Annals of Diagnostic Pathology最新文献

{"title":"Smartphone assisted telepathology: A review","authors":"Nadeem Tanveer ,&nbsp;Farhat Naz","doi":"10.1016/j.anndiagpath.2025.152493","DOIUrl":"10.1016/j.anndiagpath.2025.152493","url":null,"abstract":"<div><h3>Objectives</h3><div>Many practicing pathologists of the current generation have used smartphone-assisted telepathology at some point in time or the other. The use case may vary-second opinions, social media posts, teaching, and so on. This has largely been made possible by the recent improvements in smartphone cameras, better smartphone microscope adaptors, and faster internet. This review aims to provide insights into the different techniques, practical applications, limitations, and prospects of smartphone-assisted telepathology.</div></div><div><h3>Methods</h3><div>We provide a ready reference for all practicing pathologists who want to use smartphone-assisted telepathology more effectively. The review is based on literature available on MEDLINE and personal observations and experiences.</div></div><div><h3>Results</h3><div>Smartphone-assisted telepathology despite its limitations is here to stay. With the introduction of 5G internet, internet speeds are bound to improve. However, the extent of this improvement would ultimately decide how far the smartphone can disrupt the world of telepathology.</div></div><div><h3>Conclusion</h3><div>Learning to use the smartphone effectively for telepathology is important for all pathologists. It is a silent revolution that is slowly but surely changing the way pathologists interact with each other professionally.</div></div>","PeriodicalId":50768,"journal":{"name":"Annals of Diagnostic Pathology","volume":"78 ","pages":"Article 152493"},"PeriodicalIF":1.5,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143874268","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 the 2022 Paris System on diagnostic accuracy and estimating the risk of high-grade malignancy in urine cytology","authors":"Anju Khairwa,&nbsp;Preeti Diwaker","doi":"10.1016/j.anndiagpath.2025.152495","DOIUrl":"10.1016/j.anndiagpath.2025.152495","url":null,"abstract":"<div><div>In 2016, The Paris System 1.0 (TPS 1.0) was introduced to overcome the problem of lack of a standardized reporting system and leading to diagnostic dilemmas for treating physicians. Following this, TPS 2.0 was introduced in 2022 to deal with certain limitations of TPS 1.0. Objectives of study: To evaluate the diagnostic accuracy and risk of malignancy (ROM) with risk of high-grade malignancy (ROHM) of urinary tract by of TPS 2.0 with TPS 1.0 and conventional reporting (CR) of urine cytology. Data were collected retrospectively from 2016 to 2023 from the departmental archives. The cases were reviewed and categorized as per TPS 2.0, TPS 1.0 and CR. Of 875 urine samples studied, 168 urine samples of patients with histology correlation were analyzed. TPS 2.0 had a maximum sensitivity of 64.2 % in Group A, highest specificity of 95.5, positive predictive value of 96.4 % and negative predictive value of 37.5 % in group B comparison to TPS 1.0 and CR. TPS 2.0 has significantly high sensitivity, and maximum receiver operating curve (ROC) with area under the curve (AUC) score (0.695) compared to TPS 1.0 and CR. TPS 2.0 predicted ROM for AUC, SHGUC and HGUC categories 67.6 %, 92 % and 96.8 %, whereas ROHM 26.5 %, 46.2 %, and 98.8 %, respectively. CR and TPS 1.0 predicted ROHM (95.2 % and 81.5 %), respectively. Implementation of TPS 2.0 revealed highest diagnostic accuracy and ROC AUC score for urinary tract malignancy, compared to TPS 1.0 and CR. Our study results highlight the impact of TPS 2.0 in urine cytology reporting.</div></div>","PeriodicalId":50768,"journal":{"name":"Annals of Diagnostic Pathology","volume":"78 ","pages":"Article 152495"},"PeriodicalIF":1.5,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143863613","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":"PD - L1 (SP263) expression correlates with pathological aggressive parameters in prostate cancer","authors":"Xiaopeng Zhuang ,&nbsp;Huiting Li ,&nbsp;Zhijie You ,&nbsp;Hui Cheng ,&nbsp;Guodong Guo ,&nbsp;Xin Chen ,&nbsp;Haijian Huang","doi":"10.1016/j.anndiagpath.2025.152481","DOIUrl":"10.1016/j.anndiagpath.2025.152481","url":null,"abstract":"<div><h3>Objective</h3><div>Research on the expression of PD-L1 (clone SP263) in prostate cancer (PC) is rare. This study aims to investigate PD-L1 (SP263) expression and its clinicopathological correlations in PC.</div></div><div><h3>Methods</h3><div>A total of 265 PC samples at our center from 2021 to 2024 were included in this study. The clinical information and pathological data were collected. Whole-slide immunohistochemical analysis of PD-L1 (SP263), p53, ERG, PTEN, HER-2 and Ki67 was performed on PC samples, including core biopsies, radical prostatectomies, transurethral resections of the prostate and metastases. Next-generation sequencing was performed in 17 patients and the status of <em>TP53</em>, <em>BRCA1/2</em> were analyzed. Associations were assessed between PD-L1 status and clinicopathological parameters (age, preoperative serum prostate-specific antigen [PSA], surgical margin, Gleason Group [GG], TNM stage, Ki-67, p53/<em>TP53</em>, <em>BRCA1/2</em>, survival outcomes, etc.) using chi-square, Mann-Whitney U and Kaplan-Meier analyses.</div></div><div><h3>Results</h3><div>PD-L1 positivity (10.2 %, 27/265) correlated with advanced age (<em>P</em> = 0.007), high GG (<em>P</em> = 0.019), T3/4 stage (<em>P</em> = 0.001), positive surgical margin (<em>P</em> = 0.004), aberrant p53/TP53 (<em>P</em> = 0.043), and elevated Ki-67 (<em>P</em> = 0.042). No associations were observed between these factors (serum PSA, N category, M category, PTEN, ERG, BRCA1/2, or survival outcomes) and PD - L1.</div></div><div><h3>Conclusion</h3><div>The expression of PD-L1 (SP263) is positively associated with pathologically aggressive parameters in PC. This finding implies the potential value of PD-L1 as a biomarker for risk stratification. Moreover, it indicates the possibility of using PD-L1 (SP263) and p53 expression to guide the combinational application of mutated p53 inhibitors and PD-1/PD-L1 antibodies in PC.</div></div>","PeriodicalId":50768,"journal":{"name":"Annals of Diagnostic Pathology","volume":"78 ","pages":"Article 152481"},"PeriodicalIF":1.5,"publicationDate":"2025-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143858748","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":"The importance of MUC6 immunohistochemistry staining in the histopathologic examination of Crohn's disease: can we enhance our diagnostic power?","authors":"Merve Cin ,&nbsp;Özgecan Gündoğar ,&nbsp;Enver Yarıkkaya ,&nbsp;Selçuk Cin","doi":"10.1016/j.anndiagpath.2025.152482","DOIUrl":"10.1016/j.anndiagpath.2025.152482","url":null,"abstract":"<div><div>Crohn's disease (CD) is a chronic inflammatory bowel disease characterized by transmural inflammation and histopathologic variability, making diagnosis challenging. Pseudopyloric metaplasia (PPM) is a key histological feature of chronicity in CD. However, its identification on hematoxylin &amp; eosin (H&amp;E)-stained slides is subject to interobserver variability. MUC6 immunohistochemistry (IHC) has been suggested as a useful marker for pyloric glands. This study aims to evaluate the diagnostic utility of MUC6 staining in detecting PPM and to assess interobserver agreement compared to H&amp;E staining. In this retrospective study, 38 terminal ileum biopsies from CD patients were analyzed. H&amp;E-stained and MUC6-stained slides were evaluated independently by four pathologists for the presence and gland count of PPM. Intraobserver and interobserver agreements were assessed using Intraclass Correlation Coefficient (ICC). The mean PPM count was significantly higher with MUC6 staining than by H&amp;E alone. Intraobserver agreement between H&amp;E and MUC6 staining was “moderate” (ICC = 0.577, 0.734, 0.738) for three pathologists and “poor” (ICC = 0.439) for one. Interobserver agreement was classified as “good” for H&amp;E slides (ICC = 0.849) and “excellent” for MUC6-stained slides (ICC = 0.993). PPM is an important finding that is not specific for CD but indicates chronic mucosal damage in the gastrointestinal tract. In our study, MUC6 IHC staining in CD improved the detection of PPM and increased interobserver agreement in the detection of PPM. The increase in the number of detectable metaplastic glands in all observers demonstrates the potential of MUC6 staining as a reliable marker. MUC6 IHC may provide a more standardized and objective evaluation, reducing diagnostic variability.</div></div>","PeriodicalId":50768,"journal":{"name":"Annals of Diagnostic Pathology","volume":"78 ","pages":"Article 152482"},"PeriodicalIF":1.5,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143835057","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":"The diagnostic significance of immunohistochemical expression of SOX10 and TRPS1 in triple negative breast cancer","authors":"Shaimaa Abdelraouf Elgohary,&nbsp;Maissa Noureldin Elmaraghy,&nbsp;Ola Hassan Nada,&nbsp;Rola Mohamed Farid,&nbsp;Sara Elshaarawi,&nbsp;Bakinam Mohamed Ashoush,&nbsp;Thanaa Elsayed Helal","doi":"10.1016/j.anndiagpath.2025.152480","DOIUrl":"10.1016/j.anndiagpath.2025.152480","url":null,"abstract":"<div><div>Triple negative breast cancer (TNBC) usually exhibits heterogeneous morphological features. The absence of a specific targeted marker for the breast origin of TNBC makes the diagnosis of metastatic TNBC challenging. TRPS1 is regarded as a diagnostic marker for breast cancer of various subtypes, including the basal type of TNBC. SOX10 has been recorded in to be highly expressed in TNBCs. Our cohort study aimed to: first, assess the diagnostic value of TRPS1 and SOX10 immunohistochemical (IHC) expression in TNBC; second, investigate if any of these two markers are related to the established pathological factors of prognostic significance. The study cohort comprised 84 TNBC cases subjected to TRPS1 and SOX10 IHC staining. TRPS1 expression was demonstrated in 86.9 % of the cases. It was expressed in 85.9 %, 83.3 %, and 100 % of invasive breast carcinoma-no special type (IBC-NST), metaplastic carcinomas, and IBC with medullary pattern, respectively. SOX10 expression was identified in 61.9 % of the cases. Most (85.7 %) of IBC with medullary pattern and 83.3 % of metaplastic carcinomas showed positive SOX10 expression. Evaluation of the combined expression of both markers revealed that 52.4 %, 34.5 %, 9.5 %, and 3.6 % of TNBC cases were SOX10+/TRPS1+, SOX10-/TRPS1+, SOX10+/TRPS1-, and SOX10-/TRPS1-, respectively. TRPS1 and SOX10 are fairly sensitive markers for the diagnosis of TNBC. Accordingly, they may be of help in the detection of metastatic TNBC. However, additional studies are required to evaluate these markers on non-breast tumor tissue to further investigate their specificity.</div></div>","PeriodicalId":50768,"journal":{"name":"Annals of Diagnostic Pathology","volume":"78 ","pages":"Article 152480"},"PeriodicalIF":1.5,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143835058","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":"Clinicopathologic features of histologic transformation in lung adenocarcinoma after treatment with epidermal growth factor receptor-tyrosine kinase inhibitors","authors":"Halim Song,&nbsp;Deokhoon Kim,&nbsp;Se Jin Jang,&nbsp;Hee Sang Hwang,&nbsp;Joon Seon Song","doi":"10.1016/j.anndiagpath.2025.152478","DOIUrl":"10.1016/j.anndiagpath.2025.152478","url":null,"abstract":"<div><h3>Background</h3><div>Epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKIs) may lead to drug resistance, and the underlying mechanism may involve histologic transformations to small cell carcinoma (SCC), squamous cell carcinoma (SqCC), and sarcomatoid carcinoma (SC). Although there are reports regarding these transformations, comprehensive analyses are limited.</div></div><div><h3>Methods</h3><div>A total of 233 patients with primary lung adenocarcinoma treated with EGFR-TKIs were reviewed. Among them, 26 patients (11.1 %) showed histologic transformation.</div></div><div><h3>Results</h3><div>Eleven patients (42.3 %) showed SCC and SqCC transformations respectively, and four patients (15.4 %) showed SC transformation. The median time from TKI initiation to transformation was 19.8 months (6.8–51.4) for SCC, 45.3 months (2.4–101.5) for SqCC, and 11.8 months (6.8–15.7) for SC. The median overall survival (OS) was 41.8 months (12.5–78.9), 72.6 months (18.8–112.7), and 23.7 months (17.4–34.4), respectively. The survival from transformation was 12.3 months (2.1–28.3), 16.9 months (0.7–43.2), and 11.4 months (1.6–23.5), respectively. The most common mutations were <em>TP53</em>, <em>PTEN</em>, and <em>RB1</em> in SCC; <em>TP53</em> and <em>RB1</em> in SqCC; and <em>TP53</em> and <em>KMT2D</em> in SC. SC transformation had the worst OS, followed by SCC and SqCC (<em>p</em> &lt; 0.001). This prognosis difference was also reflected in the time to transformation after EGFR-TKI treatment (<em>p</em> = 0.005). However, survival after transformation was not associated with tumor subtypes (<em>p</em> = 0.536).</div></div><div><h3>Conclusions</h3><div>The analysis of mutation profiles and survival outcomes revealed that the transformation subtype affects prognosis. Additionally, the time taken to undergo transformation is critical for patient outcomes.</div></div>","PeriodicalId":50768,"journal":{"name":"Annals of Diagnostic Pathology","volume":"77 ","pages":"Article 152478"},"PeriodicalIF":1.5,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143817192","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":"Cytomorphological changes in thyroid nodules induced by radiofrequency ablation therapy: Emphasis on recurrent papillary thyroid carcinoma","authors":"Uiju Cho ,&nbsp;So Lyung Jung ,&nbsp;Chan Kwon Jung","doi":"10.1016/j.anndiagpath.2025.152479","DOIUrl":"10.1016/j.anndiagpath.2025.152479","url":null,"abstract":"<div><div>Radiofrequency ablation (RFA) therapy is a minimally invasive treatment option for benign thyroid nodules and metastatic papillary thyroid carcinoma (PTC). This study investigated the cytomorphological changes induced by RFA in thyroid nodules. The study included patients who received RFA for benign thyroid nodules (<em>n</em> = 6) or recurrent PTC (<em>n</em> = 14), in the thyroid bed or lymph nodes following thyroidectomy. Patients underwent fine-needle aspiration (FNA) or core needle biopsy (CNB) to evaluate therapeutic responses. Most benign thyroid nodules showed acellular or hypocellular cellularity and coagulative necrosis. Thermal artifacts, fibrosis, and foreign body reactions were also noted. All cases were successfully treated, showing reduced nodule size with no recurrence during follow-up. In patients with recurrent PTC, post-RFA biopsies diagnosed 12 out of 14 samples as PTC, with most displaying degenerated tumor cells. Cytomorphological changes included acellular necrosis, nuclear pyknosis, or karyorrhexis. The second biopsy group showed lower cellularity, fewer degenerated cells, and fewer viable PTC cells than the first biopsy group. Two patients with persistent viable PTC cells after repeated RFA underwent surgical treatment. FNA and CNB effectively evaluate the response to RFA and detect residual tumors. Acellular specimens, total necrosis, and severely degenerated tumor cells indicate successful RFA, while viable cells with preserved PTC features suggest incomplete treatment.</div></div>","PeriodicalId":50768,"journal":{"name":"Annals of Diagnostic Pathology","volume":"77 ","pages":"Article 152479"},"PeriodicalIF":1.5,"publicationDate":"2025-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143800307","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 analysis of Paraganglioma of urinary bladder: A retrospective study","authors":"Wenhua Li ,&nbsp;Wei Wei ,&nbsp;Lijun Yuan ,&nbsp;Ying Zhang ,&nbsp;MinYi","doi":"10.1016/j.anndiagpath.2025.152477","DOIUrl":"10.1016/j.anndiagpath.2025.152477","url":null,"abstract":"<div><div>Paraganglioma of urinary bladder (PUB) is a rare neuroendocrine neoplasm. This study is a retrospective analysis of clinicopathological features in 11 cases of PUB. The studied cohort included seven male and four female patients with a median age of 64 years (range 37–73 years). The maximum tumor diameter ranged from 1 to 4 cm (median: 2.5 cm). Macroscopically, most lesions appeared as smooth, polypoid intraluminal protrusions; one case exhibited a nodular mass extending into the outer bladder wall. Microscopic evaluation demonstrated tumor infiltration into the muscularis propria (6 cases) or both lamina propria and muscularis propria (5 cases). Tumor cells were arranged in nested (Zellballen) or organoid patterns. Tumor cells uniformly expressed CD56, synaptophysin, and chromogranin. The Ki-67 proliferation index was ≤8 % in 10 cases; one case with a 4 cm tumor demonstrated a higher Ki-67 index (20 %), correlating with infiltrative growth and increased mitotic activity. Among the 10 cases that were evaluated, 2 (20 %) showed a loss of SDHB expression; Eight (80 %) of 10 cases were GATA3-positive, and all cases were negative for OCT3/4. Nine (81.8 %) underwent transurethral resection of bladder tumor, and 2 (18.2 %) underwent partial cystectomy. Intraoperative blood pressure fluctuations were observed in 2 patients (18.2 %). The median follow-up time was 26 months (range 4–73 months); one patient experienced a recurrence of endometrial cancer 4 years later and was lost to follow-up at 73 months; the remaining 10 patients survived without recurrence or metastasis. Improved preoperative recognition of PUBs relies on integrating clinical, biochemical, and imaging findings. Standardized immunohistochemical panels may enhance diagnostic accuracy.</div></div>","PeriodicalId":50768,"journal":{"name":"Annals of Diagnostic Pathology","volume":"77 ","pages":"Article 152477"},"PeriodicalIF":1.5,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143725826","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 and prognostic variability of ampullary tumors: A comprehensive study on tumor location, histological subtypes, and survival outcomes","authors":"Dilara Ozyigit Buyuktalanci ,&nbsp;Eylul Gun ,&nbsp;Osman Nuri Dilek ,&nbsp;Fatma Husniye Dilek","doi":"10.1016/j.anndiagpath.2025.152476","DOIUrl":"10.1016/j.anndiagpath.2025.152476","url":null,"abstract":"<div><div>Ampullary tumors present diagnostic challenges due to the complex anatomical and histological structure of the ampullary region. They can be classified into four types based on location: Periampullary-duodenal, intra-ampullary, ampullary-ductal, and ampullary-NOS (not otherwise specified). Periampullary-duodenal tumors are exophytic, ulcerovegetative, and often intestinal-type adenocarcinomas with frequent lymph node metastasis. Intra-ampullary tumors are polypoid and confined to the ampullary canal. Ampullary-ductal tumors exhibit sclerotic thickening in the bile or pancreatic duct and are typically pancreatobiliary-type adenocarcinomas. Ampullary-NOS includes tumors that do not fit other classifications. This study aimed to classify ampullary tumors by their anatomical localization, compare histopathological features, and assess the prognostic outcomes for each group. A total of 111 ampullary tumors were selected from 229 pancreaticoduodenectomy specimens over 10 years at our hospital. Clinical, imaging, and macroscopic findings were re-evaluated microscopically. Tumors were classified into four anatomical groups, and their histopathological characteristics and prognosis were analyzed. The cohort had a mean age of 62 ± 10.49 years, with 69 (62.2 %) males and 42 (37.8 %) females. The median survival was 28.23 months. Tumor distribution was as follows: 14.4 % intra-ampullary, 25.2 % ampullary-ductal, 10.8 % periampullary-duodenal, and 49.5 % not otherwise specified (NOS). Pancreatobiliary-type adenocarcinoma (p = 0.003), perineural invasion (p &lt; 0.0001), and lymphovascular invasion (p = 0.002) were significantly more frequent in the ampullary-ductal and NOS groups, which were associated with poorer overall survival (p = 0.011). In addition, lymphovascular invasion and surgical margin positivity were identified as independent prognostic markers. Classifying ampullary tumors based on anatomical location is crucial due to significant histopathological and prognostic differences between the groups.</div></div>","PeriodicalId":50768,"journal":{"name":"Annals of Diagnostic Pathology","volume":"77 ","pages":"Article 152476"},"PeriodicalIF":1.5,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143725820","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":"Utility and limitations of Merlin immunohistochemistry for mesothelioma diagnosis in tissue sections and cell blocks","authors":"Kazuki Nabeshima ,&nbsp;Makoto Hamasaki ,&nbsp;Tomomi Furukawa ,&nbsp;Shinji Matsumoto ,&nbsp;Katsumi Takizawa ,&nbsp;Makiko Adachi ,&nbsp;Yuko Goto","doi":"10.1016/j.anndiagpath.2025.152475","DOIUrl":"10.1016/j.anndiagpath.2025.152475","url":null,"abstract":"<div><div>Distinguishing pleural mesothelioma (PM) from reactive mesothelial proliferations (RMP) can be challenging. In such cases, immunohistochemistry (IHC)-detected BAP1 or MTAP loss and FISH-detected <em>CDKN2A</em> homozygous deletion are effective. Merlin is the protein product of the <em>NF2</em> gene, which is frequently altered in mesotheliomas. Recently, IHC-detected loss of Merlin was also shown to be useful in differentiating PM from RMP. To validate these findings, we examined Merlin IHC in PM cases, including for the first time cytologic material. Merlin IHC was performed on 67 PM cases, including 47 samples from tissues and 20 from cell blocks (CBs), and 29 RMP cases. In RMP, Merlin was expressed in cell membranes and cytoplasm, with no loss. Merlin expression was lost in 49 % of PM tissues. In discriminating PM from RMP, addition of Merlin IHC to the combination of BAP1 and MTAP IHC increased sensitivity from 77 % to 95 %. However, Merlin expression could not be assessed in 8.5 % of tissues and 25 % of CBs. In CBs, Merlin loss could be assessed only in sheeted or clustered tumor cells, because PM cells could not be identified precisely in few scattered tumor cells. In cases where both tissue biopsy and CBs were available, results matched in only 50 % of cases, suggesting uneven occurrence of Merlin loss in PM tissues. Our observations support the effectiveness of Merlin IHC in differentiating PM from RMP. However, investigators should be familiar with potential challenges in interpreting Merlin IHC results, especially in CBs.</div></div>","PeriodicalId":50768,"journal":{"name":"Annals of Diagnostic Pathology","volume":"77 ","pages":"Article 152475"},"PeriodicalIF":1.5,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143705342","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}