Clinicopathological characterization of follicular helper T-cell-derived peripheral T-cell lymphoma involving Waldeyer ’s ring
In conclusion, careful morphological observation combined with immunohistochemistry and molecular analysis would help in diagnosis of TFH-derived PTCL involving the Waldeyer ’s ring, which is a rare condition that frequently presents with atypical clinical manifestations. (Source: Virchows Archiv)
Source: Virchows Archiv - March 1, 2021 Category: Pathology Source Type: research

Loss of CTNNB1 exon 3 in sclerosing angiomatoid nodular transformation of the spleen
AbstractSclerosing angiomatoid nodular transformation (SANT) is a rare vascular lesion of the spleen. Although several hypotheses have been suggested, the etiopathogenesis of SANT remains unknown. It is also unclear whether SANT is a reactive or a neoplastic lesion. SinceCTNNB1 ( β-catenin gene) exon 3 mutations were frequently detected in some rare fibrovascular lesions, we aimed to investigate the presence of oncogenicCTNNB1 mutations in SANT cases. For this purpose, 7 cases of SANT with typical histopathological features were retrieved. First, the presence ofCTNNB1 exon 3 alterations was examined with a recently de...
Source: Virchows Archiv - March 1, 2021 Category: Pathology Source Type: research

Improving tumor budding reporting in colorectal cancer: a Delphi consensus study
AbstractTumor budding is a long-established independent adverse prognostic marker in colorectal cancer, yet methods for its assessment have varied widely. In an effort to standardize its reporting, a group of experts met in Bern, Switzerland, in 2016 to reach consensus on a single, international, evidence-based method for tumor budding assessment and reporting (International Tumor Budding Consensus Conference [ITBCC]). Tumor budding assessment using the ITBCC criteria has been validated in large cohorts of cancer patients and incorporated into several international colorectal cancer pathology and clinical guidelines. With ...
Source: Virchows Archiv - March 1, 2021 Category: Pathology Source Type: research

Intratumoral heterogeneity of surrogate molecular subtypes in urothelial carcinoma in situ of the urinary bladder: implications for prognostic stratification of high-risk non-muscle-invasive bladder cancer
In conclusion, further clarification of heterogeneity of surrogate subtypes in HR NMIBC and their prognostic value is of importance with regard to potential implementation of molecular subtyping into clinical routine. The potential prognostic usefulness of patient age and smoking status f or high-risk NMIBC patients with CIS needs further validation. (Source: Virchows Archiv)
Source: Virchows Archiv - March 1, 2021 Category: Pathology Source Type: research

Multifocal in situ mantle cell neoplasia of the ileocecal region: a case report with simultaneous nodal and extranodal involvement
We report an additional case, unusual by its presentation in the large intestine and its multifocal involvement of several nodal and extranodal sites. The diagnosis was made in a 46-year-old male patient from a surgical specimen resected for cecal adenocarcinoma. Gross examination showed multiple small polypoid lesions surrounding the ileocecal valve, corresponding to lymphoid aggregates with hyperplastic follicles. Numerous cyclin D1/SOX11+ lymphoid cells, harboring the t(11;14)(q13;q32) translocation, were present in the inner layers of mantle zones. The same lesions were found in the ileum, the appendix, and the regiona...
Source: Virchows Archiv - March 1, 2021 Category: Pathology Source Type: research

PBK expression predicts favorable survival in colorectal cancer patients
AbstractColorectal cancer (CRC) is one of the most common gastrointestinal cancers worldwide with high morbidity and mortality rates. The discovery of small molecule anticancer reagents has significantly affected cancer therapy. However, the anticancer effects of these therapies are not sufficient to completely cure CRC. PDZ-binding kinase (PBK) was initially identified as a mitotic kinase for mitogen-activated protein kinase and is involved in cytokinesis and spermatogenesis. Aberrant expression of PBK has been reported to be closely associated with malignant phenotypes of many cancers and/or patient survival. However, th...
Source: Virchows Archiv - February 27, 2021 Category: Pathology Source Type: research

Micronodular thymic carcinoma with lymphoid hyperplasia: relevance of immunohistochemistry with a small panel of antibodies for diagnosis —a RYTHMIC study
We present the experience of RYTHMIC, the French national network devoted to the treatment of thymic epithelial tumors through multidisciplinary tumor boards with a review of all tumors by pathologists for classification and staging. Six cases of MNTCLH were diagnosed during a review of 1007 thymic epithelial tumors. Histologically, epithelial cells with atypia and mitoses formed micronodules that were surrounded by an abundant lymphoid background with follicles. There was neither obvious fibro-inflammatory stroma nor necrosis. Spindle cells areas were common. Initial diagnosis was micronodular thymoma in two cases, cellul...
Source: Virchows Archiv - February 24, 2021 Category: Pathology Source Type: research

ESGO/ESTRO/ESP Guidelines for the management of patients with endometrial carcinoma
AbstractA European consensus conference on endometrial carcinoma was held in 2014 to produce multidisciplinary evidence-based guidelines on selected questions. Given the large body of literature on the management of endometrial carcinoma published since 2014, the European Society of Gynaecological Oncology (ESGO), the European SocieTy for Radiotherapy& Oncology (ESTRO) and the European Society of Pathology (ESP) jointly decided to update these evidence-based guidelines and to cover new topics in order to improve the quality of care for women with endometrial carcinoma across Europe and worldwide. ESGO/ESTRO/ESP nominat...
Source: Virchows Archiv - February 19, 2021 Category: Pathology Source Type: research

The pulmonary pathology of COVID-19
AbstractThe lung is the main affected organ in severe coronavirus disease 2019 (COVID-19) caused by the novel coronavirus SARS-CoV-2, and lung damage is the leading cause of death in the vast majority of patients. Mainly based on results obtained by autopsies, the seminal features of fatal COVID-19 have been described by many groups worldwide. Early changes encompass edema, epithelial damage, and capillaritis/endothelialitis, frequently combined with microthrombosis. Subsequently, patients with manifest respiratory insufficiency exhibit exudative diffuse alveolar damage (DAD) with hyaline membrane formation and pneumocyte ...
Source: Virchows Archiv - February 19, 2021 Category: Pathology Source Type: research

Is immunohistochemical expression of GATA3 helpful in the differential diagnosis of transformed mycosis fungoides and primary cutaneous CD30-positive T cell lymphoproliferative disorders?
AbstractMycosis fungoides with large cell transformation (MFLCT) can be difficult to distinguish from primary cutaneous CD30+ T cell lymphoproliferative disorders (PC CD30+ LPD), especially primary cutaneous anaplastic large cell lymphoma (PC-ALCL). This diagnostic distinction is critical for appropriate patient management. GATA3 has been proposed to be useful in the discrimination between these two entities. We identified 25 cases of MFLCT and 24 cases of PC CD30+ LPDs (including lymphomatoid papulosis (n=14), PC-ALCL (n=6), and CD30+ LPD, not otherwise specified (n=4)) diagnosed at our institution from 2002 to 2019. Sect...
Source: Virchows Archiv - February 18, 2021 Category: Pathology Source Type: research

Primary uterine ectomesenchymoma harboring a DICER1 mutation: case report with molecular analysis
This report describes the presence of ectomesenchymoma in an unusual primary organ and in an uncharacteristic age and presents novel data regarding the genetic characteristics of this tumor. (Source: Virchows Archiv)
Source: Virchows Archiv - February 17, 2021 Category: Pathology Source Type: research

Insulitis in the pancreas of non-diabetic organ donors under age 25 years with multiple circulating autoantibodies against islet cell antigens
AbstractAutoantibodies against islet cell antigens are routinely used to identify subjects at increased risk of symptomatic type 1 diabetes, but their relation to the intra-islet pathogenetic process that leads to positivity for these markers is poorly understood. We screened 556 non-diabetic organ donors (3 months to 24 years) for five different autoantibodies and found positivity in 27 subjects, 25 single- and two double autoantibody-positive donors. Histopathological screening of pancreatic tissue samples showed lesion characteristic for recent-onset type 1 diabetes in the two organ donors with a high-risk profile, due ...
Source: Virchows Archiv - February 16, 2021 Category: Pathology Source Type: research

Comparison of antemortem clinical diagnosis and post-mortem findings in intensive care unit patients
In conclusion, discrepancies between clinical and PME diagnoses persist despite the medical progress. Secondly, the autopsy after a short hospital stay may reveal unexpected findings whose diagnosis is challenging even if it may be suspected by the intensivist. (Source: Virchows Archiv)
Source: Virchows Archiv - February 13, 2021 Category: Pathology Source Type: research

Eosinophilic cystitis mimicking bladder cancer —considerations on the management based upon a case report and a review of the literature
AbstractThe hypereosinophilic syndrome (HES) is a rare disorder characterized by hypereosinophilia and infiltration of various organs with eosinophils. Eosinophilic cystitis (EC), mimicking bladder cancer clinically but also in ultrasound and in radiographic imaging, is one potential manifestation of the HES occurring in adults as well as in children. This case report describes the course of disease in a 57-year-old male presenting with severe gait disorders and symptoms of a low compliance bladder caused by a large retropubic tumor. After extensive urine and serologic examination and histologic confirmation of EC the pati...
Source: Virchows Archiv - February 12, 2021 Category: Pathology Source Type: research

GATA3 is a useful immunohistochemical marker for distinguishing sarcomatoid malignant mesothelioma from lung sarcomatoid carcinoma and organizing pleuritis
In conclusion, GATA3 is an IHC marker with excellent sensitivity and specificity for SMM, and the combined consideration of GATA3, calretinin, and WT-1 was best for distinguishing SMM from LSC. Moreover, CKpan, WT-1, and D2-40 had no value for distinguishing SMM from OP, and GATA3 and calretinin were the most specific markers for distinguishing these two lesions. (Source: Virchows Archiv)
Source: Virchows Archiv - February 11, 2021 Category: Pathology Source Type: research

The role of FOXL2, SOX9, and β-catenin expression and DICER1 mutation in differentiating sex cord tumor with annular tubules from other sex cord tumors of the ovary
AbstractSex cord tumor with annular tubules (SCTAT) is a highly rare type of ovarian sex cord-stromal tumor (SCST), the diagnosis of which remains to be challenging. The aim of this study was to scrutinize the utility of three immunohistochemical markers including Forkhead box protein 2 (FOXL2), SOX9, and β-catenin andDICER1 mutation status in distinguishing SCTATs from other ovarian SCSTs. Nine cases of SCTAT, 10 Sertoli-Leydig cell tumor (SCLT), 10 adult-type granulosa cell tumor (AGCT), and 8 juvenile-type granulosa cell tumor (JGCT) were included in the study. SCTATs were characterized by diffuse and strong expres...
Source: Virchows Archiv - February 10, 2021 Category: Pathology Source Type: research

Awakening of SCHLAFEN 11 by immunohistochemistry: a new biomarker predicting response to chemotherapy
(Source: Virchows Archiv)
Source: Virchows Archiv - February 10, 2021 Category: Pathology Source Type: research

The adapter protein Myd88 plays an important role in limiting mycobacterial growth in a zebrafish model for tuberculosis
In this study, we have usedMycobacterium marinum (Mm) infection in zebrafish larvae as an animal model for this disease to study the role of the myeloid differentiation factor 88 (Myd88), the key adapter protein of Toll-like receptors. Previously, Myd88 has been shown to enhance innate immune responses against bacterial infections, and in the present study, we have investigated the effect of Myd88 deficiency on the granuloma morphology and the intracellular distribution of bacteria duringMm infection. Our results show that granulomas formed in the tail fin frommyd88 mutant larvae have a more compact structure and contain a...
Source: Virchows Archiv - February 9, 2021 Category: Pathology Source Type: research

Novel partners of USP6 gene in a spectrum of bone and soft tissue lesions
In this study on a series of 77 tumors (28 nodular fasciitis, 42 aneurysmal bone cysts, and 7 myositis ossificans) from the database of the French Sarcoma Group, we describe 7 new partners of theUSP6 gene. For this purpose, rearrangements were first researched by multiplexed RT-qPCRs in the entire population. A targeted RNA sequencing was then used on samples selected according to a highUSP6-transcription level expression estimated by RT-qPCR. Thanks to this multistep approach, besides the commonUSP6 fusions observed, we detected novelUSP6 partners:PDLIM7 andMYL12A in nodular fasciitis andTPM4,DDX17,GTF2I,KLF3, andMEF2A in...
Source: Virchows Archiv - February 9, 2021 Category: Pathology Source Type: research

Recent advances and conceptual changes in the classification of neuroendocrine tumors of the thymus
AbstractNeuroendocrine tumors of the thymus (TNET) are exceedingly rare neoplasms. Their histomorphology is identical to neuroendocrine tumors elsewhere in the body (in particular the lungs) and bears no similarity with thymomas and thymic carcinomas. Recent molecular findings have profoundly changed our perception of these tumors and may impact future histological classification systems. (Source: Virchows Archiv)
Source: Virchows Archiv - February 8, 2021 Category: Pathology Source Type: research

Correction to: Abstracts
A Correction to this paper has been published:https://doi.org/10.1007/s00428-021-03041-5 (Source: Virchows Archiv)
Source: Virchows Archiv - February 4, 2021 Category: Pathology Source Type: research

Chromosome X aneusomy and androgen receptor gene copy number aberrations in apocrine carcinoma of the breast
AbstractCarcinomas with apocrine differentiation (CAD) of the breast are rare tumours typically presenting high immunohistochemical expression of androgen receptor (AR) which is a target molecule for personalised therapy. To date, no studies have evaluated the genetic changes that are associated with AR immunohistochemical expression in CADs. The present work aims to characterise AR status in CADs. Twenty CAD tumours were studied with immunohistochemistry, in situ fluorescence hybridization and DNA methylation analysis, to evaluate AR expression and its regulator status. All tumours demonstrated high AR immunohistochemical...
Source: Virchows Archiv - February 3, 2021 Category: Pathology Source Type: research

Interobserver reproducibility of perineural invasion of prostatic adenocarcinoma in needle biopsies
AbstractNumerous studies have shown a correlation between perineural invasion (PNI) in prostate biopsies and outcome. The reporting of PNI varies widely in the literature. While the interobserver variability of prostate cancer grading has been studied extensively, less is known regarding the reproducibility of PNI. A total of 212 biopsy cores from a population-based screening trial were included in this study (106 with and 106 without PNI according to the original pathology reports). The glass slides were scanned and circulated among four pathologists with a special interest in urological pathology for assessment of PNI. D...
Source: Virchows Archiv - February 3, 2021 Category: Pathology Source Type: research

Mantle cell lymphomas with concomitant MYC and CCND1 breakpoints are recurrently TdT positive and frequently show high-grade pathological and genetic features
AbstractChromosomal breakpoints involving theMYC gene locus, frequently referred to asMYC rearrangements (MYC− R+), are a diagnostic hallmark of Burkitt lymphoma and recurrent in many other subtypes of B-cell lymphomas including follicular lymphoma, diffuse large B-cell lymphoma and other high-grade B-cell lymphomas and are associated with an aggressive clinical course. In remarkable contrast, in MCL, on ly fewMYC− R+ cases have yet been described. In the current study, we have retrospectively analysed 16 samples (MYC−R+,n = 15,MYC−R−,n = 1) from 13 patients and describe their morphological, i...
Source: Virchows Archiv - February 2, 2021 Category: Pathology Source Type: research

AI reality check when evaluating difficult to grade prostate cancers
(Source: Virchows Archiv)
Source: Virchows Archiv - February 2, 2021 Category: Pathology Source Type: research

Assessment of HER2 using the 2018 ASCO/CAP guideline update for invasive breast cancer: a critical look at cases classified as HER2 2+ by immunohistochemistry
AbstractIn 2018, the American Society of Clinical Oncology/College of American Pathologists revised the criteria for HER2 immunohistochemistry (IHC) equivocal (2+) classification in their updated guideline. We reviewed invasive breast cancer specimens originally classified as equivocal (2+) under the 2018 guideline that underwent HER2 fluorescence in situ hybridization (FISH) testing from August 2018 to August 2019 at our Canadian reference hospital to investigate cases with ambiguous staining patterns between the 1+ and 2+ definitions. Demographics, pathologic features, and pre-analytic conditions were recorded. The H&...
Source: Virchows Archiv - February 1, 2021 Category: Pathology Source Type: research

Correction to: Abstracts
A Correction to this paper has been published:https://doi.org/10.1007/s00428-021-03042-4 (Source: Virchows Archiv)
Source: Virchows Archiv - February 1, 2021 Category: Pathology Source Type: research

Pyloric, pseudopyloric, and spasmolytic polypeptide-expressing metaplasias in autoimmune gastritis: a case series of 22 Japanese patients
AbstractThere are two types of pyloric gland-like metaplasia in the corpus of stomach: pyloric and pseudopyloric metaplasias. They show the same morphology as the original pyloric glands in H&E staining. Pseudopyloric metaplasia is positive for pepsinogen (PG) I immunohistochemically, whereas pyloric metaplasia is negative. Recently, spasmolytic polypeptide-expressing metaplasia (SPEM) is proposed for pyloric gland-like metaplasia mainly in animal experiments. SPEM expresses trefoil factor family 2 (TFF2) and is often considered synonymous with pseudopyloric metaplasia. We reviewed consecutive 22 Japanese patients with...
Source: Virchows Archiv - January 30, 2021 Category: Pathology Source Type: research

On the existence of testicular mixed germ cell-germ cell sex cord-stromal tumor as a distinct entity
(Source: Virchows Archiv)
Source: Virchows Archiv - January 29, 2021 Category: Pathology Source Type: research

Simple mucinous cyst: another potential cancer precursor in the pancreas? Case report with molecular characterization and systematic review of the literature
We report a new case of pancreatic SMC, coupling a systematic review of the English literature mainly focused on their clinic-pathological features. We reviewed 103 cases of SMC in adults (73 women), averaging 57 (range, 26 –70) years. The SMCs were located in the body-tail region of the pancreas in 60 (58%) cases, presenting as single cystic lesions in 94% of cases; 43% of patients were asymptomatic. A preoperative fine-needle aspiration of the cyst fluid detected amylase and carcinoembryonic antigen positivity in 7 1% and 76% of cases, respectively. Patients underwent surgery mostly for suspected malignancy; in 83%...
Source: Virchows Archiv - January 28, 2021 Category: Pathology Source Type: research

Usefulness of β-catenin expression in the differential diagnosis of osteosarcoma, osteoblastoma, and chondroblastoma
AbstractThe aim of this study is to assess the usefulness of beta-catenin immunohistochemical expression in the differential diagnosis of osteoid-producing primary tumors of bone. Seventy cases of osteoid-producing tumors of bone (24 conventional osteosarcomas, 18 osteoblastomas, 13 osteoblastoma-like osteosarcomas, 10 chondroblastomas, and 5 chondroblastoma-like osteosarcomas) diagnosed at Istituto Ortopedico Rizzoli were reviewed and evaluated for the intensity, extension, and subcellular distribution of immunohistochemical expression of beta-catenin. A majority of cases (73%, 51 cases) exhibited cytoplasmic and/or membr...
Source: Virchows Archiv - January 28, 2021 Category: Pathology Source Type: research

FOXO1 gene involvement in a non-rhabdomyosarcomatous neoplasm
AbstractMyoepithelial neoplasms of soft tissue are rare tumors with clinical, morphological, immunohistochemical, and genetic heterogeneity. The morphological spectrum of these tumors is broad, and the diagnosis often requires immunostaining to confirm myoepithelial differentiation. Rarely, tumors show a morphology that is typical for myoepithelial neoplasms, while the immunophenotype fails to confirm myoepithelial differentiation. For such lesions, the term “myoepithelioma-like” tumor was introduced. Recently, two cases of myoepithelioma-like tumors of the hands and one case of the foot were described with pre...
Source: Virchows Archiv - January 28, 2021 Category: Pathology Source Type: research

Morphological intratumor heterogeneity in ductal carcinoma in situ of the breast
This study investigated morphological intratumor heterogeneity in a series of 51 large DCIS. Nuclear atypia, DCIS architecture, necrosis, calcifications, stromal architecture, and stromal inflammation were assessed in one biopsy slide and three representative slides from each corresponding resection. For each histopathological feature, a histo-score was determined per slide and compared between the biopsy and the resection, as well as within a single resection. Statistical analysis comprised of Friedman tests, post hoc Wilcoxon tests with Bonferroni corrections, Mann-WhitneyU tests, and chi-square tests. Despite substantia...
Source: Virchows Archiv - January 27, 2021 Category: Pathology Source Type: research

Undifferentiated large cell/rhabdoid carcinoma presenting in the intestines of patients with concurrent or recent non-small cell lung cancer (NSCLC): clinicopathologic and molecular analysis of 14 cases indicates an unusual pattern of dedifferentiated metastases
We present 14 cases of uni- (n = 9) or multifocal (n = 5) undifferentiated large cell/rhabdoid carcinoma presenting in the bowel of patients with concurrent (n = 9) or recent (diagnosed 1 to 25 months earlier; median, 4) non-small cell lung cancer (NSCLC). Patients were 6 females and 8 males, aged 52 to 85 years. Primary NSCLC was verified histologically in 10 cases and by imaging in 4. The undifferentiated histology was present in the lung biopsy in 4/10 patients (as sole pattern in 3 and combined with adenocarcinoma in 1) and was limited to the intestinal metastases in the remainder. PDL1 was strongly expressed in 7/9 ca...
Source: Virchows Archiv - January 27, 2021 Category: Pathology Source Type: research

Predictive significance of HER2 intratumoral heterogeneity, determined by simultaneous gene and protein analysis, for resistance to trastuzumab-based treatments for HER2-positive breast cancer
AbstractGene-protein assay (GPA), a combination of immunohistochemistry and dual in situ hybridization, allows simultaneous visualization of HER2 protein and gene on a single slide. We aimed to clarify the clinical significance of HER2 intratumoral heterogeneity (ITH) using GPA. We investigated the relationships between various HER2 ITH indicators and clinical course in 102 patients with HER2-positive breast cancer, treated with neoadjuvant trastuzumab and chemotherapy. Five representative microscopic images were captured from each GPA slide of pre-therapeutic biopsy materials. All evaluable cancer cells in the images were...
Source: Virchows Archiv - January 26, 2021 Category: Pathology Source Type: research

Concurrent epithelioid hemangioma and diffuse cavernous hemangioma in the rectum clinically mimicking a malignant tumor: a case report
We report a case of epithelioid hemangioma and diffuse cavernous hemangioma that co-occurred in the rectum. To our knowledge, this is the first report in which two rare vascular lesions coexisted. Because both epithelioid hemangioma and diffuse cavernous hemangioma are often clinically confounded by malignant tumors, differentiating these benign lesions from other possible malignant tumors is significant. (Source: Virchows Archiv)
Source: Virchows Archiv - January 26, 2021 Category: Pathology Source Type: research

Predictive biomarkers for response to immune checkpoint inhibitors in lung cancer: PD-L1 and beyond
AbstractImmune checkpoint inhibitor (ICI) therapies, including the programmed cell death protein 1 (PD-1) axis blockade, are considered a major oncological breakthrough of the early twenty-first century and have led to remarkable response rates and survival in a subset of patients with non –small cell lung cancer (NSCLC). However, the available therapies work only for one in five unselected, advanced NSCLC patients; thus, patient selection needs to be performed with the use of efficient biomarkers. Although imperfect, programmed death-ligand 1 (PD-L1) expression by immunohistochemis try (IHC) on tumor cells and/or im...
Source: Virchows Archiv - January 24, 2021 Category: Pathology Source Type: research

Morphologic and molecular classification of lung neuroendocrine neoplasms
AbstractNeuroendocrine neoplasms (NENs) of the lung encompass neuroendocrine tumors (NETs) composed of typical (TC) and atypical (AC) carcinoids and full-fledged carcinomas (NECs) inclusive of large cell neuroendocrine carcinoma (LCNEC) and small cell carcinoma (SCLC). NETs and NECs are thought to represent distinct and separate lesions with neither molecular overlap nor common developmental continuum. Two perspectives were addressed regarding the morphologic and molecular classification of lung NENs: (i) a supervised approach by browsing the traditional classification, the relevant gene alterations, and their clinical imp...
Source: Virchows Archiv - January 21, 2021 Category: Pathology Source Type: research

Pleural mesothelioma classification update
AbstractThe 2015 WHO classification of pleural mesotheliomas includes three major histologic subtypes —epithelioid, sarcomatoid, and biphasic. Recent genomic data has supported the need for a more granular and clinically valid classification beyond the three current subtypes. Because of tumor rarity and overlapping histologic features with other tumor types, diagnostic immunohistochemical work up is essential component in establishing the final diagnosis of mesothelioma. The use of BAP1 andCDKN2A/MTAP improves the diagnostic sensitivity of effusion specimens and are valuable in establishing the diagnosis of epithelio...
Source: Virchows Archiv - January 21, 2021 Category: Pathology Source Type: research

Autopsy findings after long-term treatment of COVID-19 patients with microbiological correlation
AbstractBetween April and June 2020, i.e., during the first wave of pandemic coronavirus disease 2019 (COVID-19), 55 patients underwent long-term treatment in the intensive care unit at the University Hospital of Regensburg. Most of them were transferred from smaller hospitals, often due to the need for an extracorporeal membrane oxygenation system. Autopsy was performed in 8/17 COVID-19-proven patients after long-term treatment (mean: 33.6 days). Autopsy revealed that the typical pathological changes occurring during the early stages of the disease (e.g., thrombosis, endothelitis, capillaritis) are less prevalent at this ...
Source: Virchows Archiv - January 20, 2021 Category: Pathology Source Type: research

A novel evaluation method for Ki-67 immunostaining in paraffin-embedded tissues
AbstractThe Ki-67 labeling index is traditionally used to investigate tumor aggressiveness. However, no diagnostic or prognostic value has been associated to the heterogeneous pattern of nuclear positivity. The aims of this study were to develop a classification for the patterns of Ki-67-positive nuclei; to search scientific evidence for the Ki-67 expression and location throughout the cell cycle; and to develop a protocol to apply the classification of patterns of Ki-67-positive nuclei in squamous epithelium with different proliferative activities. Based on empirical observation of paraffin sections submitted to immunohis...
Source: Virchows Archiv - January 19, 2021 Category: Pathology Source Type: research

Clear cell tumor with melanocytic differentiation and MITF-CREM translocation: a novel entity similar to clear cell sarcoma
AbstractThe presence of melanocytic differentiation in tumors of non-melanocyte origin is uncommon and is typically associated with the overexpression of MITF, the master regulator of melanin synthesis, or another member of the MIT/TFE3 family. In clear cell sarcoma, the presence of either an EWSR1-ATF1 or EWSR1-CREB1 translocation-derived fusion protein is thought to drive melanocytic differentiation by directly stimulating the expression of MITF. Here, we describe a clear cell neoplasm with melanocytic differentiation that is characterized by a novelMITF-CREM gene fusion. CREM is the third member of the ATF1/CREB1/CREM f...
Source: Virchows Archiv - January 18, 2021 Category: Pathology Source Type: research

Primary MiNEN of the urinary bladder: an hitherto undescribed entity composed of large cell neuroendocrine carcinoma and adenocarcinoma with a distinct clinical behavior
We describe a primary MiNEN of the urinary bladder, composed of a LCNEC and of an adenocarcinoma, in which the neuroendocrine component reached complete pathological regression after neoadjuvant M-VAC chemotherapy, whereas the non-neuroendocrine component of the tumor progressed to metastatic disease. Compared to mixed neuroendocrine/non-neuroendocrine neoplasms described in the literature until now, this appears to be a unique case that expands the spectrum of neuroendocrine neoplasia of the urinary bladder. (Source: Virchows Archiv)
Source: Virchows Archiv - January 17, 2021 Category: Pathology Source Type: research

Correction to: Abstracts
A correction to this paper has been published:https://doi.org/10.1007/s00428-020-03006-0 (Source: Virchows Archiv)
Source: Virchows Archiv - January 16, 2021 Category: Pathology Source Type: research

Clear cell clusters in the kidney: a rare finding that should not be misdiagnosed as renal cell carcinoma
We report histological, immunohistochemical, ultrastructural, and cytogenomic features of clear epithelial cell clusters incidentally found in four kidney specimens. Multiple microscopic clear cell clusters were present in the cortex, often in subcapsular location. They were composed of large epithelial cells with strikingly clear cytoplasm, without nuclear atypia, arranged in solid nests, and some tubules with narrow lumina. Immunohistochemically, they were positive for AE1AE3, PAX 8, EMA, kidney-specific cadherin, cytokeratin 7, E cadherin, and CD117, with focal immunoreactivity for CD10. Carbonic anhydrase IX, vimentin,...
Source: Virchows Archiv - January 14, 2021 Category: Pathology Source Type: research

Undifferentiated carcinoma of the pancreas with osteoclast-like giant cells: a challenging cancer with new horizons?
(Source: Virchows Archiv)
Source: Virchows Archiv - January 14, 2021 Category: Pathology Source Type: research

Novel genetic characteristics of multifocal micronodular pneumocyte hyperplasia (MMPH): a case report with frequent BRAF mutations analyzed by next-generation sequencing supporting benign behaviors of MMPH
In conclusion, our study of the lesions from this patient indicated the benign characteristic of MMPH. (Source: Virchows Archiv)
Source: Virchows Archiv - January 14, 2021 Category: Pathology Source Type: research

Biopsy pattern of invasion type to determine the surgical approach in early-stage oral squamous cell carcinoma
AbstractDepth of invasion (DOI) and pattern of invasion (POI) indicate tumor invasiveness of oral squamous cell carcinoma (OSCC). However, preoperative DOI evaluation is challenging, and the correlations between DOI and POI are unknown. We aimed to assess DOI and worst pattern of invasion (WPOI) in early-stage OSCC, and evaluate the preoperative predictive ability of biopsy pattern of invasion (BPOI) for WPOI and DOI. This retrospective study includedn = 444 OSCC patients with pT1-2N0M0. The prognostic value of DOI, WPOI, and BPOI and the predictive prognostic option for WPOI and DOI by BPOI were assessed. WPOI (1 –3...
Source: Virchows Archiv - January 13, 2021 Category: Pathology Source Type: research

ESP, EORTC, and EURACAN Expert Opinion: practical recommendations for the pathological diagnosis and clinical management of intermediate melanocytic tumors and rare related melanoma variants
AbstractThe recent WHO classification of skin tumors has underscored the importance of acknowledging intermediate grade melanocytic proliferations. A multistep acquisition of oncogenic events drives the progressive transformation of nevi into melanomas. The various pathways described are modulated by the initial oncogenic drivers that define the common, blue, and Spitz nevi groups. Intermediate lesions are most often the result of a clonal evolution within such nevi. Based on this established classification, we have suggested for each pathway a practical diagnostic approach, benefiting from the recently developed molecular...
Source: Virchows Archiv - January 12, 2021 Category: Pathology Source Type: research

Triumphs and tribulations of COVID-19 vaccines: Lessons to be learned from smallpox epidemics in the 1700s
(Source: Virchows Archiv)
Source: Virchows Archiv - January 12, 2021 Category: Pathology Source Type: research