The overall false-negative rate of thyroid FNAs is 10.2%, which is reduced to 4.5% with a second benign FNA. Ninety percent of patients with a false-negative FNA had suspicious sonographic features. Reaspiration should be considered in patients with sonographically suspicious nodules.
In the modern era, detailed pathologic characteristics of a thyroid tumor are crucial to achieve accurate diagnosis and guide treatment. The presence of capsular invasion (CI) is diagnostic for carcinoma, whereas vascular invasion (VI) and nodal metastasis (NM) are included in risk stratification. However, the very definition of CI and VI is surrounded by controversies and an accurate assessment of NM is lacking. Whole Block Imaging (WBI) by microCT is a new imaging modality to create 3D reconstruction of whole tissue block with microscopic level resolution without the need for tissue sectioning. In this study, we aimed to define CI, VI, and NM volume using WBI by microCT. Twenty-eight paraffin blocks (PBs) from 26 thyroid tumors were scanned. Ten PBs contained CI, whereas 7 had VI. 3D microCT images were compared with whole slide images (WSI) of corresponding H&E slides. In 2 cases with VI and/or CI, WSI of serial H&E slides were obtained and underwent 3D-reconstruction to be compared with the WBI. Satellite tumor nodules beyond tumor capsule were shown to be CI by demonstrating the point of penetration using microCT and 3D reconstruction. Additional foci of CI were detected using microCT. VI was seen using microCT. Fibrin associated with tumor thrombus was not always present on serially sectioned H&E slides. WBI by microCT scanner was able to assess the volume of NM. In conclusion, WBI is able to detect CI, VI, and assess the volume of NM in thyroid carcinoma without tissue sectioning. It is the ultimate method for the complete sampling of the tumor capsule. It has the potential to increase the detection rate of CI, better define criteria for CI and VI and provide an accurate assessment of the volume of nodal disease. This technology may impact the future practice of surgical pathology.
Keywordswhole block imaging; microCT; thyroid carcinoma; capsular invasion; vascular invasion Users may view, print, copy, and download text and data-mine the content in such documents, for the purposes of academic research, subject always to the full Conditions of use:http://www.nature.com/authors/editorial_policies/license.html#terms
Background: Bladder cancer is globally the ninth, most common malignancy, and the thirteenth most common cause, of cancer death, associated with high morbidity and mortality, if not treated optimally. Bladder cancers can be divided into molecular subtypes, referred to luminal and basal with distinct clinical behaviors. HER2 is one of the established therapeutic targets in many cancers. Claudins are tight junction proteins, known to modulate therapy resistance in cancer cells. Aim: This study aimed to assess Claudins and HER2 status in the context of tumor molecular subtypes, identified by GATA3 and CK5/6 expression, that may help to select urothelial carcinoma patients, most likely to respond to immunotherapy. Materials and Methods: This retrospective study was done upon 50 cases of conventional urothelial carcinoma. GATA3, CK5/6, HER2, Claudins1&4 and P53immunostaining were done and correlated with clinicoimmuno-pathological parameters. Results: Bladder cancers could be assigned to main intrinsic molecular subtypes, referred to luminal, basal and double negative. Basal & double negative bladder cancers were more aggressive, when compared to luminal cancers. Positive significant statistical correlation was found between HER2, claudin1 and P53 and clinicimmuno-pathological parameters as tumor size, grade, TNM stage, LVI, tumor budding and aggressive molecular subtypes (P-value< 0.05). Negative significant statistical correlation was found between claudin4 and fore mentioned clinico-immuno-pathological parameters (P-value< 0.05). Conclusions: The molecular subtypes of bladder cancers, HER2,
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