FNAC of epithelial borderline and in situ lesions of the breast. FNAC of microcalcifications

Size: px
Start display at page:

Download "FNAC of epithelial borderline and in situ lesions of the breast. FNAC of microcalcifications"

Transcription

1 FNAC of epithelial borderline and in situ lesions of the breast FNAC of microcalcifications 1 Torill Sauer, Department Torill Sauer, Department of Pathology, of Akershus University Hospital University Hospital

2 Lesions included Ductal carcinoma in situ (DCIS) High grade Non-high grade Atypical ductal hyperplasia (ADH) Columnar cell lesions (CLL), including flat atypia Lobular neoplasi Atypical lobular hyperplasia (ALH) Lobular carcinoma in situ (classical) Pleomorphic lobular carcinoma in situ 2

3 Breast lesions associated with radiological microcalcifications Atrophy, inflammatory lesions Benign non-tumour conditions Adenosis UDH (usual ductal hyperplasia) Benign tumours papilloma fibroadenoma adenomyoepithelioma Borderline proliferative lesions (= columnar cell lesions) PLCIS Ductal carcinoma in situ Invasive lesions 3

4 Ductal carcinoma in situ (WHO definition) A neoplastic proliferation of epithelial cells confined to the mammary ductal-lobular system A subtle to marked cytological atypia An inherent but not necessarily obligate tendency for progression to invasive breast cancer 4

5 (Histologic) growth pattern subtypes of DCIS Solid Cribriform Micropapillary Papillary Comedo Non-comedo Apocrine Signet ring type Clear cell type Flat/ clinging All subtypes are reflected in the cytological specimens 5

6 (Histological) grading of DCIS Depends primarily on the nuclear atypia Low nuclear grade Small monomorphic cells (growing in arcades, micropapillae, cribriform or solid patterns) Intermediate grade Cells with mild to moderate variability in shape, size, chromatin pattern and variably prominent nucleoli Comedo type necrosis may be present High nuclear grade Highly atypical cells 6

7 Grading of DCIS Sauer T, Lømo J, Garred Ø, Næss O. Cytologic features of ductal carcinoma in situ in fine-needle aspiration of the breast mirror the histopathologic growth pattern heterogeneity and grading. Cancer Cytopathol 2005;105:21-7. (modified Van Nuy) Cytological grading of DCIS high grade DCIS G3 (irrespective of growth pattern as well as comedo type necrosis or not): > 2 x RBC non-high grade DCIS: < 2 x RBC comedo type necrosis seen: G2 Concordance with histology 95 % 7 Torill Sauer, Department Torill Sauer, of Pathology, Department Akershus of Pathology, University Akershus Hospitak University Hospital

8 In a setting of mammographic microcalcifications WITHOUT a tumour the following features are characteristic of high grade DCIS: 8

9 Threedimensional solid or cribriform aggregates 9

10 Nuclei > 2 x RBC 10

11 Comedo type necrosis 11

12 Microcalcifications 12

13 Ocassionally papillary or micropapillary 13

14 Variable number of single cell component Note also the microcalcifications! 14

15 Dissociation in single cells is (still) a criterion of malignancy, But it is NOT a feature of invasiveness 15

16 Diagnostic considerations high nuclear grade DCIS Some cases of IDC grade 3 may present cytologically with necrosis and microcalcifications on FNAC, but the radiology will be that of a tumour A few DCIS may be tumour-forming (-8 % with radiological mass or assymetry) Palpable tumours with cytologic characteristics like DCIS are invasive in 97 % of the cases Microinvasion will not be sampled Invasive lesions not recognised radiologically will not have been sampled and about 20 % of radiological DCIS will have an invasive component in the surgical specimen Single cells are not a feature of invasion 16

17 DCIS varia In a setting of microcalcifications without tumour a diagnosis of high grade DCIS may be given The question is not «invasive OR in situ», but «is there an invasive component in addition to the DCIS?» The larger the extent of high grade DCIS, the larger the risk of an additional invasive component In a setting of radiological tumor, approx 97 % of the lesions are invasive (with or without an in situ component) 17

18 non-high grade DCIS In a setting of microcalcifications without tumor, the following is characteristic of a none-high grade DCIS (low and intermediate grades) 18

19 Very large three-dimensional aggregates;solid, cribriform and often more cohesive than high grade lesions 19

20 Cell monotony 20

21 Micropapillary groups 21

22 True papillary structures 22

23 Monolayer (two-dimensional) sheets +micropapillary 23

24 Variable number of single cells 24

25 Microcalcifications 25

26 Occasional comedo type necrosis 26

27 Low to moderate/intermediate nuclear atypia 27

28 Diagnostic pitfalls and considerations in low- and intermediate-grade DCIS The cytological criteria overlap with epithelial hyperplasia with and without atypia (ADH, columnar cell lesions) A diagnosis suggestive of non-high grade DCIS should ONLY result in a diagnostic biopsy for confirmation, never mastectomy or ALND Some of the lesions might appear deceivingly monotonous, in contrast to some benign, hyperplastic lesions with a polymorphous cell pattern Numerous single cells are not indicative of an invasive lesion Myoepithelial cell nuclei on the epithelial groups are no «proof» of a benign lesion. Pure subtypes as to growth pattern is virtually non-exisent 28

29 Diagnostic categories low grade DCIS Equivocal C3-C4 proliferative with low grade atypia suspicious for low grade DCIS/ADH 29

30 Columnar cell lesions (WHO) CCC and CCL are lesions of the terminal-duct lobular unit (TDLU) enlarged, variably diated acini lined by columnar epithelial cells Flat epithelial atypia is a neoplastic alteration of the TDLU replacement of the native epithelial cells by one to several layers of a single epithelial cell type showing low-grade (monomorphic) cytological atypia Radiologically seen as grouped microcalcifications 30

31 Cytological features of the columnar cell lesions have not been published in the cytological literature, but. 31

32 Monolayer sheets, microcalcifications and debris 32

33 Crowded palisading strips 33

34 Complex sheet/aggregate 34

35 Secretoric debris/mucous material, macrophages, microcalcifications 35

36 CLL diagnostics and pitfalls/caveats The full spectrum of cytologic features is not known The entity of CLL harbor a continous spectrum of architectural and cellular/nuclear changes from «benign» to «flat atypia» Myoepithelial cells/nuclei are often absent None or low grade nuclear atypia Is a risk lesion for simultaneous ILC TUB LCIS/ALH Low grade DCIS/ADH Risk of over- and underdiagnosis Reporting category: proliferative, with or without atypia, and with a reccommendation of biopsy 36

37 Example CLL 65 yrs Group of microcalcifications 1 cm US-guided FNAC 37

38 38

39 TUB CLL 39

40 Lobular neoplasia lobular carcinoma in situ several variants of lobular carcinoma in situ (LCIS) have been recognized classical type pleomorphic LCIS (PLCIS) LCIS with Comedo Necrosis carcinoma in situ with mixed ductal and lobular features clear cell variant signet ring cell variant 40

41 Pleomorphic lobular carcinoma in situ (PLCIS) Sneige N et al. Mod Pathol 2002 Cells appear dyshesive More pleomorphism than in classical LCIS Usually abundant cytoplasm Cytoplasm may appear eosinophilic or granular (apocrine appearance) Comedo type necrosis and microcalifications common 41

42 PLCIS radiologically they appear as suspicious microcalcifications (almost always present) can be difficult to differentiate from ductal carcinoma in situ (on histology) The dyshesive appearance of the cells is helpful in making this diagnosis, lack of E-cadherin 42

43 Immunophenotype of PLCIS ER/PgR positive E-cadherin negative may show HER2 protein overexpression/gene amplification (particularly if associated with invasive carcinoma) may show p53 positivity moderate to high Ki67 labeling index 43

44 Cytologic features of PLCIS Solid three-dimensional aggregates Dyscohesive with loosely cohesive cells and often abundant single cells Variable, but often abundant cytoplasm; often granular and eosinophilic Distinct cellular pleomorphism with variable cellular size and shape Often plasmacytoid Cytoplasmic vacuoles more common in PLCIS than in DCIS Distinct nuclear pleomorphism with nuclear size up in the range of high grade DCIS (> 2x RBC) Comedo type necrosis and microcalcification AS IN DCIS 44

45 Cell dissociation and pleomorphism 45

46 Comedo necrosis and microcalcifications 46

47 Microcalcification 47

48 Solid, threedimensional aggregates and myoepithelial cells 48

49 Cytoplasmic vacuoles and amount of cytoplasm 49

50 PAP and ThinPrep morphology 50

51 Which means: Nuclear features, amount and appearance of cytoplasm, dissociation and pleomorphism are not distinguishable from high nuclear grade DCIS No cytomorphological feature(s) that definitely separates PLCIS and high grade DCIS 51

52 If you consider PLCIS: E-cadherin ICC 52

53 Diagnostic considerations PLCIS Obviously malignant cells Radiological microcalcification without tumour, suspicious of high grade DCIS Total overlap with cytological criteria of high grade DCIS Perhaps more plasmacytoid in appearance and with more cytoplasm than most DCIS Cytoplasmic vacuoles more common than in DCIS Nuclear size > 2 x RBC, but usually not very much larger Previously diagnosed as DCIS in histology and cytology As of today: no difference in treatment 53

54 End of session! 54

Diagnostic Challenge. Department of Pathology,

Diagnostic Challenge. Department of Pathology, Cytology of Pleural Fluid as a Diagnostic Challenge Paavo Pääkkö,, MD, PhD Chief Physician and Head of the Department Department of Pathology, Oulu University Hospital,, Finland Oulu University Hospital

More information

Breast Fine Needle Aspiration Cytology Reporting : A Study of Application of Probabilistic Approach

Breast Fine Needle Aspiration Cytology Reporting : A Study of Application of Probabilistic Approach 54 Original Study Indian Medical Gazette FEBRUARY 2013 Breast Fine Needle Aspiration Cytology Reporting : A Study of Application of Probabilistic Approach Amrish N. Pandya, Professor & Head, IHBT Department,

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

Ductal Epithelial Lesions: Ductal Carcinoma In Situ vs Atypical Ductal Hyperplasia vs Flat Epithelial Atypia

Ductal Epithelial Lesions: Ductal Carcinoma In Situ vs Atypical Ductal Hyperplasia vs Flat Epithelial Atypia Ductal Epithelial Lesions: Ductal Carcinoma In Situ vs Atypical Ductal Hyperplasia vs Flat Epithelial Atypia Yunn-Yi Chen, M.D., Ph.D. UCSF Pathology Department yunn-yi.chen@ucsf.edu June 3, 2010 Before

More information

Breast Imaging Made Brief and Simple. Jane Clayton MD Associate Professor Department of Radiology LSUHSC New Orleans, LA

Breast Imaging Made Brief and Simple. Jane Clayton MD Associate Professor Department of Radiology LSUHSC New Orleans, LA Breast Imaging Made Brief and Simple Jane Clayton MD Associate Professor Department of Radiology LSUHSC New Orleans, LA What women are referred for breast imaging? Two groups of women are referred for

More information

Information Model Requirements of Post-Coordinated SNOMED CT Expressions for Structured Pathology Reports

Information Model Requirements of Post-Coordinated SNOMED CT Expressions for Structured Pathology Reports Information Model Requirements of Post-Coordinated SNOMED CT Expressions for Structured Pathology Reports W. Scott Campbell, Ph.D., MBA James R. Campbell, MD Acknowledgements Steven H. Hinrichs, MD Chairman

More information

Patologia neoplastica borderline della mammella"

Patologia neoplastica borderline della mammella Patologia neoplastica borderline della mammella" Anna Sapino Department of Medical Sciences University of Torino (Italy) B3 Lesion of uncertain malignant potential This category mainly consists of lesions

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

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

MAMMOGRAPHY GOALS AND OBJECTIVES

MAMMOGRAPHY GOALS AND OBJECTIVES MAMMOGRAPHY GOALS AND OBJECTIVES GOALS: After completion of the mammography rotations, the resident will be able to: 1. Demonstrate learning of the knowledge-based objectives-(practice Base Learning) 2.

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

Mammography Education, Inc.

Mammography Education, Inc. Mammography Education, Inc. 2011 LÁSZLÓ TABÁR, M.D.,F.A.C.R (Hon) 3D image of a milk duct MULTIMODALITY DETECTION and DIAGNOSIS of BREAST DISEASES PRAGUE, Czech Republic Crown Plaza, Prague June 29 - July

More information

BREAST IMAGING. Developed by the Ad Hoc Committee on Resident and Fellow Education of the Society of Breast Imaging

BREAST IMAGING. Developed by the Ad Hoc Committee on Resident and Fellow Education of the Society of Breast Imaging BREAST IMAGING Developed by the Ad Hoc Committee on Resident and Fellow Education of the Society of Breast Imaging Stephen A. Feig, M.D., Chair Ferris Hall, M.D. Debra Ikeda, M.D. Ellen Mendelson, M.D.

More information

Biom chromosomal Aberrations and Cancer

Biom chromosomal Aberrations and Cancer Clin Oncol Cancer Res (2011) 8: 123 127 123 DOI 10.1007/s11805-011-0569-5 Low-Grade and High-Grade Invasive Ductal Carcinomas of the Breast Follow Divergent routes of Progression Estifanos P.GEBREAMLAK

More information

Evaluation and Management of the Breast Mass. Gary Dunnington,, M.D. Department of Surgery Internal Medicine Ambulatory Conference December 4, 2003

Evaluation and Management of the Breast Mass. Gary Dunnington,, M.D. Department of Surgery Internal Medicine Ambulatory Conference December 4, 2003 Evaluation and Management of the Breast Mass Gary Dunnington,, M.D. Department of Surgery Internal Medicine Ambulatory Conference December 4, 2003 Common Presentations of Breast Disease Breast Mass Abnormal

More information

Non-cancerous Breast Conditions

Non-cancerous Breast Conditions Non-cancerous Breast Conditions Non-cancerous breast conditions are very common and most women have them. In fact, most breast changes that are tested turn out to be benign. Benign is another word for

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

Classificazioni citologiche: verso uno schema internazionale unificato?

Classificazioni citologiche: verso uno schema internazionale unificato? Cytology and molecular biology for thyroid nodules diagnos6c categories to clinical ac6ons From Classificazioni citologiche: verso uno schema internazionale unificato? A. Crescenzi Diagnostic categories

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

Ductal Carcinoma In Situ of the Breast

Ductal Carcinoma In Situ of the Breast Melchior de Hondecoeter, 1670. A Golden Eagle Attacking a Menagerie of Birds (detail). From the collection of Dr. and Mrs. Gordon Gilbert of St. Petersburg, FL. Ductal Carcinoma In Situ of the Breast Elisabeth

More information

Wisconsin Cancer Data Bulletin Wisconsin Department of Health Services Division of Public Health Office of Health Informatics

Wisconsin Cancer Data Bulletin Wisconsin Department of Health Services Division of Public Health Office of Health Informatics Wisconsin Cancer Data Bulletin Wisconsin Department of Health Services Division of Public Health Office of Health Informatics In Situ Breast Cancer in Wisconsin INTRODUCTION This bulletin provides information

More information

MAJOR PARADIGM SHIFT IN EARLY 1990S IN UNDERSTANDING RENAL CANCER

MAJOR PARADIGM SHIFT IN EARLY 1990S IN UNDERSTANDING RENAL CANCER Renal tumours WHO 4 MAJOR PARADIGM SHIFT IN EARLY 1990S IN UNDERSTANDING RENAL CANCER Molecular differential pathology of renal cell tumours G. KOVACS A CLASSIFICATION BASED ON UNDERSTANDING THE GENETIC

More information

R-16: Chronic nonspecific cervisit

R-16: Chronic nonspecific cervisit R-16: Chronic nonspecific cervisit Ectoservikal squamous epithelium Endoservical columnar epithelium Dilated cystic endoservical glands lymphoplasmocytes R18:Squamous cell carcinoma insitu Neoplastic epithelium

More information

Ductal Carcinoma In Situ

Ductal Carcinoma In Situ 23 rd Annual Seminar in Pathology Ductal Carcinoma In Situ A.A. Sahin, M.D. Professor of Pathology and Translation Molecular Pathology Section Chief of Breast Pathology Outline Incidence and natural history

More information

The Role of Genetic Testing in the Evaluation of Thyroid Nodules. Thyroid Cancer and FNA. Thyroid Cancer. Pure Follicular Cancers.

The Role of Genetic Testing in the Evaluation of Thyroid Nodules. Thyroid Cancer and FNA. Thyroid Cancer. Pure Follicular Cancers. Where does Molecular Analysis of FNA Specimens fit into the evaluation of thyroid nodules? The Role of Genetic Testing in the Evaluation of Thyroid Nodules Ultrasound TSH Risk factors Jill E. Langer, MD

More information

INFLAMMATION AND REACTIVE CHANGES IN CERVICAL EPITHELIUM

INFLAMMATION AND REACTIVE CHANGES IN CERVICAL EPITHELIUM INFLAMMATION AND REACTIVE CHANGES IN CERVICAL EPITHELIUM Inflammation is a response of a tissue to injury, often caused by invading microorganisms. The suffix which indicates inflammation is "-itis" (the

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

Keywords: breast cancer, breast lumps, mammary carcinoma, immunohistochemistry UNESCO EOLSS

Keywords: breast cancer, breast lumps, mammary carcinoma, immunohistochemistry UNESCO EOLSS THE PATHOLOGY OF BREAST CANCER Ali Fouad El Hindawi Cairo University. Kasr El Ainy Hospital. Egypt. Keywords: breast cancer, breast lumps, mammary carcinoma, immunohistochemistry Contents 1. Introduction

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

Management of Benign Intraductal Solitary Papilloma Diagnosed on Core Needle Biopsy

Management of Benign Intraductal Solitary Papilloma Diagnosed on Core Needle Biopsy Ann Surg Oncol (2013) 20:1900 1905 DOI 10.1245/s10434-012-2846-9 ORIGINAL ARTICLE BREAST ONCOLOGY Management of Benign Intraductal Solitary Papilloma Diagnosed on Core Needle Biopsy Ryan E. Swapp, MD 1,

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

VI. FREQUENTLY ASKED QUESTIONS CONCERNING BREAST IMAGING AUDITS

VI. FREQUENTLY ASKED QUESTIONS CONCERNING BREAST IMAGING AUDITS ACR BI-RADS ATLAS VI. FREQUENTLY ASKED QUESTIONS CONCERNING BREAST IMAGING AUDITS American College of Radiology 55 ACR BI-RADS ATLAS A. All Breast Imaging Modalities 1. According to the BI-RADS Atlas,

More information

PRIMARY SEROUS CARCINOMA OF PERITONEUM: A CASE REPORT

PRIMARY SEROUS CARCINOMA OF PERITONEUM: A CASE REPORT PRIMARY SEROUS CARCINOMA OF PERITONEUM: A CASE REPORT Dott. Francesco Pontieri (*) U.O. di Anatomia Patologica P.O. di Rossano (CS) Dott. Gian Franco Zannoni Anatomia Patologica Facoltà di Medicina e Chirurgia

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

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

Guideline for the Imaging of Patients Presenting with Breast Symptoms incorporating the guideline for the use of MRI in breast cancer

Guideline for the Imaging of Patients Presenting with Breast Symptoms incorporating the guideline for the use of MRI in breast cancer Guideline for the Imaging of Patients Presenting with Breast Symptoms incorporating the guideline for the use of MRI in breast cancer Version History Version Date Summary of Change/Process 0.1 09.01.11

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

Breast Cancer: from bedside and grossing room to diagnoses and beyond. Adriana Corben, M.D.

Breast Cancer: from bedside and grossing room to diagnoses and beyond. Adriana Corben, M.D. Breast Cancer: from bedside and grossing room to diagnoses and beyond Adriana Corben, M.D. About breast anatomy Breasts are special organs that develop in women during puberty when female hormones are

More information

Cytology of Lymph Nodes

Cytology of Lymph Nodes Indications Cytology of Lymph Nodes Lymph node enlargement That was easy Mary Anna Thrall Don Meuten Indications Lymph node enlargement Suspect metastasis Normal sized lymph nodes are Normal Do NOT aspirate

More information

Do Not Misinterpret Intraductal Carcinoma of the Prostate as High-grade Prostatic Intraepithelial Neoplasia!

Do Not Misinterpret Intraductal Carcinoma of the Prostate as High-grade Prostatic Intraepithelial Neoplasia! EUROPEAN UROLOGY 62 (2012) 518 522 available at www.sciencedirect.com journal homepage: www.europeanurology.com Editorial Do Not Misinterpret Intraductal Carcinoma of the Prostate as High-grade Prostatic

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

Polyps. Hyperplasias. CAP 2011: Course AP104. The High Risk Benign Endometrium. Mutter and Nucci 1

Polyps. Hyperplasias. CAP 2011: Course AP104. The High Risk Benign Endometrium. Mutter and Nucci 1 Course AP104 Endometrial Hyperplasia A morphologic Definition Hyperplasias Hormonal Effect or Precancer? George L. Mutter, MD Harvard Medical School and Brigham and Women s Hospital Boston, MA Endometrial

More information

Joelle M. Schoonjans, MD, Rachel F. Brem, MD

Joelle M. Schoonjans, MD, Rachel F. Brem, MD Sonographic Appearance of Ductal Carcinoma In Situ Diagnosed with Ultrasonographically Guided Large Core Needle Biopsy: Correlation with Mammographic and Pathologic Findings Joelle M. Schoonjans, MD, Rachel

More information

INVASIVE BREAST CANCER STRUCTURED REPORTING PROTOCOL (2 nd Edition 2012)

INVASIVE BREAST CANCER STRUCTURED REPORTING PROTOCOL (2 nd Edition 2012) INVASIVE BREAST CANCER STRUCTURED REPORTING PROTOCOL (2 nd Edition 2012) Core Document versions: AJCC Cancer Staging Manual 7 th edition (including errata corrected with 5th reprint 10 th Aug 2010). World

More information

330 Diagnostic Cytopathology, Vol 34, No 5 # 2006 WILEY-LISS, INC.

330 Diagnostic Cytopathology, Vol 34, No 5 # 2006 WILEY-LISS, INC. Does Hurthle Cell Lesion/Neoplasm Predict Malignancy More Than Follicular Lesion/Neoplasm on Thyroid Fine-Needle Aspiration? Robert T. Pu, M.D., Ph.D., 1 * Jack Yang, M.D., 2 Patricia G. Wasserman, M.D.,

More information

The evolving pathology of solitary fibrous tumours. Luciane Dreher Irion MREH / CMFT / NSOPS

The evolving pathology of solitary fibrous tumours. Luciane Dreher Irion MREH / CMFT / NSOPS The evolving pathology of solitary fibrous tumours Luciane Dreher Irion MREH / CMFT / NSOPS Historical review Haemangiopericytoma (HPC) first described primarily as a soft tissue vascular tumour of pericytic

More information

EIN. (Endometrial Intraepithelial Neoplasia): Improved Criteria for diagnosing endometrial precancer. Stanley J. Robboy, MD, FCAP,

EIN. (Endometrial Intraepithelial Neoplasia): Improved Criteria for diagnosing endometrial precancer. Stanley J. Robboy, MD, FCAP, EIN (Endometrial Intraepithelial Neoplasia): Improved Criteria for diagnosing endometrial precancer Stanley J. Robboy, MD, FCAP, FFPath FRCPI (Hon), FRCPath (UK, Hon) Professor of Pathology, Duke University

More information

biopsy specimens of the breast

biopsy specimens of the breast J Clin Pathol 1994;47:329-336 Expert system support using Bayesian belief networks in the diagnosis of fine needle aspiration biopsy specimens of the breast P W Hamilton, N Anderson, P H Bartels, D Thompson

More information

Case Report of Renal Cell Carcinoma Diagnosed in Voided Urine Confirmed by CD10 Immunocytochemistry

Case Report of Renal Cell Carcinoma Diagnosed in Voided Urine Confirmed by CD10 Immunocytochemistry Novel Insights from Clinical Practice DOI: 10.1159/000326940 Received: January 6, 2011 Accepted: February 21, 2011 Published online: July 22, 2011 Case Report of Renal Cell Carcinoma Diagnosed in Voided

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

Your Guide to the Breast Cancer Pathology Report

Your Guide to the Breast Cancer Pathology Report Your Guide to the Breast Cancer Pathology Report Developed for you by Breastcancer.org is a nonprofit organization dedicated to providing education and information on breast health and breast cancer. The

More information

SEMESTER VI 3 RD YEAR PATHOLOGY KIDNEY TUMORS

SEMESTER VI 3 RD YEAR PATHOLOGY KIDNEY TUMORS SEMESTER VI 3 RD YEAR PATHOLOGY KIDNEY TUMORS LEARNING OBJECTIVES At the end of the lecture, students should be able to: Know the pathology of renal tumors. RENAL TUMORS RENAL PAPILLARY ADENOMA Common

More information

Today s Topics. Tumors of the Peritoneum in Women

Today s Topics. Tumors of the Peritoneum in Women Today s Topics Tumors of the Peritoneum in Women Charles Zaloudek, M.D. Department of Pathology 505 Parnassus Ave., M563 University of California, San Francisco San Francisco, CA USA charles.zaloudek@ucsf.edu

More information

Breast Ultrasound: Benign vs. Malignant Lesions

Breast Ultrasound: Benign vs. Malignant Lesions October 25-November 19, 2004 Breast Ultrasound: Benign vs. Malignant Lesions Jill Steinkeler,, Tufts University School of Medicine IV Breast Anatomy Case Presentation-Patient 1 62 year old woman with a

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

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

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

Pleural and Pericardial fluids a one year analysis

Pleural and Pericardial fluids a one year analysis Pleural and Pericardial fluids a one year analysis Dr Olafsdottir Dr J Williams Department of Cytology, Llandough Hospital Contents Background Standards Aims/Questions Investigation group Results Conclusions

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

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

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

INTERDISCIPLINARY CONFERENCE. Florence/Firenze, Italy Nov 27-29, 2012 Centro Congressi al Duomo, Firenze BREAST SEMINAR SERIES

INTERDISCIPLINARY CONFERENCE. Florence/Firenze, Italy Nov 27-29, 2012 Centro Congressi al Duomo, Firenze BREAST SEMINAR SERIES Since breast cancer is not a systemic disease from inception, when the imagers find in situ and 1-14 mm invasive breast cancer, it is the surgeon, specialized in the treatment of breast diseases, who should

More information

Understanding your pathology report

Understanding your pathology report Understanding your pathology report 2 Contents Contents Introduction 3 What is a pathology report? 3 Waiting for your results 4 What s in a pathology report? 4 Information about your breast cancer 5 What

More information

Pathology. Journal of Cancer 2012, 3

Pathology. Journal of Cancer 2012, 3 226 Case Report Ivyspring International Publisher Journal of Cancer 2012; 3: 226-230. doi: 10.7150/jca.4091 A Case Report: Lobular Carcinoma In Situ in a Male Patient with Subsequent Invasive Ductal Carcinoma

More information

Protocol for the Examination of Specimens From Patients With Ductal Carcinoma In Situ (DCIS) of the Breast

Protocol for the Examination of Specimens From Patients With Ductal Carcinoma In Situ (DCIS) of the Breast Protocol for the Examination of Specimens From Patients With Ductal Carcinoma In Situ (DCIS) of the Breast Protocol applies to DCIS without invasive carcinoma or microinvasion. Based on AJCC/UICC TNM,

More information

PART TWO: DIAGNOSING BREAST CANCER

PART TWO: DIAGNOSING BREAST CANCER PART TWO: DIAGNOSING BREAST CANCER What is Breast Cancer? Normal cells can turn into cancer because of genetic inheritance or repeated exposure to a cancer-related substance in the environment, such as

More information

American College of Radiology ACR Appropriateness Criteria DUCTAL CARCINOMA IN SITU

American College of Radiology ACR Appropriateness Criteria DUCTAL CARCINOMA IN SITU American College of Radiology ACR Appropriateness Criteria Date of origin: 1996 Last review date: 2014 DUCTAL CARCINOMA IN SITU Expert Panel on Radiation Oncology Breast: Seth A. Kaufman, MD 1 ; Eleanor

More information

D. FREQUENTLY ASKED QUESTIONS

D. FREQUENTLY ASKED QUESTIONS ACR BI-RADS ATLAS D. FREQUENTLY ASKED QUESTIONS 1. Under MQSA, is it necessary to include a numeric assessment code (i.e., 0, 1, 2, 3, 4, 5, or 6) in addition to the assessment category in all mammography

More information

Recommendations for cross-sectional imaging in cancer management, Second edition

Recommendations for cross-sectional imaging in cancer management, Second edition www.rcr.ac.uk Recommendations for cross-sectional imaging in cancer management, Second edition Breast cancer Faculty of Clinical Radiology www.rcr.ac.uk Contents Breast cancer 2 Clinical background 2 Who

More information

Histologic Subtypes of Renal Cell Carcinoma

Histologic Subtypes of Renal Cell Carcinoma Histologic Subtypes of Renal Cell Carcinoma M. Scott Lucia, MD Associate Professor Chief of Genitourinary and Renal Pathology Director, Prostate Diagnostic Laboratory Dept. of Pathology University of Colorado

More information

Lung Carcinomas New 2015 WHO Classification. Spasenija Savic Pathology

Lung Carcinomas New 2015 WHO Classification. Spasenija Savic Pathology Lung Carcinomas New 2015 WHO Classification Spasenija Savic Pathology ***EXPECTED SPRING 2015*** This authoritative, concise reference book provides an international standard for oncologists and pathologists

More information

The Use of Immunohistochemistry to Distinguish Reactive Mesothelial Cells From Malignant Mesothelioma in Cytologic Effusions

The Use of Immunohistochemistry to Distinguish Reactive Mesothelial Cells From Malignant Mesothelioma in Cytologic Effusions The Use of Immunohistochemistry to Distinguish Reactive Mesothelial Cells From Malignant Mesothelioma in Cytologic Effusions Farnaz Hasteh, MD 1 ; Grace Y. Lin, MD, PhD 1 ; Noel Weidner, MD 1 ; and Claire

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

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

CT and MRI features of the Pathologic Subtypes of Papillary Renal Cell Carcinoma. Melissa Price, MD Aoife Kilcoyne, MD Mukesh G.

CT and MRI features of the Pathologic Subtypes of Papillary Renal Cell Carcinoma. Melissa Price, MD Aoife Kilcoyne, MD Mukesh G. CT and MRI features of the Pathologic Subtypes of Papillary Renal Cell Carcinoma Melissa Price, MD Aoife Kilcoyne, MD Mukesh G. Harisinghani, MD Disclosures Neither I nor my immediate family members have

More information

Breast Cancer Management Clinical Guidelines. Prepared by the Clinical Guidelines Committee Royal College of Surgeons in Ireland November 2000

Breast Cancer Management Clinical Guidelines. Prepared by the Clinical Guidelines Committee Royal College of Surgeons in Ireland November 2000 Breast Cancer Management Clinical Guidelines Prepared by the Clinical Guidelines Committee Royal College of Surgeons in Ireland November 2000 Mr. T. N. Walsh Prof. N. O Higgins Mr. T. N. Walsh Senior Lecturer

More information

MATERIALS AND METHODS: Aim of the study was to study the cytomorphological spectrum of breast lesions on Fine needle aspiration cytology (FNAC).

MATERIALS AND METHODS: Aim of the study was to study the cytomorphological spectrum of breast lesions on Fine needle aspiration cytology (FNAC). CYTOMORPHOLOGICAL STUDY OF SPECTRUM OF BREAST LESIONS AND DETERMINATION OF EFFICACY OF FNAC IN THE DIAGNOSIS OF VARIOUS BREAST LESIONS Manas Madan 1, Manisha Sharma 2, Rahul Mannan 3, Mridu Manjari 4,

More information

How To Diagnose And Treat A Tumour In An Effusion

How To Diagnose And Treat A Tumour In An Effusion Effusions of the Serous Cavities Annika Dejmek Professor/Consultant in Cytopathology Clinical Pathology; Department of Laboratory Medicine, Malmö, Lund University 5th EFCS Tutorial Trondheim 2012 Pleura

More information

Intraobserver and Interobserver Reproducibility of WHO and Gleason Histologic Grading Systems in Prostatic Adenocarcinomas

Intraobserver and Interobserver Reproducibility of WHO and Gleason Histologic Grading Systems in Prostatic Adenocarcinomas International Urology and Nephrology 28 (1), pp. 73-77 (1996) Intraobserver and Interobserver Reproducibility of WHO and Gleason Histologic Grading Systems in Prostatic Adenocarcinomas $. O. OZDAMAR,*

More information

Guidelines for reporting histopathology of cervical carcinoma

Guidelines for reporting histopathology of cervical carcinoma Guidelines for reporting histopathology of cervical carcinoma Naveena Singh, Consultant Pathologist Introduction Cancer management is multidisciplinary Histopathology report has a MAJOR impact on management

More information

Malignant Mesothelioma in Body Fluids - with Special Reference to Differential Diagnosis from Metastatic Adenocarcinoma -

Malignant Mesothelioma in Body Fluids - with Special Reference to Differential Diagnosis from Metastatic Adenocarcinoma - The Korean Journal of Pathology 2009; 43: 458-66 DOI: 10.4132/KoreanJPathol.2009.43.5.458 Malignant Mesothelioma in Body Fluids - with Special Reference to Differential Diagnosis from Metastatic Adenocarcinoma

More information

Your Guide to the Breast Cancer Pathology Report

Your Guide to the Breast Cancer Pathology Report Your Guide to the Breast Cancer Pathology Report Developed for you by Breastcancer.org is a nonprofit organization dedicated to providing education and information on breast health and breast cancer. The

More information

Case of the. Month October, 2012

Case of the. Month October, 2012 Case of the Month October, 2012 Case The patient is a 47-year-old male with a 3-week history of abdominal pain. A CT scan of the abdomen revealed a suggestion of wall thickening at the tip of the appendix

More information

Explanation of your PAP smear

Explanation of your PAP smear Explanation of your PAP smear Approximately 5-10% of PAP smears in the United States are judged to be abnormal. Too often, the woman who receives this news worries that she already has, or will develop,

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

Pulmonary Adenocarcinomas - Subtyping and differential diagnosis

Pulmonary Adenocarcinomas - Subtyping and differential diagnosis Pulmonary Adenocarcinomas - Subtyping and differential diagnosis by Dr. med. Arne Warth Prof. Dr. med. Wilko Weichert 1. Introduction... 3 2. The lepidic lesions... 4 2.1. Introduction... 4 2.2. Atypical

More information

Breast Cancer and Screening

Breast Cancer and Screening Chapter 1 Breast Cancer and Screening The world-wide burden of breast cancer Of the 10 million new cases of invasive cancer world-wide each year in males and females combined, 10% arise in the breast,

More information

Basic Professional Training Program for Associate Medical Technologist

Basic Professional Training Program for Associate Medical Technologist Basic Professional Training Program for Associate Medical Technologist Basic Cytology Part 2 (Preparartion and normal morphology) Normal Morphology in Liquid based Gynecologic Cytology Speaker: Mr. Fung

More information

Ovarian mucinous lesions. Ovarian mucinous lesions: Common diagnostic dilemmas. Ovarian mucinous lesions: problematic issues

Ovarian mucinous lesions. Ovarian mucinous lesions: Common diagnostic dilemmas. Ovarian mucinous lesions: problematic issues Ovarian mucinous lesions Ovarian mucinous lesions: Common diagnostic dilemmas Karuna Garg, MD University of California San Francisco Intestinal or usual type Seromucinous (Endocervical mucinous or Mullerian

More information

ALTHOUGH excellent accounts have been published in recent years of

ALTHOUGH excellent accounts have been published in recent years of THE EXFOLIATIVE CYTOLOGY OF DIFFUSE MALIGNANT MESOTHELIOMA BERNARD NAYLOR Department of Pathology, University of Michigan, Ann Arbor, Michigan, U.S.A. PLATE~ LXXXVI-XCI ALTHOUGH excellent accounts have

More information

Effusion cytology. Dr Alpha Tsui Royal Melbourne Hospital 2008

Effusion cytology. Dr Alpha Tsui Royal Melbourne Hospital 2008 Effusion cytology Dr Alpha Tsui Royal Melbourne Hospital 2008 General points: -large unilateral effusion (>1 litre) in the elderly is highly suspicious for malignancy -effusions associated with malignancies

More information

The management of lobular carcinoma in situ (LCIS). Is LCIS the same as ductal carcinoma in situ (DCIS)?

The management of lobular carcinoma in situ (LCIS). Is LCIS the same as ductal carcinoma in situ (DCIS)? E U R O P E A N J O U R N A L O F CA N C E R42 (2006) 2205 2211 available at www.sciencedirect.com journal homepage: www.ejconline.com The management of lobular carcinoma in situ (LCIS). Is LCIS the same

More information

Corporate Medical Policy Molecular Markers in Fine Needle Aspirates of the Thyroid

Corporate Medical Policy Molecular Markers in Fine Needle Aspirates of the Thyroid Corporate Medical Policy Molecular Markers in Fine Needle Aspirates of the Thyroid File Name: Origination: Last CAP Review: Next CAP Review: Last Review: molecular_markers_in_fine_needle_aspirates_of_the_thyroid

More information

Ductal carcinoma in situ (DCIS)

Ductal carcinoma in situ (DCIS) DIAGNOSIS: DCIS Ductal carcinoma in situ (DCIS) This factsheet gives information on an early form of breast cancer called ductal carcinoma in situ (DCIS). It explains what it is, how your breast is made

More information

KIDNEY CARCINOMA ASSOCIATED WITH XP11.2 TRANSLOCATION / TFE3 (ASPL-TFE3) GENE FUSION

KIDNEY CARCINOMA ASSOCIATED WITH XP11.2 TRANSLOCATION / TFE3 (ASPL-TFE3) GENE FUSION Case Report International Braz J Urol Official Journal of the Brazilian Society of Urology KIDNEY CA AND Xp11.2 TRANSLOCATION Vol. 31 (3): 251-255, May - June, 2005 KIDNEY CARCINOMA ASSOCIATED WITH XP11.2

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

Ductal Carcinoma in Situ: A Case Report

Ductal Carcinoma in Situ: A Case Report Ductal Carcinoma in Situ: A Case Report Abstract Breast ductal carcinoma in situ (DCIS) is a preinvasive form of breast cancer and is the most common type of in situ breast cancer found in women. There

More information