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Background: Ovarian clear cell carcinomas (OCCCs) are rare, aggressive and chemoresistant tumors. Geographical and ethnic differences in the incidence of OCCC have been reported with a higher incidence in Asiatic countries. There is a paucity of information regarding OCCC in Latin America (LA) and other countries., Methods: Here, we characterized two cohorts of 33 patients with OCCC from LA (24 from Brazil and 9 from Costa Rica) and a cohort of 27 patients from Spain. Genomic analysis was performed for 26 OCCC using the OncoScan platform. Tumors were classified according to their genomic landscapes into subgroups. Clinical parameters were related to the frequency of genomic aberrations., Results: The median overall survival (OS) was not significantly different between the cohorts. Genomic landscapes were characterized by different homologous recombination deficiency (HRD) levels. No difference in the distribution of genomic landscapes profiles was detected between patients from the different cohorts. OCCCs with MYC-amplified tumors harboring a concomitant loss of a region in chromosome 13q12-q13 that includes the BRCA2 gene had the longest OS. In contrast, patients carrying a high number (> 30) of total copy number (CN) aberrations with no concomitant alterations in MYC and BRCA2 genes presented the shortest OS. Furthermore, amplification of the ASH1L gene was also associated with a shorter OS. Initial-stage OCCCs with early progression were characterized by gains in the JNK1 and MKL1 genes., Conclusions: Our results provide new data from understudied OCCC populations and reveal new potential markers for OCCCs., (© 2023. The Author(s).)

The frequency and prognostic significance of the histologic type in early-stage ovarian cancer (OC) is not as well established as in advanced stages. In addition, histologic typing based only on morphologic features may be difficult, especially in high-grade tumors. In this study, we have analyzed a prospective cohort of 502 early-stage OCs to investigate their frequency, immunohistochemical characteristics, and survival of the 5 main histologic types. Histotype was assigned according to not only the morphologic features but also according to the expression pattern of WT1, p53, Napsin A, and progesterone receptors. In addition, an extended panel including p16, β-catenin, HER2, Arid1A, HINF1B, CK7, CDX2, and CK20 was used to refine the diagnosis in difficult cases. In this series, the frequency of the 5 major histologic types was as follows: endometrioid carcinoma, 32.7%; clear cell carcinoma, 25.1%; high-grade serous carcinoma (HGSC), 24.7%; mucinous carcinoma, 10.2%; low-grade serous carcinoma, 4.6%; and others, 2.8%. The combination of morphology and immunohistochemistry allowed the reclassification of 23% of OCs. The lowest concordance was found between samples initially diagnosed as endometrioid, but finally classified as high-grade serous tumors (22% error rate). Endometrioid carcinoma was the most favorable histologic type, whereas HGSC and low-grade serous carcinoma had the worst prognosis. Clear cell carcinoma with abnormal p53 immunostaining pattern also had poor prognosis. Although histologic grade was not a prognostic factor among early-stage endometrioid OCs, distinction between grade 3 endometrioid OC and HGSC is recommended, taking into account differences in prognosis and molecular alterations that can guide different treatments.

Endometrial Cancer (EC) is one of the most common malignancies in women in developed countries. Molecular characterization of different biotypes may improve clinical management of EC. The Cancer Genome Atlas (TCGA) project has revealed four prognostic EC subgroups: POLE, MSI; Copy Number Low (CNL) and Copy Number High (CNH). The goal of this study was to develop a method to classify tumors in any of the four EC prognostic groups using affordable molecular techniques. Ninety-six Formalin-Fixed Paraffin-embedded (FFPE) samples were sequenced following a NGS TruSeq Custom Amplicon low input (Illumina) protocol interrogating a multi-gene panel. MSI analysis was performed by fragment analysis using eight specific microsatellite markers. A Random Forest classification algorithm (RFA), considering NGS results, was developed to stratify EC patients into different prognostic groups. Our approach correctly classifies the EC patients into the four TCGA prognostic biotypes. The RFA assigned the samples to the CNH and CNL groups with an accuracy of 0.9753 (p < 0.001). The prognostic value of these groups was prospectively reproduced on our series both for Disease-Free Survival (p = 0.004) and Overall Survival (p = 0.030).Hence, with the molecular approach herein described, a precise and suitable tool that mimics the prognostic EC subtypes has been solved and validated. Procedure that might be introduced into routine diagnostic practices.

Aim: To determine the incidence of discrepancy rate between the initial pathology diagnosis and referral diagnosis in women with gynaecological cancer., Methods: A retrospective observational study was performed including all consecutive patients with gynaecological cancer referred and who underwent pathologic review between January 2013 and May 2017. Discrepancies were minor when future treatment was not altered or major when the treatment was modified., Results: A total of 259 patients were included. The original diagnosis was ovarian cancer ( n = 126, 48.6%), endometrial cancer ( n = 84, 32.4%), cervical cancer ( n = 43, 16.6%) and vulvar cancer ( n = 6, 2.3%). Eighteen women (6.9%) had major discrepancies and 69 patients (26.6%) had minor discrepancies. The main reason for the minor discrepancy was tumour grade or histology subtype. Regarding ovarian cancer, 13 out of 16 patients had minor discrepancies at histology subtype among serous, endometrioid, mucinous or undifferentiated tumours. The main issue for the minor discrepancy in patients with cervical cancer was among different subtype of cervical adenocarcinoma. Minor discrepancies due to tumour grade were also observed in 14, 19, 8 and 3 patients with endometrial, ovarian, cervical and vulvar cancer, respectively., Conclusions: A second pathology review also adds valid information in those cases with minor discrepancies leading to a difference in patients´ counselling regarding follow-up and prognosis., Competing Interests: All the authors declare that they have no competing interests.

Primary breast lymphoma is a rare form of extra-nodal lymphoid neoplasm. The most common histological type is the diffuse large B-cell lymphoma, which represents 60-80% of all the cases. Our study analyzes the mutational profile of the primary lymphoma of the breast through targeted massive sequencing with a panel of 38 genes in a group of 17 patients with primary breast diffuse large B-cell lymphoma. Seventy-point-five percent of the patients presented with stage IE and 29.5% with stage IIE. 44% of the cases correspond to lymphomas with germinal center phenotype and 33.3% to activated B-cell. The genes with a higher mutational frequency include PIM1 (in 50% of the analyzed samples), MYD88 (39%), CD79B, PRDM1 and CARD11 (17%), KMT2D , TNFIAP3 and CREBBP (11%). The profile of mutant genes involves mostly the NFκB signaling pathway. The high frequency of mutations in PIM1 compared with other lymphomas may have implications in the clinical presentation and evolution of this type of lymphoma., Competing Interests: CONFLICTS OF INTEREST The authors declare no competing financial interests.

Small cell carcinoma of the endometrium is a very rare entity. They are very aggressive tumours, with a poor prognosis. They represent a clinical challenge because of a lack of a standardised treatment. We see here a case of a 67-year-old woman with a history of a lobular breast carcinoma, diagnosed in 2002. After presenting with postmenopausal vaginal bleeding in October 2014, she underwent a hysteroscopy-guided biopsy which revealed a metastasis of breast carcinoma. A hysterectomy and bilateral oophorectomy was performed because of uncontrolled uterine bleeding. The pathologic diagnosis was small cell carcinoma (SCC) of the endometrium. A surgical complete cytoreduction was achieved after the case being presented in a multidisciplinary tumour board. Pathologic results revealed metastasis from peritoneal implants of SCC on the endometrium, and metastasis in pelvic and para-aortic lymph nodes from serous carcinoma of the endometrium. A total of four cycles of adjuvant chemotherapy based on cisplatin (80mg/m² day one) and etoposide (100mg/m² day one, two, three) every 21 days was given. The patient experienced persistent disease and died 17 months after the diagnosis. SCC of the endometrium is a very rare and aggressive disease that requires an individualised multidisciplinary management.

Mantle cell lymphoma (MCL) is an infrequent subtype of non-Hodgkin's lymphoma (NHL) and represents between 4-8% of adult lymphomas. Recently an increase in its incidence to 1-2 cases/100,000 inhabitants/year has been observed. The first line of treatment is based on chemoimmunotherapy and depends on age and the initial stage at diagnosis. There are no second line or successive treatments. There are currently several drugs available that provide acceptable results.

Analysis of vibrations and displacements is a hot topic in structural engineering. Although there is a wide variety of methods for vibration analysis, direct measurement of displacements in the mid and high frequency range is not well solved and accurate devices tend to be very expensive. Low-cost systems can be achieved by applying adequate image processing algorithms. In this paper, we propose the use of a commercial pocket digital camera, which is able to register more than 420 frames per second (fps) at low resolution, for accurate measuring of small vibrations and displacements. The method is based on tracking elliptical targets with sub-pixel accuracy. Our proposal is demonstrated at a 10 m distance with a spatial resolution of 0.15 mm. A practical application over a simple structure is given, and the main parameters of an attenuated movement of a steel column after an impulsive impact are determined with a spatial accuracy of 4 µm.

Pleomorphic hyalinizing angiectatic tumor (PHAT) is an uncommon soft tissue tumor usually located in extremities or trunk. We report 3 new cases with histopathologic diagnosis of PHAT, one with recurrence and sarcomatous myxofibrosarcoma component and another with unreported soft tissue palpebral location. Clinical data, histopathology, immunohistochemistry, fluorescence in situ hybridization, and follow-up data are described. The histopathology showed a tumor with angiectatic blood vessel proliferation and perivascular hyaline material associated with focal pleomorphic cells. The recurrent tumor revealed a histopathologic pattern corresponding to a myxofibrosarcoma. Vimentin and CD99 were positive in tumor cells and CD34 was strongly positive in the tumor cells from the recurrence. Ki-67 was poor positive but with increased positivity in the recurrence. The positivity of p53 and chromosome 22 polysomy were detected in the recurrence. At present, the 3 patients are free of disease and no metastases have been detected. Indeed, the possibility that PHAT may represent a histopathologic pattern and not a true neoplastic entity with specific genetic alterations cannot be excluded at present, and further studies are required.

We present a noninvasive technique for high-speed measuring of eye retraction and eyelid position during blinking. The anterior chamber of the eye is illuminated by the slit lamp of a biomicroscope and eye dynamics during a blinking sequence are captured with a high-speed camera working at 500 frames per second. Digital image processing allows quantitative analysis of cornea and eyelid positions during the closing and opening phases of the blinking process. Our method allows simultaneous measuring of corneal retraction, duration of down and up phases, total blinking duration, and average and peak speeds of the eyelids in both phases, thus providing a complete analysis of the blink's transversal motions.

Videokeratometers and Scheimpflug cameras permit accurate estimation of corneal surfaces. From height data it is possible to adjust analytical surfaces that will be later used for aberration calculation. Zernike polynomials are often used as adjusting polynomials, but they have shown to be not precise when describing highly irregular surfaces. We propose a combined zonal and modal method that allows an accurate reconstruction of corneal surfaces from height data, diminishing the influence of smooth areas over irregular zones and vice versa. The surface fitting error is decreased in the considered cases, mainly in the central region, which is more important optically. Therefore, the method can be established as an accurate resampling technique.

A knowledge of the shape of the cornea is of major importance for the planning and monitoring of surgery, and for the correct diagnosis of corneal diseases. Many authors have studied the geometry of the second corneal surface in the central region and it has been stated that there is a high correlation between the central radii of curvature and asphericities of the two corneal surfaces. In this work we extend this study to a larger, central, 6 mm diameter of the cornea. Surface height data, obtained with an Oculus Pentacam from 42 eyes of 21 subjects, were analysed to yield surface power vectors. Corneal heights of both surfaces were also decomposed into low-order Zernike polynomials and the correlations between each of the power vectors and low-order Zernike coefficients for the two surfaces were studied. There was not only a strong correlation between spherical powers and Zernike defocus coefficients, but also between the astigmatic components. The correspondence between the astigmatism in both surfaces found here can be of the utmost importance in planning optical surgery, since perfect spherical ablation of the first surface does not assure total correction of corneal astigmatism.

Numerical calculation of convergent Fresnel patterns through fast Fourier transform usually requires a large number of samples to fulfill the Nyquist sampling condition around the focus. From polynomial decomposition of the wavefront it is possible to determine which polynomial orders are the main contributors to the number of samples. This information can be used to properly modify the initial wavefront and relax the Nyquist condition thus giving a more efficient numerical algorithm.

Purpose: To compare the visual results of presbyLASIK patients to the best theoretical pseudoaccommodation that could be achieved using a multifocal refractive intraocular lens (IOL) model based on the optical structure of a simulated AMO Array multifocal IOL., Methods: The study included 10 hyperopic eyes that underwent central presbyLASIK surgery using a Technovision excimer laser platform. Mean patient age was 57 years, and mean preoperative spherical equivalent refraction was 1.28+/-0.87 diopters. The optical quality was evaluated by objective distance and near decimal visual acuities calculated using a Fresnel propagation algorithm based on a realistic eye model. Results of the presbyLASIK technique were compared with the theoretical results obtained for the same eye with an ideal, best-fit multifocal IOL (simulated Array multifocal IOL) substituted for the crystalline lens., Results: For near objective visual acuity (from 25 cm to 1 m), the ideal, theoretical Array-like lens provided values of visual acuity above 0.5 for all object distances, whereas presbyLASIK also provided good visual responses for distances beyond 45 cm. For distance vision (from 1.5 to 6 m), both the IOL and presbyLASIK visual acuities were over 0.5, but the optical performance of the ideal Array-like lens was slightly worse than with presbyLASIK., Conclusions: Overall near to distance visual acuity obtained with the presbyLASIK technique is comparable to the best visual acuity that could be achieved with a simulated Array multifocal IOL. Near visual acuity with presbyLASIK falls off from the ideal.

We present and analyze new multifocal optical elements based on an annular distribution of the transmittance. These elements provide selectable number of foci and can be designed to work between two fixed positions or even to provide extended focal depth. The energy of the foci can be modulated through a single parameter that controls the area of each ring. In our study we analyze the quality of the peaks and also the limit number of foci that can be obtained. The properties shown by these elements make them usable in instrumental optics or in ophthalmic optics, as new intraocular implants, where multifocal elements are required. The implementation has been done on a twisted nematic spatial light modulator, thus allowing real time reconfiguration of the element.

The paper presents the polychromatic analysis of two diffractive optical elements with extended depth of focus: the linear axicon and the light sword optical element. Chromatic aberration produces axial displacement of the focal segment line. Thus, we explore the possibility of extending the focal depth of these elements to permit superposition of the chromatic foci. In the case of an axicon, we achieve an achromatic zone where focusing is produced. In the case of the light sword element, we show that the focusing segment is out of axis. Therefore a superposition of colors is produced, but not on axis overlapping. Instead, three colored and separated foci are simultaneously obtained in a single plane. Three dimensional structures of the propagated beams are analyzed in order to provide better understanding of the properties and applications of such elements.

Purpose: To evaluate the changes in the optical quality of corneas of hyperopic patients operated using central multifocal presbyLASIK treatment through the study of light patterns around the retinal plane., Methods: This study included eight hyperopic eyes that underwent central presbyLASIK surgery with Presby-one software using an H. Eye Tech Technovision excimer laser platform. Mean patient age was 57 years. Mean preoperative spherical equivalent refraction was 1.28 +/- 0.87 diopters (D). Mean distance decimal visual acuity with correction was 1.02 +/- 0.13 and without correction was 0.37 +/- 0.15. The optical quality was characterized by the Strehl ratio, the spot size on the retina, and objective decimal visual acuity calculated based on measured corneal topography using Fresnel propagation algorithm based on a realistic eye model., Results: The postoperative spherical equivalent refraction was -0.55 +/- 0.48 D. The distance decimal visual acuity with correction was 0.94 and without correction was 0.70. The pseudoaccommodation range was 1.60 +/- 0.40 D. A good Pearson correlation coefficient was obtained (r2 = 0.86) for the linear fit between the real and calculated decimal visual acuity for the eight eyes. The Strehl ratio value on the retinal plane increased after the surgery by a mean factor of 4.7., Conclusions: With a complete characterization of the eye and a complete propagation algorithm (that takes into account all refractive surfaces in the eye at the same time), it is possible to evaluate the optical quality in eyes of patients who have undergone central presbyLASlK treatment.

Inflammatory diseases of the pituitary gland constitute a group of interest because of their scarce frequency, because the disorder presents with symptoms of hypopituitarism and expanding sellar mass and because of their therapeutics implications. We present one case of idiopathic granulomatous hypophysitis, in a 55-years-old patient with daily headaches, panhypopituitarism and a sellar mass lesion. Granulomatous hypophysitis is characterized by granulomas with epithelioid histiocytes and multinucleated giant cells but also shows lymphocyte collections. With respect to immunohistochemistry our results show histiocytes (CD68+) and an heterogeneous inflammatory infiltrate (CD45RO+ y CD20+). We analyze the differential diagnosis with another granulomatous processes, infectious or not infectious, and with the histiocytosis. We examine the possible relation with the lymphocytic hypophysitis.

Unlabelled: Barrett's esophagus is a condition in which the squamous mucosa that normally lines the distal esophagus is replaced by a columnar type of epithelium. Although it carries a clear risk of adenocarcinoma, the estimation of this risk and therefore the value of endoscopic screening remain highly controversial., Aim: To investigate more sensitive techniques to identify those patients who are at high risk of developing cancer and who need intensive endoscopic surveillance for early detection., Methods: A morphologic, histochemical and morphometric study was performed on paraffin-embedded material from 120 patients with Barrett's esophagus and 18 with adenocarcinoma. In addition, each sample was analyzed immunohistochemically with proliferating cell nuclear antigen (PCNA), p53, c-erbB-2, CEA and EMA antibodies., Results: In all zones of the glandular mucosa we found a higher percentage of PCNA-positive nuclei when the specialized epithelium was present. We saw PCNA expression in 75% of the patients with adenocarcinoma, and p53 expression in 15% of the patients without dysplasia, 37% of the patients with dysplasia and 44% of the patients with adenocarcinoma. Positivity for c-erbB-2 was found in 38% of the patients without dysplasia, 53% of those with dysplasia and 37% of those with adenocarcinoma. Aneuploidy was found in 70% of the patients with metaplasia or dysplasia and in all patients with adenocarcinoma., Conclusions: We conclude that p53, PCNA overexpression and aneuploidy are markers of risk for malignancy in Barrett's esophagus.

Desmoplastic trichilemmoma (DT) is a variant of trichilemmoma, characterized by a central prominent desmoplastic component which may simulate invasive carcinoma. We have studied the morphologic and immunohistochemical features of seven cases of DT. Immunohistochemistry was performed on paraffin sections using monoclonal antibodies to CD34 (QBEND/10), vimentin and GCDFP-15. CD34 was also tested in seven cases of basal cell carcinoma (BCC), three with outer root sheath differentiation and four with morphea-form features, and five squamous cell carcinomas. Histologically, features of conventional trichilemmoma were seen at the periphery of the seven lesions. In contrast, at the center, the epithelial cells tended to cluster in narrow irregular cords and nests entrapped in a dense collagenous stroma. One case of DT coexisted with a BCC. In all cases of DT, epithelial tumor cells showed CD34 immunostaining. All cases of BCC, including the one contiguous to a DT, were CD34 negative. CD34 immunodetection in the epithelial cells of the pseudoinvasive component of DT may be of great value in the differential diagnosis with other desmoplastic tumors of the skin, and particularly with BCC.

The interference technique of Newton's Rings is widely used for the quality control of optical surfaces because the precision obtained with this method proves to be very satisfactory. The dimensions of the rings permits calculation of the radii of curvature of the analysed surfaces and deformation of the interference pattern can be utilised to calculate other parameters, such as astigmatism. We describe the study of progressive surfaces by means of this technique, whereby the analysis of the various points of the progressive corridor is made, and also include information on the power function for these lenses, as well as the addition and corridor length.

Aims: Erythrophagocytosis is a characteristic feature of tumour cells in malignant histiocytosis, some leukaemias, lymphomas, and also reactive histiocytes in the haemophagocytic syndrome associated with a variety of infections and neoplasms. It has also been found exceptionally in metastatic malignant epithelial cells in bone marrow and lymph nodes. We present two cases, a cutaneous malignant melanoma and an acantholytic squamous cell carcinoma, in which erythrophagocytosis by tumour cells was demonstrable by both light and electron microscopy., Methods and Results: The melanocytic and squamous nature of these cells was supported by the immunohistochemical detection of HMB45, S100, and NKI-C3 in the former, and cytokeratin and EMA in the latter, and at ultrastructural level by the presence of melanosomes and tonofilaments, respectively., Conclusions: This is, to our knowledge, the first documented report of erythrophagocytic tumour cells in human melanomas and primary carcinomas. Biological considerations apart, this unusual feature can prove to be of value to avoid a misdiagnosis of a variety of haematopoietic malignancies.

Measuring the contrast sensitivity function (CSF) is becoming more frequent in the analyses that are routinely done in optometric practice. This measurement is generally done in far vision, and the observation distance and its effects are not considered to significantly alter this function. Among these effects we should point out the accommodation of the visual optical system to the stimulus and the errors in accommodation associated with this, changes in pupil diameter and therefore in retinal illumination when the observation distance changes, the different level of aberrations (spherical aberration, astigmatism) for different cases, and so on. All of these factors contribute to the fact that the contrast sensitivity of a visual system varies according to the accommodative stimulus. In this study we attempt to clarify the influence of these different parameters by evaluating the CSF for three observation distances. The study was done in monocular vision, with a natural pupil and with a 3 mm artificial pupil that made it possible to maintain the same level of retinal illumination for all distances.

We show how contrast (C) affects the recognition of defocused letters. To do this, the maximum distance (threshold distance) at which a subject, with an induced refraction of -5.5 D, can recognize a letter was determined. Our results show that when C = 1, the recognition threshold distance is such that the ratio eta/xi, between the pseudoimage of the letter (eta) and the blur circle (xi), corresponding to any point of the letter at this distance is about eta/xi = 2; the exact value depends on the difficulty of recognition, in agreement with previous experiments. This ratio represents the sharpness of the image in a geometrical treatment of image formation, providing a geometrical criterion for recognition. Reduction in contrast can be compensated by improving the geometrical sharpness; i.e. bringing the object closer to the subject's are point. Our results show that the increment of eta/xi as a function of the contrast is between C = 0.1 and 1.0. We suggest that a similar geometrical criterion for recognition could be used for any contrast (at least down to C = 0.1 and defocus > 1 D), provided that the proper value of eta/xi is used in each case. On this basis we propose a purely geometrical model, which agrees well with the data and predicts the relationships between tolerance to defocus, contrast and visual acuity; including the well-known relation between visual acuity and defocus when contrast is unity.

The relationship between visual acuity (VA) and background colour is a question that still creates a certain amount of confusion even today, although most authors agree that colour background does not basically affect VA, or at best, values that are only slightly better are obtained with monochromatic yellow light. The object of this paper is to try to clarify if, when the axial chromatic aberration (ACA) has been compensated for, certain differences due exclusively to colour persist or not. In order for this, the VA-luminance functions with red, green, blue and white backgrounds have been measured for two emmetropic observers, before and after compensating for the ACA. The results show that after the compensation, the curve corresponding to red is above the one corresponding to blue, with the one corresponding to green in between. The achromatic function (white background) practically overlaps with the green one. This behaviour is consistent with that shown recently for contrast sensitivity functions (CSFs). However, the asymptotic values are identical for the three colours, and so, it is understandable that no significant differences are normally found when only a standard measurement of VA is taken using the typical illumination from an optotype projector.

We have examined the possible presence of color vision anomalies in 9 individuals (17 eyes, 1 blind) with fundus findings suggesting ocular albinism using the Ishihara plates, the 28-hue Roth test, and the Davico anomaloscope. Results indicate that four of these individuals show no sign of the anomalies expected in an albino in either of the two eyes. Of the remaining cases, two are simple deuteranomals in both eyes, according to Pickford's classification criteria. The rest have protanomaly; however, in these the deviation toward red appears in both eyes in only one subject, whereas in the other two subjects it appears in only one eye, their binocular color vision being basically normal. Our study shows that a large proportion of these albinos have photophobia, pendular nystagmus, strabismus, noticeable refractive errors (astigmatism and high myopia), and poor visual acuity [usually less than 6/30 (20/100) with correction]. The measurement of contrast sensitivity function (CSF) indicates that the frequency of 12 cpd cannot be perceived, even in binocular vision.

In this article, a method for measuring the astigmatism produced by an oblique central refraction is proposed. Measurements were taken using two different values of the pantoscopic angle that can be produced by lenses mounted in frames. We show that in specific cases, and as a function of the angle and power of the lens, the resulting astigmatism can surpass the tolerance level of the eye.