American journal of clinical pathology最新文献

{"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":"https://doi.org/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":""},"PeriodicalIF":2.3,"publicationDate":"2025-01-20","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}

{"title":"External quality assessment in African clinical laboratories: A systematic review and meta-analysis.","authors":"Negesse Cherie, Elias Chane, Abiy Ayele Angelo, Bisrat Birke Teketelew, Mebratu Tamir, Dereje Mengesha Berta","doi":"10.1093/ajcp/aqae177","DOIUrl":"https://doi.org/10.1093/ajcp/aqae177","url":null,"abstract":"<p><strong>Objectives: </strong>External quality assessment (EQA) helps evaluate and improve the quality of laboratory testing by providing unbiased reviews. The study aimed to synthesize pooled EQA performance of clinical laboratories across the African region.</p><p><strong>Methods: </strong>The review was registered in PROSPERO (CRD42024562987) and reported based on the 2020 Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist. An extensive search was employed using the PubMed, Scopus, Cochrane, and Embase databases as well as gray literature. After duplicates were removed, the remaining articles were evaluated based on title, abstract, and full text. Methodologic quality was assessed using the JBI critical appraisal checklist. Random effects meta-analysis was used to estimate the pooled performance of EQA at 95% CIs. In addition, the I2 statistic was used to assess heterogeneity, and a funnel plot along with Egger regression were employed to evaluate publication bias. Trim and fill analysis was also performed to adjust the publication bias.</p><p><strong>Results: </strong>From an electronic database search, a total of 622 articles were retrieved. Of these, 17 articles met the inclusion criteria, encompassing a total sample size of 4509 participating laboratories. In this study, the overall pooled performance of EQA in the African region was 71.25% (95% CI, 63.12-79.39). The result indicated statistically significant heterogeneity (I2 = 96.36). The funnel plot displayed an asymmetrical distribution of the studies, and Egger regression revealed significant publication bias (P = .002).</p><p><strong>Conclusions: </strong>The findings revealed that the pooled EQA performance of laboratories in Africa did not meet the typical standard of 80%, indicating a need for continuous improvement. We suggest conducting further studies to gain better insights.</p>","PeriodicalId":7506,"journal":{"name":"American journal of clinical pathology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142977144","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":"https://doi.org/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":""},"PeriodicalIF":2.3,"publicationDate":"2025-01-13","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":"Like, share, and follow!: Usage of social media by pathology residency programs in the COVID-19 era.","authors":"Katsiaryna Khatskevich, Clare F Hartman, Joon Cha, Angela Nguyen, Ashley Mason, Rahul Mhaskar, Tiffany G Baker","doi":"10.1093/ajcp/aqae178","DOIUrl":"https://doi.org/10.1093/ajcp/aqae178","url":null,"abstract":"<p><strong>Objectives: </strong>Social media platforms like Facebook, X (formally Twitter), and Instagram bridge pathology programs with other health professionals, prospective students, and the public, but the extent of social media usage by residency programs remains unexplored. This study investigates the current landscape of social media utilization by pathology programs.</p><p><strong>Methods: </strong>Using the National Resident Matching Program (NRMP) Match Data from 2022, 139 anatomic and clinical pathology residency programs were analyzed and categorized into 3 prestige tiers based on Doximity ratings. There were 32,067 posts examined between January 2018 and August 2022. Statistical analyses, including analysis of variance and Tukey honestly significant difference post hoc analysis, were performed to evaluate likes/views about post type.</p><p><strong>Results: </strong>X emerged as the most used platform (68%), focusing on pathology education (27.02%). Instagram centered on resident life (25.84%), while Facebook showcased person-specific posts (35.61%). Notably, there was a correlation between program prestige and the number of posts on X and Instagram, with the most prestigious programs posting more frequently than those considered more intermediate or low in prestige rank.</p><p><strong>Conclusions: </strong>Social media is vital in connecting pathology programs with various stakeholders. Despite seasonal fluctuations, the overall utilization of social media continues to rise, underscoring its value as a long-term resource for pathology education and communication.</p>","PeriodicalId":7506,"journal":{"name":"American journal of clinical pathology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142942578","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":"Automate cancer synoptic reporting with HyperText Markup Language (HTML) and JavaScript.","authors":"Aaron Duan, Kevin Guo, Huazhang Guo","doi":"10.1093/ajcp/aqae173","DOIUrl":"https://doi.org/10.1093/ajcp/aqae173","url":null,"abstract":"<p><strong>Objectives: </strong>The College of American Pathologists (CAP) Cancer Protocols are developed to facilitate cancer synoptic reporting. CAP offers these Cancer Protocols in both free printable and commercially licensed electronic formats. Several academic institutions have also implemented these Cancer Protocols as web-based services. Due to financial and technical limitations, many resource-limited pathology laboratories still rely on the free printable Cancer Protocols that involve extensive text editing and secretarial support, and they are error-prone.</p><p><strong>This study: </strong>implemented low-cost, low-barrier, and flexible electronic CAP Cancer Protocols to automate cancer synoptic reporting.</p><p><strong>Methods: </strong>For each printable CAP Cancer Protocol, a dynamic data entry form is created using HyperText Markup Language (HTML) with embedded JavaScript, which is then presented in a web browser for pathologists to enter cancer case-specific information. Once the data entry form is complete, the case-specific information entered by the pathologists will be collected, and a synoptic report will be automatically created in the web browser by a companion JavaScript program. The synoptic report can then be copied into the corresponding pathology report.</p><p><strong>Results: </strong>We implemented the commonly used CAP Cancer Protocols into electronic form using HTML/JavaScript. Using this tool, our pathologist reported at least 50% time savings compared to the previous manual process.</p><p><strong>Conclusions: </strong>The proposed HTML/JavaScript-based Cancer Protocols are low-cost, low-barrier, and flexible alternatives to current commercially and academically available electronic CAP Cancer Protocols, especially for pathologists working in resource-limited laboratories. The same implementation methods can also be extended to implement international variants of Cancer Protocols, including non-English Cancer Protocols.</p>","PeriodicalId":7506,"journal":{"name":"American journal of clinical pathology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142913692","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 enterochromaffin-like cell hyperplasia can help categorize patients with Helicobacter-negative atrophic gastritis.","authors":"Feidi Chen, Raul S Gonzalez","doi":"10.1093/ajcp/aqae159","DOIUrl":"https://doi.org/10.1093/ajcp/aqae159","url":null,"abstract":"<p><strong>Objectives: </strong>Atrophic gastritis (AG) is characterized by atrophy of gastric glands-in particular, oxyntic glands-in the setting of chronic inflammation; it is often autoimmune. The diagnosis is confirmed by immunohistochemistry (IHC) for gastrin (to confirm biopsy site), and pathologists often use IHC for neuroendocrine markers to evaluate for enterochromaffin-like cell hyperplasia (ECL-H). The utility of neuroendocrine staining is unclear, and we undertook this study to determine whether ECL pattern provided any additional information in cases of Helicobacter-negative AG.</p><p><strong>Methods: </strong>We reviewed clinicopathologic findings in 184 cases from 184 patients with histologic AG and no evidence of Helicobacter infection. Using neuroendocrine IHC markers, cases were divided into 3 groups: Group 1 showed complete ECL-H (both qualitative and quantitative criteria met), group 2 showed focal ECL-H (qualitative but not quantitative criteria met), and group 3 showed no ECL-H (neither criteria met).</p><p><strong>Results: </strong>Group 1 patients were more likely to have positive autoantibody serologies (73%, P = .0007 vs group 2) and higher mean gastrin levels (700 pg/mL, P = .017 vs group 3), and only these patients developed gastric neuroendocrine tumors. Group 2 patients were more likely to take proton pump inhibitors (64%, P = .0002 vs group 1). Group 3 patients were more likely to be male (70%, P = .008 vs group 1) and to have microcytic anemia (44%, P = .022 vs group 2) and less likely to have intestinal metaplasia (50%, P = .044 vs group 1).</p><p><strong>Conclusions: </strong>Stratification based on degree of ECL-H is not necessary for diagnosis of AG but does lead to statistically significant clinical and pathologic differences among groups.</p>","PeriodicalId":7506,"journal":{"name":"American journal of clinical pathology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2024-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142891359","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":"Urothelial carcinoma in situ with \"early papillary formation\" vs \"lateral spread/shoulder lesion\" of prior high-grade noninvasive papillary urothelial carcinoma: A survey of pathologist and urologist interpretations.","authors":"Ankur R Sangoi, Ali Shahabi, Michelle S Hirsch, Chia-Sui Sunny Kao, Mustafa Deebajah, Justine A Barletta, Gladell P Paner, Steven C Smith, David J Grignon, Eva Compérat, Mahul B Amin, Fiona Maclean, Rajal B Shah, Kenneth A Iczkowski, Warick Delprado, Liang Cheng, Chin-Chen Pan, Jesse K McKenney, Jae Y Ro, Francesca Khani, Rodolfo Montironi, Brian D Robinson, Hikmat Al-Ahmadie, Jonathan I Epstein, Kiril Trpkov, Maria Tretiakova, Steven S Shen, Shaheen Alanee, Christopher J Weight, Mahmut Akgul, Sean R Williamson","doi":"10.1093/ajcp/aqae167","DOIUrl":"https://doi.org/10.1093/ajcp/aqae167","url":null,"abstract":"<p><strong>Objectives: </strong>Urothelial carcinoma in situ (CIS) with early papillary formation is terminology sometimes used to suggest incipient high-grade papillary urothelial carcinoma (PUC) but may lead to confusion between true CIS and lateral flat spread of PUC.</p><p><strong>Methods: </strong>It remains unclear how pathologists and urologists interpret this scenario, so a survey was circulated to 68 pathologists (group 1 = 28 academic genitourinary pathologists; group 2 = 17 pathologists with a self-reported genitourinary focus; group 3 = 23 pathologists self-reported as not genitourinary specialists) and 32 urologists.</p><p><strong>Results: </strong>Regarding atypical urothelial lesions that appear mainly flat but contain possible papillae, group 3 was more likely to label this as CIS compared with groups 1 and 2 (35% for group 3 vs 13% for groups 1 and 2), while groups 1 and 2 more often adopted another descriptive diagnosis, such as \"CIS with early papillary features\" (38% for groups 1 and 2 vs 13% for group 3). Among all 3 groups, group 1 was most likely to diagnose concomitant CIS and PUC in the same specimen but in different tissue fragments (58%). Pagetoid spread was reported to favor CIS predominantly by group 1 (61%). Urologists felt that the term lateral spread/shoulder was unclear (75%) and preferred early PUC (44%) or PUC with early growth (44%). Half (53%) of urologists felt that reporting CIS instead of lateral spread of PUC would change management.</p><p><strong>Conclusions: </strong>Documentation of flat lesions lacks consensus among pathologists and may benefit from standardized terminology. Moreover, the distinction between CIS and early or lateral spread of PUC is not always clear to urologists and can influence disease management.</p>","PeriodicalId":7506,"journal":{"name":"American journal of clinical pathology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2024-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142885218","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":"https://doi.org/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":""},"PeriodicalIF":2.3,"publicationDate":"2024-12-20","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":"Trop-2 and Ephrin B2 expression in urothelial carcinoma with divergent differentiation and aggressive urothelial carcinoma subtypes.","authors":"Katherine B Case, Dylan J Martini, Melad N Dababneh, Samuel Bidot, Bassel Nazha, Jacqueline Brown, Shreyas Joshi, Vikram Narayan, Vaunita Parihar, Faisal Saeed, Mehmet Asim Bilen, Lara R Harik","doi":"10.1093/ajcp/aqae161","DOIUrl":"https://doi.org/10.1093/ajcp/aqae161","url":null,"abstract":"<p><strong>Objectives: </strong>Urothelial carcinomas (UCs) encompass a heterogeneous group of tumors. Several histopathologic features are associated with poor clinical outcomes and limited treatment options. With new rising therapeutic modalities, we aimed to determine the pattern of expression of Trop-2 and ephrin B2 in UC with aggressive subtype histology and/or divergent differentiation (SH/DD).</p><p><strong>Methods: </strong>We performed a retrospective analysis of 113 UC samples with SH/DD at our institution from 2011 to 2021. Immunohistochemical staining for Trop-2 and ephrin B2 expression was performed on all cases. Expression was determined by the percentage of samples with a moderate or strong H-score.</p><p><strong>Results: </strong>Our results show Trop-2 expression was the highest in squamous cell carcinoma and UC with squamous differentiation, adenocarcinoma and UC with glandular differentiation, and plasmacytoid subtype, while ephrin B2 expression was highest in adenocarcinoma, UC with glandular differentiation, and small cell carcinoma.</p><p><strong>Conclusions: </strong>Expression of Trop-2 and ephrin B2 may demonstrate therapeutic possibilities for patients with SH/DD, who usually have limited treatment options, particularly in small cell carcinoma, in which few targets have been identified. Clinical trials to investigate the efficacy of these novel treatments are warranted.</p>","PeriodicalId":7506,"journal":{"name":"American journal of clinical pathology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142869280","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":"How I diagnose high-grade B-cell lymphoma.","authors":"Erika M Moore, Sarah E Gibson","doi":"10.1093/ajcp/aqae158","DOIUrl":"https://doi.org/10.1093/ajcp/aqae158","url":null,"abstract":"<p><strong>Objectives: </strong>High-grade B-cell lymphoma (HGBL), introduced in the 2016 World Health Organization (WHO) revised fourth edition classification, included cases defined by MYC and BCL2 and/or BCL6 rearrangements or by high-grade morphology. Diagnostic criteria and nomenclature for these lymphomas were refined in the 2022 WHO fifth edition (WHO-5) classification and International Consensus Classification (ICC). This review describes our approach to the diagnosis of HGBL.</p><p><strong>Methods: </strong>Two cases are presented illustrating how we diagnose HGBL, including 1 case harboring MYC and BCL6 rearrangements and a second showing TdT expression in an HGBL with MYC and BCL2 rearrangements. The ways in which these cases are distinguished from other lymphomas with high-grade features and the appropriate nomenclature using WHO-5 and ICC classifications are emphasized.</p><p><strong>Results: </strong>An HGBL diagnosis requires integration of morphology, immunophenotype, and genetics and exclusion of other lymphomas with high-grade morphology, including Burkitt lymphoma, B-lymphoblastic leukemia/lymphoma (B-LBL/ALL), and blastoid mantle cell lymphoma. A diagnosis of HGBL/large B-cell lymphoma with 11q aberration should also be considered in certain patient populations.</p><p><strong>Conclusions: </strong>High-grade B-cell lymphomas are subclassified based on morphologic and genetic features. There are differences in the nomenclature and definition of these lymphomas in the WHO-5 and ICC classifications. Distinguishing HGBLs from other mature B-cell lymphomas and B-LBL/ALL is critical so that patients receive appropriate treatment.</p>","PeriodicalId":7506,"journal":{"name":"American journal of clinical pathology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2024-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142845592","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}