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Sessile serrated adenomas:Demographic,endoscopic and pathological characteristics

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World Journal of Gastroenterology 2010年第27期16卷 3402-3405页

作者： Suryakanth R Gurudu Russell I Heigh Giovanni De Petris Evelyn G Heigh Jonathan A Leighton Shabana F Pasha Isaac B Malagon Ananya Das Division of Gastroenterology Mayo Clinic ArizonaScottsdaleAZ 85259United States Department of pathology Mayo Clinic ArizonaAZ 85259United States Department of Kinesiology Arizona State University

AIM:To study the demographic and endoscopic characteristics of patients with sessile serrated adenoma(SSA) in a single ***:Patients with SSA were identified by review of the pathology database of Mayo clinic Arizona from 2005 to 2007.A retrospective chart review was performed to extract data on demographics,polyp characteristics,presence of synchronous adenomatous polyps or cancer,polypectomy methods,and related ***:One hundred and seventy-one(2.9%) of all patients undergoing colonoscopy had a total of 226 *** mean(SE) size of the SSAs was 8.1(0.4) mm;42% of SSAs were ≤ 5 mm,and 69% were ≤ 9 ***-one per cent of SSAs were located in the cecum or ascending *** half of the patients had synchronous polyps of other histological types,including hyperplastic and adenomatous *** adenocarcinoma was present in seven(4%) ***-seven percent of polyps were removed by ***:Among patients with colon polyps,2.9% were found to have *** of the SSAs were located in the right side and were safely managed by colonoscopy.

关键词： Sessile serrated polyp Sessile serrated adenoma Colonoscopy

Fibrolamellar hepatocellular carcinoma:Exploring molecular mechanisms and differentiation pathways to better understand disease outcomes and prognosis

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Liver Research 2017年第4期1卷 187-192页

作者： Cassandra A.Kersten Elise N.Sloey Eric Zhou Ying Peng Michael S.Torbenson Yi Guo Department of Biochemistry and Molecular Biology Mayo ClinicRochesterMNUSA Division of Gastroenterology and Liver pathology Department of Laboratory Medicine and PathologyMayo ClinicRochesterMNUSA Division of Gastroenterology and Hepatology Mayo ClinicRochesterMNUSA

Fibrolamellar hepatocellular carcinoma(FLC)is a rare but aggressive liver cancer of children that occurs predominantly in teenagers without a history of liver *** resection remains the only therapeutic option,and the recurrence rate is extremely high(>50%within 3 years).A newly discovered chromosomal deletion that occurs in the majority of FLCs generates a novel kinase fusion between DnaJ heat shock protein family member B1(DNAJB1)and protein kinase cAMP-activated catalytic subunit alpha(PRKACA)(DNAJB1-PRKACA).Despite its high penetrance and apparent specificity for FLC,the oncogenic role of this fusion event remains *** this review article,we discuss the histology,presentation and diagnosis,current treatment,and roles of the DNAJB1-PRKACA as well as research models contributing to our understanding of this disease.

关键词： Fibrolamellar hepatocellular carcinoma(FLC) DnaJ heat shock protein family member B1 (DNAJB1) Protein kinase cAMP-activated catalytic subunit alpha(PRKACA)Pediatric cancer Liver cancer

Colonoscopy surveillance for high risk polyps does not always prevent colorectal cancer

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World Journal of Gastroenterology 2018年第8期24卷 905-916页

作者： Mohamad A Mouchli Lidia Ouk Marianne R Scheitel Alisha P Chaudhry Donna Felmlee-Devine Diane E Grill Shahrooz Rashtak Panwen Wang Junwen Wang Rajeev Chaudhry Thomas C Smyrk Ann L Oberg Brooke R Druliner Lisa A Boardman Division of Gastroenterology and Hepatology Mayo Clinic Knowledge and Delivery Center Mayo Clinic Biostatistics and Bioinformatics Health Sciences Research Mayo Clinic Division of Biomedical Statistics and Informatics Health Sciences Research Mayo Clinic Biostatistics and Bioinformatics Health Science Research Center for Individualized Medicine Mayo Clinic Department of Biomedical Informatics Arizona State University Primary Care Internal Medicine Mayo Clinic Center for Innovation Mayo Clinic Department of Laboratory Medicine and pathology Mayo Clinic

AIM To determine the frequency and risk factors for colorectal cancer(CRC) development among individuals with resected advanced adenoma(AA)/traditional serrated adenoma(TSA)/advanced sessile serrated adenoma(ASSA). METHODS Data was collected from medical records of 14663 subjects found to have AA, TSA, or ASSA at screening or surveillance colonoscopy. Patients with inflammatory bowel disease or known genetic predisposition for CRC were excluded from the study. Factors associated with CRC developing after endoscopic management of high risk polyps were calculated in 4610 such patients who had at least one surveillance colonoscopy within 10 years following the original polypectomy of the incident advanced polyp. RESULTS84/4610(1.8%) patients developed CRC at the polypectomy site within a median of 4.2 years(mean 4.89 years), and 1.2%(54/4610) developed CRC in a region distinct from the AA/TSA/ASSA resection site within a median of 5.1 years(mean 6.67 years). Approximately, 30%(25/84) of patients who developed CRC at the AA/TSA/ASSA site and 27.8%(15/54) of patients who developed CRC at another site had colonoscopy at recommended surveillance intervals. Increasing age; polyp size; male sex; right-sided location; high degree of dysplasia; higher number of polyps resected; and piecemeal removal were associated with an increased risk for CRC developmentat the same site as the index polyp. Increasing age; right-sided location; higher number of polyps resected and sessile endoscopic appearance of the index AA/TSA/ASSA were significantly associated with an increased risk for CRC development at a different site. CONCLUSION Recognition that CRC may develop following AA/TSA/ASSA removal is one step toward improving our practice efficiency and preventing a portion of CRC related morbidity and mortality.

关键词： Colon cancer Rectal Cancer Advanced adenoma Sessile serrated adenoma High risk polyps Post-polypectomy colorectal cancer

Pleomorphic Nasopharyngeal Liposarcoma: An Aggressive Tumor

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International Journal of Otolaryngology and Head & Neck Surgery 2024年第1期13卷 11-15页

作者： Mame Sanou Diouf Sall Ahmadou Cheikhou Ndiaye Ciré Thiam Amadou Abdoulaye Diop Deguenonvo Richard Edouard Alain Diom Evelyne Siga Ndiaye Malick Diallo Bay Karim Diouf Raymond ENT and Cervicofacial Surgery Department Idrissa Pouye General Hospital Grand-Yoff Dakar Senegal ENT Department Diamniadio Children’s Hospital Dakar Senegal ENT clinic Lamine Sine Diop Dakar Senegal ENT Department and Cervico-Facial Surgery H&#244pital de la paix Ziguinchor Senegal ENT and Cervicofacial Surgery Department Albert Royer Children’s Hospital Dakar Senegal

Nasopharyngeal liposarcoma is an extremely rare clinical entity. Less than ten cases have been reported in the literature. It mainly occurs in humans. The non-specificity of the clinical and radiological signs explains the difficulty of the diagnosis confirmed by anatomopathological and immunohistochemical examinations. Its pathogenesis remains obscure and often correlates with genetic abnormalities. Pleomorphic liposarcoma is its rarest subtype, remarkable for its aggressiveness and rapidity of growth. Complete surgical excision remains the treatment of choice. We report a case of liposarcoma whose diagnosis was made during histological examination coupled with immunohistochemistry. .

关键词： Liposarcoma Nasopharynx pathology Immunohistochemistry

Suspicious brush cytology is an indication for liver transplantation evaluation in primary sclerosing cholangitis

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World Journal of Gastroenterology 2017年第33期23卷 6147-6154页

作者： Sonja Boyd Marko Vannas Kalle Jokelainen Helena Isoniemi Heikki Makisalo Martti A Farkkila Johanna Arola Department of pathology University of Helsinki and Helsinki University Hospital Transplantation and Liver Surgery clinic University of Helsinki and Helsinki University Hospital clinic of Gastroenterology University of Helsinki and Helsinki University Hospital

AIM To investigate markers for high-grade dysplasia for the optimal timing of liver transplantation in patients with primary sclerosing cholangitis(PSC).METHODS Earlier data support a dysplasia-carcinoma sequence,even low-to high-grade dysplasia,in PSC-associated cholangiocarcinoma(CCA). Surveillance using endoscopic retrograde cholangiography(ERC) and brush cytology aims to detect cases of biliary dysplasia,and liver transplantation is an option in cases with suspicion of malignancy in brushing. This study investigated markers to identify patients with highgrade biliary dysplasia for optimal timing in early liver transplantation. Patients undergoing surveillance using ERC and brush cytology during 2008-2014 and who were diagnosed with biliary dysplasia in explanted liver or CCA until February 2016 were included in the study. Demographic data,cholangiography findings,laboratory values,cytological morphology and DNA ploidy were *** Thirty PSC patients had biliary neoplasia in the explanted liver during the study period. Sixteen of these patients had low-grade dysplasia,10 patients had high-grade dysplasia,and 4 patients had CCA. Fifteen PSC patients diagnosed with CCA were not transplanted. Patients with low-grade dysplasia were younger. Alkaline phosphatase or carcinoembryonic antigen values did not differ between groups during surveillance,but carbohydrate antigen 19-9 was higher in CCA patients. No difference in PSC duration,ERC scores,suspicious cytology,or ploidy analysis was found between groups. No difference was observed between fibrosis stage in explanted livers. Low-and high-grade dysplasia could not be differentiated before liver transplantation based on liver enzymes,tumour markers,ERC scores,brush cytology or DNA *** Repeated suspicion of neoplasia in brush cytology should be an indication for evaluations of liver transplantation prior to the development of CCA.

关键词： Endoscopic retrograde cholangiography Brush cytology Cholangiocarcinoma Biliary dysplasia

Primary leiomyosarcoma of the thyroid gland with prior malignancy and radiotherapy:A case report and review of literature

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World Journal of clinical Cases 2019年第4期7卷 473-481页

作者： Snezana Vujosevic Djordjije Krnjevic Milan Bogojevic Ljiljana Vuckovic Aleksandar Filipovic Du?ko Dun?erovi? Jelena Sopta Endocrinology Clinical Center of Montenegro Internal Medicine clinic Clinical Center of Montenegro Institute of pathology Clinical Center of Montenegro Surgery Clinical Center of Montenegro Institute of pathology University of Belgrade

BACKGROUND Leiomyosarcoma(LMS) of the thyroid gland is a rarely presented tumor that offers poor prognosis. To the best of the authors' knowledge, there currently exist only 28 known cases described in the literature(limited to English).CASE SUMMARY Herein a case is reported of a 60-year-old female patient who had an LMS of the thyroid, which was accompanied by periodic dysphonia and breathing disorder as well as the feeling of pressure in the chest and neck. At the time the disease was diagnosed, no metastases were detected. Prior to the diagnosis, the patient experienced a uterine adenocarcinoma that had been treated by surgical procedure and radiotherapy. For the LMS, a total thyroidectomy was performed,followed by radiotherapy. Since metastases were also discovered in the lungs,sternum, and femur, chemotherapy was administered as ***, the tumor cells in the thyroid indicated positively for alpha smooth muscle actin, calponin, and H-caldesmon, but were negative for CD34, p63, estrogen receptor, progesterone receptor, and Epstein-Barr *** Although the etiology of the LMS is as of yet unknown, prior malignancy and radiation should be considered as risk factors.

关键词： Thyroid Leiomyosarcoma Smooth muscle tumor Radiotherapy Thyroidectomy Case report

Current diagnostic approach to patients with adnexal masses: which tools are relevant in routine praxis?

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Chinese Journal of Cancer Research 2013年第1期25卷 55-62页

作者： Milan M. Terzic Jelena Dotlic Ivana Likic Nebojsa Ladjevic Natasa Brndusic Nebojsa Arsenovic Sanja Maricic Tihomir Mihailovic Sasa Andrijasevic clinic of Obstetrics and Gynecology Clinical Center of Serbia School of Medicine University of Belgrade Center for anesthesiology and resuscitation Clinical Center of Serbia Department of Cellular pathology PathLinks Pathology Services Lincoln County Hospital Occupational Health Department General Health Center "Savski Venac" Department of Radiology Ultramedica Clinic American Medical Academy

Objective： The aim of the study was to investigate which anamnestic, laboratory and ultrasound parameters used in routine practice could predict the nature of adnexal mass, thus enabling referral to relevant specialist. Methods： Study involved the women treated for adnexal tumors throughout a period of 2 years. On admission, detailed anamnestic and laboratory data were obtained, expert ultrasound scan was performed, and power Doppler index （PDI）, risk of malignancy index （RMI） and body mass index （BMI） were calculated for all patients. Obtained data were related to histopathological findings, and statistically analyzed. Results： The study included 689 women （112 malignant, 544 benignant, and 33 borderline tumors）. Malignant and borderline tumors were more frequent in postmenopausal women （P=0.000）. Women who had benignant tumors had the lowest BMI （P=0.000）. There were significant （P〈0.05） differences among tumor types regarding erythrocyte sedimentation rate, CA125 and carcinoembryonic antigen （CEA） levels. Among ultrasound findings, larger tumor diameter and ascites were more frequent in malignant tumors （P=0.000）. Women with malignant tumors had highest values of RMI and PDI （P=0.000）. Conclusions： Anamnestic data, ultrasound parameters and laboratory analyses were all found to be good discriminating factors among malignant, benignant and borderline tumors.

关键词： Adnexal mass risk of malignancy index power Doppler index tumor markers body mass index

Burkitt Lymphoma Presenting as Ileocolic Intussusception in an Adult

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Open Journal of Blood Diseases 2023年第4期13卷 121-132页

作者： Carla Isabel Borré Bethany Boyle Kelsey Lynch Anuradha Kanaparthi Clifford Michael Csizmar Daniel Philip Larson Matthew Dain Braithwaite Isla McKerrow Johnson Thomas Elmer Witzig Diego Armando Suarez Yale School of Public Health Yale University New Haven USA Department of Medicine Mayo Clinic Rochester USA Division of Hematopathology Department of Laboratory Medicine and Pathology Mayo Clinic Rochester USA Division of Hematology Department of Medicine Mayo Clinic Rochester USA Division of Community Internal Medicine Department of Medicine Mayo Clinic Rochester USA

Adult intussusception is rare, highly associated with a malignant lead point, and often requires emergent surgical management. We report the case of a 44-year-old male who presented with generalized abdominal pain and was found to have early ileocolic intussusception secondary to a large ileocecal mass. Biopsies of the mass and an enlarged cardiophrenic lymph node, as well as pleural fluid cytology were all consistent with Burkitt lymphoma (BL). Curiously, the patient’s abdominal exam was reassuring, and the intussusception and malignant bowel obstruction resolved over 36 hours with conservative management alone. With a Burkitt lymphoma international prognostic index (BL-IPI) score of 2, the patient proceeded to treatment with combination chemoimmunotherapy and attained a complete response after four cycles. There was no bowel perforation or recurrent intussusception throughout treatment. Thus, this report marks the first reported case of adult BL-associated intussusception to resolve with non-invasive management and establishes a precedent for conservative management in select patients.

关键词： Burkitt Lymphoma Adult Intussusception Prognostication

Phacoemulsification versus small incision cataract surgery in patients with uveitis

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International Journal of Ophthalmology(English edition) 2015年第5期8卷 965-970页

作者： Rahul Bhargava Prachi Kumar Shiv Kumar Sharma Manoj Kumar Avinash Kaur Department of Ophthalmology Laser Eye Clinic Department of pathology Santosh medical College and Hospital Department of Ophthalmology Rotary Eye Hospital

AIMTo compare the safety and efficacy of phacoemulsification and small incision cataract surgery (SICS) in patients with uveitic *** a prospective, randomized multi-centric study, consecutive patients with uveitic cataract were randomized to receive phacoemulsification or manual SICS by either of two surgeons well versed with both the techniques. A minimum inflammation free period of 3mo (defined as less than 5 cells per high power field in anterior chamber) was a pre-requisite for eligibility for surgery. Superior scleral tunnel incisions were used for both techniques. Improvement in visual acuity post-operatively was the primary outcome measure and the rate of post-operative complications and surgical time were secondary outcome measures, respectively. Means of groups were compared using t-tests. One way analysis of variance (ANOVA) was used when there were more than two groups. Chi-square tests were used for proportions. Kaplan Meyer survival analysis was done and means for survival time was estimated at 95% confidence interval (CI). A P value of <0.05 was considered statistically *** hundred and twenty-six of 139 patients (90.6%) completed the 6-month follow-up. Seven patients were lost in follow up and another six excluded due to either follow-up less than six months (n=1) or inability implant an intraocular lens (IOL) because of insufficient capsular support following posterior capsule rupture (n=5). There was significant improvement in vision after both the procedures (paired t-test; P<0.001). On first postoperative day, uncorrected distance visual acuity (UDVA) was 20/63 or better in 31 (47%) patients in Phaco group and 26 (43.3%) patients in SICS group (P=0.384). The mean surgically induced astigmatism (SIA) was 0.86±0.34 dioptres (D) in the phacoemulsification group and 1.16±0.28 D in SICS group. The difference between the groups was significant (t-test, P=0.002). At 6mo, corrected distance

关键词： small incision cataract surgery phacoemulsification uveitis corrected distance visual acuity uncorrected distance visual acuity