Human pathology最新文献

The field of central nervous system (CNS) tumor diagnostics continues to evolve and expand with the emergence and integration of diagnostic, prognostic, and predictive genomic markers. Despite such ever-increasing complexity, it remains within the ability of practicing surgical pathologists to perform an informed assessment of a majority of CNS tumors. In this review, we provide practical guidelines to evaluate the most common primary malignant and benign CNS tumor entities - high-grade diffuse glioma and meningioma.

In last few decades our understanding of bone and soft tissue tumors has evolved significantly, expanding and clarifying our current classification system. Due largely to increased utilization of ancillary testing, particularly molecular tools, new entities are continually emerging and/or being further refined. In addition to morphological and molecular differences, in many instances, the recognition of a new entity carries significant prognostic and potentially therapeutic relevance. In this review on practice updates, we endeavor to discuss five recently described tumors including pseudoendocrine sarcoma, NUT-rearranged sarcoma, VGLL3-rearranged spindle cell rhabdomyosarcoma of head and neck, superficial neurocristic FET::ETS fusion tumors, and NFATC1/2-rearranged epithelioid vascular tumors.

Accurate grading, staging, and classification are essential components of bladder and prostate cancer pathology, directly influencing clinical management and patient outcomes. Recent initiatives by the International Society of Urological Pathology (ISUP) and the Genitourinary Pathology Society (GUPS) have produced key consensus updates aimed at refining diagnostic criteria and resolving long-standing controversies. This review highlights high-impact developments in bladder and prostate pathology, including updated grading systems and T1 substaging in bladder tumors, the proposed hybrid grading approach, and the classification of urachal carcinoma. Evolving perspectives in prostate pathology are also discussed, encompassing intraductal carcinoma of the prostate (IDC-P), neuroendocrine and aggressive variant tumors, and the clinical relevance of Grade Group 1 (GG1) disease in the context of active surveillance. Recent literature and consensus statements are summarized with attention to diagnostic challenges and practical implementation. These focused updates highlight the dynamic nature of urologic pathology and reflect a broader movement toward greater diagnostic precision, reproducibility, and clinical relevance, with adoption of ISUP and GUPS frameworks essential for improving patient outcomes.

The detection of thyroid lesions is a frequently encountered especially in the adult population. Data from literature emphasize that they are found in more than 65 % of individuals. Most of these lesions are benign (90-92 %), even though the incidence of malignancy has been increasing due to frequent ultrasonographic head and neck evaluation, which can now identify small subcentimeter suspicious nodules. However, a 20 % of them, falling into the category of indeterminate lesions can lead to some pitfalls and tricky evaluations. Globally Fine needle aspiration (FNA) has been established as a safe, useful, first-line diagnostic tool, with a high positive predictive value for identifying malignancy. The development of classification system originated in order to obtain a practical classification system, able to combine each entity with a category and then with a specific risk of malignancy (ROM) and management. It is well-known that, among the others, The Bethesda System for Reporting Thyroid Cytopathology (TBSRTC) represent the most worldwide used system. The 3r edition of TBSRTC, published in July 2023, subclassified indeterminate lesions into: a) atypia of undetermined significance (AUS) with nuclear atypia or other atypia, b) follicular neoplasm (FN) and c) suspicious for malignancy (SFM). However, despite the high positive predictive value (97 %-99 %), sensitivity (65 %-99 %) and specificity (72 %-100 %) of thyroid FNAC, diagnostic pitfalls exist that can lead to false positive (FP) and/or false negative (FN) results. This inconvenience is mostly due to the overlapping of morphological features in terms of cells and even background. This review discusses the most important practical issue also related to the application of TBSRTC and the evaluation of morphological challenges that can lead to pitfalls and diagnostic errors.