RESUMO
This is the first systematic review and meta-analysis of The International System (TIS) for reporting serous fluid cytopathology. Our aims were to present the pooled malignancy rate of each TIS reporting category and the diagnostic accuracy of cytology using this system. Database search using a predefined strategy was followed by study selection, data extraction, study quality assessment, and statistical analysis. Data derived from 16 eligible studies were pooled. The pooled rates of malignancy were as follows: 27% (95% CI; 16%-41%) for "nondiagnostic" (ND), 11% (95% CI; 7%-18%) for negative for malignancy" (NFM), 49% (95% CI; 37%-61%) for "atypia of undetermined significance" (AUS), 90% (95% CI; 81%-95%) for "suspicious for malignancy" (SFM), and 100% (95% CI; 98%-100%) for "positive for malignancy" (MAL). Studies performed exclusively in cancer hospitals showed higher pooled malignancy rates, compared with academic and community hospitals serving the general population, in the ND [40% (95% CI; 21%-62%) vs. 22% (95% CI; 11%-39%)], NFM [20% (95% CI; 13%-30%) vs. 9% (95% CI; 5%-17%)], and AUS categories [55% (95% CI; 47%-63%) vs. 46% (95% CI; 31%-62%)]. Notably, the difference was significant in the NFM category ( P =0.04). When both SFM and MAL cytology interpretations were considered as malignant outcomes, the pooled sensitivity and specificity were 68.74% (95% CI; 59.90%-76.39%) and 98.81% (95% CI; 98.18%-99.22%), respectively. In addition, the diagnostic odds ratio (DOR) was found to be 170.7 (95% CI; 96.2-303.3). Despite its strengths, our study also had some limitations. Therefore, future large-scale longitudinal studies could strengthen the findings of this review.
Assuntos
Citodiagnóstico , Humanos , Citodiagnóstico/métodos , Neoplasias/diagnóstico , Neoplasias/patologia , CitologiaRESUMO
BACKGROUND: Fine-needle aspiration cytology (FNAC) is a cornerstone technique for the initial assessment of breast lesions, offering a rapid and minimally invasive option for cytological evaluation. While FNACs can forego the need for core needle biopsies (CNBs), variations in technique, subjective interpretation, and intrinsic limitations present diagnostic challenges. The International Academy of Cytology (IAC) established the Yokohama system and is developing the WHO Reporting System for Breast Cytopathology jointly with IARC, to standardize diagnostic criteria, aiming to enhance diagnostic precision and consistency. Due to the preference for CNBs, expertise in breast FNAC is low in the developed world. SUMMARY: This review assesses common pitfalls in breast cytopathology. These common and uncommon entities may easily lead to false-negative or false-positive diagnoses, due to morphological overlap or misleading clinical and radiological contexts. For instance, pauci-cellular lesions, such as lobular carcinomas, often lead to false-negative diagnoses, whereas complex sclerosing lesions, fibroadenomas, and papillary lesions may show concerning features, resulting in a false positive. The same is true for some benign inflammatory pathologies, such as steatonecrosis, and uncommon lesions, such as collagenous spherulosis. Ductal carcinoma in situ can lead to both false-negative and false-positive diagnoses, and high-grade lesions are impossible to tell apart from invasive carcinomas. These are discussed in detail. Procedural and preanalytical conditions, and the role of ancillary testing, are also briefly addressed. KEY MESSAGES: Breast FNAB is a powerful diagnostic technique, fast and minimally invasive. Even in contexts which lack expertise, this technique can be successfully adopted with a cautious approach and as long as pitfalls are kept in mind, benefiting patients and healthcare systems.
Assuntos
Neoplasias da Mama , Feminino , Humanos , Biópsia por Agulha Fina/métodos , Mama/patologia , Neoplasias da Mama/patologia , Neoplasias da Mama/diagnóstico , Citodiagnóstico/métodos , Diagnóstico Diferencial , Erros de Diagnóstico/prevenção & controle , Reações Falso-Negativas , Reações Falso-Positivas , Valor Preditivo dos Testes , Reprodutibilidade dos TestesRESUMO
Serous effusion cytology is a pivotal diagnostic and staging tool in clinical pathology, valued for its simplicity and cost-effectiveness. Staining techniques such as Giemsa and Papanicolaou are foundational, yet the search for rapid and efficient alternatives continues. Our study assesses the efficacy of an in-house-developed BlueStain, a toluidine blue variant, within the International System for Reporting Serous Fluid Cytopathology (TIS), aiming to optimize diagnostic clarity and resource use. MATERIALS AND METHODS: This section provides details on the cohort of 237 patients with serous effusions, the ethical approval process, sample collection, and staining procedures with BlueStain, Papanicolaou, and Giemsa. It also describes the microscopic evaluation criteria, scoring system, and statistical methods used to compare the stains. RESULTS: BlueStain demonstrated notable performance, particularly in identifying malignant cells, presenting a competitive alternative to the Papanicolaou stain, which, despite higher quality indices in other categories, requires more resources and time. The study revealed that BlueStain might offer a valuable balance between quality and efficiency, especially in cases where rapid diagnostic turnaround is essential. CONCLUSIONS: Our findings suggest that BlueStain is a viable staining method in the context of serous effusions, capable of providing detailed cytomorphological analysis. While traditional stains hold their place for their established diagnostic clarity, BlueStain offers a rapid and resource-optimized alternative. The absence of definitive diagnostic criteria in the atypical category and the inherent sample heterogeneity underscores the necessity for adaptable staining methods like BlueStain. The study highlights the potential trade-offs between detail and practicality in staining techniques, advocating for further research into innovative methods that do not compromise diagnostic precision for cost and time efficiency.
RESUMO
Digital cytology and artificial intelligence (AI) are gaining greater adoption in the cytopathology laboratory. However, peer-reviewed real-world data and literature are lacking regarding the current clinical landscape. The American Society of Cytopathology in conjunction with the International Academy of Cytology and the Digital Pathology Association established a special task force comprising 20 members with expertise and/or interest in digital cytology. The aim of the group was to investigate the feasibility of incorporating digital cytology, specifically cytology whole slide scanning and AI applications, into the workflow of the laboratory. In turn, the impact on cytopathologists, cytologists (cytotechnologists), and cytology departments were also assessed. The task force reviewed existing literature on digital cytology, conducted a worldwide survey, and held a virtual roundtable discussion on digital cytology and AI with multiple industry corporate representatives. This white paper, presented in 2 parts, summarizes the current state of digital cytology and AI practice in global cytology practice. Part 1 of the white paper presented herein is a review and offers best practice recommendations for incorporating digital cytology into practice. Part 2 of the white paper provides a comprehensive review of AI in cytology practice along with best practice recommendations and legal considerations. Additionally, the results of a global survey regarding digital cytology are highlighted.
Assuntos
Inteligência Artificial , Citodiagnóstico , Humanos , Técnicas Citológicas , Laboratórios , Fluxo de TrabalhoRESUMO
Digital cytology and artificial intelligence (AI) are gaining greater adoption in the cytology laboratory. However, peer-reviewed real-world data and literature are lacking in regard to the current clinical landscape. The American Society of Cytopathology in conjunction with the International Academy of Cytology and the Digital Pathology Association established a special task force comprising 20 members with expertise and/or interest in digital cytology. The aim of the group was to investigate the feasibility of incorporating digital cytology, specifically cytology whole slide scanning and AI applications, into the workflow of the laboratory. In turn, the impact on cytopathologists, cytologists (cytotechnologists), and cytology departments were also assessed. The task force reviewed existing literature on digital cytology, conducted a worldwide survey, and held a virtual roundtable discussion on digital cytology and AI with multiple industry corporate representatives. This white paper, presented in 2 parts, summarizes the current state of digital cytology and AI practice in global cytology practice. Part 1 of the white paper is presented as a separate paper which details a review and best practice recommendations for incorporating digital cytology into practice. Part 2 of the white paper presented here provides a comprehensive review of AI in cytology practice along with best practice recommendations and legal considerations. Additionally, the cytology global survey results highlighting current AI practices by various laboratories, as well as current attitudes, are reported.
Assuntos
Inteligência Artificial , Citodiagnóstico , Humanos , Técnicas Citológicas , Laboratórios , Fluxo de TrabalhoRESUMO
The recently published WHO Reporting System for Pancreaticobiliary Cytopathology (World Health Organization [WHO] System) is an international approach to the standardized reporting of pancreaticobiliary cytopathology, updating the Papanicolaou Society of Cytopathology System for Reporting Pancreaticobiliary Cytology (PSC System). Significant changes were made to the categorization of benign neoplasms, intraductal neoplasms, mucinous cystic neoplasms, and malignant neoplasms considered low grade. Benign neoplasms, such as serous cystadenoma, categorized as Neoplastic: benign in the PSC system, are categorized as Benign/negative for malignancy in the WHO system. Pancreatic neuroendocrine tumor, solid-pseudopapillary neoplasm, and gastrointestinal stromal tumor, categorized as Neoplastic: other in the PSC system, are categorized as Malignant in the WHO System in accord with their classification in the 5th edition WHO Classification of Digestive System Tumours (2019). The two new categories of Pancreaticobiliary Neoplasm Low-risk/grade and Pancreaticobiliary Neoplasm High-risk/grade are mostly limited to intraductal neoplasms and mucinous cystic neoplasms. Low-risk/grade lesions are mucinous cysts, with or without low-grade epithelial atypia. High-risk/grade lesions contain neoplastic epithelium with high-grade epithelial atypia. Correlation with clinical, imaging, and ancillary studies remains a key tenet. The sections for each entity are written to highlight key cytopathological features and cytopathological differential diagnoses with the pathologist working in low resource setting in mind. Each section also includes the most pertinent ancillary studies useful for the differential diagnosis. Sample reports are provided for each category. Finally, the book provides a separate section with risk of malignancy and management recommendations for each category to facilitate decision-making for clinicians.
Assuntos
Neoplasias Pancreáticas , Organização Mundial da Saúde , Humanos , Neoplasias Pancreáticas/patologia , Neoplasias Pancreáticas/diagnóstico , Citodiagnóstico/métodos , Citodiagnóstico/normas , Neoplasias do Sistema Biliar/patologia , Neoplasias do Sistema Biliar/diagnóstico , CitologiaRESUMO
INTRODUCTION: The integration of whole slide imaging (WSI) and artificial intelligence (AI) with digital cytology has been growing gradually. Therefore, there is a need to evaluate the current state of digital cytology. This study aimed to determine the current landscape of digital cytology via a survey conducted as part of the American Society of Cytopathology (ASC) Digital Cytology White Paper Task Force. MATERIALS AND METHODS: A survey with 43 questions pertaining to the current practices and experiences of WSI and AI in both surgical pathology and cytology was created. The survey was sent to members of the ASC, the International Academy of Cytology (IAC), and the Papanicolaou Society of Cytopathology (PSC). Responses were recorded and analyzed. RESULTS: In total, 327 individuals participated in the survey, spanning a diverse array of practice settings, roles, and experiences around the globe. The majority of responses indicated there was routine scanning of surgical pathology slides (n = 134; 61%) with fewer respondents scanning cytology slides (n = 150; 46%). The primary challenge for surgical WSI is the need for faster scanning and cost minimization, whereas image quality is the top issue for cytology WSI. AI tools are not widely utilized, with only 16% of participants using AI for surgical pathology samples and 13% for cytology practice. CONCLUSIONS: Utilization of digital pathology is limited in cytology laboratories as compared to surgical pathology. However, as more laboratories are willing to implement digital cytology in the near future, the establishment of practical clinical guidelines is needed.
RESUMO
[This corrects the article DOI: 10.3389/fmolb.2023.1082915.].
RESUMO
The discovery and the comprehension of lymphatic vessels suffered several historical delays and setbacks. The inherent anatomical problems slowed down the precise identification of the lymphatic system during the development of medical science. Gasparo Aselli, an Italian surgeon and anatomist, was the first to describe the lymphatic vessels in 1627 (De Lacteibus sive Lacteis Venis). However, most original descriptions that report the morphology of the lymphatic system in different organisms were done during the 19th and the 20th centuries. The recent identification of specific lymphatic vasculature molecular markers allows a more accurate identification and characterization of the lymphatic system evolution in different organs, as well as its role in different pathological conditions, including cancer. This study summarizes the current understanding of lymphangiogenesis in tumour progression, as well as it presents a review of the promising data regarding the prognostic value of lymphatic density and the use of therapeutic lymphangiogenic molecules.
A descoberta dos vasos linfáticos e sua compreensão enfrentaram uma série de atrasos e dificuldades históricos. As inerentes dificuldades anatômicas retardaram a identificação precisa da rede vascular linfática durante o desenvolvimento da ciência médica. Gasparo Aselli, um anatomista e cirurgião italiano, foi o primeiro a descrever os vasos linfáticos, em 1627 (De Lacteibus sive Lacteis Venis). Entretanto, a maioria das descrições originais que relatam a morfologia do sistema linfático nos diferentes organismos foi realizada depois, entre os séculos XIX e XX. A recente identificação de marcadores moleculares específicos à vasculatura linfática permite agora identificação e caracterização mais acuradas da evolução da rede linfática nos vários órgãos e em diferentes situações, inclusive no câncer. Esta revisão resume o conhecimento sobre a linfangiogênese na progressão tumoral, bem como apresenta uma síntese dos dados mais promissores em relação ao valor prognóstico da densidade linfática e da utilização das moléculas linfangiogênicas como alvo terapêutico.
Assuntos
Humanos , Animais , Linfangiogênese , Sistema Linfático/anatomia & histologia , Sistema Linfático/irrigação sanguínea , Sistema Linfático/patologia , Endotélio Vascular/crescimento & desenvolvimento , Imuno-Histoquímica , Biomarcadores Tumorais , Metástase Neoplásica/fisiopatologia , Prognóstico , Suínos/embriologiaRESUMO
Neovascularization is a crucial phenomenon for the continuous growing of neoplastic cells and cancer progression. The growth of new blood vessels from pre-existing vessels (angiogenesis) occurs in several physiological and pathological conditions, including cancer, where it is critical for tumor-cells nutrition. Recently, new remarkable insights regarding angiogenesis and blood coagulation (key events in vascular biology) have been described. The serine protease thrombin, which plays a central role in blood coagulation cascade through its ability to cleave fibrinogen conducting to fibrin clot formation, is also known to be involved in embryogenesis, inflammation, wound healing, through its active role on vascular remodeling. Although the increased knowledge of factors regulating angiogenesis and coagulation led to the understanding that angiogenesis, homeostasis and carcinogenesis are three close team players, little is still known about how these pathways support each other in the process of angiogenesis in vivo. This review summarizes current understanding of blood coagulation cascade role in conducting angiogenesis and tumor progression, as well as provides an overview of the emerging anti-angiogenic and anti-coagulation therapies inducing tumor regression.
A neovascularização é um processo fundamental para a sobrevivência e a progressão das células neoplásicas malignas. O crescimento de novos vasos sanguíneos a partir de vasos já existentes, fenômeno designado como angiogênese, está envolvido em vários processos fisiológicos e patológicos, incluindo o crescimento tumoral, onde a angiogênese desempenha papel crítico na nutrição das células tumorais. Tal como a angiogênese, o sistema de coagulação sanguínea exerce importante função na biologia vascular. A trombina, uma serina protease, tem papel fundamental na cascata de coagulação, pela quebra enzimática do fibrinogênio e pela conseqüente produção de fibrina. Essa protease encontra-se também implicada em desenvolvimento embrionário, inflamação e cicatrização, processos nos quais a remodelação vascular está altamente ativa. Apesar de o crescente conhecimento de fatores reguladores da angiogênese e da coagulação demonstrar que a carcinogênese, a coagulação e a angiogênese são três close team players, ainda muito pouco se sabe sobre o modo como esses players comunicam-se e interagem no processo de angiogênese in vivo. Esta revisão sumariza os conhecimentos atuais quanto ao papel da cascata de coagulação na condução do processo angiogênico e do crescimento tumoral, bem como oferece uma visão geral sobre recentes terapias antiangiogênicas e anticoagulantes envolvidas na regressão tumoral.
RESUMO
Invasive breast carcinomas constitute a heterogeneous group of tumours, with different clinical behaviour and response to chemotherapy. These lesions, as determined morphologically, are thought to arise exclusively from the inner, luminal epithelial cell compartment of the terminal-duct lobular unit of the breast. Irrespective of the true histogenesis of breast carcinomas, ithas become increasingly clear that a small proportion of cancers exhibit a basal/myoepithelial phenotype as defined by immunohistochemical positivity for myoepithelial markers, meaning they express molecules normally seen in the basal/myoepithelial compartment of the normal breast. The purpose of this review is to resume the more recent knowledge about the use of a panel of basal molecular markers in basal-like breast carcinomas classification and characterization. This subtypecharacterization has a great importance, since it requires a more focused investigation of putative therapeutic targets. The existing therapies against estrogen receptor (ER) or HER-2 oncogene amplification would not be expected to be effective against basal breast carcinomas, since these tumours express neither of these proteins. In contrast, basal breast carcinomasusually express basal cell cytokeratins (like CK5/6), P-cadherin adhesion molecule, p53 family member p63, and the transmembrane tyrosine kinase receptor EGFR (epidermal growth factor receptor), which can be used as excellent markers for this line of mammary carcinogenesis, and become interesting therapeutic targets against these highly aggressive lesions.
Assuntos
Neoplasias da Mama , Fator de Crescimento Epidérmico , QueratinasRESUMO
Os eventos subcelulares implicados na formação e comportamento dos adenomas hipofisários não são completamente compreendidos. Neste estudo nós investigamos a presença de p53, Ki-67 e c-erb B2 em 38 adenomas hipofisários com positividade imuno-histoquímica para GH e prolactina (n=26, 68,4%), para prolactina (n=9, 23,7%) e para GH (n=3, 7,8%). A análise revelou os seguintes resultados: 24 tumores (63,2%) expressaram positividade variável para c-erb B2, 11 (28,9%) expressaram positividade para p53 e 11 tumores (28,9%) foram variavelmente positivos para Ki-67. Nossos resultados demonstraram elevada percentagem de tumores secretores de GH/prolactina, prolactina e GH com positividade imuno-histoquímica para c-erb B2. Desde que este receptor de membrana está relacionado aos fatores de crescimento EGF e TGFa e ambos têm efeito definido no crescimento tumoral, nossos dados sugerem possível função para o c-erb B2 na evolução destes tumores.
Assuntos
Adolescente , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Hormônio do Crescimento , /análise , Proteínas de Neoplasias/análise , Neoplasias Hipofisárias/metabolismo , Prolactinoma/metabolismo , /análise , /análise , Imuno-Histoquímica , Neoplasias Hipofisárias/patologia , Prolactinoma/patologiaRESUMO
Hibernomas are benign lipomatous tumors which show differentiation toward brown fat. Recently, unusual variants have been described, including myxoid, spindle cell, and lipoma-like variants. Lipoma-like hibernoma (LLH) is characterized by mature univacuolated adipocytic cells with rare admixed multivacuolated brown fat-like cells, which may resemble lipoblasts, leading to a misdiagnosis of atypical lipoma/well-differentiated liposarcoma (AL/WDLS). We herein report a case of LLH arising on the anterior aspect of the left thigh of a 17-year-old female. A marginal excision was performed. The patient was discharged and remains well four months after surgery. Histological examination showed a lobulated neoplasm composed of univacuolated mature adipose cells admixed with small vessels and occasional mast cells. Scattered islands of brown fat-like cells accounting for less than 10 percent of the neoplasm were found. Sometimes these cells presented indented and scalloped nuclei, resembling lipoblasts. A final diagnosis of LLH was made based on the presence of focal areas with typical hibernoma morphology, and the lack of atypical hyperchromatic stromal cells. Pathologists must be aware of the typical histological findings of LLH, not to confuse it with AL/WDLS
RESUMO
Thymomas are tumors characterized by a remarkable morphological heterogeneity and variable clinical behavior. This tumor has unique clinical associations, most notably with hematological abnormalities and myasthenia gravis. According with the Müller-Hermelink criteria, there are significant differences between the histological types of thymomas and the association with myasthenia gravis. Among the different histological types, medullary thymoma is the least frequent variant associated with this autoimmune disease. In this report we describe a case of medullary thymoma presenting in a 71-year- old woman with a myasthenic syndrome
Assuntos
Humanos , Feminino , Idoso , Miastenia Gravis/complicações , Timoma/complicações , Neoplasias do Timo/complicações , Miastenia Gravis/patologia , Timoma/patologia , Neoplasias do Timo/patologiaRESUMO
A fibromatose é uma lesão caracterizada por proliferação fibroblástica, sendo raramente encontrada na mama. Atinge habitualmente a fáscia ou aponeurose da parede abdominal. Aqui se relata um caso de mulher de 72 anos com nódulo mamário de crescimento rápido, mostrando ao exame físico um nódulo em mama direita mal delimitado, não aderente a plano superficial nem profundo, medindo 20 x 30 mm, apresentando aos exames de imagem características de benignidade. Foi indicada e realizada punção aspirativa por agulha fina (PAAF), cujo resultado apresentou células fusiformes atípicas. A paciente foi submetida à exérese de lesão com biópsia de congelação que não foi conclusiva, permanecendo a suspeita de malignidade. Somente após o exame histopatológico e estudo imuno-histoquímico, o diagnóstico foi estabelecido. Vale ressaltar que a apresentação clínica da fibromatose pode ser confundida com um carcinoma de mama.
The fibromatosis is a lesion characterized by fibroblastic proliferation that is rare in breast. This pathology is frequently found in abdominal wale fascia. We present a case in a 72 year-old woman with a breast nodule that has grown fast. Physical examination showed an ill-defined but freely movable mass at right breast, measuring 2 x 3 cm. Mammography and ultrassonography showed benign findings. Citopathology showed not typical spindle cells. Excisional biopsy of the nodule was performed and the histopathological examination and immunohistochemistry established the diagnosis. Clinical examination mimics breast cancer and for this reason the presence of an unusual breast lesion may include fibromatosis as differential diagnosis.
Assuntos
Humanos , Feminino , Idoso , Fibroma/diagnóstico , Mama/lesões , Biópsia por Agulha Fina , Diagnóstico Diferencial , Neoplasias da Mama/diagnósticoRESUMO
Em estudo prospectivo foram puncionadas 50 pacientes com nódulos mamários, com o objetivo de avaliar a acuidade da punçäo aspirativa por agulha fina em nosso meio. Nossos resultados demonstaram uma taxa de especialidade de 100% e sensibilidade de 81%. O valor preditivo de resultado positivo foi de 100% e de resultado negativo de 82%. Descrevemos a técnica de aspiraçäo e enfatizamos sua importância na avaliaçäo de nódulos mamário palpáveis
Assuntos
Humanos , Feminino , Biópsia por Agulha/métodos , Mama/patologiaRESUMO
Com o objetivo de colaborar no entendimento da histogênese de tumores fusocelulares e epitelióides do trato gastrointestinal estudamos dez casos de tumores estromais gastrointestinais (TEGI), diagnosticados previamente como leiomiomas (seis casos) e leiomiossarcoma (quatro casos). Estes foram avaliados morfologicamente e do ponto de vista imunohistoquímico, com a pesquisa de três marcadores: actina específica do músculo (HHF-35), vimentina e proteínas S-100. Todos os tumores expressaram vimentina em intensidade variável. Diferenciaçäo muscular foi demonstrada em três casos - (33,3%), todos benignos. Expressäo de S-100 foi demonstrado em um caso, de localizaçäo no intestino delgado. Tais resultados demonstraram que os TEGI representam um grupo heterogêno de neoplasias, a maioria de células mesenquimais primitivas
Assuntos
Neoplasias Gastrointestinais/ultraestrutura , Imuno-Histoquímica , Leiomioma/ultraestrutura , Leiomiossarcoma/ultraestrutura , Estudos RetrospectivosRESUMO
Foram estudados todos os casos de neoplasias malignas de mama diagnosticados no Departamento de Patologia da Faculdade de Medicina de Botucatu - UNESP, no período de 1966-1984. Das 48.681 biópsias realizadas no Departamento, 293 corresponderam a neoplasias malignas de mama. Esses casos foram estudados do ponto de vista histológico, com revisäo de lâmina e reclassificaçäo, idade, tamanho do tumor e presença de microcalcificaçöes. Os resultados mostraram que o carcinoma infiltrativo de ductos mamários, sem outras especificaçöes, foi o tipo histológico mais freqüente; a faixa etária mais acometida foi entre 40 e 60 anos, o tamanho médio dos tumores foi de 4,4 cm e microcalcificaçöes estavam presentes em 70% dos casos
Assuntos
Adulto , Pessoa de Meia-Idade , Humanos , Feminino , Neoplasias da Mama/epidemiologia , Brasil , Neoplasias da Mama/patologiaRESUMO
Descreve-se um caso de carcinoma de células renais metastático para tiróide mostrando forte atividade de CD26 (dipeptidil aminopeptidase IV). CD26 tem sido proposto como um novo marcador molecular para carcinoma de tiróide bem diferenciado. A atividade de CD26 em metástase de carcinoma de células renais para tiróide rompe essa expectativa. Ao que nos parece, este é o primeiro relato de carcinoma metastático para tiróide expressando CD26.
Assuntos
Humanos , Feminino , Idoso , /análise , Carcinoma de Células Renais/diagnóstico , Neoplasias Renais/diagnóstico , Biomarcadores Tumorais , Neoplasias da Glândula Tireoide/diagnóstico , /metabolismo , Carcinoma de Células Renais/patologia , Neoplasias Renais/patologia , Neoplasias da Glândula Tireoide/secundário , Tireoidectomia , Tomografia Computadorizada por Raios XRESUMO
Investigamos a correlaçäo da citometria de fluxo os recptores de estrogênio, parâmetros clínicos e anátomo-patológicos em 63 carcinomas invasivos de mama. Avaliamos raça, paridade, mama comprometida e estadiamento. Porém, só foram correlacionados com a citometria de fluxo e com os receptores de estrogênio (RE), a idade e o tamanho do tumor. Do ponto de vista anátomo-patológico e imuno-histoquímico, correlacionamos o grau histológico e o comprometimento axilar com a citometria de fluxo e com os receptores de estrogênio, Considerando os dados disponíveis em nossa casuística, só foi possível correlacionar a citometria de fluxo e o receptor de estrogênio com o período livre de doença. Observamos as seguintes correlaçöes estatisticamente significativas: - fase S com número de mitose, volume do tumor e índice de DNA; - índice de DNA com número de mitose e grau histológico; - RE com número de mitoses, grau histológico e idade. Näo consideramos a associaçäo entre citometria de fluxo e receptor de estrogênio com o tipo histológico devido ao pequeno número de casos diferentes do carcinoma ductal invasivo. Portanto, com base em nossa investigaçäo, o número de mitoses e o grau histológico podem contribiur para o valor prognóstico na impossibilidade da realizaçäo da citometria de fluxo. Porém, a correlaçäo entre os vários parâmetros estudados, contribui com informaçöes mais precisas sobre o prognóstico do câncer de mama