The purpose of this paper is to quantify the incidence of different histological types of ovarian tumors and to demonstrate the clinical importance of an effective screening program, considering the paucisymptomatic nature of this pathology.
The incidence of ovarian epithelial tumors varied across age groups, our study group including women aged between 34 and 64 years old. Knowing the age distribution plays an important role in the implementation of screening programs. All cases presented with similar symptomatology: pelvic pain, abdominal distension and ascites. The gross appearance of these tumors was overlapping in different histological subtypes, ovarian cancer abdominal distension variable cystic and solid components.
The histological subtypes included in our study were: serous carcinoma, low ovarian cancer abdominal distension and high grade, mucinous carcinoma, endometrioid carcinoma and clear ovarian cancer abdominal distension carcinoma.
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A positive correct diagnosis of the histological subtype is essential for therapy and follow-up, and immunohistochemial studies should be performed in difficult cases. Ovarian cancer abdominal distension is a large series of antibodies used ovarian cancer abdominal distension the positive diagnosis of ovarian ovarian cancer abdominal distension, so the pathologist should know what algorithm to use in approaching a diagnosis in order to obtain a correct result.
Scopul acestei lucrări este de a cuantifica incidența diferitelor tipuri histologice de tumori ovariene și de a demonstra importanța clinică a unui program eficient de screening, având în vedere natura paucisimptomatică a acestei patologii. Incidența tumorilor epiteliale ovariene a variat în funcție de grupurile de vârstă, grupul nostru de studiu incluzând femei cu vârsta cuprinsă între 34 și 64 de ani.
Cunoașterea distribuției pe vârste joacă un rol important în implementarea programelor de screening. Toate cazurile au prezentat simptomatologie similară: durere pelviană, distensie abdominală și ascită. Aspectul macroscopic al acestor tumori se suprapune în diferite subtipuri histologice, prezentând componente variabile chistice și solide.
Subtipurile histologice incluse în studiul nostru au fost carcinomul seros, de grad scăzut sau crescut, carcinomul mucinos, ovarian cancer abdominal distension endometrioid și ovarian cancer abdominal distension cu celule clare.
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Un diagnostic corect pozitiv al subtipului histologic este esențial pentru terapie și follow-up, iar studiile imunohistochimice trebuie efectuate în cazuri dificile. Există o serie mare ovarian cancer abdominal distension anticorpi folosiți pentru diagnosticul pozitiv al carcinomului ovarian, astfel încât anatomopatologul ar trebui să știe ce algoritm să utilizeze în abordarea unui diagnostic pentru a obține un rezultat corect.
Cuvinte cheie epiteliu carcinom ovar imunohistochimie Introduction Ovarian cancer is a public health problem that affects women of reproductive age and is a major cause of morbidity and mortality. Early diagnosis is the primary method of ameliorating complications and long-term prognosis, but this is hampered by reduced symptomatology, with most patients presenting in advanced stages.
From tothe incidence rate and the mortality rate decreased by 0. The most important factor in determining the prognosis of the patient is the tumor stage. For epithelial ovarian cancer, current screening methods ultrasound and tumor markers have not been as effective as in cervical or breast tumors.
Ovarian epithelial tumors represent a heterogeneous class of neoplasia, classified by cell type in serous, mucinous, endometrioid and clear cell. Because there are no benign equivalent tissues in the ovary, the mechanism of carcinogenesis was attributed initially to the ovarian epithelium mesotheliumbut recent studies have proposed that ovarian cancer abdominal distension tumors are secondary tumors, derived from lesions of the fallopian tube fimbria, while endometrioid tumor or clear cells tumors are secondary to ovarian endometriosis 4.
Ovarian epithelial tumors are classified according to the degree of nuclear atypia, tumor proliferation and the presence or absence of stromal invasion, in benign, borderline and malignant conditions.
The borderline tumors are called this way because they present cytological and histological aspects that are intermediate between benign and malignant. Materials and method The purpose of this paper is ovarian cancer abdominal distension quantify the incidence ovarian cancer abdominal distension different histological types of ovarian ovarian cancer abdominal distension and to demonstrate the clinical importance of an effective screening program, considering the paucisymptomatic nature of this pathology.
Symptoms suggestive for this pathology were noted to demonstrate the silent clinical appearance of ovarian neoplasia. Specimens were obtained from limited tumor excision, but also from oophorectomy and hysterectomy with bilateral anexectomy, formalin fixed and paraffin embedded, then stained with Hematoxylin-Eosin.
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In some cases, additional immunohistochemical stains were needed to clarify the diagnosis. Results This study included data from a batch of 23 ovarian carcinomas, selected from ovarian pathology patients.
Ovarian cancer abdominal distension incidence of ovarian epithelial tumors varies across age groups, our study group including women aged between 34 and 64 years intraductal papilloma teenager. Knowing the age distribution plays an important role in the implementation of screening programs.
All cases presented with similar symptomatology: pelvic pain, abdominal distension and ovarian cancer abdominal distension in two cases. In the category of malignant serous tumors, we included 9 patients, 6 low-grade and 3 high-grade.
The low-grade serous carcinoma was non-invasive and showed a papillary-type development, with small nuclei, rare mitoses and a hyalinized stroma with occasional psamoma bodies. Immunohistochemical assays showed positivity to CK7 and ER.
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Figure 1. The immunohistochemical assays showed, by contrast to the previous low-grade serous cases, ovarian cancer abdominal distension mutated expression of p53 and high Ki67 index. The pattern of p53 immunosay is very important and the result should refer to the presence or absence of a mutation.
A strong and diffuse immunoexpression of p53, as well as a completely negative immunostaining should be interpreted as an indicator of a TP53 gene mutation. In our cases, all high grade showed mutated status of TP53 ovarian cancer abdominal distension. Hormone receptor testing showed no difference from the low-grade cases and is not useful in the differential diagnosis.
Also, all cases of both low-grade and high-grade serous carcinoma exhibited diffuse nuclear positivity with WT1. Figure 2. High-grade serous carcinoma of the ovary, HE, 40x, and p53 mutated, 40x The cases of carcinomas with glandular architecture, atypical cells and foci of squamous metaplasia were classified as endometroid carcinomas due to their resemblance to the endometrium 5 cases.
The immunohistochemical profile of endometriod carcinomas is similar to that of benign endometrial tumors, presenting a positive reaction for cytokeratins and both estrogenic and ovarian cancer abdominal distension receptors and different values of Ki67, depending on the aggresive character of the tumor.
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In one case, the initial intraoperative diagnosis was endometriod cyst, while extensive grossing for the final diagnosis revealed the presence of a small area of endometrioid carcinoma Figure 3.
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Endometrioid ovarian carcinoma and associated endometrioid cyst, HE, 40x A third histopathological category of ovarian epithelial tumors were the mucinous tumors, which represented 2. On ovarian cancer abdominal distension examination, two cases showed cystic appearance and the rest were solid with dimensions between 6 and 14 cm. In one case, the mucinous adenocarcinoma has shown an expansive pattern of development, without any stromal invasion and complex architecture, while the rest were infiltrative.
Figure 4. The year-old patient who was diagnosed with this tumor had epiploic metastasis at admission.
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- Ovarian high-grade serous carcinoma is a type of malignancy that is rare among young adult women, being more frequent in postmenopausal women.
Элвину казалось, что одна тайна громоздится на другую, и он, несмотря на все усилия, уходит все дальше и дальше от постижения столь влекущей его истины.
Because all bilateral or large mucinous ovarian tumors should be considered secondary dissemination until proven otherwise, immunohistochemical tests are compulsory. In our cases, three tumors turned out to be primary tumors, two were metastasis from a colorectal adenocarcinoma and one of them was a Krukenberg tumor metastasis from a gastric carcinoma.
Primary ovarian cancer abdominal distension ovarian adenocarcinoma, HE, 40x, and CK7 positive The Krukenberg tumor showed a specific pattern, with signet ring infiltrating tumoral cells, Ck20, CDx2 and CEA positive, but the diagnosis cannot be relied solely on histological and immunohistochemical pattern and it had to be confirmed by the clinical context. Figure 7. Krukenberg tumor, HE, x and CK20 positive, x Clear cell carcinomas are rare tumors and we only found two cases that showed very different histological pattern: one had hobnail cell that protruded into the lumina, while the other showed clear ovarian cancer abdominal distension.
The arhitecture was heterogenous in both cases, with tubular-cystic, papillary cores with hyalinization and solid area. The immunohistochemical tests are useful mainly for the differential diagnosis with serous and mucinous carcinoma. Also, Ki67 had a high value in both cases, as these types of ovarian cancer abdominal distension are rather aggressive Figure 8.