Pub Date : 2025-07-08DOI: 10.1016/j.anndiagpath.2025.152529
Pierre Tran , Khalid Shittu , Ehsan Aliniagerdroudbari , Sumit Singla , Momal Tara Chand , Beena U. Ahsan
Sebaceous gland ectopia (SGE) is a disorder in which sebaceous gland lobules appear in atypical anatomical locations. Sebaceous glands are normally found in the skin, particularly abundant on the face, scalp and other areas with hair follicles. SGE in the esophagus is an extremely rare, benign condition that morphologically may mimic epidermoid metaplasia due to the presence of excretory duct, lined by keratinized squamous epithelium. We present a retrospective case series of patients with evidence of SGE per endoscopic biopsy tissue analysis between 2000 and 2025. A total of 12 biopsy analyses from 10 patients were included: 7 women (70 %) and 3 men (30 %). The mean age at diagnosis was 63 years. There were 7 patients who reported previous or current alcohol use (70 %); one patient reported previous tobacco use (10 %). Gastrointestinal reflux disease, the most common clinical indication, was seen in six patients (60 %). The lesions, when visible on endoscopy, were located in the proximal and/or mid esophagus (100 %); three endoscopies noted no lesions (25 %). Two repeat biopsies in one patient showed persistent SGE. No biopsies showed dysplasia (0 %). Additionally, we performed a literature review of articles in the PubMed database, identifying 65 other reported patients. The clinicopathologic findings in this study add additional evidence on this rare entity.
{"title":"Sebaceous gland ectopia of the esophagus: A clinical, endoscopic, and pathologic study of a rare condition with literature review","authors":"Pierre Tran , Khalid Shittu , Ehsan Aliniagerdroudbari , Sumit Singla , Momal Tara Chand , Beena U. Ahsan","doi":"10.1016/j.anndiagpath.2025.152529","DOIUrl":"10.1016/j.anndiagpath.2025.152529","url":null,"abstract":"<div><div>Sebaceous gland ectopia (SGE) is a disorder in which sebaceous gland lobules appear in atypical anatomical locations. Sebaceous glands are normally found in the skin, particularly abundant on the face, scalp and other areas with hair follicles. SGE in the esophagus is an extremely rare, benign condition that morphologically may mimic epidermoid metaplasia due to the presence of excretory duct, lined by keratinized squamous epithelium. We present a retrospective case series of patients with evidence of SGE per endoscopic biopsy tissue analysis between 2000 and 2025. A total of 12 biopsy analyses from 10 patients were included: 7 women (70 %) and 3 men (30 %). The mean age at diagnosis was 63 years. There were 7 patients who reported previous or current alcohol use (70 %); one patient reported previous tobacco use (10 %). Gastrointestinal reflux disease, the most common clinical indication, was seen in six patients (60 %). The lesions, when visible on endoscopy, were located in the proximal and/or mid esophagus (100 %); three endoscopies noted no lesions (25 %). Two repeat biopsies in one patient showed persistent SGE. No biopsies showed dysplasia (0 %). Additionally, we performed a literature review of articles in the PubMed database, identifying 65 other reported patients. The clinicopathologic findings in this study add additional evidence on this rare entity.</div></div>","PeriodicalId":50768,"journal":{"name":"Annals of Diagnostic Pathology","volume":"79 ","pages":"Article 152529"},"PeriodicalIF":1.5,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144662959","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}
Pub Date : 2025-07-07DOI: 10.1016/j.anndiagpath.2025.152524
Serena Salzano , Rosario Caltabiano , Gaetano Magro , Antonio D'Amati , Cristina Pizzimenti , Andrea Maugeri , Antonella Agodi , Giuseppe Barbagallo , Francesco Certo , Francesco Fiorentino , Giovanni Tuccari , Maurizio Martini , Antonio Ieni , Valeria Barresi , Giuseppe Broggi
Objective
To evaluate the diagnostic performance of MTAP and p16 immunohistochemistry (IHC) as surrogate markers for CDKN2A/B homozygous deletion (HD) in central nervous system (CNS) tumors, and to assess their prognostic significance.
Methods
Molecular tests including gene sequencing or fluorescence in situ hybridization (FISH) have traditionally been used to assess CDKN2A/B HD. However, due to lower costs and wider availability, IHC surrogates such as MTAP and p16 are gaining interest. We investigated the concordance between MTAP and p16 IHC expression and CDKN2A/B status as determined by FISH.
Results
Our cohort consisted of 227 patients with various CNS tumor types: glioblastoma IDH-wild type (n = 64; 28.2 %), meningioma (n = 61; 26.9 %), IDH-mutant astrocytoma (n = 52; 22.9 %), IDH-mutant and 1p/19q-codeleted oligodendroglioma (n = 35; 15.4 %), and pleomorphic xanthoastrocytoma (n = 15; 6.6 %). In all tumor types, most cases with CDKN2A/B HD showed MTAP loss and p16 negativity (p-values < 0.05). The combination of MTAP and p16 IHC yielded a sensitivity of 92 %, specificity of 80 %, positive predictive value of 86 %, and negative predictive value of 88 % in detecting CDKN2A/B HD. Survival analysis demonstrated significantly reduced disease-free and overall survival among patients with MTAP loss, p16 negativity, and CDKN2A/B HD.
Conclusions
MTAP immunohistochemistry, alone or combined with p16, represents a cost-effective and feasible surrogate for detecting CDKN2A/B homozygous deletion in CNS tumors and provides relevant prognostic information.
{"title":"MTAP and p16 as immunohistochemical surrogates of CDKN2A/B homozygous deletion in central nervous system tumors: A multicentre Italian experience","authors":"Serena Salzano , Rosario Caltabiano , Gaetano Magro , Antonio D'Amati , Cristina Pizzimenti , Andrea Maugeri , Antonella Agodi , Giuseppe Barbagallo , Francesco Certo , Francesco Fiorentino , Giovanni Tuccari , Maurizio Martini , Antonio Ieni , Valeria Barresi , Giuseppe Broggi","doi":"10.1016/j.anndiagpath.2025.152524","DOIUrl":"10.1016/j.anndiagpath.2025.152524","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate the diagnostic performance of MTAP and p16 immunohistochemistry (IHC) as surrogate markers for CDKN2A/B homozygous deletion (HD) in central nervous system (CNS) tumors, and to assess their prognostic significance.</div></div><div><h3>Methods</h3><div>Molecular tests including gene sequencing or fluorescence in situ hybridization (FISH) have traditionally been used to assess CDKN2A/B HD. However, due to lower costs and wider availability, IHC surrogates such as MTAP and p16 are gaining interest. We investigated the concordance between MTAP and p16 IHC expression and CDKN2A/B status as determined by FISH.</div></div><div><h3>Results</h3><div>Our cohort consisted of 227 patients with various CNS tumor types: glioblastoma IDH-wild type (n = 64; 28.2 %), meningioma (n = 61; 26.9 %), IDH-mutant astrocytoma (n = 52; 22.9 %), IDH-mutant and 1p/19q-codeleted oligodendroglioma (n = 35; 15.4 %), and pleomorphic xanthoastrocytoma (n = 15; 6.6 %). In all tumor types, most cases with CDKN2A/B HD showed MTAP loss and p16 negativity (<em>p</em>-values < 0.05). The combination of MTAP and p16 IHC yielded a sensitivity of 92 %, specificity of 80 %, positive predictive value of 86 %, and negative predictive value of 88 % in detecting CDKN2A/B HD. Survival analysis demonstrated significantly reduced disease-free and overall survival among patients with MTAP loss, p16 negativity, and CDKN2A/B HD.</div></div><div><h3>Conclusions</h3><div>MTAP immunohistochemistry, alone or combined with p16, represents a cost-effective and feasible surrogate for detecting CDKN2A/B homozygous deletion in CNS tumors and provides relevant prognostic information.</div></div>","PeriodicalId":50768,"journal":{"name":"Annals of Diagnostic Pathology","volume":"79 ","pages":"Article 152524"},"PeriodicalIF":1.5,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144580780","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}
Pub Date : 2025-06-26DOI: 10.1016/j.anndiagpath.2025.152523
Hristo Milev , Ivan Ivanov
Ki-67 is a nuclear protein used as a proliferation marker in breast carcinoma, aiding in tumor classification and prognostic assessment. However, its clinical utility is limited by variability in immunohistochemical assessment, influenced by numerous factors, including differences in antibody clones. This study aims to compare the performance of two widely used Ki-67 antibody clones, MIB1 and SP6, and to evaluate their impact on molecular subtyping in breast cancer. Sections from formalin-fixed, paraffin-embedded biopsy samples from 35 primary breast carcinoma cases were stained using MIB1 and SP6 antibodies. Histological tumor characteristics and receptor statuses were evaluated for each case. The Ki-67 proliferative index was assessed following the latest recommendations of the International Ki-67 in Breast Cancer Working Group. Statistical analysis included Pearson correlation, paired t-test, Welch's ANOVA, and McNemar's test. A strong correlation was observed between Ki-67 indices obtained using MIB1 and SP6 (r = 0.755, p < 0.001), with no statistically significant difference in mean values (p = 0.288). Ki-67 index correlated significantly with tumor grade for both antibodies. Among Luminal HER2-negative tumors, 17 % showed discordant molecular subtyping between MIB1 and SP6 using a 20 % cut-off. Similar discrepancies were observed at 14 % and 25 % cut-offs, suggesting that antibody choice may affect subtype classification. In conclusion, both MIB1 and SP6 provide reliable assessment of proliferative index in breast carcinoma, however, discrepancies in individual cases may impact molecular subtyping and subsequent clinical decision-making. Therefore, reporting the antibody clone used in Ki-67 evaluation may be advisable, pending further validation.
Ki-67是一种核蛋白，在乳腺癌中被用作增殖标志物，有助于肿瘤分类和预后评估。然而，它的临床应用受到多种因素的影响，包括抗体克隆的差异，免疫组织化学评估的可变性的限制。本研究旨在比较两种广泛使用的Ki-67抗体克隆MIB1和SP6的性能，并评估它们对乳腺癌分子分型的影响。用MIB1和SP6抗体对35例原发性乳腺癌的福尔马林固定切片和石蜡包埋切片进行染色。对每个病例的组织学肿瘤特征和受体状态进行评估。Ki-67增殖指数是根据国际乳腺癌Ki-67工作组的最新建议进行评估的。统计分析包括Pearson相关、配对t检验、Welch方差分析和McNemar检验。使用MIB1和SP6获得的Ki-67指数之间存在很强的相关性(r = 0.755, p <；0.001)，平均值差异无统计学意义（p = 0.288）。Ki-67指数与两种抗体的肿瘤分级有显著相关性。在腔内her2阴性肿瘤中，17%的肿瘤在MIB1和SP6之间表现出不一致的分子分型。在14%和25%的临界值处观察到类似的差异，表明抗体选择可能影响亚型分类。总之，MIB1和SP6都能可靠地评估乳腺癌的增殖指数，然而，个别病例的差异可能会影响分子分型和随后的临床决策。因此，报告用于Ki-67评价的抗体克隆可能是可取的，有待进一步验证。
{"title":"Comparative analysis of MIB1 and SP6 antibodies for Ki-67 assessment in breast carcinoma with focus on the influence of molecular subtyping","authors":"Hristo Milev , Ivan Ivanov","doi":"10.1016/j.anndiagpath.2025.152523","DOIUrl":"10.1016/j.anndiagpath.2025.152523","url":null,"abstract":"<div><div>Ki-67 is a nuclear protein used as a proliferation marker in breast carcinoma, aiding in tumor classification and prognostic assessment. However, its clinical utility is limited by variability in immunohistochemical assessment, influenced by numerous factors, including differences in antibody clones. This study aims to compare the performance of two widely used Ki-67 antibody clones, MIB1 and SP6, and to evaluate their impact on molecular subtyping in breast cancer. Sections from formalin-fixed, paraffin-embedded biopsy samples from 35 primary breast carcinoma cases were stained using MIB1 and SP6 antibodies. Histological tumor characteristics and receptor statuses were evaluated for each case. The Ki-67 proliferative index was assessed following the latest recommendations of the International Ki-67 in Breast Cancer Working Group. Statistical analysis included Pearson correlation, paired <em>t</em>-test, Welch's ANOVA, and McNemar's test. A strong correlation was observed between Ki-67 indices obtained using MIB1 and SP6 (<em>r</em> = 0.755, <em>p</em> < 0.001), with no statistically significant difference in mean values (<em>p</em> = 0.288). Ki-67 index correlated significantly with tumor grade for both antibodies. Among Luminal HER2-negative tumors, 17 % showed discordant molecular subtyping between MIB1 and SP6 using a 20 % cut-off. Similar discrepancies were observed at 14 % and 25 % cut-offs, suggesting that antibody choice may affect subtype classification. In conclusion, both MIB1 and SP6 provide reliable assessment of proliferative index in breast carcinoma, however, discrepancies in individual cases may impact molecular subtyping and subsequent clinical decision-making. Therefore, reporting the antibody clone used in Ki-67 evaluation may be advisable, pending further validation.</div></div>","PeriodicalId":50768,"journal":{"name":"Annals of Diagnostic Pathology","volume":"79 ","pages":"Article 152523"},"PeriodicalIF":1.5,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144517192","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}
Fibroblastic foci (FF) are main findings in idiopathic pulmonary fibrosis (IPF) but are not specific to IPF. Pirfenidone and nintedanib are standard antifibrotic treatments for IPF and affect factors associated with fibroblasts. A proportion of interstitial lung diseases (ILDs) are progressive fibrosing ILDs (PF-ILDs). This progressive fibrosing phenotype includes various ILDs, including fibrotic hypersensitivity pneumonitis (FHP) and connective tissue disease-related ILD (CTD-ILD). We examined the relationship between FF and a relative decline in respiratory function.
Methods and results
Among patients with lung transplantation (LT), those diagnosed with IPF, nonspecific interstitial pneumonia (NSIP), CTD-ILD, and FHP for whom respiratory function test results within 24 months before LT were retrospectively available were included (n = 67). Patients were classified as PF-ILD+ or PF-ILD- based on the criteria for the progression of a relative decline in the predicted value of forced vital capacity (FVC) within 24 months before LT. We classified FF into peripheral (pFF), alveolar (aFF), centrilobular (cFF), and distorted or dense fibrotic lesions (dFF). The number of FF/cm2 at each location was counted, and its percentage was calculated. Spearman's rank correlation coefficient between a relative decline in %FVC and total FF/cm2 in NSIP was 0.721. The dFF/cm2 and dFF/total FF ratios were higher and the aFF/total FF ratio was lower in the PF-ILD+ group than in the PF-ILD- group.
Conclusion
Total FF correlated with relative declines in %FVC in NSIP. Higher dFF/total FF ratios were associated with progressive status, and higher aFF/total FF ratios were associated with less progressive status.
{"title":"Relationship between fibroblastic foci and respiratory function: Does the abundance of fibroblastic foci reflect a recent decline in respiratory function?","authors":"Hiroyuki Katsuragawa , Hiroaki Ito , Tomohiro Handa , Masatsugu Hamaji , Satona Tanaka , Ryo Sakamoto , Daisuke Nakajima , Hiroshi Date , Hironori Haga , Akihiko Yoshizawa","doi":"10.1016/j.anndiagpath.2025.152522","DOIUrl":"10.1016/j.anndiagpath.2025.152522","url":null,"abstract":"<div><h3>Aims</h3><div>Fibroblastic foci (FF) are main findings in idiopathic pulmonary fibrosis (IPF) but are not specific to IPF. Pirfenidone and nintedanib are standard antifibrotic treatments for IPF and affect factors associated with fibroblasts. A proportion of interstitial lung diseases (ILDs) are progressive fibrosing ILDs (PF-ILDs). This progressive fibrosing phenotype includes various ILDs, including fibrotic hypersensitivity pneumonitis (FHP) and connective tissue disease-related ILD (CTD-ILD). We examined the relationship between FF and a relative decline in respiratory function.</div></div><div><h3>Methods and results</h3><div>Among patients with lung transplantation (LT), those diagnosed with IPF, nonspecific interstitial pneumonia (NSIP), CTD-ILD, and FHP for whom respiratory function test results within 24 months before LT were retrospectively available were included (<em>n</em> = 67). Patients were classified as PF-ILD+ or PF-ILD- based on the criteria for the progression of a relative decline in the predicted value of forced vital capacity (FVC) within 24 months before LT. We classified FF into peripheral (pFF), alveolar (aFF), centrilobular (cFF), and distorted or dense fibrotic lesions (dFF). The number of FF/cm<sup>2</sup> at each location was counted, and its percentage was calculated. Spearman's rank correlation coefficient between a relative decline in %FVC and total FF/cm<sup>2</sup> in NSIP was 0.721. The dFF/cm<sup>2</sup> and dFF/total FF ratios were higher and the aFF/total FF ratio was lower in the PF-ILD+ group than in the PF-ILD- group.</div></div><div><h3>Conclusion</h3><div>Total FF correlated with relative declines in %FVC in NSIP. Higher dFF/total FF ratios were associated with progressive status, and higher aFF/total FF ratios were associated with less progressive status.</div></div>","PeriodicalId":50768,"journal":{"name":"Annals of Diagnostic Pathology","volume":"79 ","pages":"Article 152522"},"PeriodicalIF":1.5,"publicationDate":"2025-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144366229","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}
Subdural hematomas develop as a result of hemorrhages in bridging veins located within the subdural space, between the dura mater and arachnoid mater. Histopathological examination of surgical specimens from hematoma regions may reveal meningothelial cell hyperplasia secondary to the hemorrhage. This study aims to evaluate the frequency of meningothelial hyperplasia (MH), cell count and size observed in these specimens and to highlight this proliferation which may mimic meningioma in differential diagnosis. Histopathological slides of 68 patients operated for subdural hematoma were retrospectively analyzed. Membrane thickness and the cell count and size of hyperplasia in areas with MH were measured. Associations with clinical parameters such as age, sex, hypertension, diabetes mellitus, and chronic kidney disease, as well as histopathological parameters like granulation tissue and psammoma bodies were investigated. MH was observed in 23 patients (33.8 %) and absent in 45 patients (66.2 %). The meningothelial cell layer count ranged from a minimum of 3 to a maximum of 15, with an average cell count of 9.6. The average size of the MH areas was 482 μm and the mean membrane thickness across all patients was 1.8 mm. Psammoma bodies were observed in 23 patients (33.8 %) and granulation tissue was seen in 25 patients (36.8 %). The presence of MH was found to be associated with increasing age (p = 0.021) but was unrelated to hypertension, diabetes, or chronic kidney disease. However, increased membrane thickness was observed in patients with hypertension (p = 0.029). In conclusion, this study investigated the frequency of MH which is a reactive process in subdural hematoma specimens and further clinicopathological studies are crucial for better understanding meningothelial cells, which are also the origin of meningiomas.
{"title":"Investigation of the frequency of meningothelial hyperplasia and its clinicopathological correlation in patients diagnosed with subdural hematoma","authors":"Fadime Eda Gökalp Satıcı , Gözde Arslan , Hamide Sayar","doi":"10.1016/j.anndiagpath.2025.152521","DOIUrl":"10.1016/j.anndiagpath.2025.152521","url":null,"abstract":"<div><div>Subdural hematomas develop as a result of hemorrhages in bridging veins located within the subdural space, between the dura mater and arachnoid mater. Histopathological examination of surgical specimens from hematoma regions may reveal meningothelial cell hyperplasia secondary to the hemorrhage. This study aims to evaluate the frequency of meningothelial hyperplasia (MH), cell count and size observed in these specimens and to highlight this proliferation which may mimic meningioma in differential diagnosis. Histopathological slides of 68 patients operated for subdural hematoma were retrospectively analyzed. Membrane thickness and the cell count and size of hyperplasia in areas with MH were measured. Associations with clinical parameters such as age, sex, hypertension, diabetes mellitus, and chronic kidney disease, as well as histopathological parameters like granulation tissue and psammoma bodies were investigated. MH was observed in 23 patients (33.8 %) and absent in 45 patients (66.2 %). The meningothelial cell layer count ranged from a minimum of 3 to a maximum of 15, with an average cell count of 9.6. The average size of the MH areas was 482 μm and the mean membrane thickness across all patients was 1.8 mm. Psammoma bodies were observed in 23 patients (33.8 %) and granulation tissue was seen in 25 patients (36.8 %). The presence of MH was found to be associated with increasing age (<em>p</em> = 0.021) but was unrelated to hypertension, diabetes, or chronic kidney disease. However, increased membrane thickness was observed in patients with hypertension (<em>p</em> = 0.029). In conclusion, this study investigated the frequency of MH which is a reactive process in subdural hematoma specimens and further clinicopathological studies are crucial for better understanding meningothelial cells, which are also the origin of meningiomas.</div></div>","PeriodicalId":50768,"journal":{"name":"Annals of Diagnostic Pathology","volume":"79 ","pages":"Article 152521"},"PeriodicalIF":1.5,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144338868","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}
Fine needle aspiration cytology has emerged as a minimally invasive, cost-effective diagnostic tool with significant utility in evaluating mediastinal lesions. However, comprehensive data on its diagnostic accuracy, efficacy, and clinical impact on managing these lesions remain limited. This study aims to evaluate the diagnostic utility of fine needle aspiration cytology in mediastinal lesions, focusing on its accuracy, safety, and role in guiding therapeutic approaches. A cross-sectional retrospective analysis was conducted on patients who underwent fine needle aspiration for mediastinal lesions at our tertiary care centre between 2015 and 2024. Demographic data, cytological findings, histopathological correlation, and ancillary studies were reviewed. Diagnostic accuracy was assessed by comparing fine needle aspiration cytology findings with histopathological diagnoses. A cumulative total of 60 cases of mediastinal lesions were evaluated, of which 47 cases were considered suitable for cytological assessment. Among the 60 cases, 41 cases were identified as neoplastic (68.33 %), while 6 were classified as nonneoplastic (10 %) on cytology. Within the spectrum of neoplastic mediastinal lesions, lymphoma was recognised as the principal neoplastic entity, followed by thymic neoplasms and metastatic lesions. The overall diagnostic accuracy achieved through fine needle aspiration cytology in distinguishing these lesions was established at 83.8 %, with diagnostic accuracy being exceptionally high in metastatic lesions. Fine needle aspiration cytology of mediastinal lesions is a highly accurate, safe, and valuable diagnostic tool that significantly influences clinical management and treatment protocols. However, further studies with larger sample sizes and prospective designs are warranted to validate these results and refine procedural protocols.
{"title":"The role of fine needle aspiration cytology in the diagnosis of mediastinal lesions: A 9-year experience from coastal Karnataka","authors":"Chaithra Gowthuvalli Venkataramana , Shalini Radhakrishnan , K.M. Sinchana , Aditi Dixit , Kocherlakota Krishna Akhil , Rakshatha Nayak , Sunita Hegde , Shikha Jayasheelan","doi":"10.1016/j.anndiagpath.2025.152520","DOIUrl":"10.1016/j.anndiagpath.2025.152520","url":null,"abstract":"<div><div>Fine needle aspiration cytology has emerged as a minimally invasive, cost-effective diagnostic tool with significant utility in evaluating mediastinal lesions. However, comprehensive data on its diagnostic accuracy, efficacy, and clinical impact on managing these lesions remain limited. This study aims to evaluate the diagnostic utility of fine needle aspiration cytology in mediastinal lesions, focusing on its accuracy, safety, and role in guiding therapeutic approaches. A cross-sectional retrospective analysis was conducted on patients who underwent fine needle aspiration for mediastinal lesions at our tertiary care centre between 2015 and 2024. Demographic data, cytological findings, histopathological correlation, and ancillary studies were reviewed. Diagnostic accuracy was assessed by comparing fine needle aspiration cytology findings with histopathological diagnoses. A cumulative total of 60 cases of mediastinal lesions were evaluated, of which 47 cases were considered suitable for cytological assessment. Among the 60 cases, 41 cases were identified as neoplastic (68.33 %), while 6 were classified as nonneoplastic (10 %) on cytology. Within the spectrum of neoplastic mediastinal lesions, lymphoma was recognised as the principal neoplastic entity, followed by thymic neoplasms and metastatic lesions. The overall diagnostic accuracy achieved through fine needle aspiration cytology in distinguishing these lesions was established at 83.8 %, with diagnostic accuracy being exceptionally high in metastatic lesions. Fine needle aspiration cytology of mediastinal lesions is a highly accurate, safe, and valuable diagnostic tool that significantly influences clinical management and treatment protocols. However, further studies with larger sample sizes and prospective designs are warranted to validate these results and refine procedural protocols.</div></div>","PeriodicalId":50768,"journal":{"name":"Annals of Diagnostic Pathology","volume":"79 ","pages":"Article 152520"},"PeriodicalIF":1.5,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144263809","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}
Pub Date : 2025-06-10DOI: 10.1016/j.anndiagpath.2025.152517
Maryna Slisarenko , Reza Alaghehbandan , Joanna Rogala , Mihaela Farcas , Josef Skopal , Marian Svajdler , Ondrej Fiala , Petr Stránský Jr. , Adriena Bartos Vesela , Tomas Pitra , Milan Hora , Michal Michal , Ondrej Hes , Kristyna Pivovarcikova
Carbonic anhydrase IX (CA IX) is traditionally considered to be an immunomarker of clear cell renal cell carcinoma (RCC). However, CA IX expression has also been documented in other RCCs subtypes. Discrimination between clear cell RCC and non-clear cell RCC is crucial for further patient management. The aim of this study was to assess CA IX immunoreactivity across the spectrum of RCC with sarcomatoid differentiation. The expression of CA IX was evaluated in 32 cases of RCCs with sarcomatoid differentiation (12 clear cell RCC, 7 papillary RCC and 13 chromophobe RCC). Seven urothelial carcinomas (UC) with sarcomatoid differentiation (originally from renal pelvis) and 23 soft tissue tumors were also included as a control cohort. The sensitivity for CA IX in sarcomatoid component of clear cell RCC was 91.7 % (moderate/strong CA IX staining in >60 % of sarcomatoid component). However, the CA IX specificity was rather low (45 %), as a significant proportion of sarcomatoid components in different renal cell carcinoma subtypes also stained with CA IX (2/7 papillary RCC, 9/14 chromophobe RCC). When urothelial carcinoma and soft tissue tumors were included in the evaluation, the specificity of CA IX staining for sarcomatoid clear cell RCC reached 60 %. In conclusion, CA IX shows decent sensitivity for sarcomatoid clear cell RCC, but with low specificity, hence limiting its diagnostic utility as a reliable marker of in tumors with predominant sarcomatoid component.
{"title":"Reactivity of carbonic anhydrase IX (CA IX) across the spectrum of renal cell carcinomas with sarcomatoid differentiation","authors":"Maryna Slisarenko , Reza Alaghehbandan , Joanna Rogala , Mihaela Farcas , Josef Skopal , Marian Svajdler , Ondrej Fiala , Petr Stránský Jr. , Adriena Bartos Vesela , Tomas Pitra , Milan Hora , Michal Michal , Ondrej Hes , Kristyna Pivovarcikova","doi":"10.1016/j.anndiagpath.2025.152517","DOIUrl":"10.1016/j.anndiagpath.2025.152517","url":null,"abstract":"<div><div>Carbonic anhydrase IX (CA IX) is traditionally considered to be an immunomarker of clear cell renal cell carcinoma (RCC). However, CA IX expression has also been documented in other RCCs subtypes. Discrimination between clear cell RCC and non-clear cell RCC is crucial for further patient management. The aim of this study was to assess CA IX immunoreactivity across the spectrum of RCC with sarcomatoid differentiation. The expression of CA IX was evaluated in 32 cases of RCCs with sarcomatoid differentiation (12 clear cell RCC, 7 papillary RCC and 13 chromophobe RCC). Seven urothelial carcinomas (UC) with sarcomatoid differentiation (originally from renal pelvis) and 23 soft tissue tumors were also included as a control cohort. The sensitivity for CA IX in sarcomatoid component of clear cell RCC was 91.7 % (moderate/strong CA IX staining in >60 % of sarcomatoid component). However, the CA IX specificity was rather low (45 %), as a significant proportion of sarcomatoid components in different renal cell carcinoma subtypes also stained with CA IX (2/7 papillary RCC, 9/14 chromophobe RCC). When urothelial carcinoma and soft tissue tumors were included in the evaluation, the specificity of CA IX staining for sarcomatoid clear cell RCC reached 60 %. In conclusion, CA IX shows decent sensitivity for sarcomatoid clear cell RCC, but with low specificity, hence limiting its diagnostic utility as a reliable marker of in tumors with predominant sarcomatoid component.</div></div>","PeriodicalId":50768,"journal":{"name":"Annals of Diagnostic Pathology","volume":"79 ","pages":"Article 152517"},"PeriodicalIF":1.5,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144272305","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}
Pub Date : 2025-06-02DOI: 10.1016/j.anndiagpath.2025.152516
Noor Ul Huda , Hafsa Ahsun , Muhammad Fahad Mukhtar
Harahap et al. (2025) examine the association between BRAFV600E mutation and nuclear features in papillary thyroid carcinoma (PTC), with a focus on nuclear pseudo inclusions (NPIs). While the study contributes to understanding molecular-histo pathological correlations, several critical limitations warrant attention. The authors do not account for congenital anomalies such as thyroid hemi agenesis, which can alter tumor morphology independently of genetic mutations [2]. Additionally, coexisting autoimmune thyroid conditions like Hashimoto’s thyroiditis may confound nuclear features through inflammatory changes [3]. The study also overlooks the influence of demographic factors, such as age and gender, which are known to impact PTC prognosis and histology [4]. Reliance on a subjective nuclear scoring system without digital validation raises concerns about reproducibility and inter observer variability [5]. Addressing these gaps is significant to improve the diagnostic accuracy and clinical relevance of morpho-molecular correlations in Papillary Thyroid Carcinoma. Future research should adopt more comprehensive and standardized approaches.
{"title":"“Letter to the Editor: Nuclear pseudo inclusion is associated with BRAFV600E mutation: Analysis of nuclear features in papillary thyroid carcinoma”","authors":"Noor Ul Huda , Hafsa Ahsun , Muhammad Fahad Mukhtar","doi":"10.1016/j.anndiagpath.2025.152516","DOIUrl":"10.1016/j.anndiagpath.2025.152516","url":null,"abstract":"<div><div>Harahap et al. (2025) examine the association between BRAFV600E mutation and nuclear features in papillary thyroid carcinoma (PTC), with a focus on nuclear pseudo inclusions (NPIs). While the study contributes to understanding molecular-histo pathological correlations, several critical limitations warrant attention. The authors do not account for congenital anomalies such as thyroid hemi agenesis, which can alter tumor morphology independently of genetic mutations [2]. Additionally, coexisting autoimmune thyroid conditions like Hashimoto’s thyroiditis may confound nuclear features through inflammatory changes [3]. The study also overlooks the influence of demographic factors, such as age and gender, which are known to impact PTC prognosis and histology [4]. Reliance on a subjective nuclear scoring system without digital validation raises concerns about reproducibility and inter observer variability [5]. Addressing these gaps is significant to improve the diagnostic accuracy and clinical relevance of morpho-molecular correlations in Papillary Thyroid Carcinoma. Future research should adopt more comprehensive and standardized approaches.</div></div>","PeriodicalId":50768,"journal":{"name":"Annals of Diagnostic Pathology","volume":"79 ","pages":"Article 152516"},"PeriodicalIF":1.5,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144223230","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}
Pub Date : 2025-05-28DOI: 10.1016/j.anndiagpath.2025.152515
Jiyun Kim, Joon Young Park, So Young Kim, Sejin Jung, Joo-Young Na, Hyun Jung Lee, Dong Hoon Shin, Jung Hee Lee
This study aimed to evaluate the clinicopathological features, prognostic relevance, and classification accuracy of histological subtypes—the small duct type and the large duct type—in intrahepatic cholangiocarcinoma (iCCA) based on the WHO 5th edition criteria. A retrospective analysis was conducted on iCCA cases classified into the small duct type and the large duct type. Key pathological variables were identified using logistic regression and used to develop a random forest classification model. Survival outcomes were analyzed using Kaplan-Meier and Cox regression analyses. The random forest model, using nine significant pathological features, achieved an overall classification accuracy of 83 %. Mucin production, tumor grade, and intraepithelial lesion were among the most influential predictors. The small duct type was associated with significantly better overall survival (5-year rate: 57.6 %) and recurrence-free survival (46.6 %) compared to the large duct type (24.9 % and 20.6 %, respectively). Multivariable analysis confirmed the large duct type as an independent predictor of worse prognosis. Histological subtyping of iCCA holds important prognostic value. The small duct type is associated with a more favorable clinical course, supporting the integration of subtype-aware assessments into diagnostic and prognostic frameworks. These findings may inform future developments in computational pathology and personalized treatment strategies.
{"title":"Small but significant: Prognostic value of the small duct type in intrahepatic cholangiocarcinoma","authors":"Jiyun Kim, Joon Young Park, So Young Kim, Sejin Jung, Joo-Young Na, Hyun Jung Lee, Dong Hoon Shin, Jung Hee Lee","doi":"10.1016/j.anndiagpath.2025.152515","DOIUrl":"10.1016/j.anndiagpath.2025.152515","url":null,"abstract":"<div><div>This study aimed to evaluate the clinicopathological features, prognostic relevance, and classification accuracy of histological subtypes—the small duct type and the large duct type—in intrahepatic cholangiocarcinoma (iCCA) based on the WHO 5th edition criteria. A retrospective analysis was conducted on iCCA cases classified into the small duct type and the large duct type. Key pathological variables were identified using logistic regression and used to develop a random forest classification model. Survival outcomes were analyzed using Kaplan-Meier and Cox regression analyses. The random forest model, using nine significant pathological features, achieved an overall classification accuracy of 83 %. Mucin production, tumor grade, and intraepithelial lesion were among the most influential predictors. The small duct type was associated with significantly better overall survival (5-year rate: 57.6 %) and recurrence-free survival (46.6 %) compared to the large duct type (24.9 % and 20.6 %, respectively). Multivariable analysis confirmed the large duct type as an independent predictor of worse prognosis. Histological subtyping of iCCA holds important prognostic value. The small duct type is associated with a more favorable clinical course, supporting the integration of subtype-aware assessments into diagnostic and prognostic frameworks. These findings may inform future developments in computational pathology and personalized treatment strategies.</div></div>","PeriodicalId":50768,"journal":{"name":"Annals of Diagnostic Pathology","volume":"79 ","pages":"Article 152515"},"PeriodicalIF":1.5,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144195542","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}
Pub Date : 2025-05-27DOI: 10.1016/j.anndiagpath.2025.152514
Vinita Parkash
{"title":"Editorial Comment on Mucinous Neoplasms Associated with Mature Cystic Teratomas: A Clinicopathologic Study of 50 Cases: Are We Ready for Nomenclature Change?","authors":"Vinita Parkash","doi":"10.1016/j.anndiagpath.2025.152514","DOIUrl":"10.1016/j.anndiagpath.2025.152514","url":null,"abstract":"","PeriodicalId":50768,"journal":{"name":"Annals of Diagnostic Pathology","volume":"78 ","pages":"Article 152514"},"PeriodicalIF":1.5,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144217464","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}
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