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Papadopoulos VE, Velonakis G, Argyrakos T, Anagnostouli M, Stefanis L, Mavragani CP, Evangelopoulos ME. Lupus-like disease and progressive multifocal leukoencephalopathy following etanercept treatment: just a coincidence? Clin Exp Rheumatol 2022; 40:671-672. [DOI: 10.55563/clinexprheumatol/cfg3tk] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Accepted: 06/28/2021] [Indexed: 11/13/2022]
Affiliation(s)
- Vassilis E. Papadopoulos
- 1st Department of Neurology, National and Kapodistrian University of Athens, Eginition Hospital, Athens, Greece
| | - Georgios Velonakis
- Research Unit of Radiology, 2nd Department of Radiology, National and Kapodistrian University of Athens, Eginition Hospital, Athens, Greece
| | | | - Maria Anagnostouli
- 1st Department of Neurology, National and Kapodistrian University of Athens, Eginition Hospital, Athens, Greece
| | - Leonidas Stefanis
- 1st Department of Neurology, National and Kapodistrian University of Athens, Eginition Hospital, Athens, Greece
| | - Clio P. Mavragani
- Departments of Physiology and Pathophysiology, School of Medicine, Greece & Joint Academic Rheumatology Program, National and Kapodistrian University of Athens, Greece.
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Vakrakou AG, Brinia ME, Svolaki I, Argyrakos T, Stefanis L, Kilidireas C. Immunopathology of Tumefactive Demyelinating Lesions-From Idiopathic to Drug-Related Cases. Front Neurol 2022; 13:868525. [PMID: 35418930 PMCID: PMC8997292 DOI: 10.3389/fneur.2022.868525] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Accepted: 02/18/2022] [Indexed: 11/13/2022] Open
Abstract
Tumefactive demyelinating lesions (TDL) represent a diagnostic dilemma for clinicians, and in rare atypical cases a collaboration of a neuroradiologist, a neurologist, and a neuropathologist is warranted for accurate diagnosis. Recent advances in neuropathology have shown that TDL represent an umbrella under which many different diagnostic entities can be responsible. TDL can emerge not only as part of the spectrum of classic multiple sclerosis (MS) but also can represent an idiopathic monophasic disease, a relapsing disease with recurrent TDL, or could be part of the myelin oligodendrocyte glycoprotein (MOG)- and aquaporin-4 (AQP4)-associated disease. TDL can appear during the MS disease course, and increasingly cases arise showing an association with specific drug interventions. Although TDL share common features with classic MS lesions, they display some unique features, such as extensive and widespread demyelination, massive and intense parenchymal infiltration by macrophages along with lymphocytes (mainly T but also B cells), dystrophic changes in astrocytes, and the presence of Creutzfeldt cells. This article reviews the existent literature regarding the neuropathological findings of tumefactive demyelination in various disease processes to better facilitate the identification of disease signatures. Recent developments in immunopathology of central nervous system disease suggest that specific pathological immune features (type of demyelination, infiltrating cell type distribution, specific astrocyte pathology and complement deposition) can differentiate tumefactive lesions arising as part of MS, MOG-associated disease, and AQP4 antibody-positive neuromyelitis optica spectrum disorder. Lessons from immunopathology will help us not only stratify these lesions in disease entities but also to better organize treatment strategies. Improved advances in tissue biomarkers should pave the way for prompt and accurate diagnosis of TDL leading to better outcomes for patients.
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Affiliation(s)
- Aigli G. Vakrakou
- Demyelinating Diseases Unit, 1st Department of Neurology, School of Medicine, Aeginition Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Maria-Evgenia Brinia
- Demyelinating Diseases Unit, 1st Department of Neurology, School of Medicine, Aeginition Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Ioanna Svolaki
- Department of Pathophysiology, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | | | - Leonidas Stefanis
- Demyelinating Diseases Unit, 1st Department of Neurology, School of Medicine, Aeginition Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Constantinos Kilidireas
- Demyelinating Diseases Unit, 1st Department of Neurology, School of Medicine, Aeginition Hospital, National and Kapodistrian University of Athens, Athens, Greece
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Varytimiadis L, Viazis N, Gkolfakis P, Tribonias G, Tziatzios G, Kyriakopoulos G, Argyrakos T, Pontas C, Papastergiou V, Arkadopoulos N, Smyrniotis V, Mantzaris GJ, Papanikolaou IS. Cold snare polypectomy vs. hot snare polypectomy vs. argon plasma coagulation for small (5-9mm) left-sided colorectal polyps: a prospective randomized trial. Eur J Gastroenterol Hepatol 2021; 33:e909-e915. [PMID: 35048657 DOI: 10.1097/meg.0000000000002300] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVE To compare recurrence rates among three endoscopic treatment modalities for 5-9 mm left-sided colorectal polyps. METHODS Consecutive adults referred for elective colonoscopy (1/2015-1/2018) with at least one polyp of eligible size (5-9 mm) located distally to the splenic flexure were randomly assigned (1:1:1) to one of three treatment modalities: (1) cold snare polypectomy (CSP), (2) hot snare polypectomy (HSP) and (3) argon plasma coagulation (APC) ablation (50-60 W, flow: 2 l/min). The polyp site was marked with an endoscopic tattoo, and a follow-up colonoscopy with scar biopsies was performed >6 months after the index procedure. Outcomes were polyp recurrence rate and occurrence of complications. RESULTS One hundred nineteen patients were enrolled, of whom 112 (62.5% males, mean age 61.1 ± 9.9 years) with 121 polyps (CSP, 39; HSP, 45; APC, 37) returned for follow-up colonoscopy. Mean polyp size was 6.7 ± 0.91 mm, 58% were located in the sigmoid, 33% in the rectum and 8% in the descending colon. The majority of polyps resected by CSP or HSP were neoplastic (tubular adenomas: 25.9%, tubulovillous adenomas: 11.1% and sessile serrate adenomas/polyps: 17.5%). No cases of delayed bleeding or perforation occurred. Scar biopsies at follow-up colonoscopy (performed after a mean interval of 13.4 ± 3.8 months) revealed 7 (5.8%) cases of polyp recurrence, showing no significant difference among the three treatment groups [CSP, 3/39 (7.7%); HSP, 1/45 (2.2%); APC, 2/37 (5.4%); P = 0.51). CONCLUSIONS CSP, HSP and APC-ablation are effective and well-tolerated treatment modalities for 5-9 mm left-sided colorectal polyps. The present randomized study did not detect any difference in polyp recurrence rate among the three endoscopic techniques.
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Affiliation(s)
| | - Nikos Viazis
- Gastroenterology Department, Evangelismos General Hospital, Athens, Greece
| | - Paraskevas Gkolfakis
- Department of Gastroenterology, Hepatopancreatology and Digestive Oncology, Erasme University Hospital, Université Libre de Bruxelles, Brussels, Belgium
| | - Georgios Tribonias
- Gastroenterology Department, General Hospital of Nikaia-Piraeus "Agios Panteleimon"
| | - Georgios Tziatzios
- 2nd Department of Internal Medicine, Hepatogastroenterology Unit, "Attikon" University General Hospital, Medical School, National and Kapodistrian University of Athens
| | | | - Theodore Argyrakos
- Department of Gastroenterology, General Hospital of Nea Ionia "Konstantopoulio-Patision"
| | - Christos Pontas
- Gastroenterology Department, Evangelismos General Hospital, Athens, Greece
| | - Vasilios Papastergiou
- Department of Gastroenterology, General Hospital of Nea Ionia "Konstantopoulio-Patision"
| | - Nikolaos Arkadopoulos
- Fourth Department of Surgery, National and Kapodistrian University of Athens, Attikon University Hospital, Athens, Greece
| | - Vasilios Smyrniotis
- Fourth Department of Surgery, National and Kapodistrian University of Athens, Attikon University Hospital, Athens, Greece
| | | | - Ioannis S Papanikolaou
- 2nd Department of Internal Medicine, Hepatogastroenterology Unit, "Attikon" University General Hospital, Medical School, National and Kapodistrian University of Athens
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Vakrakou AG, Tzanetakos D, Evangelopoulos ME, Argyrakos T, Tzartos JS, Anagnostouli M, Andreadou E, Koutsis G, Velonakis G, Toulas P, Gialafos E, Dimitrakopoulos A, Psimenou E, Stefanis L, Kilidireas C. Clinico-radiologic features and therapeutic strategies in tumefactive demyelination: a retrospective analysis of 50 consecutive cases. Ther Adv Neurol Disord 2021; 14:17562864211006503. [PMID: 34046086 PMCID: PMC8135218 DOI: 10.1177/17562864211006503] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2021] [Accepted: 03/11/2021] [Indexed: 12/15/2022] Open
Abstract
Aims Our goal was to expand the spectrum of clinico-radiologic characteristics and the possible therapeutic choices in patients with tumefactive demyelinating lesions (TDLs). Methods A retrospective analysis of 50 patients with at least one TDL was performed at an academic neurology center (2008-2020). Results Our cohort comprised mostly women (33/50) with a mean age of 38 years at TDL onset. The mean follow-up time was 76 months. The mean Expanded Disability Status Scale score at TDL onset and at the latest neurological evaluation was 3.7 and 2.3, respectively. We subcategorized the patients into seven groups based mainly on the clinical/radiological findings and disease course. Group A included patients presenting with a Marburg-like TDL (n = 4). Groups B and C comprised patients presenting with monophasic (n = 7) and recurrent TDLs (n = 12), respectively. Multiple sclerosis (MS) patients who subsequently developed TDL (n = 16) during the disease course were categorized as Group D. Group E comprised patients who initially presented with TDL and subsequently developed a classical relapsing-remitting MS without further evidence of TDL (n = 5). Groups F (n = 2) and G (n = 4) involved MS patients who developed TDL during drug initiation (natalizumab, fingolimod) and cessation (interferon, fingolimod), respectively. Regarding long-term treatments applied after corticosteroid administration in the acute phase, B-cell-directed therapies were shown to be highly effective especially in cases with recurrent TDLs. Cyclophosphamide was spared for more aggressive disease indicated by a poor response to corticosteroids and plasma exchange failure. Conclusion Tumefactive central nervous system demyelination is an heterogenous disease; its stratification into distinct groups according to different phenotypes can establish more efficient treatment strategies, thus improving clinical outcomes in the future.
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Affiliation(s)
- Aigli G Vakrakou
- 1st Department of Neurology, Medical School of Athens, National & Kapodistrian University, Aeginition Hospital, 72 Vasilissis Sofias Ave, Athens, 11528, Greece
| | - Dimitrios Tzanetakos
- Demyelinating Diseases Unit, 1st Department of Neurology, School of Medicine, Eginition Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Maria-Eleptheria Evangelopoulos
- Demyelinating Diseases Unit, 1st Department of Neurology, School of Medicine, Eginition Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | | | - John S Tzartos
- Demyelinating Diseases Unit, 1st Department of Neurology, School of Medicine, Eginition Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Maria Anagnostouli
- Demyelinating Diseases Unit, 1st Department of Neurology, School of Medicine, Eginition Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Elissavet Andreadou
- Demyelinating Diseases Unit, 1st Department of Neurology, School of Medicine, Eginition Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Georgios Koutsis
- Demyelinating Diseases Unit, 1st Department of Neurology, School of Medicine, Eginition Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Georgios Velonakis
- Research Unit of Radiology, 2nd Department of Radiology, National and Kapodistrian University of Athens, Athens, Greece
| | - Panagiotis Toulas
- Research Unit of Radiology, 2nd Department of Radiology, National and Kapodistrian University of Athens, Athens, Greece
| | - Elias Gialafos
- Demyelinating Diseases Unit, 1st Department of Neurology, School of Medicine, Eginition Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Antonios Dimitrakopoulos
- Demyelinating Diseases Unit, 1st Department of Neurology, School of Medicine, Eginition Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Erasmia Psimenou
- Department of Clinical Therapeutics, National and Kapodistrian University of Athens, Athens, Greece
| | - Leonidas Stefanis
- Demyelinating Diseases Unit, 1st Department of Neurology, School of Medicine, Eginition Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Constantinos Kilidireas
- Demyelinating Diseases Unit, 1st Department of Neurology, School of Medicine, Eginition Hospital, National and Kapodistrian University of Athens, Athens, Greece
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Diavati S, Asimakopoulos JV, Galopoulos D, Konstantinou I, Argyrakos T, Toulas P, Vassilakopoulos TP, Konstantopoulos K, Angelopoulou MK. Progressive Multifocal Leukoencephalopathy Following Treatment With Obinutuzumab in a Patient With Non-Hodgkin Follicular Lymphoma: A Case Report. Clin Lymphoma Myeloma Leuk 2021; 21:e601-e605. [PMID: 33814337 DOI: 10.1016/j.clml.2021.02.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/14/2021] [Accepted: 02/27/2021] [Indexed: 10/22/2022]
Affiliation(s)
- Stavrianna Diavati
- Department of Haematology and Bone Marrow Transplantation, Laikon General Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - John V Asimakopoulos
- Department of Haematology and Bone Marrow Transplantation, Laikon General Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Dimitrios Galopoulos
- Department of Haematology and Bone Marrow Transplantation, Laikon General Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Iliana Konstantinou
- Department of Haematology and Bone Marrow Transplantation, Laikon General Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | | | - Panagiotis Toulas
- Department of Radiology, Biiatrics Group Diagnostic Centers, Athens, Greece
| | - Theodoros P Vassilakopoulos
- Department of Haematology and Bone Marrow Transplantation, Laikon General Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Kostas Konstantopoulos
- Department of Haematology and Bone Marrow Transplantation, Laikon General Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Maria K Angelopoulou
- Department of Haematology and Bone Marrow Transplantation, Laikon General Hospital, National and Kapodistrian University of Athens, Athens, Greece.
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Vakrakou AG, Tzanetakos D, Argyrakos T, Koutsis G, Evangelopoulos ME, Andreadou E, Anagnostouli M, Breza M, Tzartos JS, Gialafos E, Dimitrakopoulos AN, Velonakis G, Toulas P, Stefanis L, Kilidireas C. Recurrent Fulminant Tumefactive Demyelination With Marburg-Like Features and Atypical Presentation: Therapeutic Dilemmas and Review of Literature. Front Neurol 2020; 11:536. [PMID: 32714265 PMCID: PMC7344179 DOI: 10.3389/fneur.2020.00536] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Accepted: 05/14/2020] [Indexed: 12/31/2022] Open
Abstract
Atypical forms of demyelinating diseases with tumor-like lesions and aggressive course represent a diagnostic and therapeutic challenge for neurologists. Herein, we describe a 50-year-old woman presenting with subacute onset of left hemiparesis, memory difficulties and headache. Brain MRI revealed a tumefactive right frontal-parietal lesion with perilesional edema, mass effect and homogenous post-contrast enhancement, along with other small atypical lesions in the white-matter. Brain biopsy of cerebral lesion ruled out lymphoma or any other neoplastic process and patient placed on corticosteroids with complete clinical/radiological remission. Two years after disease initiation, there was disease exacerbation with reappearance of the tumor-like mass. The patient initially responded to high doses of corticosteroids but soon became resistant. Plasma-exchange sessions were not able to limit disease burden. Resistance to therapeutic efforts led to a second biopsy that showed perivascular demyelination, predominantly consisting of macrophages, with a small number of T and B lymphocytes, and the presence of reactive astrocytes, typical of Creutzfeldt-Peters cells. The patient received high doses of cyclophosphamide with substantial clinical/radiological response but relapsed after 7-intensive cycles. She received 4-weekly doses of rituximab with disease exacerbation and brainstem involvement. She eventually died with complicated pneumonia. We present a very rare case of recurrent tumefactive demyelinating lesions, with atypical tumor-like characteristics, with initial response to corticosteroids and cyclophosphamide, but subsequent development of drug-resistance and unexpected exacerbation upon rituximab administration. Our clinical case raises therapeutic dilemmas and points to the need for immediate and appropriate immunosuppression in difficult to treat tumefactive CNS lesions with Marburg-like features.
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Affiliation(s)
- Aigli G Vakrakou
- Demyelinating Diseases Unit, 1st Department of Neurology, School of Medicine, Aeginition Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Dimitrios Tzanetakos
- Demyelinating Diseases Unit, 1st Department of Neurology, School of Medicine, Aeginition Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | | | - Georgios Koutsis
- Demyelinating Diseases Unit, 1st Department of Neurology, School of Medicine, Aeginition Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Maria-Eleptheria Evangelopoulos
- Demyelinating Diseases Unit, 1st Department of Neurology, School of Medicine, Aeginition Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Elisabeth Andreadou
- Demyelinating Diseases Unit, 1st Department of Neurology, School of Medicine, Aeginition Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Maria Anagnostouli
- Demyelinating Diseases Unit, 1st Department of Neurology, School of Medicine, Aeginition Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Marianthi Breza
- Demyelinating Diseases Unit, 1st Department of Neurology, School of Medicine, Aeginition Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - John S Tzartos
- Demyelinating Diseases Unit, 1st Department of Neurology, School of Medicine, Aeginition Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Elias Gialafos
- Demyelinating Diseases Unit, 1st Department of Neurology, School of Medicine, Aeginition Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Antonios N Dimitrakopoulos
- Demyelinating Diseases Unit, 1st Department of Neurology, School of Medicine, Aeginition Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Georgios Velonakis
- Research Unit of Radiology, 2nd Department of Radiology, National and Kapodistrian University of Athens, Athens, Greece
| | - Panagiotis Toulas
- Research Unit of Radiology, 2nd Department of Radiology, National and Kapodistrian University of Athens, Athens, Greece
| | - Leonidas Stefanis
- Demyelinating Diseases Unit, 1st Department of Neurology, School of Medicine, Aeginition Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Constantinos Kilidireas
- Demyelinating Diseases Unit, 1st Department of Neurology, School of Medicine, Aeginition Hospital, National and Kapodistrian University of Athens, Athens, Greece
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Vaslamatzis M, Laskarakis A, Tegos T, Pavlakis M, Argyrakos T, Alevizopoulos N, Zoublios C, Vasili E, Gioti E, Athanasiadi K. 177P Clinicopathologic characteristics in large cell neuroendocrine carcinomas of the lung (LCNCL): The experience of one center. J Thorac Oncol 2018. [DOI: 10.1016/s1556-0864(18)30451-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Karagkounis G, Stranjalis G, Argyrakos T, Pantelaion V, Mastoris K, Rontogianni D, Komaitis S, Kalamatianos T, Sakas D, Tiniakos D. Anaplastic lymphoma kinase expression and gene alterations in glioblastoma: correlations with clinical outcome. J Clin Pathol 2016; 70:593-599. [DOI: 10.1136/jclinpath-2016-204102] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2016] [Revised: 11/23/2016] [Accepted: 11/27/2016] [Indexed: 11/04/2022]
Abstract
AimsTo study anaplastic lymphoma kinase (ALK) protein expression and possible underlying gene alterations in glioblastoma (GBM), correlating them with clinical outcome.MethodsWe studied ALK immunohistochemical expression and fluorescent in situ hybridisation (FISH)-detected ALK gene alterations in 51 GBMs (46 isocitrate dehydrogenase-1 (IDH1)R132H-negative and 5 IDH-mutant (IDH1R132H-positive)). We compared two anti-ALK antibodies and immunohistochemical detection systems (5Α4/Nichirei Biosciences, D5F3/Ventana). The results were correlated with tumour cell proliferation and clinical outcome.ResultsIntense granular cytoplasmic ALK immunostaining was observed in 10/51 (19.61%) GBM and correlated with high Ki67 proliferation index; only 1 in 10 ALK-positive cases displayed multiple alk gene signals by FISH. Moderate ALK immunostaining was observed in 21 (41.17%), weak immunostaining in 5 (9.80%) while 15 (29.42%) cases were negative. p53 was expressed in 26/51 GBM (50.9%) (10% cut-off). IDH1R132H-negative GBM showed higher ALK expression compared with IDH-mutant GBM (65.2% vs 20%). ALK overexpression was more common in older patients but did not correlate with other clinicopathological variables or patient overall survival.ConclusionsALK overexpression can be identified in up to 70% of GBMs and does not correlate with underlying alk gene amplification. Despite being more common in rapidly growing, clinically aggressive GBM, ALK overexpression did not show correlation with prognosis in this study.
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Kontogeorgi E, Papadopoulos D, Zafeiropoulou E, Karagkounis G, Argyrakos T, Stranjalis G, Rontogianni D, Karakalos D. A 24 year-old woman with relapsing brainstem manifestations and multiple focal brain lesions. Natural killer cell lymphoblastic lymphoma/leukemia. Brain Pathol 2015; 25:115-6. [PMID: 25521184 DOI: 10.1111/bpa.12235] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Affiliation(s)
- Elli Kontogeorgi
- Department of Neurology, Evangelismos General Hospital, 4th floor AHEPA building, GREECE
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Stranjalis G, Kalamatianos T, Stavrinou LC, Mathios D, Koutsarnakis C, Tzavara C, Loufardaki M, Protopappa D, Argyrakos T, Rontogianni DP, Sakas DE. The Evangelismos hospital central nervous system tumor registry: Analysis of 1414 cases (1998-2009). Surg Neurol Int 2013; 4:23. [PMID: 23533006 PMCID: PMC3604820 DOI: 10.4103/2152-7806.107893] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2012] [Accepted: 01/04/2013] [Indexed: 12/24/2022] Open
Abstract
Background: The Evangelismos Hospital central nervous system (CNS) Tumor Registry represents the current effort of the Departments of Neurosurgery and Pathology to collect data for primary and metastatic CNS tumor patients. In the present study, 12-year hospital data (1998-2009) were reviewed and analyzed. Methods: Patients that underwent surgery for CNS tumors for the first time were identified. Histologically confirmed tumor rates by age and gender were compared. Time trends in annual rates for specific tumor types were investigated. In-hospital mortality rates and length of hospital stay were analyzed by age and gender and their putative variations across the study period investigated. Results: A total of 1414 patients (age 15-89 years) were identified. The most frequently encountered histologies were gliomas and meningiomas, accounting for, respectively, 32.8% and 29.1% of the total sample. A greater proportion of meningiomas was found in women; the proportion of glioblastomas and metastatic tumors, as well as of mixed gliomas, were greater in men. Increased rates of glioblastoma and meningioma with advancing age at diagnosis were also apparent. There were no significant variations in time trends for specific tumor types. In-hospital mortality was significantly higher for older patients (≥70 years). An increase in the length of hospital stay was apparent between the first and middle third of the study period. Conclusions: Analysis of tumor rates in relation to age at diagnosis and gender showed significant bias in accordance with salient literature. Available data indicated no significant variations in time trends for specific tumor types across the study period, while an adverse effect of advanced age on in-hospital mortality was shown. The present findings can guide the formulation of future treatment programs and preventive strategies and provide the basis for further intra- and/or interdepartmental research.
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Affiliation(s)
- George Stranjalis
- Department of Neurosurgery, University of Athens, Evangelismos Hospital, Athens, Greece ; Hellenic Center of Neurosurgical Research (HCNR), "Professor Petros S. Kokkalis", Athens, Greece
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11
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Papadimitriou G, Koukoulaki M, Vardas K, Florou E, Argyrakos T, Lakiotis G, Apostolou T, Drakopoulos S. Small bowel obstruction caused by inflammatory cytomegalovirus tumor in a renal transplant recipient: report of a rare case and review of the literature. Transpl Infect Dis 2012; 14:E111-5. [DOI: 10.1111/j.1399-3062.2012.00784.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2012] [Revised: 05/09/2012] [Accepted: 05/27/2012] [Indexed: 02/04/2023]
Affiliation(s)
- G. Papadimitriou
- First Department of Surgery and Transplant Unit; Evangelismos General Hospital; Athens; Greece
| | - M. Koukoulaki
- First Department of Surgery and Transplant Unit; Evangelismos General Hospital; Athens; Greece
| | - K. Vardas
- First Department of Surgery and Transplant Unit; Evangelismos General Hospital; Athens; Greece
| | - E. Florou
- First Department of Surgery and Transplant Unit; Evangelismos General Hospital; Athens; Greece
| | - T. Argyrakos
- Department of Pathological Anatomy; Evangelismos General Hospital; Athens; Greece
| | - G. Lakiotis
- Second Department of Surgery; Evangelismos General Hospital; Athens; Greece
| | - T. Apostolou
- Department of Nephrology; Evangelismos General Hospital; Athens; Greece
| | - S. Drakopoulos
- First Department of Surgery and Transplant Unit; Evangelismos General Hospital; Athens; Greece
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12
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Georgiades C, Vallianou N, Argyrakos T, Aristodimou A, Kolovelonis G, Sioula E. An unusual case of desmoid tumour presenting as haemorrhagic shock. Ann R Coll Surg Engl 2012; 94:e81-2. [PMID: 22391362 DOI: 10.1308/003588412x13171221588857] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
We report the case of a 22-year-old patient who presented to the emergency department with epigastric pain and vomiting. Haematological studies showed a rapid decrease in haemoglobin levels from 13.6 g/dl to 4.9 g/dl. Abdominal ultrasonography revealed the presence of fluid around the spleen and the patient was immediately referred for surgery. An intra-abdominal desmoid tumour presenting as a hemorrhagic shock has not previously been described. Given the relatively benign course of the disease and the young age at presentation, this clinical entity should not be overlooked as it has the potential to invade vessels and therefore be fatal.
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Argyrakos T, Rontogianni D, Karmiris T, Kapsimali V, Grigoriou E, Tsantekidou M, Naum C, Galani V, Pantelidaki C, Harhalakis N, Nikiforakis E, Kanavaros P. Blastic Natural Killer (NK)-Cell Lymphoma: Report of an Unusual CD4 Negative Case and Review of the CD4 Negative Neoplasms with Blastic Features in the Literature. Leuk Lymphoma 2009; 45:2127-33. [PMID: 15370260 DOI: 10.1080/10428190410001723232] [Citation(s) in RCA: 11] [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] [Indexed: 10/26/2022]
Abstract
Blastic Natural Killer (NK)-cell lymphoma is a relatively new entity which has been recently included in the WHO classification. CD4 expression is observed in most cases of blastic NK-cell lymphomas and has been related with skin tropism. We report an unusual CD4 negative blastic NK-cell lymphoma with primary presentation in the skin, subsequent infiltration of the bone marrow and aggressive behavior. It is emphasized that extensive immunophenotyping and EBER RNA in situ hybridization are required in order to establish the diagnosis of blastic NK-cell lymphoma. We also present a review of the literature with respect to the CD4 negative NK-cell lymphomas with blastic morphological features.
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Thodou E, Argyrakos T, Kontogeorgos G. Galectin-3 as a marker distinguishing functioning from silent corticotroph adenomas. Hormones (Athens) 2007; 6:227-32. [PMID: 17724007] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/19/2023]
Abstract
OBJECTIVE Galectin-3 (Gal-3) belongs to the family of carbohydrate-binding proteins with high affinity for galactoside and is involved in many biological processes including cell growth and differentiation, cell adhesion, tumor progression, apoptosis and metastasis. The aim of this study was to disclose differences in the expression of Gal-3 in silent and functioning corticotroph pituitary adenomas. DESIGN We examined 30 pituitary adenomas (19 functioning corticotroph, 11 silent corticotroph adenomas). Two prolactinomas and 2 functioning somatotroph adenomas served as positive controls. Antigen retrieval was done by three-minute incubation via pressure boiler in citrate buffer solution, pH 6.0. A polymer was used as a secondary link to DAB chromogen. The independent variables t-test was used for comparison of the mean expression of Gal-3 in the two different corticotroph adenoma subgroups. RESULTS Eighteen of the functioning corticotroph adenomas (94.73%) were positive for Gal-3 with a cytoplasmic and focally membranous distribution; two cases also exhibited nuclear expression, whereas 9 of the silent corticotroph adenomas (81.81%) had zero or<1% expression of Gal-3 (p=0.001). CONCLUSIONS Gal-3 is highly expressed in functioning corticotroph adenomas of the pituitary gland, while silent adenomas exhibit very focal to null expression of Gal-3. This observation can be used in the pathological diagnosis to separate functioning from silent corticotroph adenomas of the pituitary.
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Affiliation(s)
- Eleni Thodou
- Department of Pathology and Pituitary Tumor Reference Center, G. Gennimatas Athens General Hospital, Athens, Greece
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Stefanaki C, Antoniou C, Stefanaki K, Petrikos G, Argyrakos T, Constantinidou CVV, Karentzou O, Stratigos A, Katsambas A. Bcl-2 and Bax in congenital naevi. Br J Dermatol 2006; 154:1175-9. [PMID: 16704651 DOI: 10.1111/j.1365-2133.2006.07177.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND Melanocytes represent a static component of the epidermis, and the role of apoptosis in basal melanocyte function and melanocytic tumour formation has not been fully elucidated. OBJECTIVES The aim of this study was to investigate the expression of Bcl-2 anti-apoptotic and Bax apoptotic proteins in congenital naevi in correlation with p-27 protein and Ki-67 proliferative index. METHODS Our material comprised 30 congenital naevi (eight giant) excised from children aged from 15 days to 14 years old. The immunohistochemical streptavidin-biotin method was performed on paraffin sections for the detection of Bcl-2 (cl100/D5), Bax (cl2D2) , Ki-67 (MIB-1) and p-27 (1B4) proteins with monoclonal antibodies. RESULTS Bcl-2 protein was detected in all cases showing a strong diffuse cytoplasmic expression in >70% of the naevocytes and was preserved in the deeper parts of the naevi. On the other hand, Bax was detected in 13 of the cases, showing a fainter cytoplasmic expression in 40-50% of the naevocytes without any particular topographic distribution. Ki-67 was detected in all cases showing a limited expression in 1-2% of the nuclei mainly in the junctional and upper dermal components. p-27 protein showed a broad diffuse nuclear expression (>70% of the nuclei) in all cases with a particular increase in the deeper parts of the naevi. Bcl-2 expression showed a parallel correlation with p-27 protein. CONCLUSIONS Broad Bcl-2 expression in congenital naevi suggests that suppression of apoptosis may play an important role in the maintenance of naevocytes despite the low proliferative activity.
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Affiliation(s)
- C Stefanaki
- Dermatology Department, Andreas Sygros Skin Hospital, 5 Ionos Dragoumi Street, Athens, Greece.
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Stefanaki C, Antoniou C, Stefanaki K, Stratigos A, Constantinidou VV, Argyrakos T, Karentzou O, Katsambas A. Expression of the cyclin-dependent kinase inhibitor p27kip-1 in benign naevi and correlation with Ki-67 proliferative index. Br J Dermatol 2005; 152:373-4. [PMID: 15727660 DOI: 10.1111/j.1365-2133.2005.06312.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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17
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Revelos K, Petraki CD, Vaslamatzis MM, Papanastassiou P, Mastoris C, Magkou C, Argyrakos T, Alevizopoulos N, Vrionis E, Koutsilieris M. The relation of androgen receptors status, neuroendocrine differentiation and angiogenesis to biochemical failure after radical prostatectomy for localized prostate cancer. J Clin Oncol 2004. [DOI: 10.1200/jco.2004.22.90140.4691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
| | | | | | | | | | - C. Magkou
- Evangelismos Hospital, Athens, Greece
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Kanavaros P, Rontogianni D, Hrissovergi D, Efthimiadoy A, Argyrakos T, Mastoris K, Stefanaki K. Extranodal cytotoxic T-cell lymphoma in a patient with X-linked agammaglobulinaemia. Leuk Lymphoma 2001; 42:235-8. [PMID: 11699214 DOI: 10.3109/10428190109097697] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [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: 11/13/2022]
Abstract
This report documents the occurrence of an extranodal cytotoxic peripheral T-cell lymphoma (PTCL) in a patient with X-linked agammaglobulinaemia (XLA). The diagnosis was based on the immunohistochemical detection of T-cell antigens and of the cytotoxic proteins TIA1 and Granzyme B in the tumour cells. This report provides further evidence that cytotoxic lymphomas are part of the differential diagnosis of neoplasia in patients with immunodeficiencies.
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Affiliation(s)
- P Kanavaros
- Department of Histology, Medical Faculty, University of Thessalia, Hellas
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