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J Kenneth Schoolmeester, William R Sukov
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September 15, 2016: International Journal of Gynecological Pathology
Stephanie M McGregor, J Kenneth Schoolmeester, Ricardo R Lastra
To date, the vast majority of collision tumors in the ovary include either a teratoma, sex cord-stromal tumor, or both. Here we report the first case of a collision tumor consisting of a steroid cell tumor and a signet-ring stromal tumor.
August 10, 2016: International Journal of Gynecological Pathology
Abigail A Delaney, Zaraq Khan, Ye Zheng, Luiz F Correa, Valentina Zanfagnin, Chandra C Shenoy, John K Schoolmeester, Abdulrahman M Saadalla, Sherif El-Nashar, Abimbola O Famuyide, Malayannan Subramaniam, John R Hawse, Khashayarsha Khazaie, Gaurang S Daftary
Endometriosis is a highly prevalent, chronic, heterogeneous, fibro-inflammatory disease that remains recalcitrant to conventional therapy. We previously showed that loss of KLF11, a transcription factor implicated in uterine disease, results in progression of endometriosis. Despite extensive homology, co-expression, and human disease association, loss of the paralog Klf10 causes a unique inflammatory, cystic endometriosis phenotype in contrast to fibrotic progression seen with loss of Klf11. We identify here for the first time a novel role for KLF10 in endometriosis...
September 2016: Biology of Reproduction
Carlos Parra-Herran, Monica Taljaard, Bojana Djordjevic, M Carolina Reyes, Lauren Schwartz, John K Schoolmeester, Ricardo R Lastra, Charles M Quick, Anna Laury, Golnar Rasty, Marisa R Nucci, Brooke E Howitt
A pattern-based classification for invasive endocervical adenocarcinoma has been proposed as predictive of the risk of nodal metastases. We aimed to determine the reproducibility of such classification in the context of common diagnostic challenges: distinction between in situ and invasive adenocarcinoma and depth of invasion measurement. Nine gynecologic pathologists independently reviewed 96 cases of endocervical adenocarcinoma (two slides per case). They diagnosed each case as in situ or invasive carcinoma classifying the latter following the pattern-based classification as pattern A (non-destructive), B (focally destructive) or C (diffusely destructive)...
August 2016: Modern Pathology: An Official Journal of the United States and Canadian Academy of Pathology, Inc
Carlos Parra-Herran, John K Schoolmeester, Liping Yuan, Paola Dal Cin, Christopher D M Fletcher, Bradley J Quade, Marisa R Nucci
Myxoid leiomyosarcoma (mLMS) of the uterus is a rare neoplasm; thus, knowledge of its clinical behavior and morphology remains limited. We therefore reviewed 30 cases initially diagnosed as uterine mLMS to better characterize its clinicopathologic features. Diagnosis was confirmed in 25 subjects (average age 51.5 y), of whom 80% were stage 1 at presentation. The average tumor size was 10.8 cm. An infiltrative tumor border was observed microscopically in 24 cases (96%); the border in 1 case could not be assessed...
March 2016: American Journal of Surgical Pathology
Deyin Xing, J Kenneth Schoolmeester, Zhiyong Ren, Christina Isacson, Brigitte M Ronnett
Lower female genital tract tumors with adenoid cystic differentiation are rare, and data on their relationship with high-risk human papillomavirus (HPV) are limited. Here we report the clinicopathologic features from a case series. Tumors with adenoid cystic differentiation, either pure or as part of a carcinoma with mixed differentiation, arising in the lower female genital tract were evaluated by means of immunohistochemical analysis for p16 expression and in situ hybridization using 1 or more probes for high-risk HPV (a high-risk probe covering multiple types, a wide-spectrum probe, and separate type-specific probes for HPV16 and HPV18) and when possible by polymerase chain reaction for high-risk HPV...
April 2016: American Journal of Surgical Pathology
J Kenneth Schoolmeester, Michael D Stamatakos, Ann M Moyer, Kay J Park, Melissa Fairbairn, Amanda N Fader
Uterine tumors with adipocytic differentiation are very uncommon. Mature adipocytes are sometimes seen as an element of smooth muscle neoplasms, more often as lipoleiomyoma, but also in the rare lipoleiomyosarcoma. Exceptional cases have been reported of various subtypes of liposarcoma associated with uterine smooth muscle tumors with or without adipocytic differentiation. We present a case of pleomorphic liposarcoma arising in a lipoleiomyosarcoma of the uterus. Genomic profiling was performed using a validated next generation sequencing panel covering 410 common cancer genes...
July 2016: International Journal of Gynecological Pathology
Ricardo R Lastra, Kay J Park, J Kenneth Schoolmeester
Stratified mucin-producing intraepithelial lesion (SMILE) is a cervical intraepithelial lesion, distinct from conventional squamous or glandular counterparts, believed to arise from embryonic cells at the transformation zone by transdifferentiation during high-risk HPV-associated carcinogenesis. It is characterized by stratified, immature epithelial cells displaying varying quantities of intracytoplasmic mucin throughout the majority of the lesional epithelium. We identified a distinct form of invasive cervical carcinoma with morphologic features identical to those in SMILE, which we have termed "invasive stratified mucin-producing carcinoma...
February 2016: American Journal of Surgical Pathology
J Kenneth Schoolmeester, Andrew P Sciallis, Patricia T Greipp, Jennelle C Hodge, Paola Dal Cin, Gary L Keeney, Marisa R Nucci
MDM2 amplification is known to occur in a variety of neoplasms and its detection by fluorescence in situ hybridization is helpful in distinguishing well-differentiated and dedifferentated liposarcoma from classic lipoma. We recently evaluated a mesenteric mass initially diagnosed as dedifferentiated liposarcoma, largely due to the neoplasm's myxoid morphology and MDM2 expression by immunohistochemistry, from a 46-yr-old woman with a history of uterine low-grade endometrial stromal sarcoma (LG-ESS) with a JAZF1 rearrangement...
November 2015: International Journal of Gynecological Pathology
J Kenneth Schoolmeester, Kay J Park
Lymphangioleiomyomatosis (LAM) is a proliferation of perivascular epithelioid cells typically affecting the lung as a low-grade, destructive and progressive disease but may also be found in lymph nodes and other organs. LAM is sometimes seen as an incidental finding in lymph node dissections performed for staging of gynecologic tumors. To our knowledge, no study has investigated the clinical significance of incidental nodal LAM in relation to subsequent development of pulmonary LAM. We identified 19 patients from our institution with LAM in lymph nodes...
October 2015: American Journal of Surgical Pathology
Elliott Grant Richards, Sherif A El-Nashar, John Kenny Schoolmeester, Abimbola O Famuyide
INTRODUCTION: The menstrual cycle is a sex steroid-driven process thought to be under the influence of multiple epigenetic modulators. DNA methytransferases (DNMT) appear to regulate gene activity during decidualization, but relative expression level by phase is not fully understood and has not been studied in abnormal uterine bleeding. METHODS: Immunohistochemistry was performed on tissue microarrays derived from 541 endometrial samples including secretory, proliferative, atrophic histopathologic diagnoses...
May 2015: Obstetrics and Gynecology
John K Schoolmeester, Karen J Fritchie
Mesenchymal neoplasms of the vulvovaginal and inguinoscrotal regions are among the most diagnostically challenging specimens in the pathology laboratory owing largely to their unique intersection between general soft tissue tumors and relatively genital-specific mesenchymal tumors. Genital stromal tumors are a unique subset of soft tissue tumors encountered at this location, and this group includes fibroepithelial stromal polyp, superficial (cervicovaginal) myofibroblastoma, cellular angiofibroma, mammary-type myofibroblastoma, angiomyofibroblastoma and aggressive angiomyxoma...
July 2015: Journal of Cutaneous Pathology
John Kenneth Schoolmeester, Aaron J Leifer, Lu Wang, Meera R Hameed
Malignant lipomatous tumors of the vulva are uncommon. We present 2 cases of liposarcoma arising in the vulva: a myxoid liposarcoma harboring DDIT3 and FUS rearrangements and a well differentiated liposarcoma/atypical lipomatous tumor harboring MDM2 amplification detected by fluorescence in situ hybridization. Both cases are the first liposarcomas of this site to be confirmed by molecular cytogenetic analysis. We also review the literature's cases of liposarcoma to further examine the clinicopathologic features of these tumors...
July 2015: International Journal of Gynecological Pathology
John Kenneth Schoolmeester, Patricia T Greipp, Gary L Keeney, Robert A Soslow
Hemangiomas of the ovary are rare with a majority described as individual reports of unusual clinical presentations or morphologic findings. Both the expected and unexpected pathologic features of these tumors in the ovary are not well detailed. Therefore, we collected the largest series of ovarian hemangiomas to comprehensively define their clinicopathologic associations and examine the significance of hormone receptors in their pathogenesis. In addition, a novel EWSR1-NFATC1 fusion has recently been described in a case of hemangioma of bone...
September 2015: International Journal of Gynecological Pathology
Andrew L Folpe, J Kenneth Schoolmeester, W Glenn McCluggage, Lisa M Sullivan, Katharine Castagna, William A Ahrens, Esther Oliva, Jaclyn A Biegel, G Petur Nielsen
Loss of expression of the SMARCB1 (INI1/BAF47/SNF5) tumor-suppressor protein, originally identified in pediatric malignant rhabdoid tumors, has been noted in significant percentages of epithelioid sarcomas of classical and proximal-type and in myoepithelial carcinomas. Epithelioid sarcoma and myoepithelial carcinoma are very rare in the vulvar region, and few of these cases have been evaluated for SMARCB1 protein loss by immunohistochemistry (IHC) or for SMARCB1 gene alterations by molecular genetic techniques...
June 2015: American Journal of Surgical Pathology
J Kenneth Schoolmeester, Linda N Dao, William R Sukov, Lu Wang, Kay J Park, Rajmohan Murali, Meera R Hameed, Robert A Soslow
TFE3 translocation-associated PEComa is a distinct form of perivascular epithelioid cell neoplasm, the features of which are poorly defined owing to their general infrequency and limited prior reports with confirmed rearrangement or fusion. Recent investigation has found a lack of TSC gene mutation in these tumors compared with their nonrearranged counterparts, which underscores the importance of recognizing the translocated variant because of hypothetical ineffectiveness of targeted mTOR inhibitor therapy...
March 2015: American Journal of Surgical Pathology
Neha Mehta, Heiko Schöder, April Chiu, John Kenneth Schoolmeester, Carol Portlock
Systemic amyloid light chain amyloidosis (AL amyloidosis) is usually seen in association with a plasma cell disorder. Amyloid deposition associated with extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue (MALT lymphoma) is a rare phenomenon that is not typically associated with systemic AL amyloidosis. We describe the unusual case of a patient with an adnexal mass secondary to MALT lymphoma with associated amyloid deposition.
2014: BMJ Case Reports
Yaser R Hussein, Britta Weigelt, Douglas A Levine, J Kenneth Schoolmeester, Linda N Dao, Bonnie L Balzer, Georgia Liles, Beth Karlan, Martin Köbel, Cheng-Han Lee, Robert A Soslow
The Cancer Genome Atlas described four major genomic groups of endometrial carcinomas, including a POLE ultramutated subtype comprising ∼10% of endometrioid adenocarcinoma, characterized by POLE exonuclease domain mutations, ultrahigh somatic mutation rates, and favorable outcome. Our aim was to examine the morphological and clinicopathological features of ultramutated endometrial carcinomas harboring somatic POLE exonuclease domain mutations. Hematoxylin and eosin slides and pathology reports for 8/17 POLE-mutated endometrial carcinomas described in the Cancer Genome Atlas study were studied; for the remaining cases, virtual whole slide images publicly available at cBioPortal (www...
April 2015: Modern Pathology: An Official Journal of the United States and Canadian Academy of Pathology, Inc
Andrew P Sciallis, Patrick P Bedroske, John K Schoolmeester, William R Sukov, Gary L Keeney, Jennelle C Hodge, Debra A Bell
The existence of a "high-grade endometrial stromal sarcoma" category of tumors has been a controversial subject owing to, among other things, the difficulty in establishing consistent diagnostic criteria. Currently, the recommended classification for such tumors is undifferentiated uterine/endometrial sarcoma. Interest in this subject has recently increased markedly with the identification of recurrent molecular genetic abnormalities. At Mayo Clinic, a group of neoplasms has been observed that morphologically resemble, either cytologically or architecturally, classic "low-grade" endometrial stromal sarcoma but feature obvious deviations, specifically, 17 tumors with unequivocally high-grade morphology...
September 2014: American Journal of Surgical Pathology
Ye Zheng, Zaid M Tabbaa, Zaraq Khan, John K Schoolmeester, Sherif El-Nashar, Abimbola Famuyide, Gary L Keeney, Gaurang S Daftary
Endocrine regulation of uterine biology is critical for embryo receptivity and human reproduction. Uterine endometrium depends on extrinsic sex steroid input and hence likely has mechanisms that enable adaptation to hormonal variation. Emerging evidence suggests that sex steroid bioavailability in the endometrium is determined by adjusting their metabolic rate and fate via regulation of cytochrome (CYP) p450 enzymes. The CYP enzymes are targeted by ubiquitously expressed Sp/Krüppel-like (Sp/KLF) transcription factors...
November 2014: Endocrinology
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