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Showing PubMed Articles 1–25 of 233 from Der Pathologe
Thyroid-like follicular carcinoma of the kidney : A separate tumor entity?
Thyroid-like follicular carcinoma of the kidney is postulated as a potentially new entity of renal tumor based on nine previously published case reports. This tumor entity is not yet integrated into the classification of tumors of the World Health Organization (WHO). In this article a new case of thyroid-like follicular carcinoma of kidney is described which was incidentally detected at autopsy. The 58-year-old patient died of complications of acute myeloid leukemia after chemotherapy and also had prostatic...
Massive ovarian edema in a 13-year-old girl.
Massive ovarian edema is a rare tumor-like condition found in young women resulting from accumulation of fluid mostly due to partial or intermittent torsion of the ovary or secondary, to a preexisting ovarian lesion. We report a case of a 13-year-old girl presenting with an ovarian mass measuring 16 cm. CA-12-5 levels were slightly elevated. Concerns regarding underlying malignancy led to salpingo-oophorectomy. Pathological evaluation revealed a massive ovarian edema and multiple thromboses of ovarian vein...
Border between reactive and neoplastic lymphoproliferative processes.
Gastric lymphoma : Still an interdisciplinary challenge.
Differentiation of chronic gastritis from marginal zone B-cell lymphoma (MZoL) of MALT type is often difficult for the pathologist. Diagnostic tools include CD20 stain to highlight lymphoepithelial lesions, Wotherspoon grading of the infiltrate, and clonality analysis of the B-cells. MZoL may partially transform into a diffuse, large B-cell lymphoma, which the authors have named blastic MZoL. Blastic MZoL may be present with or without small cell MZoL. Without this component, blastic MzoL, while being CD10-...
Mycosis fungoides is a cutaneous T-cell lymphoma with protracted clinical course and progression in different stages with increasing aggressiveness. The clinical picture as well as the histopathology of mycosis fungoides within the early patch and plaque phase is difficult to delineate from some inflammatory skin diseases. Thus, the diagnosis of these early stages of the lymphoma is only possible when clinical, histopathological, and molecular features are integrated into the diagnosis, especially as none o...
Epstein-Barr virus-associated lymphoproliferations and lymphomas.
Epstein-Barr virus (EBV) is a lymphotropic herpesvirus infecting > 95 % of the worldwide population. In case of an immunodeficiency of various causes, the virus may lead to the development of a wide spectrum of lymphoproliferations and lymphomas. This encompasses mononucleosis-like lymphoproliferations, hyperplasias of various B-cell subsets as well as aggressive non-Hodgkin lymphomas and classical Hodgkin lymphoma. These lesions occur frequently extranodal and present with a polymorphous histology with...
Grey zone lymphomas : Limitations of the classification of aggressive B-cell lymphomas.
Grey zone lymphomas are lymphatic tumors that cannot be assigned to a defined lymphoma entity due to morphological, clinical or genetic reasons. As a defining criterion they present with features of two overlapping entities or features that are intermediate. Such lymphomas may represent a grey zone in the differentiation between indolent and aggressive lymphomas. Often they may show morphological features of one entity but be more related to another entity with respect to the immunophenotype and/or genetic...
Nodular lymphocyte-predominant Hodgkin's lymphoma and differential diagnoses.
Nodular lymphocyte-predominant Hodgkin's lymphoma (NLPHL) is a rare subtype of Hodgkin's lymphoma. The histological patterns of NLPHL variants are characterized by different localizations of the tumor cells, intranodular and perinodular and by the varying composition of the microenvironment. T-cell/histiocyte-rich B-cell lymphoma may be the result of an aggressive transformation of NLPHL. Classical lymphocyte-rich Hodgkin's lymphoma can usually be clearly distinguished from NLPHL by the immunophenotype of t...
The differential diagnosis of lymphoid lesions in the central nervous system covers a broad spectrum of neoplastic and inflammatory disorders. Complex cases benefit from the combined expertise in the fields of hematopoietic and neuroepithelial tumors as well as neuroimmunology. The Network Lymphomas and Lymphomatoid Lesions in the Nervous System (NLLLN) recommends performing a biopsy prior to any therapeutic intervention as a precise diagnosis was impossible in approximately 50 % of patients pretreated wi...
Neuroendocrine neoplasms of the digestive system are classified by current World Health Organization (WHO) guidelines as G1 and G2 neuroendocrine tumors (NET) as well as neuroendocrine carcinoma (NEC) based on proliferation and differentiation. The G1 NET tumors are highly differentiated, low proliferating and usually exhibit a favorable course of the disease without the development of metastases. In the case presented here, angioinvasion by a pT3 NET G1 was demonstrated after complete work-up of the mes...
B-cell neoplasms with plasmacellular and plasmablastic differentiation.
Plasma cell malignancies are tumors of terminally differentiated B-cells in which the neoplastic plasma cells are the dominant and proliferating tumor cell component. Plasma cell myeloma (PCM) is one of the most common hematological neoplasms and typically does not cause diagnostic problems. A morphologically and immunophenotypically detectable plasmacellular orplasmablastic differentiation is, however, commonly observed in a wide range of mature B-cell lymphomas. A confident separation of the distinct enti...
In situ lymphoma and other early stage malignant non-Hodgkin lymphomas.
The increasing use of immunohistochemical and molecular investigations of lymphatic tissues results in more frequent detection of early lymphoid proliferations. These show some but not all features of malignant lymphomas without fulfilling the diagnostic criteria for the diagnosis of lymphoid malignancy. In addition to well-known premalignant B-cell proliferations, such as monoclonal gammopathy of unknown significance (MGUS) and monoclonal B-cell lymphocytosis (MBL), so-called in situ lymphomas have recentl...
Motility disorders of the esophagus.
Motility disorders of the esophagus comprise a heterogeneous spectrum of diseases. Primary malformations of the esophagus are now amenable to improved surgical and gastroenterological therapies; however, they often lead to persistent long-term esophageal dysmotility. Achalasia originates from impaired relaxation of the gastroesophageal sphincter apparatus. Systemic diseases may give rise to secondary disorders of esophageal motility. A number of visceral neuromuscular disorders show an esophageal manifestat...
We report on three cases of serrated polyps of the duodenum which were incidental endoscopic findings in three male patients with a median age of 70 years (range 63-84 years). Architecturally the histological findings in cases 1 and 2 were similar to hyperplastic polyps of the colon. In case 3 there was a low grade intraepithelial neoplasia which covered the whole polyp. This polyp relapsed after 2 years with similar histological findings. Immunohistochemically an increased proliferative activity was found...
Barrett's esophagus : Analyses from human and experimental animal studies.
Whereas attention in the past has been focused on goblet cells as the primary marker for Barrett's esophagus (BE), the recent change in the definition now includes the non-goblet cell columnar cell-lined esophagus. In the present study the histological features of neoplasia of the lower esophagus and esophago-gastric junction in a German cohort were examined using immunohistochemical staining for MUC, CD10, intestinal and gastric type major tight junction proteins (claudins). Experimental studies using rat...
Malformations of the esophagus : Diagnosis and therapy.
Esophageal malformations are rare and can occur sporadically or as a component of various syndromes. The variations and classifications are manifold. With the available modern operation techniques most malformations can be resolved with good results. However, esophageal malformations are often combined with further malformations which limit the prognosis. The separation of the trachea and esophagus after gastrulation is not yet completely researched. The results so far indicate that the localzed expression...
Lymphocytic esophagitis is a rare, ill-defined inflammatory disease of the esophagus and is characterized by an increased number of intraepithelial lymphocytes. Up to now no distinct clinical symptom or endoscopic finding could be linked to histopathological changes. Hence lymphocytic esophagitis remains a diagnosis by exclusion after ruling out other possible causes of esophageal intraepithelial lymphocytosis.
Lymph node metastasis in superficial squamous carcinoma of the esophagus.
The definition of early carcinoma of the esophagus has changed with time on the basis of new data. As from 2007 an early carcinoma is defined as an intramucosal carcinoma with or without metastasis. In the subclassification based on invasion depth, m1 and m2 squamous cell carcinomas have no metastasis and are considered curable by endoscopic resection alone, whereas less than 10% of m3 carcinomas and some 20% of sm1 squamous cell carcinomas have lymph node metastasis. In this article the relationship betwee...
BACKGROUND: In rare cases, hypothalamic-pituitary dysfunction can be associated with an extraordinarily active non-alcoholic steatohepatitis (NASH) and subsequent liver cirrhosis. CASE REPORT: The two young adult patients described in this report presented with NASH together with advanced liver fibrosis and cirrhosis 5 and 19 years, respectively after resection of a craniopharyngeoma. CONCLUSIONS: In young patients and children with active steatohepatitis, an association with hypothalamic-pituitary dysfunc...
Chronic pancreatitis with pseudocysts?
The gross examination of cystic changes in chronic pancreatitis can cause diagnostic problems particularly in the absence of grossly detectable tumor tissue. Besides the more frequently encountered pancreatitis-associated pseudocysts, pancreatic cysts should always raise attention to the differential diagnosis of a true neoplastic process.
Tumor in the small intestine in Peutz-Jeghers syndrome.
Epithelial misplacement can be present in small bowel polyps of patients with Peutz-Jeghers syndrome and can mimic invasive malignancy. For recognizing epithelial misplacement, which can also have dysplastic changes, it is helpful to demonstrate the associated lamina propria and the lack of desmoplastic response. Intramural mucinous cysts are frequently seen in the setting of epithelial misplacement.
New aspects of surgery for pancreatic cancer : Principles, results and evidence.
Ductal adenocarcinoma is the most frequent malignant tumor of the pancreas and total resection of the pancreatic tumor is still the only curative treatment option. Most tumors are located in the pancreatic head, therefore, pylorus-preserving pancreaticoduodenectomy (Whipple PPPD) is the oncological standard procedure. By concentrating pancreatic resections in specialized centers for pancreatic surgery perioperative mortality and morbidity has decreased in recent years. However, pancreatic resections remain...
Epithelial-mesenchymal transition in non-small cell lung cancer.
Non-small cell lung carcinoma (NSCLC) is a highly fibrotic malignancy, which exhibits a prominent desmoplastic stroma. Epithelial-mesenchymal transition (EMT) is one of the main modes of carcinoma invasion. We identified the stromal N-glycoprotein periostin by mass spectrometry of lung adenocarcinoma pleural effusions. Validation on a NSCLC tissue microarray and on tumor whole sections by immunohistochemistry indicated that periostin is strongly upregulated at the invasive front in both tumor epithelia and...
The histopathological lymph node staging is of crucial importance for the prognosis estimation and therapy stratification in gastrointestinal cancer. However, the recommended numbers of lymph nodes that should be evaluated are often not reached in routine practice. Methylene blue assisted lymph node dissection was introduced as a new, simple and efficient technique to improve lymph node harvest in gastrointestinal cancer. This method is inexpensive, causes no delay and needs no toxic substances. All studies...