Bench to bedside: research influencing clinical practice in breast cancer
Based on recent evidence derived from clinical trials and translational research, breast cancer pathology has witnessed a rapid increase in the utilization of predictive markers, companion diagnostics and molecular testing for tailored management of patients with breast cancer. New diagnostic entities with specific molecular phenotypes have also been included in the classification of breast cancer. Genomic assays including Oncotype DX ®21-gene Recurrence Score (RS), Prosigna and EndoPredict are currently used in routine practice to guide adjuvant/neoadjuvant therapy. (Source: Diagnostic Histopathology)
Source: Diagnostic Histopathology - September 6, 2022 Category: Pathology Authors: Abeer M Shaaban, Emily C Shaw Tags: Mini-symposium: Research influencing clinical practice Source Type: research
Editorial board
(Source: Diagnostic Histopathology)
Source: Diagnostic Histopathology - September 1, 2022 Category: Pathology Source Type: research
Placenta praevia percreta
Placenta percreta and praevia are rare and life-threatening causes of massive maternal haemorrhage. The incidence of concurrent placenta percreta and praevia has increased over recent years with the rising number of caesarean sections. Placenta praevia, defined as the ‘implantation of the placenta in the lower uterine cavity, completely or partially covering the internal os’, is the major risk factor for placenta accreta spectrum (PAS) in women with prior caesarean section. PAS is the abnormal adhesion of the placenta to the uterine wall and consists of three types; placenta accreta, increta and percreta. (Source: Diag...
Source: Diagnostic Histopathology - August 30, 2022 Category: Pathology Authors: Mai Kelleher, Gayathri Wathuge Tags: Short case Source Type: research
Bench to bedside: research influencing clinical practice in prostate pathology
Prostate cancer is biologically heterogeneous ranging from clinically indolent disease that “old men die with” to aggressive tumours that metastasise and cause death. Optimal management of this disease requires accurate prognostication to avoid over-treatment of the former and prompt appropriate treatment of the latter. Prognostication of prostate cancer is challenging as tumour is oft en not well visualized on radiological examination, is often detected in non-targeted systematic biopsies and cannot be subjected to a wide local excision for detailed histological examination. (Source: Diagnostic Histopathology)
Source: Diagnostic Histopathology - August 29, 2022 Category: Pathology Authors: Anna Elizabeth Mason, Murali Varma Tags: Mini-symposium: Research influencing clinical practice Source Type: research
A paediatric case of non-tuberculous mycobacterial infection in the neck
We discuss a case of rapid onset neck swelling in a paediatric patient with an underlying Mycobacterium avium infection. Surgical excision of the tissue revealed epithelioid granulomata with central caseating necrosis, background chronic inflammation and scanty acid-fast bacilli. Diagnosis of non-tuberculous mycobacterial infection can be reached using histological features, cultures and molecular techniques. Granulomatous inflammation has a range of infective and non-infective causes to consider when determining a diagnosis. (Source: Diagnostic Histopathology)
Source: Diagnostic Histopathology - August 28, 2022 Category: Pathology Authors: Clare McGenity, Katalin Dekany, Jens Stahlschmidt Tags: Short case Source Type: research
Infections in the gastrointestinal tract that can mimic malignancy
Infections in the gastrointestinal tract can present with the clinical impression of malignancy. These infectious mimics can take on a variety of forms from endoscopically concerning ulcers to large infiltrative masses and may be associated with lymphadenopathy and distant disease that is concerning for metastasis. In such cases, histopathology plays a key role in rendering a diagnosis of infection. In this review, we summarize the common and rare gastrointestinal infectious mimics of malignancy reported in the English medical literature. (Source: Diagnostic Histopathology)
Source: Diagnostic Histopathology - August 24, 2022 Category: Pathology Authors: David W. Dodington, Klaudia M. Nowak, Runjan Chetty Tags: Mini-symposium: Infections that mimic malignancy Source Type: research
Infections that mimic malignancy in the lung
Infections, especially granulomatous mycobacterial and fungal infections, are the most common benign mimics of malignancy in the lung. They frequently form lung nodules or masses with imaging features that raise the scepter of malignancy, including increase in size, spiculation, and fluorodeoxyglucose-avidity. Some, such as the solid variant of chronic necrotizing aspergillosis, occur in settings that increase the likelihood that they will be mistaken for a malignant process on clinical grounds (e.g., smokers with emphysema). (Source: Diagnostic Histopathology)
Source: Diagnostic Histopathology - August 24, 2022 Category: Pathology Authors: Nicole Zalles, Sanjay Mukhopadhyay Tags: Mini-symposium: Infections that mimic malignancy Source Type: research
Attackers and defenders: tumor buds and lymphocytes as morphological biomarkers in colorectal cancer
Tumor budding (TB) and tumor-infiltrating lymphocytes (TILs) are significant components of the tumor microenvironment emerging as prognostic biomarkers of colorectal cancer (CRC). TB is defined as single cells or clusters of up to four cancer cells dissociated from the tumor body and invading the surrounding stroma. Growing evidence supports TB's attacker effect in pT1 CRC and stage II colon cancer as an indicator of lymph node metastasis and unfavorable survival, respectively. TILs, in contrast, represent the host's ability against tumor progression as a defender. (Source: Diagnostic Histopathology)
Source: Diagnostic Histopathology - August 23, 2022 Category: Pathology Authors: Sonay Kus Öztürk, Tariq S. Haddad, Inti Zlobec, Alessandro Lugli, Iris D. Nagtegaal Tags: Mini-symposium: Research influencing clinical practice Source Type: research
The neuropathology of brain metastases
Metastatic brain disease frequently complicates extra central nervous system (CNS) neoplastic disease, with an increase in reported incidence over time. Brain parenchyma is the commonest anatomical site, with other lesions involving the spinal cord, dura and tissues surrounding the CNS. Metastases are usually characterised by a well-defined border with surrounding brain, although some can show an infiltrative edge. The use of appropriate immunohistochemical panels can help identify the origin of most tumours, and molecular testing should be performed according to the site of origin even if performed on a previous specimen ...
Source: Diagnostic Histopathology - August 12, 2022 Category: Pathology Authors: Mark Fabian, Mark Walker Tags: Mini-Symposium: Neuropathology Source Type: research
Transmissible human proteopathies: an expanding field
Prions are considered the prototype of transmissible proteopathies, and this property has for many decades been considered unique. More recently the transmissibility of other misfolded proteins, notably A β, tau and synuclein, has been recognized. Initially, the transmission of these proteins was shown experimentally but the relevance for humans was debated. The co-transmission of Aβ with prions through medical procedures involving preparations derived from cadaveric human tissues, such as human gr owth hormone treatment, dura mater transplants or the use of neurosurgical instruments carrying traces of Aβ protein has fu...
Source: Diagnostic Histopathology - August 12, 2022 Category: Pathology Authors: Zane Jaunmuktane, Sebastian Brandner Tags: Mini-symposium: neuropathology Source Type: research
Neuropathology of epilepsy: epilepsy-related deaths and SUDEP
Most pathologists will encounter deaths in patients with epilepsy in their practice, including sudden deaths. A systematic approach to these post-mortem examinations is required, including gathering relevant clinical details and around the circumstances of death, in order to correctly categorise these cases. Macroscopic and histological examination of the brain can reveal (i) the underlying cause of the epilepsy, as cortical dysplasia or tumours, (ii) sequel of previous seizures, including hippocampal sclerosis and contusions and (iii) potentially the cause of death. (Source: Diagnostic Histopathology)
Source: Diagnostic Histopathology - August 12, 2022 Category: Pathology Authors: Maria Thom Tags: Mini-Symposium: Neuropathology Source Type: research
Editorial board
(Source: Diagnostic Histopathology)
Source: Diagnostic Histopathology - August 1, 2022 Category: Pathology Source Type: research
Giant cell glioblastoma versus pleomorphic xanthroastrocytoma: a challenging case
Here we present a challenging case originally diagnosed as giant cell glioblastoma WHO grade 4 in a 48-year-old lady with a background of Li-Fraumeni syndrome. After an initial excision and neoadjuvant chemoradiotherapy the patient had a 5 year disease-free period before having a recurrence. The recurrent tumour alongside the original tumour were reviewed. By reviewing the clinical history and disease progression and combining this with improved genetic testing methodologies a reviewed diagnosis of anaplastic pleomorphic xanthoastrocytoma (PXA) WHO Grade 3 was made. (Source: Diagnostic Histopathology)
Source: Diagnostic Histopathology - July 16, 2022 Category: Pathology Authors: Kate Marks, Azzam Ismail Tags: Short case Source Type: research
Histological interpretation of temporal artery biopsies
Temporal artery biopsy is recommended for diagnosis of suspected giant cell arteritis, a systemic vasculitis of older adults. There is currently no formal consensus for histological interpretation of the biopsies. Typical histological findings include a transmural lymphocytic infiltrate with a population of macrophages resulting in destruction of the internal elastic lamina. However, it is a patchy process and multiple tissue levels must be examined. It is important to be aware of various subtle features that may lead to a diagnosis of arteritis, and immunohistochemistry can be helpful in some cases. (Source: Diagnostic Histopathology)
Source: Diagnostic Histopathology - July 13, 2022 Category: Pathology Authors: Mark Fabian, Mark Walker Tags: Mini-symposium: neuropathology Source Type: research
Quality assurance in cellular pathology
This review covers many of the different aspects involved in the quality assurance of cellular pathology reporting in the UK with a focus on gynaecological pathology. Although a minimum level of competence can be assumed upon completion of histopathology training, the maintenance of competency and its assessment throughout a consultant ’s career require continuing professional development (CPD), regular appraisal and revalidation, and participation in external quality assurance schemes. Leaving aside the problem of interobserver variability, the gold standard for assessing diagnostic accuracy is peer review of a consulta...
Source: Diagnostic Histopathology - July 4, 2022 Category: Pathology Authors: Saimah Arif, Jason Wong Tags: Mini-symposium: gynaecological pathology Source Type: research
