Virchows Archiv最新文献

{"title":"\"Simple Mucinous Cysts\" associated with pancreatic ductal adenocarcinoma: clinicopathologic and radiologic characterization of an enigmatic cyst and additional evidence for its possible pre-cancerous nature.","authors":"Nuray Tezcan, Duygu Atasoy, Burcu Saka, Ayse Armutlu, Cisel Aydin Mericoz, Rohat Esmer, Pelin Bagci, Burcin Pehlivanoglu, Serdar Balci, Takashi Muraki, Jeanette D Cheng, Alyssa M Krasinskas, Michelle D Reid, Olca Basturk, Bengi Gurses, N Volkan Adsay","doi":"10.1007/s00428-026-04705-w","DOIUrl":"10.1007/s00428-026-04705-w","url":null,"abstract":"<p><p>Simple mucinous cyst (SMC), previously also termed mucinous non-neoplastic cyst, is now recognized as a separate category in the WHO Classification of Pancreatic Tumours. Recent studies have increasingly identified malignancy-associated molecular alterations, high-grade dysplasia (HGD), and even cases of PDAC arising in SMC. We aimed to define the radiologic and pathologic characteristics of this rare entity and to investigate its association with PDAC by analyzing findings from 920 consecutive cases.SMCs were identified in 15 of 920 PDACs (1.6%); together with 7 additional unpublished SMCs, a total of 22 cases were analyzed. Radiologically, SMCs were typically solitary, unilocular, well-circumscribed, round-to-oval cysts with thin, often enhancing walls. They lacked features of IPMNs such as main duct communication (commonly showing a visible separation from the main duct) and cyst-by-cyst architecture. A distinctive feature was their frequent protrusion into the peripancreatic fat. Histologically, SMCs showed a paucicellular fibrous wall lined by mucinous epithelium, often with epithelial denudation. All cases exhibited cytologic atypia. Among the 7 non-PDAC SMCs, four harbored HGD, with a mean cyst size of 2.4 cm. PDAC-associated SMCs were all adjacent to the carcinoma, lacked mural nodules, and had a mean cyst size of 2.7 cm; HGD was identified in 2 of 15.This study further characterizes the pathologic and radiologic phenotype classified as SMC in the 2026 WHO classification and identifies features that aid its distinction from conventional IPMNs, MCNs, secondary cysts, and other mimics. The occurrence of SMCs in 1.6% of PDAC resections, their spatial proximity to PDAC, the presence of HGD, and previously reported cancer-related molecular alterations provide additional evidence that SMC is likely a pre-cancerous lesion, closely related to yet distinct from other pancreatic precursors. Further studies, including clonality analyses, are needed to determine whether associated PDACs develop through sequential progression from SMC, through a branch-off pathway, or independently in the same patient. Until the natural history and molecular relationships of SMC are clarified, management within the broader framework used for mucinous pancreatic cysts appears prudent.</p>","PeriodicalId":23514,"journal":{"name":"Virchows Archiv","volume":" ","pages":"829-840"},"PeriodicalIF":3.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148931251","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":"Nectin-4 expression in vulvar squamous cell carcinoma.","authors":"Frederik A Stuebs, Antje Knöll, Arndt Hartmann, Christian Matek, Nelson John, Lothar Häberle, Matthias W Beckmann, Carlos Bercebal, Markus Eckstein, Sebastian Rauch, Carol I Geppert","doi":"10.1007/s00428-026-04495-1","DOIUrl":"10.1007/s00428-026-04495-1","url":null,"abstract":"<p><p>Therapy options for women with vulvar squamous cell carcinoma (VSCC) are limited. New strategies such as immune checkpoint inhibitors (ICI) or antibody-drug conjugates (ADC) are lacking. One potential target for the ADC Enfortumab Vedotin (EV) is Nectin-4. EV has been successfully used to treat metastatic urothelial carcinoma (mUC). Currently, there is limited data on the expression of Nectin-4 for VSCC. Our aim was therefore to investigate the expression of Nectin-4 in women with VSCC. In total, 219 formalin-fixed paraffin-embedded tissue (FFPE) samples of primary VSCC were collected between 2000 and 2021. A next generation tissue microarray (ngTMA) was constructed. The assessment of Nectin-4 expression was performed through the implementation of immunohistochemistry (IHC). We also performed NECTIN-4 fluorescence in situ hybridization (FISH) to evaluate amplification of Nectin-4. The median Nectin-4 H-score for membranous expression was 22.5, with 32.4% of VSCCs exhibiting moderate to strong expression. We could not show that Nectin-4 H-score (membranous) significantly influenced overall survival in addition to other prognostic factors. The rates of regional lymph node metastases, lymphatic vascular space involvement, G3-Grading, perineural sheath invasion and p16-/p53+ were highest in Nectin-4-negative VSCC. 28.8% of recurrent VSCC had moderate or strong expression of Nectin-4. None of the investigated VSCC (primary or recurrent) showed amplification of Nectin-4 in contrast to mUC. Nectin-4 could be a potential target in the therapy of women with VSCC. Further (pre-)clinical data is needed to evaluate the use of EV in therapy of women with VSCC.</p>","PeriodicalId":23514,"journal":{"name":"Virchows Archiv","volume":" ","pages":"855-864"},"PeriodicalIF":3.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147522052","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":"Liquid biopsy in solid tumours: expert opinion paper of the European society of pathology.","authors":"Nicola Fusco, Xavier Matias-Guiu, Irene Esposito, Raed Al Dieri, Aleš Ryška, Paul Hofman","doi":"10.1007/s00428-026-04690-0","DOIUrl":"10.1007/s00428-026-04690-0","url":null,"abstract":"<p><p>Liquid biopsy (LBx), particularly plasma circulating tumour DNA (ctDNA) analysis, has become an important use case of molecular pathology in solid tumours. While tissue remains the cornerstone of diagnosis, ctDNA testing provides a minimally invasive alternative using repeatable source of tumour-derived genomic information that complements tissue analysis when samples are unavailable, insufficient, outdated, or unlikely to capture tumour heterogeneity and evolution. In this expert opinion paper, the European Society of Pathology (ESP) defines its vision for LBx implementation across Europe and reaffirms the central role of pathology in blood-based detection of genomic alterations in solid tumours. Two clinical models highlight current implementation of LBx into standard diagnostic work-up. In advanced non-small cell lung cancer (NSCLC), LBx enables rapid detection of actionable somatic genomic alterations, supports treatment decisions when tissue biopsy is not available/sufficient for molecular analysis, and identifies acquired resistance genomic alterations at progression. However, tissue remains essential for histological classification, PD-L1 assessment, recognition of histologic transformation, evaluation of tumour microenvironment, and molecular testing when comprehensive genomic profiling or confirmation of liquid biopsy findings is required. In metastatic breast cancer, LBx has become central to dynamic molecular management of patients with originally hormonally dependent disease. This paper also addresses key technical and interpretative challenges, including assay selection, next-generation sequencing, clonal haematopoiesis, tumour fraction, variant allele fraction, co-mutations, testing logistics, and quality assurance. Given heterogeneity in access to LBx testing across Europe, harmonized standards for validation, reporting, training, and equitable availability are urgently needed. Pathology laboratories have a central role in identifying somatic alterations in cancer tissue, and LBx is an obvious extension of this important task. An integrated morphological-molecular pathology assessment is needed to implement appropriate precision oncology strategies. Incorporation of specific professional personal profiles (molecular biologists, bioinformaticians) to pathology laboratories is therefore essential for such optimal approach.</p>","PeriodicalId":23514,"journal":{"name":"Virchows Archiv","volume":" ","pages":"797-811"},"PeriodicalIF":3.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148841505","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":"Expression of the immune checkpoint CD137/CD137L in oral squamous cell carcinoma (OSCC) and association with histopathological parameters.","authors":"Jacek Glajzer, Jutta Ries, Leah Trumet, Christian Matek, Marco Kesting, Manuel Weber","doi":"10.1007/s00428-026-04430-4","DOIUrl":"10.1007/s00428-026-04430-4","url":null,"abstract":"<p><p>As immunotherapy (IT) with checkpoint inhibitors continues to make rapid progress in the treatment of oral squamous cell carcinoma (OSCC), response rates still necessitate substantial improvement. Current concepts to improve therapy response mainly consider identification of further immunological targets eligible for extension of IT. One auspicious immune checkpoint is CD137 and its ligand CD137L, but expression rates and relevance for progression of OSCC are still unknown. Tissue and peripheral blood from 159 OSCC patients and 55 healthy oral mucosa (HOM) controls was collected and subsequently analyzed for expression of CD137 and CD137L by quantitative reverse transcription polymerase chain reaction (RT-qPCR). Furthermore, OSCC and HOM tissue samples from both groups were evaluated for CD137 protein expression by immunohistochemistry (IHC). Expression rates were analyzed and subsequently correlated with histomorphological characteristics. CD137 exhibited highly significant upregulation in OSCC tissue on mRNA and protein level, as evidenced by both RT-qPCR (p < 0.001) and IHC (p < 0.001) analysis. Regarding the CD137L expression in the examined tissue specimens, there was no significant difference detectable on mRNA level (p = 0.53). Comparative analysis of RT-qPCR blood data showed no statistically significance in expression rates of CD137 (p = 0.653) and CD137L (p = 0.351). Correlation analysis revealed no highly significant results with reference to the histopathological parameters. CD137 showed a highly significant upregulation in OSCC tissue compared to the HOM control group. Consequently, it may be a relevant checkpoint involved into formation and progression of OSCC. Further investigations are needed to evaluate, if CD137 represents a suitable target for a novel IT approach in OSCC treatment.</p>","PeriodicalId":23514,"journal":{"name":"Virchows Archiv","volume":" ","pages":"841-853"},"PeriodicalIF":3.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147277334","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":"Molecular insight into Proliferative Verrucous Leukoplakia: Are TERT promoter mutations a predictive marker?","authors":"Nikita Garg, Priya Kumar, Aadithya B Urs, Seema Kapoor, Somesh Kumar","doi":"10.1007/s00428-026-04423-3","DOIUrl":"10.1007/s00428-026-04423-3","url":null,"abstract":"<p><p>Proliferative verrucous leukoplakia (PVL) is a rare yet aggressive oral potentially malignant disease (OPMD) with the greatest rate of malignant transformation. Its pathophysiology is poorly understood despite much histopathological and molecular research. Particularly, Telomerase reverse transcriptase (TERT) promoter mutations at C228T and C250T have been linked to many epithelial malignancies; however, their significance in PVL is yet unknown in the Indian population. The aim of this study was to assess frequency of TERT promoter mutations (C228T, C250T) and rs2853669 single nucleotide polymorphism (SNP) in PVL, oral leukoplakia (OL), oral squamous cell carcinoma (OSCC) and healthy controls. 120 fresh frozen tissue specimens (30 each of OL, PVL, OSCC and controls) were tested for presence of C228T and C250T mutation in TERT promoter gene region and SNP at rs2853669, using Sanger sequencing on genomic DNA. TERT C228T mutation was found in 6.7%, 0% and 20% cases in PVL, OL and OSCC group (p = 0.03) respectively. TERT C250T mutation was present only in OSCC group (6.7% cases). None of the two mutations were present in controls. Both the mutations were mutually exclusive of each other. A significant association was found between rs2853669 SNP and epithelial dysplasia in OL, specifically with CC genotype (p = 0.04). Molecular signature of PVL shows limited evidence of TERT promoter mutations. The findings of this study suggest that the genetic underpinnings of PVL are distinct from those commonly observed in other forms of cancerous lesions.</p>","PeriodicalId":23514,"journal":{"name":"Virchows Archiv","volume":" ","pages":"995-1003"},"PeriodicalIF":3.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146114416","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":"Adamantinoma-like Ewing sarcoma with NRAS Q61R mutation-a hitherto unreported mutation in a case from the nasal cavity.","authors":"Bingcheng Wu, Xinyi Qu, Yi Ting Lai, Ming Liang Oon, Jaslyn Jie Lin Lee, Jian Yuan Goh, Xinni Xu, Fredrik Petersson","doi":"10.1007/s00428-025-04373-2","DOIUrl":"10.1007/s00428-025-04373-2","url":null,"abstract":"<p><p>Adamantinoma-like Ewing sarcoma (ALES) is a rare malignant neoplasm currently classified as a subtype of Ewing sarcoma (ES) and is similarly molecularly defined by a FET-ETS translocation. However, ALES demonstrates some morphologic and immunohistochemical features distinct from conventional ES. In this case report, we present the clinico-pathological features of a case of ALES in the nasal septum of a 75-year-old lady, with a hitherto unreported NRAS Q61R mutation. Further studies are required to investigate the prevalence and clinical significance of the NRAS Q61R mutation in ALES.</p>","PeriodicalId":23514,"journal":{"name":"Virchows Archiv","volume":" ","pages":"1013-1018"},"PeriodicalIF":3.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145850884","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":"Distance-based evaluation of tumor budding in colorectal cancer.","authors":"Ville K Äijälä, Päivi Sirniö, Henna Karjalainen, Meeri Kastinen, Vilja V Tapiainen, Hanna Elomaa, Maarit Ahtiainen, Vesa-Matti Pohjanen, Taneli T Mattila, Outi Lindgren, Olli Helminen, Erkki-Ville Wirta, Jukka Rintala, Sanna Meriläinen, Juha Saarnio, Tero Rautio, Toni T Seppälä, Jan Böhm, Jukka-Pekka Mecklin, Anne Tuomisto, Markus J Mäkinen, Juha P Väyrynen","doi":"10.1007/s00428-026-04471-9","DOIUrl":"10.1007/s00428-026-04471-9","url":null,"abstract":"<p><p>Tumor budding is an established adverse prognostic factor in colorectal cancer (CRC), based on the number of isolated single tumor cells or small tumor cell clusters at the invasive front. While bud counts are well studied, the prognostic significance of the spatial distribution and distance of tumor buds away from the tumor bulk is unclear. We defined TB-distance as the average distance from the tumor bulk to the three farthest tumor buds and evaluated its clinicopathologic and prognostic associations in two independent CRC cohorts (N = 776 and N = 1,100). Using a cohort-derived cutoff, high TB-distance (≥ 123 µm) was significantly associated with adverse tumor characteristics, including high grade, advanced disease stage, lymphovascular invasion, high conventional tumor budding grade, and MMR proficient status (p < 0.003 for all). High TB-distance was also associated with shorter cancer-specific survival (Cohort 1: multivariable HR (high vs. low) 1.47, 95% CI 1.04-2.09, p = 0.030; Cohort 2: multivariable HR 1.34 95% CI 1.04-1.74, p = 0.026). However, TB-distance did not provide additional prognostic information within conventional tumor budding grade strata or when modeled alongside tumor budding. These findings indicate that high TB-distance is associated with aggressive tumor morphology and worse outcome but does not improve prognostication beyond standard tumor budding assessment. TB-distance may still be useful as a visual aid in routine pathology and a quantifiable spatial feature for computational pathology.</p>","PeriodicalId":23514,"journal":{"name":"Virchows Archiv","volume":" ","pages":"887-895"},"PeriodicalIF":3.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147366752","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":"Cemento-osseous dysplasia with a NOTCH4 mutation: a case report.","authors":"Gerben E Breimer, Nard G Janssen, Anne M L Jansen, Pieter J Slootweg","doi":"10.1007/s00428-025-04212-4","DOIUrl":"10.1007/s00428-025-04212-4","url":null,"abstract":"<p><p>Cemento-osseous dysplasia (COD) is a benign fibro-osseous lesion of the jaw that can mimic other entities, particularly cemento-ossifying fibroma (COF), both radiologically and histologically. Although recent research has implicated mutations in the RAS-MAPK pathway in COD, its broader molecular landscape remains insufficiently defined. We report the case of a 32-year-old woman with an incidental lesion in the right mandibular angle. Radiographic assessment revealed a poorly demarcated lesion, and histopathological analysis confirmed features consistent with COD, including fibro-osseous tissue with interconnected bony trabeculae lacking osteoblastic rimming. Next-generation sequencing (TSO500 panel) identified a previously unreported NOTCH4 mutation. This finding expands the spectrum of genetic alterations associated with COD and raises the possibility of Notch signaling involvement in its pathogenesis. Incorporating molecular profiling into the diagnostic workflow may improve discrimination between COD and COF and deepen our understanding of fibro-osseous lesions of the jaw.</p>","PeriodicalId":23514,"journal":{"name":"Virchows Archiv","volume":" ","pages":"1043-1046"},"PeriodicalIF":3.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144856471","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":"Primary cutaneous non neuroendocrine small cell carcinoma POU2F3 subtype: morphologic, immunohistochemical, transcriptomic and methylation analysis of two cases.","authors":"Kerman Zyani, Daniel Pissaloux, Charly Liddell, Mahtab Samimi, Franck Tirode, Andreas von Deimling, Serge Guyétant, Sylvie Lantuejoul, Thibault Kervarrec","doi":"10.1007/s00428-026-04406-4","DOIUrl":"10.1007/s00428-026-04406-4","url":null,"abstract":"<p><p>Up to 10% of small cell lung carcinomas do not express any neuroendocrine markers and are characterized by an expression of the transcription factor POU2F3. Recently, few cases of poorly differentiated carcinomas harboring POU2F3 expression have been described in the breast, cervix, and bladder. Herein, we report the morphological, immunohistochemical, and molecular characterization of two primary cutaneous POU2F3-expressing small cell carcinomas. The cases arose in the temple and on the occipital region in a 92-year-old woman and a 78-year-old man respectively. Microscopic examination revealed in both cases a large and ulcerated poorly differentiated neoplasm infiltrating the full thickness of the dermis with extension into the subcutaneous tissues in case #1. The tumors harbored solid and trabecular growth patterns and were composed of poorly differentiated highly mitotic cells. Immunohistochemical investigation revealed diffuse pancytokeratin positivity while no expression of cytokeratin 20, chromogranin A, synaptophysin, CD56, or INSM1 was detected. Diffuse nuclear expression of POU2F3 was observed. Transcriptomic analysis revealed a SBS7 mutation signature related to UV-induced DNA damages in one case and evidenced an expression profile similar to the one observed in POU2F3-expressing small cell lung cancers in both. Methylation analysis confirmed the proximity of the two cases with other skin cancers. To conclude, we report herein the first description of primary cutaneous small cell carcinoma POU2F3 subtype.</p>","PeriodicalId":23514,"journal":{"name":"Virchows Archiv","volume":" ","pages":"1005-1011"},"PeriodicalIF":3.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146019851","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":"Sequential lymphoid neoplasms mimicking relapse of mediastinal grey zone lymphoma in a patient with germline variants in EP300 and PTPRK.","authors":"Maria J Tapken, Darius Juskevicius, Ilaria Balestri, Claudia Ruth Bollinger, Ilaria Alborelli, Sebastian Kurscheid, Lucian Cajacob, Niels Willi, Peter Häusermann, Stefan Dirnhofer, Alexandar Tzankov","doi":"10.1007/s00428-026-04733-6","DOIUrl":"https://doi.org/10.1007/s00428-026-04733-6","url":null,"abstract":"<p><p>Sequential lymphoid neoplasms are rare and diagnostically challenging, with a variable clonal relationship. Here we present the case of a 59-year-old woman with mediastinal grey zone lymphoma (MGZL), who, shortly after achieving complete remission, developed a subsequent cutaneous neoplasm. Comparative molecular studies were performed using high-throughput sequencing (HTS), which demonstrated that both neoplasms shared high-allele-frequency EP300:p.P2333L and PTPRK:p.R532K variants. In addition, each neoplasm harboured private, mutually exclusive variants-NFKBIA:p.R245Sfs*39 and BTG2:c.142+5G>C in the MGZL and JAK1:p.Q562* and JAK1:p.G1097D in the skin. Integrating the clinical course with HTS, we diagnosed lymphomatoid papulosis and excluded relapse of the MGZL. Interestingly, the shared variants were likely germline rather than clonal, suggesting they created a permissive background predisposing to two independent transforming events along the B- and T-cell lineages. Molecular studies may help to reveal the genetic basis of composite lymphomas and to resolve diagnostically discordant, complex presentations.</p>","PeriodicalId":23514,"journal":{"name":"Virchows Archiv","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149082067","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}