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Bateman AC, Culver EL. Challenges and pitfalls in the diagnosis of IgG4-related disease. Semin Diagn Pathol 2024; 41:45-53. [PMID: 38000975 DOI: 10.1053/j.semdp.2023.11.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Accepted: 11/14/2023] [Indexed: 11/26/2023]
Abstract
IgG4-related disease (IgG4-RD) is a relatively novel fibroinflammatory condition characterized typically by dense lymphoplasmacytic inflammation, storiform fibrosis and obliterative venulitis, together with prominent IgG4+ plasma cells and an IgG4+/IgG+ plasma cell ratio of >40 %. The diagnosis is usually made on a combination of clinical and serological features together with characteristic radiological and histological appearances. The condition may be limited to a single tissue/organ (e.g., autoimmune pancreatitis) or may be multicentric in nature - four clinical 'patterns' of disease distribution have recently been described. The diagnosis of IgG4-RD can be challenging, particularly when the clinical presentation is unusual and/or when the histological features are not typical. A diagnosis of IgG4-RD may still be achieved in these situations, after careful clinicopathological discussion e.g., at a specialist multidisciplinary team meeting. However, a wide range of other conditions (neoplastic and non-neoplastic) can mimic IgG4-RD, clinically and/or on histological examination. The relationship between IgG4-RD and non-IgG4-RD associated conditions in some clinical situations is particularly complex. This review describes the role of histological examination in the diagnosis of IgG4-RD, discusses some of the practical difficulties that may be encountered and provides an insight into the range of non-IgG4-RD associated conditions that can mimic IgG4-RD on clinical and/or histological grounds. The requirement for interpretation of histological features in the context of the global clinical picture of the patient is highlighted and emphasized.
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Affiliation(s)
- Adrian C Bateman
- Department of Cellular Pathology, Southampton General Hospital, MP002, Level E, South Block, Tremona Road, Southampton SO16 6YD, UK.
| | - Emma L Culver
- Translational Gastroenterology Unit, John Radcliffe Hospital, Oxford, UK
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Alosco ML, White M, Bell C, Faheem F, Tripodis Y, Yhang E, Baucom Z, Martin B, Palmisano J, Dams-O'Connor K, Crary JF, Goldstein LE, Katz DI, Dwyer B, Daneshvar DH, Nowinski C, Cantu RC, Kowall NW, Stern RA, Alvarez VE, Huber BR, Stein TD, McKee AC, Mez J. Cognitive, functional, and neuropsychiatric correlates of regional tau pathology in autopsy-confirmed chronic traumatic encephalopathy. Mol Neurodegener 2024; 19:10. [PMID: 38317248 PMCID: PMC10845638 DOI: 10.1186/s13024-023-00697-2] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Accepted: 12/11/2023] [Indexed: 02/07/2024] Open
Abstract
BACKGROUND Chronic traumatic encephalopathy (CTE) is a neurodegenerative disease characterized by hyperphosphorylated tau (p-tau) accumulation. The clinical features associated with CTE pathology are unclear. In brain donors with autopsy-confirmed CTE, we investigated the association of CTE p-tau pathology density and location with cognitive, functional, and neuropsychiatric symptoms. METHODS In 364 brain donors with autopsy confirmed CTE, semi-quantitative p-tau severity (range: 0-3) was assessed in 10 cortical and subcortical regions. We summed ratings across regions to form a p-tau severity global composite (range: 0-30). Informants completed standardized scales of cognition (Cognitive Difficulties Scale, CDS; BRIEF-A Metacognition Index, MI), activities of daily living (Functional Activities Questionnaire), neurobehavioral dysregulation (BRIEF-A Behavioral Regulation Index, BRI; Barratt Impulsiveness Scale, BIS-11), aggression (Brown-Goodwin Aggression Scale), depression (Geriatric Depression Scale-15, GDS-15), and apathy (Apathy Evaluation Scale, AES). Ordinary least squares regression models examined associations between global and regional p-tau severity (separate models for each region) with each clinical scale, adjusting for age at death, racial identity, education level, and history of hypertension, obstructive sleep apnea, and substance use treatment. Ridge regression models that incorporated p-tau severity across all regions in the same model assessed which regions showed independent effects. RESULTS The sample was predominantly American football players (333; 91.2%); 140 (38.5%) had low CTE and 224 (61.5%) had high CTE. Global p-tau severity was associated with higher (i.e., worse) scores on the cognitive and functional scales: MI ([Formula: see text] standardized = 0.02, 95%CI = 0.01-0.04), CDS ([Formula: see text] standardized = 0.02, 95%CI = 0.01-0.04), and FAQ ([Formula: see text] standardized = 0.03, 95%CI = 0.01-0.04). After false-discovery rate correction, p-tau severity in the frontal, inferior parietal, and superior temporal cortex, and the amygdala was associated with higher CDS ([Formula: see text] sstandardized = 0.17-0.29, ps < 0.01) and FAQ ([Formula: see text] sstandardized = 0.21-0.26, ps < 0.01); frontal and inferior parietal cortex was associated with higher MI ([Formula: see text] sstandardized = 0.21-0.29, ps < 0.05); frontal cortex was associated with higher BRI ([Formula: see text] standardized = 0.21, p < 0.01). Regions with effects independent of other regions included frontal cortex (CDS, MI, FAQ, BRI), inferior parietal cortex (CDS) and amygdala (FAQ). P-tau explained 13-49% of variance in cognitive and functional scales and 6-14% of variance in neuropsychiatric scales. CONCLUSION Accumulation of p-tau aggregates, especially in the frontal cortex, are associated with cognitive, functional, and certain neurobehavioral symptoms in CTE.
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Affiliation(s)
- Michael L Alosco
- Boston University Alzheimer's Disease Center and CTE Center, Boston University Chobanian & Avedisian School of Medicine, Boston, MA, USA
- Department of Neurology, Boston University Chobanian & Avedisian School of Medicine, Boston, MA, USA
| | - Micaela White
- Davis School of Medicine, University of California, Sacramento, CA, USA
| | - Carter Bell
- Department of Neurology, New York University Grossman School of Medicine, New York, NY, USA
| | - Farwa Faheem
- Boston University Alzheimer's Disease Center and CTE Center, Boston University Chobanian & Avedisian School of Medicine, Boston, MA, USA
| | - Yorghos Tripodis
- Boston University Alzheimer's Disease Center and CTE Center, Boston University Chobanian & Avedisian School of Medicine, Boston, MA, USA
- Department of Biostatistics, Boston University School of Public Health, Boston, MA, USA
| | - Eukyung Yhang
- Department of Biostatistics, Boston University School of Public Health, Boston, MA, USA
| | - Zachary Baucom
- Department of Biostatistics, Boston University School of Public Health, Boston, MA, USA
| | - Brett Martin
- Biostatistics and Epidemiology Data Analytics Center, Boston University School of Public Health, Boston, MA, USA
| | - Joseph Palmisano
- Biostatistics and Epidemiology Data Analytics Center, Boston University School of Public Health, Boston, MA, USA
| | - Kristen Dams-O'Connor
- Department of Rehabilitation and Human Performance, Brain Injury Research Center, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - John F Crary
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Pathology, Molecular and Cell-Based Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Lee E Goldstein
- Boston University Alzheimer's Disease Center and CTE Center, Boston University Chobanian & Avedisian School of Medicine, Boston, MA, USA
- Department of Pathology and Laboratory Medicine, Boston University Chobanian & Avedisian School of Medicine, Boston, MA, USA
- Department of Psychiatry, Boston University Chobanian & Avedisian School of Medicine, Boston, MA, USA
- Departments of Biomedical, Electrical & Computer Engineering, Boston University College of Engineering, Boston, MA, USA
| | - Douglas I Katz
- Department of Neurology, Boston University Chobanian & Avedisian School of Medicine, Boston, MA, USA
- Braintree Rehabilitation Hospital, Braintree, MA, USA
| | - Brigid Dwyer
- Department of Neurology, Boston University Chobanian & Avedisian School of Medicine, Boston, MA, USA
- Braintree Rehabilitation Hospital, Braintree, MA, USA
| | - Daniel H Daneshvar
- Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, MA, USA
| | - Christopher Nowinski
- Boston University Alzheimer's Disease Center and CTE Center, Boston University Chobanian & Avedisian School of Medicine, Boston, MA, USA
- Concussion Legacy Foundation, Boston, MA, USA
| | - Robert C Cantu
- Boston University Alzheimer's Disease Center and CTE Center, Boston University Chobanian & Avedisian School of Medicine, Boston, MA, USA
- Concussion Legacy Foundation, Boston, MA, USA
- Department of Neurosurgery, Boston University Chobanian & Avedisian School of Medicine, Boston, MA, USA
- Department of Neurosurgery, Emerson Hospital, Concord, MA, USA
| | - Neil W Kowall
- Boston University Alzheimer's Disease Center and CTE Center, Boston University Chobanian & Avedisian School of Medicine, Boston, MA, USA
- Department of Neurology, Boston University Chobanian & Avedisian School of Medicine, Boston, MA, USA
| | - Robert A Stern
- Boston University Alzheimer's Disease Center and CTE Center, Boston University Chobanian & Avedisian School of Medicine, Boston, MA, USA
- Department of Neurology, Boston University Chobanian & Avedisian School of Medicine, Boston, MA, USA
- Department of Neurosurgery, Boston University Chobanian & Avedisian School of Medicine, Boston, MA, USA
- Department of Anatomy and Neurobiology, Boston University Chobanian & Avedisian School of Medicine, Boston, MA, USA
| | - Victor E Alvarez
- Boston University Alzheimer's Disease Center and CTE Center, Boston University Chobanian & Avedisian School of Medicine, Boston, MA, USA
- Department of Neurology, Boston University Chobanian & Avedisian School of Medicine, Boston, MA, USA
- System, U.S. Department of Veteran Affairs, VA Boston Healthcare, Boston, MA, USA
- Department of Veterans Affairs Medical Center, Bedford, MA, USA
| | - Bertrand Russell Huber
- Boston University Alzheimer's Disease Center and CTE Center, Boston University Chobanian & Avedisian School of Medicine, Boston, MA, USA
- Department of Neurology, Boston University Chobanian & Avedisian School of Medicine, Boston, MA, USA
- System, U.S. Department of Veteran Affairs, VA Boston Healthcare, Boston, MA, USA
- Department of Veterans Affairs Medical Center, Bedford, MA, USA
| | - Thor D Stein
- Boston University Alzheimer's Disease Center and CTE Center, Boston University Chobanian & Avedisian School of Medicine, Boston, MA, USA
- Department of Pathology and Laboratory Medicine, Boston University Chobanian & Avedisian School of Medicine, Boston, MA, USA
- System, U.S. Department of Veteran Affairs, VA Boston Healthcare, Boston, MA, USA
- Department of Veterans Affairs Medical Center, Bedford, MA, USA
| | - Ann C McKee
- Boston University Alzheimer's Disease Center and CTE Center, Boston University Chobanian & Avedisian School of Medicine, Boston, MA, USA
- Department of Neurology, Boston University Chobanian & Avedisian School of Medicine, Boston, MA, USA
- Department of Pathology and Laboratory Medicine, Boston University Chobanian & Avedisian School of Medicine, Boston, MA, USA
- System, U.S. Department of Veteran Affairs, VA Boston Healthcare, Boston, MA, USA
- Department of Veterans Affairs Medical Center, Bedford, MA, USA
| | - Jesse Mez
- Boston University Alzheimer's Disease Center and CTE Center, Boston University Chobanian & Avedisian School of Medicine, Boston, MA, USA.
- Department of Neurology, Boston University Chobanian & Avedisian School of Medicine, Boston, MA, USA.
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Singh K, Urs AB, Koner BC, Augustine J, Shrivastava R, Narayan B. Upregulation of miRNA-196a and miRNA-196b correlates with Bryne's prognostic score in oral squamous cell carcinoma. Pathol Res Pract 2024; 253:154954. [PMID: 38039741 DOI: 10.1016/j.prp.2023.154954] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Revised: 11/13/2023] [Accepted: 11/15/2023] [Indexed: 12/03/2023]
Abstract
BACKGROUND microRNA(miRNA)-196a and miRNA-196b expression has been found to be dysregulated and involved in tumorigenesis and tumor progression in array of cancers through different targets. The role of these miRNAs together in clinical application is not always consistent and, its prognostic value in oral squamous cell carcinoma (OSCC) is still elusive. This study was performed to investigate the correlation of these miRNAs expression with histological grades of OSCC according to Bryne's histological grading system, to predict prognosis and to evaluate their relationship with clinico-pathological data. METHODS Real-time quantitative Reverse Transcription Polymerase Chain Reaction (qRT-PCR) was done to evaluate the expression levels of miRNA-196a and miRNA-196b in 75 pairs of OSCC tissue matched with adjacent normal mucosa, used as a control. RESULTS miRNA-196a and 196b expression in OSCC was significantly higher than that in corresponding adjacent normal tissues (p > 0.001). Also, a significant differential correlation was found in between the expression levels of these two miRNAs (Pearson correlation test r = 0.676, p-value<0.0001). The increased expression of these miRNAs was more frequently observed in OSCC tissues with advanced clinical and pathological TNM stages (IVa and IVb, pIVb respectively, p-value<0.0001). Significant correlation was found between miRNA-196a upregulation and moderate prognostic score (p-value<0.0001) in comparison with good and poor prognostic score of histological grades of OSCC. Sensitivity and specificity for miRNA-196a were 95 % and 85 %, respectively (AUC = 1, 95 % CI = 0.617-0.850; p 0.001), while for miRNA-196b were 94 % and 86 %, respectively (AUC = 0.808, 95 % CI = 0.701-0.916; p0.0001). CONCLUSIONS These findings suggest that the increased expression of miRNA-196a and 196b may play an important role in tumor progression in OSCC. miRNA-196a might be a useful marker for predicting the clinical outcome of OSCC, especially for advanced stages. In conclusion, our data demonstrate for the first time that these miRNAs may serve as a potent prognostic marker for tumor progression. We further highlight miRNA-196a and miRNA-196b as a promising predictor of prognostic assessment in OSCC.
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Affiliation(s)
- Kuldeep Singh
- Department of Oral Pathology and Microbiology, Maulana Azad Institute of Dental Sciences, New Delhi, India
| | - Aadithya B Urs
- Department of Oral Pathology and Microbiology, Maulana Azad Institute of Dental Sciences, New Delhi, India.
| | - Bidhan Chandra Koner
- Department of Biochemistry, Maulana Azad Medical College, New Delhi 110002, India
| | - Jeyaseelan Augustine
- Department of Oral Pathology and Microbiology, Maulana Azad Institute of Dental Sciences, New Delhi, India
| | - Ritika Shrivastava
- Department of Biochemistry, Maulana Azad Medical College, New Delhi 110002, India
| | - Bhaskar Narayan
- Department of Oral Pathology and Microbiology, Maulana Azad Institute of Dental Sciences, New Delhi, India
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VandeVrede L, La Joie R, Horiki S, Mundada NS, Koestler M, Hwang JH, Ljubenkov PA, Rojas JC, Rabinovici GD, Boxer AL, Seeley WW. Co-pathology may impact outcomes of amyloid-targeting treatments: clinicopathological results from two patients treated with aducanumab. Acta Neuropathol 2023; 146:777-781. [PMID: 37725166 PMCID: PMC10564667 DOI: 10.1007/s00401-023-02631-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Revised: 09/05/2023] [Accepted: 09/06/2023] [Indexed: 09/21/2023]
Affiliation(s)
- Lawren VandeVrede
- Department of Neurology, Memory and Aging Center, University of California San Francisco, 675 Nelson Rising Lane, Suite 190, San Francisco, CA, 94158, USA.
| | - Renaud La Joie
- Department of Neurology, Memory and Aging Center, University of California San Francisco, 675 Nelson Rising Lane, Suite 190, San Francisco, CA, 94158, USA
| | - Sheena Horiki
- Department of Neurology, Memory and Aging Center, University of California San Francisco, 675 Nelson Rising Lane, Suite 190, San Francisco, CA, 94158, USA
| | - Nidhi S Mundada
- Department of Neurology, Memory and Aging Center, University of California San Francisco, 675 Nelson Rising Lane, Suite 190, San Francisco, CA, 94158, USA
| | - Mary Koestler
- Department of Neurology, Memory and Aging Center, University of California San Francisco, 675 Nelson Rising Lane, Suite 190, San Francisco, CA, 94158, USA
| | - Ji-Hye Hwang
- Department of Neurology, Memory and Aging Center, University of California San Francisco, 675 Nelson Rising Lane, Suite 190, San Francisco, CA, 94158, USA
| | - Peter A Ljubenkov
- Department of Neurology, Memory and Aging Center, University of California San Francisco, 675 Nelson Rising Lane, Suite 190, San Francisco, CA, 94158, USA
| | - Julio C Rojas
- Department of Neurology, Memory and Aging Center, University of California San Francisco, 675 Nelson Rising Lane, Suite 190, San Francisco, CA, 94158, USA
| | - Gil D Rabinovici
- Department of Neurology, Memory and Aging Center, University of California San Francisco, 675 Nelson Rising Lane, Suite 190, San Francisco, CA, 94158, USA
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA, USA
| | - Adam L Boxer
- Department of Neurology, Memory and Aging Center, University of California San Francisco, 675 Nelson Rising Lane, Suite 190, San Francisco, CA, 94158, USA
| | - William W Seeley
- Department of Neurology, Memory and Aging Center, University of California San Francisco, 675 Nelson Rising Lane, Suite 190, San Francisco, CA, 94158, USA
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Llamas-Velasco M, Fraga J, Rodríguez-Villa Lario A, Catalá A, Pérez-González YC, Galván C, Ruiz-Villaverde R, Sánchez-Pérez J, Wiesner T, Metze D. A Series of 69 COVID-related Dermatoses With Biopsy, Immunohistochemistry With Anti-spike 3, in situ Hybridization and PCR: A Critical Reappraisal of Viral Involvement in COVID-19 Skin Lesions. Actas Dermosifiliogr 2023; 114:747-754. [PMID: 37331619 PMCID: PMC10273783 DOI: 10.1016/j.ad.2023.05.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2023] [Revised: 05/15/2023] [Accepted: 05/24/2023] [Indexed: 06/20/2023] Open
Abstract
BACKGROUND Despite the large number of articles published on skin lesions related to COVID-19, clinicopathological correlation has not been performed consistently and immunohistochemistry to demonstrate spike 3 protein expression has not been validated through RT-PCR. MATERIAL AND METHODS We compiled 69 cases of patients with confirmed COVID-19, where skin lesions were clinically and histopathologically studied. Immunohistochemistry (IHC) and RT-PCR was performed in skin biopsies. RESULTS After a careful review of the cases, 15 were found to be dermatosis not related to COVID-19, while the rest of the lesions could be classified according to their clinical characteristics as vesicular (4), maculopapular eruptions (41), urticariform (9), livedo and necrosis (10) and pernio-like (5). Although histopathological features were similar to previously reported results, we found two previously unreported findings, maculopapular eruptions with squamous eccrine syringometaplasia and neutrophilic epitheliotropism. IHC showed in some cases endothelial and epidermal staining but RT-PCR was negative in all the tested cases. Thus, direct viral involvement could not be demonstrated. CONCLUSIONS Despite presenting the largest series of confirmed COVID-19 patients with histopathologically studied skin manifestations, direct viral involvement was difficult to establish. Vasculopathic and urticariform lesions seem to be those more clearly related to the viral infection, despite IHC or RT-PCR negative results failed to demonstrate viral presence. These findings, as in other dermatological areas, highlight the need of a clinico-pathological correlation to increase knowledge about viral involvement in COVID-19 skin-related lesions.
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Affiliation(s)
- M Llamas-Velasco
- Dermatology Department of Hospital Universitario de la Princesa, Madrid, Spain.
| | - J Fraga
- Pathology Department of Hospital Universitario de la Princesa, Spain
| | | | - A Catalá
- Dermatology Department of Hospital Clinic de Barcelona, Spain
| | | | - C Galván
- Dermatology Department of Hospital de Móstoles, Madrid, Spain
| | - R Ruiz-Villaverde
- Dermatology Department of Hospital Universitario San Cecilio, Granada, Spain
| | - J Sánchez-Pérez
- Dermatology Department of Hospital Universitario de la Princesa, Madrid, Spain
| | - T Wiesner
- Dermatology Department at the Medical University in Vienna, Austria
| | - D Metze
- Department of Dermatology, University of Munster, Germany
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Llamas-Velasco M, Fraga J, Rodríguez-Villa Lario A, Catalá A, Pérez-González YC, Galván C, Ruiz-Villaverde R, Sánchez-Pérez J, Wiesner T, Metze D. A Series of 69 COVID-related Dermatoses With Biopsy, Immunohistochemistry With Anti-spike 3, in situ Hybridization and PCR: A Critical Reappraisal of Viral Involvement in COVID-19 Skin Lesions. Actas Dermosifiliogr 2023; 114:T747-T754. [PMID: 37516249 DOI: 10.1016/j.ad.2023.05.031] [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: 02/26/2023] [Accepted: 05/24/2023] [Indexed: 07/31/2023] Open
Abstract
BACKGROUND Despite the large number of articles published on skin lesions related to COVID-19, clinicopathological correlation has not been performed consistently and immunohistochemistry to demonstrate spike 3 protein expression has not been validated through RT-PCR. MATERIAL AND METHODS We compiled 69 cases of patients with confirmed COVID-19, where skin lesions were clinically and histopathologically studied. Immunohistochemistry (IHC) and RT-PCR was performed in skin biopsies. RESULTS After a careful review of the cases, 15 were found to be dermatosis not related to COVID-19, while the rest of the lesions could be classified according to their clinical characteristics as vesicular (4), maculopapular eruptions (41), urticariform (9), livedo and necrosis (10) and pernio-like (5). Although histopathological features were similar to previously reported results, we found two previously unreported findings, maculopapular eruptions with squamous eccrine syringometaplasia and neutrophilic epitheliotropism. IHC showed in some cases endothelial and epidermal staining but RT-PCR was negative in all the tested cases. Thus, direct viral involvement could not be demonstrated. CONCLUSIONS Despite presenting the largest series of confirmed COVID-19 patients with histopathologically studied skin manifestations, direct viral involvement was difficult to establish. Vasculopathic and urticariform lesions seem to be those more clearly related to the viral infection, despite IHC or RT-PCR negative results failed to demonstrate viral presence. These findings, as in other dermatological areas, highlight the need of a clinico-pathological correlation to increase knowledge about viral involvement in COVID-19 skin-related lesions.
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Affiliation(s)
- M Llamas-Velasco
- Departamento de Dermatología, Hospital Universitario de La Princesa, Madrid, España.
| | - J Fraga
- Departamento de Patología, Hospital Universitario de La Princesa, Madrid, España
| | | | - A Catalá
- Departamento de Dermatología, Hospital Clínic de Barcelona, Barcelona, España
| | | | - C Galván
- Departamento de Dermatología, Hospital de Móstoles, Madrid, España
| | - R Ruiz-Villaverde
- Departamento de Dermatología, Hospital Universitario San Cecilio, Granada, España
| | - J Sánchez-Pérez
- Departamento de Dermatología, Hospital Universitario de La Princesa, Madrid, España
| | - T Wiesner
- Departamento de Dermatología, Universidad de Medicina de Viena, Viena, Austria
| | - D Metze
- Departamento de Dermatología, Universidad de Münster, Münster, Alemania
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Paul M, Addya S, Sengupta M, Basu K, Roychowdhury A, Bandopadhyay M. Spectrum of renal vascular lesions among patients with lupus nephritis: An experience from a tertiary care center. INDIAN J PATHOL MICR 2023; 66:751-757. [PMID: 38084527 DOI: 10.4103/ijpm.ijpm_327_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Background Lupus nephritis (LN) is the assemblage of glomerular, tubulointerstitial and vascular changes. Despite the fact that glomerular changes are overemphasized in pathological classification and scoring system, but the existence of vascular damage negatively impact the clinical course. Aims and Objective This study was conducted to determine the clinicopathological spectrum of renal vascular lesions in lupus nephritis. Materials and Methods Renal microvascular lesions in biopsy proven lupus nephritis were classified into 5 major categories-thrombotic microangiopathy, true vasculitis; lupus vasculopathy, uncomplicated vascular immune deposits, and arterial. Clinical details, laboratory parameters and histopathological variables were compared among all groups. Summary of chronic changes was also assessed. Results Biopsies from 56 patients revealed thrombotic microangiopathy (2), lupus vasculopathy (3), uncomplicated vascular immune deposit (6), PAN type vasculitis (1) and arterial sclerosis (13). No renal vascular lesions were found in 35.18% of patients. At the time of biopsy, arterial sclerosis or lupus vasculopathy patients were older Nephritis subtype. Activity indices were higher in lupus vasculopathy group whereas patients with arteriosclerosis showed highest chronicity index. Conclusions Renal vascular lesions are common in systemic lupus erythematosus patients with nephritis and may be associated with aggressive clinical course.
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Affiliation(s)
- Madhumita Paul
- Department of Pathology, IPGME&R and SSKM Hospital, Kolkata, West Bengal, India
| | - Soma Addya
- Department of Pathology, IPGME&R and SSKM Hospital, Kolkata, West Bengal, India
| | - Moumita Sengupta
- Department of Pathology, IPGME&R and SSKM Hospital, Kolkata, West Bengal, India
| | - Keya Basu
- Department of Pathology, IPGME&R and SSKM Hospital, Kolkata, West Bengal, India
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Liu F, Sun J, Wang X, Jin S, Sun F, Wang T, Yuan B, Qiu W, Ma C. Focal-type, but not Diffuse-type, Amyloid Beta Plaques are Correlated with Alzheimer's Neuropathology, Cognitive Dysfunction, and Neuroinflammation in the Human Hippocampus. Neurosci Bull 2022. [PMID: 36028642 DOI: 10.1007/s12264-022-00927-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2021] [Accepted: 04/28/2022] [Indexed: 11/24/2022] Open
Abstract
Amyloid beta (Aβ) plaques are one of the hallmarks of Alzheimer’s disease (AD). However, currently available anti-amyloid therapies fail to show effectiveness in the treatment of AD in humans. It has been found that there are different types of Aβ plaque (diffuse and focal types) in the postmortem human brain. In this study, we aimed to investigate the correlations among different types of Aβ plaque and AD-related neuropathological and cognitive changes based on a postmortem human brain bank in China. The results indicated that focal plaques, but not diffuse plaques, significantly increased with age in the human hippocampus. We also found that the number of focal plaques was positively correlated with the severity of AD-related neuropathological changes (measured by the “ABC” scoring system) and cognitive decline (measured by the Everyday Cognitive Insider Questionnaire). Furthermore, most of the focal plaques were co-localized with neuritic plaques (identified by Bielschowsky silver staining) and accompanied by microglial and other inflammatory cells. Our findings suggest the potential of using focal-type but not general Aβ plaques as biomarkers for the neuropathological evaluation of AD.
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Guleria P, Kumar L, Kumar S, Bhatla N, Ray R, Singhal S, Meena J, Mathur SR. A clinicopathological study of granulosa cell tumors of the ovary: Can morphology predict prognosis? INDIAN J PATHOL MICR 2020; 63:53-59. [PMID: 32031123 DOI: 10.4103/ijpm.ijpm_403_19] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Objective Granulosa cell tumors (GCT) are low-grade malignant sex cord-stromal tumors (SCST) with late metastasis/recurrences and long disease-free periods. We performed a clinicopathological evaluation of GCT to ascertain features having prognostic impact. Materials and Methods All cases of GCT of ovary from January 2006 to December 2018 were assessed for architectural patterns, nuclear grooves, and Call-Exner bodies. Each feature was graded on frequency of occurrence: not present (0)-very frequent (3). Anisonucleosis, necrosis, and inflammation were noted. Cases were grouped on mitotic count; <10 mitosis/10 High power field (HPF) or >=11 mitoses/10 HPF and Ki-67 index; <10% Ki-67 and >=11% Ki-67. Results GCT formed 60.1% of SCST. Sixty cases' ages were in the range of 15-78 years (median 45). Clinical details were available in 37. Commonest presentation was abnormal uterine bleeding. Serum CA125 was raised in 16.1% and Inhibin in 58.8%. Seventy percent were in stage I. Disease recurrence was associated with higher stage (P = 0.007). The most frequent pattern was diffuse sheets (47%). Call-Exner bodies were absent in 22.2%. Grooves with score 1, 2, and 3 were seen in 35.8%, 23.5%, and 13.6%, respectively. Anisonucleosis was present in 26.7%, necrosis in 11.1%, and lympho-plasmacytic infiltrate in 43%. Out of total, 93.3% had <10 mitosis/10 HPF and 43.2% had recurrence, most with high Ki-67 (P = 0.064). Conclusion Our study outlines histomorphological spectrum of GCT and emphasizes its frequent occurrence in lower stages with late recurrences. The presence of grooves may indicate granulosa-cell origin. Call-Exner bodies are not a necessity. Histomorphological features are not prognostically important. However, prognostic value of Ki-67 cannot be excluded. Limitation of the study was a small number of cases with follow-up.
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Affiliation(s)
- Prerna Guleria
- Department of Pathology, All India Institute of Medical Sciences, New Delhi, India
| | - Lalit Kumar
- Department of Medical Oncology, Dr. BRA Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi, India
| | - Sunesh Kumar
- Department of Obstetrics and Gynaecology, All India Institute of Medical Sciences, New Delhi, India
| | - Neerja Bhatla
- Department of Obstetrics and Gynaecology, All India Institute of Medical Sciences, New Delhi, India
| | - Ruma Ray
- Department of Pathology, All India Institute of Medical Sciences, New Delhi, India
| | - Seema Singhal
- Department of Obstetrics and Gynaecology, All India Institute of Medical Sciences, New Delhi, India
| | - Jyoti Meena
- Department of Obstetrics and Gynaecology, All India Institute of Medical Sciences, New Delhi, India
| | - Sandeep R Mathur
- Department of Pathology, All India Institute of Medical Sciences, New Delhi, India
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10
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Arora P, Roychaudhury A, Pandey R. Non-diabetic Renal Diseases in Patients with Diabetes Mellitus Clinicopathological Correlation. Indian J Nephrol 2020; 30:295-300. [PMID: 33707815 PMCID: PMC7869641 DOI: 10.4103/ijn.ijn_13_19] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2019] [Revised: 05/28/2019] [Accepted: 06/30/2019] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND AND AIMS Non-diabetic renal diseases (NDRDs) form an important part of disease manifestations in patients with diabetes. METHODS This hospital-based prospective study was conducted to analyze incidence and spectrum of NDRDs in patients with diabetes with or without diabetic nephropathy (DN), effect of early specific interventions on outcome, and renal-retinal relationship in type 1 and type 2 diabetes mellitus with nephropathy. 44 Patients with T2DM with the clinical suspicion of NDRD were subjected to renal biopsy Renal biopsies were performed by using an automated biopsy gun. Tissue was processed for Light microscopy-LM and Immunofluorescence-IF. Electron Microscopy was done as and when required by reprocessing the tissue embedded in paraffin for LM. Biopsies were reported by one experienced renal pathologist. RESULTS Renal histopathology revealed that of 44 enrolled patients with clinically suspected NDRD, 61.4% had isolated NDRD, 13.6% had NDRD superimposed on DN, and 25% had isolated DN. The most common NDRDs were minimal change disease (19.2%) and DN + chronic pyelonephritis (33.3%) in patients with isolated NDRD, and NDRD superimposed on DN, respectively. In the DN group, no patient had proliferative diabetic retinopathy (PDR) or hypertensive retinopathy, 45.5% had nonproliferative diabetic retinopathy (NPDR) and 54.5% had no microangiopathy in retina. In the NDRD group, 9.1% each had PDR and hypertensive retinopathy, 36.4% had NPDR and 45.4% had no microangiopathy in retina. No patient in the DN group and 72.7% in the NDRD group received specific treatment. In hospital, dialysis support was provided to 27.3% and 21.2% of patients in the DN and NDRD groups, respectively. In the DN group, 72.7% of patients improved with conservative therapy, 18.2% were dependent on dialysis when discharged. One patient died during treatment. In the NDRD group, 78.8% showed recovery in the renal function and clinical improvement, 15.1% were dialysis dependent when discharged. Two patients died during treatment. CONCLUSION Accurate diagnosis of underlying NDRD by kidney biopsy facilitates initiation of specific therapy, which may lead to clinical improvement in significant number of patients.
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Affiliation(s)
- Puneet Arora
- Department of Nephrology, Max Super Speciality Hospital, Dehradun, Uttarakhand, India
| | - Arpita Roychaudhury
- Department of Nephrology, Institute of Post Graduate Medical Education and Research, Kolkata, West Bengal, India
| | - Rajendra Pandey
- Department of Nephrology, Institute of Post Graduate Medical Education and Research, Kolkata, West Bengal, India
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11
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Kłosowicz A, Thompson C, Tosti A. Erythematous Papules Involving the Eyebrows in a Patient with a History of Rosacea and Hair Loss. Skin Appendage Disord 2020; 6:190-193. [PMID: 32656245 DOI: 10.1159/000506749] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Accepted: 02/21/2020] [Indexed: 12/19/2022] Open
Affiliation(s)
- Agata Kłosowicz
- Department of Dermatology, University Hospital in Kraków, Kraków, Poland
| | | | - Antonella Tosti
- Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, Florida, USA
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12
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El Hanbuli HM, Elmahdi MH, Kamal N. Peeling Skin Syndrome: A Pathologically Invisible Dermatosis. J Microsc Ultrastruct 2019; 7:141-142. [PMID: 31548926 PMCID: PMC6753698 DOI: 10.4103/jmau.jmau_5_19] [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] [Indexed: 12/03/2022] Open
Abstract
Peeling skin syndrome is a relatively rare clinical case with pathology of apparently normal skin that needs clinical details to reach accurate diagnoses. Hence, this case was used as examples to declare how it is important for both the pathologist and the dermatologist to cooperate to reach an accurate diagnosis.
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Affiliation(s)
- Hala M El Hanbuli
- Department of Pathology, Faculty of Medicine, Fayoum University, Fayoum, Egypt
| | - Mohamed H Elmahdi
- Department of Pathology, Faculty of Medicine, Fayoum University, Fayoum, Egypt
| | - Nehal Kamal
- Department of Dermatology, Fedemen Hospital, Fayoum, Egypt
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13
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Alshedoukhy A, Cahusac P, Kashir J, Alkhawaja FH, Tulbah AMM, Anwar K. A retrospective study of malignant melanoma from a tertiary care centre in Saudi Arabia from 2004 to 2016. Clin Transl Oncol 2019; 22:663-669. [PMID: 31256363 DOI: 10.1007/s12094-019-02169-w] [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: 03/14/2019] [Accepted: 06/19/2019] [Indexed: 11/30/2022]
Abstract
BACKGROUND Malignant melanoma is a well-known and commonly lethal tumour yet there exists scarce published information available from Saudi Arabia. MATERIALS AND METHODS This study examined the demographic, clinical, and histopathological profile of melanoma in a sample of Saudi patients over a period of 13 years. Medical records of 98 patients from 2004 to 2016 were retrieved from the Department of Pathology and Laboratory Medicine at King Faisal Specialist Hospital (KFSH), Riyadh, Saudi Arabia. RESULTS Forty two males and fifty six females (median age of 58 years) were analysed. Most cases were diagnosed in patients aged 50 years or above. The most common sites of occurrence were the extremities, especially the feet, followed by the head and neck, and then mucosal regions. Most mucosal melanomas were located in the mouth. The most common histopathological form was nodular melanoma (38 cases) followed by acral lentiginous melanoma (27 cases). Most of the cases were diagnosed in late diagnostic stages III and IV (59 cases) and most had higher Clark's level and stage V Breslow thickness. The cases with preceding history of xeroderma pigmentosum and dysplastic nevi tended to be diagnosed earlier. The most common mode of treatment was surgical resection. Patients on palliative treatment were older. Only 27/40 patients were confirmed to be alive and the rest were lost to follow-up. CONCLUSION Our data contrast with previously published studies from other parts of the world. Further work is needed to confirm our findings of female preponderance, common histological subtypes of nodular and acral melanomas, and the high involvement of oral mucosa in our Saudi patients.
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Affiliation(s)
- A Alshedoukhy
- Department of Pathology, College of Medicine, Alfaisal University, Riyadh, Saudi Arabia
| | - P Cahusac
- Department of Pharmacology, College of Medicine, Alfaisal University, Riyadh, Saudi Arabia.,Department of Comparative Medicine, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - J Kashir
- Department of Comparative Medicine, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia.,Department of Anatomy, College of Medicine, Alfaisal University, Riyadh, Saudi Arabia.,School of Biosciences, Cardiff University, Cardiff, UK
| | - F H Alkhawaja
- College of Medicine, Alfaisal University, Riyadh, Saudi Arabia
| | - A M M Tulbah
- King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - K Anwar
- Department of Pathology, College of Medicine, Alfaisal University, Riyadh, Saudi Arabia.
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14
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Selvackadunco S, Langford K, Shah Z, Hurley S, Bodi I, King A, Aarsland D, Troakes C, Al-Sarraj S. Comparison of clinical and neuropathological diagnoses of neurodegenerative diseases in two centres from the Brains for Dementia Research (BDR) cohort. J Neural Transm (Vienna) 2019; 126:327-337. [PMID: 30730007 PMCID: PMC6449484 DOI: 10.1007/s00702-018-01967-w] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [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: 09/28/2018] [Accepted: 12/15/2018] [Indexed: 11/28/2022]
Abstract
Early detection and accurate diagnosis of neurodegenerative disorders may provide better epidemiological data, closer monitoring of disease progression and enable more specialised intervention. We analysed the clinical records and pathology of brain donations from 180 patients from two Brains for Dementia Research cohorts to determine the agreement between in-life clinical diagnosis and post-mortem pathological results. Clinical diagnosis was extracted from medical records and cases assigned into broad clinical groups; control, Alzheimer’s disease (AD), vascular dementia (CVD), dementia with Lewy bodies (DLB), frontotemporal dementia (FTD) and combined diseases. Pathology was assessed blindly, and cases categorised into; control, intermediate AD, severe AD, CVD, AD and CVD combined, DLB, AD and DLB combined and frontotemporal lobar degeneration (FTLD), according to the major contributing pathologies. In more than a third of cases clinical diagnosis was different from final neuropathological diagnosis. The majority of AD, DLB and control clinical groups matched the pathological diagnosis; however, thirty-five percent of clinical AD cases showed additional prominent CVD or DLB pathology which had not been diagnosed clinically and twenty-five percent of clinical control cases were found to have intermediate Tau pathology (modified Braak stage III–IV) or CVD. CVD and AD + CVD clinical groups showed an average of only thirty-two percent pathological correlation, the majority actually having no CVD, and fifty-three percent of pathologically identified FTLD cases had been incorrectly clinically diagnosed. Our results underlie the importance of neuropathological confirmation of clinical diagnosis. The relatively low accuracy of clinical diagnosis demonstrates the need for standardised and validated diagnostic assessment procedures.
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Affiliation(s)
- Sashika Selvackadunco
- Department of Basic and Clinical Neuroscience, IoPPN, King's College London, London, UK
| | - Katie Langford
- Old Age Psychiatry Department, IoPPN, King's College London, London, UK
| | - Zohra Shah
- Department of Basic and Clinical Neuroscience, IoPPN, King's College London, London, UK
| | - Siobhan Hurley
- Old Age Psychiatry Department, IoPPN, King's College London, London, UK
| | - Istvan Bodi
- Department of Basic and Clinical Neuroscience, IoPPN, King's College London, London, UK.,Department of Clinical Neuropathology, Academic Neuroscience Centre, King's College Hospital, King's College Hospital NHS Foundation Trust, 1st Floor, Denmark Hill, London, SE5 9RS, UK
| | - Andrew King
- Department of Basic and Clinical Neuroscience, IoPPN, King's College London, London, UK.,Department of Clinical Neuropathology, Academic Neuroscience Centre, King's College Hospital, King's College Hospital NHS Foundation Trust, 1st Floor, Denmark Hill, London, SE5 9RS, UK
| | - Dag Aarsland
- Old Age Psychiatry Department, IoPPN, King's College London, London, UK
| | - Claire Troakes
- Department of Basic and Clinical Neuroscience, IoPPN, King's College London, London, UK
| | - Safa Al-Sarraj
- Department of Basic and Clinical Neuroscience, IoPPN, King's College London, London, UK. .,Department of Clinical Neuropathology, Academic Neuroscience Centre, King's College Hospital, King's College Hospital NHS Foundation Trust, 1st Floor, Denmark Hill, London, SE5 9RS, UK.
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15
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Burrell JR, Ballard KJ, Halliday GM, Hodges JR. Aphasia in Progressive Supranuclear Palsy: As Severe as Progressive Non-Fluent Aphasia. J Alzheimers Dis 2019; 61:705-715. [PMID: 29254097 DOI: 10.3233/jad-170743] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND Adynamic speech is characteristic of progressive supranuclear palsy (PSP), but higher language deficits have been reported inconsistently, in the context of clinical and pathological overlaps with progressive non-fluent aphasia (PNFA). OBJECTIVE The present study tested two hypotheses: 1) PSP and PNFA display impaired single word repetition, object naming, semantic knowledge, and syntactic comprehension; and 2) PSP have reduced speed on timed cognitive tasks. METHODS Structured clinical and neuropsychological assessments of language were performed on patients with clinically defined PSP and PNFA. Language was tested using the Sydney Language Battery (SYDBAT) and the Test of Reception of Grammar (TROG). RESULTS In total, 144 participants were studied (PSP 22, PNFA 29, and Control 93). PSP patients had prominent eye movement abnormalities, parkinsonism, and falls. All 4 PSP patients who underwent postmortem examination had 4-Repeat tauopathy, with PSP pathology in 3. The frequency and severity of impairment on the SYDBAT (naming, word comprehension, semantic association), and TROG (syntactic comprehension) did not differ between PSP and PNFA, but PSP were significantly slower on timed non-language cognitive tests. CONCLUSION Tested formally, aphasia may be seen in PSP, with a severity similar to that seen in PNFA.
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Affiliation(s)
- James R Burrell
- Concord General Hospital, Sydney, Australia.,Brain and Mind Centre, University of Sydney Medical School, Sydney, Australia.,The University of Sydney, Sydney, Australia
| | - Kirrie J Ballard
- Neuroscience Research Australia, Sydney, Australia.,The University of Sydney, Sydney, Australia
| | - Glenda M Halliday
- Brain and Mind Centre, University of Sydney Medical School, Sydney, Australia.,Faculty of Medicine, University of New South Wales, Sydney, Australia.,Neuroscience Research Australia, Sydney, Australia.,The University of Sydney, Sydney, Australia
| | - John R Hodges
- Brain and Mind Centre, University of Sydney Medical School, Sydney, Australia.,The University of Sydney, Sydney, Australia
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16
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Hu Y, Teng X, Wu L, Liu W, An J. The Clinicopathological Correlations of hTERC Amplification with Esophageal Squamous Cell Precursor Lesions. Dig Dis Sci 2019; 64:68-75. [PMID: 30311151 PMCID: PMC6318245 DOI: 10.1007/s10620-018-5318-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2018] [Accepted: 10/03/2018] [Indexed: 12/09/2022]
Abstract
BACKGROUND Esophageal squamous cell precursor lesions remain one of the most controversial topics in pathology and clinical management. AIMS To analyze the dysregulation of human telomerase RNA component (hTERC) in esophageal squamous cell precursor lesions and the clinicopathological correlations with the characteristics of esophageal squamous cell precursor lesions. METHODS Florescence in situ hybridization was performed to detect hTERC amplification in different gradings of esophageal squamous cell precursor lesions. With retrospective follow-up data, clinicopathological correlations between hTERC and esophageal squamous cell precursor lesions were subjected to logistic regression analysis. RESULTS hTERC amplification gradually increased with upgrading of dysplasia, reaching the highest level in high-grade intraepithelial neoplasia, and there was a significant difference between the low-grade intraepithelial neoplasia group and the high-grade intraepithelial neoplasia group (P = 0.00). Logistic regression analysis showed that hTERC amplification was correlated with both dysplasia grading and ulcer characteristics of esophageal squamous cell precursor lesions (P < 0.05). CONCLUSIONS hTERC amplification with increasing grading of esophageal squamous cell precursor lesions and the presence of ulcer characteristics might provide an important molecular and pathological marker for the diagnosis and clinical prognosis of esophageal squamous cell precursor lesions, especially for those ambiguous cases with more divergence in classification.
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Affiliation(s)
- Yanping Hu
- 0000 0004 0369 153Xgrid.24696.3fDepartment of Pathology, Beijing LuHe Hospital, Capital Medical University, Beijing, 101149 China
| | - Xiaojing Teng
- 0000 0004 0369 153Xgrid.24696.3fDepartment of Pathology, Beijing Friendship Hospital, Capital Medical University, Beijing, 100050 China
| | - Linlin Wu
- 0000 0004 0369 153Xgrid.24696.3fDepartment of Pathology, Beijing LuHe Hospital, Capital Medical University, Beijing, 101149 China
| | - Wei Liu
- 0000 0004 0369 153Xgrid.24696.3fDepartment of Pathology, Beijing Friendship Hospital, Capital Medical University, Beijing, 100050 China
| | - Jianduo An
- 0000 0004 0369 153Xgrid.24696.3fDepartment of Pathology, Beijing LuHe Hospital, Capital Medical University, Beijing, 101149 China
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17
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Ganz AB, Beker N, Hulsman M, Sikkes S, Netherlands Brain Bank, Scheltens P, Smit AB, Rozemuller AJM, Hoozemans JJM, Holstege H. Neuropathology and cognitive performance in self-reported cognitively healthy centenarians. Acta Neuropathol Commun 2018; 6:64. [PMID: 30037350 PMCID: PMC6055341 DOI: 10.1186/s40478-018-0558-5] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2018] [Accepted: 06/21/2018] [Indexed: 11/23/2022] Open
Abstract
With aging, the incidence of neuropathological hallmarks of neurodegenerative diseases increases in the brains of cognitively healthy individuals. It is currently unclear to what extent these hallmarks associate with symptoms of disease at extreme ages. Forty centenarians from the 100-plus Study cohort donated their brain. Centenarians self-reported to be cognitively healthy at baseline, which was confirmed by a proxy. Objective ante-mortem measurements of cognitive performance were associated with the prevalence, distribution and quantity of age- and AD-related neuropathological hallmarks. Despite self-reported cognitive health, objective neuropsychological testing suggested varying levels of ante-mortem cognitive functioning. Post-mortem, we found that neuropathological hallmarks related to age and neurodegenerative diseases, such as Aβ and Tau pathology, as well as atherosclerosis, were abundantly present in most or all centenarians, whereas Lewy body and pTDP-43 pathology were scarce. We observed that increased pathology loads correlated across pathology subtypes, and an overall trend of higher pathology loads to associate with a lower cognitive test performance. This trend was carried especially by the presence of neurofibrillary tangles (NFTs) and granulovacuolar degeneration (GVD) and to a lesser extent by Aβ-associated pathologies. Cerebral Amyloid Angiopathy (CAA) specifically associated with lower executive functioning in the centenarians. In conclusion, we find that while the centenarians in this cohort escaped or delayed cognitive impairment until extreme ages, their brains reveal varying levels of disease-associated neuropathological hallmarks, some of which associate with cognitive performance.
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Affiliation(s)
- Andrea B Ganz
- Department of Molecular and Cellular Neuroscience, Center for Neurogenomics and Cognitive Research, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, De Boelelaan 1085, 1081 HV, Amsterdam, The Netherlands
- Department of Pathology, Amsterdam Neuroscience, VU University Medical Center, PO Box 7057, 1007 MB, Amsterdam, The Netherlands
- Alzheimer Centre, Department of Neurology, Amsterdam Neuroscience, VU University Medical Center, Postbus 7057, 1007 MB, Amsterdam, The Netherlands
| | - Nina Beker
- Alzheimer Centre, Department of Neurology, Amsterdam Neuroscience, VU University Medical Center, Postbus 7057, 1007 MB, Amsterdam, The Netherlands
| | - Marc Hulsman
- Department of Clinical Genetics, Amsterdam Neuroscience, VU University Medical Center, de Boelelaan, 1118 1081 HV, Amsterdam, The Netherlands
| | - Sietske Sikkes
- Alzheimer Centre, Department of Neurology, Amsterdam Neuroscience, VU University Medical Center, Postbus 7057, 1007 MB, Amsterdam, The Netherlands
| | - Netherlands Brain Bank
- Netherlands Institute for Neuroscience, Meibergdreef 47, 1105 BA, Amsterdam, The Netherlands
| | - Philip Scheltens
- Alzheimer Centre, Department of Neurology, Amsterdam Neuroscience, VU University Medical Center, Postbus 7057, 1007 MB, Amsterdam, The Netherlands
| | - August B Smit
- Department of Molecular and Cellular Neuroscience, Center for Neurogenomics and Cognitive Research, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, De Boelelaan 1085, 1081 HV, Amsterdam, The Netherlands
| | - Annemieke J M Rozemuller
- Department of Pathology, Amsterdam Neuroscience, VU University Medical Center, PO Box 7057, 1007 MB, Amsterdam, The Netherlands
| | - Jeroen J M Hoozemans
- Department of Pathology, Amsterdam Neuroscience, VU University Medical Center, PO Box 7057, 1007 MB, Amsterdam, The Netherlands
| | - Henne Holstege
- Alzheimer Centre, Department of Neurology, Amsterdam Neuroscience, VU University Medical Center, Postbus 7057, 1007 MB, Amsterdam, The Netherlands.
- Department of Clinical Genetics, Amsterdam Neuroscience, VU University Medical Center, de Boelelaan, 1118 1081 HV, Amsterdam, The Netherlands.
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18
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Ganesh K, Nair RR, Seethalekshmy NV, Kurian G, Mathew A, Sreedharan S, Paul Z. A Study of Clinical Presentation and Correlative Histopathological Patterns in Renal Parenchymal Disease. Indian J Nephrol 2018. [PMID: 29515298 PMCID: PMC5830806 DOI: 10.4103/ijn.ijn_256_16] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Suspicion and subsequent detection of renal disease is by an assessment of the urinalysis and renal function in the clinical context. Our attempt in this study is to correlate initial presenting features of urinalysis and renal function to the final histopathological diagnosis. A retrospective analysis of 1059 native kidney biopsies performed from January 2002 to June 2015 at Amrita Institute of Medical Sciences was conducted. Correlative patterns between urinalysis, renal function, and final histopathological diagnosis were studied. Five hundred and eleven (48%) patients had nephrotic syndrome. Out of these, 193 (38%) had pure: nephrotic syndrome, 181 (35.8%) had associated microhematuria, 110 (21.7%) had microhematuria and renal failure, and 27 (5.3%) had only associated renal failure. Minimal change disease (MCD) (30%), membranous nephropathy (30%), and IgA nephropathy (29%) were the major diseases in the respective groups. Five hundred and five (47.6%) patients had subnephrotic proteinuria. Out of these, 29 (5.6%) had only subnephrotic proteinuria, 134 (27%) had additional microhematuria, 300 (59%) had subnephrotic proteinuria, microhematuria, and renal failure, and 42 (8%) had subnephrotic proteinuria with renal failure. Lupus Nephritis (45% and 40%) and IgA Nephropathy (32% and 21%) were the major disorders in the subgroups respectively. Forty-two patients (3.7%) were biopsied for isolated renal failure with bland urinary sediment. Cast nephropathy and acute interstitial nephritis were the major diseases. Out of 89 patients with diabetes who were biopsied, 15 (16.8%) had diabetic nephropathy, 45 (50.5%) had no diabetic nephropathy, and 29 (32.5%) had diabetic nephropathy along with a non-diabetic renal disease. Postinfectious glomerulonephritis was the major glomerular disease. IgA nephropathy (22.2%) and membranous nephropathy (15.5%) were the major diseases in patients with diabetes with no diabetic nephropathy. In our population, MCD and membranous nephropathy formed the majority of diseases in biopsied nephrotic syndrome. Added microhematuria did not seem to decrease the incidence of either disease on the whole. We found a significant number of patients with membranous nephropathy with nephrotic syndrome, microhematuria, and additional renal failure. IgA nephropathy formed a majority of cases with nephrotic syndrome, microhematuria, and renal failure. The presence of renal failure regardless of other abnormalities in urinalysis showed a trend toward IgA nephropathy. Membranous nephropathy may have a more varied presentation than was originally thought and IgA nephropathy presenting as nephrotic syndrome may not be uncommon. MCD is the major subgroup of diseases in the pediatric population and presents both as nephrotic syndrome as well as nephrotic syndrome with microhematuria. Thus, urinalysis and renal failure may be a valuable tool in assessing renal disease.
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Affiliation(s)
- K Ganesh
- Department of Nephrology, Amrita Institute of Medical Sciences, Kochi, Kerala, India
| | - R R Nair
- Department of Nephrology, Amrita Institute of Medical Sciences, Kochi, Kerala, India
| | - N V Seethalekshmy
- Department of Pathology, Amrita Institute of Medical Sciences, Kochi, Kerala, India
| | - G Kurian
- Department of Nephrology, Amrita Institute of Medical Sciences, Kochi, Kerala, India
| | - A Mathew
- Department of Nephrology, Amrita Institute of Medical Sciences, Kochi, Kerala, India
| | - S Sreedharan
- Department of Nephrology, Amrita Institute of Medical Sciences, Kochi, Kerala, India
| | - Z Paul
- Department of Nephrology, Amrita Institute of Medical Sciences, Kochi, Kerala, India
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Abstract
Introduction Clinicopathologic correlation in non-Alzheimer's tauopathies is variable, despite refinement of pathologic diagnostic criteria. In the present study, the clinical and neuroimaging characteristics of globular glial tauopathy (GGT) were examined to determine whether subtyping according to consensus guidelines improves clinicopathologic correlation. Methods Confirmed GGT cases (n = 11) were identified from 181 frontotemporal tauopathy cases. Clinical and neuroimaging details were collected, and cases sub-typed according to the consensus criteria for GGT diagnosis. Relationships between clinical syndrome and GGT subtype were investigated. Results In total, 11 patients (seven males, four females, mean age = 67.3 +/− 10.6 years) with GGT were included. Most, but not all, presented with behavioral variant frontotemporal dementia, but none had amyotrophic lateral sclerosis. Subtyping of GGT proved to be difficult and did not improve clinicopathologic correlation. Discussion Sub-classification of GGT pathology may be difficult and did not improve clinicopathologic correlation. Better biomarkers of tau pathology are needed.
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Affiliation(s)
- James R Burrell
- Neuroscience Research Australia, Sydney, Australia; University of New South Wales, Sydney, Australia
| | - Shelley Forrest
- Discipline of Pathology, Sydney Medical School, The University of Sydney, Sydney, Australia
| | - Thomas H Bak
- Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, United Kingdom
| | - John R Hodges
- Neuroscience Research Australia, Sydney, Australia; University of New South Wales, Sydney, Australia
| | - Glenda M Halliday
- Neuroscience Research Australia, Sydney, Australia; University of New South Wales, Sydney, Australia
| | - Jillian J Kril
- Discipline of Pathology, Sydney Medical School, The University of Sydney, Sydney, Australia
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Paydas S, Acikalin A, Ergin M, Celik H, Yavuz B, Tanriverdi K. Micro-RNA (miRNA) profile in Hodgkin lymphoma: association between clinical and pathological variables. Med Oncol. 2016;33:34. [PMID: 26951445 DOI: 10.1007/s12032-016-0749-5] [Citation(s) in RCA: 50] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2016] [Accepted: 02/23/2016] [Indexed: 12/13/2022]
Abstract
miRNAs are small RNAs and control the expression of protein-encoding genes. The aim of this study was to determine the association between miRNA profile and clinical variables including age, stage, B symptom, histopathologic subtype, response to treatment, disease-free survival (DFS) and overall survival (OS) in classical Hodgkin lymphoma (cHL). A total of 377 miRNAs were studied by qPCR in 32 cases with cHL, and results were compared with 60 samples taken from cases with reactive lymphadenopathy. Biogazelle qbasePLUS 2.0 software was used to analyze the results. miR-582-3p, miR-525-3p, miR-448, miR-512-3p, miR-642a-5p, miR-876-5p, miR-532-3p, miR-654-5p, miR-128, miR-145-5p, miR-15b-5p, miR-328 and miR-660-5p were found to be decreased in cHL compared with controls. In contrast, miR-34a-5p (2.626-fold), miR-146a-5p (4.32-fold), miR-93-5p (2.347-fold), miR-20a-5p (4.930-fold), miR-339-3p (4.948-fold), miR-324-3p (4.98-fold), miR-372 (7.038-fold), miR-127-3p (8.234-fold), miR-155-5p (4.947-fold), miR-320a (17.502-fold) and miR-370 (21.479-fold) (p < 0.05) were found to be increased in cHL. There was no difference in miRNA profile according to the age, sex, stage, response to treatment, DFS and OS. However, miR-889 was found to be increased in patients with B symptom and miR-127-3p was found to be increased in nodular sclerosing subtype. Some miRNAs increase and some decrease in cHL. However, there was no clinical association between clinical variables and with the majority of the miRNA profile studied in this study. miR-889 and miR-127-3p were related to B symptom and nodular sclerosis subtype, respectively. We need more studies evaluating miRNA profile and clinical outcome in Hodgkin Lymphoma.
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Abstract
"Gain-of-function" and "loss-of-function" studies in human cancer cells and analysis of a transgenic mouse model have convincingly established that AEG-1/MTDH/LYRIC performs a seminal role in regulating proliferation, invasion, angiogenesis, metastasis, and chemoresistance, the salient defining hallmarks of cancer. These observations are strongly buttressed by clinicopathologic correlations of AEG-1/MTDH/LYRIC expression in a diverse array of cancers distinguishing AEG-1/MTDH/LYRIC as an independent biomarker for highly aggressive metastatic disease with poor prognosis. AEG-1/MTDH/LYRIC has been shown to be a marker predicting response to chemotherapy, and serum anti-AEG-1/MTDH/LYRIC antibody titer also serves as a predictor of advanced stages of aggressive cancer. However, inconsistent findings have been reported regarding the localization of AEG-1/MTDH/LYRIC protein in the nucleus or cytoplasm of cancer cells and the utility of nuclear or cytoplasmic AEG-1/MTDH/LYRIC to predict the course and prognosis of disease. This chapter provides a comprehensive analysis of the existing literature to emphasize the common and conflicting findings relative to the clinical significance of AEG-1/MTDH/LYRIC in cancer.
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Affiliation(s)
- Devanand Sarkar
- Department of Human and Molecular Genetics, School of Medicine, Virginia Commonwealth University, School of Medicine, Richmond, Virginia, USA.
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Abstract
INTRODUCTION Early diagnosis and early adequate drug treatment is very important aspect to reduce the load in cases of leprosy. So, correct labeling of paucibacillary and multibacillary cases is a prerequisite for the adequate treatment. Confirmation of diagnosis is an important indication for histopathological examination in doubtful cases. OBJECTIVES The present study was carried out to know the clinical profile of leprosy patients, concordance between clinical and histopathological diagnosis in cases of leprosy, and to assess the therapeutic efficacy of antileprosy therapy. STUDY DESIGN Two hundred and fifty clinically diagnosed leprosy patients attending skin outdoor patient department (OPD) were included in the study. Slit skin smear was performed in all the cases. In that case concordance between clinical and histology can be determined only in 30 cases. All the patients were treated with MDT (multidrug therapy) as per WHO guideline. RESULTS A total of 250 patients attended the clinic with male to female ratio of 1.7:1. The highest incidence was noted in 17-40 years of age group. In the clinical disease spectrum, 40% patients were in the borderline spectrum followed by tuberculoid leprosy (TT) (29.2%), lepromatous leprosy (LL) (26.8%), and 3.9% of indeterminate leprosy (IL). A total of 18% of patients were of primary neuritic leprosy. A total of 8.3% patients had definite history of contact in the family or neighborhood. Clinicopathological correlation was noted in 60% of patients with maximum disparity (52.9%) in the borderline group of patients. A total of 52.8% were MB (Multibacillary) and 47.2% were PB (Paucibacillary) cases. Morphological index became negative after 6 months in all patients. Mean fall of bacteriological index after 6 months was 0.19, while after 1 year, it was 1.05. CONCLUSION Timely diagnosis and adequate treatment of cases with MDT is most effective. Histopathological examination is must in doubtful cases of leprosy.
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Affiliation(s)
- Sejal Thakkar
- From the Department of Dermatology, GMERS Medical College, Gotri, India
| | - Sangita V Patel
- Preventive and Social Medicine, Medical College, Vadodara, Gujarat, India
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