Stakeholder perspectives of the clinical utility of pharmacogenomic testing in solid organ transplantation

Aims: To assess stakeholder perspectives regarding the clinical utility of pharmacogenomic (PGx) testing following kidney, liver, and heart transplantation. Methods: We conducted individual semi-structured interviews and focus groups with kidney, liver, and heart transplantation patients and providers. We analyzed the qualitative data to identify salient themes. Results: The study enrolled 36 patients and 24 providers. Patients lacked an understanding about PGx, but expressed interest in PGx testing. Providers expressed willingness to use PGx testing, but reported barriers to implementation, such as lack of knowledge, lack of evidence demonstrating clinical utility, and patient healthcare burden. Conclusion: Patient and provider educational efforts, including foundational knowledge, clinical evidence, and applications to patient care beyond just immunosuppression, may be useful to facilitate the use of PGx testing in transplant medicine.

Fine-needle aspiration of an apocrine breast carcinoma with multivacuolated, lipid-rich, giant cells

The frequency of mammary apocrine carcinoma varies considerably and reflects the definitional differences of various researchers. Lipid synthesis by malignant mammary cells is not uncommon, and occasionally it is so extensive that the designation lipid-rich carcinoma is warranted. Many subtypes of lipid-rich carcinoma are described. Although focal apocrine change is observed in one type, a tumor composed predominantly of an apocrine carcinoma with an intimate admixture of lipid-rich malignant cells is previously undescribed. The fine-needle aspiration, histologic, and ultrastructural features of such a tumor is delineated for which the descriptive title lipid-rich apocrine carcinoma is coined.

Recurrence of aneurysmal bone cyst of the fourth metatarsal

Aneurysmal bone cyst is a benign solitary lesion of unknown etiology. Its radiographic and histologic appearance can overlap with those tumors of malignant origin. It is imperative that clinical data, radiographs, and operative and pathological findings be correlated to ensure an accurate diagnosis. Aneurysmal bone cysts occur only 7% of the time in the foot. Recurrence rates are reported to be less than 12%. A case report of recurrence of aneurysmal bone cyst in the foot is reviewed, in addition to the etiology, differential diagnosis, and treatment alternatives.