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"Lobular lesions of the breast: From the classic to the variants". "乳腺小叶病变:从经典到变异"。
IF 2.9 3区 医学 Q2 MEDICAL LABORATORY TECHNOLOGY Pub Date : 2024-10-28 DOI: 10.1053/j.semdp.2024.10.002
Erinn Downs, H Evin Gulbahce

The aim of this review is to provide the surgical pathologist an overview of lobular lesions, from in situ to invasive carcinoma and the variants, by discussing the epidemiology, clinical characteristics, morphology, immunohistochemistry, known molecular data as well as the treatment recommendations. The recognition of histologic variants of both in situ and invasive lobular carcinoma has expanded the differential diagnosis. Awareness of these different entities is important as treatment recommendations continue to evolve.

本综述旨在通过讨论流行病学、临床特征、形态学、免疫组化、已知的分子数据以及治疗建议,为外科病理学家提供小叶病变(从原位癌到浸润癌及其变体)的概述。对原位癌和浸润性小叶癌组织学变异的认识扩大了鉴别诊断的范围。随着治疗建议的不断发展,对这些不同实体的认识非常重要。
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引用次数: 0
Current challenges in breast pathology. 当前乳腺病理学面临的挑战。
IF 2.9 3区 医学 Q2 MEDICAL LABORATORY TECHNOLOGY Pub Date : 2024-10-09 DOI: 10.1053/j.semdp.2024.10.004
Raza S Hoda, Patrick J McIntire
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引用次数: 0
Adenoid ameloblastoma revisited: A discursive exploration of its histological dualism, molecular aberrations, and clinical recurrence. 腺样绒毛膜母细胞瘤再探:对其组织学二元论、分子畸变和临床复发的辨证探索。
IF 2.9 3区 医学 Q2 MEDICAL LABORATORY TECHNOLOGY Pub Date : 2024-10-08 DOI: 10.1053/j.semdp.2024.10.001
Dr Sakshi Deorah, Dr Shalini Gupta

Adenoid ameloblastoma (AA) is a rare benign but locally aggressive odontogenic tumor originating from the remnants of the dental lamina or enamel organ. It was newly incorporated into the 2022 WHO classification of odontogenic lesions, standing as the sole novel entity in this update. AA is also regarded as a hybrid tumor because of the combination of histological characteristics observed in both adenomatoid odontogenic tumors and ameloblastoma. Clinically, it presents similarly to other ameloblastoma variants, with patients typically exhibiting a painless, slow-growing jaw swelling. However, this subtype is noted for its more aggressive behavior, including a higher recurrence rate and greater local invasiveness. Histopathologically, AA is distinguished by an intricate arrangement of epithelial islands, cords, and strands, generating a cribriform architectural pattern, with peripheral palisading and central stellate reticulum-like formations. Immunohistochemical profiling reveals the expression of epithelial differentiation markers, including cytokeratins, and proliferative markers such as Ki-67, further corroborating its aggressive phenotype. While its precise etiopathogenesis remains obscure, the unique histological characteristics imply a potentially distinct underlying molecular pathway. Due to its aggressive nature, AA necessitates meticulous clinical and histopathological evaluation and tailored therapeutic strategies to mitigate recurrence risks and optimize patient prognoses. Furthermore, this review integrates histological and molecular insights from recent studies conducted after its inclusion in the updated WHO classification.

腺样釉母细胞瘤(AA)是一种罕见的良性但具有局部侵袭性的牙源性肿瘤,起源于牙层或釉质器官的残余部分。它被新纳入 2022 年世界卫生组织牙源性病变分类,是此次更新中唯一的新实体。AA 也被认为是一种混合瘤,因为它结合了在牙源性腺瘤和釉母细胞瘤中观察到的组织学特征。在临床上,它的表现与其他釉母细胞瘤变体相似,患者通常表现为无痛、生长缓慢的下颌肿胀。不过,这种亚型的侵袭性更强,包括复发率更高、局部侵袭性更强。从组织病理学角度看,AA 的特征是上皮岛、索和股的复杂排列,形成楔形的建筑模式,外围有苍白化,中央有星状网状结构。免疫组化分析显示,包括细胞角蛋白在内的上皮分化标志物和 Ki-67 等增殖标志物均有表达,进一步证实了其侵袭性表型。虽然其确切的发病机制仍不明确,但其独特的组织学特征意味着其潜在的分子途径可能与众不同。由于其侵袭性,AA 需要细致的临床和组织病理学评估以及量身定制的治疗策略,以降低复发风险并优化患者预后。此外,本综述还整合了AA被纳入最新WHO分类后最新研究中的组织学和分子学观点。
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引用次数: 0
Salivary gland-like tumors of the breast: Histopathologic and genetic features with clinical implications. 乳腺唾液腺样肿瘤:具有临床意义的组织病理学和遗传学特征。
IF 2.9 3区 医学 Q2 MEDICAL LABORATORY TECHNOLOGY Pub Date : 2024-10-05 DOI: 10.1053/j.semdp.2024.10.003
Christopher J Schwartz, Gregor Krings

Salivary gland-like tumors of the breast are rare neoplasms that share morphologic, immunophenotypic, and/or genetic features with their salivary gland counterparts, highlighting a shared underlying histopathogenesis in most cases. Salivary gland-like carcinomas included in the World Health Organization classification of breast tumors are adenoid cystic carcinoma, secretory carcinoma, mucoepidermoid carcinoma, acinic cell carcinoma, and the exceedingly rare polymorphous adenocarcinoma. These carcinomas are usually triple negative for estrogen receptor and progesterone receptor expression and HER2 overexpression, yet generally have favorable prognosis, in contrast to high-grade triple negative carcinomas of no special type. On the other hand, a small subset, such as solid-basaloid adenoid cystic carcinoma, rare high-grade carcinomas, and those associated with transformation to other types of high-grade invasive carcinoma can behave more aggressively. Other salivary gland-like tumors of the breast, such as pleomorphic adenoma and adenomyoepithelioma, are usually benign but can rarely undergo malignant transformation. Although clinical experience with salivary gland-like breast tumors is overall limited, their recognition and accurate classification has important implications for prognosis and clinical management, especially to avoid overtreatment of salivary gland-like carcinomas. The identification of characteristic genetic alterations and/or immunohistochemical surrogates in many of these tumors has practical applications to establishing an accurate diagnosis and directing clinical management. This review highlights the histopathologic and genetic characteristics of salivary gland-like breast tumors and the implications of the diagnosis for current clinical management.

乳腺唾液腺样肿瘤是一种罕见的肿瘤,在形态学、免疫表型和/或遗传学上与唾液腺样肿瘤具有相同的特征,在大多数病例中突显出共同的潜在组织发病机制。世界卫生组织乳腺肿瘤分类中的唾液腺样癌包括腺样囊腺癌、分泌性癌、粘液表皮样癌、棘细胞癌以及极为罕见的多形性腺癌。这些癌通常在雌激素受体和孕激素受体表达以及 HER2 过度表达方面呈三阴性,但与无特殊类型的高级别三阴性癌相比,它们的预后通常较好。另一方面,一小部分肿瘤,如实性基底样腺样囊性癌、罕见的高级别癌,以及与转化为其他类型高级别浸润性癌有关的肿瘤,可能表现得更具侵袭性。乳腺的其他唾液腺样肿瘤,如多形腺瘤和腺肌上皮瘤,通常是良性的,但很少会发生恶性转化。虽然唾液腺样乳腺肿瘤的临床经验总体上有限,但其识别和准确分类对预后和临床治疗具有重要意义,尤其是可避免对唾液腺样癌的过度治疗。在许多此类肿瘤中识别特征性基因改变和/或免疫组化替代物对于确定准确诊断和指导临床治疗具有实际应用价值。本综述重点介绍涎腺样乳腺肿瘤的组织病理学和遗传学特征,以及诊断对当前临床治疗的意义。
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引用次数: 0
Calcifying cystic odontogenic tumour: Dilemma and pitfalls. 钙化性囊性牙源性肿瘤:困境与陷阱
IF 2.9 3区 医学 Q2 MEDICAL LABORATORY TECHNOLOGY Pub Date : 2024-09-19 DOI: 10.1053/j.semdp.2024.09.005
Arushi Tomar, Sharon John, Saloni Verma, Shalini Gupta

Odontogenic lesions are a category of lesions, which are found to be arising from the remnants of the tooth-bearing tissues of the body, that can be cystic in nature as a result of degeneration or as a result of excessive proliferation of these cells, can result in the formation of odontogenic tumours which are found in gnathic bones in the body. Since their discovery in literature and the explanation provided for their pathogenesis, these lesions have been the subject of debate and controversy amongst researchers as well as practitioners. Thereby, this review has taken into consideration one such odontogenic tumour, Calcifying Cystic Odontogenic Tumour (CCOT), which first were included under the namesake (Calcifying odontogenic cyst) as a sperate subheading under this cyst, but now has been designated under the category of tumours along with various histologic subtypes classified and described henceforth. Although the lesion has been removed in the recent classification, a wide variety of lesions in biphasic form has been reported in the past. Therefore, this present review takes a sneak-peek into this lesion with insight into its presentation, incidence, aetiology, pathogenesis, histopathology and all the controversies surrounding this category of lesion and the current literature about this lesion with proving the fact that this needs to be considered again in the category of odontogenic tumours.

牙源性病变是一类病变,产生于人体残余的牙组织,由于这些细胞的变性或过度增殖,可能形成囊性病变,也可能形成牙源性肿瘤,这些肿瘤存在于人体的颌骨中。自从在文献中发现这些病变并对其发病机理做出解释以来,这些病变一直是研究人员和从业人员争论和争议的主题。钙化性囊性牙源性肿瘤(CCOT)最初作为 "钙化性囊性牙源性囊肿 "的一个独立小标题,被归入 "肿瘤 "的范畴,并对其组织学亚型进行了分类和描述。虽然在最近的分类中,该病变已被删除,但过去曾报道过多种双相形式的病变。因此,本综述将对这一病变进行深入探讨,包括其表现、发病率、病因、发病机制、组织病理学以及围绕这类病变的所有争议和有关这一病变的现有文献,并证明这一事实,即需要在牙源性肿瘤类别中再次考虑这一病变。
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引用次数: 0
Spectrum of atypical ductal hyperplasia (ADH) and ductal carcinoma in-situ (DCIS): Diagnostic challenges. 非典型导管增生(ADH)和导管原位癌(DCIS)的谱系:诊断难题。
IF 2.3 3区 医学 Q2 MEDICAL LABORATORY TECHNOLOGY Pub Date : 2024-09-17 DOI: 10.1053/j.semdp.2024.09.001
Philip Bomeisl,Hannah Gilmore
Breast specimens are some of the more common specimens sent to the pathology laboratory for diagnosis. From a clinical perspective, the diagnoses fall into three broad categories: benign, atypical and malignant with patients then being managed according to established guidelines. However, the pathologic diagnosis can sometimes be challenging, and the distinction between these categories is sometimes far more subtle and subjective than non-pathologist may understand. One recurring diagnostic challenge in breast pathology is the diagnosis of atypical ductal hyperplasia (ADH) versus ductal carcinoma in situ (DCIS). While many cases are straightforward, others are quite borderline and challenging to classify consistently with significant interobserver variation amongst pathologists. The distinction between ADH and DCIS is critical from a clinical management perspective because one is treated as a risk factor, and the other as a malignancy that will be completely surgically excised and may require radiation therapy. This review will address the spectrum of ADH and DCIS with the associated diagnostic challenges in the real-world setting from presentation at core needle biopsy to surgery.
乳腺标本是送往病理实验室进行诊断的最常见标本。从临床角度来看,诊断可分为三大类:良性、非典型和恶性,然后根据既定指南对患者进行处理。然而,病理诊断有时也很有挑战性,这些类别之间的区别有时比非病理学家理解的要微妙和主观得多。乳腺病理诊断中经常遇到的一个难题是非典型性导管增生(ADH)与导管原位癌(DCIS)的诊断。虽然很多病例简单明了,但也有一些病例非常边缘化,病理学家之间的观察者差异很大,很难进行一致的分类。从临床管理的角度来看,ADH 和 DCIS 之间的区别至关重要,因为前者被视为风险因素,而后者则被视为恶性肿瘤,需要通过手术完全切除,并可能需要放射治疗。本综述将讨论 ADH 和 DCIS 的范围,以及在现实世界中从核心针活检到手术的整个过程中所面临的相关诊断挑战。
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引用次数: 0
Sclerosing Odontogenic Carcinoma: UPLIFTS and pitfalls. 硬化性牙源性癌:UPLIFTS 和陷阱。
IF 2.9 3区 医学 Q2 MEDICAL LABORATORY TECHNOLOGY Pub Date : 2024-09-16 DOI: 10.1053/j.semdp.2024.09.004
Arushi Tomar, Sharon John, Shalini Gupta

Sclerosing Odontogrenic Carcinoma (SOC) is a recent addition to the category of odontogenic tumours, which was first described by Koutlas et al. in 2008. It was described as primary intraosseous carcinoma with bland cytology, sclerotic stroma with presence of local infiltration showing aggressive behaviour. Following its discovery and the presentation of first case, only a handful of cases have been reported till date, which may be due to underreporting of the cases or inclusion of the case to other diagnosis since the features of this tumour overlaps with many other lesions of the oral cavity. Due to this factor, the pathogenesis of this category of tumours still remains enigmatic. The clinical features as a result of this factor are also not reported of the consistent type and overlaps with the already existing clinical features of other lesions. This lesion has only appeared till date twice in WHO classification of Odontogenic Cysts and Tumours. Thereby, the literature on this category is still in paucity. Therefore, the present review takes into account all of the features, diagnostic criteria and the markers discovered for this lesion and would provide an insight into whether this lesion is justified as a malignant lesion or should not be considered as a separate category of odontogenic tumour.

硬化性牙源性腺癌(SOC)是牙源性肿瘤中最近新增的一种,由 Koutlas 等人于 2008 年首次描述。它被描述为原发性骨内癌,细胞学表现平淡,基质硬化,局部浸润,具有侵袭性。由于该肿瘤的特征与口腔中的许多其他病变重叠,这可能是由于病例报告不足或将病例纳入其他诊断所致。由于这一因素,这类肿瘤的发病机理仍然是个谜。由于这一因素,临床特征也没有一致的报道,并且与其他病变已有的临床特征重叠。迄今为止,这种病变只在世界卫生组织的牙源性囊肿和肿瘤分类中出现过两次。因此,有关这类病变的文献仍然很少。因此,本综述将考虑到该病变的所有特征、诊断标准和已发现的标记物,并将深入探讨该病变是否有理由被视为恶性病变或不应被视为单独的一类牙源性肿瘤。
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引用次数: 0
An unusual presentation of calcifying odontogenic cyst with literature review. 牙源性钙化囊肿的不寻常表现及文献综述。
IF 2.9 3区 医学 Q2 MEDICAL LABORATORY TECHNOLOGY Pub Date : 2024-09-13 DOI: 10.1053/j.semdp.2024.09.003
Priya Devi, Sharon John, Saloni Verma, Roshna Sankar, Rajeev Kumar Singh, Shalini Gupta

The calcifying odontogenic cyst (COC) is an uncommon developmental odontogenic cyst, the oral counterpart of Malherbe's cutaneous calcifying epithelioma (pilomatricoma). This article presents two unique cases of calcifying odontogenic cysts each exhibiting distinctive histopathological features and its literature review. One case with an unexpected finding of cholesterol granuloma (CG), a rare occurrence in non-inflammatory cysts within an unusual location between two maxillary central incisors. One more instance involves the presence of a compound odontome in conjunction with COC. The cases underscore the clinical and histopathological diversity of COC and highlight the importance of radiological and histopathological assessments for accurate diagnosis. The unexpected association of COC with cholesterol granuloma challenges traditional diagnostic expectations. Additionally, the second case suggests that COCs may warrant sub-categorization to better understand their varied presentations and biological behavior. This article contributes to the expanding knowledge of COC, emphasizing the significance of documenting rare cases to enhance comprehension of its nature, pathogenesis, and oral cavity origin.

钙化性牙源性囊肿(COC)是一种不常见的发育性牙源性囊肿,是马赫贝皮肤钙化上皮瘤(皮瘤)的口腔对应物。本文介绍了两个独特的钙化性牙源性囊肿病例,每个病例都表现出独特的组织病理学特征,并对其进行了文献综述。其中一个病例意外发现了胆固醇肉芽肿(CG),这在位于两颗上颌中切牙之间的非炎症性囊肿中非常罕见。还有一个病例是复牙合伴有胆固醇肉芽肿。这些病例凸显了COC在临床和组织病理学上的多样性,并强调了放射学和组织病理学评估对准确诊断的重要性。COC与胆固醇肉芽肿的意外关联挑战了传统的诊断预期。此外,第二个病例表明,COC 可能需要进行亚分类,以更好地了解其不同的表现和生物学行为。这篇文章有助于扩大对 COC 的了解,强调记录罕见病例的重要性,以加深对其性质、发病机制和口腔起源的理解。
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引用次数: 0
Molecular insights into hybrid tumors: Exploring the heterogeneity in plexiform ameloblastoma. 混合瘤的分子研究:探索丛状母细胞瘤的异质性。
IF 2.9 3区 医学 Q2 MEDICAL LABORATORY TECHNOLOGY Pub Date : 2024-09-12 DOI: 10.1053/j.semdp.2024.09.002
Dr Sharon John, Dr Arushi Tomar, Dr Ayushi Jain, Dr Shalini Gupta

For many years, odontogenic tumors have been known to present both clinical and histopathological challenges due to their origins in the epithelial, ectomesenchymal, and/or mesenchymal components of tooth-forming tissues. Gaining a comprehensive understanding of both common and rare odontogenic tumors is crucial for their effective study and clinical management. One particularly puzzling tumor is the "plexiform ameloblastoma," a variant of the solid multicystic ameloblastoma. This term describes a distinct pattern of epithelial proliferation within the cystic cavity. Numerous studies have emphasized the variability of the stromal component, further highlighting the enigmatic nature of ameloblastoma. The presence of unique and rare features, such as primitive, mature desmoplastic, hemangiomatous, or ghost cells within the stroma of plexiform ameloblastoma, underscores the differentiation potential of the neoplastic odontogenic epithelium and offers significant insights into the tissue reactions associated with this condition. This case review discusses four instances of plexiform ameloblastoma, illustrating various atypical stromal changes and their influence on patient prognosis. It also provides important criteria for analyzing stromal alterations related to this complex odontogenic tumor.

多年来,牙源性肿瘤一直是临床和组织病理学上的难题,因为它们起源于牙齿形成组织的上皮、外生性和/或间充质成分。全面了解常见和罕见的牙源性肿瘤对有效研究和临床治疗至关重要。其中一种特别令人费解的肿瘤是 "丛状釉母细胞瘤",它是实性多囊釉母细胞瘤的一种变体。这一术语描述了囊腔内上皮增生的独特模式。大量研究强调了基质成分的可变性,进一步凸显了釉母细胞瘤的神秘性。丛状牙釉质母细胞瘤基质中存在原始的、成熟的去瘤细胞、血管瘤细胞或鬼细胞等独特而罕见的特征,强调了肿瘤性牙源性上皮的分化潜能,并为了解与该病症相关的组织反应提供了重要依据。本病例综述讨论了四例丛状牙釉质母细胞瘤,说明了各种不典型的基质变化及其对患者预后的影响。它还提供了分析这种复杂牙源性肿瘤相关基质改变的重要标准。
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引用次数: 0
Goblet cell adenocarcinoma 上皮细胞腺癌
IF 2.9 3区 医学 Q2 MEDICAL LABORATORY TECHNOLOGY Pub Date : 2024-09-01 DOI: 10.1053/j.semdp.2024.08.003
Jula Veerapong, Mojgan Hosseini

Appendix, considered a vestigial and disposable organ, has been long neglected as a source of abdominal tumors. Among the appendiceal tumors, goblet cell adenocarcinoma (GCA) is a rare primary epithelial neoplasm which has undergone multiple name changes and classifications in recent years, adding to confusion surrounding this unique amphicrine tumor. This entity was previously known as goblet cell carcinoid and adenocarcinoma ex goblet cell carcinoid. This review article provides an update on pathology, nomenclature, and recent classification systems with emphasis on 2019 World Health Organization Classification of Tumors, 3-tiered grading system.1

阑尾被认为是一种残留的一次性器官,长期以来一直被忽视为腹部肿瘤的来源。在阑尾肿瘤中,鹅口疮细胞腺癌(GCA)是一种罕见的原发性上皮肿瘤,近年来它经历了多次更名和分类,使这种独特的两性肿瘤更加扑朔迷离。这种肿瘤以前被称为鹅口疮细胞类癌和鹅口疮细胞类癌外腺癌。这篇综述文章介绍了病理学、命名法和最新分类系统的最新情况,重点介绍了2019年世界卫生组织肿瘤分类的3级分级系统。
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引用次数: 0
期刊
Seminars in Diagnostic Pathology
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