scholarly journals Inverted urothelial papilloma: A review of diagnostic pitfalls and clinical management

2017 ◽  
Vol 11 (1-2) ◽  
pp. 66 ◽  
Author(s):  
Mary K. Sweeney ◽  
Soroush Rais-Bahrami ◽  
Jennifer Gordetsky
Keyword(s):  
Smooth Surface ◽  
Squamous Metaplasia ◽  
Diagnostic Error ◽  
Superficial Layer ◽  
Proliferation Index ◽  
Ki 67 ◽  
Non Invasive ◽  
Peripheral Palisading ◽  
Urothelial Tumours ◽  
Diagnostic Pitfalls

Inverted urothelial papilloma (IUP) is a rare, non-invasive endophytic lesion that accounts for 1‒2% of urothelial tumours. On cystoscopy, IUP appears as a pedunculated/papillary mass with a smooth surface. On microscopy, IUP has an endophytic growth pattern with the bulk of the tumour covered by a superficial layer of urothelium, which can be hyperplastic or attenuated. The cytology should be bland, with uniform, spindled cells arranged in anastomosing trabeculae and cords with peripheral palisading of basaloid cells. Exophytic papillae and mitotic activity should be absent or focal. Pseudoglandular spaces and squamous metaplasia may also be present. There are distinct molecular differences between IUP and urothelial carcinoma (UC). IUP rarely has mutations of FGFR3, homozygous loss of 9p21, or gain of chromosomes 3, 7, and 17, whereas these mutations are frequently seen in UC. In addition, IUP is much less likely to have TERT mutations compared to UC. Immunohistochemistry can also be helpful in distinguishing the two entities as IUP is typically negative for CK20 and has a low Ki-67 proliferation index. Positivity for p53 may be seen in a minority of IUP. IUP can recur and be seen in association with UC. Distinguishing IUP from UC can be difficult due to the similarity between the two entities both on cystoscopy and histology, as up to 25% of UCs will also have inverted growth. Given the morphologic variants of IUP and UC, it is possible for a diagnostic error to occur, which can significantly impact patient management.

scholarly journals p16-negative warty carcinoma of the uterine cervix with superficial invasion to the endometrium: A case report focusing on diagnostic pitfalls

2017 ◽  
Vol 4 (3) ◽  
pp. 12
Author(s):  
Hyun-Jung Kim ◽  
Chul Min Lee
Keyword(s):  
Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Uterine Cervix ◽  
Low Risk ◽  
Proliferation Index ◽  
Invasive Squamous Cell Carcinoma ◽  
Ki 67 ◽  
Hpv Dna ◽  
Diagnostic Pitfalls

Warty carcinoma of the uterine cervix is a very rare and specific variant of invasive squamous cell carcinoma, usually described as a hybrid of the features of both condyloma acuminatum and invasive squamous cell carcinoma. The diagnostic pitfalls of this lesion are: 1) the bland appearance of cytomorphology, 2) distinct koilocytotic atypia, and 3) p16 negativity. A case of warty carcinoma with a fungating mass on the uterine cervix of a 75-year-old woman is presented. The original diagnosis by punch biopsy was atypical squamous cells, undetermined for malignancy, adjunct with p16 negativity. The subsequent radical hysterectomy showed a protruding mass (5.7 cm in horizontal dimension) of the uterine cervix. Light microscopy revealed a protruding mass composed of exophytic papillae and inverted nests along the endocervical glands. There were multiple micro-invasive foci (< 1 mm) of tongue like projections at the nest base and slight involvement of the upper vagina and endometrial surface. The p16 immunohistochemical staining yielded negative results. The results of the HPV DNA chip test from paraffin-embedded tissue were 6 (low risk, +++) and 42 (low risk, +). The Ki-67 proliferation index was approximately 20%. The invasive foci and patient’s age were the determining differential factors for malignancy rather than benign condylomatous lesion.

scholarly journals Case Report: Myelodysplastic syndrome- associated myeloid sarcoma: an unusual clinical presentation of a rare disease

F1000Research ◽  
2016 ◽  
Vol 5 ◽  
pp. 128 ◽  
Author(s):  
Emoke Horvath ◽  
Smaranda Demian ◽  
Elod Nagy
Keyword(s):  
Bone Marrow ◽  
Myelodysplastic Syndrome ◽  
Clinical Presentation ◽  
Final Diagnosis ◽  
Myeloid Sarcoma ◽  
Proliferation Index ◽  
Tumour Mass ◽  
Ki 67 ◽  
Blast Cells ◽  
Diagnostic Pitfalls

Myeloid sarcoma results from the extramedullary homing and proliferation of immature myeloid precursors. We present the timeline, events and diagnostic pitfalls related to a 66 year-old male patient’s case, admitted to the Hematology Clinic for pancytopenia, fever, weight loss and fatigue. The severe cytopenia and the few blasts observed in his blood smear indicated a bone marrow biopsy. The bone marrow showed hypercellularity and multilineage dysplasia with the presence of 15% myeloblasts. After the biopsy, he promptly developed paraplegia and nuclear magnetic resonance revealed an epidural tumour which was then resected.In the epidural tumour mass blast-like, round cells were observed with a complex immunophenotype, characterized by myeloperoxidase, CD117, CD15, CD99, leucocyte common antigen positivity and a high Ki-67 proliferation index. Considering the main differential diagnostic issues, the final diagnosis was stated as myelodysplastic syndrome-associated myeloid sarcoma. The prognosis was unfavourable, the bone marrow was quickly invaded by proliferating blast cells, and despite chemotherapy attempts, the patient died.

Expression of β-Catenin in Hepatocellular Carcinoma

2001 ◽  
Vol 71 (3) ◽  
pp. 116-125
Author(s):  
Norina Basa ◽  
Daniela Lazar ◽  
Remus Cornea ◽  
Sorina Taban ◽  
Melania Ardelean ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Cell Proliferation ◽  
Tumor Cell ◽  
Mitotic Index ◽  
Histological Grade ◽  
Proliferation Index ◽  
Tumor Cell Proliferation ◽  
Ki 67 ◽  
B Virus ◽  
Development And Evolution

Alteration of β-catenin expression is involved in the development and evolution of hepatocellular carcinoma (HCC); β-catenin is able to influence tumor cell proliferation. We analyzed the immunohistochemical (IHC) expression of β-catenin on a group of 32 patients diagnosed with HCC using the anti-β-catenin monoclonal antibody (clone E247). We correlated the expression of β-catenin with the proliferation index of Ki-67 (PI Ki-67), the mitotic index (MI) and other clinical and pathological features. We observed an altered β-catenin expression in 58.38% of all HCC cases. This expression was insignificantly correlated with tumor size (]5 cm) (p = 0.683), histological grade G1-G2 (p = 0.307), vascular invasion (p = 0.299) and advanced pT stage (p = 0.453); we obtained a significantly higher MI in HCC with altered β-catenin expression (p = 0.018), as compared to HCC without overexpression (1.66 � 1.37) (p = 0.038) and a PI Ki-67 of 22.49 � 20.1 and 28.24 � 18.2, respectively in tumors with altered β-catenin expression with insignificant differences compared to HCC without overexpression (25.95 � 15.2) (p = 0.682 and p = 0.731, respectively). According to the results we obtained, aberrant β-catenin expression in HCC was correlated with a high mitotic index, therefore playing an important role in tumor progression by stimulating tumor cell proliferation; non-nuclear β-catenin overexpression can have a pathological significance in HCC, especially in cases of HCC associated with hepatitis B virus (HBV) infection.

Strategic Aspects of NPY-Based Monoclonal Antibodies for Diagnosis and Treatment of Breast Cancer

2020 ◽  
Vol 21 (11) ◽  
pp. 1097-1102
Author(s):  
Drashti Desai ◽  
Pravin Shende
Keyword(s):  
Breast Cancer ◽  
Monoclonal Antibodies ◽  
Diagnosis And Treatment ◽  
Detection Methods ◽  
Active Immunotherapy ◽  
Immune Checkpoints ◽  
Proliferation Index ◽  
Protein Fusion ◽  
Ki 67 ◽  
Cost Efficient

: Immunotherapy emerges as a treatment strategy for breast cancer marker, diagnosis and treatment. In this review, monoclonal antibodies (mAbs)-based passive and peptide vaccines as active immunotherapy approaches like activation of B-cells and T-cells are studied. Passive immunotherapy is mAbs-based therapy effective against tumor cells, which acts by targeting HER2, IGF 1R, VEGF, BCSC and immune checkpoints. Neuropeptide Y (NPY) and GPCR are the areas of interest to target BC metastases for on-targeting therapeutic action. Neuropeptide S (NPS) or NPS receptor 1, acts as a biomarker for Neuroendocrine tumors (NET), mostly characterized by synaptophysin and chromogranin-A expression or Ki-67 proliferation index. The protein fusion technologies arise as a promising avenue in plant expression systems for increased recombinant Ab accumulation and cost-efficient purification. Recently, mAbs-based immunotherapy effectiveness is appreciated as a novel therapeutic combination of chemotherapy and immunotherapy to reduce the side effects and improve therapeutic responsiveness. Synthetic drug resistance will be overcome by mAbs-based therapy through several clinical trials and detection methods need to be optimized for accuracy and precision. Pharmacokinetic attributes need to be accessed for preferred receptor-agonist activity without ligand accumulation.

scholarly journals Calcitonin-Negative Neuroendocrine Carcinoma of the Thyroid Gland: Case Report and Literature Review

2021 ◽  
pp. 112-122
Author(s):  
Ricardo Fernández-Ferreira ◽  
Ildefonso Roberto De la Peña-López ◽  
Karla Walkiria Zamudio-Coronado ◽  
Luis Antonio Delgado-Soler ◽  
María Eugenia Torres-Pérez ◽  
...  
Keyword(s):  
Thyroid Carcinoma ◽  
English Language ◽  
Neoadjuvant Treatment ◽  
Complete Response ◽  
Cervical Region ◽  
Proliferation Index ◽  
Ki 67 ◽  
Definitive Evidence ◽  
Criteria For Diagnosis ◽  
Fdg Pet Ct

Calcitonin-negative neuroendocrine tumor (CNNET) of the thyroid is an extremely rare entity. In some of the previously reported cases within the literature, the terms “atypical medullary thyroid carcinoma,” “calcitonin-free oat cell carcinoma,” and “a distinct clinical entity” were applied to NETs without definitive evidence of calcitonin production. In the English-language literature, not only are there only few reported cases of CNNET, but the criteria for diagnosis in these cases are also controversial. Most of the current published cases were also treated surgically for local disease. We describe a case of NET of the thyroid with calcitonin, chromogranin A and thyroglobulin negativity, synaptophysin and TTF-1 positivity, and a high Ki-67 proliferation index with metastases in the cervical region as well as mediastinal adenopathies. This case was considered an unresectable thyroid carcinoma, and chemotherapy including cisplatin and etoposide was started as neoadjuvant treatment at the department of medical oncology. Total thyroidectomy plus bilateral and central cervical dissection was performed, and the patient underwent 2 cycles of adjuvant radiotherapy. Currently, the patient’s 18F-FDG-PET/CT findings show a complete response 17 months after diagnosis. In conclusion, CNNET of the thyroid is very rare and there is limited evidence regarding treatment in patients with metastases. Chemotherapy including cisplatin and etoposide as well as early aggressive surgical resection appears to positively impact patients’ survival.

Prognostic Implications of p53 Nuclear Overexpression and High Proliferation Index of Ki-67 in Adult Soft-Tissue Sarcomas

1994 ◽  
Vol 86 (7) ◽  
pp. 549-554 ◽  
Author(s):  
Marija Drobnjak ◽  
Esther Latres ◽  
Daphna Pollack ◽  
Martin Karpeh ◽  
Maria Dudas ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Soft Tissue Sarcomas ◽  
Proliferation Index ◽  
Ki 67 ◽  
Prognostic Implications
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