Papillary mucinous metaplasia: a distinct precursor of mucinous adenocarcinoma of the endometrium

xlomafota13 shared this article with you from Inoreader Papillary mucinous metaplasia: a distinct precursor of mucinous adenocarcinoma of the endometrium Via International Journal of Clinical and Experimental Pathology Int J Clin Exp Pathol. 2022 Feb 15;15(2):83-87. eCollection 2022. ABSTRACT Mucinous adenocarcinoma of the endometrium is heterogeneous, consisting of endometrioid adenocarcinoma composed of >50% mucinous cells, low-grade mucinous adenocarcinoma, microglandular adenocarcinoma, and gastric (gastrointestinal)-type adenocarcinoma. Previous studies have reported that papillary mucinous metaplasia is a possible precancerous lesion of mucinous adenocarcinoma with frequent KRAS mutations. Recently, we encountered a case of pure mucinous adenocarcinoma of the endometrium with concurrent papillary mucinous metaplasia in a 35-year-old woman. She underwent 6-month hormonal therapy for atypical endometrial hyperplasia. A follow-up biopsy led to a diagnosis of mucinous adenocarcinoma; therefore, total hysterectomy was performed. The tumor showed abundant intracytoplasmic mucin and mild-to-moderate cytologic atypia with papillary architectu re. KRAS mutation analysis revealed a point mutation from GGT to GTT in codon 12. Although papillary mucinous metaplasia showed an overexpression of p16INK4, especially in the intragrandular papillary tufts, and a low MKi67 labeling index, overt mucinous adenocarcinoma with a loss of P16INK4a expression showed a high proliferating index of MKI67. The mass presented with stage ІA disease. During follow-up, the patient was stable and showed no recurrence. Considering the histologic similarity and incidence of KRAS mutations between papillary mucinous metaplasia and mucinous adenocarcinoma, papillary mucinous metaplasia may be a precancerous lesion for a subset of mucinous adenocarcinoma of the endometrium. PMID:35265257 | PMC:PMC8902477 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Porokeratosis: a differential diagnosis to consider in benign lichenoid keratosis

xlomafota13 shared this article with you from Inoreader Porokeratosis: a differential diagnosis to consider in benign lichenoid keratosis Via International Journal of Clinical and Experimental Pathology Int J Clin Exp Pathol. 2022 Feb 15;15(2):56-62. eCollection 2022. ABSTRACT Porokeratosis is a disorder of keratinization with many clinical variants. The histological hallmark feature of porokeratosis is a cornoid lamella. Other accompanying features include lichenoid inflammation, atrophy towards the centre of the lesion, dermal cytoid bodies, and adjacent lichenoid changes. Lichenoid keratosis is a benign cutaneous condition, thought to largely represent a degenerating seborrheic keratosis or solar lentigo. The classical histologic appearances are characterized by parakeratosis, epidermal acanthosis, and a dense band of lichenoid lymphocytic infiltrate. Since a lichenoid inflammatory reaction pattern can be seen in porokeratosis it has the potential to be misdiagnosed as a lichenoid keratosis if the cornoid lamella is not identified or missed due to sampling selection. We critically review 104 cases of benign lichenoid keratosis to e stablish whether any of these cases had features to support a diagnosis of porokeratosis. With 9.6% of cases considered for re-classification, we review clues to reaching this histologic diagnosis. PMID:35265253 | PMC:PMC8902476 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Pleomorphic high grade endometrial stromal sarcoma with YWHAE gene amplification may be a novel variant with poor prognosis

xlomafota13 shared this article with you from Inoreader Pleomorphic high grade endometrial stromal sarcoma with <em>YWHAE</em> gene amplification may be a novel variant with poor prognosis Via International Journal of Clinical and Experimental Pathology Int J Clin Exp Pathol. 2022 Feb 15;15(2):72-78. eCollection 2022. ABSTRACT Endometrial stromal neoplasms are classified by the World Health Organization (WHO) into endometrial stromal nodule (ESN), low grade (LGESS), high grade (HGESS), and undifferentiated uterine sarcoma (UUS). HGESS is subclassified based on molecular findings, YWHAE or BCOR. The HGESS with YWHAE::NUTM2A/B (alias YWHAE::FAM22A/B) fusion usually have relatively monomorphic (as with most fusion-associated malignancies) rounded to epithelioid cells with eosinophilic cytoplasm, vesicular nuclei, nucleoli, and mitotic figures >10/10 HPF. We present a 66-year-old woman with post-menopausal bleeding found to have a heterogeneous solid-cystic uterine mass on CT who underwent total hysterectomy, bilateral salpingo-oophorectomy, omentectomy, and pelvic lymph node dissection. A 15.0×9.0 cm variegated uterine mass with hemorrhage and necrosis was identified. Histologically, the tumor was hypercellular with haphazard fascicles, microcysts, and tongue-like destructive myometrial invasion. Tumor cells exhibited marked pleomorphism and high mitotic activity with atypical mitotic figures. There was extensive cyclin-D1 and subset CD10 immunopositivity. FISH showed YWHAE amplification but without rearrangement. Interestingly, we found only two other reported cases of pleomorphic HGESS with YWHAE gene amplification upon review of 259 cases from cBioPortal database, one of which was reported as carcinosarcoma with heterologous elements. Of note, all three YWHAE amplified cases were diagnosed at high-stage and succumbed to disease within six months. Our case appears to be the third case of YWHAE-amplified pleomorphic HGESS, possibly a new variant of uterine sarcoma with aggressive biologic behavior that needs further evaluation. PMID:35265255 | PMC:PMC8902479 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Potential explanations for the reported lack of improvement in chest lymph circulation after vascularized lymph node transfer

xlomafota13 shared this article with you from Inoreader Potential explanations for the reported lack of improvement in chest lymph circulation after vascularized lymph node transfer Via Journal of plastic, reconstructive & aesthetic surgery : JPRAS J Plast Reconstr Aesthet Surg. 2022 Feb 25:S1748-6815(22)00091-2. doi: 10.1016/j.bjps.2022.02.013. Online ahead of print. NO ABSTRACT PMID:35264313 | DOI:10.1016/j.bjps.2022.02.013 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Bilateral vertebral arteries arising distal to the left subclavian artery: embryological and anatomical description

xlomafota13 shared this article with you from Inoreader Bilateral vertebral arteries arising distal to the left subclavian artery: embryological and anatomical description Via radiol anat Surg Radiol Anat. 2022 Mar 9. doi: 10.1007/s00276-022-02903-0. Online ahead of print. ABSTRACT Abnormalities in the origin of vertebral arteries are relatively uncommon, but extremely rare when this abnormality happens on both sides. We present an anatomic variation in which both vertebral arteries came from the proximal descending thoracic aorta beyond the left subclavian artery with no other supra-aortic vessels accompanying the abnormality. The right vertebral artery took a retro-oesophageal course (lusoria artery), while the right and the left vertebral arteries enter the transverse foramina at the 7th cervical vertebra. From an embryological point of view, and overall controversial, this anomaly can be explained by the bilateral persistence of the 8th intersegmental artery as the origin of vertebral artery, instead of the dorsal segment of the 7th intersegmental artery being the origin, which is normally the case. The adequate identification of vertebral artery anomalies in complementary explorations is very important to avoid misdiagnosed vertebral occlusions or unexpected vertebral artery injuries during supra-aortic trunks, thyroid, and oesophagus open surgeries, among others, or even over the course of endovascular procedures. PMID:35266028 | DOI:10.1007/s00276-022-02903-0 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Defining the limits and indications of the Draf III endoscopic approach to the lateral frontal sinus and maximizing visualization and maneuverability: a cadaveric and radiological study

xlomafota13 shared this article with you from Inoreader Defining the limits and indications of the Draf III endoscopic approach to the lateral frontal sinus and maximizing visualization and maneuverability: a cadaveric and radiological study Via http://link.springer.com/journal/405,European archives of oto-rhino-laryngology,The European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino Eur Arch Otorhinolaryngol. 2022 Mar 9. doi: 10.1007/s00405-022-07323-9. Online ahead of print. ABSTRACT PURPOSE: The DRAF III procedure has been used for access to the lateralmost part of the frontal sinus. We sought to identify anatomical and radiological measurements as well as modifications that predict the lateral limits of visualization and surgical access after this procedure. METHODS: Seven cadaver heads were imaged with computed tomography scan. The distance from midline to the medial orbital wall (MOWD), midline to the lateral end of the frontal sinus (MLD), the sum of MLDs (SMLD), interorbital distance (IOD) and the shortest anteroposterior distance of the frontal recess (APD) were utilized. The ratios MLD/MOWD, and SMLD/IOD were calculated. The same distances were measured on 41 CT scans. Orbital transposition (OT) and partial resection of the piriform aperture (PAR) were performed; the visualization and reach were ass essed. The angle of insertion was measured before and after the modifications. RESULTS: Only the ratio MLD/MOWD was consistently predictive of access to the lateral, superior and posterior wall of the frontal sinus. Following the modifications, a visualization of 100% laterally was achieved with the 30- and 45 degree endoscopes and every lateral recess could be reached with the 70 degree suction. A mean increase of the angle of insertion of 25.3 and 59.6% was recorded after OT and PAR, respectively. CONCLUSIONS: IOD rather than APD defines the limits of the Draf III approach to the lateral frontal sinus and MLD/MOWD ratio can serve as a useful preoperative tool. Along to the already described OT, PAR increases visualization and reach of the lateral frontal sinus. PMID:35266026 | DOI:10.1007/s00405-022-07323-9 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Epidemiology and Management of Zenker Diverticulum in a Low-Threshold Single-payer Health Care System

xlomafota13 shared this article with you from Inoreader Epidemiology and Management of Zenker Diverticulum in a Low-Threshold Single-payer Health Care System Via JAMA Otolaryngology–Head & Neck Surgery Current Issue This cohort study examines population-wide incidence of Z enker diverticulum in Finland over a 20-year period and management strategies across specialties and treatment settings. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Kaposiform Hemangioendothelioma of Internal Auditory Canal Presenting in 4-Week-Old Newborn

xlomafota13 shared this article with you from Inoreader Kaposiform Hemangioendothelioma of Internal Auditory Canal Presenting in 4-Week-Old Newborn Via JAMA Otolaryngology–Head & Neck Surgery Current Issue This case report describes a rare case of a kaposiform heman gioendothelioma in the internal auditory canal of a 4-week-old newborn. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

A Perplexing Pediatric Parotid Mass

xlomafota13 shared this article with you from Inoreader A Perplexing Pediatric Parotid Mass Via JAMA Otolaryngology–Head & Neck Surgery Current Issue A previously healthy 8-year-old boy presented to an outpa tient clinic for further evaluation of a fluctuating right parotid mass that had been present for 3 years. What is your diagnosis? View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Chemosensory Psychophysical Evaluation of Gustatory Dysfunction in Patients With Long-Term COVID-19

xlomafota13 shared this article with you from Inoreader Chemosensory Psychophysical Evaluation of Gustatory Dysfunction in Patients With Long-Term COVID-19 Via JAMA Otolaryngology–Head & Neck Surgery Current Issue This cross-sectional study evaluates self-reported gustat ory dysfunction in patients with long-term COVID-19. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Possible Association between Lenvatinib Use and Primary Adrenal Insufficiency: Additional Studies Very Much Needed

xlomafota13 shared this article with you from Inoreader Possible Association between Lenvatinib Use and Primary Adrenal Insufficiency: Additional Studies Very Much Needed Via Clinical Thyroidology Clinical Thyroidology, Volume 34, Issue 3, Page 132-135, March 2022. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

18F–FDG–PET/CT May Reduce Unnecessary Thyroid Surgery in Cytologically Indeterminate Thyroid Nodules

xlomafota13 shared this article with you from Inoreader 18F–FDG–PET/CT May Reduce Unnecessary Thyroid Surgery in Cytologically Indeterminate Thyroid Nodules Via Clinical Thyroidology Clinical Thyroidology, Volume 34, Issue 3, Page 116-118, March 2022. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.