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Gielen I.,Institute of Pathology and Genetics
Abdominal Imaging | Year: 2010

Imaging findings of amyloid infiltration of the greater omentum, mesentery, and retroperitoneal spaces have only extremely rarely been reported in the radiological literature. This report illustrates the MDCT findings fortuitously found in a 70-year-old male presenting with a known latent myeloma. Extra abdominal deposits-axilla and cardiophrenic angles-were first fortuitously found during thoracic MDCT. Secondary abdominal MDCT revealed the extensive abdominal spread that consisted of very diffuse but asymptomatic pseudo carcinomatous hazy omental, mesenteric and-in a minder proportion-retroperitoneal deposits; these remained isolated without calcification, lymphadenopathy, ascites, or any sign of associated bowel wall thickening. A specific definite histologic diagnosis was made without laparotomy through a biopsy in the right axilla. © 2008 Springer Science+Business Media, LLC.

Rubay R.,Clinique St Luc | Maldague P.,Clinique St Luc | Gielen I.,Institute of Pathology and Genetics
JBR-BTR | Year: 2016

We report a rare case of purely retrograde stenosing stricture of the sigmoid descending colonic junction fortuitously diagnosed during the waning of a failed virtual colonoscopy in a 69-year-old patient. The rather asymptomatic patient was addressed to investigate a positive fecal occult blood test. He had suffered a single acute colonic diverticulitis episode 19 years before. A contrast-enhanced abdominal CT and complementary focused abdominal ultrasound fully diagnosed a short curvilinear contrast-enhancing "scar-like" tissue infiltrating the posterior colonic wall and developing retractile adherences with the retroperitoneum of the left iliac fossa. The imaging features are presented with pathologic correlation. © 2016 The Author(s).

Parent M.,Institute of Pathology and Genetics
JBR-BTR | Year: 2016

Henoch-Schönlein purpura (HSP) is a form of immune complex-mediated leukocytoclastic vasculitis involving the skin and other organs. It primarily affects children. The occurrence of HSP in adults is rare, and gastrointestinal (GI) involvement is one of its most common clinical manifestations. The GI symptoms are caused by hemorrhage and edema within the bowel and wall mesentery. Complete recovery usually occurs, and life-threatening complications are rare. We report a typical case of GI involvement of the ileocecal area diagnosed with multidetector computed tomography (MDCT) and confirmed by skin biopsy. © 2016 The Author(s).

Nyiraneza C.,Catholic University of Louvain | Jouret-Mourin A.,Catholic University of Louvain | Kartheuser A.,Catholic University of Louvain | Camby P.,Catholic University of Louvain | And 4 more authors.
Human Pathology | Year: 2011

Although evidence suggests an inverse relationship between microsatellite instability and p53 alterations in colorectal cancer, no study has thoroughly examined the use of p53 immunohistochemistry in phenotyping colorectal cancers. We investigated the value of p53 immunohistochemistry in microsatellite instability-positive colorectal cancers prescreening and attempted to clarify the relationship between DNA mismatch repair system and p53 pathway. In a series of 104 consecutive colorectal cancers, we performed p53 immunohistochemistry, TP53 mutational analysis, DNA mismatch repair system efficiency evaluation (DNA mismatch repair system immunohistochemistry, microsatellite instability status, MLH1/MSH2 germ line, and BRAF, murine double minute 2, and p21 immunohistochemistry. Microsatellite instability high was observed in 25 of 104 colorectal cancers, with DNA mismatch repair system protein loss (24/25) and germ line (8/25) or BRAF mutations (8/25). p53 immunohistochemistry revealed 3 distinct patterns of expression: complete negative immunostaining associated with truncating TP53 mutations (P <.0001), diffuse overexpression associated with missense TP53 mutations (P <.0001), and restricted overexpression characterized by a limited number of homogenously scattered strongly positive tumor cells in 36.5% of colorectal cancers. This latest pattern was associated with wild-type TP53 and microsatellite instability high colorectal cancers (P <.0001) including all Lynch tumors (8/8), but its presence among 22% of DNA mismatch repair system-competent colorectal cancers decreased its positive predictive value (55.2% [95% confidence interval, 45%-65%]). It was also correlated with murine double minute 2 overexpression (P <.0001) and inversely with p21 loss (P =.0002), independently of microsatellite instability status. In conclusion, a restricted pattern of p53 overexpression is preferentially associated with microsatellite instability high phenotype and could, therefore, be of clinical use as signal for microsatellite instability analysis in a large-scale tumor screening. Its association with concomitant murine double minute 2 overexpression suggests an alternative mechanism of p53 pathway deregulation. © 2011 Elsevier Inc. All rights reserved.

Catteau X.,Institute of Pathology and Genetics | Simon P.,Erasmes University Hospital | Vanhaeverbeek M.,Free University of Colombia | Noel J.-C.,Free University of Colombia
PLoS ONE | Year: 2013

In breast carcinoma, the stromal loss of CD34 expression and acquisition of SMA myofibroblastic features may constitute a prerequisite for tumor invasiveness. However, this hypothesis remains controversial, with some authors describing the loss of CD34 fibrocytes in the absence of SMA myofibroblastic-like cells in the stroma of invasive carcinoma. Others have also described the disappearance of CD34 fibrocytes from in situ carcinoma. To clarify this issue, we compared the distribution of CD34 fibrocytes and SMA reactive myofibroblasts between stromal areas of tumor-free mammary tissue, ductal carcinoma in situ (DCIS) and invasive ductal carcinoma (IDC). In addition to 28 IDC, 300 normal duct-lobular units and 600 ducts with DCIS (158 low-grade, 266 intermediate, and 176 high-grade) were scored. The relationships between staining patterns and different histological features (grade of DCIS and presence or absence of necrosis) were compared. Loss of CD34 expression and acquisition of SMA expression were more frequent in high-grade in situ lesions than in intermediate and low-grade lesions (p<0.001). When necrosis was found in association with grade 2 or 3 DCIS, the decrease in CD34 expression was higher than in lesions without necrosis and that independently of the grade of DCIS (p<0.05). Necrosis did not appear to play a significant role in the expression of SMA (p = 0.35). In all cases, the stroma of invasive carcinomas showed a complete loss of CD34 fibrocytes. Future research on both CD34 fibrocytes and mechanisms stromal changes are essential in the future and may potentially lead to new treatment approaches. © 2013 Catteau et al.

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