Biomedical subjects

Cory A Roberts

Publications and source records attributed to Cory A Roberts.

4 recordsLinked to original sources

PubMed2005

Immunohistochemical expression of beta-catenin in solitary fibrous tumors.

CONTEXT: Immunohistochemical staining for beta-catenin may be used as an indicator of the integrity of the Wnt signaling and beta-catenin degradation pathways. Among mesenchymal tumors, aberrant nuclear localization of beta-catenin is seen in desmoid-type fibromatoses but has not been described for solitary fibrous tumors that may mimic the former lesions, especially in small biopsy samples. OBJECTIVE: To study the immunohistochemical expression of beta-catenin in solitary fibrous tumors. DESIGN: We performed immunohistochemical staining for beta-catenin in 12 solitary fibrous tumors, one of which showed histologic features of malignancy. RESULTS: All the tumors showed strong and diffuse reactivity for beta-catenin. Four tumors (33%) showed nuclear staining for beta-catenin, whereas the remaining tumors showed either a membranous or mixed membranous and cytoplasmic pattern of staining. The only histologically malignant tumor of the group showed a mixed membranous and cytoplasmic pattern of staining for beta-catenin. CONCLUSIONS: Immunohistochemical staining for beta-catenin in solitary fibrous tumors does not show a consistent pattern, which may be due to differences in tumorigenesis. Larger studies with clinical follow-up are required for estimating the impact of the variable staining pattern on clinical behavior of these tumors.

Adult↗

PubMed2003

Interpretive disparity among pathologists in breast sentinel lymph node evaluation.

BACKGROUND: Immunohistochemical staining on breast sentinel lymph nodes (SLN) is controversial. METHODS: Twenty-five SLN cases were reviewed by 10 pathologists (three academic, seven private) including 5 negative by both hematoxylin and eosin (H&E) and immunohistochemistry, 11 micrometastases (<2 mm) negative by H&E but positive by immunohistochemistry, and 8 micrometastases and 1 macrometastasis (>2 mm) positive for both H&E and immunohistochemistry. Answers included "positive," "negative," and "indeterminate" for each slide. RESULTS: The mean number of incorrect responses was 6.6 for immunohistochemistry and 5 for H&E. Twelve percent of cases were correct by all 10 pathologists; 80% of positive IHC cases had at least one pathologist score it incorrectly. As tumor cells decrease in number, incorrect responses increase. When tumor cells numbered less than 10, more than 30% of pathologists answered incorrectly. CONCLUSIONS: As tumor cells decrease in number pathologists' ability to recognize them decreases. We propose adding "indeterminate" to "positive" and "negative" when tumor cells number less than 10.

Breast Neoplasms↗

PubMed2002

Asymmetric cardiac hypertrophy at autopsy in patients who received FK506 (tacrolimus) or cyclosporine A after liver transplant.

BACKGROUND: Cardiotoxicity has been described in a group of pediatric patients receiving FK506 as a part of immunosuppression for orthotopic liver transplantation (OLT). Information regarding the cardiac pathology related to this agent is limited. METHODS: Among the first 975 liver transplants at our institution (1985-1995), autopsy hearts were available for 19 patients (14 adults and 5 children) who received FK506 for a minimum of 1 week prior to death. Patients with excessive alcohol use, significant coronary artery disease, valvular disease, diabetes mellitus, or pretransplant hypertension were excluded from analysis. We compared heart weight (HW), heart weight-to-body weight ratio (HW/BW), ventricular septal (VS) thickness with left ventricular (LV) thickness ratio (VS/LV), and cardiac histologic findings of 12 OLT patients (7 adults, 5 children) who received FK506 with a group of 75 OLT patients (48 adults, 27 children) who received Cyclosporine (CsA) and 20 (10 adults, 10 children) age-comparable control patients without OLT. RESULTS: All FK506 and CsA children and adults had cardiomegaly by HW, HW/BW (P(FK506 peds) <0.024, P(CsA peds)<0.028, P(FK506 adults) <0.017, P(CsA adults)<0.006) and increased VS/LV ratio 1.25(FK506) (P <0.006) and 1.23(CsA) (P <0.006)(pediatric) and 1.09(FK506) (P <0.0122) and 1.21(CsA) (P <0.0009)(adults), compared with control. CONCLUSION: Cardiomegaly by HW, HW/BW, and histology was uniformly present in both FK506 and CsA adult and pediatric OLT patients at autopsy. A relatively greater VS hypertrophy than LV was present in both transplant groups. We found no gross or histologic cardiac finding that separated these FK506 from CsA OLT patients at autopsy.

Adult↗

PubMedDate not supplied

Intraoperative cytologic diagnosis of breast sentinel lymph nodes in the routine, nonacademic setting: a highly specific test with limited sensitivity.

Intraoperative determination of metastatic breast carcinoma in sentinel lymph nodes (SLNs) by cytologic methods has been proposed as highly specific and sensitive. Much of these data are derived from academic institutes with highly trained personnel and without axillary dissection occurring as a direct result of the intraoperative interpretation. This prospective study was undertaken to assess the sensitivity and specificity of cytology in the routine, private-practice, intraoperative setting. A total of 207 SLNs from 96 breast carcinoma patients were evaluated by intraoperative cytologic preparations by general surgical pathologists; positive results led to axillary lymphadenectomy. Ten nodes were positive by intraoperative cytology (IC). Permanent section analysis confirmed the presence of carcinoma in the IC-positive cases and documented carcinoma in 19 of the IC-negative cases. IC sensitivity and specificity were 34% and 100%, respectively. False-negative IC interpretations occurred in nodes with occult micrometastases (12 of 19 nodes) and lobular carcinoma (6 of 19 nodes). Only one of eight grossly positive sentinel nodes resulted in a false-negative IC. While near-perfect specificity and high sensitivity can be achieved with grossly positive sentinel nodes by IC, sensitivity is quite low in cases with micrometastatic and lobular carcinoma.

Breast Neoplasms↗