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Procházková K, Vojtíšek R, Vodička J, Horová J, Hošek P, Skála M, Šebek J, Dostál J, Přibáň V, Pivovarčíková K, Hes O, Třeška V, Moláček J. Hormone receptor conversion in metastatic breast cancer. Rep Pract Oncol Radiother 2024; 28:746-755. [PMID: 38515821 PMCID: PMC10954261 DOI: 10.5603/rpor.98730] [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: 08/24/2023] [Accepted: 12/04/2023] [Indexed: 03/23/2024] Open
Abstract
Background/Objective Hormone receptor (HR) status is one of the key factors in determining the treatment of breast cancer. Previous studies suggested that HR status may change in metastatic tissue. However, available studies focused mainly on primary biopsies and there are only few trials comparing HR status in the primary tumour and the metastasis using material from complete resection. The aim of the study was to determine the frequency of HR alterations in metastatic breast cancer. Materials and methods The study retrospectively examines a total of 50 patients who underwent brain, lung, or liver metastasectomy for metastatic breast cancer between January 2000 and January 2019. Results HR conversion was observed in a total of 30 cases (60.0%), while HER-2/neu (human epidermal growth factor receptor 2) discrepancy surprisingly occurred only in one case (2.0%). A change in immunophenotype occurred in 28% of cases. Triple-negativity was more frequent in brain metastases (p = 0.039). Conclusions We have confirmed that HR conversion between the primary tumour and its metastases occurs in a significant number of cases, which has important implications for further treatment decisions.
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Affiliation(s)
- Kristýna Procházková
- Department of Surgery, Charles University and University Hospital, Pilsen, Czech Republic
| | - Radovan Vojtíšek
- Department of Oncology and Radiotherapy, Charles University and University Hospital, Pilsen, Czech Republic
| | - Josef Vodička
- Department of Surgery, Charles University and University Hospital, Pilsen, Czech Republic
| | - Jana Horová
- Department of Neurology, Charles University and University Hospital, Pilsen, Czech Republic
| | - Petr Hošek
- Biomedical Center, Faculty of Medicine in Pilsen, Charles University, Pilsen, Czech Republic
| | - Martin Skála
- Department of Surgery, Charles University and University Hospital, Pilsen, Czech Republic
| | - Jakub Šebek
- Department of Surgery, Charles University and University Hospital, Pilsen, Czech Republic
| | - Jiří Dostál
- Department of Neurosurgery, Charles University and University Hospital, Pilsen, Czech Republic
| | - Vladimír Přibáň
- Department of Neurosurgery, Charles University and University Hospital, Pilsen, Czech Republic
| | - Kristýna Pivovarčíková
- Department of Pathology, Charles University and University Hospital, Pilsen, Czech Republic
| | - Ondřej Hes
- Department of Pathology, Charles University and University Hospital, Pilsen, Czech Republic
| | - Vladislav Třeška
- Department of Surgery, Charles University and University Hospital, Pilsen, Czech Republic
| | - Jiří Moláček
- Department of Surgery, Charles University and University Hospital, Pilsen, Czech Republic
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Ferda J, Hes O, Hora M, Ferdová E, Pernický J, Rudnev V, Pecen L, Topolčan O, Mírka H. Assessment of Prostate Carcinoma Aggressiveness: Relation to 68Ga-PSMA-11-PET/MRI and Gleason Score. Anticancer Res 2023; 43:449-453. [PMID: 36585198 DOI: 10.21873/anticanres.16181] [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: 08/29/2022] [Revised: 10/10/2022] [Accepted: 10/14/2022] [Indexed: 01/01/2023]
Abstract
BACKGROUND/AIM To test the correlation of 68Ga-PSMA-11 uptake and the expression of PSMA (prostatic specific membrane antigen) with the Gleason score, apparent diffusion coefficient (ADC) and pharmacokinetic parameters obtained from dynamic contrast agent-enhanced MRI/PET. PATIENTS AND METHODS Forty newly diagnosed, therapy naïve patients with prostatic carcinoma (PC) (mean age of 56.7, range=34-79), who were referred for 68Ga-PSMA-11-PET/MRI for primary staging and had undergone radical prostatectomy (RAPE) were included in this prospective study. Their blood samples were tested for serum levels of prostate-specific antigen (PSA) and proPSA. The patients' prostates were evaluated using whole-mount sections, which helped determine the extent and grade of the tumor; tests were performed to determine immunohistochemical PSMA expression. RESULTS A correlation between PSMA expression and the accumulation of 68Ga-PSMA-11 was found using the Spearman correlation coefficient (p=0.0011). A stronger correlation was found between Gleason patterns 3 or 4 and PSMA expression (p=0.06). Furthermore, the correlation of Gleason score with the overall 68Ga-PSMA-11 accumulation within the tumor or non-tumor tissue was found to be significant (p=0.0157). A significant relation was found only with the Kep elimination rate constant, which was stronger in Gleason pattern 4 than in Gleason pattern 3. A weaker correlation was found between the accumulation of 68Ga-PSMA-11 and Ktrans in Gleason pattern 4: the most significant relation being between ADCmin and Gleason pattern 3 and 4 (p=0.0074). The total size of the tumor correlated with levels of proPSA (p<0.0001), and its extra prostatic extension correlated with levels of proPSA (p<0.0001). CONCLUSION 68Ga-PSMA-11 correlates well with the expression of PSMA. Gleason pattern 3 and 4 had a higher correlation with 68Ga-PSMA-11 levels than did Gleason pattern 5. Either no correlation, or a weak correlation, was established with pharmacokinetics.
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Affiliation(s)
- Jiří Ferda
- Department of Imaging Methods, University Hospital Pilsen, Charles University, Medical Faculty in Pilsen, Pilsen, Czech Republic; .,Institute of Anatomy, University Hospital Pilsen, Charles University, Medical Faculty in Pilsen, Pilsen, Czech Republic
| | - Ondřej Hes
- Šikl's Institute of Pathological Anatomy, University Hospital Pilsen, Charles University, Medical Faculty in Pilsen, Pilsen, Czech Republic
| | - Milan Hora
- Department of Urology, University Hospital Pilsen, Charles University, Medical Faculty in Pilsen, Pilsen, Czech Republic
| | - Eva Ferdová
- Department of Imaging Methods, University Hospital Pilsen, Charles University, Medical Faculty in Pilsen, Pilsen, Czech Republic
| | - Jan Pernický
- Department of Imaging Methods, University Hospital Pilsen, Charles University, Medical Faculty in Pilsen, Pilsen, Czech Republic.,Institute of Anatomy, University Hospital Pilsen, Charles University, Medical Faculty in Pilsen, Pilsen, Czech Republic
| | - Vladimir Rudnev
- Department of Imaging Methods, University Hospital Pilsen, Charles University, Medical Faculty in Pilsen, Pilsen, Czech Republic.,Institute of Anatomy, University Hospital Pilsen, Charles University, Medical Faculty in Pilsen, Pilsen, Czech Republic
| | - Ladislav Pecen
- Division of Immunochemical Diagnostics, University Hospital Pilsen, Charles University, Medical Faculty in Pilsen, Pilsen, Czech Republic
| | - Ondřej Topolčan
- Division of Immunochemical Diagnostics, University Hospital Pilsen, Charles University, Medical Faculty in Pilsen, Pilsen, Czech Republic
| | - Hynek Mírka
- Department of Imaging Methods, University Hospital Pilsen, Charles University, Medical Faculty in Pilsen, Pilsen, Czech Republic
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Šámal V, Jirásek T, Paldus V, Richter I, Hes O. Urachal yolk sac tumor penetrating the bladder as a diagnostic challenge: a case report and review of the literature. Diagn Pathol 2022; 17:8. [PMID: 35027045 PMCID: PMC8759170 DOI: 10.1186/s13000-022-01190-y] [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: 06/24/2021] [Accepted: 12/30/2021] [Indexed: 11/10/2022] Open
Abstract
Background Yolk sac tumor (YST) is a germ cell tumor. It is primarily located in the gonads but can also occur extragonadally (extragonadal yolk sac tumor - EGYST), most commonly in the pelvis, retroperitoneum or mediastinum. Only a few YSTs of the urachus have been described. Case report We present a rare case report of a 37-year-old male with episodes of macroscopic hematuria. The histological specimen obtained by transurethral resection showed a solid, and in some parts papillary infiltrative, high-grade tumor with numerous areas of marked nuclear atypia and clear invasion between the detrusor bundles. Glandular pattern has been observed in only minority of the tumor. Immunohistochemistry showed significant positivity for GPC3, SALL4 and cytokeratins AE1/AE3, while KRT7 and GATA3 were negative. We concluded that the biopsy findings were consistent with urothelial carcinoma with infrequent YST differentiation. In definitive surgical specimens we found a malignant epithelial, glandular and cystically arranged tumor of germinal appearance arising from urachus. The surrounding urothelium was free of invasive or in situ tumor changes. We reclassified the tumor as a urachal YST. Conclusion EGYST was suspected because glandular and hepatoid structures were found, but the presence of these structures should be verified by immunohistochemistry.
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Affiliation(s)
- Vladimír Šámal
- Department of Urology, Krajská Nemocnice Liberec a.s, Liberec, Czech Republic. .,Department Of Urology, Faculty of Medicine in Hradec Králové, Charles University, Prague, Czech Republic.
| | - Tomáš Jirásek
- Department of Pathology, Krajská Nemocnice Liberec, a.s, Liberec, Czech Republic
| | - Vít Paldus
- Department of Urology, Krajská Nemocnice Liberec a.s, Liberec, Czech Republic
| | - Igor Richter
- Department of Oncology, Krajská Nemocnice Liberec, a.s, Liberec, Czech Republic.,Department of Oncology, First Faculty of Medicine, Charles University and Thomayer Hospital, Prague, Czech Republic
| | - Ondřej Hes
- Charles University and University Hospital Pilsen, Pilsen, Czech Republic
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4
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Michalová K, Hes O, Michal M. Key changes in WHO classification 2022 of testicular tumors. Cesk Patol 2022; 67:198-204. [PMID: 36513505] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
Compared to the WHO classification of the male genital tumors in 2016, minimal changes were introduced in the current WHO 2022. Classification of germ cell tumors remains the same as in the previous edition, dividing germ cell tumors into those derived from germ cell neoplasia in situ (GCNIS) and those independent of GCNIS. The group of GCNIS derived germ cell tumors is essentially unchanged. Most remarkable change was made to the chapter teratoma with somatic malignancy. Primitive neuroectodermal tumor (PNET), a particular type of somatic malignancy arising in the setting of teratoma, is currently termed embryonic-type neuroectodermal tumor (ENET). Diagnostic criteria for teratoma with somatic type malignancy have been mildly modified. Seminoma now belongs to the group of germinomas. There is one novel entity in the category of germ cell tumors independent of GCNIS, namely testicular neuroendocrine tumor, prepubertal type. Similar to other organ systems, the term carcinoid is no longer used. Two new entities were introduced in the category of sex cord stromal tumors: myoid gonadal stromal tumor and signet ring stromal tumor. Diagnostic criteria for malignant sex cord stromal tumors were moderately changed. Mitotic activity is now assessed according to mm2 instead of historical assessment according to the number of mitoses per high power fields. There is a new separate chapter named Genetic tumor syndromes. Intratubular large cell hyalinizing Sertoli cell neoplasia which arises exclusively in patients with Peutz-Jeghers syndrome, now belongs here. Large cell calcifying Sertoli cell tumor occurs as a hereditary tumor in patients with Carney complex as well as sporadically. Therefore, it is enlisted both in the chapter on sex cord tumors and as well as in genetic tumor syndromes. Well differentiated papillary mesothelial tumor was added as a new entity to the section of testicular adnexal tumors. Sertoliform cystadenoma, a tumor previously belonging to testicular adnexal tumors, is currently recognized as a subtype of Sertoli cell tumor.
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Abstract
Eosinophilic solid and cystic renal cell carcinoma (ESC-RCC) is an emerging entity in renal neoplasia with distinctive histopathological findings and a generally favorable prognosis. The presence of melanin pigment in a renal tumor typically prompts the observer to consider the microphthalmia-associated transcription family translocation renal cell carcinomas. We present a renal tumor occurring in a 19-year-old male patient which had the typical morphology of ESC-RCC but showed the additional finding of focal melanin pigment. This tumor showed strong and diffuse positive immunolabeling with paired box gene 8 and cytokeratin 20, and was negative with epithelial membrane antigen, carbonic anhydrase 9, CD117, cytokeratin 7, and transcription factor E3. Human melanoma black-45 showed focal positivity, but Melan-A was negative. Next-generation sequencing revealed a mutation in the TSC2 gene (c.4490C > G, p.[Pro1497Arg] and c.1257 + 1del) and break apart fluorescence in-situ hybridization with TFE3 and TFEB probes was negative. In this case report, we present the novel finding of melanin pigment occurring in a genetically proven and otherwise typical ESC-RCC, and briefly discuss the differential diagnostic considerations.
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Affiliation(s)
- Alessandro Pietro Aldera
- 63726University of Cape Town, Cape Town, South Africa.,JDW Pathology Incorporated, Cape Town, South Africa
| | - Ondřej Hes
- 37740Charles University, Prague, Czech Republic.,University Hospital, Pilsen, Czech Republic
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Opatrný V, Třeška V, Zeithaml J, Hes O, Matějka R, Moláček J. Perfusion of a Kidney Graft from a Donor After Cardiac Death Based on Immediately Started Machine Perfusion: An Experimental Study on a Big Animal. Transplant Proc 2021; 53:2082-2090. [PMID: 34274120 DOI: 10.1016/j.transproceed.2021.06.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2021] [Revised: 05/13/2021] [Accepted: 06/14/2021] [Indexed: 11/24/2022]
Abstract
BACKGROUND Donation after circulatory death donors are becoming a common source of organs for transplant. Despite good long-term outcomes of grafts from donation after circulatory death, this group is affected by a higher occurrence of delayed graft function and primary nonfunction. Our hypothesis is based on the assumption that washing the kidney grafts in the donor's body using a simple mechanical perfusion pump will result in faster and better perfusion of the parenchyma and more efficient cooling compared with hydrostatic perfusion alone. METHODS A total of 7 experimental animals (pigs) were used. The animals were divided into 2 groups: group A (n = 3) and group B (n = 4). After a 30-minute ischemic period for the selected kidney (clamped renal vessels), intra-arterial perfusion was performed. In group A perfusion was performed using hydrostatic pressure; in group B mechanical controlled perfusion was performed. After perfusion, declamping of the renal vessels caused restoration of flow. For graft quality evaluation, biopsy specimens were harvested, and the cooling speed was observed. Laboratory markers or renal failure were determined. RESULTS We found no significant differences between temperature drop and total diuresis between groups A and B. A significant difference was found between the groups in both flow parameters (flow maximum and mean flow) (P = .007, respectively P = .019). No laboratory parameters were found to be statistically significantly different. Histopathological analysis strongly supports the hypothesis of better flushing of kidney grafts using mechanical perfusion. CONCLUSIONS Based on our results, better kidney graft quality can be expected after immediately started mechanical perfusion in situ.
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Affiliation(s)
- Václav Opatrný
- Faculty of Medicine in Plzen, Department of Surgery, Charles University, University Hospital in Plzen, Plzen, Czech Republic; Faculty of Medicine in Plzen, Transplantcentrum, Charles University, University Hospital in Plzen, Plzen, Czech Republic
| | - Vladislav Třeška
- Faculty of Medicine in Plzen, Department of Surgery, Charles University, University Hospital in Plzen, Plzen, Czech Republic; Faculty of Medicine in Plzen, Transplantcentrum, Charles University, University Hospital in Plzen, Plzen, Czech Republic
| | - Jan Zeithaml
- Faculty of Medicine in Plzen, Department of Surgery, Charles University, University Hospital in Plzen, Plzen, Czech Republic
| | - Ondřej Hes
- Sikl's Institute of Pathological Anatomy, University Hospital in Plzen, Plzen, Czech Republic
| | - Roman Matějka
- Faculty of Biomedical Engineering, Czech Technical University in Prague, Prague, Czech Republic
| | - Jiří Moláček
- Faculty of Medicine in Plzen, Department of Surgery, Charles University, University Hospital in Plzen, Plzen, Czech Republic; Faculty of Medicine in Plzen, Transplantcentrum, Charles University, University Hospital in Plzen, Plzen, Czech Republic.
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7
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Sedláčková H, Dolejšová O, Hora M, Ferda J, Hes O, Topolčan O, Fuchsová R, Kučera R. Prostate Cancer Diagnostic Algorithm as a "Road Map" from the First Stratification of the Patient to the Final Treatment Decision. Life (Basel) 2021; 11:life11040324. [PMID: 33917253 PMCID: PMC8068075 DOI: 10.3390/life11040324] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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: 02/28/2021] [Revised: 04/05/2021] [Accepted: 04/06/2021] [Indexed: 11/16/2022] Open
Abstract
The diagnostics of prostate cancer are currently based on three pillars: prostate biomarker panel, imaging techniques, and histological verification. This paper presents a diagnostic algorithm that can serve as a "road map": from initial patient stratification to the final decision regarding treatment. The algorithm is based on a review of the current literature combined with our own experience. Diagnostic algorithms are a feature of an advanced healthcare system in which all steps are consciously coordinated and optimized to ensure the proper individualization of the treatment process. The prostate cancer diagnostic algorithm was created using the prostate specific antigen and in particular the Prostate Health Index in the first line of patient stratification. It then continued on the diagnostic pathway via imaging techniques, biopsy, or active surveillance, and then on to the treatment decision itself. In conclusion, the prostate cancer diagnostic algorithm presented here is a functional tool for initial patient stratification, comprehensive staging, and aggressiveness assessment. Above all, emphasis is placed on the use of the Prostate Health Index (PHI) in the first stratification of the patients as a predictor of aggressiveness and clinical stage of prostrate cancer (PCa). The inclusion of PHI in the algorithm significantly increases the accuracy and speed of the diagnostic procedure and allows to choose the optimal pathway just from the beginning. The use of advanced diagnostic techniques allows us to move towards to a more advanced level of cancer care. This diagnostics algorithm has become a standard of care in our hospital. The algorithm is continuously validated and modified based on our results.
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Affiliation(s)
- Hana Sedláčková
- Department of Urology, Faculty of Medicine in Pilsen, University Hospital, 305 99 Pilsen, Czech Republic; (H.S.); (O.D.); (M.H.)
| | - Olga Dolejšová
- Department of Urology, Faculty of Medicine in Pilsen, University Hospital, 305 99 Pilsen, Czech Republic; (H.S.); (O.D.); (M.H.)
| | - Milan Hora
- Department of Urology, Faculty of Medicine in Pilsen, University Hospital, 305 99 Pilsen, Czech Republic; (H.S.); (O.D.); (M.H.)
| | - Jiří Ferda
- Department of Medical Imaging, Faculty of Medicine in Pilsen, University Hospital, 304 60 Pilsen, Czech Republic;
| | - Ondřej Hes
- Department of Pathology, Faculty of Medicine in Pilsen, University Hospital, 305 99 Pilsen, Czech Republic;
| | - Ondřej Topolčan
- Department of Immunochemistry Diagnostics, Faculty of Medicine in Pilsen, University Hospital, 305 99 Pilsen, Czech Republic; (O.T.); (R.F.)
| | - Radka Fuchsová
- Department of Immunochemistry Diagnostics, Faculty of Medicine in Pilsen, University Hospital, 305 99 Pilsen, Czech Republic; (O.T.); (R.F.)
| | - Radek Kučera
- Department of Immunochemistry Diagnostics, Faculty of Medicine in Pilsen, University Hospital, 305 99 Pilsen, Czech Republic; (O.T.); (R.F.)
- Institute of Pharmacology and Toxicology, Medical Faculty in Pilsen, Charles University, 304 60 Pilsen, Czech Republic
- Correspondence: ; Tel.: +420-603456958
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8
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Ptáková N, Martínek P, Holubec L, Janovský V, Vančurová J, Grossmann P, Navarro PA, Rodriguez Moreno JF, Alaghehbandan R, Hes O, Májek O, Pešek M, Michal M, Ondič O. Identification of tumors with NRG1 rearrangement, including a novel putative pathogenic UNC5D-NRG1 gene fusion in prostate cancer by data-drilling a de-identified tumor database. Genes Chromosomes Cancer 2021; 60:474-481. [PMID: 33583086 DOI: 10.1002/gcc.22942] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Revised: 02/02/2021] [Accepted: 02/10/2021] [Indexed: 12/13/2022] Open
Abstract
The fusion genes containing neuregulin-1 (NRG1) are newly described potentially actionable oncogenic drivers. Initial clinical trials have shown a positive response to targeted treatment in some cases of NRG1 rearranged lung adenocarcinoma, cholangiocarcinoma, and pancreatic carcinoma. The cost-effective large scale identification of NRG1 rearranged tumors is an open question. We have tested a data-drilling approach by performing a retrospective assessment of a de-identified molecular profiling database of 3263 tumors submitted for fusion testing. Gene fusion detection was performed by RNA-based targeted next-generation sequencing using the Archer Fusion Plex kits for Illumina (ArcherDX Inc., Boulder, CO). Novel fusion transcripts were confirmed by a custom-designed RT-PCR. Also, the aberrant expression of CK20 was studied immunohistochemically. The frequency of NRG1 rearranged tumors was 0.2% (7/3263). The most common histologic type was lung adenocarcinoma (n = 5). Also, renal carcinoma (n = 1) and prostatic adenocarcinoma (n = 1) were found. Identified fusion partners were of a wide range (CD74, SDC4, TNC, VAMP2, UNC5D), with CD74, SDC4 being found twice. The UNC5D is a novel fusion partner identified in prostate adenocarcinoma. There was no co-occurrence with the other tested fusions nor KRAS, BRAF, and the other gene mutations specified in the applied gene panels. Immunohistochemically, the focal expression of CK20 was present in 2 lung adenocarcinomas. We believe it should be considered as an incidental finding. In conclusion, the overall frequency of tumors with NRG1 fusion was 0.2%. All tumors were carcinomas. We confirm (invasive mucinous) lung adenocarcinoma as being the most frequent tumor presenting NRG1 fusion. Herein novel putative pathogenic gene fusion UNC5D-NRG1 is described. The potential role of immunohistochemistry in tumor identification should be further addressed.
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Affiliation(s)
- Nikola Ptáková
- Molecular Genetics Department, Bioptická Laboratoř s.r.o., Pilsen, Czech Republic.,Second Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Petr Martínek
- Molecular Genetics Department, Bioptická Laboratoř s.r.o., Pilsen, Czech Republic
| | - Luboš Holubec
- Department of Clinical Oncology, Na Homolce Hospital, Prague, Czech Republic.,Second Department of Internal Medicine, Medical Faculty in Pilsen, Charles University Prague, Pilsen, Czech Republic
| | - Václav Janovský
- Department of Oncology, Hospital České Budějovice, České Budějovice, Czech Republic
| | - Jana Vančurová
- Department of Oncology, Hospital České Budějovice, České Budějovice, Czech Republic
| | - Petr Grossmann
- Molecular Genetics Department, Bioptická Laboratoř s.r.o., Pilsen, Czech Republic
| | - Paloma Alcaraz Navarro
- Department of Pathology, FiHM-Centro Integral Oncológico Hospital de Madrid Clara Campal, Madrid, Spain
| | - Juan F Rodriguez Moreno
- Department of Pathology, FiHM-Centro Integral Oncológico Hospital de Madrid Clara Campal, Madrid, Spain
| | - Reza Alaghehbandan
- Department of Pathology, University of British Columbia, Royal Columbian Hospital, Vancouver, British Columbia, Canada
| | - Ondřej Hes
- Department of Pathology, Medical Faculty in Pilsen, Charles University Prague, Pilsen, Czech Republic
| | - Ondřej Májek
- Institute of Biostatistics and Analyses, Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Miloš Pešek
- Department of Pneumology and Phthisiology, Medical Faculty in Pilsen, Charles University Prague, Pilsen, Czech Republic
| | - Michal Michal
- Department of Pathology, Medical Faculty in Pilsen, Charles University Prague, Pilsen, Czech Republic
| | - Ondrej Ondič
- Molecular Genetics Department, Bioptická Laboratoř s.r.o., Pilsen, Czech Republic.,Department of Pathology, Medical Faculty in Pilsen, Charles University Prague, Pilsen, Czech Republic
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Beniač P, Dolejšová O, Űrge T, Ferdová E, Hes O, Hora M. Testicular Leydig cell tumors. EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)36270-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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10
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Abstract
Primary urethral adenocarcinomas are very rare neoplasms accounting for <10% of all urethral carcinomas. Site of their origin is unclear, but they seem to arise from Skene's paraurethral glands, which is the female homologue of the male prostate. The aim of this article is to report the first case of Skene's gland adenocarcinoma in which a molecular genetic profiling was performed. The patient was a 73-year-old woman with a polypoid lesion sized 3 × 2 cm located at the interface between the bladder neck and the proximal urethra. Transurethral resection was performed and small tissue fragments with positive margins were obtained. Histology revealed an epithelial neoplasm consisting of cribriform structures located in the subepithelial connective tissue of the bladder wall and proximal urethra. The lesion showed positive immunohistochemical staining with prostate specific antigen, prostatic acid phosphatase, NKX3.1, and alpha-methylacyl-CoA racemase. Using the Illumina TruSight Tumor 170 next-generation sequencing assay, a mutation and loss of heterozygosity of the phosphatase and tensin homologue (PTEN) gene was detected. No fusion in any of the examined genes was found using this assay as well as FusionPlex Solid Tumor Kit and FusionPlex Sarcoma kit assays from ArcherDX. Given the rarity of Skene's gland adenocarcinoma, it is uncertain whether the same grading and prognostic criteria that are currently used for prostatic cancer apply here as well. It is also unclear what treatment strategy should be applied, but according to the available literature, it seems that local excision or wide surgical resection could represent sufficient therapeutic modalities.
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Affiliation(s)
- Jiří Lenz
- Department of Pathology, 48246Znojmo Hospital, Czech Republic.,48384Cytohisto s.r.o., Breclav, Czech Republic.,Department of Anatomy, Histology and Embryology, Faculty of Veterinary Medicine, University of Veterinary and Pharmaceutical Sciences Brno, Czech Republic
| | - Michal Michal
- Department of Pathology, 60569Faculty of Medicine in Pilsen, Charles University, Pilsen, Czech Republic.,Bioptical Laboratory Ltd., Pilsen, Czech Republic
| | - Michael Michal
- Department of Pathology, 60569Faculty of Medicine in Pilsen, Charles University, Pilsen, Czech Republic.,Bioptical Laboratory Ltd., Pilsen, Czech Republic.,Biomedical Center, Faculty of Medicine in Pilsen, Charles University, Pilsen, Czech Republic
| | - Ondřej Hes
- Department of Pathology, 60569Faculty of Medicine in Pilsen, Charles University, Pilsen, Czech Republic.,Bioptical Laboratory Ltd., Pilsen, Czech Republic
| | - Petra Konečná
- Department of Anatomy, Histology and Embryology, Faculty of Veterinary Medicine, University of Veterinary and Pharmaceutical Sciences Brno, Czech Republic
| | - David Lenz
- 48384Cytohisto s.r.o., Breclav, Czech Republic
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Hora M, Trávníček I, Nykodýmová Š, Mlynarčík M, Ferda J, Kacerovská D, Hes O. VEILND (Video Endoscopic Inguinal Lymph Node Dissection) with florescence Idocyanine Green (ICG) marking of sentinel lymph node in penile cancer ≥ pT1G2 and cN0. EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)34117-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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12
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Pivovarčíková K, Michalová K, Hes O. Immunohistochemistry and renal neoplasias. Cesk Patol 2020; 56:130-139. [PMID: 33076665] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Tento přehledový článek stručně shrnuje možnosti využití imunohistochemie při vyšetřování především renálních karcinomů a základní molekulárně genetické znaky vybraných neoplázií. Článek však v žádném případě nelze brát jako univerzální návod pro diagnostiku renálních tumorů. Renální karcinomy dokážou mít velmi variabilní morfologický vzhled a to i v rámci jedné léze (nádorová heterogenita) a často velmi nepředvídatelný a neuniformní imunohistochemický profil. Některé renální neoplázie jsou diagnostikovány striktně na podkladě molekulárně-genetických vlastností, bez ohledu na morfologický vzhled.
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Pivovarčíková K, Hes O. Immunohistochemistry in prostate pathology. Cesk Patol 2020; 56:161-167. [PMID: 33076668] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
The diagnosis of prostatic adenocarcinoma is based on a combination of histological features, none of which is absolutely sensitive and specific. Immunohistochemical examination is therefore sometimes necessary in difficult cases for confirmation of the diagnosis and distinction of mimickers. The second major indication of immunohistochemical staining in prostatic pathology is metastatic prostatic adenocarcinoma.
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Pivovarčíková K, Švajdler M, Hes O. Immunohistochemistry in hollow urinary tract. Cesk Patol 2020; 56:140-152. [PMID: 33076666] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
There is no ideal marker or established immunohistochemistry panel to confirm urothelial differentiation. Immunohistochemistry must be always indicated in concrete differential diagnostic consideration. In this review article, immunohistochemistry will be discussed in the three different settings - distinction of benign and malignant changes of urothelium, the most frequent pitfalls and non-urothelial neoplasms of urinary tract.
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Michalová K, Michal M, Hora M, Hes O, Michal M. Practices recommendations in the applications of immunohistochemistry and molecular genetics in testicular tumors. Review article. Cesk Patol 2020; 56:153-160. [PMID: 33076667] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
The great majority of testicular tumors can be diagnosed on the basis of morphology, while immunohistochemistry and molecular genetics assist in only a small proportion of cases. Similar to other areas of pathology, ancillary diagnostic methods have to be used responsibly and assessed in correlation with morphological, serological and clinical findings. Prior to their effective use, a limited differential diagnosis based on morphology is required.The significance of germ cell tumors is underscored by the fact that they represent the most frequent solid neoplasms occurring in men between 20-30 years and if diagnosed correctly and in early stage, they have excellent prognosis. From the molecular genetic standpoint, germ cell tumors stand apart from the current trend of tumor stratification based on molecular profiles. It is mainly due to the low mutational load, since the main genetic abnormality are chromosomal aneuploidies. Given the frequency of germ cell tumors among testicular neoplasms and since morphology is usually diagnostically most valuable, this review article is focused mainly on germ cell tumors, emphasizing the morphological features. Sertoli cell tumor, NOS is the only sex-cord stromal tumor included in this review as its diagnosis can be challenging. For practical purposes, this reviewis focused on differential diagnosis, including only entities where misdiagnosis would have impact on clinical outcome.
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Kruslin B, Gatalica Z, Hes O, Xiu J, Florento E, Swensen J. TERT gene fusions characterize a subset of metastatic Leydig cell tumours. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz249.077] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Procházková K, Vodička J, Fichtl J, Krákorová G, Šebek J, Roušarová M, Hošek P, Brookman May SD, Hes O, Hora M, Třeška V. Outcomes for Patients after Resection of Pulmonary Metastases from Clear Cell Renal Cell Carcinoma: 18 Years of Experience. Urol Int 2019; 103:297-302. [PMID: 31434090 DOI: 10.1159/000502493] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [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: 07/16/2019] [Accepted: 07/31/2019] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Clear cell renal cell carcinoma (ccRCC) is the most common kidney tumor. If feasible, metastasectomy is preferably indicated in metastatic disease. OBJECTIVE The aim of this study was to determine the outcome of patients after pulmonary metastasectomy (PM). METHODS PM for ccRCC was performed in 35 patients in the period of January 2001-2019. Clinical characteristics, type of surgery, histopathology results, and follow-up data were recorded. Progression-free survival (PFS) after PM and overall survival (OS) were defined as outcome endpoints. RESULTS A total of 77 PMs were performed in 35 patients after nephrectomy for ccRCC. The mean size of pulmonary metastasis was 19.0 mm (4-90). With a median follow-up after PM of 79.2 months, the 3- and 5-year OS rates were 63.5 and 44.9%, respectively. The only statistically significant prognostic factor affecting both PFS (p = 0.019) and OS (p = 0.015) was the dimension of pulmonary metastases. CONCLUSIONS The prognosis of metastatic ccRCC is generally poor, particularly in cases of larger size of metastasis. PM might improve the individual prognosis of patients with lung metastasis even in cases with higher number of metastases, bilaterality, synchronous metastasis, or a short progression-free interval after nephrectomy.
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Affiliation(s)
- Kristýna Procházková
- Department of Surgery, Charles University, Faculty of Medicine in Pilsen and University Hospital Pilsen, Pilsen, Czechia
| | - Josef Vodička
- Department of Surgery, Charles University, Faculty of Medicine in Pilsen and University Hospital Pilsen, Pilsen, Czechia,
| | - Jakub Fichtl
- Department of Surgery, Charles University, Faculty of Medicine in Pilsen and University Hospital Pilsen, Pilsen, Czechia
| | - Gabriela Krákorová
- Department of Pneumology and Phtisiology, Charles University, Faculty of Medicine in Pilsen and University Hospital Pilsen, Pilsen, Czechia
| | - Jakub Šebek
- Department of Surgery, Charles University, Faculty of Medicine in Pilsen and University Hospital Pilsen, Pilsen, Czechia
| | | | - Petr Hošek
- Biomedical Center, Charles University, Faculty of Medicine in Pilsen, Pilsen, Czechia
| | - Sabine D Brookman May
- Department of Urology, Ludwig-Maximilians University, Campus Grosshadern, Munich, Germany
| | - Ondřej Hes
- Department of Pathology, Charles University, Faculty of Medicine in Pilsen and University Hospital Pilsen, Pilsen, Czechia
| | - Milan Hora
- Department of Urology, Charles University, Faculty of Medicine in Pilsen and University Hospital Pilsen, Pilsen, Czechia
| | - Vladislav Třeška
- Department of Surgery, Charles University, Faculty of Medicine in Pilsen and University Hospital Pilsen, Pilsen, Czechia
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Kolečková M, Tichý T, Melichar B, Veverková L, Hes O, Kolek V, Kolář Z. Metastatic Clear Cell Renal Carcinoma Without Evidence of a Primary Renal Tumour Mimicking Advanced Stage of Malignant Lung Tumour. Klin Onkol 2019; 32:154-156. [PMID: 31064187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
BACKGROUND Clear cell renal carcinoma (ccRC) accounts for 65-70% of renal carcinomas with peak occurrence at the 6th and 7th age decade, predominantly in males. At the time of diagnosis, especially pulmonary metastases can be found in one-third of patients. There have also been described as late metastases for several decades after nephrectomy. In our case report, clinical course indicated primary lung tumour. Histological differential diagnosis included malignant pleural mesothelioma, lung adenocarcinoma and squamous cell carcinoma with clear cell differentiation or primary clear cell adenocarcinoma of the lung. However, using immunohistochemistry, all these possible diagnoses were excluded. CASE REPORT We present a case of 62-year old man with 3 months history of progressive dyspnea accompanied with a cough and recurrent pleural effusions. PET/CT scan revealed metastatic tumour spread with right-sided pleural thickening, multiple pulmonary tumour foci, mediastinal, cervical, abdominal para-aortic and pelvic lymph node involvement and skeletal metastasis. The patient died one day after administration of palliative chemotherapy. The autopsy showed the majority of changes in the right hemithorax, was caused by a diffuse yellowish, extremely tough tumour infiltrating parietal and visceral pleura with adhesions and obliteration of truncus pulmonalis. In left lung and both renal cortices we could see scant nodules, mimicking primary lung tumour metastasis. In close proximity to the left renal hilum we found unusual homogeneous white round to oval tissue of 80 × 86 × 72mm in diameter, with identical histological pattern. Extensive immunohistochemical profile (positivity of CK18, PAX8, vimentin, androgen receptor, napsin A; negativity of mesothelial markers, TTF-1, CK7, CK20, CDX-2, CD10, PSA, CK34B12 and PAS-D) was compatible with metastatic ccRC. CONCLUSION We present an extremely rare case of morphologically verified metastatic ccRC without evidence of primary lesion in the kidneys. There is speculated the possibility of spontaneous regression of primary tumour. In our case, however, we cannot exclude the possibility of generalized primary tumour of ectopic kidney. This hypothesis is based on the finding of isolated tumour mass adjacent to left renal hilum.
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Pivovarčíková K, Pitra T, Hes O. Current status of urine cytology: What new does The Paris System for Reporting Urine Cytology bring? Cesk Patol 2019; 55:34-41. [PMID: 30939885] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Urine cytology is used for detection of neoplastic cells in urine. It has high sensitivity and specificity in detection high-grade urothelial carcinoma, but it is low sensitive in detection of low-grade carcinoma. Different classification systems were published in the past, need for a more standardized terminology results in Paris System for Reporting Urine cytology. This classification was published in 2016, and it is based on clear diagnostic criteria. Implementation of The Paris System will lead to global standardization and uniformity of urine cytology reports.
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Pivovarčíková K, Martínek P, Trpkov K, Alaghehbandan R, Magi-Galluzzi C, Mundo EC, Berney D, Suster S, Gill A, Rychlý B, Michalová K, Pitra T, Hora M, Michal M, Hes O. Fumarate hydratase deficient renal cell carcinoma and fumarate hydratase deficient-like renal cell carcinoma: Morphologic comparative study of 23 genetically tested cases. Cesk Patol 2019; 55:244-249. [PMID: 31842557] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Hereditary leiomyomatosis and renal cell carcinoma-associated renal cell carcinoma (HLRCC)/ fumarate hydratase deficient renal cell carcinoma (FHRCC) is an aggressive tumor defined by molecular genetic changes - alteration in fumarate hydratase (FH) gene. The morphologic spectrum of HLRCC/FHDRCC is remarkably variable. The presence of large nuclei and prominent dark red inclusion-like nucleoli and perinucleolar clearing are considered as helpful morphologic clue. We selected 23 renal neoplasms primarily based on their morphologic features suspicious for HLRCC/FHDRCC. Morphological, basic immunohistochemical, and genetic analysis was performed. The tumors were divided in two groups according to the molecular genetic findings. The first group included 13 tumors with detected FH mutation/LOH (compatible with diagnosis FHRCC), and the second group included 10 tumors without FH mutation/LOH (FH-like RCCs). In the FHRCC group, the vast majority of cases (9/13) had mixed morphology with different architectural growth patterns. All cases showed prominent macronucleoli, and perinucleolar clearing was found in 10/13 cases. Immunohistochemically, 6/7 FHRCC cases were negative for FH antibody, while one case showed strong diffuse FH reactivity. The FH-like RCC group showed more uniform architectural growth pattern. All 10 tumors had prominent macronucleoli, and perinucleolar clearing was present in 8/10 cases. Eight FH-like RCC cases showed diffuse strong positivity for FH, although 2 cases were completely negative for FH. It is evident that neither morphologic feature nor immunohistochemical analysis can be reliably used in routine practice for the diagnosis of HLRCC/FHRCC. In suspected cases, the diagnosis of HLRCC/FHRCC can be confirmed by molecular-genetic testing for FH mutation. It should be noted that the traditionally described morphologic features of HLRCC/FHRCC (prominent eosinophilic macronuclei with perinucleolar halos) can frequently be seen in other renal neoplasms.
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Trpkov K, Hes O. New and emerging renal entities: a perspective post-WHO 2016 classification. Histopathology 2018; 74:31-59. [DOI: 10.1111/his.13727] [Citation(s) in RCA: 74] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2018] [Revised: 08/08/2018] [Accepted: 08/09/2018] [Indexed: 12/19/2022]
Affiliation(s)
- Kiril Trpkov
- University of Calgary and Calgary Laboratory Services; Calgary Alberta Canada
| | - Ondřej Hes
- Charles University and University Hospital Pilsen; Pilsen Czech Republic
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Procházková K, Mírka H, Trávníček I, Pitra T, Kolár J, Roušarová M, Hošek P, Bajcurová K, Ferda J, Staehler M, Brookman May SD, Hes O, Hora M. Cystic Appearance on Imaging Methods (Bosniak III-IV) in Histologically Confirmed Papillary Renal Cell Carcinoma is Mainly Characteristic of Papillary Renal Cell Carcinoma Type 1 and Might Predict a Relatively Indolent Behavior of Papillary Renal Cell Carcinoma. Urol Int 2018; 101:409-416. [PMID: 30199877 DOI: 10.1159/000492719] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [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: 04/13/2018] [Accepted: 08/06/2018] [Indexed: 11/19/2022]
Abstract
AIM The aim of this study was to determine the proportion of cystic tumors according to preoperative CT (Bosniak III, IV) among surgically treated patients with histologically confirmed papillary renal cell carcinoma (pRCC) and to assess progression rates among patients with and without cystic appearance on imaging. METHODS A total of 138 patients with pRCC histology surgically treated in the period of January 2007-March 2017 were included. Clinical and radiological characteristics, type of surgery, histopathology results, and follow-up data were recorded and statistically evaluated. RESULTS Forty-one cases (29.7%) of cystic lesions (10× BIIF, 14× BIII, 17× BIV) were detected by CT. Patients with pRCC1 significantly more frequently presented with cystic appearance on CT (33/78; 42.3%) in comparison to other papillary types (8/60; 13.3%; p = 0.0002). During a median follow-up time of 49.4 months, only 2 patients with cystic lesions progressed after surgery. CONCLUSIONS Cystic appearance on imaging methods is mainly a characteristic of pRCC1 (42.3%). Cystic morphology on imaging might predict a relatively indolent behavior of all pRCC types. Preoperative scoring systems including tumor growth patterns (cystic vs. solid) are needed for further classification.
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Affiliation(s)
- Kristýna Procházková
- Department of Urology, Charles University and University Hospital, Pilsen, Czech
| | - Hynek Mírka
- Department of Imaging Methods, Charles University and University Hospital, Pilsen, Czech Republic.,Biomedical Center, Faculty of Medicine in Pilsen, Charles University, Pilsen, Czech Republic
| | - Ivan Trávníček
- Department of Urology, Charles University and University Hospital, Pilsen, Czech Republic
| | - Tomáš Pitra
- Department of Urology, Charles University and University Hospital, Pilsen, Czech Republic
| | - Jirí Kolár
- Department of Urology, Charles University and University Hospital, Pilsen, Czech Republic
| | | | - Petr Hošek
- Biomedical Center, Faculty of Medicine in Pilsen, Charles University, Pilsen, Czech Republic
| | - Kristýna Bajcurová
- Department of Imaging Methods, Charles University and University Hospital, Pilsen, Czech Republic.,Biomedical Center, Faculty of Medicine in Pilsen, Charles University, Pilsen, Czech Republic
| | - Jiří Ferda
- Department of Imaging Methods, Charles University and University Hospital, Pilsen, Czech Republic
| | - Michael Staehler
- Department of Urology, Ludwig-Maximilians University, Campus Grosshadern, Munich, Germany
| | - Sabine D Brookman May
- Department of Urology, Ludwig-Maximilians University, Campus Grosshadern, Munich, Germany
| | - Ondřej Hes
- Department of Pathology, Charles University and University Hospital, Pilsen, Czech Republic.,Biomedical Center, Faculty of Medicine in Pilsen, Charles University, Pilsen, Czech Republic
| | - Milan Hora
- Department of Urology, Charles University and University Hospital, Pilsen, Czech Republic
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Tupý R, Mírka H, Mraček J, Přibáň V, Hes O, Vokurka S, Ferda J. Tumor-related Perfusion Changes in White Matter Adjacent to Brain Tumors: Pharmacodynamic Analysis of Dynamic 3T Magnetic Resonance Imaging. Anticancer Res 2018; 38:4149-4152. [PMID: 29970543 DOI: 10.21873/anticanres.12707] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [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: 04/18/2018] [Revised: 05/14/2018] [Accepted: 05/16/2018] [Indexed: 11/10/2022]
Abstract
BACKGROUND/AIM To verify perfusion differences in white matter adjacent to glioblastomas and metastatic tumors in dynamic contrast-enhanced (DCE) 3T-magnetic resonance imaging (MRI) using gradient echo (GRE) T1 techniques. MATERIALS AND METHODS A retrospective comparative study was carried out on adults with glioblastoma (n=67) and brain metastases (n=31). In each patient, conventional 3T-MRI and DCE-MRI with 25 acquisitions of GRE-T1 were performed. The initial area under the contrast-uptake curve (iAUC) and transfer constant (Ktrans) in peritumoral regions of the white matter were evaluated using T1 pharmacodynamic modeling software. RESULTS Statistically significantly higher relative iAUC (p<0.001) and Ktrans (p<0.01) values were recorded for peritumoral white matter near glioblastomas compared to that near metastases: 2.29 (SD=1.11) and 2.12 (SD=1.05) vs. 0.96 (SD=0.31) and 1.18 (SD=0.35), respectively. CONCLUSION In comparison to Ktrans, the iAUC obtained by DCE-MRI is more suitable for assessing glioblastomas because it better reflects pharmacokinetic peritumoral changes. Increased iAUC in white matter near to tumor generally indicates glioblastoma, however, a low level does not exclude it.
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Affiliation(s)
- Radek Tupý
- Department of Medical Imaging, Charles University Hospital in Pilsen, Pilsen, Czech Republic
| | - Hynek Mírka
- Department of Medical Imaging, Charles University Hospital in Pilsen, Pilsen, Czech Republic
| | - Jan Mraček
- Department of Neurosurgery, Charles University Hospital in Pilsen, Pilsen, Czech Republic
| | - Vladimír Přibáň
- Department of Neurosurgery, Charles University Hospital in Pilsen, Pilsen, Czech Republic
| | - Ondřej Hes
- Sikls Pathology Department, Charles University Hospital in Pilsen, Pilsen, Czech Republic
| | - Samuel Vokurka
- Department of Oncology and Radiotherapeutics, Charles University Hospital in Pilsen, Pilsen, Czech Republic
| | - Jiří Ferda
- Department of Medical Imaging, Charles University Hospital in Pilsen, Pilsen, Czech Republic
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Ferdová E, Baxa J, Ňaršanská A, Hes O, Fínek J, Topolčan O, Ferda J. Low-dose High-resolution 18F-FDG-PET/CT Using Time-of-flight and Point-spread Function Reconstructions: A Role in the Detection of Breast Carcinoma Axillary Lymph Node Metastases. Anticancer Res 2018; 38:4145-4148. [PMID: 29970542 DOI: 10.21873/anticanres.12706] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2018] [Revised: 05/14/2018] [Accepted: 05/16/2018] [Indexed: 11/10/2022]
Abstract
AIM to evaluate the performance of N-staging assessment in clinically-proven T1 breast carcinoma by high-resolution 18F-fluorodeoxyglucose-positron-emission tomography/computed tomography (18F-FDG-PET/CT) using time-of-flight with point-spread function reconstruction. PATIENTS AND METHODS In 30 women with clinically proven T1 breast carcinoma, imaging before surgery was performed using 18F-FDG-PET/CT. The results of PET/CT in detection of lymph node metastases were compared with those obtained after pathological investigation of axillary biopsy. A four-ring PET subsystem with image reconstruction using time-of-flight and point-spread function was used with the radiopharmaceutical dose reduction to 2.5 MBq/kg. RESULTS Axillary lymph node metastasis was confirmed by histology in 13 patients, but metastasis was suspected based on PET/CT in 12 of those patients, the absence of metastasis was surgically confirmed in 17 women, 15 of which were suspected based on PET/CT. The sensitivity for detection of axillary lymph node metastasis was 93.3%, with a specificity of 88.2% in the whole patient cohort. Additionally, distant metastatic spread was found in 13.3% of patients. CONCLUSION The reconstruction of PET images with time-of-flight and point-spread function enabled the improvement of diagnostic performance in N-staging of breast carcinoma, even when the dose of radiopharmaceutical was reduced to 2.5 MBq/kg.
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Affiliation(s)
- Eva Ferdová
- Department of Imaging Methods, Charles University Hospital Pilsen, Pilsen, Czech Republic
| | - Jan Baxa
- Department of Imaging Methods, Charles University Hospital Pilsen, Pilsen, Czech Republic
| | - Andrea Ňaršanská
- Department of Surgery, Charles University Hospital Pilsen, Pilsen, Czech Republic
| | - Ondřej Hes
- Šikl´s Institute of Pathologic Anatomy, Charles University Hospital Pilsen, Pilsen, Czech Republic
| | - Jindřich Fínek
- Department of Oncology and Radiotherapy, Charles University Hospital Pilsen, Pilsen, Czech Republic
| | - Onřej Topolčan
- Immunoanalytic Laboratory, Charles University Hospital Pilsen, Pilsen, Czech Republic
| | - Jiří Ferda
- Department of Imaging Methods, Charles University Hospital Pilsen, Pilsen, Czech Republic
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Opatrný V, Moláček J, Třeška V, Matějka R, Hes O. Perfusion of a Kidney Graft From a Donor After Cardiac Death Based on Immediately Started Pulsatile Machine Perfusion—An Experimental Study on a Small Animal. Transplant Proc 2018; 50:1544-1548. [DOI: 10.1016/j.transproceed.2018.02.067] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2017] [Revised: 01/28/2018] [Accepted: 02/17/2018] [Indexed: 10/14/2022]
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Agaimy A, Amin MB, Gill AJ, Popp B, Reis A, Berney DM, Magi-Galluzzi C, Sibony M, Smith SC, Suster S, Trpkov K, Hes O, Hartmann A. SWI/SNF protein expression status in fumarate hydratase-deficient renal cell carcinoma: immunohistochemical analysis of 32 tumors from 28 patients. Hum Pathol 2018; 77:139-146. [PMID: 29689242 DOI: 10.1016/j.humpath.2018.04.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [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: 01/31/2018] [Revised: 03/13/2018] [Accepted: 04/06/2018] [Indexed: 10/17/2022]
Abstract
Fumarate hydratase-deficient renal cell carcinoma (FH-RCC) is a rare, aggressive RCC type, originally described in the setting of hereditary leiomyomatosis and RCC syndrome, which is defined by germline FH gene inactivation. Inactivation of components of the switch/sucrose nonfermentable (SWI/SNF) chromatin remodeling complex is involved in renal medullary carcinoma (SMARCB1/INI1 loss), clear cell RCC (PBRM1 loss), and subsets of dedifferentiated RCC of clear cell, chromophobe, and papillary types (loss of different SWI/SNF components). FH-RCC and SWI/SNF-deficient RCC share anaplastic nuclear features and highly aggressive course. We analyzed 32 FH-RCCs from 28 patients using 7 commercially available SWI/SNF antibodies (SMARCB1/INI1, SMARCA2, SMARCA4, SMARCC1, SMARCC2, PBRM1, and ARID1A). Variable loss of SMARCB1, ARID1A, and SMARCC1 was observed in 1 of 31, 2 of 31, and 1 of 29 evaluable cases, respectively; 3 of these 4 SWI/SNF-deficient tumors had confirmed FH mutations. No correlation of SWI/SNF loss with solid or sarcomatoid features was observed. Two tumors with SMARCB1 and ARID1A deficiency had available SWI/SNF molecular data; both lacked SMARCB1 and ARID1A mutations. The remaining 5 SWI/SNF components were intact in all cases. Especially PBRM1 seems not to be involved in the pathogenesis or progression of FH-RCC. Our data showed that a subset of FH-RCC (12%) have a variable loss of SWI/SNF complex subunits, likely as secondary genetic events. This should not be confused with SWI/SNF-deficient RCC of other types. Evaluation of FH and SWI/SNF together with comprehensive molecular genetic profiling is needed to explore possible prognostic implications of FH/SWI-SNF double deficiency and to better understand the somatic mutation landscape in high-grade RCC.
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Affiliation(s)
- Abbas Agaimy
- Institute of Pathology, Friedrich-Alexander University Erlangen-Nuremberg, University Hospital of Erlangen, 91054 Erlangen, Germany.
| | - Mahul B Amin
- Department of Pathology and Laboratory Medicine, University of Tennessee Health Sciences, Memphis, TN 38103, USA
| | - Anthony J Gill
- University of Sydney NSW Australia 2006, Cancer Diagnosis and Pathology Group, Kolling Institute, Royal North Shore Hospital NSW Australia 2065 and NSW Health Pathology, Department of Anatomical Pathology, Royal North Shore Hospital, St Leonards, NSW 2065, Australia
| | - Bernt Popp
- Institute of Human Genetics, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - André Reis
- Institute of Human Genetics, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Daniel M Berney
- Barts Cancer Institute, Queen Mary University of London, London ECIM 6BQ, UK
| | | | | | - Steven C Smith
- Department of Pathology, VCU School of Medicine, Richmond, VA 23298, USA
| | - Saul Suster
- Medical College of Wisconsin, Milwaukee, WI 53226, USA
| | - Kiril Trpkov
- Calgary Laboratory Services and University of Calgary, Calgary, Alberta, Canada
| | - Ondřej Hes
- Charles University and University Hospital Plzen, 304 60 Plzen, Czech Republic
| | - Arndt Hartmann
- Institute of Pathology, Friedrich-Alexander University Erlangen-Nuremberg, University Hospital of Erlangen, 91054 Erlangen, Germany
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Trpkov K, Athanazio D, Magi-Galluzzi C, Yilmaz H, Clouston D, Agaimy A, Williamson SR, Brimo F, Lopez JI, Ulamec M, Rioux-Leclercq N, Kassem M, Gupta N, Hartmann A, Leroy X, Bashir SA, Yilmaz A, Hes O. Biphasic papillary renal cell carcinoma is a rare morphological variant with frequent multifocality: a study of 28 cases. Histopathology 2018; 72:777-785. [PMID: 29119638 DOI: 10.1111/his.13432] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2017] [Accepted: 11/02/2017] [Indexed: 01/31/2023]
Abstract
AIMS To further characterise biphasic squamoid renal cell carcinoma (RCC), a recently proposed variant of papillary RCC. METHODS AND RESULTS We identified 28 tumours from multiple institutions. They typically showed two cell populations-larger cells with eosinophilic cytoplasm and higher-grade nuclei, surrounded by smaller, amphophilic cells with scanty cytoplasm. The dual morphology was variable (median 72.5% of tumour, range 5-100%); emperipolesis was found in all cases. The male/female ratio was 2:1, and the median age was 55 years (range 39-86 years). The median tumour size was 20 mm (range 9-65 mm). Pathological stage pT1a was found in 21 cases, pT1b in three, and pT3a and pT3b in one each (two not available). Multifocality was found in 32%: multifocal biphasic RCC in one case, biphasic + papillary RCC in two cases, biphasic + clear cell RCC in three cases, biphasic + low-grade urothelial carcinoma of the renal pelvis in one case, and biphasic + Birt-Hogg-Dubé syndrome in one case. Positive immunostains included: PAX8, cytokeratin (CK) 7, α-methylacyl-CoA racemase, epithelial membrane antigen, and vimentin. Cyclin D1 was expressed only in the larger cells. The Ki67 index was higher in the larger cells (median 5% versus ≤1%). Negative stains included: carbonic anhydrase 9, CD117, GATA-3, WT1, CK5/6, and CK20; CD10 and 34βE12 were variably expressed. Gains of chromosomes 7 and 17 were found in two evaluated cases. Follow-up was available for 23 patients (median 24 months, range 1-244 months): 19 were alive without disease, one was alive with recurrence, and one had died of disease (two had died of other causes). CONCLUSIONS Biphasic papillary RCC is a rare variant of papillary RCC, and is often multifocal.
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Affiliation(s)
- Kiril Trpkov
- Calgary Laboratory Services and University of Calgary, Rockyview General Hospital, Calgary, AB, Canada
| | - Daniel Athanazio
- Calgary Laboratory Services and University of Calgary, Rockyview General Hospital, Calgary, AB, Canada
| | | | | | | | - Abbas Agaimy
- Friedrich-Alexander-University, Erlangen, Germany
| | | | | | - Jose I Lopez
- Cruces University Hospital, BioCruces Institute, University of the Basque Country (UPV/EHU), Bizkaia, Spain
| | - Monika Ulamec
- University Clinical Hospital Centre Sestre Milosrdnice, Zagreb, Croatia
| | | | | | | | | | | | | | - Asli Yilmaz
- Calgary Laboratory Services and University of Calgary, Rockyview General Hospital, Calgary, AB, Canada
| | - Ondřej Hes
- Charles University, Pilsen, Czech Republic
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Molacek J, Opatrný V, Treska V, Matejka R, Hes O. Options to improve the quality of kidney grafts from expanded criteria donors experimental study. Rozhl Chir 2018; 97:193-201. [PMID: 29792716] [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: 06/08/2023]
Abstract
INTRODUCTION There is a worldwide discrepancy between the number of donors and the number of organs needed for transplantation, leading to certain expansion of criteria, resulting in acceptance of donor organs. This means that organs with worse parenchymal qualities may be harvested for transplantation. One possibility, how to ameliorate the quality of these organs, is to change the concept of their preservation during cold ischemia or even after sudden circulatory arrest, prior to the collection of the organ itself. The goal of our experimental study was to try to improve organ quality from these marginal donors. METHODS In the first part of our experimental study, we tested retrograde oxygen persufflation (ROP) in preservation of ischemically damaged kidney grafts. In ten animals (domestic pig), we compared standard intra-arterial perfusion of the grafts using cooled perfusion solution (N=5), with a retrograde oxygen persufflation method (N=5). The main criterion for evaluation was the histopathological analysis of renal parenchyma after transplantation of the kidney graft. In the second part of our experimental study, again using an animal model of an ischemic kidney (laboratory rabbit), we compared machine perfusion of the kidney graft with routinely used perfusion by hydrostatic pressure. For evaluation, we added another two criteria - the volume of perfusate that flowed through the graft and the temperature drop during perfusion. RESULTS In the first part of the study, we proved the ability of ROP to preserve and even ameliorate the quality of ischemically damaged kidney grafts. Results of histopathological analysis of samples taken during ROP were without statistically significant difference in comparison with those taken during standard intra-arterial perfusion. In the second part of the study, we observed a significant difference in maximal flow rate measured during perfusion of the kidney grafts, favoring mechanical perfusion over perfusion using hydrostatic pressure (p=0.004). The same situation was seen with the drop of temperature measured in the parenchyma of the grafts (p<0.001). Finally, histopathological evaluation of the renal parenchyma found better washing out of blood particles from the capillaries during mechanical perfusion (p=0.005). CONCLUSION The presented results of our experimental studies establish that alternative methods of preservation during cold ischemia and before removal of kidney grafts from the donor may be beneficial for its function after transplantation. We believe that these methods may be suitable especially for so-called marginal grafts from extended criteria donors.Key words: transplantation donors after circulatory death controlled organ perfusion in situ perfusion retrograde oxygen persufflation.
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Ferda J, Ferdová E, Hes O, Mraček J, Kreuzberg B, Baxa J. PET/MRI: Multiparametric imaging of brain tumors. Eur J Radiol 2017; 94:A14-A25. [PMID: 28283219 DOI: 10.1016/j.ejrad.2017.02.034] [Citation(s) in RCA: 14] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2016] [Revised: 02/19/2017] [Accepted: 02/20/2017] [Indexed: 12/01/2022]
Abstract
A combination of morphological imaging of the brain with microstructural and functional imaging provides a comprehensive overview of the properties of individual tissues. While diffusion weighted imaging provides information about tissue cellularity, spectroscopic imaging allows us to evaluate the integrity of neurons and possible anaerobic glycolysis during tumor hypoxia, in addition to the presence of accelerated synthesis or degradation of cellular membranes; on the other hand, PET metabolic imaging is used to evaluate major metabolic pathways, determining the overall extent of the tumor (18F-FET, 18F-FDOPA, 18F-FCH) or the degree of differentiation (18F-FDG, 18F-FLT, 18F-FDOPA and 18F-FET). Multi-parameter analysis of tissue characteristics and determination of the phenotype of the tumor tissue is a natural advantage of PET/MRI scanning. The disadvantages are higher cost and limited availability in all centers with neuro-oncology surgery. PET/MRI scanning of brain tumors is one of the most promising indications since the earliest experiments with integrated PET/MRI imaging systems, and along with hybrid imaging of neurodegenerative diseases, represent a new direction in the development of neuroradiology on the path towards comprehensive imaging at the molecular level.
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Affiliation(s)
- Jiří Ferda
- Clinic of the Imaging Methods, University Hospital Plzen, Alej Svobody 80, 304 60 Plzeň, Czech Republic.
| | - Eva Ferdová
- Clinic of the Imaging Methods, University Hospital Plzen, Alej Svobody 80, 304 60 Plzeň, Czech Republic.
| | - Ondřej Hes
- Sikl's Institute of Pathological Anatomy, University Hospital Plzen, Alej Svobody 80;304 60 Plzeň, Czech Republic.
| | - Jan Mraček
- Clinic of the Neurosurgery, University Hospital Plzen, Alej Svobody 80, 304 60 Plzeň, Czech Republic.
| | - Boris Kreuzberg
- Clinic of the Imaging Methods, University Hospital Plzen, Alej Svobody 80, 304 60 Plzeň, Czech Republic.
| | - Jan Baxa
- Clinic of the Imaging Methods, University Hospital Plzen, Alej Svobody 80, 304 60 Plzeň, Czech Republic.
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Zedníková I, Ňaršanská A, Hes O, Metelková A, Fiala O, Svoboda T. [A new perspective on axillary dissection in situations of metastatic sentinel node]. Rozhl Chir 2017; 96:346-352. [PMID: 29058925] [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: 06/07/2023]
Abstract
INTRODUCTION Breast cancer is the most common malignant disease in women and represents a worldwide problem. Up-to-date diagnostics methods, mammography screening and complex treatments have resulted in a substantial reduction of mortality rates. However, the incidence of the disease keeps growing constantly, although in a moderate way. The struggle against this disease has several levels, such as prevention, primary tumour therapy as well as the management of recurrent or generalized disease. Therefore, it is very significant to evaluate the prognosis on the basis of biological characteristics of the tumour and to determine the right individual therapy in each patient. AIM OF THE STUDY Our aim was to determine a group of patients with malignant breast disease based on biological characteristics of the tumour who can be treated without axillary exenteration even with a metastasis in the sentinel lymph node, thereby reducing the morbidity associated with this surgery, without worsening the prognosis. METHOD The research project lasted from June 2012 to June 2015. It was a prospective randomized study where the main investigated group consisted of women with primarily surgically treated mammary cancer undergoing sentinel lymph node biopsy (SNB) during their surgery. These patients were divided into three groups: group 1 - positive SNB without axillary exenteration (axillary dissection - AD); group 2 - positive SNB with AD; and group 3 - negative SNB. Group 4 consisted of patients with primarily performed AD. We investigated statistically significant prognostic factors of metastatic lymph nodes and early disease progression. The results were statistically processed and differences between individual groups were evaluated, determining prognostically usable biological characteristics of the tumour in connection with metastases in lymph nodes and progression-free survival. RESULTS The study included 214 patients with breast cancer. No metastases of axillary lymph nodes were found in 136 patients (64%); on the other hand, 78 patients (36%) had positive axillary lymph nodes and included: 28 (13%) patients with a micrometastasis in the sentinel lymph node; 38 (17%) patients with 13 positive lymph nodes; 8 (4%) patients with 49 positive lymph nodes; and 4 (2%) patients had more than 10 metastatic lymph nodes. A statistically significant difference with respect to metastatic lymph node involvement was found for the tumour size, expression of oestrogen receptors, proliferative activity and grading. CONCLUSION The following prognostic factors of metastatic lymph nodes and early disease progression were shown to be statistically significant: tumour size over 2 cm, negative expression of oestrogen receptors, tumours with moderate and high proliferative activity, and tumour grades G2 and G3. In the course of the three years of this study, no regional recurrence was found in axillary lymph nodes in any patient, and therefore, it clearly follows that the completion of axillary exenteration can be omitted in the case of tumour sizes below 2 cm, present expression of oestrogen receptors, low proliferative activity and grade 1 even if one or two positive sentinel lymph nodes are present, provided that adjuvant radiation therapy can be used. Also, axillary exenteration is not needed if a micrometastasis or isolated tumour cells are found in the sentinel lymph node.Key words: breast cancer - sentinel lymph node biopsy - axillary exenteration - prognostic factors.
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Smith SC, Trpkov K, Chen YB, Mehra R, Sirohi D, Ohe C, Cani AK, Hovelson DH, Omata K, McHugh JB, Jochum W, Colecchia M, Amin M, Divatia MK, Hes O, Menon S, da Cunha IW, Tripodi S, Brimo F, Gill AJ, Osunkoya AO, Magi-Galluzzi C, Sibony M, Williamson SR, Nesi G, Picken MM, Maclean F, Agaimy A, Cheng L, Epstein JI, Reuter VE, Tickoo SK, Tomlins SA, Amin MB. Tubulocystic Carcinoma of the Kidney With Poorly Differentiated Foci: A Frequent Morphologic Pattern of Fumarate Hydratase-deficient Renal Cell Carcinoma. Am J Surg Pathol 2016; 40:1457-1472. [PMID: 27635946 PMCID: PMC5577927 DOI: 10.1097/pas.0000000000000719] [Citation(s) in RCA: 94] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
An emerging group of high-grade renal cell carcinomas (RCCs), particularly carcinomas arising in the hereditary leiomyomatosis renal cell carcinoma syndrome (HLRCC), show fumarate hydratase (FH) gene mutation and loss of function. On the basis of similar cytomorphology and clinicopathologic features between these tumors and cases described as tubulocystic carcinomas with poorly differentiated foci (TC-PD) of infiltrative adenocarcinoma, we hypothesized a relationship between these entities. First, 29 RCCs with morphology of TC-PD were identified retrospectively and assessed for FH expression and aberrant succination (2SC) by immunohistochemistry (IHC), with targeted next-generation sequencing of 409 genes-including FH-performed on a subset. The 29 TC-PD RCCs included 21 males and 8 females, aged 16 to 86 years (median, 46), with tumors measuring 3 to 21 cm (median, 9) arising in the right (n=16) and left (n=13) kidneys. Family history or stigmata of HLRCC were identifiable only retrospectively in 3 (12%). These tumors were aggressive, with 79% showing perinephric extension, nodal involvement in 41%, and metastasis in 86%. Of these, 16 (55%) demonstrated loss of FH by IHC (14/14 with positive 2SC). In contrast, 5 (17%) showed a wild-type immunoprofile of FH+/2SC-. An intriguing group of 8 (28%) showed variable FH± positivity, but with strong/diffuse 2SC+. Next-generation sequencing revealed 8 cases with FH mutations, including 5 FH-/2SC+ and 3 FH±/2SC+ cases, but none in FH+/2SC- cases. Secondly, we retrospectively reviewed the morphology of 2 well-characterized cohorts of RCCs with FH-deficiency determined by IHC or sequencing (n=23 and n=9), unselected for TC-PD pattern, identifying the TC-PD morphology in 10 (31%). We conclude that RCCs with TC-PD morphology are enriched for FH deficiency, and we recommend additional workup, including referral to genetic counseling, for prospective cases. In addition, based on these and other observations, we propose the term "FH-deficient RCC" as a provisional term for tumors with a combination of suggestive morphology and immunophenotype but where genetic confirmation is unavailable upon diagnosis. This term will serve as a provisional nomenclature that will enable triage of individual cases for genetic counseling and testing, while designating these cases for prospective studies of their relationship to HLRCC.
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Affiliation(s)
- Steven C Smith
- Departments of Pathology and Urology, VCU Health, Richmond, VA, USA
| | - Kiril Trpkov
- Calgary Laboratory Services and University of Calgary, Calgary, AB, Canada
| | - Ying-Bei Chen
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Rohit Mehra
- Department of Pathology, University of Michigan, Ann Arbor, MI, USA
| | - Deepika Sirohi
- Department of Pathology and Laboratory Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Chisato Ohe
- Department of Pathology and Laboratory Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Andi K Cani
- Department of Pathology, University of Michigan, Ann Arbor, MI, USA
| | | | - Kei Omata
- Department of Pathology, University of Michigan, Ann Arbor, MI, USA
| | | | - Wolfram Jochum
- Institute of Pathology, Kantonsspital St. Gallen, Switzerland
| | - Maurizio Colecchia
- Department of Pathology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy
| | - Mitual Amin
- Department of Pathology, William Beaumont Health System, Royal Oak, MI, USA
| | - Mukul K Divatia
- Department of Pathology and Laboratory Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Ondřej Hes
- Department of Pathology, Charles University and University Hospital, Plzen, Czech Republic
| | - Santosh Menon
- Department of Pathology and Uro-oncology Disease Management Group, Tata Memorial Hospital, Mumbai, India
| | | | - Sergio Tripodi
- Department of Pathology, Azienda Ospedaliera Universitaria Senese, Siena, Italy
| | - Fadi Brimo
- Department of Pathology, McGill University, Montreal, Canada
| | - Anthony J Gill
- Cancer Diagnosis and Pathology Group, Kolling Institue of Medical Research, Royal North Shore Hospital, Sydney, NSW, Australia and Sydney Medical School, University of Sydney, Sydney, NSW Australia
| | | | - Cristina Magi-Galluzzi
- Robert J. Tomsich Pathology and Laboratory Medicine Institute Cleveland Clinic, Cleveland, OH, USA
| | - Mathilde Sibony
- Département d'Anatomie Pathologique, Hôpital Cochin, Université Paris Descartes, Paris, France
| | | | - Gabriella Nesi
- Division of Pathological Anatomy, University of Florence, Florence, Italy
| | - Maria M Picken
- Department of Pathology, Loyola University, Maywood, IL, USA
| | - Fiona Maclean
- Douglass Hanly Moir Pathology, Macquarie Park, NSW, Australia
| | - Abbas Agaimy
- Institute of Pathology, Friedrich-Alexander University, University Hospital, Erlangen, Germany
| | - Liang Cheng
- Department of Pathology, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Jonathan I Epstein
- Department of Pathology, Johns Hopkins Medical Institutions, Baltimore, MD, USA
| | - Victor E Reuter
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Satish K Tickoo
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Scott A Tomlins
- Department of Pathology, University of Michigan, Ann Arbor, MI, USA
- Michigan Center for Translational Pathology, Department of Urology, Comprehensive Cancer Center, University of Michigan, Ann Arbor, MI, USA
| | - Mahul B Amin
- Department of Pathology and Laboratory Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, USA
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Procházková K, Staehler M, Trávníček I, Pitra T, Eret V, Ürge T, Eberlová L, Roušarová M, Hošek P, Chudáček Z, Ferda J, Hes O, Hora M. Morphological Characterization of Papillary Renal Cell Carcinoma Type 1, the Efficiency of Its Surgical Treatment. Urol Int 2016; 98:148-155. [DOI: 10.1159/000448434] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2016] [Accepted: 07/12/2016] [Indexed: 11/19/2022]
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Hora M, Eret V, Trávníček I, Procházková K, Pitra T, Dolejšová O, Hes O, Petersson F. Surgical treatment of kidney tumors - contemporary trends in clinical practice. Cent European J Urol 2016; 69:341-346. [PMID: 28127448 PMCID: PMC5260449 DOI: 10.5173/ceju.2016.845] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2016] [Revised: 06/16/2016] [Accepted: 08/30/2016] [Indexed: 12/22/2022] Open
Abstract
INTRODUCTION The aim of this article is to generally describe the roles of main surgical modalities in treatment of renal tumors, especially in the CT1a category in clinical practice. Surgical modalities include the following: laparoscopic or open resection (LR, OR) and laparoscopic or open nephrectomy (LN, ON). Representation of these methods has been changing over years due to improved operative skills and equipment and due to a shift of tumors to the lower T categories. MATERIAL AND METHODS The sources of data were surgeries performed for renal tumors at the institution of the main author during the period 2002 to III/2016, reaching a total of 2204 cases (546 ONs, 647 LNs, 668 ORs and 343 LRs). Patients indicated for percutaneous ablative therapy or active surveillance were not included. RESULTS During the whole period, the proportions of methods were: ONs 24.8%, LNs 29.4%, ORs 30.3%, LRs 15.6%. But during the years 2014 - III/2016, these changed to 12.6%:26.3%:31.6%:29.4% (in cT1a 1.7%:8.3%:37.8%:52.2%). Category cT1a constitutes in the years 2007 - III/2016 41.3%, in 2014 - III/2016 50.9%. CONCLUSIONS Resections and minimally invasive approaches are being performed more frequently and are the preferred methods in surgical treatment of kidney tumors. Resection is now indicated in about 60% of cases (open vs. laparoscopic resection are used nearly equally with a slight tendency for laparascopic predomination). In the cT1a category (amounting to approximately 50% of all surgically treated tumors), resection is possible in about 85-90% of cases.
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Affiliation(s)
- Milan Hora
- University Hospital, Department of Urology, Plzeň, Czech Republic
| | - Viktor Eret
- University Hospital, Department of Urology, Plzeň, Czech Republic
| | - Ivan Trávníček
- University Hospital, Department of Urology, Plzeň, Czech Republic
| | | | - Tomáš Pitra
- University Hospital, Department of Urology, Plzeň, Czech Republic
| | - Olga Dolejšová
- University Hospital, Department of Urology, Plzeň, Czech Republic
| | - Ondřej Hes
- University Hospital, Department of Pathology, Plzeň, Czech Republic
| | - Fredrik Petersson
- Department of Pathology, National University Health System, Singapore, Singapore
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Fichtl J, Třeška V, Vodička J, Šulc R, Hes O, Tupý R. [Castleman disease - unusual finding after operation of retroperitoneal tumor of young patient]. Rozhl Chir 2016; 95:91-94. [PMID: 27008172] [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: 06/05/2023]
Abstract
UNLABELLED Castleman disease is rare diagnosis. It was first mentioned in literature in 1954 by doctor Castleman and Lown. It is rare sickness which primary affects lymfatic nodes. There are four histo-morfologic subtypes and two clinic manifestations (uni and mulicentric). Comon clinical picture is simple lymfadenopathy of neck, medistinal a retroperitonal lymfatic nodes. Signs of this disease are heterogenic and depend on histological subtype. Also prognosis depends on type of illness. It should take place as benign diagnosis (unicentric form) but also can be potencionally malignant form which shlould exacerbate to malignant lymfoproliferation (multicentric form). Authors present the case of 29 years old men with clinical manifestation (jundice, intermitent bowel obstruction) of lagre retroperitoneal tumor in subhepatal localization. The treatment was radical surgical extirpation, surgery was without complications. Definitive histological diagnosis was confirmed as hyaline-vascular type of Castleman disease. Because the patient´s clinical form was multicentric, he is now undergoing adjuvant oncological treatment. KEY WORDS Castleman disease reproperitoneal tumor.
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Ondič O, Hes O. [Not Available]. Cesk Patol 2016; 52:112. [PMID: 27223591] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
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Brůha J, Liška V, Třeška V, Skalický T, Fichtl J, Hes O. [Granulomatous inflammation in differential diagnosis of hepatobiliary malignancy]. Rozhl Chir 2016; 95:40-44. [PMID: 26982191] [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: 06/05/2023]
Abstract
UNLABELLED The authors present two case reports to demonstrate wide differential diagnosis of granulomatous disorders of the hepatobiliary tract. Isolated granulomatous disorders are very rare in this area. Differantial diagnosis includes infectious and systemic diseases or chemical irritation. Granulomas often immitate malignant tumors and the surgeon could be first to diagnose this disease during liver resection or cholecystectomy. KEY WORDS granulomatous inflammation hepatic granuloma non-specific inflammation liver resection cholecystectomy.
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Trávníček I, Branžovský J, Kalusová K, Hes O, Holubec L, Pele KB, Ürge T, Hora M. Tissue Biomarkers in Predicting Response to Sunitinib Treatment of Metastatic Renal Cell Carcinoma. Anticancer Res 2015; 35:5661-5666. [PMID: 26408740] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
AIM To identify tissue biomarkers that are predictive of the therapeutic effect of sunitinib in treatment of metastatic clear cell renal cell carcinoma (mCRCC). MATERIALS AND METHODS Our study included 39 patients with mCRCC treated with sunitinib. Patients were stratified into two groups based on their response to sunitinib treatment: non-responders (progression), and responders (stable disease, regression). The effect of treatment was measured by comparing imaging studies before the initiation treatment with those performed at between 3rd and 7th months of treatment, depending on the patient. Histological samples of tumor tissue and healthy renal parenchyma, acquired during surgery of the primary tumor, were examined with immunohistochemistry to detect tissue targets involved in the signaling pathways of tumor growth and neoangiogenesis. We selected mammalian target of rapamycine, p53, vascular endothelial growth factor, hypoxia-inducible factor 1 and 2 and carbonic anhydrase IX. We compared the average levels of biomarker expression in both, tumor tissue, as well as in healthy renal parenchyma. Results were evaluated using the Student's t-test. RESULTS For responders, statistically significant differences in marker expression in tumor tissue versus healthy parenchyma were found for mTOR (4%/16.7%; p=0.01031), p53 (4%/12.7%; p=0.042019), VEGF (62.7%/45%; p=0.019836) and CAIX (45%/15.33%; p=0.001624). A further significant difference was found in the frequency of high expression (more than 60%) between tumor tissue and healthy parenchyma in VEGF (65%/35%; p=0.026487) and CAIX (42%/8%; p=0.003328). CAIX was expressed at high levels in the tumor tissue in both evaluated groups. CONCLUSION A significantly higher expression of VEGF in CRCC in comparison to healthy parenchyma can predict a better response to sunitinib.
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Affiliation(s)
- Ivan Trávníček
- Department of Urology, Faculty Hospital in Pilsen, Pilsen, Czech Republic
| | | | - Kristýna Kalusová
- Department of Urology, Faculty Hospital in Pilsen, Pilsen, Czech Republic
| | - Ondřej Hes
- Department of Pathology, Faculty Hospital in Pilsen, Pilsen, Czech Republic
| | - Luboš Holubec
- Department of Oncology and Radiotherapy, Faculty Hospital in Pilsen, Pilsen, Czech Republic
| | - Kevin Bauleth Pele
- Department of Pathology, Faculty Hospital in Pilsen, Pilsen, Czech Republic
| | - Tomáš Ürge
- Department of Urology, Faculty Hospital in Pilsen, Pilsen, Czech Republic
| | - Milan Hora
- Department of Urology, Faculty Hospital in Pilsen, Pilsen, Czech Republic
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Martínek P, Grossmann P, Hes O, Bouda J, Eret V, Frizzell N, Gill AJ, Ondič O. Genetic testing of leiomyoma tissue in women younger than 30 years old might provide an effective screening approach for the hereditary leiomyomatosis and renal cell cancer syndrome (HLRCC). Virchows Arch 2015; 467:185-91. [DOI: 10.1007/s00428-015-1783-y] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2015] [Revised: 04/08/2015] [Accepted: 05/04/2015] [Indexed: 10/23/2022]
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Černá M, Zedníková I, Ňaršanská A, Svoboda T, Hes O, Záhlava J, Hlaváčková M. [Avoidance of axillary lymph node dissection in breast cancer patients with metastatic sentinel node - a pilot study]. Rozhl Chir 2015; 94:117-125. [PMID: 25754480] [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
INTRODUCTION Axillary lymph node dissection (ALND) is a standard procedure for locoregional control in metastatic sentinel lymph nodes (SN). A number of studies have provided evidence that avoiding ALND does not worsen the general prognosis. METHODS A group of 249 female patients with sentinel lymph node biopsy was analysed retrospectively for a 3-year period. The patients were divided into two groups - with non-metastatic SN and with metastatic SN. In the metastatic SN group, the patients were further divided into a group with ALND and a group without ALND, and additional lymph nodes (non-sentinel) in ALND and oncological treatment were evaluated. The goal was to find out whether ALND and oncological treatment affect the disease-free interval (DFI) and overall survival (OS) in the group of patients with metastatic SN and to compare the results with the control group. The histopathology and biology of the primary tumour, its size and the number of metastatic SN were subsequently evaluated as the factors that may be useful for predicting metastatic non-sentinel lymph node positivity. RESULTS There was a high risk of metastatic non-sentinel lymph nodes in the cases of metastatic SN (63%). Addition of ALND does not prolong either DFI or DFS without post-operative radiotherapy and systemic oncological treatment, both of which can provide a comparable length of DFI as well as DFS without ALND. Patients with metastatic SN with and without ALND had a DFI of 70 and 72 months, respectively, and a 5-year survival of 84% and 80%, respectively. Tumours over 2 cm, tumours with high proliferative activity and a high grade can be regarded as predictors of metastatic non-sentinel lymph nodes. CONCLUSION In a small patient group it has been demonstrated that the avoidance of ALND in 1 or 2 metastatic SN, regardless of the prognostic factors, does not affect either DFI or DFS if adjuvant oncological treatment is administered. High-grade tumours, tumours with high proliferative activity and tumours larger than 2 cm carry a significantly higher risk of metastatic non-sentinel lymph nodes. Nowadays, the avoidance of ALND in metastatic SN is not a lege artis procedure; further large studies are needed to create scientific guidelines.Key words: metastatic sentinel lymph node - avoidance of axillary dissection - breast cancer.
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Kobr J, Fremuth J, Sasek L, Jehlicka P, Hrdlicka R, Racek J, Hes O, Koppl J, Pizingerova K. Reduction of renal function during mechanical ventilation of healthy lungs in an animal biomodel. ACTA ACUST UNITED AC 2015; 116:25-9. [PMID: 25666958 DOI: 10.4149/bll_2015_005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVES To identify factors involved in reno-pulmonary interactions during mechanical ventilation. MATERIALS AND METHODS The study included a total of 25 domestic piglets. The animals were divided into three groups based on different strategies of ventilation. Group A; spontaneously breathing piglets; group B animals ventilated with tidal volume of 6 ml.kg-1 and group C with animals ventilated with tidal volume 10 ml.kg-1. Clinical monitoring and laboratory tests were performed for all groups at baseline and then at 1 hour and 12 hours for groups B and C. Ventilation indices, hemodynamics, urine output, creatinine clearance, glomerular filtration index, fractional excretion of sodium, free water clearance and tissue samples were recorded. The data obtained were statistically analysed. RESULTS Lower creatinine clearance and renal indices were seen in group B (p < 0.05) and in group C (p < 0.001) at 1 hour, and a difference in urine output for group C (p < 0.01) compared to group A was observed. At 12 hours, there was a further reduction in creatinine clearance and renal indices for group B (p < 0.05) and group C (p < 0.01). The lung mechanics and hemodynamics were not significantly influenced. CONCLUSIONS The study showed a causal relationship between renal dysfunction and positive pressure mechanical ventilation with respect to tidal volume and time (Tab. 4, Fig. 2, Ref. 17).
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Zedníková I, Černá M, Hlaváčková M, Hes O. [Phyllodes breast tumors]. Rozhl Chir 2015; 94:4-7. [PMID: 25604978] [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
INTRODUCTION Phyllodes tumour is a breast tumour occurring very rarely. It accounts for only in 1% of all cases of breast tumour. The diagnosis of phyllodes tumours can be difficult in consideration of the small number of cases. Treatment of phyllodes tumours is always surgical. METHODS In 2004-2013, we operated on twelve female patients with phyllodes tumours out of the total number of 1564 surgeries for breast tumours (0.8%) at the Department of Surgery at Teaching Hospital in Pilsen. We evaluated the age, the biological behaviour of the tumour depending on the tumour size and duration, the distant metastases, therapy and survival. RESULTS The average age at the time of surgery was fifty years (2684), the duration of disease to the surgical solution ranged from one month to ten years. Tumour size was in the range of two to twenty-nine centimetres, tumours measuring less than five centimetres were always benign. Tumour excision for benign phyllodes tumour was performed seven times. Malignant phyllodes tumour was diagnosed five times with mastectomy performed in each case, and the axilla was exenterated in three cases where nodes were benign in each of them. In one case, mastectomy was followed by radiotherapy because the tumour reached the edge of the resected part; the other patients were only monitored. In two patients, tumour spreading into the lungs was diagnosed at five to ten months after breast surgery. One patient with generalized disease died, the other ones live with no local recurrence of this disease. Median survival is fifty-two months; the disease-free interval is fifty months. CONCLUSION The results show that if phyllodes tumour is diagnosed in time, it is almost exclusively benign. If the case history is longer and the tumour is growing, the likelihood of malignancy increases. Surgical treatment is also sufficient in the case of malignant forms. The breast surgery does not need to be supplemented with exenteration of axilla.Key words: breast - phyllodes tumour.
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Zedníková I, Safránek J, Hlaváčková M, Hes O, Svoboda T. [Sarcoma of the chest wall after radiotherapy for breast carcinoma - a case report]. Rozhl Chir 2014; 93:396-400. [PMID: 25263476] [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: 06/03/2023]
Abstract
INTRODUCTION Sarcoma occurring in soft tissues after radiotherapy is a rare complication of radiation treatment of tumours. It was most often described after treatment for breast cancer as well as for non-Hodgkin lymphoma and cervical carcinoma. The time interval between the radiation therapy and the development of the sarcoma can be very wide. Treatment demands radical surgical resection of the sarcoma with the edge of the resected tissue without tumour cells. In some cases, this is followed by chemotherapy or radiotherapy. The median survival time is 23 months, the longest survival being associated with sarcomas removed in a radical way. CASE REPORT We present the case of a female patient with recurring leiomyosarcoma of the chest wall after radiotherapy for cancer of the right breast. In 2006, this 62-year-old patient was operated on to keep her right breast with axilla exenteration. After the surgery, hormonal therapy was followed by adjuvant radiotherapy of the right breast and the adjacent axilla. We used a linear accelerator and the total amount of radiation was 50 Gy (2 Gy fractionally once a day, five days a week). Four years after the operation, leiomyosarcoma was diagnosed in the pectoral muscle at the site where the tumour of the right breast had been excised. Between 2011 and 2013, a total of five operations of re-occurring sarcoma were performed - two excisions of the tumour, a mastectomy, rib resection and, at last, block resection of the chest wall. Adjuvant oncological treatment was not indicated. The patient, now being 69 years old, is still in a good physical and mental condition without any generalization of the disease. CONCLUSION Sarcoma of the chest wall is a relatively rare consequence of radiotherapy for breast cancer. Sarcoma treatment involves radical surgical resection of the tumour whenever possible. The surgery is mostly followed by radiotherapy which, however, is impossible in a patient after breast-preserving surgery for carcinoma with radiotherapy. Chemotherapy is not very effective in sarcomas. Therefore, the operation needs to be performed by an experienced surgeon in a sufficiently radical way.
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Hora M, Urge T, Trávníček I, Ferda J, Chudáček Z, Vaněček T, Michal M, Petersson F, Kuroda N, Hes O. MiT translocation renal cell carcinomas: two subgroups of tumours with translocations involving 6p21 [t (6; 11)] and Xp11.2 [t (X;1 or X or 17)]. Springerplus 2014; 3:245. [PMID: 24877033 PMCID: PMC4032393 DOI: 10.1186/2193-1801-3-245] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/16/2014] [Accepted: 04/30/2014] [Indexed: 02/03/2023]
Abstract
INTRODUCTION MiT translocation renal cell carcinomas (TRCC) predominantly occur in younger patients with only 25% of patients being over 40 years. TRCC contains two main subgroups with translocations involving 6p21 or Xp11.2. Herein we present 10 cases. MATERIALS Eight cases were treated at main author's institution (identified among 1653 (0.48%) cases of kidney tumours in adults). Two cases were retrieved from the Pilsen (CZ) Tumour Registry. RESULTS Six cases were type Xp11.2 and four 6p21; 7 female, 3 male patients; Xp11.2 4:2, 6p21 3:1. The mean age 49 years (range: 21-80), 5 patients (50%) over 40 years. The mean age of the group with Xp11.2 TRCCs was 55 (median 51) and 6p21 41 (32) years. One female with a 6p21 tumour (24 years) underwent nephrectomy at 4 months of pregnancy. Stage (UICC, 7th ed. 2009) was 5xI, 3xIII, 2xIV. The mean size of tumour was 80 (40-165) mm. The mean follow-up was 33.2 (1-92) months. In patients with 6p21 tumours, one (25%) died after 3 months due to widely metastatic disease. In patients with Xp11.2 tumours, 3 (50%) succumbed due to metastatic disease (range 1-8 months). Three patients with Xp11.2 are alive at 7, 52 and 92 months of follow-up, were diagnosed at early stage (T1a). CONCLUSION TRCCs were more common in females. Patient with 6p21 tumours were younger than those with Xp11.2. Both types have definitive malignant potential Type Xp11.2 seems to be a more aggressive neoplasm than 6p21. The case with metastatic 6p21 tumour is the 4th case described in the English literature.
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Affiliation(s)
- Milan Hora
- Department of Urology Faculty Hospital, E. Beneše 13, Pilsen, 305 99 Czech Republic ; Faculty of Medicine in Pilsen, Charles University in Prague, Prague, Czech Republic
| | - Tomáš Urge
- Department of Urology Faculty Hospital, E. Beneše 13, Pilsen, 305 99 Czech Republic ; Faculty of Medicine in Pilsen, Charles University in Prague, Prague, Czech Republic
| | - Ivan Trávníček
- Department of Urology Faculty Hospital, E. Beneše 13, Pilsen, 305 99 Czech Republic ; Faculty of Medicine in Pilsen, Charles University in Prague, Prague, Czech Republic
| | - Jiří Ferda
- Department of Radiology, Pilsen, Czech Republic ; Faculty of Medicine in Pilsen, Charles University in Prague, Prague, Czech Republic
| | | | - Tomáš Vaněček
- Department of Pathology, Faculty Hospital in Pilsen, Pilsen, Czech Republic
| | - Michal Michal
- Department of Pathology, Faculty Hospital in Pilsen, Pilsen, Czech Republic ; Faculty of Medicine in Pilsen, Charles University in Prague, Prague, Czech Republic
| | - Fredrik Petersson
- Department of Pathology, National University Health System, Singapore, Singapore
| | - Naoto Kuroda
- Department of Diagnostic Pathology, Kochi Red Cross Hospital, Kochi, Japan
| | - Ondřej Hes
- Department of Pathology, Faculty Hospital in Pilsen, Pilsen, Czech Republic ; Faculty of Medicine in Pilsen, Charles University in Prague, Prague, Czech Republic
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Hes O. [International Society of Urological Pathology (ISUP) Vancouver Classification of Renal Neoplasia 2012]. Cesk Patol 2014; 50:137-141. [PMID: 25418900] [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
Kidney tumours form a broad spectrum of distinguished histopathological and molecular genetic entities. The last WHO classification is dated to 2004. Current classification has been published in October 2013 by ISUP (International Society of Urological Pathology). There were 5 new epithelials tumours: tubulocystic renal cell carcinoma (RCC), acquired cystic disease-associated RCC, clear cell (tubulo-)papillary RCC, the MiT family translocation RCCs (in particular t(6;11) RCC), and hereditary leiomyomatosis RCC syndrome-associated RCC. Another 3 subtypes of RCC were added as "provisional" entities: thyroid-like follicular RCC; succinate dehydrogenase B deficiency-associated RCC; and ALK translocation RCC. Modifications were performed in already existing entities: multicystic clear cell RCC (formerly multilocular cystic RCC) is newly included as a subcategory of clear cell RCC with low malignant potential. Oncocytic papillary RCC (PRCC) has not been recognized as a distinctive subcategory of PRCC yet. Hybrid oncocytic-chromophobe tumour was placed within the chromophobe RCC category. Recent advances related to collecting duct carcinoma, renal medullary carcinoma, and mucinous spindle cell and tubular RCC were elucidated. Outside of the epithelial category, current approach to our understanding of angiomyolipoma, including the epithelioid variant and angiomyolipoma with epithelial cysts was clarified. Cystic nephroma and mixed epithelial and stromal tumour were considered as a spectrum of one entity. Synovial sarcoma was placed within the sarcoma group. The new classification is to be referred to as the International Society of Urological Pathology Vancouver Classification of Renal Neoplasia.
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Kuroda N, Tanaka A, Ohe C, Mikami S, Nagashima Y, Inoue K, Shuin T, Taguchi T, Tominaga A, Alvarado-Cabrero I, Petersson F, Brunelli M, Martignoni G, Michal M, Hes O. Review of renal carcinoid tumor with focus on clinical and pathobiological aspects. Histol Histopathol 2013; 28:15-21. [PMID: 23233056 DOI: 10.14670/hh-28.15] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Renal carcinoid tumor is a rare neoplasm. In this article, we review this neoplasm with a focus on clinical and pathobiological aspects. The majority of patients present in the fourth to seventh decades, but there is no gender predilection. Clinically, patients with renal carcinoid tumor frequently present with abdominal, back or flank pain. This tumor is occassionally associated with horseshoe kidney and/or mature cystic teratoma located in the kidney. Macroscopically, these tumors are well demarcated with a lobulated appearance and yellow or tan-brown color cut surface. Microscopically, these tumors are composed of monomorphic round to polygonal cells with granular amphophilic to eosinophilic cytoplasm. Tumor cells are arranged in trabecular, ribbon-like, gyriform, insular, glandular and solid patterns. The nuclei are round to oval and with evenly distributed nuclear chromatin, frequently with a "salt and pepper"-pattern. Immunohistochemically, tumor cells demonstrate immuno-labeling for chromogranin A and synaptophysin. Ultrastructurally, the neoplastic cells contain abundant dense core neurosecretory granules. In previous genetic studies, abnormalities of chromosomes 3 or 13 have been reported. The clinical behavior of renal carcinoid tumors is variable, but is more indolent than most renal cell carcinomas. Further investigations are warranted in order to elucidate the critical genetic abnormalities responsible for the pathogenesis of this rare entity in renal neoplastic pathology.
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Affiliation(s)
- N Kuroda
- Department of Diagnostic Pathology, Kochi Red Cross Hospital, Tokyo, Japan.
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Ferda J, Kastner J, Hora M, Hes O, Fínek J, Topolčan O, Kreuzberg B. A role of multifactorial evaluation of prostatic 3T MRI in patients with elevated prostatic-specific antigen levels: prospective comparison with ultrasound-guided transrectal biopsy. Anticancer Res 2013; 33:2791-2795. [PMID: 23749943] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
AIM To assess the role of multiparametric 3T magnetic resonance (3TMRI) of the prostate in detection of the prostatic carcinoma in a male population with elevated prostatic-specific antigen (PSA) and to compare the results with those of transrectal biopsies. MATERIALS AND METHODS A prospectively collected cohort of 191 men underwent 3T MRI before transrectal biopsy. The evaluation consisted of the assessment of T2-weighted images, diffusion-weighted images, MR spectroscopy and the pharmacokinetic evaluation of the data obtained during the dynamic post-contrast T1 imaging. The assessment included the calculation of the blood volume and transfer constant evaluations. The diagnosis of prostate carcinoma was based on a minimum of three positive signs obtained from MR studies--hypointensive T2 lesion, diffusion restriction, elevated choline/creatine peak in spectrum and malignant type of saturation by contrast agents. All biopsies were evaluated by a specialist in uropathology. RESULTS 164 patients underwent biopsy, in 27 the biopsy was omitted due to a lack or low probability of carcinoma: Overall, 84 carcinomas were found. Based on the comparison of biopsy results, 3T MRI reached a sensitivity of 97.6%, specificity of 85.0%, positive predictive value of 74.6% and negative predictive value of 96,3% respectively. There were only three false negative findings. In three patients with very suspicious MRI findings and PSA levels over 30 ng/ml, the biopsy did not confirm carcinoma, even though it was highly suspected. CONCLUSION The implementation of 3T MRI in routine assessment of patients with elevated PSA should reduce the number of biopsies performed and improve the number of tumors detected due to better targeted biopsies.
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Affiliation(s)
- Jiří Ferda
- Clinic of Imaging Methods, Charles University Teaching Hospital Plzen, Czech Republic.
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Zedníková I, Třešková I, Schmiedhuber P, Hes O. [Complications of breast augmentation - a case report]. Rozhl Chir 2012; 91:435-437. [PMID: 23153428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
As with any surgery, breast augmentation does have certain risks and complications. The aim of this article is to point out a rare complication of breast augmentation - axillary silicone lymphadenopathy (defined as the presence of silicone in the lymph nodes). The authors present a case report of silicone lymphadenopathy in a young woman after the rupture of a silicone breast implant. As the number of women with breast implants is increasing, it is necessary to bear this rare complication of breast augmentation in mind in differential diagnosis of axillary lymphadenopathy.
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Hes O, Michal M. [Pseudotumors of the testis and testicular adnexa]. Cesk Patol 2012; 48:146-149. [PMID: 23057429] [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: 06/01/2023]
Abstract
A review article dealing with the most common pseudotumors of the testicular region. Nodules of immature tubules, pseudotumors in adrenogenital syndrome, fibromatous periorchitis, pseudosarcomatous myofibroblastic proliferation, posstraumatic mesothelial glandular inclusions and vasitis nodosa are described in detail, including morphologic and immunohistochemical features, altogether with a differential diagnostic approach. Key words: testis - testicular adnexa - nodules of immature tubules - pseudotumors in adrenogenital syndrome - fibromatous periorchitis - pseudosarcomatous myofibroblastic proliferation - posstraumatic mesothelial glandular inclusions - vasitis nodosa.
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Hora M, Stránský P, Trávníček I, Ürge T, Eret V, Kreuzberg B, Baxa J, Mírka H, Petersson F, Hes O, Ferda J. Three-tesla MRI biphasic angiography: a method for preoperative assessment of the vascular supply in renal tumours—a surgical perspective. World J Urol 2012; 31:1171-6. [DOI: 10.1007/s00345-012-0870-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2012] [Accepted: 04/03/2012] [Indexed: 12/22/2022] Open
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Hora M, Eret V, Urge T, Klečka J, Trávníček I, Hes O, Petersson F, Stránský P. Complete laparoscopic nephroureterectomy with intravesical lockable clip. Cent European J Urol 2012; 65:75-9. [PMID: 24578933 PMCID: PMC3921777 DOI: 10.5173/ceju.2012.02.art4] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2012] [Revised: 03/07/2012] [Accepted: 03/16/2012] [Indexed: 12/03/2022] Open
Abstract
Introduction We present a cohort of patients with low-stage pelviureteric neoplastic disease who underwent complete laparoscopic nephroureterectomy (CLNUE) with intravesical lockable clip (IVLC). Due to the absence of a standard technique of NUE, the study was not randomized. Materials From 1/2010 to 1/2012, 21 patients were subjected to CLNUE-IVLC. The first step was transurethral excision of the ureterovesical junction with Collin's knife deep into the paravesical adipose tissue. The ureter was grasped with biopsy forceps and the distal end of the ureter was occluded with lockable clip. The applicator was introduced through a 5 mm port inserted as an epicystostomy. The patients were rotated to flank position and CLNUE followed. The endoscopically introduced clip on the distal ureter is proof of completion of the total ureterectomy. Results The mean operation time was 161 (115-200) min. In four (19.0%), the application of the clip failed and CLNUE was completed with non-occluded ureter. In three cases, subsequent laparoscopic nephrectomy was converted to open surgery. In two cases, the distal ureterectomy was completed with pluck technique through a lower abdominal incision that was also used for extraction of the specimen. There were four complications (Clavien II 2x, IIIb, V). Follow-up was available for all – mean 10.6 (range: 0-25) months. One died of disease generalization within 11 months. Conclusion CLNUE-IVLC is fast and safe. If needed, the endoscopic phase can be switched to open NUE. Disadvantages include: the need to change the position of the patient, the risk of inability to apply the clip on the distal ureter, and the risk of an unclosed defect of the urinary bladder.
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Affiliation(s)
- Milan Hora
- Department of Urology, Charles University Hospital, Pilsen, Czech Republic
| | - Viktor Eret
- Department of Urology, Charles University Hospital, Pilsen, Czech Republic
| | - Tomáš Urge
- Department of Urology, Charles University Hospital, Pilsen, Czech Republic
| | - Jiří Klečka
- Department of Urology, Charles University Hospital, Pilsen, Czech Republic
| | - Ivan Trávníček
- Department of Urology, Charles University Hospital, Pilsen, Czech Republic
| | - Ondřej Hes
- Department of Pathology, Charles University Hospital, Pilsen, Czech Republic
| | - Fredrik Petersson
- Department of Pathology, Charles University Hospital, Pilsen, Czech Republic ; Department of Pathology, National University Health System, Singapore
| | - Petr Stránský
- Department of Urology, Charles University Hospital, Pilsen, Czech Republic
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