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  1. Article ; Online: Mesothelioma: morphologic and immunohistochemical findings.

    Churg, Andrew

    Pathologie (Heidelberg, Germany)

    2024  

    Abstract: This paper reviews some basic and some new concepts in the diagnosis of mesothelioma. The term "malignant mesothelioma" is no longer recommended; rather, any tumor labeled "mesothelioma" is presumed to be malignant. Clinical and radiologic information is ...

    Title translation Mesotheliom: morphologische und immunhistochemische Befunde.
    Abstract This paper reviews some basic and some new concepts in the diagnosis of mesothelioma. The term "malignant mesothelioma" is no longer recommended; rather, any tumor labeled "mesothelioma" is presumed to be malignant. Clinical and radiologic information is very useful in the diagnosis of mesothelioma; in particular, nodular pleural thickening on CT is usually a marker of malignancy. The literature on markers that separate mesotheliomas from metastatic carcinomas has become very complex and frequently misleading, with many recommended markers actually demonstrating poor specificity. However, newer data show that a combination of HEG1 (clone SKM9-2) and claudin‑4 staining provides extremely high accuracy in separating epithelioid mesotheliomas from non-small-cell lung carcinomas with just two immunostains. This combination works at other sites as well, but caution should be used when high-grade serous carcinoma is in the differential, because all "mesothelioma" markers can also stain high-grade serous carcinomas. There are, unfortunately, no sensitive or specific markers for sarcomatoid mesotheliomas. A variety of immunohistochemical and fluorescence in situ hybridization (FISH) markers are useful in separating benign from malignant mesothelial proliferations; immunohistochemal staining for BAP1, MTAP (or CDKN2A FISH), and NF2/Merlin (or NF2 FISH) will enable the diagnosis of most mesotheliomas. Mesothelioma in situ is now recognized as either a single layer of bland cuboidal mesothelial cells that have lost BAP1, and sometimes MTAP, on immunohistochemical staining, or a process that is morphologically identical to a well-differentiated papillary mesothelial tumor that has lost BAP1/MTAP. Mesothelioma in situ probably always progresses to invasive mesothelioma, but this process is often quite slow.
    Language English
    Publishing date 2024-04-03
    Publishing country Germany
    Document type Journal Article ; Review
    ISSN 2731-7196
    ISSN (online) 2731-7196
    DOI 10.1007/s00292-024-01317-6
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: New developments in mesothelial pathology.

    Churg, Andrew

    Histopathology

    2023  Volume 84, Issue 1, Page(s) 136–152

    Abstract: This review article examines some new and some problem areas in mesothelial pathology, four of which are discussed, as follows. (1) The concept of mesothelioma in situ: this lesion is defined as a single layer of bland mesothelial cells without evidence ... ...

    Abstract This review article examines some new and some problem areas in mesothelial pathology, four of which are discussed, as follows. (1) The concept of mesothelioma in situ: this lesion is defined as a single layer of bland mesothelial cells without evidence of invasion, but that have lost BAP1 and/or MTAP by immunohistochemistry. Benign reactions can exactly mimic mesothelioma in situ, but a hint to the correct diagnosis is a story of recurrent pleural effusions/ascites of unknown aetiology without radiological or direct visual evidence of tumour. (2) The nature of well-differentiated papillary mesothelial tumour (WDPMT): WDPMT has a long history of arguments regarding its behaviour, and this uncertainty can now be seen to arise, in part, from the observation that some forms of mesothelioma in situ microscopically look exactly like WDPMT. Hence, it is recommended to always run at least a BAP1 stain on any lesion that looks like WDPMT. Both flat and WDPMT-like mesothelioma in situ are strongly associated with eventual development of invasive mesothelioma, but this process is relatively slow. (3) New immunostains for separating mesothelioma from other tumours: here, it is proposed that in most cases, and particularly when the differential is epithelioid mesothelioma versus non-small cell lung cancer, one can make this separation with extremely high sensitivity and specificity using just two stains: HEG1 and claudin-4. (4) Markers for separating benign from malignant mesothelial proliferations: this topic is briefly reviewed, with an indication of which markers are generally accepted and the best utilisation and possible limitations of each marker.
    MeSH term(s) Humans ; Carcinoma, Non-Small-Cell Lung/diagnosis ; Lung Neoplasms/pathology ; Biomarkers, Tumor ; Tumor Suppressor Proteins ; Mesothelioma, Malignant/diagnosis ; Mesothelioma/diagnosis ; Mesothelioma/pathology ; Neoplasms, Mesothelial/diagnosis ; Diagnosis, Differential ; Ubiquitin Thiolesterase ; Pleural Neoplasms/pathology
    Chemical Substances Biomarkers, Tumor ; Tumor Suppressor Proteins ; Ubiquitin Thiolesterase (EC 3.4.19.12)
    Language English
    Publishing date 2023-09-11
    Publishing country England
    Document type Journal Article ; Review
    ZDB-ID 131914-0
    ISSN 1365-2559 ; 0309-0167
    ISSN (online) 1365-2559
    ISSN 0309-0167
    DOI 10.1111/his.15007
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    Zs.A 1328: Show issues Location:
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  3. Book: Atlas of interstitial lung disease pathology

    Churg, Andrew / Müller, Nestor L.

    pathology with high resolution CT correlations

    2020  

    Author's details Andrew Churg, MD, Nestor Müller L., MD
    Language English
    Size x, 299 Seiten, Illustrationen
    Edition Second edition
    Publisher Wolters Kluwer
    Publishing place Philadelphia
    Publishing country United States
    Document type Book
    Note Zugang zu Online-Ausgabe über Code
    HBZ-ID HT020373336
    ISBN 978-1-9751-2467-0 ; 1-9751-2467-7
    Database Catalogue ZB MED Medicine, Health

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    2020 A 321 available for loan (reading room) Lesesaal EG
    Zugang zu Online-Ausgabe über Code aus lizenzrechtlichen Gründen nicht verfügbar

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  4. Article ; Online: Hypersensitivity pneumonitis: new concepts and classifications.

    Churg, Andrew

    Modern pathology : an official journal of the United States and Canadian Academy of Pathology, Inc

    2021  Volume 35, Issue Suppl 1, Page(s) 15–27

    Abstract: The clinical and pathologic diagnosis of hypersensitivity pneumonitis has been confounded by conflicting definitions, with two recent guidelines suggesting that hypersensitivity pneumonitis simply be diagnosed as nonfibrotic or fibrotic. Nonfibrotic ... ...

    Abstract The clinical and pathologic diagnosis of hypersensitivity pneumonitis has been confounded by conflicting definitions, with two recent guidelines suggesting that hypersensitivity pneumonitis simply be diagnosed as nonfibrotic or fibrotic. Nonfibrotic hypersensitivity pneumonitis is usually characterized by a bronchiolocentric chronic interstitial inflammatory infiltrate, frequently but by no means always with associated granulomas or giant cells. Fibrotic hypersensitivity pneumonitis may take the form of interstitial fibrosis confined to the peribronchiolar regions, or fibrotic nonspecific interstitial pneumonia, or a process similar to and sometimes indistinguishable from usual interstitial pneumonia/idiopathic interstitial fibrosis, but the exact pathologic features that favor a diagnosis of fibrotic hypersensitivity pneumonitis are disputed. Granulomas/giant cells are much less frequent in fibrotic compared to nonfibrotic hypersensitivity pneumonitis. Extensive peribronchiolar metaplasia, particularly peribronchiolar metaplasia affecting more than half the bronchioles, supports a diagnosis of fibrotic hypersensitivity pneumonitis over usual interstitial pneumonia, as does the presence of predominantly peribronchiolar disease with relative subpleural sparing. Clinical and CT features are crucial to the diagnosis of hypersensitivity pneumonitis: sparing of the lung bases, centrilobular nodules, air-trapping, or the triple density sign with fibrosis favor a diagnosis of fibrotic hypersensitivity pneumonitis. At this point there are no molecular tests that reliably separate fibrotic hypersensitivity pneumonitis from other forms of interstitial lung disease. Currently the separation of fibrotic hypersensitivity pneumonitis from usual interstitial pneumonia is crucial to treatment (immunosuppressives for the former, anti-fibrotics for the latter) but this approach is changing and all progressive fibrosing interstitial pneumonias will probably be treated with antifibrotics in the future.
    MeSH term(s) Alveolitis, Extrinsic Allergic/diagnosis ; Alveolitis, Extrinsic Allergic/pathology ; Biopsy ; Diagnosis, Differential ; Humans ; Idiopathic Pulmonary Fibrosis/diagnosis ; Idiopathic Pulmonary Fibrosis/pathology ; Lung/pathology ; Lung Diseases, Interstitial/diagnosis ; Lung Diseases, Interstitial/pathology
    Language English
    Publishing date 2021-09-16
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 645073-8
    ISSN 1530-0285 ; 0893-3952
    ISSN (online) 1530-0285
    ISSN 0893-3952
    DOI 10.1038/s41379-021-00866-y
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: Correspondence: SPARC, HEG1, and the Diagnosis of Epithelioid Mesothelioma.

    Churg, Andrew / Naso, Julia R

    The American journal of surgical pathology

    2024  Volume 48, Issue 5, Page(s) 632

    MeSH term(s) Humans ; Biomarkers, Tumor/genetics ; Diagnosis, Differential ; Epithelioid Cells ; Lung Neoplasms/diagnosis ; Membrane Proteins ; Mesothelioma/diagnosis ; Mesothelioma, Malignant/diagnosis ; Osteonectin
    Chemical Substances Biomarkers, Tumor ; HEG1 protein, human ; Membrane Proteins ; Osteonectin ; SPARC protein, human
    Language English
    Publishing date 2024-01-15
    Publishing country United States
    Document type Letter
    ZDB-ID 752964-8
    ISSN 1532-0979 ; 0147-5185
    ISSN (online) 1532-0979
    ISSN 0147-5185
    DOI 10.1097/PAS.0000000000002178
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    Zs.A 1356: Show issues Location:
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  6. Article ; Online: Centrilobular Fibrosis in Fibrotic (Chronic) Hypersensitivity Pneumonitis, Usual Interstitial Pneumonia, and Connective Tissue Disease-Associated Interstitial Lung Disease.

    Churg, Andrew

    Archives of pathology & laboratory medicine

    2020  Volume 144, Issue 12, Page(s) 1509–1516

    Abstract: Context.—: Various pulmonary diseases can produce centrilobular (peribronchiolar) fibrosis, which may be isolated or associated with other patterns of more diffuse fibrosis. The major forms of interstitial lung disease in which centrilobular fibrosis is ...

    Abstract Context.—: Various pulmonary diseases can produce centrilobular (peribronchiolar) fibrosis, which may be isolated or associated with other patterns of more diffuse fibrosis. The major forms of interstitial lung disease in which centrilobular fibrosis is found are fibrotic (chronic) hypersensitivity pneumonitis, connective tissue disease-associated interstitial lung disease, and (a disputed issue) usual interstitial pneumonia/idiopathic interstitial fibrosis.
    Objective.—: To review recent literature that addresses separation of these entities.
    Data sources.—: Data comprised recent publications.
    Conclusions.—: In a specially constructed multidisciplinary discussion exercise, it was found that peribronchiolar metaplasia affecting more than half the bronchioles or more than 2 foci of peribronchiolar metaplasia per square centimeter of biopsy area was strongly associated with a confident diagnosis of fibrotic hypersensitivity pneumonitis. Giant cells or granulomas were only found in cases with a greater than 50% diagnostic confidence in hypersensitivity pneumonitis. Conversely, greater numbers of fibroblast foci per square centimeter and increasing measured amounts of subpleural fibrosis favored a diagnosis of usual interstitial pneumonia. Recent data also suggest that centrilobular fibrosis can be found in usual interstitial pneumonia, although the presence of centrilobular fibrosis statistically favors an alternate diagnosis. Connective tissue disease is a major confounder because many patterns are very similar to fibrotic hypersensitivity pneumonitis or usual interstitial pneumonia. Genetic abnormalities, such as the MUC5B minor allele overlap, in these conditions and at this point cannot be used for discrimination. Thus, the separation of fibrotic hypersensitivity pneumonitis and usual interstitial pneumonia remains a difficult problem. Accurate biopsy diagnosis of all of these diseases requires correlation with imaging and clinical findings, and is crucial for treatment.
    MeSH term(s) Alveolitis, Extrinsic Allergic/diagnosis ; Alveolitis, Extrinsic Allergic/pathology ; Biopsy ; Chronic Disease ; Connective Tissue Diseases/diagnosis ; Connective Tissue Diseases/pathology ; Granuloma/diagnosis ; Granuloma/pathology ; Humans ; Idiopathic Pulmonary Fibrosis/diagnosis ; Idiopathic Pulmonary Fibrosis/pathology ; Lung/pathology ; Lung Diseases, Interstitial/diagnosis ; Lung Diseases, Interstitial/pathology
    Language English
    Publishing date 2020-04-01
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 194119-7
    ISSN 1543-2165 ; 0363-0153 ; 0096-8528 ; 0003-9985
    ISSN (online) 1543-2165
    ISSN 0363-0153 ; 0096-8528 ; 0003-9985
    DOI 10.5858/arpa.2019-0628-RA
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  7. Article ; Online: Update on Silicosis.

    Churg, Andrew / Muller, Nestor L

    Surgical pathology clinics

    2023  Volume 17, Issue 2, Page(s) 193–202

    Abstract: Although silicosis has been an established disease with a recognized cause for more than 100 years, many workers continue to be exposed to silica and new outbreaks of disease continue to occur. This article describes some of the well-established and new ... ...

    Abstract Although silicosis has been an established disease with a recognized cause for more than 100 years, many workers continue to be exposed to silica and new outbreaks of disease continue to occur. This article describes some of the well-established and new exposures, including denim sandblasting, artificial stone cutting, and some forms of "coal worker's pneumoconiosis." The authors review the imaging and pathology of acute silicosis (silicoproteinosis), simple silicosis, and progressive massive fibrosis and summarize known and putative associations of silica exposure, including tuberculosis, lung cancer, connective tissue disease (especially systemic sclerosis), and vasculitis.
    MeSH term(s) Silicosis/pathology ; Silicosis/diagnosis ; Silicosis/etiology ; Humans ; Occupational Exposure/adverse effects ; Silicon Dioxide/adverse effects
    Chemical Substances Silicon Dioxide (7631-86-9)
    Language English
    Publishing date 2023-12-11
    Publishing country United States
    Document type Journal Article ; Review
    ISSN 1875-9157
    ISSN (online) 1875-9157
    DOI 10.1016/j.path.2023.11.005
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  8. Article ; Online: Separation of Benign From Malignant Mesothelial Proliferations Using YAP-TAZ Immunohistochemistry.

    Lee, Jamie / Cheung, Simon / Churg, Andrew

    Modern pathology : an official journal of the United States and Canadian Academy of Pathology, Inc

    2024  Volume 37, Issue 5, Page(s) 100473

    Language English
    Publishing date 2024-04-05
    Publishing country United States
    Document type Letter
    ZDB-ID 645073-8
    ISSN 1530-0285 ; 0893-3952
    ISSN (online) 1530-0285
    ISSN 0893-3952
    DOI 10.1016/j.modpat.2024.100473
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  9. Book: Atlas of interstitial lung disease pathology

    Churg, Andrew / Müller, Nestor L.

    pathology with high resolution CT correlations

    2014  

    Author's details Andrew Churg ; Nestor L. Müller
    Keywords Lung Diseases, Interstitial / pathology ; Tomography, X-Ray Computed
    Language English
    Size VI, 245 S. : zahlr. Ill.
    Publisher Wolters Kluwer Lipincott Williams & Wilkins
    Publishing place Philadelphia, Pa
    Publishing country United States
    Document type Book
    Note Includes bibliographical references and index
    Accompanying material Zugang zur Internetausgabe über Code
    HBZ-ID HT017803061
    ISBN 978-1-4511-7643-8 ; 1-4511-7643-0
    Database Catalogue ZB MED Medicine, Health

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    In stock of ZB MED Cologne/Königswinter

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    2014 A 137 available for loan (reading room) Lesesaal EG
    Zugang zur Internetausgabe über Code aus lizenzrechtlichen Gründen nicht verfügbar

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  10. Article ; Online: Impact of Lung Biopsy Information on Treatment Strategy of Patients with Interstitial Lung Diseases: The Glass Is Half Full.

    Marinescu, Daniel-Costin / Churg, Andrew

    Annals of the American Thoracic Society

    2022  Volume 19, Issue 5, Page(s) 720–722

    MeSH term(s) Biopsy ; Humans ; Lung/diagnostic imaging ; Lung Diseases, Interstitial/diagnosis ; Lung Diseases, Interstitial/therapy ; Thorax
    Language English
    Publishing date 2022-04-29
    Publishing country United States
    Document type Editorial ; Comment
    ZDB-ID 2717461-X
    ISSN 2325-6621 ; 1943-5665 ; 2325-6621
    ISSN (online) 2325-6621 ; 1943-5665
    ISSN 2325-6621
    DOI 10.1513/AnnalsATS.202111-1315ED
    Database MEDical Literature Analysis and Retrieval System OnLINE

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