Annals of Diagnostic Pathology最新文献

{"title":"Expression of INSM1 in salivary carcinoma showing thymus-like elements (CASTLE).","authors":"Eiichi Sasaki, Katsuhiro Masago","doi":"10.1016/j.anndiagpath.2025.152535","DOIUrl":"10.1016/j.anndiagpath.2025.152535","url":null,"abstract":"","PeriodicalId":50768,"journal":{"name":"Annals of Diagnostic Pathology","volume":"79 ","pages":"152535"},"PeriodicalIF":1.4,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144800870","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":"Assessment of Ki-67 in breast carcinoma: Interobserver variability and comparison between core needle biopsy and resection specimens.","authors":"Hristo Milev, Desislava Dimitrova, Ivan Ivanov","doi":"10.1016/j.anndiagpath.2025.152571","DOIUrl":"https://doi.org/10.1016/j.anndiagpath.2025.152571","url":null,"abstract":"<p><p>Ki-67 is a nuclear protein linked to cellular proliferation and is used as a prognostic and predictive biomarker in breast carcinoma. However, variability in its assessment limits its clinical utility. This study evaluated interobserver reproducibility in Ki-67 scoring and compared proliferative indices between core needle biopsy (CNB) and corresponding resection specimens in invasive breast carcinoma. Sixty-three cases with matched CNB and resection specimens were retrospectively analyzed. Ki-67 immunohistochemistry was independently evaluated by two pathologists using manual image-based counting. Interobserver agreement and CNB-resection concordance were assessed using the intraclass correlation coefficient (ICC), Cohen's kappa, Bland-Altman analysis, and Spearman's correlation. Tumor characteristics were analyzed for their association with variability. Interobserver agreement was excellent, with ICCs of 0.89 for CNB and 0.91 for resection specimens. Cohen's kappa for binary classification (<20 % vs. ≥20 %) showed moderate agreement for CNB (κ = 0.54) and substantial agreement for resections (κ = 0.78). Bland-Altman analysis revealed small but consistent bias, with CNB values slightly higher (+2.89 % and + 2.25 % for raters 1 and 2, respectively). However, discrepancies >10 % were observed in some cases. Tumor characteristics had minimal to no association with scoring variability. Despite excellent statistical agreement, clinically significant variability in Ki-67 scoring may occur. These findings support interpreting Ki-67 as a continuous variable rather than relying on fixed cutoffs. Pathologists should consider specimen type and scoring limitations when reporting Ki-67, and may recommend which value is more reliable or suggest retesting when appropriate.</p>","PeriodicalId":50768,"journal":{"name":"Annals of Diagnostic Pathology","volume":"80 ","pages":"152571"},"PeriodicalIF":1.4,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145245749","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":"From the archives of MD Anderson Cancer Center: Stroma-rich hyaline vascular Castleman disease followed by indolent T-lymphoblastic proliferation and detection of PDGFRB mutation.","authors":"Omar Al-Rusan, David E Ward, Chung-Che Chang, Qi Shen, L Jeffrey Medeiros","doi":"10.1016/j.anndiagpath.2025.152573","DOIUrl":"https://doi.org/10.1016/j.anndiagpath.2025.152573","url":null,"abstract":"<p><p>Castleman disease (CD) is a complex group of at least four lymphoproliferative diseases of which unicentric CD is most common. Morphologically, unicentric CD can be subdivided into hyaline-vascular and mixed/plasmacytic variants. Indolent T-lymphoblastic proliferation (iT-LBP) is a benign, extrathymic expansion of T-lymphoblasts that sometimes can be associated with CD. Cases of iT-LBP do not exhibit morphologic atypia or a destructive growth pattern, lack evidence of monoclonality or recurrent genetic abnormalities and are regarded as reactive processes. We describe a 49-year-old woman who developed a pelvic mass. Needle biopsy showed stroma-rich hyaline-vascular unicentric CD. Two years later, the mass enlarged, and an incisional biopsy revealed a diffuse proliferation of immature lymphoblasts positive for TdT, CD4 and CD8 without immunophenotypic evidence an aberrant T-cell or B-cell population. There was no morphologic evidence of CD, however, a spindle cell proliferation was present in the background. Next generation sequencing showed a PDGFRB N666S mutation suggesting the presence of residual CD. We present this case because it highlights the known association between CD and iT-LBP and the detection of PDGFRB mutation supports the interpretation that the iT-LBP likely arose from hyaline-vascular CD.</p>","PeriodicalId":50768,"journal":{"name":"Annals of Diagnostic Pathology","volume":"80 ","pages":"152573"},"PeriodicalIF":1.4,"publicationDate":"2025-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145259974","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":"Metastases to the gallbladder: Challenges of clinical and frozen section diagnosis.","authors":"Taylor Barr, Erik Washburn, Guoli Chen, Xiaobang Hu","doi":"10.1016/j.anndiagpath.2025.152568","DOIUrl":"https://doi.org/10.1016/j.anndiagpath.2025.152568","url":null,"abstract":"<p><p>Gallbladder metastases are rare and the clinical presentations are often nonspecific. Intra-operative gross and frozen section diagnosis can be particularly challenging. Here we present three cases and reviewed the patients' clinical, gross, frozen, and final pathology findings. Patient one is a 59-year-old male with a history of clear cell renal cell carcinoma status post partial nephrectomy seven years ago. Surveillance imaging showed two small gallbladder polyps. Intra-operative gross examination showed gallbladder with a firm, polypoid area and two detached nodules. Frozen sections of the polypoid area showed histiocytic appearing inflammation and was interpreted as chronic cholecystitis. Permanent sections showed similar morphology, but positive pancytokeratin and PAX8 immunostaining confirmed metastatic renal cell carcinoma. Interestingly, sections of the detached nodules showed better tumor morphology. Patient two is an 81-year-old male with a history of urothelial carcinoma status post transurethral resection two years ago. He presented with right upper quadrant pain, and imaging showed emphysematous cholecystitis. The gallbladder was unremarkable grossly; however, histologic sections showed metastatic urothelial carcinoma. Patient three is a 55-year-old female with a history of metastatic melanoma three years ago. PET/CT showed a stable FDG-avid gallbladder lesion. Grossly the gallbladder wall showed pigmented areas and histologic sections showed metastatic melanoma. Our study shows that the clinical, gross, and frozen section diagnosis of gallbladder metastases can be challenging. Avoiding a diagnostic error will likely entail an integrated approach, inclusive of a thorough review of clinical history, a detailed gross inspection and adequate tissue sampling.</p>","PeriodicalId":50768,"journal":{"name":"Annals of Diagnostic Pathology","volume":"80 ","pages":"152568"},"PeriodicalIF":1.4,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145253665","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":"Gastric-type ampullary adenomas.","authors":"Badr AbdullGaffar, Fatma B Zarooni, Khalid Bamakramah","doi":"10.1016/j.anndiagpath.2025.152570","DOIUrl":"https://doi.org/10.1016/j.anndiagpath.2025.152570","url":null,"abstract":"<p><p>Intestinal-type adenomas of the ampullary duodenum are well-characterized and recognized entities, sharing similar clinicopathologic features to conventional colonic adenomas. However, gastric-type adenomas arising from the duodenal ampulla are less recognized and characterized due to limited available data. Our main aim is to investigate the clinical, histopathologic, histochemical and immunohistochemical features of gastric-type ampullary adenomas. We aim to compare gastric-type adenomas with intestinal-type adenomas and inflammatory hyperplastic reactive-type polyps of the ampullary duodenum. We have conducted a retrospective review study of ampullary polyps over 15-years. We found 17 patients [age range: 22-84, average age: 51.0 years, male to female ratio: 1.1:1.0] with polypoid lesions of the ampullary duodenum. Four lesions (24 %) were gastric-type adenomas [age range: 46-84, average age: 63 years, male to female ratio: 1.0:3.0, average size: 1.0 cm], eight lesions (47 %) were intestinal-type adenomas [age range: 22-76, average age: 45 years, male to female ratio: 1.5:1.0, average size: 1.2 cm], and five lesions (29 %) were reactive inflammatory hyperplastic polyps [age range: 41-76, average age: 53 years, male to female ratio: 1.5:1.0, average size: 0.7 cm]. One of the gastric-type adenomas was pure pyloric gland adenoma, one was pure foveolar adenoma, whereas two were mixed adenomas showing equal proportions of foveolar and pyloric cytoarchitectural features. The foveolar adenoma showed luminal mucin cap and expressed MUC5AC, the pyloric gland adenoma lacked apical mucin cap and expressed MUC6, whereas the mixed adenomas equally coexpressed MUC6 and MUC5AC. The intestinal-type adenomas expressed MUC2 and CDX2, but lacked MUC5AC and MUC6. Three gastric-type adenomas were originally misinterpreted as reactive polyps, whereas two other reactive polyps were originally misinterpreted as intestinal-type adenomas. Three patients with gastric-type adenomas had multiple sporadic colonic adenomas, and one recurred. Four patients with intestinal-type adenomas had colonic adenomas, three of which had familial adenomatous polyposis with recurrence, and one had sporadic colonic adenomas with recurrence. The reactive polyps were not associated with colonic adenomas and did not recur. Gastric-type adenomas are not uncommon among ampullary polyps when carefully examined. They should be distinguished from reactive polyps, because similar to intestinal-type adenomas, they are neoplastic polyps with dysplasia and a risk of recurrence.</p>","PeriodicalId":50768,"journal":{"name":"Annals of Diagnostic Pathology","volume":"80 ","pages":"152570"},"PeriodicalIF":1.4,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145245802","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":"Accuracy and clinical value of intraoperative frozen section assessment in endometrial carcinoma.","authors":"Jing Jia, Ying Zhou, Ajin Hu, Yuxiang Wang, Yue Wang, Yan Liu, Xinlan Shi, Caixia Ren, Congrong Liu","doi":"10.1016/j.anndiagpath.2025.152567","DOIUrl":"https://doi.org/10.1016/j.anndiagpath.2025.152567","url":null,"abstract":"<p><p>In this study, to evaluate the diagnostic accuracy and clinical reliability of intraoperative frozen sections (IFS) compared with paraffin-embedded sections (PS) in guiding surgical decision-making for endometrial carcinoma (EC) patients, we retrospectively analyzed the clinical data of 165 EC patients who underwent surgical resection with IFS evaluation. Diagnostic concordance between IFS and final PS pathology was assessed across six parameters: 1) tumor histological type, 2) tumor grade, 3) depth of myometrial invasion (MI), 4) cervical stromal involvement, 5) lymphovascular space invasion (LVSI) status, and 6) lymph node metastasis risk stratification. The data were statistically analyzed using Kappa coefficient and chi-square test. The IFS results concurred with the PS in 95.3 % for histological type (kappa 0.859, p = 0.125), 94.0 % for tumor grade (kappa 0.848, p = 0.039), 97.6 % for depth of MI (kappa 0.929, p = 0.046), 95.2 % for cervical involvement (kappa 0.481, p = 0.008), and 88.5 % for LVSI (kappa 0.155, p < 0.001). Risk assessment was accurately determined in 92.1 % of cases (kappa 0.796, p < 0.001). Final histopathology confirmed pelvic and paraaortic lymph node metastases in two patients whose metastatic risk had been underestimated based on the IFS risk stratification. High-intermediate/high-risk patients showed significantly higher lymph node involvement compared to low/intermediate-risk groups. IFS analysis demonstrates reliability and clinical utility in assessing disease extent and guiding surgical decisions regarding the need for complete staging procedures in EC patients.</p>","PeriodicalId":50768,"journal":{"name":"Annals of Diagnostic Pathology","volume":"80 ","pages":"152567"},"PeriodicalIF":1.4,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145245835","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":"Inflammatory myofibroblastic tumors of the skin and mucosal sites: A clinicopathological and molecular analysis of 3 cases with emphasis on differential diagnosis.","authors":"Danting Xiong, Xiaona Yin, Yongli Gan, Wenjuan Gan, Xiao Cheng, Ming Zhao","doi":"10.1016/j.anndiagpath.2025.152569","DOIUrl":"https://doi.org/10.1016/j.anndiagpath.2025.152569","url":null,"abstract":"<p><p>This study presents three molecularly confirmed cases of ALK-rearranged inflammatory myofibroblastic tumors (IMTs) occurring in superficial locations, demonstrating their rarity, clinicopathologic heterogeneity and diagnostic complexity. The series comprised tumors involving oropharyngeal mucosa, dermal/subcutaneous tissue of the forearm, and tongue mucosa. Histopathological evaluation revealed characteristic proliferations of spindle-to-ovoid cells arranged in fascicular patterns within variably collagenous to myxoid stroma, accompanied by chronic inflammatory infiltrates. Notable morphologic variations included: (1) rhabdomyoblastic differentiation evidenced by rhabdoid morphology and desmin, MyoD1 and myogenin co-expression in one case, histologically overlapping with inflammatory rhabdomyoblastic tumor; and (2) histiocytoid morphology featuring microvesicular cytoplasm in another case, resembling non-neural granular cell tumor. All cases exhibited strong diffuse cytoplasmic ALK immunoreactivity. Molecular profiling identified DCTN1(exon26)::ALK(exon20) fusions in two cases and TIMP3(exon1)::ALK(exon19) fusion in the lingual lesion, the latter corroborating established associations between TIMP3::ALK fusions and head/neck mucosal sites. With follow-up periods of 4-30 months post complete resection, all patients remained disease-free. These findings expand the recognized morphologic spectrum of cutaneous and superficial mucosal ALK-rearranged IMTs while underscoring the indispensable role of integrated histopathologic and molecular pathologic evaluation in differentiating these neoplasms from their histologic mimics, such as inflammatory rhabdomyoblastic tumor, non-neural granular cell tumor, and epithelioid fibrous histiocytoma/superficial ALK-rearranged myxoid spindle cell neoplasm.</p>","PeriodicalId":50768,"journal":{"name":"Annals of Diagnostic Pathology","volume":"80 ","pages":"152569"},"PeriodicalIF":1.4,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145245818","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 variants of head and neck squamous cell carcinomas: A multicenter study in Latin America","authors":"Heitor Albergoni Silveira ,&nbsp;Karina Helen Martins ,&nbsp;Ana Lia Anbinder ,&nbsp;Thais Aguiar Santos ,&nbsp;Elton Fernandes Barros ,&nbsp;Pollianna Muniz Alves ,&nbsp;Cassiano Francisco Weege Nonaka ,&nbsp;Ana Terezinha Marques Mesquita ,&nbsp;Matheus Henrique Lopes Dominguete ,&nbsp;Rafael Rodrigues Dias ,&nbsp;Katya Pulido Díaz ,&nbsp;Florence Juana Maria Cuadra-Zelaya ,&nbsp;Bruno Augusto Benevenuto de Andrade ,&nbsp;Elaine Maria Sgavioli Massucato ,&nbsp;Andreia Bufalino ,&nbsp;Thales Peres Candido Moreira ,&nbsp;Anderson Tangerino Ferreira da Silva ,&nbsp;Ana Carla Campos ,&nbsp;Magdalena Raquel Torres Reyes ,&nbsp;Mariângela Ottoboni Brunaldi ,&nbsp;Jorge Esquiche León","doi":"10.1016/j.anndiagpath.2025.152565","DOIUrl":"10.1016/j.anndiagpath.2025.152565","url":null,"abstract":"<div><div>Histopathological variants of head and neck squamous cell carcinoma (HNSCC) are uncommon and account for approximately 5–15 % of all HNSCC cases. Owing to their heterogeneous clinicopathological characteristics, a correct diagnosis can be challenging. We aimed to analyze the clinicopathological, histochemical (HC), immunohistochemical (IHC), and in situ hybridization (ISH) findings of HNSCC variants in a Latin American population. In total, 1415 HNSCCs were retrospectively evaluated in accordance with the 2023 World Health Organization criteria. Sixty-six (4.6 %) HNSCC variants were identified, including verrucous carcinoma (VC, <em>n</em> = 21), basaloid SCC (BSCC, <em>n</em> = 13), spindle cell SCC (SCSCC, <em>n</em> = 8), adenosquamous carcinoma (ASC, <em>n</em> = 6), clear cell SCC (CCSCC, <em>n</em> = 4), cuniculatum carcinoma (CC, n = 4), lymphoepithelial carcinoma (LC, <em>n</em> = 3), papillary SCC (PSCC, <em>n</em> = 2), acantholytic SCC (ASCC, n = 2), pigmented SCC (PigSCC, n = 2), and carcinoma with rhabdoid phenotype (CRP, <em>n</em> = 1). Histomorphology, supported by IHC (mainly p53 and Ki-67), allows the diagnosis of most cases of VC, CC, PSCC, ASCC, and PigSCC. Mutant-type p53 pattern is common in BSCCs. SCSCC diagnosis requires IHC to highlight the epithelial phenotype in most cases, almost all of which exhibit a mutant-type p53 pattern. Human papillomavirus-associated BSCC and SCSCC are rare. HC analysis supported by IHC is relevant for most ASC and CCSCC diagnoses. Owing to the inflammatory component, IHC may be crucial for highlighting LC cells, with potential Epstein–Barr virus infection. CRP diagnosis relies on IHC and ISH findings in strict clinical correlation. Therefore, detailed clinicopathological characterization of HNSCC variants is fundamental because it provides valuable data with diagnostic, therapeutic, and prognostic impacts.</div></div>","PeriodicalId":50768,"journal":{"name":"Annals of Diagnostic Pathology","volume":"80 ","pages":"Article 152565"},"PeriodicalIF":1.4,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145214333","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 surgical technique on histopathological specimen quality: Transurethral resection of the prostate versus bipolar enucleation of the prostate","authors":"Onur ERTUNÇ ,&nbsp;Taylan OKSAY ,&nbsp;Enes Emre AŞMAN ,&nbsp;Kadir ERYILMAZ","doi":"10.1016/j.anndiagpath.2025.152564","DOIUrl":"10.1016/j.anndiagpath.2025.152564","url":null,"abstract":"<div><div>This study examines the effects of Transurethral Resection of the Prostate (TURP) and Bipolar Enucleation of the Prostate (BipoLEP) techniques on the histopathological quality of specimens in benign prostatic hyperplasia surgery. A retrospective analysis was conducted on 200 patients (100 TURP, 100 BipoLEP) treated at a single center between January 2021 and January 2023. Specimens were systematically evaluated for artifacts, including fragmentation, thermal, telescoping, sectioning, processing, and staining artifacts. The relationship between surgical technique and artifact types was analyzed using independent samples <em>t</em>-tests, while pathological diagnoses were compared using the chi-square test. Additionally, a pilot group of 10 patients (5 TURP, 5 BipoLEP) underwent immunohistochemical analysis with p63, p27, and androgen receptor to assess antigen preservation. Fragmentation was significantly higher in the BipoLEP group (87 %) compared to the TURP group (6 %) (<em>p</em> &lt; 0.001). Conversely, thermal artifacts were notably more frequent in TURP specimens (97 %) than in BipoLEP (22 %) (<em>p</em> &lt; 0.001). Sectioning artifacts were observed more often after TURP (24 %) compared to BipoLEP (4 %) (p &lt; 0.001), while telescoping artifacts were also more prevalent in BipoLEP (90 %). No significant differences were detected between groups regarding processing or staining artifacts. Both techniques provided comparable diagnostic adequacy and rates of incidental prostate cancer detection. In conclusion, the choice of surgical technique substantially influences the type and frequency of histological artifacts. Therefore, awareness of the surgical method is vital for pathologists to ensure accurate interpretation and optimal patient management.</div></div>","PeriodicalId":50768,"journal":{"name":"Annals of Diagnostic Pathology","volume":"80 ","pages":"Article 152564"},"PeriodicalIF":1.4,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145201569","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":"Evaluation of gastrointestinal biopsies with two-slide serial sections: Analysis of 1715 cases with emphasis on clinical impact","authors":"Nuray Tezcan ,&nbsp;Rohat Esmer ,&nbsp;Gulbanu Canbaloglu ,&nbsp;Gokhan Baysoy ,&nbsp;Pınar Korkmaz ,&nbsp;Merve Senturk ,&nbsp;Serdar Balci ,&nbsp;Burcu Saka","doi":"10.1016/j.anndiagpath.2025.152566","DOIUrl":"10.1016/j.anndiagpath.2025.152566","url":null,"abstract":"<div><div>Although serial sectioning may improve diagnostic yield, no standardized protocol currently exists for endoscopic gastrointestinal (GI) biopsies. The aim of this study was to determine whether examining two serially sectioned slides from each biopsy specimen increases the detection of clinically relevant histopathological findings. In this prospective study, 1715 endoscopic GI biopsy specimens were evaluated using a two-slide serial sectioning approach, with eight consecutive sections per slide. A diagnostic discrepancy was defined as the presence of a histopathological finding on one slide that was absent on the other, thereby representing slide-to-slide variability in detection. Each biopsy specimen was treated as an individual case for serial sectioning and diagnostic assessment purposes, regardless of patient identity, as the study focused on per-sample diagnostic variability. Diagnostic discrepancies between slides were found in 2.2 % of cases, with 1.4 % deemed clinically significant. These included both gain of additional findings on the second slide and loss of findings that were present only on the first slide. Intestinal metaplasia was the most frequently observed clinically relevant finding, particularly in antral biopsies. Importantly, no additional malignancies were identified on second slides, and none of the biopsy-related variables showed a significant association with diagnostic discrepancies. Overall, these findings suggest that, while infrequent, diagnostic discrepancies introduced by serial sectioning may have meaningful clinical implications—particularly in detecting preneoplastic conditions such as intestinal metaplasia in the antrum.</div></div>","PeriodicalId":50768,"journal":{"name":"Annals of Diagnostic Pathology","volume":"80 ","pages":"Article 152566"},"PeriodicalIF":1.4,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145151789","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}