Thyroid carcinoma showing thymus-like differentiation (CASTLE) is a rare tumor of the thyroid gland or adjacent soft tissues of the neck. Given the comparatively good prognosis of CASTLE, it is crucial to distinguish this neoplasm from other more aggressive thyroid neoplasms that can have similar or overlapping cytomorphological features. However, there is little information about the cytomorphology of CASTLE available in the literature. Here we report the cytomorphology and histology of thyroid CASTLE in a 52-year-old woman and present a review of the literature.

Extranodal follicular dendritic cell sarcoma is a rare tumor of follicular dendritic cells that can occur in a wide variety of sites. Although fairly well characterized histologically, with a distinct immunophenotype, it remains underrecognized, with as many as one third of cases initially misdiagnosed. This is often due to a failure to consider the entity. Patients with this tumor may have a worse prognosis than originally described. Prompted by a recent case at our institution, we briefly review the clinical features, etiology, histologic, and cytologic appearance of the tumor, as well as the ancillary studies useful in resolving diagnostic issues, primarily in an attempt to increase recognition of this rare neoplasm.

Hybrid neurofibroma-schwannomas may arise within the orbit.

Cell surface expression of glucose-regulated protein 78 (GRP78) occurs in several types of cancer; however, its role in the behavior of primary cutaneous melanoma is not well studied. The association of cell surface GRP78 with other proteins such as MTJ1 stimulates cell proliferation. In this study, we characterized the pattern of expression of GRP78 and MTJ1 in invasive primary cutaneous melanomas and analyzed the relationships between the pattern of expression and various clinicopathological parameters. We found two patterns of GRP78 expression in invasive primary cutaneous melanoma. One pattern showed a gradual fading of protein expression from superficial to deeper levels within the same tumor. The second pattern of expression showed a similar fading with an abrupt regaining of expression at the deep invasive edge of the melanoma. These two distinct patterns of GRP78 expression correlated with both patient survival and depth of tumor invasion. A moderate MTJ1 expression was found to be associated with decreased patient survival; however, no significant associations were observed between patterns of GRP78 and MTJ1 expression. Our study (1) describes two distinct patterns of GRP78 in invasive primary cutaneous melanoma, (2) inversely correlates regain of GRP78 expression with patient survival, and (3) suggests a modifying effect of MTJ1 on GRP78 in enhancing tumor aggressiveness.

Testing for high-risk (HR) human papillomavirus (HPV) is a key component of current recommendations for cervical cancer screening. Herein is described our clinical experience using Cervista HPV HR, a testing platform recently approved by the USThe relationship of cervical cancer and cervical intraepithelial neoplasia grades 2 and 3 to persistent infection with human papillomavirus (HPV) is well established. Since the identification of HPV as the primary etiologic agent of cervical cancer, 1 14 sexually transmitted oncogenic variants have been identified. These variants, referred to as the high-risk subtypes (HPV 16,18,31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 66, and 68), are responsible for most cervical cancers worldwide. [2][3][4] The remarkable success of Papanicolaou test-based cervical cancer screening programs demonstrates that cervical cancer is largely preventable. However, despite its many advantages and historical success, morphologic examination of cervical cytologic material alone has limitations as a screening test. The addition of high-risk HPV (HR-HPV) DNA testing to screening algorithms has enabled better identification of clinically significant precancerous cervical lesions and more accurate evaluation of the risk of developing cervical cancer. 5,6 HR-HPV DNA testing is currently recommended by the American Society for Colposcopy and Cervical Pathology screening guidelines in two principal clinical settings. One setting in which HR-HPV DNA testing is beneficial is when cytologic findings are ambiguous or equivocal. HR-HPV DNA testing for triage of patients with atypical squamous cells of undetermined significance (ASC-US) cytological interpretations decreases colposcopic referrals by roughly half without sacrificing screening sensitivity. 7 A second setting in which HR-HPV testing is useful is for primary screening ("co-testing," along with cytology) in patients aged 30 years or older. Women in this group with both normal cytological interpretations (ie, negative for intraepithelial lesion or malignancy [NILM]) and negative HR-HPV test results are at extremely low risk of developing cervical cancer over the next several years. 8 Accordingly, the current

We describe radiologic findings in 2 patients and 18-fluoro-deoxy-glucose positron emission tomography/computed tomography findings in 1 patient who developed Kaposi sarcoma of the lung after bilateral lung transplantation. These findings included lung nodules, mediastinal or hilar lymphadenopathy, and pleural fluid.

Kaposi's sarcoma (KS) is associated with solid-organ transplantation, but is extremely rare after lung transplantation. In this report, we describe two unique cases of lung transplant recipients who developed KS in the lung allograft and were treated with sirolimus and liposomal doxorubicin. One patient survived 12 months after the diagnosis of KS; the other survived 3 months after diagnosis and was found to have concomitant EBV-negative, HHV-8-positive B-cell lymphoma. We demonstrate a partial response of pulmonary KS to reduced immunosuppression and the initiation of sirolimus in one patient, as well as an association between increasing HHV-8 viremia and progression of pulmonary KS. Our report highlights the importance of secondary malignancies in patients with transplant-related KS and supports the association between HHV-8 infection and EBV-negative PTLD.

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