Human pathologyPub Date : 2025-05-01DOI: 10.1016/j.humpath.2025.105799
Huili Li , Andres Matoso
{"title":"Unlocking diagnostic potential: A retrospective analysis of GPNMB immunohistochemistry in nearly 1000 surgical pathology specimens","authors":"Huili Li , Andres Matoso","doi":"10.1016/j.humpath.2025.105799","DOIUrl":"10.1016/j.humpath.2025.105799","url":null,"abstract":"<div><div>Glycoprotein non-metastatic melanoma protein B (GPNMB) is a lysosomal transmembrane protein regulated by the TSC/mTOR-TFE pathway and has been proposed as a diagnostic immunohistochemical (IHC) marker for tumors associated with TSC/mTOR-TFE pathway alterations. However, its diagnostic performance in routine surgical pathology has not been systematically evaluated on a large scale. We retrospectively reviewed 934 cases from the Johns Hopkins pathology archives (2021–2025) in which GPNMB IHC was performed. Diagnoses were categorized into TSC/mTOR-TFE-related, non-TSC/mTOR/TFE-related, or undefined molecular groups. Correlation with fluorescence in situ hybridization (FISH) results and histologic features was performed to assess diagnostic utility. GPNMB was diffusely positive in 94.8 % (218/230) of TSC/mTOR-TFE-related neoplasms, including renal cell carcinomas with TFE3/TFEB rearrangements, perivascular epithelioid cell tumors (PECOMA/AML), and other related entities. In contrast, 83.3 % of non-TSC/mTOR-TFE-related tumors were negative for GPNMB. Discordant cases were seen in both groups, likely reflecting molecular heterogeneity, limitations of FISH, or the complex regulation of GPNMB expression. GPNMB outperformed cathepsin K in sensitivity in FISH-confirmed cases with TFE3 or TFEB alterations. Patchy or equivocal staining required careful histologic and ancillary correlation for interpretation. GPNMB IHC is a valuable ancillary tool in diagnosing TSC/mTOR-TFE-related neoplasms, particularly in renal and mesenchymal tumors. While not perfectly specific or sensitive, it offers a rapid and cost-effective alternative to molecular testing and can guide further diagnostic workup. Positive GPNMB staining in tumors without known TSC/mTOR-TFE alterations may suggest secondary pathway involvement, warranting additional molecular studies.</div></div>","PeriodicalId":13062,"journal":{"name":"Human pathology","volume":"159 ","pages":"Article 105799"},"PeriodicalIF":2.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144089746","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}
Human pathologyPub Date : 2025-05-01DOI: 10.1016/j.humpath.2025.105812
Yuan Shen , Lan Zheng , Jianping Zhao , Yishan Wang , Hui Chen , Sinchita Roy-Chowdhuri , Ashish M. Kamat , Omar Alhalabi , Jianjun Gao , Arlene Siefker-Radtke , Peng Wei , Donna E. Hansel , Bogdan Czerniak , Charles C. Guo
{"title":"Molecular profile of micropapillary urothelial carcinoma of the urinary bladder: An analysis of 99 cases by next-generation sequencing","authors":"Yuan Shen , Lan Zheng , Jianping Zhao , Yishan Wang , Hui Chen , Sinchita Roy-Chowdhuri , Ashish M. Kamat , Omar Alhalabi , Jianjun Gao , Arlene Siefker-Radtke , Peng Wei , Donna E. Hansel , Bogdan Czerniak , Charles C. Guo","doi":"10.1016/j.humpath.2025.105812","DOIUrl":"10.1016/j.humpath.2025.105812","url":null,"abstract":"<div><div>Micropapillary urothelial carcinoma (MPUC) is an aggressive neoplasm with distinct histology. We examined the molecular profile of MPUC and its relationship to patients' clinicopathologic features in 99 patients who underwent next-generation sequencing from 2010 to 2020 at a single institution. The patients included 77 men and 22 women with a mean age of 68 years (range, 24–91 years). Next-generation sequencing was performed on primary (n = 74) and metastatic (n = 25) tumor specimens. Somatic gene mutations were detected in 98 tumors, and the most common mutations were <em>TP53</em> (n = 71), <em>TERT</em> (n = 49), <em>ARID1A</em> (n = 28), <em>ERBB2</em> (n = 24), and <em>RB1</em> (n = 22). Copy number variations were detected in 22 tumors, including <em>ERBB2</em> (n = 8), <em>CDK12</em> (n = 3), <em>CCND1</em> (n = 3), and other genes (n = 8). No gene fusions or microsatellite instability was detected. Human epidermal growth factor receptor 2 (HER2) overexpression was detected more frequently in MPUCs with <em>ERBB2</em> amplifications than those with <em>ERBB2</em> mutations. Individual gene mutations did not significantly affect the overall survival, but patients with <em>ERBB2</em> amplifications had a significantly shorter overall survival than those with <em>ERBB2</em> mutations (<em>p</em> = 0.043). MPUC demonstrated distinct gene alterations in oncogenes and tumor suppressor genes that may be involved in MPUC's oncogenesis. <em>ERBB2</em> gene amplifications were associated with HER2 overexpression in MPUC, which may contribute to MPUC's aggressive behavior.</div></div>","PeriodicalId":13062,"journal":{"name":"Human pathology","volume":"159 ","pages":"Article 105812"},"PeriodicalIF":2.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144125121","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}
Human pathologyPub Date : 2025-05-01DOI: 10.1016/j.humpath.2025.105785
Rumeal D. Whaley, Beth A. Pitel, Christopher D. Hofich, Hussam Al-Kateb, Kevin C. Halling, Lori A. Erickson
{"title":"Papillary thyroid carcinoma with amyloid-like deposition harboring a novel OCLN::PRKCI gene fusion","authors":"Rumeal D. Whaley, Beth A. Pitel, Christopher D. Hofich, Hussam Al-Kateb, Kevin C. Halling, Lori A. Erickson","doi":"10.1016/j.humpath.2025.105785","DOIUrl":"10.1016/j.humpath.2025.105785","url":null,"abstract":"","PeriodicalId":13062,"journal":{"name":"Human pathology","volume":"159 ","pages":"Article 105785"},"PeriodicalIF":2.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143994945","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}
Human pathologyPub Date : 2025-05-01DOI: 10.1016/j.humpath.2025.105786
Amanda J. Nguyen , Lori A. Erickson , David J. DiCaudo , Jorge Torres-Mora , Malvika H. Solanki , Ruifeng Guo
{"title":"Exuberant nodal nevi: study of four cases with the focus on diagnostic pitfall of metastatic melanoma","authors":"Amanda J. Nguyen , Lori A. Erickson , David J. DiCaudo , Jorge Torres-Mora , Malvika H. Solanki , Ruifeng Guo","doi":"10.1016/j.humpath.2025.105786","DOIUrl":"10.1016/j.humpath.2025.105786","url":null,"abstract":"<div><div>Nodal melanocytic nevi are benign proliferations found in lymph nodes. While they are typically localized, small proliferations within the lymph node capsule, occasionally they can show florid growth patterns, raising concern for metastatic melanoma. We report four unusual cases of exuberant nodal nevi with discussion of the morphologic and immunophenotypic features. In all four cases, the differential diagnosis included metastatic melanoma. We report these cases to highlight an important diagnostic pitfall that may occur when nodal nevomelanocytic proliferations show exuberant growth patterns.</div></div>","PeriodicalId":13062,"journal":{"name":"Human pathology","volume":"159 ","pages":"Article 105786"},"PeriodicalIF":2.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143985335","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}
Human pathologyPub Date : 2025-05-01DOI: 10.1016/j.humpath.2025.105815
Burak Tekin , John C. Cheville , Dragana Milosevic , Michael McCarthy , Rumeal D. Whaley , Loren Herrera Hernandez , Rafael E. Jimenez , Vidit Sharma , Bradley C. Leibovich , Stephen A. Boorjian , Brian A. Costello , Lance C. Pagliaro , Sounak Gupta
{"title":"Assessment of trophoblast cell-surface antigen 2 (TROP2) and nectin-4 expression in choriocarcinoma","authors":"Burak Tekin , John C. Cheville , Dragana Milosevic , Michael McCarthy , Rumeal D. Whaley , Loren Herrera Hernandez , Rafael E. Jimenez , Vidit Sharma , Bradley C. Leibovich , Stephen A. Boorjian , Brian A. Costello , Lance C. Pagliaro , Sounak Gupta","doi":"10.1016/j.humpath.2025.105815","DOIUrl":"10.1016/j.humpath.2025.105815","url":null,"abstract":"<div><h3>Objectives</h3><div>Choriocarcinoma is associated with high mortality in multiply relapsed patients. Herein, we assessed immunohistochemistry (IHC) expression of TROP2 and nectin-4 in choriocarcinoma and other germ cell tumors (GCT), as antibody drug conjugates (ADCs) targeting these markers are entering the therapeutic landscape of many tumors.</div></div><div><h3>Methods</h3><div>Archival cases of choriocarcinoma and controls (non-choriocarcinoma GCT) were evaluated for TROP2 and nectin-4 IHC, performed on whole-slide sections, and results were quantified using H-scores (range: 0–300) based on membranous staining.</div></div><div><h3>Results</h3><div>The cohort included 20 primary GCT and 15 metastases from 34 patients. Of these, 18 specimens were choriocarcinoma (3 primary and 15 metastases), including six women with gestational choriocarcinoma. Median TROP2 and nectin-4 H-scores in choriocarcinomas were 22.5 and 60, respectively. For TROP2 and nectin-4, H-scores>200 were noted in 27.8% of patients, each. There was no correlation between serum beta-hCG levels measured within 2 weeks prior to specimen collection or peak serum beta-hCG levels and TROP2 or nectin-4 expression. The control group consisted of seminoma (n = 10); yolk sac tumor (n = 9), embryonal carcinoma (n = 10), postpubertal teratoma (n = 5), and spermatocytic tumor (n = 2). The median TROP2 H-scores for embryonal carcinoma, teratoma, and yolk sac tumor were 35, 30, and 15, respectively, and 0 for the remainder. The median nectin-4 H-score was 0 for all control group categories. Choriocarcinomas had a higher nectin-4 H-score compared to the control group (p < 0.001).</div></div><div><h3>Conclusions</h3><div>Given the high TROP2 and nectin-4 expression in a subset of choriocarcinoma, ADCs targeting these biomarkers may be a promising therapeutic approach for these tumors, pending additional validation.</div></div>","PeriodicalId":13062,"journal":{"name":"Human pathology","volume":"159 ","pages":"Article 105815"},"PeriodicalIF":2.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144142438","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}
Human pathologyPub Date : 2025-05-01DOI: 10.1016/j.humpath.2025.105816
Sam Engrav , Carina A. Dehner , Judith Jebastin Thangaiah , Andrew L. Folpe , Gregory W. Charville , Jeremy Molligan
{"title":"Skeletal muscle marker expression in ossifying fibromyxoid tumor: A study of 44 tumors","authors":"Sam Engrav , Carina A. Dehner , Judith Jebastin Thangaiah , Andrew L. Folpe , Gregory W. Charville , Jeremy Molligan","doi":"10.1016/j.humpath.2025.105816","DOIUrl":"10.1016/j.humpath.2025.105816","url":null,"abstract":"<div><div>Ossifying fibromyxoid tumor (OFMT) is a rare mesenchymal neoplasm harboring variable malignant potential and showing an immunophenotype classically described as co-expression of desmin and S100. Since its original description, considerable effort has been employed to fully characterize the immunophenotype of OFMT. Prompted by a consultation case of a histologically classic OFMT in which desmin expression was accompanied by expression of the skeletal muscle-specific nuclear regulatory protein MyoD1, we examined the frequency of MyoD1 and myogenin expression in a series of forty four cases of OFMT. Of the 44 cases, MyoD1 expression was present in 23 (52 %) cases, while none were myogenin-positive. MyoD1 expression was found in 20/31 (65 %) desmin-positive tumors, whereas desmin expression was present in 20/23 (87 %) MyoD1-positive tumors. A subset of five cases were stained for PAX7, and a single case of malignant OFMT showed weak expression. To our knowledge, this is the first formal study of rhabdomyoblastic marker expression in OFMT.</div></div>","PeriodicalId":13062,"journal":{"name":"Human pathology","volume":"159 ","pages":"Article 105816"},"PeriodicalIF":2.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144158334","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}
Human pathologyPub Date : 2025-05-01DOI: 10.1016/j.humpath.2025.105817
Samir M. Amer , Mehri Mollaee , Jianming Pei , Arthur S. Patchefsky , Alexander Kutikov , Robert G. Uzzo , Shuanzeng Wei
{"title":"Mucinous tubular and spindle cell carcinoma with papillae: A report of 5 cases and comparison with 18 cases of papillary renal cell carcinoma","authors":"Samir M. Amer , Mehri Mollaee , Jianming Pei , Arthur S. Patchefsky , Alexander Kutikov , Robert G. Uzzo , Shuanzeng Wei","doi":"10.1016/j.humpath.2025.105817","DOIUrl":"10.1016/j.humpath.2025.105817","url":null,"abstract":"<div><div>As its descriptive name indicates, mucinous tubular and spindle cell carcinoma (MTSCC) is composed of tubules, spindle cells, and extracellular mucinous stroma. Papillary architecture in MTSCC is regarded as infrequent finding and often is described as papillation or pseudopapillary appearance since bona fide papillary structures with fibrovascular cores are not seen. In this study, we report five cases of MTSCC with papillary formation and compare those with 18 cases of former type 1 papillary renal cell carcinoma (PRCC). Chromosomal microarray analysis was performed to confirm the diagnosis. All 5 MTSCC tumors exhibited at least focal papillary formation. However, the fibrovascular cores were generally mucinous with scant cellularity and vessels. In addition, psammoma bodies were observed in two, and foamy macrophages were seen in four cases of MTSCC. All PRCC cases exhibited classical papillary architecture without bland spindled tumor cells. Interestingly, focal mucinous stroma was observed in 7 PRCC (39 %). Foamy macrophages were identified in 15 (83 %), and psammoma bodies in 5 PRCC cases (28 %). The MTSCC had the typical monosomy of multiple chromosomes. However, the trisomy of 7, 17, and loss of Y typically found in PRCC were not observed in any of the 5 MTSCC. In summary, MTSCC and PRCC share many morphological features, including papillary formation, foamy macrophages, psammoma bodies, and mucinous stroma which should be emphasized. These shared features make distinguishing MTSCC from PRCC difficult in a small core biopsy or fine needle aspiration (FNA) specimen. Chromosomal microarray or FISH can be helpful in problematic cases.</div></div>","PeriodicalId":13062,"journal":{"name":"Human pathology","volume":"159 ","pages":"Article 105817"},"PeriodicalIF":2.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144173024","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}
Human pathologyPub Date : 2025-05-01DOI: 10.1016/j.humpath.2025.105793
Guilin Tang , Preetesh Jain , Shimin Hu , Chi Young Ok , Wei J. Wang , Andres E. Quesada , Qing Wei , Shaoying Li , Jie Xu , Sanam Loghavi , Gocke A. Toruner , L. Jeffrey Medeiros
{"title":"Optical genome mapping reveals diverse mechanisms of cyclin activation in mantle cell lymphomas lacking IGH::CCND1","authors":"Guilin Tang , Preetesh Jain , Shimin Hu , Chi Young Ok , Wei J. Wang , Andres E. Quesada , Qing Wei , Shaoying Li , Jie Xu , Sanam Loghavi , Gocke A. Toruner , L. Jeffrey Medeiros","doi":"10.1016/j.humpath.2025.105793","DOIUrl":"10.1016/j.humpath.2025.105793","url":null,"abstract":"<div><div>The t(11;14)(q13; q32)/<em>IGH::CCND1</em> is a genetic hallmark of mantle cell lymphoma (MCL), reported to be present in about 95% of cases. In this study, we performed optical genome mapping (OGM) on 91 patients with MCL, in conjunction with next-generation sequencing (NGS), conventional chromosomal analysis and fluorescence in situ hybridization (FISH). The t(11;14)/<em>IGH::CCND1</em> was detected in 82 cases, whereas 9 (10%) cases lacked this abnormality. OGM and NGS identified alternative <em>CCND1</em> abnormalities in 7 cases: <em>IGK::CCND1</em> (n = 3), <em>IGL::CCND1</em> (n = 1), an insertion adjacent to the 5′ region of <em>CCND1</em> (n = 1); a deletion at the 5′ region of <em>CCND1</em> (n = 1), and a mutation in the 3ʹ untranslated region of <em>CCND1</em> (n = 1). OGM detected <em>CCND2</em> rearrangement with <em>IGK</em> or <em>IGL</em> in the other 2 cases. All 7 cases exhibiting <em>CCND1</em> aberrations expressed cyclin D1, although some lacked SOX11 or CD5 expression. The two cases with <em>CCND2</em> rearrangement were SOX11-positive. Six cases showed highly complex genome detected by OGM and the affected patients were refractory to chemotherapy and/or had poorer survival. In conclusion, approximately 10% of MCL cases lack the classic t(11;14)/<em>IGH::CCND1</em>. OGM is valuable in identifying variant <em>CCND1</em> and <em>CCND2</em> rearrangements, and the presence of high genome complexity may correlate with treatment resistance and poor outcomes.</div></div>","PeriodicalId":13062,"journal":{"name":"Human pathology","volume":"159 ","pages":"Article 105793"},"PeriodicalIF":2.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144072348","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}
Human pathologyPub Date : 2025-05-01DOI: 10.1016/j.humpath.2025.105797
Rumeal D. Whaley . , Daniel R. Sill . , Burak Tekin . , Micheal R. McCarthy , John C. Cheville . , Kingsley Ebare . , Melissa L. Stanton , Jordan P. Reynolds . , Aditya Raghunathan , Loren P. Herrera Hernandez , Rafael E. Jimenez , Vidit Sharma , Stephen A. Boorjian , Bradley C. Leibovich , Christopher D. Hofich , Saba Alvand , Ganesh P. Pujari , Benjamin R. Kipp , Rhett P. Ketterling , Katherine B. Geiersbach , Sounak Gupta
{"title":"Evaluation of 3,606 renal cell tumors for TFE3 rearrangements and TFEB alterations via fluorescence in situ hybridization, next generation sequencing, and GPNMB immunohistochemistry","authors":"Rumeal D. Whaley . , Daniel R. Sill . , Burak Tekin . , Micheal R. McCarthy , John C. Cheville . , Kingsley Ebare . , Melissa L. Stanton , Jordan P. Reynolds . , Aditya Raghunathan , Loren P. Herrera Hernandez , Rafael E. Jimenez , Vidit Sharma , Stephen A. Boorjian , Bradley C. Leibovich , Christopher D. Hofich , Saba Alvand , Ganesh P. Pujari , Benjamin R. Kipp , Rhett P. Ketterling , Katherine B. Geiersbach , Sounak Gupta","doi":"10.1016/j.humpath.2025.105797","DOIUrl":"10.1016/j.humpath.2025.105797","url":null,"abstract":"<div><div>Molecularly defined renal cell carcinomas include <em>TFE3</em>-rearranged renal cell carcinoma (<em>TFE3</em>-RCC) and <em>TFEB</em>-altered renal cell carcinoma (<em>TFEB</em>-RCC). There is significant morphologic and immunophenotypic overlap between these entities and common renal tumors, such that molecular testing is often required to make the diagnosis. Herein, we reviewed our reference laboratory experience pertaining to <em>TFE3</em> and <em>TFEB</em> FISH testing, targeted next generation RNA sequencing (NGS), and GPNMB immunohistochemistry (IHC). Most FISH testing (2963/3543, 83.6%) was performed on renal tumors. <em>TFE3</em> FISH showed rearrangements in 449 of 2467 specimens (18.2%), including 281 (of 1887, 14.9%) renal tumors. <em>TFEB</em> FISH identified an abnormality in 107 of 1076 (9.9%) renal tumors, including 52 (of 107, 48.6%) rearrangements, 41 (of 107, 38.3%) amplifications, or 14 (of 107, 13.1%) with both rearrangements and amplifications. More specifically, <em>TFE3</em>-rearranged, <em>TFEB</em>-rearranged, <em>TFEB</em>-amplified, and <em>TFEB</em>-rearranged/amplified renal tumors occurred in females in 54%, 69.6%, 39.1%, and 40% of cases, respectively. The pediatric and young adult population (aged ≤21 years) included 44 (of 121, 36.3%) <em>TFE3</em>-RCC and 9 (of 50, 18%) <em>TFEB</em><em>-</em>rearranged RCC. <em>TFE3</em>-RCC fusion partners included <em>RBM10</em>, <em>NONO</em>, <em>ASPSCR1</em>, <em>FUBP1</em>, <em>SFPQ</em>, <em>MAPK1IP1L</em>, and <em>PRCC</em>. <em>TFEB</em>-rearranged RCC fusion partners <em>SYNRG</em> and <em>BYSL</em> were identified. Diffuse GPNMB expression was seen in 92% of <em>TFE3</em>-RCC (24/26; median H-score 275), 100% of <em>TFEB</em>-rearranged RCC (19/19; median H-score 300), and 100% of <em>TFEB</em>-amplified RCC (17/17; 240). Finally, our cohort included 5 eosinophilic <em>TFEB</em>-amplified RCCs with non-focal keratin 20 expression. This large series of <em>TFE3</em>-RCC and <em>TFEB</em>-RCC provides population data regarding these rare tumors and demonstrates the clinical value of targeted FISH strategies. Our results suggest that GPNMB IHC is an effective screen for <em>TFE3</em>-RCC and <em>TFEB</em>-RCC. Additionally, we report a RCC harboring a novel <em>SYNRG</em>::<em>TFEB</em> fusion.</div></div>","PeriodicalId":13062,"journal":{"name":"Human pathology","volume":"159 ","pages":"Article 105797"},"PeriodicalIF":2.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144093475","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}