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1.
Anticancer Res ; 40(1): 75-80, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31892554

RESUMO

BACKGROUND/AIM: The aim of the present study was to compare human epidermal growth factor receptor 2 (HER2) expression before and after trastuzumab-based chemotherapy in patients with advanced HER2-positive gastric cancer. MATERIALS AND METHODS: We assessed HER2 expression using immunohistochemistry and/or fluorescence in situ hybridization in pre-treatment biopsied specimens and post-treatment resected specimens obtained from seven patients with advanced HER2-positive gastric cancer receiving trastuzumab-based chemotherapy. RESULTS: Four patients maintained the HER2-positive status and three patients had a change in HER2 expression from positive to negative. In patients showing the loss of HER2 expression after treatments, HER2-positive tumor cells with a dominant histological type disappeared, and HER2-negative tumor cells with another dominant histological type were identified. CONCLUSION: HER2 expression can change after trastuzumab-based chemotherapy in patients with advanced HER2-positive gastric cancer. Continuous monitoring of HER2 expression after treatments may be utilized to determine whether the continued use of trastuzumab is advisable.


Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Receptor ErbB-2/antagonistas & inibidores , Receptor ErbB-2/genética , Neoplasias Gástricas/tratamento farmacológico , Neoplasias Gástricas/genética , Adulto , Idoso , Protocolos de Quimioterapia Combinada Antineoplásica/efeitos adversos , Biomarcadores Tumorais , Terapia Combinada , Feminino , Humanos , Imuno-Histoquímica , Hibridização in Situ Fluorescente , Masculino , Pessoa de Meia-Idade , Terapia de Alvo Molecular , Imagem Multimodal/métodos , Metástase Neoplásica , Estadiamento de Neoplasias , Receptor ErbB-2/metabolismo , Recidiva , Neoplasias Gástricas/diagnóstico , Neoplasias Gástricas/metabolismo , Trastuzumab/administração & dosagem , Resultado do Tratamento
2.
Anticancer Res ; 40(1): 81-86, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31892555

RESUMO

BACKGROUND/AIM: Zinc finger protein ZKSCAN3 (ZNF306) is a promising oncogene candidate in colon, bladder, breast, uterine cervical, and prostate cancers. The present study aimed to investigate ZKSCAN3 protein expression in gastric carcinoma patient tissues and to evaluate oncological outcomes in these patients. MATERIALS AND METHODS: ZKSCAN3 was detected using the anti-ZKSCAN3 rabbit polyclonal antibody. For immunohistochemical examination, we used paraffin-embedded specimens from 87 consecutive patients with gastric cancer who underwent gastrectomy. We investigated ZKSCAN3 expression in relation with patient prognosis and clinicopathological factors. RESULTS: ZKSCAN3 was detected in 28 (32.2%) tumour specimens, with significant association with lymphatic system invasion and distant metastasis. Patients with ZKSCAN3-positive tumours had worse overall survival (OS) than those with ZKSCAN3-negative tumours based on log-rank testing. Furthermore, multivariate analysis revealed that ZKSCAN3 was an independent prognostic parameter for OS (hazard ratio: 2.6379, p=0.0164). CONCLUSION: ZKSCAN3 is a potential novel prognostic factor in gastric cancer patients.


Assuntos
Biomarcadores Tumorais , Neoplasias Gástricas/genética , Neoplasias Gástricas/mortalidade , Fatores de Transcrição/genética , Idoso , Idoso de 80 Anos ou mais , Linhagem Celular Tumoral , Feminino , Expressão Gênica , Humanos , Imuno-Histoquímica , Estimativa de Kaplan-Meier , Masculino , Pessoa de Meia-Idade , Gradação de Tumores , Metástase Neoplásica , Estadiamento de Neoplasias , Prognóstico , Modelos de Riscos Proporcionais , Recidiva , Fatores de Risco , Neoplasias Gástricas/diagnóstico , Neoplasias Gástricas/metabolismo
3.
Zhonghua Bing Li Xue Za Zhi ; 49(1): 34-39, 2020 Jan 08.
Artigo em Chinês | MEDLINE | ID: mdl-31914532

RESUMO

Objective: To investigate the clinicopathological features, special morphologic variants and potential diagnostic traps of classical follicular dendritic cell sarcoma (FDCS). Methods: A total of 25 cases of classical FDCS diagnosed in the First Hospital Affiliated to Army Medical University from 2006 to 2018 were examined by hematoxylin-eosin staining, immunohistochemistry and in situ hybridization for Epstein-Barr virus-encoded mRNA (EBER). Meanwhile, the types and characteristics of the special variants of FDCS were summarized along with those reported in the literature. Results: The age of patients ranged from 23 to 77 years (mean 52 years), the male to female ratio was 1.5, and the maximum diameter of tumor was 1.5 to 20 cm (mean 7.4 cm). Twelve cases (48%) were misdiagnosed at the initial evaluation. Follow-up information was available for 17 patients, and the follow-up time was 5 to 96 months. The propotion of patients having recurrence, metastasis and mortality was 3/17, 5/17 and 2/17, respectively. Microscopically, besides the typical morphology, 10 cases of FDCS showed special histomorphologies and/or structures, including those mimicking lymphoepithelioma-like carcinoma, desmoplastic infiltrating carcinoma, classical Hodgkin's lymphoma (CHL), anaplastic large cell lymphoma (ALCL) and hemangiopericytoma. These morphologic variants were potential diagnostic pitfalls and warranted attention. Immunohistochemistry showed that more than two markers of follicular dendritic cells (such as CD21, CD23, CD35, etc.) were expressed in cases showing typical morphology and the special variants. All 25 cases were all negative for EBER by in situ hybridization. Conclusions: Classical FDCS is rare, besides the typical morphologic features, there are many special variants. In particular, these may be confused with lymphoepithelioma-like carcinoma in the nasopharynx, CHL or ALCL in the mediastinum/lymph node. Awareness of these variants is essential for accurate diagnosis.


Assuntos
Sarcoma de Células Dendríticas Foliculares , Adulto , Idoso , Células Dendríticas Foliculares , Feminino , Humanos , Imuno-Histoquímica , Hibridização In Situ , Masculino , Pessoa de Meia-Idade , Recidiva Local de Neoplasia , Adulto Jovem
4.
Zhonghua Bing Li Xue Za Zhi ; 49(1): 40-46, 2020 Jan 08.
Artigo em Chinês | MEDLINE | ID: mdl-31914533

RESUMO

Objective: To investigate the expression of myocyte enhancer factor 2B (MEF2B) in mantle cell lymphomas (MCL), and to analyze the correlation between the expression of MEF2B and pathological subtypes, structural subtypes, SOX11 expression and its clinical significance. Methods: Paraffin-embedded tissues were stained with HE, immunohistochemistry (EnVision method) and fluorescence in situ hybridization (FISH) , in addition, the clinical and pathological data of 60 cases of MCL were collected at Sun Yat-sen University Foshan Hospital and Sun Yat-sen University Cancer Center from January,2002 to May, 2019 for analysis. Results: Of the 60 MCLs, males is predominant (M∶F=3∶1). Histologically, the typical MCL is the majority (classical MCL: variant type MCL=48 cases:12 cases) . Fifty cases were classified into non-complete FDC meshwork type MCL, and the remaining 10 cases were classified into the complete-FDC meshwork type MCL group. Patients with classical MCL were more than 60 years old. The coexistent lesion sites both node and extranode in pathological subtype or structural subtype was the most common lesion sites. SOX11(+) MCL was common in classical MCL (P=0.040) and tended to be complete-FDC meshwork type MCL (P=0.086). The expression rate of MEF2B in MCL was 60.0%(36/60). This rate of MEF2B in classical type, complete-FDC meshwork type and SOX11(+) MCL was significantly higher than that variant type, no complete-FDC meshwork type, SOX11(-)MCL (P<0.05), respectively. There was no difference in clinical characteristics of MCL between MEF2B positive and negative groups. Compared with SOX11(-)MCL, the percentage of MEF2B expressed in tumor cells of SOX11(+)MCL was significantly higher (P=0.027). The expression of MEF2B was not related to the proliferation of tumor cells (P=0.341). There was no significant difference in the survival rate between different expression groups of MEF2B and SOX11 (P=0.304 and P=0.819, respectively). Only the mortality of variant type (blastoid/pleomorphic) MCL within 2 years was significantly higher than that of classical type MCL (P<0.05). Conclusions: The expression of MEF2B in MCL is related to the pathological subtypes, structural subtypes and the expression of SOX11, but not to the proliferation and prognosis. The high mortality rate within 2 years is only found in variant MCL. However, the role of MEF2B in MCL needs to be further studied.


Assuntos
Linfoma de Célula do Manto , Adulto , Humanos , Imuno-Histoquímica , Hibridização in Situ Fluorescente , Fatores de Transcrição MEF2/metabolismo , Masculino , Pessoa de Meia-Idade , Fatores de Transcrição SOXC
5.
Anticancer Res ; 40(1): 349-356, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31892586

RESUMO

BACKGROUND/AIM: Follicle-stimulating hormone receptor (FSHr), expressed on endothelial cells of vessels in different malignant tumors, has been recently investigated as a potential pan-receptor of cancer treatment. However, the expression of this receptor has also been confirmed in other tissues under pathological conditions including cancer. The aim of the presented pilot study was to evaluate the expression of FSHr in head and neck squamous cancer (HNSCC). PATIENTS AND METHODS: A total of 28 HNSCC patient samples were immunohistochemically analyzed for the presence of FSHr using a commercially available primary antibody. RESULTS: FSHr was detected not only in the tumor tissue, but also in the basal layer or dysplastic parts of squamous mucosa and also in fibroblasts surrounding the tumor tissue. CONCLUSION: FSHr is present on different benign or malignant mesenchymal and epithelial structures in HNSCC. A brief literature review revealed a wider role of FSHr in the development of neoplasia.


Assuntos
Receptores do FSH/metabolismo , Carcinoma de Células Escamosas de Cabeça e Pescoço/metabolismo , Animais , Linhagem Celular Tumoral , Feminino , Humanos , Imuno-Histoquímica , Camundongos , Projetos Piloto
6.
Chemosphere ; 238: 124581, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31445333

RESUMO

Lead (Pb) pollution is one of the most serious environmental problems and has attracted worldwide attention. Pb causes hematological, central nervous system, as well as renal toxicity, and so on. Although many investigations about Pb in blood to evaluate pollution status and toxic effects have been reported, there are open question about biological behavior of Pb. In order to reveal any toxicological mechanisms or influences, we focused on the local distribution of Pb in mice organs. Lead acetate (100 mg/L and 1000 mg/L) in drinking water were given to the BALB/c mice (male, seven weeks of age, N = 24) for three weeks. Laser Ablation Inductively Coupled Plasma Mass Spectrometry (LA-ICP-MS) analysis revealed a homogenous distribution of Pb in the liver and inhomogeneous distribution in the kidney and brain. The hippocampus, thalamus, and hypothalamus had higher concentrations than other areas such as the white matter. Surprisingly, in the kidney, Pb tended to accumulate in the medulla rather than the cortex, strongly suggesting that high sensitivity areas and high accumulation areas differ. Moreover, distribution of stromal interacting protein 1 (STIM1) which is candidate gene of Pb pathway to the cells was homogenous in the liver and kidney whereas inhomogeneous in the brain. In contrast to our hypothesis, interestingly, Pb exposure under the current condition did not induce mRNA expressions for any candidate channel or transporter genes. Thus, further study should be conducted to elucidate the local distribution of Pb and other toxic metals, and pathway that Pb takes to the cells.


Assuntos
Química Encefálica/efeitos dos fármacos , Rim/química , Chumbo/análise , Fígado/química , Molécula 1 de Interação Estromal/análise , Animais , Encéfalo/metabolismo , Imuno-Histoquímica/métodos , Terapia a Laser , Masculino , Espectrometria de Massas/métodos , Camundongos , Camundongos Endogâmicos BALB C , Análise Espectral
7.
Biosci Biotechnol Biochem ; 84(1): 159-170, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31483212

RESUMO

We tested whether Sake Lees (SL) had inhibitory effects on hyperalgesia in the hindpaw under psychophysical stress conditions. Male rats were subjected to repeated forced swim stress treatments (FST) from Day -3 to Day -1. Intraperiotoneal administration of SL which contained low concentration of ethanol (SLX) was conducted after each FST. On Day 0, formalin-evoked licking behaviors and Fos responses in the lumbar spinal cord (DH) and several areas within the rostral ventromedial medulla (RVM) were quantified as nociceptive responses. FST-induced hyperalgesia in the hindpaw was prevented by repeated SL and SLX treatments. Fos expression was significantly increased in DH and some areas within the RVM under FST, which was prevented by repeated SL or SLX. These findings indicated that daily administration of SL had the potential to alleviate stress-induced hyperalgesia.


Assuntos
Fermentação , Membro Posterior/metabolismo , Hiperalgesia/tratamento farmacológico , Oryza/química , Extratos Vegetais/farmacologia , Proteínas Proto-Oncogênicas c-fos/metabolismo , Corno Dorsal da Medula Espinal/metabolismo , Estresse Fisiológico/fisiologia , Animais , Comportamento Animal/efeitos dos fármacos , Etanol/química , Formaldeído/administração & dosagem , Formaldeído/farmacologia , Hiperalgesia/etiologia , Imuno-Histoquímica , Masculino , Manejo da Dor , Medição da Dor , Extratos Vegetais/administração & dosagem , Proteínas Proto-Oncogênicas c-fos/imunologia , Ratos , Ratos Sprague-Dawley , Neurônios Serotoninérgicos/efeitos dos fármacos , Neurônios Serotoninérgicos/metabolismo , Serotonina/imunologia , Serotonina/metabolismo , Natação/fisiologia , Distribuição Tecidual
8.
J Clin Pathol ; 73(1): 1-6, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31308255

RESUMO

Traditionally, immunohistochemistry (IHC) is used by pathologists to localise specific proteins or peptides in tissue slides. In the era of personalised medicine, however, molecular tissue analysis becomes indispensable for correct diagnosis, prognosis and therapeutic decision, not only on the DNA or mRNA level but also on the protein level. Combining molecular information with imaging presents many advantages. Therefore, matrix-assisted laser desorption/ionisation imaging mass spectrometry (MALDI IMS) is a promising technique to be added to the armamentarium of the pathologist. Here, we focus on the workflow, advantages and drawbacks of both MALDI IMS and IHC. We also briefly discuss a few other protein imaging modalities and give examples of applications.


Assuntos
Ensaios de Triagem em Larga Escala , Imuno-Histoquímica , Serviço Hospitalar de Patologia , Patologia Clínica/métodos , Proteômica/métodos , Espectrometria de Massas por Ionização e Dessorção a Laser Assistida por Matriz , Difusão de Inovações , Humanos , Valor Preditivo dos Testes , Reprodutibilidade dos Testes , Fluxo de Trabalho
9.
Arch Oral Biol ; 109: 104571, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31586907

RESUMO

OBJECTIVE: To study the innervation of the major sublingual gland by means of immunohistochemistry. DESIGN: Bioptic and autoptic specimens of the major sublingual gland of humans were examined for the presence of immunoreactivity to tyrosine hydroxylase and dopamine-ß-hydroxylase, on one hand, and choline acetyltransferase, on the other, to indicate adrenergic and cholinergic nerves, respectively. RESULTS: Acini and ducts were supplied by both divisions of the autonomic nervous system. CONCLUSIONS: Mucous and seromucous cells of the human major sublingual glands may respond with secretion not only to parasympathetic activity but also to sympathetic activity. The major sublingual gland is therefore a potential contributor to the mucin secretion recently reported in the literature in response to high sympathetic activity during physical exercise.


Assuntos
Colina O-Acetiltransferase/metabolismo , Dopamina beta-Hidroxilase/metabolismo , Glândula Sublingual/enzimologia , Tirosina 3-Mono-Oxigenase/metabolismo , Adulto , Idoso , Feminino , Humanos , Imuno-Histoquímica , Masculino , Pessoa de Meia-Idade
11.
Xi Bao Yu Fen Zi Mian Yi Xue Za Zhi ; 35(11): 1035-1041, 2019 Nov.
Artigo em Chinês | MEDLINE | ID: mdl-31879001

RESUMO

Objective To prepare the monoclonal antibodies specifically against P protein of human respiratory syncytial virus (HRSV) and identify it. Methods HRSV P protein prepared by prokaryotic expression in the form of overlapping peptides was used as the immunogen, and monoclonal antibodies (mAbs) were screened by hybridoma technology. Western blot analysis was used to verify the binding activity of the screened mAbs and P protein, and immunofluorescence cytochemical staining was used to determine whether the obtained mAbs could be used to detect the expression of P protein in HEp-2 cells infected with HRSV. Results P181-15A3 and P211-16D8 with great reactivity and specific recognition of HRSV P protein were screened. Both mAbs could bind to P protein by Western blot analysis and could be used for immunocytochemical detection of P protein in HEp-2 cells after HRSV infection. Conclusion We have successfully prepared the mAbs against HRSV P protein.


Assuntos
Anticorpos Monoclonais/imunologia , Anticorpos Antivirais/imunologia , Vírus Sincicial Respiratório Humano , Proteínas Estruturais Virais/imunologia , Animais , Western Blotting , Humanos , Hibridomas , Imuno-Histoquímica , Camundongos
12.
Autops. Case Rep ; 9(4): e2019121, Oct.-Dec. 2019. ilus, tab
Artigo em Inglês | LILACS | ID: biblio-1024063

RESUMO

Plasminogen activator inhibitor-1 (PAI-1) is a biomarker of thrombosis. Adipose and vascular tissues are among the major sources of PAI-1 production. Previous studies indicated that fat deposits mediate increased cardiovascular risk among obese individuals. We investigated the immunohistochemical (IHC) expression of PAI-1 in adipose and vascular tissues from the omentum and the subcutaneous tissue. The pathology samples were selected from 37 random patients who underwent elective abdominal surgery between 2008-2009. PAI-1 expression was semi-quantitatively scored and compared between the groups. Significant differences were noted in the IHC expression of PAI-1 between the omental and the subcutaneous adipose tissues (1.1 ± 0.8 versus 0.8 ± 0.6, respectively (p=0.05)). Adipose tissue displayed higher IHC expression of PAI-1 compared to vascular wall tissue in both omentum and subcutaneous sections (1.1 ± 0.8 versus 0.5 ± 0.9 (p=0.004), and 0.8 ± 0.6 versus 0.4 ± 0.6 (p=0.003), respectively). In conclusion, our study compared PAI-1 expression in the omentum versus the subcutaneous tissue and adipose versus vascular tissues. IHC expression of PAI-1 level was significantly higher in the omental adipose tissue compared to the subcutaneous adipose tissue. Adipose tissue displayed significantly higher PAI-1 expression than vascular tissue. The study elucidates the biological differences of adipose and vascular tissue from subcutaneous versus omental sections.


Assuntos
Humanos , Inibidor 1 de Ativador de Plasminogênio/análise , Imuno-Histoquímica , Tecido Adiposo , Gordura Abdominal/cirurgia
13.
Medicine (Baltimore) ; 98(51): e17944, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31860949

RESUMO

To investigate the difference in messenger ribonucleic acid (mRNA) and protein expression of growth arrest DNA damage-inducible gene 45α (GADD45α), mouse double minute 2 homolog (MDM2), and P73 in cancer and cancer-adjacent tissues in patients with non-small-cell lung carcinoma (NSCLC).We compared the mRNA expression of GADD45α and MDM2 and the protein expression of GADD45α, MDM2, and P73 in lung cancer and cancer-adjacent tissues in NSCLC patients by quantitative real-time PCR, immunohistochemistry (IHC), and Western Blot (WB). We analyzed GADD45α, MDM2, and P73 expression in patients with different pathological types of NSCLC, and the correlation of these genes with gender, smoking history, and TNM/T stages.IHC results suggested that MDM2 protein expression significantly increased in cancer tissues in female patients (P = .01), but not in male patients. In addition, WB results indicated that P73 protein expression significantly decreased in cancer tissues in patients with adenocarcinoma (P = .03), but not squamous carcinoma.MDM2 and P73 protein levels were differentially regulated in cancer and cancer-adjacient tissues in patients with sub types of NSCLC. There was no significant difference in GADD45α expression between cancer and cancer-adjacent tissues in NSCLC patients.


Assuntos
Carcinoma Pulmonar de Células não Pequenas/genética , Proteínas de Ciclo Celular/genética , Regulação Neoplásica da Expressão Gênica , Neoplasias Pulmonares/genética , Proteínas Proto-Oncogênicas c-mdm2/genética , Proteína Tumoral p73/genética , Adenocarcinoma/genética , Adenocarcinoma/patologia , Idoso , Animais , Biópsia por Agulha , Western Blotting , Carcinoma Pulmonar de Células não Pequenas/patologia , Estudos de Coortes , Dano ao DNA/genética , Seguimentos , Humanos , Imuno-Histoquímica , Neoplasias Pulmonares/patologia , Camundongos , Pessoa de Meia-Idade , RNA Mensageiro/metabolismo , Reação em Cadeia da Polimerase em Tempo Real/métodos , Valores de Referência
14.
Medicine (Baltimore) ; 98(51): e17987, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31860950

RESUMO

INTRODUCTION: The odontogenic keratocyst (OKC), previously known as keratocystic odontogenic tumor has been the most disputable pathologies of the maxillofacial region. Patients with OKC are often asymptomatic but may present with pain, swelling, or discharge. Despite the aggressive nature, previous literature as early as 1970s reported the fact that parakeratinized OKC can be treated by means of marsupialization alone. PATIENTS CONCERNS: The patient had reported with a complaint of pain and swelling in relation with a tooth in mandibular right quadrant. DIAGNOSIS: This case report discusses features of a rare, extensive, panmandibular OKC that is only second of its kind mentioned in the literature. INTERVENTION: As a usual treatment protocol, marsupialization was attempted first. Immunohistochemical analysis revealed reduced expression of Ki-67 and B cell lymphoma 2 (bcl-2) markers after marsupialization from 2 separate sites. However, due to incomplete resolution in the lower right anterior region, an aggressive approach was taken by curetting it out surgically along with associated teeth and cortical plate followed by application of Carnoy's solution. OUTCOME: Postsurgery uneventful healing of the lesion was noted on regular follow-up visits with complete resolution at 40 months. The case has been followed for 10 years with no sign of relapse and reoccurrence. CONCLUSIONS: Based on the expression of markers it can thus be concluded that Ki-67 and bcl-2 are site specific and bear strong relationship with the recurrence of OKCs.


Assuntos
Doenças Mandibulares/diagnóstico por imagem , Doenças Mandibulares/cirurgia , Cistos Odontogênicos/diagnóstico por imagem , Cistos Odontogênicos/cirurgia , Radiografia Dentária/métodos , Adulto , Biópsia por Agulha , Dentística Operatória/métodos , Feminino , Seguimentos , Humanos , Imuno-Histoquímica , Doenças Mandibulares/patologia , Cistos Odontogênicos/patologia , Cuidados Pré-Operatórios/métodos , Doenças Raras , Medição de Risco , Índice de Gravidade de Doença , Fatores de Tempo , Resultado do Tratamento
15.
Medicine (Baltimore) ; 98(51): e18016, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31860952

RESUMO

INTRODUCTION: Breast metastases from primary colorectal carcinoma are extremely rare, with only 45 cases being reported previously. Since the most common malignancy in the breast and axilla is primary breast cancer regardless of cancer history, non-hematologic metastases may be misdiagnosed initially. Nevertheless, differentiating breast metastases from primary breast cancer is crucial because of their differences in prognosis and management. PATIENT CONCERNS: We present a case of a 44-year-old Asian woman who noticed a new right breast lump after undergoing surgery and chemotherapy for her primary sigmoid colon cancer. DIAGNOSIS: Image and immunohistochemistry findings were consistent with breast metastasis from primary colorectal adenocarcinoma. INTERVENTIONS: The patient underwent breast tumor excision and reinitiated chemotherapy. OUTCOMES: The patient's disease progressed despite the interventions. She passed away 7 months after the detection of breast metastasis. CONCLUSION: When a new breast lesion is detected in patients with colorectal cancer history, the physician should consider the possibility of breast metastasis due to the poor prognosis. If a biopsy is necessary, cancer history should be provided to the clinicians to prevent incorrect pathological interpretation. In establishing the diagnosis, certain immunohistochemical markers have been shown to be sensitive and specific in previously reported cases. The combination of tumor excision and chemotherapy was the most common strategy in managing this condition with inconsistent clinical outcomes.


Assuntos
Adenocarcinoma/secundário , Neoplasias da Mama/secundário , Neoplasias da Mama/terapia , Mastectomia Segmentar/métodos , Neoplasias do Colo Sigmoide/patologia , Adenocarcinoma/cirurgia , Biópsia por Agulha , Neoplasias da Mama/diagnóstico por imagem , Quimioterapia Adjuvante , Colectomia/métodos , Terapia Combinada , Progressão da Doença , Evolução Fatal , Feminino , Humanos , Biópsia Guiada por Imagem/métodos , Imuno-Histoquímica , Neoplasias do Colo Sigmoide/diagnóstico por imagem , Neoplasias do Colo Sigmoide/terapia , Tomografia Computadorizada por Raios X/métodos
16.
Medicine (Baltimore) ; 98(51): e18139, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31860960

RESUMO

RATIONALE: Rituximab is recommended to induce remission of severe granulomatosis with polyangiitis (GPA). Plasma exchange (PE) may be considered in the setting of rapidly progressive glomerulonephritis (RPGN) with a serum creatinine increase of more than 5.6 mg/dl or diffuse alveolar hemorrhage (DAH). However, there are no sufficient studies on combination therapy with rituximab and PE in GPA. PATIENT CONCERNS: A 23-year-old woman was admitted with fever, abdominal pain, and diarrhea on suspicion of infectious colitis. Colonoscopy showed hemorrhagic colitis and antibiotic treatment was ineffective. Physical examination revealed episcleritis and skin lesions similar to Janeway lesions or Osler nodes on her palms and soles. Transesophageal echocardiogram (TEE) revealed mitral valve vegetation mimicking infective endocarditis. However, no pathogen was grown in the blood culture. Ten days after admission, blood-tinged sputum and respiratory distress developed. Imaging studies of lung, bronchoscopy, and bronchoalveolar lavage indicated DAH. Moreover, serum creatinine levels rapidly increased from 0.8 mg/dl to 6.1 mg/dl with proteinuria. DIAGNOSIS: The patient was diagnosed with GPA and non-infectious endocarditis, DAH, and RPGN, based on a biopsy which revealed pauci-immune crescentic glomerulonephritis with granuloma and leukocytoclastic vasculitis and antineutrophil cytoplasmic antibodies against proteinase 3- positivity. INTERVENTIONS: Initial methylprednisolone pulse therapy (1 g daily for 3 days) proved unsuccessful. After initiating PE, creatinine levels began to slowly decline, but DAH continued to deteriorate. Rituximab combined with PE therapy was considered. We performed PE every 2 to 3 days for 5 total treatments combined with rituximab (375 mg/m, once weekly for 4 weeks). OUTCOMES: After the combination treatment of rituximab and PE, alveolar hemorrhage stopped. Chest X-ray and laboratory data, including serum creatinine and hemoglobin, notably improved. Mitral valve vegetation was no longer observed in follow-up TEE. GPA remained stable with low dose prednisolone and immunosuppressants over a follow-up period of 5 years. LESSONS: This case suggests that the use of rituximab and concurrent PE may represent a promising combination for severe and refractory GPA.


Assuntos
Granulomatose com Poliangiite/patologia , Granulomatose com Poliangiite/terapia , Troca Plasmática/métodos , Rituximab/uso terapêutico , Anticorpos Monoclonais/uso terapêutico , Biópsia por Agulha , Colite/diagnóstico , Colite/etiologia , Colonoscopia/métodos , Terapia Combinada , Esquema de Medicação , Serviço Hospitalar de Emergência , Feminino , Seguimentos , Granulomatose com Poliangiite/diagnóstico , Humanos , Imuno-Histoquímica , Medição de Risco , Índice de Gravidade de Doença , Fatores de Tempo , Tomografia Computadorizada por Raios X/métodos , Resultado do Tratamento , Adulto Jovem
17.
Medicine (Baltimore) ; 98(51): e18141, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31860961

RESUMO

RATIONALE: Peliosis hepatis (PH), which is characterized by blood-filled cavities in the liver, is a rare disease. Its diagnosis depends on postoperative pathological examinations and immunohistochemistry. PATIENT CONCERNS: A 44-year-old female complained of right-middle upper abdominal pain and distension for 1 month, with occasional vomiting and fever. DIAGNOSIS: Because of the similar imaging features, the patient was initially misdiagnosed as cystic echinococcosis (CE). The immunoassay of echinococcosis was negative. Irregular hepatectomy was performed. Eventually, the patient was diagnosed with PH based on postoperative histopathology and immunohistochemistry. INTERVENTIONS: The patient underwent hepatectomy. Then, the cystic lesion was collected for intraoperative pathological examination. Thus, the blood liquid was extracted from the cystic lesion. Pringle maneuver was administered to prevent bleeding, and then the whole cystic lesion was removed. OUTCOMES: She recovered smoothly and there was no relapse occurred during 6 months' follow-up. LESSONS: It is difficult to differentiate PH from CE and other hepatic diseases due to the lack of special imaging features. Pathological examinations and immunohistochemistry can provide a confirmed diagnosis of PH.


Assuntos
Equinococose/diagnóstico , Hepatectomia/métodos , Peliose Hepática/diagnóstico , Peliose Hepática/patologia , Dor Abdominal/diagnóstico , Dor Abdominal/etiologia , Adulto , Biópsia por Agulha , Diagnóstico Diferencial , Equinococose/diagnóstico por imagem , Feminino , Seguimentos , Humanos , Imuno-Histoquímica , Imagem por Ressonância Magnética/métodos , Peliose Hepática/diagnóstico por imagem , Peliose Hepática/cirurgia , Doenças Raras , Índice de Gravidade de Doença , Tomografia Computadorizada por Raios X/métodos , Resultado do Tratamento
18.
Medicine (Baltimore) ; 98(51): e18149, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31860962

RESUMO

RATIONALE: Retroperitoneal schwannomas are very rare and may grow very close to major abdominal vessels. Since the surgical approach to the retroperitoneal space may be complex due to surrounding vital organs, including major vessels, laparoscopic surgery is challenging and has only been recently adopted. Here, we report a case of laparoscopic resection of a large retroperitoneal schwannoma attached to large vital vessels. PATIENT CONCERNS: A 62-year-old woman presented with a chief complaint of pain in the lower right limb with consequent claudication, which had lasted for approximately 1 year. DIAGNOSES: Magnetic resonance imaging revealed a solid oval mass measuring 45 × 32 × 39 mm, located medially to the right iliopsoas muscle at the level of the intersomatic space between the 5th lumbar vertebra and the 1st sacral vertebra. This mass was inhomogeneously hypointense in T2 due to the presence of cystic areas, with intense and inhomogeneous contrast enhancement, compatible with the diagnosis of a schwannoma. The mass compressed the inferior caval vein near its bifurcation and the right common iliac vein, anteriorly dislocating the ipsilateral iliac arterial axis. INTERVENTIONS: A multidisciplinary team skilled in vascular and pelvic laparoscopy was involved. The patient underwent laparoscopic surgery via an anterior transperitoneal approach with right adnexectomy and radical excision of the tumor. The surgery lasted 120 minutes without intraoperative complications. Blood loss was less than 100 mL. The histologic diagnosis was a benign Schwannoma; grade I according to World Health Organization classification. OUTCOMES: The postoperative course was uneventful. At the 10-month follow-up, the patient had no recurrences and was asymptomatic. LESSONS: Laparoscopic removal of large retroperitoneal schwannomas, even if attached to major vital vessels, is feasible and safe when performed by experienced surgeons.


Assuntos
Laparoscopia/métodos , Neurilemoma/diagnóstico , Neurilemoma/cirurgia , Neoplasias Retroperitoneais/diagnóstico , Neoplasias Retroperitoneais/cirurgia , Veia Cava Inferior/patologia , Idoso , Biópsia por Agulha , Feminino , Seguimentos , Humanos , Imuno-Histoquímica , Comunicação Interdisciplinar , Extremidade Inferior , Dor Musculoesquelética/diagnóstico , Dor Musculoesquelética/etiologia , Invasividade Neoplásica/patologia , Estadiamento de Neoplasias , Neurilemoma/diagnóstico por imagem , Doenças Raras , Neoplasias Retroperitoneais/diagnóstico por imagem , Medição de Risco , Resultado do Tratamento
19.
Indian J Dent Res ; 30(5): 755-762, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31854369

RESUMO

Background: Oral submucous fibrosis (OSF) is an insidious, chronic, disabling disease, in which there is lack of perfusion due to reduced level of the vasculature and this is said to be responsible for the epithelial atrophy seen in OSF. The degree of vasculature of the affected mucosa and its effects on the epithelial thickness remains controversial till date. Aims: This study attempts to analyze the role of angiogenesis in OSF and its progression using vascular endothelial growth factor (VEGF) and CD34 markers. Materials and Methods: The study samples for the present study comprised of 10 cases each of early OSF, moderately advanced, advanced OSF, and 10 cases of normal oral mucosa were used as controls. All the cases were subjected to immunohistochemical staining with VEGF and CD34 markers. Results: Among the different grades of OSF, we did not find any noticeable difference in VEGF expression although we found a upregulation in microvessel density (CD34) in early and moderately advanced OSF followed by a downregulation in advanced OSF. Conclusions: As the disease progresses, there is an increased production of the extracellular matrix component (collagen I and II and fibronectin) and results in fibrosis. Subsequently, it leads to the reduction in the level of corium vascularity and results in hypoxia which ultimately causes reduction and constriction of the vascular channels. This sequence of events alerts us to the relevance of early disease diagnosis and management in an irreversible pathology such as OSF.


Assuntos
Fibrose Oral Submucosa , Humanos , Imuno-Histoquímica , Mucosa Bucal , Neovascularização Patológica , Fator A de Crescimento do Endotélio Vascular
20.
Zhonghua Bing Li Xue Za Zhi ; 48(11): 846-850, 2019 Nov 08.
Artigo em Chinês | MEDLINE | ID: mdl-31775432

RESUMO

Objective: To investigate the clinicopathological characteristics and prognosis of renal cell carcinoma (RCC) in patients with end-stage renal disease (ESRD). Methods: The clinicopathological data of patients of renal cell carcinoma arising in end-stage renal disease were collected from the Affiliated Hospital of Qingdao University (ten cases) and 971 Hospital of PLA Navy (five cases) from January 2009 to August 2018. Results: Among 15 patients, 14 were male and 1 was female, and the age ranged from 38 to 78 years (mean 51 years, median 49 years). All patients had history of chronic renal failure (7-192 months), including 9 patients treated with hemodialysis for 6 to 132 months. In 12 cases the tumor border was distinct and the tumor size ranged from 1.8 to 11.0 cm. Two cases were multifocal and one case showed extensive renal hemorrhage with an inconspicuous tumor mass. Microscopically, 9 cases were clear cell reanl cell carcinoma including one with sarcomatoid differentiation, 4 were acquired cystic kidney disease-associated(ACKD-RCC) and two were papillary renal cell carcinoma. All patients had a follow-up of 3 to 120 months. Four patients died during a follow-up of 6 to 60 months (mean 30 months) as a result of extensive distant metastases (two cases) and renal failure (two cases), while other eleven patients were alive without tumor recurrence or metastasis (median 40.8 months of follow-up ranging from 3 to 120 months). Conclusions: ESRD-RCC is more often seen in younger male patients. The time intervals from the onset of chronic renal failure to the diagnosis of renal cell carcinoma differ and tumors are frequently incidental findings. The histological types can be sporadic renal cell carcinoma or unique ACKD-RCC. Tumors are often hemorrhagic and necrotic. Routine physical examination and early detection could benefit ESRD-RCC patients. ESRD-RCC may have a favorable prognosis despite of a large tumor size or the presence of sarcomatoid differentiation.


Assuntos
Carcinoma de Células Renais/patologia , Falência Renal Crônica/patologia , Neoplasias Renais/patologia , Adulto , Idoso , Feminino , Humanos , Imuno-Histoquímica , Masculino , Pessoa de Meia-Idade , Recidiva Local de Neoplasia , Nefrectomia , Prognóstico
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