Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 6 de 6
Filtrar
1.
Am J Clin Pathol ; 156(4): 607-619, 2021 Sep 08.
Artigo em Inglês | MEDLINE | ID: mdl-33847759

RESUMO

OBJECTIVES: The Ki-67 proliferation index is integral to gastroenteropancreatic neuroendocrine tumor (GEP-NET) assessment. Automated Ki-67 measurement would aid clinical workflows, but adoption has lagged owing to concerns of nonequivalency. We sought to address this concern by comparing 2 digital image analysis (DIA) platforms to manual counting with same-case/different-hotspot and same-hotspot/different-methodology concordance assessment. METHODS: We assembled a cohort of GEP-NETs (n = 20) from 16 patients. Two sets of Ki-67 hotspots were manually counted by three observers and by two DIA platforms, QuantCenter and HALO. Concordance between methods and observers was assessed using intraclass correlation coefficient (ICC) measures. For each comparison pair, the number of cases within ±0.2xKi-67 of its comparator was assessed. RESULTS: DIA Ki-67 showed excellent correlation with manual counting, and ICC was excellent in both within-hotspot and case-level assessments. In expert-vs-DIA, DIA-vs-DIA, or expert-vs-expert comparisons, the best-performing was DIA Ki-67 by QuantCenter, which showed 65% cases within ±0.2xKi-67 of manual counting. CONCLUSIONS: Ki-67 measurement by DIA is highly correlated with expert-assessed values. However, close concordance by strict criteria (>80% within ±0.2xKi-67) is not seen with DIA-vs-expert or expert-vs-expert comparisons. The results show analytic noninferiority and support widespread adoption of carefully optimized and validated DIA Ki-67.


Assuntos
Antígeno Ki-67/análise , Biomarcadores Tumorais/análise , Proliferação de Células , Estudos de Coortes , Humanos , Processamento de Imagem Assistida por Computador , Imuno-Histoquímica , Neoplasias Intestinais , Gradação de Tumores , Tumores Neuroendócrinos , Neoplasias Pancreáticas , Neoplasias Gástricas
2.
Head Neck Pathol ; 15(3): 1007-1016, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-33048304

RESUMO

We describe the heretofore unreported case of an HPV-related carcinoma of the palatine tonsil with distinct areas of squamous cell- and adenoid cystic carcinoma-like differentiation in a 54-year old patient. The morphological, immunophenotypic and molecular findings of the tumor are illustrated. We discuss the parallels between the tumor and HPV-related multiphenotypic sinonasal carcinoma (HMSC) which is well-known to exhibit adenoid cystic carcinoma-like features. A review of the literature of high-risk HPV-associated non-squamous carcinomas of the oropharynx is presented.


Assuntos
Carcinoma Adenoide Cístico/patologia , Carcinoma Adenoide Cístico/virologia , Carcinoma de Células Escamosas de Cabeça e Pescoço/patologia , Carcinoma de Células Escamosas de Cabeça e Pescoço/virologia , Neoplasias Tonsilares/patologia , Neoplasias Tonsilares/virologia , Papillomavirus Humano 16 , Humanos , Masculino , Pessoa de Meia-Idade , Infecções por Papillomavirus/complicações
3.
Am J Clin Pathol ; 155(5): 638-648, 2021 04 26.
Artigo em Inglês | MEDLINE | ID: mdl-33511392

RESUMO

OBJECTIVES: The ongoing global severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic necessitates adaptations in the practice of surgical pathology at scale. Primary diagnosis by whole-slide imaging (WSI) is a key component that would aid departments in providing uninterrupted histopathology diagnosis and maintaining revenue streams from disruption. We sought to perform rapid validation of the use of WSI in primary diagnosis meeting recommendations of the College of American Pathologists guidelines. METHODS: Glass slides from clinically reported cases from 5 participating pathologists with a preset washout period were digitally scanned and reviewed in settings identical to typical reporting. Cases were classified as concordant or with minor or major disagreement with the original diagnosis. Randomized subsampling was performed, and mean concordance rates were calculated. RESULTS: In total, 171 cases were included and distributed equally among participants. For the group as a whole, the mean concordance rate in sampled cases (n = 90) was 83.6% counting all discrepancies and 94.6% counting only major disagreements. The mean pathologist concordance rate in sampled cases (n = 18) ranged from 90.49% to 97%. CONCLUSIONS: We describe a novel double-blinded method for rapid validation of WSI for primary diagnosis. Our findings highlight the occurrence of a range of diagnostic reproducibility when deploying digital methods.


Assuntos
Interpretação de Imagem Assistida por Computador/métodos , Patologia Cirúrgica/métodos , Telepatologia/métodos , COVID-19/epidemiologia , COVID-19/prevenção & controle , Método Duplo-Cego , Humanos , Interpretação de Imagem Assistida por Computador/normas , Variações Dependentes do Observador , Pandemias/prevenção & controle , Patologia Cirúrgica/normas , Guias de Prática Clínica como Assunto , Reprodutibilidade dos Testes , Estudos Retrospectivos , Telepatologia/normas
4.
World J Gastroenterol ; 12(21): 3400-5, 2006 Jun 07.
Artigo em Inglês | MEDLINE | ID: mdl-16733858

RESUMO

AIM: To evaluate the clinical and biochemical profile of patients with non alcoholic fatty liver disease (NAFLD) and to assess their histological severity at presentation. METHODS: Consecutive patients presenting to the liver clinic of All India Institute of Medical Sciences (AIIMS) with raised transaminases to at least 1.5 times upper limit of normal, and histologically confirmed non-alcoholic fatty liver disease were included. Patients who had significant alcohol intake or positive markers of other liver diseases or who were taking drugs known to produce fatty liver were excluded. The clinical, biochemical and histological profile of this group was studied. RESULTS: Fifty-one patients with NAFLD formed the study population. Their median age and BMI were 34(17-58) years and 26.7(21.3-32.5) kg/m(2) respectively and 46 (90.1%) were males. The majority of the patients had mild inflammation, either grade 1 [32 (63%)] or grade 2 [16 (31%)] and only 3 (6%) patients had severe (grade 3) inflammation. Twenty-three (45%), 19 (37%), 8(16%) and 1(2%) patient had stage 0, 1, 2 and 3 fibrosis respectively on index biopsy and none had cirrhosis. On univariate analysis, triglyceride levels more than 150 mg % (OR = 7.1; 95% CI: 1.6-31.5, P = 0.002) and AST/ALT ratio>1 (OR = 14.3; 95% CI: 1.4-678.5, P = 0.008) were associated with high grades of inflammation and none was associated with advanced fibrosis. On multivariate logistic regression analysis, hypertriglyceridemia >150 mg% was the only factor independently associated with presence of high grade of inflammation (OR = 1.6; 95% CI: 1.3-22.7, P = 0.02), while none was associated with advanced fibrosis. Triglyceride levels correlated positively with inflammatory grade (r = 0.412; P = 0.003). CONCLUSION: NAFLD in North Indian patients is a disease of young over-weight males, most of whom are insulin resistant and they tend to have a mild histological disease at presentation.


Assuntos
Povo Asiático , Fígado Gorduroso/etnologia , Fígado Gorduroso/patologia , Adolescente , Adulto , Povo Asiático/etnologia , Estudos Transversais , Feminino , Humanos , Hipertrigliceridemia/complicações , Incidência , Índia/etnologia , Inflamação , Resistência à Insulina , Fígado/patologia , Fígado/fisiopatologia , Masculino , Síndrome Metabólica/diagnóstico , Síndrome Metabólica/epidemiologia , Síndrome Metabólica/etnologia , Síndrome Metabólica/patologia , Pessoa de Meia-Idade , Sobrepeso , Estudos Prospectivos , Índice de Gravidade de Doença , Transaminases/sangue , Triglicerídeos/sangue
5.
BMJ Case Rep ; 20132013 Feb 15.
Artigo em Inglês | MEDLINE | ID: mdl-23417934

RESUMO

Primary mucinous carcinoma of the skin is a rare malignant neoplasm, often with periocular involvement, believed to originate from eccrine sweat glands. It is slow growing and locally destructive, at times forming tumour satellites. We present a case with six local recurrences treated with surgical resections over a period of 30 years. We have not been able to find longer follow-up in the literature, and believe this case may offer insight into the management of these uniquely indolent malignancies.


Assuntos
Adenocarcinoma Mucinoso/patologia , Glândulas Écrinas/patologia , Neoplasias Palpebrais/patologia , Procedimentos Cirúrgicos Oftalmológicos/métodos , Neoplasias das Glândulas Sudoríparas/patologia , Adenocarcinoma Mucinoso/cirurgia , Glândulas Écrinas/cirurgia , Neoplasias Palpebrais/cirurgia , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias das Glândulas Sudoríparas/cirurgia , Fatores de Tempo
6.
J Minim Invasive Gynecol ; 16(4): 504-6, 2009.
Artigo em Inglês | MEDLINE | ID: mdl-19573832

RESUMO

Androgen insensitivity syndrome is a disorder of sexual differentiation with 46XY karyotype. The gonad is at risk (33% by 50 years of age) for development of malignant tumors. Hence, gonadectomy is warranted. We present a case of a 22-year-old woman diagnosed with androgen insensitivity syndrome during investigation of primary amenorrhea. Ultrasonography showed intraabdominally-located gonads, with a large, nontender cyst of 9.2 x 5.6 x 5.4 cm size, with limited mobility, to the right of the midline. There was also a partial septum, with a wall thickness of 1 to 2 mm and containing clear fluid. Because of suspicion of malignancy, complete surgery including laparoscopic peritoneal cytologic study, gonadectomy, lymphadenectomy, and omentectomy were performed. Histopathologic study showed testis with an epididymal cyst. Formation of epididymal cyst is rare in these cases. The patient did well in the postoperative period. She was put on hormone replacement therapy and is doing well.


Assuntos
Síndrome de Resistência a Andrógenos/patologia , Síndrome de Resistência a Andrógenos/cirurgia , Espermatocele/patologia , Espermatocele/cirurgia , Colo do Útero/anormalidades , Feminino , Gônadas/cirurgia , Humanos , Laparoscopia , Masculino , Vagina/anormalidades , Adulto Jovem
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA