Diagnostic Pathology最新文献

{"title":"Immunohistochemical evaluation of androgen receptor expression in endometrial carcinoma and its clinicopathological significance.","authors":"Alaa Saad Abd Elhamid Mohamed, Heba Ashraf Hosni, Maram Salaheldeen Mahmoud, Alzahraa Abdelmoktader Mohammed","doi":"10.1186/s13000-026-01848-x","DOIUrl":"10.1186/s13000-026-01848-x","url":null,"abstract":"<p><strong>Background: </strong>Endometrial carcinoma (EC) is a leading gynecological malignancy predominantly driven by hormonal imbalances. While the roles of estrogen and progesterone are well established, the influence of androgenic signaling, specifically through the androgen receptor, remains an underexplored diagnostic dimension. This study aims to evaluate the immunohistochemical (IHC) expression of the androgen receptor (AR) in EC tissue samples and correlate its presence with key clinicopathological parameters.</p><p><strong>Methods: </strong>A retrospective cohort study was conducted utilizing 40 formalin-fixed, paraffin-embedded (FFPE) tissue specimens from patients diagnosed with EC who had undergone total hysterectomies. Cases were histologically categorized according to World Health Organization (WHO) criteria into endometrioid endometrial carcinoma (EEC), n = 32 and serous endometrial carcinoma, n = 8, and classified by the International Federation of Gynecology and Obstetrics (FIGO) for staging and grading. IHC staining was performed to evaluate nuclear AR expression, defined as positive when > 10% of neoplastic cells exhibited distinct nuclear staining. Data were statistically analyzed to identify associations between AR status and patient age, histological subtype, tumor grade, and stage.</p><p><strong>Results: </strong>Distinct nuclear AR positivity was observed in 50% (20 of 40) of the total cohort. Expression was exclusively restricted to EEC (62.5% positive), whereas all serous carcinomas lacked expression entirely (P = 0.002). Notably, positive receptor expression demonstrated a strong inverse relationship with advanced FIGO stage and high tumor grade. Immunoreactivity was significantly enriched in early-stage disease (62.1% in Stages I and II versus 18.2% in Stage III; P = 0.013) and low-grade tumors (76.0% in Grades 1 and 2 versus 6.7% in Grade 3; P < 0.001). Patient age at diagnosis yielded no statistically significant correlation with expression status (P = 0.206).</p><p><strong>Conclusion: </strong>The AR is frequently expressed in low-grade, early-stage EEC, suggesting that AR may be associated with well-differentiated tumors and favorable clinicopathological parameters. The integration of AR immunohistochemistry into routine pathology panels could serve as a hypothesis-generating foundation for future clinical trials investigating targeted antiandrogen therapies.</p>","PeriodicalId":11237,"journal":{"name":"Diagnostic Pathology","volume":"21 1","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13615620/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149059092","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnostic concordance of remote WSI-based thyroid cytology compared to conventional cytological diagnosis: a pilot study.","authors":"Abdullah Fahri Şahi̇n, Özben Yalçin, Seyma Büyücek, Merve Dogan Ayan, Hatice Elmas","doi":"10.1186/s13000-026-01820-9","DOIUrl":"10.1186/s13000-026-01820-9","url":null,"abstract":"<p><strong>Background: </strong>Whole slide imaging (WSI) has emerged as a key component of digital pathology, enabling remote diagnostics and standardized evaluation. However, its diagnostic concordance in thyroid cytopathology, particularly under real-world conditions, remains insufficiently validated.</p><p><strong>Methods: </strong>In this retrospective pilot study, thirteen thyroid cases were evaluated using both conventional light microscopy and WSI. One pathologist performed glass slide evaluation, while two independent pathologists assessed the corresponding digital slides remotely. All evaluations were conducted in a blinded manner. Diagnostic agreement was analyzed using percentage concordance and Cohen's kappa coefficient.</p><p><strong>Results: </strong>The overall concordance rate between conventional microscopy and WSI was 69.2%. Cohen's kappa values ranged from 0.58 to 0.63, indicating moderate to substantial agreement. Full concordance was observed in 7 cases, predominantly among malignant diagnoses. Partial concordance occurred in 5 cases, mainly involving borderline categories. Complete discordance was identified in 1 case, exclusively within an indeterminate cytological category. No clinically significant misclassification between benign and malignant diagnoses was observed.</p><p><strong>Conclusion: </strong>WSI demonstrated moderate diagnostic agreement with conventional microscopy in well-defined thyroid cytopathology categories. However, variability remains more pronounced in indeterminate cases, reflecting inherent diagnostic challenges. These findings support the preliminary feasibility of WSI in real-world and remote diagnostic workflows, although larger, multicenter studies are required to confirm these results.</p>","PeriodicalId":11237,"journal":{"name":"Diagnostic Pathology","volume":"21 1","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13599079/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149024043","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fine-needle-based localization techniques in parathyroid adenomas: a retrospective cohort study of histopathological safety and fibrosis patterns.","authors":"Tuğba Günler, İlker Çordan, Sabri Özden, Mustafa Çaycı","doi":"10.1186/s13000-026-01849-w","DOIUrl":"10.1186/s13000-026-01849-w","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to evaluate the association between fine-needle-based interventions widely used for preoperative and intraoperative localization of parathyroid adenomas and development of post-excision stromal fibrosis and other histopathological changes that may mimic malignancy.</p><p><strong>Methods: </strong>A total of 164 patients who underwent parathyroidectomy for primary hyperparathyroidism were retrospectively evaluated. The patients were divided into three groups according to the number of ultrasound-guided fine-needle interventions: needle-naive (Group 0, n = 70), single-needle (Group 1, n = 43), and two-needle (Group 2, n = 51). All surgical specimens were histopathologically examined for the presence and extent of stromal fibrosis, thick fibrous capsule, fibrous bands, hemorrhage, hemosiderin deposition, capsular pseudoinvasion, tumor implantation, granulation tissue, and necrosis. Intergroup comparisons were performed using Welch's t-test, the chi-square test, Fisher's exact test, and Tukey post hoc analysis.</p><p><strong>Results: </strong>The mean age of the patients was 54.8 ± 11.9 years, and 83.5% were female. Fibrosis was identified in 28 cases (17.1%). In the unadjusted analyses, fibrosis frequency differed significantly among the groups (Group 0: 12.9%; Group 1: 30.2%; Group 2: 11.8%; p = 0.028). However, this association lost statistical significance after adjustment for potential confounding variables in multivariable logistic regression analysis (overall p = 0.10). Among cases with histologically detected fibrosis, the stromal fibrosis percentage was higher in Group 0 than in Groups 1 and 2 (p = 0.045). No significant between-group differences were observed in other histopathological findings that may mimic malignancy (p > 0.05 for all).</p><p><strong>Conclusion: </strong>Fine-needle-based localization techniques, including parathyroid hormone washout (PTH-WO) and radioguided occult lesion localization (ROLL), were not associated with prominent histopathological changes suggestive of malignancy in this cohort. Although fibrosis was more frequently observed in the needle intervention groups in the unadjusted analyses, this association was no longer significant after adjustment for potential confounding variables. In contrast, the stromal fibrosis percentage was higher in the needle-naive group; however, this analysis was based solely on the 28 cases with histologically detected fibrosis and should therefore be interpreted with caution. Overall, the findings suggest that PTH-WO and ROLL, when performed using standardized techniques and appropriate clinical indications, are not associated with prominent histopathological alterations. Larger prospective studies with long-term follow-up are needed to confirm these findings.</p>","PeriodicalId":11237,"journal":{"name":"Diagnostic Pathology","volume":"21 1","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13651212/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149147827","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Generalizability of a biopsy-trained artificial intelligence algorithm to TURP and HoLEP specimens for detection of incidental prostate adenocarcinoma.","authors":"Neşe Yeldir, Burak Uzel, Elif Nur Tekin, Gizem Solmaz Yılmaz, Eren Tekin, Sercan Çayır, İbrahim Serdar Coşkun, Bahar Müezzinoğlu","doi":"10.1186/s13000-026-01846-z","DOIUrl":"https://doi.org/10.1186/s13000-026-01846-z","url":null,"abstract":"<p><strong>Background: </strong>Incidental prostatic adenocarcinoma is frequently identified in transurethral resection of the prostate (TURP) and holmium laser enucleation of the prostate (HoLEP) specimens obtained for the management of benign prostatic hyperplasia. Artificial intelligence (AI)-based algorithms have demonstrated promising performance in prostate biopsy assessment; however, their applicability to TURP and HoLEP materials remains insufficiently studied. We evaluated the standalone performance of an AI algorithm trained on prostate needle biopsies for detecting incidental adenocarcinoma in TURP and HoLEP specimens.</p><p><strong>Methods: </strong>A total of 3,241 whole-slide images from 368 consecutive patients (247 HoLEP and 121 TURP cases) received between May 2023 and December 2025 were retrospectively analyzed. All slides were scanned at ×20 magnification using a Hamamatsu NanoZoomer S360 scanner and processed using a commercially available AI algorithm. The algorithm generated heatmap masks highlighting regions suspicious for malignancy. Conventional histopathological diagnosis served as the reference standard. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), accuracy, and area under the receiver operating characteristic curve (AUC-ROC) were calculated at the case level. The Cochran-Armitage trend test was used to assess the relationship between the number of AI-flagged slides and malignancy rates.</p><p><strong>Results: </strong>Thirty-five cases contained adenocarcinoma, of which 33 were correctly identified by the algorithm, yielding an overall sensitivity of 94.3%. Specificity was 76.0%, PPV 29.2%, NPV 99.2%, and accuracy 77.7%. Sensitivity was 92.3% for HoLEP specimens and 100% for TURP specimens. The case-level AUC-ROC was 0.89. Malignancy rates increased significantly with the number of AI-flagged suspicious slides (0.8%, 13.6%, 18.8%, and 44.4% for 0, 1, 2, and ≥ 3 suspicious slides, respectively; p < 0.001). The two false-negative cases were low-volume Grade Group 1 tumors.</p><p><strong>Conclusions: </strong>A biopsy-trained AI algorithm demonstrated high sensitivity and excellent negative predictive value for detecting incidental prostatic adenocarcinoma in TURP and HoLEP specimens. These findings support its potential role as a screening and workflow-assistance tool in routine uropathology practice.</p>","PeriodicalId":11237,"journal":{"name":"Diagnostic Pathology","volume":"21 1","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13625242/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149105491","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Expression of LDHA, Pan-Kla Level and H3K18la associates with clinical progression of laryngeal squamous cell carcinoma.","authors":"Yangbingyu Wen, Miaolong Lu, Mu Yang, Yu Kang, Songqing Fan, Yuting Zhan","doi":"10.1186/s13000-026-01842-3","DOIUrl":"10.1186/s13000-026-01842-3","url":null,"abstract":"<p><strong>Aims: </strong>Laryngeal squamous cell carcinoma (LSCC) represents one of the major subtypes of head and neck squamous cell carcinoma (HNSC), imposing substantial health burdens and necessitates comprehensive clinical interventions. Lactylation, a newly discovered protein post-translational modification (PTM), has recently been recognized as a critical regulatory element in cancer biology and LDHA plays a central role in lactylation modulation. H3K18la, one of the crucial types of histone lactylation, has drawn increasing attention of studies of malignant tumors in recent years. There is no study about the relationship between the expression of LDHA, Pan-Kla level and H3K18la and clinical characteristics and prognosis of LSCC patients.</p><p><strong>Methods: </strong>It was analyzed that the mRNA expression of LDHA in HNSC in TCGA databases. The expression of LDHA, Pan-Kla level, and H3K18la was detected by immunohistochemistry (IHC) in a large scale of LSCC patients, evaluating their associations with clinicopathologic features and prognosis.</p><p><strong>Results: </strong>LDHA mRNA was significantly upregulated in HNSC and was associated with poorer prognosis by bioinformatic analysis. Expression of LDHA, Pan-Kla level and H3K18la were higher in LSCC tissues than in non-cancerous laryngeal epithelial tissues. LDHA expression and Pan-Kla level were significantly associated with T stage. H3K18la expression was significantly associated with lymph node metastasis. Kaplan-Meier survival analysis showed that high expression of LDHA, Pan-Kla level and H3K18la was associated with shorter OS in LSCC patients. Multivariate Cox regression analysis identified positive LDHA expression as an independent prognostic indicator for LSCC.</p><p><strong>Conclusions: </strong>LDHA, Pan-Kla level and H3K18la were upregulated in LSCC tissues and were associated with shorter OS. LDHA may serve as an independent prognostic biomarker for patients with LSCC.</p>","PeriodicalId":11237,"journal":{"name":"Diagnostic Pathology","volume":"21 1","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13523308/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148849953","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Deep learning-assisted detection of lymph node metastases in bladder cancer.","authors":"Adam Gorczynski, Balazs Tarján, Noora Neittaanmäki","doi":"10.1186/s13000-026-01821-8","DOIUrl":"10.1186/s13000-026-01821-8","url":null,"abstract":"<p><strong>Background: </strong>Bladder cancer is the most common malignancy of the urinary tract and is often treated with radical cystectomy with lymph node dissection, followed by a thorough pathological evaluation of the dissected nodes. This is crucial for both accurate prognosis and successful treatment. However, histopathological lymph node examination is labor-intensive and time-consuming.</p><p><strong>Aim: </strong>To develop a supervised deep learning model for detecting nodal metastases in bladder cancer, and to evaluate its influence on pathologists' assessment efficiency.</p><p><strong>Methods: </strong>This study included 100 histopathological slides representing lymph nodes collected between 2015 and 2024 from the Sahlgrenska University Hospital and scanned into whole slide images, divided into training and validation/test sets. The algorithm was trained with 3437 pixelwise annotations. In the validation set, 50 regions containing normal tissue and metastasis were assessed by AI and two specialist pathologists as validators. In the test set, two pathologists reviewed entire slides and measured review times without, and then, after the washout period, with AI assistance.</p><p><strong>Results: </strong>In the test set, the AI model achieved a sensitivity of 100% and a specificity of 60% for the detection of metastases. For pathologist 1, the median review time decreased from 9 s to 4.2 s with AI assistance, (sign test: Z = -4.73, p < 0.001). For pathologist 2, the median review time decreased from 12 to 4 s (sign test: Z = -5.00, p < 0.001).</p><p><strong>Conclusions: </strong>This study demonstrates that an AI model trained on a limited dataset can effectively assist pathologists in the detection of lymph node metastases in bladder cancer while significantly reducing review time. These findings suggest that institutions with limited case volumes may be able to develop and implement locally trained AI models to support routine histopathological assessment.</p>","PeriodicalId":11237,"journal":{"name":"Diagnostic Pathology","volume":"21 1","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13459389/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148711756","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effect of obesity on the coccoid form transformation of Helicobacter pylori and its relationship with gastric inflammation pattern: a retrospective comparative study.","authors":"Burcu Sanal Yılmaz, Sibel Acat","doi":"10.1186/s13000-026-01823-6","DOIUrl":"10.1186/s13000-026-01823-6","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background/aim: &lt;/strong&gt;Helicobacter pylori (H. pylori) can transform from its spiral form into a coccoid (viable but non-culturable; VBNC) state under adverse environmental conditions. The coccoid form is associated with antibiotic resistance and eradication failure. This study compared coccoid and spiral form proportions, H. pylori localization patterns (epithelial vs. crypt), and gastric inflammation parameters across three BMI-stratified groups.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Materials and methods: &lt;/strong&gt;This retrospective comparative study included 156 H. pylori-positive cases from the archives of Karamanoglu Mehmetbey University Faculty of Medicine (2016-2026). Groups: Group 1 (Severe obesity/Sleeve, BMI ≥ 35; sleeve gastrectomy, n = 55), Group 2 (Non-obese/Biopsy, BMI &lt; 30; biopsy, n = 68), Group 3 (Obese/Biopsy, BMI ≥ 30; biopsy, n = 33). IHC with anti-H. pylori antibody was used for morphological assessment. Coccoid/spiral proportions, HP density, Sydney-criteria gastritis parameters, coccoid categorization (&lt; 5%, 5-19%, 20-39%, ≥ 40%), and epithelial/crypt HP localization were analyzed (SPSS 25.0; p &lt; 0.05).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Median corpus coccoid proportion was significantly higher in Group 1 (10%, IQR 5-30) vs. Group 2 (1%, IQR 1-1; p &lt; 0.001), with strong BMI correlation (r = 0.639, p &lt; 0.001). The ≥ 40% coccoid category was exclusively observed in the severe obesity/sleeve group (23.6%; p &lt; 0.001). Corpus spiral proportion decreased in a stepwise inverse gradient across categories (99%→90%→80%→40%; H = 113.8, p &lt; 0.001). Corpus HP density (Sydney score) differed significantly across groups (H = 13.8, p = 0.001) and correlated positively with coccoid proportion (r = 0.267, p = 0.003). Corpus crypt H. pylori involvement differed significantly across groups (Group 1 41.8% vs. Group 2 29.2% vs. Group 3 11.1%; overall p = 0.045). In antrum, crypt involvement was higher in non-obese (36.8%) vs. obese biopsy patients (9.1%; p = 0.011). Coccoid proportion showed no significant correlation with patient age or inflammation grade. Multivariable logistic regression identified BMI as the sole independent predictor of corpus coccoid ≥ 10% (OR = 1.134 per 1 kg/m², 95% CI: 1.088-1.183, p &lt; 0.001; C-statistic = 0.849), with age and sex non-significant after adjustment.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Obesity was strongly associated with a coccoid-shifted H. pylori morphology (higher coccoid proportion) and with increased corpus crypt colonization. In this cohort the ≥ 40% coccoid category was observed exclusively in the severe obesity/sleeve group; this cut-off should be regarded as exploratory and hypothesis-generating, and requires external validation before it can be considered a histological signature of severe obesity. Because specimen type differed between groups and eradication outcomes were not assessed, these findings represent associations rather than causal relationships. IHC-based morphological assessment may be useful in ","PeriodicalId":11237,"journal":{"name":"Diagnostic Pathology","volume":"21 1","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13545797/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148891177","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Primary acinic cell carcinoma of the breast: insights from a nine-case series and comprehensive literature review.","authors":"Guofeng Zhou, Liu Yang, Xingxing Gui, Wei Qu, Aili Huang, Shimin Gui","doi":"10.1186/s13000-026-01832-5","DOIUrl":"10.1186/s13000-026-01832-5","url":null,"abstract":"<p><strong>Purpose: </strong>To better understand primary acinic cell carcinoma (AcCC) of the breast, this study investigated its clinical and pathological features.</p><p><strong>Methods: </strong>Nine cases of primary acinic cell carcinoma were thoroughly evaluated using routine pathological and immunohistochemical methods. The clinical features, pathological morphological features, and prognosis of each case were collected and analyzed.</p><p><strong>Results: </strong>The tumors were located in the left breast in four cases (44.4%) and the right breast in five (55.6%). Most lesions (88.9%, 8/9) were in the upper outer quadrant, with one (11.1%) in the lower outer quadrant. One case (11.1%) was categorized as BI-RADS 6, and eight (88.9%) as BI-RADS 4. Histologically, the cases exhibited diverse growth patterns. The predominant patterns were microglandular and acinar. Less common patterns included microcystic, cystic, follicular, clear cell, and solid structures. Eosinophilic secretions were visible within the lumens.The tumor cells showed cytoplasmic variations (granular, clear, or basophilic) and prominent nucleoli. Immunohistochemically, all tumors were negative for estrogen receptor (ER) and androgen receptor (AR). Progesterone receptor (PR) was weakly positive in two cases and negative in the remaining seven. Human Epidermal Growth Factor Receptor 2 (HER2) immunohistochemistry was negative in five cases and scored 1 + in four. Alpha-1-antichymotrypsin (AACT) was positive in four cases, while lysozyme was positive in eight. Collagen IV was negative in all cases, whereas epithelial membrane antigen (EMA) was diffusely positive. S100 protein expression was detected in seven cases. Notably, all cases exhibited an mutant-type p53 expression pattern, and the Ki-67 proliferation index ranged from 5% to 80%.</p><p><strong>Conclusion: </strong>AcCC of the breast is a rare, triple-negative malignancy that typically presents as a BI-RADS 4 lesion in the upper outer quadrant. Its diagnosis is based on characteristic morphological features-primarily microglands and acinar patterns, along with less common cystic, follicular, clear cell, and solid architectures. This is supported by a distinctive immunohistochemical profile, which consistently includes mutant-type expression of p53 protein. A comprehensive understanding of the clinicopathological and immunophenotypic spectrum of AcCC is crucial for accurate diagnosis and differential diagnosis. Enhanced recognition of this entity, particularly its rare morphological variants, will help reduce diagnostic errors and guide more precise clinical management, ultimately improving prognostic assessment for affected patients.</p>","PeriodicalId":11237,"journal":{"name":"Diagnostic Pathology","volume":"21 1","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13595732/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149016125","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Refining prostate cancer diagnosis: correlative analysis of Gleason scores and immunohistochemical markers.","authors":"Hongfeng Ao, Qian Liu","doi":"10.1186/s13000-026-01803-w","DOIUrl":"https://doi.org/10.1186/s13000-026-01803-w","url":null,"abstract":"<p><strong>Background: </strong>Distinguishing prostate cancer (PCa) from benign prostatic tissue can be challenging in equivocal cases. Gleason grading remains the gold standard, with immunohistochemical (IHC) markers such as androgen receptor (AR), prostate-specific antigen (PSA), and α-methylacyl-CoA racemase (P504S/AMACR) serving as established adjuncts. This study aimed to confirm their diagnostic utility in a retrospective Chinese cohort of PCa and benign controls (primarily benign prostatic hyperplasia [BPH]).</p><p><strong>Methods: </strong>This retrospective analysis included 147 patients (88 PCa, 59 BPH) evaluated between 2020 and 2024 at two Chinese institutions. Gleason scores were extracted from pathology reports. IHC for AR, PSA, P504S (AMACR), and hematopoietic cell kinase (HCK) was performed routinely when clinically indicated. AR staining (when available) was assessed exclusively in tumor cell nuclei, with positivity defined qualitatively by any discernible nuclear staining (typically >1% of cells, including weak intensity). Due to the retrospective design and routine practice, no uniform cutoff or re-scoring was applied. AR and PSA results were available in most cases, whereas P504S was assessed in a subset (40/88 PCa; 19/59 benign), typically diagnostically ambiguous samples. Marker positivity was compared between PCa and benign tissue and correlated with Gleason score components and patient age.</p><p><strong>Results: </strong>AR and PSA positivity were significantly higher in PCa than benign tissue (AR: 25.0% vs. 8.5%, p=0.011; PSA: 40.9% vs. 20.3%, p=0.009), consistent with prior reports. The lower AR rate in PCa (25.0%) likely reflects routine clinical reporting variability and thresholds. In assessed subsets, P504S was positive in 100% (40/40) of PCa cases versus 26.3% (5/19) of benign cases (p<0.0001), aligning with its established sensitivity. AR positivity peaked in intermediate Gleason grades but declined in high-grade tumors, while PSA showed a modest increasing trend with grade. HCK was uniformly negative in all assessed cases, supporting its limited diagnostic relevance. No significant age association was observed with Gleason categories.</p><p><strong>Conclusion: </strong>This retrospective analysis corroborates the complementary roles of P504S (in assessed subsets), AR, and PSA as valuable IHC adjuncts to Gleason grading for evaluating prostate tissue, including differentiation from benign conditions such as BPH. HCK negativity further supports its deprioritization in diagnostic panels.</p>","PeriodicalId":11237,"journal":{"name":"Diagnostic Pathology","volume":"21 1","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13628726/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149105501","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Identification of factors associated with intraductal carcinoma of the prostate.","authors":"Motoki Yamagishi, Casey M Phan, Yoshihiro Nakagami, Akiko Tokunaga, So Murai, Toshiko Yamochi, Kazuhiko Oshinomi, Masakazu Nagata, Takashi Fukagai","doi":"10.1186/s13000-026-01804-9","DOIUrl":"10.1186/s13000-026-01804-9","url":null,"abstract":"<p><strong>Background: </strong>Prostate cancer is a common malignancy. Intraductal carcinoma of the prostate (IDCP) is associated with poor prognosis, but is underreported in certain geographic regions. The presence of IDCP is recently recognized as an independent prognosticatior of poor prognosis. We aim to identify factors associated with IDCP on radical prostatectomy specimens to aid in more accurate diagnosis of IDCP.</p><p><strong>Methods: </strong>A retrospective study was conducted on specimens from Showa Medical University Hospital (Japan) and Queen's Medical Center (Hawaii) from April 2020 to March 2024. Clinical data included age, PSA, and race; pathological data included GS, GG, and factors indicated the extent of cancer (EPE, RM, LVI, PNI, SVI). IDCP was diagnosed morphologically; equivocal lesions underwent basal cell IHC. Statistical analyses identified factors associated with IDCP.</p><p><strong>Results: </strong>Among 279 cases, IDCP was found in 70 (25.1%). The IDCP-positive group had higher PSA levels (14.2 vs. 10.7 ng/ml, p = 0.048). Univariate and Multivariate analyses identified GS (OR: 16.41, p < 0.001), EPE (OR: 2.36, p = 0.02), and PNI(OR: 2.57, p = 0.02) remained independently associated.</p><p><strong>Conclusion: </strong>High grade (GS ≥ 8), EPE, and PNI serve as practical pathological triggers to scrutinize ducts and apply basal-cell IHC, which may reduce under-recognition of IDCP in RP specimens.</p>","PeriodicalId":11237,"journal":{"name":"Diagnostic Pathology","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13659963/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148454814","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}