Calcifications in prostate and ejaculatory system: a study on 298 consecutive whole mount sections of prostate from radical prostatectomy or cystoprostatectomy specimens

Although calcifications in the prostate are a common manifestation, the relationship between calcifications and prostate cancer is not clearly documented as in breast cancer. In addition, anatomical distribution of calcifications by zones of the prostate and ejaculatory system has not been systematically studied. To study the frequency and patterns of calcifications within the prostate and ejaculatory system, we reviewed the whole mount sections of 298 consecutive prostatectomy or cystoprostatectomy specimens. Calcifications were evaluated in the prostate (central, peripheral and transition zones, and verumontanum), ejaculatory ducts, and seminal vesicles. We graded the degree of calcifications as mild, moderate, or severe. Calcifications in the prostate and ejaculatory system were common, and their frequency in our series is as follows: 88.6% (264/298) of prostates, 58.1% (173/298) of seminal vesicles, and 17.1% (51/298) of ejaculatory ducts. The prostatic calcifications occurred mostly in benign glands and/or stroma of all zones and the verumontanum. Calcifications were more common in the transition zone than other zones. There were 4 cases of prostatic calcifications in the areas of prostatic adenocarcinoma: 3 cases with calcifications in the tumor glands and 1 case with calcifications in tumor stroma but not in the accompanying tumor glands. In conclusion, calcifications are a very common finding in prostatectomy specimens and seem mostly to be associated with benign prostatic hyperplasia. However, calcifications can occur in direct association with prostatic adenocarcinoma, although the incidence of this association is not as high as in breast carcinoma. Also, ejaculatory system calcifications are not an infrequent finding.     

Evaluation of direct wet mount parasitological examination of preserved fecal specimens.

A retrospective study covering a 12-year period was performed to determine the contribution of the direct wet mount microscopic examination to the identification of intestinal parasites in preserved fecal material. It was determined that each of 898 specimens contained at least one parasite when processed by the direct wet mount, concentration, and trichrome staining procedures. Of these procedures, the direct wet mount examination was solely responsible for the identification of 45 (2.9%) of 1,581 parasites identified. This is in contrast to the 15.1 and 12.5% which were found exclusively by the concentration and trichrome methods, respectively. These percentages may vary, depending on the prevalence of parasites and the stages present in the stool specimen.     

Inflated, dried whole lung specimens.

A method is described for preparing fully-inflated whole lung specimens that are suitable for instruction or research purposes. Undamaged lungs are removed from the body and then tracheally cannulated and lavaged with tap water more than 250 times. The treatment also includes rinsing blood from vessels with water. A final filling of the lung with alcohol is optional. The multiply rinsed lung is drained and inflated to 30 cm of H2O pressure with dehumidified air and held at that pressure until the tissue is completely dry. The resulting specimens are light in color and appear to be permanent if stored properly.     

Observer variability in histopathological reporting of cervical biopsy specimens.

Sections from 100 cervical biopsy specimens were studied by 12 consultant histopathologists to determine the robustness of the existing pathology terminology and classification. Analysis by kappa statistics showed good agreement in the diagnosis of CIN 3 and squamous carcinoma but an inability to distinguish accurately between the lesser grades of CIN. It is recommended that the classification be changed to low grade (present CIN 1 and 2) and high grade (present CIN 3) categories alone. There was very poor agreement in the identification of cellular changes associated with human papilloma virus (HPV) infection.     

A method for routine approach to laryngeal and hypopharyngeal surgical specimens by whole organ sections in the horizontal plane

A procedure of pathological analysis of laryngopharyngeal specimens by whole organ sections in the horizontal plane was developed and evaluated. The use of a fast decalcifying and fixative solution allowed both an easier sectioning of the whole organ and thin (5-6 microns) histological whole organ sections of laryngo pharyngectomy specimens. The complete procedure required 5 to 10 days for each case. A preliminary examination of 39 surgical laryngopharyngectomy specimens with laryngeal or hypopharyngeal carcinomas showed that most of the normal structures were histologically identifiable on whole organ horizontal histological sections. The data of the local neoplastic spread related to the main sites of origin were in accordance with the results obtained by other studies using whole organ sections in the coronal or vertical planes. In conclusion, with this procedure it is possible to obtain, in a reasonably short time, thin histological horizontal whole organ sections allowing an adequate and complete assessment of the microscopic characteristics of the tumor and of the tridimensional relationships of the neoplasm with the host organ; moreover, by this procedure pathological data may be compared with preoperative CT or MR scans in patients with laryngeal and hypopharyngeal carcinomas.     

Technique for identifying cutting artefacts in sections of undecalcified bone biopsy specimens.

Areas of fragmentation found in trabecular and cortical bone of iliac crest biopsy specimens have been described as bone quality defects and were thought to be the major factor responsible for femoral neck fractures. These appearances have also been regarded as cutting artefacts and to resolve this difference of opinion consecutive sections cut at right angles to each other in biopsy specimens from 15 patients with femoral neck fractures were compared. Sections were assessed by four independent observers; agreement by at least three was required before an area was accepted as a bone quality defect. In all, 270 were identified. Of the 161 found in sections cut parallel to the cortices, there were only 20 (12%) in coincident areas in consecutive sections. This study shows conclusively that areas of fragmentation previously described as bone quality defects are not artefacts which may be created or excluded depending on the plane of section.     

保乳手术标本定位全部取材病理检查的意义

目的探讨保证保乳手术标本切缘阴性的病理取材诊断方法及意义。方法（1）术中对145例保乳手术标本进行定位全切片检查,79例进行选择性取材检查;（2）术后对84例保乳手术标本进行定位全切片检查,226例进行选择性取材检查;（3）对两组手术病例进行随访观察。结果（1）术中定位全切片取材切缘阳性检出率（24．1％,35／145）明显高于选择性取材（6．3％,5／79）,差异具有统计学意义（P〈0．01）;（2）术后定位全切片取材切缘阳性检出率（29／84,34．5％）亦明显高于选择性取材（12．0％,27／226）,差异具有统计学意义（P〈0．01）;（3）经2～46个月随访,保乳手术标本选择性取材病例中有3例分别于术后6、15、28个月局部复发,定位全切片取材病例无复发。结论定位全切片取材和诊断可以降低保乳手术标本切缘阳性的漏诊率,并能够定位切缘阳性的部位,对减小二次手术和术后复发的风险,保证保乳手术的成功具有重要作用。     

Recommendations for the reporting of larynx specimens containing laryngeal neoplasms

 The Association of Directors of Anatomic and Surgical Pathology have developed recommendations for the surgical pathology report for common malignant tumors. The recommendations for carcinoma of the larynx are reported herein. Received: 18 February 1997 / Accepted: 3 April 1997     

Recommendations for the reporting of larynx specimens containing laryngeal neoplasms

The Association of Directors of Anatomic and Surgical Pathology have developed recommendations for the surgical pathology reporting of common malignant tumors. The recommendations for carcinoma of the larynx are reported herein.     

Observer variability in histopathological reporting of malignant bronchial biopsy specimens.

AIMS--To evaluate the ability of histopathologists to classify lung carcinomas on bronchial biopsy material using the current World Health Organisation (WHO) classification. METHODS--Eleven histopathologists each reviewed 100 randomly selected bronchial biopsy specimens which had originally been reported as showing lung carcinoma. A single haematoxylin and eosin stained section from each case was circulated and a standard proforma completed. These were analysed using kappa statistics. RESULTS--The histopathologists were excellent at distinguishing between small cell and non-small-cell carcinoma kappa = 0.86), but not so good at subclassifying the non-small cell carcinoma group kappa = 0.25). CONCLUSIONS--The clinically important distinction between small cell and non-small cell carcinoma of the lung is reliably made by competent histopathologists even on limited material.     

Data handling and reporting for microbiology specimens with a small laboratory computer system.

A small laboratory computer system designed for general application in chemistry, haematology, and urinalysis has been adapted for the bacteriology section of the laboratory using the same available programming routines. Specimens are requisitioned according to predetermined common site codes, with both preliminary and final reporting allowed for where desired. Sensitivity data also appended and entered where required, even for different organisms in the same culture.     

Recommendations for the reporting of surgically resected specimens of colorectal carcinoma

The reporting of colorectal cancer is facilitated by the provision of a checklist giving the features required for good patient care. However, the practicalities of applying such a checklist may not be straightforward. Familiar examples include finding the prescribed number of lymph nodes, distinguishing mesenteric tumor deposits from replaced lymph nodes, and deciding if a cluster of malignant cells in a lymph node sinus counts as metastasis. Checklists have traditionally focused on prognostic factors and, particularly, tumor stage. It is becoming increasingly clear that additional factors, whether morphological or molecular, will be needed for future clinical management. It is also evident that prognosis is strongly influenced by the surgical technique used, most notably by the introduction of total mesorectal excision in the case of rectal cancer. Adjuvant therapy is playing an increasingly important role in the management of colorectal cancer, and it is inevitable that morphological and molecular markers will be used to predict responses to the expanding range of therapeutic modalities. Neoadjuvant or preoperative radiotherapy is being offered to patients with advanced rectal cancer and can greatly modify the pathologic findings in operative specimens. For all the preceding reasons, the work of diagnostic pathologists has become increasingly complex and demanding. The 6th edition of the TNM classification fails to meet many of the challenges posed by the realities of modern cancer management. In fact, by changing the rules for staging without strong justification and introducing diagnostic criteria that are unhelpful and lack a good evidence base, there is a real danger that the community of pathologists will fail to engage with reporting recommendations in a standardized manner and that the quality of reporting will decline.