What's in a Name? Replacing Pejorative Terminology in Anatomic Pathology.

Recent changes to medical terminology and nomenclature have made strides to improve ethical integrity in healthcare. Removing tarnished eponymous namesakes and depreciative descriptions from the medical lexicon is a challenging, but righteous undertaking. In this article, the authors propose replacing the pejorative histologic description of "Indian file" with "Tusken Raider file."

Pathologic complete response following low-dose radiation for advanced oral cavity cancer in a patient with human immunodeficiency virus.

BACKGROUND: Advanced squamous cell carcinoma (SCCa) of the oral cavity is often not amenable to curative-intent therapy due to tumor location, tumor size, or comorbidities. CASE PRESENTATION: A 51-year-old male patient with human immunodeficiency virus and on highly active antiretroviral therapy (HAART) presented with a cT4aN2c SCCa of the tongue. He received a preoperative single course of Quad-Shot radiation therapy to 14 Gy in 4 fractions followed by surgical resection. Patient had no residual carcinoma on surgical pathology and no evidence of disease on subsequent clinical and radiological exams. CONCLUSIONS: To our knowledge, this is the first case of pathologic complete response for a patient on HAART following a single cycle of the Quad-Shot regimen for advanced oral cavity SCCa. Protease inhibitors in HAART can induce spontaneous tumor regression via inhibition of proteasome function and activation of apoptosis, and thus act as a cancer therapeutic.

Cytologic evaluation of p16 staining in head and neck squamous cell carcinoma in CytoLyt versus formalin-fixed material.

BACKGROUND: The management of high-risk human papillomavirus (HR-HPV)-related oropharyngeal head and neck squamous cell carcinomas (HNSCCs) are distinct from HNSCC linked to smoking and alcohol use. HR-HPV-positive HNSCC frequently presents as a cervical lymph node metastasis. Because fine-needle aspiration (FNA) is often the initial diagnostic procedure, evaluating HR-HPV status in cytology specimens is important. The overexpression of p16 is a surrogate for HR-HPV; however, the evaluation of p16 in FNAs remains controversial. METHODS: From September 2015 to December 2016, cytopathologists performed 25 FNAs of neck lymph nodes that were suspicious for HR-HPV-positive HNSCC. Initial passes produced smears for on-site evaluation and CytoLyt material. Additional passes were formalin-fixed. A CytoLyt cell block (CCB) and a formalin-fixed cell block (FFCB) were prepared, and p16 immunocytochemistry was performed. RESULTS: In 24 of 25 cases, the FFCB had diffuse (≥70% of cells), strong nuclear/cytoplasmic p16 staining. In all 24 of these cases, HR-HPV was detected by in situ hybridization. The corresponding CCB had weak-to-moderate p16 staining in <70% of cells (range, 5%-60% of cells) in 17 cases, 4 had weak-to-moderate diffuse staining, and 4 were acellular. The percentage of p16-positive cells was significantly higher with FFCB than with CCB (formalin: 94% ± 2%; CytoLyt, 38% ± 7%; 2-tailed, paired Student t test; P < .001; Fisher exact test, P < .001). CONCLUSIONS: The fixative used had a drastic impact on p16 staining, which explained the staining variability reported in the literature. FFCBs show a diffuse staining pattern, which correlates with HR-HPV status, whereas CCBs show a weaker and inconsistent staining pattern, which is more difficult to interpret.

Renal Papillary Necrosis Caused by Protein C Deficiency Leading to Recurrent Hydronephrosis.

A patient with history of a solitary functioning kidney and protein C deficiency (PCD) presented with recurrent severe hydronephrosis causing acute kidney injury upon chronic kidney disease. Work-up with endoscopic evaluation revealed renal papillary necrosis (RPN) and sloughed renal papillae to be the true cause of the recurrent obstruction. Pathologic evaluation of the sloughed tissue confirmed the diagnosis of RPN. This is the first case reported in the literature illustrating the unique presentation of RPN in the setting of PCD.