Ocular Oncology and Pathology最新文献

{"title":"Tissue Glue Adhesion for Plaque Radiotherapy of Uveal Melanoma in Humans: An Initial Experience.","authors":"Kushal U Agrawal, Nicholas E Kalafatis, Konica Singla, Sara E Lally, Carol L Shields","doi":"10.1159/000529382","DOIUrl":"10.1159/000529382","url":null,"abstract":"<p><strong>Purpose: </strong>The aims of this study were to study use of tissue glue instead of conventional suturing and to secure I-125 plaque in human eyes with uveal melanoma.</p><p><strong>Methods: </strong>We studied 6 patients with choroidal melanoma undergoing plaque radiotherapy who were found to have thin sclera intraoperatively. Following tumor localization and plaque placement, tissue glue was applied over and around the plaque surface. The plaque was held securely in all cases. Conjunctivoplasty was performed with 7-0 vicryl sutures to ensure complete coverage and stability of the plaque. At the time of plaque removal, the tissue glue clot was in place with plaque secured. The clot and plaque were removed without difficulty.</p><p><strong>Results: </strong>In all 6 cases, the tissue glue secured the plaque in place for the required radiation duration (mean 117.6 h (hrs), median 103.1 h, range 101.6-162.5 h) delivering a tumor apex dose (mean 63.6 cGy/h, median 69.6 cGy/h, range 44.7-70.5 cGy/h). At the time of plaque removal, the plaque was in the designated position without displacement in all cases. There were no toxicities from the tissue glue.</p><p><strong>Conclusions: </strong>Tissue glue can serve as an alternative for fixation of plaque radiotherapy to the sclera without the need for suturing. This technique might be useful in eyes with thin sclera.</p>","PeriodicalId":19434,"journal":{"name":"Ocular Oncology and Pathology","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10821786/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82941734","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mitogen-Activated Pathway Kinase Inhibitor-Associated Retinopathy: Do Features Differ with Upstream versus Downstream Inhibition?","authors":"Jasmine H Francis, William Foulsham, Julia Canestraro, James J Harding, Eli L Diamond, Alexander Drilon, David H Abramson","doi":"10.1159/000529127","DOIUrl":"10.1159/000529127","url":null,"abstract":"<p><strong>Introduction: </strong>Many cancers have derangement of the mitogen-activated pathway kinase (MAPK), making this pathway blockade a therapeutic target. However, inhibitors of MAPK can result in adverse effects including retinopathy. This study compares clinical and morphological characteristics of serous retinal disturbances in patients taking agents with variable inhibition of MAPK: either direct interference of mitogen-activated protein kinase kinase (MEK) or extracellular signal-regulated kinase (ERK) inhibitors or with indirect inhibition via interference with FGFR signaling.</p><p><strong>Methods: </strong>This retrospective observational study of prospectively collected pooled data is from a single tertiary oncology referral center. Of 339 patients receiving MAPK inhibitors (171, 107, and 61 on FGFR, MEK, and ERK inhibitors, respectively) for treatment of metastatic cancer, this study included 128 eyes of 65 patients with evidence of retinopathy confirmed by optical coherence tomography (OCT). The main outcome was characteristics of treatment-emergent choroid/retinal OCT abnormalities as compared to baseline OCT.</p><p><strong>Results: </strong>In all patients on one of three drug classes (FGFRi, MEKi, ERKi), the retinopathy manifested as subretinal fluid foci that were bilateral, fovea involving, and reversible without intervention. There were notable differences between the three classes of drugs: the proportion of patients with retinopathy, number of fluid foci per eye, proportion of eyes with intraretinal edema, and the proportion of symptomatic patients was least for the upstream target (FGFR inhibitors) and greatest for the downstream targets (MEK or ERK inhibitors).</p><p><strong>Conclusion: </strong>This study shows MAPK pathway inhibitors may cause subretinal fluid foci with unique clinical and morphological characteristics depending on the target (FGFR, MEK, or ERK) implicated. Retinopathy is more common, more symptomatic, and more severe (more fluid foci, more expansive fluid configurations) the further downstream the MAPK pathway is inhibited.</p>","PeriodicalId":19434,"journal":{"name":"Ocular Oncology and Pathology","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10821790/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74904354","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is Tumour Thickness Measurement Required for MOLES Scoring of Melanocytic Choroidal Tumours?","authors":"Jared Ching, Lamis AlHarby, Mandeep S Sagoo, Bertil Damato","doi":"10.1159/000529862","DOIUrl":"10.1159/000529862","url":null,"abstract":"<p><strong>Introduction: </strong>It can be challenging to distinguish between choroidal naevi and melanomas in the community setting, particularly without access to ultrasonography (US), required to measure the thickness of melanocytic choroidal tumours. We aimed to determine whether thickness measurement is required for MOLES scoring of melanocytic choroidal tumours.</p><p><strong>Methods: </strong>The dataset of a recent MOLES evaluation was reviewed. Patients were selected for the present study if their MOLES tumour size category was determined by tumour thickness measured with US. The largest basal tumour diameter and tumour thickness were then measured from ultra-widefield fundus images and optical coherence tomography (OCT) images, respectively.</p><p><strong>Results: </strong>The tumour size category was determined by tumour diameter in 203/222 (91.4%) with no influence of tumour thickness. The tumour thickness influenced the MOLES score in 19/222 (8.6%) patients. In 11/19 patients with OCT measurements of tumour thickness, the US measurement exceeded the OCT by more than 25% in 5 patients, more than 50% in 2 patients, and more than 75% in 1 patient. As a result, the revised tumour thickness based on OCT determined the size category in 4/216 (1.8%) patients. The ultra-widefield fundus images measurements increased the diameter score by 1 in 5 patients. As a result, the revised tumour thickness determined the size category in 4/216 (1.8%) patients. If both the revised diameter and thickness scores were considered, the MOLES score reduced in 4 patients. If both the diameter and thickness scores were considered, the MOLES score reduced in 5 and increased in 1. Only 0.94% (2/211) of melanocytic choroidal tumours assessed with MOLES when using Optos ultra-widefield fundus images diameter and OCT to measure tumour diameter and thickness, respectively, required a change in management from a reduction in MOLES score from 1 to 0.</p><p><strong>Discussion/conclusion: </strong>This study suggests that the MOLES category for size is influenced more by the tumour diameter, if it can be measured accurately, than by the thickness. This study suggests ignoring tumour thickness if this cannot be measured accurately with OCT, unless the tumour has a mushroom shape.</p>","PeriodicalId":19434,"journal":{"name":"Ocular Oncology and Pathology","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10821789/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90996753","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Response to Cook and Alsina's Letter to Editor (Reply to Augsburger et al.).","authors":"James J Augsburger, Cassandra C Skinner, Zelia M Correa","doi":"10.1159/000529562","DOIUrl":"10.1159/000529562","url":null,"abstract":"","PeriodicalId":19434,"journal":{"name":"Ocular Oncology and Pathology","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10433092/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10046620","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Primary Subretinal Seeding in Retinoblastoma: Clinical Presentation and Treatment Outcomes.","authors":"Komal Bakal, Vishal Raval, Sai Krishna Gattu, Vijay Anand Reddy Palkonda, Swathi Kaliki","doi":"10.1159/000530497","DOIUrl":"10.1159/000530497","url":null,"abstract":"<p><strong>Introduction: </strong>The aim of this study was to describe the clinical features and treatment outcomes of primary subretinal seeding (SRS) in patients with intraocular retinoblastoma (RB).</p><p><strong>Methods: </strong>Descriptive analysis of primary SRS in 47 patients (50 eyes) with RB was performed.</p><p><strong>Results: </strong>Mean age was 19 months (range, 2-72 months), and 55% (<i>n</i> = 26) of the subjects were male. At presentation, the SRS involved two or more quadrants in 88% of eyes. Most seeds appeared yellowish gray (66%) and round to oval in shape (48%). Two-thirds of SRS were seen posterior to the equator and within 5 mm from the main tumor. Associated features included subretinal fluid in 50 eyes (100%), total retinal detachment in 28 eyes (56%), and vitreous seeds in 20 eyes (40%). Treatment included intravenous chemotherapy (IVC) (<i>n</i> = 47; 94%), enucleation (<i>n</i> = 2; 4%), and intra-arterial chemotherapy (<i>n</i> = 1; 2%). SRS treatment included adjunct use of focal transpupillary thermotherapy and/or cryotherapy (<i>n</i> = 20; 40%). Retinal tumor control was achieved in 36 eyes (76%) with 32 eyes (78%) showing a type 3 regression pattern, while SRS completely regressed in 24 (48%) eyes, partially in 15 (30%) and worsened in 2 (4%) eyes. Over a mean follow-up of 30 months (range, 3-68 months), SRS recurrence was noted in 12 eyes (29%), globe salvage was achieved in 39 eyes (78%), and 1 (4%) patient died of presumed metastasis.</p><p><strong>Conclusion: </strong>Primary SRS pose a therapeutic challenge during RB treatment. The SRS responds moderately to systemic IVC, with one-third cases showing SRS recurrence and one-fifth ultimately requiring enucleation.</p>","PeriodicalId":19434,"journal":{"name":"Ocular Oncology and Pathology","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10821785/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81658339","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Peripheral Hemorrhagic Chorioretinopathy: Differentiating Features from Choroidal Melanoma.","authors":"Guneet S Sodhi, Nakul Singh, Jacquelyn Wrenn, Arun D Singh","doi":"10.1159/000528663","DOIUrl":"10.1159/000528663","url":null,"abstract":"<p><strong>Introduction: </strong>Peripheral exudative hemorrhagic chorioretinopathy (PEHCR) is one of the leading mimickers of choroidal melanoma because of overlapping features with choroidal melanoma that make the distinction between these two entities difficult.</p><p><strong>Methods: </strong>To identify nonoverlapping diagnostic features between PEHCR and choroidal melanoma, a retrospective study of 80 patients (80 eyes); 40 patients (40 eyes) with PEHCR; and 40 patients (40 eyes) with choroidal melanoma was conducted. Ophthalmoscopic and imaging features of PEHCR and choroidal melanoma were compared. Sensitivity and specificity for identifying PEHCR and choroidal melanoma were calculated. Youden's J statistic was assessed for each diagnostic feature.</p><p><strong>Results: </strong>The most frequent clinical features of PEHCR were presence of druse (100%), hemorrhagic PED (93%), dome-shaped mass (B-scan) (90%), and subretinal/intraretinal hemorrhage (78%). Statistical analysis confirmed high sensitivity of hemorrhagic PED (0.93; 95% CI 0.80-0.98) and high specificity of clot retraction cleft, presence of lipid exudation, and bilaterality (1.00; 95% CI 0.91-1.00) as diagnostic features of PEHCR. Statistical analysis revealed presence of subretinal fluid 0.80 (95% CI 0.54-0.91) was most sensitive and presence of orange pigment, mushroom shape on B-scan, ciliary body extension, and choroidal excavation were most specific (1.00; 95% CI 0.91-1.00) for choroidal melanoma. Nonoverlapping diagnostic features of PEHCR were hemorrhagic PED, clot retraction cleft, presence of lipid exudation, and bilaterality. All PEHCR patients (100%) had at least one of these nonoverlapping diagnostic features. Nonoverlapping diagnostic features of choroidal melanoma were the presence of orange pigment, choroidal excavation, mushroom-shaped mass, and ciliary body extension (the latter 3 detected on B-scan). Youden's J statistic was highest for hemorrhagic PED and lowest for dome-shape appearance on B-scan (0.075).</p><p><strong>Conclusion: </strong>PEHCR and choroidal melanoma can be differentiated by identifying diagnostic features that are exclusive to each entity. The presence of hemorrhagic PED strongly supports a diagnosis of PEHCR. B-scan ultrasonography is required to detect a mushroom-shaped mass, choroidal excavation, or ciliary body extension to exclude underlying choroidal melanoma.</p>","PeriodicalId":19434,"journal":{"name":"Ocular Oncology and Pathology","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10433100/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10046621","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dendritic Melanocytic Hyperplasia in Pterygia: A Potential Source of Diagnostic Confusion with Primary Acquired Melanosis.","authors":"Angela J Oh, Ben J Glasgow","doi":"10.1159/000530514","DOIUrl":"10.1159/000530514","url":null,"abstract":"<p><strong>Introduction: </strong>The aim of this study was to report the nearly ubiquitous prevalence of melanocytic hyperplasia in benign pterygia/pingueculae and establish that the entity is insufficiently recognized.</p><p><strong>Methods: </strong>This is a retrospective immunohistochemical pathology case series of 30 consecutive pterygia/pingueculae samples selected from an ophthalmic pathology database at a single institution. Histopathologic and immunohistochemistry analyses with anti-SOX-10 and anti-MART-1 antibodies were used for identifying melanocytes. The number of squamous cells intervening between melanocytes was determined.</p><p><strong>Results: </strong>The frequency of dendritic melanocytes was found to meet the criteria for dendritic melanocytic hyperplasia in 29 of 30 pterygia/pingueculae samples using specific antibodies. Melanocytes were found in several patterns: diffuse (28%), multifocal (28%), and focal (44%). In each case, the melanocytes were distributed as single melanocytes at the base; clusters of melanocytes were seen in 17% of samples. There were an average of about two intervening epithelial cells between melanocytes at the base.</p><p><strong>Conclusion: </strong>When diagnosed with immunohistochemistry, dendritic melanocytic hyperplasia is nearly ubiquitous in pterygia and pingueculae. Melanocytic hyperplasia may have a distribution that includes nests and single melanocytes above the basal layer, which can be confused with forms of primary acquired melanosis. It is important for pathologists to recognize these lesions as a distinct benign clinicopathologic entity.</p>","PeriodicalId":19434,"journal":{"name":"Ocular Oncology and Pathology","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10821784/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79291024","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Angiographic Features of Iris Melanocytic Tumors: Nevus versus Melanoma.","authors":"Janani Singaravelu, Alexander Melendez-Moreno, Jacquelyn Wrenn, Arun D Singh","doi":"10.1159/000529073","DOIUrl":"10.1159/000529073","url":null,"abstract":"<p><strong>Introduction: </strong>Determining the nature of iris melanocytic tumors based on clinical exam alone remains challenging. Tumor-associated vasculature of iris melanocytic lesions may facilitate the ability to discern between iris nevus and melanoma.</p><p><strong>Methods: </strong>In a single-institution, retrospective, observational study of 45 patients with pathologically confirmed iris melanoma and 15 patients with iris nevi that were either clinically stable or pathologically confirmed were included. Tumor characteristics and associated vasculature were identified on clinical exam and slit-lamp photographs. Fluorescein angiographic parameters including feeder vessels, intrinsic vessels, leakage, masking, and angiographic silence were assessed.</p><p><strong>Results: </strong>Feeder vessels were present in 17 (43%) melanomas and were absent in the nevus group (<i>p</i> = 0.002). Thirty-three (83%) iris melanomas and 5 (33%) iris nevi were observed to have intrinsic vessels, and a statistically significant association of intrinsic vessels with malignancy (<i>p</i> = 0.001) was noted. Fluorescein leakage was also observed more frequently in iris melanoma 39 (98%) than in nevi 9 (60) with a significant difference (<i>p</i> = 0.001). Angiographic silence occurred in 3 nevi (20%) and was not observed in any melanoma (<i>p</i> = 0.017). Overall, the presence of intrinsic vessels +/- feeder vessels had high sensitivity (0.85) and high positive predictive value (0.87) for diagnosis of iris melanoma.</p><p><strong>Conclusions: </strong>Anterior segment fluorescein angiography allows for the assessment of tumor-associated vascular patterns and demonstrates utility in differentiating iris nevi from melanoma. Feeder vessels were only observed in iris melanoma and were absent in iris nevi. The intrinsic vessels were present more frequently in melanomas and are thus associated with malignancy. Angiographic silence is indicative of iris nevi.</p>","PeriodicalId":19434,"journal":{"name":"Ocular Oncology and Pathology","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10433095/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10051632","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reply to Augsburger et al: Selection Bias May Impact Reported Metastasis Risk for 15-Gene Expression Profile Class 1A/B Patients.","authors":"Robert W Cook, Katherina M Alsina","doi":"10.1159/000529561","DOIUrl":"10.1159/000529561","url":null,"abstract":"","PeriodicalId":19434,"journal":{"name":"Ocular Oncology and Pathology","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10433088/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10046619","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Edge Creep: Increased Pigmentation at the Border of Choroidal Melanomas Treated with Plaque Brachytherapy.","authors":"Elaine M Binkley, Sean M Rodriguez, Daniel E Hyer, Connie J Hinz, H Culver Boldt","doi":"10.1159/000531006","DOIUrl":"10.1159/000531006","url":null,"abstract":"<p><strong>Introduction: </strong>There is an increase in pigmentation that occurs in many tumors following plaque brachytherapy for choroidal melanoma. Correctly distinguishing between increased pigment at the tumor border versus true growth is imperative. We performed a retrospective review of patients treated with I-125 brachytherapy for choroidal melanoma at our institution to study this phenomenon.</p><p><strong>Methods: </strong>Records were reviewed for all patients undergoing plaque brachytherapy for uveal melanoma for a 5-year period (<i>N</i> = 195). Patients with iris and anterior tumors were excluded. Tumors treated more than 31 days after presentation were excluded. Fundus images for patients with increased pigmentation at any of the borders of the tumor at 6-month follow-up that extended beyond the initial pigmented margin were included (<i>N</i> = 20; 8 F, 12 M). Imaging at the last follow-up was reviewed, and it was confirmed that all tumors involuted appropriately with no evidence of local recurrence. The date of initial exam, time to treatment, and follow-up interval were recorded for each included patient.</p><p><strong>Results: </strong>Twenty patients (10%) exhibited increased pigment deposition at any of the borders of the tumor at 6-month follow-up that extended beyond the initial pigmented margin. Average tumor thickness was 3.2 mm (1.3-5.1); average largest tumor basal diameter was 11.6 mm (7-15.5). Average time from diagnosis to treatment was 25 days (17-31). Average length of follow-up was 35 months (16-68). No patient developed recurrence during the duration of follow-up, and 1 patient had developed metastasis.</p><p><strong>Conclusion: </strong>We describe the phenomenon of increased pigment deposition, \"edge creep,\" at the borders of choroidal melanomas treated with plaque brachytherapy that gave the appearance of initial tumor growth but then subsequently remained stable over time. It is important that treating ocular oncologists be aware of this phenomenon to avoid unnecessary diagnosis of local recurrence.</p>","PeriodicalId":19434,"journal":{"name":"Ocular Oncology and Pathology","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10821788/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73748525","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}