Seminars in Diagnostic Pathology最新文献

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MASTHEAD (p/u from previous issue) 报头（p/u从上一期）

IF 2.9 3区医学 Q2 MEDICAL LABORATORY TECHNOLOGY

Seminars in Diagnostic Pathology

Pub Date : 2025-01-01 DOI: 10.1053/S0740-2570(25)00005-X

引用次数: 0

Calcifying cystic odontogenic tumour: Dilemma and pitfalls 钙化性囊性牙源性肿瘤：困境与陷阱

IF 2.9 3区医学 Q2 MEDICAL LABORATORY TECHNOLOGY

Seminars in Diagnostic Pathology

Pub Date : 2025-01-01 DOI: 10.1053/j.semdp.2024.09.005

Arushi Tomar, Sharon John, Saloni Verma, Shalini Gupta

Odontogenic lesions are a category of lesions, which are found to be arising from the remnants of the tooth-bearing tissues of the body, that can be cystic in nature as a result of degeneration or as a result of excessive proliferation of these cells, can result in the formation of odontogenic tumours which are found in gnathic bones in the body. Since their discovery in literature and the explanation provided for their pathogenesis, these lesions have been the subject of debate and controversy amongst researchers as well as practitioners. Thereby, this review has taken into consideration one such odontogenic tumour, Calcifying Cystic Odontogenic Tumour (CCOT), which first were included under the namesake (Calcifying odontogenic cyst) as a sperate subheading under this cyst, but now has been designated under the category of tumours along with various histologic subtypes classified and described henceforth. Although the lesion has been removed in the recent classification, a wide variety of lesions in biphasic form has been reported in the past. Therefore, this present review takes a sneak-peek into this lesion with insight into its presentation, incidence, aetiology, pathogenesis, histopathology and all the controversies surrounding this category of lesion and the current literature about this lesion with proving the fact that this needs to be considered again in the category of odontogenic tumours.

牙源性病变是一类病变，产生于人体残余的牙组织，由于这些细胞的变性或过度增殖，可能形成囊性病变，也可能形成牙源性肿瘤，这些肿瘤存在于人体的颌骨中。自从在文献中发现这些病变并对其发病机理做出解释以来，这些病变一直是研究人员和从业人员争论和争议的主题。钙化性囊性牙源性肿瘤（CCOT）最初作为 "钙化性囊性牙源性囊肿 "的一个独立小标题，被归入 "肿瘤 "的范畴，并对其组织学亚型进行了分类和描述。虽然在最近的分类中，该病变已被删除，但过去曾报道过多种双相形式的病变。因此，本综述将对这一病变进行深入探讨，包括其表现、发病率、病因、发病机制、组织病理学以及围绕这类病变的所有争议和有关这一病变的现有文献，并证明这一事实，即需要在牙源性肿瘤类别中再次考虑这一病变。

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引用次数: 0

Molecular insights into hybrid tumors: Exploring the heterogeneity in plexiform ameloblastoma 混合瘤的分子研究：探索丛状母细胞瘤的异质性。

IF 2.9 3区医学 Q2 MEDICAL LABORATORY TECHNOLOGY

Seminars in Diagnostic Pathology

Pub Date : 2025-01-01 DOI: 10.1053/j.semdp.2024.09.002

Dr. Sharon John , Dr. Arushi Tomar , Dr. Ayushi Jain , Dr. Shalini Gupta

For many years, odontogenic tumors have been known to present both clinical and histopathological challenges due to their origins in the epithelial, ectomesenchymal, and/or mesenchymal components of tooth-forming tissues. Gaining a comprehensive understanding of both common and rare odontogenic tumors is crucial for their effective study and clinical management. One particularly puzzling tumor is the "plexiform ameloblastoma," a variant of the solid multicystic ameloblastoma. This term describes a distinct pattern of epithelial proliferation within the cystic cavity. Numerous studies have emphasized the variability of the stromal component, further highlighting the enigmatic nature of ameloblastoma. The presence of unique and rare features, such as primitive, mature desmoplastic, hemangiomatous, or ghost cells within the stroma of plexiform ameloblastoma, underscores the differentiation potential of the neoplastic odontogenic epithelium and offers significant insights into the tissue reactions associated with this condition. This case review discusses four instances of plexiform ameloblastoma, illustrating various atypical stromal changes and their influence on patient prognosis. It also provides important criteria for analyzing stromal alterations related to this complex odontogenic tumor.

多年来，牙源性肿瘤一直是临床和组织病理学上的难题，因为它们起源于牙齿形成组织的上皮、外生性和/或间充质成分。全面了解常见和罕见的牙源性肿瘤对有效研究和临床治疗至关重要。其中一种特别令人费解的肿瘤是 "丛状釉母细胞瘤"，它是实性多囊釉母细胞瘤的一种变体。这一术语描述了囊腔内上皮增生的独特模式。大量研究强调了基质成分的可变性，进一步凸显了釉母细胞瘤的神秘性。丛状牙釉质母细胞瘤基质中存在原始的、成熟的去瘤细胞、血管瘤细胞或鬼细胞等独特而罕见的特征，强调了肿瘤性牙源性上皮的分化潜能，并为了解与该病症相关的组织反应提供了重要依据。本病例综述讨论了四例丛状牙釉质母细胞瘤，说明了各种不典型的基质变化及其对患者预后的影响。它还提供了分析这种复杂牙源性肿瘤相关基质改变的重要标准。

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引用次数: 0

Exploring the debates surrounding keratoameloblastoma: An in-depth review of an emerging entity 探讨围绕角膜成釉细胞瘤的争论：对一个新兴实体的深入回顾。

IF 2.9 3区医学 Q2 MEDICAL LABORATORY TECHNOLOGY

Seminars in Diagnostic Pathology

Pub Date : 2025-01-01 DOI: 10.1053/j.semdp.2025.01.002

Saloni Verma, Ayushi Jain, Sharon John, Prashasti Chundawat, Shalini Gupta

Ameloblastoma is a benign odontogenic epithelial tumor characterized by its aggressive behavior and a high likelihood of local recurrence if not fully excised. Ameloblastomas are a common type of slow-growing, true jaw tumor which may present as solid, multicystic or unicystic forms and originate from odontogenic epithelium and exhibit a variety of histological patterns. Keratoameloblastoma is considered to be a rare variant of ameloblastoma associated with more intense keratinization. Therefore, in this present review, authors report a case of keratoameloblastoma in a 14-year-old male and review giving a sneak-peek into this lesion with insight into the literature concerning its presentation, incidence, aetiology, clinical features, radiological appearance, histopathological findings and treatment options along with the current literature about this lesion.

成釉细胞瘤是一种良性牙源性上皮肿瘤，其特点是具有侵袭性，如果不完全切除，局部复发的可能性很高。成釉细胞瘤是一种常见的生长缓慢的真颌肿瘤，可表现为实性、多囊性或单囊性，起源于牙源性上皮，具有多种组织学类型。角膜成釉细胞瘤被认为是一种罕见的成釉细胞瘤，与更强烈的角化有关。因此，在本文的回顾中，作者报告了一例14岁男性的角膜成釉细胞瘤，并回顾了有关该病变的文献，包括其表现、发病率、病因、临床特征、放射学表现、组织病理学表现和治疗方案。

引用次数: 0

Adenoid ameloblastoma revisited: A discursive exploration of its histological dualism, molecular aberrations, and clinical recurrence 腺样绒毛膜母细胞瘤再探：对其组织学二元论、分子畸变和临床复发的辨证探索。

IF 2.9 3区医学 Q2 MEDICAL LABORATORY TECHNOLOGY

Seminars in Diagnostic Pathology

Pub Date : 2025-01-01 DOI: 10.1053/j.semdp.2024.10.001

Dr. Sakshi Deorah, Dr. Shalini Gupta

Adenoid ameloblastoma (AA) is a rare benign but locally aggressive odontogenic tumor originating from the remnants of the dental lamina or enamel organ. It was newly incorporated into the 2022 WHO classification of odontogenic lesions, standing as the sole novel entity in this update. AA is also regarded as a hybrid tumor because of the combination of histological characteristics observed in both adenomatoid odontogenic tumors and ameloblastoma. Clinically, it presents similarly to other ameloblastoma variants, with patients typically exhibiting a painless, slow-growing jaw swelling. However, this subtype is noted for its more aggressive behavior, including a higher recurrence rate and greater local invasiveness. Histopathologically, AA is distinguished by an intricate arrangement of epithelial islands, cords, and strands, generating a cribriform architectural pattern, with peripheral palisading and central stellate reticulum-like formations. Immunohistochemical profiling reveals the expression of epithelial differentiation markers, including cytokeratins, and proliferative markers such as Ki-67, further corroborating its aggressive phenotype. While its precise etiopathogenesis remains obscure, the unique histological characteristics imply a potentially distinct underlying molecular pathway. Due to its aggressive nature, AA necessitates meticulous clinical and histopathological evaluation and tailored therapeutic strategies to mitigate recurrence risks and optimize patient prognoses. Furthermore, this review integrates histological and molecular insights from recent studies conducted after its inclusion in the updated WHO classification.

腺样釉母细胞瘤（AA）是一种罕见的良性但具有局部侵袭性的牙源性肿瘤，起源于牙层或釉质器官的残余部分。它被新纳入 2022 年世界卫生组织牙源性病变分类，是此次更新中唯一的新实体。AA 也被认为是一种混合瘤，因为它结合了在牙源性腺瘤和釉母细胞瘤中观察到的组织学特征。在临床上，它的表现与其他釉母细胞瘤变体相似，患者通常表现为无痛、生长缓慢的下颌肿胀。不过，这种亚型的侵袭性更强，包括复发率更高、局部侵袭性更强。从组织病理学角度看，AA 的特征是上皮岛、索和股的复杂排列，形成楔形的建筑模式，外围有苍白化，中央有星状网状结构。免疫组化分析显示，包括细胞角蛋白在内的上皮分化标志物和 Ki-67 等增殖标志物均有表达，进一步证实了其侵袭性表型。虽然其确切的发病机制仍不明确，但其独特的组织学特征意味着其潜在的分子途径可能与众不同。由于其侵袭性，AA 需要细致的临床和组织病理学评估以及量身定制的治疗策略，以降低复发风险并优化患者预后。此外，本综述还整合了AA被纳入最新WHO分类后最新研究中的组织学和分子学观点。

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引用次数: 0

EDITORIAL BOARD (p/u from previous issue) 编辑委员会（p/u自上期）

IF 2.9 3区医学 Q2 MEDICAL LABORATORY TECHNOLOGY

Seminars in Diagnostic Pathology

Pub Date : 2025-01-01 DOI: 10.1053/S0740-2570(25)00006-1

引用次数: 0

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

IF 2.9 3区医学 Q2 MEDICAL LABORATORY TECHNOLOGY

Seminars in Diagnostic Pathology

Pub Date : 2025-01-01 DOI: 10.1053/S0740-2570(25)00007-3

引用次数: 0

Exploring the Rarity: Clinical insights and histopathological diversity of hybrid desmoplastic-plexiform ameloblastoma 探讨罕见性：混合型韧带增生-丛状成釉细胞瘤的临床观察与组织病理学多样性。

IF 2.9 3区医学 Q2 MEDICAL LABORATORY TECHNOLOGY

Seminars in Diagnostic Pathology

Pub Date : 2025-01-01 DOI: 10.1053/j.semdp.2024.12.001

Dr. Sakshi Deorah (Junior Resident), Dr. Shalini Gupta (Professor and Head)

Ameloblastoma represents a rare and locally aggressive odontogenic neoplasm, notable for its histopathological diversity. Among its subtypes, the desmoplastic and plexiform variants are relatively rare, with the hybrid form, encompassing both architectural patterns, representing an even more exceptional entity. This article delineates the clinical, radiological, and histopathological profile of a 45-year-old male presenting with pain persisting over the past month in the right posterior maxillary region. Radiographic imaging displayed a mixed radiolucent-radiopaque lesion with poorly demarcated margins, indicative of an aggressive pathology. Histopathological examination revealed a hybrid ameloblastoma, juxtaposing desmoplastic zones with densely fibrotic stroma and classic plexiform sections with epithelial strands in a reticular configuration. This unique hybrid variant underscores the complexity of ameloblastomas and necessitates comprehensive histopathological assessment, as radiological interpretations may prove insufficient for accurate diagnosis. Such detailed analysis contributes to understanding the biological behavior of this rare form, underscoring the need for heightened clinical awareness and continued investigative focus.

成釉细胞瘤是一种罕见的局部侵袭性牙源性肿瘤，以其组织病理多样性而闻名。在其亚型中，结缔组织和丛状变异相对罕见，混合形式，包括两种建筑模式，代表一个更特殊的实体。这篇文章描述了一位45岁男性的临床、放射学和组织病理学特征，他表现为右上颌后区持续疼痛超过一个月。x线影像显示一个混合的透光-不透光病变，边缘界限不清，表明病变具有侵袭性。组织病理学检查显示为混合型成釉细胞瘤，纤维组织增生区与致密纤维化间质并存，典型的丛状切片与网状结构的上皮链并列。这种独特的杂交变体强调了成釉细胞瘤的复杂性，需要全面的组织病理学评估，因为放射学解释可能不足以准确诊断。这种详细的分析有助于理解这种罕见形式的生物学行为，强调需要提高临床意识和持续的调查重点。

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引用次数: 0

Navigating controversies in primary intraosseous carcinoma: A comprehensive literature review concerning the odontogenic origin and diagnostic challenges 原发性骨内癌的争议：关于牙源性起源和诊断挑战的综合文献综述。

IF 2.9 3区医学 Q2 MEDICAL LABORATORY TECHNOLOGY

Seminars in Diagnostic Pathology

Pub Date : 2025-01-01 DOI: 10.1053/j.semdp.2025.01.001

Ayushi Jain , Sharon John , Saloni Verma , Shalini Gupta

Primary intraosseous carcinoma (PIOC) is a rare and challenging jawbone malignancy often linked to odontogenic cysts. With minimal connection to oral mucosa and a low incidence rate, PIOC presents significant diagnostic difficulties, often mimicking other odontogenic lesions. Histogenesis and the correct classification of the lesion remains debated, with theories suggesting origins from odontogenic epithelium or cysts. Chronic inflammation may contribute to malignant transformation, though genetic predispositions could also play a role in the pathogenesis. This review underscores the current knowledge of the lesion with the need for standardized diagnostic markers and an enhanced understanding of PIOC origin to improve diagnostic accuracy and treatment outcomes.

原发性骨内癌（PIOC）是一种罕见且具有挑战性的颌骨恶性肿瘤，通常与牙源性囊肿有关。PIOC与口腔黏膜的联系很小，发病率低，诊断困难，通常与其他牙源性病变相似。组织发生和病变的正确分类仍有争议，理论认为起源于牙源性上皮或囊肿。慢性炎症可能导致恶性转化，尽管遗传易感性也可能在发病机制中发挥作用。这篇综述强调了目前对这种病变的认识，需要标准化的诊断标记物，并加强对PIOC起源的了解，以提高诊断准确性和治疗结果。

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

Seminars in Diagnostic Pathology

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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