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Urothelial and Urethral Cancer
Published in Karl H. Pang, Nadir I. Osman, James W.F. Catto, Christopher R. Chapple, Basic Urological Sciences, 2021
Ibrahim Jubber, Karl H. Pang, James W.F. Catto
HyperplasiaThickening of the urothelium mucosa to >10 cells.Often found adjacent to LG papillary tumours and may be a precursor to these.There is no cytological atypia or mitoses.
Cancer of the Corpus Uteri
Published in Jennifer L. Kelsey, Nancy G. Hildreth, Breast and Gynecologic Cancer Epidemiology, 2019
Jennifer L. Kelsey, Nancy G. Hildreth
Hyperplasia with atypia can be subdivided according to whether there is minimal, moderate, or severe atypia. Although hyperplasia with atypia is not an irreversible change, its relatively high probability of progressing to cancer, especially when severe atypia is present, makes it a cause for serious concern.17 Hendrickson and Kempson estimate that at least 20% of hyperplasias with moderate or severe atypia will progress to adenocarcinoma over a 10-year period. The more severe the atypia, the higher the probability of progression and the sooner it takes place.18–20 Administration of progesterone can bring about reversion to normal, unless the atypia is severe, in which case reversion is less likely.21–26 Some pathologists use adenocarcinoma in situ as another more severe category distinct from hyperplasia with severe atypia, but others disagree.
The Role of Nonspecific Injury in Colon Carcinogenesis *
Published in Herman Autrup, Gary M. Williams, Experimental Colon Carcinogenesis, 2019
These results provide a unifying concept which brings large bowel carcinogenesis into perspective with carcinogenesis of other tissues. Low or single dose initiation is probably irreversible or long lasting, remaining in a cryptic state or expressed as a very low incidence of neoplastic lesions. The colonic mucosa may be able to repair carcinogen damage by extruding initiated cells over long periods of time if they are not promoted into emergence. Initiated cells emerge as atypia in high incidence in response to promoting factors such as nonspecific proliferation and in response to high or multiple doses of carcinogen which in themselves induce proliferation. Focal atypia, although possessing many features in common with overt neoplasia, may represent a reversible, precursor lesion as seen in other organs. Some additional, yet to be defined stimulus may be necessary for progression of atypia to subsequent stages of neoplasia. This stimulus may be prolonged rather than transient hyperplasia such as that induced by chronic nonspecific injury or multiple doses of carcinogen. When introduced after initiation, hyperplasia reduces the lag period for the appearance of focal atypia, stimulates the appearance of greater numbers of these lesions, and allows their emergence with subthreshold initiating doses of carcinogen. Many of the noncarcinogenic factors that enhance colon carcinogenesis, including chronic nonspecific injury, may share a common mode of action by accelerating mucosal proliferation.
Squamous cell carcinoma arising in an epidermal inclusion cyst
Published in Baylor University Medical Center Proceedings, 2022
Suzanne Alkul, Christopher N. Nguyen, Nisha S. Ramani, Mahmud Alkul, Ida Orengo, Ikue Shimizu, Bhuvaneswari Krishnan
The pathologic differential diagnostic considerations of a dermal cystic lesion lined by squamous epithelium include an inclusion cyst of epidermal or pilar type. The epidermal type shows squamous lining epithelium with preserved granular layer and lumen with epidermal-type keratinous material. The pilar type cyst epithelium shows squamous cells with absence of granular layer, and lumen with eosinophilic pilar-type keratinous material with cholesterol clefts/calcification. Squamous lined cysts secondary to human papillomavirus infection have been reported18–20 and are more commonly on the palms and soles and rarely the scalp. These cysts show squamous lining epithelia with papillomatosis, hypergranulosis, parakeratosis, and, rarely, cytoplasmic inclusions. Proliferative changes in the cyst wall occupying the cyst lumen can be seen in proliferating trichilemmal or epidermal cysts, or malignancy arising in epithelial cysts. Proliferating trichilemmal tumors, commonly seen in the scalp, show a wide spectrum of squamous proliferation. Epithelial proliferation with pleomorphism and surrounding stromal invasion is seen in carcinomas arising in trichilemmal cyst. A proliferating epidermal cyst shows squamous proliferation with epidermal-type keratinization. Atypia of the squamous cells can be seen.
Clinical, histopathological and immunohistochemical evaluation of daylight photodynamic therapy in the treatment of field cancerization: a study of 30 cases
Published in Journal of Dermatological Treatment, 2022
Beatrice Martinez Zugaib Abdalla, Bruna Simas Pedreiro, Andrezza Garcia Morales, Debora Krutman Zveibil, Francisco Macedo Paschoal
On the other hand, a reduction in atypia was observed in most biopsies performed after treatment. The reduction in keratinocyte atypia was observed in 63.33% of the AK and 70% in adjacent skin, although only the AK had a statistical significance. When assessing the degree of atypia and the response to treatment, we can observe that the greater the degree of atypia, the greater the chance of responding to treatment, as injuries with severe atypia had 100% improvement after treatment. In addition, 88.89% of moderate atypia and only 28.57% of mild atypia showed improvement after daylight PDT, but no statistical significance. For adjacent skin, this trend was also observed and also without statistical significance, which was to be expected considering 20 biopsies did not enter this statistic, because they initially did not present atypia, and it is not possible to assess improvement.
The diagnostic challenge of suspicious or positive malignant urine cytology findings when cystoscopy findings are normal: an outpatient blue-light flexible cystoscopy may solve the problem
Published in Scandinavian Journal of Urology, 2021
Marie Andersson, Marthe Berger, Karsten Zieger, Per-Uno Malmström, Mats Bläckberg
Cytology is used as an adjunct in the diagnosis and follow-up of urothelial malignancy. The interpretation is user-dependent. The cellular yield and preservation of cells may play a role, too. Bladder wash cytology is typically considered to be more sensitive than cytology of voided urine. However, for practical purposes, the voided specimen continues to be of value, first because it is non-invasive and easy to obtain and, second because it may detect upper tract or urethral tumours [27]. The specificity has not been altered significantly by different sampling techniques. Positive cytological findings have high specificity for high-grade tumours, while suspicious cytological findings are less specific. A large proportion of negative BLFC findings in this study were preceded by suspicious cytological findings, which could be due to reactive atypia. Others may be explained by precancerous lesions, and therefore careful follow-up is required. Follow-up of patients with cellular atypia depends on risk factors for urothelial malignancy. How to handle patients with suspicious cytology but negative cystoscopy? Patients with repeat suspicious cytology or symptoms have a significantly higher risk of urinary malignancy than those with normal urine cytology carried out 6–8 weeks later. Patients with persistent suspicious cytology may need further evaluation and follow-up. Asymptomatic patients with negative repeat cytology may not require further evaluation [28].