Massively parallel sequencing analysis of 68 gastric-type cervical adenocarcinomas reveals mutations in cell cycle-related genes and potentially targetable mutations.

Gastric-type cervical adenocarcinoma (GCA) is an aggressive type of endocervical adenocarcinoma characterized by mucinous morphology, gastric-type mucin, lack of association with human papillomavirus (HPV) and resistance to chemo/radiotherapy. We characterized the landscape of genetic alterations in a large cohort of GCAs, and compared it with that of usual-type HPV-associated endocervical adenocarcinomas (UEAs), pancreatic adenocarcinomas (PAs) and intestinal-type gastric adenocarcinomas (IGAs). GCAs (n = 68) were subjected to massively parallel sequencing targeting 410-468 cancer-related genes.

Choriocarcinoma in Women: Analysis of a Case Series With Genotyping.

Choriocarcinoma is an uncommon malignant neoplasm, which can be either gestational or nongestational in origin. Distinction of these subtypes has prognostic and therapeutic implications. Twenty-two tumors were genotyped using polymerase chain reaction amplification of 15 short tandem repeat loci and the amelogenin locus (XY determination).

PD-L1 Expression in Human Placentas and Gestational Trophoblastic Diseases.

One of the major immune checkpoints responsible for immune evasion in cancer cells is the interaction between programmed cell death-1 (PD-1) and its ligand (PD-L1). As human trophoblastic cells display many of the features of malignant cells such as the ability to invade normal tissue including blood vessels and are apparently not eradicated by the host immune system, we undertook the present study to determine whether PD-L1 was upregulated in different types of trophoblastic cells during normal pregnancy and in gestational trophoblastic diseases. Immunohistochemistry using an anti-PD-L1-specific antibody demonstrated that in early and term normal placentas, PD-L1 was highly expressed in syncytiotrophoblast and to a much lower extent in intermediate trophoblastic cells located in the chorion laeve and implantation site.

Morphological and Immunohistochemical Reevaluation of Tumors Initially Diagnosed as Ovarian Endometrioid Carcinoma With Emphasis on High-grade Tumors.

Ovarian endometrioid carcinomas (OEC) of low grade have characteristic morphologic features, but high-grade tumors can mimic high-grade serous and undifferentiated carcinomas. We reviewed tumors initially diagnosed as OEC to determine whether a combination of pathologic and immunohistochemical features can improve histologic subclassification. Tumors initially diagnosed as OEC were reviewed using World Health Organization criteria.

Regional differences in gallbladder cancer pathogenesis: insights from a comparison of cell cycle-regulatory, PI3K, and pro-angiogenic protein expression.

Background: The variable incidence of gallbladder cancer (GBCA) suggests regional pathogenetic differences. This study compares cell cycle-regulatory, angiogenesis-related, and PI3K pathway protein expression in GBCAs from three continents.

Methods: Immunohistochemical expression of several proteins was assessed, correlated with clinicopathologic variables, and compared among centers from Chile (Fundación Arturo López Pérez [FALP]), Japan (Yokohama City University [YCU]), and the United States (Memorial Sloan-Kettering Cancer Center [MSKCC]).

Comparing human pancreatic cell secretomes by in vitro aptamer selection identifies cyclophilin B as a candidate pancreatic cancer biomarker.

Most cases of pancreatic cancer are not diagnosed until they are no longer curable with surgery. Therefore, it is critical to develop a sensitive, preferably noninvasive, method for detecting the disease at an earlier stage. In order to identify biomarkers for pancreatic cancer, we devised an in vitro positive/negative selection strategy to identify RNA ligands (aptamers) that could detect structural differences between the secretomes of pancreatic cancer and non-cancerous cells.

The prevalence of pancreatic acinar differentiation in gastric adenocarcinoma: report of a case and immunohistochemical study of 111 additional cases.

Although pancreatic acinar metaplasia in the gastric mucosa is well recognized in chronic gastritis, gastric carcinoma with acinar differentiation is very rare. We encountered a case of gastric adenocarcinoma with prominent histologic and immunohistochemical features of pancreatic acinar differentiation in the absence of identifiable heterotopic pancreatic tissue. Distinct glandular and diffuse patterns of adenocarcinoma were also present, and there was focal mucin production.

"Low-grade leiomyosarcoma" and late-recurring smooth muscle tumors of the uterus: a heterogenous collection of frequently misdiagnosed tumors associated with an overall favorable prognosis relative to conventional uterine leiomyosarcomas.

In most instances, uterine smooth muscle tumors (USMTs) are readily diagnosed as either benign or malignant. Rare patients whose smooth muscle tumors fail to meet leiomyosarcoma (LMS) diagnostic criteria will experience recurrence, and occasional cases of LMS patients experience a protracted clinical disease course. The aim of this study was to investigate whether "low-grade uterine LMS" can be defined as a clinicopathological entity and to learn which histologic features of USMTs correlate with indolent prognosis.

A nomogram to predict postresection 5-year overall survival for patients with uterine leiomyosarcoma.

Background: The clinical course of patients with uterine leiomyosarcoma (LMS) is difficult to predict with the currently available categorical staging systems of the American Joint Committee on Cancer (AJCC) and the International Federation of Gynecology and Obstetrics (FIGO). The objective of the current study was to develop and validate a novel, clinically relevant, individualized prognostic model for patients with uterine LMS.

Methods: Patients with uterine LMS who presented at the authors' institution from 1982 to 2008 were analyzed.

Predictive value of endocervical curettage at cervical conization and provider practices in management of high-grade cervical dysplasia.

Objective: To determine the utility of endocervical curettage (ECC) at cervical conization for predicting residual or recurrent dysplasia and to evaluate differences in management between general gynecologists and gynecologic oncologists.

Study Design: From February 1999 to November 2007, 192 patients with high-grade dysplasia on conization were retrospectively identified. Data were analyzed for 54 patients who underwent repeat conization or hysterectomy to evaluate predictors of disease.

Solitary synovial osteochondroma.

Solitary synovial osteochondroma (SSO) is a rare variant of extraskeletal osteochondroma. The aim of this study was to review 5 cases of SSO, including clinical, radiographic, and histopathologic features. Five cases of SSO were retrieved from our files.

Ovarian intestinal type mucinous borderline tumors: are we ready for a nomenclature change?

At a National Cancer Institute-sponsored workshop it was proposed that the borderline category of ovarian intestinal-type mucinous tumors (OInMTs) could be eliminated if the apparent benign behavior of these tumors could be confirmed. We reviewed 33 cases of borderline OInMT, with either optimal or adequate sampling and with at least 5 years of follow-up, to investigate their behavior. Optimal sampling and adequate sampling were defined as at least 1 section per centimeter of maximum tumor dimension and at least 1 section per 2 cm of maximum tumor dimension, respectively.

Supernumerary nipple presenting as a vulvar mass in an adolescent: case report and literature review.

Background: Ectopic breast tissues can be found along the embryonic mammary ridges and can occur in the vulva. While ectopic breast tissue is not uncommon, functional breast with overlying nipple located within the vulva is exceedingly rare.

Case: A 17-year-old with undiagnosed hypothyroidism presents with vulvar mass draining milky white fluid.

Mitosis-specific marker phospho-histone H3 in the assessment of mitotic index in uterine smooth muscle tumors: a pilot study.

The assessment of an accurate mitotic index (MI) is one of the major parameters in the proper classification of uterine smooth muscle tumors. This assessment can be hampered by the presence of increased number of apoptotic bodies or piknotic nuclei, which frequently mimic mitoses. Phospho-histone H3 (PHH3) is a recently described immunomarker specific for cells undergoing mitoses.

Frequent activating mutations of PIK3CA in ovarian clear cell carcinoma.

Ovarian clear cell carcinoma (CCC) is one of the most malignant types of ovarian carcinomas, particularly at advanced stages. Unlike the more common type of ovarian cancer, high-grade serous carcinoma, ovarian CCC is often resistant to platinum-based chemotherapy, and therefore an effective treatment for this tumor type at advanced stages is urgently needed. In this study, we analyzed 97 ovarian CCCs for sequence mutations in KRAS, BRAF, PIK3CA, TP53, PTEN, and CTNNB1 as these mutations frequently occur in other major types of ovarian carcinomas.

Cystic and adenofibromatous clear cell carcinomas of the ovary: distinctive tumors that differ in their pathogenesis and behavior: a clinicopathologic analysis of 122 cases.

Ovarian clear cell carcinomas (CCC) typically present as large adnexal, stage I tumors and are generally considered highly malignant. They are frequently associated with endometriosis and, less often with clear cell adenofibromas. We hypothesized that CCCs are a heterogeneous group of tumors, some arising from a cyst and others from an adenofibroma.

Metastatic HPV-related cervical adenocarcinomas presenting with thromboembolic events (Trousseau Syndrome): clinicopathologic characteristics of 2 cases.

Two cases of systemic thromboembolism (Trousseau syndrome) associated with metastatic human papillomavirus (HPV)-related endocervical adenocarcinomas are reported. The first patient, age 36, presented with bilateral lower extremity deep vein thromboses, pulmonary embolism, and supraclavicular and cervical lymphadenopathy. Lymph node biopsy revealed metastatic mucinous adenocarcinoma with focal signet ring cell differentiation.

Myometrial myxoidosis: a report of 2 cases of a distinctive type of secondary myometrial hypertrophy in patients with lupus erythematosus.

Myxoid mesenchymal lesions of the uterus are generally restricted to tumors, but non-neoplastic myxoid mesenchymal lesions of the uterus have not received much attention in the literature. We analyzed the clinicopathologic features of 2 patients with lupus erythematosus (ages 43 and 52 yr, respectively) in whom myometrial myxoidosis produced a markedly enlarged uterus with myometrial thickening ("secondary myometrial hypertrophy"). Both patients underwent a hysterectomy for presumed leiomyomas, and intraoperatively an enlarged uterus was noted.

Sinonasal chondromyxoid fibroma.

Chondromyxoid fibroma (CMF) is a rare benign cartilaginous tumor that usually arises from the metaphysis of long bones. In rare cases, however, CMF presents in unusual locations, such as the facial bones and sinonasal tract. We present a case of a 60-year-old woman with a CMF of the nasal septum.

Sclerosing mucoepidermoid carcinoma of the salivary glands.

Mucoepidermoid carcinoma (MEC) comprises approximately 30% of all salivary gland malignancies, making it the most common malignant tumor of the salivary glands. Multiple histologic variants with a wide range of differentiation have been described. Sclerosing MEC (SMEC) is a rare subtype that may be misdiagnosed as a benign reactive condition or low-grade non-SMEC malignancy.

Heterotopic parathyroid inclusion in a cervical lymph node.

Background: During the pathologic examination of neck dissection specimens, unexpected findings within the lymph nodes may be discovered. Such findings may include benign epithelial inclusions, a second primary tumor, or chronic inflammatory diseases.

Methods: We report a case of a 59-year-old man who underwent a laryngectomy and bilateral neck dissection for a right transglottic squamous carcinoma of the larynx.

Ovarian nonsmall cell neuroendocrine carcinoma: a clinicopathologic and immunohistochemical study of 11 cases.

Nonsmall cell neuroendocrine carcinoma (NSCNEC) of the ovary is a rare and aggressive tumor commonly associated with other surface epithelial and germ cell neoplasms. In this study, we present the clinicopathologic and immunohistochemical features of 11 such cases seen at The University of Texas M.D.

Effectiveness of activated charcoal and equilibrium dialysis in removing Asian, American, Siberian and Indian ginseng from human serum.

Background: Ginsengs are used by the general population worldwide and toxicity of various ginsengs has been reported. We studied the effectiveness of activated charcoal and in vitro equilibrium dialysis for removal of Asian, American, Siberian and Indian ginseng from human serum by measuring digoxin-like immunoreactivity using the fluorescence polarization immunoassay.

Methods: 1xPBS (phosphate buffered saline) or drug free serum pool was supplemented with Asian, American, Siberian or Indian ginseng extract in amount expected in overdose.