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Canadian Journal of Volume 9 Issuenumro 4 pathology pathologie Revue canadienne de IMHMV Case RepoRt PM 43490512 www.capacp.org

Canadian Association of Pathologists Association canadienne des pathologistes T Jan 1 to Sun Jan 1 , 201 Hilton Garden Inn Toronto Airport West faculty of skilled pathologists will focus on wha

Canadian Journal of Volume 9 issue 4 eDItoRINCHIeF George M Yousef, MD, PhD FRCPC Path eDItoR eMeRItUs J. Godfrey Heathcote, MA, MB, BChir, PhD, FRCPC FoUNDING eDItoR Jagdish Butany, MBBS, MS, FRCPC

LETTER FROM THE EDITORINCHIEF OPEN ACCESS JOURNALS THE FUTURE OF SCIENTIFIC PUBLISHING he pros and cons of open access publishing is an oftendebated and controversial topic. Open access OA journals ar

eDItoRIaL boaRD eDItoRIaL boaRD Irvaym B. Barsoum MD, MSc, PhD Michael Carter MD, PhD Hala Faragalla MD, FRCPC Louis Gaboury, M.D., Ph.D., F.R.C.P.C, F.C.A.P. John Gartner, MD CM, FRCPC Laurette Geld

LETTRE DU RDACTEUR EN CHEF LES REVUES LIBRE ACCS LAVENIR DE LA PUBLICATION SCIENTIFIQUE U n sujet souvent dbattu et controvers se rapporte au pour et au contre de la publication en libre accs. Le

LettRe DU RDaCteUR eN CHeF suite colloques scientifiques, etc. Pour aller de lavant, nous devons entamer un dialogue sur la faon de couvrir les cots de publication la hausse. Diffrentes stratgies son

EMPOWERING PATHOLOGY TO IMPROVE CANCER CARE The Sectra Digital Pathology Solution offers complete review functionality for the pathologist to optimize workflow through a stateoftheart diagnostic viewe

MoleCulaR pathology CoRneR This article was peerreviewed. KeywoRds immune checkpoint, pdl1, biomarker. CoMMeNtaRy oVeRVIew oF pDL1 testING author affiliations Michelle R. Downes1,2 MBBChBAO, MRCSI,

MoleCulaR pathology CoRneR pDL1 testING cont. conventional therapies in the setting of advanced and metastatic disease.3 These results led to the Food and Drug Administration FDA granting approval for

MoleCulaR pathology CoRneR pDL1 testING cont. the potential for test interchangeability is being actively explored FDA has approved PD1PDL1 inhibitors in bladder cancer without the requirement for a

MoleCulaR pathology CoRneR pDL1 testING cont. Treatment decisions are being informed by the level of PDL1 expression evolution of combinatory therapy is ongoing with immune checkpoint inhibitors bei

Anatomical Pathologist Locum Laboratory Medicine Eastern Health The Laboratory Medicine Program of Eastern Health invites applications for the position of locum Anatomical Pathologist. All applicants

The Banff Pathology Course is a h P y o s collaborat ve effort of the Can ati anadian Association of Pathologists C ACP, CAPDepartmen of Laboratory Medicine and nt e Pathology, University of Alber a a

RubRique de pathologie MolCulaiRe Cet article a t rvis par des pairs. Mots Cls point de contrle immunitaire, pdl1, biomarqueur CoMMeNtaIRe apeRU De LaNaLyse De pDL1 auteur Michelle R. Downes1,2,

RubRique de pathologie MolCulaiRe aNaLyse De pDL1 suite rsultats ont men lapprobation par la Food and Drug Administration FDA de mdicaments antiPD1PDL1 pour traiter le mlanome, ladnocarcinome du rein

RubRique de pathologie MolCulaiRe aNaLyse De pDL1 suite le potentiel dinterchangeabilit des diffrents tests est activement tudi La dtection des patients les plus susceptibles de tirer des bienfaits

RubRique de pathologie MolCulaiRe aNaLyse De pDL1 suite immunotherapy. Nat Rev Cancer. 201212252264. 3. Topalian SL, Taube JM, Anders RA, Pardoll DM. Mechanismdriven biomarkers to guide immune checkpo

Applications and nominations are currently being accepted for the following 2018 awards BackgroundPurpose This annual award is offered by the CAPACP to recognize meritorious scientific work, experimen

ConteMporaRy issues sURUtILIsatIoN Des exaMeNs De LaboratoIRe eN MDeCINe paRVeNIR expLoIteR Les RessoURCes De MaNIRe INteLLIGeNte GRCe La CoLLaboratIoN auteurs Michelle Sholzberg, MDCM, M. Sc., F

ConteMporaRy issues This article was peerreviewed. KeywoRds laboratory utilization, blood tests, overutilization oVeRUtILIzatIoN oF Lab tests IN MeDICINe aCHIeVING sMaRt testING tHRoUGH CoLLaboratIo

ConteMporaRy issues oVeRUtILIzatIoN oF Lab tests cont. I t has been suggested that almost fifty percent of clinical laboratory testing may not be necessary.1 Unnecessary tests are those which are un

ConteMporaRy issues oVeRUtILIzatIoN oF Lab tests cont. If you have limited time and resources to make a change, focus on areas where overuse is common, and where change is most feasible. metaanalysi

Case RepoRt HypeRpLasIe MyoINtIMaLe IDIopatHIqUe Des VeINes MseNtRIqUes UN DIaGNostIC Ne pas NGLIGeR CHez Les patIeNts atteINts DUNe IsCHMIe INtestINaLe auteurs Hui Wang, M.D.1 Sheev Dattani, M.D.

Case RepoRt This article was peerreviewed. KeywoRds idiopathic myointimal hyperplasia of mesenteric veins iMhMV, inflammatory bowel disease ibd, ischemic bowel disease, toxic megacolon, elastic stain

Case RepoRt IMHMV Case RepoRt cont. cNK INTRODUCTION Idiopathic myointimal hyperplasia of mesenteric veins IMHMV is a rare disease. It was first reported in 1991 by Ganta and Haggitt4 in four male pa

Case RepoRt IMHMV Case RepoRt cont. cPK remote from the areas of ulceration, including those in submucosa and subserosa. There was marked myointimal hyperplasia of veins Figure 3. Some veins showed co

Case RepoRt IMHMV Case RepoRt cont. Generally, histopathological findings of IMHMV showing ischemic injuries vary from superficial mucosal necrosis to transmural necrosis with vascular congestion and

Case RepoRt IMHMV Case RepoRt cont. Pathologists should be alert and consider IMHMV in the differential diagnosis of ischemic bowel disease. 6. Laskaratos FM, Hamilton M, Novelli M, Shepherd N, Jon

ReseaRCh aRtiCle CaRCINoMes INVasIFs DU seIN assoCIs Des RsULtats De tests DHybRIDatIoN IN sItU qUIVoqUes poUR HeR2 UN DFI aUqUeL FoNt soUVeNt FaCe Les patHoLoGIstes et Les oNCoLoGUes auteurs Gill

ReseaRCh aRtiCle This article was peerreviewed. KeywoRds heR2 testing, breast cancer, guidelines, equivocal category. INVasIVe bReast CaRCINoMas wItH eqUIVoCaL HeR2 IN sItU HybRIDIzatIoN test ResULt

ReseaRCh aRtiCle eqUIVoCaL HeR2 IsH bReast CaNCeRs cont. Perspective HER2 ISH categories have changed, resulting in more equivocal cases. This project is intended to highlight the work undertaken when

ReseaRCh aRtiCle eqUIVoCaL HeR2 IsH bReast CaNCeRs cont. institution is generally performed on the excisional specimen for primary breast cancer, unless the preanalytical handling is nonstandard or th

ReseaRCh aRtiCle eqUIVoCaL HeR2 IsH bReast CaNCeRs cont. All 8 cases that were ultimately deemed amplified following additional workup had initial scores near thresholds for HER2 gene amplification

ReseaRCh aRtiCle eqUIVoCaL HeR2 IsH bReast CaNCeRs cont. HER2 copy number in the range of 5.06.0 in two cases or HER2CEP17 ratio between 1.82.0 in six cases Table 3. A case example is illustrated in F

ReseaRCh aRtiCle eqUIVoCaL HeR2 IsH bReast CaNCeRs cont. evaluation are generally not eligible for antiHER2 therapy in many Canadian provinces, including Ontario.13 A recent consensus statement from C

ReseaRCh aRtiCle eqUIVoCaL HeR2 IsH bReast CaNCeRs cont. We support a recommendation that repeat testing be focused on cases with equivocal scores closer to the HER2 positive cutpoints compared to t

ReseaRCh aRtiCle eqUIVoCaL HeR2 IsH bReast CaNCeRs cont. and one pathologist, with at least 120 cells scored. Most of these cases n49, 69 were in the low end of the equivocal range with a mean HER2 co

ReseaRCh aRtiCle eqUIVoCaL HeR2 IsH bReast CaNCeRs cont. guideline recommendations for HER2 testing in the management of invasive breast cancer a critical review of their implications for routing prac

ReseaRCh aRtiCle eqUIVoCaL HeR2 IsH bReast CaNCeRs cont. operable HER2positive breast cancer. N Engl J Med. 2005353167384. 15. Press MF, Sauter G, Buyse M, Fourmanoir H, Quinaux E, TsaoWei DD, et al.

VaLUatIoN DU test BLaCtatM poUR La DteCtIoN rapIDe Des btaLaCtaMases speCtRe LaRGI DIReCteMeNt paRtIR DCoUVILLoNNaGes ReCtaUx auteurs Manal Tadros, MBBS, Ph. D., FRCPC1,2 Prameet M. Sheth, Ph. D.,

ReseaRCh aRtiCle This article was peerreviewed. KeywoRds eVaLUatIoN oF tHe BLaCtatM test FoR tHe rapID DeteCtIoN oF exteNDeD speCtRUM beta LaCtaMases DIReCtLy FRoM ReCtaL swabs esbl, beta lacta, rec

ReseaRCh aRtiCle rapID DeteCtIoN oF esbL FRoM ReCtaL swabs cont. of BL was 71. BL had a sensitivity of 96 for Class A ESBL but only 15 for AmpC ESBL. For Class A ESBL producers, the sensitivity of the

ReseaRCh aRtiCle rapID DeteCtIoN oF esbL FRoM ReCtaL swabs cont. Using isolated colonies the sensitivity of the BL test for detecting Class A ESBL was 96. In contrast, the sensitivity for the detecti

ReseaRCh aRtiCle rapID DeteCtIoN oF esbL FRoM ReCtaL swabs cont. were evaluated by the BL assay. Of the 176 ESBL isolates, 108 isolates were Class A ESBL, 54 were AmpC, 5 isolates had both Class A and

ReseaRCh aRtiCle rapID DeteCtIoN oF esbL FRoM ReCtaL swabs cont. positive in all 5 KPC, 3 NDM isolates and the K1 hyper producer K. oxytoca. All KPC and NDM isolates were confirmed using a multiplex P

ReseaRCh aRtiCle rapID DeteCtIoN oF esbL FRoM ReCtaL swabs cont. This testing method would serve to significantly reduce the turnaroundtime for reporting out ESBL positive organisms. The high PPV of

ReseaRCh aRtiCle rapID DeteCtIoN oF esbL FRoM ReCtaL swabs cont. 6. Clinical and Laboratory Standards Institute CLSI. Performance standards for antimicrobial susceptibility testing 23rd informational

Congratulations to the 2017 Award recipients The CAPACP wishes to congratulate all of those who were recognized for their contributions to the CAPACP or who won an Association award this year. Award A

ReseaRCh aRtiCle CHaNGeMeNts IMMUNopatHoLoGIqUes obseRVs DaNs Les tIssUs aDIpeUx et LINtestIN Des patIeNts aUx pRIses aVeC UNe INsULINoRsIstaNCe assoCIe LobsIt auteurs Helen Luck1,2,6 Shawn Winer,

ReseaRCh aRtiCle KeywoRds intestinal immune system adipose inflammation obesity insulin resistance metabolic syndrome. aDIpose aND INtestINaL IMMUNopatHoLoGy IN obesIty ReLateD INsULIN ResIstaNCe au

ReseaRCh aRtiCle aDIpose aND INtestINaL IMMUNopatHoLoGy cont. investigated. This review aims to discuss recent advances regarding immunological changes within the visceral adipose tissue and intestine

ReseaRCh aRtiCle aDIpose aND INtestINaL IMMUNopatHoLoGy cont. The morphological signature of inflammation in VAT during insulin resistance is the infiltration of inflammatory macrophages and other im

ReseaRCh aRtiCle aDIpose aND INtestINaL IMMUNopatHoLoGy cont. VAT are just beginning to be discovered. One such target might lie within the intestinal immune system makeup, as this system interacts fi

ReseaRCh aRtiCle aDIpose aND INtestINaL IMMUNopatHoLoGy cont. Moreover, impaired function of the intestinal barrier occurs during dietinduced obesity with the leakage of bacterial products and antige

ReseaRCh aRtiCle aDIpose aND INtestINaL IMMUNopatHoLoGy cont. Interesting observations have already emerged in characterizing intestinal adaptive immune cells during dietinduced obesity in both murin

ReseaRCh aRtiCle aDIpose aND INtestINaL IMMUNopatHoLoGy cont. cNKbK Consumption of a balanced diet high in indigestible fibres shortchain fatty acids SCFA and fruits and vegetables AHR ligands contri

ReseaRCh aRtiCle aDIpose aND INtestINaL IMMUNopatHoLoGy cont. With the growing amount of evidence, it is convincing that the interactions in the intestine between the diet, gut microbiota, intestinal

ReseaRCh aRtiCle aDIpose aND INtestINaL IMMUNopatHoLoGy cont. cOWfJsqK A Western diet induces changes to the composition of the gut microbiota and to the inflammatory makeup within the intestine. Thi

ReseaRCh aRtiCle aDIpose aND INtestINaL IMMUNopatHoLoGy cont. track during obesity. Diabetologia. 20165987994. 7. Perry RJ, Camporez JP, Kursawe R, Titchenell PM, Zhang D, Perry CJ, et al. Hepatic ace

ReseaRCh aRtiCle aDIpose aND INtestINaL IMMUNopatHoLoGy cont. 27. Shen L, Chng MH, Alonso MN, Yuan R, Winer DA, Engleman EG. B1a lymphocytes attenuate insulin resistance. Diabetes. 201564593603. 28. P

ReseaRCh aRtiCle aDIpose aND INtestINaL IMMUNopatHoLoGy cont. acidinduced insulin resistance. J Clin Invest. 2006116 301525. 49. Oh DY, Walenta E, Akiyama TE, Lagakos WS, Lackey D, Pessentheiner AR, e

PDL1 TESTING MATTER Immunotherapy decisions are informed by PDL1 expression15 Current antibodies used in immunooncology target the PD1PDL1 and CTLA4 inhibitory checkpoint pathways. The treatment preve

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