Pathology (Philadelphia, Pa.)最新文献

As old terminologies begin to fail, the author says that the world of hepatopathology is ready to reassess the classification of chronic hepatitis. This chapter reviews the current status of diagnostic features and terminologies for chronic B, C, and D hepatitis and discusses recent recommendations for future directions in nomenclature.

Despite rapid progress in knowledge of the biology of hepatitis viruses, the ability to treat chronic infection is limited. In fact, interferon-alpha 2b is the only FDA-approved therapy for chronic HBV and chronic HCV. The authors report on the interferons and evolving therapies for chronic viral hepatitis and conclude with a discussion of liver transplantation.

Although some mesenchymal lesions include readily diagnosable entities, some patients have difficult presentations and unusual radiographic results. This review of mesenchymal tumors covers hemangioma, infantile hemangioendothelioma, angiomyolipoma, angiosarcoma, epitheloid hemangioendothelioma, fibroma, malignant fibrous histiocytoma, inflammatory pseudotumor, mesenchymal hamartoma, embryonal sarcoma, and sarcomatoid hepatocellular carcinoma.

The prognostic significance of clinical and histologic regression of malignant melanoma is highly controversial. Although small foci of regression in evolving malignant melanomas seem to have little or no effect on morbidity and mortality, extensive regression in larger, fully evolved lesions may be associated with poor prognosis. This chapter emphasizes the histologic features of regression and the patterns that are responsible for diagnostic pitfalls.

Proper biopsy techniques for pigmented skin lesions are critical to early detection and treatment of malignant melanoma. Complete surgical excision allows evaluation of size, symmetry, circumscription, and maturation, whereas partial biopsies may result in misinterpretation because of sampling error or inadequate architectural detail. The author briefly reviews standard techniques for excisional biopsy and addresses special clinical scenarios in which incisional or partial biopsies may be necessary.

Although overdiagnosis of malignant melanoma involves no potential loss of life, it affects the patient profoundly and therefore should be addressed conscientiously. This review of both benign and malignant, melanocytic and nonmelanocytic simulants of malignant melanoma emphasizes the pitfalls and repercussions of misdiagnosis. For more accurate differentiation, simulants are classified first as superficial (intraepidermal) or deep (dermal), then as melanocytic or nonmelanocytic.

After a brief history of the classification of melanoma in adults, this chapter describes the major features of the classic histogenetic types as well as of uncommon variants. Particular attention is paid to the meaning of controversial terms such as "minimal deviation" and "borderline." Specific problems associated with the classification of melanoma in children are also addressed, along with interpretation of atypical lesions resembling Spitz nevi.

At present the primary role of immunohistochemistry is to define an immunophenotypic profile that is characteristic of melanocytes but rare in other cell types. Its future role may include prediction of how a melanocytic neoplasm will behave. This chapter outlines a strategy for the use of immunohistochemical procedures to identify a neoplasm as melanocytic and discusses the antibodies that are relatively melanoma-specific.

Benign tumors of the liver are uncommon, and their diagnosis has never been easy. This chapter highlights the most useful criteria for the diagnosis of benign tumors and tumor-like lesions and emphasizes histologic and immunohistochemical approaches that are helpful in differentiating these conditions.

This chapter reviews the most common diseases of the liver that are associated immunodeficiencies resulting from AIDS, chemotherapy and radiation, and bone marrow and solid organ transplantation. Conditions described include liver disease, infection, venoocclusive disease, graft versus host disease, and others.