MedWorm provides a medical RSS filtering service. Over 6000 RSS medical sources are combined and output via different filters. This feed contains the latest medical blog items that have been tagged with 'adenocarcinoma'. Sat, 03 Sep 2011 02:25:01 +0100 http://www.medworm.com/index.php?rid=5159878&cid=t_202301_155_f&fid=38412&url=http%3A%2F%2Fpathlabmed.typepad.com%2Fsurgical_pathology_and_la%2F2011%2F08%2Fwclc-2011-oral-presentations-more-genomics.html This study showed the potential for using DNA methylation profiles in targeted therapy profiles.  This seemed like a lot of fancy razzle-dazzle in this context and I'm unclear what it would really add in a practical sense; it seems to me most of the work on DNA methylation patterns in lung cancer has been focused on identifying markers for early diagnosis in serum. (Source: The Daily Sign-Out) The Daily Sign-Out blogs http://www.medworm.com/rss/comments.php?id=5159878 Tue, 23 Aug 2011 20:12:54 +0100 5159878 http://www.medworm.com/index.php?rid=5119013&cid=t_202301_155_f&fid=38412&url=http%3A%2F%2Fpathlabmed.typepad.com%2Fsurgical_pathology_and_la%2F2011%2F08%2Fwclc-2011-summary-from-plenary-session.html There were three themes from the Monday, July 3 plenery session at the 2011 14th World Conference on Lung Cancer.  First, the effect of smoking cessation on lung cancer incidence was discussed in relation to a recent study showing that women who smoke 20 cigarettes a day have a risk of developing lung cancer 30 times higher than non-smokers.  However, the study also showed that quitting before age 50 reduced the risk to sic times higher and quitting before age 40 reduced it to 1.2 times higher almost completely eliminating the risk from smoking. The second major theme discussed the shift from squamous cell carcinoma (SQC) to adenocarcinoma (ADC) as the most prevalent histologic type of lung cancer.  The development of cigarette filters was discussed as one reason for this... The Daily Sign-Out blogs http://www.medworm.com/rss/comments.php?id=5119013 Wed, 10 Aug 2011 20:30:00 +0100 5119013 http://www.medworm.com/index.php?rid=5119014&cid=t_202301_155_f&fid=38412&url=http%3A%2F%2Fpathlabmed.typepad.com%2Fsurgical_pathology_and_la%2F2011%2F08%2Fwclc-2011-oral-presentations-genomics.html This study provides some preliminary benchmarking data to discuss with clinicians, although I would provide a caveat that there is likely to be a referral bias (since this is a single-institutional study from one of the world’s most reknown cancer centers) that overestimates the frequency of driver mutations in ADC. Finally, O016.06 is another presentation from the MSKCC that examined the prognostic impact of driver mutations in lung ADC with respect to smoking history.  There is important background that puts this study in context, namely, the demonstration of an independent dose-dependent relationship between smoking history and survival in patients with advanced stage NSCLC with never-smokers living 50% longer than smokers (Janjigian et al., Cancer 2010).  The authors revi... The Daily Sign-Out blogs http://www.medworm.com/rss/comments.php?id=5119014 Wed, 10 Aug 2011 12:09:27 +0100 5119014 http://www.medworm.com/index.php?rid=5086570&cid=t_202301_155_f&fid=38412&url=http%3A%2F%2Fpathlabmed.typepad.com%2Fsurgical_pathology_and_la%2F2011%2F08%2Fwclc-2011-oral-presentations-tumor-microenvironment.html This study highlights the importance of localization of immune cell response but also underscores the challenge for future studies to use more refined quantitative assessments of immune cell subpopulations and relative expression of IHC staining intesity (such as utilizing digital imaging and image analysis).  MO 22.04, also from session VIII, presented interesting complementary data to the above presentation. This study examined 196 resected stage 1-3A NSCLC using IHC for infiltrating CD8+ and FOXP3+ cells.  They counted cells expressing these markers in tumor and stromal regions in five "randomly selected" high-power-fields and reported their data as the number of cells per mm2 for each region.  They used median cell count as the cutoff to define patient subgr... The Daily Sign-Out blogs http://www.medworm.com/rss/comments.php?id=5086570 Tue, 02 Aug 2011 10:01:00 +0100 5086570 http://www.medworm.com/index.php?rid=5069835&cid=t_202301_155_f&fid=38412&url=http%3A%2F%2Fpathlabmed.typepad.com%2Fsurgical_pathology_and_la%2F2011%2F07%2Falk-positive-lung-adenocarcinoma-nejm-case-records.html The July 14, 2011 issue of The New England Journal of Medicine features a nice case report as part of the weekly "Case Records of the MGH" series.  I thought those interested in lung cancer would benefit from reading this, especially in light of recent advances recognizing ALK translocations as driver mutations in about 5% of lung ADC--and the drug crizotinib to treat these particular tumors (my previous post on ALK inhibition in lung cancer). (Source: The Daily Sign-Out) The Daily Sign-Out blogs http://www.medworm.com/rss/comments.php?id=5069835 Wed, 27 Jul 2011 14:04:46 +0100 5069835 http://www.medworm.com/index.php?rid=4768264&cid=t_202301_155_f&fid=38412&url=http%3A%2F%2Fpathlabmed.typepad.com%2Fsurgical_pathology_and_la%2F2011%2F04%2Fasco-issues-provisional-clinical-opinion-on-egfr-testing-in-non-small-cell-lung-cancer.html Hot off the electronic press is the PCO issued by ASCO recommending that patients with advanced stage NSCLC should have their tumors tested for EGFR mutation if they are being considered candidates for EGFR-TKI therapy.  Read here  for the abstract or Download ASCO EGFR testing in NSCLC for more deets. Provisional Clinical OpinionOn the basis of the results of five phase III randomized controlled trials, patients withNSCLC who are being considered for first-line therapy with an EGFR TKI (patients who havenot previously received chemotherapy or an EGFR TKI) should have their tumor tested forEGFR mutations to determine whether an EGFR TKI or chemotherapy is the appropriatefirst-line therapy. If you haven't been following this topic, the paper nicely summarizes the clinic... The Daily Sign-Out blogs http://www.medworm.com/rss/comments.php?id=4768264 Fri, 29 Apr 2011 16:50:41 +0100 4768264 http://www.medworm.com/index.php?rid=4684777&cid=t_202301_155_f&fid=38412&url=http%3A%2F%2Fpathlabmed.typepad.com%2Fsurgical_pathology_and_la%2F2011%2F04%2Faberrant-wnt1-and-beta-catenin-expression-in-nsclc.html This month's April 2011 Journal of Thoracic Oncology has an interesting paper by Xu and colleagues (abstract) that examines Wnt1 expression in non-small cell lung cancer (NSCLC) in relation to downstream Wnt signaling molecules, including beta-catenin, and correlates different marker expression with traditional clinicopathological parameters. This is an immunohistochemical study of a tissue microarray composed of 262 NSCLC resected specimens.    The authors define aberrant beta-catenin expression as: 1) decreased membranous pattern in less than 70% of tumor cells, 2) cytoplasmic pattern of expression, or 3) nuclear pattern of expression.  As expected, the majority of patients are stage 1 or 2 but nearly 36% of the study population are never-smokers--over 50% in ... The Daily Sign-Out blogs http://www.medworm.com/rss/comments.php?id=4684777 Tue, 05 Apr 2011 19:55:50 +0100 4684777 http://www.medworm.com/index.php?rid=4419464&cid=t_202301_155_f&fid=38412&url=http%3A%2F%2Fpathlabmed.typepad.com%2Fsurgical_pathology_and_la%2F2011%2F01%2Fnew-classification-of-lung-adenocarcinoma.html The February 2011 Journal of Thoracic Oncology has the long-awaited new classification for lung adenocarcinoma.  This paper is a MAJOR multidisciplinary achievement that aligns the interests, concerns, and expertise of pathologists, oncologists, surgeons, and radiologists.  I can't think of another classification in any other organ system that has attempted this kind of collaborative effort or produced an audacious result.  It is evidence-based and rationales for various critical decisions are clearly expounded. One of the interesting asides is the questions posed by different specialty stakeholders.  Studying this alone provides compelling insights into different perspectives on lung adenocarcinoma.  As pathologists, we must appreciate and understand thes... The Daily Sign-Out blogs http://www.medworm.com/rss/comments.php?id=4419464 Mon, 31 Jan 2011 12:31:00 +0100 4419464 http://www.medworm.com/index.php?rid=4298808&cid=t_202301_155_f&fid=38410&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FOncopathology%2F%7E3%2FFsQnflY9WE8%2Fbreast-carcinoma-vs-pulmonary.html Some authors have estimated that 4-9% of patients with breast carcinoma will eventually develop second pulmonary carcinomas. As a result, many pathologists have been faced with the problem of trying to determine whether a particular lung carcinoma represents metastatic breast carcinoma or a new primary pulmonary adenocarcinoma. This month, we will briefly review antibodies that may be useful in addressing this differential diagnostic problem. GCDFP-15 (gross cystic disease fluid protein-15): This marker has good specificity for breast carcinoma, although its sensitivity is not high, as only about 50% of breast carcinomas express this marker. Another potential problem with this marker (particularly when dealing with small biopsy specimens) is that it is often expressed in a focal ... Oncopathology blogs http://www.medworm.com/rss/comments.php?id=4298808 Thu, 30 Dec 2010 03:51:00 +0100 4298808 http://www.medworm.com/index.php?rid=4275599&cid=t_202301_155_f&fid=38412&url=http%3A%2F%2Fpathlabmed.typepad.com%2Fsurgical_pathology_and_la%2F2010%2F12%2Foptimal-panel-for-differentiating-nsclc-in-small-specimens.html This study makes several practical points that can be nicely summarized as bullets: For ADC the most sensitive marker and best negative predictor is CK7: 93% sensitivity, 91% NPV. For ADC the most specific marker and best positive predictor is Napsin A: 94% specificity, 90% PPV. TTF-1 has similar specificity as Napsin A for ADC. For SQC the most sensitive marker and best negative predictor is p63: 84% sensitivity, 86% NPV. For SQC the most spepcific marker and best positive predictor is NTKR2 (a neurotrophic tyrosine kinase receptor, rarely used outside of research labs) but CK5/6 has a nearly identical specificity and PPV: about 95% specificity, about 95% PPV. No single marker is BOTH highly sensitive and specific for either ADC or SQC. The authors identified a 6-marker panel that inclu... The Daily Sign-Out blogs http://www.medworm.com/rss/comments.php?id=4275599 Tue, 21 Dec 2010 12:22:00 +0100 4275599 http://www.medworm.com/index.php?rid=4175981&cid=t_202301_155_f&fid=38412&url=http%3A%2F%2Fpathlabmed.typepad.com%2Fsurgical_pathology_and_la%2F2010%2F11%2Fassociation-between-egfr-mutations-and-ercc1-expression-in-nsclc.html Gandara and colleagues from UC Davis Cancer Center have published ahead-of-print on October 21, 2010 in Journal of Thoracic Oncology an interesting article examining the association between EGFR activating mutations and ERCC1 gene expression in NSCLC. NSCLC tumors that show EGFR activating mutations are also more likely to show low expression of ERCC1 mRNA levels according to this study.  This might explain (at least in part) the clinical observation that suggest enhanced efficacy of platinum-based chemotherapy in patients with EGFR-mutant NSCLCs. The authors performed microdissection of tumors from 1207 patients with NSCLC and analyzed EGFR mutation by allele-specific by PCR and ERCC1 mRNA expression by RT-PCR. Median ERCC1 expression was histology-related: adenocarcinoma (ADC... The Daily Sign-Out blogs http://www.medworm.com/rss/comments.php?id=4175981 Wed, 17 Nov 2010 12:04:00 +0100 4175981 http://www.medworm.com/index.php?rid=4119748&cid=t_202301_155_f&fid=38412&url=http%3A%2F%2Fpathlabmed.typepad.com%2Fsurgical_pathology_and_la%2F2010%2F10%2Falk-inhibition-in-nsclc.html Great stuff in this week's NEJM! Today's (October 28, 2010) New England Journal of Medicine has no less than three articles reporting the use of small molecule ALK tyrosine kinase inhibitor crizotinib (PF-02341066, Pfizer) in non-small-cell lung cancers harboring the oncogenic fusion gene EML4-ALK and in a patient with ALK-rearrangement positive inflammatory myofibroblastic tumor, a distinctive but uncommon soft tissue neoplasm.   Pathologists should be familiar with these articles--at least so you can suggest appropriate testing for ALK rearrangement but also that you might "shine" at your next Tumor Conference ; )  BTW, the article by Kwak et al. presents in paper form the data that rocked this past summer's ASCO Annual Meeting regarding criz... The Daily Sign-Out blogs http://www.medworm.com/rss/comments.php?id=4119748 Fri, 29 Oct 2010 04:51:39 +0100 4119748 http://www.medworm.com/index.php?rid=4086528&cid=t_202301_155_f&fid=38412&url=http%3A%2F%2Fpathlabmed.typepad.com%2Fsurgical_pathology_and_la%2F2010%2F10%2Fa-little-bit-more-about-bac-of-lung.html Literally within minutes of publishing my previous post following up on a digital case challenge on bronchioloalveolar carcinoma (BAC) of the lung, I discover this month's (October 2010) Archives of Pathology and Laboratory Medicine on my desk which contains a nice article by Lindsay Schmidt and Jeffrey Myers titled, "Bronchioloalveolar Carcinoma and the Significance of Invasion: Predicting Biologic Behavior" (Arch Pathol Lab Med 2010;134:1450-1454). The issue is how to designate tumors that show stromal invasion but are mostly BAC (think Miracle Max from The Princess Bride: "It just so happens that your friend here is only MOSTLY dead. There's a big difference between mostly dead and all dead.").  Ah, but how much is mostly?  This ... The Daily Sign-Out blogs http://www.medworm.com/rss/comments.php?id=4086528 Wed, 20 Oct 2010 10:56:00 +0100 4086528 http://www.medworm.com/index.php?rid=4036956&cid=t_202301_155_f&fid=38412&url=http%3A%2F%2Fpathlabmed.typepad.com%2Fsurgical_pathology_and_la%2F2010%2F10%2Ffollow-up-on-adenocarcinoma-with-bac-features.html My last post was a "Digital Case Challenge" presenting a case of pulmonary adenocarcinoma with non-mucinous bronchioloalveolar (BAC) features. Here's my synopsis of 3 recent papers on bronchioloalveolar carcinoma that focus on the clinicopathological, histological, and molecular differences between the two subtypes, non-mucinous and mucinous, as well as the practical importance in distinguishing these two subtypes. 1.  Wislez et al, in a recently published paper in Lung Cancer (2010;68:185-191), studied 50 cases of non-resectable adenocarcinoma with bronchioloalveolar (ADC-BAC) features who were enrolled in a multicenter study to evaluate gefitinib as a first-line therapy for non-resectable ADC-BAC.  Previous trials (SWOG S0126 and IFCT0401) have shown that ... The Daily Sign-Out blogs http://www.medworm.com/rss/comments.php?id=4036956 Wed, 06 Oct 2010 21:13:32 +0100 4036956 http://www.medworm.com/index.php?rid=4031515&cid=t_202301_155_f&fid=38412&url=http%3A%2F%2Fpathlabmed.typepad.com%2Fsurgical_pathology_and_la%2F2010%2F09%2Fdigital-case-challenge-non-mucinous-bronchioloalveolar-adenocarcinoma.html It has been a long while since I've posted one of the cases I've worked on and now its time to clear off my desk (before our CAP inspection). The patient is an 83-year-old white man, non-smoker, who presented 2 months prior to surgery with cough and shortness-of-breath and was found to have a left lower lobe infiltrate and pleural effusion.  After hospital admission and a course of antibiotics, the patient's symptoms initially improved.  However, he returned again about one month later with the same symptoms and persistent infiltrate.  Bronchoscopy revealed a mass-like lesion but cytologic studies were negative.  He underwent CT-guided biopsy of the infiltrate which showed adenocarcinoma.  He subsequently underwent lobectomy and that specimen showe... The Daily Sign-Out blogs http://www.medworm.com/rss/comments.php?id=4031515 Tue, 05 Oct 2010 14:58:42 +0100 4031515 http://www.medworm.com/index.php?rid=3954493&cid=t_202301_155_f&fid=38412&url=http%3A%2F%2Fpathlabmed.typepad.com%2Fsurgical_pathology_and_la%2F2010%2F09%2Fgrading-system-for-lung-adenocarcinoma-still-elusive.html The August 2010 issue of American Journal of Surgical Pathology features an article from the Memorial Sloan Kettering Cancer Center group proposing a grading system for lung adenocarcinoma in stage 1 cancer. Sica G, Yoshizawa A, Sima CS, et al.  A grading system of lung adenocarcinoma based on histologic pattern is predictive of disease recurrence in stage I tumors.  Am J Surg Pathol 2010;34:1155-1162. The authors articulate the frustration pathologists experience in dealing with the histological heterogeneity of lung adenocarcinoma (ACa) since the vast majority are mixed subtype as well as the lack of an objective, clinically relevant grading system for lung ACa.  Recent literature has shown that mixed subtype tumors with solid or micropapillary components appear to ha... The Daily Sign-Out blogs http://www.medworm.com/rss/comments.php?id=3954493 Thu, 09 Sep 2010 11:20:00 +0100 3954493 http://www.medworm.com/index.php?rid=3907795&cid=t_202301_155_f&fid=38412&url=http%3A%2F%2Fpathlabmed.typepad.com%2Fsurgical_pathology_and_la%2F2010%2F08%2Flung-adenocarcinoma-variants.html There are five common types of adenocarcinoma (actually I would say four since "mixed" doesn't seem to me a specific 'type") recognized in the WHO classification of lung cancer.  But this classification also includes five rare but distinctive variants: fetal adenocarcinoma, mucin-producing adencarcinomas (mucinous "colloid" adenocarcinoma, mucinous cystadenocarcinoma, and signet ring adenocarcinoma), and clear cell adenocarcinoma.  While rare to exceedingly rare as pure tumors, the variant patterns are important to be aware of because they occur much more commonly as a component of mixed type adenocarcinomas, are associated with particular clinicopathologic features, and often require the exclusion of a different primary site.  Anoth... The Daily Sign-Out blogs http://www.medworm.com/rss/comments.php?id=3907795 Thu, 26 Aug 2010 11:20:00 +0100 3907795 http://www.medworm.com/index.php?rid=3876910&cid=t_202301_155_f&fid=38412&url=http%3A%2F%2Fpathlabmed.typepad.com%2Fsurgical_pathology_and_la%2F2010%2F08%2Fscreening-for-egfr-and-kras-mutations-by-clinicopathologic-featuresa-contraposition.html Dr. Sonia Dacic and the lung pathology group at University of Pittsburgh Medical Center recently published in Modern Pathology an article (full text here), "Clinicopathologic predictors of EGFR/KRAS mutational status in primary lung adenocarcinomas."  The authors state that the aim of the study was "to determine whether clinicopathological characteristics and morphology of lung adenocarcinomas might be used as predictors of tumor mutational status, which then may be implemented as the selection criteria for molecular profiling of lung adenocarcinomas in clinical practice."  Implicit in this statement are the assumptions that molecular testing of lung adenocarcinoma is expensive and that screening cases for molecular testing by morphological criteria would be... The Daily Sign-Out blogs http://www.medworm.com/rss/comments.php?id=3876910 Tue, 17 Aug 2010 11:30:00 +0100 3876910 http://www.medworm.com/index.php?rid=3787029&cid=t_202301_111_f&fid=39123&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Fnursingcomments%2Ftdtc%2F%7E3%2FGa7_4BTRZ6Y%2F                 Stomach cancer (also called gastric cancer) is the growth of cancer cells in the lining and wall of the stomach.  These two terms most often refer to stomach cancer that begins in the mucus-producing cells on the inside Early Gastric Cancer lining of the stomach (adenocarcinoma).  Adenocarcinoma is the most common type of stomach cancer.  For information purposes, it might be helpful to know that the body is made up of many types of cells.  Normally, cells grow, divide and then die.  Sometimes, cells change and begin to grow and divide more quickly than normal cells.  Rather than dying, these abnormal cells clump together to form tumors.  If these tumors are malignant (cancerous), they can invade and kill your body’s healthy tissues.  From these... Nursing Comments blogs http://www.medworm.com/rss/comments.php?id=3787029 Sat, 24 Jul 2010 13:07:32 +0100 3787029 http://www.medworm.com/index.php?rid=3767335&cid=t_202301_155_f&fid=38412&url=http%3A%2F%2Fpathlabmed.typepad.com%2Fsurgical_pathology_and_la%2F2010%2F07%2Fmucinous-bronchioloalveolar-carcinoma-of-lung-and-alk-mutation.html In this study, 96% of responders had adenocarcinoma histology--primarily signet ring morphology.This is surely a very exceptional case since mucinous ACa/BAC is a very distinctive histological subtype and has been also characterized at the molecular level as being associated with KRAS mutation.  The point is that histology is not a perfect predictor of potentially druggable molecular pathologies.  If targeted therapy is being contemplated in NSCLC, we should adopt a systematic approach to all NSCLC regardless of histology.  At this point, while we are identifying patients who may potentially benefit from targeted therapy, we are building a database that will allow a more full appreciation of the relationship between histological type and molecular pathology.Thanks t... The Daily Sign-Out blogs http://www.medworm.com/rss/comments.php?id=3767335 Tue, 20 Jul 2010 04:06:14 +0100 3767335 http://www.medworm.com/index.php?rid=3636043&cid=t_202301_155_f&fid=38412&url=http%3A%2F%2Fpathlabmed.typepad.com%2Fsurgical_pathology_and_la%2F2010%2F06%2Fasco-2010-erlotinib-plus-novel-cmet-inhibitor-in-nsclc.html I was attending the 2010 ASCO Annual Meeting this past weekend, June 5-6, and will post some blogs about my "highlights."  This is a perk of living in Chicago since the meetings were here from 2006-2008 and will be here for the next ten meetings!Dr. Joan H. Schiller, from the University of Texas Southwestern Medical Center, presented the findings of the the ARQ 197-209 Clinical Trial Group during Saturday’s Clinical Science Symposium on “Molecularly Targeted Trials in Lung Cancer” (Abstract LBA7502).  ARQ 197-209 is an investigational agent that is an inhibitor of c-MET, a high-affinity tyrosine kinase receptor for hepatocyte growth factor.  The c-MET receptor is an attractive anticancer target in NSCLC given that c-MET gene amplification correlates with a... The Daily Sign-Out blogs http://www.medworm.com/rss/comments.php?id=3636043 Mon, 07 Jun 2010 12:50:55 +0100 3636043 http://www.medworm.com/index.php?rid=3468045&cid=t_202301_155_f&fid=38410&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FOncopathology%2F%7E3%2FVhQmIUgOzag%2Fmicrocystic-adenocarcinoma-of-prostate.html Reference :Microcystic Adenocarcinoma of the Prostate: A Variant of Pseudohyperplastic and Atrophic Patterns : Yaskiv, Oksana et al.The American Journal of Surgical Pathology: April 2010 - Volume 34 - Issue 4 - pp 556-561Do you see anything in this prostate that's worrisome for malignancy? dilated glands admixed with small acini in a noduleI don't, at least not at this power, and yet this is an example of "microcystic" adenocarcinoma of the prostate. Higher power will show clear-cut cytologic features of malignancy.If this doesn't concern you about the risk of scanning prostate slides at 4x, it should!Microcystic adenocarcinoma with dilated and crowded glands displaying a predominantly flat lining layerMicrocystic adenocarcinoma with jumbled arrangement of dilated malignant glands.Microcys... Oncopathology blogs http://www.medworm.com/rss/comments.php?id=3468045 Tue, 13 Apr 2010 20:43:00 +0100 3468045 http://www.medworm.com/index.php?rid=3408672&cid=t_202301_155_f&fid=38412&url=http%3A%2F%2Fpathlabmed.typepad.com%2Fsurgical_pathology_and_la%2F2010%2F03%2Fmolecular-markers-for-targeted-therapy-in-lung-cancer-uscap-2010.html I attended the Special Course at USCAP 2010, "Basic Principles and Practice of Molecular Pathology in Cancer."  One of the talks was given by Dr. Marc Ladanyi from MSKCC and one of the leaders in the field of molecular pathology of lung cancer.  The title of his presentation was "Molecular Predictive Markers for Targeted Therapies in Lung Cancer."  Here's my "take-home" points from the talk: Term: "lung adenocarcinoma oncogenome"--(I like this) and he presented a pie chart illustrating the different (and (generally) mutually exclusive) mutations found so far in lung ACa  KRAS EGFR BRAF ERBB2 (HER2) ALK fusions (especially, ALK-EML4) MEK1 NF1 but still about one-third of lung ACa have an unknown mutation Although there a... The Daily Sign-Out blogs http://www.medworm.com/rss/comments.php?id=3408672 Fri, 26 Mar 2010 15:04:27 +0100 3408672 http://www.medworm.com/index.php?rid=3294829&cid=t_202301_155_f&fid=38412&url=http%3A%2F%2Fpathlabmed.typepad.com%2Fsurgical_pathology_and_la%2F2010%2F02%2Fmixed-adenocarcinomas-of-the-lung.html Continuing with the last post, Chilosi and Murer in the January 2010 Arch Pathol Lab Med also argue for the need of a new classification of mixed adenocarcinoma of the lung based on morphology, immunophenotyping, and molecular features.Chilosi M, Murer B.  Mixed adenocarcinoma of the lung: place in new proposals in classification, mandatory for target therapy.  Arch Pathol Lab Med 2010;134:55-65.Currently, we do not know the clinical relevance of distinguishing between different subtypes of ACa--let alone the significance of assigning percentages of different recognizable subtypes.  And the latter is of much more practical significance since 80% or so of lung ACa are "mixed."  The article by Okudela et al previously posted could be helpful in r... The Daily Sign-Out blogs http://www.medworm.com/rss/comments.php?id=3294829 Mon, 22 Feb 2010 04:19:23 +0100 3294829 http://www.medworm.com/index.php?rid=3262549&cid=t_202301_83_f&fid=34856&url=http%3A%2F%2Finsidesurgery.com%2F2010%2F02%2Fpeutzjeghers-syndrome%2F Pathophysiology 1) inherited disorder marked by numerous GI polyps (usually in small bowel but occasionally from stomach to rectum) and mucocutaneous pigmentation 2) heavy freckles on the face, hands, feet, and perineal areas usually fade at puberty but the buccal (mouth) pigmented spots do not 3) although the polyps are considered benign, 2-3% of patients develop adenocarcinoma in the small bowel Signs and Symptoms 1) abdominal obstruction 2) intussusception Histology/Gross Pathology polyps are hamartomas with smooth muscle and intestinal glands Associated Conditions increased risk of – 1) pancreatic cancer 2) breast cancer 3) ovarian cancer 4) endometrial cancer 5) testicular cancer Biochemistry affected gene codes for serine threonine kinase Inheritance/Epidemiology 1) autosomal ... Inside Surgery blogs http://www.medworm.com/rss/comments.php?id=3262549 Thu, 11 Feb 2010 01:48:02 +0100 3262549 http://www.medworm.com/index.php?rid=2691733&cid=t_202301_136_f&fid=37846&url=http%3A%2F%2Fhealthinfoispower.wordpress.com%2F2009%2F08%2F11%2Fyoung-early-stage-ovarian-cancer-patients-can-preserve-fertility%2F A new study finds that young women with early-stage ovarian cancer can preserve future fertility by keeping at least one ovary or the uterus without increasing the risk of dying from the disease. The study is published in the September 15, 2009 issue of CANCER, a peer-reviewed journal of the American Cancer Society. A new study [...] (Source: Libby's H*O*P*E*) Libby's H*O*P*E* blogs http://www.medworm.com/rss/comments.php?id=2691733 Tue, 11 Aug 2009 21:50:54 +0100 2691733 http://www.medworm.com/index.php?rid=2593219&cid=t_202301_136_f&fid=35300&url=http%3A%2F%2Fwww.metastaticlivercancer.org%2F2009-06-17-cancer-treatment%2Fadenocarcinoma-of-unknown-primary%2F What do you do when your doctors tell you that you have an adenocarcinoma of unknown primary? Did doctors use the new Pathwork Tissue of Origin test or any other more advanced test than the one used in your hospital?   Janet replied in email to Gary’s (Small cell carcinoma of the lungs) post:   how her sister passed away with adenocarcinoma of unknown primary  what cancer treatment the doctors did or didn’t try  what the care-givers did.   Poorly differentiated adenocarcinoma   When doctors told us father had a poorly differentiated adenocarcinoma, they might as well have tried to speak Swedish: I didn’t understand a thing what they were trying to say.   Using sophisticated words like "poorly differentiated adenocarcinoma" i... Metastatic liver cancer blogs http://www.medworm.com/rss/comments.php?id=2593219 Wed, 17 Jun 2009 03:12:25 +0100 2593219 http://www.medworm.com/index.php?rid=2349855&cid=t_202301_155_f&fid=38406&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FThe1xObjective%2F%7E3%2FsPNNa3G7KQc%2F My 2009 USCAP Official Submission: Overexpression of Notch-1 Correlates with Grade, Stage and Overall Survival in Colorectal Adenocarcinoma (CRC) Catch the rest of the story after the break... (Source: The 1x Objective) The 1x Objective blogs http://www.medworm.com/rss/comments.php?id=2349855 Tue, 31 Mar 2009 16:18:18 +0100 2349855 http://www.medworm.com/index.php?rid=3416379&cid=t_202301_155_f&fid=38410&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FOncopathology%2F%7E3%2FlATeL1EIfw0%2Fquirkes-method-for-dissecting.html .This is Philip Quirke's method for assessing colorectal adenocarcinoma as demonstrated for the MRC-CR07 trial participants. The first step is to assess the colon for completeness of mesorectal excision. A grade of 1, 2 or 3 (3 is best) is given.Gross pathologic assessment of completeness of mesorectal excision (i.e. complete excision of the rectal mesentery or mesorectal fat pad) be reported on all rectal cancers. The purpose of this is to identify those patients who are more likely to recur postop., giving prognostic information and thus affecting followup . There is no doubt that complete mesorectal excision will reduce local recurrence rates (from 30-40% without TME, down to 3.7% with TME (as reported by Heald).Quirke's graded assessment of completeness of mesorectal excision (MRC tria... Oncopathology blogs http://www.medworm.com/rss/comments.php?id=3416379 Wed, 11 Mar 2009 21:29:00 +0100 3416379