Here, the central zone cells are hyperplastic. Despite the cribriform structure, the bland nuclei rule out intraepithelial neoplasia or cribriform cancer. Also note the surrounding dense stroma of the central zone.
Peripheral blood smear shows leukocytosis where almost all the cells are mature neutrophils with normal morphology. It is characteristic of chronic neutrophilic leukemia that no (or at most < 5%) immature cells at earlier stage than neutrophils and bands are noted in the peripheral blood. The neutrophils show adequate segmentation and no dyspoietic features (Wright Giemsa, 400x magnification or 40x objective).
57 year old man with positive Jo1 antibody and interstitial lung disease. H&E shows necrotic fibers and myophagocytosis predominantly involving perifascicular fibers. The perimyisial connective tissue appears edematous and fragmented.
A monophasic sarcomatoid carcinoma shows only a spindle cell component with mesenchymal appearance, without admixed carcinoma. Extensive sampling and history of prostatic adenocarcinoma, preferably with immunohistochemical (keratins, rarely PSA or other prostatic markers) evidence of epithelial differentiation, helps establish the diagnosis.
Periodic acid-Schiff with diastase (PASD) highlights the basement membrane of bile ducts. It also stains alpha-1 antitrypsin globules in hepatocytes in the setting of alpha-1 antitrypsin deficiency. The lack of globules in this image is a normal finding.
The nuclear pattern of CM2B4 immunoreactivity in MCC tumor cells indicates MCPyV positivity. There is an absence of staining in the background nontumoral cells, including inflammatory, endothelial and stromal cells.
Case 1: lung; H&E staining, Fig 2A: polymorphous infiltrate in scanner view (40x). Fig 2B: lymphocytic vasculitis with infiltration of the vessel wall is seen (100x). Fig 2C: lymphocytic vasculitis with infiltration of the vessel wall is seen (200x). Fig 2D: angioinvasion by lymphoid cells in lymphomatoid granulomatosis (400x).
Haphazard circumferential proliferation of cytotrophoblasts and syncytiotrophoblasts is seen around a club shaped villus in this image of a complete mole. Some of the nuclei show considerable atypia and mitoses.
Thanks to Dr. Sakinah A. Thiryayi and Dr. Gulisa Turashvili, Mount Sinai Hospital, Toronto (Canada) for contributing this case and writing the discussion and to Dr. Ricardo R. Lastra, University of Chicago Medical Center, Chicago, Illinois (USA), for reviewing the discussion.
A 52 year old woman was found to have an ovarian mass on computed tomography imaging and an elevated CA-125 of 234 U/mL (reference range: less than 46 U/mL). The mass was excised.