{"title":"Common practice issues in pulmonary cytology/small biopsy: Diagnostic pitfalls and appropriate use of immunohistochemical stains","authors":"Jessie Xiong , Erik Polsdofer , Jian Jing","doi":"10.1016/j.hpr.2024.300735","DOIUrl":"https://doi.org/10.1016/j.hpr.2024.300735","url":null,"abstract":"<div><p>With the increasing emphasis on early detection of lung carcinoma in clinical practice, the utilization of small biopsies including cytology specimens has become more prevalent and an integral part of the diagnostic process. While holding immense significance for patient care and decision-making, the accurate identification of lung carcinoma from these small biopsies poses challenges. There is a significant overlap in the characteristics among benign, reactive, and malignant processes. This is aggravated by the absence of distinguishing biomarkers. Preserving specimen material for additional cytogenetic and molecular testing has also gained prominence to enable targeted precision medicine.</p><p>The focus of our review is directed towards understanding the morphologic attributes and potential diagnostic mimickers associated with the most frequent types of lung carcinoma observed in small biopsies. Additionally, we emphasize the importance of proper immunohistochemical staining practices to preserve tissue for further molecular testing.</p></div>","PeriodicalId":100612,"journal":{"name":"Human Pathology Reports","volume":"36 ","pages":"Article 300735"},"PeriodicalIF":0.0,"publicationDate":"2024-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2772736X24000070/pdfft?md5=4c4c979490d68c686f279c96efdf9d59&pid=1-s2.0-S2772736X24000070-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140123179","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Juan Xing , Jordan P. Reynolds , Xiaoying Liu , Liron Pantanowitz
{"title":"Urine cytology: Updates and challenges in reporting systems, ancillary studies, and artificial intelligence","authors":"Juan Xing , Jordan P. Reynolds , Xiaoying Liu , Liron Pantanowitz","doi":"10.1016/j.hpr.2024.300733","DOIUrl":"https://doi.org/10.1016/j.hpr.2024.300733","url":null,"abstract":"<div><p>Several urine cytology classifications have been published in the literature. However, global acceptance in the field of urine cytology was only gained in 2016 after The Paris System for reporting urinary cytology was published. Despite this Paris System and its shifted focus toward the detection of high-grade urothelial carcinoma, the perceived weakness of low sensitivity and indeterminate diagnoses when screening with urine cytology remains unresolved. To overcome these shortcomings, investigators have studied a variety of emerging ancillary tests to augment urine cytology (UroVysion, ImmunoCyt/uCyte+, BTA-stat/TRAK, NMP22, SCD-A7, URO17, CellDetect, UroMark, UroSEEK). Furthermore, with the advent of digital cytology, the creation of artificial intelligence tools has created innovative opportunities to aid with urine cytology. This review article discusses the lessons learned in the evolution of reporting systems, explores the merit and challenges of ancillary tests, and calls attention to potential utility of applying artificial intelligence in urine cytology.</p></div>","PeriodicalId":100612,"journal":{"name":"Human Pathology Reports","volume":"35 ","pages":"Article 300733"},"PeriodicalIF":0.0,"publicationDate":"2024-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2772736X24000057/pdfft?md5=47d0e37442379d106c973709c84ef298&pid=1-s2.0-S2772736X24000057-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139986115","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Head and neck Cytopathology: Options for high-risk HPV testing in head and neck FNA specimens, a concise review","authors":"Tieying Hou, Hector Mesa, Shaoxiong Chen, Mohamed Hamdi Fouad Bikhet, Omer Saeed, Sheila Segura, Harvey Cramer","doi":"10.1016/j.hpr.2024.300731","DOIUrl":"https://doi.org/10.1016/j.hpr.2024.300731","url":null,"abstract":"<div><p>High-risk human papillomavirus (HR-HPV)-associated oropharyngeal squamous cell carcinoma (OPSCC) is a unique form of head and neck cancer with distinct biology and better prognosis than conventional SCC. Many patients with HR-HPV positive OPSCC initially present with metastases to lateral neck lymph nodes in levels II or III. Fine-needle aspiration (FNA) is routinely used to establish a diagnosis and evaluate HPV status at these sites. However, there is no consensus regarding the best testing methods for establishing HPV status in cytology specimens. The most common methods include p16 immunohistochemistry, HR-HPV in situ hybridization and molecular tests. This review summarizes the advantages and limitation of each method.</p></div>","PeriodicalId":100612,"journal":{"name":"Human Pathology Reports","volume":"35 ","pages":"Article 300731"},"PeriodicalIF":0.0,"publicationDate":"2024-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2772736X24000033/pdfft?md5=dcd6565c75ba74bf908910f5620c8117&pid=1-s2.0-S2772736X24000033-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139726092","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Adult-onset autoimmune enterocolopathy initially presenting with lower gastrointestinal histologic findings: A case report and review of literature","authors":"Jennifer Pfeiffer , John M. Kennedy","doi":"10.1016/j.hpr.2024.300732","DOIUrl":"https://doi.org/10.1016/j.hpr.2024.300732","url":null,"abstract":"<div><p>Autoimmune enterocolopathy (AIE) is an immune-mediated disease effecting the gastrointestinal tract that has been increasingly recognized in adults. Prior reports of adult-onset AIE, as well as published diagnostic criteria, emphasize the histopathologic findings in the small bowel to support the diagnosis. However, AIE is known to be a pan-enteric disease, and the initial histologic findings could be first encountered at non-small bowel sites. Here, we report a case of adult-onset AIE, where the initial histologic findings of AIE manifested in the colon as marked loss of goblet cells and prominent basal apoptoses. We review the differential diagnostic considerations, and discuss the subsequent clinical workup needed to evaluate for AIE if it is suspected on a colon biopsy. Additionally, a literature review was performed to determine the histopathologic characteristics of adult-onset AIE in the colon. Overall, the present case report, as well as findings from the literature review, suggest that AIE should enter the differential diagnosis in an adult patient with diarrhea when loss of goblet cells and prominent basal apoptoses are observed in a patient’s colon biopsy, especially when alternative etiologies are not supported by appropriate clinical context.</p></div>","PeriodicalId":100612,"journal":{"name":"Human Pathology Reports","volume":"35 ","pages":"Article 300732"},"PeriodicalIF":0.0,"publicationDate":"2024-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2772736X24000045/pdfft?md5=c6869c8c9a75a8f2f2e6ff7388c7bf1b&pid=1-s2.0-S2772736X24000045-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139731773","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Kelly M. Garrity , Richard Chiu , Rachana Srivastava , Deborah K. McCurdy , Jonathan E. Zuckerman
{"title":"Blau syndrome complicated by granulomatous tubulointerstitial nephritis and immune complex mediated glomerulonephritis: A case report and review of the literature","authors":"Kelly M. Garrity , Richard Chiu , Rachana Srivastava , Deborah K. McCurdy , Jonathan E. Zuckerman","doi":"10.1016/j.hpr.2024.300730","DOIUrl":"https://doi.org/10.1016/j.hpr.2024.300730","url":null,"abstract":"<div><p>Blau syndrome is a rare, autosomal dominant or de novo mutation, granulomatous, auto-inflammatory disorder classically manifesting as a triad of polyarthritis, uveitis, and dermatitis. Rarely, this disease involves visceral sites such as the liver, lung, and kidney. In this report, we describe a case of a 13-year old female with Blau syndrome, with prior findings of polyarticular arthritis, uveitis, granulomatous sialadenitis of the right parotid gland, and positive NOD2 mutation testing, whose serum creatinine acutely rose despite being on anti-TNF-alpha therapy since age two. Kidney biopsy revealed granulomatous tubulointerstitial nephritis (TIN) and an immune complex (IC)-mediated glomerulonephritis attributed to Blau syndrome. We conducted a literature search to find all reported cases of Blau syndrome with biopsy findings of granulomatous renal involvement, finding ten other case reports. We assessed the likelihood of TIN and immune complex deposition, the drugs used to treat these patients, and the clinical outcomes. We found coexisting IC renal deposition rare, occurring in 2/11 patients including ours and renal involvement that was anti-TNF unresponsive was only present in our patient with a recorded renal treatment outcome.</p></div>","PeriodicalId":100612,"journal":{"name":"Human Pathology Reports","volume":"35 ","pages":"Article 300730"},"PeriodicalIF":0.0,"publicationDate":"2024-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2772736X24000021/pdfft?md5=700387b75208cc35b52a2b0adc843f45&pid=1-s2.0-S2772736X24000021-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139653699","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Fahad Al Qooz , Mohammad Alanazi , Mohammad S. Al Olaimat , Tasneem Malahmeh , Zaid Rasheed Alzoubi
{"title":"Submandibular basal cell adenoma – A rare presentation","authors":"Fahad Al Qooz , Mohammad Alanazi , Mohammad S. Al Olaimat , Tasneem Malahmeh , Zaid Rasheed Alzoubi","doi":"10.1016/j.hpr.2024.300729","DOIUrl":"https://doi.org/10.1016/j.hpr.2024.300729","url":null,"abstract":"<div><p>A basal cell adenoma is a rare salivary gland tumor that usually occurs in the parotid gland, upper lip, palate, or sometimes the nasal septum. It rarely involves the submandibular gland. To the best of our knowledge, only 6 cases involving the submandibular gland have been described in the literature. We present a case of a 41-year-old female who presented with right submandibular swelling and was diagnosed as having a basal cell adenoma.</p></div>","PeriodicalId":100612,"journal":{"name":"Human Pathology Reports","volume":"35 ","pages":"Article 300729"},"PeriodicalIF":0.0,"publicationDate":"2024-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2772736X2400001X/pdfft?md5=1e012deec972b1007d983be855a18299&pid=1-s2.0-S2772736X2400001X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139436567","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jane E. Buys , Christiaan H. Gouws , Stefanus W.D. van der Walt , Jacqueline Goedhals
{"title":"Conjunctival stromal tumour: A case report","authors":"Jane E. Buys , Christiaan H. Gouws , Stefanus W.D. van der Walt , Jacqueline Goedhals","doi":"10.1016/j.hpr.2023.300728","DOIUrl":"https://doi.org/10.1016/j.hpr.2023.300728","url":null,"abstract":"<div><p>Conjunctival stromal tumour (COST) is a rare and newly described mesenchymal tumour of the conjunctiva. We present a case of a slow-growing conjunctival lesion in a 54-year-old female. Due to persistent irritant symptoms, the lesion was excised. Histopathological assessment showed a paucicellular tumour set in an oedematous and collagenous background within the lamina propria. Significant nuclear degenerative atypia was noted. Lesional cells were positive for CD34 immunohistochemistry. The features were consistent with COST. The condition is typically unilateral and arises in the bulbar conjunctiva, with both inflammatory and neoplastic origins considered. They are sporadic and occur most frequently in adults. COSTs are indolent and managed effectively with complete surgical excision. Conjunctival myxoma is the most important differential diagnosis due to its association with the Carney complex, a potentially life-threatening condition that requires close clinical follow-up. Accurate recognition of COST and myxoma is crucial to stratify care appropriately.</p></div>","PeriodicalId":100612,"journal":{"name":"Human Pathology Reports","volume":"35 ","pages":"Article 300728"},"PeriodicalIF":0.0,"publicationDate":"2023-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2772736X23000385/pdfft?md5=676de225335f782257fabcce76cb3c7a&pid=1-s2.0-S2772736X23000385-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138839032","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ahmed Bendari , Xuelin Zhong , Sunder Sham , Reham Al-Refai , Aisha Abdelhafez , Paul C. Lee , Elana Opher , Manju Harshan
{"title":"Primary adenoid cystic carcinoma in the lung: Reporting two cases and mini-literature review","authors":"Ahmed Bendari , Xuelin Zhong , Sunder Sham , Reham Al-Refai , Aisha Abdelhafez , Paul C. Lee , Elana Opher , Manju Harshan","doi":"10.1016/j.hpr.2023.300727","DOIUrl":"https://doi.org/10.1016/j.hpr.2023.300727","url":null,"abstract":"<div><p>Primary adenoid cystic carcinoma (ACC) accounts for less than 0.2 % of all primary lung malignancies. Here we present two cases of lung ACC (ACCL), first is a 65-year-old female who was diagnosed with ACCL and surgically treated at another institution. She presented with recurrent tumor which was resected at our hospital. No adjuvant treatment was given, and she is without any signs of residual tumor or recurrence after 6 months. The second case is a 68-year-old female with a right upper lobe nodule noticed in 2017 but declined biopsy due to fear of possible complications. In 2022 she underwent biopsy at our institution which showed ACCL and was treated surgically without adjuvant therapy. Till date she is with no evidence of residual tumor or recurrence. Multiple disciplines need to work together to provide the best patient care from accurate diagnosis to surgical resection and additional therapy. More research is needed to generate guidelines for treatment of this rare malignancy, especially the indications for chemotherapy.</p></div>","PeriodicalId":100612,"journal":{"name":"Human Pathology Reports","volume":"35 ","pages":"Article 300727"},"PeriodicalIF":0.0,"publicationDate":"2023-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2772736X23000373/pdfft?md5=977f93dd5b03f2c16fceb06a50bc32c4&pid=1-s2.0-S2772736X23000373-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138570031","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Dona Maria George , Archana Lakshmanan, S Annapurneswari, Karuppasamy Usharani
{"title":"Epithelioid inflammatory myofibroblastic sarcoma – A rare case report","authors":"Dona Maria George , Archana Lakshmanan, S Annapurneswari, Karuppasamy Usharani","doi":"10.1016/j.hpr.2023.300726","DOIUrl":"https://doi.org/10.1016/j.hpr.2023.300726","url":null,"abstract":"<div><p>Inflammatory myofibroblastic tumors are mesenchymal neoplasms made up of spindle cells with inflammatory infiltrates and are intermediate-grade tumors. Inflammatory Myofibroblastic Tumor (IMT) has a variant known as Epithelioid Inflammatory Myofibroblastic Sarcoma (EIMS) with aggressive behavior. Morphologically they have round to epitheliod cells that are positive for the Anaplastic Lymphoma Kinase (ALK) receptor tyrosine kinase. The abdomen and pelvis are the most common sites of involvement. Children and young adults are frequently affected. We report a rare case of EIMS arising on the serosal aspect of the ileocaecal junction in a 33-year-old male patient. Morphologically there were sheets and loose fascicles of epithelioid cells admixed with inflammatory cells in a variably myxoid background. Tumor cells were positive for Vimentin, Desmin, CD30, and Smooth muscle actin and showed cytoplasmic and nuclear membrane ALK positivity. Molecular studies in our case showed rearrangement of ALK by Vysis LSI ALK dual color break apart FISH probe. To our knowledge, this is the fifty-ninth reported case to date. Our case report highlights the clinical, histopathological, and immunohistochemical features of EIMS. Given their rarity and novelty, increased understanding and correct identification of the histological and immunohistochemical features of EIMS can result in an accurate diagnosis and focused treatment.</p></div>","PeriodicalId":100612,"journal":{"name":"Human Pathology Reports","volume":"35 ","pages":"Article 300726"},"PeriodicalIF":0.0,"publicationDate":"2023-12-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2772736X23000361/pdfft?md5=2b3b8d08e3da92d5ddf457c6a41dd09b&pid=1-s2.0-S2772736X23000361-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138557584","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Utku Ekin , Ahmad M. Alkhatatneh , Lan Wang , Mourad Ismail
{"title":"An unusual location of micronodular thymoma with lymphoid stroma: A posterior mediastinal mass invading into pleura","authors":"Utku Ekin , Ahmad M. Alkhatatneh , Lan Wang , Mourad Ismail","doi":"10.1016/j.hpr.2023.300725","DOIUrl":"https://doi.org/10.1016/j.hpr.2023.300725","url":null,"abstract":"<div><p>Micronodular thymoma with lymphoid stroma (MNTL) is a rare type of thymoma that is often found alongside Type A thymoma. Here, we present a case of MNTL diagnosed in an 82 year-old-female who had a thymus excision seven years prior. The posterior mediastinal mass was discovered incidentally in this patient after a mechanical fall and diagnostic imaging. The patient underwent a needle biopsy of this mass, the pathology of which initially demonstrated type A thymoma. Several months later, the patient underwent a video-assisted thoracoscopic surgery (VATS) procedure with resection of the mass. Pathology this time showed mixed areas of MNTL, type B3, and focal B2 types of thymoma. The location and the histological morphology of this tumor were unique. Treatment approaches to such cases should be multidisciplinary and individualized.</p></div>","PeriodicalId":100612,"journal":{"name":"Human Pathology Reports","volume":"34 ","pages":"Article 300725"},"PeriodicalIF":0.0,"publicationDate":"2023-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49847657","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}