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Data set for the reporting of lung cancer: recommendations from the International Collaboration on Cancer Reporting (ICCR). 肺癌报告数据集:国际癌症报告合作组织(ICCR)的建议。
IF 3.9 2区 医学 Q2 CELL BIOLOGY Pub Date : 2024-10-22 DOI: 10.1111/his.15313
Wendy A Cooper, Fleur Webster, Kelly J Butnor, Fiorella Calabrese, Teh-Ying Chou, David M Hwang, Izidor Kern, Sanjay Popat, Lynette Sholl, Yasushi Yatabe, Andrew G Nicholson

Lung cancer is the leading cause of cancer related deaths worldwide, although some patients with early-stage disease can be cured with surgical resection. Standardised reporting of all clinically relevant pathological parameters is essential for best patient care and is also important for ongoing data collection and refinement of important pathological features that impact patient prognosis, staging and clinical care. Using the established International Collaboration on Cancer Reporting (ICCR) procedure, a representative international expert panel of nine lung pathologists as well as an oncologist was convened. Essential core elements and suggested non-core elements were identified for inclusion in the resected lung cancer pathology data set based on predetermined levels of evidence as well as consensus expert opinion. A lung cancer histopathology reporting guide was developed that includes relevant clinical, macroscopic, microscopic and ancillary testing. Critical review and discussion of current evidence was incorporated into the new data set including changes from the 2021 World Health Organisation (WHO) Classification of Thoracic Tumours, fifth edition, new requirements for grading invasive non-mucinous adenocarcinomas, assessment of response to neoadjuvant therapy and requirements for molecular testing in early-stage resected lung carcinomas. This ICCR data set represents incorporation of all relevant parameters for histology reporting of lung cancer resection specimens. Routine use of this data set is recommended for all pathology reporting of resected lung cancer and it is freely available worldwide on the ICCR website (https://www.iccr-cancer.org/datasets/published-datasets/). Widespread implementation will help to ensure consistent and comprehensive pathology reporting and data collection essential for lung cancer patient care, clinical trials and other research.

肺癌是全球癌症相关死亡的主要原因,尽管一些早期患者可以通过手术切除治愈。对所有与临床相关的病理参数进行标准化报告,是对患者进行最佳治疗的必要条件,同时也是对影响患者预后、分期和临床治疗的重要病理特征进行持续数据收集和改进的重要条件。利用既定的国际癌症报告合作组织 (ICCR) 程序,召集了一个由九位肺部病理学家和一位肿瘤学家组成的具有代表性的国际专家小组。根据预先确定的证据水平和专家共识,确定了纳入切除肺癌病理数据集的必要核心要素和建议非核心要素。制定了肺癌组织病理学报告指南,其中包括相关的临床、宏观、微观和辅助检测。新数据集纳入了对当前证据的严格审查和讨论,包括 2021 年世界卫生组织(WHO)胸部肿瘤分类第五版的变化、浸润性非黏液腺癌分级的新要求、新辅助治疗反应的评估以及早期切除肺癌分子检测的要求。ICCR 数据集包含了肺癌切除标本组织学报告的所有相关参数。建议在所有肺癌切除标本的病理报告中常规使用该数据集,该数据集可在全球各地的 ICCR 网站 (https://www.iccr-cancer.org/datasets/published-datasets/) 上免费获取。广泛实施将有助于确保一致和全面的病理报告和数据收集,这对肺癌患者护理、临床试验和其他研究至关重要。
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引用次数: 0
Giant cell interstitial pneumonia: case series with comprehensive ultrastructural analyses of "not only" hard metal pneumoconiosis. 巨细胞间质性肺炎:对 "不仅是 "硬金属尘肺进行全面超微结构分析的病例系列。
IF 3.9 2区 医学 Q2 CELL BIOLOGY Pub Date : 2024-10-22 DOI: 10.1111/his.15335
Francesco Fortarezza, Matteo Perilli, Mila Della Barbera, Federica Pezzuto, Eleonora Faccioli, Elisabetta Cocconcelli, Emanuele Cozzi, Anna Benedetta Somigliana, Barbara Bonvicini, Federico Rea, Cristina Basso, Stefania Rizzo, Fiorella Calabrese

Aims: Giant cell interstitial pneumonia (GIP) is a fibrosing lung disease histologically characterized by centrilobular pulmonary fibrosis and cannibalistic intra-alveolar multinucleated giant cells. It is considered a form of pneumoconiosis caused particularly by secondary exposure to hard metals (cemented carbide or tungsten carbide). Hard metals are commonly used in various industrial applications, such as cutting tools, drilling tools, machine inserts, and other wear-resistant components. However, cases with unknown exposure that recurred in transplanted lungs have been described. This has led to the hypothesis of a complex etiopathogenesis, likely multifactorial, involving the coparticipation of immune mechanisms. We aimed to identify all the elements present in a series of GIP lung samples to better understand the pathogenic mechanisms of the disease.

Methods and results: We describe five cases of histologically diagnosed GIP in patients with occupational exposure to metallic dust using ultrastructural characterization to identify metal dust and to quantify asbestos fibres. We found that tungsten was present in three cases, albeit in trace amounts in two of them. Numerous elements were identified in all samples, including asbestos fibres in patients with endstage pulmonary fibrosis. Furthermore, in one of the described cases the recurrence of the disease was also observed in transplanted lungs.

Conclusion: These findings support the hypothesis that GIP may be due to elements other than hard metals, with asbestos possibly representing a contributory factor in the expression of a more severe fibrotic disease. The recurrence of GIP observed in transplanted organs strengthens the hypothesis of the existence of a not yet fully understood etiopathogenic immune mechanism.

目的:巨细胞间质性肺炎(GIP)是一种纤维化肺病,其组织学特征是中心叶状肺纤维化和肺泡内多核巨细胞吞噬。它被认为是一种尘肺病,主要由二次接触硬金属(硬质合金或碳化钨)引起。硬质金属通常用于各种工业用途,如切削工具、钻孔工具、机床刀片和其他耐磨部件。不过,也有一些病例描述了移植肺中复发的不明接触情况。这导致了一种假设,即病因机制复杂,可能是多因素的,涉及免疫机制的共同参与。我们旨在确定一系列 GIP 肺样本中存在的所有因素,以更好地了解该疾病的致病机制:我们描述了五例经组织学确诊的 GIP 病例,这些患者都曾因职业原因接触过金属粉尘,我们通过超微结构鉴定来识别金属粉尘并量化石棉纤维。我们发现在三个病例中存在钨,尽管其中两个病例中的钨含量微乎其微。在所有样本中都发现了大量元素,包括肺纤维化晚期患者体内的石棉纤维。此外,在其中一个病例的移植肺中也发现了疾病复发:这些研究结果支持这样的假设,即 GIP 可能是由硬金属以外的元素引起的,石棉可能是导致更严重的纤维化疾病的一个因素。在移植器官中观察到的 GIP 复发情况加强了存在尚未完全理解的致病免疫机制的假设。
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引用次数: 0
Computer vision methods under rapid evolution for pathology image tasks. 用于病理图像任务的快速进化计算机视觉方法。
IF 3.9 2区 医学 Q2 CELL BIOLOGY Pub Date : 2024-10-22 DOI: 10.1111/his.15352
Nigel G Maher, Richard A Scolyer, Sidong Liu
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引用次数: 0
Genetic and immunological features of immune deficiency and dysregulation-associated lymphoproliferations and lymphomas as a basis for classification. 免疫缺陷和调节失调相关淋巴细胞增生症和淋巴瘤的遗传学和免疫学特征作为分类依据。
IF 3.9 2区 医学 Q2 CELL BIOLOGY Pub Date : 2024-10-22 DOI: 10.1111/his.15342
Daan Dierickx, Colm Keane, Yasodha Natkunam

Immune deficiency and dysregulation-associated lymphoproliferative disorders and lymphomas (IDD-LPDs) encompass a heterogeneous clinical and pathological spectrum of disorders that range from indolent lymphoproliferations to aggressive lymphomas. They arise in a variety of clinical settings and are associated with oncogenic viruses such as the Epstein-Barr virus (EBV) and Kaposi sarcoma-associated herpesvirus/human herpes virus (KSHV/HHV8) in some, but not all, cases. The recognition of IDD-LPDs as distinct from LPDs in immune competent patients is essential to tailor clinical management options for affected patients. The 5th edition of the World Health Organisation classification has introduced an integrated classification of IDD-LPDs with the goal of standardising diagnoses among different settings to enhance clinical decision support. In parallel, new knowledge in the field, particularly surrounding the role of oncogenic viruses and the tumour microenvironment, has led to clearer understanding of the complex pathogenesis of IDD-LPDs and how these features can be precisely harnessed for therapeutic purposes. In this perspective, we highlight the need for multidisciplinary decision-making to augment patient care as well as key areas where evolving concepts offer challenges and opportunities for clinical management, research and future iterations of the classification.

免疫缺陷和调节失调相关淋巴组织增生性疾病和淋巴瘤(IDD-LPDs)是一种临床和病理上的异质性疾病,其病理范围从轻度淋巴组织增生到侵袭性淋巴瘤不等。它们出现在不同的临床环境中,部分病例(但并非所有病例)与 Epstein-Barr 病毒(EBV)和卡波西肉瘤相关疱疹病毒/人类疱疹病毒(KSHV/HHV8)等致癌病毒有关。将 IDD-LPD 与免疫功能正常患者的 LPD 区分开来,对于为受影响的患者量身定制临床治疗方案至关重要。世界卫生组织第 5 版分类法引入了 IDD-LPDs 综合分类法,目的是在不同环境中实现诊断标准化,以加强临床决策支持。与此同时,该领域的新知识,尤其是围绕致癌病毒和肿瘤微环境作用的新知识,使人们对 IDD-LPDs 复杂的发病机制以及如何精确利用这些特征达到治疗目的有了更清晰的认识。在这一视角中,我们强调了多学科决策以加强患者护理的必要性,以及不断发展的概念为临床管理、研究和分类的未来迭代带来挑战和机遇的关键领域。
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引用次数: 0
Role of artificial intelligence in haematolymphoid diagnostics. 人工智能在血液淋巴诊断中的作用。
IF 3.9 2区 医学 Q2 CELL BIOLOGY Pub Date : 2024-10-22 DOI: 10.1111/his.15327
Charlotte Syrykh, Michiel van den Brand, Jakob Nikolas Kather, Camille Laurent

The advent of digital pathology and the deployment of high-throughput molecular techniques are generating an unprecedented mass of data. Thanks to advances in computational sciences, artificial intelligence (AI) approaches represent a promising avenue for extracting relevant information from complex data structures. From diagnostic assistance to powerful research tools, the potential fields of application of machine learning techniques in pathology are vast and constitute the subject of considerable research work. The aim of this article is to provide an overview of the potential applications of AI in the field of haematopathology and to define the role that these emerging technologies could play in our laboratories in the short to medium term.

数字病理学的出现和高通量分子技术的应用正在产生前所未有的海量数据。得益于计算科学的进步,人工智能(AI)方法成为从复杂数据结构中提取相关信息的一条大有可为的途径。从辅助诊断到强大的研究工具,机器学习技术在病理学中的潜在应用领域十分广阔,也是大量研究工作的主题。本文旨在概述人工智能在血液病理学领域的潜在应用,并明确这些新兴技术在中短期内可在我们的实验室中发挥的作用。
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引用次数: 0
Can molecular patterns help to classify overlapping entities in myeloid neoplasms? 分子模式能否帮助对骨髓肿瘤中的重叠实体进行分类?
IF 3.9 2区 医学 Q2 CELL BIOLOGY Pub Date : 2024-10-21 DOI: 10.1111/his.15339
Gregor Hoermann, Joseph D Khoury

Myeloid neoplasms include myeloproliferative and myelodysplastic neoplasms and acute myeloid leukaemia. Historically, these diseases have been diagnosed based on clinicopathological features with sometimes arbitrary thresholds that have persisted even as molecular features were gradually incorporated into their classification. As such, although current diagnostic approaches can classify the majority of myeloid neoplasms accurately using a combination of molecular and clinicopathological features, some areas of overlap persist and occasionally pose diagnostic challenges. These include overlap across BCR::ABL1-negative myeloproliferative neoplasms; between clonal cytopenia of undetermined significance and myelodysplastic neoplasms; myelodysplastic/myeloproliferative neoplasms; and, detection of KIT mutations in myeloid neoplasms other than mastocytosis, raising the prospect of systemic mastocytosis. Molecular testing has become state of the art in the diagnostic work-up of myeloid neoplasms, and molecular patterns can inherently help to classify overlapping entities if considered within a framework of haematological presentations. For future development, molecular testing will likely include whole genome and transcriptome sequencing, and primarily molecular classifications of myeloid neoplasms have already been suggested. As such, genetically defined groups should still constitute the basis for our understanding of disease development from early onset to progression, while clinicopathological features could then be used to describe the stage of the disease rather than the specific type of myeloid neoplasm.

髓系肿瘤包括骨髓增生性肿瘤、骨髓增生异常肿瘤和急性髓系白血病。一直以来,这些疾病都是根据临床病理特征来诊断的,有时会采用武断的阈值,即使分子特征逐渐被纳入分类中,这种阈值也一直存在。因此,尽管目前的诊断方法可以结合分子特征和临床病理特征对大多数髓系肿瘤进行准确分类,但一些重叠领域仍然存在,偶尔会给诊断带来挑战。其中包括:BCR::ABL1 阴性骨髓增生性肿瘤之间的重叠;意义未定的克隆性细胞减少症与骨髓增生异常肿瘤之间的重叠;骨髓增生异常/骨髓增生性肿瘤之间的重叠;以及在肥大细胞增多症以外的骨髓性肿瘤中检测到 KIT 突变,从而提出了系统性肥大细胞增多症的前景。分子检测已成为骨髓性肿瘤诊断工作中最先进的技术,如果在血液学表现的框架内进行考虑,分子模式本质上有助于对重叠的实体进行分类。在未来的发展中,分子检测将可能包括全基因组和转录组测序,并且已经提出了主要的髓系肿瘤分子分类。因此,基因定义的组别仍应是我们了解疾病从早期发病到发展的基础,而临床病理学特征则可用于描述疾病的阶段,而不是髓样肿瘤的具体类型。
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引用次数: 0
Thoughts on mastoctosis in COVID-19: an author's response. 对 COVID-19 中乳突病的思考:作者的回应。
IF 3.9 2区 医学 Q2 CELL BIOLOGY Pub Date : 2024-10-20 DOI: 10.1111/his.15349
Boaz V Lopuhaä, Jan H von der Thüsen
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引用次数: 0
Mastocytosis and the trigger for pulmonary fibrosis and thrombosis in patients affected by COVID-19. 肥大细胞增多症与 COVID-19 患者肺纤维化和血栓形成的诱因。
IF 3.9 2区 医学 Q2 CELL BIOLOGY Pub Date : 2024-10-20 DOI: 10.1111/his.15348
Hideki Zimermann Kamitani, Vanessa Ellen Silva Carmo, Afonso José Damásio Da Silva Filho, Lucas Mendes Reis de Moura, Bárbara Rocha Rodrigues, Rodrigo Mendes, Pedro Pereira Tenório
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引用次数: 0
4D pathology: translating dynamic epithelial tubulogenesis to prostate cancer pathology. 4D 病理学:将动态上皮管生成转化为前列腺癌病理学。
IF 3.9 2区 医学 Q2 CELL BIOLOGY Pub Date : 2024-10-20 DOI: 10.1111/his.15354
Hridya Harikumar, Martin E van Royen, Geert Jlh van Leenders

The Gleason score is the gold standard for grading of prostate cancer (PCa) and is assessed by assigning specific grades to different microscopical growth patterns. Aside from the Gleason grades, individual growth patterns such as cribriform architecture were recently shown to have independent prognostic value for disease outcome. PCa grading is performed on static tissue samples collected at one point in time, whereas in vivo epithelial tumour structures are dynamically invading, branching and expanding into the surrounding stroma. Due to the lack of models that are able to track human PCa microscopical developments over time, our understanding of underlying tissue dynamics is sparse. We postulate that human PCa expansion utilizes embryonic and developmental tubulogenetic pathways. The aim of this study is to provide a comprehensive overview of developmental pathways of normal epithelial tubule formation, elongation, and branching, and relate those to the static microscopical PCa growth patterns observed in daily clinical practise. This study could provide a rationale for the discerned pathological interobserver variability and the clinical outcome differences between PCa growth patterns.

格里森评分是对前列腺癌(PCa)进行分级的黄金标准,通过对不同的显微镜下生长模式划分特定等级来进行评估。除了格里森分级外,最近的研究表明,楔形结构等个别生长模式对疾病的预后也有独立的价值。PCa 的分级是在某一时点采集的静态组织样本上进行的,而体内的上皮肿瘤结构是动态侵入、分支并向周围基质扩展的。由于缺乏能够跟踪人类 PCa 显微发展的模型,我们对潜在组织动态的了解非常有限。我们推测人类 PCa 的扩张利用了胚胎和发育过程中的肾小管生成途径。本研究旨在全面概述正常上皮小管形成、伸长和分支的发育途径,并将其与日常临床实践中观察到的静态显微镜下 PCa 生长模式联系起来。这项研究可以为PCa生长模式之间的病理学观察者间差异和临床结果差异提供理论依据。
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引用次数: 0
Discordance of human epidermal growth factor receptor 2-low status between breast primary and distant metastases with clinical-pathological correlation. 乳腺癌原发灶和远处转移灶的人类表皮生长因子受体 2 低水平状态不一致与临床病理相关性。
IF 3.9 2区 医学 Q2 CELL BIOLOGY Pub Date : 2024-10-17 DOI: 10.1111/his.15346
Ellen Yang, Timothy M D'Alfonso, Monica Morrow, Edi Brogi, Hannah Y Wen

Aims: Breast cancer with human epidermal growth factor receptor 2 (HER2) immunohistochemistry (IHC) 1+ or 2+ with negative in-situ hybridisation (ISH) (HER2-low) can now be targeted by HER2 antibody drug conjugates. We set out to compare HER2 status between matched primary invasive breast carcinoma (IBC) and distant metastases (DM) with clinical-pathological correlation, with specific interest in HER2-low.

Methods: Biomarker studies and clinical-pathological features of primary IBC with matched DM diagnosed between 2021 and 2022 were retrospectively analysed. HER2 status was assessed per 2023 American Society of Clinical Oncology/College of American Pathologists (ASCO/CAP) guidelines for IHC (4B5) and ISH (IQFISH pharmDX). Bilateral breast primaries were excluded. HER2 IHC 0 to 1+ were reassessed.

Results: One hundred and forty-seven cases of primary IBC with matched DM were identified. Biomarkers were performed on core biopsy (n = 74) and resection (n = 73). One hundred and twenty-six (86%) were initially classified as 'HER2-negative'; of these, 67 (46%) were reclassified as HER2-low. Patients with HER2-positive primaries were younger (P = 0.01) and had an increased incidence of micropapillary carcinoma (P = 0.02). HER2-low primaries also had an increased incidence of micropapillary carcinoma (P = 0.02) and oestrogen receptor (ER) positivity (P = 0.02) compared to HER2 0. One hundred and sixty-nine matched DM cases excluding bone metastasis were identified (range = one to seven metastases per IBC). The most common sites of metastases were liver (50 of 169, 30%), lung (36 of 169; 21%), distant lymph node (26 of 169, 15%); 138 DM cases (82%) were previously classified as 'HER2-negative', and 62 (37%) were reclassified as HER2-low. Like HER2-low primaries, HER2-low metastases were frequently ER-positive (52 of 62; 84%) (P = 0.02). Brain metastases were more frequently HER2-positive (five of 32; 16%) (P = 0.04). Comparing HER2 status in matched primaries and DM, HER2 status was discordant in 62 cases (37%). Most changes occurred from HER2-low to HER2 0 (33 of 169, 20%), HER2 0 to HER2-low (17 of 169, 10%) and HER2-low to positive (10 of 169, 6%). All HER2-low to HER2 0 changes were HER2 1+ to 0. In 30 patients with multiple DM sites (47 cases), HER2 status among different DM samples was discordant in 16 patients (53%), mainly from HER2-low to HER2 0 (16 of 47, 34%).

Conclusion: A significant proportion of previous 'HER2-negative' primaries and DM cases were reclassified as HER2-low. Discordant HER2 status between IBC primary and metastasis and between different DM sites demonstrated tumour heterogeneity and highlights the need for HER2 retesting in distant metastasis.

目的:人类表皮生长因子受体 2 (HER2) 免疫组化 (IHC) 1+ 或 2+ 且原位杂交 (ISH) 阴性的乳腺癌(HER2-low)现在可以通过 HER2 抗体药物共轭物进行靶向治疗。我们着手比较匹配的原发性浸润性乳腺癌(IBC)和远处转移瘤(DM)的 HER2 状态与临床病理学的相关性,特别关注 HER2-low:方法:回顾性分析了 2021 年至 2022 年期间确诊的原发性 IBC 和匹配 DM 的生物标志物研究和临床病理特征。HER2状态根据2023年美国临床肿瘤学会/美国病理学家学会(ASCO/CAP)IHC(4B5)和ISH(IQFISH pharmDX)指南进行评估。排除双侧乳腺原发癌。重新评估 HER2 IHC 0 至 1+:结果:共发现 147 例原发性 IBC 和匹配的 DM。对核心活检(74 例)和切除术(73 例)进行了生物标志物检测。126例(86%)最初被归类为 "HER2阴性";其中67例(46%)被重新归类为HER2低水平。HER2阳性原发患者更年轻(P = 0.01),微乳头状癌的发病率更高(P = 0.02)。与HER2为0的患者相比,HER2为低的原发灶微乳头状癌(P = 0.02)和雌激素受体(ER)阳性(P = 0.02)的发生率也有所增加。共发现 169 例匹配的 DM 病例(不包括骨转移)(范围 = 每个 IBC 1 到 7 例转移)。最常见的转移部位是肝(169 例中有 50 例,占 30%)、肺(169 例中有 36 例,占 21%)、远处淋巴结(169 例中有 26 例,占 15%);138 例 DM(82%)以前被归类为 "HER2 阴性",62 例(37%)被重新归类为 HER2 低。与HER2-低的原发病例一样,HER2-低的转移病例也经常是ER阳性(62例中有52例;84%)(P = 0.02)。脑转移瘤的 HER2 阳性率更高(32 例中有 5 例;16%)(P = 0.04)。比较匹配的原发灶和DM的HER2状态,62例(37%)的HER2状态不一致。大多数变化是从 HER2 低到 HER2 0(169 例中有 33 例,占 20%),HER2 0 到 HER2 低(169 例中有 17 例,占 10%),HER2 低到阳性(169 例中有 10 例,占 6%)。在30名有多个DM部位的患者(47例)中,有16名患者(53%)的不同DM样本的HER2状态不一致,主要是从HER2-低变为HER2-0(47人中有16人,占34%):结论:很大一部分以前的 "HER2阴性 "原发病例和DM病例被重新分类为HER2低。IBC原发灶和转移灶之间以及不同DM部位之间不一致的HER2状态显示了肿瘤的异质性,并强调了对远处转移灶进行HER2再检测的必要性。
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引用次数: 0
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Histopathology
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