We have posted updates of the following topics:Bladder, ureter & renal pelvis > Glandular neoplasms > Urachal adenocarcinoma
by Rugvedita Parakh, M.D., Maria Tretiakova, M.D., Ph.D.
Topic summary: Adenocarcinoma arising from the epithelium lined tubular structure known as urachus, an embryological derivative of the urogenital sinus and allantois that connects the bladder to the umbilicus; diagnosis of urachal adenocarcinoma is usually established after excluding other mimics. Rare, < 1 case per 1 million of population. Clinical features: hematuria and irritative bladder symptoms with voiding difficulties (hematuria, dysuria, nocturia, frequency, suprapubic pain). Urachal adenocarcinoma is a clinicopathologic diagnosis. Staging is different than bladder carcinoma; local recurrence and metastatic disease are common. Treatment: umbilectomy with partial cystectomy, possibly laparoscopic.
Cervix > Inflammatory / infectious > Lactobacillus
by Hiba Al Dallal, M.B.Ch.B., Ziyan T. Salih, M.D.
Topic summary: Lactobacillus spp. is normal vaginal flora that is commonly seen in cervical Pap smears; they are beneficial because they produce lactic acid, which reduces the vaginal pH and possibly protects from infection by Candida and other pathogens. Lactobacillus is predominant during the second half of the menstrual period (luteal phase). They are blue thick rods usually found on the top of the intermediate squamous cells.They can lyse glycogen rich intermediate cells which may cause cytolysis. Excessive lactobacterial cytolysis can be associated with vaginosis-like symptoms (cytolytic vaginosis) and may cause vulvovaginal itching, burning and discharge. No treatment is needed.
CNS & pituitary tumors > Gliomas, glioneuronal tumors, and neuronal tumors > Neuronal and mixed neuronal-glial tumors > Central neurocytoma
by Daniel D. Child, M.D., Ph.D., Rebecca Yoda, M.D.
Topic summary: Rare, well differentiated, intraventricular neoplasm with neuroepithelial differentiation, typically arising near the foramen of Monro. Microscopically appears as sheets of uniform, small – medium, round cells with fine chromatin stippling (salt and pepper) and occasional perinuclear clearing, interspersed with patches of fibrillary matrix. ~0.1 – 0.5% of all primary brain tumors; mean age at presentation: 20 – 34 years. Most common presenting symptoms are related to increased intracranial pressure that is due to obstructive hydrocephalus. Generally favorable prognosis: 5 year overall survival rate: 96%; 10 year overall survival rate: 82%. Surgical resection is standard of care; when complete resection is not possible, adjuvant radiotherapy improves survival.
Informatics, digital & computational pathology > Laboratory information systems > LIS fundamentals
by Ugochukwu John Jonah, M.B.B.S., Anil Parwani, M.D., Ph.D., M.B.A.
Topic summary: A laboratory information system (LIS) is computer software that processes, stores and manages data from all stages of medical processes and tests: patient check in, order entry, specimen processing, results entry and patient demographics. It reduces the turnaround time of laboratory tests and significantly decreases errors. LIS is only certified to be of functional capacity when it meets the meaningful use program criteria of the 2009 Health Information Technology for Economic and Clinical Health (HITECH) Act; such certified LIS is usually referred to as an electronic health record [EHR] module. Ideal LIS will prevent unauthorized access in order to preserve the confidentiality of health records and ensure that only legitimate users can be granted access to the system.
Oral cavity & oropharynx > Benign epithelial tumors & processes > Verruca vulgaris
by Molly Housley Smith, D.M.D.
Topic summary: Benign epithelial proliferation of squamous mucosa; associated with human papilloma virus (HPV) types 2 and 4. Mostly found on the skin but uncommonly may be seen in the oral cavity; similar to cutaneous lesions both histopathologically and microscopically. M > F; wide age range, although more frequent in younger populations. Asymptomatic, well delineated, often white papule or nodule with a papillary or pebbled surface. Lips, palate, anterior tongue most common but can affect any intraoral location. HPV is thought to gain access to epithelial cells via microabrasion or trauma. Treatment: excision (via surgery, cryosurgery or electrosurgery); spontaneous regression has been reported. Good prognosis; rare recurrence attributed to incomplete removal of lesional tissue.