15 September 2022: Textbook Updates

We have posted updates of the following topics:

Fallopian tubes & broad ligament > General > WHO classification
by Gulisa Turashvili, M.D., Ph.D.
Topic summary: WHO classification of tumors of the female genital tract; currently on 5th edition, published in 2020. No major updates, mostly refined definitions. Most high grade serous carcinomas of the ovary arise at the fimbriated end of the fallopian tube from a precursor lesion known as serous tubal intraepithelial carcinoma (STIC). Undifferentiated carcinoma of the fallopian tube is no longer a separate category.

Kidney nontumor > Renal allograft > Recurrent and de novo diseases
by Arzu Sağlam, M.D.
Topic summary: Diseases that recur or develop de novo in the renal allograft. Most native kidney diseases can recur or develop de novo in the allograft, including cardiovascular diseases / hypertension, diabetes, metabolic diseases, infectious diseases, drug toxicities, perfusion problems and cancer, in addition to de novo / recurrent primary glomerular diseases. With improvement in treatment of rejection related complications, recurrent and de novo diseases have become a significant contributing factor to graft dysfunction. Recurrent glomerulonephritis is associated with increased risk of graft failure. Maintenance immunosuppression to prevent rejection generally alters disease course in immune mediated glomerulonephritis in comparison to native kidneys.

Lymphoma & related disorders > Mature T/NK cell disorders > Intestinal > Intestinal T cell lymphoma, NOS
by Busra Bacik Goksu, M.D., Carlos A. Murga-Zamalloa, M.D.
Topic summary: Primary intestinal T cell lymphomas (ITCL) are rare malignancies that account for < 10% of intestinal lymphomas. Intestinal T cell lymphoma, not otherwise specified is a rare and aggressive variant. Fewer than 10 cases have been reported. Computed tomography (CT) scans can be performed to show intestinal wall thickening; however, a biopsy is required for diagnosis.Survival ranges from weeks to < 2 years after diagnosis. Treatment similar to the systemic peripheral T cell lymphoma, NOS counterpart and includes induction with CHOP chemotherapy (cyclophosphamide, doxorubicin hydrochloride [hydroxydaunorubicin], vincristine sulfate [Oncovin] and prednisone).

Ovary > Metastases to ovary > Colorectal adenocarcinoma
by Adam Lechner, B.M., Carlos Parra-Herran, M.D.
Topic summary: Secondary ovarian involvement by colorectal cancer (CRC) is, by definition, evidence of advanced tumor stage (pM1). Mimic of primary ovarian endometrioid or mucinous adenocarcinoma. Rate of metastases to the ovary (OM) among all ovarian malignancies varies from 15 – 30%. Spread to the ovaries can be hematogenous, lymphatic, transperitoneal or by direct extension. Median survival of 25.5 months when ovary is sole site of metastasis. Given the high frequency of ovarian involvement by CRC and the high proportion of cases that are unsuspected before oophorectomy, preoperative investigation in a patient with an ovarian mass should include consideration for colonoscopy.

Placenta > Gestational trophoblastic disease > Neoplasms > Epithelioid trophoblastic tumor
by Rachelle Mendoza, M.D., Sonali Lanjewar, M.D., M.B.B.S., Raavi Gupta, M.D.
Topic summary: Epithelioid trophoblastic tumor (ETT) is a very rare gestational trophoblastic tumor derived from neoplastic chorionic type intermediate trophoblasts. Histologic features include nodular and expansile growth pattern of nests and cords of relatively uniform tumor cells with distinct cell borders, moderate eosinophilic to clear cytoplasm and associated extracellular eosinophilic, hyaline-like material. Usually occurs in women of 15 – 48 years of age (mean, 36.1 years). Vaginal bleeding or menometrorrhagia is the most common symptom but amenorrhea can also occur. Metastasis is seen in 25% of patients; survival rate of 87 – 90%. Surgical resection is the definitive treatment.

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s