{"title":"Artificial intelligence in thoracic pathology: diagnostic and predictive applications","authors":"Jan von der Thüsen","doi":"10.1016/j.mpdhp.2025.06.008","DOIUrl":"10.1016/j.mpdhp.2025.06.008","url":null,"abstract":"<div><div>Artificial intelligence (AI) is rapidly transforming thoracic pathology through computational analysis of histological images. This brief review outlines the current state and future directions of clinical AI applications in histopathologic diagnosis of thoracic malignancies, including diagnostic classification, prognosis, prediction of molecular alterations, response to therapy, and assessment of the tumour microenvironment (TME). The technological foundations of AI in pathology are reviewed, highlighting the practical applications and diagnostic challenges in thoracic pathology, as well as issues in interpretability, validation, infrastructure, reimbursement, and regulation.</div></div>","PeriodicalId":39961,"journal":{"name":"Diagnostic Histopathology","volume":"31 8","pages":"Pages 486-490"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144738080","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Staging in patients with multiple tumours: integrating morphology and molecular profiling","authors":"Matthew Evans","doi":"10.1016/j.mpdhp.2025.05.003","DOIUrl":"10.1016/j.mpdhp.2025.05.003","url":null,"abstract":"<div><div>With improvements in lung cancer diagnosis and management, the phenomenon of patients having more than one lung cancer is becoming increasingly frequent. Whether a second cancer is considered a separate primary lung cancer or an intrapulmonary metastasis fundamentally changes the staging and can have critical importance for treatment decisions. Histological comparison of cancers is often an effective tool in discriminating between separate primary lung cancer and intrapulmonary metastasis. The advent of genomic profiling has brought another powerful tool to our arsenal. While there is compelling evidence that both approaches accurately resolve the majority of cases, neither is without limitations and it is easy to succumb to pitfalls from both histological and genomic assessment. A combined approach by a pathologist who is skilled in recognizing discriminating histological features, and who has a good grounding in the molecular evolution of cancers and in the limitations of molecular techniques, is required to optimize these judgements. In this review, we discuss the tools which can be brought to bear on the dilemma of classifying multiple lung cancers. We begin by reviewing the clinical and radiological clues, before discussing the value of histological comparison, and finally the value which molecular profiling can bring.</div></div>","PeriodicalId":39961,"journal":{"name":"Diagnostic Histopathology","volume":"31 8","pages":"Pages 466-480"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144738078","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The pulmonary pathology of air pollution: a review","authors":"Jessica K Maguire, Aurelie Fabre","doi":"10.1016/j.mpdhp.2025.05.001","DOIUrl":"10.1016/j.mpdhp.2025.05.001","url":null,"abstract":"<div><div>Exposure to ambient and household air pollution causes respiratory disease at all stages of life and is globally responsible for 6.7 million premature deaths annually. The major known contributory pollutants are PM, SO<sub>2</sub>, O<sub>3</sub>, NO<sub>2</sub> and CO. Extensive evidence has been published describing their various pathological effects. The WHO report that 99% of the earth's population breathe air with pollution levels outside the global air quality guidelines. Lack of access to clean fuel is a major risk factor, particularly in low- and middle-income countries. The effects of pollution on the respiratory system are broad, identified from intrauterine life to old age, with most risk at the extremes of age. Many pollutants damage the airways by the same mechanism; the induction of oxidative stress and production of reactive oxygen and nitrogen species, leading to chronic airway changes. Pathologies related to environmental pollution include, but are not limited to, defects in lung development, asthma and COPD, infectious disease and respiratory tract malignancies. While the cardiovascular effects of exposure to pollution have been well described, the purpose of this review article is to outline the major ambient air pollutant types associated with respiratory disease, and describe the pulmonary pathology associated with their exposure.</div></div>","PeriodicalId":39961,"journal":{"name":"Diagnostic Histopathology","volume":"31 8","pages":"Pages 451-457"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144738076","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jonathan Callaghan, Caroline Cartlidge, Selina Bhattarai, Azzam Ismail, Jo-An Roulson
{"title":"A neuroglial neoplasm in retroperitoneal lymph nodes: metastasis from a testicular teratoma with embryonic-type neuroectodermal tumour","authors":"Jonathan Callaghan, Caroline Cartlidge, Selina Bhattarai, Azzam Ismail, Jo-An Roulson","doi":"10.1016/j.mpdhp.2025.05.005","DOIUrl":"10.1016/j.mpdhp.2025.05.005","url":null,"abstract":"<div><div>Testicular germ cell tumours are a common solid malignancy amongst young men. Most non-seminomatous germ cell tumours in adults display mixed histological types, although can be purely one type. Rarely, some non-seminomatous germ cell tumours undergo somatic malignant transformation, whereby they can differentiate into diverse malignant phenotypes, which might resemble tumours found elsewhere in the body. Although uncommon, these transformations carry significant implications for prognosis and treatment. We present a case of a testicular teratoma with somatic malignant transformation to embryonic type neuroectodermal tumour. Unusually, the associated metastases to retroperitoneal lymph nodes show neuroglial differentiation without aggressive features. This case highlights the diagnostic challenges of teratomas with somatic malignant transformation, emphasizing the role of histopathology, immunohistochemistry, and molecular techniques in diagnosis and clinical decision-making.</div></div>","PeriodicalId":39961,"journal":{"name":"Diagnostic Histopathology","volume":"31 8","pages":"Pages 491-494"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144738081","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Histological predictors of outcome in non-small cell lung cancer","authors":"Reena Khiroya","doi":"10.1016/j.mpdhp.2025.05.004","DOIUrl":"10.1016/j.mpdhp.2025.05.004","url":null,"abstract":"<div><div>The histopathological diagnosis and reporting of non-small cell carcinoma has been aided by an understanding of the factors which affect prognosis. In this review we will consider a few factors which can affect prognosis of patients with non-small cell lung carcinoma. These are: grading of non-small cell carcinomas, lymphovascular invasion, spread through air spaces, and pleural invasion. We discuss how to identify and quantify these factors, and the known evidence for their effect on prognosis. In conclusion, a better understanding of these factors and their inclusion in histopathology reports will help treatment planning and patient prognostication.</div></div>","PeriodicalId":39961,"journal":{"name":"Diagnostic Histopathology","volume":"31 8","pages":"Pages 481-485"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144738079","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Caroline Cartlidge, Edward E Carling, Bipin Mathew, Laura Wastall
{"title":"Pulmonary adenofibroma: a rare biphasic lung tumour in a young male","authors":"Caroline Cartlidge, Edward E Carling, Bipin Mathew, Laura Wastall","doi":"10.1016/j.mpdhp.2025.05.006","DOIUrl":"10.1016/j.mpdhp.2025.05.006","url":null,"abstract":"<div><div>We report a very unusual case of benign pulmonary adenofibroma (PAF) in a young man who presented with intermittent chest pain and was found to have a lung mass. PAF is extremely rare and is poorly characterized but thought to be benign based on the limited available literature. Indolent PAF may be misdiagnosed as solitary fibrous tumour (SFT), due to similar histological features. We review the morphological histopathological features and the relevant panel of immunohistochemical stains and molecular tests that can help, to prevent misdiagnosis and overtreatment.</div></div>","PeriodicalId":39961,"journal":{"name":"Diagnostic Histopathology","volume":"31 8","pages":"Pages 495-497"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144738082","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Carol Kwon , Karin Purshouse , Iain D Phillips, David A Dorward
{"title":"Neoadjuvant chemo-immunotherapy in non-small cell lung cancer: clinical rationale and methods of pathological assessment","authors":"Carol Kwon , Karin Purshouse , Iain D Phillips, David A Dorward","doi":"10.1016/j.mpdhp.2025.05.002","DOIUrl":"10.1016/j.mpdhp.2025.05.002","url":null,"abstract":"<div><div>Non-small cell lung cancer (NSCLC) remains a common cancer with poor outcomes, with even early stage, resectable tumours having a high recurrence rate. Over the past decade immunotherapy has been paradigm-changing in advanced, metastatic NSCLC while more recent evidence has demonstrated its important role as a neoadjuvant agent in surgically resectable disease. This has led to a significant shift in clinical practice and, in doing so, has altered requirements in the pathological assessment of surgical resection specimens. In this paper, we summarize the clinical, biological and pathological rationale behind neoadjuvant immunotherapy, describe the evidence base for this change in clinical practice and detail the central role of histopathology. Clinical trials have demonstrated marked event-free and overall survival advantages for combined immunotherapy and chemotherapy with pathological response an important surrogate marker of long-term outcome. We describe the key histopathological and molecular characteristics that render a patient eligible for neoadjuvant treatment as well as the requirements for assessment of surgical specimens to enable the accurate quantification of pathological response. In addition, the potential future roles for alternative measures of disease response are discussed, including circulating tumour DNA, immune cell phenotyping and artificial intelligence-based analyses.</div></div>","PeriodicalId":39961,"journal":{"name":"Diagnostic Histopathology","volume":"31 8","pages":"Pages 458-465"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144738077","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Johannes Kläger, Maximilian C Koeller, Eva Compérat
{"title":"Application of artificial intelligence in kidney neoplasms: usability of pathological data in enhancing classification, grading and prognostic and predictive models","authors":"Johannes Kläger, Maximilian C Koeller, Eva Compérat","doi":"10.1016/j.mpdhp.2025.04.005","DOIUrl":"10.1016/j.mpdhp.2025.04.005","url":null,"abstract":"<div><div>Renal cell carcinoma (RCC) is among the most common human malignancies, gold standard in diagnosis is still histology but poses challenges in classification, grading, reproducibility or identification of predictive markers. The increasing use and availability of artificial intelligence (AI) like machine learning and deep learning methods, rose hope of improving those issues. The literature is expanding rapidly and in such experimental setting promising results were shown in distinguishing RCC subtypes and grades and leveraging digital pathology data in AI-integrated multimodal approaches combining histopathologic, genetic, and clinical data enhancing prognostic and predictive models. However, significant limitations hinder clinical implementation, like missing of prospective evaluation, underrepresentation of rare subtypes and evolving classification systems. Also the \"black box\" nature of some AI models and resource intensiveness raise concerns about transparency and feasibility.</div></div>","PeriodicalId":39961,"journal":{"name":"Diagnostic Histopathology","volume":"31 7","pages":"Pages 432-437"},"PeriodicalIF":0.0,"publicationDate":"2025-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144489542","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Maximilian C Koeller, Garbiel Wasinger, Eva Compérat
{"title":"The use of artificial intelligence in bladder cancer: a histopathologic perspective","authors":"Maximilian C Koeller, Garbiel Wasinger, Eva Compérat","doi":"10.1016/j.mpdhp.2025.04.004","DOIUrl":"10.1016/j.mpdhp.2025.04.004","url":null,"abstract":"<div><div>Artificial Intelligence has shown promising results in the context of cancer diagnostics, especially due to the advancements in Digital and Computational Pathology. With regards to Bladder Cancer, AI Systems have shown to be capable of solving complex problems such as cancer detection, tumor grading, detection of lymph node metastasis or even the prediction of lymph node or mutation status (e.g. FGFR3) based solely on Hematoxylin & Eosin morphology. Furthermore, AI systems can aid pathologists by autonomously generating synoptic reports from Whole Slide Images. Against this backdrop, this review aims to provide a high level, yet comprehensive overview on the latest advancements of AI in bladder cancer, from a histopathological perspective, while discussing the current challenges in this field. In line with this scope, while highly interesting, applications of AI in the context of cystoscopy, cytology, immunohistochemistry, radiology and bioinformatics will not be discussed.</div></div>","PeriodicalId":39961,"journal":{"name":"Diagnostic Histopathology","volume":"31 7","pages":"Pages 424-431"},"PeriodicalIF":0.0,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144489541","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Atrophic-pattern prostatic adenocarcinoma: a diagnostic pitfall","authors":"Ka Wing Eric Wong, Tanjot Singh, Jo-An Roulson","doi":"10.1016/j.mpdhp.2025.04.009","DOIUrl":"10.1016/j.mpdhp.2025.04.009","url":null,"abstract":"<div><div>The atrophic pattern of prostatic adenocarcinoma is an uncommon histological pattern of acinar prostatic adenocarcinoma. Due to its deceptively benign histological appearance, it can be misdiagnosed as a benign entity. We report a case of atrophic pattern prostatic adenocarcinoma in an elderly male patient, highlighting key histopathological findings and prognostic implications. This pattern closely resembles benign atrophy, and we discuss the differences in architectural and cytological features, as well as the role of immunohistochemistry as a diagnostic adjunct. It is vital to recognise benign-appearing variants of prostatic adenocarcinoma to prevent misdiagnosis and ensure appropriate clinical management.</div></div>","PeriodicalId":39961,"journal":{"name":"Diagnostic Histopathology","volume":"31 7","pages":"Pages 447-450"},"PeriodicalIF":0.0,"publicationDate":"2025-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144489646","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}