Revista Espanola de Patologia最新文献

{"title":"Extracranial schwannomas of peripheral nervous system: An aesthetic challenge – A comprehensive analysis of 38 cases","authors":"Samikshya Thapa ,&nbsp;Ravi Hari Phulware ,&nbsp;Gajendra Kumar Yadav ,&nbsp;Ashok Singh ,&nbsp;Prashant Durgapal ,&nbsp;Rahul Kumar ,&nbsp;Amit Gupta ,&nbsp;Sanjeev Kishoree ,&nbsp;Arvind Kumar","doi":"10.1016/j.patol.2026.100858","DOIUrl":"10.1016/j.patol.2026.100858","url":null,"abstract":"<div><h3>Background</h3><div>Schwannomas are benign, slow-growing tumours that arise from Schwann cells. Extracranial schwannomas are less common than those occurring at the intracranial vestibulocochlear and cerebellopontine angles. Because extracranial schwannomas are uncommon, it is difficult to make an accurate clinical diagnosis. Therefore, histopathological examination is the gold standard.</div></div><div><h3>Methods</h3><div>In this study, we aim to describe the incidence, presenting clinical features, anatomical location, size, and initial (presumption) diagnosis of thirty-eight cases that were histopathologically diagnosed as extracranial schwannomas, along with a literature review. A retrospective, cross-sectional observational study was conducted at the Department of Pathology and Laboratory Medicine, All India Institute of Medical Science, Rishikesh, India, from January 2018 to June 2024. Data and histopathological slides were retrieved and analysed.</div></div><div><h3>Results</h3><div>Thirty-eight patients were documented, with an age range of 11–75 years and a mean age of 37 years, and a male predominance (M:F, 2.8:1) was noted. Tumour size ranged from 0.3 to 13<!--> <!-->cm. Thirteen cases of schwannomas occurred in the head and neck (34.21%), eleven in the spine (29%), six in the upper extremities (15.79%), three each in the lower extremities (7.88%) and the upper trunk (7.88%) and two in the lower trunk/visceral region (5.24%). Most patients presented with painless swellings. The study indicates that schwannomas were most commonly found in the head and neck region, followed by the spine. Within the extremities, they were more frequent in the upper extremities, while in the trunk, they were found in the chest wall, ribs, posterior mediastinum (part of the chest cavity), adrenal gland, and pararenal area.</div></div><div><h3>Conclusions</h3><div>The study indicates that schwannomas are most commonly found in the head and neck region, followed by the spine. Within the extremities, they occur more frequently in the upper extremities, while in the trunk they were found in the chest wall, ribs, posterior mediastinum (part of the chest cavity), adrenal gland, and pararenal area. The radioresistant nature of schwannomas alerts both clinicians and pathologists to the importance of early diagnosis and to be familiar with their uncommon anatomical locations.</div></div>","PeriodicalId":39194,"journal":{"name":"Revista Espanola de Patologia","volume":"59 2","pages":"Article 100858"},"PeriodicalIF":0.5,"publicationDate":"2026-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146081711","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Malakoplakia mimicking pelvic malignancy with liver metastasis and peritoneal carcinomatosis","authors":"Hector Chavarria,&nbsp;Tanvi V. Joshi,&nbsp;Jatinder Kumar,&nbsp;Jennifer Young Pierce,&nbsp;Christopher E. Keel","doi":"10.1016/j.patol.2025.100854","DOIUrl":"10.1016/j.patol.2025.100854","url":null,"abstract":"<div><div>Malakoplakia is a rare chronic inflammatory condition characterised by defective macrophage function, most commonly affecting the genitourinary tract. Although usually localised, it may occasionally present as a mass-forming lesion mimicking malignancy. We report the case of a 46-year-old woman presenting with a pelvic mass, acute kidney injury, and hydroureteronephrosis. Imaging demonstrated a necrotic 10.3<!--> <!-->cm pelvic mass with lymphadenopathy and hepatic lesions, raising suspicion of metastatic gynaecological malignancy. Surgical exploration identified a fibrotic, thickened pelvic peritoneum with extensive histiocytic inflammation.</div><div>Histopathological evaluation confirmed malakoplakia, characterised by Michaelis-Gutmann bodies and histiocytes positive for CD68. Microbiological analysis identified <em>Escherichia coli</em> as the infectious agent. The clinical and radiological features of malakoplakia can closely mimic malignancy, posing a significant diagnostic challenge. Histopathological examination remains crucial for definitive diagnosis, particularly in distinguishing malakoplakia from metastatic urological or gynaecological malignancies. Immunohistochemistry and special stains, such as von Kossa, assist in confirmation. This case underscores the importance of considering malakoplakia in the differential diagnosis of pelvic masses, including those with suspected metastasis. Early recognition can prevent misdiagnosis and unnecessary surgical intervention, highlighting the need for multidisciplinary management.</div></div>","PeriodicalId":39194,"journal":{"name":"Revista Espanola de Patologia","volume":"59 1","pages":"Article 100854"},"PeriodicalIF":0.5,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145981556","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rare malignant transformation of struma ovarii into follicular thyroid carcinoma: A case report","authors":"Adil Aziz Khan,&nbsp;Charanjeet Ahluwalia,&nbsp;Sana Ahuja","doi":"10.1016/j.patol.2025.100852","DOIUrl":"10.1016/j.patol.2025.100852","url":null,"abstract":"<div><div><em>Struma ovarii</em> is a rare monodermal ovarian teratoma primarily composed of thyroid tissue, accounting for 2–5% of all ovarian teratomas. Although generally benign, about 5% may undergo malignant transformation, predominantly into papillary thyroid carcinoma, with follicular thyroid carcinoma being exceptionally rare. A 46-year-old Asian woman presented with abdominal pain. Imaging studies identified a solid-cystic ovarian mass with elevated CA-125 levels. Surgical intervention was performed, and histopathological examination confirmed the malignant transformation of <em>struma ovarii</em> into follicular thyroid carcinoma. Post-operative PET-CT and hormone level assessments showed no residual disease. The patient is currently under regular follow-up. This case illustrates the rarity and diagnostic challenges associated with malignant <em>struma ovarii</em>. It underscores the importance of extensive sampling and a multidisciplinary approach for effective management. Given the lack of standardized treatment guidelines, personalised care and close follow-up are essential, with consideration of aggressive treatment based on risk assessment.</div></div>","PeriodicalId":39194,"journal":{"name":"Revista Espanola de Patologia","volume":"59 1","pages":"Article 100852"},"PeriodicalIF":0.5,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145981555","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pure non-gestational ovarian choriocarcinoma in a postmenopausal woman coexisting with a clear cell adenofibroma and endometriosis foci: A case report and review of the literature","authors":"Ainhoa Ordoñez Arrillaga ,&nbsp;Miguel Ángel Resano Abarzuza ,&nbsp;Marta Rezola Bajineta ,&nbsp;Begoña Aguiar Losada ,&nbsp;Yessica P. Rodríguez-Velandia ,&nbsp;Manuel Moreno Valladares ,&nbsp;Iraide Bernal Simón ,&nbsp;Ibon Jaunarena Marín ,&nbsp;Irune Ruiz Díaz","doi":"10.1016/j.patol.2026.100856","DOIUrl":"10.1016/j.patol.2026.100856","url":null,"abstract":"<div><div>Ovarian germ cell tumours are uncommon, with choriocarcinoma being the rarest of them. Among choriocarcinomas, the non-gestational type occurs mainly in premenarchal women, although cases have been described in postmenopausal women.</div><div>The distinction between gestational or non-gestational aetiology of choriocarcinoma is essential given the prognostic and therapeutic implications involved. The distinction between pure and mixed form of choriocarcinoma also has prognostic relevance.</div><div>Clear cell adenofibroma is a rare benign lesion, considered a precursor of clear cell carcinoma, with described association to endometriosis.</div><div>We present the case of a 72-year-old woman diagnosed at our centre with pure non-gestational choriocarcinoma, clear cell adenofibroma and foci of endometriosis present in the same ovary.</div><div>We performed a review of the literature, focusing on how to differentiate a gestational from a non-gestational choriocarcinoma and the pure form from the mixed form, as well as the described coexistence between germ cell and epithelial tumours.</div></div>","PeriodicalId":39194,"journal":{"name":"Revista Espanola de Patologia","volume":"59 1","pages":"Article 100856"},"PeriodicalIF":0.5,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146039308","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Benign cutaneous plexiform hybrid tumour of perineurioma and cellular neurothekeoma: A rare diagnosis","authors":"Elena María García Pastor ,&nbsp;Rosa María Castillo Muñoz ,&nbsp;Elena Gallego Domínguez","doi":"10.1016/j.patol.2025.100846","DOIUrl":"10.1016/j.patol.2025.100846","url":null,"abstract":"<div><div>Benign cutaneous plexiform hybrid tumour of perineurioma and cellular neurothekeoma (BCPHTPCN) is an uncommon mesenchymal tumour first described in 2013, characterised by mixed features of perineurioma and cellular neurothekeoma. Clinically, it presents as a small papule, most frequently located in the perioral region. Histologically, it displays a plexiform pattern composed of epithelioid and spindle cells within a myxoid stroma, together with a hybrid immunohistochemical profile. In this article, we describe the case of an 82-year-old woman presenting with a perioral nodule clinically suspected to be a basal cell carcinoma, whose histological and immunohistochemical findings confirmed the diagnosis of BCPHTPCN. The tumour's features, differential diagnoses, and the need for further studies to better define its clinicopathological spectrum are discussed.</div></div>","PeriodicalId":39194,"journal":{"name":"Revista Espanola de Patologia","volume":"59 1","pages":"Article 100846"},"PeriodicalIF":0.5,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145981557","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gastric surgery as an acquired cause of pancreatic alpha-cell hyperplasia","authors":"Ricard Onieva Carbajo ,&nbsp;Laia Casamitjana ,&nbsp;Cristina Gener Jorge ,&nbsp;Marta Vidal Borrego ,&nbsp;Joan Carles Ferreres Piñas","doi":"10.1016/j.patol.2025.100850","DOIUrl":"10.1016/j.patol.2025.100850","url":null,"abstract":"<div><h3>Introduction</h3><div>Alpha-cell hyperplasia (ACH) is a rare condition, with only eighteen cases reported in the literature. Its primary cause is Mahvash disease, a hereditary disorder associated with pancreatic neuroendocrine tumours. Based on the experience of our site, previous gastric surgery (GS) is suspected to represent a potential acquired cause of ACH – the first such case described to date.</div></div><div><h3>Material and methods</h3><div>A case–control study was designed using pancreatic tissue samples, selecting six patients with a history of gastric surgery (GS) more than six months before, and twelve patients with GS less than six months before or no history of GS. Immunohistochemical staining for chromogranin, insulin and glucagon was performed. The neuroendocrine cellularity (NEC) area, type of cellularity, and distribution pattern were evaluated.</div></div><div><h3>Results</h3><div>The mean NEC area in the cases was 6.01%, compared to 3.18% in the controls (<em>p</em> <!-->=<!--> <!-->0.047). A history of Billroth I GS was associated with a lower NEC percentage than Billroth II, which in turn was lower than that observed following bariatric surgery. All samples contained at least one islet exceeding 250<!--> <!-->μm. In five of six cases, more than 50% of islets demonstrated abundant centrally located glucagon-positive cells, compared with two of twelve controls (<em>p</em> <!-->=<!--> <!-->0.013).</div></div><div><h3>Conclusions</h3><div>A history of CG may have histological correlates in pancreatic tissue, making it important to recognise these to avoid misdiagnosing a true ACH, which carries associated implications such as a high risk of tumour development and genetic transmission.</div></div>","PeriodicalId":39194,"journal":{"name":"Revista Espanola de Patologia","volume":"59 1","pages":"Article 100850"},"PeriodicalIF":0.5,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145950271","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Changes in the classification of malignant salivary gland tumours across the last three WHO editions","authors":"Gonzalo Rojas-Alcayaga ,&nbsp;Magdalena Pinto Ávila ,&nbsp;Felipe Cáceres Villanueva ,&nbsp;Iara Vargas Piña ,&nbsp;Constanza Yutronic Adasme ,&nbsp;Iván Gallegos Méndez","doi":"10.1016/j.patol.2026.100857","DOIUrl":"10.1016/j.patol.2026.100857","url":null,"abstract":"<div><div>This article explores the evolution of the classification of malignant salivary gland tumours (MSGTs) over the years, focusing on the last three editions of the World Health Organization (WHO) texts—the third, fourth and fifth editions. It describes changes in the nomenclature of entities, the incorporation of new entities, and the removal of others. The reasons underlying the modification of existing entity names are also presented, along with an examination of the rationale for their exclusion from the classification and the persistence of these designations in the scientific literature, as well as in clinical and academic discussions. In addition, the nature and clinicopathological characteristics of the newly recognised entities are examined. This detailed analysis not only documents the observed changes but also provides insight into the reasons justifying them and the clinical implications associated with the evolving classification of these tumours.</div></div>","PeriodicalId":39194,"journal":{"name":"Revista Espanola de Patologia","volume":"59 1","pages":"Article 100857"},"PeriodicalIF":0.5,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146039411","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Expression of TRIM29 and its association with p40 and TTF1 in lung carcinoma","authors":"Neelima Kumari ,&nbsp;Sana Ahuja ,&nbsp;Satyadev Rana ,&nbsp;Jayati Chakraborty ,&nbsp;Dipti Gothi ,&nbsp;Anand Kumar Verma","doi":"10.1016/j.patol.2025.100849","DOIUrl":"10.1016/j.patol.2025.100849","url":null,"abstract":"<div><h3>Background</h3><div>Lung cancer is a leading global cause of cancer-related mortality, with over 1.8 million deaths annually. Non-small cell lung carcinoma (NSCLC) is the predominant subtype, further classified into squamous cell carcinoma (SCC) and adenocarcinoma (ADC) based on immunohistochemical markers such as p40 and TTF1. TRIM29, a member of the TRIM protein family, has been implicated in various cancers and is associated with poor prognosis. This study evaluates TRIM29 expression and its correlation with p40 and TTF1 in NSCLC subtypes.</div></div><div><h3>Materials and methods</h3><div>This prospective observational study included 45 core biopsy samples of lung carcinoma and was conducted over 18 months at a tertiary care hospital in New Delhi. Immunohistochemical analysis of TRIM29, p40, and TTF1 expression was performed. TRIM29 expression was assessed semi-quantitatively, based on intensity and proportion scores.</div></div><div><h3>Results</h3><div>Of the 45 cases, 38 (84.4%) were NSCLC, and 7 (15.6%) were small cell lung carcinoma (SCLC). TRIM29 expression was significantly higher in NSCLC compared to SCLC (<em>p</em> <!-->&lt;<!--> <!-->0.001). Among NSCLC cases, TRIM29 positivity was observed in 86.9% of SCC cases and 30.8% of ADC cases (<em>p</em> <!-->=<!--> <!-->0.001). TRIM29 demonstrated a strong positive association with p40 (86.9%) and an inverse correlation with TTF1 (77.7%; <em>p</em> <!-->&lt;<!--> <!-->0.0001).</div></div><div><h3>Conclusion</h3><div>TRIM29 is a promising biomarker for NSCLC, particularly in differentiating SCC from ADC. Its strong association with p40, coupled with an inverse relationship with TTF1, enhances its diagnostic utility. Further studies are needed to explore its role in lung cancer pathogenesis and prognosis.</div></div>","PeriodicalId":39194,"journal":{"name":"Revista Espanola de Patologia","volume":"59 1","pages":"Article 100849"},"PeriodicalIF":0.5,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145950272","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The role of Engrailed developmental genes in gynaecological cancer","authors":"Valeria Meraz Alvarado,&nbsp;Marco Antonio Fuentes García,&nbsp;Mauricio Salcedo Vargas,&nbsp;Ricardo López Romero","doi":"10.1016/j.patol.2025.100848","DOIUrl":"10.1016/j.patol.2025.100848","url":null,"abstract":"<div><div>Homeobox genes encode a superfamily of transcriptional regulators involved in the growth and development of human tissues and organs. Engrailed (En) genes are homeodomain genes, which have transcription factor functions and play a significant role in vertebrate embryonic development. The EN proteins comprise two members, Engrailed-1 (EN1) and Engrailed-2 (EN2). These proteins have been implicated in cancer development in various adult tissues, acting either as oncogenes or tumour suppressors depending on the context and cell type. Their expression has also been investigated in urinary cancers such as prostate and bladder cancer, where they have been proposed as non-invasive biomarkers detectable in urine. Studies in gynaecological tissues have suggested EN1 and EN2 may act as oncogenes in breast and ovarian cancer; however, research into their roles in other gynaecological cancers, such as endometrial, cervical and vaginal cancer, remains preliminary.</div></div>","PeriodicalId":39194,"journal":{"name":"Revista Espanola de Patologia","volume":"59 1","pages":"Article 100848"},"PeriodicalIF":0.5,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145950273","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Angiosarcoma developing in an ovarian fibroma: A case report","authors":"Ana L. Nocito ,&nbsp;Sandra I. Sarancone","doi":"10.1016/j.patol.2025.100855","DOIUrl":"10.1016/j.patol.2025.100855","url":null,"abstract":"<div><div>Angiosarcomas are malignant vascular tumors primarily located in the dermis or soft tissues predominantly in the head and neck region. Ovarian localization is extremely rare, with only a few published cases. A 63-year-old patient was admitted to the hospital due to severe pain in the hypogastric and abdominal regions. The condition was interpreted as an acute abdomen and referred to surgery, and an ovarian tumor that measured 23<!--> <!-->cm<!--> <!-->×<!--> <!-->11<!--> <!-->cm<!--> <!-->×<!--> <!-->5<!--> <!-->cm and weighed 7500<!--> <!-->g was resected. Macroscopically, the cut surface showed two well-defined areas: one consisting of a matte white tissue with a fascicular appearance and firm consistency and the other hemorrhagic with necrotic areas. Histological examination revealed two patterns: one characterized by a proliferation of spindle-shaped cells without atypia, and the other by neoplastic proliferation with marked atypia, forming vascular channels or fascicles. The vascular component was positive for CD31, CD34, and ERG. The findings were interpreted as an angiosarcoma associated with a fibroma, and the patient died in the immediate postoperative period. The low incidence and ominous prognosis of primary or metastatic ovarian angiosarcomas have been confirmed. Regarding the histogenesis, a strong likelihood exists of a relationship with the ovary's rich vascular network. In both well-differentiated and poorly differentiated cases, it is crucial to consider differential diagnoses and perform immunohistochemical techniques, which can assist in achieving an accurate diagnosis. The association between fibroma and angiosarcoma is poorly understood and the histogenesis remains unclear.</div></div>","PeriodicalId":39194,"journal":{"name":"Revista Espanola de Patologia","volume":"59 1","pages":"Article 100855"},"PeriodicalIF":0.5,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145950274","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}