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American Journal of Surgical Pathology

François Casteillo, Jean-Baptiste Guy, Pierre Dal-Col, Georgia Karpathiou, Benjamin Pommier, Sophie Bayle-Bleuez, Pierre Fournel, François Vassal, Fabien Forest
Primary lung adenocarcinoma is classified according to predominant histopathologic architecture into lepidic, papillary, acinar, solid, and micropapillary subtypes. These subtypes are related to overall survival in primary lung adenocarcinoma. The main goal of our work was to evaluate the prognostic impact of this classification on surgical resection of brain adenocarcinoma metastases in 97 patients with surgically resected brain metastases of lung adenocarcinoma from 2008 to 2017. Histopathologic subtype is associated with overall survival (P=0...
September 15, 2018: American Journal of Surgical Pathology
Matthew Walters, Mark R Pittelkow, Robert P Hasserjian, Nancy Lee Harris, William R Macon, Paul J Kurtin, Karen L G Rech
Nonclonal expansions of immature T cells outside of the thymus, termed indolent T-lymphoblastic proliferation (iT-LBP), have been identified in rare lymphoproliferative disorders. We report that iT-LBP is a frequent finding in cases of follicular dendritic cell sarcoma (FDCS), and shows an association with paraneoplastic autoimmune multiorgan syndrome (PAMS). We studied 31 cases of FDCS by paraffin immunohistochemistry using antibodies to CD21, CD23, CD35, clusterin, CXCL13, podoplanin, CD3, CD4, CD8, CD20, CD1a, and TdT...
September 15, 2018: American Journal of Surgical Pathology
Danielle Hutchings, Kevin M Waters, Matthew J Weiss, Christopher L Wolfgang, Martin A Makary, Jin He, John L Cameron, Laura D Wood, Ralph H Hruban
Invasive pancreatic ductal adenocarcinoma (PDAC) can infiltrate back into and spread along preexisting pancreatic ducts and ductules in a process known as cancerization of ducts (COD). Histologically COD can mimic high-grade pancreatic intraepithelial neoplasia (HG-PanIN). We reviewed pancreatic resections from 100 patients with PDAC for the presence or absence of ducts with histologic features of COD. Features supporting COD included adjacent histologically similar invasive PDAC and an abrupt transition between markedly atypical intraductal epithelium and normal duct epithelium or circumferential involvement of a duct...
September 12, 2018: American Journal of Surgical Pathology
Changqing Ma, Brett M Lowenthal, Reetesh K Pai
Signet ring cell carcinomas of the gastrointestinal (GI) tract are clinically aggressive neoplasms with frequent intra-abdominal metastases at initial presentation. Currently available immunohistochemistry (IHC) markers cannot distinguish signet ring cell carcinomas of the lower GI tract and upper GI tract, suggesting the need for more specific diagnostic markers. SATB2 is a novel, sensitive marker for colorectal carcinoma. We hypothesized that SATB2 IHC can reliably identify primary and metastatic signet ring cell carcinomas of lower GI tract origin...
September 12, 2018: American Journal of Surgical Pathology
Carlos Parra-Herran, Dina Bassiouny, Danielle Vicus, Ekaterina Olkhov-Mitsel, Matthew Cesari, Nadia Ismiil, Sharon Nofech-Mozes
The International Federation of Obstetrics and Gynecology (FIGO) grading system for endometrial carcinoma is currently applied to ovarian endometrioid carcinoma (OEC) in many practices. However, previous reports claim superior prognostication by using the Silverberg grading system for ovarian carcinoma. Thus, a thorough comparison between FIGO and Silverberg in OEC is still warranted. A total of 72 OECs diagnosed at our institution were independently graded using both systems. Grade (G) following Silverberg was based on combined scores for architecture, nuclear atypia, and mitotic activity...
September 12, 2018: American Journal of Surgical Pathology
Kohei Fujikura, Masayuki Akita, Tetsuo Ajiki, Takumi Fukumoto, Tomoo Itoh, Yoh Zen
This study aimed to elucidate the genetic landscape of biliary papillary neoplasms. Of 28 cases examined, 7 underwent whole exome sequencing, while the remaining 21 were used for validation studies with targeted sequencing. In the whole exome sequencing study, 4/7 cases had mutations in either APC or CTNNB1, both of which belong to the Wnt/β-catenin pathway. Somatic mutations were also identified in genes involved in RAS signaling (KRAS, BRAF), a cell cycle regulator (CDC27), histone methyltransferase (KMT2C, KMT2D), and DNA mismatch repair (MSH3, MSH6, PMS1)...
September 12, 2018: American Journal of Surgical Pathology
Sunhee S Kim, Andrew H Ko, Eric K Nakakura, Zhen J Wang, Carlos U Corvera, Hobart W Harris, Kimberly S Kirkwood, Ryutaro Hirose, Margaret A Tempero, Grace E Kim
To assess whether the College of American Pathologists (CAP) and the Evans grading systems for neoadjuvant chemotherapy without radiation-treated pancreatectomy specimens are prognostic, and if a 3-tier stratification scheme preserves data granularity. Conducted retrospective review of 32 patients with ordinary pancreatic ductal adenocarcinoma treated with neoadjuvant therapy without radiation followed by surgical resection. Final pathologic tumor category (AJCC eighth edition) was 46.9% ypT1, 34.4% ypT2, and 18...
September 11, 2018: American Journal of Surgical Pathology
David Creytens, Thomas Mentzel, Liesbeth Ferdinande, Joost van Gorp, Jo Van Dorpe, Uta Flucke
No abstract text is available yet for this article.
September 11, 2018: American Journal of Surgical Pathology
Bo-Jung Chen, Philippe Ruminy, Christine G Roth, Bettina Bisig, Barbara Mankel, Julia Steinhilber, Elodie Bohers, Fabrice Jardin, Falko Fend, Steven H Swerdlow, Christiane Copie-Bergman, Laurence de Leval, Leticia Quintanilla-Martinez
Primary mediastinal large B-cell lymphoma (PMBL) is a mature large B-cell lymphoma of putative thymic B-cell origin involving the mediastinum with younger age distribution and better prognosis than diffuse large B-cell lymphoma (DLBCL), not otherwise specified. Recently, based on gene expression profile analysis and morphologic findings, cases of PMBL without mediastinal involvement have been reported. In this study, we analyzed 3 cases of nodal DLBCL with morphologic features of PMBL presenting in submandibular or supraclavicular lymph nodes, in middle-aged to elderly patients, 2 of them without clinical or radiologic evidence of mediastinal involvement...
September 11, 2018: American Journal of Surgical Pathology
Pedram Argani, Victor E Reuter, Payal Kapur, James E Brown, Yun-Shao Sung, Lei Zhang, Richard Williamson, Glen Francis, Scott Sommerville, David Swanson, Brendan C Dickson, Cristina R Antonescu
We describe 2 cases of a distinct sarcoma characterized by a novel MEIS1-NCOA2 gene fusion. This gene fusion was identified in the renal neoplasms of 2 adults (21-y-old male, 72-y-old female). Histologically, the resected renal neoplasms had a distinctively nodular appearance, and while one renal neoplasm was predominantly cystic, the other demonstrated solid architecture, invasion of perirenal fat, and renal sinus vasculature invasion. The neoplasms were characterized predominantly by monomorphic plump spindle cells arranged in vague fascicles with a whorling pattern; however, a more primitive small round cell component was also noted...
August 31, 2018: American Journal of Surgical Pathology
Roheena Z Panni, Ivan Gonzalez, Christopher P Hartley, Gregory A Williams, Jingxia Liu, William G Hawkins, Deyali Chatterjee
In the setting of neoadjuvant therapy (NAT) for pancreatic ductual adenocarcinoma (PDAC), accurate measurement of tumor size, and consequently, staging based on AJCC eighth edition, is difficult. Attempts to address the limitations of tumor size in the NAT setting have included correlation of residual tumor percent with survival. However, only cases with complete pathologic response or minimal residual disease have shown better prognosis compared with all other groups. To date, no studies have simultaneously evaluated the prognostic value of tumor size and tumor regression in the setting of PDAC status post NAT (NAT-PDAC)...
August 31, 2018: American Journal of Surgical Pathology
Taiki Hashimoto, Reiko Ogawa, Hiroshi Yoshida, Hirokazu Taniguchi, Motohiro Kojima, Yutaka Saito, Shigeki Sekine
Colorectal traditional serrated adenomas (TSAs) are often associated with precursor polyps, including hyperplastic polyps and sessile serrated adenoma/polyps. To elucidate the molecular mechanisms involved in the progression from precursor polyps to TSAs, the present study analyzed 15 precursor polyp-associated TSAs harboring WNT pathway gene mutations. Laser microdissection-based sequencing analysis showed that BRAF or KRAS mutations were shared between TSA and precursor polyps in all lesions. In contrast, the statuses of WNT pathway gene mutations were different between the 2 components...
August 31, 2018: American Journal of Surgical Pathology
Melanie Johncilla, Zhengming Chen, Jacob Sweeney, Rhonda K Yantiss
Intestinal-type colorectal adenocarcinomas are graded based on extent of glandular differentiation, although mucinous, signet-ring cell, and solid cancers are, by convention, classified as high grade. Mismatch repair-deficient tumors frequently show high-grade histologic features, yet the World Health Organization classifies them as low grade to reflect their favorable prognosis compared with mismatch repair-proficient cancers. Although some mismatch repair-deficient colorectal cancers behave aggressively, few authors have identified features that predict their behavior...
August 31, 2018: American Journal of Surgical Pathology
Jennifer Y Ju, Anne M Mills, Mani S Mahadevan, Jinbo Fan, Stephen H Culp, Martha H Thomas, Helen P Cathro
Lynch syndrome (LS) is defined by germline mutations in DNA mismatch repair (MMR) genes, and affected patients are at high risk for multiple cancers. Reflexive testing for MMR protein loss by immunohistochemistry (IHC) is currently only recommended for colorectal and endometrial cancers, although upper tract urothelial carcinoma (UTUC) is the third-most common malignancy in patients with LS. To study the suitability of universal MMR IHC screening for UTUC, we investigated MMR expression and microsatellite status in UTUC in comparison to bladder UC (BUC), and evaluated the clinicopathologic features of UTUC...
August 24, 2018: American Journal of Surgical Pathology
Jennifer Pors, Angela Cheng, Joyce M Leo, Mary A Kinloch, Blake Gilks, Lynn Hoang
Mesonephric carcinomas of the gynecologic tract are neoplasms that are often under-recognized due to their varied morphologic appearances. Recently, GATA3 and TTF1 have been reported to be useful immunohistochemical markers for distinguishing mesonephric carcinomas from its morphologic mimics. Herein, we compared the performance of GATA3 and TTF1 to the traditional markers used for mesonephric carcinomas, CD10 and calretinin. We studied 694 cases: 8 mesonephric carcinomas (7 cervical [includes 3 mesonephric carcinosarcomas], 1 vaginal), 5 mesonephric-like carcinomas (4 uterine corpus, 1 ovarian), 585 endometrial adenocarcinomas, and 96 cervical adenocarcinomas...
August 24, 2018: American Journal of Surgical Pathology
Brandon T Larsen, Maxwell L Smith, Anja C Roden, William R Sukov, Helena Hornychová, Seshadri Thirumala, Thomas V Colby, Henry D Tazelaar
No abstract text is available yet for this article.
August 22, 2018: American Journal of Surgical Pathology
Kiyoshi Saeki, Yoshihiro Ohishi, Ryota Matsuda, Naoki Mochidome, Yoshihiro Miyasaka, Hidetaka Yamamoto, Yutaka Koga, Yoshihiko Maehara, Masafumi Nakamura, Yoshinao Oda
"Mucoepidermoid carcinoma (MEC)" has been accepted as a synonym for pancreatic adenosquamous carcinoma (ASC). Pancreatic ASC can show salivary gland-type MEC-like morphology. CRTC1/3-MAML2 fusion gene is a characteristic molecular feature of MEC of the salivary gland. We conducted this study to clarify whether the pancreatic ASC with salivary gland-type MEC-like morphology (Pan-MEC) is a pancreatic counterpart of salivary gland-type MEC (Sal-MEC). We retrospectively analyzed 37 pancreatic ASCs including 16 Pan-MECs and 21 tumors without MEC-like features (ASC-NOS [not otherwise specified]), and we investigated (1) clinicopathologic features, (2) the presence of CRTC1/3-MAML2 fusion gene by reverse transcription polymerase chain reaction, (3) the presence of rearrangement of MAML2 gene by fluorescence in situ hybridization, and (4) mucin core proteins by immunohistochemistry...
August 22, 2018: American Journal of Surgical Pathology
Adina Paulk, Giovanna Giannico, Jonathan I Epstein
Prostatic intraepithelial neoplasia like (PIN-like ductal) carcinoma are rare tumors characterized by crowded, often cystically dilated glands architecturally resembling high-grade prostatic intraepithelial neoplasia, lined by malignant pseudostratified columnar epithelium. The largest prior series studied 9 radical prostatectomies (RPs) and suggested a behavior similar to Gleason score 6. We sought to investigate this rare tumor within a larger series. PIN-like carcinoma cases were identified from in-house and consultation files from 2008 to 2017...
August 22, 2018: American Journal of Surgical Pathology
Andréanne Gagné, Étienne Racine, Michèle Orain, Salma Meziou, Serge Simard, Christian Couture, Sylvain Pagé, Sylvain Trahan, Paula Ugalde, Yves Lacasse, David Joubert, Philippe Joubert
Because of a lack of official guidelines, systematic use of intraoperative frozen section for the evaluation of surgical margins in lung oncology constitutes standard practice in many pathology departments. This costly and time-consuming procedure seems unjustified as reported rates of positive margins remain low. We aimed to evaluate clinicopathologic criteria associated with positive margins and establish evidence-based recommendations regarding the use of frozen sections. This retrospective cohort included 1903 consecutive patients with a lung resection for malignant neoplasm between 2006 and 2015...
August 17, 2018: American Journal of Surgical Pathology
Anne M R Schrader, Patty M Jansen, Maarten H Vermeer, Johanna K Kleiverda, Joost S P Vermaat, Rein Willemze
Primary cutaneous diffuse large B-cell lymphoma, leg type (PCDLBCL-LT) and primary cutaneous follicle center lymphoma (PCFCL) are cutaneous B-cell lymphomas (CBCL) with different clinical characteristics and behavior. PCDLBCL-LT is the most aggressive CBCL with a relatively poor prognosis. In nodal diffuse large B-cell lymphoma (DLBCL), rearrangements of the MYC gene, especially in combination with a second hit in BCL2 and/or BCL6, and double protein expression of MYC and BCL2 (DE) are adverse prognostic factors...
August 14, 2018: American Journal of Surgical Pathology
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