Continue reading Nottingham Grading System – Breast Carcinoma
All posts by peferguson
The Bloom-Richardson grading system was refined in the Nottingham/Tenovus Primary Breast Cancer Study (1974) into what is now referred to as the Nottingham grading system. This is a semi-quantitative evaluation with better inter-observer reproducibility and evaluation criteria.
Bloom-Richardson Grading – Breast Carcinoma
For many years it was noted that tumor differentiation corresponded to prognosis. Bloom and Richardson in 1957 published the first widely known study, which showed that taking into account nuclear atypia, tubule formation, and mitotic activity of the tumor could result in a numeric grading system.
Continue reading Bloom-Richardson Grading – Breast Carcinoma
MOC-31
MOC-31 is a glycoprotein on the cell-membrane (epithelial glycoprotein 2/epithelial cell adhesion molecule – Ep-CAM) that is widely distributed on epithelial cells and tumor cells. MOC-31 is often used to differentiate adenocarcinoma (93% positive) from mesothelioma (93% negative). Other tumors also typically negative for MOC-31 include: hepatocellular carcinoma (HCC), germ cell tumors, and renal cell (some report up to 50%+) carcinomas. Some tumors may have characteristic staining patterns (e.g. membraneous vs. cytoplasmic or apical).
MUM-1/IRF-4
MUM-1/IRF-4 (multiple myeloma oncogene 1/Interferon Regulatory Factor-4) is a nuclear transcription factor, which is expressed in late stage germinal center cells (as bcl-6 expression begins to be down-regulated) and post-germinal center lymphocytes/plasma cells. Activated T-cells may also express MUM-1.
JAK2, CALR, & MPL Testing in Myeloproliferative Neoplasms (MPN)
Molecular Testing Specimen Adequacy Summary
- JAK2, CALR, and MPL testing is often performed on peripheral blood specimens in an outpatient setting.
- JAK2 mutations are preferably analyzed in granulocytes.
- Peripheral blood and bone marrow specimens are equally adequate for the identification of JAK2 mutations.
- By extrapolation, CALR and MPL testing on peripheral blood specimens should be equally adequate.
Continue reading JAK2, CALR, & MPL Testing in Myeloproliferative Neoplasms (MPN)
Primary Cutaneous Follicular Lymphoma
- Not related to nodal FL
- t(14;18) not present. If present, then should consider cutaneous involvement of a nodal FL.
- Morphologically diverse (nodular to diffuse) with cells ranging from small lymphocytes to large centroblastic lymphoid cells.
- BCL-6 +
- CD10 and BCL-2 not consistently expressed
Extranodal Marginal Zone Lymphoma of Mucosal Associated Lymphoid Tissue (MALT Lymphoma)
Extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue (MALT) involves extra nodal tissue and shows infiltration of the marginal zones and inter follicular regions.
- Gastric MALT is associated with H. pylori infection in up to 90% of cases.
- MALT in the thyroid has been associated with Hashimoto’s thyroiditis (~20% of cases).
- Ocular MALT lymphomas have been associated with various infections.
Nodal Marginal Zone Lymphoma (NMZL)
Lymph nodes have a similar morphology to MALT lymphomas with involvement of the marginal zones, but without extra nodal extension. 10-20% may transform to DLBCL. Bone marrow involvement is thought to occur in 30-60% of cases.
Mediastinal Large B-Cell Lymphoma
Immunophenotypic Expression Pattern
Marker
|
Comment
|
Negative
|
|
Negative
|
|
Negative
|
|
Positive
|
|
Positive (usually dim)
|
|
Positive
|
References
Parker, A., et. al. “Best Practice in Lymphoma Diagnosis and Reporting.” British Committee for Standards in Haematology, Royal College of Pathologists. April, 2010.
Plasmablastic Lymphoma
Immunophenotypic Expression Pattern
Marker
|
Comment
|
Negative
|
|
Weak/Negative
|
|
Weak/Negative
|
|
Negative
|
|
Positive
|
|
Variable
|
|
Positive (Usually)
|
|
Negative (Usually)
|
|
Positive
|
|
Rare + case
|
References
Parker, A., et. al. “Best Practice in Lymphoma Diagnosis and Reporting.” British Committee for Standards in Haematology, Royal College of Pathologists. April, 2010.