Publications by authors named "John Reith"

Jaw osteosarcoma (JOS) is a rare, distinct variant that differ from long bone osteosarcoma (LBOS) in several aspects. JOS typically appears about twenty years later than LBOS, displays a lower propensity for metastasis to other organs, and exhibits better survival rates. The dissimilarities in clinical and biological behavior between JOS and LBOS are likely due, at least in part, to variations in their respective microenvironments.

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Article Synopsis
  • Most research in surgical pathology tends to focus on rare tumors, while average pathologists deal with common non-neoplastic orthopedic conditions daily, indicating a gap in knowledge for these frequent cases.* -
  • Intraoperative consultations, especially for revision arthroplasty infections, are vital, as pathologists help determine the need for antibiotic spacers based on their assessments.* -
  • Recent literature highlights the importance of thorough examination of orthopedic specimens, as it can lead to significant insights into conditions like avascular necrosis and even early diagnosis of diseases like cardiac amyloidosis.*
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Background: Bertolotti syndrome (BS) is characterized by chronic pain and functional impairment associated with lumbosacral transitional vertebrae (LSTVs). The study aimed to investigate the histologic characteristics of the pseudoarticulation between the enlarged transverse process and sacrum seen in Castellvi 2a LSTV and explore the involvement of nervous tissue in pain generation.

Methods: Immunohistochemical analysis using S100 protein staining was performed to assess the presence of nerve tissue.

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Purpose: In this study, we used a series of immunohistochemical measurements of 2 cell cycle regulators, p16 and p21, to evaluate their prognostic value, separately and in combination, for the disease outcomes.

Method: A total of 101 patients with high-grade osteosarcoma were included in this study. Clinicopathologic data were collected, and immunohistochemistry for p16 and p21 was performed and interpreted by 3 independent pathologists.

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The calcified chondroid mesenchymal neoplasm (CCMN) represents a recently recognized tumor type with only 50 well-documented cases in the English-language literature. Herein we report an additional case of CCMN presenting as a large mass in the temporomandibular joint region of a 41-year-old female. A review of previously reported cases and the current case of CCMN shows the following features: 1) average age 52 years (range 14-87 years) and an approximately even sex distribution; 2) most frequently involved sites: distal extremities (including foot, hand, wrist, forearm) (n=41) and temporomandibular joint/temporal/parotid region (n=9); 3) multilobular soft tissue tumor with chondroid to cartilaginous matrix, often grungy or lace-like calcifications, and variable cytologic atypia; 4) frequently detected FN1 rearrangement (n=15), including FN1 fusion with FGFR2 (n=7) or other receptor tyrosine kinases; 5) 2 reported local recurrences (after incomplete excision); 6) no reports of malignant biologic behavior.

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Historically, the diagnosis of giant cell-rich neoplasms arising in bone has been challenging owing to overlapping clinical and radiographic findings resulting in the difficult separation of several neoplasms, particularly when biopsy material is limited. However, with the discovery of the driver histone mutations in giant cell tumor of bone (GCTB) and chondroblastoma, as well as USP6 rearrangements in aneurysmal bone cyst, pathologists now have objective ancillary tools to aid in the separation of several histologically similar giant cell-rich neoplasms. Furthermore, the recognition of histone mutations has allowed pathologists to revisit several entities, such as "malignant chondroblastoma," and furthered our understanding of phenomena such as "aneurysmal bone cyst-like change," formerly recognized as "secondary aneurysmal bone cyst.

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Background: Time to treatment initiation (TTI) is a quality metric in cancer care. The purpose of this study is to determine the accuracy of TTI data from a single cancer center registry that reports to the National Cancer Database (NCDB) for sarcoma diagnoses.

Methods: A retrospective analysis of a single Commission on Cancer (CoC)-accredited cancer center's tumor registry between 2006 and 2016 identified 402 patients who underwent treatment of a musculoskeletal soft tissue sarcoma and had TTI data available.

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Aneurysmal bone cyst (ABC) is a benign locally destructive bone neoplasm composed of multi-loculated blood-filled cystic spaces. The most common sites of involvement are the meta-diaphysis of the long bones and posterior elements of the vertebrae. Secondary, ABC-like changes can complicate a variety of other benign and malignant primary bone neoplasms, including giant cell tumor, fibrous dysplasia, and osteosarcoma.

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Article Synopsis
  • Rosai-Dorfman disease (RDD) is a rare condition characterized by the proliferation of histiocytes, usually presenting with swollen lymph nodes and general symptoms, and it only rarely affects bones.
  • A unique case of primary, bilateral intraosseous RDD was identified in a 59-year-old man who was initially being examined for another condition affecting his tibia.
  • The diagnosis was confirmed through multiple biopsies and detailed evaluations, highlighting the complexities in diagnosing this rare disease, along with a discussion of the related clinical and imaging features.
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Background: Radiation after resection of an atypical lipomatous tumor (ALT) is controversial. This study evaluates local control and complications after the first resection of ALTs of the extremity with or without adjuvant radiation.

Methods: A dual institution, retrospective review of patients treated from 1995 to 2020 with first-time resection of an ALT in the extremity was performed.

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Osteosarcoma (OST) is the most common type of high-grade primary bone tumor, which mainly affects young adults. The current standard of care for OST combines surgical resection with chemotherapy. The clinical outcomes and the current options to treat OST patients are unsatisfactory and novel treatment strategies are needed.

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For decades, the diagnosis, treatment, and even pathogenesis of the osteofibrous dysplasia/osteofibrous dysplasia-like adamantinoma/classic adamantinoma spectrum of neoplasms have been controversial. Herein, we discuss and illustrate the radiographic and histologic spectrum, differential diagnoses, unifying chromosomal and molecular abnormalities, and current controversies and treatment recommendations for each entity.

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A 7-year-old girl with a history of Langerhans cell histiocytosis (LCH), in remission, presented with the sudden appearance of multiple, agminated nevi. Skin biopsy revealed a benign junctional nevus, without recurrence of LCH. Subsequent immunohistochemical testing of both the skin and iliac wing biopsies demonstrated a BRAF V600E mutation.

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Clear cell chondrosarcoma is a rare histological subtype of chondrosarcoma, usually with a relatively non-aggressive clinical course. However, infrequently they may relapse and metastasize. We describe a case of a male patient, 53 years old, with rib cage metastases of a clear cell chondrosarcoma 11 years after the first surgical intervention, and review the literature.

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Context.—: The incidence, distribution, and significance of calcium pyrophosphate dihydrate deposition (CPPD) disease have not been extensively compared among various total joint resections.

Objective.

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Article Synopsis
  • Bone and soft tissue tumors are complex and often defined by gene fusions, making them challenging to diagnose.
  • The study used a custom 34-gene sequencing fusion panel to analyze tumor samples from 147 patients for gene fusions over a year.
  • The results showed that 45% of cases had disease-defining fusions, providing crucial insights for accurate diagnosis and identifying novel fusion partners in some tumors.
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Objectives: To evaluate the necessity of pathologic examination for confirming the diagnosis of avascular necrosis (AVN).

Methods: We retrospectively reviewed consecutive nonfractured total hip arthroplasty cases (n = 1,722), comparing operative diagnoses and radiologic data with final histologic diagnoses, focusing specifically on AVN.

Results: Among 199 histologically confirmed cases of AVN, 62 (31%) had a preoperative diagnosis of osteoarthritis/degenerative joint disease (OA/DJD); 58 of the latter patients had radiology reports, but only two (3%) documented AVN.

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Chondroblastoma is currently classified as a benign neoplasm; however, chondroblastoma and chondroblastoma-like osteosarcoma have morphologic overlap, raising the possibility that some tumors diagnosed as chondroblastoma-like osteosarcoma might actually represent malignant chondroblastoma. The H3F3B K36M point mutation, which has not been reported in osteosarcoma, is identified in 95% of chondroblastomas and is reliably detectable by immunohistochemistry (IHC). We reviewed 11 tumors diagnosed as atypical chondroblastoma, malignant chondroblastoma, or chondroblastoma-like osteosarcoma (median follow-up: 8.

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Primary pulmonary artery sarcoma (PAS) is extremely rare in children. Nevertheless, distinguishing primary PAS from pulmonary embolism is critical to a child's survival. Primary PAS is commonly misdiagnosed as a pulmonary embolism due to similar presenting symptoms and radiographic findings.

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Article Synopsis
  • The study investigates how the time between diagnosis and treatment initiation (TTI) affects overall survival in adults with primary bone sarcoma, finding that delays in treatment do not correlate with decreased survival.
  • Analyzing data from 2,122 patients diagnosed from 2004 to 2012, the researchers used various statistical methods to assess survival based on TTI and other patient and disease factors.
  • Key factors linked with decreased survival included older age, higher morbidity scores, larger tumor sizes, and specific treatment types, while certain tumor types and receiving care at academic centers were associated with improved survival outcomes.
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