Diffuse Synaptophysin Expression in Aggressive Recurrent Castration-Resistant Acinar (Usual) Prostate Cancer: Case Report and Review of Prostatic Neuroendocrine Tumors
We present a case of metastatic acinar prostatic adenocarcinoma with neuroendocrine features with strong and diffuse synaptophysin expression, mimicking a metastatic neuroendocrine tumor. We review recognized prostatic neuroendocrine tumors, tumors with neuroendocrine differentiation requiring further investigation, relevant differential considerations, and recommended ancillary workup of challenging cases. (Source: Pathology Case Reviews)
Source: Pathology Case Reviews - May 1, 2020 Category: Pathology Tags: Case Reviews Source Type: research
Mixed Small Cell Neuroendocrine Carcinoma and Conventional Acinar Adenocarcinoma of the Prostate: A Case Report
Prostate cancer with neuroendocrine (NE) differentiation can be classified into six categories: conventional adenocarcinoma with NE differentiation, adenocarcinoma with Paneth cell–like NE differentiation, carcinoid tumor, small cell carcinoma, large cell carcinoma, and mixed NE carcinoma-acinar adenocarcinoma. Mixed NE carcinoma-acinar carcinoma is a biphasic carcinoma characterized by the presence of NE (small or large cell) carcinoma and conventional acinar adenocarcinoma. In rare cases, these two components overlap without discrete classic small cell carcinoma or a usual prostate adenocarcinoma component, making it p...
Source: Pathology Case Reviews - May 1, 2020 Category: Pathology Tags: Case Reviews Source Type: research
Hormone -Refractory Prostatic Adenocarcinoma Mimicking Basal Cell Carcinoma: A Case Report
In this report, we present a typical case of “double-negative” end-stage prostate cancer that morphologically resembled basal cell carcinoma of prostate, basaloid large nest type. (Source: Pathology Case Reviews)
Source: Pathology Case Reviews - May 1, 2020 Category: Pathology Tags: Case Reviews Source Type: research
The Morphologic Spectrum of Castration-Resistant Prostate Cancer: Case Reports and Literature Review
Conventional acinar prostatic carcinomas are dependent on the androgen receptor (AR) to proliferate. Androgen deprivation therapy (ADT) is a common treatment for prostate cancers that have metastasized and is also being administered as first-line therapy with or without radiation therapy for intermediate- or high-risk disease. Cancers that recur after initially responding to ADT, or castration-resistant prostatic carcinomas (CRPCs), have a poor prognosis and are more likely to show divergent differentiation than de novo carcinomas. This review will present four cases of CRPC to highlight the morphologic spectrum, discuss e...
Source: Pathology Case Reviews - May 1, 2020 Category: Pathology Tags: Case Reviews Source Type: research
Difficult Diagnosis of Difficult Entities of the Prostate
No abstract available (Source: Pathology Case Reviews)
Source: Pathology Case Reviews - May 1, 2020 Category: Pathology Tags: Editorial Source Type: research
A “Double-Hit” Translocation Sarcoma—First Report of the Co-occurrence of EWSR1-FLI1 and MTMR2-NTRK2 Fusion in a Small Round Blue Cell Sarcoma
We report a case of a 51-year-old man with primary diagnosis of Ewing sarcoma confined to the soft tissue, associated with EWSR1-FLI1 gene fusion demonstrated by fluorescence in situ hybridization (FISH). Six years after the diagnosis, immunohistochemistry for NTRK (neurotrophic receptor tyrosine kinase 1–3) was performed on this tumor using 2 Pan-Trk rabbit monoclonal antibodies, A7H6R (Cell Signaling Technology, Danvers, Mass) and EPR17341 (Abcam, Cambridge, Mass). Both clones showed diffuse moderate to strong cytoplasmic expression including presence of nuclear stain. RNA sequencing demonstrated the co-occurrence of M...
Source: Pathology Case Reviews - March 1, 2020 Category: Pathology Tags: Case Reports Source Type: research
Pancreatic Panniculitis—Not Just a Skin Disease
We present the case of a patient who presented with a 1-year history of intermittent nausea, bloating, and anorexia with computed tomography scan findings of a complex pancreatic cystic lesion, omental findings concerning for carcinomatosis, and ascites. She developed tender, erythematous, and hyperpigmented subcutaneous nodules on bilateral lower extremities that were first noted on admission. Pancreatic biopsy revealed pancreatic pseudocyst and laboratory findings on admission were consistent with pancreatitis and pancreatic ascites. Laparoscopic omental biopsies revealed multifocal, nodular fat necrosis and associated i...
Source: Pathology Case Reviews - March 1, 2020 Category: Pathology Tags: Case Reports Source Type: research
Case Report: Benign Phyllodes Tumor of the Vulva
Phyllodes tumor of the vulva is a rare tumor and is histologically similar to phyllodes tumor of the breast. Morphological and immunohistochemical features of a case are presented here. (Source: Pathology Case Reviews)
Source: Pathology Case Reviews - March 1, 2020 Category: Pathology Tags: Case Reports Source Type: research
When the Horse Has Stripes: Central Nervous System Blastomycosis Presenting as a Ring-Enhancing Lesion in an Immunocompetent Patient
A new, single, ring-enhancing lesion in the cortex of an immunocompetent individual has a broad differential diagnosis, although primary or metastatic malignancies are usually highest on the list. The presence of inflammation without overt malignancy, however, is cause for considerations that may require ancillary testing with fresh tissue and obtaining multiple frozen samples. Central nervous system (CNS) infection with blastomycosis is a rare but potentially fatal complication, with a mortality rate approaching 20% secondary to multiple factors including delay in presentation and diagnosis (Clin Infect Dis 2010;50:797–...
Source: Pathology Case Reviews - March 1, 2020 Category: Pathology Tags: Case Reviews Source Type: research
Pitfalls and Traps in Neuropathology
Impediments to making a correct diagnosis are avoided, and complex administrative efforts are used to make those impediments less frequent. There are quality control procedures, patient safety initiatives, and endless meetings attempting to lessen medical errors. Pitfalls and traps are encountered daily by pathologists, and most are avoided. Artifacts produce traps created by cautery, physical crush, thick sections, and drying and are well known. Appropriate deferral, recuts, stains, and collegial consultations aid in error avoidance in these instances. Neuropathology has some pitfalls and traps that are encountered infreq...
Source: Pathology Case Reviews - March 1, 2020 Category: Pathology Tags: Case Reviews Source Type: research
Mass in the Meninges: Meningioma Types and Grades
Tumors of the meninges are common, probably the most common tumor of the cranial vault. Meningiomas arise from the arachnoid, but because the arachnoid and dura are frequently fused, they may appear to be of dural origin. Meningiomas frequently arise from the arachnoid cap cells, which are arachnoidal projections into dural sinuses for reabsorption of cerebrospinal fluid. This explains the frequency of meningiomas found along the dural sinuses. Meningiomas are considered benign, but recurrences are common. More frequent recurrences are found with the higher grades. Complete surgical removal is associated with a good progno...
Source: Pathology Case Reviews - March 1, 2020 Category: Pathology Tags: Case Reviews Source Type: research
The Tale of Two Hedgehogs: Central Nervous System Embryonal Tumor Diagnosis in 3 Acts
Primitive embryonal tumors of the central nervous system have undergone considerable evolution in their categorization in the past century—most rapidly in the past decade with the application of molecular pathology in diagnosis. This presents numerous practical considerations when encountering one of these tumors. One may need to utilize multiple techniques to come to a prognostically accurate and actionable diagnosis. We review two cases, both with the final diagnosis of “medulloblastoma, SHH activated and TP53 wild type (World Health Organization grade IV).” These diagnoses were each arrived upon using separate, va...
Source: Pathology Case Reviews - March 1, 2020 Category: Pathology Tags: Case Reviews Source Type: research
A Posterior Fossa Mass in a 6-Year-Old
We present a case of pediatric medulloblastoma in which hematoxylin-eosin–stained tissue sections, reticulin special stain, immunohistochemistry, cytogenetics, and next-generation sequencing were implemented for the purpose of identifying subgroup and other markers of prognosis, such as TP53 mutation and MYC family member amplification. The discussion herein is aimed at reviewing current opinions on the integration of histomorphologic and molecular subgroups of medulloblastoma and providing a foundation for designing a practical and clinically meaningful approach to diagnosis. (Source: Pathology Case Reviews)
Source: Pathology Case Reviews - March 1, 2020 Category: Pathology Tags: Case Reviews Source Type: research
High-Grade Gliomas in Early Adulthood: A Case-Based Review of Current Molecular Diagnostic Considerations
High-grade gliomas in early adulthood (between the ages of 20 and 40 years) have a wide differential diagnosis that includes entities from childhood and late adulthood. These gliomas are increasingly defined by their molecular signatures, requiring a molecular-based workup that is informed by morphology and anatomy. Here we present four cases with four different diagnoses, some rare and some common, presenting with new brain lesions. This diagnostic process is informed by the 2016 World Health Organization guidelines, c-IMPACT Now updates, and the clinico-pathologic features shown by these high-grade tumors. Particularly, ...
Source: Pathology Case Reviews - March 1, 2020 Category: Pathology Tags: Case Reviews Source Type: research
Glial Tumors
Glial tumors comprise the majority of primary intra-axial intracranial tumors. Since its introduction in 2016, the revised fourth edition of the World Health Organization (WHO) classification of central nervous system tumors has changed the diagnostic and therapeutic approach in glial tumors (WHO Classification of Tumours of the Central Nervous System [revised fourth edition]; Lyon, France: IARC; 2016). Diffuse gliomas (WHO grades II–IV) are now molecularly stratified based on isocitrate dehydrogenase 1 or 2 mutation status and classified according to 1p/19q codeletion status into astrocytic or oligodendroglial type. Upd...
Source: Pathology Case Reviews - March 1, 2020 Category: Pathology Tags: Review Source Type: research
