Oligoclonal bands in unconcentrated CSF

Agarose gel electrophoresis (AGE) and agarose isoelectric focusing (AIEF) were performed on unconcentrated CSF from patients with multiple sclerosis and other neurological disorders. Electrophoretic profiles were examined after staining with silver. Oligoclonal distribution of immunoglobulins were observed in over 90% of patients with clinically definite multiple sclerosis and over half of all patients with possible or probable multiple sclerosis. Up to 20 samples could be simultaneously examined and required the use of only 2–20 μL of unconcentrated CSF containing 10–100 ng of total IgG. The entire procedure from sample application to completion of staining required less than 3 h. The techniques offered exquisite resolution of abnormal immunoglobulin bands and permitted distinction of normal from abnormal CSF readily.     

Interobserver reproducibility of histologic parameters of melanoma deposits in sentinel lymph nodes

BACKGROUND:

Histologic parameters of melanoma deposits in sentinel lymph nodes (SLNs) have been shown to be predictive of clinical outcome and the presence or absence of tumor in non‐SLNs, but assessment of these parameters is prone to interobserver variation.

METHODS:

Histologic sections of 44 SLNs containing metastatic melanoma were examined by 7 pathologists. Parameters assessed included cross‐sectional area of tumor deposits, cross‐sectional area of SLNs, percentage of SLN area involved by tumor calculated from the 2 previous parameters, estimated percentage of SLN area involved by tumor, tumor penetrative depth, location of tumor within the SLN, and presence of extracapsular spread. Levels of interobserver agreement were measured by using intraclass correlation coefficients (ICC).

RESULTS:

There was good to excellent interobserver agreement on measurement of quantitative parameters: maximal size of largest tumor deposits, calculated area of 3 largest tumor deposits, percentage of the area of SLN involved by tumor, and tumor penetrative depth (ICC, 0.88, 0.73, 0.68, and 0.83, respectively). There was moderate agreement on the evaluation of subcapsular versus nonsubcapsular location of tumor deposits (ICC = 0.50). Agreement on assessment of extracapsular spread was fair (ICC = 0.39).

CONCLUSIONS:

Assessment of some of the quantitative parameters was highly reproducible between pathologists. However, evaluation of the location of tumor deposits within SLNs and assessment of extracapsular spread was less reproducible. Clearer definitions and training can be expected to improve the reproducibility of assessment. These results have important implications for reliability and reproducibility of these parameters in staging, prediction of outcome, and clinical management of melanoma patients. Cancer 2009. © 2009 American Cancer Society.     

Pathological,molecular, and clinical characteristics of cholangiocarcinoma: A comprehensive review

Cholangiocarcinomas are a heterogeneous group of highly aggressive cancers that may arise anywhere within the biliary tree. There is a wide geographical variation with regards to its incidence, and risk-factor associations which may include liver fluke infection, primary sclerosing cholangitis, and hepatolithiasis amongst others. These tumours are classified into intrahepatic, perihilar and distal based on their anatomical location. Morphologically, intrahepatic cholangiocarcinomas are further sub-classified into small and large duct variants. Perihilar and distal cholangiocarcinomas are usually mucin-producing tubular adenocarcinomas. Cholangiocarcinomas develop through a multistep carcinogenesis and are preceded by dysplastic and in situ lesions. While clinical characteristics and management of these tumours have been extensively elucidated in literature, their ultra-structure and tumour biology remain relatively unknown. This review focuses on the current knowledge of pathological characteristics, molecular alterations of cholangiocarcinoma, and its precursor lesions (including biliary intraepithelial neoplasia, intraductal papillary neoplasms of the bile duct, intraductal tubulopapillary neoplasms and mucinous cystic neoplasm).