Seminars in Diagnostic Pathology最新文献_第7页

Advancements in diagnosing IgG4-related disease of the head and neck: Navigating diagnostic pitfalls 诊断头颈部 IgG4 相关疾病的进展：诊断陷阱导航

IF 2.3 3区医学

Seminars in Diagnostic Pathology Pub Date : 2024-03-01 DOI: 10.1053/j.semdp.2023.12.003

Munita Bal , Vikram Deshpande

{"title":"Advancements in diagnosing IgG4-related disease of the head and neck: Navigating diagnostic pitfalls","authors":"Munita Bal , Vikram Deshpande","doi":"10.1053/j.semdp.2023.12.003","DOIUrl":"10.1053/j.semdp.2023.12.003","url":null,"abstract":"<div>IgG4-related disease (IgG4-RD) is an immune-mediated condition affecting nearly any organ. This review focuses on the nuances of diagnosing IgG4-RD affecting the head and neck. Salivary gland involvement, especially of the submandibular glands, often permits a definitive diagnosis on biopsy. However, elevated IgG4+ plasma cells are nonspecific and can be seen in chronic sialadenitis, lymphoma, and other mimics. Careful correlation of clinical and pathological findings is essential. Given the significant overlap with chronic sinusitis, IgG4-RD of the sinonasal region is difficult to diagnose histologically. Laryngeal and pharyngeal involvement appears rare as an isolated finding of IgG4-RD. Mastoid disease is uncommon and remains a diagnosis of exclusion. Thyroid manifestations pose challenges given unclear diagnostic criteria - Riedel's thyroiditis likely represents IgG4-RD, but the fibrosing variant of Hashimoto's thyroiditis as a form of the so-called ‘IgG4-related thyroiditis’ requires better characterisation. Eosinophilic angiocentric fibrosis, despite histologic similarities, only partially overlaps with IgG4-RD. This review aims to guide diagnosing IgG4-RD in the head and neck through a systematic, organ-focused discussion of the clinical context, the utility of immunostaining, histological mimics, and controversial issues that pose diagnostic pitfalls. Increased awareness of the nuances and difficulties diagnosing IgG4-RD affecting the head and neck will improve recognition of this protean disease.</div>","PeriodicalId":49548,"journal":{"name":"Seminars in Diagnostic Pathology","volume":"41 2","pages":"Pages 54-65"},"PeriodicalIF":2.3,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139069973","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}

引用次数: 0

IgG4-related lymphadenopathy IgG4 相关淋巴腺病

IF 2.3 3区医学

Seminars in Diagnostic Pathology Pub Date : 2024-03-01 DOI: 10.1053/j.semdp.2024.01.003

Wah Cheuk , Jacob R. Bledsoe

{"title":"IgG4-related lymphadenopathy","authors":"Wah Cheuk , Jacob R. Bledsoe","doi":"10.1053/j.semdp.2024.01.003","DOIUrl":"10.1053/j.semdp.2024.01.003","url":null,"abstract":"<div>IgG4-related lymphadenopathy is a nodal manifestation of IgG4-related disease (IgG4RD) which is characterized by increased polytypic IgG4+ plasma cells and IgG4+/IgG+ plasma cell ratio in lymph nodes and morphologically manifested as various patterns of reactive lymphadenopathy: Castleman disease-like, follicular hyperplasia, interfollicular expansion, progressive transformation of germinal centers and inflammatory pseudotumor-like. It typically presents with solitary or multiple, mild to moderate lymph node enlargement in otherwise asymptomatic patients. The serum IgG4 level is frequently elevated but C-reactive protein often remains normal. In patients not having a history of IgG4RD or manifestation of extranodal IgG4RD, a diagnosis of IgG4-lymphadenopathy should only be made with great caution given the non-specific morphologic features that can overlap with ANCA-associated vasculitis, interleukin-6 syndromes, Rosai–Dorfman disease, inflammatory myofibroblastic tumor, syphilis, lymphoma, and plasma cell neoplasia. Elevated IgG4 parameters, appropriate morphologies, and clinical correlation are essential to make the diagnosis of IgG4-lymphadenopathy more specific and clinically meaningful.</div>","PeriodicalId":49548,"journal":{"name":"Seminars in Diagnostic Pathology","volume":"41 2","pages":"Pages 108-115"},"PeriodicalIF":2.3,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139373772","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}

引用次数: 0

Histopathologic clues to the etiopathogenesis of orbital inflammatory disease: Idiopathic, IgG4-related, neoplastic, autoimmune and beyond 眼眶炎症性疾病发病机制的组织病理学线索：特发性、IgG4 相关性、肿瘤性、自身免疫性及其他疾病

IF 2.3 3区医学

Seminars in Diagnostic Pathology Pub Date : 2024-03-01 DOI: 10.1053/j.semdp.2024.01.011

Anna M. Stagner

引用次数: 0

Autoimmune pancreatitis: Biopsy interpretation and differential diagnosis 自身免疫性胰腺炎：活检解读与鉴别诊断

IF 2.3 3区医学

Seminars in Diagnostic Pathology Pub Date : 2024-03-01 DOI: 10.1053/j.semdp.2024.01.001

Yoh Zen

{"title":"Autoimmune pancreatitis: Biopsy interpretation and differential diagnosis","authors":"Yoh Zen","doi":"10.1053/j.semdp.2024.01.001","DOIUrl":"10.1053/j.semdp.2024.01.001","url":null,"abstract":"<div>Autoimmune pancreatitis (AIP) is classified into type 1 (IgG4-related) and type 2 (IgG4-unrelated) and the interpretation of pancreatic biopsy findings plays a crucial role in their diagnosis. Needle biopsy of type 1 AIP in the acute or subacute phase shows a diffuse lymphoplasmacytic infiltrate, storiform fibrosis, obliterative phlebitis, and the infiltration of many IgG4-positive plasma cells. In a later phase, changes become less inflammatory and more fibrotic, making interpretations more challenging. Confirmation of the lack of ‘negative’ findings that are unlikely to occur in type 1 AIP (e.g., neutrophilic infiltration, abscess) is important to avoid an overdiagnosis. The number of IgG4-positive plasma cells increases to >10 cells/high-power field (hpf), and the IgG4/IgG-positive plasma cell ratio exceeds 40 %. However, these are minimal criteria and typical cases show >30 positive cells/hpf and a ratio >70 % even in biopsy specimens. Therefore, cases with a borderline increase in this number or ratio need to be diagnosed with caution. In cases of ductal adenocarcinoma, the upstream pancreas rarely shows type 1 AIP-like changes; however, the ratio of IgG4/IgG-positive plasma cells is typically <40 %. Although the identification of a granulocytic epithelial lesion (GEL) is crucial for type 2 AIP, this finding needs to be interpreted in conjunction with a background dense lymphoplasmacytic infiltrate. An isolated neutrophilic duct injury can occur in peritumoral or obstructive pancreatitis. Drug-induced pancreatitis in patients with inflammatory bowel disease often mimics type 2 AIP clinically and pathologically. IL-8 and PD-L1 are potential ancillary immunohistochemical markers for type 2 AIP, requiring validation studies.</div>","PeriodicalId":49548,"journal":{"name":"Seminars in Diagnostic Pathology","volume":"41 2","pages":"Pages 79-87"},"PeriodicalIF":2.3,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139095341","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}

引用次数: 0

The History of the Microscope Reflects Advances in Science and Medicine 显微镜的历史反映了科学和医学的进步

IF 2.3 3区医学

Seminars in Diagnostic Pathology Pub Date : 2024-01-11 DOI: 10.1053/j.semdp.2024.01.002

Caitlin A. Noble, Andrew P. Biesemier, Sarah McClees, Aljunaid Alhussain, Stephen E. Helms, Robert T. Brodell

引用次数: 0

Mark Wick contributions to pathology of the mediastinum 马克-维克对纵隔病理学的贡献

IF 2.3 3区医学

Seminars in Diagnostic Pathology Pub Date : 2024-01-07 DOI: 10.1053/j.semdp.2024.01.006

Horacio Maluf

引用次数: 0

Clinical-pathologic Correlation: The Impact of Grossing at the Bedside 临床与病理相关性：床旁大体检查的影响

IF 2.3 3区医学

Seminars in Diagnostic Pathology Pub Date : 2024-01-05 DOI: 10.1053/j.semdp.2024.01.007

C. Alexis Noble, Chinmoy Bhate, Buu Duong, Allison Cruse, Robert T. Brodell, Riley Hanus

{"title":"Clinical-pathologic Correlation: The Impact of Grossing at the Bedside","authors":"C. Alexis Noble, Chinmoy Bhate, Buu Duong, Allison Cruse, Robert T. Brodell, Riley Hanus","doi":"10.1053/j.semdp.2024.01.007","DOIUrl":"https://doi.org/10.1053/j.semdp.2024.01.007","url":null,"abstract":"The unenlightened clinician may submit a skin specimen to the lab and expect an “answer.” The experienced clinician knows that in performing skin biopsies, it is critical to select the most appropriate: 1) anatomic location for the biopsy1,2; 2) type of biopsy1,2; 3) depth and breadth of the biopsy; and 4) medium for hematoxylin and eosin staining (formalin) or direct immunofluorescence (Michel's Transport Medium or normal saline)2. Demographic information, anatomic location, clinical context, and differential diagnosis are all critical components of a properly completed requisition form3,4,5. Proper biopsy design and appropriate grossing of the tissue at the bedside should be added to this list. In this article, we review the basics of gross pathologic examination and then provide four examples to demonstrate that optimal clinical-pathologic correlation requires the clinician consider the needs of the pathologist when tissue is presented to the lab.","PeriodicalId":49548,"journal":{"name":"Seminars in Diagnostic Pathology","volume":"28 1","pages":""},"PeriodicalIF":2.3,"publicationDate":"2024-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139373870","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}

引用次数: 0

Contributions of Dr. Wick to the pathology of diseases of the lung and pleura. 维克博士对肺和胸膜疾病病理学的贡献。

IF 2.3 3区医学

Seminars in Diagnostic Pathology Pub Date : 2024-01-05 DOI: 10.1053/j.semdp.2024.01.005

Saul Suster

引用次数: 0

Hereditary succinate dehydrogenase-deficient renal cell carcinoma 遗传性琥珀酸脱氢酶缺陷肾细胞癌

IF 2.3 3区医学

Seminars in Diagnostic Pathology Pub Date : 2024-01-01 DOI: 10.1053/j.semdp.2023.11.001

Joanna Rogala , Ming Zhou

{"title":"Hereditary succinate dehydrogenase-deficient renal cell carcinoma","authors":"Joanna Rogala , Ming Zhou","doi":"10.1053/j.semdp.2023.11.001","DOIUrl":"10.1053/j.semdp.2023.11.001","url":null,"abstract":"<div>Succinate dehydrogenase (SDH), formed by four subunits SDHA, SDHB, SDHC, SDHD, and an assembly factor SDHAF2, functions as a key respiratory enzyme. Biallelic inactivation of genes encoding any of the components, almost always in the presence of a germline mutation, causes loss of function of the entire enzyme complex (so-called SDH deficiency) and subsequent development of SDH-deficient neoplasms which include pheochromocytoma/paraganglioma, gastrointestinal stromal tumor, and renal cell carcinoma (RCC). These tumors may occur in the same patient or kindred. SDH-deficient RCC shows distinctive morphological features with vacuolated eosinophilic cytoplasm due to distinctive cytoplasmatic inclusions containing flocculent material. The diagnosis is confirmed by loss of SDHB on immunohistochemistry with positive internal control. The majority of tumors occur in the setting of germline mutations in one of the SDH genes, most commonly SDHB. The prognosis is excellent for low-grade tumors but worse for high-grade tumors with high-grade nuclei, sarcomatoid change, or coagulative necrosis. Awareness of the morphological features and low-threshold for applying SDHB immunohistochemistry help identify patients with SDH-deficient RCC and hereditary SDH-deficient tumor syndromes. In this review we summarize recent development on the clinical and genetic features, diagnostic approach, and pitfalls of SDH-deficient syndrome, focusing on SDH-deficient renal cell carcinomas.</div>","PeriodicalId":49548,"journal":{"name":"Seminars in Diagnostic Pathology","volume":"41 1","pages":"Pages 32-41"},"PeriodicalIF":2.3,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135516526","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}

引用次数: 0

TABLE OF CONTENTS (p/u from previous issue w/updates) 目录（上期内容，有更新）

IF 2.3 3区医学

Seminars in Diagnostic Pathology Pub Date : 2024-01-01 DOI: 10.1053/S0740-2570(24)00015-7

引用次数: 0