Comment to: “Diagnostic Benefit of the Detection of Mitotic Figures in Endometriotic Lesions”

A 36 year old man presented with a mass in the chest and multiple “hot” focal lesions were identified on bone scan. Fine needle aspiration was performed of the chest mass. Routine histology showed the presence of some bundles of dense fibrous tissue and a diffuse infiltration of mononuclear cells, which varied in size and nucleo-cytoplasmic ratio. The smaller cells had eccentric hyperchromatic nuclei. Nucleoli were noted in the larger cells. There was well marked cytoplasmic vacuolation of some of the cells. Mitosis was present. A small fragment of tissue was received for electron microscopy. Examination of 1 μm sections showed trabeculae of medium-large polygonal cells with eccentric nuclei and occasional nucleoli. Some irregularly shaped cells had well marked cytoplasmic vacuolation. Mitotic figures were present.

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The structure of the gills of the axolotl, Ambystoma mexicanum

Proceedings, annual meeting, Electron Microscopy Society of America ◽

10.1017/s0424820100128407 ◽

1987 ◽

Vol 45 ◽

pp. 824-825

Author(s):

Mohinder S. Jarial

Keyword(s):

Leydig Cells ◽

Secretory Granules ◽

Light And Electron Microscopy ◽

Cell Types ◽

Ambystoma Mexicanum ◽

Basal Cells ◽

Granular Cells ◽

Gill Filaments ◽

Mitotic Figures ◽

Apical Membranes

The axolotl is a strictly aquatic salamander in which the larval external gills are retained throughout life. The external gills of the adult axolotl have been studied by light and electron microscopy for ultrastructural evidence of ionic transport. The thin epidermis of the gill filaments and gill stems is composed of 3 cell types: granular cells, the basal cells and a sparce population of intervening Leydig cells. The gill epidermis is devoid of muscles, and no mitotic figures were observed in any of its cells.The granular cells cover the gill surface as a continuous layer (Fig. 1, G) and contain secretory granules of different forms, located apically (Figs.1, 2, SG). Some granules are found intimately associated with the apical membrane while others fuse with it and release their contents onto the external surface (Fig. 3). The apical membranes of the granular cells exhibit microvilli which are covered by a PAS+ fuzzy coat, termed “glycocalyx” (Fig. 2, MV).

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DNA Testing Proves of Diagnostic Benefit in Genodermatoses

Family Practice News ◽

10.1016/s0300-7073(05)71322-0 ◽

2005 ◽

Vol 35 (3) ◽

pp. 40

Author(s):

BETSY BATES

Keyword(s):

Dna Testing ◽

Diagnostic Benefit

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[18F]Fluoride PET Indicates Reduced Bone Formation in Severe Glucocorticoid-induced Osteoporosis

Nuklearmedizin ◽

10.1055/s-0038-1629797 ◽

1998 ◽

Vol 37 (02) ◽

pp. 76-79 ◽

Cited By ~ 8

Author(s):

T. D. Kirchhoff ◽

W. Burchert ◽

J. v. d. Hoff ◽

H. Zeidler ◽

H. Hundeshagen ◽

...

Keyword(s):

Bone Formation ◽

Multiple Organ ◽

High Dose ◽

Multiple Fractures ◽

Glucocorticoid Treatment ◽

Organ Manifestations ◽

Diagnostic Benefit ◽

Sharp Syndrome ◽

18F Fluoride

SummaryA 61-year-old female patient presenting with mixed connective tissue disease (Sharp syndrome), underwent a long-term high dose glucocorticoid treatment because of multiple organ manifestations. Under steroid therapy she developed severe osteoporosis resulting in multiple fractures. A dynamic [18F]fluoride PET study in this patient revealed reduced fluoride influx in non-fractured vertebrae. This finding corresponds to pathogenetic concepts which propose an inhibition of bone formation as major cause of glucocorticoid-induced osteoporosis. In the light of the presented case it seems to be promising to evaluate the diagnostic benefit of [18F]fluoride PET in osteoporosis.

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Faculty Opinions recommendation of Variability in mitotic figures in serial sections of thin melanomas.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.718882643.793501298 ◽

2014 ◽

Author(s):

Gerardo Ferrara

Keyword(s):

Serial Sections ◽

Mitotic Figures

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Superficially Spreading Endocervical Adenocarcinoma in situ with Multifocal Microscopic Involvement of the Endometrial Surface: A Case Report with Emphasis on the Potential for Misdiagnosis Based on Endometrial Curettage Specimens

Case Reports in Oncology ◽

10.1159/000511568 ◽

2020 ◽

Vol 13 (3) ◽

pp. 1530-1536

Author(s):

Inwoo Hwang ◽

Jiyeon Lee ◽

Kyue-Hee Choi ◽

Jiheun Han ◽

Hyun-Soo Kim

Keyword(s):

Final Diagnosis ◽

Accurate Diagnosis ◽

Surface Epithelium ◽

Apoptotic Bodies ◽

Small Tumor ◽

Histological Features ◽

Endocervical Adenocarcinoma ◽

Tumor Tissues ◽

Mitotic Figures

Misdiagnosis of endocervical adenocarcinoma (EAC) as endometrial endometrioid carcinoma (EEC) is one of the major concerns when evaluating endometrial curettage specimens. It is difficult to differentiate EAC involving the endometrium from EEC, particularly when the specimens have only a few small tumor fragments. We report a case of endocervical adenocarcinoma in situ (AIS) with multifocal microscopic involvement of the endometrium. The endometrial curettage specimen obtained from an 82-year-old woman consisted of a large volume of blood and fibrin, with small endometrial tissue fragments showing microscopic foci of atypical glandular proliferation. Based on the presence of complex glands with stratified mucin-poor columnar epithelium and intermediate-grade nuclear atypia, a preoperative diagnosis of grade 1 EEC was made. However, the hysterectomy specimen revealed an endocervical AIS involving the endocervix and low uterine segment. Frequent mitotic figures and apoptotic bodies, characteristic of AIS, were present. The endometrium showed a few microscopic foci of atypical glandular proliferation involving the surface only. Their histological features were similar to those of the endocervical AIS. Immunohistochemically, the atypical glands exhibited block p16 positivity. The final diagnosis was a superficially spreading endocervical AIS with multifocal microscopic involvement of the endometrial surface epithelium. In summary, small tumor tissues in an endometrial curettage may lead to misdiagnosis of AIS or EAC as EEC, especially when the pathologists are unaware of the possibility of microscopic endometrial involvement of AIS or EAC. The origin of the tumor can be correctly determined based on a combination of histological features and immunostaining. Endocervical AIS involving the endometrium should be included in the differential diagnosis of neoplastic glandular lesions in endometrial curettage specimens. An accurate diagnosis in these cases is important because of its significant implications for clinical management.

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PATH-17. NOVEL DUAL HISTONE 3 K27M AND G34R POINT MUTATIONS IN A MIDLINE GLIOMA

Neuro-Oncology ◽

10.1093/neuonc/noaa215.699 ◽

2020 ◽

Vol 22 (Supplement_2) ◽

pp. ii167-ii167

Author(s):

Peter Pan ◽

Tejus Bale ◽

Alexandra Miller ◽

Marc Ladanyi ◽

Marc Rosenblum ◽

...

Keyword(s):

Point Mutations ◽

Histone 3 ◽

First Case ◽

Microvascular Proliferation ◽

Motor Neuron Facial Nerve ◽

Methylguanine Methyltransferase ◽

Mitotic Figures ◽

In Cis ◽

Generation Sequencing ◽

Diffuse Midline Glioma

Abstract BACKGROUND Histone H3 alterations due to mutations on H3F3A and HIST1H3B genes, have in recent years been associated with distinct entities and tumor locations within the context of infiltrative gliomas. H3K27M is associated with a midline location and is included in the WHO 2016 as the diffuse midline glioma H3K27M-mutant, a specific diagnostic entity. H3G34R, thought to be a mutually exclusive alteration, is less common but has been associated with a cerebral hemispheric location. We report the first case to our knowledge with both of these alterations in the same tumor. METHODS Clinical and pathologic records of the patient were reviewed and presented. RESULTS A 39-year-old man presented with acute right face, arm, and leg numbness and mild weakness; examination was notable for right lower motor neuron facial nerve palsy and numbness, along with numbness and subtle slowing of rapid alternating movements in the left arm and leg. A non-enhancing left thalamic mass was identified and stereotactically biopsied. Infiltrative glial neoplasm with moderately-increased cellularity was seen, with ovoid cells, enlarged nuclei, apoptotic bodies, and mitotic figures. No necrosis or microvascular proliferation seen. Immunostain was positive for H3K27M. O6-methylguanine-methyltransferase (MGMT) promoter was not methylated. Next-generation sequencing showed dual in cis H3 point mutations in K27M (HIST1H3B c.83A >T) and G34R (HIST1H3B c.103G >C). Additional alterations were noted in NF1, PIK3CA, ATRX, FGFR3, and NSD1. Isocitrate dehydrogenase (IDH1/2) mutations were not identified. CONCLUSION This case of a young man with a midline glioma is novel for carrying both H3K27M and H3G34R alterations and indicates these alterations are not mutually exclusive. The interaction seen here suggests H3K27M dominance for a midline phenotype.

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Gastrointestinal Stromal Tumor of the Ampulla of Vater: A Narrative Review

Gastrointestinal Tumors ◽

10.1159/000514613 ◽

2021 ◽

pp. 1-6

Author(s):

Bita Geramizadeh ◽

Alireza Shojazadeh

Keyword(s):

Gastrointestinal Stromal Tumor ◽

Spindle Cell ◽

English Literature ◽

Ampulla Of Vater ◽

Good Prognosis ◽

Stromal Tumor ◽

Treatment Modalities ◽

Histologic Diagnosis ◽

Lower Gi Bleeding ◽

Mitotic Figures

Background: Gastrointestinal stromal tumor (GIST) of the ampulla of Vater is a rare occurrence. To the best of our knowledge, there has been no published review on this rare tumor in the English literature so far. Summary: In this review, we will discuss all the reported details of the published cases, including demography, clinical presentation, imaging, gross pathology and histopathology, immunohistochemical findings, treatment modalities, and outcome of cases with the diagnosis GIST from the ampulla of Vater in the last 20 years. Key Message: Twenty-five cases of GIST in the ampulla of Vater have been reported in the last 20 years in the English literature. GIST in the ampulla of Vater are usually small tumors (<5 cm) in middle-age patients. The majority of the patients present with lower GI bleeding and abdominal pain. Imaging findings are not characteristic, and most of the patients without biopsy and with no histologic diagnosis were operated with the primary impression of adenocarcinoma, neuroendocrine tumor, and GIST. Perioperative tissue biopsy has been accurate in <70% of the cases. The majority of the reported cases of GISTs in the ampulla of Vater have been low risk with spindle-cell morphology, low mitotic figures, and minimal atypia; reactive for C-KIT and DOG-1; and nonreactive for SMA, desmin, and S100. In the majority of the cases, duodenectomy with or without Whipple’s operation has been performed, and most of the cases showed good prognosis.

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Ectopic Expression of Inhibitors of Protein Phosphatase Type 1 (PP1) Can Be Used to Analyze Roles of PP1 in Drosophila Development

Genetics ◽

10.1093/genetics/164.1.235 ◽

2003 ◽

Vol 164 (1) ◽

pp. 235-245

Author(s):

Daimark Bennett ◽

Balázs Szöőr ◽

Sascha Gross ◽

Natalia Vereshchagina ◽

Luke Alphey

Keyword(s):

Protein Phosphatase ◽

Muscle Development ◽

Ectopic Expression ◽

High Specificity ◽

Type I ◽

Protein Phosphatase Type 1 ◽

Mitotic Figures ◽

Protein Phosphatase Type

Abstract We have identified two proteins that bind with high specificity to type 1 serine/threonine protein phosphatase (PP1) and have exploited their inhibitory properties to develop an efficient and flexible strategy for conditional inactivation of PP1 in vivo. We show that modest overexpression of Drosophila homologs of I-2 and NIPP1 (I-2Dm and NIPP1Dm) reduces the level of PP1 activity and phenotypically resembles known PP1 mutants. These phenotypes, which include lethality, abnormal mitotic figures, and defects in muscle development, are suppressed by coexpression of PP1, indicating that the effect is due specifically to loss of PP1 activity. Reactivation of I-2Dm:PP1c complexes suggests that inhibition of PP1 activity in vivo does not result in a compensating increase in synthesis of active PP1. PP1 mutants enhance the wing overgrowth phenotype caused by ectopic expression of the type II TGFβ superfamily signaling receptor Punt. Using I-2Dm, which has a less severe effect than NIPP1Dm, we show that lowering the level of PP1 activity specifically in cells overexpressing Punt is sufficient for wing overgrowth and that the interaction between PP1 and Punt requires the type I receptor Thick-veins (Tkv) but is not strongly sensitive to the level of the ligand, Decapentaplegic (Dpp), nor to that of the other type I receptors. This is consistent with a role for PP1 in antagonizing Punt by preventing phosphorylation of Tkv. These studies demonstrate that inhibitors of PP1 can be used in a tissue- and developmental-specific manner to examine the developmental roles of PP1.

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Consultation between forensic and clinical pathologists for histopathology examination after forensic autopsy

Medicine Science and the Law ◽

10.1177/0025802420965763 ◽

2021 ◽

Vol 61 (1_suppl) ◽

pp. 25-35

Author(s):

Vito Cirielli ◽

Federica Bortolotti ◽

Luca Cima ◽

Zeno De Battisti ◽

Giovanna Del Balzo ◽

...

Keyword(s):

Bone Marrow ◽

Cause Of Death ◽

Molecular Analysis ◽

Real World ◽

Routine Practice ◽

Working Relationships ◽

Post Mortem ◽

Macroscopic Findings ◽

Diagnostic Benefit ◽

Histopathology Examination

The magnitude of the diagnostic benefit conferred by performing histopathological examinations after medico-legal/forensic autopsies remains debatable. We have tried to address this issue by reviewing a series of histopathology referrals concerning medico-legal autopsies in real-world routine practice. We present an audit of the consultations provided to forensics by clinical pathologists at our institute between 2015 and 2018. Over this period, 493 post-mortem examinations were performed by forensic pathologists. Of these cases, 52 (11%) were referred for histopathology. Gross assessment was requested in 22/52 (42%) cases. Histopathology examination was performed on single organs in 15/52 (29%) cases, primarily on the lung and heart, whereas parenchymatous multi-organ analysis was carried out in 14/52 (27%) cases. Bone-marrow sampling was studied in 4/52 (8%) cases. Immunohistochemistry was needed in 16/52 (31%) cases, special stains in 9/52 (21%) cases and molecular analysis in 4/52 (8%) cases. Focusing on technical processes, standard methodology on pre-analytical procedures was changed in 10/52 (19%) cases in order to answer specific diagnostic questions. We showed that although most of the time the diagnosis is clear by the end of dissection on the basis of the macroscopic findings, histopathology can provide, modify or confirm the cause of death in many medico-legal/forensic cases. Therefore, it is desirable that forensic pathologists and clinical pathologists establish robust working relationships in a cooperative environment. We conclude that it is important to implement guidelines based on real-world routine practice in order to identify cases where histopathology can provide useful contributions, which in our experience applied to 11% of forensic cases.

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