Pathology最新文献

英文中文

Does precursor-type intraductal carcinoma of the prostate exist? An academic debate of limited clinical significance 前列腺导管内前体癌存在吗？临床意义有限的学术辩论。

IF 3 3区医学 Q1 PATHOLOGY

Pathology

Pub Date : 2025-07-09 DOI: 10.1016/j.pathol.2025.06.003

Murali Varma , Theodorus H. van der Kwast

引用次数: 0

Extraenteric gastrointestinal neuroectodermal tumour masquerading as mucosal melanoma of the bronchus 肠外胃肠道神经外胚层肿瘤伪装成支气管粘膜黑色素瘤。

IF 3 3区医学 Q1 PATHOLOGY

Pathology

Pub Date : 2025-07-04 DOI: 10.1016/j.pathol.2025.05.003

Louise A. Jackett , Catherine Mitchell , Julie Chu

引用次数: 0

Spectrum of renal diseases caused by monoclonal immunoglobulin: experience from an Australian tertiary referral centre over a 10-year period 单克隆免疫球蛋白引起的肾脏疾病谱：澳大利亚三级转诊中心10年来的经验。

IF 3 3区医学 Q1 PATHOLOGY

Pathology

Pub Date : 2025-07-04 DOI: 10.1016/j.pathol.2025.06.001

Seethalakshmi Viswanathan , Angela Bayly , David A. Brown , Levina Neill , Michael Piza , Brian Nankivell

Monoclonal immunoglobulin (MIg)-associated renal diseases are caused by nephrotoxic MIg originating from underlying plasma cell or lymphoid clone. The present study is an analysis of patient demographics, pathological characteristics, haematological and renal biomarkers of 83 biopsy-proven cases of diseases mediated by MIg, accrued from 6196 renal biopsies in a single Australian tertiary referral centre, over a decade. Older patients were more commonly affected with 89.2% of patients over the age of 50 years, with a male predominance. The spectrum consisted of direct MIg-associated renal diseases with organised and non-organised deposits, immunoglobulin light-chain amyloidosis +/– light chain cast nephropathy (AL amyloidosis +/– LCCN; 60.2%), cryoglobulinaemic glomerulonephritis types I and II (6%), monoclonal immunoglobulin deposition disease +/– light-chain cast nephropathy (MIDD +/– LCCN; 14.4%), proliferative glomerulonephritis with monoclonal immunoglobulin deposits (PGNMID; 13.3%), light-chain proximal tubulopathy (LCPT; 1.2%), light-chain cast nephropathy (LCCN; 2.4%), and indirect complement-mediated lesions including monoclonal thrombotic microangiopathy (TMA; 1.2%) and C3 glomerulopathy (1.2%). PGNMID was the only type of lesion seen post-transplant (3.6%). Tissue clonality was reliably established by immunofluorescence (IF) on frozen tissue, with paraffin IF and immunohistochemistry as useful salvage procedures. An underlying plasma cell clone was identified in 80.3% cases and a lymphoid clone in 19.7% cases. An overt haematological malignancy was seen in 39.8% of cases. A confirmed diagnosis of monoclonal gammopathy of renal significance (MGRS) was made in 70.5% of cases and renal biopsy preceded haematological investigations in 65.8% of cases, emphasising the significant role of the pathologist in the accurate diagnosis and classification of these lesions. MIg-mediated renal diseases can be accurately diagnosed and classified on renal biopsies. The presence of LCCN was associated with adverse renal outcome and overall survival. Future studies with a larger sample size are necessary to determine individual parameters that affect renal and overall survival.

单克隆免疫球蛋白（MIg）相关的肾脏疾病是由源自潜在浆细胞或淋巴细胞克隆的肾毒性MIg引起的。本研究分析了一个澳大利亚三级转诊中心十多年来6196例肾活检中83例经活检证实的MIg介导疾病的患者人口统计学、病理特征、血液学和肾脏生物标志物。年龄较大的患者更常见，89.2%的患者年龄在50岁以上，以男性为主。谱包括有组织和无组织沉积的直接MIg沉积病，免疫球蛋白轻链淀粉样变性+/-轻链铸型肾病(AL淀粉样变性+/- LCCN；60.2%)，冷球蛋白血症型肾小球肾炎I型和II型（6%），单克隆免疫球蛋白沉积病+/-轻链铸型肾病(MIDD +/- LCCN；14.4%)，增殖性肾小球肾炎合并单克隆免疫球蛋白沉积病(PGNMID；13.3%)，轻链近端小管病变(LCPT；1.2%)，轻链铸造肾病(LCCN；2.4%)，以及间接补体介导的病变，包括单克隆血栓性微血管病(TMA；1.2%)和C3肾小球病变（1.2%）。PGNMID是移植后复发的唯一病变类型（3.6%）。通过免疫荧光（IF）在冷冻组织上可靠地建立了组织克隆，石蜡IF和免疫组织化学是有用的挽救方法。在80.3%的病例中发现潜在的浆细胞克隆，19.7%的病例中发现淋巴细胞克隆。39.8%的病例可见明显的血液学恶性肿瘤。70.5%的病例确诊为肾性单克隆伽玛病（MGRS）， 65.8%的病例在血液学检查之前进行肾活检，强调了病理学家在准确诊断和分类这些病变中的重要作用。mig介导的肾脏疾病可以通过肾活检准确诊断和分类。LCCN的存在与不良的肾脏预后和总生存期有关。未来需要更大样本量的研究来确定影响肾脏和总体生存的个体参数。

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引用次数: 0

Childhood melanoma ex-blue naevus leading to the identification of a BAP1 tumour predisposition syndrome 儿童黑色素瘤前蓝痣导致BAP1肿瘤易感综合征的鉴定。

IF 3 3区医学 Q1 PATHOLOGY

Pathology

Pub Date : 2025-07-04 DOI: 10.1016/j.pathol.2025.05.004

Mohamad El Jiar , Sophie Huybrechts , Daniel Pissaloux , Franck Tirode , Celso Pouget , François Sales , Nadège Wallet-Faber , Arnaud de la Fouchardiere

引用次数: 0

Epstein–Barr virus-associated intrahepatic cholangiocarcinoma: a diverse morphological spectrum that correlates with patient prognosis eb病毒相关肝内胆管癌：与患者预后相关的多种形态谱

IF 3 3区医学 Q1 PATHOLOGY

Pathology

Pub Date : 2025-06-28 DOI: 10.1016/j.pathol.2025.04.011

Wei Liu , Yan-mei Cui , Zheng-jin Liu , Xiao-jiang Wang , Li-bin Zhang , Mei-fang Zhang , Wen-xiu Miu , Xi-yao Yan , Hui-lin Zhang , Shu-qi Yang , Wen Li , Jun-cheng Ye , Jing-cheng Liu , Tong-mei He , Yi Shi , Dan Hu

Epstein–Barr virus (EBV)-associated intrahepatic cholangiocarcinoma (EBVaICC) is a rare condition with limited comprehensive descriptions of its clinicopathological features. This study investigated the wide morphological spectrum of EBVaICC to improve diagnostic accuracy and explored the associations between morphological characteristics and prognosis. Nineteen cases of EBVaICC were retrospectively analysed, and 102 cases reported in the literature were reviewed. Four patients were male, and 15 were female. The median age of the patients was 56 years (range 37–78 years). The median size of the tumours was 4.5 cm (range 1.3–14.0 cm), and 13 patients (68.4%) presented with a single tumour, while six (31.6%) exhibited multiple hepatic lesions. Tumours were assessed for various histological features and assigned to the following morphological groups: duct (31.6%, 6/19), lymphoepithelioma-like (15.8%, 3/19), anaplastic (26.3%, 5/19), and mixed subtypes (26.3%, 5/19). The duct subtype exhibited a variety of tubular formations with low-grade nuclear atypia and few mitoses [<5/10 high-power fields (HPFs)], mimicking well-differentiated cholangiocarcinoma within a background of dense lymphoplasmacytic infiltration. The lymphoepithelioma-like subtype featured vesicular nuclei with indistinct cell boundaries, cohesive arrangements, and characteristic lymphoepithelial lesions. The anaplastic subtype was characterised by a nest-like or solid growth pattern with high-grade nuclear atypia with abundant mitoses (≥10/10 HPF), yet lacked abundant lymphoplasmacytic infiltration. Immunohistochemically, the neoplastic cells stained positive for biliary markers (CK7 and CK19) and were 100% positive for EBV-encoded RNA. Six anaplastic cases (including one case of mixed subtype) were categorised into group A, and the other 13 cases were classified as group B. The follow-up assessment revealed significantly lower 2-year progression-free survival (0% vs 81.5%) and overall survival (0% vs 100%) rates in patients in group A than in group B (p<0.05). EBVaICC presents a diverse morphological spectrum and correlates with the patient prognosis. Recognising these morphological variations, especially the anaplastic subtype, is essential for accurate diagnosis, prognostic assessment, and personalised management.

eb病毒（EBV）相关肝内胆管癌（EBVaICC）是一种罕见的疾病，其临床病理特征的综合描述有限。本研究对EBVaICC的广泛形态学谱进行研究，以提高诊断准确性，并探讨形态学特征与预后的关系。对19例EBVaICC病例进行回顾性分析，并对文献报道的102例病例进行回顾性分析。男性4例，女性15例。患者的中位年龄为56岁（37-78岁）。肿瘤的中位大小为4.5 cm（范围1.3-14.0 cm）， 13例（68.4%）表现为单个肿瘤，6例（31.6%）表现为多发肝脏病变。评估肿瘤的各种组织学特征，并将其分为以下形态组：管状（31.6%,6/19）、淋巴上皮瘤样（15.8%,3/19）、间变性（26.3%,5/19）和混合亚型（26.3%,5/19）。导管亚型表现为多种管状结构，核非典型性低，有丝分裂少。

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引用次数: 0

Papillary intralymphatic angioendothelioma with a novel YAP1::MAML2 fusion 乳头状淋巴管内血管内皮瘤与新型YAP1::MAML2融合。

IF 3 3区医学 Q1 PATHOLOGY

Pathology

Pub Date : 2025-06-25 DOI: 10.1016/j.pathol.2025.04.013

Lan Shen , Xiufen Xue , Ting Jiang , Xiaojuan Pei

引用次数: 0

Papillary renal neoplasm with reverse polarity along with papillary adenoma in a non-functioning kidney: a rare report 无功能肾脏的乳头状肾肿瘤伴反极性乳头状腺瘤：罕见报告。

IF 3 3区医学 Q1 PATHOLOGY

Pathology

Pub Date : 2025-06-25 DOI: 10.1016/j.pathol.2025.04.012

Sushmita Vangapandu , Hari Siddardha Malla , Manoj Kumar Das , Taraprasad Tripathy , Pavithra Ayyanar

引用次数: 0

GAB1::ABL1 fusion-associated spindle cell neoplasm: expanding our knowledge of kinase-rearranged spindle cell tumours GAB1: ABL1融合相关梭形细胞肿瘤：扩大我们对激酶重排梭形细胞肿瘤的认识

IF 3 3区医学 Q1 PATHOLOGY

Pathology

Pub Date : 2025-06-19 DOI: 10.1016/j.pathol.2025.05.002

Pranav Dorwal , Alexandra Currie , James Bennett , Benjamin Wallwork , Liyan Song , Christopher Joy , Michael Walsh

引用次数: 0

Integrated histomolecular approach to discriminate primary cutaneous follicle centre and marginal zone lymphoma of the scalp 综合组织分子方法鉴别原发性头皮毛囊中心区和边缘区淋巴瘤。

IF 3 3区医学 Q1 PATHOLOGY

Pathology

Pub Date : 2025-06-19 DOI: 10.1016/j.pathol.2025.04.009

Marie Donzel , Alexis Trecourt , Stéphane Dalle , Olivier Harou , Marie Perier-Muzet , Florent Grange , Brigitte Balme , Florian Pesce , Alexandra Traverse-Glehen , Claire Mauduit

Overlapping features between follicular lymphomas (FLs) and marginal zone lymphomas (MZLs) have been described, especially in their paediatric forms. Although adult primary cutaneous follicle centre lymphoma (PCFL) and primary cutaneous marginal zone lymphoma (PCMZL) of the scalp appear to display overlapping histological and molecular features, these entities have never been studied. The aim of this study was to describe the clinical, histological, and mutational profiles of PCFL and PCMZL of the scalp and to highlight possible overlapping features. From 2011 to 2023, 38 patients with PCFL or PCMZL of the scalp from two centres were retrospectively included. In each case, a histological review, immunohistochemistry with additional immunostaining for myeloid cell nuclear differentiation antigen, BCL2 fluorescence in situ hybridisation, and targeted next-generation sequencing were performed. Among the 23 PCFL (60%) and 15 PCMZL (40%) cases included, 10 had a difficult initial diagnosis based on histological data alone. The most frequent pathogenic variants in PCFL cases were TNFRSF14 (15%), BCL2 (11%), SOCS1 (11%), and CREBBP (6%). The most frequent pathogenic variants in PCMZL cases were TNFAIP3 (24%), KMT2D (14%), CARD11 (10%), and ITPKB (10%). The integrated histomolecular approach helped reclassify five PCMZL cases into PCFL and showed plasmacytic differentiation in 12% of PCFL cases. This study highlights the histological and molecular overlaps between PCFL and PCMZL of the scalp and underscores the interest of an integrated histomolecular diagnosis to discriminate between these entities.

滤泡性淋巴瘤（FLs）和边缘区淋巴瘤（MZLs）之间的重叠特征已经被描述，特别是在他们的儿科形式。虽然头皮的成人原发性皮肤毛囊中心淋巴瘤（PCFL）和原发性皮肤边缘区淋巴瘤（PCMZL）似乎表现出重叠的组织学和分子特征，但这些实体从未被研究过。本研究的目的是描述头皮PCFL和PCMZL的临床、组织学和突变特征，并强调可能的重叠特征。从2011年到2023年，回顾性分析了来自两个中心的38例头皮PCFL或PCMZL患者。在每个病例中，都进行了组织学检查，免疫组织化学和额外的骨髓细胞核分化抗原免疫染色，BCL2荧光原位杂交，以及靶向下一代测序。在23例PCFL（60%）和15例PCMZL（40%）病例中，10例仅根据组织学资料难以进行初步诊断。PCFL病例中最常见的致病变异是TNFRSF14（15%）、BCL2（11%）、SOCS1（11%）和CREBBP（6%）。PCMZL病例中最常见的致病变异是TNFAIP3（24%）、KMT2D（14%）、CARD11（10%）和ITPKB（10%）。综合组织分子方法帮助将5例PCMZL重新分类为PCFL，并在12%的PCFL病例中显示浆细胞分化。本研究强调了头皮PCFL和PCMZL之间的组织学和分子重叠，并强调了综合组织分子诊断来区分这些实体的兴趣。

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引用次数: 0

Aztreonam-avibactam resistance rates and resistance mechanisms of NDM and NDM/OXA48-like dual-carbapenemase-producing Enterobacterales in Singapore 新加坡NDM和NDM/ oxa48样双碳青霉烯酶产肠杆菌的氨曲南-阿维巴坦耐药率及耐药机制

IF 3 3区医学 Q1 PATHOLOGY

Pathology

Pub Date : 2025-06-19 DOI: 10.1016/j.pathol.2025.04.010

Ka Lip Chew, Joey Cruz Cabang, Nur Aisyah Binte Abu Bakar, Ker Xin Tan, Jeanette Teo

Aztreonam-avibactam is a treatment option for metallo-β-lactamase carbapenemase-producing Enterobacterales (CPE). This study was performed to determine resistance rates of a collection of CPE against aztreonam-avibactam and characterise associated resistance mechanisms. Minimum inhibitory concentrations (MICs) of a collection of New Delhi metallo-β-lactamase (NDM)- and NDM/OXA-48-like dual-CPE isolates were determined using two methods, the MIC Test Strip (MTS) and broth microdilution (Sensititre). Whole-genome sequencing was also performed for molecular characterisation. A total of 44 NDM-CPE and 11 NDM/OXA-48 dual-CPE isolates from 46 patients were included. The species breakdown of included isolates was as follows: Escherichia coli (n=33), Klebsiella pneumoniae (n=12), Klebsiella oxytoca (n=1), Enterobacter cloacae complex (n=2), Citrobacter amalonaticus (n=2), Citrobacter farmeri (n=1), Citrobacter freundii (n=1), Providencia rettgeri (n=2), and Pantoea calida (n=1). Essential agreement between the two test methods was 96.4%, with 100% categorical agreement. Overall resistance was 13.7% after excluding duplicate isolates. Of note, resistance occurred only in E. coli and P. rettgeri isolates. Resistance rates in E. coli isolates were 18.8% (6/32, all isolates), 8.0% (2/25) for NDM-CPE, and 57.1% (4/7) for NDM/OXA-48 dual-CPE. All resistant isolates were found to have penicillin-binding protein 3 (PBP3) insertions in association with CMY (AmpC-type) β-lactamase; 77.8% (7/9) of E. coli isolates with increased MICs of 0.5–4 mg/L, but still within susceptible breakpoints, also had either PBP3 insertion or AmpC β-lactamase. The six aztreonam-avibactam-resistant E. coli consisted of four ST361 and two ST167 isolates. All three ST361 NDM/OXA-48-like dual-CPE isolates had 0–5 single-nucleotide polymorphisms. Aztreonam-avibactam resistance was detected in E. coli and Providencia spp. Resistance in E. coli isolates was driven by PBP3 mutations in association with AmpC production. Higher resistance rates were seen in NDM-OXA-48-like dual-carbapenemase-producing E. coli, driven by ST361 isolates. Aztreonam-avibactam susceptibility testing should be performed as part of routine diagnostic testing for invasive NDM-CPE infections.

Aztreonam-avibactam是金属β-内酰胺酶-碳青霉烯酶产肠杆菌（CPE）的治疗选择。本研究旨在确定CPE对阿唑仑-阿维巴坦的耐药率，并确定相关的耐药机制。采用MIC试纸（MTS）和微稀释（Sensititre）两种方法测定新德里金属β-内酰胺酶（NDM）和NDM/ oxa -48样双cpe分离株的最低抑菌浓度（MIC）。还进行了全基因组测序以进行分子表征。共纳入46例患者的44株NDM- cpe和11株NDM/OXA-48双cpe。纳入的菌株种类分类如下：大肠埃希菌（33株）、肺炎克雷伯菌（12株）、氧化克雷伯菌（1株）、阴沟肠杆菌复合菌（2株）、单胞柠檬酸杆菌（2株）、农柠檬酸杆菌（1株）、弗氏柠檬酸杆菌（1株）、雷氏普罗维登斯菌（2株）、加州Pantoea（1株）。两种检测方法的基本一致性为96.4%，绝对一致性为100%。排除重复菌株后，总耐药率为13.7%。值得注意的是，耐药性仅发生在大肠杆菌和鞭毛虫分离株中。大肠杆菌耐药率为18.8%（6/32，所有菌株），NDM- cpe耐药率为8.0% (2/25)，NDM/OXA-48双cpe耐药率为57.1%（4/7）。所有耐药菌株均发现与CMY （ampc型）β-内酰胺酶相关的青霉素结合蛋白3 （PBP3）插入；77.8%（7/9）的菌株mic升高至0.5 ~ 4 mg/L，但仍在敏感断点内，同时存在PBP3插入或AmpC β-内酰胺酶。6株耐阿唑南-阿维巴坦大肠杆菌包括4株ST361和2株ST167。所有三个ST361 NDM/ oxa -48样双cpe分离株均有0-5个单核苷酸多态性。大肠杆菌和普罗维登西亚菌株对氨曲南-阿维巴坦耐药。大肠杆菌的耐药是由与AmpC产生相关的PBP3突变驱动的。由ST361分离株驱动的ndm - oxa -48样双碳青霉烯酶产生大肠杆菌的耐药率较高。阿曲南-阿维巴坦药敏试验应作为侵袭性NDM-CPE感染常规诊断检测的一部分。

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