17 May 2024: Weekly Roundup #145

Here’s what you need to know about PathologyOutlines.com this week:

1. New Board of Reviewers Appointments

Dr. Mark Giffen was recently appointed to our new Board of Reviewers for Autopsy & Forensic Pathology. Dr. Giffen is an Assistant Professor of Pathology at Atrium Health – Wake Forest School of Medicine. He obtained his D.O. degree at Lake Erie College of Osteopathic Medicine before completing his anatomic and clinical pathology residency at North Carolina Baptist Hospital in Winston-Salem, NC. He completed his fellowship at the Office of the Medical Investigator in Albuquerque, NM. He then returned to North Carolina to practice as an academic forensic pathologist. His areas of interest include atypical ballistic injuries and advanced postmortem imaging techniques.

Dr. Barina Aqil was recently appointed to our new Board of Reviewers for Hematopathology. Dr. Aqil is an Assistant Professor of Pathology at Northwestern University Feinberg School of Medicine in Chicago. She completed her anatomic and clinical pathology residency at Baylor College of Medicine in Houston as well as fellowships in hematopathology and head & neck pathology at Washington University in St Louis.

2. Server Update

Please note that we underwent a server update over the last week, which may account for slower loading times and foreign characters on certain pages. If you encounter any issues, please click the “Comment” feature in the lower navigation bar (see below) and let us know.

3. Images of the Week

Here are some of our favorite images from topics posted recently:

Breast > Acinic cell carcinoma: Tumor cells with microglandular architecture and some with prominent eosinophilic cytoplasm.
Contributed by Miralem Mrkonjic, M.D., Ph.D.

Ovary > Steroid cell tumor: The tumor is well defined with sparse stroma. Eosinophilic cytoplasm can be appreciated at low power.
Contributed by Fatemeh Ghazanfari Amlashi, M.D. and Tamara Kalir, M.D., Ph.D.

14 May 2024: Image Quiz #134

Author: Jose G. Mantilla, M.D.

A radiolucent lesion in the mandible of a 38 year old man was biopsied and is shown in the image below. An H3.3 G34W immunohistochemical stain is negative. What is the correct diagnosis?

Select an answer:

A. Central giant cell granuloma

B. Chondroblastoma

C. Conventional type osteosarcoma

D. Giant cell tumor of bone

E. Solid aneurysmal bone cyst

See correct answer

To sign up for our biweekly image quiz e-newsletters and more, visit pathologyoutlines.com/subscribe.html.

8 May 2024: Cancer Precursor Project – Characteristics of Premalignant Precursors, Part 3a (Dermatopathology)

Our cancer precursor project is intended to better understand how cancer arises by compiling a regularly updated spreadsheet of all distinct human cancers (now 1,232) and their precursors (now 191).

In part 1, we noted that the percentage of identified precursors varies widely by pathology subspecialty and we discussed precursors for subspecialties with epithelial sites (breast, head & neck, gyn, GI / liver, GU / adrenal and thoracic).

Epithelial malignancies, whether carcinomas or melanomas, typically have known risk factors associated with chronic inflammation, DNA changes, constitutive hormone production or immune system dysfunction. These risk factors promote changes in molecular pathways that produce intraepithelial neoplasia or dysplasia, in situ carcinoma and ultimately invasive malignancies.

In part 2, we discussed neuropathology related malignancies and their lack of precursors and speculated that contrary to current thinking, most nonepithelial malignancies may lack precursors. These nonepithelial malignancies often have no known risk factors and may arise from random processes or bad luck.

In the skin, of the 79 distinctive malignancies identified to date, only 6 malignancies have known precursors (5 melanocytic, 1 nonmelanocytic).

More text, images and links can be found at https://www.pathologyoutlines.com/dw/Cancerprecursorproject-characteristicsofpremalignantprecursorspart3adermatopathology.pdf.

Email any thoughts you have about this project to Nat@PathologyOutlines.com.

3 May 2024: Weekly Roundup #144

Here’s what you need to know about PathologyOutlines.com this week:

1. 2024 Q1 Pathology Jobs Report

The first quarter PathologyOutlines.com Jobs report for 2024 has been posted here. For this quarter, PathologyOutlines.com listed 398 full or part time pathologist job postings, which form the basis for the statistics within the report. 

We excluded postings that were only for locum, Ph.D., residency, fellowship or nonpathologist positions. Visit pathologyoutlines.com/pathjobs2024q1.html for full details of the report.

2. New Board of Reviewers Appointment

Dr. Jieli (Shirley) Li was recently appointed to our new Board of Reviewers for Clinical Chemistry. Dr. Li holds the position of Assistant Professor-Clinical in the Department of Pathology and serves as Co-Director of the Clinical Chemistry & Toxicology Laboratory at The Ohio State University Wexner Medical Center. Dr. Li obtained her M.D. and Ph.D. degrees from the Shanghai Jiao-Tong University School of Medicine and completed her fellowship training in clinical chemistry at MD Anderson Cancer Center. Dr. Li also plays a vital role in participating in guidelines writing for the Clinical & Laboratory Standards Institute (CLSI) and serving on the Expert Panel Committee of CLSI. Furthermore, Dr. Li contributes to the field as an inspector for the College of American Pathologists (CAP) and is actively involved with CAP’s Chemistry Committee.

3. Images of the Week

Here are some of our favorite images from topics posted recently:

Skin melanocytic tumor > Pediatric melanoma: PRAME immunostain demonstrates moderate staining (200x).
Contributed by Idy Tam, M.D. and Bethany R. Rohr, M.D.

Skin nonmelanocytic tumor > Adenoid cystic carcinoma (primary cutaneous): Skin, left scapula, biopsy: adenoid cystic carcinoma. A common growth pattern is cribriform, characterized by back to back luminal glandular spaces with punched out central lumina.
Contributed by Haya Homsi, M.D., M.P.H. and Shira Ronen, M.D.

1 May 2024: Cancer Precursor Project – Characteristics of Premalignant Precursors, Part 2 (Brain and Eye Tumors)

The goal of our cancer precursor project is to better understand how cancer arises by compiling a regularly updated spreadsheet of all distinct human cancers (currently 1,232) and their premalignant precursors (currently 191).

In part 1 of this series, we noted that the percentage of identified precursors varies widely by pathology subspecialty and discussed precursors for subspecialties with epithelial sites (breast, head & neck, gyn, GI / liver, GU / adrenal and thoracic). In this essay, we discuss actual and possible malignant precursors associated with neuropathology.

Based on our work, it now appears that most brain and eye malignancies do not have a morphologic precursor. They may be initiated by a defining mutation in a single stem or progenitor cell or small cluster of cells that multiplies and acquires additional malignant properties over time. Due to its small size, detection may not be possible, at least with current methods, until it is large enough to be clinically evident.

Read more at pathologyoutlines.com/dw/Cancerprecursorproject-characteristicsofpremalignantprecursorspart2brainandeyetumors.pdf.

30 April 2024: Image Quiz #133

Authors: Anusmita Tripathy, M.D., Aliya N. Husain, M.D.

A 50 year old man with hypoxia and bilateral interstitial infiltrates on chest imaging showed intra-alveolar foamy material. Grocott-Gomori methenamine silver (GMS) stain is shown in the figure below. What is the diagnosis?

Select an answer:

A. Alveolar proteinosis

B. Candida

C. Cryptococcus

D. Pneumocystis pneumonia

See correct answer

To sign up for our biweekly image quiz e-newsletters and more, visit pathologyoutlines.com/subscribe.html.

26 April 2024: Weekly Roundup #143

Here’s what you need to know about PathologyOutlines.com this week:

1. Curing Cancer Network April Newsletter

Make sure to read our Curing Cancer Network April newsletter here. If you’re interested in more, sign up to have these newsletters delivered directly to your inbox at lp.constantcontactpages.com/su/onz6IND.

2. New Board of Reviewers Appointments

Dr. Anna Biernacka was recently appointed to our new Board of Reviewers for Breast Pathology. Dr. Biernacka is an Assistant Professor of Pathology at the University of Chicago Medicine. She earned her M.D., Ph.D. from the Medical University of Lodz in Poland and then worked as a postdoctoral research fellow at MD Anderson Cancer Center and Albert Einstein College of Medicine. She then completed a residency in anatomic pathology at Baylor College of Medicine in Houston, followed by fellowships in cytopathology at Dartmouth-Hitchcock Medical Center and breast pathology at Massachusetts General Hospital.

Dr. Carlos Murga-Zamalloa was recently appointed to our new Board of Reviewers for Hematopathology. Dr. Murga-Zamalloa is an Assistant Professor of Pathology at the University of Illinois, Chicago. He obtained his M.D. at San Martin de Porres University (Lima, Peru). Dr. Murga-Zamalloa completed an anatomic and clinical pathology residency and a hematopathology fellowship at the University of Michigan, Ann Arbor. Dr. Murga-Zamalloa has an NIH funded research laboratory that focuses on the biology of T cell lymphomas, and he participates in multi-institutional international research projects to discover novel biomarkers and therapies in T cell lymphomas.  

3. Images of the Week

Here are some of our favorite images from topics posted recently:

Cervix > Clear cell carcinoma: Papillary pattern: papillae with central hyaline fibrous tissue cores are lined by hobnail cells with hyperchromatic nuclei (200x).
Contributed by Nadia Hameed, M.D.

CNS & pituitary tumors > Ependymoma: Perivascular pseudorosette with tightly packed processes is highly characteristic on smear prep.
Contributed by Chunyu Cai, M.D., Ph.D.

24 April 2024: New Relevant GU Pathology Articles

Maria Tretiakova, M.D., Ph.D., our Deputy Editor-in-Chief for GU Pathology, recently published several articles containing novel and relevant practice information:

• Actual encounters of the kidney kind: Exploring 48 cases of renal collision tumors through the lens of literature (Hum Pathol 2024;145:26)

• Vascular, adipose tissue, and/or calyceal invasion in clear cell tubulopapillary renal cell tumour: potentially problematic diagnostic scenarios (Histopathology 2024 Feb 29 [Epub ahead of print])

• Cystic Features in Renal Epithelial Neoplasms and Their Increasing Clinical and Pathologic Significance (Adv Anat Pathol 2024;31:157)

• Enhancing upper tract urothelial carcinoma diagnosis: Utility of cytokeratin 17 and CK20/CD44/p53 immunohistochemical panel (Hum Pathol 2024;146:43)

• Molecular characterization of juxtaglomerular cell tumors: evidence of alterations in MAPK-RAS pathway (Mod Pathol 2024 Apr 11 [Epub ahead of print])

• Hybrid Oncocytic Tumors (HOTs) in Birt-Hogg-Dubé Syndrome Patients-A Tale of Two Cities: Sequencing Analysis Reveals Dual Lineage Markers Capturing the 2 Cellular Populations of HOT (Am J Surg Pathol 2024;48:163)

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Have any thoughts on these articles? Comment below or contact us at comments@pathologyoutlines.com.

23 April 2024: Superpages

Perhaps you’ve noticed the “Superpages” section on the main landing page for each chapter in our textbook (just above the alphabetical topic index) and wondered what they are. Superpages are just one of the many useful features of PathologyOutlines.com’s free, online pathology textbook.

These 3 hyperlinks (entire chapter, images and virtual slides) allow you to view a chapter’s contents in a few different ways.

Entire Chapter 

Clicking this link produces a combination of all the text and images in a chapter on a single web page. While it may be an enormous amount of information, you can scroll through it without opening any new tabs or windows. Moreover, this feature is useful for searching for a particular term in a chapter. You can also copy and paste to produce a personal document based on your interests (please see our Copyright page for information on fair use).

Images 

Clicking this link produces all the images (and their supporting descriptive text) from the chapter onto a single webpage. This includes diagrams / tables, radiology images, clinical images, gross images, microscopic (histologic) images, electron microscopy images, videos, etc. You can select which types of images to include (e.g., all micro images only) or include all of them.

Virtual Slides

Clicking this link produces all the virtual slides available for this chapter onto a single web page.

If you have any comments or questions regarding superpages on PathologyOutlines.com, please comment below or contact comments@pathologyoutlines.com.

19 April 2024: Weekly Roundup #142

Here’s what you need to know about PathologyOutlines.com this week:

1. 2023 Year in Review Video (Part 2)

We have posted a second YouTube video highlighting the significant changes that were made to PathologyOutlines.com in 2023. View this new video at https://youtu.be/8veWcCL8qs0.

2. New Board of Reviewers Appointments

Dr. Carla Ellis was recently appointed to our new Board of Reviewers for Renal Pathology. Dr. Ellis is an Associate Professor of Pathology at Northwestern University in Chicago. She obtained her M.D. at the University of Nevada School of Medicine and attended graduate school at the University of Maryland at Baltimore. She completed her anatomic and clinical pathology residency at the Johns Hopkins Hospital and School of Medicine. She subsequently did fellowships in genitourinary and medical renal pathology at Johns Hopkins as well.

Dr. Caroline Underwood was recently appointed to our new Board of Reviewers for Dermatopathology. Dr. Underwood is an Associate Professor of Pathology at ProPath Associates in Dallas, Texas. She obtained her M.D. at the Medical College of Georgia at Augusta University. She then completed her anatomic and clinical pathology residency at Duke University, where she remained for her fellowship in dermatopathology.

3. Images of the Week

Here are some of our favorite images from topics posted recently:

Soft tissue > Inflammatory leiomyosarcoma: Intermediate power showing spindle and epithelioid cells with eosinophilic cytoplasm and prominent nucleoli with admixed inflammatory cells.
Contributed by Elizabeth A. Montgomery, M.D.

Lymphoma & related disorders > Systemic EBV+ T cell lymphoma of childhood: EBER in situ hybridization for EBV demonstrates that the lymphocytes are EBV positive.
Contributed by Yoon Kyung Jeon, M.D.