4/12/2018. MUSC Pathology Symposium Kiawah Island April 18, Jesse K. McKenney, MD
|
|
|
- Wesley Clark
- 6 years ago
- Views:
Transcription
1 MUSC Pathology Symposium Kiawah Island April 18, 2018 Jesse K. McKenney, MD 1
2 Urothelial Carcinoma with Alternative Differentiation 2
3 Urothelial Carcinoma with Alternative Differentiation Recognition as Urothelial Conventional urothelial component CIS Non-invasive papillary Invasive Prior history of urothelial carcinoma Differential Diagnosis: Urothelial Carcinoma with Alternative Differentiation Squamous Primary vesical SCCA Cervical carcinoma P16? GATA3? Glandular Primary vesical adenocarcinoma Bowel primary Urachal CDX2? SATB2? B-Catenin? Diagnostic Comment is Critical! Urinary bladder, TURBT - Invasive carcinoma with glandular differentiation, involving muscularis propria Comment: Carcinomas with glandular (enteric) features may have identical histologic, immunophenotypic, and molecular features regardless of their anatomic site of origin. The possibility of direct extension (or metastasis) from another anatomic site of origin (especially colorectal) must be excluded clinically/radiographically before this neoplasm is accepted as primary to the urinary bladder (i.e. either urothelial carcinoma with glandular differentiation or primary adenocarcinoma). 3
4 Cervical Carcinoma in Urinary Bladder Cervical Carcinoma in Urinary Bladder GATA 3 p16 Cervical Carcinoma in Urinary Bladder HPV ISH 4
5 5
6 Plasmacytoid Carcinoma Recognition Inflammatory cells Gastric and breast cancer Prognosis Poor response to chemotherapy Unusual patterns of disease failure Plasmacytoid Carcinoma Plasmacytoid Carcinoma 6
7 Plasmacytoid Carcinoma Plasmacytoid Carcinoma Plasmacytoid Carcinoma Cytokeratin AE1/3 7
8 Plasmacytoid Rhabdoid Plasmacytoid Carcinoma: Presence of Signet Ring-Like Cells Plasmacytoid Carcinoma Signet-ring Adenocarcinoma 8
9 Saphir O. Am J Pathol 1955; 31: Saphir O. Am J Pathol 1955; 31:
10 Plasmacytoid Plasmacytoid Carcinoma Carcinoma: Peri-Ureteral Tissue Presence of Signet Ring-Like Cells Plasmacytoid Carcinoma: Presence of Signet Ring-Like Cells PAS stains do NOT help! 10
11 WHO 2016 Criteria Plasmacytoid Carcinoma NO extracellular mucin Similar to diffuse type gastric CA or lobular breast CA Mucinous AdenoCA with Signet-Ring Cells Extracellular mucin Similar to mucinous adenoca of colon Most cases reported in the literature as signet ring cell adenocarcinoma of the bladder, specifically those not associated with extracellular mucin, would now be classified as plasmacytoid carcinoma Saphir O. Am J Pathol 1955; 31:
12 Peritoneal spread common Bowel serosa and mesentery Ovary Peritoneal carcinomatosis Malignant effusions (pleural) Plasmacytoid Carcinoma: Peritoneal Spread Plasmacytoid Carcinoma in Peri-Ureteral Tissue 12
13 Plasmacytoid Carcinoma in Peri-Prostatic Tissue Plasmacytoid Carcinoma in Lymph Node Cytokeratin AE1/3 13
14 Plasmacytoid Carcinoma Differential Diagnosis Metastatic carcinomas to bladder? Lobular breast Diffuse type gastric Hematopoietic Urothelial Carcinoma with Plasmacytoid Features GATA-3 Lobular breast CA: GATA-3 GATA-3 Positive Urothelial CA Breast CA T-lymphocyte subset Salivary gland CA Paraganglioma Parathyroid Subset of squamous cell CA Prostatic basal cells (patchy) GYN tract urothelial neoplasia 14
15 Gastric Carcinoma Met to Bladder Stomach Urinary bladder Immunohistochemical Differential Mammaglobin Type GATA3 S100p CK7 CK20 ER PR CD138 P63 Urothelial Gastric Breast Plasmacytoid 15
16 Plasmacytoid CK20 +/- GATA3 +/- Uro II -/+ Mammo - ER - CDX2 -/+ P63 -/+ Gastric (diffuse) CK20 -/+ GATA3 --/+ Uro II - Mammo - ER - CDX2 -/+ P63 -/+ Breast (Lobular) CK20 - GATA3 +/- Uro II - Mammo +/- ER +/- CDX2 -/+ P63 -/+ Invasive urothelial carcinomas. Deceptively benign and Under-diagnosed 16
17 Invasive urothelial carcinomas. Deceptively bland and Under-diagnosed 1) Nested Carcinoma 2) Tubular Carcinoma 3) Microcystic Carcinoma 4) Large nested Invasive Urothelial Carcinoma: Nested Variant Invasive Urothelial Carcinoma: Nested Variant 17
18 Invasive Urothelial Carcinoma: Nested Variant Invasive Urothelial Carcinoma: Nested Variant Invasive Urothelial Carcinoma: Nested Variant 18
19 Invasive Urothelial Carcinoma: Nested Variant Cytology Invasive Florid urothelial Von Brunn s carcinoma, nest proliferation nested variant? Invasive Urothelial Carcinoma: Microcystic Variant 19
20 Invasive Urothelial Carcinoma: Microcystic Variant Invasive Urothelial Carcinoma: Microcystic Variant Invasive Urothelial Carcinoma: Large Nested 20
21 Invasive Urothelial Carcinoma: Large Nested Invasive Urothelial Carcinoma: Large Nested Invasive Urothelial Carcinoma: Large Nested 21
22 Non-Invasive Endophytic Urothelial Carcinoma Deceptively Bland Carcinomas Prognosis Stage-for-stage behaves as aggressively as a high-grade carcinoma I don t recommend a low-grade designation Nested Variant with Lymph Node Met 22
23 Deceptively Bland Carcinomas Differential Diagnosis Nephrogenic adenoma von Brunn nests Inverted/Endophytic Urothelial Neoplasia Deceptively Bland Carcinoma Nested Benign Mimics of Carcinoma Von Brunn s nests (ureter; renal pelvis) Urothelium Lamina Propria Muscularis Propria Tubular Microcystic Nephrogenic adenoma Von Brunn s nests (bladder) 23
24 Small Cell Carcinoma In our hospital, small cell carcinoma is the most frequently under-diagnosed, clinically significant bladder tumor upon re-review of outside slides Requires different chemotherapy regimen Small Cell Carcinoma Small Cell Carcinoma with Non-Invasive Urothelial CA 24
25 Large Cell Neuroendocrine Carcinoma Small Cell Carcinoma Small Cell Carcinoma Synaptophysin Small Cell Carcinoma Differential Diagnosis Rhabdomyosarcoma (alveolar) Lymphoma 25
26 Rhabdomyosarcoma vs. Small Cell Carcinoma Desmin Synapto Myogenin Slender, delicate filiform processes or tight papillary clusters reminiscent of papillary serous carcinoma of ovary 26
27 Bladder Micropapillary CA Ovarian Serous Carcinoma Invasive Micropapillary Carcinoma in Muscularis Propria Invasive Micropapillary Carcinoma with LVI 27
28 Lymph Node Metastasis Therapeutic Significance: On TURBT IF: pt1 (no invasion of muscularis propria) AND: micropapillary morphology THEN: suggest re-staging biopsies J Urol 2006; 175:
29 Micropapillary Carcinoma: Cystectomy for pta and pt1 Disease? Pathologic assessment Extent of micropapillary component? Definition of non-invasive micropapillary? Definition of invasive micropapillary? Kamat, Gee, Dinney et al. J Urol 2006;175: Kamat, Dinney, Gee et al. Cancer 2007;110: Where does the land stop and the water start? When does typical urothelial carcinoma become micropapillary? 29
30 Recommended Restricted Criteria Major feature 1 Multiple small nests in same lacunar space Frequently seen features 1 Epithelial ring forms 2 Back to back lacunae 3 Peripheral nuclei 4 Cytoplasmic vacuolization Features Suggesting NOT Micropapillary Major features 1 Large nests (> 5 cells across narrowest width) 2 Epithelial confluence and branching Back-to-Back Lacunae Multiple Nests in Same Lacunar Space 30
31 Back-to-Back Lacunae Multiple Nests in Same Lacunar Space Epithelial Ring Forms Back-to-Back Lacunae Intracytoplasmic Vacuoles 31
32 NOT Classic Micropapillary NOT Classic Micropapillary NOT Classic Micropapillary 32
33 Not Classic Micropapillary, But What Is It? Urothelial CA with Distinct Mixed Features: Quantitative Problem 99% 1% Even small foci of micropapillary differentiation portend a poor prognosis 33
34 Micropapillary 96% Usual UC with Retrxn 63% MUC-1 33% 13% CA % 8% Her2/neu Sangoi et al. Mod Pathol 2009; 22:660 Micropapillary Carcinoma D
35 Non-invasive Micropapillary Carcinoma (pta) Included in studies proposing immediate surgery Criteria problems Qualitative threshold Definition? Quantitative threshold Glandular (villoglandular) differentiation Non-Invasive Papillary Urothelial Carcinoma, Micropapillary 35
36 Non-Invasive Papillary Urothelial Carcinoma Does Cribriform = Micropapillary? Non-Invasive Papillary Urothelial Carcinoma Micropapillary or Villoglandular/Glandular? Micropapillary Reporting Recommendation 1. Use restrictive criteria for invasive micropapillary carcinoma 2. Report presence of ANY invasive micropapillary component and give percentage 3. We do NOT currently diagnosis pta carcinoma using micropapillary term 36
37 Sarcomatoid Carcinoma Most common malignant spindle cell neoplasm in adults May be histologically identical to a sarcoma Must always be excluded before accepting a primary vesical sarcoma Sarcomatoid Carcinoma 37
38 Sarcomatoid Carcinoma Sarcomatoid Carcinoma Sarcomatoid Carcinoma 38
39 Sarcomatoid Carcinoma: Heterologous Elements CS OS RMS Myogenin Sarcomatoid Carcinoma: Immunohistochemistry CK34BE12 p63 Sarcomatoid Carcinoma Specific differential diagnostic scenarios 1) Myofibroblastic vs. Malignant 2) Leiomyosarcoma vs. Sarcomatoid CA 39
40 Myofibroblastic Proliferations: Nomenclature Diagnostic Term Clinical Setting Postoperative Spindle Cell Nodule Myofibroblastic Pseudosarcomatous Stromal Proliferation Associated with Neoplasia History of bladder instrumentation No association with trauma or carcinoma Overlying carcinoma Morphologically Indistinguishable Myofibroblast Morphology Myofibroblast- H&E Features Tapered cytoplasmic ends Tapered nucleus Fine nuclear chromatin Single, pinpoint nucleolus Non-Trauma/Non-Tumor Related Myofibroblastic Proliferations Nomenclature Inflammatory pseudotumor Pseudosarcomatous fibromyxoid tumor Inflammatory myofibroblastic tumor Pseudosarcomatous spindle cell proliferation 40
41 Non-Trauma/Non-Carcinoma Related Myofibroblastic Proliferations Inflammatory Myofibroblastic Tumor? Myofibroblastic lesions ALK + by IHC (up to 89 %) ALK gene rearrangement by FISH Myofibroblastic Proliferations of the Urinary Bladder Clinically Relevant: Prognosis Recurrence (0-19%) Metastasis (0%) Death (1 case: untreated, died from urinary obstruction) Myofibroblastic Proliferations of the Urinary Bladder Clinically Relevant: Differential diagnosis Myofibroblastic vs Malignant Leiomyosarcoma vs Sarcomatoid carcinoma 41
42 Myofibroblastic Myofibroblastic Myofibroblastic 42
43 Myofibroblastic Myofibroblastic Muscularis Propria Invasion 43
44 Myofibroblastic in Bladder: Immunohistochemistry ALK-1 +/- (8-89%) Actin +/- Desmin -/+ (<50%) Cytokeratin +/- (36-84%) EMA - Myogenin - h-caldesmon +/- (64%!!!) Cytokeratin Immunoreactivity in Myofibroblasts Low molecular weight cytokeratin: Positive High molecular weight cytokeratin: Negative CK AE1/3 Leiomyosarcoma Although rare, most common primary vesical sarcoma in adults Two main morphologic appearances Uterine-like: Eosinophilic and tight fascicles Myxoid: Overlap with myofibroblastic 44
45 Leiomyosarcoma Leiomyosarcoma Myxoid Leiomyosarcoma 45
46 Myxoid Leiomyosarcoma Desmin Spindle Cell Algorithm (Adult) Spindle cell proliferation Other Myofibroblastic Malignant Sarcomatoid CA LMS In Younger Patients: Botryoid Rhabdomyosarcoma Morphologic features Cambium layer Varying differentiation Undifferentiated mesenchyme Rhabdomyoblasts Myxoid, hypocellular 46
47 Botryoid Rhabdomyosarcoma Botryoid Rhabdomyosarcoma Botryoid Rhabdomyosarcoma: Deceptively Bland Pattern 47
48 Myofibroblastic vs. Malignant Cytology is the one criteria reproducible from all the studies Marked nuclear pleomorphism Irregular chromatin condensation (hyperchromasia) Malignant Myofibroblasts Malignant Myofibroblasts 48
49 Malignant Myofibroblasts Malignant Myofibroblasts Malignant Spindle Cell Neoplasm (Adult) Sarcomatoid Carcinoma Leiomyosarcoma May be morphologically indistinguishable 49
50 Malignant Spindle Cell Neoplasm (Adult) Sarcomatoid Carcinoma Concomitant CIS or invasive carcinoma Prior history of high-grade urothelial carcinoma Heterologous differentiation? Malignant Spindle Cell Neoplasm No history, no morphologic clues CA LMS Diffuse CK + - EMA + - Diffuse desmin - + Diffuse actin - + Malignant Spindle Cell Neoplasm No history, no morphologic clues CA LMS P63 + -/+ LMWCK + -/+ HMWCK
51 Invasive Urothelial Carcinoma: Selected Variants Plasmacytoid Deceptively bland /Nested Small cell Micropapillary Spindle Cell Proliferations of the Urinary Bladder Malignant vs. Myofibroblastic Sarcomatoid Carcinoma vs. Leiomyosarcoma 51
52 Jesse K. McKenney, MD Cleveland Clinic 52
Urinary Bladder: WHO Classification and AJCC Staging Update 2017
Urinary Bladder: WHO Classification and AJCC Staging Update 2017 Houston Society of Clinical Pathologists 58 th Annual Spring Symposium Houston, TX April 8, 2017 Jesse K. McKenney, MD Classification
Unusual Variants of Bladder Cancer Cristina Magi-Galluzzi, MD, PhD
Unusual Variants of Bladder Cancer Cristina Magi-Galluzzi, MD, PhD Director of Genitourinary Pathology, Professor of Pathology, Lerner College of Medicine Cleveland Clinic Objectives Update on variants
Unknown Slides Conference
Unknown Slides Conference Jae Y. Ro, MD, PhD Weill Medical College of Cornell Univ. The Methodist Hospital, and UT MD Anderson Cancer Center Houston, TX November 9, 2013 Amman, Jordan 25 th Congress of
ACCME/Disclosures. Case History 4/13/2016. USCAP GU Specialty Conference Case 3. Ann Arbor, MI
USCAP GU Specialty Conference Case 3 March 2016 L. Priya Kunju, M.D. University of Michigan Health System Ann Arbor, MI University of Michigan Health System ACCME/Disclosures The USCAP requires that anyone
BLADDER CANCER EPIDEMIOLOGY
BLADDER CANCER WHAT IS NEW AND CLINICALLY RELEVANT Canadian Geese - Geist Reservoir (my backyard), Indianapolis, USA BLADDER CANCER EPIDEMIOLOGY Urinary bladder 17,960 2% Urinary bladder 4,390 1.6% Siegel
Update on Bladder Cancer: What s New in the 2016 WHO Classification of Bladder Tumors and 8 th Edition of AJCC Staging Manual
Update on Bladder Cancer: What s New in the 2016 WHO Classification of Bladder Tumors and 8 th Edition of AJCC Staging Manual Rajal B. Shah, M.D. Director, Urologic Pathology SHAHR6@ccf.org @rajalbshah
Classification (1) Classification (3) Classification (2) Spindle cell lesions. Spindle cell lesions of bladder (Mills et al.
Non-epithelial tumours and nonepithelial tumour-like lesions of the bladder Dr Jonathan H Shanks The Christie NHS Foundation Trust, Manchester, UK Classification (1) Myofibroblastic proliferations and
Condyloma Acuminatum. Mimics of Bladder Cancer. Squamous Papilloma. Squamous epithelium in bladder
Mimics of Bladder Cancer Murali Varma Cardiff, UK wptmv@cf.ac.uk Squamous epithelium in bladder Non-keratinising vaginal type mucosa common in trigone region in women Normal variant Sarajevo Nov 2013 Squamous
5/21/2018. Prostate Adenocarcinoma vs. Urothelial Carcinoma. Common Differential Diagnoses in Urological Pathology. Jonathan I.
Common Differential Diagnoses in Urological Pathology Jonathan I. Epstein Prostate Adenocarcinoma vs. Urothelial Carcinoma 1 2 NKX3.1 NKX3.1 3 4 5 6 Proposed ISUP Recommendations Option to use PSA as a
Mody. AIS vs. Invasive Adenocarcinoma of the Cervix
Common Problems in Gynecologic Pathology Michael T. Deavers, M.D. Houston Methodist Hospital, Houston, Texas Common Problems in Gynecologic Pathology Adenocarcinoma in-situ (AIS) of the Cervix vs. Invasive
Synonyms. Nephrogenic metaplasia Mesonephric adenoma
Nephrogenic Adenoma Synonyms Nephrogenic metaplasia Mesonephric adenoma Definition Benign epithelial lesion of urinary tract with tubular, glandular, papillary growth pattern Most frequently in the urinary
Jesse K. McKenney, MD
Jesse K. McKenney, MD Outline Microscopic anatomy of the urinary bladder Diagnosing invasion Subtle patterns (variants) of carcinoma Clinically important variants of carcinoma Microanatomy of Bladder Initial
A215- Urinary bladder cancer tissues
A215- Urinary bladder cancer tissues (formalin fixed) For research use only Specifications: No. of cases: 45 Tissue type: Urinary bladder cancer tissues No. of spots: 2 spots from each cancer case (90
The role of immunohistochemistry in surgical pathology of the uterine corpus and cervix
The role of immunohistochemistry in surgical pathology of the uterine corpus and cervix Prof. Ben Davidson, MD PhD Department of Pathology, Norwegian Radium Hospital, Oslo University Hospital, Oslo, Norway
57th Annual HSCP Spring Symposium 4/16/2016
An Unusual Malignant Spindle Cell Lesion to Involve the Breast Erinn Downs-Kelly, D.O. Associate Professor of Pathology University of Utah & ARUP Laboratories No disclosures Case 39 y/o female with no
Immunohistochemistry and Bladder Tumours
Immunohistochemistry and Bladder Tumours Dr. Andrew J. Evans MD PhD FRCPC Consultant in Genitourinary Pathology University Health Network Toronto, ON Objec ves Review markers of urothelial differen a on
Bladder Case 1 SURGICAL PATHOLOGY REPORT. Procedure: Cystoscopy, transurethral resection of bladder tumor (TURBT)
Bladder Case 1 February 17, 2007 Specimen (s) received: Bladder Tumor Pre-operative Diagnosis: Bladder Cancer Post operative Diagnosis: Bladder Cancer Procedure: Cystoscopy, transurethral resection of
List of Available TMAs in the PRN
TMA RPCI_BrainCa01 RPCI_BrCa03 RPCI_BrCa04 RPCI_BrCa05 RPCI_BrCa0 RPCI_BrCa07 RPCI_BrCa08 RPCI_BrCa15 RPCI_BrCa1 RPCI_BrCa17 RPCI_BrCa18 RPCI_BrCa19 RPCI_BrCa20 RPCI_BrCa21 RPCI_BrCa24 RPCI_BrCa25 RPCI_BrCa2
Presentation material is for education purposes only. All rights reserved URMC Radiology Page 1 of 98
Presentation material is for education purposes only. All rights reserved. 2011 URMC Radiology Page 1 of 98 Radiology / Pathology Conference February 2011 Brooke Koltz, Cytopathology Resident Presentation
The pathology of bladder cancer
1 The pathology of bladder cancer Charles Jameson Introduction Carcinoma of the bladder is the seventh most common cancer worldwide [1]. It comprises 3.2% of all cancers, with an estimated 260 000 new
05/07/2018. Types of challenges. Challenging cases in uterine pathology. Case 1 ` 65 year old female Post menopausal bleeding Uterine Polyp
Types of challenges Challenging cases in uterine pathology Nafisa Wilkinson Gynaecological Pathologist UCLH London Lack of complete history often, NO clinical history at all! Cases from other centres often
2018 ICD-O-3 Updates in Table Format with Annotation for Reference
Status Histology Description (this may be preferred term or a synonym) Report Comments New term 8010 3 Urachal carcinoma (C65.9, C66.9, C67._, C68._) New term 8013 3 Combined large cell neuroendocrine
PRELIMINARY CYTOLOGIC DIAGNOSIS: Suspicious for Acinic Cell Carcinoma. Cell Block: Immunohistochemical Studies CYTOLOGIC DIAGNOSIS:
1 PRELIMINARY CYTOLOGIC DIAGNOSIS: Suspicious for Acinic Cell Carcinoma. Cell Block: Immunohistochemical Studies GCDFP-15 S-100 CYTOLOGIC DIAGNOSIS: Consistent with mammary analogue secretory carcinoma.
ACCME/Disclosures ALK FUSION-POSITIVE MESENCHYMAL TUMORS. Tumor types with ALK rearrangements. Anaplastic Lymphoma Kinase. Jason L.
Companion Meeting of the International Society of Bone and Soft Tissue Pathology The Evolving Concept of Mesenchymal Tumors ALK FUSION-POSITIVE MESENCHYMAL TUMORS Jason L. Hornick, MD, PhD March 13, 2016
When Immunostains Can Get You in Trouble: Gynecologic Pathology p16: Panacea or Pandora s Box?
When Immunostains Can Get You in Trouble: Gynecologic Pathology p16: Panacea or Pandora s Box? Teri A. Longacre, MD Stanford Medicine Stanford California pi6 in Gynecologic Pathology: Panacea or Pandora
GOBLET CELL CARCINOID. Hanlin L. Wang, MD, PhD University of California Los Angeles
GOBLET CELL CARCINOID Hanlin L. Wang, MD, PhD University of California Los Angeles Disclosure of Relevant Financial Relationships USCAP requires that all planners (Education Committee) in a position to
GOBLET CELL CARCINOID
GOBLET CELL CARCINOID Hanlin L. Wang, MD, PhD University of California Los Angeles Disclosure of Relevant Financial Relationships USCAP requires that all planners (Education Committee) in a position to
Gross appearance of nodular hyperplasia in material obtained from suprapubic prostatectomy. Note the multinodular appearance and the admixture of
Tiền liệt tuyến Tiền liệt tuyến Gross appearance of nodular hyperplasia in material obtained from suprapubic prostatectomy. Note the multinodular appearance and the admixture of solid and microcystic areas.
From Morphology to Molecular Pathology: A Practical Approach for Cytopathologists Part 1-Cytomorphology. Songlin Zhang, MD, PhD LSUHSC-Shreveport
From Morphology to Molecular Pathology: A Practical Approach for Cytopathologists Part 1-Cytomorphology Songlin Zhang, MD, PhD LSUHSC-Shreveport I have no Conflict of Interest. FNA on Lymphoproliferative
Cutaneous metastases. Thaddeus Mully. University of California, San Francisco Professor, Departments of Pathology and Dermatology
Cutaneous metastases Thaddeus Mully University of California, San Francisco Professor, Departments of Pathology and Dermatology DISCLOSURE OF RELATIONSHIPS WITH INDUSTRY Thaddeus Mully Course C005 Essential
Oncocytic-Appearing Salivary Gland Tumors. Oncocytic, Cystic, Mucinous, and High Grade Salivary Gland Tumors SALIVARY GLAND FNA: PART II
William C. Faquin, MD, PhD Professor of Pathology Harvard Medical School Director of Head and Neck Pathology Massachusetts Eye and Ear Massachusetts General Hospital SALIVARY GLAND FNA: PART II Oncocytic,
Applications of IHC. Determination of the primary site in metastatic tumors of unknown origin
Applications of IHC Determination of the primary site in metastatic tumors of unknown origin Classification of tumors that appear 'undifferentiated' by standard light microscopy Precise classification
Effective January 1, 2018 ICD O 3 codes, behaviors and terms are site specific
Effective January 1, 2018 codes, behaviors and terms are site specific /N 8551/3 Acinar adenocarcinoma (C34. _) Lung primaries diagnosed prior to 1/1/2018 use code 8550/3 For prostate (all years) see 8140/3
Effective January 1, 2018 ICD O 3 codes, behaviors and terms are site specific
Effective January 1, 2018 codes, behaviors and terms are site specific Status /N 8010/3 Urachal carcinoma (C65.9, C66.9, C67. _, C68._) 8013/3 Combined large cell neuroendocrine carcinoma (C34. _, C37.9)
Inflammatory Myofibroblastic Tumor of the Bladder
Inflammatory Myofibroblastic Tumor of the Bladder We illustrate a case of an inflammatory myofibroblastic tumor (IMT) involving the bladder in a woman with dysuria and review the literature and differential
Kidney, Bladder and Prostate Neoplasia. David Bingham MD
Kidney, Bladder and Prostate Neoplasia David Bingham MD typical malignant cytology of bladder washings 1 benign 2 malignant typical malignant cytology of bladder washings b Bladder tumor Non invasive papillary
2007 Multiple Primary and
2007 Multiple Primary and Histology Coding Rules Beyond the Basics Florida Cancer Data System Annual Conference Tampa, FL July 26,2007 Steven Peace, CTR Westat Carol Johnson, CTR NCI SEER Peggy Adamo,
INTRADUCTAL LESIONS OF THE PROSTATE. Jonathan I. Epstein
INTRADUCTAL LESIONS OF THE PROSTATE Jonathan I. Epstein Topics Prostatic intraepithelial neoplasia (PIN) Intraductal adenocarcinoma (IDC-P) Intraductal urothelial carcinoma Ductal adenocarcinoma High Prostatic
Lung Tumor Cases: Common Problems and Helpful Hints
Lung Tumor Cases: Common Problems and Helpful Hints Brandon T. Larsen, MD, PhD Senior Associate Consultant Department of Laboratory Medicine and Pathology Mayo Clinic Arizona Arizona Society of Pathologists
Enterprise Interest No disclosures.
Enterprise Interest No disclosures. Secondary Tumours in Uropathology Case 2 PRESENTED AT: EUROPEAN CONGRESS OF PATHOLOGY 18 #ECP2018 Slides are the property of the author. Permission required for reuse.
Salivary Glands 3/7/2017
Salivary Glands 3/7/2017 Goals and objectives Focus on the entities unique to H&N Common board type facts Information for your future practice Salivary Glands Salivary Glands Major gland. Paratid. Submandibular.
Effusion Cytology: Diagnostic Challenges
Effusion Cytology: Diagnostic Challenges Tarik M. Elsheikh, MD Professor and Medical Director, Anatomic Pathology Cleveland Clinic Outside Consult Case 45 year old woman, presented with nausea, dyspnea,
What is New in the 2015 WHO Lung Cancer Classification? Zhaolin Xu, MD, FRCPC, FCAP
What is New in the 2015 WHO Lung Cancer Classification? Zhaolin Xu, MD, FRCPC, FCAP Professor, Dept of Pathology, Dalhousie University, Canada Pulmonary Pathologist and Cytopathologist, QEII HSC Senior
PSA. HMCK, p63, Racemase. HMCK, p63, Racemase
Case 1 67 year old male presented with gross hematuria H/o acute prostatitis & BPH Urethroscopy: small, polypoid growth with a broad base emanating from the left side of the verumontanum Serum PSA :7 ng/ml
NEW IHC A n t i b o d i e s
NEW IHC Antibodies TABLE OF CONTENTS NEW IHC ANTIBODIES from Cell Marque CITED1 (5H6).... 1 Claudin 7 (5D10F3).... 1 GATA1 (4F5).... 1 Transgelin (2A10C2).... 1 NEW IHC ANTIBODIES using RabMAb Technology
Breast cancer: IHC classification. Mogens Vyberg Professor of Clinical Pathology Director of NordiQC Aalborg University Hospital, Aalborg, Denmark
Breast cancer: IHC classification Mogens Vyberg Professor of Clinical Pathology Director of NordiQC Aalborg University Hospital, Aalborg, Denmark http://upload.wikimedia.org/wikipedia/commons/1/1a/breast.svg
EQA Circulation 43 Educational Cases
EQA Circulation 43 Educational Cases E1-E2 Monica Agarwal Monklands Hospital E1 38 yrs male Submandibular gland tumour E1 Formal excision following diagnosis of poorly differentiated carcinoma on core
Ascitic Fluid and Use of Immunocytochemistry. Mercè Jordà, University of Miami
Ascitic Fluid and Use of Immunocytochemistry Mercè Jordà, University of Miami Is It Malignant? Yes? No Ascitic Fluid Cytomorphologic Useful Findings Tight clusters with smooth borders Cellular and nuclear
New Developments in Immunohistochemistry for Gynecologic Pathology
New Developments in Immunohistochemistry for Gynecologic Pathology Michael T. Deavers, M.D. Professor, Departments of Pathology and Gynecologic Oncology Immunohistochemistry in Gynecologic Pathology Majority
Enterprise Interest Nothing to declare
Enterprise Interest Nothing to declare Diagnoses one would not like to miss in soft tissue pathology early in your career Marta Sbaraglia, MD Department of Pathology Hospital of Treviso University of Padua
Update on Cutaneous Mesenchymal Tumors. Thomas Brenn
Update on Cutaneous Mesenchymal Tumors Thomas Brenn Cutaneous Mesenchymal Tumours Wide morphological and biological spectrum Myofibroblastic, smooth muscle, neural, vascular, apidocytic, undifferentiated;
Case 3 - GYN. History: 66 year old, routine Pap test. Dr. Stelow
Case 3 - GYN History: 66 year old, routine Pap test Dr. Stelow Case 3 66 year year old woman Routine Pap Test Cytologic Features 3 dimensional clusters of cells with small to moderate amount of
Pathology Mystery and Surprise
Pathology Mystery and Surprise Tim Smith, MD Director Anatomic Pathology Medical University of South Carolina Disclosures No conflicts to declare Some problem cases Kidney tumor Scalp tumor Bladder tumor
Normal endometrium: A, proliferative. B, secretory.
Normal endometrium: A, proliferative. B, secretory. Nội mạc tử cung Nội mạc tử cung Cyclic changes in endometrium.. Approximate relationship of useful microscopic changes. Arias-Stella reaction in endometrial
Recent advances in breast cancers
Recent advances in breast cancers Breast cancer is a hetrogenous disease due to distinct genetic alterations. Similar morphological subtypes show variation in clinical behaviour especially in response
Morphologic diversity in urothelial carcinoma; pathological and clinical correlates
Morphologic diversity in urothelial carcinoma; pathological and clinical correlates Victor E. Reuter, M.D. Memorial Sloan Kettering Cancer Center A Practical Approach to Genitourinary Pathology Firenze,
Update in Salivary Gland Pathology. Benjamin L. Witt University of Utah/ARUP Laboratories February 9, 2016
Update in Salivary Gland Pathology Benjamin L. Witt University of Utah/ARUP Laboratories February 9, 2016 Objectives Review the different appearances of a selection of salivary gland tumor types Establish
Enterprise Interest None
Enterprise Interest None What are triple negative breast cancers? A synopsis of their histological patterns Ian Ellis Molecular Medical Sciences, University of Nottingham Department of Histopathology,
Basement membrane in lobule.
Bahram Memar, MD Basement membrane in lobule. Normal lobule-luteal phase Normal lobule-follicular phase Lactating breast Greater than 95% are adenocarcinomas in situ carcinomas and invasive carcinomas.
Lesions Mimicking Adenoid Cystic Carcinoma. Diagnostic Problems in Salivary Gland Pathology An Update 5/29/2009
Diagnostic Problems in Salivary Gland Pathology An Update Lesions Mimicking Adenoid Cystic Carcinoma Stacey E. Mills, M.D. W.S. Royster Professor of Pathology Director of Surgical and Cytopathology University
Mammary analogue secretory carcinoma of salivary gland A case report of new entity
Case Report Mammary analogue secretory carcinoma of salivary gland A case report of new entity Vaibhav Bhika Bari 1*, Sandhya Unmesh Bholay 2 1 Assistant Professor, 2 Associate Professor Rajiv Gandhi Medical
Urothelial carcinoma is the most common tumor in the
Micropapillary Variant of Urothelial Carcinoma in the Upper Urinary Tract A Clinicopathologic Study of 11 Cases Charles C. Guo, MD; Pheroze Tamboli, MD; Bogdan Czerniak, MD, PhD Context. Micropapillary
MECHANISMS OF HUMAN DISEASE: LABORATORY SESSION CYTOPATHOLOGY Monday, April 26, 2013 FACULTY COPY
GOAL: MECHANISMS OF HUMAN DISEASE: LABORATORY SESSION CYTOPATHOLOGY Monday, April 26, 2013 FACULTY COPY 1. Understated the role of cytopathology in the clinical management of the patient and recognize
Update on staging colorectal carcinoma, the 8 th edition AJCC. General overview of staging. When is staging required? 11/1/2017
Update on staging colorectal carcinoma, the 8 th edition AJCC Dale C. Snover, MD November 3, 2017 General overview of staging Reason for uniform staging Requirements to use AJCC manual and/or CAP protocols
Disclosure. Relevant Financial Relationship(s) None. Off Label Usage None MFMER slide-1
Disclosure Relevant Financial Relationship(s) None Off Label Usage None 2013 MFMER slide-1 Case Presentation A 43 year old male, with partial nephrectomy for a right kidney mass 2013 MFMER slide-2 2013
Papillary Lesions of the Breast A Practical Approach to Diagnosis. (Arch Pathol Lab Med. 2016;140: ; doi: /arpa.
Papillary Lesions of the Breast A Practical Approach to Diagnosis (Arch Pathol Lab Med. 2016;140:1052 1059; doi: 10.5858/arpa.2016-0219-RA) Papillary lesions of the breast Span the spectrum of benign,
performed to help sway the clinician in what the appropriate diagnosis is, which can substantially alter the treatment of management.
Hello, I am Maura Polansky at the University of Texas MD Anderson Cancer Center. I am a Physician Assistant in the Department of Gastrointestinal Medical Oncology and the Program Director for Physician
Case year female. Routine Pap smear
Case 1 57 year female Routine Pap smear Diagnosis? 1. Atypical glandular cells of unknown significance (AGUS) 2. Endocervical AIS 3. Endocervical adenocarcinoma 4. Endometrial adenocarcinoma 5. Adenocarcinoma
Updates in Urologic Pathology WHO Made Those Changes?! Peyman Tavassoli Pathology Department BC Cancer Agency
Updates in Urologic Pathology WHO Made Those Changes?! Peyman Tavassoli Pathology Department BC Cancer Agency World Health Organization Available in Feb 2016 Frame work for reporting Major contributing
How to Recognize Gynecologic Cancer Cells from Pelvic Washing and Ascetic Specimens
How to Recognize Gynecologic Cancer Cells from Pelvic Washing and Ascetic Specimens Wenxin Zheng, M.D. Professor of Pathology and Gynecology University of Arizona zhengw@email.arizona.edu http://www.zheng.gynpath.medicine.arizona.edu/index.html
Adenocarcinoma of the Cervix
Question 1. Each of the following statements about cervical adenocarcinoma is true except: Adenocarcinoma of the Cervix SAMS a) A majority of women with cervical adenocarcinoma have stage I tumors at diagnosis.
Newer soft tissue entities
Newer soft tissue entities Examples among fibroblastic tumors Turku, May 6, 2010 Markku Miettinen, M.D. AFIP, Washington, DC Fibroblastic neoplasms Solitary fibrous tumor /Hemangiopericytoma Low-grade
Renal tumours: use of immunohistochemistry & molecular pathology. Dr Lisa Browning John Radcliffe Hospital Oxford
Renal tumours: use of immunohistochemistry & molecular pathology Dr Lisa Browning John Radcliffe Hospital Oxford Renal tumours: the use of immunohistochemistry & molecular pathology Classification of RCC
Carcinoma of the Urinary Bladder Histopathology
Carcinoma of the Urinary Bladder Histopathology Reporting Proforma (Radical & Partial Cystectomy, Cystoprostatectomy) Includes the International Collaboration on Cancer reporting dataset denoted by * Family
Neuroendocrine tumors of GI and Pancreatobiliary tracts. N. Volkan Adsay, MD
Neuroendocrine tumors of GI and Pancreatobiliary tracts N. Volkan Adsay, MD New (2017) WHO WHO 2017 (endocrine book; for pancreas) WHO 2017 (endocrine book; for pancreas) PD-NE ca WD-NE Tumor Intended
Prostate Pathology: Prostate Carcinoma, variants and Gleason Grading (Part 1)
Prostate Pathology: Prostate Carcinoma, variants and Gleason Grading (Part 1) Jae Y. Ro, MD, PhD June 7, 2012 Ten Leading Cancer Types for the Estimated New Cancer Cases and Deaths By Sex, United States,
PROSTATIC ADENOCARCINOMA: DIAGNOSTIC CRITERIA AND IMPORTANT MIMICKERS PROSTATIC ADENOCARCINOMA: DIAGNOSTIC CRITERIA
PROSTATIC ADENOCARCINOMA: DIAGNOSTIC CRITERIA AND IMPORTANT MIMICKERS PROSTATIC ADENOCARCINOMA: DIAGNOSTIC CRITERIA 1 A good H & E helps! ADENOCARCINOMA DIAGNOSTIC CRITERIA Relatively uniform proliferation
Pathology of bladder cancer in Egypt; a current study.
Pathology of bladder cancer in Egypt; a current study. Thesis Submitted for partial fulfillment of Master degree in urology By Mohamed Atef Mohamed Ahmed M.B.B.CH Supervised by Prof.Dr.: Omar Mohamed Abdel-
Microcystic transitional cell carcinoma: a rare tumor of the urinary bladder
PATHOLOGICA 2017;109:151-155 Case report Microcystic transitional cell carcinoma: a rare tumor of the urinary bladder M. TRIKI 1, L. AYADI 1, R. KALLEL 1, S. CHARFI 1, I. SAGUEM 1, N. MHIRI 2, T.S. BOUDAWARA
Case 18. M75. Excision of mass on scalp. Clinically SCC. The best diagnosis is:
Case 18 M75. Excision of mass on scalp. Clinically SCC. The best diagnosis is: A. Pilomatrical carcinoma B. Adnexal carcinoma NOS C. Metastatic squamous cell carcinoma D.Primary squamous cell carcinoma
Differential Diagnosis of Oral Masses. Palatal Lesions
Differential Diagnosis of Oral Masses Palatal Lesions Palatal Masses Periapical Abscess Torus Palatinus Mucocele Lymphoid Hyperplasia Adenomatous Hyperplasia Benign Salivary Neoplasms Malignant Salivary
2 Berkeley Street, Suite 403, Toronto, Ontario M5A 2W3 Visit us at: Tel: Fax:
E-Path A.I. Engine Knowledge Base Enhancements Version 1.0.0.29 April 1, 2018 The major enhancements in the E-Path Knowledge Base from versions 1.0.0.28 through 1.0.0.29 are as follows: 1. Addition/modification
J of Evolution of Med and Dent Sci/ eissn , pissn / Vol. 3/ Issue 24/June 16, 2014 Page 6628
ADENOCARCINOMA OF BLADDER-SIGNET RING CELL MUCINOUS VARIANT S. Senthil Kumar 1, D. Prem Charles 2, B. Krishnaswamy 3, P. Viswanathan 4, S. Sarath Chandran 5 HOW TO CITE THIS ARTICLE: S. Senthil Kumar,
ACCME/Disclosures. Cribriform Lesions of the Prostate. Case
Cribriform Lesions of the Prostate Ming Zhou, MD, PhD Departments of Pathology and Urology New York University Langone Medical Center New York, NY Ming.Zhou@NYUMC.ORG ACCME/Disclosures The USCAP requires
Histopathological diagnosis of CUP
Histopathological diagnosis of CUP Dr Karin Oien karin.oien@glasgow.ac.uk Disclosure slide Dr Karin Oien has no financial interests in any company mentioned in this presentation. Dr Karin Oien is conducting
What s (new) and Important in Reporting of Uterine Cancers Katherine Vroobel The Royal Marsden
What s (new) and Important in Reporting of Uterine Cancers Katherine Vroobel The Royal Marsden Maastricht Pathology 2018 Wednesday 20 th June Endometrioid adenocarcinoma High grade carcinomas (common)
Cancers of unknown primary : Knowing the unknown. Prof. Ahmed Hossain Professor of Medicine SSMC
Cancers of unknown primary : Knowing the unknown Prof. Ahmed Hossain Professor of Medicine SSMC Definition Cancers of unknown primary site (CUPs) Represent a heterogeneous group of metastatic tumours,
Objectives. Atypical Glandular Cells. Atypical Endocervical Cells. Reactive Endocervical Cells
2013 California Society of Pathologists 66 th Annual Meeting San Francisco, CA Atypical Glandular Cells to Early Invasive Adenocarcinoma: Cervical Cytology and Histology Christina S. Kong, MD Associate
Diplomate of the American Board of Pathology in Anatomic and Clinical Pathology
A 33-year-old male with a left lower leg mass. Contributed by Shaoxiong Chen, MD, PhD Assistant Professor Indiana University School of Medicine/ IU Health Partners Department of Pathology and Laboratory
An Overview of Genital Stromal Tumors
An Overview of Genital Stromal Tumors By Konstantinos Linos MD, FCAP, FASDP Bone, Soft Tissue and Dermatopathology Assistant Professor of Pathology Dartmouth-Hitchcock Medical Center Geisel School of Medicine
Review and Updates of Immunohistochemistry in Selected Salivary Gland and Head and Neck Tumors
Review and Updates of Immunohistochemistry in Selected Salivary Gland and Head and Neck Tumors. Monophasic tumors : myoepithelioma, acinic cell carcinoma, and salivary duct carcinoma. Biphasic tumors includes
The clinically challenging entity of liver metastasis from tumors of unknown primary
The clinically challenging entity of liver metastasis from tumors of unknown primary Xuchen Zhang, MD, PhD Associate Professor of Pathology Department of Pathology Yale University School of Medicine Liver
Part 1. Slides 1-38, Rita Alaggio Soft tissue tumors Trondheim 14. mars 2013
Part 1 Slides 1-38, Rita Alaggio Soft tissue tumors Trondheim 14. mars 2013 Pediatric Pathology Soft Tissue Tumors AN UPDATE Rita Alaggio Azienda Ospedaliera Università di Padova Soft Tissue Tumors More
Impact of immunostaining of pulmonary and mediastinal cytology
Impact of immunostaining of pulmonary and mediastinal cytology Harman Sekhon MD, PhD Director of Cytopathology Head of Ottawa-site Ontario Tumour Bank June 20, 2014 Disclaimer Pfizer: Honorarium-Advisory
Neoplasms of the Canine, Feline and Lemur Liver:
Neoplasms of the Canine, Feline and Lemur Liver: Classification and Prognosis Annual Seminar of the French Society of Veterinary Pathology John M. Cullen VMD PhD DACVP North Carolina State University Primary
Enterprise Interest None
Enterprise Interest None Invasive Stratified Mucin-producing Carcinoma (ismile) of the Cervix A Study in Morphology, Immunohistochemistry and Human Papillomavirus Status Kay J. Park, MD Memorial Sloan
Breast - ductal carcinoma CK7 ER PR GATA3 Mammaglobin (50-70%) GCDFP-15 (50-70%) E-cadherin HMWCK CK20 PAX2 ER/PR/HER2 on all newly diagnosed cases
Adrenal cortical carcinoma Inhibin Synap Melan-A Calretinin Vimentin Chromogr CK7 CK20 Breast - ductal carcinoma CK7 ER PR GATA3 Mammaglobin (50-70%) GCDFP-15 (50-70%) E-cadherin HMWCK CK20 PAX2 ER/PR/HER2
4/17/2015. Case 1. A 37 year old man with a 2.2 cm solitary left thyroid mass.
Case 1 A 37 year old man with a 2.2 cm solitary left thyroid mass. Case 1 Case 1 1 Case 1: Diagnosis? A. Benign B. Atypia of undetermined significance/follicular lesion of undetermined significance C.
ACCME/Disclosures. Diagnosing Mesothelioma in Limited Tissue Samples. Papanicolaou Society of Cytopathology Companion Meeting March 12 th, 2016
Diagnosing Mesothelioma in Limited Tissue Samples Papanicolaou Society of Cytopathology Companion Meeting March 12 th, 2016 Sanja Dacic, MD, PhD University of Pittsburgh ACCME/Disclosures GENERAL RULES
Carcinoma of unknown primary origin (CUP) is defined
REVIEW ARTICLE Metastatic Carcinoma of Unknown Primary: Diagnostic Approach Using Immunohistochemistry James R. Conner, MD, PhD and Jason L. Hornick, MD, PhD Abstract: Carcinoma of unknown primary origin