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International Journal of Surgical Pathology

Kosuke Takemura, Toru Motoi, Akiko Tonooka, Nobuaki Funata, Yasukazu Nakanishi, Madoka Kataoka, Masaya Ito, Kazumasa Sakamoto, Hiroaki Suzuki, Ken-Ichi Tobisu, Fumitaka Koga
Carcinosarcoma of the upper urinary tract is very rare. In this article, we report a case of upper urinary tract carcinosarcoma with rhabdomyoblastic differentiation showing distinct transition between the epithelial and mesenchymal components confirmed by morphology and immunohistochemistry. An 81-year-old female underwent radical nephroureterectomy under the diagnosis of left ureteral urothelial carcinoma (UC). Multiple invasive tumors showed combined histology with UC and rhabdomyosarcomatous elements (pT2-ureter and pT3-renal pelvis, pN0, u-lt0, ly0, v0, RM0)...
February 15, 2019: International Journal of Surgical Pathology
Simon F Roy, Philippe Lafaille, Delphine Désy
We report the case of a 94-year-old man with a rapidly growing nodule on the preauricular area, which on histology showed a poorly differentiated spindle cell tumor with negative p63 and p40 antibody immunostains, negative high- and low-molecular-weight cytokeratins albeit for a focal expression of cytokeratin AE1/AE3. Spindle cell melanoma, angiosarcoma, and leiomyosarcoma were excluded. We explore the diagnostic approach to this challenging conundrum. Certain authors have suggested that sarcomatoid carcinoma and atypical fibroxanthoma (AFX) may lie within a spectrum of "sarcoma-like tumors of the head and neck" and that they may all run a similarly indolent clinical course...
February 14, 2019: International Journal of Surgical Pathology
David Creytens, Wouter Van Riel, Jo Van Dorpe
No abstract text is available yet for this article.
February 6, 2019: International Journal of Surgical Pathology
A W Barrett, R P Boyapati, B S Bisase, P M Norris, M J Shelley, J Collyer, K J Sneddon, A Gulati
In this series, there are 8 typical verruciform xanthomas of the oral mucosa and 3 anomalies, 1 polypoid, 1 florid, and 1 carcinomatous. All were characterized by infiltrates of CD68-positive xanthomatous histiocytes in the lamina propria. The 11 patients comprised 6 men and 5 women (mean age = 54.5 years, range = 40-69). Both keratinized and nonkeratinized sites were affected. A history of lichenoid inflammation was recorded in 5 patients. The polypoid xanthoma presented in a woman aged 54 years as a polyp of the labial commissure...
February 6, 2019: International Journal of Surgical Pathology
Derek Tsz Wai Yau, John K C Chan, Siyu Bao, Zongli Zheng, Gene Tze Chin Lau, Alexander Chak Lam Chan
Ewing sarcomas are typified by EWSR1 fusion to ETS gene family members. Tumors with fusion partners other than ETS family members and atypical histologic features pose significant diagnostic challenges and controversies as to their classification. In this article, we report a tumor with EWSR1-NFATC2 fusion in the left femur of a 43-year-old man and with unusual morphologic features that resemble undifferentiated high-grade sarcoma. Analysis together with reported cases in the literature shows that tumors with EWSR1-NFATC2 exhibit distinctive clinicopathologic features, including predilection for young male adults, highly variable histology that varies from round cell tumors frequently associated with nuclear irregularity, short spindle cells with nuclear pleomorphism, to myoepithelial tumor-like with or without myxohyaline matrix...
February 3, 2019: International Journal of Surgical Pathology
Simon F Roy, Jennifer M McNiff
No abstract text is available yet for this article.
January 31, 2019: International Journal of Surgical Pathology
Anupma Nayak, Brittany Depasquale, Norge Vergara, Thomas A Guzzo, Priti Lal
Villous adenomas arising in the bladder following augmentation cystoplasty procedures are exceedingly rare. Even rarer is their occurrence in the native bladder mucosa and the upper urinary tract. In this article, we present a unique case of multifocal recurrent villous adenoma involving native bladder mucosa of an augmented bladder, bilateral ureters, and renal pelvis, with coexistent foci of adenocarcinoma and neuroendocrine carcinoma, in a patient with history of augmentation colocystoplasty. We additionally discuss the pathogenesis of development of carcinoma in the setting of augmentation cystoplasty...
January 31, 2019: International Journal of Surgical Pathology
Genki Usui, Yoshio Masuda, Hirotsugu Hashimoto, Masashi Kusakabe, Kentaro Nakajima, Hajime Tsunoda, Nobuyuki Matsuhashi, Yasushi Harihara, Hajime Horiuchi, Teppei Morikawa
Metastatic diseases rarely develop in the colorectum, and diagnosing colorectal metastasis by biopsy without history of a malignant tumor or clinical information of a primary tumor is challenging. A 65-year-old woman with a 6-month history of constipation and diarrhea was admitted to our hospital and diagnosed with rectosigmoid colonic micropapillary carcinoma. Low anterior resection was performed after neoadjuvant chemotherapy. Because the lipoleiomyoma in the uterus obstructed the operator's vision, total hysterectomy and bilateral salpingo-oophorectomy were performed...
January 20, 2019: International Journal of Surgical Pathology
Julia A Ross, John Reith, Jaya Ruth Asirvatham
The differential diagnosis of myxoid lesions in the breast is broad and includes both benign and malignant entities. Assessment is particularly challenging on core biopsy specimens. Myofibroblastoma, initially thought to be more common in the adult male breast, is being recognized with increasing frequency in the female breast. The wider anatomic distribution of mammary-type myofibroblastoma has also become known, and many new morphological variants have been described. Though focal myxoid stroma may be noted in myofibroblastomas and occasional myofibroblastomas may contain atypical cells, there have been only 3 reports in the literature of myofibroblastomas with exclusive or predominantly myxoid stroma, and 2 of these contained atypical cells...
January 20, 2019: International Journal of Surgical Pathology
Dua Abuquteish, Iram Siddiqui, Juan Putra
No abstract text is available yet for this article.
January 16, 2019: International Journal of Surgical Pathology
Hirotsugu Hashimoto, Genki Usui, Maiko Takita, Teppei Morikawa
No abstract text is available yet for this article.
January 8, 2019: International Journal of Surgical Pathology
Sofía Cañete-Portillo, Diego F Sanchez, María José Fernández-Nestosa, Adriano Piris, Patricia Zarza, Sabrina Oneto, Lorena Gonzalez Stark, Cecilia Lezcano, Gustavo Ayala, Ingrid Rodriguez, Mai P Hoang, Martin C Mihm, Antonio L Cubilla
Lichen sclerosus (LSc) with penile cancer is found in about two thirds of specimens. It has been hypothesized that LSc represents a precancerous condition. To qualify as such, in addition to cytological atypia and similarity with the invasive tumor, a spatial correlation between LSc and neoplastic lesions needs to be demonstrated. The purpose of this study was to evaluate such a spatial relationship. Circumcision (28 cases) and penectomy (81 cases) specimens were evaluated. All cases had LSc, penile intraepithelial neoplasia (PeIN), and/or invasive squamous cell carcinomas...
January 7, 2019: International Journal of Surgical Pathology
Yashaswini Nallacheruvu, Kavita Gaur, Puja Sakhuja, Anil Kumar Agarwal, Siddharth Srivastava
Mucoepidermoid carcinoma (MEC) is rarely reported in the hepatobiliary system. In this article, we detail the first case of MEC arising from the gallbladder, presenting in a 50-year-old male. Imaging and gross examination showed a large mass in the gallbladder fossa infiltrating the liver. This microscopically displayed the classical morphology of MEC, which was confirmed on dual immunostain for p63 and CK7 and histochemical staining for mucin. MUC and p53 immunoexpression patterns suggested a poor prognosis...
December 26, 2018: International Journal of Surgical Pathology
Jordan E Baum, Kap-Jae Sung, Hung Tran, Wei Song, Paula S Ginter
We present the case of a 73-year-old woman with an epithelial-myoepithelial carcinoma of the left breast (ie, malignant adenomyoepithelioma). In both the initial needle core biopsy and in the subsequently performed lumpectomy, the tumor consisted of nests of neoplastic epithelium and myoepithelium with cytologic atypia, increased mitoses, and infiltrative growth into the surrounding tissue. Mutational analysis showed oncogenic driver mutations in HRAS and PIK3CA. In this article, we describe an epithelial-myoepithelial carcinoma of the breast with focal metaplastic differentiation, an extremely rare entity, and report the results of targeted next-generation sequencing...
December 25, 2018: International Journal of Surgical Pathology
Alexey S Konstantinov, Ksenya V Shelekhova
Dedifferentiated liposarcoma shows a wide morphological spectrum. We present a case of dedifferentiated liposarcoma of the spermatic cord in a 66-year-old male that was initially misinterpreted as pseudosarcomatous proliferative funiculitis with mesothelial proliferation.
December 24, 2018: International Journal of Surgical Pathology
Takashi Sono, Alisha D Ware, Edward F McCarthy, Aaron W James
Chondromyxoid fibroma (CMF) is a relatively uncommon benign bone tumor of cartilaginous differentiation. The primary pitfall in the histopathologic diagnosis of CMF is confusion with a high-grade chondrosarcoma, owing to the atypical stellate and spindled cells set within a chondromyxoid background. CMF is particularly challenging to diagnose within the pelvis, where clinical suspicion for chondrosarcoma is high and benign lesions may grow to a large size to occupy the pelvic bones. In our practice, we noted this difficulty in several consecutive cases, especially when older patients presented with CMF within the pelvis...
December 23, 2018: International Journal of Surgical Pathology
Rūta Žulpaitė, Žymantas Jagelavičius, Ugnius Mickys, Ričardas Janilionis
Only 1% to 2% of meningiomas have primary extrameningeal location, which is mostly head and neck region. Primary pulmonary meningiomas (PPMs) are even more uncommon with up to 50 cases reported in the literature. Only 5 cases of PPM with confirmed or possible malignancy have been previously described. Three-grade classification of meningiomas with the accordingly growing risk of aggressive behavior of the tumor has been proposed by the World Health Organization. As it is based on correlations between morphological and clinical features of intracranial meningiomas, the analogous prediction of ectopic tumors prognosis remains questionable due to scarce number of cases...
December 18, 2018: International Journal of Surgical Pathology
Anja M K Jones, Wei Ying Yue, Jenna Marcus, Debra S Heller
Serous cystadenofibromas are uncommon benign ovarian lesions, consisting of both fibrous and epithelial components, that are usually cystic but may contain solid or papillary architecture that can be confused with a malignancy on imaging. Papillary architecture seen on frozen section may also falsely steer the pathologist in the direction of a diagnosis of a borderline serous tumor. Overcalling the lesion may lead to more aggressive surgery than necessary, so extensive tissue sampling and consideration of this entity is important in possibly avoiding this mistake...
December 18, 2018: International Journal of Surgical Pathology
Ruifang Zheng, Pierre F Lespinasse, Debra S Heller
No abstract text is available yet for this article.
December 14, 2018: International Journal of Surgical Pathology
Hirotsugu Hashimoto, Genki Usui, Eiji Sakai, Ken Ohata, Teppei Morikawa
In this article, we report the case of a 40-year-old woman with a sessile polyp of the rectosigmoid junction that underwent endoscopic resection. The resected specimen showed spindle cell proliferation with eosinophilic cytoplasm between mucosal crypts, mimicking mucosal prolapse syndrome. However, these were immunohistochemically positive for S-100, indicating neural cell origin. As neural polypoid lesion of the rectum, neurofibroma, perineurioma, schwannoma, and mucosal Schwann cell hamartoma were in the differential diagnosis...
December 12, 2018: International Journal of Surgical Pathology
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