Acinar carcinoma comprises more than 90% of prostatic adenocarcinomas and is characterized by a small gland proliferation with an infiltrative growth pattern. The numerous, variably-defined histological variants of prostatic adenocarcinoma can prove to be diagnostic challenges and show prognostic differences when compared to the usual acinar carcinoma, thus emphasizing the importance in accurate recognition. Variants of acinar prostatic adenocarcinoma include the atrophic, pseudohyperplastic, microcystic, foamy gland, mucinous (colloid), signet ring-like cell, pleomorphic giant cell, and sarcomatoid variants. The atrophic, pseudohyperplastic, microcystic, and foamy gland variants can be challenging to diagnose due to their deceptively benign appearance. While the atrophic, pseudohyperplastic, microcystic, and foamy gland variants usually present as low-grade malignancies (Gleason score 6-7), the mucinous (colloid), signet ring-like cell, pleomorphic giant cell, and sarcomatoid variants often present as high-grade malignancies (Gleason score >7) and are usually associated with a worse prognosis. Small cell carcinoma is not considered as a variant of acinar carcinoma, is classified under neuroendocrine tumors, and is recommended not to be assigned a Gleason score. Small cell carcinoma is often preceded by a diagnosis of acinar adenocarcinoma, rarely presents as a de novo tumor, and, as in other organs systems has an aggressive clinical course. In this review article, we discuss variants of prostatic acinar carcinomas and briefly discuss small cell carcinoma. Awareness of variants of acinar prostate carcinoma and their clinicopathologic features is essential to rendering an accurate diagnosis and clinical management of patients with these tumors.
A 76-year-old woman, an ex-smoker, presented with several months' history of gastroesophageal reflux disease (GERD), recent weight loss, and a 1-week-old history of lower gastrointestinal bleeding. Her symptoms of heartburn were persisting despite her daily intake of omeprazole 40 mg daily. There was no associated dysphagia to solids or liquids. She also had a known history of internal hemorrhoids. Her lab tests showed a hemoglobin of 12.2 g/dL and a hematocrit of 37.8. An upper gastrointestinal endoscopy and a colonoscopy were done. Endoscopy showed multiple large white plaques in the lower esophagus, while the colonoscopy confirmed internal hemorrhoids in her lower rectum. Esophageal biopsies taken during endoscopy revealed an undulating esophageal squamous mucosa with a compact surface hyperorthokeratosis and a prominent underlying granular cell layer. An abrupt transition was noted between the area of epidermoid metaplasia and adjacent uninvolved normal squamous mucosa. PAS stain was negative for fungal organisms. There was no evidence of any dysplasia or carcinoma. A diagnosis of esophageal epidermoid metaplasia or esophageal leukoplakia was given. Esophageal leukoplakia is a rare histological counterpart of oral leukoplakia occurring in mostly middle-aged women. The most common complaint is dysphagia although few others may present with GERD symptoms (as in our patient) or achalasia. Significant risk factors that are similar to those in oral leukoplakia include smoking and alcohol consumption. The usual endoscopic appearance is that of white patches of plaque-like mucosa. Because of the reported high rate of squamous dysplasia or rarely even squamous cell carcinoma in the adjacent esophageal mucosa, these patients need close endoscopic follow-up. Also endoscopic screening should focus not only on the area of leukoplakia but also adjacent mucosa to pick up early dysplasia and/or cancer.
To investigate the vitamin D serum levels of migraine patients and compared it with a control group. Materials and Methods:The present case control study entitled was conducted in the Department of General Medicine during the period of I year. The study was performed on 150 female patients (case group n = 100 and matched control group n = 50) attended General Medicine outpatient department. 25-hydroxy vitamin D was analyzed with liquid chromatography-tandem mass spectrometry (LC/MS/MS) method. Results: The Mean Age, Serum vitamin D level and BMI among cases and controls are as follows (34.54±1.37, 33.17±1.19), (13.12±0. 98, 13.41±0.19) and (26.4±1.21, 25.8±1.53). 58% of the cases had migraine frequency per month of more than 10 episodes and 36% of the cases shown that the pain last for 4-12 hours in a day. Conclusion:The prevalence of vitamin D deficiency is roughly similar between cases and controls and between matching age groups. This suggests a high prevalence of vitamin D deficiency in both healthy population and migraine patients which implies a common underlying cause.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.