Belfast Pathology 2017. 10th Joint Meeting of the British Division of the International Academy of Pathology and the Pathological Society of Great Britain & Ireland, 20–23 June 2017

In adults with an idiopathic interstitial pneumonia (IIP), an updated classification system was published in 2013.Definitions for the 7 histological patterns remain essentially unchanged, there have been numerous advances in the last decade.For usual interstitial pneumonia (UIP), updated management recommendations were published in 2011 and a pattern of UIP is now being increasingly recognised in biopsied patients who do not have IPF after multidisciplinary review, especially chronic hypersensitivity pneumonitis and connective tissue disase (CTD)-related disease.Idiopathic non-specific interstitial pneumonia is now recognised as a specific clinico-pathological entity, with the majority cases proving to have secondary associations/causes after multidisciplinary review.Respiratory bronchiolitis-interstitial lung disease is now commonly diagnosed without surgical biopsy, and acute exacerbation of IIPs is now well defined.A group of rare entities, including pleuroparenchymal fibroelastosis and rare histologic patterns, is also introduced.There have also been advances in the undertaking of biopsies with most institutions sampling at least two sites, ideally using preoperative targeting.These histological patterns are also recognised in children, although classification is more complex and includes entities specific to a younger age group (e.g.neuroendocrine hyperplasia of infancy, pulmonary interstitial glycogenosis).Surfactant protein gene mutations are also being increasingly identified.In relation to microscopy, for CTDs in particular, it is important to remember that these diseases can affect all compartments of the lung.As an example, rheumatoid disease is not only associated with patterns of IP, but also, rheumatoid nodules, apical fibrosis, airways disease (follicular bronchitis, bronchiectasis, bronchocentric granulomatosis, constrictive obliterative bronchiolitis), pulmonary hypertension, and rarely development of lung malignancies.  The Emerging Spectrum of Non-HPV Related Cervical Adenocarcinomas P W McCluggageBelfast Health and Social Care Trust, Belfast, UK Most adenocarcinomas of the cervix are associated with high-risk human papillomavirus (HPV) infection and are referred to as usual-type adenocarcinomas.However, there is an emerging spectrum of non-HPV related cervical adenocarcinomas, the most common of which is so-called gastric-type; this accounts for approximately 10-15% of primary cervical adenocarcinoms and 2-4% of all cervical carcinomas.Cervical gastric-type adenocarcinomas are aggressive neoplasms which have a poor prognosis and often present at high stage with a propensity for ovarian, peritoneal and omental metastases.Adenoma malignum (mucinous variant of minimal deviation adenocarcinoma) represents the well differentiated end of the spectrum of gastric type adenocarcinomas.The precursor lesions of cervical gastric type adenocarcinoma are still being described but include gastric-type adenocarcinoma in situ and atypical lobular endocervical glandular hyperplasia.A variety of benign cervical glandular lesions exhibiting gastric differentiation also occur.Other non-HPV related cervical adenocarcinomas include most clear cell carcinomas and all mesonephric adenocarcinomas; a recent study has shown that the latter are commonly associated with KRAS mutations.  How Do We Assign Primary Site in Extrauterine High Grade Serous Carcinoma P N SinghBart's Health NHS Trust, London, UK Purpose: To present evidence favouring a uniform approach to primary site assignment in extra-uterine high grade serous carcinoma (HGSC) Methods: Review of literature regarding tubal origin of HGSC, variation in practice and benefits of uniform primary site assignment. Summary of results:The new unified FIGO staging system (2013) for ovarian, tubal and peritoneal carcinomas requires pathologists to assign a primary site to all cases.There is a wealth of scientific evidence indicating that the majority of HGSC arise in the fallopian tube, however this evidence is not widely known/accepted.In the absence of a uniform protocol there is potential for cases to be assigned different primary sites and even different stages in low-stage cases.A uniform approach will help minimize these discrepancies in an era of optimism over exciting new developments in prevention, early detection and treatment of HGSC that show potential to improve patient outcomes.Conclusions: There is an urgent need for universal agreement on uniform terminology and staging parameters in HGSC.These have been proposed in international guidelines for reporting ovarian, tubal and peritoneal carcinomas.

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