Seminars in Diagnostic Pathology最新文献

英文中文

An update on mixed phenotype acute leukemia 混合表型急性白血病的最新进展。

IF 2.9 3区医学 Q2 MEDICAL LABORATORY TECHNOLOGY

Seminars in Diagnostic Pathology

Pub Date : 2025-03-11 DOI: 10.1016/j.semdp.2025.150893

Olga K Weinberg , Bo Zhang , Sharon K Germans, Weina Chen

Mixed phenotype acute leukemias (MPALs) are a heterogeneous group of acute leukemias that show differentiation along more than one lineage. MPAL are rare and account for <5 % of all acute leukemias and demonstrate an inferior prognosis compared with standard acute lymphoblastic or myeloid leukemias. Historically, due to the limited understanding of its underlying pathogenesis, there were no well-established classification schemes, leading to difficulty in both diagnosis and treatment. With the advent of new nomenclature and algorithms, including the European Group for the Immunological Characterization of Leukemias (EGIL) scoring system, World Health Organization (WHO) tumor classification, and International Consensus Classification (ICC), these entities are better defined and there have been significant changes in clinical management. Additionally, an increasing variety of molecular and cytogenetic abnormalities have been recognized, which have improved the diagnostic classifications and may represent important potential therapeutic targets. However, due to its rarity, current evidence and recommendations on the clinical approach to MPAL are largely based on retrospective studies with relatively small cohorts, and it remains a diagnostic and therapeutic dilemma. In this review, we discuss the most updated classifications, genomic complexity, and diagnostic and therapeutic strategies for MPAL.

混合表型急性白血病（MPALs）是一种异质组急性白血病，显示分化沿着一个以上的谱系。MPAL是罕见的，而且是有原因的

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引用次数: 0

Non-invasive Lobular Neoplasia: Review and Updates 非侵袭性小叶肿瘤：回顾和最新进展。

IF 2.9 3区医学 Q2 MEDICAL LABORATORY TECHNOLOGY

Seminars in Diagnostic Pathology

Pub Date : 2025-03-04 DOI: 10.1016/j.semdp.2025.150883

Youley Tjendra , Barbara Susnik

Non-invasive lobular neoplasia (LN) encompasses atypical lobular hyperplasia (ALH), classic lobular carcinoma in situ (CLCIS), florid lobular carcinoma in situ (FLCIS), and pleomorphic lobular carcinoma in situ (PLCIS). Lobular neoplasia is a neoplastic epithelial proliferation of the terminal duct lobular unit. A defining feature is discohesion due to the loss of E-cadherin, a protein that facilitates cell-to-cell adhesion. Lobular neoplasia is both a risk factor and a non-obligate precursor of invasive breast carcinoma. Classic LN, characterized by small, non-cohesive monomorphic cells, includes ALH and classic LCIS. While classic LN is usually not seen on imaging and, therefore, is diagnosed incidentally, FLCIS and PLCIS are typically the imaging targets, most often manifesting as calcifications. Unlike classic LN, which is typically hormone receptor-positive and HER2-negative, FLCIS and PLCIS may present with less favorable phenotypes. While ALH and CLCIS diagnosed on concordant core biopsy are generally managed with surveillance with or without chemoprevention, complete surgical excision is recommended for FLCIS and PLCIS due to high upgrade rates to invasive carcinoma. Accurate classification of non-invasive breast neoplastic lesions is essential for guiding treatment. This review provides an overview of the clinical features, pathology, and management of lobular neoplasia, emphasizing the importance of accurate diagnosis and individualized patient care.

非侵袭性小叶肿瘤（LN）包括非典型小叶增生（ALH）、典型小叶原位癌（CLCIS）、花状小叶原位癌（FLCIS）和多形性小叶原位癌（PLCIS）。小叶肿瘤是小叶末端导管上皮的肿瘤增生。一个决定性的特征是由于e -钙粘蛋白（一种促进细胞间粘附的蛋白质）的丢失而导致的分离。小叶肿瘤是浸润性乳腺癌的危险因素和非专性前兆。典型LN包括ALH和典型LCIS，其特征是小而非内聚的单形细胞。虽然典型LN通常在影像学上不可见，因此是偶然诊断的，但FLCIS和PLCIS是典型的影像学目标，最常表现为钙化。与典型的激素受体阳性和her2阴性的经典LN不同，FLCIS和PLCIS可能表现出不太有利的表型。虽然通过一致性核心活检诊断出的ALH和CLCIS通常在有或没有化学预防的情况下进行监测，但由于FLCIS和PLCIS向浸润性癌的高升级率，建议对其进行完全手术切除。乳腺非侵袭性肿瘤病变的准确分类对指导治疗至关重要。本文综述了小叶肿瘤的临床特点、病理和治疗，强调了准确诊断和个体化治疗的重要性。

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The history of the microscope reflects advances in science and medicine 显微镜的历史反映了科学和医学的进步

IF 2.9 3区医学 Q2 MEDICAL LABORATORY TECHNOLOGY

Seminars in Diagnostic Pathology

Pub Date : 2025-03-01 DOI: 10.1053/j.semdp.2024.01.002

Caitlin A. Noble , Andrew P. Biesemier , Sarah F. McClees , Aljunaid M. Alhussain , Stephen E. Helms , Robert T. Brodell

Microscopes, more than any other instrument, reflect advances in clinical medicine over the past several hundred years. As the primary tool of the pathologist, they were, and continue to be, a key connector between the bedside and basic sciences. One specific example is the science of clinical dermatology, which relies on clinical-pathologic correlation to make a definitive diagnosis. The microscopes used by pathologists, however, are more than scientific artifacts. Many antique microscopes are hand-crafted works of art. Even while recognizing that light microscopes may soon be obsolete as scanned slides and computer joy-sticks replace optical instruments in patient care and teaching, their significance will not be diminished. The microscope will never be forgotten in the history, art, and science of medicine, for these instruments set the social and cultural stage for modern, scientific patient care.

显微镜比其他任何仪器都更能反映过去几百年来临床医学的进步。作为病理学家的主要工具，显微镜过去是、现在仍然是连接床旁和基础科学的关键纽带。临床皮肤病学就是一个具体的例子，它依赖于临床与病理的相关性来做出明确诊断。然而，病理学家使用的显微镜不仅仅是科学工艺品。许多古董显微镜都是手工制作的艺术品。虽然随着扫描切片和计算机操纵杆在患者护理和教学中取代光学仪器，光学显微镜可能很快就会被淘汰，但它们的意义并没有因此而减弱。显微镜在医学的历史、艺术和科学中永远不会被遗忘，因为这些仪器为现代科学的病人护理奠定了社会和文化基础。

引用次数: 0

Mark Wick contributions to pathology of the mediastinum 马克-维克对纵隔病理学的贡献

IF 2.9 3区医学 Q2 MEDICAL LABORATORY TECHNOLOGY

Seminars in Diagnostic Pathology

Pub Date : 2025-03-01 DOI: 10.1053/j.semdp.2024.01.006

Horacio Maluf

Mark Wick made a wide range of contributions to the field of mediastinal pathology. Early papers amplified the spectrum of neuroendocrine carcinomas of the thymus and brought attention to the aggressive nature of this tumor, also highlighting the occurrence of coexisting carcinoid tumor and small cell carcinoma of this organ. The controversial issue of thymoma classification was addressed in several papers and editorial comments, while also reporting a case of metastatic thymoma. A series of thymic carcinomas as well a report on the unusual clear cell variant bear his name as one of the authors. He summarized the topic of mediastinal cyst in a review published in 2005. Sarcomas arising in mediastinal germ cell tumors were also within the purview of his interests, with a publication of series of seven cases. He reviewed the topic of inflammatory myofibroblastic tumor of the heart and added a case to the existing literature. Two books dedicated to different aspect of mediastinal pathology also carry his name in the front cover in association with Drs Taazelar in one and Marchevsky in the other.

马克-维克在纵隔病理学领域做出了广泛的贡献。早期的论文扩大了胸腺神经内分泌癌的范围，使人们注意到这种肿瘤的侵袭性，还强调了该器官类癌和小细胞癌并存的情况。多篇论文和编辑评论探讨了胸腺瘤分类的争议问题，同时还报告了一例转移性胸腺瘤。他还是一系列胸腺癌以及不常见的透明细胞变异的报告的作者之一。他在 2005 年发表的一篇综述中总结了纵隔囊肿这一主题。纵隔生殖细胞瘤引起的肉瘤也是他关注的范围，他发表了七例系列病例。他回顾了心脏炎性肌纤维母细胞瘤这一主题，并在现有文献中增加了一个病例。他还与 Taazelar 医生和 Marchevsky 医生合作出版了两本关于纵隔病理学不同方面的书籍，其中一本的封面上还印有他的名字。

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引用次数: 0

Clinical-pathologic correlation: The impact of grossing at the bedside 临床与病理相关性：床旁大体检查的影响

IF 2.9 3区医学 Q2 MEDICAL LABORATORY TECHNOLOGY

Seminars in Diagnostic Pathology

Pub Date : 2025-03-01 DOI: 10.1053/j.semdp.2024.01.007

C. Alexis Noble , Chinmoy Bhate , Buu T. Duong , Allison R. Cruse , Robert T. Brodell , Riley C. Hanus

The unenlightened clinician may submit a skin specimen to the lab and expect an “answer.” The experienced clinician knows that in performing skin biopsies, it is critical to select the most appropriate: 1) anatomic location for the biopsy¹^,²; 2) type of biopsy¹^,²; 3) depth and breadth of the biopsy; and 4) medium for hematoxylin and eosin staining (formalin) or direct immunofluorescence (Michel's Transport Medium or normal saline).² Demographic information, anatomic location, clinical context, and differential diagnosis are all critical components of a properly completed requisition form.3, 4, 5 Proper biopsy design and appropriate grossing of the tissue at the bedside should be added to this list. In this article, we review the basics of gross pathologic examination and then provide four examples to demonstrate that optimal clinical-pathologic correlation requires the clinician consider the needs of the pathologist when tissue is presented to the lab.

不开明的临床医生可能会将皮肤标本提交给实验室，并期待得到 "答案"。有经验的临床医生知道，在进行皮肤活检时，选择最合适的方法至关重要：1) 活检的解剖位置1,2；2) 活检的类型1,2；3) 活检的深度和广度；4) 苏木精和伊红染色（福尔马林）或直接免疫荧光（米歇尔转运培养基或生理盐水）的培养基2。人口统计学信息、解剖位置、临床背景和鉴别诊断都是正确填写申请表的重要组成部分3,4,5。此外，正确的活检设计和在床旁对组织进行适当的毛细处理也应包括在内。在本文中，我们将回顾病理大体检查的基础知识，然后举出四个例子来说明，要实现最佳的临床-病理相关性，临床医生就必须在组织提交给实验室时考虑到病理学家的需求。

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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

Seminars in Diagnostic Pathology

Pub Date : 2025-03-01 DOI: 10.1053/S0740-2570(25)00022-X

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

Seminars in Diagnostic Pathology

Pub Date : 2025-03-01 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

MASTHEAD (p/u from previous issue) MASTHEAD （P/U 自上期起）

IF 2.9 3区医学 Q2 MEDICAL LABORATORY TECHNOLOGY

Seminars in Diagnostic Pathology

Pub Date : 2025-03-01 DOI: 10.1053/S0740-2570(25)00021-8

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

Seminars in Diagnostic Pathology

Pub Date : 2025-03-01 DOI: 10.1053/S0740-2570(25)00023-1

引用次数: 0

Contributions of Dr. Wick to the pathology of diseases of the lung and pleura 维克博士对肺和胸膜疾病病理学的贡献。

IF 2.9 3区医学 Q2 MEDICAL LABORATORY TECHNOLOGY

Seminars in Diagnostic Pathology

Pub Date : 2025-03-01 DOI: 10.1053/j.semdp.2024.01.005

Saul Suster

The curriculum vitae of Dr. Mark R. Wick contains 57 peer-reviewed publications, 3 editorials, 6 book chapters and a whole book dedicated to diseases of the lung and pleura. It is remarkable that such productivity should represent only a small portion of the overall output of Dr. Wick, which includes (at last count) 341 original peer-review publications, 119 invited review articles, 93 book chapters, 42 editorials, 3 society-related position papers, 18 books and 2 interactive video disks. Yet, his contributions to the literature in pulmonary and pleural pathology have been significant and influential and have established for him a national and international reputation as one of the leading experts in pulmonary pathology. Herein, it is my privilege to recount the various publications contributed by Dr. Wick to this topic, which span the gamut from transplant pathology to neoplastic diseases of the lung and pleura.

马克-R.-维克博士的简历中包含 57 篇同行评审出版物、3 篇社论、6 章著作和一本专门讨论肺和胸膜疾病的专著。令人瞩目的是，这样的成果仅占 Wick 博士总成果的一小部分，他的总成果包括（最新统计）341 篇原创同行评审出版物、119 篇特邀评论文章、93 篇书籍章节、42 篇社论、3 篇与社会相关的立场文件、18 本书籍和 2 盘互动视频。然而，他对肺和胸膜病理学文献的贡献是巨大和有影响力的，并为他建立了作为肺病理学顶尖专家之一的国内和国际声誉。在此，我很荣幸地介绍威克博士在这一领域发表的各种著作，这些著作涵盖了从移植病理学到肺部和胸膜肿瘤疾病的各个领域。

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全部化学•材料生命科学医学物理工程技术环境•农林材料科学地球科学法学管理学化学环境科学与生态学计算机科学教育学经济学农林科学人文科学生物学数学物理与天体物理心理学综合性期刊其他工业工程理学历史学农学文学信息工程

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全部 ACS Publications Elsevier ieeexplore Springer The Royal Society of Chemistry Wiley

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