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Literature Update - Surgical Pathology
June 2007
Modern Pathology, Vol. 20, No. 6, June 2007
Page 605: In a review of 69 cases of dense deposit disease (DDD), five morphological patterns were demonstrated (including membranoproliferative, mesangioproliferative, crescentic and acute proliferative/exudative), indicating a heterogeneous morphological presentation. Hence, these authors propose that DDD should NOT be regarded as type II membrano-proliferative GN. Page 617: When presented with the problem of sarcomatoid mesothelioma versus synovial sarcoma of the pleura, the latter harbors the SYT-SSX fusion which is absent in mesothelioma.Journal of Clinical Pathology, Vol. 60, No. 5, May 2007
Page 504: The dualistic VIN/SCC pathogenetic pathways have been discussed previously (undifferentiated warty/basaloid VIN, HPV positive, p16 positive, young versus differentiated VIN, lichen sclerosis background, HPV/p16 negative, older, keratinizing). This study from the Dutch challenges these pathways by demonstrating that VIN with LS is more likely to be undifferentiated with 30% HPV positive!Journal of Clinical Pathology, Vol. 60, No. 6, June 2007
- Page 585: Do renal cell oncocytomas metastasize (albeit rarely)? This question, along with
the more critical differential diagnosis (eosinophilic variant of chromophobe renal cell
carcinoma) is addressed in this excellent editorial/review.
- Page 735: Should T1 bladder urothelial carcinomas be subdivided into T1a (superficial,
invade lamina propria, stalk or base) and T1b (invade muscularis mucosae or around thick-
walled blood vessels of lamina propria)? YES, the prognosis/behavior is different and
pathologists can distinguish between 1a and 1b.
Journal of Pathology, Vol. 212, No. 2, June 2007
Page 121: A nice review addressing the challenges and new frontiers in the diagnosis of gastrointestinal dysplasia.American Journal of Clinical Pathology, Vol. 127, No. 6, June 2007
The HemePath workshop (from EAHP) continues:
Page 860: NK cell lymphoma is reviewed with morphology (angiocentric and destructive), immunohistochemistry (CD56 positive/cytoplasmic CD3/cytotoxic molecules) and classic sites (nasal, skin, GIT, testis) presented. Page 869: Hepatosplenic 纬未 T-cell lymphoma.Histopathology, Vol. 50, No. 6, May 2007
Page 773: High grade ovarian serous carcinomas demonstrate a higher expression of p16 (diffuse, strong) than low grade serous carcinomas and serous borderline tumors (focal, moderate).
Histopathology, Vol. 50, No. 7, June 2007
Page 821: An excellent review of common problems encountered in lymphoma diagnosis from a doyen of Hematopathology, Professor Peter Isaacson (still working at UCL, London). Exquisite diagnostic tips, e.g. bcl2 positive reactive germinal centers represent intrafollicular T-cells which are inherently bcl2 positive; the phagocytic histiocytes with crescentic nuclei express myeloperoxidase; AILD-T cell lymphomas are CD10 positive T cells (of germinal center origin), explaining the close association with FDC hyperplasia, etc. A must read! Page 859: Flat epithelial atypia (in columnar cell alteration) frequently co-exists with lobular neoplasia (and tubular carcinoma). Page 887: An immunohistochemical and ultrastructural study demonstrating neuronal features in oligodendrogliomas. The 27G12 clone of synaptophysin stained the majority of tumors. All tumors showed 1p19q deletion.American Journal of Surgical Pathology, Vol. 31, No. 6, June 2007
Page 827: Another lesion to add to your list of Peutz-Jegher syndrome: intratubular large cell hyalinizing Sertoli cell neoplasia of testis. These cells expand the seminiferous tubules with vacuolated, eosinophilic cytoplasm admixed with globular deposits of basement membrane material. Orchiectomy is indicated for invasive lesions. Page 846: As previously published, MSI high tumors of the colon (usually right-sided) have purported a good prognosis (in the face of high grade histology). In contrast, the present study shows that endometrioid adenocarcinomas of the uterus with MSI-H are associated with poor prognostic features: increased Lymphovascular invasion and myometrial invasion. Page 870: Beware of SFT on needle biopsies of the prostate. These may involve rectal wall or invade between prostate and rectum, hence being amenable to the prostate needle core biopsy. A note of caution is that GIST should be ruled out in this setting. Page 695: Alveolar rhabdomyosarcoma harbor the PAX/FKHR fusion with PAX2 t(2;13) and PAX7t(1;13). However, no correlation with histology is yet to be published. This study shows NO correlation with histology and the variant translocations but, importantly, almost 50% of the solid variant of AR lack the gene fusion. Page 907: To add spice to your gallbladder sign-outs: diffuse lymphoplasmacytic cholecystitis (occurs in the primary sclerosing cholangitis setting) may undergo metaplasia, dysplasia and neoplasia (supporting the 00ield effect00theory along with intrahepatic and extrahepatic biliary tract in PSC). Page 914: Beware of mesothelial cells in transbronchial biopsies. These can be present due to technique and sampling and should not be labelled as neoplastic! Page 919: The HPV-associated anogenital carcinomas are well described. This paper presents the HPV association with metaplasia-dysplasia-carcinoma of the rectum. Squamous metaplasia of the rectum may be Heterotopic, secondary to UC, or following injury. Colorectal squamous cell carcinomas are rare but should have NO continuity with anal squamous epithelium, including absence of fistulae and no SCC elsewhere in the body. Page 947: A new marker of Langerhans cells: langerin is a lectin that initiates Birbeck granule formation. Strong langerin immunoreactivity in this study is demonstrated in LCH of the lung (along with CD1a and S-100). Page 953: Should we distinguish between stage 1a and 1b of (<3 cm) the lung (NSCLC): YES, since the prognosis and treatment is different, AND we should use the elastic stain to determine whether the visceral pleural surface is breached or not. Page 957: Ever wondered why the Fuhrman grade of chromophobe renal cell carcinoma is always high? Well, it does not matter. As demonstrated in this study, there is no significant outcome correlation between nucleolar prominent, nuclear size and nuclear shape in chromophobe carcinomas.Archives of Pathology & Laboratory Medicine, Vol. 131, No. 6, June 2007
Page 917: Distinguishing AL and AA amyloid with IMF or IHC on renal biopsy can be hazardous. Both kappa and lambda light chains may stain, as well as AA. Hence, this approach to the differentiation is to be discouraged. Page 942: A nice review of high grade osteosarcomas (secondary) arising in the setting of Paget00 disease of the bone from the Mayo Clinic.Kumarasen Cooper, MBChB
Department of Pathology
University of Vermont
Burlington, Vermont 05401
E-mail address:
