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Introdução: Os tumores neuroendócrinos pancreáticos são considerados raros. Eles são classificados em funcionantes e não funcionantes. Objetivo: Definir e classificar tumores neuroendócrinos pancreáticos de acordo com sua avaliação histopatológica e imunoistoquímica, associado aos critérios diagnósticos. Método: Trata-se de revisão narrativa sobre publicações encontradas no PubMed, SciELO e Google Acadêmico. Resultados: Esses tumores podem ser bem ou pouco diferenciados e apresentam características microscópicas distintas. As células bem diferenciadas têm formato pequeno, núcleos uniformes redondos ou ovais, citoplasma finamente granular indicando forte capacidade secretória e mantêm a estrutura organoide. A presença de necrose tumoral, atividade mitótica aumentada e índice de Ki-67 elevado indicam alta probabilidade de neoplasia neuroendócrina. Cromogranina A e sinaptofisina favorecem o diagnóstico do bem diferenciado. Já a marcação positiva do BCL 10 em conjunto com a ausência de expressão da cromogranina A e da sinaptofisina mostram a precária diferenciação tumoral. A presença de marcação positiva para as expressões hormonais não define o tumor como funcionante. Conclusão: Houve aumento do diagnóstico de tumores neuroendócrinos pancreáticos com o uso de técnicas de imagem e a conscientização sobre a doença. A análise histopatológica com imunoistoquímica, especialmente quando há sintomas consumptivos, podem indicar o tipo do carcinoma e induzir ao mais adequado tratamento.
Introduction: Pancreatic neuroendocrine tumors are considered rare. They are classified into functioning and non-functioning. Objective: To define and classify pancreatic neuroendocrine tumors according to their histopathological and immunohistochemical evaluation, associated with diagnostic criteria. Method: This is a narrative review of publications found in PubMed, SciELO and Google Scholar. \Results: These tumors can be well or poorly differentiated and have distinct microscopic characteristics. Well-differentiated cells are small in shape, have uniform round or oval nuclei, finely granular cytoplasm indicating strong secretory capacity, and maintain the organoid structure. Presence of tumor necrosis, increased mitotic activity and high Ki-67 index indicate a high probability of neuroendocrine neoplasia. Chromogranin A and synaptophysin favor the diagnosis of well-differentiated. The positive staining of BCL 10 together with the absence of expression of chromogranin A and synaptophysin show poor tumor differentiation. The presence of positive staining for hormone expressions does not define the tumor as functioning. Conclusion: There was an increase in the diagnosis of pancreatic neuroendocrine tumors with the use of imaging techniques and awareness of the disease. Histopathological analysis with immunohistochemistry, especially when there are consuming symptoms, can indicate the type of carcinoma and lead to the most appropriate treatment.
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Humans , Pancreatic Neoplasms , Islets of LangerhansABSTRACT
Background: One particular cause of death from breast cancer is distant metastasis. In this study, we calculate and compare diagnostic value of Mitotic Activity Index (MAI) and Ki-67 expression in predicting distant metastasis.Methods: Study was conducted in Sanglah Hospital from January 2017 to February 2019. All histopathology results from open biopsy are examined, thus MAI and Ki-67 values were obtained. We divided this into 2 groups: MAI high (≥20/HPF), low (<20/HPF) and Ki-67 high (≥20%) and low (<20%). We compared with distant metastasis event as gold standard, obtained from radiology examination. We count all diagnostic characteristics (sensitivity, specificity, positive and negative predictive value, accuracy, and likelihood ratio). We compared these diagnostic validities from data area under curve (AUC) with p value <0.005 considered to be statistically significant.Results: A total of 173 breast cancer patients were participated in this study, 92 of them had distant metastasis (53.2%) and 81 patients didn’t have any distant metastasis (46.8%). MAI had relative high specificity (82.7%) and Ki-67 had fair sensitivity values (69.6%). There are 0.08 point AUC differences between these two variables. With p value higher than 0.05 (0.06), it can be summarized that these two variables are not different significantly and statistically.Conclusions: There is not any statistically significant difference between these two markers in predicting distant metastasis in breast cancer. We hope other researcher interest into exploring more about these markers and their function.
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Atypical, bizarre, symplasmic (symplastic), or pleomorphic leiomyoma contains bizarre tumor cells with variation in size and shape, hyperchromatic nuclei, giant cells and occasional multinucleated giant cells but no coagulative necrosis or increased mitotic activity. Mitotic counts higher than 10/10hpf in such a tumor indicates a high malignant potential smooth muscle tumor (leiomyosarcoma). Bizarre leiomyoma closely mimics leiomyosarcoma. We report a case of 31 years old, nulliparous woman who presented with a history of infertility. On examination she was found to have uterine fibroid of 28 weeks size over a period of 5 years. She was diagnosed to have fibrobid clinically and on ultrasonographic examination. Hence, a myomectomy was performed. Histomorphological features are of atypical (Symplastic) leiomyoma which closely mimics leiomyosarcoma and immunohistochemical markers are certainly of help to exclude malignancy in case of dilemma.
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Endometrial stromal tumors (EST) arise from stromal component of endometrium and are rare and common in peri or postmenopausal age group. EST are partially estrogen dependent tumors and their histopathology resemble the stromal cells of normal proliferative endometrium. They present in varied forms pathologically ranging from most begin to most mligrant variants. Diagnosis essentially is by histopathology and prognosis is based on the mitotic activity of the tumor. We have presented here a case of EST presenting in a young nulliparous woman.
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Aim was to investigate expression of tumor suppressor P53 gene, proliferating Ki-67 protein inordinary and proliferating uterine leiomyomato establish possible usefulness of these two parametersin distinguishing between ordinary leiomyoma and proliferating leiomyoma. Retrospective study of49uterine leiomyoma (25 ordinary leiomyoma, 24 proliferating leiomyoma) technically acceptable foranalysis from years 2010–2013 department of Obstetrics and Gynecology and department of Pathology,Mongolian National University of Medical Science, Ulaanbaatar, Mongolia.MethodAll tissue specimens were obtained from surgically removed tumors. Tissue was fixed in formalinand cut to thickness of 5 mm from paraffin-embedded blocks. All haematoxylineosin slides and allimunohistochemical slides for each case were reviewed by two experienced pathologist.ImmunohistochemistryParaffin-embedded tumor sections were deparaffinized and stained in automated platformDakoCytomationusing monoclonal mouse anti-human Ki-67 antigen (Dako,Glostrup, Denmark), monoclonal mouse anti-humanP53 protein (Dako, Glostrup, Denmark).Immunohistochemicalanalysis of P53 and Ki67 expression was performed. Every nuclei stained brown,regardless of shade intensivity, was considered positive. The interpretation of immunohistochemicalstaining was expressed as number of positive cells in 100 cell count in most active area of the slide.Non-parametric analysis of variance Kruskal-Walistest was performed.P53 expressionExpression of P53 was negative in 24/24 ordinary uterine leiomyoma, 2/10 mitotic activity leiomyoma,11/15 cellular leiomyoma. Expression of P53 in 1–10% of cells showed 3/10(30%) mitotic activeleiomyoma and 1/15(6.6%) cellular leiomyoma. Expression in 10-70% of cells showed 5/10(50) mitoticactivity leiomyoma, 3/15(20%) cellular leiomyoma. A significant difference in expression of P53 wasseen between ordinary and proliferative (mitotic activity and cellular) uterine leiomyoma (p<0.007, Table1).Ki-67 expressionExpression of Ki67 was negative in 20/20 (100%) ordinary leiomyoma, 4/11(36.3%) mitotic activityleiomyoma and 7/18(38.8%) cellular uterine leiomyoma. 1–10% of cells were positive in 4/11 (36.6%)mitotic activity leiomyoma, and 5/18% cellular leiomyoma. Expression was positive in 10-70%of cellsof 3/11(27.2%) mitotic activity leiomyoma and 6/18(33.3%). Statistically significant differences in Ki67expression was found between ordinary leiomyoma and proliferating leiomyoma (p<0.014, Table 2) andbetween LM and LMS (p=0.000, Table 1).Conclusion:The findings of our study in concordance with other study results are helpful information establishingmore diagnostic criteria and parameters for diagnosis in doubtful cases between two entities.Immunoassaying for Ki-67 and P53 are such parameters. The panel of their expression in specific caseeases diagnosis.
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Objectives: Odontogenic keratocysts are common, locally destructive lesions of the head and neck region. They can occur as solitary or multiple lesions, and if multiple, they are mostly associated with Gorlin-Goltz syndrome. This study aims to categorize the OKCs which behave more aggressively, using conventional histopathological techniques. Methodology: The present study exploits conventional histopathological techniques to gain an insight into the behavior of the OKC (both solitary and non-syndrome associated multiple OKCs). The histological features (keratinization pattern, presence of satellite cysts / odontogenic islands, epithelial infoldings and corrugations) and histometric parameters (total number of nuclei, epithelial height, total nuclear density, number of basal nuclei, basement membrane length, basal nuclear density and mitotic index) were compared between the two groups of cysts. Result: Multiple OKCs exhibited increase in number of infoldings, corrugations, mitotic index, reduced epithelial height, total number of nuclei, number of basal nuclei, and basal nuclear density. This information may be used to predict their biologic behavior and thus serve as a basis for diagnostic and therapeutic strategies. Conclusion: Conventional histopathological techniques can provide valuable information which may be useful to categorize those OKCs that have more aggressive biological behavior and helps in deciding the treatment protocol.
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The natural habitats of Hyssopus officinalis L. (Lamiaceae) in Bulgaria are not sufficient to satisfy the needs of this herb. Micropropagation might be used for obtaining plants with desirable traits. Hyssopus is a medicinal aromatic plant that has not been studied very much. Recently aromatic plants were investigated as potent allelopathic plants. Determining the modes of action of allelochemicals is one of the challenging aspects in allelopathic studies. The objective of this study was to determine the allelopathic activity of micropropagated Hyssopus officinalis L. water infusions. We evaluated the influence of hot and cold infusions made from the aerial parts of hyssopus under laboratory conditions. For this purpose we tested the effects of infusions on germination and root elongation of Cucumis sativus L. and Triticum aestivum L. We determined also the effect on mitotic activity using Allium cepa L. chromosome aberration test. The results demonstrated the presence of water soluble allelopathic compounds in hyssopus tissue. Infusions exhibited growth depressive effect which was stronger at early stage of growth. The inhibitory effects on germination and root elongation were stronger in T. aestivum than in C. sativus. Hyssopus also exerted mitodepressive and genotoxic effect in Allium cepa root tip cells.
Os hábitats naturais de Hyssopus officinalis L. (Lamiaceae) na Bulgária não são suficientes para satisfazer as necessidades desta erva. A micropropagação poderia ser usada para obter plantas com características desejáveis. Hyssopus é uma planta aromática medicinal que não foi estudada muito. Recentemente plantas aromáticas foram investigadas como potentes plantas alelopáticas. A determinação dos modos da ação de aleloquímicos é um dos aspectos desafiantes em estudos alelopáticos. O objetivo deste estudo foi determinar a atividade alelopática de micropropagado Hyssopus officinalis L. infusãos aquosos. Foi avaliada a influência de infusões quentes e frias feito de partes aéreas de hyssopus sob condições de laboratório. Com este propósito nós testou os efeitos de infusões em germinação e alongamento de raiz de Cucumis sativus L. e Triticum aestivum L. Determinamos também o efeito na atividade mitótica usando os Allium cepa L. teste de aberração cromossômica. Os resultados demonstraram a presença de compostos alelopáticos solúveis de água em tecido de hyssopus. As infusões exibiram o efeito depressivo do crescimento que era mais forte na fase inicial de crescimento. Os efeitos inibitivos em germinação e alongamento de raiz foram mais fortes em T. aestivum que em C. sativus. Hyssopus também exerceu efeito genotóxico e mitodepressivo em células de ponta de raiz de Allium cepa.
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Allamanda (Apocynaceae) is a genus of climbing shrubs known for producing compounds with a range of biological activities. Previous works have shown the anti-proliferative effect of the ethanolic extract of Allamanda schottii on leukemic cells. The present work was conducted to evaluate the effects of dichloromethane fraction, obtained from Allamanda schottii, on sea urchin Echinometra lucunter eggs, as a multicellular model for evaluating anti-tumor activity. Our results show an inhibition of sea urchin development in a dose-dependent manner in the presence of dichloromethane fraction. The IC50 values for first and third cleavage and blastulae stage were 103.7 µg/mL, 33.1 µg/mL and 10.2 µg/mL, respectively. These results also demonstrate the cumulative effect of this fraction on sea urchin embryos. In the present work, the expressive anti-mitotic activity of dichloromethane fraction towards sea urchin eggs, a multicellular model, reinforces the anti-tumor potential of the Allamanda schotti.
Allamanda (Apocynacea) é um gênero de arbustos escandentes conhecido por produzir compostos com várias atividades biológicas. Trabalhos anteriores têm mostrado um efeito anti-proliferativo do extrato etanólico de Allamanda schottii sobre células leucêmicas. O presente trabalho foi realizado para avaliar o efeito da fração diclorometano, obtida de Allamanda schotti, sobre os ovos de ouriço-do-mar de Echinometra lucunter, como um modelo multicelular para estudar atividade anti-tumoral. Nossos resultados mostram uma inibição do desenvolvimento dos ovos de uma maneira dose-dependente na presença da fração diclorometano. Os valores de IC50 para a primeira e terceira clivagem e para o estágio de blástula foram de 103,7 µg/mL, 33.1 µg/mL e 10,2 µg/mL, respectivamente. Estes resultados também demonstram um efeito acumulativo da fração sobre os embriões do ouriço-do-mar. No presente trabalho, esta expressiva atividade anti-mitótica da fração diclorometano sobre o desenvolvimento embrionário do ouriço-do-mar, um modelo multicelular, reforça o potencial antitumoral de Allamanda schotti.
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OBJECTIVE: To evaluate clinical-pathological aspects of uterine smooth-muscle tumors with a pathological diagnosis of uncertain malignant potential or leiomyomas with increased mitotic activity. METHODS: We reviewed the charts and pathological records of twenty seven patients with smooth muscle tumors of the uterus, with 5-9 mitotic figures per 10HPF (High power fields) and without cytological atypia or necrosis retrospectively. RESULTS: The patients were 29-60 (mean 41.8+/-6.8) years old and mean parity was 1.7+/-0.9. None of the patients had used any hormones preoperatively. The size of the myomatous tumors ranged from 2 to 23 cm (mean 7.1+/-4.6 cm). On gross examination all tumors appeared as typical leiomyomas. Twenty were intramural and 7 were submucous leiomyomas. The mitotic counts ranged 5-9/10 HPF (mean 6.0+/-1.2/10 HPF). Cytological atypia or necrosis were absent. The histological phase of the endometrium could be evaluated in 18 patients. Of these, ten had secretory-phase endometrium and proliferative endometrium was present in eight patients. Hysterectomy was performed in 20 patients with intramural leiomyoma, and myomectomy was in 7 patients under diagnosis of submucosal type. Postoperative follow-up periods ranged 5-94 months (mean 37.0+/-22.6 months). All patients were alive without evidence of recurrence or metastasis. CONCLUSION: Leiomyomas containing from five to nine mitotic figures per 10 HPF, without cellular atypia or necrosis, should be regarded as benign. Hysterectomy need not autonomically be done, as follow-up is a viable alternative. Myomectomy is an appropriate treatment, particularly in young patients interested in reproduction.