Journals American Journal of Surgical P...

American Journal of Surgical Pathology
Phoebe M Hammer, Aihui Wang, Lisa Vermij, Sabrina Zdravkovic, Lucas Heilbroner, Emily Ryan, Rachel L P Geisick, Vivek Charu, Teri A Longacre, Carlos J Suarez, Chandler Ho, Taylor M Jenkins, Anne M Mills, Tjalling Bosse, Brooke E Howitt
Since the establishment of 4 molecular subgroups of endometrial carcinoma (EC), there has been significant interest in understanding molecular classification in the context of histologic features and diagnoses. ECs with undifferentiated, spindle, and/or sarcomatous components represent a diagnostically challenging subset of tumors with overlapping clinical and histologic features. We examined the clinicopathologic, morphologic, immunohistochemical, and molecular features of these tumors identified in our institutions' pathology databases using immunohistochemistry and targeted sequencing...
May 23, 2024: American Journal of Surgical Pathology
Meihua Ye, Zhenying Guo, Jingjing Xu, Yanling Jin, Xianglei He, Minghua Ge
BACKGROUND: Primary squamous cell carcinoma (SCC) of the thyroid and anaplastic thyroid carcinoma (ATC) show significant clinical and histologic overlap. Their biological behaviors are so similar that the fifth WHO updates SCC as a morphologic pattern of ATC rather than a separate entity. However, molecular genomic evidence that determines them as the same histologic type is limited. We aimed to explore whether they belong to the same classification from a molecular-typing perspective...
May 22, 2024: American Journal of Surgical Pathology
Ashley L Kiemen, Lucie Dequiedt, Yu Shen, Yutong Zhu, Valentina Matos-Romero, André Forjaz, Kurtis Campbell, Will Dhana, Toby Cornish, Alicia M Braxton, Pei-Hsun Wu, Elliot K Fishman, Laura D Wood, Denis Wirtz, Ralph H Hruban
Pancreatic ductal adenocarcinoma (PDAC) develops from 2 known precursor lesions: a majority (∼85%) develops from pancreatic intraepithelial neoplasia (PanIN), and a minority develops from intraductal papillary mucinous neoplasms (IPMNs). Clinical classification of PanIN and IPMN relies on a combination of low-resolution, 3-dimensional (D) imaging (computed tomography, CT), and high-resolution, 2D imaging (histology). The definitions of PanIN and IPMN currently rely heavily on size. IPMNs are defined as macroscopic: generally >1...
May 20, 2024: American Journal of Surgical Pathology
David I Suster, Natali Ronen, Saul Suster
Pseudosquamous adenocarcinoma of the lung is an unusual morphologic variant of poorly differentiated non-small cell lung carcinoma that superficially resembles a squamous cell carcinoma. We have examined 10 cases of these tumors in 4 women and 6 men, aged 47 to 93 years. The tumors were all peripheral and measured from 1.5 to 5.5 cm. All cases were characterized by solid nests of large polygonal tumor cells containing atypical nuclei with abundant cytoplasm and sharp cell borders, adopting a pavement-like architecture that simulated squamous cell carcinoma...
May 20, 2024: American Journal of Surgical Pathology
Oyewale Shiyanbola, Recep Nigdelioglu, Deepti Dhall, Iván A González, Laura M Warmke, Shula Schechter, Won-Tak Choi, Shaomin Hu, Lysandra Voltaggio, Yujie Zhang, Tom Z Liang, Huaibin M Ko, Greg W Charville, Teri A Longacre
Ewing sarcoma (ES) is an uncommon mesenchymal neoplasm that typically develops as a bone mass, although up to 30% arise in extraskeletal sites. ES of the gastrointestinal (GI) and hepatobiliary tract is rare and may be misdiagnosed as other, more common neoplasms that occur in these sites. However, the correct classification of extraskeletal ES is important for timely clinical management and prognostication. We reviewed our experience of ES in the GI and hepatobiliary tract in order to further highlight the clinicopathologic features of these neoplasms and document the potential for misdiagnosis in this setting...
May 17, 2024: American Journal of Surgical Pathology
Taishi Takahara, Akira Satou, Takuji Tsuyuki, Takanori Ito, Natsuki Taniguchi, Yuki Yamamoto, Akiko Ohashi, Emiko Takahashi, Kyuichi Kadota, Toyonori Tsuzuki
The clinical significance of lung tumor spread through air spaces (STAS) has been extensively studied, and is recognized as a unique pattern of invasion. Previous studies of STAS have focused primarily on STAS in alveolar spaces, whereas STAS in the bronchiolar spaces (bronchiolar STAS) has been described in only a few case reports only. Here, we examined 306 cases of primary lung adenocarcinoma and found that bronchiolar STAS was present in 18%. Bronchiolar STAS was associated with an inferior prognosis, more advanced stage, and higher histologic grade...
May 17, 2024: American Journal of Surgical Pathology
Adebowale J Adeniran, Brian Shuch, Peter A Humphrey
Renal cell carcinoma (RCC) with sarcomatoid and rhabdoid morphologies has an aggressive biological behavior and a typically poor prognosis. The current 2022 WHO classification of renal tumors does not include them as distinct histologic entities but rather as transformational changes that may arise in a background of various distinct histologic types of RCC. The sarcomatoid component shows malignant spindle cells that may grow as intersecting fascicles, which is reminiscent of pleomorphic undifferentiated sarcoma...
May 13, 2024: American Journal of Surgical Pathology
Anna H Bauer, Khaled J Alkhateeb, Agoston T Agoston, Robert D Odze, Megha G Joshi, Brandon M Huffman, Peter Enzinger, Kimberly Perez, Vikram Deshpande, James M Cleary, Jon O Wee, Fei Dong, Lei Zhao
The role of Human papillomavirus (HPV) infection in esophageal squamous cell carcinoma (ESCC) is a topic of ongoing debate. This study used two screening approaches to look for evidence of HPV infection in esophageal squamous cell carcinoma. We initially checked for HPV infection in a randomly selected group of 53 ESCC cases. We did not detect any tumors positive for high-risk HPV. However, during clinical practice, we identified an HPV-positive ESCC in the distal esophagus, which tested positive for HPV16...
May 10, 2024: American Journal of Surgical Pathology
Julianne M Szczepanski, Joshua A Lieberman, Laura W Lamps, Raul S Gonzalez, Yue Xue, Xuchen Zhang, Osman H Yilmaz, John Hart, Thomas Krausz, Jose G Mantilla, Jonathan B McHugh, Maria Westerhoff
Mycobacterial spindle cell pseudotumors (MSPs) are a rare and diagnostically challenging manifestation of non-tuberculous mycobacterial (NTM) infections. Proper recognition of these pseudotumors is important because they are treatable and benign. In this study, we evaluated the morphologic patterns of MSPs to improve their pathologic identification. Clinical and morphologic features of 14 MSPs were analyzed. Histologic factors evaluated included the architectural growth pattern of spindled or epithelioid macrophages, granulomas and their location within the lesion, neutrophilic microabscesses, multinucleated giant cells, necrosis, and effacement of background tissue...
May 10, 2024: American Journal of Surgical Pathology
Akihiko Tamaki, Kenichi Kohashi, Koichiro Yoshimaru, Yuko Hino, Hiroshi Hamada, Naonori Kawakubo, Tomoaki Taguchi, Tatsuro Tajiri, Yoshinao Oda
Isolated hypoganglionosis (IHG) is histologically characterized by small numbers of myenteric ganglion cells and small myenteric ganglia; however, no numerical diagnostic criteria for IHG have been established. Therefore, this study aimed to develop quantitative pathologic criteria for IHG. We evaluated 160 resected intestinal tissue specimens from 29 pediatric autopsies and 10 IHG cases. These specimens were obtained from the jejunum, ileum, ascending colon, transverse colon, and rectum. Morphologic features of the myenteric ganglion cells and myenteric ganglia were quantified and analyzed in digitized HuC/HuD-immunostained and CD56-immunostained sections, respectively...
May 10, 2024: American Journal of Surgical Pathology
Ezra Baraban, Elizabeth D Thompson, Andres Matoso, Ralph H Hruban, Pedram Argani
The presence of epithelial cells within lymph node parenchyma is typically indicative of a metastatic malignancy. However, there are rare instances in which non-neoplastic epithelial or epithelioid cells may be found within lymph nodes, either due to aberrant embryologic migration, mechanical displacement, or physiological trafficking. These can potentially lead to serious potential diagnostic pitfalls, as when such situations are encountered by surgical pathologists, there is substantial risk of overdiagnosing these as metastatic malignancy...
May 9, 2024: American Journal of Surgical Pathology
David J Papke, Igor Odintsov, Brendan C Dickson, Marisa R Nucci, Abbas Agaimy, Christopher D M Fletcher
The number of recognized sarcoma types harboring targetable molecular alterations continues to increase. Here we present 25 examples of a distinctive myofibroblastic tumor, provisionally termed "myxoid inflammatory myofibroblastic sarcoma," which might be related to inflammatory myofibroblastic tumor, and which occurred in 13 males (52%) and 12 females at a median age of 37 years (range: 7 to 79 years). Primary tumor sites were peritoneum (18 patients; 72%), paratesticular (2; 8%), chest wall (1), upper extremity (1), esophagus (1), retroperitoneum (1), and uterus (1)...
May 8, 2024: American Journal of Surgical Pathology
Rumeal D Whaley, Thomas M Ulbright
Embryonic-type neuroectodermal elements are often intimately mixed with primitive endodermal-type glands, like those of yolk sac tumors, in germ cell neoplasia in situ (GCNIS)-derived germ cell tumors of the testis. Because the primitive glands mimic tubules or rosettes of embryonic-type neuroectodermal elements, these embryonic-type neuroectodermal/glandular complexes may be misinterpreted as pure lesions of embryonic-type neuroectodermal elements, which, if of sufficient size, may lead to a diagnosis of embryonic-type neuroectodermal tumor, despite that the criteria of the World Health Organization for a "somatic-type malignancy" are not met...
May 7, 2024: American Journal of Surgical Pathology
Qin Li, Zhigang Lan, Yong Jiang, Rui Wang, Ziyao Li, Xiaolin Jiang
Currently, 5 scoring systems have been proposed in the literature for predicting metastatic risk in pheochromocytoma and paraganglioma (PPGL): Pheochromocytoma of the Adrenal Gland Scaled Score (PASS), Grading System for Adrenal Pheochromocytoma and Paraganglioma (GAPP), Composite Pheochromocytoma/paraganglioma Prognostic Score (COPPS), Age, Size, Extra-adrenal location, Secretion type (ASES) score, and Size, Genetic, Age, and PASS (SGAP) model. To validate and evaluate these 5 scoring systems, we conducted a retrospective review of cases diagnosed as PPGL at the Department of Pathology, West China Hospital of Sichuan University, between January 2012 and December 2019...
May 7, 2024: American Journal of Surgical Pathology
Bella L Liu, Mehrvash Haghighi, William H Westra
Surgical pathology of the head and neck is one of the more challenging areas in all of diagnostic pathology. Its unparalleled diversity and complexity renders it highly vulnerable to diagnostic error compelling unconstrained access to specialized diagnostic expertise. Digital pathology (DP) is a state-of-the-art tool that could facilitate access to specialized expertise, but it is relatively untested in the context of pathology consultations. In a collaboration between Labcorp Dianon and a large academic hospital with subspecialized surgical pathology, DP was implemented to provide the pathology community access to head and neck pathology expertise...
May 7, 2024: American Journal of Surgical Pathology
Keisuke Goto, Yoji Kukita, Tsunekazu Hishima, Shigeto Matsushita, Takuji Tsuyuki, Kosuke Makihara, Kaori Koga, Shoko Mukumoto, Keiichiro Honma
WHO Classification of Skin Tumors, fifth edition (2023) has newly described primary cutaneous NUT carcinoma; however, information on this cancer type remains scarce. Herein, we performed clinicopathologic and genetic analyses of 4 cases. Four elderly women (median age 77 y, range: 68 to 82 y) were included. The median tumor size was 12.5 (10 to 40 mm). Tumors were located on the scalp, temple, thigh, and palm. Two (50%) patients presented with regional lymph node metastases. Neither distant metastasis nor mortality was observed during patient follow-up of 10...
May 6, 2024: American Journal of Surgical Pathology
Aarti E Sharma, Cindy B Wepy, David B Chapel, Livia Maccio, Lina Irshaid, Alyaa Al-Ibraheemi, Brendan C Dickson, Marisa R Nucci, Christopher P Crum, Christopher D M Fletcher, David L Kolin
Ewing sarcoma is an uncommon neoplasm considered in the differential diagnosis of tumors with "small round cell" morphology, but its occurrence in the gynecologic tract has only been sporadically documented. Herein, we describe the largest cohort of Ewing sarcoma localized to the female genital tract to date, and emphasize their clinicopathologic resemblance to more common gynecologic neoplasms. Ewing sarcoma (n=21) was retrospectively identified from 5 institutions. The average patient age was 35 (range 6-61) years...
May 6, 2024: American Journal of Surgical Pathology
Lijing Zhu, Lisha Sun, Ye Zhang, Xiaoxiao Liu, XueFen Li, Zheng Zhou, Yajuan Cui, Chuan-Xiang Zhou, Tie-Jun Li
Acinic cell carcinoma of the salivary gland (AciCC) is a low-grade carcinoma characterized by the overexpression of the transcription factor nuclear receptor subfamily 4 group A member 3 (NR4A3). AciCC has been the subject of a few molecular research projects. This study delves into AciCC's molecular landscape to identify additional alterations and explore their clinical implications. RNA sequencing and immunohistochemical staining for markers NR4A3/NR4A2, DOG-1, S100, and mammaglobin were utilized on 41 AciCCs and 11 secretory carcinoma (SC) samples...
April 29, 2024: American Journal of Surgical Pathology
Anne M Mills, Taylor M Jenkins, Megan E Dibbern, Kristen A Atkins, Kari L Ring
Endometrial somatically derived yolk sac tumors are characterized by yolk sac morphology with AFP, SALL-4, and/or Glypican-3 immunoexpression. Yolk sac marker expression, however, is not limited to tumors with overt yolk sac histology. Three hundred consecutive endometrial malignancies were assessed for immunomarkers of yolk sac differentiation. Of these, 9% expressed ≥1 yolk sac marker, including 29% of high-grade tumors. Only 3 (1%) met morphologic criteria for yolk sac differentiation; these were originally diagnosed as serous, high-grade NOS, and dedifferentiated carcinoma...
April 23, 2024: American Journal of Surgical Pathology
Maximilian Lennartz, Neele Löhr, Doris Höflmayer, Sebastian Dwertmann Rico, Clara von Bargen, Simon Kind, Viktor Reiswich, Florian Viehweger, Florian Lutz, Veit Bertram, Christoph Fraune, Natalia Gorbokon, Sören Weidemann, Niclas C Blessin, Claudia Hube-Magg, Anne Menz, Ria Schlichter, Till Krech, Andrea Hinsch, Eike Burandt, Guido Sauter, Ronald Simon, Martina Kluth, Andreas H Marx, Patrick Lebok, David Dum, Sarah Minner, Frank Jacobsen, Till S Clauditz, Christian Bernreuther, Stefan Steurer
Trichorhinophalangeal syndrome 1 (TRPS1) is a nuclear protein highly expressed in breast epithelial cells. TRPS1 immunohistochemistry (IHC) has been suggested as a breast cancer marker. To determine the diagnostic and prognostic utility of TRPS1 IHC, tissue microarrays containing 19,201 samples from 152 different tumor types and subtypes were analyzed. GATA3 IHC was performed in a previous study. TRPS1 staining was seen in 86 of 152 tumor categories with 36 containing at least one strongly positive case. TRPS1 staining predominated in various types of breast carcinomas (51%-100%), soft tissue tumors (up to 100%), salivary gland tumors (up to 46%), squamous cell carcinomas (up to 35%), and gynecological cancers (up to 40%)...
April 22, 2024: American Journal of Surgical Pathology
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