Pub Date : 2024-10-01Epub Date: 2024-02-22DOI: 10.1177/10668969231225773
Salim Barquet-Muñoz, Antonio Bandala-Jaques, Ma Delia Perez-Montiel, Diddier Prada, Marithe Martínez-Flores, Rosa A Salcedo-Hernández, Carlos Pérez-Plasencia, Aaron Gonzalez-Enciso, David Cantu-de Leon
Introduction: Describe factors associated with parametrial involvement, and how these factors modify the prognosis of patients with endometrial carcinoma treated with radical hysterectomy.
Methods: Observational study in which categorized patients according to those with and without parametrial involvement. A descriptive analysis and comparative analysis were performed for associations between parametrial spread and clinical, surgical, and pathology variables.
Results: We analyzed 85 patients, which 18 (21%) had parametrial involvement. Pathology factors associated with parametrial involvement were the endometrioid subtype, grade 3, and variants of poor prognosis (odds ratio (OR) 3.41, 95% CI 1.09-10.64; P = 0.035), myometrial invasion of over 50% (OR 7.76, 95% CI 1.65-36.44; P = 0.009), serosal involvement (OR 17.07, 95% CI 3.87-75.35; P < 0.001), ovarian metastasis (OR 5.15, 95% CI 1.36-19.46; P = 0.016), positive peritoneal cytology (OR 3.9, 95% CI 1.04-14.77; P = 0.044), and lymph node metastasis (OR 3.4; 95% CI 1.16-9.97; P = 0.026). Five-year disease-free survival was 74% (95% CI 57.4-85.4) for the group without parametrial spread and 50.8% (95% CI 22.7-73.4) for the group with parametrial spread (P = 0.001). Similarly, 5-year overall survival was 85.2% (95% CI 67.9-93.6) for the group without parametrial spread and 47.5% (95% CI 8.1-80.2) for the group with parametrial spread (P = 0.002).
Conclusion: Factors associated with parametrial involvement were histologies of poor prognosis, tumors affecting uterine serosa, cervix, or spread beyond the uterus. Additionally, parametrial involvement directly affects prognosis by reducing overall survival, disease-free survival and increasing odds for recurrence.
简介:描述与宫旁受累相关的因素,以及这些因素如何改变接受根治性子宫切除术的子宫内膜癌患者的预后:描述与宫旁受累相关的因素,以及这些因素如何改变接受根治性子宫切除术的子宫内膜癌患者的预后:观察性研究:将患者分为宫旁受累和未受累两类。对宫旁扩散与临床、手术和病理变量之间的关系进行了描述性分析和比较分析:我们分析了85例患者,其中18例(21%)有宫旁受累。与宫旁受累相关的病理因素有:子宫内膜样亚型、3 级、预后不良的变异型(几率比(OR)3.41,95% CI 1.09-10.64;P = 0.035)、子宫肌层浸润超过 50%(OR 7.76,95% CI 1.65-36.44;P = 0.009)、浆膜受累(OR 17.07,95% CI 3.87-75.35;P P = 0.016)、腹膜细胞学阳性(OR 3.9,95% CI 1.04-14.77;P = 0.044)和淋巴结转移(OR 3.4;95% CI 1.16-9.97;P = 0.026)。无宫旁扩散组的五年无病生存率为74%(95% CI 57.4-85.4),有宫旁扩散组为50.8%(95% CI 22.7-73.4)(P = 0.001)。同样,无宫旁扩散组的5年总生存率为85.2%(95% CI 67.9-93.6),有宫旁扩散组为47.5%(95% CI 8.1-80.2)(P = 0.002):与宫旁受累相关的因素包括组织学预后不良、肿瘤影响子宫浆膜、宫颈或扩散至子宫以外。此外,宫旁受累会直接影响预后,降低总生存率和无病生存率,增加复发几率。
{"title":"Factors Associated with Parametrial Involvement in Endometrial Carcinoma in Patients Treated with Radical Hysterectomy.","authors":"Salim Barquet-Muñoz, Antonio Bandala-Jaques, Ma Delia Perez-Montiel, Diddier Prada, Marithe Martínez-Flores, Rosa A Salcedo-Hernández, Carlos Pérez-Plasencia, Aaron Gonzalez-Enciso, David Cantu-de Leon","doi":"10.1177/10668969231225773","DOIUrl":"10.1177/10668969231225773","url":null,"abstract":"<p><strong>Introduction: </strong>Describe factors associated with parametrial involvement, and how these factors modify the prognosis of patients with endometrial carcinoma treated with radical hysterectomy.</p><p><strong>Methods: </strong>Observational study in which categorized patients according to those with and without parametrial involvement. A descriptive analysis and comparative analysis were performed for associations between parametrial spread and clinical, surgical, and pathology variables.</p><p><strong>Results: </strong>We analyzed 85 patients, which 18 (21%) had parametrial involvement. Pathology factors associated with parametrial involvement were the endometrioid subtype, grade 3, and variants of poor prognosis (odds ratio (OR) 3.41, 95% CI 1.09-10.64; <i>P</i> = 0.035), myometrial invasion of over 50% (OR 7.76, 95% CI 1.65-36.44; <i>P</i> = 0.009), serosal involvement (OR 17.07, 95% CI 3.87-75.35; <i>P</i> < 0.001), ovarian metastasis (OR 5.15, 95% CI 1.36-19.46; <i>P</i> = 0.016), positive peritoneal cytology (OR 3.9, 95% CI 1.04-14.77; <i>P</i> = 0.044), and lymph node metastasis (OR 3.4; 95% CI 1.16-9.97; <i>P</i> = 0.026). Five-year disease-free survival was 74% (95% CI 57.4-85.4) for the group without parametrial spread and 50.8% (95% CI 22.7-73.4) for the group with parametrial spread (<i>P</i> = 0.001). Similarly, 5-year overall survival was 85.2% (95% CI 67.9-93.6) for the group without parametrial spread and 47.5% (95% CI 8.1-80.2) for the group with parametrial spread (<i>P</i> = 0.002).</p><p><strong>Conclusion: </strong>Factors associated with parametrial involvement were histologies of poor prognosis, tumors affecting uterine serosa, cervix, or spread beyond the uterus. Additionally, parametrial involvement directly affects prognosis by reducing overall survival, disease-free survival and increasing odds for recurrence.</p>","PeriodicalId":14416,"journal":{"name":"International Journal of Surgical Pathology","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139931151","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-01Epub Date: 2024-01-30DOI: 10.1177/10668969241226703
Xin Wang, Elizabeth Lovelace, Richard R Pacheco, Robert Pacheco, Michael E Schuster, Adrien Bernstein, Mahmut Akgul, Andrea Lightle
Atrophic kidney-like lesion (AKLL) is a rare kidney lesion, which was recently suggested by the Genitourinary Pathology Society as a provisional entity. As of now, 16 examples of AKLL have been described in the literature. Here we report a new tumor which shows similar clinicopathologic characteristics with those previously reported in AKLL. Immunohistochemical (IHC) studies in the current lesion identified a biphasic staining pattern consisting of a mixture of WT1+/KRT7-/PAX8- large dilated cysts and WT-/KRT7+/PAX8+ small atrophic cysts. Histomorphologic features of AKLL overlap with several neoplastic and non-neoplastic entities which can lead to mischaracterization. Awareness of the differentiating features is likely important when evaluating these lesions.
{"title":"Atrophic Kidney-Like Lesion-Case Report and Review of the Literature.","authors":"Xin Wang, Elizabeth Lovelace, Richard R Pacheco, Robert Pacheco, Michael E Schuster, Adrien Bernstein, Mahmut Akgul, Andrea Lightle","doi":"10.1177/10668969241226703","DOIUrl":"10.1177/10668969241226703","url":null,"abstract":"<p><p>Atrophic kidney-like lesion (AKLL) is a rare kidney lesion, which was recently suggested by the Genitourinary Pathology Society as a provisional entity. As of now, 16 examples of AKLL have been described in the literature. Here we report a new tumor which shows similar clinicopathologic characteristics with those previously reported in AKLL. Immunohistochemical (IHC) studies in the current lesion identified a biphasic staining pattern consisting of a mixture of WT1+/KRT7-/PAX8- large dilated cysts and WT-/KRT7+/PAX8+ small atrophic cysts. Histomorphologic features of AKLL overlap with several neoplastic and non-neoplastic entities which can lead to mischaracterization. Awareness of the differentiating features is likely important when evaluating these lesions.</p>","PeriodicalId":14416,"journal":{"name":"International Journal of Surgical Pathology","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139642056","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-01Epub Date: 2024-02-04DOI: 10.1177/10668969241228285
M Ruhul Quddus, Cara A Mathews, Kamaljeet Singh
Mesonephric-like adenocarcinoma (MLA) of the endometrium shows a variety of morphologic appearances, including small glands, tubules with eosinophilic materials in the lumen, prominent papillary patterns, spindled cells, solid formations, and corded and hyalinized patterns. Unique morphology, characteristic immunohistochemical staining patterns, molecular alterations, and awareness of the pathologists make it possible to identify this tumor accurately. This report of two additional morphologic patterns, intestinal goblet cells mimicking intestinal-type mucinous carcinoma and squamous differentiation with spindle and epithelioid cells mimicking carcinosarcoma of the endometrium will expand the literature on MLA.
{"title":"Ever Expanding Morphologic Patterns of Mesonephric-like Adenocarcinomas of the Uterine Corpus: A Report of Two Tumors and a Brief Review of the Literature.","authors":"M Ruhul Quddus, Cara A Mathews, Kamaljeet Singh","doi":"10.1177/10668969241228285","DOIUrl":"10.1177/10668969241228285","url":null,"abstract":"<p><p>Mesonephric-like adenocarcinoma (MLA) of the endometrium shows a variety of morphologic appearances, including small glands, tubules with eosinophilic materials in the lumen, prominent papillary patterns, spindled cells, solid formations, and corded and hyalinized patterns. Unique morphology, characteristic immunohistochemical staining patterns, molecular alterations, and awareness of the pathologists make it possible to identify this tumor accurately. This report of two additional morphologic patterns, intestinal goblet cells mimicking intestinal-type mucinous carcinoma and squamous differentiation with spindle and epithelioid cells mimicking carcinosarcoma of the endometrium will expand the literature on MLA.</p>","PeriodicalId":14416,"journal":{"name":"International Journal of Surgical Pathology","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139681108","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-01Epub Date: 2024-02-01DOI: 10.1177/10668969241229350
Elif Cerrah, Cem Çomunoğlu
Neurofibromatosis type 1 (NF1) is the most common human genetic disease. In these patients, the incidence of malignant peripheral nerve sheath tumors (MPNST) and gastrointestinal stromal tumors (GIST) is increased. A male patient in his forties with neurofibromatosis 1, presented with the coexistence of multiple GISTs located at intestinal and colonic mesentery, MPNST located at his leg and atypical neurofibromatous neoplasm with uncertain biologic potential located at colonic mesentery. By FISH, the MPNST harbored CDKN2A loss and recurred 1 year later. After reresection and radiotherapy, the patient is now disease-free without evidence of disease. Atypical neurofibromatous neoplasm with uncertain biologic potential is a newly defined entity, and it is important to discriminate it from low-grade MPNST, which requires more aggressive treatment methods. To the best of our knowledge, this is the first report describing synchronous GISTs, MPNST, and atypical neurofibromatous neoplasm with uncertain biologic potential developing in a single NF1 patient.
{"title":"Multiple Gastrointestinal Stromal Tumors, Malignant Peripheral Nerve Sheath Tumor and Atypical Neurofibromatous Neoplasm With Uncertain Biologic Potential Developing in A Single Patient With Neurofibromatosis Type 1 Syndrome.","authors":"Elif Cerrah, Cem Çomunoğlu","doi":"10.1177/10668969241229350","DOIUrl":"10.1177/10668969241229350","url":null,"abstract":"<p><p>Neurofibromatosis type 1 (NF1) is the most common human genetic disease. In these patients, the incidence of malignant peripheral nerve sheath tumors (MPNST) and gastrointestinal stromal tumors (GIST) is increased. A male patient in his forties with neurofibromatosis 1, presented with the coexistence of multiple GISTs located at intestinal and colonic mesentery, MPNST located at his leg and atypical neurofibromatous neoplasm with uncertain biologic potential located at colonic mesentery. By FISH, the MPNST harbored <i>CDKN2A</i> loss and recurred 1 year later. After reresection and radiotherapy, the patient is now disease-free without evidence of disease. Atypical neurofibromatous neoplasm with uncertain biologic potential is a newly defined entity, and it is important to discriminate it from low-grade MPNST, which requires more aggressive treatment methods. To the best of our knowledge, this is the first report describing synchronous GISTs, MPNST, and atypical neurofibromatous neoplasm with uncertain biologic potential developing in a single NF1 patient.</p>","PeriodicalId":14416,"journal":{"name":"International Journal of Surgical Pathology","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139671750","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-01Epub Date: 2024-02-01DOI: 10.1177/10668969241226699
Peipei Zhu, Jian Wang
Anaplastic lymphoma kinase (ALK)-rearranged mesenchymal neoplasms (non-inflammatory myofibroblastic tumor and non-epithelioid fibrous histiocytoma) have been recently described which tend to occur in the superficial and deep soft tissues. Occurrence as a primary sinonasal neoplasm has not been reported thus far. Herein, we describe the first case of sinonasal ALK-rearranged mesenchymal tumor that harbored remarkable epithelioid and spindle cell morphology. The tumor affected a 40-year-old man who presented with flu-like symptoms and was thought to have influenza A. However, computed tomography demonstrated a nasal polypoid lesion causing curvature of the nasal septum. Histological examination revealed a heterogeneous tumor composed of round to epithelioid cells with foci of spindle cells. The tumor cells exhibited moderate pleomorphism and mitotic activity. By immunohistochemistry, they showed diffuse staining of CD34, S100, ALK (D5F3) and CD30. Fluorescence in situ hybridization analysis demonstrated ALK rearrangement. Subsequent next-generation sequencing (RNA-seq) identified a rare PLEKHH2exon6::ALKexon20 fusion. This study further demonstrates the importance of molecular profiling in identifying kinase fusion-positive soft tissue tumors, particularly for those that arise at unusual sites and display atypical cytomorphology.
{"title":"ALK-Rearranged Epithelioid and Spindle Cell Neoplasm of the Sinonasal Tract.","authors":"Peipei Zhu, Jian Wang","doi":"10.1177/10668969241226699","DOIUrl":"10.1177/10668969241226699","url":null,"abstract":"<p><p>Anaplastic lymphoma kinase (ALK)-rearranged mesenchymal neoplasms (non-inflammatory myofibroblastic tumor and non-epithelioid fibrous histiocytoma) have been recently described which tend to occur in the superficial and deep soft tissues. Occurrence as a primary sinonasal neoplasm has not been reported thus far. Herein, we describe the first case of sinonasal ALK-rearranged mesenchymal tumor that harbored remarkable epithelioid and spindle cell morphology. The tumor affected a 40-year-old man who presented with flu-like symptoms and was thought to have influenza A. However, computed tomography demonstrated a nasal polypoid lesion causing curvature of the nasal septum. Histological examination revealed a heterogeneous tumor composed of round to epithelioid cells with foci of spindle cells. The tumor cells exhibited moderate pleomorphism and mitotic activity. By immunohistochemistry, they showed diffuse staining of CD34, S100, ALK (D5F3) and CD30. Fluorescence in situ hybridization analysis demonstrated <i>ALK</i> rearrangement. Subsequent next-generation sequencing (RNA-seq) identified a rare <i>PLEKHH2exon6::ALKexon20</i> fusion. This study further demonstrates the importance of molecular profiling in identifying kinase fusion-positive soft tissue tumors, particularly for those that arise at unusual sites and display atypical cytomorphology.</p>","PeriodicalId":14416,"journal":{"name":"International Journal of Surgical Pathology","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139671678","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-01Epub Date: 2024-02-06DOI: 10.1177/10668969241228294
Kemal Kosemehmetoglu, Bharat Rekhi, Zeynep Betul Erdem, Adalet Elcin Yildiz, Nil Comunoglu
Certain undifferentiated round cell sarcomas displaying EWSR1::NFATC2 fusion have recently been reported, mostly in the bones. This report presents clinicopathological features of 3 additional EWSR1::NFATC2 fusion sarcomas of bone and soft tissues. We present 2 soft tissue and 1 bone tumors: A 62-year-old man with pain and a slowly growing, 8-cm-sized soft tissue mass in the anterolateral compartment of his right calf, along with multiple pulmonary metastatic lesions; a 63-year-old man with a 5-cm sized axillary mass of 4 months duration and a cystic renal mass; and a 53-year-old man with a complaint of leg pain was found to have a 2-cm diameter, intramedullary, lytic mass in the diaphysis of his left femur. Microscopic examination of the tumors in all patients revealed round to epithelioid cells arranged in cords and trabeculae in a myxohyaline stroma. Immunohistochemically, the tumor cells were positive for MIC2/CD99 (3/3), EMA (3/3), NKX3.1 (3/3), NKX2.2 (2/2), CD10 (2/2), and aggrecan (1/1), while negative for S100P and GFAP. Various keratins were also negative except focal AE1/AE3 positivity in the third tumor. By fluorescence in-situ hybridization, 2 tumors (#1 and #3) revealed EWSR1 gene rearrangement and amplification. Furthermore, 2 tumors (#1 and #2) displayed EWSR1ex8::NFATC2ex3 fusion with next-generation sequencing (NGS). The first patient was offered chemotherapy. However, he died of pulmonary metastasis. This report highlights the value of combining histopathological features and immunostains such as NXK3.1, NKX2.2, CD10, and aggrecan, along with EWSR1 testing for triaging these tumors for rare gene fusions by NGS that has prognostic implications.
{"title":"Clinicopathological Features of Three Rare <i>EWSR1::NFATC2</i> Sarcomas of Bone and Soft Tissues.","authors":"Kemal Kosemehmetoglu, Bharat Rekhi, Zeynep Betul Erdem, Adalet Elcin Yildiz, Nil Comunoglu","doi":"10.1177/10668969241228294","DOIUrl":"10.1177/10668969241228294","url":null,"abstract":"<p><p>Certain undifferentiated round cell sarcomas displaying <i>EWSR1::NFATC2</i> fusion have recently been reported, mostly in the bones. This report presents clinicopathological features of 3 additional <i>EWSR1::NFATC2</i> fusion sarcomas of bone and soft tissues. We present 2 soft tissue and 1 bone tumors: A 62-year-old man with pain and a slowly growing, 8-cm-sized soft tissue mass in the anterolateral compartment of his right calf, along with multiple pulmonary metastatic lesions; a 63-year-old man with a 5-cm sized axillary mass of 4 months duration and a cystic renal mass; and a 53-year-old man with a complaint of leg pain was found to have a 2-cm diameter, intramedullary, lytic mass in the diaphysis of his left femur. Microscopic examination of the tumors in all patients revealed round to epithelioid cells arranged in cords and trabeculae in a myxohyaline stroma. Immunohistochemically, the tumor cells were positive for MIC2/CD99 (3/3), EMA (3/3), NKX3.1 (3/3), NKX2.2 (2/2), CD10 (2/2), and aggrecan (1/1), while negative for S100P and GFAP. Various keratins were also negative except focal AE1/AE3 positivity in the third tumor. By fluorescence in-situ hybridization, 2 tumors (#1 and #3) revealed <i>EWSR1</i> gene rearrangement and amplification. Furthermore, 2 tumors (#1 and #2) displayed <i>EWSR1ex8::NFATC2ex3</i> fusion with next-generation sequencing (NGS). The first patient was offered chemotherapy. However, he died of pulmonary metastasis. This report highlights the value of combining histopathological features and immunostains such as NXK3.1, NKX2.2, CD10, and aggrecan, along with <i>EWSR1</i> testing for triaging these tumors for rare gene fusions by NGS that has prognostic implications.</p>","PeriodicalId":14416,"journal":{"name":"International Journal of Surgical Pathology","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139697365","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-01Epub Date: 2024-02-04DOI: 10.1177/10668969241228295
Ejas Palathingal Bava, Nilesh Gupta, Fatimah I Alruwaii, Ryan Nelson, Khaleel I Al-Obaidy
Renal cell carcinoma with fibromyomatous stroma, recognized as a provisional entity in the current 2022 World Health Organization classification of renal neoplasms, is rare. Recent evidence suggests recurrent alterations in the mTOR pathway, supporting its recognition as a distinct entity. Herein, we report 2 renal cell carcinomas with fibromyomatous stroma with MTOR mutations occurring in 62- and 72-year-old women and review the literature to support its recognition as a distinct entity, focusing on the characteristic morphology, immunohistochemical staining patterns as well as genetic alterations.
{"title":"Recurrent <i>MTOR</i> Mutations in Renal Cell Carcinoma With Fibromyomatous Stroma: A Report of 2 Tumors.","authors":"Ejas Palathingal Bava, Nilesh Gupta, Fatimah I Alruwaii, Ryan Nelson, Khaleel I Al-Obaidy","doi":"10.1177/10668969241228295","DOIUrl":"10.1177/10668969241228295","url":null,"abstract":"<p><p>Renal cell carcinoma with fibromyomatous stroma, recognized as a provisional entity in the current 2022 World Health Organization classification of renal neoplasms, is rare. Recent evidence suggests recurrent alterations in the mTOR pathway, supporting its recognition as a distinct entity. Herein, we report 2 renal cell carcinomas with fibromyomatous stroma with <i>MTOR</i> mutations occurring in 62- and 72-year-old women and review the literature to support its recognition as a distinct entity, focusing on the characteristic morphology, immunohistochemical staining patterns as well as genetic alterations.</p>","PeriodicalId":14416,"journal":{"name":"International Journal of Surgical Pathology","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139681109","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-01DOI: 10.1177/10668969241286081
Mehenaz Hanbazazh, Samar M Altoukhi, Lama S Aldawsari, Maysaa A Alghamdi, Nada K Ameen, Raneem M Khashab, Saad Samargandy, Abeer Zakariyah
Background and objectives: Surgical/anatomical pathologists study diseases to provide accurate diagnoses, identify pathogens, and participate in treatment. However, there is a need for more surgical pathologists worldwide due to low recruitment rates. One contributing factor is the medical students' interest and knowledge about surgical pathology as a career option. Understanding medical students' knowledge and perceptions about surgical pathologist jobs is crucial for future physicians, as it influences collaboration with pathologists and impacts patient care outcomes. This study aims to evaluate medical students' knowledge of surgical pathologists' jobs in Saudi Arabian medical colleges, which will help identify gaps in knowledge and develop targeted interventions to promote interest in surgical pathology as a career. For simplicity, in this study, we refer to anatomical/surgical pathology as "pathology".
Methods and results: A cross-sectional study was done in Saudi Arabia with a total of 478 medical students examining their perception of pathologist's job using a validated questionnaire distributed through social media platforms. The study revealed that 322 (67%) had no interest and did not consider becoming pathologists in the future, and 194 (40%) chose lack of patient contact as the main reason for not joining this field. However, 15% of the students think that pathologists have flexible lifestyle.
Conclusion: Our study shows that many students are not interested in pathology as a career, with varied responses revealing uncertainty about pathologists' roles. To spark interest, universities should involve students in laboratories and decision-making processes, prioritize understanding pathologists' roles, and emphasize their impact on patients' lives.
{"title":"Medical Students' Impression of Surgical Pathology as a Career in Saudi Arabia.","authors":"Mehenaz Hanbazazh, Samar M Altoukhi, Lama S Aldawsari, Maysaa A Alghamdi, Nada K Ameen, Raneem M Khashab, Saad Samargandy, Abeer Zakariyah","doi":"10.1177/10668969241286081","DOIUrl":"https://doi.org/10.1177/10668969241286081","url":null,"abstract":"<p><strong>Background and objectives: </strong>Surgical<b>/</b>anatomical pathologists study diseases to provide accurate diagnoses, identify pathogens, and participate in treatment. However, there is a need for more surgical pathologists worldwide due to low recruitment rates. One contributing factor is the medical students' interest and knowledge about surgical pathology as a career option. Understanding medical students' knowledge and perceptions about surgical pathologist jobs is crucial for future physicians, as it influences collaboration with pathologists and impacts patient care outcomes. This study aims to evaluate medical students' knowledge of surgical pathologists' jobs in Saudi Arabian medical colleges, which will help identify gaps in knowledge and develop targeted interventions to promote interest in surgical pathology as a career. For simplicity, in this study, we refer to anatomical/surgical pathology as \"pathology\".</p><p><strong>Methods and results: </strong>A cross-sectional study was done in Saudi Arabia with a total of 478 medical students examining their perception of pathologist's job using a validated questionnaire distributed through social media platforms. The study revealed that 322 (67%) had no interest and did not consider becoming pathologists in the future, and 194 (40%) chose lack of patient contact as the main reason for not joining this field. However, 15% of the students think that pathologists have flexible lifestyle.</p><p><strong>Conclusion: </strong>Our study shows that many students are not interested in pathology as a career, with varied responses revealing uncertainty about pathologists' roles. To spark interest, universities should involve students in laboratories and decision-making processes, prioritize understanding pathologists' roles, and emphasize their impact on patients' lives.</p>","PeriodicalId":14416,"journal":{"name":"International Journal of Surgical Pathology","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142346700","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-01DOI: 10.1177/10668969241283735
Carmen Rodríguez García, David Ramos Soler, Asunción Torregrosa Andrés, Javier Pérez Ardavín, Luis A Rubio Martínez, Francisco Giner Segura
Extra-skeletal osteosarcoma is a rare form of malignant soft tissue sarcoma. Its occurrence in the prostate gland is particularly uncommon. In this case report, we present a patient diagnosed with osteosarcoma arising within the prostatic gland. A 58-year-old man was initially diagnosed with Gleason 8 prostate acinar adenocarcinoma following a transurethral resection (TUR) of the prostate. This diagnosis was accompanied by locoregional involvement and multiple bone metastases. The patient underwent a treatment regimen including complete androgen blockade, chemotherapy, greenlight laser prostate vaporization, and palliative radiotherapy. After treatment, he achieved a complete biochemical response, and his bone metastases remained stable. However, at 16 months post-diagnosis, clinical follow-up by means of radiological examinations revealed an increase in the size of the prostatic lesion, along with additional infiltration of the tumor into the rectum and bladder walls. Remarkably, a mesenchymal tumor proliferation with intratumor calcifications was observed. A subsequent TUR biopsy of the prostate showed a malignant tumor spindle and ovoid cell proliferation with high-grade nuclear atypia, necrosis, and islets of osteoid formation, leading to a final diagnosis of high-grade prostatic extra-skeletal osteosarcoma. Despite undergoing chemotherapy, the patient's condition progressed with the development of pulmonary and liver metastases, culminating in his demise.
骨骼外骨肉瘤是一种罕见的恶性软组织肉瘤。发生在前列腺的情况尤为罕见。在本病例报告中,我们介绍了一名被诊断为前列腺内骨肉瘤的患者。一名 58 岁的男性在接受经尿道前列腺切除术(TUR)后,最初被诊断为格雷欣 8 型前列腺尖腺癌。这一诊断伴随着局部受累和多发性骨转移。患者接受了包括完全雄激素阻断、化疗、绿光激光前列腺汽化术和姑息性放疗在内的治疗方案。治疗后,他获得了完全的生化反应,骨转移也保持稳定。然而,在确诊后的 16 个月,通过放射检查进行临床随访时发现,前列腺病灶增大,肿瘤还向直肠和膀胱壁浸润。值得注意的是,观察到间质肿瘤增生并伴有瘤内钙化。随后进行的前列腺 TUR 活检显示,恶性肿瘤纺锤形和卵圆形细胞增生,伴有高级别核不典型性、坏死和骨样小体形成,最终诊断为高级别前列腺骨外骨肉瘤。尽管接受了化疗,但患者的病情仍在发展,出现了肺转移和肝转移,最终导致死亡。
{"title":"Extra-Skeletal Osteosarcoma of the Prostate After Treated Prostatic Acinar Adenocarcinoma: A Case Report and Review of the Literature.","authors":"Carmen Rodríguez García, David Ramos Soler, Asunción Torregrosa Andrés, Javier Pérez Ardavín, Luis A Rubio Martínez, Francisco Giner Segura","doi":"10.1177/10668969241283735","DOIUrl":"https://doi.org/10.1177/10668969241283735","url":null,"abstract":"<p><p>Extra-skeletal osteosarcoma is a rare form of malignant soft tissue sarcoma. Its occurrence in the prostate gland is particularly uncommon. In this case report, we present a patient diagnosed with osteosarcoma arising within the prostatic gland. A 58-year-old man was initially diagnosed with Gleason 8 prostate acinar adenocarcinoma following a transurethral resection (TUR) of the prostate. This diagnosis was accompanied by locoregional involvement and multiple bone metastases. The patient underwent a treatment regimen including complete androgen blockade, chemotherapy, greenlight laser prostate vaporization, and palliative radiotherapy. After treatment, he achieved a complete biochemical response, and his bone metastases remained stable. However, at 16 months post-diagnosis, clinical follow-up by means of radiological examinations revealed an increase in the size of the prostatic lesion, along with additional infiltration of the tumor into the rectum and bladder walls. Remarkably, a mesenchymal tumor proliferation with intratumor calcifications was observed. A subsequent TUR biopsy of the prostate showed a malignant tumor spindle and ovoid cell proliferation with high-grade nuclear atypia, necrosis, and islets of osteoid formation, leading to a final diagnosis of high-grade prostatic extra-skeletal osteosarcoma. Despite undergoing chemotherapy, the patient's condition progressed with the development of pulmonary and liver metastases, culminating in his demise.</p>","PeriodicalId":14416,"journal":{"name":"International Journal of Surgical Pathology","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142346697","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-01DOI: 10.1177/10668969241286068
Zachariah Thomas, Josh Thomas Georgy, Madhurima Ponmar, Divya Bala Thumaty, Anne Jennifer Prabhu, Ashish Singh
Pseudomyogenic hemangioendothelioma (PMHE), a rare soft tissue tumor predominantly affecting young adults, often presents as multiple nodules in various tissue planes of a limb. Malignant transformation and metastatic disease are unusual and pose diagnostic and therapeutic challenges. A 17-year-old patient from Western India, with a history of recurrent excisions for a toe swelling presented to our center for evaluation and management. A below-knee amputation was performed, and histopathology revealed PMHE. Adjuvant therapy was deemed unnecessary given the borderline nature of the tumor. Shortly thereafter, he developed features of local recurrence and underwent above-knee amputation. An expert histopathological review confirmed the diagnosis and noted features of malignant transformation-progression to a higher grade with greater cytological atypia, confluent growth, and increased mitotic activity over time. Upon further distant progression in the lung, he was started on a palliative regimen of weekly paclitaxel, vinblastine, and propranolol but eventually succumbed to his illness. In contrast to conventional descriptions of low mitotic activity, minimal nuclear atypia, and absence of necrosis, our patient exhibited increased mitotic rates, nuclear atypia, and evolving necrosis in serial histopathological evaluations. The fulminant clinical progression within a short interval was also atypical. Our patient's clinical course underscores the need for meticulous histopathological and molecular characterization and vigilant clinical surveillance after resection in patients with PMHE. Providing the standard of care for malignant disease in the adjuvant setting is challenging owing to the rarity and the lack of treatment guidelines.
{"title":"Metastatic Malignant Pseudomyogenic Hemangioendothelioma: An Exceedingly Rare Entity That Challenges Conventional Paradigms.","authors":"Zachariah Thomas, Josh Thomas Georgy, Madhurima Ponmar, Divya Bala Thumaty, Anne Jennifer Prabhu, Ashish Singh","doi":"10.1177/10668969241286068","DOIUrl":"https://doi.org/10.1177/10668969241286068","url":null,"abstract":"<p><p>Pseudomyogenic hemangioendothelioma (PMHE), a rare soft tissue tumor predominantly affecting young adults, often presents as multiple nodules in various tissue planes of a limb. Malignant transformation and metastatic disease are unusual and pose diagnostic and therapeutic challenges. A 17-year-old patient from Western India, with a history of recurrent excisions for a toe swelling presented to our center for evaluation and management. A below-knee amputation was performed, and histopathology revealed PMHE. Adjuvant therapy was deemed unnecessary given the borderline nature of the tumor. Shortly thereafter, he developed features of local recurrence and underwent above-knee amputation. An expert histopathological review confirmed the diagnosis and noted features of malignant transformation-progression to a higher grade with greater cytological atypia, confluent growth, and increased mitotic activity over time. Upon further distant progression in the lung, he was started on a palliative regimen of weekly paclitaxel, vinblastine, and propranolol but eventually succumbed to his illness. In contrast to conventional descriptions of low mitotic activity, minimal nuclear atypia, and absence of necrosis, our patient exhibited increased mitotic rates, nuclear atypia, and evolving necrosis in serial histopathological evaluations. The fulminant clinical progression within a short interval was also atypical. Our patient's clinical course underscores the need for meticulous histopathological and molecular characterization and vigilant clinical surveillance after resection in patients with PMHE. Providing the standard of care for malignant disease in the adjuvant setting is challenging owing to the rarity and the lack of treatment guidelines.</p>","PeriodicalId":14416,"journal":{"name":"International Journal of Surgical Pathology","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142346701","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}