Turkish Journal of Pathology最新文献

{"title":"Difficult Diagnosis of Interdigitating Dendritic Cell Sarcoma of the Retroperitoneum: A Case Report and A Brief Review of the Literature.","authors":"Galina Boyko, Igor Makarov","doi":"10.5146/tjpath.2024.13546","DOIUrl":"https://doi.org/10.5146/tjpath.2024.13546","url":null,"abstract":"<p><p>Interdigitating dendritic cell sarcoma (IDCS) is a rare and aggressive neoplasm classified within the M-group of malignant histiocytoses. Its diagnosis poses a significant challenge. This article aims to describe a rare clinical case of IDCS and to illustrate the differential diagnostic process undertaken by the authors in establishing this diagnosis. A 60-year-old woman was admitted for the resection of a retroperitoneal mass discovered via CT scan. Morphological examination revealed a 7.5×5.5×5.0 cm tumor, encapsulated by a thin fibrous capsule. The tumor was composed of 90-95% inflammatory infiltrate with lymphocyte-like cells showing mature nuclear morphology (CD3+ and CD20+ cells) mixed with histiocytes and plasma cells, and 5-10% large polymorphic spindle-shaped cells expressing expression of CD45, CD68, CD1a, CD21, CD35, CD31, and CD34. An extensive immunohistochemical panel was performed to exclude various other tumors. Based on the morphology and immunophenotype, a diagnosis of IDCS was established. Further literature analysis indicated the nonspecificity of symptoms in patients with this tumor localization and variability in CD45 and CD68 staining in tumor cells, with consistent lack of expression of CD21, CD23, CD35, CD1a, and specific T- and B-cell antigens. IDCS is a rare and poorly understood tumor with a poor prognosis. The nonspecificity of clinical symptoms and the need for extensive morphological differential diagnosis render this entity a diagnosis of exclusion, requiring significant diligence from the pathologist.</p>","PeriodicalId":45415,"journal":{"name":"Turkish Journal of Pathology","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2024-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142019081","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":"Investigation of the Relationship Between Tumor Microenvironment and Prognostic Parameters in Invasive Breast Carcinomas of No Special Type: A Retrospective Analysis.","authors":"Mine Ozsen, Sahsine Tolunay, Kazim Senol, Adem Deligonul, Sehsuvar Gokgoz, Turkkan Evrensel","doi":"10.5146/tjpath.2024.12805","DOIUrl":"10.5146/tjpath.2024.12805","url":null,"abstract":"<p><strong>Objective: </strong>The tumor microenvironment is a heterogeneous and constantly changing territory that plays an active role in tumor formation and progression. It constantly interacts with tumor cells, plays an active role in tumor development, and even appears as a parameter of prognostic importance, and the importance of the tumor microenvironment in breast cancer has been emphasized by recent studies. In this study, we aimed to retrospectively evaluate the relationship between the tumor microenvironment and prognostic parameters in invasive breast carcinomas of no special type.</p><p><strong>Material and methods: </strong>A total of 271 cases diagnosed as invasive breast carcinoma of no special type from resection materials in our center between 2007 and 2015 were included in the study. Hematoxylin-eosin stained slides with a thickness of 4-5 micrometers were evaluated in terms of tumor infiltrating lymphocytes, peritumoral and intratumoral desmoplastic reaction, intratumoral and peritumoral tumor budding, stromal features, and tumor growth pattern.</p><p><strong>Results: </strong>When parameters related to the tumor microenvironment were compared with other prognostic parameters, there was a significant relationship between TILs and tumor grade, size, stage, immunohistochemical subgroup and Ki-67 proliferation index. A significant relationship was detected between intratumoral stromal reaction and tumor grade, size, molecular subgroup and the Ki-67 proliferation index (p < 0.05). When stroma and other prognostic parameters were compared, tumors with desmoplastic stroma had higher grades and higher Ki-67 proliferation indexes, and they were observed more frequently in the triple negative molecular subgroup.</p><p><strong>Conclusion: </strong>We believe that including parameters related to tumor microenvironment in breast cancer reports, which hold a prognostic and predictive importance, will contribute to patient management. Considering the fact that these can be easily evaluated from routinely used hematoxylin-eosin stained slides, this does not cause additional costs or excessive time loss.</p>","PeriodicalId":45415,"journal":{"name":"Turkish Journal of Pathology","volume":" ","pages":"170-180"},"PeriodicalIF":1.1,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11401734/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141155420","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hot Trends in Pheochromocytoma and Paraganglioma: Are We Getting Closer to Personalized Dynamic Prognostication?","authors":"C Christofer Juhlin, Ozgur Mete","doi":"10.5146/tjpath.2024.13681","DOIUrl":"10.5146/tjpath.2024.13681","url":null,"abstract":"<p><p>Pheochromocytoma and abdominal paraganglioma (PPGL) are rare catecholamine-producing, keratin-negative, non-epithelial neuroendocrine neoplasms characterized by a unique association with syndromic diseases caused by constitutional mutations in a wide range of susceptibility genes. While PPGLs are recognized for their malignant potential, the risk of metastatic disease varies depending on several clinical, histological, and genetic factors. Accurate diagnosis and prognosis of these tumors require a multidisciplinary approach, integrating insights from various medical specialties. Pathologists play a crucial role in this complex task, as numerous morphological, immunohistochemical, and genetic findings can be linked to worse outcomes. Therefore, it is vital to stay informed about the latest advancements in PPGL pathology. This brief review provides an overview of the challenges associated with PPGLs and highlights the most recent developments in tumor prognostication.</p>","PeriodicalId":45415,"journal":{"name":"Turkish Journal of Pathology","volume":" ","pages":"143-148"},"PeriodicalIF":1.1,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11402475/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142019082","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Are We Where We Want to Be in Undergraduate Pathology Education?","authors":"Sibel Sensu, Nusret Erdogan","doi":"10.5146/tjpath.2023.13048","DOIUrl":"10.5146/tjpath.2023.13048","url":null,"abstract":"<p><strong>Objective: </strong>This review which aims to examine the recent and current status of pathology education in medical schools, and covers the publications related to undergraduate pathology education published between 2010 January and June 2023.</p><p><strong>Material and method: </strong>A search was performed through PubMed, Google Scholar, Semantic Scholar, and Ulakbim search engines for the Science Citation Index, Science Citation Index Expanded, Emerging Sources Citation Index, Directory of Open Access Journals, Scopus, PubMed as well as TR Dizin indexed articles. The findings are categorized into two periods as 2010 January - 2020 April (pre-COVID-19 pandemic) and May 2020 - 2023 June. A total of 24 reviews/editorials/letters to the editor and 63 research articles in the pre-pandemic period and 11 reviews/ editorials/ letters to the editor and 35 research articles between 2020 May and 2023 June are included in the analysis.</p><p><strong>Results: </strong>Currently, medical education generally depends on core education programs with defined learning objectives and outcomes. Moreover, problem-based, case-based, and team-based interactive learning are being used along with traditional didactic courses. Additionally, digital/ web-based/remote education methods have gained prominence after the COVID-19 pandemic. The virtual or augmented reality and 3D drawing applications are offered as a solution for the autopsy and macroscopy courses. A scarce number of publications are found on measuring and evaluating the effectiveness of learning.</p><p><strong>Conclusion: </strong>Artificial intelligence in pathology education is a topic that looks likely to become important in the near future. National and international comprehensive standardization is a necessity. A joint effort and collective intelligence are needed to achieve the desired goals in undergraduate pathology education.</p>","PeriodicalId":45415,"journal":{"name":"Turkish Journal of Pathology","volume":" ","pages":"78-88"},"PeriodicalIF":1.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11131570/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139543211","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical, Histopathological and Immunohistochemical Aspects of Digital Papillary Adenocarcinoma: A Case Report and Literature Review.","authors":"Sergen Yagci, Aysen Terzi, Abbas Albayati, Ahmet Cagri Uysal","doi":"10.5146/tjpath.2023.01606","DOIUrl":"10.5146/tjpath.2023.01606","url":null,"abstract":"<p><p>Digital papillary adenocarcinoma (DPA) is a rare malignant eccrine tumor. A 62-year-old female presented with a subcutaneous nodular 1.5cm-mass in the thumb. Macroscopically, a poorly circumscribed mass containing cystic and solid components was observed. Microscopically, epithelial neoplasm consisting of tubular-cystic structures with back-to-back arrangements was observed. The lining epithelium was composed of cuboidal/columnar cells with mild atypia, with micropapillary extensions. Immunohistochemistry revealed double-layered neoplastic epithelium containing two different types of cells: basaloid/myoepithelial and luminal. We recommend two out of vimentin, HMWCK, and D2-40 for myoepithelial/basaloid cells, also CK7 and EMA for luminal/columnar cells. As the tumor had infiltrated the surgical margins, the patient underwent axillary sentinel lymph node (SLN) dissection and re-excision with Mohs micrographic surgery (MMS). Two additional MMS stages were required due to suspicious surgical margin positivity in the frozen sections. The operation was continued despite the risk of loss of function. Upon examination of the permanent sections, we observed no tumors in the suspected positive foci. Additionally, no tumor was found in the surgical margins. No metastasis was detected in the sentinel lymph node. We have reached 300 reported cases of DPA in the literature. We discussed the histopathological and intraoperative diagnostic pitfalls of DPA with a literature review and our experience.</p>","PeriodicalId":45415,"journal":{"name":"Turkish Journal of Pathology","volume":" ","pages":"69-73"},"PeriodicalIF":1.1,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10823785/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9675088","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinicopathologic Evaluation of CD80, CD86, and PD-L1 Expressions with Immunohistochemical Methods in Malignant Melanoma Patients.","authors":"Esra Cobankent Aytekin, Betul Unal, Cumhur Ibrahim Bassorgun, Ozlenen Ozkan","doi":"10.5146/tjpath.2023.01608","DOIUrl":"10.5146/tjpath.2023.01608","url":null,"abstract":"<p><strong>Objective: </strong>Diagnostic and prognostic biomarkers for malignant melanoma are crucial for treatment and for developing targeted therapies. Malignant melanoma is a highly immunogenic tumor, and its regression, treatment, and prognostic evaluation are directly related to escape from immune destruction. Therefore, we aimed to determine the expression levels of CD80, CD86, and PD -L1 in malignant melanoma tissue samples by immunohistochemistry and to investigate the possible relationship between these proteins and the clinicopathological features in this study.</p><p><strong>Material and methods: </strong>Hematoxylin and eosin staining and immunohistochemical staining for CD80, CD86, and PD-L1 were evaluated for clinical data, survival, prognosis, tumor location, malignant melanoma subtypes, tumor size, and prognostic findings.</p><p><strong>Results: </strong>Higher survival rates were observed in patients with lower PD-L1 staining scores in the tumor. The 5-year survival was higher in patients with CD80-positive and CD86-positive biopsies. Mortality was lower in superficial spreading melanoma and Lentigo maligna melanoma types, whereas staining positivity of CD80 and CD86 was higher. Furthermore, a relationship between clinical stage and Breslow thickness ( < 2mm/≥2mm), tumor ulceration, lymph node metastasis, and CD80 and CD86 expression was also identified.</p><p><strong>Conclusion: </strong>Our findings suggest that PD-L1, CD80, and CD86 expression are essential in malignant melanoma and could be used as prognostic markers.</p>","PeriodicalId":45415,"journal":{"name":"Turkish Journal of Pathology","volume":" ","pages":"16-26"},"PeriodicalIF":1.1,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10823788/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10056866","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Productivity Improvement in Pathology Laboratories Using Motion and Time Study Techniques.","authors":"Canan Cinar, Afsun Ezel Esatoglu","doi":"10.5146/tjpath.2023.01610","DOIUrl":"10.5146/tjpath.2023.01610","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to determine the standard time required for the performed job and to examine the standard job critically for productivity improvement in the pathology laboratory.</p><p><strong>Material and methods: </strong>In this study that was conducted at a tertiary teaching hospital, observation, fishbone diagram, and flow charts were used to collect the information about the job process. All employees were observed from September 2017 to June 2018. The observations were recorded by video camera in order to overcome the Hawthorne effect. Nine basic procedure steps were followed for productivity improvement.</p><p><strong>Results: </strong>Within the scope of the study, the jobs of `trimming tissue blocks` and `sectioning of tissue blocks` was selected. The standard time required was 0.19 minutes for `trimming tissue blocks` and 0.34 minutes for `sectioning of tissue blocks`. The procedure steps, named `Removal of tissue block` and `Fixing the block to the device`, were removed from the flow chart to define the improved method. The implementation of the improved method brought in a gain of 11.28 work days per year.</p><p><strong>Conclusion: </strong>It is obvious that the pathology laboratory needs to take certain measures to improve working conditions and increase efficiency. Our results demonstrate applying the study techniques could reduce the workload and processing time. This study also shows that the study techniques can be applied in the hospital laboratory. Incorporation of all pathology technicians in the change or innovation process will be important in maintaining the achievements.</p>","PeriodicalId":45415,"journal":{"name":"Turkish Journal of Pathology","volume":" ","pages":"27-36"},"PeriodicalIF":1.1,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10823786/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41157847","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Case of Nasal Glial Heterotopia That Can Be Misdiagnosed as Storiform Patterned Sclerotic Fibroma/Collagenoma.","authors":"Fatma Gundogdu, Deniz Ates Ozdemir, Ibrahim Vargel","doi":"10.5146/tjpath.2023.13053","DOIUrl":"10.5146/tjpath.2023.13053","url":null,"abstract":"<p><strong>Objective: </strong>Nasal glioma, also known as nasal glial heterotopia, is a rare tumor-like lesion that often affects newborns or infants with no hereditary predisposition.</p><p><strong>Case report: </strong>A 4-year-old child with a growth on the nasal dorsum since birth was diagnosed with nasal glial heterotopia/nasal glioma. The lesion showed a sclerotic fibroma/collagenoma-like storiform pattern with entrapped glial tissue that was S100 and GFAP positive.</p><p><strong>Conclusion: </strong>When a biopsy of the nasal dorsum demonstrates sclerotic microscopic findings with a storiform pattern, nasal glioma should be considered before making a diagnosis in the collagen-rich tissue spectrum (collagenoma or Gardner's fibroma), and an immunohistochemical panel should be requested to demonstrate the presence of an unrecognized light microscopically visible glial component.</p>","PeriodicalId":45415,"journal":{"name":"Turkish Journal of Pathology","volume":" ","pages":"134-137"},"PeriodicalIF":1.1,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11131565/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139543210","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Large Language Models as a Rapid and Objective Tool for Pathology Report Data Extraction.","authors":"Beyza Bolat, Ozgur Can Eren, A Humeyra Dur-Karasayar, Cisel Aydin Mericoz, Cigdem Gunduz-Demir, Ibrahim Kulac","doi":"10.5146/tjpath.2024.13256","DOIUrl":"10.5146/tjpath.2024.13256","url":null,"abstract":"<p><p>Medical institutions continuously create a substantial amount of data that is used for scientific research. One of the departments with a great amount of archived data is the pathology department. Pathology archives hold the potential to create a case series of valuable rare entities or large cohorts of common entities. The major problem in creation of these databases is data extraction which is still commonly done manually and is highly laborious and error prone. For these reasons, we offer using large language models to overcome these challenges. Ten pathology reports of selected resection specimens were retrieved from electronic archives of Koç University Hospital for the initial set. These reports were de-identified and uploaded to ChatGPT and Google Bard. Both algorithms were asked to turn the reports in a synoptic report format that is easy to export to a data editor such as Microsoft Excel or Google Sheets. Both programs created tables with Google Bard facilitating the creation of a spreadsheet from the data automatically. In conclusion, we propose the use of AI-assisted data extraction for academic research purposes, as it may enhance efficiency and precision compared to manual data entry.</p>","PeriodicalId":45415,"journal":{"name":"Turkish Journal of Pathology","volume":" ","pages":"138-141"},"PeriodicalIF":1.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11129865/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140289225","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinico-Pathological Spectrum of Alveolar Soft Part Sarcoma: Case Series from a Tertiary Care Cancer Referral Centre in India with a Focus on Unusual Clinical and Histological Features.","authors":"Kanwalpreet Kaur, Amisha Gami, Ashini Shah, Jahnvi Gandhi, Priti Trivedi","doi":"10.5146/tjpath.2023.01605","DOIUrl":"10.5146/tjpath.2023.01605","url":null,"abstract":"<p><strong>Objective: </strong>Alveolar soft part sarcoma (ASPS) is characterized by distinctive histomorphology of variably discohesive epithelioid cells arranged in nests and translocation of t(x;17) (p11.2;q25) resulting in ASPSCR1-TFE3 fusion. The aim of the present study is to review the clinical, histopathological, and immunohistochemical profile of ASPS with a focus on unusual histological features.</p><p><strong>Material and method: </strong>The present study is retrospective and descriptive. All cases with a diagnosis of ASPS were retrieved with clinical and radiology details.</p><p><strong>Results: </strong>22 patients of ASPS were identified. The most common site was the lower extremity and the size range was 3-22 cm. 54.5% of the patients had metastasis, with the lung as the most common site. Metastasis preceded detection of primary tumour in two cases. All cases showed similar histopathology of monomorphic epithelioid cells arranged in nests encircled by sinusoidal vasculature. Architecturally, the organoid pattern (81.8%) was followed by the alveolar pattern. 68.2% of the cases showed apple bite nuclei as the predominant nuclear feature. Rare nuclear features included binucleation (n=13), multinucleation (n=8), pleomorphism (n=4), nuclear grooves in three cases and intranuclear inclusion in one case, mitosis (n=5), and focal necrosis (n=6). All cases were positive for TFE3 and negative for AE1/AE3, EMA, HMB45, PAX8, MyoD1, SMA, synaptophysin, and chromogranin. Only two cases showed focal S100 positivity while one showed focal desmin positivity.</p><p><strong>Conclusion: </strong>Diffuse strong nuclear TFE3 positivity is sensitive for ASPS in an appropriate clinicoradiological context. Due to the high propensity for early metastasis, complete metastatic work-up and long term follow up is recommended.</p>","PeriodicalId":45415,"journal":{"name":"Turkish Journal of Pathology","volume":" ","pages":"89-100"},"PeriodicalIF":1.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11131567/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9505782","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}