2016 SCPMG Thyroid NIFTP

Instructions for Validation of criteria for the new entity: Non-invasive Follicular Thyroid Neoplasm with Papillary-like Nuclear Features (NIFTP)

  1. Review these instructions and reply that you will be able to participate in the study in the time frame recommended
  2. Study the PowerPoint presentation, highlighting the features and criteria for the diagnosis
  3. Before beginning your review, ask Lester any questions, clarifications or concepts you may not clearly understand
  4. Please try to review the 30 cases in one or two seatings
  5. It will take about 30 minutes to look at the images, make a decision, and complete the appropriate line on the form
  6. The score you place (entry of 0 or 1) will be automatically added to create the 4th column
  7. Please provide your demographic data, which is only for Lester to use to avoid duplication, but also to allow the statistician to compare based on experience and volume of work
  8. Be able to complete this assignment before February 5, 2016. Return your completed Excel spreadsheet (see second tab of xls file; download below)
  9. Return Excel spreadsheet by email to Lester.D.Thompson@kp.org
  10. Aggregated results and comparison to the 26 endocrine pathologists will be provided as soon as the statistical evaluation is complete
  11. Data will be combined with academic pathologists from England (18-20 people), Japanese practicing pathologists (about 25), and the consensus conference group
  12. The information will be used to “validate” the criteria for reproducibility both between practicing pathologists and experts, but also against pathologists trained in different countries
Download Size: 12.4 MB
Download Size: 4.7 MB
Download Size: 23 KB Excel file

Sox10 — A Marker for Not Only Schwannian and Melanocytic Neoplasms But Also Myoepithelial Cell Tumors of Soft Tissue: A Systematic Analysis of 5134 Tumors

Miettinen M, McCue PA, Sarlomo-Rikala M, Biernat W, Czapiewski P, Kopczynski J, Thompson LD, Lasota J, Wang Z, Fetsch JF.
Am J Surg Pathol. 2015 Jun;39(6):826-35.
Sox10 transcription factor is expressed in schwannian and melanocytic lineages and is important in their development and can be used as a marker for corresponding tumors. In addition, it has been reported in subsets of myoepithelial/basal cell epithelial neoplasms, but its expression remains incompletely characterized. In this study, we examined Sox10 expression in 5134 human neoplasms spanning a wide spectrum of neuroectodermal, mesenchymal, lymphoid, and epithelial tumors. A new rabbit monoclonal antibody (clone EP268) and Leica Bond Max automation were used on multitumor block libraries containing 30 to 70 cases per slide. Sox10 was consistently expressed in benign Schwann cell tumors of soft tissue and the gastrointestinal tract and in metastatic melanoma and was variably present in malignant peripheral nerve sheath tumors. In contrast, Sox10 was absent in many potential mimics of nerve sheath tumors such as cellular neurothekeoma, meningioma, gastrointestinal stromal tumors, perivascular epithelioid cell tumor and a variety of fibroblastic-myofibroblastic tumors. Sox10 was virtually absent in mesenchymal tumors but occasionally seen in alveolar rhabdomyosarcoma. In epithelial tumors of soft tissue, Sox10 was expressed only in myoepitheliomas, although often absent in malignant variants. Carcinomas, other than basal cell-type breast cancers, were only rarely positive but included 6% of squamous carcinomas of head and neck and 7% of pulmonary small cell carcinomas. Furthermore, Sox10 was often focally expressed in embryonal carcinoma reflecting a primitive Sox10-positive phenotype or neuroectodermal differentiation. Expression of Sox10 in entrapped non-neoplastic Schwann cells or melanocytes in various neoplasms has to be considered in diagnosing Sox10-positive tumors. The Sox10 antibody belongs in a modern immunohistochemical panel for the diagnosis of soft tissue and epithelial tumors.
PubMed ID: 25724000
Article Size: 1.5 MB

Double reporting and second opinion in head and neck pathology.

Woolgar JA, Triantafyllou A, Thompson LD, Hunt JL, Lewis JS Jr, Williams MD, Cardesa A, Rinaldo A, Barnes L, Slootweg PJ, Devaney KO, Gnepp DR, Westra WH, Ferlito A.
Eur Arch Otorhinolaryngol. 2014 May;271(5):847-54.
FIRST PARAGRAPH: This editorial aims to discuss the practice of ‘‘double reporting’’ and ‘‘second opinion’’ diagnosis in routine diagnostic pathology interpretation. It does not encompass reviews performed as part of audit and quality assurance functions, but is from the perspective of experienced head and neck and oral and maxillofacial specialists.
PubMed ID: 24435586
Article Size: <1 MB

Telecytologic diagnosis of breast fine needle aspiration biopsies. Intraobserver concordance.

Briscoe D, Adair CF, Thompson LD, Tellado MV, Buckner SB, Rosenthal DL, O’Leary TJ.
Acta Cytol. 2000 Mar-Apr;44(2):175-80.
OBJECTIVE: To determine the intraobserver concordance between telecytologic and glass slide diagnosis of breast fine needle aspirates.
STUDY DESIGN: Twenty-five cases, originally received in consultation, were each examined by three cytopathologists. An average of seven compressed digital images per case were presented, together with a brief clinical history, using the http protocol and an internet browser.
RESULTS: Agreement between the telecytologic and glass slide diagnosis ranged from 80% to 96%. Nevertheless, two cases that had been unequivocally diagnosed as malignant based upon video images were considered to be benign by the same pathologist when reviewing the glass slides. Both diagnostic confidence and self-concordance were higher for one pathologist having significant previous video microscopy experience.
CONCLUSION: Although intraobserver concordance between telecytologic and glass slide diagnoses of breast fine needle aspirates is high, refinement of existing criteria for diagnosis of malignancy, taking account of the particular limitations associated with telecytologic diagnosis, may be prudent prior to widespread use of telecytology for fine needle aspiration evaluation.
PubMed ID: 10740603
Article Size: 2 MB

BOOK REVIEW: ‘Biopsy Interpretation of the Upper Aerodigestive Tract and Ear’ by Edward B. Stelow, Stacey E. Mills.

Thompson LD.
Am J Surg Pathol. 2013 Oct;37(10):1632.
FIRST PARAGRAPH OF REVIEW: A fan of the Biopsy Interpretation series, I was pleased to review a new title, although without reviewing the first edition. As advertised, ‘recent advances in our understanding of aerodigestive tract pathology,’ are presented in a userfriendly manner, incorporating selected and targeted use of ancillary techniques to help reach a diagnosis, although the reader is reminded to focus on the standard hematoxylin and eosin-stained material first and foremost. In fact, the entire chapter on hematopathology only has a single immunohistochemistry image, which is normally a field run amok by mmunohistochemistry stains. Always forward thinking, and utilizing all resources available to reach a diagnosis, the book itself will be as helpful as any of the supporting ancillary studies.
PubMed ID: n/a
Article Size: <1 MB