JOURNAL OF CLINICAL PATHOLOGY

Unravelling switch/sucrose non-fermentable (SWI-SNF) complex-deficient thoracic tumours: a clinicopathological comparative on undifferentiated tumours and non-small cell lung carcinomas with BRG1 and BRM deficiency
Sood R, Tandon A, Khatoon W, Vasanthraman J, Nambirajan A, Mohan A, Malik PS and Jain D
This study was undertaken to compare and expand the clinicopathological characteristics of SMARCA4-deficient thoracic undifferentiated tumour (SMARCA4-dUT) and switch/sucrose non-fermentable-deficient non-small cell lung carcinomas (SWI/SNF-dNSCLC) and to address cases with intermediate features.
Histone antibodies in primary Sjögren's disease
Lee AYS
gene variants in solid tumours: the spectrum of gene variants and potential impact in surgical pathology diagnosis
Yoon JY, El-Sharkawy Navarro F, Ding Q, Rosenbaum J and Priore S
Primary melanoma of the urinary tract: a clinicopathological study of cases and literature review
Wang L, Wali M and Sun Y
Primary malignant melanomas in the bladder or urethra are exceedingly rare. Diagnosing these tumours presents substantial challenges due to their close resemblance in gross appearance and histology to urothelial carcinomas.
Systematic literature review of published cases of reactive plasmacytosis in peripheral blood and bone marrow
Munoz de Toro M and Fernandez-Pol S
This study aims to summarise published cases of reactive plasmacytosis to provide a resource to aid haematopathologists and clinicians in the diagnostic workup of reactive plasmacytosis.
: the promiscuous king of mesenchymal neoplasia
Towery EA and Papke DJ
is the most commonly rearranged gene in mesenchymal neoplasia, and its myriad chimeric oncoproteins drive widely disparate neoplasms. Here, we survey selected rearrangements, including well-described fusions with CREB family members, and , as well as fusions in emerging entities such as mesenchymal neoplasms with and fusions. We also discuss recent data demonstrating the imperfect specificity of and, possibly, fusions.
Partial regression of conventional renal cell carcinoma displays markers of wound repair
Domonkos L, Yusenko M, Kovacs G and Banyai D
During detailed analysis of H&E-stained histological slides of 710 unbiased conventional renal cell carcinomas (cRCCs), 141 tumours displayed partial regressive changes showing strong similarity to that of wound healing. We aimed to analyse the molecular processes occurring in regressive tumours.
Sporadic hypertrophic and nodular port-wine stain: a study of 27 cases with emphasis on histological features and novel mutation type
Xue S, Qiao J, Yu R, Li M, Ding Y, Fu F and Liu Q
To investigate the clinicopathological features and molecular characteristics of sporadic hypertrophic and nodular port-wine stains (PWS).
Oesophageal sebaceous heterotopia with ducts mimicking epidermoid metaplasia: a rare diagnostic pitfall
McCloskey A, Waters KM, Larson BK, Guindi M, Lai K, Gaddam S, Vasireddy A and Hutchings DA
Fusions in salivary gland neoplasms: a review of practical diagnostic applications
Bishop JA
There is an ongoing explosion of new information regarding the underlying molecular alterations driving a variety of salivary gland neoplasms. The volume of this emerging data makes it difficult to keep up with and may cause pathologists to believe that salivary gland neoplasms cannot be diagnosed without genetic analysis. This review focuses on the practical diagnostic applications of molecular tools in surgical pathology specimens.
Assessment of PD-L1 expression and tumour infiltrating lymphocytes in early-stage non-small cell lung carcinoma with artificial intelligence algorithms
Molero A, Hernandez S, Alonso M, Peressini M, Curto D, Lopez-Rios F and Conde E
To study programmed death ligand 1 (PD-L1) expression and tumour infiltrating lymphocytes (TILs) in patients with early-stage non-small cell lung carcinoma (NSCLC) with artificial intelligence (AI) algorithms.
Updates in non-neoplastic orthopaedic pathology: what you don't know can hurt you!
Dashti NK, Reith JD and Kilpatrick SE
Even though the average surgical pathologist reviews far more non-neoplastic orthopaedic pathology on a daily basis, most current research focuses on rare tumours and their even less frequent molecular events. Our experiences among consults and focused conferences strongly suggest that there remains a practice gap regarding knowledge and diagnosing specific non-neoplastic orthopaedic conditions. One of the most frequent intraoperative consultations performed in the USA, among both academic and private institutions, relates to revision arthroplasty and the determination of infection in periprosthetic joints. Pathologists play a critical role in this algorithm, helping determine intraoperatively whether patients require antibiotic spacers prior to reimplantation. Many pathology departments have abandoned the examination of arthroplasty specimens because they (and their surgeons) mistakenly believe there is little clinically relevant information to be gained by thorough pathological examination. However, recent literature has challenged this concept, emphasising the importance of distinguishing avascular necrosis (from osteoarthritis/degenerative joint disease with secondary osteonecrosis), subchondral insufficiency fracture, septic arthritis (from so-called 'sterile' osteomyelitis/pseudoabscesses), underlying crystalline diseases and incidental/occult neoplasia. Histological evaluation of historically insignificant orthopaedic specimens, such as tenosynovium from carpal tunnel syndrome/trigger finger, is now seen as valuable in early diagnosis of cardiac amyloidosis. Not infrequently, orthopaedic conditions like haemosiderotic synovitis, osteocartilaginous loose bodies or rheumatoid nodules, may histologically mimic bona fide neoplasms, notably diffuse tenosynovial giant cell tumour, synovial chondromatosis and epithelioid sarcoma, respectively. Here is a review of the more common non-neoplastic orthopaedic conditions, those likely to be examined by the practising surgical pathologist, with updates and guidelines for establishing clinically relevant diagnoses.
Immune checkpoint inhibitor-induced gastrointestinal injury: prevalence of cytomegalovirus, adenovirus and Epstein-Barr virus
Chornenkyy Y, LaBoy C, De Hoyos SX, Hu J and Pezhouh M
Widespread use of immune checkpoint inhibitors (ICIs) for treatment of advanced malignancies led to an increase in number of immune-related adverse events such as ICI gastrointestinal (GI) injury (ICIGI). The resulting immune dysregulation of the GI mucosa is believed to predispose patients to viral infections. We characterised the histopathological features of ICIGI and the frequency of viral infections such as cytomegalovirus (CMV), adenovirus, and Epstein-Barr virus (EBV).
Vascular mimicry and mosaic vessels in parathyroid tumours: a new diagnostic approach?
Falleni M, Dal Lago M, Tosi D, Ghilardi G, De Pasquale L, Saibene AM, Felisati G, Cozzolino M and Gianelli U
Evaluation of 'alternative' vascularisation in human cancer is considered an important prognostic parameter; the 2022 WHO classification of parathyroid tumours despite progresses in clinical triaging of patients strongly emphasises new histopathological parameters to properly stratify these lesions. 'Alternative' and 'classic' vessels were here investigated for the first time in parathyroid tumours for their possible histopathological and clinical relevance during progression.
Intraductal carcinoma of the prostate: conflicting recommendations confuse clinicians
Varma M, Berney DM, Kristiansen G and van der Kwast TH
Emerging fusion-associated mesenchymal tumours: a tabular guide and appraisal of five 'novel' entities
Moodley J and Chebib I
The field of molecular pathology has undergone significant advancements in the clinical impact of sarcoma diagnosis, resulting in challenges to nosology of bone and soft tissue tumours. The surge in molecular data has led to the identification of novel fusions and description of new 'entities'. To illustrate this, we have selected five emerging entities with novel fusions: clear cell stromal tumour of the lung with fusion, fusion spindle cell neoplasm, -rearranged sarcomas, -rearranged sarcomas and calcified chondroid mesenchymal neoplasms.
Assessment of AI-based computational H&E staining versus chemical H&E staining for primary diagnosis in lymphomas: a brief interim report
Koka R, Wake LM, Ku NK, Rice K, LaRocque A, Vidal EG, Alexanian S, Kozikowski R, Rivenson Y and Kallen ME
Microscopic review of tissue sections is of foundational importance in pathology, yet the traditional chemistry-based histology laboratory methods are labour intensive, tissue destructive, poorly scalable to the evolving needs of precision medicine and cause delays in patient diagnosis and treatment. Recent AI-based techniques offer promise in upending histology workflow; one such method developed by PictorLabs can generate near-instantaneous diagnostic images via a machine learning algorithm. Here, we demonstrate the utility of virtual staining in a blinded, wash-out controlled study of 16 cases of lymph node excisional biopsies, including a spectrum of diagnoses from reactive to lymphoma and compare the diagnostic performance of virtual and chemical H&Es across a range of stain quality, image quality, morphometric assessment and diagnostic interpretation parameters as well as proposed follow-up immunostains. Our results show non-inferior performance of virtual H&E stains across all parameters, including an improved stain quality pass rate (92% vs 79% for virtual vs chemical stains, respectively) and an equivalent rate of binary diagnostic concordance (90% vs 92%). More detailed adjudicated reviews of differential diagnoses and proposed IHC panels showed no major discordances. Virtual H&Es appear fit for purpose and non-inferior to chemical H&Es in diagnostic assessment of clinical lymph node samples, in a limited pilot study.
Extraction and classification of structured data from unstructured hepatobiliary pathology reports using large language models: a feasibility study compared with rules-based natural language processing
Geevarghese R, Sigel C, Cadley J, Chatterjee S, Jain P, Hollingsworth A, Chatterjee A, Swinburne N, Bilal KH and Marinelli B
Structured reporting in pathology is not universally adopted and extracting elements essential to research often requires expensive and time-intensive manual curation. The accuracy and feasibility of using large language models (LLMs) to extract essential pathology elements, for cancer research is examined here.
Sinonasal alveolar rhabdomyosarcoma with fusion expressing SOX10 and with nodal metastases: a double diagnostic pitfall
Crane H, Young RJ, Fernando MS and Griffin J
"Find Your Y": histological differences in early stage (pT) and post-treatment (ypT) oesophageal adenocarcinoma with implications for salvage endoscopic resection
Pacheco RR, Lee G, Yang Z, Lin J, Patil DT, Youssef M, Zhang Q, Alkashash AM, Li J and Lee H
Current guidelines offer limited strategies for managing recurrent/persistent oesophageal adenocarcinoma (EAC). Salvage endoscopic mucosal/submucosal resection (ER) shows promise in oesophageal squamous cell carcinoma, however its success in EAC is limited. We aimed to elucidate histological characteristics influencing salvage ER success in patients with low-stage, pretreated EAC.
Using decision support platforms to enhance cancer diagnostics: the importance of vigilance and wise decision-making
Kim H and Park KU