Author
J. Godfrey Heathcote
Other affiliations: Queen Elizabeth II Health Sciences Centre
Bio: J. Godfrey Heathcote is an academic researcher from Dalhousie University. The author has contributed to research in topics: Lacrimal sac & Sinonasal Tract. The author has an hindex of 8, co-authored 22 publications receiving 2429 citations. Previous affiliations of J. Godfrey Heathcote include Queen Elizabeth II Health Sciences Centre.
Topics: Lacrimal sac, Sinonasal Tract, Apocrine, Histogenesis, Biopsy
Papers
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Harvard University1, University of Cambridge2, Mayo Clinic3, Okayama University4, Technische Universität München5, Dalhousie University6, University of Amsterdam7, Southampton General Hospital8, Tokyo Metropolitan Komagome Hospital9, Shinshu University10, Kanazawa University11, Kanazawa Medical University12, Kansai Medical University13, Seoul National University14, University College London15, Sapporo Medical University16, University of Verona17
TL;DR: This statement proposes a terminology scheme for the diagnosis of IgG4-related disease that is based primarily on the morphological appearance on biopsy, and advocates the use of strict criteria for accepting newly proposed entities or sites as components of the IgG 4- related disease spectrum.
2,041 citations
Harvard University1, Dalhousie University2, University of Amsterdam3, Kobe University4, Mayo Clinic5, Technische Universität München6, Tokyo Metropolitan Komagome Hospital7, Shinshu University8, Kanazawa University9, Kanazawa Medical University10, Kansai Medical University11, Seoul National University12, Okayama University13, University College London14, Sapporo Medical University15, University of Verona16, King's College London17
TL;DR: John H. Stone, Arezou Khosroshahi, Vikram Deshpande, John K.Stone, Masayuki Takahira, Hisanori Umehara, George Webster, Motohisa Yamamoto, Eunhee Yi, Tadashi Yoshino, Giuseppe Zamboni, Yoh Zen, and Suresh Chari.
Abstract: John H. Stone, Arezou Khosroshahi, Vikram Deshpande, John K. C. Chan, J. Godfrey Heathcote, Rob Aalberse, Atsushi Azumi, Donald B. Bloch, William R. Brugge, Mollie N. Carruthers, Wah Cheuk, Lynn Cornell, Carlos Fernandez-Del Castillo, Judith A. Ferry, David Forcione, Gunter Kloppel, Daniel L. Hamilos, Terumi Kamisawa, Satomi Kasashima, Shigeyuki Kawa, Mitsuhiro Kawano, Yasufumi Masaki, Kenji Notohara, Kazuichi Okazaki, Ji Kon Ryu, Takako Saeki, Dushyant Sahani, Yasuharu Sato, Thomas Smyrk, James R. Stone, Masayuki Takahira, Hisanori Umehara, George Webster, Motohisa Yamamoto, Eunhee Yi, Tadashi Yoshino, Giuseppe Zamboni, Yoh Zen, and Suresh Chari
607 citations
TL;DR: The majority of orbital exenterations performed in this series were secondary to periocular malignancies with unsuccessful/insufficient previous treatments, and were able to withstand radiation therapy without complications.
Abstract: Background Orbital exenteration is a disfiguring procedure reserved for life-threatening malignancies. This study examines the clinical course and outcomes of a large series of patients who underwent orbital exenteration for malignant periocular neoplasms. Methods This is a retrospective review of patients who underwent orbital exenteration from 1 July 2005 to 30 June 2015 at four tertiary referral centres in the USA, Australia and Canada. Demographics, indication for surgery, pathology, surgical technique, reconstruction type and outcomes were reviewed. Results Orbital exenteration was performed on 102 patients. The mean age at surgery was 67.5 years. The most common malignant tumours encountered were squamous cell carcinoma, melanoma and basal cell carcinoma. Seventy-six patients (75%) underwent reconstruction with a local myocutaneous flap, twelve with partial-thickness skin grafts (PTSG), or split skin graft, two had a free flap, and one had a dermis fat graft. Sixteen patients had combined procedures of two of the above. Complete removal of the tumour was achieved with clear margins in 81 cases. Of all patients, 72% were alive at 48 months or more. Conclusion The majority of orbital exenterations performed in this series were secondary to periocular malignancies with unsuccessful/insufficient previous treatments. Regional myocutaneous flaps, PTSG, full-thickness skin grafts and dermis fat grafts were all highly effective and durable reconstructive options, and were able to withstand radiation therapy without complications.
32 citations
TL;DR: The sensitivity and PPV in this study are high, the false-positive rate is clinically significant given the type of lesions missed, and one must be cautious in recommending conservative management for parotid tumours even when a WT is suggested by FNAB.
Abstract: Introduction: Bien que la precision generale de la cytoponction dans l'investigation d'une neoplasie parotidienne soit bien etablie, des resultats specifiques pour la tumeur de Warthin (TW) n'existent pas. Pour la majorite des tumeurs salivaires, la chirurgie est recommandee a cause du risque de croissance et de transformation maligne. Ce comportement est inhabituel avec la TW et l'indication chirurgicale vient plutot du besoin de confirmation pathologique. Un diagnostic precis par cytoponction justifierait donc un traitement conservateur chez les patients asymptomatiques. Par contre si la procedure diagnostique n'est pas fiable, on n'hesitera pas a recommander une parotidectomie. Methode: Etude retrospective de toutes les parotidectomies faites entre 1992 et 2000 pour lesquelles un resultat de cytoponction etait disponible. Tous les cas suggerant une TW ont ete identifies et les resultats de cytoponction et de pathologie compares. Sensibilite et valeur predictive positive (VPP) ont ete calculees. Resultats: Un total de 41 patients ont ete inclus dans l'etude. Trente-trois sont de vrais positifs, c'est-a-dire que la cytoponction et la pathologie finale etaient similaires. Quatre patients avaient une cytoponction suggerant une TW qui n'a pas ete confirmee a la pathologie (faux positifs). Quatre autres patients etaient de faux negatifs. La sensibilite et la VPP etaient donc de 89.2% et 89.2% respectivement. Conclusion: Bien que la sensibilite et la VPP soient elevees dans cette etude, le taux de faux-positifs est cliniquement significatif etant donne le type de pathologies manquees. Trois carcinome a cellules acinaires et un adenome pleomorphe ont ete diagnostiques erronement comme TW a la cytoponction. Il faut donc demeurer prudent quand on recommande un traitement conservateur pour une tumeur de la parotide meme si la cytoponction suggere une TW.
29 citations
TL;DR: UBM is a useful imaging technique for the in vivo assessment of primary iris melanoma and can provide detailed imaging of the tumor's interface with the angle structures and may aid the surgeon in choosing the most appropriate technique to ensure total removal.
19 citations
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01 Jan 2014
TL;DR: This work established comprehensive diagnostic criteria for IgG4-RD for the practical use of specialists and nonspecialists and describes the pathological features of each organ differ.
Abstract: Although IgG4-related disease (IgG4-RD) is a novel and important disease entity characterized by elevated serum IgG4 concentration and tumefaction or tissue infiltration by IgG4-positive plasma cells, its clinical diagnostic criteria have not been fully established. Many patients with IgG4-RD have lesions in multiple organs, either synchronously or metachronously, and the pathological features of each organ differ. We established comprehensive diagnostic criteria for IgG4-RD for the practical use of specialists and nonspecialists.
834 citations
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TL;DR: This book will be useful to physicians in various disciplines such as gastroenterology, rheumatology, ophthalmology, otolaryngology, urology, hematology, respiratory medicine and oral medicine, not only as a textbook but also as an authoritative and comprehensive reference work.
Abstract: IgG4-related disease (IgG4-RD) is a novel clinical disease entity characterized by an elevated serum IgG4 concentration and tumefaction or tissue infiltration by IgG4-positive plasma cells. IgG4-RD encompasses a wide variety of diseases, formerly diagnosed as Mikulicz's disease (MD), autoimmune pancreatitis (AIP), hypophysitis, Riedel thyroiditis, tubulointerstitial nephritis, prostatitis, retroperitoneal fibrosis, inflammatory aortic aneurysm and inflammatory pseudotumor. However, like a crow flying on a dark night, IgG4-RD passed through the history of medicine, until the concept of an overarching of these systemic disorders was established in Japan at the beginning of the present century. In addition, most clinical practitioners are not yet familiar with IgG4-RD, and thus one cannot diagnose what one does not know. The purpose of the book [1] is to raise awareness of this disease and its diagnostic pitfalls. Another goal was to delineate the characteristic features of individual organs in IgG4-RD radiologically and histopathologically with many color photographs. Most of the authors are members of the IgG4 team of the Japanese the Ministry of Health, Labor and Welfare (MHLW), and experts who have published numerous important papers in the field. Thus, this book will be useful to physicians in various disciplines such as gastroenterology, rheumatology, ophthalmology, otolaryngology, urology, hematology, respiratory medicine and oral medicine, not only as a textbook but also as an authoritative and comprehensive reference work.
796 citations
TL;DR: Advances in understanding the pathophysiology of IgG4-RD have proceeded swiftly, leading to the identification of a number of potential targeted treatment strategies, which have direct implications for the development of targeted strategies for the treatment of this condition.
Abstract: Purpose of review Remarkable insights have been gleaned recently with regard to the pathophysiology of IgG4-related disease (IgG4-RD). These findings have direct implications for the development of targeted strategies for the treatment of this condition. Recent findings Oligoclonal expansions of cells of both the B and T lymphocyte lineages are present in the blood of patients with IgG4-RD. Oligoclonal expansions of plasmablasts are a good biomarker for disease activity. An oligoclonally expanded population of CD4+ cytotoxic T lymphocytes is found not only in the peripheral blood but also at tissue sites of active disease. This cell elaborates cytokines that may drive the fibrosis characteristic of IgG4-RD. T follicular helper cells (Tfhc), particularly the Tfhc2 subset, appear to play a major role in driving the class switch to IgG4 that typifies this disease. The relationship between malignancy and IgG4-RD remains an area of interest. Summary Advances in understanding the pathophysiology of IgG4-RD have proceeded swiftly, leading to the identification of a number of potential targeted treatment strategies. The completion of classification criteria for IgG4-RD, an effort supported jointly by the American College of Rheumatology and the European League Against Rheumatism, will further facilitate studies on this disease.
753 citations
Emory University1, Harvard University2, University of Tennessee3, Wakayama Medical University4, University of British Columbia5, Mayo Clinic6, University of Verona7, Tokyo Medical University8, Ohio State University9, Tokyo Metropolitan Komagome Hospital10, Shinshu University11, Kanazawa University12, University of Ulsan13, Kyoto University14, Yokohama City University15, University of Greifswald16, Karolinska Institutet17, Kanazawa Medical University18, University of Toyama19, Kyushu University20, Nagoya City University21, Kansai Medical University22, Aix-Marseille University23, Tohoku University24, Sapporo Medical University25, Teikyo University26, University College London27, Peking Union Medical College28
TL;DR: A. H. Wallace, J. L. Carruthers, S. L€ ohr, Y. Khosroshahi, Z. Chari, E. Della-Torre, L. Frulloni, H.
Abstract: A. Khosroshahi, Z. S. Wallace, J. L. Crowe, T. Akamizu, A. Azumi, M. N. Carruthers, S. T. Chari, E. Della-Torre, L. Frulloni, H. Goto, P. A. Hart, T. Kamisawa, S. Kawa, M. Kawano, M. H. Kim, Y. Kodama, K. Kubota, M. M. Lerch, M. L€ ohr, Y. Masaki, S. Matsui, T. Mimori, S. Nakamura, T. Nakazawa, H. Ohara, K. Okazaki, J. H. Ryu, T. Saeki, N. Schleinitz, A. Shimatsu, T. Shimosegawa, H. Takahashi, M. Takahira, A. Tanaka, M. Topazian, H. Umehara, G. J. Webster, T. E. Witzig, M. Yamamoto, W. Zhang, T. Chiba, and J. H. Stone
728 citations
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TL;DR: Identification of specific antigens and T-cell clones that drive the disease will be the first steps to elucidate the pathogenesis of IgG4-related disease.
717 citations