Insulin-like growth factor family and prostate cancer: new insights and emerging opportunities.

Prostate cancer is the second most commonly diagnosed cancer in men. The mammalian insulin-like growth factor (IGF) family is made up of three ligands (IGF-I, IGF-II, and insulin), three receptors (IGF-I receptor (IGF-1R), insulin receptor (IR), and IGF-II receptor (IGF-2R)), and six IGF-binding proteins (IGFBPs). IGF-I and IGF-II were identified as potent mitogens and were previously associated with an increased risk of cancer development including prostate cancer. Several reports showed controversy about the expression of the IGF family and their connection to prostate cancer risk due to the high degree of heterogeneity among prostate tumors, sampling bias, and evaluation techniques. Despite that, it is clear that several IGF family members play a role in prostate cancer development, metastasis, and androgen-independent progression. In this review, we aim to expand our understanding of prostate tumorigenesis and regulation through the IGF system. Further understanding of the role of IGF signaling in PCa shows promise and needs to be considered in the context of a comprehensive treatment strategy.

Kikuchi Disease in Children: A Report of Two Cases.

Kikuchi disease (KD) is a benign self-limiting rare disease with unknown etiology. Prolonged fever with tender neck lymphadenitis is the most common presentation. Blood tests are not specific, and the final diagnosis is by biopsy. We describe two patients, ages seven and twelve years, who presented with fever and neck lymphadenitis. Both cases received antibiotics for more than two weeks without improvement. Blood work showed high inflammatory markers. The manifestation of the second case overlapped with Hashimoto's disease. The later diagnosis was confirmed by lymph node (LN) biopsy.

The Value of Cellblock in Diagnosing Pancreatic Lymphomas.

BACKGROUND: Endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) is the diagnostic tool of choice for pancreatic solid mass lesions. Pancreatic lymphomas represent an infrequent and challenging cytologic diagnosis. Our aim was to determine the diagnostic value of cellblock (CB) in the diagnosis of pancreatic lymphomas. METHODS: We retrieved pancreatic EUS-FNAs performed over 10-years from our institution's database. We correlated the cytologic and CB diagnosis with the histologic diagnosis as a gold standard. RESULTS: We found 5 cases (2 women and 3 men; age range, 37-66 years [average age, 52 years]) of pancreatic lymphomas with histologic follow-up biopsies. They included 1 case of T-cell lymphoma (TCL), 1 case of plasma cell neoplasm (multiple myeloma [MM]), 1 case of diffuse large B-cell lymphoma (DLBCL), 1 case of classic Hodgkin lymphoma (HL), and 1 case of high-grade B-cell lymphoma (HGBCL). Cytologically, the cases of HL and DLBCL were suspected, the cases of TCL and MM were confused with undifferentiated carcinoma and neuroendocrine carcinoma, and the case of HGBCL was inconclusive. CB samples were of value in highlighting the morphologic details of lymphomas and allowed confirmation, proper classification, and grading of the lymphomas using immunohistochemistry that matched tissue biopsies. CONCLUSIONS: EUS-FNA smears with CBs are helpful diagnostic tools, differentiating lymphomas from other malignancies and from nonneoplastic lymphocyte-rich lesions. CBs allow proper classification and grading of cases of pancreatic lymphomas.

Adrenocortical Oncocytic Carcinoma and Papillary Thyroid Carcinoma Incidentally Detected in an Asymptomatic Patient by F-18 FDG PET/CT.

F-18 FDG is the most widely used tracer in molecular imaging and it is applied for many purposes mainly in malignant diseases. Incidental finding are common in FDG-PET/CT imaging and includes benign and malignant lesions. Among the rare tumors , adrenal oncocytomas are uncommon findings and incidental findings of thyroid malignancies are not rare. Oncocytoma is a rare adrenocortical tumor and majority of bulky adrenal tumors are benign with uncertain incident of malignancy. In this study, we are reporting a 37-year-old man with two incidental malignancies detected by FDG-PET-CT. He has no symptoms has no blood and hormonal abnormalities. The scan demonstrated intense heterogeneous FDG uptake within the bulky oval shaped lesion in the left adrenal gland. Accordingly, open adrenalectomy was performed and diagnosis of adrenocortical carcinoma oncocytic type was established. Furthermore, a focal FDG uptake was identified in the right thyroid lobe and histopathology findings were consistent with well-differentiated papillary thyroid cancer. FDG plays a great role in identifying primary rare lesions and also detection of incidental findings at unexpected sites.

The prevalence and importance of crypt apoptosis, focal active cryptitis, and neutrophilic infiltrate of the lamina propria in colorectal adenomas.

Even though apoptotic bodies (ABs) are frequent in colorectal adenomas, their relevance has been covered only in a few studies. Focal active cryptitis (FAC) is a well-known manifestation of several etiologies; however, its prevalence and significance in colonic adenomas were not scrutinized. Likewise, whether the neutrophilic infiltrate of the lamina propria (LP) in colonic adenomas has a clinical or pathologic significance was not previously studied. We attempted to investigate the prevalence and importance of ABs in the cryptal epithelium and of neutrophils in the form of FAC and in the form of LP infiltrates in conventional colorectal adenomas. We conducted a retrospective review study over a 6-year period. We collected 223 conventional adenomas from 156 patients. We studied the interrelationship between these 3 histologic parameters and their potential association with other clinical and pathologic variables. Comparison controls included normal colonic mucosa, hyperplastic polyps, serrated adenomas, and flat adenomas. We found 91 (41%) adenomas to have crypt apoptosis, 40 (18%) to have FAC, and 69 (31%) to have neutrophilic infiltrate of the LP. We found ABs to be more frequent in high-grade adenomas. LP neutrophilic infiltrate was significantly associated with high-grade adenomas and in high-grade adenomas with invasive foci. In contrast, FAC was not associated with high-grade adenomas and was secondary to bowel preparations and drugs. Crypt apoptosis and LP neutrophils might have a potential prognostic value in predicting the biologic behavior of colonic adenomas. FAC in adenomas is a nonspecific finding of no prognostic significance and is related to external stimuli.