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Snippets in surgical pathology
  1. Kumarasen Cooper (kum.cooper@vtmednet.org),
  2. Runjan Chetty (runjan.chetty@uhn.on.ca)

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This section features synopses of pertinent practical publications that appear in Pathology journals in the respective sub-specialties. The summaries are mere guidelines and personal opinions of the two authors. The articles selected are diverse but occasionally reflect the authors’ bias and are from the more widely read pathology journals. It is not intended to be an assiduous search of every publication in every Pathology journal, but more of a general indication of some of the monthly highlights through the eyes of the authors.

Hopefully, these snippets will provide the reader with enough to glean some facts and tips, as well as encourage them to read the entire article if necessary.

JOURNAL OF CLINICAL PATHOLOGY, OCTOBER 2008

Tan DSP, Marchio C, Reis-Filho JS. Hereditary breast cancer: from molecular pathology to tailored therapies. J Clin Pathol 2008;61:1073–82.

An excellent overview of the major candidate genes that are implicated in hereditary breast cancer: BRCA1, BRCA2, Fanconi anaemia genes, and two tumour suppressor genes, CHK2 and ATM. In addition the syndromes associated with hereditary breast cancer are provided in an informative table. This review also highlights the pertinent morphological features of hereditary breast cancer with BRCA1 mutation cancers being high grade, with a prominent lymphocytic infiltrate, pushing borders and frequent areas of necrosis compared to BRCA2 mutation cancers and sporadic breast cancer. Immunohistochemically, BRCA1 mutation cancers show lack of oestrogen receptor expression. Indeed, BRCA1 mutation cancers tend to be “triple negative”: negative for oestrogen, progesterone receptor and Her-2 and to display the basal-like phenotype (CK5/6, 14,17, EGFR positive).

Haider SA, Lemberger RJ, Fisher C, et al. Epithelioid perineurioma: an unusual variant. J Clin Pathol 2008;61:1130–2.

Perineuriomas are spindled neoplasms with a wispy bipolar morphology (extra/intraneural, sclerosing/reticular). This report of an epithelioid perineurioma highlights a syncytial morphology mimicking meningioma (the perineurium is continuous …

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