Oropharyngeal Hairy Polyp: A Case of Respiratory Failure in a Newborn

Hairy polyps, also known as dermoid polyps (DPs), are rare benign cystic lesions of bigerminal origin that may occur in several head and neck regions, including the oropharynx. Despite their benign histopathological nature, DPs may be life threatening, due to their upper airway location, and DPs represent one of the most unusual causes of respiratory distress during the neonatal period. In this paper, we describe a case of respiratory failure in a newborn with an oropharyngeal mass that was accidentally found during difficult intubation. Magnetic resonance imaging (MRI) detected a well-defined soft tissue pedunculated mass, arising from the left oropharynx wall, consistent with an oropharyngeal DP. The newborn had a prompt recovery after trans-oral mass removal. Our case underlines the importance of imaging in differential diagnosis of children's respiratory distress, secondary to a variety of lesions within the region of the skull base or oropharynx. It allowed us to assess the origin of the lesion, as well as its relationship with the adjacent soft tissues, and to exclude intracranial extension, thus providing essential information for the surgical planning

Biomarker characterization in endometrial cancer in Europe: first survey data analysis from 69 pathological academic and hospital labs

Introduction. Endometrial carcinoma (EC) is the commonest gynecological cancer affecting women in Western populations. To predict patient risk, the 2020 edition of the World Health Organization (WHO) Classification of Tumors of the Female Genital Tract stressed the importance of integrated histo-molecular classification of the disease. This survey analysis poses attention on the most frequently used immunohistochemical and molecular markers adopted in daily categorization of ECs in European laboratories. Methods. We analyzed data collected through questionnaires administered to 40 Italian, 20 Spanish, 3 Swiss and 6 United Kingdom (UK) laboratories. We collected information regarding daily practice in EC evaluation, specifically concerning mismatch repair status (MMR) and microsatellite instability (MSI). Summary and descriptive statistical analyses were carried out to evaluate the current practice of each laboratory. Results. The results show that MMR status is mainly evaluated by using immunohistochemistry (IHC) on most EC samples. The most frequent approach for the analysis of MMR status is IHC of four proteins (PMS2, MSH6, MSH2, MLH1). MSI analysis by molecular methods is uncommon but useful as a supplemental tool in specific conditions. MLH1 promoter hypermethylation and BRAF V600 mutations analysis are performed in case of negative expression of MLH1/PMS2. Other markers (mainly p53 followed by POLE and PTEN) are investigated in particular in Spain and Switzerland in a consistent number of cases. Conclusion. Guidelines consultation and standardization of laboratory procedures are efficient means for EC prognostic risk stratification and improving the quality of care

Appendiceal collision tumors: case reports, management and literature review

Appendiceal tumors are incidentally detected in 0.5% cases of appendectomy for acute appendicitis and occur in approximately 1% of all appendectomies. Here, we report two cases of appendiceal collision tumors in two asymptomatic women. In both cases, imaging revealed right-lower-quadrant abdominal masses, which were laparoscopically resected. In both cases, histological examinations revealed an appendiceal collision tumor comprising a low-grade appendiceal mucinous neoplasm and well-differentiated neuroendocrine neoplasm (NEN). For complete oncological control, right hemicolectomy was performed in one patient for the aggressive behavior of NEN; however, histology revealed no metastasis. The other patient only underwent appendectomy. No further treatment was recommended. According to the latest guidelines, exact pathology needs to be defined. Proper management indicated by a multidisciplinary team is fundamental

Prognostic significance of cytokeratin 19 in pancreatic endocrine tumours

Presupposti. La prognosi delle neoplasie endocrine pancreatiche \ue8 difficile da stabilire nonostante la recente classificazione dell\u2019OMS. Studi recenti hanno evidenziato il potenziale ruolo prognostico di alcuni marcatori come CK19, CD99 e P27. Scopo. Valutare il ruolo prognostico dell\u2019espressione di CK19 nelle neoplasie endocrine pancreatiche. Materiali e metodi. Sono state analizzate 149 neoplasie endocrine pancreatiche per l\u2019espressione immunoistochimica di CK19 utilizzando tissue array. Risultati. La presenza di CK19 \ue8 stata riscontrata in 100/149 (67,1%) e in 26 su 35 (74.2%) corrispondenti metastasi sia linfonodali che viscerali. E\u2019 stata evidenziata una correlazione statisticamente significativa tra espressione di CK19 e le dimensioni del tumore, lo stato linfonodale, la presenza di metastasi, la sopravvivenza a cinque anni, e con i sottogruppi della classificazione OMS che mostrano una prognosi peggiore (carcinomi endocrini ben differenziati e carcinomi endocrini poco differenziati) Conclusioni: Il presente studio conferma l\u2019associazione dell\u2019espressione di CK19 con le dimensioni del tumore, lo status linfonodale, la presenza di metastasi, la sopravvivenza a cinque anni, e con i sottogruppi della OMS2004 che mostrano una prognosi peggiore. L\u2019analisi multivariata non ha confermato il ruolo della CK19 come marcatore prognostico indipendente. Possiamo quindi concludere che CK19 pu\uf2 essere utilizzato come marcatore di malignit\ue0 ma non come marcatore prognostico indipendente.Aim: Pancreatic endocrine tumours are rare neoplasm, whose behaviour is difficult to predict. Recent 2004 WHO classification gives clear criteria to define prognosis of PET, but despite these criteria some tumours show a more aggressive course. Recent studies lighted the role of some immunohistochemical markers as CK19, CD99, P27 as prognostic marker in pancreatic endocrine. The aim of this study was to evaluate the prognostic value of CK19 expression in PETs. Methods and results: 149 PETs and 35 mached metastases were studied using tissue array technology and evaluating immunohistochemical expression of CK19. The presence of CK 19 was detected in a total of 100/149 primitive tumours (67.1%) and 26/35 (74.2%) metastases both in lymph node and in other sites. The difference between the prevalence of CK 19 in metastasis and primitive tumours was not significant. There was a strong correlation between presence of CK 19 in the primitive and its matched metastasis (Fisher's test; P = 0.0012). The results were statistically compared with follow up data, showing a significant correlation with with tumour dimension, lymph node status, presence of metastasis, 5 years survival, and with the subgroups of WHO 2004 classification that have a worse prognosis (WDEC and PDEC). When the WHO parameter was added to the model, ck19 was no longer significantly associated with survival. Furthermore, ck19 expression was not significantly associated with survival when evaluated in single WHO subgroups. Conclusions: We conclude that ck19 can be used as a malignancy marker and index but they are not an independent prognostic marker

Application of Digital Imaging and Artificial Intelligence to Pathology of the Placenta

Digital imaging, including the use of artificial intelligence, has been increasingly applied to investigate the placenta and its related pathology. However, there has been no comprehensive review of this body of work to date. The aim of this study was to therefore review the literature regarding digital pathology of the placenta. A systematic literature search was conducted in several electronic databases. Studies involving the application of digital imaging and artificial intelligence techniques to human placental samples were retrieved and analyzed. Relevant articles were categorized by digital image technique and their relevance to studying normal and diseased placenta. Of 2008 retrieved articles, 279 were included. Digital imaging research related to the placenta was often coupled with immunohistochemistry, confocal microscopy, 3D reconstruction, and/or deep learning algorithms. By significantly increasing pathologists' ability to recognize potentially prognostic relevant features and by lessening inter-observer variability, published data overall indicate that the application of digital pathology to placental and perinatal diseases, along with clinical and radiology correlation, has great potential to improve fetal and maternal health care including the selection of targeted therapy in high-risk pregnancy

Biomarker characterization in endometrial cancer in Italy: first survey data analysis

Endometrial carcinoma (EC) is the most common gynecological malignant disease in high income countries. The 2020 edition of the World Health Organization (WHO) Classification of Tumors of the Female Genital Tract underlines the important clinical implications of the new integrated histo-molecular classification system, in order to correctly define the specific prognostic risk group. This survey analysis will focus on the most commonly adopted immunohistochemical and molecular biomarkers used in daily clinical characterization of a diagnosed endometrial carcinoma in Italian labs

sj-docx-1-pdp-10.1177_10935266221137953 – Supplemental material for Application of Digital Imaging and Artificial Intelligence to Pathology of the Placenta

Supplemental material, sj-docx-1-pdp-10.1177_10935266221137953 for Application of Digital Imaging and Artificial Intelligence to Pathology of the Placenta by Stefano Marletta, Liron Pantanowitz, Nicola Santonicco, Alessandro Caputo, Emma Bragantini, Matteo Brunelli, Ilaria Girolami and Albino Eccher in Pediatric and Developmental Pathology</p

Recent Advances in Cervical Cancer Management: A Review on Novel Prognostic Factors in Primary and Recurrent Tumors

Background: Several pathological parameters, including tumor size, depth of stromal invasion, lympho-vascular space invasion and lymph node status, have been proposed as prognostic predictors in cervical cancer. However, given the high mortality and recurrence rate of cervical cancer, novel parameters that are able to provide additional prognostic information are needed in order to allow a better prognostic stratification of cervical cancer patients. Methods: A search was conducted on PubMed to identify relevant literature data regarding prognostic factors in cervical cancer. The key words &ldquo;cervical cancer&rdquo;, &ldquo;prognostic factors&rdquo;, &ldquo;pathology&rdquo;, and &ldquo;outcome&rdquo; were used. Results: The novel pathological grading system based on tumor budding and cell nest size appeared the most relevant prognostic factor in primary neoplasms. Moreover, other potentially useful prognostic factors were tumor size, depth of stromal invasion, lympho-vascular space invasion, perineural invasion, tumor-free distance and tumor-infiltrating lymphocytes. Prognostic factors related to advanced-stage cervical cancer, including lymph-nodes status, endometrial and cervical involvement as well as distant metastases, were also taken into consideration. Conclusions: According to our findings, tumor budding and cell nest size grading system, depth of stromal invasion, lympho-vascular space invasion, perineural invasion, tumor-free distance and tumor-infiltrating lymphocytes appeared the most relevant factors included in the pathology report

Recent Advances in Cervical Cancer Management: A Review on Novel Prognostic Factors in Primary and Recurrent Tumors

Background: Several pathological parameters, including tumor size, depth of stromal invasion, lympho-vascular space invasion and lymph node status, have been proposed as prognostic predictors in cervical cancer. However, given the high mortality and recurrence rate of cervical cancer, novel parameters that are able to provide additional prognostic information are needed in order to allow a better prognostic stratification of cervical cancer patients. Methods: A search was conducted on PubMed to identify relevant literature data regarding prognostic factors in cervical cancer. The key words “cervical cancer”, “prognostic factors”, “pathology”, and “outcome” were used. Results: The novel pathological grading system based on tumor budding and cell nest size appeared the most relevant prognostic factor in primary neoplasms. Moreover, other potentially useful prognostic factors were tumor size, depth of stromal invasion, lympho-vascular space invasion, perineural invasion, tumor-free distance and tumor-infiltrating lymphocytes. Prognostic factors related to advanced-stage cervical cancer, including lymph-nodes status, endometrial and cervical involvement as well as distant metastases, were also taken into consideration. Conclusions: According to our findings, tumor budding and cell nest size grading system, depth of stromal invasion, lympho-vascular space invasion, perineural invasion, tumor-free distance and tumor-infiltrating lymphocytes appeared the most relevant factors included in the pathology report