Concordance of "Case Level" Global, Highest, and Largest Volume Cancer Grade Group on Needle Biopsy Versus Grade Group on Radical Prostatectomy.

The practice of assigning "case level" biopsy Grade Group (GG) or Gleason Score is variable. To our knowledge, a comparison of the concordance of different biopsy "case level" GG with the prostatectomy GG has not been done in a post-2005 prostate cancer cohort. We evaluated the GG in 2527 patients who had biopsy and radical prostatectomy performed at our institution between 2005 and 2014.

Urothelial metaplasia of the seminal vesicle and ejaculatory duct associated with crossed-fused renal ectopia and Hutch diverticulum of the bladder.

The presence of urothelial epithelial metaplasia in a seminal vesicle is an exceptionally rare finding. We describe a unique case of urothelial metaplasia of the seminal vesicle and ejaculatory duct, found in a radical prostatectomy specimen from a patient with complex urogenital anatomy. A 70-year-old patient with organ confined (pT2) prostatic adenocarcinoma (Gleason score 3+4 = 7) had a right-sided Hutch diverticulum and a left crossed-fused renal ectopia.

Gastrointestinal Stromal Tumor Metastasis to the Orbit.

A 66-year-old woman was referred to the authors' service with a 1-week history of blurry vision in her left eye and retro-orbital ache. She had previously undergone a radical distal gastrectomy and omentectomy for gastrointestinal stromal tumor, epithelioid type, 7 years prior. Exophthalmometry confirmed 2 mm of left-sided proptosis.

Malakoplakia associated with prostatic adenocarcinoma: Report of 4 cases and literature review.

Malakoplakia is an inflammatory process that has been rarely reported in the prostate. Malakoplakia in association with prostatic carcinoma is exceedingly rare with only 4 previously reported cases. We describe the clinical features and the associated pathology in 4 patients who demonstrated malakoplakia of the prostate in association with prostatic adenocarcinoma.

Mixed epithelial-stromal tumor (MEST) of seminal vesicle: a proposal for unified nomenclature.

In contrast to the common tumors of the prostate, seminal vesicle demonstrates low potential for neoplastic proliferation. Of the rare primary seminal vesicle tumors, adenocarcinoma is the most common, but there are also rare seminal vesicle neoplasms which demonstrate epithelial and stromal components. These neoplasms have been described in the literature under various names, including "epithelial-stromal tumor," "cystic epithelial-stromal tumor," "cystadenoma," "cystomyoma," "mesenchymoma," "Müllerian adenosarcoma-like tumor," "phyllodes tumor," and "cystosarcoma phyllodes.

Synchronous appendiceal and intramucosal gastric signet ring cell carcinomas in an individual with CDH1-associated hereditary diffuse gastric carcinoma: a case report of a novel association and review of the literature.

Background: Hereditary diffuse gastric carcinoma is an autosomal dominant cancer syndrome associated with mutations of the E-cadherin gene (CDH1). E-cadherin is normally involved in cell-cell adhesion, so it not surprising that individuals with this syndrome are predisposed to develop malignancies with dyshesive morphologies at a young age, such as diffuse (signet ring cell) gastric carcinoma and lobular breast carcinoma. Herein we describe the first reported case of primary appendiceal signet ring cell carcinoma arising in a CDH1-associated hereditary diffuse gastric carcinoma kindred with synchronous primary diffuse gastric carcinoma.

Intramuscular myxoid lipoma in the proximal forearm presenting as an olecranon mass with superficial radial nerve palsy: a case report.

Background: Extremity lipomas may occur in any location, including the proximal forearm. We describe a case of a patient with an intramuscular lipoma presenting as an unusual posterior elbow mass.

Case Presentation: We discuss the case of a 57-year-old Caucasian man who presented with a tender, posterior elbow mass initially diagnosed as chronic olecranon bursitis.

Hypoxia-inducible factor signaling provides protection in Clostridium difficile-induced intestinal injury.

Background & Aims: Clostridium difficile is the leading cause of nosocomial infectious diarrhea. Antibiotic resistance and increased virulence of strains have increased the number of C difficile-related deaths worldwide. The innate host response mechanisms to C difficile are not resolved; we propose that hypoxia-inducible factor (HIF-1) has an innate, protective role in C difficile colitis.

Mitogen-activated protein kinase pathways contribute to hypercontractility and increased Ca2+ sensitization in murine experimental colitis.

Inflammatory bowel disease (IBD) is associated with intestinal smooth muscle dysfunction. Many smooth muscle contractile events are associated with alterations in Ca(2+)-sensitizing pathways. The aim of the present study was to assess the effect of colitis on Ca(2+) sensitization and the signaling pathways responsible for contractile dysfunction in murine experimental colitis.

Multiple lymphomatous diverticulosis and comorbid chronic lymphocytic leukemia: novel manifestations of ileocolic mantle cell lymphoma.

Mantle cell lymphoma (MCL) has tropism for the gastrointestinal tract (GIT) identifiable as multiple polyps and mass lesions throughout the GIT. We describe 2 novel manifestations of MCL. A 60-year-old woman with known chronic lymphocytic leukemia (CLL) had an exophytic mass of the appendiceal orifice.

A definitive diagnosis of primary Hodgkin lymphoma on endoscopic biopsy material utilizing in-depth immunohistochemical analysis.

The esophagus and stomach can be primary sites for Hodgkin lymphoma (HL). The pathognomonic feature of HL is the Reed-Sternberg cell. Because these cells can be rare in HL tumours, biopsies obtained via endoscopy are usually inadequate for establishing a definitive diagnosis.

Enterocolic lymphocytic phlebitis: statistical analysis of histology features in viable and ischemic bowel.

Enterocolic lymphocytic phlebitis is a rare cause of segmental ischemic enterocolitis. This artery-sparing transmural vasculitis is classically a circumferential phlebitis with perivenular lymphocyte cuffing and thrombi in the absence of systemic manifestations. Myointimal hyperplasia may represent a chronic phase of enterocolic lymphocytic phlebitis.

Intravascular synovial sarcoma of the external iliac vein and reconstruction with the superficial femoral vein.

Intravascular synovial sarcoma is a rare neoplasm that arises in large veins of the junctional zone between the proximal leg and lower trunk in adult women. Herein we report the first case of an intravascular synovial sarcoma of the external iliac vein. It was successfully treated with neoadjuvant radiotherapy, radical excisional surgery, and combined arterial and venous reconstruction.

Acute hepatic failure and multi-system organ failure secondary to replacement of the liver with metastatic melanoma.

Background: Metastatic malignant melanoma to the liver resulting in fulminant hepatic failure is a rare occurrence.

Case Presentation: A 46 year old man presented to hospital with massive hepatomegaly, elevated liver enzymes and increased lactate three weeks following resection of a malignant melanoma from his shoulder (Clark level 5). Initially stable, he decompensated 24 to 48 hours subsequent to presentation with respiratory failure requiring mechanical ventilation, distributive shock requiring high dose vasopressor infusion, coagulopathy refractory to plasma infusion, progressive rise in liver enzymes and severe metabolic abnormalities including hyperkalemia, acidosis, hyperphosphatemia, hyperuricemia and hypocalcemia.

Case of hibernoma in the right supraclavicular fossa.

A patient with a supraclavicular mass originally diagnosed as a lipoma who was referred to a plastic surgeon for definitive treatment is presented. Gross intraoperative findings were inconsistent with lipoma, and subsequent pathological evaluation revealed the mass to be a hibernoma (a benign, brown adipose tumour). The incidence, etiology, presentation, pathology and imaging characteristics of this somewhat rare soft tissue tumour are reviewed.

Intestinal thromboangiitis obliterans in a woman: a case report and discussion of chronic ischemic changes.

Although traditionally regarded as a disease of distal extremities, mesenteric vasculature can also manifest thromboangiitis obliterans (TAO). There are 31 cases of intestinal TAO in the English literature and the majority of subjects are male. However, cases of women with TAO are becoming more common, coinciding with an increased incidence of smoking in this sex.

Atypical fibroxanthoma with prominent sclerosis.

Background: Malignant cutaneous spindle cell lesions with marked sclerosis are uncommon. Only a few cases of cutaneous leiomyosarcoma and dermatofibrosarcoma protuberans with sclerosis have been published.

Methods: We report a case of atypical fibroxanthoma (AFX) with prominent sclerosis and hyalinization occurring on the scalp of an 81-year-old male.