Histopathology最新文献

{"title":"An unusual mimic of sarcoma: HPV-associated squamous cell carcinoma of the anorectum with extensive sarcomatoid differentiation.","authors":"Andrew M Leader, Jason L Hornick, William J Anderson","doi":"10.1111/his.15430","DOIUrl":"https://doi.org/10.1111/his.15430","url":null,"abstract":"","PeriodicalId":13219,"journal":{"name":"Histopathology","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143407280","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":"Pitfalls during histological assessment in locally resected pT1 colorectal cancer.","authors":"Emma J Norton, Adrian C Bateman","doi":"10.1111/his.15425","DOIUrl":"https://doi.org/10.1111/his.15425","url":null,"abstract":"<p><p>Colorectal cancer (CRC) is a common malignancy worldwide, and the stage of the tumour is closely related to clinical outcome. Bowel cancer screening programmes have resulted in the identification of colorectal cancer at earlier stages. Approximately 10% of patients with the earliest stage of CRC (i.e. pT1) will possess regional lymph node metastases (LNM). Therefore, if these patients have initially been treated by local resection (e.g. polypectomy), this subgroup will require surgical resection. Identification of pathological risk factors for LNM within locally resected pT1 CRC is a very important process during the histological assessment of these lesions. This paper describes the most commonly encountered and clinically significant difficulties in the histological assessment of these cases. These pitfalls are illustrated using four examples of locally resected pT1 CRC that were received by our department during routine diagnostic practice.</p>","PeriodicalId":13219,"journal":{"name":"Histopathology","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143407282","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":"Retesting of oestrogen receptor, progesterone receptor and HER2 status of invasive carcinoma of the breast after neoadjuvant chemotherapy.","authors":"Andrew H S Lee, Emad A Rakha, Zsolt Hodi, Areeg Abbas, Ian O Ellis, Stephen Chan","doi":"10.1111/his.15426","DOIUrl":"https://doi.org/10.1111/his.15426","url":null,"abstract":"<p><strong>Aims: </strong>There is no consensus on whether oestrogen receptor (ER), progesterone receptor (PR) and human epidermal growth factor receptor 2 (HER2) status should be assessed after neoadjuvant chemotherapy. This study assessed the frequency of changes in ER, PR and HER2 status after neoadjuvant chemotherapy.</p><p><strong>Methods and results: </strong>Of 353 patients who had neoadjuvant chemotherapy and anti-HER2 treatment, receptors were assessed in 185 residual carcinomas. Eight per cent of carcinomas that were ER-negative in the core biopsy were ER-positive in the excision compared with 1.5% of controls. All were HER2-positive in the core biopsy and 23% were HER2-negative in the excision compared with 0% of controls. Controls were cases tested in the core biopsy and subsequent surgical resection with no neoadjuvant treatment. Of 589 patients who had neoadjuvant chemotherapy alone, receptors were assessed in 495 residual carcinomas. Six per cent of carcinomas that were ER-negative in the core biopsy were ER-positive in the excision (mainly ER-low positive) compared with 1.5% of controls. All were HER2-negative in the core biopsy and 6% were HER2-positive in the excision (mainly immunohistochemistry score 2+ and HER2 gene amplified) compared with 2% of controls.</p><p><strong>Conclusions: </strong>Negative to positive changes in receptor status after neoadjuvant chemotherapy are infrequent and the positive result in the excision is often weakly positive. These results imply that repeat assessment after neoadjuvant chemotherapy and surgery could influence the subsequent treatment in a small proportion of patients.</p>","PeriodicalId":13219,"journal":{"name":"Histopathology","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143407284","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":"Diagnostic accuracy and challenges of intraoperative frozen section evaluation for axillary sentinel lymph node biopsy and breast margins.","authors":"Natthawadee Laokulrath, Nur Diyana Md Nasir, Mihir Gudi, Puay Hoon Tan","doi":"10.1111/his.15418","DOIUrl":"https://doi.org/10.1111/his.15418","url":null,"abstract":"<p><strong>Aims: </strong>Our study aims to audit and evaluate the accuracy and pitfalls of intraoperative evaluation of frozen sentinel lymph nodes (IOE-FSLN) and resection margins (IOE-FSM) compared to final findings in paraffin sections.</p><p><strong>Methods: </strong>A total of 264 cases underwent intraoperative evaluation, encompassing 688 sentinel lymph nodes (SLNs) and 1186 surgical margins. Frozen section (FS) diagnoses were compared with corresponding permanent sections of FS (PFS). Sensitivity, specificity, false-negative rate, false-positive rate, and concordance rates were assessed. Cases with discrepancies underwent a detailed histological review.</p><p><strong>Results: </strong>The study predominantly comprised cases of invasive breast carcinoma (IBC) (74%). For FSLN reporting, sensitivity was 88.1%, specificity 100%, and FS-PFS concordance 99.0%. FSM reporting showed sensitivity of 85.0%, specificity 99.9%, and concordance 98.4%. Sampling errors accounted for 86% (FSLN) and 88% (FSM) of discrepancies, with interpretive errors present in 1/7 FSLN and in 2/17 FSM cases. The shave margin method demonstrated a higher false-negative rate in FSM reporting. The rate of final positive margins was reduced from 21.3% to 11.4% when IOE-FSM was utilized.</p><p><strong>Conclusion: </strong>IOE-FSLN and IOE-FSM showed high reliability in guiding intraoperative decisions for axillary lymph node dissection and achieving free surgical margins in one-stage surgeries. However, limitations include challenges in distinguishing metastatic carcinoma from benign mimics in FSLN and diagnosing certain features such as IBC with post-treatment changes, invasive lobular carcinoma in FSLN and FSM; IBC rich in tumour-infiltrating lymphocytes, low-grade (DCIS/IBC in FSM) without immunohistochemical studies.</p>","PeriodicalId":13219,"journal":{"name":"Histopathology","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143399121","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":"The prevalence and clinical significance of residual occult breast cancer after neoadjuvant chemotherapy: reassessing surgical pathology in cases initially described as pathological complete response.","authors":"Di Ai, Eliel N Arrey, Lauren M Postlewait, Yuan Gao, Xiaoxian Li","doi":"10.1111/his.15417","DOIUrl":"https://doi.org/10.1111/his.15417","url":null,"abstract":"<p><strong>Aims: </strong>Evaluation of pathological complete response (pCR) [no residual invasive carcinoma in the breast (RIC) or lymph node metastases (LNM) in surgical specimens following therapy] is typically based on evaluation of one level of haematoxylin and eosin (H&E) section. Not achieving pCR is associated with worse outcomes, and additional therapy may ensue. This study of patients with triple-negative (TNBC) or human epidermal growth factor receptor 2 (HER2)-positive (HER2+) breast cancer who underwent neoadjuvant therapy aims to assess whether occult residual disease (ORD) can be identified in deeper sections of tumour beds and lymph nodes in cases originally reported as pCR and whether ORD is associated with worse outcomes.</p><p><strong>Methods and results: </strong>In 84 cases of pCR (2009-17) at our institution, deeper-level recuts were assessed for ORD. Oncological and survival outcomes were compared. ORD was identified in seven of 40 TNBC (17.5%; five RIC; one LMN; one RIC and LMN) and four of 44 HER2+ (9.1%; three RIC; one LMN) cases (all residual cancer burden I). Median follow-up was 46.7 months for TNBC (one local recurrence, four distant metastases and two deaths) and 86.8 months for HER2+ (no local recurrence, three distant metastases and two deaths). All recurrence and death events occurred in patients with pCR without ORD, with no recurrence events in patients with ORD.</p><p><strong>Conclusions: </strong>In patients with TNBC and HER2+ breast cancer with pCR by standard pathological assessment, occult residual disease is not uncommon. Occult disease was not associated with worse oncological or survival outcomes, suggesting standard pathological assessment is sufficient to identify clinically meaningful disease.</p>","PeriodicalId":13219,"journal":{"name":"Histopathology","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143189257","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":"Utility of p53 and p16 immunohistochemistry in the diagnosis of human papillomavirus-associated oral epithelial dysplasia: a retrospective study of 105 patients.","authors":"Damir Rosic, Zia A Khan, Linda Jackson-Boeters, Mark R Darling, Erin Chapman, Lawrence Lee, Kelly Yi Ping Liu, Tony L Ng, Yen Chen Kevin Ko, Christina McCord","doi":"10.1111/his.15413","DOIUrl":"https://doi.org/10.1111/his.15413","url":null,"abstract":"<p><strong>Aims: </strong>This study investigated the utility of combined p16 and p53 immunohistochemistry (IHC) for diagnosing high-risk human papillomavirus (HR HPV)-associated oral epithelial dysplasia (OED) and its associated clinical behaviour, including disease recurrence and transformation to malignancy.</p><p><strong>Methods and results: </strong>The expression of p53 was evaluated in 105 cases of HR HPV-positive oral cavity OED, of which 104 were scored as positive for p16. HPV status was confirmed by reverse transcriptase quantitative polymerase chain reaction (RT-qPCR) for E6 mRNA or RNA in situ hybridization (ISH). Seven cases of p16-positive oral cavity OED with abnormal p53 expression and/or TP53 mutation and negative HPV RNA ISH were excluded. Most cases (93%) demonstrated classic HPV-associated basaloid morphology, and 7% were keratinizing. The most affected sites were the floor of the mouth/ventral tongue (61%), followed by the lateral tongue (18%) and gingiva (13%). p53 IHC showed that 76% of cases demonstrated a null-like / basal-sparing pattern, while 24% demonstrated a mid-epithelial/basal sparing pattern. Ten cases exhibited an invasive or suspicious for microinvasive component on biopsy. Dysplasia recurred in 14 cases, and a single case transformed to squamous cell carcinoma.</p><p><strong>Conclusion: </strong>The combination of p16 positivity and a basal-sparing pattern of p53 is predictive of HR HPV in OED, eliminating the need for further HPV-specific testing. Although HPV OED may co-occur with invasive squamous cell carcinoma on biopsy, the transformation to malignancy is low.</p>","PeriodicalId":13219,"journal":{"name":"Histopathology","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143189265","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":"Analysis of benign neoplasms of the rete testis formerly termed \"Sertoliform cystadenomas\" demonstrates that they are not Sertoli cell tumours with intra-rete growth.","authors":"Katrina Collins, Kvetoslava Michalova, Dario de Biase, Costantino Ricci, Giovanni Tallini, Jennifer B Gordetsky, Muhammad T Idrees, Maurizio Colecchia, Thomas M Ulbright, Andres M Acosta","doi":"10.1111/his.15422","DOIUrl":"https://doi.org/10.1111/his.15422","url":null,"abstract":"<p><strong>Aims: </strong>Benign tumours of the rete testis include mostly cystadenomas and adenomas. A subset with tubular or tubulopapillary architecture shows morphological similarities to Sertoli cell tumours; these neoplasms were previously termed \"Sertoliform cystadenomas of the rete testis\". In the most recent WHO classification, they have been interpreted as Sertoli cell tumours, not otherwise specified (NOS), with pure intra-rete growth, and therefore excluded as an entity. The remaining cystadenomas of the rete testis vaguely resemble tumours of Mullerian origin arising in the ovaries. In this study we analyse benign tumours of the rete testis, including a subset with Sertoliform features.</p><p><strong>Methods and results: </strong>Benign neoplasms of the rete testis were identified through query of consultation and institutional files. Clinicopathologic data were collected, and available slides were reviewed. Cases were assessed using IHC and three separate DNA sequencing panels. Eleven tumours from patients 32-78 years old were evaluated. Four were classified as Sertoliform adenomas/cystadenomas, displaying tubulo-papillary or tubular/trabecular architecture; all of them were PAX8-positive and lacked nuclear beta-catenin expression. The remaining seven tumours were benign cystadenomas NOS. Genomic analysis was performed successfully in 10/11 tumours (including all Sertoliform adenomas/cystadenomas) and revealed no pathogenic variants in CTNNB1, KRAS, or BRAF.</p><p><strong>Conclusion: </strong>Sertoliform cystadenomas of the rete testis differ from Sertoli cell tumours NOS, as evidenced by the absence of molecular markers characteristic of Sertoli cell tumours. The remaining benign cystadenomas lack molecular alterations seen in Mullerian tumors of the ovaries.</p>","PeriodicalId":13219,"journal":{"name":"Histopathology","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143065413","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":"Male breast atypical ductal hyperplasia (ADH): clinicopathological insights from a rare cohort.","authors":"Reham Al-Refai, Amr Ali, Sudarshana Roychoudhury, Ahmed Bendari, Sunder Sham, Diana Kantarovich, Iskender Genco, Shabnam Jaffer, Sabina Hajiyeva","doi":"10.1111/his.15419","DOIUrl":"https://doi.org/10.1111/his.15419","url":null,"abstract":"<p><strong>Aims: </strong>Atypical ductal hyperplasia (ADH) in male breast tissue is a rare condition with limited understanding. We aimed to elucidate the clinicopathological characteristics of ADH in male patients, focusing on its prevalence, presentation, and associated factors.</p><p><strong>Methods and results: </strong>We analysed 40 cases of ADH from 1626 male breast cases encountered between 2013 and 2023. Clinicopathological data were reviewed to identify key features and trends. The mean age of the patients in our cohort was 43 years. ADH was mainly discovered incidentally during the workup for gynecomastia in 85% (34/40) of cases. Only two cases, 5% (2/40), initially presented as a palpable mass; one was pure ADH and the other one an ADH with intraductal papilloma (IDP). Nipple discharge was the initial presentation in 7.5% (3/40) of cases, all of which were associated with IDP. Additionally, 5% (2/40) of cases were identified due to calcifications on imaging. Excision was the initial diagnostic procedure in 77.5% (31/40) of cases, and core needle biopsy (CNB) in 22.5% (9/40). In most patients 70% (28/40) had unilateral disease, while 84.4% (27/32) exhibited multifocal lesions, and 90.6% (29/32) showed cribriform architectural patterns. Notably, 77.3% (17/22) of patients had a history of medications linked to gynecomastia. During follow-up (9 months to 26 years), two patients developed ductal carcinoma in situ (DCIS).</p><p><strong>Conclusion: </strong>ADH in male patients primarily presents incidentally alongside gynecomastia. Multifocality and cribriform patterns are common histological features. The association with medication-induced gynecomastia and the potential progression to DCIS highlight the clinical significance of ADH in males.</p>","PeriodicalId":13219,"journal":{"name":"Histopathology","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143065416","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":"Colorectal adenosquamous carcinoma: clinicopathologic analysis of two large cohorts and literature review confirm poor prognosis and reveal prognostic aspects.","authors":"Raul S Gonzalez, Rachel K Horton, Xuchen Zhang, Rondell P Graham, Teri A Longacre, Anupamjit Mehrotra, Daniela S Allende, Kelsey E McHugh, Jinru Shia, Maria Westerhoff, Amitabh Srivastava, Wei Chen, Jennifer Vazzano, Paul E Swanson, Deyali Chatterjee, Hassam Cheema, Changqing Ma, Rifat Mannan, Runjan Chetty, Klaudia M Nowak, Stefano Serra, Diana Agostini-Vulaj, Rossana Kazemimood, Patrick Henn, Sanjay Kakar, Won-Tak Choi, Oyedele Adeyi, Sarah M Jenkins, Iris D Nagtegaal","doi":"10.1111/his.15412","DOIUrl":"https://doi.org/10.1111/his.15412","url":null,"abstract":"<p><strong>Aims: </strong>We compiled two cohorts of colorectal adenosquamous carcinoma (ASC) to describe its histologic and molecular aspects using modern parameters to compare them with literature reports using meta-analysis of cohorts and individual case series.</p><p><strong>Methods and results: </strong>We identified 53 colorectal ASC from 19 North American academic medical centres, in addition to national database reports on 94 Dutch cases. We analysed available clinical, histologic, and immunohistochemical features and patient outcome. ASC comprised 0.02% of colorectal cancers in the Dutch database. The median cohort patient ages at resection were 65 and 69 years (North American and Dutch cohorts, respectively), with a roughly equal male:female ratio. The squamous component represented between 5% and 95% of each tumour, with a median of 50%. Tumour-infiltrating lymphocytes (TILs) were generally low (66%), and tumour budding was often Bd1 (64%). Most cases were pT3 (55%) or pT4 (40%), with nodal metastases in more than half (58%). Twenty-three cases (43%) metastasized distantly, most commonly to the liver. Mismatch repair (MMR) deficiency was identified in 34% of the cases. Follow-up was available for 48 patients; 13 (27%) had recurrent disease and 29 (60%) died. A total of 31 patients progressed, with median time to progression of 18 months. Available data for the Dutch cohort revealed largely similar findings, as did review of cases in the literature.</p><p><strong>Conclusion: </strong>Colorectal ASC usually presents at an advanced stage. Despite high rates of MMR deficiency and low tumour budding, TILs were generally low, and there is a high recurrence rate and poor prognosis.</p>","PeriodicalId":13219,"journal":{"name":"Histopathology","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143065414","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":"Subareolar sclerosing ductal hyperplasia shows PI3K pathway alterations.","authors":"Baris Boyraz, Brian Robinson, Neal Lindeman, Syed A Hoda, James P Solomon","doi":"10.1111/his.15416","DOIUrl":"https://doi.org/10.1111/his.15416","url":null,"abstract":"<p><strong>Aims: </strong>Subareolar sclerosing ductal hyperplasia (SSDH) is a distinct type of complex sclerosing hyperplastic lesion first described by Rosen in 1987. There have been rare studies investigating SSDH; however, no genetic study has been performed to date.</p><p><strong>Methods and results: </strong>Seven SSDH cases, diagnosed between 2013 and 2024, were identified. All were subjected to next-generation sequencing (523 genes). Patient ages ranged from 40 to 74 years (median = 46). All lesions were located in the subareolar region. Each showed the characteristic appearance of the lesion, as described in the seminal study, with usual ductal hyperplasia in a densely sclerotic background imparting an 'infiltrative' appearance. None of the cases showed atypical hyperplasia or carcinoma. DNA sequencing identified PI3K pathway alterations in all seven cases: PIK3CA (n = three, one with two alterations), PIK3R1 (n = three) and PIK3C3 (n = one, with concurrent FAT1 mutation).</p><p><strong>Conclusion: </strong>SSDH shows PI3K pathway alterations similar to those seen in other non-atypical and atypical proliferative lesions as well as benign and malignant neoplasms of the breast. This finding may explain the rare association of SSDH with atypical hyperplasia, in-situ and invasive carcinoma.</p>","PeriodicalId":13219,"journal":{"name":"Histopathology","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143065418","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}