The Spectrum of Cervical Glandular Neoplasia and Issues in Differential Diagnosis

2014 ◽  
Vol 138 (4) ◽  
pp. 453-483 ◽  
Author(s):  
Joana Loureiro ◽  
Esther Oliva
Keyword(s):  
Differential Diagnosis ◽  
Endometrial Carcinoma ◽  
Invasive Carcinoma ◽  
Correct Interpretation ◽  
Immunohistochemical Markers ◽  
Clinical Consequences ◽  
Wrong Diagnosis ◽  
Endometrioid Endometrial Carcinoma ◽  
Usual Pattern

Context.—Premalignant and malignant glandular lesions of the cervix are known to often cause diagnostic problems with a variety of benign (more common) as well as other malignant mimics, the latter setting often being represented by secondary involvement by endometrioid endometrial carcinoma especially in small samplings. Objective.—To highlight key histologic features and immunohistochemical markers that may be helpful in the distinction of in situ endocervical carcinoma from benign glandular proliferations, and those that separate different subtypes of invasive endocervical carcinoma, as well as invasive carcinoma from other carcinomas secondarily involving the cervix and nonneoplastic proliferations of the cervix. Conclusions.—Clinical and morphologic features as well as immunohistochemistry results should be used in conjunction in the differential diagnosis of glandular proliferations of the cervix, as correct interpretation has major clinical consequences for the patient in most instances (especially benign versus malignant). Immunohistochemical markers should be used as part of a panel of antibodies, as exceptions may occur to the usual pattern of staining, and if used singly, they may mislead the pathologist to establish a wrong diagnosis.

Small Glandular Proliferations of the Breast With Absent or Attenuated Myoepithelial Reactivity by Immunohistochemistry: A Review Focusing on the Differential Diagnosis and Interpretative Pitfalls

2016 ◽  
Vol 140 (7) ◽  
pp. 651-664
Author(s):  
Paula S. Ginter ◽  
Sandra J. Shin ◽  
Timothy M. D'Alfonso
Keyword(s):  
Differential Diagnosis ◽  
Immunohistochemical Staining ◽  
Clinical Case ◽  
Invasive Carcinoma ◽  
Data Sources ◽  
Benign Lesions ◽  
Immunohistochemical Markers ◽  
Malignant Lesions ◽  
Histopathologic Features ◽  
Rule Out

Context.—Small glandular proliferations of the breast encompass a variety of benign, atypical, and malignant lesions that show some overlapping morphologic features. Myoepithelial stains are frequently used in the workup of these lesions in order to rule out or establish a diagnosis of invasive carcinoma. Some benign lesions show absent or diminished myoepithelial staining, and may represent an interpretative pitfall, particularly in small core biopsy samples. Objective.—To review small glandular proliferations of the breast that show absent or diminished staining with myoepithelial immunohistochemical markers. Data Sources.—The study comprised a review of published literature and clinical case material. Conclusions.—The interpretation of myoepithelial stains in small glandular proliferations of the breast can, on some occasions, represent a challenge in diagnosing these lesions. Recognition of the key histopathologic features and immunohistochemical staining patterns of the entities in the differential diagnosis is crucial in their workup.

Conjunctival squamous intraepithelial neoplasia and its differential diagnosis

2021 ◽  
pp. jclinpath-2020-207302
Author(s):  
Alexander Reese ◽  
Curtis Edward Margo
Keyword(s):  
Squamous Cell Carcinoma ◽  
Differential Diagnosis ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Invasive Carcinoma ◽  
Intraepithelial Neoplasia ◽  
Sebaceous Carcinoma ◽  
Pseudoepitheliomatous Hyperplasia ◽  
Squamous Intraepithelial Neoplasia

Conjunctival squamous intraepithelial neoplasia (CSIN) represents the in situ precursor of squamous cell carcinoma. The graded severity of intraepithelial dysplasia is considered a measure of risk for progression to invasive carcinoma. The range of cytoarchitectural changes in CSIN overlaps those of reactive atypia, squamous epithelial papilloma and in situ sebaceous carcinoma. Pseudoepitheliomatous hyperplasia and benign hereditary dyskeratosis of the conjunctiva are conditions without risk of neoplastic transform that are potentially mistaken for CSIN.

scholarly journals Atypical Apocrine Adenosis: Diagnostic Challenges and Pitfalls

2016 ◽  
Vol 140 (10) ◽  
pp. 1045-1051 ◽  
Author(s):  
Jaya Ruth Asirvatham ◽  
Maria Monica Garcia Falcone ◽  
Celina G. Kleer
Keyword(s):  
Ductal Carcinoma In Situ ◽  
Clinical Management ◽  
Carcinoma In Situ ◽  
Invasive Carcinoma ◽  
Ductal Carcinoma ◽  
Common Finding ◽  
Immunohistochemical Markers ◽  
Sclerosing Adenosis ◽  
Nuclear Enlargement

Apocrine change in the breast is an extremely common finding. In most cases, the benign or malignant nature of the lesion is easily recognized. Apocrine adenosis is used to describe sclerosing adenosis with apocrine change. The term apocrine atypia is used when there is significant cytologic atypia in apocrine cells, characterized by a 3-fold nuclear enlargement, prominent/multiple nucleoli, and hyperchromasia. Atypical apocrine adenosis is diagnosed when apocrine adenosis and apocrine atypia are superimposed. However, there are no definite criteria to distinguish atypical apocrine adenosis from apocrine ductal carcinoma in situ. Immunohistochemical markers can be confounding and may lead to erroneous diagnoses. Atypical apocrine features in sclerosing lesions may be misinterpreted as invasive carcinoma if the underlying lesion is not recognized. In the absence of definite features of malignancy, the diagnosis of apocrine ductal carcinoma in situ may be extremely difficult. In the present article, we review atypical apocrine adenosis focusing on diagnostic challenges and their implications on clinical management.

Quality Assurance in Breast Pathology: Lessons Learned From a Review of Amended Reports

2016 ◽  
Vol 141 (2) ◽  
pp. 260-266 ◽  
Author(s):  
Beth T. Harrison ◽  
Deborah A. Dillon ◽  
Andrea L. Richardson ◽  
Jane E. Brock ◽  
Anthony J. Guidi ◽  
...  
Keyword(s):  
Ductal Carcinoma In Situ ◽  
Carcinoma In Situ ◽  
Invasive Carcinoma ◽  
Ductal Carcinoma ◽  
Academic Medical Center ◽  
Breast Pathology ◽  
Ductal Hyperplasia ◽  
Clinical Consequences ◽  
Pathology Reports

Context.—A review of amended pathology reports provides valuable information regarding defects in the surgical pathology process. Objective.—To review amended breast pathology reports with emphasis placed on interpretative errors and their mechanisms of detection. Design.—All amended pathology reports for breast surgical specimens for a 5-year period at a large academic medical center were retrospectively identified and classified based on an established taxonomy. Results.—Of 12 228 breast pathology reports, 122 amended reports were identified. Most (88 cases; 72%) amendments were due to noninterpretative errors, including 58 report defects, 12 misidentifications, and 3 specimen defects. A few (34 cases; 27.9%) were classified as misinterpretations, including 14 major diagnostic changes (11.5% of all amendments). Among major changes, there were cases of missed microinvasion or small foci of invasion, missed micrometastasis, atypical ductal hyperplasia overcalled as ductal carcinoma in situ, ductal carcinoma in situ involving sclerosing adenosis mistaken for invasive carcinoma, lymphoma mistaken for invasive carcinoma, and amyloidosis misdiagnosed as fat necrosis. Nine major changes were detected at interpretation of receptor studies and were not associated with clinical consequences. Three cases were associated with clinical consequences, and of note, the same pathologist interpreted the corresponding receptor studies. Conclusions.—Review of amended reports was a useful method for identifying error frequencies, types, and methods of detection. Any time that a case is revisited for ancillary studies or other reasons, it is an opportunity for the surgical pathologist to reconsider one's own or another's diagnosis.

Thirty Year Old Female Presented with Nipple Destruction: A Case Report

2019 ◽  
Vol 11 (1) ◽  
pp. 81-83
Author(s):  
Md Mustafizur Rahman ◽  
Nadim Ahmed ◽  
Sami Ahmad ◽  
Shoaeb Imtiaz Alam ◽  
Mohammad Rashedul Hassan ◽  
...  
Keyword(s):  
Invasive Carcinoma ◽  
Paget’S Disease ◽  
Radical Mastectomy ◽  
Paget's Disease ◽  
College Hospital ◽  
Rare Type ◽  
Medical College ◽  
Ductal Cell ◽  
Areola Complex

Paget’s disease of the breast is a rare type of cancer of the nipple–areola complex and that is often associated with an underlying in situ or invasive carcinoma. It is often misdiagnosed as eczema of breast and treatment is delayed. Here we present a case where a 30 year old female presented with itching ulceration and destruction of her left nipple. She was treated initially by local physicians by applying local ointments but as her condition did not improve she was admitted to department of surgery Shaheed Suhrawardy Medical College hospital where she was diagnosed as Paget’s disease with infiltrating ductal cell carcinoma. She underwent modified radical mastectomy with axillary clearance and referred to oncology department for further management. J Shaheed Suhrawardy Med Coll, June 2019, Vol.11(1); 81-83

scholarly journals Jacobsen syndrome and neonatal bleeding: report on two unrelated patients

2021 ◽  
Vol 47 (1) ◽  
Author(s):  
Gregorio Serra ◽  
Luigi Memo ◽  
Vincenzo Antona ◽  
Giovanni Corsello ◽  
Valentina Favero ◽  
...  
Keyword(s):  
Developmental Delay ◽  
De Novo ◽  
Comparative Genomic ◽  
Fish Analysis ◽  
Variable Degree ◽  
Jacobsen Syndrome ◽  
Contiguous Gene ◽  
Clinical Consequences ◽  
11Q Deletion

Abstract Introduction In 1973, Petrea Jacobsen described the first patient showing dysmorphic features, developmental delay and congenital heart disease (atrial and ventricular septal defect) associated to a 11q deletion, inherited from the father. Since then, more than 200 patients have been reported, and the chromosomal critical region responsible for this contiguous gene disorder has been identified. Patients’ presentation We report on two unrelated newborns observed in Italy affected by Jacobsen syndrome (JBS, also known as 11q23 deletion). Both patients presented prenatal and postnatal bleeding, growth and developmental delay, craniofacial dysmorphisms, multiple congenital anomalies, and pancytopenia of variable degree. Array comparative genomic hybridization (aCGH) identified a terminal deletion at 11q24.1-q25 of 12.5 Mb and 11 Mb, in Patient 1 and 2, respectively. Fluorescent in situ hybridization (FISH) analysis of the parents documented a de novo origin of the deletion for Patient 1; parents of Patient 2 refused further genetic investigations. Conclusions Present newborns show the full phenotype of JBS including thrombocytopenia, according to their wide 11q deletion size. Bleeding was particularly severe in one of them, leading to a cerebral hemorrhage. Our report highlights the relevance of early diagnosis, genetic counselling and careful management and follow-up of JBS patients, which may avoid severe clinical consequences and lower the mortality risk. It may provide further insights and a better characterization of JBS, suggesting new elements of the genotype-phenotype correlations.

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