Histopathology最新文献

{"title":"Diagnostic interobserver variability of atypia assessment in columnar cell lesions among a group of expert breast pathologists in the United Kingdom and the Republic of Ireland, on behalf of the UK national coordinating committee for breast pathology.","authors":"Soha El Sheikh, Mohamed A Mansour, Elena Provenzano, Abeer Shaaban, Andrew Lee, Yasmeen Mir, Rebecca McMillan-Slater, Pauline Carder, Silvana Di Palma, Clinton Boyd, Purnima Makhija, Madhuri Warren, Susan Pritchard, Rahul Deb, Ian Ellis, Emad Rakha, Cecily Quinn, Sarah Pinder","doi":"10.1111/his.15402","DOIUrl":"https://doi.org/10.1111/his.15402","url":null,"abstract":"<p><strong>Aims: </strong>Atypical ductal hyperplasia and flat epithelial atypia (FEA) have defined diagnostic criteria, yet there is variation in the interpretation of these criteria, particularly when the atypia is present in a background of columnar cell lesions (CCLs). This study focuses upon cases which are especially challenging or difficult to classify reproducibly according to existing criteria.</p><p><strong>Methods and results: </strong>Thirteen breast pathology experts were asked to classify 10 challenging cases with CLLs as atypical or non-atypical. Interobserver agreement was calculated. After two consensus meetings, which explored the morphological features underlying the decision, the cases were reassessed. Finally, a photomontage was compiled as a visual aid for practising pathologists representing a range of straightforward cases and others where subjective interpretation causes disagreement within current diagnostic criteria. Overall interobserver agreement and pairwise pathologist agreement coefficients were both in the fair range (κ = 0.22 and κ = 0.3-0.4, respectively). This improved to moderate or substantial agreement (κ = 0.6-0.8) after two consensus meetings. The most controversial cases were atypical cases that lacked the regular rounded nuclei of FEA, and non-atypical cases that had florid architectural changes bordering on architectural atypia.</p><p><strong>Conclusion: </strong>Among expert breast pathologists, interobserver agreement in the diagnosis of atypia in CCLs was higher in cases with classical features of FEA. Consensus was difficult to achieve if nuclear or architectural atypia fell outside the classical definition of FEA, suggesting that this category does not encompass the range of low-grade cytological atypia in CLLs. This study provides rationale for expanding the definition of atypia in CCLs other than FEA.</p>","PeriodicalId":13219,"journal":{"name":"Histopathology","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142864091","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":"Ossifying fibromyxoid tumours with lipomatous and cartilaginous differentiation: A diagnostic pitfall.","authors":"Natálie Klubíčková, Steven Billings, Josephine K T Dermawan, Jeremy F Molligan, Karen Fritchie","doi":"10.1111/his.15396","DOIUrl":"https://doi.org/10.1111/his.15396","url":null,"abstract":"<p><strong>Aims: </strong>Ossifying fibromyxoid tumour is a rare mesenchymal neoplasm predominantly affecting adults characterised by a multinodular growth pattern and the presence of a fibrous pseudocapsule with areas of ossification. Prompted by the recognition of a non-ossifying ossifying fibromyxoid tumour with lipomatous differentiation which caused diagnostic difficulty, we sought to further explore cases of ossifying fibromyxoid tumour with non-osseous heterologous elements.</p><p><strong>Methods and results: </strong>A search of our institutional and consultation archives revealed three additional cases that demonstrated lipomatous components and two cases with cartilaginous differentiation. RNA-sequencing revealed fusions involving PHF1 (n = 4) or EPC1 (n = 1) in all (five of five) cases tested, including EPC1::PHC1 and JAZF1::PHF1 fusions, which have not been reported before in ossifying fibromyxoid tumour.</p><p><strong>Conclusion: </strong>These six cases expand the histomorphological spectrum of ossifying fibromyxoid tumour, introducing lipomatous differentiation as a hitherto undocumented feature. Awareness of these rare variants will ensure appropriate diagnosis and clinical management.</p>","PeriodicalId":13219,"journal":{"name":"Histopathology","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142864119","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":"Correspondence response to: can patient ancestry influence molecular classifications in myeloid neoplasms?","authors":"Gregor Hoermann, Yuri Fedoriw, Joseph D Khoury","doi":"10.1111/his.15403","DOIUrl":"https://doi.org/10.1111/his.15403","url":null,"abstract":"","PeriodicalId":13219,"journal":{"name":"Histopathology","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142864088","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":"CD23 expression in lymphoplasmacytic lymphoma: Clinical-pathological and biological correlations.","authors":"Marco Pizzi, Nicolò Danesin, Federico Scarmozzino, Martina Pinto, Greta Scapinello, Luisa Santoro, Irene Bertozzi, Gaetano Paride Arcidiacono, Valentina Trimarco, Andrea Visentin, Livio Trentin, Francesco Piazza, Angelo Paolo Dei Tos","doi":"10.1111/his.15401","DOIUrl":"https://doi.org/10.1111/his.15401","url":null,"abstract":"<p><strong>Aims: </strong>The diagnosis of lymphoplasmacytic lymphoma (LPL) in the bone marrow (BM) is challenged by aberrant phenotypes and by overlapping histological features with marginal zone lymphoma (MZL). To address these issues, we (i) assessed LPL immunophenotype on a large series of BM samples, (ii) drew possible correlations between LPL phenotype and clinical/molecular data and (iii) investigated the role of new phenotypical markers in the differential diagnosis between LPL and MZL.</p><p><strong>Materials and methods: </strong>The study retrospectively considered 81 clinically annotated LPL diagnosed at Padua University Hospital (Padua, Italy) during a 5-year period. BM findings were correlated with clinical laboratory findings and with MYD88 and CXCR4 mutational status. The obtained results were compared with a series of 77 MZL in the BM, including 46 splenic MZL (SMZL), 14 nodal MZL (NMZL) and 17 extra-nodal MZL (EMZL).</p><p><strong>Results: </strong>The LPL cohort included 52 males and 29 females (median age at diagnosis = 71 years). Aberrant CD10 and CD5 positivity was documented in 3 of 81 (3.7%) and 13 of 81 (16.1%) cases, respectively. CD23 positivity occurred in 56 of 81 (69.1%) cases, being usually partial/focal. CD23 expression did not correlate with any specific clinical-pathological parameter. Comparison with SMZL, NMZL and EMZL highlighted less frequent splenomegaly, higher serum paraprotein, higher CD23 expression and fewer follicular dendritic cell networks in LPL. A combined clinical-pathological score supported the differential diagnosis between LPL and MZL of any type. The highest diagnostic yield was obtained for the differential diagnosis between LPL and SMZL.</p><p><strong>Conclusions: </strong>Partial positivity for CD23 is a common feature of LPL in the BM. Together with other clinical and histological parameters, CD23 expression supports the differential diagnosis between LPL and MZL.</p>","PeriodicalId":13219,"journal":{"name":"Histopathology","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142864086","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 advancements in biomarkers and molecular diagnostics in hormonal receptor-positive breast cancer.","authors":"Yihong Wang, Liu Liu, Stephanie L Graff, Liang Cheng","doi":"10.1111/his.15395","DOIUrl":"https://doi.org/10.1111/his.15395","url":null,"abstract":"<p><p>Molecular applications have limited use in breast cancer compared to other cancer types. In recent years, with an improving appreciation of the molecular genetics of breast cancer and innovative novel targeted and immune-mediated therapeutics, opportunities have arisen for more biomarker analysis and molecular applications in the diagnosis and treatment of both locally advanced and metastatic breast cancers. In hormone receptor-positive, HER2-negative breast cancers, a growing number of revolutionized personalized therapies are in clinical use or on trials, such as CDK4/6 inhibitors and immune checkpoint inhibitors in adjuvant and neoadjuvant settings, and PIK3CA inhibitors in metastatic disease. In this review, we focus on biomarkers associated with those new therapeutic targets and molecular applications for genetic alterations associated with drug resistance or interaction from a pathology perspective for selecting and optimizing breast cancer treatment.</p>","PeriodicalId":13219,"journal":{"name":"Histopathology","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2024-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142835484","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":"Intranodal thyroid inclusions revisited: a morphological analysis and application of BRAF VE1 immunohistochemistry.","authors":"Yu-Che Chuang, Ying-Ju Kuo, Jen-Fan Hang","doi":"10.1111/his.15394","DOIUrl":"https://doi.org/10.1111/his.15394","url":null,"abstract":"<p><strong>Aims: </strong>The diagnosis of intranodal thyroid inclusions (ITIs) is controversial. We aim to investigate their clinicopathologic features and utilize immunohistochemistry (IHC) to support the diagnosis.</p><p><strong>Methods and results: </strong>Forty-one cases of incidentally found ITIs between 2019 and 2023 were categorized into three groups, namely, Group A: thyroidectomy due to papillary thyroid carcinoma (PTC) with regional lymph node dissection (n = 33), Group B: thyroidectomy due to benign thyroid disease with incidental perithyroid lymph node sampling (n = 4), and Group C: surgery due to other head and neck cancers with lateral neck lymph node dissection (n = 4). The overall incidence of ITIs was 4.17% (33/792) in Group A and 0.76% (4/524) in Group C. All ITIs sufficient for study were negative for BRAF VE1 IHC. HBME-1 and galectin-3 IHC were also negative in all analysed cases. Although various degrees of nuclear changes were present in ITIs, classical PTC nuclear features, i.e. pseudoinclusions, nuclear grooves, and chromatin alterations, were less commonly seen (0%, 29.3%, and 51.2%, respectively) than in metastatic PTC (90%, 95%, and 95%, respectively) (all P < 0.001). Interestingly, 77.3% (17/22) of cases with lymph node metastasis in Group A had coexistence of ITIs and metastasis in the same lymph node. During follow-up, two cases in Group A had PTC recurrence without accompanying ITIs, while none in Group B or C had recurrent thyroid lesions.</p><p><strong>Conclusion: </strong>We propose key diagnostic features for ITIs incorporating morphology and BRAF VE1, HBME-1, and galectin-3 IHC. The distinction between ITIs and metastatic PTC can be clinically relevant.</p>","PeriodicalId":13219,"journal":{"name":"Histopathology","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2024-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142835540","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 changing landscape of liver transplantation and the role of histopathology","authors":"Alastair D Burt,&nbsp;Dina G Tiniakos","doi":"10.1111/his.15397","DOIUrl":"10.1111/his.15397","url":null,"abstract":"","PeriodicalId":13219,"journal":{"name":"Histopathology","volume":"86 4","pages":"514-515"},"PeriodicalIF":3.9,"publicationDate":"2024-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142835486","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 head-to-head comparison of four grading systems for oral epithelial dysplasia.","authors":"Paul Hankinson, Mollie Clark, Hannah Walsh, Syed Ali Khurram","doi":"10.1111/his.15400","DOIUrl":"https://doi.org/10.1111/his.15400","url":null,"abstract":"<p><strong>Aims: </strong>Oral epithelial dysplasia (OED) carries a risk of malignant transformation to oral squamous cell carcinoma. Clinical risk stratification for these patients is challenging, and reliant upon histological grading. The World Health Organisation (WHO) grading system is the current gold standard, although the binary system, two- and six-point prognostic models have also been proposed. This study assesses the interobserver agreement and malignant transformation outcomes for these four grading systems.</p><p><strong>Methods and results: </strong>Up to 5 years of outcome data were collected for this retrospective cohort of 137 patients. Archived slides were reviewed by three pathologists, and grades for the WHO, binary, two- and six-point systems were assigned. Interobserver agreement was assessed with Light's kappa coefficient. Kaplan-Meier and Cox regression survival analyses were used to assess the correlation of each grading system with malignant transformation. The WHO, binary, two- and six-point systems had kappa coefficients of 0.42, 0.31, 0.17 and 0.41, respectively. All grading systems stratified lesions by malignant transformation risk, except the two-point model. Moderate OED (WHO) did not show an increased risk of malignant transformation, while severe OED had a hazard ratio (HR) of 13.7 (P = 0.02). The high-risk category for the binary and six-point systems had HRs of 4.67 (P = 0.03) and 5.28 (P = 0.03), respectively.</p><p><strong>Conclusions: </strong>The interobserver agreement of the WHO, binary and six-point systems is comparable. The six-point and binary systems provided the most useful risk stratification. This study highlights the potential value of the six-point prognostic model for OED grading, which has comparable performance with the current gold standard.</p>","PeriodicalId":13219,"journal":{"name":"Histopathology","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2024-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142835536","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 and ductal patterns of mesonephric-like adenocarcinomas are often overlooked: a retrospective revaluation of over 1000 endometrial carcinomas.","authors":"Ardalan Akbari, Jennifer Pors, Amy Lum, Samuel Leung, Dawn Cochrane, Amy Jamieson, Jessica McAlpine, Stefan Kommoss, Jutta Huvila, David Huntsman, Aline Talhouk, Naveena Singh, C Blake Gilks, Lynn Hoang","doi":"10.1111/his.15393","DOIUrl":"https://doi.org/10.1111/his.15393","url":null,"abstract":"<p><strong>Aims: </strong>Mesonephric-like adenocarcinoma (MLA) of the endometrium is often a diagnostic challenge, due to its morphological resemblance to other more common Müllerian neoplasms. This study aimed to retrospectively identify overlooked MLA in a large endometrial carcinoma cohort, using a combination of immunohistochemistry (IHC), morphology and KRAS sequencing.</p><p><strong>Methods and results: </strong>IHC was conducted on 1094 endometrial carcinomas, identifying 16 potential MLA cases based on GATA3+ and/or TTF1+ and ER- staining patterns, which subsequently underwent detailed histological review, KRAS sequencing and ProMisE molecular classification. Of the IHC screen-positive cases, one was positive for both GATA3 and TTF1, nine were positive for GATA3 only and six were positive for TTF1 only. All IHC screen-positive cases were POLE wild-type. All five tumours in the NSMP category showed morphological features of MLA, while the three MMRd and eight p53abn tumours did not show MLA morphology. The five cases diagnosed as MLA on review were all originally diagnosed as low-grade endometrioid adenocarcinoma probably because of rare morphological patterns, being predominantly papillary or ductal. Four of the five cases harboured a KRAS mutation.</p><p><strong>Conclusion: </strong>This study highlights the importance of a comprehensive diagnostic approach for accurately identifying endometrial MLA and for pathologists to be aware of papillary and ductal patterns in endometrial carcinoma assessment. Further exploration into the molecular landscape of MLA is essential for refining diagnostic criteria and developing targeted therapies.</p>","PeriodicalId":13219,"journal":{"name":"Histopathology","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2024-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142835482","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 clinicopathological and molecular features of primary high-grade neuroendocrine tumour in the breast.","authors":"Ruping Hong, Hao Wang, Yan Lin, Xianglin Yin, Jiuyuan Fang, Junyi Pang, Longyun Chen, Huanwen Wu, Zhiyong Liang","doi":"10.1111/his.15398","DOIUrl":"https://doi.org/10.1111/his.15398","url":null,"abstract":"<p><strong>Aims: </strong>Nottingham grade for breast cancers, rather than gastro-entero-pancreatic (GEP) grade for neuroendocrine tumours (NETs), is currently applied to primary breast NETs, which need further clarification. High-grade NETs in breast also remain poorly recognised.</p><p><strong>Methods and results: </strong>Among 595 breast carcinomas with diffuse synaptophysin (Syn) or chromogranin A (CgA) immunostaining (≥ 90%), 197 eligible cases were selected, including 69 NETs, 123 invasive breast carcinomas of no special type (IBC-NSTs) and five neuroendocrine carcinomas (NECs). The prognostic significance of these two grading systems in breast NETs was assessed. Furthermore, the clinicopathological features were compared in Nottingham G3 cases among three entities. Targeted sequencing and immunostaining (INSM1/p53/Rb/p16) were also performed in all Nottingham G3 NETs, NECs and 10 Nottingham G3 IBC-NSTs. All Nottingham G3 NETs (9 of 69, 13.0%) fell into GEP G3 cases (20 of 69, 29.0%). Nottingham grade provided better prognostic discrimination between G1/G2 and G3 NETs than GEP grade. Among Nottingham G3 cases, there was a trend towards reduced progression-free survival (PFS) in NETs compared with IBC-NSTs (P = 0.057), and the former were more often immunoreactive for INSM1 (44.4 versus 0%, P = 0.033). Nottingham G3 NETs were all of luminal-like phenotype (P < 0.001) and exhibited less aberrant p53 patterns (11.1 versus 80.0%, P = 0.023) as well as more favourable PFS (P = 0.012) and disease-specific survival (P = 0.002) than NECs. Rb loss (4 of 5, 80%), p16 overexpression (5 of 5, 100%) and RB1 mutation (2 of 5, 40%) were observed exclusively in NECs. Based on expression data, epithelial-mesenchymal transition and KRAS signalling pathways were significantly up-regulated in Nottingham G3 NETs (P < 0.05).</p><p><strong>Conclusions: </strong>Nottingham grade, rather than GEP grade, holds important prognostic significance in primary breast NETs. Nottingham G3 NETs represent a small proportion of breast NETs, and may demonstrate distinct clinicopathological and molecular features from other high-grade breast carcinomas with diffuse neuroendocrine markers expression.</p>","PeriodicalId":13219,"journal":{"name":"Histopathology","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2024-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142835489","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}