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American Journal of Surgical Pathology

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https://www.readbyqxmd.com/read/28796000/genomic-analysis-of-pigmented-epithelioid-melanocytomas-reveals-recurrent-alterations-in-prkar1a-and-prkca-genes
#1
Jarish N Cohen, Nancy M Joseph, Jeffrey P North, Courtney Onodera, Artur Zembowicz, Philip E LeBoit
Pigmented epithelioid melanocytoma (PEM) is a rare cutaneous melanocytic tumor first described as epithelioid blue nevus in patients with the Carney Complex (CC). PEM was among the first established examples of an intermediate class of melanocytic tumors, including atypical Spitz tumors, with frequent metastasis to lymph nodes but only rare extranodal spread. Sporadic and CC-associated PEM are essentially histologically indistinguishable. A subset of PEM shows loss of cytoplasmic expression of the protein kinase A regulatory subunit alpha (PRKAR1A), a tumor suppressor gene mutated in 70% of families with CC...
August 8, 2017: American Journal of Surgical Pathology
https://www.readbyqxmd.com/read/28795999/the-utility-of-immunohistochemistry-in-mycobacterial-infection-a-proposal-for-multimodality-testing
#2
Isaac H Solomon, Melanie E Johncilla, Jason L Hornick, Danny A Milner
Mycobacterium species are slow growing bacteria that cause significant morbidity and mortality worldwide. Because of the relative rarity of mycobacterial infections, potential for detection of nonpathogenic environmental contaminants, and substantial costs associated with molecular diagnostics, effective screening methods are needed to identify samples most suitable for molecular testing. While anatomic pathology specimens can be utilized to identify characteristic histologic inflammatory patterns and to directly visualize mycobacteria through histochemical (acid fast bacilli [AFB]) stains, the utility of immunohistochemistry (IHC) in this setting is unknown...
August 8, 2017: American Journal of Surgical Pathology
https://www.readbyqxmd.com/read/28795998/paraduodenal-pancreatitis-imaging-and-pathologic-correlation-of-47-cases-elucidates-distinct-subtypes-and-the-factors-involved-in-its-etiopathogenesis
#3
Takashi Muraki, Grace E Kim, Michelle D Reid, Pardeep Mittal, Gabriela Bedolla, Bahar Memis, Burcin Pehlivanoglu, Alexa Freedman, Ipek Erbarut Seven, Hyejeong Choi, David Kooby, Shishir K Maithel, Juan M Sarmiento, Alyssa Krasinskas, Volkan Adsay
Clinicopathologic characteristics of paraduodenal (groove) pancreatitis (PDP) remain to be fully unraveled. In this study, 47 PDPs with preoperative enhanced images available were subjected to detailed comparative analysis in conjunction with pathologic findings. PDP were predominantly in males (3:1) with a mean age of 50 years, and 60% had a preoperative diagnosis of cancer. Mean lesional size was 3.1 cm. Three distinct subtypes were identified by imaging. Solid-tumoral (type-1) with groove-predominant (type-1A, 36%) forming a distinct solid band between the duodenum and pancreas often with histologic microabscesses (69% vs...
August 8, 2017: American Journal of Surgical Pathology
https://www.readbyqxmd.com/read/28786880/criteria-for-risk-stratification-of-vulvar-and-vaginal-smooth-muscle-tumors-an-evaluation-of-71-cases-comparing-proposed-classification-systems
#4
Sadia Sayeed, Deyin Xing, Sarah M Jenkins, Paul S Weisman, Darya Buehler, Laura Warmke, Cora Uram-Tuculescu, Jamie N Bakkum-Gamez, Brooke E Howitt, Cherise Cortese, Kay J Park, J Kenneth Schoolmeester
Accurate risk stratification of smooth muscle tumors (SMTs) is essential for appropriate patient management. Yet, the rarity of SMTs of the vagina and vulva makes development of a prognostically meaningful classification system challenging. While 2 classification methods for vulvar SMTs and 1 for vaginal SMTs have been proposed, it is our experience that many pathologists tend to apply criteria for uterine SMTs when evaluating vulvovaginal tumors. We retrospectively reviewed a large cohort of vulvovaginal SMTs with clinical follow-up and evaluated which method most accurately classified tumors according to patient outcome...
August 3, 2017: American Journal of Surgical Pathology
https://www.readbyqxmd.com/read/28786879/differentiating-posttransplant-inflammatory-bowel-disease-and-other-colitides-in-renal-transplant-patients
#5
Meredith E Pittman, Jose Jessurun, Rhonda K Yantiss
Renal transplant recipients who present with gastrointestinal complaints may have symptoms related to their underlying renal disease or secondary to their immunosuppressive regimen. Immunosuppression increases patients' risk for infection and medication-induced injury, and a subset of transplant patients develop a form of inflammatory bowel disease (IBD) despite being immunosuppressed. In this study, we present the spectrum of changes in colonic biopsy histology that occur in the postrenal transplant population, with emphasis on the clinical and histologic features that may allow distinction between several common disorders...
August 3, 2017: American Journal of Surgical Pathology
https://www.readbyqxmd.com/read/28786878/immunohistochemical-differentiation-of-plasmacytoid-urothelial-carcinoma-from-secondary-carcinoma-involvement-of-the-bladder
#6
Walaa M Borhan, Ashley M Cimino-Mathews, Elizabeth A Montgomery, Jonathan I Epstein
Plasmacytoid urothelial carcinoma (UC) is a rare variant of UC that can histologically mimic metastatic cancer involving the urinary bladder. A total of 45 cases of plasmacytoid UC were collected and reviewed histologically. The following immunohistochemical markers were performed: CDX2; polyclonal carcinoembryonic antigen (p-CEA); gross cystic disease fluid protein 15 (GCDFP-15); mammaglobin; estrogen receptor (ER); progesterone receptor (PR); GATA 3 and uroplakin II. In all cases, the plasmacytoid variant of UC lacked expression of ER and mammaglobin...
August 3, 2017: American Journal of Surgical Pathology
https://www.readbyqxmd.com/read/28786877/eosinophilic-solid-and-cystic-renal-cell-carcinoma-esc-rcc-further-morphologic-and-molecular-characterization-of-esc-rcc-as-a-distinct-entity
#7
Kiril Trpkov, Hatem Abou-Ouf, Ondřej Hes, Jose I Lopez, Gabriella Nesi, Eva Comperat, Mathilde Sibony, Adeboye O Osunkoya, Ming Zhou, Neriman Gokden, Xavier Leroy, Daniel M Berney, Isabela Werneck Cunha, Maria L Musto, Daniel A Athanazio, Asli Yilmaz, Bryan Donnelly, Eric Hyndman, Anthony J Gill, Jesse K McKenney, Tarek A Bismar
Eosinophilic solid and cystic renal cell carcinoma (ESC RCC) has been recently described as a unique and indolent renal neoplasm, found in female patients with and without tuberous sclerosis complex. Although ESC RCC has a distinct morphology and frequent CK20 reactivity, its molecular karyotype has been previously studied only in few cases. We identified 19 ESC RCC from multiple institutions; all patients were female individuals without clinical features of tuberous sclerosis complex. Molecular karyotyping was performed in 13 cases (12 with informative result)...
August 3, 2017: American Journal of Surgical Pathology
https://www.readbyqxmd.com/read/28731868/inflammatory-myofibroblastic-tumors-of-the-female-genital-tract-are-under-recognized-a-low-threshold-for-alk-immunohistochemistry-is-required
#8
Justine L Pickett, Angela Chou, Juliana A Andrici, Adele Clarkson, Loretta Sioson, Amy Sheen, Jessica Reagh, Fedaa Najdawi, Yoomee Kim, Denise Riley, Jayne Maidens, David Nevell, Kirsten McIlroy, Susan Valmadre, Greg Gard, Russell Hogg, John Turchini, Gregory Robertson, Michael Friedlander, Anthony J Gill
Inflammatory myofibroblastic tumor (IMT) of the female genital tract is under-recognized. We investigated the prevalence of ALK-positive IMT in lesions previously diagnosed as gynecologic smooth muscle tumors. Immunohistochemistry (IHC) for ALK was performed on tissue microarrays of unselected tumors resected from 2009 to 2013. Three of 1176 (0.26%) "leiomyomas" and 1 of 44 (2.3%) "leiomyosarcomas" were ALK IHC positive, confirmed translocated by fluorescence in situ hybridization (FISH) and therefore more appropriately classified as IMT...
July 20, 2017: American Journal of Surgical Pathology
https://www.readbyqxmd.com/read/28719466/dedifferentiated-liposarcoma-with-epithelioid-epithelial-features
#9
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 20, 2017: American Journal of Surgical Pathology
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
#10
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
#11
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
#12
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/28719465/predictors-of-outcome-in-adenoid-cystic-carcinoma-of-salivary-glands-a-clinicopathologic-study-with-correlation-between-myb-fusion-and-protein-expression
#13
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
#14
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
#15
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/28692601/recurrent-braf-gene-rearrangements-in-myxoinflammatory-fibroblastic-sarcomas-but-not-hemosiderotic-fibrolipomatous-tumors
#16
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/28622183/cyclin-d1-is-expressed-in-neoplastic-cells-of-langerhans-cell-histiocytosis-but-not-reactive-langerhans-cell-proliferations
#17
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/28614213/pathologic-separation-of-chronic-hypersensitivity-pneumonitis-from-fibrotic-connective-tissue-disease-associated-interstitial-lung-disease
#18
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
https://www.readbyqxmd.com/read/28614212/phosphaturic-mesenchymal-tumors-clinicopathologic-immunohistochemical-and-molecular-analysis-of-22-cases-expanding-their-morphologic-and-immunophenotypic-spectrum
#19
Abbas Agaimy, Michael Michal, Simion Chiosea, Fredrik Petersson, Ladislav Hadravsky, Glenn Kristiansen, Raymund E Horch, Jan Schmolders, Arndt Hartmann, Florian Haller, Michal Michal
Phosphaturic mesenchymal tumor (PMT) is a rare neoplasm of uncertain histogenesis that has been linked to tumor-induced osteomalacia (TIO) since 1959. The neoplastic cells produce increased amount of FGF23 which results in TIO via uncontrolled renal loss of phosphate (phosphaturia), and consequently diminished bone mineralization. To date, ∼300 cases have been reported. Although there is increasing evidence that PMT can be diagnosed by reproducible histopathologic features, firm diagnosis has been often restricted to cases associated with TIO and, hence, diagnosis of "nonphosphaturic variants" remained challenging...
June 13, 2017: American Journal of Surgical Pathology
https://www.readbyqxmd.com/read/28614204/human-papillomavirus-hpv-genotypes-in-condylomas-intraepithelial-neoplasia-and-invasive-carcinoma-of-the-penis-using-laser-capture-microdissection-lcm-pcr-a-study-of-191-lesions-in-43-patients
#20
María J Fernández-Nestosa, Nuria Guimerà, Diego F Sanchez, Sofía Cañete-Portillo, Elsa F Velazquez, David Jenkins, Wim Quint, Antonio L Cubilla
Laser capture microdissection-polymerase chain reaction (LCM-PCR) supported by p16 was used for the first time to demonstrate human papillomavirus (HPV) DNA in histologically specific penile lesions, which were as follows: squamous hyperplasia (12 lesions, 10 patients), flat lesions (12 lesions, 5 patients), condylomas (26 lesions, 7 patients), penile intraepithelial neoplasia (PeIN) (115 lesions, 43 patients), and invasive squamous cell carcinomas (26 lesions, 26 patients). HPV was detected by whole-tissue section and LCM-PCR...
June 13, 2017: American Journal of Surgical Pathology
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