Importance of universal mismatch repair protein immunohistochemistry in patients with sebaceous neoplasia as an initial screening tool for Muir-Torre syndrome.

Muir-Torre syndrome, a Lynch syndrome variant, is characterized by sebaceous neoplasia plus one or more malignancies, typically colon cancer. The significance of DNA mismatch repair (MMR) deficiency detection by immunohistochemistry (IHC) in colorectal carcinomas is well established and is recommended as a screening tool for Lynch syndrome in newly diagnosed colorectal carcinomas. In comparison, literature on IHC application to detect MMR proteins (MLH1, MSH2, MSH6, and PMS2) in sebaceous neoplasia has been less studied and has been derived almost exclusively from tertiary care centers.

ERG overexpression and multifocality predict prostate cancer in subsequent biopsy for patients with high-grade prostatic intraepithelial neoplasia.

Purpose: The most important clinical significance of an isolated high-grade prostatic intraepithelial neoplasia (HGPIN) diagnosis is the risk of missed prostate cancer (PCa) in subsequent biopsies. Because most patients with HGPIN do not harbor or develop PCa, clinical, pathological, or molecular markers that predict of PCa risk are of clinical significance.

Materials And Methods: Overall, 155 men with a diagnosis of isolated HGPIN, which was based on the results of extended biopsy, and who underwent at least one repeat biopsy were analyzed for ERG oncoprotein (ERG) expression and clinicopathological parameters to determine the risk of finding PCa in subsequent biopsies.

Oesophageal signet ring cell carcinoma as complication of gastro-oesophageal reflux disease.

Background: Signet ring cell carcinoma occurs as a histological variant of oesophageal adenocarcinoma.

Aim: In a cross-sectional study, to pursue the hypothesis that oesophageal signet ring cell cancers constitute a complication of gastro-oesophageal reflux disease.

Methods: In a large national database of histopathology records, we accumulated 91 802 patients with Barrett's oesophagus (BE), 2817 with oesophageal nonsignet ring adenocarcinoma (EAC) and 278 with oesophageal signet ring cell carcinoma (SRC).

Primary Anal Canal Syphilis in Men: The Clinicopathologic Spectrum of an Easily Overlooked Diagnosis.

Context: The incidence of syphilis is on the rise, particularly in male patients who are human immunodeficiency virus (HIV) positive, and men who have sex with men.

Objective: To describe 4 cases of primary syphilis presenting in the anal canal to increase awareness of its presentation and morphology in this location, as the diagnosis can be easily overlooked clinically and by the pathologist. Design .

Ethnic Distribution of Microscopic Colitis in the United States.

Background: A large electronic database of histopathology reports was used to study the ethnic distribution of microscopic colitis in the United States.

Methods: Miraca Life Sciences is a nation-wide pathology laboratory that receives biopsy specimens submitted by 1500 gastroenterologists distributed throughout the United States. In a case-control study, the prevalence of microscopic colitis in 4 ethnic groups (East Asians, Indians, Hispanics, and Jews) was compared with that of all other ethnic groups (composed of American Caucasians and African Americans), serving as reference group.

Diagnosis of "Poorly Formed Glands" Gleason Pattern 4 Prostatic Adenocarcinoma on Needle Biopsy: An Interobserver Reproducibility Study Among Urologic Pathologists With Recommendations.

Accurate recognition of Gleason pattern (GP) 4 prostate carcinoma (PCa) on needle biopsy is critical for patient management and prognostication. "Poorly formed glands" are the most common GP4 subpattern. We studied the diagnostic reproducibility and the quantitative threshold of grading GP4 "poorly formed glands" and the criteria to distinguish them from tangentially sectioned GP3 glands.

Seasonal variation in detection of oesophageal eosinophilia and eosinophilic oesophagitis.

Background: Seasonal variation has been reported in diagnosis of eosinophilic oesophagitis (EoE), but results are not consistent across studies and there are no national-level data in the USA.

Aim: To determine if there is seasonal variation in diagnosis of oesophageal eosinophilia and EoE in the USA, while accounting for factors such as climate zone and geographic variation.

Methods: This was a cross-sectional study using a USA national pathology database.

Helicobacter infections with rare bacteria or minimal gastritis: Expecting the unexpected.

Background: The routine use of special stains for detection of Helicobacter remains controversial.

Aims: To determine the frequency of histologically atypical Helicobacter infection.

Methods: All gastric biopsies received at a large pathology reference laboratory over a 6-month period were stained for Helicobacter, and the histologic and clinicopathologic parameters evaluated.

Diagnosis of Gleason pattern 5 prostate adenocarcinoma on core needle biopsy: an interobserver reproducibility study among urologic pathologists.

Accurate recognition of Gleason pattern 5 (GP5) prostate adenocarcinoma on needle biopsy is critical as it is associated with disease progression and adverse clinical outcome. Despite important implications of this diagnosis, interobserver variation in the diagnosis of GP5 has not been adequately studied. Digital images of 66 prostate adenocarcinoma cases that potentially contained a GP5 component were distributed to 16 urologic pathologists who were asked to classify whether GP5 was present.

Heterogeneity of PTEN and ERG expression in prostate cancer on core needle biopsies: implications for cancer risk stratification and biomarker sampling.

ERG and PTEN biomarkers are increasingly being analyzed on prostate core biopsies (NBXs); ERG as a marker of clonality and number of separately arising tumor foci and PTEN for prognostic information. Yet, in patients with multiple biopsy cores positive for cancer (PCa), there is no standardized approach for interrogation of these biomarkers in terms of the number of positive cores to evaluate. A total of 194 NBX cases containing more than one positive core with cancer were evaluated for ERG overexpression and PTEN loss by immunostaining (immunohistochemistry) of all positive cores.

High Prevalence of Gastric Preneoplastic Lesions in East Asians and Hispanics in the USA.

Background: The prevalence of H. pylori infection and the incidence of gastric cancer differ widely around the world, but it is unclear whether these differences are mirrored in the multiethnic population of the USA.

Aims: This study tested the hypothesis that the prevalence of both H.

Anatomic distribution of sessile serrated adenoma/polyp with and without cytologic dysplasia.

Context: Sessile serrated adenomas/polyps (SSA/Ps) have been increasingly studied during the last 10 years. However, their detailed anatomic distribution pattern has not been studied, especially given newer (broader) criteria for the diagnosis.

Objectives: To characterize the anatomic distribution of SSA/P with and without cytologic dysplasia and to assess the demographics of these patients in a nationwide database.

Characteristics of the gastric mucosa in patients with intestinal metaplasia.

Gastric intestinal metaplasia (IM) occurs in response to different injuries, some of which involve increased risk for gastric cancer, whereas others may not. The background in which IM arises has not been systematically investigated. This study was designed to determine the relative prevalence of the histopathologic conditions of the gastric mucosa associated with IM in a large cohort.

Helicobacter-negative gastritis: a distinct entity unrelated to Helicobacter pylori infection.

Background: Helicobacter-negative gastritis is diagnosed when no organisms are detected in a gastric mucosa with typical features of Helicobacter gastritis (Hp-gastritis). If Helicobacter-negative gastritis consisted mostly of 'missed' Helicobacter infections, its prevalence should represent a constant percentage of these infections in a population, and their clinico-epidemiological features would overlap.

Aim: To compare the epidemiologic patterns of Hp-positive and Hp-negative gastritis.

Adenocarcinoma of the prostate with Gleason pattern 5 on core biopsy: frequency of diagnosis, morphologic subpatterns, and relation to pattern distribution based on the modified Gleason grading system.

Accurate recognition of Gleason pattern 5 (GP5) prostate adenocarcinoma (PCa) on core biopsy (NBX) is critical because it is associated with disease progression and the worst clinical outcome. We evaluated 1557 consecutive and prospectively collected NBXs to determine the frequency of diagnosis, morphologic subpatterns, and their relation to the amount and pattern distribution of GP5 PCa based on the 2005 modified Gleason grading system. Tertiary GP5 was upgraded to a secondary pattern to derive the final Gleason score.

Significance of the epithelioid granuloma in biopsies of Crohn's colitis.

Background: The relevance of granulomas in biopsy specimens from patients with Crohn's disease is largely unknown. Most previous studies have been performed on small samples and have produced conflicting results. This study was designed to compare the demographic, clinical, and histopathologic characteristics of a large cohort of documented patients with Crohn's disease with and without epithelioid granulomas.

High prevalence of inflammatory bowel disease in United States residents of Indian ancestry.

Background & Aims: It is unclear whether the reported low prevalence of inflammatory bowel disease (IBD) in Southern and Eastern Asia is real (caused by genetic or environmental factors) or spurious (because of differences in awareness of the condition among physicians or different interpretations of endoscopic and histologic features). We aimed to estimate the prevalence of IBD in patients of different ethnicities who underwent endoscopy in the United States, with ileocolonic biopsies evaluated by a single group of gastrointestinal pathologists.

Methods: We used a national pathology database to collect data on 1,027,977 subjects who underwent colonoscopy with ileocolonic biopsies from January 2008 through December 2013 throughout the United States; mucosal biopsy specimens were evaluated and reported by 1 group of 35 histopathologists.

Esophageal eosinophilia is increased in rural areas with low population density: results from a national pathology database.

Objectives: Eosinophilic esophagitis (EoE) is an increasingly prevalent chronic disease arising from an allergy/immune-mediated process. Generally, the risk of atopic disease differs in rural and urban environments. The relationship between population density and EoE is unknown.

Big data in gastroenterology research.

In epidemiological research, large datasets are essential to reliably capture small variations among comparative groups or detect new unsuspected associations. Although large databases of web-search information, social media, airline traffic and telephone records are already widely used to capture social trends, large databases in medical research are just emerging. With the universal use of electronic medical records underway, vast amounts of health-related information will become available for biomedical research.