Annals of Diagnostic Pathology最新文献

Pulmonary intravascular mononuclear cell accumulation in cases of mechanical asphyxia due to external neck compression 颈外压迫所致机械性窒息的肺血管内单核细胞积聚

IF 1.4 4区医学 Q3 PATHOLOGY

Annals of Diagnostic Pathology

Pub Date : 2025-12-17 DOI: 10.1016/j.anndiagpath.2025.152600

Anna Laura Santunione , Jessika Camatti , Silvia Corradi , Enrico Silingardi , Rossana Cecchi

Pulmonary intravascular mononuclear cell accumulations have been described in mechanical asphyxia, but their diagnostic value and independence from demographic or post-mortem factors remain uncertain. This study assessed the frequency of these accumulations in asphyxial deaths due to external neck compression compared with non-asphyxial deaths, and evaluated whether the association persists after adjustment for potential confounders.

Lung tissue samples from 31 external neck-compression deaths and 151 non-asphyxial controls were examined histologically. A subset underwent immunohistochemical phenotyping. Univariable comparisons were performed using χ² and Mann–Whitney U tests. A multivariable logistic regression model—including age, sex, post-mortem interval (PMI), and body mass index (BMI)—was used to evaluate the independence of the association.

Intravascular mononuclear accumulations were observed in 41.9 % of neck-compression deaths versus 17.2 % of controls (p < 0.01; unadjusted OR 3.47, 95 % CI 1.52–7.96). In the multivariable model, external neck compression remained independently associated with the presence of intravascular accumulations (adjusted OR 2.93, 95 % CI 1.14–7.52; p = 0.025), while age, sex, PMI, and BMI showed no significant effect. Immunohistochemistry confirmed that accumulations consisted of mature mononuclear cell subsets.

Pulmonary intravascular mononuclear accumulations occur significantly more often in asphyxial deaths involving external neck compression, and this association persists after adjustment for key demographic and post-mortem variables. Although not specific to mechanical asphyxia, these accumulations represent a practical ancillary marker that may support the diagnosis of neck-compression vitality, especially in cases with limited external findings.

机械性窒息中有肺血管内单个核细胞积聚的描述，但其诊断价值和与人口统计学或死后因素的独立性仍不确定。本研究评估了颈外压迫导致的窒息死亡与非窒息死亡中这些累积的频率，并评估了在调整潜在混杂因素后这种关联是否仍然存在。对31例颈外压迫死亡病例和151例非窒息对照组的肺组织样本进行组织学检查。一个亚群进行了免疫组织化学表型分析。单变量比较采用χ2和Mann-Whitney U检验。采用多变量logistic回归模型（包括年龄、性别、死亡间隔（PMI）和身体质量指数（BMI））来评估相关性的独立性。41.9%的颈部压迫死亡患者存在血管内单核细胞积聚，而对照组为17.2% （p < 0.01；未校正OR 3.47, 95% CI 1.52-7.96）。在多变量模型中，颈部外压迫仍然与血管内积累物的存在独立相关（调整后的OR为2.93,95% CI为1.14-7.52;p = 0.025），而年龄、性别、PMI和BMI没有显著影响。免疫组织化学证实，积累是由成熟的单核细胞亚群组成的。肺血管内单核细胞积聚在涉及颈外压迫的窒息性死亡中更为常见，在调整了关键的人口统计学和死后变量后，这种关联仍然存在。虽然不是机械性窒息所特有的，但这些积累代表了一个实用的辅助标志，可以支持颈部压迫活力的诊断，特别是在外部发现有限的病例中。

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引用次数: 0

Expression of INSM1 in salivary carcinoma showing thymus-like elements (CASTLE). INSM1在具有胸腺样因子（CASTLE）的涎腺癌中的表达。

IF 1.4 4区医学 Q3 PATHOLOGY

Annals of Diagnostic Pathology

Pub Date : 2025-12-01 Epub Date: 2025-08-05 DOI: 10.1016/j.anndiagpath.2025.152535

Eiichi Sasaki, Katsuhiro Masago

引用次数: 0

“Letter to the editor: Comparative analysis of MIB1 and SP6 antibodies for Ki-67 assessment in breast carcinoma with focus on the influence of molecular subtyping” 致编辑：MIB1和SP6抗体在乳腺癌Ki-67评估中的比较分析，重点是分子分型的影响

IF 1.4 4区医学 Q3 PATHOLOGY

Annals of Diagnostic Pathology

Pub Date : 2025-11-25 DOI: 10.1016/j.anndiagpath.2025.152599

Alishba Irfan

This letter evaluates the study by Milev and Ivanov (2025) comparing MIB1 and SP6 antibodies for Ki-67 assessment in breast carcinoma and outlines key methodological limitations that weaken the reliability of their conclusions. The use of a single, non blinded pathologist without interobserver or intraobserver reproducibility assessment raises concerns about scoring subjectivity. The absence of formal agreement analyses, such as Bland Altman plots, further limits confidence in the reported concordance between the two clones. Additionally, the study lacks a predefined primary endpoint, sample size justification, and power calculation, reducing its interpretive strength. Addressing these issues would enhance reproducibility, analytical validity, and the translational relevance of Ki-67 evaluation.

这封信评价了Milev和Ivanov（2025）比较MIB1和SP6抗体在乳腺癌中评估Ki-67的研究，并概述了削弱其结论可靠性的关键方法学局限性。使用单一的，非盲的病理学家，没有观察者之间或观察者内部的可重复性评估，引起了对评分主观性的担忧。缺乏正式的一致性分析，如Bland Altman图，进一步限制了对两个克隆之间报道的一致性的信心。此外，该研究缺乏预定义的主要终点、样本量论证和功率计算，降低了其解释力。解决这些问题将提高Ki-67评价的可重复性、分析有效性和翻译相关性。

引用次数: 0

Clinicopathological characterization of gastric amphicrine carcinoma: A case series 胃腺癌的临床病理特征：一个病例系列

IF 1.4 4区医学 Q3 PATHOLOGY

Annals of Diagnostic Pathology

Pub Date : 2025-11-23 DOI: 10.1016/j.anndiagpath.2025.152584

Dazhou Li , Xiaodong Lin , Wenqing Huang

Gastric amphicrine carcinoma (GAC) is a rare malignancy exhibiting dual neuroendocrine and exocrine differentiation. Claudin 18.2 expression patterns in GAC remain poorly characterized. We retrospectively analyzed four GAC cases diagnosed between 2020 and 2024 were retrospectively analyzed. Diagnosis required expression of at least two neuroendocrine markers and intracellular mucin, with amphicrine components comprising >30 % of tumor. Immunohistochemical evaluation included neuroendocrine markers, HER2, and Claudin 18.2. All patients were males aged 52–72 years (mean: 61.5 years). Tumors were located in gastric antrum (n = 2), cardia (n = 1), and body (n = 1), ranging from 4.0 to 4.5 cm. Three morphological patterns were identified: sheet-like/nested, tubular, and signet-ring trabecular. All cases expressed synaptophysin, with variable expression of chromogranin A (3/4), INSM1 (2/4), and CD56 (3/4). HER2 was negative in all cases. Claudin 18.2 expression correlated with morphological patterns: moderate to strong staining in sheet-like/nested areas (3/4) and tubular structures (3/4), but absent in signet-ring trabecular components (2/4). Follow-up demonstrated hepatic metastasis (n = 1) and death (n = 1) at 6 months, while two patients remained alive without recurrence. GAC may demonstrate distinctive morphology-dependent Claudin 18.2 expression, suggesting potential implications for targeted therapy selection and molecular subtyping. The morphological heterogeneity and aggressive clinical behavior underscore the importance of accurate diagnosis through comprehensive integrated assessment.

摘要胃两泌癌是一种罕见的神经内分泌和外分泌双重分化的恶性肿瘤。Claudin 18.2在GAC中的表达模式仍然不清楚。我们回顾性分析了2020年至2024年间诊断的4例GAC病例。诊断需要至少两种神经内分泌标志物和细胞内粘蛋白的表达，其中两性分泌成分占肿瘤的30%。免疫组化评价包括神经内分泌标志物、HER2和Claudin 18.2。所有患者均为男性，年龄52 ~ 72岁（平均61.5岁）。肿瘤位于胃窦（n = 2）、贲门（n = 1）、体（n = 1），范围4.0 ~ 4.5 cm。确定了三种形态模式：片状/巢状，管状和印戒小梁。所有病例均表达synaptophysin，其中嗜铬粒蛋白A（3/4）、INSM1（2/4）、CD56（3/4）表达不同。所有病例HER2均为阴性。Claudin 18.2的表达与形态模式相关：在片状/巢状区域（3/4）和管状结构（3/4）中有中度至强烈的染色，但在印戒小梁成分中不存在（2/4）。随访6个月发现肝转移（n = 1）和死亡（n = 1）， 2例患者存活，无复发。GAC可能表现出独特的形态依赖性Claudin 18.2表达，提示靶向治疗选择和分子分型的潜在意义。形态学的异质性和侵袭性的临床行为强调了通过全面综合评估准确诊断的重要性。

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引用次数: 0

Spread through air spaces (STAS) in lung adenocarcinoma: Prognostic impact of morphologic patterns, density, and extent 肺腺癌通过空气间隙扩散：形态学模式、密度和范围对预后的影响

IF 1.4 4区医学 Q3 PATHOLOGY

Annals of Diagnostic Pathology

Pub Date : 2025-11-19 DOI: 10.1016/j.anndiagpath.2025.152598

Sinem Eser Polat Ünal , Canan Sadullahoğlu , Hacer Boztepe Yeşilçay , Şencan Akdağ

Spread through air spaces (STAS) has emerged as a distinct invasion pattern in lung adenocarcinoma, but the prognostic implications of its morphologic features remain incompletely defined. In this study, we analyzed STAS presence, morphologic subtypes, density, and extent with clinicopathologic parameters and survival. We analyzed 184 surgically resected lung adenocarcinomas. We histopathologically examined the presence of STAS, STAS morphological subtypes (solid nests, micropapillary clusters, and single-cell spread), STAS extension, STAS density and evaluated the relationship of the findings with clinicopathological parameters. STAS was detected in 67.9 % of the tumors. The most common STAS subtype was solid (53.6 %), followed by micropapillary (30.4 %) and single-cell (16.0 %) subtypes. STAS density was categorized as low (1–4 tumor cell clusters) or high (≥5 clusters) at ×200 magnification, and STAS extent was classified as limited (≤3 alveolar spaces) or extensive (>3 spaces). High-density STAS was observed in 56 %, low-density STAS in 44 %; limited-STAS in 57.6 %, and extensive-STAS in 42.4 %. STAS positivity was significantly associated with predominant tumor pattern (p = 0.002), tumor grade (p < 0.001), pleural invasion (p = 0.004), lymphovascular invasion (LVI) (p < 0.001), recurrence (p < 0.001), metastasis (p < 0.001), pN (p = 0.003), overall survival (OS) (p < 0.001) and recurrence-free survival (DFS) (p < 0.001). Among morphologic subtypes, significant correlations were found with predominant tumor pattern (p < 0.001), grade (p = 0.001) and LVI (p = 0.005). We found STAS density to show a significant difference in OS (p = 0.009). Extensive STAS correlated with surgical resection type (p = 0.002), necrosis (p = 0.049), pN (p = 0.033), OS (p = 0.016) and DFS (p = 0.037). Our study shows that STAS and its features have prognostic significance with clinically meaningful differences in lung adenocarcinomas. These results highlight the potential clinical relevance of STAS subtype, density, and extent in risk stratification.

通过空气间隙扩散（STAS）已成为肺腺癌的一种独特的侵袭模式，但其形态学特征的预后意义仍不完全明确。在这项研究中，我们分析了STAS的存在，形态亚型，密度和范围与临床病理参数和生存率。我们分析了184例手术切除的肺腺癌。我们通过组织病理学检查了STAS的存在、STAS形态亚型（实巢、微乳头状簇状和单细胞扩散）、STAS扩展、STAS密度，并评估了这些发现与临床病理参数的关系。67.9%的肿瘤检出STAS。最常见的STAS亚型为实型（53.6%），其次是微乳头状（30.4%）和单细胞（16.0%）亚型。在×200放大下，STAS密度分为低（1-4个肿瘤细胞簇）和高（≥5个肿瘤细胞簇），STAS范围分为有限（≤3个肺泡间隙）和广泛（>；3个间隙）。高密度STAS占56%，低密度STAS占44%；限制性stas占57.6%，广泛性stas占42.4%。STAS阳性与主要肿瘤类型（p = 0.002）、肿瘤分级（p < 0.001）、胸膜浸润（p = 0.004）、淋巴血管浸润（LVI）（p < 0.001）、复发（p < 0.001）、转移（p < 0.001）、pN （p = 0.003）、总生存（OS）（p < 0.001）和无复发生存（DFS）（p < 0.001）显著相关。在形态学亚型中，与主要肿瘤类型（p < 0.001）、分级（p = 0.001）和LVI （p = 0.005）存在显著相关性。我们发现STAS密度在OS中有显著差异（p = 0.009）。广泛STAS与手术切除类型（p = 0.002）、坏死（p = 0.049）、pN （p = 0.033）、OS （p = 0.016）、DFS （p = 0.037）相关。我们的研究表明STAS及其特征在肺腺癌中具有临床意义的预后意义。这些结果强调了STAS亚型、密度和风险分层程度的潜在临床相关性。

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引用次数: 0

The diagnostic utility and frequency of CD56 expression in plasma cell myeloma CD56在浆细胞骨髓瘤中的表达及诊断价值

IF 1.4 4区医学 Q3 PATHOLOGY

Annals of Diagnostic Pathology

Pub Date : 2025-11-13 DOI: 10.1016/j.anndiagpath.2025.152587

Midori Imai , Asami Nishikori , Tomoka Haratake , Midori Filiz Nishimura , Rio Yamada , Syoma Kato , Mizuha Tabe , Hiroyuki Yanai , Hidetaka Yamamoto , Yasuharu Sato

Plasma cell myeloma (PCM) is a hematological malignancy characterized by systemic proliferation of neoplastic plasma cells within the bone marrow. Diagnosis requires clinical findings and immunohistochemical staining, including CD138, CD79a, cyclin D1, immunoglobulin κ (Igκ), and λ (Igλ). However, CD79a and cyclin D1 have limited sensitivity and specificity, and Igκ/Igλ assessment is often difficult due to overstaining. Therefore, more reliable antibodies are needed to accurately diagnose PCM. In this study, we examined the diagnostic utility of CD56 expression in PCM. We retrospectively performed immunostaining for CD138, CD56, CD79a, cyclin D1, Igκ, and Igλ in bone marrow samples from 116 patients with PCM.

CD56 expression was observed in 85/116 cases (73.3 %), CD79a was downregulated in 46/116 cases (39.7 %), and cyclin D1 expression was observed in 42/116 cases (36.2 %). The expression of CD56 was significantly higher than that of CD79a and cyclin D1 (both p < 0.001). The combination of two antibodies resulted in the highest detection rate when combining CD56 and CD79a (105/116, 90.5 %), which was significantly higher than the detection rates of CD56 and cyclin D1 (93/116, 80.2 %) and CD79a and cyclin D1 (75/116, 64.7 %) (both p < 0.001). In contrast, lymphoplasmacytic lymphoma and marginal zone lymphoma lacked CD56 and cyclin D1 expression. Furthermore, in cases where light chain restriction was undetectable (11/116, 9.5 %), all could be diagnosed as PCM based on CD56, CD79a, and cyclin D1. Among these, CD56 showed the highest detection rate (8/11, 72.7 %).

These findings highlight CD56 as a helpful marker for PCM diagnosis and support further clinical research.

浆细胞骨髓瘤（PCM）是一种血液系统恶性肿瘤，其特征是骨髓内肿瘤浆细胞的系统性增殖。诊断需要临床表现和免疫组织化学染色，包括CD138、CD79a、细胞周期蛋白D1、免疫球蛋白κ (Igκ)和λ (Igλ)。然而，CD79a和cyclin D1具有有限的敏感性和特异性，并且由于过度染色，通常难以评估Igκ/Igλ。因此，需要更可靠的抗体来准确诊断PCM。在这项研究中，我们检测了CD56表达在PCM中的诊断作用。我们回顾性地对116例PCM患者的骨髓样本进行了CD138、CD56、CD79a、细胞周期蛋白D1、Igκ和Igλ的免疫染色。CD56表达85/116例（73.3%），CD79a下调46/116例（39.7%），cyclin D1表达42/116例（36.2%）。CD56的表达显著高于CD79a和cyclin D1 （p < 0.001）。两抗体联合使用CD56与CD79a的检出率最高（105/116,90.5%），显著高于CD56与cyclin D1的检出率（93/116,80.2%）和CD79a与cyclin D1的检出率（75/116,64.7%）（均p <； 0.001）。相比之下，淋巴浆细胞性淋巴瘤和边缘带淋巴瘤缺乏CD56和cyclin D1的表达。此外，在未检测到轻链限制的病例中（11/116,9.5%），基于CD56、CD79a和cyclin D1均可诊断为PCM。其中CD56的检出率最高（8/11,72.7%）。这些发现强调了CD56作为PCM诊断的有用标记物，并支持进一步的临床研究。

{"title":"The diagnostic utility and frequency of CD56 expression in plasma cell myeloma","authors":"Midori Imai , Asami Nishikori , Tomoka Haratake , Midori Filiz Nishimura , Rio Yamada , Syoma Kato , Mizuha Tabe , Hiroyuki Yanai , Hidetaka Yamamoto , Yasuharu Sato","doi":"10.1016/j.anndiagpath.2025.152587","DOIUrl":"10.1016/j.anndiagpath.2025.152587","url":null,"abstract":"<div><div>Plasma cell myeloma (PCM) is a hematological malignancy characterized by systemic proliferation of neoplastic plasma cells within the bone marrow. Diagnosis requires clinical findings and immunohistochemical staining, including CD138, CD79a, cyclin D1, immunoglobulin κ (Igκ), and λ (Igλ). However, CD79a and cyclin D1 have limited sensitivity and specificity, and Igκ/Igλ assessment is often difficult due to overstaining. Therefore, more reliable antibodies are needed to accurately diagnose PCM. In this study, we examined the diagnostic utility of CD56 expression in PCM. We retrospectively performed immunostaining for CD138, CD56, CD79a, cyclin D1, Igκ, and Igλ in bone marrow samples from 116 patients with PCM.</div><div>CD56 expression was observed in 85/116 cases (73.3 %), CD79a was downregulated in 46/116 cases (39.7 %), and cyclin D1 expression was observed in 42/116 cases (36.2 %). The expression of CD56 was significantly higher than that of CD79a and cyclin D1 (both <em>p</em> < 0.001). The combination of two antibodies resulted in the highest detection rate when combining CD56 and CD79a (105/116, 90.5 %), which was significantly higher than the detection rates of CD56 and cyclin D1 (93/116, 80.2 %) and CD79a and cyclin D1 (75/116, 64.7 %) (both <em>p</em> < 0.001). In contrast, lymphoplasmacytic lymphoma and marginal zone lymphoma lacked CD56 and cyclin D1 expression. Furthermore, in cases where light chain restriction was undetectable (11/116, 9.5 %), all could be diagnosed as PCM based on CD56, CD79a, and cyclin D1. Among these, CD56 showed the highest detection rate (8/11, 72.7 %).</div><div>These findings highlight CD56 as a helpful marker for PCM diagnosis and support further clinical research.</div></div>","PeriodicalId":50768,"journal":{"name":"Annals of Diagnostic Pathology","volume":"81 ","pages":"Article 152587"},"PeriodicalIF":1.4,"publicationDate":"2025-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145532983","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 features of hepatic Langerhans cell histiocytosis: report of ten cases and review of the literature 肝朗格汉斯细胞组织细胞增多症的临床病理特点：附10例报告并文献复习。

IF 1.4 4区医学 Q3 PATHOLOGY

Annals of Diagnostic Pathology

Pub Date : 2025-11-13 DOI: 10.1016/j.anndiagpath.2025.152586

Qian-Qian Chen , Chun-kui Shao , Yi-wang Zhang , Jian-ning Chen , Hai-feng Li , Qiong Liang

The aim was to evaluate the clinical and histopathological characteristics of hepatic Langerhans cell histiocytosis (LCH). Data from 10 patients with hepatic LCH were collected. The clinicopathological features and immunophenotypes of hepatic LCH were assessed. The study included 6 males and 4 females (median age: 20.5 years). Clinical manifestations and imaging findings were non-specific. Six cases had multisystem involvement, while 4 had isolated hepatic LCH. All lesions were located in the portal area. Histologically, Langerhans cells (LCs) with characteristic nuclear grooves infiltrated the bile duct epithelium. Although one case initially presented as sclerosing cholangitis (SC) without detectable LCs, the patient's history of cutaneous LCH provided a crucial diagnostic clue, and Langerhans cell (LC) foci were later confirmed in the explanted liver. Immunohistochemically, these tumor cells were positive for CD1a, S100, and CD207. BRAF V600E mutations were detected in 30 % (3/10) of cases. Five cases displayed unique morphological patterns: 2 exhibited sclerosing cholangitis, 1 resembled inflammatory myofibroblastic tumor (IMT) or EBV-positive inflammatory follicular dendritic cell sarcoma (EBV+ IFDCS), and 2 showed chronic suppurative cholangitis with abscess formation. Hepatic LCH exhibits diverse morphological features. Bile duct epithelial injury with eosinophil infiltration and a history of extrahepatic LCH are important diagnostic clues. Hematoxylin-eosin staining combined with immunohistochemistry (CD1a, S100, CD207) is essential for definitive diagnosis. LCH should be differentiated from hepatic parasitic infections, primary SC, EBV+ IFDCS, and IMT.

目的是评价肝朗格汉斯细胞组织细胞增多症（LCH）的临床和组织病理学特征。收集了10例肝性LCH患者的资料。评估肝LCH的临床病理特征和免疫表型。该研究包括6名男性和4名女性（中位年龄：20.5岁）。临床表现及影像学表现无特异性。6例为多系统受累，4例为孤立性肝性LCH。所有病变均位于门静脉区。组织学上，具有特征性核沟的朗格汉斯细胞（LCs）浸润胆管上皮。虽然1例患者最初表现为硬化性胆管炎（SC），但未检测到LC，但患者的皮肤LCH病史提供了重要的诊断线索，并且后来在外植肝中证实了朗格汉斯细胞（LC）灶。免疫组化结果显示，这些肿瘤细胞CD1a、S100和CD207阳性。30%（3/10）的病例检测到BRAF V600E突变。5例表现出独特的形态特征：2例表现为硬化性胆管炎，1例表现为炎性肌纤维母细胞瘤（IMT）或EBV阳性炎性滤泡树突状细胞肉瘤（EBV+ IFDCS）， 2例表现为慢性化脓性胆管炎伴脓肿形成。肝脏LCH表现出多种形态特征。胆管上皮损伤伴嗜酸性粒细胞浸润和肝外LCH病史是重要的诊断线索。苏木精-伊红染色联合免疫组织化学（CD1a, S100, CD207）是明确诊断所必需的。LCH应与肝脏寄生虫感染、原发性SC、EBV+ IFDCS和IMT相鉴别。

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引用次数: 0

Immunohistochemical assessment of duodenal mucosal gamma/delta receptor-expressing T-lymphocytes as a diagnostic adjunct for pediatric celiac disease 免疫组织化学评估十二指肠黏膜表达γ / δ受体的t淋巴细胞作为儿科乳糜泻的诊断辅助

IF 1.4 4区医学 Q3 PATHOLOGY

Annals of Diagnostic Pathology

Pub Date : 2025-11-09 DOI: 10.1016/j.anndiagpath.2025.152585

Sara Gamal Mohamed Ouf , Mena Mahfouz , Khadiga Mohamed Ali , Amal Abd El hafez , Khaled Refaat Zalata

Celiac disease (CeD) diagnosis can be challenging in cases with borderline or discrepant serological and histopathological findings. While intraepithelial lymphocytes (IELs) are characteristic of CeD, conventional counting methods lack specificity and overlap with other enteropathies. Gamma/delta (γ/δ) T-lymphocytes quantification was identified to be more specific but require validation in formalin-fixed paraffin-embedded (FFPE) biopsies. This study aimed to assess the IEL using immunohistochemistry (IHC) for anti-CD3 and anti-TCRγ/δ (H-41) antibodies on FFPE duodenal mucosal endoscopic biopsies in pediatric CeD patients versus non-CeD controls. 64 pediatric duodenal biopsies (34 untreated CeD, 30 non-CeD) were retrospectively analyzed for histopathologic features of CeD with special attention to IEL count using H&E (hematoxylin and eosin), anti-CD3, anti-TCRγ/δ IHC. The TCRγ/δ+:CD3+ ratio were assessed. It was found that CeD patients had significantly higher IEL counts by H&E (63.5 ± 13.5 vs. 43.2 ± 10.6), CD3 (83.9 ± 21.0 vs. 48.7 ± 11.8), TCRγ/δ (27.7 ± 11.6 vs. 3.5 ± 5.7) and TCRγ/δ+:CD3+ ratio (33.8 ± 13.2 % vs. 6 ± 8.6 %) compared to non-CeD (P = 0.001). IEL densities increased in higher Marsh-Oberhuber grades, with a significant trend for CD3+ IELs. Diagnostic performance was highest for anti-TCRγ/δ followed by TCRγ/δ+:CD3+ ratio, then anti-CD3 outperforming H&E. Overall, the quantification of TCRγ/δ + IELs and TCRγ/δ+:CD3+ ratio by IHC offers superior diagnostic accuracy for pediatric CeD compared to H&E and CD3. Incorporating TCRγ/δ IHC enhances differentiation of CeD from mimicking enteropathies, particularly with borderline and equivocal histology or serology. Further validation and standardization with larger cohorts is recommended.

乳糜泻（CeD）的诊断可能具有挑战性的情况下，边界或差异的血清学和组织病理学结果。虽然上皮内淋巴细胞（iel）是CeD的特征，但传统的计数方法缺乏特异性，并且与其他肠病重叠。γ/δ (γ/δ) t淋巴细胞定量被认为更具特异性，但需要在福尔马林固定石蜡包埋（FFPE）活检中进行验证。本研究旨在利用免疫组织化学（IHC）对儿童CeD患者与非CeD对照组的FFPE十二指肠黏膜内镜活检中抗cd3和抗tcrγ /δ (H-41)抗体进行评估。回顾性分析64例儿童十二指肠活检（34例未经治疗的CeD， 30例未治疗的CeD）的组织病理学特征，特别关注IEL计数，使用H&E（苏木精和伊红），抗cd3，抗tcrγ /δ IHC。评估TCRγ/δ+:CD3+比值。结果发现，与非CeD患者相比，CeD患者在H&E（63.5±13.5比43.2±10.6）、CD3（83.9±21.0比48.7±11.8）、TCRγ/δ（27.7±11.6比3.5±5.7）和TCRγ/δ+:CD3+比值（33.8±13.2%比6±8.6%）方面的IEL计数均显著高于CeD患者（P = 0.001）。在较高的Marsh-Oberhuber等级中，IEL密度增加，其中CD3+ IEL有明显的趋势。抗TCRγ/δ诊断效能最高，其次是TCRγ/δ+:CD3+比值，然后是抗CD3优于H&E。总体而言，与H&E和CD3相比，IHC量化TCRγ/δ+ IELs和TCRγ/δ+:CD3+比值对儿童CeD的诊断准确性更高。结合TCRγ/δ IHC可以增强CeD与模拟肠病的分化，特别是具有边缘性和模棱两可的组织学或血清学。建议在更大的队列中进一步验证和标准化。

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引用次数: 0

Utility of TRPS1 Compared to GATA3, and SOX10 Immunohistochemistry in Diagnosis and Prognosis of Breast cancer Molecular Subtypes TRPS1与GATA3、SOX10免疫组化在乳腺癌分子亚型诊断和预后中的应用

IF 1.4 4区医学 Q3 PATHOLOGY

Annals of Diagnostic Pathology

Pub Date : 2025-10-22 DOI: 10.1016/j.anndiagpath.2025.152582

Manar Moustafa , Mohamed I. Abdelhamid , Kareem Amgd , MennatAllah H. Fikry

The sensitivity and specificity of immunohistochemical markers are important in the accurate identification of the tissue of origin in breast cancer (BC). The aim of our study was to identify the diagnostic utility and pattern of expression of TRPS1, GATA3, and SOX10 immunohistochemistry in a cohort of breast cancers of diverse molecular subtypes. 184 breast carcinomas cases, including luminal A (n = 61), luminal B (n = 68), HER2+ (n = 30), and triple-negative breast cancer (TNBC) (n = 25) MOLECULAR subtypes, were subjected to immunohistochemical (IHC) analyses using TRPS1, GATA3, and SOX10 antibodies. TRPS1 exhibited high positivity rates uniformly across all molecular subtypes, ranging from 92.0 % in TNBC to 94.4 % in Luminal B. GATA3 was also frequently positive in the luminal subtypes (96.7–97.2 %) but had significantly lower expression rates in TNBC (40.0 %). SOX10, in contrast, was most frequently positive in TNBC (72.0 %) and less so in the luminal subtypes (3.3–16.7). Statistical analyses did not reveal any significant difference in the rates of TRPS1 expression between the subtypes (χ² = 1.84; p = 0.62). It is concluded that TRPS1 is the most sensitive breast lineage marker across molecular subtypes, with nearly uniform expression. GATA3 and SOX10 are limited by subtype-dependent sensitivity and thus require a subtype framework for selecting the best immunohistochemical markers.

免疫组织化学标志物的敏感性和特异性对于准确识别乳腺癌（BC）的起源组织至关重要。本研究的目的是确定TRPS1、GATA3和SOX10免疫组织化学在不同分子亚型乳腺癌队列中的诊断效用和表达模式。采用TRPS1、GATA3和SOX10抗体对184例乳腺癌患者进行免疫组化（IHC）分析，包括luminal A （n = 61）、luminal B （n = 68）、HER2+ (n = 30)和三阴性乳腺癌（TNBC）（n = 25）分子亚型。TRPS1在所有分子亚型中均表现出高阳性率，在TNBC中从92.0%到94.4%不等。GATA3在Luminal亚型中也经常呈阳性（96.7 - 97.2%），但在TNBC中表达率明显较低（40.0%）。相比之下，SOX10在TNBC中最常见（72.0%），在腔内亚型中较少（3.3 - 16.7%）。TRPS1在不同亚型间的表达率差异无统计学意义（χ2 = 1.84; p = 0.62）。综上所述，TRPS1是跨分子亚型最敏感的乳腺谱系标记，其表达几乎一致。GATA3和SOX10受到亚型依赖敏感性的限制，因此需要一个亚型框架来选择最佳的免疫组织化学标志物。

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引用次数: 0

Chromosomal alterations in 7, 17, and Y demonstrate comparable sensitivity and superior specificity to diffuse strong AMACR immunostaining for papillary renal cell carcinoma 7、17和Y的染色体改变显示出弥漫性强AMACR免疫染色对乳头状肾细胞癌的相当敏感性和优越特异性。

IF 1.4 4区医学 Q3 PATHOLOGY

Annals of Diagnostic Pathology

Pub Date : 2025-10-22 DOI: 10.1016/j.anndiagpath.2025.152583

Yang Liu , Jun Yuan , Haimin Xu , Xianwei Yang , Chaofu Wang , Luting Zhou , Xiaoqun Yang

The diagnostic criteria for papillary renal cell carcinoma (PRCC) include diffuse strong AMACR and retained FH expression. Although chromosomal alterations in 7/17/Y are frequent molecular findings in PRCC, they are not included in its diagnostic criteria. This study analyzed 154 PRCC cases and 120 PRCC mimics using AMACR immunostaining and chromosomal analyses. Positive AMACR expression demonstrated the highest sensitivity (98.1 %), while a combination of diffuse strong AMACR expression and ≥2 chromosomal alterations achieved optimal specificity (93.3 %). Detection of ≥1 chromosomal alteration provided comparable sensitivity (86.4 % vs. 83.8 %) to diffuse strong AMACR expression alone but with significantly enhanced specificity (73.3 % vs. 48.3 %). Non-PRCC tumors demonstrating both diffuse strong AMACR expression and ≥2 chromosomal alterations predominantly included TFE3-rearranged RCC (3/29) and FH-deficient RCC (3/13) cases, with rare cases in clear cell RCC (1/10) and SMARCB1-deficient RCC (1/2). Collecting duct carcinoma occasionally showed multiple chromosomal alterations but usually showed negative or focal AMACR expression. These findings indicated that chromosomal alterations demonstrated comparable sensitivity and superior specificity compared to diffuse strong AMACR immunostaining for PRCC diagnosis. We propose incorporating chromosomal alterations in 7/17/Y as a desirable diagnostic criterion for PRCC. In addition, unclassified metastatic RCCs with papillary architecture should not be definitively diagnosed as PRCC based solely on chromosomal alterations. A definite diagnosis of metastatic PRCC requires exclusion of these histological and molecular mimics.

乳头状肾细胞癌（PRCC）的诊断标准包括弥漫性强AMACR和保留FH表达。虽然7/17/Y染色体改变是PRCC中常见的分子发现，但不包括在其诊断标准中。本研究使用AMACR免疫染色和染色体分析分析了154例PRCC病例和120例PRCC模拟病例。AMACR阳性表达表现出最高的敏感性（98.1%），而弥漫性强AMACR表达和≥2染色体改变的组合达到最佳特异性（93.3%）。检测≥1染色体改变对弥漫性强AMACR单独表达具有相当的敏感性（86.4%对83.8%），但特异性显著增强（73.3%对48.3%）。具有弥漫性强AMACR表达和≥2染色体改变的非prcc肿瘤主要包括tfe3重排的RCC（3/29）和fh缺陷的RCC(3/13)，在透明细胞RCC（1/10）和smarcb1缺陷的RCC（1/2）中有罕见病例。收集管癌偶尔表现为多染色体改变，但通常表现为阴性或局灶性AMACR表达。这些发现表明，与弥漫性强AMACR免疫染色相比，染色体改变对PRCC的诊断具有相当的敏感性和更高的特异性。我们建议将7/17/Y染色体改变作为PRCC的理想诊断标准。此外，具有乳头状结构的未分类转移性rcc不应仅根据染色体改变明确诊断为PRCC。转移性PRCC的明确诊断需要排除这些组织学和分子模拟物。

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