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1.
Pathol Res Pract ; 257: 155311, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38636444

RESUMO

The Silva pattern-based classification of HPV-associated endocervical adenocarcinoma has become an integral part of the histologic assessment of these tumors. Unfortunately, the Silva system reproducibility has had mixed results in past studies, and clinical practice still favors the FIGO stage assessment in directing therapeutic interventions for patients. In our study, we aimed to assess our institution's concordance including not only gynecologic pathologists, but also pathology trainees through a series of 69 cases. The grouped total kappa concordance from all participants was 0.439 (Moderate), with an overall trainee kappa of 0.417 (moderate) and an overall pathologist kappa of 0.460 (moderate). Perfect concordance among all 10 study participants was seen in 8/69 cases (11.6 %), corresponding to 5/22 Pattern A cases (22.7 %), 0/16 Pattern B cases (0 %), and 3/31 Pattern C cases (9.7 %), with similar findings between trainees and pathologists when compared within their own cohorts. Recurrence was identified in 2 Pattern A cases, indicating a potential issue with limited excisional specimens which may not fully appreciate the true biologic aggressiveness of the lesions.


Assuntos
Adenocarcinoma , Infecções por Papillomavirus , Patologistas , Neoplasias do Colo do Útero , Humanos , Feminino , Neoplasias do Colo do Útero/virologia , Neoplasias do Colo do Útero/patologia , Adenocarcinoma/virologia , Adenocarcinoma/patologia , Infecções por Papillomavirus/patologia , Infecções por Papillomavirus/virologia , Infecções por Papillomavirus/complicações , Adulto , Pessoa de Meia-Idade , Ginecologia/educação , Reprodutibilidade dos Testes , Variações Dependentes do Observador , Idoso
2.
Comput Med Imaging Graph ; 112: 102327, 2024 03.
Artigo em Inglês | MEDLINE | ID: mdl-38194768

RESUMO

Automated semantic segmentation of histopathological images is an essential task in Computational Pathology (CPATH). The main limitation of Deep Learning (DL) to address this task is the scarcity of expert annotations. Crowdsourcing (CR) has emerged as a promising solution to reduce the individual (expert) annotation cost by distributing the labeling effort among a group of (non-expert) annotators. Extracting knowledge in this scenario is challenging, as it involves noisy annotations. Jointly learning the underlying (expert) segmentation and the annotators' expertise is currently a commonly used approach. Unfortunately, this approach is frequently carried out by learning a different neural network for each annotator, which scales poorly when the number of annotators grows. For this reason, this strategy cannot be easily applied to real-world CPATH segmentation. This paper proposes a new family of methods for CR segmentation of histopathological images. Our approach consists of two coupled networks: a segmentation network (for learning the expert segmentation) and an annotator network (for learning the annotators' expertise). We propose to estimate the annotators' behavior with only one network that receives the annotator ID as input, achieving scalability on the number of annotators. Our family is composed of three different models for the annotator network. Within this family, we propose a novel modeling of the annotator network in the CR segmentation literature, which considers the global features of the image. We validate our methods on a real-world dataset of Triple Negative Breast Cancer images labeled by several medical students. Our new CR modeling achieves a Dice coefficient of 0.7827, outperforming the well-known STAPLE (0.7039) and being competitive with the supervised method with expert labels (0.7723). The code is available at https://github.com/wizmik12/CRowd_Seg.


Assuntos
Processamento de Imagem Assistida por Computador , Redes Neurais de Computação , Humanos
3.
Am J Clin Pathol ; 159(3): 255-262, 2023 03 13.
Artigo em Inglês | MEDLINE | ID: mdl-36626677

RESUMO

BACKGROUND: Improvement of liver transplantation (LT) outcomes requires better understanding of factors affecting survival. The presence of RBC alloantibodies (RBCAs) on survival in LT recipients was evaluated. METHODS: This study was a single-center, retrospective cohort study reviewing transfusion records and all-cause mortality between 2002 and 2021. RESULTS: Between 2002 and 2021, 2079 LTs were completed, 1,396 of which met inclusion criteria (1,305 RBCA negative; 91 RBCA positive [6.5%]). The cohorts were similar in age (mean [range], 55.8 [17-79] years vs 56.8 [25-73] years; P = .41, respectively) or sex (RBCA negative, 859 [65%] men and 446 [35%] women vs RBCA positive, 51 [56%] men and 40 [44%] women; P = .0684). Of 132 RBCAs detected, 10 were most common were to E (27.27%), Jka (15.91%), K (9.09%), C (8.33%), M (6.06%), D (5.3%), Fya (4.55%), e (2.27%), c (2.27%), and Jkb (2.27%). Twenty-seven patients (29.7%) had more than 1 RBCA; the most common combinations were C with Jka (7.4%) and E with Dia (7.4%). All-cause mortality was increased in men (men, 14.45 years vs women, 17.27 years; P = .0266) and patients 65 years of age and older (≥65 years of age, 10.21 years vs <64 years of age, 17.22 years; P < .0001). The presence of RBCA (≥1) did not affect all-cause mortality (RBCA negative, 14.17 years vs RBCA positive, 15.29 years; P = .4367). The top 5 causes of death were infection (11.9%), primary malignancy (solid) (10.8%), recurrent malignancy (10.5%), cardiovascular arrest (7.1%), and pulmonary insufficiency/respiratory failure (5.7%). CONCLUSIONS: Survival in RBCA-positive LT recipients is no different from that in RBCA-negative LT recipients.


Assuntos
Transplante de Fígado , Masculino , Humanos , Feminino , Criança , Adolescente , Pessoa de Meia-Idade , Estudos Retrospectivos , Recidiva Local de Neoplasia , Eritrócitos , Transfusão de Sangue , Isoanticorpos , Transplantados
4.
Int J Surg Pathol ; 31(7): 1393-1397, 2023 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-36694422

RESUMO

Primary enteric type adenocarcinomas of the vagina are extremely rare. We present a 63-year-old woman who had a polypoid mass localized to the distal vagina. The lesion was composed of a columnar glandular cell proliferation with focal cribriforming, reminiscent of tubular adenoma. Immunohistochemical stains were notable for expression of enteric markers (CDX2 and KRT20), as well as negativity for Mullerian markers (PAX8, ER, and PR), diffuse expression for p16, and positivity for high-risk HPV mRNA expression. Ultimately, a diagnosis of vaginal primary HPV-associated enteric type adenocarcinoma was rendered for this unusual lesion. To our knowledge, no prior cases of HPV-associated enteric type adenocarcinomas of the vagina have been described before.


Assuntos
Adenocarcinoma , Carcinoma in Situ , Infecções por Papillomavirus , Neoplasias do Colo do Útero , Neoplasias Vaginais , Feminino , Humanos , Pessoa de Meia-Idade , Biomarcadores Tumorais/metabolismo , Infecções por Papillomavirus/complicações , Infecções por Papillomavirus/diagnóstico , Infecções por Papillomavirus/patologia , Vagina/patologia , Neoplasias Vaginais/diagnóstico , Neoplasias Vaginais/patologia , Adenocarcinoma/patologia , Carcinoma in Situ/patologia , Neoplasias do Colo do Útero/patologia
5.
Pediatr Dev Pathol ; 26(1): 72-76, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-36448449

RESUMO

Somatic malignancies arising in mature teratomas are exceedingly rare entities and even more so are those arising in immature teratomas. Here, we present a unique case of a 13-year-old who initially underwent ovarian sparing cystectomy for a 7.7 cm left ovarian mass with a pre-operative diagnosis of mature cystic teratoma. Histologically, all 3 germ cell layers were present and immature neuroepithelial tubules were also identified. Subsequent sections revealed a nodular lesion composed of neuropil, neuroblasts with a spectrum of maturation, and Schwannian-type stroma. The neuroblasts were diffusely positive for PHOX2B. Neuroblastoma arising in an immature teratoma has only been described in the literature once previously in an adult patient.


Assuntos
Neuroblastoma , Neoplasias Ovarianas , Teratoma , Adulto , Feminino , Humanos , Adolescente , Neoplasias Ovarianas/diagnóstico , Neoplasias Ovarianas/cirurgia , Neoplasias Ovarianas/patologia , Teratoma/diagnóstico , Teratoma/cirurgia , Teratoma/patologia , Neuroblastoma/patologia
6.
Hum Pathol ; 134: 85-91, 2023 04.
Artigo em Inglês | MEDLINE | ID: mdl-36549601

RESUMO

Uterine leiomyosarcoma (LMS) is a deadly disease with high rates of recurrence and a poor prognosis. Its tumorigenesis remains largely unknown, and no specific biomarkers can be used for the differential diagnosis of LMS from other mimics. Recent whole-genome studies revealed a loss of dystrophin is common in LMS, especially in uterine LMS. To investigate the expression pattern of dystrophin expression across different types of uterine smooth muscle tumors, immunohistochemistry was performed, including usual-type leiomyoma, fumarate hydratase-deficient leiomyoma, leiomyoma with bizarre nuclei, conventional LMS, and normal myometrium for this study. To further evaluate the genomic change in dystrophin gene region, whole-genome sequencing in 10 LMS cases were analyzed. Dystrophin expression was detected in 94% (45/48) of myometrium, 97% (34/35) of usual-type leiomyoma, 84% (26/31) of fumarate hydratase-deficient leiomyoma, 60% (12/20) of leiomyoma with bizarre nuclei, and 18% (6/34) of LMS. Loss of dystrophin expression was significantly different between benign and malignant tumors (LMS cases counted as malignant only) (p < 0.01). Of note, copy number loss in the dystrophin genomic region was found in all 10 cases of LMS. Additionally, patients with dystrophin-positive LMS tend to have a better overall survival than patients with dystrophin-negative LMS.


Assuntos
Distrofina , Leiomioma , Leiomiossarcoma , Neoplasias Uterinas , Feminino , Humanos , Biomarcadores Tumorais/genética , Biomarcadores Tumorais/metabolismo , Distrofina/genética , Fumarato Hidratase/genética , Leiomioma/patologia , Leiomiossarcoma/genética , Leiomiossarcoma/diagnóstico , Neoplasias Uterinas/diagnóstico
7.
J Am Soc Cytopathol ; 11(5): 264-273, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35660360

RESUMO

INTRODUCTION: Fine needle aspiration cytology is often used for the initial diagnosis and management of patients with salivary gland tumors. Because of its global usage, a consensus classification schema was devised in 2018 to initiate universal reporting of salivary gland cytology specimens, termed the Milan system for reporting salivary gland cytopathology (MSRSGC) and composed of distinct diagnostic categories. Few retrospective studies have been undertaken to review the MSRSGC within institutions. MATERIALS AND METHODS: We analyzed salivary gland fine needle aspirations during a 10-year span from 2011 to 2021, categorized each cytology case to fit the MSRSGC, and subsequently reviewed the corresponding surgical resections, if indicated, to determine the rate of malignancy (ROM) and rate of neoplasia. RESULTS: Our ROM was higher (>10%) for the following MSRSGC categories: non-neoplastic, atypia of undetermined significance, and suspicious for malignancy. Also, our data correlated well with the following MSRSGC categories: nondiagnostic, neoplasm-benign, salivary gland neoplasm of uncertain malignant, and malignant. CONCLUSIONS: Although the data were indicative of the ROM for surgically resected salivary gland lesions, the ROM for non-neoplastic lesions could truly be lower given that most lesions in this category will not undergo surgical resection. Additionally, determination of the rate of neoplasia could a tool that could be used to further guide our clinical colleagues.


Assuntos
Neoplasias das Glândulas Salivares , Glândulas Salivares , Biópsia por Agulha Fina , Citodiagnóstico , Humanos , Estudos Retrospectivos
8.
J Am Soc Cytopathol ; 11(4): 201-209, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35474265

RESUMO

INTRODUCTION: The presence of tumor cell anaplasia and multinucleation (A/M) in oropharyngeal squamous cell carcinoma (OPSCC) has recently been found to be associated with increased disease recurrence and poorer disease-specific survival, regardless of human papillomavirus status. We studied the detection of A/M in cytology specimens. MATERIALS AND METHODS: We performed a comprehensive data search for all patients with OPSCC diagnosed and treated at Northwestern Memorial Hospital between January 2013 and April 2020. All cytology and histopathologic slides were reviewed for the presence of A/M in patients with both surgical resection or biopsy specimens and fine needle aspiration cytology of a metastatic site. RESULTS: A total of 87 patients were identified with both surgical and cytology specimens available for review. A/M was identified in 21 cytology specimens and 14 surgical specimens. Cytologic A/M was seen in 11 of the 14 patients (78.5%) with corresponding histologic A/M and in 10 of the 73 patients (13.7%) without histologic A/M. Disease-specific survival was significantly worse for the patients with cytologic A/M regardless of the presence of histologic A/M (P = 0.0064) and for the patients with cytologic A/M only (P = 0.0271). In patients with p16-positive/human papillomavirus-associated carcinoma, disease-specific survival was significantly worse for the patients with both histologic and cytologic A/M (P = 0.0305). CONCLUSIONS: A/M can be reliably identified in cytology specimens among all the various stains and preparations, irrespective of the primary tumor histologic type. Identification of A/M on cytology specimens could indicate more aggressive clinical behavior and help guide patient management.


Assuntos
Alphapapillomavirus , Carcinoma de Células Escamosas , Neoplasias de Cabeça e Pescoço , Neoplasias Orofaríngeas , Infecções por Papillomavirus , Anaplasia/complicações , Carcinoma de Células Escamosas/patologia , Neoplasias de Cabeça e Pescoço/complicações , Humanos , Neoplasias Orofaríngeas/patologia , Papillomaviridae , Infecções por Papillomavirus/diagnóstico , Carcinoma de Células Escamosas de Cabeça e Pescoço/complicações
9.
Int J Surg Pathol ; 29(5): 529-533, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-33289418

RESUMO

Hereditary pancreatitis is a rare form of recurrent acute pancreatitis that typically has an onset in early adulthood. We report a rare case of hereditary pancreatitis in an individual with a serine protease inhibitor Kazal type 1 (SPINK1) mutation. Histologically the pancreas showed features of chronic pancreatitis with variable fibrosis, acinar destruction, and prominent inspissated secretions within the pancreatic ducts. Additionally, focal areas of low-grade pancreatic intraepithelial neoplasia (PanIN) were present. Although the histopathology of common gene mutations resulting in hereditary pancreatitis have been well described, the histopathology of pancreatitis secondary to SPINK1 mutation has been described in only one previous study.


Assuntos
Pâncreas/patologia , Pancreatite Crônica/diagnóstico , Inibidor da Tripsina Pancreática de Kazal/genética , Análise Mutacional de DNA , Feminino , Testes Genéticos , Humanos , Transplante das Ilhotas Pancreáticas , Mutação , Pâncreas/cirurgia , Pancreatectomia , Pancreatite Crônica/genética , Pancreatite Crônica/patologia , Pancreatite Crônica/terapia , Recidiva , Exacerbação dos Sintomas , Adulto Jovem
11.
J Leukoc Biol ; 101(5): 1245-1252, 2017 05.
Artigo em Inglês | MEDLINE | ID: mdl-28235773

RESUMO

TLRs are important pattern-recognition receptors involved in the activation of innate immune responses against foreign pathogens. TLR10 is the only TLR family member without a known ligand, signaling pathway, or clear cellular function. Previous work has shown that TLR10 suppresses proinflammatory cytokine production in response to TLR agonists in a mixed human mononuclear cell population. We report that TLR10 is preferentially expressed on monocytes and suppresses proinflammatory cytokine production resulting from either TLR or CD40 stimulation. TLR10 engagement affects both the MAPK and Akt signaling pathways, leading to changes in the transcriptome of isolated human monocytes. Differentiation of monocytes into dendritic cells in the presence of an αTLR10 mAb reduced the expression of maturation markers and the induction of proinflammatory cytokines, again in response to either TLR or CD40 stimulation. Finally, in coculture experiments, TLR10 differentiated dendritic cells exhibited a decreased capacity to activate T cells as measured by IL-2 and IFN-γ production. These data demonstrate that TLR10 is a novel regulator of innate immune responses and of the differentiation of primary human monocytes into effective dendritic cells.


Assuntos
Células Dendríticas/imunologia , Monócitos/imunologia , Linfócitos T/imunologia , Receptor 10 Toll-Like/imunologia , Transcriptoma/imunologia , Imunidade Adaptativa , Anticorpos Monoclonais/farmacologia , Antígenos CD40/genética , Antígenos CD40/imunologia , Diferenciação Celular , Técnicas de Cocultura , Células Dendríticas/citologia , Células Dendríticas/efeitos dos fármacos , Regulação da Expressão Gênica , Humanos , Imunidade Inata , Interferon gama/genética , Interferon gama/imunologia , Interleucina-2/genética , Interleucina-2/imunologia , Proteínas Quinases Ativadas por Mitógeno/genética , Proteínas Quinases Ativadas por Mitógeno/imunologia , Monócitos/citologia , Monócitos/efeitos dos fármacos , Cultura Primária de Células , Proteínas Proto-Oncogênicas c-akt/genética , Proteínas Proto-Oncogênicas c-akt/imunologia , Transdução de Sinais , Linfócitos T/citologia , Linfócitos T/efeitos dos fármacos , Receptor 10 Toll-Like/agonistas , Receptor 10 Toll-Like/genética , Transcriptoma/genética
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