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  1. Article ; Online: What's Coming Down the Tube: Current and Emerging Topics in Gastrointestinal Pathology.

    Graham, Rondell P

    Surgical pathology clinics

    2023  Volume 16, Issue 4, Page(s) ix

    Language English
    Publishing date 2023-06-11
    Publishing country United States
    Document type Editorial
    ISSN 1875-9157
    ISSN (online) 1875-9157
    DOI 10.1016/j.path.2023.05.001
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: How Molecular Discoveries Have Changed Liver Tumor Pathology: A Brief Review.

    Taheri, Negar / Graham, Rondell P

    Archives of pathology & laboratory medicine

    2023  Volume 148, Issue 5, Page(s) e96–e102

    Abstract: Context: Recent molecular discoveries have led to improved understanding of tumor biology and the development of new diagnostic assays.: Objective: To review primarily 3 examples of liver tumors and to briefly illustrate how recent molecular ... ...

    Abstract Context: Recent molecular discoveries have led to improved understanding of tumor biology and the development of new diagnostic assays.
    Objective: To review primarily 3 examples of liver tumors and to briefly illustrate how recent molecular discoveries have altered clinical liver pathology practice.
    Data sources: First, we will discuss fibrolamellar carcinoma, which will be the main focus of discussion, as an example for new diagnostic tests that have been developed as a result of molecular discoveries. Additional information on the role of molecular diagnostics in hepatocellular adenoma and hepatocellular carcinoma will be provided. Second, we will use the example of epithelioid hemangioendothelioma as an example of how new diagnostic tools, based on molecular discoveries, may support improved prognostication. Finally, we will use the example of intrahepatic cholangiocarcinoma as an example of a liver tumor where new molecular discoveries have identified tractable therapeutic targets and led to new effective therapies. This portion of the manuscript will also include a description of the anatomic and molecular differences between intrahepatic, hilar, and extrahepatic cholangiocarcinoma.
    Conclusions: Fueled by molecular discoveries, new and better diagnostic tests and therapeutic targets have improved clinical care in patients affected by liver tumors.
    MeSH term(s) Humans ; Liver Neoplasms/genetics ; Liver Neoplasms/pathology ; Liver Neoplasms/diagnosis ; Cholangiocarcinoma/genetics ; Cholangiocarcinoma/pathology ; Cholangiocarcinoma/diagnosis ; Carcinoma, Hepatocellular/genetics ; Carcinoma, Hepatocellular/pathology ; Carcinoma, Hepatocellular/diagnosis ; Hemangioendothelioma, Epithelioid/genetics ; Hemangioendothelioma, Epithelioid/pathology ; Hemangioendothelioma, Epithelioid/diagnosis ; Adenoma, Liver Cell/pathology ; Adenoma, Liver Cell/genetics ; Adenoma, Liver Cell/diagnosis ; Bile Duct Neoplasms/genetics ; Bile Duct Neoplasms/pathology ; Bile Duct Neoplasms/diagnosis ; Biomarkers, Tumor/genetics ; Biomarkers, Tumor/metabolism ; Molecular Diagnostic Techniques
    Chemical Substances Biomarkers, Tumor
    Language English
    Publishing date 2023-08-28
    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.2023-0099-RA
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Fibrolamellar Carcinoma: What Is New and Why It Matters.

    Graham, Rondell P

    Surgical pathology clinics

    2018  Volume 11, Issue 2, Page(s) 377–387

    Abstract: Fibrolamellar carcinoma is distinctive at clinical and histologic levels. A novel DNAJB1-PRKACA fusion gene characterizes almost all cases, distinguishes it from other hepatocellular neoplasms, and drives the pathogenesis of this unique tumor. A subset ... ...

    Abstract Fibrolamellar carcinoma is distinctive at clinical and histologic levels. A novel DNAJB1-PRKACA fusion gene characterizes almost all cases, distinguishes it from other hepatocellular neoplasms, and drives the pathogenesis of this unique tumor. A subset of cases of fibrolamellar carcinoma is associated with alternate mechanisms of protein kinase A activation. This review article discusses common and unusual histologic features of fibrolamellar carcinoma, its differential diagnoses, and how to make the diagnosis while avoiding key pitfalls. The impact of the discovery of the fusion gene on the understanding of the tumor and the prognosis of fibrolamellar carcinoma are also discussed.
    MeSH term(s) Biopsy ; Carcinoma, Hepatocellular/diagnosis ; Carcinoma, Hepatocellular/genetics ; Carcinoma, Hepatocellular/pathology ; Diagnosis, Differential ; Humans ; Liver Neoplasms/diagnosis ; Liver Neoplasms/genetics ; Liver Neoplasms/pathology ; Prognosis
    Language English
    Publishing date 2018-03-21
    Publishing country United States
    Document type Journal Article ; Review
    ISSN 1875-9157
    ISSN (online) 1875-9157
    DOI 10.1016/j.path.2018.02.006
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Mismatch repair deficiency: The what, how and why it is important.

    Olave, Maria C / Graham, Rondell P

    Genes, chromosomes & cancer

    2021  Volume 61, Issue 6, Page(s) 314–321

    Abstract: The mismatch repair system is a major pathway that functions in the maintenance of genomic integrity. It is involved in mitotic and meiotic recombination, apoptosis, immunoglobulin gene rearrangement, somatic hypermutation, and other processes. ... ...

    Abstract The mismatch repair system is a major pathway that functions in the maintenance of genomic integrity. It is involved in mitotic and meiotic recombination, apoptosis, immunoglobulin gene rearrangement, somatic hypermutation, and other processes. Deficiencies in mismatch repair give rise to hypermutability and the phenomenon called microsatellite instability. Detection of deficient mismatch repair function or microsatellite instability is used diagnostically, predictively, and prognostically. Specifically, deficient mismatch repair function is used for screening of Lynch syndrome, determining patients who are likely to respond to immune checkpoint inhibition, and to contributes to an understanding of which cancer patients may pursue a more aggressive clinical course. Microsatellite instability can be evaluated directly by polymerase chain reaction (PCR) or indirectly by assessment of mismatch repair protein expression using immunohistochemistry (IHC), and mismatch repair function using next-generation sequencing assays which evaluates homopolymer indels. In this article, we provide a concise practical review on mismatch repair deficiency (MMR-d)/microsatellite instability (MSI), focusing on clinical testing, different testing methods, interpretation of findings, the predictive, and prognostic utility of MSI.
    MeSH term(s) Brain Neoplasms ; Colorectal Neoplasms/diagnosis ; Colorectal Neoplasms/genetics ; DNA Mismatch Repair/genetics ; Humans ; Microsatellite Instability ; Neoplastic Syndromes, Hereditary
    Language English
    Publishing date 2021-12-09
    Publishing country United States
    Document type Journal Article ; Review ; Research Support, Non-U.S. Gov't
    ZDB-ID 1018988-9
    ISSN 1098-2264 ; 1045-2257
    ISSN (online) 1098-2264
    ISSN 1045-2257
    DOI 10.1002/gcc.23015
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: Tumor-Infiltrating Lymphocytes for Prognostic Stratification in Nonmetastatic Colon Cancer-Are We There Yet?

    Sinicrope, Frank A / Graham, Rondell P

    JAMA oncology

    2021  Volume 7, Issue 7, Page(s) 969–970

    MeSH term(s) Biomarkers, Tumor ; Colonic Neoplasms/pathology ; Humans ; Lymphocytes, Tumor-Infiltrating ; Prognosis
    Chemical Substances Biomarkers, Tumor
    Language English
    Publishing date 2021-03-13
    Publishing country United States
    Document type Journal Article
    ISSN 2374-2445
    ISSN (online) 2374-2445
    DOI 10.1001/jamaoncol.2021.0177
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article ; Online: Gastrointestinal histoplasmosis with small intestinal perforation: 20-year experience.

    Sample, Jack W / Yonkus, Jennifer A / Mirande, Maxwell D / Graham, Rondell P / Kelley, Scott R

    Updates in surgery

    2024  

    Abstract: Postmortem studies show gastrointestinal tract involvement in as many as 70% of patients affected by disseminated histoplasmosis. Although gastrointestinal involvement is common in disseminated disease, the presentation of small intestinal perforation is ...

    Abstract Postmortem studies show gastrointestinal tract involvement in as many as 70% of patients affected by disseminated histoplasmosis. Although gastrointestinal involvement is common in disseminated disease, the presentation of small intestinal perforation is exceedingly rare with few reported cases in the literature. Herein we present our institutional case series. The aim of the study is to describe small intestinal perforation in gastrointestinal histoplasmosis with attention to management and outcomes. This is a retrospective single-institution review of patients ≥ 18 years of age treated for small intestinal perforation due to gastrointestinal histoplasmosis. A prospectively maintained institutional database was searched from 2002 to 2022. Data obtained included demographics, comorbidities, treatment course, and outcomes. Five patients with a mean age of 54 years (range 25-72) were identified. Pertinent underlying comorbid conditions included Crohn's disease, psoriatic arthritis, rheumatoid arthritis, and solid organ transplantation. All patients were on chronic immunosuppressive medication(s) with the most common being tumor necrosis factors alpha inhibitors and corticosteroids. Four had a clinical diagnosis of perforation based on physical examination and imaging. All patients underwent segmental resection(s) of the small intestine and received medical treatment with intravenous amphotericin B and eventual transition to an oral antifungal. No patients experienced complications related to surgery. The limitations of the study include nonrandomized retrospective review, single-institution experience, and small patient sample size. Although rare, histoplasmosis should be considered in the differential of patients on chronic immunosuppressive therapy who present with gastrointestinal symptoms concerning perforation, especially from endemic areas. Small intestinal perforation due to gastrointestinal histoplasmosis can be successfully treated with resection and antifungal therapy.
    Language English
    Publishing date 2024-03-20
    Publishing country Italy
    Document type Journal Article
    ZDB-ID 2572692-4
    ISSN 2038-3312 ; 2038-131X
    ISSN (online) 2038-3312
    ISSN 2038-131X
    DOI 10.1007/s13304-024-01797-4
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  7. Article ; Online: Targeting ERBB2/HER2 genetic alterations: an expanding therapeutic opportunity in gastrointestinal cancers.

    Zheng-Lin, Binbin / Graham, Rondell P / Bekaii-Saab, Tanios S

    Chinese clinical oncology

    2023  Volume 12, Issue 5, Page(s) 55

    Abstract: HER2 amplification and/or activating variations of its protein, human epidermal growth factor receptor 2 (HER2), are associated with distinct clinical and pathological features in gastrointestinal tumors, including a worse overall prognosis and a higher ... ...

    Abstract HER2 amplification and/or activating variations of its protein, human epidermal growth factor receptor 2 (HER2), are associated with distinct clinical and pathological features in gastrointestinal tumors, including a worse overall prognosis and a higher incidence of metastastic lesions in the central nervous system. Notably, the role of HER2 as a therapeutic target continues to expand beyond the scope of breast and gastroesophageal tumors, now encompassing colorectal and biliary tract cancers (BTCs), among others. In parallel, there is a burgeoning array of therapeutic agents designed to inhibit the activity of the HER2 pathway, including monoclonal antibodies, orally available tyrosine kinase inhibitors, bispecific antibodies, and antibody-drug conjugate compounds. In this comprehensive review, we will explore the current body of evidence that supports the implementation of HER2-targeting strategies in the treatment of patients with gastric, esophageal, colorectal, and biliary tract tumors. We will also describe testing methods for HER2 status in clinical practice, including immunohistochemistry (IHC), and its correlation with next-generation sequencing-based techniques. Additionally, we will review the key treatment-related adverse events associated with specific anti-HER2 agents, emphasizing the need for early diagnosis and effective management. Furthermore, a critical aspect of this exploration is determining the optimal treatment sequencing among the available therapies, which will be pivotal in enhancing treatment outcomes.
    MeSH term(s) Humans ; Receptor, ErbB-2/metabolism ; Mutation ; Gastrointestinal Neoplasms/drug therapy ; Gastrointestinal Neoplasms/genetics ; Biliary Tract Neoplasms/drug therapy ; Colorectal Neoplasms/genetics
    Chemical Substances ERBB2 protein, human (EC 2.7.10.1) ; Receptor, ErbB-2 (EC 2.7.10.1)
    Language English
    Publishing date 2023-11-15
    Publishing country China
    Document type Review ; Journal Article
    ZDB-ID 2828547-5
    ISSN 2304-3873 ; 2304-3873
    ISSN (online) 2304-3873
    ISSN 2304-3873
    DOI 10.21037/cco-23-72
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  8. Article ; Online: Perianal Basal Cell Carcinoma: 35-Year Experience.

    Liu, Shanglei / Mathis, Kellie L / Graham, Rondell P / Kelley, Scott R

    Diseases of the colon and rectum

    2022  Volume 66, Issue 2, Page(s) 217–220

    Abstract: Background: Basal cell carcinoma of the perianal region is a rare anorectal disease. This condition is not related to exposure to ultraviolet radiation. Because of the low prevalence and poor detection, there is a paucity of data relating to this ... ...

    Abstract Background: Basal cell carcinoma of the perianal region is a rare anorectal disease. This condition is not related to exposure to ultraviolet radiation. Because of the low prevalence and poor detection, there is a paucity of data relating to this condition in the literature. Perianal basal cell carcinoma presents surgical challenges different from other anatomic locations and may not share the same prevalence or natural history. Here, we describe the largest series to date on the surgical management of perianal basal cell carcinoma.
    Objective: We aimed to present our 35-year experience in managing perianal basal cell carcinoma in this study.
    Design: This was a retrospective single-center analysis.
    Setting: The study was conducted at a large tertiary referral academic health care system.
    Patients: All patients undergoing surgical management of pathology confirmed perianal basal cell carcinoma.
    Interventions: All patients underwent surgical management of their disease.
    Main outcome measures: The primary outcomes were disease recurrence, mortality, and wound complications.
    Results: A total of 29 patients were identified with an average follow-up of 5.5 years. At index presentation, 27.6% of patients had multiple basal cell carcinoma in other anatomic locations. Ninety-three percent of patients were adequately treated with local excision, but 60% had wound dehiscence at the time of their first follow-up visit. Ultimately, there were no recurrences or disease-related mortality during the follow-up period.
    Limitations: Limitations to our study include its nonrandomized retrospective nature, single-institution experience, and small patient sample size.
    Conclusions: Perianal basal cell carcinoma carries a high rate of synchronous presentation in other locations and should prompt a thorough evaluation. Perianal basal cell carcinomas can and should be successfully treated with local excision despite the high rate of wound complications. See Video Abstract at http://links.lww.com/DCR/B883 .Carcinoma perianal de células basales: 35 años de experienciaANTECEDENTES:El carcinoma de células basales de la región perianal es una enfermedad anorrectal rara. Esta condición no está relacionada con la exposición a la radiación ultravioleta. Debido a la baja prevalencia y detección pobre, hay escasez de datos relacionados con esta condición en la literatura. El carcinoma de células basales perianal presenta diferentes desafíos quirúrgicos en otras ubicaciones anatómicas y puede no compartir la misma prevalencia o historia natural. A continuación, describimos la serie más grande hasta la fecha sobre el tratamiento quirúrgico del carcinoma de células basales perianal.OBJETIVO:Presentar nuestra experiencia de 35 años en el manejo del carcinoma de células basales perianal.DISEÑO:Este fue un análisis retrospectivo de un solo centro.ENTORNO CLINICO:El estudio se llevó a cabo en un gran centro de salud académico de referencia terciaria.PACIENTES:Todos los pacientes sometidos a tratamiento quirúrgico con patología confirmatoria de carcinoma basocelular perianal.INTERVENCIONES:Todos los pacientes fueron sometidos a tratamiento quirúrgico de su enfermedad.PRINCIPALES MEDIDAS DE RESULTADO:Los resultados primarios fueron la recurrencia de la enfermedad, mortalidad, y complicaciones de la herida.RESULTADOS:Se identificaron un total de 29 pacientes con un seguimiento promedio de 5.5 años. El 27,6% de los pacientes tenían carcinoma basocelular múltiple en otras localizaciones anatómicas en la presentación inicial. El 93% de los pacientes fueron tratados adecuadamente con escisión local, pero el 60% tuvo dehiscencia de la herida en el momento de la primera visita de seguimiento. En última instancia, no hubo recurrencias ni mortalidad relacionada con la enfermedad durante el período de seguimiento.LIMITACIONES:Las limitaciones de nuestro estudio incluyen su naturaleza retrospectiva no aleatorizada, la experiencia de una sola institución y el tamaño pequeño de la muestra de pacientes.CONCLUSIONES:El carcinoma de células basales perianal tiene una alta tasa de presentación sincrónica en otras localizaciones y debe dar lugar a una evaluación exhaustiva. Los CBC perianales pueden y deben ser tratados exitosamente con escisión local a pesar de la alta tasa de complicaciones de herida. Consulte Video Resumen en http://links.lww.com/DCR/B883 . (Tradducción-Dr. Francisco M. Abarca-Rendon ).
    MeSH term(s) Humans ; Retrospective Studies ; Follow-Up Studies ; Ultraviolet Rays ; Neoplasm Recurrence, Local ; Anus Neoplasms/surgery ; Carcinoma, Basal Cell/epidemiology ; Carcinoma, Basal Cell/surgery
    Language English
    Publishing date 2022-11-27
    Publishing country United States
    Document type Video-Audio Media ; Journal Article
    ZDB-ID 212581-x
    ISSN 1530-0358 ; 0012-3706
    ISSN (online) 1530-0358
    ISSN 0012-3706
    DOI 10.1097/DCR.0000000000002234
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  9. Article ; Online: Cystic lesions of the retrorectal space.

    Brown, Ian S / Sokolova, Anna / Rosty, Christophe / Graham, Rondell P

    Histopathology

    2022  Volume 82, Issue 2, Page(s) 232–241

    Abstract: Cysts of the retrorectal space comprise a heterogeneous group of rare lesions. Most develop from embryological remnants and include tailgut cysts, dermoid cysts, rectal duplication cysts, anal canal duplication cysts, sacrococcygeal teratomas and ... ...

    Abstract Cysts of the retrorectal space comprise a heterogeneous group of rare lesions. Most develop from embryological remnants and include tailgut cysts, dermoid cysts, rectal duplication cysts, anal canal duplication cysts, sacrococcygeal teratomas and anterior meningocoele. Tailgut cyst is the most common cyst of developmental origin, usually presenting as a multilocular cystic mass with mucoid content and lined by multiple epithelial types. Compared with tailgut cysts, rectal duplication cysts display all layers of the large bowel wall including a well-defined muscularis propria. Retrorectal cysts of non-developmental origin are far less common and represent lesions that either infrequently involve the retrorectal space or undergo extensive cystic change. This review provides an overview of the various histological types of cystic lesions of the retrorectal space, divided into cysts of developmental origin and those of non-developmental origin. A practical pathological and multidisciplinary approach to diagnosing these lesions is presented.
    MeSH term(s) Humans ; Social Group ; Cysts
    Language English
    Publishing date 2022-08-24
    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.14769
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  10. Article ; Online: Clinical and histological features of secondary carcinomas in gastrointestinal tract biopsies.

    Rosty, Christophe / Pai, Rish K / Graham, Rondell P

    Histopathology

    2020  Volume 77, Issue 4, Page(s) 622–630

    Abstract: Background: Secondary carcinoma involving the gastrointestinal (GI) tract is an uncommon finding in biopsy specimens. The diagnosis can be challenging for tumours mimicking a primary carcinoma and when the clinical context is unknown.: Methods and ... ...

    Abstract Background: Secondary carcinoma involving the gastrointestinal (GI) tract is an uncommon finding in biopsy specimens. The diagnosis can be challenging for tumours mimicking a primary carcinoma and when the clinical context is unknown.
    Methods and results: A multicentre retrospective study was performed to evaluate the clinical and histological features of a series of secondary carcinoma in GI biopsies. A total of 197 cases from 190 patients (median age = 67 years; 57% females) were reviewed. In 16% of patients, the primary carcinoma was unknown. Most lesions presented endoscopically as mucosal or submucosal masses (58%). In 13%, the endoscopy was non-suspicious for malignancy. The most common tumours were carcinomas of the breast (38%), kidney (13%), lung (12%), prostate (8%) and ovary (7%). The sites of involvement were the stomach (34%), colon (27%), rectum (18%), duodenum (13%), oesophagus (5%), jejunum (3%) and anus (0.5%). Histological patterns of infiltration were mucosal (76%), submucosal (41%), lymphatic (14%), and epithelial colonisation (8%). Submucosal infiltration was found significantly more frequently in carcinomas of the prostate (67%) and lung (62%), compared with carcinomas of the ovary (27%) and breast (23%). Histological obstructive changes were observed in 36% of all cases, with the highest rate in prostate carcinoma (53%) and the lowest rate in kidney carcinoma (8%).
    Conclusion: Awareness of the main clinical and histological patterns of secondary carcinomas in GI tract biopsies may help pathologists to raise the possibility of this uncommon diagnosis and confirm it with the judicious use of immunohistochemistry.
    MeSH term(s) Adult ; Aged ; Biopsy ; Carcinoma/secondary ; Female ; Gastrointestinal Neoplasms/secondary ; Humans ; Male ; Middle Aged ; Neoplasm Metastasis/pathology ; Retrospective Studies
    Language English
    Publishing date 2020-09-12
    Publishing country England
    Document type Journal Article ; Multicenter Study
    ZDB-ID 131914-0
    ISSN 1365-2559 ; 0309-0167
    ISSN (online) 1365-2559
    ISSN 0309-0167
    DOI 10.1111/his.14195
    Database MEDical Literature Analysis and Retrieval System OnLINE

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