text stringlengths 0 5.79k |
|---|
TIL is a prognostic factor for TNBC treated with adjuvant chemotherapy [36]. Evidence is accumulating that TIL is also a predictive factor for neoadjuvant therapy in TNBC or HER2-positive tumors, but this is still insufficient to support use of TIL to determine the treatment strategy [3]. TIL may be evaluated using the... |
## FRQ5: how should PD-L1 be examined in invasive breast cancer? |
### PD-L1 examination in invasive breast cancer should be performed immunohistochemically using the companion diagnostic (CDx) for each target immune checkpoint inhibitor (ICI) |
Two ICIs, atezolizumab and pembrolizumab, are approved for unresectable/recurrent PD-L1-positive TNBC in Japan. To determine the indication for each ICI, PD-L1 should be examined immunohistochemically using the designated CDx: Ventana OptiView PD-L1 (SP142)® for atezolizumab and PD-L1 IHC 22C3 pharmDx Dako® (Code No. S... |
## FRQ6: what kind of cancer gene panel testing is available and what kind of material is needed for the test? |
### OncoGuide™ NCC Oncopanel System and FoundationOne® CDx have been approved in Japan (October, 2021) for cancer gene panel testing using pathological material. For accurate molecular diagnosis, quality management in the preanalytical step is most important. |
Slices from FFPE tissue are required for these tests. FFPE samples collected within 3 years, fixed for 6–48 h with 10% neutral buffered formalin solution, and containing tumor cells that are ≥ 30% of all nucleated cells are desirable to assure the quality of nucleic acids [41]. |
## Declarations |
### Conflict of interest |
Naoko Honma: Payment or honoraria for lectures (personal), Daiichi-Sankyo, Pfizer; Participation on an advisory board, Roche Diagnostics. Masayuki Yoshida: Consulting fees, Lilly Japan, Roche Diagnostics; Payment or honoraria for lectures (personal), Agillent technologies, Chugai, MSD, Ono, Daiichi-Sankyo; Rie Horii: G... |
## Footnotes |
## References |
8f6d56b4df1afbf0606410e814f759896a248b65aca78be35af8b21ce0c1be78 pmc10764572.txt |
PMCID: PMC10791336 |
TITLE: Solitary Fibrous Tumor of the Central Nervous System: A Report of Two Cases with Emphasis on Diagnostic Pitfalls |
LICENSE: This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
ABSTRACT: AbstractSolitary fibrous tumor (SFT) is a rare primary central nervous system neoplasm that usually presents as a dural-based mass. Awareness of the entity is limited by the rarity of the tumor which renders it prone to misdiagnosis. We present two cases of SFT located in the right parafalx and intraventricul... |
## 1. Introduction |
Solitary fibrous tumor (SFT) is a mesenchymal tumor of fibroblastic type showing a rich branching vascular pattern with a histopathological spectrum including tumors previously classified separately as meningeal solitary fibrous tumor and hemangiopericytoma (HPC) [1, 2]. The revised 4th edition of the World Health Orga... |
The initial cases of SFT were reported in the pleura, and subsequently, extrapleural cases have been identified in various locations, including the lung, pericardium, mediastinum, soft tissue, and central nervous system [7]. Central nervous system SFT has been reported in isolated reports throughout different areas suc... |
SFT needs to be distinguished from differentials, which are more common in this location which includes fibrous meningioma. The present study seeks to report on two cases of central nervous system SFT and discusses the radiopathological characteristics and potential diagnostic pitfalls. |
## 2. Case Reports |
### 2.1. Clinicoradiological Features |
#### 2.1.1. Case 1 |
A 57-year-old black female presented at the base hospital with a history of a constant headache that started three months after a pedestrian-vehicle accident (PVA). Her headache was associated with dizziness and an unsteady gait but lacked vomiting or seizures. The patient was a known hypertensive on treatment. On clin... |
#### 2.1.2. Case 2 |
A 22-year-old Asian male, presented at the base hospital complaining of blurred vision, headache, tinnitus, numbness of the face, and left hemiplegia. He had no contributory medical history. MRI revealed a right-sided macrolobulated, extra-axial, posterior parafalcine mass measuring 8.4 × 6.5 × 5.7 cm (Figure 2). A pre... |
### 2.2. Histopathological Findings |
In case 1, the tumor showed bland-appearing spindle cells, a collagenous background stroma, and prominent gaping thin-walled (staghorn) vessels. The spindle cells were arranged as short interlacing fascicles, sheets, and in areas showing storiform and patternless growth patterns (Figure 3). The neoplastic cells display... |
Case 2 tumor showed similar histopathological features in all three biopsies. The tumor was hypercellular with a diffuse growth pattern punctuated by staghorn vessels and limited background stroma (Figure 4). The tumor showed pleomorphic, round, and oval nuclei and conspicuous nucleoli. In addition, hemorrhage and hemo... |
### 2.3. Immunohistochemical Profile |
All the cases showed immunoprofile typical of soft tissue counterparts. The neoplastic cells showed STAT6, CD34, BCL-2, and CD99 positivity (Figures 3 and 4). The low-grade SFT (WHO grade 1) case showed diffuse and strong CD34 staining compared to the high-grade (WHO grade 2) case, which showed a patchy and weak staini... |
There was no immunoreactivity with epithelial membrane antigen (EMA), S-100 protein, cytokeratins (CK), progesterone receptor, synaptophysin, glial fibrillary acidic protein (GFAP), desmin, and smooth muscle actin (SMA) in both cases. Case two was also negative for HMB-45 and Melan A. The Ki-67 proliferation index was ... |
## 3. Discussion |
The identification of histopathological and immunohistochemical features of SFT is crucial for appropriate diagnosis of this entity. Central nervous system SFT is a rare neoplasm accounting for <1% of all primary CNS tumors and has undergone recent reclassification [1, 2]. The current terminology for SFT is now similar... |
SFT imaging features can resemble other more common CNS tumors such as meningiomas, schwannomas, dural metastasis, and primary dural lymphoma. At present, no specific features on CT or MRI can be used to distinguish SFT from meningiomas [13]. Pretreatment differentiation is essential as the behavior and treatment of th... |
Magnetic resonance imaging (MRI) is the imaging modality of choice. The CNS solitary fibrous tumors have an intermediate signal similar to the brain on T1. They are iso-to-hypo intense to the brain on T2 and may typically demonstrate a heterogeneous “yin yang” appearance of low and high signal intensity. Typically, avi... |
The solitary fibrous tumors may be difficult to differentiate from meningioma on imaging as they share common features such as the presence of a dural tail [1, 13]. Solitary fibrous tumors, however, rarely demonstrate calcifications and hyperostosis of adjacent bone [18]. Case 1 showed calcifications which also swayed ... |
On histopathology, SFT shows a range of phenotypes ranging from hypocellular to hypercellular phenotypes. The more classic hypocellular phenotype displays short spindle and oval-round cells arranged in a “patternless pattern” but occasionally arranged in fascicles, with alternating thick bands of hyalinized collagen an... |
The hypercellular phenotype is characterized by hypercellularity, with oval-round cells arranged in a haphazard pattern with minimal intervening stroma, and is considered malignant. These are generally treated by surgery and adjuvant radiotherapy [21]. Mitotic activity and necrosis are common, whilst calcifications are... |
SFT is typically diffusely positive for CD34, CD99, and STAT6. STAT6 immunohistochemistry has a very high specificity and sensitivity for detecting NAB2-STAT6 fusion and is considered a definitive marker of this entity [1, 3]. BCL2, EMA, SMA, and progesterone receptor positivity may rarely be identified as a focal find... |
Fibrous meningioma and myofibroblastoma need to be differentiated from hypocellular SFT [8, 25] whilst anaplastic and atypical meningioma may show histopathological features similar to hypercellular SFT [24]. Fibrous meningioma characteristically expresses EMA and is negative for CD34 and nuclear STAT6 expression. Meni... |
## 4. Conclusion |
In summary, we report here two rare cases of SFT in the central nervous system. The awareness of the existence of this tumor type, recent reclassification, and the differential diagnosis have relevance for neurosurgeons, radiologists, and pathologists. |
## Acknowledgments |
Open Access funding is enabled and organized by SANLiC Gold. |
## Data Availability |
The data supporting the conclusions of this study are found within the article and by consulting the works cited. |
## Ethical Approval |
The ethics approval for the study was provided by the Biomedical Research Ethics Committee of the University of KwaZulu-Natal (reference number: BCA535/16). |
## Conflicts of Interest |
The authors declare that they have no conflicts of interest. |
## References |
## Associated Data |
### Data Availability Statement |
The data supporting the conclusions of this study are found within the article and by consulting the works cited. |
b65c37a47aa5625418bd215cec9a036e8386a581bed863acb534d6b044261e44 pmc10791336.txt |
PMCID: PMC10899116 |
TITLE: The artificial intelligence-based model ANORAK improves histopathological grading of lung adenocarcinoma |
LICENSE: Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Com... |
ABSTRACT: AbstractThe introduction of the International Association for the Study of Lung Cancer grading system has furthered interest in histopathological grading for risk stratification in lung adenocarcinoma. Complex morphology and high intratumoral heterogeneity present challenges to pathologists, prompting the dev... |
## Main |
Lung adenocarcinoma (LUAD), the most common type of non-small cell lung cancer, is histologically characterized by distinct growth patterns: lepidic, papillary, acinar, cribriform, micropapillary and solid1 (Extended Data Fig. 1a). The proposed International Association for the Study of Lung Cancer (IASLC) grading syst... |
Computer-assisted approaches powered by artificial intelligence (AI) have been widely applied to histological image analysis7–11. While some studies have applied deep learning models to LUAD growth pattern classification12,13, automated IASLC grading by AI methods is yet to be explored. Moreover, previous deep learning... |
In this study, we developed an AI method to segment LUAD growth patterns at the pixel level using hematoxylin and eosin (H&E) whole-slide images (WSIs) (Fig. 1a and Extended Data Fig. 1b,c) and applied it to 5,540 diagnostic slides from 1,372 cases, spanning four cohorts: TRAcking non-small cell lung Cancer Evolution t... |
## Results |
### A hierarchical AI model for growth pattern quantification |
To spatially map complex growth patterns in LUAD, we developed ANORAK (pyrAmid pooliNg crOss stReam Attention networK), which encodes cross-stream interactions using a multi-order attention mechanism within convolutional neural networks14 (Fig. 1a and Extended Data Fig. 1b,c). Moreover, a pyramid pooling module (PPM)15... |
[TABLE] Patient demographics (all cohorts) |
Characteristic | TRACERx 421 | LATTICe-A | TCGA LUAD | DHMC |
Number of patients (diagnostic slides) | 206 (1,184) | 845 (3,979) | 178 (234) | 143 (143) |
Subsets and Splits
No community queries yet
The top public SQL queries from the community will appear here once available.