Pub Date : 2025-04-19DOI: 10.1016/j.patol.2025.100819
Judith González-López, Luis Rubio-Martínez, Carlos Zac-Romero, Mireya Prieto-Rodríguez, Nuria Mancheño-Franch
Currently, it is known that more than 60% of adults have one or more thyroid nodules, of which less than 5% are malignant. Among them, papillary thyroid carcinoma (PTC) is the most common thyroid malignancy, accounting for 90% of all thyroid carcinomas. The World Health Organization (WHO) 5th edition endocrine tumours classification includes several PTC subtypes. Of these, PTC with fibromatosis/fasciitis-like/desmoid-type stroma stands out not only for being one of the least frequent subtypes but also for its characteristic histology (biphasic structure) and genetic pattern, which presents mutations in both BRAF and CTNNB1. Despite these distinctive features, it remains a challenging neoplasm to suspect and easy to misdiagnose, primarily due to its radiological imaging and cytological findings. In this study, we report a classic case, review the literature, discuss when suspicion should arise, and provide a practical diagnostic guide.
{"title":"Papillary thyroid carcinoma with fibromatosis/fasciitis-like/desmoid-type stroma: When to suspect and how to diagnose","authors":"Judith González-López, Luis Rubio-Martínez, Carlos Zac-Romero, Mireya Prieto-Rodríguez, Nuria Mancheño-Franch","doi":"10.1016/j.patol.2025.100819","DOIUrl":"10.1016/j.patol.2025.100819","url":null,"abstract":"<div><div>Currently, it is known that more than 60% of adults have one or more thyroid nodules, of which less than 5% are malignant. Among them, papillary thyroid carcinoma (PTC) is the most common thyroid malignancy, accounting for 90% of all thyroid carcinomas. The World Health Organization (WHO) 5th edition endocrine tumours classification includes several PTC subtypes. Of these, PTC with fibromatosis/fasciitis-like/desmoid-type stroma stands out not only for being one of the least frequent subtypes but also for its characteristic histology (biphasic structure) and genetic pattern, which presents mutations in both <em>BRAF</em> and <em>CTNNB1</em>. Despite these distinctive features, it remains a challenging neoplasm to suspect and easy to misdiagnose, primarily due to its radiological imaging and cytological findings. In this study, we report a classic case, review the literature, discuss when suspicion should arise, and provide a practical diagnostic guide.</div></div>","PeriodicalId":39194,"journal":{"name":"Revista Espanola de Patologia","volume":"58 3","pages":"Article 100819"},"PeriodicalIF":0.0,"publicationDate":"2025-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143847919","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 : 2025-04-18DOI: 10.1016/j.patol.2025.100827
Anna Sifre-Ruiz , Cristina Esquina-Rodriguez , Africa Manero-Azua , Iñigo Gorostiaga , Guiomar Perez de Nanclares
The diagnosis of central nervous system anomalies is a challenge for pathologists, especially in the context of stillbirth. A multidisciplinary approach including gestational data, ultrasound, and genetic tests not only increases diagnostic efficacy, but also enhances the quality of care provided to families. We report the case of a legal termination of pregnancy due to encephalic malformation in a couple with a previous history of multiple miscarriages. The initial foetal autopsy guided the genetic tests, leading to the identification of a pathogenic variant responsible for Walker-Warburg syndrome – an infrequent and relatively unknown syndromic complex. By using a reverse phenotyping strategy, it was possible not only to confirm the diagnosis suggested by the genetic tests in the foetus, but also to identify the same genetic alteration in a previous miscarriage. This provided an unidentified diagnosis and enabled the provision of genetic counselling to the couple.
{"title":"Multidisciplinary approach to reach a foetal diagnosis of Walker-Warburg syndrome: From autopsy to genetics and back","authors":"Anna Sifre-Ruiz , Cristina Esquina-Rodriguez , Africa Manero-Azua , Iñigo Gorostiaga , Guiomar Perez de Nanclares","doi":"10.1016/j.patol.2025.100827","DOIUrl":"10.1016/j.patol.2025.100827","url":null,"abstract":"<div><div>The diagnosis of central nervous system anomalies is a challenge for pathologists, especially in the context of stillbirth. A multidisciplinary approach including gestational data, ultrasound, and genetic tests not only increases diagnostic efficacy, but also enhances the quality of care provided to families. We report the case of a legal termination of pregnancy due to encephalic malformation in a couple with a previous history of multiple miscarriages. The initial foetal autopsy guided the genetic tests, leading to the identification of a pathogenic variant responsible for Walker-Warburg syndrome – an infrequent and relatively unknown syndromic complex. By using a reverse phenotyping strategy, it was possible not only to confirm the diagnosis suggested by the genetic tests in the foetus, but also to identify the same genetic alteration in a previous miscarriage. This provided an unidentified diagnosis and enabled the provision of genetic counselling to the couple.</div></div>","PeriodicalId":39194,"journal":{"name":"Revista Espanola de Patologia","volume":"58 3","pages":"Article 100827"},"PeriodicalIF":0.0,"publicationDate":"2025-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143843813","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 : 2025-04-18DOI: 10.1016/j.patol.2025.100822
Bhaskar Narayan, Kuldeep Singh, Jeyaseelan Augustine, Aadithya B. Urs
Small cell osteosarcoma (SCOS) is an uncommon variant of osteosarcoma, typically affecting young adults. This case report presents an unusual case of a 35-year-old individual who presented with a growth in the mandible. Microscopically, the lesion was characterised by sheets and plexuses of atypical small round cells with minimal osteoid formation. PAS positivity in the tumour osteoid and SATB2 immunopositive tumour cells led to diagnosis of SCOS.
{"title":"Pathological insights into small cell osteosarcoma: A rare case report highlighting diagnostic approaches with a literature review","authors":"Bhaskar Narayan, Kuldeep Singh, Jeyaseelan Augustine, Aadithya B. Urs","doi":"10.1016/j.patol.2025.100822","DOIUrl":"10.1016/j.patol.2025.100822","url":null,"abstract":"<div><div>Small cell osteosarcoma (SCOS) is an uncommon variant of osteosarcoma, typically affecting young adults. This case report presents an unusual case of a 35-year-old individual who presented with a growth in the mandible. Microscopically, the lesion was characterised by sheets and plexuses of atypical small round cells with minimal osteoid formation. PAS positivity in the tumour osteoid and SATB2 immunopositive tumour cells led to diagnosis of SCOS.</div></div>","PeriodicalId":39194,"journal":{"name":"Revista Espanola de Patologia","volume":"58 3","pages":"Article 100822"},"PeriodicalIF":0.0,"publicationDate":"2025-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143843811","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 : 2025-04-18DOI: 10.1016/j.patol.2025.100823
Adil Aziz Khan, Neeti Nagar, Charanjeet Ahluwalia, Sana Ahuja
Primary ovarian clear cell carcinoma (OCCC) is a rare subtype of epithelial ovarian carcinoma (EOC), accounting for 5–10% of EOCs in the U.S., with a higher prevalence in East Asia. It is characterized by clear cells forming solid, tubular, or papillary patterns, and presents diagnostic challenges due to its resemblance to renal clear cell carcinomas. Typically affecting nulliparous postmenopausal women, OCCC is associated with high recurrence rates and low sensitivity to platinum-based chemotherapy. We report a case of bilateral primary OCCC in a 45-year-old multiparous woman with no history of endometriosis. She presented with lower abdominal pain and swelling persisting for 7–8 months. Imaging revealed a large, heterogeneous abdominopelvic mass. Surgery included total abdominal hysterectomy with bilateral salpingo-oophorectomy. Histopathological and immunohistochemical analyses confirmed bilateral OCCC, with positive staining for AMACR, Napsin A, and PAX8, and negative results for WT1, ER, and PR. This case highlights the importance of thorough diagnostic evaluation in atypical presentations. The postoperative course was uneventful, and she subsequently received adjuvant therapy.
{"title":"Bilateral primary ovarian clear cell carcinoma in a multiparous perimenopausal woman","authors":"Adil Aziz Khan, Neeti Nagar, Charanjeet Ahluwalia, Sana Ahuja","doi":"10.1016/j.patol.2025.100823","DOIUrl":"10.1016/j.patol.2025.100823","url":null,"abstract":"<div><div>Primary ovarian clear cell carcinoma (OCCC) is a rare subtype of epithelial ovarian carcinoma (EOC), accounting for 5–10% of EOCs in the U.S., with a higher prevalence in East Asia. It is characterized by clear cells forming solid, tubular, or papillary patterns, and presents diagnostic challenges due to its resemblance to renal clear cell carcinomas. Typically affecting nulliparous postmenopausal women, OCCC is associated with high recurrence rates and low sensitivity to platinum-based chemotherapy. We report a case of bilateral primary OCCC in a 45-year-old multiparous woman with no history of endometriosis. She presented with lower abdominal pain and swelling persisting for 7–8 months. Imaging revealed a large, heterogeneous abdominopelvic mass. Surgery included total abdominal hysterectomy with bilateral salpingo-oophorectomy. Histopathological and immunohistochemical analyses confirmed bilateral OCCC, with positive staining for AMACR, Napsin A, and PAX8, and negative results for WT1, ER, and PR. This case highlights the importance of thorough diagnostic evaluation in atypical presentations. The postoperative course was uneventful, and she subsequently received adjuvant therapy.</div></div>","PeriodicalId":39194,"journal":{"name":"Revista Espanola de Patologia","volume":"58 3","pages":"Article 100823"},"PeriodicalIF":0.0,"publicationDate":"2025-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143843812","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 : 2025-04-17DOI: 10.1016/j.patol.2025.100824
Michele Biscuola , Ana Belén Enguita , Yolanda Ruano , Lourdes Gómez , Teresa Hernández-Iglesias , Antonio Martínez , Santiago Ramón y Cajal , José Luis Rodríguez Peralto
Introduction and aim
Non-small cell lung cancer (NSCLC) can arise from insertions in exon 20 of the EGFR gene, among other alterations. We carried out an external quality assessment (EQA) to evaluate the accuracy of laboratory methods and to highlight the importance of detecting and identifying genetic alterations, such as EGFR exon 20 insertion, in patients with NSCLC.
Materials and methods
The 2021 EGRF exon 20 EQA program consisted of two rounds, in which four formalin-fixed paraffin-embedded specimens (round 1: two positive for EGFR exon 20 insertions/duplications, one positive for a common EGFR alteration, and one wild-type; round 2: three positive for EGFR exon 20 insertions/duplications and one wild-type) obtained from patients with NSCLC were tested.
Results
Approximately 80% of the invited laboratories participated in each round. The most common DNA isolation techniques used were the cobas® DNA Sample Preparation Kit (46.7%) in round 1 and QIAamp (37.1%) in round 2. The most frequently used genotyping method in both rounds was the cobas® EGFR Mutation Test (round 1: 53.3%; round 2: 37.1%). In both rounds, 71.1% and 73.6% of the tests, respectively, reported the expected result. The lowest success rate was observed in the H773delinsRY Exon 20 determination (round 1: 17.8%; round 2: 31.4%). This alteration was correctly determined only by next-generation sequencing.
Conclusions
The variability in the genotyping methods and the success rate obtained in our study highlight the importance of EQA in Spain to ensure high performance.
{"title":"External quality assessment for EGFR exon 20 mutation testing in patients with non-small cell lung cancer in Spain","authors":"Michele Biscuola , Ana Belén Enguita , Yolanda Ruano , Lourdes Gómez , Teresa Hernández-Iglesias , Antonio Martínez , Santiago Ramón y Cajal , José Luis Rodríguez Peralto","doi":"10.1016/j.patol.2025.100824","DOIUrl":"10.1016/j.patol.2025.100824","url":null,"abstract":"<div><h3>Introduction and aim</h3><div>Non-small cell lung cancer (NSCLC) can arise from insertions in exon 20 of the <em>EGFR</em> gene, among other alterations. We carried out an external quality assessment (EQA) to evaluate the accuracy of laboratory methods and to highlight the importance of detecting and identifying genetic alterations, such as <em>EGFR</em> exon 20 insertion, in patients with NSCLC.</div></div><div><h3>Materials and methods</h3><div>The 2021 <em>EGRF</em> exon 20 EQA program consisted of two rounds, in which four formalin-fixed paraffin-embedded specimens (round 1: two positive for <em>EGFR</em> exon 20 insertions/duplications, one positive for a common <em>EGFR</em> alteration, and one wild-type; round 2: three positive for <em>EGFR</em> exon 20 insertions/duplications and one wild-type) obtained from patients with NSCLC were tested.</div></div><div><h3>Results</h3><div>Approximately 80% of the invited laboratories participated in each round. The most common DNA isolation techniques used were the cobas® DNA Sample Preparation Kit (46.7%) in round 1 and QIAamp (37.1%) in round 2. The most frequently used genotyping method in both rounds was the cobas® EGFR Mutation Test (round 1: 53.3%; round 2: 37.1%). In both rounds, 71.1% and 73.6% of the tests, respectively, reported the expected result. The lowest success rate was observed in the H773delinsRY Exon 20 determination (round 1: 17.8%; round 2: 31.4%). This alteration was correctly determined only by next-generation sequencing.</div></div><div><h3>Conclusions</h3><div>The variability in the genotyping methods and the success rate obtained in our study highlight the importance of EQA in Spain to ensure high performance.</div></div>","PeriodicalId":39194,"journal":{"name":"Revista Espanola de Patologia","volume":"58 3","pages":"Article 100824"},"PeriodicalIF":0.0,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143843810","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}
Lynch syndrome (LS) is an autosomal dominant genetic condition, accounting for an estimated prevalence of 2–3% of the causes of hereditary colorectal carcinoma. In addition, it increases the risk of endometrial and ovarian cancer, among others.
Case report
A 56-year-old woman with a 6-month history of pelvic pain, dyspareunia and hypermenorrhoea. Family history: her mother died of endometrial cancer at the age of 71, and her younger brother died of gastric cancer at the age of 61. A transvaginal ultrasound revealed a 20 mm thickening of the endometrium, and the biopsy showed a FIGO 2 endometrioid carcinoma. Abdominal MRI demonstrated diffuse thickening of the rectum, while colonoscopy revealed an infiltrative, ulcerated tumour lesion in the sigmoid colon and a lesion in the rectum, consistent with invasive adenocarcinoma of the colon and adenoma with high-grade dysplasia in the rectal biopsy. Simultaneous surgical resection was indicated. A molecular panel confirmed a mutation in the MSH6 gene, confirming Lynch syndrome.
Conclusions
A rare case of Lynch syndrome associated with an MSH6 gene mutation, diagnosed with synchronous endometrial carcinoma and adenocarcinoma of the sigmoid colon.
{"title":"Synchronous adenocarcinoma of the endometrium and colon in a woman with Lynch syndrome associated with a mutation of the MSH6 gene","authors":"Andrés Felipe Valencia Cardona , Jhoan Sebastián Cruz Barbosa , Armando Cortés Buelvas","doi":"10.1016/j.patol.2025.100826","DOIUrl":"10.1016/j.patol.2025.100826","url":null,"abstract":"<div><h3>Introduction</h3><div>Lynch syndrome (LS) is an autosomal dominant genetic condition, accounting for an estimated prevalence of 2–3% of the causes of hereditary colorectal carcinoma. In addition, it increases the risk of endometrial and ovarian cancer, among others.</div></div><div><h3>Case report</h3><div>A 56-year-old woman with a 6-month history of pelvic pain, dyspareunia and hypermenorrhoea. Family history: her mother died of endometrial cancer at the age of 71, and her younger brother died of gastric cancer at the age of 61. A transvaginal ultrasound revealed a 20<!--> <!-->mm thickening of the endometrium, and the biopsy showed a FIGO 2 endometrioid carcinoma. Abdominal MRI demonstrated diffuse thickening of the rectum, while colonoscopy revealed an infiltrative, ulcerated tumour lesion in the sigmoid colon and a lesion in the rectum, consistent with invasive adenocarcinoma of the colon and adenoma with high-grade dysplasia in the rectal biopsy. Simultaneous surgical resection was indicated. A molecular panel confirmed a mutation in the MSH6 gene, confirming Lynch syndrome.</div></div><div><h3>Conclusions</h3><div>A rare case of Lynch syndrome associated with an MSH6 gene mutation, diagnosed with synchronous endometrial carcinoma and adenocarcinoma of the sigmoid colon.</div></div>","PeriodicalId":39194,"journal":{"name":"Revista Espanola de Patologia","volume":"58 3","pages":"Article 100826"},"PeriodicalIF":0.0,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143808274","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 : 2025-04-10DOI: 10.1016/j.patol.2025.100828
Robert Ricardo Rodríguez Carpio, Carlos Hörndler Argarate, Sandra Vicente Arregui, María Francisca Perulero Martín, Leticia Ollero Domenche
Multicystic peritoneal mesothelioma is an uncommon neoplasm characterized by multiple cysts adhering to the abdominal cavity. The symptoms are nonspecific, and their severity appears to be related to the size and location of the cysts.
We report the case of a 55-year-old man with morbid obesity in whom a multiloculated mesenteric mass was incidentally discovered on abdominal ultrasound. Complementary imaging studies revealed a multicystic peritoneal tumour with a maximum diameter of 32 cm, located in the pelvis and extending to the right hemiabdomen. Histologically, multiple cysts lined by mesothelial cells without atypia were observed, along with loose fibrous stroma containing numerous multinucleated floret-like giant cells. Based on the histopathological findings, the final diagnosis was multicystic peritoneal mesothelioma.
{"title":"Multicystic peritoneal mesothelioma with floret-like multinucleated giant cells: A case report","authors":"Robert Ricardo Rodríguez Carpio, Carlos Hörndler Argarate, Sandra Vicente Arregui, María Francisca Perulero Martín, Leticia Ollero Domenche","doi":"10.1016/j.patol.2025.100828","DOIUrl":"10.1016/j.patol.2025.100828","url":null,"abstract":"<div><div>Multicystic peritoneal mesothelioma is an uncommon neoplasm characterized by multiple cysts adhering to the abdominal cavity. The symptoms are nonspecific, and their severity appears to be related to the size and location of the cysts.</div><div>We report the case of a 55-year-old man with morbid obesity in whom a multiloculated mesenteric mass was incidentally discovered on abdominal ultrasound. Complementary imaging studies revealed a multicystic peritoneal tumour with a maximum diameter of 32<!--> <!-->cm, located in the pelvis and extending to the right hemiabdomen. Histologically, multiple cysts lined by mesothelial cells without atypia were observed, along with loose fibrous stroma containing numerous multinucleated floret-like giant cells. Based on the histopathological findings, the final diagnosis was multicystic peritoneal mesothelioma.</div></div>","PeriodicalId":39194,"journal":{"name":"Revista Espanola de Patologia","volume":"58 3","pages":"Article 100828"},"PeriodicalIF":0.0,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143808275","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 : 2025-04-09DOI: 10.1016/j.patol.2025.100820
Sana Ahuja , Marzieh Fattahi-Darghlou , Sufian Zaheer
Introduction
The Papanicolaou system plays a vital role in cytological evaluation, particularly in the diagnosis of pancreatic lesions. However, there is a lack of comprehensive evaluation regarding its diagnostic accuracy in pancreatic fine needle aspirations (FNAs). This study seeks to address this gap by conducting a systematic review and meta-analysis to assess the diagnostic accuracy of the Papanicolaou Society of Cytopathology (PSC) system in diagnosing pancreatic lesions.
Methods
A systematic search of PubMed and EMBASE databases was conducted up to March 20, 2024, using predefined search terms related to pancreas, fine needle aspiration biopsy (FNAB), and diagnostic accuracy. The selected articles were assessed for risk of bias using the QUADAS-2 tool. A meta-analysis for sensitivity and specificity for each cut-off – namely, “Atypical considered positive”, “Neoplastic considered positive”, “Suspicious of Malignancy considered positive,” and “Malignant considered positive” – was performed after excluding inadequate samples in each study. To assess diagnostic accuracy, summary receiver operating characteristic (sROC) curves were constructed, and the diagnostic odds ratio (DOR) was pooled.
Results
Twelve studies met the inclusion criteria, comprising a total of 3604 cases. Sensitivity and specificity varied across the PSC categories, with the “Malignant” category showing the highest sensitivity (70%) and specificity (99%). The “Suspicious for malignancy and higher risk categories” demonstrated high sensitivity (81%) and specificity (97%).
Conclusion
This meta-analysis underscores the accuracy of the PSC system in reporting pancreatic aspirates. It highlights the significance of the “Suspicious” and “Malignant” categories in diagnosing malignancy, as well as the “Benign” and “Atypical” categories in ruling out malignancy.
{"title":"Systematic review and meta-analysis of the Papanicolaou Society of Cytopathology (PSC) system in diagnosing pancreatic lesions: Evaluating diagnostic accuracy","authors":"Sana Ahuja , Marzieh Fattahi-Darghlou , Sufian Zaheer","doi":"10.1016/j.patol.2025.100820","DOIUrl":"10.1016/j.patol.2025.100820","url":null,"abstract":"<div><h3>Introduction</h3><div>The Papanicolaou system plays a vital role in cytological evaluation, particularly in the diagnosis of pancreatic lesions. However, there is a lack of comprehensive evaluation regarding its diagnostic accuracy in pancreatic fine needle aspirations (FNAs). This study seeks to address this gap by conducting a systematic review and meta-analysis to assess the diagnostic accuracy of the Papanicolaou Society of Cytopathology (PSC) system in diagnosing pancreatic lesions.</div></div><div><h3>Methods</h3><div>A systematic search of PubMed and EMBASE databases was conducted up to March 20, 2024, using predefined search terms related to pancreas, fine needle aspiration biopsy (FNAB), and diagnostic accuracy. The selected articles were assessed for risk of bias using the QUADAS-2 tool. A meta-analysis for sensitivity and specificity for each cut-off – namely, “Atypical considered positive”, “Neoplastic considered positive”, “Suspicious of Malignancy considered positive,” and “Malignant considered positive” – was performed after excluding inadequate samples in each study. To assess diagnostic accuracy, summary receiver operating characteristic (sROC) curves were constructed, and the diagnostic odds ratio (DOR) was pooled.</div></div><div><h3>Results</h3><div>Twelve studies met the inclusion criteria, comprising a total of 3604 cases. Sensitivity and specificity varied across the PSC categories, with the “Malignant” category showing the highest sensitivity (70%) and specificity (99%). The “Suspicious for malignancy and higher risk categories” demonstrated high sensitivity (81%) and specificity (97%).</div></div><div><h3>Conclusion</h3><div>This meta-analysis underscores the accuracy of the PSC system in reporting pancreatic aspirates. It highlights the significance of the “Suspicious” and “Malignant” categories in diagnosing malignancy, as well as the “Benign” and “Atypical” categories in ruling out malignancy.</div></div>","PeriodicalId":39194,"journal":{"name":"Revista Espanola de Patologia","volume":"58 3","pages":"Article 100820"},"PeriodicalIF":0.0,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143799010","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 : 2025-04-08DOI: 10.1016/j.patol.2025.100821
Juan Carlos Santis-Mejía, Roberto Orozco, Victor Argueta
Angiostrongyliasis, an infection caused by nematodes of the genus Angiostrongylus spp., includes nine species in the Americas. Angiostrongylus costaricensis induces eosinophilic enteritis in humans and has been documented in Guatemala. Humans are considered accidental or final hosts of A. costaricensis, as they do not release eggs or larvae in their faeces.
Most reported cases present with abdominal angiostrongyliasis (AA). Parasitic structures are difficult to identify in inflammatory lesions and larvae can occasionally migrate to extraintestinal organs. The gold standard for diagnosing A. costaricensis is histopathological analysis, confirmed by the identification of eggs, larvae in tissues, and/or adult worms in the vascular lumen.
In our department, two cases of A. costaricensis affecting pulmonary vessels were diagnosed histopathologically. Given the rarity of pulmonary involvement, the cases were consulted with Dr. Carlos Graeff-Teixeira.
{"title":"Pulmonary angiostrongyliasis: Two cases of atypical manifestations of Angiostrongylus costaricensis in Guatemala","authors":"Juan Carlos Santis-Mejía, Roberto Orozco, Victor Argueta","doi":"10.1016/j.patol.2025.100821","DOIUrl":"10.1016/j.patol.2025.100821","url":null,"abstract":"<div><div>Angiostrongyliasis, an infection caused by nematodes of the genus <em>Angiostrongylus</em> spp., includes nine species in the Americas. <em>Angiostrongylus costaricensis</em> induces eosinophilic enteritis in humans and has been documented in Guatemala. Humans are considered accidental or final hosts of <em>A. costaricensis</em>, as they do not release eggs or larvae in their faeces.</div><div>Most reported cases present with abdominal angiostrongyliasis (AA). Parasitic structures are difficult to identify in inflammatory lesions and larvae can occasionally migrate to extraintestinal organs. The gold standard for diagnosing <em>A. costaricensis</em> is histopathological analysis, confirmed by the identification of eggs, larvae in tissues, and/or adult worms in the vascular lumen.</div><div>In our department, two cases of <em>A. costaricensis</em> affecting pulmonary vessels were diagnosed histopathologically. Given the rarity of pulmonary involvement, the cases were consulted with Dr. Carlos Graeff-Teixeira.</div></div>","PeriodicalId":39194,"journal":{"name":"Revista Espanola de Patologia","volume":"58 3","pages":"Article 100821"},"PeriodicalIF":0.0,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143792515","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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