Remains your authoritative source for comprehensive coverage of those skin diseases in which histopathology plays an important role in diagnosis. This edition maintains the proven, clinicopathologic classification of cutaneous disease while incorporating a “primer” on pattern-algorithm diagnosis. More than 1,800 full-color illustrations, including photomicrographs and clinical photographs, help you visualize and make the most of the clinical diagnostic process.

Lever's Histopathology of the Skin

Clinicopathologic correlates of solitary fibrous tumors.

The pathologist is responsible for making the "final diagnosis." When pathologists disagree, however, what does the bewildered clinician do? The Atlas of Tumor Pathology fascicles, published with the assistance of the Armed Forces Institute of Pathology, Washington, DC, have been a useful guide for pathologists and have helped to produce standard diagnostic classifications and terminology. Dr Arthur Hertig's original edition on tumors of the ovary, written with Hazel Gore, was superb and would be hard to compete with, but new material and tumor classifications that have come to light in the years since that work was published are all included in the second series fascicle produced by Dr Robert E. Scully. In producing a new fascicle on ovarian and dysgenetic gonadal tumors, Dr Scully undertook a formidable assignment. Tumors of the ovary present more varied histologic types than are found in any other organ in the body. This includes a

Tumors of the Ovary and Maldeveloped Gonads

Benign tumors and cysts of the epidermis

Cancer molecular markers: A guide to cancer detection and management.

Background: Prostate cancer is a major health problem throughout the developed world. Tumor grade is one of the most important prognostic factors of prostate cancer. At present, adequate prognostic markers for prostate cancer progression are still lacking, in spite of intensive investigation. Accordingly, we studied the role of immunohistochemical (IHC) expression of p53 and Ki-67 as a prognostic factor in carcinoma prostate and correlated their expression with Gleason's grade.
Materials and Methods: In this prospective study, a total of 60 cases including 50 cases of prostate carcinoma and 10 of benign prostatic hyperplasia (BPH) were taken. Tumor grade was determined according to Gleason's grading system. p53 and Ki-67 expressions were determined by IHC staining. The obtained results were analyzed and evaluated using Spearman's statistical test (SPSS version 20).
Results: In BPH, p53 was expressed in only 2 of 10 (20%) cases while in carcinoma it was expressed in 38 of 50 (76%) cases. Ki-67 was expressed in only 1 of 10 (10%) BPH cases while in carcinoma it was expressed in 32 of 50 (64%) cases. In present study, 1 of 4 (25%) well differentiated, 23 of 31 (74.19%) moderately differentiated and 14 of 15 (93.33%) poorly differentiated tumors revealed p53 immunopositivity and a statistically significant correlation was observed between p53 expression and increased Gleason's grade (P = 0.038). All 4 (100%) cases of well-differentiated carcinoma were negative for Ki-67 expression. Nineteen of 31 (61.29%) moderately differentiated and 13 of 15 (86.66%) poorly differentiated tumors were positive for Ki-67 and a statistically significant correlation was observed between Ki-67 positivity and increased Gleason's grade (P = 0.002).
Conclusions: Both p53 and Ki-67 were significantly up-regulated in malignant lesions as compared to benign lesions and a strong relationship with the Gleason's grading was noticed, therefore, we propose that these markers can be applied along with other prostate cancer prognostic factors.

Significance of p53 and ki-67 expression in prostate cancer.

Introduction: Oral squamous cell carcinoma is a major cause of death throughout the developed world. It is associated with smoking and alcohol consumption. Human papillomavirus (HPV) type 16 has also been suggested to play a role in etiology of head and neck squamous cell carcinoma (HNSCC). p16 expression is now being used as a surrogate marker of HPV infection in squamous cell carcinoma and provides important prognostic information and future therapy planning. Materials and Methods: In this prospective study, total of 75 cases of HNSCC were taken. Tumor grade was determined according to World Health Organization (WHO) criteria. p16 expression was determined by immunohistochemical staining. The obtained results were analyzed and evaluated using Chi-square test (Statistical Package for Social Sciences (SPSS) version 20), value of P Results: Out of 75 cases, 78.7% cases were positive for p16 (inclusive of all grades), while 21.3% cases were negative. Expression of p16 was higher in nonsmokers and nonalcohol consumers and significantly associated with paan chewing habit. No significant correlation was seen with history of abnormal sexual habits, but p16 expression was significantly correlated in cases with multiple sexual partners (P = 0.003), with increasing histological grade (P = 0.045) and in cases with lymph node metastasis (P = 0.03). Conclusion: As HPV integration with transcription of viral oncoprotein induces overexpression of p16, immunohistochemical expression of p16 can be used as a surrogate marker of HPV. This approach can be implemented in diagnostic laboratories and can provide support for vaccination program in high risk group.

Assessment and clinicopathological correlation of p16 expression in head and neck squamous cell carcinoma.

Malignant peripheral nerve sheath tumor (MPNST) is a rare nerve sheath tumor derived from Schwann cells or pleuripotent cells of neural crest. Neurogenic tumors make about 10-20% of all mediastinal tumors. Incidence of MPNST is 0.001% in general population and 0.16% in patients with neurofibromatosis I (NF I). We report a case of 60 year female presenting with progressive cough and breathlessness for 2 years. The CECT revealed multiple focal enhancing lesions along inferior mediastinal pleural surface and along lateral pleural surface. A thoracotomy and tumor excision was done and MPNST was diagnosed on microscopy and immunohistochemistry. This case highlights that this unusual tumor may involve lung parenchyma. So this possibility should be kept in mind in patients with intrathoracic mass.

http://ijp.iranpath.org/article_8297_177b78ca051a5d349f7c2a66cc1eda37.pdf

Intrathoracic Malignant Peripheral Nerve Sheath Tumor: Histopathological and Immunohistochemical Features.

Primary soft tissue sarcomas of the breast constitute less than 5% of all soft tissue sarcomas and less than 1% of malignant breast cancers. The rarity of this tumor limits most studies to small retrospective case reviews and case reports. Primary breast sarcomas are locally aggressive tumors as evidenced by the high rate of local recurrence when excisional surgery is performed. A contemporary multidisciplinary approach to therapy including surgery, radiation, and chemotherapy is advocated. Herein, we report a case of 45-yr-old female, who presented with a large ulcerated breast mass and was diagnosed as carcinoma breast on fine needle aspiration. Modified radical masectomy was performed and was diagonsed with primary breast stromal sarcoma on histopathology, which is a rare entity.

http://ijp.iranpath.org/article_23773_f92ac1fc2c43e69f760b55a17ed86905.pdf

Primary Stromal Sarcoma of Breast: A Rare Entity.

Aim: The aim of this study is to analyze the correlation/diagnostic accuracy of cytology and frozen section (FS) preparations in the intraoperative diagnoses of central nervous system (CNS) lesions. Materials and Methods: A total of 63 cases of CNS lesions were included in the study from July 2012 to January 2015 at a tertiary care referral hospital. Intraoperative specimens were used for crush/squash smears and FS and correlated with the final histopathological diagnosis. Results: Majority of the patients (73.02%) were presenting in the age range of 21–50 years. There was a slight female preponderance with male-to-female ratio of 1:1.1. Two out of 63 cases were excluded from the cytology correlation analysis due to inadequate materials and 3 out of 63 cases were excluded from the FS correlation analysis due to freezing artifacts. The diagnostic accuracy of cytological preparation was 80.33% for complete correlation with histopathology and was increased to 93.44% for adding the partial correlations. The corresponding figures for FS were 81.67% and 93.33%, respectively, and the difference was insignificant (P = 0.971). The sensitivity, specificity, positive predictive value, and negative predictive value in detecting neoplastic condition on cytology were 94.4%, 85.7%, 98.07%, and 66.67%, respectively, and that of FS were 96.15%, 75%, 96.15%, and 75%, respectively. The corresponding P = 0.872, 0.652, 0.986, and 0.561, respectively. Conclusion: Crush and FS preparation are considered as effective diagnostic procedures for rapid intraoperative diagnosis in CNS lesions without any significant difference in results and when applied simultaneously can produce a higher diagnostic accuracy complementing each other's results.

Megha Ralli

Papers

Significance of p53 and ki-67 expression in prostate cancer.

Assessment and clinicopathological correlation of p16 expression in head and neck squamous cell carcinoma.

Intrathoracic Malignant Peripheral Nerve Sheath Tumor: Histopathological and Immunohistochemical Features.

Primary Stromal Sarcoma of Breast: A Rare Entity.

Comparison between crush/squash cytology and frozen section preparation in intraoperative diagnosis of central nervous system lesions