Journal of Clinical Pathology最新文献

{"title":"Lymph node metastases characteristics and spread patterns in prostatic adenocarcinoma with seminal vesicle invasion: a comprehensive analysis.","authors":"Faisal Saeed, Adeboye O Osunkoya","doi":"10.1136/jcp-2025-210299","DOIUrl":"https://doi.org/10.1136/jcp-2025-210299","url":null,"abstract":"<p><strong>Aims: </strong>Seminal vesicle invasion (SVI) in prostatic adenocarcinoma (PCa) is a high-risk feature associated with lymph node (LN) metastasis and adverse outcomes. However, the impact of SVI laterality on LN metastasis patterns, nodal burden, metastatic focus size and extranodal extension (ENE) remains underexplored.</p><p><strong>Methods: </strong>We retrospectively analysed 225 PCa patients with SVI who underwent radical prostatectomy with LN dissection. Associations between SVI laterality, tumour grade, volume and nodal parameters were assessed using univariable and multivariable models.</p><p><strong>Results: </strong>LN metastases were identified in 97 of 225 (43.1%) patients. Bilateral SVI was significantly associated with higher odds of LN metastasis (OR=2.01; p=0.040), nodal burden (IRR=1.89; p=0.004) and ENE (OR=3.76; p=0.013), independent of tumour volume, grade, age and race. Tumour volume and grade independently predicted LN metastasis (p=0.004 and p=0.048, respectively) and were associated with metastatic focus size (p=0.003 and p<0.001, respectively) and nodal burden (p=0.061 and p=0.045, respectively). LN spread mirrored SVI extent: unilateral SVI primarily led to ipsilateral involvement (22/36; 61.1%; p<0.001), while bilateral SVI increased the risk of bilateral spread (OR=3.81; p=0.003). White patients had significantly higher LN metastasis rates than black patients (p=0.010).</p><p><strong>Conclusions: </strong>Bilateral SVI is a strong, independent predictor of LN metastasis, nodal burden and ENE. SVI laterality also correlates with LN spread patterns and could inform future risk stratification, though further validation is needed.</p>","PeriodicalId":15391,"journal":{"name":"Journal of Clinical Pathology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144955495","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":"Shortwave infrared imaging increases the number of lymph nodes and improves cancer staging: a 104-patient study.","authors":"Julie M Jorns, Randall S Smith, Dennis Strenk, Greg Stauble, Sihem Khelifa, Ryan Seltzer, John Manuel, Matthew W Rosenbaum, James Almas, Zhongming Li","doi":"10.1136/jcp-2024-210038","DOIUrl":"https://doi.org/10.1136/jcp-2024-210038","url":null,"abstract":"<p><strong>Aims: </strong>Adequate lymph node examination is key to accurate cancer staging. This study investigates the effectiveness of shortwave infrared imaging in increasing the overall and positive lymph node numbers.</p><p><strong>Methods: </strong>Specimens from various anatomic sites, including colorectal, pancreatic, breast, gastric, skin and small bowel resections, were evaluated. 104 specimens were first grossed with manual palpation and then grossed with the assistance of shortwave infrared imaging. The overall and positive lymph node numbers were documented.</p><p><strong>Results: </strong>In 90 of the 104 cases (86.5%), shortwave infrared imaging helped identify additional lymph nodes. On average, 4.81 additional lymph nodes were found. In 11 of the 104 cases (10.6%), additional positive lymph nodes were found. In 4 of the 104 cases (3.8%), cancer stages were changed.</p><p><strong>Conclusions: </strong>Shortwave infrared imaging may increase the number of lymph nodes identified and has the potential to improve cancer staging accuracy. Further validation in larger, randomised or prospective studies is warranted.</p>","PeriodicalId":15391,"journal":{"name":"Journal of Clinical Pathology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144955490","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":"Immunohistochemical evaluation of ERG expression in soft tissue tumours: a tissue microarray study of 489 cases.","authors":"David I Suster, Andrew M Bellizzi, Alexander Craig Mackinnon, Saul Suster","doi":"10.1136/jcp-2025-210045","DOIUrl":"https://doi.org/10.1136/jcp-2025-210045","url":null,"abstract":"<p><strong>Aims: </strong>To investigate immunohistochemical expression of the E26 transformation-specific factors (ETS)-related gene (<i>ERG</i>) in a large number of soft tissue neoplasms using a tissue microarray technique.</p><p><strong>Methods: </strong>489 cases of soft tissue neoplasms, including benign and malignant entities, were collected from the files of the respective institutions and constructed into tissue microarrays. Tissue microarrays were stained for ERG immunohistochemistry using two antibodies, EP111 and EPR3864.</p><p><strong>Results: </strong>A total of 25 cases (5.1%) were identified that were positive for ERG using the monoclonal antibody EP111 and 15 cases (3%) using the monoclonal antibody EPR3864, including rhabdomyosarcoma, peripheral nerve sheath tumours, synovial sarcoma, myxofibrosarcoma, epithelioid sarcoma, dermatofibrosarcoma protuberans, low-grade fibromyxoid sarcoma, nodular fasciitis and dedifferentiated liposarcoma. The most consistently stained tumours included synovial sarcoma, rhabdomyosarcoma and benign and malignant peripheral nerve sheath tumours. Various other fibroblastic proliferations, including dermatofibrosarcoma protuberans, myxofibrosarcoma, low-grade fibromyxoid sarcoma and nodular fasciitis, also showed positive staining in a small fraction of cases. One case of dedifferentiated liposarcoma showed nuclear positivity for ERG, and one case of epithelioid sarcoma was also positive.</p><p><strong>Conclusions: </strong>This study supports the value of ERG as a highly sensitive and specific marker for the diagnosis of vascular neoplasms but also demonstrates rare cases of aberrant staining and underscores the need to assess soft tissue tumours using a panel of stains and interpret the results of immunohistochemistry in the appropriate histological and clinical context.</p>","PeriodicalId":15391,"journal":{"name":"Journal of Clinical Pathology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144955351","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":"Mediastinal paravertebral Müllerian cyst identified in a male patient.","authors":"Daiki Mihara, Mao Yoshikawa, Machiko Hotta, Masahiro Takatani, Hiroyuki Tao","doi":"10.1136/jcp-2025-210214","DOIUrl":"https://doi.org/10.1136/jcp-2025-210214","url":null,"abstract":"","PeriodicalId":15391,"journal":{"name":"Journal of Clinical Pathology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144955509","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":"Bronchial mucoacinar carcinoma: a newly proposed subtype of mucoepidermoid carcinoma in the bronchus.","authors":"Yu Zhang, Rui Liang, Gabriel Christopher Purnell, Lei Yan, Alia Nazarullah, Sarah Hackman, Courtney Thomas, Aaron M Abarbanell, Aaron Sugalski, Jeffrey L Foster, Linda P Thomas, Phillip Ong, Daniel DeArmond, Marjorie Parker David, Faqian Li","doi":"10.1136/jcp-2024-210027","DOIUrl":"10.1136/jcp-2024-210027","url":null,"abstract":"<p><p>Primary lung tumours are rare in paediatric patients. Mucoepidermoid carcinoma (MEC), typically low-grade and diagnostically straightforward, is the second most common tumour of the bronchus after carcinoid tumours. However, rare MEC may show divergent differentiation, be misdiagnosed as low-grade adenocarcinoma, not otherwise classified, and pose clinical challenges, especially when mastermind-like protein 2 (MAML2) gene arrangement is negative by fluorescence in situ hybridisation (FISH). Here, we report an MAML2 FISH-negative low-grade bronchial tumour in a juvenile patient that demonstrates both mucoepidermoid and acinar differentiation based on morphology and immunophenotype. Next-generation sequencing identified a CREB regulated transcription coactivator 3 (<i>CRTC3::MAML2</i>) fusion gene, located upstream of traditional translocation points and potentially undetectable by currently available FISH probes. This tumour appears to be a novel presentation of a bronchial tumour with dual mucoepidermoid and acinar differentiation, first described as mucoacinar carcinoma-a newly proposed subtype of MEC, originally described in the major salivary gland.</p>","PeriodicalId":15391,"journal":{"name":"Journal of Clinical Pathology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144882948","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 the Singapore recurrence nomogram in a US cohort with a higher proportion of borderline and malignant phyllodes tumours.","authors":"Ellery H Reason, Samantha M Thomas, Jennifer K Plichta, Astrid M Botty van den Bruele, E Shelley Hwang, Betty C Tong, Nicole A Larrier, Rachel E Factor, Juneko E Grilley-Olson, Laura H Rosenberger","doi":"10.1136/jcp-2025-210252","DOIUrl":"10.1136/jcp-2025-210252","url":null,"abstract":"<p><strong>Aims: </strong>For phyllodes tumours (PT), local and distant recurrence rates increase with higher grades and are difficult to predict. The Singapore nomogram has been used to predict recurrence events for PT. We aimed to test this nomogram for accuracy in a US cohort and to compare with a histological score.</p><p><strong>Methods: </strong>Patients with PT were selected from a prospective institutional database. Histological parameters and margin status were used to estimate the nomogram score and the histological score, as previously defined. Multivariable analyses were used to estimate the association of recurrence-free survival (RFS) with individual factors, nomogram score and histological score. Harrel's C-index was estimated.</p><p><strong>Results: </strong>Of 81 PT cases, 25.9% were benign, 40.7% borderline and 33.3% malignant. Recurrences occurred in 33.3% (n=27). The adjusted RFS analysis including the four factors used in the Singapore nomogram performed well (C-index of 0.78). However, despite a higher nomogram score being associated with increased risk of recurrence (HR 1.03, 1.01-1.05, p=0.007), the individual numeric scale defined in the nomogram only moderately fit our data (C-index of 0.66). Patients with higher histological scores also had an increased risk of recurrence (HR 1.25, 1.07-1.47, p=0.005; C-index of 0.70).</p><p><strong>Conclusion: </strong>Histological score more accurately predicted PT recurrence in our cohort, which includes a higher proportion of higher-grade PT. Refining the nomogram to include factors specific to malignant PT and factors with more variance, as well as refining the assigned weights, may result in improved performance. This study identifies an opportunity for international collaboration to refine the predictive model.</p>","PeriodicalId":15391,"journal":{"name":"Journal of Clinical Pathology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144882950","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":"\"Find Your Y\": histological differences in early stage (pT) and post-treatment (ypT) oesophageal adenocarcinoma with implications for salvage endoscopic resection.","authors":"Richard R Pacheco, Goo Lee, Zhaohai Yang, Jingmei Lin, Deepa T Patil, Mariam Youssef, Qingzhao Zhang, Ahmad Mahmoud Alkashash, Jingwei Li, Hwajeong Lee","doi":"10.1136/jcp-2024-209688","DOIUrl":"10.1136/jcp-2024-209688","url":null,"abstract":"<p><strong>Aims: </strong>Current guidelines offer limited strategies for managing recurrent/persistent oesophageal adenocarcinoma (EAC). Salvage endoscopic mucosal/submucosal resection (ER) shows promise in oesophageal squamous cell carcinoma, however its success in EAC is limited. We aimed to elucidate histological characteristics influencing salvage ER success in patients with low-stage, pretreated EAC.</p><p><strong>Methods: </strong>We retrospectively reviewed 272 EAC tumours postoesophagectomy from five US centres and collected clinicopathological data including discontinuous growth (DG), defined as separate tumour foci ≥2 mm from the main tumour. We selected 101 patients with low-stage disease and divided them into treatment-naïve (n=70) and neoadjuvant therapy (n=31) groups. We compared the two groups and differences in clinical, histological and outcome characteristics were identified.</p><p><strong>Results: </strong>In the entire cohort (n=272), DGs were identified in 22% of cases. Multivariate analysis revealed DGs as an independent prognostic factor for recurrence and positive oesophagectomy margins. Lymphovascular invasion (LVI) and background intestinal metaplasia predicted DG presence and absence, respectively. Compared with the treatment-naïve low T-stage subgroup, the pretreated subgroup exhibited higher incidence of poorly differentiated carcinoma (16% vs 46%, p=0.007), larger tumours (14 vs 30 mm, p<0.001), higher tumour, node, metastases stage (7% vs 30%, p=0.004), more nodal disease (7% vs 36%, p<0.001) and frequent DGs (1% vs 13%, p=0.030).</p><p><strong>Conclusions: </strong>In treated low T-stage EACs, DGs may contribute to suboptimal outcomes following salvage ER. Presence of LVI (as a surrogate for DGs) and poor differentiation in the absence of intestinal metaplasia in biopsy samples may serve as histological poor prognosticators in treated patients with EAC being considered for salvage ER.</p>","PeriodicalId":15391,"journal":{"name":"Journal of Clinical Pathology","volume":" ","pages":"591-598"},"PeriodicalIF":2.0,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142055685","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":"In triple-negative breast cancer, fibrotic focus, the mitotic activity index and tumour-infiltrating lymphocytes have independent prognostic value: an observational population-based cohort study with very long follow-up.","authors":"Umay Kiraz, Emma Rewcastle, Kirsten B Pettersen, Desmond M Abono, Sadia H Raghe, Einar G Gudlaugsson, Jan P A Baak, Emilius A M Janssen","doi":"10.1136/jcp-2024-209855","DOIUrl":"10.1136/jcp-2024-209855","url":null,"abstract":"<p><strong>Aims: </strong>Triple-negative breast cancer (TNBC) is prognostically and therapeutically heterogeneous. The mitotic activity index (MAI) and fibrotic focus (FF) have been established as predictors in non-TNBC but not in TNBC. Late distant metastases occur in TNBC, but previous studies had short follow-up. High stromal tumour-infiltrating lymphocytes (sTILs) are prognostically favourable, but prognostic sTILs-thresholds are not well assessed. We evaluated prognostic/predictive characteristics in an observational population-based cohort of 231 consecutive TNBC patients with long follow-up.</p><p><strong>Methods: </strong>MAI, FF, sTILs and other characteristics were analysed with standard receiver operating characteristic curve analysis, percentile-derived prognostic thresholds, univariate and multivariate survival methods. A TNBC index and decision tree were assessed for distant metastasis-free survival.</p><p><strong>Results: </strong>Long follow-up was decisive: 7% of patients developed late distant metastases. In agreement with the aggressive nature of TNBC, the strongest prognostic MAI-threshold was 5 (p=0.001), lower than that for non-TNBC phenotypes. Lymph-node (LN) status (p=0.0003), FF (p=0.002), MAI5 (p=0.009) and sTILs (threshold 40%, p=0.003) were multivariable based significant and independent prognosticators, but no other characteristics (age, tumour size and grade). LN status was the strongest prognosticator, followed by FF, MAI5 and sTILs40. Subgroup analyses of patients undergoing adjuvant chemotherapy (ACT) showed that only FF and sTILs had significant prognostic value, while LN-positivity and the combination of LN-positivity and MAI≥5 could be a predictive factor for ACT outcome.</p><p><strong>Conclusions: </strong>LN status, MAI5, FF and sTILs40 are prognostic factors in TNBC patients. In TNBC patients who have undergone ACT, the combination of LN-positivity and MAI5 is predictive for response to treatment.</p>","PeriodicalId":15391,"journal":{"name":"Journal of Clinical Pathology","volume":" ","pages":"614-622"},"PeriodicalIF":2.0,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12421104/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143449107","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":"Biliary adenofibroma: is it truly a benign neoplasm or benign-looking cholangiocarcinoma?","authors":"Yoh Zen, Claudio Luchini","doi":"10.1136/jcp-2025-210126","DOIUrl":"10.1136/jcp-2025-210126","url":null,"abstract":"","PeriodicalId":15391,"journal":{"name":"Journal of Clinical Pathology","volume":" ","pages":"581-582"},"PeriodicalIF":2.0,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144528201","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":"Identification of immune cell markers associated with ulcerative colitis histological disease activity in colonic biopsies.","authors":"Pavine L C Lefevre, Zhongya Wang, Wendy Teft, Guangyong Zou, Tanja Van Viegen, Bryan Linggi, Vipul Jairath, Brian G Feagan, Rish K Pai, Niels Vande Casteele","doi":"10.1136/jcp-2023-209327","DOIUrl":"10.1136/jcp-2023-209327","url":null,"abstract":"<p><strong>Aims: </strong>Accurate determination of histological activity in ulcerative colitis (UC) is essential given its diagnostic and prognostic importance. Data on the relationship between histology and immune cell markers are limited. We aimed to evaluate the association between histological disease activity and immune cell marker concentration in colonic biopsies from patients with UC.</p><p><strong>Methods: </strong>Sigmoid colon biopsies from 20 patients with UC were retrospectively assessed using the Robarts Histopathology Index (RHI). Targeted mass spectrometry determined the concentration of 18 immune cell markers (cluster of differentiation (CD) 4, CD8, CD19, CD20, CD40, CD56, CD68, CD103, forkhead box p3 (FOXP3), human leucocyte antigen, DR alpha chain (HLA-DRA), interleukin 10 (IL-10), IL-23 subunit alpha (IL-23A), IL-23 receptor (IL-23R), IL-2 receptor alpha chain (IL-2RA), Ki67, lymphocyte-activation gene 3 (LAG-3), programmed cell death protein 1 (PD-1) and PD ligand 1 (PD-L1)). The association between RHI score and immune cell marker concentration was quantified using Spearman's rank correlation coefficient (ρ) and related 95% CIs.</p><p><strong>Results: </strong>Fourteen of the 18 immune cell marker proteins were detected, with tissue concentration ranging from 0.003 to 11.53 fmol/µg. The overall RHI score was positively correlated with CD19, CD20, CD40, FOXP3, LAG-3, PD-1 and PD-L1 concentration (ρ=0.596-0.799) and negatively correlated with CD56 concentration (ρ=-0.460). There was no significant association between RHI score and CD4, CD8, CD68, CD103, HLA-DRA or Ki67 concentration.</p><p><strong>Conclusions: </strong>This study provides insight into the correlation between immune cell marker expression and histological disease activity and the possible molecular and immunological determinants underlying microscopic disease activity in UC.</p>","PeriodicalId":15391,"journal":{"name":"Journal of Clinical Pathology","volume":" ","pages":"605-613"},"PeriodicalIF":2.0,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139990228","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}