Annals of Diagnostic Pathology via MedWorm.com

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Annals of Diagnostic Pathology — Sun, 01 Jan 2012 05:00:00 +0100

(Source: Annals of Diagnostic Pathology)

Annals of Diagnostic Pathology — Sun, 01 Jan 2012 05:00:00 +0100

(Source: Annals of Diagnostic Pathology)

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Annals of Diagnostic Pathology — Sun, 01 Jan 2012 05:00:00 +0100

(Source: Annals of Diagnostic Pathology)

Histochemistry as a tool in morphological analysis: a historical review

Annals of Diagnostic Pathology — Sun, 01 Jan 2012 05:00:00 +0100

Abstract: Histochemistry has an interesting history, extending back to ancient times, in some ways. Man has long had a desire to understand the workings of the human body and the roles that various “humors” or chemicals have in those processes. This review traces the evolution of histochemistry as an investigative and diagnostic discipline, beginning with the efforts of medicinal chemists and extending through a period in which histology was increasingly paired with biochemistry. Those developments served as the underpinnings for an eventual marriage of microscopy, chemistry, immunology, and molecular biology, as realized in the current practice of anatomical pathology. (Source: Annals of Diagnostic Pathology)

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Annals of Diagnostic Pathology — Sun, 01 Jan 2012 05:00:00 +0100

(Source: Annals of Diagnostic Pathology)

Multicentric epithelioid hemangioendothelioma of bone. Report of a case with radiologic-pathologic correlation

Annals of Diagnostic Pathology — Fri, 09 Dec 2011 05:00:00 +0100

Abstract: Epithelioid hemangioendothelioma (EHE) is a rare vascular tumor of uncertain biologic behavior. Most cases come out as a single lesion of the soft tissue but also may appear in the lung, liver, and other locations. Epithelioid hemangioendothelioma of bone is an extremely rare tumor and more prevalent in the second and third decades of life; its behavior is uncertain, it most commonly is unifocal, and it affects preferentially lower extremities. In this work, we present the clinical, radiologic, and pathologic findings of a 19-year-old man with a multicentric EHE of bone that involved 3 vertebrae and developed lung metastasis. (Source: Annals of Diagnostic Pathology)

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Annals of Diagnostic Pathology — Thu, 17 Nov 2011 08:27:46 +0100

(Source: Annals of Diagnostic Pathology)

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Annals of Diagnostic Pathology — Thu, 17 Nov 2011 08:27:46 +0100

(Source: Annals of Diagnostic Pathology)

Annals of Diagnostic Pathology — Thu, 17 Nov 2011 08:27:46 +0100

(Source: Annals of Diagnostic Pathology)

Nonneoplastic signet-ring cell change in gastrointestinal and biliary tracts: a pitfall for overdiagnosis

Annals of Diagnostic Pathology — Thu, 17 Nov 2011 08:27:46 +0100

Abstract: Nonneoplastic signet-ring cell change (SRCC) is a rare but known phenomenon in gastrointestinal and biliary tracts and is always associated with underlying mucosal ulceration/erosion secondary to infection, ischemia, or other etiology. Because nonneoplastic SRCC closely mimics signet-ring cell adenocarcinoma (SRCA), differentiation of these 2 entities is critical because misdiagnosis of nonneoplastic SRCC as SRCA can lead to intense therapeutic interventions such as surgery and/or chemoradiation therapy. In this review, a brief overview on nonneoplastic SRCC in gastrointestinal and biliary tracts, including the spectrum of clinical presentation, important histologic features, and immunohistochemical markers that are useful in differentiating nonneoplastic SRCC from SRCA, is provi...

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Annals of Diagnostic Pathology — Thu, 17 Nov 2011 08:27:46 +0100

(Source: Annals of Diagnostic Pathology)

Correlation between the endoscopic and histologic diagnosis of gastritis

Annals of Diagnostic Pathology — Mon, 14 Nov 2011 05:00:00 +0100

Abstract: Our aims were to determine the rate of concordance between endoscopic and pathologic diagnoses of gastritis and to determine if there was any common factor in discordant cases. A retrospective analysis of data from 400 patients was performed. The endoscopic diagnoses were compared with the pathologic diagnoses, and histologic slides from discordant cases were reviewed. Of the 400 patients, there was discordance between endoscopy and histology in 136 (34%; κ statistic, 0.31). These discordant cases comprised 56 with normal endoscopy but abnormal histology and 80 with abnormal endoscopy but normal histology. In 13 patients, there was normal histology, although erosions had been diagnosed endoscopically. No consistent histologic features were found in the discordant cases. These fi...

Florid reactive lymphoid hyperplasia (lymphoma-like lesion) of the uterine cervix

Annals of Diagnostic Pathology — Mon, 07 Nov 2011 05:00:00 +0100

We describe the clinicopathologic features of 6 patients with LLL involving the uterine cervix. Five patients presented with abnormal Papanicolaou test (Pap smear), and 3 patients had a biopsy procedure performed prior to detection of LLL in a loop electrosurgical excision procedure (LEEP). In each specimen, surface epithelial erosion was associated with a superficial, polymorphous lymphoid infiltrate with numerous scattered large cells, without cellular necrosis or sclerosis. Squamous dysplasia was present in 4 patients. Immunohistochemical studies revealed a mixed population of B- and T-lymphoid cells. T-cells were more numerous but B-cells and formed aggregates or sheets in areas. The large cells were predominantly B-cells positive for CD20 and negative for CD3 in all cases. CD30 was po...

Pathologic complete response to neoadjuvant therapy in patients with pancreatic ductal adenocarcinoma is associated with a better prognosis

Annals of Diagnostic Pathology — Fri, 04 Nov 2011 04:00:00 +0100

In this study, we identified 11 patients with pCR (2.5%) from 442 patients with PDA who received neoadjuvant treatment and pancreatectomy from 1995 to 2010. There were 6 men and 5 women, with a median age of 61 years. Four patients had either synchronous or history of extrapancreatic cancer. Five patients received neoadjuvant chemotherapy followed by chemoradiation, and 6 received chemoradiation alone. Ten patients had pancreaticoduodenectomy, and 1 had distal pancreatectomy. Scar and chronic pancreatitis consistent with therapy effect were present in all cases (100%). Pancreatic intraepithelial neoplasia (PanIN) 3/carcinoma in situ was present in 5 cases, and PanIN1 and PanIN2 in 5 cases. However, no residual invasive carcinoma or lymph node metastasis was identified in all cases. Follow-...

Distinct immunophenotype of early T-cell progenitors in T lymphoblastic leukemia/lymphoma may predict FMS-like tyrosine kinase 3 mutations

Annals of Diagnostic Pathology — Fri, 04 Nov 2011 04:00:00 +0100

This study aimed to identify the immunophenotypic features that may predict FLT3 mutations. We report 3 (43%) of 7 CD117+ T-LL cases harboring FLT3-internal tandem duplication mutation. Compared with 4 FLT3-unmutated cases, all 3 FLT3-mutated cases had a distinct immunophenotype (CD1a−/CD2+/CD7+/CD34+/CD117uniform+/Tdt+) corresponding to the stage of earliest thymic T-cell progenitors possessing myeloid lineage potential. Indeed, all FLT3-mutated T-LL cases expressed myeloperoxidase on a very small subset of blasts and, thus, may be further considered a mixed phenotype acute leukemia, T/myeloid, by the 2008 World Health Organization classification scheme. We conclude that this unique immunophenotype (CD1a−/CD2+/CD7+/CD34+/CD117+/Tdt+) is a better predictor of FLT3 mutation than sole CD...

Association of mast cells with microvessel density in urothelial carcinomas of the urinary bladder

Annals of Diagnostic Pathology — Mon, 24 Oct 2011 04:00:00 +0100

This study aims to investigate the relation of mast cell (MC) accumulation with tumor grade and stage in urothelial carcinomas of the urinary bladder and to determine its relationship with angiogenesis. A total of 78 urothelial carcinomas obtained by transurethral resection were investigated immunohistochemically by using c-Kit (CD117) and anti-CD34. The correlation between MC counts and microvessels was evaluated and compared with histopathologic parameters including tumor stage and grade. There were significant correlations between MC counts, grade, and stage (P < .05; r = 0.69 and 0.63, respectively). However, MC counts in adjacent nontumoral bladder mucosa significantly were higher than the MC counts in tumoral zone (P < .001). On the other hand, significant correlation was found betwe...

Changing trends in human papillomavirus–associated head and neck squamous cell carcinoma

Annals of Diagnostic Pathology — Mon, 17 Oct 2011 04:00:00 +0100

In conclusion, the HPV detection rate in oropharyngeal squamous cell carcinoma increased from 38% to 59% between the 2000-to-2004 and 2009-to-2010 periods. (Source: Annals of Diagnostic Pathology)

Primary malignant fibrous histiocytoma (myxofibrosarcoma/pleomorphic sarcoma not otherwise specified) of the breast: clinicopathologic study of 19 cases

Annals of Diagnostic Pathology — Mon, 10 Oct 2011 04:00:00 +0100

We present 19 cases of primary breast malignant fibrous histiocytoma (MFH) or myxofibrosarcoma/pleomorphic sarcoma not otherwise specified, the largest series to date, and compare our results with those in the literature to better define MFH in this anatomical location. Twenty-seven cases (MFH, myxofibrosarcoma, or pleomorphic sarcoma not otherwise specified) were reviewed using World Health Organization and French Federation of Cancer Centers criteria. Inclusion required location within breast parenchyma without extensive chest wall involvement. Morphological features were recorded, and immunohistochemistry was applied. Clinical data were extracted from patients' medical records. Clinically, there was 1 male patient. Of 15 patients with follow-up, 5 (33% overall) died of disease within an...

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Annals of Diagnostic Pathology — Mon, 19 Sep 2011 08:23:31 +0100

(Source: Annals of Diagnostic Pathology)

Annals of Diagnostic Pathology — Mon, 19 Sep 2011 08:23:31 +0100

(Source: Annals of Diagnostic Pathology)

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Annals of Diagnostic Pathology — Mon, 19 Sep 2011 08:23:31 +0100

(Source: Annals of Diagnostic Pathology)

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Annals of Diagnostic Pathology — Mon, 19 Sep 2011 08:23:31 +0100

(Source: Annals of Diagnostic Pathology)

Malignant glandular lesions and glandular differentiation in invasive/noninvasive urothelial carcinoma of the urinary bladder

Annals of Diagnostic Pathology — Mon, 22 Aug 2011 04:00:00 +0100

Abstract: Although the lumen of the urinary bladder is covered with only urothelial epithelium, malign glandular lesions (eg, nonurachal adenocarcinoma) and benign lesions (eg, cystitis cystica and cystitis glandularis) can also rarely occur in this site due to its characteristic embryologic development. Glandular differentiation is uncommon in urothelial carcinomas and is even less common in noninvasive urothelial cancers. In addition, in situ urothelial carcinomas are more likely to progress in the presence of glandular differentiation toward high-grade urothelial carcinomas and/or aggressive urothelial carcinomas. Pure nonurachal adenocarcinomas and mixed carcinomas (urothelial carcinoma and adenocarcinoma) are very rare, and their pathogenesis is not clear. Most of the nonurachal adeno...

The immunohistochemical profile of atypical eosinophilic syncytial changes vs serous carcinoma

Annals of Diagnostic Pathology — Mon, 22 Aug 2011 04:00:00 +0100

Abstract: Endometrial epithelial cytoplasmic change (EECC) is an adaptive cytoplasmic change commonly seen in the endometrium. Previously considered “metaplasia,” EECC is now the preferred term because it offers a descriptive designation without implying a specific mechanism of development. There are 5 types of EECC: squamous, ciliated cell, eosinophilic, mucinous, and secretory (clear cell and hobmail cell) changes. Eosinophilic syncytial change (ESC) is a similar but unrelated degenerative change seen in endometrial breakdown. Some cases of ESC show atypical cytologic features that may resemble endometrial adenocarcinoma. Thirteen endometrial biopsy and curettage specimens with atypical ESCs (AESCs) were compared against 10 hysterectomy specimens with endometrial serous carcinoma. Cl...

Frequencies of different nuclear morphological features in prostate adenocarcinoma

Annals of Diagnostic Pathology — Wed, 17 Aug 2011 04:00:00 +0100

We examined 84 cases of prostate adenocarcinoma using oil immersion microscopy where necessary. Commonest Gleason pattern observed was grade 4a accounting for 42.8% of cases. Nuclear enlargement (moderate to marked in 93.8%), nucleolar enlargement (62.1%), and nonuniform chromatin distribution (100%) could serve as useful diagnostic features but did not vary with tumor differentiation. Pleomorphism (moderate in 58.6%), nuclear overlapping (62.8%), nuclear membrane infoldings (66.2%), and irregular contours (frequent in 94.5%) were significant diagnostic features that increased in frequency and extent with increasing grade and could be used to differentiate low-grade from high-grade tumors. Worsening of nuclear morphology with advancing tumor grades indicated that nuclear anaplasia accompan...

Immunohistochemical expression of ezrin in cutaneous basal and squamous cell carcinomas

Annals of Diagnostic Pathology — Wed, 17 Aug 2011 04:00:00 +0100

Abstract: Ezrin is a member of the ezrin-radixin-moesin family of proteins, which link the actin-containing cytoskeleton to the plasma membrane. Overexpression of ezrin protein is correlated with the metastatic potential in several cancers. Little is known about the distribution of ezrin in normal epidermis and nonmelanoma skin cancer; therefore, in the current study, we examined the immunohistochemical expression of ezrin in normal skin (10 biopsies) and epithelial skin tumors (25 basal cell carcinoma [BCC] and 20 squamous cell carcinoma [SCC]). Ezrin was expressed in epidermis of all normal controls with a prominent membranous pattern compared with 93.3% positivity in malignant cases with a significant higher intensity (assessed by H score) in favor of the latter (P = .002). Cytoplasmic ...

Microscopic thrombi in anaplastic astrocytoma predict worse survival?

Annals of Diagnostic Pathology — Wed, 17 Aug 2011 04:00:00 +0100

Abstract: The purpose of this study is to determine whether anaplastic astrocytoma patients with intratumoral vascular thrombi have a worse survival than anaplastic astrocytoma patients without thrombi. A retrospective review of 101 patients (60 males; mean age, 53.3 years) with anaplastic astrocytoma (World Health Organization grade III) was conducted. Thrombi were counted relative to the number of involved blood vessels in the initially resected tumor (69 biopsies, 32 subtotal resections) and were correlated with survival and development of postoperative deep venous thrombosis (DVT). Of tumors with thrombi (n = 17), the percentage of blood vessels with thrombi ranged from 1.5% to 20% (mean, 5.6%). Of these patients, 16 died of tumor (mean survival, 15.4 months), and 1 patient was alive w...

Tracheobronchopathia osteochondroplastica presenting as a single dominant tracheal mass

Annals of Diagnostic Pathology — Thu, 21 Jul 2011 04:00:00 +0100

We report an unusual presentation of tracheobronchopathia osteochondroplastica as a single dominant nodule arising from the anterior tracheal rings in a young adult man who presented with wheezing and symptoms of airway obstruction. The differential diagnosis of cartilaginous and bony endotracheal lesions is discussed. (Source: Annals of Diagnostic Pathology)

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Annals of Diagnostic Pathology — Tue, 12 Jul 2011 14:51:43 +0100

(Source: Annals of Diagnostic Pathology)

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Annals of Diagnostic Pathology — Tue, 12 Jul 2011 14:51:42 +0100

(Source: Annals of Diagnostic Pathology)

Annals of Diagnostic Pathology — Tue, 12 Jul 2011 14:51:42 +0100

(Source: Annals of Diagnostic Pathology)

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Annals of Diagnostic Pathology — Tue, 12 Jul 2011 14:51:42 +0100

(Source: Annals of Diagnostic Pathology)

A practical approach to grossing breast specimens

Annals of Diagnostic Pathology — Tue, 12 Jul 2011 14:51:42 +0100

Abstract: The grossing of breast specimens has been evolving over the past few decades. As image-guided core-needle biopsy has gradually replaced surgical biopsy in the initial assessment of breast lesions, most patients have a definitive diagnosis at the time of excision. Breast conserving therapy is now well accepted as a definitive treatment. Neoadjuvant therapy is also selected by a large number of patients. In addition, since its introduction in the 1990s, sentinel lymph node biopsy has become a standard procedure performed at the time of excision, as clinically indicated. Based on our institutional experience, practical guidelines for grossing breast excision specimens, as well as sentinel lymph nodes, are provided in this article. (Source: Annals of Diagnostic Pathology)

Clinicopathologic analysis of the impact of CD23 expression in plasma cell myeloma with t(11;14)(q13;q32)

Annals of Diagnostic Pathology — Mon, 04 Jul 2011 04:00:00 +0100

Abstract: A recent study has shown that 10% of plasma cell myelomas (PCMs) express CD23 and that expression is associated with abnormalities of chromosome 11, mainly t(11;14)(q13;q32); however, only 40% of t(11;14)(+) PCMs express CD23. Because these results were generated in a limited patient cohort and because the clinical relevance of CD23 expression in PCMs with t(11;14)(q13;q32) has not been fully characterized, we addressed this question in a large series of patients with t(11;14)(+) PCM. Forty-two bone marrow biopsies from patients with t(11;14)(+) PCM were evaluated for CD23 expression by immunohistochemistry. CD23 expression was correlated with laboratory and clinical data and outcome after autologous stem cell transplantation, including event-free survival and overall survival (O...

Plexiform leiomyoma of the esophagus: a complex radiographic, pathologic and endoscopic diagnosis

Annals of Diagnostic Pathology — Mon, 04 Jul 2011 04:00:00 +0100

Abstract: Radiographic identification of an abnormal lesion in the esophagus routinely occurs during workup of patients with symptomatic dysphagia. Leiomyoma is the most common benign finding; however, plexiform leiomyoma, a distinctive but rare variant, follows an unusual pattern of growth which can be a challenging surgical resection. A review of indexed literature identified a single previous report. We contribute a second case of plexiform leiomyoma with a discussion of the clinical, radiographic, and pathologic characteristics, as well as the differential diagnosis for plexiform lesions. (Source: Annals of Diagnostic Pathology)

Atypical polypoid adenomyoma of the uterus: an immunohistochemical study on 5 cases

Annals of Diagnostic Pathology — Mon, 20 Jun 2011 04:00:00 +0100

In conclusion, the immunoprofile of APA was reported. The findings provide basic knowledge of APA of the uterus. (Source: Annals of Diagnostic Pathology)

Adult renal cell carcinoma with rhabdoid morphology represents a neoplastic dedifferentiation analogous to sarcomatoid carcinoma

Annals of Diagnostic Pathology — Mon, 13 Jun 2011 04:00:00 +0100

Abstract: Renal cell carcinoma (RCC) with rhabdoid morphology (RCC-RM) is a recently described variant of RCC, which has an aggressive biologic behavior and poor prognosis, akin to sarcomatoid RCC. The current World Health Organization classification of RCC does not include the rhabdoid phenotype as a distinct histologic entity. The aim of this study is to investigate whether RCC-RM represents a dedifferentiation of a classifiable-type World Health Organization RCC or a carcinosarcoma with muscle differentiation. We reviewed 168 cases of RCC obtained between 2003 and 2008. From these cases, 10 (6%) were found to have areas of classic rhabdoid morphology. Immunohistochemistry for cytokeratin, epithelial membrane antigen, desmin, CD10, and CD117 was performed in each case using the labeled s...

Primary CD5-positive mucosa-associated lymphoid tissue lymphoma of the urinary bladder

Annals of Diagnostic Pathology — Wed, 08 Jun 2011 04:00:00 +0100

Primary lymphoma of the urinary bladder is very rare. To date, approximately 100 cases have been reported in the English literature . Most bladder lymphomas are B-cell neoplasms . Mucosa-associated lymphoid tissue (MALT) lymphoma and diffuse large B-cell lymphoma are the 2 most common types of the bladder lymphoma . (Source: Annals of Diagnostic Pathology)

Endometrial stromal sarcoma: clinicopathological and immunophenotype study of 18 cases

Annals of Diagnostic Pathology — Wed, 08 Jun 2011 04:00:00 +0100

In conclusion, ESS was present at 0.6% in our institution; and most were low grade. Expression of markers, such as p53, CD10, and hormonal receptors, was positive. (Source: Annals of Diagnostic Pathology)

Calretinin immunostaining as an adjunct in the diagnosis of Hirschsprung disease

Annals of Diagnostic Pathology — Mon, 06 Jun 2011 04:00:00 +0100

Abstract: Historically, the diagnosis of Hirschsprung disease was made by evaluating multiple hematoxylin and eosin–stained slides and performing acetylcholinesterase histochemical staining. Recently, calretinin immunohistochemical staining has been reported and found to be superior to acetylcholinesterase staining in the confirmation of aganglionosis. We retrieved tissue blocks from 23 patients with proven Hirschsprung disease from the archives of the Medical College of Georgia. In addition, we selected 23 control patients with ganglion cells. All cases were stained with calretinin, and the presence or absence of both intrinsic nerve fibers (INFs) and ganglion cells was scored by 4 pathologists with fairly strong agreement (κ = 0.858). All cases of proven Hirschsprung disease were nega...

Quantification of mast cells in the uterine cervix of women infected with human immunodeficiency virus

Annals of Diagnostic Pathology — Mon, 06 Jun 2011 04:00:00 +0100

The objective of the study was to identify mastocytosis in the chorionic epithelium of the uterine cervix in HIV-infected and non–HIV-infected women in autopsy specimens using histochemistry and immunohistochemistry techniques. Sixteen cervical tissue specimens were collected, of which 10 (62.50%) were from HIV-infected women. Histochemical and immunohistochemical techniques were used to evaluate mast cell density using Giemsa stain and anti-mast cell tryptase and anti-mast cell chymase antibodies, respectively. The study of the sheets and counting of mast cells with blue (Giemsa) or brown staining (anti-mast cell tryptase or chymase antibodies) were performed by 3 examiners, and 10 consecutive fields were examined under a light microscope at 400× magnification. A significant difference...

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Annals of Diagnostic Pathology — Fri, 13 May 2011 14:29:38 +0100

(Source: Annals of Diagnostic Pathology)

Annals of Diagnostic Pathology — Fri, 13 May 2011 14:29:38 +0100

(Source: Annals of Diagnostic Pathology)

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Annals of Diagnostic Pathology — Fri, 13 May 2011 14:29:38 +0100

(Source: Annals of Diagnostic Pathology)

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Annals of Diagnostic Pathology — Fri, 13 May 2011 14:29:30 +0100

(Source: Annals of Diagnostic Pathology)

Low-grade fibromyxoid sarcoma: a clinicopathologic study of 18 cases, including histopathologic relationship with sclerosing epithelioid fibrosarcoma in a subset of cases

Annals of Diagnostic Pathology — Mon, 09 May 2011 04:00:00 +0100

Abstract: Low-grade fibromyxoid sarcoma (LGFMS) is an uncommon tumor with diverse histopathologic features. It has been found to be histopathologically and genetically related to hyalinizing spindle cell tumor with giant rosettes. Lately, sclerosing epithelioid fibrosarcoma (SEF) has been identified as another rare variant of fibrosarcoma. Very few studies have addressed the aspect of its histopathologic relationship with LGFMS. The present study was conducted to critically analyze the clinicopathologic features of a series of LGFMS cases, including identification of cases with histopathologic similarity with SEF. During a 7-year period, 18 LGFMS cases were diagnosed in 9 male and 9 female patients, had ages ranging from 10 to 69 years (median, 32.5 years), and were most commonly identifie...

Atypical imaging feature of Non-secretory multiple myeloma

Annals of Diagnostic Pathology — Wed, 04 May 2011 23:00:00 +0100

We describe a rare case of non-secretory multiple myeloma in a 23 year old female presenting with bilateral limb weakness of two years duration. Clinically she was diagnosed to have Pott's spine and was treated with category 1 anti tubercular drugs. Hematological investigations showed plasmacytosis and radiography showed osteolytic lesions. No monoclonal gammopathy was found in the serum or urine. MRI showed multiple compressions with sclerosis within vertebral bodies suggestive of osteomalacia/ diffuse infiltrative disorder. The free light chain (FLC) assay revealed increment in the free kappa light chain and an abnormal κ/λ ratio. Free Light Chain assay (FLC) when used in complement with Protein Electrophoresis (PEP) and Immunofixation Electrophoresis (IFE) were pivotal in diagnosis of...

Clinicopathologic and immunohistochemical characteristics of adult primary cardiac angiosarcomas: analysis of 10 cases

Annals of Diagnostic Pathology — Wed, 04 May 2011 23:00:00 +0100

The objective of this study is to analyze the clinicopathologic characteristics of primary cardiac angiosarcoma. Ten cases of primary cardiac angiosarcoma treated in a single institution were analyzed for their clinical, pathologic, and immunohistochemical features. There were 6 men and 4 women, with a mean age of 40 years (range, 20-61 years). The patients commonly presented with dyspnea and distant metastasis. All tumors were located in the right atrium, with a mean tumor size of 6.8 cm. Tumors were hemorrhagic, with variegated tan-brown solid areas. Histologically, they exhibited high-grade morphology with mixed solid growth and anatomizing channels. Frequent mitoses and tumor necrosis were common. The tumors were strongly positive for CD31, CD34, FLI-1, and WT-1 but negative for AE1/3,...

Hyalinizing parathyroid adenoma and hyperplasia: report of 3 cases of an unusual histologic variant

Annals of Diagnostic Pathology — Tue, 19 Apr 2011 04:00:00 +0100

We report 3 cases of hyperparathyroidism (2 adenomas and 1 hyperplasia) with an unusual pattern of sclerosis. The hyalinized, eosinophilic fibrous tissue was diffusely distributed within and around the parathyroid parenchyma, often isolating groups of cells and single cells. (Source: Annals of Diagnostic Pathology)

Oral lipoma: analysis of 58 new cases and review of the literature

Annals of Diagnostic Pathology — Tue, 29 Mar 2011 23:00:00 +0100

Abstract: Lipomas are common soft-tissue tumors but occur infrequently in the oral region. Here, we present 58 new cases of oral lipoma (OL), their clinical features, diagnostic workup, and management. The records of 58 patients with OL were reviewed. Demographic data, presenting symptoms, primary tumor site, histopathology, and clinical management were analyzed. Extraoral and intraosseous lesions were excluded. The patients were 29 men and 29 women with mean age of 59.7 years, range, 11 to 98 years. Tumor sites included the buccal mucosa (n = 31), tongue (n = 10), lip (n = 6), floor of the mouth (n = 6), and vestibule (n = 5). The mean tumor size was 2.1 cm (range, 0.3-5.0 cm). The mean tumor duration before excision was 2.6 years (31.2 months), ranging from 2 months to 12 years. Most com...

Utility of cytokeratin 5/6 and high-molecular-weight keratin in evaluation of cauterized surgical margins in excised specimens of breast ductal carcinoma in situ

Annals of Diagnostic Pathology — Mon, 21 Mar 2011 00:00:00 +0100

Abstract: Evaluation of the surgical margins of excision specimens for ductal carcinoma in situ (DCIS) of breast is challenging due to cautery artifact introduced in the specimen at the time of surgery. Cautery destroys the cytoarchitectural features at the tissue margins and makes the distinction between usual ductal hyperplasia (UDH) and DCIS difficult. Previous studies have shown the value of immunohistochemical staining for cytokeratin 5/6 (CK5/6) and high-molecular-weight keratin (HMWK) in distinguishing UDH from DCIS. We hypothesized that staining for CK5/6 and HMWK (34bE12) may be helpful in evaluating the cauterized surgical margins, given the 2 antibodies follow the same pattern as described in the preserved foci of the 2 entities. Forty-three excised breast specimens were stained...

Metastatic vs primary malignant neoplasms affecting the umbilicus: clinicopathologic features of 77 tumors

Annals of Diagnostic Pathology — Fri, 18 Mar 2011 00:00:00 +0100

Abstract: Periumbilical skin is unique due to its proximity to intra-abdominal and pelvic structures. In addition to primary skin malignancies, it is a site often involved with metastatic disease. We reviewed the clinical and pathologic features of 77 umbilical malignancies occurring at our institution since 1988. Seventy-seven patients were identified (female/male ratio, 4.1:1.0) with the average age for women being 63 years and 55 years for men. Eighty-eight percent of malignancies originated outside the umbilicus and 12% were primary skin tumors. Fifty-eight (85%) patients with metastatic tumors had umbilical involvement from a known primary vs 10 (15%) with unknown primaries. Nine patients with metastatic tumors to the umbilicus would present with solitary umbilical involvement. Of the...

Undifferentiated (embryonal) liver sarcoma: synchronous and metachronous occurrence with neoplasms other than mesenchymal liver hamartoma

Annals of Diagnostic Pathology — Thu, 17 Mar 2011 00:00:00 +0100

In this study, all 3 patients were females aged 13, 13, and 58 years. Histopathologic evaluation of resected liver tumors confirmed the diagnosis of UELS in all of them. In 2 of the cases, metachronous occurrence of UELS with vaginal embryonal rhabdomyosarcoma in a teenage girl and B-acute lymphoblastic leukemia in a middle-aged woman is described. Careful clinical analysis, histologic studies, and immunohistochemistry are mandatory to distinguish UELS from other hepatic malignancies with similar or overlapping features and to exclude the possibility of other tumors that may be considered in the differential diagnosis. The association of UELS with another neoplasm is exceedingly rare. (Source: Annals of Diagnostic Pathology)

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Annals of Diagnostic Pathology — Tue, 15 Mar 2011 17:32:05 +0100

(Source: Annals of Diagnostic Pathology)

Annals of Diagnostic Pathology — Tue, 15 Mar 2011 17:32:05 +0100

(Source: Annals of Diagnostic Pathology)

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Annals of Diagnostic Pathology — Tue, 15 Mar 2011 17:32:05 +0100

(Source: Annals of Diagnostic Pathology)

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Annals of Diagnostic Pathology — Tue, 15 Mar 2011 17:32:03 +0100

(Source: Annals of Diagnostic Pathology)

Multilocular thymic cyst with epithelioid granulomata of unknown etiology: a radiologic and histopathologic correlation

Annals of Diagnostic Pathology — Fri, 11 Mar 2011 05:00:00 +0100

We report a case of a 23-year-old white man who presented with a 2-week history of progressive right-sided shoulder and chest pain. He was found to have an anterior mediastinal mass involving the thymus. This case of multilocular thymic cyst is particularly unique due to the presence of abundant epithelioid granulomata within the cyst, a finding that has not previously been emphasized as a histologic feature of these lesions, and one that expands the histopathologic differential diagnosis, warranting exclusion of infectious and autoimmune etiologies. (Source: Annals of Diagnostic Pathology)

Histopathologic characteristics of inferior turbinate vs ethmoidal polypin chronic rhinosinusitis

Annals of Diagnostic Pathology — Fri, 11 Mar 2011 00:00:00 +0100

Abstract: It seems apparently that the 2 separate anatomical areas (nasal cavity and paranasal sinus mucosa) are indeed one single unit with an identical behavior during inflammatory process. Similar histopathologic evidence in long-term condition could emphasize on the concept of rhinosinusitis in patients with inflammatory paranasal sinus disease. Prospective study was performed on 50 consecutive patients with polyposis in 2 different groups, one with and the other without asthma. Inferior turbine and polyp with ethmoid sinus origin were selected to compare the histopathologic findings of the surgical specimens from the 2 sites (affected sinus vs apparently unaffected nose). The general degree of inflammation, epithelial thickening, and inflammatory cell count were measured. The degree o...

Lipid-rich carcinoma of the breast clinicopathologic analysis of 17 cases

Annals of Diagnostic Pathology — Fri, 11 Mar 2011 00:00:00 +0100

Abstract: Lipid-rich carcinoma of the breast is a rare variant of breast cancer, accounted for 2.2). Ultrastructure showed fat droplet and electron-dense material in the cytoplasm. Statistical differences were detected among survival and age (P = .033), histologic grade (P = .004), lymph node involvement (P = .001), and HER-2 expression (P = .002), respectively, using Kaplan-Meier methods. Statistical differences were also detected (P = .017) using Cox regression methods. Receiver operating characteristic test displayed significant statistical differences; the prognosis had a correlation between HER-2 expression “+” and HER-2 expression “++” (P = .004). Lipid-rich carcinoma of the breast was an HER-2 overexpressing subtype of the breast carcinoma. Survival of lipid-rich carcinoma m...

Primary lymphoepithelioma-like carcinoma of the ureter

Annals of Diagnostic Pathology — Fri, 11 Mar 2011 00:00:00 +0100

We read with interest the article entitled: “Primary lymphoepithelioma-like carcinoma of the ureter” by Allende et al that was published in the June issue of the Journal. In that article, the authors nicely document a new case of this uncommon, primary, pure ureteral neoplasm and present a comprehensive overview of the 6 cases previously described at this location. (Source: Annals of Diagnostic Pathology)

Uterine perivascular epitheloid cell tumor (PEComa) with CD117 and PNL2 positivity and entrapped endometriotic glands, mimicking sex-cordlike differentiation

Annals of Diagnostic Pathology — Fri, 11 Mar 2011 00:00:00 +0100

We read with interest the article by Carvalho FM et al, “A new morphological variant of uterine PEComas with sex-cordlike pattern and WT1 expression: more doubts about the existence of uterine PEComas” . The authors described a case of uterine perivascular epitheloid cell tumor (PEComa) with some areas of epithelioid cells with clear to granular cytoplasm, arranged in solid cords or tubules, resembling sex-cordlike pattern. PEComas are morphologically characterized as a proliferation of mesenchymal cells with sometimes clear, mostly granular eosinophilic cells with immunohistochemical coexpression of smooth muscle and melanocytic markers. Within the latter ones, most PEComas show a positive staining with HMB-45, Melan-A, and MiTF . In a very recent case of a 65-year-old women represent...

Low-grade renal carcinoma with histologic features overlapping with renal angiomyoadenomatous tumor and featuring polysomy 7 and 17 and a mutation in the von Hippel-Lindau gene: report of a hybrid tumor and a few comments on renal angiomyoadenomatous tumor and papillary renal tumors with clear cells

Annals of Diagnostic Pathology — Fri, 11 Mar 2011 00:00:00 +0100

It is with great interest that we read the recent articles by Kuroda et al : “Clear cell renal carcinoma with focal renal adenomyoadenomatous tumor-like area” and “Clear cell papillary renal carcinoma and clear cell renal carcinoma arising in acquired cystic disease of the kidney: an immunohistochemical and genetic study.” Recently, we encountered a renal tumor in a previously healthy 66-year-old man with histologic features distinctly similar to renal angiomyoadenomatous tumor (RAT), a tumor that was first published as a case report by Michal et al in 2000, followed by a thorough clinicopathologic characterization of 5 additional cases in 2008. However, in contrast to RAT, our tumor had a mutation in the von Hippel-Lindau (VHL) gene and displayed polysomy of both chromosome 7 and ...

Low-grade nonintestinal sinonasal adenocarcinoma: a diagnosis of exclusion

Annals of Diagnostic Pathology — Fri, 11 Mar 2011 00:00:00 +0100

Abstract: The World Health Organization classifies primary sinonasal adenocarcinomas (SNACs) into salivary and nonsalivary types. Salivary types are usually well-defined myoepithelial neoplasms, which closely resemble their salivary counterparts. Nonsalivary types are separated into intestinal-type SNAC (ITAC) and non-ITAC, and both have low- and high-grade categories. Intestinal-type SNACs are aggressive tumors that resemble intestinal epithelium and often arise in the ethmoid sinus. Non-ITACs are of presumed seromucous gland origin, have marked morphologic heterogeneity, and can arise anywhere in the sinonasal tract. Moreover, ITACs typically demonstrate an intestinal-type immunohistochemical profile (CK20+, CK7−, CDX2+, and villin+), whereas non-ITACs reveal a respiratory-type profile...

Verrucous carcinoma of the skin: a report on 5 Japanese cases

Annals of Diagnostic Pathology — Fri, 11 Mar 2011 00:00:00 +0100

Abstract: Verrucous carcinoma (VC) of the skin is relatively rare. The author reports 5 Japanese cases of VC of the skin. The age ranged from 63 to 91 years with a median of 70 years. The locations were hand in 1 case, lip in 1, face in 1, and foot sole in 2. The size ranged from 0.8 cm to 30 mm with a median of 1.5 cm. Grossly, all the cases showed elevated verrucous tumors. Histologically, the tumors were composed of squamous epithelial cells with minimal cellular atypia arranged in a verrucous pattern. One case showed koilocytosis. Neutrophilic abscesses were seen in 3 cases. Microinvasion was recognized in 2 cases. Focus of less differentiated squamous cell carcinoma was seen in the VC in 1 case. Actinic karatosis or squamous cell carcinoma in situ contiguous to VC was seen in 1 case. ...

Pseudohyperplastic prostatic carcinoma in simple prostatectomy

Annals of Diagnostic Pathology — Fri, 11 Mar 2011 00:00:00 +0100

Abstract: Pseudohyperplastic carcinoma (PHPC) is a prostatic neoplasm that can be easily mistaken for nodular hyperplasia or atypical adenomatous hyperplasia. To determine the frequency and clinicopathologic characteristics of PHPC, we reviewed 200 simple prostatectomy specimens. We found 3 cases (1.5%) of PHPC. The tumors were small and ranged in size from 4 to 6 mm. Two of them were erroneously diagnosed as benign glandular proliferations in the original interpretation. Their histologic aspect at low magnification showed nodules of well-differentiated medium-sized glands with cystic dilation in a tight arrangement that imparted a benign appearance. Corpora amylacea were found in 2 cases. However, the lining cells showed nucleomegaly and prominent nuclei in most of the neoplastic glands, ...

Congenital epulis of the newborn: 10 new cases of a rare oral tumor

Annals of Diagnostic Pathology — Fri, 11 Mar 2011 00:00:00 +0100

Abstract: Congenital epulis of the newborn (CEN) is a rare benign lesion that exclusively occurs in the oral and maxillofacial regions of newborns. The clinicopathologic features of CEN were examined and reviewed from the files of the Armed Forces Institute of Pathology from 1970 to 2000. Ten cases were included. Patient lesions were all present at birth but were surgically excised between 2 days and 6 weeks (median, 5.5 days). Nine lesions were in females; 1 case did not designate patient sex. Locations included 6 on the maxilla, 2 on the mandible, 1 on the designated maxillary lip, and 1 unknown. The cases included a patient with 2 lesions: 1 on mandibular and 1 on maxillary alveolar ridges, respectively. All other lesions were solitary and polypoid. Microscopically, these were peduncula...

Primary leiomyosarcoma of bone—a clinicopathologic study of 8 uncommon cases with immunohistochemical analysis and clinical outcomes

Annals of Diagnostic Pathology — Fri, 11 Mar 2011 00:00:00 +0100

Abstract: Primary leiomyosarcoma of bone is a rare and a diagnostically challenging tumor entity. Over a 7-year period, we identified 8 such cases that fulfilled the diagnostic criteria in 6 men and 2 women, with age ranging from 25 to 59 years (mean, 42.7 years). All cases were noted in the lower limbs, including femur and tibia as the commonly involved bones in 4 and 3 cases, respectively. On radiography, the most consistent feature was a solitary osteolytic lesion with cortical destruction, unassociated with matrix formation. On histopathology, all cases showed spindly sarcomatous cells, mostly arranged in fascicles and whorls. Of 8 cases, 6 (75%) were of high grade. Prominent vasculature was noted in 5 cases. Two cases displayed focal mineralization, including calcification and heterot...

Expression and clinicopathologic significance of glypican 3 in hepatocellular carcinoma

Annals of Diagnostic Pathology — Thu, 03 Mar 2011 00:00:00 +0100

In conclusion, our results confirm the high expression of GPC3 in HCC and suggest its potential diagnostic value as a clinical marker for this disease. (Source: Annals of Diagnostic Pathology)

Kocher-Debré-Sémélaigne syndrome diagnosed by autopsy associated with disseminated intravascular coagulation

Annals of Diagnostic Pathology — Mon, 14 Feb 2011 05:00:00 +0100

Abstract: Kocher-Debré-Sémélaigne syndrome is a rare disease with little literature, which develops with myopathy in infancy associated with neuromuscular alterations, polymyositis with symmetrical proximal muscle weakness, pseudohypertrophy, muscular rigidity and spasms, exercise intolerance, myxoedema, short stature, and cretinism. Male patient aged 18 years old, 1.52 m in height, admitted in the General Hospital of Triângulo Mineiro Federal University on November 11, 2003, complaining of intense diffuse abdominal pain like severe cramps, without triggering factors, associated with asthenia and hyporexia. This seems to be one of the few reports of KDS syndrome diagnoses by autopsy, where alterations in the thyroid gland connected with hypotrophy and probable congenital hypothyroidism...

Comparison of proliferating cell nuclear antigen, thyroid transcription factor-1, Ki-67, p63, p53 and high–molecular weight cytokeratin expressions in papillary thyroid carcinoma, follicular carcinoma, and follicular adenoma

Annals of Diagnostic Pathology — Mon, 14 Feb 2011 00:00:00 +0100

Abstract: The searching of the reliable and repeatable immunohistochemical markers in the differential diagnosis of the thyroid's differentiated follicular epithelial neoplasms has been continuing. Recently, the studies have majored on immunohistochemical markers such as high–molecular weight cytokeratin (HMW-CK), galectin-3, cytokeratin 19, and p27. We aimed to evaluate the differences of the expressions of the proliferating cell nuclear antigen (PCNA), thyroid transcription factor-1 (TTF-1), Ki-67, p63, p53, and HMW-CK among the papillary thyroid carcinomas (PTCs), follicular carcinomas (FCs), and follicular adenomas (FAs). Thirty-nine patients with the diagnoses of the PTC, FC, and FA in the archives of the Izmir Tepecik Training and Research Hospital Pathology Laboratory registries i...

Metastatic gastric adenocarcinoma primarily presenting in the fallopian tube

Annals of Diagnostic Pathology — Thu, 10 Feb 2011 05:00:00 +0100

We report a 48-year-old woman presenting with gastric adenocarcinoma metastatic only to the left fallopian tube. In addition to invasive, poorly differentiated adenocarcinoma, there were areas simulating intraepithelial carcinoma, suggesting a primary fallopian tube lesion. The differential diagnosis included a metastatic process, based on unusual morphologic patterns with occasional signet-ring cells, single-cell linear pattern of infiltration, and abundant lymphvascular space invasion. Metastasis from an upper gastrointestinal primary was confirmed by immunostains (cytokeratin 7, CDX-2, and p53 positive in the tumor cells and cytokeratin 20, WT-1, estrogen, and progesterone receptors negative). Imaging studies and a posterior biopsy demonstrated primary gastric adenocarcinoma with simila...

Mucin poor mucinous tubular and spindle cell carcinoma of the kidney, with nonclassic morphologic variant of spindle cell predominance and psammomatous calcification

Annals of Diagnostic Pathology — Thu, 10 Feb 2011 05:00:00 +0100

We report a challenging case of mucin-poor MTSCC with marked spindle cell predominance and focal psammomatous calcification in a 39-year-old man and describe its histologic and immunohistochemical features. Pathologists must be aware of the histologic spectrum of MTSCCs to ensure their accurate diagnosis. (Source: Annals of Diagnostic Pathology)

Masthead

Annals of Diagnostic Pathology — Wed, 19 Jan 2011 18:58:40 +0100

(Source: Annals of Diagnostic Pathology)

Annals of Diagnostic Pathology — Wed, 19 Jan 2011 18:58:40 +0100

(Source: Annals of Diagnostic Pathology)

Instructions for Authors

Annals of Diagnostic Pathology — Wed, 19 Jan 2011 18:58:40 +0100

(Source: Annals of Diagnostic Pathology)

New developments in the molecular pathogenesis of head and neck tumors: a review of tumor-specific fusion oncogenes in mucoepidermoid carcinoma, adenoid cystic carcinoma, and NUT midline carcinoma

Annals of Diagnostic Pathology — Wed, 19 Jan 2011 18:58:40 +0100

Abstract: Tumor-specific chromosomal rearrangements often produce potent fusion oncogenes, which induce tumorigenesis by 2 alternative mechanisms: deregulation of the cell cycle resulting in gene overexpression or gene fusion resulting in a hybrid, chimeric oncogene. Tumor-specific recurrent chromosomal translocations and novel fusion oncogenes in aggressive head and neck malignancies have diagnostic, therapeutic, and prognostic implications. Recently, pathognomonic fusion transcripts have been identified in various uncommon, aggressive head and neck malignancies, including mucoepidermoid carcinoma (MEC), adenoid cystic carcinoma (ACC), and NUT midline carcinoma (NMC). The t(11;19)(q12;p13) translocation in MEC results in fusion of the MECT1 gene at 19p13 and the MAML2 gene at 11q21. The M...

Chromosomal abnormalities in renal cell carcinoma variants detected by Urovysion fluorescence in situ hybridization on paraffin-embedded tissue

Annals of Diagnostic Pathology — Wed, 19 Jan 2011 18:58:40 +0100

In conclusion, we showed that RCC has overlapping chromosomal abnormalities with urothelial carcinoma and can cause a positive UVFISH result. This has implications for the interpretation of Urovysion in patients whose urine contains malignant cells but who have negative cystoscopy and a concomitant renal mass. The chromosomal abnormalities observed in RCC are not distinct from those in urothelial carcinoma; therefore, UVFISH cannot distinguish these tumor types, nor can it type or grade RCC. (Source: Annals of Diagnostic Pathology)

Editorial Board

Annals of Diagnostic Pathology — Wed, 19 Jan 2011 18:58:39 +0100

(Source: Annals of Diagnostic Pathology)

Extraoral plasmablastic lymphoma with intravascular component and MYC translocation

Annals of Diagnostic Pathology — Tue, 18 Jan 2011 05:00:00 +0100

We describe a case of extraoral PBL in an human immunodeficiency virus–infected patient with a computed tomography–identified heterogeneously enhancing mass in the stomach. Histologically, a prominent intravascular component was identified. Fluorescent in situ hybridization analysis for MYC/IGH (immunoglobulin heavy chain) rearrangement t(8;14) identified fusion signals, confirming the presence of MYC rearrangement. The presence of a prominent intravascular in our case is unique. To our knowledge, these findings have not been observed in the previous reports of PBL. The observation of this vascular component supports the heterogeneity of PBL and may be an indicator of tumor aggressiveness. We were able to demonstrate the MYC/IGH rearrangement in our case of PBL. The interplay between E...

Oncocytoma of the kidney with prominent intracytoplasmic lumina

Annals of Diagnostic Pathology — Tue, 18 Jan 2011 05:00:00 +0100

We present the clinical and pathologic details of an oncocytoma of the kidney with an unusual histologic appearance imparted by the presence of large numbers of prominent intracytoplasmic lumens. Morphologically, the neoplasm was composed of uniform polygonal cells with copious amounts of granular, eosinophilic cytoplasm, round nuclei, and prominent nucleoli, exhibiting an organoid pattern of growth. Intracytoplasmic lumina of varying size were present throughout the tumor. There were no mitotic figures or areas of necrosis present. The diagnosis of oncocytoma was supported by immunohistochemical and ultrastructural studies. By electron microscopy, the intracytoplasmic lumens appeared as membrane bound spaces with associated microvilli. The presence of intracytoplasmic lumina in a signific...

Number of portal tract macrophages correlates with the modified hepatic activity index in chronic hepatitis C infection

Annals of Diagnostic Pathology — Tue, 18 Jan 2011 00:00:00 +0100

Abstract: The Ishak modified hepatic activity index (mHAI) is widely used to score disease activity in chronic hepatitis C infection. However, the scoring of the mHAI components is subjective and prone to interobserver variation. Liver injury results in increased numbers of portal tract macrophages, which are easily identified via periodic acid–Schiff with diastase digestion stain. Evaluation of 30 liver biopsies from patients with chronic hepatitis C revealed increasing numbers of portal tract macrophages as scores of liver inflammation increased. Specifically, the number of PASD-positive portal tract macrophages per centimeter of biopsy length correlated with the level of portal inflammation and total mHAI score, and these correlations were statistically significant (P = .039 and .029,...

A uterine leiomyoma in which a leiomyosarcoma with osteoclast-like giant cells and a metastasis of a ductal breast carcinoma are present

Annals of Diagnostic Pathology — Mon, 10 Jan 2011 05:00:00 +0100

Abstract: Leiomyosarcoma of the uterus is a rare tumor, and the presence of osteoclast-like giant cells in this tumor is even rarer. A leiomyosarcoma arising in a leiomyoma is also quite unique. Breast cancer metastasizing to the uterus is seldom seen as well. A 70-year-old woman presented with metastasized breast cancer to the bones. An evaluation of the computed tomographic scan was made, which showed an enlarged uterus with a tumor. The tumor was a leiomyoma in which a leiomyosarcoma with osteoclast-like giant cells as well as a metastasis of a ductal breast carcinoma was present. To our knowledge, this is the first report of a leiomyosarcoma containing osteoclast-like giant cells, present in a leiomyoma, in a uterus also containing a ductal breast cancer metastasis present in the leiom...

Epidemiology and correlation of the clinicopathological features in oral epithelial dysplasia: analysis of 173 cases

Annals of Diagnostic Pathology — Wed, 29 Dec 2010 00:00:00 +0100

This study aimed to determine the epidemiology and then correlate it with the clinicopathological features of OED. One hundred seventy-three cases of oral lesions retrieved from the files of a Service of Pathological Anatomy, covering a 38-year period, were submitted to descriptive statistical analysis through the Pearson χ2 test. The majority of cases were from affected females (57.9%), with a peak of occurrence in the age group of 41 and 55 years (37.3%), white patients (64.8%), and those with lesions located on the gingiva/alveolar ridge (25.1%). The lesions predominantly presented with white color (56.8%) and were described as nodules (27.4%), with a rough surface (76.7%), an exophytic growth (79.1%), and a sessile base (95.6%). The majority of the lesions with degree of mild (34.6%) ...

Cutaneous angiosarcoma. Analysis of 434 cases from the Surveillance, Epidemiology, and End Results Program, 1973-2007

Annals of Diagnostic Pathology — Wed, 29 Dec 2010 00:00:00 +0100

Abstract: Cutaneous angiosarcoma is an aggressive malignant mesenchymal vasoformative neoplasm that accounts for 1% of all soft tissue sarcomas. Using data from the National Cancer Institute's Surveillance, Epidemiology, and End Results program, we analyzed the demographics and survival of cutaneous angiosarcoma. The Surveillance, Epidemiology, and End Results program recorded 434 cases of cutaneous angiosarcoma from 1973 to 2007. The incidence was nearly the same in men (222 cases) and women (212 cases). Most patients were white (88%) with a mean age of 73 years. African Americans made up only 4% of the cases. Two hundred seventy (62%) cases were tumors of the head and neck, whereas 106 (24%) cases arose in the skin of the trunk. Grade was recorded in 194 cases (45%): 28 were grade I, 44 ...

Endolymphatic sac tumor (aggressive papillary tumor of middle ear and temporal bone): sine qua non radiology-pathology and the University of Texas MD Anderson Cancer Center experience

Annals of Diagnostic Pathology — Fri, 17 Dec 2010 00:00:00 +0100

Abstract: Endolymphatic sac tumor (ELST) is a rare lesion of the skull base for which the origin has recently been ascertained. The endolymphatic sac is derived from neuroectoderm and is located subjacent to the posteromedial surface of the temporal bone. Patients characteristically present with hearing loss, tinnitus, and vertigo; facial nerve paralysis occurs less commonly. An indolent clinical course and long-standing symptom history is typical. Endolymphatic sac tumors are known to occur more frequently in patients with von Hippel-Lindau disease, but this is not a prerequisite for diagnosis because sporadic occurrence is common. Morphologically, all of the ELSTs showed a papillary and glandular architecture. The papillary and glandular structures were lined by a single layer of flatten...

Paneth cell-like eosinophilic cytoplasmic granules in breast carcinoma

Annals of Diagnostic Pathology — Fri, 17 Dec 2010 00:00:00 +0100

In this study, we report 3 breast carcinoma cases with such granules. Two of the cases were carcinomas arising in microglandular adenosis, one of which contained areas of acinic carcinoma-like features. The other case was a mammary carcinoma with prominent microglandular adenosis and also acinic cell carcinoma growth patterns. In the latter case, the patient had a history of neoadjuvant chemotherapy; and cells with coarse granules were found in both the pretreatment and posttreatment specimens. Although all 3 tumors were negative for HER2/neu, 2 tumors were estrogen receptor/progesterone receptor negative and one was estrogen receptor/progesterone receptor positive. Follow-up for 2 patients at 12 months and 3 years showed no evidence of disease, and the other patient died of her disease at...

Breast carcinomas with isolated bone metastases have different hormone receptor expression profiles than those with metastases to other sites or multiple organs

Annals of Diagnostic Pathology — Fri, 17 Dec 2010 00:00:00 +0100

Abstract: Breast carcinoma (BC) is one of the most common osteotropic tumors. The subset of BC patients with isolated bone metastasis (IBM) forms a clinically distinct group and often has a favorable clinical outcome as compared to others with metastatic BC. We analyzed all BC patients with distal organ metastasis in our institution between 1997 and 2003 (N = 198) to identify the clinicopathologic features of BC with IBM and compare them to those with metastasis to other sites. We found that 63% of BC patients with advanced disease had bone metastases, and 44% of those were IBM. The proportion of cases with IBM that expressed estrogen receptor and/or progesterone receptor (47/52; 90%) was significantly higher than those with non–bone metastases (P < .0001) and than those with multiple me...

Invasive ductal carcinoma of the pancreas tail with noninvasive growth through the nondilated main pancreatic duct and macroscopically cystic invasive carcinomatous glands

Annals of Diagnostic Pathology — Thu, 25 Nov 2010 05:00:00 +0100

Abstract: Noninvasive growth forming macroscopically dilated cystic pancreatic ducts is a fundamental feature of intraductal papillary mucinous neoplasm (IPMN), from which invasive carcinomas can arise. However, some invasive ductal carcinomas of the pancreas also show a macroscopically cystic feature. We experienced 2 cases of invasive ductal carcinoma of the pancreas tail with noninvasive growth through the main pancreatic duct without dilation at the body side, and with collection of macroscopically cystic carcinomatous glands infiltrating at the spleen side, which resembled some IPMNs and/or IPMN-derived invasive carcinomas. These cases were different from IPMN in that they lacked macroscopic dilatation of the pancreatic ducts, and the macroscopically dilated cystic carcinomatous gland...

High-grade mucinous tubular and spindle cell carcinoma: comparative genomic hybridization study

Annals of Diagnostic Pathology — Thu, 25 Nov 2010 05:00:00 +0100

We present the first case of high-grade MTSCC with comparative genomic hybridization findings. A 60-year-old Japanese man presented with weight loss and general fatigue. He underwent radical nephrectomy because of the clinical diagnosis of renal cancer. Histologic examination of renal tumor showed findings of high-grade MTSCC. Comparative genomic hybridization analysis showed gain of chromosomes 1q, 7, 16, 19q, and Y and loss of chromosomes 1p, 6p, 8p, 11q (del(11)(q23)), and 13. G-band karyotype showed gain of chromosomes 2, 3, 5, 7, 12, 16, and 20 and loss of chromosome 15. Results of our molecular genetic analysis support the idea that high-grade MTSCC is a real counterpart of low-grade MTSCC. There is no evidence to designate such tumors as unclassified renal cell carcinoma. (Source: A...

Nuclear and cytoplasmic Id-1 expression patterns play different roles in angiogenesis and lymphangiogenesis in gastric carcinoma

Annals of Diagnostic Pathology — Thu, 25 Nov 2010 00:00:00 +0100

Abstract: The purpose of the study was to investigate the expression and impact of Id-1 (inhibitor of differentiation) on tumor progression, angiogenesis, and lymphangiogenesis in gastric adenocarcinoma. The study included 97 cases of gastric adenocarcinoma, which were surgically excised at the Second Hospital of Shandong University. Immunohistochemistry was used to detect the Id-1 expression, and dual-labeling immunohistochemistry was used to evaluate the microvessel density (MVD) and lymphatic vessel density (LVD). The Id-1 protein was mainly expressed with nuclear staining in well-differentiated carcinoma, but with cytoplasmic staining in moderately and poorly differentiated carcinoma, which showed a significant difference (P < .0001). Moreover, the expression patterns had different and...

Inhibitor of differentiation is overexpressed with progression of benign to malignant lesions and related with carcinoembryonic antigen–related cell adhesion molecule 1 distribution in mammary glands

Annals of Diagnostic Pathology — Thu, 25 Nov 2010 00:00:00 +0100

Abstract: The purpose of the study was to investigate the expression and association of inhibitor of differentiation (Id-1) and carcinoembryonic antigen–related cell adhesion molecule 1 (CEACAM1) in benign, premalignant, and malignant lesions of human mammary glands. The study included 97 cases of benign, premalignant, and malignant lesions of human mammary glands including normal terminal duct lobular units, usual ductal hyperplasia, atypical ductal hyperplasia, ductal carcinoma in situ, and invasive ductal carcinoma that were surgically excised at the Second Hospital of Shangdong University. Immunohistochemistry was used to determine the expression of Id-1 and CEACAM1. The Id-1 expression was increased with the progression of benign to malignant transformation (P < .05) and positively ...

Malignant mesothelioma with prominent adenomatoid features: a clinicopathologic and immunohistochemical study of 10 cases

Annals of Diagnostic Pathology — Thu, 25 Nov 2010 00:00:00 +0100

Abstract: The clinicopathologic and immunohistochemical features of 10 cases of pleural malignant mesothelioma with predominantly adenomatoid growth pattern are described to determine the clinical, histologic, and behavioral features of these tumors and to highlight the importance of separating this unusual pattern from the benign adenomatoid tumor. Seventy-seven cases of pleural biopsy and extrapleural pneumonectomy specimens for malignant mesothelioma were examined to identify the specific type of histologic growth pattern exhibited by the tumors. The 10 cases herein described were identified as an unusual histopathologic subset of these tumors. Nine patients were men and one was a woman with an age range of 56 to 82 years (mean, 68.5 years). The main presenting symptoms included cough, ...

Effects of interventions on intra- and interobserver agreement on interpretation of nonalcoholic fatty liver disease histology

Annals of Diagnostic Pathology — Thu, 25 Nov 2010 00:00:00 +0100

Abstract: Accurate and reproducible interpretation of nonalcoholic fatty liver disease (NAFLD) histology has significant clinical and research-related implications. We evaluated the impact of 2 interventions ([1] review of illustrative histologic images of NAFLD with the study pathologists; [2] use of a scoring sheet with written diagnostic criteria for different NAFLD phenotypes) on intra- and interobserver agreement on interpretation of NAFLD histology. Before and after the interventions, 2 pathologists twice read 65 liver biopsies done for evaluation of suspected NAFLD. The intra- and interobserver agreement was highest on assessment of steatosis and fibrosis. The interventions significantly improved the intraobserver agreement only on assessment of hepatocellular ballooning. The intero...

Editorial Board

Annals of Diagnostic Pathology — Tue, 16 Nov 2010 12:51:18 +0100

(Source: Annals of Diagnostic Pathology)

Masthead

Annals of Diagnostic Pathology — Tue, 16 Nov 2010 12:51:18 +0100

(Source: Annals of Diagnostic Pathology)

Annals of Diagnostic Pathology — Tue, 16 Nov 2010 12:51:18 +0100

(Source: Annals of Diagnostic Pathology)

Instructions to Authors

Annals of Diagnostic Pathology — Tue, 16 Nov 2010 12:51:18 +0100

(Source: Annals of Diagnostic Pathology)

Uterine tumors resembling ovarian sex cord-stromal tumors: synchronous uterine tumors resembling ovarian sex cord-stromal tumors and ovarian sex cord tumor

Annals of Diagnostic Pathology — Tue, 16 Nov 2010 12:51:14 +0100

Abstract: Uterine tumors resembling ovarian sex cord-stromal tumors (UTROSCTs) are very rare. In this article, we present 3 cases that manifest classical histomorphological features alongside diverse immunohistochemical findings. As a distinctive finding, one of the patients had UTROSCT in the uterus and an ovarian sex cord tumor, called granulosa cell tumor, in the left ovary, simultaneously. Problems in diagnosing such pathologic condition generally arise because of the variable histologic picture of UTROSCT and may cause problems for general and other nongynecologic surgical pathologists. Immunohistochemically, these tumors express different markers that indicate their polyphenotypic origins. (Source: Annals of Diagnostic Pathology)

Papillary apocrine metaplasia and columnar cell lesion with atypia: is there a shared common pathway?

Annals of Diagnostic Pathology — Tue, 16 Nov 2010 12:51:13 +0100

In this study, we investigated their relationship at the morphological level, as we noticed their histologic coexistence and proximity in daily routine. We selected 93 neoplastic and nonneoplastic cases with both PAM and CCL among 477 breast specimens and reevaluated sections by measuring the distance between these lesions. Ninety-three (19.4%) of 477 breast specimens contained both PAM and CCL; in 73.1% of the cases, the 2 lesions were in continuity with or adjacent to each other. Lesions less distant than 1 mm are grouped as “adjoining lesions”; and the rest, as “distant lesions.” A significant difference (P = .006) was found between adjoining (“zero” + “ (Source: Annals of Diagnostic Pathology)

Epithelial cell adhesion molecule expression in pituitary adenomas: an immunohistochemical study

Annals of Diagnostic Pathology — Tue, 16 Nov 2010 12:51:13 +0100

Abstract: An important amount of data correlating the expression of epithelial cell adhesion molecule (Ep-CAM) with cellular proliferation and de-differentiation could directly contribute to carcinogenesis. The aim of this study is to evaluate prognosis relevance of Ep-CAM expression in a group of pituitary adenomas. Epithelial cell adhesion molecule, proliferating cell nuclear antigen, and microvascular density labeling indices in pituitary adenomas were determined by immunohistochemistry on tissue samples obtained from each adenoma after surgery. We evaluated 45 adenomas. Sixty-two percent were nonsecretor adenomas and 37.8% were secretor tumors. Immunohistochemistry was scored for immunoexpression of Ep-CAM (cytoplasmic, membrane, and mixed pattern). Proliferating cell nuclear antigen a...

Human telomerase reverse transcriptase expression in colorectal tumors: correlations with immunohistochemical expressionand clinicopathologic features

Annals of Diagnostic Pathology — Tue, 16 Nov 2010 12:51:13 +0100

In this study, hTERT expression was determined in HP (n = 20), adenomatous polyp (AP) (n = 20), colorectal adenocarcinomas (n = 20), and normal mucosa (n = 20) by immunohistochemical method. The findings were correlated with the clinicopathologic features. The staining level of hTERT in adenomas and carcinomas was significantly higher than in normal tissues (P < .05). There was also significant difference between HP and AP (P < .05). Level of hTERT in carcinomas was higher than in adenomas, but the difference was of no statistical significance (P > .05). There was no significant association of hTERT expression in cancerous, precancerous, or normal mucosa related to clinicopathologic parameters including age, sex, and size of lesion, (P > .05), but only association with histologic grade for...

CRTC1/MAML2 fusion transcript in central mucoepidermoid carcinoma of mandible—diagnostic and histogenetic implications

Annals of Diagnostic Pathology — Tue, 16 Nov 2010 12:51:12 +0100

Abstract: Intraosseous salivary gland carcinomas are extremely rare, comprising only 2% to 3% of all mucoepidermoid carcinomas (MECs) reported. The t(11;19) translocation and its CRTC1/MAML1 fusion transcript have been identified in MEC at different sites and are believed to be associated with the development of a subset of these tumors. However, the status of the fusion transcript has not been reported in intraosseous MEC. Here, we report 3 examples of central MEC of the mandible, including a case with a history of primary retromolar MEC. Reverse transcriptase–polymerase chain reaction and DNA sequencing analyses of the microdissected components of these tumors were used for the detection and verification of the fusion transcript. We identified, for the first time, the t(11;19) fusion g...

Mucinous cystadenoma of the ureter

Annals of Diagnostic Pathology — Mon, 08 Nov 2010 05:00:00 +0100

We describe an interesting case showing features of mucinous cystadenoma arising in the ureter in which the tumor was incidentally detected in a 53-year-old man with significant secondary hydronephrosis and nonfunctioning kidney. (Source: Annals of Diagnostic Pathology)

Gangliocytic paraganglioma: a rare case with metastases of all 3 elements to liver and lymph nodes

Annals of Diagnostic Pathology — Mon, 01 Nov 2010 04:00:00 +0100

Abstract: Gangliocytic paragangliomas are a rare but well-described neuroendocrine tumor with a proclivity for the duodenal area. It is usually a locally infiltrative lesion with a good prognosis. Rare cases that spread to lymph nodes have been documented. A 52-year-old female was found to have a duodenal tumor, enlarged regional lymph nodes, and multiple small nodules in the liver. The duodenal tumor was a classic triphasic gangliocytic paraganglioma. Two regional lymph nodes and one of the nodules in the liver were noted to contain all 3 elements constituting a gangliocytic paraganglioma. This is the second case of gangliocytic paraganglioma with liver spread and is also noteworthy because of the presence of all 3 elements in the metastases. The presence of lymph node and liver metastase...

Acquired cystic disease–associated renal cell carcinoma with sarcomatoid change and rhabdoid features

Annals of Diagnostic Pathology — Mon, 01 Nov 2010 04:00:00 +0100

In conclusion, pathologists and urologists should be aware that rhabdoid features may occur in ACD-associated RCC and that the loss of chromosomes 9 and 14 may occur during the process of sarcomatoid change in ACD-associated RCC. (Source: Annals of Diagnostic Pathology)

Lipomatous variant of myofibroblastoma with epithelioid features: a rare and diagnostically challenging breast lesion

Annals of Diagnostic Pathology — Mon, 01 Nov 2010 04:00:00 +0100

We report a rare case of a lipomatous variant of myofibroblastoma with an epithelioid cell component and discuss the differential diagnosis and potential diagnostic pitfalls. (Source: Annals of Diagnostic Pathology)

Primary perivascular epithelioid cell tumor of the bladder

Annals of Diagnostic Pathology — Mon, 01 Nov 2010 04:00:00 +0100

We report a case of a 23-year-old man who presented with 2-month history of frequent micturition and odynuria. Based on clinical examination, ultrasound computed tomography imaging, surgical operation, and histopathologic studies, a definitive diagnosis was made. Further characteristic images and pathology of this disease are discussed. (Source: Annals of Diagnostic Pathology)

Central odontogenic fibroma

Annals of Diagnostic Pathology — Mon, 25 Oct 2010 04:00:00 +0100

Abstract: Odontogenic fibroma (OF) is a benign odontogenic tumor characterized by various amounts of odontogenic epithelium in a mature fibrous stroma. Two variants can be distinguished: an intraosseous or central OF (COF) and an extraosseous or peripheral. The intraosseous variant is an extremely rare tumor that presents clinical, radiographic, and histopathologic variable findings. A thorough review of the English literature revealed 78 cases of COF so far. Thus, we report an additional case of COF occurring in the maxilla of a 36-year-old woman. In addition, we performed a brief description and discussion of the cases reported in the maxilla and mandible. (Source: Annals of Diagnostic Pathology)

Carcinoma of müllerian origin presenting as colorectal cancer: a clinicopathologic study of 13 Cases

Annals of Diagnostic Pathology — Fri, 22 Oct 2010 00:00:00 +0100

In conclusion, carcinoma of müllerian origin often presents as bulky mass in rectosigmoid or rectovaginal septum clinically mimicking primary colorectal cancer. Endometriosis might be an important etiologic factor. Familiarities of this unusual clinicopathologic entity, careful morphologic evaluation, and immunohistochemical stain with a panel of markers (CK7, CK20, estrogen receptor, progesterone receptor, CDX-2) will be helpful for the correct diagnosis. (Source: Annals of Diagnostic Pathology)

Altered β-catenin expression related to cancer progression on actinic cheilitis and squamous cell carcinoma of the lip

Annals of Diagnostic Pathology — Fri, 22 Oct 2010 00:00:00 +0100

Abstract: β-Catenin is a bifunctional protein related to cell adhesion and gene transcription when activated by Wnt pathway. Altered expression of β-catenin was related to loss of differentiation, more aggressive phenotype, increase of tumor invasion, and poor prognosis in a number of different cancers. Actinic cheilitis is caused by excessive exposure to ultraviolet radiation and has a high potential to suffer malignant transformation into squamous cell carcinoma (SCC) of the lip, the most frequent oral malignancy. Studies of oral cancer have shown the correlation of β-catenin expression and oral SCC prognosis, and loss of membrane expression may be considered as a potential marker for early tumor recurrence. Thirty-five cases of actinic cheilitis and 12 cases of SCC of the lip were se...

Combined tubular adenocarcinoma and hepatoid adenocarcinoma arising in Barrett esophagus

Annals of Diagnostic Pathology — Mon, 18 Oct 2010 04:00:00 +0100

We report the fourth case here. A 76-year-old Japanese man was admitted to our hospital because of the deterioration of nephritic syndrome. He presented with chest burn, and the endoscopic examination of upper digestive tract disclosed the tumor in the lower esophagus. The subtotal esophagectomy was undertaken because of esophageal cancer. The postoperative histologic examination showed the finding of combined tubular adenocarcinoma and hepatoid adenocarcinoma arising in Barrett esophagus. Immunohistochemically, hepatoid adenocarcinoma cells were positive for a-fetoprotein, hepatocyte, a1-antitrypsin, a1-antichymotrypsin, and CDX2, but negative for MUC5AC and MUC6. Esophageal hepatoid adenocarcinoma seems to be closely associated with Barrett esophagus and show the intestinal phenotype rat...

Primary squamous carcinoma of the ovary likely arising from a monodermal cystic mucinous teratoma

Annals of Diagnostic Pathology — Mon, 11 Oct 2010 04:00:00 +0100

We present a 58-year-old woman with primary squamous carcinoma of the ovary likely arising from a monodermal cystic mucinous teratoma. Noninvolved ovary showed no Brenner tumor, endometriosis, transitional carcinoma, endometrioid adenocarcinoma, or typical multigerm layer classic mature teratoma. Moreover, no other primary site was possible because there were no prior or concomitant squamous carcinomas, or history of cervical intraepithelial neoplasia. The tumor showed strong positivity for p63 and CK5/6, reactivity that also extended from the squamous carcinoma into the basal-cell lining of the mucinous cyst of a likely monodermal teratoma. This basal-cell pattern was absent in a series of conventional benign and borderline cystic mucinous cystadenomas of the ovary, but clearly present in...

Endometrioid carcinoma with a low-grade spindle cell component: a tumor resembling an adnexal tumor of probable Wolffian origin

Annals of Diagnostic Pathology — Mon, 11 Oct 2010 04:00:00 +0100

We present a case of ovarian endometrioid carcinoma with a Wolffian adnexal tumor pattern that recurred 19 years after the original surgery; and the patient continues to remain well without evidence of disease 1 year following her second surgery, that is, 20 years of indolent behavior. This long clinical course shows evidence for low-grade behavior for this tumor. (Source: Annals of Diagnostic Pathology)

Muscularis mucosae versus muscularis propria in gallbladder, cystic duct, and common bile duct: smoothelin and desmin immunohistochemical study

Annals of Diagnostic Pathology — Thu, 23 Sep 2010 00:00:00 +0100

In this study, we characterize the histologic aspects of the muscle layer in gallbladder, cystic duct, and common bile duct by evaluation of routine histologic sections and the utilization of immunohistochemistry using desmin and smoothelin. Formalin-fixed, paraffin-embedded sections of the gallbladder (15 cases), cystic duct (11 cases), and common bile duct (10 cases) were stained for smoothelin and desmin. Staining intensity was evaluated as weak or strong. The staining pattern score was evaluated as follows: 0 or negative = less than or equal to 5% positivity, +1 or focal = 6% to 10% positivity, +2 or moderate = 11% to 50% positivity, and +3 = greater than 50% muscle cells positivity. With desmin, strong and diffuse (+3) staining was observed in all gallbladder cases (15/15, 100%), high...

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Annals of Diagnostic Pathology — Sat, 18 Sep 2010 07:34:42 +0100

(Source: Annals of Diagnostic Pathology)

Annals of Diagnostic Pathology — Sat, 18 Sep 2010 07:34:42 +0100

(Source: Annals of Diagnostic Pathology)

Early-stage mycosis fungoides variants: case-based review

Annals of Diagnostic Pathology — Sat, 18 Sep 2010 07:34:42 +0100

Abstract: Mycosis fungoides (MF) is the most common type of cutaneous T-cell lymphoma. The diagnosis of classic MF is based on a combination of clinical presentation, histopathology, and T-cell monoclonality detected by molecular studies. However, the diagnosis can be difficult in cases of early MF because of the subtle nature of histologic findings and, in cases of variants of MF, because of the unusual clinical and/or pathologic features. In this review, we presented the most frequent variants of MF at early stage including hypopigmented, folliculotropic, pagetoid reticulosis, unilesional, granulomatous, and ichthyosis forms. This case-based clinicopathologic review provides the notion that a comprehensive clinicopathologic correlation is of substantial importance to render the diagnosis...

Current status of cytology laboratories in anatomic pathology departments

Annals of Diagnostic Pathology — Sat, 18 Sep 2010 07:34:41 +0100

Abstract: Details of cytology work in 103 US histology laboratories (histolabs) and in 200 from 18 other countries are presented. Data from 1345 additional US cytology practices surveyed from 1985 to 2004 are also included. The average annual workload in 130 histolabs from the United States and 12 other countries combined is 32 200 cases. The average annual workload in 173 histolabs from Spain and 5 Hispano-American countries is 20 000 cytology cases, a workload that is significantly lower (P < .0005) than that in US laboratories. Gynecologic cases, with an average of 1.2 slides each, represent 79% of all cytology accessions in all laboratories. The average annual workload per cytotechnologist (CT) is 6600 cases; this number is not significantly different between countries (P > .10 to ...

Chagas disease and gynecologic neoplasias

Annals of Diagnostic Pathology — Sat, 18 Sep 2010 07:34:41 +0100

The objective was to determine the occurrence of gynecologic neoplasia (GN) and demographic characteristics in patients with Chagas disease (CD). We used protocols of 671 autopsies between 1976 and 2008. The patients were divided into 3 groups: with GN and CD, only with CD, and only with GN. The 2 diseases were observed in 4.5% of patients with a mean age of 47.6 years and who were predominantly white. The megaesophagus and megacolon were more frequent in the group with only CD. The most common benign neoplasm was uterine leiomyoma, and malignant, carcinoma of the cervix. We conclude that the epidemiological profile of patients with CD and GN was similar to the other groups, and the CD was found not to be a risk factor or protective against the development of GN. (Source: Annals of Diagnos...

Podoplanin, a novel marker for seminoma: A comparison study evaluating immunohistochemical expression of podoplanin and OCT3/4

Annals of Diagnostic Pathology — Sat, 18 Sep 2010 07:34:40 +0100

In this study we investigate the utility of podoplanin expression in the diagnosis of testicular germ cell tumors. Sixty-eight cases of testicular mixed germ cell tumors were analyzed using a polyclonal antibody and compared to the results for OCT3/4. Stained sections were graded semiquantitatively as follows: negative (no expression), 1+ (mild intensity), 2+ (moderate intensity), 3+ (intense staining). Diffuse cytoplasmic expression of podoplanin with membrane accentuation was seen in the seminoma component of all cases. Lymphocytes and interstitial cells were negative. In mixed germ cell tumors, podoplanin identified small clusters of seminoma cells lying adjacent to nonseminomatous components. Focal staining was present in one third of cases of choriocarcinoma. There was no significant ...

Cutaneous angiomyxoma and pilomatricoma: a new combination

Annals of Diagnostic Pathology — Sat, 18 Sep 2010 07:34:40 +0100

We present a rare and unique combination of angiomyxoma and pilomatricoma. This combination may be incidental, representing collision tumors or etiologically related. (Source: Annals of Diagnostic Pathology)

Soft tissue Rosai-Dorfman disease: 29 new lesions in 18 patients, with detection of polyomavirus antigen in 3 abdominal cases

Annals of Diagnostic Pathology — Sat, 18 Sep 2010 07:34:40 +0100

Abstract: Soft tissue Rosai-Dorfman disease (STRDD) is rare, previously reported only as single cases and few series. Simian virus 40 (SV40), a polyomavirus, has been identified in lymphoid processes and has a controversial role in neoplasia etiology. Occasional cytoplasmic pink granular inclusions and nuclear changes led us to explore a viral etiology. Only unpublished STRDD from our files with adequate material, soft tissue location, and diagnostic confirmation were included. Immunohistochemistry and follow-up were obtained. Eighteen STRDD patients, 4 male and 14 female, had 29 lesions; 5 with 2 or more lesions. Ages ranged from 8 to 81 years (mean 42.6 years and median 42.5 years). Soft tissue Rosai-Dorfman disease locations include trunk or proximal extremity (n = 19), distal extremity...

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Annals of Diagnostic Pathology — Sat, 18 Sep 2010 07:34:40 +0100

(Source: Annals of Diagnostic Pathology)

Epithelioid malignant peripheral nerve sheath tumor of the uterine corpus

Annals of Diagnostic Pathology — Wed, 01 Sep 2010 04:00:00 +0100

Abstract: Epithelioid variant of a malignant peripheral nerve sheath tumor (MPNST) is a rare sarcoma. Rarer still is its occurrence at uncommon sites like the uterine corpus where an index of suspicion for this diagnosis is extremely low. Herein, we report a rare case of a uterine epithelioid MPNST in a young girl who underwent a total abdominal hysterectomy for a uterine tumor that was initially diagnosed as an undifferentiated sarcoma and whose paraffin blocks were submitted to us for review. Biopsy sections showed a malignant tumor, predominantly composed of polygonal cells, including “rhabdoid” forms with conspicuous mitoses. On immunohistochemistry, tumor cells were diffusely positive for vimentin and S-100 and negative for smooth muscle actin, desmin, myogenin cytokeratin, epithe...

Plasmablastic lymphoma of the oral cavity in an HIV-negative patient

Annals of Diagnostic Pathology — Wed, 01 Sep 2010 04:00:00 +0100

We report a case of HIV-negative PBL arising on the left areas of posterior teeth mucosa of a 58-year-old man. Immunohistochemically, the tumor cell was immunoreactive for CD138, VS38c, VEGF, and vimentin; Ki-67 showed a high proliferation rate. Epstein-Barr virus (in situ hybridization) was nonreactive, and IgH gene rearrangement was identified by polymerase chain reaction amplification products. A diagnosis of PBL was rendered. (Source: Annals of Diagnostic Pathology)

A unique case of an indolent CD56-positive T-cell lymphoproliferative disorder of the gastrointestinal tract: a lesion potentially misdiagnosed as natural killer/T-cell lymphoma

Annals of Diagnostic Pathology — Wed, 01 Sep 2010 04:00:00 +0100

This report confirms that patients may rarely present with a CD56-positive NK/T-cell–like proliferation of the gastrointestinal tract, yet follow an indolent clinical course. Thus, all pathologic features of enteropathy-associated T-cell lymphoma or NK/T-cell lymphoma should be present before making this diagnosis and exposing the patient to toxic chemotherapy. (Source: Annals of Diagnostic Pathology)

Bile duct–like differentiation in teratoma: a clinicopathologic and immunohistochemical study

Annals of Diagnostic Pathology — Wed, 01 Sep 2010 00:00:00 +0100

Abstract: The presence of biliary differentiation as part of teratoma is very unusual and has been reported only once as part of hepatocellular component; however, its incidence and significance were not studied. We reviewed available mixed germ cell tumors and pure teratomas for the last 18 years at our institution. Data on age, tumor size, location, gross and microscopic findings, proper prior clinical history, and outcome were obtained. Histologic components of teratoma were evaluated; percentage of bile duct–like structures was calculated, and cases were immunohistochemically studied. Forty-five cases were included (19 testicular neoplasms, 20 retroperitoneal lymph node resections, 5 mediastinal tumors, and 1 pulmonary resection), obtained from male patients 15 to 48 years old (mean,...

Bilateral renal tumors; conventional clear cell carcinoma and contralateral t(6;11)/t(X;17)-like tumor: Histomorphologic, immunohistochemical, ultrastructural and molecular genetic studies including the report of a novel mutation in the VHL gene

Annals of Diagnostic Pathology — Mon, 16 Aug 2010 04:00:00 +0100

Abstract: A 34-year-old pregnant woman with bilateral kidney tumors 9.5 and 2.5 cm in maximum diameter is presented. The larger tumor was clear renal cell carcinoma. The smaller contralateral tumor was focally HMB45 positive and had unusual histomorphology, including features resembling clear renal cell carcinoma with features of both t(6;11)- and t(X;17)/ASPL-TFE3 carcinomas. This tumor displayed a complex karyotype. A novel germ line mutation in the VHL gene (c.439A>G/p.I147V) was also identified in this patient. (Source: Annals of Diagnostic Pathology)

Immunohistochemical expression of epidermal growth factor receptor, E-cadherin, and matrix metalloproteinase–9 in ovarian epithelial cancer and relation to patient deaths

Annals of Diagnostic Pathology — Mon, 16 Aug 2010 00:00:00 +0100

In this study, we investigated the immunohistochemical expression of EGFR, E-cadherin, and MMP-9 in 120 cases of ovarian epithelial carcinoma; their relation to each other; their relation to histologic type, grade, and stage; and their relation to death rates after 3years of follow-up. Our results show that EGFR and MMP-9 were overexpressed extensively in high grades and advanced stages especially in nonserous carcinomas. E-cadherin was gradually lost in advanced cancers. There was a positive relation between the 3 antibodies and between them and the death rates. There is a strong relationship between EGFR and MMP-9, and this relation may occur by affecting E-cadherin. The present study provides a rationale for evaluating drugs that target these new pathways that may be promising in ovaria...

Familial gastrointestinal stromal tumor with germ line mutation of the juxtamembrane domain of the KIT gene observed in relatively young women

Annals of Diagnostic Pathology — Tue, 20 Jul 2010 04:00:00 +0100

Abstract: Familial gastrointestinal stromal tumor (GIST) is an extremely rare autosomal dominant disorder, and approximately 20 families have been reported to date. In this article, we present one additional family. A 25-year-old Japanese woman presented with abdominal pain, and subsequent image analyses disclosed multiple tumors measuring 12 cm in maximum diameter in the lower digestive tract. The postoperative histologic examination showed multiple GISTs and diffuse hyperplasia of interstitial cells of Cajal. Her mother had a history of GIST in the digestive tract. Three members of this family including her younger sister and mother had cutaneous hyperpigmentation of external genitalia and axilla. Their DNA samples showed identical missense mutation at exon 11 in the juxtamembrane domain...

Cystic paraganglioma of the anterior mediastinum

Annals of Diagnostic Pathology — Mon, 19 Jul 2010 23:00:00 +0100

We report a case of a 43-year-old man presenting with chest pain and left arm paresthesias. Imaging studies revealed a well-defined cystic lesion located in the anterior mediastinum, with the patient undergoing subsequent surgical resection of the mass. Grossly, the heterogenous mass measured 6.0 × 3.6 × 1.7 cm, with prominent cystic spaces and scattered solid areas. Microscopic examination revealed pseudocystic spaces with proliferation of large epithelioid cells with abundant eosinophilic cytoplasm, moderate pleomorphic nuclei, and prominent nucleoli, in a nested pattern of growth along the cysts walls. Immunohistochemical stains showed strong positivity for chromogranin, synaptophysin, and CD56 in the epithelioid cells, with negative staining for cytokeratin AE1/AE3, confirming the di...

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Annals of Diagnostic Pathology — Fri, 16 Jul 2010 06:25:15 +0100

(Source: Annals of Diagnostic Pathology)

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Annals of Diagnostic Pathology — Fri, 16 Jul 2010 06:25:15 +0100

(Source: Annals of Diagnostic Pathology)

Annals of Diagnostic Pathology — Fri, 16 Jul 2010 06:25:15 +0100

(Source: Annals of Diagnostic Pathology)

The role of routine immunohistochemistry for Helicobacter pylori in gastric biopsy

Annals of Diagnostic Pathology — Fri, 16 Jul 2010 06:25:14 +0100

Abstract: Helicobacter pylori infection is associated with gastritis, gastric ulcer, gastric adenocarcinoma, and mucosal associated lymphoid tissue lymphoma. Documenting the presence of H pylori in a gastric biopsy is essential for appropriate patient care. Several special stains and immunohistochemistry (IHC) stain for H pylori are available, and many laboratories are routinely using one of them. We introduced routine IHC for H pylori about a year ago, and this study aims to investigate the value of this protocol. A total of 224 patients qualified for the study criteria during this period. The diagnoses were chronic active gastritis (68), chronic gastritis (76), no pathologic abnormality (50), reactive gastropathy (24), and polyps (6). Fifty-four cases were positive for H pylori on IHC, i...

Lobular carcinoma in situ/atypical lobular hyperplasia on breast needle biopsies: does it warrant surgical excisional biopsy? A study of 27 cases

Annals of Diagnostic Pathology — Fri, 16 Jul 2010 06:25:14 +0100

Abstract: Lobular neoplasia including lobular carcinoma in situ (LCIS) and atypical lobular hyperplasia (ALH) may be identified in breast core needle biopsies as incidental findings or associated with microcalcifications. There are no general consensus guidelines for follow-up management in patients when lobular neoplasia is the only abnormal finding on core needle biopsy. The aim of this study was to evaluate our experience in the follow-up of these patients. A total of 3163 breast core needle biopsies were retrieved from the surgical pathology files between 2003 and 2009; among them, 56 (1.8%) cases were identified with a diagnosis of ALH or LCIS. Eleven cases were excluded because of the presence of a concurrent more severe lesion in the biopsies that mandated excision. The remaining 45...

Gonadoblastoma: an unusual ovarian tumor

Annals of Diagnostic Pathology — Fri, 16 Jul 2010 06:25:14 +0100

In this study, we reviewed 3 gonadoblastoma cases, 2 of which were bilateral, in patients 21, 17, and 18 years of age. Two of them presented 46 XY karyotype and gonadal dysgenesis, whereas the third presented 46 XX karyotype. Besides, 2 of the cases were associated to dysgerminomas. In all the cases, the histologic examination showed germ cell proliferation and sex cords derivatives frequently surrounding small round deposits containing amorphous hyaline material resembling Call-Exner bodies. One of the patients died at 8 years from diagnosis because of dysgerminoma multiple metastases, one is alive with no evidence of disease at the second year of follow-up, and the evolution of the third patient remains unknown. (Source: Annals of Diagnostic Pathology)

Clinicopathologic analysis of 7 cases of oral schwannoma and review of the literature

Annals of Diagnostic Pathology — Fri, 16 Jul 2010 06:25:13 +0100

Abstract: Schwannomas, also known as neurilemmomas, are uncommon neoplasms apparently derived from Schwann cells. The growth of these tumors causes displacement and compression of the nerve of origin. Schwannomas are usually solitary lesions but can be multiple when associated with neurofibromatosis. Anti-S100 protein is the most widely used antibody for the identification of this neoplasm. Surgical excision is the treatment of choice for schwannomas, with few and controversial reports of recurrence or malignant transformation. The present article reports 7 additional cases of oral schwannoma, and the literature is reviewed regarding clinicopathologic features, immunohistochemical findings, differential diagnosis, and therapeutic management of this benign neural tumor. (Source: Annals of D...

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Annals of Diagnostic Pathology — Fri, 16 Jul 2010 06:25:13 +0100

(Source: Annals of Diagnostic Pathology)

Amphicrine carcinoma of the liver

Annals of Diagnostic Pathology — Fri, 09 Jul 2010 04:00:00 +0100

Abstract: Amphicrine tumors are defined by evidence of both glandular and neuroendocrine differentiation in the same cell. These are extremely rare tumors, with only scattered case reports in the pancreas and stomach. We here report a case of amphicrine carcinoma occurring in apparent isolation in the liver. The tumor was characterized by signet ring cell morphology, mucicarmine, and periodic acid Schiff with diastase (PASD) positivity, and expression of chromogranin, synaptophysin, villin, and CDX2. No other tumor was identified by radiological or endoscopic examination of the gastrointestinal tract. The patient is disease-free 22 months after the resection. We speculate that this represents the first reported occurrence of primary amphicrine carcinoma of the liver. (Source: Annals of Dia...

Hematolymphoid malignancies with intraocular intravascular involvement: report of 2 cases

Annals of Diagnostic Pathology — Thu, 08 Jul 2010 23:00:00 +0100

Abstract: The interaction between the endothelium and malignant hematolymphoid cells within vessels of the eye can result in focal or diffuse intravascular pathology. As a result, correlation of these findings with specific clinical and ophthalmologic features can vary. We review the ophthalmic findings in two cases of hematolymphoid malignancies limited to the intravascular space and review published literature on this topic. In cases of intravascular large B-cell lymphoma, underexpression of β1-integrin and intercellular adhesion molecule-1 by the cells of intravascular large B-cell lymphoma results in diffuse ocular vascular involvement. The widespread degree of intravascular involvement correlates with clinical ophthalmologic findings and may lead to retinal and choroidal detachment t...

Hepatocellular carcinoma arising in association with von-Meyenburg's complexes: an incidental finding or precursor lesions? A clinicopatholigic study of 4 cases

Annals of Diagnostic Pathology — Thu, 24 Jun 2010 23:00:00 +0100

Abstract: Biliary hamartomas or von-Meyenburg complexes form part of a spectrum of ductal plate malformation that includes polycystic liver disease, congenital hepatic fibrosis, and Caroli disease. These lesions are known to have neoplastic transformation. Development of intrahepatic cholangiocarcinoma is well described in these complexes. Rarely, hepatocellular carcinomas (HCCs) have been seen in association with bile duct hamartomas, however; it is not clear whether development of HCC is an epiphenomenon unrelated to the precursor lesion or biliary hamartomas may progress to liver cancers. We herein report 4 interesting cases of hepatitis C virus–, alcohol-, and nonalcoholic fatty liver disease–associated end-stage liver disease with coexisting HCC and multiple large von-Meyenburg co...

A new translocation between chromosomes 6 and 9 helps to establish diagnosis of renal oncocytoma

Annals of Diagnostic Pathology — Tue, 22 Jun 2010 23:00:00 +0100

We describe 2 patients with renal oncocytoma and a new translocation between chromosomes 6 and 9. The tumors in both patients were histologically virtually identical. The t(6;9)(p21;p23) may be a new translocation associated with renal oncocytomas. (Source: Annals of Diagnostic Pathology)

Clear cell papillary renal cell carcinoma and clear cell renal cell carcinoma arising in acquired cystic disease of the kidney: an immunohistochemical and genetic study

Annals of Diagnostic Pathology — Sun, 20 Jun 2010 23:00:00 +0100

We report such a case with focus on genetic study. A 57-year-old Japanese man was found to have 3 renal tumors. Histologically, two tumors showed findings of clear cell RCC; and the other tumor showed findings of clear cell papillary RCC that was characterized by papillary growth pattern of neoplastic cells in cystic space with purely clear cell cytology. Immunohistochemically, tumor cells of clear cell papillary RCC were diffusely positive for PAX2 and cytokeratin 7, but negative for CD10, RCC Ma, and AMACR. In fluorescence in situ hybridization study for one clear cell papillary RCC, we detected polysomy for chromosome 7 and monosomy for chromosomes 17, 16, and 20. In addition, we detected mutation of VHL gene in clear cell RCC, but found no VHL gene mutation in clear cell papillary RCC....

Malignant mixed müllerian tumor of primary peritoneal origin

Annals of Diagnostic Pathology — Sun, 20 Jun 2010 23:00:00 +0100

We describe 2 cases of primary peritoneal MMMT in which the carcinomatous and mesenchymal components were readily identifiable, predominantly involving the peritoneum, with no ovarian involvement. The peritoneum and ovaries, with their common embryologic origin, likely account for the peritoneum's ability to undergo a similar malignant transformation, with the resultant genesis of an MMMT of peritoneal origin. (Source: Annals of Diagnostic Pathology)

Primary vascular tumors of the lungs: a review

Annals of Diagnostic Pathology — Sun, 20 Jun 2010 23:00:00 +0100

Abstract: Unlike their counterparts in other organ systems, primary vascular neoplasms of the lung are rare. Most of these lesions have only been reported as isolated case studies or small series. When dealing with malignant lesions, metastasis from extrapulmonary sites will have to be excluded before a primary location in the lungs can be confirmed. In this review, the clinicopathologic, immunophenotypical, ultrastructural, and molecular biologic characteristics of primary vascular tumors of the lungs are discussed. The tumoral conditions that will be addressed include hemangioma, lymphangioma, epithelioid hemangioendothelioma, angiosarcoma, and Kaposi's sarcoma. Their respective differential diagnoses will also be discussed. (Source: Annals of Diagnostic Pathology)

Botryoid odontogenic cyst: A clinicopathologic study of 10 cases

Annals of Diagnostic Pathology — Thu, 17 Jun 2010 23:00:00 +0100

In this study, a series of 10 cases of botryoid odontogenic cysts retrieved from the archives of the Postgraduation Program in Oral Pathology, Federal University of Rio Grande do Norte (Brazil), were reviewed for epidemiologic data, clinical presentation, radiographic and histopathologic characteristics, treatment, and recurrence. (Source: Annals of Diagnostic Pathology)

Clear cell renal cell carcinoma with focal renal angiomyoadenomatous tumor-like area

Annals of Diagnostic Pathology — Thu, 17 Jun 2010 23:00:00 +0100

Abstract: Recently, renal angiomyoadenomatous tumor (RAT) has been identified. However, there are no descriptions about clear cell renal cell carcinoma (RCC) with focal RAT-like features. A 33-year-old Japanese man was found to have a tumor in the left kidney. Macroscopically, the tumor extended into the perinephric fat tissue, and the cut surface showed the yellowish color. The histologic examination of the tumor consisted of 2 components of clear cell RCC and RAT-like area. The RAT-like area showed the admixture of epithelial cells with basophilic or clear cytoplasm and stromal component containing leiomyomatous stroma, fine capillary network, and pericytic network. Immunohistochemically, epithelial neoplastic cells in RAT-like area were diffusely positive for CD10 and RCC Ma. G-band kar...

Malignant pulmonary epithelioid hemangioendothelioma with hilar lymph node metastasis

Annals of Diagnostic Pathology — Wed, 16 Jun 2010 23:00:00 +0100

In conclusion, atypical cytologic features, the presence of necrosis, a high Ki-67 labeling index, and accompanying nodules of conventional PEH in the same pulmonary lobe suggest that this case was a malignant PEH with hilar lymph node metastasis. (Source: Annals of Diagnostic Pathology)

Annals of Diagnostic Pathology via MedWorm.com

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Table of Contents

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Histochemistry as a tool in morphological analysis: a historical review

Editorial Board

Multicentric epithelioid hemangioendothelioma of bone. Report of a case with radiologic-pathologic correlation

Instructions to Authors

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Table of Contents

Nonneoplastic signet-ring cell change in gastrointestinal and biliary tracts: a pitfall for overdiagnosis

Editorial Board

Correlation between the endoscopic and histologic diagnosis of gastritis

Florid reactive lymphoid hyperplasia (lymphoma-like lesion) of the uterine cervix

Pathologic complete response to neoadjuvant therapy in patients with pancreatic ductal adenocarcinoma is associated with a better prognosis

Distinct immunophenotype of early T-cell progenitors in T lymphoblastic leukemia/lymphoma may predict FMS-like tyrosine kinase 3 mutations

Association of mast cells with microvessel density in urothelial carcinomas of the urinary bladder

Changing trends in human papillomavirus–associated head and neck squamous cell carcinoma

Primary malignant fibrous histiocytoma (myxofibrosarcoma/pleomorphic sarcoma not otherwise specified) of the breast: clinicopathologic study of 19 cases

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Malignant glandular lesions and glandular differentiation in invasive/noninvasive urothelial carcinoma of the urinary bladder

The immunohistochemical profile of atypical eosinophilic syncytial changes vs serous carcinoma

Frequencies of different nuclear morphological features in prostate adenocarcinoma

Immunohistochemical expression of ezrin in cutaneous basal and squamous cell carcinomas

Microscopic thrombi in anaplastic astrocytoma predict worse survival?

Tracheobronchopathia osteochondroplastica presenting as a single dominant tracheal mass

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Table of Contents

Instructions for Authors

A practical approach to grossing breast specimens

Clinicopathologic analysis of the impact of CD23 expression in plasma cell myeloma with t(11;14)(q13;q32)

Plexiform leiomyoma of the esophagus: a complex radiographic, pathologic and endoscopic diagnosis

Atypical polypoid adenomyoma of the uterus: an immunohistochemical study on 5 cases

Adult renal cell carcinoma with rhabdoid morphology represents a neoplastic dedifferentiation analogous to sarcomatoid carcinoma

Primary CD5-positive mucosa-associated lymphoid tissue lymphoma of the urinary bladder

Endometrial stromal sarcoma: clinicopathological and immunophenotype study of 18 cases

Calretinin immunostaining as an adjunct in the diagnosis of Hirschsprung disease

Quantification of mast cells in the uterine cervix of women infected with human immunodeficiency virus

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Low-grade fibromyxoid sarcoma: a clinicopathologic study of 18 cases, including histopathologic relationship with sclerosing epithelioid fibrosarcoma in a subset of cases

Atypical imaging feature of Non-secretory multiple myeloma

Clinicopathologic and immunohistochemical characteristics of adult primary cardiac angiosarcomas: analysis of 10 cases

Hyalinizing parathyroid adenoma and hyperplasia: report of 3 cases of an unusual histologic variant

Oral lipoma: analysis of 58 new cases and review of the literature

Utility of cytokeratin 5/6 and high-molecular-weight keratin in evaluation of cauterized surgical margins in excised specimens of breast ductal carcinoma in situ

Metastatic vs primary malignant neoplasms affecting the umbilicus: clinicopathologic features of 77 tumors

Undifferentiated (embryonal) liver sarcoma: synchronous and metachronous occurrence with neoplasms other than mesenchymal liver hamartoma

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Multilocular thymic cyst with epithelioid granulomata of unknown etiology: a radiologic and histopathologic correlation

Histopathologic characteristics of inferior turbinate vs ethmoidal polypin chronic rhinosinusitis

Lipid-rich carcinoma of the breast clinicopathologic analysis of 17 cases

Primary lymphoepithelioma-like carcinoma of the ureter

Uterine perivascular epitheloid cell tumor (PEComa) with CD117 and PNL2 positivity and entrapped endometriotic glands, mimicking sex-cordlike differentiation

Low-grade nonintestinal sinonasal adenocarcinoma: a diagnosis of exclusion

Verrucous carcinoma of the skin: a report on 5 Japanese cases

Pseudohyperplastic prostatic carcinoma in simple prostatectomy

Congenital epulis of the newborn: 10 new cases of a rare oral tumor

Primary leiomyosarcoma of bone—a clinicopathologic study of 8 uncommon cases with immunohistochemical analysis and clinical outcomes

Expression and clinicopathologic significance of glypican 3 in hepatocellular carcinoma

Kocher-Debré-Sémélaigne syndrome diagnosed by autopsy associated with disseminated intravascular coagulation

Comparison of proliferating cell nuclear antigen, thyroid transcription factor-1, Ki-67, p63, p53 and high–molecular weight cytokeratin expressions in papillary thyroid carcinoma, follicular carcinoma, and follicular adenoma

Metastatic gastric adenocarcinoma primarily presenting in the fallopian tube

Mucin poor mucinous tubular and spindle cell carcinoma of the kidney, with nonclassic morphologic variant of spindle cell predominance and psammomatous calcification

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New developments in the molecular pathogenesis of head and neck tumors: a review of tumor-specific fusion oncogenes in mucoepidermoid carcinoma, adenoid cystic carcinoma, and NUT midline carcinoma

Chromosomal abnormalities in renal cell carcinoma variants detected by Urovysion fluorescence in situ hybridization on paraffin-embedded tissue

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Extraoral plasmablastic lymphoma with intravascular component and MYC translocation