Updated Guidelines for HER2/neu Testing of Breast Cancer

Testing for HER2/neu is the important diagnostic methodology in the breast cancer management as women with HER2-positive breast cancer are greatly benefited by HER2-targeted therapy such as trastuzumab (Herceptin).

Presently the targeted HER2 therapy is expanding and few more drugs are available which are lapatinib (Tykerb), pertuzumab (Perjeta), and T-DM1 (Kadcyla).

As women with HER2-positive breast cancer are significantly benefited by HER2-targeted therapy, it is important to test for HER2 in all breast cancers.

American Society of Clinical Oncology (ASCO) and the College of American Pathologists (CAP) have jointly updated the guidelines for HER2-testing in breast cancer.

Read this article for complete details.

Diagnostic Utility of Androgen Receptor to Discriminate Poorly Differentiated Urothelial and Prostatic Carcinoma

Distinguishing poorly differentiated urothelial and prostatic carcinoma by histomorphology may be sometimes difficult in some cases with limited TURP resection. Treatment options are different for these malignant conditions.

IHC staining for androgen receptor is used to distinguish these two conditions. Intense nuclear stain with higher H-score is seen in prostatic carcinoma compared to urothelial carcinoma.

Read this article for complete details.

Sputum Analysis for Lung Cancer has Gone Molecular Level

Lung cancer is one of the most common cancer killers world-wide. It is important to diagnose the disease in early stage as the prognosis improves with early diagnosis and treatment. 

Sputum cytology, bronchial brush/ lavage, FNA cytology and biopsy are the frequent diagnostic modalities for lung cancer. Molecular markers for lung cancer have been tested in the sputum with promising results. KRAS mutation, p53 mutation, DNA hypermethylation, microsatellite instability, microRNA analysis etc are under research with promising results. But these markers are not sufficiently validated to put into clinical application. 

Read this review article forcomplete details.

The role of histology in predicting recurrence of ‘type A’ thymomas

Spindle cell thymomas (type A) are benign tumors with an excellent prognosis. A few recent studies revealed aggressive behavior with local recurrences and extrathoracic metastases.

In this study, over 600 cases of thymic tumors were analyzed and identified 23 patients of pure spindle cell thymomas (WHO type A). Approximately 43% of these cases had recurrence or metastases during the follow-up period.

The presence of necrosis correlates with both relapse and extrathoracic metastases but not with the stage of diagnosis. None of the other clinical or histological features such as size, nuclear atypia, and mitotic activity, were correlated with the outcome parameters, such as stage at diagnosis, presence or absence of relapse, and extrathoracic metastases.

Histological atypia is fairly common in ‘type A’ thymomas. The presence of necrosis was associated with both loco-regional and systemic disease and none of the other clinical or histological features correlated with aggressive behavior.

Read this article. 

Scientists Finally Discover the Function of the Human Appendix

Appendix is a vestigial organ; what we have studied during our undergraduate days. In a lighter vein it is told that the most common indication for appendicectomy is the presence of appendix!! (surgical friends, please excuse me!!). 

But now the researches say that “it acts as a safe house for good bacteria, which can be used to effectively reboot the gut following a bout of dysentery or cholera”.

Read this article. 

Hatched …

Medicine is like an ocean, someone said. But I don’t agree with!! Ocean has its own depth, limits and boundaries. But the medicine; no limits, no boundaries. Yesterday’s hypothesis today’s reality; today's reality tomorrow's history. What was right yesterday is proved wrong today and vice-versa.

Being student of pathology it was always fascinating for me know and understand new advents in the field laboratory medicine. In this limitlessly ever expanding science, as a diagnostician, it is essential to keep abreast with the recent trends and advances in the field of diagnostics. Immunology, molecular biology and genetics are the fields that are aggressively attended to in the area of laboratory medicine. 

It is virtually impossible to follow all the information that is flown in the modern day laboratory medicine. 
This blog is an attempt to share some of the recent trends and advances in the field of laboratory medicine gathered by me, without leaving the basics, precisely...!!