Analytical and Clinical Validation of the Oncomine Dx Target Test to Assess HER2 Mutation Status in Tumor Tissue Samples From Patients With Non-Small Cell Lung Cancer Treated With Trastuzumab Deruxtecan in the DESTINY-Lung01 and DESTINY-Lung02 Studies.

被引量：- 发表：1970

Histologic Features of Liver Injury Associated With SARS-CoV-2 Messenger RNA Vaccines.

Many drugs can induce liver injury; however, vaccine-induced liver injury is a rare phenomenon. SARS-CoV-2 messenger RNA (mRNA) vaccines are now widely administered, and clinical evidence of liver injury has been reported. To characterize the histologic features of SARS-CoV-2 mRNA vaccine-associated liver injury. Thirteen liver biopsies from 12 patients with elevated liver enzymes clinically favored to be secondary to SARS-CoV-2 mRNA vaccine were identified between 2021 and 2022. Demographics, clinical information, and histologic features of liver biopsies were reviewed. All patients (median age, 58 years; M:F = 4:8) received at least 1 dose of SARS-CoV-2 mRNA vaccines (7 Pfizer and 5 Moderna). Four patients had a history of liver disease. Nine patients developed symptoms between 1 day and 2 months after receiving the vaccine dose. Viral serologies were negative. Drug-induced liver injury was thought to be less likely clinically in the 3 patients who had started new medications. Autoimmune antibodies were detected in 9 patients. Moderate to severe active hepatitis was the dominant histologic pattern of injury (9 of 13 biopsies; 69%). Resolving hepatitis, cholestatic hepatitic injury, and bile duct injury were identified in 1 biopsy each. All patients recovered spontaneously or with steroid therapy except one patient who developed autoimmune hepatitis. Moderate to severe active hepatitis is commonly observed in SARS-CoV-2 mRNA vaccine-associated liver injury, and female patients may be more susceptible to injury. Liver injury resolves spontaneously or with steroid treatment. In rare cases, these vaccines may trigger an underlying immune condition.

被引量：- 发表：1970

Polypoid Kaposi Sarcoma Involving the Lower Gastrointestinal Tract: Clinicopathologic Study of 15 Cases.

Gastrointestinal manifestations of Kaposi sarcoma are rare but may cause morbidity. Lower gastrointestinal involvement is particularly rare and lesions may resemble conventional bowel polyps. To study 15 patients who presented with lower gastrointestinal tract Kaposi sarcoma with polypoid architecture. The surgical pathology files of the departments of pathology at multiple institutions were searched for cases of Kaposi sarcoma forming polyps in the lower gastrointestinal tract (jejunum, colon, rectum); 15 cases with such features were identified. Clinicopathologic information was extracted from the medical record and documented by reviewing individual hematoxylin-eosin stained slides. The patients were 13 men and 2 women aged 26-80 years (median = 44 years). Gastrointestinal tract involvement was multifocal in 11 cases and unifocal in 4. The tumors involved the rectum, recto-sigmoid junction, cecum, ascending colon, transverse colon, and descending colon and presented as polypoid lesions measuring 0.2-2.1 cm. Six patients had upper gastrointestinal tract involvement in addition to lower gastrointestinal lesions. Histologically the tumors were characterized in 6 cases by a dense spindle cell proliferation in the lamina propria; however, the remaining cases showed only a subtle fascicular spindle cell proliferation in the lamina propria that did not form an expansile mass. Biopsies of gastrointestinal polyps showing absence of the common features of hyperplastic or adenomatous polyps, particularly in immunocompromised patients, should be carefully examined for the presence of a stromal spindle cell proliferation. Use of immunohistochemical stains, particularly human herpesvirus-8, can help in establishing the correct diagnosis.

被引量：- 发表：1970

Cytologic Assessment of the Supernatants of Formalin Solution Following Histologic Examination of Transurethral Biopsy/Resection Specimens.

Urothelial denudation seen in transurethral biopsy specimens may occasionally indicate the presence of discohesive high-grade urothelial carcinoma (HGUC). To determine if denuded urothelial cells can be detected in the supernatants of formalin solution collected from the containers of transurethral biopsy/resection specimens after the entire tissue was submitted for histologic examination. We assessed the formalin supernatants by processing for cell block (n = 43) or ThinPrep smear (n = 57). In the cell block cohort, only 2 of 43 cases (5%) (1 pTa HGUC, 1 pT1 HGUC) showed rare urothelial cells. By contrast, in the ThinPrep method, the smear was satisfactory for evaluation in 52 of 57 cases (91%). The cytologic diagnosis of HGUC was made in the smears from 7 of 12 (58%) pTa/pT1 cases and 6 of 9 (67%) pTis cases. Remarkably, HGUC cells were detected in 2 of 5 cases (40%) with histologic diagnosis of urothelial atypia suspicious for but not diagnostic of urothelial carcinoma in situ. Additionally, in 31 cases exhibiting urothelial denudation without definitive cancer on hematoxylin-eosin-stained slides, HGUC cells (2 of 31; 6%), atypical urothelial cells (5 of 31; 16%), or benign-appearing urothelial cells (20 of 31; 65%) were present, and only 4 of 31 (13%) were unsatisfactory. Cytologic examination of ThinPrep smears from the formalin supernatants even following submission of the entire transurethral biopsy/resection specimens for histologic examination is useful for assessing denuded urothelial cells. This technique can particularly be applied to nonneoplastic cases showing extensive urothelial denudation to detect possible malignant cells and/or indeterminate cases to assist to make a more definitive diagnosis.

被引量：- 发表：1970

Gross Evaluation of Breast Carcinomas Post-Neoadjuvant Chemotherapy Without Radio-opaque Clip Insertion.

Gross evaluation of post-neoadjuvant chemotherapy breast carcinoma is challenging when the primary tumor is not localized before therapy with a radio-opaque wire/clip, a situation common in resource-constrained settings. To compare 2 grossing approaches in post-neoadjuvant chemotherapy breast carcinoma specimens to evaluate the sampling adequacy. Fifty breast carcinoma specimens were grossed in a 2-step manner. Tumor bed was identified using clinico-radiologic and gross correlation and 1 slice was selected as most representative (sample I). Subsequently, the entire tumor bed was submitted in grids of multiple slices (sample II). Agreement between methods was assessed using κ values. Sample I prepared an average of 8 blocks per case while sample II prepared 26 blocks. Pathologic complete response (pCR) by both methods was calculated. Sample I documented 23 cases with pCR of which 21 were confirmed by sample II. The 2 cases missed by sample I had less than 5% residual tumor (residual cancer burden class I). Both cases were human epidermal growth factor receptor 2 (HER2)-positive and residual tumor was seen in the slices adjacent to the selected slice. The concordance between the 2 methods was 94% with κ value of 0.915 for sample I, indicating excellent correlation with sample II. The average cost of sample I was 33% of that of sample II and helped calculate the residual cancer burden with similar accuracy. However, in HER2-positive cases, pCR may be overestimated. Hence, we recommend sampling slices adjacent to the selected tumor slice. Further study using this method is essential due to its limited sample size and single-center design before considering implementation in the general population.

被引量：- 发表：1970