ABSTRACT
Intraocular lymphoma with ciliary body involvement is extremely rare, which can be divided into primary and secondary types.The common pathological patterns are mucosa-associated lymphoid tissue B-cell lymphoma and diffuse large B-cell lymphoma, and T-cell lymphoma is relatively rare.The clinical manifestations of ciliary body lymphoma are similar to anterior uveitis.Hypopyon and secondary glaucoma can result from the disease, and the differentiating features include iris patches, iris neovascularization, and hyphema.Diffuse infiltration or space-occupying lesions of ciliary body lymphoma can be found by ultrasound biomicroscopy.Cytological and/or histopathological examination is the gold standard for its diagnosis.Immunohistochemistry, flow cytometry, cytokine analysis, and gene rearrangement are often used in combination to improve the diagnosis rate.Radiotherapy, chemotherapy, or combination therapy can achieve a better prognosis.This paper reviewed classification, pathological types, ocular manifestations, examinations, diagnosis, and treatment of ciliary body lymphoma to provide a reference for clinical practice.
ABSTRACT
Objective To investigate the relationships between the pathology classification, Masaoka clinical stage and postoperation myasthenic crisis in patients of myasthenia gravis with thymoma undergoing thymectomy. Methods Clinical records of 56 patients of myasthenia gravis with thymoma from January 2006 to December 2015 who had underwent thymectomy were reviewed retrospectively. The following factors were analyzed to find the relation to the occurrence of myasthenic crisis after thymectomy: WHO pathology classification, Masaoka clinical stage and tumor size. Results Sixteen patients experienced postoperative myasthenic crisis after thymectomy. Statistical analysis revealed that the incidence of postoperative myasthenic crisis in patients with Masaoka Ⅲ stage was significantly higher than that in patients with Masaoka Ⅰ and Ⅱ stage: 39.39% (13/33) vs. 13.04% (3/23), the incidence of postoperative myasthenic crisis in patients with WHO pathology classification B3 and C type was significantly higher than patients with WHO pathology classification B2 type: 50.00% (12/24) vs. 14.29% (4/28), the incidence of postoperative myasthenic crisis in patients with tumor size more than 5 cm was significantly lower than patients with tumor size less than 5 cm: 10/17 vs. 15.38% (6/39), and there were statistical differences (P＜0.05 or＜0.01). Conclusions WHO pathology classification and Masaoka clinical stage are significantly correlated with the occurrence of myasthenia crisis after thymectomy. The patients with MasaokaⅢstage, WHO pathology classification B3 and C type and tumor size more than 5 cm have the risk of postoperative myasthenic crisis after thymectomy. The comprehensive intervention before and after operation can prevent myasthenia crisis.
ABSTRACT
The aim of the study was to evaluate urinary bladder biopsies showing papillary urothelial neoplastic lesions based on the 2004 WHO/ISUP classification of Urothelial Neoplasms of the Urinary Bladder, to assess the reproducibility of the bladder carcinoma grade. Fifty consecutive transurethral tumor resection biopsies were evaluated by four pathologists independently. The final diagnoses of each pathologist were subjected to statistical analysis to assess the degree of interobserver variability and reproducibility of this classification. Significant interobserver variation was found in the reporting of urothelial neoplasms. In 22 instances there was difference in opinion between PUNLMP and low-grade carcinoma, and in 59 instances between low and high grade carcinoma. The 4 observers never unanimously agreed on the diagnosis of PUNLMP.
ABSTRACT
As pacientes com carcinoma de mama localmente avançado da mama são candidatas à quimioterapianeoadjuvante. A grande maioria delas apresenta resposta parcial ao tratamento, isto é, redução dadimensão do tumor. Entretanto, a taxa de resposta patológica completa é de apenas 24%, mesmo nosesquemas mais efetivos, como na associação de antraciclina com taxano. Um dos benefícios da quimioterapianeoadjuvante é a possibilidade da cirurgia conservadora da mama, e um dos desafios é avaliarcom exatidão o grau de resposta tumoral ao tratamento. A resposta clínica é determinada por meiode exames físicos e de imagem, os quais não são suficientes para predizer com acurácia o tamanho dotumor ou a resposta patológica completa em relação ao exame padrão-ouro, que é o histopatológico dapeça cirúrgica. Além disso, é necessário considerar que após a quimioterapia neoadjuvante pode ocorrerfragmentação do tumor, originando-se lesões residuais multifocais, de difícil detecção aos métodosde imagem. Em estudos sobre a quimioterapia neoadjuvante, observou-se que não há uniformidadeno tipo de exame utilizado para a avaliação clinicopatológica da resposta tumoral; não há descriçãoexata sobre a metodologia utilizada na marcação pré-operatória do tumor, e nem sempre toda a áreatumoral pré-quimioterapia neoadjuvante é ressecada, fato que dificulta a avaliação exata da resposta aeste tipo de quimioterapia. Portanto, resta a dúvida: em quais circunstâncias a cirurgia conservadorada mama após a quimioterapia neoadjuvante está bem indicada? Neste artigo, discute-se as diferentesformas de marcação do tumor, a avaliação da resposta patológica e sua importância, principalmentequando se pretende realizar a cirurgia conservadora no carcinoma de mama localmente avançado.
Patients with locally advanced breast carcinoma are candidates for the neoadjuvant chemotherapy.The majority of them have partial response to treatment, i.e., reduction in tumor size; however, therate of pathological complete response is of only 24%, even with the association of anthracycline and taxane. One benefit of the neoadjuvant chemotherapy is the possibility of breast-conserving surgery, and the challenge is the accurate assessment of the tumor response degree to treatment. Clinical response is determined by physical exam and imaging studies, which are not sufficient to predict accurately the tumor size or the pathological complete response in relation to the golden-standard test, which is the surgical histopathology. Moreover, it is necessary to consider that after the neoadjuvant chemotherapy there may be tumor fragmentation, originating multifocal lesions, which are difficult to be detected by imaging methods. In studies regarding neoadjuvant chemotherapy, there is no uniformity in the type of test used for clinical and pathological assessments of tumor response, and there is no exact description of the methodology used in the preoperative markup of the tumor bed, which is not always resected after the neoadjuvant chemotherapy. This is a fact that hinders the accurate assessment of response to the neoadjuvant chemotherapy. Therefore, the question is: under which circumstances a breast-conserving surgery after neoadjuvant chemotherapy is well indicated? This article has discussed the different ways of tumor marking, the evaluation of pathological response and its importance, especially considering breast-conserving treatment of locally advanced breast carcinoma.