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The Korean Journal of Gastroenterology... Feb 2010In order to determine the malignant potential of gallbladder adenoma for progression to carcinoma, we evaluated the histopathologic features of adenoma and...
BACKGROUND/AIMS
In order to determine the malignant potential of gallbladder adenoma for progression to carcinoma, we evaluated the histopathologic features of adenoma and adenoma-related lesions on cholecystectomized specimens.
METHODS
Among 1,847 cholecystectomized specimens, 63 specimens from 26 benign adenomas, 9 carcinomas in situ (CIS), and 28 invasive carcinomas were selected. A pathologist reviewed all specimens and selected benign adenomas, CIS in the adenoma, and adenoma residue in invasive carcinomas. Adenomas and adenoma-related lesions were classified according to morphology (tubular, tubulopapillary, and papillary) and the consisting epithelium (biliary, pyloric metaplasia, and intestinal metaplasia). The age and the size of the benign adenomas and carcinomas in the adenoma were also compared.
RESULTS
Adenoma and adenoma-related lesions were found in 34 out (1.8%) of all resected gallbladder. Among 9 CIS and 28 invasive carcinomas, adenoma-related lesions were detected in 7 and 1 case, respectively. All eight carcinomas arising in the adenoma were well-differentiated solitary tumors. The diameters of the carcinomas in the adenoma were, on average, larger than that of the benign adenomas (1.8 cm vs. 0.9 cm, p=0.01). The patients with carcinomas in the adenoma were, on average, older than those with benign adenomas, although the difference was insignificant (57 years vs. 47 years, p=0.09). The morphology and consisting epithelium did not differ between the benign adenomas and carcinomas in the adenoma. The malignant transformation occurred in 23.5% of adenomas.
CONCLUSIONS
Gallbladder adenoma is a rare disease, although malignant transformation occurs frequently. Adenoma is a precancerous lesion and the adenoma-carcinoma sequence is one of the gallbladder cancer carcinogenesis.
Topics: Adenoma; Adult; Age Factors; Aged; Carcinoma; Cell Transformation, Neoplastic; Cholecystectomy; Cystadenoma; Female; Gallbladder Neoplasms; Gallstones; Humans; Male; Middle Aged; Neoplasm Invasiveness
PubMed: 20168058
DOI: 10.4166/kjg.2010.55.2.119 -
Neurology India Jan 2024The WHO 2017 classification of endocrine tumors incorporates lineage-specific transcription factors (TF) and hormone expression for the classification of pituitary...
BACKGROUND
The WHO 2017 classification of endocrine tumors incorporates lineage-specific transcription factors (TF) and hormone expression for the classification of pituitary adenoma (PA). There is paucity of reports describing the spectrum of PA based on this classification.
OBJECTIVE
The aim of this study was to delineate the spectrum of PA based on WHO 2017 classification of endocrine tumors.
MATERIALS AND METHODS
PA diagnosed in the year 2018 were studied. H and E and hormonal immunohistochemistry (IHC) for GH, PRL, ACTH, TSH, FSH, LH, CK, T-Pit and MIB-1 were performed and the results were analyzed.
RESULTS
The cohort included 88 cases. M: F ratio was 2:1. Clinically, 22 (25%) were functional and 66 (75%) were non-functional adenomas. Amongst the clinically functional adenomas, GH secreting adenomas were the commonest (68%). Majority (83%) of non-functional adenomas were hormone positive with gonadotroph adenomas being the commonest (72.7%). Eleven (12.5%) PA were clinically and hormonally silent. Three of these showed intense nuclear T-Pit positivity, classifying them under silent corticotroph adenoma. Lineage of the remaining eight adenomas remained undetermined, since, IHC for Pit-1 and SF-1 was not performed. The aggressive adenomas identified by IHC included sparsely granulated somatotroph adenoma, Crooke cell adenoma, silent corticotroph adenoma, densely granulated lactotroph adenoma in men and constituted 17% of the PA. Four (4/88) cases were clinically invasive.
CONCLUSION
A large majority of PA including aggressive adenomas can be identified by IHC. Addition of T-Pit helped to identify silent corticotroph adenoma. Pit -1 and SF-1 TF would help identify plurihormonal Pit-1 PA and null cell adenomas.
Topics: Male; Humans; Pituitary Neoplasms; ACTH-Secreting Pituitary Adenoma; Adenoma; Hormones; Organic Chemicals
PubMed: 38443009
DOI: 10.4103/neuroindia.NI_913_20 -
BMJ Case Reports Aug 2021Minor salivary gland tumours are enigmatic in their behaviour and presentations. Histopathological diagnosis of these tumours encompasses a large spectrum....
Minor salivary gland tumours are enigmatic in their behaviour and presentations. Histopathological diagnosis of these tumours encompasses a large spectrum. Conventionally, small nodular tumours of the upper lip or the labial mucosa are generally adenomas, frequently pleomorphic adenomas. Here, we describe a case of a solitary nodular tumour, occurring in the upper labial mucosa, diagnosed as sclerosing polycystic adenoma (SPA) with intraductal epithelial proliferation of high grade. This is a rare lesion, which has entered into the category of salivary gland tumours recently in the 2017 WHO categorisation. We report a case of paucicystic SPA with intraductal epithelial proliferations in the labial minor salivary gland of a 56-year-old woman, which might be the first report of a case occurring in the upper labial mucosa.
Topics: Adenoma; Adenoma, Pleomorphic; Carcinoma, Intraductal, Noninfiltrating; Female; Humans; Middle Aged; Salivary Gland Neoplasms; Salivary Glands, Minor
PubMed: 34404657
DOI: 10.1136/bcr-2021-243736 -
Cancer Nov 1988A "depressed adenoma" was detected in surgically removed stomachs. There were 40 such lesions (11%) of a total of 357 lesions of gastric adenomas. Macroscopically, these...
A "depressed adenoma" was detected in surgically removed stomachs. There were 40 such lesions (11%) of a total of 357 lesions of gastric adenomas. Macroscopically, these lesions often occurred along the lesser curvature of the stomach, had shallow depressions of a light-brown color, a round or oval shape with irregular margins, and could hardly be distinguished from a depressed early carcinoma. Although 14 of the lesions were detected preoperatively with confirmation by endoscopic biopsy, the other 26 remained unrecognized until the gross examination of the formalin-fixed specimens. Histologically, all were tubular adenomas of the intestinal type with varying degrees of epithelial atypia. Carcinoma in adenoma was present in 5% of these depressed lesions, in contrast to 2.5% of the conventional protruded adenoma. Thus, depressed adenoma seems to be a variant of gastric adenoma which has a somewhat higher malignant potential.
Topics: Adenoma; Adult; Aged; Female; Gastrectomy; Gastric Mucosa; Humans; Male; Middle Aged; Stomach Neoplasms
PubMed: 3179932
DOI: 10.1002/1097-0142(19881115)62:10<2197::aid-cncr2820621021>3.0.co;2-l -
The Gastroenterologist Sep 1996The risk for development of colonic carcinoma increases with increasing size of the polyp. Endoscopists have focused attention on large polyps. Small flat adenomas are... (Review)
Review
The risk for development of colonic carcinoma increases with increasing size of the polyp. Endoscopists have focused attention on large polyps. Small flat adenomas are sessile polyps that measure less than 1 cm; they are nearly flat, and they have a slight depression in the center. They have a high incidence of cancer in situ. Adenomatous polyps follow the adenoma-carcinoma sequence. Small flat adenomas do not appear to follow this sequence, but they may be precursors of so called de novo colonic carcinoma. The genetics of small flat adenomas are not fully elucidated. Small flat adenomas may not be identified during standard colonoscopy due to the small size of the lesion. Chromoendoscopy may increase the rate of detection.
Topics: Adenoma; Colonic Neoplasms; Diagnosis, Differential; Humans
PubMed: 8891686
DOI: No ID Found -
Eksperimental'naia I Klinicheskaia... 2016The introduction of a screening diagnosis of precancerous lesions of gastric mucosa and elaboration of new methods of radical treatment is an important aspect of gastric...
The introduction of a screening diagnosis of precancerous lesions of gastric mucosa and elaboration of new methods of radical treatment is an important aspect of gastric cancer prevention. Digestive endoscopy with subsequent morphological study allows with high probability to correctly assess the structure of the lesion and to identify changes that have prognostic value. Gastric adenoma is the obligate precancerous lesion because the presence of intraepithelial neoplasia. Aim - retrospective review the clinical-morphologic characteristics-and frequency of gastric adenoma in a large series of endoscopies from patients with gastric polyps. Methods -.163 gastric adenomas were diagnosed by histological examination in a series of 990 patients who had upper digestive endoscopies done. The patients were analyzed as the age, sex, and the adenomas as the histological and Yamada classification, as well as their location, size, histopathological findings studied. Results - gastric adenomas were diagnosed in 16,5% in a series of patients with gasric polyps, more frequently in the women. Gastric adenomas were primarily single and developed in the antrum of.stomach. High grade dysplastic foci were found in 0,6% adenomas, which size was lesser than 2 cm. Intestinal metaplasia with high grade prognostic value was found in 18,4% cases. A carcinoma was not detected.
Topics: Adenoma; Adult; Aged; Biopsy; Female; Humans; Male; Middle Aged; Retrospective Studies; Sex Factors; Stomach Neoplasms
PubMed: 29889377
DOI: No ID Found -
Phytomedicine : International Journal... May 2024Colorectal adenoma is benign glandular tumor of colon, the precursor of colorectal cancer. But no pharmaceutical medication is currently available to treat and prevent... (Randomized Controlled Trial)
Randomized Controlled Trial
BACKGROUND
Colorectal adenoma is benign glandular tumor of colon, the precursor of colorectal cancer. But no pharmaceutical medication is currently available to treat and prevent adenomas.
PURPOSE
To evaluate efficacy of Shenbai Granules, an herbal medicine formula, in reducing the recurrence of adenomas.
STUDY DESIGN
This multicenter, randomized, double-blind, placebo-controlled clinical trial was conducted by eight hospitals in China.
METHODS
Patients who had received complete polypectomy and were diagnosed with adenomas within the recent 6 months were randomly assigned (1:1) to receive either Shenbai granules or placebo twice a day for 6 months. An annual colonoscopy was performed during the 2-year follow-up period. The primary outcome was the proportion of patients with at least one adenoma detected in the modified intention-to-treat (mITT) population during follow-up for 2 years. The secondary outcomes were the proportion of patients with sessile serrated lesions and other specified polypoid lesions. The data were analyzed using logistic regression.
RESULTS
Among 400 randomized patients, 336 were included in the mITT population. We found significant differences between treatment and placebo groups in the proportion of patients with at least one recurrent adenoma (42.5 % vs. 58.6 %; OR, 0.47; 95 % CI, 0.29-0.74; p = 0.001) and sessile serrated lesion (1.8 % vs. 8.3 %; OR, 0.20; 95 % CI, 0.06-0.72; p = 0.01). There was no significant difference in the proportion of patients developing polypoid lesions (70.7 % vs. 77.5 %; OR, 1.43; 95 % CI, 0.88-2.34; p = 0.15) or high-risk adenomas (9.0 % vs. 13.6 %; OR, 0.63; 95 % CI, 0.32-1.25; p = 0.18).
CONCLUSION
Shenbai Granules significantly reduced the recurrence of adenomas, indicating that they could be an effective option for adenomas. Future studies should investigate its effects in larger patient populations and explore its mechanism of action to provide more comprehensive evidence for the use of Shenbai Granules in adenoma treatment.
Topics: Humans; Colorectal Neoplasms; Colonoscopy; Double-Blind Method; Adenoma; China
PubMed: 38471368
DOI: 10.1016/j.phymed.2024.155496 -
Pituitary Apr 2015Transsphenoidal selective adenomectomy is the first-line treatment for Cushing's disease. At experienced centers, early remission rates after transsphenoidal surgery... (Review)
Review
BACKGROUND
Transsphenoidal selective adenomectomy is the first-line treatment for Cushing's disease. At experienced centers, early remission rates after transsphenoidal surgery range from 65 to 98%, however disease relapse frequently occurs with rates ranging from 2 to 35% at long-term follow up.
METHODS
This article discusses recently reported studies on the surgical outcomes from transsphenoidal surgery for Cushing's disease.
CONCLUSIONS
One of the keys to a successful long-term surgical outcome is meticulous dissection using the adenoma's pseudocapsule as a surgical plane for complete resection. MRI-negative and invasive ACTH-secreting adenomas pose particular challenges for pituitary surgeons.
Topics: ACTH-Secreting Pituitary Adenoma; Adenoma; Humans; Hypophysectomy; Neoplasm Recurrence, Local; Neoplasm, Residual; Pituitary ACTH Hypersecretion; Risk Factors; Time Factors; Treatment Outcome
PubMed: 25724315
DOI: 10.1007/s11102-015-0646-5 -
Innere Medizin (Heidelberg, Germany) Jul 2024The widespread use of diagnostic imaging has led to an increase in the incidence of pituitary tumors. The majority of incidentalomas are hormone-inactive (HI) pituitary... (Review)
Review
The widespread use of diagnostic imaging has led to an increase in the incidence of pituitary tumors. The majority of incidentalomas are hormone-inactive (HI) pituitary microadenomas. The most common clinically relevant pituitary adenomas are prolactin-secreting, followed by HI, and far less common are growth hormone (GH)-, adrenocorticotropic hormone (ACTH)- and thyroid-stimulating hormone (TSH)-secreting adenomas. Pituitary adenomas are usually benign, although aggressive growth and invasion occurs in individual cases. Very rarely, they give rise to metastases and are then termed pituitary carcinomas. All pituitary tumors require endocrine testing for pituitary hormone excess. In addition to the medical history and clinical examination, laboratory diagnostics are very important. Symptoms such as irregular menstruation, loss of libido or galactorrhea often lead to the timely diagnosis of prolactinomas, and hyperprolactinemia can easily confirm the diagnosis (considering the differential diagnoses). Diagnosis is more difficult for all other hormone-secreting pituitary adenomas (acromegaly, Cushing's disease, TSHoma), as the symptoms are often non-specific (i.e., headaches, weight gain, fatigue, joint pain). Furthermore, comorbidities such as hypertension, diabetes, and depression are such widespread diseases that pituitary adenomas are rarely considered as the underlying cause. Timely diagnosis and appropriate treatment have a significant impact on morbidity, mortality, and quality of life. Therefore, the role of primary care physicians is very important for achieving an early diagnosis. In addition, patients with pituitary adenomas should always be referred to endocrinologists to ensure optimal diagnosis as well as treatment.
Topics: Humans; Pituitary Neoplasms; Diagnosis, Differential; Adenoma; Prolactinoma
PubMed: 38869654
DOI: 10.1007/s00108-024-01729-9 -
Diagnostic Cytopathology 1986Cytologic criteria for diagnosing parathyroid adenomas and hyperplasia have not been elucidated. This report will present the cytomorphology of parathyroid tissue in the...
Cytologic criteria for diagnosing parathyroid adenomas and hyperplasia have not been elucidated. This report will present the cytomorphology of parathyroid tissue in the spectrum of normal, hyperplastic, and neoplastic states. We examined clinical needle aspirates from three patients with parathyroid lesions as well as 15 needle aspirations or touch preparations from surgical specimens. The series included three with hyperparathyroidism secondary to chronic renal failure, four with primary chief cell hyperplasia, nine with typical adenomas, and two with atypical adenomas. Normal parathyroid glands were also studied. Most parathyroid lesions could be distinguished from thyroid lesions by frequent thick fragments of cohesive cells with frayed edges and typical nuclear features. In general, the nuclei were small (6-8 mu) and round with regular coarse granular chromatin. Occasional larger nuclei (10-30 mu) with similar chromatin were observed in some cases. Oxyphil cells with abundant granular cytoplasm were present in some cases; one case with mostly oxyphil cells was difficult to differentiate from a thyroid neoplasm. Pseudocolloid was found in seven cases. Criteria for the differentiation between parathyroid hyperplasia and adenomas were not discovered. In addition, the cytology and differential diagnosis of atypical parathyroid adenomas are described and illustrated.
Topics: Adenoma; Humans; Hyperplasia; Parathyroid Glands; Parathyroid Neoplasms; Staining and Labeling
PubMed: 2424691
DOI: 10.1002/dc.2840020116