Annals of Diagnostic Pathology最新文献_第9页

Rosai-Dorfman disease of the breast: A six-case clinicopathologic study 乳腺Rosai-Dorfman病：六例临床病理研究

IF 1.5 4区医学 Q3 PATHOLOGY

Annals of Diagnostic Pathology

Pub Date : 2025-05-26 DOI: 10.1016/j.anndiagpath.2025.152513

Elif Demirci , Mostafa Kokabee , Aruuke Sulaimanova , Diana Kantarovich , Iskender Genco , Shabnam Jaffer , Alyssa Yurovitsky , Sabina Hajiyeva

引用次数: 0

OBITUARY: RENE J. BUESA, Ph.D., HTL (ASCP) 讣告：RENE J. BUESA，博士，html （ASCP）

IF 1.5 4区医学 Q3 PATHOLOGY

Annals of Diagnostic Pathology

Pub Date : 2025-05-23 DOI: 10.1016/j.anndiagpath.2025.152503

Saul Suster

引用次数: 0

Evaluating the role of cytology in diagnosing primary lung carcinoma with special reference to the 2023 WHO lung cytology reporting categories 评估细胞学在原发性肺癌诊断中的作用，特别参考2023年WHO肺细胞学报告类别

IF 1.5 4区医学 Q3 PATHOLOGY

Annals of Diagnostic Pathology

Pub Date : 2025-05-23 DOI: 10.1016/j.anndiagpath.2025.152505

Kartavya Kumar Verma, Amit Bugalia, Nighat Hussain

Diagnosing lung carcinoma in cytology specimens is notably challenging. In response, the World Health Organization (WHO) introduced reformulated categories in 2023 that reflect varying malignancy risks. To evaluate this revised classification, it is vital to correlate cytological results with biopsy findings. In this study, we reclassified previously diagnosed cases based on the new WHO cytological categories. Prospective cross-sectional study evaluated cytology samples from lung carcinoma patients at AIIMS Raipur (2019–2021) and, in 2024, reclassified them according to updated WHO categories, facilitating a new assessment of cytology sensitivity through descriptive statistics and calculations. In this study, 116 biopsy-confirmed primary lung carcinoma cases underwent cytological evaluation, with cell blocks prepared for 70 cases. Sample types included bronchoalveolar lavage (BAL) fluid (68 cases, 58.6 %), sputum (4 cases, 3.4 %), and fine needle aspiration cytology (4 cases, 3.4 %); remaining samples were pleural fluid, which were subsequently excluded. Following the adoption of new WHO classification categories in 2024, a retrospective analysis demonstrated a significant improvement in sensitivity, increasing from 36.8 % (28/76) to 65.8 % (50/76), which enhanced the detection of atypical, suspicious, or malignant cases. This study underscores the effectiveness and limitations of cytological examination in diagnosing primary lung carcinoma, demonstrating that many cases can be accurately identified. The new WHO cytology categories improve diagnostic accuracy, but sensitivity results suggest room for precision enhancement. BAL fluid's low sensitivity for peripheral lesions underscores the need for alternative sampling methods.

在细胞学标本中诊断肺癌是非常具有挑战性的。作为回应，世界卫生组织（世卫组织）在2023年引入了重新制定的类别，反映了不同的恶性肿瘤风险。为了评估这种修订后的分类，将细胞学结果与活检结果联系起来是至关重要的。在这项研究中，我们根据新的WHO细胞学分类对以前诊断的病例进行了重新分类。前瞻性横断面研究评估了AIIMS Raipur（2019-2021）肺癌患者的细胞学样本，并于2024年根据更新的世卫组织分类对其进行了重新分类，通过描述性统计和计算促进了细胞学敏感性的新评估。在本研究中，116例活检证实的原发性肺癌患者进行了细胞学评估，其中70例准备了细胞块。样本类型包括支气管肺泡灌洗液（68例，58.6%）、痰液（4例，3.4%）和细针吸痰细胞学（4例，3.4%）；剩余的样本是胸腔积液，随后被排除。在2024年采用新的世卫组织分类类别之后，回顾性分析表明敏感性显著提高，从36.8%（28/76）增加到65.8%(50/76)，这加强了对非典型、可疑或恶性病例的发现。本研究强调了细胞学检查在诊断原发性肺癌中的有效性和局限性，表明许多病例可以准确识别。新的世卫组织细胞学分类提高了诊断的准确性，但敏感性结果表明精度有提高的余地。BAL液对周围病变的低敏感性强调了对替代采样方法的需求。

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引用次数: 0

Granuloma rich hepatocellular carcinoma (GrHCC): Clinicopathologic and genomic characterization 富含肉芽肿的肝细胞癌（GrHCC）：临床病理和基因组特征

IF 1.5 4区医学 Q3 PATHOLOGY

Annals of Diagnostic Pathology

Pub Date : 2025-05-20 DOI: 10.1016/j.anndiagpath.2025.152504

Mukul Vij , Lexmi Priya Raju , Dinesh Jothimani , Evangeline Simon , Subathra Radhakrishnan , Catherine Ann Martin , Gowripriya Gowrishankar , Komalavalli Subbiah , Rajesh Rajalingam , Ilankumaran Kaliamoorthy , Ashwin Rammohan , Mohamed Rela

There is limited literature on sarcoid like granuloma (SLG) associated with hepatocellular carcinoma (HCC). Here in, we studied clinicopathological characteristics, and explored the potential significance of SLG in HCC. We termed these tumors as granuloma rich HCC (GrHCC). We reviewed clinicopathologic features in 30 GrHCC tumors that were diagnosed in 21 patients during a period of 68-month at a single institution. The study included 17 males and 4 females, with ages ranging from 43 to 71 years in males and 20 to 69 years in females. Tumor downstaging was done in 4 patients. Tumor sizes ranged from 0.6 to 23 cm, with a mean size of 2.41 cm. Majority of tumors showed well to moderate cellular differentiation. A solitary well-formed epithelioid granuloma sufficed to classify the tumor as GrHCC. The intratumoral granulomas were compact, well-formed, and discrete, consisting of collections of epithelioid histiocytes and multinucleate histiocytic giant cells. Mild lymphocytic inflammation was also noted. Single to several granulomas were identified in the tumor. Size of granuloma ranged from 170 to 650 μm. Only one tumor showed necrotizing granulomas. Genomic analysis of 4 tumors revealed TP53 mutation. Two tumors also exhibited a TERT promoter mutation. All patients were alive till last follow-up, except for one, who died due to septic shock, unrelated to the HCC. This study provides valuable insights into the clinical findings, histopathological features and molecular characteristics of GrHCC.

关于与肝细胞癌（HCC）相关的肉瘤样肉芽肿（SLG）的文献有限。在此，我们研究了肝细胞癌的临床病理特征，并探讨了SLG在肝细胞癌中的潜在意义。我们将这些肿瘤称为富含肉芽肿的HCC （GrHCC）。我们回顾了在68个月的时间里在一家机构诊断的21例患者的30例GrHCC肿瘤的临床病理特征。该研究包括17名男性和4名女性，男性年龄在43至71岁之间，女性年龄在20至69岁之间。4例患者进行肿瘤降期治疗。肿瘤大小为0.6 ~ 23 cm，平均2.41 cm。大多数肿瘤表现为良好至中度的细胞分化。单发形成良好的上皮样肉芽肿足以将肿瘤分类为GrHCC。瘤内肉芽肿致密、形态良好、离散，由上皮样组织细胞和多核组织细胞巨细胞组成。轻度淋巴细胞炎症也被注意到。肿瘤中可见单个至多个肉芽肿。肉芽肿大小为170 ~ 650 μm。仅有1例肿瘤表现为坏死性肉芽肿。4例肿瘤的基因组分析显示TP53突变。两个肿瘤也表现出TERT启动子突变。截至最后一次随访，所有患者均存活，除1例死于感染性休克，与HCC无关。本研究对GrHCC的临床表现、组织病理特征和分子特征提供了有价值的见解。

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引用次数: 0

Clinical and pathological characteristics and prognostic factors of SMARCA4-deficient non-small cell lung cancer 缺乏smarca4的非小细胞肺癌临床病理特征及预后因素分析

IF 1.5 4区医学 Q3 PATHOLOGY

Annals of Diagnostic Pathology

Pub Date : 2025-05-15 DOI: 10.1016/j.anndiagpath.2025.152499

Bowen Zhang, Xiaoyan Yang, Junle Jia

The objective of the study is to investigate the clinicopathological features and prognostic factors of SMARCA4-deficient non-small cell lung cancer (SMARCA4-deficient NSCLC). A total of 43 patients with SMARCA4-deficient NSCLC who were diagnosed at Baotou Steel Hospital between January 2021 and October 2024 were included. Kaplan-Meier survival curves were plotted, and the log-rank test was used for group comparisons. Cox regression analysis was performed to identify factors influencing the 2-year overall survival in SMARCA4-deficient NSCLC patients. SMARCA4-deficient NSCLC patients exhibited distinct characteristics: older age (P < 0.05), male predominance (P < 0.05), smoking history (P < 0.05), larger tumors (P < 0.05), higher Ki-67 index (P < 0.05), lower EGFR mutation rates (P < 0.05), fewer squamous carcinomas (P < 0.05), and more poorly differentiated tumors (P < 0.05). Immunohistochemistry revealed BRG1 loss in 93.0 % (40/43), with TTF-1 (76.7 %) and P40 (81.4 %) negativity. The 2-year survival rate was significantly worse in SMARCA4-deficient NSCLC vs. SMARCA4-intact NSCLC (log-rank P < 0.001). Multivariate Cox analysis identified age ≥ 65 years (HR = 2.8, P = 0.003), smoking (HR = 2.4, P = 0.012), tumor size >5 cm (HR = 3.1, P < 0.001), and distant metastasis (HR = 4.5, P < 0.001) as independent predictors of poor survival in SMARCA4-deficient NSCLC. Patients with advanced-stage disease (III/IV) had significantly shorter survival (P < 0.05). SMARCA4 deficiency defines an aggressive NSCLC subtype with unique clinicopathological traits, including rapid progression, and poor survival.

本研究的目的是探讨smarca4缺陷非小细胞肺癌（smarca4缺陷NSCLC）的临床病理特征及预后因素。共纳入了2021年1月至2024年10月期间在包头钢铁医院诊断的43例smarca4缺陷NSCLC患者。绘制Kaplan-Meier生存曲线，采用log-rank检验进行组间比较。采用Cox回归分析确定影响smarca4缺陷NSCLC患者2年总生存率的因素。缺乏smarca4的NSCLC患者表现出明显的特征：年龄较大(P <；0.05)，男性优势(P <；0.05)、吸烟史(P <；0.05)，较大的肿瘤(P <；0.05)， Ki-67指数较高(P <；0.05)， EGFR突变率降低(P <；0.05)，鳞状癌较少(P <；0.05)，低分化肿瘤较多(P <；0.05)。免疫组化显示BRG1缺失93.0% (40/43),TTF-1（76.7%）和P40（81.4%）阴性。smarca4缺失NSCLC的2年生存率明显低于smarca4完整NSCLC (log-rank P <；0.001)。多因素Cox分析确定年龄≥65岁（HR = 2.8, P = 0.003）、吸烟（HR = 2.4, P = 0.012）、肿瘤大小>；5 cm (HR = 3.1, P <；0.001)，远处转移(HR = 4.5, P <；0.001)作为缺乏smarca4的非小细胞肺癌生存率差的独立预测因子。晚期疾病（III/IV）患者的生存期明显缩短(P <；0.05)。SMARCA4缺陷定义了一种侵袭性NSCLC亚型，具有独特的临床病理特征，包括快速进展和较差的生存率。

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引用次数: 0

Diagnostic value of cyclin D1 immunohistochemistry in differentiating malignant mesothelioma from reactive mesothelial proliferation 细胞周期蛋白D1免疫组化在鉴别恶性间皮瘤与反应性间皮瘤增殖中的诊断价值

IF 1.5 4区医学 Q3 PATHOLOGY

Annals of Diagnostic Pathology

Pub Date : 2025-05-14 DOI: 10.1016/j.anndiagpath.2025.152502

Döndü Nergiz , Arsenal Sezgin Alikanoğlu , Dinç Süren

Introduction

Although morphologic assessment carries utmost importance in differentiating malignant mesotheliomas (MM) from reactive mesothelial proliferations (RMP), sometimes it may fail to clearly differentiate between these two entities. The aim of this study is to evaluate the potential role of cyclin D1 immunohistochemistry in this differentiation.

Material and methods

Eighty cases (40 MM, 40 RMP) were examined. Nuclear staining of the mesothelial cells was evaluated after cyclin D1 immunostaining. Immunostaining was scored according to the percentage of immunopositive cells (0 %, 1–25 %; 26–50 %; 51–75 %; 76–100 %).

Results

For MMs, 24/40 (60 %) cases demonstrated >50 % staining, with 13/24 in the 51–75 %, 11/24 in the >75 % range. RMPs generally showed no staining (27/40 cases) or 1–25 % staining (11/40 cases) with no cases showing >50 % staining. There was a statistically significant difference between RMP and MM groups according to Cyclin D1 staining percentage (p = 0.001). When 50 % was set as the cut-off value for Cyclin D1 staining, cyclin D1 immunohistochemistry had 60 % sensitivity, 100 % specificity and 80 % accuracy in differential diagnosis between MM and RMP.

Conclusion

In the diagnosis of MM, immunostaining of >50 % of the cells with cyclin D1 is a useful adjunct to morphologic assessment. Although cyclin D1 immunostaining showed high specificity when 50 % immunopositivity was set as a cut-off value in the differentiation between MM and RMP, its sensitivity and accuracy were relatively low. Validation of diagnostic utility of cyclin D1 immunohistochemistry based on the results of relevant prospective studies is necessary before its clinical application.

虽然形态学评估在区分恶性间皮瘤（MM）和反应性间皮瘤（RMP）中至关重要，但有时它可能无法明确区分这两种实体。本研究的目的是评估细胞周期蛋白D1免疫组化在这种分化中的潜在作用。材料与方法检查80例（40 MM, 40 RMP）。细胞周期蛋白D1免疫染色后评价间皮细胞核染色。免疫染色按免疫阳性细胞百分比(0 %,1 - 25%；26-50 %;51 - 75 %;76 - 100年%)。结果mm有24/40例（60%）染色为>； 50%，其中13/24例为51 - 75%，11/24例为>； 75%。RMPs通常无染色（27/40例）或1 - 25%染色（11/40例），没有病例显示50%染色。RMP组与MM组Cyclin D1染色百分比比较，差异有统计学意义（p = 0.001）。当Cyclin D1染色的临界值为50%时，Cyclin D1免疫组化对MM和RMP的鉴别诊断灵敏度为60%，特异性为100%，准确性为80%。结论对50%的细胞进行细胞周期蛋白D1免疫染色是诊断MM的有效辅助手段。虽然以50%的免疫阳性作为区分MM和RMP的临界值时，cyclin D1免疫染色具有较高的特异性，但其敏感性和准确性相对较低。在临床应用之前，有必要基于相关前瞻性研究的结果验证cyclin D1免疫组化的诊断效用。

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引用次数: 0

Rethinking tissue preservation: A review of non-toxic and environmentally sustainable fixatives 重新思考组织保存：无毒和环境可持续的固定剂的回顾

IF 1.5 4区医学 Q3 PATHOLOGY

Annals of Diagnostic Pathology

Pub Date : 2025-05-13 DOI: 10.1016/j.anndiagpath.2025.152500

Sowmiya Shri Thangamani, Swaathi Ravindran, Magesh Karuppur Thiagarajan, Sathya Kumar Mayilvakanam, Aravindhan Ravi, Sivachandran Annamalai

Fixatives are substances used in histopathology to preserve tissue samples by preventing degradation and keeping them structurally intact for microscopic analysis. The common examples include formaldehyde, glutaraldehyde, and alcohols. The widely used fixative, formaldehyde, carries significant health hazards, like respiratory distress, mucosal irritation and carcinogenic effects. Consequently, there is a growing academic impetus to explore natural alternatives to traditional chemical fixatives. Studies were obtained from PubMed database using keywords that covered a wide range of fixatives, including natural, formalin-based, sugar-based, plant-based, and alternative options. Collected data was analyzed and organized into four categories of naturally available fixatives: Aloe vera, Honey, Jaggery, Sugar. 11 studies were included from January 2013 to March 2024. In these, the alternative fixatives has been used for tissue processing. Honey was tested eight times at concentrations of 10 %, 20 %, and 100 %; jaggery six times at 30 % and 100 %; Sugar was used as sugar syrup three times at 20 % and 100 %, as sirka once and as sugarcane vinegar in one study; aloe vera once at 20 %; ethanol twice at 95 %; and formalin nine times at 4 % and 10 %. Compelling evidence demonstrates that natural fixatives can provide tissue preservation on par with formalin, particularly in short-term applications. Although these fixatives are harmless, they come with certain disadvantages Honey has shorter shelf life; Jaggery cause mold formation and produces discoloration of sample; Sugar attracts insects and leads mold formation; Aloe vera produce poor nuclear staining and cell morphology preservation.

固定剂是在组织病理学中使用的物质，通过防止降解和保持组织样本的结构完整来保存组织样本，以便进行显微镜分析。常见的例子包括甲醛、戊二醛和醇。广泛使用的固定剂甲醛具有显著的健康危害，如呼吸窘迫、粘膜刺激和致癌作用。因此，有一个日益增长的学术动力，探索自然替代品，以传统的化学固定。研究从PubMed数据库中获得，使用的关键词涵盖了广泛的固定剂，包括天然的、基于福尔马林的、基于糖的、基于植物的和替代选择。从2013年1月到2024年3月，对收集到的数据进行分析，并将其分为四类天然可用的固定剂：芦荟、蜂蜜、Jaggery、Sugar。在这些，替代固定剂已用于组织处理。蜂蜜在10%、20%和100%的浓度下测试了8次；在30%和100%的情况下有6次不均匀；在一项研究中，糖在20%和100%的浓度下被三次用作糖浆，一次用作sirka，一次用作甘蔗醋；芦荟一度在20%；95%乙醇两次；福尔马林的浓度分别为4%和10%令人信服的证据表明，天然固定剂可以提供与福尔马林相当的组织保存，特别是在短期应用中。虽然这些固定剂是无害的，但它们也有一定的缺点，蜂蜜的保质期较短；锯齿造成模具形成，使样品变色；糖吸引昆虫并导致霉菌形成；芦荟产生较差的细胞核染色和细胞形态保存。

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引用次数: 0

Sarcomatoid squamous cell carcinoma of the cervix: A case series and literature review 宫颈肉瘤样鳞状细胞癌：一个病例系列和文献复习

IF 1.5 4区医学 Q3 PATHOLOGY

Annals of Diagnostic Pathology

Pub Date : 2025-05-13 DOI: 10.1016/j.anndiagpath.2025.152501

Qiuyang Jing , Wenjuan Pu , Peng Guo , Xin Liao

Primary cervical sarcomatoid squamous cell carcinoma (SSCC), a rare biphasic malignancy with 29 documented cases, is characterized by co-existing malignant squamous epithelium and sarcomatoid spindle cells. Immunohistochemical co-expression of epithelial (PCK) and mesenchymal (vimentin) markers remains diagnostic. We analyzed 8 institutional cases (2006–2024) alongside literature reports. Patients (median age 46, range 28–72) predominantly presented with vaginal bleeding (7/8 cases), while one exhibited abdominal pain with discharge. HPV16 was detected in 2 cases. All tumors showed variable immunoreactivity for PCK, vimentin, p16, and ≥ 1 squamous marker (p63/p40/CK5/6). Treatment included chemotherapy (6/8) and radiotherapy (3/8). Follow-up (median 57.4 months, n = 7) revealed aggressive behavior: two stage IIIC patients developed supraclavicular/visceral metastases (alive with disease at 10–31 months), one stage IIIA patient died at 24 months, while others remained disease-free. Combined analysis with 29 published cases confirms SSCC's dual histologic presentation (biphasic/monophasic) and consistent epithelial-mesenchymal marker co-expression. These findings underscore SSCC's clinicopathologic heterogeneity and metastatic potential despite multimodal therapy.

原发性宫颈肉瘤样鳞状细胞癌（SSCC）是一种罕见的双相恶性肿瘤，有29例文献记载，其特征是恶性鳞状上皮和肉瘤样梭形细胞共存。上皮（PCK）和间充质（vimentin）标记物的免疫组织化学共表达仍然具有诊断意义。我们分析了8个机构案例（2006-2024）和文献报道。患者（中位年龄46岁，范围28-72岁）主要表现为阴道出血（7/8例），而1例表现为腹痛并分泌物。2例检出HPV16。所有肿瘤对PCK、vimentin、p16和≥1个鳞状标志物（p63/p40/CK5/6）均表现出不同的免疫反应性。治疗包括化疗（6/8）和放疗（3/8）。随访（中位57.4个月，n = 7）显示了侵略性行为：2例IIIA期患者发生锁骨上/内脏转移（10-31个月时存活），1例IIIA期患者在24个月时死亡，而其他患者无疾病。对29例已发表病例的综合分析证实了SSCC的双重组织学表现（双相/单相）和一致的上皮-间充质标志物共表达。这些发现强调了SSCC的临床病理异质性和转移潜力，尽管多模式治疗。

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引用次数: 0

Papillary renal neoplasm with reverse polarity shows benign behavior: Results from a 77-case clinicopathological and molecular study 反极性肾乳头状肿瘤表现为良性：77例临床病理和分子研究结果。

IF 1.4 4区医学 Q3 PATHOLOGY

Annals of Diagnostic Pathology

Pub Date : 2025-05-05 DOI: 10.1016/j.anndiagpath.2025.152498

Yong Il Lee , Ja-Min Park , Sun Young Yoon , Cheryn Song , Yong Mee Cho

Papillary renal neoplasm with reverse polarity (PRNRP) is a low-grade renal tumor characterized by oncocytic cells with apical nuclei, GATA3 expression, and frequent KRAS mutations. This study aimed to comprehensively characterize and determine prognostic significance of PRNRP by conducting clinical, histological, immunohistochemical, and genetic analyses while reviewing prior reports. A total of 506 patients with papillary renal cell carcinoma (PRCC) who underwent curative nephrectomy from 1989 to 2023 were analyzed, leading to the reclassification of 77 cases (17 %) as PRNRP. All cases were pT1 tumors with a median size of 1.5 cm. Initially, 40 %, 31 %, and 18 % were diagnosed as PRCC type 1, PRNRP, and PRCC type 2, respectively. PRNRP cases consistently displayed characteristic features; however, two tumors exhibited high-grade nuclear atypia resembling WHO/ISUP grade 3, highlighting the existence of atypical subgroups. Immunohistochemical analysis showed GATA3 expression in 97 % of cases. Transcription factor EB (TFEB) expression was observed in 86 % of cases. KRAS exon 2 mutations were identified in all cases, including the two atypical PRNRPs. Neither recurrence nor disease-specific death occurred throughout a median follow-up period of 46 months. This study highlights the necessity of thorough diagnostic evaluation, incorporating unique histological features, GATA3 positivity, and KRAS mutation analysis, especially in the presence of atypical morphology, while reaffirming the benign nature of PRNRP.

肾乳头状反极性肿瘤（PRNRP）是一种低级别肾肿瘤，其特征为尖核嗜瘤细胞、GATA3表达和频繁的KRAS突变。本研究旨在通过临床、组织学、免疫组织化学和遗传分析，同时回顾以往的报道，全面表征和确定PRNRP的预后意义。本文分析了1989 - 2023年间506例行根治性肾切除术的乳头状肾细胞癌（PRCC）患者，其中77例（17%）被重新分类为PRNRP。所有病例均为pT1肿瘤，中位大小为1.5 cm。最初，分别有40%、31%和18%的患者被诊断为PRCC 1型、PRNRP和PRCC 2型。PRNRP病例一致表现出特征性特征；然而，两个肿瘤表现出与WHO/ISUP分级3相似的高级别核非典型性，突出了非典型亚群的存在。免疫组化分析显示97%的病例表达GATA3。86%的病例有转录因子EB （TFEB）表达。KRAS外显子2突变在所有病例中都被发现，包括两个非典型PRNRPs。在46个月的中位随访期间，均未发生复发或疾病特异性死亡。本研究强调了彻底诊断评估的必要性，包括独特的组织学特征、GATA3阳性和KRAS突变分析，特别是在存在非典型形态的情况下，同时重申了PRNRP的良性本质。

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引用次数: 0

Retroperitoneal schwannoma: A clinicopathological analysis of 14 cases 腹膜后神经鞘瘤14例临床病理分析

IF 1.5 4区医学 Q3 PATHOLOGY

Annals of Diagnostic Pathology

Pub Date : 2025-05-03 DOI: 10.1016/j.anndiagpath.2025.152497

Shuting Li , Zhenyong Wu , Xiaodong Lin , Lifang Ye , Xin Zeng

Retroperitoneal schwannomas (RSs) are rare benign neurogenic tumors with nonspecific imaging features and histological mimics, posing significant diagnostic challenges. To address this gap, we retrospectively analyzed 14 RS cases to delineate clinicopathological and immunohistochemical characteristics. Cases were retrieved from the pathology database of the First Affiliated Hospital of Guangzhou Medical University (2019–2024), with hematoxylin-eosin (H&E) and immunohistochemical (IHC) staining performed for evaluation. Among 14 patients, the male/female ratio was 2:5 and the average age was 47.3 years (range, 28 to 71 years). Patients with RSs generally did not have specific symptoms, and they were usually found during routine medical examinations (9/14). All underwent total tumor resection, with a mean tumor size of 5.5 cm (range, 2.5 to 9.5 cm). Microscopically, typical schwannoma features were observed alongside degenerative changes, including cyst formation (6/14), hemorrhage (8/14), calcification (3/14), ossification (3/14), ossification with bone marrow elements (1/14), and degenerative nuclear atypia (5/14). Immunohistochemically, tumors were strongly positive for S-100 (12/12) and SOX10 (12/12), with focal EMA (1/3) and SMA (2/10) reactivity. Over a mean follow-up of 26.4 months (range, 2 to 68 months), 13 patients remained recurrence-free, while one experienced local recurrence after 43 months. Our findings highlight that RS diagnosis requires integrating clinical, radiological, morphological, and immunohistochemical analyses to distinguish these tumors from mimics. Despite their benign nature, long-term surveillance is advised due to the potential for recurrence. This study underscores the importance of a multidisciplinary approach in diagnosing and managing RSs.

腹膜后神经鞘瘤（RSs）是一种罕见的良性神经源性肿瘤，具有非特异性影像学特征和组织学模拟，给诊断带来了重大挑战。为了解决这一空白，我们回顾性分析了14例RS病例，以描述临床病理和免疫组织化学特征。从广州医科大学第一附属医院病理数据库（2019-2024）中检索病例，采用苏木精-伊红（H&；E）和免疫组化（IHC）染色进行评价。14例患者中，男女比例为2:5，平均年龄47.3岁（28 ~ 71岁）。RSs患者一般没有特定症状，通常在常规医学检查中发现（9/14）。所有患者均行肿瘤全切除术，平均肿瘤大小为5.5 cm（范围为2.5 ~ 9.5 cm）。镜下，典型的神经鞘瘤特征伴退行性改变，包括囊肿形成（6/14）、出血（8/14）、钙化（3/14）、骨化（3/14）、骨髓元素骨化（1/14）和退行性核异型（5/14）。免疫组化，肿瘤S-100（12/12）和SOX10（12/12）阳性，局灶性EMA（1/3）和SMA（2/10）阳性。平均随访26.4个月（2 - 68个月），13例患者无复发，1例患者在43个月后出现局部复发。我们的研究结果强调RS诊断需要综合临床、放射学、形态学和免疫组织化学分析来区分这些肿瘤和模拟肿瘤。尽管它们是良性的，但由于有复发的可能性，建议长期监测。这项研究强调了多学科方法在诊断和管理RSs中的重要性。

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引用次数: 0