Journal of Clinical Pathology最新文献_第5页

Liver disease diagnostics and access barriers in African settings: a narrative review. 非洲肝病诊断和获取障碍：叙述性回顾。

IF 2.6 4区医学

Journal of Clinical Pathology Pub Date : 2026-07-17 DOI: 10.1136/jcp-2026-210662

Habiblah Ayomide Jagunmolu, Emmanuel Oyedeji Oyetola, Yusuff Abiola Lawal, Stella Odunayo Akinsanya, Mukhtar Abimbola Ibrahim, Toluwanimi Oladele Idowu, Samuel Oyeponle Oyelude, Muminat Adeyemi Jubreel, Dhikrat Olamide Ajibade, Taofeek Oyetola Olaniyi, AbdulFatai Arikewuyo Sheriff

{"title":"Liver disease diagnostics and access barriers in African settings: a narrative review.","authors":"Habiblah Ayomide Jagunmolu, Emmanuel Oyedeji Oyetola, Yusuff Abiola Lawal, Stella Odunayo Akinsanya, Mukhtar Abimbola Ibrahim, Toluwanimi Oladele Idowu, Samuel Oyeponle Oyelude, Muminat Adeyemi Jubreel, Dhikrat Olamide Ajibade, Taofeek Oyetola Olaniyi, AbdulFatai Arikewuyo Sheriff","doi":"10.1136/jcp-2026-210662","DOIUrl":"10.1136/jcp-2026-210662","url":null,"abstract":"In Africa, chronic liver conditions are discordantly higher due to infectious and parasitic aetiologies, especially viral hepatitis. Early diagnosis is a linchpin for successful management and improved outcomes; however, diagnostic power is extremely limited. Yet, profound gaps compromise every step of the diagnostic continuum. Histopathological evaluation through liver biopsy remains the gold standard for establishing aetiology, grading inflammation and staging fibrosis. Biopsy services in Africa are limited by limited infrastructure, a deficit of qualified professionals, substantial costs, unreliable tissue samples and limited access to advanced pathology techniques such as immunohistochemistry and molecular testing. Non-invasive diagnostic tools such as serum markers, transient elastography and imaging techniques are unequally accessible, poorly updated for African-specific aetiologies and largely inaccessible outside tertiary centres. This review explores the aetiological spectrum of chronic liver disease in Africa and evaluates the availability and performance of both histological and non-invasive diagnostic techniques. This review illustrates gaps affecting screening, staging, initiation of management and he⁠patoc⁠e‍llular carcino‍ma surveillance. Addressing these diagnostic limitations through improved infrastructure, expanded professional training and local validation of non-invasive tools is essential to reducing the burden of liver disease across Africa. In addition, it offers tiered and feasible recommendations while considering the current reality of healthcare in sub-Saharan Africa.","PeriodicalId":15391,"journal":{"name":"Journal of Clinical Pathology","volume":" ","pages":"513-522"},"PeriodicalIF":2.6,"publicationDate":"2026-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13479226/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148054474","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}

引用次数: 0

Digital diagnostic pathology between promise and professional erosion: artificial intelligence and the future of diagnostic sovereignty. 数字诊断病理学在承诺和职业侵蚀之间：人工智能和诊断主权的未来。

IF 2.6 4区医学

Journal of Clinical Pathology Pub Date : 2026-07-17 DOI: 10.1136/jcp-2026-210728

Glen Kristiansen

引用次数: 0

Diagnostic yield and cost of three-level H&E sectioning in prostate biopsies. 前列腺活检中三级H&E切片的诊断率和费用。

IF 2.6 4区医学

Journal of Clinical Pathology Pub Date : 2026-07-17 DOI: 10.1136/jcp-2026-210815

Ruth Gichinga, Marcos Lepe, Quinn Rainer, Laura C Collins, Yue Sun

{"title":"Diagnostic yield and cost of three-level H&E sectioning in prostate biopsies.","authors":"Ruth Gichinga, Marcos Lepe, Quinn Rainer, Laura C Collins, Yue Sun","doi":"10.1136/jcp-2026-210815","DOIUrl":"10.1136/jcp-2026-210815","url":null,"abstract":"Aim: The traditional three-level H&E sectioning protocol for prostate biopsies was developed for ultrasound-guided systematic sampling and predates lesion-targeted biopsy approaches. Multiparametrical MRI (mpMRI) has improved detection of clinically significant prostate carcinoma but has also increased biopsy volume, workload, costs and digital pathology requirements, including whole-slide imaging and artificial intelligence (AI) integration.Methods and results: A retrospective institutional cost-yield analysis was performed on prostate biopsy cases at Beth Israel Deaconess Medical Center (2015-2022), comparing systematic 12-core biopsies with combined systematic and mpMRI-targeted biopsies. Case volume, tissue blocks and H&E slides were analysed. Per-slide costs were calculated, and additional digital pathology and AI workflow costs were estimated using published data and vendor pricing. Case volume increased by 27% over 7 years, while combined systematic and mpMRI-targeted protocols increased tissue blocks and H&E slides by 39%. The cost per H&E slide was $7.18, with digital pathology and AI workflows adding an estimated $4.30-5.00 per slide. In systematic 12-core biopsies, third-level sectioning identified four additional low-volume carcinomas at a cost of $2283 per diagnosis. In combined biopsies, two additional carcinomas were detected exclusively on the third level, both Grade Group 1, with a cost of $27 657 per diagnosis.Conclusion: Routine three-level H&E sectioning in combined systematic and mpMRI-targeted prostate biopsies demonstrated low incremental diagnostic yield and substantial additional processing cost. A two-level protocol with selective third-level sectioning may preserve detection of clinically significant carcinomas in this institutional cohort, while reducing workload and cost in the digital pathology era.","PeriodicalId":15391,"journal":{"name":"Journal of Clinical Pathology","volume":" ","pages":"555-559"},"PeriodicalIF":2.6,"publicationDate":"2026-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148163264","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}

引用次数: 0

Secondary BRAF-mutated histiocytic/dendritic cell sarcoma transdifferentiated from follicular lymphoma with prolonged response to BRAF/MEK inhibition and subsequent evolution to high-grade B-cell lymphoma. 继发性BRAF突变的组织细胞/树突状细胞肉瘤从滤泡性淋巴瘤转分化，对BRAF/MEK抑制的反应延长，随后演变为高级别b细胞淋巴瘤。

IF 2.6 4区医学

Journal of Clinical Pathology Pub Date : 2026-07-17 DOI: 10.1136/jcp-2026-210638

Claire Royer-Chardon, Bettina Bisig, Mounir Trimech, Baptiste Guey, Edoardo Missiaglia, Sophie Voruz, Alban Denys, Anne Cairoli, Laurence de Leval

{"title":"Secondary BRAF-mutated histiocytic/dendritic cell sarcoma transdifferentiated from follicular lymphoma with prolonged response to BRAF/MEK inhibition and subsequent evolution to high-grade B-cell lymphoma.","authors":"Claire Royer-Chardon, Bettina Bisig, Mounir Trimech, Baptiste Guey, Edoardo Missiaglia, Sophie Voruz, Alban Denys, Anne Cairoli, Laurence de Leval","doi":"10.1136/jcp-2026-210638","DOIUrl":"10.1136/jcp-2026-210638","url":null,"abstract":"Transdifferentiation from follicular lymphoma (FL) to histiocytic/dendritic cell sarcoma (HDS) is rare and requires molecular confirmation of shared clonal origin. Targetable mutations such as BRAF V600E may offer therapeutic opportunities in such aggressive neoplasms. We report an exceptional case of untreated localised FL transdifferentiated to an HDS after 18 years. Shared BCL2 rearrangement and mutation profile confirmed a clonal link, while the HDS acquired an additional BRAF V600E mutation. Treatment with BRAF/MEK inhibitors yielded a sustained 18-month clinical response. The disease later relapsed as high-grade B-cell lymphoma with MYC and BCL2 rearrangements (HGBCL-MYC/BCL2), still harbouring the BRAF mutation. Complete remission was achieved with Rituximab, Cyclophosphamide, Hydroxydaunorubicin, Oncovin and Prednisone, but the double-hit lymphoma relapsed 14 months later.This case illustrates sequential transformation from FL to BRAF-mutated HDS with excellent response to BRAF/MEK inhibition, followed by evolution into HGBCL-MYC/BCL2 responding transiently to immunochemotherapy, emphasising the value of repeated histological and molecular reassessment in FL evolution.","PeriodicalId":15391,"journal":{"name":"Journal of Clinical Pathology","volume":" ","pages":"562-572"},"PeriodicalIF":2.6,"publicationDate":"2026-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148211467","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}

引用次数: 0

Risk stratification in locally invasive pancreatic serous cystic neoplasms: systematic review and two cases. 局部浸润性胰腺浆液性囊性肿瘤的风险分层：系统回顾和2例。

IF 2.6 4区医学

Journal of Clinical Pathology Pub Date : 2026-07-17 DOI: 10.1136/jcp-2025-210480

Cong Tan, Xinyi Chen, Shu-Juan Ni, Meng Zhang, Xu Cai, Wenhua Jiang, Weiqi Sheng, Dan Huang

{"title":"Risk stratification in locally invasive pancreatic serous cystic neoplasms: systematic review and two cases.","authors":"Cong Tan, Xinyi Chen, Shu-Juan Ni, Meng Zhang, Xu Cai, Wenhua Jiang, Weiqi Sheng, Dan Huang","doi":"10.1136/jcp-2025-210480","DOIUrl":"10.1136/jcp-2025-210480","url":null,"abstract":"Aims: Current diagnostic criteria for pancreatic serous cystadenocarcinoma (SCC) create a grey zone for tumours that are locally invasive but not yet metastatic. We sought to resolve this ambiguity by defining the clinicopathological features and searching for the malignant potential of this aggressive subset of serous neoplasms.Methods: A combined cohort of 25 patients was compiled from a systematic literature review and augmented with two institutional cases.Results: Infiltrative growth was a near-universal finding (23/25), often in tumours with a prominent solid architecture. This growth pattern was reflected by frequent local invasion into adjacent organs (40%). The malignant potential of these neoplasms was confirmed by the development of metachronous distant metastases in 28% of patients (median time: 40.5 months) despite their absence at presentation. Our institutional cases highlight the diagnostic value of Ki-67 immunohistochemistry, revealing markedly elevated proliferation indices (5% and 10% in hotspots) that starkly contrast with those of conventional serous cystadenomas (<2%).Conclusion: Local invasion in serous neoplasms, especially when combined with a solid architecture and high Ki-67 index, defines a high-risk subset highly suspicious for serous cystadenocarcinoma. This interpretation must be balanced against the generally indolent behaviour of most serous neoplasms, and such cases warrant closer clinical surveillance.","PeriodicalId":15391,"journal":{"name":"Journal of Clinical Pathology","volume":" ","pages":"541-547"},"PeriodicalIF":2.6,"publicationDate":"2026-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13479205/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147972826","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}

引用次数: 0

Clinical characteristics and outcomes of myeloid neoplasms with MECOM rearrangements. 髓系肿瘤伴MECOM重排的临床特点及预后。

IF 2.6 4区医学

Journal of Clinical Pathology Pub Date : 2026-07-17 DOI: 10.1136/jcp-2025-210232

Chantana Polprasert, Chinadol Wanitpongpun, Chantiya Chanswangphuwana, Thanawat Rattanathammethee, Pimjai Niparuck, Narittee Suksawai, Ponthip Mekchay, Weerapat Owattanapanich, Smith Kungwankiattichai, Ekarat Rattarittamrong, Adisak Tantiworawit, Wasithep Limvorapitak, Supawee Saengboon, Jakrawadee Julamanee, Pirun Saelue, Kannadit Prayongratana, Ekapun Karoopongse, Ponlapat Rojnuckarin, Suporn Chuncharunee, Chantrapa Sriswasdi

引用次数: 0

MTAP loss in gallbladder carcinoma: frequency, heterogeneity and expression in precursor lesions. 胆囊癌中MTAP缺失：频率、异质性和在前驱病变中的表达。

IF 2.6 4区医学

Journal of Clinical Pathology Pub Date : 2026-07-17 DOI: 10.1136/jcp-2026-210781

Valentina Angerilli, Jessica Gasparello, Monia Niero, Giacomo Zanus, Matteo Fassan

引用次数: 0

Digital Ki-67 quantification in neuroendocrine tumours: comparing performance of camera-captured images and open-source platforms across imaging modalities. 神经内分泌肿瘤中的数字Ki-67量化：跨成像模式的相机捕获图像和开源平台的比较性能。

IF 2.6 4区医学

Journal of Clinical Pathology Pub Date : 2026-07-17 DOI: 10.1136/jcp-2026-210759

Nandan Padmanabha, Ruben Oganesyan, Laurie O'brien, Debbie Li, Shaelyn Widener, Buthaina Hakamy, Osman Yilmaz, Laura C Collins, Vikram Deshpande, Raul S Gonzalez, Monika Vyas

{"title":"Digital Ki-67 quantification in neuroendocrine tumours: comparing performance of camera-captured images and open-source platforms across imaging modalities.","authors":"Nandan Padmanabha, Ruben Oganesyan, Laurie O'brien, Debbie Li, Shaelyn Widener, Buthaina Hakamy, Osman Yilmaz, Laura C Collins, Vikram Deshpande, Raul S Gonzalez, Monika Vyas","doi":"10.1136/jcp-2026-210759","DOIUrl":"10.1136/jcp-2026-210759","url":null,"abstract":"Aims: Accurate assessment of the Ki-67 proliferation index (PI) is essential for grading and prognostication of gastrointestinal well-differentiated neuroendocrine tumours (NETs). While manual counting (MC) of 500-2000 tumour cells remains the standard, digital image analysis (DIA) offers potential advantages in efficiency and reproducibility. We evaluated the comparability of open-source DIA platforms on camera-captured (CC) images and whole-slide images (WSI) for Ki-67 quantification.Methods: Ki-67 hotspot areas of 70 NETs were photographed using a microscope-mounted camera. PI was determined by MC (gold standard) and compared with automated counts in 68 cases (two excluded owing to high background staining) using QuPath (V.0.4.4). In a randomly selected subset of 20 cases, the same hotspot areas were analysed using ImageJ, ChatGPT V.4.0 (colour-based segmentation) and the IHCexpert.com platform. Additionally, WSI files of these 20 cases were imported into QuPath for DIA; PI of identical areas were compared against static images.Results: DIA using QuPath (on CC images) demonstrated excellent agreement with MC (intraclass correlation coefficient). Only one case showed grade reclassification (manual G1, 2.92%; DIA G2, 3.38%). In the subset analysis (n=20), comparable Ki-67 indices were observed across all digital platforms and between CC images and WSI. Grade switches from changes in Ki-67 PI were observed in two additional cases (G2 to G1 in IHCexpert.com group and G1 to G2 in ChatGPT group).Conclusions: Our findings offer the prospect of eliminating variability in the analysis of PI estimation. Of note, CC images yield results similar to WSI, supporting broader applicability in resource-limited practice settings.","PeriodicalId":15391,"journal":{"name":"Journal of Clinical Pathology","volume":" ","pages":"548-554"},"PeriodicalIF":2.6,"publicationDate":"2026-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148015690","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}

引用次数: 0

Concordance of conventional two-tier HER2 classification versus three-tier classification (including HER2-low status) in invasive breast carcinoma: a retrospective real-world analysis. 浸润性乳腺癌传统两层HER2分类与三层HER2分类（包括HER2低状态）的一致性：一项回顾性现实世界分析

IF 2.6 4区医学

Journal of Clinical Pathology Pub Date : 2026-07-17 DOI: 10.1136/jcp-2026-210710

Archita Juneja, Ayushi Sahay, Pooja Padwale, Asawari Patil, Trupti Pai, Poonam Panjwani, Shalaka Joshi, Tabassum Wadasadawala, Palak Popat, Tanuja M Shet, Sudeep Gupta, Sangeeta B Desai

{"title":"Concordance of conventional two-tier HER2 classification versus three-tier classification (including HER2-low status) in invasive breast carcinoma: a retrospective real-world analysis.","authors":"Archita Juneja, Ayushi Sahay, Pooja Padwale, Asawari Patil, Trupti Pai, Poonam Panjwani, Shalaka Joshi, Tabassum Wadasadawala, Palak Popat, Tanuja M Shet, Sudeep Gupta, Sangeeta B Desai","doi":"10.1136/jcp-2026-210710","DOIUrl":"10.1136/jcp-2026-210710","url":null,"abstract":"Aim: To compare changes in HER2 expression status on reassessment across multiple clinical groups using new three-tier versus traditional binary HER2 reporting schemas.Methods: Retrospective study of 1107 paired IBC samples wherein HER2 immunohistochemistry (IHC) and, where needed, in-situ hybridisation (ISH) were performed at least twice in four clinical groups: core needle biopsy (CNB)-upfront resection (n=277); CNB-post-chemotherapy resection (n=104); primary (CNB/resection)-recurrence (local/metastatic, n=702); initial and subsequent distant metastasis (n=24). Concordance was noted for HER2-positive (HER2-IHC 3+ or 2+ ISH-amplified), negative (HER2-IHC 0) and low (HER2-IHC 1+ and 2+ ISH-non-amplified) status, and compared with the concordance of binary HER2 status (positive/negative).Results: HER2 concordance dropped sharply to 69.7% (k=0.53, 95% CI 0.48 to 0.57) on reassessment after applying the three-tier schema, driven primarily by bidirectional shifts between HER2-negative (IHC 0) and HER2-low. Referral specimens showed poorer concordance than in-house tissue in both binary (p value <0.001, OR: 2.40, 95% CI 1.40 to 4.10) and ternary classification (p value <0.001, OR: 1.72, 95% CI 1.31 to 2.2), emphasising the effects of pre-analytical factors like fixation on HER2 interpretation.Conclusions: The three-tier HER2-low classification schema demonstrates poor reproducibility on re-evaluation, with nearly one-third of cases discordant. This fluidity has significant therapeutic implications. We recommend HER2 re-evaluation with careful attention to the 0 versus 1+ distinction, especially in metastatic and post-treatment settings and when pre-analytical factors are suboptimal.","PeriodicalId":15391,"journal":{"name":"Journal of Clinical Pathology","volume":" ","pages":"526-533"},"PeriodicalIF":2.6,"publicationDate":"2026-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148030803","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}

引用次数: 0

Microbiological characteristics of granulomatous lobular mastitis revealed by metagenomic sequencing. 宏基因组测序揭示肉芽肿性小叶性乳腺炎的微生物学特征。

IF 2.6 4区医学

Journal of Clinical Pathology Pub Date : 2026-07-17 DOI: 10.1136/jcp-2026-210744

Yirui Diao, Jianrong Li, Luyao Wang, Qiong Zhang, Chenhui Xu, Ajing Peng, Chaoyi Lu, Baoyong Lai, Ruifu Chen, Junpeng Chen, Xiaohua Pei

{"title":"Microbiological characteristics of granulomatous lobular mastitis revealed by metagenomic sequencing.","authors":"Yirui Diao, Jianrong Li, Luyao Wang, Qiong Zhang, Chenhui Xu, Ajing Peng, Chaoyi Lu, Baoyong Lai, Ruifu Chen, Junpeng Chen, Xiaohua Pei","doi":"10.1136/jcp-2026-210744","DOIUrl":"10.1136/jcp-2026-210744","url":null,"abstract":"Aims: Granulomatous lobular mastitis (GLM) is a rare, chronic, benign inflammatory disease of the breast with an unclear aetiology. This study aimed to characterise the microbial features of GLM using metagenomic next-generation sequencing (mNGS) and to provide potentially relevant microbial clues for clinical evaluation.Methods: Twenty fresh lesion tissue samples were collected from 15 female patients with GLM, including one representative sample per patient and five additional deep tissue samples. Clinical data collection, mNGS, bioinformatics analysis and data interpretation were performed to characterise the microbial profiles of GLM lesions.Results: In this study, all patients presented with palpable breast masses, breast pain and abscess formation. More than half showed increased white blood cell counts, neutrophil percentages, C reactive protein levels and erythrocyte sedimentation rates together with decreased lymphocyte percentages. Based on genus-level filtering, mNGS identified 16 bacterial genera, 14 fungal genera and 3 viral genera, revealing a complex but bacteria-dominated microbial profile. The most frequently detected bacterial genera were Corynebacterium, Cutibacterium, Acinetobacter, Staphylococcus and Hathewaya, with marked interpatient variation in relative abundance, while fungal profiles were relatively more concentrated. In five patients with both superficial and deep tissue samples, microbial profiles differed across sampling depths, particularly for bacterial composition.Conclusions: mNGS revealed a complex, bacteria-dominated microbial profile in GLM lesions and indicated that sampling depth may influence the detected microbial profiles. These findings may provide useful clues for clinical evaluation, but the pathogenic significance of these micro-organisms remains to be elucidated.","PeriodicalId":15391,"journal":{"name":"Journal of Clinical Pathology","volume":" ","pages":"534-540"},"PeriodicalIF":2.6,"publicationDate":"2026-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148225584","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}

引用次数: 0