- A historical perspective on crush syndrome: the clinical application of its pathogenesis, established by the study of wartime crush injuries. [Review]
- JCJ Clin Pathol 2016 Dec 05
- Crush syndrome is a fine example of how pathology can play a direct role in revealing the best treatment and management for diseases. It can occur when crush injuries are sustained. Skeletal muscle b...
Crush syndrome is a fine example of how pathology can play a direct role in revealing the best treatment and management for diseases. It can occur when crush injuries are sustained. Skeletal muscle becomes damaged under the weight of a heavy object, and victims experience severe shock and renal failure. The discovery of the pathology of crush syndrome belongs to two individuals: Seigo Minami and Eric Bywaters. They separately helped to define the pathogenesis of crush syndrome during World Wars I and II. Seigo Minami is believed to have been the first to record the pathogenesis of crush syndrome. In 1923, he described the cases of three soldiers who died of renal failure caused by crush injury during World War I. Using microscopic studies to investigate the pathology of their kidneys, he found the soldiers had died due to 'autointoxication' caused by rhabdomyolysis. This discovery was not known to Eric Bywaters, who described crush syndrome in 1941, having studied victims of the London Blitz during World War II. He defined the 'autointoxication' as the release of rhabdomyolysis products via reperfusion. He therefore established the need for emergency fluid replacement to treat crush syndrome. The findings made by Minami and Bywaters highlight a remarkable achievement in clinical pathology, despite the adversity of war. It is these findings on which current guidelines are based. By reviewing their work, it is hoped that the role of pathology can be better appreciated as a valuable resource for delineating the treatment and management of diseases.
- Sentinel case of Richter transformation from chronic lymphocytic leukaemia/small lymphocytic lymphoma to CD3+ diffuse large B-cell lymphoma. [Journal Article]
- JCJ Clin Pathol 2016 Nov 29
- CONCLUSIONS: Chronic lymphocytic leukaemia/SLL may rarely undergo Richter transformation to a DLBCL demonstrating lineage infidelity. This is a potentially important diagnostic pitfall and such cases should not be confused with a de novo T-cell lymphoma.
- T cell-rich lymphoid infiltrates with large B cells: a review of key entities and diagnostic approach. [Review]
- JCJ Clin Pathol 2016 Nov 28
- Accurate diagnostic interpretation of a lymphoid population composed predominantly of small T cells, together with smaller numbers of large B cells, with or without a nodular architecture, is a commo...
Accurate diagnostic interpretation of a lymphoid population composed predominantly of small T cells, together with smaller numbers of large B cells, with or without a nodular architecture, is a common problem faced by the histopathologist. The differential diagnosis of this histological pattern is wide, ranging from reactive conditions such as drug reactions and viral infections, through borderline entities such as immunodeficiency-related lymphoproliferative disorders to lymphomas. The latter includes entities where the large B cells are primarily neoplastic (classical and nodular lymphocyte-predominant Hodgkin lymphomas and T cell/histiocyte-rich large B cell lymphoma) as well as T cell lymphomas such as angioimmunoblastic T cell lymphoma where the large B cells represent an epiphenomenon and may or may not be neoplastic. Several rare variants of these conditions, and the fact that treatment can significantly modify appearances, add to the diagnostic difficulty of these pathological entities. Unlike monomorphic lymphoid infiltrates, the histological pattern of T cell-rich proliferation with large B cells requires close evaluation of the inter-relationship between B cells and T cells, follicular dendritic cells and sometimes other inflammatory cells. Epstein-Barr virus plays a key role in several of these scenarios, and interpreting not only its presence but also its distribution within cellular subgroups is essential to accurate diagnosis and the avoidance of some important diagnostic pitfalls. An understanding of normal immunoarchitecture and lymphoid maturational pathways is also fundamental to resolving these cases, as is a knowledge of their common patterns of spread, which facilitates correlation with clinical and radiological findings.
- Clinicopathological features of neoplasms with neuroendocrine differentiation occurring in the liver. [Journal Article]
- JCJ Clin Pathol 2016 Nov 23
- CONCLUSIONS: Primary hepatic NET and NEC are very rare tumours. The NEC component in HNEC showed high proliferative activity and influenced patient prognoses.
- The role of lymph node size and FOXP3+ regulatory T cells in node-negative colon cancer. [Journal Article]
- JCJ Clin Pathol 2016 Nov 22
- Recently, we demonstrated that the intratumoural density of CD3+ and CD8+ T cells is independently prognostic and associated with lymph node (LN) harvest and LN size in node-negative colon cancer. We...
Recently, we demonstrated that the intratumoural density of CD3+ and CD8+ T cells is independently prognostic and associated with lymph node (LN) harvest and LN size in node-negative colon cancer. We assumed that FOXP3+ T cells (Tregs) could be inversely associated with these LN features. Therefore, we performed a retrospective immunohistochemical analysis using an already well-characterised collection of stage I/II colon cancer cases. Receiver operating characteristic analysis revealed the optimal cut-off for predicting cancer-related death to be 70 FOXP3+ Tregs/mm(2) at the invasion front. Other than T-stage, none of the relevant histopathological parameters were associated with the density of FOXP3+ cells. In particular, no relation to LN size and count were found. Cancer-specific survival was significantly improved in cases with high densities (115 vs 86 months; p=0.026) in univariable but not in multivariable analysis. In contrast to other cancers, FOXP3+ T cells are associated with a favourable outcome.
- Primary cilia are increased in number and demonstrate structural abnormalities in human cancer. [Journal Article]
- JCJ Clin Pathol 2016 Nov 21
- CONCLUSIONS: The results show upregulation of primary cilia and the presence of structural defects in a wide range of human cancer tissue samples demonstrating association of dysregulation of primary cilia with human cancer.
- Microsatellite instability evaluation by automated microfluidic electrophoresis: an update. [Letter]
- JCJ Clin Pathol 2016 Nov 21
- Identifying progression predictors of breast ductal carcinoma in situ. [Review]
- JCJ Clin Pathol 2016 Nov 18
- Ductal carcinoma in situ (DCIS) refers to neoplastic epithelial cells proliferating within the mammary ducts of the breast, which have not breached the basement membrane nor invaded surrounding tissu...
Ductal carcinoma in situ (DCIS) refers to neoplastic epithelial cells proliferating within the mammary ducts of the breast, which have not breached the basement membrane nor invaded surrounding tissues. Traditional thinking holds that DCIS represents an early step in a linear progression towards invasive ductal carcinoma (IDC). However, as only approximately half of DCIS cases progress to IDC, important questions around the key determinants of malignant progression need to be answered. Recent studies have revealed that molecular differences between DCIS and IDC cells are not found at the genomic level; instead, altered patterns of gene expression and post-translational regulation lead to distinct transcriptomic and proteomic profiles. Therefore, understanding malignant progression will require a different approach that takes into account the diverse tumour cell extrinsic factors driving changes in tumour cell gene expression necessary for the invasive phenotype. Here, we review the roles of the tumour stroma (including mesenchymal cells, immune cells and the extracellular matrix) and myoepithelial cells in malignant progression and make a case for a more integrated approach to the study and assessment of DCIS and its progression, or lack thereof, to invasive disease.
- Reacquisition of E-cadherin expression in metastatic deposits of signet-ring cell carcinoma of the upper gastrointestinal system: a potential anchor for metastatic deposition. [Journal Article]
- JCJ Clin Pathol 2016 Nov 18
- CONCLUSIONS: While the reduction of E-cadherin in primary SRCC supports its pivotal role in epithelial-mesenchymal transition, a process crucial in tumour progression and metastatic dissemination, the re-expression of this molecule in metastatic SRCC cells implies a reversal to their epithelial phenotype (thus mesenchymal-epithelial transition) which, in turn, theoretically helps tumour cells to anchor and form cohesive metastatic deposits.
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- MAGE-A family expression is correlated with poor survival of patients with lung adenocarcinoma: a retrospective clinical study based on tissue microarray. [Journal Article]
- JCJ Clin Pathol 2016 Nov 18
- CONCLUSIONS: Molecular assessment of MAGE-A family members could be considered to improve the prognostic evaluation and to provide a new potential therapeutic strategy for patients with LAC.