The purpose of this paper is to quantify the incidence of different histological types of ovarian tumors and to demonstrate the clinical importance of an effective screening program, considering the cancer symptoms abdominal pain nature of this pathology.
Blood in the urine hematuria Excessive urination How is a Ureterocele Diagnosed? In some cases, more than one procedure is necessary, while in unusual cases, observation, or no treatment, may be recommended. Each child is unique and the medical team will work with the family to determine the best option. Transurethral puncture: A form of minimally invasive therapy that punctures and decompresses the ureterocele using a cystoscope that is inserted through the urethra. Upper pole nephrectomy: If the upper half of the kidney the part associated with the ureterocele does not function because of the cancer symptoms abdominal pain and there is no vesicoureteral reflux, removal of the affected portion of the kidney is recommended.
The incidence of ovarian epithelial tumors varied across age groups, our study group including women aged between 34 and 64 years old. Knowing the age distribution plays an important role in the implementation of screening programs.
All cases presented with similar symptomatology: pelvic pain, abdominal distension and ascites. The gross appearance of these tumors was overlapping in different histological subtypes, showing variable cystic and solid components.
The histological subtypes included in our study were: serous carcinoma, low grade and high grade, mucinous cancer symptoms abdominal pain, endometrioid carcinoma and clear cell carcinoma.
A positive correct diagnosis of the histological subtype is essential for therapy and follow-up, and immunohistochemial studies should be performed in difficult cases. There is a large series cancer symptoms abdominal pain antibodies used for the positive diagnosis of ovarian carcinoma, so the pathologist should know what algorithm to use in approaching a diagnosis in order to obtain a correct result.
Scopul acestei lucrări este de a cuantifica incidența diferitelor tipuri histologice de tumori ovariene și de a demonstra importanța clinică a unui program eficient de screening, având în vedere natura paucisimptomatică a acestei patologii. Incidența tumorilor epiteliale ovariene a variat în funcție de grupurile de vârstă, grupul nostru de studiu incluzând femei cu vârsta cuprinsă între 34 și 64 de ani.
Cunoașterea distribuției pe vârste joacă un rol important în implementarea programelor de screening.
Utilitatea imunohistochimiei în diagnosticul carcinomului ovarian
Toate cazurile au prezentat simptomatologie similară: durere pelviană, distensie abdominală și ascită. Aspectul macroscopic al acestor tumori se suprapune în diferite subtipuri histologice, prezentând componente variabile chistice și solide.
Subtipurile histologice incluse în studiul nostru au fost carcinomul seros, de grad scăzut sau crescut, carcinomul mucinos, carcinomul endometrioid și carcinomul cancer symptoms abdominal pain celule clare. Un diagnostic corect pozitiv al subtipului histologic este esențial pentru terapie și follow-up, iar studiile imunohistochimice trebuie efectuate în cazuri dificile. Există o serie mare de anticorpi folosiți pentru diagnosticul pozitiv al carcinomului ovarian, astfel încât anatomopatologul cancer symptoms abdominal pain trebui să știe ce algoritm să utilizeze în abordarea unui diagnostic pentru a obține un rezultat corect.
Cuvinte cheie epiteliu carcinom ovar imunohistochimie Introduction Ovarian cancer is a public health problem that affects women of reproductive cancer symptoms abdominal pain and is a major cause of morbidity and mortality. Early diagnosis is the primary method of ameliorating complications and long-term prognosis, but this is hampered by reduced symptomatology, with most patients presenting in advanced stages.
From tothe incidence cancer symptoms abdominal pain and the mortality rate decreased by 0. The most important factor in determining the prognosis of the patient is cancer symptoms abdominal pain tumor stage.
For epithelial ovarian cancer, current screening methods ultrasound and tumor markers have not been as effective as in cervical or breast tumors. Ovarian epithelial tumors represent a heterogeneous class of neoplasia, classified by cell type in serous, cancer symptoms abdominal pain, endometrioid and clear cell.
Because there are no benign equivalent tissues in the ovary, the mechanism of carcinogenesis was attributed initially to the ovarian epithelium mesotheliumbut recent studies have proposed that serous tumors are secondary tumors, derived from lesions of the fallopian tube fimbria, while endometrioid tumor or clear cells tumors are secondary to ovarian endometriosis 4.
Ovarian epithelial tumors are classified according to the degree of nuclear cancer symptoms abdominal pain, tumor proliferation and the presence or absence of stromal invasion, in benign, borderline and malignant conditions.
The borderline tumors are called this way because they present cytological and histological aspects that are intermediate between benign and malignant.
Materials define schistosomiasis method The purpose of this paper is to quantify the incidence of different histological types of ovarian tumors and to demonstrate the clinical importance of an effective screening program, considering the paucisymptomatic nature of this pathology.
Symptoms suggestive for this pathology were noted to demonstrate the cancer symptoms abdominal pain clinical appearance of ovarian neoplasia. Specimens were obtained from limited tumor excision, but also from oophorectomy and hysterectomy with bilateral anexectomy, formalin fixed and paraffin embedded, then stained with Hematoxylin-Eosin.
In some cases, additional immunohistochemical stains were needed to clarify the diagnosis. Results This study included data from a batch of 23 ovarian carcinomas, cancer symptoms abdominal pain from ovarian pathology patients.
The utility of immunohistochemistry in the diagnosis of ovarian carcinoma
The incidence of ovarian epithelial tumors varies across age groups, our study cancer symptoms abdominal pain symptoms abdominal pain including women aged between 34 and 64 years old. Knowing the age distribution plays an important role in the implementation of screening programs. All cases presented with similar symptomatology: pelvic pain, abdominal distension and ascites in two cases.
In the category of malignant serous tumors, we included 9 patients, 6 low-grade and 3 high-grade. The low-grade serous carcinoma was non-invasive and showed a papillary-type development, with small nuclei, rare mitoses and a hyalinized stroma with occasional psamoma bodies. Immunohistochemical assays showed positivity to CK7 and ER. Figure 1. The immunohistochemical assays showed, by contrast to the previous low-grade serous cases, a mutated expression of p53 and high Ki67 index.
The pattern of p53 immunosay is very important and the result should refer to the presence or absence of a mutation. Cancer symptoms abdominal pain strong and diffuse immunoexpression of p53, as well as a completely negative immunostaining should be interpreted as an indicator of a TP53 gene mutation.
In our cases, all high grade showed mutated status of TP53 gene. Hormone receptor testing showed no difference from the low-grade cases and is not useful in the differential diagnosis.
Also, all cases of both low-grade and high-grade serous carcinoma exhibited diffuse nuclear positivity with WT1.
А это было миллиард лет. Уже тогда, видимо, Лиз потерял все связи с Диаспаром. Казалось невозможным, чтобы Лиз выжил.
Figure 2. High-grade serous carcinoma of the ovary, HE, 40x, and p53 mutated, 40x The cases of carcinomas with glandular architecture, atypical cells and foci of squamous metaplasia were classified as endometroid carcinomas due to their resemblance to the endometrium 5 cases. The immunohistochemical profile of endometriod carcinomas is similar to that of benign endometrial tumors, presenting a positive reaction for cytokeratins and both estrogenic and progesterone receptors and different values of Ki67, depending on the aggresive character of the tumor.
In one case, the initial intraoperative diagnosis was cancer symptoms abdominal pain cyst, while extensive grossing for the final diagnosis cancer symptoms abdominal pain the presence of a small area of endometrioid carcinoma Figure 3. Figure 3. Endometrioid ovarian carcinoma and associated endometrioid cyst, HE, 40x A third histopathological category of ovarian epithelial tumors were the mucinous tumors, which represented 2.
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On gross examination, two cases showed cancer symptoms abdominal pain appearance and the rest were solid with dimensions between 6 and 14 cm.
In one case, cancer symptoms abdominal pain mucinous adenocarcinoma has shown an expansive pattern of development, without any stromal invasion and complex architecture, while the rest were infiltrative. Figure 4. The year-old patient who was diagnosed with this tumor had epiploic metastasis at admission. Because all bilateral or large mucinous ovarian tumors should be considered cancer symptoms abdominal pain dissemination until proven otherwise, immunohistochemical tests are cancer symptoms abdominal pain.
In our cases, three tumors turned out to be primary tumors, two were metastasis from a colorectal adenocarcinoma and one of them was a Krukenberg tumor metastasis from a gastric carcinoma. Figure 5. Primary mucinous ovarian adenocarcinoma, HE, 40x, and CK7 positive The Krukenberg tumor showed a specific pattern, with signet ring infiltrating tumoral cells, Ck20, CDx2 and CEA positive, but the diagnosis cannot be relied solely on histological and immunohistochemical pattern and it had to be confirmed by the clinical context.
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Krukenberg tumor, HE, x and CK20 positive, x Clear cell carcinomas are rare tumors and we only found two cancer symptoms abdominal pain that showed very different histological pattern: one had hobnail cell that protruded into the lumina, while the other showed clear cytoplasm.
The arhitecture was heterogenous in both cases, with tubular-cystic, papillary cores with cancer symptoms abdominal pain and solid area. The immunohistochemical tests are useful mainly for the differential diagnosis with serous and mucinous carcinoma.
Also, Ki67 had a high value in both cases, as these types of tumors are rather aggressive Figure 8. Figure 8. Clear cell carcinoma of the ovary - EMA positive, x, and Ki67 positive, x Discussions Malignant ovarian neoplasms are the seventh most common form of cancer diagnosed in the female population.
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Another important aspect of this cancer symptoms abdominal pain is the reduced symptomatology of the incipient stages. The main symptoms are abdominal pain, palpable abdominal mass, or vaginal bleeding, which are predominantly found in borderline and malignant tumors 8. In some cases, the rapid increase in size leads to torsion of the ovary and important pain. The screening for this pathology consists in several methods, such as: transvaginal ultrasonography with or without contrast, BRCA mutation cancer symptoms abdominal pain, or tumor marker dosing.
Utilitatea imunohistochimiei în diagnosticul carcinomului ovarian
An element of interest in this pathology is represented by risk factors still incompletely elucidated. The main process involved in pathogenic epithelial ovarian tumors is inflammation of the surface epithelium.
The inflammatory changes occurring at the time of ovulation and hyaline body formation cause alterations of epithelial cell DNA A positive correct diagnosis of the histological subtype is essential for therapy and follow-up. False negative results, that might come up intraoperatively, should be solved by extensive grossing of the surgical specimen.
In our study, only one case showed false negative result. Most cases of ovarian carcinoma will need immunohistohemical confirmation, especially the mucinous subtypes. Ovarian mucinous tumors represent a wide range of neoplasms, from benign to malignant, and are distinct from other histological and molecular ovarian epithelial tumor subtypes.
The assessment of ovarian mucosal tumors requires the correlation of clinical data, imaging aspects, contralateral ovary status, the presence or absence of intraperitoneal mucin and the macroscopic aspect of the appendix.