1
|
Ali AH, Nallapeta NS, Yousaf MN, Petroski GF, Sharma N, Rao DS, Yin F, Davis RM, Bhat A, Swi AIA, Al-Juboori A, Ibdah JA, Hammoud GM. EUS-guided versus percutaneous liver biopsy: A prospective randomized clinical trial. Endosc Ultrasound 2023; 12:334-341. [PMID: 37693114 PMCID: PMC10437149 DOI: 10.1097/eus.0000000000000010] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Accepted: 04/12/2023] [Indexed: 09/12/2023] Open
Abstract
Background and Objectives Prospective studies comparing EUS-guided liver biopsy (EUS-LB) to percutaneous LB (PC-LB) are scarce. We compared the efficacy and safety of EUS-LB with those of PC-LB in a prospective randomized clinical trial. Methods Between 2020 and 2021, patients were enrolled and randomized (1:1 ratio). The primary outcome was defined as the proportion of patients with ≥11 complete portal tracts (CPTs). The sample size (n = 80) was calculated based on the assumption that 60% of those in the EUS-LB and 90% of those in the PC-LB group will have LB with ≥11 CPTs. The secondary outcomes included proportion of patients in whom a diagnosis was established, number of CPTs, pain severity (Numeric Rating Scale-Pain Intensity), duration of hospital stay, and adverse events. Results Eighty patients were enrolled (median age, 53 years); 67.5% were female. Sixty percent of those in the EUS-LB and 75.0% of those in the PC-LB group met the primary outcome (P = 0.232). The median number of CPTs was higher in the PC-LB (17 vs 13; P = 0.031). The proportion of patients in whom a diagnosis was established was similar between the groups (92.5% [EUS-LB] vs 95.0% [PC-LB]; P = 1.0). Patients in the EUS-LB group had less pain severity (median Numeric Rating Scale-Pain Intensity, 2.0 vs 3.0; P = 0.003) and shorter hospital stay (2.0 vs 4.0 hours; P < 0.0001) compared with the PC-LB group. No patient experienced a serious adverse event. Conclusions EUS-guided liver biopsy was safe, effective, better tolerated, and associated with a shorter hospital stay.
Collapse
Affiliation(s)
- Ahmad H. Ali
- Division of Gastroenterology and Hepatology, University of Missouri, Columbia, MO, USA
| | - Naren S. Nallapeta
- Division of Gastroenterology and Hepatology, University of Missouri, Columbia, MO, USA
- Division of Gastroenterology, Hepatology, and Nutrition, University of Buffalo, Buffalo, NY, USA
| | - Muhammad N. Yousaf
- Division of Gastroenterology and Hepatology, University of Missouri, Columbia, MO, USA
| | - Gregory F. Petroski
- Biostatistics and Research Design Unit, School of Medicine, University of Missouri, Columbia, MO, USA
| | - Neal Sharma
- Division of Gastroenterology and Hepatology, University of Missouri, Columbia, MO, USA
| | - Deepthi S. Rao
- Department of Pathology and Anatomical Sciences, University of Missouri, Columbia, MO, USA
| | - Feng Yin
- Department of Pathology and Anatomical Sciences, University of Missouri, Columbia, MO, USA
| | - Ryan M. Davis
- Department of Radiology, Vascular and Interventional Radiology, University of Missouri, Columbia, MO, USA
| | - Ambarish Bhat
- Department of Radiology, Vascular and Interventional Radiology, University of Missouri, Columbia, MO, USA
| | - Ahmed I. A. Swi
- Division of Gastroenterology and Hepatology, University of Missouri, Columbia, MO, USA
| | - Alhareth Al-Juboori
- Division of Gastroenterology and Hepatology, University of Missouri, Columbia, MO, USA
| | - Jamal A. Ibdah
- Division of Gastroenterology and Hepatology, University of Missouri, Columbia, MO, USA
- Research Service, Harry S. Truman Memorial Veterans Medical Center, Columbia, MO, USA
- Department of Medical Pharmacology and Physiology, University of Missouri, Columbia, MO, USA
| | - Ghassan M. Hammoud
- Division of Gastroenterology and Hepatology, University of Missouri, Columbia, MO, USA
| |
Collapse
|
2
|
Alsanie I, Rajab S, Cottom H, Adegun O, Agarwal R, Jay A, Graham L, James J, Barrett AW, van Heerden W, de Vito M, Canesso A, Adisa AO, Akinshipo AO, Ajayi OF, Nwoga MC, Okwuosa CU, Omitola OG, Orikpete EV, Soluk-Tekkesin M, Bello IO, Qannam A, Gonzalez W, Pérez-de-Oliveira ME, Santos-Silva AR, Vargas PA, Toh EW, Khurram SA. Distribution and Frequency of Salivary Gland Tumours: An International Multicenter Study. Head Neck Pathol 2022; 16:1043-54. [PMID: 35622296 DOI: 10.1007/s12105-022-01459-0] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Accepted: 04/18/2022] [Indexed: 12/14/2022]
Abstract
BACKGROUND Salivary gland tumours (SGT) are a relatively rare group of neoplasms with a wide range of histopathological appearance and clinical features. To date, most of the epidemiological studies on salivary gland tumours are limited for a variety of reason including being out of date, extrapolated from either a single centre or country studies, or investigating either major or minor glands only. METHODS This study aimed to mitigate these shortcomings by analysing epidemiological data including demographic, anatomical location and histological diagnoses of SGT from multiple centres across the world. The analysed data included age, gender, location and histological diagnosis from fifteen centres covering the majority of the world health organisation (WHO) geographical regions between 2006 and 2019. RESULTS A total of 5739 cases were analysed including 65% benign and 35% malignant tumours. A slight female predilection (54%) and peak incidence between the fourth and seventh decade for both benign and malignant tumours was observed. The majority (68%) of the SGT presented in major and 32% in the minor glands. The parotid gland was the most common location (70%) for benign and minor glands (47%) for malignant tumours. Pleomorphic adenoma (70%), and Warthin's tumour (17%), were the most common benign tumours whereas mucoepidermoid carcinoma (26%) and adenoid cystic carcinoma (17%) were the most frequent malignant tumours. CONCLUSIONS This multicentre investigation presents the largest cohort study to date analysing salivary gland tumour data from tertiary centres scattered across the globe. These findings should serve as a baseline for future studies evaluating the epidemiological landscape of these tumours.
Collapse
|
3
|
Pettit C, Kanagaratnam R, Coughlan F, Graf N, Hahn D, Durkan A. Kidney biopsy adequacy and complications in children - does technique matter? Eur J Pediatr 2022; 181:2677-84. [PMID: 35414029 DOI: 10.1007/s00431-022-04464-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Revised: 03/30/2022] [Accepted: 03/31/2022] [Indexed: 12/04/2022]
Abstract
UNLABELLED Kidney biopsy is part of the diagnostic workup of many children with renal disease. Traditionally, a perpendicular approach to the biopsy has been used, but more recently, some proceduralists have favoured a tangential approach. It is not clear if one technique is superior with regards to tissue adequacy or complication rates. In our centre, interventional radiologists (IR) use general anaesthetic and a tangential approach, whereas paediatric nephrologists (PN) use sedation and a perpendicular approach. We examined consecutive native kidney biopsies performed between January 2008 and December 2017 for adequacy (sufficient tissue for light and electron microscopy and immunofluorescence) and examined the electronic medical records for data regarding technique and complications. IR performed 72 (29%) of the 245 native kidney biopsies, obtaining more total glomeruli (median 39 vs 16, p < 0.001) and more glomeruli per tissue core (median 13 vs 8, p < 0.001) than PN. No differences in specimen adequacy were observed between the two groups (79% IR vs 81% PN, p = 0.75) and a diagnosis could be made in 99% and 94% respectively (p = 0.1). A statistically lower rate of peri-nephric haematoma (28% vs 42%, p = 0.04) was detected in the IR group, but there were no significant differences in other complications. One patient required a blood transfusion (PN) and another required surgical intervention for a perinephric haematoma (IR). CONCLUSION IR obtained larger samples and number of glomeruli, but the overall adequacy for native kidney biopsies was good using both perpendicular and tangential techniques, with low rates of significant complications. WHAT IS KNOWN • Kidney biopsy is integral to the diagnostic work-up of many children with kidney disease. • Kidney biopsy is a safe procedure with well-established complications in a minority of children. WHAT IS NEW • Interventional radiologists had higher biopsy yield than paediatric nephrologists, possibly due to the tangential approach. • Biopsy adequacy rates are high using both techniques and provided a diagnosis in over 95% of cases.
Collapse
|
4
|
Cantella R, Evola G, Di Stefano C, Trusso Zirna E, Iudica M, Piazza L. Granular cell tumor of the cecum: Case report of mini invasive surgical resection and review of the literature. Int J Surg Case Rep 2021; 87:106397. [PMID: 34534816 PMCID: PMC8450234 DOI: 10.1016/j.ijscr.2021.106397] [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: 08/20/2021] [Revised: 09/07/2021] [Accepted: 09/10/2021] [Indexed: 11/27/2022] Open
Abstract
Introduction and importance Granular Cell Tumor (GCT) is a rare lesion with unclear histogenesis, predominantly described as a skin lesion. Visceral localization of GCT is even more rare with few cases reported in the literature. Nowadays GCT guidelines are not available. Case presentation A 45-year-old Caucasian woman was visited in our surgical department for significant weight loss (about 30 kg) during the previous 6 months. Colonoscopy showed a caecal polypoid lesion that was resected with a diatermic loop and classified as GCT. Microscopically, the neoplasm partially involved the mucosa and diffusely the submucosa, extending to the endoscopic resection margins. Because of the high risk of perforation during endoscopic radicalisation attempt, the patient underwent ileocecal resection. The postoperative course was uneventful. Clinical discussion GCT is a rare soft tissue neoplasm probably deriving from Schwann cells. The main treatment for GCT is an endoscopic mucosal/submucosal resection. Nevertheless, a radicalization of the lesion through a surgical attempt should be preferred when the endoscopic procedure is linked to a high risk of perforation. It is important to distinguish GCT from other polypoid lesions of the colon, due to its malignant potential (about 2%) and its relapsing capacity when margins are involved. Conclusion GTC is a rare neoplasm and as its diagnosis is made only histologically, it should be included in differential diagnosis of colonic polypoid lesions. Surgery can be considered the best choice when an endoscopic attempt of GCT lesions is linked to a high risk of colon perforation. Granular Cell Tumor (GCT) is a rare lesion with unclear histogenesis. Visceral localizations are even more rare that skin lesions. GCT should be distinguished from all other polypoid lesions. GCT epidemiology is limited due to its unknown origin and rare occurrence. Some specialists recommend a surgical resection for lesions >2–5 cm.
Collapse
Affiliation(s)
- Roberto Cantella
- General and Emergency Surgery Department, Garibaldi Hospital, Piazza Santa Maria di Gesù 5, 95100 Catania, Italy.
| | - Giuseppe Evola
- General and Emergency Surgery Department, Garibaldi Hospital, Piazza Santa Maria di Gesù 5, 95100 Catania, Italy
| | - Carla Di Stefano
- General and Emergency Surgery Department, Garibaldi Hospital, Piazza Santa Maria di Gesù 5, 95100 Catania, Italy
| | - Ezio Trusso Zirna
- General and Emergency Surgery Department, Garibaldi Hospital, Piazza Santa Maria di Gesù 5, 95100 Catania, Italy
| | - Marianna Iudica
- General and Emergency Surgery Department, Garibaldi Hospital, Piazza Santa Maria di Gesù 5, 95100 Catania, Italy
| | - Luigi Piazza
- General and Emergency Surgery Department, Garibaldi Hospital, Piazza Santa Maria di Gesù 5, 95100 Catania, Italy
| |
Collapse
|
5
|
Marcotullio D, Zoccali F, Gilardi A, Messineo D, Riminucci M, D'Angeli G, Greco A, de Vincentiis M, Ralli M, Corsi A. Carcinoma Cuniculatum of the Larynx. Head Neck Pathol 2021; 15:1308-12. [PMID: 33394373 DOI: 10.1007/s12105-020-01264-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Accepted: 11/28/2020] [Indexed: 10/22/2022]
Abstract
Carcinoma cuniculatum (CC) is a rare clinicopathologic variant of squamous cell carcinoma. Histologically, it is characterized by invasive growth of bland, acanthotic, and keratinizing squamous epithelium that forms multiple rabbit burrow-like, keratin-filled crypts and sinuses. We present a 51-year-old male smoker with CC of the left vocal cord. The tumor was staged T1a and the patient was disease-free 12 months after surgery. To our knowledge, this is the fourth case of CC of the larynx reported in the English literature and the first, due to its early diagnosis, where radical surgery was not performed. We highlight the necessity for awareness of this entity and coordination between otolaryngologists, radiologists, and pathologists for early diagnosis and organ-sparing surgical treatment.
Collapse
|
6
|
Sikpa KH, Bernard A, Seguier D, Chaabane C, Makke S, Danjou P. Primary bladder amyloidosis: About a case of incidental discovery. Urol Case Rep 2021; 34:101469. [PMID: 33294375 PMCID: PMC7701189 DOI: 10.1016/j.eucr.2020.101469] [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: 10/02/2020] [Revised: 10/13/2020] [Accepted: 10/24/2020] [Indexed: 11/30/2022] Open
Abstract
Primary bladder amyloidosis is rare. Hematuria is the most common form of it's revelation. There are no specific clinical and paraclinical signs to differentiate it from urothelial tumors. The diagnosis is histological. We are reporting you a case of incidental discovery.
Collapse
Affiliation(s)
- Komi Hola Sikpa
- Lens Hospital Urology Départment, 99 Route de la Bassée, 62300, Lens, France
| | - Agathe Bernard
- Lens Hospital Urology Départment, 99 Route de la Bassée, 62300, Lens, France
| | - Denis Seguier
- Lens Hospital Urology Départment, 99 Route de la Bassée, 62300, Lens, France
| | | | - Samuel Makke
- Lens Hospital Urology Départment, 99 Route de la Bassée, 62300, Lens, France
| | - Philippe Danjou
- Lens Hospital Urology Départment, 99 Route de la Bassée, 62300, Lens, France
| |
Collapse
|
7
|
Banke IJ, Stade N, Prodinger PM, Tübel J, Hapfelmeier A, von Eisenhart-Rothe R, van Griensven M, Gollwitzer H, Burgkart R. Antimicrobial peptides in human synovial membrane as (low-grade) periprosthetic joint infection biomarkers. Eur J Med Res 2020; 25:33. [PMID: 32799924 PMCID: PMC7429885 DOI: 10.1186/s40001-020-00434-1] [Citation(s) in RCA: 2] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Accepted: 07/30/2020] [Indexed: 12/16/2022] Open
Abstract
Background Safe diagnosis of periprosthetic joint infection (PJI) is of utmost importance for successful exchange arthroplasty. However, current diagnostic tools show insufficient accuracy in the clinically common and challenging chronic low-grade infections. To close this diagnostic gap, reliable (bio)markers display the most promising candidates. Antimicrobial peptides (AMPs) are part of the innate immune response towards microbial growth. Recently we could show significant intraarticular levels of human cathelicidin LL-37 and β-defensin-3 (HBD-3) with high diagnostic accuracy in PJI synovial fluid. Consequently, these promising biomarkers were evaluated in PJI synovial membrane and synoviocytes, which may significantly facilitate histological diagnosis of PJI to improve outcome of septic joint replacement. Methods In this prospective single-center controlled clinical study (diagnostic level II), consecutive patients with total hip (THR) and knee (TKR) replacements were included undergoing primary arthroplasty (n = 8), surgical revision due to aseptic loosening (n = 9) and septic arthroplasty with coagulase-negative staphylococci (n = 8) according to the criteria of the Musculoskeletal Infection Society (MSIS). Semiquantitative immunohistochemical (IHC) analysis of LL-37, HBD-3 and HBD-2 in synovial membrane and isolated synoviocytes based on Total Allred Score (TS) and Immunoreactive Remmele and Stegner score (IRS) was performed. For statistical analysis, SPSS 26.0/R3.6.3 (p < 0.05) was used. Results The AMPs LL-37 and HBD-3 were significantly elevated (up to 20×) in synovial membranes from PJI compared to aseptic loosening or primary arthroplasty. The area under the curve (AUC) in a receiver operating characteristic curve analysis was equal to 1.0 for both scores revealing excellent diagnostic accuracy. Isolated synoviocytes as cellular AMP source showed comparable results with a significant LL-37/HBD-3-increase up to 3 × in PJI. In contrast, local HBD-2 levels were negligible (p > 0.23) upon PJI with a lower diagnostic accuracy (AUC = 0.65) in analogy to our previous findings with synovial fluid. Conclusions Our results implicate AMPs as promising and specific biomarkers for the histological diagnosis of PJI.
Collapse
Affiliation(s)
- Ingo J Banke
- Clinic of Orthopedics and Sports Orthopedics, Klinikum rechts der Isar, Technical University of Munich, Ismaninger Strasse 22, 81675, Munich, Germany.
| | - Niko Stade
- Clinic of Orthopedics and Sports Orthopedics, Klinikum rechts der Isar, Technical University of Munich, Ismaninger Strasse 22, 81675, Munich, Germany
| | - Peter M Prodinger
- Clinic of Orthopedics and Sports Orthopedics, Klinikum rechts der Isar, Technical University of Munich, Ismaninger Strasse 22, 81675, Munich, Germany
| | - Jutta Tübel
- Clinic of Orthopedics and Sports Orthopedics, Klinikum rechts der Isar, Technical University of Munich, Ismaninger Strasse 22, 81675, Munich, Germany
| | - Alexander Hapfelmeier
- Institute of Medical Informatics, Statistics and Epidemiology, Klinikum rechts der Isar, Technical University of Munich, Ismaninger Strasse 22, 81675, Munich, Germany
| | - Rüdiger von Eisenhart-Rothe
- Clinic of Orthopedics and Sports Orthopedics, Klinikum rechts der Isar, Technical University of Munich, Ismaninger Strasse 22, 81675, Munich, Germany
| | - Martijn van Griensven
- Department of Experimental Trauma Surgery, Klinikum rechts der Isar, Technical University of Munich, Ismaninger Strasse 22, 81675, Munich, Germany.,Department cBITE, MERLN Institute, Maastricht University, Maastricht, The Netherlands
| | - Hans Gollwitzer
- Clinic of Orthopedics and Sports Orthopedics, Klinikum rechts der Isar, Technical University of Munich, Ismaninger Strasse 22, 81675, Munich, Germany.,ECOM-Excellent Center of Medicine, Arabellastrasse 17, 81925, Munich, Germany
| | - Rainer Burgkart
- Clinic of Orthopedics and Sports Orthopedics, Klinikum rechts der Isar, Technical University of Munich, Ismaninger Strasse 22, 81675, Munich, Germany
| |
Collapse
|
8
|
Motta F, Scavo S, Vecchio GM, Fuccio-Sanzà G, Nicolosi F, Magro G. Calcifying aponeurotic fibroma: a core biopsy-based diagnosis. Pathologica 2018; 110:307-312. [PMID: 30799443] [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: 06/09/2023] Open
Abstract
Calcifying aponeurotic fibroma (CAF) is a very rare tumor of the extremities, which can be difficult to diagnose due to its wide cyto-architectural pattern. We herein report the clinicopathologic features of a case of CAF localized on the dorsal face of the foot in a 5-year-old male child, diagnosed by needle core biopsy. Differential diagnostic problems are discussed. The present case emphasizes that the diagnosis of CAF can be confidentially rendered on core needle biopsy if the main morphological components of this tumor are concurrently present; however, before making the diagnosis of CAF, the clinical and radiological context should be considered.
Collapse
Affiliation(s)
- F Motta
- Department of Medical and Surgical Sciences and Advanced Technologies, G.F. Ingrassia, Anatomic Pathology, University of Catania, Italy
| | - S Scavo
- Sevizio di Dermatologia- ASL 3 Catania, Acireale (CT), Italia
| | - G M Vecchio
- Department of Medical and Surgical Sciences and Advanced Technologies, G.F. Ingrassia, Anatomic Pathology, University of Catania, Italy
| | - G Fuccio-Sanzà
- Department of Medical and Surgical Sciences and Advanced Technologies, G.F. Ingrassia, Anatomic Pathology, University of Catania, Italy
| | - F Nicolosi
- U.O. Ortopedia e Traumatologia, ARNAS Garibaldi, Presidio Garibaldi Nesima, Catania, Italia
| | - G Magro
- Department of Medical and Surgical Sciences and Advanced Technologies, G.F. Ingrassia, Anatomic Pathology, University of Catania, Italy
| |
Collapse
|
9
|
Coimbra C, Monteiro F, Oliveira P, Ribeiro L, de Almeida MG, Condé A. Hypoparathyroidism following thyroidectomy: Predictive factors. Acta Otorrinolaringol Esp 2016; 68:106-111. [PMID: 27776803 DOI: 10.1016/j.otorri.2016.06.008] [Citation(s) in RCA: 6] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2016] [Revised: 06/02/2016] [Accepted: 06/10/2016] [Indexed: 10/20/2022]
Abstract
OBJECTIVE To evaluate the incidence and predictive factors for transient and permanent hypocalcemia and hypoparathyroidism following thyroidectomy. METHOD We studied all the 162 patients that underwent thyroid surgery in the ENT department of the Centro Hospitalar Vila Nova Gaia/Espinho from January 2005 to December 2014. We reviewed pre-operative, 6h and 12h after surgery ionized calcium and PTH levels. All patients were reviewed and evaluated according to the following criteria: gender, age, thyroid function, histologic diagnosis of the specimen, surgery extension and presence or absence of hypoparathyroidism. RESULTS There were 31 (19.1%) cases of transient hypoparathyroidism and 8 (5%) of permanent hypoparathyroidism. No significant difference was found for transient hypoparathyroidism when patients were analyzed by gender. However, all cases of permanent hypoparathyroidism were observed in female individuals. Comparing hemithyroidectomy with all other surgical procedures, we found that extension of surgery was a great predictor of transient (p=0.0001) and permanent (p=0.001) hypoparathyroidism. Diagnosis of malignancy was a strong predictor of transient hypoparathyroidism (p=0.002). It was also associated with permanent hypoparathyroidism, although differences did not reach statistical significance (p=0.096). CONCLUSION Extension of surgery (total thyroidectomy) and diagnosis of malignancy are predictors of transient and permanent hypoparathyroidism.
Collapse
Affiliation(s)
- Cristiana Coimbra
- Centro Hospitalar Vila Nova de Gaia Espinho (CHVNGE), ENT Department, Gaia, Portugal.
| | - Francisco Monteiro
- Centro Hospitalar Vila Nova de Gaia Espinho (CHVNGE), ENT Department, Gaia, Portugal
| | - Pedro Oliveira
- Centro Hospitalar Vila Nova de Gaia Espinho (CHVNGE), ENT Department, Gaia, Portugal
| | - Leandro Ribeiro
- Centro Hospitalar Vila Nova de Gaia Espinho (CHVNGE), ENT Department, Gaia, Portugal
| | | | - Artur Condé
- Centro Hospitalar Vila Nova de Gaia Espinho (CHVNGE), ENT Department, Gaia, Portugal
| |
Collapse
|
10
|
Nakashima H, Kawano M, Saeki T, Ubara Y, Hisano S, Nagata M, Zen Y, Yanagita M, Yamaguchi Y, Nishi S, Saito T. Estimation of the number of histological diagnosis for IgG4-related kidney disease referred to the data obtained from the Japan Renal Biopsy Registry (J-RBR) questionnaire and cases reported in the Japanese Society of Nephrology Meetings. Clin Exp Nephrol 2016; 21:97-103. [PMID: 27015831 PMCID: PMC5283512 DOI: 10.1007/s10157-016-1260-1] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [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: 09/10/2015] [Accepted: 03/10/2016] [Indexed: 12/04/2022]
Abstract
Background More than 2 years have passed since the proposal of the diagnostic criteria for IgG4-related kidney disease (IgG4-RKD). The aim of this study was to estimate the number of histological diagnosis for IgG4-RKD throughout Japan and to clarify the regional distribution of the development of this disease. Methods A questionnaire was supplied to 140 research facilities registered in the Japan Renal Biopsy Registry (J-RBR). The items of the questionnaire were the total number of renal biopsies performed and the number of cases diagnosed as IgG4-RKD in 2012 and 2013 at each facility. Age, sex, and diagnosis category were also included for the IgG4-RKD cases. The geographic distribution of the disease development was evaluated using clinical case reports presented at the Eastern/Western regional meeting of the Japanese Society of Nephrology during the 15 years following 2001. Results Forty-seven facilities completed the questionnaire, resulting in a collection rate of 34 %. The total numbers of renal biopsies in 2012 and 2013 were 3387 and 3591, respectively. Forty-seven of these cases (24 in 2012 and 23 in 2013) were diagnosed as IgG4-RKD. The frequency of development of IgG4-RKD per one million over 40-year-old individuals during these 15 years varied between 0.9 and 3.1, depending on Japanese geographic region of Japan. Conclusion The results of the present survey indicate that the number of diagnosis for IgG4-RKD is approximately 130 cases per year throughout Japan, and no regional differences in disease frequency appear to exist.
Collapse
Affiliation(s)
- Hitoshi Nakashima
- Division of Nephrology and Rheumatology, Department of Internal Medicine, Faculty of Medicine, Fukuoka University, 7-45-1 Nanakuma, Jonan-ku, Fukuoka, 814-0180, Japan.
| | - Mitsuhiro Kawano
- Division of Rheumatology, Department of Internal Medicine, Kanazawa University Hospital, Kanazawa, Japan
| | - Takako Saeki
- Department of Internal Medicine, Nagaoka Red Cross Hospital, Nagaoka, Japan
| | - Yoshifumi Ubara
- Nephrology Center and Okinaka Memorial Institute, Toranomon Hospital, Tokyo, Japan
| | - Satoshi Hisano
- Department of Pathology, Faculty of Medicine, Fukuoka University, Fukuoka, Japan
| | - Michio Nagata
- Department of Kidney and Vascular Pathology, Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba, Japan
| | - Yoh Zen
- Department of Diagnostic Pathology, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Motoko Yanagita
- Department of Nephrology, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | | | - Shinichi Nishi
- Division of Nephrology and Kidney Center, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Takao Saito
- Division of Nephrology and Rheumatology, Department of Internal Medicine, Faculty of Medicine, Fukuoka University, 7-45-1 Nanakuma, Jonan-ku, Fukuoka, 814-0180, Japan
| |
Collapse
|
11
|
Mastracci L, Piol N, Molinaro L, Pitto F, Tinelli C, De Silvestri A, Fiocca R, Grillo F. Interobserver reproducibility in pathologist interpretation of columnar-lined esophagus. Virchows Arch 2015; 468:159-67. [PMID: 26563401 DOI: 10.1007/s00428-015-1878-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2015] [Revised: 10/13/2015] [Accepted: 11/03/2015] [Indexed: 02/06/2023]
Abstract
Confirmation of endoscopically suspected esophageal metaplasia (ESEM) requires histology, but confusion in the histological definition of columnar-lined esophagus (CLE) is a longstanding problem. The aim of this study is to evaluate interpathologist variability in the interpretation of CLE. Thirty pathologists were invited to review three ten-case sets of CLE biopsies. In the first set, the cases were provided with descriptive endoscopy only; in the second and the third sets, ESEM extent using Prague criteria was provided. Moreover, participants were required to refer to a diagnostic chart for evaluation of the third set. Agreement was statistically assessed using Randolph's free-marginal multirater kappa. While substantial agreement in recognizing columnar epithelium (K = 0.76) was recorded, the overall concordance in clinico-pathological diagnosis was low (K = 0.38). The overall concordance rate improved from the first (K = 0.27) to the second (K = 0.40) and third step (K = 0.46). Agreement was substantial when diagnosing Barrett's esophagus (BE) with intestinal metaplasia or inlet patch (K = 0.65 and K = 0.89), respectively, in the third step, while major problems in interpretation of CLE were observed when only cardia/cardia-oxyntic atrophic-type epithelium was present (K = 0.05-0.29). In conclusion, precise endoscopic description and the use of a diagnostic chart increased consistency in CLE interpretation of esophageal biopsies. Agreement was substantial for some diagnostic categories (BE with intestinal metaplasia and inlet patch) with a well-defined clinical profile. Interpretation of cases with cardia/cardia-oxyntic atrophic-type epithelium, with or without ESEM, was least consistent, which reflects lack of clarity of definition and results in variable management of this entity.
Collapse
Affiliation(s)
- Luca Mastracci
- Department of Surgical and Diagnostic Sciences (DISC), Pathology Unit, University of Genoa, Via De Toni 14, 16132, Genoa, Italy. .,IRCCS AOU S. Martino-IST, Largo Benzi 10, 16132, Genoa, Italy.
| | - Nataniele Piol
- Department of Surgical and Diagnostic Sciences (DISC), Pathology Unit, University of Genoa, Via De Toni 14, 16132, Genoa, Italy.,IRCCS AOU S. Martino-IST, Largo Benzi 10, 16132, Genoa, Italy
| | - Luca Molinaro
- Department of Biomedical Sciences and Human Oncology, University of Turin, Via Santena 7, 10126, Turin, Italy
| | - Francesca Pitto
- Department of Surgical and Diagnostic Sciences (DISC), Pathology Unit, University of Genoa, Via De Toni 14, 16132, Genoa, Italy.,IRCCS AOU S. Martino-IST, Largo Benzi 10, 16132, Genoa, Italy
| | - Carmine Tinelli
- Clinical Epidemiology and Biometric Unit, Foundation IRCCS Policlinico S. Matteo, Via Golgi 19, 27100, Pavia, Italy
| | - Annalisa De Silvestri
- Clinical Epidemiology and Biometric Unit, Foundation IRCCS Policlinico S. Matteo, Via Golgi 19, 27100, Pavia, Italy
| | - Roberto Fiocca
- Department of Surgical and Diagnostic Sciences (DISC), Pathology Unit, University of Genoa, Via De Toni 14, 16132, Genoa, Italy.,IRCCS AOU S. Martino-IST, Largo Benzi 10, 16132, Genoa, Italy
| | - Federica Grillo
- Department of Surgical and Diagnostic Sciences (DISC), Pathology Unit, University of Genoa, Via De Toni 14, 16132, Genoa, Italy.,IRCCS AOU S. Martino-IST, Largo Benzi 10, 16132, Genoa, Italy
| | | |
Collapse
|
12
|
Alberca-Páramo A, García-Santos EP, Sánchez-García S, Ruescas-García FJ, Bertelli-Puche JL, Martín-Fernández J. [Axillary hidrosadenitis due to Leishmania: Case report and literature review]. CIR CIR 2015; 84:253-6. [PMID: 26259746 DOI: 10.1016/j.circir.2015.06.025] [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: 10/02/2014] [Accepted: 01/12/2015] [Indexed: 11/18/2022]
Abstract
BACKGROUND Hidradenitis is a disorder where abscesses appear after the infection of the apocrine sweat glands. It is located normally in the axillae, groin, perineal region, and the scalp. CLINICAL CASE A 37 year old male was referred by his GP to the General Surgery Department with axillary hidradenitis which had evolved over the years. The physical examination shows signs of hidradenitis in both axillae, with a noticeable suppurative hidradenitis in the right armpit. En bloc extirpation was performed to remove the whole affected area. The pathological examination revealed a cutaneous leishmaniasis. Subsequently, fucidin was administered topically, as well as local infiltrations of one millilitre of Glucantime™. DISCUSSION Hidradenitis normally appears in intertriginous areas and its manifestation is accompanied by recurrent subcutaneous nodules. The incidence rate in females is three times higher than in males. The isolated Hidradenitis caused by Leishmania is a rare condition presented only in endemic areas or in immunocompromised patients, such as HIV-infected patients. Clinical manifestations can be different and the diagnosis can be confirmed through haematoxylin-eosin. The main pattern displays a disorganised granuloma without necrosis. Systemic or topical treatment can be applied. Immunotherapy treatment is the most common. CONCLUSIONS Hidradenitis caused by Leishmania in HIV-negative patients is a rare condition. Therefore it is important to perform a good histological diagnosis and to administer the right treatment.
Collapse
Affiliation(s)
- Ana Alberca-Páramo
- Servicio de Cirugía General y Aparato Digestivo, Hospital General Universitario, Ciudad Real, España.
| | | | - Susana Sánchez-García
- Servicio de Cirugía General y Aparato Digestivo, Hospital General Universitario, Ciudad Real, España
| | | | - José Luis Bertelli-Puche
- Servicio de Cirugía General y Aparato Digestivo, Hospital General Universitario, Ciudad Real, España
| | - Jesús Martín-Fernández
- Servicio de Cirugía General y Aparato Digestivo, Hospital General Universitario, Ciudad Real, España
| |
Collapse
|
13
|
López JI, Zabala R, del Cura JL. Histological diagnosis of thyroid disease using ultrasound-guided core biopsies. Eur Thyroid J 2013; 2:29-36. [PMID: 24783036 PMCID: PMC3821498 DOI: 10.1159/000343825] [Citation(s) in RCA: 6] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2012] [Accepted: 09/19/2012] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Thyroid core biopsies obtained with ultrasound (US)-guided needles are an alternative to conventional fine-needle aspiration and, according to various authors, have greater sensitivity and specificity. The technique is inexpensive, rapid and reliable with a low rate of complications, similar to conventional fine-needle aspiration procedures. OBJECTIVES This paper critically reviews the methodology for obtaining samples and processing them in the pathology laboratory. METHODS Accumulated experience with 1,065 cases of US-guided core biopsy of the thyroid gland in a 15-year period. RESULTS US-guided core biopsy is a useful, inexpensive and safe method in the histological diagnosis of thyroid gland pathology. Thyroid samples obtained this way are not a substitute for fine-needle aspiration cytology. Indeed, some authors assert that the best results are obtained by combining the two approaches, the methods being complementary. CONCLUSIONS To take best advantage of the findings from these techniques, pathologists must know which types of diagnoses can be made and the fundamentals of how and, lastly, what cannot be diagnosed and the reasons why. Best results are obtained with a multidisciplinary approach in a hospital committee composed of endocrinologists, surgeons, radiologists and pathologists, who analyse and provide a background on each case.
Collapse
Affiliation(s)
- José I. López
- Department of Pathology, Cruces University Hospital, BioCruces Research Institute, University of the Basque Country, Barakaldo, Bilbao, Spain
- *Prof. José I. López, Department of Pathology, Hospital Universitario Cruces, Plaza de Cruces s/n, ES-48903 Barakaldo (Spain), E-Mail
| | - Rosa Zabala
- Department of Radiology, Basurto University Hospital, University of the Basque Country, Bilbao, Spain
| | - José Luís del Cura
- Department of Radiology, Basurto University Hospital, University of the Basque Country, Bilbao, Spain
| |
Collapse
|
14
|
Wang SF, Yang YS, Wei LX, Lu ZS, Guo MZ, Huang J, Peng LH, Sun G, Ling-Hu EQ, Meng JY. Diagnosis of gastric intraepithelial neoplasia by narrow-band imaging and confocal laser endomicroscopy. World J Gastroenterol 2012; 18:4771-80. [PMID: 23002348 PMCID: PMC3442217 DOI: 10.3748/wjg.v18.i34.4771] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2011] [Revised: 06/08/2012] [Accepted: 06/15/2012] [Indexed: 02/06/2023] Open
Abstract
AIM: To evaluate the diagnosis of different differentiated gastric intraepithelial neoplasia (IN) by magnification endoscopy combined with narrow-band imaging (ME-NBI) and confocal laser endomicroscopy (CLE).
METHODS: Eligible patients with suspected gastric IN lesions previously diagnosed by endoscopy in secondary hospitals and scheduled for further diagnosis and treatment were recruited for this study. Excluded from the study were patients who had liver cirrhosis, impaired renal function, acute gastrointestinal (GI) bleeding, coagulopathy, esophageal varices, jaundice, and GI post-surgery. Also excluded were those who were pregnant, breastfeeding, were younger than 18 years old, or were unable to provide informed consent. All patients had all mucus and bile cleared from their stomachs. They then received upper GI endoscopy. When a mucosal lesion is found during observation with white-light imaging, the lesion is visualized using maximal magnification, employing gradual movement of the tip of the endoscope to bring the image into focus. Saved images are analyzed. Confocal images were evaluated by two endoscopists (Huang J and Li MY), who were familiar with CLE, blinded to the related information about the lesions, and asked to classify each lesion as either a low grade dysplasia (LGD) or high grade dysplasia (HGD) according to given criteria. The results were compared with the final histopathologic diagnosis. ME-NBI images were evaluated by two endoscopists (Lu ZS and Ling-Hu EQ) who were familiar with NBI, blinded to the related information about the lesions and CLE images, and were asked to classify each lesion as a LGD or HGD according to the “microvascular pattern and surface pattern” classification system. The results were compared with the final histopathologic diagnosis.
RESULTS: The study included 32 pathology-proven low grade gastric IN and 26 pathology-proven high grade gastric IN that were detected with any of the modalities. CLE and ME-NBI enabled clear visualization of the vascular microsurface patterns and microvascular structures of the gastric mucosa. The accuracy of the CLE and the ME-NBI diagnosis was 88% (95% CI: 78%-98%) and 81% (95% CI: 69%-93%), respectively. The kappa coefficient of agreement between the histopathology and the in vivo CLE imaging was 0.755; between the histopathology and the in vivo CLE imaging was 0.615. McNemar’s test (binomial distribution used) indicated that the agreement was significant (P < 0.05). When patients were diagnosed by ME-NBI with CLE, the overall accuracy of the diagnosis was 86.21% (95% CI: 73%-96%), and the kappa coefficient of agreement was 0.713, according to McNemar’s test (P < 0.05).
CONCLUSION: Higher diagnostic accuracy, sensitivity and specificity of CLE over ME-NBI indicate the feasibility of these two techniques for the efficacious diagnostic classification of gastric IN.
Collapse
|