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Background/Aims: Papillary adenocarcinoma is classified to differentiated-type gastric cancer and is indicated for endoscopic submucosal dissection. However, due to its rare nature, there are limited studies on it. The purpose of this study was to determine the outcome of endoscopic submucosal dissection in patients with papillary-type early gastric cancer and to find the risk factors of lymph node metastasis.Methods: Patients diagnosed with papillary-type early gastric cancer at eight medical centers, who underwent endoscopic submucosal dissection or surgical treatment, were retrospectively reviewed. The clinical results and long-term outcomes of post-endoscopic submucosal dissection were evaluated, and the risk factors of lymph node metastasis in the surgery group were analyzed.Results: One-hundred and seventy-six patients with papillary-type early gastric cancer were enrolled: 44.9% (n=79) in the surgery group and 55.1% (n=97) in the endoscopic submucosal dissection group. As a result of endoscopic submucosal dissection, the en bloc resection and curative resection rates were 91.8% and 86.6%, respectively. The procedure-related complication rate was 4.1%, and local recurrence occurred in 3.1% of patients. Submucosal invasion (odds ratio, 3.735; 95% confidence interval, 1.026 to 12.177; p=0.047) and lymphovascular invasion (odds ratio, 7.636; 95% confidence interval, 1.730 to 22.857; p=0.004) were the risk factors of lymph node metastasis in papillary-type early gastric cancer patients.Conclusions: The clinical results of endoscopic submucosal dissection in papillary-type early gastric cancer were relatively favorable, and endoscopic submucosal dissection is considered safe if appropriate indications are confirmed by considering the risk of lymph node metastasis.

Papillary adenocarcinoma is defined as carcinoma with a well‐defined papillary or villous structure. Despite sharing clinicopathological and morphological features with tubular adenocarcinomas, papillary adenocarcinomas frequently show microsatellite instability. The present study aimed to clarify the clinicopathological features, molecular classification, and programmed death‐ligand 1 (PD‐L1) expression characteristics of papillary adenocarcinoma, especially tumors with microsatellite instability. We examined the microsatellite status and expression of mucin core proteins and PD‐L1 as well as the clinicopathological features in 40 gastric papillary adenocarcinomas. Surrogate immunohistochemical analysis of p53 and mismatch repair proteins along with Epstein‐Barr virus‐encoded RNA in situ hybridization were performed for molecular classification. Female predominance and frequent microsatellite instability were observed in papillary adenocarcinoma in comparison with tubular adenocarcinoma. The presence of microsatellite instability in papillary adenocarcinoma was significantly correlated with older age, tumor‐infiltrating lymphocytes, and Crohn's‐like lymphoid reactions. Surrogate examination demonstrated that the genomically stable type (17 cases, 42.5%) was the most common, followed by the microsatellite‐unstable type (14 cases, 35%). Among the seven cases showing PD‐L1‐positive expression in tumor cells, four involved carcinomas with microsatellite instability. These results reveal the clinicopathological and molecular characteristics of gastric papillary adenocarcinoma. [ABSTRACT FROM AUTHOR]

Abstract Background This study aimed to analyze the ability of computed tomography (CT) texture analysis to discriminate papillary gastric adenocarcinoma (PGC) and to explore the diagnostic efficacy of multivariate models integrating clinical information and CT texture parameters for discriminating PGCs. Methods This retrospective study included 20 patients with PGC and 80 patients with tubular adenocarcinoma (TAC). The clinical data and CT texture parameters based on the arterial phase (AP) and venous phase (VP) of all patients were collected and analyzed. Two CT signatures based on the AP and VP were built with the optimum features selected by the least absolute shrinkage and selection operator method. The performance of CT signatures was tested by regression analysis. Multivariate models based on regression analysis and the support vector machine (SVM) algorithm were established. The diagnostic performance of the established nomogram based on regression analysis was evaluated by receiver operating characteristic curve analysis. Results Thirty-two and fifteen CT texture parameters extracted from AP and VP CT images, respectively, differed significantly between PGCs and TACs (all p

Background: The necessity of a specific T classification for extrahepatic intraductal papillary neoplasm of the bile duct (IPNB) type 2, one of the precursors of cholangiocarcinoma (CC), remains unclear. Methods: Patients who underwent resection for extrahepatic biliary tumors were reviewed. Relapse‐free survival (RFS) was compared between IPNB type 2 and CC, stratified by T classification. Results: The cohort involved 443 patients with IPNB type 2 (n = 57) and CC (n = 386). In 342 patients with perihilar tumors, 5‐year RFS of IPNB type 2 and CC group was 49.8% versus 34.5% (p =.012), respectively. The RFS was 54.6% versus 47.2% (p =.110) for pT1‐2 tumors and 28.6% versus 22.7% (p =.436) for pT3‐4 tumors, respectively. In 92 patients with distal tumors, 5‐year RFS was 47.4% versus 42.1% (p =.678). The RFS was 68.2% versus 49.6% (p =.422) for pT1 tumors and 18.8% versus 38.3% (p =.626) for pT2‐3 tumors, respectively. Multivariate analysis identified that poor histologic grade (HR, 2.105; p <.001), microscopic venous invasion (HR, 1.568; p =.002), and nodal metastasis (HR, 1.547; p <.001) were independent prognostic deteriorators, while tumor type (IPNB type 2 vs. CC) was not. Conclusions: Prognostic impact of IPNB type 2 was limited, suggesting unnecessity of a specific T classification for IPNB type 2 with invasive carcinoma. [ABSTRACT FROM AUTHOR]

Abstract Background Mixed neuroendocrine–non-neuroendocrine neoplasms (MiNENs) of the gallbladder are rare malignancies. Here we presented two cases and reviewed the related literature. Case presentation Our two patients were postoperatively diagnosed with gallbladder MiNENs, which pathologically consisted of a large cell neuroendocrine carcinoma and papillary adenocarcinoma. After cholecystectomy, one patient had a survival time of 30 months, while the other remained alive through 12 months of follow-up. In the literature, a total of 72 cases of gallbladder MiNENs were identified, and with our two patients included, we calculated a male-to-female ratio of 0.22 and a mean age of 64.5 years for the 74 reported cases. About one-half of these patients were found to have gallstones and presented with abdominal pain or discomfort in a relatively early stage. The preoperative diagnosis of these 74 cases mainly relied on abdominal ultrasound, contrast-enhanced computed tomography (CT) scanning, and magnetic resonance imaging or positron emission tomography/CT. However, the final diagnosis was established based upon the pathological evidence and expression of synaptophysin (Syn) and/or chromogranin A identified by immunohistochemical staining or neurosecretory granules detected by electron microscopy. Fifty-eight patients (78.4%) underwent various operations including simple cholecystectomy (n = 14), en bloc cholecystectomy (n = 9), standard or non-standard radical cholecystectomy (n = 25), or extended radical cholecystectomy (n = 6). The mean size of the resected gallbladder masses was 50.8 ± 36.1 mm (n = 63) with regional lymph node metastasis in 37 patients (52.1%), liver invasion or staging greater than T3 in 33 patients (45.8%), and hepatic metastasis in 26 patients (35.1%). The postoperative median survival time was 36 ± 11.42 months (95% confidence interval, 13.62 to 58.38 months). The log-rank analysis did not find that postoperative adjuvant chemotherapy contributed to a longer survival time relative to that among the patients who did not receive chemotherapy (numbers of patients, 15 versus 43; survival times, 36 months versus 30 months, p > 0.05). Conclusions Our two cases and the cases in the literature suggest that MiNENs of the gallbladder predominantly occur in women; are associated with early lymph node metastasis, local hepatic invasion, and hepatic metastasis; and can be managed by various surgeries as well as chemotherapy combined with somatostatin analogs.

Purpose: This study aimed to analyze the clinicopathological and computed tomography (CT) findings of papillary gastric adenocarcinoma and to evaluate the feasibility of the multivariate model based on clinical information and CT findings for discriminating papillary gastric adenocarcinomas. Methods: This retrospective study included 22 patients with papillary gastric adenocarcinoma and 88 patients with tubular adenocarcinoma. The demographic data, tumor markers, histopathological information, CT morphological characteristics, and CT value-related parameters of all patients were collected and analyzed. The multivariate model based on regression analysis was performed to improve the diagnostic efficacy for discriminating papillary gastric adenocarcinomas preoperatively. The diagnostic performance of the established nomogram was evaluated by receiver operating characteristic curve analysis. Results: The distribution of age, carcinoembryonic antigen, differentiation degree, neural invasion, human epidermal growth factor receptor 2 overexpression, P53 mutation status, 4 CT morphological characteristics, and 10 CT valued-related parameters differed significantly between papillary gastric adenocarcinoma and tubular adenocarcinoma groups (all p < 0.05). The established multivariate model based on clinical information and CT findings for discriminating papillary gastric adenocarcinomas preoperatively achieved the area under the curve of 0.920. Conclusion: There existed differences in clinicopathological features and CT findings between papillary gastric adenocarcinomas and tubular adenocarcinomas. The combination of demographic data, tumor markers, CT morphological characteristics, and CT value-related parameters could discriminate papillary gastric adenocarcinomas preoperatively with satisfactory diagnostic efficiency. [ABSTRACT FROM AUTHOR]

Gastric papillary adenocarcinoma is one of the histological variants of gastric cancer that shows more aggressive clinicopathological behavior compared to tubular adenocarcinoma. Previous studies have reported higher lymphovascular and submucosal invasion rates for papillary adenocarcionoma than those of tubular adenocarcinoma. However, the current guidelines categorize papillary adenocarcinoma and tubular adenocarcinoma together as differentiated-type tumor and have recommended the same endoscopic submucosal dissection criteria. Thus, concerns have been raised regarding the appropriateness of the current policy. To validate the current guidelines, the lymph node metastasis rate from surgical specimen studies as well as the long-term outcomes of endoscopic submucosal dissection for papillary adenocarcinomas need to be taken into consideration. In this review, I aimed to review the current understanding of the clinical and pathological features of papillary adenocarcinoma. In addition, I aimed to generate an integrated view regarding the outcomes of endoscopic submucosal dissection and surgery for papillary adenocarcinoma in order to evaluate the appropriateness of the current guidelines.

Background: Mixed neuroendocrine–non-neuroendocrine neoplasms (MiNENs) of the gallbladder are rare malignancies. Here we presented two cases and reviewed the related literature. Case presentation: Our two patients were postoperatively diagnosed with gallbladder MiNENs, which pathologically consisted of a large cell neuroendocrine carcinoma and papillary adenocarcinoma. After cholecystectomy, one patient had a survival time of 30 months, while the other remained alive through 12 months of follow-up. In the literature, a total of 72 cases of gallbladder MiNENs were identified, and with our two patients included, we calculated a male-to-female ratio of 0.22 and a mean age of 64.5 years for the 74 reported cases. About one-half of these patients were found to have gallstones and presented with abdominal pain or discomfort in a relatively early stage. The preoperative diagnosis of these 74 cases mainly relied on abdominal ultrasound, contrast-enhanced computed tomography (CT) scanning, and magnetic resonance imaging or positron emission tomography/CT. However, the final diagnosis was established based upon the pathological evidence and expression of synaptophysin (Syn) and/or chromogranin A identified by immunohistochemical staining or neurosecretory granules detected by electron microscopy. Fifty-eight patients (78.4%) underwent various operations including simple cholecystectomy (n = 14), en bloc cholecystectomy (n = 9), standard or non-standard radical cholecystectomy (n = 25), or extended radical cholecystectomy (n = 6). The mean size of the resected gallbladder masses was 50.8 ± 36.1 mm (n = 63) with regional lymph node metastasis in 37 patients (52.1%), liver invasion or staging greater than T3 in 33 patients (45.8%), and hepatic metastasis in 26 patients (35.1%). The postoperative median survival time was 36 ± 11.42 months (95% confidence interval, 13.62 to 58.38 months). The log-rank analysis did not find that postoperative adjuvant chemotherapy contributed to a longer survival time relative to that among the patients who did not receive chemotherapy (numbers of patients, 15 versus 43; survival times, 36 months versus 30 months, p > 0.05). Conclusions: Our two cases and the cases in the literature suggest that MiNENs of the gallbladder predominantly occur in women; are associated with early lymph node metastasis, local hepatic invasion, and hepatic metastasis; and can be managed by various surgeries as well as chemotherapy combined with somatostatin analogs. [ABSTRACT FROM AUTHOR]

Gallbladder carcinoma (GBC) is responsible for 80%–95% of biliary tract malignancies and has a dismal prognosis. Human epidermal growth factor receptor 2 (HER2) is a promising therapeutic target of GBC. Through immunohistochemistry (IHC) and fluorescence in situ hybridization (FISH) methods, HER2 expression and gene amplification were identified on high-output tissue microarrays (TMAs) developed in 306 GBC cases to investigate its relationship with GBC and clinicopathological characteristics. Adenocarcinomas accounted for 223 (72.9%) of the cases, with 62 (27.8%) being papillary adenocarcinoma or having partial papillary structure. HER2 positivity was studied in 16.1% (36/223) of patients with adenocarcinoma and 41.9% (26/62) in adenocarcinoma with papillary structures. For 143 radically resected primary GBC cases with 24 HER2-positive tumors, survival data were valid; the median survival time was not reached, and the 5-year survival rate was 52.9%. All patients in stages 0–I survived, and the results of the HER2-positive group and the stage II HER2-negative group were similar (p = 0.354). However, in stage III, the mortality rate in the HER2-positive group was reduced (p = 0.005) and that in stage IV was higher (p = 0.005). In conclusion, HER2 positivity was significantly higher in patients with papillary GBC. The predictive value of HER2 varies by clinical stage, with no prediction in the early stages, better in stage III, and worse in stage IV. [ABSTRACT FROM AUTHOR]

Primary pulmonary papillary adenocarcinoma (PA) is a specific and rare subtype of invasive pulmonary adenocarcinoma (ADC). The knowledge concerning the clinicopathologic features and prognosis of patients with primary pulmonary PA has not been clarified because of its rarity.

Gallbladder carcinoma (GBC) is responsible for 80%–95% of biliary tract malignancies and has a dismal prognosis. Human epidermal growth factor receptor 2 (HER2) is a promising therapeutic target of GBC. Through immunohistochemistry (IHC) and fluorescence in situ hybridization (FISH) methods, HER2 expression and gene amplification were identified on high-output tissue microarrays (TMAs) developed in 306 GBC cases to investigate its relationship with GBC and clinicopathological characteristics. Adenocarcinomas accounted for 223 (72.9%) of the cases, with 62 (27.8%) being papillary adenocarcinoma or having partial papillary structure. HER2 positivity was studied in 16.1% (36/223) of patients with adenocarcinoma and 41.9% (26/62) in adenocarcinoma with papillary structures. For 143 radically resected primary GBC cases with 24 HER2-positive tumors, survival data were valid; the median survival time was not reached, and the 5-year survival rate was 52.9%. All patients in stages 0–I survived, and the results of the HER2-positive group and the stage II HER2-negative group were similar (p = 0.354). However, in stage III, the mortality rate in the HER2-positive group was reduced (p = 0.005) and that in stage IV was higher (p = 0.005). In conclusion, HER2 positivity was significantly higher in patients with papillary GBC. The predictive value of HER2 varies by clinical stage, with no prediction in the early stages, better in stage III, and worse in stage IV.

Purpose: To explore the clinicopathological features and prognosis of papillary gastric adenocarcinoma (PGC). Methods: The subjects of this retrospective analysis were 1525 patients with gastric cancer in a single center in China. Results: The patients with PGC were generally of advanced age and the tumor was located in the upper 1/3 of the stomach. PGC was well or moderately differentiated, with serosal infiltration, early lymph node metastasis, TNM stages I/II, liver metastasis, and a short postoperative overall survival time. Patients with the secondary pathological type of papillary adenocarcinoma presented with clinicopathological similarities to those with primary PGC. PGC was a risk factor for poor survival in both univariate and multivariate analyses. Conclusion: Papillary gastric adenocarcinoma (PGC) showed different clinicopathological characteristics and prognosis to other types of gastric cancer (GC), even if it was not the primary pathological type. The higher the proportion of papillary adenocarcinoma in gastric cancer samples, the shorter the postoperative survival time of patients. PGC needs further multicenter studies. [ABSTRACT FROM AUTHOR]

Introduction: In patients with intramucosal gastric cancer (MGC) who have undergone endoscopic submucosal dissection (ESD), lymphovascular invasions (LVIs) such as lymphatic invasion or venous invasion are considered risk factors of lymph node metastasis (LNM). However, the rate of LNM in MGCs with LVI and their clinicopathological features are unclear. Objective: This study aimed to examine the rate of LNM and clinical characteristics of MGCs with LVI as compared to MGCs without LVI and minimally invasive submucosal gastric cancers (mSMGCs) with LVI. Methods: Among the early gastric cancers excluding the remnant stomach who underwent ESD at our hospital from July 2003 to September 2018, the MGCs with LVI were included as the target in this study. MGCs without LVI and mSMGCs with LVI were also included as control. Results: Seventeen lesions in 17 patients with MGCs with LVI, 1,149 lesions in 865 patients with MGCs without LVI, and 29 lesions in 29 patients with mSMGCs with LVI were analyzed. LVI was noted in 1.5% (17/1,166) of MGC cases. During follow-up of the MGC cases with LVI, there were no LNM or recurrences reported, and 14 patients survived and 3 died of other diseases. However, LNM occurred in 2 cases of mSMGC. Among the MGC cases, univariate analysis showed that the pap component, elevated type, and tumor diameters of 20 mm or more were statistically significant factors with respect to LVI, while multivariate analysis showed that the pap component was the only significant factor. Conclusion: Careful follow-up may be appropriate for MGCs with LVI due to the low risk of LNM. Additionally, the pap component is a significant factor in MGCs with LVI. [ABSTRACT FROM AUTHOR]

Low grade nasopharyngeal papillary adenocarcinoma (LGNPA) is a rare variant of nasopharyngeal adenocarcinoma with an excellent prognosis and a histo-morphologic similarity with papillary thyroid carcinoma(PTC). It can be differentiated from PTC using ThyroidTranscriptionFactor-1 (TTF-1) and Thyroglobulin immunostains. We report a case of thyroid-like LGNPA in a 20 year old Nigerian student

Background/aims: Papillary adenocarcinoma is classified to differentiated-type gastric cancer and is indicated for endoscopic submucosal dissection. However, due to its rare nature, there are limited studies on it. The purpose of this study was to determine the outcome of endoscopic submucosal dissection in patients with papillary-type early gastric cancer and to find the risk factors of lymph node metastasis., Methods: Patients diagnosed with papillary-type early gastric cancer at eight medical centers, who underwent endoscopic submucosal dissection or surgical treatment, were retrospectively reviewed. The clinical results and long-term outcomes of post-endoscopic submucosal dissection were evaluated, and the risk factors of lymph node metastasis in the surgery group were analyzed., Results: One-hundred and seventy-six patients with papillary-type early gastric cancer were enrolled: 44.9% (n=79) in the surgery group and 55.1% (n=97) in the endoscopic submucosal dissection group. As a result of endoscopic submucosal dissection, the en bloc resection and curative resection rates were 91.8% and 86.6%, respectively. The procedure-related complication rate was 4.1%, and local recurrence occurred in 3.1% of patients. Submucosal invasion (odds ratio, 3.735; 95% confidence interval, 1.026 to 12.177; p=0.047) and lymphovascular invasion (odds ratio, 7.636; 95% confidence interval, 1.730 to 22.857; p=0.004) were the risk factors of lymph node metastasis in papillary-type early gastric cancer patients., Conclusions: The clinical results of endoscopic submucosal dissection in papillary-type early gastric cancer were relatively favorable, and endoscopic submucosal dissection is considered safe if appropriate indications are confirmed by considering the risk of lymph node metastasis.

Papillary adenocarcinomas of the stomach are rare and associated with a high rate of lymphovascular invasion and distant metastasis. However, the association between papillary adenocarcinoma and bone metastasis in gastric cancer remains largely unexplored. We report a rare case of bone metastasis as a recurrence of early papillary adenocarcinoma of the stomach after curative surgery. A 75-year-old man with a pedunculated polyp at the pylorus of the stomach was diagnosed with papillary adenocarcinoma after biopsy of the lesion, and the polyp was surgically resected. Pathohistological examination revealed intramucosal cancer without lymphovascular invasion or lymph node metastasis. Eight months after surgery, imaging studies showed osteolysis in the right sacrum, and the lesion was diagnosed as a bone metastasis after biopsy. The patient received palliative chemotherapy and radiotherapy for the bone metastasis, which resulted in relief of his leg pain. Subsequently, he was provided supportive care when his condition deteriorated, and he died 8 months after the diagnosis of bone metastasis. Our case shows that bone metastasis should not be overlooked, even though it is rare in gastric cancer patients. Papillary adenocarcinoma of the stomach should be carefully followed up through imaging examinations, even after curative resection. [ABSTRACT FROM AUTHOR]

Background: Primary pulmonary papillary adenocarcinoma (PA) is a specific and rare subtype of invasive pulmonary adenocarcinoma (ADC). The knowledge concerning the clinicopathologic features and prognosis of patients with primary pulmonary PA has not been clarified because of its rarity. Methods: The clinical data of a total of 3391 patients with primary pulmonary PA were retrospectively analyzed to confirm their clinical characteristics and factors influencing prognosis and were in comparison with 3236 patients with non- PA pulmonary adenocarcinoma. All patients were histologically diagnosed between 1988 and 2015 in The Surveillance Epidemiology and End Results (SEER) database. A nomogram with satisfactory predictive performance was established to visually predict long-term survival of these patients. Results and conclusion: Collectively, primary pulmonary PA is a rare pathological cancer and its prognosis is analogous to that of non-PA pulmonary adenocarcinoma. Older age, larger lesions, distant metastases, lymph node invasion, and poor pathological differentiation are correlative with unacceptable prognosis. Surgical intervention is conducive to reaping favorable prognosis. Unfortunately, radiotherapy or chemotherapy results of no significant effects on patient survival. In our study, a nomogram with prognostic function is formulated to confer individual prediction of overall survival (OS). [ABSTRACT FROM AUTHOR]

Ectopic thyroid carcinoma often occurs in the neck, and metastatic carcinoma of the nasal cavity and sinuses is extremely rare. An 11-year-old female was admitted to the hospital for one week due to nasal pain without an obvious cause and blood in the nose. A pale red mass with a peduncle at the back end of the right nasal septum was seen during the operation. Immunohistochemistry showed low-grade papillary thyroid carcinoma. Surgeons should be alert to the possibility of ectopic thyroid tissue and related diseases, Patients with suspected malignant lesions should undergo routine pathological examination, and even a normal thyroid should be checked for malignant changes to avoid negative outcomes. Although nasal endoscopic surgery is mature, for tumors with unclear properties, it is still necessary to undergo routine pathological examination to avoid habitual errors. • Introduced a rare type of ectopic thyroid carcinoma occurred in the nose. • Surgical intervention is the main treatment for Ectopic Thyroid Carcinoma. • The function and morphology of thyroid should be checked before surgery [ABSTRACT FROM AUTHOR]

Intravascular papillary endothelial hyperplasia, previously known as Masson's tumor, is a relatively uncommon reactive endothelial proliferation that occurs most commonly in the vessels of the head, neck, and extremities. We report a case of intravascular papillary endothelial hyperplasia in the neck in a 40-year-old female that was misdiagnosed as papillary adenocarcinoma on fine needle aspiration. The cytologic picture of intravascular papillary endothelial hyperplasia is diverse, making a pinpoint diagnosis of this entity difficult on fine needle aspiration.

Anaplastic lymphoma kinase‐rearranged (ALK+) lung cancers show characteristic histological features, such as solid signet ring cell patterns and mucinous cribriform patterns; however, these features are not always observed in ALK+ lung cancers. We noticed that club cell (Clara cell)‐like cells (CLCs) were frequently present in the papillary portion of ALK+ lung adenocarcinomas. In this study, we investigated the importance of CLCs in papillary patterns of ALK+ lung cancers. We compared the histological features of 18 ALK+ cases with 62 control cases (22 epidermal growth factor receptor‐positive (EGFR+) and 40 ALK‐ and EGFR‐negative (ALK−/EGFR−) cases). The present study analyzed presence of papillary pattern, proportion of papillary pattern area, presence of micropapillary pattern, frequency of CLCs and lengths of snout. The frequency of CLCs in ALK+ cases was significantly higher than that in EGFR+ cases and ALK−/EGFR− cases. Micropapillary pattern was more frequently observed in ALK+ cases than that in ALK−/EGFR− cases (P < 0.001). The present study indicated that the high frequency of CLCs in papillary patterns was significantly associated with ALK+ cases. When solid signet ring cell patterns and mucinous cribriform patterns are absent, the high frequency of CLCs in papillary adenocarcinoma could be a useful histological marker for ALK+ lung cancers. [ABSTRACT FROM AUTHOR]

Objectives: Thyroid-like low-grade nasopharyngeal papillary adenocarcinoma (TLLGNPPA) is a relatively rare nasopharyngeal tumor. We performed morphological characterization, immunohistochemical profiling, and investigated gene mutations. We also provide clinical follow-up data and brief review of the literature.Methods: Immunohistochemistry was used to evaluate the expression of TTF-1, CK19, CK7, EMA, TG, Pax-8, CK5/6, S100, and Ki-67. Additionally, in situ hybridization was utilized to identify the presence of EBV. We investigated mutations in hot-spot exons of KRAS/NRAS/BRAF to rule out common mutations seen in thyroid tumors.Results: Histopathologic examination of four cases identified tumors that were mainly occupied by papillary architectures. One case had a predominantly glandular structure. The tumors expressed TTF-1 and CK19, while TG and Pax-8 were negative. S100 was moderately expressed focally in three cases.Conclusions: While TLLGNPPA displays a morphological resemblance to papillary thyroid carcinoma (PTC), it is vital to differentiate nasopharyngeal metastasis from PTC for appropriate treatment. [ABSTRACT FROM AUTHOR]

Objectives/hypothesis: Salivary gland nasopharynx cancers (SGNPCs) are rare malignancies with few cases discussed in the literature. This study represents the largest cohort of SGNPC to date.Study Design: Retrospective population-based analysis.Methods: The Surveillance, Epidemiology, and End Results registry from 1973 to 2015 was utilized to extract 383 cases of SGNPC. Data were analyzed for demographic characteristics, incidence, clinicopathologic traits, and outcome prognosticators.Results: White female patients aged >40 years were most commonly affected. The incidence was measured as 0.019 per 100,000 people. The majority of tumors presented at advanced stages (stage III/IV, 60.8%). Adenoid cystic carcinoma, adenocarcinoma, and mucoepidermoid carcinoma were the most commonly encountered histologies (43.1%, 31.6%, 13.3%, respectively). Cervical node involvement and distant metastasis were measured at 23% and 11.9%, respectively. Mucoepidermoid carcinomas presented with the best disease-specific survival at 5 and 10 years. Asian ethnicity, age <80 years, and earlier American Joint Committee on Cancer stages were positive prognostic factors. The inclusion of surgical therapy improved 5-year outcomes among the most common histologies, except for mucoepidermoid carcinoma.Conclusions: Salivary gland nasopharyngeal cancer represents a group of rare histologies with similar outcomes as squamous cell carcinomas. However, prognosis is primarily dependent on histologic subtype, race, age, and American Joint Committee on Cancer stage. [ABSTRACT FROM AUTHOR]

Background: The previous studies demonstrated aggressive clinicopathologic features of papillary early gastric cancer (EGC). This raised concerns about the appropriateness of current Japanese guidelines that recommend the same endoscopic submucosal dissection (ESD) criteria for papillary EGC as for well-differentiated (WD) or moderately differentiated (MD) EGCs.Methods: This study included 4140 patients who underwent ESD for differentiated-type EGC (87 papillary EGCs and 4259 WD or MD EGCs). The clinicopathologic characteristics and short- and long-term outcomes of ESD for papillary EGC were reviewed and compared with those for WD or MD EGC.Results: Papillary EGCs were larger, and had higher lymphovascular and submucosal invasion rates than WD or MD EGCs. Lateral resection margin involvement and histological heterogeneity were found more frequently in papillary EGC than in WD or MD EGC. En bloc with R0 resection and curative resection rates of papillary EGC were 85.1 and 49.4%, respectively, and both were significantly lower than those of WD or MD EGC (93.0 and 82.2%). In mucosal cancers, curative resection rates of papillary EGC and WD or MD EGC were 72.5 and 93.7%, respectively. Among patients undergoing curative ESD for papillary EGC, no extra-gastric recurrences occurred during median 58 months of follow-up. Metachronous recurrence occurred in 5.2% of cases.Conclusions: Given the favorable long-term outcomes after curative resection, ESD might be indicated for papillary EGC according to the current Japanese guidelines. As papillary EGC has considerable lymphovascular and submucosal invasion rates, careful histological examination is required to accurately determine whether curative ESD is achieved. [ABSTRACT FROM AUTHOR]

Conventional adenocarcinomas comprise of about 90% of all gallbladder neoplasms; among them, pancreatobiliary is the most common phenotype followed by intestinal and gastric foveolar types. Papillary variant is the second most common form of adenocarcinoma affecting the gallbladder. Mucinous adenocarcinoma and signet-ring cell carcinoma are rarer variants with grave prognoses. We report five cases of gallbladder neoplasms with four different histopathological features. (1) To report the rare neoplasms of the gallbladder for the future researches on their histopathology-based targeted therapy. (2) To describe the clinico-pathogical characteristics of the rare variants of gallbladder neoplasm.

The uterus of an 18 month old Pit-bull removed during ovariohysterectomy formed the material of this study. Macroscopically, the uterus was whitish in color and elastic in consistency, the uterine horns were 15 cm long with a 1 cm of diameter. On cut section uterine mucosa showed variable sized cysts and was filled with a yellowish white mucus. Microscopical evaluation demonstrated a proliferation of the glandular component of the endometrium and a migration of these glands into the myometrium. Glands located in both the endometrium and the myometrium formed large cystic structures. The atypical glandular epithelium showed papillary projections into the cystic spaces. The tumor was diagnosed as uterine adenocarcinoma, an extremely rare canine tumor, especially in young dogs. [ABSTRACT FROM AUTHOR]

Background: Current Japanese gastric cancer treatment guidelines recommend the same endoscopic resection criteria for papillary early gastric cancer (EGC) and well-differentiated (WD) or moderately differentiated (MD) EGC. To evaluate the appropriateness of this recommendation, we compared the clinicopathological characteristics of papillary EGC with those of WD, MD, poorly differentiated (PD), and signet ring cell (SRC) EGC.Methods: A total of 6710 patients who underwent radical gastrectomy for EGC were included. Clinicopathological characteristics of papillary EGC were retrospectively reviewed and compared with those in other EGC subtypes.Results: Papillary EGC accounted for 1.9% (130/6710) of total cases. Patients with papillary EGC were older and showed a male predominance compared to patients with PD or SRC EGC. Papillary EGCs showed significantly higher submucosal and lymphovascular invasion rates than WD or MD EGC or PD or SRC EGC. However, the LN metastasis rate of papillary EGC was comparable to or lower than that in other EGC subtypes. LN metastasis rates in mucosal cancers were 1.5%, 1.1%, and 4.0%, and those in submucosal cancers were 9.4%, 11.9%, and 17.6% for papillary EGC, WD or MD EGC, and PD or SRC EGC, respectively. In multivariate analysis, lymphatic invasion and PD or SRC histology were the strongest risk factors for LN metastasis. Among 63 papillary EGC that met the curative endoscopic resection criteria, no case showed LN metastasis.Conclusions: Endoscopic resection can be indicated for papillary EGC according to current guidelines. Given a considerable lymphovascular invasion rate, careful histological evaluation is required after endoscopic resection for papillary EGC. [ABSTRACT FROM AUTHOR]

A pulmonary nodule is a single, nearly spherical, well-circumscribed pulmonary opacity up to 30 mm in diameter and surrounded by aerated lung tissue. In radiographs, pulmonary nodules may appear as solid, completely obscuring the lung parenchyma, or as subsolid, not completely obscuring adjacent tissues. A subsolid pulmonary nodule may be further subclassified as a pure ground glass nodule (pGGN) or a part solid nodule, a mixture of ground glass components and focal opacity obscuring the adjacent tissues. Guidelines for evaluation of solid pulmonary nodules are based on nodule size, recommending vigilance and non-operative management for small nodules (less than 8 mm in diameter) and diagnostic biopsy for nodules with a diameter of 8 mm or more. However, subsolid ground glass pulmonary nodules are an exception to this rule. Although small in size, persistent subsolid nodules are potentially premalignant or malignant. We present the case of a non-smoker who was found to have an incidental pulmonary pGGN. We then discuss the radiologic appearance, histology, clinical outcomes, and evaluation and management strategy of subsolid pulmonary nodules compared with solid nodules.