Background: Thyroid diseases are among the leading endocrine disorders affecting a large proportion of people worldwide and show geographical variation in incidence and histopathological pattern related to age, sex, d...Background: Thyroid diseases are among the leading endocrine disorders affecting a large proportion of people worldwide and show geographical variation in incidence and histopathological pattern related to age, sex, dietary and environmental factors. Histopathological patterns of surgically treated thyroid diseases play an important role in early diagnosis and management of these diseases. There is, however, limited published data regarding histopathological reports on thyroid disease in our local setting. This study aimed to determine the histopathological patterns and highlight early postoperative complications among patients with surgically treated thyroid diseases at Bugando Medical Centre (BMC). Methods: This was a longitudinal study involving all patients with surgically treated thyroid diseases seen at BMC over a period of 6 months from October 2019 to March 2020. Results: A total of 84 patients were studied. Females outnumbered males by a female to male ratio of 11:1. The median age of patients was 44 [IQR, 35 - 54] years old, the youngest was 14 years old and the oldest was 76 years old. Colloid goiter was the most common non-neoplastic lesion accounting for 34 (44.7%) patients. Among the neoplastic lesions, follicular adenoma was the most commonly encountered benign pathologies (n = 16;21.1%), while papillary carcinoma was the most commonly encountered malignancy (n = 4;50%). Following thyroidectomy, 12 (14.3%) patients developed early complications, of which hemorrhage sometimes requiring blood transfusion was the leading intra/postoperative complications accounting for 4 (33.3%) patients. Other complications include temporary recurrent laryngeal nerve palsy 2 (16.7%), surgical site infection 2 (16.7%) and tracheomalacia, bronchospasm, thyroid abscess and respiratory obstruction in 1 (8.3%) patient each, respectively. In this study, malignant thyroid lesion (p Conclusion: This study demonstrated that colloid goiter was the most common non-neoplastic lesion, and on the neoplastic category, follicular adenoma was the most common benign lesion, while papillary carcinoma was the most frequent malignant lesion.展开更多
Liver is the most common site of metastases of colorectal cancer,and liver metastases present with distinct histopathological growth patterns(HGPs),including desmoplastic,pushing and replacement HGPs and two rare HGPs...Liver is the most common site of metastases of colorectal cancer,and liver metastases present with distinct histopathological growth patterns(HGPs),including desmoplastic,pushing and replacement HGPs and two rare HGPs.HGP is a miniature of tumor-host reaction and reflects tumor biology and pathological features as well as host immune dynamics.Many studies have revealed the association of HGPs with carcinogenesis,angiogenesis,and clinical outcomes and indicates HGP functions as bond between microscopic characteristics and clinical implications.These findings make HGP a candidate marker in risk stratification and guiding treatment decision-making,and a target of imaging observation for patient screening.Of note,it is crucial to determine the underlying mechanism shaping HGP,for instance,immune infiltration and extracellular matrix remodeling in desmoplastic HGP,and aggressive characteristics and special vascularization in replacement HGP(rHGP).We highlight the importance of aggressive features,vascularization,host immune and organ structure in formation of HGP,hence propose a novel"advance under camouflage"hypothesis to explain the formation of rHGP.展开更多
Liver metastases are a leading contributor to cancer-related illness and death,occurring far more frequently than primary liver tumors.Their management remains highly challenging due to the complexity of disease behav...Liver metastases are a leading contributor to cancer-related illness and death,occurring far more frequently than primary liver tumors.Their management remains highly challenging due to the complexity of disease behavior and the need for an individualized,multidisciplinary approach.Effective care increasingly relies on integrating sophisticated diagnostic techniques,advanced systemic and locoregional therapies,and molecularly tailored treatment strategies.This review provides an in-depth analysis of the current clinicopathological perspectives on liver metastases.It explores their epidemiology,mechanisms of spread,histological growth patterns,diagnostic imaging advancements,molecular characteristics,and therapeutic interventions.Additionally,it examines the broader implications for patient quality of life(QoL),healthcare costs,and the particular difficulties associated with managing liver metastases in pediatric patients and individuals with rare malignancies.The article outlines the diverse histopathological features and tumor–liver interface growth patterns,emphasizing their prognostic and therapeutic significance.It evaluates contemporary imaging modalities–including magnetic resonance imaging and computed tomography(CT)with hepatocyte-specific agents,positron emission tomography/CT,and contrast-enhanced ultrasound–and highlights the emerging importance of liquid biopsy and molecular profiling in shaping treatment decisions.The review discusses available treatment options such as chemotherapy,targeted agents,immunotherapies,surgical resection,liver transplantation,and various locoregional therapies.Furthermore,it addresses evolving fields like prognostic scoring systems,radiomics,artificial intelligence(AI)applications,and patient–derived organoid and xenograft models.A summary of current clinical trials and translational research initiatives reflects the fast-paced evolution of this field.The management of liver metastases is rapidly advancing,driven by precision oncology principles and collaborative,multidisciplinary care.The integration of molecular diagnostics,novel therapeutic approaches,and cutting–edge technologies–including AI and organoid-based personalized drug testing-is poised to enhance treatment selection,improve clinical outcomes,and support better QoL.These innovations hold the potential to transform the outlook for patients with liver metastases,moving toward more durable disease control in appropriately selected cases.展开更多
文摘Background: Thyroid diseases are among the leading endocrine disorders affecting a large proportion of people worldwide and show geographical variation in incidence and histopathological pattern related to age, sex, dietary and environmental factors. Histopathological patterns of surgically treated thyroid diseases play an important role in early diagnosis and management of these diseases. There is, however, limited published data regarding histopathological reports on thyroid disease in our local setting. This study aimed to determine the histopathological patterns and highlight early postoperative complications among patients with surgically treated thyroid diseases at Bugando Medical Centre (BMC). Methods: This was a longitudinal study involving all patients with surgically treated thyroid diseases seen at BMC over a period of 6 months from October 2019 to March 2020. Results: A total of 84 patients were studied. Females outnumbered males by a female to male ratio of 11:1. The median age of patients was 44 [IQR, 35 - 54] years old, the youngest was 14 years old and the oldest was 76 years old. Colloid goiter was the most common non-neoplastic lesion accounting for 34 (44.7%) patients. Among the neoplastic lesions, follicular adenoma was the most commonly encountered benign pathologies (n = 16;21.1%), while papillary carcinoma was the most commonly encountered malignancy (n = 4;50%). Following thyroidectomy, 12 (14.3%) patients developed early complications, of which hemorrhage sometimes requiring blood transfusion was the leading intra/postoperative complications accounting for 4 (33.3%) patients. Other complications include temporary recurrent laryngeal nerve palsy 2 (16.7%), surgical site infection 2 (16.7%) and tracheomalacia, bronchospasm, thyroid abscess and respiratory obstruction in 1 (8.3%) patient each, respectively. In this study, malignant thyroid lesion (p Conclusion: This study demonstrated that colloid goiter was the most common non-neoplastic lesion, and on the neoplastic category, follicular adenoma was the most common benign lesion, while papillary carcinoma was the most frequent malignant lesion.
基金Supported by National Nature Science Foundation,No.81873111,No.82174454,and No.82074182Natural Science Foundation of Beijing,No.7202066。
文摘Liver is the most common site of metastases of colorectal cancer,and liver metastases present with distinct histopathological growth patterns(HGPs),including desmoplastic,pushing and replacement HGPs and two rare HGPs.HGP is a miniature of tumor-host reaction and reflects tumor biology and pathological features as well as host immune dynamics.Many studies have revealed the association of HGPs with carcinogenesis,angiogenesis,and clinical outcomes and indicates HGP functions as bond between microscopic characteristics and clinical implications.These findings make HGP a candidate marker in risk stratification and guiding treatment decision-making,and a target of imaging observation for patient screening.Of note,it is crucial to determine the underlying mechanism shaping HGP,for instance,immune infiltration and extracellular matrix remodeling in desmoplastic HGP,and aggressive characteristics and special vascularization in replacement HGP(rHGP).We highlight the importance of aggressive features,vascularization,host immune and organ structure in formation of HGP,hence propose a novel"advance under camouflage"hypothesis to explain the formation of rHGP.
基金Supported by UMM Al-Qura University,Saudi Arabia,No.25UQU4350477GSSR05.
文摘Liver metastases are a leading contributor to cancer-related illness and death,occurring far more frequently than primary liver tumors.Their management remains highly challenging due to the complexity of disease behavior and the need for an individualized,multidisciplinary approach.Effective care increasingly relies on integrating sophisticated diagnostic techniques,advanced systemic and locoregional therapies,and molecularly tailored treatment strategies.This review provides an in-depth analysis of the current clinicopathological perspectives on liver metastases.It explores their epidemiology,mechanisms of spread,histological growth patterns,diagnostic imaging advancements,molecular characteristics,and therapeutic interventions.Additionally,it examines the broader implications for patient quality of life(QoL),healthcare costs,and the particular difficulties associated with managing liver metastases in pediatric patients and individuals with rare malignancies.The article outlines the diverse histopathological features and tumor–liver interface growth patterns,emphasizing their prognostic and therapeutic significance.It evaluates contemporary imaging modalities–including magnetic resonance imaging and computed tomography(CT)with hepatocyte-specific agents,positron emission tomography/CT,and contrast-enhanced ultrasound–and highlights the emerging importance of liquid biopsy and molecular profiling in shaping treatment decisions.The review discusses available treatment options such as chemotherapy,targeted agents,immunotherapies,surgical resection,liver transplantation,and various locoregional therapies.Furthermore,it addresses evolving fields like prognostic scoring systems,radiomics,artificial intelligence(AI)applications,and patient–derived organoid and xenograft models.A summary of current clinical trials and translational research initiatives reflects the fast-paced evolution of this field.The management of liver metastases is rapidly advancing,driven by precision oncology principles and collaborative,multidisciplinary care.The integration of molecular diagnostics,novel therapeutic approaches,and cutting–edge technologies–including AI and organoid-based personalized drug testing-is poised to enhance treatment selection,improve clinical outcomes,and support better QoL.These innovations hold the potential to transform the outlook for patients with liver metastases,moving toward more durable disease control in appropriately selected cases.
