The Experts below are selected from a list of 20130 Experts worldwide ranked by ideXlab platform
Robert Mansberg - One of the best experts on this subject based on the ideXlab platform.
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68ga Prostate specific membrane antigen uptake in dissecting abdominal aortic aneurysm
Clinical Nuclear Medicine, 2020Co-Authors: Veronica Chi Ken Wong, Amanda Stevanovic, Ken Le, Robert MansbergAbstract:An 81-year-old man with Prostate Adenocarcinoma (Gleason 4 + 3 = 7) treated with brachytherapy and intermittent androgen deprivation therapy was referred for serial Ga-Prostate-specific membrane antigen (PSMA-HBED-CC) PET/CT scans for rising Prostate-specific antigen. Findings were suggestive of local prostatic recurrence and nodal metastases. An incidental PSMA-avid focus was noted in the anterior wall of an infrarenal aortic aneurysm, with a contrast-enhanced hyperdense region surrounded by a semilunar hypodense region anteriorly, consistent with enlarging dissecting thrombus. Increased PSMA avidity in atherosclerotic hypertensive lesions may relate to active plaque instability, indicating a need for further evaluation.
Jonathan I Epstein - One of the best experts on this subject based on the ideXlab platform.
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metastatic Prostate Adenocarcinoma to the penis a series of 29 cases with predilection for ductal Adenocarcinoma
The American Journal of Surgical Pathology, 2015Co-Authors: Carla Lashannon Ellis, Jonathan I EpsteinAbstract:: Twenty-nine men with metastatic Prostate Adenocarcinoma to the penis were identified at our institution between 1993 and 2013. Of the 29 patients, 19 had a prior history of Adenocarcinoma of the Prostate, and 8 of those had ductal features in the primary lesion. Sixteen of 29 revealed ductal features in the metastasis. Seven of the 8 cases with ductal features in the primary had ductal features in the penile metastasis. Seven penile metastases were proven to be of prostatic origin solely by immunohistochemistry. Three cases were originally misdiagnosed as urothelial carcinoma upon review of the penile lesion. Other variant morphologies in the metastases included sarcomatoid carcinoma, small cell carcinoma, and adenosquamous carcinoma. In summary, Prostate carcinoma involving the penis displays ductal features considerably more often than Prostate cancer in general. Features that can cause difficulty in recognizing metastatic Prostate Adenocarcinoma to the penis include the unusual anatomic site for Prostate cancer, poor differentiation, an increased prevalence of variant morphology, a long interval from the primary lesion, and, in some cases, no documented history of a primary prostatic lesion. Immunohistochemical analysis should be performed to rule out Prostate carcinoma in penile/penile urethral tumors with morphology that differs from typical squamous or urothelial carcinoma. Even in the setting of metastatic disease, there is a critical need for an accurate diagnosis so that the appropriate therapy can be initiated, symptomatic relief can be provided, and long-term survival achieved in some cases, while at the same time avoiding penectomy for a misdiagnosis of a primary penile cancer.
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Pseudopapillary Features in Prostatic Adenocarcinoma Mimicking Urothelial Carcinoma: A Diagnostic Pitfall
The American Journal of Surgical Pathology, 2014Co-Authors: Jennifer Gordetsky, Jonathan I EpsteinAbstract:High-grade Prostate Adenocarcinoma can have overlapping morphologic features with high-grade urothelial carcinoma, a critical distinction as treatments differ substantially. Pseudopapillary features have not previously been described in high-grade acinar Prostate Adenocarcinoma. We reviewed our cons
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utility of gata3 immunohistochemistry in differentiating urothelial carcinoma from Prostate Adenocarcinoma and squamous cell carcinomas of the uterine cervix anus and lung
The American Journal of Surgical Pathology, 2012Co-Authors: Alex R Chang, Ali Amin, Edward Gabrielson, Peter B Illei, Richard B S Roden, Rajni Sharma, Jonathan I EpsteinAbstract:Distinguishing invasive high-grade urothelial carcinoma (UC) from other carcinomas occurring in the genitourinary tract may be difficult. The differential diagnosis includes high-grade prostatic Adenocarcinoma, spread from an anal squamous cell carcinoma (SCC), or spread from a uterine cervical SCC. In terms of metastatic UC, the most common problem is differentiating spread of UC to the lung from a primary pulmonary SCC. Immunohistochemical analysis (IHC) for GATA binding protein 3 (GATA3), thrombomodulin (THROMBO), and uroplakin III was performed on a tissue microarray (TMA) containing 35 cases of invasive high-grade UC. GATA3 IHC was also performed on TMAs containing 38 high-grade (Gleason score ≥8) prostatic Adenocarcinomas, representative tissue sections from 15 invasive anal SCCs, representative tissue sections from 19 invasive cervical SCCs, and TMAs with 12 invasive cervical carcinomas of the cervix [SCC (n=10), SCC with neuroendocrine features (n=1), and adenosquamous carcinoma (n=1)]. In addition, GATA3 IHC was performed on representative tissue sections from 15 pulmonary UC metastases and a TMA with 25 SCCs of the lung and 5 pulmonary non-small cell carcinomas with squamous features. GATA3, THROMBO, and uroplakin III were positive in 28 (80%), 22 (63%), and 21 (60%) cases of high-grade UC, respectively. All cases of GATA3-positive staining were nonfocal; 25 (89%) cases demonstrated moderate to strong staining, and 3 (11%) demonstrated weak staining. Of the 7 cases that failed to express GATA3, 5 were positive for THROMBO and/or uroplakin III, whereas 2 were negative for all 3 markers. None of the 38 high-grade prostatic Adenocarcinomas was positive for GATA3. Weak GATA3 staining was present in occasional basal cells of benign Prostate glands, in a few benign atrophic glands, and in urothelial metaplasia. Of the 15 cases of anal SCCs, 2 (7%) cases showed focal weak staining, and 1 (3%) showed focal moderate staining. Weak staining was also rarely observed in the benign anal squamous epithelium. Of the 31 uterine cervical carcinomas, 6 (19%) showed weak GATA3 staining (3 nonfocal and 3 focal), and 2 (6%) demonstrated focal moderate staining. Twelve (80%) of the metastatic UCs to the lung were positive for GATA3, with 11 cases showing diffuse moderate or strong staining and 1 case showing focal moderate staining. None of the pulmonary SCCs or non-small cell carcinomas with squamous features was GATA3 positive. GATA3 IHC is a sensitive marker for UC, and positive staining in UC is typically nonfocal and moderate or strong in intensity. GATA3 is also highly specific in excluding high-grade Prostate Adenocarcinoma. Although some cervical and anal SCCs can be GATA3 positive, unlike in UC, staining is more commonly focal and weak. GATA3 is also a useful maker when diagnosing metastatic UC to the lung.
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quantitative gstp1 methylation and the detection of Prostate Adenocarcinoma in sextant biopsies
Journal of the National Cancer Institute, 2003Co-Authors: Susan Harden, Harriette Sanderson, Steven N Goodman, Alan W Partin, Patrick C Walsh, Jonathan I Epstein, David SidranskyAbstract:Hypermethylation of the 5 promoter region of the glutathione S-transferase gene (GSTP1) occurs at a very high frequency in Prostate Adenocarcinoma. We compared the results of blinded histologic review of sextant biopsy samples from 72 excised Prostates with those obtained using a quantitative methylation-specific polymerase chain reaction assay (QMSP) for GSTP1. Formal surgical pathologic review of the resected Prostates was used to determine the number of patients with (n 61) and without (n 11) Prostate cancer. Histology alone detected Prostate carcinoma with 64% sensitivity (95% confidence interval [CI] 51% to 76%) and 100% specificity (95% CI 72% to 100%), whereas the combination of histology and GSTP1 QMSP at an assay threshold greater than 10 detected Prostate carcinoma with 75% sensitivity (95% CI 63% to 86%) and 100% specificity (95% CI 72% to 100%), an 11% improvement (95% CI 5% to 22%) in sensitivity over histology alone. The combination of histology and GSTP1 QMSP at an assay threshold greater than 5 detected Prostate Adenocarcinoma with 79% sensitivity (95% CI 68% to 89%), a 15% improvement (95% CI 7% to 26%) over histology alone. Thus, GSTP1 QMSP improved the sensitivity of histologic review of random needle biopsies for Prostate cancer diagnosis. Further studies should determine whether detection of GSTP1 hypermethylation in a biopsy sample with normal histology indicates the need for an early repeat biopsy at the same site. [J Natl Cancer Inst 2003;95: 1634 ‐7]
Amar U Kishan - One of the best experts on this subject based on the ideXlab platform.
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long term outcomes of stereotactic body radiotherapy for low and intermediate risk Prostate Adenocarcinoma a multi institutional consortium study
Journal of Clinical Oncology, 2018Co-Authors: Amar U Kishan, Irving D Kaplan, Alan J Katz, C A Mantz, Limor Appelbaum, Andrew Loblaw, Patrick Cheung, Donald B Fuller, Huong T Pham, Robert J MeierAbstract:84Background: While a growing body of evidence supports the use of stereotactic body radiotherapy (SBRT) for the treatment of low- and intermediate-risk Prostate Adenocarcinoma (PCa), some trepidation exists regarding its long-term efficacy and safety. Methods: Men with low- and intermediate-risk PCa, as defined per the National Comprehensive Cancer Network guidelines, who were enrolled on various institutional phase II trials of SBRT between 2000-2012 were included in a multi-institutional consortium. Biochemical relapse (BCR) was defined as PSA > “nadir +2” or initiation of androgen deprivation therapy (ADT). Toxicity data were scored according to the CTCAE v 3.0 or Radiation Therapy Oncology Group scoring systems. Results: A total of 1644 men were eligible for analysis, with a median followup of 7.2 years. 297 patients (18.1%) had at least 9 years of followup. Fractionation schemes ranged from 33.50-40 Gy in 4-5 fractions. 892 patients had low-risk disease and 752 had intermediate-risk disease. 59 pati...
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radiotherapy versus radical Prostatectomy for gleason score 9 10 Prostate Adenocarcinoma a multi institutional comparative analysis of 1001 patients treated in the modern era
Journal of Clinical Oncology, 2017Co-Authors: Amar U Kishan, Jay P Ciezki, Talha Shaikh, Richard G Stock, Gregory S Merrick, Jeffrey D Demanes, J Wang, Jonathan W Said, Ryan Fiano, Govind RaghavanAbstract:7Background: To compare the outcomes of a modern cohort of patients with Gleason Score (GS) 9-10 Prostate Adenocarcinoma (CaP) following treatment with external beam radiotherapy (EBRT), extremely dose-escalated radiotherapy (as exemplified by EBRT with a brachytherapy boost [EBRT+BT]), and radical Prostatectomy (RP). Methods: One-thousand-and-one patients with biopsy GS 9-10 CaP who received definitive treatment between 2000 and 2013 were included (347 treated with EBRT, 330 with EBRT+BT, and 324 with RP). Kaplan-Meier analysis and multivariate Cox regression compared 5- and 10-year rates of distant metastasis-free survival (DMFS), cancer-specific survival (CSS), and overall survival (OS). Prostate cancer-mortality (PCSM) rates were compared with a competing risk analysis. Results: The median followup periods were 4.8, 6.4, and 5.1 years among patients receiving EBRT, EBRT + BT, and RP. The median doses among EBRT and EBRT+BT patients were equivalent to 78 Gy and 90 Gy in 2 Gy fractions. Over 90% of pati...
Veronica Chi Ken Wong - One of the best experts on this subject based on the ideXlab platform.
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68ga Prostate specific membrane antigen uptake in dissecting abdominal aortic aneurysm
Clinical Nuclear Medicine, 2020Co-Authors: Veronica Chi Ken Wong, Amanda Stevanovic, Ken Le, Robert MansbergAbstract:An 81-year-old man with Prostate Adenocarcinoma (Gleason 4 + 3 = 7) treated with brachytherapy and intermittent androgen deprivation therapy was referred for serial Ga-Prostate-specific membrane antigen (PSMA-HBED-CC) PET/CT scans for rising Prostate-specific antigen. Findings were suggestive of local prostatic recurrence and nodal metastases. An incidental PSMA-avid focus was noted in the anterior wall of an infrarenal aortic aneurysm, with a contrast-enhanced hyperdense region surrounded by a semilunar hypodense region anteriorly, consistent with enlarging dissecting thrombus. Increased PSMA avidity in atherosclerotic hypertensive lesions may relate to active plaque instability, indicating a need for further evaluation.
Robert J Meier - One of the best experts on this subject based on the ideXlab platform.
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long term outcomes of stereotactic body radiotherapy for low and intermediate risk Prostate Adenocarcinoma a multi institutional consortium study
Journal of Clinical Oncology, 2018Co-Authors: Amar U Kishan, Irving D Kaplan, Alan J Katz, C A Mantz, Limor Appelbaum, Andrew Loblaw, Patrick Cheung, Donald B Fuller, Huong T Pham, Robert J MeierAbstract:84Background: While a growing body of evidence supports the use of stereotactic body radiotherapy (SBRT) for the treatment of low- and intermediate-risk Prostate Adenocarcinoma (PCa), some trepidation exists regarding its long-term efficacy and safety. Methods: Men with low- and intermediate-risk PCa, as defined per the National Comprehensive Cancer Network guidelines, who were enrolled on various institutional phase II trials of SBRT between 2000-2012 were included in a multi-institutional consortium. Biochemical relapse (BCR) was defined as PSA > “nadir +2” or initiation of androgen deprivation therapy (ADT). Toxicity data were scored according to the CTCAE v 3.0 or Radiation Therapy Oncology Group scoring systems. Results: A total of 1644 men were eligible for analysis, with a median followup of 7.2 years. 297 patients (18.1%) had at least 9 years of followup. Fractionation schemes ranged from 33.50-40 Gy in 4-5 fractions. 892 patients had low-risk disease and 752 had intermediate-risk disease. 59 pati...
