International Journal of Surgical Pathology最新文献

{"title":"Intra-Articular Extra-Synovial Venous-Type Synovial Haemangioma of the Knee in a Young Adult: Case Report and Literature Review of This Frequently Misdiagnosed Lesion.","authors":"Eva Manuela Pena-Burgos, Ignacio Millán Arredondo, Mathilde de Andrade da Costa Gloria, Alfonso Tejerizo García, Félix Jesús Mora Alañón, Jose Juan Pozo-Kreilinger, Mar Tapia-Viñe","doi":"10.1177/10668969261478601","DOIUrl":"https://doi.org/10.1177/10668969261478601","url":null,"abstract":"<p><p>ObjectiveTo report a rare lesion, an intra-articular extra-synovial venous-type synovial haemangioma of the knee in a young adult and to review the relevant literature on this frequently misdiagnosed entity.Case reportA 21-year-old man presented with recurrent knee effusions and pain over several years. Imaging studies revealed a well-defined, intra-articular, extra-synovial soft-tissue mass located in the anteromedial compartment of the knee. Magnetic resonance imaging (MRI) demonstrated multiple tubular structures with high signal intensity on T2- and short tau inversion recovery (STIR)-weighted images and intense, homogeneous contrast enhancement, consistent with a vascular lesion. Surgical excision was performed, and histopathological analysis confirmed a venous-type synovial haemangioma, characterized by large-calibre vascular channels lined by bland endothelial cells and containing organizing thrombi. The postoperative course was uneventful, and the patient remained disease-free at 6 months of follow-up.ConclusionSynovial haemangioma, though rare, should be considered in the differential diagnosis of recurrent knee effusions in young patients. It may mimic other benign or malignant periarticular lesions. MRI plays a key role in the evaluation, and the diagnosis can be strongly suggested by imaging, but histopathological confirmation remains essential for accurate characterization and appropriate management.</p>","PeriodicalId":14416,"journal":{"name":"International Journal of Surgical Pathology","volume":" ","pages":"10668969261478601"},"PeriodicalIF":0.9,"publicationDate":"2026-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149008556","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":"Ameloblastoma With Glandular Differentiation.","authors":"Melad N Dababneh, Michel Kmeid, Alexander C Mackinnon, Somsak Sittitavornwong","doi":"10.1177/10668969261482131","DOIUrl":"https://doi.org/10.1177/10668969261482131","url":null,"abstract":"<p><p>Ameloblastoma with mucinous and/or glandular differentiation is exceedingly rare and not currently recognized by the World Health Organization (WHO) as a morphologic subtype. We report a <i>KRASG12R</i>-mutated mandibular ameloblastoma with mucinous glandular differentiation in a 72-year-old male patient, with detailed radiologic, histomorphologic, immunohistochemical and molecular findings. To our knowledge, this is the 15^th case report in literature of human ameloblastoma with a mucinous component, and the first to provide comprehensive analysis to support glandular differentiation.</p>","PeriodicalId":14416,"journal":{"name":"International Journal of Surgical Pathology","volume":" ","pages":"10668969261482131"},"PeriodicalIF":0.9,"publicationDate":"2026-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149008524","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":"Uterine <i>NTRK</i>-Rearranged Spindle Cell Neoplasm With Unusual Morphology-A Case Report and Literature Review.","authors":"Horace M H Cheung, Maximus C F Yeung","doi":"10.1177/10668969261477755","DOIUrl":"https://doi.org/10.1177/10668969261477755","url":null,"abstract":"<p><p><i>NTRK</i>-rearranged spindle cell neoplasm is a rare lesion in the uterus (including the cervix), with more than 60 tumors reported in the literature so far. Most of them are characterized by fascicles of spindle cells in herringbone pattern with entrapment of endocervical glands. We report an additional tumor occurring in the uterine cervix of a 43-year-old Chinese woman, which demonstrated unusual morphologic features in addition to the conventional fibrosarcoma-like spindle cell proliferation. These included areas of neural-like whorls, as well as nuclear palisading that resembled a schwannoma. Focal myxoid stroma with loose clusters of rhabdoid cells was also identified. The nuclear grade was intermediate to severe and geographic necrosis was identified. Immunohistochemistry showed diffuse positivity for pan-TRK with patchy CD34 and focal S100 expression. Molecular analysis revealed the presence of <i>TPM3::NTRK1</i> fusion with <i>CDKN2A/B</i> homozygous deletion and low mutational burden. Our case report and literature review highlight the diverse morphological appearance of this tumor. Specifically, nuclear palisading and rhabdoid cells are rarely reported in uterine <i>NTRK</i>-rearranged spindle cell neoplasm. As more clinical and molecular data become available, the clinicopathological features of this entity can be further characterized.</p>","PeriodicalId":14416,"journal":{"name":"International Journal of Surgical Pathology","volume":" ","pages":"10668969261477755"},"PeriodicalIF":0.9,"publicationDate":"2026-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149008294","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":"Hematoxylin in Histopathology Practice: A Comprehensive Approach and Current Perspectives.","authors":"Aykut Ulucan, Hikmet Keleş","doi":"10.1177/10668969261477756","DOIUrl":"https://doi.org/10.1177/10668969261477756","url":null,"abstract":"<p><p>Hematoxylin and eosin (H&E) staining, which has been considered the gold standard in histopathology practice for over a century, continues to form the basis of diagnostic processes. Hematoxylin, a natural flavonoid derived from the <i>Haematoxylum campechianum</i> tree, requires oxidation to convert to hematein to obtain staining ability and metallic mordants to bind with tissue. This review comprehensively analyzes the chemical mechanisms, formulation diversity, application protocols, and technological integration of hematoxylin in light of the current literature. This review details modern safety paradigms that necessitate the transition from toxic mercury oxide to safe sodium iodate-based formulations, as well as semi-oxidation strategies that extend dye life. Alongside traditional aluminum and iron mordant variants (Mayer, Harris, Gill, Weigert), the new generation chromium mordant hematoxylin X innovation, which stands out for its stability and staining capacity, is technically evaluated. Furthermore, progressive and regressive methods that directly affect staining quality, artifact management, and quality control standards (stain verification, duty cycle tracking) are examined. In conclusion, this review focuses on environmentally-friendly chemistry practices that prioritize laboratory safety and the environment, as well as the transformation brought about by artificial intelligence (AI)-powered Virtual H&E Staining technologies. Regardless of how rapidly the digital pathology revolution progresses, it has been concluded that the familiar morphological signature provided by hematoxylin will remain an essential guide for pathologists, particularly in unlocking the secrets of nuclear chromatin and preparing the groundwork for molecular analyses.</p>","PeriodicalId":14416,"journal":{"name":"International Journal of Surgical Pathology","volume":" ","pages":"10668969261477756"},"PeriodicalIF":0.9,"publicationDate":"2026-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149008503","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":"Esophageal and Gastric Phaeohyphomycosis in a Malnourished Child: A Rare Gastrointestinal Fungal Infection With Concomitant Candidiasis and Giardiasis.","authors":"Vanlal Hruaii, Rohan Grotra, Rajni Yadav, Rohan Malik","doi":"10.1177/10668969261477758","DOIUrl":"https://doi.org/10.1177/10668969261477758","url":null,"abstract":"<p><p>Phaeohyphomycosis is an uncommon fungal infection caused by dematiaceous (melanized) fungi, typically presenting as a localized subcutaneous nodule or cyst, and as systemic disease in immunocompromised individuals. It rarely involves the gastrointestinal tract. Esophageal candidiasis, a common fungal infection of the gastrointestinal tract, may cause dysphagia, whereas giardiasis is a protozoal infection, primarily associated with diarrhea and malabsorption. We report an unusual example of concomitant esophageal and gastric phaeohyphomycosis, esophageal candidiasis and duodenal giardiasis in an 8-year-old child, who presented with absolute dysphagia secondary to esophageal stricture and severe malnutrition. Histopathological examination established the diagnosis, and the patient was successfully managed with medical therapy, resulting in complete clinical, endoscopic, and histological resolution on follow-up.</p>","PeriodicalId":14416,"journal":{"name":"International Journal of Surgical Pathology","volume":" ","pages":"10668969261477758"},"PeriodicalIF":0.9,"publicationDate":"2026-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149008561","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":"Prognostic Significance of Tumor Budding, Tumor-Stroma Ratio, and Annexin A1 in Gallbladder Cancer.","authors":"Sung-Eun Choi, Jin Ho Lee, Eun Kyung Kim","doi":"10.1177/10668969261470846","DOIUrl":"https://doi.org/10.1177/10668969261470846","url":null,"abstract":"<p><p>ObjectiveGallbladder cancer (GBC) is a rare, aggressive malignancy with poor survival outcomes. The tumor microenvironment (TME), which includes stromal content, immune infiltration, and tumor budding, influences tumor progression and prognosis. ANXA1 is a multifunctional protein that mediates crosstalk within the TME to regulate cancer cell behavior and stromal dynamics; however, its prognostic role in GBC remains unclear.Patients and MethodsWe retrospectively analyzed 131 patients who underwent surgery for primary GBC. Tumor-stroma ratio (TSR), local immune responses [Klintrup-Mäkinen (KM) grade, stromal tumor-infiltrating lymphocytes (TILs), and Crohn-like lymphoid reaction (CLR)], tumor budding, and ANXA1 expression were evaluated using hematoxylin and eosin-stained slides and immunohistochemistry. Associations with clinicopathological features, disease-specific survival (DSS), and progression-free survival (PFS) were assessed using Kaplan-Meier analysis and Cox regression models.ResultsHigh-grade tumor budding was observed in 23% of tumors, and a stroma-high phenotype was identified in 29%. ANXA1 expression was positive in 80.9% of the tumors. Stroma high status and high-grade tumor budding were identified as independent predictors of poor DSS, whereas high-grade tumor budding independently predicted poor PFS. Low KM grade, stromal TILs, CLR, and ANXA1 expression were not independently associated with survival.ConclusionsHigh-grade tumor budding and stroma-rich phenotypes were independent adverse prognostic factors for GBC, whereas stromal TILs were associated with favorable outcomes. Although ANXA1 is expressed in GBC and linked to aggressive features, it does not independently predict survival. A comprehensive assessment of TME components may improve prognostic stratification and guide personalized management strategies for GBC.</p>","PeriodicalId":14416,"journal":{"name":"International Journal of Surgical Pathology","volume":" ","pages":"10668969261470846"},"PeriodicalIF":0.9,"publicationDate":"2026-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149008481","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":"Ink Unveiled: The Histopathology of Benign Core Biopsy Specimens from Axillary Lymph Nodes With Tattoo Pigment.","authors":"Rebecca C Czaja, Julie R Sullivan, Julie M Jorns","doi":"10.1177/10668969261478145","DOIUrl":"https://doi.org/10.1177/10668969261478145","url":null,"abstract":"","PeriodicalId":14416,"journal":{"name":"International Journal of Surgical Pathology","volume":" ","pages":"10668969261478145"},"PeriodicalIF":0.9,"publicationDate":"2026-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149008494","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":"Hepatocellular Carcinoma With a Grade 3 Neuroendocrine Tumor Component: A Case Report.","authors":"Xue Wen, Ruoji Zhou, Weibo Yu, Hanlin L Wang","doi":"10.1177/10668969261480728","DOIUrl":"https://doi.org/10.1177/10668969261480728","url":null,"abstract":"<p><p>Mixed hepatocellular carcinoma (HCC) and neuroendocrine tumor (NET) constitute an exceedingly rare and diagnostically challenging entity. We report a 70-year-old man with hepatitis C-related cirrhosis and multifocal HCCs, who was status post multiple microwave and radiofrequency ablation procedures. Total hepatectomy revealed a 1.9-cm viable tumor that, on histologic examination, showed moderately differentiated HCC with trabecular and pseudoacinar growth patterns and expression of albumin, arginase-1, and HepPar-1. Notably, a neuroendocrine component comprising ∼20% of the tumor volume was identified. This component consisted of sheets of intermediate-sized cells with inconspicuous nucleoli and scant cytoplasm. Scattered tumor cells with enlarged nuclei were present, but mitotic figures were difficult to identify, and no necrosis was observed. Immunohistochemically, these tumor cells were positive for synaptophysin and negative for hepatocellular markers, with wild-type p53, retained nuclear RB1, and patchy SSTR2A expression. The Ki-67 labeling index was heterogeneous, ranging from 5% in low-proliferation areas to 31% in hotspots, with an average of 11%. The morphologic and immunohistochemical findings supported a diagnosis of mixed HCC and grade 3 (high-grade) well-differentiated NET. This diagnosis should be distinguished from mixed HCC and neuroendocrine carcinoma given important differences in therapeutic decision-making and prognostic assessment.</p>","PeriodicalId":14416,"journal":{"name":"International Journal of Surgical Pathology","volume":" ","pages":"10668969261480728"},"PeriodicalIF":0.9,"publicationDate":"2026-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149008498","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":"SOX17 and TRPS1 in Müllerian, Breast, and Mesothelial Tumors: Tissue-Based Specificity Profiles and Diagnostic Pitfalls in Malignant Serous Effusions.","authors":"Gizem Issin, Fatih Demir, Esra Yaylı, Diren Vuslat Çağatay, İsmail Yılmaz, Rabia Burçin Girgin, Mehmet Gamsızkan, Ebru Zemheri, Hasan Aktuğ Şimşek, İlyas Sayar, Tuğba Taşkın Türkmenoğlu","doi":"10.1177/10668969261472121","DOIUrl":"https://doi.org/10.1177/10668969261472121","url":null,"abstract":"<p><p>BackgroundMalignant serous effusions may be the first manifestation of an underlying malignancy, and accurate primary-site attribution is essential. However, distinguishing Müllerian carcinoma, breast carcinoma, and mesothelioma in effusion cytology remains a challenge because of overlapping immunophenotypes. We evaluated SOX17 and TRPS1 in this setting.Materials and MethodsA multicenter retrospective cohort including 650 tissue specimens (300 breast carcinomas, 300 Müllerian tumors, and 50 mesothelial lesions) and 150 malignant serous effusion cell blocks was analyzed. SOX17 and TRPS1 expression was assessed by immunohistochemistry and compared with established markers, including PAX8, GATA3, WT1, and calretinin. Sensitivity, specificity, and positive predictive value (PPV) were calculated according to the primary diagnosis.ResultsIn the tissue cohort, SOX17 showed 87% sensitivity and 100% specificity for Müllerian tumors, with no expression in breast carcinomas or mesothelial lesions, including tumors with PAX8/WT1 co-expression. This specificity was retained in cell blocks, yielding a PPV of 100%. TRPS1 showed 98% sensitivity for breast carcinoma and identified 84% of GATA3-negative breast carcinomas. However, TRPS1 expression was also observed in 48% of tubo-ovarian serous carcinomas, limiting its PPV for breast carcinoma in effusions to 55% despite a negative predictive value of 97%.ConclusionSOX17 is a highly specific confirmatory marker for Müllerian origin and may help resolve diagnostic pitfalls related to PAX8-positive mesothelial lesions. TRPS1 is a complementary marker for breast carcinoma, including GATA3-negative tumors, but its stand-alone diagnostic value is limited by cross-reactivity in Müllerian serous carcinomas. These findings support a panel-based approach for accurate primary-site attribution in malignant serous effusions.</p>","PeriodicalId":14416,"journal":{"name":"International Journal of Surgical Pathology","volume":" ","pages":"10668969261472121"},"PeriodicalIF":0.9,"publicationDate":"2026-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149008332","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":"Histologic Clues Favoring Cytomegalovirus Hepatitis in Liver Allograft Biopsies With Overlapping Rejection-Type Injury.","authors":"Shunsuke Koga, Yusuf Ozcelik, Liping Wang, Sujani Madabhushi, Kristen M Stashek, Emma E Furth, Zahra Alipour, Rashmi Tondon","doi":"10.1177/10668969261476070","DOIUrl":"https://doi.org/10.1177/10668969261476070","url":null,"abstract":"<p><p>BackgroundCytomegalovirus (CMV) hepatitis after liver transplantation may mimic or coexist with acute T-cell-mediated rejection (TCMR), complicating treatment decisions. We sought practical histologic features favoring CMV hepatitis in liver allograft biopsies with overlapping rejection-type changes.MethodsWe retrospectively studied 12 patients with CMV hepatitis and 12 CMV immunohistochemistry-negative acute TCMR controls. CMV hepatitis required viral cytopathic inclusions on hematoxylin and eosin sections at the index biopsy. Two liver pathologists, including one blinded reviewer, re-reviewed hematoxylin and eosin sections; discrepancies were resolved by consensus. C4d immunohistochemistry was performed on all index biopsies and reviewed descriptively. One CMV biopsy was excluded from comparative histologic analysis because the deeper study level was unreliable, leaving 11 CMV and 12 TCMR biopsies.ResultsClinical and transplant characteristics were similar between groups. Plasma CMV DNA was detected in all tested CMV patients and absent in tested TCMR controls. Definite concurrent acute TCMR was diagnosed in 2 of 12 CMV biopsies, while 9 were indeterminate or not evaluable for TCMR. CMV hepatitis more often showed microgranulomas (7/11 vs 1/12; <i>P</i> = .009) and neutrophilic microabscesses (4/11 vs 0/12; <i>P</i> = .037). Bile duct injury was less frequent in CMV hepatitis (7/11 vs 12/12; <i>P</i> = .037) and was usually mild and patchy when present. Venous endotheliitis was common in both groups.ConclusionsMicrogranulomas, neutrophilic microabscesses, and less frequent, usually mild bile duct injury favor CMV hepatitis. These findings do not exclude concurrent TCMR but should prompt careful search for viral inclusions, a low threshold for CMV immunohistochemistry, and close clinicopathologic correlation.</p>","PeriodicalId":14416,"journal":{"name":"International Journal of Surgical Pathology","volume":" ","pages":"10668969261476070"},"PeriodicalIF":0.9,"publicationDate":"2026-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149008468","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}