Seminars in Diagnostic Pathology最新文献

英文中文

Epithelial precursor lesions of the bile duct 胆管上皮前体病变。

IF 3.5 3区医学 Q2 MEDICAL LABORATORY TECHNOLOGY

Seminars in Diagnostic Pathology

Pub Date : 2025-11-01 DOI: 10.1016/j.semdp.2025.150961

Wei Zheng , Yue Xue

Biliary epithelial precursor lesions represent key initiating steps in the multistep pathogenesis of cholangiocarcinoma. The three commonly recognized entities—biliary intraepithelial neoplasia (BilIN), intraductal papillary neoplasm of the bile duct (IPNB), and intraductal tubulopapillary neoplasm of the bile duct (ITPN-B) —include both flat and mass-forming lesions and span a broad spectrum of morphologic, immunophenotypic, and molecular profiles. While their classification partially parallels that of pancreatic precursor lesions, biliary lesions exhibit unique architectural patterns, molecular alterations, and phenotypic variability. Accurate diagnosis is often complicated by overlapping histologic features, limited or fragmented sampling, and under-recognition of critical diagnostic criteria. This review synthesizes contemporary pathologic insights into biliary precursor lesions and provides a practical diagnostic framework based on detailed histologic evaluation, supported by ancillary immunohistochemical and molecular testing, differential diagnostic considerations, and integration of clinico-radiologic context. A nuanced understanding of the defining features and biological behavior of these lesions is essential to reduce diagnostic ambiguity, guide appropriate clinical decision-making, and enable effective risk stratification.

胆道上皮前体病变是胆管癌多步骤发病机制中的关键起始步骤。胆道上皮内瘤变（BilIN）、胆管导管内乳头状瘤变（IPNB）和胆管导管内管状乳头状瘤变（ITPN-B）这三种常见的实体包括扁平和团块形成的病变，并且在形态学、免疫表型和分子谱上具有广泛的范围。虽然胆道病变的分类部分与胰腺前体病变相似，但胆道病变表现出独特的建筑模式、分子改变和表型变异性。准确的诊断往往是复杂的重叠的组织学特征，有限或碎片化的采样，和认识不足的关键诊断标准。本综述综合了当代胆道前体病变的病理学见解，并提供了一个实用的诊断框架，该框架基于详细的组织学评估，辅以免疫组织化学和分子检测，鉴别诊断考虑以及临床放射学背景的整合。对这些病变的定义特征和生物学行为的细致理解对于减少诊断歧义、指导适当的临床决策和实现有效的风险分层至关重要。

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引用次数: 0

Salivary gland cystadenoma and oncocytoma 唾液腺囊腺瘤和嗜瘤细胞瘤

IF 3.5 3区医学 Q2 MEDICAL LABORATORY TECHNOLOGY

Seminars in Diagnostic Pathology

Pub Date : 2025-11-01 DOI: 10.1016/j.semdp.2025.150962

Kevin E. Mijares, Raja R. Seethala

Salivary gland cystadenomas and oncocytomas are uncommon benign neoplasms. Cystadenomas are multicystic lesions with a proliferative epithelial lining that may appear papillary, oncocytic, or mucinous while oncocytomas are predominantly solid tumors consisting of large epithelial cells with abundant granular eosinophilic cytoplasm. However, these morphologic features can also be identified in other more frequently encountered benign and malignant salivary gland tumors. Accurate diagnosis is important for appropriate management and follow-up as cystadenomas and oncocytomas are treated by surgical resection and rarely recur or undergo malignant transformation. This review provides an overview of the clinical, pathological, and immunohistochemical features of cystadenomas and oncocytomas, including key diagnostic features and molecular findings to distinguish these benign tumors from their malignant mimics.

涎腺囊腺瘤和嗜酸细胞瘤是少见的良性肿瘤。囊腺瘤是一种多囊性病变，具有增生性上皮衬里，可表现为乳头状、嗜酸细胞状或黏液状，而嗜酸细胞瘤主要是由大上皮细胞和丰富的颗粒状嗜酸性细胞质组成的实体瘤。然而，这些形态学特征也可以在其他更常见的良性和恶性唾液腺肿瘤中发现。准确的诊断对于适当的治疗和随访是重要的，因为囊腺瘤和癌细胞瘤通过手术切除治疗，很少复发或发生恶性转化。本文综述了囊腺瘤和嗜酸细胞瘤的临床、病理和免疫组织化学特征，包括区分这些良性肿瘤和恶性肿瘤的关键诊断特征和分子特征。

引用次数: 0

GLI1-altered mesenchymal tumors of the head and neck gli1改变的头颈部间充质肿瘤

IF 3.5 3区医学 Q2 MEDICAL LABORATORY TECHNOLOGY

Seminars in Diagnostic Pathology

Pub Date : 2025-11-01 DOI: 10.1016/j.semdp.2025.150963

Narasimhan P. Agaram

GLI1-altered mesenchymal tumors are a group of soft tissue tumors that have emerged as a new entity, in large part, as a result of increased next-generation sequencing (NGS)-based DNA and RNA sequencing of tumors. Over the last decade, multiple case reports and small series have reported such tumors involving multiple sites (including soft tissue, head and neck and viscera). They appear to have rather distinctive morphology and can either show GLI1-gene fusions or GLI1-gene amplifications. Although cases with metastasis are increasingly recognized, definite morphologic indicators of metastasis have not yet been identified. In this review, we focus on GLI1-altered mesenchymal tumors of the head and neck, with an emphasis on clinicopathologic features, molecular findings and approach to the diagnosis.

gli1改变的间充质肿瘤是一组已经作为一个新的实体出现的软组织肿瘤，在很大程度上是由于基于下一代测序（NGS）的肿瘤DNA和RNA测序的增加。近十年来，多例病例报告和小系列报道了此类肿瘤累及多个部位（包括软组织、头颈部和内脏）。它们似乎具有相当独特的形态，可以显示gli1基因融合或gli1基因扩增。虽然转移的病例越来越多地被认识到，但转移的明确形态学指标尚未被确定。在这篇综述中，我们关注的是头颈部gli1改变的间充质肿瘤，重点是临床病理特征、分子表现和诊断方法。

引用次数: 0

NCOA1/2/3-rearranged low-grade fibroblastic/myofibroblastic spindle cell tumors: including emerging entities beyond the WHO 5th edition of Bone and Soft Tissue Tumors — a systematic review 重排低级别纤维母细胞/肌纤维母细胞梭形细胞肿瘤：包括WHO第5版骨和软组织肿瘤以外的新兴实体-系统综述

IF 3.5 3区医学 Q2 MEDICAL LABORATORY TECHNOLOGY

Seminars in Diagnostic Pathology

Pub Date : 2025-11-01 DOI: 10.1016/j.semdp.2025.150945

Rayan Sibira , Josephine K. Dermawan

引用次数: 0

Extrahepatic cholangiocarcinoma: Current concepts in histopathology, immunohistochemistry, and molecular diagnostics 肝外胆管癌：组织病理学、免疫组织化学和分子诊断的最新概念。

IF 3.5 3区医学 Q2 MEDICAL LABORATORY TECHNOLOGY

Seminars in Diagnostic Pathology

Pub Date : 2025-11-01 DOI: 10.1016/j.semdp.2025.150949

Jared Beyersdorf, M. Lisa Zhang

Cholangiocarcinoma (CCA) makes up a diverse group of malignancies that originate from the biliary epithelium. Despite its rarity, this is a highly aggressive group of diseases with a high mortality, which has been increasing on a global scale. Classification of CCA is based on the anatomical site of origin and consists of intrahepatic (iCCA), perihilar (pCCA), and distal (dCCA) cholangiocarcinoma. The pathologic diagnosis of CCA can be challenging from multiple standpoints, including tissue acquisition and interpretation. Surgery is the only curative treatment, but patients often present at late stages, which may not be amenable to surgical treatment. Novel therapies are emerging for CCA, and early genetic testing is essential to identify candidate patients. There is a need for further developments in immunohistochemistry and molecular characterization of CCA to enable earlier diagnosis, especially from limited samples. This review provides a concise overview of current concepts in the pathology of CCA, focusing on diagnostic challenges, histology, staging, immunohistochemistry, and evolving molecular features.

胆管癌（CCA）构成了一组不同的恶性肿瘤，起源于胆道上皮。尽管罕见，但这是一组具有高度侵袭性的疾病，死亡率高，在全球范围内一直在增加。胆管癌的分类基于起源的解剖位置，包括肝内胆管癌（iCCA）、门周胆管癌（pCCA）和远端胆管癌（dCCA）。CCA的病理诊断可能从多个角度具有挑战性，包括组织获取和解释。手术是唯一的治疗方法，但患者往往出现在晚期，这可能不适合手术治疗。CCA的新疗法正在出现，早期基因检测对于确定候选患者至关重要。需要进一步发展CCA的免疫组织化学和分子表征，以实现早期诊断，特别是在有限的样本中。这篇综述提供了当前CCA病理学概念的简要概述，重点是诊断挑战、组织学、分期、免疫组织化学和进化分子特征。

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引用次数: 0

Differential diagnosis of multiple myeloma 多发性骨髓瘤的鉴别诊断。

IF 3.5 3区医学 Q2 MEDICAL LABORATORY TECHNOLOGY

Seminars in Diagnostic Pathology

Pub Date : 2025-11-01 DOI: 10.1016/j.semdp.2025.150944

Miguel Dario Cantu, Weina Chen

Distinguishing multiple myeloma from B-cell lymphomas can be a diagnostic challenge. There can be significant morphologic, immunophenotypic and clinical overlap that may require additional molecular genetic ancillary studies and careful clinical review to render an accurate diagnosis. The focus of this review will be on the differential diagnosis of multiple myeloma with an emphasis on low-grade B-cell lymphomas with plasmacytic differentiation and aggressive B-cell lymphomas with plasmablastic morphology that can mimic true plasma cell neoplasms. Diagnostic approaches to plasmablastic neoplasms, including extramedullary plasmablastic plasmacytoma and distinguishing features of B-cell lymphomas with plasmablastic morphology are discussed. Low-grade B-cell lymphomas with plasmacytic differentiation, including lymphoplasmacytic lymphoma, marginal zone lymphoma, chronic lymphocytic leukemia/small lymphocytic lymphoma, and other low-grade B-cell lymphomas that less frequently exhibit plasmacytic differentiation such as follicular lymphoma and mantle cell lymphoma are also included. Multiple myeloma with CCND1:IGH, which can mimic low-grade B-cell lymphomas and post-treatment plasmacytic proliferations following treatment for B-cell lymphomas with plasmacytic differentiation are also discussed.

区分多发性骨髓瘤和b细胞淋巴瘤可能是一个诊断挑战。可能存在显著的形态学、免疫表型和临床重叠，这可能需要额外的分子遗传学辅助研究和仔细的临床审查才能做出准确的诊断。本综述的重点是多发性骨髓瘤的鉴别诊断，重点是具有浆细胞分化的低级别b细胞淋巴瘤和具有浆母细胞形态的侵袭性b细胞淋巴瘤，可以模拟真正的浆细胞肿瘤。讨论了质母细胞瘤的诊断方法，包括髓外质母细胞瘤和具有质母细胞形态的b细胞淋巴瘤的区别特征。伴有浆细胞分化的低级别b细胞淋巴瘤，包括淋巴浆细胞淋巴瘤、边缘带淋巴瘤、慢性淋巴细胞白血病/小淋巴细胞淋巴瘤，以及其他较少表现浆细胞分化的低级别b细胞淋巴瘤，如滤泡性淋巴瘤和套细胞淋巴瘤。我们还讨论了CCND1:IGH多发性骨髓瘤，它可以模拟低级别b细胞淋巴瘤，以及治疗后浆细胞分化b细胞淋巴瘤后的浆细胞增殖。

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Bridging Perspectives: Integrating urologist and cytopathologist insights of urine cytology 桥梁观点：整合泌尿科医生和细胞病理学家的尿细胞学见解

IF 3.5 3区医学 Q2 MEDICAL LABORATORY TECHNOLOGY

Seminars in Diagnostic Pathology

Pub Date : 2025-10-10 DOI: 10.1016/j.semdp.2025.150960

Nikka Khorsandi , Sima Porten , Christopher J. VandenBussche , Nancy Greenland , Poonam Vohra

In this comprehensive review, we explore the integration of both cytopathologic and urologic perspectives around interpretation of urine cytology under the Paris System for Reporting Urinary Cytology (TPS) and clinical management. Urine cytology is a pivotal diagnostic tool for urologists, especially in the detection and management of high-grade urothelial carcinoma (HGUC). The review highlights how TPS has standardized urine cytology interpretations through consistent diagnostic criteria and reduced atypical diagnoses. This standardization aids in communication between pathologists and clinicians. There is an educational need to foster more effective collaboration between urologists and cytopathologists. Clinicians are not formally educated about TPS, and guidelines do not exist for how TPS diagnostic categories should impact patient treatment/management. Therefore, as TPS continues to evolve, it is important for pathologists to understand how urologists perceive TPS and use its diagnostic categories. This review addresses the clinical management of various diagnostic categories under TPS, illustrating how urologists integrate urine cytology results with endoscopic and radiologic data to monitor recurrence, progression, and metastasis of bladder cancer. It also covers the adjunctive use of urinary biomarkers and advanced cystoscopic techniques to enhance diagnostic accuracy. By bridging cytopathologic insights with urologic clinical applications, this review provides a holistic understanding of the diagnostic and management strategies for bladder cancer, underscoring the indispensable role of urine cytology in urologic practice.

在这篇全面的综述中，我们探讨了在巴黎尿细胞学报告系统（TPS）和临床管理下，关于尿细胞学解释的细胞病理学和泌尿学观点的整合。尿细胞学是泌尿科医生的关键诊断工具，特别是在检测和处理高级别尿路上皮癌（HGUC）时。这篇综述强调了TPS如何通过一致的诊断标准和减少非典型诊断来标准化尿细胞学解释。这种标准化有助于病理学家和临床医生之间的交流。培养泌尿科医生和细胞病理学家之间更有效合作的教育需要。临床医生没有接受过TPS方面的正式教育，也没有关于TPS诊断类别如何影响患者治疗/管理的指南。因此，随着TPS的不断发展，病理学家了解泌尿科医生如何看待TPS并使用其诊断类别是很重要的。本文综述了TPS下各种诊断类别的临床管理，阐述了泌尿科医生如何将尿细胞学结果与内窥镜和放射学数据结合起来监测膀胱癌的复发、进展和转移。它还涵盖了辅助使用尿液生物标志物和先进的膀胱镜技术，以提高诊断的准确性。通过将细胞病理学见解与泌尿外科临床应用相结合，本文综述了膀胱癌的诊断和治疗策略的整体理解，强调了尿细胞学在泌尿外科实践中不可或缺的作用。

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TABLE OF CONTENTS (p/u from previous issue w/updates) 目录表（p/u来自上一期，更新）

IF 3.5 3区医学 Q2 MEDICAL LABORATORY TECHNOLOGY

Seminars in Diagnostic Pathology

Pub Date : 2025-08-25 DOI: 10.1053/S0740-2570(25)00090-5

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IF 3.5 3区医学 Q2 MEDICAL LABORATORY TECHNOLOGY

Seminars in Diagnostic Pathology

Pub Date : 2025-08-25 DOI: 10.1053/S0740-2570(25)00088-7

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IF 3.5 3区医学 Q2 MEDICAL LABORATORY TECHNOLOGY

Seminars in Diagnostic Pathology

Pub Date : 2025-08-25 DOI: 10.1053/S0740-2570(25)00087-5

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Seminars in Diagnostic Pathology

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