Evaluation of the Surgical Specimen After Neoadjuvant Systemic Therapy
ConclusionPostneoadjuvant systemic therapy histopathological changes are complex, and careful systematic review of the specimen is required for accurate diagnosis and follow-up treatment. For pathological complete response to be used as an indicator of response to novel therapies, it is essential to have a standardized way in which residual disease is measured and reported. We designed the recommendations specifically for the clinical trial setting; however, they can be optionally incorporated into routine practice because, in our opinion, standardization is most effective when uniformly applied. Hopefully, such standardiz...
Source: Oncopathology - March 23, 2021 Category: Cancer & Oncology Tags: breast Breast Biopsy Procedure breast cancer Source Type: blogs
Neuroendocrine tumors of GI Tract.
The World Health Organization (WHO) classifies neuroendocrine neoplasms as well-differentiated neuroendocrine tumors (either the primary tumor or metastasis) and poorly differentiated neuroendocrine carcinomas.Historically, well-differentiated neuroendocrine tumors have been referred to as “carcinoid tumors,” a term which may cause confusion because clinically a carcinoid tumor is a serotonin-producing tumor associated with functional manifestations of carcinoid syndrome.The use of the term “carcinoid” for neuroendocrine tumor reporting is therefore discouraged for these reasons.Immunohistochemistry and other ancil...
Source: Oncopathology - January 22, 2020 Category: Cancer & Oncology Source Type: blogs
Immunohistochemistry in the Differential Diagnosis of Cutaneous Basal Cell Carcinoma
Basal cell carcinoma and squamous cell carcinoma are two of the most common cutaneous tumors seen by pathologists. In the large majority of cases, the distinction between these two tumors is readily made on the basis of standard H&E morphology. However, many of us see cases from time to time that for one reason or another (minuscule biopsy, mishandled specimen, crushed beyond recognition, dryed out, poorly fixed, etc., etc.), it is difficult to know for certain whether one is dealing with a squamous carcinoma or a basal cell carcinoma. This month, we discuss several immunostains that can be of utility in approaching th...
Source: Oncopathology - November 20, 2018 Category: Cancer & Oncology Source Type: blogs
Immunohistochemistry in the Differential Diagnosis of Cutaneous Basal Cell Carcinoma
Basal cell carcinoma and squamous cell carcinoma are two of the most common cutaneous tumors seen by pathologists. In the large majority of cases, the distinction between these two tumors is readily made on the basis of standard H&E morphology. However, many of us see cases from time to time that for one reason or another (minuscule biopsy, mishandled specimen, crushed beyond recognition, dryed out, poorly fixed, etc., etc.), it is difficult to know for certain whether one is dealing with a squamous carcinoma or a basal cell carcinoma. This month, we discuss several immunostains that can be of utility in approaching th...
Source: Oncopathology - November 20, 2018 Category: Cancer & Oncology Source Type: blogs
Tumor Size (Size of Invasive Carcinoma) in Breast Carcinoma
Breast Carcinoma reporting;Tumor Size (Size of Invasive Carcinoma)The size of an invasive carcinoma is an important prognostic factor. The single greatest dimension of the largest invasive carcinoma is used to determine T classification The best size for AJCC T classification should use information from imaging, gross examination, and microscopic evaluation. Visual determination of size is often unreliable, as carcinomas often blend into adjacent fibrous tissue. The size by palpation of a hard mass correlates better with invasion of tumor cells into stroma with a desmoplastic response. Sizes should...
Source: Oncopathology - April 12, 2018 Category: Cancer & Oncology Source Type: blogs
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Grade Group in reporting of prostate acinar adenocarcinoma:The 9 Gleason scores (2-10) have been variably lumped into different groups for prognosis and patient management purposes. Epstein and associates proposed grouping scores into 5 prognostic categories, grade groups 1-5. This grade grouping, shown below in the table, strongly correlate with biochemical recurrence and have been incorporated into the new Partin tables. At the 2014 ISUP Consensus Conference, details of this prognostic system were clarified and it was recommended for usage together with the Gleason system.This grade grouping has also been...
Source: Oncopathology - April 3, 2018 Category: Cancer & Oncology Source Type: blogs
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Methods for estimating the size/extent of DCIS inspecimen.Why to measure size of DCIS in specimen:Higher rates of invasive cancer detected according to DCIS size. Progression to invasive cancer occurred in 10% of DCIS patients with a DCIS tumor size between 2.5 to 3.5 cms, 57% for tumor size 3.6 to 4.5 cms and 71% for tumors between 4.5 and 6 cms.Tumors over 2.5 cms have a higher risk of progressing to invasive cancers.J Exp Clin Cancer Res. 2006 Jun;25(2):223-7.There are multiple methods for estimating the extent of DCIS (see Figure):DCIS in 1 block: The area involved by DCIS can be measured from a single slide...
Source: Oncopathology - March 28, 2018 Category: Cancer & Oncology Source Type: blogs
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There are multiple methods for estimating the extent of DCIS (see Figure):DCIS in 1 block: The area involved by DCIS can be measured from a single slide, if DCIS is present in only 1 block. If separate foci are present, the largest distance between foci should be reported. This method will underestimate the extent of DCIS when multiple blocks are involved and should not be used in such cases. Serial sequential sampling: The entire specimen is blocked out in such a way that the location of each block can be determined. The extent of the DCIS can be calculated by using a diagram of the specimen, the thickness of the sli...
Source: Oncopathology - March 28, 2018 Category: Cancer & Oncology Source Type: blogs
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Pathology, classification, and grading of neuroendocrine tumors arising in the digestive systemThe terminology of gastroenteropancreatic (GEP) neuroendocrine neoplasms has evolved over the past two decades to reflect a separation into two major categories:●Well-differentiated neuroendocrine tumors (NETs) show a solid, trabecular, gyriform, or glandular pattern, with fairly uniform nuclei, salt-and-pepper chromatin, and finely granular cytoplasm. These tumors were traditionally referred to as carcinoid and pancreatic neuroendocrine (islet cell) tumors. Although carcinoid tumors and pancreatic NETs may have simil...
Source: Oncopathology - January 27, 2016 Category: Cancer & Oncology Source Type: blogs
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Pathology, classification, and grading of neuroendocrine tumors arising in the digestive systemThe terminology of gastroenteropancreatic (GEP) neuroendocrine neoplasms has evolved over the past two decades to reflect a separation into two major categories:●Well-differentiated neuroendocrine tumors (NETs) show a solid, trabecular, gyriform, or glandular pattern, with fairly uniform nuclei, salt-and-pepper chromatin, and finely granular cytoplasm. These tumors were traditionally referred to as carcinoid and pancreatic neuroendocrine (islet cell) tumors. Although carcinoid tumors and pancreatic NETs may have simil...
Source: Oncopathology - January 27, 2016 Category: Cancer & Oncology Source Type: blogs
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Pathology, classification, and grading of neuroendocrine tumors arising in the digestive systemThe terminology of gastroenteropancreatic (GEP) neuroendocrine neoplasms has evolved over the past two decades to reflect a separation into two major categories:●Well-differentiated neuroendocrine tumors (NETs) show a solid, trabecular, gyriform, or glandular pattern, with fairly uniform nuclei, salt-and-pepper chromatin, and finely granular cytoplasm. These tumors were traditionally referred to as carcinoid and pancreatic neuroendocrine (islet cell) tumors. Although carcinoid tumors and pancreatic NETs may have simi...
Source: Oncopathology - January 27, 2016 Category: Cancer & Oncology Source Type: blogs
