Review of findings in prophylactic gynaecological specimens in Lynch syndrome with literature review and recommendations for grossing.

AIMS: Prophylactic hysterectomy with bilateral salpingo-oophorectomy is being increasingly undertaken in patients with Lynch syndrome (LS). The pathological features in such specimens are not well described and, unlike the SEE-FIM protocol for salpingo-oophorectomy specimens in BRCA1/2 mutation carriers and the gastrectomy grossing protocols for patients with CDH1 (E-cadherin) mutations, guidelines have not been devised for the grossing of prophylactic gynaecological specimens from LS patients. We aimed to review the pathological findings in a series of prophylactic gynaecological specimens from LS patients and develop guidelines for the grossing of these specimens. METHODS AND RESULTS: We reviewed the pathological findings in 25 prophylactic gynaecological specimens from LS patients and audited the grossing protocols in different centres across Ontario, Canada. We found a 32% incidence of endometrial carcinoma or a precursor lesion; the two endometrial cancers identified were low-grade, low-stage endometrioid adenocarcinomas. To address the absence of guidelines for pathological examination, we undertook a literature review of gynaecological malignancies and incidental findings in prophylactic specimens in LS patients. CONCLUSION: We provide recommendations regarding the grossing of such specimens which includes in-toto examination of the lower uterine segment, endometrium, ovaries and fallopian tubes with representative sampling of the cervix.

Do trans-Pacific air masses deliver PBDEs to coastal British Columbia, Canada?

In order to distinguish between 'local' and 'background' sources of polychlorinated biphenyls (PCBs) and polybrominated diphenyl ethers (PBDEs) in coastal British Columbia (Canada) air, we collected samples from two sites: a remote site on western Vancouver Island, and a near-urban site in the Strait of Georgia. Seasonally-integrated samples of vapor, particulate, and rain were collected continuously during 365 days for analysis of 275 PCB and PBDE congeners. While deposition of the legacy PCBs was similar at both sampling sites, deposition of PBDEs at the remote site amounted to 42% (10.4 mg/ha/year) of that at the near-urban site. Additional research into atmospheric circulation in the NE Pacific Ocean will provide more insight into the transport and fate of priority pollutants in this region, but trans-Pacific delivery of PBDEs to the west coast of North America may underlie in part our observations. For example, approximately 40% of >12,000 ten-day back trajectories calculated for the remote site originated over Asia, compared to only 2% over North America.