Navegando por Palavras-chave "biopsy"

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    Achados histopatológicos renais em idosos
    (Sociedade Brasileira de Nefrologia, 2010-09-01) Carmo, Priscylla Aparecida Vieira do; Mastroianni Kirsztajn, Gianna [UNIFESP]; Carmo, Wander Barros do; Franco, Marcello Fabiano de [UNIFESP]; Bastos, Marcus Gomes; Fundação IMEPEN; Universidade Federal de São Paulo (UNIFESP); Universidade Federal de Juiz de Fora Faculdade de Medicina
    INTRODUCTION: The elderly population has significantly increased worldwide and recent studies have evidenced a 10-year increase in Brazilian life expectancy. Similarly to other comorbidities, glomerular diseases are also observed in the elderly, and, in that age group, kidney biopsy emerges as a fundamental diagnostic tool to help disease management, preventing unnecessary therapies. OBJECTIVE: To establish the frequency of histological diagnoses in the elderly undergoing kidney biopsy, with an emphasis on glomerulopathies (GPs), at two Brazilian universities. METHODS: Retrospective assessment of kidney biopsy reports of the Department of Pathology of UNIFESP (patients aged 60 years or above, from 01/01/1996 to 12/31/2003) and of the outpatient clinic of GPs of NIEPEN. The studies of transplanted kidneys and nephrectomies were excluded. The following data were analyzed: age; sex; clinical syndrome at presentation; and histological diagnosis (light microscopy and immunofluorescence). Nephropathies were classified as primary GPs, secondary kidney diseases, nonglomerular diseases, and others. RESULTS: One hundred and thirteen biopsies were assessed, the mean age of patients was 66.0 ± 6.0 years, and the male sex prevailed (54.8%). The most common clinical presentation was nephrotic syndrome (32.7%), followed by acute and chronic kidney failure (18.6%, each). Glomerular diseases were as follows: membranous nephropathy (MN), 15%; hypertensive nephrosclerosis, 11.5%; focal segmental glomerulosclerosis and vasculitis/crescentic GN, 9.7% each; amyloidosis, chronic glomerulonephritis, and minimal change disease, 7.1% each; diffuse proliferative GN, 4.4%; IgA nephropathy and lupus nephritis, 2.7% each. Primary GPs predominated (45.2%) as compared with other nephropathies. CONCLUSION: Nephrotic syndrome was the major indication for kidney biopsy. Regarding the kidney histological diagnoses, glomerular diseases predominated, in particular MN and hypertensive nephrosclerosis, findings compatible with previous studies in the area, but rarely assessed among us. It is clear that the diversity of diagnoses and differentiated treatments justify kidney biopsy for decision making in that group of patients.
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    Analysis of risk factors of involvement of seminal vesicles in patients with prostate cancer undergoing radical prostatectomy
    (Sociedade Brasileira de Urologia, 2004-12-01) Dall'Oglio, Marcos Francisco [UNIFESP]; Sant'Anna, Alexandre C. [UNIFESP]; Antunes, Alberto A. [UNIFESP]; Nesrallah, Luciano J. [UNIFESP]; Leite, Kátia Ramos Moreira [UNIFESP]; Srougi, Miguel [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Syrian Lebanese Hospital Section of Pathology
    OBJECTIVE: To determine through preoperative serum PSA level, Gleason score on biopsy and percentage of fragments affected by tumor on biopsy, the probability of involvement of the seminal vesicles. MATERIALS AND METHODS: During the period between March 1991 to December 2002, we selected 899 patients undergoing radical prostatectomy for treatment of localized prostate adenocarcinoma. The analyzed preoperative variables were PSA, percentage of positive fragments and Gleason score on the biopsy. Pre-operative PSA was divided in scales from 0 to 4.0 ng/mL, 4.1 to 10 ng/mL, 10.1 to 20 ng/mL and > 20 ng/mL, Gleason score was categorized in scales from 2 to 6. 7 and 8 to 10, and the percentage of affected fragments was divided in 0 to 25%, 25.1% to 50%, 50.1% to 75%, and 75.1% to 100%. All these variables were correlated with the involvement of seminal vesicles in the surgical specimen. RESULTS: Of the 899 patients under study, approximately 11% (95% CI, [9% - 13%]) had involvement of seminal vesicles. On the multivariate analysis, when PSA was < 4, the Gleason score was 2 to 6, and less than 25% of fragments were involved on the biopsy, only 3.6%, 7.6% and 6.2% of patients respectively, had involvement of seminal vesicles. On the multivariate analysis, we observed that PSA, Gleason score and the percentage of involved fragments were independent prognostic factors for invasion of seminal vesicles. CONCLUSION: The preoperative variables used in the present study allow the identification of men with minimal risk (lower than 5%) if involvement of seminal vesicles.
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    Do standardization and quantification of histopathological criteria improve the diagnosis of inflammatory bowel disease?
    (Sociedade Brasileira de Patologia ClínicaSociedade Brasileira de PatologiaSociedade Brasileira de Citopatologia, 2014-06-01) Baldin, Rosimeri Kuhl Svoboda; Telles, José Ederaldo Queiroz; Bonardi, Renato Araújo; Amarante, Heda Maria Barska Dos Santos; Baldin Júnior, Antônio; Universidade Federal do Paraná Hospital de Clínicas Medical Pathology Department; Universidade Federal de São Paulo (UNIFESP); UFPR Hospital de Clínicas Medical Pathology Department; UFPR Department of Surgery; UFPR Internal Medicine Department; UFPR Hospital de Clínicas
    Introduction:Inflammatory bowel disease comprises two major categories: Crohn's disease and ulcerative rectocolitis, both with different clinical and histological aspects, causing sometimes significant morbidity.Objectives:Choose and apply standardized and quantified histopathological diagnosis method, and compare the results and quality index with the original diagnosis.Materials and methods:43 histological colonoscopic biopsies of 37 patients were re-evaluated by standardized system.Results and discussion:The original diagnoses were more inconclusive (23.3%) than those standardized (2.3%). The agreement with gold standard (clinical, colonoscopical, and radiological diagnosis) was higher on standardized diagnoses (95.3%) than in original (74.4%), especially in relation to Crohn's disease, which percentages were 92.3% and 46.1%, respectively. The quality index was calculated in conclusive diagnosis of each method. For ulcerative rectocolitis, both methods showed sensitivity and negative predictive value of 100%; otherwise the original diagnosis demonstrated specificity of 85.7%, positive predictive value of 96.3% and accuracy of 97.0%, and the standardized diagnosis 92.3%, 96.7% and 97.6%, respectively. For Crohn's disease, there is specificity and positive predictive value of 100% in both methods; the original diagnosis showed sensitivity of 85.7%, negative predictive value of 96.3% and accuracy of 97%, while for the standardized diagnoses 92.3%, 96.7%, and 97.6%, respectively.Conclusion:The standardized diagnosis presented a higher percentage of correct and conclusive diagnoses than those presented in the original diagnosis, especially for Crohn's disease, as well as equal or slightly higher values in some quality index.
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    Eyelid swelling as the only manifestation of ocular sarcoidosis
    (Taylor & Francis Inc, 2005-10-01) Souza Filho, João Pessoa de [UNIFESP]; Martins, Maria Cristina [UNIFESP]; Sant'Anna, Ana Estela Besteti Ponce [UNIFESP]; Coutinho, Anamaria B. [UNIFESP]; Burnier, Miguel Noel Nascente [UNIFESP]; Rigueiro, Moacyr Pezati [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); McGill Univ
    Purpose: To describe a case of eyelid sarcoidosis without systemic manifestations with a three-year follow-up. Methods: A 73-year-old woman presented complaining of a one-year history of swelling and hyperemia in the right upper eyelid. To confirm the diagnosis, we performed an incisional biopsy of the eyelid. Results: Histopathological examination showed a non-caseating granulomatous process suggestive of sarcoidosis. After three years, the patient was asymptomatic and physical and laboratory examination showed no signs of systemic sarcoidosis. Conclusion: the histopathological exam was fundamental for the diagnosis.
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    Paralisia periódica: estudo anátomo-patológico do músculo esquelético de 14 pacientes
    (Academia Brasileira de Neurologia - ABNEURO, 1994-03-01) Tengan, Célia Harumi [UNIFESP]; Oliveira, Acary Souza Bulle [UNIFESP]; Morita, Maria Da Penha Ananias [UNIFESP]; Kiyomoto, Beatriz Hitomi [UNIFESP]; Schmidt, Beny [UNIFESP]; Gabbai, Alberto Alain [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    Periodic paralysis is a rare disease, characterized by transient weakness associated with abnormal levels of serum potassium. Muscle biopsy may show a wide range of abnormalities, vacuoles being more specifically linked to the disease. We analysed 17 muscle biopsies from 14 patients with periodic paralysis (14 hypokalemic, 2 hyperkalemic). All of them showed at least one histological abnormality. Fourteen specimens showed vacuoles that were peripheral, single, frequent and preferentially found in type I fibers. Frequency or severity of attacks did not correlate with the presence of vacuoles but those were more easily found in patients with long term disease. Ten biopsies showed tubular aggregates, specially on the patients with frequent crises or long term disease. A second biopsy was done in three patients and in two we observed a worsening of the histopathologic picture. One patient manifested interictal weakness with evident myopathic changes on the muscle biopsy. Nonspecific changes were found in variable degrees in 15 biopsies. Our study shows that vacuoles and tubular aggregates are frequent changes in periodic paralysis and therefore helpful for the diagnosis. Important myopathic findings in the muscle biopsy suggest a permanent myopathy which probably develops after severe crises or long term disease.
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    Pathological extension of prostate cancer as defined by gleason score on biopsy
    (Sociedade Brasileira de Urologia, 2005-08-01) Dall'Oglio, Marcos Francisco [UNIFESP]; Crippa, Alexandre [UNIFESP]; Paranhos, Mario [UNIFESP]; Nesrallah, Luciano J. [UNIFESP]; Leite, Kátia Ramos Moreira [UNIFESP]; Srougi, Miguel [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    INTRODUCTION: Based on the importance of the Gleason score on the behavior of prostate adenocarcinoma, this study attempts to predict the extension of prostate adenocarcinoma pre-operatively, as defined by the Gleason score on biopsy, in individuals who will undergo radical prostatectomy. MATERIALS AND METHODS: We selected 899 individuals who underwent retropubic radical prostatectomy from 1988 to 2004. Clinical and pathological data obtained in the preoperative period were retrospectively analyzed through digital rectal examinations of the prostate, initial serum PSA levels and pathological data provided by biopsy. The Gleason score on biopsy was assessed and divided into 3 groups: 2 to 6, 7, and 8 to 10, and correlated with the possibility of the disease being confined to the prostate. RESULTS: From the 899 selected patients, 654 (74%) showed Gleason scores of 2 to 6, 165 (18%) had a score of 7 and 80 (9%) had scores of 8 to 10 on biopsy. The likelihood of confined diseases, extraprostatic extensions, invasion of seminal vesicles and lymph nodal involvement were respectively: 74%, 18%, 8% and 0.8% for a Gleason score of 2 to 6, 47%, 30%, 19% and 4% for a Gleason score of 7, and 49%, 29%, 18% and 4% for a Gleason score of 8 to 10. CONCLUSION: In patients who will undergo radical prostatectomy due to prostate adenocarcinoma, a Gleason score of 7 on biopsy shows the same behavior as a Gleason score of 8 to 10 in relation to extension of disease.
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    The percentage of positive biopsy cores as a predictor of disease recurrence in patients with prostate cancer treated with radical prostatectomy
    (Blackwell Publishing, 2005-12-01) Antunes, Alberto Azoubel [UNIFESP]; Srougi, Miguel [UNIFESP]; Dall'Oglio, Marcos Francisco [UNIFESP]; Crippa, Alexandre [UNIFESP]; Campagnari, João C.; Leite, Kátia Ramos Moreira [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Syrian Lebanese Hosp
    OBJECTIVETo analyse the prognostic value of the percentage of positive biopsy cores (PPBC) in determining the pathological features and biochemical outcome of patients with prostate cancer treated by radical prostatectomy, as published data evaluating the prognostic value of PPBC in such patients have limitations.PATIENTS and METHODSA group of 534 patients with clinically localized prostate cancer was selected. the PPBC was defined as the number of positive biopsy cores/total number of biopsy cores x 100, and grouped into categories of <25%, 25.1-50%, 50.1-75% and 75.1-100%. Patients were divided in low-, intermediate- and high-risk groups according to the usual variables.RESULTSThe mean follow-up was 60.5 months. PPBC was associated with the preoperative serum prostate-specific antigen (PSA) level, biopsy Gleason score and clinical stage. On multivariate analysis, PPBC was a significant predictor of extraprostatic disease and seminal vesicle involvement. of patients in the four PPBC categories, 16%, 27%, 33% and 60%, respectively, had biochemical recurrence (P < 0.001), and on Cox regression analysis, PPBC was an independent predictor of disease recurrence. After segregating patients into risk groups the PPBC further stratified patients using thresholds of 75% (P = 0.006), 25% (P = 0.026) and 50% (P = 0.011) for low-, intermediate- and high-risk groups, respectively.CONCLUSIONSWe confirmed, with a longer follow-up, the clinical utility of the PPBC in determining the pathological features and biochemical outcome of patients with prostate cancer treated with radical prostatectomy, and established thresholds for use in patients in the three risk groups.
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    Prediction of pathological stage in prostate cancer through the percentage of involved fragments upon biopsy
    (Sociedade Brasileira de Urologia, 2005-10-01) Dall'Oglio, Marcos Francisco [UNIFESP]; Crippa, Alexandre [UNIFESP]; Oliveira, Luis C. [UNIFESP]; Neves Neto, Joao Ferreira [UNIFESP]; Leite, Kátia Ramos Moreira [UNIFESP]; Srougi, Miguel [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    INTRODUCTION: The need for defining the extension of disease in patients undergoing radical prostatectomy due to prostate adenocarcinoma is a relevant factor cure in such individuals. In order to identify a new independent preoperative factor for predicting the extension of prostate cancer, we assessed the role of the percentage of positive fragments upon biopsy. MATERIALS AND METHODS: A retrospective study compared the percentage of positive fragments on biopsy with the extension of disease as defined by the pathological examination of the surgical specimen from 898 patients undergoing radical prostatectomy due to clinically localized prostate cancer. RESULTS: On the univariate analysis, the percentage of positive fragments on biopsy showed a statistical significance for predicting confined disease (p < 0.001), which was found in 66.7% of the cases under study. Additionally, we observed that the total number of removed fragments exerts no influence on the extension of the disease (p = 0.567). CONCLUSION: the percentage of positive fragments is an independent factor for predicting the pathological stage of prostate adenocarcinoma, and the number of removed fragments is not related to the extension of the disease.
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    Prognostic value of the percentage of positive fragments in biopsies from patients with localized prostate cancer
    (Sociedade Brasileira de Urologia, 2005-02-01) Antunes, Alberto A. [UNIFESP]; Dall'Oglio, Marcos Francisco [UNIFESP]; Sant'anna, Alexandre C. [UNIFESP]; Paranhos, Mario [UNIFESP]; Leite, Kátia Ramos Moreira [UNIFESP]; Srougi, Miguel [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    OBJECTIVE: To assess the prognostic value of the percentage of positive fragments (PPF) in biopsies from patients with localized prostate cancer (PCa) undergoing radical prostatectomy. MATERIALS AND METHODS: During the period from March 1991 to November 2000, 440 patients were selected. Cases receiving neoadjuvant or adjuvant hormone therapy, or adjuvant radiotherapy, were excluded, as were cases presenting Gleason scores higher than 6 at biopsy. PPF was defined as the total number of fragments divided by the total number of biopsy fragments times 100. This variable was initially divided into categories from 0 to 25%, 25.1% to 50%, 50.1 to 75% and 75% to 100%. During the postoperative period, patients were assessed every 2 months for 1 year, then every 6 months for 5 years, and then yearly. Biochemical recurrence was defined as serum PSA higher than or equal to 0.4 ng/mL. Median follow-up was 60 months. RESULTS: One hundred and nine (24.8%) of the 440 patients under study had biochemical recurrence. In the univariate analysis, PPF significantly influenced disease-free survival (log-rank, p < 0.001), and patients with PPF between 75 and 100% presented a risk of a biochemical recurrence of the disease 3 times higher than patients with PPF between 0 and 25% (p < 0.001). After the Cox regression analysis, both serum PSA (p = 0.001) and PPF (p < 0.001) showed to be independent predictive factors for disease-free survival following surgery. CONCLUSION: PPF measurement in biopsy is a simple and practical method, which should be routinely used as a predictive factor for biochemical recurrence in patients with PCa presenting Gleason scores between 2 and 6.
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    Survival of patients with prostate cancer and normal PSA levels treated by radical prostatectomy
    (Sociedade Brasileira de Urologia, 2005-06-01) Dall'Oglio, Marcos Francisco [UNIFESP]; Crippa, Alexandre [UNIFESP]; Antunes, Alberto A. [UNIFESP]; Nesrallah, Luciano J. [UNIFESP]; Leite, Kátia Ramos Moreira [UNIFESP]; Srougi, Miguel [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    INTRODUCTION: The unpredictability of prostate cancer has become a daily challenge for the urologist, with different strategies being required to manage these cases. In this study, we report on the perspectives for curing prostate cancer in males undergoing radical prostatectomy with Gleason score of 2-6 on prostate biopsy in relation to pre-operative PSA levels. MATERIALS AND METHODS: From 1991 - 2000, we selected 440 individuals whose pathological diagnosis revealed a Gleason score of 2-6 upon prostate biopsy and who subsequently underwent retro-pubic radical prostatectomy due to localized prostate cancer. The clinical stage identified in the group under study was T1c: 206 (46.8%); T2a: 122 (27.7%); T2b: 93 (21.1%); T2c: 17 (3.9%); T3a: 2 (0.5%). Following surgery, we constructed a biochemical recurrence-free survival curve according to pre-operative PSA levels between 0-4; 4.1-10; 10.1-20 and > 20 ng/mL, with a median follow-up of 5 years. RESULTS: Following radical prostatectomy, the pathological stage was confirmed as pT2a: 137 (31.1%); T2b: 118 (26.8%); T2c: 85 (19.3%); T3a: 67 (15.2%); T3b: 6 (1.4%); T3c: 22 (5%). The biochemical recurrence-free survival, according to PSA values between 0-4; 4.1-10; 10.1-20 and > 20 ng/mL, was 86.6%, 62.7%, 39.8% and 24.8% respectively. CONCLUSION: Better chances for curing low-grade prostate cancer occur in individuals with normal PSA for whom a biopsy is not usually recommended.
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    Value of various PSA parameters for diagnosing prostate cancer in men with normal digital rectal examination
    (Sociedade Brasileira de Urologia, 2004-04-01) Miotto Junior, Ari [UNIFESP]; Srougi, Miguel [UNIFESP]; Brito, George A. de [UNIFESP]; Leite, Kátia Ramos Moreira [UNIFESP]; Nesrallah, Adriano J. [UNIFESP]; Ortiz, Valdemar [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    OBJECTIVES: The risks of identifying prostate cancer (PCa) in patients with serum total PSA (tPSA) between 4 and 10 ng/dl are between 25 and 35%. There are no data in Brazil showing the incidence of disease when all variables for PSA assessment are considered altogether, specifically tPSA, free fraction, PSA velocity and PSA stratified by age. The objective in this work was to define the incidence of disease in a population of men with abnormal values of PSA variables and normal digital rectal examination. MATERIALS AND METHODS: Between 1998 and 2003, 273 prostate biopsies were performed by the same radiologist and analyzed by the same pathologist. All patients had a normal digital rectal examination and biopsy had been indicated due to tPSA above 4 ng/dl or free-to-total PSA ratio (F/T PSA) below 15% or PSA velocity higher than 25% per year or a PSA level regarded as high for the age range. The relationship between these parameters and the positivity for prostate caner was determined. RESULTS: Patients' mean age was 63.8 years, and PCa was identified in 135 cases (49.5%). The incidence of PCa, related to unitary variations in tPSA, ranged from the limits of 33 to 80%, respectively, in tPSA < 3 and PSA between 15.1 to 20. When the other PSA parameters were assessed (free PSA, PSA according to age, rise velocity) PCa was detected in more than 25.3% of cases. CONCLUSION: When patients with normal digital rectal examination are selected for prostate biopsy due to tPSA levels above 4 or F/T PSA ratio lower than 15% or PSA velocity higher than 25% per year or high PSA for the age range, the incidence of PCa is quite higher than that observed in a population selected exclusively with basis on total PSA value.