Journal of Pathology and Translational Medicine

Reviews

Cervical intraepithelial neoplasia and cervical cytology in pregnancy: Ji-Young Kim, Jeong Yun Shim; J Pathol Transl Med. 2024;58(6):283-290. Published online November 7, 2024; DOI: https://doi.org/10.4132/jptm.2024.10.17

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Abstract PDF: Cervical cancer screening during pregnancy presents unique challenges for cytologic interpretation. This review focuses on pregnancy-associated cytomorphological changes and their impact on diagnosis of cervical intraepithelial neoplasia (CIN) and cervical cancer. Pregnancy-induced alterations include navicular cells, hyperplastic endocervical cells, immature metaplastic cells, and occasional decidual cells or trophoblasts. These changes can mimic abnormalities such as koilocytosis, adenocarcinoma in situ, and high-grade squamous intraepithelial lesions, potentially leading to misdiagnosis. Careful attention to nuclear features and awareness of pregnancy-related changes are crucial for correct interpretation. The natural history of CIN during pregnancy shows higher regression rates, particularly for CIN 2, with minimal risk of progression. Management of abnormal cytology follows modified risk-based guidelines to avoid invasive procedures, with treatment typically deferred until postpartum. The findings reported in this review emphasize the importance of considering pregnancy status in cytological interpretation, highlight potential problems, and provide guidance on differentiating benign pregnancy-related changes from true abnormalities. Understanding these nuances is essential for accurate diagnosis and proper management of cervical abnormalities in pregnant women.

The Asian Thyroid Working Group, from 2017 to 2023: Kennichi Kakudo, Chan Kwon Jung, Zhiyan Liu, Mitsuyoshi Hirokawa, Andrey Bychkov, Huy Gia Vuong, Somboon Keelawat, Radhika Srinivasan, Jen-Fan Hang, Chiung-Ru Lai; J Pathol Transl Med. 2023;57(6):289-304. Published online November 14, 2023; DOI: https://doi.org/10.4132/jptm.2023.10.04

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The Asian Thyroid Working Group was founded in 2017 at the 12th Asia Oceania Thyroid Association (AOTA) Congress in Busan, Korea. This group activity aims to characterize Asian thyroid nodule practice and establish strict diagnostic criteria for thyroid carcinomas, a reporting system for thyroid fine needle aspiration cytology without the aid of gene panel tests, and new clinical guidelines appropriate to conservative Asian thyroid nodule practice based on scientific evidence obtained from Asian patient cohorts. Asian thyroid nodule practice is usually designed for patient-centered clinical practice, which is based on the Hippocratic Oath, “First do not harm patients,” and an oriental filial piety “Do not harm one’s own body because it is a precious gift from parents,” which is remote from defensive medical practice in the West where physicians, including pathologists, suffer from severe malpractice climate. Furthermore, Asian practice emphasizes the importance of resource management in navigating the overdiagnosis of low-risk thyroid carcinomas. This article summarizes the Asian Thyroid Working Group activities in the past 7 years, from 2017 to 2023, highlighting the diversity of thyroid nodule practice between Asia and the West and the background reasons why Asian clinicians and pathologists modified Western systems significantly.

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Welcoming the new, revisiting the old: a brief glance at cytopathology reporting systems for lung, pancreas, and thyroid
Rita Luis, Balamurugan Thirunavukkarasu, Deepali Jain, Sule Canberk
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Are we ready to bridge classification systems? A comprehensive review of different reporting systems in thyroid cytology
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Cytopathology.2024; 35(6): 674. CrossRef
Aggressive Types of Malignant Thyroid Neoplasms
Maria Boudina, Eleana Zisimopoulou, Persefoni Xirou, Alexandra Chrisoulidou
Journal of Clinical Medicine.2024; 13(20): 6119. CrossRef
Risk of Infertility in Reproductive-Age Patients With Thyroid Cancer Receiving or Not Receiving 131I Treatment
Chun-Yi Lin, Cheng-Li Lin, Chia-Hung Kao
Clinical Nuclear Medicine.2024;[Epub] CrossRef
Fine needle aspiration cytology diagnoses of follicular thyroid carcinoma: results from a multicenter study in Asia
Hee Young Na, Miyoko Higuchi, Shinya Satoh, Kaori Kameyama, Chan Kwon Jung, Su-Jin Shin, Shipra Agarwal, Jen-Fan Hang, Yun Zhu, Zhiyan Liu, Andrey Bychkov, Kennichi Kakudo, So Yeon Park
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Association Between Metabolic Dysfunction-Associated Steatotic Liver Disease and Thyroid Cancer
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Thyroid®.2024;[Epub] CrossRef

Original Article

Elevated expression of Axin2 in intestinal metaplasia and gastric cancers: Dong Hui Lee, In Ho Jeong, Bogun Jang; J Pathol Transl Med. 2023;57(6):315-322. Published online November 7, 2023; DOI: https://doi.org/10.4132/jptm.2023.10.12

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Abstract PDF: Background
The Wnt signaling pathway regulates crucial cellular processes, including stem cell development and tissue repair. Dysregulation of this pathway, particularly β-catenin stabilization, is linked to colorectal carcinoma and other tumors. Axin2, a critical component in the pathway, plays a role in β-catenin regulation. This study examines Axin2 expression in normal gastric mucosa and various gastric pathologies.
Methods
Formalin-fixed and paraffin-embedded tissue samples from normal stomach, gastritis, intestinal metaplasia (IM), and gastric carcinoma were collected. Axin2 and β-catenin expression were evaluated using RNA in situ hybridization and immunohistochemistry, respectively. Histo-scores (H-scores) were calculated to quantify expression levels of Axin2. Associations between Axin2 expression and clinicopathological variables were examined.
Results
Axin2 expression was examined in normal stomach, gastritis, and IM tissues. Axin2 expression was mainly observed in the surface and isthmus areas in the normal stomach and gastritis, whereas Axin2 expression was markedly higher at the bases of IM. Axin2 H-scores were significantly elevated in IM (mean ± standard deviation [SD], 87.0 ± 38.9) compared to normal (mean ± SD, 18.0 ± 4.5) and gastritis tissues (mean ± SD, 33.0 ± 18.6). In total, 30% of gastric carcinomas showed higher Axin2 expression. Axin2 expression did not have significant associations with age, sex, Lauren classification, histological differentiation, invasion depth, and lymph node metastasis. However, a strong positive correlation was observed between Axin2 and nuclear β-catenin in gastric carcinomas (p < .001).
Conclusions
Axin2 expression was significantly increased in IM compared to normal and gastritis cases. In addition, Axin2 showed a strong positive association with nuclear β-catenin expression in gastric carcinomas, demonstrating a close relationship with abnormal Wnt/β-catenin signaling pathway.

Review

Trouble-makers in cytologic interpretation of the uterine cervix: Eunah Shin, Jaeeun Yu, Soon Won Hong; J Pathol Transl Med. 2023;57(3):139-146. Published online May 15, 2023; DOI: https://doi.org/10.4132/jptm.2023.04.25

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Abstract PDF

The development and standardization of cytologic screening of the uterine cervix has dramatically decreased the prevalence of squamous cell carcinoma of the uterine cervix. Advances in the understanding of biology of human papillomavirus have contributed to upgrading the histologic diagnosis of the uterine cervix; however, cytologic screening that should triage those that need further management still poses several difficulties in interpretation. Cytologic features of high grade intraepithelial squamous lesion (HSIL) mimics including atrophy, immature metaplasia, and transitional metaplasia, and glandular lesion masquerades including tubal metaplasia and HSIL with glandular involvement are described with accentuation mainly on the differential points. When the cytologic features lie in a gray zone between the differentials, the most important key to the more accurate interpretation is sticking to the very basics of cytology; screening the background and cellular architecture, and then scrutinizing the nuclear and cytoplasmic details.

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Pitfalls in Gynecological Cytology: Review of the Common and Less Frequent Entities in Pap Test
Danijela Vrdoljak-Mozetič, Snježana Štemberger-Papić, Damjana Verša Ostojić, Roberta Rubeša, Marko Klarić, Senija Eminović
Acta Cytologica.2024; 68(3): 281. CrossRef
Cytological features of human papillomavirus‐infected immature squamous metaplastic cells from cervical intraepithelial neoplasia grade 2
Mitsuaki Okodo, Kaori Okayama, Koji Teruya, Ruku Shinohara, Shuichi Mizuno, Rei Settsu, Yasuyoshi Ishii, Masahiko Fujii, Hirokazu Kimura, Mizue Oda
Journal of Medical Virology.2023;[Epub] CrossRef

Original Article

Evaluation of the characteristics of multiple human papillomavirus (HPV) infections identified using the BD Onclarity HPV assay and comparison with those of single HPV infection: Jinhee Kim, Moonsik Kim, Ji Young Park; J Pathol Transl Med. 2022;56(5):289-293. Published online September 13, 2022; DOI: https://doi.org/10.4132/jptm.2022.08.02

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Abstract PDF Supplementary Material

Background
Human papillomavirus (HPV) infection is a major cause of cervical cancer and associated precursor lesions. Multiple HPV genotype infections have been reported. However, their clinicopathological characteristics still remain elusive.
Methods
For this study, 814 consecutive patients who had undergone colposcopy and HPV genotyping test using BD Onclarity HPV assay were retrospectively selected. Clinicopathological parameters of multiple HPV infections were compared with those of single HPV infection.
Results
Multiple HPV infections were found in 110 out of 814 cases (13.5%). Multiple HPV infections were associated with a significantly higher incidence of high-grade intraepithelial lesions (HSILs) compared with single HPV infection. Other high-risk HPV genotypes, in addition to HPV 16, were found more frequently in the multiple HPV infections group; these included HPV 51, 52, 33/58, 56/59/66, and 35/39/68. No specific coinfection pattern was not identified. Additionally, the number of HPV genotypes in multiple HPV infections was not associated with the progression to HSIL or squamous cell carcinoma.
Conclusions
Multiple HPV infections have distinct clinicopathological characteristics (compared with single HPV infection). As their biological behavior is uncertain, close and frequent follow-up is warranted.

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The cervical cancer related distribution, coinfection and risk of 15 HPV types in Baoan, Shenzhen, in 2017–2023
Rukai Li, Weiwei Meng, Yunhai Zuo, Yanli Xu, Shaonan Wu
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Francesca De Falco, Anna Cutarelli, Francesca Luisa Fedele, Cornel Catoi, Sante Roperto
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Patterns of single and multiple HPV infections in female: A systematic review and meta-analysis
Dan Zhou, Jing Xue, Yaqiong Sun, Liling Zhu, Ming Zhao, Meimei Cui, Min Zhang, Jingjing Jia, Limei Luo
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Age distribution of patients with multiple High-Risk Human Papilloma Virus (HR-HPV) genotypes and HPV vaccine recommendations by age
Gülçin Çetin Uysal, Nil Tekin
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Relative distribution of HPV genotypes in histological cervical samples and associated grade lesion in a women population over the last 16 years in Burgundy, France
Christelle Auvray, Serge Douvier, Odile Caritey, Jean-Baptiste Bour, Catherine Manoha
Frontiers in Medicine.2023;[Epub] CrossRef
Epidemiologic characteristics of high-risk HPV and the correlation between multiple infections and cervical lesions
Qinli Luo, Xianghua Zeng, Hanyi Luo, Ling Pan, Ying Huang, Haiyan Zhang, Na Han
BMC Infectious Diseases.2023;[Epub] CrossRef

Review

Non-conventional dysplastic subtypes in inflammatory bowel disease: a review of their diagnostic characteristics and potential clinical implications: Won-Tak Choi; J Pathol Transl Med. 2021;55(2):83-93. Published online March 9, 2021; DOI: https://doi.org/10.4132/jptm.2021.02.17

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Abstract PDF

The early detection and grading of dysplasia is the current standard of care to minimize mortality from colorectal cancer (CRC) in patients with inflammatory bowel disease. With the development of advanced endoscopic resection techniques, colectomy is now reserved for patients with invisible/flat dysplasia (either high-grade [HGD] or multifocal low-grade dysplasia) or endoscopically unresectable lesions. Although most pathologists are familiar with the morphologic criteria of conventional (intestinal type) dysplasia, the most well-recognized form of dysplasia, an increasing number of diagnostic material has led to the recognition of several different morphologic patterns of epithelial dysplasia. The term “non-conventional” dysplasia has been coined to describe these changes, but to date, the recognition and full appreciation of these novel forms of dysplasia by practicing pathologists is uneven. The recognition of these non-conventional subtypes is becoming increasingly important, as some of them appear to have a higher risk of developing HGD or CRC than conventional dysplasia or sporadic adenomas. This review describes the morphologic characteristics of all seven non-conventional subtypes that have been reported to date as well as our current understanding of their clinicopathologic and molecular features that distinguish them from conventional dysplasia or sporadic adenomas.

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Morphological subtypes of colorectal low-grade intraepithelial neoplasia: diagnostic reproducibility, frequency and clinical impact
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Zahra Alipour, Kristen Stashek
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Nonconventional Dysplasia is Frequently Associated With Goblet Cell Deficient and Serrated Variants of Colonic Adenocarcinoma in Inflammatory Bowel Disease
Andrew Xiao, Masato Yozu, Bence P. Kővári, Lindsay Yassan, Xiaoyan Liao, Marcela Salomao, Maria Westerhoff, Anita Sejben, Gregory Y. Lauwers, Won-Tak Choi
American Journal of Surgical Pathology.2024; 48(6): 691. CrossRef
Increased Active Inflammation in the Colon is Not a Reliable Predictor of an Elevated Risk of Dysplasia in Patients With Primary Sclerosing Cholangitis and Ulcerative Colitis
Ruth Zhang, Dongliang Wang, Gregory Y. Lauwers, Won-Tak Choi
American Journal of Surgical Pathology.2024; 48(9): 1154. CrossRef
Dysplasia Detected in Patients With Serrated Epithelial Change Is Frequently Associated With an Invisible or Flat Endoscopic Appearance, Nonconventional Dysplastic Features, and Advanced Neoplasia
Dorukhan Bahceci, Lindsay Alpert, Tanner Storozuk, Xiaoyan Liao, Masato Yozu, Maria Westerhoff, Bence P. Kővári, Gregory Y. Lauwers, Won-Tak Choi
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Difficulties in diagnosis of non-conventional dysplasia in inflammatory bowel disease
Kh. M. Akhrieva, A. S. Tertychnyy, N. V. Pachuashvili, L. S. Urusova
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Gavino Faa, Matteo Fraschini, Luca Didaci, Luca Saba, Mario Scartozzi, Enrico Orvieto, Massimo Rugge
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Hypermucinosus és kehelysejtszegény, gyulladásos bélbetegséghez társult, non-conventionalis dysplasia colorectalis adenocarcinoma mellett
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DNA content abnormality frequently develops in the right/proximal colon in patients with primary sclerosing cholangitis and inflammatory bowel disease and is highly predictive of subsequent detection of dysplasia
Ruth Zhang, Peter S. Rabinovitch, Aras N. Mattis, Gregory Y. Lauwers, Won‐Tak Choi
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Dorukhan Bahceci, Gregory Y Lauwers, Won‐Tak Choi
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Increased histologic inflammation is an independent risk factor for nonconventional dysplasia in ulcerative colitis
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Case Study

Fibrocartilaginous mesenchymoma with an unusual location in the rib: Sun-Ju Oh; J Pathol Transl Med. 2021;55(1):75-78. Published online December 3, 2020; DOI: https://doi.org/10.4132/jptm.2020.10.08

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Abstract PDF

Fibrocartilaginous mesenchymoma is a rare bone tumor, with fewer than 35 cases reported in the literature since 1984. This tumor usually occurs in the long bones of children and adolescents. In the current case, the tumor affected a rib. A 17-year-old boy presented with a mass in the right fifth rib. Radiologic findings revealed an osteolytic mass with cortical destruction and calcification; en bloc resection was performed. The tumor showed three distinct histologic features: bland spindle cell proliferation, benign cartilage nodules, and epiphyseal plate-like enchondral ossification. The pathologic diagnosis was fibrocartilaginous mesenchymoma. The patient remains free of disease 1 year after the surgery. Pathological diagnosis of fibrocartilaginous mesenchymoma can be challenging, especially when the tumor occurs in an unusual site. When any fibro-osseous lesion with a cartilaginous component is encountered, the possibility of fibrocartilaginous mesenchymoma should be considered because of its locally aggressive behavior.

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Fibrocartilaginous mesenchymoma: a case report and a literature review
A. A. Karyagina, V. Yu. Roshchin, I. V. Sidorov, D. M. Konovalov
Pediatric Hematology/Oncology and Immunopathology.2024; 23(3): 158. CrossRef
Fibrocartilaginous mesenchymoma of pelvis—a potential diagnostic pitfall
Monalisa Hui, Shantveer G. Uppin, Ramakrishna Narayanan, K. Nageshwara Rao, B. Aravind Kumar
Skeletal Radiology.2023; 52(4): 791. CrossRef

Original Article

Indirect pathological indicators for cardiac sarcoidosis on endomyocardial biopsy: Myung-Jin Cha, Jeong-Wook Seo, Seil Oh, Eun-Ah Park, Sang-Han Lee, Moon Young Kim, Jae-Young Park; J Pathol Transl Med. 2020;54(5):396-410. Published online July 29, 2020; DOI: https://doi.org/10.4132/jptm.2020.06.10

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Abstract PDF Supplementary Material

Background
The definitive pathologic diagnosis of cardiac sarcoidosis requires observation of a granuloma in the myocardial tissue. It is common, however, to receive a “negative” report for a clinically probable case. We would like to advise pathologists and clinicians on how to interpret “negative” biopsies.
Methods
Our study samples were 27 endomyocardial biopsies from 25 patients, three cardiac transplantation and an autopsied heart with suspected cardiac sarcoidosis. Pathologic, radiologic, and clinical features were compared.
Results
The presence of micro-granulomas or increased histiocytic infiltration was always (6/6 or 100%) associated with fatty infiltration and confluent fibrosis, and they showed radiological features of sarcoidosis. Three of five cases (60%) with fatty change and confluent fibrosis were probable for cardiac sarcoidosis on radiology. When either confluent fibrosis or fatty change was present, one-third (3/9) were radiologically probable for cardiac sarcoidosis. We interpreted cases with micro-granuloma as positive for cardiac sarcoidosis (five of 25, 20%). Cases with both confluent fibrosis and fatty change were interpreted as probable for cardiac sarcoidosis (seven of 25, 28%). Another 13 cases, including eight cases with either confluent fibrosis or fatty change, were interpreted as low probability based on endomyocardial biopsy.
Conclusions
The presence of micro-granuloma could be an evidence for positive diagnosis of cardiac sarcoidosis. Presence of both confluent fibrosis and fatty change is necessary for probable cardiac sarcoidosis in the absence of granuloma. Either of confluent fibrosis or fatty change may be an indirect pathological evidence but they are interpreted as nonspecific findings.

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Advances in cellular and tissue-based imaging techniques for sarcoid granulomas
Junwoo Kim, Girish Dwivedi, Berin A. Boughton, Ankur Sharma, Silvia Lee
American Journal of Physiology-Cell Physiology.2024; 326(1): C10. CrossRef
Lipomatous Metaplasia Is Associated With Ventricular Tachycardia Recurrence Following Ablation in Patients With Nonischemic Cardiomyopathy
Lingyu Xu, Mirmilad Khoshknab, Juwann Moss, Ronald D. Berger, Jonathan Chrispin, David Callans, Francis E. Marchlinski, Stefan L. Zimmerman, Yuchi Han, Natalia Trayanova, Benoit Desjardins, Saman Nazarian
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Cardiac Sarcoidosis: A Comprehensive Clinical Review
András Vereckei, Zsuzsanna Besenyi, Viktória Nagy, Bence Radics, Hajnalka Vágó, Zsigmond Jenei, Gábor Katona, Róbert Sepp
Reviews in Cardiovascular Medicine.2024;[Epub] CrossRef
Cardiac sarcoidosis: phenotypes, diagnosis, treatment, and prognosis
Jukka Lehtonen, Valtteri Uusitalo, Pauli Pöyhönen, Mikko I Mäyränpää, Markku Kupari
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Cardiac sarcoidosis: a comprehensive review of risk factors, pathogenesis, diagnosis, clinical manifestations, and treatment strategies
Hussain Haider Shah, Syeda Alishah Zehra, Aliza Shahrukh, Radeyah Waseem, Tooba Hussain, Muhammad Sheheryar Hussain, Fareeha Batool, Muhammad Jaffer
Frontiers in Cardiovascular Medicine.2023;[Epub] CrossRef
Histology of Cardiac Sarcoidosis with Novel Considerations Arranged upon a Pathologic Basis
Shu Kato, Yasuhiro Sakai, Asako Okabe, Yoshiaki Kawashima, Kazuhiko Kuwahara, Kazuya Shiogama, Masato Abe, Hiroyasu Ito, Shin’ichiro Morimoto
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Cardiac sarcoidosis: A multimodal approach to reach the diagnosis
Nicolas Piriou, Patrick Bruneval
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Value of 3D mapping‐guided endomyocardial biopsy in cardiac sarcoidosis
Danielle M. Haanschoten, Ahmet Adiyaman, Nils A. ‘t Hart, Piet L. Jager, Arif Elvan
European Journal of Clinical Investigation.2021;[Epub] CrossRef
Cardiac Sarcoidosis: A Clinical Overview
Ana Carolina Alba, Shyla Gupta, Lakshmi Kugathasan, Andrew Ha, Alejandro Ochoa, Meyer Balter, Alvaro Sosa Liprandi, Maria Inés Sosa Liprandi
Current Problems in Cardiology.2021; 46(10): 100936. CrossRef

Review

Clinicopathological characteristics of BRCA-associated breast cancer in Asian patients: Eun-Kyu Kim, So Yeon Park, Sung-Won Kim; J Pathol Transl Med. 2020;54(4):265-275. Published online May 14, 2020; DOI: https://doi.org/10.4132/jptm.2020.04.07

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Abstract PDF

BRCA1/2 germline mutations account for the majority of hereditary breast cancers. Since the identification of the BRCA genes, several attempts have been made to define the clinicopathological characteristics of BRCA-associated breast cancer in comparison with sporadic breast cancer. Asians constitute 60% of the world population, and although the incidence of breast cancer in Asia remains low compared to the West, breast cancer is the most prevalent female cancer in the region. The epidemiological aspects of breast cancer are different between Asians and Caucasians. Asian patients present with breast cancer at a younger age than Western patients. The contributions of BRCA1/2 mutations to breast cancer incidence are expected to differ between Asians and Caucasians, and the different genetic backgrounds among races are likely to influence the breast cancer phenotypes. However, most large-scale studies on the clinicopathological characteristics of BRCA-associated breast cancer have been on Western patients, while studies on Asian populations were small and sporadic. In this review, we provide an overview of the clinical and pathological characteristics of BRCA-associated breast cancer, incorporating findings on Asian patients.

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The Clinical and Pathological Profile of BRCA1 Gene Methylated Breast Cancer Women: A Meta-Analysis
Ilary Ruscito, Maria Luisa Gasparri, Maria Paola De Marco, Flavia Costanzi, Aris Raad Besharat, Andrea Papadia, Thorsten Kuehn, Oreste Davide Gentilini, Filippo Bellati, Donatella Caserta
Cancers.2021; 13(6): 1391. CrossRef
Changing Patterns in Clinicopathological Characteristics of Breast Cancer and Prevalence of BRCA Mutations: Analysis in a Rural Area of Southern China
Qiuming Wang, Heming Wu, Yongquan Lan, Jinhong Zhang, Jingna Wu, Yunuo Zhang, Liang Li, Donghua Liu, Jinfeng Zhang
International Journal of General Medicine.2021; Volume 14: 7371. CrossRef

Case Studies

Morphologic variant of follicular lymphoma reminiscent of hyaline-vascular Castleman disease: Jiwon Koh, Yoon Kyung Jeon; J Pathol Transl Med. 2020;54(3):253-257. Published online February 5, 2020; DOI: https://doi.org/10.4132/jptm.2019.12.17

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225 Download
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Abstract PDF

Follicular lymphoma (FL) with hyaline-vascular Castleman disease (FL-HVCD)-like features is a rare morphologic variant, with fewer than 20 cases in the literature. Herein, we report a case of FL-HVCD in a 37-year-old female who presented with isolated neck lymph node enlargement. The excised lymph node showed features reminiscent of HVCD, including regressed germinal centers (GCs) surrounded by onion skin-like mantle zones, lollipop lesions composed of hyalinized blood vessels penetrating into regressed GCs, and hyalinized interfollicular stroma. In addition, focal areas of abnormally conglomerated GCs composed of homogeneous, small centrocytes with strong BCL2, CD10, and BCL6 expression were observed, indicating partial involvement of the FL. Several other lymphoid follicles showed features of in situ follicular neoplasia. Based on the observations, a diagnosis of FL-HVCD was made. Although FLHVCD is very rare, the possibility of this variant should be considered in cases resembling CD. Identification of abnormal, neoplastic follicles and ancillary immunostaining are helpful for proper diagnosis.

Citations

Citations to this article as recorded by

Unicentric Castleman Disease: Illustration of Its Morphologic Spectrum and Review of the Differential Diagnosis
Siba El Hussein, Andrew G. Evans, Hong Fang, Wei Wang, L. Jeffrey Medeiros
Archives of Pathology & Laboratory Medicine.2024; 148(1): 99. CrossRef
Finding a Needle in the Haystack
Hung-Yu Lin, Yi-Jen Peng, Yi-Ying Wu, Ping-Ying Chang
Journal of Medical Sciences.2023; 43(6): 292. CrossRef
Analysis of immunophenotypic features in hyaline vascular type Castleman disease
Yu Chang, Yu Ma, Chen Chang, Wensheng Li
Diagnostic Pathology.2023;[Epub] CrossRef
In‐situ follicular neoplasia: a clinicopathological spectrum
Gurdip S Tamber, Myriam Chévarie‐Davis, Margaret Warner, Chantal Séguin, Carole Caron, René P Michel
Histopathology.2021; 79(6): 1072. CrossRef

Squamous Metaplasia in Pleomorphic Adenoma: A Diagnostic and Prognostic Enigma: Swati Sharma, Monica Mehendiratta, Nivedita Chaudhary, Vineet Gupta, Maulshree Kohli, Anjana Arora; J Pathol Transl Med. 2018;52(6):411-415. Published online October 1, 2018; DOI: https://doi.org/10.4132/jptm.2018.07.15

7,016 View
133 Download
8 Web of Science
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Abstract PDF

Pleomorphic adenoma (PA) is the most common benign salivary gland tumor. Histologically, squamous metaplasia has been reported in PA, but has rarely been documented as being extensive enough to cause significant misdiagnosis. Here, we present an unusual case of PA in a 50-year-old female patient presenting with swelling on the postero-lateral aspect of the palate for a week. Histopathologically, the tumor exhibited the features of conventional PA with extensive squamous metaplasia and giant keratotic lamellae in cyst-like areas. Such exuberant squamous metaplasia and keratin can be a diagnostic and prognostic pitfall and lead to overtreatment of the patient.

Citations

Citations to this article as recorded by

Effective Management of a Giant Deforming Pleomorphic Adenoma With Airway Displacement in a 93-Year-Old Patient: A Case Report
Julio A Palomino-Payan, Jessica Guillen-Valles, Daniel A Meza-Martinez, Fernanda Urias, Luis D Montes de Oca-Gordoa
Cureus.2024;[Epub] CrossRef
ECTOPIC PLEOMORPHIC ADENOMA OF BUCCAL SPACE: CASE REPORT WITH REVIEW OF LITERATURE
SANCHIT BAJPAI
UP STATE JOURNAL OF OTOLARYNGOLOGY AND HEAD AND NECK SURGERY.2024; VOLUME 12(ISSUE 1): 55. CrossRef
Pleomorphic adenoma with extensive squamous metaplasia and keratinizing cysts: Diagnostic and clinical pitfalls – A report of two cases and review of literature
Mahadevi B. Hosur, Rudrayya S. Puranik, Satyajit G. Dandagi, Vivekanand M. Patil
Journal of Oral and Maxillofacial Pathology.2024; 28(4): 689. CrossRef
Pleomorphic adenoma of the upper lip: A rare site for a common tumor- Case report
Prasath Sathiah, Sujaya Mazumder, Santosh Tummidi, Vijay Kannaujiya
SN Comprehensive Clinical Medicine.2023;[Epub] CrossRef
Variable metaplastic entities in pleomorphic adenoma a review of a rare case report with a note on its significance
N. Mahapatra, L. Bhuyan, Dash Chandra, P. Mishra
Archive of Oncology.2023; 29(2): 18. CrossRef
Pleomorphic adenoma with extensive oncocytic papillary cystic areas and trichilemmal keratinisation – A unique presentation
CV Aiswarya, Raghunath Vandana, Kamal Firoz, Meda Samatha
Journal of Oral and Maxillofacial Pathology.2023; 27(3): 562. CrossRef
Pleomorphic Adenoma with Extensive Squamous and Adipocytic Metaplasia Mimicking as Low Grade Mucoepidermoid Carcinoma on FNAC
Anu Singh, Ravi Hari Phulware, Arvind Ahuja, Ankur Gupta, Manju Kaushal
Indian Journal of Otolaryngology and Head & Neck Surgery.2022; 74(S2): 2132. CrossRef
Aspiration cytology of pleomorphic adenoma with squamous metaplasia: A case series and literature review illustrating diagnostic challenges
Joshua J. X. Li, Joanna K. M. Ng, Eric H. L. Lau, Amy B. W. Chan
Diagnostic Cytopathology.2022; 50(2): 64. CrossRef
Pleomorphic adenoma with extensive squamous metaplasia: The first well-documented case involving the submandibular gland
David A. Gaskin, Alain Reid, Pamela S. Gaskin
Human Pathology Reports.2022; 27: 300600. CrossRef
Salivary Gland Pleomorphic Adenomas Presenting With Extremely Varied Clinical Courses. A Single Institution Case-Control Study†
Krzysztof Piwowarczyk, Ewelina Bartkowiak, Paweł Kosikowski, Jadzia Tin-Tsen Chou, Małgorzata Wierzbicka
Frontiers in Oncology.2021;[Epub] CrossRef
A case report of pleomorphic adenoma squamous metaplasia resembling metastatic oral squamous cell carcinoma
E. Donohoe, R. Courtney, S. Phelan, P.J. McCann
Advances in Oral and Maxillofacial Surgery.2021; 2: 100074. CrossRef
Extensive squamous metaplasia in minor salivary gland neoplasm mimicking squamous cell carcinoma: Diagnostic dilemma in aspiration cytology
Renu Sukumaran, Nileena Nayak, RariP Mony
Clinical Cancer Investigation Journal.2021; 10(5): 257. CrossRef
Navigating small biopsies of salivary gland tumors: a pattern-based approach
J. Stephen Nix, Lisa M. Rooper
Journal of the American Society of Cytopathology.2020; 9(5): 369. CrossRef
Giant Parotid Pleomorphic Adenoma with Atypical Histological Presentation and Long-Term Recurrence-Free Follow-Up after Surgery: A Case Report and Review of the Literature
Mohammed AlKindi, Sundar Ramalingam, Lujain Abdulmajeed Hakeem, Manal A. AlSheddi
Case Reports in Dentistry.2020; 2020: 1. CrossRef
Pleomorphic adenoma of soft palate with extensive squamous metaplasia – A diagnostic enigma
Rashmi Patnayak, Sandip Mohanty, AnjanKumar Sahoo, AdyaKinkara Panda, Amitabh Jena
Journal of Dr. NTR University of Health Sciences.2019; 8(4): 268. CrossRef

Original Article

Pulmonary Nodular Lymphoid Hyperplasia with Mass-Formation: Clinicopathologic Characteristics of Nine Cases and Review of the Literature: Jongmin Sim, Hyun Hee Koh, Sangjoon Choi, Jinah Chu, Tae Sung Kim, Hojoong Kim, Joungho Han; J Pathol Transl Med. 2018;52(4):211-218. Published online June 15, 2018; DOI: https://doi.org/10.4132/jptm.2018.04.27

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331 Download
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Abstract PDF

Background
Pulmonary nodular lymphoid hyperplasia (PNLH) is a non-neoplastic pulmonary lymphoid disorder that can be mistaken for malignancy on radiography. Herein, we present nine cases of PNLH, emphasizing clinicoradiological findings and histological features.
Methods
We analyzed radiological and clinicopathological features from the electronic medical records of nine patients (eight females and one male) diagnosed with PNLH. IgG and IgG4 immunohistochemical staining was performed in three patients.
Results
Two of the nine patients had experienced tuberculosis 40 and 30 years prior, respectively. Interestingly, none were current smokers, although two were ex-smokers. Three patients complaining of persistent cough underwent computed tomography of the chest. PNLH was incidentally discovered in five patients during examination for other reasons. The remaining patient was diagnosed with the disease following treatment for pneumonia. Imaging studies revealed consolidation or a mass-like lesion in eight patients. First impressions included invasive adenocarcinoma and mucosal-associated lymphoid tissue‒type lymphoma. Aspergillosis was suspected in the remaining patient based on radiological images. Resection was performed in all patients. Microscopically, the lesions consisted of nodular proliferation of reactive germinal centers accompanied by infiltration of neutrophils and macrophages in various degrees and surrounding fibrosis. Ultimately, all nine patients were diagnosed with PNLH and showed no evidence of recurrence on follow-up.
Conclusions
PNLH is an uncommon but distinct entity with a benign nature, and understanding the radiological and clinicopathological characteristics of PNLH is important.

Citations

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Clinical and Imaging Features of Pulmonary Nodular Lymphoid Hyperplasia
Dong-Lei Nie, Yan-Hong Shi, Xin-Min Li, Xiao-Jiang Wang, Bao-Li Han, Guo-Fu Zhang
Journal of Thoracic Imaging.2025;[Epub] CrossRef
Utilizing Immunoglobulin G4 Immunohistochemistry for Risk Stratification in Patients with Papillary Thyroid Carcinoma Associated with Hashimoto Thyroiditis
Faridul Haq, Gyeongsin Park, Sora Jeon, Mitsuyoshi Hirokawa, Chan Kwon Jung
Endocrinology and Metabolism.2024; 39(3): 468. CrossRef
Pulmonary Nodular Lymphoid Hyperplasia Evaluated with Bronchoalveolar Lavage Fluid Findings: A Case Report and Review of the Literature on Japanese Patients
Sakiko Moriyama, Takashi Kido, Noriho Sakamoto, Mai Fuchigami, Takatomo Tokito, Daisuke Okuno, Takuto Miyamura, Shota Nakashima, Atsuko Hara, Hiroshi Ishimoto, Yoshitaka Imaizumi, Kazuto Tsuruda, Katsunori Yanagihara, Junya Fukuoka, Hiroshi Mukae
Internal Medicine.2023; 62(1): 95. CrossRef
A Case of Pulmonary Nodular Lymphoid Hyperplasia Responding to Corticosteroid Treatment
Jonathan Teow Koon Goh, Issam Al Jajeh, Jessica Han Ying Tan
Cureus.2023;[Epub] CrossRef
Pulmonary nodular lymphoid hyperplasia presenting as cavitating lung mass
Aqeel Alameer, Chary Duraikannu, Avinash Kumar Kanodia, David Dorward
BMJ Case Reports.2023; 16(8): e254121. CrossRef
Clinicopathological Characteristics and Curative Effect of Lymphoma Based on Sampling Theory
Shuxiang Ding, Leipo Liu
Mathematical Problems in Engineering.2022; 2022: 1. CrossRef
Pulmonary nodular lymphoid hyperplasia presenting as multifocal subsolid nodules: A case report and literature review
Yoon Jin Cha, Duk Hwan Moon, Ji Hyun Park, Sungsoo Lee, Ji Ae Choi, Tae Hoon Kim, Chul Hwan Park
Respiratory Medicine Case Reports.2022; 36: 101581. CrossRef
Pulmonary nodular lymphoid hyperplasia in a 53-year-old man with malignant sign: a case report
Zhen Yang, Lianshuang Wei, Xu Li, Xin Liu
Journal of Cardiothoracic Surgery.2021;[Epub] CrossRef
The diagnostic challenge of adenocarcinoma in pulmonary nodular lymphoid hyperplasia
Anita Savić Vuković, Melita Kukuljan, Morana Dinter, Ksenija Jurinović, Nives Jonjić
SAGE Open Medical Case Reports.2021;[Epub] CrossRef

Case Studies

Hepatocellular Carcinoma Arising in a Huge Hepatocellular Adenoma with Bone Marrow Metaplasia: Hyo Jeong Kang, Hui Jeong Jeong, So-Woon Kim, Eunsil Yu, Young-Joo Lee, So Yeon Kim, Jihun Kim; J Pathol Transl Med. 2018;52(4):226-231. Published online December 27, 2017; DOI: https://doi.org/10.4132/jptm.2017.11.12

6,594 View
149 Download
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Abstract PDF

Hepatocellular adenoma (HCA) is the most common type of benign liver tumor, and its major complication is malignant transformation to hepatocellular carcinoma (HCC). Here, we report a case of HCC arising in HCA with bone marrow metaplasia in a 24-year-old Korean woman who presented with abdominal discomfort. A huge liver mass was found on abdominal ultrasonography. She underwent surgical hepatic resection, and the resected specimen was entirely involved by a 20-cm-sized tumor. Histological review revealed a well differentiated HCC arising from inflammatory HCA with β-catenin nuclear positivity and bone marrow metaplasia that contained hematopoietic cells. This case was unique because malignant transformation, inflammatory type HCA, β-catenin nuclear staining, and bone marrow metaplasia were simultaneously observed. Additionally, it should be noted that a large HCA with β-catenin activation can undergo malignant transformation and should be surgically resected in a timely manner.

Citations

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Adult Hepatocellular Carcinoma Coexisting with Extramedullary Hematopoiesis
Hirotsugu Noguchi, Michiyo Higashi, Ryo Desaki, Takashi Tasaki, Mari Kirishima, Ikumi Kitazono, Kazuhiro Tabata, Akihide Tanimoto
International Journal of Surgical Pathology.2022; 30(3): 339. CrossRef
Spontaneous Occurrence of Various Types of Hepatocellular Adenoma in the Livers of Metabolic Syndrome-Associated Steatohepatitis Model TSOD Mice
Wenhua Shao, Orgil Jargalsaikhan, Mayuko Ichimura-Shimizu, Qinyi Cai, Hirohisa Ogawa, Yuko Miyakami, Kengo Atsumi, Mitsuru Tomita, Mitsuko Sutoh, Shunji Toyohara, Ryoji Hokao, Yasusei Kudo, Takeshi Oya, Koichi Tsuneyama
International Journal of Molecular Sciences.2022; 23(19): 11923. CrossRef
Bilateral Diffuse Nodular Pulmonary Ossification Mimicking Metastatic Disease in a Patient with Fibrolamellar Hepatocellular Carcinoma
Pattamon Sutthatarn, Cara E. Morin, Jessica Gartrell, Wayne L. Furman, Max R. Langham, Teresa Santiago, Andrew J. Murphy
Children.2021; 8(3): 226. CrossRef
Malignant transformation of liver fatty acid binding protein-deficient hepatocellular adenomas: histopathologic spectrum of a rare phenomenon
Juan Putra, Linda D. Ferrell, Annette S.H. Gouw, Valerie Paradis, Arvind Rishi, Christine Sempoux, Charles Balabaud, Swan N. Thung, Paulette Bioulac-Sage
Modern Pathology.2020; 33(4): 665. CrossRef
Hepatocellular carcinoma arising from hepatic adenoma in a young woman
Haythem Yacoub, Hela Kchir, Dhouha Cherif, Hajer Hassine, Slim Haouet, Asma Ayari, Habiba Mizouni, Saber Mannai, Mohamed Tahar Khalfallah, Nadia Maamouri
Clinical Case Reports.2020; 8(9): 1659. CrossRef
Metanephric adenoma with osseous metaplasia and bone marrow elements
Alessandro Pietro Aldera, Jeff John, Dharshnee Chetty, Dhirendra Govender
Human Pathology: Case Reports.2019; 17: 200316. CrossRef

Multiple Neuroendocrine Tumors in Stomach and Duodenum in a Multiple Endocrine Neoplasia Type 1 Patient: Bohyun Kim, Han-Kwang Yang, Woo Ho Kim; J Pathol Transl Med. 2018;52(2):126-129. Published online December 21, 2017; DOI: https://doi.org/10.4132/jptm.2017.09.16

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Abstract PDF

A 67-year-old woman with a history of subtotal parathyroidectomy, distal pancreatectomy, and total splenectomy 23 years prior underwent surgical gastric resection for neuroendocrine tumors of the stomach and duodenum. Meticulous examination of the entire stomach and duodenum revealed multiple scattered, minute neuroendocrine tumors. To the best of our knowledge, this is the first case report of a patient diagnosed with gastroduodenal neuroendocrine tumors associated with multiple endocrine neoplasia type 1 (MEN 1) in whom complete histologic mapping of the whole gastrectomy specimen was performed. The presence of MEN 1–associated neuroendocrine tumors in the stomach is very rare, but should be considered in patients diagnosed with MEN 1 who present with a new tumor in the stomach.

Citations

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A Case of Asymptomatic Multiple Endocrine Neoplasia Type I with Thymic Carcinoid
Suk Ki Park, Moon Won Lee, In Sub Han, Young Joo Park, Sung Yong Han, Joon Woo Park, Bong Eun Lee, Gwang Ha Kim, Sang Soo Kim
The Korean Journal of Helicobacter and Upper Gastrointestinal Research.2019; 19(1): 65. CrossRef

Review

The Use of Fine-Needle Aspiration (FNA) Cytology in Patients with Thyroid Nodules in Asia: A Brief Overview of Studies from the Working Group of Asian Thyroid FNA Cytology: Chan Kwon Jung, SoonWon Hong, Andrey Bychkov, Kennichi Kakudo; J Pathol Transl Med. 2017;51(6):571-578. Published online October 27, 2017; DOI: https://doi.org/10.4132/jptm.2017.10.19

10,627 View
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Abstract PDF

Ultrasound-guided fine-needle aspiration (FNA) cytology is the most widely used screening and diagnostic method for thyroid nodules. Although Western guidelines for managing thyroid nodules and the Bethesda System for Reporting Thyroid Cytopathology are widely available throughout Asia, the clinical practices in Asia vary from those of Western countries. Accordingly, the Working Group of Asian Thyroid FNA Cytology encouraged group members to publish their works jointly with the same topic. The articles in this special issue focused on the history of thyroid FNA, FNA performers and interpreters, training programs of cytopathologists and cytotechnicians, staining methods, the reporting system of thyroid FNA, quality assurance programs, ancillary testing, and literature review of their own country’s products. Herein, we provide a brief overview of thyroid FNA practices in China, India, Japan, Korea, the Philippines, Taiwan, and Thailand.

Citations

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Impact of Thyroid Cancers on Thyroid Hormones among Patients Attended Tripoli University Hospital
Salah Elbaruni, Magdoline Almehdawi, Lubna Badi, Najua Ferrara, Nidal Bilkhier
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Differentiating BRAF V600E- and RAS-like alterations in encapsulated follicular patterned tumors through histologic features: a validation study
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Fine needle aspiration cytology diagnoses of follicular thyroid carcinoma: results from a multicenter study in Asia
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Journal of Pathology and Translational Medicine.2024; 58(6): 331. CrossRef
Cytological evaluation of thyroid nodules in children and young adults: a multi-institutional experience
Chanchal Rana, Neha Nigam, Shipra Agarwal, Prabhakar Mishra, Akanksha Singh, Andrey Bychkov
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The Asian Thyroid Working Group, from 2017 to 2023
Kennichi Kakudo, Chan Kwon Jung, Zhiyan Liu, Mitsuyoshi Hirokawa, Andrey Bychkov, Huy Gia Vuong, Somboon Keelawat, Radhika Srinivasan, Jen-Fan Hang, Chiung-Ru Lai
Journal of Pathology and Translational Medicine.2023; 57(6): 289. CrossRef
Core Needle Biopsy in Suspicious Malignant Thyroid Nodules with Repeated Nondiagnostic Fine Needle Aspiration
Farrokh Heidari, Firouzeh Heidari, Mohammad Sadeq Najafi, Reza Ansari, Kayvan Aghazadeh, Saeed Sohrabpour, Ebrahim Karimi
Indian Journal of Otolaryngology and Head & Neck Surgery.2022; 74(S2): 2071. CrossRef
Molecular Testing for Thyroid Nodules: The Experience at McGill University Teaching Hospitals in Canada
Mohannad Rajab, Richard J. Payne, Véronique-Isabelle Forest, Marc Pusztaszeri
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Cytologic diagnosis of medullary thyroid carcinoma in the Asia‐Pacific region
Chih‐Yi Liu, Andrey Bychkov, Shipra Agarwal, Yun Zhu, Jen‐Fan Hang, Chiung‐Ru Lai, Hee Young Na, Weiwei Li, Zhiyan Liu, Deepali Jain, Ayana Suzuki, Mitsuyoshi Hirokawa, Noel Chia, Min En Nga, Tikamporn Jitpasutham, Somboon Keelawat, So Yeon Park, Shinya S
Diagnostic Cytopathology.2021; 49(1): 60. CrossRef
Constitutive Cytomorphologic Features of Medullary Thyroid Carcinoma Using Different Staining Methods
Chih-Yi Liu, Chien-Chin Chen, Andrey Bychkov, Shipra Agarwal, Yun Zhu, Jen-Fan Hang, Chiung-Ru Lai, Hee Young Na, So Yeon Park, Weiwei Li, Zhiyan Liu, Deepali Jain, Ayana Suzuki, Mitsuyoshi Hirokawa, Noel Chia, Min En Nga, Tikamporn Jitpasutham, Somboon K
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Molecular Correlates and Nuclear Features of Encapsulated Follicular-Patterned Thyroid Neoplasms
Chan Kwon Jung, Andrey Bychkov, Dong Eun Song, Jang-Hee Kim, Yun Zhu, Zhiyan Liu, Somboon Keelawat, Chiung-Ru Lai, Mitsuyoshi Hirokawa, Kaori Kameyama, Kennichi Kakudo
Endocrinology and Metabolism.2021; 36(1): 123. CrossRef
Clinical Outcome of Fine Needle Aspiration Cytology and Washout Thyroglobulin in Suspicious Lymph Nodes in Differentiated Thyroid Carcinoma: Discordant Results in Real-World Practice
Jeongmin Lee, Hye Lim Park, Kwanhoon Jo, Min-Hee Kim, Ja Seong Bae, Sohee Lee, Chan Kwon Jung, So-Lyung Jung, Dong-Jun Lim
International Journal of Thyroidology.2021; 14(1): 18. CrossRef
Fine-needle Aspiration Washout Precipitation Specimens: An Acceptable Supplement to Genetic Mutation Detection of Thyroid Nodules
Yongmei Cui, Xiangqi Huang, Jinrui Guo, Nana Zhang, Jing Liang, Yiwang Zhang, Yueting Liao, Dan He
Technology in Cancer Research & Treatment.2021;[Epub] CrossRef
Emerging Biomarkers in Thyroid Practice and Research
Shipra Agarwal, Andrey Bychkov, Chan-Kwon Jung
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Differences in surgical resection rate and risk of malignancy in thyroid cytopathology practice between Western and Asian countries: A systematic review and meta‐analysis
Huy Gia Vuong, Hanh Thi Tuyet Ngo, Andrey Bychkov, Chan Kwon Jung, Trang Huyen Vu, Kim Bach Lu, Kennichi Kakudo, Tetsuo Kondo
Cancer Cytopathology.2020; 128(4): 238. CrossRef
Thyroid fine-needle aspiration cytology in Taiwan: a nationwide survey and literature update
Chien-Chin Chen, Jen-Fan Hang, Chih-Yi Liu, Yeh-Han Wang, Chiung-Ru Lai
Journal of Pathology and Translational Medicine.2020; 54(5): 361. CrossRef
Pathological diagnosis of thyroid nodules based on core needle biopsies: comparative study between core needle biopsies and resected specimens in 578 cases
Yan Xiong, Limin Yan, Lin Nong, Yalin Zheng, Ting Li
Diagnostic Pathology.2019;[Epub] CrossRef
Noninvasive Follicular Thyroid Neoplasm with Papillary-Like Nuclear Features in Asian Practice: Perspectives for Surgical Pathology and Cytopathology
Andrey Bychkov, Chan Kwon Jung, Zhiyan Liu, Kennichi Kakudo
Endocrine Pathology.2018; 29(3): 276. CrossRef
The History of Korean Thyroid Pathology
Soon Won Hong, Chan Kwon Jung
International Journal of Thyroidology.2018; 11(1): 15. CrossRef
The Usefulness of Immunocytochemistry of CD56 in Determining Malignancy from Indeterminate Thyroid Fine-Needle Aspiration Cytology
Hyunseo Cha, Ju Yeon Pyo, Soon Won Hong
Journal of Pathology and Translational Medicine.2018; 52(6): 404. CrossRef
Recent Advances in Core Needle Biopsy for Thyroid Nodules
Chan Kwon Jung, Jung Hwan Baek
Endocrinology and Metabolism.2017; 32(4): 407. CrossRef

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