American journal of clinical pathology最新文献

{"title":"Noncutaneous cytotoxic T-cell lymphomas: Recent advances and emerging concepts: A report of the 2023 Society of Hematopathology/European Association for Haematopathology T-cell lymphoma workshop.","authors":"Sanam Loghavi, L Jeffrey Medeiros","doi":"10.1093/ajcp/aqaf016","DOIUrl":"10.1093/ajcp/aqaf016","url":null,"abstract":"<p><strong>Objectives: </strong>To review and discuss cases submitted to the 2023 Society of Hematopathology/European Association for Haematopathology workshop session entitled \"Non-cutaneous Cytotoxic T-cell Lymphomas Including Hepatosplenic T-cell Lymphoma and Intestinal T-cell Lymphomas.</p><p><strong>Methods: </strong>A total of 45 cases were submitted by various contributors. These cases included clinicopathologic, immunophenotypic and molecular data.</p><p><strong>Results: </strong>Cases submitted included 12 hepatosplenic T-cell lymphoma (HSTCL) and 22 intestinal T or NK cell lymphomas or lymphoproliferative disorders (LPD) of various types. The latter group included 12 monomorphic epitheliotropic intestinal T-cell lymphoma (MEITL), 4 indolent NK-cell LPD of the gastrointestinal (GI) tract, 3 indolent (clonal) T-cell lymphoma of the GI tract, 1 refractory celiac disease type 2, 1 enteropathy-associated T-cell lymphoma and 1 intestinal T-cell lymphoma not otherwise specified. There were also 11 miscellaneous cases that did not readily fit into well known diagnostic categories but raised questions about diagnostic criteria or biology or which elucidated aspects of differential diagnosis.</p><p><strong>Conclusions: </strong>The cases submitted were instructive and helped to further characterize and, in some cases, expand these entities. We suggest that HSTCL is a disease with well recognized clinicopathologic features and genetic features. Patients were older than is reflected in the literature. The cases of MEITL in this workshop came mostly from western and/or in industrialized nations. SETD2 mutation or loss of H3K36me3 by immunohistochemistry as a surrogate for this mutation is very common and a helpful diagnostic tool in MEITL. A surprising finding was that some patients with NK-cell LPD of the GI tract exhibited aggressive clinical features including 1 patient who had disease dissemination to the lungs and bile duct.</p>","PeriodicalId":7506,"journal":{"name":"American journal of clinical pathology","volume":"164 1","pages":"36-45"},"PeriodicalIF":2.3,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144615808","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- and bone marrow-based mature T-cell and natural killer cell leukemias and lymphomas: a summary in the series of the 2023 SH/EAHP Workshop.","authors":"Wei Wang, Magdalena Czader, Sa A Wang","doi":"10.1093/ajcp/aqaf009","DOIUrl":"https://doi.org/10.1093/ajcp/aqaf009","url":null,"abstract":"<p><p>This session included 51 cases submitted to the workshop \"Progress in T- and NK-cell Lymphomas and Leukemias\" by the Society for Hematopathology and European Association for Haematopathology under \"Blood/Bone Marrow-Based Mature T- and NK-Cell Leukemias/Lymphomas\" or \"T/NK-cell neoplasms with a Leukemic Presentation.\" Entities encompassed T-cell prolymphocytic leukemia, T-cell large granular lymphocytic leukemia (LGLL), natural killer (NK)-LGLL/chronic lymphoproliferative disorder of NK cells, adult T-cell leukemia/lymphoma, aggressive NK-cell leukemia, and their mimics. Submitted cases illustrated classic and variant morphology, immunophenotype, and clinical features; the overlaps with reactive T-cell /NK-cell lymphoproliferations; and challenges in differentiating these entities from other T-cell/NK-cell neoplasms with a leukemic presentation. The cases were assessed using a multidisciplinary approach that included advancements in molecular genetics with their potential impact on clinical practice. We used the most recent classifications and summarized the key points relevant to diagnoses and differential diagnoses of respective entities.</p>","PeriodicalId":7506,"journal":{"name":"American journal of clinical pathology","volume":"164 1","pages":"7-25"},"PeriodicalIF":2.3,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144615776","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":"T and NK lymphoblastic leukemia/lymphoma: Report from the 2023 SH/EAHP Workshop.","authors":"Olga K Weinberg, Carlos E Bueso-Ramos, Rashmi Kanagal-Shamanna","doi":"10.1093/ajcp/aqaf015","DOIUrl":"https://doi.org/10.1093/ajcp/aqaf015","url":null,"abstract":"<p><strong>Objectives: </strong>The 2023 Society for Hematopathology/European Association for Hematopathology Workshop addressed advancements in the diagnosis and classification of T- and natural killer (NK)-cell lymphomas/leukemias.</p><p><strong>Methods: </strong>Session 8 of the workshop collected a diverse set of 38 cases of immature T- and NK-cell lymphoma/leukemias, as well as acute leukemia of ambiguous lineage (ALAL) and other miscellaneous cases, including indolent T-lymphoblastic proliferations.</p><p><strong>Results: </strong>Twenty patients with T-lymphoblastic leukemia/lymphoma (T-LBL/L) and 3 patients with early T-cell precursor acute lymphoblastic leukemia (ETP-ALL) presented at a median age of 21.5 years. Male sex was predominant (70% of all cases), with 40% having a mediastinal mass. Cases (60%) were negative for both CD34 and TdT. In addition, 7 ALAL and 3 mixed phenotype acute leukemia, T/myeloid subtypes were submitted with a median presenting age of 16 (range, 11-56) years, and most patients (67%) frequently showed adenopathy or splenomegaly. A single case of NK acute lymphoblastic leukemia was also submitted.</p><p><strong>Conclusions: </strong>This session highlighted unusual T-LBL/L cases with expression of cytotoxic markers, γ/δ phenotype, a more mature immunophenotype, and ALAL that are challenging to classify. Among T-ALL cases, interesting relapse changes were identified, with 1 patient developing a mature NK-cell phenotype. Patients with ALAL presented in an unusual setting of prior therapy or a germline mutation.</p>","PeriodicalId":7506,"journal":{"name":"American journal of clinical pathology","volume":"164 1","pages":"26-35"},"PeriodicalIF":2.3,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144615809","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":"Cutaneous T-cell lymphomas other than mycosis fungoides: Unusual clinical and pathologic presentations: a report of the 2023 SH-EA4HP Lymphoma Workshop (session 4).","authors":"Joan Guitart, Roberto N Miranda","doi":"10.1093/ajcp/aqaf030","DOIUrl":"10.1093/ajcp/aqaf030","url":null,"abstract":"<p><p>Thirty-two cases of cutaneous T-cell lymphoma other than mycosis fungoides were discussed at the 2023 Society of Hematopathology-European Association for Haematopathology Workshop, held November 9-11, 2023, in Houston, Texas. This session focused on diagnostically challenging rare clinical and pathologic presentations with an overrepresentation of cytotoxic cutaneous lymphomas. The variety of challenging cases reviewed in the session highlights the shortfalls of our present cutaneous lymphoma classification and provides a rich learning experience for future classification updates. Many of the cases reviewed revealed a broad and often surprising mutational profile that will contribute to more precise and molecularly relevant future classification as well as (possibly) therapeutic approaches.</p>","PeriodicalId":7506,"journal":{"name":"American journal of clinical pathology","volume":"164 1","pages":"126-141"},"PeriodicalIF":2.3,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144615778","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":"Anaplastic large cell lymphoma: unusual clinical and pathologic findings: A report of the 2023 SH-EA4HP Lymphoma Workshop.","authors":"Jie Xu, Eric D Hsi, Roberto N Miranda, Mario L Marques-Piubelli, L Jeffrey Medeiros, Andrew L Feldman","doi":"10.1093/ajcp/aqaf029","DOIUrl":"https://doi.org/10.1093/ajcp/aqaf029","url":null,"abstract":"<p><p>Anaplastic large cell lymphoma (ALCL) cases were discussed at the 2023 Society of Hematopathology/European Association for Haematopathology workshop held on November 9-11, 2023, in Houston, Texas. This session focused on the clinical and pathologic spectrum of 3 types of ALCL: anaplastic lymphoma kinase (ALK)-positive, ALK-negative, and breast implant associated (BIA). Cases of primary cutaneous ALCL were excluded because they were included in another session. Although the diagnosis of ALCL is often straightforward, the 42 submitted cases encompassed unusual clinical presentations, morphologic variants, and atypical immunophenotypes, exemplifying potential difficulties and challenges in establishing the diagnosis of ALCL. Distinguishing ALCL from CD30-positive peripheral T-cell lymphoma, not otherwise specified, or classic Hodgkin lymphoma was discussed. In patients with a previous history of mycosis fungoides and other T-cell lymphoma/leukemia, the differential diagnosis of a CD30-positive T-cell lymphoma mimicking ALCL (mycosis fungoides transformation vs de novo ALCL) was also discussed. In patients with suspected BIA-ALCL, it is critical to properly handle the periprosthetic fluid when the disease first presents and the capsule at the time of initial capsulectomy to make a correct diagnosis and pathologic staging because a missed diagnosis may lead to disease progression. Comprehensive immunohistochemical analysis; fluorescence in situ hybridization for DUSP22, TP63, or JAK2 rearrangement; assessment of clonality of the T-cell receptor and immunoglobulin genes; and sequencing for mutations were performed as part of the workup of the submitted cases, particularly on ALK-negative ALCL cases, emphasizing the importance of ancillary testing in establishing the diagnosis.</p>","PeriodicalId":7506,"journal":{"name":"American journal of clinical pathology","volume":"164 1","pages":"110-125"},"PeriodicalIF":2.3,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144615775","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":"Genomics of T-lymphoblastic leukemia/lymphoma: 2023 SH/EAHP workshop proceedings.","authors":"Rashmi Kanagal-Shamanna, Olga K Weinberg, Carlos E Bueso-Ramos","doi":"10.1093/ajcp/aqaf035","DOIUrl":"https://doi.org/10.1093/ajcp/aqaf035","url":null,"abstract":"<p><strong>Objectives: </strong>Recent molecular characterization of T‑lymphoblastic leukemia/lymphoma (T-ALL/LBL) has deepened our understanding of the pathogenesis and created a strong foundation for novel therapeutic strategies. Consequently, both the fifth edition of the World Health Organization and the International Consensus Classification systems for T-ALL/LBL have identified genomic subtypes, some as provisional entities. However, due to the challenges encountered in uncovering these alterations, molecular testing modalities and algorithms in clinical laboratory algorithms remain inconsistent or incomplete.</p><p><strong>Methods: </strong>Cases from Session 8 of the 2023 Workshop of the Society for Hematopathology and the European Association for Haematopathology highlighted various T-ALL/LBL genetic subtypes and showcased phenotypic diversity even among individuals with identical genetic abnormalities.</p><p><strong>Results: </strong>The data underscored the presence of significant genetic heterogeneity in T-ALL/LBL, highlighting the diagnostic value of specific genomic features for accurate classification, differentiation between immature and mature T-lymphoid neoplasms, and detection of underlying germline predisposition disorders. Further, the range of available standard molecular testing methodologies, including ancillary immunohistochemical studies, was discussed.</p><p><strong>Conclusions: </strong>A comprehensive standardized testing of genomic abnormalities will advance T-ALL/LBL characterization in future classification systems, as underscored by the cases submitted to Session 8 of SH2023. The genetic heterogeneity underscores the need for personalized therapies that target driver genomic abnormalities.</p>","PeriodicalId":7506,"journal":{"name":"American journal of clinical pathology","volume":"164 1","pages":"76-84"},"PeriodicalIF":2.3,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144615807","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":"T- and NK-cell lymphomas and leukemias: Insights from the 2023 Society for Hematopathology/European Association for Haematopathology Workshop.","authors":"Francisco Vega, Carlos Bueso Ramos, Javeed Iqbal, L Jeffrey Medeiros","doi":"10.1093/ajcp/aqae168","DOIUrl":"https://doi.org/10.1093/ajcp/aqae168","url":null,"abstract":"","PeriodicalId":7506,"journal":{"name":"American journal of clinical pathology","volume":"164 1","pages":"4-6"},"PeriodicalIF":2.3,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144615810","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 expanding spectrum of T-cell lymphomas with follicular helper T-cell phenotype and implications for differential diagnoses: A report of the 2023 SH/EA4HP Lymphoma Workshop.","authors":"Ahmet Dogan, Ozgur Can Eren, Laurence de Leval","doi":"10.1093/ajcp/aqaf040","DOIUrl":"https://doi.org/10.1093/ajcp/aqaf040","url":null,"abstract":"<p><strong>Objectives: </strong>The 2023 Society of Hematopathology/European Association for Haematopathology Workshop on Progress in Peripheral T- and NK-Cell Lymphomas addressed challenges in diagnosis, biomarkers, and molecular pathogenesis.</p><p><strong>Methods: </strong>Session 1 of the workshop focused on T-follicular helper (TFH) lymphomas and related entities. Sixty-one cases were submitted, and their histology, phenotype, and genetics were reviewed.</p><p><strong>Results: </strong>The panelists confirmed 46 cases as TFH lymphomas, more commonly angioimmunoblastic type than follicular or not otherwise specified. A small subset of patients were young adults. Expected immunophenotypic profile, with expression of pan T-cell markers and TFH-specific markers with subtle differences between the histologic subtypes was observed. Genetic analyses revealed classic genetic alterations associated with these tumors, including frequent mutations in epigenetic modifiers (eg, TET2, DNMT3A, and IDH2) and RHOA. A broad spectrum of clonal B-cell proliferations was associated with TFH lymphomas, including polymorphic proliferations to large B-cell lymphoma-like expansions, often associated with Epstein-Barr virus. The remaining 15 cases were reclassified with alternative diagnoses, underscoring the diagnostic challenges and complexity in distinguishing TFH lymphomas from other entities.</p><p><strong>Conclusions: </strong>The cases highlighted the clinical and biological heterogeneity and complexity of TFH lymphomas and provided a framework for pathology workup and diagnosis as well as future research.</p>","PeriodicalId":7506,"journal":{"name":"American journal of clinical pathology","volume":"164 1","pages":"85-109"},"PeriodicalIF":2.3,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144615811","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":"Comprehensive characterization of nodal peripheral T-cell lymphoma, not otherwise specified: A report of the 2023 SH/EA4HP lymphoma workshop.","authors":"Catalina Amador, Alyssa Bouska, Rauf Shah, Javeed Iqbal, Francisco Vega","doi":"10.1093/ajcp/aqaf025","DOIUrl":"https://doi.org/10.1093/ajcp/aqaf025","url":null,"abstract":"<p><strong>Objective: </strong>To summarize the conclusions of the 2023 Society for Hematopathology/European Association for Hematopathology Workshop in peripheral T-cell lymphoma, not otherwise specified (PTCL-NOS).</p><p><strong>Methods: </strong>There were 36 cases with a submitted diagnosis of PTCL reviewed in Session 2.</p><p><strong>Results: </strong>The cases were classified based on submitted data and additional studies conducted during the workshop, including nodal PTCL with γδ immunophenotype (n = 5), PTCL-NOS subclassified into PTCL-TBX21 (n = 8) and PTCL-GATA3 (n = 8) molecular subtypes, PTCL-NOS expressing CD30 (n = 2), PTCL arising from an underlying low-grade T-cell lymphoproliferative disorder (n = 2), and nodal involvement by primary cutaneous T-cell lymphoma (n = 5). Additionally, we reviewed 5 cases of T-cell lymphoma with lymphoepithelioid features, including 2 cases that do not meet the current criteria for PTCL-NOS, with 1 included in PTCL-TBX21 and 1 in PTCL γδ described above. Three cases remain unclassified. We highlight the diagnostic challenges of PTCL-NOS, emphasizing the importance of performing a comprehensive panel of immunomarkers and molecular studies to establish the diagnosis and address the heterogeneity of these lymphomas. We identify rare cases of nodal γδ PTCL-NOS with a unique immunophenotype and TP53 mutations. We also discuss the features of PTCL-GATA3 and PTCL-TBX21, including enrichment for cytotoxic markers in PTCL-TBX21 and aberrant B-cell marker expression in a subset of PTCL-GATA3 cases. The differential diagnosis of PTCL-NOS cases expressing, as well as those with lymphoepithelioid features, is briefly discussed. The importance of access to clinical history and staging is emphasized, as demonstrated by cases of nodal involvement by primary cutaneous T-cell lymphomas and cases that have progressed from low-grade lymphoproliferative disorders.</p><p><strong>Conclusions: </strong>Peripheral T-cell lymphoma, not otherwise specified is heterogeneous with distinct emerging subgroups. The diagnosis is complex and requires a comprehensive approach.</p>","PeriodicalId":7506,"journal":{"name":"American journal of clinical pathology","volume":"164 1","pages":"65-75"},"PeriodicalIF":2.3,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144615777","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":"HER2 fluorescence in situ hybridization groups 2-4 breast cancers classified as positive after targeted recounts following equivocal (2+) immunohistochemistry.","authors":"Diane Wilcock, Deepika Sirohi, Joshua F Coleman, Parisa Adelhardt, Jong Taek Kim, Daniel Albertson, Kajsa Affolter, Cameron Beech, Jolanta Jedrzkiewicz, Ana L Ruano, Allison S Cleary, Jonathan Mahlow, Michael Balatico, H Evin Gulbahce","doi":"10.1093/ajcp/aqaf006","DOIUrl":"10.1093/ajcp/aqaf006","url":null,"abstract":"<p><strong>Objectives: </strong>To investigate the correlation between the extent of (percentage of tumor cells) immunohistochemistry (IHC) staining and final human epidermal growth factor receptor 2 (HER2)-positive result in fluorescence in situ hybridization (FISH) groups 2 to 4 with equivocal (2+) IHC requiring second, blinded FISH evaluation.</p><p><strong>Methods: </strong>Breast cancer cases submitted for HER2 FISH testing with group 2 to 4 results were included.</p><p><strong>Results: </strong>Of the 2548 cases with HER2 FISH groups 2 to 4 that had HER2 IHC performed, 1104 (43.3%) (76/182 [41.8%] of group 2, 94/161 [58.4%] of group 3, 934/2205 [42.4%] of group 4) had equivocal (2+) IHC. After second blinded, IHC-guided recounts, 217 of 1104 (19.7%) (17/76 [22.4%], 75/94 [79.8%], 125/934 [13.4%] of FISH groups 2, 3, 4 with IHC 2+, respectively) had final HER2-positive status. Only 13 of 217 (6%) of the cases with HER2-positive status had more than 50% circumferential staining of the tumor targeted for rescoring.</p><p><strong>Conclusions: </strong>In over 90% of HER2 FISH group 2 to 4 breast cancers with equivocal (2+) IHC followed by targeted, blinded second FISH evaluation and final HER2-positive result, the amplified population of tumor cells was limited (<50%). Current guidelines recommend cancers having 10% to 50% of the subpopulation with amplified cells classified as having genetic heterogeneity (GH), which have a poor response to targeted therapies. Identifying these tumors as having GH and/or repeat testing may be recommended.</p>","PeriodicalId":7506,"journal":{"name":"American journal of clinical pathology","volume":" ","pages":"837-846"},"PeriodicalIF":2.3,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143397760","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}