- Cost Effectiveness of Intraoperative Gross Examination in Colorectal Resections: A Retrospective Review of 200 Consecutive Cases. [Journal Article]
- APArch Pathol Lab Med 2018 Jun 14
- CONCLUSIONS: - Our study demonstrates that no change in surgical management was a result of gross examination of colorectal resection specimens and that the associated costs were significant. Decreasing unnecessary consultations will directly save the health care system money by eliminating billable services and will also increase the efficiency of the pathology department by reducing the opportunity costs for the time of the pathologist and the pathology staff.
- Biomarkers for ALK and ROS1 in Lung Cancer: Immunohistochemistry and Fluorescent In Situ Hybridization. [Journal Article]
- APArch Pathol Lab Med 2018 Jun 14
- CONCLUSIONS: - Although fluorescence in situ hybridization remains the gold standard for detecting ALK and ROS1 rearrangement in non-small cell lung cancer, immunohistochemistry plays an important role and can be an effective screening method for detection of these genetic alterations, or a diagnostic test in the setting of ALK.
- Immunophenotypic Variations in Mantle Cell Lymphoma and Their Impact on Clinical Behavior and Outcome. [Journal Article]
- APArch Pathol Lab Med 2018 Jun 05
- Context Immunophenotypic variations in mantle cell lymphoma (MCL) from the classic CD5+/CD10-/CD23-/FMC-7+ immunophenotype have been reported in the literature, but correlation with clinical behavior...
Context Immunophenotypic variations in mantle cell lymphoma (MCL) from the classic CD5+/CD10-/CD23-/FMC-7+ immunophenotype have been reported in the literature, but correlation with clinical behavior and outcome has not been fully studied. Objective To investigate clinicopathologic and prognostic differences between immunophenotypically aberrant MCL and immunophenotypically typical MCL. Design We evaluated differences in clinical presentation, laboratory parameters, prognostic indices, response to initial treatment, and progression-free and overall survival between patients with aberrant MCL and patients with immunophenotypically typical MCL. Results There were 158 patients with newly diagnosed cyclin D1 or t(11;14)(q13;q32)+ MCL identified in the original search; of which, 29 patients (18%) showed immunophenotypic aberrancies, with CD23 coexpression being the most common. When compared with 33 randomly selected patients with immunophenotypically typical MCL, statistically significant differences were seen in white blood cell counts ( P = .02), in the presence of absolute lymphocytosis ( P = .03), in the MCL International Prognostic Index score ( P = .02), and in response to initial treatment ( P = .04). The "immunophenotypic status" of the MCL was the only independent factor associated with response to treatment ( P = .05), but not with the MCL International Prognostic Index score, absolute lymphocytosis, or white blood cell count. No significant differences were seen for progression-free or overall survival. Conclusions Immunophenotypic variations in MCL are associated with differences in clinical presentation and response to therapy when compared with immunophenotypically typical MCL. However, with current intensive frontline immunochemotherapy, immunophenotypic aberrations do not appear to affect progression-free or overall survival.
- Updates on Selected Topics in Lung Cancers: Air Space Invasion in Adenocarcinoma and Ki-67 Staining in Carcinoid Tumors. [Journal Article]
- APArch Pathol Lab Med 2018 Jun 05
- Context Air space invasion or aerogenous spread of lung adenocarcinoma is a relatively new concept and has been implicated as a potential prognostic factor as well as has been added as an exclusion p...
Context Air space invasion or aerogenous spread of lung adenocarcinoma is a relatively new concept and has been implicated as a potential prognostic factor as well as has been added as an exclusion point in the diagnosis of minimally invasive adenocarcinoma. Potential role for Ki-67 immunostaining as diagnostic and prognostic marker in pulmonary carcinoid tumors has been suggested in the literature, given the significant interobserver variability and the difficulty in predicting their clinical behavior. Objective To review the concept of air space invasion in lung adenocarcinoma and the current controversies regarding the role of Ki-67 immunostaining on pulmonary carcinoid tumors Data Sources PubMed search of English literature. Conclusions Pathologists need to recognize air space invasion with a critical evaluation to differentiate it from artifacts that are commonly seen in sections. Currently, Ki-67 immunostaining is not recommended for routine use in the diagnosis of pulmonary carcinoid tumors or for predicting their prognosis, except for the differential diagnosis from small cell carcinomas or large cell neuroendocrine carcinomas in small biopsy specimens with crush artifacts.
- Human Papillomavirus Infection of the Skin. [Journal Article]
- APArch Pathol Lab Med 2018; 142(6):700-705
- CONCLUSIONS: - The use of low-grade squamous intraepithelial lesion and high-grade squamous intraepithelial lesion terminology brings order and simplicity to these lesions, correlates with the current understanding of the biology of human papillomavirus infections, and helps to promote accurate diagnosis of and appropriate treatment for these lesions.
- Ocular Human Papillomavirus Infections. [Journal Article]
- APArch Pathol Lab Med 2018; 142(6):706-710
- CONCLUSIONS: - The low-risk HPV types 6 and 11 appear to play a role in the development of at least a subset of conjunctival squamous papillomas. The role of HPV in the pathogenesis of pterygium and ocular surface squamous neoplasia is less well defined. There is evidence to suggest that HPV may be a cofactor in the development of these lesions, acting in concert with ultraviolet radiation and/or human immunodeficiency virus infection in a subgroup of cases.
- The Role of Human Papillomavirus in Oropharyngeal Squamous Cell Carcinoma. [Journal Article]
- APArch Pathol Lab Med 2018; 142(6):715-718
- CONCLUSIONS: - The incidence of HPV-OPC is rising globally and in the United States, but rates of HPV-positivity vary with the anatomic site(s) and the population studied, as well as the method of detecting HPV infection. These tumors are more common in men. In contrast to HPV- OPC, the rates of smoking and alcohol abuse are lower. The HPV 16 subtype is predominant, and immunohistochemistry staining for p16 and in situ hybridization are the most widely used methods clinically to detect transcriptionally active HPV. Moreover, HPV-OPC has a unique tumor phenotype with predominantly nonkeratinizing morphology and a variety of patterns. These cancers often present with cystic lymph node metastases. The prognosis for HPV-OPC is significantly better than HPV- OPC and has led to differences in grading, staging, and management. Although there are similarities to cervical cancer, there are challenges in preventing such cancers.
- Dedifferentiated Solitary Fibrous Tumor: A Concise Review. [Journal Article]
- APArch Pathol Lab Med 2018; 142(6):761-766
- Solitary fibrous tumor (SFT) is a unique mesenchymal neoplasm that was originally believed to be of submesothelial origin. Eventually, SFT expanded to include what was previously called hemangioperic...
Solitary fibrous tumor (SFT) is a unique mesenchymal neoplasm that was originally believed to be of submesothelial origin. Eventually, SFT expanded to include what was previously called hemangiopericytoma in other regions of the body that had similar immunohistochemical and morphologic features. Although most are benign, many studies have tried to identify histologic features that predict which tumors will behave in an aggressive manner. Recently, dedifferentiation has been described in rare cases of SFT and does appear to correlate with a more aggressive clinical course. Dedifferentiated SFT occurs in a similar age range and location as conventional SFT and can resemble multiple different malignant entities. Utilization of ancillary studies and thorough tissue sampling is important to reach the correct diagnosis. The morphologic features, immunohistochemistry, molecular alterations, and prognosis will be discussed.
- Primary High-Risk Human Papillomavirus Testing for Cervical Cancer Screening in the United States: Is It Time? [Journal Article]
- APArch Pathol Lab Med 2018; 142(6):688-692
- CONCLUSIONS: - While there is evidence both for and against primary HPV testing, there are a growing number of countries adopting the practice. It would be worthwhile to be informed and prepared for such a change in the United States as well.
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- The Impact and Burden of Human Papillomavirus-Associated Disease. [Journal Article]
- APArch Pathol Lab Med 2018; 142(6):686-687