Hanwilliamson1840
Touch preparation (TP) alone is discouraged for intraoperative lymph node (LN) assessment in the neoadjuvant setting (NAS) owing to overall low sensitivity in detecting metastatic breast cancer.
To compare the sensitivity, specificity, and negative predictive value of intraoperative LN assessment via TP and examine potential causes of discrepancies along with the clinical, radiologic, and pathologic parameters in the neoadjuvant setting (NAS) and non-neoadjuvant setting (NNAS).
A total of 99 LNs from 47 neoadjuvant patients and 108 LNs from 56 non-neoadjuvant patients were identified. Discordant cases were reviewed retrospectively to reveal the discrepancy reasons. Clinical, radiologic, and pathologic data were obtained from chart review and pathology CoPath database.
The sensitivity, specificity, and negative predictive value of TP in NAS and NNAS were 34.2% versus 37.5%, 100% versus 100%, and 70.9% versus 90.2%, respectively. In NAS, discrepancy reasons were interpretation challenge due to lobular histotype, poor TP quality secondary to therapy-induced histomorphologic changes, and undersampling due to small tumor deposits (≤2 mm); the latter was the major reason in NNAS. More cases with macrometastasis were missed in NAS compared to NNAS (14 of 25 versus 1 of 10). The parameters associated with discrepancy were lobular histotype, histologic grade 2, ER positivity, HER2 negativity, multifocality, and pathologic tumor size greater than 10 mm in NAS; and lymphovascular space involvement and pathologic tumor size greater than 20 mm in NNAS.
In NAS, intraoperative TP alone should be used very cautiously owing to high false-negative rate of macrometastasis, especially for patients with invasive lobular carcinoma and known axillary LN metastasis before neoadjuvant therapy.
In NAS, intraoperative TP alone should be used very cautiously owing to high false-negative rate of macrometastasis, especially for patients with invasive lobular carcinoma and known axillary LN metastasis before neoadjuvant therapy.
Liver biopsy plays an important role in the clinical management of metastases and often requires workup using immunohistochemical (IHC) markers, but the approach varies among institutions.
To evaluate the utility of a morphologic pattern-based, individualized approach in the workup of hepatic metastases.
All liver biopsies with metastasis between 2015 and 2018 were identified from our institutional database and were reviewed. The morphologic pattern of the metastasis and IHC markers used in each case were recorded. The final identification of primary site of the tumor was assessed based on all the available clinicopathologic data. The academic ranking and practice pattern of the pathologist signing out the case were also recorded.
A total of 406 liver biopsies with metastasis were identified, and the cases were classified as adenocarcinoma (253 of 406; 62%), carcinoma not otherwise specified (12 of 406; 3%), neuroendocrine neoplasm (54 of 406; 13%), poorly differentiated carcinoma (43 of 406; 11%), nonepithelial tumor (24 of 406; 6%), and squamous cell carcinoma (20 of 406; 5%). The primary site was unknown in 39% (158 of 406) at the time of liver biopsy. A primary site was determined in 97% (395 of 406) of all cases, and only 3% (11 of 406) remained true carcinoma of unknown primary. The average IHC markers/case in patients with known primary was 2.6, compared with 5.9 with an initial unknown primary and 9.5 in cases of true carcinoma of unknown primary.
An individualized, case-based approach seems to be highly cost-effective and uses fewer IHC markers compared with preset panels that often comprise 10 or more IHC markers.
An individualized, case-based approach seems to be highly cost-effective and uses fewer IHC markers compared with preset panels that often comprise 10 or more IHC markers.Chemical reactions and phase stabilities in the Si-Te system at high pressures were explored using in situ angle-dispersive synchrotron powder diffraction in a large-volume multianvil press together with density functional theory-based calculations. Cubic and rhombohedrally distorted clathrates, with the general formula Te8@(Si38Te8) and wide compositional range, preceded by a hexagonal phase with the composition Si0.14Te, are formed for different mixtures of Si and Te as starting materials. Si0.14Te, with the structural formula Te2(Te0.74Si0.26)3(Te0.94Si0.06)3, is the very first chalcogenide with the Mn5Si3-type structure. Silicon sesquitelluride α-Si2Te3 decomposes into a mixture of phases that includes the clathrate and hexagonal phases at high pressures and high temperatures. The higher the pressure, the lower the temperature for the two phases to occur. Regardless of the starting compositions, only the clathrate is quenched to atmospheric conditions, while the hexagonal phase amorphizes on decompression. The rhombohedral clathrates Te8@(Si38Te8) form on quenching of the cubic phases to ambient conditions. There is a high degree of interchangeability of Si and Te not only in the clathrates but also in the Mn5Si3-type structure. The theoretical calculations of enthalpies indicate that the reported decomposition of α-Si2Te3 is energetically favorable over its transformation to another polymorph of the A2X3 type at extreme conditions.Given their comparatively narrow band gap, mixed Pb-Sn iodide perovskites are interesting candidates for bottom cells in all-perovskite tandems or single junction solar cells, and their luminescence around 900 nm offers great potential for near-infrared optoelectronics. Here, we investigate mixed FAPb1-xSnxI3 offering the first accurate determination of the crystal structure over a temperature range from 293 to 100 K. We demonstrate that all compositions exhibit a cubic structure at room temperature and undergo at least two transitions to lower symmetry tetragonal phases upon cooling. buy GI254023X Using density functional theory (DFT) calculations based on these structures, we subsequently reveal that the main impact on the band gap bowing is the different energy of the s and p orbital levels derived from Pb and Sn. In addition, this energy mismatch results in strongly composition-dependent luminescence characteristics. Whereas neat and Sn-rich compounds exhibit bright and narrow emission with a clean band gap, Sn-poor compounds intrinsically suffer from increased carrier recombination mediated by in-gap states, as evidenced by the appearance of pronounced low-energy photoluminescence upon cooling. This study is the first to link experimentally determined structures of FAPb1-xSnxI3 with the electronic properties, and we demonstrate that optoelectronic applications based on Pb-Sn iodide compounds should employ Sn-rich compositions.Peritoneal mesothelioma (PM) and serous neoplasms can be difficult to differentiate, particularly in small biopsies. BRCA1-associated protein 1 (BAP1) is expressed in benign tissues, but over 50% of PMs demonstrate complete loss of nuclear expression. Claudin-4, a tight junction protein, is expressed in most epithelial tumors but not in mesotheliomas. Methylthioadenosine phosphorylase (MTAP) is frequently co-deleted with cyclin-dependent kinase inhibitor 2a in mesotheliomas. These markers have proven useful in separating mesothelioma from its mimics, particularly when tumors are pleural based. In the peritoneum, BAP1 loss has been rarely reported in high-grade serous carcinomas, but overall, these markers have been minimally evaluated in ovarian serous borderline tumors and low-grade serous carcinomas. Thus, we assessed the utility of BAP1, claudin-4, and MTAP in the differential diagnosis of PM and low-grade serous neoplasms. Eighteen PM (16 epithelioid, 1 biphasic, and 1 sarcomatous), 24 low-grade serous carcinomas, and 25 serous borderline tumors were stained for BAP1, claudin-4, and MTAP. Loss of BAP1 nuclear expression was observed in 12 (67%) PM (11 epithelioid, 1 biphasic) but was retained in all serous tumors. Claudin-4 was positive in all serous tumors and negative in all PM. Complete loss of cytoplasmic MTAP was noted in 3 (17%) PMs and 1 (4%) serous borderline tumor, while all low-grade serous carcinomas showed retained expression. BAP1 loss reliably distinguishes PM from serous tumors, although it lacks sensitivity. Claudin-4 is a reliable marker to exclude PM. MTAP loss may occur in both PM and serous tumors, and thus is not useful in distinguishing these entities.Lung cancers in never- and light-smokers often harbor targetable oncogenic mutations in Ras pathway genes. Here, a novel OCLN-RASGRF1 fusion is identified in an otherwise Ras wild-type lung tumor. Studying this and other RASGRF1 fusions, the authors show that these fusions lead to malignant phenotypes that can be reversed by MEK inhibition. See related article by Hunihan et al., p. 3091.Eye position varies significantly among taxonomic levels, and this variation is often shaped by ecological and behavioral factors. Eye position is often positively associated with interorbital distance where species with broad visual fields possess a large distance between the left and right eye. Selective pressures underlying the evolution of the eye position are especially studied in birds and mammals. However, selective pressures underlying the evolution of anuran eye position which can be indicated by interorbital distance keep unknown. Here, we investigated the effects of ecological (e.g. habitat type, light availability) and behavioral factors (e.g. activity pattern, foraging mobility, and defensive strategy) on variations in interorbital distance among 260 anuran species in China. Our results showed that variations of the interorbital distance can be significantly predicted by the activity pattern. Nocturnal species had larger interorbital distance than both nocturnal and diurnal species. We also found that foraging mobility and defensive strategy markedly affected variation of interorbital distance. Species having slower foraging mobility and possessing poison glands had larger interorbital distance than species having faster foraging mobility and possessing non-position glands. Light availability tended to be associated with variation of interorbital distance, indicating that species living in weak light tended to possess larger interorbital distance. However, variations of the interorbital space were not associated with habitat type in anurans. Our findings suggest that anuran behaviors play key roles in shaping visual fields and eye position, thus affecting the evolution of interorbital distance.Autophagy is implicated in normal pregnancy and various pathologic pregnancy conditions. Its presence in hydatidiform moles (HM) is unknown. We immunohistochemically studied 36 HM for LC3B and p62 to precisely determine their expression in the decidua, endometrium, and villi. Nineteen nonmolar pregnancies were also studied. LC3B was found in almost half of the villi and p62 was found in almost all villi. LC3B expression was significantly higher in complete HM than in partial HM. LC3B showed different expression patterns in trophoblast layers. LC3B and p62 expression was higher in molar than nonmolar pregnancies. Autophagic markers are present in HM and their expression differs between complete and partial moles.
