1,721,018 research outputs found
Diagnostic and therapeutic management of carcinoma of unknown primary: Histopathological and molecular diagnosis
No full textNon
DCIS and LCIS are confusing and outdated terms. They should be abandoned infavor of ductal intraepithelial neoplasia (DIN) and lobular intraepithelial neoplasia (LIN)
No full textThe terms ductal and lobular intraepithelial neoplasia (DIN and LIN) were introduced by Tavossoli 15 years ago, who proposed they should replace, respectively, ductal and lobular carcinoma in situ (DCIS and LCIS). This proposal has been slowly gaining ground. We argue that DCIS and LCIS should now be definitively abandoned. Bringing together 'in situ' and other entities into the simpler and more logical DIN/LIN framework-as has been done with intraepithelial neoplasias of cervix, vagina, vulva, prostate, and pancreas-would eliminate the artificial and illogical distinctions between 'not cancers' (e.g. flat epithelial atypia, atypical ductal hyperplasia-now classified as low grade DIN) and 'cancers' (e.g. DCIS-now considered medium-high grade DIN). Elimination of the term 'carcinoma' from entities that cannot metastasize will reduce confusion among health professionals and patients, and contribute to reducing the risk of overtreatment, as well as reducing adverse psychological reactions in patients. © 2013 Elsevier Ltd
Breast cancer pathology
No full textIn recent years, the role of pathology in breast cancer has changed dramatically. Currently, it no longer has a purely diagnostic role, based exclusively on morphology. Pathologists are now asked to provide some information about prognostic and predictive factors, in other words about the risk assessment and the choice of the best treatment, according to Veronesi’s paradigm: “from maximum tolerable treatment to minimum effective treatment”. These changes can be summarized in this way: In the past we were dealing with “what to treat”, now we are dealing with “how to treat”, aiming at dealing with “whom to treat”
Clinical and pathological assessment of high-risk ductal and lobular breast lesions : what surgeons must know
No full textTerminology in pathology is sometimes over-complicated and may be misinterpreted by clinicians facing patients and having difficulty answering questions posed by them. This may especially be true for some breast lesions with an increased risk of malignant transformation, the complex terminology of which reflects attempts to stratify them according to potential risk. On the basis of morphological and molecular features, both ductal and lobular proliferations have been classified and named in different ways by pathologists, and this often makes it difficult for the treating physicians and the patients to fully understand the nature of the lesions and their associated risks. In order to clarify pathology reports, unambiguous and simple terms are needed
A new technique for foetal brain fixation and extraction
No full textWe performed a new technique for foetal brain fixation and extraction that offers a remarkable reduction in sampling time facilitates specimen handling while conserving high quality. With the new fixation method, it is possible to obtain samples adequate for macroscopic and microscopic observations and immunohistochemical analysis. The technique involves the creation of an ex vacuo phenomenon in the subarachnoideal space prior to injecting the fixative solution. In this manner, the solution is homogenously distributed. Ease, reproducibility and the possibility of standardizing the procedure are the principal advantages. Low costs, reduced working time and less need for human resources are other advantages, Histologically, we obtained, quickly, high quality slides with routine and immunohistochemical stains. Disadvantages of the technique derive from the use of formaldehyde and glacial acetic acid, rather than water, to wash the samples; thus one must work in a well ventilated area, with gloves, protective glasses and an adequate lab coat to avoid skin and respiratory tract damage
What can the pathologist offer for optimal treatment choice?
Get PDFThe choice of the most appropriate systemic treatment of patients with metastatic breast carcinoma is a multifaceted decision-making process. The role for the pathologist is to provide a definite diagnosis of metastatic breast carcinoma, whenever needed, and especially to assess the biological parameters with prognostic and predictive value. Although the vast majority of breast carcinomas maintain the same biological features both in the primary and in the metastases, some undergo changes that may indicate that a targeted systemic treatment should be stopped or started, be it endocrine or anti-HER2. Unfortunately these tumours cannot be easily identified clinically, and it may be useful to biopsy the metastatic sites for reassessment of the biological characteristic of the tumours. Intra-tumoural heterogeneity and clonal selection due to the therapy could explain changes in biological features during tumour progression, but it should also be taken into account that the available assays for evaluating hormone receptor and HER2 status are not 100% accurate, even in the hands of expert pathologists. To minimize the risk of inducing inappropriate changes in systemic treatments due to false-positive or false-negative results, the pathologists should make all efforts to improve accuracy and reproducibility of the assay procedures
Basaloid cell carcinoma of the prostate. Case report and review of the literature
No full textWe report on a case of malignant basal cell carcinoma of the prostate combined with a poorly differentiated conventional adenocarcinoma, infiltrating bilaterally the seminal vesicles and with lymph-node and distant metastases. Basal cell carcinoma represented the prevalent component of the tumour (80%), showed high mitotic activity, extensive perineural infiltration and vascular invasion and was immunoreactive for basal cell related antigens (high molecular weight cytokeratins 34βE12 and p63). Our data confirm previous observations that basal cell carcinoma represents an aggressive tumour with an adverse clinical outcome
Studio delle regioni organizzatrici argirofile del nucleolo (AgNORs) nelle neoformazioni colo-rettali quale indice di malignità biologica. [Argyrophilic nucleolar organizer regions (AgNORs) as malignancy biomarkers in colorectal neoplasms].
No full textThe high incidence of intestinal cancer has aroused strong interest in researching and trying to discover its morphologic precursors. In this contest the study of nucleolar organizing regions could be interesting as prognostic factor for bowel neoplasm and useful for differential diagnosis of intestinal diseases. The Authors report on the results of their study performed on 30 selected samples from 6 different bowel lesions. Z9
A New Possible Cut-Off of Cytokeratin 19 mRNA Copy Number by OSNA in the Sentinel Node of Breast Cancer Patients to Avoid Unnecessary Axillary Dissection: A 10-Year Experience in a Tertiary Breast Unit
No full text(1) Background: The main discriminant in breast cancer prognosis is axillary lymph node status. In a select cohort of patients, axillary lymph node dissection (ALND) may be safely spared. This study aimed to determine a new possible cut-off of cytokeratin (CK) 19 mRNA copy number in the SLN to predict cases at high risk of positive ALND. (2) Methods: Clinical records of 1339 patients were retrospectively reviewed and were separated into two groups according to the axillary status (negative: ALNs− and positive ALNs+). Receiver operative characteristic (ROC) curves were used to identify a new optimal cut-off of CK19 mRNA copy number in SLN; (3) Results: Large tumor size and high grade were found mostly in ALNs+. Results from the ROC analyses, with an AUC of 82.1%, identified a new cut-off (9150 CK19 mRNA copies) showing 94% sensitivity, 67.3% specificity, 61.2% positive, and 95.3% negative predictive values; (4) OSNA remains the most-important intra-operative tool to identify patients who can benefit from ALND but with the traditional cut-off, many patients undergo needless ALND. The results of the present study suggest a new cut-off helpful to personalize surgical treatment and avoid unnecessary invasive procedures
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