Jigna Jani - Academia.edu (original) (raw)
Papers by Jigna Jani
Archives of Pathology & Laboratory Medicine, Feb 1, 2005
A 44-year-old African American woman with a past medical history of acquired immunodeficiency syn... more A 44-year-old African American woman with a past medical history of acquired immunodeficiency syndrome and hepatitis C cirrhosis presented to our institution with complaints of right lower quadrant pain for 2 months. The pain occurred daily and was constant, with acute ...
The American surgeon
ABSTRACT
American Journal of Gastroenterology
Archives of pathology & laboratory medicine, 2005
A n 18-year-old obese man without significant past medical history presented to an outside hospit... more A n 18-year-old obese man without significant past medical history presented to an outside hospital complaining of 2 months of sharp, nonradiating right upper quadrant pain and 7-kg weight loss. Two weeks prior to admission the pain increased in intensity and he was unable to sleep. He denied fever, chills, nausea, vomiting, jaundice, diarrhea, or hematochezia. The patient's travel, social, and family histories were unremarkable. An abdominal computed tomographic scan revealed a large cystic lesion nearly replacing the right lobe of the liver. A percutaneous drain was placed, evacuating 2 L of dark fluid. Cytologic and microbiologic studies were unrevealing. The patient was transferred to the University of Illinois at Chicago Medical Center for further treatment. Physical examination revealed a 126-kg young man in no acute distress. The abdomen was soft with mild right upper quadrant tenderness on deep palpation. Laboratory evaluation was significant for hypochromic microcytic anemia (hemoglobin, 10.9 g/dL; hematocrit, 35.1%; mean corpuscular volume, 77.1 fL), with reactive thrombocytosis (platelets, 472 ϫ 10 3 /L), low serum albumin (2.4 g/ dL), and a prolonged prothrombin time with international normalized ratio of 1.650. A repeat computed tomographic scan showed a 20 ϫ 16-cm cystic lesion in the right lobe of the liver (Figure 1). The patient underwent right lobectomy (trisegmentectomy), which resulted in brisk hemorrhage and a large amount of blood loss.
Archives of pathology & laboratory medicine, 2004
Archives of pathology & laboratory medicine, 2004
Archives of pathology & laboratory medicine, 2004
Archives of pathology & laboratory medicine, 2005
We describe a rare case of high-grade osteosarcoma with intravascular extension to the right atri... more We describe a rare case of high-grade osteosarcoma with intravascular extension to the right atrium and right ventricle in a 23-year-old woman. Osteosarcomas rarely metastasize to the heart, and only a few cases have been reported in the literature thus far. Diagnoses in some of these cases were made during investigation for severe cardiac failure and in most of these cases at autopsy. We describe a unique case of intravascular extension of the tumor embolus in a cordlike fashion from the left femoral vein to the right side of the heart that morphologically resembled a chondrosarcoma.
Archives of pathology & laboratory medicine, 2005
A 44-year-old African American woman with a past medical history of acquired immunodeficiency syn... more A 44-year-old African American woman with a past medical history of acquired immunodeficiency syndrome and hepatitis C cirrhosis presented to our institution with complaints of right lower quadrant pain for 2 months. The pain occurred daily and was constant, with acute exacerbations from food consumption and mild relief from ibuprofen and lying down. She had history of anorexia but no history of nausea or vomiting. She also had a history of diarrhea for 2 months, with 2 episodes daily. There was no history of melena or hematochezia. She was taking a number of antiretroviral medications. Her physical examination revealed mild abdominal distension and marked tenderness in the right lower quadrant, with guarding but without rebound. Hepatomegaly to 2 to 3 cm below the right costal margin was noted. A digital rectal examination revealed external hemorrhoids and a 2-cm palpable rectal mass that was soft, mobile, and somewhat tender. The stools were heme positive and brown in color. Computed tomographic scan of the abdomen showed
Journal of the American Podiatric Medical Association, 2013
Background: The present study was conducted in an attempt to obtain consistent similarities among... more Background: The present study was conducted in an attempt to obtain consistent similarities among histologic findings of surgically excised neuromas. Secondly, we looked for a correlation between the presence of a neuroma with certain comorbidities. Methods: A total of 22 specimens with a preoperative diagnosis of Morton’s neuroma were sent to the pathology laboratory, and evaluation was performed by a single pathologist. Results: Degenerative changes were seen in 59% of the specimens. Patient age showed trends toward affecting nerve fibrosis, nerve diameter, vessel obstruction, and degenerative changes. The most frequent comorbidity was hypertension, seen in 44% of the participants. Conclusions: Significant histologic similarities among results were not seen; however, certain trends were discovered. Degenerative changes were appreciated in most specimens. Definite histologic findings of neuroma recur, but difficulty in consistent reproducibility may be related to factors such as ag...
Diagnostic Cytopathology, 2005
Osteosarcoma, a primary malignant tumor of the long bones, frequently metastasizes to the lungs. ... more Osteosarcoma, a primary malignant tumor of the long bones, frequently metastasizes to the lungs. We report an unusual case of osteosarcoma metastatic to the right adrenal gland in a 37-yr-old male who presented 8 yr after remission with an adrenal mass. A preoperative diagnosis was made by fine-needle aspiration (FNA) biopsy. FNA biopsy revealed pleomorphic oval cells with prominent nucleoli, spindle cells, and giant tumor cells. Diagnostic osteoid was readily seen on smears and was also detected by polarization of cell-block section. Immunocytochemical stains revealed positivity of tumor cells for vimentin and osteonectin. Cytokeratin stains were negative. The cytologic diagnosis of metastatic Osteosarcoma was made, which was later confirmed upon resection of tumor by histology. Although the role of FNA in the diagnosis of primary bone tumors, including osteogenic sarcoma (OGS), remains controversial, this case, however, demonstrates the value of FNA biopsy combined with immunocytochemistry performed on the aspirated material in diagnosing osteosarcoma from an unusual location such as the adrenal gland.
Annals of Oncology, 2004
Background: We designed a prospective study to test epidermal growth factor receptor (EGFR) expre... more Background: We designed a prospective study to test epidermal growth factor receptor (EGFR) expression by immunohistochemistry (IHC) in resected stage I-IIIA non-small-cell lung cancer (NSCLC) and to correlate overexpression with survival. Patients and methods: EGFR expression was evaluated in 130 consecutive NSCLC patients after radical surgery (60 squamous cell carcinomas, 48 adenocarcinomas, 22 large cell carcinomas: stage I, 41 (31%); stage II, 37 (29%) and stage IIIA, 52 (40%). Results: Overall, 101 of 130 (78%) specimens expressed EGFR, and with a cutoff value of 10% positive cells 48 cases (37%) were classified as positive. At univariate analysis, EGFR was significantly more expressed in stage III (50%) than stage I (20%) and stage II (25%) (P <0.03). No correlation with histotype was found. After a median follow-up of 84 months, both median survival time (18 versus 50 months), 2-year (43% versus 70%) and 5-year (31% versus 46%) survival rates of positive cases were significantly lower than negative ones [P <0.001; hazard ratio 1.96; 95% confidence interval (CI) 1.16-3.30]. At the multivariate analysis, EGFR overexpression and stage emerged as independent factors for cancer-related mortality. Conclusion: In patients with radically resected stage I-IIIA NSCLC, EGFR overexpression predicts shorter survival, thus representing a valuable prognostic factor.
The American Surgeon, 2008
Familial adenomatous polyposis (FAP) is a rare hereditary syndrome characterized by multiple colo... more Familial adenomatous polyposis (FAP) is a rare hereditary syndrome characterized by multiple colorectal polyps and early development of colorectal cancer. Although FAP uniformly involves the large bowel, it may also produce lesions in the stomach and upper intestinal tract. Fundic gland polyps are the most common gastric lesion in FAP. In the general population, these polyps are considered benign and have no malignant potential. However, in FAP patients, fundic gland polyps have been occasionally recognized as precursor lesions from which invasive cancer may develop. Herein, we present a case of gastric adenocarcinoma arising from fundic gland polyps in an FAP patient. We also review reported cases of gastric cancer in FAP and FAP variant patients in an effort to better understand the pathology, clinical course, and optimal screening and treatment strategies for this disease manifestation.
Archives of Pathology & Laboratory Medicine, Feb 1, 2005
A 44-year-old African American woman with a past medical history of acquired immunodeficiency syn... more A 44-year-old African American woman with a past medical history of acquired immunodeficiency syndrome and hepatitis C cirrhosis presented to our institution with complaints of right lower quadrant pain for 2 months. The pain occurred daily and was constant, with acute ...
The American surgeon
ABSTRACT
American Journal of Gastroenterology
Archives of pathology & laboratory medicine, 2005
A n 18-year-old obese man without significant past medical history presented to an outside hospit... more A n 18-year-old obese man without significant past medical history presented to an outside hospital complaining of 2 months of sharp, nonradiating right upper quadrant pain and 7-kg weight loss. Two weeks prior to admission the pain increased in intensity and he was unable to sleep. He denied fever, chills, nausea, vomiting, jaundice, diarrhea, or hematochezia. The patient's travel, social, and family histories were unremarkable. An abdominal computed tomographic scan revealed a large cystic lesion nearly replacing the right lobe of the liver. A percutaneous drain was placed, evacuating 2 L of dark fluid. Cytologic and microbiologic studies were unrevealing. The patient was transferred to the University of Illinois at Chicago Medical Center for further treatment. Physical examination revealed a 126-kg young man in no acute distress. The abdomen was soft with mild right upper quadrant tenderness on deep palpation. Laboratory evaluation was significant for hypochromic microcytic anemia (hemoglobin, 10.9 g/dL; hematocrit, 35.1%; mean corpuscular volume, 77.1 fL), with reactive thrombocytosis (platelets, 472 ϫ 10 3 /L), low serum albumin (2.4 g/ dL), and a prolonged prothrombin time with international normalized ratio of 1.650. A repeat computed tomographic scan showed a 20 ϫ 16-cm cystic lesion in the right lobe of the liver (Figure 1). The patient underwent right lobectomy (trisegmentectomy), which resulted in brisk hemorrhage and a large amount of blood loss.
Archives of pathology & laboratory medicine, 2004
Archives of pathology & laboratory medicine, 2004
Archives of pathology & laboratory medicine, 2004
Archives of pathology & laboratory medicine, 2005
We describe a rare case of high-grade osteosarcoma with intravascular extension to the right atri... more We describe a rare case of high-grade osteosarcoma with intravascular extension to the right atrium and right ventricle in a 23-year-old woman. Osteosarcomas rarely metastasize to the heart, and only a few cases have been reported in the literature thus far. Diagnoses in some of these cases were made during investigation for severe cardiac failure and in most of these cases at autopsy. We describe a unique case of intravascular extension of the tumor embolus in a cordlike fashion from the left femoral vein to the right side of the heart that morphologically resembled a chondrosarcoma.
Archives of pathology & laboratory medicine, 2005
A 44-year-old African American woman with a past medical history of acquired immunodeficiency syn... more A 44-year-old African American woman with a past medical history of acquired immunodeficiency syndrome and hepatitis C cirrhosis presented to our institution with complaints of right lower quadrant pain for 2 months. The pain occurred daily and was constant, with acute exacerbations from food consumption and mild relief from ibuprofen and lying down. She had history of anorexia but no history of nausea or vomiting. She also had a history of diarrhea for 2 months, with 2 episodes daily. There was no history of melena or hematochezia. She was taking a number of antiretroviral medications. Her physical examination revealed mild abdominal distension and marked tenderness in the right lower quadrant, with guarding but without rebound. Hepatomegaly to 2 to 3 cm below the right costal margin was noted. A digital rectal examination revealed external hemorrhoids and a 2-cm palpable rectal mass that was soft, mobile, and somewhat tender. The stools were heme positive and brown in color. Computed tomographic scan of the abdomen showed
Journal of the American Podiatric Medical Association, 2013
Background: The present study was conducted in an attempt to obtain consistent similarities among... more Background: The present study was conducted in an attempt to obtain consistent similarities among histologic findings of surgically excised neuromas. Secondly, we looked for a correlation between the presence of a neuroma with certain comorbidities. Methods: A total of 22 specimens with a preoperative diagnosis of Morton’s neuroma were sent to the pathology laboratory, and evaluation was performed by a single pathologist. Results: Degenerative changes were seen in 59% of the specimens. Patient age showed trends toward affecting nerve fibrosis, nerve diameter, vessel obstruction, and degenerative changes. The most frequent comorbidity was hypertension, seen in 44% of the participants. Conclusions: Significant histologic similarities among results were not seen; however, certain trends were discovered. Degenerative changes were appreciated in most specimens. Definite histologic findings of neuroma recur, but difficulty in consistent reproducibility may be related to factors such as ag...
Diagnostic Cytopathology, 2005
Osteosarcoma, a primary malignant tumor of the long bones, frequently metastasizes to the lungs. ... more Osteosarcoma, a primary malignant tumor of the long bones, frequently metastasizes to the lungs. We report an unusual case of osteosarcoma metastatic to the right adrenal gland in a 37-yr-old male who presented 8 yr after remission with an adrenal mass. A preoperative diagnosis was made by fine-needle aspiration (FNA) biopsy. FNA biopsy revealed pleomorphic oval cells with prominent nucleoli, spindle cells, and giant tumor cells. Diagnostic osteoid was readily seen on smears and was also detected by polarization of cell-block section. Immunocytochemical stains revealed positivity of tumor cells for vimentin and osteonectin. Cytokeratin stains were negative. The cytologic diagnosis of metastatic Osteosarcoma was made, which was later confirmed upon resection of tumor by histology. Although the role of FNA in the diagnosis of primary bone tumors, including osteogenic sarcoma (OGS), remains controversial, this case, however, demonstrates the value of FNA biopsy combined with immunocytochemistry performed on the aspirated material in diagnosing osteosarcoma from an unusual location such as the adrenal gland.
Annals of Oncology, 2004
Background: We designed a prospective study to test epidermal growth factor receptor (EGFR) expre... more Background: We designed a prospective study to test epidermal growth factor receptor (EGFR) expression by immunohistochemistry (IHC) in resected stage I-IIIA non-small-cell lung cancer (NSCLC) and to correlate overexpression with survival. Patients and methods: EGFR expression was evaluated in 130 consecutive NSCLC patients after radical surgery (60 squamous cell carcinomas, 48 adenocarcinomas, 22 large cell carcinomas: stage I, 41 (31%); stage II, 37 (29%) and stage IIIA, 52 (40%). Results: Overall, 101 of 130 (78%) specimens expressed EGFR, and with a cutoff value of 10% positive cells 48 cases (37%) were classified as positive. At univariate analysis, EGFR was significantly more expressed in stage III (50%) than stage I (20%) and stage II (25%) (P <0.03). No correlation with histotype was found. After a median follow-up of 84 months, both median survival time (18 versus 50 months), 2-year (43% versus 70%) and 5-year (31% versus 46%) survival rates of positive cases were significantly lower than negative ones [P <0.001; hazard ratio 1.96; 95% confidence interval (CI) 1.16-3.30]. At the multivariate analysis, EGFR overexpression and stage emerged as independent factors for cancer-related mortality. Conclusion: In patients with radically resected stage I-IIIA NSCLC, EGFR overexpression predicts shorter survival, thus representing a valuable prognostic factor.
The American Surgeon, 2008
Familial adenomatous polyposis (FAP) is a rare hereditary syndrome characterized by multiple colo... more Familial adenomatous polyposis (FAP) is a rare hereditary syndrome characterized by multiple colorectal polyps and early development of colorectal cancer. Although FAP uniformly involves the large bowel, it may also produce lesions in the stomach and upper intestinal tract. Fundic gland polyps are the most common gastric lesion in FAP. In the general population, these polyps are considered benign and have no malignant potential. However, in FAP patients, fundic gland polyps have been occasionally recognized as precursor lesions from which invasive cancer may develop. Herein, we present a case of gastric adenocarcinoma arising from fundic gland polyps in an FAP patient. We also review reported cases of gastric cancer in FAP and FAP variant patients in an effort to better understand the pathology, clinical course, and optimal screening and treatment strategies for this disease manifestation.