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Tuveri S, Debackere K, Marcelis L, Dierckxsens N, Demeulemeester J, Dimitriadou E, Dierickx D, Lefesvre P, Deraedt K, Graux C, Michaux L, Cools J, Tousseyn T, Vermeesch JR, Wlodarska I. Primary mediastinal large B-cell lymphoma is characterized by large-scale copy-neutral loss of heterozygosity. Genes Chromosomes Cancer 2022; 61:603-615. [PMID: 35611992 DOI: 10.1002/gcc.23069] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [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: 01/10/2022] [Revised: 05/17/2022] [Accepted: 05/20/2022] [Indexed: 11/07/2022] Open
Abstract
Development of primary mediastinal B-cell lymphoma (PMBL) is driven by cumulative genomic aberrations. We discovered a unique copy-neutral loss of heterozygosity (CN-LOH) landscape of PMBL which distinguishes this tumour from other B-cell malignancies, including the biologically related diffuse large B-cell lymphoma. Using single nucleotide polymorphism array analysis we identified large-scale CN-LOH lesions in 91% (30/33) of diagnostic PMBLs and both investigated PMBL-derived cell lines. Altogether, the cohort showed 157 extra-large (25.3-248.4 Mb) CN-LOH lesions affecting up to 14 chromosomes per case (mean of 4.4) and resulting in a reduction of heterozygosity an average of 9.9% (range 1.3-51%) of the genome. Predominant involvement of terminal chromosomal segments suggests the implication of B-cell specific crossover events in the pathogenesis of PMBL. Notably, CN-LOH stretches non-randomly clustered on 6p (60%), 15 (37.2%) and 17q (40%), and frequently co-occurred with homozygous mutations in the MHC I (6p21), B2M (15q15) and GNA13 (17q23) genes, respectively, as shown by preliminary whole-exome/genome sequencing data. Altogether, our findings implicate CN-LOH as a novel and distinct mutational process contributing to the molecular pathogenesis of PMBL. The aberration acting as 'second hit' in the Knudson hypothesis, ranks as the major mechanism converting to homozygosity the PMBL-related driver genes. Screening of the cohort of 199 B cell leukamia/lymphoma whole-genomes revealed significant differences in the CN-LOH landscape of PMBL and other B-cell malignancies, including the biologically related diffuse large B-cell lymphoma.
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Affiliation(s)
| | - Koen Debackere
- Laboratory for Experimental Hematology, KU Leuven, Leuven, Belgium
- Center for Cancer Biology, VIB, Leuven, Belgium
| | - Lukas Marcelis
- Translational Cell and Tissue Research, KU Leuven, Leuven, Belgium
- Department of Pathology, University Hospitals Leuven, Leuven, Belgium
| | | | - Jonas Demeulemeester
- Center for Human Genetics, KU Leuven, Leuven, Belgium
- Cancer Genomics Laboratory, The Francis Crick Institute, London, UK
| | | | - Daan Dierickx
- Department of Hematology, University Hospitals Leuven, Leuven, Belgium
| | - Pierre Lefesvre
- Department of Pathology, Free University Hospital, Brussels, Belgium
| | - Karen Deraedt
- Anatomo-Pathology, Hospital East Limburg, Genk, Belgium
| | - Carlos Graux
- Department of Hematology, Mont-Godinne University Hospital, Yvoir, Belgium
| | | | - Jan Cools
- Center for Human Genetics, KU Leuven, Leuven, Belgium
- Center for Cancer Biology, VIB, Leuven, Belgium
| | - Thomas Tousseyn
- Translational Cell and Tissue Research, KU Leuven, Leuven, Belgium
- Department of Pathology, University Hospitals Leuven, Leuven, Belgium
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Claerhout S, Lehnert S, Borght SV, Spans L, Dooms C, Wauters E, Vansteenkiste J, Weynand B, Deraedt K, Bourgain C, Bempt IV. Targeted RNA sequencing for upfront analysis of actionable driver alterations in non-small cell lung cancer. Lung Cancer 2022; 166:242-249. [DOI: 10.1016/j.lungcan.2022.02.013] [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] [Received: 12/07/2021] [Revised: 02/15/2022] [Accepted: 02/24/2022] [Indexed: 10/19/2022]
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Peeters K, Mesotten D, Willaert X, Deraedt K, Nauwelaers S, Lauwers G. Salvage Lobectomy to Treat Necrotizing SARS-CoV-2 Pneumonia Complicated by a Bronchopleural Fistula. Ann Thorac Surg 2020; 111:e241-e243. [PMID: 33279555 PMCID: PMC7713638 DOI: 10.1016/j.athoracsur.2020.10.038] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Revised: 09/28/2020] [Accepted: 10/18/2020] [Indexed: 01/05/2023]
Abstract
We report a case of necrotizing severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pneumonia complicated by a bronchopleural fistula and treated by decortication and salvage lobectomy. Owing to the unknown characteristics of the underlying SARS-CoV-2 infection, treatment of the abscess and bronchopleural fistula was delayed. This may have resulted in further deterioration of the patient, with ensuing multiple organ dysfunction. Complications of SARS-CoV-2 pneumonia, such as a bacterial abscess and a bronchopleural fistula, should be treated as if the patient were not infected with SARS-CoV-2.
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Affiliation(s)
- Karen Peeters
- Department of Thoracovascular Surgery, Ziekenhuis Oost-Limburg, Genk, Belgium.
| | - Dieter Mesotten
- Department of Anesthesiology, Ziekenhuis Oost-Limburg, Genk, Belgium; Faculty of Medicine and Life Sciences, Hasselt University, Diepenbeek, Belgium
| | - Xavier Willaert
- Department of Anesthesiology, Ziekenhuis Oost-Limburg, Genk, Belgium
| | - Karen Deraedt
- Department of Pathology, Ziekenhuis Oost-Limburg, Genk, Belgium
| | - Sigi Nauwelaers
- Department of Thoracovascular Surgery, Ziekenhuis Oost-Limburg, Genk, Belgium
| | - Geert Lauwers
- Department of Thoracovascular Surgery, Ziekenhuis Oost-Limburg, Genk, Belgium
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Melis C, Struyve M, Steelandt T, Neuville B, Deraedt K. Sprue-like enteropathy, do not forget olmesartan! Dig Liver Dis 2018; 50:621-624. [PMID: 29625908 DOI: 10.1016/j.dld.2018.03.017] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2018] [Revised: 03/09/2018] [Accepted: 03/12/2018] [Indexed: 12/11/2022]
Affiliation(s)
- C Melis
- Department of Pathology, University Hospitals of Leuven, Herestraat 49, 3000 Leuven, Belgium.
| | - M Struyve
- Department of Gastroenterology, Hepatology and Endoscopy, University Hospitals of Leuven, Herestraat 49, 3000 Leuven, Belgium; Department of Gastroenterology and Hepatology, Ziekenhuis Oost-Limburg, Schiepse Bos 6, 3600 Genk, Belgium.
| | - T Steelandt
- Department of Pathology, University Hospitals of Leuven, Herestraat 49, Leuven, 3000, Belgium.
| | - B Neuville
- Department of Gastroenterology and Hepatology, Ziekenhuis Oost-Limburg, Schiepse Bos 6, 3600 Genk, Belgium.
| | - K Deraedt
- Department of Pathology, Ziekenhuis Oost-Limburg, Schiepse Bos 6, 3600 Genk, Belgium.
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Witters I, Sieprath P, Van Holsbeke C, Theyskens C, Deraedt K. Prenatal diagnosis of multiple large subchorionic placental cysts with intracystic hemorraghe. Facts Views Vis Obgyn 2017; 9:223-225. [PMID: 30250656 PMCID: PMC6143088] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Subchorionic placental cysts occur in up to 5% of pregnancies. Large and numerous placental cysts increase the risk for intrauterine growth restriction. We describe a case with large multiple subchorionic placental cysts complicated by intracystic hemorraghe and fetal growth restriction.
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Affiliation(s)
- I Witters
- Department of Obstetrics and Gynecology, Ziekenhuis Oost-Limburg, Genk (ZOL), Genk, Belgium
| | - P Sieprath
- Department of Obstetrics and Gynecology, Ziekenhuis Oost-Limburg, Genk (ZOL), Genk, Belgium
| | - C Van Holsbeke
- Department of Obstetrics and Gynecology, Ziekenhuis Oost-Limburg, Genk (ZOL), Genk, Belgium
| | - C Theyskens
- Neonatology, Ziekenhuis Oost-Limburg, Genk (ZOL), Genk, Belgium
| | - K Deraedt
- Department of Pathology, Ziekenhuis Oost-Limburg, Genk (ZOL), Genk, Belgium
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Maeseele N, Faes J, Van de Putte T, Vlasselaer J, de Jonge E, Schobbens JC, Deraedt K, Debrock G, Van de Putte G. Axillary lymph node dissection on the run? Facts Views Vis Obgyn 2017; 9:45-49. [PMID: 28721184 PMCID: PMC5506769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
The standard approach of performing a completion axillary lymph node dissection (cALND) after a positive sentinel node for breast cancer patients is no longer generally accepted. This study applied the criterion of a 27% risk of having residual positive lymph nodes calculated by the MD Anderson nomogram to perform a cALND. This 27% cut-off is based on the number of positive non-sentinels in the Z0011 trial. A cohort of 166 cN0, sentinel positive breast cancer patients was used to validate the MD Anderson nomogram. ROC (Receiver Operating Characteristic) analysis shows an AUC (Area Under the Curve) of 0.76 and an optimal cut-off at 34% risk of positive non- SLNs (sensitivity 86%, specificity 57%). The 27% cut-off has a sensitivity of 88% and a specificity of 41% to detect positive non-sentinels. In a second cohort (N= 114) the 27% cut-off criterion was prospectively applied and appeared to be practice changing. Although we take minimal risk to leave disease behind (2/166 patients >3 positive nodes), 30.7 % in the first cohort and 54.4 % of the patients in the second cohort could be spared a cALND. The Z0011 criteria would have had more impact, omitting 90% of the cALND, but leaves more disease behind. The impact of leaving disease behind on survival remains unanswered but is awaited by long term follow up of large prospective cohort studies.
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Abstract
The case of a 15-year-old boy with a severe swelling of the 2nd toe in the left foot and a large swelling of the left inguinofemoral region is described. Histologic examination of the foot lesion showed a typical epithelioid hemangioma of bone that extended into the soft tissues, with a secondary location in the groin, suggestive of lymph node involvement. Subsequently, imaging also revealed swelling of iliac and para-aortic lymph nodes, which probably indicates further lymph node spread.. Besides the fact that epithelioid hemangioma of the toe has not been reported yet, our case showed a noncontinuous localization, most likely in draining lymph nodes. This finding suggests metastatic disease, an event that is extremely rare for epithelioid hemangioma. As such, epithelioid hemangioma might be comparable to another benign vascular tumor, the retiform hemangioendothelioma, which occasionally metastasizes to the lymph nodes without systemic spread.
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Affiliation(s)
- Giuseppe Floris
- Department of Pathology, University Hospitals, Catholic University of Leuven, Leuven, Belgium
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Detroyer D, Deraedt K, Schöffski P, Hauben E, Lagrou K, Naesens M, Delforge ML, Kuypers D. Resolution of diffuse skin and systemic Kaposi's sarcoma in a renal transplant recipient after introduction of everolimus: a case report. Transpl Infect Dis 2015; 17:303-7. [PMID: 25645490 DOI: 10.1111/tid.12357] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [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: 11/11/2014] [Revised: 01/12/2015] [Accepted: 01/18/2015] [Indexed: 01/20/2023]
Abstract
We present a case report of a patient with diffuse skin and systemic Kaposi's sarcoma (KS), 1 year after renal transplantation. A concomitant Pyrenochaeta romeroi granuloma of the right hallux was diagnosed and illustrated an important immunodysfunction in our patient. Four months after reduction in immunosuppression and switch to everolimus, a total regression of the KS was observed. Reduction in the immunosuppression and treatment with terbinafine cleared the P. romeroi infection, while lowering immunosuppression and changing the type of immunosuppressive therapy were important steps in the successful management of the KS. In recent years, evidence of the antitumor effects of everolimus is increasing: total regression of KS in combination with renal function preservation in renal graft recipients is possible with mammalian target of rapamycin (mTOR) inhibitor-based regimens. In addition, with increasing numbers of human immunodeficiency virus-positive transplant recipients, mTOR inhibitors may play a more crucial role in the management of KS.
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Affiliation(s)
- D Detroyer
- Department of Nephrology, UZ Leuven, Leuven, Belgium
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Dreyer G, Vandorpe T, Smeets A, Forceville K, Brouwers B, Neven P, Janssens H, Deraedt K, Moerman P, Van Calster B, Christiaens MR, Paridaens R, Wildiers H. Triple negative breast cancer: clinical characteristics in the different histological subtypes. Breast 2013; 22:761-6. [PMID: 23416046 DOI: 10.1016/j.breast.2013.01.009] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [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: 07/29/2012] [Revised: 12/19/2012] [Accepted: 01/18/2013] [Indexed: 01/17/2023] Open
Abstract
PURPOSE To investigate the clinical behavior of triple negative breast cancer (TNC), including age distribution, occurrence of LN (lymph node) invasion and prognosis in different histological subtypes. METHODS For this cohort study we used data on 476 patients with newly diagnosed TNC at the University Hospitals Leuven (Belgium) between 1999 and 2009. Of these, 395 received upfront surgery, 68 neoadjuvant chemotherapy and 21 had metastases at diagnosis. RESULTS Apocrine and invasive lobular TNC occur more often in older patients compared to IDC-NOS. Of the primarily operated patients with TNC, 35.1% has pathological LN involvement. There were no significant differences in nodal invasion between different histological subtypes, but most subtypes contained few patients. In contrast to previous reports, 6/14 of apocrine TNC had LN involvement. Disease free survival (DFS) was different in different histological subtypes, but group sizes were insufficient to be able to draw firm conclusions. Within the histologically 'homogeneous' IDC-NOS group with primary surgery and outcome data (n = 300), DFS with 3.5 year median follow-up decreased with increasing age, but chemotherapy and radiotherapy were much less frequently given with increasing age. In multivariable analysis, lower age, presence of LN involvement, lack of administration of chemotherapy and radiotherapy were significant predictors of relapse. CONCLUSION TNC is not a uniform disease. Different histological subtypes have different age distribution and behavior. The prognosis of the most common histological subgroup, IDC-NOS, is better in older patients, but this is counterbalanced by significantly decreased use of chemotherapy and radiotherapy.
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Affiliation(s)
- Geertje Dreyer
- Department of General Medical Oncology, University Hospitals Leuven, Leuven, Belgium.
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Hollmen M, Liu P, Wildiers H, Reinvall I, Vandorpe T, Smeets A, Deraedt K, Vahlberg T, Joensuu H, Leahy D, Schoffski P, Elenius K. P5-02-01: ErbB4 Ectodomain as a Biomarker and a Potential Therapeutic Target for Breast Cancer. Cancer Res 2011. [DOI: 10.1158/0008-5472.sabcs11-p5-02-01] [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: 11/16/2022]
Abstract
Abstract
ErbB4 function is controversial in breast cancer and influenced by alternative splicing of the ERBB4 gene. Here we evaluated the cleavable ErbB4 JM-a isoform as a potential drug target and biomarker. To address ErbB4 cleavage in breast cancer tissues in vivo, extracellular and intracellular cleavage products of ErbB4 were assessed by ELISA and immunohistochemistry using matched serum and tissue samples from a series of 243 breast cancer patients. Elevated serum ectodomain level (≥40 ng/mL) and nuclear immunoreactivity were present in 21% and 52% of the patients, respectively. An elevated serum ErbB4 ectodomain concentration was not associated with tumor nuclear immunoreactivity, but was significantly associated with the premenopausal status at diagnosis (P = 0.04). Estradiol also enhanced ErbB4 cleavage and ErbB4 cleaving enzyme activity in vitro, supporting a role for estrogen signaling in regulation of ErbB4 cleavage. Selective targeting of the cleavable ErbB4 JM-a in human breast cancer cells with an ErbB4 isoform-specific mAb 1479 inhibited ErbB4 cleavage and reduced tumor formation in a mouse xenograft model. Consistent with blocking of ErbB4 cleavage, mutagenesis studies and the 3.4 Å X-ray crystal structure of a complex of the ErbB4 extracellular region and the 1479 Fab localized the binding site of mAb 1479 on ErbB4 to a region on subdomain IV encompassing JM-a-specific residues. These data demonstrate that ErbB4 is cleaved in a subset of breast cancer patients, and suggest that the mechanisms by which mAb 1479 suppresses breast cancer cell growth involves inhibition of ErbB4 cleavage. Serum ErbB4 ectodomain concentration could be used as a biomarker to monitor the activity of compounds, such as mAb 1479, that target ErbB4 cleavage.
Citation Information: Cancer Res 2011;71(24 Suppl):Abstract nr P5-02-01.
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Affiliation(s)
- M Hollmen
- 1University of Turku, Turku, Finland; Johns Hopkins University School of Medicine, Turku, Finland; University Hospitals Leuven, Belgium; University of Turku, Finland; Helsinki University Hospital, Helsinki, Finland
| | - P Liu
- 1University of Turku, Turku, Finland; Johns Hopkins University School of Medicine, Turku, Finland; University Hospitals Leuven, Belgium; University of Turku, Finland; Helsinki University Hospital, Helsinki, Finland
| | - H Wildiers
- 1University of Turku, Turku, Finland; Johns Hopkins University School of Medicine, Turku, Finland; University Hospitals Leuven, Belgium; University of Turku, Finland; Helsinki University Hospital, Helsinki, Finland
| | - I Reinvall
- 1University of Turku, Turku, Finland; Johns Hopkins University School of Medicine, Turku, Finland; University Hospitals Leuven, Belgium; University of Turku, Finland; Helsinki University Hospital, Helsinki, Finland
| | - T Vandorpe
- 1University of Turku, Turku, Finland; Johns Hopkins University School of Medicine, Turku, Finland; University Hospitals Leuven, Belgium; University of Turku, Finland; Helsinki University Hospital, Helsinki, Finland
| | - A Smeets
- 1University of Turku, Turku, Finland; Johns Hopkins University School of Medicine, Turku, Finland; University Hospitals Leuven, Belgium; University of Turku, Finland; Helsinki University Hospital, Helsinki, Finland
| | - K Deraedt
- 1University of Turku, Turku, Finland; Johns Hopkins University School of Medicine, Turku, Finland; University Hospitals Leuven, Belgium; University of Turku, Finland; Helsinki University Hospital, Helsinki, Finland
| | - T Vahlberg
- 1University of Turku, Turku, Finland; Johns Hopkins University School of Medicine, Turku, Finland; University Hospitals Leuven, Belgium; University of Turku, Finland; Helsinki University Hospital, Helsinki, Finland
| | - H Joensuu
- 1University of Turku, Turku, Finland; Johns Hopkins University School of Medicine, Turku, Finland; University Hospitals Leuven, Belgium; University of Turku, Finland; Helsinki University Hospital, Helsinki, Finland
| | - D Leahy
- 1University of Turku, Turku, Finland; Johns Hopkins University School of Medicine, Turku, Finland; University Hospitals Leuven, Belgium; University of Turku, Finland; Helsinki University Hospital, Helsinki, Finland
| | - P Schoffski
- 1University of Turku, Turku, Finland; Johns Hopkins University School of Medicine, Turku, Finland; University Hospitals Leuven, Belgium; University of Turku, Finland; Helsinki University Hospital, Helsinki, Finland
| | - K Elenius
- 1University of Turku, Turku, Finland; Johns Hopkins University School of Medicine, Turku, Finland; University Hospitals Leuven, Belgium; University of Turku, Finland; Helsinki University Hospital, Helsinki, Finland
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Vandorpe T, Smeets A, Van Calster B, Van Hoorde K, Leunen K, Amant F, Moerman P, Deraedt K, Brouckaert O, Van Huffel S, Wildiers H, Christiaens MR, Neven P. Lobular and non-lobular breast cancers differ regarding axillary lymph node metastasis: a cross-sectional study on 4,292 consecutive patients. Breast Cancer Res Treat 2011; 128:429-35. [PMID: 21562708 DOI: 10.1007/s10549-011-1565-4] [Citation(s) in RCA: 21] [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] [Received: 04/28/2011] [Accepted: 04/28/2011] [Indexed: 11/24/2022]
Abstract
Invasive lobular carcinoma (ILC) accounts for 8-14% of all breast cancers and carries distinct prognostic and biologic implications. The goal of our study was to investigate the impact of lobular histology on axillary lymph node (ALN) involvement. This is a cross-sectional study of 4,292 consecutive patients surgically treated for breast carcinoma at the University Hospitals Leuven. Logistic regression analysis was used to relate ILC to lymph node involvement while controlling for the following clinicopathologic features: tumor size, multifocal disease, tumor grade, lobular subtype and the combined steroid, and Her-2 status. Odds ratios (ORs) and 95% confidence intervals (CIS) were computed. A subgroup analysis was performed for patients that underwent a sentinel lymph node (SLN) procedure. The observed incidence of ILC was 13%. ILCs were larger, were more often grade II, multifocal, steroid receptor positive and Her-2 negative, and tended to be present in older patients. Incidence of ALN involvement was 42.0% for ILCs versus 38.3% for other tumors (OR 1.17, 95% CI 0.97-1.40). For the SLN subgroup, ILCs were less often ALN positive than non-ILCs (20.5% versus 28.3%, OR 0.66, 95% CI: 0.41-1.00). In the multivariable analysis, the lobular subtype was identified as less likely to have ALN involvement (adjusted OR 0.66, 95% CI 0.53-0.82). The analysis for the SLN subgroup showed comparable results (adjusted OR 0.49, 95% CI 0.30-0.78). This study has demonstrated that the lobular subtype is an independent predictor of lymph node involvement with ILC having a lower incidence of involved lymph nodes. The mildly higher incidence of ALN metastasis in lobular cancers in univariable analysis is not due to the lobular subtype, but due to confounding factors that interact with lymph node involvement.
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Affiliation(s)
- T Vandorpe
- Multidisciplinary Breast Centre, University Hospitals Leuven, Leuven, Belgium
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Wildiers H, Van Calster B, van de Poll-Franse LV, Hendrickx W, Røislien J, Smeets A, Paridaens R, Deraedt K, Leunen K, Weltens C, Van Huffel S, Christiaens MR, Neven P. Relationship Between Age and Axillary Lymph Node Involvement in Women With Breast Cancer. J Clin Oncol 2009; 27:2931-7. [DOI: 10.1200/jco.2008.16.7619] [Citation(s) in RCA: 60] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Purpose To study the relation between the presence of axillary lymph node (LN) involvement and age in breast cancer. Patients and Methods The breast cancer database of the University Hospitals Leuven contains complete data on 2,227 patients with early breast cancer consecutively treated between 2000 and 2005. A multivariate piecewise logistic regression model was used to analyze LN involvement in relation to age at diagnosis. A similar analysis was then performed on a large, independent, population-based database from the Eindhoven Cancer Registry to investigate whether the effects of the Leuven model could be replicated. Results We observed a piecewise effect of age. That is, women up to 70 years of age were less likely to have positive LNs with increasing age (odds ratio per 10-year increase, 0.87). In contrast, older women were more likely to have positive LNs with increasing age. However, for older women, the effect of age interacted with tumor size (P = .0044), suggesting that increasing age is associated with increased risk of LN involvement, mainly in small tumors. These findings were replicated in the Eindhoven Cancer Registry database. Conclusion Axillary LN involvement varies with age at diagnosis; its probability decreases with increasing age up to the age of approximately 70 years, but increases again thereafter. However, this increase is mainly seen in smaller tumors and suggests a different behavior of small breast cancers in older adult patients. We hypothesize that decreased immune defense mechanisms, related with aging, may play a role in earlier invasion into LNs.
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Affiliation(s)
- Hans Wildiers
- From the Multidisciplinary Breast Centre and Departments of General Medical Oncology, Pathology, Gynecology, and Radiotherapy, University Hospitals Leuven; Department of Electrical Engineering, Katholieke Universiteit Leuven, Leuven, Belgium; Comprehensive Cancer Centre South, Eindhoven Cancer Registry, Eindhoven, the Netherlands; and Department of Biostatistics, Institute of Basic Medical Sciences, University of Oslo, Norway
| | - Ben Van Calster
- From the Multidisciplinary Breast Centre and Departments of General Medical Oncology, Pathology, Gynecology, and Radiotherapy, University Hospitals Leuven; Department of Electrical Engineering, Katholieke Universiteit Leuven, Leuven, Belgium; Comprehensive Cancer Centre South, Eindhoven Cancer Registry, Eindhoven, the Netherlands; and Department of Biostatistics, Institute of Basic Medical Sciences, University of Oslo, Norway
| | - Lonneke V. van de Poll-Franse
- From the Multidisciplinary Breast Centre and Departments of General Medical Oncology, Pathology, Gynecology, and Radiotherapy, University Hospitals Leuven; Department of Electrical Engineering, Katholieke Universiteit Leuven, Leuven, Belgium; Comprehensive Cancer Centre South, Eindhoven Cancer Registry, Eindhoven, the Netherlands; and Department of Biostatistics, Institute of Basic Medical Sciences, University of Oslo, Norway
| | - Wouter Hendrickx
- From the Multidisciplinary Breast Centre and Departments of General Medical Oncology, Pathology, Gynecology, and Radiotherapy, University Hospitals Leuven; Department of Electrical Engineering, Katholieke Universiteit Leuven, Leuven, Belgium; Comprehensive Cancer Centre South, Eindhoven Cancer Registry, Eindhoven, the Netherlands; and Department of Biostatistics, Institute of Basic Medical Sciences, University of Oslo, Norway
| | - Jo Røislien
- From the Multidisciplinary Breast Centre and Departments of General Medical Oncology, Pathology, Gynecology, and Radiotherapy, University Hospitals Leuven; Department of Electrical Engineering, Katholieke Universiteit Leuven, Leuven, Belgium; Comprehensive Cancer Centre South, Eindhoven Cancer Registry, Eindhoven, the Netherlands; and Department of Biostatistics, Institute of Basic Medical Sciences, University of Oslo, Norway
| | - Ann Smeets
- From the Multidisciplinary Breast Centre and Departments of General Medical Oncology, Pathology, Gynecology, and Radiotherapy, University Hospitals Leuven; Department of Electrical Engineering, Katholieke Universiteit Leuven, Leuven, Belgium; Comprehensive Cancer Centre South, Eindhoven Cancer Registry, Eindhoven, the Netherlands; and Department of Biostatistics, Institute of Basic Medical Sciences, University of Oslo, Norway
| | - Robert Paridaens
- From the Multidisciplinary Breast Centre and Departments of General Medical Oncology, Pathology, Gynecology, and Radiotherapy, University Hospitals Leuven; Department of Electrical Engineering, Katholieke Universiteit Leuven, Leuven, Belgium; Comprehensive Cancer Centre South, Eindhoven Cancer Registry, Eindhoven, the Netherlands; and Department of Biostatistics, Institute of Basic Medical Sciences, University of Oslo, Norway
| | - Karen Deraedt
- From the Multidisciplinary Breast Centre and Departments of General Medical Oncology, Pathology, Gynecology, and Radiotherapy, University Hospitals Leuven; Department of Electrical Engineering, Katholieke Universiteit Leuven, Leuven, Belgium; Comprehensive Cancer Centre South, Eindhoven Cancer Registry, Eindhoven, the Netherlands; and Department of Biostatistics, Institute of Basic Medical Sciences, University of Oslo, Norway
| | - Karin Leunen
- From the Multidisciplinary Breast Centre and Departments of General Medical Oncology, Pathology, Gynecology, and Radiotherapy, University Hospitals Leuven; Department of Electrical Engineering, Katholieke Universiteit Leuven, Leuven, Belgium; Comprehensive Cancer Centre South, Eindhoven Cancer Registry, Eindhoven, the Netherlands; and Department of Biostatistics, Institute of Basic Medical Sciences, University of Oslo, Norway
| | - Caroline Weltens
- From the Multidisciplinary Breast Centre and Departments of General Medical Oncology, Pathology, Gynecology, and Radiotherapy, University Hospitals Leuven; Department of Electrical Engineering, Katholieke Universiteit Leuven, Leuven, Belgium; Comprehensive Cancer Centre South, Eindhoven Cancer Registry, Eindhoven, the Netherlands; and Department of Biostatistics, Institute of Basic Medical Sciences, University of Oslo, Norway
| | - Sabine Van Huffel
- From the Multidisciplinary Breast Centre and Departments of General Medical Oncology, Pathology, Gynecology, and Radiotherapy, University Hospitals Leuven; Department of Electrical Engineering, Katholieke Universiteit Leuven, Leuven, Belgium; Comprehensive Cancer Centre South, Eindhoven Cancer Registry, Eindhoven, the Netherlands; and Department of Biostatistics, Institute of Basic Medical Sciences, University of Oslo, Norway
| | - Marie-Rose Christiaens
- From the Multidisciplinary Breast Centre and Departments of General Medical Oncology, Pathology, Gynecology, and Radiotherapy, University Hospitals Leuven; Department of Electrical Engineering, Katholieke Universiteit Leuven, Leuven, Belgium; Comprehensive Cancer Centre South, Eindhoven Cancer Registry, Eindhoven, the Netherlands; and Department of Biostatistics, Institute of Basic Medical Sciences, University of Oslo, Norway
| | - Patrick Neven
- From the Multidisciplinary Breast Centre and Departments of General Medical Oncology, Pathology, Gynecology, and Radiotherapy, University Hospitals Leuven; Department of Electrical Engineering, Katholieke Universiteit Leuven, Leuven, Belgium; Comprehensive Cancer Centre South, Eindhoven Cancer Registry, Eindhoven, the Netherlands; and Department of Biostatistics, Institute of Basic Medical Sciences, University of Oslo, Norway
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13
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Dierickx I, Deraedt K, Poppe W, Verguts J. Aggressive angiomyxoma of the vulva: a case report and review of literature. Arch Gynecol Obstet 2008; 277:483-7. [PMID: 18214507 DOI: 10.1007/s00404-008-0561-3] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2007] [Accepted: 01/03/2008] [Indexed: 10/22/2022]
Abstract
BACKGROUND Aggressive angiomyxoma (AA) is a rare vulvovaginal mesenchymal neoplasm with a marked tendency to local recurrence but which usually does not metastasize. CASE REPORT We describe a case of AA in the left labium majus pudendi in a 47-year-old woman who underwent incomplete surgical excision. Follow-up 2years later revealed no recurrence. CONCLUSION In the past, most authors advocated wide excision even if genitourinary and digestive tract resection were necessary. These days, a less radical surgery is recommended, but the significance of hormonal treatment and/or radiation therapy is not clear yet. Further investigation is necessary.
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Affiliation(s)
- Inge Dierickx
- Department of Obstetrics and Gynaecology, Katholieke Universiteit Leuven, Leuven, Belgium
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14
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Brouwers B, Paridaens R, Lobelle JP, Hendrickx W, Smeets A, Neven P, Weltens C, Deraedt K, Vanden Bempt I, Christiaens MR, Wildiers H. Clinicopathological features of inflammatory versus noninflammatory locally advanced nonmetastatic breast cancer. Tumour Biol 2008; 29:211-6. [PMID: 18781092 DOI: 10.1159/000152938] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2008] [Accepted: 06/20/2008] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Inflammatory breast cancer (IBC) is a rare but aggressive form of breast cancer. It is mainly a clinical diagnosis. The aim of this study was to compare IBC to clinically diagnosed noninflammatory locally advanced nonmetastatic breast cancer, also called cLABC. MATERIAL AND METHODS One hundred and eight patients were studied: 49 with IBC and 59 with cLABC. The following features were analyzed: age at diagnosis, body mass index (BMI), axillary lymph node status (cN), estrogen receptor status (ER), progesterone receptor status (PR), HER2 status, histological tumor grade and subtype. Short-term disease-free (DFS) and overall survival (OS) were also assessed in both groups. RESULTS Compared with cLABC, IBC was less often PR positive (41.7 vs. 66.1%, p = 0.01) and showed a trend to be more often HER2 positive (34.7 vs. 19.3%, p = 0.07). The 3-year DFS was 63 and 77%, respectively, for IBC and cLABC (p = 0.01); these figures were 83 and 85% for OS (p = 0.17). No significant differences in age at diagnosis, ER, cN, BMI, histological tumor grade or subtype were demonstrated. CONCLUSION Compared to cLABC, IBC are more frequently PR negative, have a worse DFS, and have a tendency to be more often HER2 positive. These data reinforce the idea of IBC being a distinct biological entity compared to noninflammatory breast cancer.
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Affiliation(s)
- B Brouwers
- Multidisciplinary Breast Centre, Department of General Medical Oncology, University Hospitals Leuven, Leuven, Belgium
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15
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Neven P, Van Gorp T, Deraedt K. A gene signature of loss of oestrogen receptor (ER) function and oxidative stress links ER-positive breast tumours with an absent progesterone receptor and a poor prognosis. Breast Cancer Res 2008; 10:109. [PMID: 18828867 PMCID: PMC2614504 DOI: 10.1186/bcr2135] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Prognostic gene signatures like the wound and hypoxia signature differ by assumptions of cellular growth. Although gene signatures show little overlap, they also track within the group of luminal breast tumours those with a high proliferation and poor prognosis. Oxidative stress is another assumption of cellular growth. It affects several pathological conditions through its influence on the regulation of protein kinases and signal transduction pathways. A comprehensive set of 62 core genes from cultured oestrogen- and oestrogen receptor-deprived epithelial breast cancer cells is responsive to three forms of oxidative stress. Evidence is presented that oxidative stress involves the development of an aggressive subset of primary oestrogen receptor-positive breast tumours.
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16
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Thijs L, Deraedt K, Goossens A. Granuloma possibly induced by palladium after ear piercing. Dermatitis 2008; 19:E26-E29. [PMID: 18845107] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
A case of sarcoidal-type allergic contact granuloma due to palladium is presented. The patient developed papulonodular lesions at the right earlobe after ear piercing, which after 3 to 4 years became more granulomatous and very resistant to treatment. Repeated intralesional injections with corticosteroids produced only a temporary regression of the lesions. Patch testing revealed a strong positive reaction to palladium (and nickel). Biopsy specimens taken from the persistent granulomatous lesion in the nodule at the earlobe, as well as from the site of the positive test reaction to palladium several weeks after patch testing, indicated epithelioid granulomas with some multinucleate histiocytes surrounded by a lymphocytic-histiocytic infiltrate. Similar cases (also with other metals) have been reported in the literature.
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Affiliation(s)
- Leen Thijs
- Department of Dermatology, University Hospital, K.U. Leuven, Belgium
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17
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18
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Neven P, Brouckaert O, Van Belle V, Vanden Bempt I, Hendrickx W, Cho H, Deraedt K, Van Calster B, Van Huffel S, Moerman P, Amant F, Leunen K, Smeets A, Wildiers H, Paridaens R, Vergote I, Christiaens MR. In early-stage breast cancer, the estrogen receptor interacts with correlation between human epidermal growth factor receptor 2 status and age at diagnosis, tumor grade, and lymph node involvement. J Clin Oncol 2008; 26:1768-9; author reply 1769-71. [PMID: 18519273 DOI: 10.1200/jco.2007.15.6141] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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19
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Neven P, Van Belle V, Vanden Bempt I, Deraedt K, Moerman P, Paridaens R, Leunen K, Smeets A, Wildiers H, Christiaens M. The oestrogen receptor interacts with the correlation between HER-2 over-expression and age at diagnosis, tumour grade and lymph node involvement in operable breast cancers: a single centre experience. EJC Suppl 2008. [DOI: 10.1016/s1359-6349(08)70444-0] [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: 10/22/2022] Open
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20
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Neven P, Van Belle V, Brouckaert O, Pintens S, Paridaens R, Christiaens MR, Deraedt K, Moerman P. Are gene signatures better than traditional clinical factors? Lancet Oncol 2008; 9:197-8; author reply 198-9. [DOI: 10.1016/s1470-2045(08)70047-0] [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: 12/20/2022]
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21
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Vandecaveye V, De Keyzer F, Nuyts S, Deraedt K, Dirix P, Hamaekers P, Vander Poorten V, Delaere P, Hermans R. Detection of head and neck squamous cell carcinoma with diffusion weighted MRI after (chemo)radiotherapy: Correlation between radiologic and histopathologic findings. Int J Radiat Oncol Biol Phys 2007; 67:960-71. [PMID: 17141979 DOI: 10.1016/j.ijrobp.2006.09.020] [Citation(s) in RCA: 196] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2006] [Revised: 08/29/2006] [Accepted: 09/01/2006] [Indexed: 11/23/2022]
Abstract
PURPOSE To investigate the value of diffusion weighted magnetic resonance imaging (DW-MRI) in differentiating persistent or recurrent head and neck squamous cell carcinoma (HNSCC) from nontumoral postradiotherapeutic alterations. METHODS AND MATERIALS In 26 patients with suspicion of persistent or recurrent HNSCC, MRI of the head and neck was performed, including routine turbo spin-echo (TSE) sequences and an additional echo-planar DW-MRI sequence, using a large range of b-values (0-1000 s/mm(2)). Apparent diffusion coefficient (ADC) maps were calculated. In the suspect areas at the primary site and in the suspect lymph nodes, signal intensity was measured on the native b0 and b1000 images and ADC values were calculated for these tissues. The same was done for surrounding irradiated normal tissue. Imaging results were correlated to histopathology. RESULTS Signal intensity on native b0 images was significantly lower for HNSCC than for nontumoral postradiotherapeutic tissue (p < 0.0001), resulting in a sensitivity of 66.2%, specificity of 60.8%, and accuracy of 62.4%. Signal intensity on native b1000 images was significantly higher for HNSCC than for nontumoral tissue (p < 0.0001), resulting in a sensitivity of 71.6%, specificity of 71.3%, and accuracy of 71.4%. ADC values were significantly lower for HNSCC than for nontumoral tissue (p < 0.0001), resulting in a sensitivity of 94.6%, specificity of 95.9%, and accuracy of 95.5%. When compared with computed tomography, TSE-MRI and fluorodeoxyglucose-positron emission tomography, DW-MRI yielded fewer false-positive results in persistent primary site abnormalities and in persistent adenopathies, and aided in the detection of subcentimetric nodal metastases. CONCLUSIONS Diffusion weighted-MRI accurately differentiates persistent or recurrent HNSCC from nontumoral tissue changes after (chemo)radiotherapy.
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22
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Deraedt K, Debiec-Rychter M, Sciot R. Radiation-associated synovial sarcoma of the lung following radiotherapy for pulmonary metastasis of Wilms' tumour. Histopathology 2006; 48:473-5. [PMID: 16487376 DOI: 10.1111/j.1365-2559.2005.02270.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
MESH Headings
- Adult
- Chromosomes, Human, Pair 18/genetics
- Chromosomes, Human, X/genetics
- Humans
- Immunohistochemistry
- Karyotyping
- Keratins/analysis
- Lung/metabolism
- Lung/pathology
- Lung/radiation effects
- Lung Neoplasms/etiology
- Lung Neoplasms/radiotherapy
- Lung Neoplasms/secondary
- Male
- Neoplasms, Radiation-Induced/genetics
- Neoplasms, Radiation-Induced/metabolism
- Neoplasms, Radiation-Induced/pathology
- Radiotherapy/adverse effects
- Sarcoma, Synovial/genetics
- Sarcoma, Synovial/metabolism
- Sarcoma, Synovial/pathology
- Translocation, Genetic/radiation effects
- Wilms Tumor/pathology
- Wilms Tumor/radiotherapy
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23
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Vandecaveye V, de Keyzer F, Vander Poorten V, Deraedt K, Alaerts H, Landuyt W, Nuyts S, Hermans R. Evaluation of the larynx for tumour recurrence by diffusion-weighted MRI after radiotherapy: initial experience in four cases. Br J Radiol 2006; 79:681-7. [PMID: 16641411 DOI: 10.1259/bjr/89661809] [Citation(s) in RCA: 58] [Impact Index Per Article: 3.2] [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: 11/05/2022] Open
Abstract
Radiotherapy-induced changes in the soft tissues of the neck hamper the early detection of persistent or recurrent tumour by clinical examination and imaging procedures. Diffusion-weighted (DW) MRI is a non-invasive technique capable of probing tissue properties by measuring the movement of water. The purpose of the ongoing study is to examine the usefulness of DW-MRI for differentiation of persistent or recurrent tumour from post-radiotherapeutic sequelae or complications. Four patients, suspected of tumour recurrence after radiotherapy for laryngeal squamous cell carcinoma, were examined using a DW-MRI sequence on a clinical 1.5 T MR system prior to surgery. In two patients, the DW-MRI images showed an asymmetric hyperintense lesion on b1000 images with low apparent diffusion coefficient (ADC)-value, compatible with tumour on histopathology. All surrounding tissue presented high ADC values and absent signal on the b1000 images, histopathologically correlating to post-radiotherapeutic changes. The images of the third and fourth patient showed absent or minimal symmetric hyperintensity of the laryngeal soft tissues on the b1000 images and high ADC-values. In these cases, the histopathological diagnosis of radionecrosis was made and no tumour was found. In all four cases, differentiation of tumoral tissue from radiotherapy-induced tissue alterations was possible with DW-MRI.
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Affiliation(s)
- V Vandecaveye
- Department of Radiology, University Hospitals Leuven, Leuven, Belgium
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24
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Deraedt K, Vander Poorten V, Van Geet C, Renard M, De Wever I, Sciot R. Multifocal kaposiform haemangioendothelioma. Virchows Arch 2006; 448:843-6. [PMID: 16596383 DOI: 10.1007/s00428-006-0177-6] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.2] [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: 03/07/2005] [Accepted: 04/18/2005] [Indexed: 12/31/2022]
Abstract
Kaposiform haemangioendothelioma (KHE) is a rare, locally aggressive vascular spindle cell proliferation, with resemblance to Kaposi's sarcoma. This tumour usually occurs in skin and retroperitoneum of infants and young children and is often complicated by the Kasabach-Merritt phenomenon (KMP). A 3-year-old boy presented with a right submandibular swelling due to lymphadenopathies, a violaceous skin lesion at the left commissure of the lips and an ill-defined lesion in the right thyroid lobe. There were some signs of KMP. Histological examination revealed a typical infiltrative multilobular spindle cell proliferation with slit-like vascular spaces in these three localisations. Immunohistochemical stains showed positivity for CD34 and CD31 and many alpha-smooth muscle actin-positive spindle cells around the vascular spaces. There was no Herpes virus type 8 expression. The presented case is unique in two ways. First, thyroid involvement of KHE has never been described in the literature until now. Secondly, and most remarkably, the multifocal presentation in three anatomically distinct and separated localisations is extremely unusual.
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Affiliation(s)
- Karen Deraedt
- Department of Pathology, University Hospital St. Rafaël, Katholieke Universiteit Leuven, Minderbroedersstraat 12, 3000 Leuven, Belgium
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25
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Coenegrachts K, Vanbeckevoort D, Deraedt K, Van Steenbergen W. Mri findings in primary non-Hodgkin's lymphoma of the liver. JBR-BTR 2005; 88:17-9. [PMID: 15792163] [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] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
Abstract
Primary lymphoma of the liver is a very rare malignancy. Most often, these lesions consist of diffuse large B-cell non-Hodgkin's lymphoma that occurs mostly in immunodeficient patients. To prove the primary nature of a hepatic lesion, a systemic lymphoproliferative disease should be ruled out. Secondary liver involvement during Hodgkin's and non-Hodgkin's lymphoma is frequent. In advanced cases the incidence varies from 25% to 50%. The present case describes the MRI features of a primary lymphoma of the liver presenting as a solitary nodule. The primary lymphoma presents as a T2-hyperintense homogeneous nodule, with a signal intensity comparable with the signal intensity of the spleen. Signal intensity is comparable on in and out of phase imaging. The nodule is slightly T1-hypointense and doesn't show any arterial contrast uptake. In the late venous phase a slight increase in signal intensity is noted. Two and a half minutes after the administration of contrast agent, the lesion is iso-attenuating with the liver parenchyma. This case is rare because of the concomitant presence of heterozygous sickle cell anaemia and the presence of Gamna-Gandy bodies in the splenic parenchyma. It remains uncertain whether the presence of the Gamna-Gandy bodies is associated with the liver lymphoma or with the underlying sickle cell anaemia, or with a combination of both.
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Affiliation(s)
- K Coenegrachts
- Department of Radiology, University Hospital Gasthuisberg, Herestraat 49, B-3000 Leuven, Belgium
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