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Search Results: 1 - 10 of 458 matches for " Helenice Gobbi "
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Classifica??o dos tumores da mama: atualiza??o baseada na nova classifica??o da Organiza??o Mundial da Saúde de 2012
Gobbi, Helenice;
Jornal Brasileiro de Patologia e Medicina Laboratorial , 2012, DOI: 10.1590/S1676-24442012000600013
Abstract: the world health organization released the 4th edition of the classification of breast tumors in july 2012. this review summarizes the principal changes that were introduced in the new classification with emphasis on diagnostic and therapeutic implications. the major changes were: (i) the new edition is entirely dedicated to breast tumors; (ii) the epithelial tumors were sorted differently, recognizing nine special types and variants, and eleven rare types of breast tumors apart from invasive ductal carcinoma of no special type. new codes were included for the lobular, medullary, and metaplastic subtypes; (iii) new scores were suggested for the immunohistochemical evaluation of hormone receptor (> 1% positive cells) and human epidermal growth factor receptor 2 (her2) (> 30% highly positive cells surrounding the whole membrane); (iv) a new approach to molecular and genomic classification of breast cancer was presented including predictive and prognostic tests using gene expression profile; (v) the traditional terminology of intraductal proliferative lesions was maintained and the terminology ductal intraepithelial neoplasia was not recommended; (vi) the prognostic importance of distinguishing atypical lobular hyperplasia and lobular carcinoma in situ (lcis) within the spectrum of lobular neoplasia was acknowledged; (vii) the columnar cell lesions (columnar cell change and columnar cell hyperplasia without atypia) were excluded from the flat epithelial atypia group, whose biological behavior is still unknown. it is expected that the widespread use of the new classification by pathologists and oncologists will benefit patients by improving diagnostic and therapeutic decisions.
Padr?o de mortalidade da comunidade judaica de Belo Horizonte no século XX
Balabram, Débora;Gobbi, Helenice;
Revista da Associa??o Médica Brasileira , 2006, DOI: 10.1590/S0104-42302006000600020
Abstract: objective: genetic and environmental factors are known for their importance in the genesis of the majority of diseases. it is possible to study them through the observation of prevalence of diseases, and also the mortality causes, relating it to social habits and ethnical and familial origins of the individuals. in those studies, communities in which there are social and genetic links stand out. the jewish community of belo horizonte fits these criteria. it has been consolidated in the 20th decade of the last century. nowadays the federa??o israelita de minas gerais (fisemg) has records of approximately 600 families. the purpose of this study is to define the mortality pattern in this community, and how it has changed since the community's formation. methods: data was recovered from the files of the instituto histórico israelita mineiro, the fisemg and from the cemeteries israelita and bonfim. results: 601 death registries have been studied, 61,6% belonging to men and 38,4% to women. the diseases of the circulatory system were the most frequent cause of death since the decade of 40, and infectious diseases, including tuberculosis, deserve note in the decades of 30 and 40. conclusion: there was a change in death pattern of the jewish community of belo horizonte.
Mielinolise pontina central e extra-pontinas: apresenta??o de um caso autopsiado e revis?o da literatura
Pittella, José Eymard Homem;Gobbi, Helenice;
Arquivos de Neuro-Psiquiatria , 1987, DOI: 10.1590/S0004-282X1987000300011
Abstract: an autopsied case of central pontine and extrapontine myelinolysis in a 16-year-old diabetic girl is described. due to dehydration she was treated vigorously with daily intravenous isotonic saline, from the first day of hospitalization. in the first three days the serum sodium level increased by more than 30 meq/1 when compared with the initial level. by the next days the serum sodium level, after a mild drop, rose again and was maintained above normal range for a further 12 days. on the sixth day of this new and sustained serum sodium increase, the patient presented progressive neurological manifestations that remained until her death, characterized by mutism, inability to eat, to move her head, trunk, and members and, in addition, retention of respiratory secretions. the neuropathological examination showed massive central pontine myelinolysis and similar myelinolytic lesions in the subcortical white matter of the temporal lobe, the right optic tract, the external and extreme capsules to the right, the main mammillary tract and the subcortical white matter of the left cerebellar hemisphere. the review of the literature on central pontine and extrapontine myelinolysis shows that the present case is the 30th of such condition. the clinical picture and the etiopathogenesis of central pontine and extrapontine myelinolysis are commented upon. it is suggested, as possible causative factors, the persistent and rapid correction of serum sodium concentration as well as its flutuation in patients with hyponatremia and/or dehydration.
Columnar cell lesions of the canine mammary gland: pathological features and immunophenotypic analysis
Enio Ferreira, Helenice Gobbi, Bruna S Saraiva, Geovanni D Cassali
BMC Cancer , 2010, DOI: 10.1186/1471-2407-10-61
Abstract: A total of 126 lesions were subjected to a comprehensive morphological review based upon the human breast classification system for columnar cell lesions. The presence of preinvasive (epithelial hyperplasia and in situ carcinoma) and invasive lesions was determined and immunophenotypic analysis (estrogen receptor (ER), progesterone receptor (PgR), high molecular weight cytokeratin (34βE-12), E-cadherin, Ki-67, HER-2 and P53) was perfomed.Columnar cell lesions were identified in 67 (53.1%) of the 126 canine mammary glands with intraepithelial alterations. They were observed in the terminal duct lobular units and characterized at dilated acini may be lined by several layers of columnar epithelial cells with elongated nuclei. Of the columnar cell lesions identified, 41 (61.2%) were without and 26 (38.8%) with atypia. Association with ductal hyperplasia was observed in 45/67 (67.1%). Sixty (89.5%) of the columnar cell lesions coexisted with neoplastic lesions (20 in situ carcinomas, 19 invasive carcinomas and 21 benign tumors). The columnar cells were ER, PgR and E-cadherin positive but negative for cytokeratin 34βE-12, HER-2 and P53. The proliferation rate as measured by Ki-67 appeared higher in the lesions analyzed than in normal TDLUs.Columnar cell lesions in canine mammary gland are pathologically and immunophenotypically similar to those in human breast. This may suggest that dogs are a suitable model for the comparative study of noninvasive breast lesions.The development of human breast cancer is believed to be a complex multistep process originating in terminal duct lobular units (TDLUs) and progressing towards invasive cancer. Various precursor breast lesions have been implicated in cancer development: atypical ductal hyperplasia (ADH), atypical lobular hyperplasia (ALH), lobular carcinoma in situ (LCIS), ductal carcinoma in situ (DCIS) and more recently columnar cell lesions (CCLs) [1,2].Columnar cell lesions (CCL) of the human breast comprise a group of condit
Cell cycle related proteins in hyperplasia of usual type in breast specimens of patients with and without breast cancer
Luciene SA Tafuri, Gislene FS Rocha, Helenice Gobbi
BMC Cell Biology , 2006, DOI: 10.1186/1471-2121-7-29
Abstract: Immunohistochemical evaluation was performed using antibodies against cell cycle related proteins ER, PR, p53, p21, p63, and Ki-67 in hyperplasia of usual type (HUT) in specimens of aesthetic reduction mammaplasty (ARM), in specimens of mammaplasty contralateral to breast cancer (MCC), and in specimens of invasive mammary carcinomas (IMC) presenting HUT in the adjacent parenchyma. The results showed that the immunoexpression of ER, PR, p21, p53, p63, and KI-67 was similar in HUT from the three different groups. The p63 expression in myoepithelial cells showed discontinuous pattern in the majority of HUT, different from continuous expression in normal lobules. Nuclear expression of p53 and p21 was frequently higher expressed in IMC and very rare in HUT. We also found cytoplasmic expression of p21 in benign hyperplastic lesions and in neoplastic cells of IMC.Our data failed to demonstrate different expression of cell cycle related proteins in HUT from patients with and without breast cancer. However, we found discontinuous expression of p63 in myoepithelial cells around HUT adjacent to carcinomas and cytoplasmic expression of p21 in epithelial cells of hyperplastic foci. Further studies are needed to determine how these subgroups relate to molecular abnormalities and cancer risk.The hypothetical multistep model of carcinogenesis indicates that breast cancer develops via a series of intermediate hyperplastic lesions through in situ to invasive carcinomas, with the risk of developing carcinoma increasing at each stage [1-3]. Epidemiological studies demonstrated an increased risk of developing breast cancer associated with proliferative breast lesions. Hyperplasia of usual type (HUT) is a common proliferative lesion associated with a slightly elevated risk for subsequent development of breast cancer (relative risk = 1.6, augmented to 2.1 with positive family history) [1,2,4]. HUT is not necessarily a direct precursor of invasive breast carcinoma but may identify individu
Predictive factors of breast cancer evaluated by immunohistochemistry
Gobbi, Helenice;Rocha, Rafael Malagoli;Nunes, Cristiana Buzelin;
Jornal Brasileiro de Patologia e Medicina Laboratorial , 2008, DOI: 10.1590/S1676-24442008000200010
Abstract: hormone receptor and her2 protein overexpression evaluated by immunohistochemistry (ihc) is widely validated as a predictive factor in breast cancer. the quality of the ihc reaction is influenced by tissue fixation and processing. over- and underfixation deeply affect ihc results. antigen retrieval may improve ihc but it does not recover tissue from autolysis or overfixation. the choice of primary antibody for ihc as to its sensitivity and specificity in relation to therapeutic response represents an important stage. apart from mouse monoclonal antibodies, new rabbit monoclonal antibodies are commercially available, such as clones anti-er sp1 and b644, anti-pr sp2 and b645 and anti-her2 sp3 and 4b5. they represent an alternative to hormone receptor and her2 evaluation by ihc. new polymeric non-biotinylated detection systems are also available and allow accurate and strong marking with no stromal and no non-specific cytoplasmic staining due to endogenous biotin. the most recommended cut off for estrogen and progesterone receptors (er and pr) is more than 1% of positive cells with moderate or strong staining intensity (allred's scoring system). new guidelines for her2 evaluation by ihc show a cut off of more than 30% of positive cells with strong intensity (3+) that correlates better with gene amplification. the 2+ cases are now considered indeterminate and should be confirmed by fluorescence in situ hybridisation (fish) or chromogenic in situ hybridisation cish. a quality control of pre-analytical, analytical and post-analytical phases of ihc is recommended in order to optimize results.
Hiperplasias epiteliais em espécimes de mamoplastia redutora estética bilateral e mamoplastia redutora contralateral a cancer de mama
Tafuri, Luciene Sim?es de Assis;Gobbi, Helenice;
Jornal Brasileiro de Patologia e Medicina Laboratorial , 2005, DOI: 10.1590/S1676-24442005000200012
Abstract: background: reduction mammaplasty is a surgery whose objective is to reduce the mammary size, improving aesthetic (meb), or to attain of aesthetic balance in patients submitted to mammaplasty contralateral to breast cancer (mrc). the incidence of breast lesions in these specimens is variable and the previous cancer in one breast is a known risk factor for cancer in the contralateral breast. aims: to compare the frequency of epithelial proliferative breast lesions and other histological changes in specimens of meb and mrc. methods: breast surgical specimens from 867 meb and 72 mrc had been reviewed and histological changes evaluated, with emphasis in epithelial hyperplasias relating them to patient's age. results: the average age of patients was meb = 34 years and mrc = 50.3 years. fibrocystic change was the most common diagnosis. cysts/duct estasia were present in 50.9% of meb and 59.7% of mrc. epithelial hyperplasia was diagnosed in 10.1% of meb and 43.1% of mrc specimens, especially in women over 40 years. usual hyperplasia was the most frequent type in both groups (meb = 9.8% and mrc = 33.3%). atypical hyperplasia was present in 0.3% meb and 9.7% mrc cases. conclusions: the incidence of epithelial hyperplasias was higher in mrc than in meb specimens in spite of age.
Lobular neoplasia: frequency and association with other breast lesions
Douglas S Gomes, Débora Balabram, Simone S Porto, Helenice Gobbi
Diagnostic Pathology , 2011, DOI: 10.1186/1746-1596-6-74
Abstract: Cases were selected after reviewing archived pathological reports in the Breast Pathology Laboratory, School of Medicine of Federal University of Minas Gerais (1999-2008). Cases of lobular neoplasia were reviewed and classified as atypical lobular hyperplasia, ductal involvement by cells of atypical lobular hyperplasia, lobular carcinoma in situ, and pleomorphic lobular carcinoma in situ. Coexistence of lobular neoplasia with other breast lesions, including columnar cell lesions, invasive ductal carcinoma and invasive lobular carcinoma, was evaluated. The association between lobular neoplasia and breast lesions was analyzed by Fisher's exact test and chi-square test for linear trend.We analyzed 5650 breast specimens, selecting 135 breast specimens (2.4%) that had a diagnosis of lobular neoplasia, corresponding to 106 patients. Hematoxylin and eosin-stained slides were available for 84 cases, 5 of which were excluded because they contained only "indeterminate" in situ lesions. Of the 79 remaining cases, columnar cell lesions were present in 78.5%, primarily with columnar cell changes without atypia (67.7%). Invasive carcinoma was present in 45.6% of cases of lobular neoplasia--a similar frequency (47.2%) as invasive ductal carcinoma and invasive lobular carcinoma. We noted a significant linear trend (p < 0.03) of a higher frequency of invasive carcinomas that were concomitant with lobular carcinoma in situ compared with atypical lobular hyperplasia. Invasive lobular carcinomas were associated with lobular carcinoma in situ in 33% of cases, compared with 2.8% of atypical lobular hyperplasia cases.Our findings confirm a frequent association between lobular neoplasia and columnar cell lesions, the majority of which lacked atypia. We also observed a greater frequency of invasive carcinoma, more commonly invasive lobular carcinoma, associated with more developed forms of lobular neoplasia (lobular carcinoma in situ).The virtual slide(s) for this article can be found here:
Lymph vascular invasion in invasive mammary carcinomas identified by the endothelial lymphatic marker D2-40 is associated with other indicators of poor prognosis
Vanessa FZ Marinho, Konradin Metze, Fernanda SF Sanches, Gislene FS Rocha, Helenice Gobbi
BMC Cancer , 2008, DOI: 10.1186/1471-2407-8-64
Abstract: We selected 123 cases of invasive mammary carcinomas stratified into three subgroups according to axillary lymph node status: macrometastases, micrometastases, and lymph node negative. Lymphatic (LVI) and blood (BVI) vessel invasion were evaluated by H&E and immunohistochemistry using the D2-40 and CD31 antibodies, and related to histologic tumor type and grade, estrogen and progesterone receptors, E-cadherin, Ki67, p53, and Her2/neu expression.LVI was detected in H&E-stained sections in 17/123 cases (13.8%), and in D2-40 sections in 35/123 cases (28.5%) (Kappa = 0.433). BVI was detected in H&E-stained sections in 5/123 cases (4.1%), and in CD31 stained sections in 19/123 cases (15.4%) (Kappa = 0.198). LVI is positively related to higher histologic grade (p = 0.013), higher Ki67 expression (p = 0.00013), and to the presence of macrometastases (p = 0.002), and inversely related to estrogen (p = 0.0016) and progesterone (p = 0.00017) receptors expression.D2-40 is a reliable marker of lymphatic vessels and is a useful tool for lymphatic emboli identification in immunostained sections of breast carcinomas with higher identification rates than H&E. Lymphatic vessel invasion was related to other features (high combined histologic grade, high Ki67 score, negative hormone receptors expression) associated with worse prognosis, probable reflecting a potential for lymphatic metastatic spread and aggressive behavior.Lymphatic vessels are considered the main route by which tumor cells reach axillary lymph nodes [1-3]. Lymphatic vessel invasion (LVI) is known as an independent predictor of lymph node metastases in breast cancer. The diagnosis of LVI is made based on the presence of tumor emboli within vascular channels lined by a single layer of endothelial cells without red blood cells. Lymphatic vessels are flattened channels or open spaces lined by a single layer of endothelial cells whose lumen are sometimes filled with lymphocytes. However, the identification of LVI is diffi
A comparative study between mixed-type tumours from human salivary and canine mammary glands
Marisa CLS Genelhu, Sérgio V Cardoso, Helenice Gobbi, Geovanni D Cassali
BMC Cancer , 2007, DOI: 10.1186/1471-2407-7-218
Abstract: Ten examples of each mixed tumour type (human pleomorphic adenoma and carcinomas ex-pleomorphic adenomas and canine mixed tumour and metaplastic carcinoma) were evaluated. First, clinical and morphologic aspects of benign and malignant variants were compared between the species. Then, streptavidin-biotin-peroxidase immunohistochemistry was performed to detect the expression of cytokeratins, vimentin, p63 protein, estrogen receptor, β-catenin, and E-cadherin.After standardization, similar age and site distributions were observed in human and canine tumours. Histological similarities were identified in the comparison of the benign lesions as well. Metaplastic carcinomas also resembled general aspects of carcinomas ex-pleomorphic adenomas in morphological evaluation. Additionally, immunohistochemical staining further presented similar antigenic expression between lesions.There are many similar features between human salivary and canine mammary gland mixed tumours. This observation is of great relevance for those interested in the study and management of salivary gland tumours, since canine lesions may constitute useful comparative models for their investigations.Animal models have been widely used to investigate several forms of human neoplasias. Because of centuries of coexistence with humans in the same environment, dogs are of particular interest as they provide important evolutionary information. In addition, both species show great genotypic similarities [1]. Thus, spontaneous tumours of canine mammary glands have been proposed as comparative models for the study of human breast cancer, since these lesions share epidemiological, clinical, behavioural and antigenic features [2-5].There is also a well-known relationship between the incidence of human mammary and salivary glands tumours [6-9]. Morphological similarities have been described between certain tumours of salivary glands and breast neoplasias such as those existing between polymorphous low-grade adenocarci
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