We have posted updates of the following topics:
Breast > Other invasive carcinoma subtypes, WHO classified > Apocrine
by Jonathan Marotti, M.D.
Topic summary: Invasive breast carcinoma comprised of large cells with abundant eosinophilic and granular cytoplasm, enlarged nuclei and prominent nucleoli; apocrine morphology in > 90% of tumor cells. Estrogen receptor (ER) negative, progesterone receptor (PR) negative and androgen receptor (AR) positive. Mean age of diagnosis is typically older than invasive breast carcinoma, NST. Most carcinomas with apocrine differentiation are sporadic; some carcinomas in patients with germline
PTEN mutation (Cowden syndrome) display apocrine morphology. Prognosis is based on conventional factors such as grade, tumor size and nodal status. Treatment: surgical excision; chemotherapy and radiation are dependent on stage; neoadjuvant therapy may be considered.
Stains & CD markers > CD10
by Bradford Siegele, M.D., J.D.
Topic summary: Cell membrane zinc dependent metalloendopeptidase that is widely distributed in hematopoietic cells and hematopoietic neoplasms, normal kidney tissue and renal neoplasms, as well as a wide variety of additional tissues. Encoded by
MME gene. Critical for use in diagnosis and subclassification of leukemias (e.g., B lymphoblastic leukemia, mixed phenotype acute leukemia, etc.) and lymphomas (e.g., follicular lymphoma, Burkitt lymphoma, diffuse large B cell lymphoma, angioimmunoblastic T cell lymphoma). Bladder: present in 40 – 50% of urothelial carcinoma and squamous cell carcinoma, with CD10 expression strongly correlated with high tumor grade and stage. Stromal expression in invasive breast carcinoma, NST is associated with increased biologic aggressiveness and poor prognosis.
Colon > Infectious colitis > Shigella
by Pauline Shih, M.D., Nicole E. Putnam, Ph.D.
Topic summary: Infectious diarrhea and subsequent colitis caused by bacteria of the
Shigella genus.
Shigella are highly infective, virulent, invasive, gram negative rods causing watery diarrhea associated with fever and abdominal pain, which may progress to dysentery (severe diarrhea with blood or mucus in stool). Shigellosis is a leading cause of diarrheal death, with most deaths due to
Shigella infection occurring in south Asia and sub-Saharan Africa; infection occurs from ingestion of bacteria through fecal contamination of food or water and is linked to poor hygiene and sanitation, overcrowding and lack of access to clean water. Disease is more severe in children, elderly or immunocompromised. Disease may be self limited; oral or intravenous hydration and electrolyte management are essential to replace losses.
Stomach > Carcinoma > Intestinal type adenocarcinoma
by Emma J. Norton, M.B.B.S., Adrian C. Bateman, M.B.B.S., M.D.
Topic summary: Histological subtypes of gastric adenocarcinoma previously grouped under the term intestinal adenocarcinoma; tubular adenocarcinoma represents the most common subtype of this cancer. May express HER2 or PDL1, both of which offer additional treatment options. Gastric adenocarcinoma is the third most common cancer type worldwide. Risk factors include
Helicobacter associated gastritis and autoimmune gastritis as well as cigarette smoking, working in the rubber manufacturing industry, Xray radiation and gamma radiation. Tumor stage is the most important prognostic factor, especially nodal status; higher stages are associated with worse prognosis. Tumors identified at a very early stage (i.e., pTis or pT1) may be amenable to local excision at upper gastrointestinal endoscopy.
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