Diagnosis and Pathologic Reporting of Prostate Cancer in the Era of MRI-Targeted Prostate Biopsy
Historically, the detection of prostate cancer relied upon a systematic yet random sampling of the prostate by transrectal ultrasound guided biopsy. This approach was a nontargeted technique that led to the under detection of cancers at biopsy and the upgrading of cancers at radical prostatectomy. Multiparametric MRI-targeted prostate biopsy allows for an image-directed approach to the identification of prostate cancer. MRI-targeted biopsy of the prostate is superior for the detection of clinically significant prostate cancer. As this technique has become more prevalent among urologists, pathologists need to recognize how ...
Source: Surgical Pathology Clinics - October 12, 2022 Category: Pathology Authors: Benjamin L. Coiner, Soroush Rais-Bahrami, Jennifer B. Gordetsky Source Type: research

Urothelial Carcinoma
Urothelial carcinoma (UC) is known to encompass a wide spectrum of morphologic features and molecular alterations. Approximately 15% to 25% of invasive UC exhibits histomorphologic features in the form of “divergent differentiation” along other epithelial lineages, or different “subtypes” of urothelial or sarcomatoid differentiation. It is recommended that the percentage of divergent differentiation and or subtype(s) be reported whenever possible. Recent advances in molecular biology have led to a better understanding of the molecular underpinning of these morphologic variations. In this review, we highlight histol...
Source: Surgical Pathology Clinics - October 12, 2022 Category: Pathology Authors: Jatin Gandhi, Jie-Fu Chen, Hikmat Al-Ahmadie Source Type: research

Molecular Taxonomy and Immune Checkpoint Therapy in Bladder Cancer
Bladder cancer is a heterogeneous disease, which exhibits a wide spectrum of clinical and pathologic features. Recent genomic studies have revealed that distinct molecular alterations may underlie the diverse clinical behaviors of bladder cancer, leading to a novel molecular classification. The intrinsic molecular subtypes exhibit distinct gene expression signatures and different clinicopathologic features. Genomic alterations also underlie the development of bladder cancer histologic subtypes. Genomic characterization provides new insights to understanding the biology of bladder cancer and improves the diagnosis and treat...
Source: Surgical Pathology Clinics - October 12, 2022 Category: Pathology Authors: Charles C. Guo, Bogdan Czerniak Source Type: research

How New Developments Impact Diagnosis in Existing Renal Neoplasms
In recent years, several emerging diagnostic entities have been described in renal cell carcinoma (RCC). However, our understanding of well-known and established entities has also grown. Clear cell papillary RCC is now relabeled as a tumor rather than carcinoma in view of its nonaggressive behavior. Renal tumors with a predominantly infiltrative pattern are very important for recognition, as most of these have aggressive behavior, including fumarate hydratase-deficient RCC, SMARCB1-deficient medullary carcinoma, collecting duct carcinoma, urothelial carcinoma, and metastases from other cancers. (Source: Surgical Pathology Clinics)
Source: Surgical Pathology Clinics - October 12, 2022 Category: Pathology Authors: Mahmut Akgul, Sean R. Williamson Source Type: research

Kidney Tumors
This review summarizes current knowledge on several novel and emerging renal entities, including eosinophilic solid and cystic renal cell carcinoma (RCC), RCC with fibromyomatous stroma, anaplastic lymphoma kinase-rearranged RCC, low-grade oncocytic renal tumor, eosinophilic vacuolated tumor, thyroidlike follicular RCC, and biphasic hyalinizing psammomatous RCC. Their clinical features, gross and microscopic morphology, immunohistochemistry, and molecular and genetic features are described. The diagnosis of most of them rests on recognizing their morphologic features using immunohistochemistry. Accurate diagnosis of these ...
Source: Surgical Pathology Clinics - October 12, 2022 Category: Pathology Authors: Farshid Siadat, Mehdi Mansoor, Ondrej Hes, Kiril Trpkov Source Type: research

Testicular Tumors
This article reviews the recent advances and potential future changes in the classification of testicular germ cell and sex cord stromal tumors, highlighting changes in the classification system and terminology with description on newer entities. A discussion on approaching difficult areas and diagnostic pitfalls is also included along with the utility of ancillary investigations. Areas with limited knowledge are highlighted to providing direction for future studies and a bulleted summary in the form of critical care points is provided. (Source: Surgical Pathology Clinics)
Source: Surgical Pathology Clinics - October 12, 2022 Category: Pathology Authors: Abhishek Dashora, Thomas Wagner, Daniel M. Berney Source Type: research

Prostate Cancer
The Gleason scoring system and Grade Group systems facilitate accurate grading and reporting of prostate cancer, which are essential tasks for surgical pathologists. Gleason Pattern 4 is critical to recognize because it signifies a risk for more aggressive behavior than Gleason Pattern 3 carcinoma. Prostatic adenocarcinoma with radiation or androgen therapy effect, with aberrant P63 expression, or with Paneth cell –like differentiation represent pitfalls in prostate cancer grading because although they display architecture associated with aggressive behavior in usual prostatic adenocarcinoma, they do not behave aggressiv...
Source: Surgical Pathology Clinics - October 12, 2022 Category: Pathology Authors: Ezra Baraban, Jonathan Epstein Source Type: research

Update on Flat and Papillary Urothelial Lesions
The reporting recommendations on “flat and papillary urothelial neoplasia,” published in 2 position articles by the Genitourinary Pathology Society in July 2021, was a collective contribution of 38 multidisciplinary experts aiming to clarify nomenclature, classification of flat and papillary urothelial neoplasia and controversi al issues. In this review, we discuss some of these recommendations including nomenclature, practical approaches, and their importance for clinical practice. (Source: Surgical Pathology Clinics)
Source: Surgical Pathology Clinics - October 12, 2022 Category: Pathology Authors: Eva Comp érat, André Oszwald, Gabriel Wasinger, Shahrokh Shariat, Mahul Amin Source Type: research

Molecular Genetics of Prostate Cancer and Role of Genomic Testing
Prostate cancer (PCa) is characterized by profound genomic heterogeneity. Recent advances in personalized treatment entail an increasing need of genomic profiling. For localized PCa, gene expression assays can support clinical decisions regarding active surveillance and adjuvant treatment. In metastatic PCa, homologous recombination deficiency, microsatellite instability-high (MSI-H), and CDK12 deficiency constitute main actionable alterations. Alterations in DNA repair genes confer variable sensitivities to poly(ADP-ribose)polymerase inhibitors, and the use of genomic instability assays as predictive biomarker is still in...
Source: Surgical Pathology Clinics - October 12, 2022 Category: Pathology Authors: Dilara Akhoundova, Felix Y. Feng, Colin C. Pritchard, Mark A. Rubin Source Type: research

Urothelial Carcinoma
Staging and reporting of cancers of the urinary tract have undergone major changes in the past decade to meet the needs for improved patient management. Substantial progress has been made. There, however, remain issues that require further clarity, including the substaging of pT1 tumors, grading and reporting of tumors with grade heterogeneity, and following NAC. Multi-institutional collaborative studies with prospective data will further inform the accurate diagnosis, staging, and reporting of these tumors, and in conjunction with genomic data will ultimately contribute to precision and personalized patient management. (S...
Source: Surgical Pathology Clinics - October 12, 2022 Category: Pathology Authors: Manju Aron, Ming Zhou Source Type: research

Towards Precision Genitourinary Pathology
Precision medicine requires precision pathology, that is, precise and clinically relevant histopathologic classification, grading, staging, and reporting of cancer. Genitourinary Pathology Society (GUPS), an international organization aiming to advance the science and practice of urologic pathology, recently convened experts to review new and evolving concepts and controversial topics in prostate, bladder, and kidney cancer pathology in an effort to advance precision genitourinary pathology. Six position papers ensued. (Source: Surgical Pathology Clinics)
Source: Surgical Pathology Clinics - October 12, 2022 Category: Pathology Authors: Ming Zhou Tags: Preface Source Type: research

Integrating Molecular Analysis into the Pathologic Evaluation of Pancreatic Cysts
The development of cross-sectional imaging techniques has enhanced the detection of pancreatic cystic lesions (PCLs). PCLs are found in approximately 2% of the general population, often as incidentally detected lesions on computed tomography or MRI during the evaluation of other medical conditions. Broadly, PCLs are classified as mucinous or nonmucinous. Mucinous PCLs include mucinous cystic neoplasms and intraductal papillary mucinous neoplasms. Nonmucinous PCLs include pseudocysts, serous cystadenomas, solid pseudopapillary neoplasms, and cystic pancreatic neuroendocrine tumors, as well as cystic acinar cell carcinoma, c...
Source: Surgical Pathology Clinics - August 30, 2022 Category: Pathology Authors: Phoenix D. Bell, Aatur D. Singhi Source Type: research

The Clinical and Pathologic Features of Intracholecystic Papillary-Tubular Neoplasms of the Gallbladder
Intracholecystic papillary-tubular neoplasm denotes a discrete mucosal-based neoplastic proliferation into the gallbladder lumen. It is diagnosed incidentally during cholecystectomy or radiologically during a workup for abdominal pain. The majority of polypoid lesions in the gallbladder are non-neoplastic; therefore, pathologic examination is the gold standard to establish this diagnosis. Intracholecystic papillary-tubular neoplasm is considered as premalignant, although associated invasive carcinomas may be present in the specimen. Invasive carcinoma arising from intracholecystic papillary-tubular neoplasm have a better p...
Source: Surgical Pathology Clinics - August 30, 2022 Category: Pathology Authors: Heba Abdelal, Deyali Chatterjee Source Type: research

The Evolving Clinical, Pathologic, and Molecular Landscape of Pancreatobiliary Diseases
Pancreatobiliary diseases represent a heterogeneous and complex group of disorders that span a diverse number of benign and malignant conditions. Within the past few decades, there has been a dramatic increase in patients afflicted with these diseases. In addition, the diagnosis of many pancreatobiliary disorders has been a formidable challenge and has resulted in a significant burden on current health care resources. The treatment of pancreatobiliary diseases can also be associated with considerable patient morbidity and mortality. (Source: Surgical Pathology Clinics)
Source: Surgical Pathology Clinics - August 30, 2022 Category: Pathology Authors: Aatur D. Singhi Tags: Preface Source Type: research

Pancreatobiliary Pathology
SURGICAL PATHOLOGY CLINICS (Source: Surgical Pathology Clinics)
Source: Surgical Pathology Clinics - August 30, 2022 Category: Pathology Authors: Aatur D. Singhi Source Type: research