CYTOPATHOLOGY OF THE LIVER Gladwyn Leiman

Save this PDF as:
 WORD  PNG  TXT  JPG

Size: px
Start display at page:

Download "CYTOPATHOLOGY OF THE LIVER Gladwyn Leiman"

Transcription

1 23 rd Annual Cytology Conference Pittsburgh PA CYTOPATHOLOGY OF THE LIVER Gladwyn Leiman OUTLINE MICROSCOPY Normal constituents HCC and other primary liver tumors Selected important metastatic tumors Benign liver lesions DIDACTICS Indications, contras & complications Immunochemistry in liver FNA BENIGN CONSTITUENTS Macroscopically: intact formed cores visible Epithelial cells: - Hepatocytes, single and trabecular - Bile duct cells Mesenchymal cells: - Endothelial lining cells - Macrophages (Kupffer cells) - Fibroblasts 1

2 /3576/fulltext.php?bframe=figures.htm Benign hepatocytes and endothelial cells, trabecular arrangement Benign liver plates, granular cytoplasm, endothelial cells 2

3 Benign hepatocytes with pigment Benign bile duct cells INDICATIONS AND CONTRA-INDICATIONS Indication Solid liver mass or masses Contraindications Bleeding diathesis Suspected vascular tumors Diffuse liver disease eg cirrhosis Relative: Suspected Echinococcus/hydatid Relative IN SOME CENTERS, Suspected HCC 3

4 EFFICACY AND SAFETY Among the safest of all deep organ FNAS Sensitivity >90% - operator dependent Specificity ~100% - reader dependent Hemorrhage 10-20/100,000 often sub-capsular and contained FATALITIES: LIVER FNA 21 deaths, 17 hemorrhage using 19 gauge 11 deaths, using 21 gauge or smaller 4 vascular: hemangioma 2, angiosarcoma 2 5 hemorrhage: HCC 2, met ca 3 1 sepsis 1 carcinoid crisis Smith EH: Radiol 1991; 178: NEEDLE TRACK SPREAD All reports show successful resection of NT and subcutaneous deposits No fatalities in this group, irrespective of gauge No survival differences with or without NTS Hemorrhage = 6-31 per 100,000 liver FNA NTS = 7 per 100,000 Some centers still choose not to sample apparently resectable HCCs pre-operatively 4

5 RESECTION/TRANSPLANTATION HCCs found earlier, smaller, greater resectability Transplantation (Milan criteria): < 3cm or < 5cm But false positive radiology <3cm Reports of higher recurrence rates with HCC after FNA (no needle gauge) Surgeons want clean field, thus refuse FNA 90+% world HCCs still inoperable FNA STILL FIRST LINE DIAGNOSTIC MODALITY HEPATOCELLULAR CARCINOMA (HCC) USA incidence: 22 nd ranking, 4/100,000 Major geographic variation (Africa, SE Asia) Hep-B, Hep C, aflatoxins, steroids Age: Africa 4 th decade, USA 7 th decade Macronodular >> micronodular cirrhosis Gender: M>F, 2:1-5:1 Prognosis: dismal unless resectable FNA: 90+% sensitive ~100% specific HCC geographic pattern 5

6 HCC Bare nuclei HCC Bare nuclei of HCC mimic lymphoma HCC, geographic pattern and wrapping 6

7 HCC, endothelial cell wrapping HCC, bile plugs HCC, transgressing vessels 7

8 Pleomorphism and nuclear inclusions Macronucleoli and endothelial cells HCC, clear cell variant 8

9 HCC, clear cell variant Pleomorphic HCC, multinucleation IMMUNOCHEMISTRY OLD AND NEW (AFP) oncofetal antigen (<30%) pcea canalicular 77% CD10 canalicular 80% CD34 endothelial, sinusoidal 90% HepPar1 hepatocytes, cytoplasm 75% Arginase1 - hepatocytes, cytoplasm 80% Glypican3 oncofetal, cytoplasmic 90% malignant hepatocytes only 9

10 HCC, positive Glypican 3 CHILDREN, ADOLESCENTS, YOUNG ADULTS Usual HCC Especially with vertical transmission of Hepatitis B virus Hepatoblastoma USA 0.2/100,000, <5yrs, M>F, Fetal, embryonal, macrotrabecular, small cell undifferentiated Mixed epithelial and mesenchymal, +- teratoid features Fibrolamellar variant HCC Age 2-35, mean 23, F>M, better prognosis Large polygonal cells separated by fibrosis Hepatoblastoma 10

11 Hepatoblastoma Hepatoblastoma Fibrolamellar HCC - LP 11

12 Fibrolamellar HCC, HP Fibrolamellar HCC carcinoma OTHER PRIMARY LIVER TUMORS Epithelial: Intrahepatic cholangiocarcinoma Mesenchymal: EHEE Epithelioid hemangio-endothelioma Angiosarcoma Kaposi s sarcoma 12

13 13

14 Full renal glomerulus in liver FNA Benign ciliated hepatic foregut cyst 14

15 Benign ciliated hepatic foregut cyst Degenerated benign ciliated hepatic foregut cyst Echinococcus granulosus, hydatid cyst, full scolex 15

16 E. granulosus, collarette of hooklets E. granulosus, hydatid hooklets and capsule 16

17 EMH: megakaryocytes EMH, section Benign hemangioma 17

18 Benign hemangioma Benign hemangioma Benign hepatic adenoma: Young females on OCs Radiological mass lesion Liver cells appear normal, lie singly No bile duct cells Rare endothelial cells, no wrapping GPC3 negative 18

19 Pitfall 1 Herpes hepatitis? Pitfall 2 GI epithelium 19

20 Benign biliary cyst, no cytopathology example LIVER FNA: METASTATIC TUMORS Far exceed primary tumors in FNA Any tumor may ultimately involve liver Often a prior history, diagnosis and slides Liver mass may be initial manifestation Sampling liver may be safer than primary Liver involvement no longer untreatable Recourse to immunochemistry required ADENOCARCINOMA Most common metastatic tumor type in the liver - Mainly lung & GI colorectal, pancreas - Breast and gynecologic sites - Others uncommon - prostate, head & neck Targeted immunochemistry usually required Clinical history can save thousands! Molecular markers increasingly important 20

21 Metastatic mucinous adenocarcinoma Metastatic pancreatic adenoca, well differentiated Metastatic colorectal ca, necrosis 21

22 Metastatic colorectal carcinoma Metastatic adenoca, cytoplasmic vacuoles Metastatic colonic ca, CEA 22

23 Metastatic duct carcinoma breast Metastatic breast cancer Cholangiocarcinoma, intrahepatic -Clinical, radiologic, endoscopic data more useful than immunochemistry -Can be very well differentiated, desmoplastic and mucin-producing -Positive for CK7, CEA, MOC31,MUC 4 -Neg TTF1, CK20, p53 SELECTED METASTASES OF NOTE Neuroendocrine tumors, small cell carcinoma Squamous cell carcinoma Melanoma Gastrointestinal stromal tumor Non-Hodgkins lymphoma 23

24 Neuroendocrine tumor, vascular core Neuroendocrine tumor Neuroendocrine carcinoma, small cell carcinoma 24

25 Metastatic squamous cell carcinoma, necrosis Metastatic squamous cell carcinoma Metastatic melanoma, melanotic 25

26 Melanoma, single cells, INCI Melanoma, S-100 immunostain Metastatic GIST 26

27 Metastatic GIST Metastatic GIST, c-kit Non Hodgkins lymphoma 27

28 BEST ANTIBODIES IN LIVER FNA Glypican 3, HepPar1, Arginase (+ve in HCC) CK 7, CK 20 profile (-ve in HCC) CDX-2 (+ve in GI primaries) TTF 1 (+ve for lung adenoca, NETs) TTF 1 (also +ve in hepatocyte cytoplasm) CD 56, SYN, CGA (+ve in NETs) P63, p40 (+ve in squamous-cell ca) S100, HMB45, MART-1 (+ve in melanoma) COLLECT MATERIAL FOR MOLECULAR MARKERS! - lung, colon, melanoma, breast, gastro-esophageal 28

Immunohistochemical differentiation of metastatic tumours

Immunohistochemical differentiation of metastatic tumours Immunohistochemical differentiation of metastatic tumours Dr Abi Wheal ST1. TERA 3/2/14 Key points from a review article written by Daisuke Nonaka Intro Metastatic disease is the initial presentation in

More information

LIVER TUMORS PROFF. S.FLORET

LIVER TUMORS PROFF. S.FLORET LIVER TUMORS PROFF. S.FLORET NEOPLASM OF LIVER PRIMARY 1)BENIGN 2)MALIGNANT METASTATIC/SECONDARY LIVER Primary Liver Cancer the Second Killer among tumors high morbidity and mortality(20.40/100,000) etiology

More information

Liver Cancer And Tumours

Liver Cancer And Tumours Liver Cancer And Tumours What causes liver cancer? Many factors may play a role in the development of cancer. Because the liver filters blood from all parts of the body, cancer cells from elsewhere can

More information

HKCPath Anatomical Pathology Peer Review and Scores : PDF version for download

HKCPath Anatomical Pathology Peer Review and Scores : PDF version for download AP2003R1 http://hkcpath.org. Correspondence: pkhui@ha.org.hk 1of 10 07/08/2003 HKCPath Anatomical Pathology Peer Review and Scores : PDF version for download AP141 Bone Marrow: Metastatic Carcinoma from

More information

Update on Mesothelioma

Update on Mesothelioma November 8, 2012 Update on Mesothelioma Intro incidence and nomenclature Update on Classification Diagnostic specimens Morphologic features Epithelioid Histology Biphasic Histology Immunohistochemical

More information

Tumour Markers. What are Tumour Markers? How Are Tumour Markers Used?

Tumour Markers. What are Tumour Markers? How Are Tumour Markers Used? Dr. Anthony C.H. YING What are? Tumour markers are substances that can be found in the body when cancer is present. They are usually found in the blood or urine. They can be products of cancer cells or

More information

Carbohydrate antigen 19 9 (CA 19 9) (serum, plasma)

Carbohydrate antigen 19 9 (CA 19 9) (serum, plasma) Carbohydrate antigen 19 9 (CA 19 9) (serum, plasma) 1 Name and description of analyte 1.1 Name of analyte Carbohydrate antigen 19 9 (CA 19 9) 1.2 Alternative names Cancer antigen 19 9, cancer antigen GI

More information

Histolab Products AB. Eva Alströmer Jonas Falgén. Helsingborg 7-8/10 2010

Histolab Products AB. Eva Alströmer Jonas Falgén. Helsingborg 7-8/10 2010 Histolab Products AB Eva Alströmer Jonas Falgén Helsingborg 7-8/10 2010 Table 1 Formalin Fixation Times and Estrogen Receptor Staining With 25 Minutes Antigen Retrieval Pretreatment Formalin Q-Score Difference

More information

OCCULT PRIMARY CANCER

OCCULT PRIMARY CANCER OCCULT PRIMARY CANCER พญ.ครองกมล ส หบ ณฑ หน วยมะเร งว ทยา INTRODUCTION Occult primary cancers or cancer of unknown primary (CUPS) Histologically proven metastatic malignant tumors whose primary site cannot

More information

Index. F Factor VIII-related antigen, see VWF FactorXIIIa, for dermatofibroma, 272-275 5-HT, see Serotonin

Index. F Factor VIII-related antigen, see VWF FactorXIIIa, for dermatofibroma, 272-275 5-HT, see Serotonin A Acantholytic squamous cell carcinoma vs epithelioid angiosarcoma, 56-57 Acinic cell carcinoma of pancreas, 76-77 vs ductal adenocarcinoma, 74-75 vs islet cell tumor, 78-81 Adenomatoid tumor vs hemangioma,

More information

Immunohistochemistry of soft tissue tumors

Immunohistochemistry of soft tissue tumors Immunohistochemistry of soft tissue tumors Immunohistochemistry Major advances : antigen retrieval techniques (HIER) sensitive detection systems numerous antibodies of good quality Standardization : automated

More information

LIVER CANCER AND TUMOURS

LIVER CANCER AND TUMOURS LIVER CANCER AND TUMOURS LIVER CANCER AND TUMOURS Healthy Liver Cirrhotic Liver Tumour What causes liver cancer? Many factors may play a role in the development of cancer. Because the liver filters blood

More information

Diagnosis of Mesothelioma Pitfalls and Practical Information

Diagnosis of Mesothelioma Pitfalls and Practical Information Diagnosis of Mesothelioma Pitfalls and Practical Information Mary Beth Beasley, M.D. Mt Sinai Medical Ctr Dept of Pathology One Gustave L Levy Place New York, NY 10029 (212) 241-5307 mbbeasleymd@yahoo.com

More information

Ovarian tumors Ancillary methods

Ovarian tumors Ancillary methods Ovarian tumors Ancillary methods Ovarian tumor course Oslo, 24-25/11/14 Prof. Ben Davidson, MD PhD Department of Pathology, Norwegian Radium Hospital, Oslo University Hospital, Oslo, Norway Division of

More information

- Slide Seminar - Endocrine pathology in non-endocrine organs. Case 11. Stefano La Rosa, Gioacchino D Ambrosio, Fausto Sessa

- Slide Seminar - Endocrine pathology in non-endocrine organs. Case 11. Stefano La Rosa, Gioacchino D Ambrosio, Fausto Sessa - Slide Seminar - Endocrine pathology in non-endocrine organs Case 11 Stefano La Rosa, Gioacchino D Ambrosio, Fausto Sessa Dept. of Pathology, Multimedica, Milan, Italy Dept. of Surgical and Morphological

More information

Immunohistochemistry on cytology specimens from pleural and peritoneal fluid

Immunohistochemistry on cytology specimens from pleural and peritoneal fluid Immunohistochemistry on cytology specimens from pleural and peritoneal fluid Dr Naveena Singh Consultant Pathologist Bart health NHS Trust London United Kingdom Disclosures and Acknowledgements I have

More information

Pancreas 23 rd Annual Seminar in Pathology Pittsburgh, PA. Disclosures. Outline

Pancreas 23 rd Annual Seminar in Pathology Pittsburgh, PA. Disclosures. Outline Pancreas 23 rd Annual Seminar in Pathology Pittsburgh, PA Gladwyn Leiman Director of Cytopathology, Fletcher Allen Health Care Professor of Pathology, University of Vermont Disclosures None Outline Very

More information

FNA cytology of lymphomas: useless or useful? Edneia Tani

FNA cytology of lymphomas: useless or useful? Edneia Tani FNA cytology of lymphomas: useless or useful? Edneia Tani Karolinska University Hospital Stockholm Sweden FNAC LYMPH NODE First report: FNAC LYMPH NODE Pioneers Sixten Franzén Lopez Cardoso FNAC LYMPH

More information

Disclosures. Learning Objectives. Effusion = Confusion. Diagnosis Of Serous Cavity Effusions - Beware The Mesothelial Cell!

Disclosures. Learning Objectives. Effusion = Confusion. Diagnosis Of Serous Cavity Effusions - Beware The Mesothelial Cell! Disclosures Diagnosis Of Serous Cavity Effusions - Beware The Mesothelial Cell! No Relevant Financial Relationships with Commercial Interests Syed Z. Ali, M.D. Syed Z. Ali, M.D. Associate Professor of

More information

Benign Liver Tumors. Cameron Schlegel PGY-1 3/6/2013

Benign Liver Tumors. Cameron Schlegel PGY-1 3/6/2013 Benign Liver Tumors Cameron Schlegel PGY-1 3/6/2013 Outline Benign Liver Tumors are, in general. Asymptomatic Diagnosed: imaging Treatment: Do no harm Unless Malignant potential Causing symptoms Differential

More information

190.25 - Alpha-fetoprotein

190.25 - Alpha-fetoprotein Other Names/Abbreviations AFP 190.25 - Alpha-fetoprotein Alpha-fetoprotein (AFP) is a polysaccharide found in some carcinomas. It is effective as a biochemical marker for monitoring the response of certain

More information

The develpemental origin of mesothelium

The develpemental origin of mesothelium Mesothelioma Tallinn 14.12.06 Henrik Wolff Finnish Institute of Occupational Health The develpemental origin of mesothelium Mesodermal cavities (pleura, peritoneum and pericardium ) are lined with mesenchymal

More information

Nuclear Medicine Subgroup. Faculty of Radiologists. Royal College of Surgeons in Ireland INDICATIONS FOR PET/CT IMAGING

Nuclear Medicine Subgroup. Faculty of Radiologists. Royal College of Surgeons in Ireland INDICATIONS FOR PET/CT IMAGING Nuclear Medicine Subgroup Faculty of Radiologists Royal College of Surgeons in Ireland INDICATIONS FOR PET/CT IMAGING Report November 2010 Indications for PET/CT Imaging Bladder Carcinoma Staging for nodal

More information

MALIGNANT MESOTHELIOMA UPDATE ON PATHOLOGY AND IMMUNOHISTOCHEMISTRY

MALIGNANT MESOTHELIOMA UPDATE ON PATHOLOGY AND IMMUNOHISTOCHEMISTRY MALIGNANT MESOTHELIOMA CLASSIFICATION MALIGNANT MESOTHELIOMA UPDATE ON PATHOLOGY AND IMMUNOHISTOCHEMISTRY Sisko Anttila, MD, PhD Jorvi Hospital Laboratory of Pathology Helsinki University Hospital Espoo,

More information

Outline. Workup for metastatic breast cancer. Metastatic breast cancer

Outline. Workup for metastatic breast cancer. Metastatic breast cancer Metastatic breast cancer Immunostain Update: Diagnosis of metastatic breast carcinoma, emphasizing distinction from GYN primary 1/3 of breast cancer patients will show metastasis 1 st presentation or 20-30

More information

Cytopathology Case Presentation #8

Cytopathology Case Presentation #8 Cytopathology Case Presentation #8 Emily E. Volk, MD William Beaumont Hospital, Troy, MI Jonathan H. Hughes, MD Laboratory Medicine Consultants, Las Vegas, Nevada Clinical History 44 year old woman presents

More information

PROTOCOL OF THE RITA DATA QUALITY STUDY

PROTOCOL OF THE RITA DATA QUALITY STUDY PROTOCOL OF THE RITA DATA QUALITY STUDY INTRODUCTION The RITA project is aimed at estimating the burden of rare malignant tumours in Italy using the population based cancer registries (CRs) data. One of

More information

Diagnosis Of Serous Cavity Effusions - Beware The Mesothelial Cell! Effusion = Confusion

Diagnosis Of Serous Cavity Effusions - Beware The Mesothelial Cell! Effusion = Confusion Diagnosis Of Serous Cavity Effusions - Beware The Mesothelial Cell! Effusion = Confusion Syed Z. Ali, M.D. Professor of Pathology and Radiology The Johns Hopkins Hospital Baltimore, Maryland Diagnostic

More information

MALIGNANT MESOTHELIOMA UPDATE ON PATHOLOGY AND IMMUNOHISTOCHEMISTRY

MALIGNANT MESOTHELIOMA UPDATE ON PATHOLOGY AND IMMUNOHISTOCHEMISTRY MALIGNANT MESOTHELIOMA UPDATE ON PATHOLOGY AND IMMUNOHISTOCHEMISTRY Sisko Anttila, MD, PhD Jorvi Hospital Laboratory of Pathology Helsinki University Hospital Espoo, Finland 2nd Nordic Conference on Applied

More information

MODERN IMMUNOHISTOCHEMISTRY

MODERN IMMUNOHISTOCHEMISTRY MODERN IMMUNOHISTOCHEMISTRY Cambridge Illustrated Surgical Pathology Peiguo G. Chu City of Hope National Medical Center, Duarte, California Lawrence M. Weiss City of Hope National Medical Center, Duarte,

More information

Paranasal sinus anatomy

Paranasal sinus anatomy Paranasal sinus anatomy Sphenoid Nasopharynx Respiratory mucosa Pseudostratified, goblet & ciliated cells Seromucinous glands Nasopharyngeal mucosa/carcinoma Squamous metaplasia (?) with CIS Normal respiratory

More information

A23: Oncologic Disease- Tumor Markers

A23: Oncologic Disease- Tumor Markers A23: Oncologic Disease- Tumor Markers Diagnosis Tumor Markers and Genetic Markers Use for Specific Malignancy The following information is from multiple guideline sources as recommendations for use of

More information

Hepatocellular Carcinoma (HCC)

Hepatocellular Carcinoma (HCC) Abhishek Vadalia Introduction Chemoembolization is being used with increasing frequency in the treatment of solid hepatic tumors such as Hepatocellular Carinoma (HCC) & rare Cholangiocellular Carcinoma

More information

Practical Effusion Cytology

Practical Effusion Cytology Practical Effusion Cytology A Community Pathologist s Approach to Immunocytochemistry in Body Fluid Cytology Emily E. Volk, MD William Beaumont Hospital Troy, MI College of American Pathologists 2004.

More information

Number. Source: Vital Records, M CDPH

Number. Source: Vital Records, M CDPH Epidemiology of Cancer in Department of Public Health Revised April 212 Introduction The general public is very concerned about cancer in the community. Many residents believe that cancer rates are high

More information

Effusions: Mesothelioma and Metastatic Cancers

Effusions: Mesothelioma and Metastatic Cancers Effusions: Mesothelioma and Metastatic Cancers Malignant Mesothelioma Incidence: 2,500 cases/year ~60-80% pts with pleural MM relationship with asbestos exposure Other risk factors: radiation, other carcinogens,

More information

Gladwyn Leiman, MCCCh, FIAC, FRCPath Scott Anderson, MD

Gladwyn Leiman, MCCCh, FIAC, FRCPath Scott Anderson, MD Cytology Works shop #5 Gladwyn Leiman, MCCCh, FIAC, FRCPath Scott Anderson, MD Disclosur re information The speakers have no relationship that represents a possible conflict of interest with respect to

More information

Introduction: Tumor Swelling / new growth / mass. Two types of growth disorders: Non-Neoplastic. Secondary / adaptation due to other cause.

Introduction: Tumor Swelling / new growth / mass. Two types of growth disorders: Non-Neoplastic. Secondary / adaptation due to other cause. Disorders of Growth Introduction: Tumor Swelling / new growth / mass Two types of growth disorders: Non-Neoplastic Secondary / adaptation due to other cause. Neoplastic. Primary growth abnormality. Non-Neoplastic

More information

PATHOLOGY OF THE PLEURA: Mesothelioma and mimickers Necessity of Immunohistochemistry. M. Praet

PATHOLOGY OF THE PLEURA: Mesothelioma and mimickers Necessity of Immunohistochemistry. M. Praet PATHOLOGY OF THE PLEURA: Mesothelioma and mimickers Necessity of Immunohistochemistry M. Praet Pathology of the Pleura Normal serosa: visceral and parietal layers Inflammation Neoplasia: Primary: mesothelioma

More information

ATLAS OF HEAD AND NECK PATHOLOGY THYROID PAPILLARY CARCINOMA

ATLAS OF HEAD AND NECK PATHOLOGY THYROID PAPILLARY CARCINOMA Papillary carcinoma is the most common of thyroid malignancies and occurs in all age groups but particularly in women under 45 years of age. There is a high rate of cervical metastatic disease and yet

More information

Frozen Section Diagnosis

Frozen Section Diagnosis Frozen Section Diagnosis Dr Catherine M Corbishley Honorary Consultant Histopathologist St George s Healthcare NHS Trust and lead examiner final FRCPath Practical 2008-2011 Frozen Section Diagnosis The

More information

Liver Cancer What is the liver? What is liver cancer?

Liver Cancer What is the liver? What is liver cancer? Liver Cancer What is the liver? The liver is the largest internal organ in the body and is important in digesting food. The liver performs many other functions, including collecting and filtering blood

More information

Histopathology of Major Salivary Gland Neoplasms

Histopathology of Major Salivary Gland Neoplasms Histopathology of Major Salivary Gland Neoplasms Sam J. Cunningham, MD, PhD Faculty Advisor: Shawn D. Newlands, MD, PhD Faculty Advisor: David C. Teller, MD The University of Texas Medical Branch, Department

More information

Viral hepatitis. Liver, Pancreas, Gallbladder. Viral hepatitis Clinicopathologic syndromes. Acute viral hepatitis

Viral hepatitis. Liver, Pancreas, Gallbladder. Viral hepatitis Clinicopathologic syndromes. Acute viral hepatitis Liver, Pancreas, Gallbladder Acute viral hepatitis Cirrhosis (macronodular and micronodular) Hepatocellular carcinoma Chronic pancreatitis Viral hepatitis Systemic viral infections (EBV, CMV,herpes, adeno,

More information

NEOPLASMS C00 D49. Presented by Jan Halloran CCS

NEOPLASMS C00 D49. Presented by Jan Halloran CCS NEOPLASMS C00 D49 Presented by Jan Halloran CCS 1 INTRODUCTION A neoplasm is a new or abnormal growth. In the ICD-10-CM classification system, neoplastic disease is classified in categories C00 through

More information

Surgical Treatment of Various GI Tract Cancers

Surgical Treatment of Various GI Tract Cancers Surgical Treatment of Various GI Tract Cancers By James Ouellette, DO, FACS, Surgical Oncology, Hepatobiliary Surgery Surgical treatment for most gastrointestinal (GI) cancers requires multidisciplinary

More information

An Introduction to Cancer and Basic Cancer Vocabulary

An Introduction to Cancer and Basic Cancer Vocabulary An Introduction to Cancer and Basic Cancer Vocabulary Marc B. Garnick, MD Beth Israel Deaconess Medical Center Harvard Medical School, Boston Medical Director Cancer Programs Northeast Hospital Corporation,

More information

Contents. 1. Introduction and Approach to Fine Needle Aspiration Cytology... 1. 2. Head, Neck, Orbit and Salivary Glands... 12

Contents. 1. Introduction and Approach to Fine Needle Aspiration Cytology... 1. 2. Head, Neck, Orbit and Salivary Glands... 12 Contents 1. Introduction and Approach to Fine Needle Aspiration Cytology... 1 Complications 1 Fine Needle Aspiration Technique 1 Evaluation of FNAC Smear 4 Cell Morphology 4 Nucleus 4 Cytoplasm 6 Background

More information

Seattle. Case Presentations. Case 1. 76 year old female with a history of breast cancer 12 years ago. Now presents with a pleural effusion.

Seattle. Case Presentations. Case 1. 76 year old female with a history of breast cancer 12 years ago. Now presents with a pleural effusion. Seattle Montreal IAP September 2006 Case Presentations Allen M. Gown, M.D. Medical Director and Chief Pathologist PhenoPath Laboratories Clinical Professor of Pathology University of British Columbia Case

More information

Cytology : first alert of mesothelioma? Professor B. Weynand, UCL Yvoir, Belgium

Cytology : first alert of mesothelioma? Professor B. Weynand, UCL Yvoir, Belgium Cytology : first alert of mesothelioma? Professor B. Weynand, UCL Yvoir, Belgium Introduction 3 cavities with the same embryologic origin the mesoderme Pleura Exudates Pleura Peritoneum Pericardium 22%

More information

Changes in Breast Cancer Reports After Second Opinion. Dr. Vicente Marco Department of Pathology Hospital Quiron Barcelona. Spain

Changes in Breast Cancer Reports After Second Opinion. Dr. Vicente Marco Department of Pathology Hospital Quiron Barcelona. Spain Changes in Breast Cancer Reports After Second Opinion Dr. Vicente Marco Department of Pathology Hospital Quiron Barcelona. Spain Second Opinion in Breast Pathology Usually requested when a patient is referred

More information

Treatment of Hepatic Neoplasm

Treatment of Hepatic Neoplasm I. Policy University Health Alliance (UHA) will reimburse for treatment of hepatic neoplasm outside of systemic chemotherapy alone when determined to be medically necessary and within the medical criteria

More information

A 70-year old Man with Pleural Effusion

A 70-year old Man with Pleural Effusion Mesothelioma Diagnosis: Pitfalls and Latest Updates S Klebe and DW Henderson Recommendations Indisputable malignant cells on cytomorphological criteria which demonstrate a mesothelial phenotype, which

More information

Carcinosarcoma of the Ovary

Carcinosarcoma of the Ovary Carcinosarcoma of the Ovary A Rare Finding Presented By: Kathryn Kiely Anisa I. Kanbour School of Cytotechnology of the University of Pittsburgh Medical Center Pittsburgh, PA Patient History 55 year old

More information

New Hampshire Childhood Cancer

New Hampshire Childhood Cancer Introduction: New Hampshire Childhood Cancer New Hampshire, Childhood Cancer, January 2009 Issue Brief Cancer in children is relatively uncommon, impacting fewer than twenty two of every 100,000 children

More information

Primary -Benign - Malignant Secondary

Primary -Benign - Malignant Secondary TUMOURS OF THE LUNG Primary -Benign - Malignant Secondary The incidence of lung cancer has been increasing almost logarithmically and is now reaching epidemic levels. The overall cure rate is very low

More information

4/15/2013. bi/o carcin/ chem/o immun/o onc/o radi/o sarc/o. anabrachydysectoendoneo- -ectomy -genesis -oma -plasia -sarcoma

4/15/2013. bi/o carcin/ chem/o immun/o onc/o radi/o sarc/o. anabrachydysectoendoneo- -ectomy -genesis -oma -plasia -sarcoma Chapter Sixteen Oncology bi/o carcin/ chem/o immun/o onc/o radi/o sarc/o Combining Forms Prefixes and Suffixes Carcinogenesis anabrachydysectoendoneo- -ectomy -genesis -oma -plasia -sarcoma Causes of cancer

More information

Lung Cancer. Ossama Tawfik, MD, PhD Professor, Vice Chairman Director of Anatomic &Surgical Pathology University of Kansas School of Medicine

Lung Cancer. Ossama Tawfik, MD, PhD Professor, Vice Chairman Director of Anatomic &Surgical Pathology University of Kansas School of Medicine Lung Cancer Ossama Tawfik, MD, PhD Professor, Vice Chairman Director of Anatomic &Surgical Pathology University of Kansas School of Medicine Alexandria, Egypt July 1-1 3, 2008 OBJECTIVES Describe and

More information

Part I: NCCN Practice Guidelines Tabular Summary (DD 3/20/13) PET and PET/CT

Part I: NCCN Practice Guidelines Tabular Summary (DD 3/20/13) PET and PET/CT Part I: NCCN Practice Guidelines Tabular Summary (DD 3/20/13) PET and NCCN guidelines were reviewed on 3/20/2013 for utilization of PET and (available at: http://www.nccn.org/professionals/physician_gls/f_guidelines.asp).

More information

Efficient Tumor Immunohistochemistry A Differential Diagnosis-Driven Approach

Efficient Tumor Immunohistochemistry A Differential Diagnosis-Driven Approach Efficient Tumor Immunohistochemistry A Differential Diagnosis-Driven Approach Publishing Team Erik Tanck (production manager/designer) Joshua Weikersheimer (publisher) Copyright 2006 by the American Society

More information

Report series: General cancer information

Report series: General cancer information Fighting cancer with information Report series: General cancer information Eastern Cancer Registration and Information Centre ECRIC report series: General cancer information Cancer is a general term for

More information

Something Old, Something New.

Something Old, Something New. Something Old, Something New. Michelle A. Fajardo, D.O. Loma Linda University Medical Center Clinical Presentation 6 year old boy, presented with hematuria Renal mass demonstrated by ultrasound & CT scan

More information

Neoplasia. Mar 14, 2005 Robbins and Cotran Chapter 7 pp

Neoplasia. Mar 14, 2005 Robbins and Cotran Chapter 7 pp Neoplasia Mar 14, 2005 Robbins and Cotran Chapter 7 pp. 269-339 Definitions Neoplasia - new growth Abnormal mass of tissue with growth that exceeds and is uncoordinated with that of the surrounding normal

More information

Pathology of lung cancer

Pathology of lung cancer Pathology of lung cancer EASO COURSE ON LUNG CANCER AND MESOTHELIOMA DAMASCUS (SYRIA), MAY 3-4, 2007 Gérard ABADJIAN MD Pathologist Associate Professor, Saint Joseph University Pathology Dept. Hôtel-Dieu

More information

Use of stents in esophageal cancer" Hans Gerdes, M.D. Director, GI Endoscopy Unit Memorial Sloan-Kettering Cancer Center

Use of stents in esophageal cancer Hans Gerdes, M.D. Director, GI Endoscopy Unit Memorial Sloan-Kettering Cancer Center Use of stents in esophageal cancer" Hans Gerdes, M.D. Director, GI Endoscopy Unit Memorial Sloan-Kettering Cancer Center Features of esophageal cancer Esophageal cancer is an abnormal growth that arises

More information

Pancreatic Cancer. The Killer that must be discovered early. Dr Alfred Kow Wei Chieh

Pancreatic Cancer. The Killer that must be discovered early. Dr Alfred Kow Wei Chieh Pancreatic Cancer The Killer that must be discovered early 27 th June 2015 Dr Alfred Kow Wei Chieh Consultant Department of Surgery Division of HPB Surgery & Liver Transplantation & Assistant Dean (Education)

More information

Hepatocellular Carcinoma: A Guide to Screening and Diagnosis

Hepatocellular Carcinoma: A Guide to Screening and Diagnosis February 2012 Hepatocellular Carcinoma: A Guide to Screening and Diagnosis Reid Merryman, Harvard Medical School Year III Agenda Hepatocellular carcinoma (HCC) introduction Index patient: clinical presentation

More information

Spleen. Anatomy. (Effective February 2007) (1%-5%) Normal. Related Anatomy Anterior to spleen. Medial border. Posteriorly

Spleen. Anatomy. (Effective February 2007) (1%-5%) Normal. Related Anatomy Anterior to spleen. Medial border. Posteriorly Spleen (Effective February 2007) (1%-5%) Anatomy Normal Intraperitoneal, except hilum Left hypochondrium Left hemidiaphragm superior generally considered to be ovoid, with a convex superior and a concave

More information

The Diagnosis of Cancer in the Pathology Laboratory

The Diagnosis of Cancer in the Pathology Laboratory The Diagnosis of Cancer in the Pathology Laboratory Dr Edward Sheffield Christmas Select 74 Meeting, Queen s Hotel Cheltenham, 3 rd December 2014 Agenda Overview of the pathology of cancer How specimens

More information

Lenox Hill Hospital Department of Surgery General Surgery Goals and Objectives

Lenox Hill Hospital Department of Surgery General Surgery Goals and Objectives Lenox Hill Hospital Department of Surgery General Surgery Goals and Objectives Medical Knowledge and Patient Care: Residents must demonstrate knowledge and application of the pathophysiology and epidemiology

More information

Liver Transplantation for Hepatocellular Carcinoma. John P. Roberts, MD Chief, Division of Transplant Service University of California, San Francisco

Liver Transplantation for Hepatocellular Carcinoma. John P. Roberts, MD Chief, Division of Transplant Service University of California, San Francisco Liver Transplantation for Hepatocellular Carcinoma John P. Roberts, MD Chief, Division of Transplant Service University of California, San Francisco Hepatocellular Carcinoma HCC is the 5th most common

More information

Pancreas & Liver Tumors. Boris W. Kuvshinoff, MD MBA Associate Professor of Surgery Director, Liver and Pancreas Tumor Center

Pancreas & Liver Tumors. Boris W. Kuvshinoff, MD MBA Associate Professor of Surgery Director, Liver and Pancreas Tumor Center Pancreas & Liver Tumors Boris W. Kuvshinoff, MD MBA Associate Professor of Surgery Director, Liver and Pancreas Tumor Center April 22, 2014 Liver & Pancreas Tumor Center HPB (Hepatopancreaticobiliary)

More information

CANCER OF THE LIVER HEPATOCELLULAR CARCINOMA

CANCER OF THE LIVER HEPATOCELLULAR CARCINOMA CANCER OF THE LIVER HEPATOCELLULAR CARCINOMA WHAT IS CANCER OF THE LIVER? Hepatocellular carcinoma is the most common form and it comes from the main type of liver cell, the hepatocyte. About 3 out 4

More information

Lessons from a consultation practice

Lessons from a consultation practice Pitfalls in the Application of Immunohistochemistry in Diagnostic Pathology Lessons from a consultation practice Kevin O. Leslie, MD Professor and Consultant Mayo Clinic Arizona Scottsdale, Arizona Presenter

More information

Male. Female. Death rates from lung cancer in USA

Male. Female. Death rates from lung cancer in USA Male Female Death rates from lung cancer in USA Smoking represents an interesting combination of an entrenched industry and a clearly drug-induced cancer Tobacco Use in the US, 1900-2000 5000 100 Per Capita

More information

Hepatocellular Carcinoma: What the hepatologist wants to know

Hepatocellular Carcinoma: What the hepatologist wants to know Hepatocellular Carcinoma: What the hepatologist wants to know Hélène Castel, MD Liver Unit Hôpital St-Luc CHUM? CAR Annual Scientific Meeting Saturday, April 27 th 2013 Disclosure statement I do not have

More information

David Feltl, M.D., Ph.D., MBA. Structure and organization of cancer care in the Czech Republic. Assessment of outputs and outcomes.

David Feltl, M.D., Ph.D., MBA. Structure and organization of cancer care in the Czech Republic. Assessment of outputs and outcomes. David Feltl, M.D., Ph.D., MBA Structure and organization of cancer care in the Czech Republic. Assessment of outputs and outcomes. Contents Cancer epidemiology in the Czech Republic National oncology program

More information

Renal Cell Carcinoma: Advances in Diagnosis B. Iványi, MD

Renal Cell Carcinoma: Advances in Diagnosis B. Iványi, MD Renal Cell Carcinoma: Advances in Diagnosis B. Iványi, MD Department of Pathology University of Szeged, Hungary ISUP Vancouver Classification of Renal Neoplasia Am J Surg Pathol 37:14691489, 2013 13 histologic

More information

YOUR LUNG CANCER PATHOLOGY REPORT

YOUR LUNG CANCER PATHOLOGY REPORT UNDERSTANDING YOUR LUNG CANCER PATHOLOGY REPORT 1-800-298-2436 LungCancerAlliance.org A GUIDE FOR THE PATIENT 1 CONTENTS What is a Pathology Report?...3 The Basics...4 Sections of a Pathology Report...7

More information

CASE OF THE MONTH AUGUST-2015 DR. GURUDUTT GUPTA HEAD HISTOPATHOLOGY

CASE OF THE MONTH AUGUST-2015 DR. GURUDUTT GUPTA HEAD HISTOPATHOLOGY CASE OF THE MONTH AUGUST-2015 DR. GURUDUTT GUPTA HEAD HISTOPATHOLOGY CASE HISTORY 52Y MALE RIGHT RADICAL NEPHERECTOMY Case of right renal mass with IVC thrombus. History of surgery and RT for right occipital

More information

Co-pay assistance organizations offering assistance

Co-pay assistance organizations offering assistance Acromegaly Acute Exacerbations of Multiple Sclerosis Acute Porphyrias Advanced Idiopathic Parkinson' s Disease Age-Related Macular Degeneration www.theassistancefund.org Alcohol Dependence Alpha-1 Antitrypsin

More information

Clinical Analysis of Focal Nodular Hyperplasia of the Liver in 11 Patients

Clinical Analysis of Focal Nodular Hyperplasia of the Liver in 11 Patients Clinical Analysis of Focal Nodular Hyperplasia of the Liver in 11 Patients Purpose: The purpose of this study was to determine the clinical features of focal nodular hyperplasia (FNH) and investigate its

More information

Cervical Nodes: When to Worry and What to do.

Cervical Nodes: When to Worry and What to do. Cervical Nodes: When to Worry and What to do. Donna Sutherland MD, FRCSC CancerCare Manitoba, Head and Neck Surgery University of Manitoba, Department of Otolaryngology Objectives Be familiar with various

More information

Surveillance for Hepatocellular Carcinoma

Surveillance for Hepatocellular Carcinoma Surveillance for Hepatocellular Carcinoma Marion G. Peters, MD John V. Carbone, MD, Endowed Chair Professor of Medicine Chief of Hepatology Research University of California San Francisco Recorded on April

More information

OBJECTIVES By the end of this segment, the community participant will be able to:

OBJECTIVES By the end of this segment, the community participant will be able to: Cancer 101: Cancer Diagnosis and Staging Linda U. Krebs, RN, PhD, AOCN, FAAN OCEAN Native Navigators and the Cancer Continuum (NNACC) (NCMHD R24MD002811) Cancer 101: Diagnosis & Staging (Watanabe-Galloway

More information

Immunohistochemistry in the Diagnosis of Metastatic Carcinoma of Unknown Primary Origin

Immunohistochemistry in the Diagnosis of Metastatic Carcinoma of Unknown Primary Origin Immunohistochemistry in the Diagnosis of Metastatic Carcinoma of Unknown Primary Origin Rodney T. Miller, M.D. Director of Immunohistochemistry ProPath Laboratory 1355 River Bend Drive Dallas, TX 75247-4915

More information

A 43 year old male presents with abdominal complaints. An axial CT reveals.

A 43 year old male presents with abdominal complaints. An axial CT reveals. A 43 year old male presents with abdominal complaints. An axial CT reveals. Diagnosis: Gastrointestinal Stromal Tumor Location: stomach Size: 12 cm Mitotic count: 10 mitoses / 50 high power fields Risk

More information

TUMORS OF THE TESTICULAR ADNEXA and SPERMATIC CORD

TUMORS OF THE TESTICULAR ADNEXA and SPERMATIC CORD TUMORS OF THE TESTICULAR ADNEXA and SPERMATIC CORD Victor E. Reuter, MD Memorial Sloan-Kettering Cancer Center reuterv@mskcc.org 66 th Annual Pathology Seminar California Society of Pathologists Short

More information

Académie internationale de Pathologie - Division arabe XX ème congrès 24-26 novembre 2008 Alger. Immunohistochemistry in malignant mesotheliomas

Académie internationale de Pathologie - Division arabe XX ème congrès 24-26 novembre 2008 Alger. Immunohistochemistry in malignant mesotheliomas Académie internationale de Pathologie - Division arabe XX ème congrès 24-26 novembre 2008 Alger Immunohistochemistry in malignant mesotheliomas Françoise Thivolet-Béjui Groupement Hospitalier Est Lyon-Bron

More information

Metastatic Lobular Carcinoma of the Breast Presenting as a Frontal Scalp Mass and

Metastatic Lobular Carcinoma of the Breast Presenting as a Frontal Scalp Mass and Metastatic Lobular Carcinoma of the Breast Presenting as a Frontal Scalp Mass and Masquerading as Lymphoma: A Potential Pitfall in Aspiration Cytology Lauren Altman 1, Summer Student; Raptis George 2,

More information

Cystic Neoplasms of the Pancreas: A multidisciplinary approach to the prevention and early detection of invasive pancreatic cancer.

Cystic Neoplasms of the Pancreas: A multidisciplinary approach to the prevention and early detection of invasive pancreatic cancer. This lecture is drawn from the continuing medical education program Finding Hope: Prevention, Early Detection and Treatment of Pancreatic Cancer, Nov, 2011. Robert P. Jury, MD Cystic Neoplasms of the Pancreas:

More information

Pediatric Oncology for Otolaryngologists

Pediatric Oncology for Otolaryngologists Pediatric Oncology for Otolaryngologists Frederick S. Huang, M.D. Division of Hematology/Oncology Department of Pediatrics The University of Texas Medical Branch Grand Rounds Presentation to Department

More information

Corporate Medical Policy

Corporate Medical Policy Corporate Medical Policy File Name: Origination: Last CAP Review: Next CAP Review: Last Review: microwave_tumor_ablation 12/2011 11/2015 11/2016 11/2015 Description of Procedure or Service Microwave ablation

More information

Applications of immunohistology to non-heme tumor differential diagnosis R V Rouse 7/22/2014 http://surgpathcriteria.stanford.edu

Applications of immunohistology to non-heme tumor differential diagnosis R V Rouse 7/22/2014 http://surgpathcriteria.stanford.edu Applications of immunohistology to non-heme tumor differential diagnosis R V Rouse 7/22/2014 http://surgpathcriteria.stanford.edu Table of Contents Page Undifferentiated panel 1 CK7/20 table 2 Breast carcinoma

More information

Interesting Case Review. Renuka Agrawal, MD Dept. of Pathology City of Hope National Medical Center Duarte, CA

Interesting Case Review. Renuka Agrawal, MD Dept. of Pathology City of Hope National Medical Center Duarte, CA Interesting Case Review Renuka Agrawal, MD Dept. of Pathology City of Hope National Medical Center Duarte, CA History 63 y/o male with h/o CLL for 10 years Presents with worsening renal function and hypercalcemia

More information

MRI of Benign Liver Lesions and Metastatic Disease Characterization with. Gadoxetate Disodium

MRI of Benign Liver Lesions and Metastatic Disease Characterization with. Gadoxetate Disodium MRI of Benign Liver Lesions and Metastatic Disease Characterization with Gadoxetate Disodium Rocky C. Saenz, D.O. Department of Diagnostic Radiology, Botsford Hospital, Farmington Hills, MI Introduction

More information

HCC: Risk factors, surveillance and the importance of a multidisciplinary team

HCC: Risk factors, surveillance and the importance of a multidisciplinary team HCC: Risk factors, surveillance and the importance of a multidisciplinary team Anjana Pillai MD Assistant Professor of Medicine Director, Emory University Hospital Liver Tumor Clinic Division of Digestive

More information

Nicole Kounalakis, MD

Nicole Kounalakis, MD Breast Disease: Diagnosis and Management Nicole Kounalakis, MD Assistant Professor of Surgery Goal of Breast Evaluation The goal of breast evaluation is to classify findings as: normal physiologic variations

More information

Liver Cancer. What is liver cancer? About the liver

Liver Cancer. What is liver cancer? About the liver Style Definition: List Bullet,List Bullet 1: Indent: Left: 0.13", Tab stops: 0.12", Left + Not at 2.8" What is liver cancer? Liver Cancer Cancer starts when cells in the body begin to grow out of control.

More information