pure polymorphic AIS was very rare (3 cases, 4.9%). The endocervical subtype was the most predominant subtype (67.2%), followed by a few mixed subtypes. The important diagnostic keys for AIS cytology are as follows: (1) The appearance of microbiopsies/HCG (single-cell pattern is rare), (2) mitotic figures in the microbiopsies/HCG, (3) a lack of necrotic tumor diathesis in cases with polymorphic AIS, and (4) recognition of typical cytological subtypes. Conclusions: The relatively low diagnostic accuracy AIS was caused by the underestimation of microbiopsies/HCG and the overestimation of polymorphic components. The typical cytological features of AIS are the presence of microbiopsies/HCG with mitotic figures in the absence of necrotic tumor diathesis in specimens containing endocervical samples. The recognition of infrequent AIS subtypes (endometrioid and intestinal subtypes) is also important.

scholarly journals An Unsuspected Finding of t(9;22): A Rare Case of Philadelphia Chromosome-Positive B-Lymphoblastic Lymphoma

2017 ◽  
Vol 2017 ◽  
pp. 1-4 ◽  
Author(s):  
Prajwal Boddu ◽  
C. Cameron Yin ◽  
Rashmi Kanagal-Shamanna ◽  
Guillin Tang ◽  
Beenu Thakral ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Kinase Inhibitors ◽  
Bone Marrow Involvement ◽  
Philadelphia Chromosome ◽  
Lymphoblastic Lymphoma ◽  
Accurate Diagnosis ◽  
Biopsy Specimens ◽  
B Lymphoblastic Lymphoma ◽  
Prophylactic Chemotherapy

While rare, cases of isolated extramedullary disease of B-cell Lymphoblastic Lymphoma (B-LBL) without morphologic bone marrow involvement have been described. In this report, we illustrate the case of an elderly gentleman who presented with isolated testicular and vertebral LBL involvement but had no morphologic bone marrow involvement. The initial plan of treatment was to treat along the lines of Philadelphia negative B-ALL/LBL. During this time, fluorescence in situ hybridization (FISH) and PCR testing for BCR-ABL1 rearrangements were being performed on the marrow specimens as a part of routine diagnostic workup. While the FISH returned negative, PCR testing unexpectedly detected BCR-ABL1 fusion transcripts at a low level of 0.48%. Given their presence, we performed FISH for BCR/ABL1 rearrangement in both testicular and L5 vertebral specimens which were 80–90% positive. He subsequently received rituximab, hyper-CVAD, and dasatinib, along with prophylactic intrathecal prophylactic chemotherapy. The patient achieved a prolonged remission but eventually relapsed, 4 years later. Had it not been for this fortuitous discovery, the patient would not have been treated with tyrosine kinase inhibitors. We emphasize that FISH and PCR testing for BCR-ABL1 rearrangement are integral to arriving at an accurate diagnosis and should be routinely tested on B-LBL biopsy specimens.

Isolated Ovarian Recurrence of Endocervical Adenocarcinoma In Situ

2016 ◽  
Vol 32 (3) ◽  
pp. 189-192 ◽  
Author(s):  
Elena B. Pereira ◽  
Lena El Hachem ◽  
Mazdak Momeni ◽  
Richard Eisen ◽  
Herbert Gretz
Keyword(s):  
Adenocarcinoma In Situ ◽  
Endocervical Adenocarcinoma

Peripheral ameloblastoma in-situ: an evidential fact of surface epithelium origin

2009 ◽  
Vol 108 (5) ◽  
pp. 763-767 ◽  
Author(s):  
Fumio Ide ◽  
Kenji Mishima ◽  
Yuji Miyazaki ◽  
Ichiro Saito ◽  
Kaoru Kusama
Keyword(s):  
Surface Epithelium

scholarly journals Identification of key genes related to macrophage infiltration in gastric cancer based on WGCNA

2020 ◽  
Author(s):  
Haiyan Chen ◽  
Cangang Zhang ◽  
Shuai Cao ◽  
Meng Cao ◽  
Nana Zhang ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Immune Cell ◽  
Accurate Diagnosis ◽  
Marker Genes ◽  
Hub Genes ◽  
Normal Tissues ◽  
Tumor Tissues ◽  
New Strategy ◽  
Tumor Environment ◽  
Advanced Stages

Abstract Background: Gastric cancer (GC) is rampant around the world. Most of the GC cases are detected in advanced stages with poor prognosis. The identification of marker genes for early diagnosis is of great significance. Studying the tumor environment is helpful to acknowledge the process of tumorigenesis, development, and metastasis.Methods: In GEO, 22 kinds of immune cell infiltration were calculated by CIBERSORT. Macrophages were discovered remarkably infiltrated higher in GC compared with normal tissues. WGCNA was utilized to construct the network and then identify key modules and genes related to macrophages in TCGA.Results: Finally, 18 hub genes were verified. In the PPI bar chart, the top 3 genes were chosen as hub genes involved in most pathways. On the TIMER and THPA websites, it is verified that the expression levels of CYBB, CD86 and C3AR1 genes in tumor tissues were higher than those in normal tissues.Conclusion: These genes may work as biomarkers or targets for accurate diagnosis and treatment of GC in the future. Our findings may be a new strategy for the treatment of GC.

scholarly journals Giant Aortic Aneurysm in Child with Cutis Laxa Syndrome: Unusual Presentation, New Surgical Technique

2021 ◽  
Vol 24 (6) ◽  
pp. E1054-E1056
Author(s):  
Mazen Shamsaldeen Faden ◽  
Nada Ahmed Noaman ◽  
Osman Osama Osman Osama ◽  
Ahmed Abdelrahman Elassal ◽  
Arwa Mohammed Al-ghamdi ◽  
...  
Keyword(s):  
Final Diagnosis ◽  
Ascending Aorta ◽  
Accurate Diagnosis ◽  
Aortic Aneurysms ◽  
Cutis Laxa ◽  
Descending Aorta ◽  
Aorta Aneurysm ◽  
Thoracic Aortic Aneurysms ◽  
Valvular Insufficiency ◽  
New Surgical Technique

Ascending thoracic aortic aneurysms are rare in childhood and typically are seen in the setting of connective tissue defect syndromes. These aneurysms may lead to rupture, dissection, or valvular insufficiency, so root replacement is recommended. Here, we present a 17-month-old girl who presented with fever, cough, and pericardial effusion. Initially, we suspected this could be a COVID-19 case, so a nasopharyngeal swap was performed. An ascending aorta aneurysm involving the aortic arch was confirmed by echo, and urgent ascending aorta and arch replacement were done by utilizing the descending aorta as a new arch. The final diagnosis came with cutis laxa syndrome. In similar cases, good outcomes can be achieved with accurate diagnosis and appropriate surgical management.

Feulgen stain as a special stain for mitotic figures and apoptotic bodies in oral squamous cell carcinoma

2018 ◽  
Vol 9 (4) ◽  
pp. 164
Author(s):  
Sankari Radhakrishnan ◽  
Ramesh Venkatapathy ◽  
PD Balamurali ◽  
KarthikShree V Prashad ◽  
B Premalatha ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Oral Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Apoptotic Bodies ◽  
Special Stain ◽  
Mitotic Figures
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