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Ortiz Requena D, Poveda J, McDonald OG, Ronquillo N, Garcia-Buitrago M, Montgomery EA. IgG4-related Sclerosing Disease of the Gallbladder: Incidental Malignancy Mimicker Associated With Cholelithiasis? Adv Anat Pathol 2024:00125480-990000000-00108. [PMID: 38712814 DOI: 10.1097/pap.0000000000000453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/08/2024]
Affiliation(s)
- Domenika Ortiz Requena
- Department of Pathology and Laboratory Medicine, University of Miami Miller School of Medicine, Miami, FL
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Ortiz Requena D, Goiburu MB, Velez-Torres J, Ronquillo N, Livingstone AS, Rosenberg AE. Retroperitoneal Cystic Adenopecoma with Genetic Analysis: A Rare Neoplasm. Int J Surg Pathol 2022; 31:332-337. [PMID: 35815865 DOI: 10.1177/10668969221105616] [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] [Indexed: 11/16/2022]
Abstract
Lymphangiomyomatosis is a member of the PEComa family, and usually involves the pulmonary parenchyma of middle-aged females. Infrequently, it may involve abdominal and retroperitoneal lymph nodes, and rarely it has been described to be associated with fallopian tube-type ciliated epithelium co-existing in one neoplasm. To increase our understanding of this unusual tumor, we describe the morphology and genetics of one case and review the literature. We present the case of a 50-year-old female found to have 12.5 and 7.7 cm cystic retroperitoneal masses, describe its unique pathological features and review the literature on the previously reported cases. Based on its unique morphological, immunohistochemical, and molecular features we propose the term adenoPEComa to represent this entity. This case represents a rare example of adenoPEComa with lymphangiomyomatosis of the lymph nodes. It is the first example that has undergone next-generation sequencing revealing a mutation in TSC2 making it a confirmed member of the PEComa family of tumors.
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Affiliation(s)
- Domenika Ortiz Requena
- 23215Jackson Memorial Hospital/University of Miami Miller School of Medicine, Department of Pathology and Laboratory Medicine, Miami, Florida, USA
| | - Maria Belen Goiburu
- 23215Jackson Memorial Hospital/University of Miami Miller School of Medicine, Department of Pathology and Laboratory Medicine, Miami, Florida, USA
| | - Jaylou Velez-Torres
- 12235University of Miami Miller School of Medicine, Department of Pathology and Laboratory Medicine, Miami, Florida, USA
| | - Nemencio Ronquillo
- 12235University of Miami Miller School of Medicine, Department of Pathology and Laboratory Medicine, Miami, Florida, USA
| | - Alan S Livingstone
- 12235University of Miami Miller School of Medicine, Department of Surgery, Miami, Florida, USA
| | - Andrew E Rosenberg
- 12235University of Miami Miller School of Medicine, Department of Pathology and Laboratory Medicine, Miami, Florida, USA
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Narasimman M, Mantero A, Ronquillo N, Chyou D, Goldberg D. Use of Livers With Fibrosis Based on Donor Hospital Biopsy: Missed Opportunities? Liver Transpl 2022; 28:717-721. [PMID: 34651414 DOI: 10.1002/lt.26335] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Revised: 09/29/2021] [Accepted: 10/11/2021] [Indexed: 12/13/2022]
Affiliation(s)
| | - Alejandro Mantero
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL
| | - Nemencio Ronquillo
- Department of Pathology and Laboratory Medicine, University of Miami Miller School of Medicine, Miami, FL
| | - Darius Chyou
- University of Miami Miller School of Medicine, Miami, FL
| | - David Goldberg
- Division of Digestive Health and Liver Diseases, Department of Medicine, University of Miami Miller School of Medicine, Miami, FL
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Ronquillo N, Pinto A. Gynaecological or gastrointestinal origin? Recognising Müllerian neoplasms with gastrointestinal phenotype and determining the primary site in selected entities. Pathology 2021; 54:207-216. [PMID: 34844746 DOI: 10.1016/j.pathol.2021.09.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Revised: 08/25/2021] [Accepted: 09/02/2021] [Indexed: 01/10/2023]
Abstract
Recognising metastatic gastrointestinal and pancreatobiliary tumours to gynaecological sites may be challenging, as primary Müllerian tumours can demonstrate similar histological features. Endocervical adenocarcinomas can be of gastric and intestinal types, endometrial lesions may show gastrointestinal phenotype, and finally, mucinous tumours with secondary involvement of the ovaries may mimic primary neoplasms. The aim of this review is to address selected neoplastic entities of the gynaecological tract with gastric and intestinal differentiation and provide helpful clinical and pathological parameters for the diagnosis. A brief overview of metastatic tumours originating from the gastrointestinal and pancreaticobiliary tracts is also provided, including the most common pathological features.
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Affiliation(s)
- Nemencio Ronquillo
- Department of Pathology and Laboratory Medicine, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Andre Pinto
- Department of Pathology and Laboratory Medicine, University of Miami Miller School of Medicine, Miami, FL, USA.
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O'Brien SJ, Kalbfleisch T, Srivastava S, Pan J, Rai S, Petras RE, Ronquillo N, Polk HC, Galandiuk S. Decreased Tumoral Expression of Colon-Specific Water Channel Aquaporin 8 Is Associated With Reduced Overall Survival in Colon Adenocarcinoma. Dis Colon Rectum 2021; 64:1083-1095. [PMID: 33990498 DOI: 10.1097/dcr.0000000000002071] [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] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
BACKGROUND Colon cancer survival is dependent on metastatic potential and treatment. Large RNA-sequencing data sets may assist in identifying colon cancer-specific biomarkers to improve patient outcomes. OBJECTIVE This study aimed to identify a highly specific biomarker for overall survival in colon adenocarcinoma by using an RNA-sequencing data set. DESIGN Raw RNA-sequencing and clinical data for patients with colon adenocarcinoma (n = 271) were downloaded from The Cancer Genome Atlas. A binomial regression model was used to calculate differential RNA expression between paired colon cancer and normal epithelium samples (n = 40). Highly differentially expressed RNAs were examined. SETTINGS This study was conducted at the University of Louisville using data acquired by The Cancer Genome Atlas. PATIENTS Patients from US accredited cancer centers between 1998 and 2013 were analyzed. MAIN OUTCOME MEASURES The primary outcome measures were recurrence-free and overall survival. RESULTS The median age was 66 years (147/271 men, 180/271 White patients). Thirty RNAs were differentially expressed in colon adenocarcinoma compared with paired normal epithelium, using a log-fold change cutoff of ±6. Using median expression as a cutoff, 4 RNAs were associated with worse overall survival: decreased ZG16 (log-rank = 0.023), aquaporin 8 (log-rank = 0.023), and SLC26A3 (log-rank = 0.098), and increased COL1A1 (log-rank = 0.105). On multivariable analysis, low aquaporin 8 expression (HR, 1.748; 95% CI, 1.016-3.008; p = 0.044) was a risk factor for worse overall survival. Our final aquaporin 8 model had an area under the curve of 0.85 for overall survival. On subgroup analysis, low aquaporin 8 was associated with worse overall survival in patients with high microsatellite instability and in patients with stage II disease. Low aquaporin 8 expression was associated with KRAS and BRAF mutations. Aquaporin 8 immunohistochemistry was optimized for clinical application. LIMITATIONS This was a retrospective study. CONCLUSION Aquaporin 8 is a water channel selectively expressed in normal colon tissue. Low aquaporin 8 expression is a risk factor for worse overall survival in patients who have colon cancer. Aquaporin 8 measurement may have a role as a colon-specific prognostic biomarker and help in patient risk stratification for increased surveillance. See Video Abstract at http://links.lww.com/DCR/B603. LA DISMINUCIN DE LA EXPRESIN TUMORAL DE LA ACUAPORINA DEL CANAL DE AGUA ESPECFICO DEL COLON SE ASOCIA CON UNA REDUCCIN DE LA SUPERVIVENCIA GENERAL EN EL ADENOCARCINOMA DE COLON ANTECEDENTES:La supervivencia del cáncer de colon depende del potencial metastásico y del tratamiento. Grandes conjuntos de datos de secuenciación de ARN pueden ayudar a identificar biomarcadores específicos del cáncer de colon para mejorar los resultados de los pacientes.OBJETIVO:Identificar un biomarcador altamente específico para la supervivencia general en el adenocarcinoma de colon utilizando un conjunto de datos de secuenciación de ARN.DISEÑO:La secuenciación de ARN sin procesar y los datos clínicos para pacientes con adenocarcinoma de colon (n = 271) se descargaron de The Cancer Genome Atlas. Se utilizó un modelo de regresión binomial para calcular la expresión diferencial de ARN entre muestras de cáncer de colon emparejadas y muestras de epitelio normal (n = 40). Se examinaron los ARN expresados de forma altamente diferencial.ENTORNO CLINICO:Este estudio se realizó en la Universidad de Louisville utilizando datos adquiridos por The Cancer Genome Atlas.PACIENTES:Se analizaron pacientes de centros oncológicos acreditados en Estados Unidos entre 1998-2013.PRINCIPALES MEDIDAS DE VALORACION:Las principales medidas de valoración fueron la supervivencia general y libre de recurrencia.RESULTADOS:La mediana de edad fue de 66 años (147/271 hombres, 180/271 caucásicos). Treinta ARN se expresaron diferencialmente en el adenocarcinoma de colon en comparación con el epitelio normal emparejado, utilizando un límite de cambio logarítmico de ± 6. Utilizando la expresión mediana como punto de corte, cuatro ARN se asociaron con una peor supervivencia general: disminución de ZG16 (rango logarítmico = 0,023), acuaporina8 (rango logarítmico = 0,023) y SLC26A3 (rango logarítmico = 0,098) y aumento de COL1A1 (log -rango = 0,105). En el análisis multivariable, la baja expresión de acuaporina8 (HR = 1,748, IC del 95%: 1,016-3,008, p = 0,044) fue un factor de riesgo para una peor supervivencia global. Nuestro modelo de aquaporin8 final tuvo un AUC de 0,85 para la supervivencia global. En el análisis de subgrupos, la acuaporina8 baja se asoció con una peor supervivencia general en pacientes con MSI-H y en pacientes en estadio II. La baja expresión de acuaporina8 se asoció con mutaciones de KRAS y BRAF. La inmunohistoquímica de aquaporina8 se optimizó para su aplicación clínica.LIMITACIONES:Este fue un estudio retrospectivo.CONCLUSIÓN:La acuaporina8 es un canal de agua expresado selectivamente en el tejido normal del colon. La baja expresión de AQP8 es un factor de riesgo de peor supervivencia global en pacientes con cáncer de colon. La medición de aquaporina8 puede tener un papel como un biomarcador de pronóstico específico del colon y ayudar en la estratificación del riesgo del paciente para una mayor vigilancia. Consulte Video Resumen en http://links.lww.com/DCR/B603.
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Affiliation(s)
- Stephen J O'Brien
- Price Institute of Surgical Research, Hiram C. Polk, Jr. MD, Department of Surgery, University of Louisville School of Medicine, Louisville, Kentucky
| | - Theodore Kalbfleisch
- Department of Veterinary Science, Gluck Equine Research Center, University of Kentucky, Lexington, Kentucky
| | - Sudhir Srivastava
- Department of Bioinformatics and Biostatistics, University of Louisville, Louisville, Kentucky
- Centre for Agricultural Bioinformatics, ICAR-Indian Agricultural Statistics Research Institute, New Delhi, India
| | - Jianmin Pan
- Department of Bioinformatics and Biostatistics, University of Louisville, Louisville, Kentucky
| | - Shesh Rai
- Department of Bioinformatics and Biostatistics, University of Louisville, Louisville, Kentucky
| | - Robert E Petras
- Department of Pathology, Northeast Ohio Medical University, Rootstown, Ohio
| | | | - Hiram C Polk
- Price Institute of Surgical Research, Hiram C. Polk, Jr. MD, Department of Surgery, University of Louisville School of Medicine, Louisville, Kentucky
| | - Susan Galandiuk
- Price Institute of Surgical Research, Hiram C. Polk, Jr. MD, Department of Surgery, University of Louisville School of Medicine, Louisville, Kentucky
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Keihanian T, Kumar SR, Ronquillo N, Amin S. A rare case of endosalpingiosis masquerading as a pedunculated subepithelial colonic nodule: utility of EUS and endoscopic resection. Gastrointest Endosc 2021; 93:1432-1433. [PMID: 33545138 DOI: 10.1016/j.gie.2021.01.034] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2020] [Accepted: 01/28/2021] [Indexed: 02/08/2023]
Affiliation(s)
- Tara Keihanian
- Division of Gastroenterology, Department of Medicine, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Smriti R Kumar
- Department of Medicine, Jackson Memorial Hospital, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Nemencio Ronquillo
- Department of Pathology, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Sunil Amin
- Division of Gastroenterology, Department of Medicine, University of Miami Miller School of Medicine, Miami, Florida, USA
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Ward EP, Okamuro L, Khan S, Hosseini M, Valasek MA, Ronquillo N, Kelly KJ, Veerapong J, Lowy AM, Baumgartner J. Ki67 does not predict recurrence for low-grade appendiceal mucinous neoplasms with peritoneal dissemination after cytoreductive surgery and HIPEC. Hum Pathol 2021; 113:104-110. [PMID: 33905776 DOI: 10.1016/j.humpath.2021.04.007] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Revised: 04/16/2021] [Accepted: 04/19/2021] [Indexed: 11/19/2022]
Abstract
Low-grade appendiceal mucinous neoplasms (LAMN) can disseminate to become low-grade mucinous carcinoma peritonei (LGMCP), which is optimally treated with cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (CRS/HIPEC). Approximately half of the patients with LGMCP recur despite complete cytoreduction, and risk factors for recurrence are poorly understood. We sought to evaluate if Ki67 predicts progression of LGMCP after CRS/HIPEC. A retrospective review of a prospectively maintained database was performed to identify patients treated with complete CRS/HIPEC for LGMCP from 2008 to 2019 with Ki67 assessed. Patient characteristics, histologic data, average and focally high "hotspot") Ki67 index, progression-free survival (PFS), and overall survival (OS) were analyzed. Ki-67 immunostain was performed on the histologic section with the highest cellularity and architectural complexity. Forty-four patients with LGMCP (55% male, median age 61) were identified. The median Ki67 score and hotspot Ki67 score was 15% (1-70) and 50% (1-90), respectively. On univariate analysis, average Ki67 and hotspot Ki67 were not predictive of PFS when analyzed as continuous normalized values (HR 1.0, p = 0.79 and HR 1.1, p = 0.38, respectively) or as categorical values when stratified by the median (HR 0.9, p = 0.67 and HR 1.0, p = 0.93). This remained true on multivariate analysis when stratified for peritoneal cancer index, CEA, and completeness of cytoreduction score for both normalized Ki67 and hotspot Ki67 (HR 0.9 [95% CI 0.8-1.3], p = 0.94 and HR 1.04 [95% CI 0.8-1.3], p = 0.73, respectively). Ki67 failed to predict disease recurrence for patients with LGMCP in this cohort.
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Affiliation(s)
| | | | - Sohini Khan
- University of California San Diego, 92037, USA
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Royal JM, Oh YJ, Grey MJ, Lencer WI, Ronquillo N, Galandiuk S, Matoba N. A modified cholera toxin B subunit containing an ER retention motif enhances colon epithelial repair via an unfolded protein response. FASEB J 2019; 33:13527-13545. [PMID: 31560862 DOI: 10.1096/fj.201901255r] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Cholera toxin B subunit (CTB) exhibits broad-spectrum biologic activity upon mucosal administration. Here, we found that a recombinant CTB containing an endoplasmic reticulum (ER) retention motif (CTB-KDEL) induces colon epithelial wound healing in colitis via the activation of an unfolded protein response (UPR) in colon epithelial cells. In a Caco2 cell wound healing model, CTB-KDEL, but not CTB or CTB-KDE, facilitated cell migration via interaction with the KDEL receptor, localization in the ER, UPR activation, and subsequent TGF-β signaling. Inhibition of the inositol-requiring enzyme 1/X-box binding protein 1 arm of UPR abolished the cell migration effect of CTB-KDEL, indicating that the pathway is indispensable for the activity. CTB-KDEL's capacity to induce UPR and epithelial restitution or wound healing was corroborated in a dextran sodium sulfate-induced acute colitis mouse model. Furthermore, CTB-KDEL induced a UPR, up-regulated wound healing pathways, and maintained viable crypts in colon explants from patients with inflammatory bowel disease (IBD). In summary, CTB-KDEL exhibits unique wound healing effects in the colon that are mediated by its localization to the ER and subsequent activation of UPR in epithelial cells. The results provide implications for a novel therapeutic approach for mucosal healing, a significant unmet need in IBD treatment.-Royal, J. M., Oh, Y. J., Grey, M. J., Lencer, W. I., Ronquillo, N., Galandiuk, S., Matoba, N. A modified cholera toxin B subunit containing an ER retention motif enhances colon epithelial repair via an unfolded protein response.
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Affiliation(s)
- Joshua M Royal
- Department of Pharmacology and Toxicology, James Graham Brown Cancer Center, Center for Predictive Medicine, University of Louisville School of Medicine, Louisville, Kentucky, USA
| | - Young Jun Oh
- Department of Pharmacology and Toxicology, James Graham Brown Cancer Center, Center for Predictive Medicine, University of Louisville School of Medicine, Louisville, Kentucky, USA
| | - Michael J Grey
- Division of Gastroenterology, Nutrition, and Hepatology, Boston Children's Hospital, Boston, Massachusetts, USA.,Department of Pediatrics, Harvard Digestive Disease Center, Harvard Medical School, Boston, Massachusetts, USA
| | - Wayne I Lencer
- Division of Gastroenterology, Nutrition, and Hepatology, Boston Children's Hospital, Boston, Massachusetts, USA.,Department of Pediatrics, Harvard Digestive Disease Center, Harvard Medical School, Boston, Massachusetts, USA
| | - Nemencio Ronquillo
- Division of Anatomic Pathology, Department of Pathology and Laboratory Medicine, University of Louisville School of Medicine, Louisville, Kentucky, USA
| | - Susan Galandiuk
- The Hiram C. Polk Jr., M.D. Department of Surgery, Price Institute of Surgical Research, University of Louisville, Louisville, Kentucky, USA
| | - Nobuyuki Matoba
- Department of Pharmacology and Toxicology, James Graham Brown Cancer Center, Center for Predictive Medicine, University of Louisville School of Medicine, Louisville, Kentucky, USA
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Sánchez-Rodríguez D, Calle A, Contra A, Ronquillo N, Rodríguez-Marcos A, Vázquez-Ibar O, Colominas M, Inzitari M. Sarcopenia in post-acute care and rehabilitation of older adults: A review. Eur Geriatr Med 2016. [DOI: 10.1016/j.eurger.2015.11.001] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
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