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Concurrent intestinal plasmablastic lymphoma and diffuse large B-cell lymphoma with a clonal relationship: a case report and literature review. 具有克隆关系的并发肠浆细胞淋巴瘤和弥漫大 B 细胞淋巴瘤:病例报告和文献综述。
IF 1.7 Q3 PATHOLOGY Pub Date : 2024-07-01 Epub Date: 2024-06-25 DOI: 10.4132/jptm.2024.05.14
Nao Imuta, Kosuke Miyai, Motohiro Tsuchiya, Mariko Saito, Takehiro Sone, Shinichi Kobayashi, Sho Ogata, Fumihiko Kimura, Susumu Matsukuma

Herein, we report a case of plasmablastic lymphoma (PBL) and diffuse large B-cell lymphoma (DLBCL) that occurred concurrently in the large intestine. An 84-year-old female presented with a palpable rectal tumor and ileocecal tumor observed on imaging analyses. Endoscopic biopsy of both lesions revealed lymphomatous round cells. Hartmann's operation and ileocecal resection were performed for regional control. The ileocecal lesion consisted of a proliferation of CD20/CD79a-positive lymphoid cells, indicative of DLBCL. In contrast, the rectal tumor showed proliferation of atypical cells with pleomorphic nuclei and abundant amphophilic cytoplasm, with immunohistochemical findings of CD38/CD79a/MUM1/MYC (+) and CD20/CD3/CD138/PAX5 (-). Tumor cells were positive for Epstein-Barr virus- encoded RNA based on in situ hybridization and MYC rearrangement in fluorescence in situ hybridization analysis. These findings indicated the rectal tumor was most likely a PBL. Sequencing analysis for immunoglobulin heavy variable genes indicated a common B-cell origin of the two sets of lymphoma cells. This case report and literature review provide new insights into PBL tumorigenesis.

在此,我们报告了一例同时发生在大肠的浆细胞淋巴瘤(PBL)和弥漫大 B 细胞淋巴瘤(DLBCL)病例。一名 84 岁的女性患者在影像学分析中发现可触及的直肠肿瘤和回盲部肿瘤。对这两个病灶进行的内镜活检发现了淋巴瘤圆形细胞。为了进行区域控制,患者接受了哈特曼手术和回盲部切除术。回盲部病变由 CD20/CD79a 阳性淋巴细胞增生组成,显示为 DLBCL。相比之下,直肠肿瘤表现为非典型细胞增生,细胞核多形,胞浆丰富,免疫组化结果为CD38/CD79a/MUM1/MYC(+)和CD20/CD3/CD138/PAX5(-)。根据原位杂交和荧光原位杂交分析,肿瘤细胞的Epstein-Barr病毒编码RNA和MYC重排均呈阳性。这些结果表明,直肠肿瘤很可能是一种 PBL。免疫球蛋白重型可变基因测序分析表明,两组淋巴瘤细胞来源于共同的 B 细胞。这篇病例报告和文献综述为我们提供了关于PBL肿瘤发生的新见解。
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引用次数: 0
Immunohistochemical expression in idiopathic inflammatory myopathies at a single center in Vietnam. 越南一家中心特发性炎症性肌病的免疫组化表达。
IF 1.7 Q3 PATHOLOGY Pub Date : 2024-07-01 Epub Date: 2024-06-25 DOI: 10.4132/jptm.2024.05.02
Dat Quoc Ngo, Si Tri Le, Khanh Hoang Phuong Phan, Thao Thi Phuong Doan, Linh Ngoc Khanh Nguyen, Minh Hoang Dang, Thien Thanh Ly, Thu Dang Anh Phan

Background: The identification of idiopathic inflammatory myopathies (IIMs) requires a comprehensive analysis involving clinical manifestations and histological findings. This study aims to provide insights into the histopathological and immunohistochemical aspects of IIMs.

Methods: This retrospective case series involved 56 patients diagnosed with IIMs at the Department of Pathology, University of Medicine and Pharmacy at Ho Chi Minh City, from 2019 to 2023. The histology and immunohistochemical expression of HLA-ABC, HLA-DR, C5b-9, Mx1/2/3, and p62 were detected.

Results: We examined six categories of inflammatory myopathy, including immunemediated necrotizing myopathy (58.9%), dermatomyositis (DM; 23.2%), overlap myositis (8.9%), antisynthetase syndrome (5.4%), inclusion body myositis (IBM; 1.8%), and polymyositis (1.8%). The average age of the patients was 49.7 ± 16.1 years, with a female-to-male ratio of 3:1. Inflammatory cell infiltration in the endomysium was present in 62.5% of cases, perifascicular atrophy was found in 17.8%, and fiber necrosis was observed in 42 cases (75.0%). Rimmed vacuoles were present in 100% of cases in the IBM group. Immunohistochemistry showed the following positivity rates: HLA-ABC (89.2%), HLA-DR (19.6%), C5b-9 (57.1%), and Mx1/2/3 (10.7%). Mx1/2/3 expression was high in DM cases. p62 vacuole deposits were noted in the IBM case. The combination of membrane attack complex and major histocompatibility complex I helped detect IIMs in 96% of cases.

Conclusions: The diagnosis of IIMs and their subtypes should be based on clinical features and histopathological characteristics. Immunohistochemistry plays a crucial role in the diagnosis and differentiation of these subgroups.

背景:鉴别特发性炎症性肌病(IIMs)需要对临床表现和组织学发现进行综合分析。本研究旨在深入了解特发性炎症性肌病的组织病理学和免疫组化方面:这项回顾性病例系列研究涉及胡志明市医药大学病理学系在 2019 年至 2023 年期间诊断出的 56 例 IIMs 患者。我们检测了组织学和免疫组化表达的 HLA-ABC、HLA-DR、C5b-9、Mx1/2/3 和 p62:我们检测了六类炎症性肌病,包括免疫介导坏死性肌病(58.9%)、皮肌炎(DM;23.2%)、重叠性肌炎(8.9%)、抗合成酶综合征(5.4%)、包涵体肌炎(IBM;1.8%)和多发性肌炎(1.8%)。患者的平均年龄为 49.7 ± 16.1 岁,男女比例为 3:1。62.5%的病例出现肌内膜炎性细胞浸润,17.8%的病例出现筋膜周围萎缩,42例(75.0%)病例出现纤维坏死。在 IBM 组中,100% 的病例都出现了边缘空泡。免疫组化显示了以下阳性率:HLA-ABC(89.2%)、HLA-DR(19.6%)、C5b-9(57.1%)和 Mx1/2/3(10.7%)。Mx1/2/3在DM病例中表达较高。膜攻击复合体和主要组织相容性复合体I的组合有助于在96%的病例中检测出IIMs:结论:IIMs 及其亚型的诊断应基于临床特征和组织病理学特征。免疫组化在这些亚型的诊断和鉴别中起着至关重要的作用。
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引用次数: 0
The importance of histomorphological features and ERG expression in the diagnosis of malignancy in cases with atypical small acinar proliferation 组织形态学特征和ERG表达在非典型小尖状腺增生病例恶性肿瘤诊断中的重要性
IF 2.4 Q2 Medicine Pub Date : 2024-05-15 DOI: 10.4132/jptm.2024.03.18
G. Teoman, A. Livaoglu, Hatice Kucuk, Afs ¸ın Rahman Murtezaoglu
Background: Atypical small acinar proliferation (ASAP) cases typically require rebiopsy, which are invasive and associated with increased risk of complications. Our aim in this study was to determine the importance of laboratory and histological findings and E-26 transformation-specific-related gene (ERG) expression in the diagnosis of malignancy. Methods: Between March 2016 and March 2022, 84 patients who were diagnosed with ASAP on biopsy or rebiopsy were included in the study. Clinical-laboratory features of age, serum prostate-specific antigen level, and histopathological features were compared and included multifocality, number of suspicious acini, nuclear enlargement, nucleolar prominence, hyperchromasia, cytoplasmic amphophilia, luminal amorphous acellular secretion, crystalloid presence, infiltrative appearance, inflammation, atrophy, α-methyl acyl-CoA racemase, p63, and/or high molecular weight cytokeratin were analyzed. In addition, ERG expression was evaluated immunohistochemically. Results: Statistically significant correlation was found between nucleolar prominence, nuclear hyperchromasia, crystalloid presence, infiltrative pattern, and prostate cancer (p < .001). In 19 of 84 cases (22.6%) ERG was positive in the nucleus. Prostate cancer was diagnosed at rebiopsy in 15 of the 19 ERG-positive cases (78.9%). A statistically significant correlation was found between ERG positivity and prostate cancer (p= .002). Conclusions: Our findings suggest that evaluation of these markers during initial transrectal ultrasound biopsies may decrease and prevent unnecessary prostate rebiopsy.
背景:非典型小尖锐湿疣(ASAP)病例通常需要进行再次活检,而再次活检具有创伤性,并会增加并发症的风险。本研究旨在确定实验室和组织学检查结果以及E-26转化特异性相关基因(ERG)表达在恶性肿瘤诊断中的重要性。研究方法在2016年3月至2022年3月期间,研究纳入了84名经活检或再活检确诊为ASAP的患者。比较了年龄、血清前列腺特异性抗原水平等临床-实验室特征和组织病理学特征,包括多灶性、可疑尖锐湿疣数目、核增大、核仁突出、高色素性、胞浆嗜碱性、管腔无定形细胞分泌物、结晶体存在、浸润性外观、炎症、萎缩、α-甲基酰-CoA外消旋酶、p63和/或高分子量细胞角蛋白。此外,还对ERG的表达进行了免疫组化评估。结果核突出、核高色素化、结晶体存在、浸润模式与前列腺癌之间存在统计学意义上的相关性(p < .001)。在 84 例病例中,19 例(22.6%)的核内 ERG 呈阳性。在 19 例 ERG 阳性病例中,有 15 例(78.9%)在重新活检时确诊为前列腺癌。ERG阳性与前列腺癌之间存在统计学意义上的相关性(p= .002)。结论:我们的研究结果表明,在初次经直肠超声活检时评估这些标记物可减少和避免不必要的前列腺再次活检。
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引用次数: 1
Primary epithelioid inflammatory myofibroblastic sarcoma of the brain with EML4::ALK fusion mimicking intra-axial glioma: a case report and brief literature review 模仿轴内胶质瘤的原发性上皮样炎性肌纤维母细胞肉瘤:病例报告和简要文献综述
IF 2.4 Q2 Medicine Pub Date : 2024-05-15 DOI: 10.4132/jptm.2024.04.12
E. E. Kim, Chul-Kee Park, Koung Mi Kang, Y. Kwak, Sung-Hye Park, J. Won
An aggressive subtype of inflammatory myofibroblastic tumor, epithelioid inflammatory myofibroblastic sarcoma occurs primarily inside the abdominal cavity, followed by a pulmonary localization. Most harbor anaplastic lymphoma kinase (ALK) gene rearrangements, with RANBP2 and RRBP1 among the well-documented fusion partners. We report the second case of primary epithelioid inflammatory myofibroblastic sarcoma of the brain, with a well-known EML4::ALK fusion. The case is notable for its intra-axial presentation that clinico-radiologically mimicked glioma.
上皮样炎性肌纤维母细胞肉瘤是炎性肌纤维母细胞瘤的一种侵袭性亚型,主要发生在腹腔内,其次是肺部。大多数上皮样炎性肌纤维母细胞肉瘤携带无性淋巴瘤激酶(ALK)基因重排,RANBP2和RRBP1是证据确凿的融合伙伴。我们报告了第二例原发性脑上皮样炎性肌纤维肉瘤,其EML4::ALK融合众所周知。该病例值得注意的是,其轴内表现在临床放射学上与胶质瘤相似。
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引用次数: 0
The spectrum of microvascular patterns in adult diffuse glioma and their correlation with tumor grade 成人弥漫性胶质瘤的微血管形态谱及其与肿瘤分级的关系
IF 2.4 Q2 Medicine Pub Date : 2024-05-15 DOI: 10.4132/jptm.2024.03.11
Soni, Vaishali Walke, Deepti Joshi, Tanya Sharma, Adesh Shrivastava, Amit Agrawal
Background: Primary brain tumors constitute the leading cause of cancer-related mortality. Among them, adult diffuse gliomas are the most common type, affecting the cerebral hemispheres and displaying a diffuse infiltrative pattern of growth in the surrounding neuropil that accounts for about 80% of all primary intracranial tumors. The hallmark feature of gliomas is blood vessel proliferation, which plays an important role in tumor growth, tumor biological behavior, and disease outcome. High-grade gliomas exhibit increased vascularity, the worst prognosis, and lower survival rates. Several angiogenic receptors and factors are upregulated in glioblastomas and stimulate angiogenesis signaling pathways by means of activating oncogenes and/or down-regulating tumor-suppressor genes. Existing literature has emphasized that different microvascular patterns (MVPs) are displayed in different subtypes of adult diffuse gliomas. Methods: We examined the distribution and biological characteristics of different MVPs in 50 patients with adult diffuse gliomas. Haematoxylin and eosin staining results, along with periodic acid–Schiff and CD34 dual-stained sections, were examined to assess the vascular patterns and correlate with different grades of diffuse glioma. Results: The present observational study on adult diffuse glioma evaluated tumor grade and MVPs. Microvascular sprouting was the most common pattern, while a bizarre pattern (type 2) was associated with the presence of a high-grade glioma. Vascular mimicry was observed in 6% of cases, all of which were grade 4 gliomas. Conclusions: This study supplements the role of neo-angiogenesis and aberrant vasculature patterns in the grading and progression of adult diffuse gliomas, which can be future targets for planning treatment strategies.
背景:原发性脑肿瘤是导致癌症相关死亡的主要原因。其中,成人弥漫性胶质瘤是最常见的类型,影响大脑半球,在周围神经髓质呈弥漫浸润性生长,约占所有原发性颅内肿瘤的 80%。胶质瘤的标志性特征是血管增生,这在肿瘤生长、肿瘤生物学行为和疾病预后中起着重要作用。高级别胶质瘤血管增生,预后最差,生存率较低。多种血管生成受体和因子在胶质母细胞瘤中上调,并通过激活癌基因和/或下调抑癌基因的方式刺激血管生成信号通路。现有文献强调,不同亚型的成人弥漫性胶质瘤表现出不同的微血管模式(MVP)。方法:我们研究了 50 例成人弥漫性胶质瘤患者中不同 MVP 的分布和生物学特征。我们对血色素和伊红染色结果以及周期性酸-Schiff和CD34双重染色切片进行了检查,以评估血管形态,并将其与弥漫性胶质瘤的不同分级联系起来。结果:这项针对成人弥漫性胶质瘤的观察性研究评估了肿瘤等级和 MVPs。微血管萌发是最常见的模式,而怪异模式(2 型)与高级别胶质瘤的存在有关。在6%的病例中观察到血管拟态,这些病例均为4级胶质瘤。结论:本研究补充了新血管生成和异常血管模式在成人弥漫性胶质瘤分级和进展中的作用,可作为未来规划治疗策略的目标。
{"title":"The spectrum of microvascular patterns in adult diffuse glioma and their correlation with tumor grade","authors":"Soni, Vaishali Walke, Deepti Joshi, Tanya Sharma, Adesh Shrivastava, Amit Agrawal","doi":"10.4132/jptm.2024.03.11","DOIUrl":"https://doi.org/10.4132/jptm.2024.03.11","url":null,"abstract":"Background: Primary brain tumors constitute the leading cause of cancer-related mortality. Among them, adult diffuse gliomas are the most common type, affecting the cerebral hemispheres and displaying a diffuse infiltrative pattern of growth in the surrounding neuropil that accounts for about 80% of all primary intracranial tumors. The hallmark feature of gliomas is blood vessel proliferation, which plays an important role in tumor growth, tumor biological behavior, and disease outcome. High-grade gliomas exhibit increased vascularity, the worst prognosis, and lower survival rates. Several angiogenic receptors and factors are upregulated in glioblastomas and stimulate angiogenesis signaling pathways by means of activating oncogenes and/or down-regulating tumor-suppressor genes. Existing literature has emphasized that different microvascular patterns (MVPs) are displayed in different subtypes of adult diffuse gliomas. Methods: We examined the distribution and biological characteristics of different MVPs in 50 patients with adult diffuse gliomas. Haematoxylin and eosin staining results, along with periodic acid–Schiff and CD34 dual-stained sections, were examined to assess the vascular patterns and correlate with different grades of diffuse glioma. Results: The present observational study on adult diffuse glioma evaluated tumor grade and MVPs. Microvascular sprouting was the most common pattern, while a bizarre pattern (type 2) was associated with the presence of a high-grade glioma. Vascular mimicry was observed in 6% of cases, all of which were grade 4 gliomas. Conclusions: This study supplements the role of neo-angiogenesis and aberrant vasculature patterns in the grading and progression of adult diffuse gliomas, which can be future targets for planning treatment strategies.","PeriodicalId":46933,"journal":{"name":"Journal of Pathology and Translational Medicine","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2024-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140976313","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}
引用次数: 1
Revisiting the utility of identifying nuclear grooves as unique nuclear changes by an object detector model. 通过物体检测器模型重新审视将核凹槽识别为独特核变化的实用性。
IF 2.4 Q2 Medicine Pub Date : 2024-05-01 Epub Date: 2024-04-30 DOI: 10.4132/jptm.2024.03.07
Pedro R F Rende, Joel Machado Pires, Kátia Sakimi Nakadaira, Sara Lopes, João Vale, Fabio Hecht, Fabyan E L Beltrão, Gabriel J R Machado, Edna T Kimura, Catarina Eloy, Helton E Ramos

Background: Among other structures, nuclear grooves are vastly found in papillary thyroid carcinoma (PTC). Considering that the application of artificial intelligence in thyroid cytology has potential for diagnostic routine, our goal was to develop a new supervised convolutional neural network capable of identifying nuclear grooves in Diff-Quik stained whole-slide images (WSI) obtained from thyroid fineneedle aspiration.

Methods: We selected 22 Diff-Quik stained cytological slides with cytological diagnosis of PTC and concordant histological diagnosis. Each of the slides was scanned, forming a WSI. Images that contained the region of interest were obtained, followed by pre-formatting, annotation of the nuclear grooves and data augmentation techniques. The final dataset was divided into training and validation groups in a 7:3 ratio.

Results: This is the first artificial intelligence model based on object detection applied to nuclear structures in thyroid cytopathology. A total of 7,255 images were obtained from 22 WSI, totaling 7,242 annotated nuclear grooves. The best model was obtained after it was submitted 15 times with the train dataset (14th epoch), with 67% true positives, 49.8% for sensitivity and 43.1% for predictive positive value.

Conclusions: The model was able to develop a structure predictor rule, indicating that the application of an artificial intelligence model based on object detection in the identification of nuclear grooves is feasible. Associated with a reduction in interobserver variability and in time per slide, this demonstrates that nuclear evaluation constitutes one of the possibilities for refining the diagnosis through computational models.

背景:核沟是甲状腺乳头状癌(PTC)的主要结构之一。考虑到人工智能在甲状腺细胞学中的应用具有常规诊断的潜力,我们的目标是开发一种新的有监督卷积神经网络,该网络能够在甲状腺细针穿刺术获得的 Diff-Quik 染色全切片图像(WSI)中识别核沟:我们选择了 22 张经 Diff-Quik 染色的细胞学切片,细胞学诊断为 PTC,组织学诊断一致。对每张切片进行扫描,形成 WSI。获取包含感兴趣区的图像,然后进行预格式化、核沟标注和数据增强技术。最终数据集按 7:3 的比例分为训练组和验证组:这是首个应用于甲状腺细胞病理学核结构的基于物体检测的人工智能模型。从 22 个 WSI 共获得 7255 张图像,共计 7242 个注释核沟。最佳模型是用训练数据集提交 15 次(第 14 个 epoch)后获得的,真阳性率为 67%,灵敏度为 49.8%,预测阳性值为 43.1%。结论该模型能够制定结构预测规则,表明基于物体检测的人工智能模型在核凹槽鉴定中的应用是可行的。该模型可减少观察者之间的差异和每张切片的时间,这表明核评价是通过计算模型完善诊断的可能性之一。
{"title":"Revisiting the utility of identifying nuclear grooves as unique nuclear changes by an object detector model.","authors":"Pedro R F Rende, Joel Machado Pires, Kátia Sakimi Nakadaira, Sara Lopes, João Vale, Fabio Hecht, Fabyan E L Beltrão, Gabriel J R Machado, Edna T Kimura, Catarina Eloy, Helton E Ramos","doi":"10.4132/jptm.2024.03.07","DOIUrl":"10.4132/jptm.2024.03.07","url":null,"abstract":"<p><strong>Background: </strong>Among other structures, nuclear grooves are vastly found in papillary thyroid carcinoma (PTC). Considering that the application of artificial intelligence in thyroid cytology has potential for diagnostic routine, our goal was to develop a new supervised convolutional neural network capable of identifying nuclear grooves in Diff-Quik stained whole-slide images (WSI) obtained from thyroid fineneedle aspiration.</p><p><strong>Methods: </strong>We selected 22 Diff-Quik stained cytological slides with cytological diagnosis of PTC and concordant histological diagnosis. Each of the slides was scanned, forming a WSI. Images that contained the region of interest were obtained, followed by pre-formatting, annotation of the nuclear grooves and data augmentation techniques. The final dataset was divided into training and validation groups in a 7:3 ratio.</p><p><strong>Results: </strong>This is the first artificial intelligence model based on object detection applied to nuclear structures in thyroid cytopathology. A total of 7,255 images were obtained from 22 WSI, totaling 7,242 annotated nuclear grooves. The best model was obtained after it was submitted 15 times with the train dataset (14th epoch), with 67% true positives, 49.8% for sensitivity and 43.1% for predictive positive value.</p><p><strong>Conclusions: </strong>The model was able to develop a structure predictor rule, indicating that the application of an artificial intelligence model based on object detection in the identification of nuclear grooves is feasible. Associated with a reduction in interobserver variability and in time per slide, this demonstrates that nuclear evaluation constitutes one of the possibilities for refining the diagnosis through computational models.</p>","PeriodicalId":46933,"journal":{"name":"Journal of Pathology and Translational Medicine","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11106606/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140854090","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Interpretation of PD-L1 expression in gastric cancer: summary of a consensus meeting of Korean gastrointestinal pathologists. 胃癌中 PD-L1 表达的解读:韩国胃肠道病理学家共识会议摘要。
IF 2.4 Q2 Medicine Pub Date : 2024-04-25 DOI: 10.4132/jptm.2024.03.15
Soomin Ahn, Y. Kwak, Gui-Young Kwon, Kyoung-Mee Kim, Moonsik Kim, Hyunki Kim, Y. Park, Hyeon Jeong Oh, Kyoungyul Lee, Sung-Hak Lee, Hye Seung Lee
Nivolumab plus chemotherapy in the first-line setting has demonstrated clinical efficacy in patients with human epidermal growth factor receptor 2-negative advanced or metastatic gastric cancer, and is currently indicated as a standard treatment. Programmed death-ligand 1 (PD-L1) expression is an important biomarker for predicting response to anti-programmed death 1/PD-L1 agents in several solid tumors, including gastric cancer. In the CheckMate-649 trial, significant clinical improvements were observed in patients with PD-L1 combined positive score (CPS) ≥ 5, determined using the 28-8 pharmDx assay. Accordingly, an accurate interpretation of PD-L1 CPS, especially at a cutoff of 5, is important. The CPS method evaluates both immune and tumor cells and provides a comprehensive assessment of PD-L1 expression in the tumor microenvironment of gastric cancer. However, CPS evaluation has several limitations, one of which is poor interobserver concordance among pathologists. Despite these limitations, clinical indications relying on PD-L1 CPS are increasing. In response, Korean gastrointestinal pathologists held a consensus meeting for the interpretation of PD-L1 CPS in gastric cancer. Eleven pathologists reviewed 20 PD-L1 slides with a CPS cutoff close to 5, stained with the 28-8 pharmDx assay, and determined the consensus scores. The issues observed in discrepant cases were discussed. In this review, we present cases of gastric cancer with consensus PD-L1 CPS. In addition, we briefly touch upon current practices and clinical issues associated with assays used for the assessment of PD-L1 expression in gastric cancer.
Nivolumab 联合化疗一线治疗人类表皮生长因子受体 2 阴性晚期或转移性胃癌患者的临床疗效已得到证实,目前已被列为标准治疗方法。程序性死亡配体1(PD-L1)表达是预测包括胃癌在内的多种实体瘤对抗程序性死亡1/PD-L1药物反应的重要生物标志物。在CheckMate-649试验中,使用28-8 pharmDx检测法确定的PD-L1联合阳性评分(CPS)≥5的患者临床症状明显改善。因此,准确解释 PD-L1 CPS,尤其是 5 分界线的 PD-L1 CPS 非常重要。CPS 方法同时评估免疫细胞和肿瘤细胞,可全面评估胃癌肿瘤微环境中 PD-L1 的表达。然而,CPS 评估有几个局限性,其中之一就是病理学家之间的观察一致性较差。尽管存在这些局限性,但依赖 PD-L1 CPS 的临床适应症却越来越多。为此,韩国胃肠道病理学家召开了胃癌 PD-L1 CPS 解释共识会议。11 位病理学家审查了 20 张用 28-8 pharmDx 检测法染色、CPS 临界值接近 5 的 PD-L1 切片,并确定了共识分数。讨论了在差异病例中观察到的问题。在本综述中,我们介绍了具有一致 PD-L1 CPS 的胃癌病例。此外,我们还简要介绍了用于评估胃癌中 PD-L1 表达的检测方法的当前实践和临床问题。
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引用次数: 0
What's new in thyroid pathology 2024: updates from the new WHO classification and Bethesda system. 2024年甲状腺病理学的新进展:世界卫生组织新分类和贝塞斯达系统的更新。
IF 2.4 Q2 Medicine Pub Date : 2024-03-01 Epub Date: 2024-03-13 DOI: 10.4132/jptm.2024.03.06
Andrey Bychkov, Chan Kwon Jung

In line with the release of the 5th edition WHO Classification of Tumors of Endocrine Organs (2022) and the 3rd edition of the Bethesda System for Reporting Thyroid Cytopathology (2023), the field of thyroid pathology and cytopathology has witnessed key transformations. This digest brings to the fore the refined terminologies, newly introduced categories, and contentious methodological considerations pivotal to the updated classification.

随着第五版《世界卫生组织内分泌器官肿瘤分类》(2022 年)和第三版《贝塞斯达甲状腺细胞病理学报告系统》(2023 年)的发布,甲状腺病理学和细胞病理学领域发生了重大变革。本文摘将对更新分类中的术语、新引入的类别以及有争议的方法学考虑因素进行重点介绍。
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引用次数: 0
Exploring histological predictive biomarkers for immune checkpoint inhibitor therapy response in non-small cell lung cancer. 探索非小细胞肺癌免疫检查点抑制剂治疗反应的组织学预测生物标志物。
IF 2.4 Q2 Medicine Pub Date : 2024-03-01 Epub Date: 2024-02-26 DOI: 10.4132/jptm.2024.01.31
Uiju Cho, Soyoung Im, Hyung Soon Park

Treatment challenges persist in advanced lung cancer despite the development of therapies beyond the traditional platinum-based chemotherapy. The early 2000s marked a shift to tyrosine kinase inhibitors targeting epidermal growth factor receptor, ushering in personalized genetic-based treatment. A further significant advance was the development of immune checkpoint inhibitors (ICIs), especially for non-small cell lung cancer. These target programmed death-ligand 1 (PD-L1) and cytotoxic T lymphocyte antigen 4, which enhanced the immune response against tumor cells. However, not all patients respond, and immune-related toxicities arise. This review emphasizes identifying biomarkers for ICI response prediction. While PD-L1 is a widely used, validated biomarker, its predictive accuracy is imperfect. Investigating tumor-infiltrating lymphocytes, tertiary lymphoid structure, and emerging biomarkers such as high endothelial venule, Human leukocyte antigen class I, T-cell immunoreceptors with Ig and ITIM domains, and lymphocyte activation gene-3 counts is promising. Understanding and exploring additional predictive biomarkers for ICI response are crucial for enhancing patient stratification and overall care in lung cancer treatment.

尽管除了传统的铂类化疗外,晚期肺癌的治疗难题依然存在。本世纪初,以表皮生长因子受体为靶点的酪氨酸激酶抑制剂出现了转变,开创了基于基因的个性化治疗。另一个重大进展是免疫检查点抑制剂(ICIs)的开发,尤其是针对非小细胞肺癌的治疗。这些药物以程序性死亡配体 1(PD-L1)和细胞毒性 T 淋巴细胞抗原 4 为靶点,增强了针对肿瘤细胞的免疫反应。然而,并非所有患者都会产生反应,而且还会出现与免疫相关的毒性反应。本综述强调识别用于 ICI 反应预测的生物标志物。虽然 PD-L1 是一种广泛使用、经过验证的生物标志物,但其预测准确性并不完美。对肿瘤浸润淋巴细胞、三级淋巴结构以及高内皮静脉、人类白细胞抗原 I 类、具有 Ig 和 ITIM 结构域的 T 细胞免疫受体和淋巴细胞活化基因-3 计数等新兴生物标志物进行研究很有希望。了解和探索 ICI 反应的其他预测性生物标志物对于加强肺癌治疗中的患者分层和整体护理至关重要。
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引用次数: 0
A rare goblet cell adenocarcinoma arising from Barrett's esophagus: the first reported case in the esophagus. 由巴雷特食管引发的罕见鹅口疮细胞腺癌:食管中的首个报告病例。
IF 2.4 Q2 Medicine Pub Date : 2024-03-01 Epub Date: 2024-01-08 DOI: 10.4132/jptm.2023.12.26
Chi Eun Oh, Sung Eun Kim, Sun-Ju Oh

Goblet cell adenocarcinoma (GCA) is a rare and distinctive amphicrine tumor comprised of goblet-like mucinous cells and neuroendocrine cells. It is believed to originate from pluripotent stem cells located at the base of crypts. GCA predominantly arises from the appendix, with a few reported cases in extra-appendiceal locations such as the colorectum, small intestine, and stomach. In this case report, we present a unique instance of a 64-year-old male who initially received a diagnosis of neuroendocrine carcinoma in the distal esophagus based on biopsy but, following resection, was subsequently re-diagnosed with GCA arising from Barrett's esophagus.

鹅口疮细胞腺癌(GCA)是一种罕见而独特的两性肿瘤,由鹅口疮样粘液细胞和神经内分泌细胞组成。据信,它起源于位于隐窝底部的多能干细胞。GCA 主要发生在阑尾,也有少数病例发生在阑尾以外的部位,如结肠直肠、小肠和胃。在本病例报告中,我们介绍了一个独特的病例:一名 64 岁的男性最初根据活检结果被诊断为食管远端神经内分泌癌,但在切除食管后,他又被再次诊断为来自巴雷特食管的 GCA。
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引用次数: 0
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