Polish Journal of Pathology最新文献

{"title":"An unexpected leprosy diagnosis in Nordic patient with skin lesions.","authors":"Arnhild Binde, Johannes Hendricus van der Stoep, Camilla Sivesind Mehlum, Monika Aneta Dzieniecka","doi":"10.5114/pjp.2025.158044","DOIUrl":"https://doi.org/10.5114/pjp.2025.158044","url":null,"abstract":"<p><p>Leprosy is a rare chronic infectious disease that can be challenging to diagnose in non-endemic settings due to limited clinical experience among physicians and its marked clinical heterogeneity. We report the case of leprosy in a Nordic patient with an extensive travel history who presented with cutaneous lesions, nasal congestion, and peripheral neurological symptoms. Although the histopathological findings were not fully specific, modified Ziehl-Neelsen staining revealed numerous acid-fast bacilli within the tissue samples. Mycobacterium leprae was subsequently confirmed by molecular analyses. To minimise diagnostic delay and prevent disease progression, we provide an overview of the histopathological features of leprosy and discuss relevant differential diagnoses.</p>","PeriodicalId":49692,"journal":{"name":"Polish Journal of Pathology","volume":"76 4","pages":"355-359"},"PeriodicalIF":0.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147576241","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Histopathological image analysis and enhanced diagnostic accuracy explainability for oral cancer detection.","authors":"V P Gladis Pushparathi, Sylaja Vallee NarayanS R, Pratheeba R S, V Naveen","doi":"10.5114/pjp.2025.153973","DOIUrl":"10.5114/pjp.2025.153973","url":null,"abstract":"<p><p>Deep learning (DL) has transformed medical imaging, particularly in the realm of oral cancer (OC) diagnosis using histopathological images. Timely detection of OC is es-sential for enhancing precision medicine and saving lives. However, incorrect diagnosis may impede effective treatment. In this study, we have proposed a DL model for OC classification, enhanced diagnosis decision-making and interpretability. We achieve this by starting with colour normalisation of histopathology images using the Vaha-dane 3-stain parameter normalisation and watershed segmentation method, followed by tiling and augmentation. Key features are selected using the weighted Fisher score (WFS) to address class imbalance. The U-Net classifier has been improved by using feature-based inputs instead of full images, reducing computational complexity and training time. The integration of Vahadane normalisation for consistent preprocessing across samples, WFS, and explainable artificial intelligence (XAI) addresses critical challenges in histopathological image analysis. The proposed model surpasses exist-ing approaches with a classification accuracy of 99.54%, and it outperforms Dense- Net201 and VGG10 in precision and reliability. The efficiency in handling imbal-anced datasets and explainability features make it suitable for early precise OC detec-tion, which can reduce diagnostic errors and enhance treatment outcomes.</p>","PeriodicalId":49692,"journal":{"name":"Polish Journal of Pathology","volume":"76 2","pages":"120-130"},"PeriodicalIF":0.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145114764","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of age and histological type on programmed death-ligand 1 expression in non-small cell lung cancer - a single-center analysis of 1,606 cases.","authors":"Anna Szumera-Ciećkiewicz, Piotr Wiśniewski, Agnieszka Tomczyk-Szatkowska, Magdalena Rosińska, Dorota Pierzchała, Joanna Owczarek, Kinga Winiarczyk, Patrycja Wołoszyn, Maciej Krzakowski, Magdalena Knetki-Wróblewska","doi":"10.5114/pjp.2025.157974","DOIUrl":"https://doi.org/10.5114/pjp.2025.157974","url":null,"abstract":"<p><p>Programmed death-ligand 1 (PD-L1) guides immune checkpoint inhibitor use in non-small cell lung cancer (NSCLC), yet its variation by age and histology remains uncertain. We retrospectively evaluated 1,606 consecutive NSCLC cases (2017-2022) with PD-L1 immunohistochemistry (IHC) on formalin-fixed, paraffin- embedded samples. Patients were grouped by age (< 60, 60-79, ≥ 80 years) and tumor proportion score (TPS), categorized as < 1%, 1-49%, or ≥ 50%. Associations were tested using the ² test, and independent predictors were identified using multinomial logistic regression. High PD-L1 expression (TPS ≥ 50%) occurred in 33.6% of patients, intermediate (1-49%) in 23.6%, and negative (< 1%) in 42.7%. Programmed death-ligand 1 expression ≥ 1% was most frequent in squamous cell carcinoma (63.0%), followed by adenocarcinoma (55.0%), and was least common in large cell carcinoma (36.0%; p = 0.002). Overall proportions of PD-L1 ≥ 1% did not differ significantly by age. However, patients aged ≥ 80 had nearly twice the likelihood of high expression compared to those < 60 (relative risk ratio, 1.92; 95% CI: 1.11-3.34; p = 0.02), independent of the histotype. Programmed death-ligand 1 expression in NSCLC shows distinct histotype-related patterns and a modest, age-related trend toward higher values in the oldest group. These data support routine PD-L1 assessment and suggest that advanced age alone should not preclude consideration of immunotherapy. Findings may inform trial design and real-world treatment decision-making.</p>","PeriodicalId":49692,"journal":{"name":"Polish Journal of Pathology","volume":"76 3","pages":"177-186"},"PeriodicalIF":0.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145999514","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Better pathology education during undergraduate education: Clinical dentists' expectations.","authors":"Songül Sahin","doi":"10.5114/pjp.2025.153976","DOIUrl":"https://doi.org/10.5114/pjp.2025.153976","url":null,"abstract":"<p><p>The education curriculum of the faculty of dentistry includes both general pathol-ogy and oral pathology courses. In our planned study, we aimed to determine the needs of dentists who graduated from the faculty of dentistry and received special-isation training for pathology information in their active professional lives and the importance of pathology education according to their fields of specialisation. Survey questions: Applications were made to 115 dentists who graduated from the faculty of dentistry, received specialist training, and worked in the clinic. While the benefit of pathology training in the dentist's professional life was oral and maxillofacial surgery, it was followed by periodontology, radiology, and oral diagnosis specialties. They also stated that they sent samples and evaluated reports in the fields of oral and maxillofacial surgery, periodontology, radiology, and oral diagnosis. In our study, the areas where specialist physicians benefit from pathology training in the clinic are those where the subjects overlap more with the sections in the training curriculum. It is necessary to provide adequate training in basic medical sciences to train dentists as physicians who do not perceive the patient only in terms of mouth and teeth, but can evaluate the patient as a whole and provide the right guidance at the right time. Integration should be ensured between basic sciences, dentistry, and clinical sciences. For pathology education to be permanent and useful, a curriculum should be designed with innovative teaching methods that are department-specific and practice-based, appropriate to the needs of the clinic. Dentistry graduates can improve patient outcomes and enhance their personal de-velopment by deepening their understanding of pathology education.</p>","PeriodicalId":49692,"journal":{"name":"Polish Journal of Pathology","volume":"76 2","pages":"151-157"},"PeriodicalIF":0.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145114744","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Molecular profiling of sporadic medullary thyroid carcinomas - a next-generation sequencing-based study.","authors":"Serdar Altinay, Altan Kara, Mustafa Gülbağcı, Ahmet Cem Dural, Şaban Tekin, Tuğba Köprülü, Nisa Erdoğan, Meral Mert, Ülkan Çelik, Mustafa Turan","doi":"10.5114/pjp.2025.156557","DOIUrl":"10.5114/pjp.2025.156557","url":null,"abstract":"<p><p>Medullary thyroid carcinomas (MTCs) are 75% sporadic and 25% hereditary. This study aimed to determine the histopathological parameters and molecular changes of sporadic MTCs in a university hospital by targeted next-generation sequencing (NGS) including 62 genes. All RET mutations were missense mutations. EIF1AX was suggested by artificial intelligence as a gene of interest for further analysis; subsequent testing revealed a pathogenic missense mutation in this gene in a patient with advanced-stage disease, who died at the 25th month of follow-up due to liver metastasis. We identified different gene mutations that could be associated with nodal metastasis in the presence or absence of RET mutation. We identified mutations that may be involved in tumour progression and have prognostic significance, such as HRAS, MAP3K1, and EIF1AX. We observed KDR mutation in this cohort. Although driver mutations in sporadic medullary thyroid carcinoma (sMTC) mostly come from targeted NGS data in tumours from patients with localised disease, NGS findings can also be used for therapeutic purposes in advanced-stage sMTC cases with progressive local-regional or distant metastatic disease. We believe that additional studies should be conducted with a larger number of patients so that the findings can be included in the treatment guidelines to be prepared.</p>","PeriodicalId":49692,"journal":{"name":"Polish Journal of Pathology","volume":"76 3","pages":"195-213"},"PeriodicalIF":0.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145999515","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinicopathological and molecular features of non-small cell lung cancer that transform to small-cell lung cancer: Case reports and literature review.","authors":"Qiqi Gao, Lixin Zhang, Yulong Zheng","doi":"10.5114/pjp.2025.153971","DOIUrl":"10.5114/pjp.2025.153971","url":null,"abstract":"<p><p>The purpose of this study is to explore the clinical and pathological characteristics as well as the molecular pathogenesis of patients with non-small cell lung cancer (NSCLC) transforming into small cell lung cancer (SCLC). We investigated 14 patients with advanced NSCLC that transformed into SCLC. Whole genome sequencing (WES) was applied to analyse 14 tumour specimens (including NSCLC and SCLC specimens from each patient) from 7 patients to detect genetic predictive factors for small-cell transformation. The clinicopatho-logical characteristics of these 14 patients were collected and analysed. In addition, a detailed literature review was conducted to identify similar cases of transforma-tion from NSCLC to SCLC. Fourteen cases were included. The basic condition of patients who had undergone the transformation was found to be similar to those individuals without any trans-formation. After SCLC transformation, the mutation spectrum changed: C>T de-creased and C>A increased. In comparison to the initial NSCLC, the copy number variants (CNV) burden in the transformed SCLC increased considerably in a subset of patients. Clonal evolution analysis revealed intriguing connections and notable differences between the genetic clones of the initial NSCLC and the transformed SCLC. It was found that the process of transformation took a longer time in fe-males compared to males. Furthermore, it was observed that the transformation time for LADC was longer compared to squamous cell carcinoma (SCC). Addition-ally, the analysis revealed that after completion of the transformation, the OS time for males was found to be longer than that for females. Secondary biopsy is a crucial step in assessing the genetic and histological alter-ations that occur after a patient develops resistance to their initial treatment. This procedure is vital not only for individuals who have been treated with tyrosine kinase inhibitors but also for those who have undergone chemotherapy or immuno-therapy. One interesting finding is that the mutation rate of p53 and RB1 in trans-formed SCLC is lower compared to de novo SCLC. Specifically, there is a decrease in the C > T mutation and an increase in the C > A mutation following transforma-tion. Moreover, the transformed SCLC appears to originate from the major clones of the initial NSCLC.</p>","PeriodicalId":49692,"journal":{"name":"Polish Journal of Pathology","volume":"76 2","pages":"94-109"},"PeriodicalIF":0.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145114806","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multifocal cutaneous leishmaniasis in a patient treated with golimumab for psoriaticarthritis.","authors":"Veronica Forte, Anna Silvia Biamonte, Massimo Menichini, Fabrizio Liberati, Luca Ventura","doi":"10.5114/pjp.2025.153977","DOIUrl":"10.5114/pjp.2025.153977","url":null,"abstract":"<p><p>Leishmaniasis is a zoonosis caused by protozoans transmitted by sandflies. Immu-nosuppression is a risk factor for developing leishmaniasis in patients treated with TNF inhibitors for autoimmune diseases. A 65-year-old man with a 14-year histo-ry of psoriatic arthritis in treatment with methotrexate, treated with golimumab during the last 2.5 years, presented ulcerations of the buttocks and upper back. Histopathological findings allowed us to yield the diagnosis of cutaneous leishman-iasis. Therapy was suspended and the patient underwent appropriate treatment. Five cases of leishmaniasis in patients treated with golimumab were reported in literature and ten cases were mentioned in retrospective reviews.</p>","PeriodicalId":49692,"journal":{"name":"Polish Journal of Pathology","volume":"76 2","pages":"158-162"},"PeriodicalIF":0.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145114834","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinicopathological features of anaplastic lymphoma kinase-rearranged lung adenocarcinoma initially misdiagnosed with invasive mucinous adenocarcinoma - a retrospective study.","authors":"Xiaomin Dai, Xiaoyue Feng, Yanbo Lu, Fang Peng","doi":"10.5114/pjp.2025.155788","DOIUrl":"10.5114/pjp.2025.155788","url":null,"abstract":"<p><p>Anaplastic lymphoma kinase (ALK) rearranged lung adenocarcinoma is frequently characterised by prominent mucin secretion and a heterogeneous population of mucinous cells. These histological features may result in misdiagnosis as invasive mucinous adenocarcinoma. We conducted a comprehensive analysis of 4 cases of ALK-rearranged lung adenocarcinoma, focusing on the clinicopathological features, genetic mutations, and clinical outcomes. Among these cases, 3 cases were initially diagnosed as invasive mucinous adenocarcinoma, while one case was identified as recurrent invasive mucinous adenocarcinoma. The cohort comprised 3 female and 1 male patient/s, with ages ranging from 47 to 63 years (mean age 54.8 years). The tumour cells exhibited sieve-like tubular and solid signet ring structures, with evidence of intracytoplasmic and extracellular mucin secretion. Immunohistochemical analysis demonstrated diffuse expression of TTF-1, Napsin A, and ALK(D5F3) in tumour cells, while HNF4a, CK20, and MUC5AC were consistently negative. Next-generation sequencing analysis confirmed ALK rearrangements in 3 cases. Accurate identification of this specific subtype of lung adenocarcinoma is essential for administering appropriate treatment and reducing the risk of potential misdiagnosis.</p>","PeriodicalId":49692,"journal":{"name":"Polish Journal of Pathology","volume":"76 3","pages":"187-194"},"PeriodicalIF":0.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145999557","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Unravelling the link between mismatch repair protein deficiency and immune checkpoint markers - programmed death ligand 1 and galectin-9 expression in malignant melanoma.","authors":"Gizem Teoman, Mustafa Emre Ercin, Safak Ersoz, Savas Yayli, Murat Livaoglu","doi":"10.5114/pjp.2025.155817","DOIUrl":"https://doi.org/10.5114/pjp.2025.155817","url":null,"abstract":"<p><p>Malignant melanoma is an aggressive skin cancer, with immune evasion mechanisms contributing to tumour progression. This study evaluated the relationship between mismatch repair (MMR) protein loss and the expression of immune checkpoint molecules programmed death ligand 1 (PD-L1) and galectin-9. Ninety melanoma cases (60 primary, 30 metastatic) were analysed by immunohistochemistry for MMR proteins, PD-L1, and galectin-9. Associations with clinicopathological features and overall survival (OS) were assessed. Mismatch repair protein loss occurred in 5% of primary and 16.7% of metastatic melanomas (p = 0.015). Programmed death ligand 1 was positive in 18.8% of cases, with higher expression in metastatic tumours, but this was not statistically significant (p = 0.106). All PD-L1 positive tumours retained MMR proteins. Galectin-9 expression tended to be higher in tumours with MMR loss and in PD-L1-positive cases, but correlations were not significant. Median OS was 26.0 months, and no variable significantly affected survival in multivariate analysis. Mismatch repair loss was more frequent in metastatic melanomas and associated with higher galectin-9 expression, whereas PD-L1 showed no clear link with MMR status. None of the associations reached statistical significance, emphasising the descriptive and exploratory nature of the study. These findings outline biomarker expression patterns in melanoma and support further investigation in larger cohorts, including patients treated with immune checkpoint inhibitors, to clarify their potential clinical relevance.</p>","PeriodicalId":49692,"journal":{"name":"Polish Journal of Pathology","volume":"76 3","pages":"239-247"},"PeriodicalIF":0.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145999086","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Malignant brain tumour with challenging intraoperative findings.","authors":"Gabriele Gaggero, Silvia Bozzano, Nicoletta Fasano, Michele D'Agruma, Valerio GaetanoVellone, Giulio Fraternali Orcioni","doi":"10.5114/pjp.2025.153979","DOIUrl":"10.5114/pjp.2025.153979","url":null,"abstract":"<p><p>This case report describes a rare and challenging glioblastoma variant with a bi-phasic morphology comprising both giant cell and primitive neuronal components. The tumour exhibited aggressive features and was difficult to diagnose during the intraoperative evaluation due to the predominance of small blue cell morphology, which complicated differentiation from haematological and metastatic lesions. Im-munohistochemistry and molecular profiling confirmed a glioblastoma, IDH-wild-type, with combined giant cell and primitive neuronal features, and the p53 muta-tion in both components is a novel finding with potential implications for diagnosis and treatment. This report emphasises the importance of recognising morpholog-ical diversity in glioblastoma to avoid misdiagnosis and enable appropriate clinical management.</p>","PeriodicalId":49692,"journal":{"name":"Polish Journal of Pathology","volume":"76 2","pages":"168-172"},"PeriodicalIF":0.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145114798","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}