American journal of clinical pathology最新文献

{"title":"Endoscopic ultrasound-guided pancreatic core-needle/microforceps biopsy is a valuable diagnostic tool for pancreatic lesions: Experience from a large academic institution.","authors":"Saba Shafi, Wendy L Frankel, Zaibo Li, Dan Jones, Somashekar G Krishna, Ashwini K Esnakula, Martha Yearsley, Shaoli Sun, Giovanni Lujan, Jennifer Vazzano, Wegahta Weldemichael, Peter Lee, Hamza Shah, Jordan Burlen, George Papachristou, Wei Chen","doi":"10.1093/ajcp/aqaf050","DOIUrl":"https://doi.org/10.1093/ajcp/aqaf050","url":null,"abstract":"<p><strong>Objective: </strong>Endoscopic ultrasound (EUS)-guided, fine-needle core biopsy (FNB), and through-the-needle microforceps biopsy (TTNB) are latest tools for evaluating pancreatic lesions. We aim to provide subspecialty surgical pathologists' experience with EUS-FNB/TTNB in diagnosing pancreatic lesions at a large academic center.</p><p><strong>Methods: </strong>A 3-year review identified 101 EUS pancreatic specimens submitted for surgical pathology: 87 biopsy specimens (FNB = 58, TTNB = 29) and 14 fine-needle aspirations (FNAs). Diagnoses were compared with cytology and resection specimens when available.</p><p><strong>Results: </strong>Of the 101 cases, 10 had previous EUS-FNA cytology with inconclusive diagnoses. Rebiopsy with EUS-FNB/TTNB provided definitive diagnoses in 9 cases. Thirty-five cases (18 cystic and 17 solid lesions) had concurrent surgical pathology and cytology specimens. The diagnostic yield of EUS-FNB/TTNB biopsy specimens (69%) was significantly higher than that of cytology specimens (26%, P = .0017), as was the diagnostic accuracy (P = .0012). This diagnostic advantage was statistically significant in cystic lesions (FNB/TTNB [83.3%] vs cytology [16.7%] for achieving a specific diagnosis, P = .0002) but not in solid lesions (61.5% vs 46.2%, P = .6951). Only in 1 case did cytology (adenocarcinoma) provide a more definitive diagnosis than surgical pathology (high-grade dysplasia cannot exclude adenocarcinoma).</p><p><strong>Conclusions: </strong>The EUS-FNB/TTNB methods complement EUS-FNA cytology in diagnosing pancreatic lesions, and they often outperforms concurrent cytology specimens, particularly in cystic lesions.</p>","PeriodicalId":7506,"journal":{"name":"American journal of clinical pathology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144141371","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":"p53abn high-risk endometrial cancer with PPP2R1A mutation might not benefit from adjuvant chemotherapy.","authors":"Qingxia Zhang, Yue Wang, Dan He, Jingyun Sun, Xin Li, Dong Li, Ying Dong, Yan Zhang, Suxia Wang","doi":"10.1093/ajcp/aqaf039","DOIUrl":"https://doi.org/10.1093/ajcp/aqaf039","url":null,"abstract":"<p><strong>Objectives: </strong>Recent studies have found that high-risk endometrial cancer frequently harbors mutations in tumor suppressor genes PPP2R1A and FBXW7. This study aimed to explore the prognostic utility of these genes and their potential to predict benefit from adjuvant treatment.</p><p><strong>Methods: </strong>Tissue samples of 121 patients with high-risk endometrial cancer were collected. PPP2R1A, FBXW7, and POLE exonuclease domain mutations were detected using Sanger sequencing, while mismatch repair proteins and p53 expression were tested by immunohistochemistry.</p><p><strong>Results: </strong>PPP2R1A and FBXW7 mutations were detected in 11.6% and 21.5% of tumors, respectively. PPP2R1A mutations occurred more frequently in nonendometrioid, high-grade, and advanced-stage tumors and were strongly correlated with poor prognosis. Importantly, PPP2R1A mutations were more frequent in the p53 abnormal (p53abn) subgroup than in the other 3 molecular subgroups (P = .011). In addition, patients with p53abn, PPP2R1A-mutated tumors showed poor prognosis regardless of whether they received adjuvant chemotherapy. In contrast, patients with p53abn, PPP2R1A wild-type tumors exhibited statistically significantly longer survival after adjuvant chemotherapy (P = .022). Similar associations were observed in the patients with p53abn, FBWX7 wild-type tumors.</p><p><strong>Conclusions: </strong>PPP2R1A and FBXW7 status may be related to the current adjuvant chemotherapy outcome, particularly in endometrial cancer with the p53abn subtype. Thus, incorporating PPP2R1A and FBXW7 detection in the stratification and treatment decision-making process may be helpful.</p>","PeriodicalId":7506,"journal":{"name":"American journal of clinical pathology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144141372","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":"Interobserver agreement in scoring HER2-negative and HER2-low immunohistochemistry in breast cancer: Reasons for discordance and impact of a single training session.","authors":"Yun-An Tseng, Steffanie Tamayo, Evi Abada, Shivali Marketkar, Linda C Hanley, Katrine Hansen, M Ruhul Quddus, C James Sung, Kamaljeet Singh","doi":"10.1093/ajcp/aqaf043","DOIUrl":"https://doi.org/10.1093/ajcp/aqaf043","url":null,"abstract":"<p><strong>Objective: </strong>In the DESTINY-Breast04 trial, human epidermal growth factor receptor 2 (HER2) low (HER2-L) is defined as an HER2 immunohistochemistry (IHC) score of 1+ or 2+ with negative fluorescence in situ hybridization. Limited data report poor agreement in scoring HER2-0 vs 1+. We aim to investigate the HER2 IHC concordance rate, with focus on HER2-0 vs HER2-L groups. We evaluate the impact of a single training session on concordance.</p><p><strong>Methods: </strong>Nine breast pathologists from the same institution reviewed 60 HER2 IHC stains on breast biopsy specimens in 2 rounds of 30 cases each. An educational slide review session was provided between the 2 rounds. Interobserver Cohen κ values were computed and compared.</p><p><strong>Results: </strong>Overall complete agreement for HER2 IHC was noted in 37 (62%) of 60 cases, with similar agreement in the first round (19/30 [63%]) and second round (18/30 [60%]). For all 60 cases, κ values ranged from .517 to .895, with 92% of κ values in substantial agreement or better range. For combined HER2-0 and HER2-L cases, κ values ranged from .298 to .826, with only 45% of κ values in substantial agreement or better range. In HER2-L only cases, 50% of the scorer pairs of κ values were 0 or less (no agreement), and only 14% of pairs showed substantial or better agreement. The educational session did not improve the κ values. Faint and heterogeneous HER2 expression, cytoplasmic blush, dislodged cells, and in situ component led to poor concordance in HER2-0 vs HER2-L.</p><p><strong>Conclusions: </strong>Poor concordance on HER2-0 vs HER2-L and lack of improvement after a training session likely suggest ineffective HER2 IHC expression range in HER2 low spectrum.</p>","PeriodicalId":7506,"journal":{"name":"American journal of clinical pathology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144132010","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":"NeuroD1 is frequently expressed in Merkel cell polyomavirus-negative and keratin 20-negative Merkel cell carcinoma: A potential diagnostic pitfall.","authors":"Paweł Karpiński, Cheng-Lin Wu, Mai P Hoang","doi":"10.1093/ajcp/aqaf046","DOIUrl":"https://doi.org/10.1093/ajcp/aqaf046","url":null,"abstract":"<p><strong>Objective: </strong>Neurogenic differentiation factor 1 (NeuroD1) is a known marker of a subtype of small cell lung carcinoma (SCLC). In this study, we aim to assess whether there is an association between NeuroD1 with Merkel cell polyomavirus (MCPyV) status, keratin 20, thyroid transcription factor 1 (TTF1), and overall survival (OS) in 125 Merkel cell carcinomas (MCCs).</p><p><strong>Methods: </strong>NeuroD1-positive MCC tumors were characterized by immunohistochemical stains and an external RNA sequencing data set.</p><p><strong>Results: </strong>NeuroD1 positivity (10%-100%) was seen in 29 (23%) of 125 cases, with 60 (48%) of 126 and 113 (94%) of 120 tumors MCPyV positive and keratin 20 positive, respectively. Focal TTF1 expression was seen in 9 (7.5%) of 120 tumors. NeuroD1 expression was seen more frequently in MCPyV-negative than MCPyV-positive MCCs (P = .0002) and more frequently in keratin 20-negative tumors vs keratin 20-positive ones (P < .0001). Increased NEUROD1 expression in MCPyV-negative MCC (P < .005) was confirmed in an external RNA sequencing data set (GSE235092). Univariate analyses showed NeuroD1 positivity and MCPyV-negative status correlated with worse OS (P = .024 and P = .0076, respectively); however, only MCPyV status remained significant in multivariate analyses (P = .033).</p><p><strong>Conclusions: </strong>NeuroD1-positive MCCs are significantly correlated with MCPyV-negative, keratin 20-negative expression, and focal TTF1 expression. NeuroD1 expression can pose a potential diagnostic pitfall in the distinction of MCC from SCLC, especially in a setting of a limited immunohistochemical panel.</p>","PeriodicalId":7506,"journal":{"name":"American journal of clinical pathology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144092512","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":"Blood banking services in critical access hospitals in Kansas: A laboratory perspective.","authors":"Letycia Nuñez-Argote, Alexandra Corns, Robert Moser","doi":"10.1093/ajcp/aqae169","DOIUrl":"10.1093/ajcp/aqae169","url":null,"abstract":"<p><strong>Objectives: </strong>To investigate the resource capacity for blood banking in critical access hospitals (CAHs) in Kansas and the experiences of medical laboratory personnel working in them.</p><p><strong>Methods: </strong>An electronic survey was implemented to record data from all 82 CAHs in Kansas between May and July 2023. The distance between hospitals with no blood bank services and commercial blood banks was calculated.</p><p><strong>Results: </strong>Only 63.4% of Kansas CAHs located in nonmetropolitan counties reported access to 24/7 blood bank services. In 12.2% of laboratories with 5 or fewer workers, there were no staff proficient in blood bank testing. While 72% of laboratories could perform type and screen and crossmatching, many lacked antibody identification capacity. Only 2 hospitals had the capacity to transfuse packed red blood cells, plasma, and platelets simultaneously if needed, with 20.6% of nonmetropolitan hospitals holding no blood products in inventory.</p><p><strong>Conclusions: </strong>The blood banking capacity of CAHs in Kansas is influenced by the lack of workforce availability and training, reduced availability of blood products, and distance from facilities where blood is processed. Solutions tailored to the unique rural environment are needed to ensure adequate access to blood for patients.</p>","PeriodicalId":7506,"journal":{"name":"American journal of clinical pathology","volume":" ","pages":"670-677"},"PeriodicalIF":2.3,"publicationDate":"2025-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142862579","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":"Comparative evaluation of PD-L1 expression and tumor immune microenvironment in molecular subtypes of muscle-invasive bladder cancer and its correlation with survival outcomes.","authors":"Hena Khandakar, Seema Kaushal, Amlesh Seth, Ranjit K Sahoo, Anubhav Narwal, Hemlata Jangir, Brusabhanu Nayak, Amit K Dinda","doi":"10.1093/ajcp/aqae176","DOIUrl":"10.1093/ajcp/aqae176","url":null,"abstract":"<p><strong>Objectives: </strong>Immune checkpoint inhibitors have revolutionized treatment of platinum-refractory advanced bladder cancer, offering hope where options are limited. Response varies, however, influenced by factors such as the tumor's immune microenvironment and prior therapy. Muscle-invasive bladder cancer (MIBC) is stratified into molecular subtypes, with distinct clinicopathologic features affecting prognosis and treatment. This study assessed the expression of programmed cell death 1 ligand 1 (PD-L1) and other immune markers in MIBC, categorized by molecular phenotype.</p><p><strong>Methods: </strong>Using GATA3 and CK5/6 immunohistochemistry, 90 neoadjuvant chemotherapy-naive MIBC cases were classified into luminal and non-luminal subtypes. The immune microenvironment was characterized through immunostaining for PD-L1, CD4, and CD8. We applied PD-L1 positivity thresholds of 1% or greater for tumor cells and 5% or greater for immune cells. Tumors were examined for PD-L1 expression, histologic subtypes, and immune cell infiltration.</p><p><strong>Results: </strong>Varied expression of PD-L1 and T-cell subtype densities were observed among MIBC subtypes. The double-negative subtype displayed the highest PD-L1 immune cell expression and stromal CD4 and CD8 T-cell densities, indicating an active immune profile. The basal subtype exhibited the highest PD-L1 positivity in tumor cells. In contrast, the luminal type showed the lowest PD-L1 tumor and immune cell expression, with high intratumoral CD4 T-cell density. Although PD-L1 expression in tumor or immune cells did not independently affect survival, patients with basal and double-negative tumors had poorer overall survival.</p><p><strong>Conclusions: </strong>This study highlighted the immune diversity of MIBC in the context of molecular subtypes. Distinct molecular and immune profiles could guide the development of predictive signatures for enhanced immunotherapy response in advanced bladder cancer.</p>","PeriodicalId":7506,"journal":{"name":"American journal of clinical pathology","volume":" ","pages":"708-722"},"PeriodicalIF":2.3,"publicationDate":"2025-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142977140","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":"Abdominal and intra-abdominal fibromatoses: Outcomes over time.","authors":"Fireneh N Beshah, Monica Sanchez-Avila, Amr Abulaban, Diego Montoya-Cerrillo, Domenika Ortiz Requena, Temitope Kehinde, Alan S Livingstone, Francis J Hornicek, Gina D'Amato, Andrew E Rosenberg, Elizabeth A Montgomery","doi":"10.1093/ajcp/aqae182","DOIUrl":"10.1093/ajcp/aqae182","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objectives: &lt;/strong&gt;Abdominal wall and intra-abdominal fibromatoses are locally aggressive, nonmetastasizing neoplasms. Surgery has been the mainstay of local control, but new forms of therapy have been developed that may influence the clinical course and morbidity. We studied the clinical features and outcomes of patients with abdominal and intra-abdominal fibromatoses over time.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Ninety-one patients-46 with abdominal wall and 45 with intra-abdominal fibromatosis-treated in our hospital systems between 2009 and 2023 were included. The patients were allocated to 1 of 2 groups based on the year of their initial treatment: before and including 2016 vs 2017-2023. Medical records and available histologic slides were reviewed.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Forty-six patients were treated between 2009 and 2016, and 45 patients were treated between 2017 and 2023. Patient ages ranged from 1 to 85 years (median, 39 years), and most patients (70%) were women (2:2 men to women). Patients self-reported as Hispanic (49%), followed by White (28%), Black (20%), and Asian (3%). A subset (21%) had familial adenomatous polyposis (FAP)/Gardner syndrome. Individuals with intra-abdominal fibromatoses (37%) were more likely to have FAP than individuals with abdominal wall fibromatosis (4%) (P &lt; .0001). The most common initial treatment before and during vs after 2016 was surgical excision (78% and 51% respectively; P = .02), followed by active surveillance with other medical intervention (9% and 18%, respectively; P = .28) and use of tyrosine kinase inhibitors (0% and 18%, respectively; P = .014). The rate of multivisceral transplant in patients with FAP/Gardner syndrome was 47% vs 4% in patients with sporadic disease (P &lt; .001); most transplants (92%) were performed before and during 2016. The overall tumor recurrence/persistence rate in patients who had undergone surgery was 31%. The recurrence/persistence rate in patients treated before and during 2016 was 39% (median follow-up, 24 months), which fell to 13% (median follow-up, 18 months) in individuals treated after 2016 (P = .032). The overall recurrence/persistence rate in patients with FAP/Gardner syndrome was 64% vs 21% in patients with sporadic disease (P = .002). In patients with sporadic disease, there were recurrences in 29% of patients treated before and during 2016 and in 9% of patients treated thereafter (P = .086). Intra-abdominal vs abdominal wall lesions in patients with FAP and in patients with sporadic disease were more likely to recur (26% vs 10% and 16% vs 5%), but this occurrence did not reach statistical significance (P = .15). Most recurrent tumors were treated by surgical re-excision in both groups.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Our data suggest that a combination of less morbid surgical approaches and the addition of nonsurgical approaches (active disease surveillance, use of tyrosine kinase inhibitors and other interventions) have resulted i","PeriodicalId":7506,"journal":{"name":"American journal of clinical pathology","volume":" ","pages":"744-751"},"PeriodicalIF":2.3,"publicationDate":"2025-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142998671","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":"Pilot study: Urine cell-free DNA with low-pass whole genome sequencing can detect and molecularly type upper tract urothelial carcinomas.","authors":"Chaz Quinn, L Angelica Lerma, Alexander Zhu, Raymond J Monnat, Jonathan L Wright, Christina M Lockwood, Maria S Tretiakova","doi":"10.1093/ajcp/aqae175","DOIUrl":"10.1093/ajcp/aqae175","url":null,"abstract":"<p><strong>Objectives: </strong>Upper tract urothelial carcinoma (UTUC) is an aggressive disease that is challenging to biopsy and diagnose, frequently yielding nondiagnostic cytology and tissue specimens. Therefore, UTUC is often late stage when diagnosed, with poor outcomes. Cell-free tumor DNA (cfDNA) may improve UTUC early diagnosis and assessments of heterogeneity, treatment response, and recurrence but has not been studied in the urine from patients with UTUC. This study aimed to detect recurrent, diagnostic UTUC cytogenetic abnormalities by low-pass whole genome sequencing (LPWGS) and to compare urine-derived and plasma cfDNA against abnormalities identified in patient tumor tissue.</p><p><strong>Methods: </strong>Cell-free tumor DNA extracted from voided urine and plasma before nephroureterectomy in 4 patients with UTUC was compared with genomic DNA from formalin-fixed, paraffin-embedded tumor tissue after LPWGS.</p><p><strong>Results: </strong>Abnormal autosomal genomic regions were highest in tissue (n = 11,843), intermediate in urine (n = 5,072) and lowest in plasma (n = 763), with a high concordance of flagged regions identified in tissue and urine (r = 0.88). Pairwise analysis of whole chromosome gains/losses and subchromosomal alterations between tissue and urine showed nearly identical patterns in all 4 patients (r = 0.88-0.99) in contrast to plasma (r < 0.25). Abnormal genomic regions identified by LPWGS showed a high degree of overlap (100% for tumor tissue, 94% for urine cfDNA) with cBioPortal UTUC-associated genes.</p><p><strong>Conclusions: </strong>We demonstrated the superiority of urine vs plasma cfDNA when LPWGS was used to identify UTUC-associated gene abnormalities. Voided urine cfDNA molecular signatures are highly concordant with matched tumor tissue on chromosomal and subchromosomal levels, emphasizing its feasibility as a noninvasive biomarker for UTUC detection and surveillance.</p>","PeriodicalId":7506,"journal":{"name":"American journal of clinical pathology","volume":" ","pages":"696-707"},"PeriodicalIF":2.3,"publicationDate":"2025-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143373465","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":"Bridging the gap: Evaluating ChatGPT-generated, personalized, patient-centered prostate biopsy reports.","authors":"Erin S Proctor, David J Nusbaum, John M Lee, Robert C Benirschke, Alexa Freedman, Gregory Raster, Alexander P Glaser, Craig V Labbate, Andrew M Higgins, Brian T Helfand, Eric F Glassy, Lija Joseph, Robert A Edelstein, Elizabeth A Krupinski, Hussein Alnajar, James T Kearns, John V Groth","doi":"10.1093/ajcp/aqae185","DOIUrl":"10.1093/ajcp/aqae185","url":null,"abstract":"<p><strong>Objective: </strong>The highly specialized language used in prostate biopsy pathology reports coupled with low rates of health literacy leave some patients unable to comprehend their medical information. Patients' use of online search engines can lead to misinterpretation of results and emotional distress. Artificial intelligence (AI) tools such as ChatGPT (OpenAI) could simplify complex texts and help patients. This study evaluates patient-centered prostate biopsy reports generated by ChatGPT.</p><p><strong>Methods: </strong>Thirty-five self-generated prostate biopsy reports were synthesized using National Comprehensive Cancer Network guidelines. Each report was entered into ChatGPT, version 4, with the same instructions, and the explanations were evaluated by 5 urologists and 5 pathologists.</p><p><strong>Results: </strong>Respondents rated the AI-generated reports as mostly accurate and complete. All but 1 report was rated complete and grammatically correct by the majority of physicians. Pathologists did not rate any reports as having severe potential for harm, but 1 or more urologists rated severe concern in 20% of the reports. For 80% of the reports, all 5 pathologists felt comfortable sharing them with a patient or another clinician, but all 5 urologists reached the same consensus for only 40% of reports. Although every report required edits, all physicians agreed that they could modify the ChatGPT report faster than they could write an original report.</p><p><strong>Conclusions: </strong>ChatGPT can save physicians substantial time by generating patient-centered reports appropriate for patient and physician audiences with low potential to cause harm. Surveyed physicians have confidence in the overall utility of ChatGPT, supporting further investigation of how AI could be integrated into physicians' workflows.</p>","PeriodicalId":7506,"journal":{"name":"American journal of clinical pathology","volume":" ","pages":"766-774"},"PeriodicalIF":2.3,"publicationDate":"2025-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142998672","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":"Connecting the dots: Low-grade appendiceal mucinous neoplasms and serrated polyps in the appendix.","authors":"Juhi Devendra Mahadik, Naziheh Assarzadegan","doi":"10.1093/ajcp/aqae183","DOIUrl":"10.1093/ajcp/aqae183","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to examine the relationship between low-grade appendiceal mucinous neoplasms (LAMNs) and serrated polyps (SPs) of the appendix, both characterized by KRAS mutations and overlapping morphologic features.</p><p><strong>Methods: </strong>We analyzed 27 cases of LAMN and 24 cases of SP from archival records, reviewed pathology, and performed molecular analysis on select cases. Four cases initially diagnosed as LAMN were excluded for not meeting diagnostic criteria, and 1 SP case was reclassified as LAMN.</p><p><strong>Results: </strong>Microscopic evaluation revealed serrated architecture in 8 (29.6%) of 27 LAMNs: 4 hyperplastic polyp-like, 2 sessile serrated lesion-like (SSL), and 1 traditional serrated adenoma-like (TSA). One case exhibited both SSL- and TSA-like areas. Among SPs, 3 (12.5%) of 24 cases showed morphologic overlap with LAMN due to cytoplasmic mucin, flattened mucosa, and conventional adenoma-like features; all were grossly visible. KRAS was the most common mutation in LAMNs with serrated architecture (4/4, 100%), 1 classic LAMN, and 1 SP with dysplasia and associated signet-ring cell carcinoma.</p><p><strong>Conclusions: </strong>Serrated polyps and LAMNs likely represent a biological continuum, sharing key features such as KRAS mutations and morphologic overlap. Our findings underscore the need for careful molecular and histopathologic evaluation in diagnosing these neoplasms.</p>","PeriodicalId":7506,"journal":{"name":"American journal of clinical pathology","volume":" ","pages":"752-757"},"PeriodicalIF":2.3,"publicationDate":"2025-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142998673","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}