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Petersson F.,National University Hospital Singapore | Petersson F.,Charles University | Michal M.,Charles University | Franco M.,Federal University of Sao Paolo | Hes O.,Charles University
International Journal of Clinical and Experimental Pathology | Year: 2010

Sarcomatous transformation of chromophobe renal cell carcinoma (CRCC) is a well recognized phenomenon. Of the published cases with sarcomatous transformation of CRCC, none have shown liposarcomatous differentiation. Out of a cohort of 250 cases of CRCC, 19 (7.6%) showed sarcomatous differentiation. In one case (female, age 46 years), the sarcomatous component of the tumor displayed histological features of a pleomorphic liposarcoma. Light microscopic examination revealed a biphasic pattern with a chromophobe renal cell carcinoma(CRCC) and a high-grade sarcomatous component containing large pleomorphic lipoblasts. In several areas both components were intermingled. The conventional CRCC component showed classic histological features with calcifications, medium-sized polygonal cells arranged in solid-alveolar structures with raisinoid nuclei, pale-eosinophilic flocculent cytoplasm with perinuclear haloes. In addition, a microcystic-adenomatous component had luminal spaces filled with erythrocytes. The CRCC was positive with Halés colloidal iron-stain whereas the sarcomatous component was negative. The CRCC component was diffusely positive for cytokeratin 7, parvalbumin and racemase but negative for cytokeratin 20, vimentin, CD10, carboanhydrase IX and S100-protein. The pleomorphic liposarcomatous component displayed immunereactivity for CD10, vimentin, racemase and focally for carboanhydrase IX. The proliferative activity (Mib-1/Ki-67) was 5% in the CRCC and 30% in the pleomorphic liposarcomatous component. No immunereactivity for MDM2 or CDK4 was detected. This is the first reported case of a sarcomatoid CRCC where the sarcomatous component displayed features of a pleomorphic liposarcoma. The patient died from widespread metastatic disease 12 months after nephrectomy.

Theocharis I.P.,Primevision.gr | Lima L.H.,Federal University of Sao Paolo
Acta Ophthalmologica | Year: 2012

Purpose: To investigate the frequency and patterns of vitreoretinal adherence in central serous choroidopathy (CSC) using spectral domain optical coherence tomography (SD-OCT) imaging and compare them with normal subject. Methods: A descriptive observational analytical retrospective case-control study. The study patients were split into non-chronic and chronic CSC groups and compared with an age- and gender-matched control group composed of healthy individuals without CSC. Five patterns of vitreoretinal adherence were defined: lacunae, partial posterior vitreous detachment (partial-PVD), epiretinal membrane (ERM), focal vitreomacular adherence (VMA) and no recognizable pattern. Statistical analysis was performed. Results: One hundred and four eyes of 52 patients were included in this study. Forty-eight eyes of 24 patients had chronic CSC and 56 eyes of 28 patients had non-chronic CSC. The control group for chronic CSC included 96 normal eyes of 48 subjects, and the control group for non-chronic CSC included one hundred and twelve normal eyes of 56 subjects. We found a recognizable pattern of the vitreoretinal interface (lacuna, partial-PPV, VMA or ERM) more often in non-chronic CSC (p = 0.0001, OR = 6.51 and CI = 2.71-15.62) and in chronic CSC patients (p = 0.001, OR = 4.05, CI: 1.77-9.57) than in normal subjects. Conclusion: The proportion of patterns of vitreoretinal adherence and interface found in CSC changes with age and manifests differently compared with normal eyes. The results indicate early changes in CSC patients younger than 40 years of old bilaterally. © 2012 Acta Ophthalmologica Scandinavica Foundation.

Petersson F.,National University of Singapore | Petersson F.,Charles University | Michal M.,Charles University | Grossmann P.,National University of Singapore | And 6 more authors.
International Journal of Clinical and Experimental Pathology | Year: 2010

A 30-year-old male with no previous history of neoplastic disease presented with a 5 cm large testicular tumor. Routine histopathological examination and immunohistochemical investigation showed a classical seminoma with a contiguous 8 mm large nodule. The nodule was separated from the tunica albuginea by tubuli seminiferi showing intratesticular germ cell neoplasi not otherwise specified (NOS). The nodule was composed of spindle cells with low-grade nuclear atypia, nuclear and cytoplasmic S100 protein immunoreactivity in 15% of the cells and a proliferative activity of up to 20%. No other germ cell tumor components were found. To the best of our knowledge, we herein present the first tumor of a pure classical seminoma with an associated low-grade sarcomatous component.

Sampaio L.P.B.,University of Sfax | Caboclo L.O.S.F.,Federal University of Sao Paolo | Yacubian E.M.T.,Federal University of Sao Paolo | Manreza M.L.G.,University of Sfax
Pediatric Neurology | Year: 2010

This study assessed the prevalence rate of epilepsy and its causes in children and adolescents in one area of high deprivation in São Paulo, São Paulo, in Southeast Brazil. Between July 2005 and June 2006, 4947 families from a population of 22,013 inhabitants (including 10,405 children and adolescents between the ages of 0 and 16 years) living in the shantytown of Paraisópolis, were interviewed. In the first phase, a validated questionnaire was administered, to identify the occurrence of seizures. In the second phase, clinical history, neurologic examination, electroencephalography, and structural neuroimaging were performed. The diagnosis of epilepsy, including etiology, seizure types, and epileptic syndrome classification, was according to criteria of the International League Against Epilepsy. The screening phase identified 353 presumptive cases. In the second phase, 101 of these cases (33.8%) received the diagnosis of epilepsy. Crude prevalence of epilepsy was 9.7/1000 and prevalence of active epilepsy was 8.7/1000. Partial seizures were the most frequent seizure type (62/101). Symptomatic focal epilepsy was the most common form, and hypoxic-ischemic encephalopathy the most common etiology, reflecting the socioeconomic conditions of this specific population. Adequate public policies regarding perinatal assistance could help reduce the prevalence of epilepsy. © 2010 Elsevier Inc. All rights reserved.

Pallesen L.-P.,TU Dresden | Gerber J.,TU Dresden | Dzialowski I.,TU Dresden | van der Hoeven E.J.R.J.,St. Antonius Hospital Nieuwegein | And 92 more authors.
Journal of Neuroimaging | Year: 2015

BACKGROUND AND PURPOSE: The posterior circulation Acute Stroke Prognosis Early CT Score (pc-APECTS) applied to CT angiography source images (CTA-SI) predicts the functional outcome of patients in the Basilar Artery International Cooperation Study (BASICS). We assessed the diagnostic and prognostic impact of pc-ASPECTS applied to perfusion CT (CTP) in the BASICS registry population. METHODS: We applied pc-ASPECTS to CTA-SI and cerebral blood flow (CBF), cerebral blood volume (CBV), and mean transit time (MTT) parameter maps of BASICS patients with CTA and CTP studies performed. Hypoattenuation on CTA-SI, relative reduction in CBV or CBF, or relative increase in MTT were rated as abnormal. RESULTS: CTA and CTP were available in 27/592 BASICS patients (4.6%). The proportion of patients with any perfusion abnormality was highest for MTT (93%; 95% confidence interval [CI], 76%-99%), compared with 78% (58%-91%) for CTA-SI and CBF, and 46% (27%-67%) for CBV (P < .001). All 3 patients with a CBV pc-ASPECTS < 8 compared to 6/23 patients with a CBV pc-ASPECTS ≥ 8 had died at 1 month (RR 3.8; 95% CI, 1.9-7.6). CONCLUSION: CTP was performed in a minority of the BASICS registry population. Perfusion disturbances in the posterior circulation were most pronounced on MTT parameter maps. CBV pc-ASPECTS < 8 may indicate patients with high case fatality. © 2014 by the American Society of Neuroimaging.

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