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American Journal of Surgical Pathology

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https://www.readbyqxmd.com/read/28719469/insm1-demonstrates-superior-performance-to-the-individual-and-combined-use-of-synaptophysin-chromogranin-and-cd56-for-diagnosing-neuroendocrine-tumors-of-the-thoracic-cavity
#1
Lisa M Rooper, Rajni Sharma, Qing Kay Li, Peter B Illei, William H Westra
Despite the importance of recognizing neuroendocrine differentiation when diagnosing tumors of the thoracic cavity, the sensitivity of traditional neuroendocrine markers is suboptimal, particularly for high-grade neuroendocrine carcinomas such as small cell lung carcinoma and large cell neuroendocrine carcinoma. To increase sensitivity, neuroendocrine markers are routinely ordered as panels of multiple immunostains where any single positive marker is regarded as sufficient evidence of neuroendocrine differentiation...
July 17, 2017: American Journal of Surgical Pathology
https://www.readbyqxmd.com/read/28719468/etv6-gene-rearrangements-characterize-a-morphologically-distinct-subset-of-sinonasal-low-grade-non-intestinal-type-adenocarcinoma-a-novel-translocation-associated-carcinoma-restricted-to-the-sinonasal-tract
#2
Simon Andreasen, Alena Skálová, Abbas Agaimy, Justin A Bishop, Jan Laco, Ilmo Leivo, Alessandro Franchi, Stine R Larsen, Daiva Erentaite, Benedicte P Ulhøi, Christian von Buchwald, Linea C Melchior, Michal Michal, Katalin Kiss
Low-grade sinonasal adenocarcinomas (low-grade SNACs) of the sinonasal tract comprise a poorly characterized and histologically heterogeneous group of tumors. We describe three cases of a histologically distinct variant of low-grade SNAC characterized by ETV6 gene rearrangements. The patients included 2 women (aged 32 and 88 y) and a man (aged 75 y); all were initially treated with surgery alone. Follow-up ranged from 9 to 170 months with one patient having 2 local recurrences and none experiencing distant or regional metastases...
July 17, 2017: American Journal of Surgical Pathology
https://www.readbyqxmd.com/read/28719467/pan-trk-immunohistochemistry-is-an-efficient-and-reliable-screen-for-the-detection-of-ntrk-fusions
#3
Jaclyn F Hechtman, Ryma Benayed, David M Hyman, Alexander Drilon, Ahmet Zehir, Denise Frosina, Maria E Arcila, Snjezana Dogan, David S Klimstra, Marc Ladanyi, Achim A Jungbluth
Activating neurotrophic tyrosine receptor kinase (NTRK) fusions, typically detected using nucleic-acid based assays, are highly targetable and define certain tumors. Here, we explore the utility of pan-TRK immunohistochemistry (IHC) to detect NTRK fusions. NTRK rearrangements were detected prospectively using MSK-IMPACT, a DNA-based next-generation sequencing assay. Transcription of novel NTRK rearrangements into potentially functional fusion transcripts was assessed via Archer Dx fusion assay. Pan-Trk IHC testing with mAb EPR17341 was performed on all NTRK rearranged cases and 20 cases negative for NTRK fusions on Archer...
July 17, 2017: American Journal of Surgical Pathology
https://www.readbyqxmd.com/read/28719466/dedifferentiated-liposarcoma-with-epithelioid-epithelial-features
#4
Naohiro Makise, Akihiko Yoshida, Motokiyo Komiyama, Fumihiko Nakatani, Kan Yonemori, Akira Kawai, Masashi Fukayama, Nobuyoshi Hiraoka
Dedifferentiated liposarcoma (DDLPS) demonstrates a variety of growth patterns, and their histologic resemblance to other spindle cell mesenchymal tumors has been widely recognized. However, epithelioid morphology in DDLPS has only rarely been documented. Here, we report 6 cases of DDLPS with striking epithelioid/epithelial features. The patients were 5 men and 1 woman with a median age of 61 years. All tumors were located in the internal trunk. During follow-up of 1 to 41 months, local recurrence, distant metastases, and tumor-related death occurred in 4, 2, and 4 patients, respectively...
July 17, 2017: American Journal of Surgical Pathology
https://www.readbyqxmd.com/read/28719465/predictors-of-outcome-in-adenoid-cystic-carcinoma-of-salivary-glands-a-clinicopathologic-study-with-correlation-between-myb-fusion-and-protein-expression
#5
Bin Xu, Esther Drill, Allen Ho, Alan Ho, Lara Dunn, Carlos Nicolas Prieto-Granada, Timothy Chan, Ian Ganly, Ronald Ghossein, Nora Katabi
Adenoid cystic carcinoma (ACC) is the second most common salivary gland malignancy and it has a high rate of recurrences and a poor long-term prognosis. Our aim was to assess the prognostic factors in ACC and study MYB-NFIB fusion and MYB protein expression in a large retrospective cohort of 135 patients with a median follow-up of 6.3 years. The 5- and 10-year local recurrence-free survival (RFS) rate of 94% and 78%, 5- and 10-year distant metastasis survival rate of 77% and 58%, and 5- and 10-year RFS of 66% and 44%...
July 17, 2017: American Journal of Surgical Pathology
https://www.readbyqxmd.com/read/28719464/nuclear-crx-and-foxj1-expression-differentiates-non-germ-cell-pineal-region-tumors-and-supports-the-ependymal-differentiation-of-papillary-tumor-of-the-pineal-region
#6
Shannon Coy, Adrian M Dubuc, Sonika Dahiya, Keith L Ligon, Alexandre Vasiljevic, Sandro Santagata
Papillary tumor of the pineal region (PTPR) is a neuroepithelial neoplasm first described in 2003. Despite the anatomic association of PTPR with the pineal gland, the features of these tumors resemble those of the ependymal circumventricular subcommissural organ (SCO) of the posterior third ventricle. Given the presumed distinct derivation of PTPR and pineal parenchymal tumors, we hypothesized that expression of lineage-specific transcription factors could distinguish these tumors and provide additional insight into the differentiation of PTPR...
July 17, 2017: American Journal of Surgical Pathology
https://www.readbyqxmd.com/read/28719463/do-nonseminomatous-germ-cell-tumors-of-the-testis-with-lymphovascular-invasion-of-the-spermatic-cord-merit-staging-as-pt3
#7
Jennifer Gordetsky, Joseph Sanfrancesco, Jonathan I Epstein, Karen Trevino, Huiping Xu, Adeboye Osunkoya, Guang Q Xiao, Chia-Sui Kao, Pamela Unger, Neda Hashemi-Sadraei, Constantine Albany, Julie M Jorns, David Y Lu, Andres Matoso, Soroush Rais-Bahrami, Lauren E Schwartz, Thomas M Ulbright, Muhammad T Idrees
The staging of testicular nonseminomatous germ cell tumors (NSGCTs) with lymphovascular invasion (LVI) of the spermatic cord in the absence of cord parenchymal involvement remains controversial. Our previous study showed that tumors with spermatic cord LVI present at a higher clinical stage than tumors with LVI confined to the testis (pT2). We compared NSGCTs with LVI of the spermatic cord without direct involvement of the spermatic cord soft tissues to pT3 tumors to help clarify the appropriate staging of this histologic finding...
July 17, 2017: American Journal of Surgical Pathology
https://www.readbyqxmd.com/read/28719462/spindle-cell-lipomas-in-women-a-report-of-53-cases
#8
Jennifer S Ko, Brianne Daniels, Patrick O Emanuel, Paul Elson, Vadim Khachaturov, Jesse K McKenney, John R Goldblum, Steven D Billings
Spindle cell lipomas (SCL) are typically tumors of the upper back/neck (shawl region) of men (80% to 90%). In general, there is a frequent tendency to restrict the diagnosis to this specific clinical scenario and a hesitancy to diagnose SCL in women. We hypothesized that SCL in women have a more varied presentation. A total of 395 SCL were diagnosed at our institution over the last 11 years. The diagnosis of SCL in women was confirmed by re-review. Immunohistochemical stains for CD34, desmin, estrogen receptor, and p16 were performed...
July 17, 2017: American Journal of Surgical Pathology
https://www.readbyqxmd.com/read/28719461/serotonin-atrx-and-daxx-expression-in-pituitary-adenomas-markers-in-the-differential-diagnosis-of-neuroendocrine-tumors-of-the-sellar-region
#9
Olivera Casar-Borota, Johan Botling, Dan Granberg, Jerker Stigare, Johan Wikström, Henning Bünsow Boldt, Bjarne Winther Kristensen, Fredrik Pontén, Jacqueline Trouillas
Differential diagnosis based on morphology and immunohistochemistry between a clinically nonfunctioning pituitary neuroendocrine tumor (NET)/pituitary adenoma and a primary or secondary NET of nonpituitary origin in the sellar region may be difficult. Serotonin, a frequently expressed marker in the NETs, has not been systematically evaluated in pituitary NETs. Although mutations in ATRX or DAXX have been reported in a significant proportion of pancreatic NETs, the mutational status of ATRX and DAXX and their possible pathogenetic role in pituitary NETs are unknown...
July 17, 2017: American Journal of Surgical Pathology
https://www.readbyqxmd.com/read/28704208/hgnet-bcor-tumors-of-the-cerebellum-clinicopathologic-and-molecular-characterization-of-3-cases
#10
Romain Appay, Nicolas Macagno, Laetitia Padovani, Andrey Korshunov, Marcel Kool, Nicolas André, Didier Scavarda, Torsten Pietsch, Dominique Figarella-Branger
The central nervous system (CNS) high-grade neuroepithelial tumor with BCOR alteration (CNS HGNET-BCOR) is a recently described molecular entity. We report 3 new CNS HGNET-BCOR cases sharing common clinical presentation and pathologic features. The 3 cases concerned children aged 3 to 7 years who presented with a voluminous mass of the cerebellum. Pathologic features included proliferation of uniform spindle to ovoid cells with fine chromatin associated with a rich arborizing capillary network. Methylation profiling classified these cases as CNS HGNET-BCOR tumors...
July 12, 2017: American Journal of Surgical Pathology
https://www.readbyqxmd.com/read/28692601/recurrent-braf-gene-rearrangements-in-myxoinflammatory-fibroblastic-sarcomas-but-not-hemosiderotic-fibrolipomatous-tumors
#11
Yu-Chien Kao, Valentina Ranucci, Lei Zhang, Yun-Shao Sung, Edward A Athanasian, David Swanson, Brendan C Dickson, Cristina R Antonescu
Myxoinflammatory fibroblastic sarcoma (MIFS) is a low grade soft tissue sarcoma with a predilection for acral sites, being associated with a high rate of local recurrence but very infrequent distant metastases. Although a t(1;10) translocation resulting in TGFBR3-MGEA5 fusion has been reported as a recurrent genetic event in MIFS, this abnormality is seen only in a subset of cases. As no studies to date have investigated the spectrum of alternative genetic alterations in TGFBR3-MGEA5 fusion negative MIFS, we undertook a genetic analysis of this particular cohort for further molecular classification...
July 7, 2017: American Journal of Surgical Pathology
https://www.readbyqxmd.com/read/28692600/relationship-of-lymph-node-micrometastasis-and-micropapillary-component-and-their-joint-influence-on-prognosis-of-patients-with-stage-i-lung-adenocarcinoma
#12
Chenyang Dai, Huikang Xie, Xiermaimaiti Kadeer, Hang Su, Dong Xie, Yijiu Ren, Yunlang She, Erjia Zhu, Ziwen Fan, Tao Chen, Linlin Qin, Hui Zheng, Liping Zhang, Gening Jiang, Chunyan Wu, Chang Chen
This study aimed to investigate the relationship between lymph node micrometastasis and histologic patterns of adenocarcinoma, with a particular focus on their joint effect on prognosis. We retrospectively reviewed 235 patients with stage I adenocarcinoma from January 2009 to December 2009. Lymph node micrometastasis was evaluated by immunohistochemical staining for cytokeratin (AE1/AE3) and thyroid transcription factor-1. A logistic regression model was applied to confirm the predictive factors of micrometastasis...
July 7, 2017: American Journal of Surgical Pathology
https://www.readbyqxmd.com/read/28654428/residual-pure-intralymphatic-breast-carcinoma-following-neoadjuvant-chemotherapy-is-indicative-of-poor-clinical-outcome-even-in-node-negative-patients
#13
Esther Cheng, David Ko, Michaela Nguyen, Tracy-Ann Moo, Eleni Andreopoulou, Syed A Hoda, Timothy M D'Alfonso
Residual carcinoma confined to lymphovascular spaces following neoadjuvant chemotherapy (NAC) for invasive breast carcinoma is an uncommon finding. We studied pathologic features and outcome for patients with pure intralymphatic carcinoma (PIC) following NAC, a pattern of residual disease reported to have a poor outcome in the only previously published series of this entity. Six of 284 (2.1%) patients treated with NAC were studied. All 6 patients had axillary lymph node involvement before NAC. Tumors were triple-negative (n=3) and HER2+ (n=3: 2 ER+, 1 ER-)...
June 26, 2017: American Journal of Surgical Pathology
https://www.readbyqxmd.com/read/28654427/dicer1-mutations-are-consistently-present-in-moderately-and-poorly-differentiated-sertoli-leydig-cell-tumors
#14
Leanne de Kock, Tatjana Terzic, W Glenn McCluggage, Colin J R Stewart, Patricia Shaw, William D Foulkes, Blaise A Clarke
Ovarian Sertoli-Leydig cell tumors (SLCTs) are uncommon sex cord-stromal tumors associated with both germ-line and somatic DICER1 mutations, the frequency of which has varied widely in different studies (0% to 62.5%). The current World Health Organization Classification includes 3 histologic types of SLCTs (well-differentiated, moderately differentiated, and poorly differentiated); heterologous elements and/or retiform patterns may be present in moderately and poorly differentiated neoplasms. We investigated the frequency of DICER1 mutations in a series of 38 ovarian tumors initially diagnosed as SLCTs, and explored whether identified mutations were associated with specific morphologic features...
June 26, 2017: American Journal of Surgical Pathology
https://www.readbyqxmd.com/read/28622183/cyclin-d1-is-expressed-in-neoplastic-cells-of-langerhans-cell-histiocytosis-but-not-reactive-langerhans-cell-proliferations
#15
Vignesh Shanmugam, Jeffrey W Craig, Jason L Hornick, Elizabeth A Morgan, Geraldine S Pinkus, Olga Pozdnyakova
Langerhans cell histiocytosis (LCH) is characterized by frequent activating mutations involving the mitogen-activated protein kinase (MAPK) pathway. Therefore, downstream markers of MAPK pathway activation such as cyclin D1 may be useful as novel diagnostic markers of neoplasia in LCH. The goal of this study was to investigate cyclin D1 expression in LCH and reactive Langerhans cell accumulations using immunohistochemistry on archival tissue. All LCH cases tested (39/39) showed cyclin D1 expression in CD1a/Langerin cells...
June 15, 2017: American Journal of Surgical Pathology
https://www.readbyqxmd.com/read/28622182/reflux-associated-cholecystopathy-analysis-of-76-gallbladders-from-patients-with-supra-oddi-union-of-the-pancreatic-duct-and-common-bile-duct-pancreatobiliary-maljunction-elucidates-a-specific-diagnostic-pattern-of-mucosal-hyperplasia-as-a-prelude-to-carcinoma
#16
Takashi Muraki, Bahar Memis, Michelle D Reid, Takeshi Uehara, Tetsuya Ito, Osamu Hasebe, Shinji Okaniwa, Naoto Horigome, Takeshi Hisa, Pardeep Mittal, Alexa Freedman, Shishir Maithel, Juan M Sarmiento, Alyssa Krasinskas, Jill Koshiol, Volkan Adsay
Pancreaticobiliary maljunction (PBM) is the anomalous union of the main pancreatic duct and common bile duct outside the Oddi-sphincter, allowing the reflux of pancreatic juice to the gallbladder. There is only limited awareness and understanding of the pathologic correlates of this condition, mostly from Japan; this entity is largely unrecognized in the West. In this study, 76 gallbladders from patients with PBM (64 from Japan; 12 from the United States) were analyzed and contrasted with 66 from non-PBM patients...
June 15, 2017: American Journal of Surgical Pathology
https://www.readbyqxmd.com/read/28622181/validation-of-a-mitotic-index-cutoff-as-a-prognostic-marker-in-undifferentiated-uterine-sarcomas
#17
Elin Hardell, Sofia Josefson, Mehran Ghaderi, Tone Skeie-Jensen, Sofia Westbom-Fremer, Elizabeth H Cheek, Debra Bell, Jonas Selling, John K Schoolmeester, Anna Måsbäck, Ben Davidson, Joseph W Carlson
Undifferentiated uterine sarcomas (UUS) are a heterogenous group of high-grade mesenchymal tumors. Although these tumors are highly aggressive, a subset of patients may experience long-term survival. These tumors have previously been divided morphologically into uniform and pleomorphic types. A previous study demonstrated that a mitotic index cutoff of 25 mitoses/10 high-power fields (corresponding to 11.16 mitotic figures/mm) could successfully divide tumors into 2 prognostic groups with significantly different overall survival...
June 15, 2017: American Journal of Surgical Pathology
https://www.readbyqxmd.com/read/28622180/a-prospective-study-of-loose-tissue-fragments-in-non-small-cell-lung-cancer-resection-specimens-an-alternative-view-to-spread-through-air-spaces
#18
Hans Blaauwgeers, Douglas Flieder, Arne Warth, Alexander Harms, Kim Monkhorst, Birgit Witte, Erik Thunnissen
The World Health Organization Classification of Lung Tumors considers "Spread Through Air Spaces" a form of invasion in lung adenocarcinoma. The recently described spread of free-floating cell clusters during lung specimen sectioning, otherwise known as "Spread Through A Knife Surface," represents an ex vivo artifact. The purpose of this study was to prospectively investigate the presence and frequency of these free-floating tumor cell clusters in surgically resected lung cancer specimens and their possible relation to gross examination procedures...
June 15, 2017: American Journal of Surgical Pathology
https://www.readbyqxmd.com/read/28622179/paucicellular-fibrointimal-proliferation-characterizes-pediatric-pulmonary-vein-stenosis-clinicopathologic-analysis-of-213-samples-from-97-patients
#19
Alexandra E Kovach, Philip M Magcalas, Christina Ireland, Kerry McEnany, Andre M Oliveira, Mark W Kieran, Christopher W Baird, Kathy Jenkins, Sara O Vargas
Pulmonary vein stenosis (PVS) is a luminal narrowing of extrapulmonary pulmonary veins. In pediatric patients, it arises following repair of congenital heart disease, particularly anomalous pulmonary venous return; in lung disease, especially prematurity; and rarely in isolation. The etiology is unknown and the course often fatal without lung transplantation. We hypothesized that systematic clinicopathologic review of pediatric PVS could provide further pathogenic insight. We included patients who underwent first resection of pulmonary venous tissue for symptomatic PVS at our pediatric referral center from 1995 to 2014...
June 15, 2017: American Journal of Surgical Pathology
https://www.readbyqxmd.com/read/28614213/pathologic-separation-of-chronic-hypersensitivity-pneumonitis-from-fibrotic-connective-tissue-disease-associated-interstitial-lung-disease
#20
Andrew Churg, Joanne L Wright, Christopher J Ryerson
Chronic (fibrotic) hypersensitivity pneumonitis (HP) and fibrosing interstitial pneumonias associated with connective tissue disease (CTD-ILD) can be difficult to distinguish in biopsy specimens. To investigate features that might separate these entities, 2 pathologists blinded to the diagnoses reviewed 16 cases of chronic HP and 12 cases of CTD-ILD. Fifteen predefined parameters were examined by morphometric point counting, analysis/cm of lung tissue, or presence/absence. Germinal centers were present in a minority of patients, but favored a diagnosis of CTD-ILD (7/12 CTD vs...
June 13, 2017: American Journal of Surgical Pathology
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