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Chromophobe renal cell carcinoma: Novel molecular insights and clinicopathologic updates

Asian Journal of Urology 2022年第1期9卷 1-11页

作者： Reza Alaghehbandan G.Przybycin Christopher Virginie Verkarre Rohit Mehra Department of pathology Faculty of MedicineUniversity of British ColumbiaRoyal Columbian HospitalVancouverBCCanada Robert J Tomsich pathology and Laboratory Medicine Institute Cleveland ClinicClevelandOHUSA Department of pathology Georges Pompidou European HospitalAP-HPParis UniversityINSERM UMR 970PARCCParisFrance Department of pathology University of Michigan Medical SchoolAnn ArborMIUSA Michigan Center for Translational pathology Ann ArborMIUSA Rogel Cancer Center Michigan MedicineAnn ArborMIUSA

Chromophobe renal cell carcinoma(ChRCC)is the third most common renal cell carcinoma(RCC)subtype,which predominantly occurs in sporadic *** are considered to originate from the intercalated cell of distal tubules with two main morphological variants,classic and *** ChRCCs carry a favorable clinical *** alone is limited in predicting the behavior of ChRCCs that do not have overtly aggressive morphologic findings such as necrosis and sarcomatoid *** with positive CD117 expression,classic ChRCCs generally express diffuse and uniform CK7,while eosinophilic variant demonstrates more heterogeneous CK7 expression(rare or patchy).Multiple losses of chromosomes 1,2,6,10,13,17,and 21 are considered to be the genetic hallmarks of classic and eosinophilic ChRCCs,while chromosomal gains are known to be associated with sarcomatoid ***53 and PTEN are the two most frequently mutated genes in *** major challenge in the differential diagnosis of ChRCCs includes considerations around the eosinophilic variant(of ChRCCs),where it may share overlapping features with oncocytoma or other recent emergent oncocytic *** eosinophilic ChRCCs share expression of the recently described biomarkers,LINC01187 and FOXI1,with classic ChRCCs,however,a subset of eosinophilic-like ChRCCs with lower biomarker expression have been demonstrated to harbor MTOR gene ***,the morphologic features of ChRCCs and genetic profile with combinations of chromosomal losses and gains suggest this tumor entity to represent a distinct,yet heterogeneous group of renal neoplasms.

关键词： Renal cell carcinoma Chromophobe Immunohisto-chemistry RNA in situ hybridization Next-generation sequencing Oncocytic tumors Molecular

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Brown slits for colorectal adenoma crypts on conventional magnifying endoscopy with narrow band imaging using the X1 system

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World Journal of Gastroenterology 2022年第24期28卷 2748-2757页

作者： Osamu Toyoshima Toshihiro Nishizawa Shuntaro Yoshida Hidenobu Watanabe Nariaki Odawara Kosuke Sakitani Toru Arano Hirotoshi Takiyama Hideyuki Kobayashi Hirofumi Kogure Mitsuhiro Fujishiro Department of Gastroenterology Toyoshima Endoscopy ClinicTokyo 157-0066Japan Department of Gastroenterology and Hepatology International University of Health and WelfareNarita HospitalChiba 286-8520Japan Department of pathology Pathology and Cytology Laboratory JapanTokyo 166-0003Japan Department of Gastroenterology Graduate School of MedicineThe University of TokyoTokyo 113-8655Japan Department of Gastroenterology Sakitani Endoscopy ClinicChiba 275-0026Japan Department of Gastroenterology The Fraternity Memorial HospitalTokyo 130-8587Japan Department of Surgical Oncology The University of TokyoTokyo 113-8655Japan Department of Internal Medicine Umegaoka Ekimae ClinicTokyo 154-0022Japan

BACKGROUND Accurate diagnosis of colorectal premalignant polyps,including adenomas,is vital in clinical *** To investigate the diagnostic yields of novel findings of brown slits for *** Patients who underwent colonoscopy at the Toyoshima Endoscopy clinic were *** sized≥5 mm suspected of adenomas or clinically significant serrated polyps were included in the *** defined the surface structures of colorectal polyps,which were brown curves inside and along the tubular glands identified using a combination of a new X1 system(Olympus Corporation)and a conventional magnifying colonoscope with non-staining narrow band imaging(NBI),as brown *** brown slits corresponded to slit-like lumens on endocytoscopy and histological crypt openings of an *** evaluated the diagnostic performance of brown slits for *** A total of 108 Lesions from 62 patients were *** average age was 60.4 years and 41.9%were *** mean polyp size was 7.45±2.83 ***-seven lesions were positive for brown *** diagnosis comprised 59 low-grade tubular adenomas,16 sessile serrated lesions,and 33 hyperplastic *** 59 adenomas,56(94.9%)were positive for brown *** 16 sessile serrated lesions,0(0%)was positive for brown *** 33 hyperplastic polyps,1(3.0%)was positive for brown *** sensitivity,specificity,and accuracy of brown slits for adenoma were 94.9%,98.0%,and 96.3%,*** positive predictive value and negative predictive value of brown slits for adenoma were also excellent for 98.2%,and 94.1%,*** Brown slits on conventional magnifying endoscopy with non-staining NBI using the X1 system were useful for diagnosing colorectal *** new endoscopy system could be examined using new standards.

关键词： Adenoma Colonoscopy Narrow band imaging Magnifying endoscopy X1 Serrated polyp Colorectal neoplasm Endocytoscopy

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Fatal bleeding due to an aorto-esophageal fistula: A case report and literature review

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World Journal of clinical Cases 2022年第31期10卷 11493-11499页

作者： Davorin Ćeranić Sara Nikolić Jernej Lučev Aleš Slanič Tatjana Bujas Andreja Ocepek Pavel Skok Department of Gastroenterology Internal Medicine ClinicUniversity Medical Centre MariborMaribor 2000Slovenia Department of Radiology University Medical Centre MariborMaribor 2000Slovenia Department of pathology University Medical Centre MariborMaribor 2000Slovenia

BACKGROUND Aorto-esophageal fistula is an extremely rare cause of acute upper gastrointestinal bleeding(UGIB).CASE SUMMARY We present a case of an 80-year-old woman with esophageal cancer who was admitted to our department with hemorrhagic shock due to *** the diagnostic procedure,emergency computed tomography angiography was performed and confirmed aorto-esophageal *** radiologists inserted a stent graft into the aorta,successfully closing the ***,the patient later died of heart failure following irreversible hemorrhagic *** confirmed the aorto-esophageal fistula,which formed 1 cm below the distal edge of the stent previously inserted into the esophagus for a malignant *** There are very rare causes of *** clinical decisions are made during the diagnostic workup of these patients,we must be aware of the limitations of various therapeutic options,even the most contemporary.

关键词： Aorto-esophageal fistula Upper gastrointestinal bleeding Interventional radiology Stent graft Case report

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Malakoplakia: Rare Disorder with No Significant Racial Prevalence

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Open Journal of pathology 2023年第3期13卷 146-152页

作者： Rong Chen Raheel Ahmed Cristina Magi-Galluzzi Chirag R. Patel Sameer Al Diffalha Department of pathology University of Alabama at Birmingham (UAB) Birmingham Alabama USA Department of pathology Mayo Clinic Hospital Phoenix Arizona USA

Introduction: Malakoplakia is a rare acquired granulomatous inflammatory condition. Microscopically it is characterized by sheets of histiocytes with abundant eosinophilic granular cytoplasm (known as von Hansemann cells) with intracytoplasmic rounded concentric basophilic inclusions (Michelis-Guttmann bodies). We reviewed all cases of malakoplakia diagnosed at our institution in the past 15 years, including clinical, macroscopic, and microscopic features as well as treatment and prognosis. Methods: Gross and microscopic features of cases diagnosed as malakoplakia from 2005 to 2019 at our institution were reviewed. clinical history, including sites of involvement, clinical presentation, imaging, past medical history, treatment, follow-up and prognosis, as well as demographic characteristics were obtained. Results: Eighteen surgical pathology cases of malakoplakia were identified. Most cases occurred in female (14/18, 77.8%) and all in adults (median age 48.5 years;range 31 - 87). Half of the patients were Caucasian, 44% African American and 6% were reported as “other” race. One third (6/18) of patients presented with a mass-like lesion on imaging or endoscopic studies. As to site of lesion, 61.1% (11/18) involved GU tract, 27.8% (5/18) gastrointestinal (GI) tract, 5.6% (1/18) liver, and 5.6% (1/18) vagina. 38.9% of patients (7/18) had antibiotics treatment upon diagnosis. Conclusion: Malakoplakia is a rare disorder occurring in a wide age range, more commonly in females, with no significant racial prevalence. While the GU and GI tracts are the most common sites, other anatomic locations can be involved. Accurate diagnosis and appropriate treatment are important to avoid recurrence.

关键词： Malakoplakia Von Hansemann Cells Michelis-Guttmann Bodies

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National guidelines for the diagnosis and treatment of hilar cholangiocarcinoma

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World Journal of Gastroenterology 2024年第9期30卷 1018-1042页

作者： Faisal Saud Dar Zaigham Abbas Irfan Ahmed Muhammad Atique Usman Iqbal Aujla Muhammad Azeemuddin Zeba Aziz Abu Bakar Hafeez Bhatti Tariq Ali Bangash Amna Subhan Butt Osama Tariq Butt Abdul Wahab Dogar Javed Iqbal Farooqi Faisal Hanif Jahanzaib Haider Siraj Haider Syed Mujahid Hassan Adnan Abdul Jabbar Aman Nawaz Khan Muhammad Shoaib Khan Muhammad Yasir Khan Amer Latif Nasir Hassan Luck Ahmad Karim Malik Kamran Rashid Sohail Rashid Mohammad Salih Abdullah Saeed Amjad Salamat Ghias-un-Nabi Tayyab Aasim Yusuf Haseeb Haider Zia Ammara Naveed Department of Hepatopancreatic Biliary Surgery&Liver Transplant Pakistan Kidney and Liver Institute&Research CentreLahore 54000Pakistan Department of Hepatogastroenterology and Liver Transplantation Dr.Ziauddin University HospitalKarachi 75600SindhPakistan University of Aberdeen Aberdeen B243FXUnited Kingdom Department of pathology Pakistan Kidney and Liver Institute&Research CentreLahore 54000Pakistan Department of Gastroenterology&Hepatology Pakistan Kidney and Liver Institute&Research CentreLahore 54000Pakistan Department of Radiology Aga Khan UniversityKarachi 74800Pakistan Department of Oncology Hameed Latif HospitalLahore 54000Pakistan Division of Hepatopancreatic Biliary Surgery&Liver Transplantation Shifa International HospitalIslamabad 44000Pakistan Department of Hepatopancreatic Biliary Surgery&Liver Transplant Shaikh Zayed Hospital and Post Graduate Medical InstituteLahore 54000Pakistan Department of Medicine Aga Khan University HospitalKarachi 74800Pakistan Department of Liver Transplant Pir Abdul Qadir Shah Jeelani Institute of Medical SciencesGambat 66020Pakistan Department of Medicine&Gastroenterology Lifecare Hospital and Research CentrePeshawar 25000Khyber PakhtunkhwaPakistan Department of Hepatopancreatobiliary&Liver Transplant Bahria International HospitalLahore 54000Pakistan Department of Surgery Hepatopancreatobiliary&Liver TransplantDow University of Health SciencesKarachi 74800Pakistan Department of Gastroenterology Hepatology&NutritionPir Abdul Qadir Shah Jeelani Institute of Medical SciencesGambat 66020Pakistan Department of Oncology Dr.Ziauddin HospitalKarachi 74800Pakistan Department of Radiology Rehman Medical InstitutePeshawar 25000Pakistan Army Liver Transplant Unit Pak Emirates Military HospitalRawalpindi 46000Pakistan Department of Gastroenterology Sindh Institute of Urology and TransplantationKarachi 75500Pakistan Rashid Nursing Home and Cancer clinic Rashid Nursing Home and Cancer ClinicRawalpindi 46000Pakistan Department of Gastroentero

A consensus meeting of national experts from all major national hepatobiliary centres in the country was held on May 26,2023,at the Pakistan Kidney and Liver Institute&Research Centre(PKLI&RC)after initial consultations with the *** Pakistan Society for the Study of Liver Diseases(PSSLD)and PKLI&RC jointly organised this *** effort was based on a comprehensive literature review to establish national practice guidelines for hilar cholangiocarcinoma(hCCA).The consensus was that hCCA is a complex disease and requires a multidisciplinary team approach to best manage these *** coordinated effort can minimise delays and give patients a chance for curative treatment and effective *** diagnostic and staging workup includes high-quality computed tomography,magnetic resonance imaging,and magnetic resonance *** cytology or biopsy utilizing endoscopic retrograde cholangiopancreatography is a mainstay for ***,histopathologic confirmation is not always required before *** ultrasound with fine needle aspiration of regional lymph nodes and positron emission tomography scan are valuable adjuncts for *** only curative treatment is the surgical resection of the biliary tree based on the Bismuth-Corlette *** patients with unresectable hCCA can be considered for liver *** chemotherapy should be offered to patients with a high risk of *** use of preoperative biliary drainage and the need for portal vein embolisation should be based on local multidisciplinary *** with acute cholangitis can be drained with endoscopic or percutaneous biliary *** chemotherapy with cisplatin and gemcitabine has shown improved survival in patients with irresectable and recurrent hCCA.

关键词： Hilar cholangiocarcinoma Bismuth-Corlette classification Memorial Sloan Kettering Cancer Centre Staging Preoperative biliary drainage Portal vein embolisation Surgical resection Hepatectomy

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Lymphocytic esophagitis: Still an enigma a decade later

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World Journal of Gastroenterology 2017年第6期23卷 949-956页

作者： Carol Rouphael Ilyssa O Gordon Prashanthi N Thota Department of General Internal Medicine Cleveland Clinic Foundation Department of pathology Cleveland Clinic Foundation Department of Gastroenterology and Hepatology Digestive Disease and Surgery InstituteCleveland Clinic Foundation

Lymphocytic esophagitis (LE) is a clinicopathologic entity first described by Rubio et al in 2006. It is defined as peripapillary intraepithelial lymphocytosis with spongiosis and few or no granulocytes on esophageal biopsy. This definition is not widely accepted and the number of lymphocytes needed to make the diagnosis varied in different studies. Multiple studies have described potential clinical associations and risk factors for LE, such as old age, female gender and smoking history. This entity was reported in inflammatory bowel disease in the pediatric population but not in adults. Other associations include gastroesophageal reflux disease and primary esophageal motility disorders. The most common symptom is dysphagia, with a normal appearing esophagus on endoscopy, though esophageal rings, webs, nodularities, furrows and strictures have been described. Multiple treatment modalities have been used such as proton pump inhibitors and topical steroids. Esophageal dilation seems to be therapeutic when dysphagia is present along with esophageal narrowing secondary to webs, rings or strictures. The natural history of the disease remains unclear and needs to be better delineated. Overall, lymphocytic esophagitis seems to have a chronic and benign course, except for two cases of esophageal perforation in the literature, thought to be secondary to this entity.

关键词：淋巴球的食道炎 intraepithelial 淋巴细胞 spongiosis gastroesophageal 倒流疾病 CD4 T 房间咽下困难煽动性的肠疾病食道的戒指质子泵禁止者食道的膨胀

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Magnetic resonance elastography is accurate in detecting advanced fibrosis in autoimmune hepatitis

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World Journal of Gastroenterology 2017年第5期23卷 859-868页

作者： Jin Wang Neera Malik Meng Yin Thomas C Smyrk Albert J Czaja Richard L Ehman Sudhakar K Venkatesh Department of Radiology Mayo Clinic College of MedicineMayo Clinic Department of Radiology the Third Affiliated HospitalSun Yat-Sen University Laboratory Medicine and pathology Mayo Clinic College of MedicineMayo Clinic Department of Gastroenterology and Hepatology Mayo Clinic College of MedicineMayo Clinic

To assess the value of magnetic resonance elastography(MRE) in detecting advanced fibrosis/cirrhosis in autoimmune hepatitis(AIH).METHODS In this retrospective study, 36 patients(19 treated and 17 untreated) with histologically confirmed AIH and liver biopsy performed within 3 mo of MRE were identified at a tertiary care referral center. Liver stiffness(LS) with MRE was calculated by a radiologist, and inflammation grade and fibrosis stage in liver biopsy was assessed by a pathologist in a blinded fashion. Two radiologistsevaluated morphological features of cirrhosis on conventional magnetic resonance imaging(MRI). Accuracy of MRE was compared to laboratory markers and MRI for detection of advanced fibrosis/*** Liver fibrosis stages of 0, 1, 2, 3 and 4 were present in 4, 6, 7, 6 and 13 patients respectively. There were no significant differences in distribution of fibrosis stage and inflammation grade between treated and untreated patient groups. LS with MRE demonstrated stronger correlation with liver fibrosis stage in comparison to laboratory markers for chronic liver disease(r = 0.88 vs-0.48-0.70). A trend of decreased mean LS in treated patients compared to untreated patients was observed(3.7 k Pa vs 3.84 k Pa) but was not statistically significant. MRE had an accuracy/sensitivity/specificity/positive predictive value/negative predictive value of 0.97/90%/100%/100%/90% and 0.98/92.3%/96%/92.3%/96% for detection of advanced fibrosis and cirrhosis, respectively. The performance of MRE was significantly better than laboratory tests for detection of advanced fibrosis(0.97 vs 0.53-0.80, P < 0.01), and cirrhosis(0.98 vs 0.58-0.80, P < 0.01) and better than conventional MRI for diagnosis of cirrhosis(0.98 vs 0.78, P = 0.002).CONCLUSION MRE is a promising modality for detection of advanced fibrosis and cirrhosis in patients with AIH with superior diagnostic accuracy compared to laboratory assessment and MRI.

关键词：自体免疫的肝炎先进纤维变性磁性的回声 elastography 肝僵硬肝硬化

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Pathologic tumor response to neoadjuvant therapy in borderline resectable pancreatic cancer

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Hepatobiliary & Pancreatic Diseases International 2019年第4期18卷 373-378页

作者： June S Peng Jane Wey Sricharan Chalikonda Daniela S Allende R Matthew Walsh Gareth Morris-Stiff Department of General Surgery Digestive Disease and Surgery InstituteCleveland Clinic Foundation9500 Euclid AvenueClevelandOHUSA Department of pathology Pathology and Laboratory Medicine InstituteCleveland Clinic Foundation9500 Euclid AvenueClevelandOHUSA

Background:Previous studies have demonstrated the prognostic significance of pathologic tumor response in pancreatic adenocarcinoma following neoadjuvant therapy(NAT).The aim of this study was to determine the incidence of significant pathologic response to NAT in borderline resectable pancreatic cancer(BRPC),and association of NAT regimen and other clinico-pathologic characteristics with pathologic ***:Patients with BRPC who underwent NAT and pancreatic resection between January 2012 and June 2017 were *** response was assessed on a qualitative scale based on the College of American Pathologists grading *** and baseline characteristics,oncologic treatment,pathology,and survival outcomes were ***:Seventy-one patients were included for *** patients had complete pathologic responses(tumor regression score 0),12 patients had marked responses(score 1),42 had moderate responses(score 2),and 13 had minimal responses(score 3).Patients with complete or marked responses were more likely to have received neoadjuvant gemcitabine chemoradiation(62.5%,38.1%,and 23.1%of the complete/marked,moderate,and minimal response groups,respectively;P=0.04).Of the complete/marked,moderate,and minimal response groups,margins were negative in 75.0%,78.6%,and 46.2%(P=0.16);node negative disease was observed in 87.5%,54.8%,and 15.4%(P<0.01);and median overall survival was 50.0 months,31.7 months,and 23.2 months(P=0.563).Of the four patients with pathologic complete responses,three were disease-free at 66.1,41.7 and 31.4 months,and one was deceased with metastatic liver disease at 16.9 ***:A more pronounced pathologic tumor response to NAT in BRPC is correlated with node negative disease,but was not associated with a statistically significant survival benefit in this study.

关键词： Pancreatic cancer Borderline resectable Neoadjuvant therapy Pathologic response

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Low hypoxia inducible factor-1α(HIF-1α)expression in testicular germ cell tumors--a major reason for enhanced chemosensitivity?

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Chinese Journal of Cancer Research 2017年第4期29卷 374-378页

作者： niraj shenoy roxana dronca fernando quevedo stephen a boorjian john cheville brian costello manish kohli thomas witzig lance pagliaro division of oncology mayo clinicRochesterMN 55905usa department of urology mayo clinicRochesterMN 55905usa division of clinical pathology mayo clinicRochesterMN 55905usa

The molecular basis for enhanced chemosensitivity of testicular germ cell tumors （GCT） has been an area of great interest, as it could potentially give us therapeutic leads in other resistant malignancies. Thus far, however, the increased sensitivity of C＆T has been variously attributed to multiple factors -- an inability to detoxify cisplatin, a lack of export pumps, an inability to repair the DNA damage, an intact apoptotic cascade and lack of p53 mutation; but a unifying underlying etiology leading to the aforementioned processes and having a translational implication has so far been elusive. Herein, we offer evidence to support a potential significant role for the previously demonstrated low hypoxia inducible factor-la （HIF-la） expression in mediating the general exquisite chemosensitivity of testicular GCT, through the aforementioned processes. This molecular mechanism based hypothesis could have a significant translational implication in platinum refractory GCT as well as other platinum resistant malignancies.

关键词： Hypoxia inducible factor-la (HIF-la) testicular germ cell tumor chemosensitivity

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Overview of dyslipidemia and metabolic syndrome in myeloproliferative neoplasms

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World Journal of clinical Oncology 2024年第6期15卷 717-729页

作者： Mihnea-Alexandru Găman Bahadar Singh Srichawla Yong-Feng Chen Poulami Roy Arkadeep Dhali Ahmed Nahian Muhammad Romail Manan Vincent Kipkorir Richard Christian Suteja Lakshmi Venkata Simhachalam Kutikuppala Amelia Maria Găman Camelia Cristina Diaconu Faculty of Medicine “Carol Davila”University of Medicine and PharmacyBucharest 050474Romania Department of Hematology Center of Hematolog Department of Cellular and Molecular pathology Stefan S Nicolau Institute of VirologyRomanian AcademyBucharest 030304Romania Department of Neurology University of Massachusetts Chan Medical SchoolWorcesterMA 01655United States Department of Basic Medical Sciences School of Medicine of Taizhou UniversityTaizhou UniversityTaizhou 318000Zhejiang ProvinceChina Department of Medicine North Bengal Medical College and HospitalWest Bengal 734012India Academic Department of Gastroenterology Sheffield Teaching Hospitals NHS Foundation TrustSheffield S57AUUnited Kingdom Lecom at Seton Hill GreensburgPA 15601United States Faculty of Medicine Services HospitalLahore 54000Pakistan Department of Human Anatomy and Physiology University of NairobiNairobi 00100Kenya Faculty of Medicine Udayana UniversityDenpasarBali 80361Indonesia Department of General Surgery Dr.NTR University of Health SciencesVijayawada 520008Andhra PradeshIndia Department of Pathophysiology University of Medicine and Pharmacy of CraiovaCraiova 200349Romania clinic of Hematology Filantropia City HospitalCraiova 200143Romania Department of Internal Medicine Faculty of Medicine“Carol Davila”University of Medicine and PharmacyBucharest 050474Romania Internal Medicine clinic Clinical Emergency Hospital of BucharestBucharest 105402Romania

Myeloproliferative neoplasms(MPNs)occur due to the abnormal proliferation of one or more terminal myeloid cell lines in peripheral *** suffering from MPNs display a high burden of cardiovascular risk factors,and thrombotic events are often the cause of death in this population of ***,we provide a brief overview of dyslipidemia and metabolic syndrome and their epidemiology in MPNs and examine the common molecular mechanisms between dyslipidemia,metabolic syndrome,and MPNs,with a special focus on cardio-vascular risk,atherosclerosis,and thrombotic ***,we investigate the impact of dyslipidemia and metabolic syndrome on the occurrence and survival of thrombosis in MPN patients,as well as the management of dyslipidemia in MPNs,and the impact of MPN treatment on serum lipid concentrations,particularly as side/adverse effects reported in the context of clinical trials.

关键词： Polycythemia vera Essential thrombocythemia Myelofibrosis Cardiovascular disease Hypercholesterolemia Hypertriglyceridemia Obesity Diabetes Inflammation Oxidative stress

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