Diagnostic Histopathology最新文献

{"title":"Malignant cutaneous clear cell tumours: a review of histological, immunohistochemical and molecular features","authors":"Gerardo Cazzato,&nbsp;Giulia Bagaloni,&nbsp;Nicoletta Sgarro,&nbsp;Irma Trilli,&nbsp;Andrea Marzullo,&nbsp;Alessio Giubellino,&nbsp;Domenico Ribatti","doi":"10.1016/j.mpdhp.2024.11.002","DOIUrl":"10.1016/j.mpdhp.2024.11.002","url":null,"abstract":"<div><div>Malignant cutaneous clear cell tumors encompass a diverse range of rare skin neoplasms characterized by clear cell morphology, which can be of epidermal, adnexal, mesenchymal, or melanocytic origin. Cutaneous clear cell squamous cell carcinoma (cccSCC) is a variant of squamous cell carcinoma marked by intracellular glycogen accumulation, clear cell differentiation, and a clinical presentation similar to conventional cSCC. Trichilemmal carcinoma (TC) is a malignant adnexal tumor with outer root sheath differentiation, often mimicking cccSCC histologically, but distinguished by trichilemmal keratinization and different immunohistochemical markers. Adnexal clear cell carcinoma with comedonecrosis (ACCCC) is an aggressive, rare tumor marked by distinctive zonal architecture and central comedonecrosis. Clear cell porocarcinoma (CCP) and clear cell hidroadenocarcinoma (CCH) are adnexal malignancies originating from eccrine glands and can be differentiated by their ductal differentiation and immunohistochemistry profiles. Clear cell atypical fibroxanthoma (ccAFX) is a rare variant of AFX with pleomorphic, clear cell morphology and overlapping features with other cutaneous clear cell malignancies, requiring differentiation based on cytokeratin expression and other histological markers. Malignant PEComa and clear cell sarcoma, while rare in the skin, exhibit clear cell morphology with melanocytic differentiation and have distinct molecular profiles that aid in their diagnosis. Lastly, clear cell melanoma, considered analogous to balloon cell melanoma, is a rare histological variant of melanoma characterized by its clear, glycogen-laden cells, sharing molecular features with conventional melanoma but requiring differentiation from other clear cell tumors, using ancillary studies including immunohistochemistry. Proper histopathological analysis, aided by immunohistochemical and molecular markers, is critical for distinguishing these rare malignancies and guiding appropriate treatment.</div></div>","PeriodicalId":39961,"journal":{"name":"Diagnostic Histopathology","volume":"31 2","pages":"Pages 55-63"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143134522","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":"Histopathological diagnosis of psoriasis and psoriasiform dermatitides","authors":"Maria Teresa Fernandez-Figueras Maite,&nbsp;Luis Puig","doi":"10.1016/j.mpdhp.2024.11.005","DOIUrl":"10.1016/j.mpdhp.2024.11.005","url":null,"abstract":"<div><div>The term psoriasiform dermatitis encompasses a group of skin diseases with lesions that exhibit clinical and histological similarities to psoriasis. Conditions such as pityriasis rubra pilaris, seborrheic dermatitis, and psoriasiform keratosis share alterations in certain pathogenetic mechanisms. These common mechanisms result in similar epidermal changes that define the psoriasiform pattern, characterized by regular acanthosis and abnormal cornification, often accompanied by corneal and subcorneal neutrophilic infiltrates. Despite these epidermal similarities, the dermal alterations can vary significantly among psoriasiform dermatoses. For instance, psoriasis typically presents with mild, non-specific superficial inflammation, whereas pityriasis lichenoides chronica is marked by abundant lymphocytic infiltrates, endothelial damage, and erythrocyte extravasation. Furthermore, the psoriasiform pattern frequently appears alongside other histopathological patterns. Spongiosis is a common finding, which may be incidental in psoriasis or a defining feature in seborrheic dermatitis. Lichenoid infiltrates are a defining feature in conditions such as pityriasis lichenoides chronica and pityriasis rubra pilaris and are also seen in psoriasiform cases of syphilis. Understanding the histological commonalities and distinctions, along with the clinical features of each condition, enables dermatopathologists to differentiate between various psoriasiform dermatoses and to identify specific disease entities based on their typical histopathological and clinical presentations.</div></div>","PeriodicalId":39961,"journal":{"name":"Diagnostic Histopathology","volume":"31 2","pages":"Pages 87-97"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143134525","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":"Primary cutaneous neuroendocrine neoplasms: understanding concepts and approaching the differential diagnosis","authors":"Maged Daruish,&nbsp;Gerardo Cazzato,&nbsp;Keisuke Goto,&nbsp;Thibault Kervarrec,&nbsp;Saleem Taibjee","doi":"10.1016/j.mpdhp.2024.11.004","DOIUrl":"10.1016/j.mpdhp.2024.11.004","url":null,"abstract":"<div><div>Cutaneous tumours with neuroendocrine differentiation are not uncommon. Many of these tumours share similar clinical, cytological and immunohistochemical features rendering the final diagnosis challenging. Furthermore, some cutaneous tumours may rarely show aberrant expression of neuroendocrine markers, while true neuroendocrine differentiation in these remains debatable. Nomenclature and classification of some entities have also been confusing, reflecting the difficulty in histological interpretation as well as rarity of some of the tumours described, and the evolving understanding of their pathogenesis. For instance, low-grade neuroendocrine carcinoma of the skin has been re-named to sweat gland carcinoma with neuroendocrine differentiation, indicating a likely sweat gland origin. Another example is polymorphous sweat gland carcinoma, of which existence has been debated. In this article, we review the basic histological definitions, discuss incorporating clinicopathological findings and immunohistochemical interpretation when approaching the differential diagnoses of neuroendocrine tumours. We also review the most recently described entities and their evolution in the literature.</div></div>","PeriodicalId":39961,"journal":{"name":"Diagnostic Histopathology","volume":"31 2","pages":"Pages 75-86"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143134526","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":"Don't call this a high-grade sarcoma! A case of superficial CD34-positive fibroblastic tumour","authors":"Daniel T Field,&nbsp;Jonathan Davey,&nbsp;Stuart Goudie,&nbsp;Basil J Monks","doi":"10.1016/j.mpdhp.2024.11.009","DOIUrl":"10.1016/j.mpdhp.2024.11.009","url":null,"abstract":"<div><div>Described is a case of a superficial CD34-positive fibroblastic tumour, a rare atypical mesenchymal lesion of fibroblastic origin, in a female patient in her 40's. The common clinical, histological and molecular features are discussed with an emphasis on the pathologist's role in diagnosis, differentiation and MDT discussion.</div></div>","PeriodicalId":39961,"journal":{"name":"Diagnostic Histopathology","volume":"31 2","pages":"Pages 125-129"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143134528","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":"Spitz melanocytoma vs melanoma: a case involving the use of molecular testing","authors":"Harriet Hunter,&nbsp;Jonathan Potts,&nbsp;Paul Craig","doi":"10.1016/j.mpdhp.2024.11.008","DOIUrl":"10.1016/j.mpdhp.2024.11.008","url":null,"abstract":"<div><div>This case is of a melanocytic lesion that was eventually classified as a spitzoid melanoma, after molecular testing. The differential diagnosis was between a Spitz melanocytoma (Atypical Spitz tumour) and a spitzoid melanoma. This is a subjective and ambiguous area of pathology, where the use of molecular testing can provide useful diagnostic information. In this case, a BRAF V600E mutation, and lack of kinase fusions, led to the diagnosis of a spitzoid melanoma, rather than a true member of the Spitz family.</div></div>","PeriodicalId":39961,"journal":{"name":"Diagnostic Histopathology","volume":"31 2","pages":"Pages 122-124"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143134529","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":"Histopathological differential diagnosis of nail psoriasis and onychomycosis","authors":"Eckart Haneke","doi":"10.1016/j.mpdhp.2024.11.007","DOIUrl":"10.1016/j.mpdhp.2024.11.007","url":null,"abstract":"<div><div>About 160 million in the world are suffering from psoriasis, which is thus one of the most prevalent inflammatory skin diseases. It has a genetic background with very strong environmental influence. The clinical pictures are extremely variable, and it may be justified to assume that almost every psoriasis patient has his own form. Psoriasis may be a minor problem or life-threatening. Particular localizations have a serious impact on the patients’ life. Nails are frequently affected and present with very different alterations that depend on the nail structures involved. Onychomycoses are a group of nail infections and said to be the most frequent nail diseases. The way of fungal invasion determines the clinical and histopathological characteristics. Both conditions have many features in common rendering the differential diagnosis difficult. To make it even more complicated both nail psoriasis and onychomycosis may occur in the same patient, sometimes affecting different nails, more often involving the same nails. This review describes the histopathology of these frequent nail conditions and how to differentiate them.</div></div>","PeriodicalId":39961,"journal":{"name":"Diagnostic Histopathology","volume":"31 2","pages":"Pages 107-121"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143134527","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":"Undifferentiated round cell sarcomas of the skin","authors":"Lea Korša,&nbsp;Michael Michal,&nbsp;Zlatko Marušić","doi":"10.1016/j.mpdhp.2024.11.001","DOIUrl":"10.1016/j.mpdhp.2024.11.001","url":null,"abstract":"<div><div>Undifferentiated round cell sarcomas are a heterogenous group of bone/soft tissue neoplasms characterized by relatively monotonous small blue round cell morphology, with high nuclear/cytoplasmic ratio and unspecific or overlapping immunohistochemical findings. According to the WHO Classification of Tumors of Soft tissue and Bone, this group includes Ewing sarcoma, <em>CIC</em>-rearranged sarcoma, sarcoma with <em>BCOR</em> genetic alterations, and round cell sarcoma with <em>EWSR1</em>::non-ETS fusions. Although they are quite rare in cutaneous/subcutaneous localization, they should always be included in the differential diagnosis of poorly differentiated round cell cutaneous tumors. Among them, subcutaneous/cutaneous Ewing sarcoma and superficial <em>CIC</em>- rearranged sarcoma are the most common entities and distinction between them is extremely important, as Ewing sarcoma has a significantly better prognosis, particularly in the superficial location, as opposed to <em>CIC</em>-rearranged sarcoma which is a highly aggressive sarcoma with a poor clinical outcome. Molecular analysis is required for diagnostic confirmation, and it includes FISH, standard sequencing-based methods and recently also DNA methylation profiling. This article provides a summary on contemporary knowledge regarding undifferentiated cutaneous round cell sarcomas, with an emphasis on characteristic histologic and immunohistochemical features as well as diagnostic pitfalls, including differential diagnosis and potential false-negative results in molecular assays.</div></div>","PeriodicalId":39961,"journal":{"name":"Diagnostic Histopathology","volume":"31 2","pages":"Pages 45-54"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143134524","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":"Rare variants of mycosis fungoides: a practical approach with emphasis on differential diagnosis","authors":"Gerardo Cazzato ,&nbsp;Andrea Ronchi ,&nbsp;Giulia Bagaloni,&nbsp;Alessio Giubellino,&nbsp;Paola Vitiello,&nbsp;Renato Franco,&nbsp;Domenico Ribatti,&nbsp;Giuseppe Ingravallo","doi":"10.1016/j.mpdhp.2024.11.003","DOIUrl":"10.1016/j.mpdhp.2024.11.003","url":null,"abstract":"<div><div>Mycosis fungoides (MF) is the most common form of primary cutaneous T-cell lymphoma, representing around 50% of all primary cutaneous lymphomas. Its incidence in the United States is estimated at 0.52 per 100,000 cases annually, with a male-to-female ratio of 2:1. MF predominantly affects adults, with a median age of onset between 55 and 60 years. The classic form is characterized by scaly erythematous patches and plaques, which may evolve into tumor stage, signifying more advanced disease with poorer overall survival. Large cell transformation (LCT) can occur at any stage, resulting in more aggressive disease with a median overall survival of 19–36 months. MF can mimic various inflammatory dermatoses, such as eczema and psoriasis, complicating early diagnosis. Uncommon variants like folliculotropic MF (FMF) and syringotropic MF (STMF) exhibit unique clinical and histopathological features, further broadening the differential diagnosis. FMF, characterized by follicular involvement, has a poorer prognosis compared to conventional MF. STMF involves lymphocytic infiltration of eccrine structures and typically presents on the extremities. Pagetoid reticulosis (PR) and granulomatous slack skin (GSS) are rare variants of MF, each with distinct clinical and histological presentations. Accurate diagnosis often requires a multidisciplinary approach due to the overlapping features with other neoplastic and inflammatory conditions. This review highlights the key histopathological features of these rare MF variants and discusses their differential diagnosis.</div></div>","PeriodicalId":39961,"journal":{"name":"Diagnostic Histopathology","volume":"31 2","pages":"Pages 64-74"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143134523","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 histopathological spectrum of sebaceous tumours: key features, diagnostic criteria and differential diagnosis","authors":"Liam Carroll,&nbsp;Eleni Ieremia","doi":"10.1016/j.mpdhp.2024.11.006","DOIUrl":"10.1016/j.mpdhp.2024.11.006","url":null,"abstract":"<div><div>Sebaceous tumours represent a diverse group of cutaneous proliferations originating from sebaceous glands. These tumours range from benign growths to aggressive malignancies and play a significant role in clinical management due to their potential systemic associations, such as Muir-Torre syndrome. This review aims to summarize the types, diagnosis, and implications of sebaceous neoplasms, focusing on their clinical, histopathological, and immunophenotypic features.</div></div>","PeriodicalId":39961,"journal":{"name":"Diagnostic Histopathology","volume":"31 2","pages":"Pages 98-106"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143134688","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":"A case of penetrating aortic ulcer complicated by tuberculosis: insights from the post-mortem","authors":"Gurjeevun Henry Chaggar,&nbsp;Hannah Hawrot","doi":"10.1016/j.mpdhp.2024.10.008","DOIUrl":"10.1016/j.mpdhp.2024.10.008","url":null,"abstract":"<div><div>We report an autopsy case of a penetrating aortic ulcer caused by a combination of tuberculosis infection and background aortic atheroma. The patient was a male in his mid-60s with a past medical history of essential hypertension, prostate cancer, and cigarette smoking. He presented to his GP with significant unintentional weight loss/general malaise and a CT scan revealed a 4.5 cm ulcer in the arch of his aorta. Before vascular referral could be made, he was found dead at home with a left-sided haemothorax caused by rupture of his penetrating aortic ulcer. Histological examination showed granulomatous inflammation at the ulcer site with numerous acid-fast bacilli, consistent with <em>Mycobacterium tuberculosis</em> infection, and severe atheroma in the background aorta. This case highlights the rare interaction between atherosclerosis and tuberculosis in causing aortic ulceration.</div></div>","PeriodicalId":39961,"journal":{"name":"Diagnostic Histopathology","volume":"31 1","pages":"Pages 42-44"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143152703","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}