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Sultan Qaboos University Medical Journal Aug 2017Odontogenic tumours are lesions that occur solely within the oral cavity and are so named because of their origin from the odontogenic (i.e. tooth-forming) apparatus.... (Review)
Review
Odontogenic tumours are lesions that occur solely within the oral cavity and are so named because of their origin from the odontogenic (i.e. tooth-forming) apparatus. Odontogenic tumours comprise a variety of lesions ranging from non-neoplastic tissue proliferations to benign or malignant neoplasms. However, controversies exist regarding the pathogenesis, categorisation and clinical and histological variations of these tumours. The recent 2017 World Health Organization classification of odontogenic tumours included new entities such as primordial odontogenic tumours, sclerosing odontogenic carcinomas and odontogenic carcinosarcomas, while eliminating several previously included entities like keratocystic odontogenic tumours and calcifying cystic odonogenic tumours. The aim of the present review article was to discuss controversies and recent concepts regarding odontogenic tumours so as to increase understanding of these lesions.
Topics: Ameloblastoma; Carcinoma; Humans; Odontogenesis; Odontogenic Tumors; Odontoma; World Health Organization
PubMed: 29062548
DOI: 10.18295/squmj.2017.17.03.003 -
Archives of Pathology & Laboratory... Jul 2016-The morphologic spectrum of secretory breast lesions encompasses benign, borderline, and malignant lesions. They are characterized by luminal pink, proteinaceous... (Review)
Review
CONTEXT
-The morphologic spectrum of secretory breast lesions encompasses benign, borderline, and malignant lesions. They are characterized by luminal pink, proteinaceous secretions and variable degrees of cytologic atypia ranging from low grade to high grade, with frequent papillary formations. Other lesions, benign and malignant, can also show luminal and extraluminal secretions and share similar features with secretory lesions, making them diagnostically challenging.
OBJECTIVE
-To discuss the differential diagnosis of secretory breast lesions, emphasizing the most important diagnostic features of benign and malignant lesions. Lesions with intraluminal secretions discussed at length in this review include pregnancy-like hyperplasia, cystic hypersecretory hyperplasia, collagenous spherulosis, microglandular adenosis, hypersecretory carcinoma, and secretory carcinoma. Lesions with extravasated mucin, such as mucocele-like lesions and mucinous carcinoma, are also briefly discussed.
DATA SOURCES
-Published articles obtained from a PubMed search of the English literature were the primary source for this review.
CONCLUSIONS
-Lesions with secretory features described in this review show a pathologic spectrum, sometimes even within the same lesion. As a consequence, one should employ a low threshold for recommending reexcision on a core biopsy containing benign-appearing hypersecretory glands and use all ancillary data, including clinical presentation, imaging findings, morphology, immunohistochemistry, and molecular pathology, to render a final diagnosis.
Topics: Adenocarcinoma, Mucinous; Breast; Breast Neoplasms; Carcinoma; Female; Humans
PubMed: 27362569
DOI: 10.5858/arpa.2015-0250-RA -
European Annals of Otorhinolaryngology,... Jun 2019In adult cervicofacial pathology, carcinoma of unknown primary is defined as lymph-node metastasis the anatomic origin of which is not known at the time of initial... (Review)
Review
In adult cervicofacial pathology, carcinoma of unknown primary is defined as lymph-node metastasis the anatomic origin of which is not known at the time of initial management. It constitutes up to 5% of head and neck cancers. Presentation may suggest benign pathology, delaying and confusing oncologic treatment. Diagnostic strategy in cervical lymph node with suspicion of neoplasia requires exhaustive work-up to diagnose malignancy and, in 45% to 80% of cases, depending on the series, to identify the primary site. Histologic types comprise squamous cell carcinoma, thyroid carcinoma, adenocarcinoma, neuroendocrine carcinoma and undifferentiated carcinoma. Association is sometimes found with human papilloma virus or Epstein Barr virus, guiding treatment. The objective of the present study was to provide clinicians with the necessary diagnostic tools, based on the current state of clinical, imaging and pathologic knowledge, and to detail treatment options.
Topics: Adenocarcinoma; Adult; Carcinoma, Neuroendocrine; Carcinoma, Squamous Cell; Head and Neck Neoplasms; Herpesvirus 4, Human; Humans; Lymphatic Metastasis; Nasopharyngeal Neoplasms; Neck; Neoplasms, Unknown Primary; Oropharyngeal Neoplasms; Papillomaviridae; Thyroid Neoplasms
PubMed: 31005456
DOI: 10.1016/j.anorl.2019.04.002 -
Archives of Pathology & Laboratory... Jan 2023Mucinous lesions of the breast encompass many entities ranging from benign to malignant and nonneoplastic to neoplastic. Lesions discussed under this category are... (Review)
Review
CONTEXT.—
Mucinous lesions of the breast encompass many entities ranging from benign to malignant and nonneoplastic to neoplastic. Lesions discussed under this category are mucocele-like lesion, mucinous carcinoma, mucinous micropapillary carcinoma, solid papillary carcinoma, mucinous cystadenocarcinoma, mucoepidermoid carcinoma, invasive lobular carcinoma with extracellular mucin, mucinous ductal carcinoma in situ, and metastasis.
OBJECTIVE.—
To review clinical, pathologic, and molecular features of mucinous lesions of the breast, their differential diagnoses, and challenging features on core needle biopsies.
DATA SOURCES.—
The existing scientific and clinical literature as of December 2021.
CONCLUSIONS.—
The category of mucinous lesions of the breast is vast and the differential diagnosis can be challenging, especially on core needle biopsies. In all cases, clinical, radiologic, and pathologic correlation is necessary to reach a comprehensive diagnosis. Given that the prognosis and management of each entity is different, being aware of these entities and their nuances is critical for a pathologist to guide accurate management.
Topics: Female; Humans; Adenocarcinoma, Mucinous; Biopsy, Large-Core Needle; Breast; Breast Neoplasms; Carcinoma, Ductal, Breast; Carcinoma, Intraductal, Noninfiltrating
PubMed: 36577093
DOI: 10.5858/arpa.2022-0054-RA -
Journal of Medical Ultrasonics (2001) Jul 2023There have been several investigations of non-mass-like (NML) lesions on ultrasound (US) since Uematsu first described this approach, and it is a relatively new concept... (Review)
Review
There have been several investigations of non-mass-like (NML) lesions on ultrasound (US) since Uematsu first described this approach, and it is a relatively new concept for breast examination. However, the results have varied, and there have been only a few studies related to the detailed histopathology of NML lesions on US. Here, we review the histopathology of NML lesions. NML lesions are pathologically benign, atypical, or malignant. There are two major findings of NML lesions on US: architectural distortion and calcifications. Architectural distortion pathologically indicates a fibrous change with ductal proliferation, invasive breast carcinoma, and carcinoma in situ. Histopathologically, microcalcifications are seen in both benign and malignant lesions, and it is important to distinguish between these lesions among NML lesions, particularly fibrocystic changes including adenosis and hyperplasia in the case of benign lesions and carcinoma in situ (ductal and lobular) in the case of malignant lesions. The differential major points may be whether NML lesions are associated with abundant hyperechoic foci, which indicate comedo necrosis on histology. They are usually high-grade carcinoma in situ that may be positive for HER2 or triple negativity. A recent report indicated that low-grade carcinoma in situ showed better survival than higher-grade carcinoma in situ, which is often accompanied by comedo necrosis on histology, reflecting visible microcalcification on US. NML lesions are considered to include a certain rate of low-grade carcinoma in situ. Therefore, more caution may be needed when detecting and managing NML lesions to avoid overdiagnosis and overtreatment as a result of this recent "low-risk ductal carcinoma in situ" concept.
Topics: Humans; Female; Breast; Breast Neoplasms; Carcinoma, Intraductal, Noninfiltrating; Carcinoma in Situ; Calcinosis; Fibrosis; Hyperplasia; Necrosis
PubMed: 36773105
DOI: 10.1007/s10396-023-01286-y -
Australian Journal of General Practice Sep 2019The incidence of skin cancers in Australia continues to rise. Early detection and timely management are required.
BACKGROUND
The incidence of skin cancers in Australia continues to rise. Early detection and timely management are required.
OBJECTIVE
This article presents a framework for skin examinations in primary care and outlines the various measures available to facilitate early skin cancer detection. Common characteristics of malignant cancers are also discussed.
DISCUSSION
Skin cancer awareness campaigns encourage patients to see their general practitioners (GPs) for complete skin examination. GPs are expected to correctly identify benign and malignant skin lesions and understand their high risk patients. A systematic approach to the skin examination combined with knowledge and awareness of diagnostic tools can aid in the early detection of skin malignancies, and prompt escalation as necessary.
Topics: Australia; Bowen's Disease; Carcinoma, Basal Cell; Carcinoma, Squamous Cell; Dermoscopy; Early Detection of Cancer; Humans; Keratosis, Actinic; Melanoma; Nevus; Photography; Physical Examination; Precancerous Conditions; Primary Health Care; Risk Assessment; Self-Examination; Skin Neoplasms
PubMed: 31476828
DOI: 10.31128/AJGP-03-19-4887 -
Pathologica Oct 2021Atypical ductal hyperplasia (ADH), atypical lobular hyperplasia (ALH) and flat epithelial atypia (FEA) are common lesions mainly detected during mammographic screening.... (Review)
Review
Atypical ductal hyperplasia (ADH), atypical lobular hyperplasia (ALH) and flat epithelial atypia (FEA) are common lesions mainly detected during mammographic screening. They are considered lesions at risk for the development of breast cancer, and they have been documented as non-obligate precursors of low grade carcinomas. In a monumental work in 1991 Rosai gathered them as "borderline epithelial lesions", and he described and demonstrated the subjectivity in their microscopic interpretation. Such subjectivity persists nowadays and limits considerably the diagnostic consistency. With his incredible ability to see, analyze and rationalize, Rosai introduced the concept of "" which would have better represented the biological continuum between these lesions and benign and malignant lesions.
Topics: Breast; Breast Neoplasms; Carcinoma in Situ; Carcinoma, Intraductal, Noninfiltrating; Female; Humans; Hyperplasia
PubMed: 34837093
DOI: 10.32074/1591-951X-374 -
Chirurgia (Bucharest, Romania : 1990) Dec 2021Ductal carcinoma in situ (DCIS) is thought to be a direct precursor of most cases of breast cancer and its incidence increases with age. However, the globally impressive...
Ductal carcinoma in situ (DCIS) is thought to be a direct precursor of most cases of breast cancer and its incidence increases with age. However, the globally impressive rise of DCIS cases is probably an epidemiologic "artifact" that is mainly attributed to the establishment of screening mammography in developed countries. Furthermore, considering that usually there are no clinical findings of the disease, the initial detection of DCIS is a mammographic "event" in most cases. The risk factors for DCIS are similar to those for invasive cancer including, among others, deleterious mutations in the BRCA genes, family history of breast cancer, nulliparity, late age at first birth, increased breast density, personal history of benign breast disease, and postmenopausal obesity.
Topics: Breast Neoplasms; Carcinoma in Situ; Carcinoma, Ductal, Breast; Carcinoma, Intraductal, Noninfiltrating; Early Detection of Cancer; Female; Humans; Mammography; Treatment Outcome
PubMed: 34967307
DOI: 10.21614/chirurgia.116.5.suppl.S15 -
Modern Pathology : An Official Journal... Nov 2022The vast majority of image-detected breast abnormalities are diagnosed by percutaneous core needle biopsy (CNB) in contemporary practice. For frankly malignant lesions... (Review)
Review
The vast majority of image-detected breast abnormalities are diagnosed by percutaneous core needle biopsy (CNB) in contemporary practice. For frankly malignant lesions diagnosed by CNB, the standard practice of excision and multimodality therapy have been well-defined. However, for high-risk and selected benign lesions diagnosed by CNB, there is less consensus on optimal patient management and the need for immediate surgical excision. Here we outline the arguments for and against the practice of routine surgical excision of commonly encountered high-risk and selected benign breast lesions diagnosed by CNB. The entities reviewed include atypical ductal hyperplasia, atypical lobular hyperplasia, lobular carcinoma in situ, intraductal papillomas, and radial scars. The data in the peer-reviewed literature confirm the benefits of a patient-centered, multidisciplinary approach that moves away from the reflexive "yes" or "no" for routine excision for a given pathologic diagnosis.
Topics: Humans; Female; Biopsy, Large-Core Needle; Breast; Carcinoma in Situ; Carcinoma, Intraductal, Noninfiltrating; Breast Neoplasms; Hyperplasia; Carcinoma, Lobular
PubMed: 35654997
DOI: 10.1038/s41379-022-01092-w -
World Journal of Gastroenterology Nov 2015The outcome of gallbladder carcinoma is poor, and the overall 5-year survival rate is less than 5%. In early-stage disease, a 5-year survival rate up to 75% can be... (Review)
Review
The outcome of gallbladder carcinoma is poor, and the overall 5-year survival rate is less than 5%. In early-stage disease, a 5-year survival rate up to 75% can be achieved if stage-adjusted therapy is performed. There is wide geographic variability in the frequency of gallbladder carcinoma, which can only be explained by an interaction between genetic factors and their alteration. Gallstones and chronic cholecystitis are important risk factors in the formation of gallbladder malignancies. Factors such as chronic bacterial infection, primary sclerosing cholangitis, an anomalous junction of the pancreaticobiliary duct, and several types of gallbladder polyps are associated with a higher risk of gallbladder cancer. There is also an interesting correlation between risk factors and the histological type of cancer. However, despite theoretical risk factors, only a third of gallbladder carcinomas are recognized preoperatively. In most patients, the tumor is diagnosed by the pathologist after a routine cholecystectomy for a benign disease and is termed ''incidental or occult gallbladder carcinoma'' (IGBC). A cholecystectomy is performed frequently due to the minimal invasiveness of the laparoscopic technique. Therefore, the postoperative diagnosis of potentially curable early-stage disease is more frequent. A second radical re-resection to complete a radical cholecystectomy is required for several IGBCs. However, the literature and guidelines used in different countries differ regarding the radicality or T-stage criteria for performing a radical cholecystectomy. The NCCN guidelines and data from the German registry (GR), which records the largest number of incidental gallbladder carcinomas in Europe, indicate that carcinomas infiltrating the muscularis propria or beyond require radical surgery. According to GR data and current literature, a wedge resection with a combined dissection of the lymph nodes of the hepatoduodenal ligament is adequate for T1b and T2 carcinomas. The reason for a radical cholecystectomy after simple CE in a formally R0 situation is either occult invasion or hepatic spread with unknown lymphogenic dissemination. Unfortunately, there are diverse interpretations and practices regarding stage-adjusted therapy for gallbladder carcinoma. The current data suggest that more radical therapy is warranted.
Topics: Carcinoma; Cholecystectomy; Gallbladder Neoplasms; Humans; Neoplasm Staging; Risk Factors; Treatment Outcome
PubMed: 26604631
DOI: 10.3748/wjg.v21.i43.12211