1
|
Babarović E, Marijić B, Vranić L, Ban J, Valković T, Hadžisejdić I. A Comparison of Bone Marrow Morphology and Peripheral Blood Findings in Low and High Level JAK2 V617F Allele Burden. Diagnostics (Basel) 2023; 13:2086. [PMID: 37370982 DOI: 10.3390/diagnostics13122086] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Revised: 06/11/2023] [Accepted: 06/14/2023] [Indexed: 06/29/2023] Open
Abstract
Cases with low level JAK2 V617F mutations are increasingly detected; however, the clinical interpretation of the low allele JAK2 burden may be challenging. The aim of this study is to analyze and compare the bone marrow morphology and peripheral blood findings in the low level JAK2 V617F allele burden (≤15% of JAK2) and high JAK2 V617F mutation burden patients (>15% JAK2). In total, 122 JAK2 V617F positive cases with concomitant bone marrow biopsies and peripheral blood findings were re-evaluated (62 low and 60 high level JAK2 V617F positive). Within the low burden group, normal looking megakaryocytes (p = 0.0005) were more frequently found, compared with those with no atypia (p = 0.0003), their number was more frequently not increased (p = 0.009), and they did not form clusters (p = 0.001). We found statistically significant difference in the number of platelet (p = 0.0003) and hematocrit levels (p = 0.032) when comparing the JAK2 V617F <3% and ≥3% mutation burden. In the high-level burden, the megakaryocytes were more frequently atypical (p = 0.054), and more frequently formed clusters (p = 0.053) with nuclei with maturation defects (p ≤ 0.0001). In conclusion, the JAK2 V617F mutation burden is reflected by morphological changes in the bone marrow and careful follow up of each and every patient with a low JAK2 V617F positivity is mandatory.
Collapse
Affiliation(s)
- Emina Babarović
- Faculty of Medicine, University of Rijeka, 51000 Rijeka, Croatia
- Laboratory for Molecular Pathology, Clinical Department of Pathology and Cytology, Clinical Hospital Center Rijeka, 51000 Rijeka, Croatia
| | - Blažen Marijić
- Faculty of Medicine, University of Rijeka, 51000 Rijeka, Croatia
- Department of Otorhinolaryngology and Head and Neck Surgery, Clinical Hospital Center Rijeka, 51000 Rijeka, Croatia
| | - Luka Vranić
- Faculty of Medicine, University of Rijeka, 51000 Rijeka, Croatia
- Department of Internal Medicine, Clinic for Gastroenterology, Clinical Hospital Center Rijeka, 51000 Rijeka, Croatia
| | - Josipa Ban
- Faculty of Medicine, University of Rijeka, 51000 Rijeka, Croatia
| | - Toni Valković
- Faculty of Medicine, University of Rijeka, 51000 Rijeka, Croatia
- Department of Internal Medicine, Clinic for Hematology, Clinical Hospital Center Rijeka, 51000 Rijeka, Croatia
| | - Ita Hadžisejdić
- Faculty of Medicine, University of Rijeka, 51000 Rijeka, Croatia
- Laboratory for Molecular Pathology, Clinical Department of Pathology and Cytology, Clinical Hospital Center Rijeka, 51000 Rijeka, Croatia
| |
Collapse
|
2
|
Marijić B, Tudor F, Janik S, Grasl S, Frommlet F, Maržić D, Hadžisejdić I, Vukelić J, Braut T, Velepič M, Erovic BM. Long-Term Care and Follow-Up in Laryngeal Cancer Patients: A Multicenter Retrospective Analysis. J Pers Med 2023; 13:927. [PMID: 37373916 DOI: 10.3390/jpm13060927] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2023] [Revised: 05/29/2023] [Accepted: 05/30/2023] [Indexed: 06/29/2023] Open
Abstract
PURPOSE We conducted an outcome analysis on surgically treated laryngeal squamous cell carcinoma (LSCC) patients. METHODS A multicenter retrospective study with 352 patients was analyzed. A new nomogram that incorporates age, T- and N-classification, and treatment was created. RESULTS Recurrence was observed in 65 (18.5%) patients after a mean time of 16.5 months. After 60 months, 91 (25.9%) of patients developed secondary primary tumors (SPT), most commonly in the lungs (n = 29; 8.2%) followed by other head and neck cancers (n = 21; 6.0%). Notably, the mean time to occurrence of secondary head and neck cancers was twice that of lung cancer (101.1 vs. 47.5 months). CONCLUSION Recurrent disease is less common in LSCC patients and appears much earlier than SPT. Because one in every four laryngeal cancer patients develops SPTs within 5-10 years, long-term care and follow-up, including imaging studies, are highly recommended. The nomogram was useful for estimating survival.
Collapse
Affiliation(s)
- Blažen Marijić
- Institute of Head and Neck Diseases, Evangelical Hospital, 1180 Vienna, Austria
- Department of Otorhinolaryngology, Head and Neck Surgery, Clinical Hospital Center Rijeka, 51000 Rijeka, Croatia
- Faculty of Medicine, University of Rijeka, 51000 Rijeka, Croatia
| | - Filip Tudor
- Department of Otorhinolaryngology, Head and Neck Surgery, Clinical Hospital Center Rijeka, 51000 Rijeka, Croatia
- Faculty of Medicine, University of Rijeka, 51000 Rijeka, Croatia
| | - Stefan Janik
- Department of Otorhinolaryngology, Head and Neck Surgery, Medical University Vienna, 1090 Vienna, Austria
| | - Stefan Grasl
- Department of Otorhinolaryngology, Head and Neck Surgery, Medical University Vienna, 1090 Vienna, Austria
| | - Florian Frommlet
- Center for Medical Statistics, Informatics and Intelligent Systems, Section for Medical Statistics, Medical University Vienna, 1090 Vienna, Austria
| | - Diana Maržić
- Faculty of Medicine, University of Rijeka, 51000 Rijeka, Croatia
- Department of Audiology and Phoniatrics, Clinical Hospital Centre Rijeka, 51000 Rijeka, Croatia
| | - Ita Hadžisejdić
- Faculty of Medicine, University of Rijeka, 51000 Rijeka, Croatia
- Clinical Department of Pathology and Cytology, Clinical Hospital Center Rijeka, 51000 Rijeka, Croatia
| | - Jelena Vukelić
- Faculty of Medicine, University of Rijeka, 51000 Rijeka, Croatia
- Department of Audiology and Phoniatrics, Clinical Hospital Centre Rijeka, 51000 Rijeka, Croatia
| | - Tamara Braut
- Department of Otorhinolaryngology, Head and Neck Surgery, Clinical Hospital Center Rijeka, 51000 Rijeka, Croatia
- Faculty of Medicine, University of Rijeka, 51000 Rijeka, Croatia
| | - Marko Velepič
- Department of Otorhinolaryngology, Head and Neck Surgery, Clinical Hospital Center Rijeka, 51000 Rijeka, Croatia
- Faculty of Medicine, University of Rijeka, 51000 Rijeka, Croatia
| | - Boban M Erovic
- Institute of Head and Neck Diseases, Evangelical Hospital, 1180 Vienna, Austria
| |
Collapse
|
3
|
Murković M, Babarović E, Marijić B, Grohovac D, Hadžisejdić I. Association of pre-treatment bone marrow morphology and achievement of BCR-ABL1 transcript milestones in CML. Pathol Res Pract 2023; 246:154517. [PMID: 37182315 DOI: 10.1016/j.prp.2023.154517] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2023] [Accepted: 05/06/2023] [Indexed: 05/16/2023]
Abstract
Chronic myeloid leukemia (CML) is characterized by the fusion gene BCR-ABL1 which encodes aberrantly functioning tyrosine kinase. Treatment with tyrosine kinase inhibitors (TKI) is a landmark of CML management and the main goal is to achieve major molecular response (MMR) which is defined as BCR-ABL1IS ≤ 0.1 % at 12 months of therapy. The aim of this study is to analyze histologic features of bone marrow (BM) in CML patients at the time of diagnosis and compare it to the level of BCR-ABL1IS transcript at 3 (BCR-ABL1IS ≤10 % early molecular response; EMR) and 12 months (MMR) as well as to so called molecularly undetectable leukemia (MUL) to see weather bone marrow morphology can be of value in predicting achievement molecular response milestones. Thirty-two bone marrow biopsies of CML patients, prior TKI therapy, were re-evaluated and CD34 immunohistochemistry was performed to examine microvessel density (MVD) and microvessel area (MVA) and subsequently compared it to the level of BCR-ABL1IS transcript. This study showed statistically significant association between BM hypercellularity and EMR (p = 0.048) and MUL (p = 0.034), peri-trabecular adipocyte distribution and EMR and MUL (p = 0.027 and p = 0.011, respectively), MMR and bone marrow fibrosis (p = 0.029), loose megakaryocyte clustering and EMR and MUL (p = 0.004 and p = 0.018, respectively), absence of naked nuclei and MUL (p = 0.033) but there was no statistically significant association with vascular parameters. These results suggest that some bone marrow morphologic features prior TKI therapy might be indicators of favorable molecular response.
Collapse
Affiliation(s)
- Martina Murković
- Faculty of Medicine, University of Rijeka, Braće Branchetta 20, Rijeka, Croatia; Clinical Department of Pathology and Cytology, Clinical Hospital Center Rijeka, Krešimirova 42, Rijeka, Croatia
| | - Emina Babarović
- Faculty of Medicine, University of Rijeka, Braće Branchetta 20, Rijeka, Croatia; Clinical Department of Pathology and Cytology, Clinical Hospital Center Rijeka, Krešimirova 42, Rijeka, Croatia; Laboratory for Molecular Pathology, Clinical Hospital Center Rijeka, Krešimirova 42, Rijeka, Croatia
| | - Blažen Marijić
- Faculty of Medicine, University of Rijeka, Braće Branchetta 20, Rijeka, Croatia; Department of Otorhinolaryngology and Head and Neck Surgery, Clinical Hospital Center Rijeka, Krešimirova 42, Rijeka, Croatia
| | - Dragana Grohovac
- Faculty of Medicine, University of Rijeka, Braće Branchetta 20, Rijeka, Croatia; Department of Internal Medicine, Clinic for Hematology, Clinical Hospital Center Rijeka, Krešimirova 42, Rijeka, Croatia
| | - Ita Hadžisejdić
- Faculty of Medicine, University of Rijeka, Braće Branchetta 20, Rijeka, Croatia; Clinical Department of Pathology and Cytology, Clinical Hospital Center Rijeka, Krešimirova 42, Rijeka, Croatia; Laboratory for Molecular Pathology, Clinical Hospital Center Rijeka, Krešimirova 42, Rijeka, Croatia.
| |
Collapse
|
4
|
Hadžisejdić I, Klarica L, Babarović E, Marijić B, Valković T, Jonjić N. Primary Nodal Unclassifiable CD20 Negative Diffuse Large B-cell Lymphoma With Dual IgK and TCR Gene Rearrangement: A Diagnostic Challenge. Clin Pathol 2023; 16:2632010X221149978. [PMID: 36684058 PMCID: PMC9846588 DOI: 10.1177/2632010x221149978] [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] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Accepted: 12/20/2022] [Indexed: 01/17/2023]
Abstract
Non-Hodgkin lymphomas are most frequently classified based on the lineage marker expression. However, lymphomas with aberrant marker expression as well as monoclonal IgH/IgΚ and TCR gene rearrangements may co-exist which can be misleading and confusing. Primary CD20 negative diffuse large B-cell lymphomas (DLBCL) represent a rare entity, and they account for 1% to 3% of cases. However, some CD20 negative DLBCLs could not be classified into known variants, creating both diagnostic and therapeutic dilemma's. Primary CD20 negative DLBCL are more likely to have a non-germinal centre subtype, a higher proliferation index, more frequent extra-nodal involvement, a poorer response, and poorer prognosis to conventional treatment compared to CD20 positive DLBCL. A 66- year-old postmenopausal lady, presented with palpable, bilateral neck lymphadenopathy and difficulty swallowing. She also had left leg lymphoedema, poor appetited, fatigue and weight loss. Her symptoms lasted approximately 1 month. After histological, immunohistochemical and clonality analysis of the lymph node the patient was diagnosed with primary nodal CD20 and PAX-5 negative DLBCL with dual immunoglobulin light-chain kappa (IgK) and T-cell receptor (TCR) gene rearrangement. This unusual and unique case presented a diagnostic challenge because it was CD20 and PAX-5 negative, had dual IgK and TCR gene rearrangement and, it could not be classified within the known and well established CD20 negative DLBCL variants. Describing such cases emphasises the fact that lymphomas unclassifiable within known variants of CD20 negative DLBCL do exist and that range and heterogeneity of CD20 negative DLBCL continues to evolve, and pathologist should be aware of these uncommon, atypical mature B-cell neoplasms.
Collapse
Affiliation(s)
- Ita Hadžisejdić
- Clinical Department of Pathology and
Cytology, Clinical Hospital Center Rijeka, Rijeka, Croatia,Department of Pathology, Faculty of
Medicine, University of Rijeka, Rijeka, Croatia,Ita Hadžisejdić, Clinical Department of
Pathology and Cytology, Clinical Hospital Center Rijeka, Krešimirova 42, Rijeka
51000, Croatia.
| | - Lucia Klarica
- Department of Pathology, Faculty of
Medicine, University of Rijeka, Rijeka, Croatia
| | - Emina Babarović
- Clinical Department of Pathology and
Cytology, Clinical Hospital Center Rijeka, Rijeka, Croatia,Department of Pathology, Faculty of
Medicine, University of Rijeka, Rijeka, Croatia
| | - Blažen Marijić
- Department of Otorhinolaryngology and
Head and Neck Surgery, Clinical Hospital Center Rijeka, Rijeka, Croatia,Department of Otorhinolaryngology,
Faculty of Medicine, University of Rijeka, Rijeka, Croatia
| | - Toni Valković
- Department of Haematology, Clinical
Hospital Center Rijeka, Rijeka, Croatia,Department of Internal Medicine,
Faculty of Medicine, University of Rijeka, Rijeka, Croatia
| | - Nives Jonjić
- Clinical Department of Pathology and
Cytology, Clinical Hospital Center Rijeka, Rijeka, Croatia,Department of Pathology, Faculty of
Medicine, University of Rijeka, Rijeka, Croatia
| |
Collapse
|
5
|
Vukelić J, Dobrila-Dintinjana R, Marijić B, Maržić D, Braut T. CLINICAL COURSE OF THE DISEASE AND TREATMENT OUTCOME IN PATIENTS WITH MALIGNANT LARYNGEAL TUMOR: RETROSPECTIVE FIVE-YEAR ANALYSIS. Acta Clin Croat 2022; 61:311-319. [PMID: 36818925 PMCID: PMC9934035 DOI: 10.20471/acc.2022.61.02.18] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2019] [Accepted: 06/09/2020] [Indexed: 02/10/2023] Open
Abstract
The aim was to investigate clinical course of disease in patients with malignant laryngeal tumors with emphasis on various forms of disease recurrence (local recurrence, metastasis to regional lymph nodes, occurrence of second primary tumor). A retrospective research including 78 patients with histopathologically confirmed diagnosis of squamous cell laryngeal carcinoma was conducted. Information on cancer stage, histologic grade, type of treatment and disease recurrence was obtained from medical history. Tissue samples of the patients were submitted to immunohistochemical analysis and assessment of Ki-67 proliferation index expression. The occurrence of second primary tumor was found to be related to the significantly higher Ki-67 proliferation index. The number of patients having not undergone oncologic therapy and remained free from disease recurrence was significantly higher than expected. Treatment outcome depends on patient age, histologic grade, radiotherapy applied, and clinical course of disease. It is necessary to define the predictive factors of various forms of disease recurrence more precisely in order to identify better treatment options for patients with malignant tumors of the larynx.
Collapse
Affiliation(s)
- Jelena Vukelić
- Department of Otolaryngology and Head and Neck Surgery, Rijeka University Hospital Center, Rijeka, Croatia;,Faculty of Health Studies, Clinical Sciences, Rijeka, Croatia
| | | | - Blažen Marijić
- Department of Otolaryngology and Head and Neck Surgery, Rijeka University Hospital Center, Rijeka, Croatia
| | - Diana Maržić
- Audiology and Phoniatrics Unit, Rijeka University Hospital Center, Rijeka, Croatia
| | - Tamara Braut
- Department of Otolaryngology and Head and Neck Surgery, Rijeka University Hospital Center, Rijeka, Croatia
| |
Collapse
|
6
|
Janik S, Pyka J, Faisal M, Grasl S, Golusinski P, Marijić B, Seemann R, Erovic BM. Using the DASH Questionnaire to Evaluate Donor Site Morbidity of the Serratus Anterior Free Flap in Head and Neck Reconstruction: A Multicenter Study. J Clin Med 2022; 11:jcm11092397. [PMID: 35566523 PMCID: PMC9101023 DOI: 10.3390/jcm11092397] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [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: 03/24/2022] [Revised: 04/16/2022] [Accepted: 04/21/2022] [Indexed: 12/03/2022] Open
Abstract
Objective: To evaluate donor site morbidity of the serratus anterior free flap (SAFF) in head and neck reconstruction. Methods: The Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire (0 no disability to 100 most severe disability) was applied to 20 patients (M: 16; F: 4) who underwent ablative surgery and reconstruction of the head and neck using a SAFF. Applications, as well as the donor site, recipient site and flap-related complications, were evaluated. Results: SAFF was mainly used for tongue (n = 11; 55.0%) and pharyngeal reconstruction after a laryngopharyngectomy (n = 4; 20.0%). The majority of patients presented with stage IV disease (n = 12; 60%) and had undergone previous radiotherapy (n = 14; 70%). Our free flap survival rate was 88.9% and the pectoralis major muscle flap (PMMF) was used in 5 patients as a salvage option to reconstruct pharyngeal defects. The mean/median DASH score was 21.6/19.9 (healthy norm 10.1), indicating only mild to moderate disability. However, free flap failure and the additional harvest of PMMF multiplies donor site morbidity since it was associated with a 3- and 2.6-times higher DASH score (46.0 vs. 15.5; p = 0.039 and 39.9 vs. 15.47; p = 0.081). Conclusions: The SAFF represents a versatile flap for head and neck reconstruction with low donor site morbidity.
Collapse
Affiliation(s)
- Stefan Janik
- Department of Otorhinolaryngology, Head and Neck Surgery, Medical University of Vienna, 1090 Vienna, Austria; (S.J.); (S.G.)
| | - Julian Pyka
- Department of Oral and Maxillofacial Surgery, Medical University of Vienna, 1090 Vienna, Austria;
| | - Muhammad Faisal
- Department of Surgical Oncology, Shaukat Khanum Memorial Cancer Hospital, Lahore 54000, Pakistan;
| | - Stefan Grasl
- Department of Otorhinolaryngology, Head and Neck Surgery, Medical University of Vienna, 1090 Vienna, Austria; (S.J.); (S.G.)
| | - Pawel Golusinski
- Department of Otolaryngology and Maxillofacial Surgery, University of Zielona Gora, 65-046 Zielona Gora, Poland;
| | - Blažen Marijić
- Institute of Head and Neck Diseases, Evangelical Hospital, 1180 Vienna, Austria; (B.M.); (R.S.)
- Department of Otorhinolaryngology, Head and Neck Surgery, Clinical Hospital Center Rijeka, Faculty of Medicine, University of Rijeka, 51000 Rijeka, Croatia
| | - Rudolf Seemann
- Institute of Head and Neck Diseases, Evangelical Hospital, 1180 Vienna, Austria; (B.M.); (R.S.)
| | - Boban M. Erovic
- Institute of Head and Neck Diseases, Evangelical Hospital, 1180 Vienna, Austria; (B.M.); (R.S.)
- Correspondence: ; Tel.: +43-140-422-4518
| |
Collapse
|
7
|
Braut T, Maršić M, Ravlić I, Maržić D, Marijić B, Malvić G, Vrebac I, Velepič M. Posttraumatic Vernet syndrome without fracture: A case report and short literature review. Medicine (Baltimore) 2021; 100:e27618. [PMID: 34713846 PMCID: PMC8556020 DOI: 10.1097/md.0000000000027618] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Accepted: 10/13/2021] [Indexed: 01/05/2023] Open
Abstract
RATIONALE The aim of this case is to emphasize the need to include nerve traction in the differential diagnosis of nerve deficits associated with Vernet syndrome. This mechanism of injury has been described only once, but must not be overlooked and should be considered and included as a possible cause in diagnostic algorithms. PATIENT CONCERNS A patient presenting with dysphagia, extreme hoarseness, and limited shoulder movement after head injury was admitted to the emergency department. DIAGNOSES Multidisciplinary evaluation was performed, and nerve traction-induced Vernet syndrome was established as a running diagnosis. INTERVENTIONS Intensive swallowing and speech exercises, assisted by a specialist, were performed. OUTCOMES Swallowing and speech exercises significantly and objectively improved the patient's swallowing and voice, with mild hoarseness of voice remaining as the main symptom. Spectral acoustic analysis went from a voice pitch of 163.77 Hz to normal (187.77 Hz), jitter improved from 17.87% to 0.86% and shimmer values decreased from 39.86% to 19.60%. Breathiness during phonation measuring 2.91% was reduced to 1.08% and appropriate average intensity of voice (63.95 dB) was achieved. Initial dysphagia and fluid retention in the right piriform sinus, along with tracheal aspiration, were not observed in control fiberoptic endoscopic evaluation of swallowing. LESSONS According to our knowledge and literature data, this is the second reported case of posttraumatic Vernet syndrome without radiologically confirmed jugular foramen fracture, induced by nerve traction. Such patients need a prompt multidisciplinary approach in diagnosis and timely posttraumatic rehabilitation therapy for favorable clinical evolution and retrieval of nerve function.
Collapse
Affiliation(s)
- Tamara Braut
- Clinic of Otorhinolaryngology and Head and Neck Surgery, Rijeka University Hospital Center, Rijeka, Croatia
| | - Matej Maršić
- Clinic of Otorhinolaryngology and Head and Neck Surgery, Rijeka University Hospital Center, Rijeka, Croatia
| | - Iva Ravlić
- University of Rijeka, Faculty of Medicine, Rijeka, Croatia
| | - Diana Maržić
- Clinic of Otorhinolaryngology and Head and Neck Surgery, Rijeka University Hospital Center, Rijeka, Croatia
| | - Blažen Marijić
- Clinic of Otorhinolaryngology and Head and Neck Surgery, Rijeka University Hospital Center, Rijeka, Croatia
| | - Goran Malvić
- Clinic of Otorhinolaryngology and Head and Neck Surgery, Rijeka University Hospital Center, Rijeka, Croatia
| | - Ilinko Vrebac
- Clinic of Otorhinolaryngology and Head and Neck Surgery, Rijeka University Hospital Center, Rijeka, Croatia
| | - Marko Velepič
- Clinic of Otorhinolaryngology and Head and Neck Surgery, Rijeka University Hospital Center, Rijeka, Croatia
| |
Collapse
|
8
|
Marijić B, Braut T, Babarović E, Krstulja M, Maržić D, Avirović M, Kujundžić M, Hadžisejdić I. Nuclear EGFR Expression Is Associated With Poor Survival in Laryngeal Carcinoma. Appl Immunohistochem Mol Morphol 2021; 29:576-584. [PMID: 33758141 DOI: 10.1097/pai.0000000000000932] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Accepted: 02/12/2021] [Indexed: 12/31/2022]
Abstract
The membrane EGFR (mEGFR) protein overexpression in the head and neck squamous cell carcinoma (SCC) is considered to cause increased EGFR activity which adds to tumorigenicity and therapy resistance. The mEGFR upon stimulation can translocate to the nucleus nuclear EGFR (nEGFR) where it has been associated with poor prognosis and worse survival in many cancers. The relevance of differentially located EGFR proteins in laryngeal lesions has not been studied enough and remains unclear. Aim of our study was to examine nEGFR and mEGFR protein expression as well as EGFR gene status and cell cycle proliferation markers in the laryngeal polyps, dysplasia, and SCC using immunohistochemistry and in situ hybridization. There was significantly higher frequency of strong nEGFR between SCC, dysplasia, and polyps (P<0.0001), and strong mEGFR in the SCC and laryngeal dysplasia comparing to polyps (P<0.0001). Gene amplification was confirmed only in relatively small number of SCC but not in non-neoplastic lesions. In dysplasia the statistically significant positive correlations between nEGFR, and Ki-67 (P=0.029), p53 (P=0.001), and cyclin D1 (P=0.031) were found. nEGFR and mEGFR expression showed statistically significant inverse correlation in the SCC (P=0.004) as well as nEGFR and cyclin D1 (P=0.032). Univariate statistical analysis showed statistically significant correlation between strong nEGFR protein expression and worse overall survival in laryngeal SCC, alone or in coexpression with strong cyclin D1 and high Ki-67 (P=0.025, P=0.046, P=0.043, respectively). Our data show that nEGFR cellular localization might influence biology of the laryngeal carcinogenesis and is indicator of poor survival.
Collapse
Affiliation(s)
- Blažen Marijić
- Department of Otorhinolaryngology and Head and Neck Surgery
- Departments of Otorhinolaryngology
| | - Tamara Braut
- Department of Otorhinolaryngology and Head and Neck Surgery
- Departments of Otorhinolaryngology
| | - Emina Babarović
- Pathology, Faculty of Medicine, University of Rijeka, Rijeka, Croatia
| | - Mira Krstulja
- Pathology, Faculty of Medicine, University of Rijeka, Rijeka, Croatia
| | - Diana Maržić
- Department of Audiology and Phoniatrics, Clinical Hospital Centre Rijeka
- Departments of Otorhinolaryngology
| | - Manuela Avirović
- Clinical Department of Pathology and Cytology
- Pathology, Faculty of Medicine, University of Rijeka, Rijeka, Croatia
| | - Milodar Kujundžić
- Department of Otorhinolaryngology and Head and Neck Surgery
- Departments of Otorhinolaryngology
| | - Ita Hadžisejdić
- Clinical Department of Pathology and Cytology
- Pathology, Faculty of Medicine, University of Rijeka, Rijeka, Croatia
| |
Collapse
|
9
|
Maržić D, Marijić B, Braut T, Janik S, Avirović M, Hadžisejdić I, Tudor F, Radobuljac K, Čoklo M, Erovic BM. IMP3 Protein Overexpression Is Linked to Unfavorable Outcome in Laryngeal Squamous Cell Carcinoma. Cancers (Basel) 2021; 13:cancers13174306. [PMID: 34503117 PMCID: PMC8430545 DOI: 10.3390/cancers13174306] [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] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Revised: 08/23/2021] [Accepted: 08/23/2021] [Indexed: 02/02/2023] Open
Abstract
Simple Summary IMP3 expression was analyzed in patients with malignant (laryngeal squamous cell carcinoma), semi-malignant (dysplasia) and benign (nodules, polyps) laryngeal lesions and correlated with clinical characteristics. Higher IMP3 stains were particularly found in malignant laryngeal pathologies, which might be useful for differentiation between premalignant and malignant lesions. In laryngeal cancer patients, higher IMP3 expression was associated with positive neck nodes and worse disease-specific survival. Abstract Background: The aim of this study was to (i) determine IMP3 protein expression in benign and malignant laryngeal lesions, (ii) compare its expression to Ki-67, p53, cyclin D1, and (iii) finally, to examine the prognostic power of IMP3 in squamous cell carcinomas of the larynx (LSSC). Methods: IMP3 protein expression was evaluated in 145 patients, including 62 LSCC, 45 dysplasia (25 with low and 20 with high-grade dysplasia), and 38 benign lesions (vocal cord polyps and nodules). Results: IMP3 was significantly higher expressed in LSCC compared to dysplasia and benign lesions (p < 0.001; p < 0.001, respectively). Similarly, higher expression patterns were observed for Ki-67 and p53, whereas cyclin D1 was equally distributed in all three lesions. IMP3 (p = 0.04) and Ki-67 (p = 0.02) expressions were significantly linked to neck node positivity, and IMP3 overexpression to worse disease-specific survival (p = 0.027). Conclusion: Since IMP3 showed significantly higher expression in laryngeal carcinomas, but not in high- or low-grade dysplasia, it serves as a useful marker to differentiate between invasive and noninvasive lesions. Higher IMP3 expression represented a significantly worse prognosticator for clinical outcomes of patients with squamous cell carcinoma of the larynx.
Collapse
Affiliation(s)
- Diana Maržić
- Department of Audiology and Phoniatrics, Clinical Hospital Center Rijeka, 51000 Rijeka, Croatia; (D.M.); (K.R.)
- Faculty of Medicine, University of Rijeka, 51000 Rijeka, Croatia; (B.M.); (T.B.); (M.A.); (I.H.); (F.T.)
| | - Blažen Marijić
- Faculty of Medicine, University of Rijeka, 51000 Rijeka, Croatia; (B.M.); (T.B.); (M.A.); (I.H.); (F.T.)
- Institute of Head and Neck Diseases, Evangelical Hospital, 1180 Vienna, Austria
- Department of Otorhinolaryngology, Head and Neck Surgery, Clinical Hospital Center Rijeka, 51000 Rijeka, Croatia
| | - Tamara Braut
- Faculty of Medicine, University of Rijeka, 51000 Rijeka, Croatia; (B.M.); (T.B.); (M.A.); (I.H.); (F.T.)
- Department of Otorhinolaryngology, Head and Neck Surgery, Clinical Hospital Center Rijeka, 51000 Rijeka, Croatia
| | - Stefan Janik
- Department of Otorhinolaryngology, Head and Neck Surgery, Medical University Vienna, 1190 Vienna, Austria;
| | - Manuela Avirović
- Faculty of Medicine, University of Rijeka, 51000 Rijeka, Croatia; (B.M.); (T.B.); (M.A.); (I.H.); (F.T.)
- Clinical Department of Pathology and Cytology, Clinical Hospital Center Rijeka, 51000 Rijeka, Croatia
| | - Ita Hadžisejdić
- Faculty of Medicine, University of Rijeka, 51000 Rijeka, Croatia; (B.M.); (T.B.); (M.A.); (I.H.); (F.T.)
- Clinical Department of Pathology and Cytology, Clinical Hospital Center Rijeka, 51000 Rijeka, Croatia
| | - Filip Tudor
- Faculty of Medicine, University of Rijeka, 51000 Rijeka, Croatia; (B.M.); (T.B.); (M.A.); (I.H.); (F.T.)
- Department of Otorhinolaryngology, Head and Neck Surgery, Clinical Hospital Center Rijeka, 51000 Rijeka, Croatia
| | - Katarina Radobuljac
- Department of Audiology and Phoniatrics, Clinical Hospital Center Rijeka, 51000 Rijeka, Croatia; (D.M.); (K.R.)
| | - Miran Čoklo
- Center for Applied Bioanthropology, Institute for Anthropological Research, 10000 Zagreb, Croatia;
| | - Boban M. Erovic
- Institute of Head and Neck Diseases, Evangelical Hospital, 1180 Vienna, Austria
- Correspondence:
| |
Collapse
|
10
|
Marijić B, Braut T, Tudor F, Filipović N, Hadžisejdić I, Šitum M, Crnarić I. Giant rhinophyma with olfactory and breathing dysfunction successfully treated by shave excision and electrocautery. Dermatol Ther 2021; 34:e15029. [PMID: 34133060 DOI: 10.1111/dth.15029] [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] [Received: 12/01/2020] [Revised: 03/25/2021] [Accepted: 06/04/2021] [Indexed: 11/28/2022]
Affiliation(s)
- Blažen Marijić
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Center Rijeka, Rijeka, Croatia.,Faculty of Medicine, University of Rijeka, Rijeka, Croatia
| | - Tamara Braut
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Center Rijeka, Rijeka, Croatia.,Faculty of Medicine, University of Rijeka, Rijeka, Croatia
| | - Filip Tudor
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Center Rijeka, Rijeka, Croatia.,Faculty of Medicine, University of Rijeka, Rijeka, Croatia
| | - Nika Filipović
- Department of Dermatology and Venereology, University Hospital Center "Sestre milosrdnice", Zagreb, Croatia
| | - Ita Hadžisejdić
- Faculty of Medicine, University of Rijeka, Rijeka, Croatia.,Department of Clinical Pathology and Cytology, University Hospital Center Rijeka, Rijeka, Croatia
| | - Mirna Šitum
- Department of Dermatology and Venereology, University Hospital Center "Sestre milosrdnice", Zagreb, Croatia
| | - Iva Crnarić
- Department of Dermatology and Venereology, University Hospital Center "Sestre milosrdnice", Zagreb, Croatia
| |
Collapse
|
11
|
Grasl S, Schmid E, Heiduschka G, Brunner M, Marijić B, Grasl MC, Faisal M, Erovic BM, Janik S. A New Classification System to Predict Functional Outcome after Laryngectomy and Laryngopharyngectomy. Cancers (Basel) 2021; 13:cancers13061474. [PMID: 33806944 PMCID: PMC8004622 DOI: 10.3390/cancers13061474] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [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: 02/14/2021] [Revised: 03/11/2021] [Accepted: 03/19/2021] [Indexed: 12/27/2022] Open
Abstract
Simple Summary Evaluation of the long-term functional outcome after primary or salvage laryngopharyngectomy. Long term functional outcome mainly depends on extent of pharyngectomy and salvage situation, which is reflected by our new classification system. Abstract (1) Objective: To evaluate long-term functional outcome in patients who underwent primary or salvage total laryngectomy (TL), TL with partial (TLPP), or total pharyngectomy (TLTP), and to establish a new scoring system to predict complication rate and long-term functional outcome; (2) Material and Methods: Between 1993 and 2019, 258 patients underwent TL (n = 85), TLPP (n = 101), or TLTP (n = 72). Based on the extent of tumor resection, all patients were stratified to (i) localization I: TL; II: TLPP; III: TLTP and (ii) surgical treatment (A: primary resection; B: salvage surgery). Type and rate of complication and functional outcome, including oral nutrition, G-tube dependence, pharyngeal stenosis, and voice rehabilitation were evaluated in 163 patients with a follow-up ≥ 12 months and absence of recurrent disease; (3) Results: We found 61 IA, 24 IB, 63 IIA, 38 IIB, 37 IIIA, and 35 IIIA patients. Complications and subsequently revision surgeries occurred most frequently in IIIB cases but rarely in IA patients (57.1% vs. 18%; p = 0.001 and 51.4% vs. 14.8%; p = 0.002), respectively. Pharyngocutaneous fistula (PCF) was the most common complication (33%), although it did not significantly differ among cohorts (p = 0.345). Pharyngeal stenosis was found in 27% of cases, with the highest incidence in IIIA (45.5%) and IIIB (72.7%) patients (p < 0.001). Most (91.1%) IA patients achieved complete oral nutrition compared to only 41.7% in class IIIB patients (p < 0.001). Absence of PCF (odds ratio (OR) 3.29; p = 0.003), presence of complications (OR 3.47; p = 0.004), and no need for pharyngeal reconstruction (OR 4.44; p = 0.042) represented independent favorable factors for oral nutrition. Verbal communication was achieved in 69.3% of patients and was accomplished by the insertion of voice prosthesis in 37.4%. Acquisition of esophageal speech was reached in 31.9% of cases. Based on these data, we stratified patients regarding the extent of surgery and previous treatment into subgroups reflecting risk profiles and expectable functional outcome; (4) Conclusions: The extent of resection accompanied by the need for reconstruction and salvage surgery both carry a higher risk of complications and subsequently worse functional outcome. Both factors are reflected in our classification system that can be helpful to better predict patients’ functional outcome.
Collapse
Affiliation(s)
- Stefan Grasl
- Department of Otorhinolaryngology, Head and Neck Surgery, Medical University of Vienna, 1090 Vienna, Austria; (S.G.); (E.S.); (G.H.); (M.B.); (M.C.G.)
| | - Elisabeth Schmid
- Department of Otorhinolaryngology, Head and Neck Surgery, Medical University of Vienna, 1090 Vienna, Austria; (S.G.); (E.S.); (G.H.); (M.B.); (M.C.G.)
| | - Gregor Heiduschka
- Department of Otorhinolaryngology, Head and Neck Surgery, Medical University of Vienna, 1090 Vienna, Austria; (S.G.); (E.S.); (G.H.); (M.B.); (M.C.G.)
| | - Markus Brunner
- Department of Otorhinolaryngology, Head and Neck Surgery, Medical University of Vienna, 1090 Vienna, Austria; (S.G.); (E.S.); (G.H.); (M.B.); (M.C.G.)
| | - Blažen Marijić
- Institute of Head and Neck Diseases, Evangelical Hospital, 1180 Vienna, Austria; (B.M.); (B.M.E.)
- Department of Otorhinolaryngology, Head and Neck Surgery, Clinical Hospital Center Rijeka, 51000 Rijeka, Croatia
| | - Matthaeus Ch. Grasl
- Department of Otorhinolaryngology, Head and Neck Surgery, Medical University of Vienna, 1090 Vienna, Austria; (S.G.); (E.S.); (G.H.); (M.B.); (M.C.G.)
| | - Muhammad Faisal
- Shaukat Khanum Memorial Cancer Hospital, Lahore 54000, Pakistan;
| | - Boban M. Erovic
- Institute of Head and Neck Diseases, Evangelical Hospital, 1180 Vienna, Austria; (B.M.); (B.M.E.)
| | - Stefan Janik
- Department of Otorhinolaryngology, Head and Neck Surgery, Medical University of Vienna, 1090 Vienna, Austria; (S.G.); (E.S.); (G.H.); (M.B.); (M.C.G.)
- Correspondence:
| |
Collapse
|
12
|
Maržić D, Čoklo M, Marijić B, Hadžisejdić I, Dekanić A, Krstulja M, Šepić T, Avirović M, Braut T. The expression of ribonuclear protein IMP3 in laryngeal carcinogenesis. Pathol Res Pract 2020; 216:152974. [PMID: 32370989 DOI: 10.1016/j.prp.2020.152974] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2020] [Revised: 04/11/2020] [Accepted: 04/13/2020] [Indexed: 12/15/2022]
Abstract
OBJECTIVE The aim of the study was to investigate the expression of ribonuclear protein IMP3 in laryngeal carcinogenesis, together with other biomarkers of carcinogenesis (Ki-67, p53 and cyclin D1), and to evaluate their predictive values. METHODS The study included 153 patients divided into three groups: 68 operated for primary invasive laryngeal squamous cell carcinoma (LSCC); 41 with precancerous lesions of atypical and abnormal hyperplasia; 44 with hyperplastic laryngeal nodule without atypia. Tissue microarray technique was used for immunohistochemical analysis. RESULTS All markers showed statistically significant differences between the three groups. The percentage of IMP3 positive cells is statistically significantly higher in LSCC group in comparison to precancerosis and control group. The percentage of Ki-67 positive cells is statistically significantly higher in LSCC group in comparison to precancerosis and control group. The percentage of p53 positive cells in LSCC group is statistically significantly higher than the control group and higher, but not statistically significant, than the precancerosis group. The percentage of cyclin D1 positive cells is statistically significantly higher in LSCC group than in precancerosis group and higher, but not statistically significant, than in the control group. All analyzed markers have good predictive values (AUC > 0.6), but the percentage of IMP3 positive cells is the only statistically significant marker in predicting whether the patient has LSCC or not. CONCLUSION Expression of Ki-67 and pronouncedly IMP3 generally follow the same pattern where control and precancerosis are similar and LSCC significantly differs, as opposed to p53 and cyclin D1. IMP3 expression increase possibly has an important diagnostic, therapeutic (in terms of the need for additional therapy after surgery) and prognostic value. Further studies on the exact molecular mechanisms behind it are, of course, needed.
Collapse
Affiliation(s)
- Diana Maržić
- Department of Audiology and Phoniatrics, Clinical Hospital Centre Rijeka, Rijeka, Croatia; Department of Otorhinolaryngology, Faculty of Medicine, University of Rijeka, Rijeka, Croatia
| | - Miran Čoklo
- Centre for Applied Bioanthropology, Institute for Anthropological Research, Zagreb, Croatia
| | - Blažen Marijić
- Department of Otorhinolaryngology, Faculty of Medicine, University of Rijeka, Rijeka, Croatia; Clinic for Otorhinolaryngology and Head and Neck Surgery, Clinical Hospital Centre Rijeka, Rijeka, Croatia
| | - Ita Hadžisejdić
- Department of Pathology, Faculty of Medicine, University of Rijeka, Rijeka, Croatia; Clinical Department of Pathology and Cytology, Clinical Hospital Center Rijeka, Rijeka, Croatia
| | - Andrea Dekanić
- Department of Pathology, Faculty of Medicine, University of Rijeka, Rijeka, Croatia
| | - Mira Krstulja
- Department of Pathology, Faculty of Medicine, University of Rijeka, Rijeka, Croatia
| | - Tatjana Šepić
- Department of Audiology and Phoniatrics, Clinical Hospital Centre Rijeka, Rijeka, Croatia; Department of Otorhinolaryngology, Faculty of Medicine, University of Rijeka, Rijeka, Croatia
| | - Manuela Avirović
- Department of Pathology, Faculty of Medicine, University of Rijeka, Rijeka, Croatia
| | - Tamara Braut
- Department of Otorhinolaryngology, Faculty of Medicine, University of Rijeka, Rijeka, Croatia; Clinic for Otorhinolaryngology and Head and Neck Surgery, Clinical Hospital Centre Rijeka, Rijeka, Croatia.
| |
Collapse
|
13
|
Braut T, Krstulja M, Marijić B, Maržić D, Kujundžić M, Brumini G, Vučinić D, Oštarijaš E. Immunohistochemical analysis of vocal cord polyps applying markers of squamous cell carcinogenesis. Pathol Res Pract 2019; 215:144-150. [DOI: 10.1016/j.prp.2018.11.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2018] [Accepted: 11/06/2018] [Indexed: 10/27/2022]
|
14
|
Duletić-Načinović A, Štifter S, Marijić B, Lučin K, Valković T, Petranović D, Jonjić N. Serum IL-6, IL-8, IL-10 and Beta2-Microglobulin in Association with International Prognostic Index in Diffuse Large B Cell Lymphoma. Tumori 2018; 94:511-7. [DOI: 10.1177/030089160809400412] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Aims and Background Diffuse large B-cell lymphoma displays striking heterogeneity at clinical, genetic and molecular levels. The International Prognostic Index is useful to predict the outcome of diffuse large B-cell lymphoma patients. However, patients with identical International Prognostic Index values in clinical practice exhibit marked variability in survival, suggesting the presence of significant residual heterogeneity within each category. Since cytokines such as interleukin-6, -8 and -10 play important roles in the pathogenesis of lymphomas, and plasma level of beta2-microglobulin is associated with the outcome of patients with diffuse large B-cell lymphoma, the aim of the present study was to determine whether these parameters combined with the International Prognostic Index would better stratify these patients to predict their prognosis. Patients and Methods The study included 46 untreated diffuse large B-cell lymphoma patients. Results All study parameters (International Prognostic Index, Ann Arbor stage, extra-nodal involvement, performance status, lactate dehydrogenase, beta2-microglobulin, interleukin-6 and -10, and response to therapy) except for patient age and serum interleukin-8 level were associated with overall survival. In addition, the International Prognostic Index was strongly correlated with beta2-microglobulin, interleukin-6, -8 and -10, and when combined these parameters significantly better stratified patients according to survival. On multivariate analysis, therapeutic response to the primary treatment, elevated interleukin-6 and -10 levels, and the International Prognostic Index were significant predictors of overall survival. Conclusions Our data imply that interleukins and beta2-microglobulin evaluation should be used in association with the International Prognostic Index to define prognostic subgroups in diffuse large B-cell lymphoma patients.
Collapse
Affiliation(s)
| | - Sanja Štifter
- Department of Pathology, School of Medicine, Rijeka, Croatia
| | - Blažen Marijić
- Department of Hematology, Clinical Hospital Center Rijeka, School of Medicine, Rijeka
| | - Ksenija Lučin
- Department of Pathology, School of Medicine, Rijeka, Croatia
| | - Toni Valković
- Department of Hematology, Clinical Hospital Center Rijeka, School of Medicine, Rijeka
| | - Duška Petranović
- Department of Hematology, Clinical Hospital Center Rijeka, School of Medicine, Rijeka
| | - Nives Jonjić
- Department of Pathology, School of Medicine, Rijeka, Croatia
| |
Collapse
|
15
|
Braut T, Marijić B, Sokolić Ž, Kžundić M, Maržić D, Starčević R. Myxoma of the zygomatic bone--a case report. Coll Antropol 2015; 39:215-217. [PMID: 26040093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Myxoma is a benign tumor composed of primitive connective tissue cells and mesenchymal mucousal stroma. Also referred to as, a gelationus or colloidal tumor. Although rare, it can be found in the atrium of the heart, and it is the most common heart tumor. It has also been described in other body sites, one of which is the bone. We report a case of a 57-year-old female patient, with recurrent headaches located in the area of the right half of the face. Radiological analysis (Multislice Computed Tomography of the paranasal sinuses and viscerocranium) was performed, and a formation of irregular contours, destroying the right zygomatic bone, was described, measuring 25 x 17 x 20 mm in its widest diameters. Its me- dial border was adjacent to the lateral wall of the right maxillary sinus and the cortical bone in this segment was thinned, but preserved. A probatory excision was performed in general anesthesia, and the histopathological finding showed, star-like tumor cells embedded in mucoid stroma and infiltrating the bone. After pathohistological confirmation of myxoma, the tumor was excised in total, using infraorbital surgical approach to the zygomatic bone. During the follow-up, the patient was symptom free, without headaches, and there were no signs of local tumor recurrence. Despite of the fact that myxoma behaves as a benign disease in its nature, it can cause destruction of the tissue in the vicinity of the tumor itself and thus major health issues for the patient. A timely proper diagnosis and the right choice of a surgical treatment can help avoid more extensive surgery procedures, as shown in our case report.
Collapse
|
16
|
Mustać E, Matušan-Ilijaš K, Marijić B, Smokvina M, Jonjić N. Predicting the Likelihood of Additional Nodal Metastases in Breast Carcinoma Patients With Positive Sentinel Node Biopsy. Int J Surg Pathol 2009; 18:36-41. [DOI: 10.1177/1066896909332113] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Axillary lymph node dissection (ALND) is an important procedure in the staging of breast cancer patients. However, it is associated with a significant morbidity rate. In addition, using early diagnosis a high number of cases with negative lymph nodes can be identified. A lymph node defined as sentinel lymph node (SLN) would be the first to receive tumoral drainage. A less morbid but accurate staining procedure using mapping and SLN biopsy has been introduced. The aim of this study was to estimate the likelihood of additional disease in the axilla after SLN analysis. A total of 259 breast carcinomas and SLN biopsies followed by ALND were examined. The patient median age was 59 years, approximately 75% of them postmenopausal. Tumor size was 1.4 ± 0.8 cm (almost 80% in pT1). SLNs were positive in 59 of 259 (22.8%) carcinomas, 30 (11.6%) with micrometastases (<2.0 mm) and 29 (11.2%) with metastases. Tumor size ( P = .004) and presence of lymphovascular invasion (LVI; P = .034) were found to be significant predictors of pathologically positive SLN. Following ALND, positive non-SLNs were present mostly in patients with metastasis >2 mm in SLN ( P = .003), in carcinoma with higher nuclear grade ( P = .044), decreased estrogen receptor (ER; P = .042), and progesterone receptor (PR; P = .042). Finally, lymph node status (pN) following SLN and ALND was found to be significantly associated with tumor size ( P = .006), LVI ( P = .037), PR ( P = .023), and Her-2 status ( P < .001). These results point to detailed analysis of primary tumor and SLN that may increase the precision of patient selection for further axillary surgery or radiotherapy.
Collapse
Affiliation(s)
- Elvira Mustać
- Department of Pathology, School of Medicine, University of Rijeka and University Department of Nuclear Medicine, Rijeka University Hospital Center, Rijeka, Croatia,
| | - Koviljka Matušan-Ilijaš
- Department of Pathology, School of Medicine, University of Rijeka and University Department of Nuclear Medicine, Rijeka University Hospital Center, Rijeka, Croatia
| | - Blažen Marijić
- Department of Pathology, School of Medicine, University of Rijeka and University Department of Nuclear Medicine, Rijeka University Hospital Center, Rijeka, Croatia
| | - Miljenko Smokvina
- Department of Pathology, School of Medicine, University of Rijeka and University Department of Nuclear Medicine, Rijeka University Hospital Center, Rijeka, Croatia
| | - Nives Jonjić
- Department of Pathology, School of Medicine, University of Rijeka and University Department of Nuclear Medicine, Rijeka University Hospital Center, Rijeka, Croatia
| |
Collapse
|