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Sethi HK, Shpigel M, Alnouri G, Zhou J, Sataloff RT. Cartilaginous Choristoma of the External Auditory Canal. Ear Nose Throat J 2024; 103:214-216. [PMID: 34587769 DOI: 10.1177/01455613211048974] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Cartilaginous choristoma is a rare benign lesion of the external auditory canal, generally found incidentally on physical exam in an asymptomatic patient. Our patient had the largest cartilaginous choristomas described in the literature to date. Additionally, this reviews the nomenclature and differential diagnoses of masses within the external auditory canal.
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Affiliation(s)
- Harleen K Sethi
- Department of Otolaryngology-Head and Neck Surgery, Philadelphia College of Osteopathic Medicine, Philadelphia, PA, USA
- Department of Otolaryngology-Head and Neck Surgery, Drexel University College of Medicine, Philadelphia, PA, USA
| | - Melanie Shpigel
- Philadelphia College of Osteopathic Medicine, Philadelphia, PA, USA
| | - Ghiath Alnouri
- Department of Otolaryngology-Head and Neck Surgery, Drexel University College of Medicine, Philadelphia, PA, USA
- Department of Otolaryngology-Head and Neck Surgery, Lankenau Medical Center, Wynnewood, PA, USA
| | - Jing Zhou
- Department of Pathology, Lankenau Medical Center, Wynnewood, PA, USA
| | - Robert T Sataloff
- Department of Otolaryngology-Head and Neck Surgery, Drexel University College of Medicine, Philadelphia, PA, USA
- Department of Otolaryngology-Head and Neck Surgery, Lankenau Medical Center, Wynnewood, PA, USA
- Lankenau Institute for Medical Research, Wynnewood, PA, USA
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2
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Najmi H, Aleid S, Badghaish F, Alnashwan Y. Congenital solitary osseous choristoma of the left lateral canthus: a case report. BMC Ophthalmol 2024; 24:140. [PMID: 38549111 PMCID: PMC10976811 DOI: 10.1186/s12886-024-03403-y] [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] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2023] [Accepted: 03/18/2024] [Indexed: 04/01/2024] Open
Abstract
BACKGROUND An ocular osseous choristoma is a growth of mature, compact bone in the ocular or periocular soft tissue, and it is the rarest form of ocular choristoma, accounting for only 1.7% of all epibulbar choristomas. CASE PRESENTATION Herein we present the case of a 20-month-old girl who was referred to the oculoplasty clinic with a progressively growing mass in the left lateral canthus. It had been present since birth without ocular involvement. Upon examination the mass was firm with a smooth surface, measured 9 × 6 × 3 mm, and exhibited no episcleral attachment or ocular involvement. An excisional biopsy was performed, and the histopathological findings were consistent with osseous choristoma of the left lateral canthus. CONCLUSIONS This report highlights the importance of considering osseous choristoma in the differential diagnosis of eyelid lesions, particularly those that have been present since birth. It also emphasizes the need for further studies investigating associations between osseous choristomas and ocular canthi.
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Affiliation(s)
- Hatim Najmi
- Oculoplastic Division, Department of Ophthalmology, Dhahran Eye Specialist Hospital, Dhahran, Saudi Arabia.
| | - Shaikha Aleid
- Oculoplastic Division, Department of Ophthalmology, King Fahad University Hospital, Khobar, Saudi Arabia
| | - Fatimah Badghaish
- College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Yara Alnashwan
- Department of Pathology, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
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3
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Ahmed TM, Fishman EK. Cinematic Rendering for Differentiation of Pancreatic Neuroendocrine Tumor From Intrapancreatic Accessory Spleen. AJR Am J Roentgenol 2024; 222:e2430862. [PMID: 38265000 DOI: 10.2214/ajr.24.30862] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2024]
Affiliation(s)
- Taha M Ahmed
- Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, 601 N Caroline St, JHOC 3256, Baltimore, MD 21287
| | - Elliot K Fishman
- Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, 601 N Caroline St, JHOC 3256, Baltimore, MD 21287
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4
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Barrios M, Perez NE, Briski LM, Pluguez-Turull C. Recurrent ectopic primary breast adenocarcinoma of the vulva with a 19-year follow-up period. BMJ Case Rep 2024; 17:e257791. [PMID: 38367988 PMCID: PMC10875544 DOI: 10.1136/bcr-2023-257791] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/19/2024] Open
Abstract
We present a case of an ectopic breast adenocarcinoma of the vulva with metastatic local recurrence and a total follow-up period of 19 years, the longest documented in the literature to our knowledge. Following surgical excision, radiation therapy and hormonal treatment after the recurrence, the patient has remained disease free. This case demonstrates the potential for malignant transformation in accessory breast tissue and highlights the importance of close surveillance and regular physical examinations in patients with a history of ectopic breast malignancy.
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Affiliation(s)
- Mirelys Barrios
- Department of Radiology, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Nathalie E Perez
- University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Laurence M Briski
- Department of Pathology and Laboratory Medicine, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Cedric Pluguez-Turull
- Department of Radiology, University of Miami Miller School of Medicine, Miami, Florida, USA
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5
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Zhanghuang C, Wu C, Chen J, Ji F, Yao Z, Li L, Yang Z, Tang H, Zhang K, Hang Y, Xie Y, Yan B. Brain tissue heterotopic in the adrenal gland in a child: a scarce case report. BMC Pediatr 2024; 24:97. [PMID: 38310216 PMCID: PMC10837895 DOI: 10.1186/s12887-023-04478-0] [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] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Accepted: 12/09/2023] [Indexed: 02/05/2024] Open
Abstract
Heterotopic brain tissue is rare and has not been reported. Our center made the first report. 4 years and 2 months old Girl presented with a cystic mass in the right adrenal gland 2 weeks after right upper abdominal pain. The operation was successful, and the diagnosis was confirmed by postoperative pathology. 6 months after the procedure, the incision healed well without recurrence. This case report has a detailed diagnosis and treatment process and satisfactory examination results. It can provide a reference for diagnosing and treating clinical HBT and reduce the risk of misdiagnosis and mistreatment.
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Affiliation(s)
- Chenghao Zhanghuang
- Department of Urology, Kunming Children's Hospital (Children's Hospital affiliated to Kunming Medical University), Kunming, PR China Yunnan Province Clinical Research Center for Children's Health and Disease, 288 Qianxing Road, Kunming, 650228, Yunnan, China
- Yunnan Clinical Medical Center for Pediatric Diseases; Yunnan Key Laboratory of Children's Major Disease Research, Kunming Children's Hospital (Children's Hospital affiliated to Kunming Medical University), Kunming, People's Republic of China
- Department of Oncology; Kunming Children's Solid Tumor Diagnosis and Treatment Center, Kunming Children's Hospital (Children's Hospital affiliated to Kunming Medical University), Kunming, People's Republic of China
| | - Chengchuang Wu
- Department of Urology, Kunming Children's Hospital (Children's Hospital affiliated to Kunming Medical University), Kunming, PR China Yunnan Province Clinical Research Center for Children's Health and Disease, 288 Qianxing Road, Kunming, 650228, Yunnan, China
| | - Junling Chen
- Laboratory Medicine Department, Kunming Children's Hospital (Children's Hospital affiliated to Kunming Medical University), Kunming, People's Republic of China
| | - Fengming Ji
- Department of Urology, Kunming Children's Hospital (Children's Hospital affiliated to Kunming Medical University), Kunming, PR China Yunnan Province Clinical Research Center for Children's Health and Disease, 288 Qianxing Road, Kunming, 650228, Yunnan, China
| | - Zhigang Yao
- Department of Urology, Kunming Children's Hospital (Children's Hospital affiliated to Kunming Medical University), Kunming, PR China Yunnan Province Clinical Research Center for Children's Health and Disease, 288 Qianxing Road, Kunming, 650228, Yunnan, China
| | - Li Li
- Yunnan Clinical Medical Center for Pediatric Diseases; Yunnan Key Laboratory of Children's Major Disease Research, Kunming Children's Hospital (Children's Hospital affiliated to Kunming Medical University), Kunming, People's Republic of China
| | - Zhen Yang
- Department of Oncology; Kunming Children's Solid Tumor Diagnosis and Treatment Center, Kunming Children's Hospital (Children's Hospital affiliated to Kunming Medical University), Kunming, People's Republic of China
| | - Haoyu Tang
- Department of Urology, Kunming Children's Hospital (Children's Hospital affiliated to Kunming Medical University), Kunming, PR China Yunnan Province Clinical Research Center for Children's Health and Disease, 288 Qianxing Road, Kunming, 650228, Yunnan, China
| | - Kun Zhang
- Department of Urology, Kunming Children's Hospital (Children's Hospital affiliated to Kunming Medical University), Kunming, PR China Yunnan Province Clinical Research Center for Children's Health and Disease, 288 Qianxing Road, Kunming, 650228, Yunnan, China
| | - Yu Hang
- Department of Urology, Kunming Children's Hospital (Children's Hospital affiliated to Kunming Medical University), Kunming, PR China Yunnan Province Clinical Research Center for Children's Health and Disease, 288 Qianxing Road, Kunming, 650228, Yunnan, China
| | - Yucheng Xie
- Department of Pathology, Kunming Children's Hospital (Children's Hospital affiliated to Kunming Medical University), Kunming, People's Republic of China.
| | - Bing Yan
- Department of Urology, Kunming Children's Hospital (Children's Hospital affiliated to Kunming Medical University), Kunming, PR China Yunnan Province Clinical Research Center for Children's Health and Disease, 288 Qianxing Road, Kunming, 650228, Yunnan, China.
- Laboratory Medicine Department, Kunming Children's Hospital (Children's Hospital affiliated to Kunming Medical University), Kunming, People's Republic of China.
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Toshima K, Shien T, Nishimura MF, Suzuki Y, Nakamoto S, Uno M, Yoshioka R, Tsukioki T, Takahashi Y, Iwamoto T, Iwatani T, Yanai H. Ectopic Breast Cancer Arising within an Axillary Lymph Node. Acta Med Okayama 2024; 78:89-93. [PMID: 38419320 DOI: 10.18926/amo/66676] [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] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 03/02/2024]
Abstract
We report our experience with the diagnosis and treatment of an ectopic breast cancer arising within an axillary lymph node. The patient was a 65-year-old woman diagnosed breast cancer and axillary lymph node metastasis. We performed a partial mastectomy and axillary lymph node dissection. Postoperative pathology revealed no malignant lesions in the breast; however, a nodule in one of axillary lymph nodes had mixed benign and malignant components, leading to a diagnosis of invasive ductal carcinoma derived from ectopic mammary tissue. This case represents a very rare form of breast cancer, and the malignancy was difficult to distinguish from metastasis.
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Affiliation(s)
- Kei Toshima
- Department of Breast and Endocrine Surgery, Okayama University Hospital
| | - Tadahiko Shien
- Department of Breast and Endocrine Surgery, Okayama University Hospital
| | - Midori Filiz Nishimura
- Department of Molecular Hematopathology, Graduate School of Health Sciences, Okayama University
| | - Yoko Suzuki
- Department of Breast and Endocrine Surgery, Okayama University Hospital
| | - Shogo Nakamoto
- Department of Breast and Endocrine Surgery, Okayama University Hospital
| | - Maya Uno
- Department of Breast and Endocrine Surgery, Okayama University Hospital
| | - Ryo Yoshioka
- Department of Breast and Endocrine Surgery, Okayama University Hospital
| | - Takahiro Tsukioki
- Department of Breast and Endocrine Surgery, Okayama University Hospital
| | - Yuko Takahashi
- Department of Breast and Endocrine Surgery, Okayama University Hospital
| | - Takayuki Iwamoto
- Department of Breast and Endocrine Surgery, Okayama University Hospital
| | - Tsuguo Iwatani
- Department of Breast and Endocrine Surgery, Okayama University Hospital
| | - Hiroyuki Yanai
- Department of Diagnostic Pathology, Okayama University Hospital
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Sakurai Y, Togasaki K, Nakamura Y, Fukuda H, Karaki H, Okaya T, Hirai F, Abe M, Sugano I. Gastric type III heterotopic pancreas presenting as adenomyoma in the antrum of the stomach: a case report. Clin J Gastroenterol 2024; 17:34-40. [PMID: 37831374 DOI: 10.1007/s12328-023-01872-0] [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] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Accepted: 09/27/2023] [Indexed: 10/14/2023]
Abstract
Although heterotopic pancreas usually occurs in the stomach and rarely presents as a submucosal tumor, an accurate preoperative diagnosis is often difficult because of the variety of clinical symptoms and findings depending on the size and location of the lesion. We experienced a case of gastric type III heterotopic pancreas presenting as a gastric adenomyoma in the antrum of the stomach. A 62-year-old woman visited a local hospital for epigastric discomfort. An esophagogastroduodenoscopy study indicated a submucosal tumor in the greater curvature of the gastric antrum. The patient underwent surgical resection of the tumor because it was enlarged. The histological sections of the resected specimen showed that the tumor was composed of ductular structures lined by tall columnar epithelia and a prominent smooth muscle stroma with no atypical cells. The tumor was compatible with Heinrich's type III heterotopic pancreas, which presented as an adenomyoma of the stomach. These findings provide useful histological features and some insight into a better understanding of the embryonic origin and development of adenomyoma and heterotopic pancreas in the antrum of the stomach.
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Affiliation(s)
- Yoichi Sakurai
- Department of Surgery, Chiba-Ken Saiseikai Narashino Hospital, Social Welfare Organization, Saiseikai Imperial Gift Foundation, 1-Chome 1-1 Izumi-cho, Narashino, Chiba, 275-8580, Japan.
| | - Kentaro Togasaki
- Department of Surgery, Chiba-Ken Saiseikai Narashino Hospital, Social Welfare Organization, Saiseikai Imperial Gift Foundation, 1-Chome 1-1 Izumi-cho, Narashino, Chiba, 275-8580, Japan
| | - Yusuke Nakamura
- Department of Surgery, Chiba-Ken Saiseikai Narashino Hospital, Social Welfare Organization, Saiseikai Imperial Gift Foundation, 1-Chome 1-1 Izumi-cho, Narashino, Chiba, 275-8580, Japan
| | - Hiroyuki Fukuda
- Department of Surgery, Chiba-Ken Saiseikai Narashino Hospital, Social Welfare Organization, Saiseikai Imperial Gift Foundation, 1-Chome 1-1 Izumi-cho, Narashino, Chiba, 275-8580, Japan
| | - Hirokazu Karaki
- Department of Surgery, Chiba-Ken Saiseikai Narashino Hospital, Social Welfare Organization, Saiseikai Imperial Gift Foundation, 1-Chome 1-1 Izumi-cho, Narashino, Chiba, 275-8580, Japan
| | - Tomohisa Okaya
- Department of Surgery, Chiba-Ken Saiseikai Narashino Hospital, Social Welfare Organization, Saiseikai Imperial Gift Foundation, 1-Chome 1-1 Izumi-cho, Narashino, Chiba, 275-8580, Japan
| | - Futoshi Hirai
- Department of Gastroenterology, Chiba-Ken Saiseikai Narashino Hospital, Social Welfare Organization, Saiseikai Imperial Gift Foundation, Chiba, Japan
| | - Michikazu Abe
- Department of Gastroenterology, Chiba-Ken Saiseikai Narashino Hospital, Social Welfare Organization, Saiseikai Imperial Gift Foundation, Chiba, Japan
| | - Isamu Sugano
- Pathology Division, Chiba-Ken Saiseikai Narashino Hospital, Social Welfare Organization, Saiseikai Imperial Gift Foundation, Chiba, Japan
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8
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Sadat Sandoghsaz R, Montazeri F, Shafienia H, Mehdi Kalantar S, Javaheri A, Samadi M. Expression of miR-21 &IL-4 in endometriosis. Hum Immunol 2024; 85:110746. [PMID: 38155071 DOI: 10.1016/j.humimm.2023.110746] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2022] [Revised: 12/14/2023] [Accepted: 12/14/2023] [Indexed: 12/30/2023]
Abstract
BACKGROUND Endometriosis characterized with existence of endometrial-like tissue outside the uterus. Fibrosis of ectopic lesions is an important feature of endometriosis. IL-4 induces fibrosis via fibroblast proliferation, collagen production and myofibroblast differentiation. Increasing of miR-21 expression promotes fibroblast activation and fibrosis expansion. The aim of study was to evaluate the expression of miR-21 and its relationship with IL-4 gene expression in endometrial ectopic and eutopic tissues of endometriosis patients. METHODS AND RESULTS Ectopic and eutopic tissue samples were taken from 20 women with endometriosis, and control samples were taken from the endometrium of 20 endometriosis-free women. The relative expression of IL-4 and miR-21 evaluated by Real Time PCR. IL-4 relative gene expression was significantly increased in ectopic tissue compared to eutopic (p = 0.025) and control tissue (p = 0.021). The relative expression of miR-21 gene in ectopic tissue was increased compared to eutopic (p = 0.850) and control tissue (p = 0.978) but these differences were not significant. Also, the correlation between IL-4 and miR-21 relative gene expression was not significant (p = 0.083). CONCLUSION The increased expression of miR-21 in endometrium of women with endometriosis may upregulate the IL-4 gene expression and lead to fibrosis. Further studies may suggest miR-21 and IL-4 as candidates for diagnosis of endometriosis.
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Affiliation(s)
- Reyhaneh Sadat Sandoghsaz
- International Campus, Shahid Sadoughi University of Medical Sciences, Yazd, Iran; Abortion Research Center, Yazd Reproductive Sciences Institute, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Fateme Montazeri
- Abortion Research Center, Yazd Reproductive Sciences Institute, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Hanieh Shafienia
- Abortion Research Center, Yazd Reproductive Sciences Institute, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Seyed Mehdi Kalantar
- Reproductive & Genetic Unit, Recurrent Abortion Research Center, Yazd Reproductive Science Institute, Yazd University of Medical Sciences, Yazd, Iran
| | - Atiyeh Javaheri
- Department of Obstetrics and Gynecology, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Morteza Samadi
- Department of Immunology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.
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Cicek SK, Simsek B, Gundogdu C. Right Common Femoral Vein Invasion: A Unique Case of Inguinal Ectopic Breast Cancer. Vasc Endovascular Surg 2023; 57:914-918. [PMID: 37300453 DOI: 10.1177/15385744231183489] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
OBJECTIVES Ectopic breast cancer may present anywhere in the milk line, from the axilla to the groin which is extremely rare in the inguinal region. Despite morphologic differences, ectopic breast tissue presents characteristics related to orthotopic breast tissue in terms of function and pathologic degeneration. The case report describes the treatment of a unique ectopic breast carcinoma which was located in the inguinal region with a common femoral vein invasion. METHODS We present a unique case of an ectopic breast carcinoma presenting in an unusual anatomic location along the milk line. The study was approved by the local Ethics Committee (protocol no: 12.01.2023-2023/02) Informed consent was obtained from the patient. RESULTS The patient is surgically treated and supplemented with neoadjuvant chemotherapy,radiotherapy and endocrine therapy. Histopathological examination revealed the diagnosis of invasive ductal carcinoma. The right common femoral vein was reconstructed with bovine pericardial patch after totally removal of the mass. CONCLUSIONS This report alerts the reader to be cognizant of the unusual location of an ectopic breast cancer which was detected in the inguinal region with a common femoral vein invasion and discusses the treatment, suggesting novel therapeutic advice that could bring considerable clinical advantages. A multidisciplinary approach should be warranted in such cases to confirm a complete remission.
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Affiliation(s)
- Sevim Kuslu Cicek
- Department of General Surgery, Medicana International Hospital, Istanbul, Turkey
| | - Baran Simsek
- Department of Cardiovascular Surgery, Medicana International Hospital, Istanbul, Turkey
| | - Cemal Gundogdu
- Department of Pathology, Medicana International Hospital, Istanbul, Turkey
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Prządka P, Liszka B, Gąsior L, Antończyk A, Skrzypczak P, Kiełbowicz Z, Kubiak-Nowak D, Gerus S, Patkowski D. Laparoscopic ureteroneocystostomy in the treatment of urinary incontinence due to ectopy of the ureters in female dogs: A pilot study. PLoS One 2023; 18:e0292485. [PMID: 37796812 PMCID: PMC10553214 DOI: 10.1371/journal.pone.0292485] [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: 07/19/2023] [Accepted: 09/21/2023] [Indexed: 10/07/2023] Open
Abstract
Ureteral ectopia is rare and requires surgical treatment after a thorough diagnostic workup. Open surgical techniques for repositioning ectopic ureters have been known for many years and are well described in the literature. However, to the best of our knowledge, no laparoscopic method of correcting this pathology has been described, which, in our opinion, would benefit the animal in terms of the healing process and overall clinical outcomes. This study aimed to evaluate the possibility of laparoscopic treatment of ureteral ectopia, which causes urinary incontinence in dogs. All of the operated ten dogs presented in this study were client-owned females with symptoms of urinary incontinence due to a unilateral intramural ectopic ureter. A three-trocar laparoscopic technique was used to perform the ureteroneocystostomy of the ectopic ureter. In this article, clinicopathological data, imaging features, procedural findings, complications, and short- and long-term outcomes are presented. The procedure was feasible in all cases. No major postoperative complications were observed. Among the minor complications, slight hematuria was observed in three dogs, which resolved spontaneously. In the period of at least one year after surgery, no negative impact of the procedure was observed. Seven of the ten operated dogs regained urinary continence. The remaining three dogs required additional surgery (urethral bulking) because of a lack of improvement after adjuvant pharmacological treatment. Overall, good-to-excellent long-term outcomes can be achieved; however, dogs that remain incontinent after laparoscopic ureteroneocystostomy may require additional treatment.
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Affiliation(s)
- Przemysław Prządka
- Department and Clinic of Surgery, Faculty of Veterinary Medicine, Wroclaw University of Environmental and Life Sciences, Wroclaw, Poland
| | - Bartłomiej Liszka
- Department and Clinic of Surgery, Faculty of Veterinary Medicine, Wroclaw University of Environmental and Life Sciences, Wroclaw, Poland
| | - Ludwika Gąsior
- Department and Clinic of Surgery, Faculty of Veterinary Medicine, Wroclaw University of Environmental and Life Sciences, Wroclaw, Poland
| | - Agnieszka Antończyk
- Department and Clinic of Surgery, Faculty of Veterinary Medicine, Wroclaw University of Environmental and Life Sciences, Wroclaw, Poland
| | - Piotr Skrzypczak
- Department and Clinic of Surgery, Faculty of Veterinary Medicine, Wroclaw University of Environmental and Life Sciences, Wroclaw, Poland
| | - Zdzisław Kiełbowicz
- Department and Clinic of Surgery, Faculty of Veterinary Medicine, Wroclaw University of Environmental and Life Sciences, Wroclaw, Poland
| | - Dominika Kubiak-Nowak
- Department and Clinic of Surgery, Faculty of Veterinary Medicine, Wroclaw University of Environmental and Life Sciences, Wroclaw, Poland
| | - Sylwester Gerus
- Department of Pediatric Surgery and Urology, Medical University of Wroclaw, Wroclaw, Poland
| | - Dariusz Patkowski
- Department of Pediatric Surgery and Urology, Medical University of Wroclaw, Wroclaw, Poland
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11
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Kulkarni P, Tanwar M, Kim U. Searching beyond nevi - A rare case of neurocutaneous ocular syndrome. Orbit 2023; 42:553-557. [PMID: 35298322 DOI: 10.1080/01676830.2022.2049609] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2021] [Accepted: 02/28/2022] [Indexed: 10/18/2022]
Abstract
Epidermal nevus syndrome is a rare congenital disorder affecting only a few hundred people in the world. It has ophthalmic, dermatological, and neurological manifestations, with varied presentation. Here, we report a case of two-year-old child who presented with epibulbar mass in left eye, pigmented nevi over left side of the body and alopecia over left side of parieto-temporal scalp. Imaging confirmed epibulbar mass and presence of calcification of choroid on ipsilateral side with presence of arachnoid cyst of brain with underlying pachygyria. Neurological examination was normal and dermatologist confirmed presence of verrucous nevi over skin. Excisional biopsy of epibulbar mass revealed a complex choristoma with presence of lacrimal gland tissue. Underlying ocular findings were near normal with normal posterior segment. It is a rare form of epidermal nevus syndrome with near normal ocular findings in the presence of anterior and posterior choristoma, which has not been reported.
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Affiliation(s)
- Pooja Kulkarni
- Department of Orbit and Oculoplasty, Aravind Eye Hospital and PG Institute of Ophthalmology, Madurai, India
| | - Meghana Tanwar
- Department of Orbit and Oculoplasty, Aravind Eye Hospital and PG Institute of Ophthalmology, Madurai, India
| | - Usha Kim
- Department of Orbit and Oculoplasty, Aravind Eye Hospital and PG Institute of Ophthalmology, Madurai, India
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12
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Sampath A, Panwar H, Kapoor NNA, Sharma PK. Osseous metaplasia in a rectal polyp. BMJ Case Rep 2023; 16:e254819. [PMID: 37751981 PMCID: PMC10533677 DOI: 10.1136/bcr-2023-254819] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/30/2023] Open
Abstract
Rectal polyps are finger-like projections of the mucosal surface that generally present with complaints of bleeding or mass per rectum. Polyps are classified histopathologically as neoplastic and non-neoplastic. Here, we present one such rare case of a middle-childhood boy who presented with complaints of bleeding per-rectum and revealed a 1.5 cm long rectal polyp. Histopathological examination revealed an osseous change in the rectal polyp. A detailed literature review of reported cases of benign rectal polyps with osseous metaplasia was conducted and consolidated all postulated theories of pathogenesis. This case report shows an interesting incidental finding of osseous metaplasia of the rectal polyp.
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Affiliation(s)
- Ananyan Sampath
- All India Institute of Medical Science, Bhopal, Madhya Pradesh, India
| | - Hemalata Panwar
- Department of Pathology, All India Institute of Medical Science, Bhopal, Madhya Pradesh, India
| | - Neelkamal N A Kapoor
- Department of Pathology, All India Institute of Medical Science, Bhopal, Madhya Pradesh, India
| | - Pramod Kumar Sharma
- Pediatric Surgery, All India Institute of Medical Science, Bhopal, Madhya Pradesh, India
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13
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Łukasiewicz M, Śledziński M, Szymański M, Kowalski J, Hellmann A. Therapeutic challenge: a giant, infiltrating intrathyroidal thymic carcinoma of the thyroid gland. Pol Arch Intern Med 2023; 133:16475. [PMID: 37022105 DOI: 10.20452/pamw.16475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/07/2023]
Affiliation(s)
- Martyna Łukasiewicz
- Department of General, Endocrine and Transplant Surgery, Medical University of Gdansk, Gdańsk, Poland
| | - Maciej Śledziński
- Department of General, Endocrine and Transplant Surgery, Medical University of Gdansk, Gdańsk, Poland
| | - Michał Szymański
- Department of General, Endocrine and Transplant Surgery, Medical University of Gdansk, Gdańsk, Poland
| | - Jacek Kowalski
- Department of Pathomorphology, Medical University of Gdansk, Gdańsk, Poland
| | - Andrzej Hellmann
- Department of General, Endocrine and Transplant Surgery, Medical University of Gdansk, Gdańsk, Poland.
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14
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Dias E, Santos-Antunes J, Marques M, Fonseca E, Lopes J, Macedo G. Juvenile polyps with osseous metaplasia treated by endoscopic mucosal resection. Rev Esp Enferm Dig 2023; 115:214-215. [PMID: 36719331 DOI: 10.17235/reed.2023.9489/2023] [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] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
A 17-year-old male with no previous medical history presented with a 1-year history of rectal bleeding, mucus discharge and occasional rectal prolapse. Colonoscopy revealed several polypoidal growth masses in the distal rectum, formed by multiple sessile polyps with a glistening mucus-covered surface and fleshy, friable appearance, that coalesced forming large conglomerates. Given their complexity and large size, piecemeal endoscopic mucosal resection of the rectal lesions was performed and histopathological examination revealed ulcerated polypoid mucosa with mixed inflammatory cell infiltrate in the lamina propria and dilated cystic mucus-filled glands. Remarkably, bony trabeculae surrounded by osteoblastic cells were also seen. These findings were consistent with juvenile polyps with foci of osseous metaplasia. Osseous metaplasia has been described in a wide variety of tissue types, such as prostate, uterus, breasts, lungs and urinary tract, with respect to both neoplastic and non-neoplastic conditions. However, it is exceedingly rare in colonic polyps and, to the best of our knowledge, only 9 cases have been described in juvenile polyps.
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Affiliation(s)
- Emanuel Dias
- Gastrenterology , Centro Hospitalar Universitário de São João, Portugal
| | | | - Margarida Marques
- Gastrenterology, Centro Hospitalar Universitário de São João, Portugal
| | - Elsa Fonseca
- Pathology , Centro Hospitalar Universitário de São João, Portugal
| | - Joanne Lopes
- Pathology, Centro Hospitalar Universitário de São João
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15
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Wu YL, Li ZQ, Wu AM. The Misdiagnosis of Intravesical Ectopic Prostatic Tissue as a Tumor. Urol Int 2022; 107:738-741. [PMID: 36566749 DOI: 10.1159/000528347] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Accepted: 11/21/2022] [Indexed: 12/24/2022]
Abstract
Ectopic prostatic tissue is rare, and it is usually only discovered by chance during imaging examinations or surgery. However, between 1967 and 2021, reports of ectopic prostatic tissue in the medical literature increased. It is rarely reported that ectopic prostatic tissue can be misdiagnosed as a nephrogenic adenoma (NA). This case study aimed to increase the awareness of ectopic prostatic tissue to improve its rates of diagnosis. This paper is focused on a 45-year-old male patient with a history of bladder lesions that were accidentally discovered through a health examination. A computed tomography scan revealed a homogeneous isoechoic mass in the posterior inferior wall of the bladder. At first, a transurethral cystoscopy revealed a smooth sessile mass covering the normal bladder mucosa, which was located in the middle of the interureteric ridge. The biopsy results suggested a possible intravesical NA. The mass was then completely resected under pneumovesicoscopy, and the pathological diagnosis was ectopic prostatic tissue. The clinical symptoms of ectopic prostatic tissue are similar to other bladder neoplasms, but there are too few characteristics available in imaging examinations to allow for an accurate diagnosis. Since ectopic prostatic tissue can present as a tumor in the bladder, urologists may easily misdiagnose the condition. Surgery is the basis of treatment for ectopic prostatic tissue, and it has a good prognosis.
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Affiliation(s)
- Yong-Lu Wu
- Department of Urology, Maoming People's Hospital, Maoming, China
| | - Zhi-Qin Li
- Department of Urology, Maoming People's Hospital, Maoming, China
| | - Ai-Ming Wu
- Department of Urology, Maoming People's Hospital, Maoming, China
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16
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Bravo-Taxa M, Luque Vásquez-Vásquez C, Ruiz-Figueroa E, Taxa-Rojas L. [Ectopic hepatocellular carcinoma. A case report]. Rev Esp Patol 2022; 55:282-287. [PMID: 36154738 DOI: 10.1016/j.patol.2021.02.003] [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] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/06/2020] [Revised: 02/08/2021] [Accepted: 02/21/2021] [Indexed: 06/16/2023]
Abstract
Ectopic liver (EL) is a rare developmental anomaly caused by the migration of hepatic cells to other locations during embryogenesis. Its incidence is thought to be between 0.24 and 0.47% and can occur in various sites, although the gall bladder is the most frequent. Approximately 100 cases of EL have been published, of which 28 developed hepatocellular carcinoma, whilst the orthotopic liver was unaffected. All cases are reported in Asian and Caucasian patients. We report the case of a 42-year-old patient with a solid lesion measuring 17×12×12cm apparently arising from the posterior wall of the stomach, displacing various organs and suggestive of a gastrointestinal stromal tumour (GIST). The liver, biliary tract and other structures were unremarkable. Histopathology revealed a diagnosis of hepatocellular carcinoma in ectopic liver tissue.
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Affiliation(s)
| | | | - Eloy Ruiz-Figueroa
- Departamento de Abdomen, Instituto Nacional de Enfermedades Neoplásicas, Lima, Perú
| | - Luis Taxa-Rojas
- Instituto Nacional de Enfermedades Neoplásicas, Lima, Perú; Laboratorio Oncológico Taxa, Lima, Perú
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17
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Narang V, Jindal S, Garg B, Kaur H, Soni A. Intranasal glioma (Nasal heterotopia): A rare cause of nasal polyp in neonates. INDIAN J PATHOL MICR 2022; 65:911-913. [PMID: 36308205 DOI: 10.4103/ijpm.ijpm_57_21] [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] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/16/2023] Open
Abstract
A 3-month-old boy presented with an intranasal polypoidal mass protruding out of the nostril which was present since birth and growing slowly. The mass was non-pulsatile and soft to firm in consistency. It did not increase in size on coughing, crying, or compression of the jugular vein. Magnetic resonance imaging and contrast-enhanced computed tomography (CT) revealed a lobulated well-circumscribed soft tissue mass in the left nasal cavity with no intracranial communication. Complete surgical excision of the mass was carried out via an intranasal endoscopic approach. Histopathological examination confirmed the diagnosis of intranasal glioma.
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Affiliation(s)
- Vikram Narang
- Department of Pathology, Dayanand Medical College and Hospital, Ludhiana, Punjab, India
| | - Saveena Jindal
- Department of Pathology, Dayanand Medical College and Hospital, Ludhiana, Punjab, India
| | - Bhavna Garg
- Department of Pathology, Dayanand Medical College and Hospital, Ludhiana, Punjab, India
| | - Harpreet Kaur
- Department of Pathology, Dayanand Medical College and Hospital, Ludhiana, Punjab, India
| | - Ankita Soni
- Department of Pathology, Dayanand Medical College and Hospital, Ludhiana, Punjab, India
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18
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Kishimoto K, Shibagaki K, Nonomura S, Sumi S, Fukuda N, Takahashi Y, Kotani S, Okimoto E, Oshima N, Kawashima K, Ishimura N, Ishihara S. Heterotopic Gastric Mucosa in Middle Esophagus Complicated with Esophageal Ulcers. Intern Med 2022; 61:2735-2740. [PMID: 35228416 PMCID: PMC9556244 DOI: 10.2169/internalmedicine.8705-21] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
Heterotopic gastric mucosa (HGM) of esophagus, primarily occurring in cervical esophagus, is usually asymptomatic. A healthy woman (mid-40s) with postprandial heartburn was diagnosed with middle esophageal HGM and esophageal ulcers by esophagogastroduodenoscopy. Using 8-channel pH monitoring, a sensor near the HGM area detected postprandial acid phase (pH 3-4), while areas adjacent to the proximal and distal sensors were neutral, suggesting acid secretion from the HGM. A biopsy showed fundic gland tissue expressing H+/K+-ATPase and pepsinogen-I. Oral vonoprazan improved the clinical symptoms and endoscopic findings. This is the first report using 8-channel pH monitoring to diagnose extremely rare middle esophageal HGM.
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Affiliation(s)
- Kenichi Kishimoto
- Department of Gastroenterology, Faculty of Medicine, Shimane University, Japan
| | | | - Saya Nonomura
- Department of Gastroenterology, Faculty of Medicine, Shimane University, Japan
| | - Shohei Sumi
- Department of Gastroenterology, Faculty of Medicine, Shimane University, Japan
| | | | - Yusuke Takahashi
- Department of Gastroenterology, Faculty of Medicine, Shimane University, Japan
| | - Satoshi Kotani
- Department of Gastroenterology, Faculty of Medicine, Shimane University, Japan
| | - Eiko Okimoto
- Department of Gastroenterology, Faculty of Medicine, Shimane University, Japan
| | - Naoki Oshima
- Department of Endoscopy, Shimane University Hospital, Japan
| | - Kousaku Kawashima
- Department of Gastroenterology, Faculty of Medicine, Shimane University, Japan
| | - Norihisa Ishimura
- Department of Gastroenterology, Faculty of Medicine, Shimane University, Japan
| | - Shunji Ishihara
- Department of Gastroenterology, Faculty of Medicine, Shimane University, Japan
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19
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Wadhwani M, Khatri A. An unusual case of respiratory epithelial cyst of orbit presenting as a lid swelling in a child. INDIAN J PATHOL MICR 2022; 65:671-672. [PMID: 35900498 DOI: 10.4103/ijpm.ijpm_757_21] [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] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2023] Open
Abstract
This case highlights the importance of histopathological examination in all cases of choristoma undergoing excision.
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Affiliation(s)
- Meenakshi Wadhwani
- Department of Ophthalmology, Chacha Nehru Bal Chikitsalya, New Delhi, India
| | - Arti Khatri
- Department of Pathology, Chacha Nehru Bal Chikitsalya, New Delhi, India
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20
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LeCompte MT, Mason B, Robbins KJ, Yano M, Chatterjee D, Fields RC, Strasberg SM, Hawkins WG. Clinical classification of symptomatic heterotopic pancreas of the stomach and duodenum: A case series and systematic literature review. World J Gastroenterol 2022; 28:1455-1478. [PMID: 35582670 PMCID: PMC9048474 DOI: 10.3748/wjg.v28.i14.1455] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Revised: 07/11/2021] [Accepted: 03/06/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Heterotopic pancreas (HP) is an aberrant anatomic malformation that occurs most commonly in the upper gastrointestinal tract. While the majority of heterotopic pancreatic lesions are asymptomatic, many manifest severe clinical symptoms which require surgical or endoscopic intervention. Understanding of the clinical manifestations and symptoms of HP is limited due to the lack of large volume studies in the literature. The purpose of this study is to review symptomatic cases at a single center and compare these to a systematic review of the literature in order to characterize common clinical manifestations and treatment of this disease.
AIM To classify the common clinical manifestations of heterotopic pancreas.
METHODS A retrospective review was conducted of pathologic samples containing heterotopic pancreas from 2000-2018. Review was limited to HP of the upper gastrointestinal tract due to the frequency of presentation in this location. Symptomatic patients were identified from review of the medical records and clinical symptoms were tabulated. These were compared to a systematic review of the literature utilizing PubMed and Embase searches for papers pertaining to heterotopic pancreas. Publications describing symptomatic presentation of HP were selected for review. Information including demographics, symptoms, presentation and treatment were compiled and analyzed.
RESULTS Twenty-nine patient were identified with HP at a single center, with six of these identified has having clinical symptoms. Clinical manifestations included, gastrointestinal bleeding, gastric ulceration with/without perforation, pancreatitis, and gastric outlet obstruction. Systemic review of the literature yielded 232 publications detailing symptomatic cases with only 20 studies describing ten or more patients. Single and multi-patient studies were combined to form a cohort of 934 symptomatic patients. The majority of patients presented with abdominal pain (67%) combined with one of the following clinical categories: (1) Dyspepsia, (n = 445, 48%); (2) Pancreatitis (n = 260, 28%); (3) Gastrointestinal bleeding (n = 80, 9%); and (4) Gastric outlet obstruction (n = 80, 9%). The majority of cases (n = 832, 90%) underwent surgical or endoscopic resection with 85% reporting resolution or improvement in their symptoms.
CONCLUSION Heterotopic pancreas can cause significant clinical symptoms in the upper gastrointestinal tract. Better understanding and classification of this disease may result in more accurate identification and treatment of this malformation.
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Affiliation(s)
- Michael T LeCompte
- Department of Surgical Oncology, University of North Carolina, Raleigh, NC 27608, United States
| | - Brandon Mason
- Department of Radiology, Stillwater Medical Center, Stillwater, OK 74074, United States
| | - Keenan J Robbins
- Department of General Surgery, Washington University St. Louis, St. Louis, MO 63110-8109, United States
| | - Motoyo Yano
- Department of Radiology, Mayo Clinic, Phoenix, AZ 8505, United States
| | - Deyali Chatterjee
- Department of Pathology and Immunology, MD Anderson Cancer Center, Houston, TX 77030, United States
| | - Ryan C Fields
- Department of Surgical Oncology, Washington University School of Medicine, St. Louis, MO 63110-8109, United States
| | - Steven M Strasberg
- Section of Hepatobiliary-Pancreatic and GI Surgery, Washington University St. Louis, St. Louis, MO 63110, United States
| | - William G Hawkins
- Section of Hepatobiliary-Pancreatic and GI Surgery, Washington University St. Louis, St. Louis, MO 63110, United States
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21
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Pan MH, Li JH, Hua HJ, Yang QY, Song GX, Li H. [Clinicopathological features of ectopic meningothelial hamartoma]. Zhonghua Bing Li Xue Za Zhi 2022; 51:207-211. [PMID: 35249283 DOI: 10.3760/cma.j.cn112151-20211227-00936] [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: 06/14/2023]
Abstract
Objective: To investigate the clinicopathological features, diagnosis and differential diagnosis of ectopic meningothelial hamartoma (EMH). Methods: Three cases of EMH diagnosed in the First Affiliated Hospital of Nanjing Medical University from January 2014 to December 2020 were enrolled. All cases were evaluated by clinical and imaging features, HE and immunohistochemical staining, and the relevant literature was reviewed. Results: There were one male and two female patients, aged 2, 67 and 19 years, respectively. Clinically, they presented as skin masses in the head and face region (two cases) and sacro-coccygeal region (one case). Grossly, the lesions ranged in size from 1.6 cm to 8.9 cm. Microscopically, the lesions were ill-defined, and located in the dermis and subcutis, and showed pseudovascular channels lined by monolayer of cuboidal to flattened epithelium with mild atypia, with variable cystic cavity formation. There was prominent interstitial fibrosis. Concentric, lamellated, onion skin-like arrangement with short spindle or ovoid cells and psammoma bodies were noted. Immunohistochemically, these cells were strongly positive for SSTR2, EMA, vimentin and progesterone receptor. Ki-67 positive index was low, approximately 1%. Conclusions: EMH is uncommon. Definitive diagnosis relies on histopathologic examination. The importance in recognizing the lesions is to differentiate from other more aggressive tumors.
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Affiliation(s)
- M H Pan
- Department of Pathology, the First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
| | - J H Li
- Department of Pathology, the First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
| | - H J Hua
- Department of Pathology, the First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
| | - Q Y Yang
- Department of Pathology, the First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
| | - G X Song
- Department of Pathology, the First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
| | - H Li
- Department of Pathology, the First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
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22
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Mohd Saiful AI, Nik Adilah NO, Farhana MM, Sharifah Emilia TS. A case of salivary gland choristoma presenting with ear discharge in a child having external auditory canal stenosis. Med J Malaysia 2022; 77:249-251. [PMID: 35338637] [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: 06/14/2023]
Abstract
Salivary gland choristoma in the middle ear or external ear canal is rare. Generally, it is difficult to differentiate salivary gland choristoma from congenital cholesteatoma or cholesterol granuloma on Computed Tomography (CT) and Magnetic Resonance Imaging (MRI). It is challenging to diagnose preoperatively without specific clinical or radiological symptoms or signs. Thus, histopathological examination is required for a definitive diagnosis, and a histopathological sample of the lesion is acquired. We discuss the imaging and histology of salivary gland choristoma with the best recommendation on the management.
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Affiliation(s)
- A I Mohd Saiful
- Universiti Sains Malaysia, School of Medical Sciences, Department of Otorhinolaryngology-Head & Neck Surgery, Health Campus, 16150 Kubang Kerian, Kelantan, Malaysia
| | - N O Nik Adilah
- Universiti Sains Malaysia, School of Medical Sciences, Department of Otorhinolaryngology-Head & Neck Surgery, Health Campus, 16150 Kubang Kerian, Kelantan, Malaysia.
| | - M M Farhana
- Hospital Univerisiti Sains Malaysia, 16150 Kubang Kerian, Kelantan, Malaysia
| | - T S Sharifah Emilia
- Hospital Univerisiti Sains Malaysia, 16150 Kubang Kerian, Kelantan, Malaysia
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23
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Suster D, Ronen S, Mackinnon AC, Suster S. Immature Chondroid Choristoma: Clinicopathologic, Immunohistochemical, and Molecular Study of an Unusual Benign Skin Tumor. Am J Dermatopathol 2022; 44:148-151. [PMID: 34291748 DOI: 10.1097/dad.0000000000002013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [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: 11/26/2022]
Abstract
ABSTRACT An unusual benign skin tumor is reported occurring in a 68-year-old woman with no significant medical history. The lesion presented as a small skin nodule in the neck. Histologic examination showed a well-circumscribed superficial dermal nodule composed of a solid proliferation of large, round cells with abundant eosinophilic cytoplasm and small centrally placed nuclei displaying a vaguely chondroid appearance. Immunohistochemical studies showed strong positivity of the tumor cells for S100 protein and vimentin and negative staining for SOX10, melanoma cocktail, HMB45, Melan-A, cytokeratin AE1/AE3, inhibin, desmin, smooth muscle actin, CD68, CD164, and neuron specific enolase. Next-generation sequencing using a panel of 50 actionable genes commonly encountered in human neoplasia did not reveal the presence of any mutations. Owing to the remarkable similarity of the lesion to immature cartilage, we consider this to be a benign tumor, most likely resulting from an embryologic defect. We propose the term immature chondroid choristoma to designate this lesion.
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Affiliation(s)
- David Suster
- Department of Pathology, Rutgers University Hospital, New Jersey Medical School, Newark, NJ
| | - Shira Ronen
- Department of Pathology, Cleveland Clinic Foundation, Cleveland, OH
| | | | - Saul Suster
- Department of Pathology, Medical College of Wisconsin, Milwaukee, WI
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24
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Alqahtani J, Alzoabi N, Algamdi B, Busbait S, Alakloby G, Hajla M, Alharbi N, Alakloby O. Primary Ectopic Breast Carcinoma in Man Mimicking Keloid. Med Arch 2022; 76:149-151. [PMID: 35774046 PMCID: PMC9233454 DOI: 10.5455/medarh.2022.76.149-151] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Accepted: 04/21/2022] [Indexed: 11/03/2022] Open
Abstract
Background: Case report: Conclusion:
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Affiliation(s)
- Jamal Alqahtani
- Department of Dermatology, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
- King Fahd Hospital of The University, AlKhobar, Saudi Arabia
| | - Nasser Alzoabi
- Department of Dermatology, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
- King Fahd Hospital of The University, AlKhobar, Saudi Arabia
| | - Bader Algamdi
- Department of Dermatology, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
- King Fahd Hospital of The University, AlKhobar, Saudi Arabia
| | - Saleh Busbait
- Department of Pathology, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
- King Fahd Hospital of The University, AlKhobar, Saudi Arabia
| | - Ghada Alakloby
- King Fahd Hospital of The University, AlKhobar, Saudi Arabia
| | - Mohammed Hajla
- Dammam Medical Complex, Dammam Health Network, Ministry of Health, Dammam, Saudi Arabia
| | - Nouf Alharbi
- Dammam Medical Complex, Dammam Health Network, Ministry of Health, Dammam, Saudi Arabia
| | - Omar Alakloby
- Department of Dermatology, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
- King Fahd Hospital of The University, AlKhobar, Saudi Arabia
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25
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Fernandez-Flores A, Cassarino D. Primary Idiopathic Cutaneous Intestinal Metaplasia: First Case. Am J Dermatopathol 2021; 43:970-971. [PMID: 34291742 DOI: 10.1097/dad.0000000000002032] [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] [Indexed: 11/26/2022]
Abstract
ABSTRACT Cutaneous intestinal either metaplasia or ectopia has mostly been described around intestinal stomas or in patients with Crohn disease. In this study, we described a unique case of cutaneous metaplasia on the elbow of a 25-year-old man who had a clinical history of epidermolysis bullosa simplex, but had no history of any gastrointestinal disease. The lesion had been clinically stable for 5 years. Histopathologically, the epithelium showed many columnar cells with mucinous cytoplasm, with no atypia or mitoses. The proliferation rate was low (7% by Ki67). The metaplastic areas expressed epithelial membrane antigen, carcinoembryonic antigen, cytokeratin 7, MUC5AC, MUC2, and Cyclin-D1.
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Affiliation(s)
- Angel Fernandez-Flores
- Department of Histopathology, University Hospital El Bierzo, Ponferrada, Spain
- Department of Cellular Pathology, Hospital de la Reina, Ponferrada, Spain
- Research Department, Institute for Biomedical Research of A Coruña (INIBIC), University of A Coruña (UDC), A Coruña, Spain; and
| | - David Cassarino
- Department of Dermatology, Los Angeles Medical Center (LAMC), Southern California Kaiser Permanente, Los Angeles, CA
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26
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Gautam N, Makaju R, Basnet D, Lama B, Maharjan PB. Cartilaginous Choristoma of Tonsil: A hidden clinical entity. Kathmandu Univ Med J (KUMJ) 2021; 19:528-530. [PMID: 36259202] [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: 06/16/2023]
Abstract
Choristoma is a tumor like mass which is an ectopic rest of normal tissue due to embryological developmental defect. The presence of choristoma in tonsil is extremely rare. On histopathological examination, mature hyaline cartilage were found surrounded by lymphoid follicles. We present a case of cartilaginous choristoma with the complaint of recurrent tonsillitis.
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Affiliation(s)
- N Gautam
- Department of Pathology, Dhulikhel Hospital, Kathmandu University Hospital, Kathmandu University School of Medical Sciences, Dhulikhel, Kavre, Nepal
| | - R Makaju
- Department of Pathology, Dhulikhel Hospital, Kathmandu University Hospital, Kathmandu University School of Medical Sciences, Dhulikhel, Kavre, Nepal
| | - D Basnet
- Department of Pathology, Dhulikhel Hospital, Kathmandu University Hospital, Kathmandu University School of Medical Sciences, Dhulikhel, Kavre, Nepal
| | - B Lama
- Department of Pathology, Dhulikhel Hospital, Kathmandu University Hospital, Kathmandu University School of Medical Sciences, Dhulikhel, Kavre, Nepal
| | - P B Maharjan
- Department of Pathology, Dhulikhel Hospital, Kathmandu University Hospital, Kathmandu University School of Medical Sciences, Dhulikhel, Kavre, Nepal
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27
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Abstract
Ectopic adrenal rests are a rare condition which can be found in various sites, generally in the retroperitoneum or pelvis along the path of gonadal descent. Their real prevalence is unknown. Males are more commonly affected, at least in the pediatric age. Adrenal rests are usually clinically silent and incidentally found in surgical samples, mostly in the pediatric population, and rarely in adults. With the aim of increasing knowledge and estimating the prevalence of ectopic adrenocortical tissue in the adult population, 44 adrenal rests in the urogenital tract of 40 adults are described. These represent approximately 0.07% of the total number of urogenital and gynecological surgeries performed in the 22 considered years. Adrenal rests were identified in the spermatic cord (10 males) and in paraovarian, parasalpingeal, or infundibulopelvic ligament locations (30 females). All but one was incidental findings. One case regarded an adrenocortical carcinoma arisen in adrenal rests. A literature review of adrenal ectopia in the urogenital tract of adults identified 57 reported cases from 53 patients, with similar clinicopathological features as those of our series, with the exception of a lower incidence of parasalpingeal locations. Despite their limited clinical implications, awareness of ectopic adrenal rests is essential also in adults for at least two reasons: (a) to correctly identify sources of adrenocortical hormone production in case of adrenal insufficiency or hormonal imbalance and (b) to avoid misinterpretations in the diagnostic workup of renal cell carcinoma, adrenocortical tumors, and rare gonadal neoplasms, including Sertoli/Leydig cell tumors.
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Affiliation(s)
- Enrico Costantino Falco
- Pathology Unit, Department of Medical Sciences, Città Della Salute E Della Scienza Hospital, University of Turin, Turin, Italy
| | | | - Jasna Metovic
- Pathology Unit, Department of Oncology, Città Della Salute E Della Scienza Hospital, University of Turin, Turin, Italy
| | - Enrico Bollito
- Pathology Unit, San Luigi Hospital, Orbassano, Turin, Italy
| | | | - Marco Volante
- Pathology Unit, Department of Oncology at San Luigi Hospital, University of Turin, Orbassano, Turin, Italy.
| | - Mauro Papotti
- Pathology Unit, Department of Oncology, Città Della Salute E Della Scienza Hospital, University of Turin, Turin, Italy
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Hawari R, Fernandes L, Park KJ, McCluggage WG. Skene's Gland Derivatives in the Female Genital Tract and Cervical Adenoid Basal Carcinoma are Consistently Positive With Prostatic Marker NKX3.1. Int J Gynecol Pathol 2021; 40:400-407. [PMID: 33021555 PMCID: PMC8019685 DOI: 10.1097/pgp.0000000000000717] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Cervical ectopic prostatic tissue and vaginal tubulosquamous polyp are rare lesions which exhibit variable, and often focal, immunohistochemical expression with traditional prostatic markers [prostate-specific antigen and prostatic acid phosphatase (PSAP)]. These lesions are thought to arise from periurethral Skene's glands, the female equivalent of prostatic glands in the male. Adenoid basal carcinoma is a rare and indolent cervical neoplasm. Expression of the prostatic marker NKX3.1 in ectopic prostatic tissue and tubulosquamous polyp has been reported but no studies have examined immunoreactivity with this marker in adenoid basal carcinoma. We stained 19 cases [adenoid basal carcinoma (n=6), cervical ectopic prostatic tissue (n=11), and vaginal tubulosquamous polyp (n=3); 1 case contained both adenoid basal carcinoma and ectopic prostatic tissue] with NKX3.1. In all cases, the glandular component of these lesions exhibited diffuse nuclear immunoreactivity while normal endocervical glands were negative. Prostate-specific antigen was positive in 4 of 9 and 0 of 3 cases of ectopic prostatic tissue and tubulosquamous polyp, respectively, while PSAP was positive in 3 of 4 and 2 of 2 cases of ectopic prostatic tissue and tubulosquamous polyp respectively; 3 of 5 cases of adenoid basal carcinoma tested were focally positive with PSAP and all 5 were negative with prostate-specific antigen. While the specificity of NKX3.1 should be investigated in future studies, positivity with this marker may be useful in diagnosing these uncommon lesions. NKX3.1 appears a more sensitive marker of ectopic prostatic tissue and tubulosquamous polyp than traditional prostatic markers and positive staining provides further support that these lesions exhibit "prostatic" differentiation and are of Skene's gland origin. NKX3.1 and PSAP positivity in adenoid basal carcinoma raises the possibility of an association with benign glandular lesions exhibiting prostatic differentiation and we critically discuss the possible association.
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Affiliation(s)
- Rand Hawari
- Department of Pathology, Royal Derby Hospital, Derby, United Kingdom
| | - Larissa Fernandes
- Department of Pathology, Royal Derby Hospital, Derby, United Kingdom
| | - Kay J Park
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, USA
| | - W Glenn McCluggage
- Department of Pathology, Belfast Health and Social Care Trust, Belfast, United Kingdom
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29
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Ozolek JA, Tekkesin MS. THE "-OMAS" and "-OPIAS": Targeted and Philosophical Considerations Regarding Hamartomas, Choristomas, Teratomas, Ectopias, and Heterotopias in Pediatric Otorhinolaryngologic Pathology. Head Neck Pathol 2021; 15:25-40. [PMID: 33723758 PMCID: PMC8010027 DOI: 10.1007/s12105-020-01251-y] [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] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Accepted: 11/12/2020] [Indexed: 12/17/2022]
Abstract
The spectrum of "developmental" lesions that occur in the head and neck predominantly congenital in origin and arising at birth and/or discovered in childhood is broad and fascinating. These have been grouped into categories such as "ectopias", "heterotopias", "hamartomas", and "choristomas". On a philosophical and consequently systematic level, these lesions, mostly benign tumors seem to lack a true understanding of the pathogenetic foundation on which to base a more unified taxonomic designation. In this review, we will consider some of these select tumors as they represent syndromic associations (nasal chondromesenchymal hamartoma and DICER1 syndrome), the lingual choristoma from the perspective of its nomenclature and classification, lesions with ectopic meningothelial elements, and teratomas and the enigmatic "hairy polyp" in reference to a broader discussion of pathogenesis and pluripotent cells in the head and neck. A consistent thread will be how these lesions are designated with some final thoughts on future directions regarding the investigation of their pathogenesis and taxonomic nomenclature.
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Affiliation(s)
- John A Ozolek
- Department of Pathology, Anatomy, and Laboratory Medicine, West Virginia University School of Medicine, Morgantown, WV, USA.
| | - Merva Soluk Tekkesin
- Department of Tumour Pathology, Institute of Oncology, Istanbul University, Istanbul, Capa-Istanbul, 34093, Turkey
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30
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Benson JC, Giannini C, Cohen Cohen S, Van Gompel J, Kim DK, Port J, Diehn F, Eckel L, Carr C. Optic Nerve Choristoma Mimicking a Neurenteric Cyst. AJNR Am J Neuroradiol 2021; 42:228-232. [PMID: 33303524 DOI: 10.3174/ajnr.a6892] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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: 07/29/2020] [Accepted: 08/27/2020] [Indexed: 11/07/2022]
Abstract
Optic nerve choristomas are rare entities in which a developmental focus of histologically normal tissue is abnormally located within or along a segment of the optic nerve. Although benign, choristomas may demonstrate slow growth, ultimately resulting in visual field deficits due to compression of the adjacent nerve in the few cases reported in the anterior fossa. Choristomas may have cystic components, though this has not been described in such lesions along the optic nerve. Here, a predominantly cystic optic nerve choristoma is described, with radiologic features mimicking those of an anterior cranial fossa neurenteric cyst. The case highlights the radiology-pathology correlates of choristomas and reviews the surgical approach and management of patients with such lesions.
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Affiliation(s)
- J C Benson
- From the Departments of Radiology (J.C.B., D.K.K., J.P., F.D., L.E., C.C.)
| | | | - S Cohen Cohen
- Neurosurgery (S.C.C., J.V.G.), Mayo Clinic, Rochester, Minnesota
| | - J Van Gompel
- Neurosurgery (S.C.C., J.V.G.), Mayo Clinic, Rochester, Minnesota
| | - D K Kim
- From the Departments of Radiology (J.C.B., D.K.K., J.P., F.D., L.E., C.C.)
| | - J Port
- From the Departments of Radiology (J.C.B., D.K.K., J.P., F.D., L.E., C.C.)
| | - F Diehn
- From the Departments of Radiology (J.C.B., D.K.K., J.P., F.D., L.E., C.C.)
| | - L Eckel
- From the Departments of Radiology (J.C.B., D.K.K., J.P., F.D., L.E., C.C.)
| | - C Carr
- From the Departments of Radiology (J.C.B., D.K.K., J.P., F.D., L.E., C.C.)
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Zhang D, Wang L, Guo HL, Zhang ZW, Wang C, Chian RC, Zhang ZF. MicroRNA‑202 inhibits endometrial stromal cell migration and invasion by suppressing the K‑Ras/Raf1/MEK/ERK signaling pathway. Int J Mol Med 2020; 46:2078-2088. [PMID: 33125090 PMCID: PMC7595674 DOI: 10.3892/ijmm.2020.4749] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2019] [Accepted: 07/06/2020] [Indexed: 12/23/2022] Open
Abstract
The enhanced migratory ability of endometrial stromal cells (ESCs) is a key factor in the formation of functional endometrium‑like tissues outside the uterine cavity during endometriosis (EMS). Although accumulating evidence has suggested the importance of microRNAs (miRNAs) in the pathogenesis of EMS, the role of particular miRNAs in the invasiveness of ESCs remain poorly understood. In the present study, the function of miRNAs in the invasiveness of ESCs, along with the associated underlying mechanism involved, were investigated. Initially, the expression patterns of miRNAs in the ectopic and eutopic endometrium isolated from patients with EMS were analyzed using microarray. MicroRNA‑202‑5p (miR‑202) was selected for further study due to its previously reported suppressive effects on the invasion in various types of cancers. The expression of miR‑202 and K‑Ras in eutopic and ectopic endometrioma tissues were detected using reverse transcription‑quantitative PCR, immunohistochemistry and western blotting. The migration and invasion ability of ESCs was determined using wound healing and Transwell invasion assays, respectively. Compared with that from healthy individuals, miR‑202 expression was demonstrated to be lower in the eutopic endometrium from patients with EMS, which was even lower in ectopic endometrium. Functional experiments in primary ESCs revealed that enhanced miR‑202 expression suppressed the cell invasion and migration abilities, which was also accompanied with increased E‑cadherin and reduced N‑cadherin expression in ESCs, suggesting its potentially suppressive role in epithelial‑mesenchymal transition. K‑Ras is a well‑known regulator of the ERK signaling pathway that was shown to be directly targeted and negatively regulated by miR‑202. In addition, K‑Ras expression was found to be upregulated in the ectopic endometrium, where it correlated negatively with that of miR‑202. Knocking down K‑Ras expression mimicked the anti‑invasive effects of miR‑202 overexpression on ESCs, whilst K‑Ras overexpression attenuated the inhibitory role of miR‑202 overexpression in ESC invasion. The K‑Ras/Raf1/MEK/ERK signaling pathway was also blocked by miR‑202 overexpression. These findings suggested that miR‑202 inhibited ESC migration and invasion by inhibiting the K‑Ras/Raf1/MEK/ERK signaling pathway, rendering miR‑202 a candidate for being a therapeutic target for EMS.
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Affiliation(s)
- Di Zhang
- Department of Gynecology, The Affiliated Hangzhou Hospital of Nanjing Medical University, Hangzhou, Zhejiang 310008
- Department of Reproductive Medicine, Shanghai Tenth People's Hospital, Affiliated to Tongji University, Shanghai 200003
| | - Ling Wang
- Department of Reproductive Medicine, Shanghai Tenth People's Hospital, Affiliated to Tongji University, Shanghai 200003
| | - Hua-Lei Guo
- Department of Pathology, Hangzhou Women's Hospital, Hangzhou, Zhejiang 310008
| | - Zi-Wei Zhang
- Department of Ultrasound, Shanghai First Maternity and Infant Hospital, Shanghai 200000
| | - Chong Wang
- Department of Reproductive Medicine, Hangzhou Women's Hospital, Hangzhou, Zhejiang 310008
| | - Ri-Cheng Chian
- Department of Reproductive Medicine, Shanghai Tenth People's Hospital, Affiliated to Tongji University, Shanghai 200003
- Department of Reproductive Medicine, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu 211166, P.R. China
| | - Zhi-Fen Zhang
- Department of Gynecology, The Affiliated Hangzhou Hospital of Nanjing Medical University, Hangzhou, Zhejiang 310008
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Pontarini E, Murray-Brown WJ, Croia C, Lucchesi D, Conway J, Rivellese F, Fossati-Jimack L, Astorri E, Prediletto E, Corsiero E, Romana Delvecchio F, Coleby R, Gelbhardt E, Bono A, Baldini C, Puxeddu I, Ruscitti P, Giacomelli R, Barone F, Fisher B, Bowman SJ, Colafrancesco S, Priori R, Sutcliffe N, Challacombe S, Carlesso G, Tappuni A, Pitzalis C, Bombardieri M. Unique expansion of IL-21+ Tfh and Tph cells under control of ICOS identifies Sjögren's syndrome with ectopic germinal centres and MALT lymphoma. Ann Rheum Dis 2020; 79:1588-1599. [PMID: 32963045 PMCID: PMC7677495 DOI: 10.1136/annrheumdis-2020-217646] [Citation(s) in RCA: 71] [Impact Index Per Article: 17.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Revised: 06/28/2020] [Accepted: 07/13/2020] [Indexed: 12/15/2022]
Abstract
OBJECTIVES To explore the relevance of T-follicular-helper (Tfh) and pathogenic peripheral-helper T-cells (Tph) in promoting ectopic lymphoid structures (ELS) and B-cell mucosa-associated lymphoid tissue (MALT) lymphomas (MALT-L) in Sjögren's syndrome (SS) patients. METHODS Salivary gland (SG) biopsies with matched peripheral blood were collected from four centres across the European Union. Transcriptomic (microarray and quantitative PCR) analysis, FACS T-cell immunophenotyping with intracellular cytokine detection, multicolor immune-fluorescence microscopy and in situ hybridisation were performed to characterise lesional and circulating Tfh and Tph-cells. SG-organ cultures were used to investigate functionally the blockade of T-cell costimulatory pathways on key proinflammatory cytokine production. RESULTS Transcriptomic analysis in SG identified Tfh-signature, interleukin-21 (IL-21) and the inducible T-cell co-stimulator (ICOS) costimulatory pathway as the most upregulated genes in ELS+SS patients, with parotid MALT-L displaying a 400-folds increase in IL-21 mRNA. Peripheral CD4+CXC-motif chemokine receptor 5 (CXCR5)+programmed cell death protein 1 (PD1)+ICOS+ Tfh-like cells were significantly expanded in ELS+SS patients, were the main producers of IL-21, and closely correlated with circulating IgG and reduced complement C4. In the SG, lesional CD4+CD45RO+ICOS+PD1+ cells selectively infiltrated ELS+ tissues and were aberrantly expanded in parotid MALT-L. In ELS+SG and MALT-L parotids, conventional CXCR5+CD4+PD1+ICOS+Foxp3- Tfh-cells and a uniquely expanded population of CXCR5-CD4+PD1hiICOS+Foxp3- Tph-cells displayed frequent IL-21/interferon-γ double-production but poor IL-17 expression. Finally, ICOS blockade in ex vivo SG-organ cultures significantly reduced the production of IL-21 and inflammatory cytokines IL-6, IL-8 and tumour necrosis factor-α (TNF-α). CONCLUSIONS Overall, these findings highlight Tfh and Tph-cells, IL-21 and the ICOS costimulatory pathway as key pathogenic players in SS immunopathology and exploitable therapeutic targets in SS.
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Affiliation(s)
- Elena Pontarini
- Centre for Experimental Medicine and Rheumatology, William Harvey Research Institute, London, England, UK
| | - William James Murray-Brown
- Centre for Experimental Medicine and Rheumatology, William Harvey Research Institute, London, England, UK
| | - Cristina Croia
- Immuno-Allergology Unit, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Davide Lucchesi
- Centre for Experimental Medicine and Rheumatology, William Harvey Research Institute, London, England, UK
| | - James Conway
- Oncology R&D, Astrazeneca, Gaithersburg, Maryland, USA
| | - Felice Rivellese
- Centre for Experimental Medicine and Rheumatology, William Harvey Research Institute, London, England, UK
| | - Liliane Fossati-Jimack
- Centre for Experimental Medicine and Rheumatology, William Harvey Research Institute, London, England, UK
| | - Elisa Astorri
- Centre for Experimental Medicine and Rheumatology, William Harvey Research Institute, London, England, UK
| | - Edoardo Prediletto
- Centre for Experimental Medicine and Rheumatology, William Harvey Research Institute, London, England, UK
| | - Elisa Corsiero
- Centre for Experimental Medicine and Rheumatology, William Harvey Research Institute, London, England, UK
| | | | - Rachel Coleby
- Centre for Experimental Medicine and Rheumatology, William Harvey Research Institute, London, England, UK
| | - Eva Gelbhardt
- Centre for Experimental Medicine and Rheumatology, William Harvey Research Institute, London, England, UK
| | - Aurora Bono
- Centre for Experimental Medicine and Rheumatology, William Harvey Research Institute, London, England, UK
| | | | - Ilaria Puxeddu
- Immuno-Allergology Unit, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Piero Ruscitti
- Department of Clinical Sciences and Applied Biotechnology, University of L'Aquila, L'Aquila, Abruzzo, Italy
| | - Roberto Giacomelli
- Department of Clinical Sciences and Applied Biotechnology, University of L'Aquila, L'Aquila, Abruzzo, Italy
| | - Francesca Barone
- RRG, Institute of Inflamation and Ageing, University of Birmingham, Birmingham, UK, UK
- NIHR Birmingham Biomedical Research Centre, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - Benjamin Fisher
- RRG, Institute of Inflamation and Ageing, University of Birmingham, Birmingham, UK, UK
- NIHR Birmingham Biomedical Research Centre, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - Simon J Bowman
- NIHR Birmingham Biomedical Research Centre, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - Serena Colafrancesco
- Dipartimento di Medicina Interna e Specilità Mediche, UOC Reumatologia, Universita degli Studi di Roma La Sapienza Facolta di Medicina e Odontoiatria, Roma, Lazio, Italy
| | - Roberta Priori
- Dipartimento di Medicina Interna e Specilità Mediche, UOC Reumatologia, Universita degli Studi di Roma La Sapienza Facolta di Medicina e Odontoiatria, Roma, Lazio, Italy
| | | | | | - Gianluca Carlesso
- Early ICA Discovery, Early Oncology R&D, AstraZeneca, Gaithersburg, Maryland, USA
| | - Anwar Tappuni
- Institute of Dentistry, Barts and The London School of Medicine and Dentistry, London, London, UK
| | - Costantino Pitzalis
- Centre for Experimental Medicine and Rheumatology, William Harvey Research Institute, London, England, UK
| | - Michele Bombardieri
- Centre for Experimental Medicine and Rheumatology, William Harvey Research Institute, London, England, UK
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Weinstock MS, Simons JP, Dohar JE. Heterotopic gastric mucosa of the proximal esophageal (HGMPE) and its potential role in pediatric dysphonia and dysphagia. Int J Pediatr Otorhinolaryngol 2020; 138:110271. [PMID: 32805494 DOI: 10.1016/j.ijporl.2020.110271] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Revised: 07/20/2020] [Accepted: 07/21/2020] [Indexed: 02/07/2023]
Abstract
OBJECTIVE Despite a reported incidence of HGMPE of 10%, proof of acid production, and an increased incidence of respiratory symptoms, the pediatric otolaryngology, swallowing and voice care literature is silent on this entity. This case series describes pediatric patients confirmed to have HGMPE with dysphonia and/or dysphagia. METHODS Retrospective case series of Pediatric Voice, Resonance, and Swallowing Center patients at a tertiary Children's Hospital in 2019. SETTING Tertiary academic medical center. SUMMARY OF RESULTS Three patients who underwent triple endoscopy for dysphonia or dysphagia were histologically diagnosed with HGMPE. Esophageal biopsies were otherwise normal. Two of the three patients resolved their primary aerodigestive symptoms following treatment with acid suppression and a protectant (sucralfate). The third patient reported significant improvement in symptoms by phone. The significance of this case series cannot be understated: 1) A need for increased awareness among pediatric otolaryngologists, voice care and swallowing professionals of this entity given its relatively common incidence of 10% offset by a dearth of presentations & scientific publications in our literature clearly exists. 2) Otolaryngologists have abandoned operative upper aerodigestive tract endoscopy in lieu of office-based less comprehensive videolaryngostroboscopy and fiberoptic endoscopic evaluation of swallowing. HGMPE & other esophageal disorders (i.e. eosinophilic esophagitis) support revisiting triple endoscopy in select patients where office endoscopy has failed to diagnose and successfully treat such patients. 3) Both acid suppression therapy and a protectant (sucralfate) may be useful in these patients. 4) Modification of rigid esophagoscopy technique to carefully assess the introitus and superior esophageal segment is paramount 5) Otolaryngologists over-diagnose & over-treat laryngopharyngeal reflux. The pediatric & adult literature is replete with significant safety warnings associated with acid suppression therapy and guidelines admonish their indiscriminate use, raising the liability bar of empiric treatment. Large scale prospective, randomized and controlled studies are needed to confirm the pathophysiologic role of this entity in pediatric aerodigestive disorders. CONCLUSION HGMPE is a clinical entity that can be easily missed upon swift entry into the esophagus with rigid endoscopy. Careful scrutiny and visualization of the proximal esophagus is critical in order to identify HGMPE, as there is a higher rate of laryngospasm, stricture, and potentially neoplasm in this population.
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Affiliation(s)
- Michael S Weinstock
- Department of Otolaryngology, Children's Hospital of Pittsburgh, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
| | - Jeffrey P Simons
- Department of Otolaryngology, Children's Hospital of Pittsburgh, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - Joseph E Dohar
- Department of Otolaryngology, Children's Hospital of Pittsburgh, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
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Tahara I, Oishi N, Mochizuki K, Oyama T, Miyata K, Miyauchi A, Hirokawa M, Katoh R, Kondo T. Identification of Recurrent TERT Promoter Mutations in Intrathyroid Thymic Carcinomas. Endocr Pathol 2020; 31:274-282. [PMID: 32594366 DOI: 10.1007/s12022-020-09635-0] [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] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Intrathyroid thymic carcinoma (ITTC) is a rare malignant neoplasm considered to be a eutopic thymic carcinoma (TC) arising ectopically in the thyroid. Histopathologically, ITTC resembles squamous cell carcinoma of the thymus with positive TC markers such as CD5 and c-KIT. Despite these similar histological findings, ITTC is clinically less aggressive than TC. In this study, we compared clinical, histological, and genetic characteristics of ITTCs and TCs. We collected 9 ITTCs and 8 TCs with their clinicopathological profiles. Immunohistochemistry for CD5, p63, CD117/c-KIT, Ki-67, p53, TTF-1, thyroglobulin, PAX8, EGFR, and PD-L1/CD274 plus in situ hybridization for EBER was performed. We further investigated mutation status of KIT, EGFR, BRAF, and TERT promoter using Sanger sequencing. In our study, ITTCs affected significantly younger patients than TCs. After a mean follow-up of 86 months, all patients with ITTC were alive, while two patients with TC had died. Immunohistochemistry showed ITTCs and TCs had a similar immunophenotype except for EGFR and p53. Genetic analysis did not identify KIT or BRAF mutations in any ITTCs or TCs. EGFR mutations were positive in 11% (1/9) of ITTCs and 25% (2/8) of TCs. Notably, TERT promoter C228T mutation was identified in 22% (2/9) of ITTCs but none of the TCs. There were no significant differences in age, tumor size, or sex between TERT-mutated and TERT-wild-type ITTCs. Collectively, ITTC and TC have similar histopathologic and immunophenotypic features but different clinical outcomes. Recurrent TERT promoter mutation may be a key event related to cancer progression in ITTCs and warrants further investigation.
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Affiliation(s)
- Ippei Tahara
- Department of Pathology, University of Yamanashi, Chuo, Yamanashi, Japan
| | - Naoki Oishi
- Department of Pathology, University of Yamanashi, Chuo, Yamanashi, Japan
| | - Kunio Mochizuki
- Department of Pathology, University of Yamanashi, Chuo, Yamanashi, Japan
| | - Toshio Oyama
- Department of Pathology, Yamanashi Prefectural Central Hospital, Kofu, Yamanashi, Japan
| | - Kazuyuki Miyata
- Department of Pathology, Kofu Municipal Hospital, Kofu, Yamanashi, Japan
| | - Akira Miyauchi
- Department of Surgery, Kuma Hospital, Kobe, Hyogo, Japan
| | | | - Ryohei Katoh
- Department of Pathology, Ito hospital, Tokyo, Japan
| | - Tetsuo Kondo
- Department of Pathology, University of Yamanashi, Chuo, Yamanashi, Japan.
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Heffez DS, Golchini R, Ghorai J, Cohen B. Operative findings and surgical outcomes in patients undergoing Chiari 1 malformation decompression: relationship to the extent of tonsillar ectopia. Acta Neurochir (Wien) 2020; 162:1539-1547. [PMID: 31873790 DOI: 10.1007/s00701-019-04172-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [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: 02/13/2019] [Accepted: 12/10/2019] [Indexed: 11/27/2022]
Abstract
BACKGROUND The diagnosis of Chiari 1 malformation is based on the extent of tonsillar ectopia. OBJECTIVE To examine the relationship between the extent of tonsillar ectopia and the intra-operative findings and clinical outcome following Chiari decompression surgery. METHODS Patients were divided into four groups depending on the position of the cerebellar tonsil (T): group 1: 0 < T < 3; group 2: 3 ≤ T ≤ 5; group 3: 5 < T ≤ 10; and group 4: T > 10. Intra-operative observations were recorded with regard to compression of the brain stem by posterior inferior cerebellar artery (pica), neuroma formation along the first cervical (C1), and accessory spinal nerves (XI), and pallor of the cerebellar tonsils. Brain stem auditory evoked potentials, (BAEP), were monitored in each case. One hundred sixty-eight patients accrued between 2009 and 2013 agreed to participate in an outcome study to determine the effectiveness of foramen magnum decompression. Findings across the four groups were compared using one-way ANOVA. Observed differences were further subjected to paired analysis. Intra-group comparisons were made using the paired t test. A P value less than 0.05 was considered statistically significant. RESULTS There were 98 patients in group 1, 147 patients in group 2, 180 patients in group 3, and 63 patients in group 4. The mean extent of tonsillar ectopia was 0.4, 4.0, 7.1, and 14.3 mm in the four groups respectively. The prevalence of tonsillar pallor was greatest in group 4. Otherwise, there was no difference observed in the operative findings. A reduction of > 0.1 msec in the wave III-wave V latency of the BAEP was noted in all four groups with equal frequency. One hundred ten patients complied with at least 6 months follow-up. There was no difference in the prevalence of symptoms between the four groups at the time of initial evaluation and at 6 weeks and 6 months following surgery. There was a statistically significant reduction in the intensity of individual symptoms 6 months following surgery regardless of the extent of tonsil ectopia. CONCLUSION Other than the finding of tonsillar pallor, there was no relationship between the extent of tonsillar ectopia and the intraoperative anatomical and physiological observations, nor was there any relationship to the likelihood of symptomatic improvement following surgery. These observations call into question the focus on the extent of tonsillar of ectopia in assessing the patient who presents with symptoms of the Chiari malformation.
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Affiliation(s)
- Dan S Heffez
- Milwaukee Neurological Institute, 960 N 12th ST, Suite 1800, Milwaukee, WI, 53233, USA.
- The Wisconsin Chiari Center, Columbia St. Mary's Hospital, Milwaukee, USA.
| | - Ramin Golchini
- Department of Radiology, Columbia St. Mary's Hospital, Milwaukee, WI, USA
| | - Jugal Ghorai
- Department of Mathematics, University of Wisconsin, Milwaukee, USA
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Adachi Y, Hayashi H, Yusa T, Takematsu T, Matsumura K, Higashi T, Yamamura K, Yamao T, Imai K, Yamashita Y, Baba H. Ectopic hepatocellular carcinoma mimicking a retroperitoneal tumor: A case report. World J Gastroenterol 2020; 26:2268-2275. [PMID: 32476791 PMCID: PMC7235206 DOI: 10.3748/wjg.v26.i18.2268] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Revised: 04/22/2020] [Accepted: 04/30/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND An ectopic hepatocellular carcinoma (EHCC) arises from the ectopic liver which is defined as a hepatic organ or tissue not connected to surrounding tissues. EHCC is a rare disease and it is difficult to diagnose preoperatively. Furthermore, the clinical features are not fully elucidated.
CASE SUMMARY A retroperitoneal tumor (6 cm) was located at the dorsal side of the pancreas head on abdominal ultrasonography in an 81-year old woman positive for hepatitis C virus antibody. Contrast enhanced-computed tomography and gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid-enhanced magnetic resonance imaging showed viable HCC patterns with early enhancement and delayed washout. The tumor markers — serum alpha-fetoprotein and alpha-fetoprotein-L3% — were increased to 30.1 ng/mL and 83.1%, respectively. Protein induced by vitamin K absence or antagonist-II was within normal levels (17 mAU/mL). Positron emission tomography-computed tomography showed strong accumulation into the tumor (Standardized Uptake Value max: 13.8), and the tumor cytology following endoscopic ultrasound-guided fine needle aspiration showed poorly differentiated carcinoma. Tumor extirpation was performed, and operative findings showed that the retroperitoneal tumor was disconnected from the pancreas and the liver. Swollen lymph nodes near the tumor were histologically normal. On histological examination, the tumor was finally diagnosed as EHCC with Arginase-1 positive expression.
CONCLUSION We report our experience of a rare EHCC which was difficult to diagnose, and we present a review of the literature.
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Affiliation(s)
- Yuki Adachi
- Department of Gastroenterological Surgery, Graduate School of Life Sciences, Kumamoto University, Kumamoto 8608556, Japan
| | - Hiromitsu Hayashi
- Department of Gastroenterological Surgery, Graduate School of Life Sciences, Kumamoto University, Kumamoto 8608556, Japan
| | - Toshihiko Yusa
- Department of Gastroenterological Surgery, Graduate School of Life Sciences, Kumamoto University, Kumamoto 8608556, Japan
| | - Toru Takematsu
- Department of Gastroenterological Surgery, Graduate School of Life Sciences, Kumamoto University, Kumamoto 8608556, Japan
| | - Kazuki Matsumura
- Department of Gastroenterological Surgery, Graduate School of Life Sciences, Kumamoto University, Kumamoto 8608556, Japan
| | - Takaaki Higashi
- Department of Gastroenterological Surgery, Graduate School of Life Sciences, Kumamoto University, Kumamoto 8608556, Japan
| | - Kensuke Yamamura
- Department of Gastroenterological Surgery, Graduate School of Life Sciences, Kumamoto University, Kumamoto 8608556, Japan
| | - Takanobu Yamao
- Department of Gastroenterological Surgery, Graduate School of Life Sciences, Kumamoto University, Kumamoto 8608556, Japan
| | - Katsunori Imai
- Department of Gastroenterological Surgery, Graduate School of Life Sciences, Kumamoto University, Kumamoto 8608556, Japan
| | - Yo−ichi Yamashita
- Department of Gastroenterological Surgery, Graduate School of Life Sciences, Kumamoto University, Kumamoto 8608556, Japan
| | - Hideo Baba
- Department of Gastroenterological Surgery, Graduate School of Life Sciences, Kumamoto University, Kumamoto 8608556, Japan
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Sunde J, Wasickanin M, Katz TA, Wickersham EL, Steed DOE, Simper N. Prevalence of endosalpingiosis and other benign gynecologic lesions. PLoS One 2020; 15:e0232487. [PMID: 32401810 PMCID: PMC7219775 DOI: 10.1371/journal.pone.0232487] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2019] [Accepted: 04/15/2020] [Indexed: 02/06/2023] Open
Abstract
Endosalpingiosis, traditionally regarded as an incidental pathological finding, was recently reported to have an association with gynecologic malignancies. To determine the prevalence of endosalpingiosis, we evaluated all benign appearing adnexal lesions using the Sectioning and Extensively Examining-Fimbria (SEE-Fim) protocol, and queried the pathology database for the presence of endosalpingiosis, gynecologic malignancy, endometriosis, Walthard nests, and paratubal cysts. Using the SEE-Fim protocol, the prevalence of endosalpingiosis, endometriosis, Walthard nests, and paratubal cysts were 22%, 45%, 33%, and 42% respectively, substantially higher than previously reported. All lesions were observed to increase with age except endometriosis which increased until menopause then decreased dramatically. Among specimens including ovarian tissue, the prevalence of implantation of at least one lesion type was ubiquitous in patients age 51 and older (93%). The clinical significance of endosalpingiosis should be a continued area of research with larger trials assessing prevalence, factors affecting incidence, and association with malignancy. Our findings contribute to elucidating the origin of ectopic lesions and gynecologic disease risk.
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Affiliation(s)
- Jan Sunde
- Department of Obstetrics and Gynecology, Madigan Army Medical Center, Tacoma, WA, United States of America
- Division of Gynecologic Oncology, Baylor College of Medicine, Houston, TX, United States of America
- * E-mail:
| | - Morgan Wasickanin
- Department of Obstetrics and Gynecology, Madigan Army Medical Center, Tacoma, WA, United States of America
| | - Tiffany A. Katz
- Division of Gynecologic Oncology, Baylor College of Medicine, Houston, TX, United States of America
| | - Emily L. Wickersham
- Department of Pathology Madigan Army Medical Center, Tacoma, WA, United States of America
| | - D. O. Emilie Steed
- Department of Medicine, Texas Tech University Health Sciences Center, Lubbock, TX, United States of America
| | - Novae Simper
- Department of Pathology Madigan Army Medical Center, Tacoma, WA, United States of America
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Lechner K, McKenzie AL, Kränkel N, Von Schacky C, Worm N, Nixdorff U, Lechner B, Scherr J, Weingärtner O, Krauss RM. High-Risk Atherosclerosis and Metabolic Phenotype: The Roles of Ectopic Adiposity, Atherogenic Dyslipidemia, and Inflammation. Metab Syndr Relat Disord 2020; 18:176-185. [PMID: 32119801 PMCID: PMC7196362 DOI: 10.1089/met.2019.0115] [Citation(s) in RCA: 62] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Current algorithms for assessing risk of atherosclerotic cardiovascular disease (ASCVD) and, in particular, the reliance on low-density lipoprotein (LDL) cholesterol in conditions where this measurement is discordant with apoB and LDL-particle concentrations fail to identify a sizeable part of the population at high risk for adverse cardiovascular events. This results in missed opportunities for ASCVD prevention, most notably in those with metabolic syndrome, prediabetes, and diabetes. There is substantial evidence that accumulation of ectopic fat and associated metabolic traits are markers for and pathogenic components of high-risk atherosclerosis. Conceptually, the subset of advanced lesions in high-risk atherosclerosis that triggers vascular complications is closely related to a set of coordinated high-risk traits clustering around a distinct metabolic phenotype. A key feature of this phenotype is accumulation of ectopic fat, which, coupled with age-related muscle loss, creates a milieu conducive for the development of ASCVD: atherogenic dyslipidemia, nonresolving inflammation, endothelial dysfunction, hyperinsulinemia, and impaired fibrinolysis. Sustained vascular inflammation, a hallmark of high-risk atherosclerosis, impairs plaque stabilization in this phenotype. This review describes how metabolic and inflammatory processes that are promoted in large measure by ectopic adiposity, as opposed to subcutaneous adipose tissue, relate to the pathogenesis of high-risk atherosclerosis. Clinical biomarkers indicative of these processes provide incremental information to standard risk factor algorithms and advanced lipid testing identifies atherogenic lipoprotein patterns that are below the discrimination level of standard lipid testing. This has the potential to enable improved identification of high-risk patients who are candidates for therapeutic interventions aimed at prevention of ASCVD.
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Affiliation(s)
- Katharina Lechner
- Department of Prevention, Rehabilitation and Sports Medicine, School of Medicine, Technical University of Munich, Munich, Germany
- DZHK (German Center for Cardiovascular Research), Partner Site Munich Heart Alliance, Munich, Germany
| | | | - Nicolle Kränkel
- Klinik Für Kardiologie, Campus Benjamin Steglitz, Charité—Universitätsmedizin Berlin, Berlin, Germany
- DZHK (German Center for Cardiovascular Research), Partner Site Berlin, Berlin, Germany
| | - Clemens Von Schacky
- Preventive Cardiology, Ludwig-Maximilians University, Munich, Germany
- Omegametrix, Martinsried, Germany
| | - Nicolai Worm
- German University for Prevention and Health Care Management, Saarbrücken, Germany
| | | | - Benjamin Lechner
- Department of Internal Medicine IV, Ludwig-Maximilians University, Munich, Germany
| | - Johannes Scherr
- Department of Prevention, Rehabilitation and Sports Medicine, School of Medicine, Technical University of Munich, Munich, Germany
- University Center for Prevention and Sports Medicine, Balgrist University Hospital, University of Zurich, Zurich, Switzerland
| | | | - Ronald M. Krauss
- University of California, San Francisco, San Francisco, California, USA
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Maldonado AA, Spinner RJ, Broski SM, Stone JJ, Howe BM, Carter JM. Neuromuscular choristoma-associated desmoid-type fibromatosis: Establishing a nerve territory concept. Acta Neurochir (Wien) 2020; 162:1137-1146. [PMID: 31897730 DOI: 10.1007/s00701-019-04178-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [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: 10/25/2019] [Accepted: 12/12/2019] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Desmoid-type fibromatosis (DTF) frequently arises in patients with neuromuscular choristoma (NMC). We hypothesize that NMC-associated DTF occurs in soft tissues innervated by the NMC-affected nerve, and arises from CTNNB1-mutated (myo) fibroblasts within or directly adjacent to the NMC. MATERIALS AND METHODS A retrospective review of patients treated at our institution was performed for patients with biopsy-confirmed diagnosis of NMC-DTF. Clinical presentation, physical examination, electrodiagnostic findings and radiological features (MR and FDG PET/CT images for each NMC-DTF) and pathologic re-review of available materials were analyzed. A literature review was also performed. RESULTS Eight patients from our institution met the inclusion criteria. All patients presented with neuropathic symptoms and soft tissue or bone changes in the nerve territory innervated by the NMC. All MR images (N=8 cases) showed the characteristic features of NMC, and also showed direct contact between unifocal (N=5) or multifocal (N=3) DTF(s) and the NMC-affected nerve NMC. FDG PET/CT (N=2 cases) showed diffuse, increased FDG uptake along the entire affected nerve segment, contiguous with the FDG-avid DTF. In all cases, the DTFs arose in the soft tissues of the NMC-affected nerve's territory. No patient developed DTF at any other anatomic site. CONCLUSIONS These data demonstrate that NMC-DTF arises solely within the NMC-affected nerve territory, and has direct contact with the NMC itself. Based on all these findings and the multifocality of NMC in several cases, we recommend imaging and surveillance of the entire NMC-affected nerve (from spine to distal extremity) to identify clinically-occult DTF in patients with NMC.
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Affiliation(s)
- Andrés A Maldonado
- Department of Neurosurgery, Mayo Clinic, 200 1st St. SW, Rochester, MN, 55905, USA
| | - Robert J Spinner
- Department of Neurosurgery, Mayo Clinic, 200 1st St. SW, Rochester, MN, 55905, USA.
| | - Stephen M Broski
- Department of Radiology, Mayo Clinic, 200 1st St. SW, Rochester, MN, 55905, USA
| | - Jonathan J Stone
- Department of Neurosurgery, Mayo Clinic, 200 1st St. SW, Rochester, MN, 55905, USA
| | - B Matthew Howe
- Department of Radiology, Mayo Clinic, 200 1st St. SW, Rochester, MN, 55905, USA
| | - Jodi M Carter
- Department of Laboratory Medicine and Pathology, Mayo Clinic, 200 1st St. SW, Rochester, MN, 55905, USA
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Eliasberg CD, Lin KM, Bauer TW, Rodeo SA. Development of a Meniscal Ossicle After a Meniscal Root Repair Augmented with Bone Marrow Aspirate Concentrate: A Case Report. JBJS Case Connect 2020; 10:e0419. [PMID: 32224660 DOI: 10.2106/jbjs.cc.19.00419] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [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: 06/10/2023]
Abstract
CASE A 17-year-old boy had persistent knee pain 1 year after medial meniscal root repair augmented with bone marrow aspirate concentrate injection. Radiographs and magnetic resonance imaging (MRI) demonstrated an intrameniscal ossicle which was not present on MRI performed before 6 months. He underwent arthroscopic excision of the meniscal ossicle. At the 7-month follow-up, he had complete relief of his pain. CONCLUSIONS It is possible that the meniscal ossicle developed because of osteoinductive cells and cytokines from the injected bone marrow or the drill hole for root repair and should be considered as a possible complication of this procedure.
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Affiliation(s)
- Claire D Eliasberg
- Department of Orthopaedic Surgery, Hospital for Special Surgery, New York, New York
| | - Kenneth M Lin
- Department of Orthopaedic Surgery, Hospital for Special Surgery, New York, New York
| | - Thomas W Bauer
- Department of Pathology and Laboratory Medicine, Hospital for Special Surgery, New York, New York
| | - Scott A Rodeo
- Department of Orthopaedic Surgery, Hospital for Special Surgery, New York, New York
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Mishra A, Galvankar M, Vaidya S, Chaudhari U, Modi D. Mouse model for endometriosis is characterized by proliferation and inflammation but not epithelial-to-mesenchymal transition and fibrosis. J Biosci 2020; 45:105. [PMID: 32975232] [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: 06/11/2023]
Abstract
Endometriosis is a common disorder of unknown etiology, and non-surgical therapies are still a challenge. To understand the pathogenesis and preclinical testing of drugs for endometriosis, animal models are highly desirous. Herein, we carried out longitudinal characterization of a mouse model for endometriosis where uterine tissue was transplanted onto the intestinal mesentery. During the course of lesion development from day 15 to 60 post-induction, the ectopic endometrium became pale, fluid-filled and the animals developed peritoneal adhesions. Most lesions resembled a well-differentiated type of endometriosis and ~13% of animals had mixed type of lesions. There was extensive stromal compaction in the ectopic tissue. During the progression of endometriosis, there was increased proliferation of epithelial and stromal cells as evident by PCNA staining. Cyp19a1 (aromatase) mRNA was detected in the ectopic lesions on day 15 and 30 post-induction of endometriosis, by day 60 the expression was reduced. As compared to the control endometrium, the mRNA levels of Esr1 progressively reduced while the levels of inflammation associated genes (Esr2, Ifng, Tnf and Il1b) increased in the ectopic lesions. Infiltration of macrophages and polymorphonuclear leucocytes was also observed in the ectopic lesions indicative of inflammation. As compared to control, there was no change in levels of Cytokeratin and E-cadherin in the epithelial cells of ectopic endometrium. We did not observe excessive collagen deposition or α -SMA positive myofibroblasts in the stroma of the ectopic endometrium. Thus, epithelial-to-mesenchymal transition and fibrosis are not detected in the mouse model of endometriosis. Our results show that the mouse model of endometriosis mimics some but not all the features of human endometriosis.
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Affiliation(s)
- Anuradha Mishra
- Molecular and Cellular Biology Laboratory, ICMR-National Institute for Research in Reproductive Health, Indian Council of Medical Research (ICMR), Mumbai 400 012, India
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Uozumi T, Seki H, Matsuzono E, Sogabe S, Sugai N, Fujita J, Suzuki J, Akimoto M, Yanai M, Suzuki A. Gastric adenocarcinoma of fundic gland type arising from heterotopic gastric glands during a 19-year follow-up period. Clin J Gastroenterol 2019; 12:556-561. [PMID: 31165461 PMCID: PMC6892357 DOI: 10.1007/s12328-019-00989-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/25/2018] [Accepted: 04/23/2019] [Indexed: 11/25/2022]
Abstract
A 73-year-old man with prior history of duodenal ulcer has been undergoing periodic upper gastrointestinal endoscopy since 1999. In 2017, a 25-mm submucosal tumor-like protrusion was detected in the lesser curvature of the upper stomach; histological examination of the lesion revealed gastric adenocarcinoma of fundic gland type. En bloc resection was achieved using endoscopic submucosal dissection. The patient was histopathologically diagnosed with gastric adenocarcinoma of fundic gland type arising from heterotopic gastric glands. Immunohistochemical staining was positive for MUC5AC, MUC6, pepsinogen I, and proton pump but negative for MUC2 and CD10. Moreover, the patient's Ki-67 labeling index score was extremely low. The presence of MUC5AC indicated that the tumor differentiated to the foveolar epithelium and fundic glands. Gastric adenocarcinoma of fundic gland type that differentiates to several directions has a higher malignant potential than the disease that differentiates to chief cells. A retrospective review of the patient's previous endoscopic examination revealed that the submucosal tumor-like protrusion existed since 2000; tumor size increased from 8 mm in 2000 to 25 mm in 2017. The present case is rare in that the carcinoma arose from heterotopic gastric glands. Moreover, the 19-year follow-up revealed that the tumor differentiated to the foveolar epithelium, considered as having high-grade malignancy.
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Affiliation(s)
- Takeshi Uozumi
- Departments of Gastroenterology, KKR Sapporo Medical Center, 6-3-40, Hiragishi 1jou, Toyohira-ku, Sapporo, Hokkaido, 062-0931, Japan.
| | - Hideyuki Seki
- Departments of Gastroenterology, KKR Sapporo Medical Center, 6-3-40, Hiragishi 1jou, Toyohira-ku, Sapporo, Hokkaido, 062-0931, Japan
| | - Emi Matsuzono
- Departments of Gastroenterology, KKR Sapporo Medical Center, 6-3-40, Hiragishi 1jou, Toyohira-ku, Sapporo, Hokkaido, 062-0931, Japan
| | - Susumu Sogabe
- Departments of Gastroenterology, KKR Sapporo Medical Center, 6-3-40, Hiragishi 1jou, Toyohira-ku, Sapporo, Hokkaido, 062-0931, Japan
| | - Nozomu Sugai
- Departments of Gastroenterology, KKR Sapporo Medical Center, 6-3-40, Hiragishi 1jou, Toyohira-ku, Sapporo, Hokkaido, 062-0931, Japan
| | - Jun Fujita
- Departments of Gastroenterology, KKR Sapporo Medical Center, 6-3-40, Hiragishi 1jou, Toyohira-ku, Sapporo, Hokkaido, 062-0931, Japan
| | - Junichi Suzuki
- Departments of Gastroenterology, KKR Sapporo Medical Center, 6-3-40, Hiragishi 1jou, Toyohira-ku, Sapporo, Hokkaido, 062-0931, Japan
| | - Mayuko Akimoto
- Department of Pathology, KKR Sapporo Medical Center, Sapporo, Japan
| | - Mitsuru Yanai
- Department of Pathology, KKR Sapporo Medical Center, Sapporo, Japan
| | - Akira Suzuki
- Department of Pathology, KKR Sapporo Medical Center, Sapporo, Japan
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Abstract
BACKGROUND Ectopic pancreas in the ileum, including lesions within Meckel diverticulum, can cause severe manifestations and complications; yet, it was seldom reported in English literature. AIM This study aimed to raise awareness and provide information for better clinical management of this rare yet serious condition. METHODS A total of 1713 cases of small bowel resection were performed in our hospital between 2009 and 2018, among which 10 cases of ileac ectopic pancreas were identified. A comprehensive retrospective review of the 10 cases was taken. RESULTS Five lesions were located in the ileum wall and 5 were within Meckel diverticulum. Two lesions within Meckel diverticulum were incidental; the remaining 8 lesions were all associated with abdominal pain, gastrointestinal bleeding, and anemia. Of the 5 patients with lesions in the ileum wall, computed tomography uniformly revealed ileoileal intussusceptions with masses as lead points. Capsule endoscopies were performed in 6 cases, of which 3 showed positive findings. Double-balloon enteroscopy was conducted in one case and revealed an ileal diverticulum. Therapeutically, the offending bowel segments were removed, and intussusceptions were restored except for one case in which diverticulectomy was applied. No relapse or sequela was observed in the follow-up. CONCLUSIONS Ileac ectopic pancreas can be seen in the ileum wall or Meckel diverticulum. The majority of the lesions found in clinical practice present with abdominal pain, gastrointestinal bleeding, and anemia. Lesions in the ileum wall often cause ileoileal intussusception. Computed tomography, capsule endoscopy, and double-balloon enteroscopy are helpful preoperative examinations. Segmental small bowel resection is the treatment of choice.
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Wang J, Wang M, Chen F, Wei Y, Chen X, Zhou Y, Yang X, Zhu X, Tu C, Zhang X. Nano-Hydroxyapatite Coating Promotes Porous Calcium Phosphate Ceramic-Induced Osteogenesis Via BMP/Smad Signaling Pathway. Int J Nanomedicine 2019; 14:7987-8000. [PMID: 31632013 PMCID: PMC6781424 DOI: 10.2147/ijn.s216182] [Citation(s) in RCA: 47] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2019] [Accepted: 09/17/2019] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND The hierarchical porous structure and surface topography of calcium phosphate (CaP) bioceramics have a crucial impact on their osteoinductivity. PURPOSE To fabricate a biomimetic bone graft with an interconnected porous structure analogous to that of trabecular bone and a bioactive nanostructured surface with excellent osteoinductive potential. MATERIALS AND METHODS A biphasic CaP (BCP) substrate with highly porous structure was fabricated by an improved sponge replication method. Surface modification was performed by uniformly depositing a hydroxyapatite (HA) nanoparticle layer to create nHA-coated BCP scaffolds. The effects of these scaffolds on osteogenic differentiation of murine bone marrow-derived stem cells (BMSCs) were investigated in vitro, and their osteoinductivity was further assessed in vivo. RESULTS The BCP and nHA-coated BCP scaffolds had similar trabecular bone-like architectures but different surface structures, with mean grain sizes of ~55 nm and ~1 μm, respectively. Compared with the BCP substrate, the nHA-coated BCP scaffolds favored cell adhesion and promoted osteogenic differentiation of BMSCs, as evidenced by upregulated expression of osteogenic genes, enhanced alkaline phosphatase activity, and increased osteocalcin production. This could be attributed to activation of the BMP/Smad signaling pathway, as significantly higher expression levels of BMPRI, Smad1, Smad4, and Smad5 were observed in the nHA-coated BCP group. The nHA-coated BCP scaffold not only maintained scaffold integrity but also induced ectopic bone formation when implanted into rabbit dorsal muscle in vivo for 90 days, whereas the BCP substrate underwent marked biodegradation that led to severe inflammation with no sign of osteogenesis. CONCLUSION The present study demonstrates the potential of this biomimetic bone graft with a trabecular framework and nanotopography for use in orthopedic applications.
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Affiliation(s)
- Jing Wang
- National Engineering Research Center for Biomaterials, Sichuan University, Chengdu610064, People’s Republic of China
| | - Menglu Wang
- National Engineering Research Center for Biomaterials, Sichuan University, Chengdu610064, People’s Republic of China
| | - Fuying Chen
- National Engineering Research Center for Biomaterials, Sichuan University, Chengdu610064, People’s Republic of China
| | - Yihang Wei
- National Engineering Research Center for Biomaterials, Sichuan University, Chengdu610064, People’s Republic of China
| | - Xuening Chen
- National Engineering Research Center for Biomaterials, Sichuan University, Chengdu610064, People’s Republic of China
| | - Yong Zhou
- Department of Orthopaedics, West China Hospital of Sichuan University, Chengdu610041, People’s Republic of China
| | - Xiao Yang
- National Engineering Research Center for Biomaterials, Sichuan University, Chengdu610064, People’s Republic of China
| | - Xiangdong Zhu
- National Engineering Research Center for Biomaterials, Sichuan University, Chengdu610064, People’s Republic of China
| | - Chongqi Tu
- Department of Orthopaedics, West China Hospital of Sichuan University, Chengdu610041, People’s Republic of China
| | - Xingdong Zhang
- National Engineering Research Center for Biomaterials, Sichuan University, Chengdu610064, People’s Republic of China
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Abstract
RATIONALE Uterus-like masses (ULMs) are rare benign lesions that resemble the uterus. PATIENT CONCERNS Here, we describe the case of a woman with a ULM in the right broad ligament. A 51-year-old woman with a 2-month history of irregular vaginal bleeding was found to have a mass in the right broad ligament. Imaging studies revealed a solid-cystic lesion, suggestive of an endometrial cyst with malignant transformation. INTERVENTIONS She underwent prompt surgery for the removal of the mass. Intraoperatively, the uterus and ovaries appeared normal, and an 8-cm-long mass was observed in the right broad ligament without any connection to the uterus or ovaries. The mass was successfully excised. DIAGNOSES Postoperative histopathological examination showed that the cystic mass was filled with a blackish-brownish fluid and that it had thick walls resembling the uterine myometrium. The cyst center was lined by endometrial glands that were positive for cytokeratin as well as estrogen and progesterone receptors, and by stromal cells that were positive for CD10. OUTCOMES The patient recovered well and has had no further symptoms during 2 years of follow-up. LESSONS We have reported a case of ULM in the right broad ligament in a Chinese woman. Although ULMs are rare, they should be considered in the differential diagnosis for pelvic masses.
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Couch LL, Watlington JR, Stanley JD, Jean RJ. Two Primary Adenocarcinomas in a Single Patient: A Primary Colonic Adenocarcinoma and a Primary Pancreatic Adenocarcinoma Arising from Ectopic Pancreatic Tissue. Am Surg 2019; 85:e439-e440. [PMID: 31638530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
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Meng X, Liu J, Wang H, Chen P, Wang D. MicroRNA-126-5p downregulates BCAR3 expression to promote cell migration and invasion in endometriosis. Mol Cell Endocrinol 2019; 494:110486. [PMID: 31233772 DOI: 10.1016/j.mce.2019.110486] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2019] [Revised: 06/07/2019] [Accepted: 06/07/2019] [Indexed: 02/06/2023]
Abstract
PURPOSE Endometriosis (EMs) is an estrogen-dependent multifactorial disease. Inhibition of estrogen in endometrial cells contributes to their failure to form lesions in ectopic sites. However, whether reducing or suppressing the inhibitory effect of estrogen results in the establishment of ectopic lesions remains unclear. The BCAR3 gene induces estrogen resistance in estrogen-dependent breast cancer cells and promotes cell migration, invasion, and epithelial-mesenchymal transition (EMT). However, the expression of BCAR3 in endometriosis and its effect on endometrial cell function and the anti-estrogen effect of endometriosis have not been reported. These issues are addressed in the present study. METHODS The study included 32 cases of ectopic endometrium and eutopic endometrium in patients with endometriosis and 31 cases of normal endometrium as controls. The expression of BCAR3 and microRNA (miR)-126-5p was detected by real-time PCR, immunohistochemistry, and western blotting. The effects of BCAR3 and miR-126-5p on the morphology and biological behavior of eutopic endometrial cells were verified using lentivirus overexpression and a vector knockdown model, the CCK-8 assay, Transwell experiments, and estrogen intervention experiments using primary cultures of epithelial and stromal cells. RESULTS The BCAR3 gene was highly expressed in ectopic endometrium and the eutopic endometrium of patients with endometriosis, and the expression level was higher in stage III-IV patients than in stage I-II patients. In vitro cell experiments showed that miR-126-5p negatively regulated the expression of BCAR3 and its effect on the migration and invasion of stromal cells. Low expression of miR-126-5p and high expression of BCAR3 promoted endometriosis stromal cell migration and invasion. Assessment of EMT in endometriosis compared with eutopic endometrium showed that the expression of vimentin was significantly increased and the expression of E-cadherin was significantly decreased in ectopic endometrium. Estrogen promoted EMT in eutopic endometrial epithelial cells and this effect was reversed by estrogen inhibitors. BCAR3 had no direct effect on EMT and did not act synergistically with estrogen on promoting EMT. CONCLUSION miR-126-5p negatively regulated BCAR3 expression in eutopic endometriosis, enhanced the migration and invasion of endometrial cells, and promoted the occurrence of endometriosis. BCAR3 did not induce EMT and had no synergistic effect with estrogen, but its inhibition of anti-estrogen function may provide new insight into the mechanism of local estrogen action in endometriosis.
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Affiliation(s)
- Xiannan Meng
- Department of Gynecology, Cancer Hospital of China Medical University, Liaoning Cancer Hospital and Institute, Shenyang, Liaoning, 110042, PR China
| | - Jing Liu
- Department of Gynecology, Cancer Hospital of China Medical University, Liaoning Cancer Hospital and Institute, Shenyang, Liaoning, 110042, PR China
| | - Huimin Wang
- Department of Gynecology, Cancer Hospital of China Medical University, Liaoning Cancer Hospital and Institute, Shenyang, Liaoning, 110042, PR China
| | - Peng Chen
- Department of Gynecology, Cancer Hospital of China Medical University, Liaoning Cancer Hospital and Institute, Shenyang, Liaoning, 110042, PR China
| | - Danbo Wang
- Department of Gynecology, Cancer Hospital of China Medical University, Liaoning Cancer Hospital and Institute, Shenyang, Liaoning, 110042, PR China.
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Abstract
The proximal esophagus is rarely examined, and its inspection is often inadequate. Optical chromoendoscopy techniques such as narrow band imaging improve the detection rate of inlet patches in the proximal esophagus, a region in which their prevalence is likely underestimated. Various studies have reported correlations between these esophageal marks with different issues such as Barrett's esophagus, but these findings remain controversial. Conflicting reports complicate the process of interpreting the clinical features of esophageal inlet patches and underestimate their importance. Unfortunately, the limited clinical data and statistical analyses make reaching any conclusions difficult. It is hypothesized that inlet patches are correlated with various esophageal and extraesophageal symptoms, diagnoses and the personalized therapeutic management of patients with inlet patches as well as the differential diagnosis for premalignant lesions or early cancers. Due to its potential underdiagnosis, there are no consensus guidelines for the management and follow up of inlet patches. This review focuses on questions that were raised from published literature on esophageal inlet patches in adults.
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Affiliation(s)
- Adriana Ciocalteu
- Department of Gastroenterology, Research Center of Gastroenterology and Hepatology, University of Medicine and Pharmacy of Craiova, Craiova 200349, Romania
| | - Petrica Popa
- Department of Gastroenterology, Research Center of Gastroenterology and Hepatology, University of Medicine and Pharmacy of Craiova, Craiova 200349, Romania
| | - Mircea Ionescu
- Department of Anesthesiology and Intensive Care, Emergency County Hospital of Craiova, Craiova 200642, Romania
| | - Dan Ionut Gheonea
- Department of Gastroenterology, Research Center of Gastroenterology and Hepatology, University of Medicine and Pharmacy of Craiova, Craiova 200349, Romania
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Lui H, Bindra R, Baldwin J, Ivanovski S, Vaquette C. Additively Manufactured Multiphasic Bone-Ligament-Bone Scaffold for Scapholunate Interosseous Ligament Reconstruction. Adv Healthc Mater 2019; 8:e1900133. [PMID: 31112356 DOI: 10.1002/adhm.201900133] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [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: 01/29/2019] [Revised: 04/20/2019] [Indexed: 02/02/2023]
Abstract
The scapholunate interosseous ligament (SLIL) is a frequently torn wrist ligament, and current surgical options for SLIL tears are suboptimal. This research aims to develop a novel multiphasic bone-ligament-bone scaffold (BLB) with a porous interface using 3D-printing and cell sheet technology for the reconstruction of the dorsal scapholunate interosseous ligament. The BLB comprises two bone compartments bridged by aligned polycaprolactone fibers mimicking the architecture of the native tissue. Mechanical testing of the BLBs shows their ability to withstand physiological forces. Combination of the BLB with human bone marrow mesenchymal stem cell sheet demonstrates that the harvesting did not compromise cell viability, while allowing homogeneous distribution in the ligament compartment. The BLBs are loaded with cell sheets and bone morphogenetic protein-2 in the ligament and bone compartment respectively prior to ectopic implantation into athymic rats. The histology demonstrates rapid tissue infiltration, high vascularization, and more importantly the maintenance of the compartmentalization as bone formation remains localized to the bone compartment despite the porous interface. The cells in the ligament compartment become preferentially aligned, and this proof-of-concept study demonstrates that the BLB can provide sufficient compartmentalization and fiber guiding properties necessary for the regeneration of the dorsal SLIL.
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Affiliation(s)
- Hayman Lui
- School of Medicine, Griffith University, Parklands Drive, Southport, Gold Coast Campus, QLD, 4215, Australia
| | - Randy Bindra
- School of Medicine, Griffith University, Parklands Drive, Southport, Gold Coast Campus, QLD, 4215, Australia
| | - Jeremy Baldwin
- Centre in Regenerative Medicine Institute of Health and Biomedical Innovation, Queensland University of Technology (QUT), Brisbane, 4059, Australia
| | - Saso Ivanovski
- School of Dentistry, the University of Queensland, Herston, 4006, Queensland, Australia
| | - Cedryck Vaquette
- Centre in Regenerative Medicine Institute of Health and Biomedical Innovation, Queensland University of Technology (QUT), Brisbane, 4059, Australia
- School of Dentistry, the University of Queensland, Herston, 4006, Queensland, Australia
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50
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Schwarz GM, Hirtler L. Ectopic tendons of the pectoralis minor muscle as cause for shoulder pain and motion inhibition-Explaining clinically important variabilities through phylogenesis. PLoS One 2019; 14:e0218715. [PMID: 31226146 PMCID: PMC6588231 DOI: 10.1371/journal.pone.0218715] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2019] [Accepted: 06/07/2019] [Indexed: 11/18/2022] Open
Abstract
OJECTIVE Clinical consequences of ectopic tendons of the pectoralis minor muscle (PMM) for shoulder pain and range-of-motion limitation have been demonstrated. For better understanding the existence of such ectopic tendons, a phylogenetic hypothesis is proposed. METHODS Forty-five shoulders of anatomical specimens were dissected and examined. Insertions areas of PMM were measured and occurring aberrant tendons were identified. Their relationship with the coracohumeral ligament (CHL) described and samples of the ligament were collected and histologically stained. RESULTS The prevalence of PMM variations was 37.84%. Shoulders with variations showed a statistically significant smaller coracopectoral distance (p<0.001) and larger insertion areas (p<0.003) than shoulders without. A strong negative correlation between these two variables (p<0.001, r = -0.620) was shown. CONCLUSIONS The presented results prompted the conclusion that the CHL may be in fact the remnant of the pectoralis minor tendon (PMT), which migrated from the humerus to the coracoid process through the process of phylogenetic evolution. Variations of PMTs are significantly more common than in previous studies. Imaging techniques appear to be insufficiently sensitive for reliably detecting ectopic tendons. Especially in patients experiencing shoulder pain and stiffness in whom the commoner pathologies have been ruled out the possibility of ectopic PMT should be kept in mind and ruled out.
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Affiliation(s)
- Gilbert M. Schwarz
- Department of Orthopedics and Trauma-Surgery, Medical University of Vienna, Vienna, Austria
| | - Lena Hirtler
- Division of Anatomy, Center for Anatomy and Cell Biology, Medical University of Vienna, Vienna Austria
- * E-mail:
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