About

Dr. Claudio Guerrieri is a pathologist affiliated with Rutgers New Jersey Medical School and multiple hospitals in Brooklyn, New York, including Newark Beth Israel Medical Center. He received his medical degree from Sapienza University of Rome in 1981 and has been practicing for more than 20 years. His professional focus includes pathology, with a background rooted in medical education from Italy and extensive clinical practice in the United States. His contributions include research publications on various topics in pathology, such as intracystic papillary carcinoma, rhabdomyosarcoma of the hand metastasizing to the breast, and undifferentiated embryonal sarcoma of the liver.

Research topics

• Medicine
• Biology
• Pathology
• Internal medicine
• Endocrinology

Selected publications

• 267 Fine-Needle Aspiration of Focal Liver Lesions: Superior Adequacy Compared to Core Needle Biopsy

  Laboratory Investigation · 2026-03-01

  article
  PublisherDOI

• S5594 Acute Severe Autoimmune Hepatitis – Prompt Recognition and Glucocorticoid Therapy

  The American Journal of Gastroenterology · 2025-10-01

  article

  Introduction: Autoimmune hepatitis (AIH) is an immune mediated disease defined by characteristic histologic features, elevated liver enzymes and presence of one or more characteristic autoantibodies. This disease can affect all age groups, gender and ethnicities with varied presentations ranging from asymptomatic to acute liver failure (ALF). The acute form is a rare cause of ALF and is subdivided into 3 categories: non-severe, severe, and fulminant AIH. Case Description/Methods: A 20-year-old man with hypothyroidism and chronic colitis (not on therapy) presented to the emergency room for evaluation of jaundice. He was asymptomatic aside from intermittent rectal bleeding due to colitis. Vitals were stable. Exam was notable for jaundice but without asterixis, ascites, or encephalopathy. Liver enzymes were elevated with a peak value of alanine aminotransferase 2979 IU/L, aspartate aminotransferase 2079 IU/L, Bilirubin 12.3 mg/dL, Alkaline phosphatase 287 IU/L and international normalized ratio of 1.62. ANA titer was 1:80, but other serologic workup including IgG, Alpha 1 Antitrypsin, Liver Kidney Microsomal antibody, Smooth Muscle Antibody, Anti-mitochondrial Antibody, Ceruloplasmin and viral hepatitis were within the laboratory reference range. Liver biopsy was obtained revealing severe active hepatitis with perivenular confluent necrosis and focal cholestasis. Inflammation was mixed, comprising of lymphocytes, neutrophils, macrophages, eosinophils, and areas of increased numbers of plasma cells. Colonoscopy during this admission showed moderate inflammation of the entire colon. After all alternative causes of liver injury were excluded, the patient started steroid therapy (intravenous methylprednisolone 60 mg daily) for management of acute severe autoimmune hepatitis (AS-AIH) and colitis with improvement of his liver serologies. He was discharged on prednisone with follow-up, where his serologies have markedly improved. Discussion: We present here a case of AS-AIH, which is a rare disease with poor outcomes, especially with delayed treatment. While severe hepatitis can be categorized with serologies including international normalized ratio >1.5 and elevated bilirubin, in AS-AIH patients may be autoantibody negative, have normal IgG and less specific histologic features. Early consideration of liver biopsy, in addition to a clinical history, is crucial to support the diagnosis and help exclude other disease processes. Prompt initiation of high dose glucocorticoid therapy improves outcomes, as well as early consideration of liver transplantation should the patient not respond to medical therapy.

  PublisherDOI

• Clinical Response to Olaparib in a Patient With Leptomeningeal Carcinomatosis in Newly Diagnosed Breast Cancer With Germline <i>BRCA2</i> Mutation

  JCO Precision Oncology · 2024-07-01 · 5 citations

  article

  Case of LMC in a BRCA2-mutated breast cancer patient shows clinical improvement with Olaparib therapy.

  PublisherDOI

• S4425 The Importance of Genetic Testing in a Case of Oral Contraceptive Induced Jaundice as First Manifestation of Benign Recurrent Intrahepatic Cholestasis

  The American Journal of Gastroenterology · 2024-10-01

  articleSenior author

  Introduction: Benign recurrent intrahepatic cholestasis (BRIC) is a rare cause of episodic and non-progressive cholestatic liver injury. We report a case of BRIC that was triggered by oral contraceptive pills. Case Description/Methods: A 19-year-old woman with no medical history presented with one-week of jaundice, pruritus, and abdominal pain. Six months prior she had started estrogen containing oral contraceptive pills (OCPs). Labs revealed markedly elevated bilirubin with elevated transaminases and alkaline phosphatase, and normal gamma-glutamyltransferase (GGT). Additional serologic workup was unremarkable and all abdominal imaging was normal. Liver biopsy revealed diffuse cholestasis with few foci of lobular inflammation (Figure 1). She was diagnosed with a cholestatic drug-induced liver injury secondary to OCPs. The normal GGT raised the possibility of BRIC. Genetic testing revealed a heterozygous variant of the ABCB11 gene known to be associated with BRIC. OCPs were discontinued and she was treated with ursodiol and rifampicin. Symptoms and lab abnormalities resolved over the following 2 months. Months later the patient developed a second episode of jaundice that resolved spontaneously. Discussion: BRIC presents as recurrent episodes of cholestasis without progressive liver damage which can last weeks to months.1 During episodes, patients have elevated transaminases and bilirubin but notably normal GGT levels.2 BRIC in most cases is now known to be associated with mutations in the ABCB11 gene, which encodes for the bile acid secretion pump protein. Patients with an underlying mutation often have a trigger associated with development of cholestasis such as infection or estrogen exposure, including pregnancy.³ Increased levels of estrogen decrease fluidity of hepatocyte lipid membranes and disrupt Na+/K+ ATPase and ATP-dependent bile acid secretion pump activity.³ In this case, a patient with an underlying ABCB11 mutation developed cholestasis with exposure to estrogen. We aim to heighten awareness of BRIC and the role of genetic testing in patients with cholestatic liver injury after OCP initiation, as it may guide risk of ongoing hormonal OCP use or pregnancy. References 1. van Mil SW, van der Woerd WL, van der Brugge G, et al. enign recurrent intrahepatic cholestasis type 2 is caused by mutations in ABCB11. Gastroenterology. 2004;127(2):379-84. 2. Geladari EV, Vallianou NG, Margellou E, Kounatidis D, Sevastianos V, Alexopoulou A. Benign recurrent intrahepatic cholestasis: where are we now? Gastroenterology Insights. 2024; 15(1):156-167. 3. Schreiber AJ, Simon FR. Estrogen-induced cholestasis: clues to pathogenesis and treatment. Hepatology. 1983;3(4):607-13.Figure 1.: Hematoxylin and Eosin (H&E) staining of liver demonstrating diffuse cholestasis with few foci of lobular inflammation.

  PublisherDOI

• Hepatic pseudotumor associated with <i>Strongyloides</i> infection: A case report

  World Journal of Hepatology · 2023-12-25 · 1 citations

  articleOpen access

  BACKGROUND Strongyloides sterocoralis is a parasitic infection caused by a roundworm that is transmitted through soil contaminated with larvae. It can infrequently cause hepatic abscesses in immunocompromised patients and is rarely reported to form hepatic lesions in immunocompetent hosts. CASE SUMMARY We present a case study of a 45-year-old female who presented with right upper quadrant abdominal pain and constitutional symptoms for several weeks. Cross-sectional imaging identified several malignant-appearing liver masses. Further investigation, including serological testing and histopathologic examination, revealed the presence of serum Strongyloides antibodies and hepatic granulomas with extensive necrosis. Following treatment with ivermectin for 2 wk, there was complete resolution of the liver lesions and associated symptoms. CONCLUSION This case highlights the importance of considering parasitic infections, such as Strongyloides , in the differential diagnosis of hepatic masses. Early recognition and appropriate treatment can lead to a favorable outcome and prevent unnecessary invasive procedures. Increased awareness among clinicians is crucial to ensure the timely diagnosis and management of such cases.

  PublisherDOI

• Composite FOXL2 Mutation-positive Adult Granulosa Cell Tumor and Serous Borderline Tumor of the Ovary

  International Journal of Gynecological Pathology · 2022 · 4 citations

  • Pathology
  • Biology
  • Medicine

  We report a case of a cystic ovarian neoplasm in a 76-yr-old female composed of 2 distinct and intimately associated components: a macrocystic adult granulosa cell tumor (AGCT) and a serous borderline tumor. The granulosa cell nature of the tumor was confirmed with positive immunohistochemical staining for inhibin, calretinin, and WT1, while the neoplastic nature of the granulosa cell proliferation was supported by the presence of a point mutation of the FOXL2 gene. A review of 19 previously reported mixed AGCT and epithelial neoplasms of the ovary is included. Of the eight mixed AGCT and epithelial tumors, including our case, that were tested for FOXL2 mutation, 4 of the 5 mutation-positive cases were notable for demonstrating a macroscopically visible nodule or mass of AGCT at the time of gross examination, while 2 of the 3 mutation-negative cases lacked a mass-producing granulosa cell component. This feature by itself may be sufficient to predict the true neoplastic nature of the granulosa cell proliferation. This is the first reported case of a composite neoplastic AGCT and serous borderline tumor. We also discuss the current histogenetic models for these rare mixed AGCT and epithelial tumors.

  PublisherDOI

• Pulmonary squamous cell carcinoma with a lepidic-pagetoid growth pattern

  Pathologica · 2022-09-01 · 6 citations

  articleOpen accessSenior author

  We report a rare case of a peripheral squamous cell carcinoma (SCC) of the lung in which most of the tumor displayed a "lepidic" growth pattern. The tumor cells also appeared to grow along the alveolar walls between the overlying pneumocytes and underlying basement membrane, a form reminiscent of the "pagetoid" mode of spread. The neoplastic cells were positive for the squamous markers p63 and p40. TTF-1 and CK7 highlighted residual non-neoplastic pneumocytes, which either covered the lepidic tumor cells or lined pseudoglandular formations created by the filling of alveolar spaces by the tumor. CK7 also stained the tumor cells, albeit focally and weakly, a not uncommon finding in peripheral lung SCC. The tumor cells were negative for TTF-1 (clone 8G7G3/1), but did show focal weak reactivity with the less specific clone SPT24. The invasive area measured 2.5 mm while the overall size of the tumor including the lepidic-pagetoid component was 9.0 mm. Even though the invasive component was < 0.5 cm, the only option according to existing staging criteria was to stage it as pT1a. Since the current staging system does not account for the non-invasive lepidic component of pulmonary SCC, the increasing awareness of this variant may require its inclusion within the classification and pathological staging of lung carcinoma.

  PublisherOA PDFDOI

• Pagetoid involvement of bronchioles by metastatic breast carcinoma

  Pathologica · 2021-04-01 · 1 citations

  articleOpen accessSenior author

  We report a case of a 36-year-old female with endobronchiolar spread of breast carcinoma in the lung. The patient had recently been diagnosed with invasive ductal breast carcinoma and imaging of the lungs revealed bilateral lung nodules. She then underwent a wedge resection of a lung nodule. The biopsy revealed a subpleural metastatic nodule of invasive ductal carcinoma with an intra-alveolar pattern of spread at its advancing edge. Several smaller foci of intra-alveolar tumor were noted as well as pagetoid spread of tumor cells along a 0.9 mm wide bronchiole. The neoplastic cells were TTF-1 negative, GATA3 positive and ER positive. This is the third reported case of pagetoid spread of metastatic breast carcinoma along the bronchial tree. This case emphasizes the importance of examining not only bronchi but also bronchioles to detect this unusual pattern of spread of metastatic breast carcinoma in lung resection specimens.

  PublisherOA PDFDOI

• Perineal Clear Cell Hidradenoma: A GATA3-positive Neoplasm With Potential for Misdiagnosis

  International Journal of Gynecological Pathology · 2020-09-11 · 4 citations

  article1st authorCorresponding

  We report a case of clear cell hidradenoma of the perineum that was initially misinterpreted as a papillary urothelial carcinoma, either metastatic or of Bartholin gland origin, on initial excisional biopsy. The misinterpretation may have been due to the pseudopapillary architecture and GATA3-positivity of the biopsy tissue. Clear cell hidradenomas often show a range of histologic growth patterns and cellular differentiation and are one of many tumors that react immunohistochemically with GATA3. Although rare, these tumors can occur in the genital region and can mimic malignant tumors such as metastatic renal cell carcinoma and carcinomas of the genitourinary tract. This report details the morphologic and immunohistochemical pitfalls that make accurate diagnosis of clear cell hidradenoma in this unusual location challenging.

  PublisherDOI

• Metachronous Mesorectal Recurrence after Colectomy for Ascending Colon Cancer

  Case Reports in Oncology · 2020-06-11 · 1 citations

  articleOpen accessSenior author

  BACKGROUND: An isolated metachronous recurrence in the mesorectum from a primary ascending colon cancer is a rare finding that has not been previously reported. This may represent a form of retroperitoneal spread, sometimes referred to as "drop metastasis," which is an uncommon mechanism for metachronous recurrence. CASE PRESENTATION: A 38-year-old male presented to the Emergency Department in January of 2018 with profound anemia. A colonoscopy revealed innumerable colonic polyps. He reported having multiple family members diagnosed with colon cancer and was subsequently diagnosed with familial adenomatous polyposis with rectal sparing. Total abdominal colectomy with ileorectal anastomosis was performed, revealing a T3N1a adenocarcinoma of the ascending colon. The patient subsequently underwent 12 cycles of adjuvant FOLFOX. Surveillance imaging in late 2019 revealed a suspicious mass in the superior perirectal soft tissue without any other sites of potential disease. Completion proctectomy was performed in January 2020, 2 years after the initial resection. Pathology revealed a mesorectal tumor deposit located 1.5 cm distal to the ileorectal anastomosis. No evidence of mucosal involvement or nodal metastasis was identified. CONCLUSION: Isolated mesorectal recurrence is a rare and previously unreported clinical finding following resection of an ascending colon cancer with an ileorectal anastomosis. This likely represents a form of retroperitoneal spread.

  PublisherOA PDFDOI

Frequent coauthors

• Claudio Guerrieri

  Newark Beth Israel Medical Center

  84 shared

• Patrick Anderson

  University of Ottawa

  41 shared

• Billie Fyfe

  Johnson University

  16 shared

• Patrick Anderson

  16 shared

• Eddy M. Joseph

  Rutgers, The State University of New Jersey

  9 shared

• Roy H. Rhodes

  6 shared

• Hasini Reddy

  Columbia University Irving Medical Center

  4 shared

• Jeanine Chiaffarano

  Thomas Jefferson University Hospital

  4 shared

Labs

• Rutgers New Jersey Medical School Department of Pathology, Immunology and Laboratory MedicinePI

Education

• M.D.

  University of Rome 'La Sapienza'

  1981