Introduction: A grading system for pulmonary adenocarcinoma has not been established. The International Association for the Study of Lung Cancer pathology panel evaluated a set of histologic criteria associated with prognosis aimed at establishing a grading system for invasive pulmonary adenocarcinoma. Conclusions: A grading system based on the predominant and high-grade patterns is practical and prognostic for invasive pulmonary adenocarcinoma.

Background: Successful multimodality management of advanced soft tissue sarcomas (STS) remains a clinical challenge. Although immune checkpoint blockade has shown great promise, only a minority of patients respond. Improved biomarkers could benefit the treatment choice, since cytotoxic therapies and radiotherapy (RT) can alter the immune milieu. The objective of this study was to characterize PD-L1 expression in locally advanced STS with or without preoperative RT. Design: Tissue microarrays (TMA) were constructed using formalin-fixed, paraffin-embedded STS cases (N=17). A composite H-scoring system was applied to analyze/ quantify the protein expression. TMA sections were immunostained using a rabbit anti-human PD-L1 antibody (Sino Biological, Clone: 015). The intensity and percentage of PDL-1-positive cells were calculated and scored blindly. Patients were categorized into PD-L1 high and low-expressing based on H-score above or below the median. Parametric and non-parametric statistics were used as appropriate. Results: Mean age was 55±21, 82% were female, and 53% of STS tumors were located on the extremity. Median tumor size was 15.5 cm (range 2.4-24.8 cm). Half of the cases received preoperative RT. We observed 9 recurrences, and 5 sarcoma deaths. Overall, PD-L1 expression was significantly lower among RT patients (62.5±23.1 vs 139±90.5, p=0.04), and tumor stem cell markers EGFR/CD44 were also significantly lower among chemotherapy patients (p < 0.05). Distant recurrences were more common in PDL-1 high patients (5/8, 62%) than PDL-1 low patients (2/9, 22%). Conclusions: RT is associated with decreased PD-L1 expression in locally advanced STS, and lower PD-L1 expression is associated with improved longterm outcome. The modulation of PDL-1 expression by RT and the impact on prognosis in STS warrants further study. Background: Dedifferentiated liposarcoma (DDLPS) sometimes exhibit heterologous differentiation, and its influence on prognostic outcome is still controversial. As for ossification, it is also not clear whether the bone component means heterologous differentiation or it can be formed by reactive (non-neoplastic) mesenchymal cells. We aimed to investigate the neoplastic nature of the bones formed in DDLPS, and make clear the clinical and pathological characteristics of DDLPS with ossification. Design: We examined 27 cases of DDLPS with ossification by comparing them with 24 cases of DDLPS without ossification and 17 cases of primary extraskeletal osteosarcoma (ESOS) without MDM2 amplification or overexpression. The clinical and pathological findings were reviewed. Histological grade was determined using 'modified' FNCLCC grading system proposed before emphasizing the importance of tumor differentiation scoring. Results: MDM2 amplification was confirmed in osteocytes and/or osteoblastic cells in all DDLPS cases with ossification where Fluorescence In-Situ Hybridization (FISH) was successfully performed in bone forming area (22/22). The bones found in DDLPS were mainly mature in most cases (20/27), and ...

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