25 August 2022: Textbook Updates

We have posted updates of the following topics:

Bladder, ureter & renal pelvis > Urothelial carcinoma – invasive > Micropapillary
by Timothy Isaac Miller, M.D., M.A., Maria Tretiakova, M.D., Ph.D.
Topic summary: Aggressive histologic subtype of urothelial carcinoma (UC) comprised of small papillary clusters of neoplastic cells within lacunae and without fibrovascular cores. If micropapillary urothelial carcinoma (MPUC) is seen on biopsy, it is highly associated with muscularis propria invasive disease. Some studies independently suggest a poorer prognosis than CUC; however, other studies show that this is likely because it is diagnosed at advanced stage, when controlling for pathologic stage, patients have similar outcomes. Early radial cystectomy (RC) may improve survival.

Cervix > Inflammatory / infectious > Trichomonas vaginalis
by Soumya Jaladi, M.B.B.S., Ziyan T. Salih, M.D.
Topic summary: Trichomonas vaginalis is a primitive eukaryotic organism, a parasitic protozoan that causes trichomoniasis, which is a sexually transmitted disease. Trichomoniasis is the most prevalent nonviral sexually transmitted infection in the United States, affecting an estimated 3.7 million persons. Mainly affects women from ages 16 – 35 years but can occur in postmenopausal women. People with trichomoniasis can pass the infection to others, even if they do not have symptoms. Patients and their sexual partners are treated with metronidazole or tinidazole.

Lung > Preinvasive > Atypical adenomatous hyperplasia
by Sherman Lin, Matthew J. Cecchini, M.D., Ph.D.
Topic summary: Atypical adenomatous hyperplasia (AAH) is a small, localized proliferation of atypical pneumocytes (usually ≤ 5 mm) that line intact alveolar spaces. Discrete from alveolar parenchyma with proliferation of atypical pneumocytes. Commonly seen in lung resections as an incidental finding; in some series, AAH has been reported in ≤ 30.2% of female patients undergoing a resection for adenocarcinoma. CT surveillance; frequency and duration dependent on size of nodule. Patients are cured upon resection.

Oral cavity & oropharynx > Soft tissue tumors & proliferations > Ectomesenchymal chondromyxoid tumor
by Molly Housley Smith, D.M.D.
Topic summary: Rare, benign soft tissue tumor with striking predilection for the anterior dorsal tongue. Fewer than 120 well documented cases have been reported. Histopathologically demonstrates a well defined, often multilobulated tumor with ovoid, round, fusiform or polygonal cells within a sometimes myxoid, chondromyxoid or mucoid background. Average age ~40 years. 5 cases (< 10% of reported cases with follow up information) are reported to have recurred. Treatment: conservative surgical excision is recommended.

Soft tissue > Adipose tissue tumors > Other benign lesions > Hibernoma
by Saba Anjum, M.B.B.S., Zoonish Ashfaq, M.B.B.S., Nasir Ud Din, M.B.B.S.
Topic summary: Rare, benign, adipocytic tumor composed of variable proportions of brown fat cells admixed with white adipose tissue. Benign tumor comprising multivacuolated eosinophilic granular fat cells with small, central normochromic nuclei. Usually present from 2 – 75 years. Prognosis is good with no significant potential for recurrence. Treatment: wide local excision with negative margins; for patients not fit for surgery, routine surveillance may be considered.

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