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Farooq A, Abdelkader A, Javakhishivili N, Moreno GA, Kuderer P, Polley M, Hunt B, Giorgadze TA, Jorns JM. Assessing the value of second opinion pathology review. Int J Qual Health Care 2021; 33:6153784. [PMID: 33644816 DOI: 10.1093/intqhc/mzab032] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Revised: 02/09/2021] [Accepted: 02/26/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Second opinion review of pathology cases can identify diagnostic errors that impact patient care. OBJECTIVE We sought out to determine discrepancy rates and clinical impact of review of pathology cases to reassess our policy of review on all second opinion cases. METHODS All second opinion pathology cases over 1 year (2018) were retrospectively reviewed for discrepancy, multiple pathologist review and clinicopathologic features via chart and slide review. Cases were categorized as no significant discordance, major discordance without management change and major discordance with management change. RESULTS Among 4239 second opinion cases, 3.7% (156/4239) had major discordance with no change in management and 1% (42/4239) had major discordance with change in management. Discordance was significantly associated with multiple pathologist review at our institution (P < 0.001). Highest rates of discordance were observed for thyroid fine needle aspiration (15.3%, 26/170), tissue biopsy of bone/soft tissue (9.6%), endocrine (8.8%), genitourinary (6.7%), gynecologic (6.2%), hematopathology (4%), gastrointestinal/liver (3.7%) and thoracic (3%) sites. CONCLUSIONS Our study showed a 1% major discordance rate with resulting significant change in clinical management, spread across nearly all subspecialties. Thus, we support recommendations for review of relevant outside pathology material for all patients for which review has the potential to illicit management change such as instituting a major medical or surgical therapy.
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Affiliation(s)
- Ayesha Farooq
- Department of Pathology, Medical College of Wisconsin, 9200 W. Wisconsin Avenue, Lab Building, Lower Level, Room L69, Milwaukee, WI 53226, USA
| | - Amrou Abdelkader
- SC/ACL Laboratories, Great Lakes Pathologists, 8901 W Lincoln Avenue, West Allis, WI 53227, USA
| | | | - Gustavo A Moreno
- Department of Pathology, Medical College of Wisconsin, 9200 W. Wisconsin Avenue, Lab Building, Lower Level, Room L69, Milwaukee, WI 53226, USA
| | - Pilar Kuderer
- Department of Pathology, Medical College of Wisconsin, 9200 W. Wisconsin Avenue, Lab Building, Lower Level, Room L69, Milwaukee, WI 53226, USA
| | - Marisa Polley
- Department of Pathology, Medical College of Wisconsin, 9200 W. Wisconsin Avenue, Lab Building, Lower Level, Room L69, Milwaukee, WI 53226, USA
| | - Bryan Hunt
- Department of Pathology, Medical College of Wisconsin, 9200 W. Wisconsin Avenue, Lab Building, Lower Level, Room L69, Milwaukee, WI 53226, USA
| | - Tamar A Giorgadze
- Department of Pathology, Medical College of Wisconsin, 9200 W. Wisconsin Avenue, Lab Building, Lower Level, Room L69, Milwaukee, WI 53226, USA
| | - Julie M Jorns
- Department of Pathology, Medical College of Wisconsin, 9200 W. Wisconsin Avenue, Lab Building, Lower Level, Room L69, Milwaukee, WI 53226, USA
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Abstract
CONTEXT.— Fatty liver disease is now one of the most commonly encountered entities in the practice of liver pathology. Distinguishing simple steatosis from steatohepatitis is critical because the latter requires follow-up because of long-term risks that include cirrhosis and hepatocellular carcinoma. An organized approach for evaluating liver biopsies with steatosis is recommended to capture all of the relevant features: (1) degree of steatosis, (2) presence or absence of ballooning degeneration, (3) lobular inflammation, and (4) fibrosis. Herein, we provide a stepwise approach that readers can use to evaluate liver biopsies with steatosis, including examples, pitfalls, differential diagnostic considerations, and suggested diagnostic phrasing. OBJECTIVE.— To provide a stepwise approach for the evaluation of liver biopsies showing significant steatosis (involving ≥5% of liver parenchyma). DATA SOURCES.— Biopsies demonstrating fatty liver disease encountered in our daily practice were examined as well as recent literature. CONCLUSIONS.— Effective evaluation of liver biopsies with steatosis requires careful histologic examination and correlation with clinical history, particularly regarding medications, nutrition status, and alcohol use. Examples of uniform reporting, including appropriate use of the nonalcoholic steatohepatitis Clinical Research Network Activity Score, are provided.
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Affiliation(s)
- Mohamed Mostafa
- From the Department of Pathology, Medical College of Wisconsin, Milwaukee
| | - Amrou Abdelkader
- From the Department of Pathology, Medical College of Wisconsin, Milwaukee
| | - John J Evans
- From the Department of Pathology, Medical College of Wisconsin, Milwaukee
| | - Catherine E Hagen
- From the Department of Pathology, Medical College of Wisconsin, Milwaukee
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Abdelkader A, Hunt B, Hartley CP, Panarelli NC, Giorgadze T. Cystic Lesions of the Pancreas: Differential Diagnosis and Cytologic-Histologic Correlation. Arch Pathol Lab Med 2019; 144:47-61. [PMID: 31538798 DOI: 10.5858/arpa.2019-0308-ra] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
CONTEXT.— Pancreatic cystic lesions (PCLs) are very common, and their detection is increasing with the advances in imaging techniques. Because of the major implications for management, distinguishing between neoplastic and nonneoplastic PCLs is critical. Neoplastic cysts with potential to progress into cancer include mucinous PCLs (intraductal papillary mucinous neoplasms and mucinous cystic neoplasms) and nonmucinous cysts (solid pseudopapillary tumors, serous cystic neoplasms, and neuroendocrine tumors with cystic degeneration). Nonneoplastic cysts with no risk of malignant transformation include pseudocysts, retention cysts, lymphoepithelial cysts, cystic pancreatic lymphangioma, and duplication cyst/ciliated foregut cysts. The role of endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) cytology with cyst fluid analysis in the diagnosis of PCLs has evolved during the last decade; however, a definitive diagnosis on cytologic specimens is hampered by the sparse cellularity and can be challenging. EUS-FNA can play an important role to differentiate low-risk from high-risk pancreatic cysts and to distinguish between patients with cysts who need clinical follow-up versus those who require surgery. OBJECTIVE.— To provide an integrative approach to diagnose pancreatic cystic lesions using EUS-FNA cytology and cyst fluid analysis, along with clinical, radiologic, histologic, genetic, and molecular characteristics. DATA SOURCES.— The review and analysis of the latest literature describing pancreatic cystic lesions. CONCLUSIONS.— Accurate diagnosis of PCLs requires a multidisciplinary and multimodal team approach, including the integration of clinical findings, imaging, cytology, cyst fluid analysis, and molecular testing.
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Affiliation(s)
- Amrou Abdelkader
- From the Department of Pathology, Medical College of Wisconsin, Milwaukee (Drs Abdelkader, Hunt, Hartley, and Giorgadze); and the Department of Pathology, Albert Einstein College of Medicine, The Bronx, New York (Dr Panarelli)
| | - Bryan Hunt
- From the Department of Pathology, Medical College of Wisconsin, Milwaukee (Drs Abdelkader, Hunt, Hartley, and Giorgadze); and the Department of Pathology, Albert Einstein College of Medicine, The Bronx, New York (Dr Panarelli)
| | - Christopher P Hartley
- From the Department of Pathology, Medical College of Wisconsin, Milwaukee (Drs Abdelkader, Hunt, Hartley, and Giorgadze); and the Department of Pathology, Albert Einstein College of Medicine, The Bronx, New York (Dr Panarelli)
| | - Nicole C Panarelli
- From the Department of Pathology, Medical College of Wisconsin, Milwaukee (Drs Abdelkader, Hunt, Hartley, and Giorgadze); and the Department of Pathology, Albert Einstein College of Medicine, The Bronx, New York (Dr Panarelli)
| | - Tamara Giorgadze
- From the Department of Pathology, Medical College of Wisconsin, Milwaukee (Drs Abdelkader, Hunt, Hartley, and Giorgadze); and the Department of Pathology, Albert Einstein College of Medicine, The Bronx, New York (Dr Panarelli)
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Abdelkader A, Elshorbagy A, Tuninetti M, Laio F, Ridolfi L, Fahmy H, Hoekstra AY. National water, food, and trade modeling framework: The case of Egypt. Sci Total Environ 2018; 639:485-496. [PMID: 29800842 PMCID: PMC6021596 DOI: 10.1016/j.scitotenv.2018.05.197] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/13/2018] [Revised: 05/15/2018] [Accepted: 05/15/2018] [Indexed: 05/20/2023]
Abstract
This paper introduces a modeling framework for the analysis of real and virtual water flows at national scale. The framework has two components: (1) a national water model that simulates agricultural, industrial and municipal water uses, and available water and land resources; and (2) an international virtual water trade model that captures national virtual water exports and imports related to trade in crops and animal products. This National Water, Food & Trade (NWFT) modeling framework is applied to Egypt, a water-poor country and the world's largest importer of wheat. Egypt's food and water gaps and the country's food (virtual water) imports are estimated over a baseline period (1986-2013) and projected up to 2050 based on four scenarios. Egypt's food and water gaps are growing rapidly as a result of steep population growth and limited water resources. The NWFT modeling framework shows the nexus of the population dynamics, water uses for different sectors, and their compounding effects on Egypt's food gap and water self-sufficiency. The sensitivity analysis reveals that for solving Egypt's water and food problem non-water-based solutions like educational, health, and awareness programs aimed at lowering population growth will be an essential addition to the traditional water resources development solution. Both the national and the global models project similar trends of Egypt's food gap. The NWFT modeling framework can be easily adapted to other nations and regions.
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Affiliation(s)
- A Abdelkader
- Department of Civil, Geological, and Environmental Engineering, University of Saskatchewan, Saskatoon, Canada.
| | - A Elshorbagy
- Department of Civil, Geological, and Environmental Engineering, University of Saskatchewan, Saskatoon, Canada; Global Institute for Water Security, University of Saskatchewan, Saskatoon, Canada
| | - M Tuninetti
- Department of Environmental, Land, and Infrastructure Engineering, Politecnico di Torino, Torino, Italy
| | - F Laio
- Department of Environmental, Land, and Infrastructure Engineering, Politecnico di Torino, Torino, Italy
| | - L Ridolfi
- Department of Environmental, Land, and Infrastructure Engineering, Politecnico di Torino, Torino, Italy
| | - H Fahmy
- National Water Research Centre, Ministry of water Resources & Irrigation, Egypt
| | - A Y Hoekstra
- Twente Water Centre, University of Twente, Enschede, The Netherlands; Institute of Water Policy, Lee Kuan Yew School of Public Policy, National University of Singapore, Singapore
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Fahmy MD, Gupta A, Abdelkader A, MacKinney T, Sewall S. Clinical pathologic conference: acute onset malocclusion and facial pain. Oral Surg Oral Med Oral Pathol Oral Radiol 2018; 126:301-306. [DOI: 10.1016/j.oooo.2017.04.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2017] [Revised: 04/07/2017] [Accepted: 04/17/2017] [Indexed: 11/24/2022]
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Clover T, Abdelkader A, Guru Murthy GS. Transformation of a non-secretory neuroendocrine tumor to insulinoma after treatment with Sunitinib: A case report and review of the literature. J Oncol Pharm Pract 2018; 25:1516-1519. [PMID: 30089432 DOI: 10.1177/1078155218791309] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
We report a case of a non-secretory neuroendocrine tumor which transformed into an insulin secreting tumor after treatment with Sunitinib. To our knowledge, this has only been described in three other cases worldwide. Previously reported case series find transformation of non-secretory neuroendocrine cancers into secretory lesions occurs in 3.4-6.8% of cases. Sunitinib is known to have the potential to lower blood glucose and induce epigenetic changes in cells of various types. We hypothesize that the mechanism for Sunitinib-induced transformation in cancer phenotype is through epigenetic changes in DNA expression within the tumor cells.
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Affiliation(s)
- Todd Clover
- 1 Department of Medicine, Division of Hematology and Oncology, Medical College of Wisconsin, Milwaukee, USA.,2 Department of Pathology, Medical College of Wisconsin, Milwaukee, USA
| | - Amrou Abdelkader
- 1 Department of Medicine, Division of Hematology and Oncology, Medical College of Wisconsin, Milwaukee, USA.,2 Department of Pathology, Medical College of Wisconsin, Milwaukee, USA
| | - Guru Subramanian Guru Murthy
- 1 Department of Medicine, Division of Hematology and Oncology, Medical College of Wisconsin, Milwaukee, USA.,2 Department of Pathology, Medical College of Wisconsin, Milwaukee, USA
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Abdelkader A, Olteanu H. Clinical and pathologic features of Philadelphia chromosome-like acute lymphoblastic leukemia in a pediatric patient. Arch Clin Cases 2018. [DOI: 10.22551/2018.19.0502.10127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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8
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Mostafa ME, Abdelkader A, Kuroda N, Pérez-Montiel D, Banerjee A, Hes O, Iczkowski KA. Variation in nuclear size and PD-L2 positivity correlate with aggressive chromophobe renal cell carcinoma. Ann Diagn Pathol 2018; 34:31-35. [PMID: 29661724 DOI: 10.1016/j.anndiagpath.2018.01.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2018] [Accepted: 01/08/2018] [Indexed: 01/12/2023]
Abstract
Chromophobe renal cell carcinoma (CRCC) is not amenable to International Society for Urologic Pathology-endorsed nucleolar grading. Novel grading approaches were proposed, but the rarity of adverse pathology hampers their discriminatory value. We investigate simple linear micrometer measurements and a proposed immunostain in CRCCs. 32 patients' CRCCs were studied: 12 adverse cases (stage pT3, recurrence, or metastasis), 15 controls (stage ≤pT2, no recurrence or metastasis after >3 years), and 8 metastases (3 were paired with primary adverse cases). The ratio of greatest dimensions of largest and smallest nuclei, in each of 5 "worst" high-power fields, excluding those with degenerative features, was designated variation in nuclear size (VNS). Percent multinucleate cells (PMC) were also counted. Mouse anti PD-L2 monoclonal antibody immunostaining was performed. Mean VNS measured in adverse primary and control primary tumors were 3.7 ± 0.5 and 2.4 ± 0.4 respectively (P < .001), and 3.4 ± 0.4 for metastases (P < .001). Optimal VNS cut-off was 2.5, with sensitivity and specificity 0.85 and 0.81, respectively. PMCs were 6.0 ± 3.0 for adverse group, 5.7 ± 2.7 for controls, and 4.1 ± 1.6 for metastases (P = NS). PD-L2 could not discriminate adverse versus good primary tumors (χ21.6, P = .2), but was higher in metastases (χ2 6.9, P < .01), or metastases plus adverse primary tumors (χ2 4.8, P = .03), compared to good-pathology primary tumors. In conclusion, VNS is an easily obtained measurement that can predict adverse behavior of chromophobe RCC, and may impart value for needle biopsy reporting and the choice of active surveillance. PD-L2 was elevated in metastases but was less useful for primary tumors.
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Affiliation(s)
- Mohamed E Mostafa
- Department of Pathology, Medical College of Wisconsin, Milwaukee, WI, United States
| | - Amrou Abdelkader
- Department of Pathology, Medical College of Wisconsin, Milwaukee, WI, United States
| | - Naoto Kuroda
- Department of Diagnostic Pathology, Kochi Red Cross Hospital, Japan
| | - Delia Pérez-Montiel
- Department of Pathology, Instituto Nacional de Cancerologia, Mexico, D.F., Mexico
| | - Anjishnu Banerjee
- Department of Biostatistics, Medical College of Wisconsin, Milwaukee, WI, United States
| | - Ondrej Hes
- Department of Pathology, Charles University, Faculty of Medicine in Plzeň, Czechia
| | - Kenneth A Iczkowski
- Department of Pathology, Medical College of Wisconsin, Milwaukee, WI, United States.
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Abdelkader A, Jorns JM. Pleomorphic Lobular Carcinoma: A Controversially Aggressive Variant of Invasive Lobular Carcinoma of the Breast. Int J Surg Pathol 2017; 26:434-436. [DOI: 10.1177/1066896917744878] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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10
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Ahmed Ali M, Mikhael ES, Abdelkader A, Mansour L, El Essawy R, El Sayed R, Eladawy A, Mukhtar A. Interleukin-17 as a predictor of sepsis in polytrauma patients: a prospective cohort study. Eur J Trauma Emerg Surg 2017; 44:621-626. [PMID: 28916848 DOI: 10.1007/s00068-017-0841-3] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2017] [Accepted: 09/14/2017] [Indexed: 01/09/2023]
Abstract
Sepsis is one of the most serious complications after major trauma, and may be associated with increased mortality. We sought to determine whether there is an association between serum levels of interleukin-17 (IL-17) at the time of admission to the intensive care unit (ICU) and the development of sepsis. We evaluated 100 adult patients with major trauma admitted to the surgical ICU over a 6-month period. Serum levels of IL-17, IL-6, and TNF-α were determined by enzyme-linked immunosorbent assays (ELISA). The IL-17 rs1974226 genotype was determined by real-time PCR. In both non-adjusted and adjusted analyses, IL-17 was the only biomarker significantly associated with sepsis [median serum IL-17 of 72 pg/mL in sepsis versus 37 pg/mL in those without sepsis, P = 0.0001; adjusted odds ratio (OR) 3.2, P = 0.02]. No significant association was found among IL-17 rs1974226 genotypes and related serum cytokine levels. These data suggest that elevated serum IL-17 may increase the susceptibility for septic complications in polytrauma patients and so could be a useful biomarker for trauma patient management.
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Affiliation(s)
- M Ahmed Ali
- Department of Anesthesia, Faculty of Medicine, Cairo University, 1 Al-Saray Street, Al-Manial, Cairo, 11559, Egypt.
| | - E S Mikhael
- Department of Clinical and Chemical Pathology, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - A Abdelkader
- Department of Anesthesia, Faculty of Medicine, Cairo University, 1 Al-Saray Street, Al-Manial, Cairo, 11559, Egypt
| | - L Mansour
- Department of Clinical and Chemical Pathology, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - R El Essawy
- Department of Clinical and Chemical Pathology, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - R El Sayed
- Department of Clinical and Chemical Pathology, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - A Eladawy
- Department of Anesthesia, Faculty of Medicine, Cairo University, 1 Al-Saray Street, Al-Manial, Cairo, 11559, Egypt
| | - A Mukhtar
- Department of Anesthesia, Faculty of Medicine, Cairo University, 1 Al-Saray Street, Al-Manial, Cairo, 11559, Egypt
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Ronen S, Abbott DW, Kravtsov O, Abdelkader A, Xu Y, Banerjee A, Iczkowski KA. PTEN loss and p27 loss differ among morphologic patterns of prostate cancer, including cribriform. Hum Pathol 2017; 65:85-91. [PMID: 28504208 DOI: 10.1016/j.humpath.2017.04.024] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2017] [Revised: 04/18/2017] [Accepted: 04/29/2017] [Indexed: 12/31/2022]
Abstract
The presence and extent of cribriform pattern of prostate cancer portend recurrence and cancer death. The relative expressions within this morphology of the prognostically adverse loss of PTEN, and the downstream inactivation of cell cycle inhibitor p27/Kip1 had been uncertain. In this study, we examined 52 cases of cribriform cancer by immunohistochemistry for PTEN, p27, and CD44 variant (v)7/8, and a subset of 17 cases by chromogenic in situ hybridization (ISH) using probes for PTEN or CDKN1B (gene for p27). The fractions of epithelial pixels positive by immunohistochemistry and ISH were digitally assessed for benign acini, high-grade prostatic intraepithelial neoplasia, and 8 morphologic patterns of cancer. Immunostaining results demonstrated that (1) PTEN loss was significant for fused small acini, cribriform-central cells, small cribriform acini, and Gleason grade 5 cells in comparison with other acini; (2) p27 loss was significant only for cribriform-peripheral cells and borderline significant for fused small acini in comparison with benign acini; and (3) CD44v7/8 showed expression loss in cribriform-peripheral cells; other comparisons were not significant. ISH showed that cribriform cancer had significant PTEN loss normalized to benign acini (P<.02), whereas Gleason 3 cancer or fused small acini did not. With CDKN1B, the degree of signal loss among various cancer morphologies was insignificant. In conclusion, molecular disparities emerged between the fused small acini and cribriform patterns of Gleason 4 cancer. PTEN or p27 loss as prognostic factors demands distinct assessment in the varieties of Gleason 4 cancer, and in the biphenotypic peripheral versus central populations in cribriform structures.
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Affiliation(s)
- Shira Ronen
- Department of Pathology, Medical College of Wisconsin, Milwaukee, WI 53226, USA
| | - Daniel W Abbott
- Department of Pathology, Medical College of Wisconsin, Milwaukee, WI 53226, USA
| | - Oleksandr Kravtsov
- Department of Pathology, Medical College of Wisconsin, Milwaukee, WI 53226, USA
| | - Amrou Abdelkader
- Department of Pathology, Medical College of Wisconsin, Milwaukee, WI 53226, USA
| | - Yayun Xu
- Department of Biostatistics, Medical College of Wisconsin, Milwaukee, WI 53226, USA
| | - Anjishnu Banerjee
- Department of Biostatistics, Medical College of Wisconsin, Milwaukee, WI 53226, USA
| | - Kenneth A Iczkowski
- Department of Pathology, Medical College of Wisconsin, Milwaukee, WI 53226, USA.
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Abdelkader A, Lam CA, Shahir KS, Christians K, Suster SM. Retroperitoneal lymphangioleiomyoma with lymph node involvement: A pathologic-radiologic correlation of a rare form of myomelanocytic tumor. Ann Diagn Pathol 2017; 27:69-73. [DOI: 10.1016/j.anndiagpath.2017.01.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2017] [Accepted: 01/29/2017] [Indexed: 12/12/2022]
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Gonzalez Martin J, Carrion O, Abdelkader A, Calvo E, Valero M, Rodriguez S, Amil I, Marin C, Sangüesa C, Ruiz L, Aramburu F, Sainz F, Garcia de la Peña P. SAT0233 Descriptive Study of Cardiovascular Risk Factors and Endothelial Disfunction in Patients Diagnosed with Scleroderma and Mixed Conective Tissue Disease. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.6125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Calvo Aranda E, Carriόn O, Abdelkader A, González J, Aramburu F, Valero M, Rodriguez S, Marin C, Sangüesa C, Amil I, Saiz F, García de la Peña P. THU0506 Cardiovascular Risk and Endothelial Dysfunction in Patients with Gout: Experience in A Multihospital spanish Group. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.5965] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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15
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Abdelkader A, El-Sayed MAA, Eladawy A, Elsayed R, Mukhtar A, Hammimy W. Interleukin-17a as a predictor of occurrence of sepsis in polytrauma patients: a prospective observational study. Intensive Care Med Exp 2015. [PMCID: PMC4798419 DOI: 10.1186/2197-425x-3-s1-a790] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Nouri H, Ben Maitigue M, Abid L, Nouri N, Abdelkader A, Bouaziz M, Mestiri M. Surface osteosarcoma: Clinical features and therapeutic implications. J Bone Oncol 2015; 4:115-23. [PMID: 26730360 PMCID: PMC4678793 DOI: 10.1016/j.jbo.2015.07.002] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2015] [Accepted: 07/17/2015] [Indexed: 10/28/2022] Open
Abstract
INTRODUCTION Surface osteosarcoma are rare variant of osteosarcoma that include parosteal osteosarcoma, periosteal osteosarcoma and high grade surface osteosarcoma. These lesions have different clinical presentation and biological behavior compared to conventional osteosarcoma, and hence need to be managed differently. GOAL The aim of this study is to analyze the clinico-pathological features and outcome of a series of surface osteosarcoma in an attempt to define the adequate treatment of this rare entity. PATIENT AND METHOD It is a retrospective and bicentric study of 18 surface osteosarcoma that were seen at the KASSAB's Institute and SAHLOUL Hospital from 2006 to 2013. The authors reviewed the clinical and radiologic features, histologic sections, treatments, and outcomes in this group of patients. RESULTS Seven patients were male (38.9%) and 11 were female (61.1%) with mean age of 25 years (range from 16 to 55 years). Eleven lesions were in the femur and 7 in the tibia. We identified 11 parosteal osteosarcoma (six of them were dedifferentiated), 3 periosteal osteosarcoma and 4 high grade surface osteosarcoma. Six patients had neoadjuvant chemotherapy and all lesions had surgical resection. Margins were wide in 15 cases and intra lesional in 3 cases. Histological response to chemotherapy was poor in all cases. The mean follow up was 34.5 months. Six patients (33.3%) presented local recurrence and 8 patients (44.4%) presented lung metastases. Six patients (33.3%) died from the disease after a mean follow up of 12 months (6-30 months); all of them had high grade lesions. CONCLUSION Histological grade of malignancy is the main point to assess in surface osteosarcoma since it determines treatment and prognosis. Low grade lesions should be treated by wide resection, while high grade lesions need more aggressive surgical approach associated to post operative chemotherapy.
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Affiliation(s)
- H Nouri
- Department of Adult Surgery, KASSAB's Orthopedic Institute, University El Manar II, Tunisia
| | - M Ben Maitigue
- Department of Orthopedic Surgery, SAHLOUL's Hospital, University of SOUSSE, Tunisia
| | - L Abid
- Department of Pathology, KASSAB's Orthopedic Institute, University El Manar II, Tunisia
| | - N Nouri
- Department of Radiology, KASSAB's Orthopedic Institute, University El Manar II, Tunisia
| | - A Abdelkader
- Department of Pathology, SAHLOUL's Hospital, University of SOUSSE, Tunisia
| | - M Bouaziz
- Department of Radiology, KASSAB's Orthopedic Institute, University El Manar II, Tunisia
| | - M Mestiri
- Department of Adult Surgery, KASSAB's Orthopedic Institute, University El Manar II, Tunisia
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Colombaro V, Decleves AE, Voisin V, Giordano L, Jadot I, Habsch I, Flamion B, Caron N, Ngo JP, Kett M, Pearson J, Smith D, Abdelkader A, Kar S, Bertram J, Gardiner B, Evans R, Emans TW, Ow CP, Joles JA, Evans RG, Malpas SC, Koeners MP, Dube GR, Campos-Bilderback SB, Sandoval RM, Bosukonda D, Keck P, Leger R, Bey P, Carlson W, Molitoris BA, Cernaro V, Sfacteria A, Lucisano S, Lupica R, Bruzzese AM, Aloisi C, Montuori F, Lorenzano G, Visconti L, Buemi M. EXPERIMENTAL ISCHEMIA. Nephrol Dial Transplant 2014. [DOI: 10.1093/ndt/gfu135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Vogl T, Zangos S, Engels K, Abdelkader A. Transarterielle Chemoembolisation (TACE) beim hepatozellulären Karzinom (HCC): palliative, kurative, neoadjuvante und symptomatische Therapieoptionen. ROFO-FORTSCHR RONTG 2010. [DOI: 10.1055/s-0030-1252679] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Ghomi A, Abdelkader A, Einarsson J. Laparoscopic-Assisted Vaginal Hysterectomy Versus Laparoscopic Supracervical Hysterectomy for the Non-Prolapsed Uterus. J Minim Invasive Gynecol 2008. [DOI: 10.1016/j.jmig.2008.09.034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Vogl TJ, Zangos S, Balzer JO, Nabil M, Rao P, Eichler K, Bechstein WO, Zeuzem S, Abdelkader A. [Transarterial chemoembolization (TACE) in hepatocellular carcinoma: technique, indication and results]. ROFO-FORTSCHR RONTG 2008; 179:1113-26. [PMID: 17948190 DOI: 10.1055/s-2007-963285] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
UNLABELLED To present current data on technique, indications and results of transarterial chemoembolization (TACE) for hepatocellular carcinoma (HCC). The principle of TACE is the intra-arterial injection of chemotherapeutic drug combinations like doxorubicin, cisplatin and mitomycin into the hepatic artery, followed by lipiodol injection, Gelfoam for vessel occlusion and degradable microspheres. The side effects and complications after TACE range from fever, upper abdominal pain and vomiting to acute or chronic liver cell failure. The palliative effect in unresectable HCC using TACE allows local tumor control in 15 to 60% of cases and 5-year survival rates ranging from 8-43%. The potentially curative treatment option allows local tumor control from 18-63%. The neoadjuvant treatment option of TACE in combination with other treatment options like percutaneous ethanol injection (PEI) or radiofrequency ablation (RFA) reach local tumor control rates between 80-96%. The bridging effect of TACE before liver transplantation reaches 5-year survival rates from 59-93%. The symptomatic therapy option of TACE is used to counteract pain directly caused by HCC and acute/subacute bleeding in the HCC. The local tumor response reaches up to 88% and the bleeding control is from 83 to 100%. CONCLUSION TACE is a potentially curative, palliative, neoadjuvant, bridging and symptomatic therapy option for local and diffuse HCC.
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Affiliation(s)
- T J Vogl
- Institut für Diagnostische und Interventionelle Radiologie, J. W. Goethe-Universität, Frankfurt.
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el-Badramany MH, Farag TI, al-Awadi SA, Hammad IM, Abdelkader A, Murthy DS. Familial manic-depressive illness with deleted short arm of chromosome 21: coincidental or causal? Br J Psychiatry 1989; 155:856-7. [PMID: 2620216 DOI: 10.1192/bjp.155.6.856] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
A 35-year-old Arab lady and her mother, both with bipolar manic-depressive illness and 46,XX,21p-(pcen----pter), are reported. The clinical significance of this association is considered.
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