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Acellular mucin in non-neoplastic inflammatory conditions of lower gastrointestinal tract
IF 1.5 4区 医学 Q3 PATHOLOGY
Annals of Diagnostic Pathology
Pub Date : 2025-02-07 DOI: 10.1016/j.anndiagpath.2025.152449
Zhiyan Fu , Eundong Park , Hasan Basri Aydin , Neharika Shrestha , Liz M. Yang , Antranik Dabaghian , Hwajeong Lee

Purpose

In the context of neoplasia, acellular mucin in lower gastrointestinal (GI) tract implies occult mucin-producing tumor and warrants additional workup. The clinical significance of acellular mucin in benign conditions remains unclear.

Methods

Lower GI tract surgical specimens with acellular mucin without documented neoplastic conditions (colonic diverticulitis (n = 16), appendicitis (n = 14), and others (n = 8)) were retrieved. Low grade appendiceal mucinous neoplasm (LAMN) (n = 24) and diverticulitis without acellular mucin (n = 28) were used as controls for appendicitis and diverticulitis cases, respectively. Clinical data, histological findings, and additional workups performed due to acellular mucin were collected.

Results

Patients with appendicitis with acellular mucin frequently presented with signs and symptoms of acute appendicitis (p = 0.016) compared to LAMN. 71 % were interval appendectomy, and 57 % had diverticula. In colonic diverticulitis cohort, no differences were found in terms of the duration of symptoms, age, gender and the degree of inflammation between the groups with and without acellular mucin. Seven of 8 patients with other conditions with acellular mucin had a history of abdominal surgery or fistula. Additional workup included levels (n = 7), consults (n = 11), and stains (n = 4).

Conclusion

Acellular mucin can be seen in a variety of benign conditions but this phenomenon is probably under-recognized and leads to additional investigations. Acellular mucin is likely translocated from the lumen through diverticulum or mural defect. Considering clinical context is crucial in providing accurate diagnosis while preserving laboratory resources.
{"title":"Acellular mucin in non-neoplastic inflammatory conditions of lower gastrointestinal tract","authors":"Zhiyan Fu ,&nbsp;Eundong Park ,&nbsp;Hasan Basri Aydin ,&nbsp;Neharika Shrestha ,&nbsp;Liz M. Yang ,&nbsp;Antranik Dabaghian ,&nbsp;Hwajeong Lee","doi":"10.1016/j.anndiagpath.2025.152449","DOIUrl":"10.1016/j.anndiagpath.2025.152449","url":null,"abstract":"<div><h3>Purpose</h3><div>In the context of neoplasia, acellular mucin in lower gastrointestinal (GI) tract implies occult mucin-producing tumor and warrants additional workup. The clinical significance of acellular mucin in benign conditions remains unclear.</div></div><div><h3>Methods</h3><div>Lower GI tract surgical specimens with acellular mucin without documented neoplastic conditions (colonic diverticulitis (n = 16), appendicitis (n = 14), and others (n = 8)) were retrieved. Low grade appendiceal mucinous neoplasm (LAMN) (n = 24) and diverticulitis without acellular mucin (n = 28) were used as controls for appendicitis and diverticulitis cases, respectively. Clinical data, histological findings, and additional workups performed due to acellular mucin were collected.</div></div><div><h3>Results</h3><div>Patients with appendicitis with acellular mucin frequently presented with signs and symptoms of acute appendicitis (p = 0.016) compared to LAMN. 71 % were interval appendectomy, and 57 % had diverticula. In colonic diverticulitis cohort, no differences were found in terms of the duration of symptoms, age, gender and the degree of inflammation between the groups with and without acellular mucin. Seven of 8 patients with other conditions with acellular mucin had a history of abdominal surgery or fistula. Additional workup included levels (n = 7), consults (n = 11), and stains (n = 4).</div></div><div><h3>Conclusion</h3><div>Acellular mucin can be seen in a variety of benign conditions but this phenomenon is probably under-recognized and leads to additional investigations. Acellular mucin is likely translocated from the lumen through diverticulum or mural defect. Considering clinical context is crucial in providing accurate diagnosis while preserving laboratory resources.</div></div>","PeriodicalId":50768,"journal":{"name":"Annals of Diagnostic Pathology","volume":"76 ","pages":"Article 152449"},"PeriodicalIF":1.5,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143403584","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Brachyury expression is highly specific for chordoma: A tissue microarray study involving 14,976 cancers from 135 different tumor types and subtypes
IF 1.5 4区 医学 Q3 PATHOLOGY
Annals of Diagnostic Pathology
Pub Date : 2025-02-06 DOI: 10.1016/j.anndiagpath.2025.152448
Piero Caneve , Nina Schraps , Katharina Möller , Seyma Büyücek , Florian Lutz , Viktoria Chirico , Florian Viehweger , Viktor Reiswich , Clara von Bargen , Simon Kind , Anne Menz , Martina Kluth , Claudia Hube-Magg , Christian Bernreuther , Guido Sauter , Andreas H. Marx , Ronald Simon , Till Krech , Stefan Steurer , Christoph Fraune , Andreas M. Luebke
Brachyury protein plays a role in defining the midline of bilaterian organisms. Commonly expressed in chordomas, brachyury immunohistochemistry is used to distinguish chordomas from their differential diagnoses. However, brachyury expression has also been described to frequently occur in other cancer entities. To better comprehend the role of brachyury expression in cancer, a tissue microarray containing 14,976 samples from 135 different tumor entities and 608 samples of 76 different normal tissue types were analyzed by immunohistochemistry. Brachyury staining was found in 55 (0.44 %) of the 12,409 interpretable tumor samples, including 37 (0.3 %) with weak, 10 (0.08 %) with moderate, and 8 (0.06 %) with strong positivity. Brachyury staining strongly predominated in chordomas. Of ten chordomas, 7 were strongly and 3 moderately positive. Only 5 of the 134 analyzed further tumor categories showed brachyury staining, 4 of which originated from testicular germ cells. Brachyury positivity occurred in 21.4 % of 42 yolk sac tumors, 15.2 % of 46 embryonal carcinomas, 4.4 % of 562 seminomas, and 2.4 % of 41 teratomas of the testis. Our data support the previously suggested high specificity of brachyury for chordoma detection, and demonstrate that germ cell tumors represent the only additional group of unrelated cancer entities expressing brachyury at a significant level.
{"title":"Brachyury expression is highly specific for chordoma: A tissue microarray study involving 14,976 cancers from 135 different tumor types and subtypes","authors":"Piero Caneve ,&nbsp;Nina Schraps ,&nbsp;Katharina Möller ,&nbsp;Seyma Büyücek ,&nbsp;Florian Lutz ,&nbsp;Viktoria Chirico ,&nbsp;Florian Viehweger ,&nbsp;Viktor Reiswich ,&nbsp;Clara von Bargen ,&nbsp;Simon Kind ,&nbsp;Anne Menz ,&nbsp;Martina Kluth ,&nbsp;Claudia Hube-Magg ,&nbsp;Christian Bernreuther ,&nbsp;Guido Sauter ,&nbsp;Andreas H. Marx ,&nbsp;Ronald Simon ,&nbsp;Till Krech ,&nbsp;Stefan Steurer ,&nbsp;Christoph Fraune ,&nbsp;Andreas M. Luebke","doi":"10.1016/j.anndiagpath.2025.152448","DOIUrl":"10.1016/j.anndiagpath.2025.152448","url":null,"abstract":"<div><div>Brachyury protein plays a role in defining the midline of bilaterian organisms. Commonly expressed in chordomas, brachyury immunohistochemistry is used to distinguish chordomas from their differential diagnoses. However, brachyury expression has also been described to frequently occur in other cancer entities. To better comprehend the role of brachyury expression in cancer, a tissue microarray containing 14,976 samples from 135 different tumor entities and 608 samples of 76 different normal tissue types were analyzed by immunohistochemistry. Brachyury staining was found in 55 (0.44 %) of the 12,409 interpretable tumor samples, including 37 (0.3 %) with weak, 10 (0.08 %) with moderate, and 8 (0.06 %) with strong positivity. Brachyury staining strongly predominated in chordomas. Of ten chordomas, 7 were strongly and 3 moderately positive. Only 5 of the 134 analyzed further tumor categories showed brachyury staining, 4 of which originated from testicular germ cells. Brachyury positivity occurred in 21.4 % of 42 yolk sac tumors, 15.2 % of 46 embryonal carcinomas, 4.4 % of 562 seminomas, and 2.4 % of 41 teratomas of the testis. Our data support the previously suggested high specificity of brachyury for chordoma detection, and demonstrate that germ cell tumors represent the only additional group of unrelated cancer entities expressing brachyury at a significant level.</div></div>","PeriodicalId":50768,"journal":{"name":"Annals of Diagnostic Pathology","volume":"76 ","pages":"Article 152448"},"PeriodicalIF":1.5,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143377899","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Salivary gland-like low-grade clear cell carcinomas of the thoracic cavity: A clinical, immunohistochemical, and molecular analysis of three cases
IF 1.5 4区 医学 Q3 PATHOLOGY
Annals of Diagnostic Pathology
Pub Date : 2025-01-31 DOI: 10.1016/j.anndiagpath.2025.152446
Annikka Weissferdt , Bruce Wenig , Cesar A. Moran
Three cases of an unusual neoplasm with striking clear cell features resembling salivary gland origin of the thoracic cavity are presented. The patients were three men between the ages of 52 and 69 years (average: 60.5 years), who presented with non-specific symptoms, such as chest pain, cough, and dyspnea. Diagnostic imaging showed that two tumors were intrapulmonary neoplasms, one in right lower lobe and one in the left upper lobe, while the third tumor was located in the anterior mediastinum. Surgical resection was accomplished in all cases. Grossly, the tumors were described as light tan, soft and well-delineated. Necrosis and hemorrhage were not present. Histologically, the three tumors showed similar morphological features consisting of a neoplastic cellular proliferation arranged in small lobules and round glandular structures, some of which contained amorphous eosinophilic secretions. Individual tumor cells had abundant clear cytoplasm, round nuclei, and inconspicuous nucleoli. Cellular atypia was minimal and only scattered mitotic figures were present. Immunohistochemical studies showed that the tumor cells were positive for pancytokeratin and GATA-3, focally and weakly positive for DOG1 and TRPS1 while negative for numerous other epithelial and neuroendocrine markers. Molecular analysis showed negative results for EGFR, ROS1, or ALK mutation, MAML2 and EWSR1 rearrangement and ETV6::NTRK3 fusion, respectively. Clinical follow up showed that all patients were alive without tumor recurrence or metastasis. We believe that the histological features, immunohistochemical profile, and the results of the molecular analysis are supportive of a yet undescribed tumor entity, provisionally designated as salivary gland-like low-grade clear cell carcinomas.
{"title":"Salivary gland-like low-grade clear cell carcinomas of the thoracic cavity: A clinical, immunohistochemical, and molecular analysis of three cases","authors":"Annikka Weissferdt ,&nbsp;Bruce Wenig ,&nbsp;Cesar A. Moran","doi":"10.1016/j.anndiagpath.2025.152446","DOIUrl":"10.1016/j.anndiagpath.2025.152446","url":null,"abstract":"<div><div>Three cases of an unusual neoplasm with striking clear cell features resembling salivary gland origin of the thoracic cavity are presented. The patients were three men between the ages of 52 and 69 years (average: 60.5 years), who presented with non-specific symptoms, such as chest pain, cough, and dyspnea. Diagnostic imaging showed that two tumors were intrapulmonary neoplasms, one in right lower lobe and one in the left upper lobe, while the third tumor was located in the anterior mediastinum. Surgical resection was accomplished in all cases. Grossly, the tumors were described as light tan, soft and well-delineated. Necrosis and hemorrhage were not present. Histologically, the three tumors showed similar morphological features consisting of a neoplastic cellular proliferation arranged in small lobules and round glandular structures, some of which contained amorphous eosinophilic secretions. Individual tumor cells had abundant clear cytoplasm, round nuclei, and inconspicuous nucleoli. Cellular atypia was minimal and only scattered mitotic figures were present. Immunohistochemical studies showed that the tumor cells were positive for pancytokeratin and GATA-3, focally and weakly positive for DOG1 and TRPS1 while negative for numerous other epithelial and neuroendocrine markers. Molecular analysis showed negative results for <em>EGFR</em>, <em>ROS1</em>, or <em>ALK</em> mutation<em>, MAML2 and EWSR1</em> rearrangement and <em>ETV6::NTRK3</em> fusion, respectively. Clinical follow up showed that all patients were alive without tumor recurrence or metastasis. We believe that the histological features, immunohistochemical profile, and the results of the molecular analysis are supportive of a yet undescribed tumor entity, provisionally designated as <em>salivary gland-like low-grade clear cell carcinomas</em>.</div></div>","PeriodicalId":50768,"journal":{"name":"Annals of Diagnostic Pathology","volume":"75 ","pages":"Article 152446"},"PeriodicalIF":1.5,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143076452","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Utility of the manual hematology cell counter for Ki-67 assessment in gastrointestinal and pancreatobiliary well-differentiated neuroendocrine tumors
IF 1.5 4区 医学 Q3 PATHOLOGY
Annals of Diagnostic Pathology
Pub Date : 2025-01-30 DOI: 10.1016/j.anndiagpath.2025.152443
Arkar Htoo , Soe Htet Arker , Rose Sneha George , Lorene Chung , Anne Chen
In the World Health Organization (WHO) 5th edition, prognosis of gastrointestinal (GI) well-differentiated neuroendocrine tumors (WDNET) depends on proliferation rate, commonly assessed by ki-67 immunohistochemical stain. In daily practice, the gold standard for WHO grade assessment by ki-67 staining, printing a photo of a tumor hotspot, counting the number of ki-67-positive cells out of 500 tumor cells, and calculating a percentage, is time-consuming and many cases are eyeballed. This study investigates the utility of a common tool, the manual cell counter used in hematology smear cell counting, for GI WDNET ki-67 counting. Of 59 resections, the number of cases with a WHO grade difference between gold standard print-and-count and the original report, eyeballing, and hematology counter method, was 23 (39 %), 14 (24 %) and 7 (12 %) cases, respectively. Of 37 biopsies, the number of cases with a WHO grade difference between gold standard print-and-count and the original report, eyeballing, and hematology counter method, was 10 (27 %), 12 (32 %) and 7 (19 %) cases, respectively. For resections, Chi square analysis comparing hematology counter method versus original report, where many cases were likely eyeballed, showed statistically significantly less cases with differing WHO grades from gold standard print-and-count for hematology counter-assessed cases (P = 0.0007), and the same Chi square analysis was marginally not significant (P = 0.09) for hematology counter versus eyeballing. Times taken to perform hematology counter method were statistically significantly lower than times taken for print-and-count. This study suggests the hematology cell counter could strike a reasonable balance between time and accuracy for WDNET resections.
{"title":"Utility of the manual hematology cell counter for Ki-67 assessment in gastrointestinal and pancreatobiliary well-differentiated neuroendocrine tumors","authors":"Arkar Htoo ,&nbsp;Soe Htet Arker ,&nbsp;Rose Sneha George ,&nbsp;Lorene Chung ,&nbsp;Anne Chen","doi":"10.1016/j.anndiagpath.2025.152443","DOIUrl":"10.1016/j.anndiagpath.2025.152443","url":null,"abstract":"<div><div>In the World Health Organization (WHO) 5th edition, prognosis of gastrointestinal (GI) well-differentiated neuroendocrine tumors (WDNET) depends on proliferation rate, commonly assessed by ki-67 immunohistochemical stain. In daily practice, the gold standard for WHO grade assessment by ki-67 staining, printing a photo of a tumor hotspot, counting the number of ki-67-positive cells out of 500 tumor cells, and calculating a percentage, is time-consuming and many cases are eyeballed. This study investigates the utility of a common tool, the manual cell counter used in hematology smear cell counting, for GI WDNET ki-67 counting. Of 59 resections, the number of cases with a WHO grade difference between gold standard print-and-count and the original report, eyeballing, and hematology counter method, was 23 (39 %), 14 (24 %) and 7 (12 %) cases, respectively. Of 37 biopsies, the number of cases with a WHO grade difference between gold standard print-and-count and the original report, eyeballing, and hematology counter method, was 10 (27 %), 12 (32 %) and 7 (19 %) cases, respectively. For resections, Chi square analysis comparing hematology counter method versus original report, where many cases were likely eyeballed, showed statistically significantly less cases with differing WHO grades from gold standard print-and-count for hematology counter-assessed cases (P = 0.0007), and the same Chi square analysis was marginally not significant (P = 0.09) for hematology counter versus eyeballing. Times taken to perform hematology counter method were statistically significantly lower than times taken for print-and-count. This study suggests the hematology cell counter could strike a reasonable balance between time and accuracy for WDNET resections.</div></div>","PeriodicalId":50768,"journal":{"name":"Annals of Diagnostic Pathology","volume":"75 ","pages":"Article 152443"},"PeriodicalIF":1.5,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143145236","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The diagnostic utility of SOX11 Immunohistochemical expression in malignant peripheral nerve sheath tumors and their potential mimickers
IF 1.5 4区 医学 Q3 PATHOLOGY
Annals of Diagnostic Pathology
Pub Date : 2025-01-29 DOI: 10.1016/j.anndiagpath.2025.152447
Elif Tasar Kapakli , Melike Pekmezci , Kubra Katipoglu , Figen Soylemezoglu , Gokhan Gedikoglu , Tarık Tihan , Kemal Kosemehmetoglu
Malignant peripheral nerve sheath tumor (MPNST) comprises 5–10 % of all soft tissue sarcomas, and their diagnosis may be challenging given the absence of robust immunohistochemical and molecular signatures. SOX11 expression has previously been shown to be present in a small subset of MPNST. In the present study, we evaluated a group of MPNST for SOX11 expression by immunohistochemistry. We similarly assessed a group of benign and malignant spindle cell tumors that are in the differential diagnosis of MPNST, to more expansively establish the specificity of the antibody. In total, 59 MPNSTs, 27 synovial sarcomas, 19 leiomyosarcomas, 19 rhabdomyosarcomas, 19 solitary fibrous tumors, 4 clear cell sarcomas of soft tissue, 19 malignant melanomas, 22 schwannomas (11 classical, 11 cellular), 9 neurofibromas (4 plexiform, 2 atypical, and 3 classical) and 9 nodular fasciitis were included. SOX11 was strongly positive in 41 of 59 MPNSTs (67 %), 16 of 27 synovial sarcomas (59 %), 11 of 19 rhabdomyosarcomas (58 %), 1 of 4 clear cell sarcomas (25 %), and 5 of 9 nodular fasciitis (56 %). In contrast, neurofibromas(n=11)), schwannomas (n=22), leiomyosarcomas (n=22), and solitary fibrous tumors (n=19) were either negative or showed only weak and focal expression for SOX11. The sensitivity and specificity of strong SOX11 expression in differentiating MPNST from its mimickers were 70 % and 73 %, respectively. In conclusion, the diagnostic utility of SOX11 expression for MPNST is limited, but the absence of significant SOX11 expression in benign/atypical nerve sheath tumors is interesting and deserves further investigation.
{"title":"The diagnostic utility of SOX11 Immunohistochemical expression in malignant peripheral nerve sheath tumors and their potential mimickers","authors":"Elif Tasar Kapakli ,&nbsp;Melike Pekmezci ,&nbsp;Kubra Katipoglu ,&nbsp;Figen Soylemezoglu ,&nbsp;Gokhan Gedikoglu ,&nbsp;Tarık Tihan ,&nbsp;Kemal Kosemehmetoglu","doi":"10.1016/j.anndiagpath.2025.152447","DOIUrl":"10.1016/j.anndiagpath.2025.152447","url":null,"abstract":"<div><div>Malignant peripheral nerve sheath tumor (MPNST) comprises 5–10 % of all soft tissue sarcomas, and their diagnosis may be challenging given the absence of robust immunohistochemical and molecular signatures. SOX11 expression has previously been shown to be present in a small subset of MPNST. In the present study, we evaluated a group of MPNST for SOX11 expression by immunohistochemistry. We similarly assessed a group of benign and malignant spindle cell tumors that are in the differential diagnosis of MPNST, to more expansively establish the specificity of the antibody. In total, 59 MPNSTs, 27 synovial sarcomas, 19 leiomyosarcomas, 19 rhabdomyosarcomas, 19 solitary fibrous tumors, 4 clear cell sarcomas of soft tissue, 19 malignant melanomas, 22 schwannomas (11 classical, 11 cellular), 9 neurofibromas (4 plexiform, 2 atypical, and 3 classical) and 9 nodular fasciitis were included. SOX11 was strongly positive in 41 of 59 MPNSTs (67 %), 16 of 27 synovial sarcomas (59 %), 11 of 19 rhabdomyosarcomas (58 %), 1 of 4 clear cell sarcomas (25 %), and 5 of 9 nodular fasciitis (56 %). In contrast, neurofibromas(n=11)), schwannomas (n=22), leiomyosarcomas (n=22), and solitary fibrous tumors (n=19) were either negative or showed only weak and focal expression for SOX11. The sensitivity and specificity of strong SOX11 expression in differentiating MPNST from its mimickers were 70 % and 73 %, respectively. In conclusion, the diagnostic utility of SOX11 expression for MPNST is limited, but the absence of significant SOX11 expression in benign/atypical nerve sheath tumors is interesting and deserves further investigation.</div></div>","PeriodicalId":50768,"journal":{"name":"Annals of Diagnostic Pathology","volume":"75 ","pages":"Article 152447"},"PeriodicalIF":1.5,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143076453","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Variability in primary thyroid lymphoma: A clinicopathological exploration of diffuse large B-cell, marginal zone, and follicular lymphoma
IF 1.5 4区 医学 Q3 PATHOLOGY
Annals of Diagnostic Pathology
Pub Date : 2025-01-27 DOI: 10.1016/j.anndiagpath.2025.152444
Agnes Stephanie Harahap , Ivana Santoso , Stefanny Charles , Amanda Virginia Hapsari Ardhiawan , Abdillah Hasbi Assadyk , Maria Francisca Ham
Primary thyroid lymphoma (PTL) is a rare condition, posing significant diagnostic challenges due to limited incidence and data. However timely and accurate diagnosis is crucial for effective management. This study aims to analyze the clinicopathological features of PTL cases observed over 15 years at a tertiary national referral hospital. PTL cases from 2009 to 2023 at Universitas Indonesia – Dr. Cipto Mangunkusumo Hospital archives were retrospectively analyzed, with an assessment of clinical data, histopathological, and immunohistochemistry analysis. Statistical analysis was conducted using Chi-Square and Kruskal Wallis. Women constituted the majority of cases (male-to-female ratio was 1: 2.6), with a median patient age of 55 years. Of the 40 identified PTL cases, only one was a T-cell lymphoma among the non-Hodgkin lymphomas (NHL). The NHL subtypes included diffuse large B-cell lymphoma (DLBCL [72.5 %]), marginal zone lymphoma (15.0 %), and follicular lymphoma (FL [10.0 %]). An enlarged neck mass (94.7 %) was the most frequent symptom, and 42.1 % had a history of Hashimoto's thyroiditis. The overall surviving proportion in the present study is 80.7 %, with the median survival duration of 14.5 months, ranging from 1 to 54 months. The longest duration of survival documented in FL case and the shortest in DLBCL case. Lymphoepithelial lesions could be found in all lymphoma types. The main diagnostic and treatment modality used was surgery. Prompt diagnosis and personalized treatment approaches are important to improve survival outcomes. PTL should be anticipated in middle-aged women with rapid enlarged neck mass and a history of Hashimoto's thyroiditis.
{"title":"Variability in primary thyroid lymphoma: A clinicopathological exploration of diffuse large B-cell, marginal zone, and follicular lymphoma","authors":"Agnes Stephanie Harahap ,&nbsp;Ivana Santoso ,&nbsp;Stefanny Charles ,&nbsp;Amanda Virginia Hapsari Ardhiawan ,&nbsp;Abdillah Hasbi Assadyk ,&nbsp;Maria Francisca Ham","doi":"10.1016/j.anndiagpath.2025.152444","DOIUrl":"10.1016/j.anndiagpath.2025.152444","url":null,"abstract":"<div><div>Primary thyroid lymphoma (PTL) is a rare condition, posing significant diagnostic challenges due to limited incidence and data. However timely and accurate diagnosis is crucial for effective management. This study aims to analyze the clinicopathological features of PTL cases observed over 15 years at a tertiary national referral hospital. PTL cases from 2009 to 2023 at Universitas Indonesia – Dr. Cipto Mangunkusumo Hospital archives were retrospectively analyzed, with an assessment of clinical data, histopathological, and immunohistochemistry analysis. Statistical analysis was conducted using Chi-Square and Kruskal Wallis. Women constituted the majority of cases (male-to-female ratio was 1: 2.6), with a median patient age of 55 years. Of the 40 identified PTL cases, only one was a T-cell lymphoma among the non-Hodgkin lymphomas (NHL). The NHL subtypes included diffuse large B-cell lymphoma (DLBCL [72.5 %]), marginal zone lymphoma (15.0 %), and follicular lymphoma (FL [10.0 %]). An enlarged neck mass (94.7 %) was the most frequent symptom, and 42.1 % had a history of Hashimoto's thyroiditis. The overall surviving proportion in the present study is 80.7 %, with the median survival duration of 14.5 months, ranging from 1 to 54 months. The longest duration of survival documented in FL case and the shortest in DLBCL case. Lymphoepithelial lesions could be found in all lymphoma types. The main diagnostic and treatment modality used was surgery. Prompt diagnosis and personalized treatment approaches are important to improve survival outcomes. PTL should be anticipated in middle-aged women with rapid enlarged neck mass and a history of Hashimoto's thyroiditis.</div></div>","PeriodicalId":50768,"journal":{"name":"Annals of Diagnostic Pathology","volume":"75 ","pages":"Article 152444"},"PeriodicalIF":1.5,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143082006","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Digital image analysis of tumour pattern and histological models for prognostic evaluation of invasive non-mucinous adenocarcinoma of the lung
IF 1.5 4区 医学 Q3 PATHOLOGY
Annals of Diagnostic Pathology
Pub Date : 2025-01-25 DOI: 10.1016/j.anndiagpath.2025.152445
Waratchaya Tirasarnvong, Kanet Kanjanapradit
The 2021 World Health Organisation classification of lung adenocarcinoma is based on the predominance and percentage of high-grade histological patterns, e.g. solid and micropapillary patterns, determined by semiquantitative estimation. Digital pathology can be used to evaluate the area of each pattern and calculate the exact percentage. To evaluate the prognostic predictive ability of a histological model for invasive non-mucinous adenocarcinoma using digital pathology. This retrospective cohort study included 76 patients with invasive non-mucinous lung adenocarcinoma who underwent lung resection at Songklanagarind Hospital between January 2010 and December 2016. The histological pattern area was measured on a digital slide using the QuPath Open software version 0.3.2. Clinical and pathological data, including the presence of tumour spread through airspaces, tumour necrosis, tumour-infiltrating lymphocytes, and lymphovascular invasion, were collected. The primary outcome was 5-year overall survival. The best model was provided by the Akaike information criterion, and the prognostic discrimination ability was compared with that of other models from previous studies by identifying the area under the curve (AUC) in the receiver operating characteristic analysis. The best model was validated using bootstrapping. The best model was a combination of stage and an 82 % cut-off high-grade pattern (AUC = 0.776). Tumours with ≥82 % high-grade pattern resulted in significantly worse prognoses (p = 0.001) than those with <82 % high-grade pattern. Our model had the highest AUC among all models from previous studies. This was validated using bootstrapping, with an AUC of 0.708. The best model for survival prediction was a combination of stage and an 82 % cut-off high-grade pattern.
{"title":"Digital image analysis of tumour pattern and histological models for prognostic evaluation of invasive non-mucinous adenocarcinoma of the lung","authors":"Waratchaya Tirasarnvong,&nbsp;Kanet Kanjanapradit","doi":"10.1016/j.anndiagpath.2025.152445","DOIUrl":"10.1016/j.anndiagpath.2025.152445","url":null,"abstract":"<div><div>The 2021 World Health Organisation classification of lung adenocarcinoma is based on the predominance and percentage of high-grade histological patterns, e.g. solid and micropapillary patterns, determined by semiquantitative estimation. Digital pathology can be used to evaluate the area of each pattern and calculate the exact percentage. To evaluate the prognostic predictive ability of a histological model for invasive non-mucinous adenocarcinoma using digital pathology. This retrospective cohort study included 76 patients with invasive non-mucinous lung adenocarcinoma who underwent lung resection at Songklanagarind Hospital between January 2010 and December 2016. The histological pattern area was measured on a digital slide using the QuPath Open software version 0.3.2. Clinical and pathological data, including the presence of tumour spread through airspaces, tumour necrosis, tumour-infiltrating lymphocytes, and lymphovascular invasion, were collected. The primary outcome was 5-year overall survival. The best model was provided by the Akaike information criterion, and the prognostic discrimination ability was compared with that of other models from previous studies by identifying the area under the curve (AUC) in the receiver operating characteristic analysis. The best model was validated using bootstrapping. The best model was a combination of stage and an 82 % cut-off high-grade pattern (AUC = 0.776). Tumours with ≥82 % high-grade pattern resulted in significantly worse prognoses (<em>p</em> = 0.001) than those with &lt;82 % high-grade pattern. Our model had the highest AUC among all models from previous studies. This was validated using bootstrapping, with an AUC of 0.708. The best model for survival prediction was a combination of stage and an 82 % cut-off high-grade pattern.</div></div>","PeriodicalId":50768,"journal":{"name":"Annals of Diagnostic Pathology","volume":"75 ","pages":"Article 152445"},"PeriodicalIF":1.5,"publicationDate":"2025-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143069309","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
GPNMB expression differentiates subependymal giant cell astrocytoma from other mimickers GPNMB表达可将室管膜下巨细胞星形细胞瘤与其他类似物区分开来。
IF 1.5 4区 医学 Q3 PATHOLOGY
Annals of Diagnostic Pathology
Pub Date : 2025-01-17 DOI: 10.1016/j.anndiagpath.2025.152442
Rui Pan, Xiaotong Wang, Ru Fang, Qiuyuan Xia, Xuan Wang, Rusong Zhang, Xue Wei, Nan Wu, Qiu Rao
Subependymal giant cell astrocytomas (SEGAs) are neoplasms that exhibit slow growth patterns and are closely associated with tuberous sclerosis complex (TSC). Recent research indicates that TFE3/TFEB-targeted biomarker glycoprotein nonmetastatic B (GPNMB) is upregulated inTSC1/2-related tumours. In this study, we performed molecular analysis on SEGAs and analyzed GPNMB expression in 6 SEGAs, 10 PXAs, 9 GBMs, 8 eGBMs, 8 diffuse astrocytomas, 8 oligodendrogliomas and 7 glioneuronal tumours through immunohistochemistry, 100 % (6/6) of the SEGA cases exhibited positive GPNMB expression, whereas it was negative in all other CNS tumours. The results indicated that GPNMB is specifically expressed in all SEGAs, distinguishing it from other morphologically similar tumours. The findings demonstrate specific GPNMB expression in SEGA, underscoring its promise as a diagnostic biomarker.
室管膜下巨细胞星形细胞瘤（SEGAs）是一种生长缓慢的肿瘤，与结节性硬化症（TSC）密切相关。最近的研究表明，TFE3/ tfeb靶向的生物标志物糖蛋白非转移性B （GPNMB）是上调的intsc1 /2相关肿瘤。在本研究中，我们对SEGA进行了分子分析，并通过免疫组化分析了GPNMB在6例SEGA、10例PXAs、9例GBMs、8例egbm、8例弥漫性星形细胞瘤、8例少突胶质细胞瘤和7例胶质神经元肿瘤中的表达，100%（6/6）的SEGA病例显示GPNMB阳性表达，而在其他所有中枢神经系统肿瘤中均为阴性表达。结果表明GPNMB在所有SEGAs中特异性表达，将其与其他形态相似的肿瘤区分开来。研究结果证实了GPNMB在SEGA中的特异性表达，强调了其作为诊断性生物标志物的前景。
{"title":"GPNMB expression differentiates subependymal giant cell astrocytoma from other mimickers","authors":"Rui Pan,&nbsp;Xiaotong Wang,&nbsp;Ru Fang,&nbsp;Qiuyuan Xia,&nbsp;Xuan Wang,&nbsp;Rusong Zhang,&nbsp;Xue Wei,&nbsp;Nan Wu,&nbsp;Qiu Rao","doi":"10.1016/j.anndiagpath.2025.152442","DOIUrl":"10.1016/j.anndiagpath.2025.152442","url":null,"abstract":"<div><div>Subependymal giant cell astrocytomas (SEGAs) are neoplasms that exhibit slow growth patterns and are closely associated with tuberous sclerosis complex (TSC). Recent research indicates that TFE3/TFEB-targeted biomarker glycoprotein nonmetastatic B (GPNMB) is upregulated inTSC1/2-related tumours. In this study, we performed molecular analysis on SEGAs and analyzed GPNMB expression in 6 SEGAs, 10 PXAs, 9 GBMs, 8 eGBMs, 8 diffuse astrocytomas, 8 oligodendrogliomas and 7 glioneuronal tumours through immunohistochemistry, 100 % (6/6) of the SEGA cases exhibited positive GPNMB expression, whereas it was negative in all other CNS tumours. The results indicated that GPNMB is specifically expressed in all SEGAs, distinguishing it from other morphologically similar tumours. The findings demonstrate specific GPNMB expression in SEGA, underscoring its promise as a diagnostic biomarker.</div></div>","PeriodicalId":50768,"journal":{"name":"Annals of Diagnostic Pathology","volume":"75 ","pages":"Article 152442"},"PeriodicalIF":1.5,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143015723","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Assessing the predictive value of Ki-67 and progesterone receptor algorithms for recurrence and disease-free survival in meningiomas
IF 1.5 4区 医学 Q3 PATHOLOGY
Annals of Diagnostic Pathology
Pub Date : 2025-01-16 DOI: 10.1016/j.anndiagpath.2025.152441
Servet Guresci , Ozge Basaran Aydogdu , Ahmet Eren Secen , Burak Uzel
Sophisticated refinements in histopathology are evolving to improve meningioma outcome prediction. The aim of this study is to evaluate the stand-alone performance of Ki-67 and progesterone receptor (PR) algorithm scores in meningiomas and their power in predicting recurrence and disease-free survival of the patients.
Whole slide images of Ki-67 and PR-stained slides from 404 meningioma cases were analyzed by a digital image viewer and analysis software Virapath-2.1, which analyzes the tumor cells by size, color, and shape. Ki-67 scores were calculated in the hotspot region that contains at least 1000 tumor cells, while PR was calculated on the whole slide. The results were compared with WHO grade, tumor recurrence and disease-free survival (DFS).
Mean Ki-67 scores were 4.2 ± 3.5, 12.1 ± 10.6 and 22. ± 8.5 for grade 1, 2 and 3 tumors (p < 0.05), while PR scores were 49 ± 35, 43 ± 34 and 16 ± 30, respectively (p > 0.05). Median survival of patients based on Ki-67 values ≤13.2 % and > 13.2 % was 122 versus 60 months (p = 0.004). Prediction of recurrence based on Ki-67 score was found to have acceptable discrimination (AUC = 0.74). PR expression was not found to correlate with DFS, but recurrent tumors had lower PR scores than non-recurrent tumors (31.3 ± 33.8 vs. 49.0 ± 33.0; p = 0.03).
Elevated Ki-67 levels identified by the algorithm may classify meningioma patients at high recurrence risk and inform clinical management. Although PR scores did not correlate with DFS, lower expression in recurrent tumors suggests a role in recurrence risk assessment. Larger prospective studies are needed for routine clinical practice.
{"title":"Assessing the predictive value of Ki-67 and progesterone receptor algorithms for recurrence and disease-free survival in meningiomas","authors":"Servet Guresci ,&nbsp;Ozge Basaran Aydogdu ,&nbsp;Ahmet Eren Secen ,&nbsp;Burak Uzel","doi":"10.1016/j.anndiagpath.2025.152441","DOIUrl":"10.1016/j.anndiagpath.2025.152441","url":null,"abstract":"<div><div>Sophisticated refinements in histopathology are evolving to improve meningioma outcome prediction. The aim of this study is to evaluate the stand-alone performance of Ki-67 and progesterone receptor (PR) algorithm scores in meningiomas and their power in predicting recurrence and disease-free survival of the patients.</div><div>Whole slide images of Ki-67 and PR-stained slides from 404 meningioma cases were analyzed by a digital image viewer and analysis software Virapath-2.1, which analyzes the tumor cells by size, color, and shape. Ki-67 scores were calculated in the hotspot region that contains at least 1000 tumor cells, while PR was calculated on the whole slide. The results were compared with WHO grade, tumor recurrence and disease-free survival (DFS).</div><div>Mean Ki-67 scores were 4.2 ± 3.5, 12.1 ± 10.6 and 22. ± 8.5 for grade 1, 2 and 3 tumors (p &lt; 0.05), while PR scores were 49 ± 35, 43 ± 34 and 16 ± 30, respectively (p &gt; 0.05). Median survival of patients based on Ki-67 values ≤13.2 % and &gt; 13.2 % was 122 versus 60 months (p = 0.004). Prediction of recurrence based on Ki-67 score was found to have acceptable discrimination (AUC = 0.74). PR expression was not found to correlate with DFS, but recurrent tumors had lower PR scores than non-recurrent tumors (31.3 ± 33.8 vs. 49.0 ± 33.0; p = 0.03).</div><div>Elevated Ki-67 levels identified by the algorithm may classify meningioma patients at high recurrence risk and inform clinical management. Although PR scores did not correlate with DFS, lower expression in recurrent tumors suggests a role in recurrence risk assessment. Larger prospective studies are needed for routine clinical practice.</div></div>","PeriodicalId":50768,"journal":{"name":"Annals of Diagnostic Pathology","volume":"75 ","pages":"Article 152441"},"PeriodicalIF":1.5,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143025676","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Clinicopathological and prognostic significance of stromal p16 and p53 expression in oral squamous cell carcinoma 口腔鳞状细胞癌间质p16和p53表达的临床病理及预后意义。
IF 1.5 4区 医学 Q3 PATHOLOGY
Annals of Diagnostic Pathology
Pub Date : 2025-01-15 DOI: 10.1016/j.anndiagpath.2025.152439
Yusuke Amano , Masayo Hasegawa , Atsushi Kihara , Daisuke Matsubara , Noriyoshi Fukushima , Hiroshi Nishino , Yoshiyuki Mori , Kentaro Inamura , Toshiro Niki
The tumor microenvironment is highly heterogeneous and consists of neoplastic cells and diverse stromal components, including fibroblasts, endothelial cells, pericytes, immune cells, local and bone marrow-derived stromal stem and progenitor cells, and the surrounding extracellular matrix. Although the significance of p16 and p53 has been reported in various tumor types, their involvement in the stromal cells of oral squamous cell carcinoma (OSCC) remains unclear. We performed immunohistochemical analyses of p16 and p53 expression in OSCC samples, Of the 116 samples, 74 showed p16-positive stromal cells, and 33 showed p53-positive stromal cells. Both p16 and p53 positivity were associated with an increased histological grade, lymphovascular invasion, an immature stromal pattern with abundant amorphous extracellular matrix material, infiltrative invasion patterns (Yamamoto Kohama classification-4C and 4D), and poor prognosis. Multivariate analyses identified p16 and p53 positivity in the stroma as independent prognostic factors for overall survival (P = 0.032 and P = 0.020, respectively); moreover, stromal p16 positivity correlated with stromal p53 positivity. These findings indicated that p16 and p53 stroma positivity may regulate OSCC tumor aggressiveness.
肿瘤微环境是高度异质性的，由肿瘤细胞和多种基质成分组成，包括成纤维细胞、内皮细胞、周细胞、免疫细胞、局部和骨髓来源的基质干细胞和祖细胞，以及周围的细胞外基质。尽管p16和p53在各种肿瘤类型中的意义已被报道，但它们在口腔鳞状细胞癌（OSCC）基质细胞中的作用尚不清楚。我们对OSCC样本中p16和p53的表达进行了免疫组化分析，在116个样本中，74个样本显示p16阳性基质细胞，33个样本显示p53阳性基质细胞。p16和p53阳性均与组织学分级升高、淋巴血管浸润、未成熟基质模式伴大量无定形细胞外基质物质、浸润性浸润模式（Yamamoto Kohama分类- 4c和4D）以及预后不良相关。多因素分析发现，间质中p16和p53阳性是总生存的独立预后因素（P分别= 0.032和P = 0.020）；此外，间质p16阳性与间质p53阳性相关。这些结果提示p16和p53基质阳性可能调节OSCC肿瘤的侵袭性。
{"title":"Clinicopathological and prognostic significance of stromal p16 and p53 expression in oral squamous cell carcinoma","authors":"Yusuke Amano ,&nbsp;Masayo Hasegawa ,&nbsp;Atsushi Kihara ,&nbsp;Daisuke Matsubara ,&nbsp;Noriyoshi Fukushima ,&nbsp;Hiroshi Nishino ,&nbsp;Yoshiyuki Mori ,&nbsp;Kentaro Inamura ,&nbsp;Toshiro Niki","doi":"10.1016/j.anndiagpath.2025.152439","DOIUrl":"10.1016/j.anndiagpath.2025.152439","url":null,"abstract":"<div><div>The tumor microenvironment is highly heterogeneous and consists of neoplastic cells and diverse stromal components, including fibroblasts, endothelial cells, pericytes, immune cells, local and bone marrow-derived stromal stem and progenitor cells, and the surrounding extracellular matrix. Although the significance of p16 and p53 has been reported in various tumor types, their involvement in the stromal cells of oral squamous cell carcinoma (OSCC) remains unclear. We performed immunohistochemical analyses of p16 and p53 expression in OSCC samples, Of the 116 samples, 74 showed p16-positive stromal cells, and 33 showed p53-positive stromal cells. Both p16 and p53 positivity were associated with an increased histological grade, lymphovascular invasion, an immature stromal pattern with abundant amorphous extracellular matrix material, infiltrative invasion patterns (Yamamoto Kohama classification-4C and <img>4D), and poor prognosis. Multivariate analyses identified p16 and p53 positivity in the stroma as independent prognostic factors for overall survival (<em>P</em> = 0.032 and <em>P</em> = 0.020, respectively); moreover, stromal p16 positivity correlated with stromal p53 positivity. These findings indicated that p16 and p53 stroma positivity may regulate OSCC tumor aggressiveness.</div></div>","PeriodicalId":50768,"journal":{"name":"Annals of Diagnostic Pathology","volume":"75 ","pages":"Article 152439"},"PeriodicalIF":1.5,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143015705","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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