ABSTRACT
INTRODUCTION: Lymphadenopathies are a major cause of consultation in internal medicine, with various causes of diagnosis. Unexplained persistent lymphadenopathy must be biopsied to rule out malignant tumor. CASE REPORT: We report the case of a 53-year-old man, with inguinal lymphadenopathy evolving for more than one year. The patient had no associated symptoms and his blood tests were unremarkable. Due to the progression of the adenopathy and its hypermetabolism on PET-CT, an excisional biopsy was performed. Histological analysis revealed an intranodal proliferation of spindle cells with a palisading pattern. ß-catenine and smooth muscle actin labelling were positive, leading to the diagnosis of intranodal palisaded myofibroblastoma, a benign tumour. CONCLUSION: Intranodal palisaded myofibroblastoma is a rare benign cause of adenopathy, with often inguinal lymph node localization and slow growth and without risk of recurrence after surgical removal.
Subject(s)
Lymphadenopathy , Neoplasms, Muscle Tissue , Male , Humans , Middle Aged , Positron Emission Tomography Computed Tomography , Lymph Nodes/pathology , Lymphadenopathy/diagnosis , Lymphadenopathy/etiology , Neoplasms, Muscle Tissue/complications , Neoplasms, Muscle Tissue/diagnosis , Neoplasms, Muscle Tissue/pathology , BiopsyABSTRACT
BACKGROUND: The prognosis of patients with pancreatic cancer remains poor and novel therapeutic targets are required urgently. Treatment resistance could be due to the tumour microenvironment, a desmoplastic stroma consisting of cancer-associated fibroblasts and tumour-infiltrating lymphocytes (TILs). The aim of the study was to evaluate the prognostic value of TILs and cancer-associated fibroblasts (CAFs) in pancreatic cancer of the body and tail. METHODS: Using tissue microarray from resected left-sided pancreatic cancer specimens, the immunohistochemistry of TILs (cluster of differentiation (CD) 45, CD3, CD4, FoxP3 and CD8), CAFs (vimentin and α-smooth muscle actin (αSMA)) and functional markers (PD-L1 and Ki-67) was examined, and the association with disease-free (DFS) and overall (OS) survival investigated using a computer-assisted quantitative analysis. Patients were classified into two groups, with low or high levels or ratios, using the 75th percentile value as the cut-off. RESULTS: Forty-three patients were included in the study. Their median DFS and OS were 9 and 27 months respectively. A high CD4/CD3 lymphocyte ratio was associated with poorer DFS (8 months versus 11 months for a low ratio) (hazard ratio (HR) 2·23, 95 per cent c.i. 1·04 to 4·61; P = 0·041) and OS (13 versus 27 months respectively) (HR 2·62, 1·11 to 5·88; P = 0·028). A low αSMA/vimentin ratio together with a high CD4/CD3 ratio was correlated with poorer outcomes. No significant association was found between Ki-67, PD-L1 and survival. CONCLUSION: In patients with resected left-sided pancreatic cancer, a tumour microenvironment characterized by a high CD4/CD3 lymphocyte ratio along with a low αSMA/vimentin ratio is correlated with poorer survival.
ANTECEDENTES: El pronóstico del cáncer de páncreas sigue siendo malo y se requieren nuevas dianas terapéuticas de forma urgente. La resistencia al tratamiento podría ser atribuida al microambiente tumoral, un estroma desmoplásico compuesto por fibroblastos asociados al cáncer y linfocitos infiltrantes de tumor. El objetivo del estudio fue evaluar el valor pronóstico de los linfocitos infiltrantes de tumor y de los fibroblastos asociados al cáncer en el cáncer de cuerpo y cola de páncreas. MÉTODOS: Utilizando microarray para el análisis de muestras de tejido obtenidas tras la resección de cáncer de páncreas del lado izquierdo, se realizó inmunohistoquímica de linfocitos infiltrantes de tumor (CD45, CD3, CD4, FoxP3 y CD8), fibroblastos asociados al cáncer (vimentina y actina del músculo liso alfa (αSMA)) y marcadores funcionales (PD-L1 y Ki67), y se investigó la asociación con la supervivencia libre de enfermedad y la supervivencia global. Los resultados se obtuvieron tras un análisis cuantitativo asistido por ordenador. Los pacientes se clasificaron en dos grupos, de bajo y alto riesgo, utilizando el valor del percentil 75 como punto de corte. RESULTADOS: Se incluyeron 43 pacientes en el estudio. En esta población, la mediana de supervivencia libre de enfermedad y de supervivencia global fueron 9 meses y 27 meses, respectivamente. Una alta proporción de linfocitos CD4/CD3 se asoció a peor supervivencia libre de enfermedad (8 meses versus 11 meses; cociente de riesgos instantáneos, hazard ratio, HR 2,2; i.c. del 95% 1,0-4,6; P = 0,041) y supervivencia global (13 meses versus 27 meses; HR 2,6; i.c. del 95% 1,1-5,9; P = 0.028). Una baja proporción αSMA/vimentina junto con una alta proporción CD4/CD3 se correlacionó con peores resultados. No se encontró asociación significativa entre Ki67, PD-L1 y la supervivencia. CONCLUSIÓN: En pacientes con cáncer de páncreas izquierdo resecado, un microambiente tumoral caracterizado por una alta proporción de linfocitos CD4/CD3 junto con una baja proporción de αSMA/vimentina se correlaciona con una peor supervivencia.
Subject(s)
Adenocarcinoma/pathology , Cancer-Associated Fibroblasts , Lymphocytes, Tumor-Infiltrating , Pancreatectomy , Pancreatic Neoplasms/pathology , Tumor Microenvironment , Adenocarcinoma/diagnosis , Adenocarcinoma/mortality , Adenocarcinoma/surgery , Adult , Aged , Biomarkers, Tumor/metabolism , Cancer-Associated Fibroblasts/metabolism , Cancer-Associated Fibroblasts/pathology , Female , Follow-Up Studies , Humans , Immunohistochemistry , Lymphocytes, Tumor-Infiltrating/metabolism , Lymphocytes, Tumor-Infiltrating/pathology , Male , Middle Aged , Pancreatic Neoplasms/diagnosis , Pancreatic Neoplasms/mortality , Pancreatic Neoplasms/surgery , Prognosis , Retrospective Studies , Survival Analysis , Tissue Array AnalysisABSTRACT
PURPOSE: Optic nerve pit is a rare congenital anomaly. In two third of the patients, the severity of the disease is increased by the apparition of a serous macular detachment, which may compromise the visual prognosis. The aim of this study is to propose a therapy appropriate to such complication. METHODS: A prospective study was performed including 10 patients with a serous macular detachment caused by optic nerve pit. All patients underwent intraocular surgery including vitrectomy, peripapillary photocoagulation and intravitreal injection of gas. The mean postoperative follow-up period was 9.5 months. RESULTS: Therapy success was based on anatomical and functional results. Serous macular detachment reattached in 7 patients out of 10 and a recurrence was observed in one case. Visual acuity improved from 0 to 18 lines of the EDTRS chart (mean increase: 6.7 lines). CONCLUSION: These results confirm that intraocular surgery including vitrectomy-photocoagulation-gas injection is a valuable treatment for serous macular detachment associated with optic nerve pit.
Subject(s)
Coloboma/complications , Macula Lutea , Optic Disk/abnormalities , Retinal Detachment/etiology , Adolescent , Adult , Child , Coloboma/therapy , Combined Modality Therapy , Fluorocarbons/administration & dosage , Humans , Laser Coagulation , Middle Aged , Prospective Studies , Retinal Detachment/therapy , VitrectomyABSTRACT
Basic fibroblast growth factor (bFGF), a soluble mitogen, has been isolated and purified from various organs, including the retina. In vivo angiogenic activity of bFGF has been demonstrated with several assays. An experimental model of choroidal neovascularization was developed in the mini pig by perfusion of recombinant human bFGF through an osmotic minipump. Endogenous bFGF and bFGF receptors were localized in the normal pig retina by immunohistochemistry and autoradiography after binding. The perfusion of exogenous bFGF induced well-organized new vessels along the last 3 mm of the catheter in the suprachoroidal space. This neovascularization did not penetrate the normal Bruch's membrane. Vascular cells (identified by von Willebrand factor antibody staining) increased in number and in surface from the proximal part to the end of the intraocular catheter in all bFGF perfused eyes. In eyes perfused with phosphate buffered saline (controls), but not in the bFGF perfused eyes, an inflammatory response occurred (identified by a macrophage specific antibody). These results demonstrate that choroidal angiogenesis can be achieved without an inflammatory response by perfusing an excess of bFGF in the suprachoroidal space.
Subject(s)
Choroid/blood supply , Fibroblast Growth Factor 2/toxicity , Neovascularization, Pathologic/etiology , Animals , Choroid/pathology , Disease Models, Animal , Endothelium, Vascular/metabolism , Factor VIII/metabolism , Infusion Pumps, Implantable , Neovascularization, Pathologic/pathology , Receptors, Fibroblast Growth Factor/metabolism , Retina/metabolism , Swine , Swine, MiniatureABSTRACT
We have conducted a retrospective study about 25 patients who have presented subretinal neovascularization and idiopathic recurrent multifocal choroiditis. Final visual acuity level (mean 20/30) was almost the same as the pre laser treatment visual acuity level (mean 20/25) for a follow up of 12 months. We have also studied the main clinical, angiographic and serologic features of these cases of multifocal choroiditis.
Subject(s)
Choroiditis/complications , Retinal Neovascularization/etiology , Adult , Female , Humans , Light Coagulation , Male , Middle Aged , Recurrence , Retinal Neovascularization/surgery , Retrospective StudiesABSTRACT
A retrospective study was conducted on 25 patients who presented with both recurrent multifocal choroiditis and subretinal neovascularisation. As in other series, striking features were the young age of the patients (mean age 33 years), frequent recurrences of the macular lesions during a limited follow-up period, inflammation of the vitreous or the optic disk, and macular fibrosis. However, unlike previously reported data, refraction was more often in the emetropic range, there was no female predominance, and inflammatory signs were mild or limited to papillitis. Moreover serologic tests did not indicate an acute infection due to Epstein-Barr virus in any of the patients. This study also emphasized the results of Krypton laser treatment of the subretinal neovascularisation. Final visual acuity improved or remain the same in 26 eyes (72%) and worsened in 11 eyes (28%) during a mean follow-up period of 13 months (range 2-48 months). The best results were obtained in 15 eyes with neovascular membranes located more than 200 mu from the foveal avascular zone (mean final visual acuity: 20/40). However the mean final visual acuity of the nine eyes with neovascular membranes closer than 200 mu from the FAZ, was over 20/60. Recurrences of subretinal neovascularisation occurred in 7 out of 24 treated eyes and 3 were under the center of the FAZ. These results should be confirmed by a randomized prospective clinical trial in order to assess the benefits of laser treatment in recurrent multifocal choroiditis.
Subject(s)
Choroiditis/diagnosis , Light Coagulation , Retinal Neovascularization/surgery , Adult , Choroiditis/complications , Choroiditis/pathology , Choroiditis/surgery , Female , Humans , Male , Middle Aged , Recurrence , Retinal Neovascularization/etiology , Retinal Neovascularization/pathology , Retrospective Studies , Time FactorsABSTRACT
After the debridement of the entire corneal epithelium of the rabbit eye, epithelial cells of conjunctival origin cover the denuded corneal surface. Under such experimental conditions, the rate of wound healing is considerably delayed and total regeneration is completed within 15 to 20 days, allowing evaluation of various drugs, such as the Fibroblast Growth Factor. Both acidic and basic FGF were administered topically on totally de-epithelialized rabbit eye, at three different concentrations of 1.5 and 10 Stimulation Units/50 microliters, 3 times per day. A dose-response effect was observed and in each case, acidic FGF was found to be much more potent than bFGF in increasing the rate of wound healing of the cornea. These results are correlated with a new purification procedure, avoiding acid treatment of the tissue extract. The systemic diffusion of FGF allows the contralateral eye cells to be also stimulated for mitosis and migration and to heal faster than the control eyes.