Solid cystic pseudopapillary tumor (SCPT) of the pancreas is rare and is difficult to diagnose pre-operatively. We describe four children with abdominal pain and abdominal mass who were diagnosed with SCPT. Three underwent resection of the mass, one an open liver biopsy. Histopathology showed solid epithelioid cells, cystic areas, and pseudopapillary structures. SCPT is a low-grade malignant tumor with good prognosis and should be suspected in any child with an abdominal mass and abdominal pain.

Key Words: Solid cystic pseudopapillary tumor, pancreas

MAXILLA

BACKGROUND: Histological assessment is important in evaluating liver disease. We determined the clinical diagnose and predominant histological patterns of children with liver disease and association of histological pattern with outcome.

METHODS: Consecutive patients

RESULT: 470 cases (1month-18years; 65% males; 85% <1year) were included. Most common clinical diagnose were neonatal hepatitis (49%) and biliary atresia (29%). 229 neonatal hepatitis with giant cell pattern had better outcome (96% alive after 1year vs. 136 biliary with obstructive/fibrotic pattern of whom 74% died, p=<0.05). In the other disorders namely alagille's syndrome, bile duct abnormalities, liver tumor and both chronic hepatitis and portal vein thrombosis, the predominant histologies were bile duct paucity ,fibrotic, neoplastic and near normal patterns, respectively. In these cases association with outcome could not be done due to limited patients.

CONCLUSION: Most common clinical diagnoses were neonatal hepatitis and biliary atresia. Predominant histological patterns were giant cell and obstructive type. Histological patterns of giant cell hepatitis seen in neonatal hepatitis resulted in better outcome.

Human ; Hepatitis ; Biliary Atresia ; Hepatitis ; Liver Diseases

INTRODUCTION: HER2 test result depends on a good quality histological section of the breast specimen. Laboratories that process specimens using sophisticated and molecular testing should receive suitable specimen for more accurate results and less waste of expensive resources.
METHODS: A questionnaire based on the ASCO-CAP Guidelines for HER2 testing was developed and administered to pathologists from the local laboratories of Metro Manila-Philippines tertiary referral hospitals. Questionnaire responses were analyzed using descriptive statistics.
RESULTS: Most laboratories did quality control/quality assessment monitoring for the pre-analytic, analytic,post-analytic and turn¬around time phases. Many transported their specimens from the operating room to the laboratory
CONCLUSION: Even in standardized procedures, small variations in sample processing for IHC and FISH can still occur. Inexperienced laboratories will have greater problems interpreting HER2 status results. Laboratories should look into their system in handling specimens for an accurate HER2 testing towards quality assurance.

Human ; Male ; Female ; Breast ; Surveys And Questionnaires ; Pathologists ; Laboratories ; Quality Control

INTRODUCTION: The difficulty of obtaining accurate and reproducible assessment of HER2 status in the Philippines, despite the predictive value of the test for HER2 positive breast cancer patients, may be sufficiently addressed if an effective multidisciplinary approach to HER2 testing is carried out. This may be accomplished by identifying disparities and similarities in HER2 testing for breast cancer.
METHODS: This is a cross-sectional study which included medical oncologists who had used trastuzumab for HER2-positive patients. Surgeons, who belonged to the same tertiary hospital as the medical oncologists were also interviewed. The survey questionnaires were administered via face-to-face, mail, or fax. Responses were kept confidential. Questionnaire responses were analysed using summary statistics.
RESULTS: There were 35 medical oncologists and 37 surgeons - 93% stated that all women diagnosed with breast cancer should be tested for HER2 at the point of diagnosis; 61% stated that the greatest barrier to initiating HER2 testing was inadequate patient funds. 57% medical oncologists and 65% surgeons believed that HER2 testing for all breast cancer patients at the point of clinical diagnosis was being observed at their hospital. 69% stated that medical oncologists or surgeons should request for HER2 test whoever saw the patients first; 59% stated that whoever saw the patient first provide the patient information about HER2 testing whereas 28% stated it is the medical oncologist who should provide information about HER2 testing. 47% medical oncologist and 63% surgeons stated that surgeons should arrange for breast tissue sample collection; 27% medical oncologists and 20% surgeons stated that pathologists should do this.
CONCLUSION: Medical oncologists and surgeons were similar in the opinion that all women diagnosed with breast cancer should be tested for HER2 at the point of diagnosis, financial capability was the greatest barrier for initiating HER2 testing, and whoever saw the patient first should provide patient education. There was disparity on who should request and who should arrange for tissue collection.

Human ; Male ; Female ; Aged ; Middle Aged ; Adult ; Philippines ; Breast Neoplasms ; Oncologists ; Surgeons ; Surveys And Questionnaires

INTRODUCTION: Hydatidiform mole (HM) is an abnormal gestation characterized by significant hydropic enlargement, trophoblastic proliferation and atypia involving part or all of the chorionic villi. The diagnosis and classification of hydatidiform moles is subject to great inter-observer variability due to significant morphologic overlaps. This study aims to evaluate the utility of p57KIP2 immunohistochemistry and ploidy by Her-2 FISH in refining the diagnosis of molar tissues.

METHOD: 113 and 78 molar cases were retrieved from the archives of the Histopathology Section of the Philippine General Hospital and Pathology Department of Seoul National University Hospital, respectively. TMA sections were submitted for immunohistochemical analysis for p57KIP2. Ploidy was determined by fluorescence in situ hybridization using Her-2 probe. An interrater reliability analysis was done using the Kappa statistics with 95% confidence interval.

RESULTS: All 68 (100%) cases diagnosed as CH were negative for p57KIP2 staining and are diploid. Among the 54 cases of PH, only 1 (2%) is positive for p57KIP2 and is diploid. The interrater reliability between p57KIP2 and Her-2 FISH ploidy results is 0.66 (p <.0.001), 95% CI (0.02, 1.00) which is considered "fair to good." The kappa value between review diagnosis and p57KIP2 is 0.024 while the kappa between review diagnosis and Her-2 FISH ploidy is 0.050 both signifying poor agreement beyond chance.

CONCLUSION: Morphologic assessment alone may not be sufficient in problematic cases. p57KIP2 in conjunction with by Her-2 FISH are good adjuncts in the diagnosis and classification of hydatidiform mole.

Human ; Male ; Female ; Pregnancy ; Chorionic Villi ; Immunohistochemistry ; In Situ Hybridization, Fluorescence ; Diploidy ; Reproducibility Of Results ; Hydatidiform Mole ; Trophoblasts ; Ploidies ; Molar

A 28-year old, G5P4 (4014), noted neck lymph nodes associated with cough. A chest X-ray was done showing a left nodular opacity. Antibiotics were prescribed with a resolution of symptoms. Five months after, a routine chest X-ray revealed interval progression in size of the lung nodule. A chest computed tomography (CT) scan and positron-emission tomography scan were done subsequently showing the precise location and size of the nodule and with no other focus of tumor seen. Transvaginal ultrasound was normal. With an initial diagnosis of lung carcinoma, a percutaneous needle aspiration biopsy under CT scan guidance was done. Immunohistochemical staining panel showed that beta-human chorionic gonadotropin (hCG) was positive. Subsequently, a serum beta-hCG done showed low levels from 33.48 to 59.7 mIU/ml. The final diagnosis given was a poorly differentiated malignancy highly suggestive of malignant trophoblastic tumor. A video-assisted left upper lobectomy was performed with histopathology and immunohistochemistry consistent with epithelioid trophoblastic tumor with co-existing choriocarcinoma elements. Postoperative beta-hCG level dropped to normal and remained so for 2½ years.
Choriocarcinoma ; Chorionic Gonadotropin

PURPOSE: Autogenous bones are frequently used because of their lack of antigenicity, but good osteoconductive and osteoinductive properties. This study evaluated the biological behavior of perforated and nonperforated cortical block bone grafts. METHODS: Ten nonsmoking patients who required treatment due to severe resorption of the alveolar process and subsequent implant installation were included in the study. The inclusion criteria was loss of one or more teeth; the presence of atrophy of the alveolar process with the indication of reconstruction procedures to allow rehabilitation with dental implants; and the absence of systemic disease, local infection, or inflammation. The patients were randomly divided into two groups based on whether they received a perforated (inner surface) or nonperforated graft. After a 6-month healing period, a biopsy was performed and osseointegrated implants were installed in the same procedure. RESULTS: Fibrous connective tissue was evident at the interface in patients who received nonperforated grafts. However, full union between the graft and host bed was visible in those who had received a perforated graft. CONCLUSIONS: We found that cortical inner side perforations at donor sites increased the surface area and opened the medullary cavity. Our results indicate an increased rate of graft incorporation in patients who received such perforated grafts.
Alveolar Process* ; Alveolar Ridge Augmentation* ; Atrophy ; Autografts ; Biopsy ; Connective Tissue ; Dental Implants ; Humans ; Inflammation ; Rehabilitation ; Surgery, Oral ; Tissue Donors ; Tooth ; Transplants*

BACKGROUND: Excessive weight and obesity (EwO) are independent factors in the development of heart failure; they lead to a state of myocardiopathy via inflammatory and hormonal mechanisms. If excessively accumulated, epicardial fat favors a proinflammatory state. Ventricular asynchrony is a marker of heart failure progression and has been poorly studied in EwO. The objective was evaluate the relation between epicardial fat, body mass index (BMI) and mechanical synchrony measured by echocardiography, in healthy individuals with EwO. METHODS: We included 55 healthy individuals between the ages of 18 and 35, 17 had a BMI < 25 kg/m2 (30.9%) and 38 had a BMI > 25 kg/m2 (EwO group) (69.09%), anthropometric measurements, transthoracic echocardiogram and synchrony evaluation were obtained. RESULTS: Left atrial volume, telediastolic and telesystolic left ventricular volumes and the baseline volume of the right ventricle were greater in the EwO group (20 mL/m2 vs. 15 mL/m2, p = 0.001; 106 mL vs. 82 mL, p = 0.0149 vs. 32 mL, p = 0.001 and 34 mm vs. 31 mm, p = 0.02, respectively). The Yu index also correlated with epicardial fat, r = 0.53, p < 0.01, whereby the greater the amount of epicardial fat, the greater the dispersion timing of ventricular activation. The systolic synchrony index also correlated with the BMI, p = 0.01. CONCLUSION: Mechanical intraventricular asynchrony is associated to EwO and the amount of epicardial fat; hence, asynchrony may be one more factor leading to heart failure in EwO individuals.
Body Mass Index ; Cardiomyopathies ; Echocardiography ; Heart Failure ; Heart Ventricles ; Obesity* ; Pilot Projects*

Background: Stillbirth has a complex pathophysiology, hence the difficulty in arriving at a specific cause. Objectives The study aimed to identify the probable causes of stillbirth in a tertiary hospital based on gross examination of the placenta and the fetus, as well as, to identify the demographic profile of the stillbirths.
Placenta