12 October 2020: Textbook Updates

We have posted updates of the following topics:

Gallbladder & extrahepatic bile ducts > Gallbladder benign > Intracholecystic papillary neoplasm
by Gokce Askan, M.D., Olca Basturk, M.D.
Topic summary: Intracholecystic papillary neoplasm (ICPN) is a grossly visible, mass forming, noninvasive epithelial neoplasm arising in the mucosa and projecting into the lumen of the gallbladder. Microscopically reveals papillary, tubular or tubulopapillary growth patterns. More common in the fundus and body of the gallbladder. ICPN associated invasive carcinomas are relatively indolent neoplasms with significantly better prognosis compared with conventional (pancreatobiliary type) gallbladder carcinomas. Treated primarily by surgical resection.

Kidney nontumor > Glomerular diseasenontumor > Diabetic renal diseasenontumor > Diabetic kidney disease
by Khaled A. Murshed, M.D., Noheir M. Taha, M.B.B.Ch., M.D., Mohammed Akhtar, M.D.
Topic summary: Morphologic structural change in the kidney induced by longstanding hyperglycemia manifested as relentless matrix expansion. Characterized by mesangial matrix expansion and diffuse thickening of glomerular, tubular and Bowman capsule basement membranes. Highly susceptible ethnic groups: African Americans, Native Americans and Hispanics. Diagnosis is usually established on kidney biopsy. Strict glycemic control is the mainstay of therapy for both type 1 and type 2 diabetes mellitus.

Lymphoma & related disorders > Mature T/NK cell disorders > Aggressive NK/T cell disorders > Extranodal NK / T cell lymphoma, nasal type
by Mario L. Marques-Piubelli, M.D., Carlos A. Torres-Cabala, M.D., Roberto N. Miranda, M.D.
Topic summary: Aggressive and predominantly extranodal lymphoma of NK / T cell origin characterized by angiotropism and angiodestruction, necrosis and association with Epstein-Barr virus (EBV). Rare: 0.2% of all non-Hodgkin lymphomas and 1 – 2% of all NK / T cell lymphomas. Mainly nasal presentation (65 – 85%) in nasopharynx, paranasal sinuses and orbit, regardless of the dissemination to other sites. Diagnosis is commonly difficult, particularly when atypia is not readily apparent or when only limited viable cells are identified. Treatment includes chemotherapy, radiation therapy and autologous and allogeneic HSCT.

Lymphoma & related disorders > Extranodal organ specific lymphoma > Primary CNS lymphoma
by Lena Young, D.O., Elizabeth Courville, M.D.
Topic summary: Rare aggressive large B cell lymphoma occurring predominantly in elderly individuals, with an overall poorer prognosis than systemic diffuse large B cell lymphoma. Occurs first in the brain, eye, spinal cord or leptomeninges, without systemic involvement and not arising in the setting of immunodeficiency. Accounts for < 1% of all non-Hodgkin lymphoma cases and 2 – 3% of all CNS tumors. Majority involve the supratentorial space, with the posterior fossa and spinal cord less frequently involved. High dose methotrexate based regimen is the first line induction therapy.

Soft tissue > Uncertain differentiation > Extrarenal rhabdoid tumor
by Qurratulain Chundriger, M.B.B.S., Nasir Ud Din, M.B.B.S.
Topic summary: Heterogeneous group of neoplasms unified by the presence of globular cytoplasmic inclusions, vesicular nuclei with prominent nucleoli and aggressive behavior. Abundant eosinophilic cytoplasm (due to hyaline globular inclusions of intermediate filaments) with eccentric vesicular nuclei and prominent nucleoli. Genuine rhabdoid tumors exclusively belong to the pediatric age group and are very rare. No definite chemotherapy regimen is available; some cases report successful therapy using alkaloids, platinum agents and combinations of chemotherapy, surgery and radiation.