Annales De Pathologie最新文献

The applications of artificial intelligence (AI) in anatomical and cytological pathology (ACP) are growing, particularly in image analysis. Conversational agents (CAs) based on large language models may also be useful as helps in the analysis of ACP semeiological features, but their evaluation in this field remains necessary. We submitted standardized, contextualized semeiological descriptions of ACP to ChatGPT, Copilot, Gemini, and Mistral in order to evaluate their responses. Out of 200 texts submitted, response quality varied among the four CAs, with up to 82% (ChatGPT) of correct diagnoses on the first attempt (91% after a follow-up prompt). Serious diagnostic errors ("hallucinations") occurred in as many as 9% of cases (Gemini). In addition to diagnostic suggestions, the CAs sometimes offered classification details, interpretative comments, recommendations for additional analyses, and information on the pathologies. Response heterogeneity was not related to organs, pathology types or frequencies, or the origin of the submitted texts. However, for all four CAs, response quality correlated with the number of search results per pathology on Google, Google Scholar, and PubMed-here used as indirect indicators of the volume of digital documentation accessible online. Expert review of CA outputs in the analysis of ACP text data remains crucial given the risk of inaccurate answers and serious hallucinations from these widely available AI tools, which are already being used by healthcare professionals and patients.

We report the case of a jejunal melanoma revealed by intestinal intussusception in a 75-year-old male. He was admitted for acute abdominal pain associated with vomiting. Clinical examination, combined with abdominal ultrasound and plain abdominal radiography, suggested an obstructive syndrome. Computed tomography revealed an intussusception centered on a jejunal tumor mass. Emergency laparotomy confirmed the presence of an ileo-jejunal intussusception with a palpable jejunal mass. Gross examination of the resected intestinal specimen revealed a solitary sessile polypoid blackish tumor measuring 5cm at its greatest dimension. Microscopic analysis showed a proliferation of large, loosely cohesive cells with pigmented cytoplasm and marked atypia, expressing HMB45 and S100. Histopathological examination confirmed the diagnosis of melanoma. No primary cutaneous, mucosal, ocular, or meningeal lesion was identified during complementary investigations. After 8 months of follow-up, the patient remains in good general condition with no recurrence. This case highlights the complexity of identifying a primary lesion in intestinal melanomas and rekindles the debate on their primary versus secondary origin.

We report the cases of a 68-year-old man and a 78-year-old woman affected by a tumour of the parotid gland measuring 5.5cm and 6.5cm, respectively. The clinical examination found an aspect suggesting an infiltration of the parotid gland in the first case and a rapid evolution in the second case. After excision, the pathological examination showed nodular encapsulated, non-infiltrated lesions composed of adipocytes intermixed with oncocytic cell nests, with no sign of malignancy. These were two cases of oncocytic lipoadenomas of the parotid gland. Oncocytic lipoadenoma corresponds to a very rare subtype of sialolipoma, of which 38 cases have been reported in the literature since its first description in 1998. The article reviews the pathological descriptions of the tumour in comparison with its differential diagnoses, such as oncocytic-type pleomorphic adenoma and oncocytoma of the salivary glands.