Journal of Clinical Pathology最新文献

{"title":"Karyotypic clonal fraction predicts adverse outcome in <i>TP53</i>-mutated myeloid neoplasms: an International <i>TP53</i> investigators Network (iTiN) study.","authors":"Madhavi Pandiri, Anna Stengel, Jingjing Zhang, Peng Wang, Haipeng Shao, Sinthujaa Velmurugan, Anisha Jacob, Emily Symes, Amandeep Kaur, Alexandra Rojek, Payal Sojitra, Danica Wiredja, Qianghua Zhou, Hong Chang, Esha Patil, Jay L Patel, Ami B Patel, Madhu Menon, Sharmila Ghosh, Geoffrey D Wool, Daniel A Arber, Zenggang Pan, Anthony Findley, Talha Badar, Hamza Tariq, David Sallman, Robert C Bell, Anamarija Perry, Claudia Haferlach, Carrie Fitzpatrick, Girish Venkataraman","doi":"10.1136/jcp-2024-209954","DOIUrl":"10.1136/jcp-2024-209954","url":null,"abstract":"<p><p>We investigated the prognostic impact of blast counts, <i>TP53</i> allelic state determinants (number of hits, del(17p), variant allele frequency, complex karyotype),and a novel karyotypic clonal cell fraction (≤50% clonal cells vs >50% clonal cells (termed 'CK50')) in 495 individuals with <i>TP53-</i>mutated (<i>TP53^MUT</i> ) myeloid neoplasms. Outcome examined was 24-month survival (OS24). The cohort (median age 71) included 29% (144/495) myelodysplastic syndromes (MDS)/MDS-acute myeloid leukaemia (AML) (1%-19% blasts) and 71% (351/495) AML (≥20% blasts), with 18% (81/460) having low CK50. Overall, 83% received front-line hypomethylating agents. Higher blast counts (<20% vs ≥20%) were marginally associated with CK50 (p=0.08). In the OS24 analysis, blast count showed a marginal association with OS24 (HR 1.3 (95% CI 1.0 to 1.6); p=0.07), while CK50 predicted significantly inferior outcomes (HR=1.7 (95% CI 1.2 to 2.3); p=0.002). In a multivariable model including all <i>TP53</i> allelic state determinants, only CK50 and complex karyotype remained relevant for predicting adverse outcomes.</p>","PeriodicalId":15391,"journal":{"name":"Journal of Clinical Pathology","volume":" ","pages":"629-635"},"PeriodicalIF":2.0,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144505830","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":"Reverse polarity in pseudopyloric metaplasia in Crohn's disease.","authors":"Soumya Gupta, Srinivas Bojanapu, Sanjay A Pai","doi":"10.1136/jcp-2025-210264","DOIUrl":"10.1136/jcp-2025-210264","url":null,"abstract":"","PeriodicalId":15391,"journal":{"name":"Journal of Clinical Pathology","volume":" ","pages":"651-652"},"PeriodicalIF":2.0,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144560185","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":"If you provide them, they will come: an observational study of online pathology report access by patients at a large, academic, tertiary care hospital in Canada.","authors":"Jacob Ranot, Pedram Noghani, Deanna Rothwell, Jason K Wasserman","doi":"10.1136/jcp-2025-210065","DOIUrl":"10.1136/jcp-2025-210065","url":null,"abstract":"<p><strong>Aims: </strong>Patients of The Ottawa Hospital (TOH) are given immediate access to their pathology reports via an online patient portal. The purpose of this study was to determine how often patients accessed their reports, the sociodemographic and pathologic variables associated with access and the latency between sign out and access.</p><p><strong>Methods: </strong>This retrospective cross-sectional observational study was conducted on the first 250 consecutive pathology reports published in 2023 from 10 different subspecialties in anatomical pathology at TOH. Data regarding date/time of report publication and access, as well as demographic data, and variables related to the individual report contents were extracted from the hospital's electronic health records.</p><p><strong>Results: </strong>Of the 2500 patients included in this study, 1315 (52.6%) accessed their report online. Patients under 65 years of age, female patients and those residing within Ottawa were more likely to access their reports. Biopsies and reports with malignant diagnoses were accessed at higher rates than resections and benign cases, respectively. 463 (36.0%) patients accessed their reports within 24 hours; 822 (68.5%) accessed them within the first week. In 53% of cases, the patient accessed their report before the treating physician.</p><p><strong>Conclusions: </strong>These findings highlight that while over half of patients accessed their pathology reports online, significant differences in access rates were observed based on age, gender, location and report type. The high proportion of patients reviewing their reports before their treating physician underscores the need for patient-centred strategies to enhance understanding and support timely communication of results.</p>","PeriodicalId":15391,"journal":{"name":"Journal of Clinical Pathology","volume":" ","pages":"636-640"},"PeriodicalIF":2.0,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143523393","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":"Biliary adenofibroma of the liver with dysplastic features: a case report.","authors":"Manel Moalla, Nermine Ellouze, Hela Fendri, Imed Keskes, Amira Abdelmoula, Hend Smaoui, Majdi Kchaou, Slim Charfi, Sami Fendri, Tahya Sellami, Zeineb Mnif, Salah Boujelbene, Hela Gdoura, Nabil Tahri","doi":"10.1136/jcp-2025-210075","DOIUrl":"10.1136/jcp-2025-210075","url":null,"abstract":"","PeriodicalId":15391,"journal":{"name":"Journal of Clinical Pathology","volume":" ","pages":"648-649"},"PeriodicalIF":2.0,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143700522","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":"Clinicopathological features of EBV-positive polymorphic B-cell lymphoproliferative disorders involving central nervous system in people living with HIV.","authors":"Jing Wang, Dong Zeng, Fengxiang Song, Zhenyan Wang, Ming Liang, Yuexiang Yang, Wenjuan Guo, Yuhan Shi, Ao Wang, Duoduo Li, Keyu Liu, Zhidong Hu, Yanling Feng","doi":"10.1136/jcp-2024-209958","DOIUrl":"10.1136/jcp-2024-209958","url":null,"abstract":"<p><strong>Aim: </strong>To investigate the histomorphological, immunophenotypic and molecular pathological features of Epstein-Barr virus (EBV)-positive polymorphic B-cell lymphoproliferative disorders (LPD) of the central nervous system (CNS) in people living with HIV.</p><p><strong>Methods: </strong>Seven HIV-positive patients with primary CNS lesions were retrospectively analysed. According to the 5th edition of the WHO Classification of Haematolymphoid Tumours and 2022 International Consensus Classification of mature B-cell lymphomas, these patients were pathologically diagnosed based on their H&E staining, immunohistochemistry, immunoglobulin heavy chain (IGH) clonality analysis, EBV-encoded RNA (EBER) fluorescence in situ hybridisation (FISH) and clinical data.</p><p><strong>Results: </strong>MRI revealed lesions in the frontal lobe, cerebellar vermis, occipital lobe, temporal lobe, basal ganglia and thalamus, with four patients exhibiting lesions in multiple locations. Histopathological examination revealed polymorphic lymphocytic infiltrates in brain tissue, including lymphocytes, histiocytes, immunoblasts, plasma cells, atypical large B-cell and Hodgkin-Reed-Sternberg-like cells, with B-cell predominantly. Lymphocytic infiltration was mainly perivascular, with focal coagulative necrosis observed in four cases. Immunohistochemistry identified B-cell (CD20+, CD79a+), large B-cell and immunoblasts (CD30+), T-cell (CD3+), histiocytes (CD68+) and plasma cells (CD138+). All cases were positive for BCL-2 and Ki67 (20%-60%+), with three cases positive for EBNA2. All cases were negative for LMP1, HHV8, Bcl-6 and CD15. EBER in situ hybridisation was positive in all cases, and five cases showed IGH clonal rearrangement. FISH testing for IGH breakage recombination was negative in all seven cases.</p><p><strong>Conclusion: </strong>Accurate diagnosis of EBV-positive polymorphic B-cell LPD in the CNS of HIV patients requires a comprehensive approach including histology, immunophenotyping, molecular testing, and clinical information.</p>","PeriodicalId":15391,"journal":{"name":"Journal of Clinical Pathology","volume":" ","pages":"599-604"},"PeriodicalIF":2.0,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144225603","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":"CD31 expression in human cancers: a pan-cancer immunohistochemical study.","authors":"Ayumi Ito, Yukinobu Ito, Hiroko Ikeda, Masafumi Horie, Yasufumi Omori, Akiteru Goto, Daichi Maeda","doi":"10.1136/jcp-2024-210009","DOIUrl":"10.1136/jcp-2024-210009","url":null,"abstract":"<p><strong>Aims: </strong>CD31 (platelet endothelial cell adhesion molecule 1) is a transmembrane glycoprotein involved in cell adhesion and signal transduction that is primarily expressed in vascular endothelial cells, platelets, neutrophils, and certain tumour cells. We investigated CD31 expression in cancer cells by conducting a pan-cancer gene expression analysis using data from cancer cell lines as well as an immunohistochemical analysis of surgically resected cancer specimens. The goal was to elucidate the frequency and distribution of CD31 expression across cancer types and its diagnostic significance.</p><p><strong>Methods: </strong>Gene expression data from 1073 cancer cell lines were analysed to determine the frequency of CD31 expression across different cancer types. Immunohistochemical analysis was performed on 358 resected cancer specimens, focusing on adenocarcinomas and squamous cell carcinomas. The analysis compared the frequency of CD31 expression among specific cancer subtypes and between histological types.</p><p><strong>Results: </strong>In gene expression analyses, adenocarcinomas showed a higher frequency of CD31 expression than did squamous cell carcinomas. Immunohistochemically, CD31 expression was observed in breast apocrine carcinomas (40.0%), hepatocellular carcinomas (18.8%), uterine endometrioid adenocarcinomas (31.6%), ovarian high-grade serous carcinomas (20.0%), ovarian clear cell carcinomas (40.0%) and urothelial carcinomas (25.0%). No CD31 expression was detected in oesophageal, renal, prostate or cervical cancers.</p><p><strong>Conclusions: </strong>CD31 expression is more frequent in adenocarcinomas than in squamous cell carcinomas, with variability among cancer subtypes. Recognising CD31-positive cancers is critical to avoid misdiagnosing them as endothelial-derived tumours. The mechanisms underlying CD31 expression in cancer remain unclear and warrant further investigation.</p>","PeriodicalId":15391,"journal":{"name":"Journal of Clinical Pathology","volume":" ","pages":"623-628"},"PeriodicalIF":2.0,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144132450","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":"Characterising the challenges of managing difficult red blood cell alloantibodies in liver transplant recipients.","authors":"Yevgen Chornenkyy, Margaret Catherine Fink, Christopher Felicelli, Sean R Stowell, Glenn Eugene Ramsey, Guang-Yu Yang","doi":"10.1136/jcp-2024-209399","DOIUrl":"10.1136/jcp-2024-209399","url":null,"abstract":"<p><strong>Aims: </strong>Formation of red blood cell alloantibodies (RBCAs) complicates transfusion support in liver transplantation (LT). Difficult RBCAs (DAs, >3 antibodies or antibodies for which <25% donors are antigen negative) further challenge care. This study characterises DA outcomes relative to non-difficult RBCAs (NDAs).</p><p><strong>Methods: </strong>Single-centre, retrospective analysis of LT patients (2002-2021). RBCAs were defined as clinically significant antibodies. DAs were compared with NDAs.</p><p><strong>Results: </strong>89 patients had clinically significant RBCAs (DA=50, NDA=39). More DAs were anti-Jka, anti-M; fewer were anti-E, anti-K (all p<0.05). DA patients often had multiple antibodies (44% vs 12.8% NDA, p=0.0022). Probability of finding antigen-negative blood was lower for DAs (17.4% vs 68.1% NDA, p<0.0001) as was RBCs received (9.4 vs 14.7 units in NDA, p=0.0036). Although survival was similar, patients with DAs had more adverse reactions (8% vs 0%, p=0.128). Some antibodies appeared to occur with specific liver diseases (such as primary sclerosing cholangitis, alcoholic steatohepatitis and recurrent disease); however, due to low sample size, definitive conclusions cannot be made.</p><p><strong>Conclusions: </strong>DA LT recipients contain >1 RBCA, have a lower probability of finding antigen negative blood and may experience more adverse transfusion event (ATE). Despite this, the incidence of ATEs was still quite low.</p>","PeriodicalId":15391,"journal":{"name":"Journal of Clinical Pathology","volume":" ","pages":"641-647"},"PeriodicalIF":2.0,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140945089","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":"PD-L1 expression in schistosomal granuloma: an immunohistochemical study in urinary bladder schistosomiasis.","authors":"Rofyda E Elhalaby, Wael O Zeina, Liza Nessim, Mohamed E Ahmed, Noura N Kamel, Shady E Anis, Haidong Dong, John C Cheville, Eugene D Kwon","doi":"10.1136/jcp-2025-210271","DOIUrl":"https://doi.org/10.1136/jcp-2025-210271","url":null,"abstract":"<p><strong>Aims: </strong>Schistosomiasis remains endemic in various parts of the world, and insights into pathogen immunobiology are mainly based on experimental models, while studies on human tissues are limited.</p><p><strong>Methods: </strong>We explored the role of immune checkpoint pathway by evaluating the immunohistochemical expression of programmed death-ligand 1 (PD-L1) in a retrospective cohort of patients with bilharzial cystitis. Inflammation severity by conventional histology and staining intensity by immunohistochemistry were assigned three-tier scores (0/1+/2+), and a cut-off for staining percentage was set at 5%.</p><p><strong>Results: </strong>38 biopsies from 31 patients were considered adequate for evaluation, and positive staining was detected in 80.6% of patients (34 biopsies). High expressors (22.6%) showed strong positive membranous staining (score 2+) with high staining density (more than 5% of inflammatory cells). Low expressors (58.1%) showed mild/moderate staining (score 1+) predominantly in less than 5% of the cells (91.6%) or expressed restricted cytoplasmic staining (6/31). All high expressors showed severe inflammation (score 2+) (p<0.001), and viable ova were only observed in these cases. Calcified ova were associated with mild/moderate inflammation or absent/minimal inflammation, correlating with low expressors or non-expressors (19.4%), respectively.</p><p><strong>Conclusion: </strong>Schistosomal granuloma exhibits upregulated PD-L1 expression proportional to inflammation severity and pathogen viability, highlighting a critical immune checkpoint engagement in disease pathology.</p>","PeriodicalId":15391,"journal":{"name":"Journal of Clinical Pathology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144855362","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":"Fifth edition WHO classification: mature B-cell neoplasms.","authors":"Kikkeri N Naresh, Kennosuke Karube, Anita Borges, Wah Cheuk, Sumeet Gujral, Shahin Sayed, Aliyah Sohani, Stefano Lazzi, German Ott, Ming-Qing Du, Lorenzo Leoncini, John K C Chan","doi":"10.1136/jcp-2025-210260","DOIUrl":"https://doi.org/10.1136/jcp-2025-210260","url":null,"abstract":"<p><p>We present a review of mature B-cell neoplasms as described in the fifth edition of the WHO classification of haematolymphoid tumours (WHO-HAEM5). Entities have expanded, and definitions are increasingly reliant on genomic and other technologies. However, the WHO-HAEM5 employs a hierarchical structure with family (class)-level definitions that group several specific entities. This approach enables the assignment of a family-level diagnosis when criteria for specific entities cannot be met due to resource constraints. To facilitate application in resource-limited settings, WHO-HAEM5 divides diagnostic criteria into 'essential' and desirable criteria for most entities. This review focuses on changes and updates in B-cell lymphoma classification, providing guidance on how to apply the WHO classification in resource-limited settings.</p>","PeriodicalId":15391,"journal":{"name":"Journal of Clinical Pathology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144846655","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":"Chinese guidelines for HER2 testing in breast cancer (2024 edition): summary of key recommendations.","authors":"Yueping Liu, Zhiyong Liang, Hong Bu, Wentao Yang","doi":"10.1136/jcp-2025-210175","DOIUrl":"https://doi.org/10.1136/jcp-2025-210175","url":null,"abstract":"<p><p>In December 2024, the Chinese expert panel released the updated Chinese Guidelines for human epidermal growth factor receptor 2 (HER2) testing in breast cancer (2024 edition), building on the 2019 version and incorporating recent advancements. These guidelines, referred to as the 2024 guidelines, feature significant format changes, enhance clinical applicability and provide more robust evidence-based recommendations. Identifying patients who may benefit from emerging anti-HER2 antibody-drug conjugates (ADCs) therapies has become increasingly important. The 2024 guidelines provide comprehensive guidance on the interpretation and reporting of relevant HER2 statuses. Recent advances in HER2 testing methods, along with the potential role of artificial intelligence in enhancing testing precision, are introduced. The 2024 guidelines reinforce quality control standards across multiple aspects of the testing process, including optimised specimen handling protocols, refined decalcification procedures, improved unstained slide preservation conditions and enhanced gradient external controls. These comprehensive updates are designed to improve the accuracy and clinical relevance of HER2 testing, ultimately contributing to better patient outcomes in breast cancer management.</p>","PeriodicalId":15391,"journal":{"name":"Journal of Clinical Pathology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144764961","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}