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AJSP: Reviews & Reports
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Hybrid journal (It can contain Open Access articles)
ISSN (Print) 1082-9784 - ISSN (Online) 1533-4015
Published by Wolters Kluwer - Lippincott Williams and Wilkins; Blackwell Publishing [1 journal]

Introduction to Updates in the Reporting of Selected Tumor Sites
- Authors: Otis; Christopher N.
  Abstract: No abstract available
  PubDate: Tue, 01 May 2018 00:00:00 GMT-
A Perspective on Standardized Tumor Staging, Tumor Nomenclature, and
Surgical Pathology Reports
- Authors: Otis; Christopher N.
  Abstract: No abstract available
  PubDate: Tue, 01 May 2018 00:00:00 GMT-
International Harmonization of Cancer Diagnosis, Staging, and Data Sets
for Pathology Reporting—The Role of the International Collaboration on
Cancer Reporting
- Authors: Ellis; David W.; Judge, Meagan; Srigley, John R.
  Abstract: No abstract available
  PubDate: Tue, 01 May 2018 00:00:00 GMT-
Changes and Clarifications in the Eighth Edition of the AJCC Cancer
Staging System for Breast Cancer
- Authors: Sanders; Mary Ann; Wong, Stephanie M.; Iorgulescu, Julian Bryan; Lester, Susan C.
  Abstract: In the eighth edition of the American Joint Committee on Cancer staging system for breast cancer, the definitions for T (tumor), N (nodes), and M (metastases) remain substantially unchanged but with clarifications for certain categories that may have been problematic for pathologists and clinicians. The principal change is the decision to exclude lobular carcinoma in situ from T classification. In contrast, there is a major change in how stage is determined by introducing a new clinical prognostic stage and a new pathological prognostic stage. These prognostic stages incorporate information about grade, estrogen receptor expression, progesterone receptor expression, human epidermal growth factor receptor 2 expression, and, in some cases, the Oncotype Dx Recurrence Score, in addition to T, N, and M, to create groups of cancers predicted to have a similar survival at 3 years based on information from the National Cancer Database. This review highlights the changes and notable clarifications to the TNM system and how these relate to standard pathology reporting.
  PubDate: Tue, 01 May 2018 00:00:00 GMT-
Controversies in Gynecologic Cancer Staging: An AJCC Cancer Staging
Manual, Eighth Edition Perspective
- Authors: Hagemann; Ian S.; Cole, Lisa L.; Cosin, Jonathan A.; Gress, Donna M.; Mutch, David G.; Olawaiye, Alexander B.
  Abstract: Staging systems provide a common language to support clinical research and decision making in patients with cancer. The eighth edition of the AJCC Cancer Staging Manual incorporates updates that reflect evolving clinical practices and scientific insights. The present article summarizes changes that have been made for gynecologic subsites and outlines continued challenges. Gynecologic American Joint Committee on Cancer/International Union Against Cancer staging continues to conform closely to current International Federation of Obstetrics and Gynecology staging. The eighth edition is aligned with the major revision made to International Federation of Obstetrics and Gynecology staging of ovarian cancer in 2014 and contains a unified staging system for ovarian, fallopian tube, and primary peritoneal cancer. Continuing challenges for ovarian cancer include determining the relative significance of intraoperative rupture, surface involvement, and positive washings, which are rank ordered in the new staging system. Another challenge is assignment of a tubal versus ovarian primary site for high-grade serous carcinoma, which cannot be done in a reliable way. In uterine carcinoma, endometrial intraepithelial carcinoma is now recognized as a T1 cancer, and nodal micrometastases have been defined with their own N stage. Also, isolated tumor cells in lymph nodes have been incorporated in the staging of all gynecologic carcinomas. The staging of uterine sarcoma is largely unchanged. Future revisions may consider grouping these tumors with soft tissue sarcomas at large. Staging of cervical cancer is largely unchanged. Nomenclature of early invasive carcinoma and the challenges in defining tumor dimension in cervical carcinoma are discussed. The nodal staging of vulvar cancer now incorporates a vocabulary for isolated tumor cells and micrometastases. Despite the current interest in molecular staging, the eighth edition expert panel did not identify any specific biomarkers for inclusion in stage classification, but several are recommended for collection as ancillary data elements, including p16 status in vulvar, vaginal, and cervical tumors. In the eighth edition, as in the seventh, anatomic factors remain the cornerstone of gynecologic cancer staging.
  PubDate: Tue, 01 May 2018 00:00:00 GMT-
Genitourinary Updates in the Eighth Edition of the AJCC Cancer Staging
Manual
- Authors: Spruill; Laura S.; Bruner, Evelyn T.; Smith, Michael Timothy
  Abstract: The new, eighth edition of the AJCC Cancer Staging Manual has been published, and there are many and significant changes in the staging for genitourinary organs. Pathologists will necessarily need to study the manual to acquire fluency in the staging. The staging changes and philosophy will be applicable in 2018. The TNM process involved remains the same, but some specific definition changes are present. Prostate staging is now very different; whereas prior staging included pT2a, pT2b, and pT2c, now all organ-confined disease is pT2 without consideration of half gland involvement. Staging of penis cancer previously considered urethral involvement but now corpus spongiosum involvement is considered pT2, and corpus cavernosum involvement is considered pT3 disease irrespective of the urethral involvement based on literature evidence. Invasion of the epididymis as a component of testis staging is now considered pT2 rather than pT1. These are just some of the new changes that will require understanding on the part of the pathologist. This article describes the changes and some of the background supportive literature and provides appropriate explanatory illustrations.
  PubDate: Tue, 01 May 2018 00:00:00 GMT-
Accurate Assessment of Histologic Parameters That Impact Lung Cancer
Staging: Implications for the American Joint Committee on Cancer Eighth
Edition TNM Classification
- Authors: Butnor; Kelly J.
  Abstract: The eighth edition of the American Joint Committee on Cancer TNM Classification represents a paradigm shift in lung cancer staging. Some staging parameters, such as the visceral pleural invasion, have not changed. Others are a significant departure from the prior edition, including tumor size used to assign T category, which for the first time is based solely on the invasive component, excluding any lepidic component. Understanding how to assess these histologic parameters will allow pathologists to contribute to the improved care of lung cancer patients through accurate pathologic staging.
  PubDate: Tue, 01 May 2018 00:00:00 GMT-
Pathologic Staging of Colorectal Adenocarcinoma: Changes and Updates in
the American Joint Committee on Cancer (AJCC) 8th Edition and College of
American Pathologists' Cancer Protocol
- Authors: Kakar; Sanjay
  Abstract: The eighth edition of the AJCC Cancer Staging Manual has been published, and the new staging schemes will be applicable in 2018. The College of American Pathologists has also released an updated protocol incorporating these changes. While the overall T and N categories are similar to the seventh edition, the definitions of intramucosal adenocarcinoma, T4a category, and tumor deposits have been made more precise. The category of M1c has been created for peritoneal metastasis because of its worse outcome. In the College of American Pathologists protocol, tumor budding and venous invasion have been incorporated as recommended (optional) elements, the scoring of tumor regression has been updated, and the importance of screening for microsatellite instability/mismatch repair proteins has been emphasized. This review provides a brief description and rationale for these changes and updates.
  PubDate: Tue, 01 May 2018 00:00:00 GMT-
The American Joint Committee on Cancer Eighth Edition: Changes in Thyroid
Carcinoma Staging and an Update on Reporting
- Authors: Berg; Aaron N.; Seethala, Raja R.
  Abstract: The AJCC Cancer Staging Manual, Eighth Edition (AJCC 8th edition) contains a number of significant changes, many of which affect the reporting of clinicopathologic parameters in thyroid cancers. The first key change is the separation of medullary thyroid carcinoma into its own chapter. Within differentiated and anaplastic thyroid carcinomas, anaplastic carcinomas are now assigned a T stage similar to differentiated thyroid carcinomas. However, this is largely cosmetic because these are still assigned stage group IV. Perhaps the most significant alteration from a reporting standpoint is revision of extrathyroidal extension (ETE) in terms of T staging. Pathologic stage pT3 is now subdivided into pT3a (by size) and pT3b (by ETE). Under AJCC 8th edition, pT3b is now defined by gross (clinical, radiologic, and/or macroscopic) ETE. Other key changes are the inclusion of level VII (anterior mediastinal) lymph nodes as N1a and changes in stage groupings, particularly with a new age cutoff of 55 years, and a downshift in several stage groups. In medullary thyroid carcinoma, the potential prognostic value of nonanatomic factors (ie, serum calcitonin, carcinoembryonic antigen, RET mutation status) is officially recognized, although not yet part of staging. The advent of the new terminology noninvasive follicular thyroid neoplasm with papillary-like nuclear features will remove a subset of tumors that qualify for this new designation from formal AJCC staging altogether.
  PubDate: Tue, 01 May 2018 00:00:00 GMT-
Pathologic Staging of Bone and Soft Tissue Tumors: What Is New in the
Eighth Edition of the American Joint Committee on Cancer Staging
Manual'
- Authors: Laurini; Javier A.; Cooper, Kumarasen
  Abstract: The recently published eighth edition of the AJCC Cancer Staging Manual addresses and incorporates a substantial number of advances in our understanding of bone and soft tissue sarcomas. A greater emphasis has been placed on the anatomic site of origin resulting in new staging systems. In addition, modifications to the existing AJCC prognostic stage groups and implementation of new prognostic stage groups for certain anatomic sites and tumor types were made. Minor changes in the biologic grading of bone sarcomas were also included. For retroperitoneal soft tissue sarcomas, a nomogram providing additional prognostic information has been endorsed by the AJCC Precision Medicine Core and is included as a risk assessment model. Pathologists play a central role in tumor staging and therefore should become familiar with these changes.
  PubDate: Tue, 01 May 2018 00:00:00 GMT-
Pure Red Cell Aplasia Due to T-Cell Large Granular Lymphocytic Leukemia
After Hematopoietic Stem Cell Transplantation
- Authors: Rangan; Aruna; Oliveira, Jennifer L.; Jevremovic, Dragan; Morice, William G.; Chen, Dong; Shi, Min
  Abstract: Although reactive polytypic large granular lymphocyte (LGL) expansions after hematopoietic stem cell transplant (HSCT) due to viral infection are common, T-cell large granular lymphocytic leukemia (T-LGLL) is extremely rare and usually clinically indolent and requires no treatment in the post-HSCT setting. In contrast, here we present a case of post-HSCT donor-derived T-LGLL that led to pure red cell aplasia with severe patient morbidity. After diagnosis, the patient received immunosuppressive treatment with a dramatic response and has been transfusion independent for more than a year. To our knowledge, this is the first case of a post-HSCT T-LGLL with a documented significant adverse clinical impact requiring and responding to therapeutic intervention. It underscores the importance of recognizing such a rare entity in posttransplant patients.
  PubDate: Tue, 01 May 2018 00:00:00 GMT-