			Home About us Contact

Diagnostic Biopsy (diagnostic + biopsy)

Distribution by Scientific Domains

Medical Sciences	100%

Distribution within Medical Sciences

Dermatology	31%
Oncology & Radiotherapy	12%

Selected Abstracts

Muir,Torre syndrome: Diagnostic and screening guidelines

AUSTRALASIAN JOURNAL OF DERMATOLOGY, Issue 4 2006
Brad Jones
SUMMARY A 65-year-old man presented with a history of multiple skin coloured papules on his face that were asymptomatic. He had an adenocarcinoma resected from his proximal colon 12 years prior to presentation as well as a family history of colon cancer on the maternal side. Diagnostic biopsies showed the lesions to be sebaceous adenomas and epitheliomas and the diagnosis of Muir,Torre syndrome was made. The sebaceous tumour tissue showed microsatellite instability and immunohistochemical staining indicated diminished expression in the DNA mismatch,repair protein complex MSH2/MSH6. Genetic analysis showed a germline mutation in the MSH2 gene confirming the diagnosis of Muir,Torre syndrome. The patient and his first-degree relatives have been referred for genetic counselling and screening. We review the diagnostic criteria in this syndrome and review the recommended screening guidelines. [source]

Dabska tumor arising in lymphangioma circumscriptum

JOURNAL OF CUTANEOUS PATHOLOGY, Issue 1 2008
Patrick O. Emanuel
We describe a case of Dabska tumor (DT) occurring within a large congenital lymphangioma circumscriptum on the thigh of a 14-year-old female. Diagnostic biopsy showed numerous intravascular papillary projections lined by atypical endothelial cells within the anastomosing vascular channels of a lymphangioma circumscriptum. DT is regarded as a vascular tumor of intermediate malignant potential, most probably of lymphatic origin. Although it has been described in pre-existing lymphangiomas, to the best of our knowledge this is the first case to be described in a pre-existing lymphangioma circumscriptum. During a follow-up of 9 years, the lymphangioma circumscriptum has recurred, but there has been no evidence of DT recurrence or metastasis. [source]

Thymic carcinoma in children: A report from the Polish pediatric rare tumors study,

PEDIATRIC BLOOD & CANCER, Issue 7 2010
Teresa Stachowicz-Stencel MD
Abstract Background Invasive thymomas and thymic carcinomas are rare tumors jointly accounting between 0.2% and 1.5% of malignancies in adults. They are usually at an advanced stage when diagnosed and have both high recurrence and poor survival rates. In this report, the aim is to explore our experience in the treatment of thymic carcinomas in Polish children. Procedure The clinical data of nine children with thymic carcinomas, treated between 1992 and 2008 in the Polish oncological and surgical centers was retrospectively analyzed. Results In five cases, presenting symptoms resulted from the compression of the respiratory ways by the mediastinal tumor. In two children paraneoplastic autoimmune syndromes were associated with thymic carcinoma. In accordance with the Masaoka classification, two patients had stage II, five had stage III, and two had stage IV of the disease. Diagnostic biopsy of mediastinal tumor was performed on eight patients and one underwent complete primary resection and subsequently received radiotherapy; he has passed 11 years since the conclusion of therapy. Six patients received multi-drug chemotherapy with or without steroids. Delayed surgery was performed in four children (R0-2, R1-1, and R2-1). After complete resection, one child received chemotherapy. In three patients, chemotherapy and radiotherapy was administered. Seven patients died, including six due to progression of the disease with the other as a result of complications following chemotherapy; only two patients classed at stage II remain alive. Conclusions Most thymic tumors in pediatric patients are inoperable at diagnosis, which results in poor prognosis. Improved chemotherapy approaches are needed. Pediatr Blood Cancer 2010;54:916,920 © 2010 Wiley-Liss, Inc. [source]

Microcystic Adnexal Carcinoma: A Case Series Treated with Mohs Micrographic Surgery and Identification of Patients in Whom Paraffin Sections May Be Preferable

DERMATOLOGIC SURGERY, Issue 4 2010
IOULIOS PALAMARAS MD
BACKGROUND Microcystic adnexal carcinoma (MAC) is a rare cutaneous tumor characterized by aggressive local infiltration, including a high propensity for perineural invasion (PNI). OBJECTIVES To report our experience in treating MAC using Mohs micrographic surgery (MMS) with frozen sections and to identify patients in whom that technique may have limitations. MATERIALS & METHODS A review of records between 1992 and 2008. RESULTS Nine patients with MAC were identified. All tumors were located on the face. PNI was noted in the diagnostic biopsies of two patients with periocular MAC, in both of whom tumor persisted after MMS. The mean duration of follow-up was 5.4 years. CONCLUSIONS MMS with frozen sections is reliable for treating primary MAC in which PNI is not present on a diagnostic biopsy. Previous surgery and PNI were associated with greater risk of persistence in periocular MAC. In these patients, it may be appropriate to consider MMS with paraffin-embedded sections, possibly as a layer after apparent clearance on frozen sections. Further excision of orbital contents should be considered in periocular MAC that infiltrate the deep orbital fat or are noted to have PNI. The authors have indicated no significant interest with commercial supporters. [source]

Scope of practice, referral patterns and lesion occurrence of an oral medicine service in Australia

ORAL DISEASES, Issue 4 2008
CS Farah
Aim:, The purpose of this study was to examine the scope of practice, lesion occurrence and utilisation of referral-based hospital and private practice oral medicine and oral pathology (OMP) services in Australia. Materials and methods:, Clinical records of patients referred to a hospital (n=500) and private (nbequals;1104) OMP clinic were audited. For each patient, the following parameters were recorded: age, gender, source of referral, reason for referral, site of lesion/condition if applicable, medical and drug history, diagnostic services utilised, clinical and histopathological diagnoses rendered, medications prescribed and further treatment required. Results:, A majority of the referrals were generated by general dental practitioners. The most commonly seen problems were epithelial hyperplasia/hyperkeratosis, oral candidosis, oral lichen planus, xerostomia, recurrent aphthous ulcers and burning mouth syndrome. OMP specialists requested diagnostic imaging for 13% of hospital and 9.42% of private patients, diagnostic biopsies were required for 18.4% of hospital and 19.3% of private patients, blood tests were ordered for 14.4% of hospital and 12.13% of private patients, while medications were prescribed for approximately 36% of hospital and 51% of private patients. Conclusions:, This study is the first to detail the scope of practice, lesion occurrence and utilisation of services offered by OMP specialists in Australia. The demand for OMP services is strong. [source]

Microcystic Adnexal Carcinoma: A Case Series Treated with Mohs Micrographic Surgery and Identification of Patients in Whom Paraffin Sections May Be Preferable

Diagnosing cancer: changing patterns of care

INTERNAL MEDICINE JOURNAL, Issue 2 2007
E. Lim
Abstract We prospectively assessed 100 consecutive inpatient referrals made to the Medical Oncology Unit. The major end-point was the time to diagnostic biopsy. Referral trends and treatment outcomes were also recorded. Our results show that the referring units undertook the diagnostic process in the vast majority and the time to inpatient diagnostic biopsy has fallen from 10 to 4.6 days, compared with a similar study 13 years ago. This emphasizes the changing role of the oncologist in current day multidisciplinary cancer care. [source]

Role of systematic ultrasound-guided staging biopsies in predicting extraprostatic extension and seminal vesicle invasion in men with prostate cancer

JOURNAL OF CLINICAL ULTRASOUND, Issue 3 2002
Koji Okihara MD
Abstract Purpose To assess the presence of extraprostatic extension and seminal vesicle invasion in men with prostate cancer, we performed systematic staging biopsies targeting neurovascular bundles, seminal vesicles, and other extraprostatic tissues before the men underwent radical prostatectomy. We retrospectively evaluated the clinical efficacy of these systematic staging biopsies compared with digital rectal examination (DRE) and transrectal sonography (TRUS). Methods Two hundred forty-four candidates for prostatectomy who had a diagnostic biopsy Gleason score of 8 or higher and/or indications of extraprostatic extension (eg, seminal vesicle invasion) by DRE or TRUS underwent staging biopsies using an 18-gauge Tru-Cut needle under real-time TRUS guidance between June 1997 and March 2000. We determined the number of staging biopsy cores to be taken based on the Gleason score of the diagnostic biopsy as well as abnormal DRE and/or TRUS findings. The chi-square test was used to evaluate the statistical significance of differences. Results There were no complications of staging biopsy. In 75 (31%) of the 244 patients, results of the staging biopsies were positive. The clinical stage was upgraded by staging biopsy in 18 (24%) of these 75 patients. After the staging biopsies, 90 patients underwent radical prostatectomy. Among these 90 patients, staging biopsy specimens were positive for cancer in 20 (47%) of the 43 patients who received neoadjuvant therapy and in 1 (2%) of the 47 patients who did not receive neoadjuvant therapy. There were no false-positive staging biopsies in either group. Among the 90 patients who underwent radical prostatectomy, the false-negative rate for the prediction of organ-confined disease was 43% (30/69) for staging biopsies compared with 29% (10/34) for TRUS. The diagnostic accuracy of staging biopsies (67%; 60/90) was higher than that of DRE (52%; 47/90; p < 0.05) but lower than that of TRUS (79%; 71/90; p = 0.066). Conclusions Staging biopsies can reliably sample extraprostatic tissue, including the seminal vesicles and neurovascular bundles. Positive staging biopsy results can aid in the selection of treatment options and in the prediction of outcome for individual patients by providing definitive histologic confirmation of locally advanced disease. Conventional predictive variables for staging can be applied when the results of staging biopsies are negative. © 2002 Wiley Periodicals, Inc. J Clin Ultrasound 30:123,131, 2002; DOI 10.1002/jcu.10052 [source]

Pancreatic adenocarcinoma in a young patient population,12-year experience at Memorial Sloan Kettering Cancer Center

JOURNAL OF SURGICAL ONCOLOGY, Issue 1 2009
A. Duffy MD
Abstract Background There is a dearth of data in a younger population of patients with pancreatic ductal adenocarcinoma (PAC) regarding epidemiology, genetics, prognosis, and outcome. This report examines a large cohort of patients with PAC ,45 years of age evaluated at MSKCC over a 12-year period. Methods A retrospective analysis of patients referred to MSKCC with PAC identified from the institutional tumor registry, who were ,45 years on the date of the diagnostic biopsy, between January 1995 and February 2008, was performed. Information reviewed included demographics, clinical and pathological staging, surgical management, therapy, date of relapse, death or last follow-up. Survival curves were estimated using the Kaplan,Meier method and compared using the log-rank test. Results One hundred thirty-six cases of PAC, age ,45 years at diagnosis, were identified. Seventy-four (54%) females, 62 (46%) males. Age range: 24,45; 4, 38, and 94 patients in age groups 20,29, 30,39, 40,45 years, respectively. Fifty (37%) had a smoking history. Fourteen (10.3%) had a positive family history of PAC. Thirty-five (25.7%) underwent a curative resection for localized disease. Twenty-eight (20.1%) presented with locally advanced, inoperable disease. Sixty-eight (50%) presented as AJCC Stage IV. Twenty-three (37%) of those resected underwent adjuvant chemoradiation. Thirteen received adjuvant gemcitabine. The median overall survival for the entire cohort was 12.3 months (95% CI 10.2,14.0 months). The median overall survival for the patients with locally resectable disease was 41.8 months (95% CI 20.3,47 months). The median overall survival for the patients who presented with locally advanced, unresectable disease was 15.3 months (95% CI 12,19.3 months). The median overall survival for those who presented with metastatic disease was 7.2 months (95% CI 5.2,9.5 months). Conclusions This is the largest reported cohort of young patients with PAC ,45 years of age. The data suggest that patients with stages I,II disease may have an improved prognosis, however the prognosis for stages III,IV patients appears to be similar to the typical (older) patient population with PAC. J. Surg. Oncol. 2009;100:8,12. © 2009 Wiley-Liss, Inc. [source]

Age-related changes in the human thymus studied with scanning electron microscopy

MICROSCOPY RESEARCH AND TECHNIQUE, Issue 8 2008
Carlo Cavallotti
Abstract This investigation describes some morphological, age-related changes in different compartments and cells of the human thymus. Scanning electron microscopic observations were done on human thymus samples obtained from four young and eight elderly patients during thoracic surgery and/or diagnostic biopsy of the thymus, after receiving authorization from the Ethical Committee of our university. The morphological data were submitted to quantitative image analysis so as to obtain quantitative results. Subsequently, the related values were used for statistical analysis. Our findings demonstrate that (1) all thymus compartments (subcapsular spaces, cortical, medullar, thymus microenvironment) contain numerous thymocytes even after the thymus has aged. (2) In older humans, residual thymus lymphoid islets contain, in addition to fatty cells and/or fibrous cells, also the same types of resident and nonresident cells (permanent and moving cells) that are found in young and adult subjects. (3) Endothelial cells of thymus microvessels contain numerous gaps. These gaps are tight in young subjects and become loose with age. (4) Thymocytes, in older subjects, are always found near these loose endothelial gaps of thymus microvessels. (5) While thymus cortical microvessels are provided with pericytes and/or periarteriolar spaces, microvessels of the thymus medullar are free of such spaces. Our morphological and quantitative results lead us to consider the possibility that the thymus fraction of resident and permanent cells (including thymocytes and reticular epithelial cells) is larger in younger subjects compared with older ones. The endothelial loose gaps of thymus microvessels, in older subjects, can allow the bidirectional transit of thymocytes through the wall of the said microvessels. Microsc. Res. Tech., 2008. © 2008 Wiley-Liss, Inc. [source]

Serologic screening for celiac disease in children: a comparison between established assays and tests with deamidated gliadin-derived peptides plus conjugates for both IgA and IgG antibodies

APMIS, Issue 11 2009
ANNA-KARIN ÅBERG
Selection of patients for diagnostic biopsy concerning celiac disease (CD) is mainly guided by the results with serological screening tests like anti-tissue-transglutaminase (tTG), anti-endomysium (EmA) and anti-gliadin (AGA) IgA. New tests using deamidated gliadin-derived peptides (DGP) including both IgA and IgG antibodies have been developed, to cover the IgA-deficient sera. In addition, a combined IgA and IgG DGP test, with or without human erythrocyte-derived tTG, offers possible advantages. In order to explore the screening accuracy of the new combination tests sera from 167 children below 3 years of age were assayed. Biopsy had been taken in connection with serology in 32 of these children, 24 with histopathological CD. The results with the DGP and the combined test were congruent with the IgA antibody tests for tTG, EmA and AGA, all identifying 21 of 24 of the CD cases. Two of the CD patients were AGA-IgA positive only (2/24), while 2 of 24 sera were AGA,IgA negative but positive in all the other tests. These results raises the question whether the modifications of the gliadin antigen not only decrease false positivity but also give more false-negative results, a major drawback for a screening test for an important disease. Further studies have to be undertaken to explore this. Our results also stress that serologic screening of CD in children cannot be based on one test only. [source]

Squamous cell carcinoma of the hand masquerading as a cutaneous infection

AUSTRALASIAN JOURNAL OF DERMATOLOGY, Issue 1 2006
Jemima Fisher
SUMMARY A 33-year-old male concreter presented with a small abscess on his right index finger following an injury at work. Histological examination of the lesion was consistent with chronic inflammation and Staphylococcus aureus, Streptococcus anginosus and Escherichia coli were isolated on cultures. The lesion was treated as a chronic fungal infection with bacterial superinfection. Seventeen months later, a bone scan showed periarticular involvement, and a diagnostic biopsy identified a well-differentiated squamous cell carcinoma. He underwent amputation of his index and middle fingers. After 4 years of follow up, there has been no evidence of recurrence at the primary site, but he has since developed two further primary squamous cell carcinomas. This case emphasizes the importance of considering malignancy when dealing with chronic infections of the hand. [source]

DNA content in the diagnostic biopsy for benign-adjacent and cancer-tissue areas predicts the need for treatment in men with T1c prostate cancer undergoing surveillance in an expectant management programme

BJU INTERNATIONAL, Issue 3 2010
Sumit Isharwal
Study Type , Prognosis (case series)Level of Evidence 4 OBJECTIVE To assess the DNA content in benign-adjacent and cancer-tissue areas of a diagnostic biopsy, to predict which patients would subsequently develop an unfavourable biopsy necessitating treatment for prostate cancer in the expectant management (EM) programme. PATIENTS AND METHODS Of 71 patients who had benign-adjacent and cancer-tissue areas of diagnostic biopsies available, 39 developed unfavourable biopsies (Gleason score ,7, Gleason pattern 4/5, three or more cores positive for cancer, >50% of any core involved with cancer), while 32 maintained favourable biopsies on annual surveillance examination (median follow-up 3.7 years). DNA content was measured on Feulgen-stained biopsy sections using an automatic imaging system (AutoCyteTM, TriPath Imaging Inc, Burlington, NC, USA). Cox proportional-hazard regression and Kaplan-Meier plots were used to identify significant predictors for unfavourable biopsy conversion. RESULTS Univariately, DNA content measurements i.e. an excess of optical density (OD) in the benign-adjacent tissuer area, and the sd of the OD in the cancer tissue were significant, with a hazard ratio and 95% confidence interval of 2.58 (1.17,5.68; P = 0.019) and 5.36 (1.89,15.24; P = 0.002), respectively, for predicting unfavourable biopsy conversion that required intervention. Also, several other DNA content measurements in benign-adjacent and cancer-tissue areas showed a trend to statistical significance. Further, benign-adjacent excess of OD (3.12, 1.4,6.95; P = 0.005) and cancer sd of OD (5.88, 2.06,16.82; P = 0.001) remained significant in the multivariate model to predict unfavourable biopsy conversion. Patients with benign-adjacent excess of OD > 25.0 and cancer sd of OD of >4.0 had the highest risk for unfavourable biopsy conversion (P < 0.001). CONCLUSIONS DNA content measurements in the benign-adjacent and cancer-tissue areas appear to be useful for predicting unfavourable biopsy conversion (a recommendation for intervention) on annual surveillance examinations in the EM programme. [source]

Metanephric adenoma of the kidney: clinical and radiological study of nine cases

BJU INTERNATIONAL, Issue 11 2009
Cyrille Bastide
OBJECTIVE To analyse the clinical and radiological features of metanephric adenoma (MA, a rare benign renal tumour) in nine patients, and to review previous reports. PATIENTS AND METHODS From 1992 to 2007, we identified nine patients (eight women and one man) with MA at our institution. Four patients had a radical nephrectomy and five a partial nephrectomy. Preoperative imaging was reviewed by a senior radiologist. Renal colour Doppler ultrasonography (US), abdominal computed tomography and abdominal magnetic resonance imaging were used in seven, eight and four patients, respectively. RESULTS The mean (range) age of the patients was 46.8 (19,79) years. Six tumours were discovered incidentally. Three patients were symptomatic (two with haematuria and one with polycythaemia). There was no vascular flow on colour Doppler US within the tumours. There were peripheral and/or central calcifications in six of the tumours. All the tumours were well-circumscribed with minimal enhancement after injection with non-ionic intravenous contrast or gadolinium. CONCLUSIONS Renal MA is a benign tumour occurring mainly in young and middle-aged women. Polycythaemia is associated in ,10%. Generally, MA is solid, well-circumscribed and hypovascular, often with calcifications. Based on a combination of clinical and imaging features, it might be possible to suspect the diagnosis of MA and propose a preoperative diagnostic biopsy, a partial nephrectomy or active surveillance. [source]