Differentiating Intrarenal Ectopic Adrenal Tissue From Renal Cell Carcinoma in the Kidney.

Background: Adrenal rest (AR) is the presence of ectopic adrenal cortical tissue, often identified incidentally during autopsy (20% of postmortem examination). In the kidney, AR can be found in 6% of the general population. Ectopic adrenal tissue is of no functional significance but may in some cases, pose a diagnostic challenge for the pathologist, especially in the context of renal clear cell renal cell carcinoma (RCC) and small needle biopsies.

Cartilage-forming tumors.

Cartilage-forming tumors as a group are the most common primary bone tumors; this is largely due to the common occurrence of asymptomatic benign lesions such as osteochondroma and enchondroma. The common feature of these tumors is the presence of chondrocytic cells and the formation of cartilaginous tumor matrix. Some of these tumors are true neoplasms while others are hamartomas or developmental abnormalities.

Diagnosing bone lesions: a practical non-pathology centric formulaic approach.

Bone lesions are perceived to be some of the most difficult lesions that pathologists encounter. The reasons for this are multiple and include lack of experience/familiarity, the need to rely heavily on non-pathology information and data, and the fact that many lesions are associated with either procedures or treatments with significant morbidity. However, in fact, the majority of bone lesions can be accurately assessed on the basis of data not directly related to traditional pathologic based assessment.

Secondary chondrosarcoma of the pelvis arising from a solitary exostosis in an 11-year-old patient: a case report with 5-year follow-up.

Although conversion of an osteochondroma to chondrosarcoma is a well-described rare occurrence, it is usually associated with syndromes such as multiple hereditary exostoses and is much more common after maturity. We present here a rare case of secondary pelvic chondrosarcoma arising from a solitary exostosis in a pediatric patient. An 11-year-old, otherwise healthy, female was referred to our clinic for evaluation of a pelvic mass detected on a radiograph.

Interobserver reliability in the histopathological diagnosis of cartilaginous tumors in patients with multiple osteochondromas.

The distinction between benign and malignant cartilaginous tumors located peripherally in the bone may be a challenging task in surgical pathology. The aim of this study was to investigate interobserver reliability in histological diagnosis of cartilaginous tumors in the setting of multiple osteochondromas and to evaluate possible histological parameters that could differentiate among osteochondroma, low- and high-grade secondary peripheral chondrosarcoma. Interobserver reliability was assessed by 12 specialized bone-tumor pathologists in a set of 38 cases.

Consensus statement on effective communication of urgent diagnoses and significant, unexpected diagnoses in surgical pathology and cytopathology from the College of American Pathologists and Association of Directors of Anatomic and Surgical Pathology.

Context: Recognizing the difficulty in applying the concept of critical values to anatomic pathology diagnoses, the College of American Pathologists and the Association of Directors of Anatomic and Surgical Pathology have chosen to reevaluate the concept of critical diagnoses.

Objective: To promote effective communication of urgent and significant, unexpected diagnoses in surgical pathology and cytology.

Design: A comprehensive literature search was conducted and reviewed by an expert panel.

Leiomyosarcoma of the head and neck: a population-based analysis.

Objectives: To describe the characteristics of head and neck leiomyosarcoma and to identify factors associated with survival.

Design: Retrospective population-based study.

Patients: The 17-registry Surveillance, Epidemiology, and End Results database was used to identify 578 patients with leiomyosarcoma of the head and neck.

Antibody expiration in the context of resource limitation: what is the evidence basis?

The implementation and enforcement of the College of American Pathologists Survey Checklist ANP 22432 has renewed attention on the issue of outdating of antibodies used for immunohistochemical analysis. The current study examined the staining patterns of 26 recently acquired primary antibodies and their expired counterparts. Two reviewers examined sequential sections of formalin-fixed, paraffin-embedded tissue samples for staining intensity and percentage of positivity.

The use of touch preparation for the evaluation of sentinel lymph nodes in breast cancer.

Background: This study was undertaken to evaluate the accuracy of touch preparation (touch prep) in the evaluation of sentinel lymph nodes (SLNs).

Methods: We performed a retrospective review of 402 breast cancer patients who underwent SLN biopsy.

Results: A SLN was identified in 381 patients.

Competency assessment of residents in surgical pathology using virtual microscopy.

Our goal was to develop an efficient and reliable performance-based virtual slide competency examination in general surgical pathology that objectively measures pathology resident's morphologic diagnostic skill. A Perl scripted MySQL database was used to develop the test editor and test interface. Virtual slides were created with the Aperio ScanScope.

Recommendations for the reporting of surgically resected thymic epithelial tumors.

Thymic epithelial tumors include thymoma and thymic carcinoma. Histologic findings and extent of disease are key determinants of prognosis and help guide postoperative management in patients with thymic epithelial tumors. Given the relative rarity of these tumors, the use of tumor guidelines and checklists can facilitate accurate and comprehensive pathologic reporting in this setting.

Early microrecanalization of vas deferens following biodegradable graft implantation in bilaterally vasectomized rats.

We evaluated a biodegradable graft for reconstruction of rat vasa deferentia with long obstructed or missing segments. A total of 47 Sprague-Dawley rats underwent bilateral vasectomy and were divided into groups according to length of the vas deferens affected (0.5, 1, 1.

Pathology education: quo vadis?

The teaching of pathology and the face of pathology as a career are changing rapidly. A short questionnaire was constructed covering key areas impacted by curricular change to collect data for a workshop to be held at the Annual Meeting of the West and Mid-West Region of the Association of Pathology Chairs. Questions included the ongoing existence of pathology as a separate discipline, the degree of 'control' exercised by pathology faculty, the length of the course (hours), the use of microscopes, and selected outcomes data, specifically National Board of Medical Examiners graphs of comparative performance of disciplines and US Medical Licensing Examination Step 1 data.

Involvement of growth factors in the process of post-vasectomy micro-recanalization.

Purpose: We investigated the role of growth factors in the process of post-vasectomy micro-recanalization using real-time polymerase chain reaction, enzyme-linked immunosorbent assay and histopathological analyses of the vasectomy sites and controls at different time points in a rat model.

Materials And Methods: Unilateral vasectomies were performed in 18 rats with sham surgery on the contralateral side. Vasectomy sites and vas segments of similar length from the sham operated sides were taken for analysis at 2, 8 and 12 weeks.

Comparison of fungal culture versus surgical pathology examination in the detection of Histoplasma in surgically excised pulmonary granulomas.

Context: Granulomatous pulmonary nodules are common in areas endemic for Histoplasma infection, and may require surgical excision to exclude neoplasia. Surgeons may elect to routinely send material directly to the clinical microbiology laboratory for fungal and mycobacterial cultures.

Objective: To determine if tissue from surgically excised pulmonary granulomatous nodules removed from patients in a geographic area endemic for Histoplasma infection should be routinely submitted for fungal culture.

Emerging eosinophilic (allergic) esophagitis: increased incidence or increased recognition?

Context: Eosinophilic esophagitis is a disease of the esophagus with distinct histologic features (prominent intraepithelial eosinophils, particularly superficial with clustering) and characteristic endoscopic features (trachealization, white plaques). The presence of intraepithelial eosinophils had been recognized since 1982 as indicative of reflux esophagitis but little attention was initially paid to their numbers or location. Eosinophilic esophagitis has been recently described and there have been a number of reports that its incidence is on the rise.

Chondroblastoma of the femoral diaphysis: report of a rare phenomenon and review of literature.

Chondroblastoma (CB) is a relatively rare yet well-studied benign neoplasm of bone. The purported neoplastic cell is the chondroblast, a cell which normally populates areas of secondary ossification. Numerous studies have shown that CB overwhelmingly arises from the epimetaphyseal region of skeletally immature individuals.

Ethanol as a local adjuvant for giant cell tumor of bone.

Giant cell tumor is an aggressive benign neoplasm of bone. A number of adjuvant agents have been used to supplement intralesional curettage to reduce the otherwise high local recurrence rate. High concentration ethanol is more readily available and less toxic to use than some common alternatives.