AFIP images. Mesenchymal tumors of soft tissue or other organs (Dabbs: Diagnostic Immunohistochemistry - Theranostic and Genomic Applications, 5th Edition, 2018) Carcinomas of adrenal cortex, thyroid (Am J Pathol 1986;122:343, Cancer 1992;70:2326) Breast: pseudoangiomatous stromal hyperplasia, mesenchymal component of metaplastic carcinoma Page views in 2022 to date (this page and chapter topics): 822,515 Mucosal and wrinkled portion of foreskin. Considered route for cancer spread (Am J Surg Pathol 2017;41:1542) mucosa (Mills: Sternberg's Diagnostic Surgical Pathology, 6th Edition, 2015. Stains & molecular markers - OCT 3/4. Paget Disease of the Breast A fact sheet about Paget disease of the breast, a rare type of cancer that is sometimes called Paget disease of the nipple or mammary Paget disease. Also seen in non breast cancers (Mod Pathol 2007;20:192) Anti-HER2 therapy (trastuzumab / Herceptin) plus chemotherapy reduces recurrence, metastases and mortality in HER2 gene amplified breast cancer patients (Int Semin Surg Oncol 2008;5:9, Acta Oncol 2008;47:1564); Lapatinib (Tykerb) has a similar effect (Biologics 2009;3:289) Breast malignant - Tubular carcinoma. Pancreatic adenocarcinoma (13%, Cancer Cytopathol 2012;120:230) Negative staining - disease Most cholangiocarcinomas ( Hepat Mon 2015;15:e30336 ), although intrahepatic cholangiocarcinomas may be positive ( Oncol Lett 2011;2:1046 ) Classic subtype usually presents as one or more indurated, ill defined, dermal or subcutaneous nodules (Cancer 1970;26:1029) Deep seated tumors are multinodular masses and involve tendons or fascia Cut surface is glistening with gray-white or gray-tan color and multiple areas of hemorrhage and necrosis (Arch Pathol Lab Med 2009;133:814) Very poor prognosis in some cases (J Cancer Res Clin Oncol 2012;138:1165) Even though more likely to be poorly differentiated at presentation, BSCC of the esophagus could have similar clinical features and survival outcomes when compared with SCC (J Am Coll Surg 2018;226:1086, Ann Surg Oncol 2015;22:3659) Patients with BSCC and SCC should undergo UV radiation (sun damage and indoor tanning) (Cancer 1990;65:2811, Am J Epidemiol 1999;150:459, Pediatrics 2014;134:e4) Ionizing radiation (J Natl Cancer Inst 1996;88:1848) Arsenic exposure (J Dermatol 2017;44:1374) Genetic conditions Nevoid basal cell carcinoma syndrome (Gorlin syndrome) (Lancet 1992;339:581) Page views in 2021: 98,249. Sclerosing epithelioid fibrosarcoma, small cell carcinoma (breast), solitary fibrous tumor, spindle cell epithelioma of vagina (Arch Pathol Lab Med 2001;125:547), squamous cell carcinoma (uterus), squamous papilloma (conjunctiva, Ann NY Acad Sci 2004;1030:419), synovial sarcoma (Hum Pathol 1996;27:1060), thyroid gland-CASTLE Breast cancer is the commonly diagnosed cancer in females (24%) (CA Cancer J Clin 2018;68:394) Leading cause of female cancer death worldwide ( CA Cancer J Clin 2018;68:394 ) 8 - 9% of women diagnosed with invasive breast cancer before age 75 in North America and West Europe ( NIH: SEER Cancer Statistics Review (CSR) 1975-2018 [Accessed 23 PubMed Search: Fibroadenoma of the breast pathology. Mantle cell lymphoma (Cancer Biol Med 2015;12:46) Hairy cell leukemia (Am J Clin Pathol 2020;153:322, Appl Immunohistochem Mol Morphol 2010;18:561) Nodal marginal zone lymphoma (Am J Surg Pathol 2003;27:762) Extranodal marginal zone lymphoma (Am J Surg Pathol 2002;26:1343) References: Clin Lung Cancer 2019;20:e421, Lung Cancer 2019;131:62, Arch Pathol Lab Med 2018;142:321, J Clin Pathol 2021 [Epub ahead of print], Tsao: IASLC Atlas of ALK and ROS1 Testing in Lung Cancer, 2nd Edition, 2016 CA Cancer J Clin 2018;68:394) Most common type of cervical carcinoma (> 90% of cases) Most patients are 40 - 54 years old (Cancer Manag Res 2018;10:3177) Significant disparities in incidence and mortality between low resource countries versus high resource countries (CA Cancer J Clin 2018;68:394) Incidence varies from 100 per 100,000 in unscreened American Joint Committee on Cancer pathologic staging (8th edition): pT1 pNx (Amin: AJJC Cancer Staging Manual, 8th edition, 2017) Left lower eyelid, wedge excision: Recurrent, sebaceous cell carcinoma in situ, moderately differentiated involving the skin of the left lower eyelid Tumor size: 0.7 mm Poor prognostic factor in breast cancer, esophageal squamous cell carcinoma, non small cell lung cancer (NSCLC), gastric cancer, cervical squamous cell carcinoma, right sided colon cancer, tongue squamous cell carcinoma (Oncotarget 2014;5:10803, World J Gastroenterol 2012;18:712, Int J Mol Sci 2012;13:7663, Breast myoepithelial cells (most) (Breast Cancer Res 2003;5:R151, Proc Natl Acad Sci U S A 1993;90:999) Chondrocytes, choroidal nonvascular smooth muscle cells (Folia Biol (Praha) 2006;52:167, J Anat 2005;207:381) Decidual stromal cells, fibroblastic reticulum cells (Hum Reprod 1999;14:1599, J Cancer Res Clin Oncol 1981;101:149) Foci of stromal invasion characterized by angulated glands, desmoplastic stroma and increased cytologic atypia (Cancer 1995;75:2844) Size of invasion should be measured as the largest focus of invasion (Am J Surg Pathol 2014;38:448, Arch Pathol Lab Med 2013;137:685) Asbestos exposure Erionite exposure in genetically predisposed people thought to be associated with unusual high prevalence of malignant mesothelioma in region of Cappadocia, Turkey (Cancer Res 2006;66:5063) Ionizing radiation for treatment of malignancy (Hodgkin lymphoma, non-Hodgkin lymphoma, testicular cancer) might be a risk factor (Cancer Many mutations have been found in sex cord stromal tumors and can differentiate subtypes, such as adult granulosa cell tumor (FOXL2) from poorly differentiated Sertoli-Leydig cell tumors (DICER1) and microcystic stromal tumor (CTNNB1 or APC mutation) (N Engl J Med 2009;360:2719, Am J Surg Pathol 2017;41:1178, Genes Chromosomes Cancer 2015;54:353) Gross images. Liver nodule in cirrhosis (N Engl J Med 2019;380:1450) (see also figure 1 under diagrams) If < 1cm: ultrasound surveillance every 3 - 4 months If > 1cm: contrast enhanced CT / MRI Diagnostic features for hepatocellular carcinoma include hyperenhancement during arterial phase and washout in the venous or delayed phase (due to alteration in blood supply during Stains - Cytokeratin 19 (CK19, K19) Bladder: possible urine screening test for bladder carcinoma (J Egypt Natl Canc Inst 2006;18:82) Bone / soft tissue: distinguish chordoma (CK19+) from parachordoma (CK19-, Ann Diagn Pathol 1997;1:3) Breast: presence of CK19+ peripheral blood tumor cells or CK19+ fragments is a poor prognostic factor for breast cancer (predicts CNS 90%+ tubules with low grade features, irregular angulated contours of glands ("teardrop-like"), open lumina with apocrine-like snouts and basophilic secretions / columnar cell lesions in almost all cases (Adv Anat Pathol 2008;15:140), usually with flat epithelial atypia (Am J Surg Pathol 2007;31:417, Pathol Int 2008;58:620) 2.0) of subsequent breast cancer; relative risk is higher (3.1) in complex fibroadenomas; no increased risk for juvenile fibroadenoma (N Engl J Med 1994;331:10, Int J Cancer 1994;57:681, Breast J 2017;23:182) Sites. While SMARCA4 is considered a tumor suppressor gene, both loss of protein expression as well as protein upregulation have been associated with neoplasia (Sci Rep 2018;8:2043, Cancer Res 2003;63:560) It is frequently mutated in a variety of cancer cell lines (Hum Mutat 2008;29:617) Cross section. Invasive breast carcinoma (subset; particularly basal-like subtype) (Contemp Oncol (Pozn) 2016;20:436) Metaplastic breast carcinoma (Diagn Pathol 2014;9:139) Myoepithelial tumors: myoepithelioma, myoepithelial carcinoma A fact sheet about the diagnosis and treatment of inflammatory breast cancer (IBC), an uncommon type of cancer in which the breast becomes red, swollen, and warm. Breast cancer (Appl Immunohistochem Mol Morphol 2020;28:e53) Invasive urothelial carcinoma (up to 23% SATB2+) (Arch Pathol Lab Med 2014;138:1015) Board review style question #1. When evaluating the pulmonary neoplasm shown in the image, which immunohistochemical stain is more specific than CDX2 for ruling in a colorectal metastasis? Microscopic (histologic) description. Pathology is used in the diagnosis, treatment and management of an increasing range of clinical conditions. May not warrant routine surgical excision given low upgrade rates if multidisciplinary approach taken including radiologic-pathologic correlation, clinical and imaging follow up (Breast Cancer Res Treat 2018;170:313, Breast J 2018;24:133, Breast 2016;30:201, Am J Surg Pathol 2015;39:779, Surg Pathol Clin 2018;11:1, Springerplus 2016;5:398) Pathology outlines the disease condition and treatment by using different pathology laboratory techniques. Chronic myeloid neoplasms - Chronic myeloid leukemia (CML) Most patients are diagnosed in the chronic phase Almost 50% of patients diagnosed in the United States are asymptomatic and diagnosed during a routine examination (Mayo Clin Proc 2015;90:1440) Insidious onset with leukocytosis, anemia, fatigue, weight loss, night sweats
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