1.New developments for endoscopic management of Barrett's esophagus with high grade dysplasia.
Journal of Zhejiang University. Medical sciences 2010;39(5):534-541
Barrett's esophagus is now clearly recognized as a preneoplasic condition. Progression of metaplasia through dysplasia to adenocarcinoma is a widely accepted theory for esophageal carcinogenesis. That high grade dysplasia is frequently found in association with esophageal adenocarcinoma. Long-term endoscopic surveillance of high grade dysplasia in Barrett's esophagus facilitates detection and treatment of esophageal cancers in the early stage.
Barrett Esophagus
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diagnosis
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pathology
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therapy
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Esophageal Neoplasms
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diagnosis
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Esophagoscopy
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Humans
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Hyperplasia
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pathology
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Precancerous Conditions
;
diagnosis
4.Prostatic intraepithelial neoplasia: a potential precursor lesion of prostatic adenocarcinoma.
Yonsei Medical Journal 1995;36(3):215-231
The necessity of early detection of prostate cancer renewed interest regarding putative premalignant lesions in the tumorigenesis of the prostate. Prostatic intraepithelial neoplasia (PIN) is one potential precursor for prostatic adenocarcinoma. The term PIN has been adopted to replace a wide range of synonyms in the literature that describe potential precursors. PIN is an intraluminal proliferation of the secretory cells lining architecturally benign prostatic ducts and acini that exhibit cytologic atypia. In this review, we discuss the histologic features, the differential diagnosis, the evidence that PIN is a precursor of prostatic carcinoma, and the clinical significance of PIN.
Adenocarcinoma/*pathology
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DNA, Neoplasm/analysis
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Diagnosis, Differential
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Human
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Male
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Precancerous Conditions/*pathology
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Prostatic Neoplasms/*pathology
5.Narrow-band imaging in the diagnosis of early esophageal cancer and precancerous lesions.
Liu-Ye HUANG ; Jun CUI ; Cheng-Rong WU ; Yun-Xiang LIU ; Ning XU
Chinese Medical Journal 2009;122(7):776-780
BACKGROUNDIn the recent years, the incidence of esophageal cancer in China has increased. The key point for raising the survival rate is the diagnosis and treatment at an early stage. Narrow-band imaging (NBI) can enhance the contrast of the mucous membrane of the esophagus without staining. This study aimed to explore the value of NBI in the diagnosis of early esophageal cancer and precancerous lesions.
METHODSThe esophagus was examined with ordinary endoscopy and NBI endoscopy. Pit patterns and blood capillary forms were examined with routine magnifying endoscopy and NBI endoscopy. Finally, a 1.2% Lugoul's iodine solution was used to stain the esophageal mucosal surface and a biopsy was taken at all the sites where NBI or iodine staining was positive. NBI and iodine staining scales were compared with pathologic diagnosis, which was considered as the gold standard.
RESULTSA total of 90 cases (138 lesions in total) were diagnosed as early esophageal cancer or precancerous lesions; 104 lesions (75.4%) were detected with ordinary endoscopy, 120 lesions (87.0%) were detected with NBI endoscopy, and 138 lesions (100%) were detected with iodine staining. The lesion detection rate of NBI was significantly lower than that of iodine staining (chi(2) = 17.176, P < 0.01). However, there was no significant difference between NBI and iodine staining for the diagnosis of high grade intraepithelial neoplasia (chi(2) = 1.362, P > 0.05), while the detection rate of NBI was significantly lower than that of iodine staining for the diagnosis of low grade intraepithelial neoplasia (chi(2) = 13.388, P < 0.01). The pit pattern and blood capillary form of early esophageal cancer and precancerous lesions could be demonstrated clearer with NBI than with ordinary endoscopy.
CONCLUSIONSNBI can enhance the contrast of the mucous membrane of the esophagus without staining. The combination of NBI and iodine staining can raise the diagnostic rate of early esophageal cancer and precancerous lesions.
Adult ; Aged ; Esophageal Neoplasms ; diagnosis ; pathology ; Esophagoscopy ; methods ; Esophagus ; pathology ; Female ; Humans ; Male ; Middle Aged ; Precancerous Conditions ; diagnosis ; pathology
7.Proliferative lesions with mesonephric features in the gynecologic tract: a clinicopathological analysis of sixteen cases.
Na MO ; Chun Yan HE ; Hai Yun YU ; Xiao Tao BIAN ; Yu Lan JIN
Chinese Journal of Pathology 2022;51(10):1000-1006
Objective: To investigate the clinicopathological features of proliferations with mesonephric features (PMF) of the gynecologic tract. Methods: A retrospective analysis was performed on the clinical and pathological data of 16 cases with PMF that were diagnosed from October 2016 to January 2022 at a single institution. The relevant literature was reviewed. Results: Among the 16 cases, with an average of 53 years (31-68 years), there were 5 cases of mesonephric hyperplasia, 4 cases of mesonephric adenocarcinoma and 7 cases of mesonephric-like adenocarcinoma. The five cases of mesonephric hyperplasia were located in the lateral wall of the cervix and composed of simple tubules with growth patterns of diffuse or lobular clusters, without obvious stromal reaction. Four cases of mesonephric adenocarcinoma consisted of a mixture of papillary, cribriform, solid and other architectures, the nuclei resembling these of papillary thyroid carcinoma, and strong fibroproliferative reaction. They were located deep in the cervical and vaginal stroma. One of the tumors showed atypical mesonephric hyperplasia adjacent to the tumor. Five uterine and two ovarian mesonephric-like adenocarcinoma cases had similar histological morphology with mesonephric adenocarcinoma, but no mesonephric remnants/mesonephric hyperplasia were found near the tumors. In addition, four (4/5) uterine mesonephric-like adenocarcinoma cases originated from the endometrium with secondary involvement of myometrium, including one case with clear demarcation between the normal endometrium and the neoplastic glands. One (1/5) uterine mesonephric-like adenocarcinoma case was mainly located in the deep myometrium, along with adenomyosis around the tumor, without mesonephric remnants. Two ovarian mesonephric-like adenocarcinoma cases were associated with endometriotic cyst/endometrioid cystadenoma, including one case with an abrupt transition between normal epithelium and atypical mesonephric cells within the single individual cyst directly adjacent to tumor. All mesonephric hyperplasia and mesonephric adenocarcinoma cases were positive for GATA3, PAX8 and CD10 in a varying degree, and negative for ER, PR and TTF1. Although mesonephric-like adenocarcinoma showed a considerable overlap of immunohistochemical expression with mesonephric adenocarcinoma, seven mesonephric-like adenocarcinoma cases were positive for TTF1 and negative for GATA3. Conclusions: PMF is a class of rare proliferative lesions with morphological and immunophenotypic characteristics of mesonephric duct. Its commonly involved site, microscopic morphology, associated benign and/or atypical lesions, and immunophenotype may contribute to its diagnosis and differential diagnosis.
Adenocarcinoma/pathology*
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Biomarkers, Tumor/analysis*
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Cervix Uteri/pathology*
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Diagnosis, Differential
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Female
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Humans
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Hyperplasia/pathology*
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Precancerous Conditions/pathology*
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Retrospective Studies
8.A comparative study of endoscopic image stained by iodine and histopathology in early esophageal cancer and precancerous lesions (dysplasia).
Guo-qing WANG ; Yun-yuan LIU ; Chang-qing HAO ; Shao-qing LAI ; Gui-qi WANG ; Ning LU ; Ling YANG
Chinese Journal of Oncology 2004;26(6):342-344
OBJECTIVEThe aim of this study is to evaluate the relationship between the imaging patterns of endoscopy aided by iodine stain and histological diagnosis.
METHODSA balloon cytological screening was conducted in 4000 participants in high-risk area of esophageal cancer in 1997-1998, 1050 out of these 4000 participants were confirmed as abnormal by cytology. Among them, 867 were given endoscopy examination during which mucosal stain with 1.2% iodine solution was used. The stain images were graded as four categories: Grade 1, dark yellow, protruding inlay-like with clear borders and showing pink after discoloration; Grade 2, between grade 1 and grade 3; Grade 3, light yellow, flat lesion with clear but not sharp borders and Grade 4, dark-brown color. According to the above criteria, the lesions were recorded and graded after the examination. The biopsies were taken from the unstained lesions and underwent pathologic evaluation. A comparison between the imaging patterns of endoscopy aided by iodine stain and histological diagnosis was evaluated. The correlation coefficient was estimated using Spearman's Rank Correlation.
RESULTS94.4% (68/72) of the superficial carcinoma and severe dysplasia, 61.8% (73/118) of moderate dysplasia and 27.7% (35/126) of mild dysplasia were distributed in the grade 1 and grade 2 of iodine stain images of which the patterns conforming to the principle and rule of formation of the image by iodine stain.
CONCLUSIONThere is close relationship between the imaging patterns of endoscopy aided by iodine stain and histological diagnosis. The magnitude of exposure of the malignant tissue is the pathologic basis of formation of various images by iodine stain. Iodine stain greatly helps of early detection of esophageal cancer.
Biopsy ; Early Diagnosis ; Esophageal Neoplasms ; pathology ; Esophagoscopy ; methods ; Female ; Humans ; Iodine ; Male ; Precancerous Conditions ; pathology ; Staining and Labeling ; methods
9.The breast stem cell (CK5/6(+)) concept and its relation to the diagnosis of benign and malignant ductal epithelial hyperplasia.
Chinese Journal of Pathology 2013;42(2):73-77
Breast
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pathology
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Carcinoma, Intraductal, Noninfiltrating
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diagnosis
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metabolism
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pathology
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Female
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Humans
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Hyperplasia
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metabolism
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pathology
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Keratin-5
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metabolism
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Keratin-6
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metabolism
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Precancerous Conditions
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diagnosis
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metabolism
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pathology
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Stem Cells
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metabolism
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pathology
10.Pathologic diagnosis of biliary intraepithelial neoplasia of liver.
Chinese Journal of Pathology 2007;36(11):781-784