The Diagnostic Minute

Summary of Autoimmune pancreatitis Autoimmune pancreatitis (AIP) is a chronic fibroinflammatory disease characterized by prompt response to steroid therapy. AIP presents as two distinct subtypes. AIP-1: AIP-1 belongs to the group of IgG4-related diseases histologically characterized by storiform cellular fibrosis, obliterative phlebitis, and periductal chronic inflammation rich in IgG4-positive pl...

Summary of Ovarian mucinous tumors (OMT) This mini-review highlights features of five forms of OMTs: 1.  Mucinous borderline tumor (MBT). 2.  MBT with microinvasion. 3.  MBT with intraepithelial carcinoma. 4.  Mucinous carcinoma with destructive infiltrative invasion. 5.  Mucinous carcinoma with confluent/expansile invasion.  Ovarian mucinous carcinoma must be distinguished from metastatic carcino...

Feature Summary of Ovarian leydig cell tumor:  Well circumscribe solid nodule near ovarian hylum  Fusion of cytoplasm to form nuclear-free zones is a key feature  Cytoplasmic Reinke crystals and lipochrome pigments  Fibrinoid material in blood vessels  Typically positive for inhibin, calretinin, and mellan-A 

Feature Summary of Hepatoid Tumors Histologically similar to hepatocellular carcinoma (HCC) but arises outside the liver.  Most commonly arise in the gastrointestinal tract and pancreaticobiliary system.  Hepatocellular differentiation marked by positive immunostains for heppar-1, arginase-1,  CD10 in canalicular pattern, and, to a greater extent, alfa-fetal protein and glypican-3.  Largely classi...

Feature Summary of Papillary Adenoma   Exceedingly rare, benign peripheral lung tumor Predominantly in man with wide age range Circumscribed peripheral nodule Papillary, fibrovascular cores Single layer of bland lining epithelium Positive for TTF1 and cytokeratins Main differential diagnoses include alveolar adenoma, and adenocarcinoma Complete resection curative Please visit us at:  http://www. E...

Key Feature Summary of  Adenocarcinoma in situ (AIS) Localized adenocarcinoma, ≤3 cm,   Ground glass nodule  on CT   Lepidic growth of tumor cells along alveolar walls    Bland cytology without invasion    ≥50% EGFR mutation rate    100% 5yr disease-free survival after complete resection Please visit us at:  http://www. EssentialPathology.info 

Key Feature Summary for Mucinous Cystadenoma of the Lung Rare benign lung tumor usually found incidentally   Mean age 60s, slightly more in women  Mucin-filled cyst lined by bland mucinous epithelium   No atypia, invasion, or necrosis  Cytokeratin positive, and TTF1 negative   Differential diagnosis include: Metastatic adenocarcinoma, colloid carcinoma, bronchogenic cyst.  Cured by complete surgic...

Key Feature Summary for Mucous gland adenoma  Rare benign proximal endobronchial tumor     Airway obstruction symptoms common   Exophytic, mucoid endobronchial nodules  Cystic, acinar, tubular architecture     Bland mucous cell lining, no atypia   Positive for keratin, EMA, and CEA; low Ki-67 proliferation index  Main differential diagnosis: mucoepidermoid carcinoma, mucinous adenocarcinoma  Cured...

Feature Summary: The key contrasting features of micronodular thymoma (MT) and Micronodular thymic carcinoma (MTC) are cytological atypia, tumor necrosis, mitotic activities, intratumoral TdT-positive lymphocytes, CD5, CD117, and Glut-1 expression. 

For the transcript, the key references, and more, please visit us at: http://www.essentialpathology.info/ Disclaimer: The content of "The Diagnostic Minute" is intended for educational and training purposes only. Listeners assume full responsibility for their use of the information provided in the podcast and agree to use it at their own risk. By accessing the podcast, listeners agree to...

For the transcript, the key references, and more, please visit us at: http://www.essentialpathology.info/ Disclaimer: The content of "The Diagnostic Minute" is intended for educational and training purposes only. Listeners assume full responsibility for their use of the information provided in the podcast and agree to use it at their own risk. By accessing the podcast, listeners agree to...

For the transcript, the key references, and more, please visit us at: http://www.essentialpathology.info/ Disclaimer: The content of "The Diagnostic Minute" is intended for educational and training purposes only. Listeners assume full responsibility for their use of the information provided in the podcast and agree to use it at their own risk. By accessing the podcast, listeners agree to...

For the transcript, the key references, and more, please visit us at: http://www.essentialpathology.info/ Disclaimer: The content of "The Diagnostic Minute" is intended for educational and training purposes only. Listeners assume full responsibility for their use of the information provided in the podcast and agree to use it at their own risk. By accessing the podcast, listeners agree to...

Summary Hepatocellular carcinoma (HCC) can be classified into five macroscopic types based on their gross morphology. They are associated with different potential and extents of metastasis and thus different clinical outcomes.

For the transcript, the key references, and more, please visit us at: http://www.essentialpathology.info/   Disclaimer: The content of "The Diagnostic Minute" is intended for educational and training purposes only. Listeners assume full responsibility for their use of the information provided in the podcast and agree to use it at their own risk. By accessing the podcast, listeners agree...

For the transcript, the key references, and more, please visit us at: http://www.essentialpathology.info/   Disclaimer: The content of "The Diagnostic Minute" is intended for educational and training purposes only. Listeners assume full responsibility for their use of the information provided in the podcast and agree to use it at their own risk. By accessing the podcast, listeners agree...

Feature Summary of IOPN 1. A unique and rare intraductal papillary neoplasm of the pancreaticobiliary system.  2. confluent papillary growth of oncocytic cells with ample eosinophilic cytoplasm. 3. Usually high-grade dysplasia, and 30% of cases harbor invasive carcinoma.   4. Positive for CD117 is a unique feature. 5. Also positive for Muc-1, Muc-5AC and Muc-6.  6. PRKACA-B gene fusion is a distin...

Key Point Routine elastin staining allows for superior detection and prognostication of vascular invasion in colorectal cancer compared to H&E alone, with a two to threefold increase in vascular invasion detection with elastin stains.

Key Point Small-cell (neuroendocrine) carcinoma tends to be Rb1-negative and cyclin D1-negative, while large-cell carcinomas are largely positive for Rb1 and/or cyclin D1. The use of this simplified expression pattern leads to a diagnostic accuracy of 97.3%.  

For the transcript, the key references, and more, please visit us at: http://www.essentialpathology.info/   Disclaimer: The content of "The Diagnostic Minute" is intended for educational and training purposes only. Listeners assume full responsibility for their use of the information provided in the podcast and agree to use it at their own risk. By accessing the podcast, listeners agree...

S ummary   Lung adenocarcinoma grading is based on the predominant histological pattern. Immunophenotypes also reflect tumor behavior, but these immunophenotypic features are not incorporated in the current grading schema. 

Key Points of the Mini-Review Mucosal mast cell assessment for unexplained GI symptoms or suspected systemic mastocytosis. In systemic mastocytosis, 62% exhibit endoscopic abnormalities; 66% biopsies confirm involvement (colon, ileum, duodenum). Specific architectural patterns and high mast cell counts support systemic GI mastocytosis. Clinical indications for assessment: Suspected systemic mastoc...