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Sattayaraksa T, Charoenlap C, Akarapatima K, Rattanasupar A, Chang A. Isolated focal intrahepatic extramedullary hematopoiesis mimicking hepatocellular carcinoma in a cirrhotic patient with secondary hemochromatosis from thalassemia. Gastroenterol Hepatol Bed Bench 2023; 16:527-531. [PMID: 37070104 PMCID: PMC10105509 DOI: 10.22037/ghfbb.v16i1.2696] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Accepted: 12/21/2022] [Indexed: 04/19/2023]
Abstract
Extramedullary hematopoiesis is a common complication of ineffective erythropoiesis and bone marrow replacement disorders. Because of its nonspecific presentation and radiological appearance, diagnosing focal intrahepatic extramedullary hematopoiesis is challenging and often misdiagnosed as a hepatic tumor. Herein, we describe the case of a 48-year-old male with thalassemia and AE Bart's disease with secondary hemochromatosis and cirrhosis who developed focal intrahepatic extramedullary hematopoiesis mimicking hepatocellular carcinoma. After hepatic resection, extramedullary hematopoiesis was not observed at any site, including in the remaining liver, at the 4-year follow-up.
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Affiliation(s)
| | - Cheep Charoenlap
- Department of Anatomical pathology, Hatyai Hospital, Songkhla, Thailand
| | - Keerati Akarapatima
- Division of Gastroenterology, Department of Internal Medicine, Hatyai Hospital, Songkhla, Thailand
| | - Attapon Rattanasupar
- Division of Gastroenterology, Department of Internal Medicine, Hatyai Hospital, Songkhla, Thailand
| | - Arunchai Chang
- Division of Gastroenterology, Department of Internal Medicine, Hatyai Hospital, Songkhla, Thailand
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Nakwan N, Mahasirimongkol S, Satproedprai N, Chaiyasung T, Kunhapan P, Charoenlap C, Singkhamanan K, Charalsawadi C. Possible association between a polymorphism of EPAS1 gene and persistent pulmonary hypertension of the newborn: a case-control study. J Pediatr (Rio J) 2022; 98:383-389. [PMID: 34678164 PMCID: PMC9432230 DOI: 10.1016/j.jped.2021.09.003] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Revised: 09/20/2021] [Accepted: 09/22/2021] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVE To explore possible genes related to the development of persistent pulmonary hypertension of the newborn (PPHN). METHODS The authors identified 285 single nucleotide polymorphisms (SNPs) of 11 candidate genes (BMPR2, EPAS1, PDE3A, VEGFA, ENG, NOTCH3, SOD3, CPS1, ABCA3, ACVRL1, and SMAD9), using an Illumina Asian Screening Array-24 v1.0 BeadChip Array. The FastLmmC and R package was used for statistical analyses. The chi-square test and Cochrane-Armitage trend test were used to compare the allele and genotype frequencies between the groups and to test the genetic models, respectively. RESULTS A total of 45 PPHN infants and 294 control subjects were analyzed. The most common cause of PPHN was meconium aspiration syndrome. Among the 285 SNPs, 17 SNPs from 6 candidate genes (BMPR2, EPAS1, PDE3A, VEGFA, ENG, and NOTCH3) were significantly associated with PPHN (P < 0.05). After using the Bonferroni correction (P < 0.00018), only the rs17034984 SNP located in intron 1 of the EPAS1 gene remained significantly different between the PPHN and control subjects (P = 0.00014). The frequency of the TC/TT genotype of rs17034984 in the gene with the dominant model was significant in the patients with PPHN (OR = 5.38, 95% CI: 2.15-13.49). The T allele frequency of rs17034984 in the gene showed a significant difference compared with the control subjects (OR = 4.89, 95% CI: 2.03-11.82). CONCLUSIONS The present study suggests that the rs17034984 variant of EPAS1 gene is associated with PPHN.
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Affiliation(s)
- Narongsak Nakwan
- Prince of Songkla University, Faculty of Medicine, Department of Biomedical Sciences, Hat Yai, Thailand; Hat Yai Hospital, Hat Yai Medical Education Center, Department of Pediatrics, Hat Yai, Thailand
| | - Surakameth Mahasirimongkol
- Ministry of Public Heath, Department of Medical Sciences, Division of Genomic Medicine and Innovation Support, Medical Genetics Center, Nonthaburi, Thailand
| | - Nusara Satproedprai
- Ministry of Public Heath, Department of Medical Sciences, Division of Genomic Medicine and Innovation Support, Medical Genetics Center, Nonthaburi, Thailand
| | - Tassamonwan Chaiyasung
- Ministry of Public Heath, Department of Medical Sciences, Division of Genomic Medicine and Innovation Support, Medical Genetics Center, Nonthaburi, Thailand
| | - Punna Kunhapan
- Ministry of Public Heath, Department of Medical Sciences, Division of Genomic Medicine and Innovation Support, Medical Genetics Center, Nonthaburi, Thailand
| | - Cheep Charoenlap
- Hat Yai Hospital, Hat Yai Medical Education Center, Department of Anatomical Pathology, Hat Yai, Thailand
| | - Kamonnut Singkhamanan
- Prince of Songkla University, Faculty of Medicine, Department of Biomedical Sciences, Hat Yai, Thailand
| | - Chariyawan Charalsawadi
- Prince of Songkla University, Faculty of Medicine, Department of Pathology, Hat Yai, Thailand.
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Chang A, Charoenlap C, Akarapatima K, Rattanasupar A, Prachayakul V. Immunoglobulin G4-associated autoimmune hepatitis with peripheral blood eosinophilia: a case report. BMC Gastroenterol 2020; 20:420. [PMID: 33308169 PMCID: PMC7731570 DOI: 10.1186/s12876-020-01559-7] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Accepted: 11/24/2020] [Indexed: 12/12/2022] Open
Abstract
Background Immunoglobulin G4 (IgG4) associated autoimmune hepatitis (AIH) has been recognized as a type of autoimmune disease that responds to corticosteroid. The diagnosis is based on elevation of the serum IgG4 level, abundance of IgG4 enhanced plasma cell infiltration in the portal region of the liver, and satisfaction of the criteria for “definite AIH” under the revised International Autoimmune Hepatitis Group (IAIHG) scoring system. However, the clinical course of the disease is unclear. Case presentation A 65-year-old man with jaundice and peripheral blood eosinophilia.
His IAIHG and simplified score was compatible with definite AIH and his IgG4 level was elevated. Magnetic resonance imaging did not reveal abnormalities in the hepatobiliary system or pancreas. A liver biopsy revealed interface hepatitis with IgG4 positive plasma cell infiltration in the portal region, without evidence of bile duct injury. He responded to 4-week period of induction prednisolone therapy and had no recurring symptoms under maintenance therapy of 5 mg prednisolone during the 3-year follow up. Conclusions This was a rare case that demonstrated an association between IgG4 associated AIH and the presence of peripheral blood eosinophilia.
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Affiliation(s)
- Arunchai Chang
- Division of Gastroenterology, Department of Internal Medicine, Hatyai Hospital, Songkhla, Thailand
| | - Cheep Charoenlap
- Department of Anatomical Pathology, Hatyai Hospital, Songkhla, Thailand
| | - Keerati Akarapatima
- Division of Gastroenterology, Department of Internal Medicine, Hatyai Hospital, Songkhla, Thailand
| | - Attapon Rattanasupar
- Division of Gastroenterology, Department of Internal Medicine, Hatyai Hospital, Songkhla, Thailand
| | - Varayu Prachayakul
- Siriraj Gastrointestinal Endoscopy Center, Division of Gastroenterology, Department of Internal Medicine, Siriraj Hospital, Faculty of Medicine, Mahidol University, Bangkok, 10700, Thailand.
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Nakwan N, Kamolvisit W, Napapongsuriya C, Chaiwiriyawong P, Charoenlap C. Fatal Vernix Caseosa Aspiration Associated With Persistent Pulmonary Hypertension of the Newborn. Pediatr Dev Pathol 2017; 20:168-171. [PMID: 28326961 DOI: 10.1177/1093526616686243] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [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] [Indexed: 11/15/2022]
Abstract
Vernix caseosa aspiration is an extremely rare condition resulting in high mortality if complicated by persistent hypertension of the newborn (PPHN). Herein we offer the first case report of PPHN due to massive vernix caseosa aspiration documented by histopathological examination. This case report is presented to provide a synopsis of the pathoetiology of PPHN related to vernix caseosa aspiration syndrome as likely to be encountered by neonatologists and general pediatricians involved with neonatal care.
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Affiliation(s)
- Narongsak Nakwan
- 1 Department of Pediatrics, Hat Yai Medical Education Center, Hat Yai Hospital, Songkhla, Thailand
| | - Wuttichart Kamolvisit
- 1 Department of Pediatrics, Hat Yai Medical Education Center, Hat Yai Hospital, Songkhla, Thailand
| | - Charoen Napapongsuriya
- 1 Department of Pediatrics, Hat Yai Medical Education Center, Hat Yai Hospital, Songkhla, Thailand
| | | | - Cheep Charoenlap
- 2 Department of Pathology, Hat Yai Medical Education Center, Hat Yai Hospital, Songkhla, Thailand
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Ngan S, Charoenlap C, Imanishi J, Slavin J, Ngan C, Chu J, Chander S, Choong P. Factors influencing unplanned excision in soft tissue sarcoma. Eur J Cancer 2016. [DOI: 10.1016/j.ejca.2016.03.027] [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: 10/21/2022]
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Bianchi G, Charoenlap C, Cocchi S, Rani N, Campagnoni S, Righi A, Frisoni T, Donati DM. Clear cell sarcoma of soft tissue: a retrospective review and analysis of 31 cases treated at Istituto Ortopedico Rizzoli. Eur J Surg Oncol 2014; 40:505-510. [PMID: 24560887 DOI: 10.1016/j.ejso.2014.01.016] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [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: 10/06/2013] [Revised: 01/14/2014] [Accepted: 01/26/2014] [Indexed: 12/12/2022] Open
Abstract
INTRODUCTION Clear cell sarcoma (CCS) of soft tissue is a rare melanocytic soft tissue sarcoma with different cytogenetic and natural history than that of melanoma. Objective of this study was to determine outcome predictors in patients treated in our Institute. This objective included the effectiveness of surgical intervention and disease progression after surgery. MATERIALS AND METHODS Thirty-one patients were diagnosed at our institute with clear cell sarcoma through tissue pathology and immunohistochemistry. Patients received multimodality treatment (surgery, radiotherapy and chemotherapy). Five-year survival rates and prognostic predictors were determined. RESULTS Sixteen patients were males and 15 females with a median age of 37 years (8-72-years). Twenty-eight tumors were located in extremities and 3 in the trunk area. Eight patients had metastases at their first presentation (6 local lymph nodes and 2 pulmonary metastases). Five and ten-year disease-specific survival rates were 56% and 41%. Two-year disease-specific survival rates for lymph node and pulmonary metastasis groups were 40% and 0%. All metastatic patients died within 5 years follow-up. Five and ten-year disease-specific survival rates for localized tumor cases were 72% and 53%. Male gender, less than 30-years of age, trunk tumor location and size greater than 5 cm were poor prognostic factors according to univariate analysis. Tumor location in the trunk was the only negative prognostic determinant in multivariate model. CONCLUSIONS Although surgical treatment may be beneficial for tumors without systemic involvement, new chemotherapeutic agents and molecular targeted therapy should be implemented to improve the oncologic outcome in both early and late stage disease.
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Affiliation(s)
- G Bianchi
- III Clinica Ortopedica, Istituto Ortopedico Rizzoli, Via Pupilli 1, Bologna, Italy.
| | - C Charoenlap
- III Clinica Ortopedica, Istituto Ortopedico Rizzoli, Via Pupilli 1, Bologna, Italy.
| | - S Cocchi
- Department of Pathology, Istituto Ortopedico Rizzoli, Via Pupilli 1, Bologna, Italy.
| | - N Rani
- III Clinica Ortopedica, Istituto Ortopedico Rizzoli, Via Pupilli 1, Bologna, Italy.
| | - S Campagnoni
- III Clinica Ortopedica, Istituto Ortopedico Rizzoli, Via Pupilli 1, Bologna, Italy.
| | - A Righi
- Department of Pathology, Istituto Ortopedico Rizzoli, Via Pupilli 1, Bologna, Italy.
| | - T Frisoni
- III Clinica Ortopedica, Istituto Ortopedico Rizzoli, Via Pupilli 1, Bologna, Italy.
| | - D M Donati
- III Clinica Ortopedica, Istituto Ortopedico Rizzoli, Via Pupilli 1, Bologna, Italy.
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