RESUMO
INTRODUCTION: The neurotrophic tropomyosin-related kinase (NTRK) genes encode the tropomyosin receptor kinases (TRKs). Patients with solid tumors harboring an oncogenic NTRK fusion are eligible for treatment with TRK inhibitors. NTRK fusion is often associated with TRK overexpression. Pan-TRK immunohistochemistry (IHC) is used to screen for NTRK fusions, but immunoreactivity patterns are poorly defined. METHODS: Data on pan-TRK immunoreactivity patterns in 2,669 solid tumors (comprising carcinomas, sarcomas, and melanocytic lesions) were retrospectively collected by nine laboratories and comprised tumor type, percentage of pan-TRK-positive tumor cells, staining intensity, cytoplasmic, membrane and/or nuclear staining pattern, and the presence or absence of NTRK fusion. RESULTS: Overall, 2,457 tumors (92%) were pan-TRK negative and 212 neoplasms (8%) were pan-TRK positive. Twenty-two pan-TRK-positive tumors (0.8%) harbored an NTRK fusion, representing 10% of all pan-TRK-positive tumors. Cytoplasmic immunoreactivity was most often observed, followed by membrane immunoreactivity. Nuclear pan-TRK positivity was least frequent, but was most often (33%) associated with NTRK fusion. CONCLUSION: Pan-TRK IHC can be used to screen for NTRK fusions, especially in commonly diagnosed solid tumors with low NTRK fusion prevalence. In case of pan-TRK immunoreactivity, regardless of its intensity and tumor cell percentage, subsequent molecular tests should be performed to formally confirm the presence or absence of NTRK fusions.
Assuntos
Neoplasias , Receptores Proteína Tirosina Quinases , Humanos , Imuno-Histoquímica , Neoplasias/diagnóstico , Neoplasias/genética , Receptor trkA/genética , Estudos Retrospectivos , Sarcoma/genética , Tropomiosina/genética , Receptores Proteína Tirosina Quinases/genética , Fusão Gênica/genética , Detecção Precoce de CâncerRESUMO
Sclerotic lesions of the jaw are uncommon but may be clinically relevant. In this pictorial review, the most common sclerotic lesions are discussed. Three categories of lesions are distinguished; odontogenic sclerotic lesions, non-odontogenic sclerotic lesions, and mixed lytic-sclerotic lesions. In each group, non-neoplastic conditions are discussed first, followed by benign and malignant neoplasms. For each disease a brief overview is given, including histological features, epidemiology, symptoms, typical location, imaging features, and treatment. This review emphasizes which basic observations are essential to the evaluation of sclerotic jaw lesions and what elements have to be taken into account to create a proper differential diagnosis.
RESUMO
We present two cases of patients with severe persistent diarrhoea, in whom duodenal biopsies revealed villous atrophy that could be attributed to the use of olmesartan. The differential diagnosis of villous atrophy without serological markers of celiac disease should include drugs as possible cause, with olmesartan as a recently discovered culprit. Gastroenterologist should be aware of this entity.
Assuntos
Diarreia , Duodeno/patologia , Imidazóis/efeitos adversos , Mucosa Intestinal , Microvilosidades/patologia , Tetrazóis/efeitos adversos , Idoso , Bloqueadores do Receptor Tipo 1 de Angiotensina II/administração & dosagem , Bloqueadores do Receptor Tipo 1 de Angiotensina II/efeitos adversos , Atrofia/induzido quimicamente , Atrofia/patologia , Biópsia/métodos , Diagnóstico Diferencial , Diarreia/diagnóstico , Diarreia/etiologia , Diarreia/fisiopatologia , Diarreia/terapia , Feminino , Humanos , Imidazóis/administração & dosagem , Mucosa Intestinal/ultraestrutura , Masculino , Tetrazóis/administração & dosagem , Resultado do Tratamento , Suspensão de TratamentoAssuntos
Neoplasias Cardíacas/diagnóstico , Hemangioma/diagnóstico , Achados Incidentais , Procedimentos Cirúrgicos Cardíacos/métodos , Diagnóstico Diferencial , Ecocardiografia Transesofagiana , Feminino , Neoplasias Cardíacas/cirurgia , Hemangioma/cirurgia , Humanos , Pessoa de Meia-Idade , Valva MitralAssuntos
Doença de Crohn , Espondiloartropatias , Fezes , Humanos , Complexo Antígeno L1 Leucocitário , AstronaveAssuntos
Vasos Coronários/diagnóstico por imagem , Intervenção Coronária Percutânea/efeitos adversos , Placa Aterosclerótica/diagnóstico por imagem , Complicações Pós-Operatórias/diagnóstico por imagem , Implantes Absorvíveis , Prótese Vascular , Angiografia Coronária , Vasos Coronários/patologia , Humanos , Masculino , Pessoa de Meia-Idade , Placa Aterosclerótica/complicações , Placa Aterosclerótica/patologia , Complicações Pós-Operatórias/etiologia , Complicações Pós-Operatórias/patologia , Alicerces Teciduais , Tomografia de Coerência ÓpticaRESUMO
A 65-year-old woman had on her own initiative three cervical smears taken at very short intervals. The second smear was taken only 1 day after the first one. It contained necrotic cellular material with atypia due to the scraping on the day before; it was at first mistakenly interpreted as showing malignant features. This led to the performance of various diagnostic procedures, and a considerably greater cost for the medical insurance system.