Atif Saleem

All Publications

• Epstein-Barr virus latency patterns in polymorphic lymphoproliferative disorders and lymphomas in immunodeficiency settings: Diagnostic implications. Annals of diagnostic pathology Volaric, A. K., Saleem, A., Younes, S. F., Zhao, S., Natkunam, Y. 2024; 70: 152286

  Abstract

  Epstein-Barr virus (EBV) is responsible for many B cell lymphoproliferative disorders (LPD) spanning subclinical infection to immunodeficiency-related neoplasms. EBV establishes a latent infection in the host B cell as defined histologically by the expression of EBV latent membrane proteins and nuclear antigens. Herein, we characterize the latency patterns of immunodeficiency-related neoplasms including post-transplant lymphoproliferative disorders (PTLD) and therapy-related LPD (formerly iatrogenic) with latent membrane protein-1 (LMP-1) and EBV nuclear antigen-2 (EBNA-2) immunohistochemistry. The latency pattern was correlated with immunodeficiency and dysregulation (IDD) status and time from transplant procedure. 38 cases of EBV+ PTLD in comparison to 27 cases of classic Hodgkin lymphoma (CHL) and diffuse large B cell lymphoma (DLBCL) arising in either the therapy-related immunodeficiency setting (n=12) or without an identified immunodeficiency (n=15) were evaluated for EBV-encoded small RNAs by in situ hybridization (EBER-ISH) and for LMP-1 and EBNA-2 by immunohistochemistry. A full spectrum of EBV latency patterns was observed across PTLD in contrast to CHL and DLBCL arising in the therapy-related immunodeficiency setting. Polymorphic-PTLD (12 of 16 cases, 75%) and DLBCL-PTLD (9 of 11 cases, 82%) showed the greatest proportion of cases with latency III pattern. Whereas, EBV+ CHL in an immunocompetent patient showed exclusively latency II pattern (13 of 13 cases, 100%). The majority of EBV+ PTLD occurred by three years of transplant procedure date and were enriched for latency III pattern (21 of 22 cases, 95%). Immunohistochemical identification of EBV latency by LMP-1 and EBNA-2 can help classify PTLD in comparison to other EBV+ B cell LPD and lymphomas arising in therapy-related immunodeficiency and non-immunodeficiency settings.

  View details for DOI 10.1016/j.anndiagpath.2024.152286

  View details for PubMedID 38447253

• Two cases of mycosis fungoides with large cell transformation with KMT2A rearrangements. Journal of hematopathology Wadsworth, P. A., Lawrence, L., Suarez, C. J., Saleem, A., Khodadoust, M. S., Kim, Y. H., Rieger, K. E., Fernandez-Pol, S. 2023; 16 (4): 227-234

  Abstract

  Cutaneous T-cell lymphomas (CTCL) are a clinically and molecularly heterogeneous class of lymphomas of the skin-homing T cell, and their genetic profiles are not fully characterized. Previously, rearrangements of the Lysine Methyltransferase 2A (KMT2A) gene have been identified as driver mutations only in acute leukemias. KMT2A plays a role in epigenetic regulation, and cancers with such rearrangements are responsive to epigenetic therapy including hypomethylating agents. Here, we report two cases of CTCL with novel genetic profiles. KMT2A rearrangements were identified in two aggressive cases of mycosis fungoides with large cell transformation. A KMT2A::DSCAML1 gene rearrangement was seen in Case 1, while a KMT2A::MAPRE1 fusion was identified in Case 2. These cases demonstrate that KMT2A rearrangements can be found in primary CTCLs rather than solely acute leukemias, illustrating the importance of correlating molecular findings with clinical and histologic features in diagnosis. Additionally, this finding suggests that the subset of CTCLs driven by aberrancy of the KMT2A pathway may be responsive to therapy with hypomethylating agents or menin inhibitors, as seen in acute leukemias.

  View details for DOI 10.1007/s12308-023-00567-2

  View details for PubMedID 38175436

  View details for PubMedCentralID 5854542

• Cutaneous larva migrans in the northeastern US. Dermatology online journal Johanis, M., Cheema, K. S., Young, P. A., Narala, S., Saleem, A., Novoa, R. A., Bae, G. H. 2023; 29 (4)

  Abstract

  Cutaneous larva migrans (CLM) is a dermo-epidermal parasitic infection with a disproportionate incidence in developing countries, particularly in, and near tropical areas. It is characterized by erythematous, twisting, and linear plaques that can migrate to adjacent skin. Herein, we present an otherwise healthy 45-year-old woman who acquired a pruritic, erythematous, and serpiginous rash localized to her right medial ankle during a trip to New England. Oral ivermectin, the preferred first-line treatment for cutaneous larva migrans, was administered in combination with triamcinolone. This was followed by removal of the papular area via punch biopsy; treatment was successful with a one-week recovery. Although cutaneous larva migrans has traditionally been considered a tropical disease, clinicians should be cognizant of its expanding geographic spread.

  View details for DOI 10.5070/D329461906

  View details for PubMedID 37921817

• Postpandemic Effects of COVID-19 Shelter-in-Place Orders on the Gastrointestinal Pathogen Landscape. Journal of clinical microbiology Bulterys, P. L., Leung, N. Y., Saleem, A., Budvytiene, I., Pinsky, B. A., Banaei, N. 2023: e0038523

  View details for DOI 10.1128/jcm.00385-23

  View details for PubMedID 37466426

• Mutational Profiling of Epstein Barr Virus-Positive Mucocutaneous Ulcer Volaric, A., Kumar, J., Nicholas, V., Saleem, A., Suarez, C., Natkunam, Y. ELSEVIER SCIENCE INC. 2023: S1250-S1252

  View details for Web of Science ID 000990969802350

• Bullous impetigo on a young man's abdomen. Dermatology online journal Young, P. A., Leeolou, M. C., Narala, S., Saleem, A., Bae, G. H. 2023; 29 (1)

  Abstract

  Bullous impetigo is a variant of epidermal infection by Staphylococcus aureus, representing 30% of impetigo cases. Its clinical appearance may mimic certain autoimmune blistering dermatoses and other cutaneous infections, sometimes necessitating careful evaluation. Herein we present a patient with bullous impetigo in a striking and characteristic appearance and briefly overview the approach to diagnosis, treatment, and prevention.

  View details for DOI 10.5070/D329160220

  View details for PubMedID 37040917

• Progression of Mycosis Fungoides After Fingolimod Treatment for Multiple Sclerosis and Targeted Next-Generation Sequencing Demonstrating Potential Links Between the Two Diseases. JCO precision oncology Narala, S., Che, Y., Saleem, A., Lock, C. B., Kim, Y. H., Rieger, K. E. 2023; 7: e2200501

  View details for DOI 10.1200/PO.22.00501

  View details for PubMedID 36724412

• Primary cutaneous CD4+ small/medium-sized pleomorphic T-cell lymphoproliferative disorder in a young woman. Dermatology online journal Leeolou, M. C., Young, P. A., Saleem, A., Narala, S., Bae, G. H. 2022; 28 (6)

  Abstract

  Primary cutaneous CD4+ small/medium T-cell lymphoproliferative disorder (CD4+PCSM-LPD) is a low-grade cutaneous T cell disorder. There is no standardized approach to treatment of CD4+ PCSM-LPD due to its rarity. Herein, we discuss a 33-year-old woman with CD4+PCSM-LPD which resolved after a partial biopsy. We highlight that conservative and local treatment modalities should be considered prior to utilizing more aggressive and invasive treatment options.

  View details for DOI 10.5070/D328659726

  View details for PubMedID 36809093

• Evanescent, episodic salmon-colored macules in a young woman. JAAD case reports Leeolou, M. C., Young, P. A., Dear, A. L., Narala, S., Saleem, A., Rieger, K. E., Bae, G. H. 2022; 29: 30-32

  View details for DOI 10.1016/j.jdcr.2022.08.022

  View details for PubMedID 36186409

• Burning urticarial plaques in a middle-aged woman. JAAD case reports Young, P. A., Saleem, A., Narala, S., Dear, A., Bae, G. H. 2022; 28: 138-141

  View details for DOI 10.1016/j.jdcr.2022.08.027

  View details for PubMedID 36164387

• Nontender white papule of the areola in a middle-aged female. JAAD case reports Young, P. A., Narala, S., Brown, R. A., Saleem, A., Rieger, K. E., Bae, G. H. 2022; 27: 6-8

  View details for DOI 10.1016/j.jdcr.2022.05.047

  View details for PubMedID 35941842

• Efficacy of an educational comic book for HPV vaccination information in Nigeria. Roy, M., Saleem, A., Said, A., Inoyo, I. E., Garrity, P., Bashorun, Y., Anjorin, T., Ibeka, P., Remen, D., Huang, F. W., Bhatt, A. LIPPINCOTT WILLIAMS & WILKINS. 2022: E18577

  View details for Web of Science ID 000863680303729

• Percent Agreement Between Immunohistochemistry and Next-Generation Sequencing in Testing Patients for Mismatch Repair Deficiency. Applied immunohistochemistry & molecular morphology : AIMM Lawrence, L., Longacre, T., Saleem, A., Kunder, C. 2022

  Abstract

  The presence of mismatch repair deficiency is frequently assessed in gastrointestinal and gynecologic neoplasms by surgical pathologists using immunohistochemical methods. Targeted next-generation sequencing (NGS) covering some genes in the mismatch repair complex is used with increasing frequency, however, the percent positive and negative agreement of immunohistochemical methods and NGS of mismatch repair genes is not well-described in the literature. We sought to compare performance of immunohistochemistry (IHC) and NGS of mismatch repair genes on our institutional targeted panel. We evaluated the concordance of immunohistochemical and panel-based gene sequencing methods in a retrospective cohort study of patients evaluated at our center with both immunohistochemical and panel-based sequencing. Our NGS panel covers only MLH1 and MSH2, whereas our immunohistochemical panel assesses for expression of MLH1, PMS2, MSH2, and MSH6. We identified 68 unique patients with both immunohistochemical evaluation of mismatch repair protein expression and NGS panel sequencing, of which 67 were suitable for analysis given the patterns of immunohistochemical loss of expression observed. The percent positive agreement for NGS with IHC was 50%, albeit with very rare positive cases (n=2/4). Percent negative agreement was also high at 100% (n=63/63). One case with loss of MLH1, PMS2, and MSH6 expression by IHC and no pathogenic variants by NGS exhibited MLH1 promoter hypermethylation. Percent negative agreement between immunohistochemical and NGS gene sequencing is high, although firm conclusions regarding percent positive agreement between NGS and IHC are limited by low numbers of positive cases in our cohort. In general, we consider the findings to support continued use of immunohistochemical methods to screen for the presence of mismatch repair deficiency and consider additional testing by NGS likely to add little diagnostic value in the context of intact immunohistochemical expression of mismatch repair proteins.

  View details for DOI 10.1097/PAI.0000000000001018

  View details for PubMedID 35285457

• Identification and Targeting of the Developmental Blockade in Extranodal Natural Killer/T-cell Lymphoma. Blood cancer discovery Mundy-Bosse, B. L., Weigel, C., Wu, Y., Abdelbaky, S., Youssef, Y., Casas, S. B., Polley, N., Ernst, G., Young, K. A., McConnell, K. K., Nalin, A. P., Wu, K. G., Broughton, M., Lordo, M. R., Altynova, E., Hegewisch-Solloa, E., Enriquez-Vera, D. Y., Duenas, D., Barrionuevo, C., Yu, S., Saleem, A., Suarez, C. J., Briercheck, E. L., Molina-Kirsch, H., Loughran, T. P., Weichenhan, D., Plass, C., Reneau, J. C., Mace, E. M., Gamboa, F. V., Weinstock, D. M., Natkunam, Y., Caligiuri, M. A., Mishra, A., Porcu, P., Baiocchi, R. A., Brammer, J. E., Freud, A. G., Oakes, C. C. 2022; 3 (2): 154-169

  Abstract

  Extranodal natural killer/T-cell lymphoma (ENKTL) is an aggressive, rare lymphoma of natural killer (NK) cell origin with poor clinical outcomes. Here we used phenotypic and molecular profiling, including epigenetic analyses, to investigate how ENKTL ontogeny relates to normal NK-cell development. We demonstrate that neoplastic NK cells are stably, but reversibly, arrested at earlier stages of NK-cell maturation. Genes downregulated in the most epigenetic immature tumors were associated with polycomb silencing along with genomic gain and overexpression of EZH2. ENKTL cells exhibited genome-wide DNA hypermethylation. Tumor-specific DNA methylation gains were associated with polycomb-marked regions, involving extensive gene silencing and loss of transcription factor binding. To investigate therapeutic targeting, we treated novel patient-derived xenograft (PDX) models of ENKTL with the DNA hypomethylating agent, 5-azacytidine. Treatment led to reexpression of NK-cell developmental genes, phenotypic NK-cell differentiation, and prolongation of survival. These studies lay the foundation for epigenetic-directed therapy in ENKTL.SIGNIFICANCE: Through epigenetic and transcriptomic analyses of ENKTL, a rare, aggressive malignancy, along with normal NK-cell developmental intermediates, we identified that extreme DNA hypermethylation targets genes required for NK-cell development. Disrupting this epigenetic blockade in novel PDX models led to ENKTL differentiation and improved survival. This article is highlighted in the In This Issue feature, p. 85.

  View details for DOI 10.1158/2643-3230.BCD-21-0098

  View details for PubMedID 35247900

• Epstein Barr Virus Latency Patterns in Post-Transplant Lymphoproliferative Disorders and EBV plus Mucocutaneous Ulcer: Diagnostic and Prognostic Implications Volaric, A., Saleem, A., Lawrence, L., Younes, S., Libert, D., Zhao, S., Natkunam, Y. SPRINGERNATURE. 2022: 1032-1033

  View details for Web of Science ID 000770361802297

• Exploring Potential Innate Immune Targets to Treat Fibrosis and Chronic Inflammation in Chronic Graft-Versus-Host Disease Paulson, N., De Souza, C., Cui, L., Lerbs, T., Poyser, J., Kooshesh, M., Saleem, A., Rieger, K., Brown', R., Kwong, B., Fernandez-Po, S., Arai, S., Shizuru, J., Mueller, A., Wernig, G. SPRINGERNATURE. 2022: 557

  View details for Web of Science ID 000770361801147

• Immunohistochemistry in melanocytic lesions: Updates with a practical review for pathologists. Seminars in diagnostic pathology Saleem, A., Narala, S., Raghavan, S. S. 1800

  Abstract

  This review provides a summary of the immunohistochemical markers pertinent to the diagnosis of melanocytic lesions. There is considerable morphologic overlap between benign and malignant melanocytic lesions, and given the significant differences in clinical management, the diagnostic workup becomes crucial. Immunohistochemistry aids in the distinction between various melanocytic proliferations and recent contributions to the literature have furthered our optimization of panels in the diagnostic workup. In recent years, SOX10 has been considered as the optimal marker for melanocytic lesions given the similar sensitivity but higher specificity than S100. HMB-45 is less sensitive than S100 but demonstrates utility in confirmation of deceptively banal small cell and nevoid melanoma variants where deep nests of melanocytes are highlighted. Melan-A (MART-1) and MiTF show similar sensitivity to S100 however there is a lack of expression in spindle cell and desmoplastic melanomas.

  View details for DOI 10.1053/j.semdp.2021.12.003

  View details for PubMedID 35016807

• Selective Targeting of Immune Modulatory Proteins to Mitigate Fibrosis and Inflammation in Sclerodermatous Graft-Vs-Host Disease Cui, L., De Souza, C., Lerbs, T., Poyser, J., Kooshesh, M., Saleem, A., Rieger, K., Brown, B., Kwong, B., Fernandez-Pol, S., Arai, S., Shizuru, J. A., Mueller, A. S., Wernig, G. AMER SOC HEMATOLOGY. 2021

  View details for DOI 10.1182/blood-2021-151223

  View details for Web of Science ID 000736398802184

• Impact of COVID-19 shelter-in-place order on transmission of gastrointestinal pathogens in Northern California. Journal of clinical microbiology Bulterys, P. L., Leung, N. Y., Saleem, A., Budvytiene, I., Banaei, N. 2021

  Abstract

  In response to the COVID-19 pandemic, California was the first state to impose a strict shelter-in-place (SIP) order in March 2020..

  View details for DOI 10.1128/JCM.00449-21

  View details for PubMedID 33846223

• Cutaneous cytomegalovirus - A case of disseminated cytomegalovirus presenting with extensive ulcerative skin lesions in a renal transplant recipient. Transplant infectious disease : an official journal of the Transplantation Society Ferguson, J., Mooney, K., Saleem, A., Stevens, B. A., Pinsky, B. A., Centkowski, S., Zaba, L. C., Ho, D. Y. 2021

  Abstract

  Cytomegalovirus (CMV) reactivation is common in organ transplant recipients and can lead to significant morbidity and mortality. Cutaneous CMV findings are rarely reported in the literature and diagnosis can be delayed if not clinically recognized. We describe a case of a female patient 20 years post renal transplant who presented with extensive ulcerative skin lesions and diarrhea. She rapidly deteriorated and died on day 5 of hospitalization. Autopsy noted extensive CMV involvement of skin and gastrointestinal (GI) tract by CMV-specific immunohistochemistry.

  View details for DOI 10.1111/tid.13582

  View details for PubMedID 33533137

• Deep learning predicts postsurgical recurrence of hepatocellular carcinoma from digital histopathologic images. Scientific reports Yamashita, R. n., Long, J. n., Saleem, A. n., Rubin, D. L., Shen, J. n. 2021; 11 (1): 2047

  Abstract

  Recurrence risk stratification of patients undergoing primary surgical resection for hepatocellular carcinoma (HCC) is an area of active investigation, and several staging systems have been proposed to optimize treatment strategies. However, as many as 70% of patients still experience tumor recurrence at 5 years post-surgery. We developed and validated a deep learning-based system (HCC-SurvNet) that provides risk scores for disease recurrence after primary resection, directly from hematoxylin and eosin-stained digital whole-slide images of formalin-fixed, paraffin embedded liver resections. Our model achieved concordance indices of 0.724 and 0.683 on the internal and external test cohorts, respectively, exceeding the performance of the standard Tumor-Node-Metastasis classification system. The model's risk score stratified patients into low- and high-risk subgroups with statistically significant differences in their survival distributions, and was an independent risk factor for post-surgical recurrence in both test cohorts. Our results suggest that deep learning-based models can provide recurrence risk scores which may augment current patient stratification methods and help refine the clinical management of patients undergoing primary surgical resection for HCC.

  View details for DOI 10.1038/s41598-021-81506-y

  View details for PubMedID 33479370

  View details for PubMedCentralID PMC7820423

• Diagnostic Utility of LEF1 Immunohistochemistry in Differentiating Deep Penetrating Nevi From Histologic Mimics. The American journal of surgical pathology Raghavan, S. S., Saleem, A., Wang, J. Y., Rieger, K. E., Brown, R. A., Novoa, R. A. 2020

  Abstract

  Deep penetrating nevi (DPNs) are intermediate grade lesions which have the capacity to recur, metastasize, or progress to melanoma. Differentiating DPN from other melanocytic lesions including blue and cellular blue nevi can be diagnostically challenging, and markers to distinguish these entities can be useful. Mutations of the beta-catenin and mitogen-activated protein kinase pathways have recently been elucidated as distinctive of DPN. This pathway can subsequently activate lymphoid enhancer-binding factor 1 (LEF1), a transcription factor shown to facilitate the epithelial-mesenchymal transition to propagate tumorigenesis. Seventy-two cases in total were examined on hematoxylin and eosin sections and with beta-catenin and LEF1 immunohistochemistry. This included: DPN (14), cellular blue nevi (19), blue nevi (15), congenital melanocytic nevi (12), and melanoma (12). Nuclear expression of LEF1, present throughout the entire depth of the lesion, was noted in 13/14 (93%) of DPN, 0/19 (0%) of cellular blue nevi, 0/15 (0%) of blue nevi, 1/12 (8%) of congenital melanocytic nevi, and 9/12 (75%) of melanoma cases. Nuclear expression of beta-catenin, present throughout the entire depth of the lesion, was noted in 14/14 (100%) of DPN, 0/18 (0%) of cellular blue nevi, 0/15 (0%) of blue nevi, 1/12 (8%) of congenital melanocytic nevi, and 1/12 (8%) of melanoma cases. A majority of congenital melanocytic nevi demonstrated a gradient of LEF1 and beta-catenin expression with more intense staining superficially and loss of staining with increasing depth. Deep, uniform nuclear LEF1 combined with beta-catenin immunohistochemical staining can be useful in distinguishing DPN from histologic mimics.

  View details for DOI 10.1097/PAS.0000000000001513

  View details for PubMedID 32520758

• Expansion of Bone Precursors through Jun as a Novel Treatment for Osteoporosis-Associated Fractures. Stem cell reports Lerbs, T., Cui, L., Muscat, C., Saleem, A., van Neste, C., Domizi, P., Chan, C., Wernig, G. 2020

  Abstract

  Osteoporosis and osteoporotic fractures lead to decreased life quality and high healthcare costs. Current treatments prevent losses in bone mass and fractures to some extent but have side effects. Therefore, better therapies are needed. This study investigated whether the transcriptionfactor Jun has a specific pro-osteogenic potency and whether modulating Jun could serve as a novel treatment for osteoporosis-associated fractures. We demonstrate that ectopically transplanted whole bones and distinct osteoprogenitors increase bone formation. Perinatal Jun induction disturbs growth plate architecture, causing a striking phenotype with shortened and thickened bones. Molecularly, Jun induces hedgehog signaling in skeletal stem cells. Therapeutically, Jun accelerates bone growth and healing in a drilling-defect model. Altogether, these results demonstrate that Jun drives bone formation by expanding osteoprogenitor populations and forcing them into the bone fate, providing a rationale for future clinical applications.

  View details for DOI 10.1016/j.stemcr.2020.02.009

  View details for PubMedID 32197115

• Merkel Cell Carcinoma of Lymph Node is Metastatic Cutaneous Merkel Cell Carcinoma Lawrence, L., Kunder, C., Stehr, H., Saleem, A., Natkunam, Y., Zehnder, J., Pinsky, B., Sahoo, M., Tan, S. NATURE PUBLISHING GROUP. 2020: 824–26

  View details for Web of Science ID 000518328801386

• Novel IRF8 and PD-L1 molecular aberrations in systemic EBV-positive T-cell lymphoma of childhood Human Pathology: Case Reports Volume 19, March 2020, 200356 Saleem, A., Joshi, R., Lei, L., Lezama, L., Raghavan, S. S., Neishaboori, N., Roy, M., Schroers-Martin, J., Charville, G. W., Kunder, C., Tan, B., Martin, B. A., Natkunam, Y. 2020; 19
• Is Merkel Cell Carcinoma of Lymph Node Actually Metastatic Cutaneous Merkel Cell Carcinoma? American journal of clinical pathology Lawrence, L. E., Saleem, A. n., Sahoo, M. K., Tan, S. K., Pinsky, B. A., Natkunam, Y. n., Kunder, C. A., Stehr, H. n., Zehnder, J. L. 2020

  Abstract

  The possibility of a so-called primary lymph node neuroendocrine carcinoma has been described in the literature. Here we evaluate cases fitting such a diagnosis and find that the cases demonstrate a convincing and pervasive pattern consistent with metastatic Merkel cell carcinoma.Six cases of primary lymph node Merkel cell carcinoma and one case of metastatic neuroendocrine carcinoma at a bony site, all with unknown primary, were sequenced using a combination of whole-exome and targeted panel methods. Sequencing results were analyzed for the presence of an ultraviolet (UV) mutational signature or off-target detection of Merkel cell polyomavirus (MCPyV).Four of six primary lymph node cases were positive for a UV mutational signature, with the remaining two cases positive for off-target alignment of MCPyV. One case of neuroendocrine carcinoma occurring at a bony site was also positive for a UV mutational signature.We find no evidence to corroborate the existence of so-called primary Merkel cell carcinoma of lymph node.

  View details for DOI 10.1093/ajcp/aqaa051

  View details for PubMedID 32445471

• Extranodal NK/T-Cell Lymphomas: The Role of Natural Killer Cells and EBV in Lymphomagenesis. International journal of molecular sciences Saleem, A. n., Natkunam, Y. n. 2020; 21 (4)

  Abstract

  Keywords: NK cells, extranodal NK/T-cell lymphoma, EBV.

  View details for DOI 10.3390/ijms21041501

  View details for PubMedID 32098335

• Fungal prostatitis due to endemic mycoses and Cryptococcus: A multicenter case series. The Prostate Epstein, D. J., Thompson, L. D., Saleem, A. n., Kao, C. S., Epstein, J. I. 2020

  Abstract

  Fungal prostatitis is exceedingly rare with mostly case reports.Electronic medical records at three medical centers were searched for cases of fungal prostatitis due to endemic mycoses and Cryptococcus over the preceding 10 years.Seven cases were identified from 105 600 prostate biopsies within the Southern California Permanente Medical Group for an incidence of 0.0066%. An additional eight cases were identified from two other health care systems. Excluding four patients without available clinical data, 11 patients were reviewed, most of whom underwent biopsy due to elevated prostate-specific antigen. Four were asymptomatic and the remainder had nonspecific signs or symptoms. All biopsies revealed granulomatous inflammation and fungal organisms. Seven patients had coccidioidomycosis, three patients had cryptococcosis (confirmed in two cases and suspected by organism morphology in the other), and one patient had likely histoplasmosis based on organism morphology. Prolonged antifungal treatment was standard; outcomes were favorable.Fungal prostatitis due to endemic mycoses and Cryptococcus is uncommon and associated with favorable outcomes but generally involves prolonged therapy.

  View details for DOI 10.1002/pros.24034

  View details for PubMedID 32572997

• Non-HLA Antibody-Mediated Rejection of Lung Transplant Masquerading Transfusion-Related Acute Lung Injury Yunce, M., Virk, M., Zhang, B. M., Mooney, K., Saleem, A., Shan, H. WILEY. 2019: 199A

  View details for Web of Science ID 000502826600470

• Intralymphatic Rosai-Dorfman Disease Associated With Vulvar Lymphedema: A Case Report of an Extremely Rare Phenomenon. International journal of gynecological pathology : official journal of the International Society of Gynecological Pathologists Saleem, A., Hoffmann, J., Warnke, R., Rieger, K. E., Longacre, T. 2019

  Abstract

  Sinus histiocytosis with massive lymphadenopathy, also known as Rosai-Dorfman disease (RDD), is a self-limited histiocytic disorder of unclear etiology which most commonly presents with cervical lymphadenopathy. Purely extranodal presentation of RDD is uncommon, and isolated intralymphatic/intravascular confinement of this entity has not previously been described. We report a 16-yr-old female who presented with vaginal swelling and mass-like enlargement of the right labia. The mass had been present for nearly a year without pain or tenderness. Clinically, the lesion was thought to be a Bartholin gland cyst. Following surgical resection, histologic examination demonstrated a hypocellular myxedematous stroma with a mixture of ectatic thin and thick-walled vessels within which there were numerous collections of histiocytes, lymphocytes, and plasma cells. The histopathologic differential diagnosis included localized vulvar lymphedema, a specialized genital tract neoplasm, and childhood asymmetric labium majus enlargement. The histiocytes showed occasional plasma cells and lymphocytes within their cytoplasm, consistent with emperipolesis. Immunohistochemical studies showed that the histiocytes expressed CD163 and S100, while ERG and D2-40 highlighted their intralymphatic confinement, ultimately leading to the diagnosis of intralymphatic RDD. Intralymphatic RDD may present as vulvar lymphedema and can potentially mimic other myxedematous neoplasms of the vulvovaginal region.

  View details for DOI 10.1097/PGP.0000000000000619

  View details for PubMedID 31274698

• Molecular Profiling of Intraductal Tubulopapillary Neoplasm Saleem, A., Stehr, H., Zehnder, J., Kunder, C., Lin, C. NATURE PUBLISHING GROUP. 2019

  View details for Web of Science ID 000478915501405

• Concordance Between Immunohistochemistry and Next Generation Sequencing in Testing Patients for Hereditary Nonpolyposis Colorectal Cancer Lawrence, L., Longacre, T., Saleem, A., Kunder, C. NATURE PUBLISHING GROUP. 2019

  View details for Web of Science ID 000478081103426

• Concordance Between Immunohistochemistry and Next Generation Sequencing in Testing Patients for Hereditary Nonpolyposis Colorectal Cancer Lawrence, L., Longacre, T., Saleem, A., Kunder, C. NATURE PUBLISHING GROUP. 2019

  View details for Web of Science ID 000478915503448

• Molecular Profiling of Intraductal Tubulopapillary Neoplasm Saleem, A., Stehr, H., Zehnder, J., Kunder, C., Lin, C. NATURE PUBLISHING GROUP. 2019

  View details for Web of Science ID 000478081103213

• Molecular profiling of clear cell adenocarcinoma of the urinary tract. Virchows Archiv : an international journal of pathology Lin, C. Y., Saleem, A. n., Stehr, H. n., Zehnder, J. L., Pinsky, B. A., Kunder, C. A. 2019

  Abstract

  Clear cell adenocarcinoma (CCA) of the urinary tract is a rare type of malignancy whose molecular profiles remain undefined. Here we reported an integrated clinicopathologic and molecular profiling analysis of four cases of clear cell adenocarcinoma arising in the urethra or the bladder. Utilizing a clinically validated 130-gene exon-sequencing assay, we identified recurrent pathogenic PIK3CA (p. E545K) and KRAS (p.G12D) variants in three of four (75%) of the cases. In addition, an APC variant (P.S2310X), a TP53 variant (p.R273C), and a MYC amplification event were identified. The only CCA case without either PIK3CA or KRAS variants has a distinct pathogenesis through BK virus, demonstrated by positive BK virus PCR and SV40 immunohistochemistry. The novel finding of recurrent variants in the PI3K/AKT/mTOR pathway provides not only insights into oncogenesis but also potential clinical therapeutic targets for patients with clear cell adenocarcinoma of the urinary tract.

  View details for DOI 10.1007/s00428-019-02634-5

  View details for PubMedID 31372739

• Knowledge and awareness of cervical cancer in Southwestern Ethiopia is lacking: A descriptive analysis. PloS one Saleem, A. n., Bekele, A. n., Fitzpatrick, M. B., Mahmoud, E. A., Lin, A. W., Velasco, H. E., Rashed, M. M. 2019; 14 (11): e0215117

  Abstract

  Cervical cancer remains the second most common cancer and cancer-related death among women in Ethiopia. This is the first study, to our knowledge, describing the demographic, and clinicopathologic characteristics of cervical cancer cases in a mainly rural, Southwestern Ethiopian population with a low literacy rate to provide data on the cervical cancer burden and help guide future prevention and intervention efforts.A descriptive analysis of 154 cervical cancer cases at the Jimma University Teaching Hospital in Southwestern Ethiopia from January 2008 -December 2010 was performed. Demographic and clinical characteristics were obtained from patient questionnaires and cervical punch biopsies were histologically examined.Of the 154 participants with a histopathologic diagnosis of cervical cancer, 95.36% had not heard of cervical cancer and 89.6% were locally advanced at the time of diagnosis. Moreover, 86.4% of participants were illiterate, and 62% lived in a rural area.A majority of the 154 women with cervical cancer studied at the Jimma University Teaching Hospital in Southwestern Ethiopia were illiterate, had not heard of cervical cancer and had advanced disease at the time of diagnosis. Given the low rates of literacy and knowledge regarding cervical cancer in this population which has been shown to correlate with a decreased odds of undergoing screening, future interventions to address the cervical cancer burden here must include an effective educational component.

  View details for DOI 10.1371/journal.pone.0215117

  View details for PubMedID 31714915

• A Case Report of Pediatric Clear Cell Carcinoma of the Urinary Bladder Associated With Polyomavirus AJSP-REVIEWS AND REPORTS Saleem, A., Brown, R. A., Higgins, J. T., Troxell, M. L., Kunder, C. A., Pinsky, B. A., Zambrano, E., Kao, C. 2018; 23 (6): 291–95

  View details for DOI 10.1097/PCR.0000000000000284

  View details for Web of Science ID 000457629000012

• Asystolic Arrest From Polypharmacy in a Patient with Status Epilepticus Blackney, K., Rizvi, A., Saleem, A., Hennessey, E. LIPPINCOTT WILLIAMS & WILKINS. 2017: 631

  View details for Web of Science ID 000412683000330