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Primary spinal cord melanoma is a rare disease that accounts for only 1% of all melanocytomas. Here we report a case of primary melanoma of the cervical spinal cord. In our case, 26-year-old female who were admitted to the hospital for left arm pain. Spinal magnetic resonance image (MRI) revealed a spinal cord tumor at the level of C2-3. The MRI images showed that the tumor compressed the spinal cord. At surgery, the spinal cord was under pressure and covered with shaped blackish brown neoplastic tissue. There were not any metastatic lesions. The patient is still alive six months after surgery. 33581992

Background The percutaneous approach allows for effective and safe treatment of liver lesions. But in case of subcapsular or left segments location, this approach seems to be less effective or unsafe. Endoscopic ultrasound-guided radiofrequency ablation (EUS-RFA) is a new technique used to treat pancreatic and neuroendocrine tumors in patients unfit for surgery. Methods Hereby, we describe the case of a 70-year-old patient with cirrhosis with a large subcapsular hepatocellular carcinoma (HCC) in II-III-IVb segments, in which surgery or percutaneous therapies were not feasible, treated with EUS-RFA. The HCC was treated using an EUS-RFA (EUSRA) system, which consists of a 19G water-cooled monopolar RFA needle and a dedicated generator system. Results After a multidisciplinary discussion, the lesion was ablated in two different sessions, which resulted in destruction of about 70 % of neoplastic tissue. A second step surgery was required but initially refused by the patient. Conclusions EUS-RFA could be an effective way to treat left hepatic lesions not manageable with conventional percutaneous methods. This case report does not highlight concerns about safety of this approach and this observation needs to be validated in a larger cohort of patients with cirrhosis.

Fluorescence-guided-surgery offers intraoperative visualization of neoplastic tissue. Delta-aminolevulinic acid (5-ALA), which targets enzymatic abnormality in neoplastic cells, is the only approved agent for fluorescence-guided neurosurgery. More recently, we described Second Window Indocyanine Green (SWIG) which targets neoplastic tissue through enhanced vascular permeability. We hypothesized that SWIG would demonstrate similar clinical utility in identification of high-grade gliomas compared with 5-ALA.Female C57/BL6 and nude/athymic mice underwent intracranial implantation of 300,000 GL261 and U87 cells, respectively. Tumor-bearing mice were euthanized after administration of 5-ALA (200 mg/kg intraperitoneal) and SWIG (5 mg/kg intravenous). Brain sections were imaged for protoporphyrin-IX and ICG fluorescence. Fluorescence and HE images were registered using semi-automatic scripts for analysis. Human subjects with HGG were administered SWIG (2.5 mg/kg intravenous) and 5-ALA (20 mg/kg oral). Intraoperatively, tumors were imaged for ICG and protoporphyrin-IX fluorescence.In non-necrotic tumors, 5-ALA and SWIG demonstrated 90.2 % and 89.2 % tumor accuracy (p value = 0.52) in U87 tumors and 88.1 % and 87.7 % accuracy (p value = 0.83) in GL261 tumors. The most distinct difference between 5-ALA and SWIG distribution was seen in areas of tumor-associated necrosis, which often showed weak/no protoporphyrin-IX fluorescence, but strong SWIG fluorescence. In twenty biopsy specimens from four subjects with HGG, SWIG demonstrated 100 % accuracy, while 5-ALA demonstrated 75-85 % accuracy; there was 90 % concordance between SWIG and 5-ALA fluorescence.Our results provide the first direct comparison of the diagnostic utility of SWIG vs 5-ALA in both rodent and human HGG. Given the broader clinical utility of SWIG compared with 5-ALA, our data supports the use of SWIG in tumor surgery to improve the extent of safe resections.NCT02710240 (US National Library of Medicine Registry; https://www.clinicaltrials.gov/ct2/show/NCT02710240?id=NCT02710240draw=2rank=1 ).

Introduction: Today, magnetic resonance imaging (MRI) is the standard method for monitoring patients with brain tumors. The ability of conventional MRI in differentiating neoplastic tissue from nonspecific, treatment-related changes after surgery, radio-, chemo- or immunotherapy, however, remains limited. Therefore, advanced MRI sequences and positron emission tomography (PET) are increasingly being considered to improve decision-making. Areas covered: PET using radiolabeled amino acids has evolved into an important diagnostic tool to overcome some of the shortcomings of conventional MRI. In view of the rapidly developing novel treatment strategies, a reliable statement on the response to therapy is becoming increasingly important. This article gives an overview of the current results of PET with radiolabelled amino acids in therapy monitoring of standard therapy as well as various innovative approaches in the treatment of patients with cerebral gliomas. Expert opinion: Amino acid PET has proven to be helpful in therapy monitoring of gliomas, the costs are low in relation to the costs of therapy and the clinical benefit, and a widespread clinical use is highly desirable.

Excision of all visible neoplastic tissue is the goal of EMR of colorectal laterally spreading tumors. Flat and fibrotic tissue can resist snaring. Ablation of visible polyps is associated with high recurrence rates. Avulsion is a technique to continue resection when snaring fails.We retrospectively analyzed colonic EMRs of 564 consecutive referred polyps between 2015 and 2017. Hot avulsion was used when snaring was unsuccessful. Polyps treated with and without avulsion were compared.Hot avulsion was used in 20.9% (n = 112) of all resected lesions. The recurrence rates on follow-up colonoscopy were 17.52% in the avulsion group versus 16.02% in the non-avulsion group (P = .76). Hot avulsion was associated with a trend toward higher rates of delayed hemorrhage (5.35% vs 2.58%; P = .15) and post-coagulation syndrome (1.8% vs 0.47%; P = .15), but polyps treated with any avulsion were larger than those in which no avulsion was used (P .001). There were an insufficient number of adverse events to perform a multivariable analysis to test the effects of avulsion, size, and location on the risk of overall adverse events.Unlike previous reports of using argon plasma coagulation to treat visible polyps during EMR, hot avulsion of visible/fibrotic neoplasia was associated with similar EMR efficacy compared with cases that did not require hot avulsion. The safety profile of hot avulsion appears acceptable.

Background The E-Cadherin gene (CDH1, Cadherin 1), located at 16q22.1 encodes for a calcium-dependent membranous glycoprotein with an important role in cellular adhesion and polarity maintenance. Methods To systematically determine E-Cadherin protein expression in normal and cancerous tissues, 14,637 tumor samples from 112 different tumor types and subtypes as well as 608 samples of 76 different normal tissue types were analyzed by immunohistochemistry in a tissue microarray format. Results E-Cadherin was strongly expressed in normal epithelial cells of most organs. From 77 tumor entities derived from cell types normally positive for E-Cadherin, 35 (45.5%) retained at least a weak E-Cadherin immunostaining in ≥99% of cases and 61 (79.2%) in ≥90% of cases. Tumors with the highest rates of E-Cadherin loss included Merkel cell carcinoma, anaplastic thyroid carcinoma, lobular carcinoma of the breast, and sarcomatoid and small cell neuroendocrine carcinomas of the urinary bladder. Reduced E-Cadherin expression was linked to higher grade (p = 0.0009), triple negative receptor status (p = 0.0336), and poor prognosis (p = 0.0466) in invasive breast carcinoma of no special type, triple negative receptor status in lobular carcinoma of the breast (p = 0.0454), advanced pT stage (p = 0.0047) and lymph node metastasis in colorectal cancer (p p p = 0.0104) and was associated with advanced tumor stage (p = 0.0276) and higher grade (p = 0.0035) in clear cell RCC, and linked to advanced tumor stage (p = 0.0424) and poor prognosis in papillary RCC (p ≤ 0.05). Conclusion E-Cadherin is consistently expressed in various epithelial cancers. Down-regulation or loss of E-Cadherin expression in cancers arising from E-Cadherin positive tissues as well as E-Cadherin neo-expression in cancers arising from E-Cadherin negative tissues is linked to cancer progression and may reflect tumor dedifferentiation.

Simple Summary Shear wave elastography (SWE) is a new diagnostic method allowing for a non-invasive differential diagnosis between benign and malignant mammary tumors. Mammary tumors in dogs are often hormone-dependent, and a surgical approach is currently the most recommended method for the treatment of mammary neoplasia. However, preoperative, pharmacological therapy eliminating hormonal stimulation can sometimes be indicated to reduce the size of the tumor and facilitate subsequent surgery. The aim of this study was to evaluate the influence of the reduction in the benign tumor size observed after treatment with the use of aglepristone on the shear wave elastography results, obtained before and after therapy. We noticed that a fast and significant reduction in tumor size, as a consequence of preoperative pharmacological treatment, did not influence the diagnosis performed using the SWE technique. These results seem to indicate the accuracy and usefulness of this new diagnostic method, and confirm the hypothesis that tumor tissue density is a valuable parameter when determining the benignancy of mammary tumors in dogs. Abstract Shear wave elastography (SWE) can be useful to discriminate between malignant and benign mammary tumors. In dogs with elevated progesterone levels compared to the baseline and fast-growing tumors, treatment with the use of aglepristone allows for tumor size reduction, which facilitates surgery. This study aimed to evaluate the influence of the preoperative treatment of benign mammary tumors (BMTs), performed with the use of aglepristone, on the density of the tumor tissue measured by SWE. Twelve female dogs with diagnosed BMTs and increased levels of progesterone were treated with aglepristone (Alizine, Virbac, France) at 10 mg/kg s.c. (Subcutaneous injection). twice, with a 24 h interval. The density of the tumor was evaluated by SWE before and after the treatment. The type of tumor was evaluated by fine needle aspiration cytology before treatment, and a histopathological examination was made after surgical removal, performed after the aglepristone treatment. In all the cases, a significant reduction in the mammary tumor’s size was observed following treatment, with no influence on the density of the tumor’s tissue measured by SWE. Similar studies on malignant mammary tumors are warranted to verify if in these cases, density will also be a constant parameter that is not dependent on the tumor size.

The overwhelming majority of cows with squamous cell carcinoma (SCC or “cancer eye”) can have the neoplastic tissue removed so that the eye does not have to be removed. Early detection of SCC is the key to only having to excise the neoplastic tissue while saving the eye. A lesion of approximately 1 cm or less can be readily seen when the cow walks through the chute for yearly vaccinations and/or pregnancy examination, and it is easily removed at this time. Cows with SCC should not necessarily be automatic culls. A cow with a small lesion on the third eyelid or on the cornea that is removed in a timely fashion can have a long and productive life in the herd., American Association of Bovine Practitioners Proceedings of the Annual Conference, 2020

The evolving possibilities of molecular imaging (MI) are fundamentally changing the way we look at cancer, with imaging paradigms now shifting away from basic morphological measures toward the longitudinal assessment of functional, metabolic, cellular, and molecular information in vivo. Recent developments of imaging methodology and probe molecules utilizing the vast number of novel animal models of human cancers have enhanced our ability to non-invasively characterize neoplastic tissue and follow anticancer treatments. While preclinical molecular imaging offers a whole palette of excellent methodology to choose from, we will focus on magnetic resonance imaging (MRI) techniques, since they provide excellent molecular imaging capabilities and bear high potential for clinical translation. Prerequisites and consequences of using animal models as surrogates of human cancers in preclinical molecular imaging are outlined. We present physical principles, values, and limitations of MRI as molecular imaging modality and comment on its high potential to non-invasively assess information on metabolism, hypoxia, angiogenesis, and cell trafficking in preclinical cancer research.

Background Endoscopic mucosal resection (EMR) with snare is the recommended technique to resect non-invasive colorectal neoplastic lesions between 10 and 30 mm in diameter. The objective of EMR is to resect completely the neoplastic tissue en bloc and preferably with free margins (R0), avoiding recurrences. Anchoring the tip of the snare in the submucosa is a technical trick that allows snare sliding to be reduced and larger pieces to be caught. The aim of the present study was to evaluate the effectiveness and safety of anchoring-EMR (A-EMR). Methods This was a retrospective analysis of A-EMR procedures for lesions of diameter between 10 and 30 mm (endoscopic evaluation) performed consecutively in four French centers between May 2017 and January 2018. A-EMR was routinely performed for all EMR using Olympus conventional snares (10 or 25 mm). The primary outcome was evaluation of the proportion of R0 resections. Results A total of 141 A-EMR procedures were performed by 10 operators. Mean lesion size was 19.8 mm. Anchoring was feasible in 96.5 % of cases. There were 81.6 % en bloc resections and 70.2 % R0 resections, with the percentage of procedures decreasing with increasing lesion size (82.8 % 30 mm, P = 0.002). Complete perforations closed endoscopically occurred in 3/141 cases (2.1 %); none occurred in lesions Conclusion The A-EMR technique appears to be promising with a high proportion of R0 for lesions of 10 – 20 mm in size without any perforations. It could also offer an alternative to endoscopic submucosal dissection (ESD), or to hybrid techniques to reach R0 for lesions between 20 and 30 mm in size.

Tumor recurrence in pituitary adenomas is as high as 20% after surgery. Conventional neuronavigation and white light visualization are not sufficiently accurate in detecting residual neoplastic tissue. Fluorescence-guided surgery offers accurate, real-time visualization of neoplastic tissue. The authors' group has explored the use of near-infrared imaging, which is superior to visible-light fluorescence in both signal contrast and tissue penetration, in transsphenoidal endoscopic surgeries for pituitary adenomas using 2 techniques: second window indocyanine green, in which indocyanine green passively accumulates in the tumor, and OTL38, which actively targets folate receptors on adenoma cells. This work establishes the foundation of intraoperative near-infrared imaging for fluorescence-guided neurosurgery.

Following brain cancer treatment, the capacity of anatomical MRI to differentiate neoplastic tissue from treatment-related changes (e.g., pseudoprogression) is limited. This study compared apparent diffusion coefficients (ADC) obtained by diffusion-weighted MRI (DWI) with static and dynamic parameters of O-(2-[18F]fluoroethyl)-L-tyrosine (FET) PET for the differentiation of treatment-related changes from tumour progression. Forty-eight pretreated high-grade glioma patients with anatomical MRI findings suspicious for progression (median time elapsed since last treatment was 16 weeks) were investigated using DWI and dynamic FET PET. Maximum and mean tumour-to-brain ratios (TBRmax, TBRmean) as well as dynamic parameters (time-to-peak and slope values) of FET uptake were calculated. For mean ADC calculation, regions-of-interest analyses were performed on ADC maps calculated from DWI coregistered with the contrast-enhanced MR image. Diagnoses were confirmed neuropathologically (21%) or clinicoradiologically. Diagnostic performance was evaluated using receiver-operating-characteristic analyses or Fisher’s exact test for a combinational approach. Ten of 48 patients had treatment-related changes (21%). The diagnostic performance of FET PET was significantly higher (threshold for both TBRmax and TBRmean, 1.95; accuracy, 83%; AUC, 0.89 ± 0.05; P

Secretory breast carcinoma (SBC) is a very rare subtype of breast carcinoma that reported mostly in young women, with a median age of 25 years. Despite the low frequency, SBC elicits pathologic interest because of their unique morphology and excellent prognosis. Authors report a 23-year-old woman presented with a nodule in retro areolar region of her right breast. Microbiopsic examination revealed neoplastic tissue. Pathological examination of tumor revealed SBC. This tumor is morphologically characterized by the presence of abundant eosinophilic secretions in intracellular vacuoles and intercellular spaces. The objective of this paper is to review the epidemiological, clinical, paraclinical and therapeutic aspects of SBC from a case report and literature review.

Background and objective Vibrational spectroscopic methods associated with multivariate statistical techniques have been succeeded in discriminating skin lesions from normal tissues. However, there is no study exploring the potential of these techniques to assess the alterations promoted by photodynamic effect in tissue. The present study aims to demonstrate the ability of Fourier Transform Infrared (FTIR) spectroscopy on Attenuated total reflection (ATR) sampling mode associated with principal component-linear discriminant analysis (PC-LDA) to evaluate the biochemical changes caused by photodynamic therapy (PDT) in skin neoplastic tissue. Materials and methods Cutaneous neoplastic lesions, precursors of squamous cell carcinoma (SCC), were chemically induced in Swiss mice and submitted to a single session of 5-aminolevulinic acid (ALA)-mediated PDT. Tissue sections with 5 μm thickness were obtained from formalin-fixed paraffin-embedded (FFPE) and processed prior to the histopathological analysis and spectroscopic measurements. Spectra were collected in mid-infrared region using a FTIR spectrometer on ATR sampling mode. Principal Component-Linear Discriminant Analysis (PC-LDA) was applied on preprocessed second derivatives spectra. Biochemical changes were assessed using PCA-loadings and accuracy of classification was obtained from PC-LDA . Results Sub-bands of Amide I (1,624 and 1,650 cm(-1) ) and Amide II (1,517 cm(-1) ) indicated a protein overexpression in non-treated and post-PDT neoplastic tissue compared with healthy skin, as well as a decrease in collagen fibers (1,204, 1,236, 1,282, and 1,338 cm(-1) ) and glycogen (1,028, 1,082, and 1,151 cm(-1) ) content. Photosensitized neoplastic tissue revealed shifted peak position and decreased β-sheet secondary structure of proteins (1,624 cm(-1) ) amount in comparison to non-treated neoplastic lesions. PC-LDA score plots discriminated non-treated neoplastic skin spectra from post-PDT cutaneous lesions with accuracy of 92.8%, whereas non-treated neoplastic skin was discriminated from healthy tissue with 93.5% accuracy and post-PDT cutaneous lesions was discriminated from healthy tissue with 89.7% accuracy. Conclusion PC-LDA was able to discriminate ATR-FTIR spectra of non-treated and post-PDT neoplastic lesions, as well as from healthy skin. Thus, the method can be used for early diagnosis of premalignant skin lesions, as well as to evaluate the response to photodynamic treatment. Lasers Surg. Med. 48:538-545, 2016. © 2016 Wiley Periodicals, Inc.

The study of animal models remains a cornerstone of preclinical cancer research. Recent advances in technology have led to the proliferation of animal imaging devices that are now integral to the study of cancer biology. Imaging is routinely used for the development and characterization of animal tumor models, measuring response to anticancer therapy, and for the detailed examination of individual molecular pathways within neoplastic tissue. The purpose of this chapter will be to provide an introduction to the most common imaging modalities used in contemporary oncologic investigation in order to help the reader determine if an imaging approach may complement their research goals.

Functional magnetic resonance imaging (fMRI) allows the non-invasive assessment of human brain activity in vivo. In glioma patients, fMRI is frequently used to determine the individual functional anatomy of the motor and language network in a presurgical setting to optimize surgical procedures and prevent extensive damage to functionally eloquent areas. Novel developments based on resting-state fMRI may help to improve presurgical planning for patients which are unable to perform structured tasks and might extend presurgical mapping to include additional functional networks. Recent advances indicate a promising potential for future applications of fMRI in glioma patients which might help to identify neoplastic tissue or predict the long-term functional outcome of individual patients.

Background and study aims: Early neoplasia in Barrett’s esophagus is difficult to detect and often overlooked during Barrett’s surveillance. An automatic detection system could be beneficial, by assisting endoscopists with detection of early neoplastic lesions. The aim of this study was to assess the feasibility of a computer system to detect early neoplasia in Barrett’s esophagus.Patients and methods: Based on 100 images from 44 patients with Barrett’s esophagus, a computer algorithm, which employed specific texture, color filters, and machine learning, was developed for the detection of early neoplastic lesions in Barrett’s esophagus. The evaluation by one endoscopist, who extensively imaged and endoscopically removed all early neoplastic lesions and was not blinded to the histological outcome, was considered the gold standard. For external validation, four international experts in Barrett’s neoplasia, who were blinded to the pathology results, reviewed all images.Results: The system identified early neoplastic lesions on a per-image analysis with a sensitivity and specificity of 0.83. At the patient level, the system achieved a sensitivity and specificity of 0.86 and 0.87, respectively. A trade-off between the two performance metrics could be made by varying the percentage of training samples that showed neoplastic tissue.Conclusion: The automated computer algorithm developed in this study was able to identify early neoplastic lesions with reasonable accuracy, suggesting that automated detection of early neoplasia in Barrett’s esophagus is feasible. Further research is required to improve the accuracy of the system and prepare it for real-time operation, before it can be applied in clinical practice.

Background The purpose of this study was to develop an automated image analysis algorithm to discriminate between head and neck cancer and nonneoplastic epithelium in confocal laser endomicroscopy (CLE) images. Methods CLE was applied to image head and neck cancer epithelium in vivo. Histopathologic diagnosis from biopsies was used to classify the CLE images offline as cancer or noncancer tissue. The classified images were used to train automated software based on distance map histograms. The performance of the final algorithm was confirmed by “leave 2 patients out” cross-validation and area under the curve (AUC)/receiver operating characteristic (ROC) analysis. Results Ninety-two CLE videos and 92 biopsies were analyzed from 12 patients. One hundred two frames of classified neoplastic tissue and 52 frames of nonneoplastic tissue were used for cross-validation of the developed algorithm. AUC varied from 0.52 to 0.92. Conclusion The proposed software allows an objective classification of CLE images of head and neck cancer and adjacent nonneoplastic epithelium. © 2015 Wiley Periodicals, Inc. Head Neck, 2015

Tissue engineering has raised the hopes of many surgeons to provide products, to restore the functionality of tissues and organs. The orthopedic surgeon could use these products to replace missing tissue due to trauma, infection, or surgical removal of necrotic or neoplastic tissue. Although research has shown large interest in TE, and number of publications in this field has increased tremendously in the last decade, there are still very few products available. This review provides the view of leading surgeons and their view of TE in their area of expertise. Looking at spinal surgery, cartilage repair, tendon/ligament/muscle repair, large bone defects, and biomaterials, these experts report about the current demand, the current achievements, and the future of tissue engineering in the perspective of the surgeon. Furthermore, the difficulties of translating research results to usable products will be discussed.

Initial diagnostics and follow-up of gliomas is usually based on contrast-enhanced MRI. However, the capacity of standard MRI to differentiate neoplastic tissue from posttherapeutic effects such as pseudoprogression is limited. Advanced neuroimaging methods may provide relevant additional information, which allow for a more accurate diagnosis especially in clinically equivocal situations. This review article focuses predominantly on PET using radiolabeled amino acids and advanced MRI techniques such as perfusion-weighted imaging (PWI) and summarizes the efforts of these methods regarding the identification of pseudoprogression after glioma therapy. Areas covered: The current literature on pseudoprogression in the field of brain tumors, with a focus on gliomas is summarized. A literature search was performed using the terms 'pseudoprogression', 'temozolomide', 'glioblastoma', 'PET', 'PWI', 'radiochemotherapy', and derivations thereof. Expert commentary: The present literature provides strong evidence that PWI MRI and amino acid PET can be of great value by providing valuable additional diagnostic information in order to overcome the diagnostic challenge of pseudoprogression. Despite various obstacles such as the still limited availability of amino acid PET and the lack of standardization of PWI, the diagnostic improvement probably results in relevant benefits for brain tumor patients and justifies a more widespread use of these diagnostic tools.

Metabolic imaging has come to occupy a prominent place in the diagnosis and management of microbial infection. Molecular probes available for infection imaging have undergone a rapid evolution starting with nonspecific agents that accumulate similarly in infection, sterile inflammation, and neoplastic tissue and then extending to more targeted probes that seek to identify specific microbial species. This focus review describes the metabolic and molecular imaging techniques currently available for clinical use in infection imaging and those that have demonstrated promising results in preclinical studies with the potential for clinical applications.

Photodynamic diagnostic technique with blue light cystoscopy (BLC) takes advantage of the preferential uptake and accumulation of protoporphyrins in neoplastic tissue which emit a red fluorescence when illuminated with blue light (360–450 nm wavelengths). This allows enhanced visualization of small papillary tumors and flat carcinoma in situ lesions that might have been missed on white light cystoscopy (WLC). There is compelling evidence that the ability of BLC to detect these additional tumors translates into improved recurrence rates compared to WLC. However, the impact of BLC with regard to progression rates and in patients who are managed with intravesical therapy is not yet known. Further work is required to optimize the integration of BLC into clinical practice, but the future for BLC appears promising.

Objective—To characterize signalment, clinical features, clinicopathologic variables, hepatic ultrasonographic characteristics, endocrinologic profiles, treatment response, and age at death of Scottish Terriers with progressive vacuolar hepatopathy (VH) with or without hepatocellular carcinoma (HCC). Design—Retrospective case series. Animals—114 Scottish Terriers with progressive VH. Procedures—Electronic databases from 1980 to 2013 were searched for adult (age > 1 year) Scottish Terriers with histopathologic diagnoses of diffuse glycogen-like VH. Available sections of liver specimens were histologically reevaluated to confirm diffuse VH with or without HCC; 8 dogs with HCC only had neoplastic tissue available. Physical examination, clinicopathologic, treatment, and survival data were obtained. Results—39 of 114 (34%) dogs with VH had HCC detected at surgery or necropsy or by abdominal ultrasonography. Histologic findings indicated that HCC was seemingly preceded by dysplastic hepatocellular foci. No significant differences were found in clinicopathologic variables or age at death between VH-affected dogs with or without HCC. Fifteen of 26 (58%) dogs with high hepatic copper concentrations had histologic features consistent with copper-associated hepatopathy. Although signs consistent with hyperadrenocorticism were observed in 40% (46/114) of dogs, definitive diagnosis was inconsistently confirmed. Assessment of adrenal sex hormone concentrations before and after ACTH administration identified high progesterone and androstenedione concentrations in 88% (22/25) and 80% (20/25) of tested dogs, respectively. Conclusions and Clinical Relevance—Results suggested that VH in Scottish Terriers may be linked to adrenal steroidogenesis and a predisposition to HCC. In dogs with VH, frequent serum biochemical analysis and ultrasonographic surveillance for early tumor detection are recommended.

The aim of this study was to evaluate the correlation of the expression of Fas and Fas-L proteins in gastric carcinoma cells on the occurrence of metastases to regional lymph nodes.The study included 89 patients treated surgically for gastric carcinoma. The evaluated clinicomorphological parameters were verified based on both histopathological material collected at surgery and intraoperative image. Fas and Fas-L expression was evaluated immunohistochemically in the neoplastic tissue of the removed gastric tumors.A statistically significant positive correlation between Fas expression in gastric carcinoma cells and the number of regional lymph nodes affected by metastases was observed (p0.05). No such correlation was noticed with respect to Fas-L. A statistically significant correlation between the depth of neoplastic infiltration of the stomach wall (T feature) and the number of affected lymph nodes was observed (p0.05). No statistically significant correlations in the other examined clinicomorphological features and the number of metastatic lymph nodes was observed.A positive Fas expression correlates with more frequent occurrence of metastases to regional lymph nodes. Determination of this protein expression in cancer cells prior to surgery may be helpful for planning the surgical procedure, especially with respect to the extent of lymph node excision.

Safe maximal resection is the cornerstone of malignant glioma therapy. Neoplastic tissue is often difficult to discern intra-operatively, and technologies utilizing induced tissue fluorescence for aiding discrimination have evolved into useful adjuncts. 5-Aminolevulinic acid (5-ALA) is the most highly investigated compound so far and approved for this purpose, inducing the selective accumulation of fluorescent porphyrins in malignant cells, which can be visualized using commercially available surgical microscopes. Fluorescein, a passive permeability marker, is also being studied for fluorescence-guided resections. Its use is off-label and further investigation is required. This review focuses on the background and practical use of fluorescence and provides an outlook on newer developments.

Post-resectional bronchopleural fistula is a pathological connection between the airway (bronchus) and the pleural space that may develop after lung resection; it may be caused by incomplete bronchial closure, impediment of bronchial stump wound healing, or stump destruction by residual neoplastic tissue. The clinical effect of impaired bronchial stump healing after anatomic lung resection may culminate in a life-threatening septic and ventilatory catastrophe.

Malignant gliomas are locally invasive tumors that offer a poor prognosis. Evidence shows that complete resection of the tumor at the time of surgery confers a significant improvement in overall survival. In recent years, 5- aminolevulinic acid (ALA)-induced fluorescence has been used by neurosurgeons to good effect in increasing the rate of complete resection. Despite the considerable interest in the use of 5-ALA in fluorescence-guided neurosurgery, the mechanisms behind the accumulation of Protoporphyrin IX (PpIX) in neoplastic tissue are unclear. In this review, we summarize the evidence in the literature on the mechanisms underlying the selective production of PpIX with a specific focus on gliomas.

Angiogenesis is a prerequisite for tumor growth and metastatic progression. The discovery of the first specific angiogenic cytokine, VEGF, in 1989 paved the way for the clinical approval of the first antiangiogenic tumor drug 15 years later. This brief commentary highlights and puts into historical perspective the 1985 G.H.A. Clowes Memorial Award Lecture delivered by Dr. Judah Folkman. Thirty years later, this award lecture is a lively testimony of the visionary mind of Dr. Folkman, whose legacy continues to inspire contemporary angiogenesis research. Cancer Res; 76(10); 2854–6. ©2016 AACR. See related article by Folkman J, Cancer Res 1986;46:467–73.

Objective To assess the use of an ultra–high-resolution (UHR) optical coherence tomography (OCT) as an adjuvant diagnostic tool in distinguishing ocular surface squamous neoplasia (OSSN) and pterygia. Design Prospective case series. Participants Thirty-four eyes of 34 patients with conjunctival lesions clinically suspicious for OSSN or pterygia. Methods All patients were photographed and then imaged with a custom-built UHR OCT device. Subsequently, each patient underwent excisional or incisional biopsy with histopathologic diagnosis. Main Outcome Measures Comparison of preoperative UHR OCT images and the corresponding histopathologic specimen; comparison of epithelial thickness between the 2 groups as measured by UHR OCT. Results Preoperative UHR OCT images of OSSN demonstrated similarities to the histopathologic specimens. Both optical and pathologic specimens showed a thickened layer of epithelium, often with an abrupt transition from normal to neoplastic tissue. Likewise, preoperative UHR OCT images of patients with pterygia were well correlated with the histopathologic specimens. As opposed to OSSN, both UHR OCT and pathologic images of pterygia demonstrated a normal thin epithelium, with underlying thickening of the subepithelial mucosal layers. Differences in the measured epithelial thickness on UHR OCT between OSSN and pterygia were statistically significant, with an average epithelial thickness of 346 μm (standard deviation [SD], 167) in OSSN patients and 101 μm (SD, 22) in pterygium patients ( P Conclusions Ultra–high-resolution OCT may show promise as a noninvasive diagnostic tool to evaluate ocular surface lesions. In addition to a statistically significant difference in epithelial thickness, a significant degree of morphologic correlation with the histopathologic results demonstrates its potential in evaluating ocular surface squamous neoplasia and pterygia. Financial Disclosure(s) The author(s) have no proprietary or commercial interest in any materials discussed in this article.

Prostate cancer is an androgen dependent condition where Dihydrotestosterone promotes the growth of the neoplastic tissue. Androgen deprivation has been the mainstay of therapy for this condition. This can be achieved by surgical or medical means. Types of medical regimens are intermittent maximal or sequential androgen blockade.

Introduction: Seventy percent of colonic polyps are adenomas – benign neoplastic tissue deriving from epithelium with various grades of dysplasia. Metabolic syndrome is discussed as one of the risk factors for development of colonic adenomas. Aim: To evaluate the relation between metabolic syndrome and prevalence of colonic polyps. Material and methods: In 2008-2011, 151 patients (aged 50-70 years) from the city of Strzegom were enrolled in a prophylactic programme. Each patient had the following examinations performed: physical examination, abdomen ultrasound, chest X-ray, oesophagogastroduodenoscopy, colonoscopy, ECG and laboratory tests. In females mammography and gynaecological examination were performed, and in males prostate-specific antigen (PSA) level was evaluated. Results: The prevalence of adenomas was higher in patients with metabolic syndrome (33.3% vs. 20.6%, p 95 mg%, lub stezenie cholesterolu HDL w granicach 45–95 mg% ze spelnionymi kryteriami rozpoznania zespolu metabolicznego wiąze sie z wystepowaniem gruczolakow w jelicie grubym. Wnioski: Zespol metaboliczny mozna uznac za czynnik ryzyka wystąpienia gruczolakow w jelicie grubym. Wzrost gruczolakow u pacjentow z zespolem metabolicznym moze byc przyspieszony. Cząsteczki HDL mogą odgrywac istotną role w procesach pobudzania nieprawidlowej proliferacji komorek jelita grubego prowadzącej do powstania gruczolaka.

Introduction: Fluorescence-guided resection (FGR) of brain tumors is an intuitive, practical and emerging technology for visually delineating neoplastic tissue exposed intraoperatively. Image guidance is the standard technique for producing 3-dimensional spatially coregistered information for surgical decision making. Both technologies together are synergistic: the former detects surface fluorescence as a biomarker of the current surgical margin while the latter shows coregistered volumetric neuroanatomy but can be degraded by intraoperative brain shift. We present the implementation of deformation modeling for brain shift compensation in protoporphyrin IX FGR, integrating these two sources of information for maximum surgical benefit. Methods: Two patients underwent FGR coregistered with conventional image guidance. Histopathological analysis, intraoperative fluorescence and image space coordinates were recorded for biopsy specimens acquired during surgery. A biomechanical brain deformation model driven by intraoperative ultrasound data was used to generate updated MR images. Results: Combined use of fluorescence signatures and updated MR image information showed substantially improved accuracy compared to fluorescence or the original (i.e., nonupdated) MR images, detecting only true positives and true negatives, and no instances of false positives or false negatives. Conclusion: Implementation of brain deformation modeling in FGR shows promise for increasing the accuracy of neurosurgical guidance in the delineation and resection of brain tumors.

Background : Combinations of Fluorouracil (FU) and biomodulator Leucovorin (LV) established as a standard regimen for therapy of colorectal cancer with metastases. To give better antitumor activity in colorectal cancer therapy, oxaliplatin is combined with FU/LV and give significant improvement. Fluorouracil can only be given by intravenous administration. This limitation raised effort to find alternative drugs that can be given orally, such as capecitabine. Capecitabine is an oral FU prodrug, with high oral bioavailability, highly accumulated in neoplastic tissue to be converted in FU, and well tolerated. Some clinical studies revealed effectivity of capecitabine plus oxaliplatin (XELOX) compared to FU/LV plus oxaliplatin (FOLFOX). Objective : This article is aimed to compare non inferiority of XELOX to FOLFOX in colorectal cancer with metastases, viewed form primary outcomes and secondary outcomes. Results : XELOX was comparable to FOLFOX with some benefitsover FOLFOX. Conclusion : XELOX could be considered as FOLFOX replacement as a standard therapyfor colorectal cancer with metastases.

BACKGROUND: Narrow Band Imaging (NBI) is a novel imaging technique based on the exclusion of deeper penetrating light from the colour spectrum. METHODS: Review on the current status of narrow band imaging. RESULTS: Pictures taken using NBI are characterised by contrast-enhancement of mucosal structures and visualisation of mucosal vascular pattern. NBI thus promises to facilitate the spotting of small, flat and depressed lesions, to identify mucosal patterns of tissue and to improve the diagnostic yield for neoplastic tissue throughout the gastrointestinal tract. This article tries to give an overview of the current applications of narrow band imaging as well as a comparison with established endoscopic imaging techniques. CONCLUSIONS: NBI represents a novel technique for the diagnosis and management of gastrointestinal diseases (i.e. Barrett's oesophagus).

The quantitative levels of seven of the acute-phase reactant proteins were measured in the plasma of a sample of fifty-four adults all diagnosed as suffering from tuberose sclerosis and compared to that derived from a group of control subjects resident in a hospital for the mentally subnormal. Abnormal levels were found in one or more of the proteins in all but thirteen cases, with no fewer than twenty-six subject (forty-eight per cent) showing results outside the 2SD limits in three or more of the parameters investigated. Only in the alpha1-antitrypsin and fibrinogen were the means not significantly different from the control means but even in these two proteins ten and seven cases respectively individually exceeded the normal mean by more than 2SD. It is suggested that these observations can be explained as the normal response to the presence of neoplastic tissue, and the routine investigation of these and other biochemical components known to respond to the presence of neoplastic tissue may be of help in genetic counselling.

Introduction: The assessment of cancer patients is of great clinical and radiological complexity. Distinguishing between neoplastic tissue infiltration and indirect lesions is key for correct local staging. Methods: Discussion of extrinsic (metastatic) peripheral neuropathy and muscular (multifidus) denervation cases, mainly based on MRI. Results: Precise anatomic correlation between vertebral metastases, neural compression/infiltration and selective muscular denervation. Conclusion: MRI imaging enables highly accurate differentiation between muscular neoplastic infiltration and edemas resulting from secondary peripheral neuropathy.

The chapter considers the principles, the techniques, the results of PEI for treating cirrhotic patients with HCC, and its current indications compared to those of RF, which is now considered the gold standard.

Targeted approaches in photodynamic therapy (PDT) promise to alleviate many of the limitations of the treatment, such as it being restricted to localized treatments and the most common adverse biological effects of non-specific phototoxicity. Tumor selectivity during conventional PDT is predominantly achieved through the enhanced permeability and retention effect and the regional control of the area of irradiation, restricting the application to pre-established and localized tumor foci. Continuing scientific and clinical advances in our understanding of tumor physiology and the biochemistry of tumor regulation, progression and treatment evasion have been exploited in order to target neoplastic tissue for selective photodynamic destruction. Such multifaceted approaches to targeting and sensitizing tumors through numerous strategies expand the application of PDT to locoregional or systemic neoplastic control and can enhance its therapeutic outcome by combating related treatment escape pathways. In this chapter, we discuss the developments in targeted PDT and the multiple approaches taken in order to maximize treatment outcomes. The chapter is not meant to be entirely comprehensive; rather, a broad but selective choice of approaches is discussed. Although the major portion of the chapter addresses targeted PDT of cancers, some specific examples of non-cancer applications are also discussed.

Wide range lesions may occur in the vulvar region. The aim of the present study is to have an insight into the diverse morphologic spectrum of vulvar lesions. Total of 263 patients with primary vulvar complaints seen in Ankara Numune Training and Research Hospital Gynecology and Obstetrics Outpatient Clinic were recruited into study. The present retrospective study was carried out by compiling the data from archival records from January 2010 to May 2014. The vulvar biopsies specimens were studied for histomorphological features. The lesions were categorized as non-neoplastic, neoplastic and inconclusive; neoplastic ones were further divided into benign, malignant and premalignant.The age of the women ranged from 11 to 85 years (mean 46.27±14.32) with the maximum number of patients between 41 to 50 years of age. Most common clinical presentation was itching (126 cases; 47.9%). The commonest site of vulvar lesions was labia majora (145 cases, 55.1%). Non neoplastic lesions were more common (n = 172; 65.4%) than the neoplastic lesions (n =91; 34.6%). There were 81 (30.8%) benign lesions while 10 cases (3,8%) were malignant or premalignant ones. Amongst the non-neoplastic lesions, the most common histopathologic diagnosis was of lichen sclerosus et atrophicus (46 cases; 17,5%). Early recognition of vulvar lesions and a prompt biopsy diagnosis for all lesions with suspicious changes is of great significance. Key Words: Vulvar lesion, biopsy, non-neoplastic tissue, neoplastic tissue

A cardiac mass (3 × 5 × 3 cm) was detected at the base between the right auricular wall and right vena cava of a slaughtered 6-month-old female mixed-breed pig during a meat inspection. The tumor comprised infiltrative prominent interweaving fascicles of Schwann cells with Verocay bodies. Moreover, the ganglion cells were scattered or aggregated throughout the neoplastic tissue. The ganglion and Schwann cells had neither cellular atypism nor mitosis. On the basis of the bearing site as well as the morphological and immunohistochemical features, this is the first case of a cardiac ganglioneuroma in a pig.

Background: Elastography is a relatively new technology that can generate images reflective of tissue stiffness (elasticity). Neoplastic tissue is usually stiffer than normal structures. Objectives: The aim of this study was to evaluate the feasibility and utility of elastography when combined with convex-probe endobronchial ultrasound (CP-EBUS) for predicting and localizing metastatic lymph nodes during endobronchial ultrasound with transbronchial needle aspiration (EBUS-TBNA). Methods: Consecutive results of endobronchial elastography of lymph nodes performed using EBUS- TBNA were prospectively collected and retrospectively analyzed. Elastography images were acquired as JPEG images and also recorded as video clips. Stiff area ratios [(stiff areas as blue pixels) / (lymph node areas as region of interest pixels)] for each lymph node determined by elastography were collated with the results of pathological diagnosis. We also performed elastography of surgically resected lymph nodes and compared image findings with pathological sections. Results: We evaluated 49 lymph nodes in 21 patients by CP-EBUS. There were 16 metastatic nodes (10 lung cancer metastases and 6 metastases from extrathoracic malignancies). Mean stiff area ratios were significantly greater for metastatic lymph nodes (0.478) than for benign nodes (0.216; p = 0.0002). Using a cutoff value of 0.311 for stiff area ratios, the sensitivity and specificity for predicting metastatic disease were 0.81 and 0.85, respectively. The stiff area was histologically compatible with metastatic distribution in surgically resected lymph nodes. Conclusions: Endobronchial elastography is feasible for lymph nodes when combined with CP-EBUS. Stiff area ratios are useful for predicting metastatic lymph nodes, which may be an efficient guide for TBNA.

The aim of this article is to give a brief overview of mammary neoplasia and the nursing care required for patients with the condition, following the removal of neoplastic tissue. An understanding of what is happening to the patient is vital in order to facilitate the provision of excellent support for both the animal and the veterinary surgeon, whether it be during the recovery period or palliatively.

In photodynamic therapy, neoplastic tissue is damaged and subsequently killed by the targeted illumination of previously photosensitized cells. This review is aimed at a comprehensive, but still easily understandable, presentation of all of the aspects of these methods relevant to ENT-doctors. Initially, an explanation of the clinically relevant difficulties in the therapy of (pre-)malignant lesions of the head and neck region, a historical synopsis of the development of this method and an illustration of the biophysical basics is given. The main part of the publication, however, revolves around the description of the current status of research and a presentation of internationally approved methods. At the end, a short overview of possible future developments in this field is given.

Only very few previously reported cases of pronounced lymphocytic infiltration in parathyroid adenoma can be found in the English medical literature. The objective of this report is to present such a rare case and to investigate to a certain extent the immunohistochemical profile of this rare histologic observation. The lymphoid cell population within the tumour was composed of nodule-forming B-cells and different subsets of infiltrating T-cells and caused minimal destruction of neoplastic tissue.

Sir d We read the recent article by Schmid-Tannwald et al., 1 published in the Journal with a great interest. In this article, the authors discussed the role of quantitative and qualitative assessment of diffusion-weighted (DW) images and apparent diffusion coefficient (ADC) maps in infected and non-infected collections in the liver. As we have a special interest in DW imaging in the characterization of liver lesions, 2e6 we would like to contribute regarding the efficacy of DW imaging and ADC measurement in the evaluation of the hepatic abscess and noninfected fluid collection. As the authors mentioned in the article, ADC values of each lesion were measured by drawing a circular region of interest (ROI), encompassing the entire lesion, on the image in which the lesion was largest. We think that ADC measurement must be performed several times with using small ROIs in different regions and the lowest ADC value must be take into consideration. 2e6 In our clinical practice, we noticed that ROIs encompassing the entire lesion can lead to misinterpretation of the ADC value of the lesion, particularly in those with different components such as necrotic, cystic, infected, or neoplastic tissue. Those areas with high ADC values can increase the mean ADC value of the lesion and can lead to misinterpretation. Another issue is the visual assessment of the DW images and ADC maps, which provides easy and confident evaluation of the solidecystic and simpleecomplicated focal liver lesions. Particularly, in hepatic abscess, central diffusion restriction and peripherally relative increased diffusion in DW images and ADC maps are unique findings and these features can be easily evaluated by visual assessment without time-consuming ADC measurements. Visual assessment is also useful for overcoming the reproducibility problems associated with DW imaging in the liver due different magnetic resonance imaging (MRI) machines, sequence parameters, and differences in ADC values in different parts of the liver.2,4e6

The role of aminolevulinic acid hydrochloride (ALA) in photodynamic therapy (PDT) of in situ neoplasias and tumours of epithelial tumours is steadily increasing and it has been shown to be the drug with most clinical use in PDT. In dermatology, topical PDT with ALA is already postulated to be the treatment of choice for actinic keratoses and superficial basal cell carcinomas. In gastroenterology, pulmonology, uro- and nephrology, neurology and gynaecology ALA has an important role as a photosensitiser not only in the diagnosis of neoplastic tissue but as therapy; first experiences have been made with PDT in these organs. Besides the therapeutic efficacy of this technique, the fluorescence of ALA-induced porphyrins can be effectively used to detect and delineate epithelial and endothelial neoplasms. In dermatology, other indications for ALA-treatment are non-tumoural applications, especially psoriasis, viral-induced diseases, or acne vulgaris. ALA is an effective compound in the diagnosis or therapy of various epithelial and endothelial neoplastic lesions.

The combination of light and chemicals to treat skin diseases is widely practiced in dermatology. Within this broad use of light and drugs, in recent years the concept of photodynamic therapy (PDT) has emerged. PDT is a promising modality for the management of various tumors and nonmalignant diseases, based on the combination of a photosensitizer that is selectively localized in the target tissue and illumination of the lesion with visible light, resulting in photodamage and subsequent cell death. Moreover, the fluorescence of photosensitizing compounds is also utilized as a helpful diagnostic tool for the detection of neoplastic tissue. Intensive basic and clinical research culminated in the worldwide approval of PDT for bladder, esophageal, and lung cancer. The expanding use of this relatively new therapeutic modality in dermatology at many centers around the world has revealed its efficacy for the treatment of cutaneous precancer and cancer, as well as selected benign skin disorders. The following article summarizes the main principles of PDT considering the most recent developments and provides a comprehensive synopsis of the present status of the use of PDT in dermatology. (J Am Acad Dermatol 2000;42:389-413.) Learning Objective: At the conclusion of this learning activity, participants should be able to describe the basic concepts of PDT, including fundamental knowledge of the most relevant photosensitizers, the light sources, the mechanisms involved in PDT-mediated cell destruction, as well as the indications and limitations of photodynamic treatment of skin diseases.

This section features synopses of pertinent practical publications that appear in pathology journals in the respective sub-specialties. The summaries are mere guidelines and personal opinions of the two authors. The articles selected are diverse but occasionally reflect the authors’ bias and are from the more widely read pathology journals. It is not intended to be an assiduous search of every publication in every pathology journal, but more of a general indication of some of the monthly highlights through the eyes of the authors. Hopefully, these snippets will provide the reader with enough to glean some facts and tips, as well as encourage them to read the entire article if necessary. Ahmad Z, Qureshi Z, Khurshid A. The practice of histopathology in a developing country: difficulties and challenges; plus a discussion on the terrible disease burden we carry. J Clin Pathol 2009; 62 :97–101. The next time you have the urge to complain about aspects of our surgical practice in the West, be it volume issues, staffing, salary, teaching, infra-structure (including administration), quality control, or even the autopsy, please read the sobering and humbling experiences of our pathologist colleagues at the Aga Khan University Hospital in Pakistan. Puppa G, Caneva A, Colombari R. Venous invasion detection in colorectal cancer: which approach, which technique? J Clin Pathol 2009; 62 :102–3. The authors advocate advance ordering of serial sections to avoid tissue wastage when a block is re-cut. Clarke B, McCluggage WG. Iatrogenic lesions and artefacts in gynaecological pathology. J Clin Pathol 2009; 62 :104–12. Another excellent overview of iatrogenic lesions and artefacts in gynaecological pathology. These include mechanical displacements of neoplastic tissue into lymphovascular spaces (see later), thermal artefacts (eg, post-ablation of endometrium or cautery granulomas following endometriosis), chemotherapy-induced tissue changes, and leiomyomata changes secondary to GnRH agonists, to name a few. …