Diagnostic Pitfalls Related to Morular Metaplasia in Endometrioid Carcinoma: An Underestimated Issue

Pathobiology ◽  
2021 ◽  
pp. 1-6
Author(s):  
Antonio Travaglino ◽  
Antonio Raffone ◽  
Annarita Gencarelli ◽  
Serena Saracinelli ◽  
Fulvio Zullo ◽  
...  
Keyword(s):  
Patient Management ◽  
Hormone Receptors ◽  
Immunohistochemical Analysis ◽  
Endometrioid Carcinoma ◽  
Rectosigmoid Colon ◽  
Solid Carcinoma ◽  
Colorectal Origin ◽  
A Minor ◽  
Diagnostic Pitfalls

Here, we present a case that highlights the crucial pitfalls related to the presence of morular metaplasia (MM) in endometrioid carcinoma, which are insufficiently recognized in the routine pathology practice. A 45-year-old woman underwent hysterectomy with rectosigmoidectomy due to a 11-cm mass involving uterus, right ovary, and rectosigmoid colon. Histologically, the lesion appeared as a predominantly solid carcinoma with a minor glandular component. Results of the first immunohistochemical analysis suggested a colorectal origin (PAX8-, CK7-, WT1-, hormone receptors-, and CDX2+ in the absence of mucinous features). Subsequent immunohistochemistry (nuclear β-catenin+, CD10+, and low ki67 in the solid areas) supported a diagnosis of endometrioid carcinoma with diffuse MM. This case remarks that morphological and immunohistochemical features of MM may conceal the glandular architecture and the typical immunophenotype of endometrioid carcinomas. Acknowledging the diagnostic issues related to MM appears crucial to avoid misdiagnosis and inappropriate patient management.

scholarly journals L-Thyroxine improves vestibular compensation in a rat model of acute peripheral vestibulopathy

2021 ◽  
Author(s):  
Guillaume Rastoldo ◽  
Emna Marouane ◽  
Nada El Mahmoudi ◽  
David Pericat ◽  
Isabelle Watabe ◽  
...  
Keyword(s):  
Rat Model ◽  
Hormone Receptors ◽  
Immunohistochemical Analysis ◽  
Vestibular Nuclei ◽  
Vestibular Compensation ◽  
Metabolic Effects ◽  
Iodothyronine Deiodinase ◽  
Vestibular Neurectomy ◽  
Peripheral Vestibulopathy ◽  
Unilateral Vestibular Neurectomy

AbstractUnilateral vestibular lesions induce a vestibular syndrome, which recovers over time due to vestibular compensation. The therapeutic effect of L-Thyroxine (L-T4) on vestibular compensation was investigated by behavioral testing and immunohistochemical analysis in a rat model of unilateral vestibular neurectomy (UVN). We demonstrated that an acute L-T4 treatment reduced the vestibular syndrome and significantly promoted vestibular compensation. Thyroid hormone receptors (TRα and TRβ) and type II iodothyronine deiodinase (DIO2) were present in the vestibular nuclei (VN), supporting a local action of L-T4. We confirmed the T4-induced metabolic effects by demonstrating an increase in the number of cytochrome oxidase-labelled neurons in the VN three days after the lesion. L-T4 treatment modulated glial reaction by decreasing both microglia and oligodendrocytes in the deafferented VN three days after UVN and increased cell proliferation. The survival of newly generated cells was not affected, but neuronal differentiation was altered by the L-T4 treatment.

scholarly journals Fertility Preserved Hysteroscopic Approach for the Treatment of Stage Ia Endometrioid Carcinoma

2017 ◽  
Vol 27 (9) ◽  
pp. 1919-1925 ◽  
Author(s):  
Fangfang Wang ◽  
Aijun Yu ◽  
Haichao Xu ◽  
Xiaojing Zhang ◽  
Li Li ◽  
...  
Keyword(s):  
Polycystic Ovary ◽  
Young Patients ◽  
Uterine Fibroids ◽  
Immunohistochemical Analysis ◽  
Radical Resection ◽  
Peritoneal Cytology ◽  
Endometrioid Carcinoma ◽  
Hysteroscopic Surgery ◽  
Gynecology And Obstetrics ◽  
Stage Ia

ObjectiveThis study aims to explore the feasibility of a hysteroscopic procedure combined with progestin therapy in young patients with stage Ia endometrioid carcinoma (EC) to avoid sterilization.Materials and MethodsEleven young women with stage Ia EC (International Federation of Gynecology and Obstetrics grade 1) who were treated with a hysteroscopic approach combined with progestin from July 2004 to June 2016 were retrospectively analyzed and followed up to monitor their general recovery and pregnancy outcome.ResultsThe patients' median age was 27.3 years (range, 25–39 years). Comorbidities consisted of primary infertility in 8 patients, polycystic ovary syndrome in 4, uterine fibroids in 2, and diabetes in 1. The results of immunohistochemical analysis were positive for all estrogen and progestin receptors. After treatment, 9 patients attained complete remission, and 2 patients achieved partial remission. The results of peritoneal cytology in 4 patients were negative. As of this writing, 6 of the 11 patients have given birth to 7 infants, and 1 patient had an ectopic pregnancy. Two patients ultimately underwent radical resection. The average follow-up time was 82.3 months (range, 15 to 152 months), and all patients remain disease-free.ConclusionsHysteroscopic surgery combined with progestin treatment for stage Ia EC in young patients to avoid sterilization was practical and may represent a new option for patients with stage Ia EC who wish to preserve their fertility.

Concordance of Intradepartmental Consultations of Barrett’s Dysplasia

2019 ◽  
Vol 152 (Supplement_1) ◽  
pp. S54-S55
Author(s):  
Fengming Chen ◽  
Yongjun Liu ◽  
Francesca Ruggiero
Keyword(s):  
Patient Management ◽  
Clinical Information ◽  
Final Diagnosis ◽  
Progression Rate ◽  
Low Grade ◽  
Rate Of Progression ◽  
Major Discrepancy ◽  
A Minor ◽  
Optimal Patient Management

Abstract Introduction Barrett’s esophagus (BE) is a well-known precursor to esophageal adenocarcinoma (EAC). Simple BE has an annual rate of progression to EAC of only up to 0.5%, while BE with low-grade dysplasia (LGD) or with high-grade dysplasia (HGD) has a higher progression rate of ~10% and ~40%, respectively. Therefore, accurate diagnosis and grading of dysplasia in BE are critical for optimal patient management. However, grading dysplasia is not well defined in practice, which often results in poor interobserver and/or intraobserver reproducibility. In this study, we aim to (1) investigate the concordance of intradepartmental consultations of BE dysplasia and (2) compare consultant diagnosis with final diagnosis and follow-up diagnosis. Methods We retrospectively reviewed 856 intradepartmental consultation records obtained from May 2017 to March 2018. For cases of Barrett’s dysplasia in biopsy specimens, H&E-stained slides were re-reviewed and the corresponding clinical information was retrieved from the electronic medical record. Results Twenty intradepartmental consultation cases of Barrett’s dysplasia were identified (involving 2 females and 18 males, mean age 67.8 ± 8.6 years, ranging 50-81 years). The most frequent reasons for consultation were indefinite dysplasia (IND) vs LGD and LGD vs HGD. Half of the cases showed concordance between referring pathologist and consultant pathologist(s), while 10% of the case showed a major discrepancy (resulting in significant changes in patient management and/or prognosis) and 40% showed a minor discrepancy (resulting in no significant impact on patient management and/or prognosis). The final diagnoses were changed after consultation for cases with major discrepancy, while 60% of cases with minor discrepancy remained the original diagnoses. Conclusions Intradepartmental consultations are strongly recommended for the challenging cases of BE dysplasia, which can effectively prevent over- or underdiagnosis. For challenging cases such as IND vs LGD, two or more consultants are usually needed to reach an agreement.

Mouse mandibular retromolar taste buds associated with a mucus salivary gland

2021 ◽  
Author(s):  
Quan T Nguyen ◽  
Grace E Beck Coburn ◽  
Amber Valentino ◽  
Bekir Karabucak ◽  
Marco Tizzano
Keyword(s):  
Salivary Gland ◽  
Fluorescent Protein ◽  
Minor Salivary Gland ◽  
Immunohistochemical Analysis ◽  
Taste Buds ◽  
Taste Bud ◽  
Neuronal Marker ◽  
Taste Cells ◽  
Green Fluorescent ◽  
A Minor

Abstract We have characterized a recently rediscovered chemosensory structure at the rear of the mandibular mucosa in the mouse oral cavity originally reported in the 1980s. This consists of unorganized taste buds, not contained within troughs, associated with the ducts of an underlying minor salivary gland. Using whole-mount preparations of transgenic mice expressing green fluorescent protein under the promoter of taste-signaling-specific genes, we determined that the structure contains taste bud clusters and salivary gland orifices at the rear of each mandible, distal to the last molar and anterior to the ascending ramus. Immunohistochemical analysis show in the retromolar taste buds expression of the taste receptors Tas2R131 and T1R3 and taste cascade molecules TrpM5, PLCβ2, and GNAT3, consistent with type II taste cells, and expression of GAD1, consistent with type III taste cells. Furthermore, the neuronal marker CGRP in retromolar mucosa tissue wrapping around TrpM5+ taste buds was observed. RT-PCR showed that retromolar taste buds express all three mouse tas1r genes, 28 of the 35 tas2r genes, and taste transduction signaling genes gnat3, plcb2, and trpm5, making the retromolar TBs similar to other lingual and palate taste buds. Finally, histochemistry demonstrated that the mandibular retromolar secretory gland is a minor salivary gland of mucous type. The mandibular retromolar taste structure may thus play a role in taste sensation and represent a potential novel pharmacological target for taste disorders.

scholarly journals Immunohistochemical analysis of angiogenesis in invasive ductal breast carcinoma with correlations to clinic pathological factor

2006 ◽  
Vol 63 (7) ◽  
pp. 635-642 ◽  
Author(s):  
Tatjana Ivkovic-Kapicl ◽  
Slavica Knezevic-Usaj ◽  
Milana Panjkovic ◽  
Katarina Mastilovic
Keyword(s):  
Hormone Receptors ◽  
Ductal Carcinoma ◽  
Histological Grade ◽  
P53 Protein ◽  
Immunohistochemical Analysis ◽  
Metastatic Potential ◽  
Biological Indicators ◽  
Invasive Ductal Breast Carcinoma ◽  
Large Tumor ◽  
Tumor Phenotype

Background/aim: Angiogenesis is the formation of new vessels from preexisting ones. The aim of our study was to determine the relevance of tumor-induced angiogenesis, its correlation with some of the commonly used clinical, pathological factors and the recent biological indicators, and metastatic potential of the tumor in a series of 120 patients with invasive ductal carcinoma of the breast. Methods. The identification of microvessels was performed immunohistochemically with factor VIII-related antigen. The microvessel count (MVC) was assessed at the invasive front of each carcinoma. The cases were divided into high-and low-microvessel density groups according to an average number of microvessels found in the multiple fields of the most vessel-dense part of each tumor. The nuclear immunohistochemical staining for hormone receptors, and the p53, and the membranous staining for cerbB-2 were evaluated. Results. There were significant correlations between a high MVC and a large tumor size, high histological grade, and c-erbB-2 protein over expression. There was no association between tumor angiogenesis, as assessed by the MVC, and the hormone receptors status, and the p53 protein expression. In the cases with a high MVC, there was a significant number of tumors with lymph node metastases. Conclusion. Our findings showed that a high MVC might point out an aggressive tumor phenotype. This might help to stratify patients for an appropriate therapy on an individual basis and, thus, offer the possibility of a more effectively tailored treatment program.

Expression of Cyclin D1 in Normal, Metaplastic, Hyperplastic Endometrium and Endometrioid Carcinoma Suggests a Role in Endometrial Carcinogenesis

2002 ◽  
Vol 126 (4) ◽  
pp. 459-463 ◽  
Author(s):  
M. Ruhul Quddus ◽  
Predrag Latkovich ◽  
William J. Castellani ◽  
C. James Sung ◽  
Margaret M. Steinhoff ◽  
...  
Keyword(s):  
Cyclin D1 ◽  
Immunohistochemical Analysis ◽  
Endometrial Biopsy ◽  
Surface Epithelium ◽  
Endometrioid Adenocarcinoma ◽  
Endometrioid Carcinoma ◽  
Normal Surface ◽  
Normal Endometrium ◽  
Metaplastic Epithelium ◽  
Secretory Endometrium

Abstract Context.—Endometrioid carcinoma is often preceded by characteristic histopathologic lesions known as endometrial hyperplasia. Estrogen appears to be involved in the development of endometrioid carcinoma. Other mechanisms of endometrial carcinogenesis include mutations in p53 and PTEN tumor suppressor genes and overexpression of cyclin D1. However, the pattern of cyclin D1 expression is not well defined in normal, hyperplastic, neoplastic, and metaplastic endometrium. Design.—Cyclin D1 immunohistochemical analysis was used to evaluate 108 fixed, paraffin-embedded endometrial biopsy specimens and uterine resections obtained from 108 patients. Specimens included proliferative and secretory endometria, simple and complex hyperplastic lesions, and endometrioid adenocarcinoma. Normal and metaplastic surface epithelia were also evaluated independently of glandular morphologic features. Results.—Cyclin D1 was significantly overexpressed in glands with complex hyperplasia and endometrioid adenocarcinoma compared with proliferative or secretory endometrium and simple hyperplasia. Significant overexpression was also noted in papillary, syncytial, and squamous metaplasias compared with normal surface epithelium or epithelium with tubal metaplasia. Conclusion.—Overexpression of cyclin D1 increases from normal endometrium to hyperplasia and carcinoma, suggesting that it may play a role in endometrial carcinogenesis. Overexpression of cyclin D1 in endometrial glands was independent from overexpression of cyclin D1 in surface metaplastic epithelium.

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