Imaging Patients with Kidney Failure.

The approach to imaging a patient with kidney failure continues to evolve. Overstatement of the risk of iodinated contrast material-induced (ie, contrast-induced) acute kidney injury and new guidelines for administration of gadolinium-based contrast media affect screening and the choice of contrast material. Treatment of kidney failure requires dialysis or a kidney transplant.

Fat Necrosis Mimicking Renal Cell Carcinoma Recurrence Following Cryotherapy, Partial Nephrectomy, and Nephrectomy.

Objective: To present our experience with three patients surgically treated for suspected recurrent renal cell carcinoma whose final pathology was consistent with tumefactive fat necrosis.

Methods: Three patients underwent definitive therapy for biopsy proven renal cell carcinoma (cryoablation, partial nephrectomy, and nephrectomy) and later demonstrated evidence of recurrent renal cell carcinoma on follow up imaging. All three patients underwent surgical resection of the suspected recurrences with final pathology consistent with tumefactive fat necrosis.

Thoracoabdominal resection of giant malignant esophageal solitary fibrous tumor.

Solitary fibrous tumor (SFT) is a rare mesenchymal neoplasm. It usually originates from the parietal pleura. SFT originating from the esophagus is exceedingly rare and even more so as a malignancy.

Subaortic Membrane Papillary Fibroelastoma.

A 61-year-old male presented for an annual exam and received a transthoracic echocardiogram (TTE) which revealed a mobile mass arising from a subaortic membrane. Further investigations with a transesophageal echocardiogram (TEE) and cardiac computerized tomography angiography (CTA) confirmed the presence of a mobile 9 mm × 3 mm mass on a subaortic membrane. Cardiothoracic surgery was performed with an open operation removing the mass and subaortic membrane.

Primary synovial sarcoma of the kidney-A case report and literature review.

Primary synovial sarcoma of the kidney is a very rare spindle cell neoplasm that occasionally displays epithelial differentiation. It occurs between 15-60 years of age with a mean of 35 years and a slight male predilection. Most of synovial sarcomas appear as relatively nonspecific soft tissue masses involving the kidney.

Updates on Immunohistochemical and Molecular Markers in Selected Head and Neck Diagnostic Problems.

Context: - The head and neck regions have complex anatomic structures. They are not exempted from the rare occurrences of highly unusual, diagnostically challenging malignant neoplasms and mimickers.

Objective: - To review and update the utility of immunohistochemistry and molecular biomarkers and to pursue diagnostic accuracy on selected rare neoplasms, especially some poorly differentiated malignancies.

Primary Hepatic Neuroendocrine Tumor with Unusual Thyroid Follicular-Like Morphologic Characteristics.

We describe a primary hepatic neuroendocrine tumor of a 57-year-old Thai woman who presented in 2004 with a suspicious mass in the left hepatic lobe. She underwent left hepatectomy for the 10.5-cm mass, called , .

Invasive ductal carcinoma with in situ pattern: how to avoid this diagnostic pitfall?

Although the microscopic features of invasion are usually readily recognized, occasionally invasive ductal carcinoma may mimic the pattern of comedo ductal carcinoma in situ (DCIS) by forming large cellular nests with circumscribed borders, but lacking a definitive myoepithelial cell layer. In these cases, the histologic pattern may appear deceptively noninvasive and the absence of a myoepithelial layer can be easily overlooked. We prospectively examined 10 cases of high grade DCIS.

Diagnostic utility of E-cadherin and P120 catenin cocktail immunostain in distinguishing DCIS from LCIS.

Background: Breast carcinoma in situ (CIS) is classified into ductal carcinoma in situ (DCIS) and lobular carcinoma in situ (LCIS). DCIS is treated with surgical excision while LCIS can be clinically followed with or without hormonal treatment. Thus, it is critical to distinguish DCIS from LCIS.

Smoothelin and caldesmon are reliable markers for distinguishing muscularis propria from desmoplasia: a critical distinction for accurate staging colorectal adenocarcinoma.

An accurate distinction between deep muscularis propria invasion versus subserosal invasion by colonic adenocarcinoma is essential for the accurate staging of cancer and subsequent optimal patient management. However, problems may arise in pathologic staging when extensive desmoplasia blurs the junction between deep muscularis propria and subserosal fibroadipose tissue. To address this issue, forty-three (43) cases of colonic adenocarcinoma resections from 2007-2009 at The Methodist Hospital in Houston, TX were reviewed.

Folate receptor in adenocarcinoma and squamous cell carcinoma of the lung: potential target for folate-linked therapeutic agents.

Context: Lung cancer is the number one cause of cancer deaths in the United States and globally. The advent of targeted therapies has offered a new treatment paradigm for lung cancer, but currently validated and emerging drugs are effective in only a small minority of lung cancers, predominantly adenocarcinomas. Folate receptors can serve as targets for drugs attached to folate and are overexpressed in many cancers.

Chondroblastoma-like chondroma of soft tissue: report of the first case in the base of skull.

Chondroblastoma-like chondroma (CLC) of soft tissue is a rare benign neoplasm that usually involves the soft tissues of the hand. This report describes the first case of CLC of soft tissue arising in the base of the skull. A 33-year-old man was seen with a slow growing mass in the right parotid region of his face.

Adenocarcinoma following urinary diversion.

The use of bowel segments in urinary diversions has been associated with an increased risk of neoplasia. This report describes three cases of intestinal adenocarcinoma following urinary diversion. In the first case, a 73-year-old woman developed moderately-differentiated colonic adenocarcinoma in her Indiana pouch 10.

Thyroid fine-needle aspiration: does case volume affect diagnostic yield and interpretation?

Objective: To evaluate the effect of case volume on the diagnostic yield and interpretation of thyroid fine-needle aspiration (FNA).

Design: Retrospective case series.

Setting: An academic tertiary referral center and 2 community hospital centers.

Minimal or no residual prostatic adenocarcinoma on radical prostatectomy: a 5-year experience with "vanishing carcinoma phenomenon".

Context: "Vanishing carcinoma phenomenon" (VC) has been defined as the finding of minute or no cancer on radical prostatectomy specimens after a positive biopsy.

Objective: To discuss our experience with VC and to recommend guidelines for its detection.

Design: One thousand seven hundred forty-one radical prostatectomy specimens (2004-2009) processed by whole-mount section procedure yielded 21 (1.

S100P and XIAP expression in pancreatic ductal adenocarcinoma: potential novel biomarkers as a diagnostic adjunct to fine needle aspiration cytology.

Objective: The usefulness of 2 novel biomarkers in pancreatic surgical and cytological specimens that could reliably differentiate non-neoplastic pancreatic duct and benign gut epithelium from pancreatic ductal adenocarcinoma (PDA) was evaluated.

Study Design: A total of 14 pancreatic resection specimens (RSs), 23 endoscopic ultrasound-guided fine needle aspirations (EUS-FNAs) of PDA and 8 benign pancreatic EUS-FNAs were selected. Twelve of 14 RSs had corresponding EUS-FNAs with cell blocks (CBs).

Benign salivary gland tissue inclusion in a pulmonary hilar lymph node from a patient with invasive well-differentiated adenocarcinoma of the lung: a potential misinterpretation for the staging of carcinoma.

Benign epithelial and nonepithelial inclusions have been found in lymph nodes in multiple body sites. These inclusions have been seen in cervical, axillary, mediastinal, abdominal, and pelvic lymph nodes. They appear as benign epithelial, parathyroid, decidual, mesothelial, angiolipomatous, nevus cells, or Tamm-Horsfall protein.

Secretory phospholipase A2-IIa is involved in prostate cancer progression and may potentially serve as a biomarker for prostate cancer.

The majority of prostate cancers are indolent, whereas a significant portion of patients will require systemic treatment during the course of their disease. To date, only high Gleason scores are best associated with a poor prognosis in prostate cancer. No validated serum biomarker has been identified with prognostic power.

Diagnostic utility of P504S/p63 cocktail, prostate-specific antigen, and prostatic acid phosphatase in verifying prostatic carcinoma involvement in seminal vesicles: a study of 57 cases of radical prostatectomy specimens of pathologic stage pT3b.

Context: Seminal vesicle invasion by prostatic carcinoma is directly associated with tumor staging; verification is challenging when the tumor demonstrates cribriform or papillary growth patterns or there are back-to-back small-gland proliferations. P504S is overexpressed in prostatic carcinoma and high-grade prostatic intraepithelial neoplasia with cytoplasmic immunoreactivity. p63 has positive immunoreactivity in basal cell nuclei of benign prostatic glands.

PAX-2 expression in non-neoplastic, primary neoplastic, and metastatic neoplastic tissue: A comprehensive immunohistochemical study.

PAX-2 is a transcription factor that controls the development of the kidney, organs deriving from the mesonephric (Wolffian) duct, and those related to the Müllerian duct. Although PAX-2 is shown to be a sensitive marker for tumors derived from these organs, but whether it is specific, that is, whether other tumor types also express PAX-2, has not been systematically evaluated in either primary or metastatic tumors. Tissue sections from 937 normal or reactive tissue samples, 759 primary neoplasms, and 332 metastatic neoplasms were submitted to PAX-2 immunostain.

Down-regulation of ZIP4 by RNA interference inhibits pancreatic cancer growth and increases the survival of nude mice with pancreatic cancer xenografts.

Purpose: Zinc levels have been correlated with cancer risk, although the role of zinc and zinc transporters in cancer progression is largely unknown. We recently found that a zinc transporter, ZIP4, is overexpressed in pancreatic cancer. In this study, we further deciphered the role that ZIP4 plays in a pancreatic cancer mouse model by silencing ZIP4.

Primary schwannoma in a cervical lymph node.

Background: Spindle cell neoplasms within lymph nodes are rare and include benign and malignant tumors and primary and metastatic tumors such as palisaded myofibroblastoma, leiomyoma, leiomyosarcoma, reticular cell neoplasms, and vascular sarcomas. Ancillary studies may help distinguish these neoplasms.

Methods: A 77-year-old white woman was seen with a painless, slowly growing mass of the left neck.

Mammaglobin, a valuable diagnostic marker for metastatic breast carcinoma.

Identification of metastasis and occult micrometastases of breast cancer demands sensitive and specific diagnostic markers. In this study, we assessed the utility of a mouse monoclonal antibody to human mammaglobin for one such purpose. Immunohistochemical stains were performed on paraffin-embedded sections from a total of 284 cases, which consisted of primary breast invasive carcinomas (41 cases) with matched metastases to ipsilateral axillary lymph nodes, metastatic breast carcinoma to liver (1 case) and kidney (1 case), non-breast neoplasms (161 cases), and normal human tissues (39 cases).

An unusually large granular cell tumor of the pharynx: a case report and literature review.

We report a granular cell tumor of the pharynx in a 53 year-old woman who presented with a large retropharyngeal mass. Surgical excision revealed a 5.5 cm tan rubbery unencapsulated but circumscribed mass.