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To investigate the association between occupation and the risk of non-Hodgkin's lymphoma (NHL) and chronic lymphocytic leukemia (CLL), and to test whether the associations may vary by histological type of NHL, we analyzed data from two population-based, case-control studies of NHL performed in Kansas and Nebraska. A total of 555 incident NHL cases, 56 CLL cases, and 2380 population-based controls were included in the analysis. Information on occupation and other confounding factors was collected through telephone interviews. Study pathologists reviewed slides of tumor tissues in all cases. In men, we found an increased risk of NHL and CLL for those working in agricultural, forestry, and logging industries (odds ratio [OR], 1.6; 95% confidence interval [CI], 1.2 to 2.1). The OR was 1.9 (95% CI, 1.4 to 2.6) for those producing crops. An increased risk was also observed for industries involving metalworking machinery and equipment (OR, 8.4; 95% CI, 1.4 to 50.6), motor vehicles and motor vehicle equipment (OR, 4.2; 95% CI, 1.3 to 13.9), and telephone communications (OR, 3.1; 95% CI, 1.2 to 8.0), and for teachers (OR, 2.5; 95% CI, 1.0 to 6.5), farmers (OR, 2.0; 95% CI, 1.5 to 2.8), and welders and solderers (OR, 2.9; 95% CI, 1.2 to 6.9). The risks for these associations increased by duration of employment and seem to vary by histological type. Work in the printing and publishing industry was also associated with an increased risk of NHL among women. These data suggest that the workers employed in these industries or occupations experienced an increased risk of NHL and CLL, and the risks associated with these industries or occupations may vary by histological type of NHL.

Few reports exist describing the progression-free and overall survival of children with low-grade (WHO grade II) oligodendrogliomas treated uniformly with aggressive surgery but without adjuvant chemotherapy or radiation therapy. Furthermore, significant prognostic features, including the MIB-1 labeling index (LI), have not been reported for children with oligodendrogliomas. The medical records of 20 consecutive patients with low-grade oligodendrogliomas were reviewed. All patients had been treated with aggressive surgical resection. Adjuvant chemotherapy and radiation therapy were reserved for radiographic or clinical progression. These patients have been followed for a median of 5.5 years (range 0.5–11.5 years) after diagnosis. To date, there have been no patient deaths. Six of the 20 patients experienced tumor progression at a median of 2.2 years (range 0.4–4.8 years) following the initial surgery. The MIB-1 LI was infrequently greater than 5. Of several prognostic factors for subsequent tumor progression that were examined, only tumors located within the parietal lobes were associated with a worse progression-free survival. Other risk factors, including presenting symptoms, age at diagnosis, MIB-1 LI and the extent of tumor resection, were not associated with an increased frequency of tumor progression.

Resume But de l’etude : La chirurgie des cancers avances de l’ovaire a pour but d’obtenir un residu tumoral minimal necessitant parfois des exereses digestives. Patientes et methodes : La survie globale et sans rechute, la morbidite et mortalite postoperatoires de soixante-deux patientes presentant un cancer de l’ovaire de stade III ont ete etudiees retrospectivement en fonction de differents parametres (stade, grade histologique, residu tumoral postoperatoire, vitesse de normalisation du CA 125 , complications postoperatoires et duree d’hospitalisation). Deux groupes de patientes etaient individualises en fonction de la chirurgie pratiquee (groupe 1 : chirurgie gynecologique et digestive 〚 n = 17〛 ; groupe 2 : chirurgie gynecologique exclusive 〚 n = 45〛). Toutes les patientes etaient traitees par une polychimiotherapie adjuvante a base de sel de platine. L’âge moyen etait de 60 ans (extremes : 20–83). Sept stades IIIa, dix stades IIIb et 45 stades IIIc etaient repertories. Resultats : La mortalite postoperatoire etait de 3,5 % (2/62). La morbidite postoperatoire de 26 % (13/62). La realisation d’une resection gastro-intestinale et/ou d’une splenectomie n’influencait ni la duree d’hospitalisation globale, ni la duree d’hospitalisation en unite de soins intensifs, ni la morbidite aspecifique ou specifique liee a l’acte chirurgical. La survie globale a cinq ans etait de 56 %. Seul un residu tumoral postoperatoire de moins de 2 cm 3 est un element influencant la survie globale (56 % versus 23 % ; p = 0,03) et la survie sans rechute (84 contre 46 % ; p = 0,02). Conclusion : Les exereses digestives necessaires a l’obtention d’un residu tumoral postoperatoire minimal ne semblent pas accroitre la mortalite ni la morbidite postoperatoire de la chirurgie des cancers avances de l’ovaire.

Although tumour stage and nodal status are established prognostic factors for resectable gastric cancer, the relative importance of other pathological characteristics remains unclear. This study reports univariate and multivariate analyses of the prognostic value of various pathological and staging factors based on 324 patients entered into the MRC randomised surgical trial for gastric cancer. In the univariate analysis tumour stage, nodal status, UICC clinical stage, number of involved nodes, WHO predominant type, mixed Lauren type, Ming type, tumour differentiation, lymphocytic and tumour stromal eosinophilic infiltration were all found to have a significant impact on survival (logrank test, 5% level). In the multivariate analysis, UICC clinical stage and eosinophilic infiltration were found to have a significant influence. Risk of death increased for UICC stage II and III patients (Hazard Ratio for stage II compared to stage I=2.0, 95% Confidence Interval (CI) 1.4–2.9; Hazard Ratio for stage III compared to stage I=3.5, 95% CI 2.5–4.8). Patients with numerous eosinophils had a lower risk of death than those with none (Hazard Ratio=0.5, 95% CI 0.3–0.8). This association between survival and eosinophilic infiltration merits further study. British Journal of Cancer (2002) 86, 674–679. DOI: 10.1038/sj/bjc/6600161 www.bjcancer.com © 2002 Cancer Research UK

The authors discuss the terminology, classification, diagnosis, treatment and prognosis of neuroendocrine neoplasms of the larynx.

Esophageal squamous cell carcinoma (ESCC) has been well characterized as a major histological type in China and occurred predominantly in the mountain rural region with poor economics. Nutritional deficiencies have been recognized as major risk for esophageal carcinogenesis in these rural regions. In the past decades, the rural economic status in China has improved apparently. However, the time trending for ESCC in rural regions has not been characterized. The present study was thus undertaken to determine the time trending for the ratio of rural and urban patients with ESCC in a single institute in northern China over the past 30 years (1985-2014). All the 66,515 ESCC patients in this study were derived from the esophageal and gastric cardia carcinoma databases of 500 thousands patients (1973-2015) established by Henan Key Laboratory for Esophageal Cancer Research of the First Affiliated Hospital of Zhengzhou University in Henan, China. Of the ESCC patients, 50,313 patients had been recorded with detailed address. Based on the diagnosed time, these patients were divided into three groups with periods of 1985-1994, 1995-2004 and 2005-2014. The rural and urban regions were recognized based on the government administrative division of China. The rural region in China refers to the farmer village with hundreds to thousands population. Chi-Square test was used to analyze the different distributions of ESCC patients with a p-value of less than 0.05 as significant. The results demonstrated that more than 84% of the ESCC patients occurred in rural regions with an overall ratio of 5:1 for rural and urban regions (p < 0.0001). Moreover, over the past 30 years with three periods, the ratios for rural and urban regions were 5.4:1, 5.5:1 and 5.4:1, respectively. The present results also demonstrated that over the past 30 years with three periods, ESCC occurred predominantly in males with ratios for male and female as 1.5:1, 1.4:1 and 1.5:1, respectively in rural regions and 1.6:1, 1.6:1 and 1.8:1, respectively in urban regions. Interestingly, the mean age both in male and female in urban regions was slightly older than that in rural regions (urban vs. rural: 60.7±9.86 vs. 59.8±9.38 in male and 62.2±9.57 vs. 60.6±9.47 in female, respectively). The present study demonstrated that ESCC remains the major healthy burden in rural regions in China. Considering the relative low socioeconomic status in China, the prevention and control of ESCC should be enhanced in rural regions in terms of more control programs, medical and education resources. [Supported by National High-Tech Research and Development Program of China (SQ2015AA0202183), Project for Characteristic and Advantage Discipline of Henan Province (20151208)] Note: This abstract was not presented at the meeting. Citation Format: Shou Jia Hu, Hai Jun Yang, Neng Chao Wang, Xiu Min Li, Shuang Lv, Qi De Bao, Wen Bin Yue, Hui Meng, Dan Feng Du, Xue Min Li, Fu You Zhou, Jian Li, Li Dong Wang. Time trending for the ratio of rural and urban patients with esophageal squamous cell carcinoma in a single institute in northern China over the past 30 years [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2017; 2017 Apr 1-5; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2017;77(13 Suppl):Abstract nr 264. doi:10.1158/1538-7445.AM2017-264

e20514 Background: Lung cancer is considered the most common cause of death in the world. The prognosis for patients is poor and depends on the clinical stage and the histological type of cancer. There is a need to identify and develop new therapeutic targets that could improve the prognosis of NSCLC patients and may be responsible for development of resistance to TKI therapy. Increased expression of Fn14 or CD44v and EGFR was observed in many tumors and also correlated with the overall survival of NSCLC patients Methods: We analyzed the clinical data and the immunohistochemical expression of Fn14, CD44v and EGFR in tumor tissues from 61 patients with NSCLC divided in two groups according to the presence of activating EGFR gene mutation. The aim of the study was to evaluate the correlation between the expression of the studied molecules and the neoplastic disease course of NSCLC patients. Results: Increased expression of Fn14 was observed in study group (B) compared to expression of this molecule in the control group (K). There were no differences in the intensity of the reaction with anti CD44v and EGFR antibodies in both groups. OS was significantly longer in the study group. Histological grade of tumor correlated with the intensity of CD44v expression in both groups. There was no correlation between the OS and Fn14 expression in any group. Negative correlation was noted between the expression of CD44v and the OS in the study group and between EGFR expression and the OS in both groups. Conclusions: Our observations suggest that the expression of CD44v and EGFR may be useful clinical markers of prognostic value in lung adenocarcinoma patients regardless of the presence of activating mutation in EGFR gene. Simultaneous assessment of Cd44v and EGFR expression may grant a greater prognostic value than the assessment of each receptor separately. Increased expression of Fn14 receptor in patients with EGFR gene mutation may become a new target in therapy allowing to eliminate the problem of secondary resistance to treatment with TKI’s

e20055 Background: Lung adenocarcinoma (LAC) is the most common histological type of non-small-cell lung cancer and is one of the malignancies with the most evolved personalized treatments based on molecular characteristics of the tumor. Mutations in EGFR, HER2 and BRAF, specific translocations of ALK, ROS1, RET and amplification of MET all have standard diagnostic importance and lead to specific treatment options for the individual LAC patients. Recently, in 2-4% of LAC MET gene mutations leading to skipping of exon 14 were found. These mutations were described to occur more frequently in tumors with sarcomatoid histology. LAC with MET exon 14 skipping mutations showed impressive, although temporary, responses to MET tyrosine kinase inhibitors (TKI) crizotinib, cabozantinib and capmatinib. We will present our experience with routine molecular diagnostic detection of the most common MET exon 14 skipping mutations. Methods: In January 2016 we included in our standard, DNA based, molecular diagnostics custom-made NGS analyses 4 amplicons for detection of MET skipping mutations. The analyses were performed on microdissected FFPE tissue sections or routine histology or cytology stained preparations. Nine different mutations were validated for their effect on splicing by RT-PCR on RNA isolated from the same tissue samples. Results: Between January 2016 and January 2017 676 routine molecular diagnostic analyses on LAC were performed. In 18 (2.7%) cases MET mutations were detected possibly resulting in exon 14 skipping. Nine out of 16 different mutations were tested by RT-PCR and all 9 were demonstrated to result in MET exon 14 skipping. Conclusions: MET exon 14 skipping mutations can reliably be detected in routine pathology tissue samples. These analyses can easily be included in routine molecular diagnostic NGS. When necessary, confirmation of the mutational effect on RNA splicing can be implemented as well. Routine identification of MET skipping mutations (2.7% of cases) adds substantially to the personalized targeted treatment strategies for LAC patients.

Background: Head and neck lesions include a spectrum of pathological lesions ranging from simple benign to highly malignant entities. These lesions contribute significantly to morbidity and mortality of patients. The aim of this study was to determine the histological patterns of head and neck lesions, both non- neoplastic and neoplastic and to analyse the data in relation to age, gender, topography.Methods: A two year retrospective study was conducted in the Post Graduate Department of Pathology, ASCOMS and Hospital and histopathological data pertaining to all head and neck lesions was reviewed. Each case was analysed with respect to age, gender, site and histological type.Results: One hundred and forty-five cases from the head and neck region were analysed during this two-year period. Age range was from 3 months to 85 years with maximum cases in the age group of 21-50 years (51.03%). The Male: Female ratio was 1.37:1. In our study, 53.79% benign, 24.13% inflammatory and 22.06% malignant cases were recorded. Maximum number of benign lesions was in the age group of 21-50 years. Malignancies were noted to be higher in ages 51 years and above. Squamous cell carcinoma was the most common malignancy observed.Conclusions: We conclude that site specific data like this is helpful in evaluating patterns of head and neck lesions and augment the base line data of institute and the region.

INTRODUCTION: Lung cancer is among leading causes of death worldwide. Different histological types of the lung carcinoma show significant differences in behavior. OBJECTIVES: The aim of this study is to determine the distribution patterns of metastases of different lung cancer histological types in autopsied individuals. METHODS: Protocols from all autopsies performed at the Institute of Pathology from 2008 till 2014 were reviewed retrospectively, and information on individuals' age, sex, histological type of primary lung cancer, presence and location of metastases, and causes of death were recorded. RESULTS: More than 90% of the individuals with lung cancer metastases were older than 50 years (mean age: 64.5 ± 10.3), with two-fold male predominance. The most frequent histological type in both sexes was adenocarcinoma (48%). Although, in general, hematogenous metastases were mostly found in the liver and adrenal glands, various histological types of lung cancer show specific dissemination patterns. Metastases in adrenal glands derived mostly from adenocarcinoma and large-cell carcinoma. Metastases in the intestines most frequently originated from large-cell carcinoma (P = 0.01). Metastatic complications and bronchopneumonia were the most frequent causes of death. CONCLUSIONS: While, overall, the most frequent hematogenous metastases occur in the liver and adrenal glands, various histological types of lung cancer show specific dissemination patterns. Knowing distribution of metastases is essential for making algorithms of treatment, as well as for improving clinical assessment of the patients with unclear clinical findings and suspicion on occult primary lung cancer.

AIM: To clarify the effects of the xeroderma pigmentosum group D (XPD) Asp312Asn and Lys751Gln gene polymorphisms on the risk of esophageal cancer (EC). METHODS: A computerised literature search was conducted to identify the relevant studies from the PUBMED and EMBASE databases, reviews, and reference lists of relevant articles. Odds ratios (ORs) with 95% confidence intervals (CIs) were used to assess the associations between the XPD Asp312Asn and/or Lys751Gln polymorphisms and EC susceptibility. Statistical analyses were performed using the software Stata 12.0. A fixed or random effects model was selected based on a heterogeneity test. Publication bias was estimated using funnel plots and Egger’s linear regression method. Subgroup analyses were performed based on histological type and ethnicity. RESULTS: Thirteen case-control studies with a total of 10 comparisons for the Asp312Asn polymorphism, including 2373 cases and 3175 controls, and 15 comparisons for the Lys751Gln polymorphism, including 3226 cases and 5237 controls, were recruited for the meta-analysis. In terms of the XPD Asp312Asn polymorphism, significantly increased EC risks were identified in the Asp/Asn vs Asp/Asp comparison (OR = 1.17, 95%CI: 1.02-1.33, P = 0.03) and in the dominant-model comparison (Asn/Asn+Asp/Asn vs Asp/Asp: OR = 1.18, 95%CI: 1.04-1.34, P = 0.01). However, no significant associations were found in the Asn/Asn vs Asp/Asp comparison (OR = 1.30, 95%CI: 1.00-1.70, P = 0.05) or in the recessive-model comparison (Asn/Asn vs Asp/Asn + Asp/Asp: OR = 1.17, 95%CI: 0.91-1.50, P = 0.22). In terms of the XPD Lys751Gln polymorphism, a significant association with EC susceptibility was found under the recessive model (Gln/Gln vs Lys/Gln+Lys/Lys: OR = 1.21, 95%CI: 1.02-1.43, P = 0.03). However, no associations were identified in the other comparisons (co-dominant model: Lys/Gln vs Lys/Lys: OR = 1.11, 95%CI: 0.94-1.31, P = 0.20; Gln/Gln vs Lys/Lys: OR = 1.31, 95%CI: 0.98-1.75, P = 0.07; dominant model: OR = 1.14, 95%CI: 0.96-1.35, P = 0.14). CONCLUSION: The results of this meta-analysis suggest that the XPD Asp312Asn and Lys751Gln gene polymorphisms are associated with a significantly increased risk for EC.

Introduction: Carcinoid of the appendix is a rare clinical entity in childhood and usually has a good clinical outcome. The impact of the operative preparations appendix ranges between 0.1-0.9%. The aim of our study is to report the experiences of our department in the management of appendiceal carcinoid tumors in children. Materials and Methods: Data of all patients aged 15 y or less who underwent appendectomy at the 2nd Department of Pediatric Surgery of Aristotle University of Thessaloniki between January 2004 and February 2014 were evaluated for the existence of appendiceal carcinoid tumors in pathological specimens. The collected data included: gender, patient’s age, clinical indications and surgical intervention, tumor localization in the appendix and the diameter of lesion, histological type of the tumor and postoperative care (follow up) of patients. Results: Four cases (3 girls, 1 boy) with carcinoid treated at our department during a 10 y period. Median patient age was 10.75 y (9- 12 y). In all cases the diagnosis was after appendectomy on ground of acute appendicitis. A single incident brought findings of gangrenous appendicitis. In three cases the tumor’s diameter was smaller than 1cm, while the incident with the gangrenous appendicitis was larger than 1cm in diameter. In four cases the tumor was localized at the apex of the appendix without extending to the surrounding tissues. In all patients with carcinoid tumor followed a further testing based on specific monitoring protocol. In no case was residual or metastatic disease identified and no further treatment was required. No relapse was observed during follow-up. Conclusion: Our study confirms the good prognosis of appendiceal carcinoid.

Endometrial carcinoma (EC) represents the most common gynecological malignancy in developed countries and usually manifests with abnormal vaginal bleedings in perimenopausal women. The diagnosis of EC is performed by means of transvaginal sonography and endometrial biopsy, and the treatment of choice is surgery. MRI is the imaging modality of choice for preoperative staging of EC and is extremely accurate in evaluating the depth of myometrial invasion and the presence of cervical stromal infiltration; on the other hand, MRI sensitivity in recognizing nodal metastases remains quite limited. The knowledge of MRI stage of EC in association with the knowledge of its histological type and grade enables to tailor the best surgical approach for each patient.

Background We retrospectively reviewed outcomes of treatment with pazopanib, an oral multi-tyrosine kinase angiogenesis inhibitor, in patients with advanced soft tissue sarcoma, a rare and heterogeneous tumor group with limited treatment options. Methods Between 2009 and 2013, 43 patients with metastatic soft tissue sarcoma received pazopanib as salvage chemotherapy after one or more cytotoxic regimens. Response rate, progression-free survival, and overall survival were analyzed according to histological subtype, Eastern Cooperative Oncology Group performance status, and metastatic site. Results Common histological subtypes included leiomyosarcoma (n = 9), angiosarcoma (n = 6), malignant fibrous histiocytoma/undifferentiated pleomorphic sarcoma (MFH/UPS, n = 5), malignant peripheral nerve sheath tumor (MPNST, n = 5), and synovial sarcoma (n = 4). Nineteen patients (44.2%) received more than two chemotherapy regimens before pazopanib. At the time of analysis, 208 treatment cycles of pazopanib had been administered (median, 4.8 cycles per patient), and no treatment-related mortality occurred. The disease control rate was 61.0% (95% confidence interval [CI], 46.1–75.9%), and the overall response rate was 17.1% (partial response, n = 7; complete response, n = 0). Partial response was achieved in two patients with synovial sarcoma, two with MFH/UPS, one with MPNST, one with leiomyosarcoma, and one with angiosarcoma. The median lengths of progression-free survival and overall survival were 5.0 months (95% CI, 3.6–6.4 months) and 8.2 months (95% CI, 5.8–10.6 months), respectively. Progression-free survival was shorter in the patients with liposarcoma and rhabdomyosarcoma (1.3 and 0.9 months, respectively) than in those with leiomyosarcoma, MPNST, MFH/UPS, and synovial sarcoma (5.6, 6.5, 7.1, and 7.7 months, respectively). Conclusions Pazopanib demonstrated acceptable antitumor activity in the Asian patients who had been heavily pretreated for sarcoma, with seemingly more favorable results in the patients with leiomyosarcoma, MPNST, MFH/UPS, and synovial sarcoma than in those with liposarcoma and rhabdomyosarcoma. Electronic supplementary material The online version of this article (doi:10.1186/s12885-015-1160-x) contains supplementary material, which is available to authorized users.

Background The aim of our study was to evaluate the histological characteristics and prognosis of gastric cancer. Methods Clinicopathlogical variables of 932 patients with gastric carcinoma admitted to the Department of Surgical Oncology at the First Hospital of China Medical University were analyzed retrospectively. Different histological characteristics of gastric cancer were summarized and assigned score according to the malignancy defined by WHO classification, the scores were stratified into 4 stage, the prognosis of different stages were analyzed by Kaplan-Meier analysis and cox regression. Results Among the 932 patients, 246 (26.39%) had mixed histology type of gastric cancer. Compared to the pure histological type, mixed histological type of gastric cancer was significant associated with tumor size, lymph node metastasis and depth of invasion (all P

Most tumours of the major salivary glands are single and unilateral, and involve the parotid. It is uncommon for synchronous, multifocal tumours of the same histological type to affect one gland, and cases with multiple types are rare. Extracapsular dissection, an established technique for the safe removal of benign tumours of the parotid gland, has low rates of morbidity and recurrence, but relies on careful preoperative assessment and selection of cases. In a consecutive series of 70 cases of extracapsular dissection over 5 years by one surgeon, we found a 4% incidence (n = 3) of synchronous, unilateral, multiple adenomas in the parotid gland.

Aim: To evaluate the predominant colorectal polyps in the Almadinah region of Saudi Arabia. Materials and Methods: In this iretrospective study, we analyzed pathology reports of colonoscopies performed in King Fahad Hospital, Madinah, Saudi Arabia during the period 2006 to 2013. Data based on patient age, gender, size, site and type of polyps and the degree of dysplasia were analyzed by software SPSS 17 and compared with other published studies from different geographic regions of the world. Results: During these years, 224 patients had colonic polyps, of whom 149 (66.5%) were men and 75 (33.5%) were women. The most common types of polyps were adenomatous (166), followed by hyperplastic polyps (24), juvenile (18), inflammatory (13), lipomatous (2) and one patient with Peutz-Jegher polyps. Tubulovillous adenoma was the commonest adenomatous polyp (102), followed by tubular (41) and villous (23) types. The sigmoid colon was the most commonly involved region (36.6%). Dysplasia was significantly associated with female patients who had large size tubulovillous polyps located in the left colon. Conclusions: The type and distribution of colorectal polyps in Saudi Arabia is very similar to Western countries. Patient gender, and size, histological type and location of polyps are closely related to dysplastic change in colonic polyps.

Retroperitoneal sarcomas are rare neoplasms that account for only 1%-2% of all solid tumors and liposarcomas represent the most frequent histological type. We describe the case of a 44-year-old female with a retroperitoneal myxoid liposarcoma of 22 × 19 × 8 cm in size. The only symptoms were persistent pain and progressive tenderness of the abdomen lasting for two months. The mass was radically excised during laparotomy. CT and MRI were useful to clarify the site of origin of the tumor, relationships with other organs, and planning surgery but final diagnosis was based on histological findings. Here we review the literature about the challenging diagnosis, treatment, and prognostic factors of this disease.

Malignant tumors of the central nervous system (CNS) occur mainly in the brain, as the anatomic site is in the other parts of the CNS only in

OBJECTIVE:: To study the association between occupational asbestos exposure and pleural mesothelioma, lung cancer, and laryngeal cancer, specifically addressing risk associated with the lower end of the exposure distribution, risk of cancer subtypes, and the interaction between asbestos and smoking. METHODS:: Using the Netherlands Cohort Study (n = 58,279 men, aged 55 to 69 years), asbestos exposure was estimated by linkage to job-exposure matrices. After 17.3 years of follow-up, 132 pleural mesothelioma, 2324 lung cancer, and 166 laryngeal cancer cases were available. RESULTS:: The multivariable-adjusted model showed overall positive associations between all levels of asbestos exposure and mesothelioma, lung cancer, and laryngeal cancer. Lung adenocarcinoma and glottis cancer showed only a positive association after prolonged higher asbestos exposure (hazard ratio per 10 years increment, 1.43 [95% confidence interval, 1.06 to 1.93] and 1.95 [95% confidence interval, 1.36 to 2.80], respectively). There was no statistically significant interaction between asbestos and smoking. CONCLUSIONS:: Asbestos levels encountered at the lower end of the exposure distribution may be associated with an increased risk of pleural mesothelioma, lung cancer, and laryngeal cancer. © 2013 by American College of Occupational and Environmental Medicine.

Smooth muscle tumours of the uterus are common and the majority are benign leiomyomas. However, there are some tumours which exhibit unusual morphological features or growth patterns that cause difficulty in their distinction from malignant neoplasms and those with endometrial stromal differentiation. Such lesions are reviewed in this article with detailed descriptions of their morphology, differential diagnosis and correlation with biological behaviour.

This case-control study of tobacco smoking and acute myeloid leukemia (AML), emphasizing specific associations with morphologic and cytogenetic subtypes, comprised smoking histories for 333 cases and 351 controls. Smoking status (ever smokers versus life-long non-smokers) showed no evident effect on AML risk. However, an effect of smoking was indicated at high cumulative smoking doses (pack-years), e.g. 40 pack-years was associated with an odds ratio (OR) of 1.5 [95% confidence interval (CI) 1.0-2.3]. Among morphologic subtypes, the smoking associated OR for acute erythroleukemia was 8.9 (95% CI 1.0-76). No clear associations between smoking and cytogenetic subtypes of AML were observed.

Objective: To clarify the relationship between age, histological type, and size of ovarian tumors. Method: A review was made of 1648 cases of histopathologically diagnosed ovarian tumors and tumor-like lesions, and information on the age of the patients and size of the tumor was obtained. Statistical analysis was performed using Kruskal–Wallis tests or Mann–Whitney U-tests. Results: There were 840 (51%) cases of benign tumors, 73 (4%) cases of tumors of low malignant potential (LMP), 268 (16%) cases of malignant tumors and 467 (28%) cases of tumor-like lesions. The age of the patients was significantly different among tumor-like lesions (34.6±8.1 years), benign tumors (39.8±16.4 years), LMP tumors (45.2±18.3 years) and malignant tumors (51.9±13.0 years) (P

Objective To determine whether association between classification of interval cancers (false negative, minimal sign, true interval, occult) and tumour characteristics can indicate areas for improvement in effectiveness of screening . Setting East Anglian regional Breast Screening Programme. Method The consensus classification of interval cases, obtained through peer review, was compared with tumour characteristics: size; grade; and nodal status, and with radiological signs. A set of 923 cancers with known tumour characteristics, presenting in unscreened women, was available for comparison. Result In total, 385 interval cases were analysed. Prognosis of interval cancers was at least as good as that of cancers in unscreened women, with fewer node positive cases. No significant relation was found between classification of cases and age of patients. True intervals tended to present later after a negative screen, although false negatives commonly presented earlier. Occult cancers were significantly smaller than false negatives. Analysis of histological type yielded little of relevance, and mammographic appearance was similar in all classifications. At diagnosis, cancers in the low risk group were more likely to be seen as spiculate masses, whereas high risk cases more often appeared as opacities. A higher proportion of interval cases had been assessed than in the normal screened population. Conclusion Sensitivity may be improved by reducing false negative and minimal sign cases (21% of interval cancers in East Anglia). These will include tumours in all risk groups, and with all radiological features, thus no particular age group or radiological feature may be targeted for improvement. Misdiagnosis at assessment reduces sensitivity and therefore merits particular study.

The term “orbital tumors” comprises a wide variety of lesions that often share the same cardinal clinical finding (exophthalmos) and clinical history. Age at presentation, associated ophthalmological findings, and radiological features, however, provide invaluable information as to the possible histological type of tumor. The present article serves as an introductory overview regarding the pathological characteristics, clinical features, radiological characteristics, and principles of treatment of orbital tumors.

Keywords: hepatocellular carcinoma; small hepatocellular carcinoma; hepatocellular carcinoma with lymphoid stroma; fibrolamellar carcinoma; encapsulated hepatocellular carcinoma; regressing hepatocellular carcinoma; diagnosis; prognosis

Objetivo: analisar alguns fatores que possam estar associados à ocorrência de material insuficiente nos aspirados da punção aspirativa por agulha fina (PAAF). Pacientes e Métodos: foram estudadas 351 citologias de pacientes com nódulos sólidos da mama, submetidas a PAAF, como parte de sua investigação diagnóstica. As lâminas foram analisadas por um único citologista, que classificou os esfregaços como malignos, suspeitos, benignos ou material insuficiente para diagnóstico. Foram avaliados a idade da paciente, o tamanho do tumor, o estádio clínico, o Serviço, o dispositivo utilizado na punção e o tipo de lesão puncionada, de acordo com a histologia. A significância de cada variável em relação ao material insuficiente foi testada pelo c². Resultados: houve 67 esfregaços classificados como material insuficiente (19%). O tipo de dispositivo utilizado, o tamanho do tumor, o Serviço e o estádio clínico das lesões não se relacionaram à quantidade de material suficiente ou insuficiente. A idade da paciente e o tipo histológico influenciaram a taxa de material insuficiente, sendo que as pacientes abaixo de 50 anos tiveram uma taxa de 12%, comparada a 30% daquelas acima de 50 anos (p

Since different histological types (HT) of gastric cancer (GC) may differ in their aetiology, time trend analysis by HT may afford an insight into aetiology. From the Gastric Cancer Registry of Japan, 161 067 cases diagnosed were retrieved between 1975 and 1989 to calculate the annual relative frequencies, stratified by age group and sex, of HT according to the Lauren and the Japanese Research Society for Gastric Cancer (JRSGC) classifications. Age- and sex-specific incidence rates by HT were estimated by multiplying the corresponding national cancer incidence rates of GC by the relative frequencies. Logistic regression models stratified by sex and age group were fitted to determine the time trends of HT. Using the Lauren classification, a decreasing trend of the intestinal type and a stable trend of the diffuse type were found. By the JRSGC classification, significant decreasing trends for most age groups were found for papillary and mucinous adenocarcinomas. Tubular adenocarcinomas (well differentiated type) showed a decreasing trend only in younger age groups. Tubular (moderately differentiated type), poorly differentiated adenocarcinomas, and signet ring cell carcinoma were statistically stable during the period. Considering changes in lifestyles of the Japanese, the result suggests that there are three aetiological types of GC. © 2001 Cancer Research Campaign http://www.bjcancer.com

目的:乳腺穿刺吸引細胞診による浸潤性乳管癌の組織型推定の診断精度について検討した.方法:原発性浸潤性乳管癌/44例に特殊型乳癌19例を加えた163例を対象とした. 細胞診標本はパパニコロウ染色標本で観察し, 細胞診の推定組織型と主診断組織型との一致率を検討した.成績:浸潤性乳管癌の穿刺吸引細胞診の推定組織型と主診断組織型の一致率は74%であった. 硬癌が83%で最も高く, 乳頭腺管癌72%, 充実腺管癌64%であった. また, 腫瘍を構成する組織型が10%以上を占める組織型の一つと細胞診の推定組織型との一致率は87%であった. 特殊型の粘液癌, 髄様癌, アポクリン癌は全例診断されたが, 浸潤性小葉癌の一致率は60%であった.結論:穿刺吸引細胞診による浸潤性乳管癌の組織型推定と主診断組織型は高い一致率を示し, 穿刺吸引細胞診の診断精度の信頼性が示された.

Presentation of Case A 71-year-old woman was admitted to the hospital because of a pituitary mass. During the five years before admission, the patient had been tired and anorectic, her joints had ached, and her neck and shoulders had become stiff. A diagnosis of polymyalgia rheumatica had been made, and she had refused to take prednisone. She had become depressed after the death of her husband 12 years before admission. Because she frequently traveled within the United States to visit her daughters, her medical care was fragmented and inconsistent. Laboratory tests performed six years before admission showed hyperlipidemia, with normal . . .

Aggregates of embryonic cells undergo a variety of intriguing processes including sorting by histological type and envelopment of cell masses of one type by another. It has long been held that these processes were driven by differential adhesions, as embodied in the famous differential adhesion hypothesis (DAH). Here, we use analytical mechanics to investigate the forces that are generated by various sub-cellular structures including microfilaments, cell membranes and their associated proteins, and by sources of cell–cell adhesions. We consider how these forces cause the triple junctions between cells to move, and how these motions ultimately give rise to phenomena such as cell sorting and tissue envelopment. The analyses show that, contrary to the widely accepted DAH, differential adhesions alone are unable to drive sorting and envelopment. They show, instead, that these phenomena are driven by the combined effect of several force generators, as embodied in an equivalent surface or interfacial tension. These unconventional findings follow directly from the relevant surface physics and mechanics, and are consistent with well-known cell sorting and envelopment experiments, and with recent computer simulations.

La dysplasie epitheliale du tractus gastro-intestinal est definie comme une “lesion neoplasique non equivoque” confinee a la membrane basale. La dysplasie est la phase initiale du developpement du cancer et elle peut etre reconnue en etude morphologique de routine. Le diagnostic de dysplasie est lie a la reconnaissance en routine d’anomalies cytologiques, et architecturales sur les coupes colorees a l’hematoxyline-eosine. Differents types de dysplasie peuvent etre distingues. L’histologie permet de distinguer differents sous-groupes mais la dysplasie peut se developper sur un tissu d’apparence normale ou un tissu inflammatoire chronique et dans ce cas, elle peut faire suite a une metaplasie. La dysplasie peut-etre subdivisee en differents degres de severite, qui dependent de l’intensite des anomalies cytologiques et architecturales. L’histoire naturelle de la dysplasie est peu connue et sa progression vers le cancer est une notion precieuse. Toutefois, en pratique, la dysplasie n’est pas toujours un precurseur de lesion precancereuse. Elle peut aussi constituer un marqueur de cancer invasif deja present.

A rare case of cellular schwannoma of the hypoglossal nerve, with intraspinal extension, presenting without any recognisable impairment of the function of the hypoglossal nerve is presented.

From 1990–1996, 1,485 previously untreated invasive breast carcinomas were sampled by a pathologist for flow cytometric DNA analysis. The aim of the present work was to study the variations of flow cytometric DNA ploidy and S-phase evaluation according to the conditions of DNA histogram interpretation. Results obtained with the American Consensus guidelines of 1993 and the Francois Baclesse Department of Pathology's own guidelines are presented. According to the percentage of events taken into account to identify a DNA aneuploid peak, the proportion of DNA diploid cases can change from 35–39%. For S-phase evaluation, although the two guidelines were quite different, the results of S-phase cutoff were identical. Whichever guidelines were used, there was a strong relationship between DNA ploidy and/or S-phase and classical clinicopathological factors (T, N, histological type, grade, receptor status, or lymphatic invasion), with the exception of age, whose correlation was discrepant with S phase according to the set of guidelines. Whichever guidelines were used, ploidy and S phase correlated strongly with survival (overall, metastasis-free, or recurrence-free). Hence we recommend the use of the American consensus guidelines, despite minor imperfections, because they are now well-known, allow a high yield in the ratio of assessable S phases, and permit standardization in the technical processing and reporting of S phases, thanks to the use of terciles.Cytometry (Comm. Clin. Cytometry) 42:35–42, 2000 © 2000 Wiley-Liss, Inc.

Resume But de l'etude : Alors que les resections hepatiques pour metastases sont souvent realisees dans les cancers colorectaux ou neuroendocrines, elles restent discutees dans les autres cancers. Le but de ce travail etait de rapporter une serie de 27 patients ayant eu 32 hepatectomies pour metastases non colorectales, non neuroendocrines. Patients et methode : Entre 1986 et 1997, 27 patients (20 femmes et sept hommes d'âge moyen 56,8 ans) ont ete operes dans le meme centre de metastases hepatiques. Le cancer initial etait un adenocarcinome genital (ovaires ou trompes) cinq fois, un adenocarcinome digestif non colorectal huit fois, un sarcome huit fois et d'origine diverse six fois. Les exereses hepatiques ont ete neuf fois des resections atypiques et 23 fois des hepatectomies reglees (13 droites dont deux elargies, quatre gauches, six bi- ou trisegmentectomies droites ou gauches). Resultats : Aucun deces peri-operatoire n'est survenu. Huit complications postoperatoires ont ete observees (necessitant trois reinterventions) chez sept patients. Aucun patient n'a ete perdu de vue. La survie globale a un, deux et cinq ans, toutes histologies confondues, a ete respectivement de 59, 44 et 23 %. La survie mediane la plus longue a ete observee dans les adenocarcinomes genitaux (27 mois), celle des autres types histologiques a varie de 13 a 18 mois. Conclusion : Cette serie confirme qu'une survie equivalente a celle des resections hepatiques pour metastases colorectales peut etre obtenue chez des patients selectionnes ayant des localisations hepatiques secondaires a des cancers non colorectaux, non neuroendocrines.

No Abstract Available

A case of schwannoma at the soft palate that puts into focus the problems of pre-operative diagnosis is reported. The patient was a 23-year-old female with a 13-year history of a mass at the soft palate. First, we suspected pleomorphic adenoma. CT and MRI revealed compatibility with an image of schwannoma. The surface of the tumor was smooth, but we observed small development of ulceration, and therefore, we considered the possibility of a low grade malignant tumor. Each FNA that was performed 3 times was class I.In the case of pleomorphic adenoma, we can diagnose its histological type at a considerably highrate of precision using FNA.Deducing from the results of FNA, which was performed 3 times, and was in each case class I, along with the distinctive images obtained by CT and MRI, we should have suspected schwannoma from these observations.

The authors report the case of a 44-year-old man in whom a poorly differentiated primary carcinoma of the head of the epididymis was discovered incidentally. Due to the rarity of this diagnosis, a comprehensive assessment was performed looking for a primary tumour, but without success. Despite early surgical resection, the patient developed lymph-node metastases. This exceptional tumour showed low sensitivity to chemotherapy. Malignant tumours of the epididymis are exceptional and require investigations to detect a primary tumour. Treatment is based on surgical resection, ideally via an inguinal incision, combined with chemotherapy adapted to the histological type.

Ependymomas are glial tumors. They constitute approximately 5-10% of intracranial tumors. Ependymomas are tumors which can recur. Predictive factors of outcome in ependymomas are not well-established. Karyotypic studies on ependymomas are relatively scarce, and no specific chromosomal change has been described in these neoplasms. We performed a cytogenetic study of 33 ependymomas, of which eight were recurrent tumors, to determine the type and incidence of cytogenetic changes.

Two cases of fetal intracranial tumors detected prenatally by ultrasound, together with a review of the literature on this rare disease, are presented. Sonographic features, histopathological type and location of the tumors, sex distribution, associated anomalies and overall prognosis are described as well as obstetric and postnatal therapeutic management.

We report a 74-year-old woman and a 50-year-old woman with similar histories of headache and visual disturbance who were found to have adamantinomatous craniopharyngiomas which contained melanin pigment. This finding was confirmed by the Masson Fontana method and ultrastructural studies. These are only the second and third cases reported describing melanin pigment within a craniopharyngioma. The finding of melanin in craniopharyngiomas attests to their similarities with odontogenic tumors of the jaw, which can also contain melanin pigment and also supports the hypothesis that the histogenesis of these neoplasms derives from the vestiges of Rathke's pouch epithelium.

Ce travail retrospectif presente 50 cas de pathologie tumorale digestive spontanee du chien domestique. La population compte 33 mâles et 17 femelles, l'âge moyen au moment du diagnostic est de 9,8 ans et les carcinomes dominent la serie. La predominance des tumeurs gastriques dans cette serie est due au biais de recrutement, les tumeurs intestinales — naturellement plus frequentes — faisant le plus souvent l’objet d’une laparotomie. Les sites d’origine (petite courbure pour l’estomac) et les formes lesionnelles rencontrees (ulceration carcinomateuse, linite, stenose antrale) sont classiquement decrites. Les tumeurs digestives du chien presentent de remarquables ressemblances avec les cancers humains. La pathologie digestive tumorale spontanee du chien pourrait constituer un modele pour des etudes experimentales de diagnostic precoce et de therapeutique endoscopiques.

We describe a 58-year-old woman with anaplastic multiple myeloma and multiple chromosomal abnormalities. Her karyotype showed extreme hyperploidy with 77 chromosomes. Some of the aberrations were typical of multiple myeloma (+3, +5, +15, +19, +21, t(11; 14)(q13; q32)), others were characteristic of the aggressive anaplastic myeloma (+8), t(11; 14)(q13; q32), while three chromosomal abnormalities (t(11; 20)(p11; q13); t(4; 7)(q31; q11); and t(14; 20)(q24; q13)) have not been, to the best of our knowledge, described previously in the literature. The fulminant course of the disease confirms the poor prognosis of multiple karyotypic abnormalities in myeloma.

To assess whether there has been a change in histological features and prognostic factors of primary cutaneous malignant melanoma (CMM) in young individuals in Sweden, an unselected, population-based study was undertaken; 177 cases of primary CMM in persons below 20 years of age were reported to the Swedish National Cancer Registry between 1973 and 1992. In 87% of the cases, original tumor tissue was available for histo-pathological review. The original diagnosis was verified in 88% (n = 126) of these cases. All tumors had histological features similar to adult CMM; 17% had an associated precursor lesion. Superficial spreading melanoma (SSM) was the most common sub-type, constituting 20/36 cases in the first decade and 59/90 in the second. Corresponding figures for nodular melanoma (NM) were 11/36 and 23/90. Only 5 melanomas in situ were diagnosed. In girls, the mean thickness of SSM decreased from 1.5 to 0.6 mm (p0.001). Overall mortality was 10%, 22% in the group with CMM diagnosed 0-15 years of age and 8% in individuals 15-19 years. Fatal CMM cases diagnosed below 15 years of age (n = 4) were NM1.6 mm thick and in subjects 15-19 years (n = 9) 44% of fatal tumors were NM with a mean thickness of 2.2 mm. Breslow index was the single most important prognostic factor. However, when known prognostic factors were adjusted for in a Cox regression analysis, young age remained an independent risk factor, with a relative death rate of 0.21 for individuals aged 15-19 compared with children15 years of age.