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Context.-Since 2016, transoral endoscopic thyroid resection with vestibular approach (TOETVA) has been increasingly performed in the United States. Although guidelines for the procedure are evolving, indeterminate and malignant preoperative cytopathologic diagnoses are not a contraindication. There are limited data related to the pathologic examination of these specimens. Objective.-To examine the clinicopathologic features of TOETVA specimens with particular attention to limitations of interpretation of pathologic parameters and final diagnosis. Design.-We reviewed age, sex, preoperative imaging and cytologic diagnoses, surgical pathology, and clinical follow-up data in TOETVA resections from our institution for procedures performed between March 2016 and December 2019. Results.-Fifty cases of TOETVA were identified, comprising 48 women and 2 men with a mean age of 47 years. Preoperative cytologic diagnoses were available in 47 cases and included 19 nondiagnostic/benign (Bethesda I/ II), 24 follicular lesion of undetermined significance/ suspicious for follicular neoplasm (Bethesda IIl/lV), and 4 suspicious/malignant diagnoses (Bethesda V/VI). Thirtyfour cases (68%) among the surgical resection specimens showed disruption and/or fragmentation. Thirty-nine cases were negative for carcinoma, including hyperplasias and benign/indolent neoplasms. Eleven cases exhibited papillary thyroid carcinoma. Final diagnoses were reached in all disrupted/fragmented cases. In 2 cases of papillary thyroid carcinoma, tumor size, microscopic extrathyroidal extension, and margin status could not be determined. Conclusions.-A significant proportion of TOETVA specimens are disrupted/fragmented, which can compromise information about tumors, including size, number, margin status, and microscopic extrathyroidal extension. Given that these parameters inform treatment and followup, this should be considered when selecting patients for TOETVA., Transoral endoscopic thyroid resection with vestibular approach (TOETVA) has become increasingly available in the surgical management of both neoplastic and nonneoplastic thyroid conditions in the past decade. (1) Briefly, the [...]

* In this short review, we discuss primary diffuse large B-cell lymphoma of the testis, an entity that is most commonly seen in older patients. The most common clinical presentation is a unilateral testicular mass. Microscopically, the tumor shows diffuse infiltration of lymphocytes between intact seminiferous tubules. Spermatogenic arrest, interstitial fibrosis, and tubular hyalinization are commonly seen. The tumor is positive for B-cell markers by immunohistochemistry. Treatment has traditionally been with orchiectomy and combination chemotherapy; however, only a minority of patients enjoy a prolonged disease-free survival. Differential diagnosis includes seminoma and viral and granulomatous orchitis. doi:10.5858/arpa.2010-0158-RS, Primary testicular lymphoma is a collection of neoplasms that comprises only 1% to 9% of testicular neoplasms. However, it is the most common malignant testicular tumor in men older than [...]

* In this short review, we discuss clear cell adenocarcinoma of the urinary bladder, a rare tumor that primarily affects women. The histogenesis of this neoplasm is uncertain; in some tumors the clinicopathologic and histologic features are suggestive of a mullerian origin. Clear cell adenocarcinoma consists of cells with abundant clear cytoplasm, arranged in solid, glandular, or tubulocystic patterns. These tumors are positive for pancytokeratin, cytokeratin 7, and CA 125 immunohistochemical stains. Patients typically present with gross hematuria, dysuria, and discharge. The natural history is poorly understood and patient outcomes remain unclear. Currently, surgery is the treatment of choice. Nephrogenic adenoma is the most important differential diagnostic consideration, followed by metastatic clear cell carcinoma., Clear cell adenocarcinoma (CCA) usually arises from the female genital tract. However, CCA is sometimes found in the lower urinary tract in women, most commonly involving the urethra, (1) where [...]

* Amnion nodosum is commonly regarded as a placental hallmark of severe and prolonged oligohydramnios. It consists of nodules of amorphous granular material present on the surface of the amnion. We reviewed all 45 cases of amnion nodosum from our placental database from 1994 through 2003 (study group). The control group consisted of 45 cases from the same database matched for gestational age but without amnion nodosum. Oligohydramnios, multiple pregnancy, perinatal mortality, macerated stillbirths, and chronic twin-twin transfusion were the most common clinical features encountered in the study group. Luminal vascular abnormalities of chorionic villi, fibrosis of chorionic villi, and placental edema were the placental features that were more frequently present in the study group. (Arch Pathol Lab Med. 2007;131:1829-1833), Amnion nodosum (AN) is a placental lesion consisting of numerous small nodules on the amnion of the chorionic disc, placental membranes, or the umbilical cord. Prior to 1950 when Landing [...]