Help me! Help me! These things that I study, are things I'll never see. I've gotta think of every single thing, ' cause everything can look like anything!
domenica 10 novembre 2013
50 ways to diagnose a tumor
Divertente video sulle più improbabili diagnosi differenziali che vengono in mente quando si osserva un caso difficile!
Help me! Help me! These things that I study, are things I'll never see. I've gotta think of every single thing, ' cause everything can look like anything!
Help me! Help me! These things that I study, are things I'll never see. I've gotta think of every single thing, ' cause everything can look like anything!
sabato 2 novembre 2013
Cineforum 18/11/2013 - Hysteria
La Scuola di Specializzazione in Anatomia Patologica presenta:
Hysteria
di T. Wexler
con Hugh Dancy, Maggie Gyllenhaal, Felicity Jones, Rupert Everett e Jonathan Pryce.
La proiezione sarà preceduta da un intervento del dott. S. Orlando sull' evoluzione storica del concetto di isteria.
Nota: La proiezione sarà spostata a Lunedì 18 per motivi organizzativi.
Vi aspetto numerosi, ore 15, Auletta Seminari.
domenica 13 ottobre 2013
The Anatomist - by Bill Hayes
La storia dell' Anatomia di Gray, uno dei più famosi libri di anatomia umana in lingua inglese, attraverso i diari e le lettere di Henry Vandyke Carter, il misconosciuto autore del suo splendido corredo iconografico. Bill Hayes, con questo libro, non solo penetra nelle fibre più intime della vita di H.V. Carter ma, attraverso la dissezione in prima persona dei cadaveri, anatomizza anche la propria vita fino a scoprire le più profonde, e toccanti, connessioni fra i vivi e i morti.
What is past - the past - does not, or will it, detach itself and remain where it was (or where it might have been intended to have remained) but it must bring itself forward, and smilingly, or otherwise, present itself as an old friend.
(libro consigliato dal dr. F. Merolla)
Bibliografia:
Gray, Henry. Anatomy of the Human Body. Philadelphia: Lea & Febiger, 1918; Bartleby.com, 2000. www.bartleby.com/107/.
domenica 29 settembre 2013
International Society of Urological Pathology Consensus Conference on Renal Neoplasia
The International Society of Urological Pathology (ISUP) is the international professional organization dedicated to the subspecialty of urological pathology. [...] In 2011 the Society undertook to review all aspects of the pathology of adult renal malignancy through an international consensus conference [...]. The detailed decisions relating to the consensus conference are presented in 4 reports, included this issue of the journal.
Delahunt B, Egevad L, Montironi R, Srigley JR. International Society of Urological Pathology (ISUP) Consensus Conference on Renal Neoplasia: Rationale and Organization. Am J Surg Pathol. 2013 Oct;37(10):1463-8.
Srigley JR, et al The ISUP Renal Tumor Panel. The International Society of Urological Pathology (ISUP) Vancouver Classification of Renal Neoplasia. Am J Surg Pathol. 2013 Oct;37(10):1469-1489.
A 69-year-old man, with a history of renal cancer 11 years ago, presented with a 1 cm right lung nodule, which was investigated with fine-needle aspiration under computed tomography guidance. A, Cell block preparation shows tumor cells with pink cytoplasm. B, Higher magnification of tumor cells with pink cytoplasm and nuclei that are vesicular and hyperchromatic. C, Immunohistochemical analysis with RCC marker shows strong cytoplasmic reactivity. D, Pax 2 immunohistochemistry reveals strong nuclear staining, confirming a metastasis to the lung from a primary renal tumor.
Pax 2 and/or Pax 8 were considered to be the most useful markers in the diagnosis of a renal primary.
(from Tan PH, et al, Diagnostic and Prognostic Biomarkers)
P.S. Post n. 100!
P.S. Post n. 100!
lunedì 23 settembre 2013
Vessels of Stone: Lenin's "Circulatory Disturbance of the Brain"
Many have wondered what might have become of the totalitarian state Lenin founded on merciless terror, had he not died so young. He was 52 and at the height of his power when he had his first stroke. Six months later he had another and then a third stroke three months after that. He died 3 months shy of his 54th birthday with cerebral arteries so calcified that when tapped with tweezers at the time of his autopsy, they sounded like stone. The reason for his premature atherosclerosis has yet to be explained. He had a family history of cardiovascular disease and, therefore, is suspected of having had an inherited lipid disorder. Stress too might have had a role in the progression of his atherosclerosis. However, neither would explain the extent of the calcification of his cerebral arteries identified at post mortem examination. A recently described variant of the NT5E mutation might explain such calcification, as well as Lenin's family history of cardiovascular disease, and his premature cerebrovascular attacks.Vinters H, Lurie L, Mackowiak PA. Vessels of Stone: Lenin's "Circulatory Disturbance of the Brain". Hum Pathol. 2013 Feb 18.
On the morning of January 23, 1924, the pathologist Alexei Ivanovich Abrikosov was given a task to embalm Lenin's body to keep it intact until the burial. The body is still on permanent display in the Lenin Mausoleum in Moscow. (source Wikipedia)
(to note, Abrikosov has also described the so-called Abrikosov's tumor aka Granular cell tumor)
mercoledì 4 settembre 2013
Looking too closely at thyroid nodules
Endocrinologi e patologi sono certamente co-responsabili dell' incrementata incidenza dei tumori della tiroide. Troppi noduli vengono inviati all' agoaspirato, troppi pazienti subiscono un intervento chirugico e troppe neoplasie a differente comportamento biologico e clinico vengono riunite sotto la stessa terminologia. Un corretto studio clinico può certamente evitare inutili FNA che, talora, vengono utilizzati dai clinici anche in funzione "difensiva". Così come può essere limitata l' indicazione all' intervento chirurgico, applicando agli aspirati i criteri classificativi correnti. Ad esempio, la maggior parte delle citologie "atipiche" (AUS/FLUS) può essere risolta con la semplice ripetizione dell' aspirato (con un risultato il più delle volte di benignità). Diverso il discorso per le lesioni follicolari. Considerata l' incidenza piuttosto bassa del carcinoma follicolare siamo costretti, a causa dei limiti dell' FNA, a mandare consapevolmente molti adenomi follicolari all' intervento chirurgico. Le tecniche di biologia molecolare basate sui profili di espressione genica, aumentano il valore predittivo negativo dell' aspirato "indeterminato", ma non riescono a discriminare (ancora) meglio della morfologia le lesioni effettivamente maligne. Inoltre, sono costose e attualmente non applicabili alla routine clinica. Infine, carcinomi indolenti vengono ancora classificati insieme a quelli a comportamento aggressivo, i cosiddetti "real thyroid carcinomas". Molti carcinomi papillari, come è noto, hanno un comportamento "benigno", come testimoniano i numerosi incidentalomi scoperti nelle sezioni seriate di gozzi nodulari o nelle autopsie di pazienti deceduti per altre cause. Sforzi di correlazione clinica, morfologica e molecolare devono essere fatti per separare i tumori a basso potenziale dai veri carcinomi tiroidei, in modo da ottimizzare efficacemente il managment dei pazienti con patologia nodulare tiroidea.
Bibliografia.
lunedì 26 agosto 2013
Lepidic, a Canadian Neologism
In the new classification of adenocarcinomas, the term lepidic is defined as tumor cells proliferating along the surface of intact alveolar walls without stromal or vascular invasion.[...] This word is a neologism, a new word invented in Canada in the early 1900s [by] John George Adami, MD. [...] After studying in Manchester, Cambridge, Breslau, and Paris, Dr Adami arrived at McGill University in Montreal, Canada, in 1892. Adami was a prolific writer, and he first used the term lepidic in an address to the Toronto Pathological Society on January 4, 1902. In his lecture titled ‘‘Original Communication on the Classification of Tumors,’’ he proposed 2 new terms that would be used to classify all neoplasms. The term lepidic (from greek meaning a rind, skin, or membrane) was applied to tumors that appeared to be derived from surface-lining cells. The term hylic (from greek meaning crude undifferentiated material) was applied to tumors that appeared to be derived from connective tissues. [...]
[...] The terms lepidic and hylic underwent a subtle change in meaning. In Herbert Spencer’s Pathology of the Lung,6 published in 1962, he stated that tumors may grow into the surrounding alveoli ‘‘either filling them with a solid mass of malignant cells (a hilic [sic] growth) or lining their walls (a lepidic growth).’’ This is a minor alteration in definition; however, this is where the modern definition of tumor growth along intact alveolar septa arose. [...]
In the early 1990s the erroneous belief that the term lepidic came from the etymologic origin ‘‘butterfly’’ became prevalent. [...] Soon the term was stated to mean, ‘‘like a butterfly resting on a branch,’’ ‘‘resembling butterflies sitting on a fence,’’ ‘‘butterflies alighting on shrubbery,’’ ‘‘vague resemblance in cross-section to a butterfly,’’ and a reference ‘‘to the scales of the butterfly wing.’’ While these colorful and useful metaphors evoked both the microscopic morphologic appearance and the possible aerogenous mode of dissemination, they were unrelated to the source of the term. Lepidic did not have an entomologic etymology.
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John George Adami (left) first chair of pathology at McGill University (Montreal, Canada) and creator of the term lepidic. Lepidic pattern of adenocarcinoma, characterized by noninvasive surface alveolar growth of tumor cells (right).
(seen on http://timallenmdjd.blogspot.it/ via Twitter)
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