Lymphatic vascular invasion: Diagnostic variability and overall survival impact on patients undergoing surgical resection.

Objective: The diagnostic criteria of lymphatic vascular invasion have not been standardized. Our investigation assesses the factors associated with lymphatic vascular invasion positive tumors and the impact of lymphatic vascular invasion on overall survival for patients with non-small cell lung cancer undergoing (bi)lobectomy with an adequate node dissection.

Methods: The National Cancer Database was queried from the years 2010 to 2015 to find surgical patients who underwent lobectomy with at least 10 lymph nodes examined (adequate node dissection) and with known lymphatic vascular invasion status.

Women in Academic Pathology: Pathways to Department Chair.

The Association of Pathology Chairs, an organization of American and Canadian academic pathology departments, has a record percent of women department chairs in its ranks (31%), although still not representative of the percent of women pathology faculty (43%). These women chairs were surveyed to determine what had impeded and what had facilitated their academic advancement before becoming chairs. The 2 most frequently identified impediments to their career advancement were heavy clinical loads and the lack of time, training, and/or funding to pursue research.

Pulmonary Langerhans Cell Histiocytosis.

Pulmonary Langerhans cell histiocytosis (PLCH) is a diffuse cystic lung disease that is strongly associated with exposure to cigarette smoke. Recently, activating pathogenic mutations in the mitogen-activated protein kinase pathway have been described in the dendritic cells in patients with PLCH and have firmly established PLCH to be an inflammatory myeloid neoplasm. Disease course and prognosis in PLCH are highly variable among individual patients, ranging from spontaneous resolution to development of pulmonary hypertension and progression to terminal respiratory failure.

The Association of Pathology Chairs' Pathology Leadership Academy: Experience From the First 2 Years.

Leadership development and succession planning are critical to ensure continued strength of academic pathology. The Association of Pathology Chairs developed the Pathology Leadership Academy to prepare future academic leaders. The purpose of this report is to describe: (1) Pathology Leadership Academy's development and curriculum, (2) how Pathology Leadership Academy has met leadership development needs for individuals and academic departments in its first 2 years, (3) Pathology Leadership Academy's future directions based on program feedback.

The Pathology Workforce and Clinical Licensure: The Role of the PhD Clinical Laboratorian in the United States.

There has been a recent recognition of the need to prepare PhD-trained scientists for increasingly diverse careers in academia, industry, and health care. The PhD Data Task Force was formed to better understand the current state of PhD scientists in the clinical laboratory workforce and collect up-to-date information on the training and certification of these laboratorians. In this report, we summarize the findings of the PhD Data Task Force and discuss the relevance of the data collected to the future supply of and demand for PhD clinical laboratory scientists.

Pneumonic-type mucinous lung adenocarcinoma diagnosed by transbronchial cryobiopsy.

Primary lung adenocarcinoma with lepidic growth can mimic diffuse pulmonary parenchymal processes like infectious pneumonia or idiopathic inflammatory pneumonitis. We report a case of subacute pneumonitis refractory to antibiotic therapy and empirical corticosteroids, proven to be diffuse mucinous adenocarcinoma with lepidic growth on transbronchial cryobiopsy.

Trends in extramural consultation: comparison between subspecialized and general surgical pathology service models.

Academic and community hospital pathology groups are increasingly adopting subspecialized service models for surgical pathology (SP) practice. Reasons cited include improvements in sign-out efficiency, quality and accuracy, enhancement of clinician-pathologist communications, and augmentation of resident training quality. However, there is a paucity of published quantitative data regarding the outcomes of transitioning from general to subspecialized SP service coverage.

Biologic Evaluation of Diabetes and Local Recurrence in Non-Small Cell Lung Cancer.

A recent multicenter study led by our institution demonstrated that local recurrence of non-small cell lung cancer (NSCLC) was significantly more frequent in patients with diabetes, raising the possibility of different tumor biology in diabetics. Epithelial-to-mesenchymal transition (EMT) plays a key role in local tumor recurrence and metastasis. In the present study, we investigated differences of tumor microenvironment between patients with and without diabetes by examining expression of EMT markers.

Assessment of cytotechnologist-cytopathologist interpretative agreement using the Bethesda system for reporting thyroid cytopathology.

Background: The Bethesda system for reporting thyroid cytopathology was proposed to provide a clinically relevant framework for interpretations to improve interobserver agreement. Limited data is available regarding the level of interobserver agreement between groups of cytotechnologists (CTs) and cytopathologists (CPs) examining the same thyroid fine needle aspirate (FNA) samples.

Methods: Retrospective review of 1,229 thyroid FNAs from 976 patients between 03/2010 and 08/2012 was performed.

Immunohistochemistry: applications to the evaluation of lung and pleural neoplasms: part 2.

Immunohistochemistry has come to occupy a key position among the armamentarium of tools pathologists apply to the evaluation of lung and pleural neoplasms. This technique uses antibodies that bind to specific antigens, usually proteins, enabling microscopic detection of the antigens. Over the last several decades, an impressive array of antibodies has become commercially available, and many of these antibodies have become integrated into the routine practice of pathology.

Immunohistochemistry: applications to the evaluation of lung and pleural neoplasms: part 1.

Immunohistochemistry has come to occupy a key position among the armamentarium of tools pathologists apply to the evaluation of lung and pleural neoplasms. This technique uses antibodies that bind to specific antigens, usually proteins, enabling microscopic detection of the antigens. Over the last several decades, an impressive array of antibodies has become commercially available, and many of these antibodies have become integrated into the routine practice of pathology.

MiR-365 regulates lung cancer and developmental gene thyroid transcription factor 1.

Thyroid transcription factor 1 (TTF-1 or NKX2-1) is an essential fetal lung developmental factor, which can be recurrently activated by gene amplification in adult lung cancer. We have discovered the first microRNA (i.e.

β-catenin expression in benign and malignant pleural disorders.

Benign and malignant pleural processes display a large and overlapping spectrum of morphological appearances, and can be difficult to distinguish, histologically, from each other. β-catenin, a participant in the wingless-type (Wnt) transduction pathway, is involved in the pathogenesis of malignant mesothelioma and has received limited evaluation for its ability to serve as a diagnostic aid for distinguishing between individual pleural disorders. We performed immunohistochemistry for β-catenin on 10 pleural malignant mesotheliomas, 10 examples of mesothelial hyperplasia and 18 cases of organizing pleuritis.

Causes of pulmonary granulomas: a retrospective study of 500 cases from seven countries.

Background: The frequencies of various causes of pulmonary granulomas in pathological material are unknown, as is the influence of geographical location on aetiology. The aim of this study was to identify the causes of pulmonary granulomas in pathological specimens, to define their frequencies, and to determine whether these causes vary by geographical location.

Methods: 500 lung biopsies and resections containing granulomas were reviewed retrospectively by expert pulmonary pathologists from 10 institutions in seven countries.

Should large cell neuroendocrine lung carcinoma be classified and treated as a small cell lung cancer or with other large cell carcinomas?

Background: To compare the presenting and prognostic characteristics of patients with large cell neuroendocrine lung cancer (LCNELC) with those of patients with small cell lung cancer (SCLC) or other large cell carcinomas (OLCs) and to compare overall survival (OS) and lung cancer-specific survival (LCSS) rates for patients undergoing definitive resection without radiotherapy (S-NoRT).

Methods: The Surveillance Epidemiology and End Results Database-17 from 2001 to 2007 was used. Differences between population characteristics were compared using χ(2) and Wilcoxon tests.

High levels of expression of human stromal cell-derived factor-1 are associated with worse prognosis in patients with stage II pancreatic ductal adenocarcinoma.

Background: Stromal cell-derived factor-1 (SDF-1) and its receptor, CXCR4, have been shown to mediate invasiveness and metastatic behavior in a number of cancers, including ovarian, prostate, bladder, breast, and pancreatic cancers. The expression and significance of SDF-1 in pancreatic ductal adenocarcinoma (PDA) have not been systematically studied.

Methods: We examined the expression of SDF-1 by immunohistochemistry using a mouse anti-human SDF-1/CXCL12 antibody (dilution 1:300) and a tissue microarray consisting of 72 stage II PDAs from pancreaticoduodenectomy specimens.

Immune functional assay for immunosuppressive management in post-transplant malignancy.

Immunosuppression management in post-transplant malignancy is challenging because of a lack of objective immunologic assessment tools. The ImmuKnow assay measures the ATP level from CD4 T cells, quantifying cell-mediated immunity and providing an insight into the immune status of transplant recipients. Its potential use in patients with post-transplant de novo malignancy was evaluated.

Pulmonary crystal-storing histiocytosis diagnosed by computed tomography-guided fine-needle aspiration.

Crystal-storing histiocytosis (CSH) is a rare process most often occurring in conjunction with an underlying hematopoietic neoplasm, usually multiple myeloma or low-grade B-cell lymphoma. We report the first case of pulmonary CSH diagnosed by fine-needle aspiration biopsy. A patient with a history of urothelial carcinoma developed a lung nodule, which was evaluated by fine-needle aspiration biopsy.

Molecular discrimination of multiple primary versus metastatic squamous cell cancers of the head/neck and lung.

Patients with squamous cell carcinoma (SqCa) arising in the head and neck (H/N) commonly develop solitary pulmonary metastases that mimic the clinical, radiographic, and pathologic presentation of new primary lung SqCa. Primary pulmonary and metastatic SqCas cannot be differentiated from each other histologically. However, distinguishing multiple independent primary neoplasms from a primary H/N SqCa with pulmonary metastasis has prognostic significance due to its impact on tumor stage, the most important determinant of prognosis.

Immunohistochemistry for assessment of pulmonary and pleural neoplasms: a review and update.

Diagnosis and classification of lung and pleural neoplasms are complex due to diverse histopathology and tumor heterogeneity. A large number of immunohistochemical markers have recently become available to facilitate accurate diagnosis and classification of pulmonary and pleural neoplasms. The purpose of this article is to review the current data available on these markers and to provide a practical approach to evaluate pulmonary and pleural neoplasms immunohistochemically.