Test Your Memory

A Review of Articles From Last Month’s Archives of Pathology & Laboratory Medicine

Listed below are questions based on articles that appeared in last month’s edition of the ARCHIVES. Registered continuing medical education participants should answer these questions either online or use the September 2009 answer sheet.

1. Noninvasive carcinoma ex pleomorphic adenoma (CEPA) and pleomorphic adenoma with atypia are unlikely to cause future morbidity if excised without breach of the capsule; in contrast, invasive CEPA carries a prognosis as grim as that of primary carcinoma when it has extended significantly beyond the capsule. True or False? (from Changes in the 7th Edition of the AJCC TNM Classification and Recommendations for Pathologic Analysis of Lacrimal Gland Tumors—Rootman & White)

2. Among the findings of a retrospective study that reviewed 387 eyes with retinoblastoma treated by enucleation, which one of the following statements is false? a. of the 114 patients with germline mutations, 103 had bilateral sporadic tumors, 8 had a family history of retino- blastoma, and 3 had 13q-syndrome b. for the untreated patients, the mean age at enucleation in the unilateral sporadic cases was 29.5 months compared to 14.6 months for all germline cases c. in terms of tumor differentiation in the untreated patients, 47 had many rosettes, 32 had moderate rosettes, 41 had sparse rosettes, and 121 tumors were classified as poorly differentiated d. of the 297 eyes with no prior treatment, 23% had some degree of uveal invasion; the invasion was classified as massive (defined as Ͼ3 mm in diameter) in 64% of the cases e. fifty-five of the 297 untreated eyes had high-risk histopathologic features, including 10 with both massive uveal invasion and retrolaminar optic nerve invasion (from High-Risk Features and Tumor Differentiation in Retinoblastoma—Eagle)

3. It is currently believed that in the pathogenesis of uveal melanoma, 8q amplification occurs early, and changes in chromosome 3 are a secondary change associated with tumor progression. True or False? (from Chromosomal 3 and 8 Status Within Hepatic Metastasis of Uveal Melanoma—Singh et al)

4. Among the information known concerning how to diagnose malignant mesothelioma (MM) and distinguish it from similar tumors, which one of the following statements is false? a. reactive mesothelial proliferations tend to show a uniformity of growth, as highlighted with pancytokeratin stain- ing, which shows regular sheets and sweeping fascicles of cells that respect mesothelial boundaries in contrast to the disorganized growth and haphazardly intersecting proliferations seen in mesothelioma b. although the presence of psammoma bodies might suggest certain carcinomas, their presence is not a diagnostic aid in either confirming or excluding a diagnosis of mesothelioma c. uniformity of growth and thickness of the process, surface atypia with deep maturation, and perpendicular thin- walled vessels are typical of desmoplastic mesotheliomas d. when prominent neoplastic giant cells or anaplastic cells are present (pleomorphic MM), pleomorphic carcinoma and other high-grade, poorly differentiated neoplasms metastatic to the pleura should be excluded e. there are no molecular markers as yet that are useful in confirming a diagnosis of mesothelioma; likewise, there is no single ultrastructural feature that is diagnostic of mesothelioma but rather the combination of several features that may be diagnostically useful (from Guidelines for Pathologic Diagnosis of Malignant Mesothelioma—Husain et al)

5. A comparison of the performance of slides with Candida used in the College of American Pathologists Interlaboratory Comparison Program in Cervicovaginal Cytopathology determined that after proficiency testing implementation, there appeared to be a decline in performance of the validated Candida slides; specifically, the slides were more often called low-grade squamous intraepithelial lesions (Category C). True or False? (from Performance of Candida—Fungal-Induced Atypia and Proficiency Testing—Moriarty et al) Arch Pathol Lab Med—Vol 133, September 2009 Test Your Memory 1495 6. Analysis of 148 radical prostatectomy specimens and the impact of different partial sampling methods determined that which one of the following statements is true? a. when the prostate was divided into 4 quarters in the transverse view, the tumors were most frequently located in the left anterior portion b. among all the tumors, the Gleason score was greater than 7 in 25% of the cases, while the mean tumor volume was 3.93 mL c. among cases in which lymph node dissection was performed, lymph node metastasis was noted in 13 cases d. when preoperative prostate-specific levels were in the borderline range, as in 88 cases, the prostate cancers were located more frequently in the left anterior portion e. partial sampling method 1 was the most economic and reduced the total paraffin block number to 16.4 from 26.6 blocks of entire sampling, but at the greatest expense for missing extraprostatic extension and resection margin involvement (from Limited Sampling of Radical Prostatectomy Specimens With Excellent Preservation of Prognostic Parameters of Prostate Cancer—Kim et al)

1496 Arch Pathol Lab Med—Vol 133, September 2009 Test Your Memory