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A national project for the quality assessment of breast immunohistochemistry, involving 155 pathology laboratories distributed all over the Italian territory ( 19 regions), was carried out. The Project lasted one year from December 2014 to December 2015 and it was strongly supported by the Italian Society of Anatomic Pathology (SIAPEC/IAP). Proficiency tests were carried out by the Nordic Immunohistochemical Quality Control (NordiQC) organization. The main aim of the project was to investigate on the general performance of immunohistochemistry (ER, PR and HER2) in the field of breast cancer in the Italian territory, in order to emphasize any difference and give practical support to laboratories in daily practice., The present review article focused on the description of this extraordinary pioneer Italian experience. Besides NordiQC results, further analysis concerning epidemiology and geographical distribution were done., Aim of the study was to analyze the general results and to discuss on the benefits that a national quality control program may have if it became a mandatory service provided by the National Health Care System., In general, the Italian data were in accordance with the general results obtained from the "official" NordiQC HER2, PR and ER assessments. A HER2 scoring consensus between labs and assessor group was achieved in 80% of cases., Interestingly, what emerges from our study is that no substantial differences exist among the three Italian macro-areas (North, Center and South) in the quality of Immunohistochemistry performed for breast cancer. No statistically significant difference was even found between laboratories that perform more or less than 100 tests/year., (Copyright © 2018 Società Italiana di Anatomia Patologica e Citopatologia Diagnostica, Divisione Italiana della International Academy of Pathology.)

A case of hepatic splenosis, diagnosed by FNA cytology, in a 56 years old cirrhotic man is reported. The cytologic material, aspirated from a 4.8 cm "suspicious for hepatocarcinoma" nodule, showed, within a hematic background, small-medium sized lymphoid cells, neutrophils and eosinophils granulocytes, histiocytes with large cytoplasm, plasma cells; mixtures of these cells, within a reticular network, were often aggregated in large structures, in which endothelial cells organized in vascular-like structures were also visible. The cell block, showed sinusoidal structures, lymphoid follicular aggregates and fibrous septa, strongly suggesting the micromorphology of the normal spleen. Splenosis is an autotransplant of splenic tissue, morphologically organized in non-capsulated, functioning, self-limited nodules, secondary to a post-traumatic splenectomy. Usual presentation of this condition is the presence of several bluish nodules on the peritoneal surface. Nevertheless, sporadic cases in other organs have been reported. To the best of our review of the Medical Literature, a hepatic splenosis is an exceptional even and the present is the first case in this location diagnosed by FNA cytology. The present one is also the case with the largest latency between the splenectomy and the splenosis detection (43 years).

Background: Pathologic staging and grading are the most important prognostic factors in prostatic cancer. Unfortunately, pathologic staging needs to be evaluated by surgical procedures; moreover, the proposed grading systems are largely based upon subjective histopathologic evaluations. In recent years, these problems have been approached with flow cytometry (FCM). The present study evaluates the significance of DNA ploidy of prostatic carcinoma assessed by FCM., Materials and Methods: Microscopic slides from 132 core needle biopsies and 22 surgical specimens of prostatic carcinoma were reviewed and classified according to Gleason's score modified by Epstein et al. Formalin-fixed, paraffin-embedded tissue samples were prepared for FCM evaluation using standard techniques. Adequate histograms were obtained from 113 biopsies (85.6%) and from all the surgical specimens (100%)., Results: Among the 113 biopsy specimens, a statistically significant correlation was found between DNA ploidy and Epstein's grading, since high-grade neoplasms accounted for 40.38% of non-diploid cases and only for 21.33% of diploid cases (chi square = 5.8; p = 0.05). Moreover, tetraploid tumors were defined as a separate FCM category with an absolute prevalence (65.52%) of non-high grade neoplasms (chi square = 5.9; p = 0.05). Although not submitted to statistical analysis, data collected from surgical specimens showed similar distribution., Conclusions: DNA ploidy assessment by FCM is a viable procedure in the majority of needle biopsy tissue samples of prostatic carcinoma; it may produce prognostic parameters with greater objectivity than conventional histologic grading.

The authors describe 9 cases of classic osteosarcoma treated with preoperative chemotherapy according to the current schemes and consecutively treated by surgery. All the patients were between 12 and 17 years old. They initially had a needle biopsy or open biopsy to confirm the diagnosis. After 2 cycles of chemotherapy they were treated by limb salvage procedure in 7 cases and by ablative surgery in 2 cases. The surgical specimens were very accurately examined both macroscopically and histologically to evaluate the effects of preoperative chemotherapy. For this reasons the quantity of the tumoral necrosis, that represents the reaction of the tumor to the therapy, was researched and mapped. The intention was to decide whether or not to use the same pharmacological treatment after the surgical therapy. These evaluation criteria do not only have the objective of locally keeping under control the disease, but mostly to oppose micrometastasis. In fact they are almost always present at the beginning of the symptomatology but are not diagnosed with the usual exams. The sites of viable tumor after treatment are: soft tissues around the bone, areas in contact with cartilage and subcortical areas. In 6 cases out of 9 we found macroscopically a fibrous pseudo-capsule around all the tumoral area. The follow-up of the nine cases varies from six to fifty-two months and presents the 66% of disease-free survival.