Teat sinus and duct adenomatous hyperplasia in dogs

Seventeen lesions diagnosed as teat sinus and duct adenomatous hyperplasia were identified in 10 dogs. All of the dogs were small breeds. Six were spayed female and 4 were male, 3 castrated and 1 intact. In 5 cases, the lesions involved multiple teats. They were pink to black, flattened to round, and sometimes crusted. Histologically, the lesions were usually pigmented (16/17), plaque-like to nodular masses composed of polygonal cells arranged in anastomosing trabeculae and bilayered ducts and/or cysts, with a fibrous to mucinous (Alcian blue-positive) stroma and squamous cysts (12/17). Scattered epithelial cells contained single, discrete, clear cytoplasmic vacuoles. Atypia was mild, and the mitotic count per 2.37 mm2 varied from 0 to 15 (average 2.7). Immunohistochemistry was performed on 14 of the lesions from 8 dogs. Epithelial cells were 100% panCK+ and included basally located CK14+/CK5_6+/p63+/calponin− cells and nonbasal CK19+/CK7+ cells. Cells manifesting squamous differentiation were usually panCK+/CK14+/CK5_6+/CK19−/CK7−/p63±/calponin−. In addition to fibroblasts, vimentin positivity was found in disseminated, round to stellate stromal and intraepithelial cells that often had black, granular, cytoplasmic pigment (consistent with dendritic/phagocytic cells and/or melanocytes). Of the 8 dogs for which clinical follow-up information was available, all were still alive and well, with no significant teat changes, development of mammary lesions or other masses 4 to 22 months (median 12.5) after biopsy. The histologic, immunohistochemical, and clinical findings were consistent with teat duct and sinus adenomatous hyperplasia. This is an uncommon, benign proliferative lesion that can involve multiple teats of female and male, small breed dogs.

Deciphering cell lineage specification of human lung adenocarcinoma with single-cell RNA sequencing

Lung adenocarcinomas (LUAD) arise from precancerous lesions such as atypical adenomatous hyperplasia, which progress into adenocarcinoma in situ and minimally invasive adenocarcinoma, then finally into invasive adenocarcinoma. The cellular heterogeneity and molecular events underlying this stepwise progression remain unclear. In this study, we perform single-cell RNA sequencing of 268,471 cells collected from 25 patients in four histologic stages of LUAD and compare them to normal cell types. We detect a group of cells closely resembling alveolar type 2 cells (AT2) that emerged during atypical adenomatous hyperplasia and whose transcriptional profile began to diverge from that of AT2 cells as LUAD progressed, taking on feature characteristic of stem-like cells. We identify genes related to energy metabolism and ribosome synthesis that are upregulated in early stages of LUAD and may promote progression. MDK and TIMP1 could be potential biomarkers for understanding LUAD pathogenesis. Our work shed light on the underlying transcriptional signatures of distinct histologic stages of LUAD progression and our findings may facilitate early diagnosis.

485 Unexpected Pathological Findings In 189 LVRS Patients: Clinical Relevance

Objectives LVRS improves survival and quality of life in selected patients with emphysema. In view of the great improvement in the detailed information available from CT, it is important to evaluate the benefit of routine pathological assessment of the resected specimen. We reviewed the histopathological findings in our contemporary LVRS series to determine the rate of pathological findings in addition to emphysema. Method Prospectively collected data from a specialised higher volume LVRS centre. The CT and histopathology reports of 189 consecutive LVRS procedures were reviewed. One underwent thoracotomy, 188 were by VATS, of which one was converted to thoracotomy and of which 22 were by a subxiphoid approach. The target reduction volume was 30-50% of the lung. Results All patients were reported to have emphysematous changes in both CT and histology. Ten patients, all with radiographic evidence of a lesion preoperatively, had squamous carcinoma (x2), adenocarcinoma, atypical adenomatous hyperplasia (AAH) (x2), squamous metaplasia (x2), carcinoid tumourlet, chondroid hamartoma, and DIPNECH. There were 39 neoplastic histological findings which were not radiologically reported; these were adenocarcinoma (1), AAH (10), squamous metaplasia (7), carcinoid tumourlet (5), squamous dysplasia (3), neuroendocrine hyperplasia (2), and chemodectoma. In addition, 21 inflammatory/infective cases were also reported. Conclusions Our systemic retrospective CT and histopathology review of LVRS operations shows that the rate of additional findings is 32%. Of these 83% were not reported on the pre-operative review of the CT. This supports the value of systematic pathological assessment of resected samples.

Evaluation of the Radiomics Method for the Prediction of Atypical Adenomatous Hyperplasia in Patients With Subcentimeter Pulmonary Ground-Glass Nodules

ObjectivesWe aimed to develop a prediction model to distinguish atypical adenomatous hyperplasia (AAH) from early lung adenocarcinomas in patients with subcentimeter pulmonary ground-glass nodules (GGNs), which may help avoid aggressive surgical resection for patients with AAH.MethodsSurgically confirmed cases of AAH and lung adenocarcinomas manifesting as GGNs of less than 1 cm were retrospectively collected. A prediction model based on radiomics and clinical features identified from a training set of cases was built to differentiate AAH from lung adenocarcinomas and tested on a validation set.ResultsFour hundred and eighty-five eligible cases were included and randomly assigned to the training (n = 339) or the validation sets (n = 146). The developed radiomics prediction model showed good discrimination performance to distinguish AAH from adenocarcinomas in both the training and the validation sets, with, respectively, 84.1% and 82.2% of accuracy, and AUCs of 0.899 (95% CI: 0.867–0.931) and 0.881 (95% CI: 0.827–0.936).ConclusionThe prediction model based on radiomics and clinical features can help differentiate AAH from adenocarcinomas manifesting as subcentimeter GGNs and may prevent aggressive resection for AAH patients, while reserving this treatment for adenocarcinomas.

Determine the Frequency of Endometrial Hyperplasia in Female with Abnormal Vaginal Bleeding

Objective: To determine the frequency of endometrial hyperplasia in female with abnormal vaginal bleeding. Study Design: Cross-sectional Place and Duration of Study: Department of Obstetrics & Gynaecology, Allama Iqbal Memorial Teaching Hospital, Sialkot from 1st January 2021 to 31st March 2021. Methodology: One hundred and ten females with abnormal bleeding were presented in this study. Patients were aged between 40-65 years. Demographically details of age, weight, body mass index and socio economic status were recorded after taking written consent. Complete patients were undergone for transvaginal ultrasound. Frequency of endometrial hyperplasia was recorded. Results: Mean age of the females was 47.16±7.53 years with mean BMI 26.17±8.44 kg/m2. Mean weight of the patients were 59.16±17.66 kg. Most of the patients 65 (59.09%) were from urban area and majority of the patients 70 (63.64%) were illiterate. Sixty (54.5%) cases were from low socio-economic status and 50 (45.5%) had high socio-economic status. Endometrial hyperplasia was found in 25 (22.73%) patients, in which 18 (72%) had cystic hyperplasia, adenomatous hyperplasia found in 4 (16%) and 3 (12%) had atypical hyperplasia. Among 25 cases of hyperplasia, menorrhagia found in 15 (60%), polymenorrhea found in 8 (32%) and polymenorrhagia in 2 (8%). Medical treatment were given to 20 (80%) cases and surgical treatment were given to 5 (20%). Conclusion: The prevalence of endometrial hyperplasia was 22.73% among women with abnormal bleeding. It can be cure by early diagnosis and treatment. Keywords: Transvaginal ultrasound (TVS), Endometrial hyperplasia, Abnormal vaginal bleeding, Menorrhagia