Kimura's disease. Diagnosis by aspiration cytology

OBJECTIVE: To characterize the cytologic features of Kimura's disease and distinguish the differentiating features from those of other conditions with similar cytologic findings. STUDY DESIGN: In eight cases of Kimura's disease the cytologic features were correlated with the histologic findings. RESULTS: The cytologic features included a polymorphous lymphoid population with an admixture of significant numbers of eosinophils, fragments of collagenous tissue, endothelial cells and occasional polykaryocytes. CONCLUSION: Various conditions, both benign and malignant, may mimic Kimura's disease clinically and on smears. These have to be ruled out before making a diagnosis of Kimura's disease. The cytologic features of Kimura's disease have to be interpreted in the appropriate clinical setting in order to make a correct preoperative diagnosis.     

Diagnosis of Distant Metastasis of Lung Cancer: Based on Clinical and Radiomic Features

OBJECTIVES: To analyze the distant metastasis possibility based on computed tomography (CT) radiomic features in patients with lung cancer. METHODS: This was a retrospective analysis of 348 patients with lung cancer enrolled between 2014 and February 2015. A feature set containing clinical features and 485 radiomic features was extracted from the pretherapy CT images. Feature selection via concave minimization (FSV) was used to select effective features. A support vector machine (SVM) was used to evaluate the predictive ability of each feature. RESULTS: Four radiomic features and three clinical features were obtained by FSV feature selection. Classification accuracy by the proposed SVM with SGD method was 71.02%, and the area under the curve was 72.84% with only the radiomic features extracted from CT. After the addition of clinical features, 89.09% can be achieved. CONCLUSION: The radiomic features of the pretherapy CT images may be used as predictors of distant metastasis. And it also can be used in combination with the patient's gender and tumor T and N phase information to diagnose the possibility of distant metastasis in lung cancer.     

Cytomorphologic spectrum in paraganglioma

OBJECTIVE: To study the detailed cytologic features of paragangliomas (PGs) and delineate features helpful in predicting behavior. STUDY DESIGN: We performed retrospective analysis of 12 cases cytologically suggested as PG over a period of 10 years. Smears were reviewed for cellularity, pattern, shape, cytoplasm, nuclear features and background. Cytologic diagnosis was correlated with clinicoradiologic features, histologic features and immunocytochemistry. RESULTS: Patient age ranged from 12 to 65 years, with male preponderance; they presented with a mass lesion. Sites involved were head and neck (5), retroperitoneum (5) and mediastinum (2). Smears were cellular; cells were round to oval, plasmacytoid and spindled and seen as scattered, in clusters, acinar and perivascular pattern. The most consistent feature was presence of pink granules. Pleomorphism was present in all but 1 case and less prominent in tumors with metastasis. Mitoses were more frequently seen in malignant cases. CONCLUSION: Cytologic features of PG are diverse. Although there are certain main features, they are not diagnostic unless combined with data on site, histology and ancillary studies. Presence of granules, mild pleomorphism, frequent mitoses and necrosis needs careful evaluation for malignancy potential and warrants close follow-up.     

Alport 综合征1 例报道及文献复习

目的:探讨Alport综合征的临床表现,病理学特征及研究进展。方法:分析1例此病患者的临床资料。结果:本例患者临床表现为慢性视力下降。尿常规检查提示蛋白尿,血尿。肾肾穿刺活检的光镜、电镜检查均支持诊断。结论:Alport综合征患者中眼部异常的表现有独特性;了解眼部病变特征并结合全身病史,病理学检查有助于疾病的诊断和随诊。     

Value of image cytometry in the subclassification of rhabdomyosarcoma

OBJECTIVE: To test the discriminatory capability of nuclear features in the subclassification of rhabdomyosarcoma (RMS) and especially to differentiate embryonal from alveolar RMS. STUDY DESIGN: The study included 42 patients with RMS. We performed the analysis on Feulgen-stained filtrates of cell suspensions prepared from deparaffinized tissue sections. Image analysis was performed by an automated, high-resolution image cytometer on at least 200 nuclear images. Photometric, morphometric and nuclear texture features were analyzed. Probability density distributions were calculated for each nuclear feature of individual RMS subgroups and compared in order to detect possible differences. RESULTS: There were significant differences between embryonal and alveolar RMS in five nuclear features: DNA index, sphericity, elongation, low_DNA_area and fractall_area. We were able to differentiate between the two main RMS subgroups in 82% of cases on the basis of either sphericity or elongation alone, while the power of differentiation for texture features was 72-79%. CONCLUSION: Differentiation between embryonal and alveolar RMS using one nuclear feature is not an important adjunct to light microscopy. However, the possibility of using a combination of nuclear features would probably increase the discriminatory ability.     

Echocardiographic alterations in a child with cow's milk allergy: a case report

ABSTRACT: INTRODUCTION: Cow's milk allergy is the most frequent food allergy in Europe and western countries and shows a wide spectrum of clinical features, including atopic dermatitis and gastrointestinal disease. To the best of our knowledge, this report is the first to describe Kawasaki disease-like clinical features and echocardiographic alterations which resolved after a cow's milk-free diet. CASE PRESENTATION: We report a case of a 9-month-old Caucasian girl with atopic dermatitis who developed clinical features commonly present in Kawasaki disease (erythematous skin rash, non-exudative conjunctivitis, fissured lips and neck lymph nodes), together with mild echocardiographic alterations (perivascular brightness, pericardial effusion) in the absence of fever. These features resolved within 2 weeks after the beginning of a cow's milk-free diet. CONCLUSION: Kawasaki disease has recently been considered a possible risk factor for subsequent allergic disease secondary to immune dysfunction. This case report suggests that the immune-related alterations which are commonly present in allergic patients could be similar to the antigen-related immune response in Kawasaki disease and thus could lead to similar clinical features.     

XtalPred: a web server for prediction of protein crystallizability

XtalPred is a web server for prediction of protein crystallizability. The prediction is made by comparing several features of the protein with distributions of these features in TargetDB and combining the results into an overall probability of crystallization. XtalPred provides: (1) a detailed comparison of the protein's features to the corresponding distribution from TargetDB; (2) a summary of protein features and predictions that indicate problems that are likely to be encountered during protein crystallization; (3) prediction of ligands; and (4) (optional) lists of close homologs from complete microbial genomes that are more likely to crystallize. AVAILABILITY: The XtalPred web server is freely available for academic users on http://ffas.burnham.org/XtalPred     

Optimal number of features as a function of sample size for various classification rules

MOTIVATION: Given the joint feature-label distribution, increasing the number of features always results in decreased classification error; however, this is not the case when a classifier is designed via a classification rule from sample data. Typically (but not always), for fixed sample size, the error of a designed classifier decreases and then increases as the number of features grows. The potential downside of using too many features is most critical for small samples, which are commonplace for gene-expression-based classifiers for phenotype discrimination. For fixed sample size and feature-label distribution, the issue is to find an optimal number of features. RESULTS: Since only in rare cases is there a known distribution of the error as a function of the number of features and sample size, this study employs simulation for various feature-label distributions and classification rules, and across a wide range of sample and feature-set sizes. To achieve the desired end, finding the optimal number of features as a function of sample size, it employs massively parallel computation. Seven classifiers are treated: 3-nearest-neighbor, Gaussian kernel, linear support vector machine, polynomial support vector machine, perceptron, regular histogram and linear discriminant analysis. Three Gaussian-based models are considered: linear, nonlinear and bimodal. In addition, real patient data from a large breast-cancer study is considered. To mitigate the combinatorial search for finding optimal feature sets, and to model the situation in which subsets of genes are co-regulated and correlation is internal to these subsets, we assume that the covariance matrix of the features is blocked, with each block corresponding to a group of correlated features. Altogether there are a large number of error surfaces for the many cases. These are provided in full on a companion website, which is meant to serve as resource for those working with small-sample classification. AVAILABILITY: For the companion website, please visit http://public.tgen.org/tamu/ofs/ CONTACT: e-dougherty@ee.tamu.edu.     

Cellular automaton simulation of tumour growth -- equivocal relationships between simulation parameters and morphologic pattern features.

OBJECTIVE: To develop an interpretation procedure which estimates simulation parameters (tumour cell motility, tumour cell adhesion, autocrine and paracrine growth control, stroma destruction) of simulated patterns solely based on morphometric features of the morphologic pattern. METHODS: A cellular automaton computer simulation program was developed which produces morphologic patterns by growth of a seed of tumour cells. At the beginning of each simulation run certain simulation parameters are assigned to the tumour cells. After the run has been completed, the resulting pattern is evaluated by a set of morphometric features. Simulation parameters and resulting morphometric features of 27,800 simulations were stored in a database and were used for the evaluation of potential relationships. RESULTS: Correlation analysis showed highly significant correlations between morphometric features on the one hand and the preset simulation parameters (tumour cell motility, tumour cell adhesion, autocrine and paracrine growth control, stroma destruction) on the other. Correlation coefficients, however, varied from 0.72 to 0.99. When only one simulation parameter varied while all others were kept constant, morphometric features yielded a highly reliable estimate of the particular simulation parameter. When variability was extended to 4 simulation parameters, morphometric features were less effective in estimating the setting of the parameters. Though in all patterns tested several possible simulation parameter constellations could be ruled out, morphometric features were usually compatible with more than one set of simulation parameters thus preventing a straightforward interpretation. CONCLUSIONS: Though simulation parameters significantly and reproducibly influence the resulting morphologic pattern as characterized by morphometric features, estimates of the simulation parameters based on morphometric features yield equivocal results.     

Peripheral T-cell lymphoma not otherwise specified vs. Hodgkin's lymphoma on fine needle aspiration cytology

OBJECTIVE: To study the morphologic features of peripheral T-cell lymphoma, not otherwise specified (PTCL, NOS) on fine needle aspiration cytology (FNAC) smears and to identify cytomorphologic features that would delineate them from features of cases of Hodgkin's lymphoma (HL). CONCLUSION: Fourteen cases each of PTCL, NOS, and HL with adequate FNAC smears were retrieved. These cases were analyzed for 12 cytomorphologic features: presence of atypical lymphoid cells, percentage of large lymphoid cells, lymphoid cells with cleaved/indented nuclei, typical Reed-Sternberg (RS) cells, mononuclear cells with prominent eosinophilic macronucleoli, mononuclear cells with prominent nucleoli, histiocytes, eosinophils, plasma cells, polymorphonuclear leukocytes, vessels and perivascular clustering of atypical mononuclear/atypical lymphoid cells. Each of these features was evaluated for its presence or absence and was semiquantitated on a scale from 0 to +3. RESULTS: The presence of atypical lymphoid cells with a spectrum ranging from small to intermediate and large was seen exclusively in cases of PTCL. Lymphoid cells with cleaved or indented nuclei, endothelium-lined vessels with perivascular clustering of tumor cells and absence of typical RS cells, and mononuclear cells with prominent eosinophilic macronucleoli emerged as the parameters significant in not only diagnosing cases of PTCL, NOS, but also in their delineation from cases of HL. CONCLUSION: A careful analysis of cytomorphologic features can be useful in at least suggesting a diagnosis of PTCL and help to distinguish that diagnosis from HL, which the features may mimic. Immunophenotyping and molecular studies are important in arriving at a definitive diagnosis.     

Papillary breast lesions diagnosed on cytology. Profile of 65 cases

OBJECTIVE: To analyze the cytologic features of nipple discharge and fine needle aspiration (FNA) cytologic smears from breast lesions reported as showing papillary features and to correlate them with histopathologic features. STUDY DESIGN: The study group consisted of FNA smears and/or nipple discharge smears from 65 breast lesions diagnosed on cytology as duct papilloma, papillary lesion, fibrocystic condition, fibroadenoma, papillary neoplasm or papillary carcinoma. Cytomorphologic features assessed included cellularity, cell pattern (clusters, papillary, 3-dimensionality, etc.) and cell characteristics (monomorphism, pleomorphism, apocrine change, plasmacytoid features). Histological material was available for review and cytohistologic correlation in all cases. RESULTS: Forty-six specimens were FNA smears, and 16 were nipple discharge smears; in 3 cases FNA and nipple discharge cytologic smears were available for review. Cytologic study could predict the presence of a papillary pattern in all neoplasms with pure or focal papillary differentiation. There was an overlap in cytomorphologic features between papillary and nonpapillary benign lesions as well as between benign and malignant papillary neoplasms. Frank blood in the aspirate, cell dissociation and atypia, however, were more frequent in the last. CONCLUSION: Overlap of cytologic features in nonneoplastic and neoplastic benign papillary lesions and between benign and malignant papillary neoplasms necessitates histologic evaluation in all cases diagnosed as papillary on cytology. Since 49.2% of lesions showing papillary features on cytology prove to be malignant, all cases reported as papillary on cytology should be excised urgently for histologic assessment.     

Morphometric analysis of the degree of aggregation of follicular cells in the diagnosis of malignant thyroid tumors

OBJECTIVE: To develop a system of decision criteria based on a set of features of the degree of thyrocyte aggregation with assessment of their weighting coefficient in the diagnosis of malignant and benign thyroid pathology. STUDY DESIGN: Autopsy, operative and aspiration biopsy material were the object of the study. Light microscopic morphometry was performed with semiautomated computer analysis of images. RESULTS: Of all the sets of features of the degree of thyrocyte aggregation, 10 were chosen that provided the least overlap between the groups of malignant and benign pathology. Boundary values of these features to discriminate between malignant and benign pathology were assembled into a set of diagnostic decision criteria for thyroid carcinoma diagnosis. Based on results from trials, an equation for the calculation of a weighting coefficient for each feature was derived. A diagnostic index was determined by the sum of values of weighting coefficients of the features within the range of values listed in the set of diagnostic decision criteria. CONCLUSION: A set of diagnostic decision criteria was developed for thyroid carcinoma diagnosis that is based on morphometric features reflecting the regularities of changes in the structure of thyrocyte aggregates with malignant and benign pathology. Weighting coefficients of features were assessed, making it possible to perform a probabilistic carcinoma diagnosis.     

webFOG: A web tool to map genomic features onto genes

A large number of new genomic features are being discovered using high throughput techniques. The next challenge is to automatically map them to the reference genome for further analysis and functional annotation. We have developed a tool that can be used to map important genomic features to the latest version of the human genome and also to annotate new features. These genomic features could be of many different source types, including miRNAs, microarray primers or probes, Chip-on-Chip data, CpG islands and SNPs to name a few. A standalone version and web interface for the tool can be accessed through: http://populationhealth.qimr.edu.au/cgi-bin/webFOG/index.cgi. The project details and source code is also available at http://www.bioinformatics.org/webfog.     

Comparative morphometric analysis of thyrocytes in a primary tumor and regional metastases in papillary thyroid gland cancer

OBJECTIVE: To perform a comparative analysis of thyrocyte nuclei and the aggregability degree in tumor cells in the thyroid gland with papillary cancer and in cervical lymph nodes with metastases. STUDY DESIGN: Thyrocytes in papillary cancer and those of cervical lymph nodes with its metastasis have been studied with the help of morphometry. RESULTS: As a result of mathematical transformation of the initial morphometric database, quantitative features of thyrocyte nuclei and aggregates characterizing the norm, papillary cancer and regional metastases were obtained. These features were united into 2 systems of decision criteria on the base of a set of quantitative features of thyrocyte nuclei and aggregates. Analysis was performed among the groups of comparison with the help of these systems. CONCLUSION: Malignant cells of the primary tumor have been shown to have evident quantitative features of nuclear atypia and a higher degree of aggregability compared with the norm. The differences between the quantitative features of nuclei and aggregates in malignant cells of the primary tumor in the thyroid gland and its metastases in cervical lymph nodes were less pronounced.     

Nucleolar morphometry in fine needle aspiration biopsies of the prostate.

OBJECTIVE: To find efficient morphometric nucleolar features for distinguishing different prostatic atypia groups in fine needle aspiration biopsies. STUDY DESIGN: A computerized interactive morphometry program was used to outline nucleoli of prostate cells. The samples were divided into three groups: group 1 (definitely benign [n = 10] and atypical but benign [n = 13]), group 2 (moderately atypical [n = 11] or highly suspicious [n = 13]) and group 3 (definitely malignant [n = 17]). RESULTS: The analysis revealed a difference in the number of nucleoli between definitely benign samples and other atypia groups but not between the latter. Nucleolar size features were best in distinguishing between atypia groups. The sample-associated mean size features were more powerful than cell group-associated size features. CONCLUSION: The sample-associated mean area, defined from cells selected by an experienced cytologist, if larger than 2 micron 2, was strongly associated with definitely malignant samples. The same was true for the largest nucleolar area if larger than 5.0 micron 2. Morphometric nucleolar size features appeared efficient in distinguishing between definitely malignant and other samples.     

The Potential Value of Preoperative MRI Texture and Shape Analysis in Grading Meningiomas: A Preliminary Investigation

OBJECT: Preoperative knowledge of meningioma grade is essential for planning treatment and surgery. The purpose of this study was to investigate the diagnostic value of MRI texture and shape analysis in grading meningiomas. METHODS: A surgical database was reviewed to identify meningioma patients who had undergone tumor resection between January 2015 and December 2016. Preoperative MR images were retrieved and analyzed. Texture and shape analysis was conducted to quantitatively evaluate tumor heterogeneity and morphology. Three machine learning classifiers were trained with these features to build classification models. The performance of the features and classification models was assessed. RESULTS: A total of 131 patients were included in this study: 21 with high-grade meningiomas and 110 with low-grade meningiomas. Three texture features were selected: Horzl_RLNonUni, S(2,2)SumOfSqs, and WavEnHL_s-3; three shape features were selected: GeoFv, GeoW4, and GeoW5b. The Mann–Whitney test indicated that all six features were significantly different between high-grade and low-grade meningiomas. AUC values were generally greater than 0.50 (range, 0.73 to 0.88). Sensitivities and specificities ranged from 47.62% to 90.48% and 69.09% to 96.36%, respectively. Among the nine classification models obtained, the one built by training the SVM classifier with all six features achieved the best performance, with a sensitivity, specificity, diagnostic accuracy, and AUC of 0.86, 0.87, 0.87, and 0.87, respectively. CONCLUSIONS: Texture and shape analysis, especially when combined with a SVM classifier, can provide satisfactory performance in the preoperative determination of meningioma grade and is thus potentially useful for clinical application.     

Comparison of urine cytology between the ileal conduit and Indiana pouch

OBJECTIVE: To compare the cytomorphologic features of urine obtained from two different kinds of urinary diversions constructed after total bladder resection. STUDY DESIGN: The smears of urine from 11 ileal conduits and 6 Indiana pouches were evaluated. All patients underwent total bladder resection due to transitional cell carcinoma (TCC) or other kinds of cancer before urine diversion. RESULTS: The cytologic features of Indiana pouch urine include degenerated, small, round cells without columnar cells derived from intestinal epithelium. In ileal conduit urine, well-preserved columnar cells and degenerated, small, round cells were frequently observed. The columnar cells in ileal conduit urine exhibited cytologic features that should be distinguished from TCC cells. CONCLUSION: The method of reconstructing the urinary tract is important in urine cytology from urine diversions because the cytomorphologic features of urine are different between the two kinds of urinary diversions. Since columnar cells in ileal conduit urine might lead to misdiagnosis as TCC, special consideration is required to examine ileal conduit urine.