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Journal Am J Surg Pathol

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Oropharyngeal Squamous Cell Carcinoma With Discordant p16 and HPV mRNA Results: Incidence and Characterization in a Large, Contemporary United States Cohort.

Justin R Shinn, Seth J Davis, Krystle A Lang-Kuhs, Sarah Rohde, Xiaowei Wang, Ping Liu, William D Dupont, Dale Plummer, Wade L Thorstad, Rebecca D Chernock, Mitra Mehrad, James S Lewis,

Early studies estimate that 5% to 10% of oropharyngeal squamous cell carcinomas overexpress p16 but are unassociated with transcriptionally-active high-risk human papillomavirus (HPV). Patients with discordant HPV testing may experience clinical outcomes that differ from traditional expectations. To document the rate of p16 and HPV mRNA positivity, characterize patients with ... Read more >>

Am J Surg Pathol (The American journal of surgical pathology)
[2021, 45(7):951-961]

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The 2019 International Society of Urological Pathology (ISUP) Consensus Conference on Grading of Prostatic Carcinoma.

Kenneth A Iczkowski, Geert J L H van Leenders, Theodorus H van der Kwast,

Am J Surg Pathol (The American journal of surgical pathology)
[2021, 45(7):1007]

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Distinct Small Intestine Mast Cell Histologic Changes in Patients With Hereditary Alpha-tryptasemia and Mast Cell Activation Syndrome.

Matthew J Hamilton, Melissa Zhao, Matthew P Giannetti, Emily Weller, Raied Hufdhi, Peter Novak, Lybil B Mendoza-Alvarez, Jason Hornick, Jonathan J Lyons, Sarah C Glover, Mariana C Castells, Olga Pozdnyakova,

Mast cells (MCs) are important in intestinal homeostasis and pathogen defense but are also implicated in many of the clinical manifestations in disorders such as irritable bowel syndrome. The utility of specific staining for MCs to quantify and phenotype them in intestinal biopsies in patients with gastrointestinal (GI) symptoms is ... Read more >>

Am J Surg Pathol (The American journal of surgical pathology)
[2021, 45(7):997-1004]

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JAK2 Rearrangements Are a Recurrent Alteration in CD30+ Systemic T-Cell Lymphomas With Anaplastic Morphology.

Megan J Fitzpatrick, Lucas R Massoth, Chelsea Marcus, Jo-Anne Vergilio, Eric Severson, Daniel Duncan, Shakti H Ramkissoon, Robert P Hasserjian, Annette S Kim, Aliyah R Sohani, Erik A Williams, Valentina Nardi,

Peripheral T-cell lymphoma (PTCL) comprises a heterogenous group of rare mature T-cell neoplasms. While some PTCL subtypes are well-characterized by histology, immunophenotype, and recurrent molecular alterations, others remain incompletely defined. In particular, the distinction between CD30+ PTCL, not otherwise specified and anaplastic lymphoma kinase (ALK)-negative anaplastic large cell lymphoma can ... Read more >>

Am J Surg Pathol (The American journal of surgical pathology)
[2021, 45(7):895-904]

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Survival and Prognostic Factors of Adult Intracranial Ependymoma: A Single-institutional Analysis of 236 Patients.

Fu Zhao, Tao Wu, Lei-Ming Wang, Jing Zhang, Heng Zhang, Shi-Wei Li, Shun Zhang, Peng Li, Bo Wang, Lin Luo, Pi-Nan Liu,

Adult intracranial ependymomas (EPNs) are extremely rare brain tumors. Currently, clinical and molecular factors that could inform individualized treatment strategies are still lacking for EPNs in this age group. The aim of this study was to investigate potential prognostic indicators and rational therapeutic management in a large cohort of adult ... Read more >>

Am J Surg Pathol (The American journal of surgical pathology)
[2021, 45(7):979-987]

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Atypical Endometrial Hyperplasia, Low-grade: "Much ADO About Nothing".

Emanuela D'Angelo, Iñigo Espinosa, Valentina Cipriani, Justyna Szafranska, Mattia Barbareschi, Jaime Prat,

Atypical endometrial hyperplasia (AEH) is considered a precursor of endometrioid carcinoma. The 2020 World Health Organization (WHO) classification divides endometrial hyperplasia into 2 categories: hyperplasia without atypia and atypical hyperplasia/endometrioid intraepithelial neoplasia (EIN); however, this classification does not consider the degree of nuclear atypia. We graded nuclear atypia for estimating ... Read more >>

Am J Surg Pathol (The American journal of surgical pathology)
[2021, 45(7):988-996]

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Pathology, Radiology, and Genetics of Interstitial Lung Disease in Patients With Shortened Telomeres.

Matthew J Cecchini, Tara Tarmey, Allison Ferreira, Abhishek A Mangaonkar, Alejandro Ferrer, Mrinal M Patnaik, Mark E Wylam, Sarah M Jenkins, Grant M Spears, Eunhee S Yi, Thomas E Hartman, John P Scott, Anja C Roden,

Interstitial lung diseases (ILDs) in patients with shortened telomeres have not been well characterized. We describe demographic, radiologic, histopathologic, and molecular features, and p16 expression in patients with telomeres ≤10th percentile (shortened telomeres) and compare them to patients with telomere length >10th percentile. Lung explants, wedge biopsies, and autopsy specimens ... Read more >>

Am J Surg Pathol (The American journal of surgical pathology)
[2021, 45(7):871-884]

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The Diagnostic Utility of RAS Q61R Mutation-specific Immunohistochemistry in Epithelial-Myoepithelial Carcinoma.

Masato Nakaguro, Maki Tanigawa, Hideaki Hirai, Yoshinari Yamamoto, Makoto Urano, Reisuke H Takahashi, Aoi Sukeda, Yuki Okumura, Shogo Honda, Koichiro Tasaki, Akira Shimizu, Kiyoaki Tsukahara, Yuichiro Tada, Jun Matsubayashi, William C Faquin, Peter M Sadow, Toshitaka Nagao,

Epithelial-myoepithelial carcinoma (EMC) is a rare salivary gland cancer characterized by biphasic tubular structures composed of inner ductal and outer clear myoepithelial cells. Because of its histologic variety and overlap of histologic features with other salivary gland tumors, there are broad differential diagnoses. The HRAS Q61R mutation has been reported ... Read more >>

Am J Surg Pathol (The American journal of surgical pathology)
[2021, 45(7):885-894]

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Tumor Microenvironmental Prognostic Risk in Primary Operable Small Intestinal Adenocarcinoma.

Sun-Young Jun, Eui-Jin Lee, Seung-Mo Hong, Eun Sun Jung, Joon-Yong Chung,

The tumor microenvironment (TME) has become an important area of investigation with respect to improving prognosis in malignancies. Here we evaluated TME prognostic risk in small intestinal adenocarcinomas based on histologic assessment of tumor budding at the peritumoral-invasive front (pTB) and stromal tumor-infiltrating lymphocytes (sTILs). pTB and sTILs were analyzed ... Read more >>

Am J Surg Pathol (The American journal of surgical pathology)
[2021, 45(7):917-929]

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Clear Cell Tumor With Melanocytic Differentiation and ACTIN-MITF Translocation: Report of 7 Cases of a Novel Entity.

Arnaud de la Fouchardiere, Daniel Pissaloux, Franck Tirode, Marie Karanian, Christopher D M Fletcher, John Hanna,

Clear cell morphology is an uncommon finding in tumors. A subset of clear cell neoplasms also shows melanocytic differentiation, including clear cell sarcoma, PEComa, and some subtypes of renal cell carcinoma. A hallmark of these tumor types is the activation of a member of the MIT/TFE family of transcription factors, ... Read more >>

Am J Surg Pathol (The American journal of surgical pathology)
[2021, 45(7):962-968]

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Localized Peritumoral AL Amyloidosis Associated With Mantle Cell Lymphoma With Plasmacytic Differentiation.

Mariko Yabe, Neval Ozkaya, Daphne de Jong, Umut Aypar, M Stella Ritorto, Ellis Barbé, Iris H C Miedema, Filiz Sen, Jessica R Chapman, Heather J Landau, Ahmet Dogan,

Immunoglobulin light chain (AL) amyloidosis is characterized by the deposition of amyloid fibers derived from pathologic immunoglobulin light chains. Although systemic plasma cell neoplasms are the most common cause of AL amyloidosis, a subset of cases is caused by B-cell lymphoproliferative disorders such as lymphoplasmacytic lymphoma or extranodal marginal zone ... Read more >>

Am J Surg Pathol (The American journal of surgical pathology)
[2021, 45(7):939-944]

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Morphology Matters: A Critical Reappraisal of the Clinical Relevance of Morphologic Criteria From the 2019 WHO Classification in a Large Colorectal Cancer Cohort Comprising 1004 Cases.

Moritz Jesinghaus, Maxime Schmitt, Corinna Lang, Marianne Reiser, Alexander Scheiter, Björn Konukiewitz, Katja Steiger, Miguel Silva, Markus Tschurtschenthaler, Sebastian Lange, Sebastian Foersch, Karl F Becker, Dieter Saur, Helmut Friess, Kathrin Halfter, Jutta Engel, Melanie Boxberg, Nicole Pfarr, Dirk Wilhelm, Wilko Weichert,

The 2019 World Health Organization (WHO) classification of colorectal carcinoma (CRC) profoundly reclassified CRC subtypes and introduces tumor budding as a second major grading criterion, while condensing conventional grade into a 2-tiered system. So far it remains largely unexplored how these parameters interact with each other and whether they truly ... Read more >>

Am J Surg Pathol (The American journal of surgical pathology)
[2021, 45(7):969-978]

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Intestinal Metaplasia of the "Cardia": Accurate Differentiation of Gastric or Esophageal Origin With an Expanded Biopsy Protocol.

Evan Yung, Xiaodong Li, Parakrama Chandrasoma,

Whether intestinal metaplasia (IM) distal to the endoscopic gastroesophageal junction (GEJ), that is, the cardia, is gastric or esophageal or both is controversial. Biopsies from this region are believed to be unreliable in resolving this issue and are not recommended. Our objective was to develop an accurate method of histologic ... Read more >>

Am J Surg Pathol (The American journal of surgical pathology)
[2021, 45(7):945-950]

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Clinicopathologic Features of Myelodysplastic Syndromes Involving Lymph Nodes.

Hong Fang, Sa A Wang, Wei Xie, Zhenya Tang, Shimin Hu, Savitri Krishnamurthy, L Jeffrey Medeiros, Wei Wang,

Lymph nodes (LNs) involved by a myelodysplastic syndrome (MDS) are rare and uncommonly biopsied. In this study, we report 6 MDS patients who underwent an LN biopsy that showed MDS, and we summarize the clinicopathologic features of this cohort. All patients presented with lymphadenopathy (generalized in 5), 5 patients had ... Read more >>

Am J Surg Pathol (The American journal of surgical pathology)
[2021, 45(7):930-938]

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Immunophenotypic Spectrum and Genomic Landscape of Refractory Celiac Disease Type II.

Craig R Soderquist, Suzanne K Lewis, Alejandro A Gru, George Vlad, Eli S Williams, Susan Hsiao, Mahesh M Mansukhani, David C Park, Carlos E Bacchi, Bachir Alobeid, Peter H Green, Govind Bhagat,

Refractory celiac disease type II (RCD II), also referred to as "cryptic" enteropathy-associated T-cell lymphoma (EATL) or "intraepithelial T-cell lymphoma," is a rare clonal lymphoproliferative disorder that arises from innate intraepithelial lymphocytes. RCD II has a poor prognosis and frequently evolves to EATL. The pathogenesis of RCD II is not ... Read more >>

Am J Surg Pathol (The American journal of surgical pathology)
[2021, 45(7):905-916]

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A Comparison of Genitourinary Pathology Society (GUPS) and International Society of Urological Pathology (ISUP) Prostate Cancer Grading Guidelines.

Jonathan I Epstein, Michelle S Hirsch,

Am J Surg Pathol (The American journal of surgical pathology)
[2021, 45(7):1005-1007]

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High-grade Papillary Early Gastric Carcinoma With High Risk for Lymph Node Metastasis and Poor Prognosis: A Clinicopathologic Study of 96 Cases Among 1136 Consecutive Radical Gastrectomies.

Yuqing Cheng, Mingzhan Du, Xiaoli Zhou, Lingchuan Guo, Kequn Xu, Jin Huang, Qin Huang,

Papillary early gastric carcinoma (EGC) is believed to have a low risk of lymph node metastasis (LNM) and thus can be resected endoscopically. We observed anecdotally that some papillary EGC tumors showed conspicuous high-grade dysplastic features, but the significance of these observations is unknown. In this bicenter study we investigated ... Read more >>

Am J Surg Pathol (The American journal of surgical pathology)
[2021, :]

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Optimal Method for Reporting Prostate Cancer Grade in MRI-targeted Biopsies.

Fang-Ming Deng, Bogdan Isaila, Derek Jones, Qinghu Ren, Park Kyung, Deepthi Hoskoppal, Hongying Huang, Leili Mirsadraei, Yuhe Xia, Jonathan Melamed,

When multiple cores are biopsied from a single magnetic resonance imaging (MRI)-targeted lesion, Gleason grade may be assigned for each core separately or for all cores of the lesion in aggregate. Because of the potential for disparate grades, an optimal method for pathology reporting MRI lesion grade awaits validation. We ... Read more >>

Am J Surg Pathol (The American journal of surgical pathology)
[2021, :]

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Clinical Utility of Anchored Multiplex Solid Fusion Assay for Diagnosis of Bone and Soft Tissue Tumors.

Ivan Chebib, Martin S Taylor, Valentina Nardi, Miguel N Rivera, Jochen K Lennerz, Gregory M Cote, Edwin Choy, Santiago A Lozano Calderón, Kevin A Raskin, Joseph H Schwab, John T Mullen, Yen-Lin E Chen, Yin P Hung, Gunnlaugur P Nielsen, Vikram Deshpande,

Sarcoma diagnosis has become increasingly complex, requiring a combination of morphology, immunohistochemistry, and molecular studies to derive specific diagnoses. We evaluated the role of anchored multiplex polymerase chain reaction-based gene fusion assay in sarcoma diagnostics. Between 2015 and 2018, bone and soft tissue sarcomas with fusion assay results were compared ... Read more >>

Am J Surg Pathol (The American journal of surgical pathology)
[2021, :]

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PD-L1 Expression in Metaplastic Breast Carcinoma Using the PD-L1 SP142 Assay and Concordance Among PD-L1 Immunohistochemical Assays.

Anne Grabenstetter, Achim A Jungbluth, Denise Frosina, Raza Hoda, Carlos H Dos Anjos, Sujata Patil, Varadan Sevilimedu, Britta Weigelt, Jorge S Reis-Filho, Hong Zhang, Tiffany Traina, Mark E Robson, Edi Brogi, Hannah Y Wen,

Immunotherapy for the treatment of programmed death-ligand 1 (PD-L1) positive locally advanced or metastatic triple negative breast cancer may benefit patients with metaplastic breast cancer (MpBC). Previous study of PD-L1 in MpBC scored tumor cells (TCs), different from Food and Drug Administration-approved scoring methods. We sought to define PD-L1 expression ... Read more >>

Am J Surg Pathol (The American journal of surgical pathology)
[2021, :]

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Corded and Hyalinized and Spindled Endometrioid Endometrial Carcinoma: A Clinicopathologic and Molecular Analysis of 9 Tumors Based on the TCGA Classifier.

Nida S Safdar, Emily F Thompson, C Blake Gilks, Christina Isacson, Jennifer Bennett, Blaise Clarke, Robert H Young, Esther Oliva,

Corded and hyalinized and spindled carcinomas are rare variants of endometrioid carcinoma (EC) characterized by cords of low-grade epithelial cells (±spindle cells) within a hyalinized stroma or spindled epithelial cells, respectively, that merge with conventional low-grade EC. Due to their "biphasic" morphology, these tumors are often misdiagnosed as carcinosarcoma. The ... Read more >>

Am J Surg Pathol (The American journal of surgical pathology)
[2021, :]

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Gastric Intestinal Metaplasia in Mucosa Adjacent to Gastric Cancers Is Rarely Associated With the Aneuploidy That Is Characteristic of Gastric Dysplasia or Cancer.

Ruth Zhang, Peter S Rabinovitch, Aras N Mattis, Gregory Y Lauwers, Won-Tak Choi,

Most gastric cancers (GCs) are thought to develop via gastric intestinal metaplasia (GIM)-dysplasia-carcinoma pathway. Patients with extensive and/or incomplete GIM have been reported to have a higher risk of GC. GIM can also display dysplasia-like cytoarchitectural atypia limited to the bases of gastric pits without surface involvement. However, only a ... Read more >>

Am J Surg Pathol (The American journal of surgical pathology)
[2021, :]

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Intestinal Abnormalities in Patients With SARS-CoV-2 Infection: Histopathologic Changes Reflect Mechanisms of Disease.

Rhonda K Yantiss, LiHui Qin, Bing He, Carl V Crawford, Surya Seshan, Sanjay Patel, Nabeel Wahid, Jose Jessurun,

Approximately 20% of patients with symptomatic syndrome-associated coronavirus-2 (SARS-CoV-2) infection have gastrointestinal bleeding and/or diarrhea. Most are managed without endoscopic evaluation because the risk of practitioner infection outweighs the value of biopsy analysis unless symptoms are life-threatening. As a result, much of what is known about the gastrointestinal manifestations of ... Read more >>

Am J Surg Pathol (The American journal of surgical pathology)
[2021, :]

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Expanding the Spectrum of EWSR1-NFATC2-rearranged Benign Tumors: A Common Genomic Abnormality in Vascular Malformation/Hemangioma and Simple Bone Cyst.

Sheena L M Ong, Suk Wai Lam, Brendy E W M van den Akker, Herman M Kroon, Inge H Briaire-de Bruijn, Arjen H G Cleven, Dilara C Savci-Heijink, Anne-Marie Cleton-Jansen, Daniel Baumhoer, Karoly Szuhai, Judith V M G Bovée,

A simple bone cyst (SBC) is a cystic bone lesion predominantly affecting young males. The cyst is lined by a fibrous membrane and filled with serosanguinous fluid. EWSR1/FUS-NFATC2 rearrangements were recently identified in SBC. We here report exactly the same rearrangement in 3 lesions diagnosed as vascular malformations of 2 ... Read more >>

Am J Surg Pathol (The American journal of surgical pathology)
[2021, :]

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Loss of p57 Expression in Conceptions Other Than Complete Hydatidiform Mole: A Case Series With Emphasis on the Etiology, Genetics, and Clinical Significance.

Deyin Xing, Karin Miller, Katie Beierl, Brigitte M Ronnett,

Combined p57 immunohistochemistry and DNA genotyping refines classification of products of conception specimens into specific types of hydatidiform moles and various nonmolar entities that can simulate them. p57 expression is highly correlated with genotyping and in practice can reliably be used to identify virtually all complete hydatidiform moles (CHM), but ... Read more >>

Am J Surg Pathol (The American journal of surgical pathology)
[2021, :]

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