R H Young

Harvard University, Cambridge, Massachusetts, United States

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Publications (188)

  • E. Oliva · P.B. Clement · R.H. Young
    Chapter · Jan 2015
  • C.B. Gilks · R.H. Young · P.B. Clement
    Chapter · Jan 2015
  • Chapter: Peritoneum
    J.A. Irving · R.H. Young · P.B. Clement
    Chapter · Jan 2015
  • S. Chiang · P.B. Clement · R.H. Young
    Chapter · Jan 2015
  • M.F. Lerwill · P.B. Clement · R.H. Young
    Chapter · Jan 2015
  • M. Guerra Fernandez · R. H. Young · E. Oliva
    Article · Aug 2014 · Archiv für Pathologische Anatomie und Physiologie und für Klinische Medicin
  • J.K. McKenney · J.N. Eble · R.H. Young
    Chapter · Nov 2013
  • P.B. Clement · R.H. Young
    Article · Feb 2012
  • P.B. Clement · R.H. Young
    Chapter · Feb 2012
  • R.H. Young · P.B. Clement
    Chapter · Feb 2012
  • R.H. Young · P.B. Clement
    Chapter · Feb 2012
  • R.H. Young · P.B. Clement
    Article · Feb 2012
  • M.B. Amin · R.H. Young
    Article · Feb 2005 · Seminars in Diagnostic Pathology
  • RH Young · TM Ulbright
    Article · Feb 2005 · Modern Pathology
  • DM Dahl · PR Mueller · RH Young · [...] · WS McDougal
    Article · Nov 2004 · New England Journal of Medicine
  • W G McCluggage · E Oliva · L E Connolly · [...] · R H Young
    [Show abstract] [Hide abstract] ABSTRACT: Ovarian small cell carcinoma of hypercalcemic type (OSCCHT) is a rare neoplasm with an aggressive behavior, broad differential diagnosis, and unknown histogenesis. To add to knowledge concerning the possible aid of immunohistochemistry in resolving problems in differential diagnosis and to further explore whether that modality points to any specific histogenesis, we undertook an immunohistochemical study of this neoplasm. Fifteen OSCCHTs (including four of the ''large cell" variant) were stained with a range of antibodies, some of which have not been investigated previously in this neoplasm. Cases were stained with AE1/3, EMA, BerEP4, CK5/6, calretinin, WT1, chromogranin, CD56, synaptophysin, CD99, NB84, desmin, S100, CD10, alpha inhibin, TTFI, and p53. Staining was classified as 0 (negative), 1+ (<5% cells positive), 2+ (5% to 25% cells positive), 3+ (26% to 50% cells positive), or 4+ (>50% cells positive). All cases were positive with p53 (two 1+, five 3+, eight 4+), 14 of 15 cases were positive with WT1 (one 1+, thirteen 4+), 14 of 15 with CD10 (three 1+, four 2+, two 3+, five 4+), 13 of 15 with EMA (three 1+, three 2+, two 3+, five 4+), 11 of 15 with calretinin (nine 1+, one 3+, one 4+), 9 of 15 with AE1/3 (eight 1+, one 2+), 4 of 15 with CD56 (one 1+, two 2+, one 4+), 3 of 15 with BerEP4 (two 2+, one 4+), 2 of 15 with synaptophysin (two 1+), and 1 of 15 with S100 (4+). All cases were negative with CK5/6, chromogranin, CD99, NB84, desmin, alpha inhibin, and TTF1. The only noticeable difference in the immunophenotype between typical OSCCHT and the large cell variant was that there was 4 +EMA positivity in three of four cases of large cell variant compared with two of 11 cases of typical OSCCHT. OSCCHT is characteristically positive with AE1/3, EMA, CD10, calretinin, WT1, and p53. Combined EMA and WT1 positivity, the latter usually intense and diffuse, may be of diagnostic value, inasmuch as only a few of the neoplasms in the differential diagnosis are positive with both antibodies. Negative staining with CD99, desmin, NB84, alpha-inhibin, and TTF1 may aid in the cases in which primitive neuroectodermal tumor, rhabdomyosarcoma, intraabdominal desmoplastic small round cell tumor, neuroblastoma, a sex cord-stromal tumor, and metastatic pulmonary small cell carcinoma are in the differential. Calretinin positivity precludes its use in the differential with granulosa cell tumors. The results of this investigation do not settle the issue of histogenesis, which remains enigmatic. The typical age distribution, follicle formation, and calretinin positivity are consistent with a sex cord origin. On the other hand, WT1 and EMA positivity and negative staining with alpha-inhibin would be unusual in a sex cord-stromal neoplasm and can be used as an argument for a surface epithelial origin. Germ cell and neuroendocrine origins seem highly unlikely.
    Article · Nov 2004 · International Journal of Gynecological Pathology
  • JK McKenney · MB Amin · JR Srigley · [...] · RH Young
    [Show abstract] [Hide abstract] ABSTRACT: Basaloid proliferations of the prostate with morphologic patterns other than usual basal cell hyperplasia are rare, and the distinction between benign and malignant lesions has been difficult. We describe 23 such lesions and classify them into two groups: adenoid cystic-like hyperplasia and adenoid cystic or basaloid carcinoma. Adenoid cystic-like hyperplasia (n = 19) was characterized by an older age at presentation (mean, 71.8 years), transition zone location with background of nodular hyperplasia, multifocality, lobulation, circumscription, and small acini with occasional hyalinization. A cribriform pattern limited to small- and medium-sized glands, squamous metaplasia, and hypercellular myxoid stroma were occasionally seen. Adenoid cystic carcinoma (n = 3) was characterized by a younger age at presentation (mean, 46.0 years), peripheral zone involvement, and large acini that were often dilated and exhibited extensive interanastomoses, prominent intraglandular hyalinization, perineural invasion , and extraprostatic extension. Basaloid carcinoma (n = 1) showed infiltration between normal glands, perineural invasion, and extraprostatic extension but lacked a cribriform architecture. The degree of cytologic atypia and mitotic rate overlapped between the hyperplasia and carcinoma cases. Both hyperplastic lesions and adenoid cystic carcinomas showed a basal cell phenotype with strong immunoreactivity to cytokeratins 14 and 34betaE12, but the basaloid carcinoma was negative for these markers. In all cases, the proliferating basal cells were nonreactive for myoepithelial and prostatic secretory cell markers. The 8 patients with adenoid cystic-like hyperplasia with available follow-up information had no progression of disease (mean follow-up period, 8.6 years). One patient with adenoid cystic carcinoma died with widespread metastases, but the 3 other patients with carcinomas had no disease progression (mean follow-up period, 7.0 years). In conclusion, most florid basaloid proliferations of the prostate fall into one of two categories. In the first, there is a clear association with nodular hyperplasia (adenoid cystic-like hyperplasia) and, although cytologic atypia and mitoses may be seen, they are present within a lesion that retains an orderly, vaguely nodular (noninfiltrative) pattern. The second group of cases (adenoid cystic and basaloid carcinoma) shows a widespread, haphazard infiltrative growth pattern. This study suggests that adenoid cystic carcinomas are biologically indolent following prostatectomy but have a low risk of distant metastasis.
    Article · Oct 2004 · American Journal of Surgical Pathology
  • Z Jiang · C L Wu · BA Woda · [...] · X J Yang
    [Show abstract] [Hide abstract] ABSTRACT: To test whether alpha-methylacyl-CoA racemase (AMACR) is a sensitive and specific marker of prostate cancer. The expression levels of AMACR mRNA were measured by real-time polymerase chain reaction. A total of 807 prostatic specimens were further examined by immunohistochemistry specific for AMACR. Quantitative immunostaining analyses were carried out by using the ChromaVision Automated Cellular Imaging System and the Ariol SL-50 Imaging System, respectively. AMACR mRNA levels measured in prostatic adenocarcinoma were 55 times higher than those in benign prostate tissue. Of 454 cases of prostatic adenocarcinoma, 441 were positive for AMACR, while 254 of 277 cases of benign prostate were negative for AMACR. The sensitivity and specificity of AMACR immunodetection of prostatic adenocarcinomas were 97% and 92%, respectively. Both positive and negative predictive values were 95%. By automatic imaging analyses, the AMACR immunostaining intensity and percentage in prostatic adenocarcinomas were also significantly higher than those in benign prostatic tissue (105.9 versus 16.1 for intensity, 45.7% versus 0.02% and 35.03% versus 4.64% for percentage, respectively). We have demonstrated the promising features of AMACR as a biomarker for prostate cancer in this large series and the potential to develop automated quantitative diagnostic tests.
    Article · Oct 2004 · Histopathology
  • Article · Jul 2004 · New England Journal of Medicine
  • MR Nucci · RH Young
    [Show abstract] [Hide abstract] ABSTRACT: We report 18 cases of Arias-Stella reaction involving the endocervix with an emphasis on histologic features that can be encountered and result in the misdiagnosis of carcinoma. The patients ranged in age from 19 to 44 years. Two patients had a history of oral contraceptive use and 15 were pregnant; clinical information was not available in one case. Ten lesions presented as cervical polyps, and six were incidental findings in specimens obtained because of cervical dysplasia, dysfunctional uterine bleeding, fibroids, and a missed abortion. One patient was found to have a cervical "lesion" on a routine gynecologic examination. In the remaining patient, a cervical biopsy was obtained, for unknown reasons, at the time of termination of pregnancy. Microscopic examination showed a varied histologic appearance including vacuolated clear cytoplasm (18 cases), intraglan-dular tufts (16 cases), hobnail cells (14 cases), oxyphilic cytoplasm (13 cases), delicate filiform papillae (12 cases), intranuclear pseudo-inclusions (10 cases), cribriform intraglandular growth (3 cases), and a single mitotic figure in I case. The histologic changes involved the superficial glands (6 cases), deep glands (4 cases), or both (8 cases); confluent or extensive gland involvement was seen in 8 cases. Follow-up information, available in four cases (4, 2, 1, 1 years), was unremarkable. The principal consideration in the differential diagnosis was clear cell carcinoma. The features most helpful in this distinction were the usual lack of a mass suspicious for cancer, absence of a desmoplastic response, lack of an infiltrative pattern, spectrum of cy-tologic atypia, low nuclear-cytoplasmic ratio, and usual lack of mitotic activity.
    Article · May 2004 · American Journal of Surgical Pathology

Publication Stats

7k Citations


  • 1999-2005
    • Harvard University
      Cambridge, Massachusetts, United States
    • University of British Columbia - Vancouver
      Vancouver, British Columbia, Canada
  • 1986-2003
    • Massachusetts General Hospital
      • Department of Pathology
      Boston, Massachusetts, United States
  • 1984-2000
    • Harvard Medical School
      • Department of Pathology
      Boston, Massachusetts, United States
  • 1997
    • Indiana University-Purdue University Indianapolis
      • Department of Pathology and Laboratory Medicine
      Indianapolis, IN, United States
    • Henry Ford Hospital
      • Surgery
      Detroit, Michigan, United States
    • Johns Hopkins Medicine
      • Department of Pathology
      Baltimore, MD, United States
  • 1987-1996
    • Vancouver General Hospital
      • Department of Pathology and Laboratory Medicine (UBC)
      Vancouver, British Columbia, Canada
  • 1994
    • Jefferson College
      Хиллсборо, Missouri, United States