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Adv Anat Pathol 2022 May 3. Epub 2022 May 3.

Department of Pathology, University of California San Diego, San Diego, CA.

A variety of endometrial lesions may contain mucinous cells. Herein, the author reviews the literature on the classification and clinicopathologic significance of uterine corpus proliferations with a significant mucinous component, assesses the 2020 World Health Organization classification of such lesions, and presents a diagnostic framework. The key epithelial mucinous lesions include mucinous metaplasia, atypical mucinous glandular proliferation and mucinous carcinoma. Read More

Adv Anat Pathol 2022 Apr 26. Epub 2022 Apr 26.

Department of Pathology, Faculty of Medicine and University Hospital in Plzen, Charles University in Prague, Plzen, Czech Republic.

Chromophobe renal cell carcinoma (ChRCC) is the third most common renal cell carcinoma in adults. The aim of this review is to provide a comprehensive overview highlighting the broad morphologic spectrum of ChRCC, and offer a practical approach for handling cases in daily practice. For the purpose of this review, we classify ChRCC subtypes as (1) classic, (2) eosinophilic, (3) sarcomatoid, and (4) other rare patterns. Read More

Adv Anat Pathol 2022 Apr 26. Epub 2022 Apr 26.

Department of Pathology, University of Miami Miller School of Medicine, Miami, FL.

Immune checkpoint inhibitors have been increasingly used to treat various malignant neoplasms. Despite their superior efficacy in treating certain ones, their global immune-activation effect leads to systemic side effects, referred to as immune-related adverse events. Immune-related adverse events affect a variety of organs, including the skin, gastrointestinal, hepatobiliary, and endocrine organs. Read More

Adv Anat Pathol 2022 Apr 19. Epub 2022 Apr 19.

Department of Tissue Pathology and Diagnostic Oncology, NSW Health Pathology, Royal Prince Alfred Hospital.

Oral epithelial dysplasia (OED) represents a spectrum of histologic changes in the oral cavity mucosa that has the potential to transform into oral squamous cell carcinoma. Predicting the risk of malignant transformation is predominantly based on clinicopathologic correlation, histologic examination and grading. OED often poses a diagnostic challenge, primarily due to its histologic mimics and a large number of terminologies used in the literature. Read More

Adv Anat Pathol 2022 Apr 8. Epub 2022 Apr 8.

Division of Gastroenterology, Hepatology and Nutrition, Department of Pediatrics Children's Hospital of Philadelphia and University of Pennsylvania Perelman School of Medicine, Philadelphia, PA.

Adv Anat Pathol 2022 Apr 8. Epub 2022 Apr 8.

Unit of Pathology, Fondazione IRCCS Ospedale Casa Sollievo Della Sofferenza San Giovanni Rotondo, FG, Italy.

Adv Anat Pathol 2022 Apr 7. Epub 2022 Apr 7.

Department of Pathology, Belfast Health and Social Care Trust, Belfast, Northern Ireland, UK.

Mesonephric-like adenocarcinoma (MLA) was introduced as a new tumor type in the endometrium and the ovary in the 2020 World Health Organization (WHO) Classification. This is a rare recently described (2016) and clinically aggressive carcinoma with a propensity for distant spread, especially to the lungs. MLA has a characteristic morphology and immunophenotype (hormone receptor negative; TTF1 and/or GATA3 positive). Read More

Adv Anat Pathol 2022 May;29(3):141-153

Department of Pathology, Indiana University School of Medicine, Indianapolis, IN.

The retroperitoneal soft tissues, extending from the pelvic floor to the level of the diaphragm, are the source of a variety of mesenchymal neoplasms with overlapping features and distinct clinical behaviors, making their distinction of crucial importance. Herein, we report a rare retroperitoneal angiomyofibroblastoma (AMFB) that presented as a right abdominal mass in a 25-year-old woman and that clinically simulated a primary renal carcinoma. The patient underwent complete surgical resection showing a well-circumscribed tumor adjacent to but separate from the right kidney. Read More

Adv Anat Pathol 2022 May;29(3):117-130

Department of Pathology and Laboratory Medicine, University of Tennessee Health Science Center, Memphis, TN.

The World Health Organization (WHO) recommends grading of clear cell renal cell carcinoma (RCC) and papillary RCC using the WHO/International Society of Urological Pathology (ISUP) grade, which is primarily based on nuclear features. As the spectrum of RCC continues to evolve, with more recently described subtypes in the past decade, literature evidence on grading these subtypes is limited or not available for some tumor types. Herein, we outline a pragmatic approach to the topic of grading RCC, dividing the contemporarily described RCC subtypes into 7 categories based on the potential clinical applicability of grading as a useful prognostic parameter: (1) RCC subtypes that are reasonably validated and recommended for WHO/ISUP grading; (2) RCC subtypes where WHO/ISUP is not applicable; (3) RCC subtypes where WHO/ISUP grading is potentially clinically useful; (4) inherently aggressive RCC subtypes where histologic classification itself confers an aggressive biologic potential; (5) renal epithelial tumors where WHO/ISUP grading provides potentially misleading prognostic implication; (6) renal epithelial neoplasms where low WHO/ISUP grade features are a prerequisite for accurate histologic classification; and (7) renal epithelial neoplasms with no or limited data on grading or incomplete understanding of the biologic potential. Read More

Adv Anat Pathol 2022 Mar 7. Epub 2022 Mar 7.

Departments of Pathology Urology, Emory University School of Medicine Winship Cancer Institute of Emory University, Atlanta Department of Pathology, Veterans Affairs Medical Center, Decatur, GA.

Metastases to the kidney are rare and were historically described in autopsy series, and the incidence ranged between 2.36% and 12.6%. Read More

Adv Anat Pathol 2022 Mar 7. Epub 2022 Mar 7.

Departments of Pathology Otorhinolaryngology, Faculty of Medicine in Plzen, Charles University Molecular and Genetic Laboratory, Bioptic Laboratory Ltd, Plzen, Czech Republic Institute of Biomedicine, Pathology, University of Turku and Department of Pathology, Turku University Hospital, Turku, Finland Epigenetics and Human Disease Laboratory, Department of Biomedical Sciences and Medicine, Algarve Biomedical Center (ABC), University of Algarve, Faro, Portugal Department of Anatomical Pathology, University of Calgary, Calgary, Alberta, Canada Department of Oncology, Section Head and Neck Oncology, University Hospitals Leuven, KU Leuven, Leuven, Belgium Department of Pathology and Medical Biology, University of Groningen, Groningen, The Netherlands International Head and Neck Scientific Group, Padua, Italy.

This review focuses on the heterogenous group of clear cell neoplasms of salivary glands and attempts to identify major differential diagnostic features. Within the head and neck region, clear cells are found most commonly in salivary gland tumors, but may also be seen in tumors of squamous or odontogenic epithelial origin, primary or metastatic carcinomas, benign or malignant melanocytic lesions, or benign or malignant mesenchymal tumors. Clear cells occur fairly commonly among a wide variety of salivary gland neoplasms, but mostly they constitute only a minor component of the tumor cell population. Read More

Adv Anat Pathol 2022 05;29(3):181-182

Department of Pathology and Laboratory Medicine, University of Tennessee Health Sciences, Memphis, TN.

Adv Anat Pathol 2022 May;29(3):168-177

Department of Pathology, University of Texas Southwestern Medical Center, Dallas, TX.

Renal cell carcinoma (RCC) with fibromyomatous stroma (FMS) was included as an "emerging/provisional" entity in the 2016 World Health Organization (WHO) classification as a "RCC with (angio) leiomyomatous stroma." It has been debated whether RCCFMS represents a separate entity or a group of RCCs with overlapping morphologies. Accordingly, various names have been used to refer to the RCCs that exhibited clear cells and prominent smooth muscle and fibromatous stroma. Read More

Adv Anat Pathol 2022 05;29(3):178-181

Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN.

Adv Anat Pathol 2022 May;29(3):154-167

Department of Laboratory Medicine and Pathology, Hamad Medical Corporation, Doha, Qatar.

Ovarian serous tumors and related lesions are one of the most common conditions of the female genital tract. While ovarian high-grade serous carcinoma carries high mortality and adverse prognosis, most other serous lesions have better clinical behavior. In recent years, significant progress has been made in understanding the nature and histogenesis of these lesions that has contributed to better and more precise clinical management. Read More

Adv Anat Pathol 2022 Feb 18. Epub 2022 Feb 18.

Departments of Dermatology Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN Department of Dermatology, Alexandria University, Alexandria, Egypt.

Psoriasiform dermatoses represent a wide array of skin diseases commonly encountered by clinicians and pathologists. While they may present a diagnostic challenge, thorough observation coupled with proper interpretation of subtle additional clinical or histopathologic features provide clues to the correct diagnosis. In this review, we provide updates on emerging entities and develop a systemic approach to establish the pathologic diagnosis, with emphasis on the importance of clinicopathologic correlation. Read More

Adv Anat Pathol 2022 May;29(3):131-140

Department of Laboratory Medicine and Pathology, University of Washington, Seattle, WA.

Translocation renal cell carcinoma (tRCC) with TFE3 gene rearrangements has been born as a distinct entity 20 years ago. These relatively rare tumors were notable among other RCC subtypes because of their disproportionally high incidence among children and young adults. Initial reports were focused on describing unifying morphologic criteria and typical clinical presentation. Read More

Adv Anat Pathol 2022 01;29(1):47

Adv Anat Pathol 2022 Jan;29(1):48-61

Department of Pathology, Henry Lee Moffitt Cancer Center and Research Institute.

Inflammatory bowel disease, including ulcerative colitis and Crohn disease, is an idiopathic chronic inflammatory condition of the gastrointestinal tract. Since neither the clinical manifestations nor the morphologic features of inflammatory bowel disease are pathognomonic alone, the differential diagnosis to consider is relatively broad, and it relies on the synthesis of clinical, endoscopic, and microscopic features. Long-held histologic diagnostic principles include recognizing structural and inflammatory features of chronicity, that is, architectural distortion, basal plasmacytosis, and expansion of the lamina propria lymphoplasmacytic infiltrate. Read More

Adv Anat Pathol 2022 Jan;29(1):37-47

Department of Laboratory Medicine and Pathology, Mayo Clinic Arizona, Scottsdale, AZ.

Histology is used to confirm the diagnosis of inflammatory bowel disease, exclude superimposed infections, and to evaluate for dysplasia. Histology has rarely been used to measure disease activity and guide therapy despite evidence that histologic measurements have value in predicting important clinical outcomes. More recently, there have been numerous studies supporting a role for histologic disease activity measurements in predicting a variety of outcomes including relapse, hospitalizations, steroid use, and dysplasia. Read More

Adv Anat Pathol 2022 Jan;29(1):25-36

Envoi Specialist Pathologists.

Pathologists have an important and expanding role in the diagnosis and management of inflammatory bowel disease. This role includes the initial diagnosis of the disease, assessment of the response to treatment and the identification of short-term complications such as cytomegalovirus infection and long-term complications such as dysplasia. Furthermore, the assessment of resection specimens for complication of disease is important to determining the risk of subsequent disease or inflammation within an ileal pouch. Read More

Adv Anat Pathol 2022 01;29(1)

Department of Pathology, Henry Lee Moffitt Cancer Center and Research Institute, Tampa, FL.

Adv Anat Pathol 2022 Jan;29(1):62-70

Division of Gastroenterology, Hepatology, and Nutrition, Department of Pediatrics, Children's Hospital of Philadelphia and University of Pennsylvania Perelman School of Medicine, Philadelphia, PA.

Very early-onset inflammatory bowel disease (VEO-IBD), IBD diagnosed in children younger than 6 years old, is phenotypically and genetically distinct from older onset IBD. Monogenic and digenic causative defects, particularly in primary immunodeficiency and intestinal epithelial barrier genes, have been identified in a subset of patients with VEO-IBD allowing for targeted therapies and improved outcomes. However, these findings are the minority, thus strategies to correctly diagnose patients, including identification of specific histopathologic findings with correlating clinical and laboratory features may provide critical and necessary insight into mechanisms of disease pathogenesis and subsequent therapeutic options. Read More

Adv Anat Pathol 2022 Mar;29(2):108-116

Pathology Section, Rashid Hospital, Dubai, United Arab Emirates.

Quantum mechanics (QM) and surgical pathology might seem totally unrelated fields of science. Because QM or particle physics explains the very basic structure and function of nature, there are growing interconnections between the fundamentals and applications of QM and biologic sciences. QM is not only applied to the structure of atoms but also probes the structure of biologic molecules, explains their mutational changes and has provided an insight into the basic mechanisms of many different biologic systems. Read More

Adv Anat Pathol 2022 Mar;29(2):97-107

Department of Pathology, SUNY Upstate Medical University, Syracuse.

Found in virtually any organ system, immunoglobulin (Ig) G4-related disease (RD) is a recently recognized immune-mediated, systemic, a fibroinflammatory disease characterized histologically by storiform fibrosis, obliterative phlebitis, and lymphoplasmacytic infiltrate with IgG4-positive plasma cells (PCs). IgG4-related Hashimoto thyroiditis (IgG4-RHT), also called IgG4-related thyroiditis, shares many features with IgG4-RD but is distinct in several ways. A case of IgG4-RHT in a 51-year-old African American female is assembled together with a literature review which uncovered 82 cases of IgG4-RHT. Read More

Adv Anat Pathol 2021 Nov;28(6):439-445

Department of Pathology, Peking University Cancer Hospital and Institute.

Advances in immunotherapy have increased the need for stratified predictive biomarkers in patients with non-small cell lung cancer. However, precise evaluation of tumor tissue-based immune biomarkers, such as programmed cell death-ligand 1 (PD-L1) and the characteristics of tumor infiltrating lymphocytes (TILs), is a challenge in clinical practice. In recent years, the digitization of whole-slide images of tissue has accelerated the implementation of artificial intelligence (AI) approaches in tumor pathology and provided an opportunity to use AI tools to improve the interpretation of immune biomarkers. Read More

Adv Anat Pathol 2022 Mar;29(2):71-80

Unit of Anatomic Pathology, Department of Surgical Sciences and Integrated Diagnostics (DISC), University of Genova.

Very early onset inflammatory bowel disease (VEO-IBD) is a clinical umbrella classification composed of IBD-like diseases encompassing both classic IBD (Crohn's disease and ulcerative colitis) and monogenic disorder, both arising before 6 years of age. VEO-IBD patients present significant clinical differences from IBD occurring in older children and in adults, including more severe disease, often unresponsive to conventional IBD therapy and a greater proportion of cases featuring an underlying genetic alteration. Histologic findings of gastrointestinal biopsies can show an IBD-like pattern (both Crohn's disease-like and ulcerative colitis-like pattern), an apoptotic-like and enterocolitis-like pattern. Read More

Adv Anat Pathol 2021 Nov;28(6):396-407

Department of Pathology and Laboratory Medicine, University of Tennessee Health Sciences, Memphis, TN.

Fumarate hydratase-deficient renal cell carcinoma (FH-deficient RCC) is typically considered a high-grade, aggressive subtype of RCC that frequently arises in the setting of hereditary leiomyomatosis-renal cell carcinoma (HLRCC) syndrome. Increasing experience with HLRCC-associated RCC and FH-deficient RCC has resulted in recognition of tumors with lower grade morphologic features, overlapping with those of succinate dehydrogenase-deficient RCC and other low-grade oncocytic tumors. In this review article, we report a previously unpublished case that was recently encountered in our practice and review cases in the current literature with an aim of getting a better understanding of these oncocytic tumors and their morphologic spectrum. Read More

Adv Anat Pathol 2022 Mar;29(2):81-96

*Department of Dermatology, Tufts University School of Medicine, Boston.

Medical malpractice occurs when a hospital, doctor, or other health care professional, through a negligent act or omission, causes an injury to a patient. The negligence might be the result of errors in diagnosis, treatment, aftercare, or health management. To be considered medical malpractice under the law, the claim must violate the standard of care, the injury must be caused by the negligence and, last but most certainly not least, the injury must result in significant damages. Read More

Adv Anat Pathol 2021 Nov;28(6):415-425

Departments of Pathology and Laboratory Medicine.

Amyloid arthropathy is a joint disease associated with systemic amyloidosis. Herein, we present a model case and review the clinicopathologic features and pathophysiology of this disorder. Amyloid arthropathy results from elevation of serum amyloidogenic proteins and their deposition as aggregates in synovial fluid and articular tissues. Read More