Seminars in Diagnostic Pathology最新文献

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IF 2.9 3区医学 Q2 MEDICAL LABORATORY TECHNOLOGY

Seminars in Diagnostic Pathology

Pub Date : 2025-06-07 DOI: 10.1053/S0740-2570(25)00064-4

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IF 2.9 3区医学 Q2 MEDICAL LABORATORY TECHNOLOGY

Seminars in Diagnostic Pathology

Pub Date : 2025-06-07 DOI: 10.1053/S0740-2570(25)00066-8

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IF 2.9 3区医学 Q2 MEDICAL LABORATORY TECHNOLOGY

Seminars in Diagnostic Pathology

Pub Date : 2025-06-07 DOI: 10.1053/S0740-2570(25)00065-6

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Role of the bone marrow microenvironment in multiple myeloma: Impact of niches on drug resistance mechanisms 骨髓微环境在多发性骨髓瘤中的作用：生态位对耐药机制的影响

IF 2.9 3区医学 Q2 MEDICAL LABORATORY TECHNOLOGY

Seminars in Diagnostic Pathology

Pub Date : 2025-05-22 DOI: 10.1016/j.semdp.2025.150916

Lijie Wang , Mingyue Shi , Andrew Y. Sung , C Cameron Yin , Yanliang Bai , Mingyi Chen

Multiple myeloma (MM) is a blood cancer characterized by the uncontrolled growth of plasma cells in the bone marrow. These malignant plasma cells can proliferate locally and spread to other tissues and organs. The M-protein they produce can lead to various clinical symptoms, including anemia, hypercalcemia, bone pain, bone destruction, and kidney dysfunction. Despite significant advancements in treatment over the past two decades that have improved survival and outcomes for many patients, drug resistance remains a significant therapeutic challenge. This resistance is largely driven by the complex interactions between MM cells and the bone marrow microenvironment (BMME), making long-term disease control difficult. To improve treatment outcomes, it is essential to understand how the BMME supports MM cell growth and survival, as well as how these cells evade therapies. Investigating these processes will help identify key mechanisms behind drug resistance, offering a pathway to develop targeted therapies that can overcome this challenge. This review will explore the intricate relationship between MM cells and the BMME, focusing on how both cellular and non-cellular components of the microenvironment contribute to resistance mechanisms and prompt disease progression. These insights aim to inform future therapeutic strategies to enhance treatment options for MM patients.

多发性骨髓瘤（MM）是一种以骨髓浆细胞不受控制生长为特征的血癌。这些恶性浆细胞可以局部增殖并扩散到其他组织和器官。它们产生的m蛋白可导致各种临床症状，包括贫血、高钙血症、骨痛、骨破坏和肾功能障碍。尽管在过去的二十年中，治疗取得了重大进展，改善了许多患者的生存和预后，但耐药性仍然是一个重大的治疗挑战。这种耐药性主要是由MM细胞与骨髓微环境（BMME）之间复杂的相互作用驱动的，这使得长期疾病控制变得困难。为了改善治疗效果，有必要了解BMME如何支持MM细胞生长和存活，以及这些细胞如何逃避治疗。研究这些过程将有助于确定耐药性背后的关键机制，为开发能够克服这一挑战的靶向疗法提供途径。本文将探讨MM细胞和BMME之间的复杂关系，重点关注微环境的细胞和非细胞成分如何促进耐药机制和促进疾病进展。这些见解旨在为未来的治疗策略提供信息，以增强MM患者的治疗选择。

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Inflammatory rhabdomyoblastic tumor: A review and update 炎性横纹肌母细胞瘤：综述与最新进展

IF 2.9 3区医学 Q2 MEDICAL LABORATORY TECHNOLOGY

Seminars in Diagnostic Pathology

Pub Date : 2025-05-20 DOI: 10.1016/j.semdp.2025.150917

Andrew L. Folpe

Inflammatory rhabdomyoblastic tumors (IRMT), clinicopathologically and genetically distinct skeletal muscle tumors of borderline malignancy. These rare tumors were originally believed to represent “inflammatory leiomyosarcomas” and have also been reported as “histiocyte-rich rhabdomyoblastic tumor” and “low-grade inflammatory myogenic tumor”. In addition to representing the only skeletal muscle tumor of borderline malignancy, IRMT may also rarely progress to fully malignant rhabdomyosarcoma. The clinicopathologic, immunohistochemical and molecular genetic features of IRMT and rhabdomyosarcomas arising from IRMT are reviewed.

炎性横纹肌母细胞瘤（IRMT），临床病理和遗传上不同的交界性恶性骨骼肌肿瘤。这些罕见的肿瘤最初被认为是“炎性平滑肌肉瘤”，也有报道称是“富含组织细胞的横纹肌母细胞瘤”和“低级别炎性肌源性肿瘤”。IRMT除了是唯一的交界性恶性骨骼肌肿瘤外，也很少发展为完全恶性的横纹肌肉瘤。本文综述了IRMT和由IRMT引起的横纹肌肉瘤的临床病理、免疫组织化学和分子遗传学特征。

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Cytogenetic and molecular aberrations at diagnosis and in prognosis of multiple myeloma 细胞遗传学和分子畸变在多发性骨髓瘤诊断和预后中的作用

IF 2.9 3区医学 Q2 MEDICAL LABORATORY TECHNOLOGY

Seminars in Diagnostic Pathology

Pub Date : 2025-05-17 DOI: 10.1016/j.semdp.2025.150915

Beenu Thakral , Anjanaa Vijayanarayanan , L. Jeffrey Medeiros, Pei Lin

Multiple myeloma accounts for ∼10 % of all hematologic malignancies. It is genetically a highly heterogeneous disease. Cytogenetic aberrations can be found in only one-third of myeloma cases by karyotyping, in contrast to >90 % by interphase fluorescence in situ hybridization analysis, especially when performed on CD138-enriched plasma cells. Next generation sequencing has shown that mutations affecting the MAP kinase pathway, including KRAS, NRAS and BRAF are the most frequent driver mutations in myeloma detected in up to 40 % of cases. Biallelic TP53 inactivation is one of the most important high-risk factor that is associated with poor survival, frequency of which increases in relapsed/refractory myeloma and is rare in MGUS and SMM. De novo plasma cell leukemia is associated with frequent MYC translocations and t(11;14) while plasma cell leukemia associated with a pre-existing myeloma (so-called secondary plasma cell leukemia) more commonly harbors del(17p). Early or primary cytogenetic alterations (such as trisomies and/or one of the IGH translocation) lead to formation of a founder clone which over time expands, and evolves by acquiring additional genetic abnormalities such as copy number and epigenetic changes and secondary mutations contributing to intratumoral heterogeneity seen in myeloma. Thus, presence of clonal heterogeneity at baseline, subsequent linear and branching clonal evolution that occurs with disease progression and therapeutic selection of resistant mutant clones underscores the need for a comprehensive cytogenetic and molecular testing over time. This testing allows for a better understanding of disease pathogenesis and can inform therapeutic options for better patient care and outcomes.

多发性骨髓瘤占所有血液恶性肿瘤的10%。这是一种遗传上高度异质性的疾病。通过核型分析，只有三分之一的骨髓瘤病例可以发现细胞遗传学畸变，而通过间期荧光原位杂交分析，这一比例为90%，特别是在cd138富集的浆细胞上。下一代测序显示，影响MAP激酶通路的突变，包括KRAS、NRAS和BRAF，是骨髓瘤中最常见的驱动突变，在高达40%的病例中检测到。双等位基因TP53失活是与生存率低相关的最重要的高危因素之一，其频率在复发/难治性骨髓瘤中增加，而在MGUS和SMM中罕见。新生浆细胞白血病与频繁的MYC易位和t相关（11;14），而浆细胞白血病与先前存在的骨髓瘤（所谓的继发性浆细胞白血病）相关，更常见的是del（17p）。早期或原发性细胞遗传学改变（如三体和/或IGH易位之一）导致创始克隆的形成，该克隆随着时间的推移而扩大，并通过获得额外的遗传异常（如拷贝数和表观遗传变化）和继发性突变而进化，从而导致骨髓瘤中的肿瘤内异质性。因此，基线时克隆异质性的存在，以及随后随着疾病进展和抗性突变克隆的治疗选择而发生的线性和分支克隆进化，强调了随着时间的推移进行全面的细胞遗传学和分子检测的必要性。这种测试可以更好地了解疾病的发病机制，并可以为更好的患者护理和结果提供治疗选择。

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IF 2.9 3区医学 Q2 MEDICAL LABORATORY TECHNOLOGY

Seminars in Diagnostic Pathology

Pub Date : 2025-05-01 DOI: 10.1053/S0740-2570(25)00043-7

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Seminars in Diagnostic Pathology

Pub Date : 2025-05-01 DOI: 10.1053/S0740-2570(25)00046-2

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Seminars in Diagnostic Pathology

Pub Date : 2025-05-01 DOI: 10.1053/S0740-2570(25)00044-9

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Seminars in Diagnostic Pathology

Pub Date : 2025-05-01 DOI: 10.1053/S0740-2570(25)00045-0

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