The Experts below are selected from a list of 15069 Experts worldwide ranked by ideXlab platform
Falko Fend - One of the best experts on this subject based on the ideXlab platform.
-
modern techniques for the diagnostic evaluation of the Trephine bone marrow biopsy methodological aspects and applications
Progress in Histochemistry and Cytochemistry, 2008Co-Authors: Falko Fend, Alexandar Tzankov, Karin Bink, Stefan Seidl, Leticia Quintanillamartinez, Marcus Kremer, Stephan DirnhoferAbstract:Histopathological examination of a bone marrow (BM) Trephine biopsy is an integral part of the diagnostic work-up of patients with haematological disorders and other diseases which may afflict hematopoiesis. Until recently, the dramatic increase in modern immunological and molecular techniques which have been added to the diagnostic repertoire of clinical haematology has largely bypassed the BM Trephine. In recent years, however, many of the technical obstacles preventing application of these techniques to BM biopsies have been surmounted, and immunohistochemistry, fluorescence in situ hybridization and polymerase chain reaction (PCR)-based molecular techniques for examination of DNA and RNA have successfully been applied to conventionally processed BM Trephines. This review tries to give an overview of techniques suitable for Trephine biopsies, as well as diagnostic and research applications.
-
diagnosis and classification of malignant lymphoma and related entities in the bone marrow Trephine biopsy
Pathobiology, 2007Co-Authors: Falko Fend, Markus KremerAbstract:The Trephine bone marrow (BM) biopsy is an important diagnostic tool in patients with malignant lymphoma. BM examination can serve to establish or confirm a primary diagnosis of lymphoma or to determine the extent of disease dissemination for staging purposes. BM histology renders information which cannot be gained equally from aspirate material, such as spacial distribution and extent of infiltrates, BM cellularity and fibrosis. Furthermore, cytology including flow cytometric immunophenotyping can give false-negative results in BM involvement by lymphoma due to intralesional fibrosis. In addition to morphological examination, the availability of a broad panel of antibodies suitable for paraffin-embedded tissues, in conjunction with less damaging decalcification procedures, nowadays enables us to perform complete immunophenotyping on BM Trephines and allows for classification of lymphoma infiltrates according to established algorithms. Molecular determination of clonality and interphase fluorescent in situ hybridization can be employed selectively to resolve difficult cases. This review describes important diagnostic features of malignant lymphoma in the BM, relevant differential diagnoses, and the proper use of ancillary techniques.
-
detection of the activating jak2 v617f mutation in paraffin embedded Trephine bone marrow biopsies of patients with chronic myeloproliferative diseases
The Journal of Molecular Diagnostics, 2006Co-Authors: Thomas Horn, Leticia Quintanillamartinez, Marcus Kremer, Tobias Dechow, Walther M Pfeifer, Birgit Geist, Michael Perker, Justus Duyster, Falko FendAbstract:The discovery of the activating V617F mutation in the JAK2 tyrosine kinase in a high proportion of patients with Ph− chronic myeloproliferative diseases (CMPD) represents a diagnostic breakthrough for these disorders. Trephine bone marrow biopsy is an essential part of the diagnostic workup of CMPD and represents a valuable archival source of DNA. Therefore, we studied 152 paraffin-embedded Trephines with CMPD and related disorders for the presence of the V617F mutation, using both allele-specific polymerase chain reaction (PCR) and nested PCR with subsequent digestion with BsaXI. Only 6 of 152 (4%) samples were not evaluable because of poor DNA quality. The V617F mutation was detected in 27 of 28 (96%) cases of polycythemia vera, 17 of 23 (74%) cases of essential thrombocythemia, 28 of 45 (62%) cases of chronic idiopathic myelofibrosis, six of eight (75%) cases of CMPD unclassified, and two of four (50%) cases of myelodysplastic/myeloproliferative syndrome. Ph+ chronic myelogenous leukemia (four cases), reactive (secondary) erythrocytosis (14 cases), and thrombocytosis (one case) as well as normal controls (19 cases) all lacked the V617F mutation. Based on results of BsaXI digestion and sequencing, 24 of 54 (44%) evaluable V617F+ cases were considered homozygously mutated. Thus, detection of the V617F JAK2 mutation is feasible in paraffin-embedded Trephine biopsies and represents a major advance in the diagnostic evaluation of CMPD.
-
Immunohistochemistry in bone marrow pathology: a useful adjunct for morphologic diagnosis
Virchows Archiv, 2005Co-Authors: Marcus Kremer, Leticia Quintanilla-martínez, Jörg Nährig, Christoph Schilling, Falko FendAbstract:Pathomorphological examination of Trephine biopsies of the bone marrow (BM) represents a standard method for the diagnosis and staging of hematologic neoplasms and other disorders involving the BM. The increasing knowledge about the genetic basis and biology of hematologic neoplasms, as well as the recently proposed WHO classification system, provide the framework for an accurate diagnosis. Although conventional morphology remains the gold standard for paraffin-embedded BM Trephines, immunohistochemical stainings have become an integral part of the diagnostic workup. Antibodies suitable for paraffin sections are generally applicable to BM Trephines, but modifications of staining protocols may be necessary due to the alternative fixatives and decalcification procedures used for BM biopsies. The indications for immunostainings range from confirmation and classification of lymphoma involvement, subclassification of acute leukemias, and estimating blast counts in myelodysplastic and myeloproliferative syndromes to characterization of BM involvement in nonhematologic neoplasms. Although subtyping of NHL in the BM is more difficult from the point of morphology, classification of the entities that frequently involve the BM, especially the small B-cell lymphomas, can easily be achieved with the help of immunohistochemistry. In this review, we try to summarize the current state of the art in BM immunohistochemistry for the diagnosis of hematologic disorders. Moreover, diagnostic algorithms and useful antibody panels are proposed for a rational and cost-effective approach.
Paul F Pollice - One of the best experts on this subject based on the ideXlab platform.
-
previously unreported complication of Trephine reamers in revision total hip arthroplasty
Journal of Arthroplasty, 2006Co-Authors: Matthew S Austin, Gregg R Klein, Paul F PolliceAbstract:Trephine reamers have been used in revision total hip arthroplasty to facilitate the removal of femoral prostheses without creating additional osteotomy sites. These reamers are available in graduated sizes so as to minimize bone loss. We present a complication not previously reported in the literature. While performing the extraction of a well-fixed femoral prosthesis, the Trephine reamer broke at its distal end, expanded, and created a cortical defect distal to the prosthesis.
M H Nguyen - One of the best experts on this subject based on the ideXlab platform.
-
Primary skin closure in reversal of loop ileostomy: an effective technique
Techniques in Coloproctology, 2001Co-Authors: Andrew Wignall, C A Gall, M H NguyenAbstract:Established practice in reversal of loop ileostomy relies upon secondary intention healing of the skin defect. This study demonstrates that rapid, uncomplicated healing of the skin defect can be achieved by primary skin closure of the Trephine. A retrospective case note review of 29 consecutive patients who underwent primary skin closure of the stomal Trephine during loop ileostomy closure over a 28-month period is presented. Data is examined for complications and healing times with specific reference to wound infection. Results are compared with published data on secondary intention healing of the Trephine. Wound infection occurred in 2 cases (7%), both being superficial infections responding to antibiotics and removal of sutures. This compares favourably to published infection rates for secondary intention Trephine healing and avoids long healing times with costly wound care. Primary skin closure is a safe and effective technique in loop ileostomy reversal and avoids long healing times associated with traditional methods.
-
How large should a skin Trephine be for an end stoma
The Australian and New Zealand journal of surgery, 1999Co-Authors: M H Nguyen, F. PittasAbstract:Background: Although much has been written about techniques for making a good stoma, little has been described regarding how to excise a Trephine that will perfectly fit a given end stoma. Methods A reproducible technique for making a stomal Trephine to a precise fit for each stoma is described. Results: More than 20 stomas have been made with good results. Conclusion: The skin Trephine should have a diameter approximately two-thirds of the width of the crushed bowel end.
Marcus Kremer - One of the best experts on this subject based on the ideXlab platform.
-
modern techniques for the diagnostic evaluation of the Trephine bone marrow biopsy methodological aspects and applications
Progress in Histochemistry and Cytochemistry, 2008Co-Authors: Falko Fend, Alexandar Tzankov, Karin Bink, Stefan Seidl, Leticia Quintanillamartinez, Marcus Kremer, Stephan DirnhoferAbstract:Histopathological examination of a bone marrow (BM) Trephine biopsy is an integral part of the diagnostic work-up of patients with haematological disorders and other diseases which may afflict hematopoiesis. Until recently, the dramatic increase in modern immunological and molecular techniques which have been added to the diagnostic repertoire of clinical haematology has largely bypassed the BM Trephine. In recent years, however, many of the technical obstacles preventing application of these techniques to BM biopsies have been surmounted, and immunohistochemistry, fluorescence in situ hybridization and polymerase chain reaction (PCR)-based molecular techniques for examination of DNA and RNA have successfully been applied to conventionally processed BM Trephines. This review tries to give an overview of techniques suitable for Trephine biopsies, as well as diagnostic and research applications.
-
detection of the activating jak2 v617f mutation in paraffin embedded Trephine bone marrow biopsies of patients with chronic myeloproliferative diseases
The Journal of Molecular Diagnostics, 2006Co-Authors: Thomas Horn, Leticia Quintanillamartinez, Marcus Kremer, Tobias Dechow, Walther M Pfeifer, Birgit Geist, Michael Perker, Justus Duyster, Falko FendAbstract:The discovery of the activating V617F mutation in the JAK2 tyrosine kinase in a high proportion of patients with Ph− chronic myeloproliferative diseases (CMPD) represents a diagnostic breakthrough for these disorders. Trephine bone marrow biopsy is an essential part of the diagnostic workup of CMPD and represents a valuable archival source of DNA. Therefore, we studied 152 paraffin-embedded Trephines with CMPD and related disorders for the presence of the V617F mutation, using both allele-specific polymerase chain reaction (PCR) and nested PCR with subsequent digestion with BsaXI. Only 6 of 152 (4%) samples were not evaluable because of poor DNA quality. The V617F mutation was detected in 27 of 28 (96%) cases of polycythemia vera, 17 of 23 (74%) cases of essential thrombocythemia, 28 of 45 (62%) cases of chronic idiopathic myelofibrosis, six of eight (75%) cases of CMPD unclassified, and two of four (50%) cases of myelodysplastic/myeloproliferative syndrome. Ph+ chronic myelogenous leukemia (four cases), reactive (secondary) erythrocytosis (14 cases), and thrombocytosis (one case) as well as normal controls (19 cases) all lacked the V617F mutation. Based on results of BsaXI digestion and sequencing, 24 of 54 (44%) evaluable V617F+ cases were considered homozygously mutated. Thus, detection of the V617F JAK2 mutation is feasible in paraffin-embedded Trephine biopsies and represents a major advance in the diagnostic evaluation of CMPD.
-
Immunohistochemistry in bone marrow pathology: a useful adjunct for morphologic diagnosis
Virchows Archiv, 2005Co-Authors: Marcus Kremer, Leticia Quintanilla-martínez, Jörg Nährig, Christoph Schilling, Falko FendAbstract:Pathomorphological examination of Trephine biopsies of the bone marrow (BM) represents a standard method for the diagnosis and staging of hematologic neoplasms and other disorders involving the BM. The increasing knowledge about the genetic basis and biology of hematologic neoplasms, as well as the recently proposed WHO classification system, provide the framework for an accurate diagnosis. Although conventional morphology remains the gold standard for paraffin-embedded BM Trephines, immunohistochemical stainings have become an integral part of the diagnostic workup. Antibodies suitable for paraffin sections are generally applicable to BM Trephines, but modifications of staining protocols may be necessary due to the alternative fixatives and decalcification procedures used for BM biopsies. The indications for immunostainings range from confirmation and classification of lymphoma involvement, subclassification of acute leukemias, and estimating blast counts in myelodysplastic and myeloproliferative syndromes to characterization of BM involvement in nonhematologic neoplasms. Although subtyping of NHL in the BM is more difficult from the point of morphology, classification of the entities that frequently involve the BM, especially the small B-cell lymphomas, can easily be achieved with the help of immunohistochemistry. In this review, we try to summarize the current state of the art in BM immunohistochemistry for the diagnosis of hematologic disorders. Moreover, diagnostic algorithms and useful antibody panels are proposed for a rational and cost-effective approach.
Surender Juneja - One of the best experts on this subject based on the ideXlab platform.
-
The sensitivity of CD138 immunostaining of bone marrow Trephine specimens for quantifying marrow involvement in MGUS and myeloma, including samples with a low percentage of plasma cells.
Haematologica, 2006Co-Authors: Andrew Wei, Frank Feleppa, Dinesh Bhurani, Peter Chapple, Surender JunejaAbstract:Accurate quantification of plasma cells in bone marrow samples is essential for the diagnosis, classification and prognosis of plasma-cell dyscrasias. Published comparisons between aspirate/Trephine morphology, flow cytometry and immunohistochemistry are lacking. Bone marrow plasma cells from 100 patients with plasma cell myeloma or monoclonal gammopathy of undetermined significance were quantified by a 500-cell differential count on Romanowsky-stained aspirate slides, flow-cytometry gating of CD38bright+/CD138+ cells, hematoxylin and eosin Trephine section examination and CD138 Trephine immunohistology. The results of quantification by the different methods were compared. Compared to other methods, CD138 Trephine immunohistology consistently demonstrated greater plasma-cell infiltration. Immunohistology is the most sensitive method for assessment of plasma-cell infiltration at diagnosis or post-therapy, especially in patients with minimal bone marrow involvement.
-
optimum Trephine length in the assessment of bone marrow involvement in patients with diffuse large cell lymphoma
Annals of Oncology, 2003Co-Authors: Janine Campbell, J P Matthews, John F Seymour, M Wolf, Surender JunejaAbstract:Background: The National Cancer Institute has recommended a bone marrow biopsy length of ≥20 mm for the staging and surveillance of patients with non-Hodgkin's lymphoma. However, there are few published data to support this recommendation, particularly the role of examining multiple levels. Patients and methods: Bone marrow biopsies from 172 patients with newly diagnosed diffuse large cell lymphoma (DLCL) entered in two consecutive trials of the Australasian Leukaemia and Lymphoma Group were analysed. The original haematoxylin and eosin-stained Trephine biopsy and two or more deeper sections cut at 0.1-0.2 mm intervals were assessed with respect to the morphology, extent and pattern of lymphomatous involvement. The rate of positive diagnosis was correlated with the length of the biopsy specimen and the number of sections examined. Results: Forty-seven biopsies (27%) demonstrated marrow involvement on examination of a mean of four Trephine biopsy sections. The rate of positivity increased with the examination of multiple levels and correlated with increasing Trephine length but was not dependent on the number of sites sampled. Twenty per cent of biopsies <20 mm in length were positive for lymphoma; this increased to 35% for biopsies ≥20 mm (P = 0.023). Conclusions: Morphological bone marrow involvement in DLCL is optimally demonstrated by a 20-mm long Trephine biopsy from a single site which is examined at multiple levels (four or more). This obviates the need for bilateral sampling, thereby reducing patient morbidity from the procedure. This study provides evidence to support the National Cancer Institute recommendations regarding Trephine biopsy in the staging of DLCL, providing multiple levels are examined.