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Anal canal gastrointestinal stromal tumors:Case report and literature review

World Journal of Gastroenterology 2014年第1期20卷 319-322页

作者： Nuno Carvalho Diogo Albergaria Rui Lebre Joo Giria Vitor Fernandes helena vidal Maria José Brito Department of General Surgery Garcia de Orta Hospital2801-951 AlmadaPortugal Department of Gastroenterology Garcia de Orta Hospital2801-951 AlmadaPortugal Department of Radiology Garcia de Orta Hospital2801-951 AlmadaPortugal Department of Pathology Garcia de Orta Hospital2801-951 AlmadaPortugal

Gastrointestinal stromal tumors (GIST) are an uncommon group of tumors of mesenchymal origin. GIST of the anal canal is extremely rare. At present, only 10 cases of c-kit positive anal GIST have been reported in the literature. There is no widely accepted treatment approach for this neoplasia. Literature is sparse on imaging evaluation of anal canal GIST, usually described as a lesion in the intersphincteric space. We describe the case of a 73-year-old man with a mass in the anal canal, and no other symptoms. Endoanal ultrasound and magnetic resonance imaging showed a well circumscribed solid nodule in the intersphincteric space. The patient was treated by local excision. Gross pathological examination showed a 7 cm × 3.5 cm × 3 cm mass, and histological examination showed a proliferation of spindle cells, with prominent nuclear palisading. The mitotic count was of 12 mitoses/50 HPF. The tumor was positive for KIT protein, CD34 and vimentin in the majority of cells, and negative for desmin and S100. A diagnosis of GIST, with high risk aggressive behavior was made. An abdomino-perineal resection was discussed, but refused. The follow-up included clinical evaluation and anal ultrasound. After 5 years the patient is well, with maintained continence and no evidence of local recurrence.

关键词： Gastrointestinal stromal tumors Anal canal Endoanal ultrasound Magnetic resonance imaging C-Kit receptor Local excision

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Micro-computed tomography assessment of human femoral trabecular bone for two disease groups(fragility fracture and coxarthrosis):Age and gender related effects on the microstructure

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Journal of Biomedical Science and Engineering 2013年第2期6卷 175-184页

作者： Ana Catarina Vale Manuel F.C.Pereira Antonio Maurício Bruno vidal Ana Rodrigues Joana Caetano-Lopes Ara Nazarian Joao E.Fonseca helena Canhao Maria Fatima Vaz Institute of Materials and Surface Science and Engineering LisbonPortugal Rheumatology Research Unit Instituto de Medicina MolecularFaculdade de Medicina de LisboaLisbonPortugal Center of Petrology and Geochemistry Instituto Superior TécnicoUniversidade Técnica de LisboaLisbonPortugal Rheumatology and Metabolic Bone Diseases Department Hospital de Santa MariaLisbonPortugal Orthopedic Biomechanics Laboratory Beth Israel Deaconess Medical CenterHarvard Medical SchoolBostonUSA Mechanical Engineering Department Instituto Superior TecnicoUniversidade Tecnica de LisboaLisbonPortugal

The aim of this study was to identify three-dimensional microstructural changes of trabecular bone with age and gender, using micro-computed tomography. Human trabecular bone from two disease groups, osteoporosis and osteoarthritis was analyzed. A prior analysis of the effects of some procedure variables on the micro-CT results was performed. Preliminary micro-CT scans were performed with three voxel resolutions and two acquisition conditions. On the reconstruction step, the image segmentation was performed with three different threshold values. Samples were collected from patients, with coxarthrosis (osteoarthritis) or fragility fracture (osteoporosis). The specimens of the coxarthrosis group include twenty females and fifteen males, while the fragility fracture group was composed by twenty three females and seven males. The mean age of the population was 69 ± 11 (females) and 67 ± 10 years (males), in the coxarthrosis group, while in the fragility fracture group was 81 ± 6 (females) and 78 ± 6 (males) years. The 30 μm voxel size provided lower percentage difference for the microarchitecture parameters. Acquisition conditions with 160 μA and 60 kV permit the evaluation of all the volume’s sample, with low average values of the coefficients of variation of the microstructural parameters. No statistically significant differences were found between the two diseases groups, neither between genders. However, with aging, there is a decrease of bone volume fraction, trabecular number and fractal dimension, and an increase of structural model index and trabecular separation, for both disease groups and genders. The parameters bone specific surface, trabecular thickness and degree of anisotropy have different behaviors with age, depending on the type of disease. While in coxarthrosis patients, trabecular thickness increases with age, in the fragility fracture group, there is a decrease of trabecular thickness with increasing age. Our findings indicate that disease, age and

关键词： Trabecular Bone Micro-Computed Tomography Coxarthrosis Fragility Fracture Age Gender

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