International Journal of Surgical Pathology最新文献

{"title":"Crystal-Storing Histiocytosis of the Duodenum in a Patient With IgG-Lambda Multiple Myeloma.","authors":"Shunsuke Koga, Zhaohai Yang, Zahra Alipour","doi":"10.1177/10668969251343639","DOIUrl":"https://doi.org/10.1177/10668969251343639","url":null,"abstract":"<p><p>Crystal-storing histiocytosis is a rare condition characterized by the accumulation of crystalline immunoglobulins within histiocytes, often associated with plasma cell disorders such as multiple myeloma. We report a 70-year-old man with a history of IgG-lambda multiple myeloma, systemic amyloidosis, and end-stage renal disease managed with peritoneal dialysis and long-term lanthanum carbonate therapy for hyperphosphatemia, who presented with gastrointestinal bleeding. Endoscopy revealed nodular erythematous mucosa in the duodenum, and biopsies showed histiocytosis in the lamina propria. The histiocytes showed abundant cytoplasm containing periodic acid-Schiff-positive diastase-resistant intracellular material. Immunohistochemical staining revealed diffuse CD68 positivity and lambda light-chain restriction of the storage material in the histiocytes, supporting a diagnosis of crystal-storing histiocytosis. Differential diagnoses, including Whipple disease, mycobacterial infections, lanthanum deposition, amyloidosis, and xanthoma, were excluded based on histological findings and clinical history. This report highlights the importance of recognizing crystal-storing histiocytosis in uncommon sites such as the duodenum, especially in the context of plasma cell dyscrasias.</p>","PeriodicalId":14416,"journal":{"name":"International Journal of Surgical Pathology","volume":" ","pages":"10668969251343639"},"PeriodicalIF":0.9,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144181639","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Simple Nephrectomy for Non-Functioning Kidney: An Institutional Experience with Non-Neoplastic and Incidentally Detected Neoplastic Lesions.","authors":"Maitrayee Roy, Akshay Bali, Ayushi Kediya, Vishesh Dhawan, Vijay Shrawan Nijhawan","doi":"10.1177/10668969251339803","DOIUrl":"https://doi.org/10.1177/10668969251339803","url":null,"abstract":"<p><p><i>Introduction.</i> Chronic kidney diseases are attributed to a variety of etiologies, including diabetes mellitus, hypertension, vascular diseases, cystic kidney diseases, chronic tubulo-interstitial diseases, chronic pyelonephritis, and glomerular diseases. Simple nephrectomy is indicated when the loss of renal function in a unilateral non-functional kidney is permanent in a persistently symptomatic patient. Uncommonly, a non-functional kidney may develop neoplasm unsuspected pre-operatively and be diagnosed only during histopathological examination of nephrectomy specimen. <i>Material and methods.</i> We examined 275 simple nephrectomies performed between 2019 and 2024 in patients with non-functional kidneys confirmed by DMSA scan. All nephrectomies done for diagnosed or even suspected tumors by pre-operative imaging were excluded from the study. <i>Results.</i> Chronic pyelonephritis (79.3%) was the most common histopathological diagnosis, followed by xanthogranulomatous pyelonephritis (8.7%) and granulomatous pyelonephritis (5.4%). In five (1.8%) patients, microscopy revealed non-specific chronic interstitial inflammation and interstitial fibrosis. One patient (0.4%) was diagnosed with large solitary pyelogenic cyst and renal nocardiosis. Eleven patients (4%) were diagnosed with neoplasms. Clear cell renal cell carcinoma was the most common diagnosis (27.2%), followed by urothelial carcinomas of renal pelvis (18.2%), one patient each of collecting duct carcinoma, squamous cell carcinoma of renal pelvis, and multilocular cystic renal neoplasm of low malignant potential. Three patients had papillary adenomas. <i>Conclusion.</i> Diligent histopathological examination of simple nephrectomy is crucial in establishing the final diagnosis with important further therapeutic implications. This is especially important in neoplastic pathologies developing in non-functional kidneys that may rarely be unsuspected by pre-operative imaging and diagnosed only during histopathological evaluation.</p>","PeriodicalId":14416,"journal":{"name":"International Journal of Surgical Pathology","volume":" ","pages":"10668969251339803"},"PeriodicalIF":0.9,"publicationDate":"2025-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144142121","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rapid Malignant Transformation of a Biopsy Proven Sporadic Soft Tissue Schwannoma to Spindle Cell MPNST With <i>TP53</i> Mutation as an Early Event.","authors":"Madhurya Ramineni, Veronica Ulici, David G Hicks, Aaron R Huber, Gregory Dieudonne, Xi Wang","doi":"10.1177/10668969251340430","DOIUrl":"https://doi.org/10.1177/10668969251340430","url":null,"abstract":"<p><p>Malignant peripheral nerve sheath tumors (MPNSTs) primarily originate from the neurofibromatosis 1 (NF1)- associated and/or sporadic neurofibromas. Reports of malignant transformation from a sporadic soft tissue schwannoma are rare. In most tumors documented in this context so far, the malignant component is an epithelioid MPNST with a strong and diffuse S100 positivity. We present a patient diagnosed with a sporadic soft tissue schwannoma on core biopsy, which underwent rapid malignant transformation to a spindle cell type MPNST. Somatic tumor profiling of the excision specimen revealed <i>NF2</i> loss, <i>TP53</i>, <i>NRAS</i>, and subclonal <i>RICTOR</i> gene mutations. A retrospective immunohistochemical stain for p53 on the core biopsy demonstrated an aberrant staining pattern, indicating an early effect of <i>TP53</i> in the process of malignant transformation.</p>","PeriodicalId":14416,"journal":{"name":"International Journal of Surgical Pathology","volume":" ","pages":"10668969251340430"},"PeriodicalIF":0.9,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144127415","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Polythelia (Supernumerary Nipple): Clinicopathological Characterization of an Atavistic Lesion.","authors":"Majd Al Assaad, Diana R Vulcain, Andy Phan, Baris Boyraz, Syed A Hoda","doi":"10.1177/10668969251338577","DOIUrl":"https://doi.org/10.1177/10668969251338577","url":null,"abstract":"<p><p>Polythelia refers to the presence of additional nipples typically located along the \"milk line.\" While its atavistic nature and associations with congenital anomalies are well documented, its clinicopathological features are less defined. This retrospective study reviewed 131 lesions diagnosed as polythelia in 112 patients from 1999 to 2024. The median age of patients at the time of excision was 28 years (range: 6 months to 72 years). Most (101, 90.2%) patients were female. Lesions were located around the breast (42%), chest (28%), axilla (15%), inframammary fold (8%), and abdomen (6%). Histopathology of 107 lesions showed breast glandular tissue in 83 (77.6%). Sixty (72.3%) of these also exhibited nipple-type smooth muscle, and 24 (22.4%) contained smooth muscle only. Among lesions with glandular tissue, 66/83 (79.5%) had ducts, and 17/83 (20.5%) exhibited lobules. In addition, 54 lesions, initially misdiagnosed as accessory nipples, were reclassified as \"clinical pseudo-polythelia.\" The latter included nevi (48.1%), seborrheic keratosis (13.0%), and hemangiomas (3.7%). Based on our study, polythelia (when encountered in routine practice) is typically a benign and solitary lesion, excised for cosmetic reasons in younger females. Although one lesion of ductal carcinoma <i>in situ</i> in polymastia, under a polythelia, was encountered, no tumor with any nipple or breast lesion was identified in polythelia <i>per se</i>. No other congenital diseases or medical condition was identified in our cohort; however, there were ipsilateral or contralateral malignancies in the native breast in 7.6% of the lesions. Recognition of polythelia is essential to distinguish it from other skin lesions.</p>","PeriodicalId":14416,"journal":{"name":"International Journal of Surgical Pathology","volume":" ","pages":"10668969251338577"},"PeriodicalIF":0.9,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144109878","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Whipple Disease Initial Presentation as Supraclavicular Lymphadenopathy in a Patient With Rheumatoid Arthritis: A Diagnostic Challenge.","authors":"Sara E Amin, Swati Gite, Audrey Wanger, Violeta Chavez, Jacob Armstrong, Beenu Thakral, Patricia Navarro, Jennifer Makhoul, Amer Wahed, Navneet Narula, Karan Saluja","doi":"10.1177/10668969251342475","DOIUrl":"https://doi.org/10.1177/10668969251342475","url":null,"abstract":"<p><p>Whipple disease is a rare systemic disease caused by <i>Tropheryma whipplei.</i> It can present with a wide range of nonspecific symptoms that might overlap with underlying medical conditions, posing a diagnostic challenge. We present a 61-year-old man with a past medical history of rheumatoid arthritis and chronic inflammatory demyelinating polyneuropathy, who presented with persistent leukocytosis and supraclavicular lymphadenopathy. A positron emission tomography scan revealed hypermetabolic activity in the supraclavicular, abdominal, and pelvic lymph nodes along with a myocardial hypermetabolic lesion, concerning a lymphoproliferative disorder versus sarcoidosis. A supraclavicular lymph node excisional biopsy revealed complete architectural effacement by a diffuse foamy histiocytic infiltrate without granuloma formation or necrosis. The differential diagnosis included underlying infection, histiocytic neoplasm, lymphoproliferative disorder, storage disorder, and others. Immunostains show the histiocytic cells were positive for CD68 and CD163, while negative for S100, CD1a, kappa, lambda, and BRAF V600E. Grocott-Gömöri's methenamine silver and periodic acid-Schiff (PAS) stains demonstrated diffuse intracytoplasmic granular staining that was resistant to diastase treatment. Gram, acid fast bacilli, and Fite stains were negative. Electron microscopy revealed rod-shaped organisms with a trilaminar plasma membrane, morphologically consistent with <i>T whipplei.</i> Polymerase chain reaction was positive for <i>T whipplei</i>, confirming the diagnosis. Although rare, Whipple disease should be considered in immunocompromised patients presenting with nonspecific nongastrointestinal symptoms and lymphadenopathy clinically simulating lymphoma. Periodic acid-Schiff D-positive inclusions, along with confirmatory molecular results, are crucial for diagnosis. Whipple disease is a curable disease that can be lethal if unrecognized, emphasizing the importance of heightened awareness for early diagnosis and timely treatment.</p>","PeriodicalId":14416,"journal":{"name":"International Journal of Surgical Pathology","volume":" ","pages":"10668969251342475"},"PeriodicalIF":0.9,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144119795","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Positive Immunohistochemical Staining of Cytomegalovirus in Colon Biopsy Samples Suggests That the Viral DNA Load in qPCR Is High.","authors":"Guanglan Wang, Jianmin Zhao, Junchang Jiang, Aihua Huang, Lingna Ye, Zhinong Jiang","doi":"10.1177/10668969251339808","DOIUrl":"https://doi.org/10.1177/10668969251339808","url":null,"abstract":"<p><p>Background and AimImmunohistochemistry (IHC) and/or polymerase chain reaction (PCR) are essential for confirming active cytomegalovirus (CMV) infection in patients with inflammatory bowel disease (IBD). A definitive cut-off has not yet been established; however, Roblin et al suggested a viral load threshold of > 250 viral copies/mg of tissue. In this study, we examined the concordance between IHC and quantitative real-time PCR (qPCR) in the detection of CMV in colonic biopsy specimens.MethodsA total of 170 samples that underwent IHC and qPCR were collected. The positive rate and concordance of IHC and qPCR were studied, and the impact of ulcer tissue on both detection methods was observed.ResultsIn a study of 170 hematoxylin-eosin (H&E) sections, 8 samples were found to be infected with cytomegalovirus. The positive rates of CMV detection using IHC and qPCR were 17% (29/170) and 25% (43/170), respectively. Among the IHC-positive samples, the qPCR positive rate was 100% (29/29), with all CMV-DNA loads > 250 copies/mg. The concordance between IHC and qPCR was 94% (kappa = 0.756, <i>P</i> < .001). IHC analysis revealed that positive cells in ulcerated mucosa were more frequent than those in nonulcerated mucosa (<i>P</i> < .001). Additionally, a total of 14 samples tested negative for CMV via IHC but positive through qPCR. Among these, 11 samples did not contain ulcerated tissue.ConclusionThe presence of one or more IHC-positive cells in colon biopsy samples indicates a high CMV-DNA load in qPCR (> 250 copies/mg). IHC-positive cells were more frequently observed in ulcerated mucosa compared to nonulcerated mucosa.</p>","PeriodicalId":14416,"journal":{"name":"International Journal of Surgical Pathology","volume":" ","pages":"10668969251339808"},"PeriodicalIF":0.9,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144078079","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Morphologically In Situ Solid Papillary Carcinoma of the Breast With Lymph Node and Lung Metastasis: A Rare Case Report and Literature Review.","authors":"Sayed Matar, Seyed Reza Taha, Fouad Boulos","doi":"10.1177/10668969251339807","DOIUrl":"https://doi.org/10.1177/10668969251339807","url":null,"abstract":"<p><p>Solid papillary carcinoma (SPC) is rare, accounting for less than 1% of all breast cancers. According to the 5th edition of the WHO Classification of Breast Tumors (2019), SPC is divided into invasive (ISPC) and in situ (SPC in situ) subtypes. ISPC is characterized by an irregular or jigsaw pattern lacking myoepithelial cells, while SPC in situ is well-circumscribed, regardless of myoepithelial cell presence. Metastasis is infrequently reported, with most patients involving lymph nodes and arising from ISPC. Metastases from SPC in situ without myoepithelial cells have rarely been reported. We present a 66-year-old woman with a 28 × 13 mm hypoechoic breast mass detected on ultrasound. Microscopic examination revealed well-circumscribed nests of SPC, positive for ER, PR, and synaptophysin, with a Ki-67 proliferation index of 10%. HER2 was negative. Myoepithelial markers, including p63, smooth muscle actin, keratin 5/6, p40, and CD10, were all negative, confirming the absence of a myoepithelial layer. Axillary lymph node dissection revealed metastasis in three of eighteen lymph nodes, with the metastatic foci demonstrating the same well-circumscribed SPC architecture as the primary tumor in the breast. Additionally, a lung biopsy exhibited metastatic SPC with identical histomorphology and immunohistochemical profile to the primary tumor. Although rare, SPC presenting a well-circumscribed morphology, and classified as in situ according to the WHO, should be approached with caution when myoepithelial cells are absent, as the in situ histomorphology does not necessarily exclude the potential for metastasis.</p>","PeriodicalId":14416,"journal":{"name":"International Journal of Surgical Pathology","volume":" ","pages":"10668969251339807"},"PeriodicalIF":0.9,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144078075","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gastrointestinal Amphicrine Carcinoma: A Clinicopathologic Study of Five Patients.","authors":"Hairen Chen, Jinping Chen, Rong Ge","doi":"10.1177/10668969251333111","DOIUrl":"https://doi.org/10.1177/10668969251333111","url":null,"abstract":"<p><p><i>Objective.</i> To investigate the clinicopathological features, immunophenotype, diagnosis, differential diagnosis, and prognosis of amphicrine carcinoma (AC), a rare tumor characterized by dual differentiation between adenocarcinoma and neuroendocrine carcinoma. <i>Methods.</i> The clinicopathological data of five patients with AC diagnosed by pathology at Ningbo Clinical Pathology Diagnosis Center between 2020 and 2024 were collected. These specimens were analyzed using light microscopy, special staining, and immunohistochemical staining. Relevant literature was also reviewed. <i>Results.</i> The study included four men and one woman (range: 21-80 years) with gastric (3) and colorectal neoplasms (2). In all patients, tumor cells exhibited infiltrative growth, involving the subserosal or the serosal layer. Three tumors showed diffuse growth, with some cells displaying signet-ring cell features, others showing poorly differentiated neuroendocrine carcinoma changes, and some cells exhibiting plasmacytoid characteristics. In one patient, tumor cells were arranged in nests, with relatively uniform cell sizes and a palisaded pattern at the periphery. Another patient exhibited most tumor cells arranged in glandular structures with minimal mucin in the cytoplasm. Epithelial markers were positive in all patients. All tumor cells tested positive for AB-PAS staining in the cytoplasm. At least one neuroendocrine marker (synaptophysin, chromogranin A, CD56, insulinoma-associated protein 1) was diffusely and strongly positive in each patient. The expression of mismatch repair proteins (MLH1, MSH2, MSH6, PMS2) and RB protein at immunohistochemistry was retained in all samples. <i>Conclusion.</i> Gastrointestinal amphicrine carcinoma is rare and exhibits distinct histological and immunophenotypic features. The combination of histological morphology, immunophenotype, and AB-PAS special staining is crucial for both the diagnosis and differential diagnosis of this tumor.</p>","PeriodicalId":14416,"journal":{"name":"International Journal of Surgical Pathology","volume":" ","pages":"10668969251333111"},"PeriodicalIF":0.9,"publicationDate":"2025-05-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143996045","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Calcifying Nested Stromal-Epithelial Tumor (CNSET) of the Liver: A Case Report With Its Molecular Profile.","authors":"Hazal İzol Özmen, Nevra Dursun, Sibel Erdamar, Kamuran Tutuş, Nazli Gülsüm Akyel, İlgin Özden, Banu Yilmaz Özgüven","doi":"10.1177/10668969251338570","DOIUrl":"https://doi.org/10.1177/10668969251338570","url":null,"abstract":"<p><p>Calcifying Nested Stromal-Epithelial Tumor (CNSET) of the liver is a hepatic neoplasm of uncertain lineage, primarily affecting young individuals. This case report aims to elucidate the clinical, histopathological, and molecular characteristics of CNSET, contributing to the sparse knowledge regarding this unusual entity. We present here a 17-year-old female patient diagnosed with CNSET, highlighting the tumor's radiologic appearance, surgical management, and postoperative findings, alongside a comprehensive review of existing literature on the subject.The patient was evaluated for obesity and discovered to have a liver mass through imaging studies. The tumor demonstrated distinctive MRI features and was surgically resected, with histopathology confirming the diagnosis of CNSET. Molecular analysis revealed <i>CTNNB1</i> and <i>TERT</i> promoter mutations.This case report underscores the importance of considering CNSET in differential diagnoses of liver tumors in young patients and adds valuable insights into its molecular underpinnings, emphasizing the need for further research to understand its pathogenesis and optimize management strategies.</p>","PeriodicalId":14416,"journal":{"name":"International Journal of Surgical Pathology","volume":" ","pages":"10668969251338570"},"PeriodicalIF":0.9,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143996451","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Differential Expression of TLE1 in Small Round Cell Tumors: A Proposed Solution for Challenging Differentials Impacting Treatment Strategies.","authors":"Nisha Modi, Amit Varma, Rajesh Patidar, Vrushali Gadre, Srushti Karmarkar","doi":"10.1177/10668969251339810","DOIUrl":"https://doi.org/10.1177/10668969251339810","url":null,"abstract":"<p><p><i>Introduction.</i> Small round cell tumors (SRCTs) represent a heterogeneous group of neoplasms with overlapping histological features but varying origins, prognoses, and treatments. TLE1 is a well-established marker for synovial sarcoma (SS). However, TLE1's diagnostic utility is limited by its expression in a broad range of tumor types, reducing its specificity for SS. This study explores TLE1 expression across SRCTs and proposes an immunohistochemical algorithm to enhance diagnostic accuracy. <i>Methods.</i> This retrospective, single-center observational study, conducted from 2019 to 2024, reviewed pathology records for SRCTs. TLE1 staining was evaluated using the immunoreactive score system, categorized as follows: 0 (negative), 1+ (weak), 2+ (moderate), and 3+ (strong). <i>Results.</i> A total of 301 SRCTs were evaluated with diverse distribution: neuroendocrine neoplasms (21%, n = 63), extraskeletal Ewing sarcoma (15%, n = 45), lymphoblastic lymphoma (11%, n = 34), and poorly differentiated synovial sarcoma (PDSS) (8%, n = 24). TLE1 expression of 3 + was most frequently observed in PDSS (75%, 18/24). Other tumors with TLE1 3 + included extraskeletal Ewing sarcoma, extracutaneous malignant melanoma, neuroendocrine neoplasms, rhabdomyosarcoma, and endometrial stromal sarcoma. TLE1 2 + was noted in lymphoblastic lymphoma and desmoplastic SRCT, while TLE1 1 + was seen in some gastrointestinal stromal tumors. The remaining specimens were negative for TLE1. These findings led to a diagnostic framework for SRCTs based on TLE1 expression patterns. <i>Conclusions.</i> Although TLE1 is a key marker for SS, its expression in other tumors can present diagnostic challenges. Integrating clinical features, histological assessment, and a panel of immunohistochemistry markers is essential for accurate diagnosis and effective management of SRCTs.</p>","PeriodicalId":14416,"journal":{"name":"International Journal of Surgical Pathology","volume":" ","pages":"10668969251339810"},"PeriodicalIF":0.9,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144012481","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}