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Intricacies of plexiform unicystic ameloblastoma: A rare intraluminal journey in the jaw. 丛状单囊釉母细胞瘤的复杂性:一种罕见的颌骨腔内病变。
IF 2.9 3区 医学 Q2 MEDICAL LABORATORY TECHNOLOGY Pub Date : 2024-11-07 DOI: 10.1053/j.semdp.2024.11.001
Dr Sakshi Deorah, Dr Sharon John, Dr Shalini Gupta

Ameloblastoma is a true benign odontogenic epithelial tumor, primarily arising in the jaw, and ranks as the second most prevalent odontogenic neoplasm following odontoma. Known for its diverse clinical, radiographic, and histological manifestations, ameloblastoma encompasses a wide spectrum of presentations. Unicystic ameloblastomas (UAs), a less common and generally less aggressive variant, appear as cystic lesions that can mimic ordinary jaw cysts in their clinical and radiologic features. However, histological examination reveals a distinctive odontogenic epithelium lining the cyst cavities, with some cases exhibiting luminal and mural growth. This article presents a unique case involving a 40-year-old female patient who experienced swelling in the right posterior maxilla for four months. Initially presumed to be a routine ameloblastoma, subsequent histopathological analysis identified it as an intraluminal type of UA with rare plexiform changes. It is characterized by a cystic space lined with ameloblast-like cells in a plexiform arrangement, setting it apart from other UA subtypes. Imaging often reveals a unilocular cystic appearance, which may obscure differential diagnosis by closely resembling other odontogenic cysts. The variations within ameloblastoma have always sparked considerable discussion, and we aim to elucidate the reasons behind this specific transformation and its distinctive characteristics.

釉母细胞瘤是一种真正的良性牙源性上皮肿瘤,主要发生于颌骨,是仅次于牙瘤的第二大牙源性肿瘤。釉母细胞瘤的临床、影像学和组织学表现多种多样。单囊性绒毛膜母细胞瘤(UAs)是一种较少见且通常侵袭性较低的变异型绒毛膜母细胞瘤,表现为囊性病变,其临床和放射学特征与普通的颌骨囊肿相似。然而,组织学检查显示,囊腔内衬有独特的牙源性上皮,部分病例表现为管腔和壁层增生。本文介绍了一个独特的病例,患者是一名 40 岁的女性,右后上颌骨肿胀长达四个月。起初推测为常规的羊膜母细胞瘤,但随后的组织病理学分析发现这是一种腔内型 UA,伴有罕见的丛状改变。其特点是囊腔内衬有丛状排列的成釉细胞样细胞,这使其有别于其他 UA 亚型。其影像学表现通常为单眼囊性外观,由于与其他牙源性囊肿非常相似,可能会影响鉴别诊断。釉母细胞瘤内部的变异一直引发着广泛的讨论,我们旨在阐明这种特殊转化及其独特特征背后的原因。
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引用次数: 0
Targetoid hemosiderotic hemangioma: A review article. 靶形血蜘蛛网状血管瘤:综述文章。
IF 2.9 3区 医学 Q2 MEDICAL LABORATORY TECHNOLOGY Pub Date : 2024-11-05 DOI: 10.1053/j.semdp.2024.11.002
Toan Bui, Laura M Rezac, C Alexis Noble, Ariel R Velasquez-Evers, Robert T Brodell

Background: Targetoid hemosiderotic hemangioma (THH), also known as hobnail lymphatic malformation (HLL) or hobnail hemangioma, is an uncommon, acquired vascular lesion with a dynamic presentation and an unclear etiology. It predominantly affects adults with an age range from 9 to 78 years and has no gender predilection. The lesion is thought to arise from trauma, leading to micro-shunts between small lesional capillaries and adjacent lymphatic vessels.

Methods: This review article examines the clinical, histologic, and immunohistochemical characteristics of THH, and explores its differential diagnoses, including Kaposi's sarcoma, solitary angiokeratoma, retiform hemangioendothelioma, and Dabska tumor.

Results: THH presents clinically as asymptomatic, well-circumscribed lesions with a central red-blue and/or brown papule surrounded by a peripheral ecchymotic ring, giving a "bull's-eye" or targetoid appearance. Histologically, THH exhibits dilated vascular channels lined by hobnail endothelial cells, red blood cell extravasation, hemosiderin deposition, and mild lymphohistiocytic infiltrates. Immunohistochemistry is positive for D2-40, a lymphatic endothelial marker.

Conclusions: Heightened awareness of the clinical appearance of these solitary targetoid lesions is important. Without clinical-pathologic correlation, the branching telangiectatic vessels and purpura seen in THH could suggest more concerning vascular lesions like Kaposi sarcoma.

背景:靶形血淤性血管瘤(THH)又称蜗牛淋巴畸形(HLL)或蜗牛血管瘤,是一种不常见的后天性血管病变,表现动态,病因不清。它主要影响 9 至 78 岁的成年人,没有性别偏好。这种病变被认为是由创伤引起的,导致病变小毛细血管与邻近淋巴管之间的微分流:这篇综述文章研究了 THH 的临床、组织学和免疫组化特征,并探讨了其鉴别诊断,包括卡波西肉瘤、单发血管角皮瘤、网状血管内皮瘤和达布斯卡肿瘤:THH在临床上表现为无症状、圆形皮损,中央为红蓝色和/或棕色丘疹,周围有瘀斑环,呈 "靶心 "或靶状外观。组织学上,THH 表现为内衬为梭形内皮细胞的扩张血管通道、红细胞外渗、血色素沉积和轻度淋巴组织细胞浸润。免疫组化结果显示淋巴内皮标记物 D2-40 呈阳性:结论:提高对这些单发靶样病变临床表现的认识非常重要。在没有临床病理相关性的情况下,THH 中出现的毛细血管分支和紫癜可能提示更严重的血管病变,如卡波济肉瘤。
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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 : 2024-11-01 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
MASTHEAD (p/u from previous issue) MASTHEAD (P/U 自上期起)
IF 2.9 3区 医学 Q2 MEDICAL LABORATORY TECHNOLOGY Pub Date : 2024-11-01 DOI: 10.1053/S0740-2570(24)00094-7
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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 : 2024-11-01 DOI: 10.1053/j.semdp.2024.10.004
Raza S. Hoda, Patrick J. McIntire
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引用次数: 0
Intraoperative evaluation of sentinel lymph nodes in patients with breast cancer: A review emphasizing clinical concepts pathologists need to know 乳腺癌患者前哨淋巴结的术中评估:强调病理学家需要了解的临床概念的综述。
IF 2.9 3区 医学 Q2 MEDICAL LABORATORY TECHNOLOGY Pub Date : 2024-11-01 DOI: 10.1053/j.semdp.2024.06.004
Andrew Sciallis
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引用次数: 0
EDITORIAL BOARD (p/u from previous issue) 编辑委员会(上期增刊)
IF 2.9 3区 医学 Q2 MEDICAL LABORATORY TECHNOLOGY Pub Date : 2024-11-01 DOI: 10.1053/S0740-2570(24)00095-9
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引用次数: 0
TABLE OF CONTENTS (p/u from previous issue w/updates) 目 录(上期内容,有更新)
IF 2.9 3区 医学 Q2 MEDICAL LABORATORY TECHNOLOGY Pub Date : 2024-11-01 DOI: 10.1053/S0740-2570(24)00096-0
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引用次数: 0
"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 : 2024-11-01 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
Intraoperative evaluation of surgical margins in breast cancer 乳腺癌手术边缘的术中评估。
IF 2.9 3区 医学 Q2 MEDICAL LABORATORY TECHNOLOGY Pub Date : 2024-11-01 DOI: 10.1053/j.semdp.2024.06.005
Lauren Kopicky , Betty Fan , Stephanie A. Valente
Achieving clear resection margins at the time of lumpectomy is essential for optimal patient outcomes. Margin status is traditionally determined by pathologic evaluation of the specimen and often is difficult or impossible for the surgeon to definitively know at the time of surgery, resulting in the need for re-operation to obtain clear surgical margins. Numerous techniques have been investigated to enhance the accuracy of intraoperative margin and are reviewed in this manuscript.
在进行肿瘤切除术时获得清晰的切除边缘对患者获得最佳治疗效果至关重要。切缘状态传统上由标本的病理评估决定,外科医生在手术时往往很难或不可能确定切缘状态,因此需要再次手术以获得清晰的手术切缘。为了提高术中切缘的准确性,人们研究了许多技术,本手稿将对这些技术进行综述。
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Seminars in Diagnostic Pathology
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