Human pathology最新文献

{"title":"Routine prostate biopsy reports carry grade-specific tumor burden information beyond the highest Grade Group.","authors":"Yoichiro Okubo, Shu Yuguchi, Rika Kasajima, Shinya Sato, Noboru Nakaigawa, Yukihiko Hiroshima, Kota Washimi, Shuka Wada, Yuki Kobayashi, Tatsuma Juichi, Atsuto Suzuki, Kimitsugu Usui, Yohei Miyagi","doi":"10.1016/j.humpath.2026.106285","DOIUrl":"https://doi.org/10.1016/j.humpath.2026.106285","url":null,"abstract":"<p><p>Routine prostate biopsy reports contain quantitative information that is lost when a case is reduced to the single highest Grade Group (GG). We examined whether GG-specific tumor burden in routine biopsy reports provides information on radical prostatectomy (RP) pathology beyond the highest biopsy GG. This retrospective single-institution study included 508 analyzable paired biopsy-RP cases from 2014 to 2026. For GG3, GG4, and GG5, burden was reconstructed as the number of positive reporting units and summed cancer length. Firth penalized logistic regression adjusted for highest biopsy GG and non-target GG3-GG5 burden. The focused endpoints were RP GG4-5 for GG4 burden, pT3 or higher disease for GG3 burden, and RP GG5 for GG5 burden. For count models, odds ratios (ORs) were expressed per additional target reporting unit. GG4 count was associated with RP GG4-5 (OR, 1.72; 95% confidence interval [CI], 1.29-2.29), GG3 count with pT3 or higher disease (OR, 1.72; 95% CI, 1.41-2.10; n=473), and GG5 count with RP GG5 (OR, 3.46; 95% CI, 1.40-8.59). Corresponding cancer-length measures showed concordant associations, and the strict 318-case quality-control sensitivity subset yielded similar estimates. Adding target GG burden to models already containing highest biopsy GG and non-target GG burden yielded optimism-corrected area-under-the-curve gains of 0.029 for GG4 count, 0.042 for GG3 count, and 0.010 for GG5 count. Grade-specific burden already present in routine biopsy reports therefore provides complementary information on subsequent RP grade and local stage beyond the highest biopsy GG alone.</p>","PeriodicalId":13062,"journal":{"name":"Human pathology","volume":" ","pages":"106285"},"PeriodicalIF":3.0,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149193271","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}

{"title":"Aberrant HER2 Expression as a Specific and Feasible Diagnostic Marker for Fumarate Hydratase-Deficient Renal Cell Carcinoma.","authors":"Jue Hu, Mengxin Zhang, Liyang Meng, Linmao Zheng, Ying Yang, Jiaxiang Tang, Xiuyi Pan, Xiaoxue Yin, Ting Yu, Ling Nie, Yuyan Wei, Qiao Zhou, Xueqin Chen, Ni Chen","doi":"10.1016/j.humpath.2026.106281","DOIUrl":"https://doi.org/10.1016/j.humpath.2026.106281","url":null,"abstract":"<p><p>The presence of human epidermal receptor 2 (HER2) in fumarate hydratase-deficient renal cell carcinoma (FH-deficient RCC) remains unexplored. We investigated immunohistochemical staining for HER2 (clone 4B5), FH, 2SC, and AKR1B10 on 72 cases of FH-deficient RCC and 440 cases of other RCC subtypes. HER2 positivity was observed in 88.9% (64/72) of FH-deficient RCCs, manifesting as cytoplasmic only (6.9%), cytoplasmic and nuclear (47.2%), cytoplasmic and membranous (2.8%), or cytoplasmic, nuclear, and membranous (31.9%) patterns. Notably, all four cases of low-grade FH-deficient RCC exhibited cytoplasmic, nuclear, and membranous positivity. HER2 fluorescence in situ hybridization test showed no amplification in any of the 30 HER2-positive FH-deficient RCCs. Next, 27 FH-deficient RCCs stained with two additional N-terminal HER2 antibodies (A21248 and HA721178) revealed cytoplasmic and membranous positivity similar to those with 4B5 but lacked nuclear expression, and western blot confirmed recognition of the 185 kDa HER2 protein by all three antibodies. In contrast, HER2 (4B5) staining was absent in clear cell RCCs, chromophobe RCCs, typical papillary RCCs, papillary renal neoplasms with reverse polarity, and SMARCB1-deficient renal medullary carcinomas, whereas positivity was observed in 2.4% (2/83) of TFE3-translocation and 22.2% (2/9) of oncocytic papillary RCCs. HER2 achieved 88.9% sensitivity (superior to FH; inferior to 2SC and AKR1B10) and 99.1% specificity (superior to 2SC and AKR1B10; inferior to FH), with the HER2/FH combination yielding optimal diagnostic efficacy. In conclusion, FH-deficient RCCs are characterized by prevalent cytoplasmic HER2 staining with variable nuclear/membranous reactivity, and the combined HER2/FH panel may serve as an effective screening strategy.</p>","PeriodicalId":13062,"journal":{"name":"Human pathology","volume":" ","pages":"106281"},"PeriodicalIF":3.0,"publicationDate":"2026-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149181638","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}

{"title":"Myeloid neoplasms with unusual patterns of disease evolution and progression other than acute leukemia: a European Bone Marrow Working Group workshop report.","authors":"Alexandar Tzankov, Leonie Saft, Karl Sotlar, Gorana Gasljevic, Falko Fend, Sa A Wang","doi":"10.1016/j.humpath.2026.106284","DOIUrl":"https://doi.org/10.1016/j.humpath.2026.106284","url":null,"abstract":"<p><p>Myeloid neoplasms (MN) undergo dynamic clinical, morphologic, and molecular evolution over time. Although transformation to acute myeloid leukemia (AML) is the most widely recognized form of progression, MN may evolve through diverse, less well-recognized patterns. The European Bone Marrow Working Group dedicated a workshop at the XVII International Bone Marrow Course and Workshop in Salzburg, Austria, in 2025 to unusual patterns of MN evolution and progression other than acute leukemia. The submitted cases illustrate the remarkable phenotypic and genetic plasticity of MN. Recurrent patterns included acquisition of myelodysplastic features in myeloproliferative neoplasms (MPN); emergence or worsening of proliferative features, including monocytosis and neutrophilia, in MPN, myelodysplastic syndromes (MDS), and MDS/MPN; progressive myelofibrosis; extramedullary myeloid tumors; and histiocytic or dendritic cell outgrowths. These changes were frequently accompanied by clonal evolution and acquisition or expansion of additional genetic abnormalities. Importantly and as exemplified by a few workshop cases, apparent clinical progression may occasionally represent an independent second neoplasm or a reactive process rather than true progression of the original disease. These observations emphasize that follow-up evaluation of MN should extend beyond blast enumeration and incorporate clinical findings, morphology, immunophenotype, molecular genetics, and extramedullary manifestations. Changes in phenotype, morphology, immunophenotype, or genetic profile should generally be regarded as manifestations of disease evolution rather than, by themselves, criteria for reclassification into another MN subtype. The original disease entity should therefore be retained, while subsequent disease evolution, progression, transformation, lineage outgrowth, and extramedullary manifestations should be documented as part of an integrated diagnostic assessment.</p>","PeriodicalId":13062,"journal":{"name":"Human pathology","volume":" ","pages":"106284"},"PeriodicalIF":3.0,"publicationDate":"2026-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149181689","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}

{"title":"Comprehensive Genomic Characterization of Primary Dermal Melanoma: Delineating it from Metastatic Melanoma with Unknown Primary.","authors":"Joyce M Chen, Jason C Chang, Achim A Jungbluth, Konstantinos Linos, Alexander N Shoushtari, Michael A Postow, Klaus J Busam","doi":"10.1016/j.humpath.2026.106273","DOIUrl":"https://doi.org/10.1016/j.humpath.2026.106273","url":null,"abstract":"<p><p>Primary dermal melanoma (PDM) is a rare type of melanoma that originates in the dermis or subcutis without epidermal involvement. PDM poses significant diagnostic challenges for accurate staging, because it may be confused with cutaneous metastatic melanoma (CMM). To assess potential misclassification of PDM, we retrospectively reviewed referred cases of metastatic melanoma with unknown primary (MUP) that underwent concurrent molecular profiling using the MSK-IMPACT platform. Nineteen cases meeting criteria for PDM were identified and exhibited a lower overall burden of genomic alterations, and a superior overall survival compared with CMM, supporting their reclassification as primary neoplasms rather than metastatic lesions. In PDM, the most frequently altered genes were TERT (79%), TP53 (37%), NRAS (37%), and APC (32%). Exclusive mutations identified in PDM included ZFHX3, FGFR3, NTRK3, and SMARCA4. Compared with CMM, PDM demonstrated a distinct mutational profile, characterized by a higher frequency of NRAS and TP53 mutations, and a lower prevalence of BRAF alterations. Clinically, PDM exhibited a more favorable overall survival (follow-up: 8.9 years) relative to conventional primary melanoma, further supporting the distinction from metastatic disease. Patients harboring isolated NRAS or concurrent NRAS/TP53 mutations exhibited superior survival compared with their respective NRAS wild-type or NRAS/TP53 wild-type counterparts. Taken together, these findings highlight the genomic and clinical distinctiveness of PDM relative to CMM, refine its molecular characterization, and support its recognition as a separate entity with implications for accurate staging and therapeutic decision-making.</p>","PeriodicalId":13062,"journal":{"name":"Human pathology","volume":" ","pages":"106273"},"PeriodicalIF":3.0,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149136492","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}

{"title":"Intratumoral granulomas in hepatocellular carcinoma: Clinicopathologic associations, prognostic significance, and diagnostic pitfalls.","authors":"Jingjing Jiao, Xuchen Zhang","doi":"10.1016/j.humpath.2026.106275","DOIUrl":"10.1016/j.humpath.2026.106275","url":null,"abstract":"<p><p>Intratumoral granulomas (ITGs) are rarely described in hepatocellular carcinoma (HCC) and may obscure malignancy in limited biopsy specimens. We retrospectively reviewed 614 HCCs diagnosed from 2010 to 2023 to identify tumors with ITG and compared clinicopathologic features and overall survival with HCCs lacking ITG. ITG was identified in 32/614 cases (5.2%). All granulomas were non-necrotizing; 3/32 cases also had granulomas in background liver. No patient had sarcoidosis, primary biliary cholangitis, or documented infection. Patients with ITG were predominantly male (23/32, 71.9%), with a mean age of 67.5 years. Metabolic dysfunction-associated steatotic liver disease (MASLD) was the most common underlying liver disease (13/32, 40.6%). Compared with HCCs without ITG, HCCs with ITG were significantly associated with MASLD (13/32, 40.6% vs 98/582, 16.8%; P = 0.0072), steatohepatitic subtype (22/32, 68.8% vs 119/576, 20.7%; P < 0.0001), intratumoral lymphocytic inflammation (26/28, 92.9% vs 366/572, 64.0%; P = 0.0001), and at least moderate peritumoral inflammation (11/18, 61.1% vs 60/255, 23.5%; P = 0.003). Granuloma-associated inflammation was T-cell predominant and enriched for CD4-positive T cells. On univariable analysis, patients with ITG had improved overall survival (P = 0.004); however, the association was attenuated and did not reach statistical significance after adjustment for age, tumor size, stage, and MASLD etiology (HR 0.52, 95% CI 0.20-1.11; P = 0.098). Among stage II tumors, patients with ITG had borderline improved survival (P = 0.05). Prominent ITG may mask HCC in biopsy specimens. These findings support ITG as an uncommon but recognizable HCC-associated tumor microenvironment enriched in MASLD-related and steatohepatitic HCC.</p>","PeriodicalId":13062,"journal":{"name":"Human pathology","volume":" ","pages":"106275"},"PeriodicalIF":3.0,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149127275","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}

{"title":"Myeloid sarcoma: Clinical, pathologic, and molecular findings.","authors":"Ann-Kathrin Eisfeld, L Jeffrey Medeiros","doi":"10.1016/j.humpath.2026.106218","DOIUrl":"10.1016/j.humpath.2026.106218","url":null,"abstract":"<p><p>Myeloid sarcoma is defined as a neoplasm of myeloid blasts that involves an extramedullary site as a mass and effaces tissue architecture. Myeloid sarcoma is considered clinically to be equivalent to acute myeloid leukemia (AML) and requires appropriate therapy. As currently defined, extramedullary AML that does not form a mass is inconsistent with the diagnosis of myeloid sarcoma and the management of patients with extramedullary AML is less well defined. Furthermore, the pathogenetic relationship and clinical importance of extramedullary AML versus myeloid sarcoma is under explored. Recent studies have shown the importance of the MAPK/ERK pathway in pathogenesis of myeloid sarcoma and extramedullary AML. These studies also have shown that extramedullary sites of myeloid disease often evolve independently from medullary AML, likely related to microenvironmental clonal selection pressures and immune evasion mechanisms at extramedullary sites that differ from bone marrow disease. Here we review the clinicopathologic, immunophenotypic and molecular findings of myeloid sarcoma as currently defined. We also discuss the differential diagnosis of myeloid sarcoma and its relationship to non-mass forming extramedullary AML.</p>","PeriodicalId":13062,"journal":{"name":"Human pathology","volume":" ","pages":"106218"},"PeriodicalIF":3.0,"publicationDate":"2026-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148697476","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}

{"title":"Elastica-van Gieson-based periarterial/perivenous invasion and periductal invasion as differential predictors of lymph node metastasis after neoadjuvant chemotherapy in invasive breast carcinoma of no special type.","authors":"Chikara Mashiba, Akihiro Shioya, Takeru Oyama, Jia Han, Motona Kumagai, Miyako Shimasaki, Takanobu Takata, Yusuke Haba, Emi Morioka, Masafumi Inokuchi, Sohsuke Yamada","doi":"10.1016/j.humpath.2026.106277","DOIUrl":"https://doi.org/10.1016/j.humpath.2026.106277","url":null,"abstract":"<p><strong>Background/objectives: </strong>Periarterial/perivenous invasion (periA/V) on Elastica-van Gieson (EVG) staining is a highly sensitive histological marker of lymph node metastasis (LNM) in invasive breast carcinoma of no special type (IBC-NST) without neoadjuvant chemotherapy (NAC), but its value after NAC remains unclear. We evaluated periA/V and periductal invasion (periD) as LNM predictors according to histological therapeutic effect.</p><p><strong>Methods: </strong>We retrospectively analyzed 108 patients with residual IBC-NST after NAC, stratified into good-response (n = 44) and poor-response (n = 64) groups. LNM was defined as N0(i+), N1mi, or N1-3. Associations were assessed by Fisher's exact test and conventional or Firth logistic regression. Multivariate models included pathological T category and, in the overall cohort, histological therapeutic effect.</p><p><strong>Results: </strong>LNM was present in 56 (51.9%) patients. In the overall cohort, periD (odds ratio [OR], 3.65; 95% confidence interval [CI], 1.26-10.60) and ypT2-4 (OR, 2.97; 95% CI, 1.02-8.64) were independently associated with LNM, whereas periA/V and histological therapeutic effect were not. In good responders, periD showed a borderline multivariate association (OR, 5.75; 95% CI, 0.955-60.675; p = 0.056), with high specificity (96.3%) and positive predictive value (83.3%). In poor responders, periA/V remained independently associated with LNM (OR, 6.67; 95% CI, 1.14-69.97; p = 0.034), with high sensitivity (97.4%) and negative predictive value (90.0%).</p><p><strong>Conclusions: </strong>Associations of EVG-based parameters with LNM differed by histological therapeutic effect: periD showed a borderline association in good responders, whereas periA/V remained independently associated in poor responders, suggesting complementary roles in post-NAC risk stratification.</p>","PeriodicalId":13062,"journal":{"name":"Human pathology","volume":" ","pages":"106277"},"PeriodicalIF":3.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149108796","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}

{"title":"Spatial and interlesional heterogeneity of FGFR2b expression in paired primary and metastatic gastric and gastroesophageal junction adenocarcinomas.","authors":"Qingxia Zhang, Lili Liu, Yangnan Shi, Yajie Hu, Xinya Zhao, Lisha Yin, Ran Wang, Binyan Wu, Ziyu Li, Yu Sun","doi":"10.1016/j.humpath.2026.106278","DOIUrl":"10.1016/j.humpath.2026.106278","url":null,"abstract":"<p><strong>Background: </strong>FGFR2b is an emerging therapeutic target in gastric and gastroesophageal junction adenocarcinoma (G/GEJ), although expression heterogeneity may compromise biomarker assessment and patient selection.</p><p><strong>Methods: </strong>This retrospective study evaluated FGFR2b heterogeneity in 169 patients with paired primary and metastatic G/GEJ specimens, comprising 369 samples. Immunohistochemistry was performed for FGFR2b, HER2, PD-L1, CLDN18.2, and MMR proteins, and FGFR2 gene amplification was assessed by fluorescence in situ hybridization (FISH).</p><p><strong>Results: </strong>Using the any 2+/3+ cutoff, FGFR2b positivity was observed in 24 primary tumors (14.2%) and 16 metastatic lesions (9.5%). Using the ≥10% 2+/3+ cutoff, 12 primary tumors (7.1%) and 12 metastatic lesions (7.1%) were FGFR2b-positive. FGFR2b status was not significantly associated with major clinicopathologic variables. Spatial analysis showed significantly fewer FGFR2b-positive tumor cells in superficial than in deeper regions. Marked discordance was observed between primary and metastatic lesions, mainly due to positive-to-negative conversion: 58.3% of primary tumors with FGFR2b any 2+/3+ expression became 0/1+ in metastatic lesions, and 25.0% of primary tumors with FGFR2b ≥ 10% 2+/3+ expression became <10% 2+/3+. FGFR2b status was not significantly associated with HER2, CLDN18.2, MMR, or PD-L1 status. Notably, 33.3% of FGFR2b any 2+/3+ tumors lacked all other currently targetable biomarkers. FGFR2b immunohistochemistry showed moderate agreement with FGFR2 FISH, and all tumors with homogeneous FGFR2b expression harbored FGFR2 amplification.</p><p><strong>Conclusion: </strong>These findings highlight the importance of considering expression heterogeneity in FGFR2b-targeted trial design and patient selection. Despite its low prevalence, FGFR2b may represent an independent therapeutic target for a distinct subset of patients.</p>","PeriodicalId":13062,"journal":{"name":"Human pathology","volume":" ","pages":"106278"},"PeriodicalIF":3.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149108793","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}

{"title":"Expanding the clinicopathological spectrum of BAP1 mutated ccRCC: a study of 84 cases in multi-center cohort.","authors":"Neng-Qiao Wen, Xing-Si Peng, Chan Huang, Feng Chen, Ding-Kang Wang, Dan-Dan Zheng, Yun Cao","doi":"10.1016/j.humpath.2026.106276","DOIUrl":"https://doi.org/10.1016/j.humpath.2026.106276","url":null,"abstract":"<p><strong>Aims: </strong>Somatic BAP1 mutations drive a distinct and aggressive subtype of clear cell renal cell carcinoma (ccRCC), but its full histomorphological spectrum remains unclear due to small sample sizes in previous studies. This study aimed to comprehensively characterize BAP1-mutated ccRCC, define its morphological subtypes in a multi-center cohort.</p><p><strong>Methods and results: </strong>A retrospective multi-center study was performed including 84 BAP1-mutated ccRCC cases from three cohorts, 16 from Sun Yat-sen University Cancer Center (SYSUCC), 38 from TCGA-KIRC, and 30 from CPTAC-ccRCC. Truncating mutations were the predominant BAP1 mutation type across all cohorts, accounting for 68.8% in SYSUCC, 60.5% in TCGA-KIRC, and 60.0% in CPTAC-ccRCC. Six distinct morphological subtypes were identified (Classic ccRCC, Macroacinar, Papillary, Sarcomatoid/Rhabdoid, Trabecular, and Mixed), with Macroacinar and Mixed subtypes being the most prevalent. 50% of Mixed subtype cases were a combination of Papillary and Macroacinar subtypes. All SYSUCC cases showed complete nuclear BAP1 loss in tumor cells by IHC, accompanied by predominantly diffuse-strong AMACR (P504S) immunostaining. Over 65% of cases in each cohort had high nuclear grade (G3/G4), with progression rates of 37.5% in the SYSUCC cohort, 39.5% in the TCGA-KIRC cohort, and 23.8% in the CPTAC-ccRCC cohort, respectively. For the entire cohort, the median overall survival (OS) was 73.8 months and median disease-free survival (DFS) was 63.8 months.</p><p><strong>Conclusions: </strong>This study clarifies the clinicopathological and morphological features of BAP1-mutated ccRCC and defines six distinct morphological subtypes. These findings expand the clinicopathological spectrum of this aggressive ccRCC subset, provide a standardized morphological classification for clinical diagnosis.</p>","PeriodicalId":13062,"journal":{"name":"Human pathology","volume":" ","pages":"106276"},"PeriodicalIF":3.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149108742","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}

{"title":"Papillary endothelial hyperplasia in late post-radiation or late post-operative breast hematomas mimicking angiosarcoma.","authors":"Andrew Y Xiao, Anicia Mirchandani, Gregory R Bean, Cansu Karakas, Kimbery H Allison, Megan L Troxell","doi":"10.1016/j.humpath.2026.106280","DOIUrl":"https://doi.org/10.1016/j.humpath.2026.106280","url":null,"abstract":"<p><p>Women treated for breast cancer with lumpectomy and radiation therapy are at risk for disease recurrence, as well as radiation-associated (secondary) angiosarcoma. Hematomas are rarely responsible for new masses in this setting. We examined a series of breast hematomas with papillary endothelial hyperplasia (PEH), some of which raised concern for angiosarcoma, to identify features that aid in distinguishing these benign lesions from angiosarcoma in diagnostically challenging cases. Hematomas diagnosed in twenty-eight breast biopsy and/or resection specimens from nineteen women within our institutional archive were studied (2013-2026). Clinical, imaging, and pathology data were correlated. Immunohistochemical evaluation included PRAME, MYC, p53 and ERG IHC, along with Martius-Scarlet-Blue (MSB) histochemical staining. The mean age at hematoma presentation was 72.4 years, with patients presenting long after surgery (mean: 18.5 years) and radiotherapy (mean: 17.5 years). Several patients were on medications interfering with coagulation (13). Most masses were categorized as BI-RADS 4 and underwent multiple diagnostic procedures. In hematomas, reactive endothelium dissected organizing fibrin rather than collagen, highlighted by MSB or trichrome stains. PRAME was negative while MYC and p53 demonstrated wild type expression in all tested lesions. With the breast cancer survivor population increasing in number, age, and use of anti-coagulation, late breast hematomas are increasingly encountered by breast pathologists and radiologists. Careful evaluation to distinguish organizing hematoma with PEH from angiosarcoma is necessary.</p>","PeriodicalId":13062,"journal":{"name":"Human pathology","volume":" ","pages":"106280"},"PeriodicalIF":3.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149108754","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}