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  1. Article ; Online: The Clinical and Pathologic Features of Intracholecystic Papillary-Tubular Neoplasms of the Gallbladder.

    Abdelal, Heba / Chatterjee, Deyali

    Surgical pathology clinics

    2022  Volume 15, Issue 3, Page(s) 565–577

    Abstract: Intracholecystic papillary-tubular neoplasm denotes a discrete mucosal-based neoplastic proliferation into the gallbladder lumen. It is diagnosed incidentally during cholecystectomy or radiologically during a workup for abdominal pain. The majority of ... ...

    Abstract Intracholecystic papillary-tubular neoplasm denotes a discrete mucosal-based neoplastic proliferation into the gallbladder lumen. It is diagnosed incidentally during cholecystectomy or radiologically during a workup for abdominal pain. The majority of polypoid lesions in the gallbladder are non-neoplastic; therefore, pathologic examination is the gold standard to establish this diagnosis. Intracholecystic papillary-tubular neoplasm is considered as premalignant, although associated invasive carcinomas may be present in the specimen. Invasive carcinoma arising from intracholecystic papillary-tubular neoplasm have a better prognosis than de novo gallbladder carcinomas. The pathology of intracholecystic papillary-tubular neoplasm, including the challenges involved in the diagnosis of this entity, is discussed.
    MeSH term(s) Adenocarcinoma/pathology ; Carcinoma ; Gallbladder Neoplasms/diagnosis ; Gallbladder Neoplasms/pathology ; Humans ; Precancerous Conditions/diagnosis
    Language English
    Publishing date 2022-08-02
    Publishing country United States
    Document type Journal Article ; Review
    ISSN 1875-9157
    ISSN (online) 1875-9157
    DOI 10.1016/j.path.2022.05.011
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  2. Article ; Online: Tuberous sclerosis complex mutations in patients with pancreatic neuroendocrine tumors. Observations on phenotypic and treatment-related associations.

    Navale, Pooja / Chatterjee, Deyali / Itani, Malak / Trikalinos, Nikolaos A

    Virchows Archiv : an international journal of pathology

    2023  Volume 483, Issue 2, Page(s) 167–175

    Abstract: Pancreatic neuroendocrine tumors (PanNETs) in familial tuberous sclerosis (TSC1 and TSC2 mutations) have been known and studied. However, little is known about PanNET patients harboring the very rare (less than 2%) sporadic TSC mutations. Some renal ... ...

    Abstract Pancreatic neuroendocrine tumors (PanNETs) in familial tuberous sclerosis (TSC1 and TSC2 mutations) have been known and studied. However, little is known about PanNET patients harboring the very rare (less than 2%) sporadic TSC mutations. Some renal tumors have been shown to harbor sporadic TSC mutations, with a distinctive morphological correlate. We hereby describe this rather unusual molecular alteration in well-differentiated pancreatic neuroendocrine tumors (WD PanNETs) with a focus on their morphology and treatment outcomes. Six cases of WD PanNETs harboring sporadic TSC mutations were identified retrospectively. H&E slides and corresponding immunostains were reviewed for all cases. Clinical, molecular, and radiological information was obtained using the electronic medical records. Cohort consisted of 4 males and 2 females. Median age at diagnosis was 50 years (range 33-74 years). Origin of neoplasm was the pancreas and, in all but one, patient had liver metastasis by the time of presentation. Six out of six cases demonstrated a unique tumor morphology, with ample eosinophilic cytoplasm. Tumors were arranged in sheets and nests; prominent cystic change was noted in one case. Two cases were additionally biopsied post-treatment with capecitabine and temozolomide, and showed even more abundant oncocytic cytoplasm, eccentric nuclei, and a prominent cherry red nucleolus, and were arranged in a cluster of 3-4 cells, separated by stromal cells. Every patient had a different TSC2 variant with no cases of TSC1 mutations. Other common variants included MEN1 (4/6), DAXX (2/6), and TP53 (2/6). Per the WH0 2019 classification, tumors were graded as NET-G3 (n = 3) and NET-G2 (n = 3). Ki-67 s ranged from 7.2 to 60. All cases had retained MMR protein expression. The majority of patients (4/6) have expired. Although they received multiple treatments, a consistent pattern observed in patients was marked radiologic response to chemotherapy with capecitabine and temozolomide (offered in 5/6 patients) with duration of responses reaching 11 months in the majority of cases, with one patient showing near complete pathologic response of localized disease. TSC2 mutations may confer distinctive appearance in WD PanNETs, reminiscent of their effects in renal tumors. Although not entirely specific, this distinct morphological pattern with abundant eosinophilic cytoplasm in WD PanNETs could be reflective of an associated TSC mutation, with suggestions of significant therapeutic response to a specific cytotoxic chemotherapy.
    MeSH term(s) Male ; Female ; Humans ; Adult ; Middle Aged ; Aged ; Neuroendocrine Tumors/genetics ; Neuroendocrine Tumors/pathology ; Tuberous Sclerosis/genetics ; Tuberous Sclerosis/pathology ; Capecitabine ; Retrospective Studies ; Temozolomide ; Mutation/genetics ; Kidney Neoplasms/pathology ; Pancreatic Neoplasms/genetics ; Pancreatic Neoplasms/therapy ; Pancreatic Neoplasms/pathology
    Chemical Substances Capecitabine (6804DJ8Z9U) ; Temozolomide (YF1K15M17Y)
    Language English
    Publishing date 2023-06-24
    Publishing country Germany
    Document type Journal Article
    ZDB-ID 1184867-4
    ISSN 1432-2307 ; 0945-6317
    ISSN (online) 1432-2307
    ISSN 0945-6317
    DOI 10.1007/s00428-023-03570-1
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  3. Article ; Online: ASO Author Reflections: Accuracy of Grading in Pancreatic Neuroendocrine Neoplasms and Effect on Survival Estimates: An Institutional Experience.

    Trikalinos, Nikolaos A / Chatterjee, Deyali

    Annals of surgical oncology

    2020  Volume 27, Issue 9, Page(s) 3551–3552

    MeSH term(s) Humans ; Neoplasm Grading ; Neuroendocrine Tumors ; Pancreatic Neoplasms
    Language English
    Publishing date 2020-04-06
    Publishing country United States
    Document type Journal Article
    ZDB-ID 1200469-8
    ISSN 1534-4681 ; 1068-9265
    ISSN (online) 1534-4681
    ISSN 1068-9265
    DOI 10.1245/s10434-020-08424-7
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  4. Article: Histopathological Features of Drug-Induced Liver Injury Secondary to Osimertinib.

    González, Iván / Chatterjee, Deyali

    ACG case reports journal

    2019  Volume 6, Issue 2, Page(s) e00011

    Abstract: In the past few years, a better understanding of the genomic alterations in lung cancer has facilitated a targeted therapy. Lung adenocarcinomas with epidermal growth factor receptor mutations have a good response to tyrosine kinase inhibitors (TKIs). ... ...

    Abstract In the past few years, a better understanding of the genomic alterations in lung cancer has facilitated a targeted therapy. Lung adenocarcinomas with epidermal growth factor receptor mutations have a good response to tyrosine kinase inhibitors (TKIs). Osimertinib is a third-generation TKI approved by the Food and Drug Administration (FDA). Drug-induced liver injury is a well-known adverse effect of TKIs as a group and reported to show an autoimmune hepatitis-like picture. However, little is known about the histopathologic changes with osimertinib. We present a case of drug-induced liver injury secondary to osimertinib and discuss the histopathologic findings.
    Language English
    Publishing date 2019-02-25
    Publishing country United States
    Document type Case Reports
    ZDB-ID 2814825-3
    ISSN 2326-3253
    ISSN 2326-3253
    DOI 10.14309/crj.0000000000000011
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  5. Article ; Online: Single institutional experience on primary neuroendocrine neoplasms of the kidney: a rare distinct entity.

    Amin, Manik / Trikalinos, Nikolaos / Chatterjee, Deyali

    Human pathology

    2021  Volume 114, Page(s) 36–43

    Abstract: Primary pure renal neuroendocrine neoplasms (R-NENs) are a distinct and rare entity. Not much is known about the histopathology and biologic behavior of these tumors. We attempted to review the clinicopathologic aspects of these neoplasms encountered at ... ...

    Abstract Primary pure renal neuroendocrine neoplasms (R-NENs) are a distinct and rare entity. Not much is known about the histopathology and biologic behavior of these tumors. We attempted to review the clinicopathologic aspects of these neoplasms encountered at our institution. We performed a retrospective chart review to identify primary pure (not admixed with any other tumor component) R-NENs from institutional Cancer Registry database. Pathologic review of the diagnostic archival slides was done for detailed assessment of the histologic features. R-NENs were classified according to the current WHO system for gastroenteropancreatic neuroendocrine neoplasms (GEP-NENs). Eight pure R-NEN cases were identified, all unifocal, and most (6/8) involved the right kidney. Three patients had poorly differentiated neuroendocrine carcinoma (NEC), and five had well-differentiated neuroendocrine tumor (NET). All tumors were located near the renal hilum, stained diffusely with synaptophysin, variably with chromogranin, and were negative for renal site-specific marker PAX8 or for markers of renal cell carcinoma. We identified two distinct patterns of growth: one of sheets with interspersed rosettes and the other of large nests with low proliferative crowded centers and peripheral cells with higher proliferation and prominent palisading. Based on Ki-67 proliferative index, the tumors were classifiable into WHO grade 1 or grade 2 (based on GEP-NEN). All three NECs characteristically showed cytologic features intermediate between classic large and small cell type. This is the first comprehensive clinicopathologic study involving the rare group of R-NEN. Classifying and grading them according to the GEP-NEN system is of prognostic significance.
    MeSH term(s) Adult ; Aged, 80 and over ; Biomarkers, Tumor/analysis ; Biomarkers, Tumor/genetics ; Cell Proliferation ; Chromogranins/analysis ; Databases, Factual ; Female ; Humans ; Immunohistochemistry ; Ki-67 Antigen/analysis ; Kidney Neoplasms/chemistry ; Kidney Neoplasms/genetics ; Kidney Neoplasms/pathology ; Kidney Neoplasms/therapy ; Male ; Middle Aged ; Mitotic Index ; Neoplasm Grading ; Neuroendocrine Tumors/chemistry ; Neuroendocrine Tumors/genetics ; Neuroendocrine Tumors/pathology ; Neuroendocrine Tumors/therapy ; PAX8 Transcription Factor/analysis ; Retrospective Studies ; Synaptophysin/analysis
    Chemical Substances Biomarkers, Tumor ; Chromogranins ; Ki-67 Antigen ; MKI67 protein, human ; PAX8 Transcription Factor ; PAX8 protein, human ; SYP protein, human ; Synaptophysin
    Language English
    Publishing date 2021-04-21
    Publishing country United States
    Document type Journal Article
    ZDB-ID 207657-3
    ISSN 1532-8392 ; 0046-8177
    ISSN (online) 1532-8392
    ISSN 0046-8177
    DOI 10.1016/j.humpath.2021.04.006
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  6. Article ; Online: The modern face of esophageal candidiasis in an oncology center: Correlating clinical manifestations, endoscopic grade, and pathological data in 323 contemporary cancer patients.

    Matsuo, Takahiro / Singh, Ben Allen / Wurster, Sebastian / Jiang, Ying / Bhutani, Manoop S / Chatterjee, Deyali / Kontoyiannis, Dimitrios P

    The Journal of infection

    2024  , Page(s) 106172

    Abstract: Objectives: Clinical presentation and outcomes of esophageal candidiasis (EC) in cancer patients are scarcely studied in the azole era, as is the correlation between clinical, endoscopic, and histopathological EC manifestations.: Methods: We ... ...

    Abstract Objectives: Clinical presentation and outcomes of esophageal candidiasis (EC) in cancer patients are scarcely studied in the azole era, as is the correlation between clinical, endoscopic, and histopathological EC manifestations.
    Methods: We retrospectively reviewed the risk factors, clinical features, and outcomes of pathology-documented EC cases at MD Anderson Cancer Center. We further assessed associations between presence of symptoms, standardized 4-stage endoscopic grade (Kodsi classification), histopathological data, and fluconazole treatment failure.
    Results: Among 323 cancer patients with EC, 89% had solid tumors, most commonly esophageal cancer (29%). Thirty-three percent of EC patients were asymptomatic. The proportion of symptomatic EC patients significantly increased with endoscopic grade (P=0.005). Among 202 patients receiving oral fluconazole, 27 (13%) had treatment failure. Underlying esophageal disease was the only independent predictor of fluconazole treatment failure (odds ratio: 3.88, P=0.005). Endoscopic grade correlated significantly with Candida organism burden (Correlation coefficient [ρ]=0.21, P<0.01) and neutrophilic inflammation (ρ=0.18, P<0.01). Candida invasion of the squamous mucosal layer was associated with treatment failure (P=0.049).
    Conclusions: EC was predominantly encountered in patients with solid tumors. One third of EC patients were asymptomatic, challenging traditional symptom-based diagnosis. Development of integrated clinicopathological scoring systems could further guide therapeutic management of cancer patients with EC.
    Language English
    Publishing date 2024-05-10
    Publishing country England
    Document type Journal Article
    ZDB-ID 424417-5
    ISSN 1532-2742 ; 0163-4453
    ISSN (online) 1532-2742
    ISSN 0163-4453
    DOI 10.1016/j.jinf.2024.106172
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  7. Article ; Online: Rare aggressive solid pseudopapillary neoplasm of the ovary with metastatic disease following surgical resection.

    Kushner, Bradley S / Chatterjee, Deyali / Hammill, Chet

    BMJ case reports

    2020  Volume 13, Issue 12

    Abstract: Extra-pancreatic solid pseudopapillary neoplasms (SPNs) are rare tumours with an overall favourable prognosis and low malignant potential. SPNs with metastatic spread, distant lymph node metastasis and extrapancreatic origin are exceedingly rare. ... ...

    Abstract Extra-pancreatic solid pseudopapillary neoplasms (SPNs) are rare tumours with an overall favourable prognosis and low malignant potential. SPNs with metastatic spread, distant lymph node metastasis and extrapancreatic origin are exceedingly rare. Significant controversy regarding the treatment and the management of metastatic disease exists and, currently, there are no standardised guidelines or treatment recommendations for the use of adjuvant therapy. In this case report, the authors present a patient with widely metastatic SPN of likely ovarian origin with the invasion of the inguinal lymph nodes and multiple abdominal metastatic deposits. Using the currently available literature, the authors discuss treatment options for metastatic SPN of the ovary and highlight the need for continued research in this important field.
    MeSH term(s) Adult ; Carcinoma, Papillary/diagnosis ; Carcinoma, Papillary/pathology ; Carcinoma, Papillary/surgery ; Female ; Humans ; Lymph Nodes/pathology ; Neoplasm Metastasis/diagnosis ; Ovarian Neoplasms/diagnosis ; Ovarian Neoplasms/pathology ; Ovarian Neoplasms/surgery ; Positron-Emission Tomography
    Language English
    Publishing date 2020-12-09
    Publishing country England
    Document type Case Reports ; Journal Article
    ISSN 1757-790X
    ISSN (online) 1757-790X
    DOI 10.1136/bcr-2020-238136
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  8. Article ; Online: Enterochromaffin-like Cell Hyperplasia-Associated Gastric Neuroendocrine Tumors May Arise in the Setting of Proton Pump Inhibitor Use.

    Rais, Rehan / Trikalinos, Nikolaos A / Liu, Jingxia / Chatterjee, Deyali

    Archives of pathology & laboratory medicine

    2021  Volume 146, Issue 3, Page(s) 366–371

    Abstract: Context.—: Hypergastrinemia states such as achlorhydria from gastric mucosal atrophy or a gastrin-producing tumor in humans have been associated with the development of enterochromaffin-like (ECL) cell hyperplasia and gastric neuroendocrine tumors ( ... ...

    Abstract Context.—: Hypergastrinemia states such as achlorhydria from gastric mucosal atrophy or a gastrin-producing tumor in humans have been associated with the development of enterochromaffin-like (ECL) cell hyperplasia and gastric neuroendocrine tumors (GNETs). Whether drugs that can elevate serum gastrin levels, such as proton pump inhibitors (PPIs), can produce the same tissue effect is not known, and there is no concrete evidence linking the use of PPIs to GNETs outside animal models and case reports.
    Objective.—: To explore the clinicopathologic association for GNETs of presumed ECL cell origin that cannot be reliably placed into any of the 3 established categories currently recognized by the World Health Organization.
    Design.—: This is a retrospective clinicopathologic study of GNETs in the body/fundus during a period of 15 years (2005-2019).
    Results.—: Of a total of 87 cases, 57 (65.5%) were associated with atrophic gastritis, 2 (2.3%) were associated with Zollinger-Ellison syndrome, and 28 (32.2%) were unclassified. Of the latter, 11 were consistent with true sporadic/type 3 GNETs, while 17 had background mucosal changes of parietal cell and ECL cell hyperplasia but without underlying detectable gastrinoma, and 88.2% (15 of 17) of patients from this group had documented long-term PPI use. This subtype of GNETs was more commonly multifocal and of higher grade (P = .03) than "true" sporadic GNETs.
    Conclusions.—: A subset of GNETs arises in the background of gastric mucosal changes suggestive of hypergastrinemia, but without underlying gastrinoma, and could be linked to long-term PPI use.
    MeSH term(s) Animals ; Enterochromaffin-like Cells/pathology ; Humans ; Hyperplasia/chemically induced ; Hyperplasia/pathology ; Neuroendocrine Tumors/pathology ; Proton Pump Inhibitors/adverse effects ; Retrospective Studies ; Stomach Neoplasms/chemically induced ; Stomach Neoplasms/pathology
    Chemical Substances Proton Pump Inhibitors
    Language English
    Publishing date 2021-07-20
    Publishing country United States
    Document type Journal Article
    ZDB-ID 194119-7
    ISSN 1543-2165 ; 0363-0153 ; 0096-8528 ; 0003-9985
    ISSN (online) 1543-2165
    ISSN 0363-0153 ; 0096-8528 ; 0003-9985
    DOI 10.5858/arpa.2020-0315-OA
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  9. Article ; Online: Sequential histologic evolution of gallbladder inflammation in acute cholecystitis over the first 10 days after onset of symptoms.

    Panni, Roheena Z / Chatterjee, Deyali / Panni, Usman Y / Robbins, Keenan J / Liu, Jingxia / Strasberg, Steven M

    Journal of hepato-biliary-pancreatic sciences

    2022  Volume 30, Issue 6, Page(s) 724–736

    Abstract: Background: The timing of cholecystectomy during acute cholecystitis (AC) is controversial, especially whether it is advisable to perform in patients with duration of symptoms between 3 and 10 days. The purpose of this study is to define clearly the ... ...

    Abstract Background: The timing of cholecystectomy during acute cholecystitis (AC) is controversial, especially whether it is advisable to perform in patients with duration of symptoms between 3 and 10 days. The purpose of this study is to define clearly the sequential evolution of histological changes following symptoms onset to guide recommendations regarding timing of cholecystectomy.
    Methods: We identified patients with AC (2005-2018) who had cholecystectomy within 10 days of symptom onset of a first attack of AC. Histologic features of gallbladder injury including cellular and exudative inflammatory response to injury were determined on blinded pathologic slides.
    Results: One hundred and forty-nine patients were divided into three groups; early-who underwent cholecystectomy 1-3 days after symptom-onset, intermediate-4-6 days, and late-7-10 days. Key features of injury were necrosis and hemorrhage. A subgroup of patients in the early phase developed severe necrosis and hemorrhage of an extent associated with difficult cholecystectomy. Large spikes in extent of necrosis and hemorrhage occurred at 7-10 days. Major inflammatory responses to injury were eosinophilic and lymphocytic infiltration and early fibrosis.
    Conclusions: Severe necrosis may develop rapidly and be present in the early period after symptom onset of AC. Cholecystectomy may be reasonable in some patients but by day 7-10, severe necrosis and hemorrhage may be expected to be present in most patients.
    MeSH term(s) Humans ; Cholecystectomy, Laparoscopic ; Cholecystitis/pathology ; Cholecystitis, Acute/surgery ; Cholecystitis, Acute/pathology ; Cholecystectomy ; Necrosis/pathology ; Retrospective Studies ; Gallbladder/surgery ; Gallbladder/pathology
    Language English
    Publishing date 2022-12-01
    Publishing country Japan
    Document type Journal Article
    ZDB-ID 2536236-7
    ISSN 1868-6982 ; 1868-6974
    ISSN (online) 1868-6982
    ISSN 1868-6974
    DOI 10.1002/jhbp.1274
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  10. Article ; Online: Liver pathology in retinal vasculopathy with cerebral leukoencephalopathy and systemic manifestations: vasculopathic disease beyond nodular regenerative hyperplasia.

    Khonde, Pooja / Chatterjee, Deyali / Bogacki, Madonna / Liszewski, M Kathryn / Ford, Andria L / Miner, Jonathan J / Atkinson, John P / Brunt, Elizabeth M

    Human pathology

    2023  Volume 135, Page(s) 22–34

    Abstract: Retinal vasculopathy with cerebral leukoencephalopathy and systemic manifestations (RVCL-S) is a rare autosomal dominant disease resulting from a frame-shift mutation in TREX1, an intracellular 3'-5' exonuclease 1. Hepatic findings include an elevated ... ...

    Abstract Retinal vasculopathy with cerebral leukoencephalopathy and systemic manifestations (RVCL-S) is a rare autosomal dominant disease resulting from a frame-shift mutation in TREX1, an intracellular 3'-5' exonuclease 1. Hepatic findings include an elevated alkaline phosphatase (ALP) and nodular regenerative hyperplasia (NRH). Affected individuals typically succumb to brain lesions before clinically apparent hepatic manifestations; thus, little else is known about the hepatic pathology. Autopsy reports and a liver section from each (n = 11) of three unrelated kindreds with the most common mutation in TREX1 (V235Gfs∗6) were studied with standard and immunohistochemical stains. Cases were compared with "normal liver" controls from similar autopsy years. Cases consisted of six men and five women who died at a median age of 50 yr (range, 41-60 yr.). Seven had elevated ALP. Two had liver atrophy. Foci of NRH were variably detected in all. Inhomogeneous distribution of other findings included patternless parenchymal fibrous bands, approximation of vascular structures, and commonly, architectural changes of vascular structures. Only bile duct epithelia were unaffected. In addition, small trichrome-positive nodules were found along vein walls or isolated in the parenchyma. Rare foci of non-NRH hepatocytic nodules were noted in 3. Increased CD34 and altered α-SMA IHC expression were variably noted. Periportal ductules and perivenular K7 IHC expression were increased to unpredictable degrees. The extensive but inhomogeneous histopathologic findings in livers of autopsied patients with RVCL-S appear to involve hepatic vascular structures. These findings validate inclusion of vascular liver involvement beyond NRH in this complex hereditary disorder.
    MeSH term(s) Male ; Humans ; Female ; Hyperplasia/pathology ; Liver/pathology ; Leukoencephalopathies/genetics ; Leukoencephalopathies/pathology ; Vascular Diseases/genetics ; Vascular Diseases/pathology ; Liver Diseases/genetics ; Liver Diseases/pathology
    Language English
    Publishing date 2023-03-05
    Publishing country United States
    Document type Journal Article
    ZDB-ID 207657-3
    ISSN 1532-8392 ; 0046-8177
    ISSN (online) 1532-8392
    ISSN 0046-8177
    DOI 10.1016/j.humpath.2023.02.013
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