Human pathology最新文献

Subclassification of unilateral primary aldosteronism using an optimal cut-off value for positive CYP11B2 (aldosterone synthase) immunohistochemistry and modified histologic criteria in the Korean population. 在韩国人群中使用CYP11B2（醛固酮合成酶）免疫组织化学阳性的最佳临界值和修改的组织学标准对单侧原发性醛固酮增多症进行亚分类。

IF 2.7 2区医学

Human pathology Pub Date : 2025-07-19 DOI: 10.1016/j.humpath.2025.105876

Won Gi Hong, Byung-Chang Kim, Tae-Yon Sung, Seung Hun Lee, Dong Eun Song

{"title":"Subclassification of unilateral primary aldosteronism using an optimal cut-off value for positive CYP11B2 (aldosterone synthase) immunohistochemistry and modified histologic criteria in the Korean population.","authors":"Won Gi Hong, Byung-Chang Kim, Tae-Yon Sung, Seung Hun Lee, Dong Eun Song","doi":"10.1016/j.humpath.2025.105876","DOIUrl":"https://doi.org/10.1016/j.humpath.2025.105876","url":null,"abstract":"<p><p>The histopathology of primary aldosteronism (HISTALDO) consensus indicates the necessity of CYP11B2 (aldosterone synthase) immunostaining in diagnosing primary aldosteronism (PA). However, proper threshold for positive interpretation of CYP11B2 immunostaining is yet to be established. Therefore, we aimed to correlate the subclassification of PA and postsurgical outcomes to define an optimal cut-off value for CYP11B2 immunostaining in 83 unilateral PA patients. Initial 73 classical PA patients using a 1% cut-off value revealed a similar rate of absence of clinical success between classical PA (9.7%) and non-classical PA (11.1%, p > 0.999). The absence of biochemical success was lower in classical PA (4.4%) than non-classical PA (20.0%, p = 0.120). After establishing new 30% cut-off value for CYP11B2 immunostaining, 68 of 83 (81.9%) patients were re-classified as classical PA. Despite statistical insignificance, the absence of both clinical and biochemical success was lower in classical PA (8.8% and 4.7%, respectively) than non-classical PA (14.3%, p = 0.158; 14.3%, p = 0.218, respectively). Finally, a modified histologic subclassification was applied according to the presence of single aldosterone producing lesion using both 1% and 30% cut-off values. 69 (1% cut-off) and 64 (30% cut-off) cases were subclassified as modified classical PA. However, they were not superior to their non-classical counterparts in terms of both clinical and biochemical success using both cut-off values. In summary, the clinical and biochemical outcomes were not successfully predicted by either 1% or 30% cut-off values and modified histologic criteria. Further validation study on a larger patient cohort is needed.</p>","PeriodicalId":13062,"journal":{"name":"Human pathology","volume":" ","pages":"105876"},"PeriodicalIF":2.7,"publicationDate":"2025-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144682468","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

IF 2.7 2区医学

Human pathology Pub Date : 2025-07-18 DOI: 10.1016/j.humpath.2025.105873

Tiane Chen, Tatianna C Larman, Lysandra Voltaggio, Jacqueline E Birkness-Gartman

{"title":"IgG4-Related Disease of the Tubular Gastrointestinal Tract: A Rare Cause of Lymphoplasmacytosis, Eosinophilia, and Mass-Forming Lesions.","authors":"Tiane Chen, Tatianna C Larman, Lysandra Voltaggio, Jacqueline E Birkness-Gartman","doi":"10.1016/j.humpath.2025.105873","DOIUrl":"https://doi.org/10.1016/j.humpath.2025.105873","url":null,"abstract":"<p><p>IgG4-related disease (IgG4RD) is a systemic fibroinflammatory condition that can affect multiple organs, but rarely involves the tubular gastrointestinal (GI) tract. We identified patients with definitive or possible IgG4RD of the GI tract diagnosed at our institution. Our cohort included 8 patients with a median age of 37 years (range 15-73) and a slight male predominance (63%). Sites of disease included the esophagus (5 biopsies), terminal ileum (2 biopsies), and colon (1 biopsy with subsequent resection). Two patients presented with masses (1 colon, 1 terminal ileum) and 1 with an esophageal stricture. All cases featured a prominent plasma cell-rich infiltrate with scattered eosinophils and neutrophils; a subset had variably prominent histiocytes (3 cases) and lymphoid aggregates (4 cases). The colonic resection specimen demonstrated subserosal storiform fibrosis and obliterative phlebitis, features not detectable in the biopsies. All cases had >50 IgG4-positive cells per high-power field and an IgG4:IgG ratio >40% when evaluable (5 cases). One of two patients with terminal ileal involvement had serum IgG4 >135 mg/dL, and both patients responded to steroid treatment. Three patients with esophageal involvement had serum IgG4 <135 mg/dL. We conclude that IgG4RD is a rare cause of mass-forming lesions in the terminal ileum and colon, and a possible cause of esophageal inflammation and strictures. Diagnosing IgG4RD on biopsies is challenging, as the full histologic spectrum of features is not detectable in mucosa. Lymphoplasmacytic and eosinophilic infiltration, elevated IgG4-positive cell counts by immunohistochemistry, and correlation with serum IgG4 levels and response to steroids may aid in diagnosis.</p>","PeriodicalId":13062,"journal":{"name":"Human pathology","volume":" ","pages":"105873"},"PeriodicalIF":2.7,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144674568","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Biliary adenofibroma and cholangiocarcinoma: neighbors or relatives? A systematic and critical review. 胆道腺纤维瘤和胆管癌：邻居还是亲戚？系统性和批判性的回顾

IF 2.7 2区医学

Human pathology Pub Date : 2025-07-12 DOI: 10.1016/j.humpath.2025.105872

Paola Mattiolo, Yoh Zen, Xuchen Zhang, Aldo Scarpa, Claudio Luchini, Rondell P Graham

{"title":"Biliary adenofibroma and cholangiocarcinoma: neighbors or relatives? A systematic and critical review.","authors":"Paola Mattiolo, Yoh Zen, Xuchen Zhang, Aldo Scarpa, Claudio Luchini, Rondell P Graham","doi":"10.1016/j.humpath.2025.105872","DOIUrl":"https://doi.org/10.1016/j.humpath.2025.105872","url":null,"abstract":"<p><p>Biliary adenofibroma (BAF) is currently classified as a benign intrahepatic biliary tumor. However, a growing body of literature has documented BAFs with invasive components or associated cholangiocarcinoma. To better characterize this challenging entity, we performed a systematic review of BAF. PubMed, SCOPUS, and Embase were searched through April 2025 to identify all studies on BAFs. Clinicopathological, immunohistochemical (IHC), and molecular data have been extracted and analyzed. A total of 55 cases of BAF were identified in the literature. Macroscopically, BAFs usually showed mixed features, ranging from cysts intermingled with solid nodules to spongy, non-capsulated lesions. Histologically, the lining epithelium consisted of non-mucin-secreting biliary cells (55/55, 100%). BAFs with invasive components accounted for 52.7% of the literature (29/55). In two cases, innocent-looking tubulocystic structures were present but showed frankly invasive components. Although most patients were alive and disease-free after resection (34/43, 79.1%), two patients died of disease (2/43, 4.6%) and six experienced relapses (6/43, 14%). In 7 studies with a total of 13 cases, molecular investigations demonstrated gene alterations typically seen in small-duct cholangiocarcinoma, including mutations in ARID1A (2/13), BAP1, PBRM1, and TP53 (one per case), and FGFR2 fusion (1/13). Taken together, our findings reveal that BAF is frequently associated with invasive malignancy. The frequent presence of tubulocystic structures with invasive features warrants further investigation of this entity, particularly given the challenging spectrum of the lesions in the differential diagnoses, ranging from benign to malignant neoplasms.</p>","PeriodicalId":13062,"journal":{"name":"Human pathology","volume":" ","pages":"105872"},"PeriodicalIF":2.7,"publicationDate":"2025-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144636927","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Triple-negative lobular breast cancer: focus on pathology and clinical challenges. 三阴性小叶性乳腺癌：关注病理和临床挑战。

IF 2.7 2区医学

Human pathology Pub Date : 2025-07-08 DOI: 10.1016/j.humpath.2025.105871

Fulvio Borella, Niccolò Gallio, Mariausilia Giurdanella, Giulia Capella, Paola Cassoni, Isabella Castellano

{"title":"Triple-negative lobular breast cancer: focus on pathology and clinical challenges.","authors":"Fulvio Borella, Niccolò Gallio, Mariausilia Giurdanella, Giulia Capella, Paola Cassoni, Isabella Castellano","doi":"10.1016/j.humpath.2025.105871","DOIUrl":"10.1016/j.humpath.2025.105871","url":null,"abstract":"<p><p>Triple-negative invasive lobular carcinoma is a rare and under-characterized subtype of breast cancer, distinct from the more common triple-negative invasive ductal carcinoma. While triple-negative invasive ductal carcinoma is generally recognized for its aggressive clinical behavior and lack of targeted treatment options, triple-negative invasive lobular carcinoma presents unique histopathological and molecular features that may influence its prognosis and therapeutic responsiveness. Despite these differences, triple-negative invasive lobular carcinoma remains poorly studied, leading to a reliance on treatment strategies adapted from ductal histotype, which may not fully address its biological complexities. This review aims to provide a comprehensive overview of triple-negative invasive lobular carcinoma by analyzing its clinicopathological characteristics, prognostic factors, and emerging therapeutic approaches. We explore the genetic alterations commonly observed in triple-negative invasive lobular carcinoma, their potential implications for treatment selection, and the challenges in current management strategies. Furthermore, we discuss the need for specialized research efforts and clinical trials to define treatment paradigms better. As precision oncology continues to evolve, understanding the biological distinctions of triple-negative invasive lobular carcinoma will be essential for optimizing patient outcomes and developing more effective treatment strategies.</p>","PeriodicalId":13062,"journal":{"name":"Human pathology","volume":" ","pages":"105871"},"PeriodicalIF":2.7,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144608187","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Tumor infiltrating lymphocytes in breast cancer: A narrative review with focus on analytic validity, clinical validity, and clinical utility. 肿瘤浸润淋巴细胞在乳腺癌中的作用：分析效度、临床效度和临床应用综述。

IF 2.7 2区医学

Human pathology Pub Date : 2025-07-02 DOI: 10.1016/j.humpath.2025.105866

Brian S Finkelman, Huina Zhang, David G Hicks, David L Rimm, Bradley M Turner

{"title":"Tumor infiltrating lymphocytes in breast cancer: A narrative review with focus on analytic validity, clinical validity, and clinical utility.","authors":"Brian S Finkelman, Huina Zhang, David G Hicks, David L Rimm, Bradley M Turner","doi":"10.1016/j.humpath.2025.105866","DOIUrl":"10.1016/j.humpath.2025.105866","url":null,"abstract":"<p><p>Since Dr. Stephen Paget first proposed the \"seed and soil\" hypothesis in 1889, the tumor microenvironment has been recognized as a crucial component of tumor growth, progression, and metastasis. Tumor-infiltrating lymphocytes (TILs) are an important part of the tumor microenvironment, as well as an important prognostic and predictive biomarker for many cancers. This narrative review aims to summarize the current literature on the analytic validity, clinical validity, and clinical utility of TILs in breast cancer, including discussion of all major clinical subtypes. We summarize the current recommendations of the International Immuno-Oncology Biomarker Working Group on Breast Cancer for pathologist assessment and reporting of TILs, the state of the evidence justifying their usefulness as a biomarker in breast cancer, particularly for triple-negative and HER2+ breast cancer, as well as ongoing challenges and areas of future development, such as automated TIL scoring algorithms. Based on currently available evidence as well as ongoing clinical trials, we expect that TILs will increasingly become a cost-effective, easily available, and widely utilized biomarker in breast cancer, helping to guide treatment selection and optimization of therapy for many patients.</p>","PeriodicalId":13062,"journal":{"name":"Human pathology","volume":" ","pages":"105866"},"PeriodicalIF":2.7,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144560018","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Multi-modal convolutional neural network-based thyroid cytology classification and diagnosis 基于多模态卷积神经网络的甲状腺细胞学分类与诊断

IF 2.7 2区医学

Human pathology Pub Date : 2025-07-01 DOI: 10.1016/j.humpath.2025.105868

Dandan Yang , Tianlun Li , Lu Li , Shuai Chen , Xiangli Li

{"title":"Multi-modal convolutional neural network-based thyroid cytology classification and diagnosis","authors":"Dandan Yang , Tianlun Li , Lu Li , Shuai Chen , Xiangli Li","doi":"10.1016/j.humpath.2025.105868","DOIUrl":"10.1016/j.humpath.2025.105868","url":null,"abstract":"<div><h3>Background</h3><div>The cytologic diagnosis of thyroid nodules' benign and malignant nature based on cytological smears obtained through ultrasound-guided fine-needle aspiration is crucial for determining subsequent treatment plans. The development of artificial intelligence (AI) can assist pathologists in improving the efficiency and accuracy of cytological diagnoses. We propose a novel diagnostic model based on a network architecture that integrates cytologic images and digital ultrasound image features (CI-DUF) to solve the multi-class classification task of thyroid fine-needle aspiration cytology. We compare this model with a model relying solely on cytologic images (CI) and evaluate its performance and clinical application potential in thyroid cytology diagnosis.</div></div><div><h3>Methods</h3><div>A retrospective analysis was conducted on 384 patients with 825 thyroid cytologic images. These images were used as a dataset for training the models, which were divided into training and testing sets in an 8:2 ratio to assess the performance of both the CI and CI-DUF diagnostic models.</div></div><div><h3>Results</h3><div>The AUROC of the CI model for thyroid cytology diagnosis was 0.9119, while the AUROC of the CI-DUF diagnostic model was 0.9326. Compared with the CI model, the CI-DUF model showed significantly increased accuracy, sensitivity, and specificity in the cytologic classification of papillary carcinoma, follicular neoplasm, medullary carcinoma, and benign lesions.</div></div><div><h3>Conclusions</h3><div>The proposed CI-DUF diagnostic model, which intergrates multi-modal information, shows better diagnostic performance than the CI model that relies only on cytologic images, particularly excelling in thyroid cytology classification.</div></div>","PeriodicalId":13062,"journal":{"name":"Human pathology","volume":"161 ","pages":"Article 105868"},"PeriodicalIF":2.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144557226","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Somatic yolk sac tumors in the urinary tract: A form of rare divergent differentiation 泌尿道卵黄囊体细胞肿瘤：一种罕见的分化形式。

IF 2.7 2区医学

Human pathology Pub Date : 2025-07-01 DOI: 10.1016/j.humpath.2025.105859

Nicholas Tedrow , Kenneth Ogan , Shreyas Joshi , Mehmet Asim Bilen , Jacqueline Brown , Bradley Carthon , Faisal Saeed , Jatin Gandhi , Elizabeth Genega , Lara Harik

{"title":"Somatic yolk sac tumors in the urinary tract: A form of rare divergent differentiation","authors":"Nicholas Tedrow , Kenneth Ogan , Shreyas Joshi , Mehmet Asim Bilen , Jacqueline Brown , Bradley Carthon , Faisal Saeed , Jatin Gandhi , Elizabeth Genega , Lara Harik","doi":"10.1016/j.humpath.2025.105859","DOIUrl":"10.1016/j.humpath.2025.105859","url":null,"abstract":"<div><h3>Context</h3><div>Yolk sac tumor (YST) is a germ cell tumor, arising commonly from the gonads and rarely from other midline sites. Somatic Yolk sac tumors, arising from somatic malignancy, have been rarely reported in the gastrointestinal tract, gynecologic tract, and recently, in the urinary tract.</div></div><div><h3>Objective</h3><div>We share our institutional experience of somatic YST arising from the urothelium.</div></div><div><h3>Design</h3><div>Electronic medical records (EMR) were searched for cases of somatic YST differentiation in the urinary tract. Clinico-pathologic parameters were collected and reviewed, including clinical presentation, histologic and immunohistochemical findings, follow-up status, and duration.</div></div><div><h3>Results</h3><div>EMR search identified 4 cases of somatic yolk sac tumor arising from the urothelial tract. In 3 of 4 patients, the YST component was admixed with urothelial carcinoma. Histologic features of somatic YST included glandular differentiation with clearing of the cytoplasm. Papillary/pseudopapillary and solid components were also present. An immunohistochemical panel including AFP, Glypican 3 and SALL4 is helpful in confirming this rare form of divergent differentiation. Two cases presented de novo, one of them showed a pedunculated urethral mass composed of pure somatic YST; i12p on this case was negative.</div></div><div><h3>Conclusions</h3><div>Somatic YST differentiation in the urinary tract is a rare occurrence with potential for treatment implications. Familiarity with the histologic features is key to diagnosing this rare form of divergent differentiation. Molecular events leading to the development of somatic YST and optimal therapy remain unclear.</div></div>","PeriodicalId":13062,"journal":{"name":"Human pathology","volume":"161 ","pages":"Article 105859"},"PeriodicalIF":2.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144511752","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Secondary pancreatic tumors in endoscopic ultrasound-guided fine-needle biopsy: Clinicopathologic characteristics and morphological diagnostic challenges 内镜超声引导下细针活检继发性胰腺肿瘤：临床病理特征和形态学诊断挑战。

IF 2.7 2区医学

Human pathology Pub Date : 2025-07-01 DOI: 10.1016/j.humpath.2025.105869

Min Cui , Mohamed Amed , Michelle D. Reid , Yue Xue

{"title":"Secondary pancreatic tumors in endoscopic ultrasound-guided fine-needle biopsy: Clinicopathologic characteristics and morphological diagnostic challenges","authors":"Min Cui , Mohamed Amed , Michelle D. Reid , Yue Xue","doi":"10.1016/j.humpath.2025.105869","DOIUrl":"10.1016/j.humpath.2025.105869","url":null,"abstract":"<div><div>Pancreatic metastases are rare and often difficult to diagnose, especially in limited tissue samples. However, accurate diagnosis is crucial for guiding appropriate clinical management. This study evaluates the clinical, radiologic, and pathologic features of pancreatic metastases, with a focus on morphological patterns that mimic common primary pancreatic tumors in endoscopic ultrasound-guided fine-needle biopsy (EUS-FNB) specimens. Among 1054 pancreatic neoplasms diagnosed over a nine-year period, 62 cases (5.9 %) were identified as metastases. The interval from initial diagnosis to pancreatic involvement ranged from synchronous presentation to 24 years. Most metastatic lesions (74 %, n = 46/62) presented as solitary masses, and 58 % (n = 26/45) were initially misinterpreted as primary pancreatic tumors on imaging. Histologically, 73 % (n = 45/62) were epithelial neoplasms, most commonly of renal origin (11 cases, 17.8 %), followed by lung (9, 14.5 %), cutaneous (6, 9.7 %), and Müllerian-derived tumors (6, 9.7 %). Among non-epithelial neoplasms, hematopoietic malignancies were most common (9, 14.5 %), followed by mesenchymal tumors (5, 8.1 %) and melanoma (3, 4.8 %). Several metastatic tumor types—including renal cell carcinoma, lung adenocarcinoma, breast carcinoma, gastrointestinal adenocarcinoma, Merkel cell carcinoma, and adult granulosa cell tumor—closely mimicked the histology of primary pancreatic neoplasms such as pancreatic ductal adenocarcinoma, neuroendocrine neoplasm, and solid-pseudopapillary neoplasms. Accurate diagnosis requires correlation with clinical history and a comprehensive ancillary workup, including immunohistochemistry. In summary, pancreatic metastases present a significant diagnostic challenge due to their overlap with primary tumors across clinical, radiologic, and histologic dimensions. A multidisciplinary diagnostic approach is essential to ensure accurate classification and optimal patient care.</div></div>","PeriodicalId":13062,"journal":{"name":"Human pathology","volume":"161 ","pages":"Article 105869"},"PeriodicalIF":2.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144567380","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Clinicopathologic characteristics of papillary thyroid carcinoma, tall cell subtype and subtype with tall cell features, an institutional experience 甲状腺乳头状癌的临床病理特点，高细胞亚型和具有高细胞特征的亚型，有机构经验。

IF 2.7 2区医学

Human pathology Pub Date : 2025-07-01 DOI: 10.1016/j.humpath.2025.105867

Xueting Jin, Shunsuke Koga, Xiao Zhou, Niaz Z. Khan, Zubair W. Baloch

{"title":"Clinicopathologic characteristics of papillary thyroid carcinoma, tall cell subtype and subtype with tall cell features, an institutional experience","authors":"Xueting Jin, Shunsuke Koga, Xiao Zhou, Niaz Z. Khan, Zubair W. Baloch","doi":"10.1016/j.humpath.2025.105867","DOIUrl":"10.1016/j.humpath.2025.105867","url":null,"abstract":"<div><div>Papillary thyroid carcinoma (PTC) is categorized into various subtypes, including classic PTC (cPTC) with 0 % tall cell morphology, PTC with tall cell features (PTCtcf) with >0 but <30 % tall cells, and tall cell subtype of PTC (tcsPTC) having ≥30 % tall cells. This case-cohort study investigated the clinicopathologic characteristics of cPTC, PTCtcf, and tcsPTC. Patients with.</div><div>tcsPTC subtype were older (mean 50.2 years) than patients with cPTC (42.0 years) and PTCtcf (45.6 years). tcsPTC subtype presented with more advanced tumor stages than cPTC, indicating more aggressive tumor behavior. The frequency of extra-thyroidal extension in tcsPTC (60.1 %) and PTCtcf (39.7 %) was higher than in cPTC (23.6 %). Angioinvasion was more frequent in tcsPTC (15.1 %) than cPTC (7.6 %). Positive margins were more common in PTCtcf (12.4 %) and tcsPTC (23.9 %) than cPTC (4.9 %). tcsPTC and PTCtcf had more tumor foci than cPTC. Recurrent or persistent disease occurred more frequently in PTCtcf (13.2 %) and tcsPTC (6.7 %) compared with cPTC (1.5 %). Kaplan-Meier survival analysis demonstrated that all tcsPTC tumors and those tcsPTC tumors ≤1 cm had worse overall and disease-unrelated survival outcomes compared with cPTC, which was mostly due to second non-thyroid tumors. There were no differences in disease-related survival among the 3 PTC subgroups possibly due to efficacy of radioactive iodine therapy more frequently used for treating PTCtcf and tcsPTC compared with cPTC. In conclusion, the findings highlight the aggressive nature of tcsPTC and PTCtcf and emphasize the value of histologic subtyping in guiding management of thyroid carcinoma.</div></div>","PeriodicalId":13062,"journal":{"name":"Human pathology","volume":"161 ","pages":"Article 105867"},"PeriodicalIF":2.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144564676","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

BSND: An emerging immunohistochemical marker that reliably distinguishes benign from malignant oncocytic salivary gland tumors BSND：一种新兴的免疫组织化学标记物，可可靠地区分良性和恶性嗜癌性唾液腺肿瘤

IF 2.7 2区医学

Human pathology Pub Date : 2025-07-01 DOI: 10.1016/j.humpath.2025.105870

Arshi Tandon , Sabari Sinehaa , Sheeba Saifi , Amit Kumar Adhya , Kavneet Kaur , Aanchal Kakkar

{"title":"BSND: An emerging immunohistochemical marker that reliably distinguishes benign from malignant oncocytic salivary gland tumors","authors":"Arshi Tandon , Sabari Sinehaa , Sheeba Saifi , Amit Kumar Adhya , Kavneet Kaur , Aanchal Kakkar","doi":"10.1016/j.humpath.2025.105870","DOIUrl":"10.1016/j.humpath.2025.105870","url":null,"abstract":"<div><div>Oncocytic cells appear in various salivary gland lesions (SGLs) like oncocytic hyperplasia, metaplasia and several neoplasms. It is particularly challenging to distinguish oncocytoma and Warthin tumor from oncocytic and Warthin-like mucoepidermoid carcinoma (MEC) in the absence of molecular testing. A spectrum of oncocytic SGLs underwent immunohistochemistry for BSND, a novel marker of striated ducts and oncocytic tumor cells. <em>MAML2</em> fluorescence in situ hybridization (FISH) was performed in suspected MECs.</div><div>BSND immunoexpression was assessed in 138 SGLs, including 132 in-house and 4 consult cases. In-house cases comprised 5 non-neoplastic, 43 benign and 84 malignant SGLs. All nodular oncocytic hyperplasia (100 %) were BSND positive, while intercalated duct hyperplasia was negative. Among benign tumors, oncocytic cystadenomas (3/3), Warthin tumor (15/15), and oncocytoma (1/1) were BSND-positive (100 %). One clear cell oncocytoma reclassified as clear cell MEC on resection was BSND-negative. All remaining benign tumors were negative. Among all malignant tumors, one Warthin-like MEC was reclassified as infarcted metaplastic Warthin tumor on morphology and as it lacked <em>MAML2</em> rearrangement; it was BSND positive. All remaining 83 malignant neoplasms were BSND-negative (100 %). All consult cases submitted as oncocytoma and oncocytic carcinoma were reclassified on ancillary testing, with BSND reliably distinguishing benign from malignant SGLs. In 21 cases with <em>MAML2</em> FISH, <em>MAML2</em> rearrangement was mutually exclusive with BSND immunopositivity.</div><div>BSND is thus newly validated as an immunomarker to resolve diagnostic uncertainty in oncocytic SGLs. Use of BSND in routine practice could streamline the diagnostic process and improve patient management by reducing reliance on ambiguous morphological features, particularly in settings lacking molecular testing.</div></div>","PeriodicalId":13062,"journal":{"name":"Human pathology","volume":"161 ","pages":"Article 105870"},"PeriodicalIF":2.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144572022","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0