The Experts below are selected from a list of 219 Experts worldwide ranked by ideXlab platform
Asif Khalid - One of the best experts on this subject based on the ideXlab platform.
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Pancreatic Endocrine Tumor eus guided fna dna microsatellite loss and mortality
Gastrointestinal Endoscopy, 2009Co-Authors: Kenneth E Fasanella, Kevin Mcgrath, Michael K Sanders, Debra Brody, Robyn T Domsic, Asif KhalidAbstract:Background The clinical course of Pancreatic Endocrine Tumors (PET) depends on Tumor size, the presence of invasion or metastasis, the Ki-67 index, mitoses per high power field, and mutational damage. Most of this information is not available before surgery for clinical decision making or prognostication. Objective To evaluate PET EUS-guided FNA (EUS-FNA) microsatellite loss analysis in the context of PET-related mortality. Design A single institution retrospective cohort. Patients Patients with PET diagnosed by EUS-FNA who underwent DNA microsatellite loss analysis and at least 1 year of follow-up or subsequent death. Intervention PET microsatellite loss analysis results and current clinical status were compared. Results Twenty-nine patients were included in the final analysis; the mean age of the patients was 57 years, and 10 were women (35%). The mean follow-up was 33.7 months (median 30 months, range 2-66 months). Twelve patients had disease progression, and 8 died, all from disease-specific causes. Malignant PET contained multiple microsatellite losses, with a median fractional allelic loss (FAL) of 0.37 (range 0.12-0.69, interquartile range [IQR] 0.23-0.42), significantly different from benign PET, median FAL 0 (range 0-0.18, IQR 0-0.08, P P 0.2 ( P 0.2 and disease status or mortality. Limitations Retrospective design, referral bias, and DNA analysis availability. Conclusions PET EUS-FNA microsatellite loss analysis provides preoperative prognostic information. An FAL >0.2 is not only associated with disease progression but also with mortality.
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endoscopic ultrasound guided fine needle aspirate microsatellite loss analysis and Pancreatic Endocrine Tumor outcome
Clinical Gastroenterology and Hepatology, 2006Co-Authors: Laurentia Nodit, Kevin Mcgrath, Maliha Zahid, Niraj Jani, Karen E Schoedel, Paul N Ohori, Sally E Carty, Sydney D Finkelstein, Asif KhalidAbstract:Background & Aims: The clinical course of Pancreatic Endocrine Tumor (PET) varies depending on Tumor aggressiveness, disease extent, and possibly accumulated molecular alterations. Endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) results, although accurate in diagnosing PET, correlate poorly with PET outcome. The role of detecting key molecular abnormalities in predicting PET behavior and clinical outcome from EUS-FNA material remains unknown. Methods: Patients with confirmed PET who underwent EUS-FNA during a 32-month period were included. Patient demographics and clinical data were recorded and follow-up information was obtained by contacting their physician to evaluate disease progression. Representative Tumor cells were microdissected from the FNA material. DNA was harvested and amplified, targeting a panel of 17 polymorphic microsatellite markers on chromosomes 1p, 3p, 5q, 9p, 10q, 11q, 17p, 17q, 21q, and 22q. The polymerase chain reaction products were subjected to fluorescent capillary gel electrophoresis to detect microsatellite loss. The fractional allelic loss (FAL) was calculated. Results: Twenty-five patients were studied. Thirteen were classified histologically as benign PET limited to the pancreas and 12 as malignant PET (invasive or metastatic). The mean FAL in the benign and malignant PET was 0.03 and 0.37 ( P P Conclusions: Microsatellite loss analysis of EUS-FNA material from PET can be performed reliably and an FAL value of more than 0.2 is associated with disease progression. This technique may have value in the preoperative assessment and risk stratification of patients with PET.
Hong Qi Peng - One of the best experts on this subject based on the ideXlab platform.
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metastatic merkel cell carcinoma of the pancreas mimicking primary Pancreatic Endocrine Tumor diagnosed by endoscopic ultrasound guided fine needle aspiration cytology
Acta Cytologica, 2009Co-Authors: Summer L Nugent, Peter Darwin, Hong Qi PengAbstract:Background Merkel cell carcinoma (MCC) is a relatively infrequent, rapidly progressive and often fatal cutaneous malignancy exhibiting neuroEndocrine differentiation. It has a penchant for local recurrence and distant metastasis to various sites, including regional lymph nodes, distant skin, lung, liver, testis and other rare organs, such as the pancreas. There are only 4 cases of MCC metastatic to the pancreas reported in the English-language literature, and they were all diagnosed by histology from Pancreatic resection. Case A 79-year-old woman with a large Pancreatic tail mass underwent endoscopic ultrasound guided fine needle aspiration (EUS-FNA). She had a history of MCC of the upper extremity with wide local excision 15 months earlier. Metastatic MCC was diagnosed based on the cytomorphology, characteristic immunohistochemical staining pattern, clinical history and comparison of the morphology with that of the primary Tumor. Conclusion The cytomorphology and immunohistochemical profile of this neoplasm mimicked a Pancreatic Endocrine Tumor. We discuss the diagnostic pitfalls and differential diagnoses of the metastatic Pancreatic MCC, highlighting the importance of thorough clinical history, attention to cytologic detail and corroborating immunohistochemistry in arriving at the correct diagnosis. This is the first case of a metastatic Pancreatic MCC diagnosed by EUS-FNA cytology.
Kevin Mcgrath - One of the best experts on this subject based on the ideXlab platform.
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Pancreatic Endocrine Tumor eus guided fna dna microsatellite loss and mortality
Gastrointestinal Endoscopy, 2009Co-Authors: Kenneth E Fasanella, Kevin Mcgrath, Michael K Sanders, Debra Brody, Robyn T Domsic, Asif KhalidAbstract:Background The clinical course of Pancreatic Endocrine Tumors (PET) depends on Tumor size, the presence of invasion or metastasis, the Ki-67 index, mitoses per high power field, and mutational damage. Most of this information is not available before surgery for clinical decision making or prognostication. Objective To evaluate PET EUS-guided FNA (EUS-FNA) microsatellite loss analysis in the context of PET-related mortality. Design A single institution retrospective cohort. Patients Patients with PET diagnosed by EUS-FNA who underwent DNA microsatellite loss analysis and at least 1 year of follow-up or subsequent death. Intervention PET microsatellite loss analysis results and current clinical status were compared. Results Twenty-nine patients were included in the final analysis; the mean age of the patients was 57 years, and 10 were women (35%). The mean follow-up was 33.7 months (median 30 months, range 2-66 months). Twelve patients had disease progression, and 8 died, all from disease-specific causes. Malignant PET contained multiple microsatellite losses, with a median fractional allelic loss (FAL) of 0.37 (range 0.12-0.69, interquartile range [IQR] 0.23-0.42), significantly different from benign PET, median FAL 0 (range 0-0.18, IQR 0-0.08, P P 0.2 ( P 0.2 and disease status or mortality. Limitations Retrospective design, referral bias, and DNA analysis availability. Conclusions PET EUS-FNA microsatellite loss analysis provides preoperative prognostic information. An FAL >0.2 is not only associated with disease progression but also with mortality.
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endoscopic ultrasound guided fine needle aspirate microsatellite loss analysis and Pancreatic Endocrine Tumor outcome
Clinical Gastroenterology and Hepatology, 2006Co-Authors: Laurentia Nodit, Kevin Mcgrath, Maliha Zahid, Niraj Jani, Karen E Schoedel, Paul N Ohori, Sally E Carty, Sydney D Finkelstein, Asif KhalidAbstract:Background & Aims: The clinical course of Pancreatic Endocrine Tumor (PET) varies depending on Tumor aggressiveness, disease extent, and possibly accumulated molecular alterations. Endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) results, although accurate in diagnosing PET, correlate poorly with PET outcome. The role of detecting key molecular abnormalities in predicting PET behavior and clinical outcome from EUS-FNA material remains unknown. Methods: Patients with confirmed PET who underwent EUS-FNA during a 32-month period were included. Patient demographics and clinical data were recorded and follow-up information was obtained by contacting their physician to evaluate disease progression. Representative Tumor cells were microdissected from the FNA material. DNA was harvested and amplified, targeting a panel of 17 polymorphic microsatellite markers on chromosomes 1p, 3p, 5q, 9p, 10q, 11q, 17p, 17q, 21q, and 22q. The polymerase chain reaction products were subjected to fluorescent capillary gel electrophoresis to detect microsatellite loss. The fractional allelic loss (FAL) was calculated. Results: Twenty-five patients were studied. Thirteen were classified histologically as benign PET limited to the pancreas and 12 as malignant PET (invasive or metastatic). The mean FAL in the benign and malignant PET was 0.03 and 0.37 ( P P Conclusions: Microsatellite loss analysis of EUS-FNA material from PET can be performed reliably and an FAL value of more than 0.2 is associated with disease progression. This technique may have value in the preoperative assessment and risk stratification of patients with PET.
Laurentia Nodit - One of the best experts on this subject based on the ideXlab platform.
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endoscopic ultrasound guided fine needle aspirate microsatellite loss analysis and Pancreatic Endocrine Tumor outcome
Clinical Gastroenterology and Hepatology, 2006Co-Authors: Laurentia Nodit, Kevin Mcgrath, Maliha Zahid, Niraj Jani, Karen E Schoedel, Paul N Ohori, Sally E Carty, Sydney D Finkelstein, Asif KhalidAbstract:Background & Aims: The clinical course of Pancreatic Endocrine Tumor (PET) varies depending on Tumor aggressiveness, disease extent, and possibly accumulated molecular alterations. Endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) results, although accurate in diagnosing PET, correlate poorly with PET outcome. The role of detecting key molecular abnormalities in predicting PET behavior and clinical outcome from EUS-FNA material remains unknown. Methods: Patients with confirmed PET who underwent EUS-FNA during a 32-month period were included. Patient demographics and clinical data were recorded and follow-up information was obtained by contacting their physician to evaluate disease progression. Representative Tumor cells were microdissected from the FNA material. DNA was harvested and amplified, targeting a panel of 17 polymorphic microsatellite markers on chromosomes 1p, 3p, 5q, 9p, 10q, 11q, 17p, 17q, 21q, and 22q. The polymerase chain reaction products were subjected to fluorescent capillary gel electrophoresis to detect microsatellite loss. The fractional allelic loss (FAL) was calculated. Results: Twenty-five patients were studied. Thirteen were classified histologically as benign PET limited to the pancreas and 12 as malignant PET (invasive or metastatic). The mean FAL in the benign and malignant PET was 0.03 and 0.37 ( P P Conclusions: Microsatellite loss analysis of EUS-FNA material from PET can be performed reliably and an FAL value of more than 0.2 is associated with disease progression. This technique may have value in the preoperative assessment and risk stratification of patients with PET.
Summer L Nugent - One of the best experts on this subject based on the ideXlab platform.
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metastatic merkel cell carcinoma of the pancreas mimicking primary Pancreatic Endocrine Tumor diagnosed by endoscopic ultrasound guided fine needle aspiration cytology
Acta Cytologica, 2009Co-Authors: Summer L Nugent, Peter Darwin, Hong Qi PengAbstract:Background Merkel cell carcinoma (MCC) is a relatively infrequent, rapidly progressive and often fatal cutaneous malignancy exhibiting neuroEndocrine differentiation. It has a penchant for local recurrence and distant metastasis to various sites, including regional lymph nodes, distant skin, lung, liver, testis and other rare organs, such as the pancreas. There are only 4 cases of MCC metastatic to the pancreas reported in the English-language literature, and they were all diagnosed by histology from Pancreatic resection. Case A 79-year-old woman with a large Pancreatic tail mass underwent endoscopic ultrasound guided fine needle aspiration (EUS-FNA). She had a history of MCC of the upper extremity with wide local excision 15 months earlier. Metastatic MCC was diagnosed based on the cytomorphology, characteristic immunohistochemical staining pattern, clinical history and comparison of the morphology with that of the primary Tumor. Conclusion The cytomorphology and immunohistochemical profile of this neoplasm mimicked a Pancreatic Endocrine Tumor. We discuss the diagnostic pitfalls and differential diagnoses of the metastatic Pancreatic MCC, highlighting the importance of thorough clinical history, attention to cytologic detail and corroborating immunohistochemistry in arriving at the correct diagnosis. This is the first case of a metastatic Pancreatic MCC diagnosed by EUS-FNA cytology.
