Publications by authors named "Joaquin J Garcia"

Objective: Margin distance is a significant prognosticator in oral cavity cancer but its role in HPV-related oropharyngeal squamous cell carcinoma [HPV(+)OPSCC] remains unclear. Here, we investigate the impact of margin distance on locoregional recurrence in HPV(+)OPSCC.

Study Design: This is a retrospective cohort study of surgically treated HPV(+)OPSCC patients.

View Article and Find Full Text PDF

Background: Sarcomatoid carcinomas (SC) are rare tumors with both epithelial and mesenchymal characteristics, linked to aggressive behavior and poor prognosis. Sarcomatoid carcinoma of unknown primary (SCUP) is an exceedingly rare subset with limited literature and no standardized management guidelines. This study aims to characterize the clinical presentations, treatment patterns, and genomic landscape of SCUP.

View Article and Find Full Text PDF

Background: Deep learning techniques excel at identifying tumor-infiltrating lymphocytes (TILs) and immune phenotypes in hematoxylin and eosin (H&E)-stained slides. However, their ability to elucidate detailed functional characteristics of diverse cellular phenotypes within tumor immune microenvironment (TME) is limited. We aimed to enhance our understanding of cellular composition and functional characteristics across TME regions and improve patient stratification by integrating H&E with adjacent immunohistochemistry (IHC) images.

View Article and Find Full Text PDF

Soft tissue aneurysmal bone cysts (STABCs) are rare neoplasms histopathologically identical to aneurysmal bone cysts. These benign lesions are characterized by thin, peripheral ossification and no skeletal continuity. STABC may be difficult to distinguish from myositis ossificans (MO) and malignant entities from imaging and fine needle aspiration, due to rarity and overlapping features.

View Article and Find Full Text PDF

Searching for similar images in archives of histology and histopathology images is a crucial task that may aid in patient tissue comparison for various purposes, ranging from triaging and diagnosis to prognosis and prediction. Whole slide images (WSIs) are highly detailed digital representations of tissue specimens mounted on glass slides. Matching WSI to WSI can serve as the critical method for patient tissue comparison.

View Article and Find Full Text PDF
Article Synopsis
  • - The study evaluated 121 patients with penile squamous cell carcinoma (pSCC) to explore how well different methods identify high-risk human papillomavirus (HPV) status and to analyze its prevalence and impact on patient outcomes.
  • - Results showed that 30.6% of patients were high-risk HPV-positive, with a high sensitivity (97.3%) of morphologic evaluation in predicting HPV status; progression was more common in high-risk HPV-negative patients.
  • - The findings suggest that HPV status and certain tumor characteristics can influence prognosis, with differentiation levels in HPV-negative tumors and basaloid morphology in HPV-positive cases playing a significant role in patient mortality.
View Article and Find Full Text PDF
Article Synopsis
  • The study investigates the changes in staging criteria for pT2/pT3 penile squamous cell carcinoma (pSCC) and compares the current AJCC criteria with a proposed modified system based on histopathological variables.
  • A total of 48 cases were analyzed, showing no significant difference in disease-free survival (DFS) and progression-free survival (PFS) using AJCC criteria, but significant differences emerged using the modified criteria.
  • The proposed staging system may enhance prognostication for pT2/pT3 pSCC tumors, but further research is required to validate its effectiveness across different patient populations.
View Article and Find Full Text PDF

Context.—: Artificial intelligence is a transforming technology for anatomic pathology. Involvement within the workforce will foster support for algorithm development and implementation.

View Article and Find Full Text PDF

Patching whole slide images (WSIs) is an important task in computational pathology. While most of them are designed to classify or detect the presence of pathological lesions in a WSI, the confounding role and redundant nature of normal histology are generally overlooked. In this paper, we propose and validate the concept of an "atlas of normal tissue" solely using samples of WSIs obtained from normal biopsies.

View Article and Find Full Text PDF

The main function of interstitial cells of Cajal (ICCs) is to regulate gastrointestinal peristalsis by acting as a "pacemaker" cell by generating spontaneous slow electrical waves. In 2005, electron microscopy revealed a cell type similar to ICCs (ICC-like) outside the gastrointestinal tract, with contractile activity and c-Kit immunohistochemistry shared with ICCs. Among the locations where ICC-like cells have been observed, it is in the uterus where they have a significant functional and pathophysiological role.

View Article and Find Full Text PDF

Objective: Early identification of human papillomavirus associated oropharyngeal squamous cell carcinoma (HPV(+)OPSCC) is challenging and novel biomarkers are needed. We hypothesized that a panel of methylated DNA markers (MDMs) found in HPV(+) cervical squamous cell carcinoma (CSCC) will have similar discrimination in HPV(+)OPSCC tissues.

Materials And Methods: Formalin-fixed, paraffin-embedded tissues were obtained from patients with primary HPV(+)OPSCC or HPV(+)CSCC; control tissues included normal oropharynx palatine tonsil (NOP) and cervix (NCS).

View Article and Find Full Text PDF

Adenoid cystic carcinoma (AdCC) is a rare triple-negative breast cancer analogous to its extramammary counterparts. Diagnosis of the more aggressive solid-basaloid variant of AdCC (SB-AdCC) can be challenging due to poorly defined histopathologic and molecular features. We characterized 22 invasive and in situ basaloid carcinomas by morphology, immunohistochemistry, genetics, and MYB status using multiple platforms and assessed clinical behavior and neoadjuvant chemotherapy responses.

View Article and Find Full Text PDF

Fibromyalgia syndrome (FMS) is a chronic widespread pain syndrome that is accompanied by fatigue, sleep disturbances, anxiety, depression, lack of concentration, and neurocognitive impairment. As the currently available drugs are not completely successful against these symptoms and frequently have several side effects, many scientists have taken on the task of looking for nonpharmacological remedies. Many of the FMS-related symptoms have been suggested to be associated with an altered pattern of endogenous melatonin.

View Article and Find Full Text PDF

The enteric nervous system (ENS) is organized into two plexuses-submucosal and myenteric-which regulate smooth muscle contraction, secretion, and blood flow along the gastrointestinal tract under the influence of the rest of the autonomic nervous system (ANS). Interstitial cells of Cajal (ICCs) are mainly located in the submucosa between the two muscle layers and at the intramuscular level. They communicate with neurons of the enteric nerve plexuses and smooth muscle fibers and generate slow waves that contribute to the control of gastrointestinal motility.

View Article and Find Full Text PDF

Amyotrophic lateral sclerosis (ALS) is a progressive neurodegenerative disease affecting motor neurons in the spinal cord, cerebral cortex, and medulla oblongata. Most patients present a clinical phenotype of classic ALS-with predominant atrophy, muscle weakness, and fasciculations-and survival of 3 to 5 years following diagnosis. In the present review, we performed a literature search to provide an update on the etiology and pathophysiological mechanisms involved in ALS.

View Article and Find Full Text PDF

Background: Pretreatment identification of pathological extranodal extension (ENE) would guide therapy de-escalation strategies for in human papillomavirus (HPV)-associated oropharyngeal carcinoma but is diagnostically challenging. ECOG-ACRIN Cancer Research Group E3311 was a multicentre trial wherein patients with HPV-associated oropharyngeal carcinoma were treated surgically and assigned to a pathological risk-based adjuvant strategy of observation, radiation, or concurrent chemoradiation. Despite protocol exclusion of patients with overt radiographic ENE, more than 30% had pathological ENE and required postoperative chemoradiation.

View Article and Find Full Text PDF

Objective: We aim to explore the prognostic value of tumor-infiltrating lymphocytes (TILs) in the primary tumor and metastatic lymph nodes of patients with HPV(+)OPSCC. We hypothesize that TILS density at both sites is associated with disease-free survival in HPV(+)OPSCC.

Study Design: Matched case-control study among HPV(+)OPSCC patients who underwent intent-to-cure surgery.

View Article and Find Full Text PDF

Purpose: The latest generation of scanners can digitize histopathology glass slides for computerized image analysis. These images contain valuable information for diagnostic and prognostic purposes. Consequently, the availability of high digital magnifications like and is commonly expected in scanning the slides.

View Article and Find Full Text PDF
Article Synopsis
  • HPV-associated oropharyngeal squamous cell carcinoma (HPV[+]OPSCC) needs refined clinical staging to enhance treatment decisions, specifically by analyzing the number of radiographically positive lymph nodes in patients classified as clinical N1 (cN1).
  • A study involving 260 patients who underwent surgical treatment and various radiation therapies found that the count of positive lymph nodes significantly influenced progression-free survival (PFS), with higher counts correlating to worse outcomes.
  • The findings suggest using the number of positive lymph nodes as a meaningful categorization tool for cN1 patients with HPV(+)OPSCC, warranting further research to validate these results.
View Article and Find Full Text PDF

Background: SARS-CoV-2 is an RNA virus that primarily causes respiratory disease; however, infection of other tissue has been reported. Evaluation of SARS-CoV-2 in tissue specimens may increase understanding of SARS-CoV-2 pathobiology.

Materials And Methods: A qualitative test for detection of SARS-CoV-2 in formalin-fixed paraffin-embedded (FFPE) tissues was developed and validated using droplet digital PCR (ddPCR), which has a lower limit of detection than reverse transcription (RT)-qPCR.

View Article and Find Full Text PDF

Introduction: Loss of BAP1 protein expression emerged as a negative prognostic marker in uveal melanoma (UM) and has primarily been studied in enucleations. Intraocular biopsy is frequently performed prior to UM globe-conserving therapy.

Methods: We retrospectively evaluated BAP1 immunostaining of UM in 16 biopsies and 8 subsequent enucleations, and results were correlated with the UM-specific gene expression profile (GEP; = 11), chromosome 3 status by FISH and/or chromosomal microarray ( = 12; 9 also had GEP), and clinical outcomes.

View Article and Find Full Text PDF
Article Synopsis
  • The study aims to evaluate how detectable ctHPVDNA (circulating tumor HPV DNA) is in patients with HPV-positive oropharyngeal squamous cell carcinoma (OPSCC) after surgery but before starting additional therapy, and to assess if this detectability indicates a higher risk of cancer recurrence.
  • A total of 204 samples were analyzed from patients, including 45 pre-surgery and 159 post-surgery, with significant findings that 94% had ctHPVDNA detectable before surgery, while only 41% did post-surgery.
  • Results showed that patients with detectable ctHPVDNA after surgery had an 83% survival rate without recurrence after 18 months, compared to a 100% rate for those
View Article and Find Full Text PDF

Purpose: Definitive or postoperative chemoradiation (CRT) is curative for human papillomavirus-associated (HPV+) oropharynx cancer (OPC) but induces significant toxicity. As a deintensification strategy, we studied primary transoral surgery (TOS) and reduced postoperative radiation therapy (RT) in intermediate-risk HPV+ OPC.

Methods: E3311 is a phase II randomized trial of reduced- or standard-dose postoperative RT for resected stage III-IVa (American Joint Committee on Cancer-seventh edition) HPV+ OPC, determined by pathologic parameters.

View Article and Find Full Text PDF

Purpose: Determine rates of intra-parotid and neck nodal metastasis, identify risk factors for recurrence, and report outcomes in patients with primary high-grade parotid malignancy who undergo total parotidectomy and neck dissection.

Materials & Methods: Retrospective review of patients undergoing total parotidectomy and neck dissection for high-grade parotid malignancy between 2005 and 2015. The presence and number of parotid lymph nodes, superficial and deep, as well as cervical lymph nodes involved with metastatic disease were assessed.

View Article and Find Full Text PDF