The histopathological diagnosis of gastric mucosal biopsy and endoscopic mucosal resection/endoscopic submucosal dissection specimens is important,but the diagnostic criteria,terminology,and grading system are not the...The histopathological diagnosis of gastric mucosal biopsy and endoscopic mucosal resection/endoscopic submucosal dissection specimens is important,but the diagnostic criteria,terminology,and grading system are not the same in the East and West.A structurally invasive focus is necessary to diagnose carcinoma for most Western pathologists,but Japanese pathologists make a diagnosis of cancer based on severe dysplastic cytologic atypia irrespective of the presence of invasion.Although the Vienna classification was introduced to reduce diagnostic discrepancies,it has been difficult to adopt due to different concepts for gastric epithelial neoplastic lesions.Korean pathologists experience much difficulty making a diagnosis because we are influenced by Japanese pathologists as well as Western medicine.Japan is geographically close to Korea,and academic exchanges are active.Additionally,Korean doctors are familiar with Western style medical terminology.As a result,the terminology,definitions,and diagnostic criteria for gastric intraepithelial neoplasia are very heterogeneous in Korea.To solve this problem,the Gastrointestinal Pathology Study Group of the Korean Society of Pathologists has made an effort and has suggested guidelines for differential diagnosis:(1) a diagnosis of carcinoma is based on invasion;(2) the most important characteristic of low grade dysplasia is the architectural pattern such as regular distribution of crypts without severe branching,budding,or marked glandular crowding;(3) if nuclear pseudostratification occupies more than the basal half of the cryptal cells in three or more adjacent crypts,the lesion is considered high grade dysplasia;(4) if severe cytologic atypia is present,careful inspection for invasive foci is necessary,because the risk for invasion is very high;and(5) other structural or nuclear atypia should be evaluated to make a final decision such as cribriform pattern,papillae,ridges,vesicular nuclei,high nuclear/cytoplasmic ratio,loss of nuclear polarity,thick and irregular nuclear membrane,and nucleoli.展开更多
Papillary thyroid cancer(PTC)represents 80%-85%of thyroid cancer and its prevalence has been rising in the last decades.Primary thyroid lymphoma(PTL)accounts for 3%of extranodal lymphomas and about 5%of thyroid malign...Papillary thyroid cancer(PTC)represents 80%-85%of thyroid cancer and its prevalence has been rising in the last decades.Primary thyroid lymphoma(PTL)accounts for 3%of extranodal lymphomas and about 5%of thyroid malignancies,having a prevalence of one or two cases per million people.Mucosa-Associated Lymphoid Tissue lymphoma represents approximately30%of PTL.Both entities have an indolent course and a very good prognosis.Diagnosis is made by ultrasound and fine needle aspiration(FNA)or surgery specimen pathology.They have also been associated with Hashimoto’s thyroiditis(HT),but pathogenesis and its links remains to be known.Treatment remains controversial and surgery is generally accepted in cases of disease limited to thyroid,as the present.Patients with thyroid nodules should be observed and followed.If there is an enlargement by ultrasound or clinical symptoms,FNA should be performed promptly.Patients with HT deserve additional surveillance,since this condition is associated with both PTC and PTL.In this case,the management with surgery and radioactive iodine ablation therapy was effective for both entities.Patients with thyroid nodules should be properly evaluated with ultrasound and thyroid function tests.If there is an enlargement of the neck,reported by symptoms or ultrasound,it requires further investigation.HT is associated to both PTC and PTL so if the enlargement of the nodules is on this context additional tests such as FNA should be performed.In this case,the patient was managed with surgery and radioactive iodine ablation therapy and it was effective for both entities.展开更多
Type I gastric cardnoid tumors result from hypergastrinemia in 1%-7% of patients with pernicious anemia. We diagnosed pernicious anemia in a 48-year-old female patient with complaint of fatigue for three months. She h...Type I gastric cardnoid tumors result from hypergastrinemia in 1%-7% of patients with pernicious anemia. We diagnosed pernicious anemia in a 48-year-old female patient with complaint of fatigue for three months. She had no gastrointestinal symptoms. Endoscopic examination ot the upper gastrointestinal tract revealed atrophic gastritis and a polypoid lesion in the corpus of 3-4 mm in size. Endoscopic polypectomy was performed. Histopathological examination of the specimen revealed positive chromogranin A and synaptophysin stainings compatible with the diagnosis of a carcinoid tumor. Serum gastrin level was increased, urinary 5-hydroxyindoleacetic acid was within the normal range. There was no other symptom, sign, or laboratory finding of a carcinoid syndrome in the patient. No metastasis was found with indium-ill octreotide scan, computed tomographies of abdomen and thorax. Type I gastric carcinoid tumors are only rarely solitary and patients with tumors 〈 1 cm in size may benefit from endoscopic polypectomy.展开更多
AIM: To describe the clinicopathologic features of concurrent polyomavirus nephropathy(PVN) and endarteritis due to rejection in renal allografts.METHODS: We searched our electronic records database for cases with tra...AIM: To describe the clinicopathologic features of concurrent polyomavirus nephropathy(PVN) and endarteritis due to rejection in renal allografts.METHODS: We searched our electronic records database for cases with transplant kidney biopsies demonstrating features of both PVN and acute rejection(AR). PVN was defined by the presence of typical viral cytopathic effect on routine sections and positive polyomavirus SV40 large-T antigen immunohistochemistry. AR was identified by endarteritis(v1 by Banff criteria). All cases were subjected to chart review in order to determine clinical presentation, treatment course and outcomes. Outcomes were recorded with a length of follow-up of at least one year or time to nephrectomy. RESULTS: Of 94 renal allograft recipients who developed PVN over an 11-year period at our institution, we identified 7(7.4%) with viral cytopathic changes, SV40 large T antigen staining, and endarteritis in the same biopsy specimen, indicative of concurrent PVN and AR. Four arose after reduction of immunosuppression(IS)(for treatment of PVN in 3 and tuberculosis in 1), and 3 patients had no decrease of IS before developing simultaneous concurrent disease. Treatment consisted of reduced oral IS and leflunomide for PVN, and antirejection therapy. Three of 4 patients who developed endarteritis in the setting of reduced IS lost their grafts to rejection. All 3 patients with simultaneous PVN and endarteritis cleared viremia and were stable at 1 year of follow up. Patients with endarteritis and PVN arising in a background of reduced IS had more severe rejection and poorer outcome.CONCLUSION: Concurrent PVN and endarteritis may be more frequent than is currently appreciated and may occur with or without prior reduction of IS.展开更多
Background: Filarial disease has a very high prevalence in South East Asian region especially India. It commonly presents as an affliction of the lymphatic system like acute lymphangitis and chronic lymphedema. Presen...Background: Filarial disease has a very high prevalence in South East Asian region especially India. It commonly presents as an affliction of the lymphatic system like acute lymphangitis and chronic lymphedema. Presentation of lymphatic filariasis as a subcutaneous nodule is a rare but previously reported scenario. Aim: We discuss a case with incidental detection of filaria in a subcutaneous nodule following excision biopsy. Case Presentation: 20-year-old male patient presented with subcutaneous swelling in left lower chest. Undergoing excision biopsy for same and on histopathological examination was found to be an encysted filarial worm. Conclusion: Such rare presentation of filariasis has been reported earlier also and should be kept in mind.展开更多
Objective Accumulation of estrogenic compounds and other carcinogens in normal breast tissues contributes to unpredictable breast cancer incidence during adolescence and throughout life.To assess the role of parabens ...Objective Accumulation of estrogenic compounds and other carcinogens in normal breast tissues contributes to unpredictable breast cancer incidence during adolescence and throughout life.To assess the role of parabens in this phenomenon,the paraben content of adjacent normal-malignant breast tissues is measured in women with breast cancer living in Isfahan Province,Iran.Methods Adjacent normal-malignant breast tissue samples were obtained from 53 subjects.The parabens including methyl-paraben(Me PB),ethyl-paraben(Et PB),propyl-paraben(Pr PB),and butylparaben(Bu PB)were extracted from the sample supernatant and then subjected to gas chromatography analysis.Results Some risk factors for breast cancer were stimulated by parabens in adjacent malignant-normal breast tissues among young and middle-aged women with breast cancer.We observed a significant association for dose-response pattern of Me PB[OR=98.34(11.43–185.2),P=0.027]for both ER+and PR+women and Me PB[OR=164.3(CI:112.3–216.3),P<0.001]for HER2+women than women with negative receptors.The risk of 95-fold increase in Me PB dose and 164-fold increase in∑PBs dose were significant for women with hereditary breast cancer in first-degree relatives.Conclusions These results may promote future epidemiology studies and strategies to improve women's lifestyle and consume paraben-free products.展开更多
AIM To investigate the synergistic hepato-protective properties of curcumin and vitamin E in an Hfe^(-/-)high calorie diet model of steatohepatitis.METHODS Hfe^(-/-)C57BL/6J mice were fed either a high calorie diet or...AIM To investigate the synergistic hepato-protective properties of curcumin and vitamin E in an Hfe^(-/-)high calorie diet model of steatohepatitis.METHODS Hfe^(-/-)C57BL/6J mice were fed either a high calorie diet or a high calorie diet with 1 mg/g curcumin;1.5 mg/g vitamin E;or combination of 1 mg/g curcumin+1.5 mg/g vitamin E for 20 wk.Serum and liver tissue were collected at the completion of the experiment.Liver histology was graded by a pathologist for steatosis,inflammation and fibrosis.RNA and protein was extracted from liver tissue to examine gene and protein expression associated with fatty acid oxidation,mitochondrial biogenesis and oxidative stress pathways.RESULTS Hfe^(-/-)mice fed the high calorie diet developed steatohepatitis and pericentral fibrosis.Combination treatment with curcumin and vitamin E resulted in a greater reduction of percent steatosis than either vitamin E or curcumin therapy alone.Serum alanine aminotransferase and non-alcoholic fatty liver disease(NAFLD)activity score were decreased following combination therapy with curcumin and vitamin E compared with high calorie diet alone.No changes were observed in inflammatory or fibrosis markers following treatment.Epididymal fat pad weights were significantly reduced following combination therapy,however total body weight and liver weight were unchanged.Combination therapy increased the m RNA expression of Adipo R2,Ppar-α,Cpt1 a,Nrf-1 and Tfb2 m suggesting enhanced fatty acid oxidation and mitochondrial biogenesis.In addition,combination treatment resulted in increased catalase activity in Hfe^(-/-)mice.CONCLUSION Combination curcumin and vitamin E treatment decreases liver injury in this steatohepatitis model,indicating that combination therapy may be of value in NAFLD.展开更多
Objective: Making the interest of using immunohistochemistry clear in addition to histological test in the diagnosis of lymphomas. Methods: This is a retrospective study from January 2011 to June 2013 involving 18 cas...Objective: Making the interest of using immunohistochemistry clear in addition to histological test in the diagnosis of lymphomas. Methods: This is a retrospective study from January 2011 to June 2013 involving 18 cases of lymphomas collected in the teaching hospitals of Treichville and Yopougon. Results: 1) 38.88% diagnosis of LMNH B large-cell in histology against 38.88% LDGCB with IHC. 2) 11.11% diagnosis of LMNH small cell in histology against 11.11% with IHC. 3) 5.55% diagnosis of T lymphoma in histology against 27.77% diagnosis of T lymphoma with IHC. 4) 5.55% diagnosis of follicular lymphoma in histology against 11.11% diagnosis of LF with IHC. 5) 11.11% diagnosis of Burkitt lymphoma in histology against 5.55% diagnosis of LB with IHC. 6) 5.55% diagnosis of medullary hypoplasia in histology against 5.55% diagnosis of Hodgkin’s disease. Our results confirm the contribution of immunohistochemistry in the diagnosis of lymphomas in addition to histological test. This is striking, especially as there is 27.77% of T lymphoma with immunohistochemistry against only 5.55% with histology.展开更多
Vertebral hemangiomas are common benign lesions of the spine, characterized by abnormal vascular proliferation, being commonly asymptomatic incidental findings, presenting symptoms in only a small portion of affected ...Vertebral hemangiomas are common benign lesions of the spine, characterized by abnormal vascular proliferation, being commonly asymptomatic incidental findings, presenting symptoms in only a small portion of affected individuals. In a smaller number of cases, however, hemangiomas can present an expansive effect and extra-osseous extension, determining a mass effect and neurological symptoms, being therefore called aggressive hemangiomas. On MRI, aggressive hemangiomas are characterized by having a larger vascular component and a smaller fat component, thus producing a low signal on T1-weighted images. We illustrate the case of a young male patient who presented with pain in the upper thoracic spine, who developed paraparesis and ascending sensory deficit and progressive lower limbs, progressing to paraplegia and loss of sphincter control.展开更多
Microscopic enteritis(ME) is an inflammatory condition of the small bowel that leads to gastrointestinal symptoms,nutrient and micronutrient deficiency.It is characterised by microscopic or sub-microscopic abnormaliti...Microscopic enteritis(ME) is an inflammatory condition of the small bowel that leads to gastrointestinal symptoms,nutrient and micronutrient deficiency.It is characterised by microscopic or sub-microscopic abnormalities such as microvillus changes and enterocytic alterations in the absence of definite macroscopic changes using standard modern endoscopy.This work recognises a need to characterize disorders with microscopic and submicroscopic features,currently regarded as functional or non-specific entities,to obtain further understanding of their clinical relevance.The consensus working party reviewed statements about the aetiology,diagnosis and symptoms associated with ME and proposes an algorithm for its investigation and treatment.Following the 5th International Course in Digestive Pathology in Bucharest in November 2012,an international group of 21 interested pathologists and gastroenterologists formed a working party with a view to formulating a consensus statement on ME.A five-step agreement scale(from strong agreement to strong disagreement) was used to score 21 statements,independently.There was strong agreement on all statements about ME histology(95%-100%).Statements concerning diagnosis achieved 85% to 100% agreement.A statement on the management of ME elicited agreement from the lowest rate(60%) up to 100%.The remaining two categories showed general agreement between experts on clinical presentation(75%-95%) and pathogenesis(80%-90%) of ME.There was strong agreement on the histological definition of ME.Weaker agreement on management indicates a need for further investigations,better definitions and clinical trials to produce quality guidelines for management.This ME consensus is a step toward greater recognition of a significant entity affecting symptomatic patients previously labelled as non-specific or functional enteropathy.展开更多
文摘The histopathological diagnosis of gastric mucosal biopsy and endoscopic mucosal resection/endoscopic submucosal dissection specimens is important,but the diagnostic criteria,terminology,and grading system are not the same in the East and West.A structurally invasive focus is necessary to diagnose carcinoma for most Western pathologists,but Japanese pathologists make a diagnosis of cancer based on severe dysplastic cytologic atypia irrespective of the presence of invasion.Although the Vienna classification was introduced to reduce diagnostic discrepancies,it has been difficult to adopt due to different concepts for gastric epithelial neoplastic lesions.Korean pathologists experience much difficulty making a diagnosis because we are influenced by Japanese pathologists as well as Western medicine.Japan is geographically close to Korea,and academic exchanges are active.Additionally,Korean doctors are familiar with Western style medical terminology.As a result,the terminology,definitions,and diagnostic criteria for gastric intraepithelial neoplasia are very heterogeneous in Korea.To solve this problem,the Gastrointestinal Pathology Study Group of the Korean Society of Pathologists has made an effort and has suggested guidelines for differential diagnosis:(1) a diagnosis of carcinoma is based on invasion;(2) the most important characteristic of low grade dysplasia is the architectural pattern such as regular distribution of crypts without severe branching,budding,or marked glandular crowding;(3) if nuclear pseudostratification occupies more than the basal half of the cryptal cells in three or more adjacent crypts,the lesion is considered high grade dysplasia;(4) if severe cytologic atypia is present,careful inspection for invasive foci is necessary,because the risk for invasion is very high;and(5) other structural or nuclear atypia should be evaluated to make a final decision such as cribriform pattern,papillae,ridges,vesicular nuclei,high nuclear/cytoplasmic ratio,loss of nuclear polarity,thick and irregular nuclear membrane,and nucleoli.
基金supported by 4th Incentives for Research of the Universidad Peruana de Ciencias AplicadasLima-Peru(Grant-UPC-401-2014)
文摘Papillary thyroid cancer(PTC)represents 80%-85%of thyroid cancer and its prevalence has been rising in the last decades.Primary thyroid lymphoma(PTL)accounts for 3%of extranodal lymphomas and about 5%of thyroid malignancies,having a prevalence of one or two cases per million people.Mucosa-Associated Lymphoid Tissue lymphoma represents approximately30%of PTL.Both entities have an indolent course and a very good prognosis.Diagnosis is made by ultrasound and fine needle aspiration(FNA)or surgery specimen pathology.They have also been associated with Hashimoto’s thyroiditis(HT),but pathogenesis and its links remains to be known.Treatment remains controversial and surgery is generally accepted in cases of disease limited to thyroid,as the present.Patients with thyroid nodules should be observed and followed.If there is an enlargement by ultrasound or clinical symptoms,FNA should be performed promptly.Patients with HT deserve additional surveillance,since this condition is associated with both PTC and PTL.In this case,the management with surgery and radioactive iodine ablation therapy was effective for both entities.Patients with thyroid nodules should be properly evaluated with ultrasound and thyroid function tests.If there is an enlargement of the neck,reported by symptoms or ultrasound,it requires further investigation.HT is associated to both PTC and PTL so if the enlargement of the nodules is on this context additional tests such as FNA should be performed.In this case,the patient was managed with surgery and radioactive iodine ablation therapy and it was effective for both entities.
文摘Type I gastric cardnoid tumors result from hypergastrinemia in 1%-7% of patients with pernicious anemia. We diagnosed pernicious anemia in a 48-year-old female patient with complaint of fatigue for three months. She had no gastrointestinal symptoms. Endoscopic examination ot the upper gastrointestinal tract revealed atrophic gastritis and a polypoid lesion in the corpus of 3-4 mm in size. Endoscopic polypectomy was performed. Histopathological examination of the specimen revealed positive chromogranin A and synaptophysin stainings compatible with the diagnosis of a carcinoid tumor. Serum gastrin level was increased, urinary 5-hydroxyindoleacetic acid was within the normal range. There was no other symptom, sign, or laboratory finding of a carcinoid syndrome in the patient. No metastasis was found with indium-ill octreotide scan, computed tomographies of abdomen and thorax. Type I gastric carcinoid tumors are only rarely solitary and patients with tumors 〈 1 cm in size may benefit from endoscopic polypectomy.
文摘AIM: To describe the clinicopathologic features of concurrent polyomavirus nephropathy(PVN) and endarteritis due to rejection in renal allografts.METHODS: We searched our electronic records database for cases with transplant kidney biopsies demonstrating features of both PVN and acute rejection(AR). PVN was defined by the presence of typical viral cytopathic effect on routine sections and positive polyomavirus SV40 large-T antigen immunohistochemistry. AR was identified by endarteritis(v1 by Banff criteria). All cases were subjected to chart review in order to determine clinical presentation, treatment course and outcomes. Outcomes were recorded with a length of follow-up of at least one year or time to nephrectomy. RESULTS: Of 94 renal allograft recipients who developed PVN over an 11-year period at our institution, we identified 7(7.4%) with viral cytopathic changes, SV40 large T antigen staining, and endarteritis in the same biopsy specimen, indicative of concurrent PVN and AR. Four arose after reduction of immunosuppression(IS)(for treatment of PVN in 3 and tuberculosis in 1), and 3 patients had no decrease of IS before developing simultaneous concurrent disease. Treatment consisted of reduced oral IS and leflunomide for PVN, and antirejection therapy. Three of 4 patients who developed endarteritis in the setting of reduced IS lost their grafts to rejection. All 3 patients with simultaneous PVN and endarteritis cleared viremia and were stable at 1 year of follow up. Patients with endarteritis and PVN arising in a background of reduced IS had more severe rejection and poorer outcome.CONCLUSION: Concurrent PVN and endarteritis may be more frequent than is currently appreciated and may occur with or without prior reduction of IS.
文摘Background: Filarial disease has a very high prevalence in South East Asian region especially India. It commonly presents as an affliction of the lymphatic system like acute lymphangitis and chronic lymphedema. Presentation of lymphatic filariasis as a subcutaneous nodule is a rare but previously reported scenario. Aim: We discuss a case with incidental detection of filaria in a subcutaneous nodule following excision biopsy. Case Presentation: 20-year-old male patient presented with subcutaneous swelling in left lower chest. Undergoing excision biopsy for same and on histopathological examination was found to be an encysted filarial worm. Conclusion: Such rare presentation of filariasis has been reported earlier also and should be kept in mind.
基金funded by Isfahan University of Medical Sciences,Isfahan,Iran [Research Project code:397158]
文摘Objective Accumulation of estrogenic compounds and other carcinogens in normal breast tissues contributes to unpredictable breast cancer incidence during adolescence and throughout life.To assess the role of parabens in this phenomenon,the paraben content of adjacent normal-malignant breast tissues is measured in women with breast cancer living in Isfahan Province,Iran.Methods Adjacent normal-malignant breast tissue samples were obtained from 53 subjects.The parabens including methyl-paraben(Me PB),ethyl-paraben(Et PB),propyl-paraben(Pr PB),and butylparaben(Bu PB)were extracted from the sample supernatant and then subjected to gas chromatography analysis.Results Some risk factors for breast cancer were stimulated by parabens in adjacent malignant-normal breast tissues among young and middle-aged women with breast cancer.We observed a significant association for dose-response pattern of Me PB[OR=98.34(11.43–185.2),P=0.027]for both ER+and PR+women and Me PB[OR=164.3(CI:112.3–216.3),P<0.001]for HER2+women than women with negative receptors.The risk of 95-fold increase in Me PB dose and 164-fold increase in∑PBs dose were significant for women with hereditary breast cancer in first-degree relatives.Conclusions These results may promote future epidemiology studies and strategies to improve women's lifestyle and consume paraben-free products.
文摘AIM To investigate the synergistic hepato-protective properties of curcumin and vitamin E in an Hfe^(-/-)high calorie diet model of steatohepatitis.METHODS Hfe^(-/-)C57BL/6J mice were fed either a high calorie diet or a high calorie diet with 1 mg/g curcumin;1.5 mg/g vitamin E;or combination of 1 mg/g curcumin+1.5 mg/g vitamin E for 20 wk.Serum and liver tissue were collected at the completion of the experiment.Liver histology was graded by a pathologist for steatosis,inflammation and fibrosis.RNA and protein was extracted from liver tissue to examine gene and protein expression associated with fatty acid oxidation,mitochondrial biogenesis and oxidative stress pathways.RESULTS Hfe^(-/-)mice fed the high calorie diet developed steatohepatitis and pericentral fibrosis.Combination treatment with curcumin and vitamin E resulted in a greater reduction of percent steatosis than either vitamin E or curcumin therapy alone.Serum alanine aminotransferase and non-alcoholic fatty liver disease(NAFLD)activity score were decreased following combination therapy with curcumin and vitamin E compared with high calorie diet alone.No changes were observed in inflammatory or fibrosis markers following treatment.Epididymal fat pad weights were significantly reduced following combination therapy,however total body weight and liver weight were unchanged.Combination therapy increased the m RNA expression of Adipo R2,Ppar-α,Cpt1 a,Nrf-1 and Tfb2 m suggesting enhanced fatty acid oxidation and mitochondrial biogenesis.In addition,combination treatment resulted in increased catalase activity in Hfe^(-/-)mice.CONCLUSION Combination curcumin and vitamin E treatment decreases liver injury in this steatohepatitis model,indicating that combination therapy may be of value in NAFLD.
文摘Objective: Making the interest of using immunohistochemistry clear in addition to histological test in the diagnosis of lymphomas. Methods: This is a retrospective study from January 2011 to June 2013 involving 18 cases of lymphomas collected in the teaching hospitals of Treichville and Yopougon. Results: 1) 38.88% diagnosis of LMNH B large-cell in histology against 38.88% LDGCB with IHC. 2) 11.11% diagnosis of LMNH small cell in histology against 11.11% with IHC. 3) 5.55% diagnosis of T lymphoma in histology against 27.77% diagnosis of T lymphoma with IHC. 4) 5.55% diagnosis of follicular lymphoma in histology against 11.11% diagnosis of LF with IHC. 5) 11.11% diagnosis of Burkitt lymphoma in histology against 5.55% diagnosis of LB with IHC. 6) 5.55% diagnosis of medullary hypoplasia in histology against 5.55% diagnosis of Hodgkin’s disease. Our results confirm the contribution of immunohistochemistry in the diagnosis of lymphomas in addition to histological test. This is striking, especially as there is 27.77% of T lymphoma with immunohistochemistry against only 5.55% with histology.
文摘Vertebral hemangiomas are common benign lesions of the spine, characterized by abnormal vascular proliferation, being commonly asymptomatic incidental findings, presenting symptoms in only a small portion of affected individuals. In a smaller number of cases, however, hemangiomas can present an expansive effect and extra-osseous extension, determining a mass effect and neurological symptoms, being therefore called aggressive hemangiomas. On MRI, aggressive hemangiomas are characterized by having a larger vascular component and a smaller fat component, thus producing a low signal on T1-weighted images. We illustrate the case of a young male patient who presented with pain in the upper thoracic spine, who developed paraparesis and ascending sensory deficit and progressive lower limbs, progressing to paraplegia and loss of sphincter control.
文摘Microscopic enteritis(ME) is an inflammatory condition of the small bowel that leads to gastrointestinal symptoms,nutrient and micronutrient deficiency.It is characterised by microscopic or sub-microscopic abnormalities such as microvillus changes and enterocytic alterations in the absence of definite macroscopic changes using standard modern endoscopy.This work recognises a need to characterize disorders with microscopic and submicroscopic features,currently regarded as functional or non-specific entities,to obtain further understanding of their clinical relevance.The consensus working party reviewed statements about the aetiology,diagnosis and symptoms associated with ME and proposes an algorithm for its investigation and treatment.Following the 5th International Course in Digestive Pathology in Bucharest in November 2012,an international group of 21 interested pathologists and gastroenterologists formed a working party with a view to formulating a consensus statement on ME.A five-step agreement scale(from strong agreement to strong disagreement) was used to score 21 statements,independently.There was strong agreement on all statements about ME histology(95%-100%).Statements concerning diagnosis achieved 85% to 100% agreement.A statement on the management of ME elicited agreement from the lowest rate(60%) up to 100%.The remaining two categories showed general agreement between experts on clinical presentation(75%-95%) and pathogenesis(80%-90%) of ME.There was strong agreement on the histological definition of ME.Weaker agreement on management indicates a need for further investigations,better definitions and clinical trials to produce quality guidelines for management.This ME consensus is a step toward greater recognition of a significant entity affecting symptomatic patients previously labelled as non-specific or functional enteropathy.
基金Direction Generale de la Sante and P rogramme Hospitaller de Recherche CliniqueFrench Ministry of Health (AOM98010)+2 种基金Association pour la Recherche surle Cancer(9099)The guarantor accepts full responsibility for the conduct of the studyhad access to t
