Purpose:To investigate the histopathological characteristics of breast carcinomas with strong high-signal intensity (SHi) on T2-weighted (T2W) MR images (T2-SHi), and discuss the differential diagnosis between T2-SHi breast carcinomas and T2-SHi fibroadenomas. Materials and Methods:Thirty of 480 breast carcinomas examined by MRI were defined as tumors with T2-SHi (defined as homogeneous higher signal intensity (SI) compared to surrounding normal breast tissue on fat-suppressed T2W imaging (T2WI). They included eight mucinous and 22 nonmucinous carcinomas. The histopathological characteristics of T2-SHi breast carcinomas, their signal-to-noise ratios (SNRs) on T2WI, contrast-enhancement patterns, and morphology were compared with those of 22 non-T2-SHi breast carcinomas and 19 T2-SHi fibroadenomas. Results:In nonmucinous carcinomas T2-SHi was attributable to a mixture of background matrix, a higher proportion of cells than stroma, abundant cytoplasm, edematous stroma, and hemorrhage. The significantly high SNR (mean ϭ 75) and enhancing internal septations seen in mucinous carcinomas, and the washout phenomenon, irregular border, absence of internal septation, and rim enhancement seen in nonmucinous carcinomas provide useful information for differentiating these tumors from T2-SHi fibroadenomas. Conclusion:A mixture of several histopathological characteristics was associated with T2-SHi breast carcinomas. The combined information from T2WI and contrast-enhanced (CE) imaging may help distinguish T2-SHi breast carcinomas from T2-SHi fibroadenomas. BREAST MRI is now widely used to diagnose and characterize suspected breast lesions identified by mammography and ultrasonography. Contrast-enhanced (CE) breast MRI has a high sensitivity (approximately 90%) but lower specificity (37-86%) for detecting breast carcinoma (1-9). Attempts have been made to increase its specificity, and some studies have indicated that careful analysis of T2-weighted images (T2WI) can aid in establishing a differential diagnosis (10 -15).T2WI are typically used to identify and characterize cysts. Typical breast carcinomas have shorter T2 relaxation times and display lower signal intensity (SI) on T2WI than benign lesions (16,17). However, many benign lesions and some carcinomas, including mucinous (colloid) carcinomas (18), have a long T2 relaxation time and are occasionally difficult to distinguish from cysts on T2WI alone. The SI of fibroadenomas on T2WI, and the histopathological correlation have been analyzed. Myxoid and edematous fibroadenomas yield strong high-SI (SHi) on T2WI (T2-SHi) (19,20). However, few studies have examined the correlation between SI on T2WI and histopathology of carcinoma.Since it remains to be determined why some breast carcinomas other than mucinous carcinomas display T2-SHi, we investigated the histopathological characteristics of breast carcinomas with T2-SHi. We discuss the diagnostic utility of the combined information provided by T2-SHi and the enhancement patterns and morphology on CE images for differentiat...
Neoadjuvant chemotherapy (NAC) is now a relatively standard treatment for breast carcinoma. However, some tumors are known to develop resistance to chemotherapies. We investigated whether the status of estrogen receptor (ER), progesterone receptor (PR) and Her-2 expressions in breast cancer cases prior to NAC could be changed after NAC. We used immunohistochemistry (IHC) and fluorescence in situ hybridization (FISH) methods. No differences were found in ER or Her-2 status, but a significant difference was found in PR status. Changes in Her-2 status were suspected in four specimens after NAC (3+ to 1+ for 3 patients, and 1+ to 3+ for one patient) according to the IHC results. However, in all four of these cases, FISH of the resections showed no change. When IHC indicates a change in Her-2 expression after NAC, FISH is recommended.
To investigate the morphologic characteristics of the nipple-areola complex, the diameter of the nipple-areola complex and the height of the nipple in 300 adult women (600 breasts) were measured using micrometer calipers. Furthermore, the morphologic characteristics were classified into four types by visual observation. Mean diameter of the areola was 4.0 cm, mean diameter of the nipple was 1.3 cm, and mean height of the nipple was 0.9 cm. From the morphologic point of view, the elevated plateau type without constriction (IIs) was most commonly found, being present in 60.2% of breasts. Inverted nipples (III) were found in 3.5% and unclassified type (IV) such as multiple or divided nipples was found in 0.3%. Because women have become sensitive about the appearance of their breasts and there is increasing cosmetic interest following surgery for breast carcinoma, operations on the nipple-areola complex are now common. When a surgeon counsels a patient and designs a reconstruction method prior to operation, these data may be helpful.
An attempt to identify cysts of Entamoeba histolytica and E. dispar in human stool was conducted by polymerase chain reaction (PCR) using two sets of primers (p11 plus p12 and p13 plus p14) specific for either species of ameba. The cysts in stool specimens obtained from 12 infected individuals were concentrated, freeze-thawed, and treated with Triton X-100 before their examination by PCR. The results of PCR on the cysts were generally consistent with data obtained by PCR on ameba trophozoites hatched from the cysts, by zymodeme analysis, and by enzyme-linked immunosorbent assay (ELISA) and with clinical findings. This PCR was negative for the stool containing large numbers of cysts of either E. coli, E. hartmanni, or Giardia lamblia as well as for the stool specimens obtained from uninfected individuals. The ameba cyst in stool processed using the present method was effective for the PCR analysis even after 1 month of storage at 4 degrees C. The present PCR was sensitive enough to detect ten cysts of either of the amebae.
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