TNM Classification of Malignant Tumours
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Table of Contents 1
GENERAL THORACIC SURGERY DATABASE v.2.3 TRAINING MANUAL January 2018 Table of Contents 1. Demographics ................................................................................................................................................................. 2 2. Follow Up ........................................................................................................................................................................ 9 3. Admission ..................................................................................................................................................................... 10 4. Pre-Operative Evaluation ............................................................................................................................................. 14 5. Diagnosis (Category of Disease) ................................................................................................................................... 49 6. Procedure ..................................................................................................................................................................... 72 7. Post-Operative Events ................................................................................................................................................ 114 8. Discharge .................................................................................................................................................................... 141 9. Quality Measures ...................................................................................................................................................... -
PROPOSED REGULATION of the STATE BOARD of HEALTH LCB File No. R057-16
PROPOSED REGULATION OF THE STATE BOARD OF HEALTH LCB File No. R057-16 Section 1. Chapter 457 of NAC is hereby amended by adding thereto the following provision: 1. The Division may impose an administrative penalty of $5,000 against any person or organization who is responsible for reporting information on cancer who violates the provisions of NRS 457. 230 and 457.250. 2. The Division shall give notice in the manner set forth in NAC 439.345 before imposing any administrative penalty 3. Any person or organization upon whom the Division imposes an administrative penalty pursuant to this section may appeal the action pursuant to the procedures set forth in NAC 439.300 to 439. 395, inclusive. Section 2. NAC 457.010 is here by amended to read as follows: As used in NAC 457.010 to 457.150, inclusive, unless the context otherwise requires: 1. “Cancer” has the meaning ascribed to it in NRS 457.020. 2. “Division” means the Division of Public and Behavioral Health of the Department of Health and Human Services. 3. “Health care facility” has the meaning ascribed to it in NRS 457.020. 4. “[Malignant neoplasm” means a virulent or potentially virulent tumor, regardless of the tissue of origin. [4] “Medical laboratory” has the meaning ascribed to it in NRS 652.060. 5. “Neoplasm” means a virulent or potentially virulent tumor, regardless of the tissue of origin. 6. “[Physician] Provider of health care” means a [physician] provider of health care licensed pursuant to chapter [630 or 633] 629.031 of NRS. 7. “Registry” means the office in which the Chief Medical Officer conducts the program for reporting information on cancer and maintains records containing that information. -
Head & Neck Surgery Course
Head & Neck Surgery Course Parapharyngeal space: surgical anatomy Dr Pierfrancesco PELLICCIA Pr Benjamin LALLEMANT Service ORL et CMF CHU de Nîmes CH de Arles Introduction • Potential deep neck space • Shaped as an inverted pyramid • Base of the pyramid: skull base • Apex of the pyramid: greater cornu of the hyoid bone Introduction • 2 compartments – Prestyloid – Poststyloid Anatomy: boundaries • Superior: small portion of temporal bone • Inferior: junction of the posterior belly of the digastric and the hyoid bone Anatomy: boundaries Anatomy: boundaries • Posterior: deep fascia and paravertebral muscle • Anterior: pterygomandibular raphe and medial pterygoid muscle fascia Anatomy: boundaries • Medial: pharynx (pharyngobasilar fascia, pharyngeal wall, buccopharyngeal fascia) • Lateral: superficial layer of deep fascia • Medial pterygoid muscle fascia • Mandibular ramus • Retromandibular portion of the deep lobe of the parotid gland • Posterior belly of digastric muscle • 2 ligaments – Sphenomandibular ligament – Stylomandibular ligament Aponeurosis and ligaments Aponeurosis and ligaments • Stylopharyngeal aponeurosis: separates parapharyngeal spaces to two compartments: – Prestyloid – Poststyloid • Cloison sagittale: separates parapharyngeal and retropharyngeal space Aponeurosis and ligaments Stylopharyngeal aponeurosis Muscles stylohyoidien Stylopharyngeal , And styloglossus muscles Prestyloid compartment Contents: – Retromandibular portion of the deep lobe of the parotid gland – Minor or ectopic salivary gland – CN V branch to tensor -
Supporting Information Modular Control of L-Tryptophan Isotopic Substitution Via an Efficient Biosynthetic Cascade
Electronic Supplementary Material (ESI) for Organic & Biomolecular Chemistry. This journal is © The Royal Society of Chemistry 2020 Supporting Information Modular Control of L-Tryptophan Isotopic Substitution via an Efficient Biosynthetic Cascade Thompson, C. M.; McDonald, A. D.; Yang, H.; Cavagnero, S.*; Buller, A. R.* Department of Chemistry, University of Wisconsin-Madison 1101 University Avenue Madison, WI 53706 *corresponding authors: Andrew R. Buller, email:[email protected]; Silvia Cavagnero, email: [email protected] Table of contents 1. General information 2 2. Experimental section 2 2.1 Materials 2 2.2 Methods 2 2.2.1 Cloning, expression, and purification of PfTrpB2B9 and TmLTA 2 2.2.2 Optimization of TmLTA-TrpB2B9 cascade 3 2.2.3 Preparative-scale synthesis of Trp isotopologs 4 2.2.4 Analytical- and preparative-scale chromatography 5 2.2.5 Determination of enantiopurity of Trp isotopologs 5 2.2.6 NMR analysis 6 3. Characterization of Trp and Trp isotopologs 7 4. Supporting references 10 5. Supporting tables and figures 11 - 17 − 1 − 1. General information The glassware used in the reactions carried out in this work was thoroughly washed, and all experiments were executed following necessary safety precautions. Evaporation of solvents was performed at reduced pressure using a rotary evaporator. Electronic-absorption measurements were done with a UV-2600 spectrophotometer (Shimadzu). 2. Experimental section 2.1. Materials Chemicals and solvents were obtained from commercial suppliers and used without further 13 purification: formaldehyde-D2 (Cambridge Isotope Laboratories, Inc.); (2- C)glycine (Cambridge Isotope Laboratories, Inc.); D2O 99.9% (Sigma-Aldrich); indole (Sigma- Aldrich); pyridoxal 5’ monophosphate; (Sigma-Aldrich) L-serine (Sigma-Aldrich). -
Variants of Acinar Adenocarcinoma of the Prostate Mimicking Benign Conditions Peter a Humphrey
Modern Pathology (2018) 31, S64–S70 S64 © 2018 USCAP, Inc All rights reserved 0893-3952/18 $32.00 Variants of acinar adenocarcinoma of the prostate mimicking benign conditions Peter A Humphrey Department of Pathology, Yale School of Medicine, New Haven, CT, USA Histological variants of acinar adenocarcinoma of the prostate may be of significance due to difficulty in diagnosis or due to differences in prognosis compared to usual acinar adenocarcinoma. The 2016 World Health Organization classification of acinar adenocarcinoma includes four variants that are deceptively benign in histological appearance, such that a misdiagnosis of a benign condition may be made. These four variants are atrophic pattern adenocarcinoma, pseudohyperplastic adenocarcinoma, microcystic adenocarcinoma, and foamy gland adenocarcinoma. They differ from usual small acinar adenocarcinoma in architectural glandular structure and/or cytoplasmic and nuclear alterations. The variants are often admixed, in variable proportions, with usual small acinar adenocarcinoma that is often Gleason pattern 3 but may be high-grade pattern 4 in a minority of cases. Atrophic pattern adenocarcinoma can be identified in a sporadic setting or after radiation or hormonal therapy. This variant is characterized by cytoplasmic volume loss and can resemble benign glandular atrophy, an extremely common benign process in the prostate. The glands of pseudohyperplastic adenocarcinoma simulate usual epithelial hyperplasia, with gland complexity that is not typical of small acinar adenocarcinoma. These complex growth configurations include papillary infoldings, luminal undulations, and branching. Microcystic adenocarcinoma is characterized by cystic dilation of prostatic glands to a size that is much more commonly observed in cystic change in benign prostatic glands. Finally, the cells in foamy gland adenocarcinoma display cytoplasmic vacuolization and nuclear pyknosis, features that can found in benign glands and macrophages. -
Supplementary Table 1) Immunohistochemical Protocol and Antibody Information Antibody Company Clone/# Clonality Dilution Incubat
H. Reis et al: Differential proteomic and tissue expression analyses identify valuable diagnostic biomarkers of hepatocellular differentiation and hepatoid adenocarcinomas Suppl ementary Table 1) Immunohistochemical protocol and antibody information Antibody Company Clone/# Clonality Dilution Incubation Antigen retrieval Detection ABAT Abcam EPR4433 mono 1/3000 30 min, RT pH 9.0, WB, 95°C, 20 min. Zytomed Polymer HRP ACAA2 Abcam EPR6733 mono 1/100 30 min, RT pH 9.0, WB, 95°C, 20 min Zytomed Polymer HRP ACADM Abcam EPR3708 mono 1/3000 30 min, RT pH 9.0, WB, 95°C, 20 min Zytomed Polymer HRP ADH1B Abcam 4F12 mono 1/12.000 30 min, RT pH 9.0, WB, 95°C, 20 min Zytomed Polymer HRP Arginase1 Abcam EPR6672(B) mono 1/1000 30 min, RT pH 9.0, WB, 95°C, 20 min. Zytomed Polymer HRP BHMT Abcam EPR6782 mono 1/100 30 min, RT pH 9.0, WB, 95°C, 20 min. Zytomed Polymer HRP FABP1 Acris AIV\09011PU-S mono 1/15.000 30 min, RT pH 9.0, WB, 95°C, 20 min. Zytomed Polymer HRP HAOX1 Acris AP18044PU-N poly 1/100 30 min, RT pH 9.0, WB, 95°C, 20 min. Zytomed Polymer HRP HepPar1 Dako OCH1E5 mono 1/800 30 min, RT pH 9.0, WB, 95°C, 20 min. Zytomed Polymer HRP HMGCS2 Abcam Ab104807 poly 1/50 60 min, RT pH 9.0, WB, 95°C, 20 min Zytomed Polymer HRP H. Reis et al: Differential proteomic and tissue expression analyses identify valuable diagnostic biomarkers of hepatocellular differentiation and hepatoid adenocarcinomas Supplementary Table 2) Composition of the non-liver tumor TMA Diagnosis n % ADC 11 2.9 ADC Adenocarcinoma of the lung Carc. -
Deep Neck Infections 55
Deep Neck Infections 55 Behrad B. Aynehchi Gady Har-El Deep neck space infections (DNSIs) are a relatively penetrating trauma, surgical instrument trauma, spread infrequent entity in the postpenicillin era. Their occur- from superfi cial infections, necrotic malignant nodes, rence, however, poses considerable challenges in diagnosis mastoiditis with resultant Bezold abscess, and unknown and treatment and they may result in potentially serious causes (3–5). In inner cities, where intravenous drug or even fatal complications in the absence of timely rec- abuse (IVDA) is more common, there is a higher preva- ognition. The advent of antibiotics has led to a continu- lence of infections of the jugular vein and carotid sheath ing evolution in etiology, presentation, clinical course, and from contaminated needles (6–8). The emerging practice antimicrobial resistance patterns. These trends combined of “shotgunning” crack cocaine has been associated with with the complex anatomy of the head and neck under- retropharyngeal abscesses as well (9). These purulent col- score the importance of clinical suspicion and thorough lections from direct inoculation, however, seem to have a diagnostic evaluation. Proper management of a recog- more benign clinical course compared to those spreading nized DNSI begins with securing the airway. Despite recent from infl amed tissue (10). Congenital anomalies includ- advances in imaging and conservative medical manage- ing thyroglossal duct cysts and branchial cleft anomalies ment, surgical drainage remains a mainstay in the treat- must also be considered, particularly in cases where no ment in many cases. apparent source can be readily identifi ed. Regardless of the etiology, infection and infl ammation can spread through- Q1 ETIOLOGY out the various regions via arteries, veins, lymphatics, or direct extension along fascial planes. -
1 Effective January 1, 2018 ICD‐O‐3 Codes, Behaviors and Terms Are Site‐Specific Alpha Order Last Updat
Effective January 1, 2018 ICD‐O‐3 codes, behaviors and terms are site‐specific Alpha Order Last updated 8/22/18 Status ICD‐O‐3 Term Reportable Comments Morphology Y/N Code New Term 8551/3 Acinar adenocarcinoma (C34. _) Y Lung primaries diagnosed prior to 1/1/2018 use code 8550/3 For prostate (all years) see 8140/3 New Term 8140/3 Acinar adenocarcinoma (C61.9 ONLY) Y For prostate only, do not use 8550/3 New Term 8572/3 Acinar adenocarcinoma, sarcomatoid (C61.9) Y New Term 8550/3 Acinar cell carcinoma Y Excludes C61.9‐ see 8140/3 New Term 8316/3 Acquired cystic disease‐associated renal cell carcinoma (RCC) Y (C64.9) New 8158/1 ACTH‐producing tumor N code/term New Term 8574/3 Adenocarcinoma admixed with neuroendocrine carcinoma (C53. _) Y Behavior 8253/2 Adenocarcinoma in situ, mucinous (C34. _) Y Important note: lung Code/term primaries ONLY: For cases diagnosed 1/1/2018 forward do not use code 8480 (mucinous adenocarcinoma) for in‐ situ adenocarcinoma, mucinous or invasive mucinous adenocarcinoma. 1 Status ICD‐O‐3 Term Reportable Comments Morphology Y/N Code Behavior 8250/2 Adenocarcinoma in situ, non‐mucinous (C34. _) Y code/term New Term 9110/3 Adenocarcinoma of rete ovarii (C56.9) Y New 8163/3 Adenocarcinoma, pancreatobiliary‐type (C24.1) Y Cases diagnosed prior to code/term 1/1/2018 use code 8255/3 Behavior 8983/3 Adenomyoepithelioma with carcinoma (C50. _) Y Code/term New Term 8620/3 Adult granulosa cell tumor (C56.9 ONLY) N Not reportable for 2018 cases New Term 9401/3 Anaplastic astrocytoma, IDH‐mutant (C71. -
Collaborative Stage Manual Part II
SEER Program Coding and Staging Manual 2004, Revision 1 Collaborative Staging Codes Nasal Cavity C30.0 C30.0 Nasal cavity (excludes nose, NOS C76.0) Note: Laterality must be coded for this site, except subsites Nasal cartilage and Nasal septum, for which laterality is coded 0. CS Tumor Size CS Site-Specific Factor 1 - Size of The following tables are available CS Extension Lymph Nodes at the collaborative staging CS TS/Ext-Eval CS Site-Specific Factor 2 - website: CS Lymph Nodes Extracapsular Extension, Lymph Nodes Histology Exclusion Table CS Reg Nodes Eval for Head and Neck AJCC Stage Reg LN Pos CS Site-Specific Factor 3 - Levels I- Lymph Nodes Size Table Reg LN Exam III, Lymph Nodes for Head and Neck CS Mets at DX CS Site-Specific Factor 4 - Levels IV- CS Mets Eval V and Retropharyngeal Lymph Nodes for Head and Neck CS Site-Specific Factor 5 - Levels VI- VII and Facial Lymph Nodes for Head and Neck CS Site-Specific Factor 6 - Parapharyngeal, Parotid, Preauricular, and Sub-Occipital Lymph Nodes, Lymph Nodes for Head and Neck Nasal Cavity CS Tumor Size SEE STANDARD TABLE Nasal Cavity CS Extension Code Description TNM SS77 SS2000 00 In situ; non-invasive Tis IS IS 10 Invasive tumor confined to site of origin T1 L L Meatus (superior, middle, inferior) Nasal chonchae (superior, middle, inferior) Septum Tympanic membrane 30 Localized, NOS T1 L L 40 Extending to adjacent connective tissue within the nasoethomoidal T2 RE RE complex Nasolacrimal duct 60 Adjacent organs/structures including: T3 RE RE Bone of skull Choana Frontal sinus Hard palate -
Esophagopharyngeal Perforation and Prevertebral Abscess After Anterior Cervical Discectomy and Fusion: a Case Report
232 Case Report Esophagopharyngeal perforation and prevertebral abscess after anterior cervical discectomy and fusion: a case report Jay K. Shah1^, Filippo Romanelli1, Jason Yang2, Naina Rao3, Michael C. Gerling4 1Division of Orthopedic Surgery, Department of Orthopedic Surgery, Jersey City Medical Center – Robertwood Johnson Barnabas Health, Jersey City, NJ, USA; 2Robert Wood Johnson University Hospital, RWJBarnabas Health, New Brunswick, NJ, USA; 3New York Grossman School of Medicine, NYU Langone Health, New York, NY, USA; 4Chief of Spine Surgery, Department of Orthopaedic Surgery, New York University Langone Hospital-Brooklyn, Tribeca, New York, NY, USA Correspondence to: Jay K. Shah, DO. Division of Orthopedic Surgery, Department of Orthopedic Surgery, Jersey City Medical Center – Robertwood Johnson Barnabas Health, 355 Grand Street, Jersey City, NJ 07302, USA. Email: [email protected]. Abstract: Anterior cervical discectomy and fusion (ACDF) represents one of the most commonly performed spine surgeries. Dysphagia secondary to esophageal injury during retraction is one of the most common complications, and usually leads to self-limiting dysphagia. However, actual perforation and violation of the esophageal tissue is much rarer and can lead to delayed deep infections. Prevertebral abscess’ are one of the most feared complications after ACDF, as they can lead to severe tissue swelling, osteomyelitis, hardware failure, and even death. Due to their rarity, a gold standard of workup and treatment is still unknown. A healthy 47-year-old female presents 9 months after a C4–C7 ACDF done at an outside institution with a large prevertebral abscess, osteomyelitis, hardware failure, and pseudoarthrosis secondary to esophagopharyngeal defect and prominent hardware. Overall, the patient underwent eight surgeries, and required an extended course of intravenous (IV) antibiotics, multiple diagnostic procedures, and complex soft tissue coverage using an anterolateral thigh free flap. -
December 2020 E-Tips Solid Tumor Rules
New Jersey State Cancer Registry December 2020 E-Tips Cancer Epidemiology Services http://www.nj.gov/health/ces (609) 633-0500 Solid Tumor Rules: December 2020 Update ICD-0-3.2 changes have also been added to applicable site modules. Most changes are minor: terminology, additional definitions, new notes and examples. In order to clarify histology coding instructions, new rules have been added and histology tables updated. These updates do not require review of already abstracted cases. The December 2020 rules replace the current rules and should be used now. SEER Strongly recommends reading the December 2020 Change Log to understand what changes were made. The updated Solid Tumor Rules may be accessed at: https://seer.cancer.gov/tools/solidtumor/ Reportability Changes for 2021 Radiation Coding Total Dose (1533) Starting 01/01/2021 the following terms are reportable: If doses across phases to a single point of region, code Sum of all phases. ** (see 2019 update below) Early or evolving melanoma in situ, or any other early or If doses are to multiple metastatic sites, code highest evolving melanoma, are reportable. dose site. If doses are to primary site and metastatic site, code dose All GIST tumors are reportable and classified as 8936/3 in from the primary site only. ICD-O-3.2. When you have two different sites, you cannot add the Nearly all thymomas are reportable; the exceptions are doses together to get the total dose. microscopic thymoma or thymoma benign (8580/0), micronodular thymoma with lymphoid stroma (8580/1), Radiation Tips and updates for 2019 and ectopic hamartomatous thymoma (8587/0). -
Head and Neck Specimens
Head and Neck Specimens DEFINITIONS AND GENERAL COMMENTS: All specimens, even of the same type, are unique, and this is particularly true for Head and Neck specimens. Thus, while this outline is meant to provide a guide to grossing the common head and neck specimens at UAB, it is not all inclusive and will not capture every scenario. Thus, careful assessment of each specimen with some modifications of what follows below may be needed on a case by case basis. When in doubt always consult with a PA, Chief/Senior Resident and/or the Head and Neck Pathologist on service. Specimen-derived margin: A margin taken directly from the main specimen-either a shave or radial. Tumor bed margin: A piece of tissue taken from the operative bed after the main specimen has been resected. This entire piece of tissue may represent the margin, or it could also be specifically oriented-check specimen label/requisition for any further orientation. Margin status as determined from specimen-derived margins has been shown to better predict local recurrence as compared to tumor bed margins (Surgical Pathology Clinics. 2017; 10: 1-14). At UAB, both methods are employed. Note to grosser: However, even if a surgeon submits tumor bed margins separately, the grosser must still sample the specimen margins. Figure 1: Shave vs radial (perpendicular) margin: Figure adapted from Surgical Pathology Clinics. 2017; 10: 1-14): Red lines: radial section (perpendicular) of margin Blue line: Shave of margin Comparison of shave and radial margins (Table 1 from Chiosea SI. Intraoperative Margin Assessment in Early Oral Squamous Cell Carcinoma.