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Diagnostic Cytopathology Jan 2021Salivary gland lymphadenoma (LAD) is a rare benign neoplasm comprising sebaceous (SLAD) and nonsebaceous (NSLAD) types. Despite established histologic criteria, limited...
BACKGROUND
Salivary gland lymphadenoma (LAD) is a rare benign neoplasm comprising sebaceous (SLAD) and nonsebaceous (NSLAD) types. Despite established histologic criteria, limited data on cytomorphology, tumor heterogeneity, and overlap with other entities make the diagnosis of LAD by fine needle aspiration (FNA) challenging. We describe a multi-institutional cohort of 14 LADs with cytology, clinical, radiologic, and histopathologic data.
METHODS
Our cohort included nine SLAD and five NSLAD with corresponding histopathology. Mean patient age and M:F ratio were 60.4 years (range 45-86 years) and 1:2 for SLADs and 57.4 years (range 42-80 years) and 1:1.5 for NSLADs, respectively. One NSLAD patient had a germline predisposition for Cowden syndrome. Glass slides and whole slide images of air-dried Diff-Quik (DQ), alcohol-stained Papanicolaou smears (Pap) and cellblocks were reviewed for key cytomorphologic findings.
RESULTS
FNAs from SLAD and NSLADs demonstrated vacuolated and basaloid epithelial clusters within a lymphoid background. Vacuolated cells from SLAD showed sebaceous cells with microvesicular cytoplasm indenting a central nucleus. Vacuolated cells from NSLAD were columnar with eccentric nuclei, corresponding to abluminal glandular cells. SLADs were classified using the Milan System for Reporting Salivary Gland Cytopathology as nondiagnostic (11.1%), nonneoplastic (44.4%), atypia of uncertain significance (AUS) (22.2%), and salivary gland neoplasm of uncertain malignant potential (SUMP) (22.2%). NSLADs were classified as AUS (40%), SUMP (40%) and Benign Neoplasm (20%).
CONCLUSION
Although rare, knowing the cytologic features of salivary LAD is important to avoid diagnostic pitfalls. Vacuolated cells can be prominent in both SLAD and NSLAD aspirates. Diagnostic issues arise from insufficient sampling of all tumor components leading to marked variation in diagnostic classification of LAD.
Topics: Adult; Aged; Aged, 80 and over; Biopsy, Fine-Needle; Cytodiagnosis; Diagnosis, Differential; Epithelial Cells; Female; Humans; Male; Middle Aged; Precancerous Conditions; Retrospective Studies; Salivary Gland Neoplasms; Salivary Glands; Specimen Handling
PubMed: 32926569
DOI: 10.1002/dc.24602 -
Medicine Sep 2021Plexiform fibromyxoma (PF) is a rare mesenchymal neoplasm which can be misdiagnosed as the gastrointestinal stromal tumor. This tumor almost formed a lobulated... (Review)
Review
Plexiform fibromyxoma (PF) is a rare mesenchymal neoplasm which can be misdiagnosed as the gastrointestinal stromal tumor. This tumor almost formed a lobulated intramural/submucosal mass in the gastric antrum and prepyloric area. It was considered as a benign tumor that exhibited no recurrence, metastasis, or tumor-related mortality. In this study, we reported 2 cases of gastric PF. The first case was a PF patient coexisting with gastric adenocarcinoma. The second case occurred in the gastric upper body close to gastric fundus. They underwent distal gastrectomy and laparoscopic partial gastric resection, respectively. Both of them exhibited a plexiform growth pattern in the submucosa, muscularis propria, and subserosal adipose tissues. The nodules were composed of abundant myxoid or fibromyxoid matrix riching in small thin-walled blood vessels and bland-looking spindle cells. The first case partially showed staggered growth pattern of PF and adenocarcinoma. Immunohistochemically, the spindle cells were diffusely immunoreactive for SMA and vimentin, and focally immunoreactive for CD10. It was important to distinguish the PF from other spindle cell tumors involving the stomach.
Topics: Adenocarcinoma; Adult; Diagnosis, Differential; Female; Fibroma; Gastrectomy; Humans; Male; Middle Aged; Neoplasm Recurrence, Local; Neoplasms, Multiple Primary; Stomach Neoplasms
PubMed: 34516510
DOI: 10.1097/MD.0000000000027164 -
Pathology Oncology Research : POR Jun 2009Intranodal palisaded myofibroblastoma (IPM) also called as intranodal hemorrhagic spindle cell tumor with amianthoid fibers is a distinctive and rare mesenchymal... (Review)
Review
Intranodal palisaded myofibroblastoma (IPM) also called as intranodal hemorrhagic spindle cell tumor with amianthoid fibers is a distinctive and rare mesenchymal neoplasm of lymph nodes. This entity generally misdiagnosed as intranodal Kaposi's sarcoma or schwannoma in past. In contrast to Kaposi's sarcoma, it behaves in a benign fashion and does not need any further therapy except total surgical resection of the mass. This neoplasm has a great predilection for the inguinal region. The lesion presents typically as a unilateral, painless, solitary mass. To our knowledge, approximately 53 cases of IPM have been reported in the English-language literature. We present a 43-year-old-male patient with IPM and discuss histological, immunohistochemical features and pathogenesis of this rare benign neoplasm.
Topics: Adult; Biomarkers, Tumor; Carcinoma; Humans; Immunoenzyme Techniques; Lymph Nodes; Male; Neoplasms, Muscle Tissue
PubMed: 18991023
DOI: 10.1007/s12253-008-9122-0 -
BMJ Open Sep 2021The purpose of this scoping review is to: (1) identify existing supervised machine learning (ML) approaches on the prediction of cancer in asymptomatic adults; (2) to... (Review)
Review
OBJECTIVES
The purpose of this scoping review is to: (1) identify existing supervised machine learning (ML) approaches on the prediction of cancer in asymptomatic adults; (2) to compare the performance of ML models with each other and (3) to identify potential gaps in research.
DESIGN
Scoping review using the population, concept and context approach.
SEARCH STRATEGY
PubMed search engine was used from inception to 10 November 2020 to identify literature meeting following inclusion criteria: (1) a general adult (≥18 years) population, either sex, asymptomatic (population); (2) any study using ML techniques to derive predictive models for future cancer risk using clinical and/or demographic and/or basic laboratory data (concept) and (3) original research articles conducted in all settings in any region of the world (context).
RESULTS
The search returned 627 unique articles, of which 580 articles were excluded because they did not meet the inclusion criteria, were duplicates or were related to benign neoplasm. Full-text reviews were conducted for 47 articles and a final set of 10 articles were included in this scoping review. These 10 very heterogeneous studies used ML to predict future cancer risk in asymptomatic individuals. All studies reported area under the receiver operating characteristics curve (AUC) values as metrics of model performance, but no study reported measures of model calibration.
CONCLUSIONS
Research gaps that must be addressed in order to deliver validated ML-based models to assist clinical decision-making include: (1) establishing model generalisability through validation in independent cohorts, including those from low-income and middle-income countries; (2) establishing models for all cancer types; (3) thorough comparisons of ML models with best available clinical tools to ensure transparency of their potential clinical utility; (4) reporting of model calibration performance and (5) comparisons of different methods on the same cohort to reveal important information about model generalisability and performance.
Topics: Adult; Calibration; Humans; Machine Learning; Neoplasms; Risk Factors; Supervised Machine Learning
PubMed: 34521662
DOI: 10.1136/bmjopen-2020-047755 -
International Journal of Environmental... May 2022This study focused on investigating possible associations between exposure to urban air pollution and the number of emergency department (ED) visits for various health...
This study focused on investigating possible associations between exposure to urban air pollution and the number of emergency department (ED) visits for various health outcomes. The outcomes were grouped into four chapters of the International Classification of Diseases Tenth Revision (ICD-10) system (i.e., Chapter II-IV: "Neoplasms", "Diseases of the blood", "Endocrine, nutritional and metabolic diseases", and XVIII: "Symptoms, signs and abnormal clinical and laboratory findings"). The data were collected for the city of Toronto, Canada, (2004-2015, 4292 days). Four gaseous air pollutants (carbon monoxide (CO), nitrogen dioxide (NO), ground level ozone (O), and sulfur dioxide (SO)) and fine particulate matter (PM), and two calculated air quality health indexes (AQHI) based on Toronto were used. The statistical models were constructed by applying the conditional Poisson regression. The exposure was assessed over a maximum of 15 days (time lags 0-14 days). An analysis was performed with the following strata: sex, age, and seasons. Relative risks (RR) and their 95% confidence intervals (95%CI) were estimated for an increase in concentration by a one interquartile range (IQR). For the AQHI (composed of NO, O, and PM), IQR = 1, the estimations for lag 1 and all patients, are RR = 1.023 (95%CI: 1.008, 1.038), 1.026 (1.012, 1.040), 1.013 (1.003, 1.024), and 1.007 (1.003, 1.010) for Chapters II-IV and XVIII, respectively. The results show that in the four large, analyzed health groups, the impact of air quality mainly occurs over a short period (from current day to a maximum of 3 days after exposure).
Topics: Air Pollutants; Air Pollution; Emergency Service, Hospital; Environmental Exposure; Humans; Neoplasms; Nitrogen Dioxide; Ozone; Particulate Matter; Sulfur Dioxide
PubMed: 35564996
DOI: 10.3390/ijerph19095603 -
The Kurume Medical Journal Jan 2020Mammography after breast-conserving surgery and radiation therapy is an important tool for followup. Early diagnosis of local recurrence enables prompt treatment... (Review)
Review
Mammography after breast-conserving surgery and radiation therapy is an important tool for followup. Early diagnosis of local recurrence enables prompt treatment decisions, which may affect patient prognosis. For complicated post-treatment changes, radiologists sometimes have difficulties in interpreting follow-up mammography. Fat necrosis, dystrophic calcifications, suture calcification features, breast edema, seroma and distorted breast are benign changes related to treatment. These findings may mimic or hide tumor recurrence making it difficult to diagnose recurrences or prevent inappropriate biopsies. Recurrent tumors in follow-up mammography show several typical findings such as increasing asymmetric density, enlarging mass, reappearance of breast edema, and micro-calcifications. The purpose of this pictorial review is to demonstrate and discuss mammographic findings of recurrent tumors and important post-treatment changes that may mimic benign or malignant lesions, also using breast ultrasound images or breast magnetic resonance images. Recognizing post-treatment changes may help radiologists to more effectively identify candidates for suspected local recurrences.
Topics: Breast Neoplasms; Diagnosis, Differential; Female; Humans; Magnetic Resonance Imaging; Mammography; Mastectomy, Segmental; Neoplasm Recurrence, Local; Predictive Value of Tests; Radiotherapy, Adjuvant; Treatment Outcome; Ultrasonography, Mammary
PubMed: 31723078
DOI: 10.2739/kurumemedj.MS654005 -
Arthritis Research & Therapy Nov 2023Prior research has revealed a heightened prevalence of neoplasms in individuals diagnosed with rheumatoid arthritis (RA). The primary objective of this study is to delve...
OBJECTIVE
Prior research has revealed a heightened prevalence of neoplasms in individuals diagnosed with rheumatoid arthritis (RA). The primary objective of this study is to delve into the causal association between RA and two distinct types of neoplasms: benign neoplasm of bone and articular cartilage (BNBAC) and malignant neoplasm of bone and articular cartilage (MNBAC).
METHODS
We employed summary data from genome-wide association analyses (GWAS) to investigate the causal relationship between RA and two neoplasms, BNBAC and MNBAC, using a two-sample bidirectional Mendelian randomization (MR) study design. The IEU OpenGWAS database provided the GWAS summary data for RA, while the Finnish consortium supplied the GWAS summary data for BNBAC and MNBAC. Our analysis involved the utilization of eight distinct MR methods, namely random-effects inverse variance weighted (IVW), MR Egger, weighted median, simple mode, weighted mode, maximum likelihood, penalized weighted median, and fixed effects IVW. Subsequently, we conducted assessments to evaluate heterogeneity, horizontal pleiotropy, outliers, the impact of a single-nucleotide polymorphism (SNP), and adherence to the assumption of normal distribution in the MR analysis.
RESULTS
The results from the MR analysis revealed that there was no significant genetic association between RA and BNBAC (P = 0.427, odds ratio [OR] 95% confidence interval [CI] = 0.971 [0.904-1.044]). However, a positive genetic association was observed between RA and MNBAC (P = 0.001, OR 95% CI = 1.413 [1.144-1.745]). Conducting a reverse MR analysis, we found no evidence to support a genetic causality between BNBAC (P = 0.088, OR 95% CI = 1.041 [0.994-1.091]) or MNBAC (P = 0.168, OR 95% CI = 1.013 [0.995-1.031]) and RA. Our MR analysis demonstrated the absence of heterogeneity, horizontal pleiotropy, and outliers and confirmed that the effect was not driven by a single SNP. Additionally, the data exhibited a normal distribution.
CONCLUSION
The findings of this study demonstrate that RA constitutes a significant risk factor for MNBAC. In the context of clinical application, it is advisable to conduct MNBAC screening in RA patients and remain vigilant regarding its potential manifestation. Importantly, the outcomes of this investigation introduce a fresh vantage point into the understanding of the tumorigenesis associated with RA.
Topics: Humans; Cartilage, Articular; Genome-Wide Association Study; Mendelian Randomization Analysis; Neoplasms; Arthritis, Rheumatoid
PubMed: 37957703
DOI: 10.1186/s13075-023-03205-5 -
Tidsskrift For Den Norske Laegeforening... Aug 2000Tumours of the heart are rare, but of great clinical interest as the majority are benign and amenable to radical excision.
BACKGROUND
Tumours of the heart are rare, but of great clinical interest as the majority are benign and amenable to radical excision.
MATERIAL AND METHODS
We report on 30 patients with cardiac tumours resected at the National Hospital, Oslo, Norway from 1990 to 1999. Data were obtained from patient files.
RESULTS
27 patients had benign tumours, 25 of which were myxomas predominantly located in the left atrium. One patient had a primary malignant tumour (rhabdomyosarcoma) and two had secondary malignant tumours (metastases from malignant tumours). All patients were alive at follow-up four to ten years after operation.
INTERPRETATION
Patient with benign tumours are cured by surgery, whereas in malignant primary tumours the surgery will most often be palliative. Surgery for cardiac metastases may be indicated in selected symptomatic patients.
Topics: Adolescent; Adult; Aged; Child; Child, Preschool; Echocardiography; Female; Fibroma; Follow-Up Studies; Heart Neoplasms; Humans; Infant; Male; Middle Aged; Myxoma; Neoplasm Recurrence, Local; Palliative Care; Retrospective Studies; Rhabdomyoma; Rhabdomyosarcoma
PubMed: 11475222
DOI: No ID Found -
Archives of Pathology & Laboratory... Jul 2007Plexiform fibrohistiocytic tumor is a rare mesenchymal neoplasm of intermediate malignancy, first reported by Enzinger and Zhang in 1988. It has a predilection for... (Review)
Review
Plexiform fibrohistiocytic tumor is a rare mesenchymal neoplasm of intermediate malignancy, first reported by Enzinger and Zhang in 1988. It has a predilection for children and young adults but can occur at any age. The tumor usually involves the upper limbs as a slow-growing, painless mass. The tumor has a high local recurrence rate but metastasizes only rarely. Histologically, the tumor is characterized by poorly demarcated dermal or subcutaneous mass with multinodular plexiform growth and fibrohistiocytic cytomorphology. There are three distinct recognized growth patterns: fibrohistiocytic, fibroblastic, and mixed types. The tumor displays uniform immunoreactivity for vimentin and CD68. Ultrastructurally, the tumor cells have features of myofibroblasts and histiocyte-like cells. Complete surgical resection of the tumor, preferably with wider margins, is required to prevent local recurrence. Long-term follow-up is necessary to detect any nodal or pulmonary metastasis.
Topics: Adolescent; Adult; Aged; Child; Child, Preschool; Diagnosis, Differential; Female; Histiocytoma, Benign Fibrous; Humans; Infant; Male; Middle Aged; Prognosis; Soft Tissue Neoplasms
PubMed: 17617005
DOI: 10.5858/2007-131-1135-PFTABR -
Medicine Apr 2019Ganglioneuromas are benign neoplasm of neuroblastic origin which arise from central or peripheral parts of the autonomic nervous system. They are normally found at... (Review)
Review
RATIONALE
Ganglioneuromas are benign neoplasm of neuroblastic origin which arise from central or peripheral parts of the autonomic nervous system. They are normally found at posterior mediastinum, retroperitoneum, and the adrenal gland but ganglioneuromas are rarely found in the cervical region.
PATIENT CONCERNS
A 12-year-old boy was admitted with a left-lateral neck mass slow growing over a 7-days duration. The tumor was painless and was not associated with any systemic or compression-related symptoms. No symptoms of Horner's syndrome, including ptosis, myosis, ipsilateral facial anhidrosis, and flushing, were observed. Laboratory routine tests were within normal limits, and magnetic resonance imaging demonstrated a solid and well-circumscribed mass in the carotid space.
DIAGNOSIS
Due to the patient's symptoms, laboratory test results together with radiographic investigation findings, the 12 years old boy was diagnosed with cervical ganglioneuroma combined with tetralogy of Fallot.
INTERVENTIONS
Surgical excision.
OUTCOMES
The postoperative period was uneventful with the exception of Horner's syndrome on the left side in short period, and it was finally resolved after 8 months recovery. The patient is now in stable condition after operation, with improvement in symptoms during follow-up recovery.
LESSONS
Ganglioneuromas should be accounted as the differential diagnosis of pediatric soft tissue tumors of the head and neck. The diagnosis for ganglioneuromas in cervical region can only be ascertained with postoperative pathologic examination, and excision is considered as the only effective treatment modality known so far which may cause Horner's syndrome at times. However, patients have a favorable prognosis without recurrence overall.
Topics: Cervical Vertebrae; Child; Diagnosis, Differential; Ganglioneuroma; Head and Neck Neoplasms; Humans; Male
PubMed: 30985715
DOI: 10.1097/MD.0000000000015203