Assuntos
Duodeno/diagnóstico por imagem , Tumores do Estroma Gastrointestinal/diagnóstico por imagem , Sarcoma de Ewing/diagnóstico por imagem , Antineoplásicos/uso terapêutico , Duodeno/patologia , Endoscopia , Tumores do Estroma Gastrointestinal/tratamento farmacológico , Humanos , Achados Incidentais , Masculino , Pessoa de Meia-Idade , RadiologiaRESUMO
Pancreatic ductal adenocarcinoma (PDA) is an aggressive malignant tumor with poor prognosis. Epidermal growth factor receptor (EGFR) is an important cell adhesion and signaling pathway mediator. The aim of this study was to evaluate the expression of EGFR in both pancreatic intraepithelial neoplasia (PanIN) and PDA and their relationship to clinicopathologic characteristics. Formalin-fixed, paraffin-embedded tissues including 81 cases with pancreatic ductal adenocarcinoma, 27 with normal pancreas, 16 with PanIN-1A, 18 with PanIN-1B, 11 with PanIN-2, and 24 with PanIN-3 were used for construction of tissue microarrays. Imunohistochemistry for EGFR was performed. Normal pancreatic ducts, PanIN-1A, and PanIN-1B did not show EGFR overexpression. EGFR overexpression was observed in 18.2% (2/9) of PanIN-2, 41.7% (10/14) of PanIN-3, and 64.2% (52/81) of PDA, respectively. Significantly higher EGFR overexpression was observed in PDAs than in PanIN lesions (P<0.05). No statistically significant correlation was observed between EGFR overexpression and patient age, sex, tumor location, size, histological grade, vascular invasion, lymph node metastasis and stage at presentation, respectively. In conclusion, EGFR expression increased from PanIN to PDA. EGFR may be involved in early stage in development of PDA.
Assuntos
Biomarcadores Tumorais/análise , Carcinoma in Situ/química , Carcinoma Ductal Pancreático/química , Receptores ErbB/análise , Neoplasias Pancreáticas/química , Carcinoma in Situ/mortalidade , Carcinoma in Situ/patologia , Carcinoma in Situ/terapia , Carcinoma Ductal Pancreático/mortalidade , Carcinoma Ductal Pancreático/patologia , Carcinoma Ductal Pancreático/terapia , Feminino , Humanos , Imuno-Histoquímica , Estimativa de Kaplan-Meier , Masculino , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Neoplasias Pancreáticas/mortalidade , Neoplasias Pancreáticas/patologia , Neoplasias Pancreáticas/terapia , Fatores de Tempo , Análise Serial de Tecidos , Resultado do Tratamento , Regulação para CimaRESUMO
Fluorescence in situ hybridization (FISH) can detect minor genetic changes that cytogenetic analysis may miss; however, there are few reports on the kinds of genetic changes that show large discrepancies between results obtained with FISH versus G-banding techniques. To investigate genetic changes that tend to be detected with FISH only, we compared the results of cytogenetic study and FISH analysis in 919 consecutive specimens from 304 patients with hematologic malignancies, covering most of the frequent genetic changes by using 18 types of FISH probes. The genetic changes with especially large discrepancy rates at diagnosis were del(7q) (20.0%), PML/RARA (17.6%), and trisomy 21 (12.5%) and, at follow-up, BCR/ABL (28.2%) and AML1/ETO (24.4%); the latter two showed only small discrepancies at diagnosis (4.7 and 4.8%, respectively). The overall discrepancy rate was 6.0% at diagnosis and 11.9% at follow-up, indicating generally greater discrepancy rates at follow-up. In all but one of the cases with discrepant results, G-banding missed the corresponding chromosomal abnormalities revealed with FISH. Considered by type of leukemia, the discrepancy rate at follow-up was higher in acute biphenoptypic leukemia (38%) and acute lymphoblastic leukemia (24.5%) than in acute myelogenous leukemia (10.6%). Given these results, all patients with known genetic changes should have FISH analysis in follow-up, for an accurate assessment of the likelihood of complete remission or recurrence. If this is not practical, then at a minimum FISH analysis should be done in follow-up for patients with genetic changes of BCR/ABL and AML1/ETO seen at diagnosis.
Assuntos
Bandeamento Cromossômico , Proteínas de Fusão bcr-abl/genética , Rearranjo Gênico , Neoplasias Hematológicas/genética , Proteínas de Fusão Oncogênica/genética , Fatores de Transcrição/genética , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Aberrações Cromossômicas , Subunidade alfa 2 de Fator de Ligação ao Core , Feminino , Neoplasias Hematológicas/diagnóstico , Humanos , Hibridização in Situ Fluorescente , Lactente , Masculino , Pessoa de Meia-Idade , Proteína 1 Parceira de Translocação de RUNX1RESUMO
We describe a 55-year-old woman who presented with pancytopenia with a normocytic and normochromic anemia which was progressive despite conventional treatments such as folic acid, vitamin B6, and oxymetholone. Her physical findings and history of a previous massive postpartum hemorrhage suggested Sheehan's syndrome, and the pituitary hormonal studies revealed panhypopituitarism. After 4 months of thyroxine and glucocorticoid replacement therapy, her pancytopenia and bone marrow hypoplasia recovered completely. Pancytopenia is a rare manifestation of a hormonal abnormality, but hematologists need to be aware of panhypopituitarism as a differential diagnosis when women showing features of hypopituitarism present with pancytopenia because it can be reversed with adequate hormone replacement.