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Multifocal Carcinoma (multifocal + carcinoma)
Selected AbstractsAggressive, multifocal oral verrucous leukoplakia: proliferative verrucous leukoplakia or not?JOURNAL OF ORAL PATHOLOGY & MEDICINE, Issue 7 2003Naseem Ghazali Abstract Background:, Some oral verrucal lesions may constitute parts of the clinicopathological spectrum of proliferative verrucous leukoplakia (PVL). Because of its idiopathic yet sinister nature, it is possible that PVL may exist in other populations. The aim of this study was to review the clinicopathological features of persistent, multifocal, oral verrucal lesions in Malaysian population. Methods:, Patients with multifocal oral verrucal lesions were selected from surgical and histopathological records. Results:, Nine patients of diverse ethnicity with 43 biopsies were reviewed. The mean age at the presentation was 62 years. The most frequent sites affected were gum, sulci, cheek and tongue. Indulgence in risk habits was reported in about 70% of patients. Four cases developed multifocal carcinoma from multifocal leukoplakia. Conclusions:, In retrospect, none of the cases fulfilled the original PVL criteria, although three cases were suggestive of PVL. Nevertheless, these findings do not necessarily preclude the existence of PVL as a clinicopathological entity in Malaysian population. [source] Primary tumour diameter as a risk factor for advanced disease features of differentiated thyroid carcinomaCLINICAL ENDOCRINOLOGY, Issue 2 2009Frederik A. Verburg Summary Objective, To study the relationship between primary tumour size and the risk of advanced disease features (multifocal or locally invasive disease, lymph-node or distant metastases) in differentiated thyroid carcinoma (DTC). Design, A retrospective chart review study. Patients, The study sample comprised 935 papillary (PTC) and 291 follicular thyroid carcinoma (FTC) patients treated in our hospital from 1978 to 2007. Measurements, Kaplan,Meier analyses and log-rank tests were performed to calculate tumour size-adjusted cumulative risk of advanced disease features. Results, Accounting for primary tumour diameter, there were no significant differences in cumulative risks of multifocal carcinoma (P = 0·12) or distant metastases (P = 0·49) between PTC and FTC. PTC showed higher cumulative risks of local invasion (P < 0·0001) or lymph-node metastases (P < 0·0001). The cumulative risk of tumour multifocality increased 5%/cm of primary tumour diameter. The cumulative risk of local invasion or lymph-node metastases in PTC and of distant metastases in DTC increased exponentially at a threshold tumour diameter of 10 mm. In FTC, lymph-node metastases are associated almost exclusively with primary tumours showing extrathyroidal growth. Conclusions, Starting with a 1 cm primary tumour diameter, increasing tumour size is associated with an exponentially increasing risk of local invasion or lymph-node or distant metastases of DTC. The current classification of carcinomas < 2 cm as T1 is therefore questionable. [source] Origin of multifocal carcinomas of the bladder and upper urinary tract: Molecular analysis and clinical implicationsINTERNATIONAL JOURNAL OF UROLOGY, Issue 8 2005TOMONORI HABUCHI Abstract The simultaneous or metachronous development of multifocal tumors with identical or variable histological features in the urothelial tract in a single patient is a well-known characteristic of urothelial cancer. To explain this phenomenon, two distinct concepts have been proposed: the ,field defect' hypothesis according to which urothelial cells in patients are primed to undergo transformation by previous carcinogenic insults and the ,single progenitor cell' hypothesis, which asserts that the multifocal development is caused by the seeding or intraepithelial spread of transformed cells. Results of recent molecular genetic studies support the ,single progenitor cell' hypothesis, and indicate that the genetic and phenotypic diversity observed in multifocal urothelial tumors is a consequence of clonal evolution from a single transformed cell. An understanding of the mechanism of the heterotopic recurrence of urothelial cancer may provide new prospects for early molecular detection and prevention of heterotopic recurrence of urothelial cancer. [source] Utility of fine-needle aspiration for diagnosis of carcinoma associated with multinodular goitreCLINICAL ENDOCRINOLOGY, Issue 6 2004Antonio Ríos Summary background, Fine-needle aspiration (FNA) is a useful method for evaluating a solitary thyroid nodule; however, this is not an agreed method for a multinodular goitre (MNG). The aim of this study was to assess the utility of preoperative FNA for detecting malignancy in MNG. patients and method, We analysed operated MNGs in which FNA had been performed. Puncture was carried out on the dominant nodule and any other nodules with features suggesting malignancy. The diagnosis was classed as colloid, follicular or Hürthle proliferation, suggestive of malignancy, haematic and inadequate. The thyroid FNA results, grouped into suggestive of malignancy (positive result) and other diagnoses (negative result), were compared to those of the final histological study in order to calculate the value of the test in diagnosing malignancy. results, FNA was performed in 432 MNGs, of which 42 (9·7%) were associated with carcinoma. Overall, the results of the test were poor, revealing a sensitivity of 17%, specificity of 96% and diagnostic accuracy of 88%, with a positive predictive value of 32% and negative predictive value of 88%. When the values were recalculated with the exclusion of microcarcinomas ,considering their minor clinical importance , there was a slight improvement in the results: the sensitivity increased to 26%, diagnostic accuracy to 93% and negative predictive value to 96%. However, the specificity remained at 96%, and the positive predictive value fell from 32% to 25%. The results of the test improved in multifocal carcinomas. conclusions, Thyroid fine needle aspiration is not useful for differentiating MNG with malignant degeneration from benign MNG, as more than 80% of carcinomas go unnoticed; it provides a sensitivity of 17% for detecting carcinomas, rising to 26% if microcarcinomas are excluded. We therefore suggest that clinical criteria should prevail over FNA. [source] | ||||||||||