International Journal of Surgical Pathology最新文献

{"title":"A Rare Placental Site Nodule Involving the Ovary.","authors":"Saroja Devi Geetha, Sudarshana Roychoudhury, Sunder Sham, Alexander M Truskinovsky","doi":"10.1177/10668969241269974","DOIUrl":"10.1177/10668969241269974","url":null,"abstract":"<p><p>Placental site nodule (PSN) is a benign lesion representing a nodular aggregate of intermediate trophoblast, embedded in a hyalinized stroma, thought to arise from noninvoluted placental site remaining from a past gestation. Uterus is the most common site of PSN. Occurrence in extrauterine sites is rare, with most examples being reported in the fallopian tubes. Here we report an example of PSN in the ovary. A 35-year-old woman, gravida 4, para 1, with history of adnexal ectopic pregnancy treated with methotrexate, at 39 weeks and 1 day of a subsequent pregnancy, underwent a scheduled C-section. The surgery was successful, and a healthy female infant was delivered. Intraoperative adnexal inspection revealed a small pedunculated mass on the right ovary, which was excised and sent for pathological examination. Gross inspection showed a soft, tan-white tissue fragment measuring 2.0 × 1.0 × 0.2 cm. Microscopic examination showed epithelioid cells with hyperchromatic, mildly atypical nuclei and abundant eosinophilic cytoplasm, embedded in a hyalinized stroma, forming a nodule. A diagnosis of placental site nodule was made. Immunohistochemical stains for keratin AE1/AE3, vimentin, and inhibin were strongly positive in the epithelioid cells, and immunostain for p63 was focally positive, supporting the diagnosis. PSN of the ovary is extremely rare. To our knowledge, there has been only one reported patient in the literature so far. Extrauterine PSNs are thought to arise from ectopic pregnancies. Our patient's ovarian PSN is most likely a consequence of her previous adnexal ectopic pregnancy, which was treated medically.</p>","PeriodicalId":14416,"journal":{"name":"International Journal of Surgical Pathology","volume":" ","pages":"745-748"},"PeriodicalIF":0.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142008787","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":"AI-Based Computational H&E Staining Enables Spatial Transcriptomic Analysis in Classic Hodgkin Lymphoma.","authors":"Michael E Kallen, Laura M Wake, Rima Koka, Elba Vidal, Raymond Kozikowski, Yair Rivenson, Serge Alexanian","doi":"10.1177/10668969241268410","DOIUrl":"10.1177/10668969241268410","url":null,"abstract":"","PeriodicalId":14416,"journal":{"name":"International Journal of Surgical Pathology","volume":" ","pages":"666-669"},"PeriodicalIF":0.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142008788","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":"Letter to the Editor Regarding \"Primary Well-Differentiated Neuroendocrine Tumor/Carcinoid of the Prostate: Case Report and Review of Literature\".","authors":"Begum Calım Gurbuz, Elif Gokce Devecioglu Gursen, Ramazan Ugur, Ibrahim Kulac, Dilek Ertoy Baydar","doi":"10.1177/10668969241308203","DOIUrl":"10.1177/10668969241308203","url":null,"abstract":"","PeriodicalId":14416,"journal":{"name":"International Journal of Surgical Pathology","volume":" ","pages":"791-794"},"PeriodicalIF":0.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142948992","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":"Extra-Axial Poorly Differentiated Chordoma Initially Misdiagnosed as Epithelioid Sarcoma.","authors":"Paige O'Connor, Yvonne Y Cheung, Donald C Green, Joel A Lefferts, Vickie Y Jo, Darcy A Kerr","doi":"10.1177/10668969241286086","DOIUrl":"10.1177/10668969241286086","url":null,"abstract":"<p><p>Poorly differentiated chordoma is an exceedingly rare, aggressive subtype of chordoma. These tumors typically arise in the axial skeleton of young patients, most commonly the skull base, followed by the cervical spine. Herein, we present a 60-year-old patient with longstanding knee pain and nondiagnostic imaging, initially thought to be due to osteoarthritis. No discrete mass-forming lesion was identified by radiology. Synovial histology at the time of arthroplasty revealed a multinodular proliferation of epithelioid-to-histiocytoid cells with a moderate amount of eosinophilic-to-clear, vacuolated cytoplasm. Scattered cells with high-grade nuclear atypia were present. A diagnosis of metastatic carcinoma was considered due to immunohistochemical positivity for keratin and GATA3. However, a diagnosis of epithelioid sarcoma was rendered based on clinical context, morphology, and loss of immunohistochemical expression for SMARCB1 (INI1). However, upon re-review of the tumor, brachyury was retrospectively added to the immunohistochemistry panel and showed strong positivity, thus prompting amendment of the initial diagnosis of epithelioid sarcoma to extra-axial poorly differentiated chordoma. Given the rarity of this diagnosis, molecular testing was performed which revealed a unique <i>SMARCB1</i> molecular profile with a single-nucleotide variant in addition to the commonly reported loss of chromosome 22q. This report of an ultra-rare sarcoma in an uncommon anatomic site highlights multiple potential pitfalls in the diagnosis of poorly differentiated chordoma, emphasizes the importance of brachyury immunohistochemistry in rendering a correct interpretation, and underscores an opportunity for further molecular analysis to better define the molecular profile of this entity.</p>","PeriodicalId":14416,"journal":{"name":"International Journal of Surgical Pathology","volume":" ","pages":"646-655"},"PeriodicalIF":0.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142620529","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":"Medical Students' Impression of Surgical Pathology as a Career in Saudi Arabia.","authors":"Mehenaz Hanbazazh, Samar M Altoukhi, Lama S Aldawsari, Maysaa A Alghamdi, Nada K Ameen, Raneem M Khashab, Saad Samargandy, Abeer Zakariyah","doi":"10.1177/10668969241286081","DOIUrl":"10.1177/10668969241286081","url":null,"abstract":"<p><p>Background and objectivesSurgical<b>/</b>anatomical pathologists study diseases to provide accurate diagnoses, identify pathogens, and participate in treatment. However, there is a need for more surgical pathologists worldwide due to low recruitment rates. One contributing factor is the medical students' interest and knowledge about surgical pathology as a career option. Understanding medical students' knowledge and perceptions about surgical pathologist jobs is crucial for future physicians, as it influences collaboration with pathologists and impacts patient care outcomes. This study aims to evaluate medical students' knowledge of surgical pathologists' jobs in Saudi Arabian medical colleges, which will help identify gaps in knowledge and develop targeted interventions to promote interest in surgical pathology as a career. For simplicity, in this study, we refer to anatomical/surgical pathology as \"pathology\".Methods and resultsA cross-sectional study was done in Saudi Arabia with a total of 478 medical students examining their perception of pathologist's job using a validated questionnaire distributed through social media platforms. The study revealed that 322 (67%) had no interest and did not consider becoming pathologists in the future, and 194 (40%) chose lack of patient contact as the main reason for not joining this field. However, 15% of the students think that pathologists have flexible lifestyle.ConclusionOur study shows that many students are not interested in pathology as a career, with varied responses revealing uncertainty about pathologists' roles. To spark interest, universities should involve students in laboratories and decision-making processes, prioritize understanding pathologists' roles, and emphasize their impact on patients' lives.</p>","PeriodicalId":14416,"journal":{"name":"International Journal of Surgical Pathology","volume":" ","pages":"630-635"},"PeriodicalIF":0.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142346700","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":"Defining the Etiology of Renal Allograft Dysfunction Using Banff 2019 Classification: Correlation with Post-Transplant Duration and Creatinine Levels-A Comprehensive Analysis of 200 Renal Biopsies at a Tertiary Care Medical Center Hospital.","authors":"Rabia Saleem, Humaira Nasir, Tushar Chakravarty, Ibrahim Mansoor, Sama Alazawi, Casem Ballouk, Mohammad Abdulwaasey, Nuha Shaker, Omar P Sangueza, Nada Shaker","doi":"10.1177/10668969241283737","DOIUrl":"10.1177/10668969241283737","url":null,"abstract":"&lt;p&gt;&lt;p&gt;ObjectiveChronic kidney disease is a growing global health issue, contributing significantly to morbidity and mortality. The incidence of end-stage renal disease (ESRD) is approximately 100 per million population. Renal transplantation remains the cornerstone treatment for ESRD, with a projected 20-year survival rate of 60%. We aim to define the etiology of renal allograft dysfunction using the Banff 2019 classification by analyzing 200 renal allograft biopsies in correlation with creatinine levels across post-transplant time frames.Methodology200 renal allograft biopsies are analyzed using the recent Banff 2019 classification with creatinine levels and post-transplant duration correlation.ResultsThe study included 150 (75%) male patients and 50 (25%) female patients, with the majority 78 (39%) representing the age group of 16-30 years. 36 (18%) biopsies were within 3-month post-transplant, while 92 (46%) were 2-year post-transplant. According to the Banff 2019 classification, 92 (46.0%) transplant rejection biopsies were identified, with most 54 (27%) exhibiting antibody-mediated rejection (Category 2), including 40 (20%) active acute antibody-mediated rejection (ABMR) and 14 (7.0%) chronic active ABMR. T-cell-mediated rejection (TCMR; Category 4) represented 12 (6%) biopsies, including 10 (5%) acute TCMR and 2 (1%) chronic active TCMR. Category 5, the miscellaneous group, represented 100 (50%) biopsies, out of which 32 (16%) exhibited calcineurin inhibitor (CNI) toxicity, 38 (19%) acute tubular necrosis, and 8 (4%) thrombotic microangiopathy. A notable variation in the dysfunction distribution across different post-transplant time frames indicated a temporal evolution in the underlying causes of allograft dysfunction. Specific Banff categories showed a robust association with renal dysfunction, potentially contributing to the elevation of creatinine levels and renal function deterioration.ConclusionOur study highlights the intricate pathophysiology of renal allograft dysfunction. Most biopsies were attributed to ABMR whereas one-third of biopsies exhibited mixed lesions (ABMR and TCMR or ABMR and calcineurin inhibitor toxicity (CNIT)). Additionally, this study suggests that renal allograft rejection remains a significant contributor to graft dysfunction. A complex interplay between histological findings, Banff classification, and renal function is noted. A significant difference in the distribution of dysfunction across post-transplant time frames is noted suggesting a temporal evolution in the etiology of allograft dysfunction. Certain Banff categories demonstrate a stronger association with renal dysfunction that may influence creatinine level increase and renal function deterioration. In correspondence to the recent Banff 2019 guidelines for diagnosing ABMR, we emphasize the role of C4d staining on immunofluorescence or immunohistochemistry in allograft biopsies as imperative for timely diagnosis and immunosuppressant therapy adjustmen","PeriodicalId":14416,"journal":{"name":"International Journal of Surgical Pathology","volume":" ","pages":"615-622"},"PeriodicalIF":0.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142365198","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":"Myoid Hamartoma of the Breast With <i>HMGA2</i> Rearrangement and Associated In-Situ and Invasive Carcinoma: Case Report and Review of Literature.","authors":"Flora Mae G Sta Ines, Shivali Marketkar, Stephanie Ng, Padmini Manrai, C James Sung, Julia A Bridge, Kamaljeet Singh","doi":"10.1177/10668969241271420","DOIUrl":"10.1177/10668969241271420","url":null,"abstract":"<p><p>Myoid hamartoma of the breast is an uncommon benign breast neoplasm. We describe an unusual example of an in-situ and invasive carcinoma arising in a myoid hamartoma. We also describe the unique molecular findings in the myoid hamartoma and review the pertinent literature. In radiology studies, the mammogram showed increased density/attenuation, and the ultrasound revealed a change in the overall echogenicity with hyperechoic and anechoic areas. The stromal compartment contained smooth muscle bundles and adipose tissue on microscopic examination. The stromal cells showed <i>HMGA2</i> gene rearrangement by fluorescence in-situ hybridization analysis and overexpression of HMGA2 by immunohistochemistry. The breast myoid hamartoma is likely underpinned by <i>HMGA2</i> gene rearrangement and HMGA2 protein overexpression, which can be used as an ancillary test to diagnose this rare breast lesion. Although most myoid hamartomas have a benign clinical course, the likelihood of malignant transformation should always be considered.</p>","PeriodicalId":14416,"journal":{"name":"International Journal of Surgical Pathology","volume":" ","pages":"689-699"},"PeriodicalIF":0.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142545415","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":"Solitary Fibrous Tumor of the Stomach in a Patient With Autoimmune Atrophic Gastritis: A Case Report.","authors":"Sumayya Aslam, Arnav Chandan, Sejal S Shah","doi":"10.1177/10668969241283492","DOIUrl":"10.1177/10668969241283492","url":null,"abstract":"","PeriodicalId":14416,"journal":{"name":"International Journal of Surgical Pathology","volume":" ","pages":"673-675"},"PeriodicalIF":0.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142390459","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":"Extra-Skeletal Osteosarcoma of the Prostate After Treated Prostatic Acinar Adenocarcinoma: A Case Report and Review of the Literature.","authors":"Carmen Rodríguez García, David Ramos Soler, Asunción Torregrosa Andrés, Javier Pérez Ardavín, Luis A Rubio Martínez, Francisco Giner Segura","doi":"10.1177/10668969241283735","DOIUrl":"10.1177/10668969241283735","url":null,"abstract":"<p><p>Extra-skeletal osteosarcoma is a rare form of malignant soft tissue sarcoma. Its occurrence in the prostate gland is particularly uncommon. In this case report, we present a patient diagnosed with osteosarcoma arising within the prostatic gland. A 58-year-old man was initially diagnosed with Gleason 8 prostate acinar adenocarcinoma following a transurethral resection (TUR) of the prostate. This diagnosis was accompanied by locoregional involvement and multiple bone metastases. The patient underwent a treatment regimen including complete androgen blockade, chemotherapy, greenlight laser prostate vaporization, and palliative radiotherapy. After treatment, he achieved a complete biochemical response, and his bone metastases remained stable. However, at 16 months post-diagnosis, clinical follow-up by means of radiological examinations revealed an increase in the size of the prostatic lesion, along with additional infiltration of the tumor into the rectum and bladder walls. Remarkably, a mesenchymal tumor proliferation with intratumor calcifications was observed. A subsequent TUR biopsy of the prostate showed a malignant tumor spindle and ovoid cell proliferation with high-grade nuclear atypia, necrosis, and islets of osteoid formation, leading to a final diagnosis of high-grade prostatic extra-skeletal osteosarcoma. Despite undergoing chemotherapy, the patient's condition progressed with the development of pulmonary and liver metastases, culminating in his demise.</p>","PeriodicalId":14416,"journal":{"name":"International Journal of Surgical Pathology","volume":" ","pages":"772-777"},"PeriodicalIF":0.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142346697","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":"Updated Morphological and Immunohistochemical Profile of Neuroendocrine Tumors Developing in Ovarian Teratomas: A Large Series of a Rare and Heterogeneous Disease.","authors":"J Leclerc, M Tihy, C Genestie, R Chen, O Hentic, M Koskas, S Gouy, J Y Scoazec, A Couvelard, Margot Bucau","doi":"10.1177/10668969241271923","DOIUrl":"10.1177/10668969241271923","url":null,"abstract":"<p><p>IntroductionOvarian neuroendocrine tumors are rare and often arise within mature teratoma of the ovary. No recent re-evaluation of the immunophenotype of these tumors with the new markers available in the field of neuroendocrine neoplasms has been performed. The objectives were to describe the morphologic and immunohistochemical characteristics of neuroendocrine tumors (NETs) arising from ovarian teratomas, to correlate them with the type of teratomatous epithelial components present and to evaluate their proliferative activity using the WHO recommendations for gastroenteropancreatic NETs.Materials and MethodsThis is a bi-centric retrospective study using a panel of markers (chromogranin-A, chromogranin-B, synaptophysin, CDX2, SATB2, TTF1, PAX8, islet-1, serotonin and calcitonin) and Ki-67 proliferation index.ResultsThe 34 NETs studied were unilateral and presented when it's done four distinct immunophenotypic profiles: 8 NETs expressed serotonin and CDX2 (small intestinal profile), 12 SATB2 (colorectal profile), one TTF1 (thoracic profile) and 4 \"null\" tumors expressed none of the above markers. The Ki-67 index ranged from 0 to 19.82% (median: 1.51%). 28 tumors were grade 1 (85%), 5 tumors were grade 2 (15%). They were associated with squamous (n = 26), respiratory (n = 23), thyroid (n = 10) and gastrointestinal (n = 5) components.Discussion and ConclusionThe main type of NET is intestinal phenotype, but rarely accompanied with digestive tissue. This suggests that the cell of origin may be a neuroendocrine precursor present in the teratoma, and confirms that primary NETs arising in ovarian teratomas should not be classified or named according to the type of the surrounding teratoma tissue.</p>","PeriodicalId":14416,"journal":{"name":"International Journal of Surgical Pathology","volume":" ","pages":"605-614"},"PeriodicalIF":0.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142380833","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}