Carcinoma Rectum :MRI

Discussion by Dr MGK Murthy, Dr GA PrasadMR- useful to assist staging &identify ­ patients who may benefit from preoperative chemotherapy–radiation therapy, and in surgical planning.Currently, surgical resection with stage-appropriate neoadjuvant combined-modality therapy is the mainstay in the treatment of rectal cancer.Total mesorectal excision (TME) has reduced the prevalence of local recurrence from 38% to less than 10%. TME is surgical en bloc resection of the primary tumor and the mesorec ­tum by means of dissection along the mesorectal fascial plane or the circumferential resection margin (CRM) . Even with TME, however, the presence of a tumor or malignant node within 1 mm of the CRM remains an important pre­disposing factor for local recurrence.Randomized trials have shown that combined preoperative radiation therapy –TME reduces the prevalence of local recurrence from 8% to 2% and is superior to postoperative radia­tion therapy alone. Also lone radiation therapy yields little survival benefit and results in significant morbidity when used to treat stage T1 –T2 or favorable-risk early stage T3 tumors (5 mm invasion outside the muscularis propria).Key sequences -Orthogonal,  sagittal and coronal high-resolution T2-weighted imagesof the primary tumor; the mesorectal fascia, peri ­toneal reflection, other pelvic viscera; and superior rectal and pel­vic sidewall lymph nodes. Diffusion-weighte...
Source: Sumer's Radiology Site - Category: Radiology Authors: Source Type: blogs

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This study reports the clinicopathologic features of 31 cases with a TP53 mutation involving nuclear localization, the largest study to date, emphasizing practical strategies for recognizing this uncommon variant and distinguishing it from the p53 wild-type pattern. The study also evaluates the prognostic significance of TP53 mutation involving nuclear localization in the ovarian high-grade serous carcinoma (HGSC) cohort of The Cancer Genome Atlas database. Most of the 31 tumors were advanced stage pelvic or endometrial HGSC. All TP53 mutations were predicted to result in loss of function. The p53 overexpression pattern wa...
Source: The American Journal of Surgical Pathology - Category: Pathology Tags: Original Articles Source Type: research
Ovarian clear cell carcinoma (OCCC) and ovarian endometrioid carcinoma (OEC) are both associated with endometriosis but differ in histologic phenotype, biomarker profile, and survival. Our objectives were to refine immunohistochemical (IHC) panels that help distinguish the histotypes and reassess the prevalence of mismatch repair deficiency (MMRd) in immunohistochemically confirmed OCCC. We selected 8 candidate IHC markers to develop first-line and second-line panels in a training set of 344 OCCC/OEC cases. Interobserver reproducibility of histotype diagnosis was assessed in an independent testing cohort of 100 OCC/OEC ini...
Source: The American Journal of Surgical Pathology - Category: Pathology Tags: Original Articles Source Type: research
This study supports the proposal for the usage of the term “EBV-associated pulmonary carcinoma” to encompass the entire morphologic spectrum of this distinct EBV-associated disease entity.
Source: The American Journal of Surgical Pathology - Category: Pathology Tags: Original Articles Source Type: research
We examined whole‐tissue sections from 111 SGTs with molecular characterization, including 26 SCs (23 with ETV6-NTRK3 fusion and 3 with ETV6-RET fusion detected by ligation-dependent reverse transcription-polymerase chain reaction, next-generation sequencing and 85 non-SC SGTs (no ETV6-NTRK3 fusion). Immunohistochemistry was performed with a pan‐TRK rabbit monoclonal antibody. When any pan‐TRK staining (nuclear or cytoplasmic with any staining intensity) was considered to indicate positivity, 22 of 23 SCs with ETV6-NTRK3 fusion (95.7%) and 33 of 85 non‐SC (38.8%) salivary neoplasms were positive, mainly basal cell ...
Source: The American Journal of Surgical Pathology - Category: Pathology Tags: Original Articles Source Type: research
Tumor spread through air spaces (STAS) is associated with locoregional recurrence in patients undergoing limited resection (LR) for non−small cell lung carcinoma (NSCLC). We hypothesized that the observation of STAS in both the initial LR specimen and the additional resection specimen from the same patient, processed using different knives, would provide evidence that STAS is an in vivo phenomenon contributing to locoregional recurrence. We retrospectively identified patients with NSCLC (9 adenocarcinoma, 1 squamous cell carcinoma) who underwent LR, had STAS in the LR specimen, and underwent additional resection (lob...
Source: The American Journal of Surgical Pathology - Category: Pathology Tags: Original Articles Source Type: research
Extraneural metastases of glioblastoma (GBM), although rare, are becoming an increasingly recognized occurrence. Currently, the biological mechanism underlying this rare occurrence is not understood. To explore the potential genomic drivers of extraneural metastasis in GBM, we present the molecular features of 4 extraneural metastatic GBMs, along with a comprehensive review and analysis of previously reported cases that had available molecular characterization. In addition to our 4 cases, 42 patients from 35 publications are reviewed. To compare the molecular profiles between GBM cases with extraneural metastasis and the g...
Source: The American Journal of Surgical Pathology - Category: Pathology Tags: Original Articles Source Type: research
High-grade prostatic adenocarcinoma involving duct/acinar structures is labeled intraductal carcinoma of the prostate (IDCP). As numerous studies have shown that IDCP is associated with high stage disease with a significant negative impact on cancer-specific survival, accurate diagnosis is crucial to ensure appropriate patient management. The definition of IDCP recommended by 2016 World Health Organization (WHO) classification suggests that cases of IDCP with micropapillary or loose cribriform architecture without comedonecrosis should have cells with ≥6× nuclear enlargement. It is unclear how this size criterion ...
Source: The American Journal of Surgical Pathology - Category: Pathology Tags: Original Articles Source Type: research
We report a novel NIPBL-NACC1 gene fusion in a rare primary hepatic neoplasm previously described as the “cholangioblastic variant of intrahepatic cholangiocarcinoma.” The 2 index cases were identified within our consultation files as morphologically distinctive primary hepatic neoplasms in a 24-year-old female and a 54-year-old male. The neoplasms each demonstrated varied architecture, including trabecular, organoid, microcystic/follicular, and infiltrative glandular patterns, and biphasic cytology with large, polygonal eosinophilic cells and smaller basophilic cells. The neoplasms had a distinctive immunoprof...
Source: The American Journal of Surgical Pathology - Category: Pathology Tags: Original Articles Source Type: research
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Source: The American Journal of Surgical Pathology - Category: Pathology Tags: Letters to the Editor Source Type: research
CONCLUSION: Transabdominal utilization of the EEA stapler in LAR for colorectal carcinoma is an alternative to the conventional approach and may be advantageous in avoidance of the lithotomy position with potential nerve injury, risk of deep venous thrombosis, and stapler-induced sphincter trauma. PMID: 33342264 [PubMed - as supplied by publisher]
Source: The American Surgeon - Category: Surgery Authors: Tags: Am Surg Source Type: research
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