Recent Advances in Histopathology 23 Massimo Pignatelli, Patrick Gallagher
INDEX
Note: Page numbers in bold or italic refer to tables or figures, respectively.
A
Abortion, 24
Acetaminophen overdose, and liver failure, 88, 89
Acinar predominant adenocarcinoma (APA), 33, 33
Acute cellular rejection (ACR), 1 see also Antibody-mediated rejection (AMR); Transplantation
Adenocarcinoma, 31, 32
adenocarcinoma in situ, 32
atypical adenomatous hyperplasia, 3132
fetal, 34, 35
in Barrett's oesophagus, 73, 77 (see also Barrett's oesophagus)
invasive mucinous, 3435, 35
invasive nonmucinous, 33, 3334
minimally invasive, 32
Adenosquamous carcinoma, 36, 39
Adiponectin, 52
Afatinib, 43
AFES see Amniotic fluid embolism syndrome (AFES)
Amniotic fluid embolism syndrome (AFES), 20, 2021, 21, 22
Amoebic colitis, 120, 120
Amplification refractory mutation system (ARMS), 66, 66
AMR see Antibody-mediated rejection (AMR)
Anaplastic lymphoma kinase (ALK), 4243
Antibody-mediated rejection (AMR), 1
and acute cellular rejection, 1
antibodies in pathogenesis of, role of, 23
capillary endothelial cells in, 2
cardiac, 69, 8
classification of, 3, 4
in liver, 910, 11
pathological diagnosis of, 34
pulmonary, 1013, 12, 13
renal, 46, 5, 7
severity of, 4
ATRA (all-trans retinoic acid), 63
Atypical adenomatous hyperplasia (AAH), 3132
Autofluorescence imaging (AFI), 79
B
Bariatric surgery, 5557, 56
and cholelithiasis, 57
deaths after, 55, 57
laparoscopic gastric banding, 55, 56
Roux-en-Y gastric bypass, 56, 57
vertical sleeve gastrectomy, 55, 56, 57
Barrett's oesophagus, 7374
adenocarcinomas in, 73, 77
biomarkers and risk stratification in, 8283
cancer risk in, 7677
diagnosis of, 76
dysplasia diagnosis in, 7879, 7981
endoscopic treatments, 83, 83, 84
imaging and detection of dysplasia, 79, 8182
mucosal phenotypes of, 7476, 75
population screening for, 76
postascertainment surveillance, 7778
Breast cancer, 6869, 178
Bronchiolitis obliterans syndrome (BOS), 11
Bronchioloalveolar carcinoma (BAC), 31, 32
C
Campylobacter jejuni, 142
Cancer
in Barrett's oesophagus, risk of, 7677
gene mutations in, 6163 (see also Gene mutations, in cancer)
genome screening, 6163, 62
lung (see Lung cancer)
obesity and, 54
Tensin proteins in, role of, 177178
Cancer Research UK Stratified Medicine Programme, 42
Carcinosarcoma, 36
Cardiac allograft vasculopathy (CAV), 4
Cardiac antibody-mediated rejection, 69
capillary endothelial cells and lumen, 7, 8
diffuse capillary deposition, 8, 8
diffuse microvascular inflammation in, 7, 8
grading, 7
ISHLT criteria, 6, 7
Cell adhesion, 169, 170, 170 see also Focal adhesions; Tensin proteins
Cervical cancer, 159 see also Human papilloma virus (HPV)
Cetuximab, 63
Chemotherapy, for treatment of non-small-cell lung carcinoma, 4041
Chronic inflammatory bowel disease (CIBD), 117118
amoebic colitis and, 120, 120
appendiceal neoplasia in, 132
appendix and, 125127, 126
basal plasmacytosis in, 118
colorectal carcinoma in, 129, 130, 130
dysplasia in, detection of, 131
granulomas and, 127129, 128
ileal histology in, 122123, 123
and infective colitis, 118, 119
lymphoma in, 131132
macroscopic pathological assessment in, 120123, 121, 121
pouch cancer in, 131
pouchitis and prepouch ileitis in, 124
tuberculosis and, 120
upper GI tract in, 124125
Yersinia infection and, 120
Chronic kidney disease (CKD), obesity and, 53, 5354
CIBD see Chronic inflammatory bowel disease (CIBD)
Cirrhotic nodules, 90
Clostridium difficile, 120
Colloid adenocarcinoma, 34
Colorectal carcinoma, in chronic inflammatory bowel disease, 129, 130, 130
Colorectal neoplastic progression
adenoma–carcinoma pathway of, 103
serrated neoplastic pathways of, 103, 105 (see also Serrated pathway lesions)
Complement-dependent lymphocytotoxicity (CDL), 2, 3
Confocal laser endomicroscopy (CLE), 79
Congenital heart disease (CHD), 27
Continuing professional development (CPD), 149, 153 see also Revalidation, medical
Coronary artery disease, obesity and, 52
CpG island methylator phenotype (CIMP), 103 see also Serrated pathway lesions
Crizotinib, 42, 43, 63, 68
Crohn's disease, 117 see also Chronic inflammatory bowel disease (CIBD)
C-terminal Tensin-like (Cten), 172, 173 see also Tensin proteins
D
Dilated cardiomyopathy, 51
Disseminated intravascular coagulation (DIC), 20, 22
Donor-specific antibodies (DSAs), 1
Dumping syndrome, 57
Dysplasia
in Barrett's oesophagus, 7879, 7981
in chronic inflammatory bowel disease, 131
Dysplastic nodules, 9294, 93
as HCC precursors, 92
high-grade, 9394
large cell change, 93
low-grade, 93
small cell change, 93
E
Echinoderm microtubule-associated protein-like 4 (EML4-ALK), 42
Eclampsia, 21 see also Hypertensive diseases of pregnancy
EGFR mutations, 6768
EML4-ALK fusion gene, 68
Endothelial transcripts, 6
Enteric adenocarcinoma, 3435, 35
Epidermal growth factor receptor (EGFR) signalling pathway, 176, 177
Epidermal growth factor receptor tyrosine kinase inhibitors, in NSCLC treatment, 4142, 43
Erlotinib, 43, 63, 68
F
Fetal adenocarcinoma, 34, 35
Fibrillar adhesions, 172, 174
Fibrolamellar carcinoma, 97
Flow cytometry, 82
Focal adhesions, 169172, 171 see also Tensin proteins
fibrillar adhesions, 172
function of, 171172
life-cycle of, 171
nascent adhesions, 172
structure of, 169170, 171
Focally enhanced gastritis (FEG), 125
Focal nodular hyperplasia (FNH), 91, 91
Formalin fixed, paraffin embedded (FFPE) tumour tissue, 64, 69
Fragment length analysis, 66
G
Gastric cardia, 7476 see also Barrett's oesophagus
Gastrointestinal MALT lymphoma, 137140
chemotherapy for, 142143
Helicobacter pylori eradication therapy for, 141142
posteradication biopsies, assessment of, 143, 143145
radiotherapy for, 142
Gefitinib, 41, 43, 63, 68
GELA scoring system, for posteradication biopsies assessment, 143, 143
Gene mutations, in cancer, 6163
breast cancer and, 6869
detection of, techniques for, 6467, 6566, 70
lung cancer and, 6768
melanoma and, 69
molecular analysis, technical challenges in, 6970
molecular pathology report, requirements of, 67
terminology related to, 62
General Medical Council (GMC), 149151 see also Revalidation, medical
Genital tract trauma, 24
Giant cell carcinoma, 36
Glutathione S-transferase T1 (GSTT1), 3, 9
Granulomatous appendicitis, 126127, 129
H
HCA see Hepatocellular adenoma (HCA)
HCC see Hepatocellular carcinoma (HCC)
Helicobacter heilmannii, 137
Helicobacter pylori, 124
and gastric cancer, 73
MALT lymphoma and, 137
Hepatic antibody-mediated rejection, 910, 11
Hepatic progenitor cells, 87
Hepatocellular adenoma (HCA), 9496, 95
Hepatocellular carcinoma (HCC), 9699
and angiomyolipoma, 98
fibrolamellar variant of, 96, 97
growth pattern, 96
histological features, 98
risk factor for, 96
tumour cells in, 97
Hepatocellular necrosis, and regenerative nodules, 88
Hepatocellular nodules, 8788
neoplastic, 9294
regenerative, 8892, 8991
Hep-Par-1 (hepatocyte paraffin 1), 97, 98
Hereditary non-polyposis colorectal cancer (HNPCC) see Lynch syndrome (LS)
High-resolution DNA melting analysis (HRM), 65
HIV/AIDS, 28
HPV see Human papilloma virus (HPV)
Human leucocyte antigens (HLAs), 1, 2
Human papilloma virus (HPV), 159
Abbott Real Time and Roche Cobas test, 164
biomarkers for, 165
and cervical screening programme, 159160
genetics of, 162163
Genprobe Aptima HPV assay, 163164
Hologic Cervista HPV test, 164
HPV 16/18 genotyping, 164
Hybrid Capture II test, 163
immunisation programme, 160161
primary screening test, 162, 165
testing, 163164
testing in triage, 161162
test of cure, 162
types of, and cervical cancer, 159
Hyperplastic polyposis syndrome (HPS), 104, 106
Hyperplastic polyps, 104 see also Serrated pathway lesions
Hypertensive diseases of pregnancy, 2123
brain and, 22
kidney and, 22, 23
liver and, 23
maternal death in, 22
uterus and placenta and, 22
I
Imatinib, 63
Immunofluorescence (IF), 4
Immunohistochemistry (IHC), 4
Immunoproliferative small intestinal disease (IPSID), 140
Infection, obesity and, 5455
Influenza, 27
Integrins, 169170
Intrahepatic cholangiocarcinoma, 98
Invasive mucinous adenocarcinoma (IMA), 3435, 35
Invasive nonmucinous adenocarcinoma (INA), 33, 3334
K
KRAS mutations, in colorectal adenomas, 111
L
Large cell carcinoma (LCC), 3536, 39
Lepidic predominant adenocarcinoma (LPA), 33, 33
Leptin, 52
Luminex assay, 3
Lung cancer, 31 see also Non-small-cell lung carcinoma (NSCLC)
molecular analysis in, 6768
Lymphocytic oesophagitis (LE), 124, 124, 125
Lynch syndrome (LS), 111112
M
MALT lymphoma, 135137, 136
gastrointestinal, 137140
and reactive lymphoid infiltrates, 140141
and small B cell lymphomas, 141
Maternal deaths, 17
abortion and, 24
amniotic fluid embolism syndrome and, 20, 2021, 21, 22
autopsy in, role of, 17, 19
cardiovascular disease and, 2627
causes of, 1819
classification of, 19
coincidental, 17, 19
definition of, 17
direct, 17, 19, 2026
epidemic influenza and, 27
HIV/AIDS and, 28
hypertensive diseases of pregnancy and, 2123, 23
indirect, 17, 19, 2628
peri- and postpartum haemorrhage and, 2324, 24
sepsis and, 25, 25, 26
thrombotic thrombocytopaenic purpura and, 27
venous thromboembolism and, 26
Mean fluorescence intensity (MFI), 3
Melanoma, 69
Metabolic syndrome, obesity and, 54
Micropapillary predominant adenocarcinoma (MPA), 33, 34
Microsatellite instability (MSI), 103 see also Serrated pathway lesions
Minimally invasive adenocarcinoma (MIA), 32
Miscarriage, 24
Mucoepidermoid carcinoma, 39
Mucosa-associated lymphoid tissue (MALT), 135
Mutator phenotype, 112
N
Narrow band imaging (NBI), 79
Neutrophilic capillaritis, 1112
and neutrophilic margination, 12
Next-generation sequencing, 65
Nodular regenerative hyperplasia, 89, 9091
Nonalcoholic steatohepatitis (NASH), 5253
Non-small-cell lung carcinoma (NSCLC), 31
adenocarcinoma, 3135
adenosquamous carcinoma, 36
diagnosis of, problems in, 3839
large cell carcinoma, 3536
sarcomatoid carcinomas, 3637
squamous cell carcinoma, 35
staging of, 37, 37, 38
treatment of, 40, 4043, 43, 43
NSCLC see Non-small-cell lung carcinoma (NSCLC)
O
Obesity, 47
adipose tissue in, 47
bariatric surgery in, 5557, 56
body mass index and, 47, 48
cancer and, 54
degrees of, 47
fatal conditions with, 47
heart, effect on, 5052, 52
infection and, 5455
kidney, effect on, 53, 5354
liver, effect on, 5253
metabolic syndrome and, 54
and mortality rate, 47
respiratory system, effect on, 4850
venous thromboembolic disease and, 5455
WHO classification of, 48, 48
Obesity cardiomyopathy, 5051, 52
Obesity hypoventilation syndrome (OHS), 4950, 50
Obliterative bronchiolitis (OB), 4
Obstructive sleep apnoea (OSA), 4849
Oncotype DX, 69
P
Panel-reactive antibodies (PRAs), 2
Panitumumab, 63
Papillary predominant adenocarcinoma (PPA), 33, 33
P16, detection of, 165
Peri- and postpartum haemorrhage, 18, 2324, 24
creta syndromes and, 2324, 24
genital tract trauma and, 24
placental abruption and, 23
placenta praevia and, 23
retained placenta and, 23
uterine atony and, 23
uterine rupture and, 24
Peripartum cardiomyopathy (PPCM), 17, 27
Pertuzumab, 63
Pickwickian syndrome see Obesity hypoventilation syndrome (OHS)
PI3 kinase/Akt signalling pathway, 176
Placenta creta syndromes, 2324, 24
Placental abruption, 23
Placenta praevia, 23
Pleomorphic carcinoma, 36
Polymerase chain reaction (PCR), 64
Polysomnography, 48, 49
Posterior reversible leukoencephalopathy syndrome (PRES), 22
Pouch cancer, 131
Pre-eclampsia, 21 see also Hypertensive diseases of pregnancy
Primary sclerosing cholangitis, 90, 90
ProExC (Beckton Dixon), 165
Proteomics profiling, of liver tumours, 99
Proton pump inhibitors (PPI), 78
Pulmonary antibody-mediated rejection, 1013, 12, 13
Pulmonary blastoma, 36
Pyrosequencing, 65, 66
R
Radio frequency ablation (RFA), 82, 83
Ras homology family member A (RhoA), 172
Regenerative nodules, 8892, 8991
acetaminophen overdose and, 88, 89
in chronic biliary disorders, 89, 90
in core needle biopsy specimen, 92
differential diagnosis of, 9192
liver injury and, 88, 89
in nodular regenerative hyperplasia, 89, 9091
Renal antibody-mediated rejection, 46
acute, 4, 56
Banff criteria, 5, 6
chronic, 5, 6, 7
glomerulitis, 5, 5
peritubular capillaritis, 5, 56
transplant glomerulopathy, 6
Revalidation, medical, 149151
appraisal and, 151152
colleague and patient feedback, 154
continuing professional development, 153
documentation from previous appraisals, 153
documentation in, 155, 155156
General Medical Council (GMC) on, 149151
historical perspective on, 149150
impact of, 156
process for medical appraisal for, 152153
quality improvement activities, 153154
recommendation, 156
relicensing and revalidation, 150
Responsible Officer (RO), 151152
scope of work, 153
significant events and, 154
statement of health in, 154
statement of probity in, 155
summative question/formative question, 151
supporting information in, 155
Rho-associated protein kinase (ROCK), 172
Roux-en-Y stasis syndrome, 57
S
Sanger (dideoxy-) sequencing method, 65, 66
Sarcomatoid carcinomas, 3637
Seattle biopsy protocol, 78
Sentinel sites project, 160
Sepsis, 25
classification and pathology, 25
postpartum, 26
in pregnancy, 25
Serrated pathway lesions, 103, 104, 105
hyperplastic polyps, 104106, 105
immunohistochemistry in, diagnosis of, 113
mixed polyps, 106, 106
molecular abnormalities, 111113
serrated adenocarcinomas, 109, 110
sessile serrated polyps, 106108, 107108
surveillance intervals after, 113, 113
traditional serrated adenomas, 108109, 109
WHO classification, 104
Serrated polyposis syndrome see Hyperplastic polyposis syndrome (HPS)
Sessile serrated lesions (SSLs), 106108, 107108
Single-strand conformational polymorphism analysis (SSCP/SSCA), 6466, 65
Sjögren's syndrome, 137
Small cell lung cancer, 40
Small intestinal bacterial overgrowth (SIBO) syndrome, 57
Solid predominant adenocarcinoma (SPA), 33, 34
Spindle cell carcinoma, 36
Spontaneous abortion, 24
Squamous cell carcinoma (SCC), 35, 38, 39
SSLs see Sessile serrated lesions (SSLs)
Stat3 signalling, 177
Stratified cancer medicine, 6170 see also Gene mutations, in cancer
Sudden death in obesity, 51
Sudden unexpected death in epilepsy (SUDEP), 22
Systemic inflammatory response syndrome (SIRS), 20
T
Tensin proteins, 172 see also Focal adhesions
in carcinogenesis, role of, 177178
cell adhesion and motility, role in, 174175, 175, 176
cell survival and apoptosis and, 176
members of Tensin gene family, 172, 173
regulation of, 176, 177
structure of, 172174, 173
Thrombotic thrombocytopaenic purpura (TTP), 27
Thymidylate synthetase (TS), 41
TP53, 82
Traditional serrated adenomas (TSAs), 103, 108109, 109
Transplantation, 1, 2 see also Antibody-mediated rejection (AMR)
Trastuzumab, 63
Trastuzumab emtansine, 63
Tyrosine kinase inhibitors, in clinical use in NSCLC, 4142, 43
U
Ulcerative colitis (UC), 117 see also Chronic inflammatory bowel disease (CIBD)
Uterine atony, 23
Uterine rupture, 24
V
Vemurafenib, 63, 63
Venous thromboembolism (VTE), 18, 26
obesity and, 55
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1Recent Advances in Histopathology 23
Massimo Pignatelli MD PhD FRCPath Dean of Medicine, Nazarbayev University AstanaKazakhstan Adjunct Professor of Pathology, University of Pittsburgh School of Medicine PittsburghUSA Patrick Gallagher MD PhD FRCPath Senior Clinical Lecturer, University of Bristol BristolUK
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3Preface
We are delighted to present Recent Advances in Histopathology 23 after careful selection of the most important developments within the field.
The practice of pathology is a constantly evolving speciality. To reflect this, one of the main goals of this edition is to review the rapid development and application of molecular techniques to complement the morphological assessment of tissue diagnosis, prognosis and response to treatment.
We have commissioned a wide range of chapters, in order to provide a comprehensive update of key topics in histopathology for those preparing for their pathology postgraduate exams. We believe that both generalist as well as specialist consultant and academic histopathologists will find information of relevance to their daily practice and continued professional development.
This volume of Recent Advances in Histopathology continues the series' role as a key resource for pathologists, both in the UK and internationally, who wish to remain up to date with current trends in modern histopathology. We are especially grateful to the contributors, who responded to our invitation with enthusiasm and produced well written and interesting chapters in a timely fashion. The next edition is already under development, and we welcome chapter suggestions from our readers.
Massimo Pignatelli
Patrick Gallagher
March 2014