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1.
ESMO Open ; 8(5): 101628, 2023 10.
Article in English | MEDLINE | ID: mdl-37713929

ABSTRACT

BACKGROUND: Testing for epidermal growth factor receptor (EGFR) mutations is an essential recommendation in guidelines for metastatic non-squamous non-small-cell lung cancer, and is considered mandatory in European countries. However, in practice, challenges are often faced when carrying out routine biomarker testing, including access to testing, inadequate tissue samples and long turnaround times (TATs). MATERIALS AND METHODS: To evaluate the real-world EGFR testing practices of European pathology laboratories, an online survey was set up and validated by the Pulmonary Pathology Working Group of the European Society of Pathology and distributed to 64 expert testing laboratories. The retrospective survey focussed on laboratory organisation and daily EGFR testing practice of pathologists and molecular biologists between 2018 and 2021. RESULTS: TATs varied greatly both between and within countries. These discrepancies may be partly due to reflex testing practices, as 20.8% of laboratories carried out EGFR testing only at the request of the clinician. Many laboratories across Europe still favour single-test sequencing as a primary method of EGFR mutation identification; 32.7% indicated that they only used targeted techniques and 45.1% used single-gene testing followed by next-generation sequencing (NGS), depending on the case. Reported testing rates were consistent over time with no significant decrease in the number of EGFR tests carried out in 2020, despite the increased pressure faced by testing facilities during the COVID-19 pandemic. ISO 15189 accreditation was reported by 42.0% of molecular biology laboratories for single-test sequencing, and by 42.3% for NGS. 92.5% of laboratories indicated they regularly participate in an external quality assessment scheme. CONCLUSIONS: These results highlight the strong heterogeneity of EGFR testing that still occurs within thoracic pathology and molecular biology laboratories across Europe. Even among expert testing facilities there is variability in testing capabilities, TAT, reflex testing practice and laboratory accreditation, stressing the need to harmonise reimbursement technologies and decision-making algorithms in Europe.


Subject(s)
Carcinoma, Non-Small-Cell Lung , Lung Neoplasms , Humans , Carcinoma, Non-Small-Cell Lung/diagnosis , Carcinoma, Non-Small-Cell Lung/genetics , Carcinoma, Non-Small-Cell Lung/pathology , Lung Neoplasms/diagnosis , Lung Neoplasms/genetics , Lung Neoplasms/pathology , Laboratories , Retrospective Studies , Pandemics , Mutation , ErbB Receptors/genetics , Europe
3.
Prog Urol ; 28(6): 344-350, 2018 May.
Article in English | MEDLINE | ID: mdl-29673906

ABSTRACT

OBJECTIVES: There are only few predictive factors for response of non-musculo-invasive bladder cancer (NMIBC) to Bacillus Calmette-Guérin (BCG) therapy. Our study analyzed the results of the sequencing of new generation (NGS) targeted on 50 genes of oncological interest obtained on bladder resection parts in high-risk NMIBC patients treated with BCG, to describe this population from a molecular point of view and try to correlate these results in patients who present or not recurrence after BCG. METHODS: We reviewed 63 patients with high grade NMIBC treated between 2014 and 2016 with BCG after endoscopic resection. Each one had NGS analysis. Association tests between mutations detected by NGS and recurrence or progression were realized. RESULTS: The 45 remaining patients were fully analysed. For 73% of cases a mutation has been found, most frequent one's being FGFR3, TP53 and PIK3CA. With a median follow-up of 24 months (4-40), recurrence was present in 15 patients (33.3%), with 10 NMIBC (22.2%) and 5 progressions to muscular-invasive cancer (11.1%). If some mutations were more frequent in different prognostic groups no significant association has been found. No patient presenting CIS had FGFR3 mutation (P<0.0001). CONCLUSION: Next generation sequencing in NMIBC could be a supplementary aid in treatment decision making in the future. In an area where personalized medicine is rapidly growing in importance we need larger studies to define molecular characteristics in tumours to detect genomic associations between clinical phenotypes and recurrence or progression of the disease. LEVEL OF EVIDENCE: 3.


Subject(s)
BCG Vaccine/therapeutic use , Carcinoma, Squamous Cell/diagnosis , Carcinoma, Squamous Cell/drug therapy , High-Throughput Nucleotide Sequencing , Molecular Diagnostic Techniques/methods , Urinary Bladder Neoplasms/diagnosis , Urinary Bladder Neoplasms/drug therapy , Adult , Aged , Aged, 80 and over , Biomarkers, Tumor/analysis , Biomarkers, Tumor/genetics , Carcinoma, Squamous Cell/genetics , Carcinoma, Squamous Cell/pathology , DNA Mutational Analysis/methods , Disease Progression , Female , Humans , Male , Middle Aged , Neoplasm Invasiveness , Neoplasm Staging , Predictive Value of Tests , Prognosis , Retrospective Studies , Risk Factors , Treatment Outcome , Urinary Bladder Neoplasms/genetics , Urinary Bladder Neoplasms/pathology
4.
J Neurooncol ; 136(1): 115-125, 2018 Jan.
Article in English | MEDLINE | ID: mdl-28988341

ABSTRACT

Axitinib is a small molecule tyrosine kinase inhibitor with high affinity and specificity for the family of vascular endothelial growth factor receptors. It has previously demonstrated anti-tumor activity in a small cohort of patients with recurrent glioblastoma (rGB). We conducted a non-comparative randomized phase II clinical trial investigating axitinib monotherapy versus axitinib plus lomustine (LOM) in patients with rGB. Primary endpoint was 6 month progression-free survival (6mPFS). Patients who progressed on axitinib-monotherapy were allowed to cross-over. Between August 2011 and July 2015, 79 patients were randomized and initiated axitinib monotherapy (n = 50; AXI) or axitinib plus lomustine (n = 29; AXILOM). Median age was 55y [range 18-80], 50M/28F. Baseline characteristics were well balanced between study arms. Nineteen patients in the AXI-arm crossed-over at the time of progression. Treatment was generally well tolerated. AXILOM patients were at higher risk for grade 3/4 neutropenia (0 vs. 21%) and thrombocytopenia (4 vs. 29%). Best Overall Response Rate (BORR) in the AXI-arm was 28 vs. 38% in the AXILOM-arm. 6mPFS was 26% (95% CI 14-38) versus 17% (95% CI 2-32) for patients treated in the AXI versus AXILOM-arms, respectively. Median overall survival was 29 weeks (95% CI 20-38) in the AXI-arm and 27.4 weeks (95% CI 18.4-36.5) in the AXILOM-arm. MGMT-promoter hypermethylation and steroid treatment at baseline correlated significantly with PFS and OS. We conclude from these results that axitinib improves response rate and progression-free survival in patients with rGB compared to historical controls. There is no indication that upfront combination of axitinib with LOM improves results (European Clinical Trials Database (EudraCT) Study Number: 2011-000900-16).


Subject(s)
Antineoplastic Agents/therapeutic use , Axitinib/therapeutic use , Brain Neoplasms/drug therapy , Glioblastoma/drug therapy , Lomustine/therapeutic use , Neoplasm Recurrence, Local/drug therapy , Adolescent , Adult , Aged , Aged, 80 and over , Antineoplastic Agents, Alkylating/therapeutic use , Antineoplastic Combined Chemotherapy Protocols , Female , Humans , Male , Middle Aged , Progression-Free Survival , Protein Kinase Inhibitors/therapeutic use , Treatment Outcome , Young Adult
6.
J Neurooncol ; 128(1): 147-155, 2016 05.
Article in English | MEDLINE | ID: mdl-26935577

ABSTRACT

We conducted a randomized, non-comparative, multi center, phase II clinical trial in order to investigate the efficacy of axitinib, an oral small molecule tyrosine kinase inhibitor with high affinity and specificity for the vascular endothelial growth factor receptors, in patients with recurrent glioblastoma following prior treatment with radiation and temozolomide. Forty-four patients were randomly assigned to receive treatment with axitinib (5 mg BID starting dose; N = 22) or "physicians best alternative choice of therapy" that consisted of bevacizumab (N = 20) or lomustine (N = 2). Six-month progression-free survival served as the primary endpoint. The estimated 6-month progression-free survival rate was 34 % (95 % CI 14-54) for patients treated with axitinib and 28 % (95 % CI 8-48) with best alternative treatment; median overall survival was 29 and 17 weeks, respectively. Objective responses according to RANO criteria were documented in 28 % of patients treated with axitinib and 23 % of patients treated with best alternative therapy. A decrease in maximal uptake of 18F-fluoro-ethyL-tyrosine (18F-FET) by the glioblastoma on PET imaging was documented in 85 % of patients at the time of response on axitinib. Corticosteroid treatment could be stopped in four and tapered in seven out of the 15 patients who were treated with steroids at baseline in the axitinib cohort. Most frequent axitinib related grade ≥3 adverse events consisted of fatigue (9 %), diarrhea (9 %), and oral hyperesthesia (4.5 %). We conclude that axitinib has single-agent clinical activity and a manageable toxicity profile in patients with recurrent glioblastoma.


Subject(s)
Angiogenesis Inhibitors/therapeutic use , Brain Neoplasms/drug therapy , Glioblastoma/drug therapy , Imidazoles/therapeutic use , Indazoles/therapeutic use , Adult , Aged , Angiogenesis Inhibitors/adverse effects , Antineoplastic Agents, Alkylating/therapeutic use , Axitinib , Bevacizumab/therapeutic use , Brain Neoplasms/diagnostic imaging , Brain Neoplasms/genetics , Disease-Free Survival , Female , Fluorodeoxyglucose F18 , Glioblastoma/diagnostic imaging , Glioblastoma/genetics , Humans , Imidazoles/adverse effects , Indazoles/adverse effects , Lomustine/therapeutic use , Male , Middle Aged , Neoplasm Recurrence, Local/diagnostic imaging , Neoplasm Recurrence, Local/drug therapy , Neoplasm Recurrence, Local/genetics , Positron-Emission Tomography , Protein Kinase Inhibitors/adverse effects , Protein Kinase Inhibitors/therapeutic use , Protein-Tyrosine Kinases/antagonists & inhibitors , Radiopharmaceuticals , Steroids/therapeutic use , Treatment Outcome , Young Adult
7.
Rev Med Brux ; 37(3): 152-158, 2016.
Article in French | MEDLINE | ID: mdl-28525188

ABSTRACT

Gliomas are the most common primary brain tumors and include different diagnoses associated with a different prognosis. Histology remains the gold standard for the diagnosis of these tumors. However, pathologists may encounter diagnostic difficulties due to tumor heterogeneity or to the small size of the samples. Recently, major advances in discovery of molecular alterations of these cancers have led to the development of new molecular markers, some with a diagnostic role, others with a prognostic impact and / or predictive of therapeutic response. The testing of different molecular alterations such as 1p / 19q codeletion, mutations of IDH genes, p16 deletion, EGFR amplification or MGMT promoter methylation has been included in the daily practice in order to confirm the diagnosis, assess the patient prognosis and guide treatment choices.


Les gliomes représentent les tumeurs cérébrales primitives les plus fréquentes et regroupent différentes entités au pronostic très différent. L'examen anatomopathologique est le gold standard pour le diagnostic de ces tumeurs. Cependant, les pathologistes peuvent rencontrer des difficultés diagnostiques dues, entre autres, à l'hétérogénéité tumorale ou à la petite taille des prélèvements. Nous avons assisté, ces dernières années, à des avancées majeures dans la découverte des altérations moléculaires de ces cancers, ce qui a mené au développement de nouveaux marqueurs moléculaires, certains avec un rôle diagnostique, d'autres avec un impact pronostique et/ou prédictif de la réponse thérapeutique. Dans la pratique quotidienne, il est donc devenu utile de tester la présence de différentes altérations moléculaires telles que la codélétion 1p/19q, les mutations des gènes IDH, la délétion du gène CDKN2A/p16, l'amplification du gène EGFR ou la méthylation du promoteur du gène MGMT, afin de confirmer le diagnostic, d'évaluer le pronostic des patients ainsi que d'orienter les choix thérapeutiques.


Subject(s)
Brain Neoplasms/diagnosis , Brain Neoplasms/genetics , Glioma/diagnosis , Glioma/genetics , Promoter Regions, Genetic , Biomarkers , DNA Methylation , Diagnosis, Differential , Humans , Mutation , Prognosis
8.
Rev Med Brux ; 37(5): 436-438, 2016.
Article in French | MEDLINE | ID: mdl-28525213

ABSTRACT

Fine needle aspiration is the gold standard method to differentiate benign thyroid nodules from malignant. However, for 15 to 30% of the cases the cytological diagnosis is indeterminate, leading to surgery. Integration of new molecular markers is opening new perspectives in order to increase the diagnostic precision of thyroid nodules with an indeterminate cytology.


La méthode diagnostique de référence pour différencier les nodules thyroïdiens bénins des nodules malins est la ponction écho-guidée à l'aiguille fine. Cependant dans 15 à 30 % des cas le diagnostic cytologique est indéterminé, menant à une intervention chirurgicale. L'intégration de nouveaux marqueurs moléculaires nous ouvrent de nouvelles perspectives pour augmenter la précision diagnostique des nodules thyroïdiens de diagnostic cytologique indéterminé.


Subject(s)
High-Throughput Nucleotide Sequencing , Molecular Diagnostic Techniques/methods , Thyroid Nodule/diagnosis , Biopsy, Fine-Needle , High-Throughput Nucleotide Sequencing/methods , Humans , Sensitivity and Specificity , Thyroid Neoplasms/diagnosis , Thyroid Neoplasms/pathology , Thyroid Nodule/genetics , Thyroid Nodule/pathology
9.
Br J Cancer ; 113(5): 729-37, 2015 Sep 01.
Article in English | MEDLINE | ID: mdl-26291053

ABSTRACT

BACKGROUND: Glioblastomas (GBMs) are the most common malignant primary brain tumours in adults and are refractory to conventional therapy, including surgical resection, radiotherapy and chemotherapy. The insulin-like growth factor (IGF) system is a complex network that includes ligands (IGFI and IGFII), receptors (IGF-IR and IGF-IIR) and high-affinity binding proteins (IGFBP-1 to IGFBP-6). Many studies have reported a role for the IGF system in the regulation of tumour cell biology. However, the role of this system remains unclear in GBMs. METHODS: We investigate the prognostic value of both the IGF ligands' and receptors' expression in a cohort of human GBMs. Tissue microarray and image analysis were conducted to quantitatively analyse the immunohistochemical expression of these proteins in 218 human GBMs. RESULTS: Both IGF-IR and IGF-IIR were overexpressed in GBMs compared with normal brain (P<10(-4) and P=0.002, respectively). Moreover, with regard to standard clinical factors, IGF-IR positivity was identified as an independent prognostic factor associated with shorter survival (P=0.016) and was associated with a less favourable response to temozolomide. CONCLUSIONS: This study suggests that IGF-IR could be an interesting target for GBM therapy.


Subject(s)
Biomarkers, Tumor/metabolism , Brain Neoplasms/metabolism , Glioblastoma/metabolism , Receptors, Somatomedin/metabolism , Adult , Aged , Aged, 80 and over , Brain Neoplasms/mortality , Brain Neoplasms/pathology , Female , Glioblastoma/mortality , Glioblastoma/pathology , Humans , Kaplan-Meier Estimate , Male , Middle Aged , Prognosis , Proportional Hazards Models , Receptor, IGF Type 1 , Young Adult
10.
Acta Chir Belg ; 113(2): 71-6, 2013.
Article in English | MEDLINE | ID: mdl-23741925

ABSTRACT

In Belgium, approximately 1100 new cases of pancreatic ductal adenocarcinoma are diagnosed each year. Although in the last twenty years several advances have been registered in the field of pancreatic pathology, few therapies are efficacious, and it remains one of the deadliest of all cancers. Histological variants with a somewhat different prognosis have been recognised, and precursor lesions identified. This article reviews the histological aspects of ductal adenocarcinoma, its variants and the precursor lesions. Study and knowledge of these precursor lesions offers the best hope for treating pancreatic cancer before an incurable invasive tumour develops.


Subject(s)
Adenocarcinoma/pathology , Pancreatic Neoplasms/pathology , Precancerous Conditions/pathology , Adenocarcinoma/etiology , Adenocarcinoma/therapy , Humans , Pancreatic Neoplasms/etiology , Pancreatic Neoplasms/therapy , Precancerous Conditions/etiology , Precancerous Conditions/therapy
11.
JBR-BTR ; 95(2): 77-9, 2012.
Article in English | MEDLINE | ID: mdl-22764660

ABSTRACT

We report a case of a 2-year-old child presenting with right forearm pain. Based on imaging analysis, the initial diagnosis was osteomyelitis but the final diagnosis demonstrated by histology was Eosinophilic Granuloma (EG) of the forearm. We detail the rare radiological presentation of such a lesion, the various clinical presentations and the work-up advised in this context.


Subject(s)
Forearm , Histiocytosis, Langerhans-Cell/diagnosis , Biopsy , Contrast Media , Diagnosis, Differential , Female , Humans , Infant , Magnetic Resonance Imaging , Tomography, X-Ray Computed
12.
J Neuroradiol ; 39(2): 119-22, 2012 May.
Article in English | MEDLINE | ID: mdl-21641646

ABSTRACT

Primary solitary amyloidoma of Meckel's cave is rare, and a bilateral location is even more rare. To the best of our knowledge, only 12 cases in the literature have described such a primary lesion, including one case of bilateral involvement of Meckel's cave. We report here on the case of a 57-year-old woman presenting with pseudotumor masses involving both Meckel's caves and responsible for trigeminal neuropathy. The final diagnosis of amyloidoma was made on the basis of histological examination of surgical biopsy specimens.


Subject(s)
Amyloidosis/diagnosis , Cranial Nerve Neoplasms/diagnosis , Dura Mater/pathology , Amyloidosis/complications , Amyloidosis/surgery , Biopsy , Cranial Nerve Neoplasms/complications , Cranial Nerve Neoplasms/surgery , Diagnosis, Differential , Female , Humans , Magnetic Resonance Angiography , Magnetic Resonance Imaging , Magnetic Resonance Imaging, Interventional , Middle Aged , Positron-Emission Tomography , Tomography, X-Ray Computed , Trigeminal Nerve Diseases/etiology , Trigeminal Nerve Diseases/surgery
13.
Ultrasound Obstet Gynecol ; 36(6): 773-5, 2010 Dec.
Article in English | MEDLINE | ID: mdl-20737457

ABSTRACT

We describe a case of a large chorioangioma diagnosed at 18 weeks' gestation. Because of advanced fetal heart failure at 23 weeks' gestation, embolization of the chorioangioma's vessels was performed by percutaneous injection of Glubran 2 surgical glue. There was no immediate secondary effect of treatment. Devascularization was complete and durable. Signs of fetal cardiac failure normalized after 1 month and a healthy infant was delivered at 38 weeks. To our knowledge this is the first reported case of perinatal survival after successful embolization of a chorioangioma using tissue glue.


Subject(s)
Cyanoacrylates/administration & dosage , Embolization, Therapeutic/methods , Hemangioma/therapy , Placenta Diseases/therapy , Pregnancy Complications, Neoplastic/therapy , Tissue Adhesives/administration & dosage , Adult , Female , Fetal Diseases/therapy , Gestational Age , Heart Failure/therapy , Hemangioma/diagnostic imaging , Humans , Infant, Newborn , Placenta Diseases/diagnostic imaging , Pregnancy , Pregnancy Complications, Neoplastic/diagnostic imaging , Pregnancy Outcome , Ultrasonography
14.
Rev Med Brux ; 31(2): 122-6, 2010.
Article in French | MEDLINE | ID: mdl-20677668

ABSTRACT

A 46-year-old woman presents with walk instability. A diagnosis of cerebellar hemangioblastoma is made on MRI and neurosurgical excision was performed. In the postoperative course, the patient died of a bulbar cerebral stroke with respiratory distress. At the autopsy, the finding of a bilateral renal clear cell carcinoma in addition to the cerebellar hemangioblastoma allows for the diagnosis of von Hippel-Lindau disease. It is an inherited, autosomal dominant syndrome charaterized by a VHL gene mutation. Affected individuals are at risk of developing various benign and malignant tumors of multiple organs, reviewed in this article. Despite a decrease of number of necropsy, this case as the review of literature demonstrates clinical importance of autopsy.


Subject(s)
von Hippel-Lindau Disease/pathology , Autopsy , Female , Humans , Middle Aged
16.
AJNR Am J Neuroradiol ; 29(3): 476-82, 2008 Mar.
Article in English | MEDLINE | ID: mdl-18079184

ABSTRACT

BACKGROUND AND PURPOSE: MR imaging-based apparent diffusion coefficient (ADC) and regional cerebral blood volume (rCBV) measurements have been related respectively to both cell and microvessel density in brain tumors. However, because of the high degree of heterogeneity in gliomas, a direct correlation between these MR imaging-based measurements and histopathologic features is required. The purpose of this study was to correlate regionally ADC and rCBV values with both cell and microvessel density in gliomas, by using coregistered MR imaging and stereotactic biopsies. MATERIALS AND METHODS: Eighteen patients (9 men, 9 women; age range, 19-78 years) with gliomas underwent diffusion-weighted and dynamic susceptibility contrast-enhanced MR imaging before biopsy. Eighty-one biopsy samples were obtained and categorized as peritumoral, infiltrated tissue, or bulk tumor, with quantification of cell and microvessel density. ADC and rCBV values were measured at biopsy sites and were normalized to contralateral white matter on corresponding maps coregistered with a 3D MR imaging dataset. ADC and rCBV ratios were compared with quantitative histologic features by using the Spearman correlation test. RESULTS: The highest correlations were found within bulk tumor samples between rCBV and cell density (r=0.57, P < .001) and rCBV and microvessel density (r=0.46, P < .01). An inverse correlation was found between ADC and microvessel density within bulk tumor (r=-0.36, P < .05), whereas no significant correlation was found between ADC and cell density. CONCLUSION: rCBV regionally correlates with both cell and microvessel density within gliomas, whereas no regional correlation was found between ADC and cell density.


Subject(s)
Blood Volume , Brain Neoplasms/blood supply , Brain Neoplasms/pathology , Diffusion Magnetic Resonance Imaging/methods , Glioma/blood supply , Glioma/pathology , Image Interpretation, Computer-Assisted/methods , Microcirculation/pathology , Neovascularization, Pathologic/pathology , Adult , Aged , Cell Count , Female , Humans , Male , Middle Aged
17.
Neuropathol Appl Neurobiol ; 34(3): 316-29, 2008 Jun.
Article in English | MEDLINE | ID: mdl-17983425

ABSTRACT

AIMS: Tenascin-C (TN-C) is an extracellular matrix brain glycoprotein for which conflicting in vitro and in vivo results are reported in the literature dealing with its involvement in astrocytoma aggressiveness, in particular astrocytoma invasion. In view of these conflicting results and the lack of data available on low-grade astrocytomas, the present study focuses on pilocytic World Health Organization (WHO) grade I, and diffuse WHO grade II astrocytomas, that is, two histological entities associated with very different invasive abilities. METHODS: Using real-time reverse transcription polymerase chain reaction and immunohistochemistry, we analysed the TN-C expression in normal brain tissue as well as in a series of 54 pilocytic and 53 grade II astrocytomas. CONCLUSIONS: Our data on normal brain showed that while TN-C is largely expressed in supratentorial white matter, it was largely absent in infratentorial white matter. Paralleling these observations, we showed that TN-C expression in low-grade astrocytomas similarly varies according to tumour site. Cox regression analysis evidenced that TN-C provided an independent prognostic value which is enhanced in the case of grade II astrocytomas for which positive TN-C expression is associated with a higher risk of recurrence. We also analysed TN-C expression specifically in vascular areas of low-grade astrocytomas without demonstrating any prognostic value for this additional feature. RESULTS: Similarly to normal brain, low-grade astrocytomas exhibit variations in TN-C expression with site, and this expression is associated with an independent prognostic value in terms of recurrence.


Subject(s)
Astrocytoma/metabolism , Astrocytoma/pathology , Brain Neoplasms/metabolism , Brain Neoplasms/pathology , Tenascin/biosynthesis , Adult , Age Factors , Astrocytoma/mortality , Biomarkers, Tumor/analysis , Brain Neoplasms/mortality , Child , Female , Humans , Immunohistochemistry , Kaplan-Meier Estimate , Male , Neoplasm Recurrence, Local/pathology , Prognosis , Reverse Transcriptase Polymerase Chain Reaction , Spinal Cord Neoplasms/metabolism , Spinal Cord Neoplasms/mortality , Spinal Cord Neoplasms/pathology
18.
AJNR Am J Neuroradiol ; 27(4): 818-21, 2006 Apr.
Article in English | MEDLINE | ID: mdl-16611771

ABSTRACT

Intradural extramedullary location of ependymoma is rare. To the best of our knowledge, only 9 cases have been described in the literature. We report a case of a histologically confirmed ependymoma (WHO grade II) presented in the MR imaging as a cystic, nonenhancing thoracic intradural extramedullary lesion compressing the spinal cord. The cystic appearance mimicking an arachnoid cyst at diagnosis and the leptomeningeal dissemination developed later were peculiarities that have never been previously described in relation to these rare tumors.


Subject(s)
Ependymoma/pathology , Spinal Cord Neoplasms/pathology , Aged , Arachnoid Cysts/pathology , Diagnosis, Differential , Female , Humans , Magnetic Resonance Imaging , Thoracic Vertebrae
19.
Int J Immunopathol Pharmacol ; 18(3): 431-43, 2005.
Article in English | MEDLINE | ID: mdl-16164826

ABSTRACT

The WHO classification of lymphomas was established on the basis of clinical, morphological, immunohistochemical and genetic criteria. However, each entity displays its own spectrum of clinical aggressiveness. Treatment success varies widely and is not predictable. Since galectins are involved in oncogenesis and the physiology of immune cells, we investigated whether galectin-1 and galectin-3 immunohistochemical expression could differ in 25 normal lymphoid tissues, 42 non-Hodgkins and 14 Hodgkins lymphomas. Immunohistochemical galectin expression was submitted to semi-quantitative and quantitative (computer-assisted microscopy) evaluations. This study is completed by an analysis (by means of quantitative RT-PCR) of galectin-3 mRNA expression in 3 normal lymph nodes, 3 follicular lymphomas (FLs) and 3 diffuse large B-cell lymphomas (DLBCLs). The data show that in normal lymphoid tissue, lymphocytes do not express galectin-1 and rarely express galectin-3. In contrast, galectin-3 was expressed in 8 of the 16 DLBCL cases and in 1 of the 8 FL cases. Furthermore, galectin-3 mRNA was expressed 3 times more in the DLBCLs than in the FLs. While the blood vessel walls of the lymphomas expressed galectin-1, the vessel walls of normal lymphoid tissues did not. This expression of galectin-1 in blood vessel walls was correlated with vascular density. The present study thus shows that DLBCL can be distinguished from normal lymphoid tissue and other lymphomas on the basis of galectin-3 expression.


Subject(s)
Galectin 1/metabolism , Galectin 3/metabolism , Hodgkin Disease/metabolism , Lymphoid Tissue/metabolism , Lymphoma, Non-Hodgkin/metabolism , Humans , Image Processing, Computer-Assisted , Immunohistochemistry , Lymphocytes/metabolism , RNA, Messenger/metabolism , Reverse Transcriptase Polymerase Chain Reaction
20.
Rev Med Brux ; 25(2): 103-6, 2004 Apr.
Article in French | MEDLINE | ID: mdl-15157064

ABSTRACT

We report the case of a man presenting a deafness and a hemorrhagic ear discharge since one year. CT scanner and MRI reveal an invasive tumoral lesion of the external auditory meatus (EAM) expending into the posterior fossa. After surgery the diagnosis of high grade ceruminal gland adenocarcinoma is established whereas the malignancy was not obvious on earlier biopsy. Cancers arising in the EAM are uncommon and are essentially representating by squamous cell cancers and basal cell cancers. The precise diagnosis of a glandular tumor is a challenge for the pathologist because the limits between benign and malignant tumors are not obvious. Integration of clinical and radiological behavior and the histology of the tumor is necessary for a early diagnosis and a complete surgery.


Subject(s)
Adenocarcinoma/surgery , Ear Neoplasms/surgery , Adenocarcinoma/pathology , Aged , Aged, 80 and over , Biopsy , Deafness/etiology , Ear Neoplasms/diagnosis , Ear Neoplasms/pathology , Ear, External , Humans , Male
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