Low incidence of BRAF and NRAS mutations in a population with a high incidence of melanoma.

Reported rates of BRAF mutation in Irish cutaneous melanoma cohorts are lower than the reported international data. We aimed to assess the mutational status of a cohort of primary cutaneous melanomas and to correlate it with clinical follow-up data.A total of 92 cases of primary cutaneous melanoma diagnosed at a single institution in 2012 were analyzed.

Aberrant p16, p53 and Ki-67 immunohistochemistry staining patterns can distinguish solitary keratoacanthoma from cutaneous squamous cell carcinoma.

Keratoacanthoma (KA) is widely considered a benign, usually self-resolving, neoplasm distinct from cutaneous squamous cell carcinoma (cSCC), while some consider KA to be indistinguishable from cSCC. Published studies indicate utility for p16, p53, Ki-67 immunostaining and elastic van Gieson (EVG) in the assessment of KA and cSCC. We compared clinical features and staining patterns for p16, p53, Ki-67 and EVG in fully excised KA, cSCC with KA-like features (cSCC-KAL) and other cSCC (cSCC-OTHER).

The lupus band test: A review of the sensitivity and specificity in the diagnosis of lupus erythematosus.

Background: The lupus band test (LBT) is a direct immunofluorescence (DIF) technique which shows a band of localised immunoglobulins at the dermo-epidermal junction in lesional, non-sun-exposed skin of patients with both systemic and cutaneous lupus erythematosus (LE), and in perilesional skin of patients with systemic LE. However, low sensitivity and poor concordance between histological and clinical diagnoses warrant a review of the application of the LBT in the diagnosis of LE.

Objectives: To assess the sensitivity and specificity of the LBT in diagnosing LE following clinico-pathological correlation (CPC).

A single-centre experience of secondary cutaneous tumours with special reference to precocious metastases.

Background: Secondary involvement of skin by tumour comprises 2% of cutaneous neoplasia, in a small proportion of cases serving as the primary manifestation of occult disease.

Methods: Cases of cutaneous metastases (CM) were retrieved from our pathology files between 2013 and 2018 and clinical and histopathological data reviewed.

Results: There were 159 cases (median age 70).

Therapeutic Response Evaluation in Advanced Melanoma Patients Incorporating Plasma cfDNA, LDH, VEGF, PD-L1, and IFN-γ Measurements.

Background/aim: Current treatment strategies for advanced melanoma require serial assessment of disease status in affected patients. In this study, we sought to examine the relationship between radiographic tumour burden and blood borne biomarkers including plasma cfDNA, serum LDH, plasma VEGF, PD-L1 and IFN-γ in advanced melanoma patients receiving immunotherapy. We hypothesized that a combination of these explanatory variables in a suitable regression analysis model may predict changes in tumour burden during patient treatment.

Pembrolizumab-induced follicular eruption and response to isotretinoin.

Pembrolizumab is a monoclonal antibody targeting PD-1. Folliculitis secondary to pembrolizumab has rarely been reported in the treatment of malignant melanoma. A 49-year-old with a history of mild lower limb folliculitis developed metastatic malignant melanoma, and immunotherapy with pembrolizumab was initiated.

Cytokeratin 7 and 19 expression in oropharyngeal and oral squamous cell carcinoma.

Purpose: The precise etiopathogenesis of human papillomavirus (HPV)-related oropharyngeal squamous cell carcinoma (OPSCC), and reasons for predilection for crypt epithelium, remain uncertain. The purpose of this study is to investigate the interaction between HPV and specific cytokeratins 7 (CK7) and 19 (CK19) in crypt epithelium.

Methods: This is a retrospective cohort study of patients presenting between 1999 and 2015 at a tertiary referral center.

The effect of calcium electroporation on viability, phenotype and function of melanoma conditioned macrophages.

Electroporation in combination with chemotherapy is an established treatment used on solid malignancies that results in enhanced chemotherapeutic uptake. Recent advances have begun to transition to the use of non-toxic compounds, such as calcium, in lieu of chemotherapy, which can also induce tumour cell death. While the effect of treatment on tumour cell death has been well characterized and has been shown to induce an immunogenic form of cell death, the effect of treatment on intratumoural immune cells has not been investigated.

Differential association of CD68 and CD163 macrophages with macrophage enzymes, whole tumour gene expression and overall survival in advanced melanoma.

Background: The density and phenotype of tumour-associated macrophages have been linked with prognosis in a range of solid tumours. While there is strong preclinical evidence that tumour-associated macrophages promote aspects of tumour progression, it can be challenging to infer clinical activity from surface markers and ex vivo behaviour. We investigated the association of macrophage infiltration with prognosis and functional changes in the tumour microenvironment in primary human melanoma.

The role of tumour morphology in assigning HPV status in oropharyngeal squamous cell carcinoma.

Objectives: There is no consensus on the optimal approach to human papilloma virus (HPV) testing in oropharyngeal squamous cell carcinoma (OPSCC). Our objective was to classify OPSCC as HPV positive or negative based on (1) morphology alone, (2) p16 status alone, (3) combined morphology and p16 status with additional HPV testing in discordant cases in keeping with 2012 College of American Pathologists (CAP) guidelines (combined approach), and to evaluate and compare survival outcomes.

Materials And Methods: Retrospective review of 168 patients, 146 with OPSCC and 22 with cervical SCC of unknown primary site (SCCUP).

Tumour Cell Anaplasia and Multinucleation as Prognosticators in Oropharyngeal Squamous Cell Carcinoma.

Human papilloma virus (HPV)-positive oropharyngeal squamous cell carcinomas (OPSCC) tend to have good outcomes, however a subset does not share this favourable prognosis. The aim of this paper is to investigate the utility of tumour cell anaplasia and multinucleation as prognostic markers in oropharyngeal squamous cell carcinoma. Retrospective review of 104 patients with OPSCC or squamous cell carcinoma of unknown primary site (SCCUP) who underwent primary resection and/or lymph node dissection.

Should We Always Biopsy in Clinically Evident Lichen Sclerosus?

Unlabelled: The aims of the study were to review cases of clinically diagnosed lichen sclerosus (LS) and to compare the histological features found on biopsy to clinical features seen on examination.

Methods: A retrospective chart review was undertaken of patients attending a specialist vulval service between 2013 and 2015 with a clinical diagnosis of LS. Patients in whom there was clinical diagnostic uncertainty or those with features of lichen planus or lichen planus/LS overlap were excluded.

High concordance of BRAF mutational status in matched primary and metastatic melanoma.

Background: Techniques for the accurate identification of activating mutations of BRAF in metastatic melanoma are of great clinical importance, due to the availability of targeted therapies for these tumors. There is uncertainty regarding the frequency with which BRAF status differs between primary and metastatic sites.

Methods: Between 2011 and 2016, 219 melanoma cases underwent BRAF testing in our institution.

Sampling of wide local excision specimens in cutaneous malignant melanoma.

Background: Wide local excisions (WLEs) are frequently undertaken in the management of cutaneous melanoma; however, there is a considerable variability in their macroscopic sampling. The aim of our study was to establish evidence-based guidelines for the macroscopic handling of these specimens with a subsequent review of the impact on our service.

Methods: The study group of 128 cases with initial biopsy and subsequent WLE in our institution in 2010 were identified by a computer-generated search.

Presentation of Chronic Lymphocytic Leukemia/Small Lymphocytic Lymphoma in a Warthin Tumor: Case Report and Literature Review.

Warthin tumor is the second most common salivary gland neoplasm. It occurs more commonly in males than in females. Malignant transformation in Warthin tumor is a rare but well-recognized phenomenon; however, the development or presentation of lymphoma in a Warthin tumor is rare.

Impact of positive margins on outcomes of oropharyngeal squamous cell carcinoma according to p16 status.

Background: Currently, positive surgical margins in head and neck cancer are considered to be an indicator for postoperative chemoradiotherapy (CRT) over radiotherapy (RT) alone. However, there are less data regarding the impact of margin status on human papillomavirus (HPV)-related oropharyngeal squamous cell carcinoma (SCC).

Methods: We performed a retrospective review of 55 patients with oropharyngeal SCC undergoing primary surgical treatment.

BRAF V600 mutation detection in melanoma: a comparison of two laboratory testing methods.

Aims: The assessment of B-raf proto-oncogene, serine/threonine kinase () gene status is now standard practice in patients diagnosed with metastatic melanoma with its presence predicting a clinical response to treatment with BRAF inhibitors. The gold standard in determining BRAF status is currently by DNA-based methods. More recently, a BRAF V600E antibody has been developed.

Impact of lymphocytic thyroiditis on incidence of pathological incidental thyroid carcinoma.

Background: The purpose of this study was to investigate the impact of lymphocytic thyroiditis on incidence of incidental thyroid cancers.

Methods: We conducted a retrospective review of 713 consecutive patients who underwent thyroidectomies. Incidental thyroid cancer was defined as an unexpected cancer discovered on pathological examination outside the index nodule undergoing preoperative cytology.

Pattern of invasion and lymphovascular invasion in squamous cell carcinoma of the floor of the mouth: an interobserver variability study.

Aims: Lymphovascular invasion (LVI) and the histological pattern of invasion (POI) at the invasive tumour front have been reported as adverse prognosticators in oral squamous cell carcinoma (SCC). However, assessment of these parameters is hampered by variation in the criteria used for their evaluation. Our objective was to evaluate interobserver variability in the assessment of the POI and LVI in SCC of the floor of the mouth (FOM), and to study the impact of the POI on clinical outcomes by using varying quantitative cut-offs.