PATHOLOGICA最新文献

{"title":"Immune checkpoint inhibitor therapy in metastatic renal cell carcinoma: tumour response and immune-related renal vasculitis following cytoreductive nephrectomy.","authors":"Ekta Jain, Jorge A Diaz, Mustafa Goksel, Arnab Basu, Cristina Magi-Galluzzi","doi":"10.32074/1591-951X-N998","DOIUrl":"https://doi.org/10.32074/1591-951X-N998","url":null,"abstract":"<p><strong>Objective: </strong>Therapeutic landscape of metastatic renal cell carcinoma (mRCC) has transformed over the last 2 decades, particularly with the advent of immune checkpoint inhibitors (ICI). While ICI offer therapeutic benefits, they can also provoke immune-related adverse events (iRAEs). Vasculitis as a clinical iRAE from ICI is rare in association with RCC treatment.</p><p><strong>Methods: </strong>This study included patients treated at our institution with ICI for mRCC (2019-2024). We collected clinicopathologic data and type and duration of immunotherapy. Histologic sections of tumors were re-reviewed by two pathologists to determine pathologic response and features of ICI-related renal injuries.</p><p><strong>Results: </strong>We identified 8 patients (median age 61.5 years) of which six (75%) presented with metastases at multiple sites, while two had recurrent oligometastatic disease post-partial nephrectomy. All patients were treated with ICI for a duration ranging from 6 to 20 months; 7 patients received combination therapy (CT) [iplimumab & nivolumab (n = 3), pembrolizumab & lenvatinib (n = 2), nivolumab & carbozantinib (n = 1), pembrolizumab & axitinib (n = 1)], while one received monotherapy (MT) (pembrolizumab). Patients were poor surgical candidates at diagnosis (25% Stage 3, 75% stage 4). Six (75%) patients had clear cell RCC (CCRCC), 2 patients had RCC with papillary and eosinophilic features. Tumor necrosis was noted in 75% of cases. Partial tumor response occurred in 7 (87.5%) patients, with 3 (37.5%) achieving tumor downstaging. One patient showed stable primary disease despite resolution of metastatic burden and none of the patients achieved complete response. Three patients (37.5%) had histopathological confirmed renal iRAEs. Two (25%) patients displayed vascular lymphocytic infiltrates, consistent with medium vessels vasculitis; they received CT for 6 months. One patient, who received CT for 20 months, showed a non-necrotizing granuloma.</p><p><strong>Conclusion: </strong>This study highlights the potential of ICIs for tumor downstaging and disease control in mRCC, though further investigation is warranted to optimize management of iRAEs and long-term outcomes. ICI-associated renal vasculitis is likely underrecognized and underreported highlighting the need for thorough pathological evaluation of non-neoplastic renal tissue in patients receiving ICI.</p>","PeriodicalId":45893,"journal":{"name":"PATHOLOGICA","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144235438","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":"From dominance to decline: can we reverse the trend in small molecule and TKI cancer therapies?","authors":"Denis Horgan, Paul Hofman, Daniel Schneider, Umberto Malapelle, Vivek Subbiah","doi":"10.32074/1591-951X-N869","DOIUrl":"https://doi.org/10.32074/1591-951X-N869","url":null,"abstract":"<p><p>Over the past two decades, precision oncology has seen unprecedented advances, particularly with the rise of small molecule drugs. These drugs have significantly benefitted patients with cancer harboring somatic genomic alterations, contributing to precision cancer medicine. Despite their early promise, there is a growing concern that major pharmaceutical companies are recently moving away from developing small molecules and tyrosine kinase inhibitors (TKIs) due to market saturation, primary and secondary resistance, and economic factors. The Inflation Reduction Act (IRA) further threatens innovation by reducing incentives for small molecule drug development. Additionally, patient access to comprehensive genomic testing remains a significant barrier. To reverse this trend, a multifaceted approach is urgently needed. Embracing cutting-edge technologies, fostering collaborations, and regulatory innovation are essential. Addressing systemic deficiencies, improving patient access, and ensuring ongoing investment in personalized medicine are crucial for realizing the full potential of small molecule oncology drugs and improving patient outcomes. Collaboration among stakeholders is imperative for advancing effective cancer treatments.</p>","PeriodicalId":45893,"journal":{"name":"PATHOLOGICA","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144112103","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 tricky nasal polyp.","authors":"Federica Filipello, Daniela Finocchiaro, Alessandro Vinciguerra, Sara Racca, Claudio Doglioni, Federica Pedica","doi":"10.32074/1591-951X-783","DOIUrl":"10.32074/1591-951X-783","url":null,"abstract":"<p><p>Leishmaniasis is an infectious disease caused by a protozoon of the genus Leishmania. It can manifest as cutaneous, mucosal, localized lymphadenitis forms or it can result as multiorgan involvement. In this article we present the case of a 59-year-old male with a polypoid mass attached to the septum at the right nasal cavity and symptoms as nasal congestion, hyposmia and anterior rhinorrhea. Histological sections of the mass showed oval-shaped inclusions in the cytoplasm of histiocytes suspicious for Leishmania amastigotes. The diagnosis was confirmed by detection of Leishmania complex DNA with polymerase chain reaction (PCR).</p>","PeriodicalId":45893,"journal":{"name":"PATHOLOGICA","volume":"117 2","pages":"153-155"},"PeriodicalIF":4.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12142294/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144235508","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":"Cell-mediated mucositis of the oral cavity: narrative review on etiology, clinico-pathological aspects and malignant transformation.","authors":"Giulia Querzoli, Anna Gabusi, Davide Bartolomeo Gissi, Sara Bassani, Roberto Rossi, Achille Tarsitano, Lucio Montebugnoli, Maria Pia Foschini","doi":"10.32074/1591-951X-1093","DOIUrl":"10.32074/1591-951X-1093","url":null,"abstract":"<p><p>Cell-mediated mucositis is the expression of a type IV hypersensitivity, in which cytotoxic CD8+ T lymphocytes attack the keratinocytes of the basal layer responsible for activating the immune response. There is sufficient evidence for an increased risk of oral cancer in patients with a diagnosis cell mediated mucositis. This review aims to examine the etiology, clinical-histological features, management and malignant transformation of a group of cell-mediated mucositis, including oral lichen planus, oral lichenoid lesions, Graft versus host disease, oral lesion of lupus erythematous.</p><p><p>The authors conducted a literature review, selecting relevant studies based on their novelty, applicability, and impact. The text highlights the varying rates of malignant transformation associated with different oral conditions. For oral lichen planus, the risk of transformation ranges from 0.44% to 2.28%, while for oral lichenoid lesions (OLLs), the rate is slightly higher, between 1.20% and 3.80%. Conditions like graft-versus-host disease are linked to a malignant transformation rate of 3.47%, and oral lesions associated with lupus erythematosus carry a similar risk at 3.3%, often involving squamous cell carcinoma of the lips. In cases of oral epithelial dysplasia, the risk increases significantly with severity, reaching 24.1% for severe dysplasia. The condition with the highest malignant potential is proliferative verrucous leukoplakia, with a transformation rate estimated at 49.5%. These findings underscore the importance of accurate diagnosis, vigilant monitoring, and the development of new therapeutic strategies. Recent advancements in treatments, such as nivolumab and imiquimod, show promise in early trials. These approaches aim to move beyond passive observation, shifting towards personalized medical interventions to reduce the risk of malignant transformation in high-risk patients.</p>","PeriodicalId":45893,"journal":{"name":"PATHOLOGICA","volume":"117 2","pages":"84-100"},"PeriodicalIF":4.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12142298/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144235510","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":"Myeloid/lymphoid neoplasms with eosinophilia and tyrosine kinase gene fusion: report of two cases with different clinical presentation.","authors":"Elisabetta Merenda, Katia Paciaroni, Emilia Scalzulli, Massimo Breccia, Stefano Licci, Luisa Bizzoni, Carla Giordano, Emma Rullo","doi":"10.32074/1591-951X-975","DOIUrl":"10.32074/1591-951X-975","url":null,"abstract":"<p><p>Myeloid/lymphoid neoplasms with eosinophilia and tyrosine kinase gene fusions (M/LN-eo-TK) such as PDGFRA, PDGFRB, FGFR1, JAK2, FLT3 rearrangement and ETV6::ABL1 fusion include rare and heterogeneous clinical-pathological entities with some similarities, not always associated with peripheral eosinophilia. Accurate diagnosis and demonstration of the specific genetic substrate have important implications since target therapy is possibly available. Herein we report two cases showing different bone marrow features and clinical presentation. Recognition of eosinophilic granuloblasts prompted genetic analysis that showed PDGFRB (case 1) and PDGFRA (case 2) gene rearrangement. Diagnosis of M/LN-eo-TK may be challenging. Pathologists may be the first professionals to suspect the disorder and should be aware of the therapeutic implication. Accurate BOM marrow evaluation with a panel of immunohistochemical reactions, and specific molecular analyses are required for proper diagnosis.</p>","PeriodicalId":45893,"journal":{"name":"PATHOLOGICA","volume":"117 2","pages":"156-161"},"PeriodicalIF":4.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12142289/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144235518","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":"Eosinophilic vacuolated tumor of the kidney can have distant metastasis: a histo-molecular case study.","authors":"Yang Liu, Luting Zhou, Xianwei Yang, Jing Xie, Fei Yuan, Haimin Xu, Chaofu Wang, Xiaoqun Yang","doi":"10.32074/1591-951X-1122","DOIUrl":"10.32074/1591-951X-1122","url":null,"abstract":"<p><p>Eosinophilic vacuolated tumor (EVT) is an emerging renal entity and further studies are required to characterize this neoplasm. EVT is considered generally indolent because metastasis or death from the disease has never been reported. Herein, we report the first case of EVT with mediastinal lymph node metastasis to validate its at least borderline behavior. Based on the morphological features, we additionally used a large panel of immunohistochemical antibodies and next-generation sequencing (NGS) to confirm the diagnosis of EVT and exclude other renal entities. This case report highlights the notion that EVT can exhibit mediastinal lymph node metastasis and patients with EVT need to be closely followed.</p>","PeriodicalId":45893,"journal":{"name":"PATHOLOGICA","volume":"117 2","pages":"162-164"},"PeriodicalIF":4.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12142300/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144235512","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":"Head and neck hematolymphoid proliferations: what is new?","authors":"Silvia Varricchio, Rosaria Cappiello, Francesca Magnoli, Daniela Russo, Giovanna Motta, Clara Bertuzzi, Elena Sabattini, Gennaro Ilardi, Mariarosaria Cervasio, Claudia Giordano, Alessandro Severino, Marco Picardi, Massimo Mascolo","doi":"10.32074/1591-951X-1207","DOIUrl":"10.32074/1591-951X-1207","url":null,"abstract":"<p><p>In 2024, the World Health Organization published its 5th edition of tumor classification, which comprises several updates and modifications in the \"blue book\" focused on head and neck tumors. These changes feature a systematized and expanded discussion on haematolymphoid proliferations using a multi-parameter approach that comprises clinical features, morphology, immunophenotype, and genetic data, with the latter becoming an essential characteristic for classification. Moreover, for the first time, the World Health Organization has included non-neoplastic diseases, such as reactive lymphoid proliferations, alongside several recognized independent disorders, including Epstein-Barr Virus positive mucocutaneous ulcers and IgG4-related diseases. Also, various neoplastic diseases, such as paediatric-type follicular lymphoma and large B-cell lymphoma with IRF4 rearrangement, are recognized as independent entities. Finally, the focus has expanded to include different types of histiocytic neoplasms. This review examines and illustrates the main changes and updates on hematolymphoid proliferation and neoplasia in the Head and Neck chapter of the 5th Edition of the Head and Neck WHO classification.</p>","PeriodicalId":45893,"journal":{"name":"PATHOLOGICA","volume":"117 2","pages":"101-110"},"PeriodicalIF":4.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12142295/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144235514","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":"Head and neck synovial sarcoma in a woman with previous lymphoma and papillary thyroid carcinoma.","authors":"Mariano Lombardi, Daniela Lepanto, Eleonora Pisa, Valeria Midolo De Luca, Renato Lobrano, Simona Pessina, Chiara Zanetti, Marta Tagliabue, Elvio De Fiori, Fausto Maffini","doi":"10.32074/1591-951X-1034","DOIUrl":"10.32074/1591-951X-1034","url":null,"abstract":"<p><p>Synovial sarcoma is a rare malignant mesenchymal neoplasm that rarely arises in the head and neck and thyroid lodge. Researchers have documented only few cases in the literature. We present the case of a young woman diagnosed with synovial sarcoma that originated in the thyroid region one year after a total thyroidectomy for a primary papillary carcinoma and eight years after chemo-radiotherapy for a lymphoma.</p>","PeriodicalId":45893,"journal":{"name":"PATHOLOGICA","volume":"117 2","pages":"131-135"},"PeriodicalIF":4.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12142290/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144235515","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":"One protocol to rule them all: a pilot study to identify the best fixation and decalcification approach for bone marrow biopsy immunohistochemistry.","authors":"Michele Paudice, Alessandro Gambella, Simona Pigozzi, Michela Campora, Francesca Pitto, Silvia Bozzano, Luca Mastracci, Federica Grillo","doi":"10.32074/1591-951X-1065","DOIUrl":"10.32074/1591-951X-1065","url":null,"abstract":"<p><strong>Objective: </strong>Standardization of the pre-analytical phases of bone marrow trephine biopsy (BM) has yet to be achieved. In particular, several fixative and decalcifying reagents with specific benefits and drawbacks are described, but only a few direct comparisons are available. This study aims to test the most used fixation and decalcification protocols and evaluate their effect on tissue antigenicity via immunohistochemistry (IHC).</p><p><strong>Methods: </strong>To avoid damaging and exhausting diagnostic BMs, we used \"surrogate\" BMs obtained from dedicated grossing of a non-pathologic spleen. Eleven fixation and decalcification protocols were tested, and their performances were evaluated via IHC protein expression of 25 biomarkers.</p><p><strong>Results: </strong>The IHC yield varied based on the fixative and decalcifying reagents, but the overall quality is mainly related to the fixative rather than the decalcifying phases. The protocol with the lowest number of inadequate IHC stains (5 out of 25) combined commercially available B5-based fixative and EDTA-based decalcifying reagents. The worst metrics (8 inadequate IHC stains out of 25) were obtained with a protocol based on \"in-house\" B5-based and EDTA-based reagents.</p><p><strong>Conclusions: </strong>We compared different protocols and found the best combination of fixative and decalcifying reagents for accurate IHC staining. These findings can improve bone marrow sample handling and standardization in pathology laboratories.</p>","PeriodicalId":45893,"journal":{"name":"PATHOLOGICA","volume":"117 2","pages":"145-152"},"PeriodicalIF":4.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12142299/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144235519","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":"Cholesterol granuloma. Another brick in the wall of mediastinal lesions.","authors":"Michela Campora, Giampiero Negri, Virgilio Longari, Maurilio Ponzoni","doi":"10.32074/1591-951X-1054ER","DOIUrl":"10.32074/1591-951X-1054ER","url":null,"abstract":"","PeriodicalId":45893,"journal":{"name":"PATHOLOGICA","volume":"117 2","pages":"173-177"},"PeriodicalIF":4.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12142293/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144235511","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}