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PubMed1983

Use of immunofluorescence, Gram's staining, histologic examination, and seroagglutination in the diagnosis of porcine colibacillosis.

An indirect fluorescent antibody (IFA) test of ileal impression smears for K88, K99, and 987P pilus antigens was compared with histologic examination and seroagglutination of Escherichia coli isolates for efficacy in determining colibacillosis in pigs. Histologic examination appeared to be more effective than the IFA test in revealing colonization of the ileum by bacteria. However, histologic examination revealed little about the nature of the colonizing bacteria. Correlation between bacterial adherence, as observed in histologic sections of ileum, and the presence of bacteria with adherence pili, as determined by IFA testing, was 91%. Results of seroagglutination for pilus antigens correlated with results of histologic examination in only 84% of the cases. Pilus antigens were not identified by IFA testing or seroagglutination in 5% of the cases in which adherent bacteria were observed in histologic sections of the small intestine. Because little preparation time was required for the IFA test, results were available within 2 hours of necropsy. In contrast to histologic examination, the IFA test made possible identification of the colonizing organism as E coli and revealed the type of pilus antigen present. Adherence pili were identified more frequently by IFA testing than by seroagglutination. Examination of Gram's-stained ileal impression smears was useful in screening for colibacillosis in pigs. Bacterial adherence was found in positive correlation with the number of gram-negative bacilli observed. Bacterial adherence rarely was observed in histologic sections of ileum when smears contained less than or equal to 10 gram-negative bacilli/1,000 X microscopic field. Each diagnostic test compared offered advantages and disadvantages over the other tests. Seemingly, concurrent use of several of these tests, rather than one, should be used in the diagnosis of porcine colibacillosis.

Agglutination Tests↗
PubMed1995

An interactive histology image-barcode manual for a videodisc image library.

UNLABELLED: Cell Biology and HISTOLOGY (alias Microanatomy, alias Microscopic Anatomy) is a required course for first-year medical and dental students in most health science centers. The traditional approach used in teaching this discipline is to present photomicrographic images of structures to students in lecture using 35 mm slides of fields seen through the microscope. The students then spend many hours viewing and studying specimens of tissues using a light microscope in a laboratory setting. Students in traditional courses of histology spend an inordinate amount of time learning the component structures by attempting to find and identify them in tissue sections using a microscope, where the structure being sought is surrounded by a multitude of other structures with which they are also not familiar. With the recent availability of videodisc stored image libraries of histological samples, it is now possible to study histological principles without the use of the microscope as the primary learning tool. A videodisc entitled " HISTOLOGY: A Photographic Atlas" by S. Downing (published by Image Premastering Services Limited, Minneapolis, MN, 1991) has been incorporated into our histology course. Fifteen videodisc player stations are provided for 150 students. Images are retrieved by students using a bar code scanner attached to a videodisc player (Pioneer CLD-2400). Using this kind of image library, students can now learn basic histological structure, such as cell and tissue types, without the use of a microscope or as a tool for facilitating microscopy. The use of a videodisc library of randomly accessible images simplifies learning the basic components which all organs are composed of by presenting the learner with clear-cut examples to avoid confusion with other structures. However, videodisc players and TV monitors are still not appropriately priced for every student to own. This presents a problem in that the same images studied in class are not available to study and review outside of class. There is a need for resources for additional study outside of the institutional setting, for students to have and interact with to reinforce the learning experience in the teaching laboratory. A hard copy manual was created and is being used in our course; it incorporates photos captured from the videodisc. The images displayed in the manual are chosen to give the student one example of each histological component. Additional labeling is added to the images, and each image is accompanied by a bar code that may be used at a videodisc player with a bar code reader to retrieve the same color image from the disc displayed in larger format on a TV monitor. Each topic in the manual is accompanied by learning objectives and a statement of clinical relevance. Following the presentation of the images in each section of the manual, the students are encouraged to practice by viewing multiple examples of each structural component presented in the lesson. They can do this by using the bar-coded catalog supplied with each disc. The presentation of each topic concludes with a quiz composed of questions about images that the student can retrieve from the videodisc using barcodes in the text of the manual. Some of the images on the quiz are printed in miniature in the manual to provide the student with an opportunity for personal review at home when hardware to obtain and display images from a video disc is not available. This manual provides an answer to the dilemma faced by the learner when access to hardware is not available; reinforcement is therefore facilitated outside the teaching laboratory. This allows learning to continue outside of the classroom, using the same materials. (abstract truncated)

Computer-Assisted Instruction↗
PubMed1999

Central neurocytoma: histologic atypia, proliferation potential, and clinical outcome.

BACKGROUND: Although central neurocytomas are considered benign, recent reports suggest that some patients with histologic atypia and/or elevated proliferation potential may have a poor outcome. METHODS: A retrospective review identified 15 cases of central neurocytoma. Clinical follow-up was available for 14 patients. Each tumor was evaluated for the presence of atypical histologic features, including cellular pleomorphism, endothelial proliferation, and necrosis. The proliferation potential was assessed by MIB-1 immunohistochemistry. The correlation among histology, MIB-1 labeling index (MIB-1 LI), and clinical outcome was evaluated. RESULTS: Histologic atypia was identified in 3 tumors (20%). The MIB-1 LI ranged from 0.1% to 6.0%, and 5 cases (33%) had an MIB-1 LI >2%. The correlation between histologic atypia and MIB-1 LI was poor, with only 1 tumor having both atypia and MIB-1 LI >2%. Clinical follow-up ranged from 13 to 255 months postoperatively (mean, 68 months). Although most patients were alive and well at last follow-up, three developed symptomatic recurrence and one died as a result of increased tumor growth. The tumors from all 4 patients with a poor outcome had MIB-1 LI >2%, but only 1 had histologic atypia. CONCLUSIONS: The proliferation potential of central neurocytoma is a useful predictor of clinical outcome, whereas histologic atypia alone is not prognostically significant. It would be appropriate to recognize a subgroup of central neurocytomas with elevated proliferation potential as WHO Grade 2 lesions. The terms "atypical" and "anaplastic" are not appropriate to describe these lesions, as they imply a certain histologic appearance. The most accurate designation would be "proliferating neurocytoma."

Adult↗
PubMed1990

Correlation between histologic grade of malignancy and copy number of c-erbB-2 gene in breast carcinoma. A retrospective analysis of 176 cases.

A system of histologic grade of malignancy in human breast carcinoma was devised by significantly modifying the way of evaluating number of mitoses and architectural atypia in the histologic grading of Bloom and Richardson. The modified grading system was applicable to all histologic subtypes of adenocarcinoma and showed a good association with prognosis of breast carcinoma patients in retrospective analysis of 176 consecutive surgical cases (P less than 0.0001). Of the three components of histologic grade, architectural atypia and number of mitotic figures independently had a significant effect on the prognosis. The copy number of c-erbB-2, a prognostic factor independent of tumor size and nodal status, was strongly correlated with the histologic grade, number of mitotic figures, and degree of nuclear atypia (P less than 0.001, each). Cox's regression model analysis showed that nodal status and histologic grade were two determinants of prognosis, and the independent effect of c-erbB-2 amplification was absorbed within that of the histologic grade. Although the importance of c-erbB-2 gene copy number seemed to be inferior to that of the histologic grade, both were shown to be strongly associated with the aggressiveness of the tumor itself rather than the extent of tumor spread.

Breast Neoplasms↗
PubMed2001

Predictive value of grade for metastasis development in the main histologic types of adult soft tissue sarcomas: a study of 1240 patients from the French Federation of Cancer Centers Sarcoma Group.

BACKGROUND: Histologic grade is said to be the most important prognostic factor in adult soft tissue sarcomas (STS), but most grading systems have been tested in the overall sarcoma group and the predictive value of histologic grade needs to be assessed specifically for each of the histologic categories. METHODS: From 1980 to 1994, 1240 nonmetastatic patients were entered in the French STS database. The following parameters were studied: patient's age and gender, previous history, tumor location, size and depth, neurovascular or bone involvement (NBI), histologic type and subtype, and grade (the French Federation of Cancer Centers [FNCLCC] system). Median follow-up for the survivors was 88 months; only 5% of patients were lost to follow-up. The authors performed univariate and multivariate analyses for metastasis-free survival for the overall sarcoma group and for every main histologic type. RESULTS: In order of importance, parameters were respectively retained as independent predictors of metastasis as follows: grade, tumor size, NBI and tumor depth for the overall group, grade and NBI for malignant fibrous histiocytomas (n = 349), tumor size, histologic subtype and grade for liposarcomas (n = 188), NBI, grade and tumor size for leiomyosarcomas (n = 148), grade and NBI for synovial sarcomas (n = 125), grade for unclassified sarcomas (n = 140), and sarcomas of other types (n = 158). No parameter was significant for malignant schwannomas (n = 72) or for rhabdomyosarcomas (n = 60). CONCLUSION: In this study, histologic grade appeared as an independent predictor of metastasis development in the main histologic types of adult STS, with the exception of malignant schwannomas and rhabdomyosarcomas.

Adolescent↗
PubMed2005

The prognostic impact of histology and 1p/19q status in anaplastic oligodendroglial tumors.

BACKGROUND: It has been reported previously that the combined loss of chromosomal arms 1p and 19q is a significant predictor of outcome for patients with anaplastic oligodendroglial (AO) tumors and that such chromosomal loss correlates with classic histology in AO. The authors sought to determine whether histology was an equivalent or superior predictor of outcome compared with 1p/19q status in 131 patients with AO tumors. METHODS: The status of 1p and 19q was determined using real-time, quantitative polymerase chain reaction analysis and/or fluorescence in situ hybridization. Clinical features (response to adjuvant therapy and tumor location) and molecular genetic abnormalities (9p and 10q deletions, overexpression of p53 and epidermal growth factor receptor) were determined on available specimens. Histologic assessments for classic oligodendroglial features were performed by five neuropathologists. RESULTS: Classic histology was associated closely with 1p/19q loss, as reported previously. Patients who had tumors that were considered classic by at least four of the five neuropathologists showed significantly increased progression-free and overall survival compared with the patients who had less classic tumors. The authors also tested the correlation between 1p/19q status and outcome in subsets of patients stratified according to classic tumor features. The association of 1p/19q status with survival was related closely to the presence of classic histology. Loss of 1p/19q was predictive of improved outcome only among patients who had tumors with classic histologic features. CONCLUSIONS: The current results suggested that, in addition to 1p/19q status, histologic features contribute information to the prediction of outcome in patients with AO. Loss of 1p and 19q appeared to be a prognostic marker only in the subset of patients who had AO tumors with classic histologic features.

Base Sequence↗
PubMedDate not supplied

Lymph node metastasis in squamous cell carcinoma of the oral cavity: correlation between histologic features and the prevalence of metastasis.

A retrospective study was made of the correlation between preoperative clinical or histologic findings and the prevalence of lymph node metastasis in 60 patients with squamous cell carcinoma of the oral cavity who had histologically confirmed neck metastasis. Of these 60 patients, 39 with clinically N+ necks underwent immediate therapeutic neck dissection, and 21 whose necks were initially N0 but progressed to N+ during observation underwent subsequent therapeutic neck dissection. The primary site, TNM staging, histologic grade of malignancy of biopsy specimen, and location and number of histologically positive lymph nodes were reviewed in each case. The results were as follows: (1) The prevalence of neck metastasis was not significantly correlated with primary site and T stage; however, there was an apparent correlation between histologic grade of malignancy and the prevalence of neck metastasis. Patients with grade I-II histologic malignancy showed limited metastases that involved lymph nodes in levels I-II. On the other hand, patients showing grade III-IV histologic malignancy often had metastases that extended beyond level III, regardless of T stage. These results suggest that histologic grade of malignancy, as well as clinical features, must be taken into consideration when deciding whether supraomohyoid neck dissection is indicated. (2) The group that underwent subsequent neck dissection exhibited less advanced neck metastasis and a better prognosis than the group which underwent immediate neck dissection. These findings show that if they are closely followed up, it is possible to delay neck dissection in N0 patients until a neck metastasis is detected.

Adult↗
PubMedDate not supplied

The application of a numerical scoring system for evaluating the histological outcome in patients with chronic hepatitis B followed in long-term.

A numerical scoring system was applied and compared with conventional histological classification to assess the histological outcome in 42 patients with chronic hepatitis B followed for 16 to 162 months (mean = 75 months). Four histological categories in the biopsies were assessed and scored: (i) piecemeal necrosis; (ii) lobular necrosis; (iii) portal inflammation, and (iv) fibrosis and cirrhosis. The sum of all four categories was defined as the "Histological Activity Index." Altogether, 102 liver specimens, including 2 to 4 repeats from each patient, were investigated. A good correlation was noted between a high value of the Histological Activity Index score and several liver histology as monitored by conventional terminology for chronic hepatitis. Among patients with HBeAg persistence, 8 of 14 (57%) deteriorated during follow-up as judged by an increase in the Histological Activity Index score compared to 3 of 13 (23%) of the patients with HBeAg seroconversion (0.5 less than p less than 0.1). Piecemeal necrosis has been postulated to be a predictive marker for the eventual development of cirrhosis. Here, we found that a low score for piecemeal necrosis in the initial liver biopsy was significantly less predictive of a high fibrosis score in the follow-up biopsy than was a high score for initial piecemeal necrosis (p less than 0.001). It is concluded that the scoring system used can be applied to monitor the histological long-term follow-up, especially when separated into its four constituent categories. It also offers a means of predicting a chronic hepatitis outcome.

Adult↗
PubMed1978

Steroid hormone receptor characterization of several histologic variants of a rat prostatic adenocarcinoma.

Several histologic variants of the transplantable R-3327 prostatic adenocarcinoma carried in male Copenhagen rats have been characterized and the histologic types have been correlated with steroid hormone receptor content. One type is clearly an adenocarcinoma; this tumor is hormonally responsive and contains substantial amounts of both androgen and estrogen receptors. In contrast, another histologic type, a fibrosarcoma, is hormonally nonresponsive and does not contain either receptor. A third histologic variant is classified as a carcinosarcoma and contains histological elements of both adenocarcinoma and fibrosarcoma and is also hormonally responsive. This tumor contains lower receptor levels than the adenocarcinomas but more than the fibrosarcomas. The androgen receptor appears to be identical in the different histologic forms of the tumor: the sedimentation coefficient is 7.8S and the dissociatiln constant for methyltrienolone is 4 x 10(-9) M. Similarly, the estrogen receptor from the different histologic forms of the tumor has a sedimentation coefficient of 8.3S and the dissociation constant for estradiol is 7 x 10(-10) M. These findings clearly distinguish the cytosol binding macromolecules from plasma binding proteins, and classify them as steroid hormone receptors. Further, rat serum was devoid of androgen and estrogen binding in the 8S region. Normal prostate tissue from Copenhagen rats contained low levels of an androgen receptor, but no estrogen receptor. It is possible that during growth and/or passage of the R-3327 tumor, the hormonally responsive adenocarcinoma cells do not survive and there is a gradual emergence of the nonresponsive fibrosarcoma. If, as we suspect, the receptors are found in the epithelial cells and not the stromal cells, there clearly should be considerable variation of receptor content in the different intermediary histologic forms of the tumor.

Adenocarcinoma↗
PubMed1998

Histology corresponding to mildly dyskaryotic smears--a study of 190 laser cone biopsied patients.

OBJECTIVES: The aim of the study was to evaluate the histological outcome of laser ring biopsies in patients with one or more smears showing cytological mild dyskaryosis where punch biopsies were not performed. The possibilities of predicting histological findings of CIN 2 and CIN 3 were analyzed. METHODS: The study comprised 190 laser ring biopsied patients with mildly dyskaryotic smears. Eighty-five patients were excluded from the initial 275 because of up- and downgrading of smears. Conization specimens and smears were reviewed by an experienced histopathologist and two experienced cytotechnicians. The histological findings were correlated to smear findings. RESULTS: Histologically, CIN 2 was found in 60 and CIN 3 in 45 patients (31 and 24%, respectively). The incidence of histological CIN 3 was higher in those with two or more mildly dyskaryotic smears and in those dyskaryotic smears lacking koilocytic change. Mildly dyskaryotic smears without endocervical cells indicated higher incidence of histological CIN 3. The fact that 36 of 96 CIN 2 and 3 lesions (38%) involved only 3 mm or less of the mucosa might be one important explanation for the absence of representative cells in the corresponding smears. CONCLUSIONS: Our study has shown that a mildly dyskaryotic smear is a strong indicator of CIN 2-3 histologically, especially in those cases without koilocytic cells and in those with repeatedly abnormal smears. The importance of inadequate sampling is indicated by higher incidence of histological CIN 3 in those with less than optimal smears. These findings are some of the factors to be taken into account when planning treatment strategies for this group of patients.

Adult↗
PubMed1989

The predictive value of chorionic villus histology for identifying chromosomally normal and abnormal spontaneous abortions.

To evaluate the significance of placental histology, a collaborative histological and cytogenetic study on the products of 123 spontaneous abortions of 6-19 week pregnancies was performed. From each sample, 2-3 g was dissected randomly and analysed histologically with no prior knowledge of the karyotype. Chromosomes were prepared from the remaining chorionic villi after an overnight incubation in culture medium; they were analysed by Q- or G-banding. The frequency and type of chromosome anomalies detected are comparable to those seen in other studies. Altogether, 49.6% were chromosomally abnormal, trisomies predominating (49.2%), followed by polyploidy (27.9%) and monosomy X (14.5%). The histological classification failed for technical reasons in 11 cases (8.9%). To classify the remaining cases, 18 different histological criteria were considered independently by two pathologists. A definite diagnosis was not possible for 27 abortions (22.0%), and 50 were classified as being chromosomally abnormal. This proved to be correct in 36 (72.0%), but incorrect in as many as 14 (28.0%). No evidence for an abnormal karyotype was found histologically in samples from 35 abortuses. Nevertheless, 9 of them (25.7%) had an abnormal karyotype. The predictive value of chorionic villus histology seems to be inadequate, as only 62 of 112 samples were correctly classified by histology (55.4%). The value differs little from the a priori probability of an abnormal or normal karyotype in abortuses of corresponding gestational ages.

Abortion, Spontaneous↗
PubMed1991

Detection of bone marrow infiltration by non-Hodgkin's lymphoma--comparison of histological findings, analysis of gene rearrangements, and examination by magnetic resonance imaging.

The histological examination of bone marrow specimens is one of the standard procedures in staging non-Hodgkin's lymphoma. To investigate the validity of a conventional unilateral iliac crest biopsy, we performed a prospective study comparing histological findings with analysis of gene rearrangements in bone marrow samples and magnetic resonance imaging of bone marrow. Twenty-seven consecutive patients with non-Hodgkin's lymphoma (ten with high grade, seventeen with low grade) were studied. In twelve patients, histological examination revealed bone marrow infiltration. Results of histology and magnetic resonance imaging were discordant in three of the twenty-seven patients. With magnetic resonance imaging, suspected infiltration was found in two patients without histological evidence for bone marrow involvement in the disease. In one patient, an infiltration was described by histology but MRI revealed no pathological findings. In this case, DNA analysis confirmed bone marrow infiltration by detection of a clonal rearrangement of the immunoglobulin heavy chain gene. Analysis of gene rearrangements was performed in ten patients. As examined by histology, five of them had bone marrow involvement in the disease and five had not. In all these cases, analysis of gene rearrangements confirmed the histological findings. Our data show that, despite the small volume of bone marrow specimens, the sensitivity of an iliac crest biopsy seems to be high in staging non-Hodgkin's lymphoma.

Adult↗
PubMed2006

[Histological examination following adenoidectomy and tonsillectomy in children. Surprising results are very rare].

BACKGROUND: The histological examination of lymphatic tissue resected in children during adenoidectomy or tonsillectomy has to be considered as a screening method. Its purpose is to detect rare diseases that differ from "chronic inflammation" or "lymphatic hyperplasia". That this examination is economically reasonable in relation to the frequency of surprising results with therapeutic consequences is doubtful. The aim of this study was to define the frequency of surprising or clinically relevant results in histological reports following adenoidectomy and/or tonsillectomy in children. METHODS: From both 1999 and 2004, 200 patients were identified, 10 years old or less, who underwent adenoidectomy/tonsillectomy due to recurrent throat infections or stenotic symptoms of the upper airways or upper swallowing path. The histological reports on these 400 children were evaluated. RESULTS: At the date of surgery, the median age was 4 years. In 140 children, an adenoidectomy-tonsillectomy was performed, 26 underwent tonsillectomy alone and 234 adenoidectomy alone. No reports with a histological diagnosis other than "lymphatic hyperplasia" or "chronic tonsillitis" were found. DISCUSSION: A histological report that is surprising or might influence the further treatment of the patient is rare. From the literature, an unusual diagnosis in children occurs in less than 1 per 1,000. The routine histological examination of adenoidectomy/tonsillectomy tissue cannot nowadays be economically justified. On the other hand, the ethical aspects of the abolition of this inefficient but established method should be discussed. If routine histological examination is abandoned, the surgeon would be responsible for the decision of whether a histological examination is necessary for each individual case (asymmetry of tonsils, extraordinary cervical lymph node status, striking history e.g.).

Adenoidectomy↗
PubMedDate not supplied

Determination of stent stenosis: an in vivo experimental comparison of intravascular ultrasound and angiography with histology.

PURPOSE: To compare intravascular ultrasound (IVUS) and angiography with histology in determining the degree of stent stenosis in an in vivo experiment. METHODS: In 16 sheep, a total of 64 stents were implanted into the external iliac arteries. Two stents were inserted on either side. Patency was followed by angiography and IVUS. Four types of stent were used: two Dacron-covered (Cragg Endopro and heparinized Cragg Endopro) and two noncovered (Cragg and Memotherm stents). Eight animals were killed after 1 month, eight others after 6 months. Histological sections were prepared from the stented vessels. Measurements of the patent and total stent diameters determined by IVUS, angiography, and histology were compared. RESULTS: Correlation between IVUS and angiography was 0.75, between IVUS and histology 0.77, and between angiography and histology 0.85. A mean stent stenosis of 17 +/- 11% (range 0-51%) was found on angiography, of 10 +/- 11% (0-46%) on IVUS, and of 20 +/- 11% (4%-49%) on histology. In comparison with histology, IVUS underestimated the degree of stenosis by 10 +/- 8%, and angiography underestimated it by 3 +/- 6%. Resolution of IVUS was calculated to be about 0.35 mm and that of angiography to be about 0.15 mm. CONCLUSION: Under experimental conditions, IVUS was not superior to angiography in determining the degree of stent stenosis in long-segment stenoses of iliac artery stents, when measurements were correlated with histology. Angiography is sufficient for following the patency of iliac artery stents.

Angiography↗
PubMed1999

Relationship between Helicobacter pylori infection and histologic features of gastritis in biopsy specimens in gastroduodenal diseases, including evaluation of diagnosis by polymerase chain reaction assay.

We investigated the relationship between Helicobacter pylori infection and the histologic features of gastritis in gastroduodenal disease, and evaluated the diagnostic usefulness of the polymerase chain reaction (PCR) assay for the detection of H. pylori before and after eradication therapy. Endoscopic biopsy specimens from 81 patients with gastroduodenal disease were examined for the presence of H. pylori by culture and histologic examination. Histologic features of gastritis were classified according to the updated Sydney System, and results of the PCR assay were compared with those of histologic examination, using histologic scores. The density of H. pylori was significantly correlated with polymorphonuclear neutrophil activity and chronic inflammation. These findings suggest that the grades of infiltration of polymorphonuclear neutrophil cells and chronic inflammatory cells correspond to the density of H. pylori infection assessed by the updated Sydney System. Patients with positive results on PCR assay and negative results on histologic examination may have a low density of H. pylori because of severe atrophy in the gastric mucosa. Differences in results for the PCR assay and histologic examination were found in 2 of 12 patients in the detection of H. pylori after eradication therapy. According to the results of the PCR assay and histologic features before and after eradication, the gastric tissue-based PCR assay for H. pylori after eradication may be too sensitive to judge successful eradication of H. pylori.

Adolescent↗
PubMed2000

Predictive value of histology at the invasive margin in the prognosis of early invasive colorectal carcinoma.

To accurately select patients with malignant colorectal polyps who are at high risk of adverse outcome, we examined the predictive value of clinicopathological factors, with special attention paid to the histology at the invasive margin. We examined 75 submucosal carcinomas from 75 patients, initially resected by polypectomy, including endoscopic, trans-anal, trans-sacral, and trans-sphincteric local excision. The associations between clinicopathological features such as sex and age; tumor size, location, shape, depth of submucosal invasion, vascular invasion, histology at the central part, and histology at the invasive margin; and the presence or absence of a residual adenomatous component and adverse outcome were examined by univariate and multivariate logistic regression analyses. Lymph node metastases were found in 2 patients, local recurrence in 4, and distant metastases in 2. Univariate logistic regression analysis showed that unfavorable histology at the invasive margin was significantly associated with lymph node metastasis or local recurrence (P = 0.0373), whereas the association of lymphatic invasion and vascular (lymphatic or venous) invasion with lymph node metastasis or local recurrence had marginal significance (P = 0.0785; P = 0.0990). Multivariate logistic regression analysis, with unfavorable histology at the invasive margin and lymphatic invasion as independent variables, showed that unfavorable histology alone had significance (P = 0.0373) in predicting adverse outcome. Widely accepted criteria such as massive submucosal invasion, positive vascular invasion, and poorly differentiated histology, were less useful in predicting adverse outcome. These results suggest that unfavorable histology at the invasive margin is a useful risk factor for predicting lymph node metastasis or local recurrence in patients with malignant colorectal polyps.

Adult↗
PubMed1990

Histologic sampling requirements in ovarian carcinoma: a review of 51 tumors.

In a review of 29 serous and 22 mucinous adenocarcinomas of the ovary, we quantitated the various histologic patterns seen in these neoplasms in order to document histologic variability and assess current anecdotal recommendations (one section per 1-2 cm of maximum tumor diameter) for adequate histologic sampling of epithelial ovarian neoplasms. Mucinous carcinomas showed more histologic variation than serous carcinomas, but both showed substantial portions with benign or borderline histology in many neoplasms. One serous and one mucinous carcinoma were likely to have been classified as borderline tumors if only current sampling recommendations had been followed. The remaining adenocarcinomas were adequately sampled by current standard practice. The two tumors in question had unusual clinical and histological features which prompted additional sampling. Caution is particularly warranted when initial frozen section sampling shows features of borderline tumor histology or low grade epithelial atypia, especially in mucinous epithelial neoplasms where histologic variability is greatest.

Adenocarcinoma, Mucinous↗
PubMed1992

Outcome of conservative therapy for invasive breast cancer by histologic subtype.

Between 1977 and 1986, 879 patients with Stage I and II breast cancer underwent excisional biopsy, axillary dissection, and radiation. Median follow-up was 61 months (range 2-159 months). The patients were divided into seven groups based on histologic subtype: (a) 368 patients with both infiltrating and intraductal ductal carcinoma, (b) 389 infiltrating ductal carcinoma, (c) 41 infiltrating lobular carcinoma, (d) 23 combined infiltrating ductal and lobular carcinoma, (e) 28 medullary carcinoma, (f) 12 colloid carcinomas, and (g) 18 tubular carcinomas. Significant differences in clinical T status, pathologic nodal involvement, administration of chemotherapy, estrogen receptor positivity, progesterone receptor positivity, and age were observed between some histologic subgroups. Tubular and colloid carcinomas were more likely to present with T1 lesions, hormone receptor positivity, and node negative status than the other histologic subtypes. Most medullary carcinomas were hormone receptor negative and were younger than 50 years old. Infiltrating lobular carcinoma patients were more frequently lymph node negative, older, node negative, and estrogen receptor positive compared to the other groups (except for tubular and colloid patients). Differences in the administration of chemotherapy primarily reflected differences in lymph node involvement. Location of the tumor in the breast and menopausal status did not correlate with histologic subtype. There were no significant differences in 5-year actuarial overall survival, cause-specific survival, or relapse-free survival between the histologic categories. In addition, patterns of first failure were not significantly different among the histologic groups in terms of local-only first failure, any local component of first failure, regional-only first failure, or any regional component of first failure. There was, however, a difference among the seven groups in distant metastasis-only at first failure with invasive ductal carcinomas having the highest rate. Despite this difference, histologic subtype had no impact on survival. The site of in-breast failure relative to the location of the original tumor was not significantly different between groups. The histologic subtype of invasive breast cancer is not an independent risk factor in predicting survival or pattern of failure. Conservative surgery and radiation therapy is effective treatment of ductal, lobular, medullary, colloid, and tubular invasive breast cancer.

Adenocarcinoma↗