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Van Breusegem P, Verswijvel G, Fransis S, Van der Speeten K. Peritoneal Surface Malignancies Originating From Urachal Carcinoma: Case Reports and Review of the Literature. Indian J Surg Oncol 2023; 14:109-121. [PMID: 37359934 PMCID: PMC10284781 DOI: 10.1007/s13193-022-01679-4] [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: 07/09/2022] [Accepted: 10/19/2022] [Indexed: 12/23/2022] Open
Abstract
Urachal carcinoma (UC) is a rare and aggressive tumor arising from the urachal remnants, with the potential for peritoneal dissemination. Patients diagnosed with UC often have a poor prognosis. To date, there is no standardized treatment. Our objective is to present two cases of patients with peritoneal carcinomatosis (PC) secondary to an UC, who were treated with cytoreductive surgery (CRS) and hyperthermic peroperative intraperitoneal chemotherapy (HIPEC). A review of the literature on CRS and HIPEC in UC suggests CRS and HIPEC to be a safe and viable treatment option. Two patients with PC of UC underwent CRS and HIPEC in our institution. All available data were gathered and reported on. A literary search was carried out to find all available cases of patients with PC secondary to UC treated with CRS and HIPEC. Both patients underwent CRS and HIPEC and are currently free of recurrence. Literature research revealed nine other publications adding up to a total of 68 additional cases. CRS and HIPEC can provide satisfactory long-term oncological outcome with acceptable morbidity and mortality rates in patients with PC of urachal origin. It should be considered as a safe and feasible treatment option with curative potential.
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Affiliation(s)
- Paulien Van Breusegem
- Department of Surgical Oncology, Hospital Oost-Limburg, Schiepse Bos 6, 3600 Genk, Belgium
| | | | - Sabine Fransis
- Department of Pathology, Hospital Oost-Limburg, Genk, Belgium
| | - Kurt Van der Speeten
- Department of Surgical Oncology, Hospital Oost-Limburg, Schiepse Bos 6, 3600 Genk, Belgium
- Faculty of Medicine and Life Sciences, BIOMED Research Institute, University Hasselt, Hasselt, Belgium
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2
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Verquin M, Politis C, Thonnart F, Fransis S, Schepers S. A Rare Case Report of GVHD-related Cutaneous Horns of the lower lip. JAAD Case Rep 2022; 21:59-62. [PMID: 35169603 PMCID: PMC8829441 DOI: 10.1016/j.jdcr.2021.12.035] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Affiliation(s)
- Michaël Verquin
- Department of Oral and Maxillofacial Surgery, Hospital of Oost-Limburg, Schiepse Bos 6, Genk, Belgium
- Correspondence to: Michaël Verquin, MD, DDS, Division of Maxillofacial Surgery, Department of Oral and Maxillofacial Surgery, Hospital of Oost-Limburg, Schiepse Bos 6, 3600 Genk, Belgium.
| | - Christophe Politis
- Department of Oral and Maxillofacial Surgery, Hospital of Oost-Limburg, Schiepse Bos 6, Genk, Belgium
| | - François Thonnart
- Department of Oral and Maxillofacial Surgery, Hospital of Oost-Limburg, Schiepse Bos 6, Genk, Belgium
| | - Sabine Fransis
- Department of Pathology, Hospital of Oost-Limburg, Schiepse Bos 6, Genk, Belgium
| | - Serge Schepers
- Department of Oral and Maxillofacial Surgery, Hospital of Oost-Limburg, Schiepse Bos 6, Genk, Belgium
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Heylen L, Boeckx B, Jacobs T, Bosisio FM, Weynand B, Marcelis L, Dendooven A, Hendrickx L, Fransis S, Steensels D, Van Boxstael S, Van Asbroeck PJ, Thevissen K, Van Eyken P, Lambrechts D. MO249SINGLE-CELL TRANSCRIPTOME OF COVID19 ASSOCIATED IGA NEPHROPATHY*. Nephrol Dial Transplant 2021. [PMCID: PMC8195045 DOI: 10.1093/ndt/gfab104.007] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background and Aims
Acute kidney injury is common in patients infected with the novel coronavirus SARS-CoV-2. Predominant findings in case series of kidney biopsies include acute tubular injury and collapsing podocytopathy. We performed single-cell RNA sequencing on kidney biopsy of a patient with COVID19-associated Henoch-Schönlein vasculitis, to investigate the underlying molecular changes.
Method
A 46-year-old woman presented with cutaneous vasculitis, arthritis, fever and microscopic hematuria. SARS-CoV-2 PCR on nasopharyngeal swab turned positive. Despite quick spontaneous resolution of symptoms, hematuria persisted and proteinuria increased in the next weeks. Subsequent kidney biopsy showed IgA nephropathy. Kidney biopsy was dissociated into a single-cell suspension and RNA was sequenced. 6126 kidney cells passed quality filters. Publicly available single cell sequencing data of 3 healthy kidney samples were integrated to allow comparison. The skin biopsy, performed at the initial presentation, was stained for the SARS-CoV-2 spike protein and the ACE2 protein using immunohistochemistry.
Results
Unsupervised clustering analysis of kidney identified 12 distinct cell types (Figure 1). T-lymphocytes were significantly enriched in COVID19 associated IgA nephropathy (16.7% versus 0.5%, 1.2% and 4.1% in healthy kidney, IgA nephropathy/healthy kidney ratio of relative % of T-/NK-cell clusters of 8.5), with a deviation towards CD8 lymphocytes and NK(T) cells (Figure 2). NK cells were solely present in IgA nephropathy compared to healthy kidney (1.5% versus 0% in all healthy kidneys).
Several genes involved in immune activation, oxidative stress and injury were upregulated in podocytes and mesangial cells. For example, one of the genes upregulated in podocytes was macrophage migration inhibitory factor (MIF) which is known to be involved in podocyte injury and mesangial sclerosis. In endothelial cells pathways involved in NK cell immunity, antigen presentation, interferon gamma signaling, and viral entry were upregulated. In T lymphocytes pathways of antigen presentation and T cell cytotoxicity were enriched.
In the skin biopsy, immunohistochemistry was positive for SARS-CoV-2 spike protein inside inflammatory cells, while the ACE2 receptor was positive in the same inflammatory cells, as well as inside endothelial cells.
Conclusion
Although both innate and adaptive immunity are considered to be involved in IgA nephropathy, our single cell sequencing data demonstrates that mainly T-lymphocytes, especially CD8 cells and NK cells, are enriched in COVID19 associated IgA nephropathy. Further elucidation of the involved pathways and the T cell receptor is planned. Interestingly, the SARS-CoV-2 virus could be identified inside the inflammatory cells in the skin in the context of cutaneous vasculitis, suggesting a direct pathologic effect.
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Affiliation(s)
| | - Bram Boeckx
- VIB - Center for Cancer Biology, Leuven, Belgium
| | - Tim Jacobs
- ZOL Genk, Emergency Medicine, Genk, Belgium
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Vanden Bempt I, Vander Borght S, Sciot R, Spans L, Claerhout S, Brems H, Lehnert S, Dehaspe L, Fransis S, Neuville B, Topal B, Schöffski P, Legius E, Debiec-Rychter M. Comprehensive targeted next-generation sequencing approach in the molecular diagnosis of gastrointestinal stromal tumor. Genes Chromosomes Cancer 2020; 60:239-249. [PMID: 33258138 DOI: 10.1002/gcc.22923] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [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: 10/29/2020] [Revised: 11/25/2020] [Accepted: 11/28/2020] [Indexed: 12/26/2022] Open
Abstract
Mutational analysis guides therapeutic decision making in patients with advanced-stage gastrointestinal stromal tumors (GISTs). We evaluated three targeted next-generation sequencing (NGS) assays, consecutively used over 4 years in our laboratory for mutational analysis of 162 primary GISTs: Agilent GIST MASTR, Illumina TruSight 26 and an in-house developed 96 gene panels. In addition, we investigated the feasibility of a more comprehensive approach by adding targeted RNA sequencing (Archer FusionPlex, 11 genes) in an attempt to reduce the number of Wild Type GISTs. We found KIT or PDGFRA mutations in 149 out of 162 GISTs (92.0%). Challenging KIT exon 11 alterations were initially missed by different assays in seven GISTs and typically represented deletions at the KIT intron 10-exon 11 boundary or large insertions/deletions (>24 base pairs). Comprehensive analysis led to the additional identification of driver alterations in 8/162 GISTs (4.9%): apart from BRAF and SDHA mutations (one case each), we found five GISTs harboring somatic neurofibromatosis type 1 (NF1) alterations (3.1%) and one case with an in-frame TRIM4-BRAF fusion not reported in GIST before. Eventually, no driver alteration was found in two out of 162 GISTs (1.2%) and three samples (1.9%) failed analysis. Our study shows that a comprehensive targeted NGS approach is feasible for routine mutational analysis of GIST, thereby substantially reducing the number of Wild Type GISTs, and highlights the need to optimize assays for challenging KIT exon 11 alterations.
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Affiliation(s)
- Isabelle Vanden Bempt
- Department for Human Genetics, University Hospitals Leuven, KU Leuven, Leuven, Belgium
| | - Sara Vander Borght
- Department for Human Genetics, University Hospitals Leuven, KU Leuven, Leuven, Belgium.,Department of Pathology, University Hospitals Leuven, KU Leuven, Leuven, Belgium
| | - Raf Sciot
- Department of Pathology, University Hospitals Leuven, KU Leuven, Leuven, Belgium
| | - Lien Spans
- Department for Human Genetics, University Hospitals Leuven, KU Leuven, Leuven, Belgium
| | - Sofie Claerhout
- Department for Human Genetics, University Hospitals Leuven, KU Leuven, Leuven, Belgium
| | - Hilde Brems
- Department for Human Genetics, University Hospitals Leuven, KU Leuven, Leuven, Belgium
| | - Stefan Lehnert
- Department for Human Genetics, University Hospitals Leuven, KU Leuven, Leuven, Belgium
| | - Luc Dehaspe
- Department for Human Genetics, University Hospitals Leuven, KU Leuven, Leuven, Belgium
| | - Sabine Fransis
- Department of Pathology, Ziekenhuis Oost Limburg, Genk, Belgium
| | - Bart Neuville
- Department of Gastroenterology and Hepatology, Ziekenhuis Oost-Limburg, Genk, Belgium
| | - Baki Topal
- Department of Abdominal Surgery, University Hospitals Leuven, KU Leuven, Leuven, Belgium
| | - Patrick Schöffski
- Department of General Medical Oncology, University Hospitals Leuven, Leuven Cancer Institute, and Department of Oncology, KU Leuven, Laboratory of Experimental Oncology, Leuven, Belgium.,Department of Oncology, KU Leuven, Laboratory of Experimental Oncology, Leuven, Belgium
| | - Eric Legius
- Department for Human Genetics, University Hospitals Leuven, KU Leuven, Leuven, Belgium
| | - Maria Debiec-Rychter
- Department for Human Genetics, University Hospitals Leuven, KU Leuven, Leuven, Belgium
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5
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Swinnen J, Gelin G, Fransis S, Vandevenne J, Van Cauter S. Glioblastoma with extracranial parotid, lymph node, and pulmonary metastases: a case report. Radiol Case Rep 2019; 14:1334-1347. [PMID: 31516649 PMCID: PMC6732724 DOI: 10.1016/j.radcr.2019.08.011] [Citation(s) in RCA: 4] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2019] [Revised: 08/07/2019] [Accepted: 08/09/2019] [Indexed: 11/16/2022] Open
Abstract
We present a rare case of an isocitrate dehydrogenase-wildtype glioblastoma with histologically proven parotid, cervical lymph node, and lung metastases. While recent therapy advances are likely to increase glioblastoma mid- and long-term survival, this will also increase the time window for extraneural glioblastoma spread. Radiologists should be aware of this risk, so they can accurately detect and interpret metastatic glioblastoma disease.
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Affiliation(s)
- Jeroen Swinnen
- Department of Radiology, Ziekenhuis Oost-Limburg, Schiepse Bos 6, 3600 Genk, Belgium.,Department of Radiology, University Hospitals Leuven, Herestraat 49, 3000 Leuven, Belgium
| | - Geert Gelin
- Department of Radiology, Ziekenhuis Oost-Limburg, Schiepse Bos 6, 3600 Genk, Belgium
| | - Sabine Fransis
- Department of Pathology, Ziekenhuis Oost-Limburg, Schiepse Bos 6, 3600 Genk, Belgium
| | - Jan Vandevenne
- Department of Radiology, Ziekenhuis Oost-Limburg, Schiepse Bos 6, 3600 Genk, Belgium.,Faculty of Medicine, University of Hasselt, Agoralaan gebouw D, 3590 Diepenbeek, Belgium
| | - Sofie Van Cauter
- Department of Radiology, Ziekenhuis Oost-Limburg, Schiepse Bos 6, 3600 Genk, Belgium.,Department of Radiology, University Hospitals Leuven, Herestraat 49, 3000 Leuven, Belgium
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6
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Ameye H, Fransis S, Lerut E, Metalidis C, Sprangers B. Beneficial Effect of Rituximab in the Treatment of Esophageal Cancer-Associated Pauci-Immune Glomerulonephritis. Kidney Int Rep 2016; 1:131-134. [PMID: 29142922 PMCID: PMC5678843 DOI: 10.1016/j.ekir.2016.06.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- Heleen Ameye
- Department of Nephrology, University Hospitals Leuven, Leuven, Belgium
| | - Sabine Fransis
- Department of Pathology, Ziekenhuis Oost-Limburg Hospital, Genk, Belgium
| | - Evelyne Lerut
- Department of Morphology and Molecular Pathology, University Hospitals Leuven, Leuven, Belgium
| | | | - Ben Sprangers
- Department of Nephrology, University Hospitals Leuven, Leuven, Belgium.,Department of Microbiology and Immunology, University of Leuven, Leuven, Belgium
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7
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Verbeek J, Lannoo M, Pirinen E, Ryu D, Spincemaille P, Vander Elst I, Windmolders P, Thevissen K, Cammue BPA, van Pelt J, Fransis S, Van Eyken P, Ceuterick-De Groote C, Van Veldhoven PP, Bedossa P, Nevens F, Auwerx J, Cassiman D. Roux-en-y gastric bypass attenuates hepatic mitochondrial dysfunction in mice with non-alcoholic steatohepatitis. Gut 2015; 64:673-83. [PMID: 24917551 DOI: 10.1136/gutjnl-2014-306748] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
OBJECTIVE No therapy for non-alcoholic steatohepatitis (NASH) has been approved so far. Roux-en-y gastric bypass (RYGB) is emerging as a therapeutic option, although its effect on NASH and related hepatic molecular pathways is unclear from human studies. We studied the effect of RYGB on pre-existent NASH and hepatic mitochondrial dysfunction-a key player in NASH pathogenesis-in a novel diet-induced mouse model nicely mimicking human disease. DESIGN C57BL/6J mice were fed a high-fat high-sucrose diet (HF-HSD). RESULTS HF-HSD led to early obesity, insulin resistance and hypercholesterolaemia. HF-HSD consistently induced NASH (steatosis, hepatocyte ballooning and inflammation) with fibrosis already after 12-week feeding. NASH was accompanied by hepatic mitochondrial dysfunction, characterised by decreased mitochondrial respiratory chain (MRC) complex I and IV activity, ATP depletion, ultrastructural abnormalities, together with higher 4-hydroxynonenal (HNE) levels, increased uncoupling protein 2 (UCP2) and tumour necrosis factor-α (TNF-α) mRNA and free cholesterol accumulation. In our model of NASH and acquired mitochondrial dysfunction, RYGB induced sustained weight loss, improved insulin resistance and inhibited progression of NASH, with a marked reversal of fibrosis. In parallel, RYGB preserved hepatic MRC complex I activity, restored ATP levels, limited HNE production and decreased TNF-α mRNA. CONCLUSIONS Progression of NASH and NASH-related hepatic mitochondrial dysfunction can be prevented by RYGB. RYGB preserves respiratory chain complex activity, thereby restoring energy output, probably by limiting the amount of oxidative stress and TNF-α. These data suggest that modulation of hepatic mitochondrial function contributes to the favourable effect of RYBG on established NASH.
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Affiliation(s)
- Jef Verbeek
- Department of Hepatology, University Hospitals KU Leuven, Leuven, Belgium
| | - Matthias Lannoo
- Department of Abdominal Surgery, University Hospitals KU Leuven, Leuven, Belgium
| | - Eija Pirinen
- Laboratory for Integrative and Systems Physiology, Ecole Polytechnique Fédérale de Lausanne, Lausanne, Switzerland Departments of Biotechnology and Molecular Medicine, A.I. Virtanen Institute for Molecular Sciences, Biocenter Kuopio, University of Eastern Finland, Kuopio, Finland
| | - Dongryeol Ryu
- Laboratory for Integrative and Systems Physiology, Ecole Polytechnique Fédérale de Lausanne, Lausanne, Switzerland
| | | | - Ingrid Vander Elst
- Department of Hepatology, University Hospitals KU Leuven, Leuven, Belgium
| | - Petra Windmolders
- Department of Hepatology, University Hospitals KU Leuven, Leuven, Belgium
| | - Karin Thevissen
- Centre of Microbial and Plant Genetics (CMPG), KU Leuven, Leuven, Belgium
| | - Bruno P A Cammue
- Centre of Microbial and Plant Genetics (CMPG), KU Leuven, Leuven, Belgium Department of Plant Systems Biology, Vlaams Instituut voor Biotechnologie (VIB), Ghent, Belgium
| | - Jos van Pelt
- Department of Hepatology, University Hospitals KU Leuven, Leuven, Belgium
| | - Sabine Fransis
- Department of Pathology, Ziekenhuis Oost-Limburg, Genk, Belgium
| | - Peter Van Eyken
- Department of Pathology, Ziekenhuis Oost-Limburg, Genk, Belgium
| | - Chantal Ceuterick-De Groote
- Laboratory of Ultrastructural Neuropathology, Institute Born-Bunge (IBB), University of Antwerp, Antwerp, Belgium
| | - Paul P Van Veldhoven
- Laboratory of Lipid Biochemistry and Protein Interactions, KU Leuven, Leuven, Belgium
| | - Pierre Bedossa
- Department of Pathology, Hopital Beaujon, Clichy, France
| | - Frederik Nevens
- Department of Hepatology, University Hospitals KU Leuven, Leuven, Belgium
| | - Johan Auwerx
- Laboratory for Integrative and Systems Physiology, Ecole Polytechnique Fédérale de Lausanne, Lausanne, Switzerland
| | - David Cassiman
- Department of Hepatology, University Hospitals KU Leuven, Leuven, Belgium Metabolic Center, University Hospitals KU Leuven, Leuven, Belgium
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Van Holsbeke C, Ameye L, Testa AC, Mascilini F, Lindqvist P, Fischerova D, Frühauf F, Fransis S, de Jonge E, Timmerman D, Epstein E. Development and external validation of new ultrasound-based mathematical models for preoperative prediction of high-risk endometrial cancer. Ultrasound Obstet Gynecol 2014; 43:586-595. [PMID: 24123609 DOI: 10.1002/uog.13216] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/13/2013] [Revised: 09/02/2013] [Accepted: 09/17/2013] [Indexed: 06/02/2023]
Abstract
OBJECTIVES To develop and validate strategies, using new ultrasound-based mathematical models, for the prediction of high-risk endometrial cancer and compare them with strategies using previously developed models or the use of preoperative grading only. METHODS Women with endometrial cancer were prospectively examined using two-dimensional (2D) and three-dimensional (3D) gray-scale and color Doppler ultrasound imaging. More than 25 ultrasound, demographic and histological variables were analyzed. Two logistic regression models were developed: one 'objective' model using mainly objective variables; and one 'subjective' model including subjective variables (i.e. subjective impression of myometrial and cervical invasion, preoperative grade and demographic variables). The following strategies were validated: a one-step strategy using only preoperative grading and two-step strategies using preoperative grading as the first step and one of the new models, subjective assessment or previously developed models as a second step. RESULTS One-hundred and twenty-five patients were included in the development set and 211 were included in the validation set. The 'objective' model retained preoperative grade and minimal tumor-free myometrium as variables. The 'subjective' model retained preoperative grade and subjective assessment of myometrial invasion. On external validation, the performance of the new models was similar to that on the development set. Sensitivity for the two-step strategy with the 'objective' model was 78% (95% CI, 69-84%) at a cut-off of 0.50, 82% (95% CI, 74-88%) for the strategy with the 'subjective' model and 83% (95% CI, 75-88%) for that with subjective assessment. Specificity was 68% (95% CI, 58-77%), 72% (95% CI, 62-80%) and 71% (95% CI, 61-79%) respectively. The two-step strategies detected up to twice as many high-risk cases as preoperative grading only. The new models had a significantly higher sensitivity than did previously developed models, at the same specificity. CONCLUSION Two-step strategies with 'new' ultrasound-based models predict high-risk endometrial cancers with good accuracy and do this better than do previously developed models.
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Affiliation(s)
- C Van Holsbeke
- Department of Obstetrics and Gynaecology, University Hospitals Leuven, Leuven, Belgium; Department of Obstetrics and Gynaecology, Ziekenhuis Oost-Limburg, Genk, Belgium
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10
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Jansen E, Fransis S, Ahmad S, Timmerman D, Van Holsbeke C. Imaging in gynaecological disease: clinical and ultrasound characteristics of mucocele of the appendix. A pictorial essay. Facts Views Vis Obgyn 2013; 5:209-12. [PMID: 24753946 PMCID: PMC3987369] [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: 11/30/2022] Open
Abstract
The aim of this pictorial essay is to describe the ultrasound characteristics of the mucocele of the appendix (MA) by transvaginal ultrasound. The databases of the pathology and gynaecology departments of two Belgian hospitals were retrospectively searched for all cases of MA. Only patients who received a pre-operative transvaginal ultrasound scan by an experienced ultrasound examiner following the IOTA protocol were included. Ultrasound -characteristics were described and pattern recognition was applied in order to find morphological characteristics typical for MA. Thirty-one cases were found of which five underwent a transvaginal ultrasound. In three out of these five cases a mucocele was described. All three masses had a similar morphology, i.e. a para-ovarian uni-locular tubular mass with a color score of 1. A typical characteristic was the aspect of the cyst content, which resembled whipped cream. Although MA is seldom diagnosed by gynaecologists, transvaginal ultrasound is able to make an accurate diagnosis. MA is a -para-ovarian, unilocular tubular mass that typically has a cyst content that resembles whipped cream.
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Affiliation(s)
- E. Jansen
- Department of Obstetrics and Gynaecology, ZOL Hospitals Campus St Jan, Genk, Belgium
| | - S. Fransis
- Department of Pathology, ZOL Hospitals Campus St Jan, Genk, Belgium
| | - S. Ahmad
- Department of Pathology, University Hospitals KU Leuven, Leuven, Belgium
| | - D. Timmerman
- Department of Obstetrics and Gynaecology, University Hospitals KU Leuven, Leuven, Belgium
| | - C. Van Holsbeke
- Department of Obstetrics and Gynaecology, ZOL Hospitals Campus St Jan, Genk, Belgium
,Department of Obstetrics and Gynaecology, University Hospitals KU Leuven, Leuven, Belgium
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11
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Testa AC, Timmerman D, Van Holsbeke C, Zannoni GF, Fransis S, Moerman P, Vellone V, Mascilini F, Licameli A, Ludovisi M, Di Legge A, Scambia G, Ferrandina G. Ovarian cancer arising in endometrioid cysts: ultrasound findings. Ultrasound Obstet Gynecol 2011; 38:99-106. [PMID: 21351179 DOI: 10.1002/uog.8970] [Citation(s) in RCA: 28] [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] [Subscribe] [Scholar Register] [Accepted: 04/14/2011] [Indexed: 05/30/2023]
Abstract
OBJECTIVES To describe sonographic characteristics of malignant transformation in endometrioid cysts. METHODS Women with a histological diagnosis of ovarian endometrioid cysts, borderline tumors arising in endometrioid cysts and carcinoma arising in endometrioid cysts, preoperatively examined sonographically, were included in this retrospective study. Gray-scale and Doppler ultrasound characteristics of the endometrioid cysts were compared with those of the borderline tumors and primary cancers arising in endometrioid cysts. The performance of an experienced examiner in classifying the masses was also assessed. RESULTS Of 324 cases collected for the study, 309 (95.3%) lesions were classified as endometrioid cysts, four (1.2%) as borderline tumors arising in endometrioid cysts and 11 (3.4%) as carcinoma arising in endometrioid cysts. Women with malignant findings (borderline ovarian tumors and cancers) were older (median age 52 (range, 28-79) years) than those with benign endometrioid cysts (median age 34 (range, 18-76) years) (P<0.0001), and the prevalence of postmenopausal status was significantly higher in malignant cases. All (15/15) malignant tumors vs. 16% (50/309) of benign tumors were characterized by the presence of solid tissue (P<0.0001). The prevalence of solid tissue with positive Doppler signals was higher in malignant tumors (100%) than in benign cysts (7.8%) (P<0.0001). Papillary projections were a more frequent sonographic feature among malignant lesions (86.7%) than among benign endometrioid cysts (11.3%) (P<0.0001); power Doppler signals were detected within the projections in 92.3% and 37.1% of malignant and benign lesions, respectively. The examiner correctly diagnosed 94.8% (293/309) of benign lesions as benign and 93.3% (14/15) of malignant lesions as malignant. The risk estimation of the examiner was 'uncertain' in three (20%) and 'probably/certainly malignant' in 12 (80%) of 15 malignant cases. CONCLUSION Borderline tumors and carcinomas arising in endometrioid cysts show a vascularized solid component at ultrasound examination.
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Affiliation(s)
- A C Testa
- Department of Obstetrics and Gynecology, Catholic University, Rome, Italy.
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Evenepoel P, Zeegers M, Segaert S, Claes K, Kuypers D, Maes B, Flamen P, Fransis S, Vanrenterghem Y. Nephrogenic fibrosing dermopathy: a novel, disabling disorder in patients with renal failure. Nephrol Dial Transplant 2004; 19:469-73. [PMID: 14736976 DOI: 10.1093/ndt/gfg506] [Citation(s) in RCA: 64] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- Pieter Evenepoel
- Division of Nephrology, Department of Medicine, University Hospital Leuven, Leuven, Belgium.
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