1
|
Gonzalez MF, Akhtar I. Hyalinising clear cell carcinoma with a novel fusion gene: Insights into the diagnosis. Cytopathology 2023; 34:611-616. [PMID: 37555501 DOI: 10.1111/cyt.13286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 01/04/2023] [Revised: 06/08/2023] [Accepted: 07/24/2023] [Indexed: 08/10/2023]
Abstract
Hyalinising clear cell carcinoma (HCCC) is a rare salivary gland neoplasm characterised by an EWSR1::ATF1 fusion. Rare cases showing EWSR1::CREB1 rearrangements have been reported. This article presents a case of HCCC with a novel EWSR1-CREB1 fusion, diffuse eosinophilic appearance, novel cytomorphological findings, PAS-negativity, and late regional and distant lymph node metastases.
Collapse
Affiliation(s)
- Maria F Gonzalez
- Temple University Hospital and Lewis Katz School of Medicine, Philadelphia, Pennsylvania, USA
| | - Israh Akhtar
- Temple University Hospital and Lewis Katz School of Medicine, Philadelphia, Pennsylvania, USA
| |
Collapse
|
2
|
Lazim A, Akhtar I, Rong Y, Arriola A, Mollaee M. A Rare Presentation of Thoracic Intramedullary Chordoma with Adjacent Bone Involvement: A Case Report and Review of the Literature. Am J Clin Pathol 2022. [DOI: 10.1093/ajcp/aqac126.069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
Abstract
Introduction/Objective
Chordoma originates from remnants of the embryonal notochord, and arise in bones anywhere along the spine and skull base. The most common location was thought to be the sacrum, followed by the clivus, and to a much lesser extent the rest of the spine. However, some studies have suggested an equal distribution among the skull base (32%), mobile spine (32.8%), and sacro-coccygeal bones (29.2%). Here we report a case of chordoma involving the thoracic spine. at the level of T2.
Methods/Case Report
A 63-year-old male with no significant past medical history who presented with 5-6 months of intermittent, bilateral lower extremity weakness and numbness in the trunk and lower extremities. MRI of the thoracic spine demonstrated a contrast enhancing mass at T2 vertebral level with spinal cord compression and adjacent bone destruction. T1-3 laminectomy with debulking of the tumor was performed. Microscopically, the tumor cells have a lobulated architecture and are composed of epithelioid cells arranged in cords, clusters or nests, embedded in a myxoid mucinous matrix. The epithelioid cells have a variably vacuolated cytoplasm ("physaliphorous" cells). The epithelioid cells are positive for CK AE1/3, Cam5.2, EMA and Brachyury (nuclear stain), and S100 (focal). These findings support a diagnosis of chordoma.
Results (if a Case Study enter NA)
N/A.
Conclusion
The most important and difficult differential diagnosis of chordoma is with well-differentiated chondrosarcoma. Although both chordomas and chondrosarcomas express S100, chondrosarcomas do not express cytokeratins, EMA or brachyury. Chordomas have an aggressive clinical course and poor outcome with local extension, recurrence and even metastasis. The treatment is en block surgical resection with adjuvant radiotherapy. The extent of the initial surgical resection is the most significant prognostic factor.
Collapse
Affiliation(s)
- A Lazim
- Pathology, Temple University Hospital , Philadelphia, Pennsylvania , United States
| | - I Akhtar
- Pathology, Temple University Hospital , Philadelphia, Pennsylvania , United States
| | - Y Rong
- Pathology, Temple University Hospital , Philadelphia, Pennsylvania , United States
| | - A Arriola
- Pathology, Temple University Hospital , Philadelphia, Pennsylvania , United States
| | - M Mollaee
- Pathology, Temple University Hospital , Philadelphia, Pennsylvania , United States
| |
Collapse
|
3
|
Zenezan D, Tabet G, Mollaee M, Akhtar I. Pulmonary Sclerosing Pneumocytoma; A Frozen Section Diagnostic Dilemma. Am J Clin Pathol 2022. [DOI: 10.1093/ajcp/aqac126.326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Introduction/Objective
Pulmonary Sclerosing Pneumocytoma (PSP)is a benign neoplasm with features of pneumocytic differentiation and dual-cell population. It is a rare tumor of adults with female predilection. The tumor is mostly asymptomatic. However, it can rarely show pleural invasion or lymph node metastasis. Presenting as a mass lesion by imaging studies frequently mandates a frozen section, which can be extremely challenging, and misdiagnosed as lung adenocarcinoma. We report a case of PSP with focal visceral pleural invasion that was submitted for frozen section.
Methods/Case Report
We report a case of a 57- year old female found to have a 2.5 cm nodule of the right lower lobe of lung on the CT scan. The patient underwent a wedge resection and the specimen was sent for intraoperative diagnosis. Sectioning revealed a firm, tan-white lesion measuring 2.1 x 2.0 x 1.1 cm. Frozen section diagnosis was suggestive of lepidic pattern adenocarcinoma with areas of fibrosis. Respectively, permanent section of the lesion revealed sheets of bland appearing cuboidal cells lining the papillary and sclerotic areas with round, bland appearing cells within the stroma. A few cells showed mild cytologic atypia with occasional prominent nucleoli and scattered mitotic figures were noted, besides visceral pleural invasion. Foci of atypical adenomatous hyperplasia were noted in close vicinity raising the suspicion of lepidic pattern adenocarcinoma on frozen section.The immunohistochemical staining was positive for Napsin, keratin, and CK7 in the surface cells but not in the round cells and EMA immunostain highlighted the surface cells and scattered round cells. Additional immunostains showed expression of estrogen receptor in the round cell component and TTF1 in both the round and surface components. The immunoprofile further supported the diagnosis of PSP and the elastic stain highlighted the visceral pleural involvement. Combined morphology and immunoprofile supported the diagnosis of PSP.
Results (if a Case Study enter NA)
NA
Conclusion
PSP is a rare benign neoplasm. It is important to recognize this challenging entity during intraoperative diagnosis as it can be easily mistaken for lung adenocarcinoma, especially in the presence of pleural invasion. The best treatment is still surgery for this neoplasm.
Collapse
Affiliation(s)
- D Zenezan
- Pathology , Temple , Philadelphia, Pennsylvania , United States
| | - G Tabet
- Pathology , Temple , Philadelphia, Pennsylvania , United States
| | - M Mollaee
- Pathology , Temple , Philadelphia, Pennsylvania , United States
| | - I Akhtar
- Pathology , Temple , Philadelphia, Pennsylvania , United States
| |
Collapse
|
4
|
Senitko M, Oberg CL, Abraham GE, Hillegass WB, Akhtar I, Folch E. Microwave Ablation for Malignant Central Airway Obstruction: A Pilot Study. Respiration 2022; 101:666-674. [PMID: 35316812 PMCID: PMC9393822 DOI: 10.1159/000522544] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Accepted: 02/07/2022] [Indexed: 11/19/2022] Open
Abstract
Background Malignant central airway obstruction (CAO) is a debilitating complication of primary lung cancer and pulmonary metastases. Therapeutic bronchoscopy is used to palliate symptoms and/or bridge to further therapy. Microwave ablation (MWA) heats tissue by creating an electromagnetic field around an ablation device. We present a pilot study utilizing endobronchial MWA via flexible bronchoscopy as a novel modality for the management of malignant CAO. Methods Therapeutic bronchoscopy with a flexible MWA probe was performed in 8 cases. We reviewed tumor size, previous ablative techniques, number of applications, ablation time, amount of energy delivered, rate of successful recanalization, complications, and 30-day follow-up. Results Successful airway recanalization was achieved in all cases. No complications were noted. In 1 case, tumor in-growth within a silicone stent was ablated with no damage to the stent. Discussion Endobronchial MWA is a novel technique for tumor destruction while maintaining an airway axis. The oven effect and air gap around a tumor allow for safe and effective tissue devitalization and hemostasis without a thermal effect on structures surrounding the airway.
Collapse
Affiliation(s)
- Michal Senitko
- Division of Pulmonary, Critical Care, and Sleep Medicine, University of Mississippi Medical Center, Jackson, Mississippi, USA.,Division of Cardiothoracic Surgery, University of Mississippi Medical Center, Jackson, Mississippi, USA
| | - Catherine L Oberg
- Division of Pulmonary, Critical Care Medicine, Clinical Immunology, and Allergy, David Geffen School of Medicine at UCLA, Los Angeles, California, USA
| | - George E Abraham
- Division of Pulmonary, Critical Care, and Sleep Medicine, University of Mississippi Medical Center, Jackson, Mississippi, USA
| | - William B Hillegass
- Departments of Data Science and Medicine, University of Mississippi Medical Center, Jackson, Mississippi, USA
| | - Israh Akhtar
- Department of Pathology, University of Mississippi Medical Center, Jackson, Mississippi, USA.,Department of Pathology and Laboratory Medicine, Temple University Health System, Philadelphia, Pennsylvania, USA
| | - Erik Folch
- Division of Pulmonary and Critical Care Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA
| |
Collapse
|
5
|
Kretschmer P, Akhtar I, Aneja A. Educational Case: Immune and inflammatory diseases: A case of pulmonary sarcoidosis. Acad Pathol 2022; 9:100012. [PMID: 35600748 PMCID: PMC9115718 DOI: 10.1016/j.acpath.2022.100012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Revised: 09/22/2021] [Accepted: 12/24/2021] [Indexed: 11/17/2022] Open
|
6
|
Laharwani H, Prakash V, Walley D, Akhtar I. DFSP of the Breast: Histomorphological, Immunohistochemical, and Molecular Features of a Rare Case in an Unusual Location. Appl Immunohistochem Mol Morphol 2021; 29:e73-e82. [PMID: 34282067 DOI: 10.1097/pai.0000000000000935] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Accepted: 02/12/2021] [Indexed: 11/26/2022]
Abstract
We present a case of a 21-year-old female with a vague nontender mass in the lower inner quadrant of the left breast discovered incidentally on chest imaging following trauma. A breast ultrasound demonstrated an 8×6×8 mm irregular hyperechoic mass at the 7 o'clock position of the left breast, 9 cm from the nipple. The mass was graded Breast Imaging Reporting and Data System (BI-RADS) category 4 (suspicious finding). An ultrasound-guided biopsy of the mass showed a proliferation of monotonous spindled cells in a storiform pattern with tapered nuclei with infiltration into the adipose tissue. No normal breast elements were identified in the biopsy. Myofibroblastoma was the first differential diagnosis; however, the characteristic infiltrative pattern of the tumor mandated additional tests including fluorescence in situ hybridization to rule out a dermatofibrosarcoma protruberance (DFSP). Immunohistochemical staining showed positive staining for CD34, which can be positive in myofibroblastoma also. However, fluorescence in situ hybridization demonstrated a platelet-derived growth factor B (22q13.1) gene rearrangement confirming a diagnosis of DFSP. The patient underwent a wide local excision of the DFSP for definitive treatment. She is doing well with no recurrence reported so far, after 15 months of follow-up. Conventional DFSP does not metastasize but is prone to recurrence making wide margins imperative for definitive treatment.
Collapse
Affiliation(s)
- Hansini Laharwani
- Department of Pathology, University of Mississippi Medical Center, Jackson, MS
| | | | | | | |
Collapse
|
7
|
Manucha V, Gonzalez MF, Akhtar I. Analysis of the risk of malignancy associated with the basaloid and oncocytic subtypes of the salivary gland neoplasm of unknown malignant potential (SUMP) category in the Milan system. Cancer Cytopathol 2021; 129:603-611. [PMID: 33788998 DOI: 10.1002/cncy.22427] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [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: 01/23/2021] [Accepted: 02/25/2021] [Indexed: 02/06/2023]
Abstract
BACKGROUND The salivary gland neoplasm of unknown malignant potential (SUMP) category reflects the cytomorphologic overlap and complexity of reporting salivary gland cytology in the Milan system. It includes neoplasms for which a diagnosis of a specific entity cannot be made and, more importantly, for which a carcinoma cannot be entirely excluded. For risk stratification, the subcategorization of SUMP based on the predominant cell type is recommended. This study was aimed at evaluating the risk of neoplasm (RON) and the risk of malignancy (ROM) of the basaloid and oncocytic subtypes of the SUMP category. METHODS A retrospective analysis of 482 salivary gland fine-needle aspirations from 2012 to 2019 resulted in 48 SUMP cases. The cytology of these cases was reviewed and reclassified as the basaloid or oncocytic subtype. Surgical follow-up was available for 36 cases. The RON and ROM for each subtype were calculated. RESULTS The RON and ROM were 100% and 23%, respectively, for monomorphic basaloid tumors and 88% and 58.8%, respectively, for monomorphic oncocytic tumors. The ROM for basaloid tumors was 8.3% without matrix/with minimal matrix and 60% with an nonfibrillary matrix. The ROM for oncocytic tumors was 50% without a cystic background and 60% with a cystic or mucinous background. The difference was not statistically significant for either of the subgroups. CONCLUSIONS Even though statistically not significant in our study, the differential ROMs within the oncocytic and basaloid subgroups help in the risk stratification of SUMP cases. Further subcategorization based on the stroma and background helps in limiting the differential diagnosis but does not necessarily add to the value of the risk stratification.
Collapse
Affiliation(s)
- Varsha Manucha
- Department of Pathology, University of Mississippi Medical Center, Jackson, Mississippi
| | - Maria F Gonzalez
- Department of Pathology, University of Mississippi Medical Center, Jackson, Mississippi
| | - Israh Akhtar
- Department of Pathology, University of Mississippi Medical Center, Jackson, Mississippi
| |
Collapse
|
8
|
Manucha V, Gonzalez MF, Akhtar I. Impact of the Milan System for Reporting Salivary Gland Cytology on risk assessment when used in routine practice in a real-time setting. J Am Soc Cytopathol 2020; 10:208-215. [PMID: 32893181 DOI: 10.1016/j.jasc.2020.08.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [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: 07/06/2020] [Revised: 08/02/2020] [Accepted: 08/07/2020] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Several retrospective studies across the world have validated the role of the Milan System for Reporting Salivary Gland Cytology (MSRSGC) in improving communication between pathologists and clinicians. In this study, we evaluated the applications of MSRSGC in a real-time setting for 2 years. MATERIALS AND METHODS All salivary gland lesions that underwent fine-needle aspiration (FNA) from January 2018 to December 2020 were categorized according to MSRSGC guidelines. The risk of malignancy (ROM) was calculated for each category and compared with the ROM proposed by MSRSGC and recent retrospective studies. RESULTS A total of 160 FNA of salivary gland lesions were categorized as: nondiagnostic (ND) 30 (18%), non-neoplastic (NN) 7 (10.6%), atypia of undetermined significance (AUS) 5 (3.1%), benign neoplasm (BN) 59 (36.8%), salivary gland of uncertain malignant potential (SUMP) 21 (13%), suspicious for malignancy (SM) 3 (1.84%), and malignant (M) 25 (15.6%). Histopathologic follow-up was available for 94 (57.5%) cases. The ROM for each category was ND 54%, NN 0%, AUS 66%, BN 0%, SUMP 37.56%, SM 100%, and M 100%. CONCLUSION With strict adherence to the diagnostic criteria and MSRSGC guidelines, a ROM of 100% in SM and M categories and a ROM of 0% in NN can be achieved in a real-time setting. The high ROM in the ND category in our study highlights the value of repeat FNA/biopsy for this category. High ROM for AUS indicates the tendency to classify high-grade tumors as AUS, calling for refinement in its criteria.
Collapse
Affiliation(s)
- Varsha Manucha
- Department of Pathology, University of Mississippi Medical Center, Jackson, Mississippi.
| | - Maria F Gonzalez
- Department of Pathology, University of Illinois at Chicago, Chicago, Illinois
| | - Israh Akhtar
- Department of Pathology, University of Mississippi Medical Center, Jackson, Mississippi
| |
Collapse
|
9
|
Abstract
Fine-needle aspiration (FNA) and core needle biopsy are the primary diagnostic modalities for assessing mass lesions. Any superficial or deep-seated lesion occurring anywhere in the body, including bone and soft tissue, can undergo this procedure to pathologically characterize it. The outcomes of FNA, performed either alone or in combination with core biopsy, are best when performed and interpreted by skilled individuals. The roles of interventional radiologists and cytologists are pivotal in ensuring adequacy of the specimen and leading the clinical team in making the diagnosis and avoiding repeat diagnostic procedures or a more invasive open surgical biopsy.
Collapse
Affiliation(s)
- Israh Akhtar
- Department of Pathology, University of Mississippi Medical Center, 2500 North State Street, Jackson, MS 39216, USA.
| | - Varsha Manucha
- Department of Pathology, University of Mississippi Medical Center, 2500 North State Street, Jackson, MS 39216, USA
| |
Collapse
|
10
|
Manucha V, Hansen JT, Gonzalez MF, Akhtar I. Role of cytology and immunochemistry in diagnosis of metastatic malignancies in the lung: A critical appraisal. Diagn Cytopathol 2018; 46:936-944. [PMID: 30353676 DOI: 10.1002/dc.24034] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2018] [Revised: 06/04/2018] [Accepted: 06/07/2018] [Indexed: 12/19/2022]
Abstract
BACKGROUND Lung is one of the most common sites for primary and metastatic malignancies and a challenging site to diagnose primary versus a metastatic origin of the tumor on cytology. Pathologic diagnosis of the site of origin of cancer has major implications in the management and staging purposes and may have to be followed by testing for predictive/prognostic markers. The clinical history of a known extrapulmonary primary and the radiologic findings of multiple nodules in the lung are useful in arriving at the right diagnosis but is not always available. Rarely pulmonary metastasis may be the first manifestation of an extrapulmonary tumor or may even present as a single nodule. METHOD In this study, we reviewed cytomorphologic features of tumors metastatic to the lung (2014-2017) in conjunction with immunochemistry and evaluation of needle core biopsy when available. The review of the slides was performed with an emphasis on our ability to identify the site of origin in the tumors. RESULTS We identified 47 cases of metastatic tumors in the lung diagnosed on cytology. Clinical history was available in 83% cases and with aid of immunostains, a definitive diagnosis on the origin of the tumor was made in all these cases. In the remaining 8 cases, a primary origin could only be suggested. The use of immunochemistry facilitated the diagnosis but could be misleading. CONCLUSION The approach to the diagnosis of metastatic tumors in the lung on cytology should be largely guided by the previous clinical history and comparison with previous tissue/cellular material if available.
Collapse
Affiliation(s)
- Varsha Manucha
- Department of Pathology, University of Mississippi Medical Center, Jackson, Mississippi
| | - Jeffery T Hansen
- Department of Pathology, University of Mississippi Medical Center, Jackson, Mississippi
| | - Maria F Gonzalez
- Department of Pathology, University of Mississippi Medical Center, Jackson, Mississippi
| | - Israh Akhtar
- Department of Pathology, University of Mississippi Medical Center, Jackson, Mississippi
| |
Collapse
|
11
|
Abstract
A 50-year-old female patient with no significant medical history presented with left knee pain. Radiographs of the knee showed a circumferential swelling of the distal femur suggestive of neoplasia. Further evaluation revealed multiple lesions in the left iliac bone and proximal femur. Biopsy was suggestive of a reparative granuloma or an aneurysmal bone cyst. Laboratory assessment showed hypercalcaemia and elevated parathyroid hormone consistent with severe primary hyperparathyroidism. Osseous survey was significant for salt and pepper appearance of the skull. Ultrasound of the neck and 99mTc-sestamibi parathyroid scintigraphy localised a left parathyroid adenoma/carcinoma. Parathyroidectomy was successful, and a large parathyroid adenoma was excised. Six months later, the patient was doing fine with her gait returning to normal. On follow-up 2 years later, she had no recurrence of the lesions.
Collapse
Affiliation(s)
- Vishnu Vardhan Garla
- Internal Medicine, University of Mississippi Medical Center, Jackson, Mississippi, USA
| | - Israh Akhtar
- Pathology, University of Mississippi Medical Center, Jackson, Mississippi, USA
| | - Sohail Salim
- Internal Medicine, University of Mississippi Medical Center, Jackson, Mississippi, USA
| | - Angela Subauste
- Internal Medicine, University of Mississippi Medical Center, Jackson, Mississippi, USA
| |
Collapse
|
12
|
Manucha V, Sessums MT, Lewin J, Akhtar I. Cyto-histological correlation of Xp11.2 translocation/TFE3 gene fusion associated renal cell carcinoma: Report of a case with review of literature. Diagn Cytopathol 2017; 46:267-270. [PMID: 29024535 DOI: 10.1002/dc.23839] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [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: 08/16/2017] [Revised: 09/18/2017] [Accepted: 09/27/2017] [Indexed: 01/02/2023]
Abstract
The MiT family translocation renal cell carcinomas (RCCs) are relatively rare in comparison to the conventional RCC. The cytologic features overlap with conventional clear cell RCC and papillary RCCs, thereby making the diagnosis extremely challenging. Here, we describe a case of TFE3 translocation associated RCC in a 58-year-old patient, with emphasis on cytomorphologic features and clues toward this diagnostic entity. Correlating the cytohistologic findings and review of touch imprints revealed that presence of hyaline nodules resembling leisegang rings and psammoma bodies in cytologic smears from kidney tumors serve as an important clue in raising a suspicion for the diagnosis of MiT family translocation RCCs.
Collapse
Affiliation(s)
- Varsha Manucha
- Department of Pathology, University of Mississippi Medical Center, Jackson, Mississippi
| | - Mary T Sessums
- Department of Pathology, University of Mississippi Medical Center, Jackson, Mississippi
| | - Jack Lewin
- Department of Pathology, University of Mississippi Medical Center, Jackson, Mississippi
| | - Israh Akhtar
- Department of Pathology, University of Mississippi Medical Center, Jackson, Mississippi
| |
Collapse
|
13
|
Butt NA, Kumar A, Dhar S, Rimando AM, Akhtar I, Hancock JC, Lage JM, Pound CR, Lewin JR, Gomez CR, Levenson AS. Targeting MTA1/HIF-1α signaling by pterostilbene in combination with histone deacetylase inhibitor attenuates prostate cancer progression. Cancer Med 2017; 6:2673-2685. [PMID: 29024573 PMCID: PMC5673954 DOI: 10.1002/cam4.1209] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [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: 06/27/2017] [Revised: 07/07/2017] [Accepted: 08/30/2017] [Indexed: 12/30/2022] Open
Abstract
The metastasis‐associated protein 1(MTA1)/histone deacetylase (HDAC) unit is a cancer progression‐related epigenetic regulator, which is overexpressed in hormone‐refractory and metastatic prostate cancer (PCa). In our previous studies, we found a significantly increased MTA1 expression in a prostate‐specific Pten‐null mouse model. We also demonstrated that stilbenes, namely resveratrol and pterostilbene (Pter), affect MTA1/HDAC signaling, including deacetylation of tumor suppressors p53 and PTEN. In this study, we examined whether inhibition of MTA1/HDAC using combination of Pter and a clinically approved HDAC inhibitor, SAHA (suberoylanilide hydroxamic acid, vorinostat), which also downregulates MTA1, could block prostate tumor progression in vivo. We generated and utilized a luciferase reporter in a prostate‐specific Pten‐null mouse model (Pb‐Cre+; Ptenf/f; Rosa26Luc/+) to evaluate the anticancer efficacy of Pter/SAHA combinatorial approach. Our data showed that Pter sensitized tumor cells to SAHA treatment resulting in inhibiting tumor growth and additional decline of tumor progression. These effects were dependent on the reduction of MTA1‐associated proangiogenic factors HIF‐1α, VEGF, and IL‐1β leading to decreased angiogenesis. In addition, treatment of PCa cell lines in vitro with combined Pter and low dose SAHA resulted in more potent inhibition of MTA1/HIF‐1α than by high dose SAHA alone. Our study provides preclinical evidence that Pter/SAHA combination treatment inhibits MTA1/HIF‐1α tumor‐promoting signaling in PCa. The beneficial outcome of combinatorial strategy using a natural agent and an approved drug for higher efficacy and less toxicity supports further development of MTA1‐targeted therapies in PCa.
Collapse
Affiliation(s)
- Nasir A Butt
- Cancer Institute, University of Mississippi Medical Center, Jackson, Mississippi.,Department of Pathology, University of Mississippi Medical Center, Jackson, Mississippi
| | - Avinash Kumar
- Cancer Institute, University of Mississippi Medical Center, Jackson, Mississippi.,Arnold & Marie Schwartz College of Pharmacy and Health Sciences, Long Island University, Brooklyn, New York
| | - Swati Dhar
- Cancer Institute, University of Mississippi Medical Center, Jackson, Mississippi.,Department of Radiation Oncology, University of Mississippi Medical Center, Jackson, Mississippi
| | - Agnes M Rimando
- United State Department of Agriculture, Agriculture Research Service, Natural Product Utilization Research Unit, University, Mississippi
| | - Israh Akhtar
- Department of Pathology, University of Mississippi Medical Center, Jackson, Mississippi
| | - John C Hancock
- Department of Pathology, University of Mississippi Medical Center, Jackson, Mississippi
| | - Janice M Lage
- Department of Pathology, University of Mississippi Medical Center, Jackson, Mississippi
| | - Charles R Pound
- Division of Urology, Department of Surgery, University of Mississippi Medical Center, Jackson, Mississippi
| | - Jack R Lewin
- Department of Pathology, University of Mississippi Medical Center, Jackson, Mississippi
| | - Christian R Gomez
- Cancer Institute, University of Mississippi Medical Center, Jackson, Mississippi.,Department of Pathology, University of Mississippi Medical Center, Jackson, Mississippi.,Department of Radiation Oncology, University of Mississippi Medical Center, Jackson, Mississippi
| | - Anait S Levenson
- Cancer Institute, University of Mississippi Medical Center, Jackson, Mississippi.,Department of Pathology, University of Mississippi Medical Center, Jackson, Mississippi.,Arnold & Marie Schwartz College of Pharmacy and Health Sciences, Long Island University, Brooklyn, New York
| |
Collapse
|
14
|
Gonzalez MF, Akhtar I, Manucha V. Additional diagnostic features of mammary analogue secretory carcinoma on cytology. Cytopathology 2017; 29:100-103. [PMID: 28929545 DOI: 10.1111/cyt.12465] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/12/2017] [Indexed: 01/05/2023]
Affiliation(s)
- M F Gonzalez
- Department of Pathology, University of Mississippi Medical Center, Jackson, MS, USA
| | - I Akhtar
- Department of Pathology, University of Mississippi Medical Center, Jackson, MS, USA
| | - V Manucha
- Department of Pathology, University of Mississippi Medical Center, Jackson, MS, USA
| |
Collapse
|
15
|
Abstract
OBJECTIVE To explore the current and anticipated changes in the practice of cytopathology. STUDY DESIGN The present review is based on a review of recent literature and an evaluation of the authors' personal experiences. RESULTS AND CONCLUSION In recent years the practice of cytopathology, nationwide and in our institute, has witnessed a major change affecting gynecologic and nongynecologic cytology. There has been a decline in the number of Papanicolaou tests which has affected the utilization of cytotechnologists and provoked a reorganization of their work flow. The "need to do more with less" in the era of targeted therapy/personalized medicine has resulted in an increasing preference for needle core biopsy when performing a rapid on-site evaluation. We feel that this change is unavoidable. It is pertinent that cytopathologists as a group recognize this change and prepare themselves and the trainees not only to become adapt but also to use this as an opportunity to discover the yet unexplored world of cytology.
Collapse
Affiliation(s)
- Maria F Gonzalez
- Department of Pathology, University of Mississippi Medical Center, Jackson, MS, USA
| | | | | |
Collapse
|
16
|
Dhar S, Kumar A, Gomez CR, Akhtar I, Hancock JC, Lage JM, Pound CR, Levenson AS. MTA1-activated Epi-microRNA-22 regulates E-cadherin and prostate cancer invasiveness. FEBS Lett 2017; 591:924-933. [PMID: 28231399 DOI: 10.1002/1873-3468.12603] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [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: 01/05/2017] [Revised: 02/16/2017] [Accepted: 02/17/2017] [Indexed: 12/14/2022]
Abstract
We have previously shown that metastasis-associated protein 1 (MTA1), a chromatin remodeler, plays an important role in prostate cancer invasiveness, likely through regulation of epithelial-to-mesenchymal transition. Here, we identified miR-22 as an epigenetic-microRNA (Epi-miR) directly induced by MTA1 and predicted to target E-cadherin. Loss-of-function and overexpression studies of MTA1 reinforced its regulatory role in miR-22 expression. MiR-22 directly targets the 3'-untranslated region of E-cadherin, and ectopic overexpression of miR-22 diminishes E-cadherin expression. Overexpression of miR-22 in prostate cancer cells promotes cell invasiveness and migration. Meta-analysis of patient tumor samples indicates a positive correlation between MTA1 and miR-22, supporting their inhibitory effect on E-cadherin expression. Our findings implicate the MTA1/Epi-miR-22/E-cadherin axis as a new epigenetic signaling pathway that promotes tumor invasion in prostate cancer.
Collapse
Affiliation(s)
- Swati Dhar
- Cancer Institute, University of Mississippi Medical Center, Jackson, MS, USA
- School of Medicine-Department of Radiation/Oncology, University of Mississippi Medical Center, Jackson, MS, USA
| | - Avinash Kumar
- Cancer Institute, University of Mississippi Medical Center, Jackson, MS, USA
| | - Christian R Gomez
- Cancer Institute, University of Mississippi Medical Center, Jackson, MS, USA
- School of Medicine-Department of Radiation/Oncology, University of Mississippi Medical Center, Jackson, MS, USA
- Department of Pathology, University of Mississippi Medical Center, Jackson, MS, USA
| | - Israh Akhtar
- Department of Pathology, University of Mississippi Medical Center, Jackson, MS, USA
| | - John C Hancock
- Department of Pathology, University of Mississippi Medical Center, Jackson, MS, USA
| | - Janice M Lage
- Department of Pathology, University of Mississippi Medical Center, Jackson, MS, USA
| | - Charles R Pound
- Division of Urology, Department of Surgery, University of Mississippi Medical Center, Jackson, MS, USA
| | - Anait S Levenson
- Cancer Institute, University of Mississippi Medical Center, Jackson, MS, USA
- Department of Pathology, University of Mississippi Medical Center, Jackson, MS, USA
| |
Collapse
|
17
|
Akhtar I, Flowers R, Nuttli T, Nath V, Baliga M. Poorly differentiated squamous cell carcinoma of the cervix with sarcomatoid differentiation: Report of a case with cytohistological correlation. Diagn Cytopathol 2016; 45:137-142. [PMID: 27669672 DOI: 10.1002/dc.23612] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [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: 01/20/2016] [Revised: 08/20/2016] [Accepted: 08/30/2016] [Indexed: 11/06/2022]
Abstract
Sarcomatoid squamous cell carcinoma (SSCC) of the uterine cervix is a rare malignancy with uncertain pathogenesis and aggressive clinical behavior. The diagnosis of this tumor poses a challenge to the cytopathologist since accurate diagnosis is based on identification of two malignant components, that is, epithelial and sarcomatoid. Most cases usually lack the sarcomatoid component on Papanicolaou test (Pap test). Therefore, a poorly differentiated carcinoma or malignant neoplasm is the most often rendered diagnosis. To date, less than 20 cases have been reported. Most of these cases were diagnosed by histopathologic findings. To our knowledge, cytomorphologic findings of SSCC on a liquid-based Pap test, with utility of cell block sections, in recognition of the two components of tumor, with follow-up histopathologic correlation have not been described. A case of SSCC occurring in a 57-year-old postmenopausal woman, describing the cytologic features on a liquid-based Pap-test, histopathologic findings of subsequent cervical biopsy, differential diagnosis, and role of ancillary studies are illustrated and discussed. Diagn. Cytopathol. 2017;45:137-142. © 2016 Wiley Periodicals, Inc.
Collapse
Affiliation(s)
- Israh Akhtar
- Department of Pathology, University of Mississippi Medical Center, Jackson, Mississippi
| | - Rhyne Flowers
- Department of Pathology, University of Mississippi Medical Center, Jackson, Mississippi
| | - Theresa Nuttli
- Department of Pathology, University of Mississippi Medical Center, Jackson, Mississippi
| | - Vikas Nath
- Department of Pathology, University of Mississippi Medical Center, Jackson, Mississippi
| | - Mithra Baliga
- Department of Pathology, University of Mississippi Medical Center, Jackson, Mississippi
| |
Collapse
|
18
|
Martin C, Akhtar I, Halpin J, Holloway W, Akhtar N. O-019 Novel Method for Intracranial Deployment of 6 and 8 mm diameter Self Expanding Cobalt Chromium Stents in the Arterial and Venous Circulations. J Neurointerv Surg 2016. [DOI: 10.1136/neurintsurg-2016-012589.19] [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]
|
19
|
Akhtar I, Halpin J, Holloway W, Martin C, Akhtar N. E-019 Outcome of the Patients Presenting with Basilar Occlusions in a Busy Stroke Center Treated with new Generation Stent Retrievers. J Neurointerv Surg 2016. [DOI: 10.1136/neurintsurg-2016-012589.91] [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]
|
20
|
Holloway W, Akhtar I, Halpin J, Martin C, Akhtar N. P-012 Longer Working Length of the Solitaire Retrieval Device Improves Revascularization. J Neurointerv Surg 2016. [DOI: 10.1136/neurintsurg-2016-012589.54] [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]
|
21
|
Bernieh A, Adams K, Susan Liu X, Flowers R, Shenoy V, Baliga M, Akhtar I. Fibrolamellar hepatocellular carcinoma in ascitic fluid: A case report with cytohistological correlation. Diagn Cytopathol 2016; 44:757-60. [PMID: 27218242 DOI: 10.1002/dc.23509] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [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: 02/05/2016] [Revised: 04/12/2016] [Accepted: 05/05/2016] [Indexed: 11/11/2022]
Abstract
The fibrolamellar variant of hepatocellular carcinoma (FL-HCC) is distinguished from other hepatocellular carcinoma's (HCC) by its unique clinical and pathological features. Cytological features of this tumor on fine needle aspiration have been described earlier. We report a rare case of a 17-year-old African American male with metastatic FL-HCC, diagnosed by body fluid cytology. The patient presented with ascites and computed tomography (CT) scan revealed multiple omental masses and liver lesions. The fluid sample was obtained along with the omental biopsy and was found positive for metastatic fibrolamellar hepatocellular carcinoma. The fluid cytology showed atypical polygonal cells with enlarged nuclei, prominent nucleoli, and abundant granular cytoplasm. Cytomorphologic features of FL-HCC presenting in body fluids have been rarely described before. This case enriches the cytopathology literature by providing awareness of this tumor presenting as metastasis in body fluids, especially in young individuals with liver lesions. Presence of a concurrent biopsy specimen provided cytohistological correlation, as it remains the gold standard for the accuracy and reliability of cytological diagnoses. Diagn. Cytopathol. 2016;44:757-760. © 2016 Wiley Periodicals, Inc.
Collapse
Affiliation(s)
- Anas Bernieh
- Cytology Division, Department of Pathology, University of Mississippi Medical Center, Jackson, Mississippi
| | - Kristen Adams
- Cytology Division, Department of Pathology, University of Mississippi Medical Center, Jackson, Mississippi
| | - Xuehui Susan Liu
- Cytology Division, Department of Pathology, University of Mississippi Medical Center, Jackson, Mississippi
| | - Rhyne Flowers
- Cytology Division, Department of Pathology, University of Mississippi Medical Center, Jackson, Mississippi
| | - Veena Shenoy
- Cytology Division, Department of Pathology, University of Mississippi Medical Center, Jackson, Mississippi
| | - Mithra Baliga
- Cytology Division, Department of Pathology, University of Mississippi Medical Center, Jackson, Mississippi
| | - Israh Akhtar
- Cytology Division, Department of Pathology, University of Mississippi Medical Center, Jackson, Mississippi
| |
Collapse
|
22
|
Schneider T, Dibue-Adjei M, Neumaier F, Akhtar I, Hescheler J, Kamp MA, Tevoufouet EE. R-Type Voltage-Gated Ca²⁺ Channels in Cardiac and Neuronal Rhythmogenesis. Curr Mol Pharmacol 2015; 8:102-8. [PMID: 25966704 DOI: 10.2174/1874467208666150507093845] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2014] [Revised: 02/06/2015] [Accepted: 04/20/2015] [Indexed: 11/22/2022]
Abstract
During the past decades, an increasing number of ion channel and transporter types have been identified acting together to produce cardiac and neuronal pacemaker action potentials. The basis of pacemaker activity was understood in more detail by using single-microelectrode recordings on cells isolated from pacemaker regions. Meanwhile, this powerful technique was complemented by computer modeling and recombinant technologies, including gene inactivation of ion channels and transporters, which may be involved in the generation of the electrical activity of pacemaker cells. Several genes of the voltage-gated Ca(2+) channel (VGCC) family have been ablated, and their role in cardiac and neuronal pacemaking is compared in the present summary, focusing on the role of murine R-type voltage-gated Ca(2+) channels encoded by cacna1e and expressing the ion conducting subunit Cav2.3.
Collapse
Affiliation(s)
- T Schneider
- Institute of Neurophysiology, University of Cologne, Robert-Koch-Str. 39, D-50931 Cologne, Germany.
| | | | | | | | | | | | | |
Collapse
|
23
|
Adams K, Liu XS, Akhtar I, Flowers R, Baliga M. Pleural-based neuroblastoma-like schwannoma: A case report with cytologic findings and review of literature. Diagn Cytopathol 2015; 43:650-3. [DOI: 10.1002/dc.23293] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2014] [Revised: 03/11/2015] [Accepted: 03/30/2015] [Indexed: 11/11/2022]
Affiliation(s)
- Kristen Adams
- Cytology Division; Department of Pathology; University of Mississippi Medical Center; Jackson Mississippi
| | | | - Israh Akhtar
- Cytology Division; Department of Pathology; University of Mississippi Medical Center; Jackson Mississippi
| | - Rhyne Flowers
- Cytology Division; Department of Pathology; University of Mississippi Medical Center; Jackson Mississippi
| | - Mithra Baliga
- Cytology Division; Department of Pathology; University of Mississippi Medical Center; Jackson Mississippi
| |
Collapse
|
24
|
Mraity H, England A, Akhtar I, Aslam A, De Lange R, Momoniat H, Nicoulaz S, Ribeiro A, Mazhir S, Hogg P. Development and validation of a psychometric scale for assessing PA chest image quality: A pilot study. Radiography (Lond) 2014. [DOI: 10.1016/j.radi.2014.03.007] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
25
|
Adams K, Liu X, Akhtar I, Baliga M. A Rare Case of Neuroblastoma-like Schwannoma Arising in the Mediastinum: Cytohistologic Correlation and Immunohistochemical Findings. Am J Clin Pathol 2014. [DOI: 10.1093/ajcp/142.suppl1.060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
| | - Xuehui Liu
- University of Mississippi Medical Center, Jackson
| | - Israh Akhtar
- University of Mississippi Medical Center, Jackson
| | | |
Collapse
|
26
|
Liu X, Akhtar I, Flowers R, Baliga M. Sebaceous Lymphadenoma of Parotid Gland Mimicking Acinic Cell Carcinoma on Fine Needle Aspiration: Case Report with Cytologic and Histopathologic Correlation. Am J Clin Pathol 2013. [DOI: 10.1093/ajcp/140.suppl1.168] [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: 11/13/2022] Open
|
27
|
Liu X, Shenoy V, Flowers R, Baliga M, Akhtar I. Metastatic Fibrolamellar Hepatocellular Carcinoma in Ascitic Fluid: A Report of a Case With Cytologic and Histologic Findings. Am J Clin Pathol 2013. [DOI: 10.1093/ajcp/140.suppl1.170] [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
|
28
|
Ishaq N, Bhaijee F, Siddiqi A, Akhtar I. Diagnostic Efficacy of Fine-Needle Aspiration Biopsies of Head and Neck Lesions: A Review of 153 Cases at a Large Academic Medical Center. Am J Clin Pathol 2012. [DOI: 10.1093/ajcp/138.suppl2.86] [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: 11/12/2022] Open
|
29
|
Mourad W, Packianathan S, Baird M, Shourbaji R, Khan M, Akhtar I, Cheng S, Caudell J, Jennelle R, Vijayakumar S. Radiation Induced Malignancy after Prophylactic Radiation Therapy in Prevention of Heterotopic Ossification. Int J Radiat Oncol Biol Phys 2010. [DOI: 10.1016/j.ijrobp.2010.07.1420] [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]
|
30
|
Siddiqi A, Spataro M, McIntire H, Akhtar I, Baliga M, Flowers R, Lin E, Guo M. Hybrid capture 2 human papillomavirus DNA testing for women with atypical squamous cells of undetermined significance Papanicolaou results in SurePath and ThinPrep specimens. Cancer 2009; 117:318-25. [PMID: 19693966 DOI: 10.1002/cncy.20043] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
BACKGROUND Human papillomavirus (HPV) DNA testing using Hybrid Capture 2 assay with ThinPrep Papanicolaou (Pap) collection is the only US Food and Drug Administration-approved method for the triage of women with atypical squamous cells of undetermined significance (ASCUS). Although SurePath Pap collection has been used for Hybrid Capture 2 HPV DNA testing, clinical validation of this method has been scarce. METHODS From a cervical cancer-screening program in Mississippi, we analyzed data from screenings of 8380 women with ASCUS Pap results who underwent reflex Hybrid Capture 2 HPV DNA tests during a course of 4 years. Of these, 4145 were screened with the ThinPrep collection system, and 4235 were screened with SurePath. Results of follow-up biopsies within 3 months of Pap tests were available for the ThinPrep group (229 cases) and the SurePath group (455 cases). Hybrid Capture 2 positive rates and the follow-up biopsy results from both groups were compared. RESULTS Hybrid Capture 2 detected high-risk HPV DNA in 68.8% of ThinPrep and 66.7% of SurePath-collected specimens (P = .37). Detection rates for CIN2+ and CIN3+ were also comparable between ThinPrep (21.4%, 3.1%) and SurePath (15.4%, 4.2%) using Hybrid Capture 2 (P = .06, P = .45). In ThinPrep-collected specimens, 4.4% were quantitatively insufficient for Hybrid Capture 2 testing. Significantly more equivocal Hybrid Capture 2 results were observed in SurePath (11.4%) than in ThinPrep specimens (3.2%). However, 67.4% of women with equivocal Hybrid Capture 2 results had negative 1-year Pap cytology follow-up in the SurePath group. CONCLUSIONS Hybrid Capture 2 positive rates and CIN2-3 detection rates were comparable for the SurePath and ThinPrep Pap collection systems, thus supporting the use of SurePath for Hybrid Capture 2 testing.
Collapse
Affiliation(s)
- Anwer Siddiqi
- Department of Pathology, University of Mississippi Medical Center, Jackson, Mississippi, USA
| | | | | | | | | | | | | | | |
Collapse
|
31
|
Castle PE, Fetterman B, Akhtar I, Husain M, Gold MA, Guido R, Glass AG, Kinney W. Age-appropriate use of human papillomavirus vaccines in the U.S. Gynecol Oncol 2009; 114:365-9. [PMID: 19464729 DOI: 10.1016/j.ygyno.2009.04.035] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2009] [Revised: 04/17/2009] [Accepted: 04/23/2009] [Indexed: 11/25/2022]
Abstract
Cervical infections by approximately 15 cancer-associated (carcinogenic) human papillomavirus (HPV) genotypes cause virtually all cervical cancer and its immediate precursor lesions worldwide. Prophylactic vaccines against human papillomavirus (HPV) types HPV16 and HP18, which cause 70% of cervical cancer worldwide, hold great promise for reducing the burden of cervical cancer worldwide. However, current HPV vaccines prevent future infections and related cervical abnormalities and do not treat pre-existing HPV infections. In the U.S., HPV vaccine introduction should be considered in the context of a very successful cervical cancer screening program that has reduced the rates of cervical cancer by 75% or more. Thus, HPV vaccines will only prevent an incremental number of additional cervical cancers in the U.S. The introduction of HPV vaccines can also prevent other HPV-related sequelae, most importantly cervical intraepithelial neoplasia grade 2 or 3 (CIN2/3), which precede the development of cervical cancer and require clinical follow-up and treatment. Examining data from 7 clinical centers in the U.S., the median age of CIN2/3 is typically between 25 and 30 years of age in 2007; if screen-detected CIN2/3 develops on average 5-10 years after the causal infection is acquired, HPV vaccination will only prevent a significant proportion of CIN2/3 if it is given to women before the age of 26 and more so if given to women 18 and younger. It is increasingly evident that prophylactic HPV vaccines will provide the greatest public health or population benefit only when delivered to adolescent, mostly HPV-naive women.
Collapse
Affiliation(s)
- Philip E Castle
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, DHHS, Bethesda, MD 20892-7234, USA.
| | | | | | | | | | | | | | | |
Collapse
|
32
|
Nagarajarao HS, Akhtar I, Heard K, Baliga M. Unusual presentation of chronic myelogenous leukemia as multiple skin chloromas: report of a case with clinical and cytologic correlation. Acta Cytol 2009; 53:235-8. [PMID: 19365984 DOI: 10.1159/000325133] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
BACKGROUND Chronic myelogenous leukemia (CML) presenting as multiple skin chloromas is an extremely rare manifestation. Though often seen in acute myelogenous leukemia, to date there have been no reported cases of CML presenting as multiple skin chloromas in the chronic phase. Chloromas in blastic phase of CML at different body sites have been reported previously. CASE A 53-year-old African American male presented to his primary care provider with multiple skin nodules. A complete blood cound showed a high white cell count, for which he was transferred to a university tertiary care center. Fine needle aspiration (FNA) of the skin lesion revealed cellular smears consisting of immature myeloid cells of CML. Based on these findings, and with clinical correlation, a preliminary diagnosis of chloroma was made and confirmed by ancillary studies. CONCLUSION This rare manifestation should alert a clinician to include CML in chronic phase in the differential diagnosis of patients presenting with multiple nonpigmented, nonpruritic skin nodules. FNA with ancillary studies can provide a rapid diagnosis.
Collapse
MESH Headings
- Biopsy, Fine-Needle
- Flow Cytometry
- Humans
- In Situ Hybridization, Fluorescence
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/genetics
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/pathology
- Male
- Middle Aged
- Sarcoma, Myeloid/genetics
- Sarcoma, Myeloid/pathology
- Skin Neoplasms/genetics
- Skin Neoplasms/pathology
Collapse
Affiliation(s)
- Harsha Santheshivara Nagarajarao
- Department ot Internal Medicine, Division of Cytopatology, University of Mississippi Medical Center, 2500 North State Street, Jackson, Mississippi 39216-4505, USA
| | | | | | | |
Collapse
|
33
|
Akhtar I, Ispas CL, Flowers R, Siddiqi A, Young L, Donnellan KA, Heard K, Baliga M. Ductopapillary apocrine carcinoma of the eyelid metastatic to the parotid gland: Report of a case diagnosed by fine-needle aspiration biopsy. Diagn Cytopathol 2009; 37:91-5. [DOI: 10.1002/dc.20956] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
|
34
|
Baliga M, Flowers R, Heard K, Siddiqi A, Akhtar I. Solitary fibrous tumor of the lung: A case report with a study of the aspiration biopsy, histopathology, immunohistochemistry, and autopsy findings. Diagn Cytopathol 2007; 35:239-44. [PMID: 17351947 DOI: 10.1002/dc.20611] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Solitary fibrous tumor (SFT) is a rare mesenchymal neoplasm of ubiquitous location. In addition to its classic presentation as a pleural-based mass, it can be encountered in a variety of other sites. A pleural-based lung lesion can be easily accessed by radiologic guidance for cytologic study. Several reports have described the cytologic findings of SFT at various locations, including the lung. However, diagnostic difficulties can occur due to unusual clinical, radiologic, atypical cytomorphologic, and histologic features. We describe a case of intrapulmonary SFT in which a false-positive malignant diagnosis was rendered on fine-needle aspiration biopsy and concurrent surgical core biopsy prior to radiofrequency ablation. The patient died of procedural complications, and an autopsy was performed. Retrospective study of the case, especially correlation of cytologic, histologic, autopsy findings, and immunohistochemistry results were helpful in correctly diagnosing the case as SFT. We are reporting this case with emphasis on avoiding diagnostic pitfalls by being familiar with the accepted cytohistologic features and appropriate immunohistochemical results.
Collapse
Affiliation(s)
- Mithra Baliga
- Division of Cytopathology, University of Mississippi Medical Center, 2500 North State Street, Jackson, MS 39216-4505, USA.
| | | | | | | | | |
Collapse
|
35
|
Akhtar I, Flowers R, Siddiqi A, Heard K, Baliga M. Fine needle aspiration biopsy of vertebral and paravertebral lesions: retrospective study of 124 cases. Acta Cytol 2006; 50:364-71. [PMID: 16900996 DOI: 10.1159/000325974] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
OBJECTIVE To evaluate the diagnostic value of image-guided fine needle aspiration biopsy (FNAB) in the diagnosis and management of vertebral and paravertebral lesions and to review similar studies in the literature. STUDY DESIGN One hundred twenty-four FNAB cases (113 [corrected] patients) of vertebral and paravertebral lesions occurring over a 10-year period were retrieved from the archives of the University of Mississippi Medical Center for review and clinico-radiologic correlation. Thirty-four of the cases included a concurrent core needle biopsy sample, 15 cases had subsequent surgical specimens, while 32 cases had previously established malignancy. The age range was 11 days to 91 years (mean, 46 years), with 57 male patients and 56 female. RESULTS One hundred five cases were vertebral lesions, and 19 cases were paravertebral lesions. FNAB diagnosis were malignant in 33.87% of cases, benign in 5.64%, suspicious in 4.03%, infectious/inflammatory and degenerative in 12.91%, unsatisfactory in 16.13% and negative in 27.42%. The overall sensitivity of the procedure was 89.3% and the specificity, 93.8%. The positive predictive value was 95.7% and negative predictive value, 85.2%. CONCLUSION FNAB is an effective means of establishing a definitive diagnosis of vertebral and paravertebral lesions, allowing appropriate patient management. Cell blocks, core biopsies and ancillary studies are useful adjuncts in rendering the diagnosis.
Collapse
Affiliation(s)
- Israh Akhtar
- Department of Pathology, School of Health Related Professions, University of Mississippi Medical Center, Jackson, Mississippi 39216-4505, USA.
| | | | | | | | | |
Collapse
|
36
|
Abstract
BACKGROUND Recent studies in rural areas of Pakistan have yielded high prevalence rates of common mental disorders, especially among women. AIMS To investigate emotional distress and common mental disorders in a poor urban district using the same survey method. METHOD First-stage screening of a slum district of Rawalpindi used the Bradford Somatic Inventory. Psychiatric interviews were conducted with stratified samples using the ICD-10 research diagnostic criteria. RESULTS On a conservative estimate, 25% of women and 10% of men suffered from anxiety and depressive disorders. Levels of emotional distress increased with age in both men and women. Women living in joint households reported more distress than those living in unitary families. Higher levels of education were associated with lower risk of common mental disorders, especially in younger women. Emotional distress was negatively correlated with socio-economic variables among women. CONCLUSIONS This study found levels of emotional distress and psychiatric morbidity in a poor district of Rawalpindi to be less than half those in a nearby rural village in the Punjab, although rates in women were still double those in men. Possible explanations are that more healthy people migrate to the cities or that urban living is more conducive to good mental health in Pakistan.
Collapse
Affiliation(s)
- D B Mumford
- Division of Psychiatry, University of Bristol, Bristol, UK
| | | | | | | | | |
Collapse
|
37
|
Akhtar I, Gold JP, Pan LY, Ferrara JL, Yang XD, Kim JI, Tan KN. CD4+ beta islet cell-reactive T cell clones that suppress autoimmune diabetes in nonobese diabetic mice. J Exp Med 1995; 182:87-97. [PMID: 7790825 PMCID: PMC2192107 DOI: 10.1084/jem.182.1.87] [Citation(s) in RCA: 40] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
We report the isolation of a panel of CD4+ T helper type 1 autoreactive T cell clones from the spleen of unprimed nonobese diabetic mice, a murine model of human insulin-dependent diabetes mellitus. The T cell clones express a diverse repertoire of T cell receptors, three of which recognize beta islet cell autoantigen(s). The islet cell-reactive T cell clones inhibit adoptive transfer of insulin-dependent diabetes mellitus and intraislet lymphocytic infiltration. The protective capacity of the T cell clones correlates with their ability to produce a novel immunoregulatory activity that potently inhibits in vitro allogeneic mixed lymphocyte reaction. The partially purified activity significantly inhibited the adoptive transfer of diabetes. Our work provides evidence in support of the existence of T helper type 1, CD4+ T cells reactive to beta islet cell autoantigens that have acquired a protective instead of a diabetogenic effector function. These T cells mediate their protective action in part by production of an immunoregulatory activity capable of down-regulating immune responses, and they are likely to represent a population of regulatory T cells that normally plays a role in maintaining peripheral tolerance.
Collapse
Affiliation(s)
- I Akhtar
- Division of Pediatric Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts, USA
| | | | | | | | | | | | | |
Collapse
|