A 2020 Vision Into Hodgkin Lymphoma Biology
Hodgkin lymphomas (HLs) are lymphoid neoplasms uniquely characterized by a paucity of neoplastic cells embedded in a supportive heterogenous cellular microenvironment. Although first described in the 19th century, systematic biological understanding of HLs has been hindered due to the challenges presented in studying the complex tumor microenvironment and scarce tumorigenic cells. Recent advances in single-cell isolation and characterization, sensitive mutational analytic tools, and multiplex immunohistochemical strategies have allowed further advances in understanding the development and progression of HL. Here we provide...
Source: Advances in Anatomic Pathology - August 13, 2020 Category: Pathology Tags: Review Articles Source Type: research

Implementing Deep Learning Algorithms in Anatomic Pathology Using Open-source Deep Learning Libraries
This article aims to act as an introductory tutorial to illustrate how to create, train, and evaluate simple artificial learning models (neural networks) on histopathology data sets in the programming language Python using the popular freely available, open-source libraries Keras, TensorFlow, PyTorch, and Detecto. Furthermore, it aims to introduce pathologists to commonly used terms and concepts used in artificial intelligence. (Source: Advances in Anatomic Pathology)
Source: Advances in Anatomic Pathology - June 16, 2020 Category: Pathology Tags: Review Articles Source Type: research

Whole Slide Imaging: Technology and Applications
This article will review the digital pathology ecosystem and discuss clinical and nonclinical applications of its use. (Source: Advances in Anatomic Pathology)
Source: Advances in Anatomic Pathology - June 16, 2020 Category: Pathology Tags: Review Articles Source Type: research

Explainable AI (xAI) for Anatomic Pathology
This article outlines xAI enabled applications in anatomic pathology workflow that improves efficiency and accuracy of the practice. In addition, we describe HistoMapr-Breast, an initial xAI enabled software application for breast core biopsies. HistoMapr-Breast automatically previews breast core WSIs and recognizes the regions of interest to rapidly present the key diagnostic areas in an interactive and explainable manner. We anticipate xAI will ultimately serve pathologists as an interactive computational guide for computer-assisted primary diagnosis. (Source: Advances in Anatomic Pathology)
Source: Advances in Anatomic Pathology - June 16, 2020 Category: Pathology Tags: Review Articles Source Type: research

Whole-slide Imaging: Clinical Workflows and Primary Diagnosis
This article will discuss the preparatory steps needed to implement digital pathology as well as some implementation styles that may be sufficient for a pathology department. (Source: Advances in Anatomic Pathology)
Source: Advances in Anatomic Pathology - June 16, 2020 Category: Pathology Tags: Review Articles Source Type: research

Clinical Application of Image Analysis in Pathology
Quantitative biomarkers are key prognostic and predictive factors in the diagnosis and treatment of cancer. In the clinical laboratory, the majority of biomarker quantitation is still performed manually, but digital image analysis (DIA) methods have been steadily growing and account for around 25% of all quantitative immunohistochemistry (IHC) testing performed today. Quantitative DIA is primarily employed in the analysis of breast cancer IHC biomarkers, including estrogen receptor, progesterone receptor, and human epidermal growth factor receptor 2/neu; more recently clinical applications have expanded to include human ep...
Source: Advances in Anatomic Pathology - June 16, 2020 Category: Pathology Tags: Review Articles Source Type: research

Convergence of Digital Pathology and Artificial Intelligence Tools in Anatomic Pathology Practice: Current Landscape and Future Directions
No abstract available (Source: Advances in Anatomic Pathology)
Source: Advances in Anatomic Pathology - June 16, 2020 Category: Pathology Tags: Editorial Source Type: research

Advances in Diagnostic Immunohistochemistry for Primary Tumors of the Central Nervous System
This article reviews novel immunohistochemical markers that may be used to determine mutation status, activation of signaling pathways, druggable targets, and cell lineage in many diverse tumor types. In particular, recently added entities to the 2016 WHO classification of central nervous system tumors will be addressed, including IDH-mutant gliomas, diffuse midline glioma, epithelioid glioblastoma, angiocentric glioma, RELA-rearranged ependymoma, embryonal tumors (medulloblastoma, atypical teratoid/rhabdoid tumor, pineoblastoma, embryonal tumor with multilayered rosettes, and other genetically defined high-grade neuroepit...
Source: Advances in Anatomic Pathology - April 10, 2020 Category: Pathology Tags: Review Articles Source Type: research

An Update on the Role of Immunohistochemistry in the Evaluation of Gastrointestinal Tract Disorders
As in other organ systems, immunohistochemistry (IHC) serves as an ancillary diagnostic tool for a wide variety of neoplastic and non-neoplastic disorders, including infections, work-up of inflammatory conditions, and subtyping neoplasms of the gastrointestinal (GI) tract. In addition, IHC is also used to detect a variety of prognostic and predictive molecular biomarkers for carcinomas of the GI tract. The purpose of this review is to highlight the use of IHC in common diagnostic scenarios throughout the tubular GI tract. The clinical indication and guidelines for performing IHC for detecting Helicobacter pylori is discuss...
Source: Advances in Anatomic Pathology - April 10, 2020 Category: Pathology Tags: Review Articles Source Type: research

A Comprehensive Review of Biomarker Use in the Gynecologic Tract Including Differential Diagnoses and Diagnostic Pitfalls
Morphologic (ie, hematoxylin and eosin) evaluation of the Mullerian tract remains the gold standard for diagnostic evaluation; nevertheless, ancillary/biomarker studies are increasingly utilized in daily practice to assist in the subclassification of gynecologic lesions and tumors. The most frequently utilized “biomarker” technique is immunohistochemistry; however, in situ hybridization (chromogenic and fluorescence), chromosomal evaluation, and molecular analysis can also be utilized to aid in diagnosis. This review focuses on the use of immunohistochemistry in the Mullerian tract, and discusses common antibod...
Source: Advances in Anatomic Pathology - April 10, 2020 Category: Pathology Tags: Review Articles Source Type: research

An Algorithmic Immunohistochemical Approach to Define Tumor Type and Assign Site of Origin
Immunohistochemistry represents an indispensable complement to an epidemiology and morphology-driven approach to tumor diagnosis and site of origin assignment. This review reflects the state of my current practice, based on 15-years’ experience in Pathology and a deep-dive into the literature, always striving to be better equipped to answer the age old questions, “What is it, and where is it from?” The tables and figures in this manuscript are the ones I “pull up on the computer” when I am teaching at the microscope and turn to myself when I am (frequently) stuck. This field is so exciting bec...
Source: Advances in Anatomic Pathology - April 10, 2020 Category: Pathology Tags: Review Articles Source Type: research

Immunohistochemistry in Surgical Pathology: Part 2
No abstract available (Source: Advances in Anatomic Pathology)
Source: Advances in Anatomic Pathology - April 10, 2020 Category: Pathology Tags: Editorial Source Type: research

Metastatic Cutaneous Basal Cell Carcinoma: Report of 2 Cases Preceding the Hedgehog Pathway Antagonists Era
We present retrospectively 2 personal cases of metastatic BCC of the skin, from the premolecular therapy era, from primary tumors that arose years before in the head and neck area. The former case occurred in a 45-year-old woman with a history of recurrent BCC of the retroauricular skin who eventually died due to diffuse metastatic spread. The latter case concerned a 70-year-old man also with a history of recurrent BCC of the nasal-perinasal skin who developed multiple subcutaneous and lymph node metastases in the neck. In both cases, the diagnoses were based on biopsies of the metastatic sites. The first patient died 5 mo...
Source: Advances in Anatomic Pathology - February 11, 2020 Category: Pathology Tags: AMR Series Source Type: research

Diabetic Kidney Disease: Past and Present
Diabetes mellitus (DM) afflicting humans has been recognized as a disease for>3000 years. However, very little was known about its etiology and pathogenesis until about a century ago when increasing knowledge about anatomy and physiology of the human body gradually led to our understanding that the hormone insulin produced by the Islets of Langerhans in the pancreas plays a crucial role in the metabolism of glucose and maintaining the blood sugar level within a normal range. DM is caused by inadequate insulin production (type 1) or insulin resistance (type 2). For thousands of years, DM has been considered as a disease ...
Source: Advances in Anatomic Pathology - February 11, 2020 Category: Pathology Tags: Review Articles Source Type: research

Practical Approach to the Histologic Diagnosis of Gastrointestinal Lymphomas Through the First-line Marker Battery of CD20, CD3, CD30, and Epstein-Barr Virus–encoded RNAs
The gastrointestinal (GI) tract is a prevalent site for extranodal lymphomas. Some subtypes of GI tract lymphomas are aggressive and have dismal clinical outcomes. Therefore, prompt histopathologic detection of such types can be very important. We thus introduce a practical approach in the histopathologic diagnosis of GI lymphomas according to the revised World Health Organization (WHO) classification. When lymphocyte proliferation is found in the GI tract, a stepwise approach can help narrow down the differential diagnoses. When considering subtype incidence, macroscopic findings, and microscopic patterns, applying a firs...
Source: Advances in Anatomic Pathology - February 11, 2020 Category: Pathology Tags: Review Articles Source Type: research

Lymphoid Neoplasms With Plasmablastic Differentiation: A Comprehensive Review and Diagnostic Approaches
Plasmablastic neoplasms encompass several entities including plasmablastic lymphoma, plasmablastic plasmacytoma/multiple myeloma, primary effusion lymphoma and its extracavitary variant, anaplastic lymphoma kinase–positive large B-cell lymphoma, and Kaposi sarcoma–associated herpesvirus/human herpesvirus 8 (HHV8)-positive diffuse large B-cell lymphoma, not otherwise specified. Morphologically, the tumor cells are large with eccentrically located nuclei, prominent nucleoli, and basophilic/amphophilic cytoplasm. Immunophenotypically, the tumor cells express plasma cell–related antigens including CD38, CD138...
Source: Advances in Anatomic Pathology - February 11, 2020 Category: Pathology Tags: Review Articles Source Type: research

Sinonasal Undifferentiated Carcinoma (SNUC): From an Entity to Morphologic Pattern and Back Again—A Historical Perspective
Since the first description of sinonasal undifferentiated carcinoma (SNUC) as a distinctive highly aggressive sinonasal neoplasm with probable origin from the sinonasal mucosa (Schneiderian epithelium), SNUC has been the subject of ongoing study and controversy. In particular, the SNUC category gradually became a “wastebasket” for any undifferentiated or unclassifiable sinonasal malignancy of definite or probable epithelial origin. However, with the availability of more specific and sensitive immunohistochemical antibodies and increasing implementation of novel genetic tools, the historical SNUC category became...
Source: Advances in Anatomic Pathology - February 11, 2020 Category: Pathology Tags: Review Articles Source Type: research

Genomic Molecular Classification of CNS Malignancies
Molecular studies have identified distinct genomic drivers providing insights in biology of brain tumors. Advances in genetic and epigenetic analysis, as well as development of mutation-specific antibodies enable more accurate classification of histologically indistinguishable tumors. Compared with histopathologic grading, molecular biomarkers are also superior in predicting natural behavior of tumors and therapeutic response. Diffuse gliomas can be separated in astrocytoma and oligodendroglioma based on IDH1/2, ATRX, and TP53 mutational status. Pediatric gliomas are molecularly distinct from adult tumors and molecular dri...
Source: Advances in Anatomic Pathology - December 7, 2019 Category: Pathology Tags: Review Articles Source Type: research

Updates on the Genomics of Bladder Cancer and Novel Molecular Taxonomy
Urothelial carcinoma (UC) is the most common malignant neoplasm of the bladder that encompasses a wide spectrum of histopathologic features and various molecular alterations and subtypes, responsible for its significant morphologic and genomic heterogeneity. Morphologically, in addition to classic UC (not otherwise specified), many well documented variant histologies are a common finding in invasive UC, and include squamous, glandular, micropapillary, sarcomatoid, small cell/neuroendocrine, clear cell, lymphoepithelioma-like, and plasmacytoid types, among others. This review provides an update on the recent advances in the...
Source: Advances in Anatomic Pathology - December 7, 2019 Category: Pathology Tags: Review Articles Source Type: research

Molecular Classification of Breast Cancer
Cancer classification aims to provide an accurate diagnosis of the disease and prediction of tumor behavior to facilitate oncologic decision making. Traditional breast cancer classification, mainly based on clinicopathologic features and assessment of routine biomarkers, may not capture the varied clinical courses of individual breast cancers. The underlying biology in cancer development and progression is complicated. Recent findings from high-throughput technologies added important information with regard to the underlying genetic alterations and the biological events in breast cancer. The information provides insights i...
Source: Advances in Anatomic Pathology - December 7, 2019 Category: Pathology Tags: Review Articles Source Type: research

Molecular Pathology of Colorectal Cancer
Colorectal cancer (CRC) is the third most commonly diagnosed cancer. This review gives an overview of the current knowledge of molecular mechanisms of colorectal carcinogenesis and the role of molecular testing in the management of CRC. The majority of CRCs arise from precursor lesions such as adenoma, transforming to adenocarcinoma. Three molecular carcinogenesis pathways have been identified; (1) chromosomal instability, (2) microsatellite instability (MSI), and (3) CpG island methylator phenotype, each account for ~85%, 15%, and 17%, respectively. Evaluation of MSI status, extended RAS mutation analysis, and BRAF mutati...
Source: Advances in Anatomic Pathology - December 7, 2019 Category: Pathology Tags: Review Articles Source Type: research

The Genomic and Molecular Pathology of Prostate Cancer: Clinical Implications for Diagnosis, Prognosis, and Therapy
Prostate cancer (PCa) is the most common noncutaneous malignancy affecting American men and the second most common cause of cancer death. The traditional risk classification schemes for PCa are limited due to the vast clinical and molecular heterogeneity of the disease. Fortunately, recent advancements in sequencing technologies have provided us with valuable insight into the genomics of PCa. To date, a wide array of recurrent genomic alterations in PCa have been identified. Incorporating these distinct molecular subtypes of PCa into prediction models provides opportunities for improved risk stratification and ultimately b...
Source: Advances in Anatomic Pathology - December 7, 2019 Category: Pathology Tags: Review Articles Source Type: research

Non–Small Cell Lung Cancer as a Precision Oncology Paradigm: Emerging Targets and Tumor Mutational Burden (TMB)
Non–small cell lung cancer (NSCLC), since the recognition of epidermal growth factor receptor (EGFR) mutations that sensitized tumors to EGFR tyrosine kinase inhibitors, has been a poster child for precision oncology in solid tumors. The emergence of resistance to the EGFR tyrosine kinase inhibitors led to the unveiling of multiple resistance mechanisms that are now recognized to be frequent mechanisms across multiple tumor types. Coevolution of technological advancements in testing methods available to clinical laboratories now has identified a growing number of molecularly defined subsets of NSCLC that have new the...
Source: Advances in Anatomic Pathology - December 7, 2019 Category: Pathology Tags: Review Articles Source Type: research

The Ever Changing Landscape of Anatomic Pathology Practice
No abstract available (Source: Advances in Anatomic Pathology)
Source: Advances in Anatomic Pathology - December 7, 2019 Category: Pathology Tags: Editorial Source Type: research

Classification of Endometrial Carcinoma: New Perspectives Beyond Morphology
Endometrial carcinoma has been traditionally divided into type 1 or endometrioid type that is usually moderate to well differentiated and type 2 that is usually poorly differentiated with high histologic grade and aggressive clinical behavior. However, interobserver diagnostic agreement is suboptimal, particularly among the high-grade histotypes. Furthermore, recent data indicate that this histotype assignment does not independently correlate with survival. In recent years, there has been remarkable progress in our understanding of the molecular basis of endometrial carcinoma and extensive molecular studies have been perfo...
Source: Advances in Anatomic Pathology - October 9, 2019 Category: Pathology Tags: Review Articles Source Type: research

Immunohistochemistry as a Genetic Surrogate in Dermatopathology: Pearls and Pitfalls
Immunohistochemistry (IHC) is routinely performed in most laboratories, and other than purchase of commercially available antibodies, requires no additional equipment or reagents. As such, IHC is an accessible and relatively inexpensive test and one that can be performed quite quickly. This is in sharp contrast to genomic or mutational testing methodologies that are routinely “send out” tests as they require specialized equipment and reagents as well as individuals with expertise in the performance of the tests and analysis of the results, resulting in a prolonged turn-round-time and enhanced associated costs. ...
Source: Advances in Anatomic Pathology - October 9, 2019 Category: Pathology Tags: Review Articles Source Type: research

Primary Mediastinal Nodal and Extranodal Non-Hodgkin Lymphomas: Current Concepts, Historical Evolution, and Useful Diagnostic Approach: Part 2
Primary mediastinal non-Hodgkin lymphomas (PM-NHLs) represent ∼5% of all non-Hodgkin lymphomas (NHLs) and comprise lymphomas of B-cell and T-cell origin. PM-NHLs are defined as involvement of mediastinal lymph nodes, thymus, and/or mediastinal organs (heart, lung, pleura, pericardium) by NHL without evidence of systemic disease at presentation. The clinical scenario is variable and depends on the lymphoma subtype. The radiologic presentation is also variable ranging from a mediastinal mass with or without superior vena cava syndrome, a pleural or a cardiac mass associated with effusion, or as an effusion only. The diag...
Source: Advances in Anatomic Pathology - October 9, 2019 Category: Pathology Tags: Review Articles Source Type: research

Primary Mediastinal Nodal and Extranodal Non-Hodgkin Lymphomas: Current Concepts, Historical Evolution, and Useful Diagnostic Approach: Part 1
Primary mediastinal non-Hodgkin lymphomas (PM-NHLs) represent ~5% of all NHLs and comprise lymphomas of B-cell and T-cell origin. PM-NHLs are defined as involvement of mediastinal lymph nodes, thymus, and/or mediastinal organs (heart, lung, pleura, pericardium) by NHL without evidence of systemic disease at presentation. The clinical scenario is variable and depends on the lymphoma subtype. The radiologic presentation is also variable ranging from a mediastinal mass with or without superior vena cava syndrome, a pleural or a cardiac mass associated with an effusion, or as an effusion only. The diagnosis of PM-NHLs can only...
Source: Advances in Anatomic Pathology - October 9, 2019 Category: Pathology Tags: Review Articles Source Type: research

Thymic Mucoepidermoid Carcinoma: A Systematic Review and Meta-analysis
Thymic mucoepidermoid carcinoma is a rare tumor that remains poorly characterized and a diagnostic challenge. The aim of this review is to characterize this tumor in a larger cohort of patients using all the available cases in the literature. We systematically searched the PubMed and Scopus database for primary thymic mucoepidermoid carcinoma. A total of 24 studies were included in the final analysis. A total of 41 patients were identified; 23 (56.1%) were male and 18 (43.9%) were female. Mean age was 49.8±21.3 years. Mean tumor size was 7.6±3.5 cm. Twenty (66.7%) were low grade and 8 (26.7%) were high...
Source: Advances in Anatomic Pathology - October 9, 2019 Category: Pathology Tags: Review Articles Source Type: research

A Comprehensive Review of Ovarian Serous Carcinoma
Although ovarian serous carcinoma is a well-studied human gynecologic malignancy, this high-grade tumor remains fatal. The main purpose of this review is to summarize the accumulated evidence on serous malignant tumors and to clarify the unresolved issues. We discuss the 8 dichotomies of serous carcinoma: high grade versus low grade, ovarian versus extraovarian primary, extrauterine versus uterine primary, sporadic versus hereditary, orthodox versus alternative histology, p53 overexpression versus complete absence of immunophenotype, TP53-mutated versus intact precursor, and therapy responsive versus refractory. In additio...
Source: Advances in Anatomic Pathology - August 9, 2019 Category: Pathology Tags: Review Article Source Type: research

Phosphaturic Mesenchymal Tumor of Soft Tissue of the Foot: Report of a Case With Review of the Literature
We report a case of a PMT in a young adult male who presented in 2007 with the classic constellation of signs and symptoms. A small soft-tissue tumor was detected in his right heel, 3 years after exhaustively seeking for it by various imaging techniques performed at different institutions. Before the tumor was detected, attempts to manage this patient’s osteomalacia with phosphate and vitamin D (both calcitriol and ergocalciferol) supplementation were unsuccessful. Following surgical resection, the patient experienced prompt correction of the phosphaturia and gradual reconstitution of his bone mineralization. The pat...
Source: Advances in Anatomic Pathology - August 9, 2019 Category: Pathology Tags: AMR Series Source Type: research

Urothelial Carcinoma In Situ (CIS): New Insights
Urothelial carcinoma in situ (CIS) is a high-grade noninvasive malignancy with a high tendency of progression. Although it is typically grouped with other nonmuscle invasive bladder cancers, its higher grade and aggressiveness make it a unique clinical entity. Urothelial CIS is histologically characterized by replacement of the urothelium by cells which fulfill the morphologic criteria of malignancy including nuclear pleomorphism, hyperchromasia, prominent nucleoli, and increased numbers of normal and abnormal mitoses. Urothelial CIS may be categorized as primary when it is not associated with any past or present urothelia...
Source: Advances in Anatomic Pathology - August 9, 2019 Category: Pathology Tags: Review Articles Source Type: research

Celiac Disease: Updates on Pathology and Differential Diagnosis
Celiac disease is a gluten-triggered immune-mediated disorder, characterized by inflammation of the enteric mucosa following lymphocytic infiltration and eventually resulting in villous blunting. There have been many developments in refining diagnostic laboratory tests for celiac disease in the last decade. Biopsy-sparing diagnostic guidelines have been proposed and validated in a few recent prospective studies. However, despite these developments, histologic evaluation of duodenal mucosa remains one of the most essential diagnostic tools as it helps in the diagnosis of celiac disease in individuals who do not fulfill the ...
Source: Advances in Anatomic Pathology - August 9, 2019 Category: Pathology Tags: Review Articles Source Type: research

Utility of Cyclin D1 in the Diagnostic Workup of Hematopoietic Neoplasms: What Can Cyclin D1 Do for Us?
Cyclin D1, encoded by CCND1, promotes cell cycle progression from G1 to S phase. Its expression is induced by MAPK/ERK pathway as well as translocations/rearrangements involving CCND1 gene. The evaluation of cyclin D1 expression by immunohistochemistry plays an important role in the diagnostic workup of various hematopoietic diseases. In this review, we aimed to discuss the value of cyclin D1 immunostain in the diagnosis and different diagnosis of hematopoietic neoplasms. (Source: Advances in Anatomic Pathology)
Source: Advances in Anatomic Pathology - August 9, 2019 Category: Pathology Tags: Review Articles Source Type: research

Determination of Mismatch Repair Status in Human Cancer and Its Clinical Significance: Does One Size Fit All?
The clinical management of cancers has progressed rapidly into the immunopathology era, with the unprecedented histology-agnostic approval of pembrolizumab in mismatch repair (MMR) deficient tumors. Despite the significant recent achievements in the treatment of these patients, however, the identification of clinically relevant subclasses of cancers based on the MMR status remains a major challenge. Many investigations have assessed the role of different diagnostic tools, including immunohistochemistry, microsatellite instability, and tumor mutational burden in both prognostic and therapeutic settings, with heterogenous re...
Source: Advances in Anatomic Pathology - June 12, 2019 Category: Pathology Tags: Review Articles Source Type: research

Non-Neoplastic and Benign Tumoral Lesions of the Thymic Gland: A Review and Update
The thymus is a dynamic organ that undergoes changes throughout life and can demonstrate a myriad of pathologic alterations. A number of benign entities of the thymus prove to be diagnostic dilemmas owing to their resemblance and association with true thymic tumors. These are usually discovered incidentally on routine imaging and most patients are either asymptomatic or present with signs and symptoms of compression of adjacent organs. The radiologic appearance of these lesions varies from simple cysts to complex masses that are suspicious for malignancy. The diagnosis is usually made purely on morphologic grounds, however...
Source: Advances in Anatomic Pathology - June 12, 2019 Category: Pathology Tags: Review Articles Source Type: research

Intrinsic Molecular Subclassification of Urothelial Carcinoma of the Bladder: Are We Finally there?
Bladder cancer is a highly prevalent disease throughout the world usually encountered in older patients, and associated with substantial morbidity, mortality, and cost. The treatment of bladder cancer has remained unchanged for the last several decades. However, in recent years the availability of comprehensive genomic data from The Cancer Genome Atlas and other large projects have considerably improved our understanding of the pathogenesis of these tumors. These studies demonstrated that bladder cancers can be grouped into 2 broad categories namely basal and luminal molecular subtypes with recognizable subgroups in each o...
Source: Advances in Anatomic Pathology - June 12, 2019 Category: Pathology Tags: Review Articles Source Type: research

Well-differentiated Neuroendocrine Carcinoma of the Larynx: Confusion of Terminology and Uncertainty of Early Studies
Well-differentiated neuroendocrine carcinoma (also known as “carcinoid”) of the larynx is an exceedingly rare tumor that has an epithelial origin. These tumors are malignant and have a low, but definite, risk of metastasis. Although it can be challenging, this tumor should be differentiated from moderately differentiated neuroendocrine carcinoma (also known as “atypical carcinoid”). The clinical and pathologic features of this tumor, as well as treatment and prognosis, are reviewed in detail. (Source: Advances in Anatomic Pathology)
Source: Advances in Anatomic Pathology - June 12, 2019 Category: Pathology Tags: Review Articles Source Type: research

Pathogenesis of Testicular Germ Cell Neoplasia: A Conceptual Approach
Testicular germ cell tumors are a diverse group of neoplasms, consisting of the prepubertal type 1 tumors, pure teratoma, and pure yolk sac tumor, the type 2 tumors, which are biologically malignant, preceded by germ cell neoplasia in situ, and harbor chromosome 12p abnormalities, and the type 3 tumor, spermatocytic tumor, which features chromosome 9p amplification.1 These arise in distinct clinical settings, and harbor distinct genetic abnormalities, immunohistochemical properties, and morphologic features. Here we have attempted to unify embryology, morphology, immunohistochemistry, and genetics in order to distill this ...
Source: Advances in Anatomic Pathology - June 12, 2019 Category: Pathology Tags: Review Articles Source Type: research

Fibrosing/Sclerosing Lesions of the Mediastinum: A Review
Fibrosing lesions of the mediastinum represent a small but challenging group of lesions that range in etiology from infectious to idiopathic to neoplastic. The diagnosis of such lesions becomes more challenging in the setting of mediastinoscopic biopsies. In addition, over the years, there has been further accumulation of knowledge of the clinical aspects of these lesions that needs to be incorporated into their evaluation. Therefore, it is essential that in the general evaluation of these fibrosing processes, one not only carefully examines the histopathologic features of the lesion, that of a fibroinflammatory process wi...
Source: Advances in Anatomic Pathology - June 12, 2019 Category: Pathology Tags: Review Articles Source Type: research

Evaluation of Breast and Axillary Lymph Node Specimens in Breast Cancer Patients Treated With Neoadjuvant Systemic Therapy
This article reviews the key issues regarding the gross and microscopic evaluation of post-neoadjuvant systemic therapy breast and lymph node specimens, and emphasizes the importance of accurate specimen evaluation in assessing treatment response. (Source: Advances in Anatomic Pathology)
Source: Advances in Anatomic Pathology - June 12, 2019 Category: Pathology Tags: Review Articles Source Type: research

One Actor, Many Roles: Histopathologies Associated With: APOL1: Genetic Variants
Genetic variants in APOL1, encoding apolipoprotein L1, are major drivers of glomerular disease in peoples of sub-Saharan African descent. APOL1-associated primary glomerular diseases include focal segmental glomerulosclerosis, human immunodeficiency virus-associated nephropathies, and arterionephrosclerosis. Other conditions where APOL1 variants affect outcomes include membranous nephropathy, lupus nephritis, diabetic nephropathy, preeclampsia, and kidney transplant. In focal segmental glomerulosclerosis, APOL1 variants are associated with upregulation of RNA encoding chemokine C-X-C motif receptor 3 ligands and ubiquitin ...
Source: Advances in Anatomic Pathology - April 11, 2019 Category: Pathology Tags: Review Articles Source Type: research

The Implementation of an Introductory Surgical Pathology Didactic Series to Transition First Year Residents and Facilitate Upper Level Resident Teaching
The increasing complexity of the practice of pathology and health care in general requires that pathology residents acquire a vast number of skills during their training. This has been reflected by the broad range of skills addressed in the Accreditation Council for Graduate Medical Education (ACGME) milestones. In order to address some of these milestones, our residency program instituted an introductory didactic series in surgical pathology that focused on 2 objectives. First, the didactics provided basic grossing and histology training to first year residents transitioning from medical school. Second, the sessions allow...
Source: Advances in Anatomic Pathology - April 11, 2019 Category: Pathology Tags: Review Articles Source Type: research

New and Emerging Biomarkers in Endocrine Pathology
Significant advances in genomics and molecular genetics in recent years have reshaped the practice of endocrine pathology. Pan-genomic studies, including the pioneering ones on papillary thyroid carcinoma, phaeochromocytoma/paraganglioma, and adrenal cortical carcinoma from the Cancer Genome Atlas (TCGA) project, provided a comprehensive integrated genomic analysis of endocrine tumors into distinct molecularly defined subtypes. Better understanding of the molecular landscape and more accurate definition of biological behavior has been accordingly achieved. Nevertheless, how any of these advances are translated into routine...
Source: Advances in Anatomic Pathology - April 11, 2019 Category: Pathology Tags: Review Articles Source Type: research

Epithelioid Vascular Tumors: A Review
Vascular tumors are a diagnostically challenging area. This is particularly true in the case of epithelioid vascular tumors. Not only is the distinction between different epithelioid vascular tumors challenging, but also the differential diagnosis may be substantially expanded by the inclusion of melanoma, carcinomas, and other epithelioid soft tissue tumors. Recently developed immunohistochemical markers and more comprehensive genetic characterizations continue to advance our understanding of epithelioid vascular tumors. The present paper briefly reviews and updates basic concepts with regard to the following epithelioid ...
Source: Advances in Anatomic Pathology - April 11, 2019 Category: Pathology Tags: Review Articles Source Type: research

Iatrogenic Disease of the Genitourinary Tract
The objective of this review is to cover iatrogenic inflammatory diseases, pseudotumors and tumors of the kidney, bladder, prostate, testis and paratestis of most interest to surgical pathologists. For this reason, disease caused by the following will not be covered: iatrogenic glomerulonephritis, self-inflicted injury including the introduction of foreign bodies, surgical error, drugs of abuse and herbal medications, and iatrogenic disease in the transplant setting including ischemia/reperfusion injury. Emphasis is placed upon commonly encountered diseases in order to ensure that the review is of utility to practicing pat...
Source: Advances in Anatomic Pathology - April 11, 2019 Category: Pathology Tags: Review Articles Source Type: research

Review of Drug-induced Injury in Mucosal Biopsies From the Tubular Gastrointestinal Tract
The use of prescription and over-the-counter medications is on the rise in the US population, especially among those aged 65 and over, with over 46% of the population taking at least 1 prescription medication. Given the frequency of medication use, and that the majority of these medications are taken orally, it has become increasingly relevant for pathologist examining endoscopically obtained gastrointestinal tract mucosal biopsies to consider and recognize patterns of mucosal injury associated with various drugs. Reports on injuries associated with certain classes of drugs can be scattered among different sources, making ...
Source: Advances in Anatomic Pathology - April 11, 2019 Category: Pathology Tags: Review Articles Source Type: research

Anaplastic Kaposi’s Sarcoma of the Adrenal in an HIV-negative Patient With Literature Review
We report a case of anaplastic retroperitoneal KS, occurring in an HIV-negative adult man. This patient presented with a huge left suprarenal mass, which was totally resected, and initially diagnosed as inflammatory leiomyosarcoma, because of the monomorphic spindle cell tumor morphology. After 12 years the tumor recurred locally as an unresectable mass, which was biopsied and examined. At the time of recurrence, the histologic slides of the primary tumor were reviewed, and the previous diagnosis was changed to that of atypical KS. Histologically the recurrent tumor showed both spindle cell and epithelioid appearances. Str...
Source: Advances in Anatomic Pathology - February 12, 2019 Category: Pathology Tags: AMR Series Source Type: research

Papillary Renal Cell Carcinoma (PRCC): An Update
Papillary renal cell carcinoma (PRCC) is the second most common type of renal carcinoma following clear cell renal cell carcinoma. Papillary renal cell carcinoma is usually divided histologically into 2 types namely, type 1 and type 2. This classification, however, is unsatisfactory as many of papillary carcinoma are unclassifiable by the existing criteria. In recent years there has been a remarkable progress in our understanding of the molecular basis of PRCC. These studies have revealed that type 2 PRCCs represent a heterogenous group which may be subdivided into additional subtypes based on the genetic and molecular mak...
Source: Advances in Anatomic Pathology - February 12, 2019 Category: Pathology Tags: Review Articles Source Type: research

Update on Molecular Testing for Cytologically Indeterminate Thyroid Nodules
Fine needle aspiration biopsy (FNAB) and ultrasonography are the most common modalities for the diagnosis and follow up of thyroid nodules. FNAB is able to distinguish benign from malignant nodules with high sensitivity and specificity; however, 20% to 30% of nodules are diagnosed as indeterminate with a risk of malignancy varying from 10% to 75% based on the 2017 revision of the Bethesda System for Reporting Thyroid Cytopathology. Molecular tests are being increasingly used to triage this group of nodules. Several molecular tests are commercially available and newer upgrades are being developed to either “rule in&rd...
Source: Advances in Anatomic Pathology - February 12, 2019 Category: Pathology Tags: Review Articles Source Type: research