Pathology最新文献

{"title":"Endometriosis mimicking malignancy: a case of polypoid atypical endometriosis with vascular involvement.","authors":"Joshua Anderson, Samantha Tan, Clair Shadbolt, Rosemary McBain, Karen L Talia","doi":"10.1016/j.pathol.2025.04.005","DOIUrl":"https://doi.org/10.1016/j.pathol.2025.04.005","url":null,"abstract":"","PeriodicalId":19915,"journal":{"name":"Pathology","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144576026","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Aztreonam-avibactam resistance rates and resistance mechanisms of NDM and NDM/OXA48-like dual-carbapenemase-producing Enterobacterales in Singapore.","authors":"Ka Lip Chew, Joey Cruz Cabang, Nur Aisyah Binte Abu Bakar, Ker Xin Tan, Jeanette Teo","doi":"10.1016/j.pathol.2025.04.010","DOIUrl":"https://doi.org/10.1016/j.pathol.2025.04.010","url":null,"abstract":"<p><p>Aztreonam-avibactam is a treatment option for metallo-β-lactamase carbapenemase-producing Enterobacterales (CPE). This study was performed to determine resistance rates of a collection of CPE against aztreonam-avibactam and characterise associated resistance mechanisms. Minimum inhibitory concentrations (MICs) of a collection of New Delhi metallo-β-lactamase (NDM)- and NDM/OXA-48-like dual-CPE isolates were determined using two methods, the MIC Test Strip (MTS) and broth microdilution (Sensititre). Whole-genome sequencing was also performed for molecular characterisation. A total of 44 NDM-CPE and 11 NDM/OXA-48 dual-CPE isolates from 46 patients were included. The species breakdown of included isolates was as follows: Escherichia coli (n=33), Klebsiella pneumoniae (n=12), Klebsiella oxytoca (n=1), Enterobacter cloacae complex (n=2), Citrobacter amalonaticus (n=2), Citrobacter farmeri (n=1), Citrobacter freundii (n=1), Providencia rettgeri (n=2), and Pantoea calida (n=1). Essential agreement between the two test methods was 96.4%, with 100% categorical agreement. Overall resistance was 13.7% after excluding duplicate isolates. Of note, resistance occurred only in E. coli and P. rettgeri isolates. Resistance rates in E. coli isolates were 18.8% (6/32, all isolates), 8.0% (2/25) for NDM-CPE, and 57.1% (4/7) for NDM/OXA-48 dual-CPE. All resistant isolates were found to have penicillin-binding protein 3 (PBP3) insertions in association with CMY (AmpC-type) β-lactamase; 77.8% (7/9) of E. coli isolates with increased MICs of 0.5-4 mg/L, but still within susceptible breakpoints, also had either PBP3 insertion or AmpC β-lactamase. The six aztreonam-avibactam-resistant E. coli consisted of four ST361 and two ST167 isolates. All three ST361 NDM/OXA-48-like dual-CPE isolates had 0-5 single-nucleotide polymorphisms. Aztreonam-avibactam resistance was detected in E. coli and Providencia spp. Resistance in E. coli isolates was driven by PBP3 mutations in association with AmpC production. Higher resistance rates were seen in NDM-OXA-48-like dual-carbapenemase-producing E. coli, driven by ST361 isolates. Aztreonam-avibactam susceptibility testing should be performed as part of routine diagnostic testing for invasive NDM-CPE infections.</p>","PeriodicalId":19915,"journal":{"name":"Pathology","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144626944","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Novel strategy for overcoming interference from anti-CD47 agents in pretransfusion testing.","authors":"Hua Wei, Jie Chen, Dongxia Ren, Jingya Zhao, Yan Zheng, Shijie Mu, Longfei Yang","doi":"10.1016/j.pathol.2025.04.008","DOIUrl":"https://doi.org/10.1016/j.pathol.2025.04.008","url":null,"abstract":"<p><p>CD47 is an important immune checkpoint in haematopoietic and solid malignancies. However, panreactivity of anti-CD47 agents leads to interference during pretransfusion compatibility testing binding to red blood cells. To address this issue, we created immunomagnetic beads (IMBs) to adsorb anti-CD47 monoclonal antibodies (mAbs): IMB-OVCAR3, coated with lysed protein from the OVCAR3 cell line, which was screened using flow cytometry and immunofluorescence staining, and IMB-CD47, coated with a recombinant CD47 protein. Plasma adsorbed by IMBs was collected for gel column agglutination testing and flow cytometry to verify elimination of anti-CD47 mAb interference. The effects of IMBs on irregular antibody screening and adsorption ability of IMBs over preservation time were also analysed. Following successful preparation, IMBs were shown to adsorb anti-CD47 mAb in plasma and reduce anti-CD47 mAb interference of simulated and clinical samples in 30 ​s. Moreover, IMBs did not adsorb irregular antibodies. Both IMBs retained their anti-CD47 mAb adsorption capacity for 3 weeks in a preservation solution. IMB-OVCAR3 and IMB-CD47 can serve as novel tools for the efficient removal of CD47 interference during transfusion compatibility testing in transfusion laboratories.</p>","PeriodicalId":19915,"journal":{"name":"Pathology","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144626945","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mixed acinar cell carcinoma/non-ampullary adenocarcinoma of the duodenum.","authors":"Alexander Rochwarger, Borhan R Saeed, Isabell Götting, Sarah Kalmbach, Robert Bachmann, Stephan Singer, Christian M Schürch","doi":"10.1016/j.pathol.2025.04.006","DOIUrl":"https://doi.org/10.1016/j.pathol.2025.04.006","url":null,"abstract":"","PeriodicalId":19915,"journal":{"name":"Pathology","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144576027","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The diagnostic utility of the captopril challenge test for primary aldosteronism in a Bangladeshi population: a prospective study.","authors":"Sharmin Jahan, Zhong X Lu, Muhammad Akram, M A Hasanat, M Fariduddin, Peter J Fuller, Jun Yang","doi":"10.1016/j.pathol.2025.04.003","DOIUrl":"https://doi.org/10.1016/j.pathol.2025.04.003","url":null,"abstract":"<p><p>Primary aldosteronism (PA) is the most common cause of endocrine hypertension. Current screening uses the plasma aldosterone-to-renin ratio (ARR) followed by confirmatory testing with one of several tests. The saline suppression test (SST) is widely used but contraindicated in patients with renal insufficiency or congestive heart failure. The captopril challenge test (CCT) offers a safe, inexpensive and convenient alternative to the SST, but diagnostic thresholds and reported accuracy vary between centres. Furthermore, none of the previous comparative studies have been carried out in low- and middle-income countries, where the affordability of the CCT may offer distinct advantages. This study aimed to evaluate the diagnostic accuracy of the CCT compared to the SST in a Bangladeshi population. In this prospective study, consecutive hypertensive patients with an ARR >50 ​pmol/mIU underwent both the SST and CCT. Using the SST as the reference standard, where plasma aldosterone concentration (PAC) post SST ≥170 ​pmol/L is considered diagnostic of PA, the area under the receiver operating characteristic curve (AUC), sensitivity, specificity, and negative and positive predictive values of different diagnostic criteria for the CCT were calculated. A total of 103 patients completed both confirmatory tests. The diagnostic accuracy of the post-captopril PAC at both 1 ​h and 2 ​h outperformed post-captopril ARR or the percentage suppression of PAC (AUC 0.77, 0.70 and 0.56, respectively; p<0.001). PACs >333 ​pmol/L at 1 ​h and 2 ​h post administration of captopril demonstrated sensitivities of 54.5% and 44.4%, with specificities of 91.5% and 93.6%, respectively. A post-captopril PAC <151 ​pmol/L effectively ruled out PA with 96.4% sensitivity, while a PAC >380 ​pmol/L ruled in the diagnosis of PA with 95.7% specificity. Overall, our findings indicate that the CCT, based on post-captopril PAC, achieves comparable diagnostic accuracy to the seated SST. The diagnostic performance was similar at either 1 ​h or 2 ​h post administration of captopril, suggesting that 1 ​h may be preferred in a CCT protocol for efficiency. The CCT represents a safe and convenient confirmatory test to guide decisions on PA subtyping or medical treatment, especially in resource-limited settings.</p>","PeriodicalId":19915,"journal":{"name":"Pathology","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144565095","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A simple 3D-printed plastic holder to improve the biosafety of slide handling for the Vitek MS MALDI-TOF instrument.","authors":"Matthias Maiwald, Leng Yee Poh","doi":"10.1016/j.pathol.2025.04.004","DOIUrl":"https://doi.org/10.1016/j.pathol.2025.04.004","url":null,"abstract":"","PeriodicalId":19915,"journal":{"name":"Pathology","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144529160","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The relationship between blood culture time-to-positivity and Enterococcus faecalis infective endocarditis.","authors":"Christopher Robson, Hakim Khan, Ralph K Junckerstorff, Maryza Graham, Rhonda L Stuart, Stephen J Nicholls, Benjamin A Rogers","doi":"10.1016/j.pathol.2025.04.002","DOIUrl":"https://doi.org/10.1016/j.pathol.2025.04.002","url":null,"abstract":"<p><p>Infective endocarditis (IE) can be difficult to diagnose due to non-specific symptoms and the imperfect sensitivity of blood cultures and echocardiography. The interval between blood culture collection and the first detection of bacterial growth is known as time-to-positivity (TTP) and is considered a proxy for bacterial load. Several studies have demonstrated a shorter TTP in staphylococcal IE compared to staphylococcal bacteraemia of other sources; however, evidence in enterococcal IE is limited. We characterise the relationship between blood culture TTP and a diagnosis of Enterococcus faecalis IE, along with the impact of demographic and patient-specific factors. Retrospective analysis was performed for patients with blood cultures growing E. faecalis at a single centre from 2017 to 2021. Exclusion criteria included polymicrobial growth, repeat/relapsed episodes of enterococcal bacteraemia and receipt of pre-blood culture antibiotics. TTP was compared between participants with and without a definite diagnosis of IE per the 2023 Duke-International Society for Cardiovascular Infectious Diseases criteria. Comparison was also made between participants with and without a clinical diagnosis of IE. After exclusions, 114 episodes of E. faecalis bacteraemia were identified. Twenty-seven (24%) had a definite diagnosis of IE. Nineteen of the 27 (70%) IE cases were left-sided, and three (11%) were device-related. One case of prosthetic valve endocarditis was included. Other infective sources included the urinary tract ​(37/114, 32%) or an unidentified source (34/114, 30%). Median TTP was shorter in bacteraemia of other sources than in Duke definite IE (10.6 vs 11.3 h), but was not statistically significant (p=0.07). The area under the receiver-operator characteristic curve for the ability of TTP to diagnose IE was 0.62. Median TTP was shorter in the clinical IE group than bacteraemia of other sources (10.0 vs 11.4 h); however, this difference was not significant (p=0.34). E. faecalis IE was not associated with a shorter TTP than bacteraemia of other sources in this study. Higher-quality evidence is required to inform the utility of TTP in this condition.</p>","PeriodicalId":19915,"journal":{"name":"Pathology","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144541829","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"High-grade histological patterns in metastatic lymph nodes associated with poor prognosis in resected lung adenocarcinoma: a multicentre retrospective cohort study.","authors":"Huiyan Deng, Shaonan Xie, Yueping Liu, Qingyi Liu, Yan Ding, Hanxu Jiang, Keqi Jia, Meng Zhao, Fang Li, Lingling Zhang, Jianfei Guo, Zhiyu Wang","doi":"10.1016/j.pathol.2025.03.012","DOIUrl":"https://doi.org/10.1016/j.pathol.2025.03.012","url":null,"abstract":"<p><p>We aimed to investigate the prognostic value of high-grade patterns (HGPs) in lymph node metastasis in lung adenocarcinoma (LUAD). We retrospectively analysed patients (n=345; 2016-2018) with pathological stage IIB-IIIB LUAD who underwent lobectomy. We evaluated the overall survival (OS) and recurrence-free survival (RFS) of patients with and without a micropapillary/solid pattern in the primary tumour and lymph node metastases. Among the patients, the median age was 61.0 years, 54.2% (n=187) were female and 36.5% (n=126) had a history of smoking. Among the involved lymph nodes, 70.4% (n=243) were in pN2 stage and 29.6% (n=102) were in pN1 stage. Of the patients, 32.8% (n=113) had only one lymph node metastasis at the N2 station, whereas 37.7% (n=130) had multiple lymph node metastases at the N2 station. Patients with vascular invasion (p=0.003), pN2 stage (p<0.001), and a predominantly solid histological pattern in the primary tumour (p<0.001) were more likely to have metastatic lymph nodes of the solid subtype. Using a cut-off value of 10% rather than 20%, HGPs were more significant in evaluating RFS (p<0.001 vs p=0.22) and OS (p=0.009 vs p=0.46). Compared to patients without HGPs in lymph node metastases, the presence of a solid component [hazard ratio (HR) 2.07, 95% confidence interval (CI) 1.27-3.38; p=0.004], micropapillary component (HR 3.20, 95% CI 1.81-5.68; p<0.001), and both solid and micropapillary components (HR 2.60, 95% CI 1.54-4.40; p<0.001) in lymph node metastasis were all significantly associated with poorer OS. Patients with only micropapillary components (HR 1.96, 95% CI 1.19-3.22; p=0.008) or both micropapillary and solid components (HR 1.75, 95% CI 1.12-2.71; p=0.013) in lymph node metastasis had significantly poorer RFS. For surgically resected LUAD patients with lymph node metastasis, those with high-grade histological patterns in metastatic lymph nodes had a poorer prognosis, and the histological patterns of metastatic lymph nodes can be used to stratify such patients.</p>","PeriodicalId":19915,"journal":{"name":"Pathology","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144529161","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Increased incidence of Hodgkin lymphoma with decreased association with Epstein-Barr virus in Taiwan: a shift toward Western style.","authors":"Kung-Chao Chang, Chih-Hui Hsu, Chun-Ju Chiang, Shu-Hsien Wang, Sheng-Hsiang Lin","doi":"10.1016/j.pathol.2025.03.011","DOIUrl":"https://doi.org/10.1016/j.pathol.2025.03.011","url":null,"abstract":"<p><p>Previous studies have reported a global increasing trend in the incidence of Hodgkin lymphoma (HL), especially among individuals who are female, of younger age and from Asian nations. However, detailed long-term trend analyses on individual countries and investigation of reasons for these temporal trends, including Epstein-Barr virus (EBV) association, are limited. We compared nationwide registration data from Taiwan and the USA during the interval 2001 through 2020 and used an age-period-cohort model to analyse individual effects of time period and birth cohort on the incidence trends. The incidence of HL in Taiwanese people was much lower than that in White Americans (7.39 vs 28.43 per million inhabitants). However, in contrast to a slightly decreased incidence rate in White Americans, HL in Taiwanese people showed a steadily increasing incidence rate during the 20-year interval (overall annual percentage change +2.82%), especially for women with nodular sclerosis subtype and aged 25-30 years, during the period 2011-2020. The prominent increase in relative risks was revealed by the time period and birth-cohort effects in Taiwanese people compared with White Americans. Interestingly, the linear trend test demonstrated a significant decrease in EBV association in Taiwanese HL over the 20-year period, from ∼60% to ∼20% (p=0.025), with a bimodal EBV-positive pattern in childhood (<10 years, 50%) and in older adults (>70 years, 93%). These findings suggest environmental influences and Westernisation of lifestyle in HL aetiology and that improvement of public health may influence the incidence and biological features of HL.</p>","PeriodicalId":19915,"journal":{"name":"Pathology","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144507497","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"TRPS1 expression in 451 tubo-ovarian tumours: a potential prognostic marker for high-grade serous carcinoma.","authors":"Quang Hiep Bui, Ivana Stružinská, Michaela Kendall Bártů, Romana Michálková, Jana Drozenová, Pavel Fabian, Jitka Hausnerová, Jan Laco, Radoslav Matěj, Petr Škapa, Marián Švajdler, Zuzana Špůrková, Gábor Méhes, Pavel Dundr, Kristýna Němejcová","doi":"10.1016/j.pathol.2025.04.001","DOIUrl":"https://doi.org/10.1016/j.pathol.2025.04.001","url":null,"abstract":"<p><p>Trichorhinophalangeal syndrome type 1; transcriptional repressor GATA binding 1 (TRPS1), a member of the GATA transcription factor family, functions primarily as a transcriptional repressor. TRPS1 is frequently utilised as a diagnostic marker for breast carcinoma, although its specificity is lower than previously believed. Moreover, TRPS1 is expressed in various solid tumours originating from the skin, salivary glands, soft tissues, prostate, urothelium, and female genital tract. The current study evaluated the diagnostic and prognostic significance of TRPS1 in 451 primary tubo-ovarian tumours. The cohort included 94 high-grade serous carcinomas (HGSCs), 81 low-grade serous carcinomas (LGSCs), 31 micropapillary serous borderline tumours (mSBTs), 92 clear cell carcinomas (CCCs), 52 endometrioid carcinomas (ECs), 31 mucinous carcinomas (MCs), and 70 mucinous borderline tumours (MBTs). Immunohistochemical analysis was performed using tissue microarrays following standardised protocols. Clinical data were analysed to determine the prognostic relevance of TRPS1 expression. TRPS1 expression was detected in 47% of HGSCs, 44% of ECs, 35% of CCCs, 19% of LGSCs, and 29% of mSBTs with complete negativity in MC/MBT. TRPS1-negative HGSC cases had higher recurrence rates than those with positive staining. Furthermore, TRPS1 expression significantly correlated with improved metastasis-free survival in HGSC cases. These findings suggest that TRPS1 may serve as an independent prognostic marker for HGSC. Despite varying expression rates across primary tubo-ovarian carcinomas, the routine use of TRPS1 in the differential diagnosis seems to be limited, ​as other robust immunohistochemical markers are available for distinguishing the individual subgroups. Further research is needed to clarify the specific functions and clinical implications of TRPS1 in tubo-ovarian cancer.</p>","PeriodicalId":19915,"journal":{"name":"Pathology","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144485500","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}