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Surgical Pathology Clinics

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https://www.readbyqxmd.com/read/29103544/-unknown-title
#1
EDITORIAL
Rhonda K Yantiss
No abstract text is available yet for this article.
December 2017: Surgical Pathology Clinics
https://www.readbyqxmd.com/read/29103543/immunohistochemical-pitfalls-common-mistakes-in-the-evaluation-of-lynch-syndrome
#2
REVIEW
Michael Markow, Wei Chen, Wendy L Frankel
At least 15% of colorectal cancers diagnosed in the United States are deficient in mismatch repair mechanisms. Most of these are sporadic, but approximately 3% of colorectal cancers result from germline alterations in mismatch repair genes and represent Lynch syndrome. It is critical to identify patients with Lynch syndrome to institute appropriate screening and surveillance for patients and their families. Exclusion of Lynch syndrome in sporadic cases is equally important because it reduces anxiety for patients and prevents excessive spending on unnecessary surveillance...
December 2017: Surgical Pathology Clinics
https://www.readbyqxmd.com/read/29103542/persistent-problems-in-colorectal-cancer-reporting
#3
REVIEW
Rhonda K Yantiss
Tumor stage, as determined by the Tumor, Node, Metastasis (TNM) staging system, is the single most influential factor determining treatment decisions and outcome among patients with colorectal cancer. Several stage-related elements in pathology reports consistently pose diagnostic challenges: recognition of serosal penetration by tumor (ie, pT3 vs pT4a), evaluation of regional lymph nodes, distinction between tumor deposits and effaced lymph nodes, and assessment of tumor stage in the neoadjuvant setting. This article discusses each of these issues in detail and provides practical tips regarding colorectal cancer staging...
December 2017: Surgical Pathology Clinics
https://www.readbyqxmd.com/read/29103541/problematic-colorectal-polyps-is-it-cancer-and-what-do-i-need-to-do-about-it
#4
REVIEW
Maurice B Loughrey, Neil A Shepherd
Two issues commonly arise for pathologists reporting adenomatous polyps of the colorectum. Particularly problematic within large sigmoid colonic adenomas is the distinction between benign misplacement of epithelium into the submucosa and invasive malignancy. This distinction requires careful morphologic evaluation of key discriminatory features, assisted only rarely by the application of selected adjunctive immunohistochemistry. Following a diagnosis of adenocarcinoma within a polypectomy or other local excision specimen, systematic assessment is required of features that may indicate the risk of residual local and/or nodal neoplastic disease and inform management decision-making regarding the need for further endoscopic or surgical intervention...
December 2017: Surgical Pathology Clinics
https://www.readbyqxmd.com/read/29103540/emerging-concepts-in-gastric-neoplasia-heritable-gastric-cancers-and-polyposis-disorders
#5
REVIEW
Rachel S van der Post, Fátima Carneiro
Hereditary gastric cancer is a relatively rare disease with specific clinical and histopathologic characteristics. Hereditary gastric cancer of the diffuse type is predominantly caused by germline mutations in CDH1. The inherited cause of familial intestinal gastric cancer is unknown. Gastric adenocarcinoma and proximal polyposis of the stomach is a hereditary cancer syndrome caused by germline mutations in promoter 1B of APC. Other well-defined cancer syndromes, such as Lynch, Li-Fraumeni, and hereditary breast or ovarian cancer syndromes, are associated with increased risk of gastric cancer...
December 2017: Surgical Pathology Clinics
https://www.readbyqxmd.com/read/29103539/mucosal-biopsy-after-bone-marrow-transplantation
#6
REVIEW
Maria Westerhoff, Laura W Lamps
Gastrointestinal mucosal biopsies in the hematopoietic stem cell transplantation setting are challenging because histologic features of graft-versus-host disease (GVHD), which is treated by increasing immunosuppression, overlap with those of other conditions, such as infection, which can get worse with GVHD treatment. More than one condition can occur at the same time. It is important to understand the histologic features of GVHD, drug toxicity, infection, and clinical factors surrounding patients, including timing of biopsy in relation to transplantation, medication history, and laboratory data...
December 2017: Surgical Pathology Clinics
https://www.readbyqxmd.com/read/29103538/the-many-faces-of-medication-related-injury-in-the-gastrointestinal-tract
#7
REVIEW
Heewon A Kwak, John Hart
Every year many new medications are approved for clinical use, several of which can cause clinically significant gastrointestinal tract toxicity. This article emphasizes the histologic features and differential diagnosis of drug-induced injury to the gastrointestinal mucosa. Ultimately, clinical correlation and cessation of a drug with resolution of symptoms are needed to definitively confirm a drug as a causative factor in mucosal injury. Recognizing histologic features in gastrointestinal biopsies, however, can allow surgical pathologists to play a key role in establishing a diagnosis of drug-induced gastrointestinal toxicity...
December 2017: Surgical Pathology Clinics
https://www.readbyqxmd.com/read/29103537/the-differential-diagnosis-of-acute-colitis-clues-to-a-specific-diagnosis
#8
REVIEW
Jose Jessurun
This review describes a systematic approach to the interpretation of colonic biopsy specimens of patients with acute colitis. Five main histologic patterns are discussed: acute colitis, focal active colitis, pseudomembranous colitis, hemorrhagic colitis, and ischemic colitis. For each pattern, the most common etiologic associations and their differential diagnoses are presented. Strategies based on histologic analysis and clinical considerations to differentiate acute from chronic colitides are discussed.
December 2017: Surgical Pathology Clinics
https://www.readbyqxmd.com/read/29103536/chronic-colitis-in-biopsy-samples-is-it-inflammatory-bowel-disease-or-something-else
#9
REVIEW
Eun-Young Karen Choi, Henry D Appelman
Chronic colitis, regardless of type, is defined histologically by chronic inflammation, mainly plasmacytosis, in the lamina propria. Specific diagnosis of chronic colitides in biopsies can be challenging for practicing pathologists. This article focuses on discussing specific histologic features in biopsies of the inflammatory bowel diseases (IBDs), including ulcerative colitis, Crohn colitis, and colitis of indeterminate type. It also offers suggestions as to how to separate the IBDs from other chronic colitides, such as lymphocytic colitis, collagenous colitis, diverticular disease-associated colitis, diversion colitis, and chronic colitides that are due to drugs...
December 2017: Surgical Pathology Clinics
https://www.readbyqxmd.com/read/29103535/practical-approach-to-the-flattened-duodenal-biopsy
#10
REVIEW
Thomas C Smyrk
Celiac disease features duodenal intraepithelial lymphocytosis with or without villous atrophy. Lymphocytosis without villous atrophy will be proven to represent celiac disease in 10% to 20% of cases. The differential diagnosis is broad: Helicobacter pylori gastritis, NSAID injury and bacterial overgrowth are considerations. Lymphocytosis with villous atrophy is very likely to be celiac disease, but there are mimics to consider, including collagenous sprue, tropical sprue, drug injury, and common variable immunodeficiency...
December 2017: Surgical Pathology Clinics
https://www.readbyqxmd.com/read/29103534/patterns-of-gastric-injury-beyond-helicobacter-pylori
#11
REVIEW
Won-Tak Choi, Gregory Y Lauwers
Gastric biopsies are routinely obtained from patients with symptoms related to the gastrointestinal tract and, as a result, a variety of histologic changes are observed in patients with or without endoscopic evidence of mucosal injury. Although Helicobacter pylori-related gastritis is still common, several other patterns of mucosal injury are increasingly encountered. These patterns of injury are classified based on the nature and distribution of inflammation, location of epithelial cell injury, presence of crystal or pigment deposition, and/or other unique features...
December 2017: Surgical Pathology Clinics
https://www.readbyqxmd.com/read/29103533/diagnosis-and-management-of-barrett-related-neoplasia-in-the-modern-era
#12
REVIEW
Lysandra Voltaggio, Elizabeth A Montgomery
Whereas in the past, pathologists were hesitant to diagnose high-grade dysplasia in patients with Barrett esophagus, because this diagnosis prompted esophagectomy, current international consensus is that endoscopic treatment is the management for high-grade dysplasia and intramucosal carcinoma. Furthermore, many centers advocate endoscopic ablation for low-grade dysplasia. As such, establishing a diagnosis of dysplasia has become the key step; separation between the grades of dysplasia is less critical. This article offers some criteria for separating dysplasia from reactive changes, discusses pitfalls in interpreting endoscopic mucosal resection specimens, and outlines management strategies...
December 2017: Surgical Pathology Clinics
https://www.readbyqxmd.com/read/29103532/other-forms-of-esophagitis-it-is-not-gastroesophageal-reflux-disease-so%C3%A2-now-what-do-i-do
#13
REVIEW
Nicole C Panarelli
Esophagitis results from diverse causes, including gastroesophageal reflux, immune-mediated or allergic reactions, therapeutic complications, and infections. The appropriate clinical management differs in each of these situations and is often guided by pathologic interpretation of endoscopic mucosal biopsy specimens. This review summarizes the diagnostic features of unusual forms of esophagitis, including eosinophilic esophagitis, lymphocytic esophagitis, esophagitis dissecans superficialis, drug-induced esophageal injury, and bullous disorders...
December 2017: Surgical Pathology Clinics
https://www.readbyqxmd.com/read/29103531/lymphoproliferative-diseases-of-the-gut-a-survival-guide-for-the-general-pathologist
#14
REVIEW
Scott R Owens
The gastrointestinal tract is the most common extranodal site of involvement by lymphoma, with B-cell tumors outnumbering T-cell tumors by a wide margin. Diffuse large B-cell lymphoma is the most common lymphoid neoplasm involving the gastrointestinal tract; but a variety of other B- and T-cell neoplasms occur in the gastrointestinal organs, often with characteristic associations and/or manifestations. Although the diagnosis of gastrointestinal lymphomas can sometimes seem daunting to general pathologists, a knowledge of the most commonly encountered entities, in combination with a reasoned and pragmatic approach to the diagnostic workup, makes it possible to approach most cases with confidence...
December 2017: Surgical Pathology Clinics
https://www.readbyqxmd.com/read/29103530/molecular-testing-of-colorectal-cancer-in-the-modern-era-what-are-we-doing-and-why
#15
REVIEW
Efsevia Vakiani
A plethora of tests are routinely ordered and interpreted by pathologists to assist the management of colorectal cancer patients. Many of these tests are immunohistochemistry assays using antibodies against prognostically relevant proteins, some of which predict therapeutic response. This review focuses on tissue DNA-based tests. It presents novel methodologies for assessing well-established biomarkers, updates the expanding spectrum of genetic alterations that are associated with resistance to inhibition of epidermal growth factor receptor signaling, and briefly discusses emerging actionable alterations that may translate into new therapeutic options for colorectal cancer patients...
December 2017: Surgical Pathology Clinics
https://www.readbyqxmd.com/read/28797513/molecular-pathology-of-bone-tumors-what-have-we-learned-and-how-does-it-affect-daily-practice
#16
EDITORIAL
Judith V M G Bovée
No abstract text is available yet for this article.
September 2017: Surgical Pathology Clinics
https://www.readbyqxmd.com/read/28797512/tumor-syndromes-that-include-bone-tumors-an-update
#17
REVIEW
Maria Gnoli, Francesca Ponti, Luca Sangiorgi
Tumor syndromes, including bone neoplasias, are genetic predisposing conditions characterized by the development of a pattern of malignancies within a family at an early age of onset. Occurrence of bilateral, multifocal, or metachronous neoplasias and specific histopathologic findings suggest a genetic predisposition syndrome. Additional clinical features not related to the neoplasia can be a hallmark of specific genetic syndromes. Mostly, those diseases have an autosomal dominant pattern of inheritance with variable percentage of penetrance...
September 2017: Surgical Pathology Clinics
https://www.readbyqxmd.com/read/28797511/conditions-simulating-primary-bone-neoplasms
#18
REVIEW
Jodi M Carter, Benjamin Matthew Howe, Carrie Y Inwards
A number of nonneoplastic conditions can mimic tumors of bone. Some of the more common mimics of primary bone tumors include infectious, inflammatory, periosteal, and degenerative joint disease-associated lesions that produce tumorlike bone surface-based or intraosseous lesions. This article considers a spectrum of reactive and nonreactive processes including stress fracture, subchondral cysts, osteonecrosis, heterotopic ossification, osteomyelitis, sarcoidosis, and amyloidoma that can present in such a way that they are mistaken for a tumor arising primary in bone...
September 2017: Surgical Pathology Clinics
https://www.readbyqxmd.com/read/28797510/soft-tissue-tumors-rarely-presenting-primary-in-bone-diagnostic-pitfalls
#19
REVIEW
Marta Sbaraglia, Alberto Righi, Marco Gambarotti, Daniel Vanel, Piero Picci, Angelo P Dei Tos
Primary bone sarcomas represent extremely rare entities. The use of now abolished labels, such as malignant fibrous histiocytoma and hemangiopericytoma, has significantly hampered the chance of identifying specific entities. It is now accepted that a broad variety of mesenchymal malignancies most often arising on the soft tissue may actually present as primary bone lesions. A more accurate morphologic partition is justified based on availability of distinct therapeutic options. An integrated diagnostic approach represents the only way to achieve a correct classification...
September 2017: Surgical Pathology Clinics
https://www.readbyqxmd.com/read/28797509/bone-related-lesions-of-the-jaws
#20
REVIEW
Daniel Baumhoer
The jaws combine several unique properties that mainly result from their distinct embryonic development and their role in providing anchorage for the teeth and their supporting structures. As a consequence, several bone-related lesions almost exclusively develop in the jaws (eg, osseous dysplasias, ossifying fibromas), have distinct clinical features (eg, osteosarcoma), or hardly ever occur at this location (eg, osteochondroma, enchondroma). The specific characteristics of these tumors and tumorlike lesions are outlined in this article...
September 2017: Surgical Pathology Clinics
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