Pub Date : 2026-01-01DOI: 10.1016/j.patol.2025.100848
Valeria Meraz Alvarado, Marco Antonio Fuentes García, Mauricio Salcedo Vargas, Ricardo López Romero
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.
{"title":"The role of Engrailed developmental genes in gynaecological cancer","authors":"Valeria Meraz Alvarado, Marco Antonio Fuentes García, Mauricio Salcedo Vargas, 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}
Pub Date : 2026-01-01DOI: 10.1016/j.patol.2025.100855
Ana L. Nocito , Sandra I. Sarancone
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.
{"title":"Angiosarcoma developing in an ovarian fibroma: A case report","authors":"Ana L. Nocito , 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}
Pub Date : 2026-01-01DOI: 10.1016/j.patol.2025.100847
Carmen Rodríguez García , David Ramos Soler , Nuria Rausell Fontestad , Carmen Gutiérrez Sánchez , Pablo Guerrero Antolino , Franscico Giner Segura
Appendiceal mucinous neoplasms (AMNs) represent an infrequent type of appendiceal tumour, characterised by their potential for aggressive biological behaviour and the possibility of developing peritoneal carcinomatosis. There is still uncertainty about which variables can predict the clinical evolution and recurrence risk of this disease. The primary objective of this study is to reevaluate cases of AMN diagnosed at our institution to identify morphological and clinical factors that may serve as predictors of recurrence. A retrospective study of 49 patients diagnosed with AMN at tertiary hospital from 2011 to 2023 was carried out. Histological parameters, such as architectural pattern, mitotic index, and loss of polarity, along with pre- and post-operative clinical data were collected. Variables significantly associated with the first recurrence were surgical reintervention (p = 0.002), death due to AMN (p = 0.008), carcinomatosis at diagnosis (p = 0.003), adjuvant therapy (p = 0.01), TNM stage (p = 0.01), morphological pattern (p = 0.02), and loss of nuclear polarity (p = 0.02). Survival analysis revealed that an undulating pattern (p = 0.04) and the presence of micropapillary structures (p = 0.01) were associated with an increased risk of recurrence. In contrast, the risk of recurrence decreased with increasing age (p = 0.02) and focal loss of nuclear polarity. The risk was higher in cases classified as HAMN (p = 0.008). The results indicate that age and focal loss of nuclear polarity are inversely correlated with recurrence risk, while an undulating pattern and the presence of micropapillary structures are directly correlated with time to first recurrence. These findings contribute to improved risk stratification and the optimization of therapeutic strategies for patients with AMN.
{"title":"Morphological and clinical predictive factors in appendiceal mucinous neoplasms: A retrospective analysis of 49 cases","authors":"Carmen Rodríguez García , David Ramos Soler , Nuria Rausell Fontestad , Carmen Gutiérrez Sánchez , Pablo Guerrero Antolino , Franscico Giner Segura","doi":"10.1016/j.patol.2025.100847","DOIUrl":"10.1016/j.patol.2025.100847","url":null,"abstract":"<div><div>Appendiceal mucinous neoplasms (AMNs) represent an infrequent type of appendiceal tumour, characterised by their potential for aggressive biological behaviour and the possibility of developing peritoneal carcinomatosis. There is still uncertainty about which variables can predict the clinical evolution and recurrence risk of this disease. The primary objective of this study is to reevaluate cases of AMN diagnosed at our institution to identify morphological and clinical factors that may serve as predictors of recurrence. A retrospective study of 49 patients diagnosed with AMN at tertiary hospital from 2011 to 2023 was carried out. Histological parameters, such as architectural pattern, mitotic index, and loss of polarity, along with pre- and post-operative clinical data were collected. Variables significantly associated with the first recurrence were surgical reintervention (<em>p</em> <!-->=<!--> <!-->0.002), death due to AMN (<em>p</em> <!-->=<!--> <!-->0.008), carcinomatosis at diagnosis (<em>p</em> <!-->=<!--> <!-->0.003), adjuvant therapy (<em>p</em> <!-->=<!--> <!-->0.01), TNM stage (<em>p</em> <!-->=<!--> <!-->0.01), morphological pattern (<em>p</em> <!-->=<!--> <!-->0.02), and loss of nuclear polarity (<em>p</em> <!-->=<!--> <!-->0.02). Survival analysis revealed that an undulating pattern (<em>p</em> <!-->=<!--> <!-->0.04) and the presence of micropapillary structures (<em>p</em> <!-->=<!--> <!-->0.01) were associated with an increased risk of recurrence. In contrast, the risk of recurrence decreased with increasing age (<em>p</em> <!-->=<!--> <!-->0.02) and focal loss of nuclear polarity. The risk was higher in cases classified as HAMN (<em>p</em> <!-->=<!--> <!-->0.008). The results indicate that age and focal loss of nuclear polarity are inversely correlated with recurrence risk, while an undulating pattern and the presence of micropapillary structures are directly correlated with time to first recurrence. These findings contribute to improved risk stratification and the optimization of therapeutic strategies for patients with AMN.</div></div>","PeriodicalId":39194,"journal":{"name":"Revista Espanola de Patologia","volume":"59 1","pages":"Article 100847"},"PeriodicalIF":0.5,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145981558","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}
Non-neural granular cell tumour (NNGCT) is a rare cutaneous neoplasm characterised by the absence of S100 expression and a differentiation of uncertain lineage. We present the case of a 13-year-old male patient with a cutaneous lesion on the left wrist, initially diagnosed as pilomatrixoma. Histological analysis revealed a proliferation of spindle-shaped cells with eosinophilic granular cytoplasm and immunohistochemical positivity for ALK, NKI/C3, CD10, and CD68, with negativity for S100. ALK positivity in this case supports the hypothesis of a potential genetic alteration shared with other ALK-positive tumours. The patient had a favourable outcome following tumour excision, with no evidence of recurrence or metastasis. This case contributes to the characterisation of ALK-positive NNGCT and highlights its relevance in the differential diagnosis of cutaneous granular cell tumours.
{"title":"Granular cell tumour of non-neural origin, ALK positive: Case report and literature review","authors":"Viviana Dávila Flores , Alicia Sánz , Michelle Jurado , Susana Ramos , Rafael Sánchez","doi":"10.1016/j.patol.2025.100853","DOIUrl":"10.1016/j.patol.2025.100853","url":null,"abstract":"<div><div>Non-neural granular cell tumour (NNGCT) is a rare cutaneous neoplasm characterised by the absence of S100 expression and a differentiation of uncertain lineage. We present the case of a 13-year-old male patient with a cutaneous lesion on the left wrist, initially diagnosed as pilomatrixoma. Histological analysis revealed a proliferation of spindle-shaped cells with eosinophilic granular cytoplasm and immunohistochemical positivity for ALK, NKI/C3, CD10, and CD68, with negativity for S100. ALK positivity in this case supports the hypothesis of a potential genetic alteration shared with other ALK-positive tumours. The patient had a favourable outcome following tumour excision, with no evidence of recurrence or metastasis. This case contributes to the characterisation of ALK-positive NNGCT and highlights its relevance in the differential diagnosis of cutaneous granular cell tumours.</div></div>","PeriodicalId":39194,"journal":{"name":"Revista Espanola de Patologia","volume":"59 1","pages":"Article 100853"},"PeriodicalIF":0.5,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146012743","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}
Pub Date : 2026-01-01DOI: 10.1016/j.patol.2025.100851
Miriam Rubiera Valdés , Inés Gómez de la Riva , José María Alonso de la Campa , Adela Alonso Fernández-Velásco
Primary sarcomas of the breast are exceptionally rare, accounting for fewer than 1% of malignant breast lesions. Mammary liposarcomas comprise less than 5% of all breast sarcomas, and among these, primary pleomorphic liposarcoma is particularly uncommon, with a reported frequency of less than 0.01% of malignant breast lesions. It is a highly aggressive tumour, characterised by a high recurrence rate. The characteristic microscopic findings of pleomorphic liposarcoma include atypical lipomatous cells with marked nuclear pleomorphism, as well as abundant lipoblasts, frequent mitoses, and extensive areas of necrosis. In this article, we present a case of primary pleomorphic liposarcoma of the breast.
{"title":"Pleomorphic liposarcoma of the breast","authors":"Miriam Rubiera Valdés , Inés Gómez de la Riva , José María Alonso de la Campa , Adela Alonso Fernández-Velásco","doi":"10.1016/j.patol.2025.100851","DOIUrl":"10.1016/j.patol.2025.100851","url":null,"abstract":"<div><div>Primary sarcomas of the breast are exceptionally rare, accounting for fewer than 1% of malignant breast lesions. Mammary liposarcomas comprise less than 5% of all breast sarcomas, and among these, primary pleomorphic liposarcoma is particularly uncommon, with a reported frequency of less than 0.01% of malignant breast lesions. It is a highly aggressive tumour, characterised by a high recurrence rate. The characteristic microscopic findings of pleomorphic liposarcoma include atypical lipomatous cells with marked nuclear pleomorphism, as well as abundant lipoblasts, frequent mitoses, and extensive areas of necrosis. In this article, we present a case of primary pleomorphic liposarcoma of the breast.</div></div>","PeriodicalId":39194,"journal":{"name":"Revista Espanola de Patologia","volume":"59 1","pages":"Article 100851"},"PeriodicalIF":0.5,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145950275","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}
Pub Date : 2025-10-01DOI: 10.1016/j.patol.2025.100844
Miguel Ángel Idoate Gastearena , Santiago Nieto Llanos
{"title":"Subspecialisation in Pathology with the Advent of Digitalisation and Telepathology: Opportunity or Threat?","authors":"Miguel Ángel Idoate Gastearena , Santiago Nieto Llanos","doi":"10.1016/j.patol.2025.100844","DOIUrl":"10.1016/j.patol.2025.100844","url":null,"abstract":"","PeriodicalId":39194,"journal":{"name":"Revista Espanola de Patologia","volume":"58 4","pages":"Article 100844"},"PeriodicalIF":0.5,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145319765","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}
Pub Date : 2025-09-10DOI: 10.1016/j.patol.2025.100842
Daniela Alejandra García Alonso , Moisés Salamanca García , María Edith Salgado Alday
Background
Ectopic thyroid tissue is a rare condition, with an estimated prevalence of 1 case per 300,000 individuals. The lingual region is the most common site of ectopia. To date, only two cases of ectopic thyroid tissue in the mandibular bone have been reported.
Clinical case
A 62-year-old woman presented with oedema and pain in the lower left second molar, which had progressively worsened and did not improve despite analgesic treatment. As an initial diagnostic approach, an orthopantomogram was performed, revealing extensive destruction of the left mandible. A biopsy of the affected area was subsequently obtained. Histological examination identified thyroid tissue within the bone trabeculae, consisting of thyroid follicles with colloid content.
Conclusion
The diagnosis of ectopic thyroid is uncommon and often challenging to establish. It is therefore essential to be aware of the various clinical manifestations and possible locations of ectopia in order to achieve accurate diagnosis and appropriate treatment.
{"title":"Ectopic thyroid tissue in the mandible: Case report","authors":"Daniela Alejandra García Alonso , Moisés Salamanca García , María Edith Salgado Alday","doi":"10.1016/j.patol.2025.100842","DOIUrl":"10.1016/j.patol.2025.100842","url":null,"abstract":"<div><h3>Background</h3><div>Ectopic thyroid tissue is a rare condition, with an estimated prevalence of 1 case per 300,000 individuals. The lingual region is the most common site of ectopia. To date, only two cases of ectopic thyroid tissue in the mandibular bone have been reported.</div></div><div><h3>Clinical case</h3><div>A 62-year-old woman presented with oedema and pain in the lower left second molar, which had progressively worsened and did not improve despite analgesic treatment. As an initial diagnostic approach, an orthopantomogram was performed, revealing extensive destruction of the left mandible. A biopsy of the affected area was subsequently obtained. Histological examination identified thyroid tissue within the bone trabeculae, consisting of thyroid follicles with colloid content.</div></div><div><h3>Conclusion</h3><div>The diagnosis of ectopic thyroid is uncommon and often challenging to establish. It is therefore essential to be aware of the various clinical manifestations and possible locations of ectopia in order to achieve accurate diagnosis and appropriate treatment.</div></div>","PeriodicalId":39194,"journal":{"name":"Revista Espanola de Patologia","volume":"58 4","pages":"Article 100842"},"PeriodicalIF":0.5,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145026679","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}
Pub Date : 2025-09-03DOI: 10.1016/j.patol.2025.100831
Sagir Akhtar , Adil Aziz Khan , Geet Bhuyan , Sumanta Das
Introduction
Epithelioid sarcoma (ES) is an uncommon malignant mesenchymal tumour that occurs in young adults and adolescents. Few documented series have elucidated the cytopathological features and immunostaining results of epithelioid sarcoma. Here, we present one of the largest series documenting 15 cases of ES.
Method
Archives of cytology and histopathology have been searched for data on epithelioid sarcoma from the past 10 years. Only cases with histopathological records and immunohistochemistry follow-up have been included.
Result
Out of the 27 cases of ES in our database, 15 had both cytology and corresponding histopathology. Of these 15 cases, Fine Needle Aspiration Cytology (FNAC) was indicated for primary diagnosis in 4 cases, for recurrent settings in 5 cases, and metastatic settings in 6 cases. Immunohistochemistry was correlated wherever available. In 8 cases, retrospective immunohistochemistry was performed for confirmation of epithelioid sarcoma.
Conclusion
FNAC is a valuable tool in the recurrent and metastatic settings of epithelioid sarcoma. However, for primary diagnosis, it is helpful but not diagnostic, as various morphologies can be observed and several differential diagnoses must be taken into account.
{"title":"Fine needle aspiration cytology of epithelioid sarcoma: A case series with histopathological correlation and literature review","authors":"Sagir Akhtar , Adil Aziz Khan , Geet Bhuyan , Sumanta Das","doi":"10.1016/j.patol.2025.100831","DOIUrl":"10.1016/j.patol.2025.100831","url":null,"abstract":"<div><h3>Introduction</h3><div>Epithelioid sarcoma (ES) is an uncommon malignant mesenchymal tumour that occurs in young adults and adolescents. Few documented series have elucidated the cytopathological features and immunostaining results of epithelioid sarcoma. Here, we present one of the largest series documenting 15 cases of ES.</div></div><div><h3>Method</h3><div>Archives of cytology and histopathology have been searched for data on epithelioid sarcoma from the past 10 years. Only cases with histopathological records and immunohistochemistry follow-up have been included.</div></div><div><h3>Result</h3><div>Out of the 27 cases of ES in our database, 15 had both cytology and corresponding histopathology. Of these 15 cases, Fine Needle Aspiration Cytology (FNAC) was indicated for primary diagnosis in 4 cases, for recurrent settings in 5 cases, and metastatic settings in 6 cases. Immunohistochemistry was correlated wherever available. In 8 cases, retrospective immunohistochemistry was performed for confirmation of epithelioid sarcoma.</div></div><div><h3>Conclusion</h3><div>FNAC is a valuable tool in the recurrent and metastatic settings of epithelioid sarcoma. However, for primary diagnosis, it is helpful but not diagnostic, as various morphologies can be observed and several differential diagnoses must be taken into account.</div></div>","PeriodicalId":39194,"journal":{"name":"Revista Espanola de Patologia","volume":"58 4","pages":"Article 100831"},"PeriodicalIF":0.5,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144931996","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}
Pub Date : 2025-09-03DOI: 10.1016/j.patol.2025.100837
Francesc Tresserra , Isabel Colmenero , Mar Iglesias , Luis Ortega , Jordi Temprana-Salvador , Antonio Martínez Lorente , Carme Dinares , Empar Mayordomo , Maria Dolores Lozano , Xavier Matias Guiu , Santiago Ramon y Cajal
Introduction
As diagnostic complexity in pathology increases, mainly in cancer diagnoses, the demand for second opinions from specialized and highly qualified centres also increases. There is a certain lack of uniformity in the criteria for carrying out these consultations, managing the material under review, and the responses from the consultant centre.
Material and methods
In order to establish recommendations on the aspects to be considered both by the pathologist or referring centre and by the pathologist or consultant centre, a group of experts from the Spanish Society of Anatomical Pathology conducted a literature review of guidelines and recommendations from other societies and relevant published articles. Based on this review, consensus criteria have been established.
Results
Recommendations are provided on how second opinions in pathology should be managed by both the referring and consultant pathologists, including aspects of material submission and funding.
Conclusion
Second opinions should be carried out following standardized guidelines for both the referring and consultant pathologists, covering referral, management of discrepancies, and funding to ensure a consistent system.
{"title":"Management of second opinions in pathology: Recommendations of the Spanish Society of Anatomical Pathology (SEAP). Second opinions in pathology","authors":"Francesc Tresserra , Isabel Colmenero , Mar Iglesias , Luis Ortega , Jordi Temprana-Salvador , Antonio Martínez Lorente , Carme Dinares , Empar Mayordomo , Maria Dolores Lozano , Xavier Matias Guiu , Santiago Ramon y Cajal","doi":"10.1016/j.patol.2025.100837","DOIUrl":"10.1016/j.patol.2025.100837","url":null,"abstract":"<div><h3>Introduction</h3><div>As diagnostic complexity in pathology increases, mainly in cancer diagnoses, the demand for second opinions from specialized and highly qualified centres also increases. There is a certain lack of uniformity in the criteria for carrying out these consultations, managing the material under review, and the responses from the consultant centre.</div></div><div><h3>Material and methods</h3><div>In order to establish recommendations on the aspects to be considered both by the pathologist or referring centre and by the pathologist or consultant centre, a group of experts from the Spanish Society of Anatomical Pathology conducted a literature review of guidelines and recommendations from other societies and relevant published articles. Based on this review, consensus criteria have been established.</div></div><div><h3>Results</h3><div>Recommendations are provided on how second opinions in pathology should be managed by both the referring and consultant pathologists, including aspects of material submission and funding.</div></div><div><h3>Conclusion</h3><div>Second opinions should be carried out following standardized guidelines for both the referring and consultant pathologists, covering referral, management of discrepancies, and funding to ensure a consistent system.</div></div>","PeriodicalId":39194,"journal":{"name":"Revista Espanola de Patologia","volume":"58 4","pages":"Article 100837"},"PeriodicalIF":0.5,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144932123","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}
Pub Date : 2025-09-02DOI: 10.1016/j.patol.2025.100841
Caterina Fumagalli, Anna Mozos, Justyna Szafranska, Ruth Orellana
Melanoma is known for its remarkable histopathological heterogeneity, capable of mimicking both epithelial and mesenchymal neoplasms. We report the case of a 46-year-old male who was externally diagnosed with sarcoma and presented with a subcutaneous pre-sternal mass comprising a proliferation of epithelioid–histiocytoid cells, hemosiderin deposition, and chronic inflammation, closely resembling an angiomatoid fibrous histiocytoma (AFH). A peripheral pseudo-capsule and a pericapsular lymphocytic cuff were also observed. Immunohistochemically, the tumour cells were focally positive for desmin and S100 protein, but negative for EMA, CD99 and CD68. Further studies demonstrated SOX10 positivity and identified a BRAF p.V600E mutation, findings consistent with melanoma. Review of the external clinical history confirmed that the patient had undergone surgery for a melanoma near the current lesion site three years earlier. In conclusion, the integration of histology, immunohistochemistry, molecular studies and clinical history is essential for the accurate diagnosis of melanoma and for avoiding misdiagnosis.
{"title":"Metastatic melanoma mimicking an angiomatoid fibrous histiocytoma","authors":"Caterina Fumagalli, Anna Mozos, Justyna Szafranska, Ruth Orellana","doi":"10.1016/j.patol.2025.100841","DOIUrl":"10.1016/j.patol.2025.100841","url":null,"abstract":"<div><div>Melanoma is known for its remarkable histopathological heterogeneity, capable of mimicking both epithelial and mesenchymal neoplasms. We report the case of a 46-year-old male who was externally diagnosed with sarcoma and presented with a subcutaneous pre-sternal mass comprising a proliferation of epithelioid–histiocytoid cells, hemosiderin deposition, and chronic inflammation, closely resembling an angiomatoid fibrous histiocytoma (AFH). A peripheral pseudo-capsule and a pericapsular lymphocytic cuff were also observed. Immunohistochemically, the tumour cells were focally positive for desmin and S100 protein, but negative for EMA, CD99 and CD68. Further studies demonstrated SOX10 positivity and identified a <em>BRAF</em> p.V600E mutation, findings consistent with melanoma. Review of the external clinical history confirmed that the patient had undergone surgery for a melanoma near the current lesion site three years earlier. In conclusion, the integration of histology, immunohistochemistry, molecular studies and clinical history is essential for the accurate diagnosis of melanoma and for avoiding misdiagnosis.</div></div>","PeriodicalId":39194,"journal":{"name":"Revista Espanola de Patologia","volume":"58 4","pages":"Article 100841"},"PeriodicalIF":0.5,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144925619","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}
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