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Am J Clin Pathol ; 151(5): 479-485, 2019 Apr 02.
Artigo em Inglês | MEDLINE | ID: mdl-30576407


OBJECTIVES: Rete testis invasion by germ cell tumors is frequently concomitant with lymphovascular or spermatic cord invasion (LVI/SCI); independent implications for staging are uncertain. METHODS: In total, 171 seminomas and 178 nonseminomatous germ cell tumors (NSGCTs; 46 had 1%-60% seminoma component) came from five institutions. Metastatic status at presentation, as a proxy for severity, was available for all; relapse data were unavailable for 152. Rete direct invasion (ReteD) and rete pagetoid spread (ReteP) were assessed. RESULTS: ReteP and ReteD were more frequent in seminoma than NSGCT. In seminoma, tumor size bifurcated at 3 cm or more or less than 3 cm predicted metastatic status. Tumors with ReteP or ReteD did not differ in size from those without invasions but were less than with LVI/SCI; metastatic status or relapse did not show differences. In NSGCT, ReteP/ReteD did not correlate with size, metastatic status, or relapse. CONCLUSIONS: Findings support retaining American Joint Committee for Cancer pathologic T1 stage designation for rete testis invasion and pT1a/pT1b substaging of seminoma.

J Urol ; 196(4): 1076-81, 2016 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-27265220


PURPOSE: ISUP (International Society for Urologic Pathology) and WHO adopted prognostic Grade Groups 1 to 5 that simplify prostate cancer grading for prognosis. Grade Group 4 is Gleason score 8 cancer, which is heterogeneous, and it encompasses Gleason score 4 + 4 = 8, 3 + 5 = 8 and 5 + 3 = 8. The comparative prognostic implications of these various Gleason scores had not been studied by urological pathologists after a re-review of slides. MATERIALS AND METHODS: Patients with a highest biopsy Gleason score of 3 + 5 = 8 or 4 + 4 = 8 were included in the study. Controls were cases with a highest Gleason score of 4 + 3 = 7 or 9-10. A total of 423 prostatic biopsy cases accessioned from 2005 to 2013 at 2 institutions were reviewed. Clinicopathological findings and followup (median 33.4 months) were assessed. RESULTS: Among Gleason score 8 cancers the cancer status outcome in 51 men with Gleason score 3 + 5 = 8 was marginally worse than in 114 with Gleason score 4 + 4 = 8 (p = 0.04). This was driven by a persistent nonmetastatic (after radiation/hormone therapy) cancer rate of 37% among Gleason score 3 + 5 = 8 cases vs 24% among Gleason score 4 + 4 = 8 cases. Conversely, cancer specific survival at 36-month followup was 97.8% in 3 + 5 cases vs 92.6% in 4 + 4 cases but this was not significant (p = 0.089). Cancer specific survival in the Gleason score 8 group was dichotomized by the presence of cribriform growth (p = 0.018). All Gleason score categories did not differ in the fraction of biopsy cores positive, clinical presentation or pathological findings, including the frequency of Gleason pattern 5, in 70 patients who underwent prostatectomy. CONCLUSIONS: Using the most current standards of prostate cancer grading the prognosis is not different in Gleason score 3 + 5 = 8 and 4 + 4 = 8 cancers. This justifies including both in Grade Group 4.

Biópsia com Agulha de Grande Calibre/métodos , Gradação de Tumores/métodos , Próstata/patologia , Neoplasias da Próstata/patologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Humanos , Masculino , Pessoa de Meia-Idade , Prognóstico
Fetal Pediatr Pathol ; 34(3): 190-6, 2015 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-25871299


Bilateral nephroblastomatosis (NB) is an uncommon renal anomaly characterized by multiple confluent nephrogenic rests scattered through both kidneys, with only a limited number of cases reported in the medical literature. Some of these children may have associated either Perlman or Beckwith-Wiedemann syndrome and others do not demonstrate syndromic features. We report a full-term boy with anteverted nose, bilateral bronchial stenosis due to lack of cartilage, bilateral obstructive renal dysplasia and NB with glomeruloid features. The infant had visceromegaly, but neither gigantism nor hemihypertrophy. Immunohistochemistry for PAX2 (Paired box gene-2) and WT-1 (Wilms Tumor 1) were strongly positive in the areas of NB. GLEPP-1 (Glomerular Epithelial Protein) did not stain the areas of NB with a glomeruloid appearance, but was positive in the renal glomeruli as expected. We found neither associated bronchial stenosis nor the histology of NB resembling giant glomeruli in any of the reported cases of NB.

Anormalidades Múltiplas/patologia , Brônquios/anormalidades , Nefropatias/patologia , Rim/anormalidades , Constrição Patológica , Humanos , Recém-Nascido , Masculino
J Neuroophthalmol ; 35(2): 171-4, 2015 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-25621861


Intracranial germinomas are typically present in the suprasellar or pineal location, and their origin within the optic nerve or chiasm is extremely rare. We report a 25-year-old woman with an exophytic primary optic chiasm germinoma who underwent partial resection followed by radiation and had no detectable tumor on magnetic resonance imaging at 1-year follow-up.

Germinoma , Quiasma Óptico/patologia , Neoplasias do Nervo Óptico , Adulto , Feminino , Germinoma/diagnóstico , Germinoma/terapia , Humanos , Imagem por Ressonância Magnética , Neoplasias do Nervo Óptico/diagnóstico , Neoplasias do Nervo Óptico/terapia
J Radiol Case Rep ; 8(12): 1-8, 2014 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-25926911


Solitary fibrous tumors represent fewer than 2% of all soft tissue tumors, and only about 12-15% of them occur in the head and neck. We report a case of a 38-year-old male who presented with a six-month history of increasing right cheek swelling. Computed tomography of the paranasal sinuses with contrast demonstrated a well-circumscribed avidly enhancing mass in the right retroantral fat. On magnetic resonance imaging the lesion was homogenously slightly hyperintense to muscle on T1 weighted and T2 weighted images and enhanced avidly with contrast. Surgical resection was performed and pathology was consistent with solitary fibrous tumor. There have been very few reported cases of solitary fibrous tumors in the infratemporal fossa and none described as originating in the retroantral fat.

Neoplasias de Cabeça e Pescoço/diagnóstico , Neoplasias de Cabeça e Pescoço/cirurgia , Tumores Fibrosos Solitários/diagnóstico , Tumores Fibrosos Solitários/cirurgia , Osso Temporal/cirurgia , Adulto , Humanos , Imagem por Ressonância Magnética/métodos , Masculino , Osso Temporal/diagnóstico por imagem , Osso Temporal/patologia , Tomografia Computadorizada por Raios X/métodos , Resultado do Tratamento
J Pers Soc Psychol ; 96(2): 363-80, 2009 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-19159137


Why are people with low self-esteem (LSE) less motivated than people with high self-esteem (HSE) to improve sad moods? The present research examined whether feelings of personal deservingness contribute to this difference. Four experiments with undergraduate participants involved a sad mood induction, a manipulation of personal deservingness, or both. Results suggested that (a) LSEs feel less deserving of positive outcomes and of positive moods than do HSEs, (b) feelings of personal deservingness can vary with the situation, and be lowered through reminders of social rejection and personal flaws, and (c) feeling relatively undeserving dampens LSEs', but not HSEs', motivation to repair sad moods. These results have implications for the emotion regulation, self-esteem, and social justice literatures.

Afeto , Motivação , Autoimagem , Feminino , Humanos , Masculino , Controles Informais da Sociedade , Técnicas Sociométricas , Inquéritos e Questionários