This Week in Modern Pathology

In Modern Pathology, researchers led by Memorial Sloan-Kettering Cancer Center's Douglas Levine examine whether there are morphological characteristics common to ovarian cancers in cases with BRCA1 and BRCA2 mutations. They found that BRCA1- and BRCA2-associated cancers had more solid, pseudo-endometrioid, and transitional cell carcinoma-like morphology, and that BRCA1-associated cancers also had higher mitotic indices, a greater number of tumor-infiltrating lymphocytes, and geographic or comedo necrosis. "We have demonstrated very strong correlations between genotype and high-grade serous carcinoma phenotype," Levine and his colleagues write. The researchers also developed two algorithms to distinguish BRCA1-associated cancers from non-associated cancers based on morphological features. "The data suggest that the algorithms significantly enrich the pool of patients to be tested by increasing the positive predictive value from that expected by chance (16 [to] 17 percent) to as high as 60 percent, although it is acknowledged that the test set overrepresents the prevalence of BRCA1 germline mutations," the researchers add.

Researchers in Spain examined the sensitivity and specificity of CD2 and CD25 expression for diagnosing systemic mastocytosis. The researchers note that the World Health Organization's diagnostic criterion for the condition includes "aberrant expression of CD2 and/or CD25 by bone marrow, peripheral blood, or other extracutaneous tissue mast cells." From their sample, the researchers found that the WHO criterion had 100 percent sensitivity and 99 percent specificity, while CD25 expression alone yielded 100 percent sensitivity and 99.2 percent specificity — inclusion of CD2 actually decreased the test's specificity. "Our results suggest that expression of CD2 does not add to that of CD25 in the diagnosis of systemic mastocytosis, and that this should be considered in future revisions of the current World Health Organization phenotypic criterion for systemic mastocytosis," the researchers add.