Assessment of the human corneal endothelium: in vivo Topcon SP2000P specular microscope versus ex vivo sambacornea eye bank analyser

Comparison between assessment of donor tissue in eye banks and specular microscopy in the recipient is important to quantify the post-keratoplasty cell loss dynamics. Our aim was to determine the agreement between the in vivo non-contact specular microscope Topcon SP2000P and the computer-assisted eye bank endothelial analyser Sambacornea. We enrolled 51 future recipients of penetrating keratoplasty, and determined the endothelial cell density (ECD) and morphometry firstly in vivo with Topcon and then ex vivo with Sambacornea on the excised cornea stained with Alizarin Red. Specular microscopy was found to underestimate the ECD by 11%, (95% CI 6 to 15), whereas morphometric parameters did not differ

Perfusion-sensitive MRI of pilocytic astrocytomas: initial results.

International audiencePURPOSE: To present the imaging and perfusion data obtained in nine patients with pilocytic astrocytomas (PA) and to discuss the original functional issues of this technique. METHOD: Nine patients with pathologically proven PA underwent conventional and perfusion MR imaging. Various areas of relative cerebral blood volume (rCBV) within the tumors were obtained. The maximum rCBV ratios were identified and considered as representative of the tumor. The results were compared with the pathological findings. RESULTS: In all patients, rCBV was <1.5 (mean 1) and the signal intensity curve overshot the baseline. CONCLUSION: PA tend to have low rCBV values and a first-pass curve that crosses the baseline. These characteristics may be explained by the histological profile of the tumoral vascularity and are of relevance in the identification of these rare tumors

Impact of Expert Pathologic Review of Lymphoma Diagnosis: Study of Patients From the French Lymphopath Network

International audiencePurposeTo prospectively assess the clinical impact of expert review of lymphoma diagnosis in France.Materials and MethodsFrom January 2010 to December 2013, 42,145 samples from patients with newly diagnosed or suspected lymphomas were reviewed, according to the 2008 WHO classification, in real time by experts through the Lymphopath Network. Changes in diagnosis between referral and expert review were classified as major or minor according to their potential impact on patient care.ResultsThe 42,145 reviewed samples comprised 36,920 newly diagnosed mature lymphomas, 321 precursor lymphoid neoplasms, 314 myeloid disorders, and 200 nonhematopoietic neoplasms, with 4,390 benign lesions. There were 4,352 cutaneous and 32,568 noncutaneous lymphomas. The most common mature noncutaneous lymphomas were diffuse large B-cell lymphomas (32.4%), follicular lymphomas (15.3%), classic Hodgkin lymphomas (13%), peripheral T-cell lymphomas (6.3%) of which angioimmunoblastic T-cell lymphomas (2.3%) were the most frequent, and mucosa-associated lymphoid tissue lymphomas (5.8%). A diagnostic change between referral and expert review occurred in 19.7% of patients, with an estimated impact on patient care for 17.4% of patients. This rate was significantly higher for patients sent with a provisional diagnosis seeking expert second opinion (37.8%) than for patients sent with a formal diagnosis (3.7%). The most frequent discrepancies were misclassifications in lymphoma subtype (41.3%), with 12.3% being misclassifications among small B-cell lymphoma entities. Fewer than 2% of changes were between benign and malignant lymphoid conditions. Minor changes (2.3%) mostly consisted of follicular lymphoma misgrading and diffuse large B-cell lymphoma subtype misclassification.ConclusionTo our knowledge, this study provides the largest ever description of the distribution of lymphoma entities in a western country and highlights how expert review significantly contributes to a precise lymphoma diagnosis and optimal clinical management in a proportion of patients