Journal of Pathology and Translational Medicine

Case Studies

Intrathyroidal metastasis of tonsillar squamous cell carcinoma masquerading as a primary thyroid tumor: Jai-Hyang Go; J Pathol Transl Med. 2023;57(4):242-245. Published online July 11, 2023; DOI: https://doi.org/10.4132/jptm.2023.06.16

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Intrathyroidal metastasis of tonsillar squamous cell carcinoma is rare. To date, only six cases have been reported in the literature. This case was unusual and presented with thyromegaly before the diagnosis of the primary tumor. A 55-year-old male patient was suspected to have a primary thyroid tumor with nodal metastasis. The thyroid gland was diffusely enlarged, with no discernible mass. Histologically, the thyroid parenchyma revealed extensive endolymphatic tumor emboli, which were positive for p40 and p16 in a background of chronic lymphocytic thyroiditis. Positron emission tomography–computed tomography revealed hypermetabolic activity in the right tonsillar region. Tonsillar biopsy revealed human papillomavirus–positive squamous cell carcinoma. The present case is the first reported case of intrathyroidal metastasis of tonsillar squamous cell carcinoma with an initial clinical presentation of thyroid enlargement before the primary tumor of tonsillar cancer was diagnosed.

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Metastatic oropharyngeal squamous cell carcinoma to the thyroid: A case report and review of literature
Hannah Walker, Jed Speers, Milena Fabry, Sameep Kadakia
American Journal of Otolaryngology.2024; : 104306. CrossRef

Metastatic choroidal melanoma in the breast: a case report and review of the literature: Loay Abudalu, Vinisha Malhotra, Nabila Nasir, Sami Titi; J Pathol Transl Med. 2023;57(4):238-241. Published online July 11, 2023; DOI: https://doi.org/10.4132/jptm.2023.06.07

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Abstract PDF: The breast is an unusual site for metastases, accounting for less than 2% of malignant breast lesions but include those from malignant melanomas, carcinomas, sarcomas, and lymphomas from various organs. We diagnosed a very rare case of metastatic choroidal melanoma for a 67-year-old female who presented with a right breast lump and who had been previously diagnosed with choroidal melanoma-monosomy 3 in 2017. To the best of our knowledge, only five such cases have been published so far, with one in a male patient.

Original Articles

Clinicopathologic characterization of cervical metastasis from an unknown primary tumor: a multicenter study in Korea: Miseon Lee, Uiree Jo, Joon Seon Song, Youn Soo Lee, Chang Gok Woo, Dong-Hoon Kim, Jung Yeon Kim, Sun Och Yoon, Kyung-Ja Cho; J Pathol Transl Med. 2023;57(3):166-177. Published online May 10, 2023; DOI: https://doi.org/10.4132/jptm.2023.04.12

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Background
Research regarding cervical metastasis from an unknown primary tumor (CUP) according to human papillomavirus (HPV) and Epstein-Barr virus (EBV) status in Korea has been sporadic and small-scale. This study aims to analyze and understand the characteristics of CUP in Korea according to viral and p16 and p53 status through a multicenter study.
Methods
Ninety-five cases of CUP retrieved from six hospitals in Korea between January 2006 and December 2016 were subjected to high-risk HPV detection (DNA in situ hybridization [ISH] or real-time polymerase chain reaction), EBV detection (ISH), and immunohistochemistry for p16 and p53.
Results
CUP was HPV-related in 37 cases (38.9%), EBV-related in five cases (5.3%), and unrelated to HPV or EBV in 46 cases (48.4%). HPV-related CUP cases had the best overall survival (OS) (p = .004). According to the multivariate analysis, virus-unrelated disease (p = .023) and longer smoking duration (p < .005) were prognostic factors for poor OS. Cystic change (p = .016) and basaloid pattern (p < .001) were more frequent in HPV-related cases, and lymphoepithelial lesion was frequent in EBV-related cases (p = .010). There was no significant association between viral status and p53 positivity (p = .341), smoking status (p = .728), or smoking duration (p = .187). Korean data differ from Western data in the absence of an association among HPV, p53 positivity, and smoking history.
Conclusions
Virus-unrelated CUP in Korea had the highest frequency among all CUP cases. HPV-related CUP is similar to HPV-mediated oropharyngeal cancer and EBVrelated CUP is similar to nasopharyngeal cancer in terms of characteristics, respectively.

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Expansion of tumor-infiltrating lymphocytes from head and neck squamous cell carcinoma to assess the potential of adoptive cell therapy
Sangjoon Choi, Mofazzal Hossain, Hyun Lee, Jina Baek, Hye Seon Park, Chae-Lyul Lim, DoYeon Han, Taehyun Park, Jong Hyeok Kim, Gyungyub Gong, Mi-Na Kweon, Hee Jin Lee
Cancer Immunology, Immunotherapy.2024;[Epub] CrossRef

Correlation between myoferlin expression and lymph node metastasis in papillary thyroid carcinoma: Ji Min Na, Dong Chul Kim, Dae Hyun Song, Hyo Jung An, Hyun Min Koh, Jeong-Hee Lee, Jong Sil Lee, Jung Wook Yang, Min Hye Kim; J Pathol Transl Med. 2022;56(4):199-204. Published online May 11, 2022; DOI: https://doi.org/10.4132/jptm.2022.03.19

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Abstract PDF: Background
Myoferlin is a multifunctional protein expressed in various normal and cancer cells, with novel oncogenic roles being newly discovered. Recently, correlations have been found between myoferlin expression and unfavorable prognosis in various carcinomas. This study investigated the prognostic role of myoferlin expression in papillary thyroid carcinoma (PTC), specifically that associated with nodal metastasis.
Methods
We collected clinicopathological data and PTC tissues from 116 patients who had been admitted to Gyeongsang National University Hospital in 2010. Immunohistochemical analysis was performed on surgical specimen-derived tissue microarray blocks. Myoferlin expression was graded, and the relationship between expression level and pathological features of tumors based on the American Joint Committee on Cancer staging system was evaluated.
Results
Of the 116 patient samples, 100 cases exhibited positive myoferlin expression. Higher grade of myoferlin expression was correlated with lower T category group (p = .010). Presence of lymph node metastasis was determined to be significantly correlated with low-grade myoferlin expression (p = .019), with no significant difference between pN1a and pN1b tumors.
Conclusions
Our study revealed an adverse correlation between myoferlin expression and pathological features of PTC, evidence of the potential prognostic role of myoferlin in PTC lymph node metastasis.

Clinicopathologic features of cutaneous metastases from internal malignancies: Hyeong Mok Kwon, Gyu Yeong Kim, Dong Hoon Shin, Young Kyung Bae; J Pathol Transl Med. 2021;55(4):289-297. Published online July 7, 2021; DOI: https://doi.org/10.4132/jptm.2021.05.24

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Background
Cutaneous metastasis (CM) is the spread of cancer cells from a primary site to the skin and is rarely the first sign of silent cancer. We investigated the clinicopathological characteristics of CM from internal malignancies in Korean patients treated at our institution over 20 years.
Methods
The clinicopathological findings of 112 patients (62 females, 50 males) with CM diagnosed at Yeungnam University Hospital between 2000 and 2020 were retrospectively reviewed.
Results
Mean patient age was 58.6 years (range, 26 to 87 years), and the most common primary cancer site was breast (74.2%) in women and lung (36.0%) in men. Ninety-six patients (85.7%) presented with CM after primary tumor diagnosis. CM from the lung or biliary tract usually occurred within 2 years of primary tumor diagnosis, whereas metastases from the breast and kidney occurred several years later. The chest, abdomen, and scalp were common sites of CM. Breast cancer usually metastasized to chest skin, while gastrointestinal tract cancers commonly metastasized to the abdomen. The scalp was a common location for CM from various tumors. The most common dermatologic presentations were nodules and masses. Immunohistochemical studies helped identify underlying malignancies when primary tumors were unknown.
Conclusions
The relative frequency of CM parallels the overall incidence of primary malignant tumors, and CMs usually occur at anatomic sites close to the primary tumor. CM can be diagnosed based on clinical, radiological, and histological features; however, immunohistochemical study is required in some cases.

Citations

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A Mirror of Metastatic Destiny – A Case Series of Cutaneous Metastases
Rochelle Monteiro, Monisha Madhumita, Hemanth Kumar, Jacintha Martis
Clinical Dermatology Review.2024; 8(1): 58. CrossRef
Nonbrain metastases seen on magnetic resonance imaging during metastatic brain tumor screening
Mio Sakai, Nobuo Kashiwagi, Katsuyuki Nakanishi, Noboru Maeda, Yasuhiro Nakaya, Junichiro Tanaka, Shinichiro Watanabe, Hidenari Hongyo, Yu Tanaka, Sawaka Yamada, Atsushi Kawata, Sou Toda, Koji Takano, Hideyuki Arita, Noriyuki Tomiyama
Japanese Journal of Radiology.2023; 41(4): 367. CrossRef
Cutaneous Metastasis as a Diagnostic Prelude in a 48-year-old Female
Nagatoshi M. Ebisawa, Isabel G. Palabyab-Imperial, Leilani R. Senador, Luella Joy A. Escueta-Alcos
Journal of the Philippine Dermatological Society.2023; 32(2): 107. CrossRef
Pigmented epidermotropic breast cancer metastases: A rare variant with a particularly unusual feature
Juan Torre‐Castro, Cristina Moya‐Martínez, Lara Haya‐Martínez, María Dolores Mendoza‐Cembranos, Itziar Eraña‐Tomás, Luis Requena
Journal of Cutaneous Pathology.2022; 49(1): 99. CrossRef
Skin metastases in the clinical and dermoscopic aspects
Grazyna Kamińska-Winciorek, Aleksandra Pilśniak, Wojciech Piskorski, Jerzy Wydmański
Seminars in Oncology.2022; 49(2): 160. CrossRef
Dermoscopy and novel non invasive imaging of Cutaneous Metastases
Dimitrios Alexandris, Nektarios Alevizopoulos, Leonidas Marinos, Charikleia Gakiopoulou
Advances in Cancer Biology - Metastasis.2022; 6: 100078. CrossRef

Potential of AKT2 expression as a predictor of lymph-node metastasis in invasive breast carcinoma of no special type: Primariadewi Rustamadji, Elvan Wiyarta, Kristina Anna Bethania, Kusmardi Kusmardi; J Pathol Transl Med. 2021;55(4):271-278. Published online June 14, 2021; DOI: https://doi.org/10.4132/jptm.2021.04.26

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Abstract PDF

Background
Invasive breast carcinoma of no special type (IBC-NST) is the most common type of breast cancer and mainly causes regional lymph-node metastasis (LNM). We investigated the potential for AKT2 expression as a predictive biomarker for LNM in IBC-NST.
Methods
Forty-eight paraffin blocks containing IBC-NST primary tumors were divided into two groups based on presence or absence of LNM. Age, tumor grade, tumor size, lymphovascular invasion (LVI), and AKT expression were assessed. AKT2 expression was assessed based on immunohistochemical staining, while other data were collected from archives.
Results
Multiple logistic regression results showed that AKT2 expression and LVI were significantly associated with LNM (odds ratio [OR], 5.32; 95% confidence interval [CI], 1.42 to 19.93 and OR, 4.46; 95% CI, 1.17 to 16.97, respectively). AKT2 expression was able to discriminate against LNM (area under the receiver operating characteristic, 0.799 ± 0.063; 95% CI, 0.676 to 0.921) at an H-score cutoff of 104.62 (83.3% sensitivity, 62.5% specificity).
Conclusions
AKT2 expression has potential as a predictor of LNM in IBC-NST. The H-score cutoff for AKT2 expression can be used as a classification guide in future studies.

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Association of Src with Nottingham Prognostic Index in Breast Cancer: Implications for Breast Cancer Prognostication
Primariadewi Rustamadji, Elvan Wiyarta
Journal of Nature and Science of Medicine.2024; 7(2): 90. CrossRef
Exploring the Expression of Survivin on Neoadjuvant Chemotherapy in Invasive Breast Carcinoma
Primariadewi Rustamadji, Elvan Wiyarta, Ineke Anggreani
Open Access Macedonian Journal of Medical Sciences.2022; 10(B): 1440. CrossRef
Effect of Omega-3-Rich Fish Oil on TNF-  Expression in Mice's Colonic Tissue Induced with Azoxymethane (AOM) and Dextran Sodium Sulphate (DSS)
Elvan Wiyarta, Kusmardi Kusmardi, Yurnadi Hanafi Midoen
Research Journal of Pharmacy and Technology.2022; : 3179. CrossRef
The potential of lunasin extract for the prevention of breast cancer progression by upregulating E-Cadherin and inhibiting ICAM-1
Kusmardi Kusmardi, Elvan Wiyarta, Numlil Khaira Rusdi, Andi Muh. Maulana, Ari Estuningtyas, Hadi Sunaryo
F1000Research.2021; 10: 902. CrossRef
CD44 Variant Exon 6 Isoform Expression as a Potential Predictor of Lymph Node Metastasis in Invasive Breast Carcinoma of No Special Type
Primariadewi Rustamadji, Elvan Wiyarta, Kristina A. Bethania, Rakesh Sathish Nair
International Journal of Breast Cancer.2021; 2021: 1. CrossRef

Histologically confirmed distant metastatic urothelial carcinoma from the urinary bladder: a retrospective review of one institution’s 20-year experience: Youngeun Yoo, Junghye Lee, Heae Surng Park, Min-Sun Cho, Sun Hee Sung, Sanghui Park, Euno Choi; J Pathol Transl Med. 2021;55(2):94-101. Published online December 3, 2020; DOI: https://doi.org/10.4132/jptm.2020.10.19

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Abstract PDF

Background
Urothelial carcinoma (UC) accounts for roughly 90% of bladder cancer, and has a high propensity for diverse differentiation. Recently, certain histologic variants of UC have been recognized to be associated with unfavorable clinical outcomes. Several UC studies have also suggested that tumor budding is a poor prognostic marker. Distant metastasis of UC after radical cystectomy is not uncommon. However, these metastatic lesions are not routinely confirmed with histology.
Methods
We investigated the histopathologic features of 13 cases of UC with biopsy-proven distant metastases, with a special emphasis on histologic variants and tumor budding.
Results
Lymph nodes (6/13, 46%) were the most common metastatic sites, followed by the lung (4/13, 31%), liver (4/13, 31%), and the adrenal gland (2/13, 15%). The histologic variants including squamous (n=1), micropapillary (n=4), and plasmacytoid (n=1) variants in five cases of UC. Most histologic variants (4/5, 80%) of primary UCs appeared in the metastatic lesions. In contrast, high-grade tumor budding was detected in six cases (46%), including one case of non-muscle invasive UC. Our study demonstrates that histologic variants are not uncommonly detected in distant metastatic UCs. Most histologic variants seen in primary UCs persist in the distant metastatic lesions. In addition, high-grade tumor budding, which occurs frequently in primary tumors, may contribute to the development of distant metastasis.
Conclusions
Therefore, assessing the presence or absence of histologic variants and tumor budding in UCs of the urinary bladder, even in non-muscle invasive UCs, may be useful to predict distant metastasis.

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Do Histology and Primary Tumor Location Influence Metastatic Patterns in Bladder Cancer?
Hyung Kyu Park
Current Oncology.2023; 30(10): 9078. CrossRef

Lymph node size and its association with nodal metastasis in ductal adenocarcinoma of the pancreas: Jaehoon Shin, Seungbeom Shin, Jae Hoon Lee, Ki Byung Song, Dae Wook Hwang, Hyoung Jung Kim, Jae Ho Byun, HyungJun Cho, Song Cheol Kim, Seung-Mo Hong; J Pathol Transl Med. 2020;54(5):387-395. Published online July 21, 2020; DOI: https://doi.org/10.4132/jptm.2020.06.23

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Abstract PDF

Background
Although lymph node metastasis is a poor prognostic factor in patients with pancreatic ductal adenocarcinoma (PDAC), our understanding of lymph node size in association with PDAC is limited. Increased nodal size in preoperative imaging has been used to detect node metastasis. We evaluated whether lymph node size can be used as a surrogate preoperative marker of lymph node metastasis.
Methods
We assessed nodal size and compared it to the nodal metastatic status of 200 patients with surgically resected PDAC. The size of all lymph nodes and metastatic nodal foci were measured along the long and short axis, and the relationships between nodal size and metastatic status were compared at six cutoff points.
Results
A total of 4,525 lymph nodes were examined, 9.1% of which were metastatic. The mean size of the metastatic nodes (long axis, 6.9±5.0 mm; short axis, 4.3±3.1 mm) was significantly larger than that of the non-metastatic nodes (long axis, 5.0±4.0 mm; short axis, 3.0±2.0 mm; all p<.001). Using a 10 mm cutoff, the sensitivity, specificity, positive predictive value, overall accuracy, and area under curve was 24.8%, 88.0%, 17.1%, 82.3%, and 0.60 for the long axis and 7.0%, 99.0%, 40.3%, 90.6%, and 0.61 for the short axis, respectively.
Conclusions
The metastatic nodes are larger than the non-metastatic nodes in PDAC patients. However, the difference in nodal size was too small to be identified with preoperative imaging. The performance of preoperative radiologic imaging to predict lymph nodal metastasis was not good. Therefore, nodal size cannot be used a surrogate preoperative marker of lymph node metastasis.

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Comparison of MRI and CT-based radiomics for preoperative prediction of lymph node metastasis in pancreatic ductal adenocarcinoma
Piaoe Zeng, Chao Qu, Jianfang Liu, Jingjing Cui, Xiaoming Liu, Dianrong Xiu, Huishu Yuan
Acta Radiologica.2023; 64(7): 2221. CrossRef
Prevalence of Adenopathy at Chest Computed Tomography After Vaccination for Severe Acute Respiratory Syndrome Coronavirus 2
Georgeann McGuinness, Jeffrey B. Alpert, Geraldine Brusca-Augello, Lea Azour, Jane P. Ko, Farah Tamizuddin, Elliott K. Gozansky, William H. Moore
Journal of Computer Assisted Tomography.2023; 47(1): 50. CrossRef
Predictive role of radiomics features extracted from preoperative cross-sectional imaging of pancreatic ductal adenocarcinoma in detecting lymph node metastasis: a systemic review and meta-analysis
Mohammad Mirza-Aghazadeh-Attari, Seyedeh Panid Madani, Haneyeh Shahbazian, Golnoosh Ansari, Alireza Mohseni, Ali Borhani, Shadi Afyouni, Ihab R. Kamel
Abdominal Radiology.2023; 48(8): 2570. CrossRef
Long‐term outcomes of neoadjuvant gemcitabine, nab‐paclitaxel, and S1 (GAS) in borderline resectable pancreatic cancer with arterial contact: Results from a phase II trial
Kenichiro Uemura, Naru Kondo, Takeshi Sudo, Tatsuaki Sumiyoshi, Ryuta Shintakuya, Kenjiro Okada, Kenta Baba, Takumi Harada, Yoshiaki Murakami, Shinya Takahashi
Journal of Hepato-Biliary-Pancreatic Sciences.2023;[Epub] CrossRef
Regional lymph node metastasis detected on preoperative CT and/or FDG-PET may predict early recurrence of pancreatic adenocarcinoma after curative resection
Ja Kyung Yoon, Mi-Suk Park, Seung-Seob Kim, Kyunghwa Han, Hee Seung Lee, Seungmin Bang, Ho Kyoung Hwang, Sang Hyun Hwang, Mijin Yun, Myeong-Jin Kim
Scientific Reports.2022;[Epub] CrossRef
Role of CA 19.9 in the Management of Resectable Pancreatic Cancer: State of the Art and Future Perspectives
Alessandro Coppola, Vincenzo La Vaccara, Tommaso Farolfi, Michele Fiore, Roberto Cammarata, Sara Ramella, Roberto Coppola, Damiano Caputo
Biomedicines.2022; 10(9): 2091. CrossRef
Evaluation of the 8th Edition AJCC Staging System for the Clinical Staging of Pancreatic Cancer
Huapyong Kang, Seung-seob Kim, Min Je Sung, Jung Hyun Jo, Hee Seung Lee, Moon Jae Chung, Jeong Youp Park, Seung Woo Park, Si Young Song, Mi-Suk Park, Seungmin Bang
Cancers.2022; 14(19): 4672. CrossRef
Does direct invasion of peripancreatic lymph nodes impact survival in patients with pancreatic ductal adenocarcinoma? A retrospective dual-center study
Daisuke Hashimoto, Sohei Satoi, Mitsuaki Ishida, Kenji Nakagawa, Masaya Kotsuka, Tadataka Takagi, Hironori Ryota, Taichi Terai, Tatsuma Sakaguchi, Minako Nagai, So Yamaki, Takahiro Akahori, Tomohisa Yamamoto, Mitsugu Sekimoto, Masayuki Sho
Pancreatology.2021; 21(5): 884. CrossRef
CA19.9 Serum Level Predicts Lymph-Nodes Status in Resectable Pancreatic Ductal Adenocarcinoma: A Retrospective Single-Center Analysis
Alessandro Coppola, Vincenzo La Vaccara, Michele Fiore, Tommaso Farolfi, Sara Ramella, Silvia Angeletti, Roberto Coppola, Damiano Caputo
Frontiers in Oncology.2021;[Epub] CrossRef

Sarcoma metastasis to the pancreas: experience at a single institution: Miseon Lee, Joon Seon Song, Seung-Mo Hong, Se Jin Jang, Jihun Kim, Ki Byung Song, Jae Hoon Lee, Kyung-Ja Cho; J Pathol Transl Med. 2020;54(3):220-227. Published online April 22, 2020; DOI: https://doi.org/10.4132/jptm.2020.03.04

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Abstract PDF

Background
Reports of metastatic sarcoma to the pancreas are limited. We reviewed the clinicopathologic characteristics of such cases.
Methods
We reviewed 124 cases of metastatic tumors to the pancreas diagnosed at Asan Medical Center between 2000 and 2017.
Results
Metastatic tumors to the pancreas consisted of 111 carcinomas (89.5%), 12 sarcomas (9.6%), and one melanoma (0.8%). Primary sarcoma sites were bone (n = 4); brain, lung, and soft tissue (n = 2 for each); and the uterus and pulmonary vein (n = 1 for each). Pathologically, the 12 sarcomas comprised 2 World Health Organization grade III solitary fibrous tumors/hemangiopericytomas, and one case each of synovial sarcoma, malignant solitary fibrous tumor, undifferentiated pleomorphic sarcoma, osteosarcoma, mesenchymal chondrosarcoma, intimal sarcoma, myxofibrosarcoma, myxoid liposarcoma, rhabdomyosarcoma, subtype uncertain, and high-grade spindle-cell sarcoma of uncertain type. The median interval between primary cancer diagnosis and pancreatic metastasis was 28.5 months. One case manifested as a solitary pancreatic osteosarcoma metastasis 15 months prior to detection of osteosarcoma in the femur and was initially misdiagnosed as sarcomatoid carcinoma of the pancreas.
Conclusions
The metastatic sarcoma should remain a differential diagnosis when spindle-cell malignancy is found in the pancreas, even for solitary lesions or in patients without prior history.

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Metástasis pancreática de sarcoma, un hallazgo infrecuente
Daniel Aparicio-López, Jorge Chóliz-Ezquerro, Carlos Hörndler-Algárate, Mario Serradilla-Martín
Gastroenterología y Hepatología.2023; 46(5): 376. CrossRef
Pancreatic metastasis from sarcoma, an infrequent finding
Daniel Aparicio-López, Jorge Chóliz-Ezquerro, Carlos Hörndler-Algárate, Mario Serradilla-Martín
Gastroenterología y Hepatología (English Edition).2023; 46(5): 376. CrossRef
Acute pancreatitis secondary to osteosarcoma metastasis
Pablo Salmón Olavarría, Ana Gordo Ortega, Maren Eizagirre Ubegun, Verónica Ubieto Capella, Elena Carracedo Vega, Juan Carrascosa Gil, David Ruiz-Clavijo García
Revista Española de Enfermedades Digestivas.2023;[Epub] CrossRef
First Recurrence of Synovial Sarcoma Presenting With Solitary Pancreatic Mass
Raja R Narayan, Greg W Charville, Daniel Delitto, Kristen N Ganjoo
Cureus.2022;[Epub] CrossRef
Intravenous Leiomyosarcoma of the Lower Extremity: As Peripheral as It Gets
Levent F Umur, Selami Cakmak, Mehmet Isyar, Hamdi Tokoz
Cureus.2021;[Epub] CrossRef
Could the burden of pancreatic cancer originate in childhood?
Smaranda Diaconescu, Georgiana Emmanuela Gîlcă-Blanariu, Silvia Poamaneagra, Otilia Marginean, Gabriela Paduraru, Gabriela Stefanescu
World Journal of Gastroenterology.2021; 27(32): 5322. CrossRef
Staged Surgical Resection of Primary Pulmonary Synovial Sarcoma with Synchronous Multiple Pancreatic Metastases: Report of a Rare Case and Review of the Literature
Panagiotis Dorovinis, Nikolaos Machairas, Stylianos Kykalos, Paraskevas Stamopoulos, George Agrogiannis, Nikolaos Nikiteas, Georgios C. Sotiropoulos
Journal of Gastrointestinal Cancer.2021; 52(3): 1151. CrossRef

Prognostic Role of Metastatic Lymph Node Ratio in Papillary Thyroid Carcinoma: Jung-Soo Pyo, Jin Hee Sohn, Kyungseek Chang; J Pathol Transl Med. 2018;52(5):331-338. Published online August 30, 2018; DOI: https://doi.org/10.4132/jptm.2018.08.07

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Abstract PDF

Background
The aim of this study is to elucidate the clinicopathological significances, including the prognostic role, of metastatic lymph node ratio (mLNR) and tumor deposit diameter in papillary thyroid carcinoma (PTC) through a retrospective review and meta-analysis.
Methods
We categorized the cases into high (≥ 0.44) and low mLNR (< 0.44) and investigated the correlations with clinicopathological parameters in 64 PTCs with neck level VI lymph node (LN) metastasis. In addition, meta-analysis of seven eligible studies was used to investigate the correlation between mLNR and survival.
Results
Among 64 PTCs with neck level VI LN metastasis, high mLNR was found in 34 PTCs (53.1%). High mLNR was significantly correlated with macrometastasis (tumor deposit diameter ≥ 0.2 cm), extracapsular spread, and number of metastatic LNs. Based on linear regression test, mLNR was significantly increased by the largest LN size but not the largest metastatic LN (mLN) size. High mLNR was not correlated with nuclear factor κB or cyclin D1 immunohistochemical expression, Ki-67 labeling index, or other pathological parameters of primary tumor. Based on meta-analysis, high mLNR significantly correlated with worse disease-free survival at the 5-year and 10-year follow-up (hazard ratio [HR], 4.866; 95% confidence interval [CI], 3.527 to 6.714 and HR, 5.769; 95% CI, 2.951 to 11.275, respectively).
Conclusions
Our data showed that high mLNR significantly correlated with worse survival, macrometastasis, and extracapsular spread of mLNs. Further cumulative studies for more detailed criteria of mLNR are needed before application in daily practice.

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Thyroglobulin expression, Ki-67 index, and lymph node ratio in the prognostic assessment of papillary thyroid cancer
Helene Lindfors, Marie Karlsen, Ellinor Karlton, Jan Zedenius, Catharina Larsson, Catharina Ihre Lundgren, C. Christofer Juhlin, Ivan Shabo
Scientific Reports.2023;[Epub] CrossRef
Incidental Node Metastasis as an Independent Factor of Worse Disease-Free Survival in Patients with Papillary Thyroid Carcinoma
Renan Aguera Pinheiro, Ana Kober Leite, Beatriz Godoi Cavalheiro, Evandro Sobroza de Mello, Luiz Paulo Kowalski, Leandro Luongo Matos
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A High-Quality Nomogram for Predicting Lung Metastasis in Newly Diagnosed Stage IV Thyroid Cancer: A Population-Based Study
WenYi Wang, JiaJing Liu, XiaoFan Xu, LiQun Huo, XuLin Wang, Jun Gu
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Lymph Node Ratio Predicts Recurrence in Patients with Papillary Thyroid Carcinoma with Low Lymph Node Yield
Il Ku Kang, Joonseon Park, Ja Seong Bae, Jeong Soo Kim, Kwangsoon Kim
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Superiority of metastatic lymph node ratio over number of node metastases and TNM/AJCC N classification in predicting cancer‐specific survival in medullary thyroid cancer
Andreas Machens, Kerstin Lorenz, Frank Weber, Henning Dralle
Head & Neck.2022; 44(12): 2717. CrossRef
Value of Combining Clinical Factors, Conventional Ultrasound, and Contrast-Enhanced Ultrasound Features in Preoperative Prediction of Central Lymph Node Metastases of Different Sized Papillary Thyroid Carcinomas
Yanfang Wang, Fang Nie, Guojuan Wang, Ting Liu, Tiantian Dong, Yamin Sun
Cancer Management and Research.2021; Volume 13: 3403. CrossRef
Atypical Histiocytoid Cells and Multinucleated Giant Cells in Fine-Needle Aspiration Cytology of the Thyroid Predict Lymph Node Metastasis of Papillary Thyroid Carcinoma
Ji Eun Choi, Ja Seong Bae, Dong-Jun Lim, So Lyung Jung, Chan Kwon Jung
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Patients Aged ≥55 Years With Stage T1-2N1M1 Differentiated Thyroid Cancer Should Be Downstaged in the Eighth Edition AJCC/TNM Cancer Staging System
Zeming Liu, Sichao Chen, Yihui Huang, Di Hu, Min Wang, Wei Wei, Chao Zhang, Wen Zeng, Liang Guo
Frontiers in Oncology.2019;[Epub] CrossRef
Prognostic Implication of Metastatic Lymph Node Ratio in Colorectal Cancers: Comparison Depending on Tumor Location
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Journal of Clinical Medicine.2019; 8(11): 1812. CrossRef

Case Study

Malignant Pleural Effusion from Metastatic Prostate Cancer: A Case Report with Unusual Cytologic Findings: Jinyoung Jeon, Tae-Jung Kim, Hong Sik Park, Kyo-Young Lee; J Pathol Transl Med. 2018;52(4):257-261. Published online June 7, 2018; DOI: https://doi.org/10.4132/jptm.2018.05.08

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Abstract PDF

We present a case of 55-year-old man who complained of dyspnea and sputum for a month. He was an ex-smoker with a history of prostate cancer and pulmonary tuberculosis. Chest radiographs revealed bilateral pleural effusions of a small to moderate amount. Pigtail catheters were inserted for drainage. The pleural fluid consisted of large clusters and tightly cohesive groups of malignant cells, which however could not be ascribed to prostate cancer with certainty. We performed immunocytochemical panel studies to determine the origin of cancer metastasis. The immunostaining results were positive for prostate-specific antigen, alpha-methylacyl-coenzyme A racemase, and Nkx 3.1, consistent with prostate cancer. Pleural effusion associated with prostate cancer is rare. To our knowledge, this is the first case report in Korea to describe cytologic features of malignant pleural effusion associated with prostate cancer.

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Cytopathological Features of Extensive Bilateral Pleural Effusions in Metastatic Prostate Cancer: Report of a Rare Case
Hehua Huang, Caroline Yap
Cureus.2024;[Epub] CrossRef
Rare metastatic prostate cancer mimicking lymphoma with malignant pleural effusion
Tung Liu, En Meng, Yu-Chun Lin, Tai-Kuang Chao, Yi-Ming Chang
Journal of Medical Sciences.2022; 42(1): 46. CrossRef
Bilateral pleural effusion: etiology, diagnostics
N. A. Stogova
PULMONOLOGIYA.2022; 32(6): 885. CrossRef

Original Article

Prognostic Utility of Histological Growth Patterns of Colorectal Lung Oligometastasis: Son Jae Yeong, Min Gyoung Pak, Hyoun Wook Lee, Seung Yeon Ha, Mee Sook Roh; J Pathol Transl Med. 2018;52(2):98-104. Published online February 12, 2018; DOI: https://doi.org/10.4132/jptm.2017.12.27

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Abstract PDF

Background
Patients with resectable colorectal lung oligometastasis (CLOM) demonstrate a heterogeneous oncological outcome. However, the parameters for predicting tumor aggressiveness have not yet been fully investigated in CLOM. This study was performed to determine the prognostic value of histological growth patterns in patients who underwent surgery for CLOM.
Methods
The study included 92 patients who were diagnosed with CLOM among the first resection cases. CLOMs grow according to three histological patterns: aerogenous, pushing, and desmoplastic patterns. The growth patterns were evaluated on archival hematoxylin and eosin–stained tissue sections.
Results
The aerogenous pattern was found in 29.4% (n=27) of patients, the pushing pattern in 34.7% (n=32), the desmoplastic pattern in 6.5% (n=6), and a mix of two growth patterns in 29.4% (n=27). The size of the aerogenous pattern was significantly smaller than that of metastases with other patterns (p=.033). Kaplan-Meier analysis demonstrated that patients showing an aerogenous pattern appeared to have a poorer prognosis, which was calculated from the time of diagnosis of the CLOM (p=.044). The 5-year survival rate from the diagnosis of colorectal cancer tended to be lower in patients with an aerogenous pattern than in those who had a non-aerogenous pattern; however, the difference was marginally significant (p=.051). In the multivariate Cox analysis, the aerogenous pattern appeared as an independent predictor of poor overall survival (hazard ratio, 3.122; 95% confidence interval, 1.196 to 8.145; p=.020).
Conclusions
These results suggest that the growth patterns may play a part as a histology-based prognostic parameter for patients with CLOM.

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Predicting liver metastases growth patterns: Current status and future possibilities
Rui Caetano Oliveira, Henrique Alexandrino, Maria Augusta Cipriano, Filipe Caseiro Alves, José Guilherme Tralhão
Seminars in Cancer Biology.2021; 71: 42. CrossRef
Histological growth patterns and molecular analysis of resected colorectal lung metastases
Emanuela Pilozzi, Damiano Fedele, Andrea Montori, Laura Lorenzon, Valentina Peritore, Giorgia Mannocchi, Nikta Bagheri, Chiara Leone, Antonio Palumbo, Michela Roberto, Giulio Ranazzi, Erino Rendina, Genoveffa Balducci, Mohsen Ibrahim
Pathology - Research and Practice.2021; 222: 153414. CrossRef

Case Studies

Merkel Cell Carcinoma Metastatic to Pleural Fluid: A Case Report: Ye-Young Rhee, Soo Hee Kim, Eun Kyung Kim, Se Hoon Kim; J Pathol Transl Med. 2018;52(3):206-209. Published online November 23, 2017; DOI: https://doi.org/10.4132/jptm.2017.11.10

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Abstract PDF

Merkel cell carcinoma (MCC) is a rare aggressive neuroendocrine carcinoma of the skin that shows locoregional or distant metastasis. Metastasis of MCC to body cavity effusion is extremely rare; only three cases have been reported so far. Metastatic MCC in effusion cytology shows small blue round cells with fine stippled chromatin like other small blue round cell tumors such as small cell lung carcinoma or lymphoma. The diagnosis of metastatic MCC can grant patients good chances at recently advanced therapeutic options. Here, we present a case of metastatic MCC to pleural effusion with characteristic single file-like pattern.

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Merkel cell carcinoma presenting as a malignant pleural effusion post‐COVID‐19 hospitalization: A case report and literature review
Joel Lanceta, Mesut Toprak, Oana C. Rosca
Diagnostic Cytopathology.2022;[Epub] CrossRef
Cytology coupled with immunocytochemistry identifies Merkel cell carcinoma: A rare intruder in the cerebrospinal fluid
Reetu Kundu, Brijdeep Singh, Pranab Dey
Cytopathology.2022; 33(4): 530. CrossRef
Derrame pleural por carcinoma de células de Merkel
María J. Soler-Sempere, María O. Alvárez-Fernández, Isabel Padilla-Navas, María Cabezas-Macián, Jose F. Sánchez-Hernández, Eduardo García-Pachón
Archivos de Bronconeumología.2021; 57(11): 715. CrossRef
A rare case of pleural localisation of both metastatic Merkel cell carcinoma and chronic lymphocytic leukaemia
Elise Kaspi, Shirley Fritz, Julien Colle, Florent Amatore, Diane Frankel, Patrice Roll
Cytopathology.2021; 32(3): 367. CrossRef
Merkel cell carcinoma with pleural effusion
María J. Soler-Sempere, María O. Alvárez-Fernández, Isabel Padilla-Navas, María Cabezas-Macián, Jose F. Sánchez-Hernández, Eduardo García-Pachón
Archivos de Bronconeumología (English Edition).2021; 57(11): 715. CrossRef

Aggressive Supratentorial Ependymoma, RELA Fusion-Positive with Extracranial Metastasis: A Case Report: Seong-Ik Kim, Yoojin Lee, Seung Ki Kim, Hyoung Jin Kang, Sung-Hye Park; J Pathol Transl Med. 2017;51(6):588-593. Published online November 15, 2017; DOI: https://doi.org/10.4132/jptm.2017.08.10

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216 Download
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Abstract PDF

Ependymoma is the third most common pediatric primary brain tumor. Ependymomas are categorized according to their locations and genetic abnormalities, and these two parameters are important prognostic factors for patient outcome. For supratentorial (ST) ependymomas, RELA fusion-positive ependymomas show a more aggressive behavior than YAP1 fusion-positive ependymomas. Extracranial metastases of intra-axial neuroepithelial tumors are extremely rare. In this paper, we report a case of aggressive anaplastic ependymoma arising in the right frontoparietal lobe, which had genetically 1q25 gain, CDKN2A homozygous deletion, and L1CAM overexpression. The patient was a 10-year-old boy who underwent four times of tumor removal and seven times of gamma knife surgery. Metastatic loci were scalp and temporalis muscle overlying primary operation site, lung, liver, buttock, bone, and mediastinal lymph nodes. He had the malignancy for 10 years and died. This tumor is a representative case of RELA fusion-positive ST ependymoma, showing aggressive behavior.

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A Pediatric Case of Extraneural Subcutaneous Metastasis of Ependymoma
Chika Ueno, Masayuki Tanaka, Ayako Yamazaki, Shuichi Yamamoto
Journal of Pediatric Hematology/Oncology.2023; 45(8): e1025. CrossRef
Patterns of Extraneural Metastases in Children With Ependymoma
Priya P. Chan, Nicholas S. Whipple, Biswarathan Ramani, David A. Solomon, Holly Zhou, Luke L. Linscott, John R.W. Kestle, Carol S. Bruggers
Journal of Pediatric Hematology/Oncology.2023; 45(2): e272. CrossRef
Magnetic Resonance Imaging Features of Zinc Finger Translocation Associated-RELA Fusion Ependymoma Compared to Its Wild-Type Counterpart
Hanbing Shao, Ni Chen, Xiaorui Su, Linmao Zheng, Xibiao Yang, Xinyue Wan, Simin Zhang, Qiaoyue Tan, Shuang Li, Qiyong Gong, Qiang Yue
World Neurosurgery.2023; 175: e1283. CrossRef
A clinicopathological analysis of supratentorial ependymoma, ZFTA fusion-positive: utility of immunohistochemical detection of CDKN2A alterations and characteristics of the immune microenvironment
Naohito Hashimoto, Tomonari Suzuki, Keisuke Ishizawa, Sumihito Nobusawa, Hideaki Yokoo, Ryo Nishikawa, Masanori Yasuda, Atsushi Sasaki
Brain Tumor Pathology.2023; 40(3): 163. CrossRef
Recurrent intracranial anaplastic ependymoma with late‐onset giant scalp metastasis
Gianluca Scalia, Gianluca Ferini, Bipin Chaurasia, Francesca Graziano, Stefano Priola, Paolo Amico, Giuseppe Emmanuele Umana
Clinical Case Reports.2023;[Epub] CrossRef
Extra-Neural Metastases From Primary Intracranial Ependymomas: A Systematic Review
Paolo Palmisciano, Gianluca Ferini, Fabio Barone, Vishal Chavda, Fabrizio Romano, Paolo Amico, Donatella Emmanuele, Giovanni F. Nicoletti, Gianluca Pompili, Giuseppe Roberto Giammalva, Rosario Maugeri, Domenico Gerardo Iacopino, Lidia Strigari, Tseng T. Y
Frontiers in Oncology.2022;[Epub] CrossRef
Changes to pediatric brain tumors in 2021 World Health Organization classification of tumors of the central nervous system
Murat Alp Oztek, Sakura M. Noda, Erin K. Romberg, Bonnie L. Cole, Jason N. Wright, Gisele E. Ishak, Francisco A. Perez
Pediatric Radiology.2022; 53(3): 523. CrossRef
Delineation of molecular characteristics in pediatric PFA ependymoma involving rare osseous and pulmonary metastases: A case report and literature review
Mading Zhou, Leiming Wang, Peng Sun, Yutong Liu, Ge Chen, Gao Zeng
Frontiers in Oncology.2022;[Epub] CrossRef
SeekFusion - A Clinically Validated Fusion Transcript Detection Pipeline for PCR-Based Next-Generation Sequencing of RNA
Jagadheshwar Balan, Garrett Jenkinson, Asha Nair, Neiladri Saha, Tejaswi Koganti, Jesse Voss, Christopher Zysk, Emily G. Barr Fritcher, Christian A. Ross, Caterina Giannini, Aditya Raghunathan, Benjamin R. Kipp, Robert Jenkins, Cris Ida, Kevin C. Halling,
Frontiers in Genetics.2021;[Epub] CrossRef
Cytology of Extraneural Metastases of Nonhematolymphoid Primary Central Nervous System Tumors: Six Cases with Histopathological Correlation and Literature Update
Joerg Schwock, Lorna Mirham, Zeina Ghorab
Acta Cytologica.2021; 65(6): 529. CrossRef
Mutation profiling of anaplastic ependymoma grade III by Ion Proton next generation DNA sequencing
Ejaz Butt, Sabra Alyami, Tahani Nageeti, Muhammad Saeed, Khalid AlQuthami, Abdellatif Bouazzaoui, Mohammad Athar, Zainularifeen Abduljaleel, Faisal Al-Allaf, Mohiuddin Taher
F1000Research.2020; 8: 613. CrossRef
Cortically based cystic supratentorial RELA fusion-positive ependymoma: a case report with unusual presentation and appearance and review of literature
Yasmine T. Sallam, Qi Zhang, Sachin K. Pandey
Radiology Case Reports.2020; 15(12): 2495. CrossRef
Mutation profiling of anaplastic ependymoma grade III by Ion Proton next generation DNA sequencing
Muhammad Butt, Sabra Alyami, Tahani Nageeti, Muhammad Saeed, Khalid AlQuthami, Abdellatif Bouazzaoui, Mohammad Athar, Zainularifeen Abduljaleel, Faisal Al-Allaf, Mohiuddin Taher
F1000Research.2019; 8: 613. CrossRef
Extraneural metastatic anaplastic ependymoma: a systematic review and a report of metastases to bilateral parotid glands
Gray Umbach, Tarek Y El Ahmadieh, Aaron R Plitt, Salah G Aoun, Om J Neeley, Kristopher A Lyon, Ekokobe Fonkem, Jack M Raisanen, Justin A Bishop, Zabi Wardak, Toral R Patel, Larry Myers, Bruce E Mickey
Neuro-Oncology Practice.2019;[Epub] CrossRef
RELA Fusion in Supratentorial Extraventricular Ependymomas: A Morphologic, Immunohistochemical, and Molecular Study of 43 Cases
Leiming Wang, Lina Liu, Hainan Li, PeiPei Wang, Zeliang Hu, Yukui Wei, Ming Zhang, Wenjuan Wen, Zhi Li, Li Liu, Lihong Zhao, Dehong Lu, Lianghong Teng
American Journal of Surgical Pathology.2019; 43(12): 1674. CrossRef
Epithelial-to-mesenchymal transition–related transcription factors are up-regulated in ependymomas and correlate with a poor prognosis
Prit Benny Malgulwar, Aruna Nambirajan, Pankaj Pathak, Madhu Rajeshwari, Vaishali Suri, Chitra Sarkar, Manmohan Singh, Mehar Chand Sharma
Human Pathology.2018; 82: 149. CrossRef

Original Article

Programmed Death-Ligand 1 Expression and Its Correlation with Lymph Node Metastasis in Papillary Thyroid Carcinoma: Hyo Jung An, Gyung Hyuck Ko, Jeong-Hee Lee, Jong Sil Lee, Dong Chul Kim, Jung Wook Yang, Min Hye Kim, Jin Pyeong Kim, Eun Jung Jung, Dae Hyun Song; J Pathol Transl Med. 2018;52(1):9-13. Published online October 3, 2017; DOI: https://doi.org/10.4132/jptm.2017.07.26

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Abstract PDF

Background
The immunotherapeutic role of programmed death-ligand 1 (PD-L1) in life expectancy in many cancers has been highlighted. However, data regarding PD-L1 expression in papillary thyroid carcinoma (PTC) are limited. In this study, we describe the PD-L1 and programmed cell death protein 1 (PD-1) expressions in PTC and analyze their correlation with lymph node (LN) metastasis.
Methods
Clinicopathological data were obtained from 116 patients with PTC who were treated in Gyeongsang National University Hospital, Jinju, Korea in 2009. Tissue microarray blocks were made using representative paraffin blocks of classical PTCs excluding follicular variants. Two pathologists graded the proportion and intensity of PD-L1 and PD-1 expression in both tumor and inflammatory cells. According to their proportions, positive PTC cells were scored as negative (0%), grade 1 (1%–50%), and grade 2 (51%–100%). Similarly, positive inflammatory cells were graded as negative (0%), grade 1 (1%–10%), and grade 2 (11%–20%). The intensity of each protein expression was simplified as positive or negative.
Results
A statistically significant correlation exists between the proportions of PD-1 and PD-L1 expression both in papillary carcinoma (p=.001) and peritumoral lymphoid cells in the thyroid (p<.001). In addition, the proportion of PD-L1 expression in PTC cells was closely related to metastatic LNs (p=.036).
Conclusions
PD-L1 is a valuable predictive marker for LN metastasis in PTC. Immunomodulating therapies that inhibit PD-L1 might be an option for patients with LN metastasis.

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Vitor Barreto Santana, Vitória Machado Krüger, Maria Cristina Yunes Abrahão, Pietru Lentz Martins Cantú, Rosicler Luzia Brackmann, Gisele Moroni Pandolfi, Liane Scheffler Marisco, Gabriela Remonatto, Luciana Adolfo Ferreira, Marcia Silveira Graudenz
Head and Neck Pathology.2024;[Epub] CrossRef
Update regarding the role of PD-L1 in oncocytic thyroid lesions on cytological samples
Marco Dell'Aquila, Pietro Tralongo, Alessia Granitto, Maurizio Martini, Sara Capodimonti, Mariangela Curatolo, Vincenzo Fiorentino, Alfredo Pontecorvi, Guido Fadda, Celestino Pio Lombardi, Maco Raffaelli, Liron Pantanowitz, Luigi Maria Larocca, Esther Dia
Journal of Clinical Pathology.2023; 76(10): 671. CrossRef
Analysis of anti‐apoptotic PVT1 oncogene and apoptosis‐related proteins (p53, Bcl2, PD‐1, and PD‐L1) expression in thyroid carcinoma
Afaf T. Ibrahiem, Amin K. Makhdoom, Khalid S. Alanazi, Abdulaziz M. Alanazi, Abdulaziz M. Mukhlef, Saad H. Elshafey, Eman A. Toraih, Manal S. Fawzy
Journal of Clinical Laboratory Analysis.2022;[Epub] CrossRef
EphA10 drives tumor progression and immune evasion by regulating the MAPK/ERK cascade in lung adenocarcinoma
Wenyue Zhao, Lu Liu, Xuehao Li, Shun Xu
International Immunopharmacology.2022; 110: 109031. CrossRef
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Peter P. Issa, Mahmoud Omar, Yusef Buti, Chad P. Issa, Bert Chabot, Christopher J. Carnabatu, Ruhul Munshi, Mohammad Hussein, Mohamed Aboueisha, Mohamed Shama, Ralph L. Corsetti, Eman Toraih, Emad Kandil
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Mohamed Sherif Ismail, Amr Mousa Abdel Gawad Mousa, Mohammed Faisal Darwish, M. Mostafa Salem, Randa Said
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Ilaria Girolami, Liron Pantanowitz, Ozgur Mete, Matteo Brunelli, Stefano Marletta, Chiara Colato, Pierpaolo Trimboli, Anna Crescenzi, Massimo Bongiovanni, Mattia Barbareschi, Albino Eccher
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Andrea Palermo, Andrea Napolitano, Daria Maggi, Anda Mihaela Naciu, Gaia Tabacco, Silvia Manfrini, Anna Crescenzi, Chiara Taffon, Francesco Pantano, Bruno Vincenzi, Guiseppe Tonini, Daniele Santini
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