Int J Gyn Path July 2017

Lichen Sclerosus in Vulvar Squamous Cell Ca- Davick et al.

Is seen in 30% of the cases of SCC.

It would be more informative to include: 1- histologic features that might indicate the progression tp SCC, epithelial proliferation? Atypia?

And 2-the result of p53 stain in the different components.

Biomarkers Accuracy in AdenoCa of the Cervix-Lee et al.

A very extensive review of the literature without significant results. According to the authors, the main stain identifying endocervical adenocarcinoma is p16; however, there is no mention of the problem that 5% of the metaplastic lesions create because of a positive "block positive" staining.

An important comment would be that immunostains are probably not needed in most cases of endocervical adenocarcinomas.

Virilization of Mesonephric Duct Remmants and Cervical Squamous Epithelium in Transgenders- Singh et al.

Excellent article describing a new type of pathology.

A Biomarker Panel Increases the Reproducibility in Endometrial Biopsy Diagnosis-Nastic et al.

What is the gold standard in pathology?

The opinion of a few pathologists or what happened to the patients? Does FIGO agree that the grading of endometrial carcinoma depends on the immuno results? How the authors classify an endometrioid carcinoma that is positive for ER and also for p53?

Shouldn't they do studies correlating the results of the immuno with the follow-up of the tumor?

They should include references supporting that 70% staining with p53 is a significant value.

Endometrial Thickness by Ultrasound and Histopatologic Diagnosis- Patel

Excellent study showing that bleeding is more importanat than endometrial thickness.

L1CAM and HER2 in Endometrial Cancer-Azim et al.

I believe that when markers that are not in common use for a neoplasm are reported as having an important effect in the prognosis of the neoplasm, they should be compared with the most common markers used in the same tumor. L1CAM and HER2 vs ER, PR, Ki67, and Pten.

Value of Pathology Review of Ovarian Tumors-Stewart et al.

It is difficult to see the value of this study, it is a pathology review, but in 90% of the cases only the report was reviewed. Apparently, the goal of the authors was to change any diagnosis that was not high grade serous carcinoma, low grade serous carcinoma, endometrioid carcinoma, clear cell carcinoma, or mucinous carcinoma. Cases diagnosed as undifferentiated carcinoma, transitional carcinoma, or mixed types were reclassified as serous carcinoma. The authors explain that this uniformity is better for epidemiologic studies. Obviiously, it would be easier for epidemiologic studies if there few subtypes of ovarian cancer. However, there must be a reason why these carcinomas have a different histologic appearance. There is a possibility that this is related to different genes. A clear example of this is in the cases with SET morphology in BRCA + patients. My view of progress in cancer is the following: Pathologists find the histologic variants of a given tumor, and then researchers find the genes that are seen in these histologic variants. Then it is possible to develop personalized treatments.

There are many samples of malignant neoplasms that today are characterized by a genetic change. But, the first step was achieved by an anatomic pathologists identifying different histologic changes.

I also wonder: How they can teach a resident in Western Australia that a solid carcinoma in the endometrium is an undifferentiated carcinoma but a similar tumor in the ovary is a serous carcinoma?

For many years the term referring to serous carcinoma of the ovary was papillary serous carcinoma. Since this term did not fit the image that some authors had of serous carcinoma ( some were not papillary), the papillary part of the name was dropped. Since many of these tumors do not have serous differentiation, are they going to drop the serous part of the name?

Primary Mucinous Carcinoma of the Fallopian Tube- Wheal et al.

This is a highly unusual case report, irrelevant as a case report, but it has a great message. I believe that multicentricity is very important explaining why serous neoplasms are usually high stage neoplasms. Low grade lesions are usually found in conjunction with endosalpingiosis. Something similar applies to endometrioid tumors and endometriosis. In this article by Wheal et al, mucinous carcinoma in the fallopian tube was found in association with mucinous tumors in the ovaries, benign, and borderline, and with areas of mucinous metaplasia. The concept of multicentricity probably applies to all the different epithelial types of ovarian lesions.