7,877 results match your criteria American Journal Of Surgical Pathology[Journal]


Steatohepatitic Variant of Hepatocellular Carcinoma Is Associated With Both Alcoholic Steatohepatitis and Nonalcoholic Steatohepatitis: A Study of 2 Cohorts With Molecular Insights.

Am J Surg Pathol 2020 Jun 30. Epub 2020 Jun 30.

The Department of Pathology, Molecular, and Cell-Based Medicine, The Icahn School of Medicine at Mount Sinai, New York, NY.

Steatohepatitic hepatocellular carcinoma (SH-HCC) is a variant of hepatocellular carcinoma (HCC) with established association with nonalcoholic steatohepatitis (NASH), while its association with alcoholic steatohepatitis (ASH) is unclear. We studied 2 cohorts of patients who underwent resection for HCC in the setting of steatohepatitis. In our Mount Sinai (New York) cohort, we found SH-HCC in 17/24 (71%) patients with NASH and in 14/19 (74%) patients with ASH, while SH-HCC was the predominant tumor morphology in 12/24 (50%) in the NASH group and 9/19 (47%) in the ASH group. Read More

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http://dx.doi.org/10.1097/PAS.0000000000001533DOI Listing

Plexiform Myofibroblastoma: Clinicopathologic Analysis of 36 Cases of a Distinctive Benign Tumor of Soft Tissue Affecting Mainly Children and Young Adults.

Am J Surg Pathol 2020 Jun 30. Epub 2020 Jun 30.

Department of Pathology, Brigham and Women's Hospital.

The spectrum of benign superficial fibroblastic/myofibroblastic tumors continues to expand and includes entities such as plexiform fibrohistiocytic tumor, dermatomyofibroma and fibroblastic connective tissue nevus. Here, we describe a seemingly distinctive group of lesions which we have labeled "plexiform myofibroblastoma" (PM). PM is a rare superficial mesenchymal tumor of fibroblastic/myofibroblastic lineage that predominantly occurs in children and young adults. Read More

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http://dx.doi.org/10.1097/PAS.0000000000001534DOI Listing

Molecular Profiles of Mixed Endometrial Carcinoma.

Am J Surg Pathol 2020 Jun 26. Epub 2020 Jun 26.

Departments of Pathology and Laboratory Medicine.

Mixed endometrial carcinomas are defined as a combination of 2 or more distinct histologic subtypes, one of which must be a type II tumor comprising at least 5% of the tumor volume. The oncogenesis of these tumors remains unclear, particularly in light of the increasingly appreciated morphologic overlap among subtypes, as well as evolving molecular data. We evaluated 8 cases of mixed endometrial carcinoma, including 4 endometrioid (EC)/serous (SC), 1 SC/clear cell (CC), and 3 EC/CC cases, to study the underlying molecular features and oncogenic mechanisms at play. Read More

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http://dx.doi.org/10.1097/PAS.0000000000001519DOI Listing

A Morphologic and Immunohistochemical Comparison of Nuclear β-Catenin Expressing Testicular Sertoli Cell Tumors and Pancreatic Solid Pseudopapillary Neoplasms Supporting Their Continued Separate Classification.

Am J Surg Pathol 2020 Jun 26. Epub 2020 Jun 26.

Indiana University School of Medicine, Indianapolis, IN.

Some recent reports suggested that many Sertoli cell tumors, not otherwise specified (SCTs-NOS) of the testis were analogs of the solid pseudopapillary neoplasm (SPN) of the pancreas. One of the most relied on pieces of information for this assertion was the shared occurrence in both neoplasms of exon 3 mutations of the CTNNB1 gene, which was reflected by nuclear β-catenin expression. We, therefore, compared the morphologic and immunohistochemical features of 18 SCTs-NOS with strong, diffuse nuclear β-catenin expression with 16 SPNs that also showed such positivity. Read More

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http://dx.doi.org/10.1097/PAS.0000000000001527DOI Listing

The Width of Invasion in Malignant Melanoma Is a Novel Prognostic Feature That Accounts for Outcome Better Than Breslow Thickness.

Am J Surg Pathol 2020 Jun 26. Epub 2020 Jun 26.

University Hospitals of Leicester NHS Trust, Leicester, UK.

Breslow thickness (BT) is the cornerstone of malignant melanoma staging. However, to our knowledge no-one has ever assessed the horizontal width of invasion, measured microscopically, as a prognostic feature. This was investigated as a prognostic feature in this study. Read More

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http://dx.doi.org/10.1097/PAS.0000000000001529DOI Listing

Acquired Cystic Kidney Disease-associated Renal Cell Carcinoma (ACKD-RCC) Harbor Recurrent Mutations in KMT2C and TSC2 Genes.

Am J Surg Pathol 2020 Jun 26. Epub 2020 Jun 26.

Department of Pathology and Laboratory Medicine, Hospital of the University of Pennsylvania.

Individuals with acquired cystic kidney disease (ACKD) in the setting of end-stage renal disease (ESRD) have a high risk of developing renal cell carcinoma (RCC). ACKD-RCC is considered a distinct renal neoplasm in the International Society of Urologic Pathologists (ISUP)-World Health Organization (WHO) classification of kidney tumors which may behave aggressively. Since its original description, there have been multiple case reports and series published; however, the pathogenesis of this neoplasm is uncertain and there is limited data on the genetic aberrations of this tumor. Read More

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http://dx.doi.org/10.1097/PAS.0000000000001530DOI Listing

A Molecular Reappraisal of Glomus Tumors and Related Pericytic Neoplasms With Emphasis on NOTCH-gene Fusions.

Am J Surg Pathol 2020 Jun 26. Epub 2020 Jun 26.

Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY.

Glomus tumors (GTs), together with myofibroma (MF), myopericytoma (MP), and angioleiomyoma (AL) are classified as members of the perivascular myoid family of tumors. The reported genetic abnormalities across these neoplasms is dissimilar, arguing against a pathogenetically unified family; half of the GT showing NOTCH-gene fusions and a smaller subset BRAFV600E mutations, while PDGFRB mutations are noted in a subset of MF and MP. This study aimed to investigate the prevalence and specificity of NOTCH-gene fusions in a large group of GT and correlate with clinical features. Read More

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http://dx.doi.org/10.1097/PAS.0000000000001531DOI Listing

PHOX2B Immunostaining: A Simple and Helpful Tool for the Recognition of Ganglionic Cells and Diagnosis of Hirschsprung Disease.

Am J Surg Pathol 2020 Jun 26. Epub 2020 Jun 26.

Departments of Pathology.

Hirschsprung disease (HD) is a congenital disorder of the enteric nervous system that occurs in ∼1 in 5000 live births. It is characterized by the absence of ganglionic cells (GCs) in the distal intestine. The diagnosis relies on the thorough analysis of a rectal suction biopsy (RSB), which must show a complete absence of GCs after careful examination of at least 100 serial sections. Read More

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http://dx.doi.org/10.1097/PAS.0000000000001528DOI Listing

Genomic and Immunophenotypic Landscape of Aggressive NK-Cell Leukemia.

Am J Surg Pathol 2020 Jun 24. Epub 2020 Jun 24.

Departments of Hematopathology.

Aggressive natural killer-cell leukemia (ANKL) is a rare, lethal disease with pathologic features that are underdescribed in the literature, particularly in Western nations. In addition, although data on the molecular pathogenesis of ANKL has been reported, evaluation of such data in a clinicopathologic context remains limited. Patients diagnosed with ANKL were identified retrospectively. Read More

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http://dx.doi.org/10.1097/PAS.0000000000001518DOI Listing

Neuroendocrine Cells Are Commonly Absent in the Intestinal Crypts in Autoimmune Enteropathy.

Am J Surg Pathol 2020 Jun 24. Epub 2020 Jun 24.

Division of Anatomic Pathology, Mayo Clinic, Rochester, MN.

The absence of neuroendocrine (NE) cells in the intestinal mucosa in autoimmune enteropathy (AIE) has been occasionally reported. However, the status of NE cells has not been studied in detail in AIE. Small bowel and colonic biopsies were retrospectively retrieved from 18 AIE patients (26 baseline [18 small bowel and 8 colon]; and 15 follow-up [11 duodenum and 4 colon] biopsies in 11 patients). Read More

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http://dx.doi.org/10.1097/PAS.0000000000001516DOI Listing

Lower Rate of CTNNB1 Mutations and Higher Rate of APC Mutations in Desmoid Fibromatosis of the Breast: A Series of 134 Tumors.

Am J Surg Pathol 2020 Jun 24. Epub 2020 Jun 24.

Departments of Pathology.

Desmoid fibromatosis (DF) is a rare, locally aggressive, nonmetastasizing fibroblastic/myofibroblastic tumor with a tendency to recur and an unpredictable clinical course. A "wait-and-see" policy is the new standard of care. DF are characterized by activating alterations of the wnt/β-catenin pathway: CTNNB1 or adenomatous polyposis coli gene (APC) mutations (these mutations being mutually exclusive). Read More

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http://dx.doi.org/10.1097/PAS.0000000000001517DOI Listing

Inflammatory Myofibroblastic Tumor of the Uterus: An Immunohistochemical Study of 23 Cases.

Am J Surg Pathol 2020 Jun 19. Epub 2020 Jun 19.

Massachusetts General Hospital, Boston, MA.

Inflammatory myofibroblastic tumors (IMT) of the uterus may be underrecognized as their morphology and immunophenotype may overlap with myxoid variants of uterine smooth muscle tumors and endometrial stromal tumors. Although ALK is a helpful biomarker, not all uterine IMTs are ALK-rearranged, and a small subset of myxoid leiomyosarcomas is ALK-positive. Herein, we evaluated a series of 23 IMTs for the novel endometrial stromal markers interferon-inducible transmembrane protein-1 (IFITM1) and BCOR, the novel myoid marker transgelin, and possible predictive markers p16 and p53 by immunohistochemistry to determine their expression profile and potential prognostic value. Read More

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http://dx.doi.org/10.1097/PAS.0000000000001525DOI Listing

Syphilis: A Contemporary Clinicopathologic Assessment.

Am J Surg Pathol 2020 Jun 19. Epub 2020 Jun 19.

Department of Pathology and Laboratory Medicine, NorthShore University HealthSystem, Evanston, IL.

Syphilis is a sexually transmitted disease caused by the spirochetal bacterium Treponema pallidum that has been of public health concern for centuries. In the United States, it is currently a reportable disease and one which is recently generating increasing case numbers especially in at risk populations of immune deficiency and men who have sex with men. The present series examines biopsies from 13 patients collected over a 12-year period from a general hospital network in north suburban Cook County, Illinois. Read More

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http://dx.doi.org/10.1097/PAS.0000000000001523DOI Listing

An Integrative Morphomolecular Classification System of Gastric Carcinoma With Distinct Clinical Outcomes.

Am J Surg Pathol 2020 Jun 19. Epub 2020 Jun 19.

Departments of Pathology.

A robust morphomolecular classification system for gastric carcinoma is required. A 4-tier morphologic classification is proposed, including diffuse, intestinal, tubular, and lymphoid types. A tissue microarray for mismatch repair immunohistochemistry and Epstein-Barr virus (EBV) in situ hybridization were performed in 329 gastric carcinomas. Read More

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http://dx.doi.org/10.1097/PAS.0000000000001521DOI Listing

Epstein-Barr Virus-negative Marginal Zone Lymphoma as an Uncommon Form of Monomorphic Posttransplant Lymphoproliferative Disorder.

Am J Surg Pathol 2020 Jun 16. Epub 2020 Jun 16.

Laboratory of Pathology, Center for Cancer Research, National Cancer Institute, NIH, Bethesda, MD.

Monomorphic posttransplant lymphoproliferative disorders have been defined as lymphoid or plasmacytic proliferations that fulfill criteria for one of the B-cell or T/NK-cell neoplasms recognized in immunocompetent hosts in the current WHO Classification. Low-grade B-cell neoplasms have historically been excluded from this category, although rare reports of marginal zone lymphoma (MZL) have been described. We report 9 cases of posttransplant Epstein-Barr virus-negative MZL, all arising in solid organ transplant recipients (4 renal, 3 liver, 1 cardiac, and 1 liver, pancreas, and small bowel). Read More

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http://dx.doi.org/10.1097/PAS.0000000000001514DOI Listing

Recurrent Loss of SMARCA4 in Sinonasal Teratocarcinosarcoma.

Am J Surg Pathol 2020 Jun 5. Epub 2020 Jun 5.

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

Molecular analysis has reshaped the landscape of high grade sinonasal tumors by defining novel entities and identifying recurrent mutations in established tumor types. However, sinonasal teratocarcinosarcoma (TCS), a rare and aggressive tumor with intermixed teratomatous, carcinomatous, and sarcomatous elements, remains poorly understood. The multiphenotypic differentiation of TCS has engendered persistent controversy about its histogenesis and leads to diagnostic overlap with several other malignancies. Read More

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http://dx.doi.org/10.1097/PAS.0000000000001508DOI Listing

Mutational Analysis Reinforces the Diagnosis of Nodal Marginal Zone Lymphoma With Robust PD1-positive T-Cell Hyperplasia.

Am J Surg Pathol 2020 Jun 5. Epub 2020 Jun 5.

Department of Pathology and Laboratory Medicine, Hospital of the University of Pennsylvania Philadelphia, PA.

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http://dx.doi.org/10.1097/PAS.0000000000001515DOI Listing
June 2020
5.145 Impact Factor

Histopathologic Analysis of Signet-ring Cell Carcinoma In Situ in Patients With Hereditary Diffuse Gastric Cancer.

Am J Surg Pathol 2020 Jun 9. Epub 2020 Jun 9.

Division of Pathology, Cancer Institute.

Hereditary diffuse gastric cancer (HDGC) is a rare autosomal dominant syndrome associated with an increased risk of developing Laurén's diffuse-type gastric carcinoma and lobular breast carcinoma. Although signet-ring cell carcinoma (SRCC) in situ (SRCC-pTis) has been reported as a characteristic lesion in HDGC cases with CDH1 germline mutations (CDH1 pathogenic variant), and a precursor of conventional intramucosal SRCC (SRCC-pT1a), its histopathologic features and specificity have not been sufficiently clarified. Here, we examined gastrectomy samples from 6 Japanese HDGC patients with CDH1 germline mutation, belonging to 4 families, and analyzed SRCC lesions histologically and immunohistochemically. Read More

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http://dx.doi.org/10.1097/PAS.0000000000001511DOI Listing

Diagnostic Utility of LEF1 Immunohistochemistry in Differentiating Deep Penetrating Nevi From Histologic Mimics.

Am J Surg Pathol 2020 Jun 9. Epub 2020 Jun 9.

Departments of Pathology.

Deep penetrating nevi (DPNs) are intermediate grade lesions which have the capacity to recur, metastasize, or progress to melanoma. Differentiating DPN from other melanocytic lesions including blue and cellular blue nevi can be diagnostically challenging, and markers to distinguish these entities can be useful. Mutations of the β-catenin and mitogen-activated protein kinase pathways have recently been elucidated as distinctive of DPN. Read More

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http://dx.doi.org/10.1097/PAS.0000000000001513DOI Listing

How Many Lymph Nodes Are Enough in a Colorectal Resection?

Am J Surg Pathol 2020 Jun 2. Epub 2020 Jun 2.

Department of Pathology, Baptist Health of South Florida and Miami Cancer Institute, Miami, FL.

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http://dx.doi.org/10.1097/PAS.0000000000001504DOI Listing

Loss of MHC Class I Expression in HPV-associated Cervical and Vulvar Neoplasia: A Potential Mechanism of Resistance to Checkpoint Inhibition.

Am J Surg Pathol 2020 Jun 2. Epub 2020 Jun 2.

Department of Pathology, Division of Anatomic Pathology.

Tumor cell expression of major histocompatibility complex (MHC) class I is required for antigen presentation and adaptive immune recognition. Absent or diminished MHC class I expression is thought to contribute to immunotherapeutic resistance in some epithelial tumors but has not been previously studied in cervical and vulvar carcinoma. Given that anti-programmed cell death 1 (PD-1) checkpoint inhibition is deployed for programmed cell death ligand 1 (PD-L1)-positive recurrent and metastatic cervical squamous carcinomas, identifying tumors with loss of MHC class I is of clinical interest to optimize the selection of immunotherapeutic candidates. Read More

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http://dx.doi.org/10.1097/PAS.0000000000001506DOI Listing

SOX6 is a Novel Immunohistochemical Marker for Differential Diagnosis of Epithelioid Mesothelioma From Lung Adenocarcinoma.

Am J Surg Pathol 2020 Jun 2. Epub 2020 Jun 2.

Department of Pathology, Graduate School of Biomedical and Health Science.

The differential diagnosis of epithelioid mesothelioma from lung adenocarcinoma using immunohistochemistry is improving. However, immunohistochemical markers with high sensitivity and specificity have yet to be identified. In this study, we investigated the utility of sex-determining region Y box 6 (SOX6) as a novel immunohistochemical marker, identified by analyzing previous gene expression data. Read More

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http://dx.doi.org/10.1097/PAS.0000000000001507DOI Listing

Intravascular Lobular Capillary Hemangioma (Intravascular Pyogenic Granuloma): A Clinicopathologic Study of 40 Cases.

Am J Surg Pathol 2020 Jun 2. Epub 2020 Jun 2.

Department of Pathology, Robert J. Tomsich Pathology & Laboratory Medicine Institute, Cleveland Clinic, Cleveland, OH.

Intravascular lobular capillary hemangioma (ILCH), or intravascular pyogenic granuloma, is relatively rare and likely underrecognized. We reviewed all ILCH cases from our institution confirmed pathologically from 2006 to 2019. Immunostains for smooth muscle actin and Wilms tumor 1 were performed on all cases and prior immunohistochemical stains were reviewed. Read More

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http://dx.doi.org/10.1097/PAS.0000000000001509DOI Listing

The 2019 International Society of Urological Pathology (ISUP) Consensus Conference on Grading of Prostatic Carcinoma.

Am J Surg Pathol 2020 May 26. Epub 2020 May 26.

Department of Pathology, Medical College of Wisconsin, Milwaukee, WI.

Five years after the last prostatic carcinoma grading consensus conference of the International Society of Urological Pathology (ISUP), accrual of new data and modification of clinical practice require an update of current pathologic grading guidelines. This manuscript summarizes the proceedings of the ISUP consensus meeting for grading of prostatic carcinoma held in September 2019, in Nice, France. Topics brought to consensus included the following: (1) approaches to reporting of Gleason patterns 4 and 5 quantities, and minor/tertiary patterns, (2) an agreement to report the presence of invasive cribriform carcinoma, (3) an agreement to incorporate intraductal carcinoma into grading, and (4) individual versus aggregate grading of systematic and multiparametric magnetic resonance imaging-targeted biopsies. Read More

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http://dx.doi.org/10.1097/PAS.0000000000001497DOI Listing

Independent Validation of Tumor Budding Activity and Cell Nest Size as Determinants of Patient Outcome in Squamous Cell Carcinoma of the Uterine Cervix.

Am J Surg Pathol 2020 May 22. Epub 2020 May 22.

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

A novel 3-tiered grading system that combines tumor budding activity and cell nest size has been found to be highly prognostic in squamous cell carcinomas (SCCs) of various sites, including lung, oral cavity, larynx, hypopharynx, and esophagus. A similar grading system has recently been proposed for SCC of the uterine cervix. In this study, we appraise this grading system in an institutional cohort of cervical SCC to assess its prognostic value in an independent dataset. Read More

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http://dx.doi.org/10.1097/PAS.0000000000001472DOI Listing

A Proposed Grading Scheme for Medullary Thyroid Carcinoma Based on Proliferative Activity (Ki-67 and Mitotic Count) and Coagulative Necrosis.

Am J Surg Pathol 2020 May 22. Epub 2020 May 22.

Cancer Diagnosis and Pathology Group, Kolling Institute of Medical Research.

We investigated the prognostic value of a range of histologic parameters in medullary thyroid carcinoma (MTC) to design a grading system to predict overall survival. We assessed 76 patients with MTCs undergoing primary tumor resection for age, sex, tumor size, vascular space invasion, lymph node metastasis, multiple endocrine neoplasia type 2 (MEN2) status, mitotic count, Ki-67 proliferative index, spindled morphology, sheet-like growth pattern, coagulative necrosis, incipient necrosis, nuclear grade, multinucleation, prominent nucleoli, fibrosis, and amyloid deposition. In addition to the clinical features of age and the diagnosis of MEN2, the only histologic features that significantly predicted reduced overall survival were Ki-67 proliferative index, mitotic count, and the presence of coagulative necrosis. Read More

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http://dx.doi.org/10.1097/PAS.0000000000001505DOI Listing

An Update on Endocrine Mucin-producing Sweat Gland Carcinoma: Clinicopathologic Study of 63 Cases and Comparative Analysis.

Am J Surg Pathol 2020 May 22. Epub 2020 May 22.

Departments of Ophthalmology and Visual Sciences.

Endocrine mucin-producing sweat gland carcinoma (EMPSGC) is a rare, low-grade adnexal neoplasm with predilection for the periorbital skin of older women. Histologically and immunophenotypically, EMPSGC is analogous to another neoplasm with neuroendocrine differentiation, solid papillary carcinoma of the breast. Both lesions are spatially associated with neuroendocrine mucinous adenocarcinomas of the skin and breast, respectively. Read More

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http://dx.doi.org/10.1097/PAS.0000000000001462DOI Listing
May 2020
5.145 Impact Factor

Dedifferentiated Chordoma: Clinicopathologic and Molecular Characteristics With Integrative Analysis.

Am J Surg Pathol 2020 May 14. Epub 2020 May 14.

Departments of Pathology.

Dedifferentiated chordoma is a rare chordoma subtype characterized by a high-grade sarcoma juxtaposed to conventional chordoma. We identified a series of dedifferentiated chordomas, reviewed clinicopathologic features, performed next-generation sequencing in select cases, and analyzed all related English-language publications. Our series included 7 men and 3 women (age 15 to 80 y [median: 54 y]; <1% of >1000 chordomas surveyed). Read More

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http://dx.doi.org/10.1097/PAS.0000000000001501DOI Listing
May 2020
5.145 Impact Factor

Clinical, Histologic, and Molecular Characteristics of Anaplastic Lymphoma Kinase-positive Primary Cutaneous Anaplastic Large Cell Lymphoma.

Am J Surg Pathol 2020 Jun;44(6):776-781

Departments of Dermatology.

Unlike systemic anaplastic large cell lymphoma, the vast majority of primary cutaneous anaplastic large cell lymphomas (C-ALCL) do not carry translocations involving the ALK gene and do not express ALK. Expression of ALK protein therefore strongly suggests secondary cutaneous involvement of a systemic anaplastic large cell lymphoma. Recent studies described a small subgroup of ALK-positive C-ALCL, but information on frequency, prognosis, and translocation partners is virtually lacking. Read More

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http://dx.doi.org/10.1097/PAS.0000000000001449DOI Listing

Giant Cell Tumor of Bone With Cartilage Matrix: A Clinicopathologic Study of 17 Cases.

Am J Surg Pathol 2020 Jun;44(6):748-756

Department of Pathology and Laboratory Medicine, University of Miami, Miami, FL.

Giant cell tumor of bone (GCT) is a benign locally aggressive neoplasm composed of mononuclear cells admixed with innumerable osteoclast-type giant cells. H3F3A gene mutations producing mutant histone protein product H3.3 have been identified in 96% of GCT; mutant H3. Read More

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http://dx.doi.org/10.1097/PAS.0000000000001446DOI Listing

Clinicopathologic and Molecular Characteristics of Familial Adenomatous Polyposis-associated Traditional Serrated Adenoma.

Am J Surg Pathol 2020 May 6. Epub 2020 May 6.

Division of Diagnostic Pathology.

Colorectal carcinogenesis in familial adenomatous polyposis (FAP) follows a conventional adenoma-carcinoma sequence. However, previous studies have also reported the occurrence of traditional serrated adenomas (TSAs) in patients with FAP. In the present study, we analyzed the clinicopathologic and molecular features of 37 TSAs from 21 FAP patients. Read More

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http://dx.doi.org/10.1097/PAS.0000000000001502DOI Listing

Molecular Heterogeneity of Endometrioid Ovarian Carcinoma: An Analysis of 166 Cases Using the Endometrial Cancer Subrogate Molecular Classification.

Am J Surg Pathol 2020 Jul;44(7):982-990

Institute Ramón y Cajal for Health Research (IRYCIS).

Endometrioid ovarian carcinoma (EOC) has clinical and biological differences compared with other histologic types of ovarian carcinomas, but it shares morphologic and molecular features with endometrioid endometrial carcinoma. To analyze the molecular heterogeneity of EOC according to the new molecular classification of endometrial cancer and to evaluate the prognostic significance of this molecular classification, we have analyzed 166 early-stage EOC by immunohistochemistry for mismatch repair proteins and p53 expression, and by Sanger sequencing for the exonuclease domain of polymerase epsilon (POLE EDM). In addition, we have carried out next-generation sequencing analysis of tumors with POLE EDM mutations to confirm the ultramutated profile. Read More

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http://dx.doi.org/10.1097/PAS.0000000000001478DOI Listing

PD-L1 Expression and CD8+ Tumor-infiltrating Lymphocytes in Different Types of Tubo-Ovarian Carcinoma and Their Prognostic Value in High-grade Serous Carcinoma.

Am J Surg Pathol 2020 May 6. Epub 2020 May 6.

Departments of Pathology.

The prevalence and significance of programmed death-1 ligand (PD-L1) expression in different types of tubo-ovarian carcinoma have not been well defined. We evaluated PD-L1 expression and CD8 tumor-infiltrating lymphocyte (TIL) density in whole tissue sections of 189 cases of tubo-ovarian carcinoma, including high-grade serous carcinoma (HGSC, n=100), clear cell carcinoma (CCC, n=24), endometrioid carcinoma (EmC, n=40), and mucinous carcinomas (MC, n=25). Using the tumor proportion score (TPS) with a 1% cutoff, PD-L1 expression was present in 21% of HGSC, 16. Read More

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http://dx.doi.org/10.1097/PAS.0000000000001503DOI Listing
May 2020
5.145 Impact Factor

Middle Ear and Temporal Bone Nonkeratinizing Squamous Cell Carcinomas With DEK-AFF2 Fusion: An Emerging Entity.

Am J Surg Pathol 2020 May 1. Epub 2020 May 1.

Laboratory Medicine Program, University Health Network.

Primary squamous cell carcinomas (SCCs) of the middle ear and temporal bone are rare and usually keratinizing by morphology. Nonkeratinizing, basaloid SCCs arising in this area are exceedingly rare, and, due to the anatomic proximity to the skull base, nasopharynx, and nasal sinuses, the differential diagnosis is broad. Most tumors with squamous differentiation arising in these subsites are either viral-induced (human papillomavirus/Epstein-Barr virus) or rarely may have specific molecular alterations (BRD4-NUT, EWSR1-FLI translocations). Read More

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http://dx.doi.org/10.1097/PAS.0000000000001498DOI Listing

Mucinous Cell Clusters in Infantile Congenital Pulmonary Airway Malformations Mimic Adult Mucinous Adenocarcinoma But Are Not Associated With Poor Outcomes When Appropriately Resected.

Am J Surg Pathol 2020 Apr 28. Epub 2020 Apr 28.

Department of Pathology and Laboratory Medicine, The Children's Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA.

Congenital pulmonary airway malformations (CPAMs) are abnormalities of the lung arising during development. At our institution the majority of type I infantile CPAMs contain mucinous cell clusters (MCCs). The overlapping histology of MCCs and adult in situ mucinous adenocarcinomas, as well as reports of metastatic mucinous adenocarcinoma arising in CPAMs resected later in childhood raise concerns about the malignant potential of these cells. Read More

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http://dx.doi.org/10.1097/PAS.0000000000001488DOI Listing

Reappraisal of Primary Epstein-Barr Virus (EBV)-positive Diffuse Large B-Cell Lymphoma of the Gastrointestinal Tract: Comparative Analysis Among Immunosuppressed and Nonimmunosuppressed Stage I and II-IV Patients.

Am J Surg Pathol 2020 Apr 28. Epub 2020 Apr 28.

Departments of Pathology and Laboratory Medicine.

Epstein-Barr virus (EBV)-positive diffuse large B-cell lymphoproliferation encompasses a broad range of clinicopathologic findings, including specific subtypes, for example, EBV mucocutaneous ulcer. Here we reassessed 36 cases of primary EBV diffuse large B-cell lymphomas (16 men and 20 women; median age, 69.5 y; range, 35 to 84 y), including 8 immunosuppressed patients (Lugano stage II-IV; median age, 74 y), 7 nonimmunosuppressed patients with stage I disease (median age, 69 y), and 21 nonimmunosuppressed patients with stage II-IV disease (median age, 69 y). Read More

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http://dx.doi.org/10.1097/PAS.0000000000001499DOI Listing

The International Society of Urological Pathology Consultation on Molecular Pathology of Urogenital Cancer.

Am J Surg Pathol 2020 Jul;44(7):859-861

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

The 2019 Consultation Conference on the molecular pathology of urogenital cancers was organized by the International Society of Urological Pathology (ISUP) to have an understanding of the current use of molecular-genetic markers and to make recommendations on their application in prostate, bladder, renal, testicular, and penile cancer. This brief introductory article describes the organization of this conference and provides its rationale and main findings. Read More

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http://dx.doi.org/10.1097/PAS.0000000000001496DOI Listing

Comparison of Systemic EBV-positive T-Cell and NK-Cell Lymphoproliferative Diseases of Childhood Based on Classification Evolution: New Classification, Old Problems.

Am J Surg Pathol 2020 Apr 20. Epub 2020 Apr 20.

Departments of Pathology.

Systemic Epstein-Barr virus-positive T-cell and natural killer (NK)-cell lymphoproliferative diseases of childhood are a group of lethal diseases mostly affecting children and young adults. The Ohshima Grading System and the 2017 World Health Organization (WHO) classification have been used for classifying this spectrum, but these systems have not been validated externally and compared. Therefore, we examined 36 cases of systemic Epstein-Barr virus-positive T-cell and NK-cell lymphoproliferative diseases of childhood with long-term follow-up, from Southwest China, to systematically summarize the clinicopathologic features and to validate and compare the Ohshima Grading System and the 2017 WHO classification in discrimination ability, predictive accuracy, concordance indices, and explained variation. Read More

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http://dx.doi.org/10.1097/PAS.0000000000001495DOI Listing
April 2020
5.145 Impact Factor

Apocrine Variant of Pleomorphic Lobular Carcinoma In Situ: Further Clinical, Histopathologic, Immunohistochemical, and Molecular Characterization of an Emerging Entity.

Am J Surg Pathol 2020 Apr 20. Epub 2020 Apr 20.

Department of Pathology and Laboratory Medicine, Weill Cornell Medicine, New York, NY.

To date, the apocrine variant of lobular carcinoma in situ (AP-LCIS) has been cursorily described as a subtype of lobular carcinoma in situ (LCIS). We retrospectively reviewed 34 cases of AP-LCIS (including 23 associated with invasive lobular carcinoma) to fully characterize it. AP-LCIS typically presented with screen-detected calcifications in older women (mean age: 65 y) and was characterized by distended terminal duct lobular units with relatively large "pleomorphic" cells, central necrosis, and calcifications. Read More

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http://dx.doi.org/10.1097/PAS.0000000000001493DOI Listing

Comparison of Immunohistochemistry for PRAME With Cytogenetic Test Results in the Evaluation of Challenging Melanocytic Tumors.

Am J Surg Pathol 2020 Jul;44(7):893-900

Department of Pathology, Memorial Sloan Kettering Cancer, New York, NY.

PRAME (PReferentially expressed Antigen in MElanoma) is a melanoma-associated antigen. Although diffuse immunoreactivity for PRAME is found in most primary cutaneous melanomas, melanocytic nevi express PRAME usually only in a subpopulation of tumor cells or not at all. Hence, testing for PRAME expression has the potential to provide useful information for the assessment for diagnostically ambiguous melanocytic neoplasms. Read More

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http://dx.doi.org/10.1097/PAS.0000000000001492DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7289661PMC

Gastrointestinal Malakoplakia: Clinicopathologic Analysis of 26 Cases.

Am J Surg Pathol 2020 Apr 14. Epub 2020 Apr 14.

Department of Pathology, Johns Hopkins School of Medicine, Baltimore, MD.

Malakoplakia is an inflammatory process related to defective macrophage response to bacterial infection. To further characterize the clinicopathologic manifestations of gastrointestinal malakoplakia, 26 cases were identified from 6 institutions. Hematoxylin and eosin-stained slides and available stains were reviewed, and pertinent clinicopathologic features analyzed. Read More

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http://dx.doi.org/10.1097/PAS.0000000000001491DOI Listing

A Modified Histopathologic Staging in Penile Squamous Cell Carcinoma Predicts Nodal Metastasis and Outcome Better Than the Current AJCC Staging.

Am J Surg Pathol 2020 Apr 14. Epub 2020 Apr 14.

Departments of Pathology.

Recently, the American Joint Committee on Cancer (AJCC) updated the staging system for penile squamous cell carcinoma. According to it, unlike its previous version, the involvement of urethra does not upstage the tumor; however, the involvement of corpora cavernosa (CC) does. The tumors involving CC are now staged pT3, whereas those involving corpora spongiosa (CS) are staged pT2, irrespective of the involvement of the urethra. Read More

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http://dx.doi.org/10.1097/PAS.0000000000001490DOI Listing

Mismatch Repair Deficiency in Ovarian Carcinoma: Frequency, Causes, and Consequences.

Am J Surg Pathol 2020 May;44(5):649-656

Institute Ramón y Cajal for Health Research.

Mismatch repair deficiency (MMRD) is involved in the initiation of both hereditary and sporadic tumors. MMRD has been extensively studied in colorectal cancer and endometrial cancer, but not so in other tumors, such as ovarian carcinoma. We have determined the expression of mismatch repair proteins in a large cohort of 502 early-stage epithelial ovarian carcinoma entailing all the 5 main subtypes: high-grade serous carcinoma, endometrioid ovarian carcinoma (EOC), clear cell carcinoma (CCC), mucinous carcinoma, and low-grade serous carcinoma. Read More

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http://dx.doi.org/10.1097/PAS.0000000000001432DOI Listing

Subarticular Inflammatory Pseudoabscesses: A Pathologic Study With Clinical Correlation.

Am J Surg Pathol 2020 May;44(5):633-640

Department of Pathology and Laboratory Medicine, Hospital for Special Surgery.

Abnormal accumulation of neutrophils in a subarticular bone usually raises the concern for osteomyelitis or septic arthritis, a disabling and potentially life-threatening medical condition. At the pathology department of a specialized orthopedic institute, we observed a distinct pattern of subarticular inflammation mimicking infection characterized by collections of neutrophils, macrophages, and fibrin in pseudocystic spaces of variable size and extent in the superficial subarticular bone not accompanied by granulation tissue or necrosis. We coined the term "inflammatory pseudoabscess" to describe these accumulations. Read More

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http://dx.doi.org/10.1097/PAS.0000000000001440DOI Listing

Prostatic Metaplasia of the Vagina and Uterine Cervix: An Androgen-associated Glandular Lesion of Surface Squamous Epithelium.

Am J Surg Pathol 2020 Apr 10. Epub 2020 Apr 10.

Departments of Pathology.

Prostatic-type differentiation in the lower female genital tract is encountered rarely and its causes and clinical associations are not well established. Within the vagina, reports to date have invariably described ectopic prostatic-type differentiation as restricted to the lamina propria. We recently encountered a patient receiving testosterone for gender dysphoria whose vaginectomy specimen showed a prostatic glandular proliferation within the surface epithelium. Read More

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http://dx.doi.org/10.1097/PAS.0000000000001486DOI Listing

Follicular Thyroid Neoplasms: Comparison of Clinicopathologic and Molecular Features of Atypical Adenomas and Follicular Thyroid Carcinomas.

Am J Surg Pathol 2020 Jul;44(7):881-892

Department of Pathology, University of Chicago Medical Center.

In follicular thyroid neoplasms without invasion, a diagnosis of atypical adenoma (AA) (follicular tumor of uncertain malignant potential) may be rendered if atypical features (indefinite capsular/vascular invasion, necrosis, solid growth, increased mitoses) are present. This study compares clinical, histologic, and molecular features of patients with AAs (n=31), nonmetastatic follicular thyroid carcinoma (nmFTC) (n=18), and metastatic follicular thyroid carcinoma (mFTC) (n=38). Patients with mFTC were older. Read More

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http://dx.doi.org/10.1097/PAS.0000000000001489DOI Listing

Unexpected High Prevalence of Lymphocytic Infiltrates in Myenteric Ganglions in Intestinal Inertia.

Am J Surg Pathol 2020 Apr 7. Epub 2020 Apr 7.

Departments of Pathology and Immunology.

Intestinal inertia is a severe form of gut dysmotility that may require surgical resection. Loss of myenteric ganglion cells has been proposed as a possible etiology. Preclinical models have also suggested that virus infection-associated ganglionitis may be an alternative pathogenic factor. Read More

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http://dx.doi.org/10.1097/PAS.0000000000001484DOI Listing

Invasive Stratified Mucinous Carcinoma (iSMC) of the Cervix Often Presents With High-risk Features That Are Determinants of Poor Outcome: An International Multicenter Study.

Am J Surg Pathol 2020 Apr 7. Epub 2020 Apr 7.

Pathology, Memorial Sloan Kettering Cancer Center, New York, NY.

Invasive stratified mucinous carcinoma (iSMC) has been suggested to represent an aggressive subtype of endocervical adenocarcinoma. We sought to investigate the outcomes of iSMC and determine which clinical and pathologic parameters may influence the prognosis. Slides from 52 cases of iSMC were collected and classified as follows: pure iSMC (>90% of the entire tumor) and iSMC mixed with other human papillomavirus-associated adenocarcinoma components (miSMC) (>10%, but <90% of the entire tumor). Read More

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http://dx.doi.org/10.1097/PAS.0000000000001485DOI Listing