Background and Objectives: In this study, we aimed to describe the clinical and ultrasound (US) features and the outcome in a group of patients suspected of or diagnosed with early onset intrauterine growth restriction (IUGR) requiring iatrogenic delivery before 32 weeks, having no structural or genetic fetal anomalies, managed in our unit. A secondary aim was to report the incidence of the condition in the population cared for in our hospital, data on immediate postnatal follow-up in these cases and to highlight the differences required in prenatal and postnatal care. Materials and Methods: We used as single criteria for defining the suspicion of early IUGR the sonographic estimation of fetal weight < p10 using the Hadlock 4 technique at any scan performed before 32 weeks’ gestation (WG). We used a cohort of patients having a normal evolution in pregnancy and uneventful vaginal births as controls. Data on pregnancy ultrasound, characteristics and neonatal outcomes were collected and analyzed. We hypothesized that the gestational age (GA) at delivery is related to the severity of the condition. Therefore, we performed a subanalysis in two subgroups, which were divided based on the GA at iatrogenic delivery (between 27+0 WG and 29+6 WG and 30+0–32+0 WG, respectively). Results: The prospective cohort study included 36 pregnancies. We had three cases of intrauterine fetal death (8.3%). The incidence was 1.98% in our population. We confirmed that severe cases (very early diagnosed and delivered) were associated with a higher number of prenatal visits and higher uterine arteries (UtA) pulsatility index (PI) centile in the third trimester—TT (compared with the early diagnosed and delivered). In the very early suspected IUGR subgroup, the newborns required significantly more NICU days and total hospitalization days. Conclusions: Patients with isolated very early and early IUGR—defined as ultrasound (US) estimation of fetal weight < p10 using the Hadlock 4 technique requiring iatrogenic delivery before 32 weeks’ gestation—require closer care prenatally and postnatally. These patients represent an economical burden for the health system, needing significantly longer hospitalization intervals, GA at birth and UtA PI centiles being related to it.
Non-small cell lung carcinomas (NSCLC) are common lung tumors with numerous growth patterns associated with lesion types, which are frequently diagnosed late and are associated with a reserved prognosis. In this study, we analyzed histopathologically and statistically 52 cases of NSCLC, for which the growth types/patterns were described and compared with tumor grade, the presence of vessels invasion and stage of tumor. We observed the predominance of adenocarcinomas (ADK) and acinar, cribriform, solid and papillary growth patterns, frequent mixed transitional areas, while for squamous cell carcinomas (SCC) the non-keratinized aspect was dominant. Vascular invasion was identified in 38.5% of cases, most NSCLC being in advanced stages, respectively 57.7%. ADK with cribriform, solid, and micropapillary patterns, as well as nonkeratinized SCC (NKSCC) and large cell carcinoma (LCC) were significantly associated with high grade, vessels invasion, and advanced stage of tumos. Transitional areas of ADK and focal keratinizations in SCC suggest the presence of specific lung tumor histological lesions, which in evolution acquire aggressive patterns.
Background/Objectives: Endometrial carcinoma is an emerging challenge for public health systems globally, especially in countries with a high development index. Traditionally, histopathological staging and grading have been the main criteria informing treatment modalities. More recently, clinically actionable molecular targets have been developed, following observations from the TCGA project and the ProMisE cohort. Although promising, the cost of these methods is an obstacle for some countries that lack well developed theranostics infrastructure in their public systems. This study aimed to contextualize our center’s diagnostic experience from the perspective of histopathological diagnosis. Methods: This is a retrospective study that selected 109 cases of already diagnosed endometrial carcinoma from the interval of 2017–2023. We analyzed traditional parameters related to staging and grading, using the FIGO 2009 system as well as basic histological parameters (lymphovascular invasion, perineural invasion, necrosis). Excel and SPSS 26 were used for database management and correlations. Findings were contextualized using the more recent studies that reported on similar parameters. Results: Higher-grade tumors were associated with lymphovascular invasion (p = 0.04) and lymph node involvement (p = 0.0006), as well as deeper myoinvasion (p = 0.0018). Myoinvasion (p = 0.013) and lymphovascular invasion (p = 0.0001) were associated with advanced disease (FIGO III and IV). Our cohort showed a relative paucity (6.5%) of non-endometrioid endometrial carcinoma and presence of lymphovascular invasion (9.2%). Perineural invasion was found in 3 cases with extrauterine involvement. Conclusions: Histopathological diagnosis represents an integral component in informing clinical management for endometrial carcinoma and should serve as a means of triage for more expensive molecular techniques. It nevertheless presents reproducibility issues. Further efforts should focus on resolving such issues or possibly introducing less-researched parameters like perineural invasion.
Gastric adenocarcinomas (GAC) constitute a major problem in clinical practice, for which late diagnosis and heterogeneity contribute greatly to maintaining epidemiological mortality rates. One of the recent approaches related to the prognosis and therapy of GAC refers to the activation of an effective antitumor immune response, which is not fully known in terms of cellular substrate or interaction with the tumor parenchyma. In this study, we analyzed the chronic mononuclear inflammatory infiltrate in 125 primitive GAC, in relation to the classic histological parameters of tumor aggressiveness, based on a composite histological score (CHS) that took into account the distribution and density of the elements tracked. The results indicated significant differences, most GAC having a predominantly peritumoral infiltrate except for poorly cohesive signet ring cell carcinomas (PC-SRC) in which intratumoral elements predominated. Density and CHS were higher in PC-SRC GAC and MX-GAC (mixed), in high-grade, stage III tumors with vascular invasion. Although the pattern or density of inflammation in GAC does not necessarily reflect the orientation or antitumor efficacy of immune elements, the data obtained may be useful for the development of histological criteria to assist in stratifying patients for therapy.
The most common tumor of the western world is comprised of forms of non-melanoma skin cancers, previously known as keratinocyte carcinomas (KCs) The purpose of this study was to determine de incidence of non-melanoma skin tumors and the relationship between histopathological risk factors in patients with skin cancers. The study was composed from 332 cases of skin malignancies for which clinical and histopathological aggressivity factors were statistically analyzed through comparison tests and also stored digitally. For basal cell carcinoma (BCC) statistical analysis indicated significant relationships between pT category and gender, tumor size, ulceration, depth of invasion and positive resection limits. For squamous cell carcinoma (SCC) statistical analysis indicated significant relationships between pT category and tumor size, depth of invasion and positive resection limits. Clinical and histological analysis of certain characteristics of the above-mentioned skin cancers is an essential step in documenting and improving both prognosis and therapy standards.