Radhika Sekhri , Xuejun Tian , Jiani Chai , Preeti Malik , Ukuemi Edema , Hania Shakeri , Yungtai Lo , Nicole C. Panarelli
{"title":"胃淋巴组织增生分类线索的跨学科分析:外科病理学家的作用。","authors":"Radhika Sekhri , Xuejun Tian , Jiani Chai , Preeti Malik , Ukuemi Edema , Hania Shakeri , Yungtai Lo , Nicole C. Panarelli","doi":"10.1016/j.humpath.2025.105931","DOIUrl":null,"url":null,"abstract":"<div><div>Surgical pathologists who examine gastric biopsies must triage exuberant lymphoid infiltrates for hematopathology consultation, a task that should account for resource and time utilization. We assembled all cases of chronic gastritis sent by surgical pathologists to hematopathology due to concern for low-grade lymphoma over a 4-year interval. The cases were ultimately classified as reactive (n = 37), atypical (n = 9), or lymphoma (n = 18). A surgical pathologist assessed lymphoid aggregates for their distribution and density, the presence of lymphoepithelial lesions, destruction of native structures, and monocytoid and/or centrocytoid and/or high grade cytology. Endoscopic findings, <em>Helicobacter pylori</em> infection, and any history of lymphoma were documented. Most reactive infiltrates displayed only one of the aforementioned concerning features, whereas atypical cases tended to have at least two and lymphomas at least 3 histologic hallmarks of lymphoma. Logistic regression analysis showed that history of lymphoma, and presence of >3 concerning histologic features were significantly associated with final classification of atypical or lymphoma. The presence of full thickness lymphoid infiltrates approached significance. Combination of these three features produced an area under a receiver operating characteristic (ROC) curve of 0.9, indicating excellent discrimination between reactive and atypical lymphoid infiltrates/lymphomas. We conclude that surgical pathologists can reliably triage gastric lymphoid infiltrates for consultation and ancillary studies by combining clinical data with evaluation of histologic features.</div></div>","PeriodicalId":13062,"journal":{"name":"Human pathology","volume":"164 ","pages":"Article 105931"},"PeriodicalIF":2.6000,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Interdisciplinary analysis of cues to triage gastric lymphoid proliferations: Role of the surgical pathologist revisited\",\"authors\":\"Radhika Sekhri , Xuejun Tian , Jiani Chai , Preeti Malik , Ukuemi Edema , Hania Shakeri , Yungtai Lo , Nicole C. Panarelli\",\"doi\":\"10.1016/j.humpath.2025.105931\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><div>Surgical pathologists who examine gastric biopsies must triage exuberant lymphoid infiltrates for hematopathology consultation, a task that should account for resource and time utilization. We assembled all cases of chronic gastritis sent by surgical pathologists to hematopathology due to concern for low-grade lymphoma over a 4-year interval. The cases were ultimately classified as reactive (n = 37), atypical (n = 9), or lymphoma (n = 18). A surgical pathologist assessed lymphoid aggregates for their distribution and density, the presence of lymphoepithelial lesions, destruction of native structures, and monocytoid and/or centrocytoid and/or high grade cytology. Endoscopic findings, <em>Helicobacter pylori</em> infection, and any history of lymphoma were documented. Most reactive infiltrates displayed only one of the aforementioned concerning features, whereas atypical cases tended to have at least two and lymphomas at least 3 histologic hallmarks of lymphoma. Logistic regression analysis showed that history of lymphoma, and presence of >3 concerning histologic features were significantly associated with final classification of atypical or lymphoma. The presence of full thickness lymphoid infiltrates approached significance. Combination of these three features produced an area under a receiver operating characteristic (ROC) curve of 0.9, indicating excellent discrimination between reactive and atypical lymphoid infiltrates/lymphomas. We conclude that surgical pathologists can reliably triage gastric lymphoid infiltrates for consultation and ancillary studies by combining clinical data with evaluation of histologic features.</div></div>\",\"PeriodicalId\":13062,\"journal\":{\"name\":\"Human pathology\",\"volume\":\"164 \",\"pages\":\"Article 105931\"},\"PeriodicalIF\":2.6000,\"publicationDate\":\"2025-09-09\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Human pathology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S0046817725002187\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"PATHOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Human pathology","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0046817725002187","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"PATHOLOGY","Score":null,"Total":0}
Interdisciplinary analysis of cues to triage gastric lymphoid proliferations: Role of the surgical pathologist revisited
Surgical pathologists who examine gastric biopsies must triage exuberant lymphoid infiltrates for hematopathology consultation, a task that should account for resource and time utilization. We assembled all cases of chronic gastritis sent by surgical pathologists to hematopathology due to concern for low-grade lymphoma over a 4-year interval. The cases were ultimately classified as reactive (n = 37), atypical (n = 9), or lymphoma (n = 18). A surgical pathologist assessed lymphoid aggregates for their distribution and density, the presence of lymphoepithelial lesions, destruction of native structures, and monocytoid and/or centrocytoid and/or high grade cytology. Endoscopic findings, Helicobacter pylori infection, and any history of lymphoma were documented. Most reactive infiltrates displayed only one of the aforementioned concerning features, whereas atypical cases tended to have at least two and lymphomas at least 3 histologic hallmarks of lymphoma. Logistic regression analysis showed that history of lymphoma, and presence of >3 concerning histologic features were significantly associated with final classification of atypical or lymphoma. The presence of full thickness lymphoid infiltrates approached significance. Combination of these three features produced an area under a receiver operating characteristic (ROC) curve of 0.9, indicating excellent discrimination between reactive and atypical lymphoid infiltrates/lymphomas. We conclude that surgical pathologists can reliably triage gastric lymphoid infiltrates for consultation and ancillary studies by combining clinical data with evaluation of histologic features.
期刊介绍:
Human Pathology is designed to bring information of clinicopathologic significance to human disease to the laboratory and clinical physician. It presents information drawn from morphologic and clinical laboratory studies with direct relevance to the understanding of human diseases. Papers published concern morphologic and clinicopathologic observations, reviews of diseases, analyses of problems in pathology, significant collections of case material and advances in concepts or techniques of value in the analysis and diagnosis of disease. Theoretical and experimental pathology and molecular biology pertinent to human disease are included. This critical journal is well illustrated with exceptional reproductions of photomicrographs and microscopic anatomy.