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Results for “Neoplasm Grading”

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PubMed1999

Histopathological changes in hepatocellular carcinoma after hepatic arterial embolization.

Hepatic arterial embolization (HAE) is used to treat hepatocellular carcinoma (HCC), but little is known about the histopathological changes occurring after HAE. Thirty-nine cases of liver neoplasms treated with HAE and 11 cases of liver neoplasms after digital selective angiography (DSA) were analyzed histopathologically. The pathological type, histological grade, degree of necrosis, capsular changes, number of HAE, vessel injury, and lymphocytic infiltration were recorded. Six cases showed 100% necrosis, 14 cases had 30 to 95% necrosis, and 19 cases 0 to 5% necrosis after HAE. Eleven cases of DSA did not reveal histological features of necrosis. The necrosis was related to the pathological type of tumor, encapsulation, and degree of vascular injury and was independent of histological grade, number of HAE, or lymphocytic infiltration of the neoplasm. HAE is an effective therapy for advanced stage of HCC. The encapsulated HCC is a preferred indicator for HAE.

Adult↗

PubMed2005

Correlation of glial fibrillary acidic protein (GFAP) with grading of the neuroglial tumours.

OBJECTIVE: To determine the distribution of glial fibrillary acidic protein (GFAP) in human neuroglial tumours and its correlation with histologic grading. DESIGN: Analytical. PLACE AND DURATION OF STUDY: Postgraduate Medical Institute, Lahore, on the cases from 1999 to 2001. MATERIALS AND METHODS: Fifty formalin fixed paraffin-embedded tissue blocks were obtained. Two sections from each block were taken. One was stained with heamatoxylin-eosin stain while second for GFAP that is the unlabelled antibody immunoperoxidase (peroxidase - antiperoxidase PAP) method was used. The non-neoplastic brain tissue was used as positive control, while cases reported medulloblastoma tumour was used as negative control. We applied a scoring scale 0 to 3+, to evaluate its correlation with the grade of tumour. RESULTS: In positive control only the cell process and perikaryons of fibrous astrocytes was stained. The 35 cases of various grade astrocytoma showed a varying intensity of GFAP staining. Similarly, 3 cases of glioblastoma multiforme, 2 cases of sub-ependymal giant cell astrocytoma, 2 cases of pleomorphic xanthoastrocytoma, 2 out of 4 cases of ependymoma and the case of oligoastrocytoma showed a positive reaction. The stain was more intense over processes than in perikaryons, with the exception of gemistocytic astrocytomas and the giant cells in glioblastoma multiforme, which showed an equally intense stain over perikaryons and processes. Comparison of the histological grade with GFAP score was significantly higher in high grade tumour when compared with tumour of grade I (p<0.001). In astrocytic neoplasms the number of GFAP positive cells and the intensity of the stain were directly proportional to the degree of malignancy. All the 3 cases of oligodendroglioma showed a negative reaction to GFAP. Only astrocytic component was positive which are poorly visualize by H&E stain. CONCLUSION: The GFAP score shows significant relation with the present WHO grading system of glial tumours. GFA protein is specific for glial cells and it is useful to diagnose those glial tumours which are difficult to be identified by heamatoxylin-eosin stain or due to rare or unusual site.

Astrocytoma↗

PubMedDate not supplied

Multiple biopsies in bladder urothelial carcinomas. Correlation of atypical lesions with histological grade, clinical staging and number of tumors.

Twenty-eight cases of transitional cell carcinomas, (19 papillary cell carcinomas, 9 nonpapillary invasive carcinomas) with concomitant mucosal biopsies are reported. Multiple biopsies were obtained cystoscopically at diagnosis (during resection or biopsy of the main tumor) or afterwards, during post-operative evaluation. Fifteen patients (53.6%) were positive for dysplasia, carcinoma "in situ" or micro-invasive carcinoma in the biopsies. These lesions were correlated with the primary neoplasm in regard to: 1) histological grade. Atypical lesions were more frequent the higher the grade (0.01 < p < 0.05); 2) clinical staging. The possibility of finding atypical lesions was higher in cases with more advanced staging (0.01 < p < 0.05) and 3) presence of one or more tumors visible cystoscopically. The results were not statistically significant (0.10 < p < 0.50) but there was a trend toward a higher incidence of atypical lesions among patients with more than one tumor at cystoscopy. Performance of multiple mucosal biopsies is the only means of diagnosing for atypical lesions of the bladder because, due to their plane configuration, they are not detected cystoscopically. The presence of these lesions is very important because they influence the prognosis and the therapeutic measures.

Adult↗

PubMedDate not supplied

Expression of the tyrosine kinase activity growth factor receptors (EGFR, ERB B2, ERB B3) in colorectal adenocarcinomas and adenomas.

The overexpression of three growth factor receptors: epidermal growth factor receptor (EGFR), ERB B2 and ERB B3 was evaluated immunohistochemically in 77 malignant and 15 benign colorectal neoplasms considering clinicopathological variables (histological structure, grade of differentiation, tumor localization, clinical stage of the disease). The relationship between the coexpression of EGFR-related proteins in individual patients was also evaluated. EGFR expression was revealed in comparable percentages of colorectal adenoma and in adenocarcinoma cases (80% and 70%) while ERB B2 expression was detectable more frequently in adenoma than in adenocarcinoma cases (87% and 54%). The presence of ERB B3 was observed in a higher percentage of adenocarcinoma than adenoma cases (65% and 40%). There was no correlation between the expression of studied tyrosine kinase receptors and histological grade or Dukes' clinical stage and localization (proximal or distal) of colorectal adenocarcinoma. The incidence of EGFR and ERB B2 expression was higher in tubulovillous (100% for both receptors) than in tubular adenomas (63% and 75%), while the ERB B3 receptor was revealed more frequently in tubular than in tubulovillous neoplasms (50% and 28%). These differences appeared to be statistically nonsignificant. The concomitant expression of two growth factor receptors was observed in a higher percentage of colorectal adenomas than adenocarcinomas, and the coexistence of three growth factors was revealed in comparable percentages in malignant and benign colorectal tumors. Our results support the promotional rather than direct transformational role for the EGFR supergene family in colorectal tumorigenesis. The frequently observed coexpression of more than one EGFR-related protein in colorectal neoplasms indicates the possible cooperation of these receptors in mitogenic signaling transduction, facilitating the development and maintenance of the malignant phenotype.

Adenocarcinoma↗

PubMed1998

Cytofluorimetric evaluation of DNA ploidy in the diagnosis of bladder cancer.

OBJECTIVE: The aim of the study is to investigate the relationship between urinary cytology, traditional indexes of malignancy of bladder carcinoma and DNA-ploidy (diploid, near-diploid, aneuploid). METHODS: 52 specimens of bladder cancers (transitional cell carcinoma) were obtained from 46 patients at TURB and from 6 patients at radical cystectomy. In every specimen the nuclear content of DNA was investigated using the cytofluorimetric method. Cells were processed in standard fashion for flow cytometry with propidium iodide staining; cellular suspension was obtained mechanically. Peripheral blood lymphocytes were used as diploid standard. Bladder cytology was performed in every patient. RESULTS: A relationship between DNA-ploidy and histological malignancy was observed. The largest portion of near-diploid neoplasm was observed in stage T1, grade G2 malignancies. In some cases negative bladder cytology occurred together with aneuploid DNA content, whilst in other cases positive bladder cytology occurred together with diploid DNA content. In consequence there is not always a relationship between bladder cytology and DNA-ploidy. CONCLUSIONS: Since observed correlations may point out some neoplasms with particular biological behaviour, follow-up of near-diploid malignancies is of great interest.

Carcinoma, Transitional Cell↗

PubMed2001

Gene expression profiling with oligonucleotide microarrays distinguishes World Health Organization grade of oligodendrogliomas.

Oligodendrogliomas are the second most common type of glial neoplasm with distinct prognostic and therapeutic implications. Although refinements have led to improved clinical stratification, current grading schemes are still limited by subjective histopathological criteria. In this report, we have used oligonucleotide array technology to perform expression profiling in morphologically classic oligodendrogliomas. Expression information from approximately 1100 genes divided tumors into two molecularly distinct groups that corresponded exactly to their previously assigned histological grades. Subsequent gene clustering identified a subset of 196 transcripts showing a common, differential expression pattern between tumor grades. A number of these genes have been associated with the maintenance of cytoarchitecture, cellular differentiation and maturation, immunogenicity, and chemotherapeutic resistance. These results demonstrate the utility of gene expression profiling as an objective, ancillary tool for grading oligodendrogliomas and a potential approach for classifying diffuse gliomas where histological assessment may be difficult or ambiguous.

Adult↗

PubMedDate not supplied

Intraventricular supratentorial tumors in children.

Overall, intraventricular supratentorial tumors are rare in childhood. Classification can be based on the separation of lesions originating in intraventricular structures, such as choroid plexuses, from glial neoplasms of the ventricular wall which tend to infiltrate the ventricular cavities. Aim of the present study is to review the most common neoplasms of this region in childhood. Choroid plexus tumors (papillomas and carcinomas) and subependymal giant cell astrocytomas are dealt with, while for the other neoplasms which are rarer or more typic of other age ranges, specific reports should be consulted. Choroid plexus papillomas affect infants and are the most frequent oncological type among congenital tumors. The malignant variant (grade III-IV) is represented by the less frequent the neoplasms. The malignant variant (grade III-IV) is represented by the less frequent choroid plexus carcinoma which is markedly invasive with respect to adjacent nervous structures and has a high tendency to form metastases even at onset. Anaplastic papillomas are intermediate forms whose correct histopathology is still debated. Most frequent glial tumors are subependymal giant-cell astrocytomas. They are benign tumors (grade I) typically albeit not constantly associated to tuberous sclerosis. In this case the differentiation from subependymal nodules plays a major role. Contrast enhanced CT is fundamental in this assessment. Anaplastic variants, though rare, are well-known.

Brain↗

PubMed1976

Management of ovarian carcinoma in young women.

On the basis of available information, the following criteria regarding ovarian carcinoma may be considered for the young patient who has not completed her family and is desirous of further childbearing. Any ovarian enlargements must be promptly and adequately evaluated. A lesion of high grade or high stage is not amenable to conservative surgery, and definitive total abdominal hysterectomy, bilateral salpinog-oophorectomy with or without partial omentectomy, and subsequent chemotherapy or radiotherapy are indicated. In the individual who has a low-grade and intracystic or encapsulated ovarian neoplasm, conservative surgery may be considered, provided there is no evidence otherwise of any periotneal or other spread and particularly if the opposite ovary is histologically evaluated, preferably by wedge resection. Data have indicated that this is a reasonable process to consider, and if followed carefully this should allow these individuals to accomplish their childbearing function with minimal risk. In general, because of the bilaterality of ovarian tumors, such conservative surgery probably is indefensible unless these riged criteria are met. It would also seem preferable to complete the surgical procedure with hysterectomy and salpingo-oophorectomy once the patient's family is complete, thus obviating any possible appearance of a malignant tumor in the remaining ovary. The use of exogenous estrogesn would also seem far preferable to the risk of an insidious low-grade tumor that could not be adequately followed.

Adult↗

PubMed1976

Large bowel carcinoma in strain-2 guinea pigs by intrarectal instillation of N-methyl-N'-nitro-n-nitrosoguanidine.

Intrarectal instillation of 0.5 ml of a 0.125% solution of N-methyl-N'-nitro-N-nitrosoguanidine twice weekly for 53 weeks to female inbred strain-2 guinea pigs induced multiple large bowel adenocarcinomas in 13 of 15 animals in 52 to 85 weeks. The lesions were plaque-shaped in small tumors and infiltrative or constrictive in large advanced tumors. The neoplasms showed histological features in varied grades of differentiation and invasiveness similar to those of human cases. These findings distinquished them from large bowel cancers chemically induced in rats and mice.

Adenocarcinoma↗

PubMed1992

Neoplasms and related disorders.

Spinal neoplasms may be primary or metastatic, benign or malignant. In adults, metastatic involvement of the spine will represent the most important neoplastic disease of this region. However, hemangiomas are the most common spinal neoplasms. The vast majority of intradural, extramedullary neoplasms that will be identified in the spine are meningiomas and neurofibromas. Both lesions may be sporadic or associated with phakomatoses. Intramedullary spinal cord and filum terminale tumors are relatively rare and are far less common than intramedullary brain tumors. As is the case in the brain, these are overwhelmingly glial neoplasms, with ependymomas and low-grade astrocytomas representing the majority of the lesions. Hemangioblastoma deserves mention because of its often characteristic imaging findings and its association with von Hippel-Lindau disease.

Humans↗

PubMed2000

[Revisions in the WHO histological classification of urothelial bladder tumors and flat urothelial lesions].

Recently the World Health Organization published a new classification of urinary bladder tumors which is intended to take into account better the biology of the various lesions and to better distinguish between clearly benign and malignant lesions. We examine the possible diagnostic and clinical impact of the new classification, including recent immunohistochemical findings. Papillary urothelial lesions include papillomas, papillary neoplasms of low malignant potential, and papillary carcinomas. Flat urothelial lesions include hyperplasia, reactive atypia/atypia of unknown significance, dysplasia, and carcinoma in situ. Invasive patterns of papillary carcinomas are discussed, with special emphasis on lamina muscularis mucosae substaging. The most important feature of the new classification is its differentiation of two types of low-grade, noninvasive papillary urothelial lesions: papillary neoplasm of low malignant potential vs. papillary carcinoma. Long-term follow-up studies are needed to determine the clinical significance of this differentiation.

Carcinoma, Transitional Cell↗

PubMedDate not supplied

Giant hepatic metastasis from gastrointestinal stromal tumor of the rectum 12 years after surgery.

Gastrointestinal stromal tumors are non-epithelial neoplasms that arise from the gastrointestinal tract. Their variable cytologic atypia makes it difficult to predict their prognosis. We report a case of right hepatectomy for a giant metastasis detected 12 years after the surgical treatment of a rectal neoplasm, histologically demonstrated as a low-grade leiomyosarcoma initially, having morphological and immunohistochemical features of low malignancy. Histological examination of the hepatic metastases demonstrated that the tumors were composed of spindle cells similar to those in the rectal neoplasm. Immunohistochemical staining of the hepatic metastases with Ki-67 revealed stronger than the primary tumor. In conclusion, although histological and immunohistochemical analyses provide useful prognostic information, the prognosis of gastrointestinal stromal tumors is difficult to predict. Therefore, a patient with gastrointestinal stromal tumor diagnosed as low-grade malignancy requires carefully long-term follow-up.

Hepatectomy↗

PubMed2003

Grade 2 chondrosarcoma: stage I or stage II tumor?

We analyzed chondrosarcomas of bone to assess whether Grade 2 tumors are more appropriately grouped with Grade 1 chondrosarcomas or Grade 3 and dedifferentiated chondrosarcomas (Musculoskeletal Tumor Society Stage I or Stage II). A retrospective chart review identified 109 patients who presented with nonmetastatic chondrosarcoma. Data were gathered on each tumor's histologic grade, extent (intracompartmental versus extracompartmental), resection margin status, and site (axial versus appendicular). The cohort included 60 males and 49 females with a mean age of 50 years. Forty tumors were located in the axial skeleton and the remainder were distributed throughout the appendicular skeleton. Fifty-three tumors were Grade 1, 40 tumors were Grade 2, eight tumors were Grade 3, and eight tumors were dedifferentiated. Statistical analysis established grade as the only significant variable for this group of patients; extracompartmental tumor spread also correlated with outcome, but not independent of the grade. Margin status and site were not statistically significant with respect to outcome. Chi-square analysis also established that Grade 2 tumors are grouped more appropriately with the Grade 1 chondrosarcomas as Musculoskeletal Tumor Society Stage I neoplasms. These data should be considered when developing the surgical plan, particularly for patients with Grade 2 appendicular chondrosarcomas.

Adolescent↗

PubMed1999

Endometrial stromal sarcoma: a clinicopathologic study.

BACKGROUND: This study is a clinicopathologic evaluation of five patients with endometrial stromal sarcoma. PATIENTS AND METHODS: Over a period of 9 years 5 cases of ESS were observed in our Unit. The patients were retrospectively staged according to the FIGO staging system for endometrial cancer. The neoplasm was divided into two groups based on mitotic activity. Patients underwent endouterine curettage, surgery therapy and, except one of them, chemotherapy. RESULTS: Two patients had low-grade ESS stage Ib and Ic. The other three had high-grade ESS, and were in stage IIIa. Treatment was surgery for all patients, and adjuvant chemotherapy for 4 out of 5. Both patients in stage I are alive, clinically free from the disease, 25 and 36 months after diagnosis. In stage III all patients died 14, 25 and 36 months after diagnosis. CONCLUSION: ESS is a rare uterine neoplasm. Histologic grade is the most important prognostic factor.

Adult↗

PubMed1998

Metastizing low-grade clear cell leiomyosarcoma of the uterus.

An unusual case of uterine clear cell tumor is reported in a 56-year-old woman. The neoplasm was identified as a peculiar low-grade leiomyosarcoma, composed mainly of watery, clear large cells with round, fairly regular nuclei. No appreciable pleomorphism or high mitotic activity was noted. There was no necrosis. The presence of occasional areas of transition between these cells and typical spindle leiomyosarcoma cells, together with the immunohistochemical results, allowed the recognition of a smooth muscle origin of this clear cell tumor. The patient was treated by hysterectomy. Six years later she developed an inguinal metastasis resembling an hibernoma, and then later developed a large retroperitoneal metastasis, which was composed entirely of clear cells and was distinguished from a liposarcoma by immunohistochemistry.

Actins↗

PubMed1998

Prognostic factors in uterine carcinosarcoma: a clinicopathologic study of 25 patients.

BACKGROUND: Carcinosarcoma (malignant mixed mullerian tumor) of the female genital tract is a highly malignant neoplasm. The tumor stage and histologic grade of the carcinomatous component are among the important prognostic indicators cited in the literature for this tumor. METHODS: Twenty-five patients with uterine carcinosarcoma at 4 hospitals in the Kyoto and Nara areas of Japan were studied retrospectively. The clinicopathologic and immunohistochemical data including p53, bcl-2, Ki-67, and proliferating cell nuclear antigen (PCNA) staining were analyzed using univariate and multivariate analysis with the Cox proportional hazards model to investigate potential prognostic indicators for this neoplasm. RESULTS: The 5-year survival rate was 36.4% for all stages, 62.3% for Stage I, and 0% for Stages II-IV. From the univariate analysis, stage (P = 0.0001), endometrioid adenocarcinoma as a carcinomatous component (P = 0.0006), age (P = 0.0355), and a heterologous sarcomatous component (P = 0.0421) were found to be prognostically significant for patient survival. Stage was the only independent significant factor in the multivariate analysis (t = 2.212). None of the other factors (history of pregnancy and gestation, gross appearance of the tumors, grade of the carcinomatous component, mitotic count of the sarcomatous component, Ki-67 and PCNA reactivity, or p53 or bcl-2 positive staining) was found to be a significant prognostic indicator. CONCLUSIONS: Stage appears to be the only definite independent prognostic indicator of survival in patients with uterine carcinosarcoma. It is uncertain whether age, endometrioid adenocarcinoma as a carcinomatous component, or absence of a heterologous component in the sarcomatous area are prognostic factors. Immunohistochemical expression of p53, bcl-2, Ki-67, or PCNA is not a prognostic indicator. The immunohistochemical results of the current study may support the hypothesis of a common stem cell origin of this tumor.

Adult↗

PubMed1996

Prognostic parameters for survival of patients with malignant mesenchymal tumors of the uterus.

BACKGROUND: Malignant mesenchymal uterine neoplasms are the most aggressive type of primary uterine tumors, with most patients dying within a few years of diagnosis. Thus, it would be very important to define prognostic factors for predicting the malignancy potential of at least some of their subtypes. METHODS: Flow cytometric cell cycle analysis (proliferative activity, DNA ploidy, and DNA index) was performed on archival paraffin embedded blocks from 80 patients with malignant mesenchymal uterine neoplasms (endometrial stromal sarcomas, malignant smooth muscle tumors, and malignant Müllerian mixed tumors). The Cox proportional hazards regression model was used to assess relative effects of the following factors on patient survival: clinical stage, mode of therapy, DNA+proliferative activity, DNA index, histologic type, cellularity, degree of atypia, mitotic activity, and depth of myometrial invasion. RESULTS: There were 9 low grade stromal sarcomas, 17 high grade stromal sarcomas, 8 smooth muscle neoplasms with uncertain malignant potential, 23 leiomyosarcomas, and 16 homologous and 7 heterologous malignant Müllerian mixed tumors. In univariate analysis for stromal sarcomas, statistical significance was found for DNA ploidy+proliferative activity (P < 0.001), histologic type (P = 0.005), and DNA index (P < 0.001). In multivariate analysis, DNA index appeared to be the only significant parameter influencing patient survival (P = 0.005). In univariate analysis for malignant smooth muscle neoplasms, statistical significance was detected for mitotic activity (P = 0.049) and International Federation of Gynecology and Obstetrics classification (P = 0.021), but in multivariate analysis, clinical stage appeared to be the only significant parameter influencing patient survival (P = 0.032). In univariate analysis for malignant Müllerian mixed tumors, statistical significance was found for the depth of myometrial invasion (P = 0.039), DNA index (P = 0.037), and clinical stage (P = 0.013), but in multivariate analysis, only the depth of myometrial invasion (P = 0.036) and clinical stage (P = 0.025) were of statistical significance. CONCLUSIONS: The most powerful prognostic indicator for stromal sarcomas was the DNA index, for malignant smooth muscle neoplasms it was the clinical stage, and for malignant Müllerian mixed tumors it was the depth of myometrial invasion.

Analysis of Variance↗

PubMed1991

Primary sarcomas of the major salivary glands.

Sarcomas arising in the major salivary glands are rare. This article presents the clinicopathologic features of 11 patients with primary sarcomas of the parotid gland (eight men and three women aged 7 to 75 years; mean age, 42 years). The 11 sarcomas were histologically typified as follows: three malignant fibrous histiocytomas and two each of neurosarcomas, rhabdomyosarcomas, fibrosarcomas, and osteosarcomas. Four patients experienced disease recurrences, and seven patients developed metastases. Seven patients died of their sarcomas, with a mean survival time of 30 months. Four patients were alive from 5 to 12 years (one each with angiomatoid malignant fibrous histiocytoma, embryonal rhabdomyosarcoma, fibrosarcoma, and neurosarcoma). Prognosis correlated with size of the neoplasm, type of sarcoma, and histologic grade. In this respect, salivary gland sarcomas behaved in identical fashion to their soft-tissue counterparts.

Adult↗