biopsy

摘要： BACKGROUND The lymphoma of the mucosa-associated lymphoid tissue(MALT)is predominantly found in the stomach.The few cases reported in the literature of MALT lymphomas affecting the ileum are in patients who are already symptomatic and with clear advanced endoscopic findings.We present the first case of an asymptomatic female patient who underwent colonoscopy as a routine examination with the findings of an ulcer in the distal ileum region,which histopathological examination and associated immunohistochemistry revealed the diagnosis of MALT lymphoma.CASE SUMMARY A 57-year-old asymptomatic female patient underwent a colonoscopy exam for screening.The examination revealed an ulcer of medium depth with well-defined borders covered by a thin layer of fibrin and a halo of hyperemia in the distal ileum portion.Findings are nonspecific but may signal infections by viruses,protozoa,and parasites or inflammatory diseases such as Crohn's disease.Biopsies of the ulcer were taken.The anatomopathological result revealed an atypical diffuse lymphocytic infiltrate of small cells with a characteristic cytoplasmic halo of marginal zone cells.The immunohistochemical study was performed and the results demonstrated a negative neoplastic infiltrate for the expression of cyclin D1 and cytokeratin AE1/AE3 and a positive for BCL60 in the germinal center.The test also revealed CD10 positivity in the glandular epithelium and germinal center of a reactive follicle with dual-labeling of CD20 and CD3 demonstrating the B lymphocyte nature of the neoplastic infiltrate.In BCL2 protein labeling,the neoplastic infiltrate is strongly positive with a negative germinal center.The findings are consistent with immunophenotype B non-Hodgkin's lymphoma,better classified as extranodal MALT.The patient was treated with chemotherapy and showed complete regression of the disease,as evidenced by colonoscopy performed after treatment.CONCLUSION MALT lymphomas in the terminal ileum are extremely rare and only 4 cases have been reported in the literature.Given the low sensitivity and specificity of endoscopic images in these cases,the pathology can be confused with other important differential diagnoses such as inflammatory diseases or infectious diseases and which makes the biopsy important,even in asymptomatic patients,paired with anatomopathological analysis and immunohistochemistry which is the gold standard for correct diagnosis.

摘要： Renal biopsy is an invasive procedure used to evaluate the activity and the therapeutic management of kidney disease and kidney transplantation. Objective: The aim of this study was to describe the epidemiological, clinical, and pathological features of kidney disease diagnosed by biopsy in the Ivory Coast. Materials and Methods: This was a descriptive and prospective study conducted between January 2015 and December 2018 in the Department of Anatomy and Cytology of the Pathology of Cocody (Abidjan) and Bouake. Specimens were obtained from the nephrology department of Ivory Coast and from teaching hospitals in Togo, Guinea, Burkina Faso, and Mali. Samples were analyzed according to standard renal biopsy procedures. One kidney fragment was fixed in acetic acid formalin (AAF) for optical microscopy examination. The other fragment, soaked in physiological water, was immediately sent for immunofluorescence examination. All renal pathologies were included in this study. The study parameters were frequency, age, sex, origin, occupation, clinical and biological signs, and pathological aspects with optical microscopy, and immunofluorescence. Results: 153 cases (2.23%) of kidney biopsies were examined on a total of 10,573 specimens. Ivory Coast specimens accounted for 91.5% of cases (n = 140). Nephrotic syndrome (49%) was the most common clinical sign and indication for renal biopsy, followed by acute renal failure (16.3%), chronic renal failure (19.6%), and a combination of chronic renal failure with hypertension (11.18%) and glomerulonephritis (4%). Mean proteinuria was 3.03 g/24h (range, 0.14 to 11.5 g/24h). Histologically, 90.8% (n = 139) were glomerular nephropathies, including 26.6% HIV-associated nephropathy, 17.3% focal segmental glomerulosclerosis, 13.6% nephroangiosclerosis, 11.5% post-infectious glomerulonephritis, 9.3% membranous glomerulonephritis, and 21.6% miscellaneous glomerular nephropathies (n = 30). The incidence of various tubulo-interstitial lesions was 9.2% (n = 14). Conclusion: Glomerular nephropathies represent the most important renal diseases. Young people are most commonly affected with a high prevalence of focal segmental glomerulosclerosis and HIV-associated nephropathy.

摘要： Although COVID-19 clinical manifestations are mostly respiratory gastrointestinal manifestations may also be encountered in some instances. However, at the time of our writing, little is known about COVID-19, associated pathologic changes in the digestive system. We describe a case of COVID-19 disease with digestive manifestations that demonstrated specific pathologic changes in the gastrointestinal tract. Histological examination of endoscopic biopsy samples from duodenum was performed in combination with a review of the literature. According to our literature review, digestive histopathologic changes have been reported in 14 cases of COVID-19 patients. Pathological findings were generally nonspecific in all these cases and ranged from epithelial damage, lymphoplasmacytic and macrophages infiltrates, prominent endothelitis and ischemic enterocolitis. In our patient, histological features were more specific, characterized by several viral cytopathic effects associated with mucosal damage, numerous microthrombi and positive staining of ACE2 on various enterocytes. Histological analysis is not a practical option for the diagnosis of SARS-CoV-2 infections but could help to elucidate pathophysiology of the disease. Those changes may be specific in the GI tract and related clinical manifestations should not be overlooked. Furthermore, preventive measures for oral-fecal transmission should not be minimized.

摘要： Risk calculators have offered a viable tool for clinicians to stratify patients at risk of prostate cancer(PCa)and to mitigate the low sensitivity and specificity of screening prostate specific antigen(PSA).While initially based on clinical and demographic data,incorporation of multiparametric magnetic resonance imaging(MRI)and the validated prostate imaging reporting and data system suspicion scoring system has standardized and improved risk stratification beyond the use of PSA and patient parameters alone.Biopsy-naïve patients with lower risk profiles for harboring clinically significant PCa are often subjected to uncomfortable,invasive,and potentially unnecessary prostate biopsy procedures.Incorporating risk calculator data into prostate MRI reports can broaden the role of radiologists,improve communication with clinicians primarily managing these patients,and help guide clinical care in directing the screening,detection,and risk stratification of PCa.

摘要： Objective:Treatment delays in prostate cancer have been characterised,although not explicitly in men undergoing transperineal prostate biopsies.We aimed to determine if delays to radical prostatectomy correlate with adverse outcomes using a contemporary population-based cohort of men diagnosed by transperineal biopsies.Methods:This study analysed men with prostate cancer of the International Society for Urological Pathology grade group≥2,diagnosed by transperineal prostate biopsies who underwent prostatectomy,using the prospectively data from 1 January 2014 to 30 June 2018 Prostate Cancer Outcomes Registry-Victoria.Data were analysed according to stratified demographic and disease characteristics.Time intervals from biopsy(28,60,90,120,and 270 days)were compared using odds ratios and regression analyses for proportion of upgrading,early biochemical recurrence,pT3 disease at prostatectomy,and positive surgical margins.Results:In total,2008 men were analysed.There were 306(16.7%)men with upgrading,151(8.4%)with biochemical recurrence,1068(54.1%)with pT3 disease,and 464(23.1%)with positive surgical margins(percentages excluded patients with missing data).All adverse outcomes studied were significantly associated with higher prostate-specific antigen and grade at diagnosis.Delays of 120-270 days did not adversely alter the incidence of Gleason upgrading,pT3,or recurrence.Delays(most frequent 60-89 days,28%)were associated with positive surgical margins but not monotonically.Regression modelling demonstrated no increased likelihood of most adverse outcomes for up to 270 days.Conclusion:Men with prostate cancer of grade group≥2 diagnosed through transperineal biopsy may wait up to 270 days for a prostatectomy without a greater likelihood of upgrading,pT3 disease,positive surgical margins,or biochemical recurrence.

摘要： Objective:To evaluate the efficacy and safety of percutaneous core needle biopsy(PCNB)using ultrasound(US)-guided and contrast-enhanced ultrasound(CEUS)-guided procedures for anterior mediastinal masses(AMMs).Methods:In total,284 consecutive patients(166 men,118 women;mean age,43.0±18.4 years)who underwent PCNB for AMMs were enrolled.Patients were divided into the US-guided group(n=133)and the CEUS-guided group(n=151).PCNB was performed using a core needle(16-gauge or 18-gauge).Internal necrosis,diagnostic yield,and diagnostic accuracy were compared between the two groups.Results:The predominant final diagnosis of the cases in this study was thymoma(29.7%),lymphoma(20.5%),thymic carcinoma(13.3%),and germ cell tumour(13.3%),respectively.There was no significant difference in patient age,sex,number of percutaneous biopsies,or display rate of internal necrosis on conventional US between the two groups.The rate of internal necrosis of the lesions was significantly higher after contrast agent injection(72.2%vs.41.7%;P<0.001).The CEUS-guided group had a higher diagnostic yield than the US-guided group(100%vs.89.5%,P<0.001).There was no significant difference between the diagnostic accuracy of the CEUSguided and US-guided groups(97.3%vs.97.4%;P=1.000).None of the patients experienced adverse reactions or complications after US-guided or CEUS-guided PCNB.Conclusions:CEUS-guided PCNB can improve the diagnostic yield by optimizing the biopsy procedure.

摘要： BACKGROUND Neuronal intranuclear inclusion disease(NIID)is a rare neurological degenerative disorder with diverse manifestations and inadequate awareness.Only a few cases of NIID have been reported,and typical imaging findings can provide certain clues for the diagnosis of the disease.Furthermore,skin biopsy and genetic testing are important to confirm the diagnosis.CASE SUMMARY An 84-year-old man presented to the Neurology Department of our hospital complaining of a progressive course of cognitive impairment and unsteady gait for 2 years.The symptoms gradually progressed and affected his daily life.The patient was initially diagnosed with Parkinson’s disease and vascular dementia.The patient did not respond to conventional treatment,such as dopasehydrazine.Therefore,magnetic resonance imaging(MRI)was performed.Based on the imaging findings,we suspected an NIID diagnosis.During the 3-year follow-up in our hospital,his clinical symptoms gradually progressed,and imaging findings became more significant.A high signal intensity along the corticomedullary junction persisted on MRI.Gene testing and skin biopsy were recommended in our hospital;however,the patient refused these procedures.NIID was also considered when he went to a superior hospital in Shanghai.The patient eventually agreed to undergo gene testing.This revealed abnormal GGC repeat expansions in the NOTCH2NLC gene.CONCLUSION The clinical manifestations of NIID are diverse.Patients with clinical manifestations similar to Parkinson’s disease and dementia may have NIID.

摘要： BACKGROUND Post-transplant lymphoproliferative disease(PTLD)is the most common malignant tumor that occurs after kidney transplantation in children,and is associated with Epstein-Barr virus(EBV).CASE SUMMARY We report a case of PTLD that occurred in a 17-year-old female patient at 5 mo post-transplant.The first symptom was abdominal pain accompanied by fever,nausea,and vomiting.EBV-associated monomorphic PTLD with multiple abdominal nodules was diagnosed by pathology,clinical manifestations,imaging results,and the presence of EB-DNA.After successful treatment with rituximab,the abdominal nodules in the spleen and liver disappeared.CONCLUSION Early pathological biopsy to confirm the diagnosis is critical to treatment and prognosis.Reducing immunosuppression and rituximab therapy are effective methods for treating PTLD,but need to be initiated as early as possible.

摘要： BACKGROUND Papillary thyroid cancer(PTC)has good prognosis so that the local recurrence or distant metastasis can occur later on the lifetime follow up.In this study,we report recurrence of PTC in subcutaneous area combined with lymph node metastasis.A suspicion of needle tract implantation after core needle biopsy was found.CASE SUMMARY A 66-year-old female patients who underwent right thyroid lobectomy for PTC complained of palpable nodule on anterior neck area.The location of the palpable nodule was not associated with her postoperative scar.After excision of the skin tumor,it was diagnosed as recurrence of PTC.Furthermore,results of subsequent imaging showed lymph node metastasis on her right cervical area.According to the previous medical records,the patient received core needle biopsy through the neck of the patient midline and hematoma was noted after the procedure.The time interval from the first diagnosis to local recurrence or metastasis to the skin and lymph nodes was ten years.As treatment,the patient underwent lymph node dissection in the right and completion thyroidectomy for radioisotope treatment.CONCLUSION Needle tract implantation can occur after core needle biopsy.Further studies are needed to compare core-needle biopsy and fine-needle aspiration.

摘要： BACKGROUND Metabolic associated fatty liver disease(MAFLD)is a novel concept proposed in 2020.AIM To compare the characteristics of MAFLD and MAFLD with hepatitis B virus(HBV)infection.METHODS Patients with histopathologically proven MAFLD from a single medical center were included.Patients were divided into MAFLD group(without HBV infection)and HBV-MAFLD group(with HBV infection).Propensity score matching was utilized to balance the baseline characteristics between two groups.RESULTS A total of 417 cases with MAFLD were included,359(86.1%)of whom were infected with HBV.There were significantly more males in the HBV-MAFLD group than in the MAFLD group(P0.05).The rank sum test results showed that the degree of liver steatosis in the MAFLD group was more severe than that in the HBV-MAFLD group,while the degree of inflammation and fibrosis in the liver was less severe(P<0.05).In multivariate analysis,HBV infection was associated with significantly lower grade of hepatic steatosis[odds ratio(OR)=0.088,95%confidence interval(CI):0.027-0.291]but higher inflammation level(OR=4.059,95%CI:1.403-11.742)and fibrosis level(OR=3.016,95%CI:1.087-8.370)after adjusting for age,gender,and other metabolic parameters.CONCLUSION HBV infection is associated with similar metabolic risks,lower steatosis grade,higher inflammation,and fibrosis grade in MAFLD patients.

摘要： 用于从生物活体获取组织样本的活组织检查装置，例如经皮穿刺活检，包括外针(50)和用于容纳切断的组织样本的样本容纳装置(52)，该样本容纳装置可在空心针中移动。该装置包括用于在空心针中移动样本容纳装置的输送装置(66)，该输送装置包括可弯伸长元件，如钢丝、用例如塑料材料制成的带齿线或能够分别在远近方向上推动和拉动样本容纳装置的Bowden电缆。卷绕装置(74)设置用于该可弯伸长元件。该可弯伸长元件和卷绕装置可以包括在一次性单元(106)中，该一次性单元可连接到手持单元(105)上，该手持单元包括用于驱动输送装置的马达。定向装置设置用于将样本容纳装置相对于空心针正确定向。