Pub Date : 2025-03-01DOI: 10.1016/j.semdp.2025.150895
Justin A. Bishop
{"title":"Festschrift for Drs. Wick and Santa Cruz","authors":"Justin A. Bishop","doi":"10.1016/j.semdp.2025.150895","DOIUrl":"10.1016/j.semdp.2025.150895","url":null,"abstract":"","PeriodicalId":49548,"journal":{"name":"Seminars in Diagnostic Pathology","volume":"42 2","pages":"Article 150895"},"PeriodicalIF":2.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143619274","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-21DOI: 10.1053/j.semdp.2025.02.002
Baris Boyraz, Syed A. Hoda
In the second part of this two-part review series, we revisit Chapter X of the seminal textbook Problems in Breast Pathology written by Dr. John G. Azzopardi and discuss breast malignancies which may be underdiagnosed. We include the two major lesions covered in Dr. Azzopardi's textbook: ductal carcinoma in situ and lobular carcinoma in situ. Furthermore, we discuss microinvasive carcinoma, residual invasive carcinoma status-post neoadjuvant treatment and carcinomas with certain morphologic features which may lead to underdiagnosis. While discussing these lesions, we highlight problems raised by Dr. Azzopardi and discuss both their morphologic features as well as ancillary tools developed since then to aid reaching the diagnosis.
在这个由两部分组成的回顾系列的第二部分，我们将重温由John G. Azzopardi博士撰写的开创性教科书《乳腺病理学问题》的第十章，并讨论可能未被诊断的乳腺恶性肿瘤。我们包括Azzopardi博士的教科书中涵盖的两个主要病变：导管原位癌和小叶原位癌。此外，我们还讨论了微创癌、新辅助治疗后残留浸润癌的状态以及具有某些可能导致漏诊的形态学特征的癌。在讨论这些病变时，我们强调Azzopardi博士提出的问题，并讨论了它们的形态学特征以及自那时以来开发的辅助工具，以帮助达到诊断。
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Pub Date : 2025-02-21DOI: 10.1053/j.semdp.2025.02.001
Baris Boyraz, Syed A. Hoda
Dr. John G. Azzopardi's textbook Problems in Breast Pathology is a critical work for breast pathologists. His observations on over- and underdiagnosis of breast malignancy are summarized in two chapters which are highly educational for everyday practice to reach an accurate diagnosis. Almost five decades later, his observations are still valid, and the same problems persist. In two separate reviews, we revisit these chapters and discuss these diagnostic challenges with an updated perspective and include developments (most importantly immunohistochemistry) in the field since then. In part I, lesions which may be overdiagnosed as malignancy are discussed, including those that were covered in Dr. Azzopardi's textbook (mainly sclerosing adenosis and radial scar) and some others that exert challenges on the pathologist. In part II, we will cover underdiagnosis of breast malignancy.
John G. Azzopardi博士的教科书《乳腺病理学问题》是乳腺病理学家的重要著作。他对乳腺恶性肿瘤的过度诊断和诊断不足的观察总结在两章，这是高度教育的日常实践，以达到准确的诊断。近五十年后，他的观察仍然有效，同样的问题仍然存在。在两篇单独的评论中，我们重新审视这些章节，并以更新的视角讨论这些诊断挑战，并包括自那时以来该领域的发展（最重要的是免疫组织化学）。在第一部分中，讨论了可能被过度诊断为恶性肿瘤的病变，包括Azzopardi博士教科书中涵盖的病变（主要是硬化性腺病和放射状疤痕）和其他一些对病理学家构成挑战的病变。在第二部分，我们将介绍乳腺恶性肿瘤的诊断不足。
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Pub Date : 2025-01-01DOI: 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。
{"title":"Intricacies of plexiform unicystic ameloblastoma: A rare intraluminal journey in the jaw","authors":"Dr. Sakshi Deorah , Dr. Sharon John , Dr. Shalini Gupta","doi":"10.1053/j.semdp.2024.11.001","DOIUrl":"10.1053/j.semdp.2024.11.001","url":null,"abstract":"<div><div>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.</div></div>","PeriodicalId":49548,"journal":{"name":"Seminars in Diagnostic Pathology","volume":"42 1","pages":"Pages 18-21"},"PeriodicalIF":2.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142639912","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-01DOI: 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.
{"title":"Sclerosing Odontogenic Carcinoma: UPLIFTS and pitfalls","authors":"Arushi Tomar , Sharon John , Shalini Gupta","doi":"10.1053/j.semdp.2024.09.004","DOIUrl":"10.1053/j.semdp.2024.09.004","url":null,"abstract":"<div><div>Sclerosing Odontogrenic Carcinoma (SOC) is a recent addition to the category of odontogenic tumours, which was first described by Koutlas <em>et al</em>. 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.</div></div>","PeriodicalId":49548,"journal":{"name":"Seminars in Diagnostic Pathology","volume":"42 1","pages":"Pages 29-32"},"PeriodicalIF":2.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142299517","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ameloblastomas (AM) are locally aggressive tumors, with hemangiomatous ameloblastoma (HA) being a rare subtype characterized by vascular proliferation, predominantly in the stroma but occasionally within the epithelial component. We report a case of a 32-year-old male with recurrent mandibular swelling, histopathologically diagnosed as unicystic HA, showing vascularity in both stroma and odontogenic epithelial islands with GLUT1 positivity in the latter. A review of 31 cases revealed a male predilection, mandibular dominance (89.74 %), and overlap with conventional AM features. Vascularity in HA is attributed to reactive, neoplastic, or angiogenic mechanisms, with rare epithelial involvement suggesting aberrant angiogenesis or vascular mimicry. Further research is essential to clarify its pathogenesis and clinical implications.
{"title":"Hemangiomatous ameloblastoma; A separate entity?”","authors":"Roshna Sankar , Sharon John , Priya Devi , Saloni Verma , Priyanka Singh , Shalini Gupta","doi":"10.1053/j.semdp.2025.01.003","DOIUrl":"10.1053/j.semdp.2025.01.003","url":null,"abstract":"<div><div>Ameloblastomas (AM) are locally aggressive tumors, with hemangiomatous ameloblastoma (HA) being a rare subtype characterized by vascular proliferation, predominantly in the stroma but occasionally within the epithelial component. We report a case of a 32-year-old male with recurrent mandibular swelling, histopathologically diagnosed as unicystic HA, showing vascularity in both stroma and odontogenic epithelial islands with GLUT1 positivity in the latter. A review of 31 cases revealed a male predilection, mandibular dominance (89.74 %), and overlap with conventional AM features. Vascularity in HA is attributed to reactive, neoplastic, or angiogenic mechanisms, with rare epithelial involvement suggesting aberrant angiogenesis or vascular mimicry. Further research is essential to clarify its pathogenesis and clinical implications.</div></div>","PeriodicalId":49548,"journal":{"name":"Seminars in Diagnostic Pathology","volume":"42 1","pages":"Pages 44-49"},"PeriodicalIF":2.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143043073","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The Calcifying Odontogenic Cysts (COC) displays a wide range of clinical and histopathological variations as well as diverse biological behaviors. This diversity has led to confusion and disagreement regarding the terminology and classification of this lesion. The previous classification attempts to categorize COC into two concepts. The first concept, termed "monistic," suggests that all COCs are neoplastic despite the majority being cystic in structure and seemingly non-neoplastic. The second concept, known as "dualistic," posits that COC comprises two distinct entities: a cyst and a neoplasm. This research discusses various previous classifications of COC found in the literature and proposes a new, straightforward universal classification based solely on histopathology, aiming to facilitate understanding for surgeons.
Material and methods
Fifteen cases of COC have been collected with clinicopathological parameters including detailed information regarding patient demographics, symptoms, anatomical site, radiological characteristics, duration of evolution, recurrence, and types of histopathology according to the proposed classification.
Result
A total of fifteen cases of COC were analyzed. According to the histological analysis of the proposed classification Type 1: 5 (33.3), Type II: 4 (26.6), Type III: 3(20), and Type IV:3(20) and recurrence in 3 (20 %) of cases.
Conclusion
It simplifies the complexities arising from variations in the cystic linings of type IV of COC, which can be overlooked and have caused recurrence in the current research. Therefore, the key requirement for arriving at a validated and practical conclusion lies in the accurate histological classification of calcifying odontogenic cysts and their impact on treatment.
{"title":"Calcifying odontogenic cysts: A novel outlook on classification, diagnosis and management","authors":"Sharon John, Priya Devi, Kriti Sharma, Roshna Sankar, Shalini Gupta","doi":"10.1053/j.semdp.2024.08.006","DOIUrl":"10.1053/j.semdp.2024.08.006","url":null,"abstract":"<div><h3>Background</h3><div>The Calcifying Odontogenic Cysts (COC) displays a wide range of clinical and histopathological variations as well as diverse biological behaviors. This diversity has led to confusion and disagreement regarding the terminology and classification of this lesion. The previous classification attempts to categorize COC into two concepts. The first concept, termed \"monistic,\" suggests that all COCs are neoplastic despite the majority being cystic in structure and seemingly non-neoplastic. The second concept, known as \"dualistic,\" posits that COC comprises two distinct entities: a cyst and a neoplasm. This research discusses various previous classifications of COC found in the literature and proposes a new, straightforward universal classification based solely on histopathology, aiming to facilitate understanding for surgeons.</div></div><div><h3>Material and methods</h3><div>Fifteen cases of COC have been collected with clinicopathological parameters including detailed information regarding patient demographics, symptoms, anatomical site, radiological characteristics, duration of evolution, recurrence, and types of histopathology according to the proposed classification.</div></div><div><h3>Result</h3><div>A total of fifteen cases of COC were analyzed. According to the histological analysis of the proposed classification Type 1: 5 (33.3), Type II: 4 (26.6), Type III: 3(20), and Type IV:3(20) and recurrence in 3 (20 %) of cases.</div></div><div><h3>Conclusion</h3><div>It simplifies the complexities arising from variations in the cystic linings of type IV of COC, which can be overlooked and have caused recurrence in the current research. Therefore, the key requirement for arriving at a validated and practical conclusion lies in the accurate histological classification of calcifying odontogenic cysts and their impact on treatment.</div></div>","PeriodicalId":49548,"journal":{"name":"Seminars in Diagnostic Pathology","volume":"42 1","pages":"Pages 1-4"},"PeriodicalIF":2.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142114073","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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.
{"title":"An unusual presentation of calcifying odontogenic cyst with literature review","authors":"Priya Devi , Sharon John , Saloni Verma , Roshna Sankar , Rajeev Kumar Singh , Shalini Gupta","doi":"10.1053/j.semdp.2024.09.003","DOIUrl":"10.1053/j.semdp.2024.09.003","url":null,"abstract":"<div><div>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.</div></div>","PeriodicalId":49548,"journal":{"name":"Seminars in Diagnostic Pathology","volume":"42 1","pages":"Pages 33-36"},"PeriodicalIF":2.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142299515","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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