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Ling LLL, Hsu CC, Yong CC, Elsarawy AM, Chan YC, Wang CC, Li WF, Lin TL, Kuo FY, Cheng YF, Lin LM, Chen CL, Lin CC. FDG-PET predicted unfavorable tumor histology in living donor liver transplant recipients; a retrospective cohort study. Int J Surg 2019; 69:124-131. [DOI: 10.1016/j.ijsu.2019.07.035] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2019] [Revised: 07/26/2019] [Accepted: 07/26/2019] [Indexed: 02/07/2023]
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Özgün G, Haberal Reyhan N, Özdemir BH, Haberal M. Liver Transplant for Hepatocellular Carcinoma: Pathologic Point Of View. EXP CLIN TRANSPLANT 2017; 15:50-54. [PMID: 28301999 DOI: 10.6002/ect.tond16.l12] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Primary liver cancer is the fifth most common cancer overall and the second most common cause of cancer mortality worldwide. Hepatocellular carcinoma accounts for up to 90% of all primary hepatic malignancies and represents a major international health problem. It is a complex and heterogeneous malignancy, frequently occurs in the setting of a chronically diseased organ, and has multiple confounding factors. Liver transplant for hepatocellular carcinoma has been established as a standard treatment in selected patients. Liver resection and locoregional therapies could be other options for treatment. Pathologic evaluation of hepatocellular carcinoma is a complicated process that includes tumor grading and evaluation of microvascular invasion. Although macrovascular invasion can be detected with imaging techniques, microvascular invasion is diagnosed pathologically. Pathologic evaluation provides additional information about the tumor biology, using immunohistochemical and molecular methods to predict patient outcomes. Hepatocellular carcinoma requires a multidisciplinary approach to determine the most appropriate treatment, as well as requires accurate timing of various treatments for optimal outcomes.
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Affiliation(s)
- Gonca Özgün
- Department of Pathology, Baskent University Medical School, Ankara, Turkey
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Kornberg A, Schernhammer M, Friess H. 18F-FDG-PET for Assessing Biological Viability and Prognosis in Liver Transplant Patients with Hepatocellular Carcinoma. J Clin Transl Hepatol 2017; 5:224-234. [PMID: 28936404 PMCID: PMC5606969 DOI: 10.14218/jcth.2017.00014] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2017] [Revised: 05/18/2017] [Accepted: 06/05/2017] [Indexed: 12/12/2022] Open
Abstract
Liver transplantation (LT) has become standard of care in patients with non-resectable early stage hepatocellular carcinoma (HCC) in liver cirrhosis. Currently, patient selection for LT is strictly based on tumor size and number, provided by the Milan criteria. This may, however, exclude patients with advanced tumor load but favourable biology from a possibly curative treatment option. It became clear in recent years that biological tumor viability rather than tumor macromorphology determines posttransplant outcome. In particular, microvascular invasion and poor grading reflect tumor aggressiveness and promote the risk of tumor relapse. Pretransplant biopsy is not applicable due to tumor heterogeneity and risk of tumor cell seeding. 18F-fludeoxyglucose (18F-FDG) positron emission tomography (PET), an established nuclear imaging device in oncology, was demonstrated to non-invasively correlate with unfavorable histopathologic features. Currently, there is an increasing amount of evidence that 18F-FDG-PET is very useful for identifying eligible liver transplant patients with HCC beyond standard criteria but less aggressive tumor properties. In order to safely expand the HCC selection criteria and the pool of eligible liver recipients, tumor evaluation with 18F-FDG-PET should be implemented in pretransplant decision process.
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Affiliation(s)
- Arno Kornberg
- *Correspondence to: Arno Kornberg, Department of Surgery, Klinikum rechts der Isar, Technical University Munich, Ismaningerstr. 22, D-81675 Munich, Germany. Tel: +89-41405087, Fax: +89-41404884, E-mail:
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Traficante D, Assalone P, Tomei F, Calista F, Falleti J, Caranci E, Di Lullo L. A case report of HCC cutaneous metastasis. J Gastrointest Oncol 2014; 5:E65-7. [PMID: 25083308 DOI: 10.3978/j.issn.2078-6891.2014.021] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2014] [Accepted: 03/30/2014] [Indexed: 01/12/2023] Open
Abstract
INTRODUCTION Hepatocellular carcinoma (HCC) is one of the most common solid tumors in the world. HCC muscle and cutaneous metastases are rare and can occur by hematogenous spread or following surgical procedures performed for diagnostic or therapeutic aims. CASE STUDY We present a 47-year-old man underwent liver biopsy followed by surgical resection for moderately differentiated HCC in January 1999. In February 2010 the patient presented with HCC cutaneous metastases in the surgical scare and with HCC metastases of the right abdominal rectus muscle. En bloc tumor resection with the right abdominal rectus muscle was performed. In March 2011 the patient underwent resection of a locoregional muscle relapse. In November 2011 we started Sorafenib for intraepatic recurrence. DISCUSSION This case suggests that in the follow-up of patients who underwent surgical resection or diagnostic and therapeutic procedures for HCC should be considered the possibility of abdominal wall metastasis even after many years, particularly in the cases with favorable evolution.
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Affiliation(s)
- Divina Traficante
- 1 Medical Oncology, "F. Veneziale" Hospital, Isernia, Italy ; 2 Anatomic Phatology Unit, "F. Veneziale" Hospital, Isernia, Department of Biomorphological Science, Anatomic Pathology Section, Federico II University, Napoli, Italy ; 3 General Surgery, "F. Veneziale" Hospital, Isernia, Italy
| | - Pasquale Assalone
- 1 Medical Oncology, "F. Veneziale" Hospital, Isernia, Italy ; 2 Anatomic Phatology Unit, "F. Veneziale" Hospital, Isernia, Department of Biomorphological Science, Anatomic Pathology Section, Federico II University, Napoli, Italy ; 3 General Surgery, "F. Veneziale" Hospital, Isernia, Italy
| | - Federica Tomei
- 1 Medical Oncology, "F. Veneziale" Hospital, Isernia, Italy ; 2 Anatomic Phatology Unit, "F. Veneziale" Hospital, Isernia, Department of Biomorphological Science, Anatomic Pathology Section, Federico II University, Napoli, Italy ; 3 General Surgery, "F. Veneziale" Hospital, Isernia, Italy
| | - Franco Calista
- 1 Medical Oncology, "F. Veneziale" Hospital, Isernia, Italy ; 2 Anatomic Phatology Unit, "F. Veneziale" Hospital, Isernia, Department of Biomorphological Science, Anatomic Pathology Section, Federico II University, Napoli, Italy ; 3 General Surgery, "F. Veneziale" Hospital, Isernia, Italy
| | - Jessica Falleti
- 1 Medical Oncology, "F. Veneziale" Hospital, Isernia, Italy ; 2 Anatomic Phatology Unit, "F. Veneziale" Hospital, Isernia, Department of Biomorphological Science, Anatomic Pathology Section, Federico II University, Napoli, Italy ; 3 General Surgery, "F. Veneziale" Hospital, Isernia, Italy
| | - Enrico Caranci
- 1 Medical Oncology, "F. Veneziale" Hospital, Isernia, Italy ; 2 Anatomic Phatology Unit, "F. Veneziale" Hospital, Isernia, Department of Biomorphological Science, Anatomic Pathology Section, Federico II University, Napoli, Italy ; 3 General Surgery, "F. Veneziale" Hospital, Isernia, Italy
| | - Liberato Di Lullo
- 1 Medical Oncology, "F. Veneziale" Hospital, Isernia, Italy ; 2 Anatomic Phatology Unit, "F. Veneziale" Hospital, Isernia, Department of Biomorphological Science, Anatomic Pathology Section, Federico II University, Napoli, Italy ; 3 General Surgery, "F. Veneziale" Hospital, Isernia, Italy
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Fujii LL, Levy MJ. Basic techniques in endoscopic ultrasound-guided fine needle aspiration for solid lesions: Adverse events and avoiding them. Endosc Ultrasound 2014; 3:35-45. [PMID: 24949409 PMCID: PMC4063261 DOI: 10.4103/2303-9027.123006] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2013] [Accepted: 11/14/2013] [Indexed: 02/06/2023] Open
Abstract
Endoscopic ultrasound (EUS) guided fine-needle aspiration (FNA) is often the preferred technique for tissue acquisition in the diagnosis of suspected intrathoracic and intraabdominal pathology. Although EUS FNA is a safe and accurate procedure, it has been associated with a low risk of adverse events. The unique properties of the echoendoscope and its ability to acquire tissue outside of the gastrointestinal lumen impart risks that are not associated with routine endoscopic procedures. In this review, we discuss the risk of perforation related to the echoendoscope itself and adverse events related to FNA of solid masses including infections, bleeding, pancreatitis and pancreatic duct leak, bile duct leak and tumor seeding. We also provide tips on how to avoid the most common adverse events related to EUS-FNA.
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Affiliation(s)
- Larissa L Fujii
- Mayo Clinic, Division of Gastroenterology and Hepatology, 200 1 St. SW, Rochester, MN 55905, USA
| | - Michael J Levy
- Mayo Clinic, Division of Gastroenterology and Hepatology, 200 1 St. SW, Rochester, MN 55905, USA
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Lopez KT, Kuwada SK, Wong LL. Consequences of needle tract seeding of hepatocellular cancer after liver transplant. Clin Transplant 2013; 27:E400-6. [PMID: 23837571 DOI: 10.1111/ctr.12160] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/10/2013] [Indexed: 12/12/2022]
Abstract
Although liver biopsy is a relatively safe procedure, needle tract seeding (NTS) of hepatocellular carcinoma (HCC) is described in up to 5% of patients after liver biopsy. The rate of NTS in patients with HCC who had liver transplantation is unknown. We performed a retrospective analysis of 759 HCC cases from August 1992 to August 2011. Demographics, ethnicities, risk factors, tumor characteristics, treatments, recurrence, and survival were collected. Patients who underwent percutaneous liver biopsy, resection, and transplant were identified. In all, 359 underwent biopsy to diagnose HCC and 42 patients underwent liver transplant. None of 171 patients who underwent radiofrequency ablation alone had seeding. None of the 11 patients who had biopsy and radiofrequency ablation performed in a single session developed NTS; however, two of 12 patients who had biopsy and radiofrequency ablation performed at separate sessions had NTS. Two patients underwent liver transplantation and subsequently developed needle tract seeding eventually died from HCC. Although the incidence of needle tract seeding was low in liver transplant patients, it can potentially change a curative therapy into a non-curative one. Single-session liver biopsy and radiofrequency ablation may reduce the risk of needle tract seeding of HCC.
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Affiliation(s)
- Kristi T Lopez
- Department of Medicine, University of Hawaii, John A. Burns School of Medicine, Honolulu, HI, USA
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Geens L, Robays JV, Geert V, der Speeten KV. An Unusual Location of Extraosseous Ewing's Sarcoma. Case Rep Oncol 2013; 6:293-302. [PMID: 23898272 PMCID: PMC3725030 DOI: 10.1159/000351836] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Ewing's sarcoma (ES) is the second most common malignant bone tumor in children and young adults. ES also occurs as a primary soft tissue neoplasm without involvement of bone. We report the second case of extraosseous (EO) ES emerging from the omentum and a review of the relevant literature. EO ES should be included in the differential diagnosis of soft tissue neoplasms in the abdomen.
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Affiliation(s)
- Lisanne Geens
- Departments of Surgical Oncology, Ziekenhuis Oost-Limburg, Genk, Belgium
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Binitie O, Tejiram S, Conway S, Cheong D, Temple HT, Letson GD. Adult soft tissue sarcoma local recurrence after adjuvant treatment without resection of core needle biopsy tract. Clin Orthop Relat Res 2013; 471:891-8. [PMID: 22968531 PMCID: PMC3563812 DOI: 10.1007/s11999-012-2569-z] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Core needle biopsies of sarcomas allow a diagnosis in a high percentage of patients with few complications. However, it is unclear whether the tract needs to be excised to prevent recurrences. QUESTIONS/PURPOSES We therefore determined the rates of recurrence and metastases in patients with Stage III extremity sarcomas, who underwent wide local resection without excision of the needle tract and also received adjuvant treatment. METHODS We retrospectively reviewed 59 adult patients with deep, larger than 5 cm, high-grade soft tissue sarcomas of the upper or lower extremity treated between January 1999 and April 2009. All the patients underwent a core needle biopsy. Resection was performed with wide margins. The biopsy tract was not resected during the definitive surgery. Fifty-seven patients (97%) received preoperative and/or postoperative radiation, whereas 49 patients (83%) received chemotherapy. Local recurrence and distant recurrence rates were determined. The minimum followup was 24 months (median, 56 months; range, 24-122 months). RESULTS The local recurrence rate was 9%. Fifteen patients (25%) developed metastasis after diagnosis. Seven of the 59 patients (12%) had microscopic positive margins at resection. CONCLUSIONS Our data demonstrate no increase in local recurrence rates or rates of metastatic disease compared with previously published studies when resection of the core biopsy tract was not performed. LEVEL OF EVIDENCE Level IV, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence.
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Affiliation(s)
- Odion Binitie
- />H. Lee Moffitt Cancer Center & Research Institute, Sarcoma Program, 12902 Magnolia Drive, Tampa, FL 33612 USA
| | - Shawn Tejiram
- />H. Lee Moffitt Cancer Center & Research Institute, Sarcoma Program, 12902 Magnolia Drive, Tampa, FL 33612 USA
| | - Sheila Conway
- />Department of Orthopaedics and Rehabilitation, University of Miami Miller School of Medicine, Miami, FL USA
| | - David Cheong
- />H. Lee Moffitt Cancer Center & Research Institute, Sarcoma Program, 12902 Magnolia Drive, Tampa, FL 33612 USA
| | - H. Thomas Temple
- />Department of Orthopaedics and Rehabilitation, University of Miami Miller School of Medicine, Miami, FL USA
| | - G. Douglas Letson
- />H. Lee Moffitt Cancer Center & Research Institute, Sarcoma Program, 12902 Magnolia Drive, Tampa, FL 33612 USA
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Yan J, Zhuo S, Chen G, Tan C, Zhu W, Lu J, Fan J, Chen J, Zhou J. Use of multiphoton microscopy to diagnose liver cancer and lung metastasis in an orthotopic rat model. SCANNING 2012; 34:271-277. [PMID: 22331704 DOI: 10.1002/sca.21005] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/09/2011] [Accepted: 11/14/2011] [Indexed: 05/31/2023]
Abstract
Liver or lung biopsy for suspicious lesions has several disadvantages such as bleeding, bile leak or pneumothorax, needle track seeding, and time-consuming histopathological procedure. The ability to directly observe cellular and subcellular details and then perform "optical biopsy" is a major goal in the development of new interventional techniques. Multiphoton microscopy (MPM) enables real-time noninvasive visualization of tissue architecture and cell morphology in live tissue. We performed a study to evaluate whether MPMcan make real-time optical diagnosis for liver cancer and lung metastasis using an orthotopic rat model with Morris hepatoma. We found that real-time high-resolution MPMimaging could clearly show tissue architecture and cell morphology. In the normal liver tissue, MPMimaging clearly revealed the blood-filled sinusoids and cords of hepatocytes. In the cancerous tissue, MPMimaging clearly illustrated that cancer cells displayed marked cellular and nuclear pleomorphism. MPMimages were comparable to golden standard hematoxylin-eosin staining images. Moreover, MPMimaging had deep penetration with the capability of optical sectioning. In short, MPMcan make real-time optical diagnosis for liver cancer and lung metastasis. This study provides the groundwork for further using multiphoton endoscopy to perform real-time noninvasive "optical biopsy" for liver cancer and lung metastasis in the near future.
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Affiliation(s)
- Jun Yan
- Liver Cancer Institute, Zhongshan Hospital, Fudan University, Shanghai, PR China
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Zachau L, Zeckey C, Schlue J, Sander J, Meyer-Heithuis C, Winkler M, Klempnauer J, Schrem H. Haematogenous abdominal wall metastasis of differentiated, alpha-fetoprotein-negative hepatocellular carcinoma after previous antiandrogen therapy within a site of lipoma manifestation since childhood. World J Surg Oncol 2012; 10:98. [PMID: 22647077 PMCID: PMC3408335 DOI: 10.1186/1477-7819-10-98] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2012] [Accepted: 05/30/2012] [Indexed: 02/06/2023] Open
Abstract
Background Cases with subcutaneous metastasis of differentiated hepatocellular carcinoma to the abdominal wall without prior seeding as a consequence of local interventions with a negative or normal alpha-fetoprotein level in the serum are extremely rare. Case report This is the first report of a case with AFP-negative, differentiated hepatocellular carcinoma metastasis to the abdominal wall within a pre-existing subcutaneous lipoma since childhood after antiandrogen therapy with leuprorelin and buserelin acetate for prostate cancer without seeding. Methods Clinical features including histology, immunohistochemistry, clinical course and surgical approach are presented. Results Histological examination revealed a hepatocellular carcinoma with a trabecular and pseudoglandular growth pattern with moderately atypical hepatocytes with multifocal bile formation within a lipoma. The postoperative course of abdominal wall reconstruction with a monocryl-prolene mesh and a local flap after potentially curative resection was uncomplicated. Discussion and conclusion It may be that previous antiandrogen treatment for prostate carcinoma contributed to the fact that our patient developed alpha-fetoprotein-negative and androgen receptor-negative subcutaneous abdominal wall metastasis within a pre-existing lipoma since childhood.
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Affiliation(s)
- L Zachau
- General, Visceral und Transplantation Surgery, Hanover Medical School, Carl-Neuberg-Str, 1, 30625, Hannover, Germany
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Abstract
PURPOSE OF REVIEW Cholangiocarcinoma is a malignancy arising from biliary tract epithelium that is increasing in incidence and is associated with a poor prognosis. The difficulty in diagnosis and relatively poor staging accuracy complicate management. In this review we examine the utility of endoscopic ultrasound (EUS), which is increasingly used in this setting to overcome the limitations of other imaging and biopsy techniques. RECENT FINDINGS Inherent limitations of current approaches to cholangiocarcinoma diagnosis and staging have driven the pursuit of new technologies including EUS. However, there remains a relative paucity of data and some uncertainty as to the role of EUS within the diagnostic algorithm for patients with suspected or known cholangiocarcinoma. In addition, there is controversy regarding the role of EUS fine-needle aspiration, the findings of which may enhance diagnosis, but may also predispose to tumor seeding and iatrogenic upstaging. SUMMARY An emerging indication for EUS is the diagnosis and staging of cholangiocarcinoma. This information may be used to help guide patient care and improve outcomes, but may also be employed in a manner that risks patient well being.
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Klopfleisch R, Sperling C, Kershaw O, Gruber AD. Does the taking of biopsies affect the metastatic potential of tumours? A systematic review of reports on veterinary and human cases and animal models. Vet J 2011; 190:e31-e42. [PMID: 21723757 DOI: 10.1016/j.tvjl.2011.04.010] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2011] [Revised: 04/08/2011] [Accepted: 04/09/2011] [Indexed: 02/06/2023]
Abstract
Clinicians and pathologists are sporadically asked by owners whether the taking of tumour biopsies may affect the behaviour of the tumour, including its potential to metastasise. Unfortunately, systematic studies on this subject are unavailable in veterinary medicine, and the aim of this study was to estimate the risk of adverse effects of biopsy taking on tumour progression in animals. A systematic review of veterinary and human case reports and clinical studies as well as experimental animal models of biopsy-induced tumour metastasis was undertaken. There were only two veterinary case reports of needle tract metastases (NTM) following the taking of needle biopsies from urogenital and pulmonary tumours. Seventeen experimental studies found a high incidence of NTM but only a rat osteosarcoma and a hamster squamous carcinoma model showed an increased incidence of distant or regional metastases after incision or excision biopsy. In human medicine, the occurrence of NTM has been reported after the taking of biopsies from mesotheliomas (15%), melanomas (11%) and gall bladder tumours (11%), liver metastases of colon carcinomas (4%) and mammary carcinomas (4%) but an incidence of only <1% for all other tumours. Circulating tumour cells increased immediately after the taking of biopsies from human squamous cell, prostate, breast and hepatocellular carcinomas. Although no increased risk of biopsy-induced distant metastasis has been reported for any type of tumour, this is inconclusive due to a lack of non-biopsied control groups in human studies. Reports of biopsy-induced metastasis in animal tumours indicate that the taking of transcutaneous biopsies from urogenital tumours may be associated with a risk of NTM. However, there is no evidence of a general increase in risk of distant metastases in any tumour type in people or animals. The overall risk therefore appears to be negligible when compared to the valuable information obtained from biopsies in veterinary practice.
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Affiliation(s)
- R Klopfleisch
- Freie Universität Berlin, Institute of Veterinary Pathology, Robert-von-Ostertag-Strasse 15, 14163 Berlin, Germany.
| | - C Sperling
- Freie Universität Berlin, Institute of Veterinary Pathology, Robert-von-Ostertag-Strasse 15, 14163 Berlin, Germany
| | - O Kershaw
- Freie Universität Berlin, Institute of Veterinary Pathology, Robert-von-Ostertag-Strasse 15, 14163 Berlin, Germany
| | - A D Gruber
- Freie Universität Berlin, Institute of Veterinary Pathology, Robert-von-Ostertag-Strasse 15, 14163 Berlin, Germany
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Fassina A, Fabbro M, Cappellesso R, Fassan M. Seeding of tumour cells after fine needle aspiration cytology in liver nodules: myth or reality? Cytopathology 2010; 21:413-4. [DOI: 10.1111/j.1365-2303.2010.00782.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Gupta PK. Progression from on-site to point-of-care fine needle aspiration service: Opportunities and challenges. Cytojournal 2010; 7:6. [PMID: 20607093 PMCID: PMC2895872 DOI: 10.4103/1742-6413.63195] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2009] [Accepted: 03/19/2010] [Indexed: 11/20/2022] Open
Abstract
Background Standard-of-care requires the availability of an efficient, economical and accurate on-site fine needle aspiration (FNA) service. Presence of a trained individual during the procedure ensures an improved patient care. Appropriate selection of the equipment, interaction with the clinicians and compliance with the various regulations during the procedure is essential. This is often done by an on-site FNA service. Organization and implementation of such a system in a large academic center is challenging. Method we reviewed the ambulatory care needs in the new Perelman Center for Advanced Medicine (PeCAM). Multiple (9) FNA sites have been established keeping in view the patient's convenience, clinic demands, various regulatory requirements and laboratory staff. Each location has dedicated FNA station with microscopes and supplies. In addition, state- ofthe -art technologies including a mobile FNA cart (Penn-A- Cart), remote specimen evaluation (TeleCyP) have been incorporated. Results The new set up is extremely efficient and much valued by the patients and the clinicians. It has improved patient care. Conclusion With necessary investments and resources a point-of-care FNA service has been created which has improved patient care. This, albeit with certain modifications may serve as a model for FNA service.
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Affiliation(s)
- Prabodh K Gupta
- Address: Department of Pathology and Laboratory Medicine, Hospital of the University of Pennsylvania,3400 Spruce St., Pennsylvania - 19104, Philadelphia
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Pitman MB. Liver. Diagn Cytopathol 2010. [DOI: 10.1016/b978-0-7020-3154-0.00008-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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