• Title/Summary/Keyword: Low grade dysplasia

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The Diagnostic Accuracy of Endoscopic Biopsy for Gastric Dysplasia

  • Lee, Sung-Bae;Kang, Hye-Yun;Kim, Kwang-Il;Ahn, Dae-Ho
    • Journal of Gastric Cancer
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    • v.10 no.4
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    • pp.175-181
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    • 2010
  • Purpose: There is controversy over the treatment for low grade dysplasia, while resection is recommended for high grade dysplasia. But the concordance of the grade of dysplasia between pre- and post-resection is low because of sampling errors with endoscopic biopsy. We attempted to establish a clearer direction for the treatment of dysplasia by clarifying the discrepancy between the pre- and postresection diagnoses. Materials and Methods: We performed a retrospective review of 126 patients who had undergone resection with the diagnosis of dysplasia on biopsy at Bundang CHA Hospital from 1999 to 2009. Results: Seventy patients were diagnosed with low grade dysplasia and 56 patients were diagnosed with high grade dysplasia. Among the 33 patients who received gastrectomy with lymph node dissec-tion, 30 patients were revealed to have invasive cancers and 4 patients showed lymph node metastasis. Discordance between the diagnoses from biopsy and resection occurred in 55 patients (44%). There was no correlation on the comparative analysis between the size, location or gross type of lesion and the grade of dysplasia. Conclusions: The rate of discordance between the diagnoses of endoscopic biopsy and the post resection pathologic report was as high as 44%. Endoscopic mucosal resection was not sufficient for some patients who were diagnosed with dysplasia on biopsy due to the presence of lymph node metastasis. It is necessary to be prudent when determining the follow-up and treatment based solely on the result of the biopsy.

Diagnostic Value of Endocervical Curettage for Detecting Dysplastic Lesions in Women with Atypical Squamous Cells of Undetermined Significance (ASC-US) and Low Grade Squamous Intraepithelial Lesion (LSIL) Papanicolaou Smears

  • Poomtavorn, Yenrudee;Suwannarurk, Komsun;Thaweekul, Yuthadej;Maireang, Karicha
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.8
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    • pp.3461-3464
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    • 2014
  • Background: To determine the frequency of dysplastic lesions in the endocervical curettage (ECC) specimens of women with ASC-US and LSIL Pap and to evaluate the possible factors associated with high grade dysplasia in those ECC specimens. Materials and Methods: Two hundred and sixty patients with ASC-US and LSIL cytologic smears who underwent an ECC at the time of colposcopic examination during January 2010 and December 2012 were reviewed. Demographic and clinicopathologic data were collected. Multivariate analysis using binary logistic regression was used to identify factors that might be associated with high grade endocervical dysplasia. Results: The frequency of endocervical dysplasia was 7.7% (20 out of 260 patients). Cervical intraepithelial neoplasia (CIN) 1 and CIN 2-3 lesions in the endocervical canal were observed in 12 and 8 patients, respectively. No microinvasive or invasive cervical cancers were identified. There was no difference in the frequency of high grade endocervical dysplasia between the patients with satisfactory and unsatisfactory colposcopic examinations (1.4% vs 5.1%, respectively, p=0.087). A multivariate logistic regression analysis demonstrated a significant association between high grade CIN on ectocervical biopsy as well as LSIL cytologic smears and high grade dysplasia in endocervical canal (OR=0.046, 95%CI=0.007-0.288; p=0.001 and OR=0.154, 95%CI=0.025-0.942; p=0.043, respectively). Conclusions: The frequency of high grade endocervical dysplasia in women with ASC-US and LSIL cytologic smears was low. Therefore, routine performance of ECC in those women is debatable. High grade ectocervical dysplasia and LSIL cytologic smears may be used as predictors for high grade dysplasia in endocervical canal and ECC in these patients is reasonable.

Secondary Chondroblastic Osteosarcoma from Polyostotic Fibrous Dysplasia Initially Misdiagnosed as Low Grade Chondrosarcoma Provoking Fallacy in Treatment Strategy (저 악성도 연골육종으로 악성 변화한 섬유성 이형성증으로 오진하여 치료방침의 오류가 발생한 연골 모세포형 골육종 - 증례 보고 -)

  • Lee, Seung-Jun;Koh, Jae-Soo;Won, Ho-Hyun;Jeon, Dae-Geun
    • The Journal of the Korean bone and joint tumor society
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    • v.14 no.1
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    • pp.62-67
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    • 2008
  • Malignant degeneration of fibrous dysplasia is rare and involves transformation into osteosarcoma, fibrosarcoma and chondrosarcoma. The most frequent sites involved in malignant transformation were craniofacial bones, proximal femur, humerus, pelvis, tibia and scapula in a decreasing order of frequency. An 41-year-old man with a history of polyostotic fibrous dysplasia presented with increasing left arm pain. Plain radiograph showed expansile destructive lesion along the humeral shaft. As initial biopsy report was low grade chondrosarcoma, he underwent marginal resection. However, he developed local recurrence 7 month later and subsequent pathologic finding was chondroblastic osteosarcoma. We report one case of secondary chondroblastic osteosarcoma from polyostotic fibrous dysplasia initially misdiagnosed as low grade chondrosarcoma that caused fallacy in treatment strategy.

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Clinical Study on 3 Cases of Cervical Dysplasia (자궁경부 이형성증 진단을 받은 환자 3례에 대한 임상적 고찰)

  • Park, Chan-Soo;Jung, Hyuk-Sang;Sohn, Young-Joo
    • The Journal of Korean Obstetrics and Gynecology
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    • v.21 no.4
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    • pp.237-246
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    • 2008
  • Purpose: Recently people who want to treatment of cervical dysplasia by Traditional Korean Medicine (TKM) were increased. The purpose of these studies are to confirm the clinical effectiveness of TKM treatment to clinical symptoms of the patients who diagnosed as cervical dysplasia. Methods: The patients who diagnosed as cervical dysplasia, had elytrorrhagia, leukorrhea, dysmenorrhea et al. The patients were treated by TKM such as herb medication and acupuncture therapy. Results: After the oriental medical treatment. the clinical symptoms such as elytrorrhagia, leukorrhea, dysmenorrhea were improved. Conclusion: To treatment and management of cervical dysplasia, we were based on improvement of clinical symptoms. And we used TKM to the clinical symptoms of patients with cervical dysplasia, in result clinical symptoms of cervical dysplasia were improved. TKM is expected to have positive effects on clinical symptoms of cervical dysplasia.

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Evidence for Enhanced Telomerase Activity in Barrett's Esophagus with Dysplasia and Adenocarcinoma

  • Merchant, Nipun B.;Dutta, Sudhir K.;Girotra, Mohit;Arora, Manish;Meltzer, Stephen J.
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.2
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    • pp.679-683
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    • 2013
  • Background: Dysplasia and adenocarcinoma developing in Barrett's esophagus (BE) are not always endoscopically identifiable. Molecular markers are needed for early recognition of these focal lesions and to identify patients at increased risk of developing adenocarcinoma. The aim of the current study was to correlate increased telomerase activity (TA) with dysplasia and adenocarcinoma occurring in the setting of BE. Materials and Methods: Esophageal mucosal biopsies were obtained from patients (N=62) who had pathologically verified BE at esophagogastroduodenoscopy (EGD). Mucosal biopsies were also obtained from the gastric fundus as controls. Based on histopathology, patients were divided into three groups: 1) BE without dysplasia (n=24); 2) BE with dysplasia (both high grade and low grade, n=13); and 3) BE with adenocarcinoma (n=25). TA was measured by a PCR-based assay (TRAPeze$^{(R)}$ ELISA Telomerase Detection Kit). Statistical analyses were performed using one-way ANOVA and post-hoc Bonferroni testing. Results: TA was significantly higher in biopsies of BE with dyplasia and BE with adenocarcinoma than in BE without dysplasia. Subgroup analyses did not reveal any significant correlations between TA and patient age, length of BE, or presence of gastritis. Conclusions: Telomerase activity in esophageal mucosal biopsies of BE may constitute a useful biomarker for the early detection of esophageal dysplasia and adenocarcinoma.

Malignant Pancreatic Intraductal Papillary Mucinous Neoplasm with Splenic Invasion: A Case Report (악성 췌관내 유두상 점액성 종양의 비장 침범: 증례 보고)

  • Yeaseul Hur;Young Han Kim
    • Journal of the Korean Society of Radiology
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    • v.85 no.4
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    • pp.795-800
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    • 2024
  • Intraductal papillary mucinous neoplasm (IPMN) is a tumor originating from pancreatic ductal epithelial cells, leading to excessive mucus secretion and dilation of the pancreatic duct. Pathologically, IPMNs display a wide range of dysplasia, ranging from low-grade dysplasia to invasive carcinoma. Invasion into surrounding organs, especially into spleen, is rare and has not been reported in Korean journals. Worldwide, only two cases have been reported. Here, the authors report their experience with a rare case of IPMN in the pancreas that invaded the spleen.

The diagnostic value of i-scan image-enhanced endoscopy in the diagnosis of oral cavity leukoplakia (구강 백반증 진단에 있어서 i-scan image-enhanced 내시경의 진단적 유용성)

  • Lee, Young Chan;Eun, Young-Gyu;Park, Il-Seok
    • Korean Journal of Head & Neck Oncology
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    • v.34 no.2
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    • pp.29-34
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    • 2018
  • Background/Objectives: The aim of this study was to investigate the diagnostic value of i-scan in the differential diagnosis of oral cavity leukoplakia based on visualization of abnormal vascular features. Materials & Methods: Thirty- one patients with oral cavity leukoplakia were enrolled in the study. Images of their oral cavity obtained using conventional white light endoscopy and an i-scan-enhanced endoscopy (Pentax DEFINA EPK-3000 Video Processors, with Pentax VNLJ10) were reviewed. The microvascular features of the lesions and vascular changes were analyzed and the results were compared with the histopathologic diagnosis. Results: Among the 31 oral cavity leukoplakia patients, 8 (25.8%) patients revealed hyperkeratosis, 10 (31.2%) low-grade dysplasia, 5 (16.2%) high-grade dysplasia and 8 (25.8%) invasive squamous cell carcinoma on histopathologic examination. Using i-scan-enhanced endoscopy, we could found abnormal vascular change with neoplastic neoangiogenesis in most high-grade dysplasia or invasive cancer in oral cavity. (high-grade dysplasia: 4/5 [80.0%], and invasive squamous cell carcinoma: 7/8 [87.5%]). Conclusion: i-scan-enhanced endoscopy could be a useful optical technique for the diagnosis of oral cavity leukoplakia. Our results suggest that i-scan may be a promising diagnostic tool in the early detection of suspected oral mucosal lesion.

What are the Endoscopic and Pathological Characteristics of Colorectal Polyps?

  • Bas, Bilge;Dinc, Bulent;Oymaci, Erkan;Mayir, Burhan;Gunduz, Umut Riza
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.13
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    • pp.5163-5167
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    • 2015
  • Background: Colon polyps need to be excised upon detection during colonoscopy due to the risk of malignancy irrespective of their size. In our study, we retrospectively evaluated the clinicopathological characteristics of polyps detected during colonoscopy. Materials and Methods: We assessed 379 patients with polyps detected during colonoscopy between January 2010 and May 2012. The demographics, complaints, colonoscopy findings (shape, place and size of the polyp) and histopathological findings were recorded. We carried out statistical analysis using PASW 18.0 for Windows. Results: There were 227 males (59.9%) and 152 females (40.1%) in the trial. The mean age was 53.8 years (32-90). The most common complaint was rectal bleeding (36.1%), followed by abdominal pain (35.4%). Polyps were detected most commonly in the rectosigmoid region (43.8%), followed by the descending colon (17.4%). Some 239 patients had a single polyp (63.1%) while 140 were found to have multiple polyps (36.9%). While tubular adenoma was the most common pathological type, occurring in 181 patients (47.8%), tubulovillous adenoma (14.2%) and hyperplastic polyp (12.7%) followed, occurring in 54 and 48 patients respectively. While 313 patients (82.6%) did not feature dysplasia, 37 patients (9.7%) exhibited low-grade dysplasia, 28 (7.7%) had high-grade dysplasia and 4 had cancer (1.1%). The rates of villous components and dysplasia were detected to be high among pedunculated polyps and polyps larger than 1 cm (p<0.001). Conclusions: Due to the fact that large-diameter polyps with malignant potential are commonly located in the left colon and have a high prevalence among the middle-aged individuals, it would be appropriate to screen this population at regular intervals via rectosigmoidoscopy.

The pattern of metachronous recurrence after endoscopic submucosal dissection for gastric adenocarcinoma and dysplasias

  • Sunah Suk;Yeon Joo Seo;Dae Young Cheung;Han Hee Lee;Jin Il Kim;Soo-Heon Park
    • Clinical Endoscopy
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    • v.56 no.4
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    • pp.470-478
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    • 2023
  • Background/Aims: Metachronous recurrence incidences and risk factors following endoscopic submucosal dissection (ESD) for gastric adenocarcinoma and dysplasias were investigated. Methods: Retrospective review of electronic medical records of patients who underwent gastric ESD at The Catholic University of Korea, Yeouido St. Mary's Hospital. Results: A total of 190 subjects were enrolled for analysis during the study period. The mean age was 64.4 years and the male sex occupied 73.7%. The mean observation period following ESD was 3.45 years. The annual incidence rate of metachronous gastric neoplasms (MGN) was about 3.96%. The annual incidence rate was 5.36% for the low-grade dysplasia group, 6.47% for the high-grade dysplasia group, and 2.74% for the EGC group. MGN was more frequent in the dysplasia group than in the EGC group (p<0.05). For those with MGN development, the mean time interval from ESD to MGN was 4.1 (±1.8) years. By using the Kaplan-Meier model, the estimated mean MGN free survival time was 9.97 years (95% confidence interval, 8.53-11.40) The histological types of MGN were not related to the primary histology types. Conclusions: MGN following ESD developed in 3.96% annually and MGN was more frequent in the dysplasia group. The histological types of MGN did not correlate with those of primary neoplasm.

Adipo-R1 and Adipo-R2 Expression in Colorectal Adenomas and Carcinomas

  • Ayyildiz, Talat;Dolar, Enver;Ugras, Nesrin;Eminler, Ahmet Tarik;Erturk, Banu;Adim, Saduman Balaban;Yerci, Omer
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.1
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    • pp.367-372
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    • 2015
  • Background: Human adiponectin (ApN), a 30 kDa glycoprotein of 244-amino acids which is predominantly produced by adipocytes, exerts its effects via two receptors, namely adiponectin receptor-1 (adipo-R1) and adiponectin receptor-2 (adipo-R2) with differential binding affinity to globular adiponectin. Adiponectin receptor expression has been studied in several cancer tissues. However, there are no studies of colorectal adenomas which are considered to be precursors for colorectal carcinoma (CRC). Objectives: In the present study, the expression of adipo-R1 and adipo-R2 was investigated immunohistochemically in colorectal adenomas and colorectal carcinoma tissues in an attempt to determine associations with these tumors. Materials and Methods: The study enrolled 50 CRC patients with tumor resection and 82 patients who were diagnosed with adenomatous polyps, classified as negative for neoplasia, low-grade dysplasia (L-GD) or high- grade dysplasia (H-GD). Results: Expression of both adipo-R1 and adipo-R2 was found to be significantly lower in the CRCs than in colorectal adenomas (tubular and tubulovillous, p=0.009 and p<0.001, respectively). Adipo-R1 and adipo-R2 expression was also significantly lower in the CRC group when compared with the groups of patients with low grade dysplasia, high-grade dysplasia or no neoplasia (p=0.012 and p<0.001, respectively). In addition, it was observed that adipo-R2 expression was generally positive in the non-neoplastic group irrespective of the adipo-R2 expression. In the L-GD, H-GD and CRC groups, the adipo-R2 result was positive whenever adipo-R1 result was positive but some patients with negative adipo-R1 had positive adipo-R2 (p<0.001, p=0.004, p<0.001, respectively). Conclusions: This study indicated that ApN may play a role in the progression of colorectal adenomatous polyps to carcinoma through actions on adipo-R1 and adipo-R2 receptors.