Asunto(s)
Humanos , Masculino , Femenino , Educación del Paciente como Asunto/tendencias , Neoplasias Pancreáticas/epidemiología , Cistadenocarcinoma Papilar/complicaciones , Cistadenocarcinoma Papilar/diagnóstico , Pronóstico , Páncreas/patología , Páncreas , Cistadenocarcinoma Papilar/fisiopatología , Cistadenocarcinoma PapilarRESUMEN
OBJECTIVE: The aim of this study was to compare the effectiveness of transvaginal power Doppler sonography with spectral Doppler analysis as an aid in preoperatively distinguishing primary ovarian carcinoma and metastatic carcinoma to the ovary (Krukenberg tumors). METHODS: Fifty women with ovarian disease were preoperatively examined with transvaginal power Doppler sonography. Six basic parameters were measured, including intratumoral peak systolic velocity, end-diastolic velocity, time-averaged maximum velocity, pulsatility index (PI), resistive index (RI), and velocity index (VeI). Blood flow analyses were detectable in all patients. Twelve patients with metastatic carcinoma to the ovary were classified as group 1; 38 patients with primary ovarian carcinoma were classified as group 2. Comparison of intratumoral blood flow analyses between the two groups was performed. RESULTS: The PI, RI, and VeI were significantly lower in patients with metastatic carcinoma to the ovary than those with primary ovarian carcinoma (P < .05). There were no significant differences in the peak systolic velocity (P = .871), end-diastolic velocity (P = .508), and time-averaged maximum velocity (P = .850) between the two groups. CONCLUSIONS: Transvaginal power Doppler sonography with spectral Doppler analysis is an effective method in evaluating intratumoral blood flow of Krukenberg tumors. Low impedance (PI, RI, and VeI) might assist us in making differential diagnoses between primary ovarian carcinoma and Krukenberg tumors according to our preliminary results.
Asunto(s)
Carcinoma/diagnóstico por imagen , Tumor de Krukenberg/diagnóstico por imagen , Neoplasias Ováricas/diagnóstico por imagen , Flujo Pulsátil/fisiología , Ultrasonografía Doppler , Resistencia Vascular/fisiología , Adenocarcinoma Mucinoso/diagnóstico por imagen , Adenocarcinoma Mucinoso/fisiopatología , Adulto , Anciano , Velocidad del Flujo Sanguíneo/fisiología , Carcinoma/fisiopatología , Carcinoma/secundario , Carcinoma Endometrioide/diagnóstico por imagen , Carcinoma Endometrioide/fisiopatología , Cistadenocarcinoma Papilar/diagnóstico por imagen , Cistadenocarcinoma Papilar/fisiopatología , Cistadenocarcinoma Seroso/diagnóstico por imagen , Cistadenocarcinoma Seroso/fisiopatología , Diagnóstico Diferencial , Femenino , Humanos , Tumor de Krukenberg/fisiopatología , Persona de Mediana Edad , Neoplasias de Células Germinales y Embrionarias/diagnóstico por imagen , Neoplasias de Células Germinales y Embrionarias/fisiopatología , Neoplasias Ováricas/fisiopatología , Estudios Prospectivos , Flujo Sanguíneo Regional/fisiología , Tumores de los Cordones Sexuales y Estroma de las Gónadas/diagnóstico por imagen , Tumores de los Cordones Sexuales y Estroma de las Gónadas/fisiopatología , Ultrasonografía Doppler en Color , Ultrasonografía Doppler de PulsoRESUMEN
BACKGROUND: Primary papillary serous carcinoma (PPSC) of the peritoneum is a rare neoplasm, histologically indistinguishable from papillary serous carcinoma of the ovary, which diffusely involves the peritoneum but spares or minimally invades the ovaries. To the best of our knowledge, the preoperative and the fine needle aspiration diagnosis of this disorder have not been reported before. CASE: A woman developed an extensive peritoneal neoplasm 4 years after hysterectomy and bilateral salpingo-oophorectomy for benign disease. Fine needle aspiration of the tumor was performed, and the cytologic and immunocytochemical findings were consistent with papillary serous carcinoma. A diagnosis of PPSC of the peritoneum was rendered because review of all slides from previous surgical specimens showed no evidence of carcinoma and no other primary tumors were found elsewhere. CONCLUSION: Fine needle aspiration cytology coupled with immunocytochemical and clinical data allows an unequivocal preoperative diagnosis of papillary serous carcinoma (primary peritoneal or with an ovarian origin). The sole limitation to establish a primary peritoneal origin before surgery is the requirement to histologically study the ovaries. Based on this fact, the preoperative fine needle aspiration cytology diagnosis of PSCP should be restricted to oophorectomized patients.
Asunto(s)
Cistadenocarcinoma Papilar/diagnóstico , Cistadenocarcinoma Seroso/diagnóstico , Neoplasias Ováricas/diagnóstico , Neoplasias Peritoneales/diagnóstico , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Ascitis/etiología , Biomarcadores de Tumor/análisis , Biomarcadores de Tumor/biosíntesis , Biopsia con Aguja Fina/métodos , Cistadenocarcinoma Papilar/tratamiento farmacológico , Cistadenocarcinoma Papilar/fisiopatología , Cistadenocarcinoma Seroso/tratamiento farmacológico , Cistadenocarcinoma Seroso/fisiopatología , Diagnóstico Diferencial , Femenino , Humanos , Histerectomía , Inmunohistoquímica/métodos , Persona de Mediana Edad , Neoplasias Ováricas/tratamiento farmacológico , Neoplasias Ováricas/fisiopatología , Neoplasias Peritoneales/tratamiento farmacológico , Neoplasias Peritoneales/fisiopatología , Derrame Pleural Maligno/etiología , Derrame Pleural Maligno/patología , Valor Predictivo de las Pruebas , Resultado del TratamientoRESUMEN
AIMS: Salivary gland tumours of the tongue are rare. The most common type is low-grade mucoepidermoid carcinoma followed by adenoid cystic carcinoma. Papillary cystadenocarcinoma of salivary glands are uncommon lesions with low-grade mucoepidermoid carcinoma followed by adenoid cystic carcinoma. Papillary cystadenocarcinoma of salivary glands are uncommon lesions with low-grade histological and clinical features. We report a high-grade papillary cystadenocarcinoma in an 80-year-old man who presented with a tongue mass and metastatic disease in the neck. METHODS AND RESULTS: He was treated with partial glossectomy and bilateral neck dissection but developed local and regional recurrences 6 months later. The tumour had a prominent cystic appearance and had areas of necrosis. The cyst lumen was occupied by numerous papillae lined by pseudostratified columnar cells with a high nuclear-cytoplasmic ratio. The cytoplasm was eosinophilic, the nuclei were pleomorphic and exhibited irregular nuclear membranes, vesicular chromatin and prominent eosinophilic nucleoli. The mitotic activity was high and there were occasional abnormal mitotic figures. Metastatic carcinoma was present in four lymph nodes. The differential diagnosis of this unusual lesion includes cystadenoma, salivary duct carcinoma and metastases. CONCLUSIONS: This case and a review of the literature indicates that papillary cystadenocarcinomas of salivary gland origin exhibit a wider morphologic spectrum than described in the latest World Health Organization (WHO) classification which defines these lesions as low-grade neoplasms.
Asunto(s)
Cistadenocarcinoma Papilar , Neoplasias de la Lengua , Anciano , Anciano de 80 o más Años , Cistadenocarcinoma Papilar/patología , Cistadenocarcinoma Papilar/fisiopatología , Cistadenocarcinoma Papilar/terapia , Humanos , Masculino , Neoplasias de la Lengua/patología , Neoplasias de la Lengua/fisiopatología , Neoplasias de la Lengua/terapiaRESUMEN
The cell nuclear antigens PCNA (Proliferative cell nuclear antigen) and Ki-67 in selected advanced serous papilliferous ovarian cancers were evaluated by histochemical assays. PCNA and Ki-67 expression in primitive tumor cells appeared to be correlated with grading, stage and survival. High expression was found in G3 and in more advanced stages while in low expression survival rate was better.