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In This Issue THE JOURNAL OF THE AAPA VOLUME 8 ISSUE 4 2018 IN THIS ISSUE Peer-Reviewed 1 CE Quiz & Peer-Reviewed Manuscript: New Malignant Transformation of Childhood Malignant Transformation of Burn Wound with Metastasis: A Case CE Article Report Childhood Burn Wound with 3 Letter from the Editor Metastasis: A Case Report N. Dominic Alessio, PA(ASCP)CM 6 CE Quiz & Peer-Reviewed Manuscript: Breast Cancer Metastasis to the Colon Detroit Medical Center, Detroit, MI Presenting After Fifteen Years Fellow members were given the opportunity to apply for a travel grant to attend an upcoming Fall Conference or Spring Meeting of 8 Peer-Reviewed Manuscript: their choice. Fellows were required to write a manuscript, and the Aurora Diagnostics Pathologists’ Assistant four winning entries received a grant valued at up to $1800 (full week Breast Specimen Handling Best Practice Guideline registration + $1000 to help cover travel expenses). Congratulations, Dominic, on your winning submission! 11 44th Annual Continuing Education Conference Recap Abstract 12 44th Annual Continuing Education Marjolin’s ulcer is a rare and aggressive form of cutaneous squamous cell carcinoma Conference Photos (SCC) which forms through malignant transformation of chronically irritated previous injury, such as incompletely healed burns, ulcers, and other wounds. Although similar in 17 8th Annual Spring Meeting microscopic morphology, Marjolin’s ulcer is unique from other cutaneous SCCs in many other significant characteristics. The carcinoma often appears decades after the initial 18 Board of Trustees Chair’s Report trauma, but once present it follows a rapid course of growth and metastasis. In the current case study, a male in his mid-30s with history of extensive burns as a child presented 21 Gross Photo Unknown to the Emergency Department complaining of a large, open wound on his lower back. Biopsy of the primary lesion showed moderately to poorly differentiated squamous cell 22 Town Hall Meeting Recap carcinoma, prompting wide local excision. Subsequent radiology and biopsy showed positive metastasis to the right ventricle of the heart, with concern for metastasis to 23 Legislative Update the left lung and left axillary lymph nodes. The following article presents a rare and unique case, while advocating for complete submission of skin resection margins on 24 Book Review: Human Errors large specimens even in the context of multiple negative intraoperative diagnoses. A Panorama of Our Glitches, From Pointless to Broken Genes Key words: Marjolin’s ulcer, squamous cell carcinoma, burn scar, skin excision 25 Calendar Introduction and Brief Review of Literature 26 Member Spotlight One of the rarest and most aggressive forms of squamous cell carcinoma 27 Gross Photo Tutorial (SCC) of the skin is found in malignant transformation of a site of previous 27 Institutional PA Program Members trauma, a condition often nicknamed “Marjolin’s ulcer” after a French physician 28 Sustaining Members who first described the condition in the early 19th century. However, this presentation represents only a small subsection of a much broader condition. While cutaneous SCC as a category is quite common, especially in older and light-skinned individuals, the predominant cause is exposure to ultraviolet (UV) light.1 The high-energy UV light rays cause DNA damage and subsequent mutations in the well-known tumor suppressor TP53. Transformation continued on page 4 > Gross Photo Unknown, see page 21 AAPA EXECUTIVE DIRECTOR Michelle L. Sok, CAE [email protected] AAPA CENTRAL OFFICE 2345 Rice Street, Suite 220 St. Paul, MN 55113 Phone: 800.532.AAPA or 651.697.9264 Fax: 651.317.8048 Email: [email protected] AAPA - The Premier PA Organization Mission: pathassist.org The AAPA is dedicated to providing comprehensive professional support for pathologists’ assistants. Vision: facebook.com/pathassist The AAPA will be the premier professional association for pathologists’ assistants, supporting the individual practitioners as they serve patients, pathologists, and the profession. twitter.com/pathassist 2018 Board of Trustees instagram.com/pathassist JOURNAL SUBMISSIONS The AAPA encourages any AAPA member or interested party to John Eckman Thomas Reilly Jana Sovereign Lindsay McCarley Shannon McWilliams BOT Chair, Vice Chair/Secretary, Chief Financial Trustee Trustee contribute articles, updates, Executive Council Executive Council Officer, Administration Committee Education photos or upcoming event Executive Council Oversight Committee Oversight announcements for the quarterly edition of The Cutting Edge. In particular, articles related to the field of pathology are welcomed. Articles and photos may be submitted electronically. (Note: photo files must be a minimum Beth Obertino-Norwood Steven Rath Ryan Schniederjan Dennis Strenk of 300 dpi resolution.) Trustee Trustee Trustee Trustee Education Committee Membership Committee MarComm Committee MarComm Committee Oversight Oversight Oversight Oversight Use the upload link on the AAPA website or send your 2018 Board of Trustees Appointed Adjuncts contributions directly to journal@ pathassist.org. All submitted material is edited for content and clarity. Research articles and case reports are subjected to a peer review process. Please see the AAPA website Mary Dydo James Moore Erika Paulsen for complete submission details. APATP NAACLS CoC JOURNAL DEADLINES Issue 1: January 1 Issue 2: April 1 Issue 3: July 1 Issue 4: October 1 Elizabeth Rizzo Michael Sovocool Jon Wagner Legislative ASCP BOC AJCC Page 2 THE CUTTING EDGE THE JOURNAL OF THE AAPA The Cutting Edge Journal is published Letter from the Editor by the American Association Beth Felicelli, PA(ASCP)CM of Pathologists’ Assistants Editor-in-Chief [email protected] Cutting Edge Journal Staff Beth Felicelli works at Western Editor-in-Chief: Beth Felicelli Michigan Pathology Associates in Assistant Editor: Minda Koval Holland, MI. She has been a member of the AAPA since 1997, and recently Book Review: Chet Sloski became Managing Editor of The Cutting Edge. She serves CE Quiz: Nea Moyer as the Print Communication Subcommittee Chair for the Karah Jones MarComm Committee. Gross Photo Tutorial: Emily Paull Acheson This issue features a recap of the 2018 fall conference AAPA Committee & Subcommittee Chairs in New Orleans as well as information on the upcoming 2019 spring meeting in Phoenix. Both the fall conference Administration: Karen Ron and the spring meeting are great ways to earn continuing Vice Chair: Chevanne Scordinsky education credits, network with others in our field, meet old Governing Documents: Chevanne Scordinsky friends, and make new ones. I highly recommend attending Nominations/Elections: Karen Ron these events and although I could not be in New Orleans, I enjoyed living vicariously through the photographs and stories! Education: Jennifer Perez Vice Chair: Megan Pickard We are featuring a CE article from one of our recent Beyond the Bench: April Reineke recipients of the Board of Trustees Award, Dominic Allesio. CE Content Generation: Nea Moyer This interesting article about a malignant transformation Meetings: Heather Manternach of a burn wound was the 2018 Fellow Conference Travel Becky Stankowski Grant Neoplastic case winner. Our second CE article is Study Materials: Matt Guerin the 2018 Student Non-Delegate Conference Travel Grant winner, Samantha Etters, with a case study of a breast cancer metastasizing to the colon. Our third article is a Marketing/Communications: Charlene Gettings timely feature on the proper handling of breast cases, by Vice Chair: Joel Wichmann James Barry and Angeline Dowell. Ad Sales: Janelle Fabian Advocacy: Open All three featured articles are informative and great reads. Communication - Electronic: Open Each case study was something I have never come across Communication - Print: Beth Felicelli in my 20+ years at the bench. I always enjoy reading about Marketing - External: Open cases I’ve never seen and it’s a great opportunity to learn Marketing - Internal: Annie Schniederjan something new. Media: Ryan Schniederjan Larry Marquis was presented the Lifetime Achievement Award in New Orleans this fall. Thank you, Larry, for all you Membership: Roseann Vitale have done for the AAPA! See page 13 for more information Vice Chair: Dominic Alessio on Larry’s achievements. Recruitment: Tara Shea-Leandro Retention: James Romnes Specialty Groups: Coy Wagoner Student Committee: Sabrina Innes Kristina Scharer-Zielinski AAPA Core Values: Student Delegate Program: Brittin Cavanagh Surveys: Derek Deutsch Quality Patient Care: Volunteer Management: Open The AAPA ensures quality patient care is an integral component to the environment and endeavors of the Association. Operations Dir. of Professional Development: Connie Thorpe Education: Dir. of Professional Outreach: Jon Wagner The AAPA provides educational opportunities that support patient Technical Support: Ryan Schniederjan care and promote the advancement of professional competencies. Advocacy: The AAPA advocates for pathologists’ assistants. Collaboration: The AAPA commits to active collaboration with outside organizations whose purposes are synergistic with the Association. PATHASSIST.ORG Page 3 Transformation invasion, lymphatic spread and wide outflow tract mass measuring nearly 3 cm metastasis.4 As with most conditions, early in greatest dimension, protruding into the > Continued from cover diagnosis and treatment leads to improved right ventricle. Initial CT scans additionally In addition, the HRAS gene
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