{"title":"Cytology and small biopsy diagnosis of pancreatic ductal adenocarcinoma","authors":"Maria Pimenova , Matthew W. Rosenbaum","doi":"10.1016/j.semdp.2026.150992","DOIUrl":"10.1016/j.semdp.2026.150992","url":null,"abstract":"<div><div>Pancreatic ductal adenocarcinoma (PDAC) is a leading cause of cancer-related deaths, accounting for over 90 % of pancreatic cancer cases. Accurate diagnosis is crucial, but often challenging. It typically relies on minimally invasive procedures, such as endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) and small biopsy samples. These small biopsies may be the only tissue diagnosis made before embarking on neoadjuvant therapy, major surgery, or transition to comfort care, depending on clinicoradiologic factors. This paper reviews important diagnostic strategies and criteria for cytologic and small biopsy samples, highlighting cytomorphologic characteristics, histologic patterns, and the role of immunohistochemical and molecular diagnostics. PDAC cytology often shows hypercellular aspirates with disorganized glandular fragments, significant nuclear atypia, prominent nucleoli, and a necrotic background. In contrast, small biopsy samples typically reveal invasive glandular structures surrounded by desmoplastic stroma and nuclear pleomorphism. However, biopsies are often scant and there are a variety of difficult histologic subtypes and mimics that complicate these cases. Although there is a lack of sensitive or specific markers for PDAC, immunohistochemical markers, such as P53, and SMAD4, can be useful for supporting a diagnosis of PDAC over chronic pancreatitis/tumor mimics. Molecular alterations in KRAS, TP53, BRCA1/2, and others may aid in diagnosis, prognostication, and the selection of targeted therapeutic options. By systematically integrating clinicoradiologic, cytological, histological, immunophenotypic, and molecular data, pathologists can effectively differentiate PDAC from benign or reactive lesions and metastatic neoplasms, ensuring accurate diagnoses that are essential for optimal patient management.</div></div>","PeriodicalId":49548,"journal":{"name":"Seminars in Diagnostic Pathology","volume":"43 2","pages":"Article 150992"},"PeriodicalIF":3.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146138025","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":"Secondary neoplasms following treatment for multiple myeloma","authors":"Sharon Koorse Germans , Bo Zhang , Olga Weinberg","doi":"10.1016/j.semdp.2025.150976","DOIUrl":"10.1016/j.semdp.2025.150976","url":null,"abstract":"<div><div>Multiple myeloma (MM) is a hematologic malignancy characterized by the clonal proliferation of plasma cells within the bone marrow, leading to significant end-organ damage. Recent therapeutic advancements, including immunomodulatory drugs (IMiDs), proteasome inhibitors, autologous stem cell transplant (ASCT), and chimeric antigen receptor T-cell (CAR-T) therapy, have significantly improved survival outcomes. However, with prolonged survival, there is an emerging concern regarding therapy-related secondary malignancies (SM), particularly therapy-related myeloid neoplasms (tMN) and secondary lymphoid neoplasms. This article reviews the incidence, contributing factors, clinicopathological features, and outcomes associated with secondary malignancies in MM patients, including recent observations on therapy-related B-lymphoblastic leukemia and lymphomas.</div></div>","PeriodicalId":49548,"journal":{"name":"Seminars in Diagnostic Pathology","volume":"43 1","pages":"Article 150976"},"PeriodicalIF":3.5,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145679273","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}
Katrina Collins, Andres M. Acosta, Muhammad T. Idrees, Thomas M. Ulbright
{"title":"Postchemotherapy phenotypes of GCNIS-derived testicular germ cell tumors, focusing on yolk sac tumor variants, trophoblastic tumors, and somatic-type malignancies","authors":"Katrina Collins, Andres M. Acosta, Muhammad T. Idrees, Thomas M. Ulbright","doi":"10.1016/j.semdp.2025.150974","DOIUrl":"10.1016/j.semdp.2025.150974","url":null,"abstract":"<div><div>Postchemotherapy retroperitoneal lymph node dissection (PC-RPLND) specimens from patients with testicular germ cell tumors (TGCTs) often reveal a complex mix of residual tumor components and treatment-related changes. This review focuses on the morphologic spectrum of yolk sac tumor (YST) variants, trophoblastic tumors, and somatic-type malignancies in PC-RPLNDs, which continue to pose significant diagnostic and clinical challenges. Accurate identification of these entities is critical, as they carry distinct prognostic implications and influence management decisions. A multidisciplinary approach—integrating histopathology, immunohistochemistry, clinical history, and imaging—is essential for navigating these complex specimens. Emerging insights into chemotherapy resistance and tumor evolution are refining our understanding of TGCT biology and informing future diagnostic and therapeutic strategies. Herein, we highlight the increased frequency in postchemotherapy resections of glandular, hepatoid, parietal, and sarcomatoid differentiation in YSTs, as well as cystic, epithelioid, and placental site trophoblastic tumors, sarcomas, adenocarcinomas, and embryonic-type neuroectodermal tumors.</div></div>","PeriodicalId":49548,"journal":{"name":"Seminars in Diagnostic Pathology","volume":"43 1","pages":"Article 150974"},"PeriodicalIF":3.5,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145618366","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":"Diagnostic dilemmas in pulmonary mesenchymal tumors","authors":"Annikka Weissferdt","doi":"10.1016/j.semdp.2025.150980","DOIUrl":"10.1016/j.semdp.2025.150980","url":null,"abstract":"<div><div>Tumors of mesenchymal origin only rarely arise in the bronchopulmonary system and range from indolent neoplasms to highly malignant sarcomas. While many of these tumors occur more frequently outside of the thoracic cavity, there are some mesenchymal neoplasms that are unique to the lung, such as primary pulmonary myxoid sarcoma or clear cell stromal tumor of the lung. The diagnosis of these unusual neoplasms can be difficult, especially when dealing with small biopsy material or separating sarcomas from non-mesenchymal tumors with sarcomatoid morphology. Likewise, a metastatic process from a soft tissue primary should always be excluded before a diagnosis of primary pulmonary sarcoma can be confirmed. Fortunately, the increasing identification of distinct molecular aberrations in soft tissue, as well as pulmonary sarcomas, adds a significant diagnostic tool in this context. Since the treatment and prognosis for patients with pulmonary sarcomas varies greatly from those with bronchogenic carcinomas, comprehensive evaluation, to include immunohistochemical and molecular analysis, is not only essential for correct diagnosis, but also to predict patient outcome.</div></div>","PeriodicalId":49548,"journal":{"name":"Seminars in Diagnostic Pathology","volume":"43 1","pages":"Article 150980"},"PeriodicalIF":3.5,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145884562","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}
Nourhan Ibrahim, Daniel Rivera, Janhavi Govande, Brenda Mai
{"title":"Multiple Myeloma: A Structured and Multidisciplinary Approach to Diagnosis","authors":"Nourhan Ibrahim, Daniel Rivera, Janhavi Govande, Brenda Mai","doi":"10.1016/j.semdp.2025.150975","DOIUrl":"10.1016/j.semdp.2025.150975","url":null,"abstract":"<div><div>Multiple myeloma is a hematologic malignancy characterized by the clonal proliferation of post-germinal center B cells, leading to monoclonal immunoglobulin (M protein) production. Its diagnosis remains complex due to diverse clinical presentations, ranging from asymptomatic cases detected through routine screening to symptomatic disease with bone pain, renal dysfunction, anemia, and hypercalcemia. A multimodal diagnostic approach integrating imaging, laboratory testing and bone marrow evaluation is essential for accurate disease characterization. Advances in serum protein electrophoresis (SPEP), immunofixation (IFE), free light chain (FLC) assays, next-generation sequencing (NGS), and artificial intelligence (AI)-assisted imaging have refined diagnostic precision, enabling earlier detection and better risk stratification. This review provides an overview of current and evolving diagnostic strategies in multiple myeloma, highlighting their impact on disease detection and classification.</div></div>","PeriodicalId":49548,"journal":{"name":"Seminars in Diagnostic Pathology","volume":"43 1","pages":"Article 150975"},"PeriodicalIF":3.5,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145839965","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":"Calcified chondroid mesenchymal neoplasm","authors":"John M. Gross , Karen J. Fritchie","doi":"10.1016/j.semdp.2025.150978","DOIUrl":"10.1016/j.semdp.2025.150978","url":null,"abstract":"<div><div>Calcified chondroid mesenchymal neoplasm (CCMN) is a recently described benign matrix-forming soft tissue tumor with a predilection for the distal extremities and the temporomandibular joint (TMJ) of adults which frequently harbors FN1 fusions. Since its initial description in 2021, nearly 100 CCMNs have been reported thus broadening its clinicopathologic and molecular genetic spectrum in recent years. This manuscript will discuss, in detail, our current understanding of CCMN including a historical review of morphologically similar entities, as well as provide pertinent differential diagnoses of CCMN with a specific focus on tumors arising within the head and neck region.</div></div>","PeriodicalId":49548,"journal":{"name":"Seminars in Diagnostic Pathology","volume":"43 1","pages":"Article 150978"},"PeriodicalIF":3.5,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145783539","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":"TABLE OF CONTENTS (p/u from previous issue w/updates)","authors":"","doi":"10.1053/S0740-2570(26)00004-3","DOIUrl":"10.1053/S0740-2570(26)00004-3","url":null,"abstract":"","PeriodicalId":49548,"journal":{"name":"Seminars in Diagnostic Pathology","volume":"43 1","pages":"Article 150984"},"PeriodicalIF":3.5,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145976737","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}