Virchows Archiv最新文献

{"title":"Can Dedifferentiated Liposarcoma be Reliably Excluded Based on Mitotic Rate? Prognostic and Diagnostic Implications of Mitotic Activity in Liposarcoma.","authors":"Jieun Lee, Seyoung Moon, Hyun Jung Kwon, Gheeyoung Choe, Kyu Sang Lee","doi":"10.1007/s00428-025-04235-x","DOIUrl":"https://doi.org/10.1007/s00428-025-04235-x","url":null,"abstract":"<p><p>Distinguishing well-differentiated liposarcoma (WDLPS) from dedifferentiated liposarcoma (DDLPS) is challenging, particularly when the low-grade (LG) sarcoma component does not meet the histopathological criteria for typical DDLPS. Previous studies have suggested that the diagnosis of DDLPS requires at least five mitotic figures per 10 high-power fields (≥ 5/10 HPF). This study aimed to validate the prognostic and diagnostic significance of the mitotic rate in LPS. We retrospectively reviewed 238 cases of WDLPS and DDLPS from our institution and assessed the prognostic value of the mitotic rate, MDM2/CEP12 amplification ratio, and Ki-67 proliferation index. Digital pathology and automated image analysis were used to obtain precise mitotic counts and minimise inter-observer variability. Among 238 patients, 165 had WDLPS, 26 had LG DDLPS, and 47 had DDLPS. LG DDLPS was reclassified when intermediate histological features were observed along with a mitotic rate < 5/10 HPF. Recurrence-free survival (RFS) was significantly worse in LG DDLPS than in WDLPS (P = 0.012) but better than in DDLPS (P = 0.001). Notably, lung metastasis occurred in two (7.7%) of the 26 LG DDLPS cases. The MDM2 amplification ratio progressively increased from WDLPS to DDLPS, whereas the Ki-67 expression level was not significantly associated with prognosis. This study demonstrated that the mitotic rate is a crucial diagnostic and prognostic marker in LPS. LG DDLPS exhibits more aggressive behaviour than WDLPS. Our results suggest that LG DDLPS should not be underestimated or classified as WDLPS based solely on mitotic rate.</p>","PeriodicalId":23514,"journal":{"name":"Virchows Archiv","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145055997","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":"Myxoid inflammatory myofibroblastic sarcoma with multiple liver metastases showing both PML::JAK1 fusion and KRAS mutation.","authors":"Xianghan Chen, Li Yang, Weihuan Hou, Hongjuan Zhang, Yingmei Wang, Peizhen Hu, Lu Yu","doi":"10.1007/s00428-025-04228-w","DOIUrl":"https://doi.org/10.1007/s00428-025-04228-w","url":null,"abstract":"<p><p>Recently, Papke et al. reported two cases of myxoid inflammatory myofibroblastic sarcoma with PML::JAK1 fusion. Smith et al. identified a high-grade PML::JAK1 fusion sarcoma. Here, we present the fourth case of a PML::JAK1 fusion sarcoma, the first to harbor a concomitant KRAS hotspot mutation (KRAS Q61H). Morphological manifestations include prominent myxoid stroma, lobulated but infiltrative growth patterns, and branching blood vessels. In contrast to Papke et al., we observed distinct non-myxoid stromal fascicular herringbone solid architecture and perivascular spaces, thereby expanding the morphological spectrum of PML::JAK1 fusion. The tumor was approximately 80% myxoid and 20% solid in composition. Importantly, a needle biopsy confirmed liver metastases of myxoid inflammatory myofibroblastic sarcoma in this case, suggesting its bland morphology but aggressive clinical behavior, which is a major potential diagnostic pitfall for this tumor. In addition, the presence of both myxoid lobular and herringbone regions in the present case suggests that the PML::JAK1 fusion sarcomas reported by Papke et al. and Smith et al. might be on a biological spectrum.</p>","PeriodicalId":23514,"journal":{"name":"Virchows Archiv","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145056040","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":"Multicentric Castleman disease with splenic presentation: report of two rare cases with focus on histopathological features and review of the literature.","authors":"Vincenzo Guastafierro, Deborah Marchiori, Arturo Bonometti, Daoud Rahal, Sara Fraticelli, Giulia Grion, Leonardo Campiotti, Silvia Uccella","doi":"10.1007/s00428-025-04251-x","DOIUrl":"10.1007/s00428-025-04251-x","url":null,"abstract":"<p><p>Castleman disease (CD) is a rare, heterogeneous, lymphoproliferative disorder that typically involves lymph nodes or, less commonly, extranodal sites such as the spleen. Based on clinical presentation CD is categorized into unicentric (UCD) and multicentric (MCD) forms, the latter further classified into HHV8-related, POEMS-associated, and idiopathic forms. We report two cases of HHV8-related MCD diagnosed on splenectomy specimens from patients presenting with splenomegaly, lymphadenopathies, and B symptoms. Histopathological analysis revealed mixed hyaline-vascular and plasma cell patterns with HHV8-positive lymphoid cells, and, in one case, an associated Kaposi sarcoma in splenic hilum lymph nodes. A systematic review of the literature identified 27 additional cases of CD diagnosed on splenectomy, which were analyzed alongside our two cases. Our study highlights that histologic evaluation of spleen tissue reliably reflects nodal CD patterns in both unicentric and multicentric forms and that, in selected cases, splenectomy remains a valuable diagnostic tool in Castleman disease.</p>","PeriodicalId":23514,"journal":{"name":"Virchows Archiv","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145041334","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":"Immunohistochemical expression of Nectin-4 and potential implications for enfortumab vedotin therapy in germ cell tumors of the testis: a preliminary study.","authors":"Costantino Ricci, Francesca Ambrosi, Tania Franceschini, Alessia Grillini, Eugenia Franchini, Francesco Vasuri, Agnese Orsatti, Luisa Di Sciascio, Francesco Massari, Veronica Mollica, Andrea Marchetti, Federico Mineo Bianchi, Maurizio Colecchia, Andres Martin Acosta, João Lobo, Michelangelo Fiorentino","doi":"10.1007/s00428-025-04243-x","DOIUrl":"https://doi.org/10.1007/s00428-025-04243-x","url":null,"abstract":"<p><p>A subset of germ cell tumors of the testis (GCTT) shows an aggressive clinical behavior, with chemo-resistance, metastases, and recurrences. Recently, enfortumab vedotin (EV), an antibody-drug conjugate (ADC) targeting Nectin-4, has been shown to improve the survival in urothelial carcinoma and has been approved for the locally advanced or metastatic cases. We stained for Nectin-4 (EPR15613-68 rb, Abcam) 46 cases (42 chemo-naive primary testicular tumors and 4 post-chemotherapy metastatic recurrences) and adopted the H-score and the specific Nectin-4 score (negative (H-score 0-14), weak (H-score 15-99), moderate (H-score 100-199), and strong (H-score 200-300)) for both the cytoplasm and the membrane. The expression of Nectin-4 was compared between different histotypes by adopting the specific Nectin-4 score and Fisher's exact test. Nectin-4 membrane expression was positive in 14/89 (15.7%) GCTT components, with median H-score of 0 (range 0-120; IQR 0-10). Choriocarcinoma (CHC) (median H-score 29 (range 20-40, IQR 21.25-38.25)) and isolated syncytiotrophoblast cells (iSTCs) [median H-score 65 (range 0-90; IQR 10-147.5)) showed statistically significant higher Nectin-4 membrane expression than the other GCTT components (p < 0.001), with staining mostly observed in syncytiotrophoblasts in CHC and thus mirroring what found in \"normal\" syncytiotrophoblasts of placental tissue (adopted as positive control). Additionally, 2/4 (50%) post-chemotherapy metastatic recurrences (one Tpt and one YSTpt) and 3/25 (12%) EC showed positive weak Nectin-4 membrane expression. To summarize, our study reveals that only a small minority of GCTT exhibit positive weak Nectin-4 membrane expression. However, a subgroup of potentially aggressive GCTT (especially CHC and post-chemotherapy metastatic recurrences) more frequently exhibits Nectin-4 membrane expression, thus prompting future studies to assess whether these patients may be potentially eligible for EV therapy.</p>","PeriodicalId":23514,"journal":{"name":"Virchows Archiv","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145041419","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":"Immunohistochemistry for PTEN testing in HR +/HER2- metastatic breast cancer.","authors":"Nicola Fusco, Elena Guerini-Rocco, Isabella Castellano, Umberto Malapelle","doi":"10.1007/s00428-025-04249-5","DOIUrl":"https://doi.org/10.1007/s00428-025-04249-5","url":null,"abstract":"<p><p>The PTEN tumor suppressor regulates the PIK3CA/AKT1 pathway, and its inactivation significantly contributes to tumorigenesis and progression in hormone receptor-positive/HER2-negative (HR + /HER2 -) metastatic breast cancer (MBC). In ~ 5% of these patients, PTEN loss, primarily due to gene deletions, leads to aberrant PI3K signaling and enhanced oncogenic potential. Findings from the CAPItello-291 study further establish PTEN together with PIK3CA and AKT1 as a predictive biomarker for Capivasertib, a pan-AKT inhibitor, in these patients. Despite next-generation sequencing (NGS) being the most precise method for detecting gene losses, immunohistochemistry (IHC) offers some advantages, including accessibility, cost-effectiveness, and applicability when archival tissue is inadequate for NGS or when pre-analytical failure occurs. Notably, recent evidence supports a pragmatic IHC positivity criterion, defining PTEN deficiency as staining in less than 10% of tumor cells, regardless of intensity. In this manuscript, we provide a comprehensive overview of the clinical scenarios associated with PTEN IHC testing in HR + /HER2 - MBC, outline best practices to minimize the impact of pre-analytical and analytical variability, and propose a structured pathology report to standardize PTEN IHC evaluation in this context.</p>","PeriodicalId":23514,"journal":{"name":"Virchows Archiv","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145034150","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":"Beyond the first cut: evaluating CMV IHC reliability in serial gastrointestinal biopsy sections.","authors":"Anna Hochner-Ger, Liat Anafi, Ido Veisman, Iris Barshack, Chen Mayer","doi":"10.1007/s00428-025-04226-y","DOIUrl":"https://doi.org/10.1007/s00428-025-04226-y","url":null,"abstract":"<p><p>Cytomegalovirus(CMV) is a major pathogen in immunocompromised individuals, often causing severe gastrointestinal complications. Immunohistochemistry (IHC) is widely used for CMV detection due to its high specificity, but its reliability in cases with sparse CMV-positive cells remains uncertain. This study evaluates the reproducibility of CMV IHC in gastrointestinal biopsies by assessing CMV detection across serial sections. A prospective observational study was conducted at the Pathology Institute of Sheba Medical Center between the years 2023 and 2024. Twenty-five CMV colitis cases diagnosed based on IHC were included and categorized as positive (≥ 2 CMV-positive cells) or equivocal (1 CMV-positive cell). Serial sectioning of the tissue blocks and subsequent CMV IHC staining was performed. Descriptive statistical analysis, including the Friedman test and Wilcoxon signed-rank test, was used to assess variability in CMV detection. CMV-positive cell counts varied significantly across serial sections (p = 0.047, Friedman test). While some cases remained stable, others fluctuated, transitioning from positive to equivocal or negative. Among initially positive cases, 33.3% (7/21) had at least one negative section, and 33.3% (7/21) had at least one equivocal section. Equivocal cases were highly unstable, with all showing at least one negative section and one converting to positive. Pairwise Wilcoxon tests showed no consistent significant differences. CMV IHC exhibits variability in low-positive cases, leading to diagnostic transitions. Serial sectioning enhances confidence but does not fully eliminate variability. A multimodal approach integrating IHC with molecular methods and further standardization of IHC protocols may improve CMV detection accuracy.</p>","PeriodicalId":23514,"journal":{"name":"Virchows Archiv","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145041395","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":"Recurrent clonal radiotherapy-associated fibroepithelial polyp of the pharynx: do low grade radiogenic stromal tumours exist? Case report.","authors":"Andrej Sirek, Ivana Bratic Hench, Jürgen Hench, Ilaria Alborelli, Markus W Gross, Jens Jakscha, Patrick Schaller, Gideon Nagel, Daniel Baumhoer, Alexandar Tzankov","doi":"10.1007/s00428-025-04252-w","DOIUrl":"10.1007/s00428-025-04252-w","url":null,"abstract":"<p><p>There is a wide range of tissue changes that may arise after exposition to ionizing radiation. Most of these changes fall in the non-neoplastic category. Nevertheless, due to the damaging effect radiation has on the DNA, there is a risk of developing secondary tumours, usually high-grade sarcomas. Here, we present a case of an elderly man who developed recurrent fibroepithelial polyps of the pharyngeal mucosa. He had a history of ipsilateral squamous cell carcinoma of the tonsil 17 years before treated by complete surgical resection followed by adjuvant radiotherapy. Histologically, these polyps consisted of relatively well-defined, partially eroded mucosal projections with a fibro-myxoid and inflamed stroma lacking evident signs of malignancy. The 4th recurrence was submitted to DNA panel sequencing, which identified three pathogenic variants in the PTEN, DNMT3A, and TERT genes that were not present in the local normal tissue before radiotherapy. On further analysis, well-known and established radiation induced changes such as copy number (CN) alterations or a radiation signature were not detected. The clinical presentation and the mutations detected argue against a purely reactive, but rather a likely benign neoplastic process that is thought to have developed post-actinically, without clear evidence of malignancy (absence of atypia, no invasive growth, flat CN profile). This case report raises awareness of a possible association between radiotherapy and the subsequent development of a benign-appearing low-grade mucosal soft tissue neoplasm.</p>","PeriodicalId":23514,"journal":{"name":"Virchows Archiv","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145041337","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":"MiNEN, amphicrine carcinomas, and conventional carcinomas with neuroendocrine differentiation: diagnostic criteria, open questions, and future perspectives.","authors":"Moritz Jesinghaus, Maxime Philipp Schmitt, Sebastian Foersch, Björn Konukiewitz","doi":"10.1007/s00428-025-04241-z","DOIUrl":"https://doi.org/10.1007/s00428-025-04241-z","url":null,"abstract":"<p><p>Mixed neuroendocrine and non-neuroendocrine neoplasms (MiNEN) represent a heterogeneous group of bidirectionally differentiated epithelial malignancies that are, in most cases, highly aggressive. They are defined by the presence of morphologically distinct, yet clonally related, neuroendocrine and non-neuroendocrine components, each comprising at least 30% of the tumor mass according to current guidelines. Tumors that fall within the differential diagnostic spectrum of MiNEN include amphicrine carcinomas-characterized by the co-expression of neuroendocrine and non-neuroendocrine features within the same tumor cell-as well as conventional carcinomas that lack neuroendocrine morphology but exhibit immunohistochemical expression of neuroendocrine markers. However, these entities do not fulfill the current diagnostic criteria for MiNEN. In this review, we aim to outline the current diagnostic framework for MiNEN and examine the conceptual and classification boundaries of amphicrine carcinomas and conventional carcinomas with aberrant neuroendocrine marker expression in relation to what is presently defined as a MiNEN. In addition, we highlight key unresolved questions that should be addressed in future guidelines to streamline the diagnostic process and improve consistency. Finally, we provide an outlook on emerging technologies and future perspectives that may further refine the classification and clinical management of these complex neoplasms.</p>","PeriodicalId":23514,"journal":{"name":"Virchows Archiv","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145034193","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":"Inflammatory gene expression profile of oral plasmablastic lymphoma.","authors":"Roberta Rayra Martins-Chaves, Marina Gonçalves Diniz, Fernanda Faria Rocha, Cinthia Veronica Bardález López de Cáceres, Pablo Agustin Vargas, Bruno Augusto Benevenuto de Andrade, Aline Araújo Sampaio, Nicolau Conte Neto, Hélder Antônio Rebelo Pontes, Ricardo Alves Mesquita, Ciro Dantas Soares, Guilherme Rossi Assis de Mendonça, Ricardo Santiago Gomez, Felipe Paiva Fonseca","doi":"10.1007/s00428-025-04255-7","DOIUrl":"https://doi.org/10.1007/s00428-025-04255-7","url":null,"abstract":"<p><p>Plasmablastic lymphoma (PBL) is a rare and aggressive non-Hodgkin lymphoma with a poor prognosis and short survival rates. It is classified as a large B-cell lymphoma subtype, but carries a plasmacytic immunophenotype. Therefore, PBL has pathogenetic overlaps with diffuse large B-cell lymphoma not otherwise specified (DLBCL NOS) and plasma cell neoplasms (PCNs). Although recent studies have characterized important genetic abnormalities in PBL, the precise molecular mechanisms driving its pathogenesis remain elusive. In this study, we analyzed 607 inflammatory genes in 10 PBL, 11 DLBCL NOS/high-grade B-cell lymphoma (DLBCL NOS/HGBCL), and 11 PCN samples to uncover the PBL immunoregulatory landscape and to identify promising therapeutic target candidates. Several differentially expressed genes were observed, including STAT4, STAT5A, and MAPK14, with enriched pathways such as JAK-STAT, nuclear factor-kappa B (NF-κB), and complement signaling in the PBL group. Notably, CR2 was underexpressed in PBL compared to DLBCL NOS/HGBCL and PCNs, suggesting a restricted Wp latency stage of Epstein-Barr virus (EBV), which may contribute to immune evasion. Functional analyses identified key immune pathways, including cytokine-receptor interactions, Toll-like receptor signaling, and neutrophil extracellular trap formation, with protein-protein interaction networks, emphasizing complement activation and JAK-STAT signaling pathways. In conclusion, oral PBL exhibits a complex inflammatory gene expression profile, and key signaling pathways, particularly JAK-STAT, NF-κB, and complement activation, are enriched in this tumor compared to DLBCL NOS/HGBCL and PCNs.</p>","PeriodicalId":23514,"journal":{"name":"Virchows Archiv","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145034186","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":"An unusual spindle cell variant of papillary thyroid carcinoma with KIF5B::MET fusion: report of a case.","authors":"Qi Ding, Yongli Gan, Ming Zhao","doi":"10.1007/s00428-025-04246-8","DOIUrl":"https://doi.org/10.1007/s00428-025-04246-8","url":null,"abstract":"<p><p>The spindle cell variant of papillary thyroid carcinoma (PTC) is exceptionally rare and poses significant diagnostic challenges due to its morphological overlap with other spindle cell lesions of the thyroid. We report a novel case of spindle cell variant PTC in a 66-year-old woman presenting with a TI-RADS 4 thyroid nodule, initially classified as Bethesda III on fine-needle aspiration. Histopathological examination revealed a biphasic tumor composed predominantly of bland spindle cells arranged in solid sheets and fascicles, admixed with entrapped thyroid follicles. Both components demonstrated subtle nuclear features of PTC, including mild nuclear enlargement, elongation, nuclear membrane irregularities, and occasional nuclear grooves and intranuclear pseudoinclusions. The tumor showed strong immunoreactivity for CK19, TTF-1, PAX-8, and galectin-3. Comprehensive molecular profiling by targeted next-generation sequencing identified a KIF5B::MET kinase fusion, confirmed by reverse-transcription PCR, Sanger sequencing, and MET break-apart fluorescence in situ hybridization. This case represents the first spindle cell variant PTC documented to harbor a kinase fusion. The identification of KIF5B as a novel MET fusion partner further expands the molecular spectrum of kinase-driven thyroid carcinomas. The patient exhibited no evidence of recurrence after 38 months post-thyroidectomy, suggesting indolent behavior. Our findings underscore the diagnostic utility of molecular profiling in spindle cell thyroid neoplasms and highlight MET fusions as potential therapeutic targets. This case contributes to emerging evidence that MET-rearranged thyroid carcinomas may exhibit variable clinical outcomes.</p>","PeriodicalId":23514,"journal":{"name":"Virchows Archiv","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145024271","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}