International Journal of Surgical Pathology最新文献

{"title":"Abdominal Abscess as a Rare Manifestation of Gout.","authors":"Hanna Siatecka, Sara Faiz","doi":"10.1177/10668969251318039","DOIUrl":"10.1177/10668969251318039","url":null,"abstract":"<p><p>Gout is a common inflammatory arthritis in adults. Elevated levels of uric acid lead to the formation of monosodium urate crystals and their deposition in joints, and rarely, other parts of the body. The tissues most frequently involved are synovium, bone, cartilage, skin, tendon, ligament, and kidney. Here, we report an unusual presentation of gout manifesting as an abdominal abscess. A 60-year-old man with a history of opioid abuse, hypertension, and knee gouty arthritis presented to the emergency department with severe right knee pain. During hospitalization, he complained of pain in the left lower abdominal quadrant and developed coffee-ground emesis. Computed tomography showed pneumoperitoneum. The patient underwent laparotomy and was found to have gastric perforation and a large abdominal abscess. Drainage of the abscess revealed necrotic and hemorrhagic fragments of omentum. Microscopic examination showed adipose tissue with fat necrosis, acute inflammation, and fungal hyphae. Eosinophilic, amorphous deposits of polarizable needle-shaped crystals were observed in all sections, indicating the presence of monosodium urate crystals. The combined characteristics suggested intra-abdominal gout with concurrent fungal infection resulting from gastric perforation. This presentation is very rare. Only one occurrence of intra-abdominal gout mimicking a pelvic abscess has been reported in the literature.</p>","PeriodicalId":14416,"journal":{"name":"International Journal of Surgical Pathology","volume":" ","pages":"1491-1494"},"PeriodicalIF":0.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12276393/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143458031","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Histopathological Markers of Immunoglobulin G4-related Disease: Analyzing Diagnostic Patterns and Immunohistochemical Findings.","authors":"Sakthisankari Shanmugasundaram, Anita Michael","doi":"10.1177/10668969251316911","DOIUrl":"10.1177/10668969251316911","url":null,"abstract":"<p><p><b>Introduction:</b> Immunoglobulin G4 (IgG4) related disease is a localized or multisystem chronic inflammatory disease with characteristic pathological features. Several consensus criteria are available to aid in the diagnosis and its management. These criteria are highly specific, owing to their dependency on major histopathological criteria and laboratory investigations to diagnose IgG4-related diseases (IgG4-RD). We evaluated the lesions diagnosed as IgG4-RDs with histopathological scoring criteria based on histopathology, immunohistochemistry, and serology in the screening of IgG4-RDs. <b>Materials and methods:</b> The lesions diagnosed as IgG4-RD during the study period were evaluated using the histopathological scoring criteria which include storiform fibrosis, obliterative phlebitis, plasmacytic infiltrates, and lymphoid follicles. Immunohistochemistry with IgG4 was performed on all these lesions. <b>Results:</b> There were twelve patients with IgG4-RD involving the retroperitoneum, pancreas, lymph node, and nasal sinuses. Lesions involving the retroperitoneum showed all the characteristic histopathological findings of IgG4-RD. Storiform fibrosis and obliterative vasculitis were seen in 67% and 58% of the lesions respectively. Two patients (17%) lacked both storiform fibrosis and obliterative phlebitis. Additionally, lymphoid follicles were present in 58%, perineural infiltration in 33%, and tissue eosinophilia in 58% of individuals. Two patients with eosinophilic angiocentric fibrosis and a single patient with IgG4-RD associated with retroperitoneal mucinous cystadenoma were identified. <b>Conclusion:</b> IgG4-RD is a group of rare diseases that needs a multidisciplinary team approach for diagnosis. In our study, we report a rare association of IgG4-RD and retroperitoneal mucinous cystadenoma as well as rare lesions of IgG4-related eosinophilic angiocentric fibrosis. Clinicopathological and radiological correlation is crucial in the accurate diagnosis of IgG4-RD and to avoid overdiagnosis.</p>","PeriodicalId":14416,"journal":{"name":"International Journal of Surgical Pathology","volume":" ","pages":"1393-1400"},"PeriodicalIF":0.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143483056","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":"Basal Cell Carcinoma: A Digital Study of Immunohistochemical BCL2, P53 and CD138 Expression in Low- and High-Risk Types.","authors":"Janet Lyndsay de Stadler, Amsha Ramburan, Riyaadh Roberts","doi":"10.1177/10668969251314120","DOIUrl":"10.1177/10668969251314120","url":null,"abstract":"<p><p>IntroductionBasal cell carcinoma (BCC) is the leading cancer in Caucasians globally. Certain histological types of BCC are defined as high-risk for recurrence by the World Health Organisation (WHO). Identifying biological differences, such as protein expression, between histological types could result in druggable targets and improve future management, potentially offsetting rising costs in the health sector due to an increase in the global incidence of aggressive BCC.MethodsA laboratory-based, immunohistochemical study was undertaken at our institution. BCL2, P53 and CD138 antibodies were applied to formalin-fixed, paraffin-embedded tissue from low-risk and high-risk BCC types; followed by whole slide scanning and digital interpretation using QuPath software. Staining intensity, proportion and scores were assessed with the addition of BCL2 labelling and CD138 location. Statistical analyses were performed using STATA and R. A p value < 0.05 was considered statistically significant.ResultsOf 121 BCCs examined, 78 were low- and 43 high-risk. BCL2, P53 and CD138 tumoural expression in BCC were 78%, 91% and 100%, respectively. BCL2 staining was predominantly weak and focal while P53 and CD138 were diffuse. Significantly decreased tumoural BCL2 labelling (p = 0.04) and CD138 scores (p = 0.0035) were observed in high-risk BCCs. Conversely, significantly increased peritumoural stromal CD138 expression was observed in this category (p < 0.0001). There was no significant difference in P53 expression between the two categories.ConclusionThe identification of decreased BCL2 labelling in high-risk BCC highlights an important area for further research to evaluate the effect BCL2 downregulation has on non-surgical therapeutic options in aggressive BCC.</p>","PeriodicalId":14416,"journal":{"name":"International Journal of Surgical Pathology","volume":" ","pages":"1360-1372"},"PeriodicalIF":0.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143501323","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":"Aberrant Cytoplasmic INSM1 Expression in Erythroid Cells: A Potential Diagnostic Pitfall Versus Neuroendocrine Neoplasms.","authors":"Douglas Jian-Xian Wu, Gregory W Charville, Ankur R Sangoi","doi":"10.1177/10668969241311524","DOIUrl":"10.1177/10668969241311524","url":null,"abstract":"<p><p>Insulinoma-associated protein 1 (INSM1) is a relatively new immunostain used in the diagnostic assessment of tumors with neuroendocrine differentiation. While INSM1 positivity has been described in some non-neuroendocrine neoplasms, reactivity in red blood cells (RBCs) has only been anecdotally noted in one prior study without description of the degree/extent of staining. INSM1 staining in nucleated erythroid precursors has not been previously reported. Herein, 100 small biopsy specimens containing RBCs where INSM1 was used for diagnostic workup were reviewed. Additionally, 5 benign bone specimens and 5 adrenal myelolipoma specimens containing nucleated erythroid precursors were stained with INSM1. INSM1 staining intensity (0-3) and staining extent (0-100%) in RBC/erythroid cells was evaluated and an H-score was calculated (0-300). Positive cytoplasmic INSM1 staining in RBCs was observed in 99/100 (99%) specimens, with mean staining intensity of 2.1 (median = 2) and mean staining percent of 59% (median = 70%), with mean H-score of 125 (median = 140). Positive cytoplasmic INSM1 staining was identified in 10/10 (100%) specimens containing nucleated erythroid precursors, with mean staining intensity of 2.7 (median = 3) and mean staining percent of 53% (median = 50%), with mean H-score of 132 (median = 120). INSM1 is frequently positive in RBCs and nucleated erythroid precursors, albeit with variable staining intensity and extent. Although the INSM1 staining is cytoplasmic in RBCs (lacking nuclei) and nucleated erythroid precursors, the morphological features can mimic positive nuclear staining of neuroendocrine neoplasms. Particularly in small biopsy samples, which often contain background RBCs, positive INSM1 staining should be reviewed with caution to avoid misdiagnosis of neuroendocrine differentiation.</p>","PeriodicalId":14416,"journal":{"name":"International Journal of Surgical Pathology","volume":" ","pages":"1433-1436"},"PeriodicalIF":0.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143052490","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":"Molecular Characteristics of a <i>ZFTA::RELA</i> Fusion Gliosarcoma: A Case Report.","authors":"Tzah Feldman, Eugene Vlodavsky, Shada Sarji, Asmaa Yousef Abu El Hija, Mony Benifla, Liat Oren, Myriam Ben-Arush, Yaniv Zohar","doi":"10.1177/10668969241311520","DOIUrl":"10.1177/10668969241311520","url":null,"abstract":"<p><p>The combination of ependymoma and gliosarcoma elements in the same tumor is extremely rare, and the molecular characteristics of these entities are not clear. Here, we present a rare aggressive brain tumor in a 12-year-old boy harboring a <i>ZFTA::RELA</i> gene fusion, a characteristic feature of supratentorial ependymomas. On the other hand, the histopathological, molecular, and methylation profiles were compatible with a diagnosis of a mesenchymal type, IDH wild-type glioblastoma multiforme (GBM). Additional somatic alterations provide evidence of RAS/MAPK signaling pathway activation. Overall, this report highlights the histopathological and molecular characteristics of a rare and aggressive glial tumor.</p>","PeriodicalId":14416,"journal":{"name":"International Journal of Surgical Pathology","volume":" ","pages":"1450-1453"},"PeriodicalIF":0.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143065700","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":"Germline Mutations in Renal Neoplasms and Their Clinicopathological Correlations.","authors":"Meihua Chen, Yang Liu, Xianwei Yang, Yijin Gu, Lei Dong, Haimin Xu, Luting Zhou, Xiaoqun Yang","doi":"10.1177/10668969251318038","DOIUrl":"10.1177/10668969251318038","url":null,"abstract":"<p><p><b><i>Introduction</i>.</b> Germline mutations have been described in multiple renal neoplasm entities in the fifth edition of the World Health Organization Classification of Urinary and Male Genital Systems. However, our knowledge of renal neoplasms with germline mutations remains limited. <b><i>Methods</i>.</b> To expand our understanding, 15 tumors with germline mutations were retrieved from 284 renal neoplasms that underwent next-generation sequencing, including well-known <i>VHL</i>, <i>FH</i>, <i>SDHB</i>, <i>FLCN</i>, <i>TSC1</i>, and less common genes such as <i>MUTYH</i>, <i>NF2</i>, and <i>BARD1</i>. <b><i>Results</i>.</b> Interesting findings included clear cell renal cell carcinoma (RCC) with <i>FH</i> germline mutation and succinate dehydrogenase (SDH)-deficient RCC with high-grade transformation. Patients with germline mutations of these uncommon altered genes in renal neoplasms, such as <i>MUTYH</i>, <i>NF2</i>, and <i>BARD1</i> were diagnosed with different renal entities, including entities with favorable outcomes (renal cell carcinoma with fibromyomatous stroma) or adverse outcomes (collecting duct carcinoma and FH deficient renal cell carcinoma). <b><i>Conclusions</i>.</b> Besides the well-known germline mutations in renal neoplasms, we described germline mutations in some genes that are common in other sites but uncommon in the kidney. Although they cannot be used to determine a definite renal entity, they may also contribute to the pathogenesis of renal neoplasms. Tumors need to be diagnosed based on morphology, immunohistochemistry, and other molecular evidence.</p>","PeriodicalId":14416,"journal":{"name":"International Journal of Surgical Pathology","volume":" ","pages":"1401-1410"},"PeriodicalIF":0.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143515552","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":"A Rare Testicular Serous Cystadenocarcinoma Diagnosed in a Retroperitoneal Lymph Node Dissection Specimen With a Review of the Literature.","authors":"Sunayana Misra, Seema Rao, Sonia Badwal, Shyam Aggarwal, Ashwin Mallya","doi":"10.1177/10668969251314123","DOIUrl":"10.1177/10668969251314123","url":null,"abstract":"<p><p>Ovarian-type epithelial tumors of the testicular and paratesticular tissue are rare tumors that histologically resemble their ovarian counterparts. These tumors pose significant diagnostic challenges, especially to general pathologists, and may be misdiagnosed as the more commonly encountered germ cell tumors or mesotheliomas, if an appropriate immunohistochemistry panel is not applied. In this case report, we describe a serous cystadenocarcinoma in the retroperitoneal lymph node dissection specimen which was initially misdiagnosed in the primary testicular tumor as a germ cell tumor at an outside center, thus emphasizing the role of the pathologist in critically evaluating the histomorphological findings and applying a comprehensive immunohistochemistry panel to argue against the differential diagnoses at this site and reach the correct diagnosis.</p>","PeriodicalId":14416,"journal":{"name":"International Journal of Surgical Pathology","volume":" ","pages":"1484-1490"},"PeriodicalIF":0.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143458026","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":"Utility of CA9 Immunostain in Margin Assessment of Clear Cell Renal Cell Carcinoma Nephrectomies.","authors":"Courtney C Sparger, Richard R Pacheco, Ankur R Sangoi","doi":"10.1177/10668969251323934","DOIUrl":"10.1177/10668969251323934","url":null,"abstract":"","PeriodicalId":14416,"journal":{"name":"International Journal of Surgical Pathology","volume":" ","pages":"1441-1444"},"PeriodicalIF":0.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143515553","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":"Lactating Vulvar Adenoma Associated With Fibroadenoma.","authors":"Samuel Robichaud, Danh Tran-Thanh, Zhi Ping Zhang, France Durocher, Kurosh Rahimi","doi":"10.1177/10668969251314125","DOIUrl":"10.1177/10668969251314125","url":null,"abstract":"<p><p>Ectopic breast is found to occur most commonly in the axilla, but also less commonly on the vulva and on sites outside the \"milk line\" like the face, neck and chest. Vulvar adenofibroma developing on ectopic breast tissue in the vulva is exceptionally rare. More precisely, vulvar adenofibroma associated with adenoma with lactating changes has only been documented three times to our knowledge. We herein report a vulvar mass specimen consistent with vulvar lactating adenoma associated with vulvar fibroadenoma occurring in a 36-year-old woman in the postpartum period.</p>","PeriodicalId":14416,"journal":{"name":"International Journal of Surgical Pathology","volume":" ","pages":"1473-1476"},"PeriodicalIF":0.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12276389/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143440934","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Uterine Spindle Cell Smooth Muscle Tumor of Uncertain Malignant Potential With Mitotic Figures Greater Than or Equal to 15/10 High-Power Fields: A Clinicopathologic Study of 20 Patients With a Rare Tumor.","authors":"Ting Li, Yiqin Wang, Lihong Zhang, Jing Li, Xiaolei Yu, Yan Ning, Chenyan Zhao","doi":"10.1177/10668969251314124","DOIUrl":"10.1177/10668969251314124","url":null,"abstract":"<p><p><i>Background.</i> This study aimed to investigate the prognostic factors associated with uterine spindle cell smooth muscle tumors of uncertain malignant potential (STUMPs) with mitotic figures ≥15/10 high-power fields (HPFs). <i>Methods.</i> A total of 20 patients between January of 2009 and December of 2020 at the Department of Pathology of the Obstetrics and Gynecology Hospital of Fudan University were enrolled. Pathological features and immunohistochemical staining (including estrogen receptor (ER), progesterone receptor (PR), Ki67, p53, and phosphorylated histone H3 (PHH3)) were assessed, and clinical follow-up data were collected. <i>Results.</i> Among the 16 patients with Stage I, 3 recurrence, mitotic figures and PHH3 were associated with recurrence (<i>P</i> = 0.014 and <i>P</i> = 0.001, respectively). Among all 20 patients, stage, mitotic figures, PHH3 and Ki67 were associated with recurrence (<i>P</i> = 0.007, <i>P</i> = 0.003, <i>P</i> = 0.000, and <i>P</i> = 0.028, respectively). The areas under the receiver operating characteristic curve were 0.890 and 0.934 for mitotic figures and PHH3, with a cutoff value of mitotic figures 21/10 HPFs. Three patients (43%) did not experience recurrence without chemotherapy, and 6 patients (86%) did not experience recurrence after bilateral ovariectomy. <i>Conclusions</i>: For STUMPs with mitotic figures ≥15/10 HPFs, the higher the number of mitotic figures, the more likely it is for the tumor be extrauterine and recurrent. Recurrence could be assessed by using the diagnostic cutoff value of mitotic figures >21/10 HPFs or PHH3 >21/10 HPFs. We postulate that ovariectomy or antiestrogen therapy may be beneficial in preventing recurrence.</p>","PeriodicalId":14416,"journal":{"name":"International Journal of Surgical Pathology","volume":" ","pages":"1349-1359"},"PeriodicalIF":0.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143440935","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}