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* Context.--Noninvasive papillary urothelial carcinomas (PUCs) comprise most urinary bladder tumors. Distinction between low-grade (LG-PUC) and high-grade (HG-PUC) PUCs is pivotal for determining prognosis and subsequent treatment. Objective.--To investigate the histologic characteristics of tumors with borderline features between LG-PUC and HG-PUC, focusing on the risk of recurrence and progression. Design.--We reviewed the clinicopathologic parameters of noninvasive PUC. Tumors with borderline features were subcategorized as follows: tumors that look like LGPUC but have occasional pleomorphic nuclei (1-BORDNUP) or elevated mitotic count (2-BORD-MIT), and tumors with side-by-side distinct LG-PUC and less than 50% HG-PUC (3-BORD-MIXED). Recurrence-free, total progression-free, and specific invasion-free survival curves were derived from the Kaplan-Meier method, and Cox regression analysis was performed. Results.--A total of 138 patients with noninvasive PUC were included, with the following distribution: LG-PUC (n = 52; 38%), HG-PUC (n = 34; 25%), BORD-NUP (n = 21; 15%), BORD-MIT (n = 14; 10%), and BORD-MIXED (n = 17; 12%). Median (interquartile range) follow-up was 44.2 months (29.9-73.1 months). Invasion-free survival was different between the 5 groups (P = .004), and pairwise comparison showed that HG-PUC had a worse prognosis compared with LG-PUC (P < .001). On univariate Cox analysis, HG-PUC and BORD-NUP were 10.5 times (95% CI, 2.3-48.3; P = .003) and 5.9 times (95% CI, 1.1-31.9; P = .04) more likely to invade, respectively, when compared to LG-PUC. Conclusions.--Our findings confirm a continuous spectrum of histologic changes in PUC. Approximately a third of noninvasive PUCs show borderline features between LG-PUC and HG-PUC. Compared with LG-PUC, BORDNUP and HG-PUC were more likely to invade on followup. BORD-MIXED tumors did not statistically behave differently from LG-PUC. (Arch Pathol Lab Med. 2024;148:223-229; doi: 10.5858/arpa.2022-0268-OA), Bladder tumors are the fourth most common tumors in males. More than 80 000 patients receive a diagnosis of bladder cancer and 17 000 patients die of the disease each [...]

IntroductionCryoablation is an acceptable treatment option for small renal cortical neoplasms (RCN). Unlike extirpative interventions, intraoperative needle biopsy is the only pathologic data for ablated tumors. It is imperative that sampled tissue accurately captures pathology. We studied the optimal intraoperative needle core biopsy protocol for small RCN during laparoscopic renal cryoablation (LCA).MethodsPatients with RCN

Transthyretin cardiomyopathy (ATTR-CM) is a cardiac condition caused by the deposition of transthyretin (TTR) fibrils in cardiac tissue. Recent studies have shown that ATTR amyloidosis may be present in a significant proportion of patients with heart failure, transcatheter aortic valve repair, and hypertrophic cardiomyopathy. The prevalence of ATTR-CM may be even higher among Black Americans due to a specific genetic variant. This article proposes the possibility of using prostate samples to screen for amyloid deposits as a potential method for early detection of ATTR-CM. Several studies have shown that a percentage of prostate samples contain amyloid deposits, and a significant proportion of these patients may develop cardiac involvement. However, further research is needed to accurately distinguish TTR amyloid from other types and to determine the clinical relevance of prostatic amyloid deposits. [Extracted from the article]

PURPOSE: A subgroup of prostate cancer patients who have experienced biochemical relapse after radical retropubic prostatectomy (RRP) can benefit from radiation therapy to the prostate fossa. These patients demonstrate biochemical relapse secondary to local failure in the absence of distant failure. In order to define this subgroup, we investigated the impact of pathological and biochemical variables and pre-radiation therapy biopsy of the prostate fossa on biochemical disease-free survival (bNED) and initial prostate-specific antigen response. METHODS: Sixty-two patients with localized prostate cancer who had biochemical relapse after RRP were treated with post-RRP radiation therapy localized to the prostate fossa (median dose, 6120 cGy) and were subsequently followed up for a median time of 47 months. Cox regression analyses and Kaplan-Meier estimates for bNED were used to identify prognostic variables. The Fisher's exact test was used to test the interaction of initial prostate-specific antigen response with identified prognostic variables. RESULTS: Cox regression analysis of bNED as a function of pathological and biochemical parameters showed that only Gleason's score was a significant predictor of bNED. On univariate analysis, seminal vesicle involvement was also found to be a significant predictor. Prostate fossa biopsy result was not significantly related to bNED. Because of the overall high rates of biochemical failure, we wished to identify a high-risk subgroup that did not have local relapse as a component of biochemical relapse after RRP. We assessed initial biochemical response following radiation therapy as a surrogate for local relapse. A complete biochemical response was observed in 50% of patients, and a partial biochemical response was observed in an additional 34%, yielding an overall biochemical response rate of 84%. When stratified by Gleason's score, seminal vesicle, pre-radiation therapy prostate-specific antigen, and biopsy result,... [ABSTRACT FROM AUTHOR]

Editorial. Examines several issues concerning gastrointestinal diseases. Information on the use of sucralfate for the treatment of active duodenal ulcer in the U.S.; Details on the incidence of gastric carcinoma in the U.S.; Discussion on the classification of inflammatory bowel disease.