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  1. Article ; Online: The liver in fatal COVID-19, the end of an era (or so we hope!).

    Lagana, Stephen M

    Annals of diagnostic pathology

    2023  Volume 68, Page(s) 152245

    MeSH term(s) Humans ; COVID-19 ; Liver
    Language English
    Publishing date 2023-12-14
    Publishing country United States
    Document type Editorial
    ZDB-ID 1440011-x
    ISSN 1532-8198 ; 1092-9134
    ISSN (online) 1532-8198
    ISSN 1092-9134
    DOI 10.1016/j.anndiagpath.2023.152245
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Challenges in Diagnosing and Reporting Cholangiocarcinoma.

    El Jabbour, Tony / Molnar, Attila / Lagana, Stephen M

    Surgical pathology clinics

    2023  Volume 16, Issue 3, Page(s) 599–608

    Abstract: Intrahepatic cholangiocarcinoma is a challenge to the practicing surgical pathologist for several reasons. It is rare in many parts of the world, and thus practical exposure may be limited. Related to the fact of its rarity is the fact that more common ... ...

    Abstract Intrahepatic cholangiocarcinoma is a challenge to the practicing surgical pathologist for several reasons. It is rare in many parts of the world, and thus practical exposure may be limited. Related to the fact of its rarity is the fact that more common tumors which frequently metastasize to the liver can be morphologically indistinguishable (eg, pancreatic ductal adenocarcinoma). Immunohistochemical testing is generally non-contributory in this context. Other difficulties arise from the protean morphologic manifestations of cholangiocarcinoma (ie, small duct vs. large duct) and the existence of combined cholangiocarcinoma and hepatocellular carcinoma. These, and other issues of concern to the practicing diagnostic pathologist are discussed herein.
    MeSH term(s) Humans ; Bile Ducts, Intrahepatic/pathology ; Bile Duct Neoplasms/pathology ; Cholangiocarcinoma/diagnosis ; Cholangiocarcinoma/pathology ; Liver Neoplasms/diagnosis ; Liver Neoplasms/pathology ; Pancreatic Neoplasms/pathology
    Language English
    Publishing date 2023-06-23
    Publishing country United States
    Document type Journal Article ; Review
    ISSN 1875-9157
    ISSN (online) 1875-9157
    DOI 10.1016/j.path.2023.04.012
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Multivisceral transplantation for the treatment of mitochondrial neurogastrointestinal encephalomyopathy.

    Rust, Dylan / Martinez, Mercedes / Lagana, Stephen / Hirano, Michio / Kato, Tomoaki / Weiner, Joshua

    Clinical transplantation

    2024  Volume 38, Issue 1, Page(s) e15230

    MeSH term(s) Humans ; Mitochondrial Encephalomyopathies/surgery ; Organ Transplantation
    Language English
    Publishing date 2024-01-30
    Publishing country Denmark
    Document type Case Reports ; Letter
    ZDB-ID 639001-8
    ISSN 1399-0012 ; 0902-0063
    ISSN (online) 1399-0012
    ISSN 0902-0063
    DOI 10.1111/ctr.15230
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  4. Article ; Online: Biopsy Diagnosis of Celiac Disease: The Pathologist's Perspective in Light of Recent Advances.

    Lagana, Stephen M / Bhagat, Govind

    Gastroenterology clinics of North America

    2018  Volume 48, Issue 1, Page(s) 39–51

    Abstract: Celiac disease is a common immune-mediated disorder that occurs in individuals with permissive genetics (HLA-DQ2/DQ8 genotype) following exposure to certain wheat proteins. The histopathologic manifestations of small intestinal mucosal injury (villus ... ...

    Abstract Celiac disease is a common immune-mediated disorder that occurs in individuals with permissive genetics (HLA-DQ2/DQ8 genotype) following exposure to certain wheat proteins. The histopathologic manifestations of small intestinal mucosal injury (villus atrophy, crypt hyperplasia, and intraepithelial lymphocytosis) are well recognized. However, these findings are not specific for celiac disease, because they are observed in other small intestinal disorders. These mimics include common and rare entities, the list of which continues to grow. This article discusses the histopathology and differential diagnosis of celiac disease and provides the pathologist's perspective on biopsy adequacy, evaluation, and reporting in light of current knowledge.
    MeSH term(s) Biopsy/methods ; Biopsy/trends ; Celiac Disease/diagnosis ; Celiac Disease/pathology ; Gastroenterologists ; Humans ; Interdisciplinary Communication ; Intestine, Small/pathology ; Pathologists
    Language English
    Publishing date 2018-12-14
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 92114-2
    ISSN 1558-1942 ; 0889-8553
    ISSN (online) 1558-1942
    ISSN 0889-8553
    DOI 10.1016/j.gtc.2018.09.003
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  5. Article: Composite intestinal adenoma-microcarcinoid: An update and literature review.

    Fu, Zhi-Yan / Kmeid, Michel / Aldyab, Mahmoud / Lagana, Stephen M / Lee, Hwajeong

    World journal of gastrointestinal endoscopy

    2022  Volume 13, Issue 12, Page(s) 593–606

    Abstract: Composite intestinal adenoma-microcarcinoid (CIAM) is a rare intestinal lesion consisting of conventional adenoma and small, well differentiated carcinoid [microcarcinoid (MC)] at its base. The incidence of CIAM is 3.8% in surgically resected colorectal ... ...

    Abstract Composite intestinal adenoma-microcarcinoid (CIAM) is a rare intestinal lesion consisting of conventional adenoma and small, well differentiated carcinoid [microcarcinoid (MC)] at its base. The incidence of CIAM is 3.8% in surgically resected colorectal polyps. While its pathogenesis is unknown, studies support the role of Wnt/β-catenin pathway in the tumorigenesis of CIAM. CIAMs have been primarily reported in the colon wherein they present as polyps with well-defined margins, similar to conventional adenomatous polyps. MC is usually found in adenomatous polyps with high-risk features such as large size, villous architecture, or high grade dysplasia. Histologically, the MC component is often multifocal and spans 3.9 to 5.8 millimeters in size. MC is usually confined within the mucosa but occasional CIAM cases with MC extending to the submucosa have been reported. MC of CIAM demonstrates bland cytology and inconspicuous proliferative activity. The lesional cells are positive for synaptophysin and 60% to 100% of cases show nuclear β-catenin positivity. MC poses a diagnostic challenge with its morphologic and immunohistochemical resemblance to both benign and malignant lesions, including squamous morules/metaplasia, adenocarcinoma, squamous cell carcinoma, sporadic neuroendocrine tumor and goblet cell adenocarcinoma. CIAM is an indolent lesion with a favorable outcome. Complete removal by polypectomy is considered curative. Awareness and recognition of this rare entity will help arrive at correct diagnosis and improve patient care. Currently, CIAM is not recognized as a subtype of mixed neuroendocrine-non-neuroendocrine neoplasm by WHO.
    Language English
    Publishing date 2022-01-13
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 2573698-X
    ISSN 1948-5190
    ISSN 1948-5190
    DOI 10.4253/wjge.v13.i12.593
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article ; Online: Esophageal squamous cell carcinoma with pagetoid spread: a clinicopathologic study.

    Miller, Tiffany R / Zhang, Xuchen / Ko, Huaibin M / Lagana, Stephen M / Setia, Namrata / Yassan, Lindsay / Westerhoff, Maria / Deshpande, Vikram / Hornick, Jason L / Redston, Mark S / Zhao, Lei

    Virchows Archiv : an international journal of pathology

    2024  

    Abstract: Pagetoid spread in esophageal squamous epithelium associated with underlying esophageal adenocarcinoma (EAC) has been well studied. Case reports describing pagetoid spread of esophageal squamous cell carcinomas (ESCC) also exist in the literature. The ... ...

    Abstract Pagetoid spread in esophageal squamous epithelium associated with underlying esophageal adenocarcinoma (EAC) has been well studied. Case reports describing pagetoid spread of esophageal squamous cell carcinomas (ESCC) also exist in the literature. The latter, however, has not been systematically studied. In this study, we report seven cases of pagetoid spread associated with ESCC. The clinical, morphologic, and immunophenotypic profiles of pagetoid spread in the context of ESCC and EAC are compared. Cases of pagetoid spread of ESCC were identified through computerized search of pathology archives at five institutions. Additional cases were identified through manual review of surgical resection cases of treatment naive ESCC in Mass General Brigham (MGB) pathology archive. Clinical history was collected via chart review. Immunohistochemistry for CK7, CK20, CDX2, p53, p63, and p40 was performed on selected cases. A computerized search of pathology archives of five institutions revealed only two cases. A manual review of 76 resected untreated ESCC revealed five additional cases with unequivocal pagetoid spread of ESCC, indicating the condition was not uncommon but rarely reported. Patient age ranged from 54 to 78 years (median, 65). There were six women and one man. One case had in situ disease, five had pT1 (1 pT1a and 4 pT1b), and one had pT3 disease. One of the patients with pT1 tumor had a positive lymph node, while the remaining six patients were all N0. Four tumors were in the proximal to mid esophagus, and three in the distal esophagus. Patient survival ranged from 25 months to more than 288 months. The pagetoid tumor cells demonstrated enlarged, hyperchromatic nuclei with variable amounts of eosinophilic cytoplasm. The cytoplasm was often condensed to the perinuclear area, creating peripheral clearing. By immunohistochemistry, the pagetoid cells were positive for p40 (6/6) and p63 (7/7) and negative for CDX2 (7/7). The tumor cells showed mutant-type staining for p53 in five of seven cases. One of the patients had pagetoid tumor cells at the resection margin and subsequently had recurrent disease 2 years later. All other patients had negative resection margins and did not have local recurrence. Four cases of pagetoid spread in the context of EAC were used as a comparison group. Previously published studies were also analyzed. These tumors were all located in the distal esophagus or gastroesophageal junction. All cases were associated with underlying invasive EAC. Pagetoid spread associated with EAC often had cytoplasmic vacuoles or mucin. They were more frequently positive for CK7 than pagetoid ESCC (p = 0.01). Both ESCC and EAC may give rise to pagetoid spread of tumor cells within surface squamous epithelium. Pagetoid spread from ESCC and EAC have overlapping morphologic features. P40 and p63 immunostains can facilitate the distinction between ESCC and EAC. P53 immunostain can aid in confirmation of malignancy. Understanding their overlapping pathologic features will help pathologists avoid pitfalls and diagnose these lesions correctly on biopsy specimens.
    Language English
    Publishing date 2024-04-26
    Publishing country Germany
    Document type Journal Article
    ZDB-ID 1184867-4
    ISSN 1432-2307 ; 0945-6317
    ISSN (online) 1432-2307
    ISSN 0945-6317
    DOI 10.1007/s00428-024-03788-7
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  7. Article ; Online: Update on hepatocellular carcinoma: Pathologists' review.

    El Jabbour, Tony / Lagana, Stephen M / Lee, Hwajeong

    World journal of gastroenterology

    2019  Volume 25, Issue 14, Page(s) 1653–1665

    Abstract: Histopathologic diversity and several distinct histologic subtypes of hepatocellular carcinoma (HCC) are well-recognized. Recent advances in molecular pathology and growing knowledge about the biology associated with distinct histologic features and ... ...

    Abstract Histopathologic diversity and several distinct histologic subtypes of hepatocellular carcinoma (HCC) are well-recognized. Recent advances in molecular pathology and growing knowledge about the biology associated with distinct histologic features and immuno-profile in HCC allowed pathologists to update classifications. Improving sub-classification will allow for more clinically relevant diagnoses and may allow for stratification into biologically meaningful subgroups. Therefore, immuno-histochemical and molecular testing are not only diagnostically useful, but also are being incorporated as crucial components in predicting prognosis of the patients with HCC. Possibilities of targeted therapy are being explored in HCC, and it will be important for pathologists to provide any data that may be valuable from a theranostic perspective. Herein, we review and provide updates regarding the pathologic sub-classification of HCC. Pathologic diagnostic approach and the role of biomarkers as prognosticators are reviewed. Further, the histopathology of four particular subtypes of HCC: Steatohepatitic, clear cell, fibrolamellar and scirrhous - and their clinical relevance, and the recent consensus on combined HCC-cholangiocarcinoma is summarized. Finally, emerging novel biomarkers and new approaches to HCC stratification are reviewed.
    MeSH term(s) Biomarkers, Tumor/analysis ; Biomarkers, Tumor/metabolism ; Carcinoma, Hepatocellular/classification ; Carcinoma, Hepatocellular/mortality ; Carcinoma, Hepatocellular/pathology ; Carcinoma, Hepatocellular/therapy ; Cholangiocarcinoma/classification ; Cholangiocarcinoma/mortality ; Cholangiocarcinoma/pathology ; Cholangiocarcinoma/therapy ; Humans ; Liver/pathology ; Liver Neoplasms/classification ; Liver Neoplasms/mortality ; Liver Neoplasms/pathology ; Liver Neoplasms/therapy ; Patient Selection ; Prognosis ; Theranostic Nanomedicine/methods
    Chemical Substances Biomarkers, Tumor
    Language English
    Publishing date 2019-04-22
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 2185929-2
    ISSN 2219-2840 ; 1007-9327
    ISSN (online) 2219-2840
    ISSN 1007-9327
    DOI 10.3748/wjg.v25.i14.1653
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  8. Article ; Online: Narrowing the focus on fibrostenotic eosinophilic esophagitis.

    Lagana, Stephen M / Abrams, Julian A

    Gastrointestinal endoscopy

    2014  Volume 79, Issue 4, Page(s) 586–588

    MeSH term(s) Eosinophilic Esophagitis/diagnosis ; Female ; Humans ; Male
    Language English
    Publishing date 2014-04
    Publishing country United States
    Document type Comment ; Editorial
    ZDB-ID 391583-9
    ISSN 1097-6779 ; 0016-5107
    ISSN (online) 1097-6779
    ISSN 0016-5107
    DOI 10.1016/j.gie.2013.12.008
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  9. Article ; Online: Update on Ancillary Testing in the Evaluation of High-Grade Liver Tumors.

    Koehne de Gonzalez, Anne / Lagana, Stephen M

    Surgical pathology clinics

    2018  Volume 11, Issue 2, Page(s) 367–375

    Abstract: Tissue diagnosis is the gold standard for mass lesions of the liver, but needle core biopsies may sometimes prove challenging. Presented here is a review of a panel of immunohistochemical stains, including hepatocyte in paraffin 1, arginase-1, polyclonal ...

    Abstract Tissue diagnosis is the gold standard for mass lesions of the liver, but needle core biopsies may sometimes prove challenging. Presented here is a review of a panel of immunohistochemical stains, including hepatocyte in paraffin 1, arginase-1, polyclonal carcinoembryonic antigen, CD10, bile salt export pump, glypican-3, as well as in situ hybridization for albumin RNA, to establish hepatocellular origin in cases in which hepatocellular carcinoma is suspected but the sample is limited or the morphology is challenging, as it may be with cases of scirrhous, fibrolamellar carcinoma, intrahepatic cholangiocarcinoma, and combined hepatocellular-cholangiocarcinoma.
    MeSH term(s) Albumins/genetics ; Bile Duct Neoplasms/diagnosis ; Biomarkers, Tumor/metabolism ; Carcinoma, Hepatocellular/diagnosis ; Cholangiocarcinoma/diagnosis ; Diagnosis, Differential ; Humans ; In Situ Hybridization/methods ; Liver Neoplasms/diagnosis
    Chemical Substances Albumins ; Biomarkers, Tumor
    Language English
    Publishing date 2018-03-26
    Publishing country United States
    Document type Journal Article ; Review
    ISSN 1875-9157
    ISSN (online) 1875-9157
    DOI 10.1016/j.path.2018.02.004
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  10. Article ; Online: A pan-cancer analysis implicates human

    Postler, Thomas S / Wang, Anqi / Brundu, Francesco G / Wang, Pingzhang / Wu, Zikai / Butler, Kelly E / Grinberg-Bleyer, Yenkel / Krishnareddy, Suneeta / Lagana, Stephen M / Saqi, Anjali / Oeckinghaus, Andrea / Rabadan, Raul / Ghosh, Sankar

    Proceedings of the National Academy of Sciences of the United States of America

    2023  Volume 120, Issue 46, Page(s) e2312595120

    Abstract: The NF-κB family of transcription factors and the Ras family of small GTPases are important mediators of proproliferative signaling that drives tumorigenesis and carcinogenesis. The κB-Ras proteins were previously shown to inhibit both NF-κB and Ras ... ...

    Abstract The NF-κB family of transcription factors and the Ras family of small GTPases are important mediators of proproliferative signaling that drives tumorigenesis and carcinogenesis. The κB-Ras proteins were previously shown to inhibit both NF-κB and Ras activation through independent mechanisms, implicating them as tumor suppressors with potentially broad relevance to human cancers. In this study, we have used two mouse models to establish the relevance of the κB-Ras proteins for tumorigenesis. Additionally, we have utilized a pan-cancer bioinformatics analysis to explore the role of the κB-Ras proteins in human cancers. Surprisingly, we find that the genes encoding κB-Ras 1 (
    MeSH term(s) Animals ; Humans ; Mice ; Carcinogenesis/genetics ; Cell Transformation, Neoplastic/genetics ; Genes, ras ; NF-kappa B/metabolism ; ras Proteins/metabolism ; Genes, Tumor Suppressor ; Carrier Proteins/genetics
    Chemical Substances NF-kappa B ; ras Proteins (EC 3.6.5.2) ; NKIRAS1 protein, human ; Carrier Proteins
    Language English
    Publishing date 2023-11-06
    Publishing country United States
    Document type Journal Article
    ZDB-ID 209104-5
    ISSN 1091-6490 ; 0027-8424
    ISSN (online) 1091-6490
    ISSN 0027-8424
    DOI 10.1073/pnas.2312595120
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