Advances In Anatomic Pathology最新文献

{"title":"Hot Topics in Urologic Pathology.","authors":"Rajal B Shah, Cristina Magi-Galluzzi","doi":"10.1097/PAP.0000000000000427","DOIUrl":"10.1097/PAP.0000000000000427","url":null,"abstract":"","PeriodicalId":7305,"journal":{"name":"Advances In Anatomic Pathology","volume":null,"pages":null},"PeriodicalIF":6.7,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139072999","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Artificial Intelligence-Enabled Prostate Cancer Diagnosis and Prognosis: Current State and Future Implications.","authors":"Swati Satturwar, Anil V Parwani","doi":"10.1097/PAP.0000000000000425","DOIUrl":"10.1097/PAP.0000000000000425","url":null,"abstract":"<p><p>In this modern era of digital pathology, artificial intelligence (AI)-based diagnostics for prostate cancer has become a hot topic. Multiple retrospective studies have demonstrated the benefits of AI-based diagnostic solutions for prostate cancer that includes improved prostate cancer detection, quantification, grading, interobserver concordance, cost and time savings, and a potential to reduce pathologists' workload and enhance pathology laboratory workflow. One of the major milestones is the Food and Drug Administration approval of Paige prostate AI for a second review of prostate cancer diagnosed using core needle biopsies. However, implementation of these AI tools for routine prostate cancer diagnostics is still lacking. Some of the limiting factors include costly digital pathology workflow, lack of regulatory guidelines for deployment of AI, and lack of prospective studies demonstrating the actual benefits of AI algorithms. Apart from diagnosis, AI algorithms have the potential to uncover novel insights into understanding the biology of prostate cancer and enable better risk stratification, and prognostication. This article includes an in-depth review of the current state of AI for prostate cancer diagnosis and highlights the future prospects of AI in prostate pathology for improved patient care.</p>","PeriodicalId":7305,"journal":{"name":"Advances In Anatomic Pathology","volume":null,"pages":null},"PeriodicalIF":6.7,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139097108","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multicystic Clear Cell Renal Tumors With Low-grade Nuclear Features: Time to Include TFE3 Translocation-associated Carcinomas.","authors":"Qi Cai, Jeffrey Gagan, Prasad Koduru, Jeffrey Cadeddu, Rajal B Shah, Payal Kapur, Doreen N Palsgrove","doi":"10.1097/PAP.0000000000000420","DOIUrl":"10.1097/PAP.0000000000000420","url":null,"abstract":"<p><p>TFE3 -rearranged renal cell carcinoma (RCC) is a distinct, uncommon entity with more than 20 different fusion partners identified; however, histomorphology may be suggestive of specific fusion partners in select TFE3 -rearranged RCCs. For example, most MED15 :: TFE3 fusion associated RCCs exhibit multilocular cystic morphology, mimicking multilocular cystic renal neoplasm of low malignant potential. Here we present a case of MED15 :: TFE3 RCC in an older adult and review the literature with an emphasis on practical diagnostic approaches for predominantly cystic, low-grade, clear cell renal tumors.</p>","PeriodicalId":7305,"journal":{"name":"Advances In Anatomic Pathology","volume":null,"pages":null},"PeriodicalIF":6.7,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71476984","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"#PathMastodon: An Up-In-Coming Platform for Pathology Education Among Pathologists, Trainees, and Medical Students.","authors":"Casey Schukow, Lavisha S Punjabi, Jerad M Gardner","doi":"10.1097/PAP.0000000000000405","DOIUrl":"10.1097/PAP.0000000000000405","url":null,"abstract":"<p><p>Social media use in pathology has continued to grow and become more mainstream among pathologists, trainees, and medical students over the past decade. Twitter has historically been (and still seems to be) a positive platform for the social media pathology community to engage with each other virtually (ie, PathTwitter). However, as a new era of Twitter leadership began to unfold in October 2022, a young platform called \"Mastodon\" began to gain notice within this community as the hashtag #PathMastodon became prevalent. Founded in 2016 by Eugen Rochko, Mastodon is a decentralized, open-sourced, ads-free platform intended to promote public knowledge in a safe and public manner. When compared with Twitter, however, Mastodon is globally much smaller, and its medical professional server called \"Med-Mastodon\" is more cumbersome with certain features (eg, tracking analytics and username changes). Nevertheless, this new platform, which looks and feels much like Twitter, has great potential to provide continued medical education and virtual excellence among the social media pathology community. Thus, the purpose of this review is to provide a relevant synopsis of how Mastodon, Med-Mastodon, and #PathMastodon may benefit pathologists, trainees, and medical students who use social media. A qualitative analysis of pertinent peer-reviewed and non-peer-reviewed materials relative to the topic will be performed. In addition, we will provide a comparison of Mastodon and Twitter, provide example figures of #PathMastodon and related posts, and elaborate on the importance this discussion brings to the social media pathology community.</p>","PeriodicalId":7305,"journal":{"name":"Advances In Anatomic Pathology","volume":null,"pages":null},"PeriodicalIF":6.7,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9920032","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"On the Histologic Classification of Thymoma.","authors":"David Suster, Saul Suster","doi":"10.1097/PAP.0000000000000412","DOIUrl":"10.1097/PAP.0000000000000412","url":null,"abstract":"<p><p>The classification of thymoma continues to be a source of controversy in pathology. The difficulties in histologic classification are evident from the number of proposals that have been offered over the years, as well as for the continuous changes and modifications introduced by the World Health Organization to their classification system over the past 20 years. We analyze here some of the issues involved in the classification of these tumors and the difficulties encountered for practicing pathologists in deciphering the \"letters and numbers\" system devised by the World Health Organization. We would like to propose an alternate approach to thymoma histologic classification that capitalizes on the basic observation of their cytologic features and incorporates the pattern of growth resulting from the interplay of the tumor cells with other cellular constituents as a secondary characteristic. The proposed histologic classification provides a simplified, reproducible means of histologically categorizing these tumors and can be easily understood by most practicing pathologists in simple and clear morphologic terms.</p>","PeriodicalId":7305,"journal":{"name":"Advances In Anatomic Pathology","volume":null,"pages":null},"PeriodicalIF":6.7,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10221676","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Application of ChatGPT in Routine Diagnostic Pathology: Promises, Pitfalls, and Potential Future Directions.","authors":"Casey Schukow, Steven Christopher Smith, Eric Landgrebe, Surya Parasuraman, Olaleke Oluwasegun Folaranmi, Gladell P Paner, Mahul B Amin","doi":"10.1097/PAP.0000000000000406","DOIUrl":"10.1097/PAP.0000000000000406","url":null,"abstract":"<p><p>Large Language Models are forms of artificial intelligence that use deep learning algorithms to decipher large amounts of text and exhibit strong capabilities like question answering and translation. Recently, an influx of Large Language Models has emerged in the medical and academic discussion, given their potential widespread application to improve patient care and provider workflow. One application that has gained notable recognition in the literature is ChatGPT, which is a natural language processing \"chatbot\" technology developed by the artificial intelligence development software company OpenAI. It learns from large amounts of text data to generate automated responses to inquiries in seconds. In health care and academia, chatbot systems like ChatGPT have gained much recognition recently, given their potential to become functional, reliable virtual assistants. However, much research is required to determine the accuracy, validity, and ethical concerns of the integration of ChatGPT and other chatbots into everyday practice. One such field where little information and research on the matter currently exists is pathology. Herein, we present a literature review of pertinent articles regarding the current status and understanding of ChatGPT and its potential application in routine diagnostic pathology. In this review, we address the promises, possible pitfalls, and future potential of this application. We provide examples of actual conversations conducted with the chatbot technology that mimic hypothetical but practical diagnostic pathology scenarios that may be encountered in routine clinical practice. On the basis of this experience, we observe that ChatGPT and other chatbots already have a remarkable ability to distill and summarize, within seconds, vast amounts of publicly available data and information to assist in laying a foundation of knowledge on a specific topic. We emphasize that, at this time, any use of such knowledge at the patient care level in clinical medicine must be carefully vetted through established sources of medical information and expertise. We suggest and anticipate that with the ever-expanding knowledge base required to reliably practice personalized, precision anatomic pathology, improved technologies like future versions of ChatGPT (and other chatbots) enabled by expanded access to reliable, diverse data, might serve as a key ally to the diagnostician. Such technology has real potential to further empower the time-honored paradigm of histopathologic diagnoses based on the integrative cognitive assessment of clinical, gross, and microscopic findings and ancillary immunohistochemical and molecular studies at a time of exploding biomedical knowledge.</p>","PeriodicalId":7305,"journal":{"name":"Advances In Anatomic Pathology","volume":null,"pages":null},"PeriodicalIF":6.7,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10263205","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Invasive Squamous Cell Carcinoma of the Cervix: A Review of Morphological Appearances Encountered in Human Papillomavirus-associated and Papillomavirus-independent Tumors and Precursor Lesions.","authors":"Simona Stolnicu, Douglas Allison, Andrei Patrichi, Jessica Flynn, Alexia Iasonos, Robert A Soslow","doi":"10.1097/PAP.0000000000000411","DOIUrl":"10.1097/PAP.0000000000000411","url":null,"abstract":"<p><p>Cervical cancer is the fourth most common cancer among women globally. Historically, human papillomavirus (HPV) infection was considered necessary for the development of both precursor and invasive epithelial tumors of the cervix; however, studies in the last decade have shown that a significant proportion of cervical carcinomas are HPV-independent (HPVI). The 2020 World Health Organization (WHO) Classification of Female Genital Tumors separates both squamous cell carcinomas (SCCs) and endocervical adenocarcinomas (ECAs) by HPV status into HPV-associated (HPVA) and HPVI tumors. The classification further indicates that, in contrast to endocervical adenocarcinomas, HPVI and HPVA SCCs cannot be distinguished by morphological criteria alone and suggests that HPV testing or correlates thereof are required for correct classification. Moreover, while HPVA SCC precursor lesions (ie, high-grade squamous intraepithelial lesion) are well known and characterized, precursors to HPVI SCCs have only been described recently in a small number of cases. We studied 670 cases of SCCs from the International Squamous Cell Carcinoma Project (ISCCP) to analyze the reproducibility of recognition of invasive SCC growth patterns, presence of lymphovascular space invasion, tumor grade, and associations with patient outcomes. Consistent with previous studies, we found histologic growth patterns and tumor types had limited prognostic implications. In addition, we describe the wide morphologic spectrum of HPVA and HPVI SCCs and their precursor lesions, including tumor growth patterns, particular and peculiar morphologic features that can lead to differential diagnoses, and the role of ancillary studies in the diagnosis of these tumors.</p>","PeriodicalId":7305,"journal":{"name":"Advances In Anatomic Pathology","volume":null,"pages":null},"PeriodicalIF":6.7,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10841279/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10439719","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Current Challenges and Controversies in Colorectal Carcinoma Pathologic Staging-A Practical Guide.","authors":"Ian Clark, Ansa Mehreen, Paxton V Dickson, David Shibata, Evan S Glazer, Nabajit Choudhury, Richa Jain","doi":"10.1097/PAP.0000000000000410","DOIUrl":"10.1097/PAP.0000000000000410","url":null,"abstract":"<p><p>The pathologic assessment of colorectal carcinoma specimens plays a crucial role in the therapeutic management of patients and disease prognostication. The TNM staging system is used globally and is a critical component of colorectal carcinoma pathology reporting. However, our experience informs us that there are significant variations in the assignment of the TNM stage, both between pathologists and between hospital centers. We identify several potential reasons for this, among them suboptimal gross and microscopic assessment of colorectal resection specimens and, later, nonuniformity in applying criteria set forth in pathologic TNM staging guidelines. In addition, some defining characteristics of the staging system remain poorly defined. We aim to enlist those issues with potential remedies to improve reproducibility and, therefore, multidisciplinary discussion.</p>","PeriodicalId":7305,"journal":{"name":"Advances In Anatomic Pathology","volume":null,"pages":null},"PeriodicalIF":6.7,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138486455","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Update on the Use of Molecular Subtyping in Breast Cancer.","authors":"Thomas J Lawton","doi":"10.1097/PAP.0000000000000416","DOIUrl":"10.1097/PAP.0000000000000416","url":null,"abstract":"<p><p>The standard of care for invasive cancers of the breast has been and continues to be to evaluate them for breast prognostic markers: estrogen receptor, progesterone receptor, and human epidermal growth factor receptor 2 by immunohistochemistry. Over 2 decades ago, a study was the first to report on the molecular subtypes of breast cancer. Four main subtypes were reported. Since then there have been some changes in the molecular subtype classification, but overall many studies have shown that this subtyping has clinical prognostic and predictive value. More recently, molecular assays have been developed and studies have shown similar clinical prognostic and predictive value. We reviewed the literature for studies evaluating the clinical significance of all 3 of these methods of evaluation and the follow-up findings of that review are presented below.</p>","PeriodicalId":7305,"journal":{"name":"Advances In Anatomic Pathology","volume":null,"pages":null},"PeriodicalIF":6.7,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41092273","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is it Time to Retire the Term of Low-Grade Ductal Carcinoma in Situ and Replace it With Ductal Neoplasia?","authors":"Shahla Masood,&nbsp;Melvin J Silverstein","doi":"10.1097/PAP.0000000000000418","DOIUrl":"10.1097/PAP.0000000000000418","url":null,"abstract":"<p><p>As the leading cause of cancer morbidity and the second leading cause of cancer mortality among women, breast cancer continues to remain a major global public health problem. Consequently, significant attention has been directed toward early breast cancer detection and prevention. As a result, the number of image-detected biopsies has increased, and minimally invasive diagnostic procedures have almost replaced open surgical biopsies. Therefore, pathologists are expected to provide more information with less tissue and diagnose increasing numbers of atypical proliferative breast lesions, in situ lesions, and small breast carcinomas. This is a difficult task, as reflected by continuous reports highlighting the challenges associated with morphologic distinction between atypical ductal hyperplasia and low-grade ductal carcinoma in situ. The current interobserver variability among pathologists to accurately define these two entities often leads to silent overdiagnosis and overtreatment. Up to now, there are no reproducible morphologic features and/or any reliable biomarkers that can accurately separate the above-mentioned entities. Despite these reports, patients diagnosed with low-grade ductal carcinoma in situ are subject to cancer therapy regardless of the fact that low-grade ductal carcinoma in situ is known to be an indolent lesion. Studies have shown that low and high-grade ductal carcinoma in situ are genetically different forms of breast cancer precursors; however, the term ductal carcinoma in situ is followed by cancer therapy regardless of the grade and biology of the tumor. In contrast, patients with the diagnoses of atypical ductal hyperplasia do not undergo cancer therapy. In the current article, attempts are made to highlight the continuous dilemma in distinction between atypical ductal hyperplasia and low-grade ductal carcinoma in situ. Going forward, we suggest that low-grade ductal carcinoma in situ be referred to as ductal neoplasia. This alternative terminology allows for different management and follow-up strategies by eliminating the word carcinoma.</p>","PeriodicalId":7305,"journal":{"name":"Advances In Anatomic Pathology","volume":null,"pages":null},"PeriodicalIF":6.7,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41093829","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}