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104. Non-Metastatic Esophageal Adenocarcinoma: Circulating Tumor Cells in the Course of Multimodal Tumor Treatment

Author

Kuvendjiska, Jasmina, Bronsert, Peter, Martini, Verena, Lang, Sven, Pitman, Martha B., Hoeppner, Jens, and Kulemann, Birte

Subjects
surgery, adenocarcinoma, education, metastasis, esophageal cancer, circulating tumor cells, chemotherapy, chemoradiation, lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens, neoplasms, lcsh:RC254-282, Article, digestive system diseases
Abstract

Background: Isolation of circulating tumor cells (CTC) holds the promise to improve response-prediction and personalization of cancer treatment. In this study, we test a filtration device for CTC isolation in patients with non-metastatic esophageal adenocarcinoma (EAC) within recent multimodal treatment protocols. Methods: Peripheral blood specimens were drawn from EAC patients before and after neoadjuvant chemotherapy (FLOT)/chemoradiation (CROSS) as well as after surgery. Filtration using ScreenCell&reg, devices captured CTC for cytologic analysis. Giemsa-stained specimens were evaluated by a cytopathologist, the cut-off was 1 CTC/specimen (6 mL). Immunohistochemistry with epithelial (pan-CK) and mesenchymal markers (vimentin) was performed. Results: Morphologically diverse malignant CTCs were found in 12/20 patients in at least one blood specimen. CTCs were positive for both vimentin and pan-CK. More patients were CTC positive after neoadjuvant therapy (6/20 vs. 9/15) and CTCs per/ml increased in most of the CTC-positive patients. After surgery, 8/13 patients with available blood specimens were still CTC positive. In clinical follow-up, 5/9 patients who died were CTC-positive. Conclusions: Detection of CTC by filtration within multimodal treatment protocols of non-metastatic EAC is feasible. The rate of CTC positive findings and the quantity of CTCs changes in the course of multimodal neoadjuvant chemoradiation/chemotherapy and surgery.

Published
2019

106. Colaboradores

Author

Alexander, Erik K., Ali, Syed Z., Auger, Manon, Baloch, Zubair W., Bishop, Justin A., Bongiovanni, Massimo, Chandra, Ashish, Cibas, Edmund, Cochand-Priollet, Béatrix, Cooper, David S., Crothers, Barbara A., Elsheikh, Tarik M., Fadda, Guido, Faquin, William C., Filie, Armando C., Firat, Pinar, Frates, Mary C., Gharib, Hossein, Henry, Michael R., Hong, Soon Won, Kakudo, Kennichi, Krane, Jeffrey F., Layfield, Lester J., LiVolsi, Virginia A., Michael, Claire W., Nayar, Ritu, Nishino, Michiya, Pitman, Martha B., Powers, Celeste N., Pusztaszeri, Marc P., Randolph, Gregory W., Renshaw, Andrew A., Rossi, Esther Diana, Sanchez, Miguel A., Schmitt, Fernando, Shidham, Vinod B., Sidawy, Mary K., Staerkel, Gregg A., Stelow, Edward B., VanderLaan, Paul A., Vielh, Philippe, Westra, William H., Yang, Grace C.H., and Zarka, Matthew A.

Published
2022
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108. Determining the significance of psammoma bodies in pelvic washings: A 10‐year retrospective review.

Author

Sun, Tong, Pitman, Martha B., and Torous, Vanda F.

Abstract

Background: Pelvic washing specimens are relatively common and are submitted for patients undergoing gynecologic surgery to evaluate them for metastatic or occult disease. Psammoma bodies are a relatively uncommon finding in these specimens. To date, large‐scale studies of their cytologic‐histologic correlates and thus clinical significance have been limited. Methods: A 10‐year retrospective search for all pelvic washing specimens was performed, and all cases were reviewed for the presence of psammoma bodies. The findings for the corresponding surgical pathology specimens were then catalogued. Results: Psammoma bodies were present in 138 cases (3.6% of 3840 total pelvic washings). More than half of the cases (n = 73 [53%]) were associated with benign processes, including mesothelial hyperplasia (n = 44), endosalpingiosis (n = 11), endometriosis (n = 11), and ovarian cystadenoma/cystadenofibroma (n = 7). Nineteen cases (14%) were associated with serous borderline tumors. Malignancies were noted in a third of the cases (n = 46 [33%]) and were most frequently low‐grade serous adenocarcinomas (n = 15), high‐grade serous adenocarcinomas (n = 11), or endometrioid endometrial carcinomas (n = 8). Patients found to have benign processes (median age, 50 years) or borderline disease (median age, 56 years) were significantly younger than patients with malignancies (median age, 65 years; P <.0001). In addition, the correlation of cytologic interpretation categories with concurrent histopathologic findings showed that cytologic analysis was highly sensitive and specific in determining the nature of underlying processes. Conclusions: The majority of psammoma bodies noted in pelvic washings were associated with benign processes or borderline tumors, with approximately a third of the cases associated with malignancies. Psammoma bodies in pelvic washings from younger patients were significantly more likely to be associated with benign processes or borderline tumors. Psammomatous calcifications are a relatively uncommon occurrence in pelvic washing specimens and can be associated with both benign and malignant processes. Because of the limited literature on the incidence of this finding and the cytologic‐histologic correlates, a large, 10‐year retrospective study has been conducted to explore the significance of identifying psammoma bodies in pelvic washing fluids. [ABSTRACT FROM AUTHOR]

Published
2021
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113. Pancreatic mucinous cystic neoplasm of the main pancreatic duct

Author

Masia, Ricard, Mino-Kenudson, Mari, Warshaw, Andrew L., Pitman, Martha B., and Misdraji, Joseph

Subjects
Ventana Medical Systems Inc., Inhibins, Medical equipment industry, Immunohistochemistry, Tumors, Estrogens, Progesterone, Medical test kit industry, Medical equipment and supplies industry, Estrogen, Inhibin
Abstract

Mucin-producing cystic neoplasms of the pancreas comprise 2 entities, each with characteristic clinical and pathologic features: mucinous cystic neoplasm (MCN) and intraductal papillary mucinous neoplasm (IPMN). (1) Mucinous cystic neoplasm [...], * Mucinous cystic neoplasm and intraductal papillary mucinous neoplasm are 2 types of cystic pancreatic mucinous tumors, each with its own distinct clinicopathologic features and pathogenetic mechanisms. We report here an unusual pancreatic mucinous neoplasm with features of both a mucinous cystic neoplasm and an intraductal papillary mucinous neoplasm in a 40-year-old woman who underwent total pancreatectomy. The endoscopic retrograde cholangiopancreatogram and gross examination demonstrated a mucin-producing intraductal neoplasm involving the length of the main pancreatic duct, typical of main duct intraductal papillary mucinous neoplasm, but histology of the main duct showed involvement by a biphasic tumor composed of columnar epithelium overlying ovarian-type stroma, characteristic of a mucinous cystic neoplasm. Immunohistochemistry confirmed that the stromal cells expressed estrogen and progesterone receptors, inhibin, and calretinin. Pancreatic mucinous cystic neoplasm involving the entire main pancreatic duct has not, to our knowledge, been previously reported.

Published
2011

114. Whole-slide imaging digital pathology as a platform for teleconsultation: a pilot study using paired subspecialist correlations

Author

Wilbur, David C., Madi, Kalil, Colvin, Robert B., Duncan, Lyn M., Faquin, William C., Ferry, Judith A., Frosch, Matthew P., Houser, Stuart L., Kradin, Richard L., Lauwers, Gregory Y., Louis, David N., Mark, Eugene J., Mino-Kenudson, Mari, Misdraji, Joseph, Nielsen, Gunnlauger P., Pitman, Martha B., Rosenberg, Andrew E., Smith, R. Neal, Sohani, Aliyah R., Stone, James R., Tambouret, Rosemary H., Wu, Chin-Lee, Young, Robert H., Zembowicz, Artur, and Klietmann, Wolfgang

Subjects
Technology application, Usage, Continuing medical education, Diagnostic imaging -- Usage, Pathology -- Technology application
Abstract

Whole-slide imaging at resolutions comparable to standard microscopic evaluation is now technologically feasible. (1) A variety of commercial systems that perform technically simple and rapid image capture and viewing are [...], Context.--Whole-slide imaging technology offers promise for rapid, Internet-based telepathology consultations between institutions. Before implementation, technical issues, pathologist adaptability, and morphologic pitfalls must be well characterized. Objective.--To determine whether interpretation of whole-slide images differed from glass-slide interpretation in difficult surgical pathology cases. Design.--Diagnostically challenging pathology slides from a variety of anatomic sites from an outside laboratory were scanned into whole digital format. Digital and glass slides were independently diagnosed by 2 subspecialty pathologists. Reference, digital, and glass-slide interpretations were compared. Operator comments on technical issues were gathered. Results.--Fifty-three case pairs were analyzed. There was agreement among digital, glass, and reference diagnoses in 45 cases (85%) and between digital and glass diagnoses in 48 (91%) cases. There were 5 digital cases (9%) discordant with both reference and glass diagnoses. Further review of each of these cases indicated an incorrect digital whole-slide interpretation. Neoplastic cases showed better correlation (93%) than did cases of nonneoplastic disease (88%). Comments on discordant cases related to digital whole technology focused on issues such as fine resolution and navigating ability at high magnification. Conclusions.--Overall concordance between digital whole-slide and standard glass-slide interpretations was good at 91%. Adjustments in technology, case selection, and technology familiarization should improve performance, making digital whole-slide review feasible for broader telepathology subspecialty consultation applications. (Arch Pathol Lab Med. 2009;133:1949-1953)

Published
2009

115. An algorithmic approach to the diagnosis of pancreatic neoplasms

Author

Klimstra, David S., Pitman, Martha B., and Hruban, Ralph H.

Subjects
Diagnosis, Analysis, Usage, Algorithm, Algorithms -- Analysis -- Usage, Pancreatic cancer -- Diagnosis, Immunohistochemistry -- Analysis, Radiology -- Usage, Radiology, Medical -- Usage
Abstract

To help classify pancreatic neoplasms, we have developed a simple diagnostic algorithm that integrates the gross and radiographic features with the histologic and immunohistochemical findings. By following the steps detailed [...], * Context.--The pancreas gives rise to an array of distinct neoplasms that can be solid, cystic, or intraductal and can recapitulate the various lines of differentiation present in the normal gland. Objective.--To develop an algorithmic approach to the diagnosis of pancreatic neoplasms that simplifies their pathologic evaluation. Data Sources.--We reviewed literature related to the classification of pancreatic neoplasms on the basis of their gross, histologic, and immunohistochemical features. Conclusions.--By using a series of dichotomous decisions, the differential diagnosis of a pancreatic neoplasm can be narrowed, and in cases of the more common neoplasms, accurate classification can be achieved. Uncommon neoplasms not accounted for by this approach are also discussed, and the additional diagnostic information needed for complete pathologic reporting is presented. (Arch Pathol Lab Med. 2009;133:454-464)

Published
2009

118. Author Correction: Pancreatic cancer: Circulating Tumor Cells and Primary Tumors show Heterogeneous KRAS Mutations

Author

Kulemann, Birte, primary, Rösch, Stephanie, additional, Seifert, Sindy, additional, Timme, Sylvia, additional, Bronsert, Peter, additional, Seifert, Gabriel, additional, Martini, Verena, additional, Kuvendjiska, Jasmina, additional, Glatz, Torben, additional, Hussung, Saskia, additional, Fritsch, Ralph, additional, Becker, Heiko, additional, Pitman, Martha B., additional, and Hoeppner, Jens, additional

Published
2017
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119. Dr. John Henry Eichhorn, July 12, 1959–April 19, 2017

Author

Young, Robert H., primary, Black-Schaffer, W. Stephen, additional, Ferry, Judith A., additional, Lerwill, Melinda J., additional, Oliva, Esther, additional, Pitman, Martha B., additional, Roberts, Drucilla J., additional, Tambouret, Rosemary H., additional, Wilbur, David C., additional, Bell, Debra A., additional, and Talbert, Michael L., additional

Published
2017
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122. A Multicenter, Validation Study of Cyst Fluid Analysis for MAB Das-1 for the Identification of High-Risk and Malignant Mucinous Cysts of the Pancreas

Author

Das, Koushik K., primary, Geng, Xin, additional, Morales-Oyarvide, Vicente, additional, Huynh, Tiffany, additional, Pergolini, Ilaria, additional, Pitman, Martha B., additional, Ferrone, Cristina R., additional, Brugge, William R., additional, Efishat, Mohammad Al, additional, Haviland, Dana, additional, Thompson, Elizabeth, additional, Wolfgang, Christopher L., additional, Lennon, Anne Marie, additional, Allen, Peter, additional, Lillemoe, Keith D., additional, Castillo, Carlos Fernandez-Del, additional, Das, Kiron M., additional, and Mino-Kenudson, Mari, additional

Published
2017
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132. Circulating Epithelial Cells in Patients with Pancreatic Lesions: Clinical and Pathologic Findings

Author

Cauley, Christy E., Pitman, Martha B., Zhou, Jiahua, Perkins, James, Kuleman, Birte, Liss, Andrew S., Fernandez-del Castillo, Carlos, Warshaw, Andrew L., Lillemoe, Keith D., and Thayer, Sarah P.

Abstract

Circulating epithelial cell (CEC) isolation has provided diagnostic and prognostic information for a variety of cancers, previously supporting their identity as circulating tumor cells in the literature. However, we report CEC findings in patients with benign, premalignant, and malignant pancreatic lesions using a size-selective filtration device.

Published
2024
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136. Su1466 The Value of KRAS Mutation Testing With CEA for the Diagnosis of Pancreatic Mucinous Cysts

Author

Kadayifci, Abdurrahman, primary, Al-Haddad, Mohammad A., additional, Atar, Mustafa, additional, DeWitt, John M., additional, Forcione, David G., additional, Sherman, Stuart, additional, Casey, Brenna, additional, Fernandez-del Castillo, Carlos, additional, Schmidt, C. Max, additional, Pitman, Martha B., additional, and Brugge, William R., additional

Published
2015
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137. 666 - A Multicenter, Validation Study of Cyst Fluid Analysis for MAB Das-1 for the Identification of High-Risk and Malignant Mucinous Cysts of the Pancreas

Author

Das, Koushik K., Geng, Xin, Morales-Oyarvide, Vicente, Huynh, Tiffany, Pergolini, Ilaria, Pitman, Martha B., Ferrone, Cristina R., Brugge, William R., Efishat, Mohammad Al, Haviland, Dana, Thompson, Elizabeth, Wolfgang, Christopher L., Lennon, Anne Marie, Allen, Peter, Lillemoe, Keith D., Castillo, Carlos Fernandez-Del, Das, Kiron M., and Mino-Kenudson, Mari

Published
2017
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139. Pancreatic Adenocarcinoma, Version 2.2014

Author

Tempero, Margaret A., primary, Malafa, Mokenge P., additional, Behrman, Stephen W., additional, Benson, Al B., additional, Casper, Ephraim S., additional, Chiorean, E. Gabriela, additional, Chung, Vincent, additional, Cohen, Steven J., additional, Czito, Brian, additional, Engebretson, Anitra, additional, Feng, Mary, additional, Hawkins, William G., additional, Herman, Joseph, additional, Hoffman, John P., additional, Ko, Andrew, additional, Komanduri, Srinadh, additional, Koong, Albert, additional, Lowy, Andrew M., additional, Ma, Wen Wee, additional, Merchant, Nipun B., additional, Mulvihill, Sean J., additional, Muscarella, Peter, additional, Nakakura, Eric K., additional, Obando, Jorge, additional, Pitman, Martha B., additional, Reddy, Sushanth, additional, Sasson, Aaron R., additional, Thayer, Sarah P., additional, Weekes, Colin D., additional, Wolff, Robert A., additional, Wolpin, Brian M., additional, Burns, Jennifer L., additional, and Freedman-Cass, Deborah A., additional

Published
2014
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141. 88 Comparison of the International Consensus Guidelines for Management of Intraductal Papillary Mucinous Neoplasm (IPMN) With Analysis of Pancreatic Cyst Fluid Aspirates for mAb-Das-1 Reactivity in Identifying High-Risk and Malignant IPMN

Author

Das, Koushik K., primary, Marchegiani, Giovanni, additional, Geng, Xin, additional, Xiao, Hong, additional, Castillo, Carlos Fernandez-del, additional, Forcione, David G., additional, Casey, Brenna, additional, Brugge, William R., additional, Pitman, Martha B., additional, Das, Kiron M., additional, and Mino-Kenudson, Mari, additional

Published
2014
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142. Automated algorithm for differentiation of human breast tissue using low coherence interferometry for fine needle aspiration biopsy guidance

Author

Harvard University--MIT Division of Health Sciences and Technology, Bouma, Brett E., Tearney, Guillermo J., Goldberg, Brian D., Iftimia, Nicusor V., Bressner, Jason E., Pitman, Martha B., Halpern, Elkan, Harvard University--MIT Division of Health Sciences and Technology, Bouma, Brett E., Tearney, Guillermo J., Goldberg, Brian D., Iftimia, Nicusor V., Bressner, Jason E., Pitman, Martha B., and Halpern, Elkan

Abstract

Fine needle aspiration biopsy (FNAB) is a rapid and cost-effective method for obtaining a first-line diagnosis of a palpable mass of the breast. However, because it can be difficult to manually discriminate between adipose tissue and the fibroglandular tissue more likely to harbor disease, this technique is plagued by a high number of nondiagnostic tissue draws. We have developed a portable, low coherence interferometry (LCI) instrument for FNAB guidance to combat this problem. The device contains an optical fiber probe inserted within the bore of the fine gauge needle and is capable of obtaining tissue structural information with a spatial resolution of 10 μm over a depth of approximately 1.0 mm. For such a device to be effective clinically, algorithms that use the LCI data must be developed for classifying different tissue types. We present an automated algorithm for differentiating adipose tissue from fibroglandular human breast tissue based on three parameters computed from the LCI signal (slope, standard deviation, spatial frequency content). A total of 260 breast tissue samples from 58 patients were collected from excised surgical specimens. A training set (N = 72) was used to extract parameters for each tissue type and the parameters were fit to a multivariate normal density. The model was applied to a validation set (N = 86) using likelihood ratios to classify groups. The overall accuracy of the model was 91.9% (84.0 to 96.7) with 98.1% (89.7 to 99.9) sensitivity and 82.4% (65.5 to 93.2) specificity where the numbers in parentheses represent the 95% confidence intervals. These results suggest that LCI can be used to determine tissue type and guide FNAB of the breast., Medical Free Electron Laser program (Grant No. FA9550-04-1-0079), National Institutes of Health (U.S.) (Ruth L. Kirschstein individual fellowship Grant No. 1 F31 EB005141–01A2)

Published
2012

144. mAb Das-1 is specific for high-risk and malignant intraductal papillary mucinous neoplasm (IPMN)

Author

Das, Koushik K, primary, Xiao, Hong, additional, Geng, Xin, additional, Fernandez-del-Castillo, Carlos, additional, Morales-Oyarvide, Vicente, additional, Daglilar, Ebubekir, additional, Forcione, David G, additional, Bounds, Brenna C, additional, Brugge, William R, additional, Pitman, Martha B, additional, Mino-Kenudson, Mari, additional, and Das, Kiron M, additional

Published
2013
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149. Branch Duct Intraductal Papillary Mucinous Neoplasms

Author

Sahora, Klaus, primary, Mino-Kenudson, Mari, additional, Brugge, William, additional, Thayer, Sarah P., additional, Ferrone, Cristina R., additional, Sahani, Dushyant, additional, Pitman, Martha B., additional, Warshaw, Andrew L., additional, Lillemoe, Keith D., additional, and Fernandez-del Castillo, Carlos F., additional

Published
2013
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