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Article ; Online: Clear Cell Renal Cell Carcinoma with Prominent Micropapillary Pattern: A Case Report of a Previously Undescribed Morphology.

Fahoum, Ibrahim / Hershkovitz, Dov / Erental, Ariel / Argani, Pedram

International journal of surgical pathology

2023 Volume 32, Issue 4, Page(s) 821–824

Abstract: The classic morphology of clear cell renal cell carcinoma consists of nests of cells with clear cytoplasm. Nevertheless, other histologic patterns may be seen including cells with eosinophilic cytoplasm, bizarre multinucleated giant tumor cells and ... ...

Abstract	The classic morphology of clear cell renal cell carcinoma consists of nests of cells with clear cytoplasm. Nevertheless, other histologic patterns may be seen including cells with eosinophilic cytoplasm, bizarre multinucleated giant tumor cells and pseudopapillary structures. In this article, we present the first case of clear cell renal cell carcinoma with a prominent micropapillary pattern.
MeSH term(s)	Humans ; Carcinoma, Renal Cell/pathology ; Carcinoma, Renal Cell/diagnosis ; Carcinoma, Renal Cell/surgery ; Kidney Neoplasms/pathology ; Kidney Neoplasms/diagnosis ; Kidney Neoplasms/surgery ; Male ; Middle Aged ; Female ; Nephrectomy ; Biomarkers, Tumor/analysis
Chemical Substances	Biomarkers, Tumor
Language	English
Publishing date	2023-10-16
Publishing country	United States
Document type	Case Reports ; Journal Article
ZDB-ID	1336393-1
ISSN	1940-2465 ; 1066-8969
ISSN (online)	1940-2465
ISSN	1066-8969
DOI	10.1177/10668969231195071
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Article ; Online: PET radiotracers for whole-body in vivo molecular imaging of prostatic neuroendocrine malignancies.

Cohen, Dan / Hazut Krauthammer, Shir / Fahoum, Ibrahim / Kesler, Mikhail / Even-Sapir, Einat

European radiology

2023 Volume 33, Issue 9, Page(s) 6502–6512

Abstract: Prostatic neuroendocrine malignancies represent a spectrum of diseases. Treatment-induced neuroendocrine differentiation (tiNED) in hormonally treated adenocarcinoma has been the subject of a large amount of recent research. However, the identification ... ...

Abstract	Prostatic neuroendocrine malignancies represent a spectrum of diseases. Treatment-induced neuroendocrine differentiation (tiNED) in hormonally treated adenocarcinoma has been the subject of a large amount of recent research. However, the identification of neuroendocrine features in treatment-naïve prostatic tumor raises a differential diagnosis between prostatic adenocarcinoma with de novo neuroendocrine differentiation (dNED) versus one of the primary prostatic neuroendocrine tumors (P-NETs) and carcinomas (P-NECs). While [
MeSH term(s)	Male ; Humans ; Positron Emission Tomography Computed Tomography/methods ; Fluorodeoxyglucose F18 ; Prostate/pathology ; Gallium Radioisotopes ; Ligands ; Prostatic Neoplasms/pathology ; Adenocarcinoma/diagnostic imaging ; Molecular Imaging ; Somatostatin
Chemical Substances	Fluorodeoxyglucose F18 (0Z5B2CJX4D) ; Gallium Radioisotopes ; Ligands ; Somatostatin (51110-01-1)
Language	English
Publishing date	2023-04-13
Publishing country	Germany
Document type	Journal Article ; Review
ZDB-ID	1085366-2
ISSN	1432-1084 ; 0938-7994 ; 1613-3749
ISSN (online)	1432-1084
ISSN	0938-7994 ; 1613-3749
DOI	10.1007/s00330-023-09619-8
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Article ; Online: Revisiting the issue of "beach balls" in holmium laser enucleation of prostate: clinical and histological characterization.

Herzberg, Haim / Savin, Ziv / Fahoum, Ibrahim / Lifshitz, Karin / Schwarztuch Gildor, Omri / Veredgorn, Yotam / Marom, Ron / Yossepowitch, Ofer / Sofer, Mario

World journal of urology

2024 Volume 42, Issue 1, Page(s) 201

Abstract: Purpose: To clinically and histologically characterize prostatic nodules resistant to morcellation ("beach balls," BBs).: Patients and methods: We reviewed a consecutive cohort of 559 holmium laser enucleation of the prostate (HoLEP) procedures ... ...

Abstract	Purpose: To clinically and histologically characterize prostatic nodules resistant to morcellation ("beach balls," BBs). Patients and methods: We reviewed a consecutive cohort of 559 holmium laser enucleation of the prostate (HoLEP) procedures performed between January 2020 and November 2023. The BBs group comprised 55 men (10%) and the control group comprised 504 men (90%). The clinical, intraoperative, outcome, and histologic data were statistically processed for the prediction of the presence of BBs and their influence on the perioperative course and outcome. Results: The BBs group in comparison to the controls was older (75 vs 73 years, respectively, p = 0.009) and had higher rates of chronic retention (51 vs 29%, p = 0.001), larger prostates on preoperative abdominal ultrasound (AUS) (140 vs 80 cc, p = 0.006 Conclusions: BBs are expected in older patients and cases of chronic retention. Prostatic volume is the most reliable predictor of their presence. They contribute to prolonged operating time and increased risk of complications. The predominantly stromal composition of the BBs apparently confers their resistance to morcellation.
MeSH term(s)	Aged ; Humans ; Male ; Holmium ; Laser Therapy/methods ; Lasers, Solid-State/therapeutic use ; Prostate/surgery ; Prostate/pathology ; Prostatectomy/methods ; Prostatic Hyperplasia/complications ; Retrospective Studies ; Transurethral Resection of Prostate/methods ; Treatment Outcome
Chemical Substances	Holmium (W1XX32SQN1)
Language	English
Publishing date	2024-03-28
Publishing country	Germany
Document type	Journal Article
ZDB-ID	380333-8
ISSN	1433-8726 ; 0724-4983
ISSN (online)	1433-8726
ISSN	0724-4983
DOI	10.1007/s00345-024-04902-9
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Zs.A 1832: Show issues

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Article: A combined MRI-PSAD risk stratification system for prioritizing prostate biopsies.

Bar-Yaakov, Noam / Savin, Ziv / Fahoum, Ibrahim / Barnes, Sophie / Bar-Yosef, Yuval / Yossepowitch, Ofer / Keren-Paz, Gal / Mano, Roy

The Canadian journal of urology

2024 Volume 31, Issue 1, Page(s) 11793–11801

Abstract: Introduction: Prostate cancer screening with PSA is associated with low specificity; furthermore, little is known about the optimal timing of biopsy. We aimed to evaluate whether a risk classification system combining PSA density (PSAD) and mpMRI can ...

Abstract	Introduction: Prostate cancer screening with PSA is associated with low specificity; furthermore, little is known about the optimal timing of biopsy. We aimed to evaluate whether a risk classification system combining PSA density (PSAD) and mpMRI can predict clinically significant cancer and determine biopsy timing. Materials and methods: We reviewed the medical records of 256 men with a PI-RADS ≥ 3 lesion on mpMRI who underwent transperineal targeted and systematic biopsies of the prostate between 2017-2019. Patients were stratified into three risk groups based on PSAD and mpMRI findings. The study endpoint was clinically significant prostate cancer (CSPC). The association between the risk groups and CSPC was evaluated. Results: Based on the proposed risk stratification system 42/256 men (16%) were high-risk (mpMRI finding of extra-prostatic extension and/or seminal vesicle invasion and/or a PI-RADS 5 lesion with a PSAD > 0.15 ng/mL²), 164/256 (64%) intermediate-risk (PI-RADS 4-5 lesions and/or PSAD > 0.15ng/mL² with no high-risk features) and 50/256 (20%) low-risk (PI-RADS 3 lesions and PSAD ≤ 0.15 ng/mL²). High-risk patients had significantly higher rates of CSPC (76%) when compared to intermediate-risk (26%) and low-risk (4%). On multivariable logistic regression analysis adjusted for age, previous biopsy, and clinical T-stage we found an association between intermediate-risk (OR = 4.84, p = 0.038) and high-risk (OR = 40.13, p < 0.001) features and CSPC. High-risk patients had a shorter median biopsy delay time (110 days) compared to intermediate- and low-risk patients (141 and 147 days, respectively). We did not find an association between biopsy delay and CSPC. Conclusions: Our findings suggest that a three-tier risk classification system based on mpMRI and PSAD can identify patients at high-risk for CSPC who may benefit from earlier biopsy.
MeSH term(s)	Humans ; Male ; Early Detection of Cancer ; Image-Guided Biopsy ; Magnetic Resonance Imaging ; Prostate/diagnostic imaging ; Prostate/pathology ; Prostate-Specific Antigen ; Prostatic Neoplasms/diagnostic imaging ; Prostatic Neoplasms/pathology ; Retrospective Studies ; Risk Assessment
Chemical Substances	Prostate-Specific Antigen (EC 3.4.21.77)
Language	English
Publishing date	2024-02-05
Publishing country	Canada
Document type	Journal Article
ZDB-ID	2064475-9
ISSN	1195-9479
ISSN	1195-9479
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Article ; Online: The role of tumor density in predicting significant cancer on targeted biopsy of the prostate.

Erlich, Guy / Savin, Ziv / Fahoum, Ibrahim / Barnes, Sophie / Dahan, Eliran / Bar-Yosef, Yuval / Yossepowitch, Ofer / Keren-Paz, Gal / Mano, Roy

Urologic oncology

2023 Volume 41, Issue 7, Page(s) 323.e9–323.e15

Abstract: Objective: Multiparametric magnetic resonance imaging (mpMRI) is central to diagnosing prostate cancer; however, not all imaged lesions represent clinically significant tumors. We aimed to evaluate the association between the relative tumor volume on ... ...

Abstract	Objective: Multiparametric magnetic resonance imaging (mpMRI) is central to diagnosing prostate cancer; however, not all imaged lesions represent clinically significant tumors. We aimed to evaluate the association between the relative tumor volume on mpMRI and clinically significant prostate cancer on biopsy. Materials and methods: We retrospectively reviewed the medical records of 340 patients who underwent combined transperineal targeted and systematic prostate biopsies between 2017 and 2021. Tumor volume was estimated based on the mpMRI diameter of suspected lesions. Relative tumor volume (tumor density) was calculated by dividing the tumor and prostate volumes. The study outcome was clinically significant cancer on biopsy. Logistic regression analyses were used to evaluate the association between tumor density and the outcome. The cutoff for tumor density was determined with ROC curves. Results: Median estimated prostate and peripheral zone tumor volumes were 55cm Conclusion: Peripheral zone tumor density is associated with clinically significant prostate cancer in patients with PI-RADS 4 and 5 mpMRI lesions. Future studies are required to validate our findings and evaluate the role of tumor density in avoiding unnecessary biopsies.
MeSH term(s)	Male ; Humans ; Prostate/diagnostic imaging ; Prostate/pathology ; Prostatic Neoplasms/diagnostic imaging ; Prostatic Neoplasms/pathology ; Prostate-Specific Antigen ; Magnetic Resonance Imaging/methods ; Retrospective Studies ; Image-Guided Biopsy/methods
Chemical Substances	Prostate-Specific Antigen (EC 3.4.21.77)
Language	English
Publishing date	2023-05-18
Publishing country	United States
Document type	Journal Article
ZDB-ID	1336505-8
ISSN	1873-2496 ; 1078-1439
ISSN (online)	1873-2496
ISSN	1078-1439
DOI	10.1016/j.urolonc.2023.03.009
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Article ; Online: Tumor-to-Tumor Metastasis of Colorectal Adenocarcinoma to Ovarian Cystadenofibroma: A Case Report and Review of the Literature.

Fahoum, Ibrahim / Brazowski, Eli / Hershkovitz, Dov / Aizic, Asaf

International journal of gynecological pathology : official journal of the International Society of Gynecological Pathologists

2019 Volume 39, Issue 3, Page(s) 270–272

Abstract: Tumor-to-tumor metastasis is being described in different types of tumors and in increasing amount of cases. Being aware of this phenomenon is important, as it affects disease stage and treatment approach. In this report, we descried an incidental ... ...

Abstract	Tumor-to-tumor metastasis is being described in different types of tumors and in increasing amount of cases. Being aware of this phenomenon is important, as it affects disease stage and treatment approach. In this report, we descried an incidental histopathologic finding of metastatic adenocarcinoma to an ovarian cystadenofibroma and review cases published previously in the literature.
MeSH term(s)	Adenocarcinoma/pathology ; Aged, 80 and over ; Colorectal Neoplasms/pathology ; Cystadenofibroma/pathology ; Female ; Humans ; Neoplasms, Second Primary/pathology ; Ovarian Neoplasms/pathology
Language	English
Publishing date	2019-03-18
Publishing country	United States
Document type	Case Reports ; Journal Article ; Review
ZDB-ID	604859-6
ISSN	1538-7151 ; 0277-1691
ISSN (online)	1538-7151
ISSN	0277-1691
DOI	10.1097/PGP.0000000000000592
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Article ; Online: Short Training Significantly Improves Ganglion Cell Detection Using an Algorithm-Assisted Approach.

Greenberg, Ariel / Samueli, Benzion / Fahoum, Ibrahim / Farkash, Shai / Greenberg, Orli / Zemser-Werner, Valentina / Sabo, Edmond / Hagege, Rami R / Hershkovitz, Dov

Archives of pathology & laboratory medicine

2022 Volume 147, Issue 2, Page(s) 215–221

Abstract: Context.—: Medical education in pathology relies on the accumulation of experience gained through inspection of numerous samples from each entity. Acquiring sufficient teaching material for rare diseases, such as Hirschsprung disease (HSCR), may be ... ...

Abstract	Context.—: Medical education in pathology relies on the accumulation of experience gained through inspection of numerous samples from each entity. Acquiring sufficient teaching material for rare diseases, such as Hirschsprung disease (HSCR), may be difficult, especially in smaller institutes. The current study makes use of a previously developed decision support system using a decision support algorithm meant to aid pathologists in the diagnosis of HSCR. Objective.—: To assess the effect of a short training session on algorithm-assisted HSCR diagnosis. Design.—: Five pathologists reviewed a data set of 568 image sets (1704 images in total) selected from 50 cases by the decision support algorithm and were tasked with scoring the images for the presence or absence of ganglion cells. The task was repeated a total of 3 times. Each pathologist had to complete a short educational presentation between the second and third iterations. Results.—: The training resulted in a significantly increased rate of correct diagnoses (true positive/negative) and a decreased need for referrals for expert consultation. No statistically significant changes in the rate of false positives/negatives were detected. Conclusions.—: A very short (<10 minutes) training session can greatly improve the pathologist's performance in the algorithm-assisted diagnosis of HSCR. The same approach may be feasible in training for the diagnosis of other rare diseases.
MeSH term(s)	Humans ; Rare Diseases ; Pathologists ; Educational Status ; Algorithms
Language	English
Publishing date	2022-06-18
Publishing country	United States
Document type	Journal Article
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.2021-0481-OA
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Article ; Online: Anterior and apical samplings during transperineal image-guided prostate biopsy.

Savin, Ziv / Dekalo, Snir / Marom, Ron / Bar-Yaakov, Noam / Fahoum, Ibrahim / Barnes, Sophie / Yossepowitch, Ofer / Keren-Paz, Gal / Mano, Roy

Urologic oncology

2021 Volume 40, Issue 1, Page(s) 5.e15–5.e21

Abstract: Introduction: Concurrent systematic biopsies during image-guided targeted biopsies of the prostate were found to improve the detection rate of clinically significant prostate cancer (CSPC). However, these biopsies do not routinely include anterior or ... ...

Abstract	Introduction: Concurrent systematic biopsies during image-guided targeted biopsies of the prostate were found to improve the detection rate of clinically significant prostate cancer (CSPC). However, these biopsies do not routinely include anterior or apical sampling. We aimed to evaluate the significance of anterior and apical samplings during combined biopsies. Methods: After obtaining institutional review board approval we identified 303 consecutive patients who underwent transperineal combined biopsies of the prostate between 2017-2020. Systematic biopsies were obtained from the peripheral zone, anterior zone, and apex. Study outcomes included CSPC and any cancer on anterior or apical biopsies. Logistic regression analyses were used to evaluate the association between pre-biopsy characteristics and study outcomes. Results: Median prostatic-specific-antigen value was 6.8 ng/dL. Most patients had stage T1c disease (77%). Overall, combined biopsies detected CSPC in 87 patients (29%). Any cancer and CSPC in the anterior zone were found in 54 (18%) and 19 (6%) patients, respectively. Any cancer and CSPC in the apex were found in 54 (18%) and 16 (5%) patients, respectively. Anterior/apical samplings upgraded the pathological result in 19 patients (6%). Logistic regression analyses demonstrated that PI-RADS 5 lesions predicted the presence of CSPC in both the anterior zone (OR = 8, 95%CI = 3-22, P <0.001) and apex (OR = 4, 95%CI = 1-10, P = 0.01). Conclusions: Avoiding anterior and apical samplings during prostate biopsy does not result in substantial under-diagnosis of significant cancer. However, these areas are easily accessible using the transperineal approach and should be sampled in selected patients, particularly those with PI-RADS 5 lesions.
MeSH term(s)	Aged ; Humans ; Image-Guided Biopsy/methods ; Male ; Middle Aged ; Perineum ; Prostate/pathology ; Prostatic Neoplasms/pathology ; Retrospective Studies ; Specimen Handling/methods
Language	English
Publishing date	2021-07-31
Publishing country	United States
Document type	Journal Article
ZDB-ID	1336505-8
ISSN	1873-2496 ; 1078-1439
ISSN (online)	1873-2496
ISSN	1078-1439
DOI	10.1016/j.urolonc.2021.07.011
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Article: An international multi-institutional validation study of the algorithm for prostate cancer detection and Gleason grading.

NPJ precision oncology

2023 Volume 7, Issue 1, Page(s) 77

Abstract: Pathologic examination of prostate biopsies is time consuming due to the large number of slides per case. In this retrospective study, we validate a deep learning-based classifier for prostate cancer (PCA) detection and Gleason grading (AI tool) in ... ...

Abstract	Pathologic examination of prostate biopsies is time consuming due to the large number of slides per case. In this retrospective study, we validate a deep learning-based classifier for prostate cancer (PCA) detection and Gleason grading (AI tool) in biopsy samples. Five external cohorts of patients with multifocal prostate biopsy were analyzed from high-volume pathology institutes. A total of 5922 H&E sections representing 7473 biopsy cores from 423 patient cases (digitized using three scanners) were assessed concerning tumor detection. Two tumor-bearing datasets (core n = 227 and 159) were graded by an international group of pathologists including expert urologic pathologists (n = 11) to validate the Gleason grading classifier. The sensitivity, specificity, and NPV for the detection of tumor-bearing biopsies was in a range of 0.971-1.000, 0.875-0.976, and 0.988-1.000, respectively, across the different test cohorts. In several biopsy slides tumor tissue was correctly detected by the AI tool that was initially missed by pathologists. Most false positive misclassifications represented lesions suspicious for carcinoma or cancer mimickers. The quadratically weighted kappa levels for Gleason grading agreement for single pathologists was 0.62-0.80 (0.77 for AI tool) and 0.64-0.76 (0.72 for AI tool) for the two grading datasets, respectively. In cases where consensus for grading was reached among pathologists, kappa levels for AI tool were 0.903 and 0.855. The PCA detection classifier showed high accuracy for PCA detection in biopsy cases during external validation, independent of the institute and scanner used. High levels of agreement for Gleason grading were indistinguishable between experienced genitourinary pathologists and the AI tool.
Language	English
Publishing date	2023-08-15
Publishing country	England
Document type	Journal Article
ISSN	2397-768X
ISSN	2397-768X
DOI	10.1038/s41698-023-00424-6
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Article ; Online: Preoperative 68Ga-PSMA PET/CT defines a subgroup of high-risk prostate cancer patients with favorable outcomes after radical prostatectomy and lymph node dissection.

Dekalo, Snir / Kuten, Jonathan / Mintz, Ishai / Fahoum, Ibrahim / Gitstein, Gilad / Keizman, Daniel / Sarid, David / Matzkin, Haim / Mabjeesh, Nicola J / Beri, Avi / Even-Sapir, Einat / Yossepowitch, Ofer / Mano, Roy

Prostate cancer and prostatic diseases

2021 Volume 24, Issue 3, Page(s) 910–916

Abstract: Background: High-risk prostate cancer is associated with adverse pathology and unfavorable outcomes after radical prostatectomy. : Methods: We retrospectively reviewed 149 patients with high-risk localized or locoregional prostate cancer who ... ...

Abstract	Background: High-risk prostate cancer is associated with adverse pathology and unfavorable outcomes after radical prostatectomy. Methods: We retrospectively reviewed 149 patients with high-risk localized or locoregional prostate cancer who underwent Results: Of 149 identified patients, 19 (13%) were found to have lymph node involvement on preoperative Conclusions: Preoperative staging with
MeSH term(s)	Aged ; Follow-Up Studies ; Gallium Isotopes/metabolism ; Gallium Radioisotopes/metabolism ; Humans ; Lymph Node Excision/mortality ; Male ; Middle Aged ; Neoplasm Recurrence, Local/diagnostic imaging ; Neoplasm Recurrence, Local/mortality ; Neoplasm Recurrence, Local/pathology ; Neoplasm Recurrence, Local/surgery ; Positron Emission Tomography Computed Tomography/methods ; Preoperative Care ; Prognosis ; Prostatectomy/mortality ; Prostatic Neoplasms/diagnostic imaging ; Prostatic Neoplasms/mortality ; Prostatic Neoplasms/pathology ; Prostatic Neoplasms/surgery ; Radiopharmaceuticals/metabolism ; Retrospective Studies ; Survival Rate
Chemical Substances	Gallium Isotopes ; Gallium Radioisotopes ; Radiopharmaceuticals ; gallium 68 PSMA-11
Language	English
Publishing date	2021-03-31
Publishing country	England
Document type	Journal Article
ZDB-ID	1419277-9
ISSN	1476-5608 ; 1365-7852
ISSN (online)	1476-5608
ISSN	1365-7852
DOI	10.1038/s41391-021-00347-y
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