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Blastomas of the digestive system in adults:A review

World Journal of Gastrointestinal Surgery 2024年第4期16卷 1030-1042页

作者： Yu Liu tony el jabbour Jonathan Somma Yukihiro Nakanishi Saverio Ligato Hwajeong Lee Zhi-Yan Fu Department of Pathology LSU Health Sciences Center School of MedicineNew OrleansLA 70112United States Department of Pathology Hartford HealthCareHartfordCT 06102United States Department of Pathology Moffitt Cancer CenterTampaFL 33612United States Department of Pathology and Laboratory Medicine Albany Medical CenterAlbanyNY 12208United States

Blastomas,characterized by a mixture of mesenchymal,epithelial,and undifferentiated blastematous components,are rare malignant neoplasms originating from precursor blast *** review focuses on digestive system blastomas in adult patients,including gastroblastoma,hepatoblastoma,and *** is a biphasic,epitheliomesenchymal tumor,with only sixteen cases reported to *** addition to the characteristic histology,metastasisassociated lung adenocarcinoma transcript 1-glioma-associated oncogene homolog 1 gene fusion is typical,although recently novel ewing sarcoma breakpoint region 1-c-terminal binding protein 1 and patched 1-glioma-associated oncogene homolog 2 fusions have been *** is exceptionally rare in adults and can show a variety of histologic patterns which may cause diagnostic ***,primarily a pediatric tumor,displays acinar differentiation and squamoid nests with other lines of differentiation also present,especially *** approaches for these blastomas include a combination of imaging modalities,histopathological examination,and molecular *** treatment generally involves surgical resection,which may be supplemented by chemotherapy or radiotherapy in some *** vary with gastroblastoma generally showing favorable outcomes post-surgery whereas hepatoblastoma and pancreatoblastoma often have poorer outcomes,particularly in the setting of *** review highlights the complexity of diagnosing and managing these rare adult blastomas as well as the need for ongoing research to better understand their pathogenesis and improve treatment strategies.

关键词： Adult blastomas Gastroblastoma Hepatoblastoma Pancreatoblastoma Digestive system

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Retrospective analysis of discordant results between histology and other clinical diagnostic tests on helicobacter pylori infection

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World Journal of Gastrointestinal Endoscopy 2024年第2期16卷 64-71页

作者： Xiaohua Qi Kevin Kuan tony el jabbour Yungtai Lo Qiang Liu Yanan Fang Department of Pathology Albert Einstein College of Medicine/Montefiore Medical CenterBronxNY 10467United States Department of Pathology Albert Einstein College of Medicine/Montefiore Medical CenterNew YorkNY 10467United States Department of Epidemiology&Population Health Albert Einstein College of MedicineBronxNY 10461United States Department of Pathology Montefiore Medical Center/Albert Einstein College of MedicineBronxNY 10467United States

BACKGROUND A reliable test is essential for diagnosing Helicobacter pylori(***)infection,and crucial for managing ***-related *** as an excellent method for detecting *** infection,histologic examination is a test that clinicians heavily rely on,especially when complemented with immunohistochemistry(IHC).Additionally,other diagnostic tests for ***,such as the rapid urease test(CLO test)and stool antigen test(SA),are also highly sensitive and ***,the results of histology and other tests align with each ***,on rare occasions,discrepancy between histopathology and other *** diagnostic tests *** To investigate the discordance between histology and other *** tests,the underlying causes,and the impact on clinical *** Pathology reports of gastric biopsies were retrieved spanning August 2013 and July *** were included in the study only if there were other *** tests within seven days of the *** additional tests include CLO test,SA,and *** *** between histopathology and other tests was determined based on the consistency of *** instances where histology results were negative while other tests were positive,the slides were retrieved for re-assessment,and the clinical chart was *** Of 1396 pathology reports were identified,each accompanied by one additional *** *** concordance rates in detecting *** infection between biopsy and other tests did not exhibit significant differences based on the number of biopsy fragments.117 discrepant cases were *** 20 cases(9 with CLO test and 11 with SA)had negative biopsy but positive results in other *** cases initially stained with Warthin-Starry turned out to be positive for *** with subsequent IHC *** the remaining 16 true discrepant cases,10 patients were on proton pump inhibitors before the biopsy and/or other *** patients underwe

关键词： Helicobacter pylori Discordance Gastric biopsy Histology Rapid urease test Stool antigen test Helicobacter pylori culture

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Update on hepatocellular carcinoma: Pathologists' review

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World Journal of Gastroenterology 2019年第14期25卷 1653-1665页

作者： tony el jabbour Stephen M Lagana Hwajeong Lee Department of Pathology and Laboratory Medicine Albany Medical College Department of Pathology and Cell Biology College of Physicians and Surgeons Columbia University

Histopathologic diversity and several distinct histologic subtypes of hepatocellular carcinoma(HCC) are well-recognized. Recent advances in molecular pathology and growing knowledge about the biology associated with distinct histologic features and immuno-profile in HCC allowed pathologists to update classifications. Improving sub-classification will allow for more clinically relevant diagnoses and may allow for stratification into biologically meaningful subgroups. Therefore, immuno-histochemical and molecular testing are not only diagnostically useful, but also are being incorporated as crucial components in predicting prognosis of the patients with HCC. Possibilities of targeted therapy are being explored in HCC, and it will be important for pathologists to provide any data that may be valuable from a theranostic perspective. Herein, we review and provide updates regarding the pathologic sub-classification of *** diagnostic approach and the role of biomarkers as prognosticators are reviewed. Further, the histopathology of four particular subtypes of HCC:Steatohepatitic, clear cell, fibrolamellar and scirrhous-and their clinical relevance, and the recent consensus on combined HCC-cholangiocarcinoma is summarized. Finally, emerging novel biomarkers and new approaches to HCC stratification are reviewed.

关键词： Hepatocellular carcinoma Subtype Classification Review Update

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Benign vs malignant pancreatic lesions: Molecular insights to an ongoing debate

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World Journal of Gastrointestinal Surgery 2021年第5期13卷 406-418页

作者： Mahmoud Aldyab tony el jabbour Megan Parilla Hwajeong Lee Department of Pathology and Laboratory Medicine Albany Medical CenterAlbanyNY 12208United States Department of Pathology Memorial Sloan Kettering Cancer CenterNew YorkNY 10065United States

Several benign conditions such as chronic pancreatitis, autoimmune pancreatitis,and paraduodenal pancreatitis can present as mass lesions and may mimicpancreatic ductal adenocarcinoma (PDAC) clinically and radiologically. Thoroughhistologic examination with attention to certain morphologic features can assist indeciphering neoplastic from reactive, however small biopsies often remain achallenge. Variable histologic patterns in conventional PDAC may also confoundthe diagnosis of PDAC. Uncommon subtypes of pancreatic carcinoma such asadenosquamous and squamous cell carcinoma, colloid carcinoma, medullarycarcinoma, hepatoid carcinoma and signet ring cell carcinoma necessitateexcluding metastasis from other sites prior to rendering the diagnosis ofpancreatic carcinoma. The use of immunohistochemical staining and molecularmarkers can aid in separating benign from malignant and PDAC from *** expresses a few non-specific epithelial and mucin immunomarkers such asCK7, CK19, MUC1, MUC4 and MUC5AC. However, the only immunohistochemicalmarker that is specific for PDAC in the right clinical context is *** of SMAD4 within atypical glands and ducts supports the diagnosis of PDACin a limited sample. Unfortunately, this finding is seen only in 50% of PDACcases. The identification of certain mutations can help support a diagnosis ofPDAC when benign conditions are in the differential. At the molecular level,KRAS oncogene mutations are seen in approximately 93% of PDACs. Subsequentneoplastic progression is driven by additional mutations of tumor suppressorgenes, such as CDKN2A, TP53, and SMAD4. Molecular markers can also providean insight to the prognosis. For instance, the loss of SMAD4 is associated with apoor outcome whereas mutations in MLL, MLL2, MLL3, and ARID1A are associatedwith improved survival.

关键词： Pancreas Pancreatitis Autoimmune SMAD4 Molecular

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Liver manifestations in COVID-19 patients:A review article

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World Journal of Clinical Cases 2023年第10期11卷 2189-2200页

作者： Mariana Helou Janane Nasr Nour el Osta elsy jabbour Rola Husni Division of Emergency Medicine Department of Internal MedicineLebanese American University Medical CenterLebanese American University School of MedicineBeirut 1102-2801Lebanon Division of Infectious Diseases Department of Internal MedicineLebanese American UniversitySchool of MedicineBeirut 1102-2801Lebanon Division of Emergency Department of Internal MedicineLebanese American UniversitySchool of MedicineBeirut 1102-2801Lebanon

The coronavirus disease 2019(COVID-19)initially presented as a disease that affected the ***,studies revealed that it intricately affected disparate organs in the human body,with the liver being one of the most affected *** review aimed to assess the association between COVID-19 and liver function,shedding light on its clinical ***,its exact pathophysiology remains unclear,involving many factors,such as active viral replication in the liver cells,direct cytotoxic effects of the virus on the liver or adverse reactions to viral *** symptoms are mild-to-moderate transaminase *** some patients,with underlying liver disease,more serious outcomes are ***,liver function should be meticulously considered in patients with COVID-19.

关键词： COVID-19 Liver injury Liver disease Liver manifestations

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Dilemma of first line regimens in metastatic pancreatic adenocarcinoma

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World Journal of Gastroenterology 2016年第46期22卷 10124-10130页

作者： Marwan Ghosn tony Ibrahim Tarek Assi elie el Rassy Hampig Raphael Kourie Joseph Kattan Department of Oncology Faculty of Medicine Saint Joseph University

Pancreatic cancer is one of the deadliest cancers,ranking fourth among cancer-related deaths. Despite all the major molecular advances and treatment breakthroughs, mainly targeted therapies, the cornerstone treatment of metastatic pancreatic cancer(m PC) remains cytotoxic chemotherapy. In 2016, more than 40 years after the introduction of gemcitabine in the management of m PC, the best choice for first-line treatment has not yet been fully elucidated. Two main strategies have been adopted to enhance treatment efficacy. The first strategy is based on combining non-cross resistant drugs, while the second option includes the development of newer generations of chemotherapy. More recently, two new regimens, FOLFIRINOX and gemcitabine/nab-paclitaxel(GNP), have both been shown to improve overall survival in comparison with gemcitabine alone, at the cost of increased toxicity. Therefore, the best choice for first line therapy is a matter of debate. For some authors, FOLFIRINOX should be the first choice in patients with an Eastern Cooperative Oncology Group score(0-1) given its lower hazard ratio. However, others do not share this opinion. In this paper, we review the main comparison points between FOLFIRINOX and GNP. We analyze the two pivotal trials to determine the similarities and differences in study design. In addition, we compare the toxicity profile of the two regimens as well as the impact on quality of life. Finally, we present studies revealing real life experiences and review the advantages and disadvantages of possible second-line therapies including their cost effectiveness.

关键词：评论变形胰腺的癌症 FOLFIRINOX Gemcitabine/nab-paclitaxel 枢轴的试用

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Post-Obstructive Diuresis: Physiopathology, Diagnosis and Management after Urological Treatment of Obstructive Renal Failure

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Open Journal of Urology 2018年第9期8卷 267-274页

作者： Sumba Harrison Abdelouahed Lasri Youness jabbour Amine Slaoui Jacquet Djamal Tariq Karmouni Kadir el Khader Abdelatif Koutani Ahmed Ibn Attiya Andaloussi Department of Urology “B” Ibn Sina University Hospital Rabat Morocco Faculty of Medicine and Pharmacy Mohamed V University Rabat Morocco Department of Uro-Andrology Faculty of Health Sciences Cotonou Benin

Obstructive acute renal failure is both a medical and a surgical emergency. The first treatment modality is urological by relief of obstruction. Post-obstructive diuresis is an abnormal condition of prolonged polyuria, involving both excessive solute and water loss, after acute drainage of obstructed urinary tract system. Physiopathology mechanisms are multiples. In most patients, diuresis will resolve once the kidneys normalize the volume and solute status and homeostasis is achieved. Post-obstructive diuresis can occur in up to 50% of patients with substantial urinary tract obstruction and can be life-threatening if it becomes pathologic. It can be detected by hourly monitoring of diuresis. Medical treatment of post-obstructive diuresis consists of oral or intravenous fluids adjusted to the findings of clinical examination, diuresis (volume and electrolytes) and close monitoring of patient. Fluid compensation should be tapered off over several days. Patients at high risk of post-obstructive diuresis should be identified and appropriately monitored.

关键词： Post-Obstructive Diuresis Acute Renal Failure Water and electrolyte Compensation

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Cystitis Glandularis: A Rare Benign Condition Presenting as Bladder Tumor

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Open Journal of Urology 2018年第12期8卷 336-343页

作者： Sumba Harrison Hamza Lamchahab Jacquet Djamal Youness jabbour Touzani Alae Tariq Karmouni Kadir el Khader Abdelatif Koutani Ahmed Ibn Attiya Andaloussi Department of Urology “B” Ibn Sina University Hospital Rabat Morocco Faculty of Medicine and Pharmacy Mohamed V University Rabat Morocco Department of Uro-Andrology Faculty of Health Sciences Cotonou Benin

Cystitis glandularis or glandular metaplasia of the urinary bladder, is a benignreactive metaplasia of the urothelium, which occurs in the context of chronic irritation, in less than 2% of the general population. It is a condition in most casesasymptomatic, but also characterized by nonspecific symptoms and paraclinical findings, which is why this condition is underdiagnosed. Its evolution is mainly focused on the risk of malignant degeneration. This condition affects men much more commonly than women. Two forms of cystitis glandularis are recognized: typical and intestinal form. They differ in their histology, incidence, difficulty of diagnosis, and possible association with adenocarcinoma of the bladder. Diagnosis of certainty is histological by careful analysis of chips from bladder endoscopic resection. This rare pathology is managed by endoscopic bladder resection, with repeated cystoscopy as a monitoring tool. Extensive surgical is needed in severe or recurrent cases. We present here-in a case of a female patient having cystitis glandularis presenting with lower urinary tract symptoms. We review equally data reported in literature. To the best of our knowledge our case represents the fourth case of cystitis glandularis affecting a female patient reported in the English literature so far.

关键词： Cystitis Glandularis Cystoscopy Bladder Resection

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Management of Heart Failure with Reduced Ejection Fraction Globally and in Lebanon: Where Do SGLT-2is Stand?

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World Journal of Cardiovascular Diseases 2023年第3期13卷 138-169页

作者： Hadi Skouri tony Abdel Massih Saiid Chaaban elie Chammas Malek Mohamad Samer Nasr Fadi Turquieh Cardiology Division Department of Internal Medicine American University of Beirut Medical Center Beirut Lebanon Department of Cardiology Hôtel-Dieu de France University Medical Center Beirut Lebanon Cardiology Division Department of Internal Medicine Hammoud Hospital University Medical Center Sidon Lebanon Heart Center Clemenceau Medical Center Beirut Lebanon Department of Cardiology Sahel General Hospital Beirut Lebanon Department of Cardiology Mount Lebanon Hospital University Medical Center Hazmieh Lebanon Department of Cardiology Haykel Hospital El Koura Lebanon

Heart failure (HF) is a clinical syndrome due to structural and/or functional cardiac anomalies, accompanied by elevated natriuretic peptide levels and/or cardiogenic pulmonary or systemic congestion;severely compromising patients’ health, performance and quality of life. The advancement of novel treatment and their endorsement by international medical and scientific societies have shifted the treatment of HF with reduced ejection fraction (HFrEF) towards quadruple therapy: an angiotensin receptor-neprilysin inhibitor or an angiotensin-converting enzyme inhibitor, a beta-blocker, a mineralocorticoid receptor antagonist and a sodium/glucose co-transporter-2 inhibitor (SGLT2i). This paper reviews the available literature on state-of-the-art diagnostic and therapeutic advances in HFrEF, discusses landmark trials that shifted the paradigm towards quadruple therapy in HFrEF, visits the potential challenges in Lebanon and globally, proposes an algorithm for treatment introduction and sequencing in HFrEF and highlights clinical considerations for HFrEF management and patient education and follow-up. This practical guidance could serve cardiologists and other medical specialists in identifying clinical signs of HFrEF, diagnosing patients, referring them or prescribing the components of quadruple therapy, and offering medical advice and follow-up. We highlight the role of SGLT2is in HF management and their effectiveness in reducing rates of hospitalization for HF as well as cardiovascular deaths, with satisfactory safety profile.

关键词： Heart Failure HFrEF Management SGLT2i Clinical Guidance Quadruple Therapy

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MALDI质谱成像技术用于皮肤T细胞淋巴瘤疾病标记物研究

MALDI质谱成像技术用于皮肤T细胞淋巴瘤疾病标记物研究

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中华医学会第十八次全国皮肤性病学术年会

作者： Liu Jie Marven el Osta Caroline Truntzer Delphine Pecqueur tony Petrella Patrick Ducoroy Beijing Union Medical College Hospital Dermatology CLIPP(Clinical Innovation Proteomic Platform) IFR 100 Sante STICUniversite de Bourgogne1 rue Professeur Marion21079 Dijon.100730

目的原发性皮肤淋巴瘤是以皮肤损害为初发或首要表现的淋巴瘤,占结外非霍奇金淋巴瘤的第二位,仅次于胃肠道,估计年发病率为1:100,000。皮肤T细胞淋巴瘤是最常见的原发性皮肤淋巴瘤,蕈样肉芽肿(mycosis fungoides,MF)是其中最具代表性的...

目的原发性皮肤淋巴瘤是以皮肤损害为初发或首要表现的淋巴瘤,占结外非霍奇金淋巴瘤的第二位,仅次于胃肠道,估计年发病率为1:100,000。皮肤T细胞淋巴瘤是最常见的原发性皮肤淋巴瘤,蕈样肉芽肿(mycosis fungoides,MF)是其中最具代表性的疾病类型,占所有原发性皮肤淋巴瘤的50%。MF发病初期临床表现类似良性炎症性皮肤病,缺乏特异性,而MF晚期患者病情发展呈侵袭性,患者平均寿命明显缩短。目前尚无高度特异的MF早期肿瘤标记物,早期诊断仍有困难。近期基

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