Pathologists are from Mercury, clinicians are from Uranus: the perverted prospects for perceptual pathology.

Clinicians and pathologists do their work, of course, in quite different ways. Because both groups are trained as physicians, however, this training commonality makes all involved seem basically to be on the same "medical team." There are, nevertheless, some fundamental differences between the 2 groups that can on occasion cause significant difficulties in mutual understanding; there are reasons to believe that such differences are becoming more pronounced.

Explaining sarcoidosis of bone.

The radiographic features of sarcoidosis of bone are such as to suggest a possible infection as a cause of the lesions. This article explains how such lesions can be explained without resorting to a hypothesized infection as the etiology. Accepting that sarcoidosis definitely is not an infection is important for clinicians because not doing so can result in treatment errors.

The cause of sarcoidosis: the Centurial enigma solved.

I am an experienced pathologist (4 decades), and I can now confidently perceive the cause of sarcoidosis. I can see clearly now because of 2 things: (1) modern evidence indicating a genetic-based immune dysregulation as an essential predisposing causal cofactor and (2) a century of accumulated pathology observations relevant to the point. The first factor helps explain numerous environmental, clinical, and research uncertainties, contradictions, and puzzles.

Idiopathic midline destructive disease: fact or fiction.

The differential diagnosis of a progressive destructive lesion of the midface and upper airway region includes both neoplastic and non-neoplastic entities; of these, the majority of cases prove to be either Wegener's granulomatosis or lymphoma. Historically, these sorts of necrotizing midfacial lesions were diagnosed clinically, and as a consequence a variety of overlapping categories of disease sprang up. As pathologic examination of biopsy material became both more widespread and (particularly in the last several years) more sophisticated, many lesions previously thought to be of mysterious origins have proven to be examples of lymphoma (in particular, sinonasal natural killer cell or T cell [NK/T] lymphomas).

Chaotic tumors and 2 mistakes of molecular oncologists.

The structure of DNA is wondrously appealing in its elegant simplicity combined with its captivating power. The power of DNA derives directly from, and solely from, the fact that it represents digital information. However, this delightful digital determinism does not carry over into the multitude of cellular processes, especially in a cancer cell.

Allergic fungal sinusitis is a histopathologic diagnosis; paranasal mucocele is not.

Allergic fungal sinusitis has been known to pathologists for two decades. During this time, multiple articles have stressed that the condition continues to be underdiagnosed. This is true, but it can also be overdiagnosed.

Ectopic hamartomatous thymoma: a clinicopathologic and immunohistochemical analysis of 21 cases with data supporting reclassification as a branchial anlage mixed tumor.

This report describes the clinicopathologic and immunohistochemical findings in 21 cases of a highly distinctive tumor with a strong predilection for the lower neck region of adult males. Our study group consisted of 20 males and one female. The patients were 28 to 79 years old (mean age, 47 years; median age, 40 years), and they presented with solitary, lobular or multilobular masses ranging in size from 2.

Brain in the middle ear or nasal cavity: heterotopia or encephalocele?

Brain in the middle ear or nasal cavity: heterotopia or encephalocele? The answer to this question is greatly influenced by clinical information. Sometimes, however, this information is insufficient and the pathologist's opinion may influence patient management. It seems that most pathologists tend to get the answer wrong.

Benign postoperative spindle cell nodule of the urinary bladder? don't think so.

According to colleagues specializing in genitourinary pathology, the so-called postoperative spindle cell nodule of the bladder can be extremely difficult to distinguish from a spindle cell sarcomatoid carcinoma. What I have learned in 25 years about spindle cell sarcomatoid carcinoma of the larynx may, by analogy, possibly help with the genitourinary pathology problem.

The truth about alveolar rhabdomyosarcoma.

The alveolar variant of rhabdomyosarcoma continues to be underdiagnosed by pathologists. Yet, the correct recognition of this subtype can be of significant import to the oncologist for specifics of patient treatment. This review discusses the important aspects of alveolar rhabdomyosarcoma and hopefully can be of some help in the proper diagnosis of this tumor.

Infinitesimals, quantum mechanics, and exiguous carcinomas: how to possibly save a patient's larynx.

Occasionally, a patient will have a minimally invasive squamous cell carcinoma of the larynx that is such a meager carcinoma that, following biopsy, the larynx is surgically removed and the pathologic specimen contains no evidence of residual carcinoma or even significant dysplasia. Such gross overtreatment is a tragedy. How does this happen and what can a pathologist do to help preclude this event?

Let's make grading of squamous cell carcinomas more meaningful to clinicians (via "Ed's Insight").

Histologic grading of squamous cell carcinomas seems to lack clinical import or usefulness in most instances. Perhaps this is because we are doing it incorrectly. This article suggests a simple grading philosophy that potentially may prove more meaningful.

Wegener's granulomatosis is not a granulomatous disease.

The histologic diagnosis of Wegener's granulomatosis is usually challenging. It is made more so by the failure of most pathologists to realize that the disease is fundamentally neither a vasculitis nor a granulomatous reaction. This problem can contribute to delays in diagnosis and consequent adverse effects for patient prognosis.

Spindle cell (sarcomatoid) carcinomas of the larynx: a clinicopathologic study of 187 cases.

Laryngeal spindle cell (sarcomatoid) carcinomas are uncommon tumors, frequently misdiagnosed as reactive lesions or mesenchymal malignancies. The records of 187 patients with tumors diagnosed as laryngeal spindle cell (sarcomatoid) carcinoma were retrieved from the files of the Otorhinolaryngic Tumor Registry of the Armed Forces Institute of Pathology. There were 174 men and 13 women, 35-92 years of age (average, 65.