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El Bejjaj I, Mercier A, Mcleer A, Valmary-Degano S. [Fibro-osseous pseudotumor of the digits: One of USP6-related fibroblastic/myofibroblastic tumors]. Ann Pathol 2024:S0242-6498(23)00232-8. [PMID: 38341311 DOI: 10.1016/j.annpat.2023.12.004] [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: 09/15/2023] [Revised: 10/12/2023] [Accepted: 12/14/2023] [Indexed: 02/12/2024]
Abstract
Fibro-osseous pseudotumor of the digits is a benign tumour closely related to myositis ossificans. It is a rare lesion seldom reported in the literature. We report the case of a 33-year-old woman with lancinating pain in the first phalanx of the second finger of the right hand, associated with inflammation. The histopathological examination of the surgical excision biopsy of the lesion revealed a spindle-shaped proliferation within a sclerosing, hyaline, and osteoid stroma. In our observation, immunohistochemistry and molecular biology are the main elements that helped to establish the diagnosis and eliminate the various differential diagnoses, despite a non-specific histopathological aspect.
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Affiliation(s)
- Iatimad El Bejjaj
- Service d'anatomie et cytologie pathologique, CHU de Grenoble Alpes, 38000 Grenoble, France
| | - Anaïs Mercier
- Service d'anatomie et cytologie pathologique, CHU de Grenoble Alpes, 38000 Grenoble, France
| | - Anne Mcleer
- Service d'anatomie et cytologie pathologique, CHU de Grenoble Alpes, 38000 Grenoble, France; Université de Grenoble Alpes, Inserm U1209, CNRS UMR5309, institut pour l'avancée des biosciences, département de pathology, CHU Grenoble Alpes, 38000, Grenoble, France
| | - Séverine Valmary-Degano
- Service d'anatomie et cytologie pathologique, CHU de Grenoble Alpes, 38000 Grenoble, France; Université de Grenoble Alpes, Inserm U1209, CNRS UMR5309, institut pour l'avancée des biosciences, département de pathology, CHU Grenoble Alpes, 38000, Grenoble, France.
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2
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Eliahiai I, Eljiar M, Chaib S, KHarmoum J, Chraïbi M. [HER2 epidermal growth factor receptor, tests used to look for its amplification in breast cancer: Principles and limitations]. Bull Cancer 2023; 110:1301-1310. [PMID: 37858426 DOI: 10.1016/j.bulcan.2023.08.012] [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: 04/25/2023] [Revised: 08/16/2023] [Accepted: 08/28/2023] [Indexed: 10/21/2023]
Abstract
HER2-positive breast cancer accounts for 20 % of all invasive breast cancers. It is associated with increased recurrence, a higher risk of brain metastases and a shorter overall survival than luminal A and B cancers. The presence of ERBB2 gene amplification is predictive of a good response to anti-HER2 therapies. Determining HER2 status is a hot topic, given recent studies on HER2-low subtypes. Although several techniques are available, the latest 2018 update from the American Society of Clinical Oncology and College of American Pathologists (ASCO/CAP) recommends a first immunohistochemical study followed by a fluorescence in situ hybridisation study indicated only for equivocal cases. This article summarises the different techniques used to determine HER2 status and provides a detailed review of the literature on pre-analytical factors and intrinsic tumour-specific factors that can distort or complicate the interpretation of results.
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Affiliation(s)
- Imane Eliahiai
- Laboratoire d'anatomie et cytologie pathologique, centre hospitalier universitaire Mohammed VI Tanger-Tétouan-Al Hoceima (TTA), 90000 Tangier, Maroc; Université Abdelmalek-Essaadi, faculté de médecine et de pharmacie de Tangier, Tangier, Maroc.
| | - Mohammed Eljiar
- Laboratoire d'anatomie et cytologie pathologique, centre hospitalier universitaire Mohammed VI Tanger-Tétouan-Al Hoceima (TTA), 90000 Tangier, Maroc; Université Abdelmalek-Essaadi, faculté de médecine et de pharmacie de Tangier, Tangier, Maroc
| | - Sanae Chaib
- Laboratoire d'anatomie et cytologie pathologique, centre hospitalier universitaire Mohammed VI Tanger-Tétouan-Al Hoceima (TTA), 90000 Tangier, Maroc; Université Abdelmalek-Essaadi, faculté de médecine et de pharmacie de Tangier, Tangier, Maroc
| | - Jinane KHarmoum
- Laboratoire d'anatomie et cytologie pathologique, centre hospitalier universitaire Mohammed VI Tanger-Tétouan-Al Hoceima (TTA), 90000 Tangier, Maroc; Université Abdelmalek-Essaadi, faculté de médecine et de pharmacie de Tangier, Tangier, Maroc
| | - Mariame Chraïbi
- Laboratoire d'anatomie et cytologie pathologique, centre hospitalier universitaire Mohammed VI Tanger-Tétouan-Al Hoceima (TTA), 90000 Tangier, Maroc; Université Abdelmalek-Essaadi, faculté de médecine et de pharmacie de Tangier, Tangier, Maroc
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3
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Coulibaly ZI, Gumus N, Demetter P. [Rectal mass revealing peritoneal inclusion cyst with peritoneal endometriosis incidentally discovered: About a case and review of the literature]. Ann Pathol 2023; 43:487-490. [PMID: 37202297 DOI: 10.1016/j.annpat.2023.04.001] [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: 12/31/2022] [Revised: 03/20/2023] [Accepted: 04/10/2023] [Indexed: 05/20/2023]
Abstract
Peritoneal inclusion cyst is a rare benign tumor. It usually affects women of reproductive age. Its etiology is poorly understood; a history of endometriosis, pelvic inflammatory disease and pelvic surgery are sometimes implicated in its occurrence. Its diagnosis is difficult with complex management. We report the case of a 29-year-old woman presenting a rectal mass for which the analysis of echo-endoscopic samples was not contributory. The PET-scan revealed a rectal submucosal mass and deep adenopathy. An exploratory laparoscopy was performed, and allowed to remove cystic inflammatory areas and lymph nodes. The histopathological study confirmed the diagnosis of peritoneal inclusion cyst with endometriosis and reactive adenitis. Peritoneal inclusion cyst is a rare condition that develops at the expense of the serosa. The risk of recurrence is high with a possibility of malignant transformation. Excision and monitoring are essential for good management.
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Affiliation(s)
- Zana Ismael Coulibaly
- Service d'anatomie pathologique de l'Institut Jules-Bordet, rue Meylemeersch 62, 1070 Bruxelles, Belgique; Département d'anatomie pathologique de l'université Félix Houphouët-Boigny, Abidjan, Côte d'Ivoire; Centre hospitalier et universitaire de Treichville, Treichville, Côte d'Ivoire
| | - Nejla Gumus
- Service d'anatomie pathologique de l'Institut Jules-Bordet, rue Meylemeersch 62, 1070 Bruxelles, Belgique
| | - Pieter Demetter
- Service d'anatomie pathologique de l'Institut Jules-Bordet, rue Meylemeersch 62, 1070 Bruxelles, Belgique; Université libre de Bruxelles Bruxelles, Belgique.
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4
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Neyrand S, Bringuier PP, Benzerdjeb N, Hervieu V, Fenouil T. [Differential diagnostic between hepatocellular carcinoma and hepatoid carcinoma with bone metastasis revelation: What tools can be used?]. Ann Pathol 2023; 43:407-411. [PMID: 36822899 DOI: 10.1016/j.annpat.2023.01.004] [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: 12/20/2021] [Revised: 07/26/2022] [Accepted: 01/04/2023] [Indexed: 02/23/2023]
Abstract
Bone metastases of hepatocellular carcinoma (HCC) are rare and disease-revealing bone metastasis are exceptional. Here, we report the case of a 69-year-old man with a cervical vertebral metastasis of hepatocellular carcinoma. Morphological aspect of a metastatic tumor with eosinophilic and polygonal cells raises the question of the differential diagnosis between a localization of a hepatocellular carcinoma or an hepatoid carcinoma, notably when the metastasis is the first clinical manifestation. The morphological aspect by itself does not provide strong enough arguments for diagnosis. Well selected immunohistochemical markers can sometimes help to orientate towards one of the two hypotheses, in particular SALL4 and LIN28 which are in favour of hepatoid carcinoma when both are positive. Finally, as these two entities have different molecular profiles, molecular study can also be helpful to distinguish them. Indeed, HCCs often present TERT promoter, CTNNB1 mutations and IL-6/JAK/STAT pathway activation while hepatoid adenocarcinoma frequently presents chromosome 20 long arm gain. TP53 mutations are found in both entities and are therefore not discriminating. Differential diagnosis is important because the treatment will be that of the primary. Prognostic data for HCC revealed by bone metastasis are scarce, although they seem to be associated with a poor prognosis, with a 1 to 2 months overall survival. There is currently no data for hepatoid adenocarcinoma with bone metastasis.
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Affiliation(s)
- Sophie Neyrand
- Institut de pathologie multisite, centre de biologie et de pathologie Est, groupement hospitalier Est, hospices civils de Lyon, 59, boulevard Pinel, 69677 Bron, France
| | - Pierre-Paul Bringuier
- Institut de pathologie multisite, centre de biologie et de pathologie Est, groupement hospitalier Est, hospices civils de Lyon, 59, boulevard Pinel, 69677 Bron, France
| | - Nazim Benzerdjeb
- Institut de pathologie multisite - Site Sud, groupement hospitalier Sud, hospices civils de Lyon, Pierre-Bénite, France
| | - Valérie Hervieu
- Institut de pathologie multisite, centre de biologie et de pathologie Est, groupement hospitalier Est, hospices civils de Lyon, 59, boulevard Pinel, 69677 Bron, France
| | - Tanguy Fenouil
- Institut de pathologie multisite, centre de biologie et de pathologie Est, groupement hospitalier Est, hospices civils de Lyon, 59, boulevard Pinel, 69677 Bron, France.
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Tauziède-Espariat A, Mehdi L, Roux A, Zaomi M, Pucelle N, Lacombe J, Gigant P, Berthaud C, Brigot E, Massé J, Collard A, Métais A, Hasty L, Chrétien F, Varlet P, Lechapt E. [The use of immunohistochemical slides for performing FISH as a useful method of conserving tissue samples]. Ann Pathol 2023; 43:7-12. [PMID: 35710499 DOI: 10.1016/j.annpat.2022.05.007] [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: 02/08/2022] [Revised: 04/19/2022] [Accepted: 05/09/2022] [Indexed: 01/25/2023]
Abstract
Diagnostic updates, an increased precision of tumor sub-type classification and the development of new diagnostic biomarkers (immunohistochemistry (IHC), Fluorescence in situ hybridization (FISH) and other molecular pathology techniques), have a significant impact on pathologists' management of tissue samples. The objective of this work was to test and validate the FISH technique on detached IHC slides. An IHC technique was first performed on 30 tissue samples. After detachment of the lamella, a FISH technique was then performed according to the usual protocol with a centromeric probe. A validation cohort (n=10) with duplicate testing using a traditional FISH technique and an IHC slide with a detached lamella was then carried out. Finally, a cohort of 20 "old" cases (IHC carried out over 2years ago) was also tested. Different types of probes (specific locus, break apart) have been used. All the slides were interpreted by a technician and a pathologist. Evaluation criteria were: the general interpretability of the slide ; the percentage of labeled nuclei; intensity of the signal and the presence or absence of autofluorescence. FISH was interpretable in 100% of recently treated cases and 90% of "old" cases with a satisfactory intensity and a high percentage of labeled nuclei, without autofluorescence. The results of our study show that the reuse of IHC slides for performing FISH is a powerful means of economizing tissue samples, especially for small samples and in the absence of archived representative material.
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Affiliation(s)
- Arnault Tauziède-Espariat
- Service de neuropathologie, GHU Paris-psychiatrie et neurosciences, centre hospitalier Sainte-Anne, 75014 Paris, France.
| | - Leïla Mehdi
- Service de neuropathologie, GHU Paris-psychiatrie et neurosciences, centre hospitalier Sainte-Anne, 75014 Paris, France
| | - Alexandre Roux
- Service de neurochirurgie, GHU Paris-psychiatrie et neurosciences, centre hospitalier Sainte-Anne, 75014 Paris, France
| | - Myriam Zaomi
- Service de neuropathologie, GHU Paris-psychiatrie et neurosciences, centre hospitalier Sainte-Anne, 75014 Paris, France
| | - Noémie Pucelle
- Service de neuropathologie, GHU Paris-psychiatrie et neurosciences, centre hospitalier Sainte-Anne, 75014 Paris, France
| | - Joëlle Lacombe
- Service de neuropathologie, GHU Paris-psychiatrie et neurosciences, centre hospitalier Sainte-Anne, 75014 Paris, France
| | - Priscille Gigant
- Service de neuropathologie, GHU Paris-psychiatrie et neurosciences, centre hospitalier Sainte-Anne, 75014 Paris, France
| | - Charlotte Berthaud
- Service de neuropathologie, GHU Paris-psychiatrie et neurosciences, centre hospitalier Sainte-Anne, 75014 Paris, France
| | - Enola Brigot
- Service de neuropathologie, GHU Paris-psychiatrie et neurosciences, centre hospitalier Sainte-Anne, 75014 Paris, France
| | - Joëlle Massé
- Service de neuropathologie, GHU Paris-psychiatrie et neurosciences, centre hospitalier Sainte-Anne, 75014 Paris, France
| | - Aurélien Collard
- Service de neuropathologie, GHU Paris-psychiatrie et neurosciences, centre hospitalier Sainte-Anne, 75014 Paris, France
| | - Alice Métais
- Service de neuropathologie, GHU Paris-psychiatrie et neurosciences, centre hospitalier Sainte-Anne, 75014 Paris, France
| | - Lauren Hasty
- Service de neuropathologie, GHU Paris-psychiatrie et neurosciences, centre hospitalier Sainte-Anne, 75014 Paris, France
| | - Fabrice Chrétien
- Service de neuropathologie, GHU Paris-psychiatrie et neurosciences, centre hospitalier Sainte-Anne, 75014 Paris, France
| | - Pascale Varlet
- Service de neuropathologie, GHU Paris-psychiatrie et neurosciences, centre hospitalier Sainte-Anne, 75014 Paris, France
| | - Emmanuèle Lechapt
- Service de neuropathologie, GHU Paris-psychiatrie et neurosciences, centre hospitalier Sainte-Anne, 75014 Paris, France
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Miquelestorena-Standley E, Tallegas M, Bouvier C, Larousserie F, Aubert S, Gomez-Brouchet A, Guinebretière JM, Le Loarer F, Galant C, de Pinieux G. [From an optimal management of bone tissue samples to a quality patients' care in 2022 : A new paradigm]. Ann Pathol 2022; 42:202-207. [PMID: 35093248 DOI: 10.1016/j.annpat.2022.01.001] [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: 12/24/2021] [Accepted: 01/04/2022] [Indexed: 10/19/2022]
Abstract
Bone tissue can be involved by primitive or metastatic tumors and requires a specific processing both at the department of pathology and during multidisciplinary meetings. The development of fine-needle percutaneous biopsies and of molecular techniques in bone tumor pathology requires a specific management. Moreover, decalcification of samples is crucial but can be deleterious if not controlled or not appropriate. The aim of this review is to provide recommendations for management and decalcification of bone tumor samples.
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Affiliation(s)
- Elodie Miquelestorena-Standley
- Service d'anatomie et cytologie pathologiques, CHRU de Tours, hôpital Trousseau, avenue de la République, 37170 Chambray-les-Tours, France; Faculté de médecine, Université de Tours, 10, boulevard Tonnellé, 37000 Tours, France.
| | - Matthias Tallegas
- Service d'anatomie et cytologie pathologiques, CHRU de Tours, hôpital Trousseau, avenue de la République, 37170 Chambray-les-Tours, France; Plateforme de génétique moléculaire des cancers, CHRU de Tours, hôpital Trousseau, avenue de la République, 37170 Chambray-les-Tours, France
| | - Corinne Bouvier
- Service d'anatomie et cytologie pathologiques, CHU de Marseille La Timone, 264, rue Saint-Pierre, 13005 Marseille, France
| | - Frédérique Larousserie
- Service d'anatomie et cytologie pathologiques, Hôpital Cochin, 27, rue du Faubourg Saint-Jacques, 75014 Paris, France
| | - Sébastien Aubert
- Service d'anatomie et cytologie pathologiques, CHU de Lille, 2, avenue Oscar Lambret, 59000 Lille, France
| | - Anne Gomez-Brouchet
- CRB Cancer IUCT-oncopole, 1, avenue Irène Joliot-Curie, 31100 Toulouse, France
| | - Jean-Marc Guinebretière
- Service d'anatomie et cytologie pathologiques, Hôpital Curie, 26, rue d'Ulm, 75005 Paris, France
| | - François Le Loarer
- Service d'anatomie pathologique, Institut Bergonié, 229, cours Argonne, 33000 Bordeaux, France
| | - Christine Galant
- Service d'anatomie et cytologie pathologiques, Cliniques Universitaires Saint-Luc, 10, avenue Hippocrate, 1200 Bruxelles, Belgique
| | - Gonzague de Pinieux
- Service d'anatomie et cytologie pathologiques, CHRU de Tours, hôpital Trousseau, avenue de la République, 37170 Chambray-les-Tours, France; Faculté de médecine, Université de Tours, 10, boulevard Tonnellé, 37000 Tours, France
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Franchet C, Djerroudi L, Maran-Gonzalez A, Abramovici O, Antoine M, Becette V, Berghian A, Blanc-Fournier C, Brabencova E, Charafe-Jauffret E, Chenard MP, Dauplat MM, Delrée P, Duprez-Paumier R, Fleury C, Ghnassia JP, Haudebourg J, Leroux A, MacGrogan G, Mathieu MC, Michenet P, Penault-Llorca F, Poulet B, Robin YM, Roger P, Russ E, Tixier L, Treilleux I, Valent A, Verriele V, Vincent-Salomon A, Arnould L, Lacroix-Triki M. [2021 update of the GEFPICS' recommendations for HER2 status assessment in invasive breast cancer in France]. Ann Pathol 2021; 41:507-520. [PMID: 34393014 DOI: 10.1016/j.annpat.2021.07.014] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [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: 03/24/2021] [Revised: 07/01/2021] [Accepted: 07/11/2021] [Indexed: 12/15/2022]
Abstract
The last international guidelines on HER2 determination in breast cancer have been updated in 2018 by the American Society of Clinical Oncology and College of American Pathologists, on the basis of a twenty-year practice and results of numerous clinical trials. Moreover, the emerging HER2-low concept for 1+ and 2+ non amplified breast cancers lead to refine French practices for HER2 status assessment. The GEFPICS group, composed of expert pathologists, herein presents the latest French recommendations for HER2 status evaluation in breast cancer, taking into account the ASCO/CAP guidelines and introducing the HER2-low concept. In the era of personalized medicine, HER2 status assessment remains one of the most important biomarkers in breast cancer and its quality guaranties the optimal patients' care. French pathologists' commitment in theranostic biomarker quality is more than ever required to provide the most efficient cares in oncology.
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Affiliation(s)
- Camille Franchet
- Groupe d'étude des facteurs pronostiques immunohistochimiques dans le cancer du sein, Unicancer, 101, rue de Tolbiac, 75654 Paris cedex 13, France.
| | - Lounes Djerroudi
- Groupe d'étude des facteurs pronostiques immunohistochimiques dans le cancer du sein, Unicancer, 101, rue de Tolbiac, 75654 Paris cedex 13, France
| | - Aurélie Maran-Gonzalez
- Groupe d'étude des facteurs pronostiques immunohistochimiques dans le cancer du sein, Unicancer, 101, rue de Tolbiac, 75654 Paris cedex 13, France
| | - Olivia Abramovici
- Groupe d'étude des facteurs pronostiques immunohistochimiques dans le cancer du sein, Unicancer, 101, rue de Tolbiac, 75654 Paris cedex 13, France
| | - Martine Antoine
- Groupe d'étude des facteurs pronostiques immunohistochimiques dans le cancer du sein, Unicancer, 101, rue de Tolbiac, 75654 Paris cedex 13, France
| | - Véronique Becette
- Groupe d'étude des facteurs pronostiques immunohistochimiques dans le cancer du sein, Unicancer, 101, rue de Tolbiac, 75654 Paris cedex 13, France
| | - Anca Berghian
- Groupe d'étude des facteurs pronostiques immunohistochimiques dans le cancer du sein, Unicancer, 101, rue de Tolbiac, 75654 Paris cedex 13, France
| | - Cécile Blanc-Fournier
- Groupe d'étude des facteurs pronostiques immunohistochimiques dans le cancer du sein, Unicancer, 101, rue de Tolbiac, 75654 Paris cedex 13, France
| | - Eva Brabencova
- Groupe d'étude des facteurs pronostiques immunohistochimiques dans le cancer du sein, Unicancer, 101, rue de Tolbiac, 75654 Paris cedex 13, France
| | - Emmanuelle Charafe-Jauffret
- Groupe d'étude des facteurs pronostiques immunohistochimiques dans le cancer du sein, Unicancer, 101, rue de Tolbiac, 75654 Paris cedex 13, France
| | - Marie-Pierre Chenard
- Groupe d'étude des facteurs pronostiques immunohistochimiques dans le cancer du sein, Unicancer, 101, rue de Tolbiac, 75654 Paris cedex 13, France
| | - Marie-Mélanie Dauplat
- Groupe d'étude des facteurs pronostiques immunohistochimiques dans le cancer du sein, Unicancer, 101, rue de Tolbiac, 75654 Paris cedex 13, France
| | - Paul Delrée
- Groupe d'étude des facteurs pronostiques immunohistochimiques dans le cancer du sein, Unicancer, 101, rue de Tolbiac, 75654 Paris cedex 13, France
| | - Raphaëlle Duprez-Paumier
- Groupe d'étude des facteurs pronostiques immunohistochimiques dans le cancer du sein, Unicancer, 101, rue de Tolbiac, 75654 Paris cedex 13, France
| | - Clémence Fleury
- Groupe d'étude des facteurs pronostiques immunohistochimiques dans le cancer du sein, Unicancer, 101, rue de Tolbiac, 75654 Paris cedex 13, France
| | - Jean-Pierre Ghnassia
- Groupe d'étude des facteurs pronostiques immunohistochimiques dans le cancer du sein, Unicancer, 101, rue de Tolbiac, 75654 Paris cedex 13, France
| | - Juliette Haudebourg
- Groupe d'étude des facteurs pronostiques immunohistochimiques dans le cancer du sein, Unicancer, 101, rue de Tolbiac, 75654 Paris cedex 13, France
| | - Agnès Leroux
- Groupe d'étude des facteurs pronostiques immunohistochimiques dans le cancer du sein, Unicancer, 101, rue de Tolbiac, 75654 Paris cedex 13, France
| | - Gaëtan MacGrogan
- Groupe d'étude des facteurs pronostiques immunohistochimiques dans le cancer du sein, Unicancer, 101, rue de Tolbiac, 75654 Paris cedex 13, France
| | - Marie-Christine Mathieu
- Groupe d'étude des facteurs pronostiques immunohistochimiques dans le cancer du sein, Unicancer, 101, rue de Tolbiac, 75654 Paris cedex 13, France
| | - Patrick Michenet
- Groupe d'étude des facteurs pronostiques immunohistochimiques dans le cancer du sein, Unicancer, 101, rue de Tolbiac, 75654 Paris cedex 13, France
| | - Frédérique Penault-Llorca
- Groupe d'étude des facteurs pronostiques immunohistochimiques dans le cancer du sein, Unicancer, 101, rue de Tolbiac, 75654 Paris cedex 13, France
| | - Bruno Poulet
- Groupe d'étude des facteurs pronostiques immunohistochimiques dans le cancer du sein, Unicancer, 101, rue de Tolbiac, 75654 Paris cedex 13, France
| | - Yves Marie Robin
- Groupe d'étude des facteurs pronostiques immunohistochimiques dans le cancer du sein, Unicancer, 101, rue de Tolbiac, 75654 Paris cedex 13, France
| | - Pascal Roger
- Groupe d'étude des facteurs pronostiques immunohistochimiques dans le cancer du sein, Unicancer, 101, rue de Tolbiac, 75654 Paris cedex 13, France
| | - Elisabeth Russ
- Groupe d'étude des facteurs pronostiques immunohistochimiques dans le cancer du sein, Unicancer, 101, rue de Tolbiac, 75654 Paris cedex 13, France
| | - Lucie Tixier
- Groupe d'étude des facteurs pronostiques immunohistochimiques dans le cancer du sein, Unicancer, 101, rue de Tolbiac, 75654 Paris cedex 13, France
| | - Isabelle Treilleux
- Groupe d'étude des facteurs pronostiques immunohistochimiques dans le cancer du sein, Unicancer, 101, rue de Tolbiac, 75654 Paris cedex 13, France
| | - Alexander Valent
- Groupe d'étude des facteurs pronostiques immunohistochimiques dans le cancer du sein, Unicancer, 101, rue de Tolbiac, 75654 Paris cedex 13, France
| | - Véronique Verriele
- Groupe d'étude des facteurs pronostiques immunohistochimiques dans le cancer du sein, Unicancer, 101, rue de Tolbiac, 75654 Paris cedex 13, France
| | - Anne Vincent-Salomon
- Groupe d'étude des facteurs pronostiques immunohistochimiques dans le cancer du sein, Unicancer, 101, rue de Tolbiac, 75654 Paris cedex 13, France
| | - Laurent Arnould
- Groupe d'étude des facteurs pronostiques immunohistochimiques dans le cancer du sein, Unicancer, 101, rue de Tolbiac, 75654 Paris cedex 13, France
| | - Magali Lacroix-Triki
- Groupe d'étude des facteurs pronostiques immunohistochimiques dans le cancer du sein, Unicancer, 101, rue de Tolbiac, 75654 Paris cedex 13, France
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Uguen A, Csanyi-Bastien M, Sabourin JC, Penault-Llorca F, Adam J. [How to test for NTRK gene fusions: A practical approach for pathologists]. Ann Pathol 2021; 41:387-398. [PMID: 33846022 DOI: 10.1016/j.annpat.2021.03.005] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2021] [Revised: 03/06/2021] [Accepted: 03/10/2021] [Indexed: 11/29/2022]
Abstract
The recent availability of targeted anti-TRK therapies represents a new opportunity to treat patients with advanced cancers harboring NTRK gene fusions. In this article, we present an update on the practical modalities of implementing a "NTRK testing" to search for these fusions in view of the performances and availability of the different testing methods and the epidemiological characteristics of the tumors liable to present the NTRK1, NTRK2 or NTRK3 gene fusions.
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Affiliation(s)
- Arnaud Uguen
- Inserm, CHU de Brest, LBAI, UMR1227, Université Brest, 29200 Brest, France; Service d'anatomie et cytologie pathologiques, CHRU Brest, 29200 Brest, France.
| | | | | | - Frédérique Penault-Llorca
- Inserm U1240, département d'anatomie et de cytologie pathologiques, centre Jean-Perrin, université Clermont-Auvergne, 63011 Clermont-Ferrand, France
| | - Julien Adam
- Service d'anatomie et cytologie pathologiques, Hôpital Saint-Joseph, 75014 Paris, France
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Aka E, Horo A, Koffi A, Fanny M, Didi-Kouko C, Nda G, Abouna A, Kone M. [Management of breast cancer in Abidjan: A single center experience]. ACTA ACUST UNITED AC 2021; 49:684-690. [PMID: 33677121 DOI: 10.1016/j.gofs.2021.03.001] [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: 11/11/2020] [Indexed: 11/17/2022]
Abstract
AIM To present the results of the personalized care of Ivorian women suffering from breast cancer since the advent of immunohistochemistry in Côte d'Ivoire. METHODS We carried out a single-center retrospective study at the Yopougon university hospital from January 2014 to December 2018. All women's breast cancer with complementary immunohistochemistry and treated at the Yopougon hospital center were selected. Standard descriptive statistical tests were used to describe patient and tumor characteristics, and univariate and multivariate analyzes were performed with a statistical significance set at a P-value of 0.05 using SPSS version 20.0. RESULTS The mean age of women is 48.27 years, SD (11.92). 50.88 % of the tumors were hormone-dependent. The triple negative subgroup was the most represented (43.28 %) followed by luminal A (35.42 %). Conservative treatment represented 18.51 % of cases. In the univariate analysis, the risk of developing a hormone-dependent cancer is statistically significant respectively in women with an education level removed OR=1.98 (P˂0.015) and with a wealthy salary OR=1.85 (P˂0.009). On the other hand, the high level of education (OR=0.44; P˂0.005), and the well-off salary condition (OR=0.59; P˂0.024) would be protective factors for the development of triple negative breast cancer. All these factors are not significant in multivariate analysis, whether for hormone-dependent or triple negative tumors. CONCLUSION The personalized care of breast cancer in our African context remains difficult and must take into account several medical and extra-medical parameters.
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Affiliation(s)
- E Aka
- Teaching Hospital of Yopougon-Abidjan/Obstetrics and Gynecology Unit, University Félix Houphouët Boigny (FHB), Abidjan, Cote d'Ivoire.
| | - A Horo
- Teaching Hospital of Yopougon-Abidjan/Obstetrics and Gynecology Unit, University Félix Houphouët Boigny (FHB), Abidjan, Cote d'Ivoire.
| | - A Koffi
- Teaching Hospital of Yopougon-Abidjan/Obstetrics and Gynecology Unit, University Félix Houphouët Boigny (FHB), Abidjan, Cote d'Ivoire.
| | - M Fanny
- Teaching Hospital of Yopougon-Abidjan/Obstetrics and Gynecology Unit, University Félix Houphouët Boigny (FHB), Abidjan, Cote d'Ivoire.
| | - C Didi-Kouko
- University Félix Houphouët Boigny (FHB), Teaching Hospital of Treichville-Abidjan/Oncology Unit, Abidjan, Cote d'Ivoire.
| | - G Nda
- University Félix Houphouët Boigny (FHB), Ivoirian Cancer Registry, Abidjan, Cote d'Ivoire.
| | - A Abouna
- University Félix Houphouët Boigny (FHB), Teaching Hospital of Treichville-Abidjan/Anatomy-Pathology Unit, Abidjan, Cote d'Ivoire.
| | - M Kone
- Teaching Hospital of Yopougon-Abidjan/Obstetrics and Gynecology Unit, University Félix Houphouët Boigny (FHB), Abidjan, Cote d'Ivoire.
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Bourgade R, Piriou N, Bressollette-Bodin C, Loussouarn D, Toquet C. [Inflammatory cardiomyopathies: Diagnosis, correlations with imaging, interest of myocardial biopsy and place of molecular biology]. Ann Pathol 2020; 41:71-84. [PMID: 33388193 DOI: 10.1016/j.annpat.2020.10.007] [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: 10/01/2020] [Revised: 10/23/2020] [Accepted: 10/31/2020] [Indexed: 12/01/2022]
Abstract
Inflammatory cardiomyopathies, also known as "myocarditis" are inflammatory pathologies affecting the myocardium and characterized by vast etiological and clinical heterogeneity. They can be asymptomatic, particularly in viral forms, or be responsible for sudden death, particularly in subjects under 35 years olds. Due to insufficient sensitivity and specificity of imaging and biology, the gold standard is histopathological and is performed on an endomyocardial biopsy or on explanted heart samples in a transplant context. Their classification has considerably evolved and is now based on the identification of a predominant cell pattern such as lymphocytic, neutrophilic or eosinophilic polynuclear, giant cell or granulomatous myocarditis. These different patterns will guide the etiological diagnosis, prognosis and the therapies to be implemented. Due to the importance of viral etiologies, this morphological analysis must be complemented by a virological analysis based on PCR with viral load quantification. In addition, some authors have been able to demonstrate the occurrence of myocarditis in patients with arrhythmogenic cardiomyopathy of genetic origin. The aim of this chapter is to review the current state of knowledge on inflammatory cardiomyopathies and their management.
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Affiliation(s)
- Raphaël Bourgade
- Service d'anatomie et cytologie pathologiques, CHU de Nantes, 9, quai Moncousu - Plateau technique 1, 44093 Nantes cedex 1, France
| | - Nicolas Piriou
- Service de cardiologie, Institut du thorax, CHU de Nantes, 44093 Nantes cedex 1, France; Service de médecine nucléaire, CHU de Nantes, 44093 Nantes cedex 1, France
| | | | - Delphine Loussouarn
- Service d'anatomie et cytologie pathologiques, CHU de Nantes, 9, quai Moncousu - Plateau technique 1, 44093 Nantes cedex 1, France
| | - Claire Toquet
- Service d'anatomie et cytologie pathologiques, CHU de Nantes, 9, quai Moncousu - Plateau technique 1, 44093 Nantes cedex 1, France; Institut du thorax, UMR 1087, CNRS, université de Nantes, CHU de Nantes, Nantes, France.
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Chalabreysse L, Dubois R, Hofman V, Le Naoures C, Mansuet-Lupo A, de Montpréville VT, De Muret A, Parrens M, Piton N, Rouquette I, Secq V, Singeorzan C, Marx A, Girard N, Besse B, Molina TJ. [Thymoma and squamous thymic carcinoma diagnosis; experience from the RYTHMIC network]. Ann Pathol 2021; 41:154-65. [PMID: 33309329 DOI: 10.1016/j.annpat.2020.11.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2020] [Revised: 10/10/2020] [Accepted: 11/11/2020] [Indexed: 11/23/2022]
Abstract
The RYTHMIC network, supported by the French National Cancer Institute is dedicated to the management of patients with thymic epithelial tumors through regional and national multidisciplinary tumor boards. Tumor board decisions are based on the initial pathology diagnoses. However, following clinical inclusion in the network, a central pathology review is organized, implicating a panel of pathologists, for histotype and stage classification, which is different from a classical second opinion from pathologist to pathologist for a difficult case. Thanks to the participation of all French pathologists, more than 1000 cases have been reviewed by the panel. The aim of this review is to share with the French pathology community, the experience of the group. It underlines the importance of macroscopy and surgeon-pathologist involvement to allow a good central review, the main histopathological and immunophenotypical patterns of the most frequent thymomas and thymic carcinoma types, the differential diagnoses, as well as the difficulties for the panel to reproducibly assess on slides, stage, for some cases.
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12
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Osché M, Mitcov M, Lipsker D, Cribier B. [Anatomoclinical and immunohistochemical study of 8 cases of dermatomyofibroma]. Ann Dermatol Venereol 2020; 147:721-728. [PMID: 33059951 DOI: 10.1016/j.annder.2020.01.025] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2019] [Revised: 09/06/2019] [Accepted: 01/10/2020] [Indexed: 12/01/2022]
Abstract
INTRODUCTION Dermatomyofibroma (DMF) is a rare, benign tumour that is little-known among clinicians. However, it has typical clinical, histological and immunohistochemical features that distinguish it from other fibrous tumours. METHOD We report herein on the clinical, histological and immunohistochemical aspects of eight cases of DMF identified between 2008 and 2019 at the dermatopathology laboratory of Strasbourg. RESULTS Five men and three women of average age at diagnosis of 21 years and 9 months (range: 9 to 54 years) were included. Lesions ranged in size from 1 to 11cm. Most cases involved the upper body (6 cases), with one case on the abdomen and one on the side. The lesions presented as a solitary asymptomatic red or reddish brown nodule or plaque that gradually developed. The plaques were hard and caused functional discomfort on movement of the neck. Well-circumscribed spindle cell proliferation was noted in the reticular dermis parallel to the epidermis, without mitotic figures or cytological atypia. The subcutis was infiltrated in 5 cases. Expression of calponin was positive in all cases but one, while that of caldesmon, PS100 and desmin was negative. Expression of smooth muscle actin was positive in 2 cases, and both cases were also positive for stromylesin-3. CD34 was positive in 2 cases. DISCUSSION DMF is an extensive tumour capable of attaining large diameters and must be completely excised. The main differential diagnoses of DMF are dermatofibrosarcoma protuberans, dermatofibroma, fibrous hamartoma, myofibromatosis and cheloid. It can be identified based on various factors, whether clinical (young age, extensive lesion), histological (horizontal proliferation in the reticular dermis) or immunohistochemical (positive expression of calponin).
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Affiliation(s)
- M Osché
- Clinique dermatologique de Strasbourg, hôpitaux universitaires de Strasbourg, université de Strasbourg, 1, place de l'Hôpital, 67091 Strasbourg cedex, France.
| | - M Mitcov
- Clinique dermatologique de Strasbourg, hôpitaux universitaires de Strasbourg, université de Strasbourg, 1, place de l'Hôpital, 67091 Strasbourg cedex, France
| | - D Lipsker
- Clinique dermatologique de Strasbourg, hôpitaux universitaires de Strasbourg, université de Strasbourg, 1, place de l'Hôpital, 67091 Strasbourg cedex, France
| | - B Cribier
- Clinique dermatologique de Strasbourg, hôpitaux universitaires de Strasbourg, université de Strasbourg, 1, place de l'Hôpital, 67091 Strasbourg cedex, France
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Seidou F, Tamarit C, Sevestre H. [Paraganglioma of the cauda equina region: Report of 9 cases]. Ann Pathol 2020; 40:436-441. [PMID: 32331813 DOI: 10.1016/j.annpat.2020.02.018] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2019] [Revised: 01/28/2020] [Accepted: 02/18/2020] [Indexed: 11/30/2022]
Abstract
INTRODUCTION The paraganglioma of the cauda equina is a rare tumor, the diagnosis is morphological and the immunohistochemistry provides a definite diagnosis. The objective of our study is to specify the clinical signs, radiological and associated pathological criteria and to compare our data with those of the literature. PATIENTS AND METHOD This is a retrospective study of nine cases of paragangliomas of the cauda equina diagnosed in our department from 2003 to 2018. The median age of the patients was 50 years-old with a male predominance (sex ratio: 3,5/1). All patients had preoperative magnetic resonance imaging (MRI) and surgery to remove the tumor. The diagnosis was performed after HES (Hematoxylin Eosin Saffron) and immunohistochemical sections examination. RESULTS Radiculalgia was the chief symptom of these tumors. MRI showed an oval lesion uniformly enhanced by Gadolinium in the eight patients whose records were available. Histologically, the tumors had a lobular and trabecular pattern with neuroendocrine-like cells and a rich vascularization. By immunohistochemistry, the cells expressed chromogranin, synaptophysin and CD56. DISCUSSION AND CONCLUSION Paragangliomas of the cauda equina are rare, benign tumors. Except for cases of secreting tumors, the preoperative diagnosis is difficult. MRI is useful and may reveal radiological features suggestive of these tumors. However, it is rare for the diagnosis to be made before surgery. The diagnosis is established by histological examination and immunohistochemical techniques must be used to confirm the diagnosis. The paragangliomas of the cauda equina are well encapsulated tumors whose complete excision is curative. When the excision is incomplete, treatment with radiotherapy is recommended. Long-term clinical and radiological monitoring is recommended because of the slow evolution of the tumor and the potential for recurrence.
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Affiliation(s)
- Falilatou Seidou
- Laboratoire d'anatomie et cytologie pathologiques de la faculté des sciences de la santé de Cotonou (LAPC/FSS), Bénin
| | - Clémence Tamarit
- Service d'anatomie et de cytologie pathologiques, CHU Amiens, place Victor-Pauchet, 80054 Amiens cedex 1, France.
| | - Henri Sevestre
- Service d'anatomie et de cytologie pathologiques, CHU Amiens, place Victor-Pauchet, 80054 Amiens cedex 1, France
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Renaud F, Svrcek M. [Hereditary gastric cancer: Challenges for the pathologist in 2020]. Ann Pathol 2020; 40:95-104. [PMID: 32147190 DOI: 10.1016/j.annpat.2020.02.007] [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: 01/04/2020] [Revised: 01/26/2020] [Accepted: 02/05/2020] [Indexed: 12/24/2022]
Abstract
Gastric cancer is the third most common cancer worldwide. The majority of gastric cancers are sporadic but familial clustering is seen in more than 10% of cases. This manuscript is divided into two parts. The first part is dedicated to the non-syndromic hereditary gastric cancer, particularly the hereditary diffuse gastric cancer (HDGC) and other gastric polyposes including the recently described GAPPS (Gastric adenocarcinoma and proximal polyposis of the stomach). The second part concerns the syndromic gastric cancer, namely the HNPCC syndrome (Hereditary Non Polyposis Colorectal Cancer) occurring as part of a genetic predisposition syndrome to cancer. Recent advances in oncogenetics and next generation sequencing technology have enabled the identification of new entities. This enhancement in knowledge regarding inherited syndromes predisposing to gastric cancer has consequently improved the management of patients and their families. In this context, pathologists play a major role in identifying particular morphologic entities prompting genetic investigation. The aim of this manuscript is to provide an update on the current knowledge about hereditary gastric cancer.
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Affiliation(s)
- Florence Renaud
- Sorbonne université, Inserm, unité Mixte de Recherche Scientifique 938, SIRIC CURAMUS, centre de recherche Saint-Antoine, équipe instabilité des microsatellites et cancer, équipe labellisée par la Ligue Nationale contre le cancer, 75012 Paris, France; Service d'anatomie et cytologie pathologiques, hôpital Saint-Antoine, AP-HP, 184, rue du Faubourg-Saint-Antoine, 75571 Paris cedex 12, France.
| | - Magali Svrcek
- Sorbonne université, Inserm, unité Mixte de Recherche Scientifique 938, SIRIC CURAMUS, centre de recherche Saint-Antoine, équipe instabilité des microsatellites et cancer, équipe labellisée par la Ligue Nationale contre le cancer, 75012 Paris, France; Service d'anatomie et cytologie pathologiques, hôpital Saint-Antoine, AP-HP, 184, rue du Faubourg-Saint-Antoine, 75571 Paris cedex 12, France
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15
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Broudin C, Favier J, Verkarre V, Méatchi T. [Pathologist contribution in the diagnosis of hereditary predisposition to paranganglioma and pheochromocytoma]. Ann Pathol 2020; 40:134-41. [PMID: 32146049 DOI: 10.1016/j.annpat.2020.01.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2020] [Accepted: 01/23/2020] [Indexed: 11/20/2022]
Abstract
Hereditary predispositions are responsible for more than 30% of or paraganglioma. Their identification is essential to optimize medical care and to offer an appropriate screening to relatives. To date, there are more than 15 known paraganglioma/pheochromocytoma predisposing genes. The most frequently involved are those encoding the succinate dehydrogenase (SDHx), accounting for half of cases and the VHL gene, causing the Von Hippel Lindau syndrome and representing approximately 20% of genetically determined cases. Patients with SDHB genes mutations have a higher risk of metastatic disease. An oncogenetic counseling is recommended to all patients developing one or several paragangliomas, isolated or associated with other tumors. Apart from the clinical presentation and in particular the syndromic forms characterized by specific tumor spectra, there is no validated morphological criterion allowing to suspect a hereditary form. On the other hand, pathologists have now access to several immunohistochemical tools allowing the identification of some hereditary forms, in particular those linked to the SDHx, VHL and FH genes. Thus, the loss of expression in immunohistochemistry of the SDHB or FH proteins orientates respectively, towards SDHx and FH genes, while the membrane expression of carbonic anhydrase IX (CA-IX) is a sensitive and specific tool pointing towards a VHL anomaly. Other immunohistochemical markers are under evaluation. A systematic SDHB immunohistochemical staining is recommended on all paragangliomas/pheochromocytomas in order to allow an early detection of the most common hereditary forms and to contribute to the interpretation of the genetic results in these patients seen in oncogenetics consultation.
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Basset N, Desseignés C, Boucher C, Coulet F, Benusiglio PR. [Clinical Cancer Genetics: A guide for the pathologist]. Ann Pathol 2020; 40:63-9. [PMID: 32046877 DOI: 10.1016/j.annpat.2020.01.003] [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] [Subscribe] [Scholar Register] [Received: 12/02/2019] [Revised: 01/14/2020] [Accepted: 01/18/2020] [Indexed: 11/22/2022]
Abstract
It is paramount to identify patients whose cancer is associated with genetic susceptibility to the disease, since their long-term management depends on it. Anatomical and molecular pathologists play a key role in the process. Indeed, their diagnosis supports or even sometimes warrants germline genetic testing. For example, a colorectal cancer with mismatch repair protein expression loss suggests Lynch syndrome, while a rare type of renal cell carcinoma with fumarate hydrate expression loss is highly evocative of hereditary leiomyomatosis and renal cell carcinoma syndrome. Similarly, the presence of the T790M EGFR variant before treatment in a non-small-cell lung carcinoma warrants further testing as the variant is likely of germline origin. Patients with suspected genetic susceptibility to cancer are referred to the nearest clinical cancer genetics clinic. The cancer geneticist, assisted by a genetic counsellor, then collects detailed personal and familial information, sometimes feeds them into bioinformatics tools or clinico-pathological scores, decides whether germline genetic analysis is justified, determines which genes should be analysed and prescribes testing. Germline testing is carried out on a blood sample by expert laboratories using next generation sequencing on panels of cancer susceptibility genes. The cancer geneticists then return the result to the patient. When a pathogenic variant is identified, the patient's management is modified, with recommendations ranging from intensified surveillance to risk-reducing surgery. Treatment is sometimes adapted to the pathogenic variant. In addition, relatives can undergo genetic testing, should they wish to know whether they carry the familial variant. In the near future, we expect clinical cancer genetics to move towards strengthened partnerships with molecular pathologists and medical oncologists. Somatic genetic analyses are now routine, at least in metastatic cancer, and a proportion of the tumoral variants identified are actually of germline origin. As for the oncologists, the development of mainstreaming programs where they are allowed to prescribe germline testing under the supervision of a cancer genetics team is unavoidable.
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Tesson JR, Fontaine R, Fumery M, Gaudet LV, Attencourt C, Chatelain D. [Immunohistochemical diagnosis of colonic spirochetosis with anti-treponema antibody in patients consulting for chronic diarrhea. Results of a prospective study conducted in 137 patients]. Ann Pathol 2019; 39:280-285. [PMID: 30929971 DOI: 10.1016/j.annpat.2019.02.008] [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: 09/19/2018] [Revised: 01/28/2019] [Accepted: 02/22/2019] [Indexed: 10/27/2022]
Abstract
AIM To assess the incidence of colonic spirochetosis, diagnosed by immunohistochemical stain with anti-Treponema pallidum antibody, in a prospective study of colonic biopsies of patients presenting with chronic diarrhea. MATERIAL AND METHODS From March 2017 to March 2018 the colonic biopsies of patients presenting with chronic diarrhea were stained with Hematoxylin Eosin and anti-Treponema pallidum antibody. The positive cases were also stained with Steiner stain. RESULTS A total of 137 colonic biopsies were assessed and 3 cases were positive for immunohistochemical stain with anti-Treponema pallidum antibody (2% of the patients). One case was easy to diagnose with HE stain but the 2 other cases were not. The bacteria were stained with Steiner stain, but less easily seen than with the immunohistochemical stain. No patient was treated with antibiotics. DISCUSSION AND CONCLUSION The colonic spirochetosis can be easily diagnosed by pathologists with immunohistochemical stain with anti-Treponema pallidum antibody. The bacteria are more easily diagnosed with immunohistochemical stain than with HE stain or Steiner stain. However, colonic spirochetosis is rarely diagnosed on colonic biopsies of patients presenting with chronic diarrhea (2% of the patients in our study). Due to the rarity of the entity, and the cost of immunohistochemical stain and the weak benefit for the patient (no patient in our study was treated with antibiotics for colonic spirochetosis) we cannot advise to perform systematic immunohistochemical stain with anti-Treponema pallidum antibody in all the colonic biopsies of patients presenting with chronic diarrhea.
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Affiliation(s)
- Jean-René Tesson
- Service d'anatomie pathologique, CHU d'Amiens, CHU Nord, place Victor-Pauchet, 80000 Amiens, France.
| | - Rémi Fontaine
- Service d'anatomie pathologique, CHU d'Amiens, CHU Nord, place Victor-Pauchet, 80000 Amiens, France
| | - Mathurin Fumery
- Service de gastroentérologie, CHU d'Amiens, CHU Sud, 80054 Amiens, France
| | - Louis-Victor Gaudet
- Service d'anatomie pathologique, CHU d'Amiens, CHU Nord, place Victor-Pauchet, 80000 Amiens, France
| | - Christophe Attencourt
- Service d'anatomie pathologique, CHU d'Amiens, CHU Nord, place Victor-Pauchet, 80000 Amiens, France
| | - Denis Chatelain
- Service d'anatomie pathologique, CHU d'Amiens, CHU Nord, place Victor-Pauchet, 80000 Amiens, France
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Svrcek M, Lascols O, Cohen R, Collura A, Jonchère V, Fléjou JF, Buhard O, Duval A. MSI/MMR-deficient tumor diagnosis: Which standard for screening and for diagnosis? Diagnostic modalities for the colon and other sites: Differences between tumors. Bull Cancer 2019; 106:119-28. [PMID: 30713006 DOI: 10.1016/j.bulcan.2018.12.008] [Citation(s) in RCA: 57] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2018] [Accepted: 12/17/2018] [Indexed: 12/31/2022]
Abstract
Microsatellite instability (MSI), which is caused by deficiency of the DNA mismatch repair (MMR) system, is the molecular abnormality observed in tumors associated with Lynch syndrome. Lynch syndrome represents one of the most frequent conditions of cancer predisposition in human, thus requiring specific care and genetic counseling. Moreover, research has recently focused increasingly on MMR deficiency due to its positive predictive value for the efficacy of immune checkpoints inhibitors (ICKi) in metastatic tumors, regardless of their primary origin. MSI has also been demonstrated to constitute an independent prognostic factor in several tumor types, being also associated with alternative response to chemotherapy. These observations have led many professional medical organizations to recommend universal screening of all newly diagnosed colorectal cancers for dMMR/MSI status and increasing evidence support the evaluation of MSI in all human tumors regardless of the cancer tissue of origin. Currently, two standard reference methods, namely immunohistochemistry and polymerase chain reaction, are recommended for the detection of dMMR/MSI status. These methods are equally valid as the initial screening test for dMMR/MSI in colorectal cancer. To date, there is no recommendation for the detection of dMMR/MSI in other primary tumors. In this review, we will present a comprehensive overview of the methods used for evaluation of tumor dMMR/MSI status in colorectal cancer, as well as in other tumor sites. We will see that the evaluation of this status remains challenging in some clinical settings, with the need to improve the above methods in these specific contexts.
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Dembélé SB, Diakité I, Samaké M, Coulibaly B, Saye Z, Bah A, Konaté S, Togo E, Sidibé BY, Coulibaly Z, Kanté L, Togo A. [Breast Cancer: Immunohistochemistry And Prognosis At Gabriel Touré Teaching Hospital In Bamako-Mali]. Mali Med 2019; 34:36-39. [PMID: 35897225] [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] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
UNLABELLED Breast cancer is the second cancer of women in Mali. Immunohistochemistry is poorly performed in our African countries. OBJECTIVES To describe the immunohistochemical aspect and determine the prognosis of breast cancer. METHODOLOGY This is a retrospective descriptive study (March 2006-July 2016) in the General Surgery Department of Gabriel Toure University Hospital in Bamako, Mali. Immunohistochemistry was performed in all patients through a collaboration of our German partners. RESULTS We collected 98 patients (95 women and 3 men) with an average age of 40.04 ± 13.07 years. Twenty-two patients (22.44%) had a personal history of benign breast disease. In 16 patients (16.33%), we found a family breast cancer. The most common histological types were intra ductal carcinoma with 84 (85.72%) and invasive lobular carcinoma in 9 cases (9.18%). Immunohistochemistry found a predominance of triple negative with forty nine patients (50%) followed by Luminal A subtype with 26 cases (26.23%). According to the TNM classification, 44 patients (44.90%) were received at stage III. The median survival was 60 months in the group of patients who received hormone therapy versus 28 months for the group without hormone therapy (p = 0.007). CONCLUSION Immunohistochemistry is essential for the adequate management of breast cancer. Its realization has allowed us to improve the prognosis of hormone-dependent cancers.
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Affiliation(s)
- S B Dembélé
- Service de chirurgie générale CHU Gabriel Touré
| | - I Diakité
- Service de chirurgie générale CHU Gabriel Touré
| | - M Samaké
- Service de chirurgie générale CHU Gabriel Touré
| | | | - Z Saye
- Service de chirurgie générale CHU Gabriel Touré
| | - A Bah
- Service de chirurgie générale CHU Gabriel Touré
| | - S Konaté
- Service de chirurgie générale CHU Gabriel Touré
| | - E Togo
- Service de Gynécologie Obstétrique CHU Point G
| | - B Y Sidibé
- Service de chirurgie générale CHU Gabriel Touré
| | - Z Coulibaly
- Service de chirurgie générale CHU Gabriel Touré
| | - L Kanté
- Service de chirurgie générale CHU Gabriel Touré
| | - A Togo
- Service de chirurgie générale CHU Gabriel Touré
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Bentefouet TL, Boye A, Diousse P, Fall AS, Diop O, Gaulier A, Dieng MT, Touré A. [Primary cutaneous localization revealing leukemia/T-cell lymphoma associated with chronic HTLV-1 infection in a adult. A case presentation]. Ann Pathol 2018; 39:40-46. [PMID: 30578040 DOI: 10.1016/j.annpat.2018.10.001] [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: 04/08/2017] [Revised: 09/17/2018] [Accepted: 10/13/2018] [Indexed: 11/28/2022]
Abstract
Adult T-cell leukemia/lymphoma (ATLL) is a rare medical condition and a diagnosis that ought to be considered for patients living in an area endemic for the HTLV-1 virus (human T-lymphotrophic virus) where a T-cell lymphoproliferative diagnosis has been made. The cutaneous clinical forms may be the first manifestation of the disease. We report here an observation in a 60-year-old Senegalese woman whose skin lesions were sampled to reveal the ATLL immunophenotypic profile CD4+, CD25+, FoxP3-, and CD7-. HTLV-1 seropositivity confirmed the histopathological diagnosis, and should be corroborated by demonstration of a molecular clonal rearrangement by PCR (Polymerase Chain Reaction). This is a problem because such techniques are not always available in Africa.
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Affiliation(s)
| | - Ahmadou Boye
- Centre hospitalier universitaire Aristide le Dantec, service d'hématologie, avenue Pasteur, BP 3001, Dakar, Sénégal
| | - Pauline Diousse
- Centre hospitalier régional Thiès, avenue Malick Sy prolongée, B.P 34A, Thiès, Sénégal
| | - Abibatou Sall Fall
- Centre hospitalier universitaire Aristide le Dantec, service d'hématologie, avenue Pasteur, BP 3001, Dakar, Sénégal
| | - Oumar Diop
- Centre hospitalier régional Thiès, avenue Malick Sy prolongée, B.P 34A, Thiès, Sénégal
| | - Alain Gaulier
- Laboratoire Cerba, 95066 Cergy Pontoise cedex 9, France
| | - Mame Thierno Dieng
- Centre hospitalier universitaire Aristide le Dantec, service d'hématologie, avenue Pasteur, BP 3001, Dakar, Sénégal
| | - Awa Touré
- Centre hospitalier universitaire Aristide le Dantec, service d'hématologie, avenue Pasteur, BP 3001, Dakar, Sénégal
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Mlika M, Lamzirbi O, Limam M, Mejri N, Ben Saad S, Chaouch N, Ben Miled K, Marghli A, Mezni F. [Clinical and pathological profile of the pleural malignant mesothelioma: A retrospective study about 30 cases]. Rev Pneumol Clin 2018; 74:427-435. [PMID: 30293912 DOI: 10.1016/j.pneumo.2018.06.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/28/2018] [Revised: 05/24/2018] [Accepted: 06/14/2018] [Indexed: 06/08/2023]
Abstract
BACKGROUND The malignant pleural mesothelioma (MPM) is a rare tumour usually associated to asbestos exposure. The delay between the exposure and the occurrence of the cancer can reach 40 years. This caused the pick of incidence described in many countries including Tunisia. The diagnosis is suspected based on clinical features but positive diagnosis is microscopic. Our aim was to describe the clinical and microscopic features of MPM through a single institution experience. PATIENTS AND METHODS We conducted a retrospective study about 30 MPM diagnosed over a 20-year-period (1995-2015). We included only patients with complete records including clinical, radiologic and microscopic features. All the microscopic diagnoses were reviewed by 2 pathologists. A mean of 12 slides per case was reviewed. The diagnosis was based on the 2015 WHO classification. RESULTS The mean age of the patients was 61 years, average 22 to 80 years. The sex ratio was 6,5. An asbetose exposition was reported in 21 cases. The most frequent symptoms was chest pain reported in 25 cases. Physical exam was normal in 9 cases. It revealed pleural syndorm in most patients (60 %). Imaging findings consisted mainly in diffuse pleural thickening in 17 cases. Twelve tumours were classified as stage I, 3 stage II, 14 stage III et 1 stage IV. Pleural biopsy was performed using needle in 18 cases, through thoracoscopy in 16 cases, thoracotomy in 3 cases and allowed the diagnosis in respectively 7 cases/18, 16 cases/16 and 3 cases/3. A lymph node biopsy was performed through mediastinoscopy in one case and yelded the diagnosis. The diagnosis was performed on surgical specimen in 2 patients: one bullectomy and one right upper lobectomy. The microscopic exam concluded to an EM in 17 cases, sarcomatoid mesothelioma (SM) in 4 cases and biphasic mesothelioma (BM) in 9 cases. Pan-cytokeratin antibody was used in all cases in association with 2 antibodies with positive diagnostic value and 2 antibodies with negative diagnostic value. It was repeated in 15 cases and the most used antibodies were the anti-calretinin and the TTF1. This was due to the lack of fixation in one case and in order to reach a quality criteria in the other cases. Surgical resection was possible in 2 patients. 15 patients were lost of view after a mean follow-up period of 3 months. Thirteen patients died before or during the follow-up. CONCLUSION This work was about a Tunisian experience in the diagnosis and management of MPM. The major limits faced were the incomplete databases, the small number of patients included. Microsocpic positive diagnosis necessitates a degree of expertise and every laboratory has to determine the most valuable antibodies through its experience in order to optimize the diagnosis and to reduce the delay of diagnosis.
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Affiliation(s)
- M Mlika
- Service de Pathologie, Hôpital Abderrahman Mami, 2037 Ariana, Tunisie; Unité de recherche, 12SP18, Ariana, Tunisie.
| | - O Lamzirbi
- Service de Pathologie, Hôpital Abderrahman Mami, 2037 Ariana, Tunisie; Unité de recherche, 12SP18, Ariana, Tunisie
| | - M Limam
- Unité de recherche, 12SP18, Ariana, Tunisie
| | - N Mejri
- Unité de recherche, 12SP18, Ariana, Tunisie
| | - S Ben Saad
- Unité de recherche, 12SP18, Ariana, Tunisie; Service de Pneumologie, Pavillon IV, Hôpital Abderrahman Mami, Ariana, Tunisie
| | - N Chaouch
- Service de Pneumologie, Pavillon II, Hôpital Abderrahman Mami, Ariana, Tunisie
| | - K Ben Miled
- Service de Radiologie, Hôpital Abderrahman Mami, Ariana, Tunisie
| | - A Marghli
- Service de Chrirugie Thoracique, Hôpital Abderrahman Mami, Ariana, Tunisie
| | - F Mezni
- Service de Pathologie, Hôpital Abderrahman Mami, 2037 Ariana, Tunisie; Unité de recherche, 12SP18, Ariana, Tunisie
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Choughri H, Coindre JM, Leclère FM. Intra-articular nodular fasciitis of the proximal interphalangeal joint of a finger: A case report. Hand Surg Rehabil 2019; 38:74-8. [PMID: 30661512 DOI: 10.1016/j.hansur.2018.09.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/27/2018] [Accepted: 09/04/2018] [Indexed: 11/21/2022]
Abstract
Nodular fasciitis is a benign reactive lesion, often mistaken for a soft-tissue sarcoma in clinical practice. Involvement of the finger is rare, and a finger joint even rarer. We report on the clinical, radiological and histological features of intra-articular nodular fasciitis in a 52-year-old man, originating from the proximal interphalangeal joint of the right ring finger, with cortical erosion of adjacent bone. The discussion is focused on the tumor diagnosis and therapeutic approach, the differential diagnosis and the importance of immunohistochemical staining to establish the final diagnosis.
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Campedel L, Seisen T, Cussenot O, Comperat E, Varinot J, Rouprêt M, Cancel-Tassin G. [Prognostic value of PD-1/PD-L1 expression in upper tract urothelial carcinoma]. Prog Urol 2018; 28:900-5. [PMID: 30219646 DOI: 10.1016/j.purol.2018.08.009] [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] [Subscribe] [Scholar Register] [Received: 01/22/2018] [Revised: 07/20/2018] [Accepted: 08/09/2018] [Indexed: 11/22/2022]
Abstract
Current literature supports the efficacy of anti-PD-1 and anti-PD-L1 immune checkpoint inhibitors for the treatment of urothelial carcinomas. While the prognostic value of PD-1 and PD-L1 levels has been comprehensively analyzed for urothelial carcinoma of the bladder, less is known for upper tract urothelial carcinoma. In addition, available data on the prognostic value of PD-1 and/or PD-L1 level in the tumor and/or peritumoral microenvironment are heterogeneous and even sometimes contradictory. In this article, we compared the methodologies of the various available studies in order to highlight the factors that can explain these discordant results.
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Martel A, Oberic A, Moulin A, Tieulie N, Hamedani M. [Clinical, radiological, pathological features, treatment and follow-up of periocular and/or orbital amyloidosis: Report of 6 cases and literature review]. J Fr Ophtalmol 2018; 41:492-506. [PMID: 29954616 DOI: 10.1016/j.jfo.2017.11.027] [Citation(s) in RCA: 2] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2017] [Revised: 10/22/2017] [Accepted: 11/28/2017] [Indexed: 11/30/2022]
Abstract
PURPOSE To assess demographic, clinical, radiological, pathological features, treatment and follow-up of periocular or/and orbital amyloidosis. PATIENTS AND METHODS We conducted an observational retrospective monocentric study from January 2004 to April 2017 in patients diagnosed with histologically proven periocular or/and orbital amyloidosis. RESULTS Six patients were included (2 females, 4 males). Mean age was 76.8 years (range 66-88 years). Mean time between first ophthalmological symptoms and diagnosis was 27 months (range 11-36 months). The main symptoms were subconjunctival infiltration (6 patients; 100%), periocular pain or discomfort (4 patients; 66.6%) and subconjunctival hemorrhage (1 patient; 16.6%). Clinical findings included ptosis (4 patients; 66.6%), keratitis (3 patients; 50%) leading to corneal perforation in one patient, and proptosis (3 patients; 50%). One-half of the patients showed bilateral involvement. AL amyloidosis was identified on immunohistochemistry in 5 patients (83.3%). One case of B cell marginal zone orbital lymphoma was diagnosed. Systemic work-up was negative for all patients. Treatment consisted of simple monitoring (1 patient; 16.6%), surgical debulking (3 patients; 50%), ptosis surgery (1 patient; 16.6%), eyelid or eyelash malposition surgery (2 patients; 33.3%) and orbital radiation beam therapy (2 patients; 33.3%). Mean follow-up was 14.6 months (range 6-36 months), and no progression nor recurrence were noted. CONCLUSION Periocular or/and orbital amyloidosis is rarely encountered. Diagnosis is based on pathological examination, and immunohistochemistry analysis should always be performed to guide systemic work-up. Orbital lymphoma and multiple myeloma should be ruled out if AL amyloidosis is diagnosed. Progression is slow, and surgery is the mainstay of treatment in symptomatic patients. Long-term multidisciplinary follow-up is advocated.
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Affiliation(s)
- A Martel
- Hôpital ophtalmique Jules-Gonin, 15, avenue de France, 1004 Lausanne, Suisse; Service d'ophtalmologie, hôpital Pasteur 2, CHU de Nice, 30, voie Romaine, 06000 Nice, France.
| | - A Oberic
- Hôpital ophtalmique Jules-Gonin, 15, avenue de France, 1004 Lausanne, Suisse
| | - A Moulin
- Hôpital ophtalmique Jules-Gonin, 15, avenue de France, 1004 Lausanne, Suisse
| | - N Tieulie
- Service de rhumatologie, hôpital Pasteur 2, CHU de Nice, 30, voie Romaine, 06000 Nice, France
| | - M Hamedani
- Hôpital ophtalmique Jules-Gonin, 15, avenue de France, 1004 Lausanne, Suisse
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Doh K, Thiam I, Takin RCA, Sonhaye K, Woto-Gaye G. [A rare parotid tumor]. Ann Pathol 2018; 38:321-324. [PMID: 29880294 DOI: 10.1016/j.annpat.2018.04.005] [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] [Subscribe] [Scholar Register] [Received: 08/31/2017] [Revised: 04/08/2018] [Accepted: 04/19/2018] [Indexed: 11/16/2022]
Abstract
INTRODUCTION Sebaceous lymphadenoma of the parotid (SLP) is a rare, benign tumor with similar epidemiological and macroscopic characteristics with other sebaceous differentiated tumors of the parotid (SDTP). The authors report a case of SLP in an 80-year-old woman. They then recall the distinctive histological and immunohistochemical criteria of SDTP. OBSERVATION Mrs P. D. was received during a surgical consultation for the management of a painless right parotid swelling that has evolved for 10years, increasing slightly in volume. At admission, the mass was movable, firm with a healthy skin without facial paralysis or satellite lymphadenopathy. The surgical intervention performed removed a nodular mass measuring 7cm, encapsulated, yellowish. It was made of regular epithelial cells without atypia or mitoses organized in nests, trabeculae and massifs. This tumor also included small canalicular cystic dilatations associated with several islands of sebaceous glands. The stroma was dense lymphoid with follicles and germinal centers. The tumor cells were CK7+, P63+, MSA+ and had a Ki67<5%. The diagnosis of an SLP was retained. No additional therapy was performed. One year after surgery, the patient had no local recurrence or metastatic foci. CONCLUSION SLP is a rare tumor with a particular histological and immunohistochemical profile. It is an epithelial tumor with sebaceous islands, a dense reactional lymphoid stroma, expression of luminal and basal epithelial markers and a low proliferation index.
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Affiliation(s)
- Kwame Doh
- Laboratoire d'anatomie et de cytologie pathologiques de l'hôpital Aristide-Le-Dantec, pavillon Bichat, avenue Pasteur, BP 3001, Dakar, Sénégal.
| | - Ibou Thiam
- Laboratoire d'anatomie et de cytologie pathologiques de l'hôpital Aristide-Le-Dantec, pavillon Bichat, avenue Pasteur, BP 3001, Dakar, Sénégal.
| | - Romulus Carmen Adechina Takin
- Laboratoire d'anatomie et de cytologie pathologiques de l'hôpital régional de Troyes, hôpital général de Troyes, 101, avenue Anatole-France, 10000 Troyes, France.
| | - Khaled Sonhaye
- Service d'ORL et de CCF de l'hôpital régional de Ziguinchor, BP 535, Ziguinchor, Sénégal.
| | - Gisèle Woto-Gaye
- Laboratoire d'anatomie et de cytologie pathologiques de l'hôpital Aristide-Le-Dantec, pavillon Bichat, avenue Pasteur, BP 3001, Dakar, Sénégal
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Kassem Youssef H, Blind A, Chouta Ngaha F, Drenou B, Nojavan H, Michel C. Secondary pulmonary syphilis: Case report and review of literature. Ann Dermatol Venereol 2018; 145:278-87. [PMID: 29463465 DOI: 10.1016/j.annder.2017.11.015] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2017] [Revised: 08/17/2017] [Accepted: 11/02/2017] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Syphilis is a sexually transmitted disease that can affect numerous organs in its secondary or tertiary stages. We describe a case of secondary syphilis with pulmonary involvement and we present a literature review. PATIENTS AND METHODS A 69-year-old male patient was admitted to hospital for dyspnoea and extended papular exanthema with palmoplantar involvement. The serological test for syphilis was positive. Ocular examination showed bilateral papillitis and retinal haemorrhage. Chest radiography revealed an interstitial alveolar infiltrate predominantly in the upper lobes, mild pleural effusion and hilar adenopathy. These infiltrates were slightly hypermetabolic on PET scan suggesting inflammatory or infectious origin. Treatment with intravenous penicillin G was effective on cutaneous, ocular and pulmonary manifestations. DISCUSSION Lung involvement in secondary syphilis is poorly known and rarely described. We found 27 cases of pulmonary syphilis reported in English and the main European languages since 1967. Mean age at diagnosis was 46 years with clear male predominance (89%). HIV co-infection was declared in 5 cases. Treponema pallidum was found in 6 patients using PCR on bronchoalveolar lavage (BAL) (3 patients) or on a lung biopsy (1 patient), immunohistochemistry (IHC) on BAL (1 patient) and Giemsa staining on a pleural fluid sample (1 patient). Chest X-rays may show unilateral or bilateral infiltrates or nodules with or without pleural effusion or hilar adenopathy. Sub-pleural involvement is frequent and penicillin is the treatment of choice. CONCLUSION Pulmonary syphilitic involvement should be suspected where pulmonary symptoms or radiological changes occur in secondary syphilis. IHC, special staining or PCR on BAL, pleural fluid or lung tissue are useful for the identification of spirochetes.
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Etienne M, Oca F, Prunier-Mirebeau D, Croué A, Martin L. [Immunohistochemistry using clone VE1 is an economic, specific and sensitive method for detecting the presence of BRAFV600E mutations in melanoma]. Ann Dermatol Venereol 2017; 145:159-165. [PMID: 29221650 DOI: 10.1016/j.annder.2017.10.011] [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: 04/25/2017] [Revised: 07/24/2017] [Accepted: 10/31/2017] [Indexed: 10/18/2022]
Abstract
BACKGROUND Determination of BRAF mutation status is mandatory in the management of patients with inoperable stage IIIC or stage IV melanoma. Currently, molecular biology (MB) has been validated for detecting the presence of BRAF mutations. OBJECTIVE To compare the sensitivity, specificity and cost of immunohistochemistry (IHC) (clone VE1) versus BM methods (qPCR and Sanger sequencing). PATIENTS AND METHODS All the samples for which BRAF mutation status was requested between March 2013 and February 2015 at the cellular and molecular analysis laboratory of the Angers Hospital were included retrospectively and consecutively. The IHC (clone VE1) and BM analyses were performed with the same formalin-fixed paraffin embedded tumour samples. The cost of these two methods was determined on the basis of the cost for the French Health Insurance. RESULTS Two hundred and seven samples were subjected to a determination of BRAF mutational status in IHC and BM. Only one sample was discordant between these two methods (positive in IHC, negative in BM). The sensitivity and specificity of the IHC was 100% and 99.25% respectively. The ratio of the cost of IHC/BM testing was 1:2.1. CONCLUSION IHC (clone VE1) is a specific, sensitive and economic method for determining BRAFV600E mutation status. Nevertheless, this method must be validated in order to be integrated into a decisional algorithm, alongside BM methods, to determine whether targeted BRAF-inhibitor therapy is indicated.
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Affiliation(s)
- M Etienne
- Dermatologie, CHU, 4, rue Larrey, 49100 Angers, France.
| | - F Oca
- Biologie moléculaire, CHU, 4, rue Larrey, 49100 Angers, France
| | | | - A Croué
- Laboratoire d'anatomopathologie, CHU, 4, rue Larrey, 49100 Angers, France
| | - L Martin
- Dermatologie, CHU, 4, rue Larrey, 49100 Angers, France
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Miladi S, Harrar Y, Battistella M, Bertheau P, Meignin V, Roche B, Bouhidel FA. [Primary epithelioid adrenal angiosarcoma mimicking undifferentiated carcinoma]. Ann Pathol 2017; 37:162-165. [PMID: 28291558 DOI: 10.1016/j.annpat.2016.10.002] [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: 02/22/2016] [Revised: 09/06/2016] [Accepted: 10/04/2016] [Indexed: 10/20/2022]
Abstract
The adrenal primary epithelioid angiosarcoma (ASE) is a rare malignant tumor which can be histologically confused with other neoplasms. We report one case in a 79-year-old man who underwent adrenal tumor surgery for a mass fortuitly discovered by imaging for examination of an inflammatory syndrome associated with anemia. The histological diagnosis was difficult because of the undifferentiated and epithelioid appearance of tumor cells, whose immunohistochemical epithelial markers positivity led to frequent confusion with a metastatic carcinoma. Careful research for vascular differentiation at histopathological study and expression of immunohistochimical endothelial markers, are crucial to confirm the diagnosis.
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Affiliation(s)
- Samira Miladi
- Service de pathologie, hôpital Saint-Louis, AP-HP, 1, avenue Claude-Vellefaux, 75475 Paris cedex 10, France
| | - Yaëlle Harrar
- Service de pathologie, hôpital Saint-Louis, AP-HP, 1, avenue Claude-Vellefaux, 75475 Paris cedex 10, France
| | - Maxime Battistella
- Service de pathologie, hôpital Saint-Louis, AP-HP, 1, avenue Claude-Vellefaux, 75475 Paris cedex 10, France; Université Paris-Diderot, 10, rue Françoise-Dolto, 75205 Paris cedex 13, France; Inserm UMR-S-1165, 1, avenue Claude-Vellefaux, 75475 Paris cedex 10, France
| | - Philippe Bertheau
- Service de pathologie, hôpital Saint-Louis, AP-HP, 1, avenue Claude-Vellefaux, 75475 Paris cedex 10, France; Université Paris-Diderot, 10, rue Françoise-Dolto, 75205 Paris cedex 13, France; Inserm UMR-S-1165, 1, avenue Claude-Vellefaux, 75475 Paris cedex 10, France
| | - Véronique Meignin
- Service de pathologie, hôpital Saint-Louis, AP-HP, 1, avenue Claude-Vellefaux, 75475 Paris cedex 10, France; Inserm UMR-S-1165, 1, avenue Claude-Vellefaux, 75475 Paris cedex 10, France
| | - Brigitte Roche
- Service de pathologie, hôpital Saint-Louis, AP-HP, 1, avenue Claude-Vellefaux, 75475 Paris cedex 10, France
| | - Fatiha Amira Bouhidel
- Service de pathologie, hôpital Saint-Louis, AP-HP, 1, avenue Claude-Vellefaux, 75475 Paris cedex 10, France; Inserm UMR-S-1165, 1, avenue Claude-Vellefaux, 75475 Paris cedex 10, France.
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Fourati A, El Amine O, Ben Ayoub W, Cherni I, Goucha A, El May MV, Gamoudi A, El May A. Expression profile of biomarkers altered in papillary and anaplastic thyroid carcinoma: Contribution of Tunisian patients. Bull Cancer 2017; 104:433-41. [PMID: 28185633 DOI: 10.1016/j.bulcan.2016.12.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2016] [Revised: 11/09/2016] [Accepted: 12/07/2016] [Indexed: 01/04/2023]
Abstract
AIMS The objective of this study was to compare the protein expression profile between well-differentiated (papillary) and undifferentiated (anaplastic) thyroid carcinoma in Tunisian patients. METHODS This first Tunisian retrospective study concerned data of 38 thyroid cancer cases (19 papillary carcinoma PTC and 19 anaplastic carcinoma ATC) collected at Salah Azaiez Institute of Tunisia. Immunohistochemistry was used to evaluate tumor expression of different molecular markers (p53, Ki67, E-cadherin, cyclin D1, bcl2, S100 and Her-2). The molecular expression was correlated with the clinicopathological characteristics of the tumors. RESULTS There were 6 differentially expressed markers when comparing anaplastic thyroid carcinoma ATC with papillary thyroid carcinoma PTC. Expression of p53 and Ki67 were significantly increased in 16 and 18 ATC cases respectively, the Ki67 expression was lost in PTC. Cyclin D1, E-cadherin, bcl2 and S100 were overexpressed in PTC tumors; however, they were significantly decreased in ATC. The last marker, Her-2 was expressed in one case of PTC only. CONCLUSION Our results, similar with findings of other ethnic groups, showed alteration in expression of molecular markers associated with tumor dedifferentiation, indicating loss of cell cycle control with increased proliferative activity in ATC carcinoma. These data support the hypothesis that ATC may derive from dedifferentiation of preexisting PTC tumor.
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Hofman P, Ilié M, Lassalle S, Long E, Bence C, Butori C, Hofman V. [PD1/PD-L1 immunohistochemistry in thoracic oncology: Where are we?]. Ann Pathol 2017; 37:39-45. [PMID: 28159404 DOI: 10.1016/j.annpat.2016.12.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2016] [Accepted: 12/06/2016] [Indexed: 10/20/2022]
Abstract
The assays for the assessment of the PD-L1 status by immunohistochemistry are available in clinical studies in thoracic oncology to predict response to immunotherapies targeting the PD-1/PD-L1 pathway. With the arrival of this new class of molecules in second line and very soon in first line of treatment for patients with advanced or metastatic non-small cell lung cancer, these tests will certainly be required in routine once these new drugs will be granted marketing authorization. The rapid introduction of these "companion" or "complementary" tests seems essential to select patients to benefit from these effective but also expensive and sometimes toxic therapies. Although challenged by some oncologists (as some patients not expressing PD-L1 may sometimes respond to PD-1/PD-L1 blockade), the anti-PD-L1 immunohistochemically approach seems inevitable in 2017. This new activity developed in the pathology laboratories raises several questions: which anti-PD-L1 clone should be used? On which device? What threshold of positivity should be considered? Should PD-L1 expression be assessed on tumor cells as well as on the immune cells? What controls should be used? Comparative studies are underway or have been already implemented in order to answer some of these questions. This review addresses the different evaluation criteria for immunohistochemistry using the main anti-PD-L1 antibodies used to date as well the recently published studies using these antibodies in thoracic oncology.
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Ahanogbe KMH, Ibahioin K, Karkouri M, Dianka MB, Akpo W, El Azhari A. [Cerebral primitive osteosarcoma, a radiological and histological atypia]. Neurochirurgie 2016; 62:277-280. [PMID: 27771113 DOI: 10.1016/j.neuchi.2016.06.004] [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: 01/04/2016] [Revised: 05/08/2016] [Accepted: 06/12/2016] [Indexed: 11/17/2022]
Abstract
INTRODUCTION Osteosarcoma is a malignant mesenchymal tumor including cells that present an osteoblastic differentiation. On the skull, it has often extra-axial development associated with bone reaction. We report an atypical and rare case of intracranial or cerebral osteosarcoma underline the radiological and pathological diagnostic difficulties. CASE REPORT Our case concerns a primary osteosarcoma without bone involvement in a 10-year old boy who was admitted for intracranial hypertension with progressive worsening and brachial monoparesis. Subtotal resection was performed but the postoperative course was not favorable. The child died five months after the initial surgery. Its radiological aspect prompted us evoke several diagnoses including glioma or meningioma. On the histological level, osteosarcoma, especially with poorly differentiated cells, can be deceiving with other processes, including a gliosarcoma that was revealed by simple microscopic reading before being confirmed by an immunohistochemical study. CONCLUSION In the absence of any bone reaction or known extra-cranial location, it can be difficult to suggest the diagnosis of osteosarcoma based on imagery alone. Immunohistochemistry is essential for an accurate diagnosis.
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Affiliation(s)
- K M H Ahanogbe
- Service de neurochirurgie, CHU Ibn Rochd, Casablanca, Maroc.
| | - K Ibahioin
- Service de neurochirurgie, CHU Ibn Rochd, Casablanca, Maroc
| | - M Karkouri
- Service d'anatomie pathologique, CHU Ibn Rochd, Casablanca, Maroc
| | - M B Dianka
- Service de neurochirurgie, CHU Ibn Rochd, Casablanca, Maroc
| | - W Akpo
- Service d'anatomie pathologique, CHU Ibn Rochd, Casablanca, Maroc
| | - A El Azhari
- Service de neurochirurgie, CHU Ibn Rochd, Casablanca, Maroc
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Benderra MA, Ilié M, Hofman P, Massard C. [Standard of care of carcinomas on cancer of unknown primary site in 2016]. Bull Cancer 2016; 103:697-705. [PMID: 27372228 DOI: 10.1016/j.bulcan.2016.05.003] [Citation(s) in RCA: 10] [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] [Received: 03/15/2016] [Revised: 05/09/2016] [Accepted: 05/10/2016] [Indexed: 01/17/2023]
Abstract
Patients with Cancer of unknown primary (cup) represent 2-10%, and have disseminated cancers for which we cannot find the primary site despite the clinical, pathological and radiological exams at our disposal. Diagnosis is based on a thorough clinical and histopathologic examination as well as new imaging techniques. Several clinicopathologic entities requiring specific treatment can be identified. Genome sequencing and liquid biopsy (circulating tumor cells and tumor free DNA) could allow further advances in the diagnosis. Therapeutically, in addition to surgery, radiotherapy and chemotherapy, precision medicine provides new therapeutic approaches.
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Affiliation(s)
- Marc-Antoine Benderra
- Gustave-Roussy Cancer Campus, département d'oncologie médicale, 114, rue Édouard-Vaillant, 94800 Villejuif, France
| | - Marius Ilié
- CHU de Nice, hôpital Pasteur, laboratoire de pathologie clinique et expérimentale, 06000 Nice, France; Université de Nice Sophia Antipolis, faculté de médecine, Ircan Inserm U1081/CNRS UMR 7284, 06000 Nice, France; CHU de Nice, fédération hospitalo-universitaire OncoAge, 06000 Nice, France
| | - Paul Hofman
- CHU de Nice, hôpital Pasteur, laboratoire de pathologie clinique et expérimentale, 06000 Nice, France; Université de Nice Sophia Antipolis, faculté de médecine, Ircan Inserm U1081/CNRS UMR 7284, 06000 Nice, France; CHU de Nice, fédération hospitalo-universitaire OncoAge, 06000 Nice, France; CHU de Nice, hôpital Pasteur, Biobanque hospitalière (BB 0025-00033), 06000 Nice, France
| | - Christophe Massard
- Gustave-Roussy Cancer Campus, département d'oncologie médicale, 114, rue Édouard-Vaillant, 94800 Villejuif, France.
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Joubert C, Boissonneau S, Fina F, Figarella-Branger D, Ouafik L, Fuentes S, Dufour H, Gonçalves A, Charaffe-Jauffret E, Metellus P. [Immunohistochemical hormonal mismatch and human epidermal growth factor type 2 [HER2] phenotype of brain metastases in breast cancer carcinoma compared to primary tumors]. Neurochirurgie 2016; 62:151-6. [PMID: 27236733 DOI: 10.1016/j.neuchi.2016.01.007] [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: 01/05/2015] [Revised: 01/22/2016] [Accepted: 01/29/2016] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Phenotype changes between primary tumor and the corresponding brain metastases are recent reported data. Breast cancer, with biological markers predicting prognosis and guiding therapeutic strategy remains an interesting model to observe and evaluate theses changes. The objective of our study was to compare molecular features (estrogen receptor [ER], progesterone receptor [PR], and human epidermal growth factor receptor type 2, [HER2]) between brain metastases and its primary tumor in patients presenting with pathologically confirmed breast cancer. MATERIAL AND METHODS This retrospective study was based on the immunohistochemical analysis of the brain metastases paraffin embedded samples stored in our institutional tumor bank, after surgical resection. The level of expression of hormonal receptors and HER2 on brain metastases were centrally reviewed and compared to the expression status in primary breast cancer from medical records. RESULTS Forty-four samples of brain metastases were available for analysis. Hormonal receptor modification status was observed in 11/44 brain metastases (25%) for ER and 6/44 (13.6%) for PR. A modification of HER2 overexpression was observed in brain metastases in 6/44 (13.6%). Molecular subtype modification was shown in 17 cases (38.6%). A significant difference was demonstrated between time to develop brain metastases in cases without status modification (HER2, ER and PR) (med=49.5months [7.8-236.4]) and in cases in which brain metastases status differs from primary tumor (med=27.5months [0-197.3]), (P=0.0244, IC95=3.09-51.62, Mann and Whitney test). CONCLUSION the main interest of this study was to focus on the molecular feature changes between primary tumor and their brain metastases. Time to develop brain metastases was correlated to phenotypic changes in brain metastases.
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Affiliation(s)
- C Joubert
- Département de neurochirurgie, Aix-Marseille université, CHU Timone, AP-HM, 264, rue Saint-Pierre, 13005 Marseille cedex 05, France
| | - S Boissonneau
- Département de neurochirurgie, Aix-Marseille université, CHU Timone, AP-HM, 264, rue Saint-Pierre, 13005 Marseille cedex 05, France
| | - F Fina
- Inserm UMR 911, CRO2, Aix-Marseille université, Marseille, France; Laboratoire de transfert d'oncologie biologique, Aix-Marseille université, AP-HM, Marseille, France
| | - D Figarella-Branger
- Laboratoire de transfert d'oncologie biologique, Aix-Marseille université, AP-HM, Marseille, France; Département d'anatomie pathologique, Aix-Marseille Université, CHU Timone, AP-HM, Marseille, France
| | - L Ouafik
- Inserm UMR 911, CRO2, Aix-Marseille université, Marseille, France; Laboratoire de transfert d'oncologie biologique, Aix-Marseille université, AP-HM, Marseille, France
| | - S Fuentes
- Département de neurochirurgie, Aix-Marseille université, CHU Timone, AP-HM, 264, rue Saint-Pierre, 13005 Marseille cedex 05, France
| | - H Dufour
- Département de neurochirurgie, Aix-Marseille université, CHU Timone, AP-HM, 264, rue Saint-Pierre, 13005 Marseille cedex 05, France
| | - A Gonçalves
- Département d'oncologie moléculaire, centre de lutte contre le cancer, institut Paoli-Calmettes, Marseille, France
| | - E Charaffe-Jauffret
- Département d'anatomie pathologique, centre de lutte contre le cancer, institut Paoli-Calmettes, Marseille, France
| | - P Metellus
- Département de neurochirurgie, Aix-Marseille université, CHU Timone, AP-HM, 264, rue Saint-Pierre, 13005 Marseille cedex 05, France; Inserm UMR 911, CRO2, Aix-Marseille université, Marseille, France.
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Meurgey A, Henaine R, Bouvagnet P, Chalabreysse L. [About a case of a recurrent glandular cardiac myxoma in a child]. Ann Pathol 2016; 36:214-7. [PMID: 27234518 DOI: 10.1016/j.annpat.2016.01.007] [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: 06/02/2015] [Revised: 10/21/2015] [Accepted: 01/31/2016] [Indexed: 10/21/2022]
Abstract
Primary cardiac tumors are extremely rare and mainly benign. The majority of these are myxomas (40%). Myxoma are generally sporadic tumors which occur most commonly in adult females between 30 and 40 years, and are seldom found in the paediatric population (5%). Seven percent are associated with igenetic diseases. We report the case of an eight-year-old boy presenting a recurrent glandular cardiac myxoma. In 2011, he presented a deterioration of the general state. An echocardiography highlighted a left atrial mass on the interatrial septum, with a pedicular insertion. On the microscope, it consisted of a proliferation of stellate cells isolated or clustered in rudimentary vessels in a myxoid stroma presenting haemorrhage changes. These cells expressed CD34 and calretinine. Glandular elements without atypia were clustered within the myxomatous proliferation. They expressed cytokeratin (CK) 7. Surgical resection was macroscopically complete. In 2014, the boy had a sudden neurological deficit during a football match. An echocardiography revealed a recurrence at the same location. The lesion was excised and addressed in several fragments. Classical myxoma was associated with glands without atypia. This last component expressed CKAE1/AE3 and CK7. Ki67 index of proliferation was low. The surgical reintervention was macroscopically complete. The final diagnosis was glandular cardiac myxoma. A genetic survey was conducted, showing the presence of Carney complex. This is the first description in the litterature of a recurrent glandular cardiac myxoma occuring in a child.
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Affiliation(s)
- Alexandra Meurgey
- Service d'anatomie et cytologie pathologique, groupement hospitalier Est, hospices civils de Lyon, 59, boulevard Pinel, 69677 Lyon, France
| | - Roland Henaine
- Unité médico-chirurgicale des cardiopathies congénitales adultes et enfants, groupement hospitalier Est, hospices civils de Lyon, 69677 Lyon, France
| | - Patrice Bouvagnet
- EA 4173, laboratoire cardiogénétique, groupement hospitalier Est, hospices civils de Lyon, université Lyon 1 et hôpital Nord Ouest, 69677 Lyon, France
| | - Lara Chalabreysse
- Service d'anatomie et cytologie pathologique, groupement hospitalier Est, hospices civils de Lyon, 59, boulevard Pinel, 69677 Lyon, France.
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Gardette E, Moguelet P, Barete S, Frances C, Senet P. [Unusual course of CD8+ epidermotropic cutaneous T-cell lymphoma]. Ann Dermatol Venereol 2016; 143:846-851. [PMID: 27161647 DOI: 10.1016/j.annder.2016.03.022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2015] [Revised: 02/12/2016] [Accepted: 03/10/2016] [Indexed: 12/22/2022]
Abstract
BACKGROUND Aggressive epidermotropic cutaneous T-cell lymphoma (AECL) is a rare and aggressive form of lymphoma that exhibits systemic spread within a few months that is not preceded by any indolent form. Herein, we report a case of AECL occurring on foot lesions present for six years, and initially diagnosed as Woringer-Kolopp disease, or pagetoid cutaneous T-cell lymphoma. PATIENTS AND METHODS A male patient presented an ulcerated lesion of the ankle that had been present for six years. Biopsy revealed pagetoid migration of CD8+, CD2-, CD5-, CD7+, CD30- and CD56- lymphocytes with expression of cytotoxic markers and of Ki67 in over 60% of cells. The resulting diagnosis was one of pagetoid cutaneous T-cell lymphoma, also known as Woringer-Kolopp disease. Despite treatment with methotrexate and carmustine, the ulcer worsened rapidly within two months. Subsequent biopsy revealed epidermal and dermal infiltration with large cells of identical phenotype to that seen in the previous biopsy, with angiocentrism and expression of Ki67 in over 90% of cells, pointing to a diagnosis of AECL. Progression to disseminated ulceronecrotic lesions occurred rapidly, and the patient died of sepsis within a few months. DISCUSSION AECL is characterised by ulcerative-haemorrhagic lesions that develop aggressively without any preceding mild cutaneous lesions. Median survival is 12 months. Histological analysis shows pagetoid epidermotropism comprising large monomorphic CD8+, CD2- and CD5- cells with markers for cytotoxicity and high expression of Ki67. The initial indolent phase in the case we report herein accounts for the diagnostic confusion at the outset with Woringer-Kolopp disease. Negative status of CD2 and CD5 labels may allow prompt diagnosis of AECL.
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Affiliation(s)
- E Gardette
- Service de dermatologie et d'allergologie, hôpital Tenon, AP-HP, 4, rue de la Chine, 75970 Paris cedex 20, France.
| | - P Moguelet
- Service d'anatomopathologie, hôpital Tenon, AP-HP, 4, rue de la Chine, 75970 Paris cedex 20, France
| | - S Barete
- Service de dermatologie, groupe hospitalier Pitié-Salpétrière, AP-HP, 47-83, boulevard de l'hôpital, 75013 Paris, France
| | - C Frances
- Service de dermatologie et d'allergologie, hôpital Tenon, AP-HP, 4, rue de la Chine, 75970 Paris cedex 20, France
| | - P Senet
- Service de dermatologie et d'allergologie, hôpital Tenon, AP-HP, 4, rue de la Chine, 75970 Paris cedex 20, France
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Cazorla A, Alanio A, Bretagne S, Polivka M, Shaar-Chneker C, Kaci R, Brouland JP, Chrétien F, Jouvion G. [Cryptococcus where they are not expected: Five case reports of extra-cerebral and extra-pulmonary cryptococcosis]. Ann Pathol 2015; 35:479-85. [PMID: 26596691 DOI: 10.1016/j.annpat.2015.10.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2014] [Accepted: 10/01/2015] [Indexed: 12/29/2022]
Abstract
Cryptococcosis is a serious infection, possibly lethal, of worldwide distribution. It mainly affects immunosuppressed patients resulting with pulmonary and/or meningeal involvements or disseminated infections. Due to the rarity of visceral and osseous infections, and to the absence of specific clinical symptoms, this diagnosis is often deferred. Resulting of diagnostic errors, samples are often directed to the department of pathology and more rarely to the department of mycology. Histopathological examination appears crucial, highlighting encapsulated yeasts with alcian blue staining. Once the diagnosis is performed, an appropriate antifungal therapy must be quickly introduced because these infections are associated with a high mortality rate. The aim of our work was to report five extra-cerebral and extra-pulmonary cryptococcosis cases, to describe their histopathological features, to evoke diagnostic techniques and to discuss the differential diagnoses.
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Affiliation(s)
- Arnault Cazorla
- Service de pathologie, AP-HP Lariboisière, 2, avenue Ambroise-Paré, 75475 Paris, France; Service d'anatomie et cytologie pathologiques, AP-HP Lariboisière, 2, avenue Ambroise-Paré, 75475 Paris, France.
| | - Alexandre Alanio
- Service de parasitologie-mycologie, AP-HP, hôpital Saint-Louis, 75010 Paris, France; Unité de mycologie moléculaire, CNRS URA3012, Institut Pasteur, Centre national de référence mycoses invasives et antifongiques, 28, rue du Dr.-Roux, 75724 Paris, France
| | - Stéphane Bretagne
- Service de parasitologie-mycologie, AP-HP, hôpital Saint-Louis, 75010 Paris, France; Unité de mycologie moléculaire, CNRS URA3012, Institut Pasteur, Centre national de référence mycoses invasives et antifongiques, 28, rue du Dr.-Roux, 75724 Paris, France
| | - Marc Polivka
- Service de pathologie, AP-HP Lariboisière, 2, avenue Ambroise-Paré, 75475 Paris, France
| | | | - Rachid Kaci
- Service de pathologie, AP-HP Lariboisière, 2, avenue Ambroise-Paré, 75475 Paris, France
| | | | - Fabrice Chrétien
- Unité d'histopathologie humaine et modèles animaux, Institut Pasteur, 28, rue du Dr.-Roux, 75724 Paris, France; Service de neuropathologie, centre hospitalier Sainte-Anne, 1, rue Cabanis, 75475 Paris, France; Université Paris Descartes, PRES Sorbonne Paris Cité, 75006 Paris, France
| | - Grégory Jouvion
- Unité d'histopathologie humaine et modèles animaux, Institut Pasteur, 28, rue du Dr.-Roux, 75724 Paris, France; Université Paris Descartes, PRES Sorbonne Paris Cité, 75006 Paris, France
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Feki J, Fourati N, Mnif H, Khabir A, Toumi N, Khanfir A, Boudawara T, Amouri H, Daoud J, Frikha M. [Primary neuroendocrine tumors of the breast: a retrospective study of 21 cases and literature review]. Cancer Radiother 2015. [PMID: 26215367 DOI: 10.1016/j.canrad.2015.04.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
PURPOSE The aim of the present study was to discuss the epidemiology, clinical and pathologic features, treatment, and prognosis of primary neuroendocrine carcinomas of the breast. PATIENTS AND METHODS We report 21 cases diagnosed over a period of 12 years (1995-2011) at the university hospital of Sfax. A review of the clinical data with pathology and immunohistochemistry study was carried out for all the cases. RESULTS The average age was 62 years (34-86 years). At the time of the diagnosis, tumours were classified T1 and T2 (16 cases), N1 (11 cases) and M1 in two cases. The histological examination has shown 13 cases of solid neuroendocrine carcinoma, six cases of large cell type and two cases of atypical carcinoid. Grade I and II SBR were found in 18 cases. Eighty-one percent of the tumours were reactive for synaptophysin; all tumours were positive for chromogranin. Thirteen (61.9%) tumours were estrogen receptor-positive and 12 (57.5%) progesterone receptor-positive. Nineteen (90.5%) tumours were negative for HER2/neu. Overall five-year survival was 72.7%. All patients had surgical treatment with modified radical mastectomy in 13 cases. Adjuvant treatment was indicated according to histopronostic elements. CONCLUSION For primary neuroendocrine carcinoma of the breast, multivariate analysis identified three predictive factors for mortality: disease stage, histological grade and lymph node involvement.
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Affiliation(s)
- J Feki
- Service de carcinologie médicale, CHU Habib-Bourguiba, 3029 Sfax, Tunisie
| | - N Fourati
- Service de carcinologie-radiothérapie, CHU Habib-Bourguiba, 3029 Sfax, Tunisie.
| | - H Mnif
- Laboratoire d'anatomie et de cytologie pathologiques, CHU Habib-Bourguiba, 3029 Sfax, Tunisie
| | - A Khabir
- Laboratoire d'anatomie et de cytologie pathologiques, CHU Habib-Bourguiba, 3029 Sfax, Tunisie
| | - N Toumi
- Service de carcinologie médicale, CHU Habib-Bourguiba, 3029 Sfax, Tunisie
| | - A Khanfir
- Service de carcinologie médicale, CHU Habib-Bourguiba, 3029 Sfax, Tunisie
| | - T Boudawara
- Laboratoire d'anatomie et de cytologie pathologiques, CHU Habib-Bourguiba, 3029 Sfax, Tunisie
| | - H Amouri
- Service de gynécologie-obstétrique, CHU Hédi-Chaker, 3029 Sfax, Tunisie
| | - J Daoud
- Service de carcinologie-radiothérapie, CHU Habib-Bourguiba, 3029 Sfax, Tunisie
| | - M Frikha
- Service de carcinologie médicale, CHU Habib-Bourguiba, 3029 Sfax, Tunisie
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Lechapt Zalcman E, Bazille C, Rousseau A, Burel-Vandenbos F, Pierga JY. [Histological and molecular analysis of brain metastases]. Cancer Radiother 2015; 19:10-5. [PMID: 25636728 DOI: 10.1016/j.canrad.2014.11.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2014] [Accepted: 11/26/2014] [Indexed: 11/27/2022]
Abstract
The first step in the diagnosis of a metastatic brain lesion is to exclude a primary central nervous sytem tumour, followed by verification or identification of the primary tumor site, in order to guide the clinician to specific therapy. In addition to morphological features, ancillary immunohistochemical study is most effective for the evaluation of a metastatic neoplasm of unknown primary. Although the main principles are same, there are slight variations in the approach to the secondary lesion in the central nervous system versus other regions. Indeed, immunohistochemical approach focuses on the most common tumor types associated with secondary brain colonization: lung cancer, breast cancer and melanoma. Several studies have reported that targeted therapies are capable of reducing brain metastases in melanoma or non-small cell lung cancer, sometimes with a high dramatic response. These results have clearly impacted routine neuropathological practice. It is likely that molecular subtyping of central nervous system metastases will play an increasing role in the future. In accordance with the recommendations of Inca (French national cancer institute), the pathologist develops appropriate strategies for molecular and immunohistochemical analysis, in order to provide results as soon as possible. This article summarizes the diagnosic approach to brain metastases, with a focus on the recent emergence of targeted therapies.
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Affiliation(s)
- E Lechapt Zalcman
- Laboratoire d'anatomie pathologique, centre hospitalier universitaire de Caen, avenue de la Côte-de-Nacre, 14033 Caen cedex, France; CNRS, UMR 6301 ISTCT, CERVOxy, GIP Cyceron, boulevard Henri-Becquerel, BP 5229, 14074 Caen cedex, France.
| | - C Bazille
- Laboratoire d'anatomie pathologique, centre hospitalier universitaire de Caen, avenue de la Côte-de-Nacre, 14033 Caen cedex, France
| | - A Rousseau
- Département de pathologie cellulaire et tissulaire, CHU d'Angers, 4, rue Larrey, 49100 Angers, France
| | - F Burel-Vandenbos
- Laboratoire central d'anatomie pathologique, centre hospitalier universitaire de Nice, 06000 Nice, France
| | - J-Y Pierga
- Département d'oncologie médicale, institut Curie, 26, rue d'Ulm, 75005 Paris, France
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Kottler D, Rivet J, Hickman G, Comte C, Duron JB, Basset-Seguin N, Lebbe C, Bagot M, Janin A. [Eccrine porocarcinoma with Bowenoid changes: a challenging diagnosis of adnexal neoplasm]. Ann Pathol 2014; 34:378-83. [PMID: 25439991 DOI: 10.1016/j.annpat.2014.08.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2013] [Revised: 07/16/2014] [Accepted: 08/11/2014] [Indexed: 10/24/2022]
Abstract
Eccrine porocarcinoma is a rare malignant sweat gland tumor, representing less than 0.01% of all cutaneous neoplasms, with eccrin differentiation. Its acrosynringeal origin and physiopathology still remain discussed. The prognosis of this carcinoma is held to be poor with a significant risk of lymph node metastasis and local recurrence. Also, this not specific tumor can be a challenging histological diagnosis, in particular, in Bowenoid variant. We report a case of Bowenoid and keratinizing variant of eccrine porocarcinoma of the left ring finger with pejorative evolution and initial diagnosis of infiltrating squamous cell carcinoma arising in Bowen's disease. The knowledge of these patterns and identification of eccrine differentiation of the tumor are essential for the diagnosis and for adapted therapeutic care.
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Affiliation(s)
- Diane Kottler
- Service de pathologie, hôpital Saint-Louis, AP-HP, 1, avenue Claude-Vellefaux, 75010 Paris, France.
| | - Jacqueline Rivet
- Service de pathologie, hôpital Saint-Louis, AP-HP, 1, avenue Claude-Vellefaux, 75010 Paris, France
| | - Geoffroy Hickman
- Service de dermatologie, hôpital Saint-Louis, AP-HP, 1, avenue Claude-Vellefaux, 75010 Paris, France
| | - Christelle Comte
- Service de dermatologie, hôpital Saint-Louis, AP-HP, 1, avenue Claude-Vellefaux, 75010 Paris, France
| | - Jean-Brice Duron
- Service de chirurgie plastique, hôpital Saint-Louis, AP-HP, 1, avenue Claude-Vellefaux, 75010 Paris, France
| | - Nicole Basset-Seguin
- Service de dermatologie, hôpital Saint-Louis, AP-HP, 1, avenue Claude-Vellefaux, 75010 Paris, France
| | - Celeste Lebbe
- Service de dermatologie, hôpital Saint-Louis, AP-HP, 1, avenue Claude-Vellefaux, 75010 Paris, France
| | - Martine Bagot
- Service de dermatologie, hôpital Saint-Louis, AP-HP, 1, avenue Claude-Vellefaux, 75010 Paris, France
| | - Anne Janin
- Service de pathologie, hôpital Saint-Louis, AP-HP, 1, avenue Claude-Vellefaux, 75010 Paris, France
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Faguer R, Tanguy JY, Rousseau A, Clavreul A, Menei P. Early presentation of primary glioblastoma. Neurochirurgie 2014; 60:188-93. [PMID: 24856049 DOI: 10.1016/j.neuchi.2014.02.008] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2013] [Revised: 02/08/2014] [Accepted: 02/18/2014] [Indexed: 10/25/2022]
Abstract
BACKGROUND Clinical and neuroimaging findings of glioblastomas (GBM) at an early stage have rarely been described and those tumors are most probably under-diagnosed. Furthermore, their genetic alterations, to our knowledge, have never been previously reported. METHODS We report the clinical as well as neuroimaging findings of four early cases of patients with GBM. RESULTS In our series, early stage GBM occurred at a mean age of 57 years. All patients had seizures as their first symptom. In all early stages, MRI showed a hyperintense signal on T2-weighted sequences and an enhancement on GdE-T1WI sequences. A hyperintense signal on diffusion sequences with a low ADC value was also found. These early observed occurrences of GBM developed rapidly and presented the MRI characteristics of classic GBM within a few weeks. The GBM size was multiplied by 32 in one month. Immunohistochemical analysis indicated the de novo nature of these tumors, i.e. absence of mutant IDH1 R132H protein expression, which is a diagnostic marker of low-grade diffuse glioma and secondary GBM. CONCLUSIONS A better knowledge of early GBM presentation would allow a more suitable management of the patients and may improve their prognosis.
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Affiliation(s)
- R Faguer
- Department of neurosurgery, university hospital, 4, rue Larrey, 49933 Angers cedex 9, France
| | - J-Y Tanguy
- Department of radiology, university hospital, 4, rue Larrey, 49933 Angers cedex 9, France
| | - A Rousseau
- Department of pathology, university hospital, 4, rue Larrey, 49933 Angers cedex 9, France
| | - A Clavreul
- Department of neurosurgery, university hospital, 4, rue Larrey, 49933 Angers cedex 9, France
| | - P Menei
- Department of neurosurgery, university hospital, 4, rue Larrey, 49933 Angers cedex 9, France.
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