Segmentation of color images from serous cytology for automated cell classification

OBJECTIVE

To design an automated system for the classification of cells based on analysis of serous cytology, with the aim of segmenting both cytoplasm and nucleus using color information from the images as the main characteristic of the cells.

STUDY DESIGN

The segmentation strategy uses color information coupled with mathematical morphology tools, such as watersheds. Cytoplasm and nuclei of all diagnostic cells are retained; erythrocytes and debris are eliminated. Special techniques are used for the separation of clustered cells.

RESULTS

A large set of cells was assessed by experts to score the segmentation success rate. All cells were segmented whatever their spatial configurations. The average success rate was 92.5% for nuclei and 91.1% for cytoplasm.

CONCLUSION

This color information-based segmentation of images of serous cells is accurate and provides a useful tool. This segmentation strategy will improve the automated classification of cells.

[Synchronous bilateral renal cell carcinoma. Renal transplantation after nephrectomy]

INTRODUCTION

Treatment of bilateral and synchronous renal cell cancer may require bilateral nephrectomy and chronic dialysis. After an arbitrarily determined waiting period (2 years) on dialysis, kidney transplantation may be proposed.

CASE REPORTS

Two patients underwent kidney transplantation after bilateral nephrectomy for early-stage low-grade renal cell cancer. Eight years after nephrectomy and 6 years after transplantation, there is no evidence of cancer recurrence and renal function is satisfactory.

DISCUSSION

Certain patients treated for cancer may be candidates for kidney transplantation, even if the risk for cancer is higher in transplant recipients. Moreover, kidney transplantation without a required period on chronic dialysis could be proposed in early-stage lowgrade renal cell cancer.

[Relationship between type III intestinal metaplasia, age and gastric cancer. 560 biopsies]

OBJECTIVE

A significant association between type III intestinal metaplasia and gastric adenocarcinoma has been demonstrated in gastrectomy and biopsy series. We investigated the effect of age in a large series of gastric biopsies in order to determine whether this association is age dependent or independent.

METHODS

Histochemistry examinations were performed in 560 gastric biopsies showing intestinal metaplasia. The percentage of type III versus type I/II metaplasia in patients with malignant (n = 41) or benign disease (n = 519) was compared between patients aged 50 to 69 years and patients aged 70 to 89 years.

RESULTS

The prevalence of type III metaplasia increased with age both in malignant (30 vs 61% in the 50-69 and 70-89 year age groups respectively) and benign disease (9 vs 17% respectively). In patients with cancer, type III metaplasia was found more often than type I/II metaplasia (n = 22 vs 19). In the 70-89 year age group, there was a significant difference (p < 0.001) in the percentage of type III metaplasia in patients with cancer (61%) and those with benign disease (17%).

CONCLUSION

These findings demonstrate that there is a specific age-independent relationship between intestinal metaplasia and gastric cancer.

[Malacoplakia in a rectal adenocarcinoma. Review of the literature. Apropos of a case]

Malakoplakia is a rare granulomatous lesion involving rarely organs other than the urinary bladder. 39 cases of colo-rectal Malakoplakia have been published. 12 of them are associated with a colo-rectal tumor. The authors report in this paper a new case of rectal Malakoplakia associated with an adenocarcinoma. An ultrastructural study show septate junctions between the phagolysosomes. This very rare feature and the physiopathology of the association Malakoplakia-adenocarcinoma are discussed.

Autopsy findings in 111 cases of esophageal cancer

Autopsy findings for 111 cases of esophageal cancer are presented. Residual tumor in the esophagus was present in 75% of the cases. Lymph node metastases were found in 74.5% and visceral metastases in 50% of the cases. Autopsy revealed a second primary tumor in 21% of the cases; 12% of these were oropharyngeal-laryngeal (OPL) carcinomas, and 9% were visceral carcinomas or malignant lymphomas. Nonmalignant disease found in association with esophageal cancer was dominated by conditions related to chronic alcoholism. Autopsy findings thus revealed that the patients bore not only esophageal lesions, but also patterns of other associated malignant and nonmalignant diseases which would seem to correspond to a complex pathologic state occurring in association with chronic alcoholism. The time between onset of symptoms and autopsy averaged 10.6 months and between first consultation and autopsy, 6.3 months. The brevity of survival from onset of symptoms would seem to confirm that by the time esophageal cancer manifests clinically, it is already at a stage of development beyond the scope of treatment.

Autopsy findings in 111 cases of esophageal cancer

Autopsy findings for 111 cases of esophageal cancer are presented. Residual tumor in the esophagus was present in 75% of the cases. Lymph node metastases were found in 74.5% and visceral metastases in 50% of the cases. Autopsy revealed a second primary tumor in 21% of the cases; 12% of these were oropharyngeal-laryngeal (OPL) carcinomas, and 9% were visceral carcinomas or malignant lymphomas. Nonmalignant disease found in association with esophageal cancer was dominated by conditions related to chronic alcoholism. Autopsy findings thus revealed that the patients bore not only esophageal lesions, but also patterns of other associated malignant and nonmalignant diseases which would seem to correspond to a complex pathologic state occurring in association with chronic alcoholism. The time between onset of symptoms and autopsy averaged 10.6 months and between first consultation and autopsy, 6.3 months. The brevity of survival from onset of symptoms would seem to confirm that by the time esophageal cancer manifests clinically, it is already at a stage of development beyond the scope of treatment.

Autopsy findings in 111 cases of esophageal cancer

Autopsy findings for 111 cases of esophageal cancer are presented. Residual tumor in the esophagus was present in 75% of the cases. Lymph node metastases were found in 74.5% and visceral metastases in 50% of the cases. Autopsy revealed a second primary tumor in 21% of the cases; 12% of these were oropharyngeal-laryngeal (OPL) carcinomas, and 9% were visceral carcinomas or malignant lymphomas. Nonmalignant disease found in association with esophageal cancer was dominated by conditions related to chronic alcoholism. Autopsy findings thus revealed that the patients bore not only esophageal lesions, but also patterns of other associated malignant and nonmalignant diseases which would seem to correspond to a complex pathologic state occurring in association with chronic alcoholism. The time between onset of symptoms and autopsy averaged 10.6 months and between first consultation and autopsy, 6.3 months. The brevity of survival from onset of symptoms would seem to confirm that by the time esophageal cancer manifests clinically, it is already at a stage of development beyond the scope of treatment.

[Kawasaki disease (mucocutaneous lymph node syndrome). Description of a case (author's transl)]

The authors relate a case of mucocutaneous lymph node syndrome, first described by Kawasaki in 1967, including a fever, lasting more than five days, an erythematous rash, cervical lymphadenitis, with a usually good prognosis. One to two percent of patients die suddenly of cardiac failure with coronary aneurysm and thrombosis. Microscopically coronary arteries such as other arteries show inflammation with dilaceration of the vascular wall without necrosis. These pathologic features suggest a relationship to infantile periarteritis nodosa.