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Evaluating ChatGPT in pathology: towards multimodal AI in medical imaging J. Clin. Pathol. (IF 3.4) Pub Date : 2024-03-14 Shunsuke Koga
I read with great interest the manuscript by Laohawetwanit et al , which evaluates the performance of Chat Generative Pre-trained Transformer (ChatGPT) in detecting and classifying colorectal adenomas from histopathological images.1 The study reports that ChatGPT achieved a median sensitivity of 74% and a specificity of 36% for adenoma detection, with an overall median accuracy of 56%. It further demonstrates
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Impact of NOTCH1 expression in primary breast adenoid cystic carcinoma J. Clin. Pathol. (IF 3.4) Pub Date : 2024-03-12 Alireza Salem, Yun Wu, Qingqing Ding, Lavinia P Middleton
Aims Adenoid cystic carcinoma (AdCC) originates from salivary-type like glands in the head and neck, lung, and breast. AdCC shows chromosomal translocation, resulting in MYB::NFIB fusion and overexpression of MYB. Recently, NOTCH1 pathway alteration has been recognised in a subset of patients with salivary gland AdCC and has been shown to be associated with poor survival. In this study, we investigated
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Joint online distance learning to complement postgraduate pathology training in preparation for national board examinations J. Clin. Pathol. (IF 3.4) Pub Date : 2024-03-08 Bas de Leng, Laura Helle, Otto Jokelainen, Mikko Kainulainen, Pauliina Kronqvist, Christian Mol, Friedrich Pawelka, Vesa-Matti Pohjanen, Koen Vincken
Aims To meet the flexible learning needs of pathology residents preparing for national board examinations, a joint distance learning approach was developed using both asynchronous and synchronous activities with whole slide images, drawing on empirical educational research on online distance learning. Methods In a case study of an implementation of the designed joint distance learning approach with
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PHOX2B: a diagnostic cornerstone in neurocristopathies and neuroblastomas J. Clin. Pathol. (IF 3.4) Pub Date : 2024-03-08 Mei-Lan Windels, Fleur Cordier, Jo Van Dorpe, Liesbeth Ferdinande, David Creytens
Paired-like homeobox 2B ( PHOX2B ) is a gene essential in the development of the autonomic nervous system. PHOX2B mutations are associated with neurocristopathies—Hirschsprung disease (HSCR) and congenital central hypoventilation syndrome (CCHS)—and peripheral neuroblastic tumours. PHOXB2 plays an important role in the diagnostics of these conditions. Genotyping of a PHOX2B pathogenic variant is required
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How—and why—to fill up a surgical pathology requisition form J. Clin. Pathol. (IF 3.4) Pub Date : 2024-03-07 Sanjay A Pai
In his excellent review on macroscopic pathology, Shepherd refers to the lack of adequate clinical information on pathology requisition forms.1 This is a common rant among pathologists and I wonder if this lacuna is partly because of clinicians’ lack of awareness of the specific information that is needed (with dermatology, nephrology and neurology/neurosurgery being honourable exceptions). The only
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Phaeochromocytoma and paraganglioma J. Clin. Pathol. (IF 3.4) Pub Date : 2024-03-07 Julie Ann Tarling, Rajeev Kumar, Louise J Ward, Christopher Boot, WS Wassif
Phaeochromocytomas and paragangliomas are rare catecholamine-producing neuroendocrine tumours which can potentially cause catastrophic crises with high morbidity and mortality. This best practice article considers the causes and presentation of such tumours, screening and diagnostic tests, management of these patients and consideration of family members at risk.
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Emerging and under-recognised patterns of colorectal carcinoma morphologies: a comprehensive review J. Clin. Pathol. (IF 3.4) Pub Date : 2024-03-06 Yuho Ono, Osman Yilmaz
While the overwhelming majority of colorectal carcinomas (CRC) are diagnosed as adenocarcinoma not otherwise specified, there are numerous under-recognised morphologic patterns of CRC. These patterns are recognised by the WHO, appear in reporting manuals for the American Joint Committee of Cancer, and/or are listed on synoptic reports, while many other variants have either fallen out of favour or are
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High-grade osteosarcoma arising from a clinically aggressive infantile fibrosarcoma J. Clin. Pathol. (IF 3.4) Pub Date : 2024-03-01 Larissa V Furtado, Teresa Santiago, Zachary R Abramson, Marija Kacar, Zonggao Shi, Selene C Koo, Robert E Ruiz, Roya Mostafavi, Matthew J Krasin, Barry Shulkin, Lindsay J Talbot, Alberto S Pappo, Jessica Gartrell
Infantile fibrosarcoma (IFS) is a soft tissue tumour of intermediate malignant potential that commonly affects the extremities of young children and is characterised by an ETV6::NTRK3 fusion.1 2 Recurrent copy number changes, including the gain of chromosomes 8, 17 and 20, have been reported in IFS,3–5 but pathogenic mutations in other pathways are rare in this tumour type.6 We previously reported
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Rapid microdissection of tissue sections via laser ablation J. Clin. Pathol. (IF 3.4) Pub Date : 2024-03-01 Robin JN Coope, Stephen Pleasance, Pawan Pandoh, Colin Schlosser, Richard D Corbett, Marco A Marra
We demonstrate a method for tissue microdissection using scanning laser ablation that is approximately two orders of magnitude faster than conventional laser capture microdissection. Our novel approach uses scanning laser optics and a slide coating under the tissue that can be excited by the laser to selectively eject regions of tissue for further processing. Tissue was dissected at 0.117 s/mm2 without
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Novel and unusual USP6 fusion partners in aneurysmal bone cyst and their role in pathogenesis and histopathological evaluation of this disease J. Clin. Pathol. (IF 3.4) Pub Date : 2024-03-01 Jan Balko, William Golas, Ludvik Kaspar, Lenka Krskova, Martina Strnadova, Johana Kotis, Josef Zamecnik
Aims The purpose of this study is to report novel and unusual USP6 fusion partners in aneurysmal bone cysts (ABCs). These findings may be useful in routine diagnostics as well as in studying the biology of USP6 -related disorders. Methods A cohort of seven patients diagnosed with ABC examined between 2014 and 2023 at Motol University Hospital in Prague was included into this retrospective non-randomised
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International Delphi consensus on the histopathological diagnosis of adenomyosis J. Clin. Pathol. (IF 3.4) Pub Date : 2024-03-01 Tristan McCaughey, Samantha S Mooney, Marsali Newman, Leonie Constable, Charlotte Reddington, Helen C McNamara, Martin Healey
Adenomyosis has long been referred to as the ‘elusive’ condition in gynaecology.1 Clinical diagnosis is complicated by symptoms shared with other gynaecological pathologies. Despite being a common part of preoperative workup, ultrasound and MRI lack both sensitivity and specificity.2 Histological assessment of the uterus, while viewed as gold standard, has an inter-pathologist variation as wide as
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Gene of the month: the uroplakins J. Clin. Pathol. (IF 3.4) Pub Date : 2024-02-28 Krithicck Sivakumaar, Jon Griffin, Ella Schofield, James W F Catto, Ibrahim Jubber
Uroplakins are a family of membrane-spanning proteins highly specific to the urothelium. There are four uroplakin proteins in humans. These are encoded by the following UPK genes: UPK1A , UPK1B , UPK2 and UPK3 . Uroplakin proteins span the apical membrane of umbrella cells of the urothelium, where they associate into urothelial plaques. This provides a barrier function to prevent passage of urine across
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Identification of immune cell markers associated with ulcerative colitis histological disease activity in colonic biopsies J. Clin. Pathol. (IF 3.4) Pub Date : 2024-02-28 Pavine L C Lefevre, Zhongya Wang, Wendy Teft, Guangyong Zou, Tanja Van Viegen, Bryan Linggi, Vipul Jairath, Brian G Feagan, Rish K Pai, Niels Vande Casteele
Aims Accurate determination of histological activity in ulcerative colitis (UC) is essential given its diagnostic and prognostic importance. Data on the relationship between histology and immune cell markers are limited. We aimed to evaluate the association between histological disease activity and immune cell marker concentration in colonic biopsies from patients with UC. Methods Sigmoid colon biopsies
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Increased PI3K pathway activity is associated with recurrent breast cancer in patients with low and intermediate 21-gene recurrence score J. Clin. Pathol. (IF 3.4) Pub Date : 2024-02-21 Lawrence Hsu Lin, Yvonne Wesseling-Rozendaal, Varshini Vasudevaraja, Guomiao Shen, Margaret Black, Dianne van Strijp, Sigi Neerken, Paul A van de Wiel, George Jour, Paolo Cotzia, Farbod Darvishian, Matija Snuderl
Aims We investigated key signalling pathways’ activity and mutational status of early-stage breast carcinomas with low and intermediate 21-gene recurrence score (RS) to identify molecular features that may predict recurrence. Methods This is a retrospective case–control study of 18 patients with recurrent breast carcinoma with low and intermediate 21-gene RS (<25) and control group of 15 non-recurrent
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Dissociation in hepatic vein pressure gradient, liver stiffness measurement and complications in histological subtypes of porto-sinusoidal vascular disease J. Clin. Pathol. (IF 3.4) Pub Date : 2024-02-20 Chhagan Bihari, Sneha Dhariwal, Saggere Murlikrishna Shasthry, Archana Rastogi, Manoj Kumar Sharma, Shiv Kumar Sarin
Background and aims Portosinusoidal vascular disease (PSVD) is a broad term encompassing varied histological patterns with changes in portal tracts and sinusoids without cirrhosis. We aimed to assess whether there is any clinical and pathological difference among the various histological categories of PSVD. Patients and methods This study included liver biopsy cases classified as PSVD (2020–2022).
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Diagnostic challenges of the idiopathic plasmacytic lymphadenopathy (IPL) subtype of idiopathic multicentric Castleman disease (iMCD): Factors to differentiate from IgG4-related disease J. Clin. Pathol. (IF 3.4) Pub Date : 2024-02-20 Asami Nishikori, Midori Filiz Nishimura, David C Fajgenbaum, Yoshito Nishimura, Kanna Maehama, Tomoka Haratake, Tetsuya Tabata, Mitsuhiro Kawano, Naoya Nakamura, Shuji Momose, Remi Sumiyoshi, Tomohiro Koga, Hidetaka Yamamoto, Frits van Rhee, Atsushi Kawakami, Yasuharu Sato
Aims and methods Idiopathic multicentric Castleman disease (iMCD) is currently considered to be classified into three clinical subtypes, including idiopathic plasmacytic lymphadenopathy (IPL), thrombocytopaenia, anasarca, fever, reticulin fibrosis/renal dysfunction, organomegaly (TAFRO) and not otherwise specified (NOS). Among the three, iMCD-IPL closely mimics IgG4-related disease (IgG4-RD). In diagnosing
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Addition of cribriform pattern 4 and intraductal prostatic carcinoma into the CAPRA-S tool improves post-radical prostatectomy patient stratification in a multi-institutional cohort J. Clin. Pathol. (IF 3.4) Pub Date : 2024-02-20 Ngoc-Nhu Jennifer Nguyen, Kristen Liu, Katherine Lajkosz, Kenneth A Iczkowski, Theodorus H van der Kwast, Michelle R Downes
Aims Pre-surgical risk classification tools for prostate cancer have shown better patient stratification with the addition of cribriform pattern 4 (CC) and intraductal prostatic carcinoma (IDC) identified in biopsies. Here, we analyse the additional prognostic impact of CC/IDC observed in prostatectomies using Cancer of Prostate Risk Assessment post-surgical (CAPRA-S) stratification. Methods A retrospective
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The difficulty with measuring the largest melanoma tumour diameter in sentinel lymph nodes J. Clin. Pathol. (IF 3.4) Pub Date : 2024-02-20 Annelien E Laeijendecker, Mary-Ann El Sharouni, Nikolaos Stathonikos, Clothaire P E Spoto, Bart A van de Wiel, Erik J E Eijken, Marijne Mulder, Antien L Mooyaart, Anna Szumera-Cieckiewicz, Daniela Mihic-Probst, Daniela Massi, Martin Cook, Senada Koljenovic, Llucia Alos, Paul J van Diest, Alexander C J van Akkooi, Willeke Blokx
Identification of sentinel node (SN) metastases can set the adjuvant systemic therapy indication for stage III melanoma patients. For stage IIIA patients, a 1.0 mm threshold for the largest SN tumour diameter is used. Therefore, uniform reproducible measurement of its size is crucial. At present, the number of deposits or their microanatomical sites are not part of the inclusion criteria for adjuvant
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Endometriosis with colonic mucosal colonisation: a diagnostic confounder J. Clin. Pathol. (IF 3.4) Pub Date : 2024-03-01 Jeremy Adler, Khaled Algashaamy, Monica T Garcia de Buitrago, Andre Pinto, Elizabeth Anne Montgomery
Aims Secondary mucosal colonisation by a carcinoma originating from a distant site is a pattern of metastasis to the intestines and hepatobiliary tract and a mimic of primary neoplasia. Although endometriosis is considered benign, its ability to spread widely underscores its quasi-neoplastic nature. After noting that endometriotic glands can colonise the colonic mucosa along the basement membrane,
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Assessment of large droplet fat in frozen sections of donor liver biopsies: utility and interobserver variability of the newly described Banff method compared to a simplified Average of Fields method J. Clin. Pathol. (IF 3.4) Pub Date : 2024-03-01 Alexander T Kikuchi, Naoki Akanuma, Won-Tak Choi, Ryan M Gill, Sanjay Kakar
Aims There is great variability in the assessment and reporting of fat in frozen sections of donor liver biopsies. The Banff Working Group has proposed a novel method and definition for scoring large droplet fat (LDF) in donor liver biopsies. This study compares the Banff method with a simpler Average of Fields (AF) method and evaluates the impact of different LDF definitions. Methods Three pathologists
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Macroscopic pathology and all that: a personal view J. Clin. Pathol. (IF 3.4) Pub Date : 2024-03-01 Neil A Shepherd
I hope that this treatise adds to the excellent reviews by Varma and colleagues, emphasising the importance of accurate macroscopic assessment and report provision. I have especially highlighted the importance of not divorcing the clinical data and the macroscopic analysis from the microscopic assessment as all are required to provide an accurate and cogent overall composition. The review has also
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Macroscopic examination of pathology specimens: a critical reappraisal J. Clin. Pathol. (IF 3.4) Pub Date : 2024-03-01 Murali Varma, Laura C Collins, Runjan Chetty, Dipti M Karamchandani, Karen Talia, John Dormer, Monika Vyas, Brendan Conn, Yaileen D Guzmán-Arocho, Adam V Jones, Miranda Pring, W Glenn McCluggage
Meticulous macroscopic examination of specimens and tissue sampling are crucial for accurate histopathology reporting. However, macroscopy has generally received less attention than microscopy and may be delegated to relatively inexperienced practitioners with limited guidance and supervision. This introductory paper in the minisymposium, Macroscopy Under the Microscope , focuses on issues regarding
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Essentials of macroscopic evaluation of specimens from gastrointestinal tract J. Clin. Pathol. (IF 3.4) Pub Date : 2024-03-01 Monika Vyas, Dipti M Karamchandani
An astute macroscopic examination, coupled with correlating the gross findings with clinical indication and operative notes along with judicious, yet all pertinent sectioning for pathological examination is crucial for an accurate histopathological diagnosis, eventually leading to optimal patient care. This succinct review highlights the general concepts that lay the foundation of evaluating and grossing
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Macroscopy of specimens from the genitourinary system J. Clin. Pathol. (IF 3.4) Pub Date : 2024-03-01 Murali Varma, John Dormer
Macroscopic specimen examination is often critical for accurate histopathology reporting but has generally received insufficient attention and may be delegated to inexperienced staff with limited guidance and supervision. This review discusses issues around macroscopic examination of some common urological specimens; highlighting findings that are critical for patient management and others that are
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Macroscopy of specimens from the head and neck J. Clin. Pathol. (IF 3.4) Pub Date : 2024-03-01 Brendan Conn, Miranda Pring, Adam V Jones
Macroscopic examination of surgical resections from the head and neck may be difficult due to the complex anatomy of this area. Recognition of normal anatomical structures is essential for accurate assessment of the extent of a disease process. Communication with the surgical team, correct specimen orientation and sampling are critical for assessment and the importance of radiological and clinical
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Macroscopic examination of gynaecological specimens: a critial and often underemphasised aspect of pathological reporting J. Clin. Pathol. (IF 3.4) Pub Date : 2024-03-01 Karen L Talia, Carlos Parra-Herran, W Glenn McCluggage
Pathological examination of surgical specimens and compilation of a surgical pathology report comprises a series of events which includes macroscopic examination and tissue sampling, either complete or selected. This step is critical but often overlooked in the literature and not given the attention it deserves. In this review, we discuss the macroscopic examination and grossing of gynaecological pathology
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Pragmatic guide to the macroscopic evaluation of breast specimens J. Clin. Pathol. (IF 3.4) Pub Date : 2024-03-01 Yaileen D Guzmán-Arocho, Laura C Collins
The pathological assessment of a breast surgical specimen starts with macroscopic evaluation, arguably one of the most critical steps, as only a small percentage of the tissue is examined microscopically. To properly evaluate and select tissue sections from breast specimens, it is essential to correlate radiological findings, prior biopsies, procedures and treatment with the gross findings. Owing to
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Clinicopathological characterisation of MTAP alterations in gastrointestinal cancers J. Clin. Pathol. (IF 3.4) Pub Date : 2024-02-13 Gianluca Mauri, Giorgio Patelli, Laura Roazzi, Emanuele Valtorta, Alessio Amatu, Giovanna Marrapese, Erica Bonazzina, Federica Tosi, Katia Bencardino, Gabriele Ciarlo, Elisa Mariella, Silvia Marsoni, Alberto Bardelli, Emanuela Bonoldi, Andrea Sartore-Bianchi, Salvatore Siena
Background Methylthioadenosine phosphorylase (MTAP) is an essential metabolic enzyme in the purine and methionine salvage pathway. In cancer, MTAP gene copy number loss ( MTAP loss) confers a selective dependency on the related protein arginine methyltransferase 5. The impact of MTAP alterations in gastrointestinal (GI) cancers remains unknown although hypothetically druggable. Here, we aim to investigate
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Response to anti-HER2 neoadjuvant chemotherapy in HER2-positive invasive breast cancers with different HER2 FISH patterns J. Clin. Pathol. (IF 3.4) Pub Date : 2024-02-12 Hong Lv, Qian-Ming Bai, Ming Li, Meng-Yuan Cai, Shu-Ling Zhou, Yin Liu, Zhong-Hua Wang, Ruo-Hong Shui, Hong-Fen Lu, Xiao-Li Xu, Bao-Hua Yu, Xiao-Yu Tu, Rui Bi, Yu-Fan Cheng, Xiao-Yan Zhou, Zhi-Min Shao, Wen-Tao Yang
Aims Human epidermal growth factor receptor 2 (HER2)-positive patients with breast cancer may have different HER2/CEP17 ratios and HER2 copy numbers, with inconsistent responses to anti-HER2 neoadjuvant chemotherapy (NACT). Our study aimed to explore the relationship between different HER2 fluorescence in situ hybridisation (FISH) patterns in HER2-positive patients with breast cancer and responses
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Use of CD32, CD44 and CD71 to differentiate follicular lymphoma and diffuse large B-cell lymphoma subtypes by flow cytometry J. Clin. Pathol. (IF 3.4) Pub Date : 2024-02-09 Lukas W Schwarz, Jason E Love, Kikkeri N Naresh, Afshin Shameli, Jonathan R Fromm
Many lymphomas can be immunophenotyped by flow cytometry (FCM), providing valuable diagnostic information.1 However, FCM cannot typically be used to distinguish follicular lymphoma (FL), diffuse large B-cell lymphoma, germinal centre type (DLBCL-GCB) and diffuse large B-cell lymphoma, non-germinal centre type (DLBCL-nGCB). To expand the utility of clinical FCM, we compared the expression of CD32, CD44
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Dematiaceous fungal infections: clinical and pathologic conundrums J. Clin. Pathol. (IF 3.4) Pub Date : 2024-02-09 Emily Mae Hartsough, Ruth K. Foreman, Maria Martinez-Lage, John Branda, Aliyah R. Sohani, Lawerence Zukerberg
Dematiaceous fungi are defined by pigment within their cell walls. They are increasingly recognised human pathogens, causing a wide range of clinical presentations, from localised subcutaneous infections to disseminated disease in rare cases. We report our institutional experience with diagnosis of dematiaceous fungal infections from 2005 to 2022 and highlight four instructive cases that clinically
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Commentary on sudden unexpected death in a middle-aged woman: spontaneous coronary artery dissection (SCAD), myocardial infarction and cardiac biomarkers J. Clin. Pathol. (IF 3.4) Pub Date : 2024-02-05 Paul Collinson
Spontaneous coronary artery dissection (SCAD) is an uncommon cause of myocardial infarction (MI). It presents clinically either as sudden cardiac death, as in this case, or as an acute coronary syndrome with clinical symptoms, changes in the ECG (ST segment elevation MI or non-ST elevation MI) and a rise in cardiac biomarkers. Although initially thought to be very rare, SCAD is increasingly recognised
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Sudden unexpected death in a middle-aged woman J. Clin. Pathol. (IF 3.4) Pub Date : 2024-02-05 Faye Victoria C Casimero, Eva D Patalas, James R Stone
The patient was a woman in her 50s with a history of migraine and Raynaud’s disease. She had episodes of severe migraine that only partially responded to triptans, and worsened during pregnancy approximately 14 years prior, and also during the perimenopausal period approximately 2 years ago. After menopause, her migraines improved, occurred once a month, and responded well to triptans. She had elevated
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Invited commentary on: sudden cardiac death J. Clin. Pathol. (IF 3.4) Pub Date : 2024-02-05 Melanie C. Bois, M.D.
Postmortem examination holds a pivotal role in our society. The implications of this procedure are vast, ranging from medicolegal consequences to characterisation of heritable genetic syndromes and closure for those proximal to the deceased. Despite its widespread intrinsic value, a surprising 1%–5% of postmortem examinations will lack revealing gross, histologic, or laboratory findings that inform
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Genomic discordances and heterogeneous mutational burden, PD-L1 expression and immune infiltrates of non-small cell lung cancer metastasis J. Clin. Pathol. (IF 3.4) Pub Date : 2024-02-02 Jianghua Wu, Luning Mao, Wanjun Lei, Wei Sun, Xin Yang, Yanhui Zhang, Xiaozheng Huang, Dongmei Lin
Aims To investigate the genomic discordances and heterogeneous mutational burden, PD-L1 expression and immune cell (IC) infiltrates of non-small cell lung cancer (NSCLC) metastasis. Methods Surgical samples from 41 cases of NSCLC with metastatic tumours (MTs) and paired primary tumours (PTs) were collected. PD-L1 expression and ICs were quantified using image-based immunohistochemistry profiling. Whole
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GPT-4 and histopathological image detection and classification of colorectal adenomas J. Clin. Pathol. (IF 3.4) Pub Date : 2024-01-29 Hinpetch Daungsupawong, Viroj Wiwanitkit
We would like to respond to a comment on the published article entitled ‘Accuracy of GPT-4 in histopathological image detection and classification of colorectal adenomas’.1 In order to assess their competence in histopathological diagnosis, 100 colorectal polyp photomicrographs were analysed using the traditional and custom versions of the GPT-4. Pathologists evaluated the GPT-4 responses for descriptive
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Russell body typhilitis: An unusual mimicker of malignancy! J. Clin. Pathol. (IF 3.4) Pub Date : 2024-01-29 Devika Chauhan, Surbhi Goyal, Puja Sakhuja, Ujjwal Sonika
Colorectal Russell body lesions are exceedingly rare with only four cases described in literature to date.1 We report here a case of Russell body typhilitis in a middle-aged woman on neoadjuvant chemotherapy for breast carcinoma. The first case of Russell body-containing lesion of the gastrointestinal tract (GI) was documented in the stomach, in 1998. Since then, around 40 cases have been reported
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Investigating the relative frequencies of unascertained causes of death and advanced decomposition at autopsy J. Clin. Pathol. (IF 3.4) Pub Date : 2024-01-29 Theodore Estrin-Serlui, Jeong Yoon, Michael Osborn
An established dogma of autopsy pathology is that it is not possible to ascertain a cause of death in about 2–5% of postmortems.1 One of the most common reasons for a cause of death to be unascertained is due to postmortem decomposition. Decomposition change can affect the macroscopic and microscopic appearances of pathology and can introduce uncertainty into the interpretation of postmortem findings
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Digital odyssey: lessons learnt from a reverse transition from a digital to a manual pathology workflow J. Clin. Pathol. (IF 3.4) Pub Date : 2024-01-24 Alessandro Caputo, Miriam Angeloni, Francesco Merolla, Simona Vatrano, Fulvia Ferrazzi, Filippo Fraggetta
In the fully digital Caltagirone pathology laboratory, a reverse shift from a digital to a manual workflow occurred due to a server outage in September 2023. Here, insights gained from this unplanned transition are explored. Surveying the affected pathologists and technicians revealed unanimous preferences for the time-saving and error-reducing capabilities of the digital methodology. Conversely, the
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Clinicopathological features of kidney injury in patients receiving immune checkpoint inhibitors (ICPi) combined with anti-vascular endothelial growth factor (anti-VEGF) therapy J. Clin. Pathol. (IF 3.4) Pub Date : 2024-01-19 Shi Jin, Ziyan Shen, Jie Li, Xueguang Liu, Qifan Zhu, Fang Li, Yiqin Shi, Pan Lin, Xialian Xu, Xiaohong Chen, Xuemei Geng, Xiaoqiang Ding, Hong Liu
Background Immune checkpoint inhibitor (ICPi) combined with anti-vascular endothelial growth factor (VEGF) therapy has increasingly become a promising strategy in various malignancies. However, the combination might be associated with increased risk of nephrotoxicity. Methods We retrospectively recruited patients who suffered kidney injury and received renal biopsy after anti-VEGF/ICPi mono- or combination
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Gene of the month: VSTM2A J. Clin. Pathol. (IF 3.4) Pub Date : 2024-02-01 Lisha Wang, Osman Yilmaz, Brendan A Veeneman, Yuping Zhang, Saravana M Dhanasekaran, Rohit Mehra
The V-set and transmembrane domain containing 2A ( VSTM2A) gene is located on chromosome 7. In the physiological state, VSTM2A regulates preadipocyte cell differentiation. VSTM2A is highly expressed in normal human brain tissue and minimally expressed in other normal tissues. Mucinous tubular and spindle cell carcinoma (MTSCC) of the kidney is a distinct renal tumour subtype with signature chromosomal
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Recently described types of dysplasia associated with IBD: tips and clues for the practising pathologist J. Clin. Pathol. (IF 3.4) Pub Date : 2024-02-01 Zahra Alipour, Kristen Stashek
Longstanding inflammatory bowel disease (especially in patients with severely active disease or primary sclerosing cholangitis) is associated with an increased risk of developing dysplasia and adenocarcinoma. This review covers critical clinical aspects, such as risk factors and screening endoscopy basics, emphasising the SCENIC (Surveillance for Colorectal Endoscopic Neoplasia Detection in Inflammatory
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Alternative lengthening of telomeres: mechanism and the pathogenesis of cancer J. Clin. Pathol. (IF 3.4) Pub Date : 2024-02-01 Joakin O Mori, Joshua Keegan, Rachel L Flynn, Christopher M Heaphy
Telomere maintenance and elongation allows cells to gain replicative immortality and evade cellular senescence during cancer development. While most cancers use telomerase to maintain telomere lengths, a subset of cancers engage the alternative lengthening of telomeres (ALT) pathway for telomere maintenance. ALT is present in 5%–10% of all cancers, although the prevalence is dramatically higher in
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Evolving educational landscape in pathology: a comprehensive bibliometric and visual analysis including digital teaching and learning resources J. Clin. Pathol. (IF 3.4) Pub Date : 2024-02-01 Luca Cima, Nicole Bussola, Lewis A Hassell, Tim-Rasmus Kiehl, Casey Schukow, Norman Zerbe, Enrico Munari, Evelin Torresani, Mattia Barbareschi, Matthew J Cecchini, Vito Cirielli, Francesca Pagliuca, Muhammad Ahsan, Sambit K Mohanty, Ernesto Arbitrio, Griffin Hughes, Kamran M Mirza
Aims Pathology education is a core component of medical training, and its literature is critical for refining educational modalities. We performed a cross-sectional bibliometric analysis to explore publications on pathology education, focusing on new medical education technologies. Methods The analysis identified 64 pathology journals and 53 keywords. Relevant articles were collected using a web application
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Mergers and afflictions: can wellness soothe the healthcare beast? J. Clin. Pathol. (IF 3.4) Pub Date : 2024-02-01 Benjamin L. Mazer
Every US healthcare worker practices in the belly of the medical golem, a trillion-dollar beast out to gobble up market share and relative value units. Employees toil away in their hospitals and medical centres, which once seemed large but are now engulfed by ever-swelling and transmogrifying healthcare systems. The beast is handled from a distance by fortune-seeking enterprises or, in the non-profit
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Health impacts in pathology workforce during mergers and acquisitions (M&A) J. Clin. Pathol. (IF 3.4) Pub Date : 2024-02-01 Paul Zone Chiou, R Patti Herring, Jisoo Oh, Ernest Medina
Aims To compare burn-out in laboratory professionals (LPs) with exposure to consolidation to those without, and to investigate the role of social support as a moderator in the exposure to mergers and acquisitions (M&A). Methods Surveys were sent to the clinical LPs, including 732 with exposure to M&A and 819 without. The dependent variable was burn-out, and the independent variable was exposure to
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Comparative analyses of tumour immune microenvironment between collecting duct carcinoma and fumarate hydratase-deficient renal cell carcinoma J. Clin. Pathol. (IF 3.4) Pub Date : 2024-02-01 Daisuke Kiyozawa, Kenichi Kohashi, Dai Takamatsu, Shinya Umekita, Masatoshi Eto, Mitsuru Kinjo, Kenichi Nishiyama, Kenichi Taguchi, Yumi Oshiro, Yusuke Kuboyama, Yoshinao Oda
Aims Collecting duct carcinoma (CDC) and fumarate hydratase-deficient renal cell carcinoma (FH-deficient RCC) have similar histological morphologies and both show a poor prognosis. Programmed death ligand 1 (PD-L1) inhibitor has been approved for the treatment of RCC. However, tumour-infiltrating neutrophils stimulated by interleukin-8 (IL-8) interfere with PD-L1 inhibitors. Here, we retrospectively
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Clinicopathological and genetic analyses of pulmonary enteric adenocarcinoma J. Clin. Pathol. (IF 3.4) Pub Date : 2024-02-01 Fumi Okada, Maiko Takeda, Tomomi Fujii, Tomoko Uchiyama, Shoh Sasaki, Minami Matsuoka, Yuji Nitta, Chiyoko Terada, Katsuya Maebo, Kohei Morita, Eiwa Ishida, Noriyoshi Sawabata, Chiho Ohbayashi
Aims Pulmonary enteric adenocarcinoma (PEAC) is a rare variant of pulmonary adenocarcinoma. Due to its rarity, few pathological and molecular studies have been performed on PEAC. We herein conducted clinicopathological, immunohistochemical and molecular analyses of PEAC with a focus on its differentiation from invasive mucinous adenocarcinoma (IMA). Methods We examined the clinicopathological features
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Characterisation of T cell receptor repertoires in coeliac disease J. Clin. Pathol. (IF 3.4) Pub Date : 2024-02-01 Lik Wee Lee, Shahin Shafiani, Beryl Crossley, Ryan O Emerson, David Williamson, Anna Bunin, Justin Vargas, Arnold S Han, Ian M Kaplan, Peter H R Green, Ilan Kirsch, Govind Bhagat
Aims Characterise T-cell receptor gene (TR) repertoires of small intestinal T cells of patients with newly diagnosed (active) coeliac disease (ACD), refractory CD type I (RCD I) and patients with CD on a gluten-free diet (GFD). Methods Next-generation sequencing of complementarity-determining region 3 (CDR3) of rearranged T cell receptor β (TRB) and γ (TRG) genes was performed using DNA extracted from
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GTF2I mutation in micronodular thymoma with lymphoid stroma J. Clin. Pathol. (IF 3.4) Pub Date : 2024-02-01 Andrea Bille, Katherine Fryer, Andrew Wallace, Daisuke Nonaka
Aims Micronodular thymoma with lymphoid stroma is a rare subtype of thymoma with characteristic clinical and pathological features. Some of the features, such as indolent nature, principally spindle morphology and no significant association to myasthenia gravis, are shared with type A and AB thymoma, which is closely linked to GTF2I mutation. However, not much is known regarding the molecular genetics
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Prognostic value and tumour microenvironment characteristics of the Glasgow Microenvironment Score in primary triple-negative breast cancer J. Clin. Pathol. (IF 3.4) Pub Date : 2024-02-01 Xunxi Lu, Yue Wang, Mengting He, Zongchao Gou
Aims The Glasgow Microenvironment Score (GMS) reflects the tumour microenvironment (TME) status by combining inflammatory cell infiltration and the tumour-stroma percentage. This study aimed to investigate the prognostic value and TME characteristics of the GMS for patients with triple-negative breast cancer (TNBC). Methods A total of 123 patients with stage I-III TNBC were enrolled in this study.
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Improving practice in PD-L1 testing of non-small cell lung cancer in the UK: current problems and potential solutions J. Clin. Pathol. (IF 3.4) Pub Date : 2024-02-01 John R Gosney, Michael D Peake, Keith M Kerr
Aims Programmed cell death ligand 1 (PD-L1) expression, used universally to predict response of non-small cell lung cancer (NSCLC) to immune-modulating drugs, is a fragile biomarker due to biological heterogeneity and challenges in interpretation. The aim of this study was to assess current PD-L1 testing practices in the UK, which may help to define strategies to improve its reliability and consistency
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Machine-learning-based image analysis algorithms improve interpathologist concordance when scoring PD-L1 expression in non-small-cell lung cancer J. Clin. Pathol. (IF 3.4) Pub Date : 2024-02-01 Alexander Haragan, Piya Parashar, Danielle Bury, Gregory Cross, John R Gosney
Programmed death ligand 1 (PD-L1) expression on tumour cells is the only predictive biomarker of response to immuno-modulatory therapy for patients with non-small-cell lung cancer (NSCLC). Accuracy of this biomarker is hampered by its challenging interpretation. Here we explore if the use of machine-learning derived image analysis tools can improve interpathologist concordance of assessing PD-L1 expression
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Accuracy of GPT-4 in histopathological image detection and classification of colorectal adenomas J. Clin. Pathol. (IF 3.4) Pub Date : 2024-01-10 Thiyaphat Laohawetwanit, Chutimon Namboonlue, Sompon Apornvirat
Aims To evaluate the accuracy of Chat Generative Pre-trained Transformer (ChatGPT) powered by GPT-4 in histopathological image detection and classification of colorectal adenomas using the diagnostic consensus provided by pathologists as a reference standard. Methods A study was conducted with 100 colorectal polyp photomicrographs, comprising an equal number of adenomas and non-adenomas, classified
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Clinicopathological analysis of BRAF and non-BRAF MAPK pathway-altered gliomas in paediatric and adult patients: a single-institution study of 40 patients J. Clin. Pathol. (IF 3.4) Pub Date : 2024-01-09 Rola H Ali, Mohamad Almanabri, Nawal Y Ali, Ahmad R Alsaber, Nisreen M Khalifa, Rania Hussein, Mona Alateeqi, Eiman M A Mohammed, Hiba Jama, Ammar Almarzooq, Noelle Benobaid, Zainab Alqallaf, Amir A Ahmed, Shakir Bahzad, Maryam Almurshed
Aims Mitogen-activated protein kinase (MAPK) pathway alteration is a major oncogenic driver in paediatric low-grade gliomas (LGG) and some adult gliomas, encompassing BRAF (most common) and non-BRAF alterations. The aim was to determine the frequency, molecular spectrum and clinicopathological features of MAPK-altered gliomas in paediatric and adult patients at our neuropathology site in Kuwait. Methods
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Indian childhood cirrhosis: a retrospective study –redefining the older myths! J. Clin. Pathol. (IF 3.4) Pub Date : 2024-01-08 Surbhi Goyal, Akanksha Singh, Shivanshu Gangwar, Aditi Goyal, Puja Sakhuja, Seema Kapoor
Aims This retrospective study emphasises the need of awareness for clinicopathological attributes of Indian childhood cirrhosis (ICC) in order to enable timely diagnosis and management. Methods This study was done on liver archival tissue of our department from the period of January 2016 to December 2022. Of these, cases of copper overload on paediatric biopsies were retrieved. The histopathological
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Predictors of an informative or actionable cytological diagnosis on repeat breast aspiration after an insufficient aspirate: a multicentre retrospective review J. Clin. Pathol. (IF 3.4) Pub Date : 2024-01-08 Joshua Li, Billy S W Lai, Joanna K M Ng, Julia Y S Tsang, Gary M K Tse
An insufficient/inadequate diagnosis on fine-needle aspiration cytology (FNAC) of the breast is not an uncommon diagnostic dilemma. This study aims to review the rate and clinical features predicting an informative or actionable diagnosis on repeating breast aspiration after an insufficient aspirate. Methods Unsatisfactory/insufficient/inadequate or equivalent breast aspirates were retrieved from the
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Multisite clinical cross-validation and variant interpretation of a next generation sequencing panel for lymphoid cancer prognostication J. Clin. Pathol. (IF 3.4) Pub Date : 2024-01-05 Peter J.B. Sabatini, Josh Bridgers, Shujun Huang, Gregory Downs, Tong Zhang, Clare Sheen, Nicole Park, Robert Kridel, Marco A Marra, Christian Steidl, David W Scott, Aly Karsan
Aims Genomic sequencing of lymphomas is under-represented in routine clinical testing despite having prognostic and predictive value. Clinical implementation is challenging due to a lack of consensus on reportable targets and a paucity of reference samples. We organised a cross-validation study of a lymphoma-tailored next-generation sequencing panel between two College of American Pathologists (CAP)-accredited
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Revealing RB1 loss in an emerging entity: report of two cases of PRRX1-rearranged mesenchymal tumours J. Clin. Pathol. (IF 3.4) Pub Date : 2023-12-28 Fleur Cordier, Sharareh Fadaei, Liesbeth Ferdinande, Frederick Dochy, Lieve Vanwalleghem, Karolien Van Den Bossche, Siebe Loontiens, Joni Van der Meulen, Nadine Van Roy, Jo Van Dorpe, David Creytens
Aims PRRX1 -rearranged mesenchymal tumours are a recently identified and rare subgroup of soft tissue neoplasms with distinct morphological features and genetic alterations. This study aims to further investigate the immunohistochemical profile and underlying genetic alterations in these tumours in order to get more insight on their underlying biology and the unique profile of these tumours. Methods
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Diagnosis and clinical relevance of uncommon subtypes of colorectal carcinoma J. Clin. Pathol. (IF 3.4) Pub Date : 2023-12-28 Raul S Gonzalez
I read with interest the article by Deshpande et al 1 regarding the immune milieu and the prognosis of micropapillary colorectal carcinoma. Their study found that this uncommon subtype of colorectal carcinoma is not associated with inferior disease-specific survival. Our group reported similar findings several years ago in a stage-matched prognostic comparison,2 even though the subtype has a high rate