Medical Specialties Commons^™

Gata3 Is A Useful Immunohistochemical Marker To Differentiate Variants Of Renal Tubular Lesions From Different Segments Of Renal Tubules, M Deebajah, Z Qu, P Zhang

Conference Presentation Abstracts

Introduction/Objective GATA3 is found in glomerular mesangial cells, and the distal tubules & collecting ducts in metanephros and eventual kidneys, but not associated with the proximal tubules and loops of Henle. We hypothesize that GATA3 can be used as a marker to identify the origin of tubular differentiation in most renal tumors.

Methods/Case Report Ten negative controls and 43 renal mass lesions (RCC, papillary, clear cell papillary, and chromophobe carcinomas, oncocytoma, and polycystic kidney disease). GATA3 nuclear stain was graded as negative (absent stain), equivocal and positive (< 5 and > 5% cells, respectively). Details of their GATA3 nuclear expression was analyzed for …

A Case Report Of Autopsy: Large Mass Of Pulmonary Metastatic Calcification In A Patient With End-Stage Renal Disease, V D. Mahalingam, P Zhang

Conference Presentation Abstracts

Introduction/Objective: Metastatic calcifications are reported in patients with end-stage renal disease (ESRD) in radiology literature but there are no pathologic reports regarding this clinical scenario in autopsy. Methods/Case Report: We report the case of a 27-yearold African American man with nephrotoxic injury secondary to gentamicin treatment at a young age leading to ESRD requiring dialysis who then later developed congestive heart disease and arrhythmia. Prior to the patient’s last hospitalization, he had normal breath sounds with no signs of respiratory distress, rales, or wheezing. Imaging of the chest showed a patchy density in the right lung and a large parenchymal …

Recurrent Focal Segmental Glomeruloscleosis Progressing To Collapsing Glomerulopathy In Renal Graft Of An Autopsy Study, C Thorburn, K J Jabbar, W Li, H Kanaan, P Zhang

Conference Presentation Abstracts

Introduction/Objective: Collapsing glomerulopathy (CGN) mainly occurs in patients of African descent because a majority of these patients have APOL-1 gene mutations that results in damage of terminally differentiated podocytes, diffuse fusion of foot processes, and podocyte hyperplasia. Idiopathic FSGS is associated with high rates of recurrent FSGS in renal transplants and can be seen in patients with APOL-1 gene mutations as well, but recurrent FSGS progressing to CGN is not reported. Here we report an autopsy case with renal transplant showing recurrent FSGS progressing to CGN. Methods/Case Report: Our patient was a 32 year old African American man who had …

Weakened Igg4 Staining And Positive Pla2r Staining Indicate Resolving Primary Membranous Glomerulopathy (Mgn), Y Al-Othman, W Li, H Kanaan, P Zhang

Conference Presentation Abstracts

Introduction/Objective: IgG4 related disease, a systemic autoimmune inflammatory disorders, can be identified by high% of IgG4 positive plasma cells, thus IgG4 staining in paraffin embedded tissue is widely available in the most of pathology labs. IgG4 staining has been found useful to identify primary MGN (PLA2R and/or THSD7A positive) by others and us. This study was to scrutinize the findings of primary vs secondary MGN needed for IgG4 staining as a screening tool in our renal pathology practice over pasts 5 years Methods/Case Report: IgG4 staining in paraffin embedded tissue was performed in 45 primary MGN and 43 secondary MGN …

Case Report. Cryoglobulin Hyaline-Thrombi Associated Acute Jejunitis In A Patient With Type 2 Cryoglobulinemic Glomerulonephritis, Y Al-Othman, Z Qu, P Zhang

Conference Presentation Abstracts

Introduction/Objective Only one prior case report indicates that mixed positive cryoglobulin in serum can be associated with intestinal vasculitis (Annals of Internal Medicine, 1974).

Methods/Case Report We report a 63-year old man with history of positive serum cryoglobulin and hepatitis-C 4 years ago and membranoproliferative pattern of glomerulonephritis with possible cryoglobulin type of deposits by electron microscopy on renal biopsy. After treatment, his hepatitis C became negative. But he was recently found to have monoclonal IgM-kappa and positive cryoglobulin in his serum, and the concurrent renal biopsy showed membranoproliferative pattern of glomerulopathy with many hyaline-thrombi (eosinophilic vascular occlusions with no …

Increased Activated Plasma Cells In Inflammatory Bowel Disease When Compared To Ischemic Acute Colitis, C Thornburn, Z Qu, P Zhang

Conference Presentation Abstracts

Introduction/Objective Inflammatory bowel disease (IBD) and acute ischemic colitis can both be involved by active colitis. IBD is characterized by crypt architectural distortion, basal lymphoplasmacytosis, and occasional granulomatous changes. However, diagnosis of IBDs is still largely by exclusion of other types of active colitis with similar changes. We previously demonstrated that glucose regulated protein 94 (grp94) is mainly expressed by activated plasma cells. We postulate that increased numbers of grp94-positive plasma cells may support diagnosis of IBDs. Here, we compared IBD and active ischemic colitis for grp94 expression in mucosal plasma cells of colectomy specimens

Methods/Case Report Tissue sections from …

Utilization Of 2d Barcode Technology To Create Surgical Pathology Reports, Zhenhong Qu, Elaine Qu, James Huang, Mark A. Micale, E Li

Conference Presentation Abstracts

Introduction/Objective: After professional transcription service is eliminated, pathologists inevitably undertake the task of diagnostic data entry into pathology repot by adapting a variety of methods such as speech recognition, manual typing, and pre-texted command. Errors and inefficiency in reporting remain common problems, especially for information with unusual syntax such as genotype or nucleotide sequences. To overcome these shortcomings, we introduce here a novel application of a well-established technology as a complementary method, namely 2- dimensional (2D) barcode symbology. Methods/Case Report: Commonly used diagnostic wordings of pathology reports including specimen type, surgical procedure, diagnosis, and test results are collated and organized …

Interobserver Variability In Differentiated Vulvar Intraepithelial Neoplasia Between Surgical Pathology Subspecialties, Grace Y. Wang

Conference Presentation Abstracts

Abstract:Background: Differentiated vulvar intraepithelial neoplasia (dVIN) is a human papillomavirus-independent lesion with potential for rapid progression to invasive squamous cell carcinoma (SCC). The histologic features of dVIN are diverse and have overlapping characteristics with lichen sclerosus (LS) and lichen simplex chronicus (LSC); and may be diagnosed by dermatopathologists or gynecologic pathologists. The goal of our study is to examine interobserver variability in the diagnosis of dVIN between pathologists with different subspecialty expertise. Design: Biopsies diagnosed as dVIN, LS and LSC from 2011-2018 were retrieved from the pathology database at a large academic institution. Using Fleiss kappa statistic, histologic features and …

A Unique Case Of Renal Pelvic Urothelial Carcinoma With Extensive Small Round Cell Sarcoma Differentiation Showing Swsr1 Gene Rearrangement, Zubin Shetty, Mitual Amin, Savitha Balaraman, Sugandh Shetty

Conference Presentation Abstracts

Introduction: Ewings-like sarcoma is a rare subgroup of small round cell sarcoma with immunohistochemistry and morphological similarities to Ewing Sarcoma. We report a rare case of renal pelvis invasive urothelial carcinoma with small round cell sarcoma differentiation showing EWSR1 gene rearrangement. Case: An 84-year-old male presented with 6 months of intermittent painless gross hematuria. Workup revealed a 5.4cm left renal pelvicalyceal mass suspicious for transitional cell carcinoma and a 2.5cm enhancing left renal cortical lesion. The patient underwent an uncomplicated robotic left nephroureterectomy. Pathology revealed small round cell sarcoma composing greater than 80% of the renal pelvis tumor with the …

Anti-Nmda-Receptor Encephalitis In A Patient With Ovarian Teratoma, Harboring Brain Histology Of Varying Developmental Stages And Regions With Chronic Inflammation, S Fatemi, E Qu, J Fullmer

Conference Presentation Abstracts

Introduction/Objective Anti-NMDA-receptor encephalitis is a subacute, autoimmune disorder thought to be caused by autoantibodies directed against the N-methyl-D-aspartate (NMDA) receptor. Clinical symptoms of anti-NMDAR encephalitis may mimic schizophrenia and psychotic spectrum disorders or substance-induced psychosis. Although initially described in association with ovarian teratomas in women, anti-NMDAR encephalitis has been reported in individuals without paraneoplastic association, as well as in males. Herein, we report a case of a 29-year-old woman with suicidal ideation and other neuropsychiatric manifestations who was found to have a right ovarian cystic mass by imaging study. Microscopically, the resected ovarian mass is composed of mature skin, fat, …

How Much Time Do General Surgical Pathologists Spend On Diagnostic Data Entry?, Zhenhong Qu, Lanjin Zhang, Xianzhong Ding, Kausar Jabbar

Conference Presentation Abstracts

Context: As many pathology institutions have eliminated transcription service by office assistants, pathologists assume the task of diagnostic data entry (DDE) into pathology reports in the laboratory information system. This is not a trivial undertaking, yet tangible data are lacking on how much DDE adds to the workload of pathologists. Without such data, it is very difficult to assess the financial benefit of such a task shift and establish benchmarks. Design: Four practicing pathologists covering a general surgical pathology service in 3 institutions with different laboratory information systems were selected for their dominant DDE method (speech recognition, pre-text, or manual …

Use Of Immunohistochemistry To Determine Expression Of Rab5 Subfamily Of Gtpases In Mature And Developmental Brains, Kwok Ling Kam, Paige Parrack, Marcellus Banworth, Sheeja Aravindan, Guangpu Li, Kar Ming Fung

Books and Book Chapters

Rab GTPases are essentially molecular switches. They serve as master regulators in intracellular membrane trafficking from the formation and transport of vesicles at the originating organelle to its fusion to the membrane at the target organelle. Their functions are diversified and each has their specific subcellular location. Their expression may vary significantly in the same cell when the level of protein production is significantly different in different physiologic status. One of the best examples is the transition from fetal to mature status of cells. Expression and localization of Rab GTPases in mature and developing brains have not been well studied. …

Mosaic Pattern Of Progenitor Cell Marker Cd133 Expression To Identify Podocyte Proliferation Supports Collapsing Variant Of Focal Segmental Glomerulosclerosis (Fsgs), A Xiao, H Kanaan, W Li, P Zhang

Conference Presentation Abstracts

Introduction: Previous studies using immunofluorescent methods indicate that both the cellular crescents in crescentic glomerulonephritis and the podocyte proliferation in collapsing FSGS may both originate from parietal epithelial cells, which serve as CD133 positive progenitor cells. We have previously confirmed positive CD133 staining in the cellular crescents of crescentic glomerulonephritis. However, the role of CD133 expression in highlighting the proliferative podocytes in collapsing FSGS has not been adapted to the renal pathology practice. Methods: We have identified 19 collapsing FSGS from our archive over past 10 years (out of 3942 renal biopsies, 0.5 %). The collapsing FSGS cases were either …

Illumina Trusight Oncology 500 Sequencing Panel Validation At A Large Community Based Hospital, Sandeep Kumar, John Schwartz, Mitual Amin, Jennifer Kilbourn, Hlee Vue, Susan Daraiseh, Kausar Jabbar

Conference Presentation Abstracts

Background: With growing efficacy of targeted therapy, it is critical to have comprehensive tumor profiling. TruSight Oncology 500 (TSO500) is a hybrid capture based next generation sequencing (NGS) assay that enables comprehensive genomic profiling of tumor samples. TSO500 includes 523 cancer-related genes which provides identification of pertinent single nucleotide variants (SNV), insertions and deletions (Indels), splice variants, fusions, copy number variants (CNV), tumor mutational burden (TMB) and microsatellite instability (MSI), from genomic DNA and RNA. Design: We evaluated the performance of TSO500 using a combination of 102 formalin fixed paraffin embedded (FFPE) tumor types, 41 hematologic samples and 27 reference …

Treatment-Resistant Hypercalcemia From Ectopic Pth Hypersecretion Suspected Secondary To Disseminated Ovarian Cancer, Alexander M. Balinski, Neil J. Khatter, Jeffrey M. Gold, Krishna S. Pothugunta, Vamshi K. Garlapaty, Steven M. Rankin, Christopher A. Thornburn, Jamal Abu-Khaled

Articles

Hypercalcemia of malignancy (HCM) can present secondary to hypersecretion of parathyroid hormone (PTH)-related protein (PTHrP) from malignant tumors, but rare cases of HCM have also been documented due to inappropriate PTH secretion from ectopic neoplasms. Here, we report an unusual case of HCM due to hypersecretion of PTH suspected secondary to a disseminated mucinous ovarian adenocarcinoma. A 45-year-old female presented with severe hypercalcemia and significant elevations in both PTH and PTHrP two weeks after total abdominal hysterectomy with bilateral salpingo-oophorectomy and suboptimal debulking of a newly discovered left ovarian mucinous adenocarcinoma with numerous metastases. Ectopic PTH secretion was highly suspected …