Integrating cytology into routine digital pathology workflow: a 5-year journey
This study describes our 5-year institutional experience with the implementation of digital cytology. The routine cytology workflow included conventional two-step screening by cytotechnologists, followed by sign out by pathologists. We introduced sign out of cytologic cases using a microscopic digital imaging platform operated by cytotechnologists, which allowed for remote review of slides by cytopathologists via video streaming. We also provided cytologic correlation to support the virtual slide-based sign out of histopathological specimens and for a weekly pathology-radiology conference. In addition, positive cytology ca...
Source: Virchows Archiv - April 29, 2023 Category: Pathology Source Type: research
Surufatinib-induced renal thrombotic microangiopathy: first case report and review of literature
AbstractAngiogenesis inhibitors such as tyrosine kinase inhibitors (TKIs) are common therapeutics currently used to treat oncologic disease. Surufatinib is a novel, small-molecule multiple receptor TKI approved by the National Medical Products Administration (NMPA) for the treatment of progressive, advanced, and well-differentiated pancreatic and extrapancreatic neuroendocrine tumours (NETs). Thrombotic microangiopathy (TMA) is a well-documented complication of TKIs targeting the VEGF-A/VEGFR2 signalling pathway. Here, we describe a 43-year-old female patient with biopsy-proven TMA and nephrotic syndrome due to surufatinib...
Source: Virchows Archiv - April 26, 2023 Category: Pathology Source Type: research
CREB fusion –associated epithelioid mesenchymal neoplasms of the female adnexa: three cases documenting a novel location of an emerging entity and further highlighting an ambiguous misleading immunophenotype
AbstractEWSR1/FUS-CREB-rearranged mesenchymal neoplasms are an emerging heterogeneous group of soft tissue tumors that encompasses low-grade lesions (angiomatoid fibrous histiocytoma/AFH) and a group of predominantly intra-abdominal aggressive sarcomas with epithelioid morphology and frequent keratin expression. Both entities occasionally harborEWSR1::ATF1 fusions as alternate to the more frequentEWSR1/FUS::CREB1/CREM fusions. AlthoughEWSR1/FUS-CREB-rearranged epithelioid malignant neoplasms have been described in diverse intra-abdominal sites, none involved the female adnexa. Herein, we describe three cases involving uter...
Source: Virchows Archiv - April 25, 2023 Category: Pathology Source Type: research
Characterization and digital spatial deconvolution of the immune microenvironment of intraductal oncocytic papillary neoplasms (IOPN) of the pancreas
AbstractIntraductal oncocytic papillary neoplasm (IOPN) of the pancreas is a distinct entity from intraductal papillary mucinous neoplasms (IPMNs) and is considered one of the precursor lesions of pancreatic cancer. Through immunohistochemistry (IHC) and an artificial intelligence (AI)-based approach, this study aims at characterizing its immune microenvironment. Whole-slide IHC was performed on a cohort of 15 IOPNs, 2 of which harboring an associated adenocarcinoma. The following markers were tested: CD3, CD4, CD8, CD20, CD68, CD163, PD-1, PD-L1, MLH1, PMS2, MSH2, and MSH6. The main findings can be summarized as follows: ...
Source: Virchows Archiv - April 22, 2023 Category: Pathology Source Type: research
Solitary fibrous tumor of the thyroid: report of three cases with a focus on cytological features and histological clues for malignancy
AbstractSolitary fibrous tumor is a mesenchymal tumor of intermediate malignant potential characterized by a recurrent NAB2::STAT6 fusion and STAT6 nuclear expression. Primary thyroid solitary fibrous tumor is relatively uncommon, with 45 cases described in the English literature to date. Although its histologic features are characteristic, its diagnosis in the thyroid can be problematic, especially in small biopsies or cytology specimens. We herein present three new cases of thyroid solitary fibrous tumor, one of which is malignant, with new insights on the morphological spectrum and malignant potential of this tumor. We ...
Source: Virchows Archiv - April 20, 2023 Category: Pathology Source Type: research
Claudin-10 is a new candidate prognostic marker in metastatic high-grade serous carcinoma
The objective of this study was to analyze the expression and prognostic role of the gap junction protein claudin-10 in high-grade serous carcinoma (HGSC). Claudin-10 protein expression by immunohistochemistry was analyzed in 588 HGSC (414 effusions, 174 surgical specimens). Expression in mesotheliomas (n = 97; 47 effusions, 50 surgical specimens) was studied for comparative purposes.CLDN10 mRNA expression by quantitative RT-PCR (qRT-PCR) was analyzed in 40 HGSC effusions. Claudin-10 protein expression was found in 360/588 (61%) HGSC vs. 19/97 (20%) mesotheliomas (p < 0.001), and was higher in HGSC surgical s...
Source: Virchows Archiv - April 17, 2023 Category: Pathology Source Type: research
Comparison of NTRK fusion detection methods in microsatellite-instability-high metastatic colorectal cancer
AbstractTropomyosin receptor kinase (TRK) inhibitors have been approved for metastatic solid tumors harboringNTRK fusions, but the detection ofNTRK fusions is challenging. International guidelines recommend pan-TRK immunohistochemistry (IHC) screening followed by next generation sequencing (NGS) in tumor types with low prevalence ofNTRK fusions, including metastatic colorectal cancer (mCRC). RNA-based NGS is preferred, but is expensive, time-consuming, and extracting good-quality RNA from FFPE tissue is challenging. Alternatives in daily clinical practice are warranted. We assessed the diagnostic performance of RNA-NGS, FF...
Source: Virchows Archiv - April 17, 2023 Category: Pathology Source Type: research
PIK3CA mutation testing as a valuable molecular surrogate for lipomatosis of the median nerve: clinicopathological and molecular analysis of six cases
AbstractLipomatosis of peripheral nerves (LPN, also known as fibrolipomatous or lipofibromatous hamartoma of peripheral nerves) is a very rare, benign, intraneural, tumorous lesion that predominantly involves the median nerve but may rarely affect any peripheral nerve. Recently,PIK3CA mutations have been reported in macrodactyly, a rare condition related to LPN, and in other localized lipomatous overgrowth syndromes. In this retrospective study, we report 6 cases of FPN involving the median nerve (4 of them identified among 570 patients with carpal tunnel syndrome who underwent surgical decompression at our center from 201...
Source: Virchows Archiv - April 17, 2023 Category: Pathology Source Type: research
Survival is associated with repressive histone trimethylation markers in both HR-positive HER2-negative and triple-negative breast cancer patients
AbstractAbout 30% of patients with hormone receptor (HR)-positive breast cancers and up to 50% of human epidermal growth factor receptor 2 (HER2)-positive patients develop progression due to treatment resistance, highlighting the need for more differentiated tumor classifications within the breast cancer molecular subtype to optimize the therapies. We aim to examine the roles of histone modification markers. The levels of common repressive histone markers, histone H3 lysine 9 trimethylation (H3K9me3), histone H3 lysine 27 trimethylation (H3K27me3), and histone H4 lysine 20 trimethylation (H4K20me3), in tumors were evaluate...
Source: Virchows Archiv - April 15, 2023 Category: Pathology Source Type: research
Intrathyroid thymic carcinoma: clinicopathological features and whole exome sequencing analysis
We present nine cases of ITC that were analysed by immunohistochemical staining, of which five were analysed using whole exome sequencing (WES). These cases included six women and three men with an age range of 31 –66 years. The average postoperative follow-up term was 37.8 months (range, 7–95 months), and all patients survived well except for one case with lung metastasis. Microscopically, ITC showed solid islands of tumour cells separated by fibrous connective tissue containing lymphocytes and other inflammatory cells. Tumour cells strongly expressed Ckpan (AE1/AE3), P63, and CD117. And all cases but one were posi...
Source: Virchows Archiv - April 5, 2023 Category: Pathology Source Type: research
Impact of template-based synoptic reporting on completeness of surgical pathology reports
In conclusion, template-based synoptic reporting without underlying database structure can be a useful transitory phase in the implementation of synoptic reporting. It can result in a similar degree of completeness as reported in the literature for database solutions and provides other benefits of synoptic reporting while facilitating its implementation. (Source: Virchows Archiv)
Source: Virchows Archiv - April 5, 2023 Category: Pathology Source Type: research
Atypical meningiomas with an immunohistochemical profile consistent with hypermetabolic or proliferative molecular groups show high mitotic index, chromosomal instability, and higher recurrence risk
AbstractThe use of adjuvant radiotherapy is controversial for atypical meningiomas undergoing gross total resection. It has recently been proposed that meningiomas may be classified into four molecular groups (MG): immunogenic (MG1), benignNF2-wildtype (MG2), hypermetabolic (MG3), and proliferative (MG4). The two latter have the worst prognosis, and it has been suggested that they can be identified using ACADL and MCM2 immunostainings. We studied 55 primary atypical meningiomas, treated with gross total resection and no adjuvant therapies, to assess whether ACADL and MCM2 immuno-expression may identify patients at higher r...
Source: Virchows Archiv - April 4, 2023 Category: Pathology Source Type: research
TRPS1 expression in cytokeratin 5 expressing triple negative breast cancers, its value as a marker of breast origin
AbstractThe lack of oestrogen receptor, progesterone receptor and human epidermal growth factor receptor-2 expression in breast cancer (BC) is the basis for the categorization of the tumour as triple negative breast carcinoma (TNBC). The majority of TNBCs are aggressive tumours with common metastases and decreased expression of markers that could help in identifying the metastatic lesion as of mammary origin. Breast markers, such as gross cystic disease fluid protein-15 (GCDPF-15), GATA binding protein 3 (GATA3), mammaglobin (MGB) and SOX10, are not uniquely specific to BC. Our aim was to evaluate trichorhinophalangeal syn...
Source: Virchows Archiv - April 3, 2023 Category: Pathology Source Type: research
In this issue
(Source: Virchows Archiv)
Source: Virchows Archiv - April 1, 2023 Category: Pathology Source Type: research
Adenosquamous carcinoma in situ of the anus: a case series
AbstractWhile human papillomavirus (HPV)-associated adenocarcinoma of the anus resembling endocervical adenocarcinoma has recently been described, anal adenocarcinoma in situ/AIS has not. Moreover, to the best of our knowledge, truly biphasic anal adenosquamous carcinoma in situ (ADSQ-IS) is essentially non-existent in the literature. Here, we report four cases of anal ADSQ-IS including one with associated invasive adenosquamous carcinoma. Histologically, all cases of ADSQ-IS showed a basal/peripheral population of stratified, p40-positive dysplastic squamous cells adjacent to luminal, columnar, p40-negative dysplastic gla...
Source: Virchows Archiv - April 1, 2023 Category: Pathology Source Type: research
