Biomedical subjects

Claudia Valentina Georgescu

Publications and source records attributed to Claudia Valentina Georgescu.

12 recordsLinked to original sources

PubMed2007

Endoscopic ultrasound (EUS)-guided Trucut biopsy adds significant information to EUS-guided fine-needle aspiration in selected patients: a prospective study.

OBJECTIVE: Endoscopic ultrasound (EUS)-guided Trucut biopsy (EUS-TCB) has recently emerged as a method that seeks to overcome the limitations of EUS-guided fine needle aspiration (EUS-FNA) by providing a core-tissue specimen needed to increase the yield and accuracy of the diagnosis. The aim of our study was to evaluate whether EUS-TCB adds any information to EUS-FNA in selected patients and to assess the diagnostic yield, overall accuracy and complications of EUS-TCB as compared with EUS-FNA. MATERIAL AND METHODS: The study prospectively included 30 patients who had undergone both procedures. RESULTS: The yield of adequate tissue harvesting was similar for EUS-FNA and EUS-TCB (96.4% versus 89.3%, p=NS), with the same number of passes done. The diagnostic accuracy of EUS-FNA was also similar to that of EUS-TCB for the diagnosis of malignant mediastinal masses (73.7% versus 68.4%, p=NS). However, the accuracy for obtaining a specific diagnosis was significantly lower for EUS-FNA compared with EUS-TCB (5.3% and 68.4%, p<0.005). EUS-TCB did not appear to help as a rescue procedure in mediastinal tumours, after a false negative result of EUS-FNA. All cases of submucosal tumours were correctly classified by EUS-TCB as gastrointestinal stromal cell tumours (GISTs) or leiomyomas, while EUS-FNA raised only a suspicion of mesenchymal tumour. CONCLUSIONS: EUS-TCB was certainly useful when immunohistochemistry was needed, for example in submucosal tumours and lymphoma, as well as to confirm and characterize the primary or metastatic origin of mediastinal masses. The information provided by EUS-FNA and EUS-TCB is complementary, especially in selected cases where a complete histological diagnosis has an important impact on the clinical management.

Adult↗

PubMed2006

Power Doppler endoscopic ultrasonography for the differential diagnosis between pancreatic cancer and pseudotumoral chronic pancreatitis.

OBJECTIVE: The accuracy of endoscopic ultrasonography (EUS) and EUS-guided fine-needle aspiration for the differential diagnosis of pancreatic masses is variable in the literature, being as low as 75% in some studies. The aim of the study was to assess the accuracy of power Doppler EUS for the differential diagnosis between pancreatic cancer and pseudotumoral chronic pancreatitis. METHODS: We included 42 consecutive patients with pancreatic tumor masses (27 men and 15 women) examined by EUS between January 2002 and August 2004. Endoscopic ultrasonographic procedures included power Doppler EUS as well as EUS-guided fine-needle aspiration in all patients. Final diagnosis of pancreatic cancer was confirmed in 29 patients on the basis of a combination of information provided by imaging tests, follow-up of at least 6 months, and laparotomy in 18 patients for diagnostic or palliative reasons. RESULTS: Sensitivity and specificity of the absence of power Doppler signals inside the suggestive pancreatic mass were 93% and 77%, respectively, with accuracy of 88%. Moreover, the addition of the information provided by the presence of peripancreatic collaterals improved the sensitivity and specificity to 97% and 92%, with accuracy of 95%. CONCLUSIONS: Power Doppler EUS provides useful information for the differential diagnosis of pancreatic masses. The results were in concordance with previous studies that showed a hypovascular pattern of pancreatic carcinoma, as well as the formation of collaterals in advanced cases due to the invasion of the splenic or portal veins. Further studies of dynamic EUS with contrast agents are necessary to better characterize pancreatic masses.

Adult↗

PubMed2006

Histopathological and immunohistochemical aspects in both basaloid and spindle cell variant of cervical carcinoma.

The study was performed by using a number of eight cases of cervical carcinomas suiting to basaloid carcinomas and spindle cell carcinomas under the circumstances of usual histopathological staining. Immunohistochemically we used anticytokeratin monoclonal antibody (AE1/AE3) to confirm the epithelial differentiation and also PCNA to evaluate the cell proliferation rate. Tumor positiveness for AE1/AE3 cytokeratin cocktail confirmed its epithelial nature. Immunoexpression for PCNA indicated a high index of cell proliferation for all the cases with a more increased value for the basaloid carcinomas.

Adult↗

PubMed2006

P53 and PCNA immunoexpression in endometrial carcinomas.

This paper analyzes 18 endometrial carcinomas with different degrees of differentiation, the objective being to estimate involvement of p53 oncoprotein in the mechanism of endometrial carcinogenesis and the possible correlations with the tumoral proliferative activity evaluated by PCNA. The p53 immunoexpression was positive in 44.4% of the studied endometrial carcinomas, divided in three groups, the intensity of the immunostaining for p53 being increased for the low differentiated and undifferentiated endometrial carcinomas, whereas the differentiated endometrial carcinomas were moderate or low p53 positive. All the investigated tumors were PCNA positive, the PCNA index being of 40% in well-differentiated carcinomas, while in low differentiated and undifferentiated endometrial carcinomas the medium values of PCNA were of 60%, respectively 85%. Correlating the p53 and PCNA findings, we noted that PCNA was expressed especially in the cases with increased proliferative activity, without a significant statistic correlation between p53 and PCNA expression.

Cell Differentiation↗

PubMed2006

The place of the histopathologic exam for establishing the profile of the squamous cell carcinoma of the lower lip with a high degree of malignity.

UNLABELLED: The squamous cell carcinoma of the lip has a metastasizing potential by lymphatic or/and sanguine ways. OBJECTIVE: Knowing the profile of the squamous cell carcinoma of the lip with a high degree of metastasizing. PATIENTS AND METHOD: We have analyzed on a group of 322 patients the influence of the degree of the histological differentiation of the tumor and the influence of the seriousness of the invasion over the metastasized potential. The bioptic fragments have been processed according to the usual histological technique paraffin embedding, and the sections have been colored with Hematoxylin-Eosin. Some of the cases have been immunomarked, to confirm the diagnosis, with antibody anti-cytokeratins, anti-vimentin, anti-protein S100 and anti-alpha actin. RESULTS: 12.24% of the patients with tumors with Broders II degree, 28.5% of those with Broders III degree and 52.94% of those patients with Broders IV degree presented metastasis, that show that the incidence of the regional ganglionary metastasis is higher in the case of the tumors with a low histological differentiation (test chi(2), p<0.001). 1.88% of the patients with an invasive squamous cell carcinoma under 6 mm and 38.60% of those with tumors of over 6 mm presented metastasis, that show that the risk of metastasizing is higher when the profoundness of the invasion is over 6 mm (test chi(2), p<0.001). In two cases we faced the changing of the malignity degree, meaning that it got worse passing from the Broders III degree (primary tumor) to Broders IV degree (relapse of the tumor). CONCLUSIONS: The histological differential degree of the tumor and the profoundness of the invasion are two important parameters when shaping the profile of the squamous cell carcinoma of the lip with a high degree of metastasis. The degree of malignity of the tumor may worsen during the evolution of the lip cancer, raising the risk of metastasizing as well.

Adult↗

PubMed2005

Curative endoscopic ultrasound-assisted submucosal resection of a gastric stromal tumor.

Endoscopic submucosal resection has been proposed as a feasible alternative for the diagnosis and treatment of small submucosal tumors (< 3 cm), as compared to classic interventions (surgical intervention or frequent follow-up). Therapeutic options should be established after precise endoscopic ultrasound assessment of the tumor characteristics. We present the case of a 60 year-old patient, admitted to the Emergency Department for upper gastrointestinal (GI) bleeding. Upper GI endoscopy showed a submucosal tumor on the posterior gastric wall, with hyperemic covering mucosa, without central ulceration. Endoscopic ultrasound identified a 10-mm well-delimited hypoechoic lesion, with the origin in the third hyperechoic layer (submucosa). After injection of 1:10000 epinephrine in the submucosa, with subsequent elevation of the protrusive formation, we performed an endoscopic submucosal resection without any complications. Pathology exam showed a gastric stromal tumor with low mitotic activity, the endoscopic resection being considered curative. The absence of independent risk factors determined by ultrasound endoscopy (size > 3 cm, irregular margins, hyperechoic foci > 3 mm, cystic spaces > 4 mm, presence of intratumoral Doppler signal), as well as the low mitotic activity, permitted the subsequent follow-up of the patient. A control endoscopic examination performed after 4 weeks showed the healing of the post-resection ulceration. In conclusion, ultrasound endoscopy allowed the establishment of a correct presumptive diagnosis and the subsequent assistance of endoscopic submucosal resection, used for pathological confirmation and for curative endoscopic treatment.

Biopsy↗

PubMed2005

Gingival angiosarcoma: histopathologic and immunohistochemical study.

Angiosarcomas of the head and neck are rare tumors, the intra-oral localization being considered exceptionally in the specialty literature. The diagnosis of this kind of tumor in gingival location is difficult, both to the rarity of this lesion at this site, and to the various histopathological aspects. We present the case of 70 years old male patient clinically diagnosed with tumor of the alveolar crest of mandible, which, histopathologically, associated areas of predominant vascular proliferation, with areas of carcinoma and sarcoma. Immunohistochemical, the tumor was investigated for antibodies which prove the origin of proliferating cells: CD31, AE1-AE3 and vimentin.

Antigens, CD↗

PubMed2005

HPV and p53 expression in dysplastic lesions and squamous carcinomas of the oral mucosa.

We studied 18 premalignant and malignant lesions of the oral mucosa, 3 dysplasias, and 15 oral squamous carcinomas with varied localizations: lips, palate, and tongue. Immunoassays for HPV were positive in 42.8% of the squamous carcinomas, without correlation with the pattern or the degree of differentiation of the lesions. P53 immuno-expression was positive in 2 of the 3 studied cases of dysplasia (66.6%) and in 13 from the 15 cases of squamous carcinomas (86.6%). The p53 immuno-positivity in both lesional categories, with a higher rate in carcinomas, indicates the fact that the p53 gene mutations can appear precocious in the oral carcinogenesis, but can not be used as malign potential prediction factor.

Cell Differentiation↗

PubMed2005

Morphoclinical study of intracerebral haemorrhage with intraventricular extension.

AIMS: The study is an integrated assessment of clinical, image and morphological parameters in severe intracerebral haemorrhages (ICH) complicated with intraventricular extension (IVE). MATERIAL AND METHODS: The studied group had 93 cases of patients with ICH and IVE who were hospitalized in the Emergency County Hospital of Craiova and died during hospitalization. The parameters evaluated were clinical (relation with the seasons, age, sex, arterial blood pressure, the motor deficit, degree of coma, Glasgow score at admission and medical care) and morphological (the sites of the intraparenchymal haematoma and IVE, the size of the intraparenchymal haematoma, the presence of the mass effect, perilesional oedema and subarachnoid effusion). The latter were assessed on CT films and during autopsy. RESULTS: The presence of IVE as a complication of ICH showed a predilection for cold seasons, especially autumn. From the 93 studied cases 51 were men and 42, women. 52.6% of the patients were in the fifth and sixth life decade. Almost 80% of the patients had IIIrd stage arterial hypertension at admission, over 80% motor deficits and almost 60% Glasgow scores lower than 6. The ventricular effusion involved at least one of the lateral ventricles. The hematomas had huge dimensions as compared to hosting encephalic structures, in lobar sites involving more than one lobe. Other risk factors as mass effect and perilesional oedema were constantly present. CONCLUSIONS: The association of IVE with other independent risk factors such as hypertension, low Glasgow scores volume of intraventricular bleeding, dimensions of haemorrhagic foci, presence of mass effect and perilesional oedema results in the death of patient despite any sustained therapeutic intervention.

Adult↗

PubMed2005

Pseudo-tumoral lesions of the cervix.

Pseudo-tumoral lesions of the cervix implies some reactive, non-neoplastic changes (metaplasia, hyperplasia, inflammation) that, occasionally, are wrong interpreted as precancerous or malign lesions. Even some can present architectural or cytological abnormal aspects, these are different from the one noted in carcinomas or the precursor lesions of carcinomas. Them recognition is indispensable in order to avoid the diagnose errors and the super evaluation of these benign lesions.

Cervix Uteri↗

PubMed2005

Study of cerebral vascular structures in hypertensive intracerebral haemorrhage.

AIMS: The study was performed in order to assess the alterations of extra-parenchymal and intraparenchymal vascular structures in 82 hypertensive patients suspected of primary intraparenchymal hematoma, which died and were autopsied in order to confirm the diagnosis. MATERIAL AND METHODS: The studied material consisted of nervous tissue situated near and distant from the haemorrhagic lesion. The specimens of nervous tissue were processed by the classical histological technique and stained with the usual stainings and with immunohistochemical stains for basement membranes and endothelial cells. RESULTS: Extra-parenchymal arteries showed classic lesions of atherosclerosis. Atheromatous lesions were of all types, even the extension towards the media being encountered a complication with thrombosis. At the level of the intraparenchymal blood vessels, the spectrum of the lesions due to arterial hypertension included all steps of vascular wall degeneration, from hypertrophy of smooth muscle layer to complete hyalinization of arterial wall, but with a focal irregular distribution, not related with the proximity of haemorrhagic focus. High arterial blood pressure also influenced the capillary walls which showed focal or circumferential thickening due to the densification of the type IV collagen material from the basement membrane structure. The CD34 immunostaining showed that endothelial cells kept their structural integrity. CONCLUSIONS: The sequence of degenerative lesions of the cerebral vascular wall culminates with the hyalinization of excessive fibrillar material form arteriolar wall or from basement membranes. Hyalin material is weakening the wall resistance to the stress determined by the high values of blood pressure in hypertension, and, correlated with a minimal resistance of the surrounding cerebral parenchyma, can explain why the cerebral parenchyma is the only tissue in which blood pressure variations can determinate vascular rupture and cerebral haemorrhage. The more adequate term for describing the vascular wall changes seems to be sclerosis (arteriolar and even capillary) with hyalinosis.

Arterioles↗

PubMed2005

Diagnostic particularities in primitive diffuse form hepatocellular carcinoma associated with portal vein thrombosis.

The diagnosis of primitive hepatocellular carcinoma, infiltrative form, arose on liver cirrhosis is often difficult because the imagistic investigations could not relevate the tumoral formation. We are presenting the case of a 56 years patient, diagnosed with viral B liver cirrhosis, in which the clinical symptomatology and laboratory investigations were leading to hepatocellular carcinoma, but the ultrasonography and CT scan could not confirm the malignant transformation. In these conditions we performed ultrasonographically guided biopsy from the liver parenchyma and visualized thrombus in portal vein lumen. Histopathological exam from the thrombus tissue samples confirmed hepatocellular carcinoma diagnosis.

Biopsy↗