Human pathology最新文献

{"title":"Endometrial carcinomas – Challenges and updates on selected topics","authors":"Natalia Buza,&nbsp;Tong Sun,&nbsp;Pei Hui","doi":"10.1016/j.humpath.2025.106016","DOIUrl":"10.1016/j.humpath.2025.106016","url":null,"abstract":"<div><div>Endometrial carcinoma comprises a heterogeneous group of tumors with distinct histologic, immunophenotypic, and molecular profiles that have important diagnostic and clinical implications. This review focuses on selected subtypes of endometrial carcinomas with the most update. Endometrial serous carcinoma, though representing ∼10 % of endometrial cancers, accounts for a disproportionate number of endometrial cancer deaths; its early forms - serous endometrial intraepithelial carcinoma and superficial serous carcinoma, collectively termed minimal uterine serous carcinoma (MUSC) - predominantly arise in an endometrial polyp and demonstrate a paradoxically high rate of extrauterine spread despite minimal tumor volume, mandating comprehensive staging. Corded and hyalinized endometrioid carcinoma (CHEC) and pilomatrix-like high-grade endometrial carcinoma (PiMHEC) are CTNNB1/β-catenin–driven variants of endometrioid carcinoma with biphasic or basaloid morphology that may mimic carcinosarcoma, serous, or squamous carcinoma and show variable, sometimes aggressive behavior. Mesonephric-like adenocarcinoma (MLA) is an ER/PR-negative, KRAS-mutated carcinoma with mesonephric-type morphology, frequent deep myometrial and lymphovascular invasion, and a predilection for pulmonary metastasis. Primary endometrial squamous cell carcinoma (PESCC) and endometrial gastric (gastrointestinal)-type mucinous carcinoma (EmGA) are exceptionally rare entities that require stringent exclusion of cervical or metastatic primaries and are typically associated with p53-abnormal and/or gastrointestinal-type molecular signatures and poor outcomes. Across these variants, integration of morphology with immunohistochemistry and molecular testing (including p53, MMR status, POLE) is essential for accurate classification and risk stratification. HER2 overexpression and/or amplification occurs in 25–30 % endometrial serous carcinoma and HER2 testing has become a standard biomarker for selecting patients with recurrent or advanced disease for trastuzumab, and more recently trastuzumab-deruxtecan therapy.</div></div>","PeriodicalId":13062,"journal":{"name":"Human pathology","volume":"169 ","pages":"Article 106016"},"PeriodicalIF":2.6,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145751772","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":"Updates in bladder and prostate pathology: Diagnostic consensus and clinical relevance","authors":"Katrina Collins ,&nbsp;Sounak Gupta ,&nbsp;Liang Cheng","doi":"10.1016/j.humpath.2025.106018","DOIUrl":"10.1016/j.humpath.2025.106018","url":null,"abstract":"<div><div>Accurate grading, staging, and classification are essential components of bladder and prostate cancer pathology, directly influencing clinical management and patient outcomes. Recent initiatives by the International Society of Urological Pathology (ISUP) and the Genitourinary Pathology Society (GUPS) have produced key consensus updates aimed at refining diagnostic criteria and resolving long-standing controversies. This review highlights high-impact developments in bladder and prostate pathology, including updated grading systems and T1 substaging in bladder tumors, the proposed hybrid grading approach, and the classification of urachal carcinoma. Evolving perspectives in prostate pathology are also discussed, encompassing intraductal carcinoma of the prostate (IDC-P), neuroendocrine and aggressive variant tumors, and the clinical relevance of Grade Group 1 (GG1) disease in the context of active surveillance. Recent literature and consensus statements are summarized with attention to diagnostic challenges and practical implementation. These focused updates highlight the dynamic nature of urologic pathology and reflect a broader movement toward greater diagnostic precision, reproducibility, and clinical relevance, with adoption of ISUP and GUPS frameworks essential for improving patient outcomes.</div></div>","PeriodicalId":13062,"journal":{"name":"Human pathology","volume":"169 ","pages":"Article 106018"},"PeriodicalIF":2.6,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145780966","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":"Four pressing problems in liver pathology","authors":"Nazire E. Albayrak ,&nbsp;Sarah E. Umetsu ,&nbsp;Gwyneth Soon ,&nbsp;Sanjay Kakar ,&nbsp;Michael Torbenson","doi":"10.1016/j.humpath.2026.106055","DOIUrl":"10.1016/j.humpath.2026.106055","url":null,"abstract":"<div><div>Four important challenges in liver pathology are explored. Recognizing challenges in diagnostic pathology is one of the most important ways the field grows and improves, and this is reflected in the four challenges selected for review. The first problem considers the best approach to low-grade hepatocellular lesions in livers with chronic vascular disease. The second problem addresses the difficulties in making a diagnosis of portal vein disease and in choosing the best nomenclature. Problem 3 focuses on best practices for primary carcinomas of the liver that are difficult to classify as hepatocellular carcinoma versus cholangiocarcinoma. Problem 4 discusses the good and the bad of ongoing efforts to change established names of disease entities. All of these problems are discussed in their historical contexts and emphasize the practical aspects relevant to surgical pathology.</div></div>","PeriodicalId":13062,"journal":{"name":"Human pathology","volume":"169 ","pages":"Article 106055"},"PeriodicalIF":2.6,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146085649","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":"Making routine head and neck pathology Easy: From dissection to diagnosis","authors":"Jasmine Siaw ,&nbsp;Timothy Fielder ,&nbsp;Sebastian Senff ,&nbsp;Carsten E. Palme ,&nbsp;Jonathan R. Clark ,&nbsp;Caroline L. Cooper ,&nbsp;Ruta Gupta","doi":"10.1016/j.humpath.2025.106030","DOIUrl":"10.1016/j.humpath.2025.106030","url":null,"abstract":"<div><div>Resections from the mobile tongue, the oropharynx and neck dissections constitute a large proportion of routine head and neck pathology workload. Histologically detected proximity to margins and prognostic factors like depth of invasion, perineural or lymphovascular invasion, or extranodal extension guide adjuvant radiotherapy and/or chemotherapy.</div><div>This review discusses practical approaches to macroscopic examination of the various types of tongue and oropharyngeal resections and neck dissections. Differential inking and radial sections demonstrate proximity of tumour to margins. The macroscopic examination and sampling should then be directed towards identifying remaining adverse prognostic features including the maximum extent of invasion at the primary site and extranodal extension, nodal matting or soft tissue deposits in the neck dissections.</div><div>The diagnostic challenges differ in the tongue and oropharynx. The diagnosis of tongue SCC is relatively easy, however, precursor oral epithelial dysplasia can be challenging. Architectural and cytologic clues assisting in identifying dysplasia and practical clues distinguishing it from reactive changes are discussed. In contrast, dysplasia is not diagnosed in the oropharynx. p16 immunostaining and detection of human papillomavirus (HPV) play a critical role in the diagnosis and prognosis of oropharyngeal SCC. Nuances in the implementation and interpretation of p16 immunostaining and HPV assays are discussed.</div></div>","PeriodicalId":13062,"journal":{"name":"Human pathology","volume":"169 ","pages":"Article 106030"},"PeriodicalIF":2.6,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145878198","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":"A special issue dedicated to general surgical pathology for 2026","authors":"Sounak Gupta ,&nbsp;Lori A. Erickson","doi":"10.1016/j.humpath.2026.106087","DOIUrl":"10.1016/j.humpath.2026.106087","url":null,"abstract":"","PeriodicalId":13062,"journal":{"name":"Human pathology","volume":"169 ","pages":"Article 106087"},"PeriodicalIF":2.6,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147283499","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":"Recent updates and debates on basal crypt dysplasia, serrated epithelial change, and p53 immunostaining in inflammatory bowel disease","authors":"Dorukhan Bahceci ,&nbsp;Won-Tak Choi","doi":"10.1016/j.humpath.2025.105959","DOIUrl":"10.1016/j.humpath.2025.105959","url":null,"abstract":"<div><div>Early detection of dysplasia, followed by endoscopic or surgical resection, remains the cornerstone of colorectal cancer (CRC) prevention in patients with inflammatory bowel disease (IBD). Most dysplastic lesions in IBD resemble sporadic adenomas and pose little diagnostic difficulty, but several distinct morphologic patterns (collectively termed “nonconventional dysplasia”) have recently been described. Among these, basal crypt dysplasia presents particular diagnostic challenges, as it is characterized by mild atypia confined to the crypt bases without surface involvement, contrasting with the traditional expectation that dysplasia involves both crypts and surface epithelium. Identification of basal crypt dysplasia is crucial because it typically appears as invisible or flat dysplasia, is frequently associated with synchronous and/or metachronous neoplasia, and is considered a high-risk marker for subsequent advanced neoplasia. Serrated epithelial change (SEC) represents another controversial entity in IBD. Often defined as hyperplastic polyp-like mucosal changes detected on random or non-targeted colon biopsies, SEC has been linked to synchronous/metachronous neoplasia, including invisible/flat dysplasia, nonconventional dysplasia, and advanced neoplasia, which is often found adjacent to or within the same colonic segment as SEC. Ancillary studies, such as p53 immunohistochemistry, can assist in diagnosing dysplasia, including basal crypt dysplasia and subtle dysplasia associated with SEC. This review summarizes the morphologic criteria, clinicopathologic features, and recommended reporting practices for basal crypt dysplasia and SEC, and highlights the diagnostic utility of p53 immunohistochemistry in identifying dysplasia.</div></div>","PeriodicalId":13062,"journal":{"name":"Human pathology","volume":"169 ","pages":"Article 105959"},"PeriodicalIF":2.6,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145389020","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":"Three practice updates in non-Hodgkin lymphoma for 2026","authors":"Rebecca L. King ,&nbsp;Sarah L. Ondrejka ,&nbsp;James R. Cook","doi":"10.1016/j.humpath.2025.106012","DOIUrl":"10.1016/j.humpath.2025.106012","url":null,"abstract":"<div><div>Lymphoid neoplasms present many challenges in routine surgical pathology practice, given the numerous forms of non-Hodgkin lymphoma that must be distinguished from each other through careful morphologic evaluation supplemented by an ever-growing battery of ancillary studies that may include immunohistochemistry, flow cytometry, in situ hybridization studies, and, increasingly, next generation sequencing. A further complicating factor is the existence of two partially-overlapping but distinct classification systems currently in widespread clinical practice, the 5th edition World Health Organization classification and the International Consensus Classification. This review provides practical updates in three important areas. First, we discuss the evaluation and classification of follicular lymphoma, one of the most common small B-cell neoplasms, and highlight how to distinguish conventional follicular lymphoma from other forms of follicular lymphoma with very different clinical features and management. Secondly, we describe the current approach to high grade B-cell lymphomas, including “double hit” lymphomas and high-grade B-cell lymphoma, not otherwise specified, and how these challenging cases should be distinguished from the much more common diffuse large B-cell lymphoma, not otherwise specified. Finally, we briefly describe the features of common nodal T-cell lymphomas, including the T-follicular helper cell lymphomas, anaplastic large cell lymphoma, and peripheral T-cell lymphoma, NOS. In each of these areas, we provide guidance on helpful ancillary studies and advice for navigating current classification systems.</div></div>","PeriodicalId":13062,"journal":{"name":"Human pathology","volume":"169 ","pages":"Article 106012"},"PeriodicalIF":2.6,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145751768","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":"What is new for 2026: Challenges & updates in pulmonary pathology","authors":"Ying-Chun Lo ,&nbsp;Susan Armstrong ,&nbsp;Jason C. Chang","doi":"10.1016/j.humpath.2025.106021","DOIUrl":"10.1016/j.humpath.2025.106021","url":null,"abstract":"","PeriodicalId":13062,"journal":{"name":"Human pathology","volume":"169 ","pages":"Article 106021"},"PeriodicalIF":2.6,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145780990","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":"A practical approach for assessing high-grade diffuse gliomas and meningiomas","authors":"Yi Zhu ,&nbsp;Mark A. Rudolf ,&nbsp;Kyle Conway ,&nbsp;Jorge A. Trejo-Lopez ,&nbsp;Sandra Camelo-Piragua ,&nbsp;Aditya Raghunathan","doi":"10.1016/j.humpath.2025.106022","DOIUrl":"10.1016/j.humpath.2025.106022","url":null,"abstract":"<div><div>The field of central nervous system (CNS) tumor diagnostics continues to evolve and expand with the emergence and integration of diagnostic, prognostic, and predictive genomic markers. Despite such ever-increasing complexity, it remains within the ability of practicing surgical pathologists to perform an informed assessment of a majority of CNS tumors. In this review, we provide practical guidelines to evaluate the most common primary malignant and benign CNS tumor entities - high-grade diffuse glioma and meningioma.</div></div>","PeriodicalId":13062,"journal":{"name":"Human pathology","volume":"169 ","pages":"Article 106022"},"PeriodicalIF":2.6,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145793670","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":"Information for Authors","authors":"","doi":"10.1016/S0046-8177(26)00051-1","DOIUrl":"10.1016/S0046-8177(26)00051-1","url":null,"abstract":"","PeriodicalId":13062,"journal":{"name":"Human pathology","volume":"169 ","pages":"Article 106082"},"PeriodicalIF":2.6,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147417759","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}