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We recently reported the prevalence of atypical proliferative lesions (APL) in reduction mammoplasty specimens from patients that were treated mainly for macromastia with no known history of breast cancer. The current study is to investigate the prevalence of APLs in breast reduction specimens from patients with a history of breast cancer and compare it to that from patients without a history of breast cancer. A retrospective chart review of pathology records on patients that underwent reduction mammoplasty from 2006 to 2012 generated 179 cases. Laterality, specimen weight, number of blocks submitted and presence of APL were recorded and analyzed. We defined APL as invasive carcinoma, ductal (DCIS) or lobular carcinoma in situ, atypical ductal or lobular hyperplasia (ADH or ALH), and flat epithelial atypia (FEA). The presence of papillomas, radial scars and fibroadenomas were also recorded. At least 1 APL was identified in 23 (12.8%) of 179 specimens including invasive lobular carcinoma (n = 3), DCIS (n = 1), ADH/FEA (n = 9) and lobular carcinoma in situ/ALH (n = 10). The most common APL in this cohort was lobular neoplasia (5.6%) followed by ADH and FEA (5.0%). Invasive carcinoma and DCIS was identified in 2.3% of this cohort. In conclusion, the frequency of detection of APLs in patients with history of breast cancer is significantly higher than that in patients without history of breast cancer (12.8% versus 4.3%). Our data assessed the prevalence of APLs in this setting and, therefore, provide new information on decision-making for contralateral breast reduction in patients with history of breast cancer. [ABSTRACT FROM AUTHOR]

Primary ovarian carcinoids and metastatic tumors share similar morphologic features. Metastatic carcinoids must be excluded from primary ones for prognostic and therapeutic reasons. Gastrointestinal neuroendocrine (carcinoid) tumors are much more common with the majority arising from small intestine and appendix. The aim of this study is to evaluate the role of immunohistochemistry for CDX2 in differentiating primary ovarian from metastatic carcinoids of primary gastrointestinal origin. Thirty primary pure ovarian carcinoids, 16 primary ovarian carcinoids arising in association with benign teratomas, 10 ovarian carcinoids metastatic from primary gastrointestinal tract and 70 gastrointestinal neuroendocrine tumors were studied for the expression of CDX2 by immunohistochemistry. CDX2 expression revealed that 40 (57.1%) of 70 cases of gastrointestinal carcinoids and 9 (90%) of 10 ovarian metastatic carcinoids showed positive nuclear staining (diffuse or focal). On the other hand, 3 (18.8%) of 16 primary carcinoids with teratomatous elements showed weak positivity. Among the 70 gastrointestinal carcinoids, CDX2 was positive in 38 (90.5%) of 42 cases in the duodenum, small intestine, appendix, and only in 2 (11.8%) of 17 cases of colorectal carcinoids and none of the 11 cases in the stomach. It is concluded that CDX2 may be a useful marker to distinguish primary ovarian carcinoid from metastasis from small intestinal and appendiceal neuroendocrine tumors. [ABSTRACT FROM AUTHOR]

In the past several decades, the concept of serous ovarian carcinoma has been revised repeatedly. However, the exact pathogenesis remains controversial. The most popular current concept is origin from the epithelium of the fimbriated ends of the fallopian tubes. The objective of our study was to evaluate the characteristic clinical and morphologic features of serous tubal intraepithelial carcinoma (STIC) and associated invasive carcinomas. One hundred sixteen consecutive cases of STIC seen from 2007 to 2011 were included in this study. High-grade serous carcinoma (HGSC) with or without a mixed component was identified in 107 cases (92.2%), non-HGSC in 5 cases, and STICs without invasive carcinoma in 4 cases. Using conventional criteria, HGSCs were classified as fallopian tube in origin in 65 cases (60.7%), as ovarian in 30 (28.0%), as peritoneal in 9 (8.4%), and as endometrial in 3 (2.8%). Among the 107 cases with HGSCs, most STICs (86; 80%) were present unilaterally, whereas invasive tumors more commonly involved the ovaries bilaterally (79%; 84 cases). These findings support the hypothesis that STIC acts as a precursor lesion for most fallopian tube, ovarian, and peritoneal HGSCs, but not for endometrial HGSC. [ABSTRACT FROM AUTHOR]