Top PDF Biopsy in Musculoskeletal Tumors

Biopsy in Musculoskeletal Tumors

Biopsy in Musculoskeletal Tumors

For open biopsies the incision should be as small as necessary, and longitudinal, transverse incisions are not advisable, to perform an intraosseus biopsy the windows should be circular or oblong and as small as needed to prevent a pathologic fracture. Closing of the opening window by PMMA prevents tumor cell contamination. Compressing the PMMA exceeds chance of metastasis as a rule culture what you biopsy and biopsy what you culture. Use of a tourniquet without exsanguinations helps better visualization and meticulous hemostasis so prevents tumor cells spread in the hematoma. But is should be deflated before closing the wound (3).
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Radiol Bras  vol.45 número5

Radiol Bras vol.45 número5

There are several techniques for obtain- ing soft tissue tumors specimens for histo- logical analysis. Open surgical biopsy al- lows direct access to the tumor and gener- ally the collection of larger amounts of material than in percutaneous biopsies, which tends to favor a correct diagnosis, increasing the capability of differentiating benign from malignant tissues. However, its main disadvantages are the high cost and morbidity, as it is the case in any open sur- gical procedure (6) . For such reasons, percu-

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Effects of THBS3, SPARC and SPP1 expression on biological behavior and survival in patients with osteosarcoma

Effects of THBS3, SPARC and SPP1 expression on biological behavior and survival in patients with osteosarcoma

In this study, we observed that biopsy samples had higher expression of SPP1 than samples from primary tumor resection and metastasis, showing that high levels of SPP1 are not necessary for tumor progression in OS. At the same time, we noticed that the level of expression is an inde- pendent variable from the presence of metastatic disease at diagnosis; these two characteristics indicate that high expression of SPP1 is not necessary for tumor progression or metastatic disease in OS. In contrast, high expression of SPP1 in other tumors, such as breast cancer, lung cancer, prostate cancer, hepatocellular carcinoma, colon cancer has been associated with tumor progression and metas- tases [49-52]. Another contrast is that we observed over expression of SPP1 correlates with better overall survival, event-free survival and relapse free survival. A study of 57
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Lung biopsy with guillotine cutting needle and biopsy forceps though transdiaphragmatic thoracoscopy in dogs with pulmonary alterations

Lung biopsy with guillotine cutting needle and biopsy forceps though transdiaphragmatic thoracoscopy in dogs with pulmonary alterations

Lung diseases are common in small animal clinical routine. Diagnosis is usually affected due to nonspecific symptoms. Imaging features such as radiography and chest ultrasound are acceptable screening tests, although lung biopsy can provides a precise diagnosis. Thus thoracoscopy provides a minimally invasive diagnostic assessment for chest diseases and offers the benefits such as improved illumination and magnification of the image when compared with thoracotomy. In this study we evaluated the transdiaphragmatic thoracoscopic-assisted techniques of lung biopsy with a the guillotine cutting needle and biopsy forceps, in dogs presenting radiographic suspicion on pulmonary tumors. Fourteen dogs regardless of breed, gender, age and body weight admitted at the Hospital of Veterinary Clinics (HCV) of the Veterinary College (FAVET) of Universidade Federal do Rio Grande do Sul (UFRGS), were assessed. Inclusion criteria were presence of nodules on chest radiography and triage tests without changes that could hinder general anesthesia and surgical approach. The animals were positioned in dorsal recumbence and two thoracoscopic ports were established: the first port for working instruments; the second paraxyphoid port for the telescope. Three samples were collected using each sampling method from each lesion or from tumors macroscopically similar whenever their size was less than one centimeter. The samples were sent for histopathological examination in the Veterinary Pathology Laboratory of FAVET/UFRGS. Surgical time was recorded from first incision to wound closure and surgical complications were reported. The dogs were evaluated for the presence of subcutaneous emphysema, hematoma, seroma, local infection and dehiscence. No conversion to open surgery was necessary during the thoracoscopic procedure in any patient. Thoracoscopic assisted biopsy using guillotine needle and biopsy forceps was a safe and fast technique, without perioperative complications. Both devices provided good quality samples for histopathological analysis of lung abnormalities. However the cutting guillotine needle was more efficient especially in larger pulmonary nodules. The transdiaphragmatic access provided optimal approach for both hemithoraces.
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Neuroendocrine tumors (carcinoids) of the stomach and intestines - early diagnosis and minimally invasive endoscopic procedures

Neuroendocrine tumors (carcinoids) of the stomach and intestines - early diagnosis and minimally invasive endoscopic procedures

ABSTRACT. Background. Neuroendocrine tumors of the stomach and intestines are rare diseases. Increasing incidence and complexity of diagnosis of these diseases cause acuteness of the problem. Objective. To evaluate the effectiveness of mor- phological examination of endoscopic biopsy material for diagnostics of neuroendocrine tumors and for evaluation of com- pleteness of minimally invasive endoscopic surgical interventions (endoscopic mucosal resection and endoscopic submucosal dissection) at neuroendocrine tumors. Methods. On the basis of Medical center "Oberig" in 2009 - 2013 in eight cases neu- roendocrine tumors were diagnosed: 2 (25 %) in the stomach, 2 (25%) – in the duodenum, 2 (25%) - in the small intestine, 1 (12.5 %) - in the ascending colon, 1 (12.5%) - in the rectum. Neuroendocrine tumors of stomach and ileum were removed by endoscopic mucosal resection, duodenal bulb and rectum neuroendocrine tumors – by endoscopic submucosal dissection, papillary duodenum, colon and jejunum neuroendocrine tumors – by surgical resection. Results. It was shown, that morpho- logical evaluation of endoscopic mucosal biopsies is effective way to diagnose the neuroendocrine tumors. Conclusion. En- doscopic mucosal resection and endoscopic submucosal dissection allows to get advanced material for morphological diag- nosis of neuroendocrine tumors and an adequate method of their removing.
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Radiol Bras  vol.46 número3

Radiol Bras vol.46 número3

pancreatic tumors were involved by other abdominal organs or structures such as bowel loops, kidneys, liver, spleen and great vessels. The approach through the liver, spleen or kidneys should be avoided be- cause of the risk for bleeding. Fine needle puncture through the gastrointestinal tract seems to be safe, however no study about core biopsy is found in the literature, so the possibility of peritonitis should ever been considered. Thus, the pneumodissection maneuver was selected as the best approach for these specific lesions, avoiding the in- volvement of adjacent organs and reducing the risks inherent to the procedure.
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Plasmocitoma extramedular em bulbo peniano de cão: relato de caso.

Plasmocitoma extramedular em bulbo peniano de cão: relato de caso.

Non-cutaneous extramedullary plasmacytomas are relatively rare in dogs, affecting mainly the oral cavity and bowel loops. The involvement of the penile bulb has not been described, a fact of great importance for obstetric and veterinary oncology. The aim of this case report is to describe the occurrence of plasmacytoma in a dog’s penile bulb, classified as a non-cutaneous extramedullary disease of rare location and unpublished casuistry. A non castrated dog of undefined breed, with seven years of age and weighing 15kg, presented clinical history of anorexia, vomiting, anuria and constipation. By specific examination of the external genitalia, a penile bulb mass was found in the preputial inspection, which was adhered to the encapsulated skin, extremely firm and rounded, measuring approximately 6 cm in diameter. By ultrasound evaluation of the structure in the penile bulb an increase of regional volume with heterogeneous echotexture and mixed echogenicity and tissue neovascularization upon color Doppler was observed. Incisional biopsy of the mass was performed and showed the presence of neoplasia of round cells. The characterization of the tumor was performed by immunohistochemistry and the neoplastic immuno cells were expressed CD79a and MUM1, indicating the diagnosis of extramedullary plasmacytoma. Although the penile tumors in dogs are predominantly transmissible venereal tumors (TVT) and plasmocytomas are rare neoplasms in this location, this case report provides a novel occurrence of extramedullary plasmacytoma in the penile bulb of a dog, a condition not yet described in veterinary.
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Int. braz j urol.  vol.37 número4

Int. braz j urol. vol.37 número4

The indings are very similar to a study from my Institution published in Int Braz J Urol (1). We found that tumor extent on needle biopsies inluences the predictive value of PNI for pathologic stage > pT2 (pT3a and/or pT3b) on radical prostatectomies. In patients with more extensive tumors on needle biopsy, PNI pre- dicted pathologic stage > pT2 on radical prostatectomy on univariate analysis but on multivariate analysis did not show independent predictive value. This inding is in accordance to most of the studies in the literature. In patients with less extensive tumors on biopsy (< 13.6% of tissue in mm containing carcinoma) and PNI, there was no association to any one clinical or pathological variables studied; no difference in the time to biochemical (PSA) progression-free outcome comparing to patients without PNI; and, no predictive value for pathological stage > pT2 on both univariate and multivariate analysis. With a higher number of small tumors currently detected, our results favor that PNI on needle biopsy should not be considered in the decision to sacriice or not the neurovascular bundle in planning nerve-sparing radical prostatectomy.
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Arq. NeuroPsiquiatr.  vol.71 número1

Arq. NeuroPsiquiatr. vol.71 número1

A retrospective study of 81 patients with low-grade astrocytoma (LGA) comparing the efficacy of aggressive versus less aggressive surgery in eloquent and non-eloquent brain areas was conducted. Extent of surgical resection was analyzed to assess overall survival (OS) and pro- gression-free survival (PFS). Degree of tumor resection was classified as gross total resection (GTR), subtotal resection (STR) or biopsy. GTR, STR and biopsy in patients with tumors in non-eloquent areas were performed in 31, 48 and 21% subjects, whereas in patients with tumors in eloquent areas resections were 22.5, 35 and 42.5%. Overall survival was 4.7 and 1.9 years in patients with tumors in non-eloquent brain areas submitted to GTR/STR and biopsy (p=0.013), whereas overall survival among patients with tumors in eloquent area was 4.5 and 2.1 years (p=0.33). Improved outcome for adult patients with LGA is predicted by more aggressive surgery in both eloquent and non-eloquent brain areas. Key words: astrocytoma, survival analysis, neurosurgery.
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ASPIRATION BIOPSY PECULIARITIES IN CASE OF INACCESIBLE TUMORS OF ABDOMINAL CAVITY ORGANS

ASPIRATION BIOPSY PECULIARITIES IN CASE OF INACCESIBLE TUMORS OF ABDOMINAL CAVITY ORGANS

[2,4,5] На наш вз ляд , выполнение тон ои ольных п н ций оча овых образований ор анов брюшной полости под льтрасоно рафичес им или рент еноло ичес им онтролем является дост пной и относи[r]

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Musculoskeletal ultrasound and ESPER

Musculoskeletal ultrasound and ESPER

In 1994, at the rheumatology department of Hospi- tal de Santa Maria, the first MSUS assessments were just starting. However, those examinations were still very conditioned by the available technology. Meanwhile, the accumulated experience allowed the elaboration of five courses on MSUS, between 2004 and 2008, orga- nized by portuguese rheumatologists (Fernando Sarai- va, Manuela Costa, Margarida Silva and Margarida Cruz), for further dissemination of the method among senior rheumatologists and residents, under the pa- tronage of the Portuguese Society of Rheumatology (PSR).

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The electroencephalogram in metastatic brain tumors

The electroencephalogram in metastatic brain tumors

Sixty cases of intracranial metastatic tumors diagnosed either clinically or by neurosurgery (28 operative cases, 26 with radiological contrast exami- nations and 6 with clinical diagno[r]

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Musculoskeletal manifestations of bacterial endocarditis

Musculoskeletal manifestations of bacterial endocarditis

CASE REPO RT: A 4 5 -year-o ld-man, witho ut addictio ns and witho ut kno wn previo us cardio pathy, was diagno sed as having definitive acute bacterial endo carditis due to Staphylo co ccus aureus. Its etio l- o gy was co mmunity-acquired, arising fro m a no n-apparent primary fo cus. In additio n, the musculo skeletal sympto ms preceded the infec- tive endo carditis (IE) by abo ut 1 mo nth, which o ccurred to gether with o ther sympto ms, e.g. myco tic aneurysms and petechiae. Later, the patient sho wed perfo ratio n o f the mitral valve and mo derate mitral insufficiency with clinical co ntro l.
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Musculoskeletal injuries in young footballers and associated risk factors

Musculoskeletal injuries in young footballers and associated risk factors

An IR peak was seen in the preseason training (July) and in the first month of competitive season (August), declining after those periods. 19, 20 Preseason injuries accounted for 17% of total with an average IR of 0.2 per player per preseason. Preseason’s most common injury locations were the thigh (23%), knee (17%), and ankle. Muscle strains (19%), fractures (15%), ligament sprains (13%) and meniscal tears were the most common major injuries. Moderate injuries were mostly strains (42%), sprains (25%) and tendinopathies (8%). Sprains affected mostly the ankle (59%, of which 74% and 21% affected the lateral and medial ligament complexes, respectively) and knee (30%) joints. Lower leg injuries, such as muscle strains / rupture (37%) and tendon related injuries (e.g.: Achilles related injuries, 32%) were more prevalent in preseason, probably due to training characteristics (increased intensity and duration). Preseason muscle strains occurred in the rectus femoris muscle (29%; because of its participation in running and shooting activities), adductor longus (12%) and biceps femoris (21%). Non-contact mechanisms of injury (e.g.: running, 25%) accounted for 68% of cases. Injuries resulting from contact (e.g.: contusion, tissue bruising) were less prevalent. More slight (13%) and minor (27%) injuries and less severe injuries (61%) were recorded in the preseason when compared with the competitive season (9%, 22% and 69%, respectively). Overuse injuries were more prevalent (3%) in preseason. It is suggested that starting to train, suddenly, on a new surface allowing no adaptation from the athlete may explain those findings. 20
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Diagnosis of malignancies in children with musculoskeletal complaints

Diagnosis of malignancies in children with musculoskeletal complaints

Laboratory฀ tests฀ may฀ be฀ normal฀ at฀ the฀ onset฀of฀the฀clinical฀manifestations฀of฀neo- plasia.฀ In฀ the฀ present฀ study,฀ blood฀ counts฀ indicated฀that฀anemia฀was฀the฀most฀common฀ hematological฀ change฀ among฀ the฀ patients,฀ although฀this฀was฀not฀serious฀in฀most฀cases;฀ white฀ blood฀ cell฀ and฀ platelet฀ changes฀ were฀ less฀ frequent.฀ Progressive฀ anemia฀ usually฀ represents฀ an฀ early฀ warning฀ sign,฀ and฀ was฀ found฀in฀the฀Trapani฀series. 2

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Radiol Bras  vol.47 número6

Radiol Bras vol.47 número6

Case 1 – A male, 56-year-old patient with history of papilliferous thyroid carcinoma whose follow-up facial CT detected the presence of a right intraorbital expansile pro- cess (Figure 1A). At physical examination, the patient pre- sented with no visual complaint and with normal external ocular movements. Orbital magnetic resonance imaging (MRI) was requested and demonstrated the presence of a retrobulbar solid cystic, extraconal lesion in the posterior and superolateral region of the right orbit, leading to inferomedial displacement of the superior rectus muscle and of the optic nerve (Figures 1B and 1C). The lesion was ovoid, with regular contours, presenting with delayed contrast-en- hancement of the solid portions. The lesion measured about de 28 × 16 × 12 mm. Thinning of the adjacent orbital roof bone was observed.
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Inappropriate cervical injection of radiotracer for sentinel node mapping in a uterine cervix cancer patient: importance of lymphoscintigraphy and blue dye injection

Inappropriate cervical injection of radiotracer for sentinel node mapping in a uterine cervix cancer patient: importance of lymphoscintigraphy and blue dye injection

(erein, we report a case of sentinel lymph node mapping in a uterine cervix cancer patient, referring to the nuclear medicine department of our institute. Lymphoscintigraphy images showed inappropriate intra‐cervical injection of radiotracer. Blue dye technique was applied for sentinel lymph node mapping, using intra‐cervical injection of methylene blue. Two blue/cold sentinel lymph nodes, with no pathological involvement, were intra‐operatively identified, and the patient was spared pelvic lymph node dissection. The present case underscores the importance of lymphoscintigraphy imaging in sentinel lymph node mapping and demonstrates the added value of blue dye injection in selected patients. )t is suggested that pre‐ operative lymphoscintigraphy imaging be considered as an integral part of sentinel lymph node mapping in surgical oncology. Detailed results of lymphoscintigraphy images should be provided for surgeons prior to surgery, and in case the sentinel lymph nodes are not visualized, use of blue dye for sentinel node mapping should be encouraged.
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Clinical analysis of 152 cases of multiple primary malignant tumors in 15,398 patients with malignant tumors.

Clinical analysis of 152 cases of multiple primary malignant tumors in 15,398 patients with malignant tumors.

The etiology of MPMTs remains unclear. Curtis RE al. [10] studied leukemia following che- motherapy for breast cancer among patients diagnosed during 1973–1985 within the popula- tion-based tumor registries in the Surveillance, Epidemiology, and End Results, Program. They found that among 20 cases (17 incident leukemia and 3 deaths due to preleukemia) and 60 matched controls, alkylating agents were linked to an 11.9-fold risk of ANLL (acute nonlym- phocytic leukemia) and preleukemia (95% confidence interval = 2.6–55). Chemotherapy regi- ments including melphalan were related to a higher risk of leukemic conditions than those including cyclophosphamide. Haas J.F et al [11] conducted a case-control study to determine whether the development of leukemia was associated with chemotherapy for neoplasms of the ovary or breast, in a population where most such chemotherapy consisted of cyclophospha- mide alone. The study indicated that the relative risk for acute leukemia following treatment with cyclophosphamide alone was significantly elevated (P<0.05), at 14.6 for ovarian tumor patients and 2.7 for breast cancer patients. Harvey and Brinton [12] examined the data for 41,109 women diagnosed with breast cancer between 1935 and 1982 and found that women treated with radiation were at a higher risk of developing a second breast cancer than were non- irradiated women (SIR, 3.9versus2.8). Murakamiet al. [13] observed an excess risk of contralat- eral breast cancer in the radiotherapy group only among those diagnosed at 10 or more years after the first breast cancer diagnosis (SIR, 7.6) compared with the nonradiotherapy group (SIR, 2.9), whereas the overall SIR was 3.8 for the radiotherapy group and 4.8 for the nonra- diotherapy group. Alfred I al. [14] investigated whether there was a similar relationship be- tween breast cancer, colorectal cancer, and prostate cancer in men. In this study, that breast and colorectal cancer appear to co-occur in women but not in men suggests that certain risk
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Proteomics-driven analysis of ovine whey colostrum.

Proteomics-driven analysis of ovine whey colostrum.

Going into details on the characterization of the identified proteins in ovine whey colos- trum, we found that several of them belong to the casein family (mainly alpha casein), most likely representing unassembled casein micelles. It is demonstrated that caseins are responsible for important biological functions such as ion carriers (calcium, phosphate, iron, zinc, copper), bioactive peptide precursors and immunomodulators [34]. It was also demonstrated that the casein proteolytic fragments have an antimicrobial activity, suggesting that proteases may also play a role in the host defence [35]. In addition, peptides derived from caseins are receiving much attention as possible sources of natural bioactivity with health benefits for humans, prob- ably because they stimulate the innate immune system within the mammary gland and prevent udder infections during the dry phase [36]. As expected, proteins involved in metabolic and immune system processes account for 51.6% and 21.1% of the total proteins, respectively [36]. In our study we also found many proteins involved in lipid metabolism (fatty acid synthase, apolipoproteins A-I, butyrophilin, xanthine dehydrogenase, and endothelial lipase) suggesting that colostrum contains the enzymes necessary to balance the equilibrium between lipid syn- thesis and breakdown. While lipases contribute to effective digestion and retention of colos- trum fat, the apolipoproteins acts as carriers of fatty acids in the circulation. Fatty acid synthase is an indispensible component of lipogenesis and energy production [37]. Xanthine dehydrogenase and butyrophilin, appears to be essential for milk fat globule production [38, 39]. Xanthine dehydrogenase and butyrophilin with other four milk fat globule membrane pro- teins (Milk Fat Globule-EGF factor 8 or lactadherin, ATP-binding cassette sub-family G mem- ber 2, protein disulfide isomerase family A member 3, and ras-related protein RAB11A) probably represent a small fraction dissociated from the membranes.
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