RESUMEN
Neonatal calves are highly susceptible to infectious disorders including diarrhea. Therefore, epithelial innate immunity, including antimicrobial peptides/proteins (AMPs), is important during the early stage of their lives. Chemerin, a multifunctional protein that was originally identified as a chemokine, possesses a potent antimicrobial activity. The present study investigated the expression levels of chemerin in the gastrointestinal (GI) tract of growing calves. Chemerin and its coding gene, retinoic acid receptor responder protein 2 (RARRES2), were highly expressed in duodenum, jejunum, and ileum compared with other parts of the GI tract. Immunohistochemistry demonstrated that chemerin-producing cells were localized in the crypt of the intestinal mucosa. Finally, the expression level of RARRES2 was higher compared with those of other major AMPs in duodenum, although it was lower compared with that of enteric ß-defensin but mostly higher than those of other AMPs in jejunum and ileum at various ages in calves. The expression levels of RARRES2 were not influenced by the age of calves in duodenum and jejunum, whereas a higher expression level of RARRES2 in ileum was observed in younger calves. This study revealed that chemerin is produced in the small intestine of calves and has the potential to contribute to the gut epithelial barrier system.
Asunto(s)
Antiinfecciosos , Mucosa Intestinal , Animales , Bovinos , Íleon , Intestino Delgado , YeyunoRESUMEN
We report an 18-year-old Japanese male with a lack of secondary sex characterization and growth failure caused by a rare association between Rathke's cyst and hypophysitis. He was referred to us because of delayed secondary sex characterization. Endocrinological examination showed panhypopituitarism, and the replacement of hydrocortisone, levothyroxine, and desmopressin acetate (DDAVP) was initiated. Brain magnetic resonance imaging (MRI) showed a suprasellar region and a swollen pituitary stalk. The mass was partially resected using the transsphenoidal approach. The pathological diagnosis was hypophysitis and Rathke's cyst. Follow-up MRI performed 1 year after surgery showed that the size of sellar region had not changed. After surgery, in addition to pre-operative hormonal replacement, growth hormone and testosterone were initiated. Two years later, the size of sellar region remains unchanged. In conclusion, while an association between Rathke's cyst and hypophysitis is rare, we suggest that this condition should be included in differential diagnosis of the sellar region, even in adolescents.
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Quistes del Sistema Nervioso Central/complicaciones , Trastornos del Desarrollo Sexual/etiología , Trastornos del Crecimiento/etiología , Hipopituitarismo/complicaciones , Hipófisis/inmunología , Neoplasias Hipofisarias/complicaciones , Adolescente , Desarrollo del Adolescente/efectos de los fármacos , Quistes del Sistema Nervioso Central/fisiopatología , Quistes del Sistema Nervioso Central/cirugía , Trastornos del Desarrollo Sexual/prevención & control , Trastornos del Crecimiento/prevención & control , Terapia de Reemplazo de Hormonas , Hormona de Crecimiento Humana/uso terapéutico , Humanos , Hipopituitarismo/tratamiento farmacológico , Hipopituitarismo/inmunología , Hipopituitarismo/fisiopatología , Masculino , Tamaño de los Órganos/efectos de los fármacos , Hipófisis/patología , Hipófisis/fisiopatología , Hipófisis/cirugía , Neoplasias Hipofisarias/fisiopatología , Neoplasias Hipofisarias/cirugía , Testosterona/uso terapéutico , Resultado del TratamientoAsunto(s)
Fosa Craneal Posterior/patología , Síndrome de Down/complicaciones , Tumor del Seno Endodérmico/terapia , Neoplasias de la Base del Cráneo/terapia , Preescolar , Terapia Combinada , Tumor del Seno Endodérmico/patología , Proteínas Fetales/sangre , Humanos , Inmunohistoquímica , Imagen por Resonancia Magnética , Masculino , Procedimientos Neuroquirúrgicos , Neoplasias de la Base del Cráneo/patologíaRESUMEN
A 46-year-old man with factor VIII deficiency presented with a rare case of hemophilic pseudotumor in the temporal bone manifesting as severe conductive hearing loss and external ear bleeding. The pseudotumor expanded and destroyed the temporal bone and skin of the external ear over the course of 8 years. The pseudotumor was surgically excised, and the patient's symptoms improved. Histological examination of a specimen collected from inside the pseudotumor demonstrated blood products in various stages of evolution and showed that the outer membrane consisted of a collagen layer. Hemophilic pseudotumors are rare complications occurring in 1-2% of patients with mild or severe hemophilia. Pseudotumors are chronic, slowly expanding, encapsulated cystic masses, and most are located in the long bones and pelvis. The present case suggests that cranial pseudotumor should be considered in the differential diagnosis of cranial lesion in a patient with hemophilia.
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Pérdida Auditiva Conductiva/diagnóstico , Pérdida Auditiva Conductiva/etiología , Hematoma/complicaciones , Hematoma/diagnóstico , Hemofilia A/complicaciones , Hemofilia A/diagnóstico , Hueso Temporal/patología , Biopsia , Pérdida Auditiva Conductiva/cirugía , Hematoma/cirugía , Humanos , Imagen por Resonancia Magnética , Masculino , Persona de Mediana Edad , Hueso Petroso/patología , Hueso Petroso/cirugía , Hueso Temporal/cirugía , Tomografía Computarizada por Rayos XRESUMEN
A 25-year-old man presented with malignant transformation to malignant peripheral nerve sheath tumor (MPNST) in the cervical spine associated with neurofibromatosis type 1. He presented with a 3-week history of rapidly increasing weakness and numbness in all four extremities. Magnetic resonance (MR) imaging of the cervical spine demonstrated a dumbbell-shaped tumor, which compressed the spinal cord at the C2-3 level. The tumor was excised, mainly within the spinal canal to decompress the spinal cord. The histological diagnosis was benign neurofibroma. Three months after surgery, he rapidly developed progressive tetraparesis and MR imaging revealed marked regrowth of an extradural mass into the spinal canal. At reoperation, the regrown mass in the spinal canal was totally excised. The histological diagnosis revealed MPNST. He underwent radiation therapy, with a total dose of 32 Gy, for approximately 3 weeks after the second surgery, but MR imaging showed tumor regrowth within the spinal canal, and his condition deteriorated. The decision was made to remove the tumor radically, including the involved facet and extradural lesion. Posterior fusion using a pedicle screw was performed one month later. He manifested no additional neurological deficits. He has been free of relapse for 46 months. Radical resection remains the most effective treatment for MPNST, although complete removal with a clear tumor margin is often impossible in practice.
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Vértebras Cervicales/cirugía , Neoplasias de la Vaina del Nervio/cirugía , Radioterapia Adyuvante , Neoplasias de la Columna Vertebral/cirugía , Tornillos Óseos , Transformación Celular Neoplásica , Terapia Combinada , Descompresión Quirúrgica , Progresión de la Enfermedad , Humanos , Imagen por Resonancia Magnética , Masculino , Neoplasias Primarias Múltiples/patología , Neoplasias Primarias Múltiples/cirugía , Neoplasias de la Vaina del Nervio/genética , Neoplasias de la Vaina del Nervio/radioterapia , Neurofibroma/patología , Neurofibroma/cirugía , Neurofibromatosis 1 , Cuadriplejía/etiología , Reoperación , Canal Medular , Compresión de la Médula Espinal/etiología , Compresión de la Médula Espinal/cirugía , Fusión Vertebral , Neoplasias de la Columna Vertebral/complicaciones , Neoplasias de la Columna Vertebral/radioterapia , Resultado del Tratamiento , Adulto JovenRESUMEN
Spontaneous rupture of adrenal neuroblastoma is very rare in infants, in contrast to neonates. This report describes a 9-month-old boy presenting with acute hemorrhagic shock due to spontaneous rupture of adrenal neuroblastoma. MYCN oncogene amplification may be a predisposing factor for spontaneous rupture and bleeding of neuroblastoma. An appropriate surgical treatment for this condition must be discussed according to the patient's general state and the tumor features, such as staging, the origin, and local invasiveness.
Asunto(s)
Neoplasias de las Glándulas Suprarrenales/complicaciones , Neuroblastoma/complicaciones , Choque Hemorrágico/etiología , Neoplasias de las Glándulas Suprarrenales/sangre , Neoplasias de las Glándulas Suprarrenales/tratamiento farmacológico , Neoplasias de las Glándulas Suprarrenales/genética , Neoplasias de las Glándulas Suprarrenales/cirugía , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Cisplatino/administración & dosificación , Soluciones Cristaloides , Ciclofosfamida/administración & dosificación , Doxorrubicina/administración & dosificación , Transfusión de Eritrocitos , Genes myc , Trasplante de Células Madre Hematopoyéticas , Hemoperitoneo/etiología , Humanos , Lactante , Soluciones Isotónicas/uso terapéutico , Masculino , Melfalán/administración & dosificación , Neuroblastoma/sangre , Neuroblastoma/tratamiento farmacológico , Neuroblastoma/genética , Neuroblastoma/cirugía , Inducción de Remisión , Factores de Riesgo , Rotura Espontánea , Choque Hemorrágico/terapia , Tiotepa/administración & dosificación , Trasplante Autólogo , Vincristina/administración & dosificaciónAsunto(s)
Enfermedad Hepática Inducida por Sustancias y Drogas/etiología , Conducto Colédoco/anomalías , Inhibidores Enzimáticos/efectos adversos , Guanidinas/efectos adversos , Hígado/efectos de los fármacos , Enfermedades Pancreáticas/congénito , Conductos Pancreáticos/anomalías , Pancreatitis/tratamiento farmacológico , Benzamidinas , Biopsia , Enfermedad Hepática Inducida por Sustancias y Drogas/diagnóstico , Enfermedad Hepática Inducida por Sustancias y Drogas/patología , Preescolar , Pancreatocolangiografía por Resonancia Magnética , Conducto Colédoco/cirugía , Humanos , Hígado/patología , Masculino , Necrosis , Enfermedades Pancreáticas/complicaciones , Enfermedades Pancreáticas/diagnóstico , Enfermedades Pancreáticas/cirugía , Conductos Pancreáticos/cirugía , Pancreatitis/diagnóstico , Pancreatitis/etiologíaRESUMEN
BACKGROUND: Lymph node metastasis is one of the most important prognostic factors for extra-hepatic bile duct carcinoma (ExHBDC). Extra capsular lymph node involvement (ExCLNI) is the extension of cancer cells through the nodal capsule into the perinodal fatty tissue. The prognostic impact of ExCLNI has been shown to be significant mainly in head and neck malignancies. Recently, the prognostic impacts of ExCLNI have evaluated in gastrointestinal malignancies. However no data is available regarding the incidence and prognostic significance of extra-capsular lymph node involvement (ExCLNI) in resectable ExHBDCs. The aim of the present study is first to evaluate the incidence of ExCLNI in surgically-treated ExHBDCs and second, to determine the prognostic impact of ExCLNI in patients with surgically-treated ExHBDCs. METHODS: A total of 228 patients (110 cases of hilar cholangiocarcinoma and 118 cases of distal cholangiocarcinoma) with surgically-treated ExHBDCs were included in this retrospective study. ExCLNI was defined as the extension of cancer cells through the nodal capsule into the perinodal fatty tissue. The existence of ExCLNI and its prognostic value were analyzed as a subgroup of lymph node metastasis. RESULTS: ExCLNI was detected in only 22% of patients with lymph node metastasis of surgically-treated ExHBDC. The presence of ExCLNI correlated with distal cholangiocarcinoma (p = 0.002). On univariate analysis for survival, perineural invasion, vascular invasion, histological grade, and lymph node metastasis were statistically significant factors. On multivariate analysis, only lymph node metastasis was identified as a significant independent prognostic factor in patients with resectable ExHBDC. Subgroups of lymph node metastasis including the presence of ExCLNI, location of lymph node metastasis, and the number of lymph node metastasis had no statistically significant impact on survival. CONCLUSION: ExCLNI was present in only 22% of the LNM (7% of overall patients) in patients with surgical treated ExHBDCs. And ExCLNI would have no impact on the survival of patients with surgically-treated ExHBDCs.
Asunto(s)
Neoplasias de los Conductos Biliares/patología , Conductos Biliares Extrahepáticos , Colangiocarcinoma/patología , Adulto , Anciano , Anciano de 80 o más Años , Neoplasias de los Conductos Biliares/mortalidad , Neoplasias de los Conductos Biliares/terapia , Colangiocarcinoma/mortalidad , Colangiocarcinoma/terapia , Femenino , Humanos , Metástasis Linfática , Masculino , Persona de Mediana Edad , Estadificación de Neoplasias , PronósticoRESUMEN
A 45-year-old man was admitted to our hospital with flaccid paraplegia. Neurological examination at a local hospital, 2 months before admission to our hospital, showed sensory impairment of the right posterior surface of the thigh and a decreased Achilles tendon reflex. Spinal magnetic resonance imaging (MRI) showed a T2 weighted high-intensity area at the Th10-11 level that was more pronounced in the gray matter. The patient developed flaccid paraparesis and urinary retention. No improvement was observed after 2 rounds of methylprednisolone (mPSL) pulse therapy. Spinal cord biopsy showed demyelinated axons and myelinophagia without any tumorous lesion. Myelopathy exacerbated, and hence, plasma exchange was performed. However, this was ineffective. We suspected that myelopathy was caused by intravascular lymphoma (IVL) because of the presence of a low-grade fever, weight loss, and elevated serum soluble IL-2 receptor titers. Random biopsies, including skin, rectal, bone marrow, muscle, and renal biopsies, and splenectomy were performed to make a definite diagnosis of IVL myelopathy. Among these biopsies, the diagnosis of IVL myelopathy was confirmed from the renal specimen. The patient underwent chemotherapy at our hospital, and the IVL remitted. The results of this study confirm that sufficient systemic investigation by using tissue biopsy specimens should be performed in order to confirm the diagnosis of IVL myelopathy.
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Biopsia , Linfoma de Células B Grandes Difuso/diagnóstico , Linfoma de Células B Grandes Difuso/patología , Enfermedades de la Médula Espinal/etiología , Neoplasias Vasculares/diagnóstico , Neoplasias Vasculares/patología , Diagnóstico Diferencial , Humanos , Riñón/irrigación sanguínea , Riñón/patología , Linfoma de Células B Grandes Difuso/complicaciones , Imagen por Resonancia Magnética , Masculino , Persona de Mediana Edad , Médula Espinal/patología , Enfermedades de la Médula Espinal/diagnóstico , Enfermedades de la Médula Espinal/patología , Neoplasias Vasculares/complicacionesRESUMEN
A 44-year-old man presented with exertional dyspnea. Transthoracic echocardiography (TTE) revealed a large tumor protruding into the right atrium and extending into the left ventricle. Cardiac magnetic resonance imaging and contrast enhanced computed tomography also confirmed the intracardiac tumor detected by TTE. An endomyocardial biopsy was performed under the intracardiac echocardiography (ICE) guidance, and he was diagnosed to have diffuse large B-cell lymphoma following the histological analysis. ICE-guided cardiac tumor biopsy is expected to be a useful diagnostic strategy that can minimize the risk of procedural complications.
Asunto(s)
Técnicas de Imagen Cardíaca/métodos , Ecocardiografía/métodos , Neoplasias Cardíacas/diagnóstico por imagen , Linfoma de Células B Grandes Difuso/diagnóstico por imagen , Adulto , Endoscopía/métodos , Humanos , Masculino , RadiografíaAsunto(s)
Linfoma de Células B/fisiopatología , Regresión Neoplásica Espontánea , Neoplasias de la Retina/fisiopatología , Anciano de 80 o más Años , Antígenos CD20/metabolismo , Linfocitos T CD8-positivos/patología , Enucleación del Ojo , Reordenamiento Génico , Humanos , Cadenas Pesadas de Inmunoglobulina/genética , Interleucina-10/metabolismo , Linfoma de Células B/genética , Linfoma de Células B/metabolismo , Masculino , Reacción en Cadena de la Polimerasa , Neoplasias de la Retina/genética , Neoplasias de la Retina/metabolismo , Agudeza Visual/fisiología , Vitrectomía , Cuerpo Vítreo/metabolismoRESUMEN
Meconium peritonitis is a sterile chemical peritonitis caused by bowel perforation with intraperitoneal extravasation of the meconium in utero. When the inflamed intestinal loops become fixed, meconium peritonitis leads to a cystic cavity with a fibrous wall, and the result is termed cystic-type meconium peritonitis. On the contrary, a meconium pseudocyst has a muscle layer continuous with the normal intestine and is distinguished from cystic-type meconium peritonitis based on the histopathologic findings. This report describes the rare case of a neonate complicated by a meconium pseudocyst, which was successfully treated with 1-stage resection and primary anastomosis. There have been few cases of meconium pseudocysts reported in the literature. Meconium peritonitis should be considered in the differential diagnosis in patients who develop large abdominal cysts with air and fluid content. Cystic-type meconium peritonitis is usually treated using drainage with subsequent elective surgery. However, for a meconium pseudocyst, 1-stage intestinal resection with primary anastomosis may be recommended. A meconium pseudocyst may be treatable using 1-stage resection based on histopathologic features.
Asunto(s)
Atresia Intestinal/diagnóstico , Perforación Intestinal/diagnóstico , Intestino Delgado/patología , Meconio , Peritonitis/diagnóstico , Femenino , Humanos , Recién Nacido , Atresia Intestinal/complicaciones , Perforación Intestinal/complicaciones , Perforación Intestinal/congénito , Intestino Delgado/anomalías , Peritonitis/congénito , Peritonitis/etiologíaAsunto(s)
Neoplasias Encefálicas/complicaciones , Neoplasias Encefálicas/radioterapia , Germinoma/complicaciones , Germinoma/radioterapia , Neoplasias Meníngeas/patología , Meningioma/patología , Neoplasias Inducidas por Radiación/patología , Adolescente , Biopsia , Edema Encefálico/patología , Corteza Cerebral/patología , Terapia Combinada , Femenino , Fluorodesoxiglucosa F18 , Humanos , Imagen por Resonancia Magnética , Neoplasias Meníngeas/diagnóstico por imagen , Neoplasias Meníngeas/etiología , Meningioma/diagnóstico por imagen , Meningioma/etiología , Neoplasias Inducidas por Radiación/diagnóstico por imagen , Neoplasias Inducidas por Radiación/etiología , Tomografía de Emisión de Positrones , Radiofármacos , Adulto JovenRESUMEN
Pineal parenchymal tumors (PPTs) are rare neoplasms which occupy less than 1% of primary CNS tumors. Because of their rare incidence, previous reports on PPTs are limited in number and the useful molecular markers for deciding histological grading and even selecting chemotherapy are undetermined. In this study, we conducted immunohistochemical analysis of 12 PPT specimens, especially for expression of O6-methylguanine DNA methyltransferase (MGMT) to assess whether temozolomide (TMZ) could serve as a possible alternative therapy for PPTs. We analyzed 12 PPTs, consisting of three pineocytomas, six PPTs of intermediate differentiation (PPTIDs), and three pineoblastomas. Immunohistochemical analysis was performed using antibodies against MGMT, synaptophysin, neurofilament protein (NF), p53, and neuronal nuclear antigen (NeuN). Immunohistochemically, 11 out of 12 cases were positive for MGMT. The mean MIB-1 labeling index was less than 1% in pineocytoma, 3.5% in PPTID, and 10.5% in pineoblastoma. All 12 cases were positive for synaptophysin and 11 cases, except one PPTID case, showed positive for NF. Nuclear staining of NeuN was negative in all cases although cytoplasmic staining of NeuN was observed in five cases. No case was positive for p53. Eleven out of 12 cases of PPTs demonstrated MGMT expression, suggesting chemoresistancy to TMZ treatment. This is the first report showing MGMT expression in PPTs. In addition, MIB-1 labeling index correlated with WHO grade, although the immunoreactivity of synaptophysin, NF, NeuN and p53 did not correlate with the histological grade.
Asunto(s)
Antineoplásicos Alquilantes/uso terapéutico , Neoplasias Encefálicas/metabolismo , Metilasas de Modificación del ADN/metabolismo , Enzimas Reparadoras del ADN/metabolismo , Dacarbazina/análogos & derivados , Antígeno Ki-67/metabolismo , Glándula Pineal/metabolismo , Pinealoma/metabolismo , Proteínas Supresoras de Tumor/metabolismo , Adulto , Anciano , Neoplasias Encefálicas/patología , Dacarbazina/uso terapéutico , Femenino , Humanos , Inmunohistoquímica/métodos , Antígeno Ki-67/efectos de los fármacos , Masculino , Persona de Mediana Edad , Proteínas de Neurofilamentos/metabolismo , Pinealoma/tratamiento farmacológico , Pinealoma/patología , Sinaptofisina/metabolismo , Temozolomida , Adulto JovenRESUMEN
Rhabdoid meningioma (RM) is a rare aggressive phenotype and is classified as a grade III neoplasm by the World Health Organization. A 29-year-old woman initiated treatment with clomiphene citrate for infertility. Two weeks later, she presented with acute headache and nausea. Brain computed tomography and magnetic resonance imaging demonstrated a tumor with hematoma in the left frontoparietal region. Surgical resection was performed, and the tumor was subtotally removed. The tumor was diagnosed as a rhabdoid meningioma (RM). Despite radiation and chemotherapy, she experienced regrowth and dissemination to the spinal cord. She died 11 months after onset of symptoms. Spontaneous hemorrhage is an unusual presentation of RM. In our case, infertility treatment may have triggered progression and bleeding because of an imbalance of sex hormones.
Asunto(s)
Infertilidad Femenina/etiología , Hemorragias Intracraneales/etiología , Meningioma/complicaciones , Tumor Rabdoide/complicaciones , Adulto , Clomifeno/efectos adversos , Clomifeno/uso terapéutico , Terapia Combinada , Resultado Fatal , Femenino , Fármacos para la Fertilidad Femenina/efectos adversos , Fármacos para la Fertilidad Femenina/uso terapéutico , Humanos , Infertilidad Femenina/tratamiento farmacológico , Imagen por Resonancia Magnética , Meningioma/patología , Meningioma/cirugía , Corteza Motora/patología , Procedimientos Neuroquirúrgicos , Tumor Rabdoide/patología , Tumor Rabdoide/cirugía , Tomografía Computarizada por Rayos XRESUMEN
A pregnant woman with extensive brain lesions on magnetic resonance imaging was tested positive for anti-aquaporin4 (AQP4) antibodies. An open biopsy of the left temporal lobe showed pathological changes in both the white and gray matter. Hematoxylin and eosin, Klüver-Barrera, and myelin basic protein staining results were indicative of demyelination in the white matter. Loss of AQP4 and glial fibrillary acidic protein was observed in the white matter, and this finding is consistent with the neuropathological findings of neuromyelitis optica spinal lesions. Moreover, loss of AQP4 was observed in the gray matter. The presence of anti-AQP4 antibodies, and the pathology, led to the diagnosis of anti-AQP4 antibodies-related encephalopathy.
Asunto(s)
Acuaporina 4/inmunología , Autoanticuerpos/sangre , Encefalopatías/patología , Encéfalo/patología , Enfermedad de Hashimoto/patología , Neuromielitis Óptica/patología , Complicaciones del Embarazo/patología , Biomarcadores/análisis , Biopsia , Encéfalo/inmunología , Encéfalo/metabolismo , Encefalopatías/inmunología , Encefalopatías/metabolismo , Diagnóstico Diferencial , Encefalitis , Femenino , Proteína Ácida Fibrilar de la Glía/análisis , Enfermedad de Hashimoto/inmunología , Enfermedad de Hashimoto/metabolismo , Humanos , Inmunohistoquímica , Imagen por Resonancia Magnética , Neuromielitis Óptica/inmunología , Neuromielitis Óptica/metabolismo , Valor Predictivo de las Pruebas , Embarazo , Complicaciones del Embarazo/inmunología , Complicaciones del Embarazo/metabolismoRESUMEN
BACKGROUND: Intrahepatic and extrahepatic recurrence remains a significant problem for hepatocellular carcinoma (HCC). The aim of this study was to determine the usefulness of diffusion-weighted magnetic resonance imaging (DWI) for histological tumor grading and preoperative prediction of early HCC recurrence within 6 months of operation. METHODS: A total of 44 patients who had undergone hepatic resection for HCC (50 nodules) were reviewed retrospectively. DWI was performed within 30 days before hepatectomy, and apparent diffusion coefficients (ADCs) were measured using 2 methods: mean ADC and minimum-spot ADC. Relationships between ADCs and histological differentiation and between ADCs and early recurrence of HCC were analyzed. RESULTS: Mean ADC was significantly lower in poorly differentiated HCC (n=18, 1.07±0.15×10(-3) mm2/s) than in moderately differentiated HCC (n=29, 1.29±0.21×10(-3) mm2/s; P<.05). Minimum-spot ADC was significantly lower in poorly differentiated HCC (n=18, 0.69±0.19×10(-3) mm2/s) than in well-differentiated HCC (n=3, 1.15±0.10×10(-3) mm2; P<.01) or in moderately differentiated HCC (n=29, 0.98±0.18×10(-3) mm2/s; P<.0001). Of 34 patients who were able to be observed for >6 months after resection, 9 showed early recurrence. Minimum-spot ADC was significantly lower in patients with early recurrence (n=9, 0.64±0.24×10(-3) mm2/s) than in patients without early recurrence (n=25, 0.88±0.19×10(-3) mm2/s; P<.05). On multivariate analysis, minimum-spot ADC was a significant risk factor for early recurrence (P<.05). CONCLUSION: Quantitative measurement of ADC of HCC with magnetic resonance diffusion weighted imaging is a promising functional imaging tool in the prediction of histological grade and early recurrence before treatment.
Asunto(s)
Carcinoma Hepatocelular/patología , Imagen de Difusión por Resonancia Magnética , Neoplasias Hepáticas/patología , Recurrencia Local de Neoplasia/patología , Anciano , Anciano de 80 o más Años , Carcinoma Hepatocelular/cirugía , Femenino , Hepatectomía , Humanos , Neoplasias Hepáticas/cirugía , Masculino , Persona de Mediana Edad , Análisis Multivariante , Clasificación del Tumor , Valor Predictivo de las Pruebas , Cuidados Preoperatorios , Estudios RetrospectivosRESUMEN
The HLA class I antigen processing machinery (APM) plays a crucial role in the anticancer immune response. The aim of this study was to assess the clinical significance of APM components in esophageal cancer. A total of 11 esophageal cancer cell lines were evaluated by Western blot analysis for 13 HLA class I APM components. There was a different expression pattern among cancer cell lines for HLA class I heavy chain (HLA-HC), ß2 microglobulin, Tapasin, TAP-1, TAP-2, LMP-7 and LMP-10. Immunohistochemical staining utilizing a tissue microarray method for HLA class I APM expression showing different expression patterns among cell lines was performed for 95 surgical specimens from patients with esophageal cancer. Prognostic factors were the down-regulation of HLA-HC, and the up-regulation of ß2 microglobulin and TAP-1 in the cancer tissues. Multivariate analysis using a Cox regression model indicated that the down-regulation of HLA-HC, and up-regulation of TAP-1 in cancer tissues are independent, unfavorable prognostic factors (hazard ratio, 2.361 and 2.297; P=0.0141 and 0.0145, respectively). Although there was no significant difference in survival for selected p-stage I and II patients (n=54) in all APM components, only down-regulation of HLA-HC was an unfavorable prognostic factor by a Cox regression model for selected p-stage III and IV patients (n=41). In conclusion, the current results suggest that the down-regulation of HLA-HC in tumors is especially associated with a poor prognosis among advanced esophageal cancer patients.
Asunto(s)
Neoplasias Esofágicas/inmunología , Antígenos HLA/inmunología , Antígenos de Histocompatibilidad Clase I/inmunología , Animales , Línea Celular Tumoral , Regulación hacia Abajo , Neoplasias Esofágicas/genética , Femenino , Antígenos HLA/genética , Antígenos de Histocompatibilidad Clase I/genética , Humanos , Inmunohistoquímica , Ratones , Ratones SCID , Análisis por Micromatrices , Pronóstico , Tasa de Supervivencia , Trasplante Heterólogo , Microglobulina beta-2/genética , Microglobulina beta-2/inmunologíaRESUMEN
A 2-year-old female presented with a rare case of recurrent giant cell tumor affecting the frontal bone. She had already undergone partial removal twice at the ages of 14 and 18 months. The tumor was located in the frontal bone, expanding to the ethmoid and orbital bones, and invading the frontal base dura mater. The tumor was totally removed including the surrounding bone and frontal base dura mater. No local recurrence and metastasis were observed at 18 months after the last operation. Most giant cell tumors occur in the epiphyses of long bones and are rare in the cranio-facial bone. These tumors usually affect young adults and few pediatric cases are reported.