Early-stage mucinous sweat gland adenocarcinoma of eyelid

We present the findings of an early-stage primary mucinous sweat gland adenocarcinoma in the lower eyelid of a Japanese patient. The patient was a 73-year-old man who had had a nodule on the left lower eyelid for two years. He was referred to our hospital with a diagnosis of a swollen chalazion. The clinical and histopathological records were reviewed and the mass was excised. Histopathological examination revealed a mucinous sweat gland adenocarcinoma. Postoperative magnetic resonance imaging and positron emission tomography excluded systemic metastases. After the histopathological findings, a complete surgical excision of the margins of the adenocarcinoma was performed, with histopathological confirmation of negative margins. After the final histopathological examination, the patient was diagnosed with a primary mucinous sweat gland adenocarcinoma of the left eyelid. Six months after the surgery, no recurrence has been observed. Because the appearance of mucinous sweat gland adenocarcinoma of the eyelid is quite variable, the final diagnosis can only be made by histopathological examination. A complete surgical excision is recommended

Online Training and Self-assessment in the Histopathologic Classification of Endocervical Adenocarcinoma and Diagnosis of Pattern of Invasion: Evaluation of Participant Performance

Histopathologic classification of endocervical adenocarcinomas (EAC) has recently changed, with the new system based on human papillomavirus (HPV)-related morphologic features being incorporated into the 5th edition of the WHO Blue Book (Classification of Tumours of the Female Genital Tract). There has also been the introduction of a pattern-based classification system to assess invasion in HPV-associated (HPVA) endocervical adenocarcinomas that stratifies tumors into 3 groups with different prognoses. To facilitate the introduction of these changes into routine clinical practice, websites with training sets and test sets of scanned whole slide images were designed to improve diagnostic performance in histotype classification of endocervical adenocarcinoma based on the International Endocervical Adenocarcinoma Criteria and Classification (IECC) and assessment of Silva pattern of invasion in HPVA endocervical adenocarcinomas. We report on the diagnostic results of those who have participated thus far in these educational websites. Our goal was to identify areas where diagnostic performance was suboptimal and future educational efforts could be directed. There was very good ability to distinguish HPVA from HPV-independent adenocarcinomas within the WHO/IECC classification, with some challenges in the diagnosis of HPV-independent subtypes, especially mesonephric carcinoma. Diagnosis of HPVA subtypes was not consistent. For the Silva classification, the main challenge was related to distinction between pattern A and pattern B, with a tendency for participants to overdiagnose pattern B invasion. These observations can serve as the basis for more targeted efforts to improve diagnostic performance

Application of cell block preparation in effusion cytology: Analysis of mismatched diagnosis and utility of immunostaining

Objective: To analyze the mismatched cases between liquid-based cytology (LBC) and cell block in effusion cytology and to confirm the utility of cell block. Methods: One hundred eighty-two samples of effusions were examined. Cell blocks were prepared from residual samples after LBC preparation, and the details about the diagnostic concordance and difference in cytological characteristics were investigated. Cell block immunostaining was performed to predict the histological type and the primary site of the carcinoma in 32 cases. ALK rearrangement and EGFR mutation were also analyzed using the cell block. Results: The diagnostic concordance rate between LBC and cell block was 97.3%. Diagnoses using LBC and cell block were mismatched in five cases. By immunostaining, the histological type was determined in 91.0% of carcinomas, and primary sites were identified in 76.5% of adenocarcinomas. ALK rearrangement was examined in two cases of lung carcinoma and EGFR mutation was examined in four cases of lung carcinoma. Conclusion: A high concordance rate between LBC and cell block in effusion cytology was found. The main cause of the mismatched diagnosis was the small amount of atypical cells in LBC or cell block. We also showed the utility of cell block in immunostaining and DNA analysis