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Inflammatory Lesions of the Breast. 乳腺炎症性病变。
IF 4.6 3区 医学 Q1 Health Professions Pub Date : 2023-10-01 DOI: 10.5858/arpa.2022-0477-RA
Gulisa Turashvili, Xiaoxian Li

Context.—: Inflammatory lesions of the breast are rare but not infrequently pose problems both clinically and morphologically, particularly on needle core biopsies. These lesions range from acute inflammatory conditions to chronic lymphoplasmacytic and lymphohistiocytic to granulomatous inflammatory diseases.

Objective.—: To provide a comprehensive overview of inflammatory lesions of the breast, with etiopathogenesis and clinical, radiologic, and pathologic features as well as differential diagnostic considerations, clinical management, and prognosis.

Data sources.—: The existing literature in the English language, including original research articles and review articles describing inflammatory lesions of the breast.

Conclusions.—: Inflammatory lesions of the breast are characterized by a wide variety of clinical, radiologic, and morphologic features. The histopathologic differential diagnosis often includes a neoplastic process requiring ancillary studies and correlation with clinical and radiologic findings. Although most specimens display nonspecific findings precluding a definitive pathologic diagnosis, pathologists have a unique opportunity to play a crucial role in identifying key histologic features suggestive of certain entities, such as cystic neutrophilic granulomatous mastitis, immunoglobulin (Ig) G4 mastitis, or squamous metaplasia of lactiferous ducts, in the right clinical and radiologic context, and thereby guiding optimal and timely clinical management. The information presented herein will be helpful to practicing anatomic pathologists and pathology trainees in becoming more familiar with specific morphologic features and overcoming differential diagnostic challenges related to pathology reporting of inflammatory lesions of the breast.

上下文。--:乳腺炎症性病变很罕见,但在临床和形态学上都会出现问题,尤其是在针芯活检中。这些病变范围从急性炎症性疾病到慢性淋巴浆细胞性、淋巴组织细胞性到肉芽肿性炎症性疾病。目标。--:提供乳腺炎症性病变的全面概述,包括病因、临床、放射学和病理学特征,以及鉴别诊断考虑因素、临床管理和预后。数据源。--:现有的英文文献,包括描述乳腺炎症病变的原始研究文章和综述文章。结论。--:乳腺炎症性病变具有多种临床、放射学和形态学特征。组织病理学鉴别诊断通常包括需要辅助研究的肿瘤过程以及与临床和放射学结果的相关性。尽管大多数标本显示出非特异性的发现,排除了明确的病理诊断,但病理学家有一个独特的机会在识别提示某些实体的关键组织学特征方面发挥关键作用,如囊性中性粒细胞肉芽肿性乳腺炎、免疫球蛋白G4乳腺炎或乳管鳞状化生,在正确的临床和放射学背景下,从而指导最佳和及时的临床管理。本文提供的信息将有助于实习解剖病理学家和病理学实习生更加熟悉特定的形态学特征,并克服与乳腺炎症病变病理学报告相关的鉴别诊断挑战。
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引用次数: 0
Immunohistochemistry in the Diagnosis and Classification of Breast Tumors. 免疫组织化学在乳腺肿瘤诊断和分类中的应用。
IF 4.6 3区 医学 Q1 Health Professions Pub Date : 2023-10-01 DOI: 10.5858/arpa.2022-0464-RA
Hongxia Sun, Qingqing Ding, Aysegul A Sahin

Context.—: In the clinical practice of breast pathology, immunohistochemistry (IHC) of different markers is widely used for the diagnosis and classification of breast lesions.

Objective.—: To provide an overview of currently used and recently identified IHC stains that have been implemented in the field of diagnostic breast pathology.

Data sources.—: Data were obtained from literature review and clinical experience of the authors as breast pathologists.

Conclusions.—: In the current review, we summarize the common uses of IHC stains for diagnosing different types of breast lesions, especially invasive and noninvasive breast lesions, and benign and malignant spindle cell lesions. In addition, the cutting-edge knowledge of diagnostic carcinoma markers will lead us to further understand the different types of breast carcinoma and differentiate breast carcinomas from other carcinomas of similar morphology. Knowing the strengths and limitations of these markers is essential to the clinical practice of breast pathology.

上下文。--:在乳腺病理学的临床实践中,不同标志物的免疫组织化学(IHC)被广泛用于乳腺病变的诊断和分类。目标。--:概述目前使用的和最近发现的IHC染色剂,这些染色剂已在乳腺病理学诊断领域得到应用。数据源。--:数据来源于文献综述和作者作为乳腺病理学家的临床经验。结论。--:在目前的综述中,我们总结了IHC染色在诊断不同类型乳腺病变中的常见用途,特别是侵袭性和非侵袭性乳腺病变,以及良性和恶性梭形细胞病变。此外,癌症诊断标志物的前沿知识将使我们进一步了解不同类型的乳腺癌,并将乳腺癌与其他形态相似的癌症区分开来。了解这些标志物的优势和局限性对乳腺病理学的临床实践至关重要。
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引用次数: 1
Salivary Gland-like Tumors of the Breast. 乳腺涎腺样肿瘤。
IF 4.6 3区 医学 Q1 Health Professions Pub Date : 2023-09-01 DOI: 10.5858/arpa.2023-0038-RA
Edward T Richardson, Vickie Y Jo, Stuart J Schnitt

Context: The World Health Organization classification of tumors of the breast recognizes several special type carcinomas and benign lesions with features comparable to those of salivary gland tumors.

Objective: To discuss the histologic, immunophenotypic, molecular, and clinical features of salivary gland-like carcinomas of the breast. These breast tumors are often negative for hormone receptors and human epidermal growth factor receptor 2 (HER2), that is, triple-negative, but they generally have a much better prognosis than triple-negative breast carcinomas of no special type. We compare the immunophenotypic, molecular, and clinical features of these breast tumors with their salivary gland counterparts, highlighting similarities and differences. We also discuss benign salivary gland-like breast tumors. Finally, we highlight recent developments in understanding the molecular pathogenesis of these breast tumors and novel ancillary studies that can be used to support their diagnosis.

Data sources: A literature review was conducted, and papers were selected for further analysis and discussion by the authors of this review based on their novelty, applicability, and impact in the field.

Conclusions: Breast tumors that exhibit morphologic overlap with salivary gland tumors have been recognized by pathologists for decades, but the similarities and differences in their molecular pathogenesis have not been understood until more recently. These developments have led to novel diagnostic tools and further knowledge of these rare breast lesions.

背景:世界卫生组织对乳腺肿瘤的分类识别了几种特殊类型的癌和良性病变,其特征与唾液腺肿瘤相似。目的:探讨乳腺涎腺样癌的组织学、免疫表型、分子及临床特征。这些乳腺肿瘤通常是激素受体和人表皮生长因子受体2 (HER2)阴性,即三阴性,但通常比无特殊类型的三阴性乳腺癌预后好得多。我们比较了这些乳腺肿瘤与唾液腺肿瘤的免疫表型、分子和临床特征,突出了相似性和差异性。我们也讨论良性涎腺样乳腺肿瘤。最后,我们强调了在了解这些乳腺肿瘤的分子发病机制和新的辅助研究方面的最新进展,这些研究可用于支持其诊断。资料来源:通过文献综述,根据论文的新颖性、适用性和在该领域的影响力,选择论文进行进一步的分析和讨论。结论:乳腺肿瘤与唾液腺肿瘤在形态上的重叠已经被病理学家发现了几十年,但直到最近才了解它们在分子发病机制上的异同。这些发展导致了新的诊断工具和进一步了解这些罕见的乳腺病变。
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引用次数: 0
Do General Pathologists Assess Gastric and Duodenal Eosinophilia? 普通病理学家评估胃和十二指肠嗜酸性粒细胞增多吗?
IF 4.6 3区 医学 Q1 Health Professions Pub Date : 2023-09-01 DOI: 10.5858/arpa.2022-0204-OA
A Joe Saad, Robert M Genta, Kevin O Turner, Amol P Kamboj, Evan S Dellon, Mirna Chehade

Context.—: Eosinophilic diseases of the gastrointestinal tract (EGIDs), eosinophilic gastritis (EoG), and eosinophilic duodenitis (EoD) are rarely suspected clinically and infrequently detected by pathologists.

Objective.—: To determine whether histories of allergic or eosinophilic disorders and requests to rule out EoG and EoD affect pathologists' awareness of eosinophils in gastrointestinal biopsies.

Design.—: Thirty-one community-based pathologists were given 16 sets of biopsies from gastric and duodenal mucosa with elevated eosinophils, Helicobacter pylori gastritis, atrophic gastritis, normal stomach and duodenum, lymphocytosis, and celiac disease. Participants were assigned to 3 groups: group A did not receive histories of allergic or eosinophilic conditions; group B received similar histories plus a clue of possible allergic or eosinophilic conditions; and group C received the same histories as B and was asked to rule out EoG/EoD. A list of gastric and duodenal diagnoses and a space for comments were provided. Results were analyzed descriptively.

Results.—: Pathologists correctly diagnosed most noneosinophilic gastrointestinal disorders, indicating competence in gastrointestinal pathology. With respect to EoG and EoD, pathologists in group C performed significantly better that those in groups A and B. The combined odds ratio with 95% CI was 12.34 (2.87-53.04), P < .001, for A versus C and 4.02 (1.60-10.09), P < .02, for B versus C.

Conclusions.—: Most pathologists neither reported gastric/duodenal eosinophilia nor diagnosed EoG/EoD, even when provided histories of eosinophilic disorders. Requests to rule out EoG/EoD resulted in only 4 of 11 participants evaluating and counting eosinophils in some cases. Simple evidence-based histopathologic criteria are needed before pathologists can be expected to consider and diagnose EGIDs.

上下文。-:胃肠道嗜酸性疾病(EGIDs)、嗜酸性胃炎(EoG)和嗜酸性十二指肠炎(EoD)在临床上很少被怀疑,病理学家也很少发现。目的:确定过敏史或嗜酸性粒细胞疾病史以及排除EoG和EoD的要求是否会影响病理学家在胃肠道活检中对嗜酸性粒细胞的认识。-: 31名社区病理学家对嗜酸性粒细胞升高、幽门螺杆菌胃炎、萎缩性胃炎、正常胃和十二指肠、淋巴细胞增多症和乳糜泻的胃和十二指肠粘膜进行了16组活检。参与者被分为3组:A组没有过敏或嗜酸性粒细胞病史;B组患者有相似的病史,并可能有过敏或嗜酸性粒细胞增多的情况;C组接受与B组相同的病史,并被要求排除EoG/EoD。提供了胃和十二指肠诊断的清单和评论空间。结果进行描述性分析。-:病理学家正确诊断了大多数非嗜酸性胃肠道疾病,表明了他们在胃肠道病理学方面的能力。在EoG和EoD方面,C组病理医师的表现明显优于A、B组。A组与C组的合并优势比(95% CI)为12.34 (2.87 ~ 53.04),P < 0.001; B组与C组的合并优势比(95% CI)为4.02 (1.60 ~ 10.09),P < 0.02。大多数病理学家既没有报告胃/十二指肠嗜酸性粒细胞增多症,也没有诊断出EoG/EoD,即使提供了嗜酸性粒细胞增多症的病史。在某些情况下,要求排除EoG/EoD导致11名参与者中只有4人评估和计数嗜酸性粒细胞。在病理学家考虑和诊断EGIDs之前,需要简单的循证组织病理学标准。
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引用次数: 2
Applications of Artificial Intelligence in Breast Pathology. 人工智能在乳腺病理学中的应用。
IF 4.6 3区 医学 Q1 Health Professions Pub Date : 2023-09-01 DOI: 10.5858/arpa.2022-0457-RA
Yueping Liu, Dandan Han, Anil V Parwani, Zaibo Li

Context.—: Increasing implementation of whole slide imaging together with digital workflow and advances in computing capacity enable the use of artificial intelligence (AI) in pathology, including breast pathology. Breast pathologists often face a significant workload, with diagnosis complexity, tedious repetitive tasks, and semiquantitative evaluation of biomarkers. Recent advances in developing AI algorithms have provided promising approaches to meet the demand in breast pathology.

Objective.—: To provide an updated review of AI in breast pathology. We examined the success and challenges of current and potential AI applications in diagnosing and grading breast carcinomas and other pathologic changes, detecting lymph node metastasis, quantifying breast cancer biomarkers, predicting prognosis and therapy response, and predicting potential molecular changes.

Data sources.—: We obtained data and information by searching and reviewing literature on AI in breast pathology from PubMed and based our own experience.

Conclusions.—: With the increasing application in breast pathology, AI not only assists in pathology diagnosis to improve accuracy and reduce pathologists' workload, but also provides new information in predicting prognosis and therapy response.

上下文。-:越来越多的全切片成像的实施,加上数字工作流程和计算能力的进步,使得人工智能(AI)在病理学(包括乳腺病理学)中的应用成为可能。乳腺病理学家通常面临着巨大的工作量,诊断复杂,繁琐的重复性任务,以及半定量的生物标志物评估。人工智能算法的最新进展为满足乳腺病理学的需求提供了有希望的方法。-:提供乳腺病理学人工智能的最新综述。我们研究了当前和潜在的人工智能应用在乳腺癌和其他病理变化的诊断和分级、淋巴结转移检测、乳腺癌生物标志物量化、预测预后和治疗反应以及预测潜在分子变化方面的成功和挑战。数据源。-:我们根据自己的经验,通过检索和回顾PubMed关于乳腺病理学人工智能的文献,获得数据和信息。-:随着人工智能在乳腺病理中的应用越来越多,人工智能不仅可以辅助病理诊断,提高准确性,减少病理医生的工作量,还可以为预测预后和治疗反应提供新的信息。
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引用次数: 6
Diagnostic Pitfalls in Breast Cancer Pathology With an Emphasis on Core Needle Biopsy Specimens. 诊断陷阱在乳腺癌病理与核心针活检标本的重点。
IF 4.6 3区 医学 Q1 Health Professions Pub Date : 2023-09-01 DOI: 10.5858/arpa.2023-0007-RA
Liza M Quintana, Laura C Collins

Context.—: Breast pathology has many mimics and diagnostic pitfalls. Evaluation of malignant breast lesions, particularly in the biopsy setting, can be especially challenging, with diagnostic errors having significant management implications.

Objective.—: To discuss the pitfalls encountered when evaluating ductal carcinoma in situ and invasive breast carcinomas, providing histologic clues and guidance for appropriate use and interpretation of immunohistochemistry to aid in the correct diagnosis.

Data sources.—: Data were obtained from review of pertinent literature of ductal carcinoma in situ and invasive breast carcinomas and from the experience of the authors as practicing breast pathologists.

Conclusions.—: Awareness of the pitfalls in diagnosing breast cancers is important when creating a differential diagnosis for each breast lesion evaluated. This review will cover some of these scenarios to aid in the diagnostic process.

上下文。乳腺病理学有许多相似之处和诊断缺陷。对乳腺恶性病变的评估,特别是在活检中,尤其具有挑战性,诊断错误具有重要的管理意义。-:探讨乳腺导管原位癌和浸润性乳腺癌评估时遇到的陷阱,为正确使用和解释免疫组织化学提供组织学线索和指导,以帮助正确诊断。数据源。-:资料来源于对导管原位癌和浸润性乳腺癌的相关文献的回顾,以及作者作为乳腺病理学家的经验。-:在对每一个乳房病变进行鉴别诊断时,认识到诊断乳腺癌的缺陷是很重要的。本文将介绍其中的一些情况,以帮助诊断过程。
{"title":"Diagnostic Pitfalls in Breast Cancer Pathology With an Emphasis on Core Needle Biopsy Specimens.","authors":"Liza M Quintana,&nbsp;Laura C Collins","doi":"10.5858/arpa.2023-0007-RA","DOIUrl":"https://doi.org/10.5858/arpa.2023-0007-RA","url":null,"abstract":"<p><strong>Context.—: </strong>Breast pathology has many mimics and diagnostic pitfalls. Evaluation of malignant breast lesions, particularly in the biopsy setting, can be especially challenging, with diagnostic errors having significant management implications.</p><p><strong>Objective.—: </strong>To discuss the pitfalls encountered when evaluating ductal carcinoma in situ and invasive breast carcinomas, providing histologic clues and guidance for appropriate use and interpretation of immunohistochemistry to aid in the correct diagnosis.</p><p><strong>Data sources.—: </strong>Data were obtained from review of pertinent literature of ductal carcinoma in situ and invasive breast carcinomas and from the experience of the authors as practicing breast pathologists.</p><p><strong>Conclusions.—: </strong>Awareness of the pitfalls in diagnosing breast cancers is important when creating a differential diagnosis for each breast lesion evaluated. This review will cover some of these scenarios to aid in the diagnostic process.</p>","PeriodicalId":8305,"journal":{"name":"Archives of pathology & laboratory medicine","volume":null,"pages":null},"PeriodicalIF":4.6,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10150259","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"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
Human Epidermal Growth Factor Receptor 2 Testing in Breast Cancer. 人表皮生长因子受体2在乳腺癌中的检测。
IF 4.6 3区 医学 Q1 Health Professions Pub Date : 2023-09-01 DOI: 10.5858/arpa.2023-0950-SA
Antonio C Wolff, Mark R Somerfield, Mitchell Dowsett, M Elizabeth H Hammond, Daniel F Hayes, Lisa M McShane, Thomas J Saphner, Patricia A Spears, Kimberly H Allison

Purpose.—: To update the American Society of Clinical Oncology-College of American Pathologists (ASCO-CAP) recommendations for human epidermal growth factor receptor 2 (HER2) testing in breast cancer. An Update Panel is aware that a new generation of antibody-drug conjugates targeting the HER2 protein is active against breast cancers that lack protein overexpression or gene amplification.

Methods.—: The Update Panel conducted a systematic literature review to identify signals for updating recommendations.

Results.—: The search identified 173 abstracts. Of 5 potential publications reviewed, none constituted a signal for revising existing recommendations.

Recommendations.—: The 2018 ASCO-CAP recommendations for HER2 testing are affirmed.

Discussion.—: HER2 testing guidelines have focused on identifying HER2 protein overexpression or gene amplification in breast cancer to identify patients for therapies that disrupt HER2 signaling. This update acknowledges a new indication for trastuzumab deruxtecan when HER2 is not overexpressed or amplified but is immunohistochemistry (IHC) 1+ or 2+ without amplification by in situ hybridization. Clinical trial data on tumors that tested IHC 0 are limited (excluded from DESTINY-Breast04), and evidence is lacking that these cancers behave differently or do not respond similarly to newer HER2 antibody-drug conjugates. Although current data do not support a new IHC 0 versus 1+ prognostic or predictive threshold for response to trastuzumab deruxtecan, this threshold is now relevant because of the trial entry criteria that supported its new regulatory approval. Therefore, although it is premature to create new result categories of HER2 expression (eg, HER2-Low, HER2-Ultra-Low), best practices to distinguish IHC 0 from 1+ are now clinically relevant. This update affirms prior HER2 reporting recommendations and offers a new HER2 testing reporting comment to highlight the current relevance of IHC 0 versus 1+ results and best practice recommendations to distinguish these often subtle differences. Additional information is available at www.asco.org/breast-cancer-guidelines.

目的。-:更新美国临床肿瘤学会-美国病理学家学会(ASCO-CAP)对乳腺癌中人表皮生长因子受体2 (HER2)检测的建议。一个更新小组意识到,针对HER2蛋白的新一代抗体-药物偶联物对缺乏蛋白过表达或基因扩增的乳腺癌具有活性。-:更新小组进行了系统的文献回顾,以确定更新建议的信号。-:检索出173篇摘要。在审查的5份潜在出版物中,没有一份构成修订现有建议的信号。-:确认2018年ASCO-CAP关于HER2检测的建议。-: HER2检测指南的重点是识别乳腺癌中HER2蛋白过表达或基因扩增,以确定患者是否需要破坏HER2信号传导的治疗。这一更新承认了曲妥珠单抗deruxtecan在HER2未过度表达或扩增,但免疫组织化学(IHC) 1+或2+未通过原位杂交扩增时的新适应症。检测IHC 0的肿瘤的临床试验数据有限(排除在DESTINY-Breast04之外),并且缺乏证据表明这些癌症对较新的HER2抗体-药物偶联物表现不同或没有相似的反应。尽管目前的数据不支持对曲妥珠单抗德鲁德康反应的新的IHC 0 vs 1+预后或预测阈值,但由于支持其新的监管批准的试验进入标准,该阈值现在是相关的。因此,尽管创建新的HER2表达结果分类(例如HER2- low, HER2- ultra - low)还为时过早,但区分IHC 0和1+的最佳实践现在具有临床相关性。该更新确认了先前的HER2报告建议,并提供了新的HER2检测报告评论,以强调IHC 0和1+结果的当前相关性,以及区分这些通常细微差异的最佳实践建议。更多信息请访问www.asco.org/breast-cancer-guidelines。
{"title":"Human Epidermal Growth Factor Receptor 2 Testing in Breast Cancer.","authors":"Antonio C Wolff,&nbsp;Mark R Somerfield,&nbsp;Mitchell Dowsett,&nbsp;M Elizabeth H Hammond,&nbsp;Daniel F Hayes,&nbsp;Lisa M McShane,&nbsp;Thomas J Saphner,&nbsp;Patricia A Spears,&nbsp;Kimberly H Allison","doi":"10.5858/arpa.2023-0950-SA","DOIUrl":"https://doi.org/10.5858/arpa.2023-0950-SA","url":null,"abstract":"<p><strong>Purpose.—: </strong>To update the American Society of Clinical Oncology-College of American Pathologists (ASCO-CAP) recommendations for human epidermal growth factor receptor 2 (HER2) testing in breast cancer. An Update Panel is aware that a new generation of antibody-drug conjugates targeting the HER2 protein is active against breast cancers that lack protein overexpression or gene amplification.</p><p><strong>Methods.—: </strong>The Update Panel conducted a systematic literature review to identify signals for updating recommendations.</p><p><strong>Results.—: </strong>The search identified 173 abstracts. Of 5 potential publications reviewed, none constituted a signal for revising existing recommendations.</p><p><strong>Recommendations.—: </strong>The 2018 ASCO-CAP recommendations for HER2 testing are affirmed.</p><p><strong>Discussion.—: </strong>HER2 testing guidelines have focused on identifying HER2 protein overexpression or gene amplification in breast cancer to identify patients for therapies that disrupt HER2 signaling. This update acknowledges a new indication for trastuzumab deruxtecan when HER2 is not overexpressed or amplified but is immunohistochemistry (IHC) 1+ or 2+ without amplification by in situ hybridization. Clinical trial data on tumors that tested IHC 0 are limited (excluded from DESTINY-Breast04), and evidence is lacking that these cancers behave differently or do not respond similarly to newer HER2 antibody-drug conjugates. Although current data do not support a new IHC 0 versus 1+ prognostic or predictive threshold for response to trastuzumab deruxtecan, this threshold is now relevant because of the trial entry criteria that supported its new regulatory approval. Therefore, although it is premature to create new result categories of HER2 expression (eg, HER2-Low, HER2-Ultra-Low), best practices to distinguish IHC 0 from 1+ are now clinically relevant. This update affirms prior HER2 reporting recommendations and offers a new HER2 testing reporting comment to highlight the current relevance of IHC 0 versus 1+ results and best practice recommendations to distinguish these often subtle differences. Additional information is available at www.asco.org/breast-cancer-guidelines.</p>","PeriodicalId":8305,"journal":{"name":"Archives of pathology & laboratory medicine","volume":null,"pages":null},"PeriodicalIF":4.6,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10151531","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"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: 8
The American Society of Clinical Oncology-College of American Pathologists Guideline Update for Human Epidermal Growth Factor Receptor 2 Testing in Breast Cancer. 美国临床肿瘤学会-美国病理学家学会乳腺癌中人类表皮生长因子受体2检测指南更新。
IF 4.6 3区 医学 Q1 Health Professions Pub Date : 2023-09-01 DOI: 10.5858/arpa.2023-0187-ED
Stuart J Schnitt, Paolo Tarantino, Laura C Collins
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引用次数: 0
High-Grade Desmoplastic Foamy Gland Prostatic Adenocarcinoma. 高级别结缔组织增生泡沫腺前列腺腺癌。
IF 4.6 3区 医学 Q1 Health Professions Pub Date : 2023-09-01 DOI: 10.5858/arpa.2022-0165-OA
Guofeng Gao, Jonathan I Epstein

Context.—: It is important to recognize high-grade foamy gland prostatic adenocarcinoma with desmoplastic stroma given its aggressive clinical course with frequent metastases and death.

Objective.—: To review the morphology, immunohistochemistry, and prognosis for this rare subtype of prostate adenocarcinoma.

Design.—: Twenty-four cases received for consultation from 2010 to 2021 were analyzed including needle biopsy (n = 21), transurethral resection (n = 2), and a cystoprostatectomy (n = 1).

Results.—: Patients ranged in age from 40 to 89 years (mean, 67 years). On average, 8 cores per case were involved (mean 67% core involvement). Extraprostatic extension and seminal vesicle invasion were observed in 6 of 21 (29%) and 3 of 21 (14%) needle biopsy cases, respectively. Twenty of the 24 cases (83%) were Grade Group (GG) 5 with 4 of 24 (17%) being GG4. Tumor necrosis as a component of Gleason pattern 5 was observed in 21 of 24 cases (88%). Associated intraductal adenocarcinoma (IDC) was observed in 22 of 24 cases (92%), with 4 of 24 cases (17%) demonstrating extensive IDC. Diagnostic challenges were as follows: (1) sparse isolated cancer glands embedded in the dense desmoplastic stroma; (2) fragmented glands; and (3) aberrant staining for high-molecular-weight cytokeratin in a nonbasal cell pattern in all cases. PTEN loss was observed in 9 cases, and p53 nuclear accumulation was observed in 8 cases. Three patients were lost to follow-up. Overall, of the 16 patients with meaningful follow-up, 12 (75%) either had metastases or died from prostate cancer.

Conclusions.—: High-grade desmoplastic foamy gland adenocarcinoma is difficult to diagnose and grade and has a poor prognosis.

上下文。结论:高级别泡沫腺前列腺腺癌伴间质增生,其临床病程具有侵袭性,易发生转移和死亡。目的:回顾这一罕见前列腺腺癌亚型的形态学、免疫组织化学和预后。-:对2010年至2021年接受会诊的24例患者进行分析,包括针活检(n = 21)、经尿道切除术(n = 2)和膀胱前列腺切除术(n = 1)。-:患者年龄40 ~ 89岁(平均67岁)。平均每个病例涉及8个核心(平均67%核心受累)。21例穿刺活检患者中有6例(29%)出现前列腺外展,21例中有3例(14%)出现精囊侵犯。24例中有20例(83%)为GG 5级组,4例(17%)为GG4级组。肿瘤坏死作为Gleason模式5的组成部分在24例中有21例(88%)。24例患者中有22例(92%)伴有导管内腺癌(IDC), 24例患者中有4例(17%)表现为广泛的IDC。诊断挑战如下:(1)稀疏的孤立癌腺体嵌埋在致密的间质中;(2)破碎腺体;(3)在所有病例中,高分子量细胞角蛋白的非基底细胞模式异常染色。PTEN缺失9例,p53核积累8例。3例患者失访。总体而言,在16例有意义的随访患者中,12例(75%)发生转移或死于前列腺癌。-:高级别结缔组织增生泡沫腺腺癌难以诊断和分级,预后较差。
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引用次数: 0
Hot Topics in Breast Pathology. 乳腺病理学的热门话题。
IF 4.6 3区 医学 Q1 Health Professions Pub Date : 2023-09-01 DOI: 10.5858/arpa.2023-0194-ED
Gulisa Turashvili, Xiaoxian Li
{"title":"Hot Topics in Breast Pathology.","authors":"Gulisa Turashvili,&nbsp;Xiaoxian Li","doi":"10.5858/arpa.2023-0194-ED","DOIUrl":"https://doi.org/10.5858/arpa.2023-0194-ED","url":null,"abstract":"","PeriodicalId":8305,"journal":{"name":"Archives of pathology & laboratory medicine","volume":null,"pages":null},"PeriodicalIF":4.6,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10141739","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"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
期刊
Archives of pathology & laboratory medicine
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